bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiovascular Risk and Treatment Outcomes in Severe Hypercholesterolemia: A Nationwide Cohort Study
Authors: Lee Chan Joo , Park Sanghyun , Han Kyungdo , Lee Sang‐Hak 
Published: April 2022

Background
This study aimed to evaluate the cardiovascular risk and outcomes after lipid reduction in patients with severe hypercholesterolemia using a nationwide cohort.

Methods and Results

This study used the database from the National Health Insurance Service of Korea. Among individuals who underwent regular health examination and follow‐up, 2 377 918 were enrolled and categorized into 3 groups with severe hypercholesterolemia according to low‐density lipoprotein cholesterol (LDL‐C) levels, namely, ≥260, 225 to 259, and 190 to 224 mg/dL groups, and a control group (<160 mg/dL). Risks of composite cardiovascular events (myocardial infarction, coronary revascularization, and ischemic stroke) and total mortality were compared. In statin new users, the outcomes after statin use were further analyzed according to posttreatment LDL‐C levels. The prevalence of individuals with LDL‐C≥190 mg/dL was 1 of 106. Adjusted hazard ratios of composite events and total mortality (median follow‐up, 6.1 years) in the groups ranged up to 2.4 (log‐rank
P
<0.0001) and 2.3 (log‐rank
P
=0.0002), respectively, and were dependent on LDL‐C levels. The risks of each event were up to 4.1‐, 3.8‐, and 1.9‐fold higher, respectively, in these groups. The risk of composite events (median follow‐up, 6.2 years) was lower after lipid lowering; particularly, the risk was lowest in the group showing LDL‐C<100 mg/dL after treatment (hazard ratio, 0.56, log‐rank
P
=0.043).

Conclusions
Using large Korean cohort data, our study proved incrementally elevated cardiovascular risk and clinical benefit associated with LDL‐C<100 mg/dL in individuals with severe hypercholesterolemia. These results support aggressive lipid lowering and provide evidence for the LDL‐C target in this population.
Epidemiology and Management of ST‐Segment–Elevation Myocardial Infarction in Patients With COVID‐19: A Report From the American Heart Association COVID‐19 Cardiovascular Disease Registry
Authors: Bhatt Ankeet S. , Varshney Anubodh S. , Goodrich Erica L. , Gong Jingyi , Ginder Curtis , Senman Balimkiz C. , Johnson Matthew , Butler Kayleigh , Woolley Ann E. , de Lemos James A. , Morrow David A. , Bohula Erin A. 
Published: April 2022

Background
Early reports from the COVID‐19 pandemic identified coronary thrombosis leading to ST‐segment–elevation myocardial infarction (STEMI) as a complication of COVID‐19 infection. However, the epidemiology of STEMI in patients with COVID‐19 is not well characterized. We sought to determine the incidence, diagnostic and therapeutic approaches, and outcomes in STEMI patients hospitalized for COVID‐19.

Methods and Results

Patients with data on presentation ECG and in‐hospital myocardial infarction were identified from January 14, 2020 to November 30, 2020, from 105 sites participating in the American Heart Association COVID‐19 Cardiovascular Disease Registry. Patient characteristics, resource use, and clinical outcomes were summarized and compared based on the presence or absence of STEMI. Among 15 621 COVID‐19 hospitalizations, 54 (0.35%) patients experienced in‐hospital STEMI. Among patients with STEMI, the majority (n=40, 74%) underwent transthoracic echocardiography, but only half (n=27, 50%) underwent coronary angiography. Half of all patients with COVID‐19 and STEMI (n=27, 50%) did not undergo any form of primary reperfusion therapy. Rates of all‐cause shock (47% versus 14%), cardiac arrest (22% versus 4.8%), new heart failure (17% versus 1.4%), and need for new renal replacement therapy (11% versus 4.3%) were multifold higher in patients with STEMI compared with those without STEMI (
P
<0.050 for all). Rates of in‐hospital death were 41% in patients with STEMI, compared with 16% in those without STEMI (
P
<0.001).

Conclusions
STEMI in hospitalized patients with COVID‐19 is rare but associated with poor in‐hospital outcomes. Rates of coronary angiography and primary reperfusion were low in this population of patients with STEMI and COVID‐19. Adaptations of systems of care to ensure timely contemporary treatment for this population are needed.
Diagnostic Yield of Genetic Testing in Young Patients With Atrioventricular Block of Unknown Cause
Authors: Resdal Dyssekilde Johnni , Frederiksen Tanja Charlotte , Christiansen Morten Krogh , Hasle Sørensen Rikke , Pedersen Lisbeth Nørum , Loof Møller Peter , Christensen Lene Svendstrup , Larsen Jacob Moesgaard , Thomsen Kristian Korsgaard , Lindhardt Tommi Bo , Böttcher Morten , Molsted Stig , Havndrup Ole , Fischer Thomas , Møller Dorthe Svenstrup , Henriksen Finn Lund , Johansen Jens Brock , Nielsen Jens Cosedis , Bundgaard Henning , Nygaard Mette , Jensen Henrik Kjærulf 
Published: April 2022

BackgroundThe cause of atrioventricular block (AVB) remains unknown in approximately half of young patients with the diagnosis. Although variants in several genes associated with cardiac conduction diseases have been identified, the contribution of genetic variants in younger patients with AVB is unknown.Methods and ResultsUsing the Danish Pacemaker and Implantable Cardioverter Defibrillator (ICD) Registry, we identified all patients younger than 50 years receiving a pacemaker because of AVB in Denmark in the period from January 1, 1996 to December 31, 2015. From medical records, we identified patients with unknown cause of AVB at time of pacemaker implantation. These patients were invited to a genetic screening using a panel of 102 genes associated with inherited cardiac diseases. We identified 471 living patients with AVB of unknown cause, of whom 226 (48%) accepted participation. Median age at the time of pacemaker implantation was 39 years (interquartile range, 32–45 years), and 123 (54%) were men. We found pathogenic or likely pathogenic variants in genes associated with or possibly associated with AVB in 12 patients (5%). Most variants were found in theLMNAgene (n=5).LMNAvariant carriers all had a family history of either AVB and/or sudden cardiac death.ConclusionsIn young patients with AVB of unknown cause, we found a possible genetic cause in 1 out of 20 participating patients. Variants in theLMNAgene were most common and associated with a family history of AVB and/or sudden cardiac death, suggesting that genetic testing should be a part of the diagnostic workup in these patients to stratify risk and screen family members.
Long‐Term Outcome and Quality of Life in Patients With Stroke Presenting With Extensive Early Infarction
Authors: Beyeler Morin , Weber Loris , Buffle Eric , Kurmann Christoph C. , Piechowiak Eike Immo , Branca Mattia , Meinel Thomas Raphael , Jung Simon , Seiffge David , Heldner Mirjam R. , Pilgram‐Pastor Sara M. , Dobrocky Tomas , Mordasini Pasquale , Arnold Marcel , Gralla Jan , Fischer Urs , Kaesmacher Johannes 
Published: April 2022

Background
The benefit of mechanical thrombectomy in patients with low Alberta Stroke Program Early Computed Tomography Score (ASPECTS) for short‐term outcomes is debatable and long‐term outcomes remain unknown. This retrospective, monocentric cohort study aimed to assess the association between reperfusion grade and the long‐term functional outcome measured with modified Rankin scale as well as the long‐term health‐related quality of life recorded at the last follow‐up in patients according to baseline ASPECTS (0–5 versus 6–10).

Methods
Deceased patients were identified from the Swiss population register and follow‐up telephone interviews were conducted with all surviving patients with stroke treated with mechanical thrombectomy between January 1, 2010, and December 31, 2018. Favorable outcome was defined as modified Rankin scale 0 to 3; health‐related quality of life was assessed using the 3‐level version of the EuroQol 5‐dimensional questionnaire. The EuroQol 5‐dimension utility index was calculated for statistical analyses. The reperfusion grade was core laboratory adjudicated using the expanded treatment in cerebral ischemia score. Adjusted odds ratios for the association between the reperfusion grade assessed by expanded treatment in cerebral ischemia and outcomes were calculated from multivariable logistic regression.

Results

Of the 1114 patients with available long‐term follow‐up records (median follow‐up, 3.67 years), 997 were included in the final analysis. Respectively, patients with low ASPECTS more often had complaints regarding mobility (67.1% versus 42.1%,
P
<0.001), self‐care (53.4% versus 31.2%,
P
<0.001), and usual activities (65.8% versus 41.4%,
P
<0.001) than patients with high ASPECTS, whereas reported pain/discomfort (65.7% versus 69.9%,
P
=0.49) and anxiety/depression (71.2% versus 78.9%,
P
=0.17) did not differ. In patients with low ASPECTS, increasing reperfusion grade was associated with a higher likelihood of long‐term favorable functional outcome (adjusted odds ratio, 1.43; 95% CI, 1.09–1.88 [
P=
0.01]) and health‐related quality of life (adjusted linear correlation coefficient, 0.05; 95% CI, 0.02–0.08) despite early extensive infarction.

Conclusion
Despite low baseline ASPECTS, a higher reperfusion grade results in better functional outcomes and may improve health‐related quality of life in the long term.
Revisiting the Hail Radar Reflectivity–Kinetic Energy Flux Relation by Combining T-Matrix and Discrete Dipole Approximation Calculations to Size Distribution Observations
Authors: Cecchini Micael A. , Heymsfield Andrew J. , Honeyager Ryan , Field Paul , Machado Luiz A. T. , Dias Maria A. F. da Silva 
Published: April 2022

Abstract
The retrieval of hail kinetic energy with weather radars or its simulation in numerical models is challenging because of the shape complexity and variable density of hailstones. We combine 3D scans of individual hailstones with measurements of the particle size distributions (PSD) and T-matrix calculations to understand how hail reflectivity Z changes when approximating hailstones as spheroids, as compared to the realistic shapes obtained by 3D scanning technology. Additionally, recent terminal velocity relations are used to compare Z to the hail kinetic energy flux . We parameterize the hail backscattering cross sections at L, S, C, and X bands as a function of size between 0.5 and 5.0 cm, matching the range of the observed PSDs. The scattering calculations use the T-matrix method for size parameters below 1.0 and the discrete dipole approximation (DDA) method otherwise. The DDA calculations are done for 48 digital models of realistic hailstones of sizes between 1 and 5 cm. The DDA cross sections are calculated for multiple orientations and averaged assuming a fully random orientation distribution to provide a single value per hailstone. The T-matrix reflectivity assuming solid ice spheres presents negligible differences to DDA results for size parameters below 1.0. Therefore, T matrix was used to fill in the gaps left by the DDA calculations. The results are mapped to the same size bins of the observed PSDs, allowing the calculation of the radar reflectivity. This is then correlated to , allowing a potential improvement of past retrieval methods of from Z in multiple wavelengths.
The Basic Equations under Weak Temperature Gradient Balance: Formulation, Scaling, and Types of Convectively Coupled Motions
Authors: Adames Ángel F. 
Published: April 2022

Abstract
The weak temperature gradient (WTG) approximation is extended to the basic equations on a rotating plane. The circulation is decomposed into a diabatic component that satisfies WTG balance exactly and a deviation from this balance. Scale analysis of the decomposed basic equations reveals a spectrum of motions, including unbalanced inertio-gravity waves and several systems that are in approximate WTG balance. The balanced systems include equatorial moisture modes with features reminiscent of the MJO, off-equatorial moisture modes that resemble tropical depression disturbances, “mixed systems” in which temperature and moisture play comparable roles in their thermodynamics, and moist quasigeostrophic motions. In the balanced systems the deviation from WTG balance is quasi nondivergent, in nonlinear balance, and evolves in accordance to the vorticity equation. The evolution of the strictly balanced WTG circulation is in turn described by the divergence equation. WTG balance restricts the flow to evolve in the horizontal plane by making the isobars impermeable to vorticity and divergence, even in the presence of diabatically driven vertical motions. The vorticity and divergence equations form a closed system of equations when the irrotational circulation is in WTG balance and the nondivergent circulation is in nonlinear balance. The resulting “WTG equations” may elucidate how interactions between diabatic processes and the horizontal circulation shape slowly evolving tropical motions.

Significance Statement
Many gaps in our understanding of tropical weather systems still exist and there are still many opportunities to improve their forecasting. We seek to further our understanding of the tropics by extending a framework known as the “weak temperature gradient approximation” to all of the equations for atmospheric flow. Doing this reveals a variety of motions whose scales are similar to observed tropical weather systems. We also show that two equations describe the evolution of slow systems: one that describes tropical thunderstorms and one for the rotating horizontal winds. The two equations may help us understand the dynamics of slowly evolving tropical systems.
Comparison of Desroziers and Three-Cornered Hat Methods for Estimating COSMIC-2 Bending Angle Uncertainties
Authors: Semane Noureddine , Anthes Richard , Sjoberg Jeremiah , Healy Sean , Ruston Benjamin 
Published: April 2022

Abstract
We compare two seemingly different methods of estimating random error statistics (uncertainties) of observations, the three-cornered hat (3CH) method and Desroziers method, and show several examples of estimated uncertainties of COSMIC-2 (C2) radio occultation (RO) observations. The two methods yield similar results, attesting to the validity of both. The small differences provide insight into the sensitivity of the methods to the assumptions and computational details. These estimates of RO error statistics differ considerably from several RO error models used by operational weather forecast centers, suggesting that the impact of RO observations on forecasts can be improved by adjusting the RO error models to agree more closely with the RO error statistics. Both methods show RO uncertainty estimates that vary with latitude. In the troposphere, uncertainties are higher in the tropics than in the subtropics and middle latitudes. In the upper stratosphere–lower mesosphere, we find the reverse, with tropical uncertainties slightly less than in the subtropics and higher latitudes. The uncertainty estimates from the two techniques also show similar variations between a 31-day period during Northern Hemisphere tropical cyclone season (16 August–15 September 2020) and a month near the vernal equinox (April 2021). Finally, we find a relationship between the vertical variation of the C2 estimated uncertainties and atmospheric variability, as measured by the standard deviation of the C2 sample. The convergence of the error estimates and the standard deviations above 40 km indicates a lessening impact of assimilating RO above this level.

Significance Statement
Uncertainties of observations are of general interest and their knowledge is important for assimilation in numerical weather prediction models. This paper compares two methods of estimating these uncertainties and shows that they give nearly identical results under certain conditions. The estimation of the COSMIC-2 bending angle uncertainties and how they compare to the assumed bending angle error models in several operational weather centers suggests that there is an opportunity for obtaining improved impact of RO observations in numerical model forecasts. Finally, the relationship between the COSMIC-2 bending angle errors and atmospheric variability provides insight into the sources of RO observational uncertainties.
Lidar Observations and Data Assimilation of Low-Level Moist Inflows Causing Severe Local Rainfall Associated with a Mesoscale Convective System
Authors: Yoshida Satoru , Sakai Tetsu , Nagai Tomohiro , Ikuta Yasutaka , Shoji Yoshinori , Seko Hiromu , Shiraishi Koichi 
Published: April 2022

Abstract
We conducted an observational survey using a ground-based water vapor Raman lidar (RL) during the warm season in Japan to investigate the water vapor structure of low-level inflows that contribute to the formation of a mesoscale convective system (MCS). After the passage of a warm front, low-level moisture convergence contributed to the initiation and development of numerous convective clouds that composed the MCS. The RL observations showed that the vertical profiles of the water vapor mixing ratio (WVMR) associated with low-level inflows into the MCS exceeded 20 g kg−1 below 500 m above sea level, which is comparable to WVMRs in previous reports associated with MCSs in Japan and the United States. We conducted two assimilation experiments using a four-dimensional variational data assimilation system: one is to assimilate operational observational data (CNTL), and the other is to assimilate WVMR vertical profiles and operational observational data (TEST). A comparison between TEST and CNTL showed that data assimilation of the WVMR vertical profiles not only modified the moisture field but also the wind field. It appears that the modifications observed in horizontal wind are related to the modification of the WVMR in the analysis fields. These WVMR and wind modifications improved the reproduction of the frontal surface and forecasting of 6-h precipitation amount slightly. Data assimilation of vertical profiles of the WVMR has positive and negative impacts on the WVMR and horizontal wind, respectively, implying that the vertical profiles of both the horizontal wind and the WVMR might better estimate initial conditions and forecasts.

Significance Statement
Low-level moisture inflows are one of the key parameters involved in the formation of mesoscale convective systems (MCSs). Therefore, data assimilation of low-level moisture profiles is one of the prospective methods for better forecasting heavy precipitation associated with MCSs. However, few direct observations of the low-level moisture structure associated with MCSs and data assimilation experiments have been undertaken to date. We observed the vertical profiles of moisture associated with an MCS in Japan using a ground-based water vapor Raman lidar and show the existence of a relatively moist low-level inflow into the MCS. The data assimilation of low-level moisture has positive and negative impacts on moisture and horizontal wind, respectively, and improves slightly 6-h precipitation forecasts.
Extreme Winter Precipitation Regimes in Eastern North America: Synoptic-Scale and Thermodynamic Environments
Authors: Low Yeechian , Gyakum John R. , Atallah Eyad 
Published: April 2022

Abstract
We define extreme precipitation regimes (EPRs) during the eastern North American winter based on widespread and persistent heavy precipitation, using ERA5 precipitation data from 1979 to 2020. We find 62 EPRs and analyze their synoptic-scale and thermodynamic environments. EPRs impact most of eastern North America with heavy precipitation, especially from Louisiana to Quebec, and generally last for 5–8 days. They are associated with an anomalously strong 500-hPa trough–ridge over western–eastern North America that travels slowly eastward, favoring intrusions of moist, tropical air into eastern North America, and a strong baroclinic zone from the central United States to Atlantic Canada. They are also characterized by high frequencies of cyclones in the midwestern United States, anticyclones over eastern Canada and the subtropical Atlantic, and atmospheric rivers (ARs) in eastern North America. Precipitation is maintained by large moisture influxes, primarily from the Gulf of Mexico and Caribbean Sea, from the EPR start to the time midway through the EPR period. The influxes are often associated with ARs feeding into cyclones, where the moisture falls as precipitation. We also categorize EPRs based on the spatial anomaly correlation (AC) of synoptic-scale weather patterns between individual EPRs and the EPR composite. High AC EPRs have similar but stronger 500-hPa features over North America, greater moisture flux from the Gulf of Mexico and inland precipitation over eastern North America, farther inland cyclone track, higher frequency of subtropical Atlantic anticyclones, and lower EPR-to-EPR variability than low AC EPRs.

Significance Statement
Cool-season extreme precipitation regimes (EPRs) often lead to flooding and other impacts and represent a significant forecast challenge. We define and analyze EPRs during the eastern North American winter to obtain a better understanding of their associated meteorological conditions. We also categorize EPRs into two distinct categories to capture the variability among EPRs. EPRs generally last 5–8 days and are associated with slowly moving large-scale weather patterns favoring intrusions of moist, tropical air into eastern North America, a strong temperature contrast, and frequent cyclones in the midwestern United States with anticyclones to the north and south. The intrusions of moist, tropical air are often associated with atmospheric rivers (ARs) that deposit their moisture in cyclones as precipitation.
Effects of Weather Conditions on the Public Demand for Weather Information via Smartphone in Multiple Regions of China
Authors: Cao Yuyao , Zhang Qinghong , Sun Juanzhen , Li Rumeng , Huang Yaohai , Zhuang Jing , Xu Jun , Chen Yun 
Published: April 2022

Abstract
Understanding when weather information is required by the public is essential for evaluating and improving user-oriented weather services. Because of the popularity of smartphones, most people can easily access weather information via smartphone applications. In this study, we analyzed usage data for the Moji Weather smartphone application in 2017 and 2018 and devised a demand index to determine how often the weather information was used by the public under different weather conditions. Using hourly observations of surface temperature, wind intensity, precipitation, and visibility, we quantified the relationship between the demand for weather information and weather conditions in different regions of China. In general, the demand index increased with increases in local hourly precipitation or surface wind intensity in all regions; however, there were notable regional differences in the increasing trends. Extreme hot weather was found to increase the demand index in Northern China, Xinjiang, and the Sichuan Basin while in Southern China it increased more in response to extreme cold weather. We quantified the relationships between the demand index and weather conditions by performing a polynomial regression analysis for each weather element and region. The high-demand thresholds were found to vary among regions, suggesting the need for customized weather services for users in different geographical regions. The study also revealed the contribution of weather warnings to weather information demand in two megacities and showed that warnings were effective for conveying information about weather-related risks.