bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of quality improvement methodology to improve care of women with hypertensive disease in pregnancy and haemorrhage in Yemen (low-income, high-insecurity setting)
Authors: Das Sabrina , Abdulwahid Emtiaz , Moisan Audrey , De Jesus Anna Kathrina 
Published: December 2022

This safety improvement project used quality improvement methods in a Comprehensive Emergency Obstetric and Newborn Care facility in Yemen, managed by an international humanitarian non-governmental organisation. It is responsible for about 6500 deliveries per annum. Following a local review of maternal deaths and serious incidents in 2020–2021, care for women with severe hypertensive disease in pregnancy and postpartum haemorrhage were highlighted as potential areas for improvement. These are also the two most common reasons recorded for maternal mortality in Yemen (and in many low-income countries worldwide). We also wanted to foster an open and honest safety culture within the department that encouraged learning from error.We used an inclusive approach in designing the improvements, with change ideas collated via frontline doctors, midwives and nurses working in the maternity unit. Data were collected via manual audit, and through routinely collected data. We focused on the following measures: number of incidents reported per month, documentation quality of antihypertensive prescriptions, fluid restriction practices in women with severe pre-eclampsia, number of minutes taken to control severe hypertensive episodes, postpartum haemorrhage identification rates and tranexamic acid stock usage. We evaluated the efficacy of team simulation training through precourse and postcourse questionnaires.We found demonstrable improvement in our measures relating to treatment of women with hypertensive disorders of pregnancy, and in postpartum haemorrhage identification and treatment. Team simulation training was a difficult intervention to sustain but was received well with positive results during our test session. Incident reporting showed a temporary increase, but this effect was not sustained.We concluded that quality improvement methodology is a valuable tool even in challenged healthcare settings such as this one, in an active conflict zone. Behaviour change in team culture and safety culture is harder to sustain and demonstrate without a long-term strategy.
Pre-arrest comorbidity burden and the future risk of out-of-hospital cardiac arrest in Korean adults
Authors: Hong Seok-In , Kim Youn-Jung , Kim Ye-Jee , Kim Won Young 
Published: December 2022

ObjectiveTo investigate the impact of pre-arrest comorbidities on future out-of-hospital cardiac arrest (OHCA) development using a nationwide dataset.MethodsThis population-based, matched case-control study used the national health insurance claims data relevant to OHCA in South Korea from January 2009 to December 2018. Case patients were randomly matched to controls by age, sex and date of cardiac arrest. Controls were defined as patients who did not experience OHCA based on claim codes in national health screening data. The comorbidity burden was assessed using the Charlson Comorbidity Index (CCI).ResultsA total of 191 370 OHCA patients were matched to 347 568 controls. The mean CCI in the case group was 3.76, which was significantly higher than that in the control group (1.75, p<0.001). Overall, OHCA was 1.35 (95% CI 1.34 to 1.35) times more likely to occur with every 1 point increase in the CCI. All other comorbidities constituting the CCI were associated with the OHCA risk (p<0.001). Patients with CCI ≥3 presented an OR of 3.71 (95% CI 3.67 to 3.76) for the risk of OHCA occurrence. This association was more pronounced in patients aged <70 years than in those aged ≥70 years (OR (95% CI) 16.07 (15.48 to 16.68) vs 6.50 (6.33 to 6.68)).ConclusionA high burden of pre-arrest comorbidity was associated with a higher risk of OHCA development, which was more pronounced in patients with less advanced age.
Computational model of CAR T-cell immunotherapy dissects and predicts leukemia patient responses at remission, resistance, and relapse
Authors: Liu Lunan , Ma Chao , Zhang Zhuoyu , Witkowski Matthew T , Aifantis Iannis , Ghassemi Saba , Chen Weiqiang 
Published: December 2022

BackgroundAdaptive CD19-targeted chimeric antigen receptor (CAR) T-cell transfer has become a promising treatment for leukemia. Although patient responses vary across different clinical trials, reliable methods to dissect and predict patient responses to novel therapies are currently lacking. Recently, the depiction of patient responses has been achieved using in silico computational models, with prediction application being limited.MethodsWe established a computational model of CAR T-cell therapy to recapitulate key cellular mechanisms and dynamics during treatment with responses of continuous remission (CR), non-response (NR), and CD19-positive (CD19+) and CD19-negative (CD19−) relapse. Real-time CAR T-cell and tumor burden data of 209 patients were collected from clinical studies and standardized with unified units in bone marrow. Parameter estimation was conducted using the stochastic approximation expectation maximization algorithm for nonlinear mixed-effect modeling.ResultsWe revealed critical determinants related to patient responses at remission, resistance, and relapse. For CR, NR, and CD19+relapse, the overall functionality of CAR T-cell led to various outcomes, whereas loss of the CD19+antigen and the bystander killing effect of CAR T-cells may partly explain the progression of CD19−relapse. Furthermore, we predicted patient responses by combining the peak and accumulated values of CAR T-cells or by inputting early-stage CAR T-cell dynamics. A clinical trial simulation using virtual patient cohorts generated based on real clinical patient datasets was conducted to further validate the prediction.ConclusionsOur model dissected the mechanism behind distinct responses of leukemia to CAR T-cell therapy. This patient-based computational immuno-oncology model can predict late responses and may be informative in clinical treatment and management.
An Enhanced Deep Neural Network-Based Approach for Speaker Recognition Using Triumvirate Euphemism Strategy
Authors: Pedalanka P. S. Subhashini , Ram Manchikalapudi Satya Sai , Rao Duggirala Sreenivasa 
Published: December 2022

Automatic Speech Recognition (ASR) has been an intensive research area during the recent years in internet to enable natural human–machine communication. However, the existing Deep Neutral Network (DNN) techniques need more focus on feature extraction process and recognition accuracy. Thus, an enhanced deep neural network (DNN)-based approach for speaker recognition with a novel Triumvirate Euphemism Strategy (TES) is proposed. This overcomes poor feature extraction from Mel-Frequency Cepstral Coefficient (MFCC) map by extracting the features based on petite, hefty and artistry of the features. Then, the features are trained with Silhouette Martyrs Method (SMM) without any inter-class and intra-class separability problems and margins are affixed between classes with three new loss functions, namely A-Loss, AM-Loss and AAM-Loss. Additionally, the parallelization is done by a mini-batch-based BP algorithm in DNN. A novel Frenzied Heap Atrophy (FHA) with a multi-GPU model is introduced in addition with DNN to enhance the parallelized computing that accelerates the training procedures. Thus, the outcome of the proposed technique is highly efficient that provides feasible extraction features and gives incredibly precise results with 97.5% accuracy in the recognition of speakers. Moreover, various parameters were discussed to prove the efficiency of the system and also the proposed method outperformed the existing methods in all aspects.
Utilizing publicly available datasets for identifying offshore salt strata and developing salt caverns for hydrogen storage
Authors: Allsop Craig , Yfantis Georgios , Passaris Evan , Edlmann Katriona 
Published: December 2022

Abstract
Hydrogen is expected to play a key role in a future climate-neutral economy by decarbonizing ‘hard to abate’ sectors, and importantly act as an energy carrier to balance intermittent renewable energy production, which, if stored, could be used to address grid-scale energy demands. It is evident that for unlocking the vast potential of hydrogen technologies, large-scale hydrogen storage with the capability of fast cyclic operations needs to be secured.
Underground salt caverns, where decades of operational experience exist, offer an attractive option for hydrogen storage due to the high hydrogen sealing potential of salt, capability for large injection/withdrawal flow rates and capacity for large volume storage.
This study presents a novel methodology for selecting offshore salt cavern sites based on publicly available datasets, which leads to eventually estimating regional hydrogen storage capacities. The Southern North Sea was investigated and a case study detailing a single diapiric salt structure is presented, demonstrating the strength and practicality of the framework as well as highlighting the potential of offshore salt cavern storage of hydrogen in the decarbonization energy journey of the UK.
Pharmacological Targeting of Androgen Receptor Elicits Context-Specific Effects in Estrogen Receptor–Positive Breast Cancer
Authors: Wei Lixuan , Gao Huanyao , Yu Jia , Zhang Huan , Nguyen Thanh Thanh L. , Gu Yayun , Passow Marie R. , Carter Jodi M. , Qin Bo , Boughey Judy C. , Goetz Matthew P. , Weinshilboum Richard M. , Ingle James N. , Wang Liewei 
Published: December 2022

Abstract

Androgen receptor (AR) is expressed in 80% to 90% of estrogen receptor α–positive (ER+) breast cancers. Accumulated evidence has shown that AR is a tumor suppressor and that its expression is associated with improved prognosis in ER+ breast cancer. However, both a selective AR agonist (RAD140) and an AR inhibitor (enzalutamide, ENZ) have shown a therapeutic effect on ER+ breast cancer, so the potential for clinical application of AR-targeting therapy for ER+ breast cancer is still in dispute. In this study, we evaluated the efficacy of ENZ and RAD140 in vivo and in vitro in AR+/ER+ breast cancer models, characterizing the relationship of AR and ER levels to response to AR-targeting drugs and investigating the alterations of global gene expression and chromatin binding of AR and ERα after ENZ treatment. In the AR-low setting, ENZ directly functioned as an ERα antagonist. Cell growth inhibition by ENZ in breast cancer with low AR expression was independent of AR and instead dependent on ER. In AR-high breast cancer models, AR repressed ERα signaling and ENZ promoted ERα signaling by antagonizing AR. In contrast, RAD140 activated AR signaling and suppressed AR-high tumor growth by deregulating ERα expression and blocking ERα function. Overall, analysis of the dynamic efficacies and outcomes of AR agonist, and antagonist in the presence of different AR and ERα levels reveals regulators of response and supports the clinical investigation of ENZ in selected ER+ tumors with a low AR/ER ratio and AR agonists in tumors with a high AR/ER ratio.

Significance:
The ratio of androgen receptor to estrogen receptor in breast cancer dictates the response to AR-targeted therapies, providing guidelines for developing AR-directed treatment strategies for patients with breast cancer.
Linking Physical Activity to Breast Cancer Risk via the Insulin/Insulin-like Growth Factor Signaling System, Part 2: The Effect of Insulin/Insulin-like Growth Factor Signaling on Breast Cancer Risk
Authors: Drummond Ann E. , Swain Christopher T.V. , Milne Roger L. , English Dallas R. , Brown Kristy A. , Skinner Tina L. , Lay Jannelle , van Roekel Eline H. , Moore Melissa M. , Gaunt Tom R. , Martin Richard M. , Lewis Sarah J. , Lynch Brigid M. 
Published: December 2022

Abstract
Perturbation of the insulin/insulin-like growth factor (IGF) signaling system is often cited as a mechanism driving breast cancer risk. A systematic review identified prospective cohort studies and Mendelian randomization studies that examined the effects of insulin/IGF signaling (IGF, their binding proteins (IGFBP), and markers of insulin resistance] on breast cancer risk. Meta-analyses generated effect estimates; risk of bias was assessed and the Grading of Recommendations Assessment, Development and Evaluation system applied to evaluate the overall quality of the evidence. Four Mendelian randomization and 19 prospective cohort studies met our inclusion criteria. Meta-analysis of cohort studies confirmed that higher IGF-1 increased risk of breast cancer; this finding was supported by the Mendelian randomization studies. IGFBP-3 did not affect breast cancer. Meta analyses for connecting-peptide and fasting insulin showed small risk increases, but confidence intervals were wide and crossed the null. The quality of evidence obtained ranged from ‘very low’ to ‘moderate’. There were insufficient studies to examine other markers of insulin/IGF signaling. These findings do not strongly support the biological plausibility of the second part of the physical activity—insulin/IGF signaling system—breast cancer pathway. Robust conclusions cannot be drawn due to the dearth of high quality studies.
See related article by Swain et al., p. 2106
Can Tax Incentives Affect MSME Tax Compliance?
Authors: Budiman Nita Andriyani , Nurkamid Mukhamad , Sriyana Jaka , Akhsyim  
Published: December 2022

The government issued a tax incentive policy for the business sector. This policy was taken to help the public and business actors to survive in the middle period of the Covid-19 outbreak. The Covid-19 pandemic has influenced the relationship between tax incentives and MSME tax compliance. This study examines how much influence tax incentives have on MSME tax compliance. MSME actors get a total income tax incentive of 0.5% as referred to PP No. 23/2018 which is created by the government, where the taxpayers of MSME do not require to make tax deposits. During the Covid-19 pandemic, the government provided tax incentives that are expected to boost MSME tax compliance. The main objective of this study was to examine the impact of tax incentives on MSME tax compliance, using the Covid-19 situation as a moderating factor. The tax incentives in this study consist of knowledge of tax incentives and the use of tax incentives. The research data was obtained from UMKM in Kudus Regency with a sampling technique using purposive sampling. Data were collected from 231 respondents using a survey method. The data was analyzed using moderated regression analysis. The study's findings indicate that knowledge of tax incentives has a positive effect on MSME tax compliance, that use of tax incentives has no impact on MSME tax compliance, and that the Covid-19 pandemic has no influence on the relationship between knowledge of tax incentives and use of tax incentives on MSME tax compliance. The expected implication in this research is to be able to contribute to providing information about the compliance level of MSME taxpayers during the Covid-19 pandemic and to be used as evaluation material for the application of related policies.
Supplementary Instructional Materials Via Video-Clip (SIMVI): Effects On Grade 9 Students’ Conceptual Understanding and Motivation
Authors: Bebita Darilyn Joy 
Published: December 2022

The study aimed to develop, evaluate, and determine the effectiveness of recorded video-clip lessons as supplementary materials in teaching least mastered learning competencies in science among forty Grade 9 students during the School Year 2021 - 2022. The quantitative research was used in this study using the questionnaires and pretest/ posttest and LRMDS rating sheets as the data gathering instruments. The statistical methods used to treat the data were mean, standard deviation, t-test, percentage and ranking. Both the science teachers and experts evaluated the SIMVI with a grand mean of 3.97 and 3.88 respectively interpreted as strongly agree in selected criteria such as content quality, instructional quality, technical quality and technical accuracy. There was no significant difference between the evaluation of the two groups of respondents in terms of content quality, instructional quality, technical quality and technical accuracy of SIMVI with computed t values of 0.89, 1.84, 1.46 and 1.00 which are all less than the tabular t value of 2.20. It is recommended that future researchers may conduct similar study and validate the veracity of the SIMVI as to relevance, effectiveness and efficiency.
“The Object Comes Alive”: A Conversation with Claes Oldenburg
Authors: Foster Hal 
Published: December 2022

Abstract
In this interview, the late Claes Oldenburg looks back on both the motivations and the modalities of his distinctive practice. Among the topics discussed are his signature “guises,” such as the Ray Guns and the Flags, the performative basis of his early objects, and his sustained commitment to an aesthetic of shape-shifting.
Relationship of Multiwavelength Radar Measurements to Ice Microphysics from the IMPACTS Field Program
Authors: Heymsfield Andrew , Bansemer Aaron , Heymsfield Gerald , Noone David , Grecu Mircea , Toohey Darin 
Published: December 2022

Abstract
Coincident radar data with Doppler radar measurements at X, Ku, Ka, and W bands on the NASA ER-2 aircraft overflying the NASA P-3 aircraft acquiring in situ microphysical measurements are used to characterize the relationship between radar measurements and ice microphysical properties. The data were obtained from the Investigation of Microphysics and Precipitation for Atlantic Coast-Threatening Snowstorms (IMPACTS). Direct measurements of the condensed water content and coincident Doppler radar measurements were acquired, facilitating improved estimates of ice particle mass, a variable that is an underlying factor for calculating and therefore retrieving the radar reflectivity Ze, median mass diameter Dm, particle terminal velocity, and snowfall rate S. The relationship between the measured ice water content (IWC) and that calculated from the particle size distributions (PSDs) using relationships developed in earlier studies, and between the calculated and measured radar reflectivity at the four radar wavelengths, are quantified. Relationships are derived between the measured IWC and properties of the PSD, Dm, Ze at the four radar wavelengths, and the dual-wavelength ratio. Because IWC and Ze are measured directly, the coefficients in the mass–dimensional relationship that best match both the IWC and Ze are derived. The relationships developed here, and the mass–dimensional relationship that uses both the measured IWC and Ze to find a best match for both variables, can be used in studies that characterize the properties of wintertime snow clouds.

Significance Statement
The goal of this study is to provide reliable microphysical measurements and algorithms to facilitate improvements in cloud model microphysical parameterizations and in retrieval of snow precipitation properties from spaceborne active remote sensors and to characterize ice and snow precipitation development within clouds. This work draws upon a unique set of in situ measurements of the ice and total water content coupled with overflying aircraft radar measurements at four radar wavelengths. Better estimates of the contributions of the ice phase to the total global precipitation using spaceborne radar data pave the way for assessing and advancing global climate modeling, thereby strengthening predictions of global climate change.
Post-evacuation return of psychiatric hospital inpatients evacuated to hospitals outside the Fukushima prefecture after the nuclear accident: A Retrospective Cohort Study
Authors: Terui Toshihiro , Kunii Yasuto , Hoshino Hiroshi , Kakamu Takeyasu , Hidaka Tomoo , Fukushima Tetsuhito , Anzai Nobuo , Gotoh Daisuke , Miura Itaru , Yabe Hirooki 
Published: December 2022

Background: Post-evacuation return after mandatory hospital evacuation due to complicated disasters is often overlooked and not well-discussed. Aims: In this study, we explored the factors which are related to the ease or difficulty of the post-evacuation return to Fukushima prefecture of psychiatric inpatients who had been evacuated to hospitals outside the prefecture because of the Great East Japan Earthquake (GEJE) and subsequent Fukushima Daiichi Nuclear Power Plant (FDNPP) accident. Method: This retrospective cohort study included evacuated psychiatric hospital inpatients who were registered in the Matching Project for Community Transition (MPCT) and had been traced until July 31, 2019. A total of 531 patients were included for the analyses. Univariable and multivariable analysis were conducted to detect the patients’ traits including their psychiatric/physical backgrounds which were associated with their outcome – the time from GEJE to the date of return to Fukushima. Results: Over half of the patients returned to Fukushima. In the multivariable analysis, the patients’ gender (male), age (older), and psychiatric diagnoses of schizophrenia, schizotypal and delusional disorders (ICD-10, F20–29) showed lower hazard ratio (HR) and statistically significant association with the difficulties of post-evacuation return. Meanwhile, disorders of psychological development (F80–89), diseases of the nervous (G00–99, except G40–41) and genitourinary (N00–99) systems showed higher HR and statistically significant association with the ease of return. Conclusions: The specific characteristics of the psychiatric inpatients including their psychiatric and physical status are associated with their post-evacuation return to their hometown. These results indicated that the evacuated hospitals’ practitioners and staffs from the MPCT understood the necessity of the earlier return of inpatients to their hometown. Moreover, clinicians should pay more attention to some symptoms unique to psychiatric patients which contributed to their difficulties in returning safely or expressing their hope to return.
The value of magnetic resonance blood oxygen level-dependent imaging in evaluating the efficacy of advanced cervical cancer combined with radiotherapy and chemotherapy
Authors: Yin Liang , Zhuang Xin , Li Jian-lin 
Published: December 2022

Background Blood oxygen level-dependent magnetic resonance imaging (BOLD-MRI) is an imaging method used to analyze oxygenation status of the tumor. Purpose To investigate the feasibility of BOLD-MRI in evaluating the efficacy of advanced cervical cancer combined with radiotherapy and chemotherapy. Material and Methods This prospective study included 85 patients with advanced cervical cancer who received BOLD-MRI examination before and after concurrent chemoradiotherapy from October 2020 to December 2021. To investigate the changes of baseline R2* values and △R2* values of cervical cancers before and after treatment. Results 29 cases were complete response, 34 cases were partial response, and 22 cases showed progression. The baseline R2* values of the tumors were lower than that of the normal cervical muscle ( P < 0.0001). After oxygen stimulation, the baseline R2* values of the tumors decreased ( P = 0.012). After treatment, the baseline R2* values of the tumors increased ( P = 0.007), and the dynamic △R2* values of the tumors decreased ( P = 0.025). The baseline R2* value of the complete response was the highest ( P = 0.000), the dynamic △R2* value of the complete response was the lowest ( P = 0.017). Conclusion BOLD-MRI can evaluate the efficacy of concurrent chemoradiotherapy for advanced cervical cancer.