bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ocean Surface Boundary Layer Response to Abruptly Turning Winds
Authors: Wang Xingchi , Kukulka Tobias 
Published: March 2021

AbstractTurbulence driven by wind and waves controls the transport of heat, momentum, and matter in the ocean surface boundary layer (OSBL). For realistic ocean conditions, winds and waves are often neither aligned nor constant, for example, when winds turn rapidly. Based on a Large Eddy Simulation (LES) method, which captures shear-driven turbulence (ST) and Langmuir turbulence (LT) driven by the Craik-Leibovich vortex force, we investigate the OSBL response to abruptly turning winds. We design idealized LES experiments, whose winds are initially constant to equilibrate OSBL turbulence before abruptly turning 90° either cyclonically or anticyclonically. The transient Stokes drift for LT is estimated from a spectral wave model. The OSBL response includes three successive stages that follow the change in direction. During stage 1, turbulent kinetic energy (TKE) decreases due to reduced TKE production. Stage 2 is characterized by TKE increasing with TKE shear production recovering and exceeding TKE dissipation. Transient TKE levels may exceed their stationary values due to inertial resonance and non-equilibrium turbulence. Turbulence relaxes to its equilibrium state at stage 3, but LT still adjusts due to slowly developing waves. During stages 1 and 2, greatly misaligned wind and waves lead to Eulerian TKE production exceeding Stokes TKE production. A Reynolds stress budget analysis and Reynolds-averaged Navier-Stokes equation models indicate that Stokes production furthermore drives the OSBL response. The Coriolis effects result in asymmetrical OSBL responses to wind turning directions. Our results suggest that transient wind conditions play a key role in understanding realistic OSBL dynamics.
Using Drifter Velocity Measurements to Assess and Constrain Coarse-Resolution Ocean Models
Authors: Zhao Mengnan , Ponte Rui M. , Wang Ou , Lumpkin Rick 
Published: March 2021

AbstractProperly fitting ocean models to observations is crucial for improving model performance and understanding ocean dynamics. Near-surface velocity measurements from the Global Drifter Program (GDP) contain valuable information about upper-ocean circulation and air–sea fluxes on various space and time scales. This study explores whether GDP measurements can be used for usefully constraining the surface circulation from coarse-resolution ocean models, using global solutions produced by the consortium for Estimating the Circulation and Climate of the Ocean (ECCO) as an example. To address this problem, a careful examination of velocity data errors is required. Comparisons between an ECCO model simulation, performed without any data constraints, and GDP and Ocean Surface Current Analyses Real-Time (OSCAR) velocity data, over the period 1992–2017, reveal considerable differences in magnitude and pattern. These comparisons are used to estimate GDP data errors in the context of the time-mean and time-variable surface circulations. Both instrumental errors and errors associated with limitations in model physics and resolution (representation errors) are considered. Given the estimated model–data differences, errors, and signal-to-noise ratios, our results indicate that constraining ocean-state estimates to GDP can have a substantial impact on the ECCO large-scale time-mean surface circulation over extensive areas. Impact of GDP data constraints on the ECCO time-variable circulation would be weaker and mainly limited to low latitudes. Representation errors contribute substantially to degrading the data impacts.
Biological sources of variations of tartrate-resistant acid phosphatase 5b in a healthy Japanese population
Authors: Kikuchi Wataru , Ichihara Kiyoshi , Mori Kazuo , Shimizu Yoshihisa 
Published: March 2021

Background Tartrate-resistant acid phosphatase 5b (TRACP5b) is a bone resorption marker that is mainly used in clinical management of osteoporosis. For proper interpretations of test results for serum TRACP5b, we explored their biological sources of variation, esp. age-related changes, and associations with other bone-related markers in healthy Japanese adults. Methods During the 2009 East-Southeast Asian multicentre study for determination of reference intervals, 72 major laboratory tests were measured by centralized assays in 3541 well-defined healthy volunteers. The current study included 1980 test results in Japanese subjects for five bone-related markers: TRACP5b, bone alkaline phosphatase, intact parathyroid hormone, calcium and inorganic phosphate. Information on sources of variation, including body mass index, smoking habits and ABO-blood group, were obtained from a health status questionnaire. Results Gender-specific profiles of age-related changes were observed for each parameter. Increased values starting from 40 years of age in females were most prominent for TRACP5b, followed by bone alkaline phosphatase and inorganic phosphate. TRACP5b in males decreased with body mass index, bone alkaline phosphatase and TRACP5b were higher in blood type-O subjects, especially in males. TRACPT5b was closely correlated with bone alkaline phosphatase, and moderately correlated with adjusted calcium and inorganic phosphate, especially in females aged ≥45 years. Reference intervals for each analyte were determined parametrically based on gender and age. Conclusions This study elucidated sources of variation of TRACP5b and related bone markers in healthy Japanese subjects and demonstrated a specific age profile for each marker. These results are of relevance for better clinical usage and interpretations of serum levels of bone markers.
A Meta-Analysis of Extracorporeal Anticoagulants in Pediatric Continuous Kidney Replacement Therapy
Authors: Raina Rupesh , Agrawal Nirav , Kusumi Kirsten , Pandey Avisha , Tibrewal Abhishek , Botsch Alexander 
Published: March 2021

Objective: Continuous kidney replacement therapy (CKRT) is the primary therapeutic modality utilized in hemodynamically unstable patients with severe acute kidney injury. As the circuit is extracorporeal, it poses an increased risk of blood clotting and circuit loss; frequent circuit losses affect the provider’s ability to provide optimal treatment. The objective of this meta-analysis is to evaluate the safety and efficacy of the extracorporeal anticoagulants in the pediatric CKRT population. Data Sources: We conducted a literature search on PubMed/Medline and Embase for relevant citations. Study Selection: Studies were included if they involved patients under the age of 18 years undergoing CKRT, with the use of anticoagulation (heparin, citrate, or prostacyclin) as a part of therapy. Only English articles were included in the study. Data Extraction: Initial search yielded 58 articles and a total of 24 articles were included and reviewed. A meta-analysis was performed focusing on the safety and effectiveness of regional citrate anticoagulation (RCA) vs unfractionated heparin (UFH) anticoagulants in children. Data Synthesis: RCA had statistically significantly longer circuit life of 50.65 hours vs. UFH of 42.10 hours. Two major adverse effects metabolic alkalosis and electrolyte imbalance seen more commonly in RCA compared to UFH. There was not a significant difference in the risk of systemic bleeding when comparing RCA vs. UFH. Conclusion: RCA is the preferred anticoagulant over UFH due to its significantly longer circuit life, although vigilant circuit monitoring is required due to the increased risk of electrolyte disturbances. Prostacyclin was not included in the meta-analysis due to the lack of data in pediatric patients. Additional studies are needed to strengthen the study results further.
How do male and female Headteachers evaluate their authenticity as school leaders?
Authors: Lee Catherine 
Published: March 2021

This article utilises the model of authentic leadership by Bill George et al. to explore the extent to which gender influences teacher leader authenticity in the school workplace. Four male and four female Secondary Heads of School were asked to complete George et al.’s authentic leadership self-assessment tool and provide a written commentary reflecting on and contextualising their performance in five key areas identified by George et al.: Purpose – Passion; Values – Behaviour; Heart – Compassion; Relationships – Connectedness and Self-discipline – Consistency. The responses of the four male teacher leaders were compared with those of the four female teacher leaders and the results show that the male teacher leaders rated themselves more positively than female counterparts in all areas except Relationships – Connectedness. In all five categories the written reflections suggest that male and female leaders have gendered approaches to the notion of authenticity and conceive of school leadership in markedly different ways.
Life Quality Index–based cost–benefit analysis of equipping life preservers aboard airplanes
Authors: Yang Rui-liang , Yang Li-bin , Wang Li-jing , Li Sha , Geng Dong-han 
Published: March 2021

The life preservers aboard airplanes play a critical role in ensuring occupant safety in water-related accidents. However, several airlines off-load life preservers to save fuel and costs. In this study, a cost–benefit analysis was performed considering the Life Quality Index to examine the necessity of life preservers aboard aircraft. It was noted that the placement of life preservers aboard airplanes was reasonable and beneficial in the recent 15 years. Although life preservers are primarily required for extended overwater (EOW) operations, the distance from the shoreline for most of the water-related accidents was considerably smaller than that of an EOW operation, and most water-related accidents occurred close to an airport. In other words, air passengers were at risk of water-related accidents, regardless of whether the flight was classified as an EOW flight. Thus, life preservers must be made available for all the occupants on all passenger flights, regardless of the flight path.
Opioid Prescribing Practices in Cleft Lip and Cleft Palate Reconstruction
Authors: Falola Reuben A. , Blough Jordan T. , Abraham Jasson T. , Brooke Sebastian M. 
Published: March 2021

Introduction: Currently, there is no consensus regarding the role of opioids in the management of perioperative pain in children undergoing cleft lip/palate repair. Method: The present study evaluated opioid prescribing patterns of surgeon members within the American Cleft Palate-Craniofacial Association surgeons utilizing an anonymous survey. Results: Respondents performing cleft lip repair typically operate on patients 3 to 6 months of age (86%), admit patients postoperatively (82%), and discharge them on the first postoperative day (72%). Comparatively, respondents performed palatoplasty between the ages of 10 and 12 months (62%), almost always admit the patients (99%), and typically discharge on the first postoperative day (78%). Narcotics were more frequently prescribed after palatoplasty than after cleft lip repair, both for inpatients (66%; 49%) and at discharge (38%; 22%). Oxycodone was the most prescribed narcotic (39.1%; 41.4%), typically for a duration of 1 to 3 days (81.5%; 81.2%). All surgeons who reported changing their narcotic regimen (34.4% dose, 32.8% duration) after cleft lip repair, decreased both parameters from earlier to later in their career. Similarly, surgeons who changed the dose (32.2%) and duration (42.5%) of narcotics after palatoplasty, mostly decreased both parameters (96%). Additionally, physicians with >15 years of practice were less likely to prescribe opioids in comparison with colleagues with ≤15 years of experience. Ninety-two percent of respondents endorsed prescribing nonopioid analgesics after prescribing cleft surgery, most commonly acetaminophen (85.7%; 85.4%). Conclusion: Cleft surgeons typically prescribe opioids to inpatients and rarely upon discharge. Changes to opioid-prescribing patterns typically involved a decreased dose and duration.
Pulmonary Embolism Does Not Have an Unusually High Incidence Among Hospitalized COVID19 Patients
Authors: Gallastegui Nicolas , Zhou Jenny Y. , Drygalski Annette von , Barnes Richard F. W. , Fernandes Timothy M. , Morris Timothy A. 
Published: March 2021

Introduction: Acute respiratory illnesses from COVID19 infection are increasing globally. Reports from earlier in the pandemic suggested that patients hospitalized for COVID19 are at particularly high risk for pulmonary embolism (PE). To estimate the incidences of PE during hospitalization for COVID19, we performed a rigorous systematic review of published literature. Methods: We searched for case series, cohort studies and clinical trials from December 1, 2019 to July 13, 2020 that reported the incidence of PE among consecutive patients who were hospitalized for COVID19 in ICUs and in non-ICU hospital wards. To reflect the general population of hospitalized COVID19 patients, we excluded studies in which subject enrollment was linked to the clinical suspicion for venous thromboembolism (VTE). Results: Fifty-seven studies were included in the analysis. The combined random effects estimate of PE incidence among all hospitalized COVID19 patients was 7.1% (95% CI: 5.2%, 9.1%). Studies with larger sample sizes reported significantly lower PE incidences than smaller studies (r2 = 0.161, p = 0.036). The PE incidence among studies that included 400 or more patients was 3.0% (95% CI: 1.7%, 4.6%). Among COVID19 patients admitted to ICUs, the combined estimated PE incidence was 13.7% (95% CI: 8.0%, 20.6%). The incidence of ICU-related PE also decreased as the study sample sizes increased. The single largest COVID19 ICU study (n = 2215) disclosed a PE incidence of 2.3% (95% CI: 1.7%, 3.0%). Conclusion: PE incidences among hospitalized COVID19 patients are much lower than has been previously postulated based on smaller, often biased study reports. The incidence of “microthrombosis,” leading to occlusion of microscopic blood vessels, remains unknown.
Citrobacter braakii CLABSI in a hematopoietic stem cell transplant patient
Authors: Tollkuci Eris , Myers Rebecca 
Published: March 2021

Introduction Citrobacter bacteria are gram-negative anaerobic bacilli commonly found in water, soil, food, and the intestinal tracts of animals and humans. Patients at highest risk of these nosocomial infections include neonates and adults who are ≥65 years of age, debilitated, or immunocompromised. Citrobacter braakii ( C. braakii), specifically, has been reported to cause sepsis in immunocompromised patients. Herein, we describe a case of an allogeneic stem cell transplant (SCT) adult patient with C. braakii bloodstream infection. Case Report We report our experience managing a central line-associated bloodstream infection (CLABSI) due to C. braakii in an allogeneic SCT patient. Management and Outcomes: Our patient was initially managed with cefepime. The central venous catheter (CVC) was removed. Blood cultures cleared 24 hours after antibiotic initiation. Therapy was transitioned to oral levofloxacin once susceptibilities resulted. Discussion The course of this patient highlights the important relationship between an unusual pathogen, C. braakii, in an immunocompromised allogeneic SCT patient. In our case, the source of the bacteremia was most likely a CLABSI given the positive catheter tip cultures. Although this report describes the successful utilization of cefepime and levofloxacin in the treatment of C. braakii infection, caution should be exercised when choosing empiric antimicrobial therapy as AmpC resistance. This clinical scenario can aid health care providers in making informed treatment decisions when faced with patients diagnosed with this relatively uncommon pathogen. Further reports should be published to determine C. braakii bacteremia management in hematopoietic stem cell transplant patients.
Sigma receptor knockdown augments dysfunction and apoptosis of beta cells induced by palmitate
Authors: Ke Mengting , He Guangzhen , Wang Huawei , Cheng Siyuan , Xu Yancheng 
Published: March 2021

Sigma-1 receptor (Sig-1R) is located in the endoplasmic reticulum (ER) and clustered on the mitochondria related endoplasmic membranes, which are involved in the regulation of nervous system disease. Here, we designed Sig-1R silence MIN6 cells and studied the influence of Sig-1R silence on beta cells. We showed Sig-1R inactivation in MIN6 cells could not only decrease cell proliferation but also inhibit cell cycle, and this inhibitory effect on cell cycle might be achieved by regulating the FoxM1/Plk1/Cenpa pathway.  Moreover, Sig-1R deficiency increased MIN6 cells sensitivity to lipotoxicity, exaggerated palmitate (PA)-induced apoptosis, and impaired insulin secretion. On the other hand, ER chaperone GRP78 and ER proapoptotic molecules CHOP increased in Sig-1R knockdown MIN6 cells. The ATP level decreased and reactive oxygen species (ROS) increased in this kind of cells. Furthermore not only GRP78 and CHOP levels, but also ATP and ROS levels changed more in Sig-1R silence cells after cultured with PA. Therefore, Sig-1R deficiency exaggerated PA induced beta cells apoptosis by aggravating ER stress and mitochondrial dysfunction. Together, our study showed that Sig-1R might influence the proliferation, apoptosis, and function of beta cells.
Trends in Patient, Physician, and Public Perception of Ulnar Collateral Ligament Reconstruction Using Social Media Analytics
Authors: Yu Jonathan S. , Carr James B. , Thomas Jacob , Kostas Julianna , Wang Zhaorui , Khilnani Tyler , Liu Katie , Dines Joshua S. 
Published: March 2021

Background: Social media posts regarding ulnar collateral ligament (UCL) injuries and reconstruction surgeries have increased in recent years. Purpose: To analyze posts shared on Instagram and Twitter referencing UCL injuries and reconstruction surgeries to evaluate public perception and any trends in perception over the past 3 years. Study Design: Cross-sectional study. Methods: A search of a 3-year period (August 2016 and August 2019) of public Instagram and Twitter posts was performed. We searched for >22 hashtags and search terms, including #TommyJohn, #TommyJohnSurgery, and #tornUCL. A categorical classification system was used to assess the sentiment, media format, perspective, timing, accuracy, and general content of each post. Post popularity was measured by number of likes and comments. Results: A total of 3119 Instagram posts and 267 Twitter posts were included in the analysis. Of the 3119 Instagram posts analyzed, 34% were from patients, and 28% were from providers. Of the 267 Twitter posts analyzed, 42% were from patients, and 16% were from providers. Although the majority of social media posts were of a positive sentiment, over the past 3 years, there was a major surge in negative sentiment posts (97% increase) versus positive sentiment posts (9% increase). Patients were more likely to focus their posts on rehabilitation, return to play, and activities of daily living. Providers tended to focus their posts on education, rehabilitation, and injury prevention. Patient posts declined over the past 3 years (–28%), whereas provider posts increased substantially (110%). Of posts shared by health care providers, 4% of posts contained inaccurate or misleading information. Conclusion: The majority of patients who post about their UCL injury and reconstruction on social media have a positive sentiment when discussing their procedure. However, negative sentiment posts have increased significantly over the past 3 years. Patient content revolves around rehabilitation and return to play. Although patient posts have declined over the past 3 years, provider posts have increased substantially with an emphasis on education.
Ambulatory Surgery vs Overnight Observation for Total Thyroidectomy: Cost Analysis and Outcomes
Authors: Rosen Philip , Bailey Luke , Manickavel Sudhir , Gentile Christopher , Grayson Jessica , Buczek Erin 
Published: March 2021

ObjectiveTo compare financial impact between patients undergoing ambulatory (same‐day discharge) vs overnight admission after total thyroidectomy while showing associated surgical outcomes.Study DesignRetrospective review.SettingUniversity of Alabama at Birmingham Medical Center from October 2011 and July 2017.MethodsPatients undergoing total thyroidectomy without concurrent procedures were selected for review. Demographics, comorbidities, admission status, postoperative outcomes including minor and major complications, charges, and costs were collected. Admission status was categorized as inpatient (admission to hospital ≥1 night) or outpatient (discharged from the postoperative recovery unit). Costs were obtained from all related hospital, clinic, and emergency department visits at the University of Alabama at Birmingham within 30 days of the original surgery. After statistical analysis, outcomes and costs were compared between inpatient and outpatient total thyroidectomy patients.ResultsOf 870 total thyroidectomy patients included for analysis, 367 (42.2%) met outpatient criteria. A total of 169 patients (19.4%) had a complication, and only hypocalcemia occurred significantly more in the inpatient group (14.3% vs 9.26%; P <. 05). No complications occurred more frequently in the outpatient population. There were no mortalities. There was a statistically significant difference between the total cost of inpatient and outpatient thyroidectomies, with outpatient surgery costing on average $2367.27 less per patient (P <. 0001).ConclusionOutpatient total thyroidectomy can lead to cost reduction in highly selected patients who have few comorbidities while remaining safe for the patient.
Key Technologies and Development Trends in Advanced Intelligent Sawing Equipments
Authors: Wang Yangyu , Zhang Yongle , Tan Dapeng , Zhang Yongchao 
Published: March 2021

AbstractAs a starting point in equipment manufacturing, sawing plays an important role in industrial production. Intelligent manufacturing equipment is an important carrier of intelligent manufacturing technologies. Due to the backwardness of intelligent technology, the comprehensive performance of sawing equipments in China is obviously different from that in foreign countries. State of the art of advanced sawing equipments is investigated along with the technical bottleneck of sawing machine tool manufacturing, and a new industrial scheme of replacing turning-milling by sawing is described. The key technologies of processing-measuring integrated control, multi-body dynamic optimization, the collaborative sawing network framework, the distributed cloud sawing platform, and the self-adapting service method are analyzed; with consideration of the problems of poor processing control stableness, low single machine intelligence level, no on-line processing data service and active flutter suppression of sawing with wide-width and heavy-load working conditions. Suggested directions for further research, industry implementation, and industry-research collaboration are provided.