bluuebunny/crossref_metadata_2025_split huggingface dataset:
Speech Synthesis in the “Mother Tongue”: Designing, Training, and Evaluating a Text-to-Speech System for Yiddish
Authors: Bleaman Isaac L. , Webber Jacob J. , Lo Samuel K. 
Published: June 2023

Abstract
Although few linguistic corpora are available in Yiddish, there are numerous sources of so-called “found data” that can be adapted for language research, pedagogy, and resource development. We describe the steps taken to create the first speech synthesis (text-to-speech) program in Yiddish. A state-of-the-art TTS model, FastSpeech 2, was trained on a hand-corrected data set consisting of literary texts paired with audio narrations by native speakers of the Polish and Lithuanian dialects. A quantitative evaluation by listeners found that the system produced speech that was both intelligible and natural-sounding. To demonstrate the system’s applications for language pedagogy, we offer a qualitative evaluation of Yiddish phonological features that are present or absent in a sample of synthesized recordings. We hope that the success of speech synthesis in Yiddish will inspire future projects to enable technological support for other minority languages in which transcribed recordings are available.
How Sampling Errors in Covariance Estimates Cause Bias in the Kalman Gain and Impact Ensemble Data Assimilation
Authors: Hodyss Daniel , Morzfeld Matthias 
Published: June 2023

Abstract
Localization is the key component to the successful application of ensemble data assimilation (DA) to high-dimensional problems in the geosciences. We study the impact of sampling error and its amelioration through localization using both analytical development and numerical experiments. Specifically, we show how sampling error in covariance estimates accumulates and spreads throughout the entire domain during the computation of the Kalman gain. This results in a bias, which is the dominant issue in unlocalized ensemble DA, and, surprisingly, we find that it depends directly on the number of independent observations but only indirectly on the state dimension. Our derivations and experiments further make it clear that an important aspect of localization is a significant reduction of bias in the Kalman gain, which in turn leads to an increased accuracy of ensemble DA. We illustrate our findings on a variety of simplified linear and nonlinear test problems, including a cycling ensemble Kalman filter applied to the Lorenz-96 model.

Significance Statement
The dampening of long-range correlations has been the key to the success of ensemble data assimilation in global numerical weather prediction. In this paper, we show how noise in covariance estimates propagates through the state estimation process and corrupts state estimates. We show that this noise results in a bias and that this bias depends on the number of observations and not, as might be expected, on the state dimension. We go on to show how dampening long-range covariances through a process referred to as “localization” helps to mitigate the detrimental effects of this sampling noise.
Evaluation of a Statewide Flavored Tobacco Restriction on Use, Access, and Cessation Among Black and White Tobacco Users in Massachusetts
Authors: McGinnes Hannah , Kingsley Melody , Song Glory , Rosewarne Jana , Gonthier Stephanie , Doane Jacqueline , Henley Patricia 
Published: June 2023

Purpose To evaluate the impact of a statewide flavored tobacco restriction among Massachusetts residents who use menthol or flavored tobacco and to assess differences in impact between Black and White users, as the tobacco industry has targeted menthol to Black users. Design An online survey was distributed through a panel provider and household mailings. Setting Eleven Massachusetts communities with higher-than-state-average Black, Indigenous or People of Color populations Subjects Black (n = 63) and White (n = 231) non-Hispanic residents who used menthol or other flavored tobacco products in the past year. Measures Impact of the law on use, access, and quitting behaviors. Analysis Outcomes were assessed between Blacks and Whites using Pearson chi-square tests. Results Over half (53% of White, 57% of Black) of respondents believed the law made it more difficult to access menthol products; two-thirds (67% of White,64% of Black) accessed menthol products in another state. Black users were significantly more likely to report purchasing menthol products off the street ( P ≤ .05). One-third (28% of White, 32% of Black) believed the law made it easier to quit, and one-third (27% of White, 34% of Black) completely quit in the past year. Conclusions Flavored tobacco restrictions may positively and equitably impact cessation. Cross-border access and off-the-street purchasing suggest the need for greater cessation support and underscore the importance of a national policy.
Inhibitory Potential of Apium graveolens L. Extract on Inflammation in Diethylnitrosamine-induced Hepatocellular Carcinoma in Mice
Authors: Lyngdoh Anisha , Baruah Taranga Jyoti , Sharan Rajeshwar Nath , Kma Lakhon 
Published: June 2023

Background Hepatocellular carcinoma (HCC) is the most common form of liver cancer, with a recurrence rate of 80–90% and a high mortality rate. It is an inflammation-related cancer where cytokines production plays a major role, resulting in a non-resolving inflammation in the tumor microenvironment, which promotes the disease. Therefore, targeting inflammation is a logical way to combat HCC. Natural products can be helpful in the co-treatment and prevention of HCC. Hypothesis This study aimed to evaluate the hepatoprotective properties of a methanolic extract of Apium graveolens L. (MAG) in diethylnitrosamine (DEN)-induced toxicity in BALB/c mice. Materials and Methods We checked the antioxidant, anti-inflammatory, and anti-cancer properties of MAG. DEN is known to induce oxidative stress by increasing reactive oxygen species (ROS) production. This can result in liver damage, increased SGOT, SGPT, and ALP activity in serum, increased expression of HCC biomarkers like AFP and GPC-3, and increased levels of the inflammatory biomarkers NF-κB, IL-6, IL-4, IL-1β, and TNF-α. The above factors can cause the activation of the inflammatory signaling pathways, triggering the development of HCC. Results MAG was able to lower the detrimental effects of DEN by restoring liver function; decrease oxidative stress by increasing superoxide dismutase (SOD), catalase (CAT), glutathione peroxide (GPx), and ϒ-L-glutamyl-L-Cysteinyl-glycine (GSH); decrease the inflammatory factors responsible for HCC; and increase caspase-3 activity. Molecular docking studies showed how phytoconstituents like luteolin, apigenin, and kaempferol present in MAG could potentially be responsible for lowering the effects of DEN in the mice’s liver. Conclusion Altogether, the present study showed that MAG was able to ameliorate inflammation in the DEN-induced liver carcinogenesis in BALB/c mice. To the best of the authors’ knowledge, this is the first report on the use of a whole plant ( Apium graveolens) in an anti-cancer study in a mouse model.
Effectiveness of Probiotics and Phototherapy Compared to Phototherapy Alone in Treating Hyperbilirubinemia in Neonates ≥35 Weeks Gestation: A Comparative Observational Study
Authors: Singh Suraj Kumar , Gupta Girish , Wasim Sanober , Kumar Rakesh , Patra Saikat , Chinmay Chetan 
Published: June 2023

Introduction Neonatal jaundice is a common condition in neonatal practice. Phototherapy is accepted first line of therapy in its treatment. Probiotics can be an addition as it decreases enterohepatic circulation and improves gut function. Materials and Methods The observational study was conducted in 40 neonates. Participants were divided into 2 groups, phototherapy alone (PA) and probiotics plus phototherapy (PP). The mean difference in total serum bilirubin (mg/dL) levels, total duration of phototherapy, incidence of rebound hyperbilirubinemia, frequency of stooling after initiation of therapy, feed intolerance, and occurrence of new onset sepsis was compared. Results The mean difference in serum bilirubin level was not statistically significant after 12 hours ( p = .321), 24 hours ( p = .544) and 48 hours ( p = .863) after initiation of phototherapy. An increase in frequency of stool in the first 24 hours was observed in PP group ( p = .003). The total duration of phototherapy was less in PP group although not statistically significant (25 hours vs 38 hours, p = .054). Rebound hyperbilirubinemia was significantly higher in PA ( p = .023). There were no cases of feed intolerance and sepsis. Conclusion The addition of probiotics did not alter the clinical course of jaundice. However, probiotics can reduce the rebound hyperbilirubinemia and is safe as it did not increase incidence of new onset sepsis or feed intolerance.
Using Various Types of Embedded Participants to Enhance Culturally Congruent, Family-Centered Simulation-Based Education
Authors: Díaz Desiree A. , Todd Andrew D. , Gilbert Gregory E. , López Castillo Humberto , Anderson Mindi , Jackson James P. , Linnell Marlee R. , Ng Kristen Y. , Walker Alison G. , Díaz Rubén Z. 
Published: June 2023

Background Simulation provides a controlled, standardized experience, where learners have increased autonomy to provide culturally congruent care in a healthcare disparity scenario. Importance is noted for scenarios including pediatric populations, to include role players such as the caregiver. The simulation in this study emphasized paternal involvement in the care of a 12-hour-old newborn within a Family-Centered Care Model (FCCM) using embedded participants (EPs). The purpose was to explore the impact and benefit of the EP. The hypotheses included: (1) Learner perception of simulation effectiveness changes when an EP is physically present compared to being virtually present (tele-embedded); (2) Tele-embedded participants (tele-embedded EPs), playing a paternal role, differ between a pop-up parent versus being in-person. Methods A randomized historical control, posttest-only design guided this study once IRB was obtained. A purposive sample of 115 BSN students was used. Instruments included demographics, SET-M, and ACTS Tool. Results Differences were noted between groups; however, SET-M and ACTS scores were constant with little variance noted between the EP and tele-embedded EP. Conclusion Embedded participants, regardless of in-person or via tele-embedded, can add to the scenario. Participants actively engaged in communication with both the in-person and remote EP. All the simulation based education scenarios were effective, encouraging continued use within simulation-based education. Embedded participant involvement has the potential to enhance scenarios by providing opportunities to practice culturally congruent care while cultivating effective communication and education of all family members. Further exploration of the use of EPs is needed to understand the potential added benefit of incorporating them into scenarios.
Azacitidine as a rare cause of reactive arthritis in a patient with acute myeloid leukemia
Authors: Alsaadi Daniah , Low Lyndon , Zubairu Mustafa , Clesham Kevin , Rowan Fiachra 
Published: June 2023

Introduction Azacitidine (AZA), a demethylating agent, is one of the mainstay treatments for patients with myelodysplastic syndromes (MDS) and acute myeloid leukaemia (AML) who are ineligible for curative allogeneic stem-cell transplantation and is recommended as first-line treatment in multiple countries. While arthralgia and myalgia have been commonly reported as side effects, the incidence of drug-induced reactive arthritis has only been reported twice so far. Case report We present a retrospective overview of a clinical case of a 71-year-old patient that developed new cytopenias on a background of Chronic Lymphocytic Leukaemia and was diagnosed with therapy-associated AML. His treatment included an indefinite course of AZA to induce remission and optimise long-term survival which resulted in a satisfactory haematological response. However, after his ninth AZA cycle, he presented to the emergency department with knee swelling and erythema and conjunctivitis. Management and outcomes Arthrocentesis of the knee revealed reactive arthritis with no crystal or organism growth. His symptoms were managed effectively with conservative management including NSAIDs, analgesia and temporary immobilization for joint rest. The adverse drug reaction probability score in our study was calculated as six and adverse drug reaction was thus assigned to the “probable” category. Conclusion We report a case that points to AZA as a probable cause of arthritis flares in MDS patients. The current limitation of this study is the lack of available data, future reviews and research will aid in providing stronger evidence of a correlation between arthritis and AZA treatment.
Assessing Fear, Embarrassment, and Disgust in Colonoscopy: The Development of Measurement Instruments and Psychometric Evidence
Authors: Peng Wei , McKinnon-Crowley Jocelyn , Huang Qian , Mao Bingjing 
Published: June 2023

Background Avoidance of colonoscopy is often associated with fear, embarrassment, and disgust aroused in screening procedures. However, each emotion can be linked to different challenges faced by patients. More research is needed to evaluate and address the causes of these respective emotions. Aim The purpose of this study was to develop and assess the scales of three negative emotions (i.e., fear, embarrassment, and disgust) caused by specific issues in colonoscopy screening. Method The measurement items were developed based on multiple common barriers in colonoscopy screening procedures. An online sample of 232 adults aged 45-75 was recruited from Amazon Mechanical Turk to test the scales. Explorative and confirmatory factor analyses were conducted to validate the measurement models. Results Psychometric evidence demonstrated the factor structures of three negative emotions. Each emotional factor was caused by unique combinations of barriers in the preparation, screening, and recovery stages of colonoscopy. Most of the emotional factors were associated with attitudes and screening intention. Conclusion This study showed different dimensions of negative emotions and their underlying causes in colonoscopy. These findings will help assess specific causes of negative emotions in colonoscopy and develop effective interventions to improve screening uptake.
Value of 1-Hour Plasma Glucose During an Oral Glucose Tolerance Test in a Multiethnic Cohort of Obese Children and Adolescents
Authors: Brar Preneet Cheema , Mehta Shilpa , Brar Ajay , Pierce Kristyn A , Albano Alesandro , Bergman Michael 
Published: June 2023

One hour plasma glucose (1-hr PG) concentration during an oral glucose tolerance test (OGTT) is steadily emerging as an independent predictor of type 2 diabetes (T2D). Methods: We applied the current cut off thresholds reported in the pediatric literature for the 1-hr PG, 132.5 (7.4 mmol/l) and 155 mg/dL (8.6 mmol/l) during an OGTT, to report abnormal glucose tolerance (AGT) using ROC curve analyses. We determined the empirical optimal cut point for 1-hr PG for our multi ethnic cohort using the Youden Index. Results: About 1-hour and 2-hours plasma glucose showed the highest predictive potential based on Areas under the curve (AUC) values of 0.91 [CI: 0.85, 0.97] and 1 [CI: 1, 1], respectively. Further comparison of the ROC curves of the 1-hour and 2-hour PG measurements as predictors of an abnormal OGTT showed that their associated AUCs differed significantly ( X2(1) = 9.25, P < .05). Using 132.5 mg/dL as the cutoff point for plasma glucose at 1-hour yielded a ROC curve with an AUC of 0.796, a sensitivity of 88%, and a specificity of 71.2%. Alternatively, the cutoff point of 155 mg/dL resulted in a ROC AUC of 0.852, a sensitivity of 80%, and a specificity of 90.4%. Conclusion: Our cross-sectional study affirms that the 1-hr PG can identify obese children and adolescents at increased risk for prediabetes and/or T2D with almost the same accuracy as a 2-hr PG. In our multi-ethnic cohort, a 1-hr PG ⩾ 155 mg/dL (8.6 mmol/l) serves as an optimal cut-point, using the estimation of the Youden index with AUC of 0.86 and sensitivity of 80%.We support the petition to consider the 1-hr PG as integral during an OGTT, as this adds value to the interpretation of the OGTT beyond the fasting and 2-hr PG.
Clinical course of multiple sclerosis and patient experiences during breast cancer treatment
Authors: Nylander Alyssa N , Singh Jessica , Poole Shane , Anderson Annika , Marrie Ruth Ann , Rugo Hope , Bove Riley 
Published: June 2023

Background: Over one-third of multiple sclerosis (MS) patients are post-menopausal women, the primary demographic affected by breast cancer. After breast cancer diagnosis, there is little information about patients’ clinical experiences with both diseases. Objective: Utilize a case series of MS patients diagnosed with breast cancer to characterize oncologic and MS trajectories, and generate novel insights about clinical considerations using qualitative analysis. Methods: A single-center retrospective review was performed on medical record data of patients with MS and breast cancer. Thematic analysis was used to characterize experiences with the concurrent diagnoses. Results: For the 43 patients identified, mean age was 56.7 years at cancer diagnosis and MS duration was 16.5 years. Approximately half were treated with MS disease modifying therapy at cancer diagnosis, and half of these subsequently discontinued or changed therapy. Altogether 14% experienced MS relapse(s) during follow-up (with 2 relapses in the first 2 years), with mean annualized relapse rate of 0.03. Cohort Expanded Disability Status Scale (EDSS) scores remained stable during follow-up. Qualitative insights unique to this population were identified regarding immunosuppression use and neurologic symptoms. Conclusions: MS relapses were infrequent, and there was modest progression during breast cancer treatment. Oncologic outcomes were comparable to non-MS patients with similarly staged cancer.
Chronic stroke survivors’ perspective on the use of serious games to motivate upper limb rehabilitation – a qualitative study
Authors: Amorim Paula , Serra Helder , Sousa Beatriz Santos , Dias Paulo , Castelo-Branco Miguel , Martins Henrique 
Published: June 2023

Upper limb paresis occurs quite commonly after stroke and may result in the affected limb’s disuse or learned non-use. As a result, its cortical representation may be suppressed, further inhibiting its spontaneous utilization, resulting in motor function deterioration, increase in spasticity, joint stiffness and pain. The aim of this work was to involve stroke survivors in a qualitative study within a user centred design process to better understand the perspectives of stroke survivors on virtual reality - based serious games (SG) for upper limb rehabilitation during the chronic phase and use those insights to design a VR-based serious games which promotes activation of the affected cortical area. A qualitative research method was performed using a multi professional focus group discussion, including a representative group of stroke survivors. With the insights of this work, the authors initiated the design of a VR-based SG prototype for upper limb rehabilitation with two modes, one version to be played with any arm to pick a virtual hammer and hit targeted objects, and other version, a mirror version based on mirror therapy.
Surgical Versus Non-Surgical Treatment for Thoracolumbar Burst Fractures Without Neurological Deficit: A Systematic Review and Meta-Analysis
Authors: Chou Tzu-Yi , Tsuang Fon-Yih , Hsu Yu-Lun , Chai Chung Liang 
Published: June 2023

Study Design A systematic review and meta-analysis. Objective To update the systematic review comparing the outcomes between surgical and non-surgical treatment for thoracolumbar burst fractures without neurological deficit. Methods We registered a protocol in PROSPERO (ID: CRD42021291769) and searched Medline, Embase, Web of Science, and Google Scholar databases. Surgical and non-surgical treatments were compared in patients with thoracolumbar burst fractures without neurological deficits. Predefined outcomes at ≥6 months included pain (defined as a visual analog scale [VAS] of 0-100), functional outcomes (Oswestry Disability Index [ODI] of 0-50 and Roland-Morris Disability Questionnaire [RMDQ] of 0-24), and kyphotic angulation. Results Nineteen studies involving 1056 patients were included in the analyses. For outcomes at ≥6 months, little to no difference was found in pain VAS score (mean difference, .95 [95% confidence interval {CI}, -6.02 to 7.92]; 827 participants; 15 studies; I2 = 92%), ODI (mean difference, -1.40 [95% CI, -5.11 to 2.31]; 446 participants; 7 studies; I2 = 79%), and RMDQ (mean difference, -.73 [95% CI, -5.13 to 3.66]; 216 participants; 5 studies; I2 = 77%). The kyphotic angulation in the surgery group was 6.35° lower than that in the non-surgery group (mean difference, -6.56° [95% CI, -10.26° to -2.87°]; 527 participants; ten studies; I2 = 86%). The trial sequential analysis indicated all outcomes reached adequate statistical power. The certainty of the evidence for all 4 outcomes was very low. For the analysis of minimally invasive procedures compared to traditional open surgeries, a statistically significant subgroup difference was found for VAS and ODI ( P < .01 and P < .04, respectively). Conclusion Surgical and non-surgical treatments showed little or no difference in outcomes at ≥6 months. This review provides a conclusion with adequate statistical power by including non-randomized studies. However, non-randomized studies also lowered the certainty of the evidence to a very low level.
Status and Educational Effects of Practical Nursing Training for Medical Students as Part of Interprofessional Education
Authors: Igarashi Ryoko 
Published: June 2023

Objectives The WHO has recognized the importance of multidisciplinary education and recommended its promotion worldwide. In our medical school, students experience practical nursing training in their first year to promote multidisciplinary education. Herein, we clarified the learning experiences of medical students during a practical nursing training for enhancing multidisciplinary collaborative education. Methods A questionnaire about nursing practice was conducted after training completion. Regarding attitudes during the training, the nurses in charge of shadowing evaluated the students, and the students also evaluated themselves. The survey results were analyzed qualitatively, and the attitude evaluation results quantitatively. Results There were 76 students who provided informed consent, of whom 55 completed the survey. Three main learning areas were extracted from survey: Nursing treatment, support, and communication activities (7 categories), Nursing care for hospitalized patients (3 categories), Multidisciplinary collaboration through effective communication and coordination (2 categories). On the first training day, the scores of evaluation by others were higher than those of self-evaluation in 6 items. On the second day, the scores of self-evaluation were higher than those of evaluation by others in “Actively learning” and “Communicating appropriately with medical staff and patients.” Conclusion Through the training, students learned about Nursing treatment, support, and communication activities; Nursing care for hospitalized patients; and Multidisciplinary collaboration through effective communication and coordination. The training enabled the students to understand the doctors’ roles in the clinical setting, and to reflect on what doctors should be. Leaning from nursing training is highly beneficial for medical students.