bluuebunny/crossref_metadata_2025_split huggingface dataset:
Obesity Has a Stronger Relationship with Colorectal Cancer in Postmenopausal Women than Premenopausal Women
Authors: Chang Ji Won , Shin Dong Wook , Han Kyung Do , Jeon Keun Hye , Yoo Jung Eun , Cho In Young , Choi Yun Jin , Hong Jung Yong 
Published: August 2020

Abstract

Background:
To examine the relationship between obesity measured by waist circumference (WC) and body mass index (BMI) and the incidence of colorectal cancer in premenopausal and postmenopausal women.

Methods:
A total of 1,418,180 premenopausal and 4,854,187 postmenopausal women without cancer at baseline and ages over 40 were identified using the Korean National Health Insurance System Cohort during 2009 to 2014. The hazard ratio (HR) for colorectal cancer incidence was assessed according to menopausal state using Cox proportional hazards models.

Results:
During a mean follow-up period of 7.2 years, 7,094 and 57,449 colorectal cancer cases occurred in premenopausal and postmenopausal women, respectively. Compared with the reference group (WC 65–75), the HRs [95% confidence interval (CI)] of colorectal cancer in WC &lt;65, 75–85, 85–95, and &gt;95 groups were 1.01 (0.91–1.11), 1.02 (0.97–1.07), 1.09 (1.00–1.18), and 1.31 (1.12–1.52), respectively, in premenopausal women and 1.01 (0.95–1.17), 1.09 (1.07–1.12), 1.19 (1.00–1.18), and 1.30 (1.25–1.35), respectively, in postmenopausal women. Compared with the reference group (BMI 18.5–22.9), HRs (95% CI) for colorectal cancer in BMI &lt;18.5, 23–25, 25–30, and &gt;30 groups were 0.99 (0.87–1.14), 0.99 (0.94–1.06), 0.98 (0.92–1.04), and 1.06 (0.92–1.20), respectively, in premenopausal women. In postmenopausal women, those values were 0.99 (0.93–1.05), 1.05 (1.03–1.08), 1.11 (1.09–1.13), and 1.20 (1.16–1.25), respectively.

Conclusions:
WC is associated with the risk of colorectal cancer in both groups of women, but this association was stronger in postmenopausal women than in premenopausal women. BMI increased the incidence of colorectal cancer only in postmenopausal women

Impact:
Obesity has a stronger relationship with colorectal cancer in postmenopausal women than in premenopausal women.
Optimizing Atherosclerotic Cardiovascular Disease Risk Estimation for Veterans With Diabetes Mellitus
Authors: Raghavan Sridharan , Ho Yuk-Lam , Vassy Jason L. , Posner Daniel , Honerlaw Jacqueline , Costa Lauren , Phillips Lawrence S. , Gagnon David R. , Wilson Peter W.F. , Cho Kelly 
Published: August 2020

Background:
Estimated 10-year atherosclerotic cardiovascular disease (ASCVD) risk in diabetes mellitus patients is used to guide primary prevention, but the performance of risk estimators (2013 Pooled Cohort Equations [PCE] and Risk Equations for Complications of Diabetes [RECODe]) varies across populations. Data from electronic health records could be used to improve risk estimation for a health system’s patients. We aimed to evaluate risk equations for initial ASCVD events in US veterans with diabetes mellitus and improve model performance in this population.

Methods AND RESULTS:

We studied 183 096 adults with diabetes mellitus and without prior ASCVD who received care in the Veterans Affairs Healthcare System (VA) from 2002 to 2016 with mean follow-up of 4.6 years. We evaluated model discrimination, using Harrell’s C statistic, and calibration, using the reclassification χ
2
test, of the PCE and RECODe equations to predict fatal or nonfatal myocardial infarction or stroke and cardiovascular mortality. We then tested whether model performance was affected by deriving VA-specific β-coefficients. Discrimination of ASCVD events by the PCE was improved by deriving VA-specific β-coefficients (C statistic increased from 0.560 to 0.597) and improved further by including measures of glycemia, renal function, and diabetes mellitus treatment (C statistic, 0.632). Discrimination by the RECODe equations was improved by substituting VA-specific coefficients (C statistic increased from 0.604 to 0.621). Absolute risk estimation by PCE and RECODe equations also improved with VA-specific coefficients; the calibration
P
increased from <0.001 to 0.08 for PCE and from <0.001 to 0.005 for RECODe, where higher
P
indicates better calibration. Approximately two-thirds of veterans would meet a guideline indication for high-intensity statin therapy based on the PCE versus only 10% to 15% using VA-fitted models.

Conclusions:
Existing ASCVD risk equations overestimate risk in veterans with diabetes mellitus, potentially impacting guideline-indicated statin therapy. Prediction model performance can be improved for a health system’s patients using readily available electronic health record data.
What is Quality End‐of‐Life Care for Patients With Heart Failure? A Qualitative Study With Physicians
Authors: Hutchinson Rebecca N. , Gutheil Caitlin , Wessler Benjamin S. , Prevatt Hayley , Sawyer Douglas B. , Han Paul K. J. 
Published: August 2020

Background
Advanced heart failure (AHF) carries a morbidity and mortality that are similar or worse than many advanced cancers. Despite this, there are no accepted quality metrics for end‐of‐life (EOL) care for patients with AHF.

Methods and Results
As a first step toward identifying quality measures, we performed a qualitative study with 23 physicians who care for patients with AHF. Individual, in‐depth, semistructured interviews explored physicians' perceptions of characteristics of high‐quality EOL care and the barriers encountered. Interviews were analyzed using software‐assisted line‐by‐line coding in order to identify emergent themes. Although some elements and barriers of high‐quality EOL care for AHF were similar to those described for other diseases, we identified several unique features. We found a competing desire to avoid overly aggressive care at EOL alongside a need to ensure that life‐prolonging interventions were exhausted. We also identified several barriers related to identifying EOL including greater prognostic uncertainty, inadequate recognition of AHF as a terminal disease and dependence of symptom control on disease‐modifying therapies.

Conclusions
Our findings support quality metrics that prioritize receipt of goal‐concordant care over utilization measures as well as a need for more inclusive payment models that appropriately reflect the dual nature of many AHF therapies.
Big Oil and Climate Regulation: Business as Usual or a Changing Business?
Authors: Vormedal Irja , Gulbrandsen Lars H. , Skjærseth Jon Birger 
Published: August 2020

AbstractThere is a long and continuing debate in the literature on corporate political power about whether businesses that advocate public-interest regulation do so for strategic political reasons or because they anticipate economic gains. Previous research on Big Oil’s strategies in climate politics has largely converged on the first view, arguing that global majors feign support for moderate carbon pricing largely to prevent the adoption of more drastic and costly policies. In contrast, this article argues that Big Oil’s growing stake in natural gas expansion is its economic motive for supporting favorably designed carbon pricing. The article finds that policy, technology, and energy market changes have paved the way for a shift toward natural gas and that a moderate carbon price, by triggering coal-to-gas switching, supports the realization of a gray transition in which “Big Gas” can expand its market share at the expense of coal and become a major bridge fuel next to renewables. Our findings underscore the importance of studying the competitive rivalry that underpins evolving industry demands for climate policy and regulation.
Geospatial QPE Accuracy Dependence on Weather Radar Network Configurations
Authors: Kurdzo James M. , Joback Emily F. , Kirstetter Pierre-Emmanuel , Cho John Y. N. 
Published: August 2020

AbstractThe relatively low density of weather radar networks can lead to low-altitude coverage gaps. As existing networks are evaluated for gap fillers and new networks are designed, the benefits of low-altitude coverage must be assessed quantitatively. This study takes a regression approach to modeling quantitative precipitation estimation (QPE) differences based on network density, antenna aperture, and polarimetric bias. Thousands of cases from the warm-season months of May–August 2015–17 are processed using both the specific attenuation [R(A)] and reflectivity–differential reflectivity [R(Z, ZDR)] QPE methods and are compared with Automated Surface Observing System (ASOS) rain gauge data. QPE errors are quantified on the basis of beam height, cross-radial resolution, added polarimetric bias, and observed rainfall rate. The collected data are used to construct a support vector machine regression model that is applied to the current WSR-88D network for holistic error quantification. An analysis of the effects of polarimetric bias on flash-flood rainfall rates is presented. Rainfall rates that are based on 2-yr/1-h return rates are used for a contiguous-U.S.-wide analysis of QPE errors in extreme rainfall situations. These errors are then requantified using previously proposed network design scenarios with additional radars that provide enhanced estimate capabilities. Last, a gap-filling scenario utilizing the QPE error model, flash-flood rainfall rates, population density, and potential additional WSR-88D sites is presented, exposing the highest-benefit coverage holes in augmenting the WSR-88D network (or a future network) relative to QPE performance.
Thermal Chains and Entrainment in Cumulus Updrafts. Part I: Theoretical Description
Authors: Morrison Hugh , Peters John M. , Varble Adam C. , Hannah Walter M. , Giangrande Scott E. 
Published: August 2020

AbstractRecent studies have shown that cumulus updrafts often consist of a succession of discrete rising thermals with spherical vortex-like circulations. In this paper, a theory is developed for why this “thermal chain” structure occurs. Theoretical expressions are obtained for a passive tracer, buoyancy, and vertical velocity in axisymmetric moist updrafts. Analysis of these expressions suggests that the thermal chain structure arises from enhanced lateral mixing associated with intrusions of dry environmental air below an updraft’s vertical velocity maximum. This dry-air entrainment reduces buoyancy locally. Consequently, the updraft flow above levels of locally reduced buoyancy separates from below, leading to a breakdown of the updraft into successive discrete thermals. The range of conditions in which thermal chains exist is also analyzed from the theoretical expressions. A transition in updraft structure from isolated rising thermal, to thermal chain, to starting plume occurs with increases in updraft width, environmental relative humidity, and/or convective available potential energy. Corresponding expressions for the bulk fractional entrainment rate ε are also obtained. These expressions indicate rather complicated entrainment behavior of ascending updrafts, with local enhancement of ε up to a factor of ~2 associated with the aforementioned environmental-air intrusions, consistent with recent large-eddy simulation (LES) studies. These locally large entrainment rates contribute significantly to overall updraft dilution in thermal chain-like updrafts, while other regions within the updraft can remain relatively undilute. Part II of this study compares results from the theoretical expressions to idealized numerical simulations and LES.
The Compressional Beta Effect: Analytical Solution, Numerical Benchmark, and Data Analysis
Authors: Ong Hing , Roundy Paul E. 
Published: August 2020

AbstractThis study derives a complete set of equatorially confined wave solutions from an anelastic equation set with the complete Coriolis terms, which include both the vertical and meridional planetary vorticity. The propagation mechanism can change with the effective static stability. When the effective static stability reduces to neutral, buoyancy ceases, but the role of buoyancy as an eastward-propagation mechanism is replaced by the compressional beta effect (i.e., vertical density-weighted advection of the meridional planetary vorticity). For example, the Kelvin mode becomes a compressional Rossby mode. Compressional Rossby waves are meridional vorticity disturbances that propagate eastward owing to the compressional beta effect. The compressional Rossby wave solutions can serve as a benchmark to validate the implementation of the nontraditional Coriolis terms (NCTs) in numerical models; with an effectively neutral condition and initial large-scale disturbances given a half vertical wavelength spanning the troposphere on Earth, compressional Rossby waves are expected to propagate eastward at a phase speed of 0.24 m s−1. The phase speed increases with the planetary rotation rate and the vertical wavelength and also changes with the density scale height. Besides, the compressional beta effect and the meridional vorticity tendency are reconstructed using reanalysis data and regressed upon tropical precipitation filtered for the Madden–Julian oscillation (MJO). The results suggest that the compressional beta effect contributes 10.8% of the meridional vorticity tendency associated with the MJO in terms of the ratio of the minimum values.
Characterizing Drying in the South American Monsoon Onset Season with the Moist Static Energy Budget
Authors: Smyth Jane E. , Ming Yi 
Published: August 2020

AbstractThe tropical atmospheric circulation and attendant rainfall exhibit seasonally dependent responses to increasing temperatures. Understanding changes in the South American monsoon system is of particular interest given the sensitivity of the southern Amazon rainforest to changes in dry season length. We utilize the latest Geophysical Fluid Dynamics Laboratory Atmospheric Model (GFDL AM4) to analyze the response of the South American monsoon to uniform sea surface temperature (SST) warming. SST warming is a poorly understood yet impactful component of greenhouse gas–induced climate change. Region-mean rainfall declines by 11%, and net precipitation (precipitation minus evaporation) declines by 40%, during the monsoon onset season (September–November), producing a more severe dry season. The column-integrated moist static energy (MSE) budget helps elucidate the physical mechanisms of the simulated drying. Based on the seasonal analysis, precipitation reductions tend to occur when 1) a convecting region’s climatological MSE export is dominated by horizontal rather than vertical advection, and 2) the horizontal MSE advection increases in the perturbed climate, impeding ascent. On a synoptic scale, the South American low-level jet strengthens and exports more moisture from the monsoon sector, exacerbating spring drying.
Investigating the Evaluation Uncertainty for Satellite Precipitation Estimates Based on Two Different Ground Precipitation Observation Products
Authors: Chen Hanqing , Yong Bin , Qi Weiqing , Wu Hao , Ren Liliang , Hong Yang 
Published: August 2020

AbstractThe evaluation uncertainty caused by a standard reference itself is harmful to both algorithm developers and data users in substantially understanding the error features and the performance of satellite precipitation products (SPPs). In this study, the Climate Precipitation Center Unified (CPCU) data and the Merged Precipitation Analysis (MPA) data are used as the benchmark to investigate the evaluation uncertainties of satellite precipitation estimates generated by the reference itself. Two SPPs, IMERG-Late and GSMaP-MVK, are employed here. The results show that the approach using two different ground-based precipitation products as the references can effectively reveal the potential evaluation uncertainties. Interestingly, it is found that the evaluation results are prone to resulting in larger uncertainties over semihumid areas. Furthermore, evaluation uncertainty of statistical metrics is closely related to rainfall intensity in that it has a gradually decreasing tendency with increasing rainfall intensities. Additionally, we also found that the dependency of the false alarm ratio (FAR) and root-mean-square error (RMSE) scores on the spatial density of rain gauges is relatively low. Both relative bias (RBIAS) and normalized root-mean-square error (NRMSE) scores for light precipitation (1–5 mm day−1) increase with the spatial density of the rain gauges, suggesting that the evaluation of light precipitation can easily cause uncertainties relative to medium-to-high rain rates. Finally, the minimum gauge density required for different scores and different rainfall intensities is discussed. This study is expected to provide criteria to investigate the reliability of evaluation results for the satellite quantitative precipitation estimation community.
The Lightning Distribution of Tropical Cyclones over the Western North Pacific
Authors: Lin Shu-Jeng , Chou Kun-Hsuan 
Published: August 2020

AbstractThis study examines the characteristics of tropical cyclone (TC) lightning distribution and its relationship with TC intensity and environmental vertical wind shear (VWS) over the western North Pacific. It uses data from the World Wide Lightning Location Network and operational global analysis data from National Centers for Environmental Prediction Final Analysis for 230 TCs during 2005–17. The spatial distribution of TC lightning frequency and normalized lightning rate demonstrates that the VWS dominates the azimuthal distribution of the lightning. The flashes are active in the downshear-left side of the inner core and the downshear-right side of the outer region. TC lightning distribution for various VWS strengths and TC intensities are further investigated. As VWS increases, the flashes of lightning become more asymmetric and exhibit a higher proportion at the outer region of the downshear side. Moreover, the same features occur as TC intensity decreases. A series of composite analyses indicated that stronger TCs with weaker VWS exhibit a more compact and symmetric lightning distribution, whereas weaker TCs with stronger VWS have a more asymmetric lightning distribution. Furthermore, the TC lightning distribution and its association with TC intensity changes are also examined for three lead times. Results show that among the composite analyses of five TC intensity changes, the lightning distribution for rapid intensification type exhibits more inner-core lightning and is more axisymmetric than the distributions for other categories. These features result from favorable environmental conditions comprising greater upper-level divergence, sea surface temperature, maximum potential intensity, and weaker vertical wind shear.
Laparoscopic Ventral Hernia Repair in the Geriatric Population
Authors: Elhage Sharbel A. , Shao Jenny M. , Deerenberg Eva B. , Prasad Tanushree , Colavita Paul D. , Kercher Kent W. , Augenstein Vedra A. , Todd Heniford B. 
Published: August 2020

Objectives Laparoscopic ventral hernia repair (LVHR) has been shown to decrease wound complications and length of stay (LOS) but results in more postoperative discomfort. The benefits of LVHR for the growing geriatric population are unclear. The aim of our study is to evaluate long-term outcomes and quality of life (QOL) after LVHR in the geriatric population. Methods A prospectively collected single-center database was queried for all patients who underwent LVHR (1999-2019). Age groups were defined as <40 (young), 40-64 (middle age), and ≥65 years (geriatric). QOL was assessed with the Carolinas Comfort Scale. Results LVHR was performed in 1181 patients, of which 13.4% were young, 61.6% middle aged, and 25.0% geriatric. Hernia defect size (64.2 ± 94.4 vs 79.9 ± 102.4 vs 84.7 ± 110.0 cm2) and number of comorbidities (2.2 ± 2.1 vs 3.2 ± 2.2 vs 4.3 ± 2.2) increased with age (all P < .05). LOS increased with age (2.9 ± 2.5 vs 3.8 ± 2.9 vs 5.2 ± 5.3 days, P < .0001). Rates of postoperative cardiac events, pneumonia, respiratory failure, wound complication, reoperation, and death were similar ( P > .05). Geriatric patients had increased rate of ileus and urinary retention (all P < .05). Overall recurrence rate was 5.7% with an average follow-up of 43.5 months, with no differences in recurrence between groups ( P > .05). Geriatric patients had better overall QOL at 2 weeks ( P = .0008) and similar QOL at 1, 6, and 12 months. Discussion LVHR offers excellent results in the geriatric population. Despite having increased rates of comorbidities and larger hernia defects, which may relate to LOS, rates of complications and recurrence were similar compared with younger cohorts, with better short-term QOL.
Organizational commitment across different institutional settings: how perceived procedural constraints frustrate self-sacrifice
Authors: Giacomelli Giorgio , Vainieri Milena , Garzi Rosita , Zamaro Nereo 
Published: August 2020

The positive impact of public service motivation on several individual work outcomes of public sector employees has been documented. Recent research into the ‘dark side’ of such an individual trait, however, has led some scholars to suggest that organizational conditions such as procedural constraints could affect one’s motivation, thus leading to the resignation of other-oriented employees. This study explores the relationships between one of the dimensions of public service motivation – namely, self-sacrifice – procedural constraints and organizational commitment by expanding the job demands–resources model of organizational commitment to different institutional settings. The study employs a mixed-methods approach that combines quantitative (structural equation modelling) and qualitative (focus groups and in-depth interviews) data from three industries in Italy (health, local public administration and non-profit organizations). Our findings show that self-sacrifice positively moderates the negative relationship between procedural constraints and organizational commitment. The findings also highlight some of the undesirable effects of self-sacrifice that organizations have to deal with. Points for practitioners Selflessly motivated employees tend to be more sensitive to burdensome procedures, and are hence likely to experience tougher effects of such conditions on their commitment. Given the evidence of the public sector being a highly bureaucratic working context, the sources and remedies for this issue deserve attention from both public administration scholars and practitioners. The findings of the study support the development of practices aimed at warding selflessly motivated employees from the risk of entering a loss cycle of psychological impairment.