bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cutoff Lows, Moisture Plumes, and Their Influence on Extreme-Precipitation Days in Central Chile
Authors: Muñoz Cristian , Schultz David M. 
Published: January 2021

AbstractA study of 500-hPa cutoff lows in central Chile during 1979–2017 was conducted to contrast cutoff lows associated with the lowest quartile of daily precipitation amounts (LOW25) with cutoff lows associated with the highest quartile (HIGH25). To understand the differences between low- and high-precipitation cutoff lows, daily precipitation records, radiosonde observations, and reanalyses were used to analyze the three ingredients necessary for deep moist convection (instability, lift, and moisture) at the eastern and equatorial edge of these lows. Instability was generally small, if any, and showed no major differences between LOW25 and HIGH25 events. Synoptic-scale ascent associated with Q-vector convergence also showed little difference between LOW25 and HIGH25 events. In contrast, the moisture distribution around LOW25 and HIGH25 cutoff lows was different, with a moisture plume that was more defined and more intense equatorward of HIGH25 cutoff lows as compared with LOW25 cutoff lows where the moisture plume occurred poleward of the cutoff low. The presence of the moisture plume equatorward of HIGH25 cutoff lows may have contributed to the shorter persistence of HIGH25 events by providing a source for latent-heat release when the moisture plume reached the windward side of the Andes. Indeed, whereas 48% of LOW25 cutoff lows persisted for longer than 72 h, only 25% of HIGH25 cutoff lows did, despite both systems occurring mostly during the rainy season (May–September). The occurrence of an equatorial moisture plume on the eastern and equatorial edge of cutoff lows is fairly common during high-impact precipitation events, and this mechanism could help to explain high-impact precipitation where the occurrence of cutoff lows and moisture plumes is frequent.
Subtidal to Supertidal Variability of Reynolds Stresses in a Midlatitude Stratified Inner Shelf
Authors: Palóczy André , MacKinnon Jennifer A. , Waterhouse Amy F. 
Published: January 2021

AbstractWe describe the spatiotemporal variability and vertical structure of turbulent Reynolds stresses (RSs) in a stratified inner shelf with an energetic internal wave climate. The RSs are estimated from direct measurements of velocity variance derived from bottom-mounted acoustic Doppler current profilers. We link the RSs to different physical processes, namely, internal bores, midwater shear instabilities within vertical shear events related to wind-driven subtidal along-shelf currents, and nonturbulent stresses related to incoming nonlinear internal wave (NLIW) trains. The typical RS magnitudes are O(0.01) Pa for background conditions, with diurnal pulses of O(0.1–1) Pa, and O(1) Pa for the NLIW stresses. A NLIW train is observed to produce a depth-averaged vertical stress divergence sufficient to accelerate water 20 cm s−1 in 1 h, suggesting NLIWs may also be important contributors to the depth-averaged momentum budget. The subtidal stresses show significant periodic variability and are O(0.1) Pa. Conditionally averaged velocity and RS profiles for northward/southward flow provide evidence for downgradient turbulent momentum fluxes, but also indicate departures from this expected regime. Estimates of the terms in the depth-averaged momentum equation suggest that the vertical divergence of the RSs are important terms in both the cross-shelf and along-shelf directions, with geostrophy also present at leading-order in the cross-shelf momentum balance. Among other conclusions, the results highlight that internal bores and shoaling NLIWs may also be important dynamical players in other inner shelves with energetic internal waves.
MJO-Induced Intraseasonal Mixed Layer Depth Variability in the Equatorial Indian Ocean and Impacts on Subsurface Water Obduction
Authors: Liu Lingling , Li Yuanlong , Wang Fan 
Published: January 2021

AbstractChange of oceanic surface mixed layer depth (MLD) is critical for vertical exchanges between the surface and subsurface oceans and modulates surface temperature variabilities on various time scales. In situ observations have documented prominent intraseasonal variability (ISV) of MLD with 30–105-day periods in the equatorial Indian Ocean (EIO) where the Madden–Julian oscillation (MJO) initiates. Simulation of Hybrid Coordinate Ocean Model (HYCOM) reveals a regional maximum of intraseasonal MLD variability in the EIO (70°–95°E, 3°S–3°N) with a standard deviation of ~14 m. Sensitivity experiments of HYCOM demonstrate that, among all of the MJO-related forcing effects, the wind-driven downwelling and mixing are primary causes for intraseasonal MLD deepening and explain 83.7% of the total ISV. The ISV of MLD gives rise to high-frequency entrainments of subsurface water, leading to an enhancement of the annual entrainment rate by 34%. However, only a small fraction of these entrainment events (<20%) can effectively contribute to the annual obduction rate of 1.36 Sv, a quantification for the amount of resurfacing thermocline water throughout a year that mainly (84.6%) occurs in the summer monsoon season (May–October). The ISV of MLD achieves the maximal intensity in April–May and greatly affects the subsequent obduction. Estimation based on our HYCOM simulations suggests that MJOs overall reduce the obduction rate in the summer monsoon season by as much as 53%. A conceptual schematic is proposed to demonstrate how springtime intraseasonal MLD deepening events caused by MJO winds narrow down the time window for effective entrainment and thereby suppress the obduction of thermocline water.
Measuring the Efficiency of Automation-Aided Performance in a Simulated Baggage Screening Task
Authors: Boskemper Melanie M. , Bartlett Megan L. , McCarley Jason S. 
Published: January 2021

Objective The present study replicated and extended prior findings of suboptimal automation use in a signal detection task, benchmarking automation-aided performance to the predictions of several statistical models of collaborative decision making. Background Though automated decision aids can assist human operators to perform complex tasks, operators often use the aids suboptimally, achieving performance lower than statistically ideal. Method Participants performed a simulated security screening task requiring them to judge whether a target (a knife) was present or absent in a series of colored X-ray images of passenger baggage. They completed the task both with and without assistance from a 93%-reliable automated decision aid that provided a binary text diagnosis. A series of three experiments varied task characteristics including the timing of the aid’s judgment relative to the raw stimuli, target certainty, and target prevalence. Results and Conclusion Automation-aided performance fell closest to the predictions of the most suboptimal model under consideration, one which assumes the participant defers to the aid’s diagnosis with a probability of 50%. Performance was similar across experiments. Application Results suggest that human operators’ performance when undertaking a naturalistic search task falls far short of optimal and far lower than prior findings using an abstract signal detection task.
Ultra-low-dose computed tomography and its utility in wrist trauma in the emergency department
Authors: Tekin Erdal , Tuncer Kutsi , Ozlu Ibrahim , Sade Recep , Pirimoglu Rustem Berhan , Polat Gokhan 
Published: January 2021

Background The use and frequency of computed tomography (CT) are increasing day by day in emergency departments (ED). This increases the amount of radiation exposed. Purpose To evaluate the image quality obtained by ultra-low-dose CT (ULDCT) in patients with suspected wrist fractures in the ED and to investigate whether it is an alternative to standard-dose CT (SDCT). Material and Methods This is a study prospectively examining 336 patients who consulted the ED for wrist trauma. After exclusion criteria were applied, the patients were divided into the study and control groups. Then, SDCT (120 kVp and 100 mAs) and ULDCT (80 kVp and 5 mAs) wrist protocols were applied simultaneously. The images obtained were evaluated for image quality and fracture independently by a radiologist and an emergency medical specialist using a 5-point scale. Results The effective radiation dose calculated for the control group scans was 41.1 ± 2.1 µSv, whereas the effective radiation dose calculated for the study group scans was 0.5 ± 0.0 µSv. The effective radiation dose of the study group was significantly lower than that of the control group ( P < 0.01). The CT images in the study group showed no significant differences in the mean image quality score between observer 1 and observer 2 (3.4 and 4.3, respectively; P = 0.58). Both observers could detect all fractures using the ULDCT images. Conclusion ULDCT provides high-quality images in wrist traumas while reducing the radiation dose by approximately 98% compared to SDCT without any changes in diagnostic accuracy.
Combined treatment with a gastric inhibitory polypeptide receptor antagonist and a peptidyl peptidase-4 inhibitor improves metabolic abnormalities in diabetic mice
Authors: Yang Fei , Dang Shan , LV Hongjun , Shi Bingyin 
Published: January 2021

Objectives Dipeptidyl peptidase-4 inhibition and gastric inhibitory polypeptide (GIP) receptor antagonism have therapeutic effects in type 2 diabetes mellitus. We assessed the effects of sitagliptin and Pro 3 (GIP) in a mouse model of diabetes. Methods Diabetes was induced in C57BL/6J mice by a high-fat diet and intraperitoneal injection of streptozocin. Blood glucose was assessed weekly. Six weeks later, serum triglycerides, total cholesterol and glucose tolerance were assessed and pancreatic and adipose tissues were collected. Results Combination therapy with sitagliptin and Pro 3 (GIP) resulted in significantly greater reductions of blood glucose and triglycerides than either monotherapy. Combination therapy also improved insulin sensitivity and glucose tolerance. β-cell mass and insulin-positive cell percentage in the pancreas was higher in mice receiving combination therapy compared with either monotherapy. Crown-like structures, inflammatory markers in adipose tissue, and serum leptin concentrations were decreased in mice receiving combination therapy compared with either monotherapy. Conclusions Combination therapy with Pro 3 (GIP) and sitagliptin improved metabolic abnormalities in diabetic mice. Changes in serum leptins and reduced inflammatory cell infiltration in adipose tissue might account for the observed effects.
Examining Batting Performance After a Sports-Related Concussion Among Major League Baseball Position Players
Authors: Green Gary , Pollack Porter Keshia M. , Kvit Anton , Conte Stan , D’Angelo John , Valadka Alex , Curriero Frank C. 
Published: January 2021

Background: An ongoing challenge in sports-related concussion (SRC) is determining full recovery. This study examines performance metrics in baseball after an SRC and provides a template for assessment of return-to-performance parameters. Purpose: To determine whether batting performance returns to baseline after an SRC. Study Design: Descriptive epidemiological study. Methods: Participants were all Major League Baseball (MLB) position players with confirmed SRCs that occurred during the 2011-2015 seasons. A retrospective review and assessment of performance metrics before and after injury were conducted as defined relative to the number of plate appearances (PAs) to yield reliable performance statistics. Seven batting metrics were considered as outcomes in longitudinal regressions: batting average, on-base percentage, slugging percentage, on-base plus slugging, bases on balls, strikeouts, and home runs. Metrics were calculated for each player 60, 30, and 14 days before their SRCs, as well as for the 14, 30, and 60 days after returning to play. Other variables controlled for included defensive position, player age at the time of SRC, number of days missed, mechanism of injury, whether the player completed a rehabilitation stint, and year in which the mild traumatic brain injury (MTBI) occurred (2011-2015). Results: A total of 77 MTBI case events occurred in MLB position players over 5 seasons. These injuries resulted in a mean 11.4 days lost to injury. For all performance metrics using 60 or 30 days before MTBI as baseline, no statistically significant differences were found in batting performance. In total, 63 events met PA criteria before injury. Varying the PA cutoff thresholds to be more inclusive or more restrictive yielded similar regression results. For the 48 events that met PA criteria before and after injury, most performance metrics showed no significant performance change after MTBI and, in some events, a slight though mostly nonsignificant performance improvement after MTBI. Conclusions: MLB position players who are medically cleared to return to play after an SRC perform at the same offensive performance levels as their preinjury statistics when an adequate number of PAs is used to compare performance before and after injury.
Successful implementation of telemedicine depends on personal relations between company representatives and healthcare providers: A qualitative study of business models for Danish home telemonitoring
Authors: Korsgaard Frederik , Hasenkam John Michael , Vesterby Martin 
Published: January 2021

The struggle to transform telemedicine from project level to daily clinical practice is ongoing. An assessment of the business models of telemedicine applications could provide insights into how to facilitate this transition. Our aim was to identify the qualitative characteristics of business models of long-term operational telemedicine providers in Denmark. A structured interview study design was applied to interviews of representatives from seven Danish companies providing home telemonitoring in long-term operation. Data was analysed using Osterwalder’s Business Model Canvas framework. Multiple themes emphasized the importance of strong personal relationships between company representatives and healthcare providers. Personal relations could 1) secure a strong relationship to lead users and clinical ambassadors; 2) facilitate work with healthcare providers to develop, test and revise value propositions; 3) promote user support and education; 4) establish an indirect connection between companies and healthcare managers or decision makers. Thus, a strong personal relationship between company representatives and healthcare providers is of paramount importance when integrating home telemonitoring from project stage into clinical practice. However, this strategy could lack patient involvement, use of data, and business scalability. Additionally, companies with the ability to establish strong personal connections could be favoured over companies which provide strong clinical and economic evidence.
Long-term Clinical Results of Carpal Tunnel Release Using Ultrasound Guidance
Authors: Leiby Braeden M. , Beckman John P. , Joseph Anthony E. 
Published: January 2021

Background: The purpose of this study was to determine the long-term safety and efficacy of carpal tunnel release (CTR) using ultrasound guidance in a group of patients treated by a single physician. Methods: The study group consisted of 76 consecutive CTRs performed on 47 patients between June 2017 and April 2019 for whom 1-year follow-up was available. All procedures were performed by the same operator using a single CTR technique. Outcomes included complications; Boston Carpal Tunnel Questionnaire symptom severity (BCTQ-SSS) and functional status (BCTQ-FSS) scores; Quick Disabilities of the Arm, Shoulder, and Hand (QDASH) scores; and a 5-point global satisfaction score (4 = satisfied, 5 = very satisfied). Results: The 47 patients included 27 females and 20 males (ages 31-91 years). Twenty-five patients (50 hands) had simultaneous bilateral CTRs, 4 patients (8 hands) had staged bilateral CTRs, and 18 patients had unilateral CTRs. No complications occurred. Statistically and clinically significant reductions in BCTQ-SSS, BCTQ-FSS, and QDASH scores occurred by 1 to 2 weeks post-CTR and persisted at 1-year (mean 1-year changes vs. pre-CTR -2.11, -1.70, and -44.99, respectively; P < .001 for all). The mean global satisfaction score at 1-year was 4.63. Conclusions: CTR using ultrasound (US) guidance is a safe and effective procedure that produces statistically and clinically significant improvements within 1 to 2 weeks postprocedure that persist to 1 year. Furthermore, simultaneous bilateral CTRs using US guidance are feasible and may be advantageous for patients who are candidates for bilateral CTR.
Effectiveness of Quickcast Versus Custom-Fabricated Thermoplastic Orthosis Immobilization for the Treatment of Mallet Fingers: A Randomized Clinical Trial
Authors: Cavanaugh Priscilla K. , Watkins Cynthia , Jones Christopher , Maltenfort Mitchell G. , Beredjiklian Pedro K. , Rivlin Michael 
Published: January 2021

Background: Mallet finger is a common injury involving a detachment of the terminal extensor tendon from the distal phalanx. This injury is usually treated with immobilization in a cast or splint. The purpose of this study is to compare outcomes of mallet fingers treated with either a cast (Quickcast) or a traditional thermoplastic custom-fabricated orthosis. Methods: Our study was a prospective, assessor-blinded, single-center randomized clinical trial of 58 consecutive patients with the diagnosis of bony or soft tissue mallet finger treated with immobilization. Patients were randomized to either an orfilight thermoplastic custom-fabricated orthosis or a Quickcast orthosis. Patients were evaluated at 3, 6, and 10 weeks for bony and 4, 8, and 12 weeks for soft tissue mallets. Skin complications, pain with orthosis, compliance, need for surgical intervention, and extensor lag were compared between the 2 groups. Results: Both bony and soft tissue mallet finger patients experienced significantly less skin complications (33% vs 64%) and pain (11.2 vs 21.6) when using Quickcast versus an orfilight thermoplastic custom-fabricated orthosis. The soft tissue mallet group revealed a greater difference in pain, favoring Quickcast (6.2 vs 22). No significant difference in final extensor droop or need for secondary surgery was found between the 2 groups. Conclusions: Quickcast immobilization for the treatment of mallet finger demonstrated fewer skin complications and less pain compared with orfilight custom-fabricated splints.
Successful flow diversion treatment of ruptured infectious middle cerebral artery aneurysms with the use of Pipeline Flex with Shield technology
Authors: Samples Derek C , Ravindra Vijay M , Thoms Dewey J , Tarasiewicz Izabela , Grandhi Ramesh 
Published: January 2021

Background Rupture of infectious intracranial aneurysms (IIAs) is associated with a high likelihood of mortality. Endovascular treatment of IIAs via parent artery sacrifice offers good efficacy and outcomes; however, depending on the lesion’s location, neurologic deficit may result. Case description We describe a pediatric patient with ruptured IIAs off the left middle cerebral artery (MCA) treated with coil embolization and endovascular flow diversion using the Pipeline Flex Embolization Device (PED) with Shield technology. We chose to place a flow diverter because 1) there was a second, more distal IIA not amenable to direct coil embolization, 2) there was significant potential for aneurysm regrowth and need for retreatment, and 3) we believed the diseased parent MCA needed to be reconstructed. Conclusions In the setting of previous hemicraniectomy, PED-Shield gave us the option to discontinue dual antiplatelet therapy should the patient require further neurosurgical intervention. Our case supports a role for PED-Shield to address ruptured pseudoaneurysms.
Sustained clinical response and safety of etanercept in patients with early axial spondyloarthritis: 10-year results of the ESTHER trial
Authors: Proft Fabian , Weiß Anja , Torgutalp Murat , Protopopov Mikhail , Rodriguez Valeria Rios , Haibel Hildrun , Behmer Olaf , Sieper Joachim , Poddubnyy Denis 
Published: January 2021

Aims: Long-term data on TNFi treatment in patients with axSpA is scarce. The objective of this analysis was to assess long-term clinical efficacy of etanercept in early axSpA [including both non-radiographic and radiographic axSpA forms], who participated in the long-term (until year 10) extension of the ESTHER-trial. Methods: In the previously reported ESTHER-trial, patients with early active axSpA were randomized to treatment with etanercept ( n = 40) or sulfasalazine ( n = 36) during the first year. Patients in remission discontinued their therapy and were followed up until the end of year 2; in case of remission-loss, etanercept was (re)-introduced and continued until the end of year 10. If remission was not achieved at year 1, patients continued receiving (or were switched to) etanercept for up to 10 years. Results: A total of 19 patients (12 with r-axSpA and 7 with nr-axSpA at baseline) out of the initial 76 patients (= 25%) completed year 10 of the study. In the entire group, a sustained clinical response was seen over 10 years of follow up in the as-observed analysis. Completers were significantly more often male and showed lower values of patient and physician global assessments of disease activity, Ankylosing Spondylitis Disease Activity Score (ASDAS), and Ankylosing Spondylitis Quality of Life questionnaire (ASQoL) scores at baseline as compared with non-completers. When analyzing clinical data of the completers, mean Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI) values were constantly below 2 and mean ASDAS below 2.1 during follow up with no statistically significant differences between the r-axSpA and nr-axSpA subgroups. A total of 39 serious adverse events were documented over the 10 years, while six of them were seen as possibly associated with the etanercept treatment, which led in five patients to treatment discontinuation. Conclusion: A sustained clinical response was observed over the 10 years of the study with comparable response and drop-out rates between r-axSpA and nr-axSpA. Etanercept was well tolerated across the entire treatment period and showed a good safety profile with no new safety signals.
Outcomes Following the Use of Subtalar Arthroereisis in the Correction of Adult Acquired Flatfoot: A Systematic Review
Authors: Baryeh Kwaku Wiredu , Ismail Hiba , Sobti Anshul , Harb Ziad 
Published: January 2021

Background Adult acquired flatfoot deformity (AAFD) is a condition affecting approximately 3% of the adult population. It can lead to severe morbidity, and therefore, prompt treatment is of the upmost importance in maintaining and restoring function. Recently, the use of subtalar arthroereisis has become more widespread in the treatment of AAFD. The purpose of this systematic review is to examine the clinical and radiological outcomes of AAFD when treated with subtalar arthroereisis. Methods Studies involving the use of subtalar arthroereisis for the management of AAFD were reviewed, and appropriate studies selected based on inclusion and exclusion criteria. Studies were reviewed for both clinical and radiological outcomes following the use of subtalar arthroereisis as well as reported complications. Results Nine studies met our inclusion criteria, with most of these involving stage II AAFD. A total of 190 subtalar arthroereisis procedures were performed with all studies demonstrating improvement in both clinical and radiological scores with a low rate of complications. Conclusion Subtalar arthroereisis may have benefits when used as an adjunct to treat stage II AAFD. However, more high-quality studies are needed to establish its best use. Levels of Evidence: Level IV: Systematic review