bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diet-Related Metabolomic Signature of Long-Term Breast Cancer Risk Using Penalized Regression: An Exploratory Study in the SU.VI.MAX Cohort
Authors: Lécuyer Lucie , Dalle Céline , Lefevre-Arbogast Sophie , Micheau Pierre , Lyan Bernard , Rossary Adrien , Demidem Aicha , Petera Mélanie , Lagree Marie , Centeno Delphine , Galan Pilar , Hercberg Serge , Samieri Cecilia , Assi Nada , Ferrari Pietro , Viallon Vivian , Deschasaux Mélanie , Partula Valentin , Srour Bernard , Latino-Martel Paule , Kesse-Guyot Emmanuelle , Druesne-Pecollo Nathalie , Vasson Marie-Paule , Durand Stéphanie , Pujos-Guillot Estelle , Manach Claudine , Touvier Mathilde 
Published: November 2019

Abstract

Background:
Diet has been recognized as a modifiable risk factor for breast cancer. Highlighting predictive diet-related biomarkers would be of great public health relevance to identify at-risk subjects. The aim of this exploratory study was to select diet-related metabolites discriminating women at higher risk of breast cancer using untargeted metabolomics.

Methods:
Baseline plasma samples of 200 incident breast cancer cases and matched controls, from a nested case–control study within the Supplémentation en Vitamines et Minéraux Antioxydants (SU.VI.MAX) cohort, were analyzed by untargeted LC-MS. Diet-related metabolites were identified by partial correlation with dietary exposures, and best predictors of breast cancer risk were then selected by Elastic Net penalized regression. The selection stability was assessed using bootstrap resampling.

Results:
595 ions were selected as candidate diet–related metabolites. Fourteen of them were selected by Elastic Net regression as breast cancer risk discriminant ions. A lower level of piperine (a compound from pepper) and higher levels of acetyltributylcitrate (an alternative plasticizer to phthalates), pregnene-triol sulfate (a steroid sulfate), and 2-amino-4-cyano butanoic acid (a metabolite linked to microbiota metabolism) were observed in plasma from women who subsequently developed breast cancer. This metabolomic signature was related to several dietary exposures such as a “Western” dietary pattern and higher alcohol and coffee intakes.

Conclusions:
Our study suggested a diet-related plasma metabolic signature involving exogenous, steroid metabolites, and microbiota-related compounds associated with long-term breast cancer risk that should be confirmed in large-scale independent studies.

Impact:
These results could help to identify healthy women at higher risk of breast cancer and improve the understanding of nutrition and health relationship.
ВИВЧЕННЯ ДУМКИ ІНОГОРОДНІХ СТУДЕНТІВ ЩОДО ДОСТУПНОСТІ ТА ЯКОСТІ МЕДИЧНОГО ОБСЛУГОВУВАННЯ
Authors: Hupalo I. V. , Bubleiko I.-O. O. , Kopach Ya. M. 
Published: November 2019

Мета: виявити основні проблеми у сфері охорони здоров’я, що стосуються доступності та якості медичного обслуговування іногородніх студентів, пошук методів та способів вирішення цих проблем.
Матеріали і методи. Проведено анонімне соціологічне опитування методом анкетування 100 іногородніх студентів ІІІ–VІ курсів Львівського національного медичного університету імені Данила Галицького.
Результати. Медичне обслуговування іногородніх студентів зумовлює багато проблем: віддають перевагу при погіршенні самопочуття альтернативним варіантам допомоги (поради колег, родичів, знайомих, пошук інформації в мережі «Інтернет»), а не професійній допомозі лікарів; неприязне ставлення з боку медичного персоналу до іногородніх студентів; небажання консультувати їх чи надавати інші види медичної допомоги.
Виявлено, що більшість іногородніх студентів (57,0±5,0) % у разі погіршення самопочуття звертається за медичною допомогою до родичів, (30,0±4,6) % – шукають аналогічні симптоми захворювання в мережі «Інтернет», що призводить до виникнення ускладнень. Більшість (81,0±3,9) % іногородніх студентів підписала декларацію за місцем проживання ще до вступу в навчальний заклад, це може зумовлювати труднощі при отриманні медичної допомоги через віддалене їх розташування. Тільки (42,0±4,9) % опитаних звертаються у лікувально-профілактичні заклади з метою профілактики захворювань, періодичного обстеження, що призводить до виявлення хвороб на пізніх термінах, іноді вже у термінальній стадії. Для удосконалення медичного обслуговування іногородніх студентів необхідно проводити санітарно-просвітню роботу, тижні профілактики найбільш поширених та небезпечних захворювань у навчальних закладах.
СУЧАСНІ ТЕНДЕНЦІЇ, ДЕТЕРМІНАНТИ ТА ПЕРСПЕКТИВИ РОЗВИТКУ МЕДИЧНОГО ТА ЛІКУВАЛЬНО-ОЗДОРОВЧОГО SPA- ТА WELLNESS-ТУРИЗМУ В СВІТІ
Authors: Mochulska O. M. , Shulhai A. H. , Oshlianska O. A. , Bondarchuk V. I. , Zavidnyuk Yu. V. , Chornomydz I. B. , Dobrovolska L. I. , Sverstiuk A. S. 
Published: November 2019

Мета: проаналізувати сучасний стан, основні тенденції та особливості функціонування туристичної інфра­структури, вивчити детермінанти, перспективи розвитку медичного та лікувально-оздоровчого spa- та wellness-туризму в світі.
Матеріали і методи. У дослідженні застосовано бібліосемантичний, структурно-логічний, математично-статистичний та аналітичний методи.
Результати. Медичний і лікувально-оздоровчий spa- та wellness-туризм перебуває на стадії активного швидкого розвитку. Spa- та wellness-відпочинок є складовою частиною життя населення в більшості країн в усьому світі. Клієнт (пацієнт), обравши медичний, лікувально-оздоровчий spa- та wellness-туризм, зможе одночасно відпочити, комплексно обстежитись і лікуватись, омолоджуватись і покращувати свій зовнішній вигляд. Медичний і лікувально-оздоровчий spa- та wellness-туризм має такий великий потенціал, що тепер виділяється у самостійний сегмент туристичного ринку з широким колом інвестиційних можливостей: від масштабних готельних проектів, що прилягають до клінік та розташовані в межах міста, до вже існуючих спеціалізованих комплексів із деякими модифікаціями у структурі послуг.
Висновки. Медичний, лікувально-оздоровчий spa- та wellness-туризм є найперспективнішими видами ту­ризму в світі, які активно розвиваються під впливом низки політичних та економічних чинників, що зумовлені трансформаційними процесами, що відбуваються в світі.
Cost-Related Medication Nonadherence in Adults With Atherosclerotic Cardiovascular Disease in the United States, 2013 to 2017
Authors: Khera Rohan , Valero-Elizondo Javier , Das Sandeep R. , Virani Salim S. , Kash Bita A. , de Lemos James A. , Krumholz Harlan M. , Nasir Khurram 
Published: November 2019

Background:
Medication nonadherence is associated with worse outcomes in patients with atherosclerotic cardiovascular disease (ASCVD), a group who requires long-term therapy for secondary prevention. It is important to understand to what extent drug costs, which are potentially actionable factors, contribute to medication nonadherence.

Methods:
In a nationally representative survey of US adults in the National Health Interview Survey (2013–2017), we identified individuals ≥18 years with a reported history of ASCVD. Participants were considered to have experienced cost-related nonadherence (CRN) if in the preceding 12 months they reported skipping doses to save money, taking less medication to save money, or delaying filling a prescription to save money. We used survey analysis to obtain national estimates.

Results:
Of the 14 279 surveyed individuals with ASCVD, a weighted 12.6% (or 2.2 million [95% CI, 2.1–2.4]) experienced CRN, including 8.6% or 1.5 million missing doses, 8.8% or 1.6 million taking lower than prescribed doses, and 10.5% or 1.9 million intentionally delaying a medication fill to save costs. Age <65 years, female sex, low family income, lack of health insurance, and high comorbidity burden were independently associated with CRN, with >1 in 5 reporting CRN in these subgroups. Survey respondents with CRN compared with those without CRN had 10.8-fold higher odds of requesting low-cost medications and 8.9-fold higher odds of using alternative, nonprescription, therapies.

Conclusions:
One in 8 patients with ASCVD reports nonadherence to medications because of cost. The removal of financial barriers to accessing medications, particularly among vulnerable patient groups, may help improve adherence to essential therapy to reduce ASCVD morbidity and mortality.
A Stochastic Unified Convection Scheme (UNICON). Part I: Formulation and Single-Column Simulation for Shallow Convection
Authors: Shin Jihoon , Park Sungsu 
Published: November 2019

AbstractBy extending the previously developed unified convection scheme (UNICON), we develop a stochastic UNICON with convective updraft plumes at the surface randomly sampled from the correlated multivariate Gaussian distribution for updraft vertical velocity w^ and thermodynamic scalars ϕ^, of which standard deviations and intervariable correlations are derived from the surface-layer similarity theory. The updraft plume radius R^ at the surface follows a power-law distribution with a specified scale break radius. To enhance computational efficiency, we also develop a hybrid stochastic UNICON consisting of n bin plumes and a single stochastic plume, each of which mainly controls the ensemble mean and variance of grid-mean convective tendency, respectively. We evaluated the stochastic UNICON using the large-eddy simulation (LES) of the Barbados Oceanographic and Meteorological Experiment (BOMEX) shallow convection case in a single-column mode. Consistent with the assumptions in the stochastic UNICON, the LES w^ and ϕ^ at the surface follow approximately the half- and full-Gaussian distributions, respectively. LES showed that a substantial portion of the variability in ϕ^ at the cloud base stems from the surface, which also supports the concept of stochastic UNICON that simulates various types of moist convection based on the dry stochastic convection launched from the surface. Overall, stochastic UNICON adequately reproduces the LES grid-mean thermodynamic states as well as the mean and variance of ϕ^, including their dependency on the domain size and R^. A sensitivity test showed that the perturbations of ϕ^ as well as R^ at the surface are important for the correct simulation of the grid-mean thermodynamic states.
Surface Fluxes Modulate the Seasonality of Zonal-Mean Storm Tracks
Authors: Barpanda Pragallva , Shaw Tiffany A. 
Published: November 2019

Abstract
The observed zonal-mean extratropical storm tracks exhibit distinct hemispheric seasonality. Previously, the moist static energy (MSE) framework was used diagnostically to show that shortwave absorption (insolation) dominates seasonality but surface heat fluxes damp seasonality in the Southern Hemisphere (SH) and amplify it in the Northern Hemisphere (NH). Here we establish the causal role of surface fluxes (ocean energy storage) by varying the mixed layer depth d in zonally symmetric 1) slab-ocean aquaplanet simulations with zero ocean energy transport and 2) energy balance model (EBM) simulations. Using a scaling analysis we define a critical mixed layer depth dc and hypothesize 1) large mixed layer depths (d &gt; dc) produce surface heat fluxes that are out of phase with shortwave absorption resulting in small storm track seasonality and 2) small mixed layer depths (d &lt; dc) produce surface heat fluxes that are in phase with shortwave absorption resulting in large storm track seasonality. The aquaplanet simulations confirm the large mixed layer depth hypothesis and yield a useful idealization of the SH storm track. However, the small mixed layer depth hypothesis fails to account for the large contribution of the Ferrel cell and atmospheric storage. The small mixed layer limit does not yield a useful idealization of the NH storm track because the seasonality of the Ferrel cell contribution is opposite to the stationary eddy contribution in the NH. Varying the mixed layer depth in an EBM qualitatively supports the aquaplanet results.
A Hindcast Approach to Diagnosing the Equatorial Pacific Cold Tongue SST Bias in CESM1
Authors: Siongco Angela Cheska , Ma Hsi-Yen , Klein Stephen A. , Xie Shaocheng , Karspeck Alicia R. , Raeder Kevin , Anderson Jeffrey L. 
Published: November 2019

AbstractAn ensemble seasonal hindcast approach is used to investigate the development of the equatorial Pacific Ocean cold sea surface temperature (SST) bias and its characteristic annual cycle in the Community Earth System Model, version 1 (CESM1). In observations, eastern equatorial Pacific SSTs exhibit a warm phase during boreal spring and a cold phase during late boreal summer–autumn. The CESM1 climatology shows a cold bias during both warm and cold phases. In our hindcasts, the cold bias during the cold phase develops in less than 6 months, whereas the cold bias during the warm phase takes longer to emerge. The fast-developing cold-phase cold bias is associated with too-strong vertical advection and easterly wind stress over the eastern equatorial region. The antecedent boreal summer easterly wind anomalies also appear in atmosphere-only simulations, indicating that the errors are intrinsic to the atmosphere component. For the slower-developing warm-phase cold bias, we find that the too-cold SSTs over the equatorial region are associated with a slowly evolving upward displacement of subsurface ocean zonal currents and isotherms that can be traced to the ocean component.
The Impact of Dropsonde and Extra Radiosonde Observations during NAWDEX in Autumn 2016
Authors: Schindler Matthias , Weissmann Martin , Schäfler Andreas , Radnoti Gabor 
Published: November 2019

Abstract
Dropsonde observations from three research aircraft in the North Atlantic region, as well as several hundred additionally launched radiosondes over Canada and Europe, were collected during the international North Atlantic Waveguide and Downstream Impact Experiment (NAWDEX) in autumn 2016. In addition, over 1000 dropsondes were deployed during NOAA’s Sensing Hazards with Operational Unmanned Technology (SHOUT) and Reconnaissance missions in the west Atlantic basin, supplementing the conventional observing network for several intensive observation periods. This unique dataset was assimilated within the framework of cycled data denial experiments for a 1-month period performed with the global model of the ECMWF. Results show a slightly reduced mean forecast error (1%–3%) over the northern Atlantic and Europe by assimilating these additional observations, with the most prominent error reductions being linked to Tropical Storm Karl, Cyclones Matthew and Nicole, and their subsequent interaction with the midlatitude waveguide. The evaluation of Forecast Sensitivity to Observation Impact (FSOI) indicates that the largest impact is due to dropsondes near tropical storms and cyclones, followed by dropsondes over the northern Atlantic and additional Canadian radiosondes. Additional radiosondes over Europe showed a comparatively small beneficial impact.
Functional and Aesthetic Outcomes of Extracorporeal Septoplasty: A Systematic Review and Meta-Analyses
Authors: Bresler Amishav , Povolotskiy Roman , Nguyen Brandon , Zuliani Giancarlo F. , Eloy Jean Anderson , Paskhover Boris , Svider Peter 
Published: November 2019

Objective: The safety and efficacy of extracorporeal septoplasty (ECS) has long been debated. Our objective was to determine this technique’s functional and aesthetic outcomes and complications through a systematic review of the literature. Data Sources: PubMed/MEDLINE, Embase, Cochrane Library, and Web of Science databases were evaluated for studies detailing functional or aesthetic outcomes of ECS. Review Methods: Bias was evaluated using the Cochrane Risk of Bias Tool and the Methodological Index for Non-randomized Studies (MINORS) score. Aesthetic and functional outcomes in addition to complications were evaluated using subjective and objective measures. Meta-analyses were performed when appropriate. Results: Seventeen studies encompassing 1418 patients were included. The average MINORS score for observational studies was 9.2. Overall there was a significant improvement in subjective nasal function with a preoperative average Nasal Obstruction Symptom Evaluation (NOSE) score of 75 (±16) decreasing to 19.5 (±16.5) postoperatively for a mean difference (MD) of −55 (95% confidence interval (CI): –60 to −49.5). In terms of objective nasal function, at 6 months postoperatively, there was an improvement of nasal flow measured by rhinometry ranging from 70 to 71% across studies. Anthropometric measurements were utilized for objective aesthetic outcomes. There was a significant improvement in I-shaped deviations (MD: –2.7°, 95% CI: –5.6 to −0.16) and C-shaped deviations improved by 11.9° (95% CI +2.8-+21.2). Complication rates ranged from 0 to 18%. Conclusion: ECS can achieve significant improvements in the subjective and objective function of the nose. The associated complication rate is low but variable between surgeons.
Modified Arthroscopic Latarjet Procedure: Suture-Button Fixation Achieves Excellent Remodeling at 3-Year Follow-up
Authors: Xu Jian , Liu Haifeng , Lu Wei , Deng Zhenhan , Zhu Weimin , Peng Liangquan , Ouyang Kan , Li Hao , Wang Daping 
Published: November 2019

Background: Some studies have advocated the use of suture-button fixation during the Latarjet procedure to reduce complications associated with screw fixation. However, the sample size of these studies is relatively small, and their follow-up period is short. Purpose: To investigate the efficacy of the suture-button Latarjet procedure with at least 3 years of follow-up and remodeling of the coracoid graft. Study Design: Case series; Level of evidence, 4. Methods: A total of 152 patients who underwent the suture-button Latarjet procedure between February 2013 and February 2016 were selected, and 128 patients who met the inclusion criteria were enrolled in this study. Preoperative and postoperative clinical results were assessed. The position and healing condition of the coracoid graft and arthropathy of the glenoid and humeral head were also assessed using radiography and 3-dimensional computed tomography (CT). Results: The mean follow-up time was 40.3 ± 5.8 months. There were 102 patients included in this study. The mean visual analog scale score for pain during motion, the American Shoulder and Elbow Surgeons score, the Rowe score, and the Walch-Duplay score were improved considerably. A total of 100 grafts achieved bone union. The overall absorption rate was 12.6% ± 4.3%. Graft absorption mostly occurred on the edge and outside the “best-fit” circle of the glenoid. A vertical position was achieved in 98 grafts (96% of all cases) immediately postoperatively, with the mean graft midline center at the 4 o’clock position. In the axial view, CT showed that 89 grafts were flush to the glenoid, whereas 2 and 11 grafts were fixed medially and laterally, respectively. In all cases, the bone graft and glenoid tended to extend toward each other to form concentric circles during the remodeling process. During follow-up observations, the height of the 11 grafts that were positioned laterally (ie, above the glenoid level) exhibited a wave-curved change. No arthropathy was observed in any patient. Conclusion: Patient outcomes were satisfactory after the modified arthroscopic suture-button Latarjet technique. Graft absorption mostly occurred on the edge and outside the “best-fit” circle of the glenoid. The graft exhibited the phenomenon of ectatic growing when it fused with the glenoid and finally remodeled to a new concentric circle with the humeral head analogous to the original glenoid. Grafts positioned laterally did not cause arthropathy of the joints within the period of the study.
Managing Opioids, Including Misuse and Addiction, in Patients With Serious Illness in Ambulatory Palliative Care: A Qualitative Study
Authors: Merlin Jessica S. , Young Sarah R. , Arnold Robert , Bulls Hailey W. , Childers Julie , Gauthier Lynn , Giannitrapani Karleen F. , Kavalieratos Dio , Schenker Yael , Wilson J. Deanna , Liebschutz Jane M. 
Published: November 2019

Background: Pain and opioid management are core ambulatory palliative care skills. Existing literature on how to manage opioid misuse/use disorder excludes patients found in palliative care settings, such as individuals with serious illness or those at the end of life. Objectives: We conducted an exploratory study to: (1) Identify the challenges palliative care clinicians face when prescribing opioids in ambulatory settings and (2) explore factors that affect opioid decision-making. Methods: We recruited palliative care clinicians who prescribe opioids in ambulatory settings, which included open-ended questions and was conducted online. Results were analyzed qualitatively using a content analysis-based approach. Results: Eighty-three palliative care clinicians (mostly MDs/DOs) participated. Challenges faced when prescribing opioids included clinician differences in approach to care (eg, transitioning from another clinician with more permissive opioid prescribing), medication access (eg, inadequate pharmacy supply), resource constraints (eg, access to mental health and addiction expertise), managing problems outside the typical palliative care scope (eg addiction). Participants also discussed factors that influenced their opioid prescribing decisions, such as opioid-related harms and risks that they need to weigh; they also spoke about the necessity of considering other factors like the patient’s environment, disease, treatment, and prognosis. Conclusion: This study highlights the challenge of opioid management in patients with serious illness, particularly when misuse or substance use disorder is present, and suggests areas for future research focus. Our next step will be to establish consensus on approaches to opioid prescribing decision-making and policy in seriously ill patients presenting to ambulatory palliative care.
Venous thrombosis at altitude presents with distinct biochemical profiles: a comparative study from the Himalayas to the plains
Authors: Prabhakar Amit , Chatterjee Tathagata , Bajaj Nitin , Tyagi Tarun , Sahu Anita , Gupta Neha , Kumari Babita , Nair Velu , Kumar Bhuvnesh , Ashraf Mohammad Zahid 
Published: November 2019

Key PointsHA exposure alters hemostatic systems and contributes to the onset of VTE at a younger age. Aggravated disruption of coagulation, platelet, and endothelial function differentiates HA-induced VTE from VTE on the plains.
Mixed-gas CH4/CO2/CO detection based on linear variable optical filter and thermopile detector array
Authors: Zhang Shaoda , Bin Wu , Xu Binbin , Zheng Xingyu , Chen Binbin , Lv Xueqin , San Haisheng , Hofmann Werner 
Published: November 2019

AbstractThis paper presents the design, fabrication, and characterization of a middle-infrared (MIR) linear variable optical filter (LVOF) and thermopile detectors that will be used in a miniaturized mixed gas detector for CH4/CO2/CO measurement. The LVOF was designed as a tapered-cavity Fabry-Pérot optical filter, which can transform the MIR continuous spectrum into multiple narrow band-pass spectra with peak wavelength in linear variation. Multi-layer dielectric structures were used to fabricate the Bragg reflectors on the both sides of tapered cavity as well as the antireflective film combined with the function of out-of-band rejection. The uncooled thermopile detectors were designed and fabricated as a multiple-thermocouple suspension structure using micro-electro-mechanical system technology. Experimentally, the LVOF exhibits a mean full-width-at-half-maximum of 400 nm and mean peak transmittance of 70% at the wavelength range of 2.3~5 μm. The thermopile detectors exhibit a responsivity of 146 μV/°C at the condition of room temperature. It is demonstrated that the detectors can achieve the quantification and identification of CH4/CO2/CO mixed gas.