bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tornadoes in Southeast South America: Mesoscale to Planetary-Scale Environments
Authors: Veloso-Aguila Daniel , Rasmussen Kristen L. , Maloney Eric D. 
Published: November 2023

Abstract
A multiscale analysis of the environment supporting tornadoes in southeast South America (SESA) was conducted based on a self-constructed database of 74 reports. Composites of environmental and convective parameters from ERA5 were generated relative to tornado events. The distribution of the reported tornadoes maximizes over the Argentine plains, while events are rare close to the Andes and south of Sierras de Córdoba. Events are relatively common in all seasons except in winter. Proximity environment evolution shows enhanced instability, deep-layer vertical wind shear, storm-relative helicity, reduced convective inhibition, and a lowered lifting condensation level before or during the development of tornadic storms in SESA. No consistent signal in low-level wind shear is seen during tornado occurrence. However, a curved hodograph with counterclockwise rotation is present. The Significant Tornado Parameter (STP) is also maximized prior to tornadogenesis, most strongly associated with enhanced CAPE. Differences in the convective environment between tornadoes in SESA and the U.S. Great Plains are discussed. On the synoptic scale, tornado events are associated with a strong anomalous trough crossing the southern Andes that triggers lee cyclogenesis, subsequently enhancing the South American low-level jet (SALLJ) that increases moisture advection to support deep convection. This synoptic trough also enhances vertical shear that, along with enhanced instability, sustains organized convection capable of producing tornadic storms. At planetary scales, the tornadic environment is modulated by Rossby wave trains that appear to be forced by convection near northern Australia. Madden–Julian oscillation phase 3 preferentially occurs 1–2 weeks ahead of tornado occurrence.

Significance Statement
The main goal of this study is to describe what atmospheric conditions (from local to global scales) are present prior to and during tornadic storms impacting southeast South America (SESA). Increasing potential for deep convection, wind shear, and potential for rotating updrafts, as well as reducing convective inhibition and cloud-base height, are predominant a few hours before and during the events in connection to low-level northerly winds enhancing moisture transport to the region. Remote convective activity near northern Australia appears to influence large-scale atmospheric circulation that subsequently triggers convective storms supporting tornadogenesis 1–2 weeks later in SESA. Our findings highlight the importance of accounting for atmospheric processes occurring at different scales to understand and predict tornado occurrences.
Del Nido cardioplegia in adult cardiac surgery: Clinical outcomes in a single center all-comer study
Authors: Di Bacco Lorenzo , Rosati Fabrizio , Repossini Alberto , Baudo Massimo , Renghini Mauro , Maddinelli Debora , Boldini Francesca , Zanin Francesca , Tomasi Cesare , Muneretto Claudio , Benussi Stefano 
Published: November 2023

Introduction The use of Del Nido Cardioplegia (DNC) has been extended in the latest years from pediatrics to adult cardiac surgery with encouraging results. We sought to investigate clinical and biochemical outcomes in adult patients who underwent cardiac surgery with different degrees of complexity who received DNC for myocardial protection. Methods Data on one-thousand patients were retrospectively collected from 2020 to 2022. The only exclusion criteria was off-pump adult cardiac surgery. Surgical procedures weight was categorized according EuroSCORE II in six groups: Single-CABG(G1), isolated non-CABG(mitral) (G2), isolated non-CABG(aortic) (G3), isolated non-CABG(any) (G4), 2-procedures(G5), 3/more-procedures(G6). Primary endpoint was to identify a binomial correlation between hs-TnT/CK-MB and the cross-clamp time (X-Clamp). A secondary endpoint was the comparison between the treatment groups of the vasoactive-inotropic score (VIS) and the need of mechanical circulatory support (MCS). Results A linear correlation was identified between hs-TnT and X-clamp in the overall population (rho:0.447, p< .001) and in the treatment groups (G1:rho=0.357, p< .001/G2:rho=0.455, p< .001/G3:rho=0.307, p= .001/G4:rho=0.165, p= .257/G5:rho=0.157, p= .031/G6:rho=0.226, p= .015). Similarly, a linear correlation between CK-MB and X-clamp in the overall population (rho=0.457, p< .001) and treatment group (G1:rho=0.282, p< .001/G2:rho=0.287, p= .025/G3:rho=0.211, p= .009/G4:rho=0.0878, p= .548/G5:rho=0.309, p< .001/G6: rho=0.212, p= .024) was identified. As regard for the secondary endpoint, no differences were reported between the treatment groups in terms of VIS and MCS (VIS G1:7; G2:4; G3:7; G4:7, G5:5.5, G6:6, p-value= .691) (MCS G1: 4.5%; G2:4.8%; G3:3.3%; G4:3.1%; G5:1.4%; G6:5.3%; p-value= .372). Conclusions Del Nido Cardioplegia is a safe and useful tool in adult cardiac surgery allowing operators to achieve a stable and durable cardioplegic arrest. Despite accounting with different types of surgery, the six subgroups of our study population showed similar perioperative results.
When and how political skill becomes counterproductive: A moral licensing view
Authors: Zahid Fariha , Butt Arif Nazir , Malik Muhammad Abdul Rahman 
Published: November 2023

Counterintuitive to the generally prevailing positive view of political skill, we suggest that this social competency also has the potential to foster dysfunctional outcomes for organizations. Drawing insights from moral licensing theory, the study examines a framework that explains how politically skilled employees strategize to fulfill their self-serving objectives through leader-member exchange (LMX) relations. The findings from a multi-source sample of 250 private sector employees supported our proposed framework and demonstrated that political skill is indirectly related to self-serving counterproductive behaviors through LMX, with psychological entitlement as an important boundary condition. The study’s implications, its strengths and limitations, and future research directions are also discussed. JEL Classification: D23
Factors Influencing the Medication Adherence in Adults With Attention-Deficit/Hyperactivity Disorder (ADHD) and Its Impact on Healthcare Utilization
Authors: Jeun Ki Jin , Nduaguba Sabina , Al-Mamun Mohammad A. 
Published: November 2023

Objective: This study aims to investigate the factors influencing medication adherence among adults with Attention-Deficit/Hyperactivity Disorder (ADHD) and impact of central nervous system stimulants (CNS) adherence on healthcare utilization (HCU). Methods: This was a cross-sectional study using Medical Expenditure Panel Survey 2013 to 2019, with participants (≥18 years of age) with ADHD and had at least one CNS prescription. Multivariate logistic and linear regression were utilized to evaluate the medication adherence and its impact on HCU, respectively. Result: Total 798 (10,718,005 weighted) ADHD patients, were mostly White (81%), aged between 18 and 25 (35%), and non-adherent to CNS (65%). The use of extended-release medications (OR = 1.51 [1.03, 2.23]) and new users (OR = 3.46 [2.12, 5.63], p ≤ .05) were positively associated with medication adherence. The adherent group utilized more outpatient visits (0.04 vs. 0.46) and prescription refills (18.38 vs. 31.25) compared to non-adherent. Conclusion: Our findings can be applied to improve the medication adherence, patient education, and optimize intervention for adults with ADHD.
Coping in Post-Mastectomy Breast Cancer Survivors and Need for Intervention: Systematic Review
Authors: Mishra Anju , Nair Jayajith , Sharan Anjali Midha 
Published: November 2023

Background: Breast cancer is the most prominent cancer type to affect women. Surgical treatment of invasive breast cancers involves mastectomy. Due to mastectomy, women are subjected to social, emotional, and cultural problems which need to be addressed. Objective: The objective of the study is to understand how women cope with body image–related issues, trauma, anxiety, and depression post-mastectomy. Design: A systematic literature review was conducted for understanding the coping in post-mastectomy patients. The methods for identifying the studies were based on Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) guidelines. Databases: Medline/PubMed, PsycInfo, and Cochrane databases were used for searching relevant articles. A final of 19 studies were analyzed for the work. Methods: Search strings such as “coping strategies and post mastectomy,” “body image coping and post mastectomy” and “anxiety coping and post mastectomy” were used for identification of references from databases. Eligibility criteria were used for finalizing the references. Results: Analysis of the 19 studies has clearly shown that women who undergo mastectomy suffer from anxiety, stress, and trauma. This study has observed that women have problems with their body image post-mastectomy along with bouts of depression. Self-coping has been observed in relatively few studies. Psychological interventions before surgery have been observed to be a better coping strategy. In most of the studies, women opted for breast reconstruction to overcome the trauma associated with mastectomy. Conclusion: Mastectomy has a severe impact on women’s appearance and psychology. Breast reconstruction and acceptance have played an important role in coping among these women. However, breast reconstruction is not accepted by many women due to a multitude of factors. Thus, it is essential to have proper intervention programs in place to ensure women can cope with this situation and can lead healthy lives. Registration: Systematic literature review (SLR) is submitted to PROSPERO. The application confirmation number is 449135. Registration awaited from the database.
Hydrophobic modification of mesh spunlace nonwoven for medical dressing contact layer
Authors: Gu Jiahua , Wang Huiting , Dai Xinxin , Zhu Yuqi , Lin Dongqi , Liu Siyi , Han Xu , Lu Bin , Hu Yinsong , Zhang Yinjiang 
Published: November 2023

The contact layer of traditional medical dressing is easy to adhere to the new wound granulation tissue, which brings the deficiency of secondary wound injury. This work assumed that low-cost and soft mesh spunlace nonwoven was used as medical dressing contact layer. After micro-nano SiO2 modification, polydimethylsiloxane (PDMS)/n-heptane were uniformly sprayed on the surface of materials. PDMS modification was studied by using the three-factor three-level orthogonal experiment. The results showed that when the PDMS concentration was 1%, the heat treatment temperature and time were 120°C and 12 h respectively, material possessed the optimal hydrophobicity and its water contact angle (CA) was 151.0 ± 1.1°. Meanwhile, the hydrophobicity, microstructure, thermogravimetry, composition, tensile mechanics, adhesion resistance and durability of materials with/without treatment were compared. It was proved that PDMS was indeed grafted onto the material and could effectively improve the hydrophobicity in coordination with micro-nano SiO2 without affecting the mesh structure of material. The machine direction (MD) and cross-machine direction (CD) strength of material decreased but the elongation increased slightly. The MD and CD peeling energy was 129.7 ± 33.9 J/m2 and 98.1 ± 38.3 J/m2, respectively. Moreover, the water CA of material modified by micro-nano SiO2/PDMS was still 139.4 ± 1.4° after 10 friction stroke tests, indicating that the modified material possessed the great durability. Overall, this study can provide the research basis for the development of anti-adhesion medical dressing contact layer.
Acute Thrombosis of an Aneurysm of the Small Saphenous Vein: A Case Report
Authors: Hamdan Rémy , Precup Calin Gheorge , Falchero Catherine , Baldassini Anne-Laure , Castillo Christine 
Published: November 2023

Background A venous aneurysm (VA) is a focal dilatation of a nonvariceal vein (diameter increased by at least 1.5 times compared to the adjacent upstream or downstream venous segment), which carries a risk of venous thromboembolism (VTE) when located in the deep veins of the lower limbs but also when it affects the veins above the muscle fascia. Case We report the case of a 40-year-old woman who presented with a painful and disabling mass-like lesion of the upper third of the right calf. A Doppler ultrasound (DUS) examination revealed a small saphenous vein (SSV) dilated at the saphenopopliteal junction (SPJ) and thrombosed along its entire length. Anticoagulant treatment was initiated but although the thrombosis regressed on DUS, the functional impotence and the persistence of pain prompted a stripping of the SSV. Histology allowed the diagnosis of SSV’s primary aneurysm. Discussion Dilated segments of the saphenous vein are not always varicose veins (VVs). True VAs can develop on veins located above the muscular fascia and, like deep VAs, may trigger VTE. Small saphenous vein aneurysms have seldom been reported, and only a few clinical observations have described the thrombosis of a SSV aneurysm. Any mass in the popliteal fossa or upper part of the calf should be examined by DUS to look for an SSV aneurysm. Excision of the saphenous vein with junctional ligation is advised if thrombosis is present at the time of diagnosis.
Applications of Repetitive Transcranial Magnetic Stimulation to Improve Upper Limb Motor Performance After Stroke: A Systematic Review
Authors: Safdar Afifa , Smith Marie-Claire , Byblow Winston D. , Stinear Cathy M. 
Published: November 2023

Background Noninvasive brain stimulation (NIBS) is a promising technique for improving upper limb motor performance post-stroke. Its application has been guided by the interhemispheric competition model and typically involves suppression of contralesional motor cortex. However, the bimodal balance recovery model prompts a more tailored application of NIBS based on ipsilesional corticomotor function. Objective To review and assess the application of repetitive transcranial magnetic stimulation (rTMS) protocols that aimed to improve upper limb motor performance after stroke. Methods A PubMed search was conducted for studies published between 1st January 2005 and 1st November 2022 using rTMS to improve upper limb motor performance of human adults after stroke. Studies were grouped according to whether facilitatory or suppressive rTMS was applied to the contralesional hemisphere. Results Of the 492 studies identified, 70 were included in this review. Only 2 studies did not conform to the interhemispheric competition model, and facilitated the contralesional hemisphere. Only 21 out of 70 (30%) studies reported motor evoked potential (MEP) status as a biomarker of ipsilesional corticomotor function. Around half of the studies (37/70, 53%) checked whether rTMS had the expected effect by measuring corticomotor excitability (CME) after application. Conclusion The interhemispheric competition model dominates the application of rTMS post-stroke. The majority of recent and current studies do not consider bimodal balance recovery model for the application of rTMS. Evaluating CME after the application rTMS could confirm that the intervention had the intended neurophysiological effect. Future studies could select patients and apply rTMS protocols based on ipsilesional MEP status.
Ketone-Based Alert System for Insulin Pump Failures
Authors: Aiello Eleonora M. , Laffel Lori M. , Patti Mary-Elizabeth , Doyle Francis J. 
Published: November 2023

Background: An increasing number of individuals with type 1 diabetes (T1D) manage glycemia with insulin pumps containing short-acting insulin. If insulin delivery is interrupted for even a few hours due to pump or infusion site malfunction, the resulting insulin deficiency can rapidly initiate ketogenesis and diabetic ketoacidosis (DKA). Methods: To detect an event of accidental cessation of insulin delivery, we propose the design of ketone-based alert system (K-AS). This system relies on an extended Kalman filter based on plasma 3-beta-hydroxybutyrate (BOHB) measurements to estimate the disturbance acting on the insulin infusion/injection input. The alert system is based on a novel physiological model capable of simulating the ketone body turnover in response to a change in plasma insulin levels. Simulated plasma BOHB levels were compared with plasma BOHB levels available in the literature. We evaluated the performance of the K-AS on 10 in silico subjects using the S2014 UVA/Padova simulator for two different scenarios. Results: The K-AS achieves an average detection time of 84 and 55.5 minutes in fasting and postprandial conditions, respectively, which compares favorably and improves against a detection time of 193 and 120 minutes, respectively, based on the current guidelines. Conclusions: The K-AS leverages the rapid rate of increase of plasma BOHB to achieve short detection time in order to prevent BOHB levels from rising to dangerous levels, without any false-positive alarms. Moreover, the proposed novel insulin-BOHB model will allow us to understand the efficacy of treatment without compromising patient safety.
Cavernous Malformations and Hemangioblastomas of the Spinal Cord Show Distinct Differences in Clinical Course – A Retrospective Single-Center Analysis of 112 Patients
Authors: Pantel Tobias , Mende Klaus Christian , Mohme Theresa , Mohme Malte , Viezens Lennart , Matschke Jakob , Westphal Manfred , Eicker Sven Oliver 
Published: November 2023

Study Design Retrospective cohort study. Objective Cavernous malformations (CMs) and hemangioblastomas (HBs) of the spinal cord exhibit distinct differences in histopathology but similarities in the neurological course. The aim of our study was to analyze the clinical differences between the vascular pathologies and a benign tumor of the spinal cord in a perioperative situation. Methods We performed a retrospective analysis of patients who had undergone surgery for lesions in the spinal cord between 1984 and 2015. Patients were screened for CMs and HBs as the primary inclusion criteria. General patient information, surgical data, and disease-specific data were collected from the records. Cooper–Epstein scores for clinical symptoms were evaluated preoperatively, at discharge, and at the 6-month follow-up. Results A total of 112 patients were included, of which 46 had been diagnosed with CMs and 66 with HBs. Patients with CMs often demonstrated more preoperative neurological deterioration compared to those with HBs ( P < .05); accordingly, in took longer to diagnose HBs. Complete resection was possible for 96.8% of all patients with CMs and 90% of those with HBs. At the 6-month follow-up, patients with HBs more often presented with persisting neurologic impairment of the upper extremities compared to the CM patients ( P < .001). Conclusion CMs and HBs of the spinal cord have similarities but also exhibit significant differences in neurological presentation and perioperative course. Surgical therapy is the treatment of choice for symptomatic lesions, and complete surgical resection is possible in the majority of cases for both entities. Neurologic outcomes are usually favorable, although patients with HBs retain neurologic deficits more often.
Reliability of the Tibial Spine Versus ACL Stump in Assisting Tibial Tunnel Positioning During ACL Reconstruction: Analysis Based on 3-Dimensional Computed Tomography Modeling
Authors: Liu Weijie , Wu Yumei , Wang Xiaopeng , Kuang Shida , Su Chao , Xiong Yiling , Tang Hang , Xiao Yifan , Meng Jiahao , Gao Shuguang 
Published: November 2023

Background: Several techniques have been used by surgeons for anatomic tibial tunnel placement in anterior cruciate ligament (ACL) reconstruction, including the ACL stump positioning (ASP) technique and the tibial spine positioning (TSP) technique. Purpose/Hypothesis: The purpose of this study was to evaluate whether bony landmarks (medial and lateral tibial spine [MLTS]) can be a reliable reference for improving the accuracy of tibial tunnel placement in anatomic single-bundle ACL reconstruction compared with the ACL stump. It was hypothesized that the MLTS would not be a reliable bony landmark for tibial tunnel placement. Study Design: Cohort study; Level of evidence, 3. Methods: The 3-dimensional computed tomography images of 111 patients who underwent ACL reconstruction between 2020 and 2021 were included in this study. For tibial tunnel placement, the ASP technique was used in 49 patients, and the TSP technique was used in 62 patients. The 3-dimensional computed tomography images were reconstructed to enable measurements of the locations of the MLTS and tunnel center based on a grid method. Statistical analysis was conducted to compare the MLTS location and tibial tunnel position as well as the accuracy (mean distance of each actual location from the anatomic center) and precision (standard deviation of the accuracy, indicating the reproducibility of the tunnel position) of the tunnel position between the ASP and TSP groups. Results: Significant differences were observed between the ASP and TSP groups in terms of the tibial tunnel position on the mediolateral axis (46.7% ± 2.0% vs 45.9% ± 2.2%, respectively; P = .034), while no significant differences were found in terms of the accuracy (4.1% vs 4.6%, respectively; P = .259) or precision (2.1% vs 2.1%, respectively; P = .259) of tibial tunnel positioning between the 2 groups. Conclusion: In anatomic single-bundle ACL reconstruction, the use of the MLTS for tibial tunnel placement achieved comparable accuracy and precision compared with the use of ACL remnants, supporting its role as a reliable bony landmark in tibial tunnel positioning.
Brentuximab vedotin with dacarbazine or nivolumab as frontline cHL therapy for older patients ineligible for chemotherapy
Authors: Friedberg Jonathan W. , Bordoni Rodolfo , Patel-Donnelly Dipti , Larson Timothy , Goldschmidt Jerome , Boccia Ralph , Cline Vivian J. M. , Mamidipalli Adrija , Liu Jingmin , Akyol Alev , Yasenchak Christopher A. 
Published: November 2023

Abstract
Older patients with advanced-stage classical Hodgkin lymphoma (cHL) have inferior outcomes compared with younger patients, potentially due to comorbidities and frailty. This noncomparative phase 2 study enrolled patients aged ≥60 years with cHL unfit for conventional chemotherapy to receive frontline brentuximab vedotin (BV; 1.8 mg/kg) with dacarbazine (DTIC; 375 mg/m2) (part B) or nivolumab (part D; 3 mg/kg). In parts B and D, 50% and 38% of patients, respectively, had ≥3 general comorbidities or ≥1 significant comorbidity. Of the 22 patients treated with BV-DTIC, 95% achieved objective response, and 64% achieved complete response (CR). With a median follow-up of 63.6 months, median duration of response (mDOR) was 46.0 months. Median progression-free survival (mPFS) was 47.2 months; median overall survival (mOS) was not reached. Of 21 patients treated with BV-nivolumab, 86% achieved objective response, and 67% achieved CR. With 51.6 months of median follow-up, mDOR, mPFS, and mOS were not reached. Ten patients (45%) with BV-DTIC and 16 patients (76%) with BV-nivolumab experienced grade ≥3 treatment-emergent adverse events; sensory peripheral neuropathy (PN; 27%) and neutropenia (9%) were most common with BV-DTIC, and increased lipase (24%), motor PN (19%), and sensory PN (19%) were most common with BV-nivolumab. Despite high median age, inclusion of patients aged ≤88 years, and frailty, these results demonstrate safety and promising durable efficacy of BV-DTIC and BV-nivolumab combinations as frontline treatment, suggesting potential alternatives for older patients with cHL unfit for initial conventional chemotherapy. This trial was registered at www.clinicaltrials.gov as #NCT01716806.