bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of Venoarterial Extracorporeal Membrane Oxygenation Plus Intra‐Aortic Balloon Pumping for Treatment of Acute Myocardial Infarction Complicated by Cardiogenic Shock
Authors: Nishi Takeshi , Ishii Masanobu , Tsujita Kenichi , Okamoto Hiroshi , Koto Satoshi , Nakai Michikazu , Sumita Yoko , Iwanaga Yoshitaka , Matoba Satoaki , Kobayashi Yoshio , Hirata Ken‐Ichi , Hikichi Yutaka , Yokoi Hiroyoshi , Ikari Yuji , Uemura Shiro 
Published: April 2022

BackgroundClinical outcomes of acute myocardial infarction complicated by cardiogenic shock remain poor with high in‐hospital mortality. Veno‐arterial extracorporeal membrane oxygenation (VA‐ECMO) has been widely used for patients with acute myocardial infarction complicated by cardiogenic shock refractory to conservative therapy, which is likely fatal without mechanical circulatory support. However, whether additional intra‐aortic balloon pumping (IABP) use during VA‐ECMO support improves clinical outcomes remains controversial. This study sought to investigate prognostic impact of the combined VA‐ECMO plus IABP treatment compared with VA‐ECMO alone.Methods and ResultsFrom the nationwide Japanese administrative case‐mix Diagnostic Procedure Combination (DPC), the JROAD (Japanese Registry of All Cardiac and Vascular Diseases)–DPC, we identified 3815 patients with acute myocardial infarction complicated by cardiogenic shock who underwent primary percutaneous coronary intervention and managed with VA‐ECMO. Of these, 2964 patients (77.7%) were managed with IABP (VA‐ECMO plus IABP), whereas 851 (22.3%) were managed without IABP (VA‐ECMO alone). We compared in‐hospital, 7‐day, and 30‐day mortality between the VA‐ECMO plus IABP versus the VA‐ECMO alone support. Patients managed with VA‐ECMO plus IABP demonstrated significantly lower in‐hospital, 7‐day, and 30‐day mortality than those managed with VA‐ECMO alone (adjusted odds ratios [95% CI] of 0.47 [95% CI, 0.38–0.59], 0.41 [95% CI, 0.33–0.51], and 0.30 [95% CI, 0.25–0.37], respectively). The findings were consistent in the propensity matching and inverse probability of treatment‐weighting models.ConclusionsThis large‐scale, nationwide study demonstrated that the combination of VA‐ECMO plus IABP support was associated with significantly lower mortality compared with VA‐ECMO support alone in patients presenting with acute myocardial infarction complicated by cardiogenic shock who underwent primary percutaneous coronary intervention.
Measurements from inside a Thunderstorm Driven by Wildfire: The 2019 FIREX-AQ Field Experiment
Authors: Peterson David A. , Thapa Laura H. , Saide Pablo E. , Soja Amber J. , Gargulinski Emily M. , Hyer Edward J. , Weinzierl Bernadett , Dollner Maximilian , Schöberl Manuel , Papin Philippe P. , Kondragunta Shobha , Camacho Christopher P. , Ichoku Charles , Moore Richard H. , Hair Johnathan W. , Crawford James H. , Dennison Philip E. , Kalashnikova Olga V. , Bennese Christel E. , Bui Thaopaul P. , DiGangi Joshua P. , Diskin Glenn S. , Fenn Marta A. , Halliday Hannah S. , Jimenez Jose , Nowak John B. , Robinson Claire , Sanchez Kevin , Shingler Taylor J. , Thornhill Lee , Wiggins Elizabeth B. , Winstead Edward , Xu Chuanyu 
Published: April 2022

Abstract
The 2019 Fire Influence on Regional to Global Environments and Air Quality (FIREX-AQ) field experiment obtained a diverse set of in situ and remotely sensed measurements before and during a pyrocumulonimbus (pyroCb) event over the Williams Flats fire in Washington State. This unique dataset confirms that pyroCb activity is an efficient vertical smoke transport pathway into the upper troposphere and lower stratosphere (UTLS). The magnitude of smoke plumes observed in the UTLS has increased significantly in recent years, following unprecedented wildfire and pyroCb activity observed worldwide. The FIREX-AQ pyroCb dataset is therefore extremely relevant to a broad community, providing the first measurements of fresh smoke exhaust in the upper troposphere, including from within active pyroCb cloud tops. High-resolution remote sensing reveals that three plume cores linked to localized fire fronts, burning primarily in dense forest fuels, contributed to four total pyroCb “pulses.” Rapid changes in fire geometry and spatial extent dramatically influenced the magnitude, behavior, and duration of pyroCb activity. Cloud probe measurements and weather radar identify the presence of large ice particles within the pyroCb and hydrometers below cloud base, indicating precipitation development. The resulting feedbacks suggest that vertical smoke transport efficiency was reduced slightly when compared with intense pyroCb events reaching the lower stratosphere. Physical and optical aerosol property measurements in pyroCb exhaust are compared with previous assumptions. A large suite of aerosol and gas-phase chemistry measurements sets a foundation for future studies aimed at understanding the composition of smoke plumes lifted by pyroconvection into the UTLS and their role in the climate system.
Can Areawide Building Retrofitting Affect the Urban Microclimate? An LES Study for Berlin, Germany
Authors: Maronga Björn , Winkler Matthias , Li Dan 
Published: April 2022

Abstract
In this work, we investigate the effect of areawide building retrofitting on summertime, street-level outdoor temperatures in an urban district in Berlin, Germany. We perform two building-resolving, weeklong large-eddy simulations: one with nonretrofitted buildings and the other with retrofitted buildings in the entire domain to meet today’s energy efficiency standards. The comparison of the two simulations reveals that the mean outdoor temperatures are higher with retrofitted buildings during daytime conditions. This behavior is caused by the much smaller inertia of the outermost roof/wall layer in the retrofitting case, which is thermally decoupled from the inner roof/wall layers by an insulation layer. As a result, the outermost layer heats up more rigorously during the daytime, leading to increased sensible heat fluxes into the atmosphere. During the nighttime, the outermost layer’s temperature drops down faster, resulting in cooling of the atmosphere. However, as the simulation progresses, the cooling effect becomes smaller and the warming effect becomes larger. After 1 week, we find the mean temperatures to be 4 K higher during the daytime while the cooling effects become negligible.

Significance Statement
Building retrofitting is taking place in Europe and other continents as a measure to reduce energy consumption. The change in the building envelope directly influences the urban atmosphere. Our study reveals that areawide retrofitting in a German city district can have negative effects on the outdoor microclimate in summer by causing higher air temperatures.
Dynamical Analysis of Tropopause Folding Events in the Coastal Region of Antarctica
Authors: Kohma Masashi , Mizukoshi Masatoshi , Sato Kaoru 
Published: April 2022

Abstract
Tropopause folding events (TFs) are characterized by the rapid and deep descent of the tropopause and are considered to play a significant role in mass exchange between the stratosphere and troposphere. In the present study, TFs occurring in the Antarctic coastal region were examined using the ERA5 dataset. First, the climatological distribution of TF frequency in the extratropics of the Southern Hemisphere was examined. Similar to results from previous studies, TFs were found to often occur along the coast of Antarctica, which is located more than 1000 km south of the maximum of the eddy kinetic energy of synoptic-scale disturbances. This result suggests that the climatological pattern of frequency of TFs in the southern high latitudes cannot be explained only by the geographical distribution of storm tracks. Next, a composite analysis of TFs at Syowa Station was performed. When the negative anomaly of the tropopause height was greatest, strong Q-vector divergence and downwelling were observed in the vicinity of the TF locations. The distribution of Q vectors is related to a local westerly jet and strengthening of the frontal structure associated with meridionally contracted synoptic-scale disturbances. The roles of the topography of the Antarctic Plateau and the radiative cooling on the surface of the continent during the contraction of the disturbances are also discussed based on ray-tracing theory.
Comparing and Interpreting Differently Designed Random Forests for Next-Day Severe Weather Hazard Prediction
Authors: Loken Eric D. , Clark Adam J. , McGovern Amy 
Published: April 2022

Abstract
Recent research has shown that random forests (RFs) can create skillful probabilistic severe weather hazard forecasts from numerical weather prediction (NWP) ensemble data. However, it remains unclear how RFs use NWP data and how predictors should be generated from NWP ensembles. This paper compares two methods for creating RFs for next-day severe weather prediction using simulated forecast data from the convection-allowing High-Resolution Ensemble Forecast System, version 2.1 (HREFv2.1). The first method uses predictors from individual ensemble members (IM) at the point of prediction, while the second uses ensemble mean (EM) predictors at multiple spatial points. IM and EM RFs are trained with all predictors as well as predictor subsets, and the Python module tree interpreter (TI) is used to assess RF variable importance and the relationships learned by the RFs. Results show that EM RFs have better objective skill compared to similarly configured IM RFs for all hazards, presumably because EM predictors contain less noise. In both IM and EM RFs, storm variables are found to be most important, followed by index and environment variables. Interestingly, RFs created from storm and index variables tend to produce forecasts with greater or equal skill than those from the all-predictor RFs. TI analysis shows that the RFs emphasize different predictors for different hazards in a way that makes physical sense. Further, TI shows that RFs create calibrated hazard probabilities based on complex, multivariate relationships that go well beyond thresholding 2–5-km updraft helicity.
Influence of Hospital Formularies on Outpatient Prescribing Practices: Analysis of the Introduction of a Local Formulary: A Single-Center, 2-Year Follow-Up, Retrospective Cohort Study of a Local Formulary in Japan
Authors: Kanai Norihito , Ando Masazumi , Shimodate Momoko , Miyazaki Yoshiko , Saito Toshio 
Published: April 2022

Purpose The impact of a hospital formulary was evaluated to provide a guide for the establishment of local formularies to optimize patient care and healthcare costs. Methods A formulary was introduced by formulary pharmacists of the Toda Medical Group for suggesting recommended medicines to physicians based on the medication history. Patients who were hospitalized in the rehabilitation ward of the Niiza Hospital and prescribed medicines according to the formulary introduced between April 2017 and March 2018 were included and followed-up for six months. Results Of the 183 patients screened, 154 patients were enrolled as the formulary’s introduction patients (76 males/78 females, median age 78 years); 92% of these patients received formulary-proposed prescriptions at the specified timepoints; and 19 patients re-consulted at the Niiza Hospital after discharge and continued the same formulary medicines. The proposed acceptance rate by physicians was 100%. Most changes suggested introduced generic formulations. The doses were equivalent for all pharmacological classes with the exception of medicines that interfere with the renin–angiotensin system, which fell from 10.7 to 7.2 mg ( P< .0001). Overall daily medication costs fell at discharge compared to admission (38.5 vs. 94.6 yen per patient, respectively, P< .0001). This was valid for all pharmacological classes except for calcium channel blockers. Conclusion Hospital formulary-prescribed medications continued after discharge and promoted significant decreases in costs associated with outpatient prescriptions. Introducing a hospital formulary provides a basis for the introduction of local formularies and contributes to the reduction of local healthcare costs.
Re-visiting micro ESR as a screening tool for neonatal sepsis
Authors: Gupta Kshitij , Bhaskar Vikram , Narayanan Anand , Batra Prerna 
Published: April 2022

Our study evaluated the role of micro-erythrocte sedimentation rate (micro-ESR) in the early detection of neonatal sepsis. Neonates with >34 completed weeks of gestation, appropriate for gestational age, admitted in our Neonatal Intensive Care Unit with clinical suspicion of early onset sepsis were enrolled in the study. A sepsis screen and blood culture was performed on all the babies within 4 h of admission. The sensitivity of micro-ESR for detecting positive blood culture was calculated and the best cut-off was determined using the Area Under Curve.
Too hunky to help: A person-centered approach to masculinity and prosocial behavior beliefs among adolescent boys
Authors: Nielson Matthew G. , Jenkins Diana L. , Fraser Ashley M. 
Published: April 2022

Boys’ beliefs about prosocial behavior toward other boys may be negatively affected by masculine norm adherence, and there is evidence that early adolescence is a time when boys feel heightened levels of pressure from multiple sources (e.g., friends, family, and self) to adhere to masculine norms like emotional restriction (e.g., appearing stoic and uncaring). However, the relation between boys’ masculinity and their prosocial behavior beliefs is likely further affected by boys’ social competency. Generally, boys’ social competency is positively associated with prosocial behavior, but this is not the case for “tough” boys (boys who adhere to many traditionally masculine norms). We expected that analyzing the relation between early adolescent boys’ pressure to adhere to masculine norms and boys’ unique social profiles (created using adherence to masculine norms and aspects of social competency) would further illuminate boys’ patterns of prosocial behavior beliefs toward other boys. A latent profile analysis estimated profiles of masculinity and social competence among 260 early adolescent boys (59% White, M age = 11.45 years old, Range age = 10–12) in the southwestern U.S. Three profiles emerged which we labeled socially precarious (50%), socially self-confident (41%), and socially avoidant (9%). R3Step and BCH procedures indicated that higher levels of felt pressure from all three sources resulted in a significantly higher likelihood of being in the socially precarious profile compared to the socially self-confident profile and that boys in the socially self-confident profile had significantly higher mean levels of prosocial behavior beliefs toward other boys ( M = 3.22) compared to boys in the socially precarious profile ( M = 3.01). Overall, this study encourages the socialization of social competency while simultaneously discouraging the perpetuation of certain masculine norms among adolescent boys.
Mechanical traction from different knee joint angles in patients with knee osteoarthritis: A randomized controlled trial
Authors: Abdel-Aal Nabil Mahmoud , Ibrahim Amal Hussein , Kotb Mohamed Mostafa , Hussein Alaa Abdelraheem , Hussein Hisham Mohamed 
Published: April 2022

Objective To compare the effect of mechanical traction from different knee angles on pain, physical function, and range of motion in patients with knee osteoarthritis. Design A single-blinded, randomized controlled trial. Setting Outpatient public and governmental Hospital clinics. Participants One hundred and twenty patients with knee osteoarthritis were randomly assigned into 4 equal groups with 30 patients in each group. Interventions Group (A) received conventional physiotherapy(CPT) treatment; group (B) received CPT with knee traction from full extension, group (C) received CPT with knee traction from 90° flexion, while group (D) received CPT with knee traction from 20° flexion. Interventions were applied 3 sessions a week for 4 weeks. Outcome measurements Visual analog scale (VAS), knee passive range of motion and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were measured at baseline, immediately after 4 weeks of intervention, and after 4 weeks of no intervention as a follow-up. Results After eight weeks, the mean (SD) for VAS scores were 30.97 ± 8.68, 24.0 ± 8.8, 15.43 ± 6.31, and 16.17 ± 6.11 mm; for total WOMAC scores were 26.77 ± 9.19, 20.3 ± 8.52, 13.27 ± 6.25, and 13.43 ± 7.14 for groups A, B, C and D, respectively. The three traction groups showed statistically significant changes in pain scores, physical function, and total WOMAC, but not for knee passive range of motion, in favor of traction groups C and D than the conventional group ( P < 0.05). Conclusions Traction from 90°and 20° of knee flexion was found superior to full extension knee in improving pain and physical function, but not for knee passive range of motion, in patients with knee osteoarthritis.
Developing Economic Models for Assessing the Cost-Effectiveness of Multiple Diagnostic Tests: Methods and Applications
Authors: Xie Xuanqian , Tiggelaar Sean , Guo Jennifer , Wang Myra , Vandersluis Stacey , Ungar Wendy J. 
Published: April 2022

Background Clinical pathways with multiple diagnostic tests are complex to model, but problematic and simplistic approaches are often used in economic evaluations. Methods We analyzed statistical methods of handling multiple diagnostic tests and provided guidance on applying these methods in economic modeling. We first introduced a statistical model to quantify the correlations between 2 tests and how those correlations can be incorporated within an economic model. We also presented the general form of conditional dependence among multiple tests. We then introduced net reclassification improvement (NRI), a measure that evaluates the added value of a new risk factor (e.g., biomarker) for risk prediction. We further provided 2 examples to illustrate the application of these methods. Results Our first example illustrated how to model an add-on test to an existing test, in the absence of a perfect reference standard. After accounting for the imperfect nature of both tests and the conditional dependence between tests, the potential health benefits from the additional test were reduced. This led to differential cost-effectiveness results when comparing models using the perfect test and conditional independence assumptions. The second example illustrated how to evaluate the added value of a new risk factor using the NRI measure. Using the new risk classification provides greater precision in risk prediction, and in the example, the strategy using the new risk classification with treatment for selected individuals led to more favorable cost-effectiveness results. Conclusions These innovative methods for handling multiple diagnostic tests have improved the methodology within the field and should be adopted to provide more accurate estimates within cost-effectiveness analyses. Highlights Economic evaluations of multiple diagnostic tests often apply problematic simplistic approaches, such as ignoring conditional dependence between 2 tests or assuming a perfect final test in the diagnostic pathway. We provided guidance on how to apply improved methods for economic modeling. We introduced methods to model conditional dependence between 2 imperfect tests. We used an example to illustrate how assumptions about perfect diagnostic test accuracy and conditional independence between tests affect cost-effectiveness. Compared with the results of the area under the receiver-operating-characteristic curve, net reclassification improvement has distinct advantages in measuring the added value of a new risk factor for model-based economic evaluation. Economic evaluations that appropriately account for the complexities of diagnostic test pathways can help decision makers ensure efficient use of resources.
Effect of Previous Knee Surgery on Clinical Outcome After ACI for Knee Cartilage Defects: A Propensity Score–Matched Study Based on the German Cartilage Registry (KnorpelRegister DGOU)
Authors: Seiferth Nick L. , Faber Svea O. , Angele Peter , Kniffler Heino , Loer Ingo , Schauf Gunnar , Spahn Gunter , Zinser Wolfgang , Niemeyer Philipp 
Published: April 2022

Background: Autologous chondrocyte implantation (ACI) is an established procedure for the treatment of cartilage damage in the knee joint. At present, it is still unclear how previous surgery influences outcome after ACI. Purpose: To evaluate the effect of previous knee surgery related or nonrelated to the treated cartilage defect on clinical outcome after ACI for knee cartilage defects. Study Design: Cohort study; Level of evidence, 3. Methods: An overall 730 patients with ACI who underwent previous unspecific knee surgery, whether related to the defect being currently treated or not, were identified from a cohort of 5961 patients registered in the German Cartilage Registry. Propensity score matching was used to match these patients to 690 patients with analogous characteristics but without previous surgery. Subsequently, 317 patients with previously failed cartilage treatment at the defect site were identified and compared with a matched collective of 254 patients without previous cartilage treatment. In a subgroup analysis, the type of previous cartilage surgery was additionally investigated. Outcome was evaluated by Knee injury and Osteoarthritis Outcome Score (KOOS), visual analog scale for pain, rate of reintervention, and patient satisfaction up to 36 months. A chi-square test was used to compare categorial variables and an unpaired t test to compare continuous variables. Results: Patients with previous knee surgery not related to the cartilage defect showed a lower KOOS at 6 months (68.3 vs 70.8; P = .026), while patients with previous cartilage surgery showed significantly lower KOOS values at all follow-up time points when compared with patients without any previous knee or cartilage surgery (all P < .05). A comparison of KOOS values in patients with previous therapy at the cartilage defect with ACI versus bone marrow stimulation did not show any significant differences at any follow-up. Conclusion: Previously failed cartilage treatment at the defect site represents a negative prognostic factor up to 3 years after ACI. However, this influence appears to be independent of the type of previous treatment at the defect site and applies equally to failed bone marrow stimulation as well as previous ACI. In contrast, a negative effect of previous surgery to the knee unrelated to the cartilage defect could not be shown in the 3-year follow-up.
Transitions of care for hospital discharges in a primary care network
Authors: Schaub Jessica , Shpilkerman Yana Ilin , Roland Heather , Keyko Kacey , Parisé Katrina 
Published: April 2022

Transitions to and from primary care are a time of concern, especially for patients with chronic conditions and complex care needs. The Edmonton Southside Primary Care Network (ESPCN) developed a process for nurses to ensure timely post-discharge follow-up calls and physician appointments after hospitalization, assessing readmission risk with LACE and Clinical Frailty scores. Over 84% of eligible high-risk discharges received follow-up within 14 days. Of 7,400 index discharges, 1,464 had an emergency department revisit and 725 patients were readmitted within 30 days. Overall, ESPCN rates of readmission (9.8%) and rates of Family Practice Sensitive Conditions (FPSC) (5.7%) were significantly lower than national and provincial rates. FPSC rates for high-risk patients were significantly lower than low- or medium-risk groups. Consistent processes that support nursing involvement enable primary care teams to focus on those with highest risk for adverse outcomes and support patients to access the most appropriate place for the care they need.