bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Impact of Hypoattenuating Leaflet Thickening After Transcatheter Aortic Valve Replacement
Authors: Garcia Santiago , Fukui Miho , Dworak Marshall W. , Okeson Brynn K. , Garberich Ross , Hashimoto Go , Sato Hirotomo , Cavalcante João L. , Bapat Vinayak N. , Lesser John , Cheng Victor , Newell Marc C. , Goessl Mario , Elmariah Sammy , Bradley Steven M. , Sorajja Paul 
Published: March 2022

Background:
Hypoattenuated leaflet thickening (HALT), identified on functional cardiac computed tomography (CTA), can affect valve function and clinical outcomes. The objective of this study was to assess the impact of HALT on clinical outcomes in patients treated with transcatheter aortic valve replacement (TAVR).

Methods:
In July 2015, Minneapolis Heart Institute implemented prospective screening of HALT at 30-day post-TAVR with CTA. Patients with evidence of HALT were recommended to initiate anticoagulation for 3 to 6 months with warfarin. Echocardiographic, ischemic, and bleeding outcomes were compared between HALT+ and HALT− patients. Survival rates were compared between HALT+ and HALT− patients using log-rank test, with Cox regression analysis used to identify variables independently associated with long-term death landmarked at time of CTA. This analysis included patients treated from July 1, 2015 to October 31, 2019.

Results:

Of 856 patients undergoing TAVR during the study period, 638 (75%) underwent CTA post-TAVR (median time 31 [30–37] days). HALT+ was evident in 79 (12.3%). HALT+ patients were more likely prescribed warfarin at 1, 3, and 12 months (all
P
<0.001) and had similar gradients compared with HALT− patients. After a median follow-up of 2.2 years (1.5-3.2), HALT+ patients had increased mortality (30% versus 20%;
P
=0.001). In Cox regression analysis, presence of HALT (hazard ratio, 1.83 [95% CI, 1.13–2.97];
P
=0.014) remained independently associated with long-term mortality.

Conclusions:
In a large, real-world cohort of patients receiving TAVR followed by systematic screening with CTA 30-days post-procedure, HALT was found in 12% of patients and independently associated with long-term mortality. Findings of this nonrandomized, observational cohort study require independent validation.
Spirit-led Missions
Authors: Sande Nomatter , Nyadzo Silas 
Published: March 2022

Abstract
A rigorous approach to missions is a significant trait of classical Pentecostalism. However, the multi-cultural context of the United Kingdom shows that most African Pentecostal churches are struggling to attract much indigenous populace as compared to mega-churches in Africa. Using the case study of Apostolic Faith Mission International Ministries UK, this study explores the church’s strategies to missions and its impact on church growth in the United Kingdom. The study used Spirit-infusion as a theological framework for discussing Spirit-led missions. The study is phenomenological observation qualitative research, data was gathered through in-depth interviews, questionnaires, and participant observations. A key finding was that the church’s missions strategy is spontaneous, all-believers, auxiliary and structured; but they are failing to translate into church growth. The study concludes that the church should revisit the issue of ‘experience’ coupled with negotiating to move beyond the cultural, ethnic, and colonial boundaries. The study recommends that the African Pentecostal theology of missions in diasporic contexts must consider: the Spirit experience; lives concentrated to the Spirit; Spirit of miracles; and Spirit of excellence.
Verbascum birjandense and V. urumiense (Scrophulariaceae), two new endemic species for Flora of Iran
Authors: SOTOODEH ARASH , ATTAR FARIDEH , LAITUNG BERYL , CIVEYREL LAURE 
Published: March 2022

Verbascum birjandense and V. urumiense are described as new endemic species of Verbascum from eastern and northwestern Iran. It was not possible to assign the samples of these two taxa to any of the known Verbascum species in Iran and adjacent regions. Collating the morphological characters of the samples against the specialized and pertinent literature of the genus led us to propose them as new species. Both belong to section Bothrosperma, subsection Fasciculata.
These new species are morphologically close to V. erianthum and V. songaricum based on some key characteristics, but show some differences in basal leaves shape, pedicel size, the ratio of pedicel to calyx, presence of hairs inside the corolla, and the hair color of the stamen’s filaments. Distribution map and details of important characters are also presented.
Intercomparison of Dynamically and Statistically Downscaled Climate Change Projections over the Midwest and Great Lakes Region
Authors: Byun Kyuhyun , Sharma Ashish , Wang Jiali , Tank Jennifer L. , Hamlet Alan F. 
Published: March 2022

AbstractDownscaling of global climate model (GCMs) simulations is a key element of regional-to-local-scale climate change projections that can inform impact assessments, long-term planning, and resource management in different sectors. We conduct an intercomparison between statistically and dynamically downscaled GCMs simulations using the hybrid delta (HD) and the Weather Research and Forecast (WRF) Model, respectively, over the Midwest and Great Lakes region to 1) validate their performance in reproducing extreme daily precipitation (P) and daily maximum temperature (Tmax) for summer and winter and 2) evaluate projections of extremes in the future. Our results show the HD statistical downscaling approach, which includes large-scale bias correction of GCM inputs, can reproduce observed extremePandTmaxreasonably well for both summer and winter. However, raw historical WRF simulations show significant bias in both extremePandTmaxfor both seasons. Interestingly, the convection-permitting WRF simulation at 4-km grid spacing does not produce better results for seasonal extremes than the WRF simulation at 12 km using a parameterized convection scheme. Despite a broad similarity for winter extremePprojections, the projected changes in the future summer storms are quite different between downscaling methods; WRF simulations show substantial increases in summer extreme precipitation, while the changes projected by the HD approach exhibit moderate decreases overall. The WRF simulations at 4 km also show a pronounced decoupling effect between seasonal totals and extreme dailyPfor summer, which suggests that there could be more intense summer extremes at two different time scales, with more severe individual convective storms combined with longer summer droughts at the end of the twenty-first century.
The Statistical Relationship of Lightning Activity and Short-Duration Rainfall Events over Guangzhou, China, in 2017
Authors: Zou Qiangli , Cui Xiaopeng , Hao Shifeng 
Published: March 2022

Abstract
The Earth Networks Total Lightning Network (ENTLN) lightning observation and rainfall data from 270 automatic weather stations (AWS) over Guangzhou in 2017 are examined. The high spatiotemporal resolution data are used to analyze the relationship between lightning activity and precipitation in 14 758 short-duration rainfall (SDR) events. About 43% of the SDR events are reported to be accompanied by lightning activity (SDRWL). The rainfall intensity of SDRWL is significantly higher than that of SDR events with no lightning (SDRNL). Lightning activity is more likely to occur in SDR events with higher rainfall rates. A power-law relationship is found between lightning flash rate and rainfall rate, with a max correlation coefficient of 0.44. In about 55% of SDRWL, lightning flashes occur later than precipitation, and the opposite is found in about 35% of SDRWL. When lightning is delayed for 5–10 min, the lagged correlation coefficient between lightning and precipitation is the largest. The results also show that the lightning flash rate peak mostly occurs from −10 to 20 min after the rainfall rate peak, and this time lag is common in SDRWL with all intensities. The starting time of lightning is related to the rainfall intensity. In heavy SDRWL, lightning activity usually occurs from −10 to 20 min after the beginning of precipitation, while in weak SDRWL, the above time window expands to ±1 h. These results indicate that the quantity and time relationship between lightning and precipitation are more solid in heavy SDR events.
Telemedicine in Otolaryngology During COVID-19: An Exploratory Assessment of Provider and Patient Attitudes
Authors: Alwani Mohamedkazim , Campiti Vincent , Nesemeier Ryan , Vernon Dominic , Shipchandler Taha , Ting Jonathan , Parker Noah 
Published: March 2022

Objective: To determine provider and patient attitudes toward telemedicine in Otolaryngology—Head and Neck Surgery (OHNS). Methods: Otolaryngology practitioners conducting outpatient clinics at an academic tertiary referral center were provided with a pre-Study Provider Perception Questionnaire (pre-PPQ) designed to evaluate pre-study perception of telemedicine in otolaryngology. A post-study Provider Perception Questionnaire (post-PPQ) designed to evaluate elements similar to those constituting the PrePPQ was completed at 6 weeks. Additionally, following each visit, providers and patients completed Individual Encounter Survey Questionnaires (IESQ) to evaluate the virtual clinical encounter experience. Results: The pre-PPQ was completed by 29 providers, while the post-PPQ was completed by 12 providers. A total of 236 post-visit provider IESQs were completed, of which 208 were deemed successful. Audio/visual (AV) difficulties and limited server connectivity for the patient were most common causes for unsuccessful encounters. Providers reported that the most appropriate use of telemedicine, on both pre-PPQ and post-PPQ, was triaging patients to determine the need for in-person visits. The inability to perform a physical exam was rated as the primary barrier to telemedicine in OHNS on both pre-PPQ and post-PPQ. Patients strongly agreed with the statements, “My healthcare provider was able to understand my healthcare condition” and, “I felt comfortable communicating with my healthcare provider” 92.0% and 95.4% of the time, respectively. Conclusion: Both providers and patients demonstrated an overall positive attitude toward the use of telemedicine in the provision of otolaryngologic care.
When Is Less More? Boundary Conditions of Effective Entrepreneurial Bricolage
Authors: Steffens Paul Richard , Baker Ted , Davidsson Per , Senyard Julienne Marie 
Published: March 2022

Abstract While prior research suggests that entrepreneurial bricolage is often useful as a coping mechanism for resource-constrained new ventures, other accounts document detrimental effects of bricolage. As the conditions for effective bricolage have not been systematically examined in prior research, we develop and test theoretical explanations for some important boundary conditions. We propose that while bricolage has a positive influence through a resource replacement mechanism, it may be detrimental through the intertwined “second-best solutions” and “tinkering trap,” which together lead to an accumulation of compromises that may result in a detrimental path dependence. We hypothesize that the intensity of these counteracting mechanisms differs depending on the venture's stage of development (nascent vs. operational) and its level of growth expectations. In essence, we argue that ventures expecting to achieve more derive greater benefit from resource replacement. In addition, they are more likely to resist an accumulation of compromises. We test our hypotheses using a longitudinal study of early-stage ventures. Although the results mostly support our theory, they also point to one interesting surprise for which we extend our theorizing to propose an explanation. Counter to the prevailing view in the literature, we find that bricolage is particularly effective for developing competitiveness for early-stage ventures striving to develop and grow. Complementing this, our results suggest the net effects of bricolage may actually be detrimental to the competitiveness of operational ventures that are not actively trying to grow.
Venovenous extracorporeal membrane oxygenation experience in a community level I trauma center
Authors: Neubauer Steven , DelloStritto Daniel J , Capal Nicholas , Hotrum Andrew , Henn Lucas , Marchand Tiffany 
Published: March 2022

Background There is limited literature of venovenous extracorporeal membrane oxygenation use in a community, non-university, setting in the trauma population. Methods We reviewed our cases over 2 years from March 2018 to March 2020. This study was conducted in a community hospital with a General Surgery residency with no direct affiliation to a medical school. Primary outcome reviewed was survival to discharge. Secondary outcomes included duration of extracorporeal membranous oxygenation (ECMO) support, blood transfusion requirement, complications, and disposition. Results Five patients were cannulated during this time period. All patients survived to discharge. Mean time on ECMO was 153.4 h or 6.4 days (range 60–216 h). All patients required a transfusion while cannulated, with a mean of 10 units PRBC transfused (range 3–24). One patient required CPR, one required cessation of heparin drip for bleeding, and one had clinical signs of a stroke. Three patients were discharged to long-term acute care facilities and the other two to acute rehab. Conclusions Community level I trauma centers are capable of handling trauma patients requiring ECMO. It does require a multi-disciplinary team of surgical intensivists and cardiothoracic surgeons along with the support of nursing, respiratory therapists, and perfusionists. The outcomes in this limited series show that ECMO can be a tool utilized in the community setting.
A six-year study of complications related to peripherally inserted central catheters: A multi-center retrospective cohort study in China
Authors: Wan Rong , Gu Lilei , Yin Bi , Cai Shengwei , Zhou Rengui , Yang Weilin 
Published: March 2022

Objective Peripherally inserted central catheters (PICCs), the most frequent central venous catheter, are used to provide medical treatments, although long-term PICC-related adverse outcomes are unknown in China. This study systematically investigated PICC-related complications in four Chinese hospitals. Methods Between January 2014 and January 2020, we analyzed the results of 3550 patients with PICC who were referred to four Chinese hospitals. All patients underwent PICC treatment in four Chinese hospitals. Patient-reported signs and symptoms of a putative PICC-related complication or functional were studied. Long-term outcomes and hospitalization costs were also evaluated. Results An aggregate of 3285 patients were enrolled in the analytic cohort. 58.6% were females and 41.4% were males. The most common reasons for PICC placement included oncologic malignancy and critically ill patients. The majority of PICCs had valved systems (90.7%) and were implanted in the right side (85.5%) and into the basilic vein (87.7%). At least one potential PICC-related problem or adverse effects (AEs) was reported by 67.3% of patients. Central line-associated bloodstream infection (28.1%) and symptomatic deep vein thrombosis (20.7%) were the most common complications. The majority of PICCs were removed for causes other than AEs, with just 723 reported AEs accounting for 22.0% of all PICC removals. The most reasons for PICCs removal were occlusion (425, 12.9%) and exit‐site infections (189, 5.8%). Conclusions This study is the first retrospective study in our country to explore PICC-related complications. While living with a PICC, more than 67.3% of patients report signs and symptoms of at least one PICC-related problem or adverse impacts, such as difficulties with PICC use and poor effects on physical and social function. In this group, PICCs are safe and effective, although the danger of PICC-related problems should not be disregarded.
Headache characteristics and postoperative course in Chiari I malformation
Authors: Thunstedt Dennis C , Schmutzer Michael , Fabritius Matthias P , Thorsteinsdottir Jun , Kunz Mathias , Ruscheweyh Ruth , Straube Andreas 
Published: March 2022

Background Chiari I malformation typically presents with cough headache. However, migraine-like or tension-type-like headaches may also occur. There are limited publications on Chiari I malformation-associated headache semiologies and the effect of foramen magnum decompression on different headache types. Methods A retrospective analysis complemented by structured phone interviews was performed on 65 patients with Chiari I malformation, treated at our hospital between 2010 and 2021. Headache semiology (according to ICHD-3), frequency, intensity, and radiological characteristics were evaluated pre- and postoperatively. Results We included 65 patients. 38 patients were female and 27 male. Mean age was 43.9 ± 15.7 years. Headache was predominant in 41 patients (63.0%). Twenty-one patients had cough headache and 20 had atypical headache (12 migrainous, eight tension-type headache-like). Thirty-five patients with headache underwent surgery. Frequency, intensity, and analgesic use was significantly reduced in cough headache ( p < 0.001). Atypical headaches improved less ( p = 0.004 to 0.176). Exploratory analysis suggested that larger preoperative tonsillar descent correlated with larger postoperative headache intensity relief ( p = 0.025). Conclusion Decompression was effective in Chiari I malformation-related cough headache. Atypical headache responded less well, and the causal relation with Chiari I malformation remains uncertain. For atypical headache, decompression should only be considered after failed appropriate preventive therapy and within an interdisciplinary approach involving a neurologist.
Accuracy of Computer Navigation–Assisted Arthroscopic Osteochondroplasty for Cam-Type Femoroacetabular Impingement Using the Model-to-Image Registration Method
Authors: Abe Koki , Oba Masatoshi , Kobayashi Naomi , Higashihira Shota , Choe Hyonmin , Tezuka Taro , Ike Hiroyuki , Inaba Yutaka 
Published: March 2022

Background: Precise osteochondroplasty is important in arthroscopic hip surgery for cam-type femoroacetabular impingement (FAI). Although computer-assisted surgery with a navigation system may enhance the accuracy of arthroscopic osteochondroplasty, few clinical studies have assessed its accuracy. Purpose: To evaluate the accuracy of arthroscopic osteochondroplasty by a computed tomography (CT)–based navigation system for cam-type FAI, using 3-dimensional (3D) reconstruction with more detail compared with previous methods. Study design: Case series; Level of evidence, 4. Methods: Twenty patients (14 men and 6 women) who underwent navigation-assisted arthroscopic surgery for cam-type FAI were included. The preoperative 3D model of the femur was constructed from each patient’s CT data, and a planned model with virtual cam resection was generated. A femoral model was reconstructed from CT data postoperatively. The 3 models for each patient were overlaid using a 3D model registration method. Then, the contours of the bone resection area of each model were compared by measuring them. To measure the deviation between planned and actual bone resections, 4 cross-sectional images of the 3 femoral models were set at one-quarter intervals from the femoral head radius. All measurements were based on clockface lines set around the femoral neck axis at 30-minute intervals. Differences between the planned and postoperative contour lines were deemed resection deviations. Results: All cam resections were performed in the anterior half of the region of interest. Therefore, only the anterior half (48 points) of the 96 points per case were analyzed. In 876 (91.3%) points of the total measurement points (960 points/20 cases), the error in resection depth was within 3 mm. Overresection was observed at 35 (3.6%) points and underresection at 49 (5.1%) points. The observed maximum deviations from the planned models were 6.3 mm overresection and –7.1 mm underresection. The alpha angles of the postoperative model at the posterior 9- to 3-o’clock position were <55° in all patients. Conclusion: Navigation-assisted arthroscopic osteochondroplasty showed favorable accuracy. Underresection was more frequent than overresection on the anterosuperior side of the femur, despite assistance of the navigation system.
The cooperative effect of short-cut carbon fiber and carbon black on the performance of electric-driven morphing skins
Authors: Ren Xiaoming , Zhu Guangming 
Published: March 2022

Shape memory polymers (SMPs) with variable stiffness properties become the most promising candidate materials for morphing skins. Due to the influence of external environment, electric-driven composite skin is becoming the trend of development. In this paper, rubber toughed hydro-epoxy morphing skins filled with conductive carbon black (CB) and short-cut carbon fiber (SCF) were prepared. The total mass fraction of CB and SCF was fixed at 2.6 wt %. By adjusting the content ratio of CB and SCF (CB/SCF), the in-plane mechanical property, fracture morphology, thermal-mechanical behavior, electronic resistivity, and out-of-plane shape memory behavior of five types of skin were investigated. These results showed that the addition of CB and SCF had a synergistic effect on skin performance. When CB/SCF was 5:5, the composite skin had the highest tensile strength and the lowest glass transition temperature (Tg). In the thermo-active shape memory test, the composite skin presented good shape fixity rate (Rf) and shape recovery rate (Rr). Due to the bridging effect of SCFs on CB particles, the composite skin with CB/SCF ratio of 5:5 has the minimum resistivity and can return to its initial shape within 29 s at 60 V.
In Pursuit of the Quadruple Aim: A Geriatric Prescribing Context’s Impact on Clinician Workflows and Alert Fatigue
Authors: Drago Kathleen , De Lima Bryanna , Sharpe Jackie , Eckstrom Elizabeth 
Published: March 2022

The impact of a novel Geriatric Prescribing Context (GPC) on hospital clinicians’ prescribing workflows is still unknown. A cross-sectional survey was distributed to 346 inpatient pharmacists, physicians, and advance practice providers employed at three pilot site hospitals affected by the GPC to assess awareness and impact to usual workflow. The GPC, a set of medication default doses and frequencies for patients 75 years and older, was unnoticed by 74% of survey respondents ( n = 119) with pharmacists more likely to be aware of the context than prescribers. The impact of the GPC on clinicians’ workflow differed by setting, with academic respondents reporting no change or decreased time to write or verify orders, and community respondents reporting no change or increased time to write or verify orders. The GPC has smoothly integrated into usual prescribing workflows for both prescribers and pharmacists and both overall reported positive responses to the implementation.