bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sensitivity Analysis and Validation of WRF-ARW Parameterizations for Potential Solar and Wind Energy Sources over Malaysia
Authors: Adomako Abigail Birago , Yusup Yusri , Elsebakhi Emad , Jaafar Mohd Hafiidz , Ishak Muhammad Izzuddin Syakir , Hwee San Lim , Ahmad Mardiana Idayu 
Published: October 2024

Abstract
This study investigates how accurately the Weather Research and Forecasting (WRF) simulation anticipates the viability of renewable energy options in Malaysia, with specific attention paid to wind and solar power potential. Due to Malaysia’s transition toward sustainable energy, precise forecasting is essential for grid stability and efficient integration. The research used simulations across East and West Malaysia for October 2022 with varying parameterization schemes to determine the most suitable configurations for accurate energy predictions. Eleven unique scheme permutations were analyzed against Mesonet, ERA5-Land, and Centre for Marine and Coastal Studies (CEMACS) datasets. The results revealed that certain permutations, specifically run 9 and run 10, significantly reduced the root-mean-square error (RMSE) for predicting radiation and wind speed outputs, indicating higher accuracy in simulations. The two best runs were then validated for November 2022 and used to estimate wind (run 10: WRF single-moment 6-class microphysics, RRTMG longwave radiation, Dudhia shortwave radiation, unified Noah land surface model, MYJ PBL, Eta surface layer, and new Tiedtke cumulus schemes) and solar photovoltaic (run 9: Morrison 2-moment microphysics, CAM longwave radiation, RRTMG shortwave radiation, unified Noah land surface model, MYJ PBL, and Eta surface layer schemes) potential maps over CEMACS and Kuching locations. Solar photovoltaic energy was estimated at a total of 3165 and 3379 kWh for CEMACS and Kuching, respectively, and a good potential overall, ranging from about 5500 to 7881 kWh, while wind energy had a much more variability appearance of 115 936 and 6250 kWh for CEMACS and Kuching, respectively. This study highlights the potential for targeted weather forecasting models to enhance the reliability and integration of renewable energy sources into national grids.

Significance Statement
This study explores the effective use of weather forecasting models to enhance renewable energy generation in Malaysia, a region increasingly focusing on sustainable energy solutions. By analyzing and validating various weather model configurations, this research provides vital information for selecting optimal settings for accurate predictions of solar and wind energy potential. This crucial advancement, which effectively integrates renewable energy into power grids to reliably provide a steady and efficient flow of energy, is essential for moving progressively closer to a more sustainable and eco-friendly energy. The results of this study both enhance scientific comprehension of atmospheric simulations utilized in energy sectors and carry meaningful consequences for policy formation and renewable infrastructure evolution within tropical regions.
Do Remittances Finance Clean Energy in Bangladesh? Evidence from a Natural Experiment
Authors: Hassan Gazi M. , Mahmud Sakib 
Published: October 2024

Using a natural experiment of rainfall-driven remittances, we provide experimental measures of remittances’ effect on rural households’ choice of cylinder gas (LPG) as a cooking fuel in Bangladesh. We use the instrumental variable probit (IV-Probit) approach. The treatment of remittances is randomly assigned to households that suffered losses due to a natural shock from the cyclone-Roanu enabling the instrument to identify the average treatment effect for the treatment group (cyclone-affected remittances recipient households). We find that an exogenous increase in remittances by 1,000 Taka causes the probability of using LPG to rise by 1 percent. The impact of remittances is conditional on the household’s health expenditures. Remittances’ impact on the households’ likelihood of using LPG gets stronger with access to clean water and sanitary toilets. The results are robust to potential violations of the exclusion restriction, alternative specifications and instruments, and possibly omitted variable bias. We recommend policies that should utilize overseas migrant remittances as a strategic tool in formulating a financial, legal, and regulatory framework to achieve SDG 7 by 2030. JEL Classifications: F24, Q40, R20.
Outcomes of fenestration versus none in extracardiac total cavopulmonary connection
Authors: Taksaudom Noppon , Horsatidkul Jakaparn , Tepsuwan Thitipong , Tantraworasin Apichat , Sittiwangkul Rekwan , Phothikun Amarit 
Published: October 2024

Background Fenestrated total cavopulmonary connection has gained popularity due to its capacity to reduce systemic venous pressure and enhance cardiac output. However, there is ongoing debate about the immediate and long-term advantages of fenestration in this context. Method A retrospective cohort study was conducted involving 97 patients who underwent extracardiac total cavopulmonary connection at Chiang Mai University Hospital between January 1999 and December 2019. The patients were initially categorized into two groups: fenestrated ( n = 71) and nonfenestrated ( n = 26). After exclusion and reassignment, the long-term outcomes were analyzed for the fenestrated ( n = 68) and nonfenestrated ( n = 25) groups. To address potential confounding factors between the two groups, propensity scores were computed using logistic regression analysis. Results The study found no significant differences in preoperative and operative data. Immediate postoperative outcomes showed no significant variations in major complications, intensive care unit stay, oxygen saturation, and posttotal cavopulmonary connection pressure. In the long-term assessment, the fenestrated group demonstrated significantly lower rates of mortality, protein-losing enteropathy, liver mass, and cirrhosis. However, after employing a multilevel model stratified by propensity score analysis, only long-term mortality rate was significantly lower in the fenestrated group (hazard ratio = 0.12, 95% confidence interval = 0.02–0.97). Fenestration patency closed gradually through spontaneous closure and device intervention. Conclusion The study found no major differences in immediate postoperative outcomes. In the fenestrated cohort, significantly lower incidences of protein-losing enteropathy, liver mass, cirrhosis, and long-term mortality were observed. However, multilevel model stratified by propensity score analysis indicated that only the lower long-term mortality demonstrated a major effect.
Extubation Advisor: Implementation and Evaluation of A Novel Extubation Clinical Decision Support Tool
Authors: Hryciw Brett N. , Hudek Natasha , Brehaut Jamie C. , Herry Christophe , Scales Nathan , Lee Emma , Sarti Aimee J. , Burns Karen E.A. , Seely Andrew J.E. 
Published: October 2024

Importance Extubation Advisor (EA) is a novel software tool that generates a synoptic report for each Spontaneous Breathing Trial (SBT) conducted to inform extubation decision-making. Objectives To assess bedside EA implementation, perceptions of utility, and identify barriers and facilitators of use. Design, Setting and Participants We conducted a phase I mixed-methods interventional study in three mixed intensive care unit (ICUs) in two academic hospitals. We interviewed critical care physicians (MDs) and respiratory therapists (RTs) regarding user-centered design principles and usability. Analysis We evaluated our ability to consent participants (feasibility threshold 50%), capture complete data (threshold 90%), generate and review EA reports in real-time (thresholds 75% and 80%, respectively), and MD perception of tool usefulness (6-point Likert scale). We analyzed interview transcripts using inductive coding to identify facilitators and barriers to EA implementation and perceived benefit of tool use. Results We enrolled 31 patients who underwent 70 SBTs. Although consent rates [31/31 (100%], complete data capture [68/68 (100%)], and EA report generation [68/70 (97.1%)] exceeded feasibility thresholds, reports were reviewed by MDs for [55/70 (78.6%)] SBTs. Mean MD usefulness score was 4.0/6. Based on feedback obtained from 36 interviews (15 MDs, 21 RTs), we revised the EA report twice and identified facilitators (ability to track patient progress, enhance extubation decision-making, and provide support in resource-limited settings) and barriers (resource constraints, need for education) to tool implementation. Half of respondents (9 MDs, 9 RTs; combined 50%) perceived definite or potential benefit to EA tool use. Conclusion This is the first study of a waveform-based variability-derived, predictive clinical decision support tool evaluated in adult ICUs. Our findings support the feasibility of integrating the EA tool into bedside workflow. Clinical trials are needed to assess the utility of the EA tool in practice and its impact on extubation decision-making and outcomes. Trial Registration NCT04708509
Influence of the Type of Antiretroviral Treatment on the Time to Reach High Pharmacotherapy Complexity in People Living With HIV
Authors: Contreras Macías Enrique , Robustillo Cortés María de las Aguas , Blanco Ramos José Ramón , Morillo Verdugo Ramón 
Published: October 2024

Background: The introduction of antiretroviral therapy (ARV) has significantly improved the survival of people living with HIV (PLWH), increasing the proportion of individuals over 50 years old. This aging trend poses challenges, such as the development of age-related comorbidities and a higher prevalence of polypharmacy. The pharmacotherapeutic complexity, assessed using the Medication Regimen Complexity Index (MRCI), is crucial for identifying and optimizing treatment, especially in elderly and polymedicated patients. Objective: The main objective was to assess the association between different ARV regimens and the time required to reach a high level of pharmacotherapeutic complexity in PLWH. Methods: A single-center observational analytical research study was conducted, including adult PLWH on active ARV from January 2010 to December 2021 with follow-up until December 2023. An analysis of the time to reach MRCI ≥11.25 was performed, followed by a Cox regression model to determine the influence of ARV on high MRCI. Results: A total of 789 PLWH were included, median age of 52 years (interquartile range: 45-58). Overall, 195 patients had an MRCI value ≥11.25 with a mean time to reach it of 181.86 months (95% confidence interval [CI]: 176.24 to 187.49). Significant differences were observed in sex, advanced age, AIDS stage, presence of comorbidities, polypharmacy, and ARV-related variables. A multivariate Cox proportional hazards model showed an association between integrase inhibitor (INSTI)-containing regimens (hazard ratio [HR]: 1.83; 95% CI: 1.08 to 3.10) and non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimens (HR: 0.72; 95% CI: 0.52 to 0.98) with the time to reach high MRCI. Conclusions and Relevance: In summary, NNRTI-based regimens were associated with a lower likelihood of developing high MRCI compared to INSTI-based regimens, which was associated with a higher likelihood. These conclusions are based on a profile of PLWH that included advanced age and a high prevalence of comorbidities and polypharmacy. Identifying high MRCI may help us implement pharmacotherapeutic optimization strategies to improve health outcomes.
Guidelines for Orbital Defect Assessment and Patient-Specific Implant Design: Introducing OA2 (Orbital Assessment Algorithm)
Authors: Gellrich Nils-Claudius , Grant Michael , Matic Damir , Korn Philippe 
Published: October 2024

Study Design This study presents a review of the evolutionary development in reconstructive orbital surgery over the past 3 decades. Additionally, it proposes the Orbital Assessment Algorithm (OA2) to enhance decision-making for intraorbital reconstruction of post-traumatic orbital deformities. Objective The objective of this paper is to provide insights into modern post-traumatic orbital reconstruction from a surgeon’s perspective, with a specific focus on adult patients. It aims to highlight the advancements in computer-aided design and manufacturing techniques, particularly in the field of reconstructive orbital surgery, and to introduce the OA2 as a tool for improved decision-making in this context. Methods The study conducts a comprehensive review of the evolution of reconstructive orbital surgery, focusing on the integration of 3D technology into surgical practices. It also outlines the development and rationale behind the proposed OA2, emphasizing its potential to enhance the accuracy and efficacy of intraorbital reconstruction procedures for post-traumatic deformities. Results The review demonstrates the significant progress made in reconstructive orbital surgery, particularly in leveraging 3D technology for virtual modeling, navigation, and the design and manufacturing of patient-specific implants. The introduction of the OA2 provides a structured approach to assessing and addressing post-traumatic orbital deformities, offering potential benefits in decision-making and surgical outcomes. Conclusions In conclusion, this paper underscores the pivotal role of computer-aided design and manufacturing in advancing reconstructive orbital surgery. It highlights the importance of integrating innovative design concepts into implant manufacturing processes and emphasizes the potential of the OA2 to guide surgeons in the management of post-traumatic orbital deformities, ultimately contributing to improved patient outcomes.
Surgical Management of Complex Ankle Bony Impingement Combined With Chronic Ankle Instability
Authors: Bai Lu , Liu Sanbiao , Tang Lubo , Guan Siyao , Xie Xiaoxiao , Zhang Xintao 
Published: October 2024

Background: Anterior ankle bony impingement, which can cause pain and dysfunction of the ankle, is commonly seen in sports injuries. Its primary cause is repeated injury due to chronic ankle instability. An excellent clinical result has been reported by surgically removing osteophytes and ankle stabilization. However, reports of complex anterior impingement combined with lateral ankle instability are rare, which remains challenging in clinical practice. Purpose/Hypothesis: The purpose of this study was to evaluate the clinical outcomes of anterior ankle bony impingement combined with lateral ankle instability with surgical dissection of osteophytes and stabilization. It was hypothesized that complex ankle osteophytes with instability would achieve optimal clinical outcomes through surgical management. Study Design: Case series; Level of evidence, 4. Methods: A total of 57 patients with complex ankle bony impingement combined with lateral instability treated with surgical dissection of complex osteophytes between September 2013 and January 2019 were enrolled in the study. The clinical outcomes were evaluated by visual analog scale (VAS) for pain score, American Orthopedic Foot and Ankle Society (AOFAS) score, Karlsson score, and radiographic examination with a mean follow-up time of 39.6 months. Postoperative ankle function and complications were compared using the t test and post hoc Tukey significant difference test. Results: The mean AOFAS score significantly increased at the 3-month, 1-year, and 2-year follow-ups compared with the preoperative condition ( t = 10.57, P = .0001). The mean Karlsson score after surgery also significantly improved at each follow-up time compared with the preoperative score ( t = 12.93, P = .0001). The preoperative VAS score significantly decreased at 3 months, 1 year, and 2 years postoperatively ( t = 8.73, P = .001). A significant improvement of mean dorsiflexion difference was observed at 3 months and 1 year compared with the preoperative condition, but it seemed to have regressed at the 2-year follow-up ( t = 2.11, P = .01). Tibial side recurrence was found in 9 cases, including 7 Scranton type 1 and 2 Scranton type 2. Talar side recurrence was also found in 3 of those cases. Conclusion: Our retrospective study demonstrated that complex ankle bony impingement combined with lateral instability can yield good clinical results when treated surgically with both ankle stabilization and osteophyte removal.
Management Anterior Cruciate Ligament Tibia Spine Avulsion Fracture
Authors: Wien Aryana IGN 
Published: October 2024

Anterior cruciate ligament (ACL) tibial avulsion fractures, also known as tibial eminence fractures, are intra-articular fractures of the bony attachment of the ACL on the tibia. The Meyers and McKeever classification categorizes fractures of the tibial eminence into 3 types. Type I fractures refer to nondisplaced or minimally displaced eminence fractures. Type II fractures indicate that the anterior one-third to one-half of the avulsed bone has been displaced proximally or hinged. Type III fractures refer to complete separation of the avulsed fragments. Rotated and comminuted fractures are identified as type IV. For displaced ACL avulsion fractures, nonoperative treatment commonly results in higher rates of nonunion; therefore, surgical fixation should be considered for these types of fractures. Fixation for avulsion fracture fragments can be achieved by using a variety of implants such as Kirschner wires, sutures, and screws. Among these techniques, arthroscopic fixations with screws or sutures are the current mainstream interventions. In biomechanical performance, the comparative fixation strength between sutures and screws remains inconclusive. Tsukada et al found screw fixation to be superior in obtaining rigid fixation under cyclic loading. Mahar et al showed no clear biomechanical differences, including in failure tensile force and deformation after cyclic loading, between fixation methods using screws and sutures. Other studies concluded that sutures provide more fixation strength than screw fixations. In addition to the biomechanical findings, the clinical results showed contrasting findings for screw fixations and suture fixations used for tibial avulsion fractures. Better pivot-shift performance and shorter operating times were observed in screw-fixation surgical procedures, whereas lower subsequent surgery rate and better functional outcome scores were observed for suture-fixation surgical procedures. The latest clinical study conducted by Callanan et al revealed that suture and screw fixations lead to comparable clinical outcomes. Common complications following treatment are residual laxity, knee stiffness, and nonunion or malunion.
Diagnosis and Treatment of Patellar Instability
Authors: Adachi Nobuo 
Published: October 2024

The patellar instability is the complicated knee condition, which has several potential congenital factors, such as balance disorder between medial and lateral soft tissues, dysplasia of femoral condyle, patella height, rotation of femur and tibia, or general joint laxity. The patella dislocation is usually categorized in to “permanent”, “habitual”, and “recurrent” dislocation. It goes without saying that precise diagnosis and proper selection of treatment is indispensable for successful clinical outcomes for any patellar instability. First, we will demonstrate some knacks and pitfalls for diagnosis of patella instability. There have been many surgical procedures for those disorders, such as proximal realignment or distal realignment. Because some biomechanical studies demonstrated that the medial patellofemoral ligament (MPFL) is main restraint against lateral dislocation or displacement of the patella, recently, MPFL reconstruction has become the most popular procedure for especially recurrent patellar instability. Many MPFL reconstructions have been reported using artificial ligaments, free semitendinosus, gracilis, quadriceps, or other autogenous tendons. We have performed the MPFL reconstruction using semitendinosus tendon for young and adult patients. However, for habitual or permanent patella instability, only MPFL reconstruction is not enough to obtain normal kinematics of the patella, requiring complicated bony procedures. Because we have experienced several interesting cases of permanent or habitual patellar instability, we would like to demonstrate those cases in this presentation.
Which One is Better Between Conservative and Surgical Procedure on Navicular Stress Fracture in Professional Runner: A Systematic Review
Authors: Faza Agya Ghilman 
Published: October 2024

Introduction: Stress fractures are common overuse injuries in the lower extremities. Stress fractures are most commonly observed in the tibia (24%), tarsal navicular (18%), metatarsal (16%), fibula (16%), femoral neck (5%). Navicular Stress Fracture (NSF) is becoming increasingly recognized in athletes, with an estimated prevalence about 35% of stress fractures in the foot and ankle. The optimal management of NSF has been a matter of debate for the last decades. Earlier literature suggested that conservative management in the form of non-weight bearing cast immobilization had a comparable success rate with surgical management. This paper describes the best therapy of NSF in runner. Objectives: time to return to play (RTP), complication of NSF in future (non-union, mal-union, re-fracture). Materials and Methods: Our trial was an international, expertise-based. Details of the trial objectives and design have been published previously. Additional information about the eligibility criteria, interventions, follow-up, outcome definitions, and statistical analysis. To identify studies pertaining to the clinical results about our topic of systematic review, we reviewed the Cochrane, Pubmed, ScienceDirect databases for relevant articles published up to July 2023. We also reviewed the references of all identified articles to identify additional studies. Search terms were as follows: NSF, conservative, surgical, runner. Following the PICOS (Participants, Interventions, Comparisons, Outcomes and Study design) principle, the key search terms included (P) patients were professional runner with NSF; (I) patients were running as a professional runner; (C/O) time to RTP, complication of NSF; (S) Meta-analysis, cohort, case control, systematic review. Results: Results Literature search the flow diagram of study selection is shown in Figure 1. A total of 13 meta-analysis, cohort, case control, and systematic review, which one is better between conservative and surgical on NSF in Professional Runner. Discussions: Operative procedure of NSF provides a higher success rate, a lower re-fracture rate, and a lower non-union rate as compared to non-operative management options. The choice of therapy management also depends on the type of sport and target recovery time. Conclusions: Operative procedure is better than conservative treatment in management of NSF for runner.