bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Relative Importance of Updraft and Cold Pool Characteristics in Supercell Tornadogenesis Using Highly Idealized Simulations
Authors: Fischer Jannick , Dahl Johannes M. L. 
Published: September 2020

AbstractIn the recent literature, the conception has emerged that supercell tornado potential may mostly depend on the strength of the low-level updraft, with more than sufficient subtornadic vertical vorticity being assumed to be present in the outflow. In this study, we use highly idealized simulations with heat sinks and sources to conduct controlled experiments, changing the cold pool or low-level updraft character independently. Multiple, time-dependent heat sinks are employed to produce a realistic near-ground cold pool structure. It is shown that both the cold pool and updraft strength actively contribute to the tornado potential. Furthermore, there is a sharp transition between tornadic and nontornadic cases, indicating a bifurcation between these two regimes triggered by small changes in the heat source or sink magnitude. Moreover, larger updraft strength, updraft width, and cold pool deficit do not necessarily result in a stronger maximum near-ground vertical vorticity. However, a stronger updraft or cold pool can both drastically reduce the time it takes for the first vortex to form.
Bootstrap Methods for Statistical Inference. Part II: Extreme-Value Analysis
Authors: Gilleland Eric 
Published: September 2020

AbstractThis paper is the sequel to a companion paper on bootstrap resampling that reviews bootstrap methodology for making statistical inferences for atmospheric science applications where the necessary assumptions are often not met for the most commonly used resampling procedures. In particular, this sequel addresses extreme-value analysis applications with discussion on the challenges for finding accurate bootstrap methods in this context. New bootstrap code from the R packages “distillery” and “extRemes” is introduced. It is further found that one approach for accurate confidence intervals in this setting is not well suited to the case when the random sample’s distribution is not stationary.
Impacts of Stochastic Mixing in Idealized Convection-Permitting Simulations of Squall Lines
Authors: Stanford McKenna W. , Morrison Hugh , Varble Adam 
Published: September 2020

AbstractThis study investigates impacts of altering subgrid-scale mixing in “convection-permitting” kilometer-scale horizontal-grid-spacing (Δh) simulations by applying either constant or stochastic multiplicative factors to the horizontal mixing coefficients within the Weather Research and Forecasting Model. In quasi-idealized 1-km Δh simulations of two observationally based squall-line cases, constant enhanced mixing produces larger updraft cores that are more dilute at upper levels, weakens the cold pool, rear-inflow jet, and front-to-rear flow of the squall line, and degrades the model’s effective resolution. Reducing mixing by a constant multiplicative factor has the opposite effect on all metrics. Completely turning off parameterized horizontal mixing produces bulk updraft statistics and squall-line mesoscale structure closest to an LES “benchmark” among all 1-km simulations, although the updraft cores are too undilute. The stochastic mixing scheme, which applies a multiplicative factor to the mixing coefficients that varies stochastically in time and space, is employed at 0.5-, 1-, and 2-km Δh. It generally reduces midlevel vertical velocities and enhances upper-level vertical velocities compared to simulations using the standard mixing scheme, with more substantial impacts at 1- and 2-km Δh compared to 0.5-km Δh. The stochastic scheme also increases updraft dilution to better agree with the LES for one case, but has less impact on the other case. Stochastic mixing acts to weaken the cold pool but without a significant impact on squall-line propagation. It also does not affect the model’s overall effective resolution unlike applying constant multiplicative factors to the mixing coefficients.
Updraft-Based Adaptive Assimilation of Radial Velocity Observations in a Warn-on-Forecast System
Authors: Kerr Christopher A. , Wicker Louis J. , Skinner Patrick S. 
Published: September 2020

AbstractThe Warn-on-Forecast system (WoFS) provides short-term, probabilistic forecasts of severe convective hazards including tornadoes, hail, and damaging winds. WoFS initial conditions are created through frequent assimilation of radar (reflectivity and radial velocity), satellite, and in situ observations. From 2016 to 2018, 5-km radial velocity Cressman superob analyses were created to reduce the observation counts and subsequent assimilation computational costs. The superobbing procedure smooths the radial velocity and subsequently fails to accurately depict important storm-scale features such as mesocyclones. This study retrospectively assimilates denser, 3-km radial velocity analyses in lieu of the 5-km analyses for eight case studies during the spring of 2018. Although there are forecast improvements during and shortly after convection initiation, 3-km analyses negatively impact forecasts initialized when convection is ongoing, as evidenced by model failure and initiation of spurious convection. Therefore, two additional experiments are performed using adaptive assimilation of 3-km radial velocity observations. Initially, an updraft variance mask is applied that limits radial velocity assimilation to areas where the observations are more likely to be beneficial. This experiment reduces spurious convection as well as the number of observations assimilated, in some cases even below that of the 5-km analysis experiments. The masking, however, eliminates an advantage of 3-km radial velocity assimilation for convection initiation timing. This problem is mitigated by additionally assimilating 3-km radial velocity observations in locations where large differences exist between the observed and ensemble-mean reflectivity fields, which retains the benefits of the denser radial velocity analyses while reducing the number of observations assimilated.
Socioeconomic Characteristics of Patients Undergoing Ambulatory Parathyroidectomy and a Comparison of Institutional Charges
Authors: Moeller Ellie A. , Walker Tamar , F. Khan Zahra , P. Parreco Joshua , L. Buicko Jessica 
Published: September 2020

Background Parathyroidectomy is frequently performed as ambulatory surgery. This study seeks to characterize the socioeconomic factors that may impact the patient selection for outpatient parathyroidectomy. Methods The 2016 Florida State Inpatient Database (SID) and the 2016 Florida State Ambulatory Surgery Database (SASD) were queried for all patients undergoing parathyroidectomy using the International Classification of Diseases 10 (ICD-10) procedure codes. Univariable comparison and multivariate logistic regression were performed for outpatient versus inpatient parathyroidectomy using all relevant patient and hospital characteristics from the database. Results Seven hundred and sixteen patients underwent parathyroidectomy in Florida in 2016; 322 parathyroidectomies were performed in the ambulatory setting (45.0%). After multivariate logistic regression, patients over age 65 and parathyroidectomies performed at high-volume centers were more likely to be performed at an outpatient center. Those patients who were black, Hispanic, had a Charlson Comorbidity Index ≥3, Medicare, Medicaid, and Self-pay were associated with a decreased likelihood of having an outpatient procedure. Discussion Access to ambulatory parathyroidectomy is more common in patients with private insurance, white ethnicity, and fewer comorbidities.
Development of chimeric antigen receptor-modified T cells for the treatment of esophageal cancer
Authors: Yu Feng , Wang Xiaoyan , Shi Hui , Jiang Maorong , Xu Jun , Sun Min , Xu Qinggang , Addai Frank Peprah , Shi Haifeng , Gu Jie , Zhou Yang , Liu Liqiong 
Published: September 2020

Background: Human epidermal growth factor receptor 2 (HER2) is an overexpressed antigen in esophageal squamous cell carcinomas (ESCCs) but with limited expression levels in normal esophageal tissues. Therefore, employing the adoptive transfer of T cells genetically modified to express chimeric antigen receptor (CAR) targeting HER2 could be a promising therapeutic strategy against ESCC. Methods: Two different second-generation CAR-T cells expressing antibodies for HER2 and CD19 antigens were developed using retroviral vector transduction. The expression of HER2 antigen in ESCC tissue and cell lines was examined by immunohistochemistry and flow cytometry, respectively. The tumor killing efficacy of the CAR-T cells in mice model and ESCC cell lines and its potential for the treatment of ESCC was evaluated by determining tumor size in mice xenograft, and by crystal violet staining, MTS assay, and cytokine release. Results: In vitro, HER2.CAR-T cells efficiently recognized and killed HER2-positive tumor cells as evidenced by the secretion of proinflammatory cytokines, interferon-γ, and interleukin 2 and by cytotoxicity assays. In vivo, intratumor injection of HER2.CAR-T cells resulted in a significant suppression of established ESCCs in a subcutaneous xenograft BALB/c nude mouse model. In contrast, the injection of CD19.CAR-T cells did not affect the tumor growth pattern. Conclusions: An effective HER2 CAR targeting ESCC was developed successfully. The HER2.CAR-T cell showed promising immunotherapeutic potential for the treatment of HER2-positive esophageal cancer.
Cultural Aspects of End-of-Life Advance Care Planning for African Americans: An Ethnonursing Study
Authors: Collins John W. , Zoucha Rick , Lockhart Joan Such , Mixer Sandra J. 
Published: September 2020

Introduction: Advance directive completion rates among the general population are low, with even lower completion rates among African Americans (AAs). This study’s purpose was to identify culturally based meanings, expressions, and traditions of end-of-life (EOL) advance care planning (ACP) and decision making in order to promote culturally congruent nursing care among African Americans. Methodology: Leininger’s Culture Care Theory and Ethnonursing Research Method guided the study. A convenience sample of 21 informants were interviewed in community settings. Data analysis was guided using Leininger’s phases of ethnonursing data analysis for qualitative data. Results: Three themes emerged that affect EOL decision making: (a) faith in God and belief in life after death, (b) a strong matriarchal family structure, and (c) fear of talking about death and mistrust of the U.S. health care system. Discussion: AA culture, beliefs, and traditions influence EOL ACP and practices, and must be considered while providing culturally congruent care.
Palliative Care and Rapid Emergency Screening Tool and the Palliative Performance Scale to Predict Survival of Older Adults Admitted to the Hospital From the Emergency Department
Authors: Paske Jonas R. Te , DeWitt Sarah , Hicks Robin , Semmens Shana , Vaughan Leigh 
Published: September 2020

Background: The Palliative Care and Rapid Emergency Screening (P-CaRES) tool has been validated to identify patients in the emergency department (ED) with unmet palliative care needs, but no prognostic data have been published. The Palliative Performance Scale (PPS) has been validated to predict survival based on performance status and separately has been shown to predict survival among adults admitted to the hospital from the ED. Objective: To concurrently validate the 6-month prognostic utility of P-CaRES with a replication of prior studies that demonstrated the prognostic utility of the PPS among adults admitted to the hospital from the ED. Design: Prospective cohort study. Setting/Subjects: Adults >55 years admitted to the hospital from the ED at an urban academic hospital in South Carolina. Measurement: Baseline PPS score and P-CaRES status were evaluated within 51 hours of admission. Vital status at 6 months was evaluated by phone or chart review. Results: 131 of 145 participants completed the study. Six-month survival was 79.2% of those with a PPS of 60-100 (22/106 died) and 48% of those with a PPS of 10-50 (13/25 died) (p = 0.0004). Six-month survival was 85.2% for P-CaRES negative (13/88 died) and 48.8% for P-CaRES positive (22/43 died) (p < 0.0001). The inferred hazard ratio (HR) for PPS 10-50, as compared to PPS 60-100 was 3.003 (95%CI (1.475, 6.112) p = 0.0024) and the HR for P-CaRES positive, as compared to P-CaRES negative was 4.186 (95%CI (2.052, 8.536) p < 0.0001). Conclusion: The P-CaRES tool and PPS can predict 6-month survival of older adults admitted from the ED.
Educational Attainment of Children Born with Unilateral Cleft Lip and Palate in the United Kingdom
Authors: Grewal Sukhraj S. , Ponduri Sirisha , Leary Sam D. , Wren Yvonne , Thompson John M. D. , Ireland Anthony J. , Ness Andy R. , Sandy Jonathan R. 
Published: September 2020

Objective: This study evaluated association between functional outcomes in children born with unilateral cleft lip and palate (UCLP) and educational attainment. Design: Cleft Care UK (CCUK) was a United Kingdom (UK) wide cross-sectional study. Setting: UK Cleft Teams (data collected from all UK sites providing centralized cleft services). Patients, Participants: Five-year olds born with nonsyndromic UCLP (n = 268). Main Outcome Measure(s): National tests for educational attainment Key Stage 1 (KS1) undertaken by children at age 7 were linked to CCUK data to describe differences in educational attainment. Associations between functional outcomes and KS1 results were evaluated using regression analysis. We adjusted for birth month, gender, and an area-based measure of socioeconomic status. Results: Data were available for 205 children with UCLP. These children scored lower than national average (NA) scores across all subject areas, with a 0.62 lower score observed in the Average Point Score (APS; P = .01). There was association between being in a lower category for a cleft related outcomes and poorer KS1 results, with a trend for poorer attainment with higher numbers of poor functional outcomes. Those with 3 or more poor outcomes had a −2.26 (−3.55 to −0.97) lower APS compared to those with 0 to 1 poor outcomes. Conclusions: Children born with UCLP have poorer educational attainment at age 7 across all subject areas though differences were modest. Children with poor functional outcomes at age 5 had worse educational outcomes age 7. Improvements in functional outcomes could enhance educational outcomes.
Central diabetes insipidus induced by temozolomide: A report of two cases
Authors: Mahiat Cédric , Capes Antoine , Duprez Thierry , Whenham Nicolas , Duck Lionel , Labriola Laura 
Published: September 2020

Introduction Central diabetes insipidus is a heterogeneous condition characterized by decreased release of antidiuretic hormone by the neurohypophysis resulting in a urine concentration deficit with variable degrees of polyuria. The most common causes include idiopathic diabetes insipidus, tumors or infiltrative diseases, neurosurgery and trauma. Temozolomide is an oral DNA-alkylating agent capable of crossing the blood-brain barrier and used as chemotherapy primarily to treat glioblastoma and other brain cancers. Cases Two men (aged 38 and 54 years) suddenly developed polyuria and polydispsia approximately four weeks after the initiation of temozolomide for a glioblastoma. Plasma and urine parameters demonstrated the presence of a urinary concentration defect. Management The clinical and laboratory abnormalities completely resolved with intranasal desmopressin therapy, allowing the continuation of temozolomide. The disorder did not relapse after cessation of temozolomide and desmopressin and relapsed in one patient after rechallenge with temozolomide. Discussion Our report highlights the importance of a quick recognition of this exceptional complication, in order to initiate promptly treatment with desmopressin and to maintain therapy with temozolomide.
Toward Understanding of Environmental Risk Factors in Systemic Sclerosis
Authors: Ouchene Lydia , Muntyanu Anastasiya , Lavoué Jérôme , Baron Murray , Litvinov Ivan V. , Netchiporouk Elena 
Published: September 2020

Importance Systemic sclerosis (SSc) is a severe, chronic, and incurable autoimmune fibrotic skin disease with significant extracutaneous involvement. Low concordance rate in twin studies and unequal geographic distribution of SSc argues for importance of environment in disease initiation and progression. Objective In this manuscript we provide a summary of all investigated potential external risk factors for SSc. Data sources A literature search in PubMed and EMBASE database was performed for studies published until January 1, 2020 by 2 reviewers (EN and LO) independently. Findings Occupational and/or environmental exposures to silica and organic solvents are associated with increased incidence and severity of SSc. Exposure to epoxy resins, asbestos, and particulate air pollution favors increased risk of SSc, but data are based on limited number of observational studies. There is insufficient evidence to conclude an association between SSc development and other occupational (eg, welding fumes) or personal exposures (eg, smoking, vitamin D deficiency). Association of SSc with silicone breast implants has been disproven. Infectious pathogens (eg, Helicobacter pylori and angiotropic viruses) and dysbiosis seem to play a role in SSc development and severity, but their role remains to be clarified. Conclusions and relevance It may be prudent to counsel our patients with SSc (or those at risk of SSc) to avoid occupations with exposure to silica, organic solvents, asbestos and epoxy resins; restraint from smoking, using cocaine or drugs with pro-fibrotic potential. While the association between low vitamin D and SSc remains to be confirmed, we believe that SSc patients should be encouraged to maintain healthy vitamin D levels as benefits outweigh the risks.
Three-and-a-half to 18 year outcome data for costal osteochondral grafts for salvage of the proximal pole of the scaphoid
Authors: Bain Charles , Tham Stephen , Powell Chris , Berger Anthony , Withers Aaron , McCombe David 
Published: September 2020

Twelve patients who had undergone costal osteochondral graft reconstruction of the proximal pole of scaphoid were evaluated with clinical examination, patient-reported outcome scores and radiographs with an average follow-up of 10 years (range 3.5–18). The range of wrist motion was not significantly changed compared with the preoperative range of motion and functional outcomes scores were acceptable. The patients reported low pain scores despite the universal presence of radiographic changes of reduced carpal height and arthritis of the midcarpal and radiocarpal joints. Costal osteochondral graft reconstruction of the proximal pole of scaphoid offers good long-term pain relief and function. Level of evidence: IV
The management of clenched fist injuries with local anaesthesia and field sterility
Authors: Kay Harrison F. , Kang Hyunwoo P. , Fisch Robert , Stevanovic Milan , Ghiassi Alidad , Nicholson Luke T. 
Published: September 2020

Clenched fist injury is associated with a high risk of infectious complications and is commonly managed with formal irrigation and debridement in the operating theatre. The purpose of this study was to determine outcomes associated with irrigation and debridement of clenched fist injuries under local anaesthesia using field sterility outside the operative theatre. In this single centre study, 232 patients were identified with clenched fist injury and 210 were treated with a standard protocol beginning with administration of intravenous antibiotics and then irrigation and debridement at the bedside. Primary outcome measures were the need for repeat debridement and complications. Secondary outcome measures included factors associated with the need for repeat debridement. Fifteen of the 210 patients (7%) required repeat debridement. Patients with cultures positive for gram-negative organisms had a significantly increased risk of repeat debridement. Irrigation and debridement under local anaesthesia using field sterility results in an acceptably low risk of complications or need for repeat debridement. Level of evidence: IV
Modern radiopharmaceuticals for lung cancer imaging with positron emission tomography/computed tomography scan: A systematic review
Authors: Theodoropoulos Athanasios S , Gkiozos Ioannis , Kontopyrgias Georgios , Charpidou Adrianni , Kotteas Elias , Kyrgias George , Tolia Maria 
Published: September 2020

Introduction: In this study, we evaluated the use and the contribution of radiopharmaceuticals to the field of lung neoplasms imaging using positron emission tomography/computed tomography. Methods: We conducted review of the current literature at PubMed/MEDLINE until February 2020. The search language was English. Results: The most widely used radiopharmaceuticals are the following: Experimental/pre-clinical approaches: (18)F-Misonidazole (18F-MISO) under clinical development, D(18)F-Fluoro-Methyl-Tyrosine (18F-FMT), 18F-FAMT (L-[3-18F] (18)F-Fluorothymidine (18F-FLT)), (18)F-Fluoro-Azomycin-Arabinoside (18F-FAZA), (68)Ga-Neomannosylated-Human-Serum-Albumin (68Ga-MSA) (23), (68)Ga-Tetraazacyclododecane (68Ga-DOTA) (as theranostic agent), (11)C-Methionine (11C-MET), 18F-FPDOPA, ανβ3 integrin, 68Ga-RGD2, 64Cu-DOTA-RGD, 18F-Alfatide, Folate Radio tracers, and immuno-positron emission tomography radiopharmaceutical agents. Clinically approved procedures/radiopharmaceuticals agents: (18)F-Fluoro-Deoxy-Glucose (18F-FDG), (18)F-sodium fluoride (18F-NaF) (bone metastases), and (68)Ga-Tetraazacyclododecane (68Ga-DOTA). The quantitative determination and the change in radiopharmaceutical uptake parameters such as standard uptake value, metabolic tumor volume, total lesion glycolysis, FAZA tumor to muscle ratio, standard uptake value tumor to liver ratio, standard uptake value tumor to spleen ratio, standard uptake value maximum ratio, and the degree of hypoxia have prognostic and predictive (concerning the therapeutic outcome) value. They have been associated with the assessment of overall survival and disease free survival. With the positron emission tomography/computed tomography radiopharmaceuticals, the sensitivity and the specificity of the method have increased. Conclusion: In terms of lung cancer, positron emission tomography/computed tomography may have clinical application and utility (a) in personalizing treatment, (b) as a biomarker for the estimation of overall survival, disease free survival, and (c) apply a cost-effective patient approach because it reveals focuses of the disease, which are not found with the other imaging methods.