bluuebunny/crossref_metadata_2025_split huggingface dataset:
The CORDEX-CORE EXP-I Initiative: Description and Highlight Results from the Initial Analysis
Authors: Giorgi Filippo , Coppola Erika , Jacob Daniela , Teichmann Claas , Abba Omar Sabina , Ashfaq Moetasim , Ban Nikolina , Bülow Katharina , Bukovsky Melissa , Buntemeyer Lars , Cavazos Tereza , Ciarlo` James , da Rocha Rosmeri Porfirio , Das Sushant , di Sante Fabio , Evans Jason P. , Gao Xuejie , Giuliani Graziano , Glazer Russell H. , Hoffmann Peter , Im Eun-Soon , Langendijk Gaby , Lierhammer Ludwig , Llopart Marta , Mueller Sebastial , Luna-Nino Rosa , Nogherotto Rita , Pichelli Emanuela , Raffaele Francesca , Reboita Michelle , Rechid Diana , Remedio Armelle , Remke Thomas , Sawadogo Windmanagda , Sieck Kevin , Torres-Alavez José Abraham , Weber Torsten 
Published: October 2021

Abstract
We describe the first effort within the Coordinated Regional Climate Downscaling Experiment–Coordinated Output for Regional Evaluation, or CORDEX-CORE EXP-I. It consists of a set of twenty-first-century projections with two regional climate models (RCMs) downscaling three global climate model (GCM) simulations from the CMIP5 program, for two greenhouse gas concentration pathways (RCP8.5 and RCP2.6), over nine CORDEX domains at ∼25-km grid spacing. Illustrative examples from the initial analysis of this ensemble are presented, covering a wide range of topics, such as added value of RCM nesting, extreme indices, tropical and extratropical storms, monsoons, ENSO, severe storm environments, emergence of change signals, and energy production. They show that the CORDEX-CORE EXP-I ensemble can provide downscaled information of unprecedented comprehensiveness to increase understanding of processes relevant for regional climate change and impacts, and to assess the added value of RCMs. The CORDEX-CORE EXP-I dataset, which will be incrementally augmented with new simulations, is intended to be a public resource available to the scientific and end-user communities for application to process studies, impacts on different socioeconomic sectors, and climate service activities. The future of the CORDEX-CORE initiative is also discussed.
Blasts from the Past: Reimagining Historical Storms with Model Simulations to Modernize Dam Safety and Flood Risk Assessment
Authors: Mahoney Kelly , McColl Chesley , Hultstrand Douglas M. , Kappel William D. , McCormick Bill , Compo Gilbert P. 
Published: October 2021

Abstract
Accurate estimation of the potential “upper limit” for extreme precipitation is critical for dam safety and water resources management, as dam failures pose significant risks to life and property. Methods used to estimate the theoretical upper limit of precipitation are often outdated and in need of updating. The rarity of extreme events means that old storms with limited observational data are often used to define the upper bound of precipitation. Observations of many important old storms are limited in spatial and temporal coverage, and sometimes of dubious quality. This reduces confidence in flood hazard assessments used in dam safety evaluations and leads to unknown or uncertain societal risk. This paper describes a method for generating and applying ensembles of high-resolution, state-of-the-art numerical model simulations of historical past extreme precipitation events to meet contemporary stakeholder needs. The method was designed as part of a research-to-application-focused partnership project to update state dam safety rules in Colorado and New Mexico. The results demonstrated multiple stakeholder and user benefits that were applied directly into storm analyses utilized for extreme rainfall estimation, and diagnostics were developed and ultimately used to update Colorado state dam safety rules, officially passed in January 2020. We discuss how what started as a prototype research foray to meet a specific user need may ultimately inform wider adoption of numerical simulations for water resources risk assessment, and how the historical event downscaling method performed offers near-term, implementable improvements to current dam safety flood risk estimates that can better serve society today.
Historical changes in the Davis Strait Baffin Bay surface winds and waves, 1979-2016
Authors: Wang Xiaolan L. , Casas-Prat Mercè , Feng Yang , Crosby Alex , Swail Val R. 
Published: October 2021

AbstractThis study presents and analyzes Environment Canada’s Davis Strait Baffin Bay (EC-DSBB) Wind and Wave Reanalysis for the period 1979-2016, to characterize the historical changes in the surface wind speed and ocean surface waves. The trend analysis is carried out only for the months of May-December, when there is a significant ice-free sea area. The results show that 10-meter wind speed (Ws) has increased significantly in most area of the domain in September-December, with some significant decreases over the open water area in June and July. The Ws increases are most extensive in September, with significant increases in both the mean and extremes. It is also shown that the mean wind direction (Wd) has a distinctive seasonal variation, being mainly north- and northwest-ward in June-August, and predominantly south- and southeast-ward in May and September-December. The most notable changes in Wd are seen in June. The results also show that significant wave height (Hs) and wave power (Wp) have significantly increased in September-December and decreased in June. For example, the September regional mean Hs has increased at a rate of 0.4%/year. In September-December, the local Ws increases seem to be the main driver for the Hs and Wp increases, but such southeast-ward direction is favored by increasing fetch as sea ice retreats. In September and December, the positive trend in both Ws and Hs has intensified in the 2001-2016. In June, however, the mean Wd and the changes therein also play an important role in the Hs changes, which are more affected by remotely generated waves.
Asthma Among Adults and Children by Urban–Rural Classification Scheme, United States, 2016-2018
Authors: Guo Zijing , Qin Xiaoting , Pate Cynthia A. , Zahran Hatice S. , Malilay Josephine 
Published: October 2021

Objectives Although data on the prevalence of current asthma among adults and children are available at national, regional, and state levels, such data are limited at the substate level (eg, urban–rural classification and county). We examined the prevalence of current asthma in adults and children across 6 levels of urban–rural classification in each state. Methods We estimated current asthma prevalence among adults for urban–rural categories in the 50 states and the District of Columbia and among children for urban–rural categories in 27 states by analyzing 2016-2018 Behavioral Risk Factor Surveillance System survey data. We used the 2013 National Center for Health Statistics 6-level urban–rural classification scheme to define urban–rural status of counties. Results During 2016-2018, the current asthma prevalence among US adults in medium metropolitan (9.5%), small metropolitan (9.5%), micropolitan (10.0%), and noncore (9.6%) areas was higher than the asthma prevalence in large central metropolitan (8.6%) and large fringe metropolitan (8.7%) areas. Current asthma prevalence in adults differed significantly among the 6 levels of urban–rural categories in 19 states. In addition, the prevalence of current asthma in adults was significantly higher in the Northeast (9.9%) than in the South (8.7%) and the West (8.8%). The current asthma prevalence in children differed significantly by urban–rural categories in 7 of 27 states. For these 7 states, the prevalence of asthma in children was higher in large central metropolitan areas than in micropolitan or noncore areas, except for Oregon, in which the prevalence in the large central metropolitan area was the lowest. Conclusions Knowledge about county-level current asthma prevalence in adults and children may aid state and local policy makers and public health officers in establishing effective asthma control programs and targeted resource allocation.
Optimal design on Watt-chain double-toggle mold clamping mechanism for injection molding machine
Authors: Hsieh Long-Chang , Chen Tzu-Hsia , Lai Po-Cheng , Zheng Sheng-wen 
Published: October 2021

Introduction The mode clamping mechanism is the most important part of forming section for the plastic injection molding machine. If this mechanism has double-toggle effects at the close position, it will get a larger clamping force and have higher safety. This study focuses on the optimal design of the Watt-chain mechanism with double-toggle effects at the close position. Methods The Watt-chain double-toggle mechanism is chosen to be the mold clamping mechanism by referring to the existing patents. Then, the kinematic characteristics of the Watt-chain double-toggle mechanism are analyzed by the vector loop method. Finally, based on the kinematic requirements and the proposed optimal design process according to the objective function, the optimal design on Watt-chain double-toggle mechanism is accomplished in this study. Results This study proposes an optimal design process on Watt-chain double-toggle mold clamping mechanism. By following the optimal design process, the optimal Watt-chain double-toggle mold clamping mechanism has a maximum acceleration 3418 mm/s2 ( amax = 3418 mm/s2) and a force ratio is 2.24 ( Fin/ Fout = 2.24). Discussion According to the studies on the optimal designs of mechanisms, the optimal Watt-chain double-toggle mechanism, which is better than the multiple-joint double-toggle mold clamping mechanism in the existing patent by reducing 19.5% of acceleration and 30% of a driving force, is proposed. The results of this study could be the design reference in engineering when designing mold clamping mechanisms for plastic injection molding machines.
A Systematic Chart Review of Adults with Post-Traumatic Stress Disorder: Data from a Tertiary Care Psychiatry Center in India
Authors: Krishnakumari K. , Munivenkatappa Manjula , Hegde Shantala , Muralidharan Kesavan 
Published: October 2021

Background: Post-traumatic stress disorder (PTSD) is an understudied construct in the psychiatric setting. The majority of existing Indian studies on PTSD focus on the general population or disaster-stricken communities. Here, we present data from a five-year retrospective chart review from a tertiary care psychiatric center in India. Methods: Medical records of adult patients (≥18 years) who had attended psychiatry outpatient services between April 1, 2015 and March 31, 2020 (five years) and were diagnosed with PTSD, as per ICD-10 criteria, were reviewed ( n = 113). The relevant sociodemographic and clinical details were extracted using a semistructured pro forma. Results: The percentage of adult patients with PTSD diagnosis in the five years was 0.22%. PTSD was more common in females (n = 65, 57.5%). Most patients had interpersonal trauma (n = 85, 75.2%), specifically sexual abuse (n = 47, 41.6%).The median age of onset was 22 years. All the patients had re-experiencing symptoms, with an equally high rate of avoidance (n = 109, 96.5%) and arousal symptoms (n = 110, 97.3%). 82%(93) had a comorbid psychiatric disorder, with mood disorder being the most common (n = 44, 38.9%). Males had a higher rate of comorbid substance use disorder (n = 14, 29.2%) and depression (n = 20, 42%), and females had a higher rate of comorbid dissociative disorder (n = 13, 20%). Most of the patients received non-trauma-focused psychological interventions, and only 18% (20) received evidence-based trauma-focused psychological interventions. Conclusion: Interpersonal trauma, specifically sexual abuse, largely contributes to PTSD among adults attending psychiatric services. The need for trauma-focused psychological interventions is underscored.
Don’t Throw Your Heart Away: Increased Transparency of Donor Utilization Practices in Transplant Center Report Cards Alters How Center Performance Is Evaluated
Authors: Butler Alison E. , Chapman Gretchen B. 
Published: October 2021

Background Publicly available report cards for transplant centers emphasize posttransplant survival and obscure the fact that some centers reject many of the donor organs they are offered (reflecting a conservative donor acceptance strategy), while others accept a broader range of donor offers (reflecting an open donor acceptance strategy). Objective We assessed how the provision of salient information about donor acceptance practices and waitlist survival rates affected evaluation judgments of hospital report cards given by laypeople and medical trainees. Methods We tested 5 different report card formats across 4 online randomized experiments ( n1 = 1,003, n2 = 105, n3 = 123, n4 = 807) in the same hypothetical decision. The primary outcome variable was a binary choice between transplant hospitals (one with an open donor acceptance strategy and the other with a conservative donor acceptance strategy). Results Report cards featuring salient information about donor organ utilization rates (transplant outcomes categorized by quality of donor offers accepted) or overall survival rates (outcomes from both waitlist and transplanted patients) led lay participants (studies 1, 3, and 4) and medical trainees (study 2) to evaluate transplant centers with open donor acceptance strategies more favorably than centers with conservative strategies. Limitations Due to the nature of the decision, a hypothetical scenario was necessary for both ethical and practical reasons. Results may not generalize to transplant clinicians or patients faced with the decision of where to join the transplant waitlist. Conclusions These findings suggest that performance evaluations for transplant centers may vary significantly based not only on what outcome information is presented in report cards but also how the information is displayed.
Incorporating diffusion-weighted imaging in a diagnostic algorithm for multiparametric MR mammography
Authors: Vassiou Katerina , Fanariotis Michael , Tsougos Ioannis , Fezoulidis Ioannis 
Published: October 2021

Background Apparent diffusion coefficient (ADC) measurements are not incorporated in BI-RADS classification. Purpose To assess the probability of malignancy of breast lesions at magnetic resonance mammography (MRM) at 3 T, by combining ADC measurements with the BI-RADS score, in order to improve the specificity of MRM. Material and Methods A total of 296 biopsy-proven breast lesions were included in this prospective study. MRM was performed at 3 T, using a standard protocol with dynamic sequence (DCE-MRI) and an extra echo-planar diffusion-weighted sequence. A freehand region of interest was drawn inside the lesion, and ADC values were calculated. Each lesion was categorized according to the BI-RADS classification. Logistic regression analysis was employed to predict the probability of malignancy of a lesion. The model combined the BI-RADS classification and the ADC value. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were calculated. Results In total, 153 malignant and 143 benign lesions were analyzed; 257 lesions were masses and 39 lesions were non-mass-like enhancements. The sensitivity and specificity of the combined method were 96% and 86%, respectively, in contrast to 95% and 81% with BI-RADS classification alone. Conclusion We propose a method of assessing the probability of malignancy in breast lesions by combining BI-RADS score and ADC values into a single formula, increasing sensitivity and specificity compared to BI-RADS classification alone.
Rocuronium Reversal in the Emergency Department: Retrospective Evaluation of Hemodynamic Instability Following Administration of Sugammadex Versus Neostigmine With Glycopyrrolate
Authors: Hile Garrett B. , Healy Karl J. , Almassalkhi Lars R. 
Published: October 2021

Background: Rocuronium is an intermediate-acting non-depolarizing neuromuscular blocking agent frequently used in the emergency department for rapid sequence intubation. The prolonged effects of rocuronium may prevent the ability to conduct a meaningful neurological examination, thereby delaying appropriate diagnosis and treatment. Sugammadex and neostigmine are pharmacologic agents commonly used to reverse rocuronium. The safety of sugammadex versus neostigmine with glycopyrrolate for the reversal of rocuronium in the emergency department has not been well described. Objective: Evaluate the occurrence of hemodynamic instability post-administration of sugammadex versus neostigmine with glycopyrrolate in the emergency department for the reversal of rocuronium. Methods: A retrospective cohort study conducted among adult patients that received sugammadex or neostigmine with glycopyrrolate in the emergency department for the reversal of rocuronium. The primary outcome was occurrence of hemodynamic instability that required escalation of treatment. Secondary outcomes included occurrence of hypotensive, bradycardic, or cardiac arrest events. Results: A total of 37 patients met inclusion criteria (n = 10, sugammadex; n = 27, neostigmine). There was no difference between the two groups in regard to hemodynamic instability that required escalation of treatment within 30 minutes after receiving either sugammadex or neostigmine with glycopyrrolate ( P = .557). Conclusion: There was no difference between the two groups in regard to occurrence of hemodynamic instability that required escalation of treatment. Given the small sample size, future studies are warranted to further delineate the safety of sugammadex and neostigmine with glycopyrrolate for the reversal of rocuronium in the emergency department.
Neuropsychiatric involvement in juvenile-onset systemic lupus erythematosus: Data from the UK Juvenile-onset systemic lupus erythematosus cohort study
Authors: Giani Teresa , Smith Eve MD , Al-Abadi Eslam , Armon Kate , Bailey Kathryn , Ciurtin Coziana , Davidson Joyce , Gardner-Medwin Janet , Haslam Kirsty , Hawley Dan P , Leahy Alice , Leone Valentina , McErlane Flora , Mewar Devesh , Modgil Gita , Moots Robert , Pilkington Clarissa , Pregnolato Francesca , Ramanan Athimalaipet V , Rangaraj Satyapal , Riley Phil , Sridhar Arani , Wilkinson Nick , Cimaz Rolando , Beresford Michael W , Hedrich Christian M ,   on behalf of the UK JSLE Cohort Study
Published: October 2021

Introduction Juvenile-onset systemic lupus erythematosus (JSLE) is a rare autoimmune/inflammatory disease with significant morbidity and mortality. Neuropsychiatric (NP) involvement is a severe complication, encompassing a heterogeneous range of neurological and psychiatric manifestations. Methods Demographic, clinical, and laboratory features of NP-SLE were assessed in participants of the UK JSLE Cohort Study, and compared to patients in the same cohort without NP manifestations. Results A total of 428 JSLE patients were included in this study, 25% of which exhibited NP features, half of them at first visit. Most common neurological symptoms among NP-JSLE patients included headaches (78.5%), mood disorders (48.6%), cognitive impairment (42%), anxiety (23.3%), seizures (19.6%), movement disorders (17.7%), and cerebrovascular disease (14.9%). Peripheral nervous system involvement was recorded in 7% of NP-SLE patients. NP-JSLE patients more frequently exhibited thrombocytopenia (<100 × 109/L) ( p = 0.04), higher C-reactive protein levels ( p = 0.01), higher global pBILAG score at first visit ( p < 0.001), and higher SLICC damage index score at first ( p = 0.02) and last ( p < 0.001) visit when compared to JSLE patients without NP involvement. Conclusions A significant proportion of JSLE patients experience NP involvement (25%). Juvenile-onset NP-SLE most commonly affects the CNS and is associated with increased overall disease activity and damage.
Heritability Analysis in Twins Indicates a Genetic Basis for Velopharyngeal Morphology
Authors: Lee Myoung Keun , Liu Chenxing , Leslie Elizabeth J. , Shaffer John R. , Perry Jamie L. , Weinberg Seth M. 
Published: October 2021

The velopharyngeal mechanism is comprised of several muscular components that act in a coordinated manner to control airflow through the nose and mouth. Proper velopharyngeal function is essential for normal speech, swallowing, and breathing. The genetic basis of normal-range velopharyngeal morphology is poorly understood. The purpose of this study was to estimate the heritability of velopharyngeal dimensions. We measured five velopharyngeal variables (velar length, velar thickness, effective velar length, levator muscle length and pharyngeal depth) from MRIs of 155 monozygotic and 208 dizygotic twin pairs and then calculated heritability for these traits using a structural equation modeling approach. The heritability estimates were statistically significant (95% confidence intervals excluded zero) and ranged from 0.19 to 0.46. There was also evidence of significant genetic correlations between pairs of traits, pointing to the influence of common genetic effects. These results indicate that genetic factors influence variation in clinically relevant velopharyngeal structures.
Impact of the Result of Continued Thrombolysis After Stenting Following Pharmacomechanical Thrombectomy for Iliofemoral Deep Vein Thrombosis—A Retrospective Study
Authors: Zhou Ya-dong , Chen Ying-ying , Xue Ming , Zheng Xue-xun , Chen Xing-sheng , Guan Yun-biao 
Published: October 2021

Objective The aim of this study is to compare the procedure and treatment outcomes of using either direct stenting alone following pharmacomechanical thrombectomy or continued catheter-directed thrombolysis after stenting for treatment of acute left iliofemoral deep vein thrombosis while clot removal degree achieved grade III. Methods From March 2018 to May 2019, 82 patients who underwent iliac venous stenting for treatment of acute left iliofemoral deep vein thrombosis with iliac vein stenosis after pharmacomechanical thrombectomy therapy using the AngioJet system while Clot removal degree achieved grade III were divided into two groups: Direct stenting alone group ( n = 39) and continued catheter-directed thrombolysis after stenting group ( n = 43). Comparisons were made regarding the treatment outcomes, stent patency rate, and Villalta scale between these two groups. Results No serious perioperative complications occurred. The mean urokinase dose and hospitalization time in the stenting alone group and continued catheter-directed thrombolysis after the stenting group were 0.30 million U versus 1.76 ± 0.54 million U and 4.85 ± 0.93 days versus 6.33 ± 1.02 days, ( P < .001). In the first 30 days after the operation, there were 3 recurrent episodes of deep vein thrombosis in the stenting alone group ( P = 0.064). Each patient has completed at least one year of follow-up, the mean follow-up was 15.95 ± 3.44 months. Overall cumulative stent patency rates were 87.2% in stenting alone group and 97.7% in continued catheter-directed thrombolysis after stenting group at 12months ( P = 0.037). The Villalta scores at 12 months had a significant difference between the two groups. The mean Villalta scores in the stenting alone group and continued catheter-directed thrombolysis after the stenting group were 4.44 ± 1.63 and 1.63 ± 1.29, respectively ( P < 0.001). Conclusion When the clot removal degree of pharmacomechanical thrombectomy thrombectomy reaches grade III, both stenting alone and continued catheter-directed thrombolysis after stenting are effective treatment modalities. For young patients with low bleeding risk, continued catheter-directed thrombolysis after stenting has a better patency rate and a lower 1-year post-thrombotic syndrome risk and does not increase major bleeding events. However, it may increase the time and costs of hospitalization accordingly.