bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comparison between the Only Two Documented Tornado Outbreak Events in China: Tropical Cyclone versus Extratropical Cyclone Environments
Authors: Wen Jingyi , Meng Zhiyong , Bai Lanqiang , Zhou Ruilin 
Published: February 2024

Abstract
This study documents the features of tornadoes, their parent storms, and the environments of the only two documented tornado outbreak events in China. The two events were associated with Tropical Cyclone (TC) Yagi on 12 August 2018 with 11 tornadoes and with an extratropical cyclone (EC) on 11 July 2021 (EC 711) with 13 tornadoes. Most tornadoes in TC Yagi were spawned from discrete minisupercells, while a majority of tornadoes in EC 711 were produced from supercells imbedded in QLCSs or cloud clusters. In both events, the high-tornado-density area was better collocated with the K index rather than MLCAPE, and with entraining rather than non-entraining parameters possibly due to their sensitivity to midlevel moisture. EC 711 had a larger displacement between maximum entraining CAPE and vertical wind shear than TC Yagi, with the maximum entraining CAPE better collocated with the high-tornado-density area than vertical wind shear. Relative to TC Yagi, EC 711 had stronger entraining CAPE, 0–1-km storm relative helicity, 0–6-km vertical wind shear, and composite parameters such as an entraining significant tornado parameter, which caused its generally stronger tornado vortex signatures (TVSs) and mesocyclones with a larger diameter and longer life span. No significant differences were found in the composite parameter of these two events from U.S. statistics. Although obvious dry air intrusions were observed in both events, no apparent impact was observed on the potential of tornado outbreak in EC 711. In TC Yagi, however, the dry air intrusion may have helped tornado outbreak due to cloudiness erosion and thus the increase in surface temperature and low-level lapse rate.
Updates in the NCEP GFS PBL and Convection Models with Environmental Wind Shear Effect and Modified Entrainment and Detrainment Rates and Their Impacts on the GFS Hurricane and CAPE Forecasts
Authors: Han Jongil , Peng Jiayi , Li Wei , Wang Weiguo , Zhang Zhan , Yang Fanglin , Zheng Weizhong 
Published: February 2024

Abstract
To reduce hurricane intensity bias, the NCEP Global Forecast System (GFS) planetary boundary layer (PBL) and convection schemes have been updated with a new parameterization for environmental wind shear and enhanced entrainment and detrainment rates with increasing PBL or subcloud mean turbulent kinetic energy (TKE) in their updraft and downdraft mass-flux schemes. Tests with the GFS show that the updated schemes significantly reduce the hurricane intensity bias by reducing the momentum transport in the mass-flux schemes. Along with the reduced intensity bias, the hurricane intensity and track errors have also been reduced. On the other hand, to reduce the PBL overgrowth over areas with a higher vegetation fraction or larger surface roughness, the entrainment rate in the PBL mass-flux scheme has also been increased with increasing vegetation fraction or increasing surface roughness. This entrainment rate increase has increased near-surface moisture, and as a result, helped to increase the underestimated convective available potential energy (CAPE) forecasts over the continental United States.
Impact of Contrast-Associated Acute Kidney Injury on One-Year Outcomes in Very Elderly STEMI Patients: Insights From a Multicenter Registry in Northern Italy
Authors: Ruzzarin Alessandro , Muraglia Simone , Fabris Enrico , Caretta Giorgio , Zilio Filippo , Pezzato Andrea , Campo Gianluca , Unterhuber Matthias , Donazzan Luca 
Published: February 2024

Data about contrast-associated acute kidney injury (CA-AKI) in oldest old (age ≥85 years) ST-elevation myocardial infarction (STEMI) patients are scarce. We evaluated the incidence and the 1-year prognostic impact of CA-AKI in this population. Patients were included in a multicenter real-world registry, and CA-AKI was defined according to KDIGO (Kidney Disease Improving Global Outcomes) criteria. Major adverse cardiac and cerebrovascular events (MACCEs) were defined as the composite of all-cause death, stroke, unplanned coronary revascularization, and heart failure hospitalization. The primary outcome was the incidence and impact of CA-AKI on MACCEs at 1 year follow-up. Out of 461 STEMI patients (mean age 88.6 ± 2.9 years), 102 (22.1%) patients developed CA-AKI. Chronic kidney disease was the strongest predictor of CA-AKI (odds ratio [OR]: 4.52, 95% CI: 2.81–7.30, P < .01). The CA-AKI cohort showed a higher risk of MACCEs (adjusted HR: 1.75, 95% CI: 1.13–2.71, P = .01), driven mainly by all-cause death (adjusted hazard ratio [HR]: 2.39, 95% CI: 1.41–4.07, P = .01) and followed by heart failure hospitalization (adjusted HR: 2.01, 95% CI: 1.08–3.76, P = .01). Among oldest old STEMI, CA-AKI was frequent and associated with a higher incidence of MACCEs at 1-year follow-up.
How palliative care professionals develop coping competence through their career: A grounded theory
Authors: Arantzamendi Maria , Sapeta Paula , Belar Alazne , Centeno Carlos 
Published: February 2024

Background: Palliative care professionals face emotional challenges when caring for patients with serious advanced diseases. Coping skills are essential for working in palliative care. Several types of coping strategies are mentioned in the literature as protective. However, little is known about how coping skills are developed throughout a professional career. Aim: To develop an explanatory model of coping for palliative care professionals throughout their professional career. Design: A grounded theory study. Two researchers conducted constant comparative analysis of interviews. Setting/participants: Palliative care nurses and physicians across nine services from Spain and Portugal ( n = 21). Theoretical sampling included professionals who had not continued working in palliative care. Results: Professionals develop their coping mechanisms in an iterative five-stage process. Although these are successive stages, each one can be revisited later. First: commencing with a very positive outlook and emotion, characterized by contention. Second: recognizing one’s own vulnerability and experiencing the need to disconnect. Third: proactively managing emotions with the support of workmates. Fourth: cultivating an integrative approach to care and understanding one’s own limitations. Fifth: grounding care on inner balance and a transcendent perspective. This is a transformative process in which clinical cases, teamwork, and selfcare are key factors. Through this process, the sensations of feeling overwhelmed sometimes can be reversed because the professional has come to understand how to care for themselves. Conclusions: The explicative model presents a pathway for personal and professional growth, by accumulating strategies that modulate emotional responses and encourage an ongoing passion for work.
A transhumeral prosthesis with an artificial neuromuscular system: Sim2real-guided design, modeling, and control
Authors: Toedtheide Alexander , Fortunić Edmundo Pozo , Kühn Johannes , Jensen Elisabeth , Haddadin Sami 
Published: February 2024

In this work we introduce a new type of human-inspired upper-limb prostheses. The Artificial Neuromuscular Prosthesis (ANP) imitates the human neuromuscular system in the sense of its compliance, backdrivability, natural motion, proprioceptive sensing, and kinesthetics. To realize this challenging goal, we introduce a novel human-inspired and simulation-based development paradigm to design the prosthesis mechatronics in correspondence to the human body. The ANP provides body awareness, contact awareness, and human-like contact response, realized via floating base rigid-body models, disturbance observers, and joint impedance control—concepts known from established state-of-the-art robotics. The ANP mechatronics is characterized by a four degrees of freedom (dof) torque-controlled human-like kinematics, a tendon-driven 2-dof wrist, and spatial orientation sensing at a weight of 1.7 kg (without hand and battery). The paper deals with the rigorous mathematical modeling, control, design and evaluation of this device type along initially defined requirements within a single prototype only. The proposed systemic and grasping capabilities are verified under laboratory conditions by an unimpaired user. Future work will increase the technology readiness level of the next generation device, where human studies with impaired users will be done.
Impact of weight reduction on structural and functional parameters of the optic nerve in idiopathic intracranial hypertension
Authors: Banerjee Mousumi , Phuljhele Swati , Saxena Rohit , Sharma Pradeep , Misra Vasundhra , Vibha Deepti , Pandit Awadh Kishor 
Published: February 2024

Purpose To evaluate the effect of weight reduction on the structural and functional parameters of the optic nerve in established cases of papilledema in Idiopathic Intracranial Hypertension (IIH). Methods A prospective observational study in early and established cases of papilledema in IIH presenting from December 2019 to February 2021. Functional parameters (visual acuity, contrast sensitivity, mean deviation, VER), structural parameters (RNFL, GCL-IPL, and optic disc height), and clinical grading of papilledema were measured at baseline and every 6 weeks for 6 months. All patients underwent medical (oral acetazolamide) and diet therapy. Results Mean body mass index (BMI) at presentation was 26.32 ± 3.52 kg/m² and the mean change in BMI over 6 months was 1.27 ± 0.50 kg/m². 67% of eyes had papilledema of grades 2–3 at the presentation. At the end of 6 months, 75% of eyes had grade 1 papilledema while 13% showed complete resolution. A reduction of 5.32 ± 3.58 in mean deviation (r = 0.316; p-value 0.01) and gain in VER P100 amplitude of 4.2 ± 2.7 µV (r = 0.40; p-value 0.003) were noted over 6 months with reduction in BMI over 6 months. A statistically significant reduction in optic disc height (ODH) was noticed with BMI reduction over 6 months (p = 0.0007; r = 0.45). A reduction of 1.72 ± 0.90 kg/m² ( equivalent to 6.53% weight loss) in BMI was associated with a four-grade change in clinical grading of papilledema. Conclusion Reduction in BMI had a significant impact on both structural and functional parameters of the optic nerve in IIH. The involvement of a well-certified dietician should be an integral part of treatment in IIH.
Epibulbar simple cartilaginous choristoma associated with unique pigmented multicystic component
Authors: Yu Julia , Eagle Ralph C , Syed Zeba A 
Published: February 2024

Purpose To report an atypical presentation of an epibulbar simple cartilaginous choristoma with a unique pigmented multicystic component. Case Description A 69-year-old African American female presented for evaluation of a right nasal epibulbar lesion that had progressed over the prior year. Slit-lamp evaluation revealed an immobile, mildly pigmented multicystic lesion measuring 6.0 × 4.5 mm that involved the nasal bulbar conjunctiva and the plica semilunaris. The lesion appeared benign, without feeder vessels or features of epithelial dysplasia. Given its recent growth and the patient's cosmetic concerns, the lesion was excised with ocular surface reconstruction. Histopathological evaluation disclosed a well-circumscribed nodule of well-differentiated cartilage in the substantia propria, consistent with a simple cartilaginous choristoma. The overlying conjunctival stroma contained multiple cysts lined by focally pigment epithelium. The patient recovered well from surgery, with satisfactory cosmetic results. Conclusions Our case of epibulbar simple cartilaginous choristoma includes a prominent superficial component of pigmented epithelial cysts, which has not been previously reported in the literature. This augments our knowledge on the spectrum of presentations of cartilaginous choristomas and underscores the importance of histopathological evaluation for definitive diagnosis.
Literacy in nonspeaking autistic people
Authors: Jaswal Vikram K , Lampi Andrew J , Stockwell Kayden M 
Published: February 2024

Autistic people who cannot speak risk being underestimated. Their inability to speak, along with other unconventional behaviors and mannerisms, can give rise to limiting assumptions about their capacities, including their capacity to acquire literacy. In this preregistered study, we developed a task to investigate whether autistic adolescents and adults with limited or no phrase speech ( N = 31) have learned English orthographic conventions. Participants played a game that involved tapping sequentially pulsing targets on an iPad as quickly as they could. Three patterns in their response times suggest they know how to spell: (a) They were faster to tap letters of the alphabet that pulsed in sequences that spelled sentences than letters or nonsense symbols that pulsed in closely matched but meaningless sequences; (b) they responded more quickly to pairs of letters in meaningful sequences the more often the letters co-occur in English; and (c) they spontaneously paused before tapping the first pulsing letter of a new word. These findings suggest that nonspeaking autistic people can acquire foundational literacy skills. With appropriate instruction and support, it might be possible to harness these skills to provide nonspeaking autistic people access to written forms of communication as an alternative to speech. Lay abstract Many autistic people who do not talk cannot tell other people what they know or what they are thinking. As a result, they might not be able to go to the schools they want, share feelings with friends, or get jobs they like. It might be possible to teach them to type on a computer or tablet instead of talking. But first, they would have to know how to spell. Some people do not believe that nonspeaking autistic people can learn to spell. We did a study to see if they can. We tested 31 autistic teenagers and adults who do not talk much or at all. They played a game on an iPad where they had to tap flashing letters. After they played the game, we looked at how fast they tapped the letters. They did three things that people who know how to spell would do. First, they tapped flashing letters faster when the letters spelled out sentences than when the letters made no sense. Second, they tapped letters that usually go together faster than letters that do not usually go together. This shows that they knew some spelling rules. Third, they paused before tapping the first letter of a new word. This shows that they knew where one word ended and the next word began. These results suggest that many autistic people who do not talk can learn how to spell. If they are given appropriate opportunities, they might be able to learn to communicate by typing.
An ethnography of mealtime care for people living with dementia in care homes
Authors: Faraday James , Abley Clare , Patterson Joanne M , Exley Catherine 
Published: February 2024

Many people living with dementia have difficulties at mealtimes, which can result in serious complications for physical and mental health, leading to hospital admissions and even death. However, current training in mealtime care for staff working with this population has been found to be poorly reported, with variable effectiveness. It is essential that care home staff are able to provide good care at mealtimes. This study used ethnography to explore current practice in mealtime care for this population, identify good practice, and understand the factors influencing mealtime care. Approximately 28 h of mealtime observations were conducted in two UK care homes with diverse characteristics. Observations focused on interactions between care staff and residents living with dementia. Twenty-five semi-structured interviews were carried out with care home staff, family carers, and visiting health and social care professionals, to explore mealtime care from their perspectives. A constant comparative approach was taken, to probe emergent findings and explore topics in greater depth. Key thematic categories were identified, including: tensions in mealtime care; the symbolic nature of mealtime care; navigating tensions via a person-centred approach; contextual constraints on mealtime care; and teamwork in mealtime care. The findings indicated that a person-centred approach helps carers to find the right balance between apparently competing priorities, and teamwork is instrumental in overcoming contextual constraints. This evidence has contributed to development of a training intervention for care home staff. Future research should investigate the feasibility of mealtime care training in care homes.
Physician-led thoracic ultrasound-guided biopsy; a district general hospital perspective
Authors: Cafferkey M.J. , Martin G.A. 
Published: February 2024

Background: Physician-led thoracic ultrasound (TUS)-guided biopsies provide a prompt route to tissue diagnosis in pleural and peripheral lung malignancies. This retrospective study reviews the diagnostic performance and safety of this approach in a UK District General Hospital. Methods: Time to biopsy, diagnostic yield and complication rate were analysed in a cohort of 49 patients undergoing ultrasound-guided tissue sampling between September 2019 and December 2022. Results: Fifty-one TUS-guided biopsies were attempted. Mean time from decision to biopsy was 5 days. The overall diagnostic yield was 82%. Complication rate was low; 3 minor adverse effects were reported which led to no change in routine care. Conclusion: This single centre retrospective study shows that physician-led TUS-guided biopsy provides a safe and timely method of obtaining a tissue diagnosis in thoracic malignancy. It offers an alternative to computer tomography (CT)-guided or thoracoscopic biopsies and should be considered in selected patients where local procedural expertise exists.
STABILISE (Stent-Assisted Balloon-Induced Intimal Disruption and Relamination in Aortic Dissection Repair) Is Associated With Good Anatomical Results on the Distal Thoracoabdominal Aorta at 2 Years
Authors: Maurin Arnaud , Jacquier Alexis , Bartoli Axel , Barral Pierre-Antoine , Vecchini Fabien , Mancini Julien , Omnes Virgile , DeMasi Mariangela , Piquet Philippe , Gaudry Marine 
Published: February 2024

Purpose: The aim of this comparative study was to evaluate the increased aortic diameter of the distal aorta after implementing the STABILISE technique in complicated type B aortic dissection (AD). Design: This is a comparative monocentric retrospective study. Materials and Methods: All patients who underwent an STABILISE procedure for complicated AD between 2018 and 2020 were included and compared with a historic cohort treated with thoracic endovascular aortic repair (TEVAR) alone. Aortic diameters were measured at 6 different levels on the thoracic and abdominal aorta. The primary end point was an increased aortic diameter at 1 and 2 years. The exclusion criterion was the absence of a computed tomography (CT) scan at 1 or 2 years. Results: A total of 55 patients were included: 24 in the TEVAR group and 31 in the STABILISE group. At the level of the stent graft, there was a decrease in aortic diameters in both groups without significant differences. At the level of the distal aorta, there was an increase in aortic diameters in both groups without significant differences. There were significantly more patients in the TEVAR group with an unfavorable increase in aortic diameter >5 mm of the distal aorta at 2 years than in the STABILISE group: 8 (33%) vs 1 (3%) (p=0.01). For chronic ADs, a significantly greater increase in aortic diameters of the distal aorta was observed in the STABILISE group. Conclusions: The STABILISE technique is technically feasible and potentially leads to decreased longer re-intervention rates; indeed, more patients had an unfavorable increase in aortic diameter in the TEVAR group than in the STABILISE group at 2 years. The high rate of long-term distal aortic aneurysm progression and reintervention after TEVAR alone suggests that this option is not sufficient to definitively treat these complex patients. Clinical Impact This article reported the results of stent assisted balloon induced intimal disruption and relamination (STABILISE) with a follow-up at 2 years. This is the first comparative study between STABILISE, which has emerged as a new technique inducing aortic remodeling and therefore better long-term outcome, and the standard technique TEVAR alone. STABILISE technique is associated with good results on the distal aorta at 2 years with a rate of patient with unfavorable aortic diameter evolution greater in TEVAR group compared to STABILISE group and could improve the long-term results on the distal aorta by inducing extensive aortic remodeling.
Drug safety in older patients with alcohol use disorder: a retrospective cohort study
Authors: Schröder Sebastian , Westhoff Martin Schulze , Pfister Tabea , Seifert Johanna , Bleich Stefan , Koop Felix , Proskynitopoulos Phileas Johannes , Glahn Alexander , Heck Johannes 
Published: February 2024

Background: Older patients with alcohol use disorder are at particular risk of developing adverse drug reactions due to multimorbidity, polypharmacy, and altered organ function. Objectives: In this study, we investigated the frequency and characteristics of potentially serious alcohol–medication interactions, potentially inappropriate medications (PIMs) for older adults, and potential drug–drug interactions (pDDIs) in a population of older patients with alcohol use disorder over a 10-year period. Design: Retrospective monocentric cohort study. Methods: Prescribed medications were screened for potentially serious alcohol–medication interactions, PIMs, and pDDIs using the POSAMINO (POtentially Serious Alcohol–Medication INteractions in Older adults) criteria, the PRISCUS 2.0 list, the FORTA (Fit fOR The Aged) classification, and the drug interaction program AiD Klinik®. Results: We enrolled 114 patients aged ⩾65 years with alcohol use disorder, who were treated in an addiction unit of a university hospital in Germany. About 80.7% of the study population had at least one potentially serious alcohol–medication interaction. Potentially serious alcohol–medication interactions most commonly affected the cardiovascular (57.7%) and the central nervous system (32.3%). A total of 71.1% of the study population received at least one prescription of a FORTA C or D drug, compared with 42.1% who received at least one PIM prescription according to the PRISCUS 2.0 list. A total of 113 moderate and 72 severe pDDIs were identified in the study population. Conclusion: Older patients with alcohol use disorders are frequently exposed to potentially serious alcohol–medication interactions, PIMs, and pDDIs. Improvements in the quality of prescribing should primarily target the use of cardiovascular and psychotropic drugs.