bluuebunny/crossref_metadata_2025_split huggingface dataset:
Classification of Cloud Particle Imagery from Aircraft Platforms Using Convolutional Neural Networks
Authors: Przybylo Vanessa M. , Sulia Kara J. , Schmitt Carl G. , Lebo Zachary J. 
Published: March 2022

Abstract
A vast amount of ice crystal imagery exists from a variety of field campaign initiatives that can be utilized for cloud microphysical research. Here, nine convolutional neural networks are used to classify particles into nine regimes on over 10 million images from the Cloud Particle Imager probe, including liquid and frozen states and particles with evidence of riming. A transfer learning approach proves that the Visual Geometry Group (VGG-16) network best classifies imagery with respect to multiple performance metrics. Classification accuracies on a validation dataset reach 97% and surpass traditional automated classification. Furthermore, after initial model training and preprocessing, 10 000 images can be classified in approximately 35 s using 20 central processing unit cores and two graphics processing units, which reaches real-time classification capabilities. Statistical analysis of the classified images indicates that a large portion (57%) of the dataset is unusable, meaning the images are too blurry or represent indistinguishable small fragments. In addition, 19% of the dataset is classified as liquid drops. After removal of fragments, blurry images, and cloud drops, 38% of the remaining ice particles are largely intersecting the image border (≥10% cutoff) and therefore are considered unusable because of the inability to properly classify and dimensionalize. After this filtering, an unprecedented database of 1 560 364 images across all campaigns is available for parameter extraction and bulk statistics on specific particle types in a wide variety of storm systems, which can act to improve the current state of microphysical parameterizations.
Tornado Heading and Speed Changes Associated with Large and Intense Internal Rear-Flank Surges in Three Supercells
Authors: Lee Bruce D. , Finley Catherine A. 
Published: March 2022

Abstract
Tornado motion changes occurring with major internal rear-flank momentum surges are examined in three significant tornado-producing supercells. The analysis primarily uses fixed-site Doppler radar data, but also utilizes in situ and videographic observations when available. In the cases examined, the peak lowest-level remotely sensed or in situ rear-flank surge wind speeds ranged from 48 to at least 63 m s−1. Contemporaneous with major surges impacting the tornadoes and their parent low-level mesocyclones, longer-duration tornado heading changes were leftward and ranged from 30° to 55°. In all cases, the tornado speed increased substantially upon surge impact, with tornado speeds approximately doubling in two of the events. A storm-relative change in the hook echo orientation accompanied the major surges and provided a signal that a marked leftward heading change for an ongoing tornado was under way. Concurrent with the surge interaction, the hook echo tip and associated low-level mesocyclone turned leftward while also moving in a storm-relative downshear direction. The major rear-flank internal surges influenced tornado motion such that a generally favorable storm updraft-relative position was maintained. In all cases, the tornado lasted well beyond (≥21 min) the time of the surge-associated left turn with no evident marked loss of intensity until well down-track of the turn. The local momentum balance between outflow and inflow that bounds the tornado or its parent circulation, especially the directionality evolution of the bounding momentum, is the most apparent explanation for tornado down-track or off-track accelerations in the featured events.
Das „Zweite Programm“ Zwischen Gemeinsamer Praxis und Reflektiertem Glauben
Authors: Abel Dominik 
Published: March 2022

Celebrations of blessing for newborns are examples of a group of services that have a high sensitivity toward a certain milieu, social context, or occasion. These services are described as “second program” or alternative services. But are they actually “liturgy” at all? In order to approach this question, this article first analyzes various excerpts from an interview. As a next step, a historical discourse is outlined that was dedicated to a similar question. Already in 1933, the theologian Josef Andreas Jungmann raised this question in his article “What is Liturgy?”. A conclusion connects both approaches: The close connection between liturgy and church classifies these celebrations as liturgy. In a reverse direction these liturgies also raise the question of an image of church that emerges from these celebrations. Die Segensfeiern für Neugeborene sind ein Beispiel für eine Gruppe von Feiern, die eine hohe Sensibilität für eine bestimmte Zielgruppe oder einen bestimmten Anlass besitzen. Diese Gottesdienste werden als „Zweites Programm“ bezeichnet. Aber handelt es sich bei diesen Feiern um Liturgie? Um sich dieser Frage zu nähern, analysiert der Beitrag zunächst verschiedene Auszüge aus einem Interview. In einem nächsten Schritt wird ein historischer Diskurs skizziert, der sich einer ähnlichen Fragestellung widmete. Bereits 1933 stellte der Theologe Josef Andreas Jungmann in seinem Artikel “Was ist Liturgie?” die Frage nach dem Rang der Andachten. Ein Fazit verbindet beide Ansätze: Die enge Verbindung von Liturgie und Kirche ordnet diese Feiern der Liturgie zu. Umgekehrt stellt sich bei diesen Liturgien auch die Frage nach einem Bild von Kirche, das aus diesen Feiern erwächst.
What Helps Me Cope With Work–Family Conflict at My High-Performance Work System in India: A Thematic Analysis of Sociocultural Factors
Authors: Anand Anjni , Vohra Veena 
Published: March 2022

Executive Summary This study is located in the context of high-performance work systems (HPWS) in India. Extant literature indicates that the darker side of HPWS and work intensification impact employee lives and trigger work–family conflict (WFC) experiences. With the shift in organizational focus on employee well-being, it has become imperative to understand and unpack WFC experiences of employees in the Indian sociocultural context to design effective and contextual remedial mechanisms. Responding to this need, WFC experiences of employees in Indian HPWS contexts were closely examined in this study to unpack the role of prevalent sociocultural factors. Additionally, the study explored how employees coped with these life situations. Since organizations are now beginning to work towards enhancing the well-being of employees, this study offers insights into what coping mechanisms are deliberately or inadvertently in use to evaluate their effectiveness. Studying the nature of WFCs and coping mechanisms from a sociocultural lens, this study identifies and develops four major themes. Passive acceptance of WFC, unambiguous communication, emotional and instrumental support from family, informational support at work emerged as the four significant themes discussed at length in this article. Insights generated from the discussion of these themes point overarchingly towards the highly personalized and localized, individual-level approach prevalent amongst employees of HPWS in response to WFC episodes. The discussion and conclusion sections highlight the need for well-designed and mindful organizational interventions built upon an understanding of the sociocultural factors at work to effectively mitigate the employee stress generated by the HPWS environments. This work is especially relevant in an era of pandemic-related work models, millennial workers and work intensification due to the increased digitalization of workplace practices.
Prostate Cancer Screening, Diagnostic, Treatment Procedures and Costs in Sub-Saharan Africa: A Situational Analysis
Authors: Makau-Barasa Louise K. , Manirakiza Achille , Carvalho Andre L. , Rebbeck Timothy R. 
Published: March 2022

Purpose Prostate cancer mortality is predicted to nearly double by 2040 in Sub-Saharan Africa (SSA). The lack of prostate cancer screening in SSA contributes to late-stage diagnosis, treatment delays, and poor survival among patients. We analyzed the availability and use of prostate cancer screening, diagnostic and treatment guidelines, procedures, and costs in few SSA countries to determine factors for consideration in the development of prostate cancer screening guidelines for SSA. Methods We applied mixed methods approaches to collect data through an electronic survey administered to clinicians (oncologists, urologists, pathologists, nurses, and radiation oncologists) providing prostate cancer screening, diagnosis, and treatment services in multiple sub-Saharan countries. Results Inconsistencies in respondents’ understanding of the availability and use of prostate cancer screening guidelines in their countries were noted. Prostate Specific Antigen (PSA) and Digital Rectal Examination (DRE) were the most commonly available screening modalities. Available diagnostic procedures included a combination of prostate biopsies, transrectal ultrasonography, and DRE. Our study’s data suggest that PSA and DRE exams are available for early diagnosis and screening procedures. Availability of treatment modalities with curative intent and costs for prostate cancer related procedures varied between and within countries. Conclusions PSA and DRE are available for detecting prostate cancer and may detect aggressive cancers early, leading to improved outcomes. However, PSA screening is also associated with overdiagnosis and over-treatment. National prostate cancer policies should consider health systems, evidence-based guidelines, population characteristics and healthcare financing to ensure access to clinically relevant and safe prostate cancer related care.
Topics in the routine assessment of newborn kitten vitality: Apgar score, reflexes and complementary assessments
Authors: Hibaru Viviane Yukari , Pereira Keylla Helena Nobre Pacífico , Fuchs Kárita da Mata , Lopes Maria Denise , Alfonso Angélica , de Souza Fabiana Ferreira , Chiacchio Simone Biagio , Tsunemi Miriam Harumi , Machado Luiz Henrique de Araújo , Lourenço Maria Lucia Gomes 
Published: March 2022

Objectives The aim of this study was to perform neonatal clinical assessments at birth to identify newborn kittens at risk according to type of delivery, thus allowing immediate intervention and increasing their chances of survival. Methods This study compared Apgar scores, reflexes and clinical parameters (temperature, weight, blood glucose and peripheral oxygen saturation [SpO2]) between eutocic neonates and those delivered by emergency cesarean section. The animals were evaluated at birth and after 10 and 60 mins. Results Thirty-two neonates were evaluated, with 19 animals in the eutocic group (EG) and 13 animals in the cesarean group (CG). When comparing groups, CG neonates had significantly lower Apgar scores ( P <0.0001), lower SpO2 ( P = 0.0535), higher blood glucose ( P = 0.0009), reduced reflexes ( P <0.0001) and lower respiratory rates ( P <0.0001) at birth and after 10 and 60 mins than EG neonates. Apgar scores positively correlated with parameters such as heart rate, reflex score, SpO2 and weight. The mortality rate in evaluated newborns was 15.6% (5/32). The early mortality rate (0–2 days old) was 80% (4/5) and the late mortality rate (3–30 days old) was 20% (1/5). Conclusions and relevance This study showed lower vitality in cats delivered by emergency cesarean section than in those delivered through eutocic birth. In general, neonates delivered by cesarean section have greater depression and low vitality at birth and may require advanced resuscitation procedures. The evaluations carried out in this study identified newborns with low vitality and those requiring advanced resuscitation, thus allowing immediate intervention. Apgar and reflex scores for feline neonates were suggested. Newborn-specific clinical assessment with these feline vitality scores allows the identification of at-risk neonates. Care immediately after birth increases the chance of survival among these patients.
Stronger Microstructural Damage Revealed in Multiple Sclerosis Lesions With Central Vein Sign by Quantitative Gradient Echo MRI
Authors: Levasseur Victoria A. , Xiang Biao , Salter Amber , Yablonskiy Dmitriy A. , Cross Anne H. 
Published: March 2022

Background Multiple sclerosis (MS) lesions typically form around a central vein that can be visualized with FLAIR* MRI, creating the central vein sign (CVS) which may reflect lesion pathophysiology. Herein we used gradient echo plural contrast imaging (GEPCI) MRI to simultaneously visualize CVS and measure tissue damage in MS lesions. We examined CVS in relation to tissue integrity in white matter (WM) lesions and among MS subtypes. Objective We aimed to determine if CVS positive lesions were specific to MS subtype, if CVS can be detected consistently among readers using the GEPCI method, and if there were differences in tissue damage in lesions with vs without CVS. Subjects and Methods Thirty relapsing-remitting MS (RRMS) subjects and 38 primary and secondary progressive MS (PMS) subjects were scanned with GEPCI protocol at 3T. GEPCI T2*-SWI images were generated to visualize CVS. Two investigators independently evaluated WM lesions for CVS and measured lesion volumes. To estimate tissue damage severity, total lesion volume, and mean lesion volume, R2t*-based tissue damage score (TDS) of individual lesions and tissue damage load (TDL) were measured for CVS+, CVS-, and confluent lesions. Spearman correlations were made between MRI and clinical data. One-way ANCOVA with age and sex as covariates was used to compare measurements of CVS+ vs CVS- lesions in each individual. Results 398 of 548 lesions meeting inclusion criteria showed CVS. Most patients had ≥40% CVS+ lesions. CVS+ lesions were present in similar proportion among MS subtypes. Interobserver agreement was high for CVS detection. CVS+ and confluent lesions had higher average and total volumes vs CVS- lesions. CVS+ and confluent lesions had more tissue damage than CVS- lesions based on TDL and mean TDS. Conclusion CVS occurred in RRMS and PMS in similar proportions. CVS+ lesions had greater tissue damage and larger size than CVS- lesions.
Elevated body mass index is associated with tibial plateau fracture complexity and post-operative complications
Authors: McGurk Kathy M , Traven Sophia A , McCadden Austin , LeBrun Christopher T , Reid Kristoff R , Hartsock Langdon A , Slone Harris S 
Published: March 2022

Introduction As the average body mass index (BMI) is increasing at an alarming rate, dichotomous literature exists regarding whether BMI is protective or disadvantageous for fracture risk. Therefore, the purpose of this study was to evaluate the relationship between BMI, fracture complexity, and post-operative complications for tibial plateau fractures. Methods A retrospective analysis of the National Surgical Quality Improvement Program’s database for the years 2005–2018 was completed. Only patients undergoing primary surgical fixation of an isolated tibial plateau fracture were included. Patients were then stratified into unicondylar and bicondylar fracture patterns by CPT code. Multivariate logistic regression analyses were used to assess risk factors for fracture severity, post-operative complications, and staged fixation. Results Of the 3454 patients identified for inclusion, we found that patients with higher BMIs were more likely to sustain a bicondylar fracture compared with patients with lower BMIs. For each additional BMI point, the risk of sustaining a bicondylar fracture increased by 1.0%. Additionally, there was a 3.8% increased risk of surgical complications for every increased BMI point. Specifically, the risk of a deep infection increased by 6.1%, wound dehiscence by 8.5%, and venous thromboembolism by 4.2%. Conclusion This data demonstrates that an elevated BMI is associated with increased tibial plateau fracture complexity and post-operative complications. These results may be used to help surgeons and hospitals identify at-risk patients to help guide perioperative management in an effort to help mitigate such complications as much as possible.
Predicting Mechanical Failure Following Cervical Deformity Surgery: A Composite Score Integrating Age-Adjusted Cervical Alignment Targets
Authors: Lafage Renaud , Smith Justin S , Soroceanu Alexandra , Ames Christopher , Passias Peter , Shaffrey Christopher , Mundis Gregory , Alshabab Basel Sheikh , Protopsaltis Themistocles , Klineberg Eric , Elysee Jonathan , Kim Han Jo , Bess Shay , Schwab Frank , Lafage Virginie ,   On behalf of the International Spine Study Group (ISSG)
Published: March 2022

Study Design Retrospective cohort study. Objectives Investigate a composite score to evaluate the relationship between alignment proportionality and risk of distal junctional kyphosis (DJK). Methods 84 patients with minimum 1 year follow-up were included (age = 61.1 ± 10.3 years, 64.3% women). The Cervical Score was constructed using offsets from age-adjusted normative values for sagittal vertical axis (SVA), T1 Slope (TS), and TS minus cervical lordosis (CL). Individual points were assigned based on offset with age-adjusted alignment targets and summed to generate the Cervical Score. Rates of mechanical failure (DJK revision or severe DJK [DJK> 20° and ΔDJK> 10°]) were assessed overall and based on Cervical Score. Logistical regressions assessed associations between early radiographic alignment and 1-year failure rate. Results Mechanical failure rate was 21.4% (N = 18), 10.7% requiring revision. By multivariate logistical regression: 3-month T1S (OR: .935), TS-CL (OR:0.882), and SVA (OR:1.015) were independent predictors of 1-year failure (all P < .05). Cervical Score ranged (−6 to 6), 37.8% of patients between −1 and 1, and 50.0% with 2 or higher. DJK patients had significantly higher Cervical Score (4.1 ± 1.3 vs .6 ± 2.2, P < .001). Patients with a score ≥3 were significantly more likely to develop a failure (71.4%) with OR of 38.55 (95%CI [7.73; 192.26]) and Nagelkerke r2 .524 (P < .001) Conclusion This study developed a composite alignment score predictive of mechanical failures in CD surgery. A score ≥3 at 3 months following surgery was associated with a marked increase in failure rate. The Cervical Score can be used to analyze sagittal alignment and help define realignment objectives to reduce mechanical failure.
A Survey of Treatment Trends for Acute Quadriceps Tendon Ruptures Among North American Surgeons
Authors: Matthies Norah-Faye , Paul Ryan A. , Dwyer Tim , Chahal Jaskarndip , Whelan Daniel 
Published: March 2022

Background: To date, little clinical evidence exists to support a specific surgical technique or postoperative rehabilitation protocol for quadriceps tendon ruptures. With a lack of evidence-based superiority, assessment of clinical practices and surgeon preferences is pertinent. Purpose: To describe the current surgical technique and rehabilitation preferences among members of the Canadian Orthopaedic Association and American Orthopaedic Society for Sports Medicine pertaining to acute quadriceps tendon rupture. Study Design: Cross-sectional study. Methods: Orthopaedic staff members of the Canadian Orthopaedic Association and American Orthopaedic Society for Sports Medicine were invited to complete an internet-based survey composed of 26 questions assessing current trends in the management and rehabilitation of acute quadriceps tendon rupture. Survey questions were developed after a thorough review of current literature. Survey responses were analyzed and reported using descriptive statistics (absolute values, frequencies, and percentages) where appropriate. Statistical comparisons and contrasts between Canadian and American surgeons were made using chi-square analyses and Student t tests. Results: A total of 264 surgeons participated in the survey (136 Canadians; 128 Americans). Canadian surgeons were more likely to obtain a preoperative ultrasound as compared with Americans (43.0% vs 6.7%; P < .00001), while American respondents were more likely to obtain magnetic resonance imaging scans (65.8% vs 10.2%; P < .00001). The transosseous drill hole technique was the most commonly utilized (70.2%); the suture anchor technique was used 20.6% of the time. Canadian respondents trended toward a higher use of transosseous tunnels; however, this was not statistically significant (75.8% vs 64.2%; P = .068). American respondents were more likely to utilize suture anchors (27.5% vs 14.1%; P = .0096). Most respondents advanced range of motion goals stepwise in 2-week intervals of 30° (Canadians, 54.0% vs Americans, 58.5%; P = .3091); timing of range of motion initiation varied. Conclusion: Among North American surgeons who responded to this study, the transosseous technique was the most commonly used, and range of motion was generally advanced in a 2-week stepwise fashion. We found several differences in practice between Canadian and American respondents, including the type of preoperative imaging and the frequency of using the suture anchor technique.
Training Internal Medicine Residents in Difficult Diagnosis: A Novel Diagnostic Second Opinion Clinic Experience
Authors: Testa Stefano , Joshi Mugdha , Lotfi Justin , Lin Bryant , Artandi Maja , Chiang Kim F. , Chang Kevin , Singh Baldeep , Geng Linda N. 
Published: March 2022

Background In primary care clinics, time constraints and lack of exposure to highly complex cases may limit the breadth and depth of learning for internal medicine residents. To address these issues, we piloted a novel experience for residents to evaluate patients with puzzling symptoms referred by another clinician. Objective To increase internal medicine residents’ exposure to patients with perplexing presentations and foster a team-based approach to solving diagnostically challenging cases. Methods During the academic year 2020–2021, residents participating in their 2-week primary care “block” rotation were given protected time to evaluate 1–2 patients from the Stanford Consultative Medicine clinic, an internist-led diagnostic second opinion service, and present their patients at the case conference. We assessed the educational value of the program with resident surveys including 5-point Lickert scale and open-ended questions. Results 21 residents participated in the pilot with a survey response rate of 66.6% (14/21). Both the educational value and overall quality of the experience were rated as 4.8 out of 5 (SD 0.4, range 4-5; 1:”very poor”; 5:”excellent”). Residents learned about new diagnostic tools as well as how to approach complex presentations and diagnostic dilemmas. Residents valued the increased time devoted to patient care, the team-based approach to tackling difficult cases, and the intellectual challenge of these cases. Barriers to implementation include patient case volume, time, and faculty engagement. Conclusions Evaluation of diagnostically challenging cases in a structured format is a highly valuable experience that offers a framework to enhance outpatient training in internal medicine.