bluuebunny/crossref_metadata_2025_split huggingface dataset:
Projected Changes in Snow Water Equivalent over the Tibetan Plateau under Global Warming of 1.5° and 2°C
Authors: You Qinglong , Wu Fangying , Wang Hongguo , Jiang Zhihong , Pepin Nick , Kang Shichang 
Published: March 2020

AbstractSnow water equivalent (SWE) is a critical parameter for characterizing snowpack, which has a direct influence on the hydrological cycle, especially over high terrain. In this study, SWE from 18 coupled model simulations from phase 5 of the Coupled Model Intercomparison Project (CMIP5) is validated against the Canadian Sea Ice and Snow Evolution Network (CanSISE) SWE. The model simulations under RCP8.5 and RCP4.5 are employed to investigate projected changes in spring/winter SWE over the Tibetan Plateau (TP) under global warming of 1.5° and 2°C. Most CMIP5 models overestimate the CanSISE SWE. A decrease in mean spring/winter SWE for both RCPs over most regions of the TP is predicted in the future, with most significant reductions over the western TP, consistent with pronounced warming in that region. This is supported by strong positive correlations between SWE and mean temperature in the future in both seasons. Compared with the preindustrial period, spring/winter SWE over the TP under global warming of 1.5° and 2°C will reduce significantly, at faster rates than over China as a whole and the Northern Hemisphere. SWE changes over the TP do not show a simple elevation dependency under global warming of 1.5° and 2°C, with maximum changes in the elevation band of 4000–4500 m. Moreover, there are also strong positive correlations between projected SWE and historical mean SWE, indicating that the initial conditions of SWE are an important parameter of future SWE under specific global warming scenarios.
Quantifying the Radiative Impact of Clouds on Tropopause Layer Cooling in Tropical Cyclones
Authors: Rivoire Louis , Birner Thomas , Knaff John A. , Tourville Natalie 
Published: March 2020

AbstractA ubiquitous cold signal near the tropopause, here called “tropopause layer cooling” (TLC), has been documented in deep convective regions such as tropical cyclones (TCs). Temperature retrievals from the Constellation Observing System for Meteorology, Ionosphere, and Climate (COSMIC) reveal cooling of order 0.1–1 K day−1on spatial scales of order 1000 km above TCs. Data from the Cloud Profiling Radar (onboardCloudSat) and from the Cloud–Aerosol Lidar with Orthogonal Polarization [onboard theCloud–Aerosol Lidar and Infrared Pathfinder Satellite Observations(CALIPSO)] are used to analyze cloud distributions associated with TCs. Evidence is found that convective clouds within TCs reach the upper part of the tropical tropopause layer (TTL) more frequently than do convective clouds outside TCs, raising the possibility that convective clouds within TCs and associated cirrus clouds modulate TLC. The contribution of clouds to radiative heating rates is then quantified using theCloudSatandCALIPSOdatasets: in the lower TTL (below the tropopause), clouds produce longwave cooling of order 0.1–1 K day−1inside the TC main convective region, and longwave warming of order 0.01–0.1 K day−1outside; in the upper TTL (near and above the tropopause), clouds produce longwave cooling of the same order as TLC inside the TC main convective region, and up to one order of magnitude smaller outside. Considering that clouds also produce shortwave warming, it is suggested that cloud radiative effects inside and outside TCs only explain modest amounts of TLC while other processes must provide the remaining cooling.
The standardised cancer booklet and beyond: Patient perspectives on patient education for breast cancer care
Authors: Choudhury Romita , Pujadas-Botey Anna , Wheeler Laura , Marlett Nancy , Estey Angela 
Published: March 2020

Objective: This qualitative study engaged with breast cancer patients to create a standardised cancer education booklet. This paper identifies lessons from that engagement process, showing how patients experienced their cancer education and how they were able to ensure their concerns and priorities were included in the standardised patient education booklet. Method: In semi-structured focus groups and interviews, patients reviewed the print materials they had received and a draft standardised booklet. Discussions were then analysed thematically through comparison and interpretive coding. Results: Patient education needs to provide key information on breast cancer and its treatment while also providing the kind of educational support that can strengthen patient capacity to take decisions, feel a sense of control, and move through the journey with optimism and courage. Conclusion: Patient education, including standardised materials, can reflect patient autonomy and empowerment if patients are engaged in developing educational materials in a broad, inclusive and sustained way.
Comparison of methods between CT perfusion source images and CT angiography in collateral flow assessment
Authors: Yang Lumeng , Ling Yifeng , Wu Fei , Cheng Xin , Dong Qiang , Cao Wenjie 
Published: March 2020

Background The methods used for grading leptomeningeal collateral flow (LMF) on single-phase computed tomography angiography (CTA) are heterogeneous and limited by temporal resolution. Purpose To compare the reliability of relative filling time delay (rFTD) on CT perfusion source images (CTP-SI) and the currently used single-phase CTA collateral assessment methods and evaluate their ability to predict clinical outcomes in acute ischemic stroke patients. Material and Methods We analyzed consecutive middle cerebral artery or internal carotid artery occlusion patients who received multimodal CT before treatment and within 12 h of stroke symptom onset from October 2015 to December 2018. Patients were dichotomized using the 90-day mRS into good (0–1) versus adverse (2–6) outcomes. CTP-SI was used to identify the rFTD score. CTA images were reconstructed to assess collateral status using the collateral score (Cs) and region leptomeningeal collateral score (rLMCs). Two observers independently assessed images. Results The baseline characteristics (n = 54) were median age of 67 years and 68.5% of the participants were men. The baseline median NIHSS was 14. Good clinical outcomes were observed in 19 (35.2%) patients. The k value was higher for rFTDs ( k = 0.779, P < 0.001) than Cs ( k = 0.666, P < 0.001) and rLMCs ( k = 0.763, P < 0.001). Higher rFTDs were correlated with lower rLMCs (Spearman’s rho –0.68, P < 0.001) and Cs (rho –0.66, P < 0.001). In multivariate logistic regression, rFTD was associated with functional outcomes ( P = 0.044). Conclusion The rFTDs method is comparable to single-phase CTA-based assessments in assessing LMFs in acute ischemic stroke patients. Higher rFTDs is independently associated with adverse long-term functional outcomes.
Side of contrast injection and breast size correlate with motion artifacts grade and image quality on breast MRI
Authors: Carbonaro Luca A , Schiaffino Simone , Clauser Paola , Tomkova Ludmila , Iodice Maria , Zuiani Chiara , Sardanelli Francesco 
Published: March 2020

Background Motion is a relevant cause of artifacts in breast magnetic resonance imaging (MRI), potentially degrading image quality, even with optimized protocols. Purpose To investigate the causes of motion artifacts (MA) impacting on image quality (IQ) of contrast-enhanced breast MRI. Material and Methods Retrospective two-center study on consecutive 1.5-T contrast-enhanced breast MRI, independently reviewed by two radiologists on first subtracted and maximum intensity projection images to define the side most affected by MA. IQ was scored as 1 (optimal), 2 (reduced, but without reduction of diagnostic power), or 3 (reduced, with reduced diagnostic power). Correlations with injection side, breast size (A/B vs. C/D cups), patient age, clinical indication, and MRI scanner/protocol were assessed using χ2 and Fisher’s exact statistics. Results In total, 237 examinations were included, with right injection performed in 124 (52%) and left in 113 (48%). MA were more frequent on the side ipsilateral to the injection (144/237, 61%, 95% confidence interval [CI] 54–67%) than on the contralateral (93/237, 95% CI 33–46%) ( P < 0.001); IQ was scored 1 in 154/237 (65%), 2 in 63/237 (27%), and 3 in 20/237 (8%) examinations; patients with A/B cups showed higher IQ score than patients with C/D cups (scores 1, 2, and 3: 54% vs. 70%; 29% vs. 25%; 17% vs. 5%, respectively, P = 0.002). No significant correlations were found for MA ( P≥0.106) or IQ ( P ≥ 0.318) between ipsi- or contralateral injection and right/left injection, breast size, age, indication, or scanner/protocol. Conclusion MA were more frequent in breasts ipsilateral to contrast injection and showed a reduced IQ for small breasts.
Trajectories of Symbol Digit Modalities Test performance in individuals with multiple sclerosis
Authors: Healy Brian C , Barker Lindsay , Bakshi Rohit , Benedict Ralph H B , Gonzalez Cindy T , Chitnis Tanuja , Weiner Howard L , Glanz Bonnie I 
Published: March 2020

Background: Although cognitive problems have been identified in people with multiple sclerosis (PwMS), few studies have investigated the long-term change in cognitive functioning. Objective: To identify trajectories of change in cognitive functioning for PwMS. Methods: Participants enrolled in the quality-of-life subgroup from the Comprehensive Longitudinal Investigation of Multiple Sclerosis at Brigham and Women’s Hospital (CLIMB) were eligible for our analysis. In 2006, participants in this group began to complete the Symbol Digit Modalities Test (SDMT) annually. Latent trajectory models were used to identify groups of participants with similar longitudinal change in SDMT scores. Linear and quadratic trajectory models were fit, and the models were compared. Latent trajectory models were also fit adjusting for baseline age and disease duration as well as using normalized SDMT scores. The groups identified across the approaches were compared. Results: We found that classes with higher-than-average baseline values improved, classes with average baseline values remained relatively constant, and classes with lower baseline values experienced cognitive worsening. Similar results were observed in the alternative latent trajectory models accounting for other variables. Conclusion: Our models show that subjects with higher SDMT scores at baseline showed improvement, while subjects with lower SDMT scores at baseline showed worsening. Baseline age and disease duration were also associated with SDMT performance.
Numerical Investigation on Fracture Initiation Properties of Interface Crack in Dissimilar Steel Welded Joints
Authors: Zhao Longfei , Shao Chendong , Takashima Yasuhito , Minami Fumiyoshi , Lu Fenggui 
Published: March 2020

AbstractFracture toughness property is of significant importance when evaluating structural safety. The current research of fracture toughness mainly focused on crack in homogeneous material and experimental results. When the crack is located in a welded joint with high-gradient microstructure and mechanical property distribution, it becomes difficult to evaluate the fracture toughness behavior since the stress distribution may be affected by various factors. In recent years, numerical method has become an ideal approach to reveal the essence and mechanism of fracture toughness behavior. This study focuses on the crack initiation behavior and driving force at different interfaces in dissimilar steel welded joints. The stress and strain fields around the crack tip lying at the interfaces of ductile-ductile, ductile-brittle and brittle-brittle materials are analyzed by the numerical simulation. For the interface of ductile-ductile materials, the strain concentration on the softer material side is responsible for ductile fracture initiation. For the ductile-brittle interface, the shielding effect of the ductile material plays an important role in decreasing the fracture driving force on the brittle material side. In the case of brittle-brittle interface, a careful matching is required, because the strength mismatch decreases the fracture driving force in one side, whereas the driving force in another side is increased. The results are deemed to offer support for the safety assessment of welded structures.
Endogenous endophthalmitis caused by group B streptococcus; case reports and review of 35 reported cases
Authors: Yoshida Masaaki , Yokokura Shunji , Nishida Takashi , Mochizuki Kiyofumi , Suzuki Takashi , Maruyama Kazuichi , Otomo Takaaki , Nishiguchi Koji M. , Kunikata Hiroshi , Nakazawa Toru 
Published: March 2020

AbstractBackgroundGroup B streptococcus (GBS), a gram-positive coccus that occasionally causes neonatal sepsis or invasive infection in the elderly, has been considered a rare cause of endogenous bacterial endophthalmitis (EBE). However, the number of invasive GBS infections is increasing, particularly in elderly patients with underlying conditions such as diabetes mellitus (DM), cardiovascular disease and cancer. We report 6 cases of EBE caused by GBS and review the literature.MethodsRetrospective case series and literature review.ResultsIn the current case series, 6 eyes of 6 patients developed EBE caused by GBS. The average age was 73.5 years. The focus of infection included the urinary tract, cellulitis, arthritis, peritonitis, catheter-associated infection and endocarditis. Four patients had DM. While all 6 strains were sensitive to β-lactams (penicillins and cephems), 4 strains were resistant to levofloxacin (no data for 1 isolate). Each case was treated with the systemic antibiotic to which the individual strain was sensitive. All cases showed poor visual acuity at presentation (decimal visual acuity: less than 0.03). Vitrectomy with intravitreal antibiotics injection was performed in 4 cases. Visual acuity recovered in 4 cases and did not recover in 2 cases, even after vitrectomy. The literature review of 53 eyes of 41 patients revealed that 60% of eyes finally lost all vision, and death occurred in 2 cases. Initial visual acuity of less than counting fingers was associated with a final outcome of lost vision. Of 41 patients, 13 (32%) had DM as an underlying medical condition. The most common extra-ocular infection focus was endocarditis (37%).ConclusionsDM is common in patients with EBE caused by GBS. While the 4 cases in the current report had a relatively good visual acuity outcome, despite poor initial visual acuity, the literature review indicated that EBE caused by GBS is generally a severe condition with a poor prognosis. The current study also indicates the importance of considering the possibility of endocarditis on encountering EBE caused by GBS.
The risk of vancomycin toxicity in patients with liver impairment
Authors: Brunetti Luigi , Song Jong Hwa , Suh David , Kim Heui Jae , Seong Yeon Hee , Lee Dae Song , Lee Seung-Mi , Suh Dong-Churl 
Published: March 2020

Abstract
Background
The influence of liver disease on the pharmacokinetic profile, the risk of acute kidney injury, and excessive drug exposure in patients treated with vancomycin was examined.

Methods
A retrospective cohort study was performed with patients discharged from a medical center between January 2011 and June 2018 who received vancomycin therapy. Patients were stratified according to liver dysfunction (no to mild liver dysfunction (NMLD) and moderate to severe liver dysfunction (MSLD) based on the Child–Pugh score. The risk of acute kidney injury was compared between patients who were stratified by the attainment of a target serum trough concentration (10 mg/dL to 20 mg/dL) and the vancomycin ratio formed between the area under the curve and minimum inhibitory concentration. The impact of liver dysfunction and a daily dose of vancomycin on the risk of acute kidney injury and vancomycin AUC:MIC > 600 were tested using logistic regression with and without adjusting for the study variables.

Results
A total of 408 patients empirically treated with vancomycin were included in this study (237 with NMLD and 171 with MSLD). Mean vancomycin trough concentrations (17.5 ± 8.4 mg/dL versus 15.3 ± 5.2 mg/dL, p = 0.0049) and AUC:MIC ratios (549.4 ± 217.2 versus 497.5 ± 117.3, 0.0065) were significantly higher in the MSLD group when compared to the NMLD group, respectively. Vancomycin clearance was also lower in the MSLD group and corresponded to a longer half-life. The proportion of patients who developed acute kidney injury was greater in patients with MSLD when compared to NMLD (7.6% versus 3.8%, respectively; p = 0.0932); however, the difference was statistically insignificant. Furthermore, supratherapeutic serum trough concentrations and AUC:MIC ratios were more common in the MSLD group versus the NMLD group (27.5% versus 13.9%, p = 0.0007 and 28.7% versus 17.3%, respectively; p = 0.0063).

Conclusions
MSLD correlates with an increased risk of supratherapeutic vancomycin exposure. Although patients with MSLD had a higher risk of acute kidney injury, the difference was not significant.
A preliminary study of the child abuse and central sensitization in adolescent patients with chronic non-organic chest pain and an overlooked condition: juvenile fibromyalgia syndrome
Authors: Mansiz-Kaplan Basak , Ayhan F. Figen , Cagli Mihriban , Atik Fatih , Ece İbrahim 
Published: March 2020

Abstract
Background
Only a small percentage of pediatric chest pain is of cardiac origin and the most common detected cause is musculoskeletal. Among musculoskeletal causes, acute chest pain is better described, with the causes of chronic pain not being adequately investigated in the literature. The aim of studuy is to evaluate the musculoskeletal causes of non-cardiac chest pain and investigate the relationship of chest pain with child abuse and central sensitization.

Methods
Patients aged 12 to 18 years presenting with chest pain for at least 3 months were evaluated by a pediatric cardiologist and those without an organic pathology were referred to the physical medicine and rehabilitation clinic. In addition to detailed history and physical examination, juvenile fibromyalgia was questioned according to the 2016 revised diagnostic criteria of the American College of Rheumatology. The visual analog scale (to measure intensity of chest pain), the Central Sensitization Inventory (to evaluate the presence of central sensitization), the Hospital Anxiety Depression Scale (to determine depression and anxiety), the Childhood Trauma Questionnaire (to assess the presence of child abuse) were administered.

Results
The study was completed with 64 patients. Twenty-six percent of patient (n = 17) were diagnosed with juvenile fibromyalgia, and central sensitization was detected in 34.4% (n = 22). Pain intensity, anxiety, depression and abuse scores were higher in patients with juvenile fibromyalgia than those without juvenile fibromyalgia and in patients with central sensitization compared to those without central sensitization (p < 0.001 for both). Higher scores of pain were related with child abuse [beta = 0.763, p < 0.001, (%95 CI, 4.397; 8.841)] and central sensitization of pain [beta = 0.382, p = 0.008 (95% CI: (0.986;6.231)] in regression analyses.

Conclusion
In this study, juvenile fibromyalgia was detected as a cause of non-cardiac chest pain. Juvenile fibromyalgia or central sensitization may also indicate childhood abuse.
Successful generation of epigenetic disease model mice by targeted demethylation of the epigenome
Authors: Horii Takuro , Morita Sumiyo , Hino Shinjiro , Kimura Mika , Hino Yuko , Kogo Hiroshi , Nakao Mitsuyoshi , Hatada Izuho 
Published: March 2020

AbstractBackgroundEpigenetic modifications, including DNA methylation, play an important role in gene silencing and genome stability. Consequently, epigenetic dysregulation can cause several diseases, such as cancer, obesity, diabetes, autism, and imprinting disorders.ResultsWe validate three methods for the generation of epigenome-edited mice using the dCas9-SunTag and single-chain variable fragment-TET1 catalytic domain. We generate model mice for Silver-Russell syndrome (SRS), an imprinting disorder, by target-specific DNA demethylation in theH19differentially methylated region. Like SRS patients, these mice showH19upregulation andIgf2downregulation, leading to severe intrauterine and postnatal growth retardation.ConclusionThis is the first report of an imprinting disease model animal generated by targeted demethylation of specific loci of the epigenome in fertilized eggs. Epigenome-edited animals are also useful for exploring the causative epimutations in epigenetic diseases.
Neuropsychiatric symptoms in cognitively normal older persons, and the association with Alzheimer’s and non-Alzheimer’s dementia
Authors: Liew Tau Ming 
Published: March 2020

AbstractBackgroundNeuropsychiatric symptoms (NPS) have been reported to be useful in predicting incident dementia among cognitively normal older persons. However, the literature has not been conclusive on the differential utilities of the various NPS in predicting the subtypes of dementia. This study compared the risks of Alzheimer’s and non-Alzheimer’s dementia associated with the various NPS, among cognitively normal older persons.MethodsThis cohort study included 12,452 participants from the Alzheimer’s Disease Centers across USA, who were ≥ 60 years and had normal cognition at baseline. Participants completed the Neuropsychiatric Inventory-Questionnaire at baseline and were followed up almost annually for incident dementia (median follow-up = 4.7 years). Symptom clusters of NPS—as identified from exploratory and confirmatory factor-analyses—were included in the Cox regression to investigate their associations with incident dementia.ResultsThe various NPS showed independent yet differential associations with incident dementia. Although psychotic symptoms were rarely endorsed by the participants, they predicted much higher risk of dementia (HR 3.6, 95% CI 2.0–6.4) than affective symptoms (HR 1.5, 95% CI 1.2–1.8) or agitation symptoms (HR 1.6, 95% CI 1.3–2.1). Psychotic symptoms predicted all dementia subtypes, while affective and agitation symptoms differentially predicted some subtypes. Across dementia subtypes, psychotic symptoms had relatively higher risk estimates than affective or agitation symptoms, with the risk estimates being particularly high in non-Alzheimer’s dementia.ConclusionsAmong cognitively normal individuals, the presence of NPS may warrant greater clinical vigilance as precursors to dementia and its subtypes. The findings highlight the need for further research to enrich our understanding on the neurobiological links between various NPS and dementia subtypes. They may also change the clinical approach in managing late-life psychotic symptoms, requiring a greater emphasis on dementia surveillance in the diagnostic criteria of late-life psychotic disorders.