bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ride-hailing origin-destination demand prediction with spatiotemporal information fusion
Authors: Wang Ning , Zheng Liang , Shen Huitao , Li Shukai 
Published: May 2023

Abstract
Accurate demand forecasting for online ride-hailing contributes to balancing traffic supply and demand, and improving the service level of ride-hailing platforms. In contrast to previous studies, which have primarily focused on the inflow or outflow demands of each zone, this study proposes a conditional generative adversarial network with a Wasserstein divergence objective (CWGAN-div) to predict ride-hailing origin-destination (OD) demand matrices. Residual blocks and refined loss functions help to enhance the stability of model training. Interpretable conditional information is employed to capture external spatiotemporal dependencies and guide the model towards generating more precise results. Empirical analysis using ride-hailing data from Manhattan, New York City, demonstrates that our proposed CWGAN-div model can effectively predict the network-wide OD matrix and exhibits strong convergence performance. Comparative experiments also show that the CWGAN-div outperforms other benchmarking methods. Consequently, the proposed model displays potential for network-wide ride-hailing OD demand prediction.
Dead-Space Ventilation Indices and Mortality in Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis*
Authors: Jayasimhan Dilip , Chieng Jennifer , Kolbe John , Sidebotham David A. 
Published: May 2023

OBJECTIVES:
Acute respiratory distress syndrome (ARDS) is associated with high ventilation-perfusion heterogeneity and dead-space ventilation. However, whether the degree of dead-space ventilation is associated with outcomes is uncertain. In this systematic review and meta-analysis, we evaluated the ability of dead-space ventilation measures to predict mortality in patients with ARDS.

DATA SOURCES:
MEDLINE, CENTRAL, and Google Scholar from inception to November 2022.

STUDY SELECTION:
Studies including adults with ARDS reporting a dead-space ventilation index and mortality.

DATA EXTRACTION:
Two reviewers independently identified eligible studies and extracted data. We calculated pooled effect estimates using a random effects model for both adjusted and unadjusted results. The quality and strength of evidence were assessed using the Quality in Prognostic Studies and Grading of Recommendations, Assessment, Development, and Evaluation, respectively.

DATA SYNTHESIS:
We included 28 studies in our review, 21 of which were included in our meta-analysis. All studies had a low risk of bias. A high pulmonary dead-space fraction was associated with increased mortality (odds ratio [OR], 3.52; 95% CI, 2.22–5.58; p < 0.001; I
2 = 84%). After adjusting for other confounding variables, every 0.05 increase in pulmonary-dead space fraction was associated with an increased odds of death (OR, 1.23; 95% CI, 1.13–1.34; p < 0.001; I
2 = 57%). A high ventilatory ratio was also associated with increased mortality (OR, 1.55; 95% CI, 1.33–1.80; p < 0.001; I
2 = 48%). This association was independent of common confounding variables (OR, 1.33; 95% CI, 1.12–1.58; p = 0.001; I
2 = 66%).

CONCLUSIONS:
Dead-space ventilation indices were independently associated with mortality in adults with ARDS. These indices could be incorporated into clinical trials and used to identify patients who could benefit from early institution of adjunctive therapies. The cut-offs identified in this study should be prospectively validated.
A Mixed-Methods Study of Social Determinants and Self-care in Adults With Heart Failure
Authors: Osei Baah Foster , Brawner Bridgette M. , Teitelman Anne M. , Ruger Jennifer Prah , Riegel Barbara 
Published: May 2023

Background
The burden of heart failure (HF) is unequally distributed among population groups. Few study authors have described social determinants of health (SDoH) enabling/impeding self-care.

Aim
The aim of this study was to explore the relationship between SDoH and self-care in patients with HF.

Methods
Using a convergent mixed-methods design, we assessed SDoH and self-care in 104 patients with HF using the Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences (PRAPARE) and the Self-Care of HF Index v7.2 with self-care maintenance, symptom perception, and self-care management scales. Multiple regression was used to assess the relationship between SDoH and self-care. One-on-one in-depth interviews were conducted in patients with poor (standardized score ≤ 60, n = 17) or excellent (standardized score ≥ 80, n = 20) self-care maintenance. Quantitative and qualitative results were integrated.

Results
Participants were predominantly male (57.7%), with a mean age of 62.4 ± 11.6 years, with health insurance (91.4%) and some college education (62%). Half were White (50%), many were married (43%), and most reported adequate income (53%). The money and resources core domain of PRAPARE significantly predicted self-care maintenance (P = .019), and symptom perception (P = .049) trended significantly after adjusting for other PRAPARE core domains (personal characteristics, family and home, and social and emotional health) and comorbidity. Participants discussed social connectedness, health insurance coverage, individual upbringing, and personal experiences as facilitators of self-care behavior.

Conclusion
Several SDoH influence HF self-care. Patient-specific interventions that address the broader effects of these factors may promote self-care in patients with HF.
Automated diagnosis and management of follicular thyroid nodules based on the devised small-datasets interpretable foreground optimization network deep learning: A multicenter diagnostic study
Authors: Yang Zheyu , Yao Siqiong , Heng Yu , Shen Pengcheng , Lv Tian , Feng Siqi , Tao Lei , Zhang Weituo , Qiu Weihua , Lu Hui , Cai Wei 
Published: May 2023

Background:
Currently, follicular thyroid carcinoma (FTC) has relatively low incidence with a lack of effective preoperative diagnostic means. To reduce the need for diagnostic invasive procedures and to address information deficiencies inherent in a small-dataset, we utilized interpretable foreground optimization network deep learning to develop a reliable preoperative FTC detection system.

Methods:
In this study, a deep learning model (FThyNet) was established using preoperative ultrasound images. Data on patients in training and internal validation cohort (n=432) were obtained from XXX Hospital, China. Data on patients in external validation cohort (n=71) were obtained from four other clinical centers. We evaluated the predictive performance of FThyNet and its ability to generalize across multiple external centers and compared the results yielded with assessments from physicians directly predicting FTC outcomes. In addition, the influence of texture information around the nodule edge on the prediction results was evaluated.

Results:
FThyNet had a consistently high accuracy in predicting FTC with area under the receiver operating characteristic curve (AUC) of (89.0% [95% CI 87.0-90.9]). Particularly, the AUC for grossly invasive-FTC reached 90.3%, which was significantly higher than that of the radiologists (56.1% [95% CI 51.8-60.3]). The parametric visualization study found that those nodules with blurred edges and relatively distorted surrounding textures were more likely to have FTC. Furthermore, edge texture information played an important role in FTC prediction with an AUC of (68.3% [95% CI 61.5–75.5]), and highly invasive malignancies had the highest texture complexity.

Conclusion:
FThyNet could effectively predict FTC, provide explanations consistent with pathological knowledge, and improve clinical understanding of the disease.
Impact of Anticholinergic Medications on Speech Perception Performance after Cochlear Implantation
Authors: Layfield Eleanor , Hwa Tiffany Peng , Quimby Alexandra E. , Brant Jason A. , Bigelow Douglas , Ruckenstein Michael J. , Eliades Steven J. 
Published: May 2023

Objective
To identify and characterize the impact of anticholinergic medications, which have known adverse effects on cognition in older adults, on speech perception after cochlear implantation.

Study Design
Retrospective cohort.

Setting
Tertiary referral center.

Subject Population
Adult patients who underwent cochlear implantation between January 2010 and September 2020 with speech perception scores at 3, 6, and 12 months.

Interventions
Anticholinergic burden of patients' prescribed medications.

Main Outcome Measures
AzBio speech perception scores after implantation.

Results
One hundred twenty-six patients had documented AzBio in quiet speech perception score at all three postactivation time points. Patients were divided into three groups by anticholinergic burden (ACB) score, including ACB = 0 (90 patients), 1 (23 patients), and ≥2 (13 patients). There was no statistically significant difference between ACB groups in audiologic performance at candidacy testing (p = 0.77) or at 3 months after implantation (p = 0.13). Beginning at 6 months, a lower mean AzBio was seen in patients with higher ACB scores (68% ACB = 0; 62% ACB = 1; 48.1% ACB ≥ 2; p = 0.03). At 12 months, there were further differences between the groups (71.0% ACB = 0, 69.5% ACB = 1, 48.0% ACB ≥2, p < 0.01). Controlling for the effects of age using multivariate linear regression showed persistent effects of ACB score on learning-related AzBio improvements. Comparatively, the negative impact of a single ACB score point was equivalent to nearly 10 years of aging (p = 0.03).

Conclusions
Increased ACB is associated with worse speech perception scores after cochlear implantation, an effect that persists even when accounting for patient age, suggesting that these medications may have cognitive and learning effects that reduce cochlear implant performance.
Gluten Immunogenic Peptides Are Not Correlated With Reported Adherence to Gluten-Free Diet in Children With Celiac Disease
Authors: Guz-Mark Anat , Perets Tsachi Tsadok , Biran Neta , Jack Yifat , Zevit Noam , Silbermintz Ari , Matar Manar , Nachmias-Friedler Vered , Waisbourd-Zinman Orith , Bar-Lev Michal Rozenfeld , Huta Yair , Ashorov Olga , Gingold-Belfer Rachel , Shamir Raanan 
Published: May 2023

Objective:
There is no gold standard to assess adherence to gluten-free diet (GFD) among patients with celiac disease (CeD). Gluten immunogenic peptides (GIPs) in urine and stool were suggested as novel markers for evaluating adherence to GFD. Our aim was to assess the presence of GIP in pediatric patients with CeD, and to compare the results with alternative methods for evaluating GFD adherence.

Methods:
Pediatric patients diagnosed with CeD, who were on GFD for at least 1 year, were enrolled and followed prospectively between November 2018 and January 2021. Study visits included clinical assessment, a dietitian interview, Biagi score, food questionnaires, anthropometric and laboratory measurements, and urine and stool samples obtained for laboratory GIP analysis.

Results:
The study included 74 patients (63.5% females), with median (interquartile range, IQR) age of 9.9 (7.8–11.7) years, and median (IQR) duration on GFD of 2.5 (2–5.5) years. Good GFD adherence, assessed by Biagi score, was reported in 93.1% of cases. GIP was evaluated during 134 visits, with GIP detected in 27 of 134 (20.1%) of the visits (16.3% of stool samples and 5.3% of urine samples). Positive GIP results were significantly more common in males compared to females (30.6% vs 14.1%, respectively, P < 0.05). Detection of positive GIP was not associated with dietary assessment of GFD adherence, celiac serology results, or reported symptoms.

Conclusions:
Stool and urine GIP can be detected in children with CeD, even when dietary assessment indicate good adherence to GFD. The role of GIP testing in clinical practice should be further explored.
Social Determinants of Health Are Associated With Visits for Ambulatory Care Sensitive Conditions
Authors: Das Kristol , Onwuka Amanda J. , Chisolm Deena J. 
Published: May 2023

Objectives
Population health experts have described the link between social factors and health, but few studies link specific social needs to disease processes. Nationwide Children's Hospital implemented a universal, annual screener for social determinants of health (SDH) in 2018. Early analyses have shown that patients identifying an SDH need were more likely to have an emergency department (ED) or inpatient stay. The objective of this study is to identify links between SDH and ED presentation for ambulatory care sensitive conditions (ACSCs).

Methods
This was a retrospective observational study of children aged 0–21 years receiving care at Nationwide Children's Hospital from 2018 to 2021 that were screened for SDH. Acute care utilization within 6 months of screener completion, sociodemographic, and clinical data were collected via EPIC data extraction. Patients that completed screening tool for the first time in the ED were excluded to minimize selection bias. Logistic regression was used to analyze the association between ED presentation for ACSCs and SDH needs.

Results
A total of 108,346 social determinants screeners were included with 9% of screeners identifying a need. Five percent of the population expressed food needs, 4% transportation needs, 3% utility needs, and 1% housing needs. Eighteen percent of patients had an ED visit for ACSC, with the most common complaints being upper respiratory infections and asthma. Having any SDH need was associated with ED visits for ACSCs (odds ratio, 1.12; 95% confidence interval, 1.06–1.18). Needs in all domains were significantly associated with increased visits for ACSCs; however, patients with housing needs had the highest odds of utilization (odds ratio, 1.25; confidence interval, 1.11–1.41).

Conclusions
The odds of ED presentation for ACSCs are higher in patients with expressed social needs. Further delineating the connections between specific SDH and health outcomes can inform timely and appropriate interventions.
Closing the Loop
Authors: McGahern Candice , Cantor Zachary , De Mendonca Benjamin , Dawson Jennifer , Boisvert Liane , Dalgleish Dale , Newhook Dennis , Reddy Deepti , Bresee Natalie , Alnaji Fuad 
Published: May 2023

Objectives
Providing emergency care to acutely ill or injured children is stressful and requires a high level of training. Paramedics who provide prehospital care are typically not involved in the circle of care and do not receive patient outcome information. The aim of this quality improvement project was to assess paramedics' perceptions of standardized outcome letters pertaining to acute pediatric patients that they had treated and transported to an emergency department.

Methods
Between December 2019 and December 2020, 888 outcome letters were distributed to paramedics who provided care for 370 acute pediatric patients transported to the Children's Hospital of Eastern Ontario in Ottawa, Canada. All paramedics who received a letter (n = 470) were invited to participate in a survey that collected their perceptions and feedback about the letters, as well as their demographic information.

Results
The response rate was 37% (172/470). Approximately half of the respondents were Primary Care Paramedics and half Advanced Care Paramedics. The respondents' median age was 36 years, median years of service was 12 years, and 64% identified as male. Most agreed that the outcome letters contained information pertinent to their practice (91%), allowed them to reflect on care they had provided (87%), and confirmed clinical suspicions (93%). Respondents indicated that they found the letters useful for 3 reasons: 1) increases capacity to link differential diagnoses, prehospital care, or patient outcomes; 2) contributes to a culture of continuous learning and improvement; and 3) gives closure, reduces stress, or provides answers for difficult cases. Suggestions for improvement included providing more information, provision of letters on all patients transported, faster turnaround time between call and receipt of letter and inclusion of recommendations or interventions/assessments.

Conclusions
Paramedics appreciated receiving hospital-based patient outcome information after their provision of care and reported that the letters offered opportunities for closure, reflection, and learning.
Clinical Efficiency of High-Intensity Laser Therapy in Patients With Cervical Radiculopathy
Authors: İnce Songül , Eyvaz Nuran , Dündar Ümit , Toktaş Hasan , Yeşil Hilal , Eroğlu Selma , Adar Sevda 
Published: May 2023

ObjectiveThe purpose of this study was to research the clinical effectiveness of high-intensity laser therapy combined with exercise on pain, quality of life, and disability in patients with cervical radiculopathy and compared it with that of placebo and exercise alone.DesignNinety participants with cervical radiculopathy were randomized into the following three groups: high-intensity laser therapy + exercise (n= 30), placebo + exercise (n= 30), and exercise only (n= 30). Pain, cervical range of motion, disability, and quality of life (36-item Short Form Health Survey) were assessed at baseline and weeks 4 and 12.ResultsThe mean age of the patients (66.7% female) was 48.9 ± 9.3 yrs. Pain intensity in the arm and neck, neuropathic and radicular pain levels, disability, and several parameters of the 36-item Short Form Health Survey showed an improvement in the short and medium term in all three groups. These improvements were greater in the high-intensity laser therapy + exercise group than in the other two groups.ConclusionsHigh-intensity laser therapy + exercise was much more effective in improving medium-term radicular pain, quality of life, and functionality in patients with cervical radiculopathy. Thus, high-intensity laser therapy should be considered for the management of cervical radiculopathy.To Claim CME CreditsComplete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCMECME ObjectivesAt the conclusion of this article, readers will be able to: (1) Define cervical radicular pain and its clinical presentation, and explain the main pathomechanism in cervical radiculopathy (CR); (2) Describe the effects of laser administration on neuropathic pain; and (3) Discuss the clinical significance of coadministration of high-intensity laser therapy (HILT) with exercise (HILT + EX) in CR.LevelAdvancedAccreditationThe Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
The burden of cardiovascular risk in individuals with spinal cord injury (SCI) and its association with rehabilitation outcomes – Results from the Swiss SCI Cohort
Authors: Raguindin Peter Francis , Mueller Gabi , Stoyanov Jivko , Eriks-Hoogland Inge , Jordan Xavier , Stojic Stevan , Hund-Georgiadis Margret , Muka Taulant , Stucki Gerold , Glisic Marija ,   on behalf of the SwiSCI Study Group
Published: May 2023

Abstract

Objectives
To determine the cardiovascular risk burden rehabilitation discharge, and explore the association between recovery during rehabilitation and CVD-risk profile

Methods
We included adults without CVD history admitted for rehabilitation. We evaluated rehabilitation outcomes on admission and discharge. CVD-risk was assessed by Framingham risk score (FRS), high-density lipoprotein (HDL), and fasting glucose level.

Results
We analyzed data from 706 participants (69.55% men) with median age of 53.5 years. The median time-since-injury was 14 days and the admission length was 5.2 months. Majority had paraplegia (53.26%), and motor incomplete injury (53.68%). One-third of the cohort had high cardiovascular risk profile pre-discharge. At discharge, poorer anthropometric measures were associated with higher FRS and lower HDL levels. Individuals with higher forced vital capacity (>2.72 L) and peak expiratory flow (>3.4 L/min) had 0.16 mmol/L and 0.14 mmol/L higher HDL compared to those with lower respiratory function, respectively. Individuals with higher mobility score (>12.5) and functional independence score (>74) had 0.21 mmol/L and 0.18 mmol/L higher HDL compared to those with lower scores.

Conclusion
There is high cardiometabolic syndrome burden and CVD-risk upon rehabilitation discharge. Higher respiratory function, mobility, and overall independence were associated with better CVD profile, although with study design limitations and short follow-up. Future studies should explore whether rehabilitation outcomes could be used to prioritize screening.
Predictors of Speech Language Pathology Referral Following Pediatric Concussion Using a Speech Language Checklist: A Brief Report
Authors: Oldham Jessie , Lent Barbara , Peretiatko Steven , Dec Katherine 
Published: May 2023

AbstractSpeech language pathologists (SLPs) have the training to treat pediatric concussion issues in communication; however, they have traditionally not been included in initial concussion treatment. Despite physician understanding of SLP engagement in traumatic brain injury, SLP referrals happen only after significant issues in returning to school occurred. Therefore, the purpose of this study was to investigate predictors of physician referral to SLP using an SLP screening checklist. This was a retrospective, cross-sectional study from an academic outpatient clinic. Our study included 60 concussion patients (57% female, 67% white, age: 18.3 ± 4.0 years) who were evaluated by specialist physicians. The independent variables include age, sex, and the speech screening checklist domains (attention, memory/organization, social interactions, word finding, executive function) and their associated subcategories. The primary study outcome was referral to SLP following concussion. Twenty-six patients (43%) were referred to SLP. The speech checklist domains significantly associated with a referral to SLP were attention and memory/organization. Individuals who reported trouble with attention or memory/organization on the speech language checklist were most likely to be referred in a concussion treatment plan. The use of a SLP checklist during patient visits may expedite referrals to SLP, achieve earlier therapeutic intervention, and facilitate recovery.