bluuebunny/crossref_metadata_2025_split huggingface dataset:
Musculoskeletal injuries in US Air Force Tactical Air Control Party trainees: an 11-year longitudinal retrospective cohort study and presentation of a musculoskeletal injury classification matrix
Authors: Hando Ben R , Bryant J , Pav V , Haydu L , Hogan K , Mata J , Butler C 
Published: May 2023

IntroductionLittle is known of the epidemiology of musculoskeletal injuries (MSKIs) in US Air Force Special Warfare (AFSPECWAR) Tactical Air Control Party trainees. The purpose of this longitudinal retrospective cohort study was to (1) report the incidence and type of MSKI sustained by AFSPECWAR trainees during and up to 1 year following training, (2) identify factors associated with MSKI, and (3) develop and present the MSKI classification matrix used to identify and categorise injuries in this study.MethodsTrainees in the Tactical Air Control Party Apprentice Course between fiscal years 2010–2020 were included. Diagnosis codes were classified as MSKI or non-MSKI using a classification matrix. Incidence rates and incidence proportion for injury types and regions were calculated. Measures were compared for differences between those who did and did not sustain an MSKI during training. A Cox proportional hazards model was used to identify factors associated with MSKI.ResultsOf the 3242 trainees, 1588 (49%) sustained an MSKI during training and the cohort sustained MSKIs at a rate of 16 MSKI per 100 person-months. Overuse/non-specific lower extremity injuries predominated. Differences were seen in some baseline measures between those who did and did not sustain an MSKI. Factors retained in the final Cox regression model were age, 1.5-mile run times and prior MSKI.ConclusionSlower run times and higher age were associated with an increased likelihood of MSKI. Prior MSKI was the strongest predictor of MSKI during training. Trainees sustained MSKIs at a higher rate than graduates in their first year in the career field. The MSKI matrix was effective in identifying and categorising MSKI over a prolonged (12-year) surveillance period and could be useful for future injury surveillance efforts in the military or civilian settings. Findings from this study could inform future injury mitigation efforts in military training environments.
Tirofiban combined with Aspirin in the Treatment of Acute Penetrating Artery Territory Infarction (STRATEGY): protocol for a multicentre, randomised controlled trial
Authors: Liao Xiaoling , Feng Shuo , Wang Yicong , Pan Yuesong , Chen Weiqi , Qu Hui , Zhao Xingquan , Liu Liping , Wang Yongjun , Wang Yilong 
Published: May 2023

BackgroundPerforating artery territorial infarction (PAI) caused by branch atheromatous disease (BAD) is prone to recurrence and early progression without an effective and well-documented antiplatelet treatment regimen. Tirofiban, an adjunctive antiplatelet agent, has shown great potential to treat acute ischaemic stroke. However, whether the combination of tirofiban and aspirin can improve the prognosis of PAI remains unclear.AimTo explore an effective and safe antiplatelet regimen for reducing the risk of recurrence and early neurological deterioration (END) in PAI caused by BAD by comparing the tirofiban and aspirin combination with placebo and aspirin combination.MethodsTirofiban combined with Aspirin in the Treatment of Acute Penetrating Artery Territory Infarction (STRATEGY) trial is an ongoing multicentre, randomised, placebo-controlled trial in China. Eligible patients shall be randomly assigned to receive standard aspirin with tirofiban or placebo on the first day and standard aspirin from days 2 to 90. The primary endpoint is a new stroke or END within 90 days. The primary safety endpoint is severe or moderate bleeding within 90 days.DiscussionThe STRATEGY trial will assess whether tirofiban combined with aspirin is effective and safe in preventing recurrence and END in patients with PAI.Trial registration numberNCT05310968.
An overlooked market: loose cigarettes, informal vendors and their implications for tobacco taxation
Authors: Gallien Max , Occhiali Giovanni , Ross Hana 
Published: May 2023

Objective
To examine the features of markets for loose cigarettes in several low-income and middle-income countries and their effects on tobacco control policies, particularly taxation.

Design
An analysis of survey data targeting people who smoke in two African, one Southeast Asian and two South Asian countries and retailers across 16 African countries to study loose cigarette markets and examine how prices in these markets move relative to the prices for cigarette packs.

Results
Markets for loose cigarettes are large, and their consumer base tends to differ from the wider population of people who smoke. Loose cigarette prices are on average higher than those of cigarettes bought in packs, and they respond differently to tax increases, at least partially due to a denomination effect.

Conclusions
The features of the loose cigarette markets present a challenge for tobacco control policy, especially tobacco tax policy. One way to overcome this challenge is to aim for large, rather than incremental, tax increases.
Array of cryogenic calorimeters to evaluate the spectral shape of forbidden $$\beta $$-decays: the ACCESS project
Authors: Pagnanini L. , Benato G. , Carniti P. , Celi E. , Chiesa D. , Corbett J. , Dafinei I. , Di Domizio S. , Di Stefano P. , Ghislandi S. , Gotti C. , Helis D. L. , Knobel R. , Kostensalo J. , Kotila J. , Nagorny S. , Pessina G. , Pirro S. , Pozzi S. , Puiu A. , Quitadamo S. , Sisti M. , Suhonen J. , Kuznetsov S. ,   The ACCESS Collaboration
Published: May 2023

AbstractThe ACCESS (Array of Cryogenic Calorimeters to Evaluate Spectral Shapes) project aims to establish a novel technique to perform precision measurements of forbidden $$\beta $$
β
-decays, which can serve as an important benchmark for nuclear physics calculations and represent a significant background in astroparticle physics experiments. ACCESS will operate a pilot array of cryogenic calorimeters based on natural and doped crystals containing $$\beta $$
β
-emitting radionuclides. In this way, natural (e.g. $$^{113}$$

113

Cd and $$^{115}$$

115

In) and synthetic isotopes (e.g. $$^{99}$$

99

Tc) will be simultaneously measured with a common experimental technique. The array will also include further crystals optimised to disentangle the different background sources, thus reducing the systematic uncertainty. In this paper, we give an overview of the ACCESS research program, discussing a detector design study and promising results of $$^{115}$$

115

In.
Intelligent Multimedia Network Security and PBL Teaching Mode in the Basic Course Teaching of College Design Major
Authors: Gao Yuan , Wu Yani , Qian Jun 
Published: May 2023

At this stage, there are problems of disconnection between theoretical knowledge and practice and lack of coherence and progression in the teaching of basic courses for design majors. The teaching of basic courses for design majors is an important part of design disciplines. Improving the teaching effect of basic courses of design majors is conducive to cultivating students' design thinking and improving students' creative ability. Under the traditional teaching mode, the teaching of the basic courses of design majors excessively pursues the cultivation of skills, ignoring the cultivation of students' imagination and creativity. Students are not very motivated to study the basic courses of design majors. Therefore, this article studied the application of intelligent multimedia Project-based Learning (PBL) teaching mode in the teaching of basic courses of design majors and analyzed the intelligent multimedia PBL teaching mode from five aspects: students' interest in learning, teamwork ability, learning efficiency, academic level, and satisfaction. Research showed that under the intelligent multimedia PBL teaching mode, students' interest in learning has increased by 4.37%, teamwork ability has increased by 5.07%, learning efficiency has increased by 4.65%, academic performance has increased by 5.85%, and student satisfaction has also increased.
Safety and Clinical Response to Combined Immunotherapy with Autologous iNKT Cells and PD-1+CD8+ T Cells in Patients Failing First-line Chemotherapy in Stage IV Pancreatic Cancer
Authors: Wang Jing , Cheng Xiaobo , Jin Yanling , Xia Bili , Qin Ran , Zhang Wei , Hu Huiliang , Mao Xiaoting , Zhou Liting , Yan Jia , Zhang Xiaoyan , Xu Jianqing 
Published: May 2023

Purpose:
A phase I clinical trial was conducted to assess the safety and feasibility of invariant natural killer T (iNKT) cells combined with PD-1+CD8+ T cells in patients with advanced pancreatic cancer and failing the first-line chemotherapy.

Patients and Methods:
Fifteen eligible patients were enrolled, of whom 9 received at least three cycles of treatment each. In total, 59 courses were administered.

Results:
Fever was the most common adverse event, peaking at about 2–4 hours after cell infusion and reverting within 24 hours without treatment in all patients. Influenza-like reactions such as headache, myalgia, and arthralgia were also observed in 4, 4, and 3 of the patients, respectively. In addition, vomiting and dizziness were prevalent, while abdominal pain, chest pain, rash, and stuffy nose were rare adverse events, each reported in 1 patient. Side effects above grade 2 were not observed. Two patients achieved partial regression, while 1 patient experienced disease progression assessed 4 weeks after the third course. Three patients are still alive at the time of writing and have progression-free survival longer than 12 months. The overall survival time has been extended to over 12 months in 6 of the 9 patients. No constant changes of CD4+ T, B, and NK cells were recorded except for elevated CD8+ T cells after the first course.

Conclusions:
The combination of autologous iNKT cells and PD-1+CD8+ T cells was a safe therapeutic strategy against advanced pancreatic cancer. The patients exhibited a potentially promising prolonged survival time. Further study appears warranted to evaluate the efficacy of these combined cell infusions in pancreatic cancer.

Trial registration:
This trial was included in the clinical trial which was registered in ClinicalTrials.gov (ID:NCT03093688) on March 15, 2017.

Significance:
There is an unmet need for novel, more effective, and tolerable therapies for pancreatic cancer. Here we present a phase I clinical trial employing iNKT cells combined with PD-1+CD8+ T cells in 9 patients with advanced pancreatic cancer and failing the first-line chemotherapy. The combined immunotherapy was shown to be feasible in the enrolled patients with limited side effects and optimistic clinical responses, which could bring opportunity of therapeutic advancement.
Decreased Muscle Strength in Children With Repaired Tetralogy of Fallot: Relation With Exercise Capacity
Authors: Eshuis Graziëlla , van Duinen Hiske , Lelieveld Otto T. H. M. , Hegeman Anneke K. , Nijenhuis Hessel , Willems Tineke P. , Hepping Ann M. , Maurits Natasha , du Marchie Sarvaas Gideon J. , Berger Rolf M. F. 
Published: May 2023

Background
The aim of this study is to describe muscle strength in pediatric patients with repaired tetralogy of Fallot compared with healthy peers and to analyze the correlation between muscle strength and peak oxygen uptake, exercise capacity (mL/min).

Methods and Results

A prospective, cross‐sectional study was carried out in the University Medical Center Groningen between March 2016 and December 2019, which included 8 ‐to‐19‐year‐old patients with repaired tetralogy of Fallot. Exclusion criteria comprised the following: Down syndrome, unstable pulmonary disease and severe scoliosis affecting pulmonary function, neuromuscular disease, and mental or physical limitations that prohibit the execution of the functional tests. Muscle strength was compared with 2 healthy pediatric cohorts from the Northern Netherlands. Handgrip strength, maximal voluntary isometric contraction, and dynamic muscle strength in correlation with peak oxygen uptake, exercise capacity (mL/min) were the main outcomes of the study. The 67 patients with repaired tetralogy of Fallot (42% female; aged 12.9 [interquartile range, 10.0–16.3] years old) were compared with healthy children. The patients showed reduced grip strength (
z
‐score [mean±SD] −1.5±1.2,
P
<0.001), and total muscle strength (
z
‐score −0.9±1.3,
P
<0.001). Dynamic strength (Bruininks‐Oseretsky test) was significantly reduced (
z
‐score −0.3±0.8,
P
=0.001), but running, speed, and agility were normal (
z
‐score 0.1±0.7,
P
=0.4). Univariate correlation analyses showed strong correlations between absolute peak oxygen uptake, exercise capacity (mL/min), and muscle strength (grip strength
r
=0.83, total muscle strength
r
=0.88;
P
<0.001). In multivariate analyses, including correction for age and sex, total muscle strength (B 0.3;
P
=0.009), and forced vital capacity (B 0.5;
P
=0.02) correlated with peak oxygen uptake, exercise capacity (mL/min), independent of conventional cardiovascular parameters.

Conclusions
Children with repaired tetralogy of Fallot show reduced muscle strength, which strongly correlated with their exercise performance.
Metabolism and Art
Authors: Rogers Hannah Star , Bencard Adam 
Published: May 2023

Abstract
Metabolism holds potential as both a crucial topic and an analytical tool for our current biopolitical moment, for understanding the agency and significance of material forces as they move into and through bodies. From this vantage point, this article suggests practicing a metabolic gaze by reading together metabolism and contemporary art. It discusses ways of defining metabolism that might be productive in helping to produce tools and touchstones for metabolic readings, before presenting examples of artworks that might be interestingly illuminated by light of this sign.
Collaborations in Art and Medicine: Institutional Critique, Patient Participation, and Emerging Entanglements
Authors: Johnstone Fiona 
Published: May 2023

Abstract
In recent decades, collaborations between artists and clinicians or biomedical researchers have become increasingly common and now constitute a distinctive category of art-science collaboration. This article reflects on the intellectual and material conditions of such collaborations, exploring two genealogies for these practices—”sciart” and arts and health—with a focus on two key areas: (1) the need for stakeholders to recognize fine art practice as research and knowledge-production (rather than merely as illustrative, educational, or therapeutic); (2) the challenges and opportunities presented by patient-participant involvement. Finally, it explores critical medical humanities as an emergent framework currently shaping these kinds of collaborations.
Explaining Loss of Standing to Blame
Authors: Snedegar Justin 
Published: May 2023

Abstract
Both in everyday life and in moral philosophy, many think that our own past wrongdoing can undermine our standing to indignantly blame others for similar wrongdoing. In recent literature on the ethics of blame, we find two different kinds of explanation for this. Relative moral status accounts hold that to have standing to blame, you must be better than the person you are blaming, in terms of compliance with the norm. Fault-based accounts hold that those who blame others for things of which they are also guilty exhibit familiar moral faults, such as making an exception of oneself, and that these faults explain why they lack standing. I argue in support of relative moral status accounts, showing that they both better trace our practice of dismissing blame on the basis of lack of standing, and that they have more explanatory resources than have been appreciated.
Taxonomic update of Magnolia subsect. Talauma (Magnoliaceae) from Cuba
Authors: TESTÉ ERNESTO , GARCÍA-BELTRÁN JOSÉ ANGEL , PALMAROLA ALEJANDRO , ROBERT THIERRY , BÉCQUER ELDIS R. 
Published: May 2023

The taxonomy of Magnolia subsect. Talauma in Cuba has long been debated with many changes in the last few years. New evidence based on ecological, morphological and genetic data has indicated the occurrence of three taxa, with changes in the limits from the latest taxonomic treatment. In this sense, the taxonomy and nomenclature of Magnolia subsect. Talauma in Cuba is reviewed. Diagnoses of all taxa are presented with an identification key, nomenclatural information and distribution. Magnolia subsect. Talauma in Cuba comprises three endemic species: Magnolia orbiculata, M. minor and M. oblongifolia. Magnolia orbiculata is the only species that keeps the same limits as in the previous taxonomic treatments of the group, whereas it is not the same for the northeastern Cuban species.
Cessation of Labrador Sea Convection Triggered by Distinct Fresh and Warm (Sub)Mesoscale Flows
Authors: Clément Louis , Frajka-Williams E. , von Oppeln-Bronikowski N. , Goszczko I. , de Young B. 
Published: May 2023

Abstract
By ventilating the deep ocean, deep convection in the Labrador Sea plays a crucial role in the climate system. Unfortunately, the mechanisms leading to the cessation of convection and, hence, the mechanisms by which a changing climate might affect deep convection remain unclear. In winter 2020, three autonomous underwater gliders sampled the convective region and both its spatial and temporal boundaries. Both boundaries are characterized by higher subdaily mixed layer depth variability sampled by the gliders than the convective region. At the convection boundaries, buoyant intrusions—including eddies and filaments—instead of atmospheric warming primarily trigger restratification by bringing buoyancy with a comparable contribution from either fresh or warm intrusions. At the edges of these intrusions, submesoscale instabilities, such as symmetric instabilities and mixed layer baroclinic instabilities, seem to contribute to the decay of the intrusions. In winter, enhanced lateral buoyancy gradients are correlated with strong destabilizing surface heat fluxes and alongfront winds. Consequently, winter atmospheric conditions and buoyant intrusions participate in halting convection by triggering restratification while surface fluxes are still destratifying. This study reveals freshwater anomalies in a narrow area offshore of the Labrador Current and near the convective region; this area has received less attention than the more eddy-rich West Greenland Current, but is a potential source of freshwater in closer proximity to the region of deep convection. Freshwater fluxes from the Arctic and Greenland are expected to increase under a changing climate, and our findings suggest that they may play an active role in the restratification of deep convection.
Influence of Physically Constrained Initial Perturbations on the Predictability of Mei-Yu Heavy Precipitation
Authors: Ke Jiaying , Mu Mu , Fang Xianghui 
Published: May 2023

Abstract
Based on the conditional nonlinear optimal perturbation (CNOP) approach, the predictability of mei-yu heavy precipitation and its underlying physical processes is investigated. As an extension of our previous work, the practical predictability of heavy precipitation events is studied using more realistic initial perturbations than previously considered. The initial perturbation reflects certain physical connections among multiple variables, including zonal and meridional winds, potential temperature (T), and water vapor mixing ratio (Q). Two types of initial perturbations for the CNOP are identified, with similar spatial distributions but opposite signs and resulting effects. The accumulated precipitation is strengthened with mostly positive perturbations in the T and Q components for the CNOP and weakened by negative perturbations. Comparing downscaling (DOWN) perturbations and random perturbations (RPs) with the CNOP, it is found that the CNOP and DOWN perturbations exhibit particularly large- and mesoscale spatial structures, respectively, while the RPs yield a spatial distribution with mostly convective-scale features. Also, the CNOP results in the largest error growth and forecast uncertainty, especially for Q, followed by the DOWN perturbations; those in the RPs are the smallest. These results provide important implications for optimizing the initial perturbations of convection-permitting ensemble prediction systems, especially precipitation forecasts. Moreover, it is suggested that small-scale related variables, that is, those associated with vertical motion and microphysical processes, are much less predictable than thermodynamic variables, and the errors grow through distinct physical processes for the three types of initial perturbations, that is, those with flow-dependent features.
M-PERC: A New Satellite Microwave-Based Model to Diagnose the Onset of Tropical Cyclone Eyewall Replacement Cycles
Authors: Kossin James P. , Herndon Derrick C. , Wimmers Anthony J. , Guo Xi , Blake Eric S. 
Published: May 2023

Abstract
Eyewall replacement cycles (ERCs) in tropical cyclones (TCs) are generally associated with rapid changes in TC wind intensity and broadening of the TC wind field, both of which can create unique forecasting challenges. As part of the NOAA Joint Hurricane Testbed Project, a new model was developed to provide operational probabilistic guidance on ERC onset. The model is based on the time evolution of TC wind intensity and passive satellite microwave imagery and is named “M-PERC” for Microwave-Based Probability of Eyewall Replacement Cycle. The model was initially developed in the Atlantic basin but is found to be globally applicable and skillful. The development of M-PERC and its performance characteristics are described here, as well as a new intensity prediction model that extends previous work. Application of these models is expected to contribute to a reduction of TC intensity forecast error.
Injury Patterns, Imaging Usage, and Disparities Associated With Car Restraint Use in Children
Authors: McCauley Christopher J. , Purcell Laura N. , Schiro Sharon E. , Nakayama Don K. , McLean Sean E. 
Published: May 2023

Background Motor vehicle collision (MVC) is a leading cause of accidental death in children. Despite effective forms of child safety restraint (eg, car seat and booster seat), studies demonstrate poor compliance with guidelines. The goal of this study was to delineate injury patterns, imaging usage, and potential demographic disparities associated with child restraint use following MVC. Methods A retrospective review of the North Carolina Trauma Registry was performed to determine demographic factors and outcomes associated with improper restraint of children (0-8 years) involved in MVC from 2013 to 2018. Bivariate analysis was performed by the appropriateness of restraint. Multivariable Poisson regression identified demographic factors for the relative risk of inappropriate restraint. Results Inappropriately restrained patients were older (5.1 years v. 3.6 yrs, P < .001) and weighed more (44.1 lbs v. 35.3 lbs, P < .001). A higher proportion of African American (56.9% v. 39.3%, P < .001) and Medicaid (52.2% v. 39.0%, P < .001) patients were inappropriately restrained. Multivariable Poisson regression showed that African American patients (RR 1.43), Asian patients (RR 1.51), and Medicaid payor status (RR 1.25) were associated with a higher risk of inappropriate restraint. Inappropriately restrained patients had a longer length of stay, but injury severity score and mortality were no different. Discussion African American children, Asian children, and Medicaid insurance payor status patients had an increased risk of inappropriate restraint use in MVC. This study describes unequal restraint patterns in children, which suggests opportunity for targeted patient education and necessitates research to further delineate the underlying etiology of these differences.