bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship of POLST to Hospitalization and ICU Care Among Nursing Home Residents in California
Authors: Zingmond David , Powell David , Jennings Lee A. , Escarce Jose J. , Liang Li-Jung , Parikh Punam , Wenger Neil S. 
Published: August 2023

Abstract
Background
Physician Orders for Life Sustaining Treatment (POLST) document instructions for intensity of care based upon patient care preferences. POLST forms generally reflect patients’ wishes and dictate subsequent medical care, but it is not known how POLST use and content among nursing home residents is associated with inpatient utilization across a large population.

Objective
Evaluate the relationship between POLST use and content with hospital utilization among nursing home residents in California.

Design
Retrospective cohort study using the Minimum Data Set linked to California Section S (POLST documentation), the Medicare Beneficiary Summary File, and Medicare line item claims.

Patients
California nursing home residents with Medicare fee-for-service insurance, 2011–2016.

Main Measures
Hospitalization, days in the hospital, and days in the intensive care unit (ICU) after adjustment for resident and nursing home characteristics.

Key Results
The 1,112,834 residents had a completed and signed (valid) POLST containing orders for CPR with Full treatment 29.6% of resident-time (in person-years) and a DNR order with Selective treatment or Comfort care 27.1% of resident-time. Unsigned POLSTs accounted for 11.3% of resident-time. Residents experienced 14 hospitalizations and a mean of 120 hospital days and 37 ICU days per 100 person-years. Residents with a POLST indicating CPR Full treatment had utilization nearly identical to residents without a POLST. A gradient of decreased utilization was related to lower intensity of care orders. Compared to residents without a POLST, residents with a POLST indicating DNR Comfort care spent 56 fewer days in the hospital and 22 fewer days in the ICU per 100 person-years. Unsigned POLST had a weaker and less consistent relationship with hospital utilization.

Conclusions
Among California NH residents, there is a direct relationship between intensity of care preferences in POLST and hospital utilization. These findings emphasize the importance of a valid POLST capturing informed preferences for nursing home residents.
Identifying Implementation Factors for the Development, Operation, and Sustainment of Ambulatory Care Pharmacy Programs: a Qualitative Study
Authors: Qureshi Nabeel , Keller Michelle S. 
Published: August 2023

Abstract
Background
Pharmacist-led programs and clinics have been integrated into primary and specialty care clinics in a variety of ways, for example, to improve diabetes outcomes via patient education and counseling. However, factors important to the implementation of different outpatient pharmacy models have not been well elucidated.

Objective
To identify provider- and health system–level drivers of implementation and sustainability of pharmacy-led programs in the outpatient setting.

Design
Qualitative study of key informants using semi-structured interviews of individuals working in various roles throughout a large health system, including ambulatory clinical pharmacists, pharmacy managers, medical directors and physician leaders, and operations and quality managers.

Participants
Key informants (n=19) with leadership roles in pharmacy programs and front-line experience providing integrated pharmacy care were selected purposively and with snowball sampling.

Approach
We coded the interviews using a codebook derived from the 2022 Consolidated Framework for Implementation Research (CFIR), which details various internal and external factors important for implementation.

Key Results
We identified the following themes related to implementing ambulatory care pharmacy programs: (1) pharmacy programs varied in their level of embeddedness in the outpatient clinic, (2) establishing pharmacy program required leadership advocacy and coordination among stakeholders, (3) continued operations required integrated workflows and demonstrated value to the health system and clinicians, and (4) established revenue streams or added indirect value and continued improvement of integration sustained programs over time.

Conclusions
External policies and incentives such as new reimbursement codes and quality measurement programs that rely on pharmacy input play a significant role in shaping the design, implementation, and sustainability of health system outpatient pharmacy programs. Ensuring that quality metrics used in value-based contracts or programs demonstrate pharmacy benefits will be critical to supporting and growing pharmacy programs.
Moral judgments under uncertainty: risk, ambiguity and commission bias
Authors: Song Fei , Shou Yiyun , Olney Joel , Yeung Felix S. H. 
Published: August 2023

AbstractPrevious research on moral dilemmas has mainly focused on decisions made under conditions of probabilistic certainty. We investigated the impact of uncertainty on the preference for action (killing one individual to save five people) and inaction (saving one but allowing five people to die) in moral dilemmas. We reported two experimental studies that varied the framing (gain vs loss), levels of risk (probability of gain and loss) and levels of ambiguity (imprecise probability information) in the choice to save five individuals by sacrificing one. We found that participants preferred actions with uncertainty (risk/ambiguity) over inaction. Specifically, we found that participants preferred actions with precise probability information (risk) over inaction, and they preferred actions with modest or high levels of ambiguity over actions with precise probabilities, especially when moral dilemmas had a loss frame. We also observed commission bias in Study 2. We discussed the implications for research in moral decision-making.
Exchangeable FGM copulas
Authors: Blier-Wong Christopher , Cossette Hélène , Marceau Etienne 
Published: August 2023

AbstractCopulas provide a powerful and flexible tool for modeling the dependence structure of random vectors, and they have many applications in finance, insurance, engineering, hydrology, and other fields. One well-known class of copulas in two dimensions is the Farlie–Gumbel–Morgenstern (FGM) copula, since its simple analytic shape enables closed-form solutions to many problems in applied probability. However, the classical definition of the high-dimensional FGM copula does not enable a straightforward understanding of the effect of the copula parameters on the dependence, nor a geometric understanding of their admissible range. We circumvent this issue by analyzing the FGM copula from a probabilistic approach based on multivariate Bernoulli distributions. This paper examines high-dimensional exchangeable FGM copulas, a subclass of FGM copulas. We show that the dependence parameters of exchangeable FGM copulas can be expressed as a convex hull of a finite number of extreme points. We also leverage the probabilistic interpretation to develop efficient sampling and estimating procedures and provide a simulation study. Throughout, we discover geometric interpretations of the copula parameters that assist one in decoding the dependence of high-dimensional exchangeable FGM copulas.
Contextual effects in salary satisfaction
Authors: Birnbaum Michael H. , Rouvere Julien 
Published: August 2023

Abstract
This article reports a series of studies of judgments of satisfaction with salary, manipulating the distribution of salaries of others doing the same work. The experiments were designed to compare 6 theories of contextual effects in judgment, including adaptation-level theory, correlation–regression theory, inferred distribution (ID) theory, decision by sampling (DbS), ensemble (EN) theory, and range–frequency (RF) theory. Manipulations of the frequency distribution using cubic density functions produce a double crossover of curves relating judgments to salaries; this double crossover violates implications of 4 of the theories but remains consistent with DbS and RF theories. ID theory assumes that rank is inferred from the mean and endpoints, so it fails to describe the double crossover. Manipulations of the endpoints produce changes in the heights and slopes of the curves, which are not explained by DbS and are partially inconsistent with EN theory. EN theory implies no effect of the rank of a salary and assumes that endpoints only affect judgments of salaries on the same side of the mean, contrary to the results. RF theory implies that ratings of stimuli holding the same ranks in 2 contexts with differing endpoints should be linearly related, and the data appeared consistent with this implication. RF theory is the only theory that gives a consistent account of all of the results. RF theory can be extended in order to estimate the effective context, which appears to differ systematically between people according to their full-time incomes.
Paleoenvironmental changes in the eastern Kumtag Desert, northwestern China since the late Pleistocene
Authors: Song Haoze , Yang Xiaoping , Preusser Frank , Fülling Alexander , Chen Bo 
Published: August 2023

AbstractSedimentary records from the Kumtag (also known as Kumtagh) Desert (KMD) in northwestern China are investigated to better understand Late Quaternary paleoenvironmental changes in this hyper-arid region. Presented here are the results of probably the first systematic survey of sedimentary sequences from the KMD, with the chronology determined by the optically stimulated luminescence dating. The variation of sedimentary facies, supported by granular and geochemical paleoenvironmental proxies, is used to decipher the history of Late Quaternary environment changes. The results demonstrate that a constantly dry condition characterized the eastern KMD since the last glacial maximum, but with occurrences of wetter periods. From ca. 17 to 15 ka, fluvial activity was probably triggered by melting of glaciers in mountains located south of the KMD. A distinctly drier stage (ca. 13–7 ka) was recognized due to the prominent occurrence of aeolian sands. A wetter environment likely persisted between ca. 4.4 and 2.2 ka, consistent with evidence of human activities. While the causes of paleoenvironmental changes in the eastern KMD are still a matter of debate, the melting of glaciers in the Altyn-Tagh Mountains in the south must be considered as an important factor.
Simultaneous presentation of dual pathologies within the oral cavity: an unusual and diagnostically challenging presentation
Authors: Thandi Beant Singh , Jane Rosemarie , Chavda Vinay , Chapple Iain L. C. 
Published: August 2023

AbstractNecrotising sialometaplasia (NS) is a rare condition, with a limited scientific evidence base regarding its aetiology and pathophysiology. Diagnosing NS demands extensive investigatory tests. Their accuracy is vital in order to exclude oral malignancy and prevent unwarranted, invasive management.Within Birmingham Dental Hospital, a 22-year-old, South Asian woman presented with generalised pain from the lower right third molar extending to involve the palate, to which the patient's general medical practitioner previously attributed to a viral upper respiratory infection. Clinical examination revealed bilateral erythematous: non-ulcerated, palatal swellings (10 mm x 5 mm) at the greater palatine foramina. Following extensive investigations, the challenging definitive diagnoses of two distinct pathologies were made: non-ulcerative NS and pericoronitis.This case report describes the successful diagnosis and management of non-ulcerating NS, an 'atypical' presentation of a rare condition, that was confounded by a simultaneous episode of pericoronitis - a presentation not previously documented within scientific literature.
Structural snapshots along K48-linked ubiquitin chain formation by the HECT E3 UBR5
Authors: Hehl Laura A. , Horn-Ghetko Daniel , Prabu J. Rajan , Vollrath Ronnald , Vu D. Tung , Pérez Berrocal David A. , Mulder Monique P. C. , van der Heden van Noort Gerbrand J. , Schulman Brenda A. 
Published: August 2023

AbstractUbiquitin (Ub) chain formation by homologous to E6AP C-terminus (HECT)-family E3 ligases regulates vast biology, yet the structural mechanisms remain unknown. We used chemistry and cryo‐electron microscopy (cryo‐EM) to visualize stable mimics of the intermediates along K48-linked Ub chain formation by the human E3, UBR5. The structural data reveal a ≈ 620 kDa UBR5 dimer as the functional unit, comprising a scaffold with flexibly tethered Ub-associated (UBA) domains, and elaborately arranged HECT domains. Chains are forged by a UBA domain capturing an acceptor Ub, with its K48 lured into the active site by numerous interactions between the acceptor Ub, manifold UBR5 elements and the donor Ub. The cryo-EM reconstructions allow defining conserved HECT domain conformations catalyzing Ub transfer from E2 to E3 and from E3. Our data show how a full-length E3, ubiquitins to be adjoined, E2 and intermediary products guide a feed-forward HECT domain conformational cycle establishing a highly efficient, broadly targeting, K48-linked Ub chain forging machine.
Using pseudo-labeling to improve performance of deep neural networks for animal identification
Authors: Ferreira Rafael E. P. , Lee Yong Jae , Dórea João R. R. 
Published: August 2023

AbstractContemporary approaches for animal identification use deep learning techniques to recognize coat color patterns and identify individual animals in a herd. However, deep learning algorithms usually require a large number of labeled images to achieve satisfactory performance, which creates the need to manually label all images when automated methods are not available. In this study, we evaluated the potential of a semi-supervised learning technique called pseudo-labeling to improve the predictive performance of deep neural networks trained to identify Holstein cows using labeled training sets of varied sizes and a larger unlabeled dataset. By using such technique to automatically label previously unlabeled images, we observed an increase in accuracy of up to 20.4 percentage points compared to using only manually labeled images for training. Our final best model achieved an accuracy of 92.7% on an independent testing set to correctly identify individuals in a herd of 59 cows. These results indicate that it is possible to achieve better performing deep neural networks by using images that are automatically labeled based on a small dataset of manually labeled images using a relatively simple technique. Such strategy can save time and resources that would otherwise be used for labeling, and leverage well annotated small datasets.
Biocontrol of Rhizoctonia solani in basmati rice by the application of Lactobacillus and Weissella spp.
Authors: Akhtar Maira , Nosheen Asia , Keyani Rumana , Yasmin Humaira , Naz Rabia , Mumtaz Saqib , Hassan Muhammad Nadeem 
Published: August 2023

AbstractRice is a staple food crop and is a major source of employment and income in the world. However, the attack of fungal disease poses a serious threat to the crop growth and productivity and leads toward yield loses. Therefore, current study was performed to evaluate the biocontrol potential of Lactobacillus and Weissella spp. on basmati rice against Rhizoctonia solani. Agar disc method was performed to evaluate the antifungal activity of both bacteria against R. solani. Petri plate and pot experiments were conducted to evaluate the growth promotion and biocontrol potential of both bacteria in Basmati rice under R. solani stress. Results indicated that maximum antifungal activity (82%) was recorded by Lactobacillus sp. Maximum phosphate solubilization and siderophore production was recorded by Weissella sp. In petri plate experiment, maximum root length, root fresh and dry weight (36%, 40% and 13%) was recorded by Weissella sp. and maximum shoot length and shoot fresh weight (99% and 107%) by Lactobacillus sp. In pot experiment, both bacteria enhanced the growth parameters of Basmati rice including root and shoot length, fresh and dry weight as well as no. of lateral roots. Application of Weissella sp. resulted in maximum increase (332% and 134%) in chlorophyll a and b content while Lactobacillus sp. + R. solani showed maximum (42%) carotenoid contents. Lactobacillus sp. + R. solani showed maximum increase in the proline (54%) and sugar contents (100%) while Lactobacillus sp. alone showed maximum (35%) soluble protein contents. Plant defense enzymes i-e SOD (400%), POD (25%), CAT (650%), PPO (14%) and PAL (124%) were notably increased by Weissella sp. + R. solani and Lactobacillus sp + R. solani. The Lactobacillus sp showed the best results in antifungal activity against R. solani and Weissella sp. showed the best results in production of defense enzymes in basmati rice against R. solani stress and can be suggested as the potent biocontrol agents for the rice crop.
Endothelial Cell Stress with Arterial Re-entry During Bypass
Authors: Beckley Philip D. , Duffner Brett D. , Laribee Julia A. , O’Brien William B. , Wittenmyer Barbara L. 
Published: August 2023

High velocity arterial blood re-entry during cardiopulmonary bypass is known to be associated with numerous potential deleterious effects. One of these may be endothelial cell stress with resulting intimal injury. Previous studies by others would suggest that endothelial cell injury of this type could result in long-term vascular disease. To test the hypothesis that arterial reentry during cardiopulmonary bypass will induce endothelial injury, six mongrel dogs were divided into three study pairs: control (no bypass), continuous (non-pulsatile) bypass, and pulsatile bypass. Evans blue dye was used as a marker of aortic endothelial cell injury. Following each experimental period, the aorta was removed en bloc and examined for Evans Blue Dye staining. Sections of aortic tissue were also examined histologically for cellular damage.
All subjects tolerated the study period without incident. Gross tissue examination of the control subject aortic segments revealed no Evans Blue Dye staining. Histologic examination of these segments was unremarkable. Gross tissue examination of the bypass subject aortic segments revealed Dye staining in all cases with the pulsatile bypass pair staining more extensively and heavily than the continuous bypass pair. Histologic examination of the stained tissue showed acute and focal endothelial denudation (J. Extra-Corporeal Technol. 21(2): 52-55, 1989).
Technique: Arteriorarterial Bypass For Renal Transplant Protection During Abdominal Aortic Aneurysmectomy Using a Centrifugal Pump and Limited Heparinization
Authors: Fabrizio M. Charlene 
Published: August 2023

Today, renal transplant patients have increasing longterm success rates. Since the arteriosclerotic disease plaguing the renal patient seems to be more intensified after hemodialysis, expectations are that greater numbers of renal transplant patients with aortic disease will be seen.
When clamping of the aorta occurrs during aneurysmectomy, perfusion of the transplanted kidney is compromised. A Bio-Medicus [a] centrifugal pump was utilized in the repair of an abdominal aortic aneurysm to protect the transplanted renal graft. The bypass consisted of cannulated sites of the left axillary artery and the left femoral artery with the centrifugal pump unit interposed. The resulting bypass was considered to be an “in situ” perfusion of the kidney. A small amount of heparin was given. The transplanted kidney excreted urine the entire procedure; the creatinine levels remained stable, and the patient did well.
Successful use of this simple yet effective arterioarterial bypass lends itself to greater use in the future (J. Extra-Corpor. Technol., 21(2): 61-64, 1989, 11 Ref).
“Heparin less” Venovenous Bypass for Renal Cell Carcinoma Involving the Inferior Vena Cava: A Case Report
Authors: Fabrizio M. Charlene 
Published: August 2023

This presentation offers a simple yet effective method of venovenous bypass without systemic heparinization to assist in the surgical intervention of renal cell carcinoma involving the inferior vena cava. This system is comprised of a closed BioMedicus (a) centrifugal pump system and cannulation sites of femoral vein and axillary vein. No direct cardiac cannulation is made.
Renal cell carcinomas involving the inferior vena cava have been surgically treated by means of cavotomy, often with major loss of blood (1). Risks also include embolization to the right heart and lungs, poor visualization with less than desirable results, uncertainty as to retrieval of tumor thrombus, and the possibility of decreased return of venous blood to the right heart and those sequelae.
Other surgical measures have included cardiopulmonary bypass with or without circulatory arrest. Also, a venovenous bypass from femoral vein to right atrium has been conducted (2, 3). Some complications associated with these uses will be discussed in the following text The degree of inferior vena caval involvement in this case report extended to the diaphragm and was handled surgically with the assist of this venovenous bypass system, but cases involving thrombus above the level of the diaphragm might also be considered depending on the extent and surgeon discretion.
The bypass described herein affords a simple, convenient method to offer hemodynamic stability in the surgical procedure without cannulation of the heart and systemic heparinization. This bypass will be utilized in future cases based on individual situations.
Atrial Fibrillation after Descending Aorta Repair: Occurrence, Risk Factors, and Impact on Outcomes
Authors: Pujara Akshat C. , Koprivanac Marijan , Stembal Filip , Lowry Ashley M. , Nowicki Edward R. , Chung Mina , Wagoner David V. , Blackstone Eugene H. , Roselli Eric E. 
Published: August 2023

Abstract
Background As risks of repairing the descending thoracic and thoracoabdominal aorta diminish, common complications that may prolong hospital stay, or actually increase risk, require attention. One such complication is postoperative atrial fibrillation (AF). Therefore, we characterized prevalence of, risk factors for, and effects of postoperative atrial fibrillation (PoAF) after descending and thoracoabdominal aorta repair.
Methods From January 2000 to January 2011, 696 patients underwent open descending or thoracoabdominal aorta repair at Cleveland Clinic. Operations approached via median sternotomy (n = 178) and patients treated preoperatively for arrhythmias (32 amiodarone, 9 paced) or in AF on preoperative electrocardiogram (n = 14) were excluded, leaving 463. Logistic regression analysis identified risk factors for PoAF. Temporal relation of PoAF with postoperative morbidities was determined, and outcomes following PoAF were compared between propensity-matched pairs.
Results New-onset PoAF occurred in 101 patients (22%) at a median 68 hours of postincision. Risk factors included older age (p = 0.002) and history of remote AF (p = 0.0004) but not operative details, such as pericardiotomy for cardiac cannulation. Hypoperfusion and neurologic complications tended to precede PoAF, whereas sepsis, respiratory failure, and dialysis followed. Among 94 propensity-matched patient pairs, those developing PoAF were more likely to experience hypoperfusion (p = 0.006), respiratory failure (p = 0.009), dialysis (p = 0.04), paralysis (p < 0.0001), longer intensive care unit stay (median 7 vs. 5 d, p = 0.02), and longer postoperative hospital stay (median 15 vs. 13 d, p = 0.004). However, hospital death was similar (6/94 PoAF [6.4%] vs. 7/94 no PoAF [7.4%], p = 0.8).
Conclusion PoAF after descending thoracic aorta surgery is relatively common and a part of a constellation of other serious complications prolonging postoperative recovery. While PoAF was associated with adverse events, it did not impact postoperative cost and mortality. Descending thoracic aorta surgery is by itself comorbid enough, which is likely why PoAF does not have a more significant effect on postoperative recovery and cost.