bluuebunny/crossref_metadata_2025_split huggingface dataset:
Compositional Zero-Shot Domain Transfer with Text-to-Text Models
Authors: Liu Fangyu , Liu Qianchu , Bannur Shruthi , Pérez-García Fernando , Usuyama Naoto , Zhang Sheng , Naumann Tristan , Nori Aditya , Poon Hoifung , Alvarez-Valle Javier , Oktay Ozan , Hyland Stephanie L. 
Published: September 2023

Abstract
Label scarcity is a bottleneck for improving task performance in specialized domains. We propose a novel compositional transfer learning framework (DoT51) for zero-shot domain transfer. Without access to in-domain labels, DoT5 jointly learns domain knowledge (from masked language modelling of unlabelled in-domain free text) and task knowledge (from task training on more readily available general-domain data) in a multi-task manner. To improve the transferability of task training, we design a strategy named NLGU: We simultaneously train natural language generation (NLG) for in-domain label-to-data generation, which enables data augmentation for self-finetuning and natural language understanding (NLU) for label prediction. We evaluate DoT5 on the biomedical domain and the resource-lean subdomain of radiology, focusing on natural language inference, text summarization, and embedding learning. DoT5 demonstrates the effectiveness of compositional transfer learning through multi-task learning. In particular, DoT5 outperforms the current state-of-the-art in zero-shot transfer by over 7 absolute points in accuracy on RadNLI. We validate DoT5 with ablations and a case study demonstrating its ability to solve challenging NLI examples requiring in-domain expertise.
Identifying Shifts in Modes of Low-Frequency Circulation Variability Using the 20CR Renalysis Ensemble
Authors: Piskala Vladimír , Huth Radan 
Published: September 2023

Abstract
Principal component analysis (PCA) is a widely used technique to identify modes of low-frequency variability of atmospheric circulation and their spatial changes. However, it turns out that PCA is highly sensitive to the period analyzed and the length of the time window used. Its results can vary considerably if the period is shifted by even 1 year. We present temporal variability of modes from the late nineteenth century using moving PCA of winter (DJF) monthly mean 500-hPa height anomalies for 20–50-yr moving periods with 1-yr step. We employ the congruence coefficient to compare spatial patterns of the modes and identify their substantial changes. Shorter moving periods are more susceptible to sudden fluctuations in mode patterns from one period to the next, while longer periods yield more stable results. We strongly recommend applying a moving PCA to detect spatial changes in modes of low-frequency variability, as it unveils any hidden sudden changes in the modes. These changes can be influenced by many aspects, such as data quality, sampling variability, and length of the analyzed period. Spatial patterns of the Atlantic–European modes are more stable across ensemble members than those over the Pacific and North America, especially before the 1920s. During this period, North Atlantic and European modes explain more variance in the ensemble mean than in ensemble members, while the reverse holds for Pacific and North American modes. In data-sparse regions, modes in ensemble members exhibit greater variability. The process of averaging then leads to weaker modes in the ensemble mean, explaining less variance compared to ensemble members.
Exploring the Asymmetries of Pan-Tropical Connections from the Tropical Indian to the Pacific Basin
Authors: Naha Rajashree , McGregor Shayne , Singh Martin 
Published: September 2023

Abstract
Recent analysis of pan-tropical interactions suggests that post-1980 the tropical Indian Ocean’s (TIO) influence on the tropical Pacific Ocean (TPO) appears to have subdued, while the tropical Atlantic Ocean’s (TAO) influence has become more pronounced. The present study explores whether we can identify and dynamically explain any asymmetries in the pan-tropical connection between the TIO and TPO SSTs in an attempt to explain the recently reported weakening of the TIO influence. To this end, we carry out two idealized atmosphere-only experiments using the ACCESS atmospheric general circulation model where the sign of the decadal TIO SST signal is varied—presenting warm and cool TIO scenarios. We find a relatively strong asymmetric response of TPO precipitation to TIO SST anomalies, where average TPO precipitation shows a strong increase in response to TIO cooling, but a weaker decrease in response to TIO warming. The asymmetry is hypothesized to result from differences in the depth of latent heating over the TIO, which ultimately affects the depth of the remote response over the TPO. Asymmetries also occur in the spatial pattern of the changes in precipitation and surface winds. In the fully coupled system, these asymmetries would be expected to also alter the background state on which ENSO develops, providing a further mechanism by which the TIO influence may vary depending on its phase.
User-Responsive Diagnostic Forecast Evaluation Approaches: Application to Tropical Cyclone Predictions
Authors: Brown Barbara G. , Nance Louisa B. , Williams Christopher L. , Newman Kathryn M. , Franklin James L. , Rappaport Edward N. , Kucera Paul A. , Gall Robert L. 
Published: September 2023

Abstract
The Hurricane Forecast Improvement Project (HFIP; renamed the “Hurricane Forecast Improvement Program” in 2017) was established by the U.S. National Oceanic and Atmospheric Administration (NOAA) in 2007 with a goal of improving tropical cyclone (TC) track and intensity predictions. A major focus of HFIP has been to increase the quality of guidance products for these parameters that are available to forecasters at the National Weather Service National Hurricane Center (NWS/NHC). One HFIP effort involved the demonstration of an operational decision process, named Stream 1.5, in which promising experimental versions of numerical weather prediction models were selected for TC forecast guidance. The selection occurred every year from 2010 to 2014 in the period preceding the hurricane season (defined as August–October), and was based on an extensive verification exercise of retrospective TC forecasts from candidate experimental models run over previous hurricane seasons. As part of this process, user-responsive verification questions were identified via discussions between NHC staff and forecast verification experts, with additional questions considered each year. A suite of statistically meaningful verification approaches consisting of traditional and innovative methods was developed to respond to these questions. Two examples of the application of the Stream 1.5 evaluations are presented, and the benefits of this approach are discussed. These benefits include the ability to provide information to forecasters and others that is relevant for their decision-making processes, via the selection of models that meet forecast quality standards and are meaningful for demonstration to forecasters in the subsequent hurricane season; clarification of user-responsive strengths and weaknesses of the selected models; and identification of paths to model improvement.

Significance Statement
The Hurricane Forecast Improvement Project (HFIP) tropical cyclone (TC) forecast evaluation effort led to innovations in TC predictions as well as new capabilities to provide more meaningful and comprehensive information about model performance to forecast users. Such an effort—to clearly specify the needs of forecasters and clarify how forecast improvements should be measured in a “user-oriented” framework—is rare. This project provides a template for one approach to achieving that goal.
Fermented Cordyceps Powder Attenuates Inflammation and Pulmonary Arterioles Remodeling by Inhibiting p38 MAPK/NF-κB Signaling Pathway in Hypoxic Pulmonary Hypertension Rats
Authors: Li Jia , Chen Tingting , Yang Zhanting , Su Shanshan , Wang Yuhua , Li Zhanqiang , Lu Dianxiang 
Published: September 2023

Background Pulmonary hypertension (PH) is a pulmonary vascular disease caused by a variety of causes and has a poor prognosis. Hypoxic pulmonary hypertension (HPH) is one of the types of PH. Cordyceps sinensis could treat a variety of lung diseases; its pharmacological active ingredients mainly include cordycepin, nucleosides, cordyceps polysaccharides, sterols, and amino acids. Fermented cordyceps powder (FCP) is an alternative to C. sinensis. In order to investigate the effect of FCP on HPH in rats, we established the HPH rat model. Materials and Methods Forty-two male Sprague–Dawley (SD) rats were randomly divided into a control group, hypoxia group, hypoxia + FCP (0.1 g.kg−1.d−1), hypoxia + FCP (0.2 g.kg−1.d−1), hypoxia + FCP (0.4 g.kg−1.d−1), and hypoxia + sildenafil (30 mg.kg−1.d−1) group. Except for the control group, the other five groups of rats were fed in the hypobaric chamber. The corresponding dose was given by intragastric administration, once a day, for 28 days. The mean pulmonary arterial pressure (mPAP) and right ventricle hypertrophy index (RVHI) were measured; hematological parameters white blood cells (WBC), neutrophils (Neu), Lymphocytes (Lym), monocytes (Mon), red blood cells (RBC), hemoglobin (HGB), hematocrit (HCT), and platelets (PLT) levels were detected; serum levels of interleukin-1β (IL-1β) and interleukin-6 (IL-6) were determined by enzyme-linked immunosorbent assay (ELISA); the morphological changes of pulmonary arterioles were observed by hematoxylin and eosin (H&E) staining, and the vascular remodeling indexes, vessel wall thickness as a percentage of vascular outer diameter (WT%), vascular wall area as a percentage of total vessel area (WA%), and lumen area as a percentage of the total vascular area (LA%) were calculated; the protein expression levels of IL-1β, IL-6, p-p38, p38, p-IκBα, IκBα, p-p65, and p65 were determined by western blotting. Results FCP could significantly downregulate mPAP, improve pulmonary arteriole remodeling, and reduce the serum levels of IL-1β and IL-6 in HPH rats. In addition, FCP downregulated the protein levels of IL-1β, IL-6, p-p38, p-IκBα, and p-p65. Conclusion FCP could alleviate mPAP and vascular remodeling in HPH rats. Its mechanism could be through inhibiting the p38 mitogen-activated protein kinase (MAPK)/nuclear factor-kappa B (NF-κB) signaling pathway and by downregulating the expression of inflammatory factors. Our study might provide a research basis for the therapeutic potential of FCP in HPH.
Retrospective analysis of the management of pelvic decubitus ulcers and their outcomes
Authors: Damioli Laura , Shepard Zachary , Wilson Melissa P. , Erlandson Kristine M. 
Published: September 2023

Background: Many patients with decubitus-related osteomyelitis are ineligible for myocutaneous flapping, and optimal management in this population is unknown. We describe treatments and outcomes of hospitalized patients with decubitus ulcer-related osteomyelitis who did not undergo surgical reconstruction or coverage. Methods: We systematically identified hospitalized patients with diagnoses of pelvic, sacral, or femoral osteomyelitis due to decubitus ulceration between 1 January 2018 and 31 December 2018. Demographics, comorbidities, laboratory data, and outcomes were collected by manual chart review. T-tests or Chi-square tests were used for descriptive statistical comparisons; logistic regressions were used to explore the odds of readmission, osteomyelitis-related readmission, and death. Results: Of 89 patients meeting inclusion criteria, 34 (38%) received surgical debridement and ⩾6 weeks of antibiotics; 55 (62%) received either antibiotics alone or debridement and <6 weeks of antibiotics. Mean age was 55 (standard deviation 18) years, 55% of patients were male, and 69% had spinal cord injury or other form of paralysis. Within 1 year, 56 (63%) patients were readmitted, 38 (44%) patients were readmitted due to complications from osteomyelitis, and 15 (17%) died. We found no significant differences in readmission (OR = 1.33, 95% CI: 0.54–3.21, p = 0.53), readmission related to osteomyelitis (OR = 1.64, 95% CI: 0.69–4.04, p = 0.27), subsequent sepsis (OR = 2.27, 95% CI: 0.83–6.93, p = 0.13), or death (OR = 2.88, 95% CI: 0.83–13.4, p = 0.12) by treatment group. Conclusions: Among patients with decubitus-related osteomyelitis who did not undergo myocutaneous flapping, outcomes were generally poor regardless of treatment, and not significantly improved with prolonged antibiotics. Prospective studies are needed to assess best practice strategies for this challenging patient population.
Evaluating Dysphagia Duration and Severity After ACDF in Patients With Underlying Dysphagia - A Prospective, Multicenter Study
Authors: Mazmudar Aditya , Paziuk Taylor , Tran Khoa S. , Henry Tyler , Oh Samuel , Purtill Caroline , Habbal Daniel , Yalla Goutham , Harrill Quinlin , Sherrod Brandon , Bisson Erica , Brodke Darrel , Kepler Christopher , Schroeder Gregory , Vaccaro Alexander , Hilibrand Alan , Rihn Jeffrey A. 
Published: September 2023

Study Design Prospective Cohort Study Objectives The purpose of this study was to prospectively evaluate the impact of preoperative dysphagia on the postoperative incidence and severity of dysphagia in patients undergoing ACDF at multiple institutions. Methods After IRB approval, patients over 18 years of age who underwent an elective ACDF for degenerative conditions were prospectively enrolled at two academic centers from 2018 to 2021. Preoperative dysphagia was self-reported by patients through a pre-operative questionnaire on a binary basis. Patients completed dysphagia surveys (Bazaz, Dysphagia Short Questionnaire, 10-item Eating Assessment Tool) to assess dysphagia severity during their preoperative visit, and these dysphagia surveys were repeated immediately postoperatively, at two weeks and again at six, 12, and 24 weeks postoperatively. Patients were stratified into three subgroups based on dysphagia status preoperatively and immediately postoperatively and compared using ANOVA tests or Kruskal–Wallis tests for continuous variables and Pearson chi-square analysis or Fisher’s Exact test for categorical variables. Results A total of 168 patients (23 with preoperative dysphagia, 145 without preoperative dysphagia) met study criteria and were enrolled in the study. Patients with preoperative dysphagia had less frequent alcohol consumption (23.8% vs 53.7%, P = .0210), and higher rates of dysphagia at 2-weeks (77.8% vs 38.7%, P = .004) and 24-weeks (43.8% vs 14.8%, P = .010) postoperatively. These patients also had higher severity scores for dysphagia on the Bazaz ( P = .001), DSQ ( P = .012), EAT10 ( P = .022) questionnaires at the 2-week follow-up period, higher DSQ scores ( P = .036) at the 6-week follow-up period, higher EAT-10 scores ( P = .009) at the 12-week follow-up period, and higher Bazaz ( P = .001), DSQ ( P = .002), and EAT-10 ( P = .005) scores at the 24-week follow-up period. There were no differences in demographic, medical history, surgical variables, rates of ENT consultation, length of stay, or other in-hospital events between groups. Conclusions Patients undergoing ACDF who had preoperative dysphagia have prolonged postoperative dysphagia and greater dysphagia severity. Surgeons should be aware of the risk of prolonged dysphagia severity that may persist past 24 weeks after surgery when discussing clinical decisions with patients.
Comparison of Knee Articular Cartilage Defect Size Between Measurements Obtained on Preoperative MRI Versus During Arthrotomy
Authors: Perry Jade , Kuiper Jan Herman , McCarthy Helen S. , Jermin Paul , Gallacher Peter D. , Tins Bernhard , Roberts Sally 
Published: September 2023

Background: Treatment decisions for cartilage defects are often based on lesion size. Magnetic resonance imaging (MRI) is widely used to diagnose cartilage defects noninvasively; however, their size estimated from MRI may differ from defect sizes measured during arthrotomy, especially after debridement to healthy cartilage if undergoing autologous chondrocyte implantation. Purpose/Hypothesis: The purpose of this study was to evaluate the reliability of 2 methods to assess knee cartilage defect size on preoperative MRI and determine their accuracy in predicting postdebridement defect sizes recorded during arthrotomy. It was hypothesized that defect size would be predicted more accurately by the total area of abnormal articular cartilage rather than the area of full-thickness cartilage loss as identified on MRI. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: This study included 64 patients (mean age, 41.8 ± 9.6 years) who underwent autologous cell therapy. Each patient received a 3-T MRI at 6.1 ± 3.0 weeks before cell implantation. Three raters, a radiologist, a surgeon, and a scientist, measured (1) the full-thickness cartilage defect area and (2) the total predicted abnormal cartilage area, identified by an abnormal signal on MRI. Interrater reliability was assessed using the intraclass correlation coefficient (ICC). Actual pre- and postdebridement defect sizes were obtained from intraoperative surgical notes. Postdebridement surgical measurements were considered the clinical reference standard and were compared with the radiologist’s MRI measurements. Results: Eighty-seven defects were assessed, located on the lateral (n = 8) and medial (n = 26) femoral condyle, trochlea (n = 17), and patella (n = 36). The interrater reliability of the cartilage defect measurements on MRI was good to excellent for the full-thickness cartilage defect area (ICC = 0.74) and the total predicted abnormal cartilage area (ICC = 0.78). The median full-thickness cartilage defect area on MRI underestimated the median postdebridement defect area by 78.3%, whereas the total predicted abnormal cartilage area measurement underestimated the postdebridement defect area by 14.3%. Conclusion: Measuring the full-thickness cartilage defect area on MRI underestimated the area to treat, whereas measuring the total abnormal area provided a better estimate of the actual defect size for treatment.
Are there more acute cardiac hospitalizations in winter in patients with systemic sclerosis? An analysis from the National Inpatient Sample
Authors: Luo Yiming , Ross Laura , Zheng Jiayi , Bernstein Elana J 
Published: September 2023

Objective: Cold-induced transient myocardial ischemia has been described in patients with systemic sclerosis. The clinical impact of cold exposure in systemic sclerosis patients with acute cardiac conditions is unknown. We compared the seasonal variation of acute cardiac hospitalizations in patients with and without systemic sclerosis. Methods: We performed a retrospective cross-sectional study using the National Inpatient Sample from 2016 to 2019. The primary outcome was acute cardiac hospitalization primarily due to heart failure, acute myocardial infarction, or cardiac arrhythmias. We compared the proportion of acute cardiac hospitalizations in each season in patients with and without systemic sclerosis. We also performed a subgroup analysis by US geographic region (Northeast, Midwest, South, West). Results: There were a total of 10,118,002 acute cardiac hospitalizations over the 4-year study period. Compared to those without systemic sclerosis, patients with systemic sclerosis who were hospitalized for acute cardiac care were younger (mean age 67 ± 13 vs 70 ± 14 years, p < 0.01), a greater proportion were female (82% vs 45%, p < 0.01), and a smaller proportion were Caucasian (68% vs 71%, p < 0.01). There was a lesser proportion of traditional cardiovascular risk factors in systemic sclerosis compared to non-systemic sclerosis patients. There was no significant difference in the proportion of winter admissions between systemic sclerosis and non-systemic sclerosis patients for total acute cardiac hospitalizations (26.4% vs 25.9%, p = 0.51), heart failure (27.0% vs 26.5%, p = 0.64), acute myocardial infarction (26.9% vs 25.5%, p = 0.50), or arrhythmias (24.3% vs 25.0%, p = 0.68). The results were consistent across all four US geographic regions. Conclusion: Our study did not support that patients with systemic sclerosis had a disproportionally higher risk of acute cardiac hospitalization in winter compared to the general population. We found that systemic sclerosis patients hospitalized for acute cardiac care had a lower burden of traditional cardiovascular risk factors than their non-systemic sclerosis counterparts.
Using stakeholder intervention refinement teams to develop approaches for real-time integration of patient-reported safety information during older adults’ hospital-to-home-health care transitions
Authors: Arbaje Alicia I , Greyson Sylvan , Keita Fakeye Maningbe , Hohl Dawn , Carl Kimberly , Hsu Yea-Jen , Leff Bruce 
Published: September 2023

Background The hospital-to-home transition remains a high-risk care interval for older adults. Skilled home health (HH) agencies are uniquely positioned to address care-transitions-associated patient safety threats. We previously developed the Hospital-to-Home-Health Transition Quality (H3TQ) Index to identify safety issues after hospital discharge. Our objective is to evaluate a participatory ergonomics process engaging stakeholders to develop strategies to implement the H3TQ into HH agency workflow to improve transition-associated safety issues in real-time. Methods Stakeholders participated in three, two-hour Intervention Refinement Team (IRT) meetings with a focus on: (1) identifying facilitators and barriers to collect H3TQ data in real-time, (2) integration of H3TQ into workflows, and (3) sharing H3TQ safety threat information to improve care transition safety outcomes. We used the human factors engineering-informed Systems Ambiguity Framework to guide the structure of IRT meetings and qualitative data analysis to evaluate the IRT process itself. Results Stakeholders (N = 9) represented patients, family caregivers, and HH staff. Stakeholders identified three key strategies for H3TQ implementation: (1) mechanism and timing of H3TQ data collection using multiple platforms; (2) data sharing conditions for safety reporting across the health system; and (3) identification of targeted care transitions outcomes for improvement. Participants highly rated IRT meetings regarding meeting usefulness, comfort, and degree of input into the discussion. Conclusions The IRT participatory ergonomics process was successful. Stakeholders identified strategies to facilitate implementation of the H3TQ implementation to improve the hospital-to-HH. IRTs have potential application to other health system issues related to the care of people with complex needs.