bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Investigation of Large Cross-Track Errors in North Atlantic Tropical Cyclones in the GEFS and ECMWF Ensembles
Authors: Leonardo Nicholas M. , Colle Brian A. 
Published: November 2020

AbstractThe largest medium-range (72–120 h) cross-track errors (CTE) of tropical cyclone (TC) forecasts from the Global Ensemble Forecast System (GEFS) over the northern Atlantic Ocean are examined for the 2008–16 seasons. The 38 unique forecasts within the upper quartile of most negative CTEs (i.e., left-of-track bias larger than 250 km by 72 h) do not have a clear common source of steering error, although 12 of the forecasts involve the underprediction of a weak upper-level trough to the west of the TC by 36 h. Meanwhile, at least 18 of the 36 most positive CTEs (right-of-track bias) are associated with TCs embedded in the southwest extent of a subtropical ridge, the strength of which is increasingly underpredicted during the first 24 h of the forecast. Excessive height falls north of the TC are driven by overpredicted divergence aloft, which corresponds to overpredicted TC outer-core convection. The convection is triggered by a 5%–20% overprediction of near-TC moisture and instability in the initial conditions. Weather Research and Forecasting (WRF) Model simulations are run at 36-, 12-, and 4-km grid spacing for select right-of-track cases, using the GEFS for initial and lateral boundary conditions. The 36-km WRF reproduces the same growth of errors as the GEFS because of, in part, sharing the same stability and moisture errors in the initial conditions. Changes in the convective parameterization affect how quickly these errors grow by affecting how much convection spins up. The addition of a 4-km nest with no convective parameterization causes the errors to grow ~20% faster, resulting in an even larger right-of-track error.
Subseasonal Prediction of Wintertime Northern Hemisphere Extratropical Cyclone Activity by SubX and S2S Models
Authors: Zheng Cheng , Kar-Man Chang Edmund , Kim Hyemi , Zhang Minghua , Wang Wanqiu 
Published: November 2020

AbstractThe prediction of wintertime extratropical cyclone activity (ECA) on subseasonal time scales by models participating in the Subseasonal Experiment (SubX) and the Seasonal to Subseasonal Prediction (S2S) is assessed. Consistent with a previous study that investigated the S2S models, the SubX models have skillful predictions of ECA over regions from central North Pacific across North America to western North Atlantic, as well as East Asia and northern and southern part of eastern North Atlantic at 3–4 weeks lead time. SubX provides daily mean data, while S2S provides instantaneous data at 0000 UTC each day. This leads to different variance of ECA. Different S2S and SubX models have different reforecast initialization times and reforecast time periods. These factors can all lead to differences in prediction skill. To fairly compare the prediction skill between different models, we develop a novel way to evaluate the prediction of individual model across the two ensembles by comparing every model to the Climate Forecast System, version 2 (CFSv2), as CFSv2 has 6-hourly output and forecasts initialized every day. Among the S2S and SubX models, the European Centre for Medium-Range Weather Forecasts model exhibits the best prediction skill, followed by CFSv2. Our results also suggest that while the prediction skill is sensitive to forecast lead time, including forecasts up to 4 days old into the ensemble may still be useful for weeks 3–4 predictions of ECA.
A Community Pediatric Camp Escape Room: An Interactive Approach to Applying Real-Life Critical Thinking Skills
Authors: Spears Syretta , Díaz Gabriel M. , Diaz Desiree A. 
Published: November 2020

Background. Escape rooms have been utilized to incorporate teamwork, communication, policy, and procedures reinforcement, as well as clinical care. Often themed, escape rooms challenge a team of players to discover clues and sequentially solve puzzles with the ultimate task of accomplishing a specific goal in a limited time frame, fostering critical thinking. Method. This learning activity incorporates legal implications for prelicensure nursing students in a pediatric community summer camp/after school care environment. Care and legal implications for a minor experiencing respiratory distress was the premise of this escape room. Outcomes. While this was not a research study, surveys were distributed for quality improvement and a deeper needs assessment related to the content and delivery of an escape room. Learners discussed the positive aspects of this activity through journal entries and a survey, noting the need for increased content related to legal implications for the medical team. This room engaged the learner in the forward-thinking that is needed related to emergency care, Good Samaritan Act, liability for cost, and permission to treat in a time-pressured environment. Future Plans. Testing the knowledge pre-post survey related to legal implications with implied care will be explored.
Macitentan in infants and children with pulmonary hypertensive vascular disease. Feasibility, tolerability and practical issues – a single‐centre experience
Authors: Albinni Sulaima , Pavo Imre , Kitzmueller Erwin , Michel‐Behnke Ina 
Published: November 2020

Macitentan is a safe and effective substance for treatment of adults with pulmonary arterial hypertension. Data on its use in paediatric patients are limited. In this single‐centre prospective study, we report on our experience with macitentan in children focusing on applicability and practical aspects. Between December 2014 and July 2018, macitentan was introduced to paediatric patients according to a dosing protocol adjusted to body weight. Blood pressure, heart rate, saturation and clinical symptoms were recorded daily during introduction. Liver function parameters and haemoglobin levels were measured at baseline, four weeks and three months after initiation and after one year of treatment. Twenty‐four patients (14 male, 10 female) were enrolled for treatment with macitentan. The mean age was 10.7 ± 7.6 years (range: 0.1 year–23 years). Fifteen out of 24 patients were World Health Organization functional class (FC) II, 7 patients in FC III and 2 patients in FC IV. Twenty out of 24 patients (83%) received additional advanced therapy with sildenafil and/or prostacyclines. We had two early discontinuations because of clinical relevant oedema. In the remaining 22 patients, macitentan was well tolerated. Liver function parameters and blood count levels remained stable during the observational time. The introduction of macitentan was feasible and mostly well tolerated in paediatric patients. Special attention should be paid to oedema during introduction of the drug. To the best of our knowledge, this is the first study to report on its applicability in infants and children. However, larger prospective trials are warranted to verify these preliminary findings.
Adaptive T-cell immunity controls senescence-prone MyD88- or CARD11-mutant B-cell lymphomas
Authors: Reimann Maurice , Schrezenmeier Jens , Richter-Pechanska Paulina , Dolnik Anna , Hick Timon Pablo , Schleich Kolja , Cai Xiurong , Fan Dorothy N. Y. , Lohneis Philipp , Maßwig Sven , Denker Sophy , Busse Antonia , Knittel Gero , Flümann Ruth , Childs Dorothee , Childs Liam , Gätjens-Sanchez Ana-Maria , Bullinger Lars , Rosenwald Andreas , Reinhardt Hans Christian , Schmitt Clemens A. 
Published: November 2020

Abstract
Aberrant B-cell receptor/NF-κB signaling is a hallmark feature of B-cell non-Hodgkin lymphomas, especially in diffuse large B-cell lymphoma (DLBCL). Recurrent mutations in this cascade, for example, in CD79B, CARD11, or NFKBIZ, and also in the Toll-like receptor pathway transducer MyD88, all deregulate NF-κB, but their differential impact on lymphoma development and biology remains to be determined. Here, we functionally investigate primary mouse lymphomas that formed in recipient mice of Eµ-myc transgenic hematopoietic stem cells stably transduced with naturally occurring NF-κB mutants. Although most mutants supported Myc-driven lymphoma formation through repressed apoptosis, CARD11- or MyD88-mutant lymphoma cells selectively presented with a macrophage-activating secretion profile, which, in turn, strongly enforced transforming growth factor β (TGF-β)-mediated senescence in the lymphoma cell compartment. However, MyD88- or CARD11-mutant Eµ-myc lymphomas exhibited high-level expression of the immune-checkpoint mediator programmed cell death ligand 1 (PD-L1), thus preventing their efficient clearance by adaptive host immunity. Conversely, these mutant-specific dependencies were therapeutically exploitable by anti–programmed cell death 1 checkpoint blockade, leading to direct T-cell–mediated lysis of predominantly but not exclusively senescent lymphoma cells. Importantly, mouse-based mutant MyD88- and CARD11-derived signatures marked DLBCL subgroups exhibiting mirroring phenotypes with respect to the triad of senescence induction, macrophage attraction, and evasion of cytotoxic T-cell immunity. Complementing genomic subclassification approaches, our functional, cross-species investigation unveils pathogenic principles and therapeutic vulnerabilities applicable to and testable in human DLBCL subsets that may inform future personalized treatment strategies.
How to manage CML patients with comorbidities
Authors: Cortes Jorge 
Published: November 2020

Abstract
Patients with chronic myeloid leukemia (CML) often have comorbidities, at an incidence that might be higher than in the general population. Because of the favorable outcome of most patients with CML treated with tyrosine kinase inhibitors (TKIs), a greater number of comorbidities might be the most significant adverse feature for long-term survival. The presence of comorbidities may also affect the risk of developing adverse events with TKIs. This effect is perhaps best exemplified by the risk of developing arterio-occlusive events, which is greatest for patients who have other risk factors for such events, with the risk increasing with higher numbers of comorbidities. The coexistence of comorbidities in patients with CML not only may affect TKI selection but also demands close monitoring of the overall health condition of the patient to optimize safety and provide the opportunity for an optimal outcome to such patients. With optimal, holistic management of leukemia and all other conditions afflicting them, patients with CML and comorbidities may aim for a near-normal life expectancy, just as the more select patients enrolled in clinical trials now enjoy.
Increased B4GALT1 expression is associated with platelet surface galactosylation and thrombopoietin plasma levels in MPNs
Authors: Di Buduo Christian A. , Giannini Silvia , Abbonante Vittorio , Rosti Vittorio , Hoffmeister Karin M. , Balduini Alessandra 
Published: November 2020

Abstract
Aberrant megakaryopoiesis is a hallmark of the myeloproliferative neoplasms (MPNs), a group of clonal hematological malignancies originating from hematopoietic stem cells, leading to an increase in mature blood cells in the peripheral blood. Sialylated derivatives of the glycan structure β4-N-acetyllactosamine (Galβ1,4GlcNAc or type-2 LacNAc, hereafter referred to as LacNAc) regulate platelet life span, hepatic thrombopoietin (TPO) production, and thrombopoiesis. We found increased TPO plasma levels in MPNs with high allele burden of the mutated clones. Remarkably, platelets isolated from MPNs had a significant increase in LacNAc expression that correlated with the high allele burden regardless of the underlying identified mutation. Megakaryocytes derived in vitro from these patients showed an increased expression of the B4GALT1 gene encoding β-1,4-galactosyltransferase 1 (β4GalT1). Consistently, megakaryocytes from MPN showed increased LacNAc expression relative to healthy controls, which was counteracted by the treatment with a Janus kinase 1/2 inhibitor. Altered expression of B4GALT1 in mutant megakaryocytes can lead to the production of platelets with aberrant galactosylation, which in turn promote hepatic TPO synthesis regardless of platelet mass. Our findings provide a new paradigm for understanding aberrant megakaryopoiesis in MPNs and identify β4GalT1 as a potential actionable target for therapy.
Persistent challenges with treating multiple myeloma early
Authors: Goodman Aaron M. , Kim Myung S. , Prasad Vinay 
Published: November 2020

Abstract
Over the past decade, 2 strategies have advanced the treatment of patients with multiple myeloma and its precursor diseases. First, the definition has changed to include patients without end organ damage, who previously would not have been treated. Second, there is widespread enthusiasm for treating high-risk, smoldering multiple myeloma. In this commentary, we explore the evidence supporting these therapeutic expansions. Although early treatment adds cost and therapeutic burden, it remains unknown whether survival and health-related quality of life are improved by early treatment. Herein, we consider the implications of diagnostic expansion in multiple myeloma.
Sulfated vizantin causes detachment of biofilms composed mainly of the genus Streptococcus without affecting bacterial growth and viability
Authors: Hasegawa Taisuke , Takenaka Shoji , Oda Masataka , Domon Hisanori , Hiyoshi Takumi , Sasagawa Karin , Ohsumi Tatsuya , Hayashi Naoki , Okamoto Yasuko , Yamamoto Hirofumi , Ohshima Hayato , Terao Yutaka , Noiri Yuichiro 
Published: November 2020

Abstract
Background
Sulfated vizantin, a recently developed immunostimulant, has also been found to exert antibiofilm properties. It acts not as a bactericide, but as a detachment-promoting agent by reducing the biofilm structural stability. This study aimed to investigate the mechanism underlying this activity and its species specificity using two distinct ex vivo oral biofilm models derived from human saliva.

Results
The biofilm, composed mainly of the genus Streptococcus and containing 50 μM of sulfated vizantin, detached significantly from its basal surface with rotation at 500 rpm for only 15 s, even when 0.2% sucrose was supplied. Expression analyses for genes associated with biofilm formation and bacterial adhesion following identification of the Streptococcus species, revealed that a variety of Streptococcus species in a cariogenic biofilm showed downregulation of genes encoding glucosyltransferases involved in the biosynthesis of water-soluble glucan. The expression of some genes encoding surface proteins was also downregulated. Of the two quorum sensing systems involved in the genus Streptococcus, the expression of luxS in three species, Streptococcus oralis, Streptococcus gordonii, and Streptococcus mutans, was significantly downregulated in the presence of 50 μM sulfated vizantin. Biofilm detachment may be facilitated by the reduced structural stability due to these modulations. As a non-specific reaction, 50 μM sulfated vizantin decreased cell surface hydrophobicity by binding to the cell surface, resulting in reduced bacterial adherence.

Conclusion
Sulfated vizantin may be a candidate for a new antibiofilm strategy targeting the biofilm matrix while preserving the resident microflora.
Poor cardiovascular health status among Chinese women
Authors: Han Tian-Wen , Liu Yu-Qi , Dong Wei , Bai Xiao-Juan , Liu Yu-Yang , Su Xi , Li Yu-Ming , Qian Ju-Ying , Xiang Mei-Xiang , Cai Lin , Lin Qian , Hou Jing-Bo , Yang Jie , Li Dan-Dan , Yang Huan-Wan , Zhou Shan-Shan , Wang Jing , Tian Feng , Zhao Xue-Qiao , Chen Yun-Dai 
Published: November 2020

AbstractBackgroundSystematic investigation and analysis of cardiovascular health status (CVHS) of Chinese women is rare. This study aimed to assess CVHS and atherosclerotic cardiovascular disease (ASCVD) burden in the Chinese women physicians (CWP) and community-based non-physician cohort (NPC).MethodsIn this prospective, multicenter, observational study, CVHS using the American Heart Association (AHA) defined 7 metrics (such as smoking and fasting glucose) and ASCVD risk factors including hypertension, hyperlipidemia and type-2 diabetes were evaluated in CWP compared with NPC.ResultsOf 5832 CWP with a mean age of 44 ± 7 years, only 1.2% achieved the ideal CVHS and 90.1% showed at least 1 of the 7 AHA CVHS metrics at a poor level. Total CVHS score was significantly decreased and ASCVD risk burden was increased in postmenopausal subjects in CWP although ideal CVHS was not significantly influenced by menopause. Compared to 2596 NPC, fewer CWP had ≥ 2 risk factors (8% vs. 27%,P < 0.001); CWP scored significantly higher on healthy factors, a composite of total cholesterol, blood pressure, fasting glucose (P < 0.001), but, poorly on healthy behaviors (P < 0.001), specifically in the physical activity component; CWP also showed significantly higher levels of awareness and rates of treatment for hypertension and hyperlipidemia, but, not for type-2 diabetes.ConclusionChinese women’s cardiovascular health is far from ideal and risk intervention is sub-optimal. Women physicians had lower ASCVD burden, scored higher in healthy factors, but, took part in less physical activity than the non-physician cohort. These results call for population-specific early and improved risk intervention.
GERO Cohort Protocol, Chile, 2017–2022: Community-based Cohort of Functional Decline in Subjective Cognitive Complaint elderly
Authors: Slachevsky Andrea , Zitko Pedro , Martínez-Pernía David , Forno Gonzalo , Court Felipe A. , Lillo Patricia , Villagra Roque , Duran-Aniotz Claudia , Parrao Teresa , Assar Rodrigo , Orellana Paulina , Toledo Carolina , Rivera Rodrigo , Ibañez Agustín , Parra Mario A. , González-Billault Christian , Amieva Helena , Thumala Daniela 
Published: November 2020

AbstractBackgroundWith the global population aging and life expectancy increasing, dementia has turned a priority in the health care system. In Chile, dementia is one of the most important causes of disability in the elderly and the most rapidly growing cause of death in the last 20 years. Cognitive complaint is considered a predictor for cognitive and functional decline, incident mild cognitive impairment, and incident dementia. The GERO cohort is the Chilean core clinical project of the Geroscience Center for Brain Health and Metabolism (GERO). The objective of the GERO cohort is to analyze the rate of functional decline and progression to clinical dementia and their associated risk factors in a community-dwelling elderly with subjective cognitive complaint, through a population-based study. We also aim to undertake clinical research on brain ageing and dementia disorders, to create data and biobanks with the appropriate infrastructure to conduct other studies and facilitate to the national and international scientific community access to the data and samples for research.MethodsThe GERO cohort aims the recruitment of 300 elderly subjects (> 70 years) from Santiago (Chile), following them up for at least 3 years. Eligible people are adults not diagnosed with dementia with subjective cognitive complaint, which are reported either by the participant, a proxy or both. Participants are identified through a household census. The protocol for evaluation is based on a multidimensional approach including socio-demographic, biomedical, psychosocial, neuropsychological, neuropsychiatric and motor assessments. Neuroimaging, blood and stool samples are also obtained. This multidimensional evaluation is carried out in a baseline and 2 follow-ups assessments, at 18 and 36 months. In addition, in months 6, 12, 24, and 30, a telephone interview is performed in order to keep contact with the participants and to assess general well-being.DiscussionOur work will allow us to determine multidimensional risks factors associated with functional decline and conversion to dementia in elderly with subjective cognitive complain. The aim of our GERO group is to establish the capacity to foster cutting edge and multidisciplinary research on aging in Chile including basic and clinical research.Trial registrationNCT04265482in ClinicalTrials.gov. Registration Date: February 11, 2020. Retrospectively Registered.
Age and education as factors associated with medication literacy: a community pharmacy perspective
Authors: Plaza-Zamora Javier , Legaz Isabel , Osuna Eduardo , Pérez-Cárceles María D. 
Published: November 2020

Abstract
Background
Aging implies a higher prevalence of chronic pathologies and a corresponding increase in medication. The correct adherence and use of the medication are prerequisites for reducing risks of disease progression, comorbidity, and mortality. Medication literacy (ML) is the specific ability to safely access and understand the information available concerning medication, and to act accordingly. Currently, there are few specific instruments that ascertain the extent of ML in the general population. The aim of this work was to analyse ML in a large cohort of pharmacy customers.

Methods
A total of 400 community pharmacy clients were analyzed to assess the level of ML (documental and numeracy) through the validated MedLitRxSE tool.

Results
The results showed that out of a total of 400 community pharmacy clients only 136 (34%) had an adequate degree of ML, while the rest of the clients (n = 264; 66%) were adjudged not to have this ability. Statistically significant differences were found between the different age groups in terms of ML (P < 0.001; OR = 0.312; 95% CI: 0.195–0.499), the 51–65 and >65-year age groups having a lower frequency of adequate ML (23.5 and 7.1%, respectively) than the rest of the age groups. A statistically significant increase in adequate ML was observed as the academic level of the clients increased (P < 0.001; OR = 15.403; 95% CI: 8.109–29.257). Multivariate logistic regression confirmed the influence of both variables on ML.

Conclusions
An inadequate ML level was found in community pharmacy clients over the age of 51, and also in those with primary or non-formal studies. Our data add to our knowledge about ML, and should pharmacists and other health professionals to adopt new strategies to prevent, or at least reduce, errors in taking medicines, thus avoiding the undesirable effects of any misuse.