bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Multiyear Survey Evaluating Clinician Electronic Health Record Satisfaction
Authors: Garabedian Pamela M. , Rui Angela , Volk Lynn A. , Neville Bridget A. , Lipsitz Stuart R. , Healey Michael J. , Bates David W. 
Published: August 2023

Abstract
Objectives We assessed how clinician satisfaction with a vendor electronic health record (EHR) changed over time in the 4 years following the transition from a homegrown EHR system to identify areas for improvement.
Methods We conducted a multiyear survey of clinicians across a large health care system after transitioning to a vendor EHR. Eligible clinicians from the first institution to transition received a survey invitation by email in fall 2016 and then eligible clinicians systemwide received surveys in spring 2018 and spring 2019. The survey included items assessing ease/difficulty of completing tasks and items assessing perceptions of the EHR's value, usability, and impact. One item assessing overall satisfaction and one open-ended question were included. Frequencies and means were calculated, and comparison of means was performed between 2018 and 2019 on all clinicians. A multivariable generalized linear model was performed to predict the outcome of overall satisfaction.
Results Response rates for the surveys ranged from 14 to 19%. The mean response from 3 years of surveys for one institution, Brigham and Women's Hospital, increased for overall satisfaction between 2016 (2.85), 2018 (3.01), and 2019 (3.21, p < 0.001). We found no significant differences in mean response for overall satisfaction between all responders of the 2018 survey (3.14) and those of the 2019 survey (3.19). Systemwide, tasks rated the most difficult included “Monitoring patient medication adherence,” “Identifying when a referral has not been completed,” and “Making a list of patients based on clinical information (e.g., problem, medication).” Clinicians disagreed the most with “The EHR helps me focus on patient care rather than the computer” and “The EHR allows me to complete tasks efficiently.”
Conclusion Survey results indicate room for improvement in clinician satisfaction with the EHR. Usability of EHRs should continue to be an area of focus to ease clinician burden and improve clinician experience.
Safety and Efficacy of Genicular Artery Embolization for the Treatment of Knee Pain Secondary to Osteoarthritis—Initial Indian Experience
Authors: Gorsi Ujjwal , Singh Damandeep , Kang Mandeep , Kumar Vishal , Prakash Mahesh , B.C Sreedhara 
Published: August 2023

Abstract
Background Osteoarthritis (OA) is the commonest form of arthritis with pain and disability as hallmark symptoms. Despite various nonpharmacologic, pharmacologic, and surgical approaches, pain control may be hard to achieve. Over the last few years, few studies have been conducted on managing knee OA using novel endovascular genicular artery embolization (GAE) with varied outcomes. No such study has been reported in India yet to the best of our knowledge.
Purpose The main aim of this article was to evaluate the efficacy and safety of transcatheter GAE in relieving knee pain in patients with mild-to-moderate OA.
Materials and Methods Ten patients with radiographic knee OA and moderate-to-severe pain refractory to conservative therapy were enrolled in a prospective observational study. GAE was performed with 100 to 300-μm spherical particles. Patients were assessed with magnetic resonance imaging at the baseline. Visual analog scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used to assess pain and disability respectively at the baseline, 1 month, and 3 months. Clinical success was asserted by the downstaging of VAS and WOMAC scores. Adverse events were recorded at all-time points. Descriptive and inferential statistics have been performed using SPSS. A p-Value less than 0.05 was considered statistically significant.
Results Embolization of at least 1 genicular artery was achieved in all the patients (100%). Clinical success was demonstrated in 08 (80%) of the patients. Median VAS reduced from 07 at baseline to 3.5 at 3-month follow-up (p < 0.001). Median WOMAC score improved from 53 to 23.50 at 3-month follow-up (p < 0.001). Minor complications were seen in two patients in the form of puncture site hematoma and mild petechial spots over the knee.
Conclusion Our pilot study demonstrates GAE as a safe and efficacious procedure to treat knee pain secondary to OA. Further randomized comparative studies with a larger sample size are needed to determine the true treatment effect versus the placebo effect.
Gastrointestinal Dysfunction in Genetically Defined Neurodevelopmental Disorders
Authors: Davidson Elizabeth A. , Holingue Calliope , Jimenez-Gomez Andres , Dallman Julia E. , Moshiree Baharak 
Published: August 2023

AbstractGastrointestinal symptoms are common in most forms of neurodevelopment disorders (NDDs) such as in autism spectrum disorders (ASD). The current patient-reported outcome measures with validated questionnaires used in the general population of children without NDDS cannot be used in the autistic individuals. We explore here the multifactorial pathophysiology of ASD and the role of genetics and the environment in this disease spectrum and focus instead on possible diagnostics that could provide future objective insight into the connection of the gut-brain-microbiome in this disease entity. We provide our own data from both humans and a zebrafish model of ASD called Phelan-McDermid Syndrome. We hope that this review highlights the gaps in our current knowledge on many of these profound NDDs and that it provides a future framework upon which clinicians and researchers can build and network with other interested multidisciplinary specialties.
Lipofilling—A Regenerative Alternate for Remodeling Burn Scars: A Clinico-Immunohistopathological Study
Authors: Jatin Bhojani , Karki Durga , Ahluwalia Charanjeet , Muthukumar Vamseedharan , Karki Divyanjali 
Published: August 2023

Abstract
Introduction Any injury involving the dermis will lead to scarring. Scar tissue can cause functional limitations, cosmetic impairments, pain, and itch. Adipose-derived stem cells have also been shown to play a role in scar modulation. This study evaluates changes in lipofilled scar over the period of time and compares it with non-lipofilled scar tissue.
Materials and Methods A prospective case–control study with intraindividual follow-up was performed on 30 adult patients with post-burn scars from November 2016 to May 2019. Clinical, histopathological, and immunohistochemical parameters were assessed among the case and control regions of the scar.
Results Mean age of the study population was 30.6 years. The duration of the scar included in this study ranged from 1 to 28 years, with a mean duration of 5.91 years. There was a significant reduction in pain, itch, stiffness, and an increase in the pliability of the scar, and a substantial improvement in the modified Vancouver Scar Score in the lipofilled group. In histopathological analysis, the case group showed organized parallel collagen fibers, a significant reduction in melanocytes, improvement in vascularity, and a significantly increased amount of collagen fibers at the reticular dermis. Immunohistochemical analysis indicated new cell synthesis in the scar tissue and reduced melanocytes.
Conclusion The remodeling effect of adipocyte-derived stem cells is long-lasting, and there is a gradual improvement in most of the parameters. Lipofilling has regenerative capacity, which leads to the improved overall appearance of scar and improvement at the cellular level.
A Prospective Observational Study of Diagnostic Reliability of Semiquantitative and Quantitative High b-Value Diffusion-Weighted MRI in Distinguishing between Benign and Malignant Lung Lesions at 3 Tesla
Authors: Mohakud Sudipta , Das Rasmibala , Bag Nerbadyswari D. , Mohapatra Prasanta R. , Mishra Pritinanda , Naik Suprava 
Published: August 2023

Abstract
Aim The aim of this study was to evaluate the usefulness of high b-value diffusion-weighted imaging (DWI) to differentiate benign and malignant lung lesions in 3 Tesla magnetic resonance imaging (MRI).
Materials and Methods Thirty-one patients with lung lesions underwent a high b-value (b= 1000 s/mm 2) DW MRI in 3 Tesla. Thirty lesions were biopsied, followed by histopathological analysis, and one was serially followed up for 2 years. Statistical analysis was done to calculate the sensitivity, specificity, and accuracy of different DWI parameters in distinguishing benign and malignant lesions. Receiver operating characteristic (ROC) curves were used to determine the cutoff values of different parameters.
Results The qualitative assessment of signal intensity on DWI based on a 5-point rank scale had a mean score of 2.71 ± 0.75 for benign and 3. 75 ± 0.60 for malignant lesions. With a cutoff of 3.5, the sensitivity, specificity, and accuracy were 75, 86, and 77.6%, respectively. The mean ADC min (minimum apparent diffusion coefficient) value of benign and malignant lesions was 1. 49 ± 0.38 × 10-3 mm 2/s and 1.11 ± 0.20 ×10-3 mm 2/s, respectively. ROC curve analysis showed a cutoff value of 1.03 × 10-3 mm 2/s; the sensitivity, specificity, and accuracy were 87.5, 71.4, and 83.3%, respectively. For lesion to spinal cord ratio and lesion to spinal cord ADC ratio with a cutoff value of 1.08 and 1.38, the sensitivity, specificity, and accuracy were 83.3 and 87.5%, 71.4 and 71.4%, and 80.6 and 83.8%, respectively. The exponential ADC showed a low accuracy rate.
Conclusion The semiquantitative and quantitative parameters of high b-value DW 3 Tesla MRI can differentiate benign from malignant lesions with high accuracy and make it a reliable nonionizing modality for characterizing lung lesions.
Early versus Standard Weight Bearing Following Operative Treatment of Tibial Plateau Fractures: Do We Really Have to Wait So Long?
Authors: Heiman Erick , Menken Luke G. , Tang Alex , Vialonga Mason , Jankowski Jaclyn M. , Liporace Frank A. , Yoon Richard S. 
Published: August 2023

AbstractPostoperative management of tibial plateau fractures classically involves a prolonged period between 10 and 12 weeks of nonweight bearing or partial weight bearing. In recent years, there has been some support for earlier weight-bearing protocols although this remains controversial. The goal of this study was to investigate the difference in outcomes between early weight-bearing (EWB) and traditional weight-bearing (TWB) protocols. This investigation is a retrospective review of 92 patients treated with open reduction and internal fixation of tibial plateau fractures at a single institution, from August 2018 to September 2020. Subjects were divided into EWB (< 10 weeks) and traditional nonweight bearing groups (≥ 10 weeks). Key outcome measures collected include injury classification, mechanism of injury, surgical fixation method, bone grafting, time to full weight bearing, radiographic time to union, range-of-motion, all-cause complications, and subsidence at an average follow-up time of 1 year. The EWB group had an earlier average time to weight bearing versus the TWB group (6.5 ± 1.4 vs. 11.8 ± 2.3 weeks, p < 0.0001). There was no difference in the classification of fractures treated between the two groups, with Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association B3 fractures the most common in the EWB group, and C3 fractures the most common in the TWB group. Radiographic time to union was no different between the two groups (93.5 ± 53.7 days for EWB vs. 103.7 ± 77.6 days for TWB, p = 0.49). There was no significant difference in complication rates or subsidence. Following operative treatment of tibial plateau fractures, patients who underwent a weight-bearing protocol earlier than 10 weeks were able to recover faster with similar outcomes and complications compared with patients who started weight bearing after 10 weeks or more.
Level of Evidence III.
Expression of CD44 in Head and Neck Squamous Cell Carcinoma—An In-Silico Study
Authors: Kavitha Loganathan , Vijayashree Priyadharsini Jayaseelan , Kattula Deepthi , Rao Umadevi Krishna Mohan , Balaji Srikanth Rajabather , Kuzhalmozhi Manogaran , Ranganathan Kannan 
Published: August 2023

AbstractIntroduction CD44, a multistructural and multifunctional transmembrane glycoprotein, is a promising cancer stem cell (CSC) marker that regulates the properties of CSCs, including self-renewal, tumor initiation, and metastasis, and confers resistance to chemotherapy and radiotherapy. The aim of the present study was to evaluate the gene and protein expression of CD44 and explore its prognostic value in head and neck squamous cell carcinoma (HNSCC).Methodology The present observational study employs computational tools for analysis. The Cancer Genome Atlas Head-Neck Squamous Cell Carcinoma dataset (520 primary HNSCC and 44 normal tissues) from the University of Alabama at Birmingham Cancer platform was used to study the association of CD44 mRNA transcript levels with various clinicopathological characteristics of HNSCC including age, gender, tumor grade, tumor stage, human papillomavirus (HPV) status, p53 mutation status, and overall survival. The CD44 protein expression in HNSCC and normal tissues was ascertained using the National Cancer Institute's Clinical Proteomic Tumor Analysis Consortium Head-and-Neck cancer dataset (108 primary HNSCC and 71 normal tissues).Results CD44 mRNA transcript and protein expression levels were significantly higher in HNSCC tissues than in normal tissues, and high CD44 expression was correlated with poor survival. CD44 was upregulated in Stage 1 and Grade 2 HNSCC compared with other stages and grades. Overexpression of CD44 was observed in HPV-negative and TP53-positive mutant status in HNSCC.Conclusion The pleiotropic roles of CD44 in tumorigenesis urge the need to explore its differential expression in HNSCC. The study concludes that CD44 can be a potential diagnostic and prognostic biomarker for HNSCC and offer new molecular targets for CD44-targeted therapy for cancer management.
Continuous phase transition of the de Sitter spacetime with charged black holes and cloud of strings and quintessence*
Authors: Zhen 甄 Hai-Long 海龙 , Du 杜 Yun-Zhi 云芝 , Li 李 Huai-Fan 怀繁 , Li 李 Xin-Ping 新平 , Zhang 张 Li-Chun 丽春 
Published: August 2023

Abstract
Recently, some meaningful results have been obtained by studying the phase transition, critical exponents, and other thermodynamical properties of different black holes. Especially for the Anti-de Sitter (AdS) black holes, their thermodynamical properties nearby the critical point have attracted considerable attention. However, there exists little work on the thermodynamic properties of the de Sitter (dS) spacetime with black holes. In this paper, based on the effective thermodynamical quantities and the method of the Maxwell's equal-area law, we explore the phase equilibrium for the de Sitter spacetime with the charged black holes and the cloud of string and quintessence (i.e., C-dSSQ spacetime). The boundaries of the two-phase coexistence region in both

and

diagrams are obtained. The coexistent curve and the latent heat of phase transition for this system are also investigated. Furthermore, we analyze the effect of parameters (the state parameter ω and the ratio of two horizon radii

/

) on the two-phase coexistence region boundary. The results indicate that the phase transition in C-dSSQ spacetime is analogous to that in a van der Waals fluid (vdw) system, which is determined by the electrical potential at the horizon. These results are helpful for understanding the basic properties of black holes and are also of great value for the establishment of quantum gravity.
Fast neutron radiography detector with polyethylene converter and MCP: development and performance evaluation
Authors: Ma Zhan-Wen , Bai Xiao-Hou , Liu Chang-Qi , Hu Zhi-Ming , Huang Chang , Wang Jun-Run , Lu Xiao-Long , Wei Zheng , Zhang Yu , Yao Ze-En 
Published: August 2023

Abstract
We present a new position-sensitive fast neutron detector for 14 MeV fast neutron radiography, comprising a high-density polyethylene converter, a micro-channel plate (MCP), a P43 phosphor screen, a reflection mirror, and a CCD camera. Experimental tests are conducted using a DT neutron generator at CIAE, with different samples and a knife-edge measurement used to determine overall image resolution. Results show that the detector is feasible for fast neutron radiography, producing a fast neutron image with a neutron
flux of ∼ 3.22 × 104 n · s-1 · cm-2
and 120 s exposure time. Our study demonstrates the potential of this detector for use in fast neutron radiography applications.
Tropospheric ozone data assimilation in the NASA GEOS Composition Forecast modeling system (GEOS-CF v2.0) using satellite data for ozone vertical profiles (MLS), total ozone columns (OMI), and thermal infrared radiances (AIRS, IASI)
Authors: Kelp Makoto M , Keller Christoph A , Wargan Krzysztof , Karpowicz Bryan M , Jacob Daniel J 
Published: August 2023

Abstract
The NASA Goddard Earth Observing System Composition Forecast system (GEOS-CF) provides global near-real-time analyses and forecasts of atmospheric composition. The current version of GEOS-CF builds on the GEOS general circulation model with Forward Processing assimilation of meteorological data (GEOS-FP) and includes detailed GEOS-Chem tropospheric and stratospheric chemistry. Here we add 3D variational data assimilation in GEOS-CF to assimilate satellite observations of ozone including MLS vertical profiles, OMI total columns, and AIRS and IASI hyperspectral 9.6 μm radiances. We focus our evaluations on the troposphere. We find that the detailed tropospheric chemistry in GEOS-CF significantly improves the simulated background ozone fields relative to previous versions of the GEOS model, allowing for specification of smaller background errors in assimilation and resulting in smaller assimilation increments to correct the simulated ozone. Assimilation increments are largest in the upper troposphere and are consistent between satellite data sets. The OMI and MLS ozone data generally provide more information than the AIRS and IASI radiances except at high latitudes where the radiances provide more information. Comparisons to independent ozonesonde and aircraft (ATom-4) observations for 2018 show significant GEOS-CF improvement from the assimilation, particularly in the extratropical upper troposphere.
The role of climate change awareness for trust in institutions in sub-Saharan Africa
Authors: Dirksmeier Peter , Nolte Kerstin , Mewes Lars , Tuitjer Leonie 
Published: August 2023

Abstract
Within the context of climate change in sub-Saharan Africa, trust in institutions is an important prerequisite to implement climate change adaptation and mitigation policies. There is a lack of systematic investigation of the relationship between climate change awareness, conflicts, and trust in institutions. We address this pressing research gap based on a regression analysis with trust in institutions as dependent variables, and climate change awareness and violence as independent variables drawing on Afrobarometer individual data and aggregated data on armed conflicts. Our main findings indicate that trust in institutions in sub-Saharan Africa is influenced by both the individual climate change awareness and the violence context. First, we find a negative relationship between those who are aware of climate change and trust in institutions. Second, we observe a socio-economic divide: young, urban and educated parts of the population as well as those who feel their ethnic group is treated unfairly do not trust institutions. Third, we see a regional divide: those far from political centres are not aware of climate change, and those close to the political centres do not trust institutions.
Ultrametric identities in glassy models of natural evolution
Authors: Agliari Elena , Alemanno Francesco , Aquaro Miriam , Barra Adriano 
Published: August 2023

Abstract
Spin-glasses constitute a well-grounded framework for evolutionary models. Of particular interest for (some of) these models is the lack of self-averaging of their order parameters (e.g. the Hamming distance between the genomes of two individuals), even in asymptotic limits, much as like what happens to the overlap between the configurations of two replica in mean-field spin-glasses. In the latter, this lack of self-averaging is related to a peculiar behavior of the overlap fluctuations, as described by the Ghirlanda–Guerra identities and by the Aizenman–Contucci polynomials, that cover a pivotal role in describing the ultrametric structure of the spin-glass landscape. As for evolutionary models, such identities may therefore be related to a taxonomic classification of individuals, yet a full investigation on their validity is missing. In this paper, we study ultrametric identities in simple cases where solely random mutations take place, while selective pressure is absent, namely in flat landscape models. In particular, we study three paradigmatic models in this setting: the one parent model (which, by construction, is ultrametric at the level of single individuals), the homogeneous population model (which is replica symmetric), and the species formation model (where a broken-replica scenario emerges at the level of species). We find analytical and numerical evidence that in the first and in the third model nor the Ghirlanda–Guerra neither the Aizenman–Contucci constraints hold, rather a new class of ultrametric identities is satisfied; in the second model all these constraints hold trivially. Very preliminary results on a real biological human genome derived by The 1000 Genome Project Consortium and on two artificial human genomes (generated by two different types neural networks) seem in better agreement with these new identities rather than the classic ones.
The flow method for the Baker-Campbell-Hausdorff formula: exact results
Authors: Zadra Federico , Bravetti Alessandro , Alejandro García-Chung Angel , Seri Marcello 
Published: August 2023

Abstract
Leveraging techniques from the literature on geometric numerical integration, we propose a new general method to compute exact expressions for the Baker-Campbell-Hausdorff (BCH) formula. In its utmost generality, the method consists in embedding the Lie algebra of interest into a subalgebra of the algebra of vector fields on some manifold by means of an isomorphism, so that the BCH formula for two elements of the original algebra can be recovered from the composition of the flows of the corresponding vector fields. For this reason we call our method the flow method. Clearly, this method has great advantage in cases where the flows can be computed analytically. We illustrate its usefulness on some benchmark examples where it can be applied directly, and discuss some possible extensions for cases where an exact expression cannot be obtained.