bluuebunny/crossref_metadata_2025_split huggingface dataset:
Statistical Response of ENSO Complexity to Initial Condition and Model Parameter Perturbations
Authors: Andreou Marios , Chen Nan 
Published: August 2024

Abstract
Studying the response of a climate system to perturbations has practical significance. Standard methods in computing the trajectory-wise deviation caused by perturbations may suffer from the chaotic nature that makes the model error dominate the true response after a short lead time. Statistical response, which computes the return described by the statistics, provides a systematic way of reaching robust outcomes with an appropriate quantification of the uncertainty and extreme events. In this paper, information theory is applied to compute the statistical response and find the most sensitive perturbation direction of different El Niño–Southern Oscillation (ENSO) events to initial value and model parameter perturbations. Depending on the initial phase and the time horizon, different state variables contribute to the most sensitive perturbation direction. While initial perturbations in sea surface temperature (SST) and thermocline depth usually lead to the most significant response of SST at short and long ranges, respectively, initial adjustment of the zonal advection can be crucial to trigger strong statistical responses at medium range around 5–7 months, especially at the transient phases between El Niño and La Niña. It is also shown that the response in the variance triggered by external random forcing perturbations, such as the wind bursts, often dominates the mean response, making the resulting most sensitive direction very different from the trajectory-wise methods. Finally, despite the strong non-Gaussian climatology distributions, using Gaussian approximations in the information theory is efficient and accurate for computing the statistical response, allowing the method to be applied to sophisticated operational systems.

Significance Statement
The purpose of this work is to better understand how El Niño–Southern Oscillation (ENSO) responds to changes in its initial state and internal dynamics or external forcings. A statistical quantification of this response allows for the comprehension of the triggering conditions and the effect of climate change on the occurrence frequency and strength of each type of ENSO event. Such a study also allows to detect the most sensitive perturbation directions, which has practical significance in guiding anthropogenic activities. The approach used to study the response in this work is through the framework of information theory, which allows for an unbiased and robust assessment of the statistical response that is not affected by the turbulent dynamics of the system.
Impact of Atmospheric River Reconnaissance Dropsonde Data on the Assimilation of Satellite Radiance Data in GFS
Authors: Zheng Minghua , Delle Monache Luca , Wu Xingren , Kawzenuk Brian , Ralph F. Martin , Zhu Yanqiu , Torn Ryan , Tallapragada Vijay S. , Zhang Zhenhai , Wu Keqin , Wang Jia 
Published: August 2024

Abstract
Satellites provide the largest dataset for monitoring the earth system and constraining analyses in numerical weather prediction models. A significant challenge for utilizing satellite radiances is the accurate estimation of their biases. High-accuracy nonradiance data are commonly employed to anchor radiance bias corrections. However, aside from the impacts of radio occultation data in the stratosphere, the influence of other types of “anchor” observation data on radiance assimilation remains unclear. This study provides an assessment of impacts of dropsonde data collected during the Atmospheric River (AR) Reconnaissance program, which samples ARs over the northeast Pacific, on the radiance assimilation using the Global Forecast System (GFS) and Global Data Assimilation System at the National Centers for Environmental Prediction. The assimilation of this dropsonde dataset has proven crucial for providing enhanced anchoring for bias corrections and improving the model background, leading to an increase of ∼5%–10% in the number of assimilated microwave radiance in the lower troposphere/midtroposphere over the northeast Pacific and North America. The impact on tropospheric infrared radiance is not only small but also beneficial. Impacts of dropsondes on the use of stratospheric channels are minimal due to the absence of dropsonde observations at certain altitudes, such as aircraft flight levels (e.g., 150 hPa). Results in this study underscore the usefulness of dropsondes, along with other conventional data, in optimizing the assimilation of satellite radiance. This study reinforces the importance of a diverse observing network for accurate weather forecasting and highlights the specific benefits derived from integrating dropsonde data into radiance assimilation processes.

Significance Statement
This study aims to evaluate the impact of aircraft reconnaissance dropsondes on the assimilation of satellite radiance data, utilizing observations from the 2020 Atmospheric River Reconnaissance program. The key findings reveal a substantial enhancement in the model first guess and improved estimates of radiance biases. Notably, there is a significant 5%–10% increase in microwave radiance observations over the northeastern Pacific and North America, with positive yet modest effects observed in tropospheric infrared radiance. These findings underscore the crucial role of atmospheric river reconnaissance dropsondes as anchor data, enhancing the assimilation of radiance observations. In essence, the inclusion of these dropsondes in routine networks is particularly valuable for optimizing data assimilation in regions with sparse observational data.
An experimental investigation of nano clay and functionalized nano graphene oxide effects on ablation of carbon/phenolic nanocomposites
Authors: Hosseini Kordkheili Seyed Ali , Jafari HR 
Published: August 2024

This work aims to study thermal stability and ablative behaviors of Carbon/Phenolic composites containing nano clay, nano graphene oxide and hybrid additives. To this end a detailed explained and illustrated process is involved to synthesize factionalized graphene oxide based on Hummers method. The XRD test result shows a major shift in basal plane reflection to below 2θ = 20° in the provided spectrum, which indicates achievement in the functionalization process. Prepared nanoparticles suspensions are then mixed by resol resin with desire wt% to outcome nanocomposites. An in-depth analysis of SEM images with focus on the dispersion, morphology, and interaction of the nanofillers with the resin matrix reveals that nanoparticles are dispersed properly with no agglomeration. 200 gr/m2 carbon woven fabric is then impregnated with prepared nanocomposites employing an own made prepreg machine to use to construct standard flexural as well as oxy acetylene test specimens. Using bending test, thermogravimetric analysis and oxyacetylene torch test, effects of different percentages of considered nanoparticles on the mechanical properties, thermal stability and ablative of carbon/phenolic composites are assessed and the results are reported. According to the results, adding only 0.1 wt% of nano graphene oxide increases char yield around 5% and remain back surface temperature under 100°C during flame test. Moreover samples with 0.2 wt% of nano clay and hybrid (0.05 wt% nano graphene oxide and 0.1 wt% nano clay) additives provides best reaming amount of solid.
CHA2DS2-VASc Score as Predictor of New-Onset Atrial Fibrillation and Mortality in Critical COVID-19 Patients
Authors: Ioannidis Panagiotis S. , Sileli Maria , Kerezidou Eleni , Kamaterou Myrto , Iasonidou Christina , Kapravelos Nikos 
Published: August 2024

Background Pre-existing and new-onset atrial fibrillation (NOAF) is a common arrhythmia in COVID-19 patients and is related to increased mortality. CHA2DS2-VASc score was initially developed to evaluate thromboembolic risk in patients with AF. Moreover, it predicted adverse outcomes in other clinical conditions, including SARS-CoV-2 infection. We aimed to evaluate the association of CHA2DS2-VASc with NOAF, ICU length of stay (LOS) and mortality in critically ill COVID-19 patients. We also examined the relationship of NOAF with mortality. We reviewed the literature to describe the link between cardiovascular risk factors and inflammatory response of severe COVID-19. Methods and results We retrospectively studied 163 COVID-19 patients admitted to a level 3 general ICU from March 2020 to April 2022. Patients were of advanced age (median 64 years, IQR 56.5-71) and the majority of them were male (67.5%). Regarding NOAF, we excluded 12 patients with AF history. In this group, CHA2DS2VASc score was significantly elevated (3 IQR (1-4) versus 1 IQR (1-2.75), p = 0.003). Specifically, three components of CHA2DS2VASc were notably increased: age (p < 0.001), arterial hypertension (p = 0.042) and stroke (p = 0.047). ICU mortality was raised in the NOAF group [75.8% versus 34.8%, p < 0.001 OR 5.87, 95% CI (2.43, 14.17)]. This was significant even after adjusting for ICU clinical scores (APACHE II and SOFA). About mortality in the entire sample, survivors were younger (p = 0.001). Non-survivors had greater APACHE II (p = 0.04) and SOFA (p = 0.033) scores. CHA2DS2VASc score was positively associated with mortality [p = 0.031, OR 1.28, 95% CI (1.03, 1.6)]. ICU length of stay was associated with mortality (p = 0.016) but not with CHA2DS2VASc score (p = 0.842). Conclusions NOAF and CHA2DS2VASc score were associated with higher mortality in COVID-19 ICU patients. CHA2DS2VASc score was also associated with NOAF but not with ICU LOS.
Cost Analysis of Routine Histopathologic Evaluation of Specimens Following Total Ankle Arthroplasty
Authors: Padilla Jorge A. , Andriani Nicholas , Papalia Aidan , Huyke-Hernández Fernando , Cohn Randy M. , Bitterman Adam D. 
Published: August 2024

Background: Routine histopathologic examination of orthopaedic surgical specimens is a standard practice at many institutions. Previous studies have demonstrated that this practice seldom altered patient management for several orthopaedic procedures. As a result, the value of such practices has come into question. The purpose of this study is to determine the cost-effectiveness of routine histopathologic analysis of specimens obtained during total ankle arthroplasty (TAA). Methods: A retrospective analysis was performed of patients who underwent uncomplicated primary TAA at a large, academic, health system between January 2015 and December 2021. The postoperative histopathologic diagnoses were compared with the respective patient’s preoperative clinical and intraoperative diagnoses. The prevalence of concordant, discrepant, and discordant diagnoses was determined. Cost-effectiveness analysis was conducted to assess the financial implications of obtaining routine specimens for histopathologic examination for TAA. Results: A total of 85 TAAs were identified in 85 individual patients and were included in the present study. A total of 172 specimens were sent for routine histopathologic review. On histopathologic analysis, a final diagnosis was confirmed in 82 (96.5%) of the total specimens reviewed. A discrepant diagnosis was discovered in 3 (3.5%; 2 cases of gout/pseudogout and 1 case of osteonecrosis) cases and 0 (0%) discordant diagnoses were discovered, corresponding to positive and negative predictive values of 97% and 100%, respectively The total estimate of costs incurred for the routine analysis of all specimens included in the study was between $12 299.20 and 17 846.00. The estimated cost to establish each discrepant diagnosis ranged between $4099.73 and $5948.67, and the cost for a discordant diagnosis was unable to be established. Conclusion: Routine histopathologic analysis of specimens obtained during TAA rarely revealed a discordant diagnosis and resulted in no alterations to patients’ plan of care. Furthermore, the additional costs of routine histopathologic examination are significant. As such, it is recommended that such interventions in TAA should be performed on a per-case basis at the operating surgeon’s discretion.
Ocular and adnexal injuries after two major earthquakes in Turkey on February 6, 2023
Authors: Şensoy Melike , Bayram Nurettin , Sensoy Eyupcan , Sonmez Kenan 
Published: August 2024

Purpose This study aimed to determine the forms of ocular and adnexal injuries and to examine the treatment modalities applied after two major earthquakes in Turkey on February 6, 2023. Methods Following the earthquakes, the medical records of 34 patients admitted with emergency ophthalmic complaints to Hatay Training and Research Field Hospital and Etlik City Hospital were retrospectively reviewed. Of these patients, 35 eyes of 34 individuals diagnosed with earthquake-related ocular and adnexal injuries were included in the study. Demographic characteristics were recorded, including ocular and adnexal findings, treatment modalities, and postoperative complications. Results Of the patients, 16 (47.1%) were female, and 18 (52.9%) were male. The mean age was 37.38 ± 17.3 years. The mean time from the earthquake to the first admission to the hospital was 3.82 ± 1.78 days. Initial and final best-corrected visual acuities (BCVA) were 0.54 ± 0.66 logMAR and 0.22 ± 0.41 logMAR, respectively ( p = 0.0003). The initial and final BCVA of 2 eyes was no light perception. The most common forms of ocular/periocular injury associated with earthquakes were eyelid laceration (n:25, 71.4%) and orbital fracture (n:17, 48.6%). The most common accompanied systemic trauma was extremity/rib fractures (38.2). The most frequently performed surgery was the primary repair of the eyelid/canalicular (n:17, 48.6%). Conclusion While earthquake-related ocular and adnexal traumas are relatively uncommon, understanding the specific injury types, promptly identifying cases requiring urgent intervention, and mastering effective treatment modalities are essential for minimizing the risk of severe permanent visual impairment in these patients.
Diabetic retinopathy screening with confocal fundus camera and artificial intelligence - assisted grading
Authors: Piatti A. , Rui C. , Gazzina S. , Tartaglino B. , Romeo F. , Manti R. , Doglio M. , Nada E. , Giorda C.B. 
Published: August 2024

Purpose Screening for diabetic retinopathy (DR) by ophthalmologists is costly and labour-intensive. Artificial Intelligence (AI) for automated DR detection could be a clinically and economically alternative. We assessed the performance of a confocal fundus imaging system (DRSplus, Centervue SpA), coupled with an AI algorithm (RetCAD, Thirona B.V.) in a real-world setting. Methods 45° non-mydriatic retinal images from 506 patients with diabetes were graded both by an ophthalmologist and by the AI algorithm, according to the International Clinical Diabetic Retinopathy severity scale. Less than moderate retinopathy (DR scores 0, 1) was defined as non-referable, while more severe stages were defined as referable retinopathy. The gradings were then compared both at eye-level and patient-level. Key metrics included sensitivity, specificity all measured with a 95% Confidence Interval. Results The percentage of ungradable eyes according to the AI was 2.58%. The performances of the AI algorithm for detecting referable DR were 97.18% sensitivity, 93.73% specificity at eye-level and 98.70% sensitivity and 91.06% specificity at patient-level. Conclusions DRSplus paired with RetCAD represents a reliable DR screening solution in a real-world setting. The high sensitivity of the system ensures that almost all patients requiring medical attention for DR are referred to an ophthalmologist for further evaluation.
Reproducibility of SIMPLE classification for diabetic retinopathy screening and its comparison to current Italian guidelines
Authors: Donati Maria Carla , Cifarelli Lorenzo , Morelli Alberto , Alonzo Ludovica , Tartaro Ruggero , Sasso Paola , Maceroni Martina , Minnella Angelo Maria , Rizzo Stanislao , Mannucci Edoardo , Vitale Valentina , Curran Katie , Peto Tunde , Giansanti Fabrizio , Virgili Gianni 
Published: August 2024

Purpose To evaluate the reproducibility of SIMPLE (Single field Image Multi Parameters defined Lesions Extent), a new Diabetic Retinopathy (DR) classification for screening of 45° single field fundus pictures of patients with diabetes (PwDM), assessing DR, Diabetic Maculopathy (DMac) and referral rate agreement and comparing it to current Italian Guidelines (IG). Materials and methods We conducted a retrospective, observational, multicentre study, collecting 1000 retinal 45° single field images of PwDM obtained during routine visits in two diabetes clinics. Three ophthalmologists evaluated each image, determining the presence and number of specific DR lesions and then assigning a stage according to the current IG for screening. SIMPLE staging was performed automatically via Excel software, based on the pre-specified DR characteristics observed by the graders. We analysed intra-centre, inter-centre and total inter-grader agreement for DR and DMac stage and referral rate of the two classifications. Results Agreement amongst the three graders was consistently higher when using SIMPLE classification than when using current IG classification. For DR, kappa (k) was 0.86 with IG and 0.95 with SIMPLE classification; for DMac, k-IG was 0.78, while k-SIMPLE was 0.96; concordance on the referral rate was 0.91 with IG and 0.99 with SIMPLE. Similar results were obtained in sub-analyses for the evaluation of intra-centre and inter-centre concordance. Conclusions Our results suggest that the new SIMPLE classification has an excellent reproducibility amongst graders, comparable or superior to the current IG for DR screening proposed in 2015, improving the standardisation of the decision on referability.
High Expression of SRSF10 Promotes Colorectal Cancer Progression by Aberrant Alternative Splicing of RFC5
Authors: Xu Shuai , Zhong Fangmin , jiang Junyao , Yao Fangyi , Li Meiyong , Tang Mengxin , Cheng Ying , Yang Yulin , Wen Wen , Zhang Xueru , Huang Bo , Wang Xiaozhong 
Published: August 2024

Background Colorectal cancer (CRC) remains a global health concern with persistently high incidence and mortality rates. However, the specific pathogenesis of CRC remains poorly understood. This study aims to investigate the role and pathogenesis of serine and arginine rich splicing factor 10 (SRSF10) in colorectal cancer. Methods Bioinformatics analysis was employed to predict SRSF10 gene expression in CRC patients. Functional experiments involving SRSF10 knockdown and overexpression were conducted using CCK8, transwell, scratch assay, and flow cytometry. Additionally, the PRIdictor website was utilized to predict the SRSF10 interaction site with RFC5. The identification of different transcripts of SRSF10-acting RFC5 pre-mRNA was achieved through agarose gel electrophoresis. Result The knockdown of SRSF10 inhibited the proliferation and migration ability of CRC cells, while promoting apoptosis and altering the DNA replication of CRC cells. Conversely, when SRSF10 was highly expressed, it enhanced the proliferation and migration ability of CRC cells and caused changes in the cell cycle of colorectal cancer cells. This study revealed a change in the replicating factor C subunit 5 (RFC5) gene in colorectal cancer cells following SRSF10 knockdown. Furthermore, it was confirmed that SRSF10 increased RFC5 exon2-AS1(S) transcription variants, thereby promoting the development of colorectal cancer through AS1 exclusion to exon 2 of RFC5. Conclusion In summary, this study demonstrates that SRSF10 promotes the progression of colorectal cancer by generating an aberrantly spliced exclusion isoform of AS1 within RFC5 exon 2. These findings suggest that SRSF10 could serve as a crucial target for the clinical diagnosis and treatment of CRC.
Wearable-Based Kinematic Analysis of Upper-Limb Movements During Daily Activities Could Provide Insights into Stroke Survivors’ Motor Ability
Authors: Lee Sunghoon Ivan , Liu Yunda , Vergara-Díaz Gloria , Pugliese Benito Lorenzo , Black-Schaffer Randie , Stoykov Mary Ellen , Bonato Paolo 
Published: August 2024

Background Frequent and objective monitoring of motor recovery progression holds significant importance in stroke rehabilitation. Despite extensive studies on wearable solutions in this context, the focus has been predominantly on evaluating limb activity. This study aims to address this limitation by delving into a novel measure of wrist kinematics more intricately related to patients’ motor capacity. Objective To explore a new wearable-based approach for objectively and reliably assessing upper-limb motor ability in stroke survivors using a single inertial sensor placed on the stroke-affected wrist. Methods Seventeen stroke survivors performed a series of daily activities within a simulated home setting while wearing a six-axis inertial measurement unit on the wrist affected by stroke. Inertial data during point-to-point upper-limb movements were decomposed into movement segments, from which various kinematic variables were derived. A data-driven approach was then employed to identify a kinematic variable demonstrating robust internal reliability, construct validity, and convergent validity. Results We have identified a key kinematic variable, namely the 90th percentile of movement segment distance during point-to-point movements. This variable exhibited robust reliability (intra-class correlation coefficient of .93) and strong correlations with established clinical measures of motor capacity (Pearson’s correlation coefficients of .81 with the Fugl-Meyer Assessment for Upper-Extremity; .77 with the Functional Ability component of the Wolf Motor Function Test; and −.68 with the Performance Time component of the Wolf Motor Function Test). Conclusions The findings underscore the potential for continuous, objective, and convenient monitoring of stroke survivors’ motor progression throughout rehabilitation.
Reducing Unnecessary Instruments in Tonsil Hemorrhage Trays at a Canadian Tertiary Care Center: A Quality Improvement Project
Authors: Van Osch Kylen , Madou Edward , Belisle Sheena , Strychowsky Julie E. 
Published: August 2024

Background In the emergency department (ED), there are pre-assembled tonsillar hemorrhage trays for management of post-tonsillectomy hemorrhage and peritonsillar abscess. After use, the tray is sent to the medical device reprocessing (MDR) department for decontamination, sterilization, and re-organization, all at a significant cost to the hospital and environment. Objective The goal of this project was to reduce unnecessary instruments on the tonsil hemorrhage tray by 30% by 1 year and report on the associated cost and carbon dioxide (CO2) emissions savings. Methods This quality improvement project was framed according to the Institute for Healthcare Improvement’s Model for Improvement. ED and Otolaryngology–Head & Neck Surgery staff and residents were surveyed to determine which instruments on the tonsil hemorrhage trays were used regularly. Based on results, a new tray was developed and compared to the old tray using MDR data and existing CO2 emissions calculations. Results Tray optimization resulted in a total cost reduction from $1092.63 to $330.21 per tray per year, decreased processing time from 12 to 6-8 minutes per tray, and decreased CO2 emissions from 6.11 to 2.85 kg per year for the old versus new tray, respectively. Overall, the new tray contains half the number of instruments, takes half the time to assemble, produces 50% less CO2 emissions, and will save the hospital approximately $100,000 over 10 years. Conclusion Healthcare costs and environmental sustainability are collective responsibilities. Surgical and procedure tray optimization is a simple, effective, and scalable form of eco-action.