bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ownership Change and Care Quality: Lessons From Minnesota’s Experience With Value-Based Purchasing
Authors: Hass Zachary , Abrahamson Kathleen , Arling Greg 
Published: April 2022

AbstractBackground and ObjectivesMinnesota’s implementation of a new nursing home value-based reimbursement (VBR) system in 2016 presented an opportunity to compare the response of nursing homes (NHs) to financial incentives to improve their quality and efficiency. The state substantially increased reimbursement for care-related costs and tied this rate increase to a composite quality score. Coinciding with rate increases of the new VBR system was an increase in ownership changes, with new owners being primarily for-profit entities from outside of Minnesota, including several private equity firms. Our objective was to examine NHs that underwent a change in ownership to determine their cost and quality response to the change.Research Design and MethodsOur sample consists of 342 Minnesota NHs that submitted Medicaid cost reports each year from 2013 to 2019. A time differential two-way fixed-effects difference-in-difference model is used to assess changes in quality metrics by comparing measures in years prior to and years following the sale for NHs that changed ownership versus NHs with consistent ownership. Nursing home characteristics, revenue, and spending patterns are examined to understand differences in performance.ResultsThose NHs with ownership change experienced a decline in quality scores with notable changes to expenditure patterns. They performed worse on Minnesota Department of Health inspection scores and had nonsignificant declines in measures of quality of life and clinical care. They had declining staff dental and medical benefits and occupancy rates, greater revenue growth from Medicare Part B, and larger increases in administrative management fees.Discussion and ImplicationsMinnesota like many other states has given wide latitude for nursing home ownership changes, without specific oversight for the quality of care and expenditure patterns of new owners. Recommendations include strict guidelines for the transparency of ownership structures, quality performance targets, rigorous financial auditing, and enhanced regulatory oversight.
Histologic Activity and Steroid Use History Are Risk Factors of Clinical Relapse in Ulcerative Colitis With Mayo Endoscopic Subscore of 0 or 1
Authors: Seong Gyeol , Song Joo Hye , Kim Ji Eun , Kim Tae Jun , Kim Eun Ran , Hong Sung Noh , Chang Dong Kyung , Kim Seok-Hyung , Ha Sang Yun , Kim Young-Ho 
Published: April 2022

Abstract

Background
The treatment goal of ulcerative colitis (UC) has changed from the control of symptoms to mucosal healing, previously evaluated mainly by endoscopy. Recently, the importance of histologic activity has emerged. Therefore, this study aimed to investigate the risk of clinical relapse according to histologic activity in UC with a Mayo endoscopic subsccore (MES) of 0 or 1.

Methods
In a retrospective cohort after our center’s biopsy guideline for UC was instituted, 492 UC patients with an MES of 0 or 1 were enrolled and analyzed. The primary outcome was the development of a clinical relapse including changes in medication, hospitalization, colectomy, and the development of colorectal cancer during the follow-up period.

Results
During the median 549 days of follow-up, 92 (18.7%) patients had a clinical relapse. All the patients changed their medication, including 4 hospitalized patients. Histologic activity defined by a Geboes score of ≧3.1 (hazard ratio [HR], 1.732; P = .035) and steroid use history (HR, 1.762; P = .008) were independent factors associated with clinical relapse. When stratified, the 1- and 2-year incidence rates of clinical relapse were 4.1% and 10.6%, respectively, for patients with histologic improvement and no steroid use history, whereas the rates were 23.9% and 39.4% for patients with histologic activity and steroid use history.

Conclusions
In UC with an MES of 0 or 1, histologic activity and steroid use history can be used to stratify the risk of clinical relapse.
Prevalence of SARS-COV-2 Vaccination and Factors Impacting Likelihood of Vaccination in a Nationwide Veterans Affairs Cohort of IBD Patients
Authors: Mahmud Nadim , Shah Yash , Khan Nabeel 
Published: April 2022

Lay Summary
Despite all efforts, about one-third of IBD patients are still not vaccinated. Although there is an emphasis on the booster dose, there is still a large population that has received no vaccination. Younger, healthy smokers with CD and on anti-TNF agents residing in the South and Midwest are less likely to get vaccinated. Targeted efforts should be made at this subset of IBD patients to increase vaccination rates.
Assessing socioeconomic bias in machine learning algorithms in health care: a case study of the HOUSES index
Authors: Juhn Young J , Ryu Euijung , Wi Chung-Il , King Katherine S , Malik Momin , Romero-Brufau Santiago , Weng Chunhua , Sohn Sunghwan , Sharp Richard R , Halamka John D 
Published: April 2022

Abstract

Objective
Artificial intelligence (AI) models may propagate harmful biases in performance and hence negatively affect the underserved. We aimed to assess the degree to which data quality of electronic health records (EHRs) affected by inequities related to low socioeconomic status (SES), results in differential performance of AI models across SES.

Materials and Methods
This study utilized existing machine learning models for predicting asthma exacerbation in children with asthma. We compared balanced error rate (BER) against different SES levels measured by HOUsing-based SocioEconomic Status measure (HOUSES) index. As a possible mechanism for differential performance, we also compared incompleteness of EHR information relevant to asthma care by SES.

Results
Asthmatic children with lower SES had larger BER than those with higher SES (eg, ratio = 1.35 for HOUSES Q1 vs Q2–Q4) and had a higher proportion of missing information relevant to asthma care (eg, 41% vs 24% for missing asthma severity and 12% vs 9.8% for undiagnosed asthma despite meeting asthma criteria).

Discussion
Our study suggests that lower SES is associated with worse predictive model performance. It also highlights the potential role of incomplete EHR data in this differential performance and suggests a way to mitigate this bias.

Conclusion
The HOUSES index allows AI researchers to assess bias in predictive model performance by SES. Although our case study was based on a small sample size and a single-site study, the study results highlight a potential strategy for identifying bias by using an innovative SES measure.
Comparing the Efficiency of Tumescent Infiltration Techniques in Burn Surgery
Authors: Fouché Tom W , Bond Stephanie M , Vrouwe Sebastian Q 
Published: April 2022

AbstractTangential excision and grafting of burn wounds result in significant intraoperative blood loss, and infiltration of a dilute epinephrine solution (tumescence) is routinely performed to reduce such bleeding. Tumescent infiltration has been described using both a manual technique (syringe) and a pump device. The purpose of this study is to compare the efficiency of these two methods in terms of time and economy of motion. Consecutive adult burn patients at a single center requiring excision and grafting were enrolled in the study and randomized into either the manual or pump technique. Excisions involving less than 2% TBSA were excluded, along with specific anatomic regions (eg, head and neck). Infiltration with epinephrine solution (1:500,000) was performed to the endpoint of tumescence by a single surgeon and filmed/coded for duration, number of maneuvers, and volume of tumescence injected. Fourteen patients were enrolled, and 16 cases were randomized to either manual (N = 8) or pump infiltration (N = 8). The pump method required less time (2.0 vs 1.1 cm2/s, P &lt; .001) and fewer maneuvers (37.8 vs 1.1 cm2/move, P &lt; .001) to reach the desired endpoint of tumescence. Use of the infiltration pump also resulted in a reduced volume of tumescent fluid required to reach this point of tumescence (1.7 vs 2.4 mL/cm2, P = .01). Compared to the manual technique, an infiltration pump was significantly more efficient in terms of both time and economy of motion. These reductions are potentially useful for improving operating room efficiency as well as minimizing operator fatigue.
Is there a persistent capital femoral epiphysis growth after screw fixation for slipped capital femoral epiphysis?
Authors: Sleth Camille , Bauzou François , De Cristo Claudia , Alkar Fanny , Joly-Monrigal Pauline , Jeandel Clément , Cottalorda Jérôme , Louahem M’Sabah Djamel , Delpont Marion 
Published: April 2022

ABSTRACT
Femoral neck screwing during child development is controversial. The objective of this study was to evaluate the residual growth of the capital femoral physis after screw fixation. This retrospective study included children aged younger than 12 years treated for slipped capital femoral epiphysis (SCFE) with a single percutaneous partially threaded cannulated screw. The children were followed up for at least 1 year. Some patients also underwent prophylactic contralateral screwing. Preoperative, immediate postoperative and final follow-up X-rays were evaluated to determine the degree of slippage, pin–joint ratio (PJR), neck–pin ratio (NPR), number of threads crossing the physis, neck–shaft angle (NSA), screw–physis angle and screw position in the physis. We included 17 patients (29 hips: 18 SCFE and 11 prophylactic) with a mean age of 10.1 years (range: 7.1–11.9 years) at the time of surgery. Significant evolution of radiological growth parameters of the proximal femoral physis was noted during a mean follow-up of 2.4 years (range: 1–4.3 years). The mean PJR significantly decreased from 7.3 to 6.0, the mean NPR significantly decreased from 106 to 96 and the mean number of threads beyond the physis decreased from 3.3 to 1.8. The mean NSA decreased by 6.5°, from 139° to 132.5°. Persistent capital femoral epiphysis growth occurs after screw fixation. The NSA significantly decreases over time but remains within the physiological limits.
Level of evidence: IV (case series)
Universal rule and regional variation of vegetation height assembly of typical grasslands in China
Authors: Hou Jihua , Li Qiuyue , Yan Pu , Xu Li , Li Mingxu , He Nianpeng 
Published: April 2022

AbstractMeasuring plant heights one by one is an important way to explore the height structure of grassland plant communities, and can be used to analyze the universal rules and regional variations of vegetation growth under environmental change. We chose grasslands in three plateaus, namely Tibetan Plateau (TP), Mongolian Plateau (MP) and Loess Plateau (LP), and set up three grassland transects along the precipitation gradients from meadow, steppe to desert. The mean height of grassland vegetation was 30.38 ± 22.44 cm, and the mean height from TP, MP to LP increased significantly. The aggregation of grassland vegetation exhibited a positive skew distribution (0.91, 3.60), and the community aggregation from TP, MP to LP tended to a normal distribution (0, 3). However, for TP, there was an exponential distribution in community aggregation of meadows, and a uniform distribution in that of desert. The explanatory effect of climate and soil nutrients on the variation of mean height in each region was more than 70%, while the explanatory effect on the community aggregation was the highest at TP, only 29%. From TP, MP to LP, response intensity of mean height to environmental changes increased significantly, and the influence of temperature and precipitation gradually increased, the influence of radiation, wind speed, and nutrients gradually weakened, and the synergy among environmental factors strengthened. Our study shows that normal distribution is a universal rule of grassland height construction, and that the synergy of environmental factors varies from region to region.
Queering Ethnic Rites of Passage: Transparent and One Day at a Time
Authors: Pridgeon Stephanie 
Published: April 2022

Abstract
I take account of queered ethnic rites of passage in the popular television series Transparent (2014-19) and One Day at a Time (2017-20), shows through which directors Joey Soloway and Gloria Calderón Kellett explore the intersections between queer youth and Jewish and Latinx identities, respectively. Transparent uses flashbacks to character Ari’s decision to forego their bat mitzvah in such a way that is inexorable from both their vexed relationship to their family’s immigrant history and their burgeoning queer (and later nonbinary) identification as a twenty-something in the series’ present. Likewise, One Day at a Time presents character Elena’s process of coming to terms with whether or not to celebrate her quinceañera, which she perceives as a misogynist, patriarchal tradition, as she duly grapples with coming out. Both series include gendered rites of passages, the Latinx quinceañera and the Jewish bat mitzvah, in a way that shows sexuality and ethnicity to sit uncomfortably with one another for queer adolescents whose grandparents immigrated to the United States. The two storylines share a family as a site of compulsory heterosexuality, adolescent characters who negotiate their sexual identities as they grapple with a rite of passage, and the use of humor as a tactic to question, resist, and at times reify patriarchal norms.
Impact of extreme spins and mass ratios on the post-merger observables of high-mass binary neutron stars
Authors: Papenfort L Jens , Most Elias R , Tootle Samuel , Rezzolla Luciano 
Published: April 2022

ABSTRACTThe gravitational-wave events GW170817 and GW190425 have led to a number of important insights on the equation of state of dense matter and the properties of neutron stars, such as their radii and the maximum mass. Some of these conclusions have been drawn on the basis of numerical-relativity simulations of binary neutron-star mergers with vanishing initial spins. While this may be a reasonable assumption in equal-mass systems, it may be violated in the presence of large mass asymmetries accompanied by the presence of high spins. To quantify the impact of high spins on multimessenger gravitational-wave events, we have carried out a series of high-mass binary neutron-star mergers with a highly spinning primary star and large mass asymmetries that have been modelled self-consistently using two temperature-dependent equations of state. We show that, when compared with equal-mass, irrotational binaries, these systems can lead to significant differences in the remnant lifetime, in the dynamical ejecta, in the remnant disc masses, in the secular ejecta, and on the bulk kilonova properties. These differences could be exploited to remove the degeneracy between low- and high-spin priors in the detection of gravitational waves from binary neutron-star mergers.
Magneto-thermal instability in galaxy clusters – I. Theory and two-dimensional simulations
Authors: Perrone Lorenzo M , Latter Henrik 
Published: April 2022

ABSTRACT
Determining the origin of turbulence in galaxy clusters, and quantifying its transport of heat, is an outstanding problem, with implications for our understanding of their thermodynamic history and structure. As the dilute plasma of the intracluster medium (ICM) is magnetized, heat and momentum travel preferentially along magnetic field lines. This anisotropy triggers a class of buoyancy instabilities that destabilize the ICM, and whose turbulent motions can augment or impede heat transport. We focus on the magneto-thermal instability (MTI), which may be active in the periphery of galaxy clusters. We aim to take a fresh look at the problem and construct a general theory that explains the MTI saturation mechanism and provides scalings and estimates for the turbulent kinetic energy, magnetic energy, and heat flux. We simulate MTI turbulence with a Boussinesq code, snoopy, which, in contrast to previous work, allows us to perform an extensive sampling of the parameter space. In two dimensions the saturation mechanism involves an inverse cascade that carries kinetic energy from the short MTI injection scales to larger scales, where it is arrested by the stable entropy stratification; at a characteristic ‘buoyancy scale’, the energy is dumped into large-scale g-modes, which subsequently dissipate. Consequently, the entropy stratification sets an upper limit on the size and strength of turbulent eddies. Meanwhile, the MTI conveys a substantial fraction of heat, despite the tangled geometry of the magnetic field. In a companion paper, these results are extended to three-dimensional flows, and compared to observations of real clusters.
Stochastic gravitational-wave background searches and constraints on neutron-star ellipticity
Authors: De Lillo Federico , Suresh Jishnu , Miller Andrew L 
Published: April 2022

ABSTRACTRotating neutron stars (NSs) are promising sources of gravitational waves (GWs) in the frequency band of ground-based detectors. They are expected to emit quasi-monochromatic, long-duration GW signals, called continuous waves (CWs), due to their deviations from spherical symmetry. The degree of such deformations, and hence the information about the internal structure of an NS, is encoded in a dimension-less parameter ε called ellipticity. Searches for CW signals from isolated Galactic NSs have shown to be sensitive to ellipticities as low as $\varepsilon \sim \mathcal {O}(10^{-9})$. These searches are optimal for detecting and characterizing GWs from individual NSs, but they are not designed to measure the properties of NSs as population, such as the average ellipticity εav. These ensemble properties can be determined by the measurement of the stochastic gravitational-wave background (SGWB) arising from the superposition of GW signals from individually undetectable NSs. In this work, we perform a cross-correlation search for such a SGWB using the data from the first three observation runs of Advanced LIGO and Virgo. Finding no evidence for an SGWB signal, we set upper limits on the dimension-less energy density parameter Ωgw(f). Using these results, we also constrain the average ellipticity of Galactic NSs and five NS ‘hotspots’, as a function of the number of NSs emitting GWs within the frequency band of the search Nband. We find $\varepsilon _{\mathrm{av}} \lesssim 1.8 \times 10^{-8}$, with Nband = 1.6 × 107, for Galactic NSs, and $\varepsilon _{\mathrm{av}} \lesssim [3.5-11.8]\times 10^{-7}$, with Nband = 1.6 × 1010, for NS hotspots.
Intermediate- and high-velocity clouds in the Milky Way – I. Covering factors and vertical heights
Authors: Lehner Nicolas , Howk J Christopher , Marasco Antonino , Fraternali Filippo 
Published: April 2022

ABSTRACT
Intermediate- and high-velocity clouds (IVCs, HVCs) are a potential source of fuel for star formation in the Milky Way (MW), but their origins and fates depend sensitively on their distances. We search for IVCs and HVCs in HST high-resolution ultraviolet spectra of 55 halo stars at vertical heights $|z|\gtrsim \,1$ kpc. We show that IVCs (40 ≤ |$v$LSR| &lt; 90 ${\rm km\, s}^{-1}$) have a high detection rate – the covering factor, fc – that is about constant (fc = 0.90 ± 0.04) from $z$ = 1.5 to 14 kpc, implying IVCs are essentially confined to |$z$| ≲ 1.5 kpc. For the HVCs (90 ≤ |$v$LSR| ≲ 170 ${\rm km\, s}^{-1}$), we find fc increases from fc ≃ 0.14 ± 0.10 at |$z$| ≲ 2–3 kpc to fc = 0.60 ± 0.15 at 6 ≲ |$z$| ≲ 14 kpc, the latter being similar to that found towards QSOs. In contrast, the covering factor of very high-velocity clouds (VHVCs; |$v$LSR| ≳ 170 ${\rm km\, s}^{-1}$) is $f_c \lt 0.04$ in the stellar sample compared to 20 per cent towards QSOs, implying these clouds must be at d ≳ 10–15 kpc (|$z$| ≳ 10 kpc). Gas clouds with |$v$LSR| &gt; 40 ${\rm km\, s}^{-1}$ at |b| ≳ 15° have therefore |$v$LSR| decreasing with decreasing |$z$|. Our findings are consistent with a Galactic rain and/or fountain origin for these clouds. In the latter scenario, VHVCs may mostly serve as fuel for the MW halo. In view of their high covering factors and since all the IVCs and some HVCs are found in the thick disc, they appear good candidates as gas reservoirs to help sustain star formation in the MW.
Sakurai’s Object revisited: new laboratory data for carbonates and melilites suggest the carrier of 6.9-μm excess absorption is a carbonate
Authors: Bowey J E , Hofmeister A M 
Published: April 2022

ABSTRACTWe present new room-temperature 1100–1800-cm−1 spectra of melilite silicates and 600–2000-cm−1 spectra of three randomly orientated fine-grained carbonates to determine the possible carrier(s) of a 6.9-μm absorption feature observed in a variety of dense astronomical environments, including young stellar objects and molecular clouds. We focus on the low-mass post-asymptotic giant branch star Sakurai’s Object, which has been forming substantial quantities of carbonaceous dust since an eruptive event in the 1990s. Large melilite grains cannot be responsible for the 6.9-μm absorption feature because the similarly shaped feature in the laboratory spectrum was produced by very low (0.1 per cent by mass) carbonate contamination, which was not detected at other wavelengths. Due to the high band strength of the 6.9-μm feature in carbonates, we conclude that carbonates carry the astronomical 6.9-μm feature. Replacement of melilite with carbonates in models of Sakurai’s Object improves fits to the 6–7-μm Spitzer spectra without significantly altering other conclusions of Bowey’s previous models except that there is no link between the feature and the abundance of melilite in meteorites. With magnesite (MgCO3), the abundance of 25-μm-sized SiC grains is increased by 10–50 per cent and better constrained. The mass of carbonate dust is similar to the mass of polycyclic aromatic hydrocarbon dust. Existing experiments suggest that carbonates are stable below 700 K; however, it is difficult to ascertain the applicability of these experiments to astronomical environments, and more studies are required.
Oncogenic RABL6A promotes NF1-associated MPNST progression in vivo
Authors: Kohlmeyer Jordan L , Kaemmer Courtney A , Lingo Joshua J , Voigt Ellen , Leidinger Mariah R , McGivney Gavin R , Scherer Amanda , Koppenhafer Stacia L , Gordon David J , Breheny Patrick , Meyerholz David K , Tanas Munir R , Dodd Rebecca D , Quelle Dawn E 
Published: April 2022

Abstract

Background
Malignant peripheral nerve sheath tumors (MPNSTs) are aggressive sarcomas with complex molecular and genetic alterations. Powerful tumor suppressors CDKN2A and TP53 are commonly disrupted along with NF1, a gene that encodes a negative regulator of Ras. Many additional factors have been implicated in MPNST pathogenesis. A greater understanding of critical drivers of MPNSTs is needed to guide more informed targeted therapies for patients. RABL6A is a newly identified driver of MPNST cell survival and proliferation whose in vivo role in the disease is unknown.

Methods
Using CRISPR-Cas9 targeting of Nf1 + Cdkn2a or Nf1 + Tp53 in the mouse sciatic nerve to form de novo MPNSTs, we investigated the biological significance of RABL6A in MPNST development. Terminal tumors were evaluated by western blot, qRT-PCR, and immunohistochemistry.

Results
Mice lacking Rabl6 displayed slower tumor progression and extended survival relative to wildtype animals in both genetic contexts. YAP oncogenic activity was selectively downregulated in Rabl6-null, Nf1 + Cdkn2a lesions whereas loss of RABL6A caused upregulation of the CDK inhibitor, p27, in all tumors. Paradoxically, both models displayed elevated Myc protein and Ki67 staining in terminal tumors lacking RABL6A. In Nf1 + p53 tumors, cellular atypia and polyploidy were evident and increased by RABL6A loss.

Conclusions
These findings demonstrate that RABL6A is required for optimal progression of NF1 mutant MPNSTs in vivo in both Cdkn2a and p53 inactivated settings. However, sustained RABL6A loss may provide selective pressure for unwanted alterations, including increased Myc, cellular atypia, and polyploidy, that ultimately promote a hyper-proliferative tumor phenotype akin to drug-resistant lesions.