bluuebunny/crossref_metadata_2025_split huggingface dataset:
The WRF-Based Incremental Analysis Updates and Its Implementation in an Hourly Cycling Data Assimilation System
Authors: Chen Min , Huang Xiang-Yu , Wang Wei 
Published: April 2023

Abstract
An incremental analysis update (IAU) scheme is successfully implemented into a WRF/WRFDA-based hourly cycling data assimilation system with the goal to reduce the imbalance introduced by the high-frequency intermittent data assimilation, especially when radar data are included. With the application of IAU, the analysis increment is smoothly introduced into the model integration over a time window centered at the analysis time. As in digital filter initialization (DFI), the IAU scheme is able to limit large shocks in the early part of a model forecast. Compared to DFI, IAU does better in hydrometeor spinup and produces more continuous precipitation forecasts from cycle to cycle. The run with IAU is shown to improve the precipitation forecast skills (10+% for CSI scores) compared to the regular cycling forecasts without IAU. The data assimilation system with IAU is also able to accept more observations due to balanced first-guess fields. Comparable results are obtained in IAU tests when the time-varying weights are used versus constant weights. Because of its better property, the IAU with the time-varying weights is implemented in the operational system.
Intraoperative electrical stimulation for persistent, post-traumatic facial paralysis
Authors: North Monique , Weishaar Jeffrey , Leonetti John P. 
Published: April 2023

Approximately 7–10% of temporal bone fractures result in facial nerve paralysis. Treatment is dependent upon the severity of the nerve trauma and can range from conservative medical management to surgical intervention. A study by Hato et al. detailed the relationship between surgical timing and recovery rate for patients with facial nerve palsy secondary to temporal bone trauma. The rates of complete recovery and good recovery decline that the longer surgical intervention is delayed. We present the case of a 14-year-old male with a temporal bone fracture and delayed onset right-sided facial paralysis. This patient was treated with a transmastoid middle cranial fossa (MCF) approach with intraoperative electrical stimulation of the perigeniculate portion of the facial nerve. Despite a 53-day delay between trauma and surgical intervention, the patient’s facial function improved from House Brackmann (HB) grade VI to grade II within 6 months. Intraoperative facial nerve stimulation, which we have previously used for unresolved Bell’s palsy, may be useful for patients with post-traumatic, persistent facial paralysis.
Description of patient reported experience measures (PREMs) for hospitalised patients with palliative care needs and their families, and how these map to noted areas of importance for quality care: A systematic review
Authors: Virdun Claudia , Garcia Maja , Phillips Jane L , Luckett Tim 
Published: April 2023

Background: The global need for focused improvements in palliative care within the acute hospital setting is well noted. A large volume of evidence exists detailing what hospitalised patients with palliative care needs and their families note as important for high quality care. Patient Reported Experience Measures (PREMs) are one mechanism that hospitals could use to inform improvement work. To date there has not been a review of PREMs available for hospitalised patients with palliative care needs and/or their family, nor how they align with noted priorities for high quality care. Aim: To identify and describe PREMs designed for hospitalised patients with palliative care needs and their families; and their alignment with patient and family identified domains for high quality care. Design: A systematic review. Data sources: A systematic search of CINAHL, Medline and PsycInfo was conducted up to September 23, 2022 and supplemented by handsearching article reference lists and internet searches. PREMs written in English and designed for patients with palliative care needs in acute hospitals were eligible for inclusion. Included PREMs were described by: summarising key characteristics; and mapping their items to domains noted to be important to hospitalised patients with palliative care needs and their families informed by outcomes from a published study completed in 2021. Evidence for psychometric properties were reviewed. Results: Forty-four PREMs with 827 items were included. Items per PREM varied from 2 to 85 (median 25, IQR 13–42). Two-thirds ( n = 534, 65%) of the items were designed for families and a third ( n = 283, 34%) for hospitalised patients, and very few ( n = 10, 1%) for both. Sixty-six percent of items measured person-centred care, 30% expert care and 4% environmental aspects of care. Available PREMs address between 1 and 11 of the 14 domains of importance for quality palliative care. PREMs had a median of 38% (IQR 25.4–56.3) of items >Grade 8 measured by the Flesch-Kincaid readability test, with Grade 8 or lower recommended to ensure health information is as accessible as possible across the population. Conclusions: Whilst 44 PREMs are available for hospitalised patients with palliative care needs or their families, a varied number of items are available for some domains of care provision that are important, compared to others. Few are suitable for people with lower levels of literacy or limited cognitive capacity due to illness.
Iatrogenic suffering at the end of life: An ethnographic study
Authors: Green Laura , Capstick Andrea , Oyebode Jan 
Published: April 2023

Background: Across the developed West, a significant proportion of older people die in hospital It has been argued that an acute hospital setting is not well equipped to support dying well. A palliative approach, which involves recognising and alleviating suffering, might lead to improved quality of care. Yet suffering is an intangible and contested phenomenon and little is known about people’s actual experiences of suffering in this clinical setting. Aim: To examine the context of end-of-life care for older people in an acute hospital setting, particularly focusing on the experience of suffering. Design: An observational study, using an ethnographic approach. Data analysis was inductive and iterative. Reflexive analysis included observations and inferences from a participant-observer perspective. Over a period of 3 months in 2016, 186 h of observations of clinical care were carried out. Settings/participants: The study was carried out on a 30-bedded acute older peoples’ hospital ward in the United Kingdom. Participants included 11 patients and 33 members of staff and visitors. Results: Patient suffering was influenced by a range of factors. Delays in recognising and acknowledging dying often led to treatments that were burdensome or futile, exacerbating patient suffering. This was frequently associated with clinical decision-making that did not take into consideration long term concerns such as prognosis or quality of life. Environmental factors in the physical clinical setting such as noise and smell also exacerbated suffering. Finally, aspects of interpersonal interactions, such as paternalistic attitudes or ineffective communication, affected patient experience. Conclusion: Acute care for older people in hospital was shaped by an overarching ideology of rescue which predicted and dictated the process of care. Suffering was not restricted to the direct experiences of life-limiting illness but was also associated with the experience of receiving care in an acute hospital setting. Avoiding or minimising iatrogenic suffering is an essential component of compassionate care.
Normative Values of Tibial Tubercle–Trochlear Groove Distance and Tibial Tubercle–Posterior Cruciate Ligament Distance in Children
Authors: Park Se Jin , Won Seung Hyun , Park Moon Seok , Sung Ki Hyuk 
Published: April 2023

Background: Patellar instability is a common knee pathology in skeletally immature patients. In skeletally mature populations, a tibial tubercle–trochlear groove (TT-TG) distance of ≥20 mm is generally considered a pathological value. However, as pediatric patients grow and as the TT-TG distance varies with age, applying the same cutoff value as adult patients to them is unreasonable. Purpose/Hypothesis: This study aimed to analyze the normative values of the TT-TG and tibial tubercle–posterior cruciate ligament (TT-PCL) distances in children with no patellofemoral instability and to propose the cutoff value of the TT-TG and TT-PCL distances predictive of increased risk of patellofemoral instability in pediatric patients. We hypothesized that the TT-TG and TT-PCL distances increase with age in children and adolescents. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Magnetic resonance imaging scans of the knee were collected from the patellar instability group and the control group. The TT-TG and TT-PCL distances were measured. The normalized values of the TT-TG and TT-PCL distances were calculated by dividing them by the femoral width. Segmented analysis with 1 breakpoint was performed for both the TT-TG and the TT-PCL distances. The optimal cutoff values of the TT-TG and TT-PCL distances were calculated by maximizing the sum of the sensitivity and specificity. Results: A total of 87 patients had patellar instability, and 509 patients did not. The median values of TT-TG and TT-PCL distances in the control group (8.18 mm and 19.48 mm, respectively) were significantly smaller than those in the instability group (16.10 mm and 24.41 mm, respectively). For those aged <15 years, the TT-TG distance significantly increased by 0.39 mm as the age increased by 1 year. The TT-PCL distance increased by 1.14 mm/year until the age of 11 years. In our cohort, the cutoff value of the TT-TG distance of 14.90 mm yielded 66% sensitivity and 81.9% specificity for predicting an increased risk of patellar instability. The cutoff value of the TT-PCL distance of 23.68 mm yielded 63.9% sensitivity and 65.3% specificity for predicting an increased risk of patellar instability. Conclusion: In our cohort of 596 participants, we have documented the normative values of the TT-TG and TT-PCL distances in children aged <20 years. During the surgery for patellar instability in pediatric patients, orthopaedic surgeons should consider the normative values of the TT-TG and TT-PCL distances according to age to determine which patients need distal realignment surgery.
Association Between Anterior Tibial Subluxation of Lateral Compartment and High-Grade Knee Laxity in Patients With Anterior Cruciate Ligament Deficiency
Authors: Ye Zipeng , Wu Xiulin , Chen Jiebo , Cho Eunshinae , Xie Guoming , Dong Shikui , Xu Junjie , Zhao Jinzhong 
Published: April 2023

Background: High-grade knee laxity and excessive anterior tibial subluxation (ATS) are correlated with poor clinical outcomes in patients with anterior cruciate ligament (ACL) deficiency and share similar risk factors; however, the association between excessive ATS and high-grade knee laxity remains unclear. Purpose: To identify the association between excessive ATS and high-grade knee laxity in patients with ACL deficiency and determine the possibility that ATS can predict high-grade knee laxity. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 226 patients who underwent ACL reconstruction between May 2018 and March 2022 were analyzed in the present study; the high-grade group consisted of 113 patients who had a grade 3 result on the preoperative anterior drawer test, Lachman test, or pivot-shift test while under anesthesia, and the low-grade group consisted of 113 matched patients. The ATS values for medial and lateral compartments (ATSMC and ATSLC) were measured on magnetic resonance imaging while patients relaxed the quadriceps in the supine position under no anesthesia. The optimal cutoff values of ATSMC and ATSLC for high-grade knee laxity were determined using receiver operating characteristic curves. Univariate and multivariate logistic regression analyses with stratification were performed to identify the association between excessive ATS and high-grade knee laxity. Results: Compared with the low-grade group, the high-grade group had a longer time from injury to surgery; higher rates of medial meniscus posterior horn tear (MMPHT), lateral meniscus posterior horn tear (LMPHT), and anterolateral ligament (ALL) abnormality; and larger lateral tibial slope, ATSMC, and ATSLC. The optimal cutoff value was 2.6 mm (sensitivity, 52.2%; specificity, 76.1%) for ATSMC and 4.5 mm (sensitivity, 67.3%; specificity, 64.6%) for ATSLC in predicting high-grade knee laxity. After adjustment for covariates, ATSLC ≥4.5 mm (odds ratio [OR], 2.94; 95% CI, 1.56-5.55; P = .001), MMPHT (OR, 2.62; 95% CI, 1.35-5.08; P = .004), LMPHT (OR, 2.39; 95% CI, 1.20-4.78; P = .014), and ALL abnormality (OR, 2.09; 95% CI, 1.13-3.89; P = .019) were associated with high-grade knee laxity. The association between excessive ATSLC and high-grade knee laxity was validated in patients with acute ACL injury as well as those with chronic ACL injury. Conclusion: Excessive ATSLC was associated with high-grade knee laxity in patients who had ACL deficiency, with a predictive cutoff value of 4.5 mm. This study may help surgeons estimate the degree of knee instability more accurately before anesthesia and may facilitate preliminary surgical decision-making, such as appropriate graft choices and consideration of extra-articular augmentation.
Examining the Role of Physical Function on Future Fall Likelihood in Older Adults With a Fear of Falling, With and Without Activity Restriction
Authors: Garbin Alexander J. , Fisher Beth E. 
Published: April 2023

Objectives Assess the influence of physical function on balance and future falls in older adults with fear of falling (FOF) and whether activity restriction modifies the contribution to falls. Methods: Analyses utilized data from Baltimore Longitudinal Study of Aging ( n = 680) and National Health and Aging Trends Study ( n = 4376) community-dwelling older adults. The role of physical function was examined by comparing balance performance and future fall odds before/after controlling for function in older adults with/without FOF. Fall likelihood analyses were repeated with FOF stratified by activity restriction. Results: When controlling for physical function, differences in balance and fall odds secondary to FOF/activity restricting FOF reduced but remained significant. Fall odds secondary to non-activity restricting FOF only slightly decreased. Discussion: Physical function contributes to balance and falls in older adults with FOF, more so in those restricting activity. Reduced balance and increased fall risk persists independent of function suggesting additional contributing factors.
A Newborn with Extremely Rare Cerebro-Costo-Mandibular Syndrome; A Case Report Study
Authors: Mirfazeli Arezou , Shariatalavi Reyhaneh , Lashkarbolouk Narges , Lahoti Dorna , Mazandarani Mahdi 
Published: April 2023

Background Cerebro-costo-mandibular syndrome (CCMS) is a rare congenital syndrome consisting of the main features of micrognathia and posterior rib gaps. Due to multiple abnormalities, patients almost have difficulty breathing with upper airway obstruction, decreased thoracic capacity, spina bifida, and scoliosis. Case presentation We describe a case of a late preterm neonate boy presenting with low Apgar, respiratory distress, and complicated orofacial anomalies that had a poor outcome. His radiographic findings showed mandibular hypoplasia (micrognathia), chest deformity, multiple posterior rib gap defects, and abnormal costotransverse articulation. Based on physical examination and radiologic findings, the diagnosis of CCMS confirmed for the patient. Conclusion Physicians should always consider the diagnosis of CCMS in all infants with micrognathia and rib-gap defects. These infants need careful respiratory function monitoring. Early airway management improves growth and development. In addition, their physical and psychological development should be assessed regularly.
Simultaneous adjunctive treatment of malaria and its coevolved genetic disorder sickle cell anemia
Authors: Safeukui Innocent , Ware Russell E. , Mohandas Narla , Haldar Kasturi 
Published: April 2023

Abstract
Effective treatments for genetic disorders that coevolved with pathogens require simultaneous betterment of both conditions. Hydroxyurea (HU) offers safe and efficacious treatment for sickle cell anemia (SCA) by reducing clinical complications, transfusions, and death rates. Despite concerns that the HU treatment for SCA would increase infection risk by the human malaria Plasmodium falciparum, (the genetic driver of the sickle mutation), HU instead reduced clinical malaria. We used physiologically relevant drug exposures that mimic in vivo pharmacokinetics in humans. Under these conditions, we showed that HU and other ribonucleotide reductase (RNR) inhibitors have significant, intrinsic killing activity in vitro against schizont stages of P falciparum in both normal and sickle red blood cells. Long-term in vitro selection with HU increased the expression of Pfrnr genes but showed a low risk of eliciting stably resistant parasites or compromising the potency of current antimalarial drugs. Additive activity devoid of antagonism by HU was observed with a wide spectrum of commonly used antimalarial treatments. These data endorse broad, safe, and long-term use of HU for SCA in malaria-endemic countries and provide a novel biological model for the treatment of a genetic disorder with simultaneous, adjunct therapy of a life-threatening infection needed in a global health setting.
Machine learning and drug discovery for neglected tropical diseases
Authors: Breslin William , Pham Doan 
Published: April 2023

AbstractNeglected tropical diseases affect millions of individuals and cause loss of productivity worldwide. They are common in developing countries without the financial resources for research and drug development. With increased availability of data from high throughput screening, machine learning has been introduced into the drug discovery process. Models can be trained to predict biological activities of compounds before working in the lab. In this study, we use three publicly available, high-throughput screening datasets to train machine learning models to predict biological activities related to inhibition of species that cause leishmaniasis, American trypanosomiasis (Chagas disease), and African trypanosomiasis (sleeping sickness). We compare machine learning models (tree based models, naive Bayes classifiers, and neural networks), featurizing methods (circular fingerprints, MACCS fingerprints, and RDKit descriptors), and techniques to deal with the imbalanced data (oversampling, undersampling, class weight/sample weight).
Silicon, by promoting a homeostatic balance of C:N:P and nutrient use efficiency, attenuates K deficiency, favoring sustainable bean cultivation
Authors: Costa Milton G. , Prado Renato de M. , Santos Sarah Marcilene M. , Souza Júnior Jonas P. , de Souza Antonia Erica S. 
Published: April 2023

Abstract
Background
In many regions of the world, K is being depleted from soils due to agricultural intensification a lack of accessibility, and the high cost of K. Thus, there is an urgent need for a sustainable strategy for crops in this environment. Si is an option for mitigating stress due to nutritional deficiency. However, the underlying effects of Si in mitigating K deficiency C:N:P homeostasis still remains unknown for bean plants. This is a species of great worldwide importance. Thus, this study aims to evaluate whether i) K deficiency modifies the homeostatic balance of C, N and P, and, if so, ii) Si supply can reduce damage caused to nutritional stoichiometry, nutrient use efficiency, and production of dry mass in bean plants.

Results
K deficiency caused a reduction in the stoichiometric ratios C:N, C:P, and P:Si in shoots and C:N, C:P, C:Si, N:Si, and P:Si in roots, resulting in a decrease in K content and use efficiency and reducing biomass production. The application of Si in K-deficient plants modified the ratios C:N, C:Si, N:P, N:Si, and P:Si in shoots and C:N, C:P, C:Si, N:Si, N:P, and P:Si in roots, increasing the K content and efficiency, reducing the loss of biomass. In bean plants with K sufficiency, Si also changed the stoichiometric ratios C:N, C:P, C:Si, N:P, N:Si, and P:Si in shoots and C:N, C:Si, N:Si, and P:Si in roots, increasing K content only in roots and the use efficiency of C and P in shoots and C, N, and P in roots, increasing the biomass production only in roots.

Conclusion
K deficiency causes damage to the C:N:P homeostatic balance, reducing the efficiency of nutrient use and biomass production. However, Si is a viable alternative to attenuate these nutritional damages, favoring bean growth. The future perspective is that the use of Si in agriculture in underdeveloped economies with restrictions on the use of K will constitute a sustainable strategy to increase food security.
Penehyclidine hydrochloride for treating postoperative nausea and vomiting after laparoscopic bariatric surgery: a double-blinded randomized controlled trial
Authors: Ding Xiahao , Chen Dapeng , Che Jinxing , Xu Siyang , Liang Hui , Gui Bo 
Published: April 2023

Abstract
Background
Postoperative nausea and vomiting (PONV) is a common and distressing complication of laparoscopic bariatric surgery (LBS). Penehyclidine hydrochloride has been reported to be effective in preventing PONV. Considering the potential preventive effects of penehyclidine against PONV, we hypothesized that intravenous infusion of penehyclidine may alleviate PONV within the first 48 h in patients scheduled for LBS.

Methods
Patients who underwent LBS were randomly assigned (1:2) to receive saline (Control group, n = 113) or a single intravenous dose of penehyclidine 0.5 mg (PHC group, n = 221). The primary outcome was incidence of PONV within the first 48 h postoperatively. Secondary endpoints included severity of PONV, need for rescue antiemetic therapy, volume of water intake, and time to first flatus.

Results
PONV occurred in 159 (48%) patients within the first 48 h postoperatively, including 51% in the Control group and 46% in the PHC group. There was no significant difference in the incidence or severity of PONV between the two groups (P > 0.05). Within the first 24 h and 24–48 h, no significant difference was found in incidence or severity of PONV, postoperative nausea, postoperative vomiting, need for rescue antiemetic therapy, or volume of water intake (P > 0.05). Kaplan–Meier curves showed that penehyclidine was significantly associated with a prolonged time to first flatus (median onset time: 22 h vs. 21 h, P = 0.036).

Conclusions
Penehyclidine did not decrease incidence and severity of PONV in patients undergoing LBS. However, a single intravenous dose of penehyclidine (0.5 mg) was associated with a slightly prolonged time to first flatus.

Trial registration
Chinese Clinical Trial Registry (ChiCTR2100052418, http://www.chictr.org.cn/showprojen.aspx?proj=134893, date of registration: 25/10/2021).
Screw fixation without fusion for low lumbar chance fracture accompanied by spinal epidural hematoma in patient with ankylosing spondylitis
Authors: Kim Dae Kyun , Kim Seok Won 
Published: April 2023

AbstractAnkylosing spondylitis (AS) is a chronic inflammatory disease involving the sacroiliac joint and axial spine. AS may render the ankylosed spine prone to trauma and cause an increased frequency of associated epidural hematomas in spine fractures. Herein, we report a rare case of L5 chance fracture and epidural hematoma in a 27-year-old female patient with AS. She was treated surgically but without bone fusion or decompressive laminectomy due to the neurologically intact status despite significant neural compression by the spinal epidural hematoma (SEH). We believe that conservative treatment with close observation of neurological status may be effective in SEH presenting with mild neurological symptoms despite significant neural compression.