bluuebunny/crossref_metadata_2025_split huggingface dataset:
Large Differences in Diffuse Solar Radiation Among Current-Generation Reanalysis and Satellite-Derived Products
Authors: Chakraborty T. , Lee X. 
Published: May 2021

AbstractThough the partitioning of shortwave radiation (K↓) at the surface into its diffuse (K↓,d) and direct beam (K↓,b) components is relevant for, among other things, the terrestrial energy and carbon budgets, there is a dearth of large-scale comparisons of this partitioning across reanalysis and satellite-derived products. Here we evaluateK↓,K↓,d, andK↓,b, as well as the diffuse fraction (kd) of solar radiation in four current-generation reanalysis (NOAA-CIRES-DOE, NCEP/NCAR, MERRA-2, ERA5) datasets and one satellite-derived product (CERES) using ≈1400 site years of observations. Although the systematic positive biases inK↓is consistent with previous studies, the biases in griddedK↓,dandK↓,bvary in direction and magnitude, both annually and across seasons. The inter-model variability in cloud cover strongly explains the biases in bothK↓,dandK↓,b. Over Europe and China, the long-term (10-year plus) trends inK↓,din the gridded products are noticeably differ from corresponding observations and the grid-averaged 35-year trends show an order of magnitude variability. In the MERRA-2 reanalysis, which includes both clouds and assimilated aerosols, the reduction in both clouds and aerosols reinforce each other to establish brightening trends over Europe, while the effect of increasing aerosols overwhelm the effect of decreasing cloud cover over China. The inter-model variability inkdseen here (0.27 to 0.50 from CERES to MERRA-2) suggests substantial differences in shortwave parameterization schemes and their inputs in climate models and can contribute to inter-model variability in coupled simulations. Based on these results, we call for systematic evaluations ofK↓,dandK↓,bin CMIP6 models.
Association Between Breastfeeding and Child Overweight in Mexico
Authors: Campos Ana Paola , Vilar-Compte Mireya , Hawkins Summer Sherburne 
Published: May 2021

Background: Globally, the prevalence of child overweight has increased over the past few decades. The largest burden of child overweight is identified among upper-middle-income countries, such as Mexico. Breastfeeding has been identified as one of the key affordable and modifiable maternal health behaviors protecting against child overweight. Objective: To examine the association between breastfeeding and child overweight while sequentially controlling for individual, household, and area factors in Mexican children. Methods: Secondary data analysis using the 2012 Mexican National Health and Nutrition Survey which included risk factors for overweight on 2089 children aged 6 to 35 months and analyzed data to estimate fixed- and mixed-effects logistic regression models. Results: Overall, 9.0% of children were overweight and 71.1% of mothers reported any breastfeeding for ≥ 6 months. We found no evidence for a protective effect of any breastfeeding for ≥ 6 months on child overweight when compared to children who were never breastfed in the fully adjusted model and across all models (model 4, adjusted odds ratio [AOR] [95% CI] = 0.76 [0.31-1.86]). We identified risk factors for child overweight at the individual and area levels, with maternal obesity and offspring high birthweight being significant in the fully adjusted model and across all models (model 4, AOR [95% CI] = 2.26 [1.32-3.85] and 2.83 [1.44-5.56], correspondingly). Conclusions: Our results suggest shared obesogenic environment influences from which the overweight-obese maternal-child dyads are emerging in Mexican households. More research is needed to better understand these obesogenic environments grounded on the particular contexts among upper-middle-income countries.
Preoperative Advance Care Planning for Older Adults Undergoing Major Abdominal Surgery
Authors: Bleicher Josh , McGuire Lauren E. , Robbins Riann B. , Johnson Jordan E. , Fischbuch Sarah , Gupta Sumati , Beck Anna C. , Cohan Jessica N. 
Published: May 2021

Background: Advance care planning (ACP) is recommended for older patients undergoing surgery. ACP consists of creating advance directives (ADs), identifying surrogate decision makers (SDMs), and documenting goals of care. We identified factors associated with documentation of preoperative ACP to identify opportunities to optimize ACP for older surgical patients. Methods: This was a retrospective study of surgical patients ≥70 years old who underwent elective, high-risk abdominal procedures between 01/2015-08/2019. Clinical data were obtained from our institution’s National Surgical Quality Improvement Project database. ACP metrics were extracted from the electronic medical record. We analyzed the data to identify patient factors associated with ACP metrics. We also analyzed whether ACP was more frequent for patients who experienced postoperative complications or death. Results: 267/1,651 patients were included. 97 patients (36%) had an AD available on the day of surgery, 57 (21%) had an SDM identified, and 31 (12%) had a documented goals of care conversation. On multivariable analysis, older age and white race were associated with an increased likelihood of having an AD available on the day of surgery. Women were 1.7 times more likely to have an SDM (p = 0.02). No patient or surgeon factors were significantly associated with goals of care documentation. ACP was not performed more frequently in patients who experienced postoperative complications or death. Conclusion: In this series, ACP was not routinely documented for older patients undergoing major surgery. ACP was not more frequent in patients who experienced complications or death, demonstrating the importance of universal preoperative ACP in older patients.
Preventing the Spread: A Comprehensive Cancer Center’s Journey to Prevent the Spread of Coronavirus Disease (Covid-19) During the 2020 Pandemic
Authors: Carraway Stephanie , Martin Stacy , Greene John N. 
Published: May 2021

Background: On March 11, 2020, the World Health Organization (WHO) declared Coronavirus Disease (COVID-19) a pandemic. Hospitals around the world began to implement infection prevention and control (IPC) measures to stop further spread and prevent infections within their facilities. Healthcare organizations were challenged to develop response plans, procure personal protective equipment (PPE) that was in limited supply while continuing to provide quality, safe care. Methods: As a comprehensive cancer center with immunocompromised patients, our efforts began immediately. Preventative measures were established and, as of September 2020, over 14,000 patients have been tested within the facility. From March 2020 through September 2020, only one case of hospital acquired (HA) COVID-19 was identified among our patients. Two cases of suspected community acquired (SCA) cases were also identified. Following the Centers for Disease Control (CDC) guidance, IPC measures were implemented within the facility as information science about the virus developed. This article addresses the IPC measures taken, such as enhancing isolation precautions, implementing screening protocols, disinfecting and reusing N95 respirators, by the center throughout the pandemic as well as the challenges that arouse with a new and emerging infectious disease. Conclusions: The infection control measures implemented at our comprehensive cancer center during the COVID-19 pandemic allowed our center to continue to provide world class cancer care with minimal COVID-19 infection transmission among patients and team members.
Chronic Inflammatory Placental Lesions Correlate With Bronchopulmonary Dysplasia Severity in Extremely Preterm Infants
Authors: Sharma Amit , Sood Beena G , Qureshi Faisal , Xin Yuemin , Jacques Suzanne M 
Published: May 2021

Objective Correlation of BPD with placental pathology is important for clarification of the multifactorial pathogenesis of BPD; however, previous reports have yielded varying results. We report placental findings in no/mild BPD compared to moderate/severe BPD, and with and without pulmonary hypertension (PH). Methods Eligible infants were 230/7-276/7 weeks gestational age. BPD was defined by the need for oxygen at ≥28 days with severity based on need for respiratory support at ≥36 weeks. Acute and chronic inflammatory placental lesions and lesions of maternal and fetal vascular malperfusion were examined. Results Of 246 eligible infants, 146 (59%) developed moderate/severe BPD. Thirty-four (23%) infants developed PH, all but 1 being in the moderate/severe BPD group. Chronic deciduitis (32% vs 16%, P = .003), chronic chorioamnionitis (23% vs 12%, P = .014), and ≥ 2 chronic inflammatory lesions (13% vs 3%, P = .007) were more frequent in the moderate/severe BPD group. Development of PH was associated with placental villous lesions of maternal vascular malperfusion (30% vs 15%, P = .047). Conclusions The association of chronic inflammatory placental lesions with BPD severity has not been previously reported. This supports the injury responsible for BPD as beginning before birth in some neonates, possibly related to cytokines associated with these chronic inflammatory lesions.
Noncoplanar Versus Coplanar Intensity-Modulated Radiation Therapy (IMRT) for Protection of the Lip and Buccal Mucosa
Authors: Lao Zheng , Bi Fan , Fan Wenhui , Xu Xuanli , Tu Wenyong , Shi Huifeng 
Published: May 2021

Objective: In this study, by comparing coplanar and noncoplanar intensity-modulated radiation therapy (IMRT) treatment planning in treating tongue cancer, the significance of noncoplanar fields in the protection of the lip and buccal mucosa was determined, and a reasonable solution was selected. Methods: Forty-eight tongue cancer patients treated from June 2019 to February 2021 were selected and randomly divided into a coplanar field group and a noncoplanar field group. The mucosal dose limit changed from 15 Gy to 45 Gy for comparison of the two treatment plans. The evaluation indicators (conformal index (CI); homogeneity index (HI); D5, D50, and D98 of the target volume; and the dose of normal tissues) were calculated under different mucosal dose limits. The clinical observation of the lip and buccal mucosa of 48 cases was monitored and graded carefully according to NCI-CTCAE V4.0. Statistical analyses were performed. Results: The differences in CI, HI, D98, D50 and D5 between the two groups in the target volume tended to decrease when the mucosal dose limit was less than 30 Gy, with a significant difference ( P < 0.05). When the limit exceeded 30 Gy, significant differences in other indicators except CI ( P < 0.05) were still noted. In normal tissue, differences in doses between the two groups existed when the mucosal limit was less than 20 Gy, with a significant difference ( P < 0.05). When the limit exceeded 20 Gy, no significant difference was noted. Patients in the noncoplanar group showed significantly better results than those in the other group in terms of the radiation-related toxicity of the lip and cheek membrane( P < 0.001). Conclusions: Compared with coplanar field radiotherapy, noncoplanar field radiotherapy can effectively reduce the exposure dose to the lip and buccal mucosa. The application of noncoplanar treatment plans exhibits good clinical significance and deserves to be promoted.
Relationship of triglyceride–glucose index with chronic limb-threatening ischemia in lower extremity peripheral artery disease
Authors: Pala Arda Aybars , Urcun Yusuf Salim 
Published: May 2021

Objectives Triglyceride-glucose index (TyG index), which is defined as the simple and novel marker of insulin resistance, is becoming increasingly important as a promising predictive marker for atherosclerotic diseases. Chronic limb-threatening ischemia is defined as the most advanced stage of the lower extremity peripheral artery disease, whose main cause is atherosclerosis and is associated in this respect with amputation, impaired quality of life, and mortality. The main purpose of the present study was to investigate the relation between the calculated TyG index values and chronic limb-threatening ischemia development. Methods A total of 296 patients who were diagnosed with lower extremity peripheral artery disease in our outpatient clinic between October 2018 and October 2020 were included in this study retrospectively. Two groups were formed by clinically staging the patients according to Rutherford Classification. Patients who did not develop chronic limb-threatening ischemia were classified as “Group 1” ( n = 224) and those who developed were classified as “Group 2” ( n = 72). Results The mean TyG index values that were calculated in Group 2 were significantly higher than in Group 1 (9.27 ± 0.31 vs. 9.00 ± 0.34, p < 0.001). In the multivariate logistic regression analysis conducted to determine the predictors of chronic limb-threatening ischemia development, C-reactive protein (OR [Odds Ratio]: 1.220, 95% CI [confidence interval]: 1.092–1.363, p < 0.001), high-density lipoprotein cholesterol (OR: 0.775, 95% CI: 0.715–0.839, p < 0.001) and TyG index (OR: 5.796, 95% CI: 2.050–16.382, p = 0.001) were identified as independent predictors. Receiver operating characteristic analysis revealed that the cut-off value of TyG index was 9.13 (area under the curve: 0.721, p < 0.001) with 70.8% sensitivity and 65.2% specificity. The TyG index was significantly correlated with Rutherford category, high-density lipoprotein cholesterol and mean platelet volume. Conclusions Chronic limb-threatening ischemia development may be predicted with the TyG index value, which is calculated easily from routine biochemical parameters, in patients diagnosed with lower extremity peripheral artery disease.
Evidence-Based Design in Architectural Education: Designing the First Maggie’s Centre in Israel
Authors: Pilosof Nirit Putievsky , Grobman Yasha Jacob 
Published: May 2021

Objective: The study examines the integration of the Evidence-based Design (EBD) approach in healthcare architecture education in the context of an academic design studio. Background: Previous research addressed the gap between scientific research and architectural practice and the lack of research on the use of the EBD approach in architectural education. Methods: The research examines an undergraduate architectural studio to design a Maggie’s Centre for cancer care in Israel and evaluates the impact of the EBD approach on the design process and design outcomes. The research investigates the impact of the integration of three predesign tasks: (1) literature review of healing architecture research, (2) analysis and comparison of existing Maggie’s Centres, and (3) analysis of the context of the design project. Results: The literature review of scientific research supported the conceptual design and development of the projects. The analysis of existing Maggie’s centers, which demonstrated the interpretation of the evidence by different architects, developed the students’ ability to evaluate EBD in practice critically, and the study of the projects’ local context led the students to define the relevance of the evidence to support their vision for the project. Conclusions: The research demonstrates the advantages of practicing EBD at an early stage in healthcare architectural education to enhance awareness of the impact of architectural design on the users’ health and well-being and the potential to support creativity and innovative design. More studies in design studios are needed to assess the full impact of integrating EBD in architectural education.
Understanding progressive multifocal leukoencephalopathy: links between milky-way appearance and mismatch T2/FLAIR
Authors: Ruiz Romagnoli Emiliano , Akly Manuel Perez , Miquelini Luis A , Funes Jorge , Gillanders Tatiana , Besada Cristina 
Published: May 2021

Background Magnetic resonance imaging is essential to diagnose progressive multifocal leukoencephalopathy. The broad radiological spectrum may partially be explained by genetic viral mutations and their differential neurotropism. Recent pharmacovigilance-magnetic resonance imaging studies have provided new insight into pathophysiology and radiological markers of early stages. However, how lesions evolve and why certain anatomical locations are more frequently affected remains unknown. We aim to describe a new sign – T2/fluid-attenutated inversion recovery mismatch – as a complementary marker of cavitated lesions and propose a link with the milky-way appearance, a key early sign. Furthermore, we hypothesise viral dissemination routes. Methods We conducted a retrospective longitudinal study from January 2010 to January 2020, to analyse clinical and magnetic resonance imaging features of 13 progressive multifocal leukoencephalopathy individuals at the symptomatic stage (mean age 58.3 years (SD ± 16.8) – 61.5% were women). Results The most prevalent pathology was HIV (61.5%) and motor deficit prevailed regarding other symptoms (76.9%). Frontal lobes (76.9%), middle cerebellar peduncle (61.5%), cerebellum (61.5%), and pons (53.8%) were most commonly affected, and the cortico-ponto-cerebellar pathway seemed involved in these patients. Five patients had a pure radiological pattern. Milky-way appearance was the most frequent radiological sign (58.3%). Five patients with milky-way appearance had concomitantly T2/fluid-attenuated inversion recovery mismatch ( P = 0.02). This sign showed high sensitivity and specificity (100–71%, P = 0.02) to assess evolved lesions besides diffusion. Conclusion The possible tract-dependent spread, as well as clinical and genetic, have implications on the MRI variability of progressive multifocal leukoencephalopathy. The milky-way appearance could reflect a transitional phase towards evolved lesions, the latter demonstrated by T2/fluid-attenuated inversion recovery mismatch. Both could be key magnetic resonance imaging signs to diagnose progressive multifocal leukoencephalopathy at the symptomatic stage.
The efficacy of single suture for exit site wound closure and stabilization of hemodialysis central tunneled catheter
Authors: Porazko Tomasz , Piersiak Andrzej , Klinger Marian 
Published: May 2021

Introduction: The majority of the end-stage renal disease patients begin hemodialysis with the central tunneled catheter as a permanent or bridge vascular access. The procedure of central tunneled catheter insertion can be complicated by exit site bleeding, prolonged tunnel healing, and infection. The study aimed at evaluating whether the catheter exit site wound closing with a single-suture method is equally effective as the double suture method, which is most frequently applied. The assumption was that the single-suture method, which is less traumatizing for the skin, could offer an advantage for the patients with “paper” skin, that is, elderly, after long-term immunosuppressive treatment. Methods: Insertion of central tunneled catheter with antegrade tunnel formation was performed in 140 patients divided randomly into two groups of 70 patients using either single-suture method or double suture method. Results: Follow-up observations revealed a comparable number of early complications, that is, bleeding or exit site infection, in about 26% of the patients from both groups. No difference appeared in the catheter displacement, either. The percentage of patients with a prolonged central tunneled catheter exit site wound healing was not significantly lower in the single-suture method group: 5.8% versus 11.3%, p = 0.367. There was no impact of single-suture method versus double suture method on the central tunneled catheter long-term function and survival. Conclusion: The single-suture method of the central tunneled catheter exit closure is equal in efficacy to the double suture method. Its potential benefit for the patients with an increased risk of poor wound healing should be tested in further study.
Otolaryngologists Practice Pattern on Oral Allergy Syndrome
Authors: Zhang, MD Yunjia , Marzouk, MD Haidy 
Published: May 2021

Background Oral allergy syndrome is a unique type of food allergy caused by cross-sensitivity between inhalant allergens and food allergens. Despite its significant prevalence and potentially serious outcome, the knowledge base and practice patterns on OAS are not well known among otolaryngologists. Our study is designed to understand the practice patterns of otolaryngologists in screening, testing, and treating OAS through a web-based survey. Methods Three thousand otolaryngologists were randomly selected from a membership list of the American Academy of Otolaryngology – Head and Neck Surgery. A survey was designed to include demographic questions and questions about OAS understanding, screening, and management. Surveys were sent to selected otolaryngologists via mail. Responses were de-identified and analyzed using SPSS. Results Out of the 50 survey responses, 46 reported treating environmental allergy in their practices. Twenty eight out of 46 reported knowing about OAS (60.9%). Fifteen out of the 28 physicians screened for OAS (53.6%). Out of the responders who knew about OAS, 12 (42.9%) reported diagnosing under 5 cases in the past year, 7 (25%) diagnosed 5 to 10 cases, and 7 (25%) reported diagnosed more than 10 cases in the past year. Eleven (39.3%) reported ordering component allergy testing for food allergies. Twenty six (92.9%) reported using avoidance, 18 (64.3%) prescribed oral antihistamine medications, 14 (50%) prescribed epi-pen, and 19 (67.9%) desensitized patients to environmental allergies as a treatment for OAS. 26 (93%) reported using more than one of the listed treatments. 10 (36%) reported using all four methods. Conclusion Only 60.9% of the responders had a knowledge of OAS. Only 53.6% of those screened for OAS. Current treatment for OAS includes avoidance of allergens, desensitization of environmental allergens, prescription of oral antihistamine and epi-pen. Nearly everyone (93%) reported using more than one treatment method.
Adolescent Girls With Overweight and Obesity Feel Physically Healthy and Highlight the Importance of Mental Health
Authors: Yerges April L. , Snethen Julia A. , Carrel Aaron L. 
Published: May 2021

Introduction Obesity in adolescence is a significant ongoing public health problem that has not improved over the past decade. Objective This descriptive qualitative study explores the perspective of female adolescents who are overweight or obese regarding their views on health and weight within the clinic setting. Methods In-depth interviews were conducted with female adolescents (age 13–19 years old; BMI ≥85th percentile) from the mid-west region of the United States (N = 28). Inductive thematic analysis using Braun & Clarke’s methods was utilized. Results The findings from this study revealed that the adolescents’ view of health encompasses physical, mental, and psychosocial health dimensions, and despite being overweight and obese, the participants felt healthy. Participants discussed the need to eat healthier and increase their daily physical activity, but were unable to transform this into action. Within the clinical setting, the adolescents were sensitive to weight discussions. Conclusion Results from this study can increase providers’ understanding of the adolescent, increase awareness of adolescent sensitivity, and assist researchers in developing age-appropriate interventions for effective treatment and prevention of childhood obesity.