bluuebunny/crossref_metadata_2025_split huggingface dataset:
On the Investigation of the Typology of Fog Events in an Arid Environment and the Link with Climate Patterns
Authors: Mohan T. S. , Temimi Marouane , Ajayamohan R. S. , Nelli Narendra Reddy , Fonseca Ricardo , Weston Michael , Valappil Vineeth 
Published: June 2020

AbstractThe central aim of this work is to investigate the characteristics of fog events over the United Arab Emirates (UAE) and identify the underlying physical processes responsible for fog initiation and dissipation. To achieve this, hourly meteorological measurements at eight airport stations, along with ERA5 reanalysis data (1995–2018), are utilized. The analysis indicates the dominance of radiation fog (RAD) as, on average, 70% of the observed events fall under this category. Fog in the UAE typically forms between 2000 and 0200 local time (LT) and dissipates between 0600 and 0900 LT. During a typical dense fog event recorded during 22–23 December 2017, cooling and moistening tendencies of up to 1.2 K h−1 and 0.7 g kg−1 h−1 are observed ~5–6 h before fog onset. In the vertical, a dry and warm layer above 750 hPa gradually descends from above 500 hPa to promote the development of fog. Similar conclusions are reached when analyzing composites of fog events. Further, the variability of fog occurrence associated with El Niño–Southern Oscillation (ENSO) patterns is explored. It is concluded that the El Niño (warm) and La Niña (cold) phases exhibit very different spatial characteristics with respect to surface meteorological variables. In particular, during El Niño events, the near-surface atmosphere is cooler and moister compared to La Niña events, favoring RAD fog formation over the UAE. Besides, fog events during El Niño years tend to last longer compared to La Niña years due to an earlier onset.
Long-Term Evaluation of Drivers’ Behavioral Adaptation to an Adaptive Collision Avoidance System
Authors: Muslim Husam , Itoh Makoto 
Published: June 2020

Objective Taking human factors approach in which the human is involved as a part of the system design and evaluation process, this paper aims to improve driving performance and safety impact of driver support systems in the long view of human–automation interaction. Background Adaptive automation in which the system implements the level of automation based on the situation, user capacity, and risk has proven effective in dynamic environments with wide variations of human workload over time. However, research has indicated that drivers may not efficiently deal with dynamically changing system configurations. Little effort has been made to support drivers’ understanding of and behavioral adaptation to adaptive automation. Method Using a within-subjects design, 42 participants completed a four-stage driving simulation experiment during which they had to gradually interact with an adaptive collision avoidance system while exposed to hazardous lane-change scenarios over 1 month. Results Compared to unsupported driving (stage i), although collisions have been significantly reduced when first experienced driving with the system (stage ii), improvements in drivers’ trust in and understanding of the system and driving behavior have been achieved with more driver–system interaction and driver training during stages iii and iv. Conclusion While designing systems that take into account human skills and abilities can go some way to improving their effectiveness, this alone is not sufficient. To maximize safety and system usability, it is also essential to ensure appropriate users’ understanding and acceptance of the system. Application These findings have important implications for the development of active safety systems and automated driving.
Consequences of Medical Hierarchy on Medical Students, Residents, and Medical Education in Otolaryngology
Authors: Salehi Parsa P. , Jacobs Daniel , Suhail‐Sindhu Timur , Judson Benjamin L. , Azizzadeh Babak , Lee Yan Ho 
Published: June 2020

ObjectiveTo (1) review concepts of medical hierarchy; (2) examine the role of medical hierarchy in medical education and resident training; (3) discuss potential negative impacts of dysfunctional hierarchy in medical and surgical training programs, focusing on otolaryngology; and (4) investigate solutions to these issues.Data SourcesOvid Medline, Embase, GoogleScholar, JSTOR, Google, and article reference lists.Review MethodsA literature search was performed to identify articles relating to the objectives of the study using the aforementioned data sources, with subsequent exclusion of articles believed to be outside the scope of the current work. The search was limited to the past 5 years.ConclusionsTwo types of hierarchies exist: “functional” and “dysfunctional.” While functional medical hierarchies aim to optimize patient care through clinical instruction, dysfunctional hierarchies have been linked to negative impacts by creating learning environments that discourage the voicing of concerns, legitimize trainee mistreatment, and create moral distress through ethical dilemmas. Such an environment endangers patient safety, undermines physician empathy, hampers learning, lowers training satisfaction, and amplifies stress, fatigue, and burnout. On the other hand, functional hierarchies may improve resident education and well‐being, as well as patient safety.Implications for PracticeOtolaryngology–head and neck surgery programs ought to work toward creating healthy systems of hierarchy that emphasize collaboration and improvement of workplace climate for trainees and faculty. The goal should be to identify aspects of dysfunctional hierarchy in one’s own environment with the ambition of rebuilding a functional hierarchy where learning, personal health, and patient safety are optimized.
Time for a Paradigm Shift in Head and Neck Cancer Management During the COVID‐19 Pandemic
Authors: Han Albert Y. , Miller Jessa E. , Long Jennifer L. , St John Maie A. 
Published: June 2020

ObjectiveThe coronavirus disease 2019 (COVID‐19) pandemic has caused physicians and surgeons to consider restructuring traditional cancer management paradigms. We aim to review the current evidence regarding the diagnosis and management of head and neck cancer, with an emphasis on the role of the multidisciplinary team (MDT) during a pandemic.Data SourcesCOVID‐19 resources from PubMed, Google Scholar, the American Academy of Otolaryngology–Head and Neck Surgery, and the American Head and Neck Society were examined.Review MethodsStudies and guidelines related to the multidisciplinary management of head and neck cancer in the COVID‐19 setting were reviewed. A total of 54 studies were included. Given the continuously evolving body of literature, the sources cited include the latest statements from medical and dental societies.ResultsThe unpredictable fluctuation of hospital resources and the risk of the nosocomial spread of SARS‐CoV‐2 have direct effects on head and neck cancer management. Using an MDT approach to help define “essential surgery” for immediately life‐ or function‐threatening disease processes in the context of available hospital resources will help to maximize outcomes. Early enrollment in an MDT is often critical for considering nonsurgical options to protect patients and health care workers. The role of the MDT continues after cancer treatment, if delivered, and the MDT plays an essential role in surveillance and survivorship programs in these challenging times.ConclusionHead and neck cancer management during the COVID‐19 pandemic poses a unique challenge for all specialists involved. Early MDT involvement is important to maximize patient outcomes and satisfaction in the context of public and community safety.
Netrin-1 reduces lung ischemia-reperfusion injury by increasing the proportion of regulatory T cells
Authors: Chen Zhili , Chen Yuxi , Zhou Jue , Li Yong , Gong Changyao , Wang Xiaobo 
Published: June 2020

Objective Inflammation is the primary mechanism of lung ischemia-reperfusion injury (LIRI) and neurologic factors can regulate inflammatory immune responses. Netrin-1 is an axonal guidance molecule, but whether Netrin-1 plays a role in LIRI remains unclear. Methods A mouse model of LIRI was established. Immunohistochemistry was used to detect expression of Netrin-1 and to enumerate macrophages and T cells in lung tissue. The proportion of regulatory T cells (Tregs) was assessed by flow cytometry. Levels of apoptosis were assessed by terminal deoxynucleotidyl transferase dUTP nick end staining. Results Numbers of macrophages and T cells in the lung tissues of mice with LIRI were elevated, while expression of netrin-1 was significantly decreased. Flow cytometry showed that the proportion of Tregs in mice with LIRI was significantly decreased. The proportion of Tregs among lymphocytes was positively correlated with netrin-1 expression. In vitro experiments showed that netrin-1 promoted an increase in Treg proportion through the A2b receptor. Animal experiments showed that netrin-1 could inhibit apoptosis and reduce T cell and macrophage infiltration by increasing the proportion of Tregs, ultimately reducing LIRI. Treg depletion using an anti-CD25 monoclonal antibody blocked the effects of netrin-1. Conclusion Netrin-1 reduced LIRI by increasing the proportion of Tregs.
Meta-analysis of matrix metalloproteinase (MMP)-9 C1562T polymorphism and susceptibility to ischemic stroke in the Chinese population
Authors: Jiang Yan , Liu HongYu , Wang Yukai , Shi Xinxiu , Shao Yankun , Xu ZhongXin 
Published: June 2020

Objective Many studies have shown that the C1562T polymorphism in the matrix metalloproteinase (MMP)-9 gene promoter is associated with susceptibility to ischemic stroke (IS), but the association between them remains controversial. Our objective was to explore the relationship between MMP9 C1562T polymorphism and susceptibility to IS in the Chinese population. Methods We conducted a database search of Wanfang, China Science and Technology Journal database, China National Knowledge Infrastructure, Medline, Embase, PubMed and Springerlink through September 2019. Meta-analysis was performed using Stata15.0 software (StataCorp LP, College Station, TX, USA). Results Thirteen articles were included, including 3,996 patients and 3,815 controls. Among the Chinese population, the results showed no significant difference for the allele model (T vs. C; odds ratio = 1.05, 95%CI: 0.80–1.37). Significant differences were found in the dominant model (TT+TC vs. CC; odds ratio = 2.94, 95%CI: 1.58–5.45) and in the recessive model (TT vs. TC+CC; pooled OR = 0.81, 95%CI: 0.66–0.99). Neither the homozygous model or heterozygous model was significant. Conclusion We identified a correlation between MMP-9 C1562T polymorphism and IS in the Chinese population; the TT+TC genotype may increase the risk of IS.
Determination of psychosocial factors in cluster headache – construction and psychometric properties of the Cluster Headache Scales (CHS)
Authors: Klan Timo , Bräscher Anne-Kathrin , Vales Annabella , Liesering-Latta Eva , Witthöft Michael , Gaul Charly 
Published: June 2020

Background Cluster headache (CH) is clinically associated with considerable psychosocial burden. However, instruments to assess and characterize psychosocial factors in cluster headache more specifically are lacking. This study aimed to develop a self-report questionnaire, which assesses the broadest possible spectrum of psychosocial factors in cluster headache, the Cluster Headache Scales (CHS). Method Items of the Cluster Headache Scales were constructed based on a literature review and semi-structured interviews with several experts (including persons with cluster headache). A cross-sectional online survey was conducted to determine the psychometric properties and the factor structure of the Cluster Headache Scales. Data was analyzed using exploratory factor analysis as well as exploratory structural equation modelling (ESEM). Results In total, n = 342 subjects with cluster headache (mean age 47.8, 63% male, 51% with episodic cluster headache) were included. Factor analysis yielded eight clearly interpretable factors: Medical care, medication side effects, fear of attacks, disability, (auto)aggression, coping, physical activity, and financial burden, which are assessed via 36 items. The internal consistencies of the subscales were acceptable to excellent and ranged between Cronbach’s alpha = .76 and .93. The pattern of correlations with related instruments provides first evidence for convergent validity. Conclusion The CHS represents a reliable and valid self-report instrument for the assessment of psychosocial factors in persons with cluster headache, which appears useful for both clinical practice as well as research. Trial registration: The study was registered at the German Clinical Trials Register ( www.drks.de , ID-Number: DRKS00016502).
Dopaminergic symptoms in migraine: A cross-sectional study on 1148 consecutive headache center-based patients
Authors: Barbanti Piero , Aurilia Cinzia , Egeo Gabriella , Fofi Luisa , Guadagni Fiorella , Ferroni Patrizia 
Published: June 2020

Background Dopaminergic symptoms may be extremely pronounced in some migraine patients during the attack, representing a major source of disability. Objectives We aimed to carefully characterize the clinical picture of migraine patients with dopaminergic symptoms in a large patients’ population as a putative migraine endophenotype, allowing more precise disease management, treatment and outcome prediction. Methods We screened 1148 consecutive tertiary care episodic and chronic migraine patients with face-to-face interviews collecting thorough data on lifestyle, socio-demographic factors, and clinical migraine features. Results We identified 374 patients with migraine with dopaminergic symptoms (32.6%). The most frequent dopaminergic symptom was yawning followed by somnolence, nausea, vomiting, fatigue, mood changes and diuresis. Migraine patients with dopaminergic symptoms had longer attack duration (OR: 1.82; 95% CI: 1.41–2.36, p < 0.0001), more frequent osmophobia (OR: 2.01; 95% CI: 1.50–2.69, p < 0.0001), allodynia (OR: 1.43; 95% CI: 1.10–1.85, p = 0.0071) and unilateral cranial autonomic symptoms (OR: 1.31; 95% CI: 1.01–1.68, p = 0.045), but used less preventative treatments (OR: 0.74; 95% CI: 0.57–0.98, p = 0.033) than patients without dopaminergic symptoms. Conclusions Migraine patients with dopaminergic symptoms are characterized by a full-blown, more disabling migraine. Dopaminergic system modulation should be carefully considered in individuals with migraine with dopaminergic symptoms for both acute and preventative treatments in future ad hoc designed studies.
Preventing prejudice by preserving the spirit of mental health legislation during the COVID-19 national emergency
Authors: Ouliaris Calina , Sheahan Linda , George Duncan 
Published: June 2020

Objective: The COVID-19 national emergency activates legislative powers that allow a proportional infringement upon individual liberties. We canvas the complex legal landscape governing mental health consumers in this climate, highlight ethical considerations in application of the law and offer a simple algorithm to navigate this space. Conclusion: In times of emergency, it is crucial that we uphold the safeguards embodied within mental health legislation to prevent prejudicial treatment of mental health consumers.
A single-center qualitative study evaluating the safety and efficacy of a pharmacist-driven protocol for high-dose methotrexate management
Authors: Matta Stephanie F , Gieselman Leslie A , Mancini Robert S 
Published: June 2020

Introduction Delayed methotrexate clearance in several patients admitted to the oncology unit at a regional medical center necessitated the development of a pharmacist-driven protocol for supportive therapy with high-dose methotrexate. This performance improvement project evaluated the impact of the protocol on inpatient length of stay, patient safety, and clinical outcomes. Methods Retrospective data were collected over 14 months pre-implementation and prospective data were collected over 19 months post-implementation. Primary outcomes included mean length of stay and incidence of kidney injury. Secondary outcomes included myelosuppression, treatment delays, mucositis, protocol adherence, and pharmacist interventions. Chi-squared and unpaired two sample t-test were used for data analysis. Intervention A literature review of consensus recommendations for supportive care post high-dose methotrexate administration was conducted to develop the protocol. Education on implementation was provided to involved disciplines. Results One-hundred ten high-dose methotrexate admissions for 23 patients were analyzed: 24 pre-protocol and 86 post-protocol. Mean length of stay was 5.17 nights pre-protocol and 3.91 nights post-protocol ( p = 0.026). Incidence of kidney injury significantly decreased (16.7% pre-protocol versus 3.5% post-protocol; p = 0.0394). Lower incidences of all-grade anemia (83.3% versus 58.1%), neutropenia (62.5% versus 29.1%), and thrombocytopenia (58.3% versus 33.7%) as well as treatment delays (29.2% versus 11.6%; p = 0.036) were reported post protocol. No statistically significant difference in mucositis was detected. Pharmacist adherence to protocol was ≥80% resulting in 348 interventions with 99.4% provider acceptance. Conclusion The implementation of a pharmacist-driven high-dose methotrexate management protocol resulted in a statistically significant decrease in inpatient length of stay and kidney injury. Further studies are needed to assess the impact on additional outcomes.
Prevalence and clinical characteristics of phenobarbitone-associated adverse effects in epileptic cats
Authors: Marsh Oliver , Corsini Giulia , Van Dijk Jan , Gutierrez-Quintana Rodrigo , De Risio Luisa 
Published: June 2020

Objectives The study objective was to investigate the prevalence and clinical characteristics of phenobarbitone-associated adverse effects in epileptic cats. Methods The medical records of two veterinary referral clinics from 2007 to 2017 were searched for cats fulfilling the inclusion criteria of a diagnosis of epilepsy, treatment with phenobarbitone and available follow-up information on the occurrence of adverse effects. Follow-up information was obtained from the medical records of the primary veterinarian and referral institutions and a questionnaire completed by the cats’ owners. Results Seventy-seven cats met the inclusion criteria. Fifty-eight were affected by idiopathic epilepsy and 19 by structural epilepsy. One or more of the following adverse effects were reported in 47% of the cats: sedation (89%); ataxia (53%); polyphagia (22%); polydipsia (6%); polyuria (6%); and anorexia (6%). Logistic regression analyses revealed significant associations between adverse effect occurrence and both phenobarbitone starting dosage and administration of a second antiepileptic drug (AED). For each 1 mg/kg q12h increment of phenobarbitone, the likelihood of adverse effects increased 3.1 times. When a second AED was used, the likelihood of adverse effects increased 3.2 times. No association was identified between epilepsy aetiology and adverse effect occurrence. An idiosyncratic adverse effect, characterised by severe neutropenia and granulocytic hypoplasia, was diagnosed in one cat. This resolved following phenobarbitone discontinuation. Conclusions and relevance The prevalence of phenobarbitone-associated adverse effects was 47%. Sedation and ataxia were most common. These are type A adverse effects and are predictable from phenobarbitone’s known pharmacological properties. In the majority of cases, adverse effects occurred within the first month of treatment and were transient. Idiosyncratic (type B) adverse effects, which were not anticipated given the known properties of the drug, occurred in one cat. Increased phenobarbitone starting dosage and the addition of a second AED were significantly associated with the occurrence of adverse effects.
Postural Behavior in Medicated Parkinson Disease Patients: A Preliminary Study Searching for Indicators to Track Progress
Authors: Degani Adriana Menezes , Cardoso Vinicius Saura , Magalhães Alessandra Tanuri , Assunção Ana Larissa Sousa , Soares Erica de Carvalho , Danna-dos-Santos Alessander 
Published: June 2020

Purpose:The establishment of early diagnostic methods for Parkinson disease (PD) is one of the key features to clinically control the rate of PD progression. This study aimed to give a first step toward recognizing the efficacy of multiple postural indices of balance control in differentiating medicated PD patients from health participants.Methods:Nine individuals with PD (Hoehn and Yahr Stage up to 2), 9 staged 2.5 and up, and 9 healthy age-matched Controls performed bipedal stances for 120 seconds with eyes either open or closed on a stable force platform. All participants with PD were under anti-Parkinsonian medication. Non-parametric tests investigated the effects of PD and visual input on postural indices extracted from the center of pressure coordinates.Results:Independent of the stage of the disease, individuals with PD presented faster and shakier body sway compared with Controls. Advanced stages of PD also revealed increased body sway length and variability. In addition, medio-lateral postural instability was more pronounced in all stages of PD when visual inputs were not allowed.Conclusion and Significance:Body sway velocity, jerkiness, length, and its variability revealed to be potential markers for subclinical signs of adjustments in the neuromechanisms of balance control and postural instability even at early stages of disease and under anti-Parkinsonian medication. Results produced here will direct future studies aiming to investigate the efficacy of these same indices on recognizing subclinical development of PD as well as those individuals susceptible to faster rates of progression.
Efficacy and safety of leflunomide versus cyclophosphamide for initial-onset Takayasu arteritis: a prospective cohort study
Authors: Ying Sun , Xiaomeng Cui , Xiaomin Dai , Jiang Lin , Peng Lv , Lili Ma , Rongyi Chen , Zongfei Ji , Huiyong Chen , Lindi Jiang 
Published: June 2020

Background: Leflunomide (LEF) has been considered as an alternative treatment for Takayasu arteritis (TA); however, data on its efficacy are still scanty. Objective: To investigate the efficacy and safety of LEF versus cyclophosphamide (CYC) for initial-onset TA. Methods: Initial-onset TA patients with active disease were enrolled in this research. Patients enrolled from 1 January 2009 to 31 December 2015 were treated with glucocorticoids and CYC, while patients enrolled from 1 January 2016 to 31 October 2018 received glucocorticoids and LEF. Treatment response including complete remission (CR), partial remission (PR), and effectiveness rate (ER) and side effects were evaluated at 6 and 12 months. Results and conclusion: In total, 92 patients were enrolled. A total of 47 patients were treated with LEF, while 45 patients were treated with CYC. The CR and ER rates were 75.55%, and 88.89% at 6 months, and 85.37% and 95.12% at 12 months in the LEF group. The CR and ER rates were 39.02% and 70.73% at 6 months, and 56.41% and 82.05% at 12 months in the CYC group. The CR rate was significantly higher in the LEF group than in the CYC group both at 6 months (75.61% versus 38.24%, p < 0.01) and 12 months (77.42% versus 53.33%, p < 0.05) after adjustment for propensity scores. The incidence of side effects in the LEF group was much lower than that in the CYC group (21.28% versus 44.44%). In conclusion, LEF provided a better treatment response, along with lower reproductive toxicity, compared with CYC in initial-onset TA.