bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparisons between Short- and Long-Lived Break Events during the Western North Pacific Summer Monsoon
Authors: Xu Ke , Lu Riyu 
Published: December 2022

Abstract
The break events of the western North Pacific summer monsoon vary significantly in duration, ranging from a few days to more than 2 weeks. In this study, we classify the monsoon break events into short-lived (≤8 days) and long-lived (>8 days) events, which account for 78% and 22% of the total events during 1979–2020, respectively. The results show that convection suppression is stronger and broader for long-lived events than for short-lived events. In addition, the temporal distributions of the two break categories are distinct: short-lived events present a roughly even distribution from late July to late September, while long-lived events are highly concentrated, with a striking frequency peak around early September. The mechanisms responsible for break events are investigated. Results indicate that both break categories are co-contributed by 10–25- and 30–60-day oscillations. Short-lived events result from a phase lock of the two oscillations, which explain 54% and 35% of the convection suppression, respectively. By contrast, long-lived events are initiated by both oscillations but maintained only by 30–60-day oscillations. In addition, 30–60-day oscillations reach the peak intensity after the monsoon onset due to seasonal background changes, which is critical for forming the frequency peak of long-lived events around early September. Furthermore, it is found that long-lived events tend to occur in the developing phase of positive SST anomalies in the tropical central Pacific, when 30–60-day oscillations are abnormally enhanced over the western North Pacific.

Significance Statement
The monsoon break usually refers to significant rainfall reduction during the monsoon season, which can induce abnormal weather, such as heatwaves and droughts, resulting in huge economic losses. To date, however, there are only a few studies on the break of the western North Pacific summer monsoon (WNPSM), in sharp contrast to the well-known Indian monsoon break. We note that break events of the WNPSM vary widely in duration. This study aims to reveal the remarkable difference between short- and long-lived events, including intensity, spatial extent, occurrence time, and physical mechanisms. These results will help us better understand the diversity of the break phenomenon and may serve as a scientific basis for improving the subseasonal prediction of the WNPSM.
Low-Frequency Variability in the Real-Time Multivariate MJO Index: Real or Artificial?
Authors: Ren Hong-Li , Wei Yuntao , Zhao Shuo 
Published: December 2022

Abstract
The real-time multivariate Madden–Julian oscillation (MJO) (RMM) index has now been widely applied as a standard in operational subseasonal prediction and monitoring. Its calculation procedures involve the extraction of major intraseasonal variability (ISV) by subtracting the prior 120-day mean. However, this study uncovers that such a real-time strategy artificially creates unwanted low-frequency variability (LFVartificial) that might cause nonnegligible influences on the RMM amplitude and phase. Compared to the real LFV, the LFVartificial explains more (∼70% in boreal summer) of the residual LFV (LFVresidual) in the RMM index. It occupies 33% of all days that the LFVresidual explains more than one-half of total RMM amplitude, 19% that the LFV contribution exceeds ISV, and 10% that the LFVartificial-associated RMM amplitude surpasses 0.8. The RMM-defined “MJO” is obscured by the LFVresidual in such a way that the eastward-propagating mode is stronger and bigger with a slower phase speed, as compared with the “true” MJO derived from the 20–100-day filtered data. The interference effects of LFVresidual on the MJO might be particularly strong when the background state is changing rapidly with time. However, these issues can be well avoided when one chooses to remove the centered 120-day mean, as evidenced by the largely reduced three percentages (17%, 8%, and 1%) mentioned above in the so-derived index. These results give us a reminder that more attention should be paid to monitoring or predicting an MJO using the RMM index in a rapidly changing low-frequency background or in the boreal summer.

Significance Statement
The real-time multivariate MJO (RMM) index has been widely applied in the monitoring and prediction of the MJO, the major tropical intraseasonal variability influencing global weather and climate. Using observational analysis, we reveal that there exist such scenarios (∼16%) when large-amplitude RMM indices do not represent a strong MJO, mainly due to the obscuring effect of residual, while largely artificial, low-frequency variability introduced by the RMM calculation procedures. This finding is of great significance as it informs the research community that serious caution should be given when relating large RMM amplitude to the MJO, especially in a condition when the low-frequency background state is rapidly changing with time or in the boreal summer.
Costs of Hospital Care for Strokes in India: A Scoping Review
Authors: Benedetto Valerio , Cadilhac Dominique A. , Spencer Joseph , Clegg Andrew , Lightbody Catherine Elizabeth , Maulik Pallab K. , Srivastava Madakasira Vasantha Padma , Pandian Jeyaraj , Sylaja P. N. , Watkins Caroline L. 
Published: December 2022

The incidence of stroke in India is one of the largest worldwide. With this scoping review, we assessed the evidence on the costs of stroke, which is essential to evaluate whether stroke care interventions are cost-effective. We adopted a healthcare sector and broader societal perspective and searched electronic databases for records including stroke cost estimates (up to 2020). Following deduplication and screening of 2,510 records, we extracted the data (converted into 2020 Indian rupees [INR]) and assessed the quality of eight eligible studies. These studies, published between 2011 and 2020, covered the whole of India and specific localities and were: cost-of-illness studies (n = 3); economic evaluations (n = 2); cross-sectional costing study (n = 1); simulated costing study (n = 1); and policy/clinical review (n = 1). Among the extracted estimates, the mean total costs of stroke care per patient for the period up to six months post admission ranged from ₹19,428.86 in a government hospital in Punjab to ₹118,040.15 in a private tertiary care centre in Ludhiana. The median total out-of-pocket (OOP) payments for cardiovascular disease-related expenditures ranged from ₹18,148.88 to ₹68,464.39 across different income groups. Despite methodological limitations, the data from our scoping review will help in designing economic evaluations of stroke care interventions in India.JEL Codes: C18, C80, D61, I15, I19
The connections of physical and psychosocial symptoms among patients with terminal illnesses: A network analysis
Authors: Jiao Keyuan , Chow Amy YM 
Published: December 2022

Background: Patients with terminal illnesses have different symptoms. The goal of palliative care is to alleviate the suffering induced by these symptoms. Available research on symptoms has focused on their prevalence or identification of clusters. Little is known about the central symptoms contributing to the maintenance of the whole system of symptoms or the mechanism of influence between symptoms, particularly between physical and psychosocial symptoms. Aim: The study used network analysis to explore symptom clusters among patients with terminal illnesses and identify the central symptoms, the bridge symptoms, and pathways between physical and psychosocial symptoms. Design and Setting/Participants: This is a retrospective cohort study using baseline symptom assessment of 677 adults with terminal illnesses receiving care from the Integrated Community End-of-Life Care Support Teams. Results: Three symptom clusters were identified: physical, psychological, and practical clusters. “Weakness or lack of energy” was identified as the crucial symptom affecting the changes of other symptoms, followed by depression and anxiety. Three connections between the psychological and physical symptoms were identified: anxiety-pain, depression-constipation, and perceived family anxiety-poor appetite pathways. Pathways of practical concern-peace and practical concern-depression were indicated between practical and psychological symptoms. Conclusions: This study is the first of its kind to investigate the connections and mechanism of influence between symptoms among patients with terminal illnesses. It offers clear pathways for intervention with the most influential symptoms of weakness, anxiety, and depression.
BONSAI-2 study: Nivolumab as therapeutic option after cabozantinib failure in metastatic collecting duct carcinoma patients
Authors: Buti Sebastiano , Trentini Francesca , Sepe Pierangela , Claps Melanie , Isella Luca , Verzoni Elena , Procopio Giuseppe 
Published: December 2022

Background: The BONSAI phase II trial recently demonstrated the activity of cabozantinib in metastatic collecting duct patients. The outcomes of patients in this setting treated with immunotherapy as second-line is unknown. The aim of the present report was to describe outcomes of patients enrolled in the BONSAI trial that received nivolumab as second-line treatment. Material and methods: We describe the oncological outcomes in terms of overall response rate, progression-free survival, overall survival and safety. We excluded patients that did not receive any second-line treatment or were treated with agents other than nivolumab. Results: We identified five patients of whom one was excluded due to lack of data. Three patients obtained clinical benefit (one partial response, two stable disease); the second-line progression-free survival (nivolumab) ranged from 2.8 to 19.9 months to and second-line overall survival ranged from 5.1 to 26.5 months. No new safety signals were observed. Conclusions: Nivolumab may be considered as second-line therapy option after cabozantinib failure in selected metastatic collecting duct carcinoma patients.
Getting Yourself Published: Steps and Strategies From Journal Editors
Authors: Bansak Cynthia , Zebedee Allan A. 
Published: December 2022

In this short paper, we share our experiences serving as editors, associate editors, and on editorial boards over the past two decades. Our goal is to provide insights regarding successful publishing from the perspective of those reviewing manuscripts. Our suggestions and tips are by no means comprehensive or definitive and other editors may not agree with our advice. However, we hope these tips are useful guidance toward navigating the often challenging and disheartening journey of moving one’s research through the publication process. JEL codes: A11, A14, A23
An approach for predicting longitudinal free vibration of axially functionally graded bar by artificial neural network
Authors: Demir Ersin , Sayer Metin , Callioglu Hasan 
Published: December 2022

In this study, an Artificial Neural Network (ANN) model is designed for the analysis of the longitudinal free vibration of an axially Functional Graded (FG) bar. The material of the bar is varied from one end to the other end according to power law function. Aluminum and Alumina and the mixture of these two materials are used in the analysis. The radius of the bar is also varied along to the longitudinal direction according to power law function. In addition, the effect of the variation in the slenderness ratio is also investigated. An ANN code is written in Matlab in order to obtain a generalized approach for vibration analysis of the FG bar. In the ANN training, some results of free vibration analysis obtained from the SolidWorks program based on Finite Element Method are used. The predicted values that are not used in the training are also obtained in SolidWorks for comparison. A Matlab program code, which based ANN method is used to find new values to be predicted. The process is also made for comparison with the ANN based Matlab nntool program. When the results obtained from SolidWorks and prepared Matlab code and Matlab nntool are compared, it is seen that the results are in harmony. AMS subject classifications: 74H45, 68T07
Iatrogenic ANA: An emerging source of expensive diagnostic confusion
Authors: Ali Hammad , Buechler Connor R. , Sanaullah Oneeb , Lucas Alexandria , Lohr Kristine L. 
Published: December 2022

Intravenous immune globulin (IVIg) therapy has been shown to be useful in a multitude of disorders. IVIg is produced from pooled human plasma; therefore, autoantibodies found in the general population are also present in IVIg and transferred to those being transfused. This can prove a particular hazard for screening and diagnostic tests based on autoantibodies. We present a patient who was found to have a positive antinuclear antibody (ANA) titer after multiple IVIg transfusions, resulting in diagnostic confusion and unnecessary workup. A 45-year-old gentleman was diagnosed with atypical CIDP, initiated on a course of IVIg, and sent for inpatient rehabilitation. However, recovery was complicated by multiple readmissions for recurrent weakness, and as part of the workup for other etiologies, an ANA was found to be positive. Sub-serologies and paraneoplastic autoantibody panel were negative. In the absence of clinical symptoms, we recommended continued monitoring and repeat ANA testing 6 months after the last dose of IVIg; as any drug needs 5 half-lives to be eliminated from the body. Clinicians should consider any recent IVIg treatments when evaluating the pre-test probability of detecting an underlying connective tissue disease with ANA screening. Indiscriminate ANA levels in patients recently given IVIg lead to unnecessary and expensive further testing and consultation.
Persistence and adherence to second-generation antipsychotic long-acting injectable medications for schizophrenia: A comparative study in the Australian context
Authors: Pai Nagesh , McGeachie Andrew B , Puig Andrea , Huang Tom H-W , Brahmbhatt Prachi 
Published: December 2022

Objective To examine patient characteristics, persistence and adherence to treatment associated with use of second-generation antipsychotic long-acting injectable (SGA LAI) medications in the Australian real-world setting. Method Five SGA LAIs were compared using a retrospective 10% sample of prescriptions in Australian Pharmaceutical Benefits Scheme (PBS) data: paliperidone palmitate 1-monthly (PP1M), paliperidone palmitate 3-monthly (PP3M), aripiprazole monohydrate (ARI), risperidone (RLAI) and olanzapine pamoate (OLAI). Results Patients in the PP3M cohort were more persistent with treatment ( p < 0.001). Median months of persistence: PP3M (36 months); ARI (18 months); PP1M (11 months); OLAI (8 months); RLAI (4 months). Patients in the PP3M cohort were more adherent to treatment ( p < 0.001): PP3M (78%); ARI (51%); PP1M (46%); OLAI (35%); RLAI (33%). Conclusions Patients on PP3M treatment showed comparatively longer persistence and better adherence. Treatments for schizophrenia with longer dosing intervals may provide patients with symptomatic stability that could allow for reduced hospitalisations/relapse and increased focus on functional recovery.
Outpatient initiation of venetoclax in patients with acute myeloid leukemia
Authors: Palmer Shannon , Patel Anand , Wang Christopher , Patel Bianka , Zeidner Joshua , Foster Matthew , Muluneh Benyam , Buhlinger Kaitlyn 
Published: December 2022

Introduction Venetoclax is a treatment option in patients with acute myeloid leukemia (AML) in both the front-line and relapsed/refractory settings. Initiation of therapy has been previously restricted to the inpatient setting at some institutions due to a risk of tumor lysis syndrome (TLS) and limitations in medication access efficiency given the high cost of therapy. Methods We assessed the safety of initiating venetoclax in the outpatient setting through a single-arm, retrospective study of adult AML patients between April 1, 2019 and June 30, 2020. Results Eighty-two patients started venetoclax during this time, with 47 (57%) patients initiated in the outpatient setting. Fifty-five percent of patients received venetoclax as first-line treatment for AML (n = 45) and 45% of patients received venetoclax for relapsed/refractory AML (n = 37). Successful initiation, defined as no hospitalizations secondary to TLS within seven days of therapy initiation, occurred in 98% of patients. The rate of TLS was 2.1% (n = 1) following venetoclax initiation. TLS symptoms were managed during hospitalization, requiring only one day of missed AML therapy. Median turnaround time for medication access was three days. Hospitalizations within seven days occurred in 17% of patients (n = 8), with the majority due to febrile neutropenia. Conclusions The results of our study provide further evidence for the safety and feasibility of initiating venetoclax in the outpatient setting with a pharmacist-led interdisciplinary protocol.
Fluocinolone acetonide implant (Iluvien®) for macular edema associated with retinitis pigmentosa: A case report
Authors: Jomaa Emilie , Delyfer Marie-Noëlle , Korobelnik Jean-François 
Published: December 2022

Purpose Macular edema can be observed in 20% of patients with retinitis pigmentosa (RP) and is often responsible of central vision impairment. Intraocular administration of corticosteroids (either triamcinolone or dexamethasone implant) has been found to be effective in that indication. We here describe the first report of a successful bilateral administration of fluocinolone acetonide implant in a patient with steroid-dependent macular edema associated to RP. Methods Case report. Case report A 34-year female patient with RP was referred for a one-year bilateral persistent ME. She had been refractory either to topical or to general carbonic anhydrase inhibitors. Bilateral off-label administration of 0.7 mg dexamethasone implant (Ozurdex®, Allergan, CA) was therefore decided. Efficacy and tolerance were very good in both eyes. Still, every four-month injections were required to maintain the macula dry. Off-label use of 0.19 mg fluocinolone acetonide (FAc) implant (Iluvien®, Alimera Sciences, GA) was then proposed and injected, first, in the right eye and, two-years after, in the left eye. No recurrences of the edema were observed from then on, i.e., for 3 years in the right eye and for 1 year in the left eye. Conclusion Intravitreal fluocinolone acetonide could represent a promising means in the therapeutic management of persistent steroid-dependent ME related to RP.
Asynchronous training for ultrasound-guided peripheral IV placement among critical care nurses
Authors: Schott Christopher K , Devore Jennifer A , Kelly Monique YB , Mayr Florian B 
Published: December 2022

Objective: Teaching ultrasound (US) guidance for placement of peripheral intravenous (PIV) catheters requires significant time for synchronous didactic and hands-on training. The investigators assessed the feasibility of an asynchronous model for critical care nurses to learn the novel skill of US-guided PIV placement. Secondary outcomes included the percentage of successful attempts and number of sticks per attempt for anatomy versus US-guided approaches. Methods: The investigators built a self-contained training cart for learners to practice and record their performance. Training occurred asynchronously. The learners recorded data from PIV attempts. Participants completed pre- and post-training surveys. Data from this prospective observational cohort was analyzed for descriptive and comparative statistics, using Kirkpatrick’s Model for evaluation of this educational intervention. Results: During a 6 month period, 21 nurses completed the asynchronous training, with eight recording their PIV placements. 81.0% of the training occurred outside of a Monday to Friday 9AM–5PM period. There were 64 attempts by anatomy approach and 84 with US-guidance. The anatomic approach was successful in 35.9% of attempts with a mean of 1.5 sticks (SD 1.0, Range 1–5). The US-guided approach had a statistically significant greater rate of success (77.4%; p < 0.001) with a mean of 1.2 sticks (SD 1.2, range 1–2, p < 0.01). Participants reported increased confidence in US-guided PIV placement and enjoyment with this method of learning. Conclusions: Asynchronous learning model with cart-based instruction and practice is a feasible means for nurses to learn US-guided PIV placement. Significant outcomes were seen across Kirkpatrick levels I–IV for educational outcome assessment.
Cause and place of death in Norwegian nursing home residents
Authors: Vossius Corinna , Bergh Sverre , Selbæk Geir , Lichtwarck Bjørn , Myhre Janne 
Published: December 2022

Background: Nursing home (NH) residents are in their last phase of life, and two aims of the NH’s medical care in Norway is to prevent unnecessary hospital admissions that would not benefit the resident and to facilitate a peaceful death in familiar surroundings when the time comes. However, little is known about the share of residents dying in NHs and the causes of death. We therefore evaluated the cause and place of death in a cohort of NH residents followed from the time of NH admission until death. Methods: NH residents were followed from admission to the NH and over the entire course of their NH stay. Demographic and clinical data were collected. Cause and place of death were retrieved from the Norwegian Cause of Death Registry. Results: Of 1283 residents, 6.2% died in hospital and 91.2% in a NH. Those who died in hospitals were more often male, died sooner after NH admission, had a less severe degree of dementia and had poorer general health. Dementia was the most common underlying cause of death, followed by cardiovascular disease. Conclusions: Dementia is one of the main causes of death in NH residents. In addition, our findings indicate a low number of inappropriate referrals to hospital during the last stage of life. However, further research should explore whether the terminal phase of NH residents is formed in accordance with their preferences and whether appropriate palliative care is offered.