bluuebunny/crossref_metadata_2025_split huggingface dataset:
Resolution Dependence of Extreme Wind Speed Projections in the Great Lakes Region
Authors: Morris Michael , Kushner Paul J. , Moore G. W. K. , Mercan Oya 
Published: March 2024

Abstract
The effect of anthropogenic climate change on extreme near-surface wind speeds is uncertain. Observed trends are weak and difficult to disentangle from internal variability, and model projections disagree on the sign and magnitude of trends. Standard coarse-resolution climate models represent the fine structures of relevant physical phenomena such as extratropical cyclones (ETCs), upper-level jet streaks, surface energy fluxes, and land surface variability less skillfully than their high-resolution counterparts. Here, we use simulations with the NCAR Community Earth System Model with both uniform (110 km) resolution and the variable-resolution configuration (VR-CESM-SONT, from 110 to 7 km) to study the effect of refined spatial resolution on projections of extreme strong and weak wind speeds in the Great Lakes region under end-of-century RCP8.5 forcing. The variable-resolution configuration projects strengthening of strong-wind events in the refined region with the opposite occurring in the uniform-resolution simulation. The two configurations provide consistent changes to synoptic-scale circulations associated with high-wind events. However, only the variable-resolution configuration projects weaker static stability, enhanced turbulent vertical mixing, and consequentially enhanced surface wind speeds because boundary layer dynamics are better captured in the refined region. Both models project increased frequency of extreme weak winds, though only VR-CESM-SONT resolves the cold-season inversions and summertime high temperatures associated with stagnant wind events. The identifiable mechanism of the changes to strong winds in VR-CESM-SONT provides confidence in its projections and demonstrates the value of enhanced spatial resolution for the study of extreme winds under climate change.

Significance Statement
In this study, we compare climate change projections of high and low extreme wind speeds in the Great Lakes region between a standard coarse-resolution simulation and a high-resolution simulation performed using the same climate model. The fine-resolution simulation projects strengthening high wind speeds, opposite to the coarse-resolution simulation. Both project increasing frequency of extreme weak winds, but the human-health-related impacts of stagnant winds are only captured at fine resolution. The changes in the coarse-resolution simulation are explained by changes to large-scale circulation, while the fine-resolution changes are linked to local processes the coarse model does not resolve. This helps explain the diverging projections of strong winds and gives greater credibility to the fine-resolution simulation.
To what extent are guidelines used in spasticity clinics? A qualitative study of facilitators and barriers to spasticity guideline implementation
Authors: Sutherland Edwina , Williams Gavin , Dobson Fiona , Hill Bridget , Woo Chi Ching Angie , Lawford Belinda 
Published: March 2024

Objective To determine the common understanding of focal muscle spasticity guidelines amongst clinicians working in spasticity clinics. To examine the facilitators and barriers to their implementation as well as their influence on clinic processes. Design A qualitative study based on a phenomenological approach. Setting Online videoconferencing platform. Participants Sixteen experienced multi-disciplinary clinicians providing specialised care across 12 spasticity clinics in Victoria, Australia. Intervention Observational. Main measures Two independent reviewers performed line by line coding of transcripts. Reflexive thematic analysis was undertaken with themes/subthemes inductively derived. Results Seven key themes emerged. First, knowledge of specific guideline recommendations was low amongst some clinicians. Second, there is a lack of health service resources to support guideline implementation. Third, a limited evidence base for guidelines affected clinicians’ willingness to implement the recommendations. Fourth, peer support was highly valued but opportunities to collaborate were limited. Fifth, a large amount of intrinsic motivation and personal time was required from clinicians to successfully implement guideline recommendations. Sixth, the standardisation of clinic processes was one way in which clinicians felt they could better align their clinical practice to guidelines. Lastly, guidelines overall had a moderate influence on spasticity clinic processes. Conclusions Knowledge of recommendations varied but, overall, guidelines had an influence on clinic processes and staff perceptions across the state-wide services. Health service resources, limited evidence for guideline recommendations and time constraints were considered barriers to spasticity guideline implementation. Multi-disciplinary expertise and teamwork, the individual's motivation to change and inter-clinic collaboration were considered to be the facilitators.
Association between a low-risk COVID-19 extracorporeal membrane oxygenation criteria and mortality: A retrospective study
Authors: Gostyuzhev Igor , Mohamed Adham , Freiberger-O’Keefe Carole E , Haines Michelle M , Kozinn Jonathan B 
Published: March 2024

Objective: Our study aimed to compare the outcomes of COVID-19 patients who met a low-risk inclusion criteria for veno-venous extra corporeal membrane oxygenation (VV ECMO) with those who did not meet criteria due to higher risk but were subsequently cannulated. Methods: This was a retrospective observational cohort study that included adult patients who were placed on VV ECMO for COVID-19 related acute respiratory distress syndrome (ARDS) at a tertiary care academic medical center. The primary outcome was the association between the low-risk criteria and mortality. The patients met the criteria if they met EOLIA severe ARDS criteria, no absolute contraindications (age > 60 years, BMI > 55 kg/m2, mechanical ventilation (MV) duration >7 days, irreversible neurologic damage, chronic lung disease, active malignancy, or advanced multiorgan dysfunction), and had three or less relative contraindications (age > 50 years, BMI > 45 kg/m2, comorbidities, MV duration > 4 days, acute kidney injury, receiving vasopressors, hospital LOS > 14 days, or COVID-19 diagnosis > 4 weeks). Results: Sixty-five patients were included from March 2020 through March 2022. Patients were stratified into low-risk or high-risk categories. The median Sequential Organ Failure Assessment score was 7 and the median PaO2/FiO2 ratio was 44 at the time of ECMO cannulation. The in-hospital mortality was 47.8% in the low-risk group and 69.0% in the high-risk group ( p = 0.096). Conclusion: There was not a statistically significant difference in survival between low-risk patients and high-risk patients; however, there was a trend toward higher survival in the lower-risk group.
Exploring the use of natural fiber-reinforced polymer composites in electronic circuit boards
Authors: Subramaniam Omprakasam , Raman Raghu , Karuppannan Ramsami Prabha 
Published: March 2024

Sustainable banana fiber has become potential alternative reinforcement materials instead of synthetic fibers for the development of the polymer composites. These natural fiber-reinforced polymer composites can be utilized for numerous applications. The current study aims to fabricate the epoxy/banana fiber composites under varying fraction of banana fibers. Compression molding process was employed to fabricate the composites since it is frequently used for production of large-scale composite parts like automotive components. Various weight percentages of banana fiber (50%, 60%, 70%, and 80% by weight) and epoxy (50%, 40%, 30%, and 20% by weight) were utilized for the development of the composites. Results revealed that the combination of the epoxy (40 wt. %)/banana fiber (60%) has the higher tensile strength of 22.67 MPa, flexural strength of 39.56 MPa, impact strength of 2.97 kJ/m2, and Barcol hardness of 35.24 among the various combinations of the epoxy and banana fiber composites. This work highlights the viability of sustainable materials within the materials engineering field, promoting the development of eco-friendly alternatives in composite fabrication.
Postoperative Outcomes Between Positive and Negative Electrodiagnosis in Patients With Tarsal Tunnel Syndrome: A Retrospective Comparative Study
Authors: Rungprai Chamnanni , Suksintharanon Methasit , Hempongphan Tanarat , Pongpinyopap Warongporn , Boonma Pisit , Hathaiareerug Chanasak , Sripanich Yantarat 
Published: March 2024

Background: The sensitivity of diagnosing tarsal tunnel syndrome with an electrodiagnostic study is just over 50%. Given this low reliability, many surgeons prefer to make a diagnosis solely from a physical examination, despite reported electrodiagnostic findings. Thus, to understand the clinical ramifications between these 2 methods of diagnosis, this investigation compared the postoperative outcomes following a tarsal tunnel release between patients with positive and negative preoperative electrodiagnosis (EDx). Methods: This study retrospectively reviewed 53 consecutive patients who underwent tarsal tunnel release by a single surgeon between 2015 and 2022. The primary outcome was pain level using visual analog scale (VAS) whereas the secondary outcomes were 36-Item Short Form Health Survey questionnaire, Foot and Ankle Ability Measure, recovery times (time to return to activities of daily living, work, and sports), and complications. Pre- and postoperative functional outcomes were compared within each EDx group using a paired sample t test. Postoperative outcomes between groups were compared using a generalized linear model adjusted for potential confounders. Results: Both EDx groups (positive studies = 31 patients and negative studies = 22 patients) demonstrated significant improvement of all functional outcomes ( P < .001). We found no significant difference in recovery time or postoperative outcomes between the 2 groups ( P > .05). Multivariable analysis showed diabetes (risk ratio [RR] = 1.79, 95% CI 1.11-2.90) and longer duration of symptoms before surgery (RR = 1.02, 95% CI 1.00-1.04) as prognostic factors for residual pain following tarsal tunnel release. Conclusion: In our series, we found that preoperative electrodiagnostic results did not prognosticate postoperative functional outcomes or recovery times after tarsal tunnel release.
Peripheral arterial catheter securement and catheter survival in the pediatric intensive care unit
Authors: Pilarz Mary S , Walker Sarah B , Rowland Matthew J 
Published: March 2024

Background: Peripheral arterial catheters (PACs), and their associated complications, are common in the pediatric intensive care unit (PICU). Accidental catheter displacement and non-functional PACs are the most common complications, and this may be related to inadequate catheter securement. There is mixed guidance on the best way to secure PACs to prevent complications. The authors hypothesized that sutures would not be associated with a decreased risk of malfunction or accidental removal. Methods: This was a single center retrospective cohort study at a quaternary-care PICU. PICU patients with a peripheral arterial catheter placed in the PICU from 7/2020 to 1/2023 were included. The primary outcome was unplanned PAC removal. A univariate and multivariate Cox proportional hazards regression analysis was performed, using patient weight, sedation, paralytic, and role of the proceduralist as covariates. The secondary outcome was survival probability. A log-rank test was used to compare survival curves. Results: Of 761 PACs that met inclusion criteria in 437 unique patients, 599 were sutured (78.7%) and 162 were un-sutured (21.3%). In 257 cases (33.8%), the PAC had an unplanned removal. Among all PACs, the median duration of PAC placement was 5.3 days (IQR 2.1–10.5 days). There was an unplanned removal rate of 42.2% (68) in the un-sutured group and 31.4% (188) in the sutured group ( p < 0.001). In multivariable analysis, sutured PACs were also associated with a lower rate of unplanned removal (hazard ratio, 0.59; 95% CI, 0.44–0.78). Use of continuous sedation was also associated with an increased risk of unplanned removal of PACs (hazard ratio, 1.54; 95% CI, 1.10–2.16). There was a 50% survival probability at 13.3 days for un-sutured PACs and 23.7 days for sutured PACs. Conclusions: Suturing is associated with fewer unplanned removals and longer catheter survival, compared to un-sutured PACs in pediatric patients.
Patient Learning Pathway: Identifying Patient Competencies in Teledermatology for Effective Management of Dermatological Conditions
Authors: Montiel Corentin , Jackson Mathieu , Clovin Tiffany , Bogdanova Eleonora , Côté Catherine , Descoteaux Annie , Wong Caroline , Dumez Vincent , Pomey Marie-Pascale , Hanna Dominique 
Published: March 2024

Background: Dermatology consultations in Québec, Canada, face accessibility challenges, with most dermatologists concentrated in urban areas. Teledermatology, offering remote diagnosis and treatment, holds promise in overcoming these limitations. However, concerns regarding patient-doctor relationships and logistical issues exist. Objectives: This article aims to introduce a dermatology patient learning pathway (PLP) developed by the Centre of Excellence on Partnership with Patients and the Public (CEPPP), focusing on knowledge, abilities, and skills mobilized by patients and their loved ones at key moments of the life course with an illness, as well as emerging educational needs. Methods: The PLP development was co-developed with dermatology patient and caregiver partners, stakeholders, and the CEPPP team. The process encompassed stakeholder engagement, exploration, recruitment of patient and caregiver partners, co-development of the PLP draft, and validation through consensus building. Results: The PLP methodology led to the creation of 44 learning objectives, comprising a total of 107 subobjectives. These objectives were organized into 8 phases of the patient life course with a dermatological condition: (1) prevention and predisposition; (2) discovery, self-examination, or observation of a change; (3) first consultation; (4) wandering; (5) consultation with a dermatologist; (6) diagnosis; (7) treatments; and (8) living with it. Conclusions: The dermatology PLP serves as a resource outlining patient competency across different stages of managing a dermatological condition throughout their life course. In the context of teledermatology, the PLP might facilitate patient and caregiver engagement by helping select appropriate information and tools to support active participation in care.
Post-stroke emotionalism: Diagnosis, pathophysiology, and treatment
Authors: Broomfield Niall M , Blake Joshua , Gracey Fergus , Steverson Tom 
Published: March 2024

Background: Post-stroke emotionalism affects one in five stroke sufferers 6 months after their stroke, but despite its frequency remains a poorly understood stroke symptom. The literature is limited, especially compared to other frequently observed neurological conditions such as aphasia and visual neglect. Aim and Methods: This narrative review presents a summary of the post-stroke emotionalism literature, to inform clinical practice and future research. We cover discussion of definitions, prevalence, neurobiology, predisposing and precipitating factors, and treatment. Results: Increasing evidence suggests that damage to specific areas functionally linked to emotion expression or regulation processes, disruption to structural pathways and those related to serotonin production and modulation individually or in concert give rise to emotionalism-type presentations. A range of emotionalism measurement tools have been used in research contexts making between study comparisons difficult. Testing for Emotionalism after Recent Stroke–Questionnaire (TEARS-Q) has recently been developed to allow standardized assessment. Treatment options are limited, and there have been few adequately powered treatment trials. Antidepressants may reduce severity, but more trial data are required. There have been no randomized-controlled trials of non-pharmacological interventions. Conclusions: More research is needed to improve recognition and treatment of this common and disabling symptom. We conclude with research priorities and recommendations for the field.
Characteristics Associated With Elevated Time Below Range in Elderly Patients With Type 1 Diabetes Using an Automated Insulin Delivery System
Authors: Gómez Medina Ana María , Parra Prieto Darío A. , Henao Carrillo Diana Cristina , Gómez Claudia Milena , Muñoz Velandia Oscar Mauricio , Caicedo Sandra , Kerguelen Villadiego Alfonso Luis , Rodríguez Hortúa Luis Miguel , Lucero Pantoja Oscar David , Uribe Valencia Mauricio , García Guete María Margarita , Robledo Gómez Sofia , Rondón Sepúlveda Martin 
Published: March 2024

Background: This study investigated the characteristics associated with an increased risk of hypoglycemia, in elderly patients with type 1 diabetes mellitus (T1D) using automated insulin delivery (AID) systems. Methods: Cross-sectional observational study including patients >60 years, using sensor-augmented insulin pump therapy with predictive low-glucose management (SAPT-PLGM), hybrid closed-loop (HCL), and advanced hybrid closed-loop (AHCL), for more than three months. A geriatric assessment was performed, and body composition was determined to investigate its association with achieving time below range (TBR) <70 mg/dL goals. Results: The study included 59 patients (47.5% of men, mean age of 67.6 years, glycated hemoglobin [HbA1c] of 7.5 ± 0.6%, time in range (TIR) 77.8 ± 9.9%). Time below range <70 and <54 mg/dL were 2.2 ± 2.3% and 0.4 ± 0.81%, respectively. Patients with elevated TBR <70 mg/dL (>1%) had higher HbA1c levels, lower TIR, elevated time above range (TAR), and high glycemic variability. Regarding body composition, greater muscle mass, grip strength, and visceral fat were associated with a lower TBR <70 mg/dL. These factors were independent of the type of technology used, but TIR was higher when using AHCL systems compared with SAPT-PLGM and HCL systems. Conclusions: In elderly patients treated with AID systems with good functional status, lower lean mass, lower grip strength, and lower visceral fat percentage were associated with TBR greater than 1%, regardless of the device used. A similar finding along was found with CGM indicators such as higher HbA1c levels, lower TIR, higher TAR, and higher CV. Geriatric assessment is crucial for personalizing patient management.
Indications, Associated Procedures, and Results of Ankle Plafond-Plasty for Varus Ankle Osteoarthritis: A Systematic Review and Meta-Analysis
Authors: Zielli Simone Ottavio , Mazzotti Antonio , Artioli Elena , Marcolli Daniele , Arceri Alberto , Bonelli Simone , Faldini Cesare 
Published: March 2024

Backgrounds Plafond-plasty is a joint-preserving procedure to treat varus ankle osteoarthritis (OA) with asymmetrical joint involvement. The aim of this systematic review and meta-analysis was to evaluate indications, different surgical techniques, associated procedures, and results of plafond-plasty in varus ankle OA and to analyze the level of evidence (LOE) and quality of evidence (QOE) of the included studies. Methods A systematic review of the literature was performed using MEDLINE, Embase, and Cochrane. Results Five studies evaluating 99 ankles were included. A non-rigid varus ankle deformity and an ankle OA Takakura stage 3b or less were the most recommended pre-operative indications. Meta-analysis showed a significant post-operative improvement in clinical and radiological parameters. Many associated surgical procedures have been reported, the most frequent being medial additional supramalleolar osteotomy and lateral ankle ligament reconstruction. The level of evidence and methodological quality assessment of the included studies showed an overall low quality. Conclusion Plafond-plasty seems to be a promising surgical option when managing varus ankle OA with asymmetrical joint involvement, extending the indications for joint sparing surgery. Additional associated procedures should be carefully evaluated case-by-case. Levels of Evidence: IV
Evidence-Based Update on the Surgical Technique and Clinical Outcomes of Retrograde Drilling: A Systematic Review
Authors: Yasui Youichi , Miyamoto Wataru , Shimozono Yoshiharu , Tsukada Keisuke , Kawano Hirotaka , Takao Masato 
Published: March 2024

Background Retrograde drilling is an established surgical technique to treat osteochondral lesions of the talus (OLT). It involves non-trans-articular drilling to induce subchondral bone revascularization and bone formation without damaging the overlying articular cartilage. The present study aimed to elucidate the heterogeneity of clinical studies on retrograde drilling for OLT. Design A systematic search of the MEDLINE, Web of Science, EMBASE, and Cochrane Library databases for studies published between January 1996 and August 27, 2022, was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines by two independent reviewers. The included studies were evaluated for their level of evidence (LoE) and quality of evidence (QoE) using the Modified Coleman Methodology Score. Variables reporting surgical and clinical outcomes and complications were evaluated. Results Eleven studies with 207 ankles were included (mean follow-up period = 31.1 months). The mean LoE was 3.8 (LoE 3: two studies, LoE 4: nine studies), and the mean QoE was 50.8 (fair: three studies, poor: eight studies). Ten studies used the American Orthopedic Foot and Ankle Society (AOFAS) score, which improved from 57.9 preoperatively to 86.1 postoperatively. The period and protocol of conservative treatment, lesion character, surgical technique, and postoperative protocol were inconsistent or underreported. Conclusions This systematic review revealed that low LoE and poor QoE, coupled with heterogeneity among the included studies, impede definitive conclusions regarding the effectiveness of this technique. Consequently, well-designed clinical trials are essential to develop standardized clinical guidelines for using retrograde drilling in OLT.
Assessment of Mild Cognitive Impairment Using CogEvo: A Computerized Cognitive Function Assessment Tool
Authors: Satoh Toru , Sawada Yoichi , Saba Hideaki , Kitamoto Hiroshi , Kato Yoshiki , Shiozuka Yoshiko , Kuwada Tomoko , Shima Sayoko , Murakami Kana , Sasaki Megumi , Abe Yudai , Harano Kaori 
Published: March 2024

Introduction/Objectives: To assess the utility of the computerized cognitive function assessment tool, CogEvo, as a screening tool for mild cognitive impairment in primary care, we explored the relationship between CogEvo performance, age, and the severity of cognitive dysfunction evaluated by the Mini-Mental State Examination (MMSE). Methods: The observational cross-sectional study included 209 individuals’ data (mean age 79.4 ± 8.9 years). We conducted a correlation analysis between CogEvo and MMSE scores, compared the performance among the 3 cognitive function groups (MMSE ≥ 28 group; MMSE24-27 group; MMSE ≤ 23 group) using the MMSE cut-off, and evaluated CogEvo’s predictive accuracy for cognitive dysfunction through ROC analysis. Results: Both total CogEvo and MMSE scores significantly decreased with age. A significant positive correlation was observed between total CogEvo and MMSE scores, but a ceiling effect was detected in MMSE performance. Significant differences were observed in the total CogEvo score, including orientation and spatial cognitive function scores, among the 3 groups. CogEvo showed no educational bias. ROC analyses indicated moderate discrimination between the MMSE ≥ 28 group and the MMSE24-27 and MMSE ≤ 23 groups. Conclusions: The computer-administered CogEvo has the advantage of not exhibiting ceiling effects or educational bias like the MMSE, and was found to be able to detect age-related cognitive decline and impairment.