bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assimilation of New York State Mesonet Surface and Profiler Data for the 21 June 2021 Convective Event
Authors: Lin Hsiao-Chun , Sun Juanzhen , Weckwerth Tammy M. , Joseph Everette , Kay Junkyung 
Published: November 2022

Abstract
The New York State Mesonet (NYSM) has provided continuous in situ and remote sensing observations near the surface and within the lower troposphere since 2017. The dense observing network can capture the evolution of mesoscale motions with high temporal and spatial resolution. The objective of this study was to investigate whether the assimilation of NYSM observations into numerical weather prediction models could be beneficial for improving model analysis and short-term weather prediction. The study was conducted using a convective event that occurred in New York on 21 June 2021. A line of severe thunderstorms developed, decayed, and then reintensified as it propagated eastward across the state. Several data assimilation (DA) experiments were conducted to investigate the impact of NYSM data using the operational DA system Gridpoint Statistical Interpolation with rapid update cycles. The assimilated datasets included National Centers for Environmental Prediction Automated Data Processing global upper-air and surface observations, NYSM surface observations, Doppler lidar wind retrievals, and microwave radiometer (MWR) thermodynamic retrievals at NYSM profiler sites. In comparison with the control experiment that assimilated only conventional data, the timing and location of the convection reintensification was significantly improved by assimilating NYSM data, especially the Doppler lidar wind data. Our analysis indicated that the improvement could be attributed to improved simulation of the Mohawk–Hudson Convergence. We also found that the MWR DA resulted in degraded forecasts, likely due to large errors in the MWR temperature retrievals. Overall, this case study suggested the positive impact of assimilating NYSM surface and profiler data on forecasting summertime severe weather.
A Comparative Study of Various Approaches for Producing Probabilistic Forecasts of Upper-Level Aviation Turbulence
Authors: Shin Hyeyum Hailey , Deierling Wiebke , Sharman Robert 
Published: November 2022

Abstract
The skill of operational deterministic turbulence forecasts is impacted by the uncertainties in both weather forecasts from the underlying numerical weather prediction (NWP) models and diagnoses of turbulence from the NWP model output. This study compares various probabilistic turbulence forecasting approaches to quantify these uncertainties and provides recommendations on the most suitable approach for operational implementation. The approaches considered are all based on ensembles of NWP forecasts and/or turbulence diagnostics, and include a multi-diagnostic ensemble (MDE), a time-lagged NWP ensemble (TLE), a forecast-model NWP ensemble (FME), and combined time-lagged MDE (TMDE) and forecast-model MDE (FMDE). Both case studies and statistical analyses are provided. The case studies show that the MDE approach that represents the uncertainty in turbulence diagnostics provides a larger ensemble spread than the TLE and FME approaches that represent the uncertainty in NWP forecasts. The larger spreads of MDE, TMDE, and FMDE allow for higher probabilities of detection for low percentage thresholds at the cost of increased false alarms. The small spreads of TLE and FME result in either hits with higher confidence or missed events, highly dependent on the performance of the underlying NWP model. Statistical evaluations reveal that increasing the number of diagnostics in MDE is a cost-effective and powerful method for describing the uncertainty of turbulence forecasts, considering trade-offs between accuracy and computational cost associated with using NWP ensembles. Combining either time-lagged or forecast-model NWP ensembles with MDE can further improve prediction skill and could be considered if sufficient computational resources are available.
The tourism area life cycle hypothesis: A micro-foundation
Authors: Marsiglio Simone , Tolotti Marco 
Published: November 2022

We provide a simple micro-foundation of the tourism area life cycle hypothesis, based on tourists’ utility maximization. As a result of social interactions among tourists which determine destinations popularity, the market share of visitors which decides to visit a specific destination follows a logistic dynamics, consistent with what predicted by the tourism area life cycle hypothesis. We show that different preference drivers explain the duration of the different tourism area life cycle stages: the net benefit from visiting the destination characterizes the exploration, involvement, and development phases, while social effects associated with destination popularity characterize the phases of consolidation and stagnation Different from previous studies our results hold true independently of whether we focus on the repeating or non-repeating segment of the tourism market. We also provide a calibration of our model to the case of the city of Venice (Italy) showing that it performs well in capturing the evolution of tourism in the historical center of the city over the last 60 years, suggesting that TALC-like dynamics may occur even in the context of cultural and heritage destinations.
Overall cerebral small vessel disease burden is associated with outcome of acute ischemic stroke after mechanical thrombectomy
Authors: Fan Rumeng , Gan Jiehua , Chen Feng , Le Chensheng , Chen Yong 
Published: November 2022

Objectives To investigate the association between the overall cerebral small vessel disease (CSVD) burden and the therapeutic outcome of mechanical thrombectomy (MT) in patients with acute anterior circulation large-vessel occlusion stroke. Materials and Methods Data of patients who achieved successful revascularization after MT for acute anterior circulation large-vessel occlusion stroke in the Ningbo Medical Center Lihuili Hospital between April 2017 and January 2022 were retrospectively analyzed. The overall CSVD burden was evaluated by total CSVD score based on MRI images. According to the 90-day modified Rankin Scale (mRS) score, the participants were divided into the Good outcome group (mRS score 0–2) and Poor outcome group (mRS score 3–6). Multivariate Logistic regression was applied to assess the relationship between the overal CSVD burdern and 90-day outcome. Results In total, 145 eligible patients were included and classified into the Good outcome group (n = 77, 62.3% males, mean age: 64.92 ± 13.67 years) and Poor outcome group (n = 68, 50% males, mean age: 69.76 ± 10.88 years). Symptomatic intracranial hemorrhage (OR = 2.788, 95%CI: 1.143–8.745, P = 0.048), poor preoperative collateral status (OR = 3.619, 95%CI: 1.670–7.844, P = 0.001), and high total CSVD score (score 2: OR = 3.800, 95%CI: 1.173 = 12.311, P = 0.026; score 3: OR = 7.529, 95%CI: 1.555–36.460, P = 0.012) were independently prognostic for poor 90-day outcome in patients receiving MT. Conclusion This study identified that the overall CSVD burden was independently associated with the prognosis of patients receiving MT for acute anterior circulation large-vessel occlusion stroke.
Association between high-mobility group box 2 and subclinical hypertension-mediated organ damage in young adults
Authors: Wan Jindong , Liu Gang , Xia Siwei , Liu Sen , Yang Yi , Wang Dan , Hou Jixin , Dai Xiaozhen , Zhou Peng , Wang Peijian 
Published: November 2022

Background: Hypertension-mediated organ damage (HMOD) is an emerging problem among young adults. The potential role of chronic immune-mediated inflammation in the pathogenesis of HMOD is increasingly being recognized. High-mobility group box 2 (HMGB2) is known for its role in the modulation of innate immunity and exerts signaling functions that affect various inflammatory diseases. However, the association between HMGB2 and HMOD in young adults remains unclear. Objectives: The aim of this study was to explore the association between HMGB2 and subclinical HMOD in young adults. Design: This is a cross-sectional study. Methods: Body composition, carotid ultrasound, carotid-femoral PWV (cf-PWV) measures, echocardiography, serum HMGB2 levels, and serum classic cardiometabolic risk factors were measured in 988 untreated young adults. We estimated the risk related to serum HMGB2 using multivariable-adjusted linear and logistic regression models. Then, we conducted a pathway overrepresentation analysis to examine which key biological pathways may be linked to serum HMGB2 in young adults with HMOD. Results: Among the 988 untreated young adults, we identified four distinct hypertension phenotypes: normotension (40.0%), white-coat hypertension (16.0%), masked hypertension (20.9%), and sustained hypertension (23.1%). High levels of serum HMGB2 were related to increased carotid intima-media thickness (cIMT) and left ventricular mass index (LVMI), higher cf-PWV and blood pressure, and a lower estimated glomerular filtration rate (eGFR). Linear regression analysis showed that serum HMGB2 was positively associated with cf-PWV and negatively associated with eGFR in all patients. Multivariate analysis showed that high levels of serum HMGB2 were associated with high odds of subclinical HMOD (damage in at least one organ). Biological pathway analysis indicated that patients with high serum HMGB2 levels had increased activity of pathways, related to endothelial dysfunction, inflammatory processes, and atherosclerosis. Conclusion: High serum concentrations of HMGB2 are associated with an increased risk of subclinical HMOD in untreated young adults.
Hypertrophic Ligamentum Flavum in Lumbar Spine Stenosis Is Associated With the Increased Expression of Secreted Protein Acidic and Rich in Cysteine
Authors: Lee Ching-Yu , Wu Meng-Huang , Huang Tsung-Jen , Wang Po-Yao , Wu Alexander T. H 
Published: November 2022

Study Design Basic research Objectives Secreted protein acidic and rich in cysteine (SPARC) is a critical pro-fibrotic mediator. This study aims to characterize the role of SPARC in hypertrophic ligamentum flavum (LF) and fibrosis. Methods Hypertrophic LF samples were obtained from 8 patients with L4/5 lumbar spinal stenosis (LSS) during the decompressive laminectomy. Non-hypertrophic LF from age- and sex-matched 8 patients with L4/5 lumbar disc herniation was selected as control. An in vitro model of fibrosis in human LF cells was established by interleukin 6 (IL-6) to assess SPARC expression. Results Hypertrophic LF samples had higher fibrosis scores than control samples by Masson's trichrome staining (3.6 vs. 1.3, P < .001). Hypertrophic LF samples had significantly more positive staining for collagen and SPARC. Collagen III (Col3), α smooth muscle actin (α-SMA), and SPARC mRNA expression levels were significantly higher in hypertrophic LF samples than in control samples by qPCR. SPARC expression and fibrotic and inflammatory makers (collagen I, Col3, IL-6, interleukin 1β) were significantly upregulated in IL-6 stimulation of normal LF in vitro. Conclusion SPARC was detected in human LF and significantly upregulated in the clinical samples of hypertrophic LF compared to their normal counterparts. We also demonstrated an increased level of SPARC in an in vitro fibrosis model of LF. Thus, SPARC could be a crucial biomarker for the pathogenesis of hypertrophic LF and a therapeutic target for LSS.
Platelet-Rich Plasma in Acute Achilles Tendon Ruptures: A Systematic Review and Meta-Analysis
Authors: Abdolrazaghi Sina , Akram Nimra , Boksh Khalis , Elbashir Mohamed , Thomas Owain , Divall Pip , Mangwani Jitendra 
Published: November 2022

Category: Trauma; Sports Introduction/Purpose: Platelet Rich Plasma (PRP) is known to exert multi-directional biological effects favouring tendon healing. However, conclusions drawn by numerous studies on its clinical efficacy for acute Achilles tendon rupture are limited. We performed a systematic review and meta-analysis to investigate this and to compare to those without PRP treatment. Methods: The Cochrane Controlled Register of Trials, Pubmed, Medline and Embase were used and assessed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria with the following search terms: ('plasma' OR 'platelet-rich' OR 'platelet-rich plasma' or 'PRP') AND ('Achilles tendon rupture/tear' OR' calcaneal tendon rupture/tear' OR 'tendo calcaneus rupture/tear'). Data pertaining to biomechanical outcomes (heel endurance test, isokinetic strength, calf- circumference and range of motion), patient-reported outcome measures (PROMs) and incidence of re-ruptures were extracted. Meta-analysis was performed for same outcomes measured in at least three studies. Pooled outcome data were analysed by random and fixed-effects models. Results: After abstract and full-text screening, 6 studies were included. In total there were 510 patients of which 256 had local PRP injection and 254 without. The average age was41.6 years, mean time from injury to treatment 5.9 days and mean follow-up at 61 weeks. Biomechanically, there was similar heel endurance, isokinetic strength, calf circumference and range of motion between both groups. In general, there were no differences in patient reported outcomes from all scoring systems used in the studies. Both groups returned to their pre-injured level at a similar time and there were no differences on the incidence of re- rupture (OR 1.13, 95% CI, 0.46 to 2.80, p = 0.79). Conclusion: PRP injections for acute Achilles tendon ruptures do not improve medium to long-term biomechanical and clinical outcomes. However, future studies incorporating the ideal application and biological composition of PRP are required to investigate its true clinical efficacy.
Anterior and Posterior Ankle Arthroscopy in Prone Position: Description of Technique
Authors: Ambrosio Gustavo Henrique Carillo Ambro G. , Mansur Nacime SB , Nery Caio A. , Raduan Fernando C. 
Published: November 2022

Category: Arthroscopy; Ankle Introduction/Purpose: The ankle arthroscopy has many advantages compared to open surgery and it is possible to access the ankle anteriorly and posteriorly. The pathologies localized in the anterior and posterior aspects of the ankle may coexist and demand the combination of these approaches. The objective is to describe the anterior and posterior ankle arthroscopic access, keeping the patient in prone position, reducing the risks of contamination, surgical time and favoring the operative strategy. Methods: Patients diagnosed with chronic ankle instability and posterior ankle impingement, who failed conservative treatment for 3 months were selected. These patients were positioned in ventral decubitus and performed arthroscopic resection of posterior impingement followed by a Brostrom-Gould procedure, without decubitus change. Results: Patients were positioned in prone position, with spinal block performed and application of pneumatic tourniquet on the thigh. The posterior arthroscopic approach was first stablished through the posterolateral and posteromedial portals. The Os Trigonum could be identified and then removed. Maintaining the decubitus, the anterior approach was performed through 90° knee flexion, enabling the creation of the anteromedial and anterolateral portals. At this time, the lateral ankle instability could be treated by a Broström-Gould procedure in a upside down manner. Conclusion: The anterior and posterior approach by arthroscopy may provide a faster rehabilitation associated with lesser soft tissue trauma and lesser post-operative comorbities compared to open techniques. Also the combination of these approaches without decubitus change may reduce the surgery time and contamination risks. Disadvantages should also be considered and these includes the risk of compartimental syndrome and its severe complications. In addition, the arthroscopic images can be difficult to understand at first and the Broström-Gould procedure performed in a upside down manner will require a experienced staff in the surgery.
Clinical Outcomes of Anatomical Reconstruction of the Lateral Ankle Ligament Complex: A Systematic Review
Authors: Azam Mohammad T. , Mulvin Conor , Mercer Nathaniel P. , Toale James P. , Hurley Eoghan T. , Weiss Matthew B. , Ubillus Hugo A. , Kennedy John G. 
Published: November 2022

Category: Ankle; Hindfoot; Sports; Trauma Introduction/Purpose: While surgery is often indicated in the treatment of chronic ankle instability (CAI), there lacks consensus on which procedure is preferable in light of the multiple different procedures available. In this systematic review, we evaluate the recent literature on the anatomical reconstruction of the lateral ligaments in the treatment of CAI in an effort to identify differences in clinical and radiological outcomes between allograft and autograft reconstruction techniques. Methods: A systematic search of PubMed, EMBASE, and Cochrane Library databases was performed in October 2019 resulting in 13 studies ranging from the years 1991 to 2017. The studies included were carefully evaluated with regards to the level of evidence (LOE) and quality of evidence (QOE), clinical and radiological outcomes, complications, revision rates and return to sport. Results: Thirteen studies including a total of 296 ankles were included; Within the autograft group, the weighted mean AOFAS improved from 66.9 to 95.9 at a weighted mean follow-up of 29.6 months, KPSSAF scores improved from 48 to 92.2 at a weighted mean follow-up of 37 months, VAS scores improved from 6.8 to 0.2 at a weighted mean follow up of 33.5 months, and the complication rate was 7.7% at a follow up of 31.2 months. Within the allograft group the AOFAS improved from 53.7 to 89.3 at a follow-up of 35.5 months, KPSSAF scores improved from 42.8 to 90.4 at a follow up of 34 months, VAS scores improved from 7.3 to 1.9 at a follow up of 38 months, and the complication rate was 7% at a follow up of 34.9 months. Conclusion: The current systematic review demonstrated that anatomical reconstruction of CAI resulted in favorable clinical and radiological outcomes, low complication and revision rates and excellent return to sport rates in the short-term follow-up. Comparison of autograft and allograft reconstruction techniques for chronic lateral ankle instability showed minor differences both clinically and radiologically but none which would suggest superiority of one technique over another.
Incidence of Acute Achilles Repair Surgeries in the Peri-Pandemic COVID Era: And Parallels to the Current 2021-22 NFL Season
Authors: Azam Mohammad T. , Bi Andrew S. , Alaia Michael J. , Jazrawi Laith M. , Gonzalez-Lomas Guillem , Kennedy John G. 
Published: November 2022

Category: Sports; Ankle Introduction/Purpose: The World Health Organization declared the outbreak of COVID-19 a pandemic on March 11, 2020, leading to lockdowns, quarantines, and increased sedentary behaviors. As the general population as well as athletes returned to their normal physical activities or sport in 2021, the risk for musculoskeletal injury increases after inactivity. Thus, the purpose of this study was (1) to investigate the rates of AATR requiring repair in a single academic center in NYC, and (2) see if a corollary exists in the NFL. Our hypothesis is that after a decrease in AATRs in 2020 from decreased physical activity due to a combination of lockdown sanctions and COVID pandemic-induced fears, there is a rebound increase in AATRs in 2021, possibly even to greater than pre-pandemic levels. Methods: All study protocols were approved by the Institutional Review Board at the senior author's institution. A retrospective search was conducted using current procedural terminology to identify the total number of Achilles acute primary repair surgeries performed from years 2017 to 2021 at a sincle academic center. NFL data was obtained from publicly available sites according to previously validated studies. Chi-square analysis was conducted between proportion of Achilles surgeries performed in 2021 and 2017-2020 at a single academic center. Additional Chi-square analysis was performed in a similar manner, however between each year and 2021. Results: A total of 588 patients who sustained AATRs and underwent primary surgical repair were identified, primarily men (75.7%, n = 445), with an average age of 43.22+-14.4 years. The incidence of the total number of AATR repairs per year was: 2017: 21.1% (n = 124), 2018: 18.7% (n = 110), 2019: 22.1% (n = 130), 2020: 14.6% (n = 86), 2021: 23.5% (n = 138), indicating a 7.5% decrease in rate of AATRs from 2019 to 2020, followed by an 8.9% increase in incidence from 2020 to 2021. Within the NFL, the number of AATRs resulting in an IR stint increased every regular season from 2019-2020: 21.2% (n = 11), to 2020-2021: 32.7% (n = 17), to this past 2021-2022 season: 46.2% (n = 24). Conclusion: The main finding of our study is a decrease in the incidence of AATRs during the height of the COVID pandemic quarantine in 2020, with a 8.9% increase in 'post-COVID' 2021 at a single academic institution. There was also a 2.9% higher incidence of AATR in 2021 compared to 'pre-COVID' normal levels when averaged between 2017 to 2019, findings that are mirrored in the NFL. This information provides important information for providers when counseling patients and athletes on return to sport in this current pandemic, especially with possible future lockdowns or quarantines due to new variants such as Omicron.
Increased Complication and Hardware Removal Rates Associated with Headed Screws in Subtalar and Ankle Arthrodeses
Authors: Bailey Evan , Hoch Caroline P. , Goodloe Jonathan B. , Scott Daniel J. , Gross Christopher E. 
Published: November 2022

Category: Ankle; Other Introduction/Purpose: With a reported screw removal rate of 9-47% following subtalar (ST) or ankle arthrodesis, an added economic and surgical burden is imposed on both the patients and the healthcare system. The purpose of this study is to determine if there are any clinical or patient-reported outcome differences between headless, variable-pitched screws and headed screws in ST or ankle arthrodesis. Methods: A retrospective chart review identified 120 patients (128 feet) who underwent ST (n=98) or ankle (n=30) arthrodesis with a single fellowship-trained foot and ankle surgeon at a single academic medical center between December 2015 and December 2020. These patients passed the criteria of excluding those who underwent both arthrodeses simultaneously (i.e., tibiotalocalcaneal arthrodesis) and did not have at least three months of follow-up or postoperative X-rays in their medical record. Overall, 71 procedures used headless screws and 57 used headed screws. Results: There was no difference in any treatment duration or postoperative patient-reported outcome measure between groups. However, there was a significant difference between groups among rates of nonunion (headless=19.7%, headed=35.1%;p=.050), overall complication (headless=33.8%, headed=54.4%; p=.019), reoperation (headless=11.3%, headed=33.3%; p=.002), and hardware removal (headless=4.2%, headed=29.8%; p<.001). There were also significantly more screw issues (i.e., broken, displacement, impingement) with headed screws (headless=0.0%, headed=5.3%; p=.050). Furthermore, of the eight patients who underwent two arthrodeses, headed screws were removed six (37.5%) times, with half attributable to nonunion, whereas headless screws were never removed. Conclusion: The use of headed screws in ST or ankle arthrodesis is associated with significantly higher rates of complication and hardware removal, as compared to headless screws. These results suggest headless, variable-pitched screw fixation for ST and ankle arthrodesis procedures may offer improved outcomes, although further studies should be conducted to confirm this.