bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urbanization-Induced Land and Aerosol Impacts on Storm Propagation and Hail Characteristics
Authors: Lin Yun , Fan Jiwen , Jeong Jong-Hoon , Zhang Yuwei , Homeyer Cameron R. , Wang Jingyu 
Published: December 2020

AbstractChanges in land surface and aerosol characteristics from urbanization can affect dynamic and microphysical properties of severe storms, thus affecting hazardous weather events resulting from these storms such as hail and tornadoes. We examine the joint and individual effects of urban land and anthropogenic aerosols of Kansas City on a severe convective storm observed during the 2015 Plains Elevated Convection At Night (PECAN) field campaign, focusing on storm evolution, convective intensity, and hail characteristics. The simulations are carried out at the cloud-resolving scale (1 km) using a version of WRF-Chem in which the spectral-bin microphysics (SBM) is coupled with the Model for Simulating Aerosol Interactions and Chemistry (MOSAIC). It is found that the urban land effect of Kansas City initiated a much stronger convective cell and the storm got further intensified when interacting with stronger turbulence induced by the urban land. The urban land effect also changed the storm path by diverting the storm toward the city, mainly resulting from enhanced urban land-induced convergence in the urban area and around the urban–rural boundaries. The joint effect of urban land and anthropogenic aerosols enhances occurrences of both severe hail and significant severe hail by ~20% by enhancing hail formation and growth from riming. Overall the urban land effect on convective intensity and hail is relatively larger than the anthropogenic aerosol effect, but the joint effect is more notable than either of the individual effects, emphasizing the importance of considering both effects in evaluating urbanization effects.
Outcome of Surgical Management of Pancreas Neoplasms in a Large Community Hospital
Authors: Biswas Sukanto , Udekwu Pascal , Stiles Anquonette , Roy Sara 
Published: December 2020

Background Outcomes of complex pancreatic procedures have been used as an index for quality, and higher volume has been associated with improved outcomes, leading to advocacy for referral to those centers. The aim of the study was to evaluate the outcomes of pancreaticoduodenectomy (PD) at a low-volume referral center. Materials and Methods This retrospective study included patients who had a PD within a 7-year period. Operative performance parameters and outcomes were examined. Results Overall, there were 47 pancreatic resections, of which 38 met the inclusion criteria and were used for analyses. The overall median for blood loss, packed red blood cells units transfused, and postoperative days in hospital was as follows, respectively: 675 mL (interquartile range [IQR] = 500-900), 0 units (IQR = 0-2), 12 days (IQR = 9-18). Demographic characteristics, comorbidities, and complications align with the literature. The 30-day in-hospital mortality rate was 5%. Survival probability for those with pancreatic adenocarcinoma at 1 year was 52% and 7% for years 2 and 3. Discussion As cases increased, significant improvement was noted in process outcomes including blood loss, blood transfusion rates, and length of stay (LOS). Survival was comparable to that in the literature, with limitation of not being adjusted for adjuvant therapy. Outcomes of complex pancreatic procedures, like PD, at a low-volume center with commitment and adequate support systems, can match those at high-volume centers.
Does Wound Management Technique Impact Surgical Site Infection in Open Emergency Colon Procedures?
Authors: Turcotte Justin J. , Boord Andrea , Antognoli Lauren , Klune J. Robert , Feather Cristina B. 
Published: December 2020

Background Emergency open large bowel procedures have higher rates of intraoperative contamination and increased risk of surgical site infection (SSI) than elective colon surgeries. Several wound management strategies have been proposed, such as vacuum-assisted closure (VAC) therapy and delayed primary closure to improve results. The purpose of this study is to evaluate the relationship between wound management technique and SSI and other quality measures. Methods We performed a retrospective review of patients undergoing open emergency colon surgery from January 2017 to December 2018 by our acute care surgery service. The primary outcome measure was incidence of SSI. Secondary outcome measures included length of stay, reoperation, and 30-day readmission. Results A total of 118 patients were included in the study, with a mean age of 62.8 years and mean BMI of 28.8. Overall incidence of SSI was 19.5%. There was no significant difference in incidence of SSI, reoperation, or 30-day readmission when stratifying by wound management technique or procedure type after controlling for confounding variables. Notably, patients managed with VAC therapy had a statistically significant longer average length of stay and higher total postoperative antibiotic days (both P = .001) than other techniques. Discussion We conclude from our data that wound management technique does not seem to influence rate of SSI, but wound management may influence length of stay or antibiotic duration. These findings suggest that there may not be an advantage to alternative methods of wound management in this high-risk population. Further prospective evaluation should be performed to confirm these findings.
Preservation of the Arterial Arc Formed by Left Colic Artery, Proximal Inferior Mesenteric Artery, and the First Branch of Sigmoid Arteries in Anus Saving Treatment of Low Rectal Cancer
Authors: Shaibu Zakari , Chen Zhi-hong , Theophilus Acquah , Mzee Said A. S. 
Published: December 2020

Background Low anterior, ultralow anterior, and intersphincteric resection are conventional, elective anus-sparing techniques for low rectal cancer, and good prognosis depends on a good blood supply and tension-free anastomosis. Aim The goal is to assess the effect of preserving the arc formed by the left colic and proximal inferior mesenteric arteries (IMAs), and first branch of the sigmoid arteries on the anastomotic blood supply, tension, and leakage rate in anus-sparing surgery for low rectal cancer. Method From 2011 to 2020, a patient with low rectal cancer resection was distributed into the ligation group (42 cases with inferior mesenteric artery ligation) and the preservation group (61 cases with preservation of the left colic and proximal IMAs and first branch of the sigmoid artery). Results We evaluated patient characteristics, operative results, morbidity, and postoperative follow-up results. There were comparable outcomes between ligation and preservation groups in relations to the number of patients in each operative procedure, duration of surgery, operative blood loss, postoperative hospital stay, and the number of patients with protective stoma ( P >.05). In postoperative morbidity, there were similar outcomes between ligation and preservation groups in terms of anastomotic subclinical dehiscence, bleeding and stricture, and urinary retention ( P >.05). There were significant differences in anastomotic leakage and intra-abdominal abscess ( P < .05). Conclusion Preservation of the arterial arc formed by left colic artery, proximal IMA, and the first branch of sigmoid arteries with apical lymph node dissection could increase anastomotic blood supply, reduce anastomotic tension, and leakage rate in anus-saving treatment of low rectal cancer.
Core Strength Training Can Alter Neuromuscular and Biomechanical Risk Factors for Anterior Cruciate Ligament Injury
Authors: Jeong Jiyoung , Choi Dai-Hyuk , Shin Choongsoo S. 
Published: December 2020

Background: Core stability is influential in the incidence of lower extremity injuries, including anterior cruciate ligament (ACL) injuries, but the effects of core strength training on the risk for ACL injury remain unclear. Hypothesis: Core muscle strength training increases the knee flexion angle, hamstring to quadriceps (H:Q) coactivation ratio, and vastus medialis to vastus lateralis (VM:VL) muscle activation ratio, as well as decreases the hip adduction, knee valgus, and tibial internal rotation angles. Study Design: Controlled laboratory study. Methods: A total of 48 male participants were recruited and randomly assigned to either the intervention group (n = 32) or the control group (n = 16). Three-dimensional trunk, hip, knee, and ankle kinematic data and muscle activations of selected trunk and lower extremity muscles were obtained while the participants performed side-step cutting. The core endurance scores were measured before and after training. Two-way analyses of variance were conducted for each dependent variable to determine the effects of 10 weeks of core strength training. Results: The trunk endurance scores in the intervention group significantly increased after training ( P < .05 for all comparisons). The intervention group showed decreased knee valgus ( P = .038) and hip adduction angles ( P = .032) but increased trunk flexion angle ( P = .018), rectus abdominis to erector spinae coactivation ratio ( P = .047), H:Q coactivation ratio ( P = .021), and VM:VL activation ratio ( P = .016). In addition, the knee valgus angle at initial contact was negatively correlated with the VM:VL activation ratio in the precontact phase ( R2 = 0.188; P < .001) but was positively correlated with the hip adduction angle ( R2 = 0.120; P < .005). No statistically significant differences were observed in the trunk endurance scores, kinematics, and muscle activations for the control group. Conclusion: Core strength training altered the motor control strategies and joint kinematics for the trunk and the lower extremity by increasing the trunk flexion angle, VM:VL activation ratio, and H:Q activation ratio and reducing the knee valgus and hip adduction angles. Clinical Relevance: Training core muscles can modify the biomechanics associated with ACL injuries in a side-step cutting task; thus, core strength training might be considered in ACL injury prevention programs to alter the lower extremity alignment in the frontal plane and muscle activations during sports-related tasks.
Functional, Magnetic Resonance Imaging, and Second-Look Arthroscopic Outcomes After Pullout Repair for Avulsion Tears of the Posterior Lateral Meniscus Root
Authors: Zhuo Hongwu , Pan Ling , Xu Yangkai , Li Jian 
Published: December 2020

Background: Little data exist in the literature regarding second-look arthroscopic outcomes after pullout repair for avulsion tears of the posterior lateral meniscus root. Purpose: To (1) assess the functional, magnetic resonance imaging (MRI), and second-look arthroscopic outcomes after pullout repair for avulsion tears of the posterior lateral meniscus root; (2) determine which demographic and clinical factors influenced healing of the repaired posterior lateral meniscus root; and (3) compare outcomes between different meniscal healing status groups. Study Design: Case series; Level of evidence, 4. Methods: A total of 31 patients underwent pullout repair for avulsion tears of the posterior lateral meniscus root and had a minimum 2-year follow-up. Functional outcomes were assessed using patient-reported scores (Lysholm, Tegner, and International Knee Documentation Committee [IKDC] scores). Lateral meniscal extrusion, cartilage degeneration of the lateral compartment, and healing of the repaired posterior lateral meniscus root were assessed via MRI. The healing status was also assessed using second-look arthroscopic surgery, and the patients were divided into different healing status groups. Results: The postoperative patient-reported scores improved significantly compared with the preoperative values ( P = .001). Lateral meniscal extrusion was reduced significantly from 3.37 ± 0.82 mm preoperatively to 0.63 ± 0.80 mm at final follow-up ( P = .001). The grade of cartilage degeneration of the lateral compartment progressed from 0.69 ± 0.67 preoperatively to 0.95 ± 0.83 at final follow-up ( P = .213). MRI scans showed complete healing in 28 patients (90.3%) and partial healing in 3 patients (9.7%). Second-look arthroscopic surgery showed stable healing in 18 of 23 patients (78.3%) and lax healing in 5 of 23 patients (21.7%). Patients with stable healing had significantly higher Lysholm and IKDC scores, more reduction of meniscal extrusion, and less progression of cartilage degeneration than did patients with lax healing ( P < .05). Concomitant anterior cruciate ligament reconstruction was found to significantly positively influence healing of the repaired posterior lateral meniscus root ( P = .047). Conclusion: Pullout repair for avulsion tears of the posterior lateral meniscus root yielded significantly improved patient-reported scores, reduced meniscal extrusion, and a satisfactory healing rate at final follow-up. Patients with stable healing had significantly better functional and MRI outcomes than did patients with lax healing.
A Scoping Review of Resilience-Focused Interventions of Kunjing Children in Mainland China
Authors: Wang Miao , Zhang Qingzhu , Fan Yao , Hong Jun Sung 
Published: December 2020

Purpose: Kunjing children refer to those who endure harsh living conditions due to family poverty, health problems, and lack of parental care in Mainland China. This scoping review aims to explore interventions promoting the resilience of kunjing children in China. Method: Both Chinese and English studies published by January 2020 were reviewed through a comprehensive search of articles in Web of Science and Chinese National Knowledge Infrastructure. Empirical studies targeting resilience-focused interventions for kunjing children in China were selected. Results: A total of 12 studies were reviewed. Seven studies tested interventions involving only kunjing children, and the other five involved both children and parents/caregivers. Children with health problems and those who lack parental care participated in the programs, but children in poverty were absent. Group-based interventions were the most commonly used programs, which were effective. Conclusion: The current state of intervention studies calls for programs that promote resilience of kunjing children and their parents/caregivers.
Characteristics and Academic Productivity Among Pediatric Plastic Surgeons in the United States
Authors: Egro Francesco M. , Williams Abraham A. , Roy Eva , Smith Brandon T. , Goldstein Jesse A. , Losee Joseph E. , Nguyen Vu T. 
Published: December 2020

Background: The characteristics that predispose plastic surgeons to a career in pediatric plastic surgery remain unclear. Therefore, the aim of this study is to analyze the characteristics of current pediatric plastic surgeons and to determine their academic productivity. Methods: Pediatric plastic surgeons were identified through an internet search of all academic children’s hospitals affiliated with an Accreditation Council for Graduate Medical Education–accredited integrated or independent plastic surgery program. Demographics, training background, institutional and leadership positions, and academic productivity were determined. Results: A total of 304 pediatric plastic surgeons were identified. The majority of pediatric plastic surgeons were white (n = 217, 71.8%) males (n = 235, 77.6%). Clinical fellowships were completed by 86.8% (n = 263) of the cohort, with craniofacial (n = 181, 59.7%) being the most common followed by hand (n = 54, 17.8%); 41.1% had clinical fellowship training at 10 institutions, with the top 3 most represented programs being University of Pennsylvania (n = 19, 6.2%), University of California-Los Angeles (n = 16, 5.3%), and Harvard University (n = 15, 4.9%); 25.7% (n = 78) held leadership positions within their institutions. A significant higher academic productivity was found among research fellowship-trained surgeons, chiefs of pediatric plastic surgery, fellowship directors, and members of departments of plastic surgery. Those who completed an independent residency had a significant higher H-index and number of citations. Conclusion: Pediatric plastic surgery is represented by surgeons of diverse training background. An elite cohort of programs has trained the most pediatric plastic surgeons. Lastly, high academic productivity was found to be correlated with certain demographic and leadership variables highlighting its impact on career advancement.
Development of an Intraoperative Pipeline for Holographic Mixed Reality Visualization During Spinal Fusion Surgery
Authors: Buch Vivek P. , Mensah-Brown Kobina G. , Germi James W. , Park Brian J. , Madsen Peter J. , Borja Austin J. , Haldar Debanjan , Basenfelder Patricia , Yoon Jang W. , Schuster James M. , Chen Han-Chiao I. 
Published: December 2020

Objective. Holographic mixed reality (HMR) allows for the superimposition of computer-generated virtual objects onto the operator’s view of the world. Innovative solutions can be developed to enable the use of this technology during surgery. The authors developed and iteratively optimized a pipeline to construct, visualize, and register intraoperative holographic models of patient landmarks during spinal fusion surgery. Methods. The study was carried out in two phases. In phase 1, the custom intraoperative pipeline to generate patient-specific holographic models was developed over 7 patients. In phase 2, registration accuracy was optimized iteratively for 6 patients in a real-time operative setting. Results. In phase 1, an intraoperative pipeline was successfully employed to generate and deploy patient-specific holographic models. In phase 2, the registration error with the native hand-gesture registration was 20.2 ± 10.8 mm (n = 7 test points). Custom controller-based registration significantly reduced the mean registration error to 4.18 ± 2.83 mm (n = 24 test points, P < .01). Accuracy improved over time (B = −.69, P < .0001) with the final patient achieving a registration error of 2.30 ± .58 mm. Across both phases, the average model generation time was 18.0 ± 6.1 minutes (n = 6) for isolated spinal hardware and 33.8 ± 8.6 minutes (n = 6) for spinal anatomy. Conclusions. A custom pipeline is described for the generation of intraoperative 3D holographic models during spine surgery. Registration accuracy dramatically improved with iterative optimization of the pipeline and technique. While significant improvements and advancements need to be made to enable clinical utility, HMR demonstrates significant potential as the next frontier of intraoperative visualization.
Incidence and Risk Factors for Complications and Mortality After Vertebroplasty or Kyphoplasty in the Osteoporotic Vertebral Compression Fracture—Analysis of 1,932 Cases From the American College of Surgeons National Surgical Quality Improvement
Authors: Kim Ho-Joong , Zuckerman Scott L. , Cerpa Meghan , Yeom Jin S. , Lehman Ronald A. , Lenke Lawrence G. 
Published: December 2020

Study Design: Retrospective cohort. Objective: The purpose was to investigate the incidence of and risk factors for complications associated with vertebroplasty (VP) or kyphoplasty (KP) for osteoporotic vertebral compression fracture (OVCF) using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Methods: A cohort of patients undergoing VP/KP was constructed from the 2011-2013 ACS-NSQIP dataset using Current Procedural Terminology (CPT) codes. The incidences of minor complications (i.e. urinary tract infection, pneumonia, renal insufficiency, superficial infection, wound dehiscence), major complications (i.e. reoperation, deep vein thrombosis, pulmonary embolism, sepsis, dialysis, cardiac arrest, deep infection, stroke), and mortality within 30 days post-surgery were investigated, and their risk factors were assessed using logistic regression modeling. Results: Of 1932 patients undergoing VP/KP, 166 (8.6%) experienced a complication, including minor complications in 53 (2.7%), major complications in 95 (4.9%), and death in 40 (2.1%). Multivariate logistic regression analysis indicated that the adjusted odds ratios (95% confidence interval [CI]) of mortality was significantly associated with ASA 4: 16.604 (1.956-140.959) and increased creatinine (≥ 1.3 mg/dL): 3.494 (1.128-10.823). History of chronic obstructive pulmonary disease was associated with minor complications. Increased WBC count and hypoalbuminemia (<3.0 g/dL) were also associated with major complications. Conclusions: The major complication and mortality rates associated with VP/KP were 4.9% and 2.1% respectively, higher than previous reports. Increased creatinine and ASA 4 were independently associated with mortality after VP/KP. Therefore, cautious monitoring and counseling is needed for elderly, patients with preexisting kidney disease or ASA 4 undergoing VP/KP.
E-cigarette or vaping product use–associated lung injury and state-level cannabis policies
Authors: Smith Danielle M. , Goniewicz Maciej L. 
Published: December 2020

Abstract
Background
Multiple cases of e-cigarette or vaping product use–associated lung injury (EVALI) have been reported in the USA, which have been attributed to informally obtained cannabis oil vaping devices. This report estimated whether cumulative incidence of EVALI differed according to state-level cannabis policy.

Methods
Publicly available information was used to estimate the cumulative incidence of EVALI. Odds of incident EVALI were calculated according to policy status (active, legal adult-use recreational policy vs. no legal access). Figures were statistically compared using chi-square tests.

Results
Estimated cumulative incidence of EVALI was 5.19 per 100,000 cannabis users across all states with recreational cannabis policies (95% CI 4.70–5.72), and 15.89 per 100,000 cannabis users across all states with no legal access to cannabis (95% CI 14.88–16.96). Odds of EVALI were 3.06 times higher (95% CI 2.71–3.45) among users living in states with no legal access to cannabis compared to users in states with active recreational policies, with significant differences detected according to policy exposure (χ2 = 385.57, p < 0.0001).

Conclusions
Estimates suggest there may have been a protective effect of state-level, recreational adult-use cannabis policies on incident EVALI. Effects of specific state-level regulations (e.g., laboratory testing, product quality standards, tracking systems) should be considered alongside additional geographic indices in future assessments of EVALI causes.
A variational principle for the (3 + 1)-dimensional extended quantum Zakharov-Kuznetsov equation in plasma physics
Authors: Wang Kang-Jia 
Published: December 2020

AbstractThe Zakharov-Kuznetsov equation plays a key role in the plasma physics, and its solution has always been a hot topic, however its variational principle has not been studied. So this paper develops a variational formulation for the (3+1)-dimensional extended quantum Zakharov-Kuznetsov equation by the semi-inverse method, which shows an energy conservation law for the dust-ion-acoustic solitary waves in a magnetized two-ion-temperature dusty plasma. The whole derivation process is presented in detail. The obtained results in this paper are expected to shed a bright light on the study of theoretical basis for the magnetized plasma.
Cascade or not cascade? Energy transfer and elastic effects in active nematics
Authors: Carenza L. N. , Biferale L. , Gonnella G. 
Published: December 2020

Abstract
We numerically study the multi-scale properties of a 2d active gel to address the energy transfer mechanism. We find that activity is able to excite long-ranged distortions of the nematic pattern giving rise to spontaneous laminar flows and to a chaotic regime by further increasing the rate of active energy injection. By means of a scale-to-scale spectral analysis we find that the gel is basically driven by the local balancing between active injection and viscous dissipation, without any signal of non-linear hydrodynamical transfer and turbulent cascades. Furthermore, elasticity may qualitatively play an important role by transferring energy from small to larger scales through nemato-hydrodynamic interactions.