bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multi-Model Forecast Quality Assessment of CMIP6 Decadal Predictions
Authors: Delgado-Torres Carlos , Donat Markus G. , Gonzalez-Reviriego Nube , Caron Louis-Philippe , Athanasiadis Panos J. , Bretonnière Pierre-Antoine , Dunstone Nick J. , Ho An-Chi , Nicoli Dario , Pankatz Klaus , Paxian Andreas , Pérez-Zanón Núria , Cabré Margarida Samsó , Solaraju-Murali Balakrishnan , Soret Albert , Doblas-Reyes Francisco J. 
Published: May 2022

Abstract
Decadal climate predictions are a relatively new source of climate information for interannual to decadal time scales, which is of increasing interest for users. Forecast quality assessment is essential to identify windows of opportunity (e.g., variables, regions, and forecast periods) with skill that can be used to develop climate services to inform users in several sectors and define benchmarks for improvements in forecast systems. This work evaluates the quality of multi-model forecasts of near-surface air temperature, precipitation, Atlantic multidecadal variability index (AMV), and global near-surface air temperature (GSAT) anomalies generated from all the available retrospective decadal predictions contributing to phase 6 of the Coupled Model Intercomparison Project (CMIP6). The predictions generally show high skill in predicting temperature, AMV, and GSAT, while the skill is more limited for precipitation. Different approaches for generating a multi-model forecast are compared, finding small differences between them. The multi-model ensemble is also compared to the individual forecast systems. The best system usually provides the highest skill. However, the multi-model ensemble is a reasonable choice for not having to select the best system for each particular variable, forecast period, and region. Furthermore, the decadal predictions are compared to the historical simulations to estimate the impact of initialization. An added value is found for several ocean and land regions for temperature, AMV, and GSAT, while it is more reduced for precipitation. Moreover, the full ensemble is compared to a subensemble to measure the impact of the ensemble size. Finally, the implications of these results in a climate services context, which requires predictions issued in near–real time, are discussed.
A Pan-Alpine Climatology of Lightning and Convective Initiation
Authors: Manzato Agostino , Serafin Stefano , Miglietta Mario Marcello , Kirshbaum Daniel , Schulz Wolfgang 
Published: May 2022

Abstract
A new lightning-flash and convective initiation climatology is developed over the Alpine area, one of the hotspots for lightning activity in Europe. The climatology uses cloud-to-ground (CG) data from the European Cooperation for Lightning Detection (EUCLID) network, occurring from 2005 to 2019. The CG lightning data are gridded at a resolution of approximately 2 km and 10 min. A new and simple method of identifying convective initiation (CI) events applies a spatiotemporal mask to the CG data to determine CI timing and location. Although the method depends on a few empirical thresholds, sensitivity tests show the results to be robust. The maximum activity for both CG flashes and CI events is observed from mid-May to mid-September, with a peak at the end of July; the peak in the diurnal cycle occurs in the afternoon. CI is mainly concentrated over and around the Alps, particularly in northern and northeastern Italy. Since many thunderstorms follow the prevailing midlatitude westerly flow, a peak of CG flashes extends from the mountains into the plains and coastal areas of northeastern Italy and Slovenia. CG flashes and CI events over the sea/coast occur less frequently than in plains and mountains, have a weaker diurnal cycle, and have a seasonal maximum in autumn instead of summer.
Predicting Rapid Intensification in North Atlantic and Eastern North Pacific Tropical Cyclones Using a Convolutional Neural Network
Authors: Griffin Sarah M. , Wimmers Anthony , Velden Christopher S. 
Published: May 2022

Abstract
This study develops a probabilistic model based on a convolutional neural network to predict rapid intensification (RI) in both North Atlantic and eastern North Pacific tropical cyclones (TCs). Coined “I-RI,” an advantage of using a convolutional neural network to predict RI is that it is designed to learn from spatial fields, like two-dimensional satellite imagery, as well as scalar features. The resulting model RI probability output is validated against two operational RI guidances—an empirical and a deterministic method—to assess skill at predicting RI over 12-, 24-, 36-, 48-, and 72-h lead times. Results indicate that in North Atlantic TCs, AI-RI is more skillful at predicting RI over 12- and 24-h lead times compared to both operational RI guidances. In eastern North Pacific TCs, AI-RI is more skillful than the empirical operational RI guidance at most RI thresholds, but less skillful than the deterministic RI guidance at all thresholds. For TCs north of 15°N, where the deterministic skill was lower, AI-RI was more skillful than the deterministic operational guidance for over half of the RI thresholds. It is also found that AI-RI struggles to reach the higher RI probabilities produced by both of the operational RI guidances in both basins. This work demonstrates that the two-dimensional structures within the satellite imagery of TCs and the evolution of these structures identified using the difference in satellite images, captured by a convolutional neural network, yield better 12–24-h indicators of RI than existing scalar assessments of satellite brightness temperature.

Significance Statement
The purpose of this study is to develop a method to predict tropical cyclone rapid intensification using artificial intelligence. The developed model uses a convolutional neural network, which can identify features in satellite imagery that are indicative of rapid intensification. The results suggest that, compared with current operational rapid intensification models, a convolutional neural network approach is generally more skillful at predicting rapid intensification.
Bilateral Gluteal Fasciocutaneous Advancement Flaps With and Without Tie-Over Sutures in Treatment of Chronic Pilonidal Disease: A Prospective Case Series
Authors: Nasseri Yosef , Oka Kimberly , Soliman Jesse , Kasheri Eli , Zhu Ruoyan , Cohen Jason , Barnajian Moshe 
Published: May 2022

Purpose Flap procedures following pilonidal excision have high recurrence and dehiscence rates. We present a cosmetic, outpatient technique to reconstruction via bilateral gluteal fasciocutaneous advancement flaps with and without tie-over sutures. Methods This is a prospective case series of 51 patients (40 males and 11 females). Following elliptical excision of pilonidal disease, gluteal fasciocutaneous advancement flaps were elevated circumferentially using blunt, discontinuous dissection, and a multilayered closure was performed. The resulting scar was midline. Thirty-five patients (68.6%) also had two full-thickness, compressing sutures tied over rolled up gauze. Results Patients had a mean age of 28.2 and body mass index of 26.8. Eight (15.9%) were smokers and 11 (21.6%) were obese. At a mean follow-up of 38.7 months, there were no recurrences and 19 (37.3%) patients had wound dehiscence. There was no significant difference in dehiscence between patients with and without tie-over sutures (31.4% vs 50%, P = 0.20). There was no significant difference in dehiscence between smokers and non-smokers, (62.5% vs 41.9%, P = 0.47), or between obese and non-obese patients (36.4% vs 46.3%, P = 0.51). Obese patients with tie-over sutures had significantly less dehiscence compared to obese patients without tie-over sutures (14% vs 75%, P = 0.03). Conclusion Bilateral gluteal fasciocutaneous advancement flap with consideration of tie-over sutures is an outpatient treatment for chronic pilonidal disease with resultant midline scar and with no recurrence in our series.
Thromboelastography-Based Evaluation of Gender-Associated Hypercoagulability
Authors: Rodgers Skylar C. , Carter Kristen T. , Patki Deepti , O’Brien Robert C. , Kutcher Matthew E. 
Published: May 2022

Background Age, race, and gender differences in coagulation status of healthy volunteers have been reported in previous case series; however, rigorous multivariate analysis adjusting for these factors is lacking. We aimed to investigate the effects of age, race, and gender on baseline coagulation status in healthy volunteers. Methods Thirty healthy volunteer controls with no history of bleeding or thrombotic events and no previous anticoagulant or antiplatelet use were recruited. Citrated and heparinized blood samples were drawn, and kaolin and platelet-mapping thromboelastography (TEG) assays performed. Results Thirty participants had a mean age of 37, mean body mass index of 29 kg/m2, and were 47% African-American and 70% female. Women were significantly older than men (40 ± 11 y vs 28 ± 7 y, P = .002); there were no significant differences in demographics by race. Multivariate analysis of variance for the effect of age, race, and gender across TEG parameters yielded evidence for gender differences in hypercoagulability (Pillai’s trace P = .02), which appear to be driven by differences in K-time, alpha angle, maximal amplitude, and G parameter. Women were hypercoagulable compared to men, as manifested by shorter K-time, steeper alpha angle, higher maximal amplitude, and larger G parameter. Discussion Women at baseline have relatively hypercoagulable fibrin deposition kinetics, platelet contributions to clot formation, and overall clot strength compared to men, even when adjusted for age and race. Additional research is needed to specifically detail the key patient-level factors, clinical implications, and opportunities for tailored therapy related to gender-associated hypercoagulability.
Racial Disparity, Social Determinates of Health, and Slavery During the Boston Smallpox Epidemics of the Eighteenth Century
Authors: Nakayama Don K. 
Published: May 2022

When Benjamin Franklin published the mortality rates from smallpox during the Boston smallpox epidemic of 1752, he revealed that Blacks not only had a higher mortality rate from smallpox (12.8%, 62/485; 8.9% for whites, 452/5,059), but once inoculated, had less protection from fatal disease (mortality rate 5.0%, 7/139; 1.2% for whites, 23/1,954). His report was thus the first publication to document racial disparities in a disease and its treatment. The differential outcomes came about in the context of slavery, poverty, and war, the predecessors of the social determinates of health that we observe today. During the 1752 outbreak only 28 percent of the Boston’s occupants were inoculated, a level that failed to protect the community. When the contagion returned in 1764, the town selectmen decided to provide inoculations at no cost to all that needed them. That year inoculated smallpox reached 87 percent of the total caseload. “This lowered the death rate for smallpox so markedly,’ wrote John Blake, historian at the National Library of Medicine, ”that for the first time a smallpox year failed to stand out as one of unusual mortality.” One final observation came from Franklin’s data: the unexpectedly high prevalence of inoculations among Blacks (6.8% of those inoculated, 146/2,143; 8.5% of all those contracting the disease, 693/8,201). Boston’s whites had made certain enslaved Blacks were inoculated, evidence the extent to which slavery was essential to the economy of colonial Boston.
Atrial Cannulation During Resuscitative Clamshell Thoracotomy
Authors: Willis Grant , Robinson Jordan N. , Green John M. , Dieffenbaugher Sean T. , Madjarov Jeko M. , LeNoir Bradley J. , Frederick John R. , Sing Ronald F. , Cunningham Kyle W. 
Published: May 2022

Background Resuscitative thoracotomy and clamshell thoracotomy are performed in the setting of traumatic arrest with the intent of controlling hemorrhage, relieving tamponade, and providing open chest cardiopulmonary resuscitation. Historically, return of spontaneous circulation rates for penetrating traumatic arrest as well as out of hospital survival have been reported as low as 40% and 10%. Vascular access can be challenging in patients who have undergone a traumatic arrest and can be a limiting step to effective resuscitation. Atrial cannulation is a well-established surgical technique in cardiac surgery. Herein, we present a case series detailing our application of this technique in the context of acute trauma resuscitation during clamshell thoracotomy for traumatic arrest in the emergency department. Methods A retrospective case series of atrial cannulation during traumatic arrest was conducted in Charlotte, NC at Carolinas Medical Center an urban level 1 trauma center. Results The mean rate of return of spontaneous circulation in our series, 60%, was greater than previously published upper limit of return of spontaneous circulation for penetrating causes of traumatic arrest. Discussion Intravenous access can be difficult to establish in the hypovolemic and exsanguinating patient. Traditional methods of vascular access may be insufficient in the setting of central vascular injury. Atrial appendage cannulation during atrial cannulation is a quick and reliable technique to achieve vascular access that employs common methods from cardiac surgery to improve resuscitation of traumatic arrest.
Predictors of Clinical Outcomes Following Laparoscopic Colectomy for Traumatic Injury
Authors: Cheng Vincent , Schellenberg Morgan , Ashbrook Matthew , Grigorian Areg , Donohue Sean , Emigh Brent , Matsushima Kazuhide , Inaba Kenji 
Published: May 2022

Background Laparoscopic colectomy following traumatic injury has been increasingly utilized, but open resection remains the standard of care. Therefore, identifying appropriate candidates for laparoscopy is critically important. This study’s purpose was to identify predictors of clinical outcomes in patients undergoing laparoscopic colectomy following traumatic injury Methods The National Trauma Databank was queried for patients undergoing laparoscopic colectomy within 48 hours of admission between 2007 and 2015. Patient, injury, and management characteristics were abstracted. Multivariable regression analyses adjusted for baseline characteristics and identified significant predictors of clinical outcomes. Results A total of 581 patients satisfied inclusion criteria. The median age was 31 years, 465 (80%) were male, and 321 (55%) sustained penetrating injuries. An ostomy was created in 143 (25%) cases. Multivariable logistic regression showed that significant predictors of mortality included a falling mechanism (odds ratio [OR] 104.917, P = .002), admission tachycardia (OR 5.823, P = .001), admission hypotension (OR 26.089, P < .001), and multi-system injuries like head (OR 1.587, P = .008) and thoracic (OR 1.627, P = .001) injuries. Significant predictors of unplanned reoperation included transverse (OR 7.657, P = .033) and left (OR 17.155, P = .014) colon resections, obesity (OR 24.407, P = .016), and chronic respiratory disease (OR 32.963, P = .018). Ostomy creation was significantly associated with neither mortality nor unplanned reoperation. Conclusion These data suggest that readily identifiable preoperative characteristics are significantly associated with differences in clinical outcomes. Additional research is required to determine if varying treatment based on these qualities can improve outcomes.
Open and Closed Approaches to Skin Closure After Nonelective Open Colorectal Operations
Authors: Turcotte Justin J. , Allen Rebecca S. , Klune J. Robert , Feather Cristina B. 
Published: May 2022

Introduction Optimal wound management strategies to reduce surgical site infections (SSIs) in nonelective open colorectal surgery (NOCS) remain controversial and variable. Our aim is to describe SSI and other 30-day outcome measures among patients with varying wound management techniques undergoing NOCS. Methods All NOCS patients were extracted from the 2016 to 2018 ACS-NSQIP database. Outcomes of patients managed with all layers closed (ALC) were compared to patients managed with skin open (SO), using propensity score matching (PSM) to control for significant confounding risk factors for SSI. Results A total of 40,820 patients were included; 4622 patients managed with SO and 36,198 managed with ALC. Patients in the SO group were more likely to have a history of hypertension, renal failure, chronic obstructive pulmonary disease, smoking, obesity, and sepsis on presentation (P < .001). After PSM, no differences in risk factors remained; 4622 and 4344 patients were included in the SO and ALC cohorts, respectively. While ALC patients experienced a higher rate of superficial SSI (1.4% vs 7.3%, P < .001) and any wound complications (6.8% vs 10.8%, P < .001), the SO group had higher wound dehiscence (4.4% vs 2.8%, P < .001). There were no significant differences in deep wound infection. The SO group had longer average length of stay (14.7 vs 13.1 days, P < .001), higher non-wound-related complications, discharge to SNF, and in-hospital mortality. Discussion Significant differences in SSI rates among NOCS patients with differing wound management techniques were observed. More notably, other important quality measures, such as length of stay, disposition, mortality, and non-wound-related complications were also significantly impacted by wound management strategy.
The Association of Race With Adequate Lymph Node Evaluation for Gastric Cancer
Authors: Tsao Miriam W. , Kahl Madison S. , Deneve Jeremiah L. , Yakoub Danny , Glazer Evan S. , Shibata David , Jain Richa , Clark Ian , Dickson Paxton V. 
Published: May 2022

Background National studies have reported racial and socioeconomic disparities in gastric cancer (GC) care. The current study evaluated adequate lymph node (LN) assessment (≥16 LNs) during resection for GC within a healthcare system servicing a socioeconomically disparate, mostly non-White population in the Southeast United States. Methods A retrospective cohort study of patients undergoing resection for GC between 2003-2019 was performed. Factors associated with adequate LN assessment including patient and tumor characteristics were analyzed. Results Among 202 patients, adequate LN assessment was performed in 97 (48%) patients. On univariable analysis, younger age, non-White race, lower Charlson Comorbidity Index (CCI), Medicaid or no insurance, D1+/D2 lymphadenectomy, clinical evidence of regional LN metastases, total gastrectomy, and receipt of neoadjuvant therapy were associated with adequate LN assessment. On multivariable analysis, non-White race (OR 2.79, 95% CI 1.38-5.65), CCI <4 (OR 2.14, 95% CI 1.15-3.96), and D1+/D2 lymphadenectomy (OR 3.63, 95% CI 1.96-6.74) were the only factors independently associated with adequate LN evaluation. Conclusions In the current study, non-White race, independent of socioeconomics, was significantly associated with adequate LN assessment. Future work is necessary to improve standardization and achieve higher rates of adequate LN assessment for all patients during resection for GC.
Trends in calls to a state poisons centre and presentation to emergency departments for intentional antidepressant overdose in Victoria, Australia
Authors: Doherty Zakary , Wong Anselm , Hayman Jane , Greene Shaun 
Published: May 2022

Objective: To describe the rates and trends of emergency department presentations and calls to a state poisons centre for antidepressant overdose. Methods: A retrospective cohort study utilising the Victorian Emergency Minimum Dataset and Victorian Poisons Information Centre call registry between January 2009 and December 2018 was conducted. This captured all presentations to Victorian emergency departments and calls to the Victorian Poisons Information Centre. Any intentional overdose involving an antidepressant was included. Annual rates of emergency department presentations and calls per 100,000 persons and 100,000 prescriptions for antidepressants overall and individual antidepressant classes, in addition to age-group-specific rates, were reported. Results: A total of 3650 presentations to emergency department and 7096 calls to the poisons centre were included. No changes were seen in overall emergency department presentation rates when controlled for population or prescription numbers, but large and significant increases were seen for younger age groups. The 10–14- and 15–19-year age groups had average annual increases of 13.1% (95% CI = [6.5%, 19.7%], p < 0.001) and 7.2% (95% CI = [2.8%, 11.5%], p < 0.001) per 100,000 persons, respectively. Increases were seen in overall annual call rates of 6.7% (95% CI = [5.2%, 8.1%], p < 0.001) per 100,000 persons and 7.5% (95% CI = [4.9%, 10.1%], p < 0.001) per 100,000 prescriptions. Conclusion: Overall, emergency department presentation rates remained stable during the study period. Overall poisons centre call rates increased moderately. However, when examining younger persons, large increases were seen in both emergency department presentations and poison centre call rates. These findings highlight the need for future interventions to mitigate against intentional overdose in younger populations.
Influenza vaccination uptake during COVID-19 pandemic: A trusted messenger approach
Authors: Wu Tsu-Yin , Raghunathan Vedhika , Lally Sarah , Rainville Alice Jo , Bessire Rachel 
Published: May 2022

Objective: Seasonal influenza is a preventable disease that may cause high morbidity and mortality. In the USA, the 2020 influenza season overlapped with the first wave of coronavirus disease 2019 (COVID-19) pandemic. There is a dearth of research on understanding influenza vaccination uptake and attitudes towards the vaccine among marginalised communities in the USA. The aim of this study was to examine general knowledge, misconceptions about, and barriers to influenza vaccination and determine if flu education delivered via trusted messengers improved knowledge among Asian Americans. Design: Quantitative prospective pre- and post-test design. Setting: Asian American communities in Metro Detroit area, Hamtramck, and Kent County in Michigan. Method: The study started with a training event in which 26 community leaders were trained to become trusted messengers to disseminate flu education. A total of 260 Asian American participants subsequently completed pre- and post-education surveys. Results: Asian Americans in the study reported low flu vaccination rate (48.5%). Reasons varied but included access-related issues (e.g. no access and no insurance) and health literacy (did not know they needed it). After education by trusted messengers, the paired t tests measuring improvement between pre- and post-survey scores showed a significant improvement ( p < .05) for all of the knowledge items. Conclusion: Educational campaigns using targeted messages to address specific barriers and acknowledge individuals’ concerns regarding misconceptions while providing equitable vaccine access can be key for the successful implementation of vaccination programmes.