bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can We Integrate Spatial Verification Methods into Neural Network Loss Functions for Atmospheric Science?
Authors: Lagerquist Ryan , Ebert-Uphoff Imme 
Published: September 2022

Abstract
In the last decade, much work in atmospheric science has focused on spatial verification (SV) methods for gridded prediction, which overcome serious disadvantages of pixelwise verification. However, neural networks (NN) in atmospheric science are almost always trained to optimize pixelwise loss functions, even when ultimately assessed with SV methods. This establishes a disconnect between model verification during versus after training. To address this issue, we develop spatially enhanced loss functions (SELF) and demonstrate their use for a real-world problem: predicting the occurrence of thunderstorms (henceforth, “convection”) with NNs. In each SELF we use either a neighborhood filter, which highlights convection at scales larger than a threshold, or a spectral filter (employing Fourier or wavelet decomposition), which is more flexible and highlights convection at scales between two thresholds. We use these filters to spatially enhance common verification scores, such as the Brier score. We train each NN with a different SELF and compare their performance at many scales of convection, from discrete storm cells to tropical cyclones. Among our many findings are that (i) for a low or high risk threshold, the ideal SELF focuses on small or large scales, respectively; (ii) models trained with a pixelwise loss function perform surprisingly well; and (iii) nevertheless, models trained with a spectral filter produce much better-calibrated probabilities than a pixelwise model. We provide a general guide to using SELFs, including technical challenges and the final Python code, as well as demonstrating their use for the convection problem. To our knowledge this is the most in-depth guide to SELFs in the geosciences.

Significance Statement
Gridded predictions, in which a quantity is predicted at every pixel in space, should be verified with spatially aware methods rather than pixel by pixel. Neural networks (NN), which are often used for gridded prediction, are trained to minimize an error value called the loss function. NN loss functions in atmospheric science are almost always pixelwise, which causes the predictions to miss rare events and contain unrealistic spatial patterns. We use spatial filters to enhance NN loss functions, and we test our novel spatially enhanced loss functions (SELF) on thunderstorm prediction. We find that different SELFs work better for different scales (i.e., different-sized thunderstorm complexes) and that spectral filters, one of the two filter types, produce unexpectedly well calibrated thunderstorm probabilities.
Understanding Responses of Summer Continental Daily Temperature Variance to Perturbations in the Land Surface Evaporative Resistance
Authors: Kong Wenwen , McKinnon Karen A. , Simpson Isla R. , Laguë Marysa M. 
Published: September 2022

Abstract
Understanding the roles of land surface conditions and atmospheric circulation on continental daily temperature variance is key to improving predictions of temperature extremes. Evaporative resistance (rs, hereafter), a function of the land cover type, reflects the ease with which water can be evaporated or transpired and is a strong control on land–atmosphere interactions. This study explores the effects of rs perturbations on summer daily temperature variance using the Simple Land Interface Model (SLIM) by mimicking, for rs only, a global land cover conversion from forest to crop/grassland. Decreasing rs causes a global cooling. The cooling is larger in wetter areas and weaker in drier areas, and primarily results from perturbations in shortwave radiation (SW) and latent heat flux (LH). Decreasing rs enhances cloud cover due to greater land surface evaporation and thus reduces incoming SW over most land areas. When rs decreases, wetter areas experience strong evaporative cooling, while drier areas become more moisture-limited and thus experience less cooling. Thermal advection further shapes the temperature response by damping the combined impacts of SW and LH. Temperature variance increases in drier areas and decreases in wetter areas as rs decreases. The temperature variance changes can be largely explained from changes in the combined variance of SW and LH, including an important contribution of changes in the covariance of SW and LH. In contrast, the effects of changes in thermal advection variance mainly affect the Northern Hemisphere midlatitudes.

Significance Statement
This study aims to better understand processes governing daily near-surface air temperature variance over land. We use an idealized modeling framework to explore the effects of land surface evaporative resistance (a parameter that controls how hard it is to evaporate water from the surface) on summer daily temperature variance. We find that a uniform decrease of evaporative resistance across the global land surface causes changes in the temperature variance that can be predicted from changes in the combined variance of shortwave radiation and latent heat flux. The variance of horizontal advection is important in altering the temperature variance in the Northern Hemisphere midlatitudes. Our findings shed light on predicting the characteristics of temperature variability as a function of surface conditions.
Bleeding After Hemorrhoidectomy in Patients on Anticoagulation Medications
Authors: Kolbeinsson Hordur M. , Otto Maxwell , Kogelschatz Benjamin , Virk Usman , Luchtefeld Martin A. , Ogilvie James W. 
Published: September 2022

Background Post-hemorrhoidectomy bleeding is a serious complication after hemorrhoidectomy. In the setting of a new wave of anticoagulants, we aimed to investigate the relationship of post-operative anticoagulation timing and delayed bleeding. Methods We performed a retrospective analysis of all patients undergoing hemorrhoidectomy at a single institution over a 10-year period. Fisher’s exact and Wilcoxon Rank Sum tests were utilized to test for association between delayed bleeding and anticoagulation use. Results Between January 2011 and October 2020, 1469 hemorrhoidectomies were performed. A total of 216 (14.7%) were taking platelet inhibitors and 56 (3.8%) other anticoagulants. Delayed bleeding occurred in 5.2% (n = 76) of which 47% (n = 36) required operative intervention. Mean time to bleeding was 8.7 days (SD ±5.9). Time to bleeding was longer in those taking antiplatelet inhibitors vs. non-platelet inhibitors vs. none (11 vs. 8 vs. 7 days, P = .05). Among anticoagulants (n = 56), novel oral anticoagulants were more common than warfarin (57% vs 43%) and had a nonsignificant increase in delayed bleeding (31% vs 16%, P = .21). Later restart (>3 days) of novel anticoagulants after surgery was associated with increased bleeding (10.5% vs 61.5%, P=.005). On multivariable analysis, only anticoagulation use (OR 4.5, 95% CI: 2.1–10.0), male sex (OR 1.8, 95% CI: 1.1–2.9), and operative oversewing (OR 3.5, 95% CI: 1.8–6.9) were associated with delayed bleeding. Conclusion Post-hemorrhoidectomy bleeding is more likely to occur with patients on anticoagulation. Later restart times within the first week after surgery was not associated with a decrease in bleeding.
Factors influencing the derivation and clinical application of blood calcium adjustment equations
Authors: Conrich-Wilks Georgia , Ivison Fiona , Kilpatrick Eric S 
Published: September 2022

Background Laboratories are recommended to use patient data to derive their local adjusted calcium (adjCa) equation, using numerous criteria to exclude patients with potential calcium metabolism abnormalities. It is not known which, if any, of the exclusions influence the final equation formula, or to what extent. This study investigated the effect using fewer exclusions has on adjCa equations and on patient results when compared to a reference equation. Methods A reference ACB adjCa equation was derived from the total calcium and albumin pairs of 1305 individuals who, from an initial 22,906 adults, met recommended criteria (excluding abnormalities in either calcium, albumin, creatinine, magnesium, ALP or ALT, and specific clinical areas). This reference equation was compared to seven alternatives derived using fewer criteria, including one with no exclusions. All equations were applied to a validation cohort ( n=19,640) to determine their effect on adjCa results and on categorizing patients into hypo-, normo- or hypercalcaemia. Results Most alternative adjCa equations, including the one without any exclusions, showed no statistical ( p < 0.05) difference in their slope or intercept compared to the ACB reference. Nor did any of the validation cohort have a clinically significantly different adjCa result (>5% and >0.1 mmol/L different) when applying an alternative rather than the reference equation. Additionally, no alternative equation changed the kappa categorization of the validation population’s calcium status. Conclusions When deriving adjCa equations, most exclusion criteria have little influence on the equation or patient results, including using none at all. This knowledge could simplify deployment of local equations.
General Equilibrium Trade Policy Analysis among One Belt One Road Nations Using Structural Gravity Framework
Authors: Manzoor Hajra , Mir Parvez Ahmad 
Published: September 2022

Currently, the world is witnessing one of China’s most significant economic integration initiatives–One Belt One Road (OBOR). This article aims to evaluate the general equilibrium (GE) effects of this initiative on member nations. The structural gravity model is used in this study to perform the counterfactual analysis while analysing the conditional and general equilibrium effects of the trade policy of border removal on international trade flow among the member countries. The estimates suggest varied strade gains for the member countries in response to the trade policy changes. Most Asian countries are witnessing an increase in producers’ prices and therefore gaining more from globalisation. We also deduced that the member countries had reached half of their potential to trade gains, with most developing countries witnessing a decrease in multilateral trade resistance (MTR). The findings of this study implicate a debate for the policymakers over continuing support for further trade integration. JEL Codes: C21, F15, F17
Do people with musculoskeletal pain differ from healthy cohorts in terms of global measures of strength? A systematic review and meta-analysis
Authors: Verdini Enrico , Maestroni Luca , Clark Michael , Turner Anthony , Huber Jörg 
Published: September 2022

ObjectiveIt is currently unknown if people with musculoskeletal pain display different multi-joint strength capacities than healthy cohorts. The aim was to investigate whether people with musculoskeletal pain show differences in global measures of strength in comparison to healthy cohorts.Data sourcesA systematic review was conducted using three databases (Medline, CINAHL and SPORTDiscus) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Review methodsStudies involving participants with painful musculoskeletal conditions and multi-joint strength assessment measured at baseline were included. A meta-analysis was also performed to compute standardized mean differences (± 95% confidence intervals), using Hedge's g, and examined the differences in multi-joint strength at baseline between participants with painful musculoskeletal conditions and healthy participants.ResultsIn total, 5043 articles were identified, of which 20 articles met the inclusion criteria and were included in the qualitative analysis. The available evidence revealed that multi-joint strength values were limited to knee osteoarthritis, fibromyalgia, chronic low back pain, and rheumatoid arthritis. Only four studies were included in the quantitative synthesis and revealed that only small differences in both chest press ( g = −0.34, 95% CI [−0.64, −0.03]) and leg press ( g = −0.25, 95% CI [−0.49, −0.02]) existed between adult women with fibromyalgia and active community women.ConclusionThere is a paucity of multi-joint strength values in participants with musculoskeletal pain. Quantitative comparison with healthy cohorts was limited, except for those with fibromyalgia. Adult women with fibromyalgia displayed reduced multi-joint strength values in comparison to active community women.
Evaluation of Orthodontic Treatment Need—An Ethnic and Gender Prospective
Authors: Yadav Rajiv , Ranabhat Mukti , Yadav Anil Kumar 
Published: September 2022

Introduction: Index for Orthodontic Treatment Need is a widely used index to assess the orthodontic treatment need among various populations. Aim: The aim of this study is to evaluate and compare orthodontic treatment needs of Nepali among gender and ethnicity. Materials and Methods: A total of 800 children (400 males and 400 females) above 14 years of age were selected from different schools of Kathmandu using multistage sampling technique. The study sample was grouped into 2 ethnic groups: Indo-Aryan and Janajati. Two trained and calibrated examiners examined school-going children using Index for Orthodontic Treatment Need tool. Statistical comparison of the study variables by gender and ethnicity was done. Results: Dental Health Component showed 36.75% male and 34.5% female, and 39% Indo-Aryan and 29.76% Janajati had great treatment need. The Aesthetic Component (AC) showed 13.75% male and 12.25% female, and 12.5% Indo-Aryan 14.58% Janajati had great/severe need. Conclusions: Males had great/severe need of treatment for both Dental Health Component and Aesthetic Component (AC). Indo-Aryan showed higher degree of great/severe need for Dental Health Component and lesser degree of great/severe need for Aesthetic Component (AC) than Janajati.
A Culturally Tailored Narrative Decreased Resistance to COVID-19 Vaccination Among Latinas
Authors: Phelps Ashley , Rodriguez-Hernandez Yulissa , Murphy Sheila T. , Valente Thomas W. 
Published: September 2022

Purpose This study tested the relative efficacy of a culturally tailored dramatic narrative promoting COVID-19 vaccination in changing attitudes and behavioral intent among unvaccinated Latinas compared to a nonnarrative control containing similar information. Design A pretest-posttest experimental study with unvaccinated Latinas randomly assigned to watch either a dramatic narrative featuring Latina characters countering prevalent myths about COVID-19 vaccines or a nonnarrative film containing similar information (control condition). Setting The experiment was hosted online with the films embedded in the survey. Participants Three-hundred-ninety adult Latinas living in the United States (mean age = 33.4 years; SD = 11.2) who had not been vaccinated against COVID-19 despite being eligible. At pretest, 57.7% were hesitant and 42.3% were resistant (refusing) to get vaccinated. Measures Self-reported measures of engagement with the film, COVID-19 vaccine attitudes, and intent to get vaccinated within 30 days at pretest and posttest. Results Resistant women were significantly more engaged in the dramatic narrative than the nonnarrative control film ( P = .03). Being engaged in a film predicted more positive post-viewing attitudes toward the vaccine (b = .28; P < .001) and higher intent to get vaccinated (b = 2.34, P < .001). Conclusion Using culturally tailored stories to promote healthy behaviors such as vaccination can be an effective way of reaching resistant audiences.
Investigating the role of inflammation in keratoconus: A retrospective analysis of 551 eyes
Authors: Nichani Prem A H , Solomon Benjamin , Trinh Tanya , Mimouni Michael , Rootman David , Singal Neera , Chan Clara C 
Published: September 2022

Purpose Keratoconus (KCN), classically defined as a noninflammatory corneal ectasia, was recently associated with chronic inflammation. This study aimed to further evaluate the association between inflammation and KCN severity by assessing patient tear films. Methods Retrospective chart review of consecutive patients (July 2016–February 2020) referred to a tertiary KCN centre. Using tomography Kmax values, the worst-eyes of patients with a diagnosis of KCN and tear film test results were included. Eyes were stratified as matrix metalloproteinase-9 (MMP9) positive or negative and analyzed using independent t and Pearson chi-squared tests. A p-value ≤ 0.05 was considered significant. Results 551 (51.40%) unilateral eyes were included. Mean age was 30.1 years and 70.1% were male. 55.5% of the eyes were MMP9 positive. Mean corrected distance visual acuity was 20/30<συπ>−3</sup> Snellen and Kmax was 60.1 Diopters. MMP9 positive eyes had a higher Kmax (p = 0.048), and were more likely from patients who were male (p < 0.001), had a paediatric history of asthma (p = 0.042), and used glasses (p = 0.041). MMP9 negative eyes more likely corresponded to soft contact lens users (p = 0.012). No other significant differences were found in risk factors, topography, tomography, and tear film osmolarity. Conclusion MMP9 positive keratoconic eyes had significantly higher Kmax readings which may correlate with increased disease severity, supporting an association between keratoconus and inflammation. Further research is warranted to evaluate the role of targeted therapy and contact lens use on MMP9 levels in keratoconic eyes and whether disease progression is affected.
Factors Influencing Drug Use Information Received at Primary Healthcare Centre Pharmacies in Ghana
Authors: Ansah Edward Wilson , Menyanu Elias Kweshievi 
Published: September 2022

Background: Health literacy addresses environmental, political, and social factors that determine health. Drug dispensers play a major role in educating patients on drug use to increase effective and efficient drug utilisation, thereby promoting positive healthcare outcomes. From the patients’ perspective, this study examined the communication quality between patients and drug dispensers at primary healthcare centres in the Cape Coast Metropolis of Ghana. Method: We conveniently surveyed 269 patients seeking health care at primary healthcare facilities using a researcher-constructed 13-item instrument. In SPSS version 21 software, we analysed the data using percentages, chi-square analysis, and logistic regression. Results: Almost half of the participants (n = 132) reported low health literacy, with 81% (n = 218) reporting that drug side effects were not discussed with them at the pharmacies. The findings further indicated that health literacy and educational level predicted general communication quality between participants and drug dispensers; participants with secondary education were about 3 times more likely to report not being told of the side effects of prescribed drugs as compared with those who had completed only basic education. Conclusions: There is still a high level of low health literacy among patients seeking healthcare at primary healthcare centres and a very high percentage of patients did not receive any education on side effects of dispensed drugs. Drug use directives from dispensers at primary healthcare facilities can make a difference between any 2 patients.
Intravascular Lithotripsy Assisted Carotid Stent Expansion
Authors: Mehta Veena , Wooster Mathew 
Published: September 2022

Purpose: Carotid stenting has been demonstrated to effectively reduce the risk of stroke in appropriately selected patients. However, application of carotid artery stenting remains limited in the setting of heavily calcified disease. Case Report: We present here 3 patients, who were treated with intravascular lithotripsy of the internal and common carotid arteries. All 3 patients recovered uneventfully and have demonstrated excellent stent expansion on surveillance imaging. Conclusion: Intravascular lithotripsy is an effective adjunct for enabling stent expansion in heavily calcified lesions and can be employed for the treatment of high-risk carotid lesions that would otherwise be poor endovascular candidates. Clinical Impact Carotid artery stenting via transfemoral or transcarotid application remains limited by heavily calcified disease. We present here the off-label use of intravascular lithotripsy as an effective adjunct for enabling stent expansion in heavily calcified lesions. There is potential for intravascular lithotripsy to expand the use of carotid stenting.
Giant Inferior Mesenteric Vein Aneurysm Secondary to Iatrogenic Inferior Mesenteric Arteriovenous Fistula
Authors: Pedersen Vilde , Ohrlander Tomas , Frevert Susanne , Malina Martin 
Published: September 2022

Purpose: Visceral venous aneurysms are rare, especially in the inferior mesenteric vein (IMV). We report a giant IMV aneurysm secondary to an iatrogenic arteriovenous fistula (AVF). Case Report: A woman presented with an incidental finding of a 7 cm large IMV aneurysm and an inferior mesenteric arteriovenous shunt. The patient underwent successful endovascular occlusion of the shunt to avoid aneurysm rupture and portal hypertension. Conclusion: Embolization is a possible treatment strategy for mesenteric venous aneurysms with an AVF. Clinical Impact We describe an unusual mesenteric AV-shunt from a surgical crush injury that caused a giant venous mesenteric aneurysm and offer technical aspects on minimally invasive endovascular treatment.
Influence of Graft Type on Lower Extremity Functional Test Performance and Failure Rate After Anterior Cruciate Ligament Reconstruction
Authors: Roach Megan H. , Aderman Michael J. , Gee Shawn M. , Peck Karen Y. , Roach Sean P. , Goss Donald L. , Posner Matthew A. , Haley Chad A. , Svoboda Steven J. , Cameron Kenneth L. 
Published: September 2022

Background: Both autografts and allografts are used to reconstruct the anterior cruciate ligament (ACL) after injury; however, it is unclear whether graft source affects lower extremity functional test performance or failure rate in an active military population. Objective: To compare lower extremity functional test performance and graft failure rates between ACL grafts [allograft, hamstring, bone-patellar tendon-bone (BTB)]. Study Design: Cross-sectional. Level of Evidence: Level 2. Methods: Ninety-eight cadets entering a US Service Academy with a history of unilateral ACL reconstruction (ACLR) agreed to participate. Before basic training, participants completed 4 lower extremity functional tests. Active injury surveillance was conducted within the study cohort to identify all subsequent graft failures. Results: Cadets with hamstring autografts outperformed the BTB and allograft groups on the Lower Quarter Y-Balance Test-Posteromedial direction and single-leg hop test, respectively. No differences were detected by graft type for the other functional tests. The incidence of subsequent ipsilateral graft failures in patients with autograft was 8.11%. No failures were observed in the allograft group during the follow-up period. After controlling for sex, joint hypermobility, and time since injury and surgery, the risk of graft failure was 9.8 times higher for patients with a hamstring autograft than with a BTB ( P = 0.045). Conclusion: After ACLR, graft type appears to influence some single-limb measures of lower extremity function and the risk of subsequent failure. Hamstring autografts demonstrated better functional performance but increased risk of graft failure. Clinical Relevance: Surgeons need to weigh the pros and cons of all graft options in relation to the patient’s lifestyle. Regardless of graft type, individuals with an ACLR may require additional rehabilitation to regain neuromuscular control during dynamic single-limb tasks and mitigate graft failure.