bluuebunny/crossref_metadata_2025_split huggingface dataset:
Along-Wind Dispersion by Horizontal Turbulent Jets in the Upper Ocean
Authors: Kukulka Tobias , Thoman Todd X. 
Published: July 2021

AbstractDispersion processes in the ocean surface boundary layer (OSBL) determine marine material distributions such as those of plankton and pollutants. Sheared velocities drive shear dispersion, which is traditionally assumed to be due to mean horizontal currents that decrease from the surface. However, OSBL turbulence supports along-wind jets; located in near-surface convergence and downwelling regions, such turbulent jets contain strong local shear. Through wind-driven idealized and large-eddy simulation (LES) models of the OSBL, this study examines the role of turbulent along-wind jets in dispersing material. In the idealized model, turbulent jets are generated by prescribed cellular flow with surface convergence and associated downwelling regions. Numeric and analytic model solutions reveal that horizontal jets substantially contribute to along-wind dispersion for sufficiently strong cellular flows and exceed contributions due to vertical mean shear for buoyant surface-trapped material. However, surface convergence regions also accumulate surface-trapped material, reducing shear dispersion by jets. Turbulence resolving LES results of a coastal depth-limited ocean agree qualitatively with the idealized model and reveal long-lived coherent jet structures that are necessary for effective jet dispersion. These coastal results indicate substantial jet contributions to along-wind dispersion. However, jet dispersion is likely less effective in the open ocean because jets are shorter lived, less organized, and distorted due to spiraling Ekman currents.
Optimized intelligent algorithm for classifying cloud particles recorded by a Cloud Particle Imager
Authors: Wu Zepei , Liu Shuo , Zhao Delong , Yang Ling , Xu Zixin , Yang Zhipeng , Liu Dantong , Liu Tao , Ding Yan , Zhou Wei , He Hui , Huang Mengyu , Li Ruijie , Ding Deping 
Published: July 2021

AbstractCloud particles have different shapes in the atmosphere. Research on cloud particle shapes plays an important role in analyzing the growth of ice crystals and the cloud microphysics. To achieve an accurate and efficient classification algorithm on ice crystal images, this study uses image-based morphological processing and principal component analysis, to extract features of images and apply intelligent classification algorithms for the Cloud Particle Imager (CPI). Currently, there are mainly two types of ice-crystal classification methods: one is the mode parameterization scheme, and the other is the artificial intelligence model. Combined with data feature extraction, the dataset was tested on ten types of classifiers, and the highest average accuracy was 99.07%. The fastest processing speed of the real-time data processing test was 2,000 images/s. In actual application, the algorithm should consider the processing speed, because the images are in the order of millions. Therefore, a support vector machine (SVM) classifier was used in this study. The SVM-based optimization algorithm can classify ice crystals into nine classes with an average accuracy of 95%, blurred frame accuracy of 100%, with a processing speed of 2,000 images/s. This method has a relatively high accuracy and faster classification processing speed than the classic neural network model. The new method could be also applied in physical parameter analysis of cloud microphysics.
Half a cubic hectometer mooring array of 3000 temperature sensors in the deep sea
Authors: van Haren Hans , Bakker Roel , Witte Yvo , Laan Martin , van Heerwaarden Johan 
Published: July 2021

AbstractThe redistribution of matter in the deep-sea depends on water-flow currents and turbulent exchange, for which breaking internal waves are an important source. As internal waves and turbulence are essentially three-dimensional ‘3D’, their dynamical development should ideally be studied in a volume of seawater. However, this is seldom done in the ocean where 1D-observations along a single vertical line are already difficult. We present the design, construction and successful deployment of a half-cubic-hectometer (480,000 m3) 3D-T mooring array holding 2925 high-resolution temperature sensors to study weakly density-stratified waters of the 2500-m deep Western Mediterranean. The stand-alone array samples temperature at a rate of 0.5 Hz, with precision <0.5 mK, noise level <0.1 mK and expected endurance of 3 years. The independent sensors are synchronized inductively every 4 h to a single standard clock. The array consists of 45 vertical lines 125 m long, at 9.5 m horizontally from their nearest neighbor. Each line is held under tension of 1.3 kN by a buoyancy element that is released chemically one week after deployment. All fold-up lines are attached to a grid of cables that is tensioned in a 70 m diameter ring of steel tubes. The array is build-up in harbor-waters, with air filling the steel tubes for floatation. The flat-form array is towed to the mooring site under favorable sea-state conditions. By opening valves in the steel tubes, the array is sunk and its free-fall is controlled by a custom-made drag-parachute reducing the average sinking speed to 1.3 m s-1 and providing smooth horizontal landing on the flat seafloor.
Future Projections of Heat Mortality Risk for Major European Cities
Authors: Karwat Alexia , Franzke Christian L. E. 
Published: July 2021

AbstractOver the last few decades heat waves have intensified and have led to excess mortality. While the probability of being affected by heat stress has significantly increased, the risk of heat mortality is rarely quantified. This quantification of heat mortality risk is necessary for systematic adaptation measures. Furthermore, heat mortality records are sparse and short, which presents a challenge for assessing heat mortality risk for future climate projections. It is therefore crucial to derive indicators for a systematic heat mortality risk assessment. Here, risk indicators based on temperature and mortality data are developed and applied to major cities in Germany, France and Spain, using regional climate model simulations. Bias-corrected daily maximum, minimum and wet-bulb temperatures show increasing trends in future climate projections for most considered cities. Additionally, we derive a relationship between daily maximum temperatures and mortality for producing future projections of heat mortality risk due to extreme temperatures based on low (Representative Concentration Pathway; RCP2.6) and high (RCP8.5) emission scenario future climate projections. Our results illustrate that heat mortality increases by about 0.9%/decade in Germany, 1.7%/decade in France and 7.9%/decade in Spain for RCP8.5 by 2050. The future climate projections also show that wet-bulb temperatures above 30°Cwill be reached regularly with maxima above 40°Clikely by 2050. Our results suggest a significant increase of heat mortality in the future, especially in Spain. On average, our results indicate that the mortality risk trend is almost twice as high in all three countries for the RCP8.5 scenario compared to RCP2.6.
Short-Term Outcomes Following Removal of Infected Hernia Mesh
Authors: Tung Christine , Ozao-Choy Junko , Kim Dennis Y. , de Virgilio Christian , Moazzez Ashkan 
Published: July 2021

There are limited studies regarding outcomes of replacing an infected mesh with another mesh. We reviewed short-term outcomes following infected mesh removal and whether placement of new mesh is associated with worse outcomes. Patients who underwent hernia repair with infected mesh removal were identified from 2005 to 2018 American College of Surgeons-National Surgical Quality Improvement Program database. They were divided into new mesh (Mesh+) or no mesh (Mesh-) groups. Bivariate and multivariate logistic regression analyses were used to compare morbidity between the two groups and to identify associated risk factors. Of 1660 patients, 49.3% received new mesh, with higher morbidity in the Mesh+ (35.9% vs. 30.3%; P = .016), but without higher rates of surgical site infection (SSI) (21.3% vs. 19.7%; P = .465). Mesh+ had higher rates of acute kidney injury (1.3% vs. .4%; P = .028), UTI (3.1% vs. 1.3%, P = .014), ventilator dependence (4.9% vs. 2.4%; P = .006), and longer LOS (8.6 vs. 7 days, P < .001). Multivariate logistic regression showed new mesh placement (OR: 1.41; 95% CI: 1.07-1.85; P = .014), body mass index (OR: 1.02; 95% CI: 1.00-1.03; P = .022), and smoking (OR: 1.43; 95% CI: 1.05-1.95; P = .025) as risk factors independently associated with increased morbidity. New mesh placement at time of infected mesh removal is associated with increased morbidity but not with SSI. Body mass index and smoking history continue to contribute to postoperative morbidity during subsequent operations for complications.
Does Gender Matter: A Multi-Institutional Analysis of Viscoelastic Profiles for 1565 Trauma Patients With Severe Hemorrhage
Authors: Smith Alison , Duchesne Juan , Marturano Matthew , Lawicki Shaun , Sexton Kevin , Taylor John R. , Richards Justin , Harris Charles , Moreno-Ponte Oscar , Cannon Jeremy W. , Guzman Jessica F. , Pickett Maryanne L. , Cripps Michael W. , Curry Terry , Costantini Todd , Guidry Chrissy 
Published: July 2021

Background Viscoelastic tests including thromboelastography (TEG) and rotational thromboelastometry (ROTEM) are being used in patients with severe hemorrhage at trauma centers to guide resuscitation. Several recent studies demonstrated hypercoagulability in female trauma patients that was associated with a survival advantage. The objective of our study was to elucidate the effects of gender differences in TEG/ROTEM values on survival in trauma patients with severe hemorrhage. Methods A retrospective review of consecutive adult patients receiving massive transfusion protocol (MTP) at 7 Level I trauma centers was performed from 2013 to 2018. Data were stratified by gender and then further examined by TEG or ROTEM parameters. Results were analyzed using univariate and multi-variate analyses. Results A total of 1565 patients were included with 70.9% male gender (n = 1110/1565). Female trauma patients were older than male patients (43.5 ± .9 vs 41.1 ± .6 years, P = .01). On TEG, females had longer reaction times (6.1 ± .9 min vs 4.8 ± .2 min, P = .03), increased alpha angle (68.6 ± .8 vs 65.7 ± .4, P < .001), and higher maximum amplitude (59.8 ± .8 vs 56.3 ± .4, P < .001). On ROTEM, females had significantly longer clot time (99.2 ± 13.7 vs 75.1 ± 2.6 sec, P = .09) and clot formation time (153.6 ± 10.6 sec vs 106.9 ± 3.8 sec, P < .001). When comparing by gender, no difference for in-hospital mortality was found for patients in the TEG or ROTEM group ( P > .05). Multivariate analysis showed no survival difference for female patients (OR 1.11, 95% CI .83-1.50, P = .48). Conclusions Although a difference between male and females was found on TEG/ROTEM for certain clotting parameters, no difference in mortality was observed. Prospective multi-institutional studies are needed.
Examining Adult E-cigarette Use in Kentucky and Its Appalachian Region Using the Behavioral Risk Factor Surveillance System, 2016-2017
Authors: Christian W. Jay , Valvi Nimish R. , Walker Courtney J. 
Published: July 2021

Objectives Electronic cigarette (e-cigarette) use has increased steadily in the United States, but little research has examined its prevalence in states comprising Appalachia, a rural region known for high rates of tobacco use. This study assessed lifetime and current e-cigarette use among adults by sociodemographic characteristics, geographic region, and cigarette smoking in Kentucky, with a focus on the Appalachian region. Methods We used data from the 2016-2017 Behavioral Risk Factor Surveillance System (BRFSS) surveys to calculate the prevalence of lifetime and current e-cigarette use, and we used weighted multivariable logistic regression analyses to examine the relative influence of other factors. Results Among adults in Kentucky, 5.8% (95% CI, 5.2%-6.4%) were current e-cigarette users and 27.0% (95% CI, 25.9%-28.0%) were lifetime users, compared with state medians of 4.6% (95% CI, 4.0%-5.1%) and 21.4% (95% CI, 19.4%-23.5%) for the United States. Multivariable regression models showed similar patterns for all regions: higher prevalence odds of current e-cigarette use among adults aged 18-24, current conventional smokers, and adults unable to work. Generally, Appalachian residents of Kentucky did not have significantly higher rates of lifetime or current e-cigarette use as compared with other non-Appalachian residents of Kentucky. Hispanic residents of Appalachian Kentucky, however, had higher rates of e-cigarette use than Hispanic residents of other regions of Kentucky. Conclusions Rates of e-cigarette use were higher in Kentucky than in the United States but were not further elevated in Kentucky’s Appalachian region. High rates of e-cigarette use among Hispanic residents of Appalachia indicate a need to focus future interventions in the region.
A variant in the 3ʹ-untranslated region of the MC2R gene decreases the risk of schizophrenia in a female Han Chinese population
Authors: Tang Liang , Xiang Qin , Xiang Ju , Li Jianming , Chen Danna 
Published: July 2021

Objective Schizophrenia is a complex mental disorder with high heritability. The hypothalamic–pituitary–adrenal (HPA) axis, which is the stress system of the neuroendocrine system, is considered to impact psychotic disorders. We hypothesized that polymorphisms of HPA axis genes might be involved in the development of schizophrenia. Methods A case–control study comprising 234 patients with schizophrenia and 399 matched healthy controls was conducted to investigate the association between the human melanocortin 2 receptor (MC2R) gene and schizophrenia risk. Seven tag single nucleotide polymorphisms (SNPs) (rs16941303, rs16941314, rs2186944, rs28926188, rs7230126, rs948322, and rs948331) of MC2R were genotyped by direct sequencing. Results No significant associations were observed between any of the alleles, genotypes, or haplotypes examined within the MC2R gene and the risk of schizophrenia in the total group or in subgroups stratified by smoking or alcoholism. However, a subgroup analysis stratified by sex revealed that under the additive model, the C allele of the MC2R rs948331 SNP significantly decreased the risk of schizophrenia in females (odds ratio=0.18). Conclusion The C allele of the MC2R rs948331 locus may be a protective factor, reducing the risk of schizophrenia in the female Han Chinese population.
Increased burden of rare variants in genes of the endosomal Toll-like receptor pathway in patients with systemic lupus erythematosus
Authors: Lea-Henry Tom N , Chuah Aaron , Stanley Maurice , Athanasopoulos Vicki , Starkey Malcolm R , Christiadi Daniel , Kitching A Richard , Cook Matthew C , Andrews Thomas D , Vinuesa Carola G , Walters Giles D , Jiang Simon H 
Published: July 2021

Objective To compare the frequency of rare variants in genes of the pathophysiologically relevant endosomal Toll-like receptor (eTLR) pathway and any quantifiable differences in variant rarity, predicted deleteriousness, or molecular proximity in patients with systemic lupus erythematosus (SLE) and healthy controls. Patients and methods 65 genes associated with the eTLR pathway were identified by literature search and pathway analysis. Using next generation sequencing techniques, these were compared in two randomised cohorts of patients with SLE (n = 114 and n = 113) with 197 healthy controls. Genetically determined ethnicity was used to normalise minor allele frequencies (MAF) for the identified genetic variants and these were then compared by their frequency: rare (MAF < 0.005), uncommon (MAF 0.005–0.02), and common (MAF >0.02). This was compared to the results for 65 randomly selected genes. Results Patients with SLE are more likely to carry a rare nonsynonymous variant affecting proteins within the eTLR pathway than healthy controls. Furthermore, individuals with SLE are more likely to have multiple rare variants in this pathway. There were no differences in rarity, Combined Annotation Dependent Depletion (CADD) score, or molecular proximity for rare eTLR pathway variants. Conclusions Rare non-synonymous variants are enriched in patients with SLE in the eTLR pathway. This supports the hypothesis that SLE arises from several rare variants of relatively large effect rather than many common variants of small effect.
Impact of switching from digital mammography to tomosynthesis plus digital mammography on breast cancer screening in Alberta, Canada
Authors: Pang Jack XQ , Newsome James , Sun Maggie , Chiang Bonnie , Mutti-Packer Seema , McDonald Sheila W , Yang Huiming 
Published: July 2021

Objectives To compare abnormal call rates (ACR), cancer detection rates (CDR), positive predictive values (PPVs), and annual return to screen recommendations after switching from digital mammography (DM) to digital breast tomosynthesis plus DM (DBT + DM) for breast cancer screening. Setting The Alberta Breast Cancer Screening Program collects screening data from clinics throughout the province of Alberta, Canada. Methods This study retrospectively collected data, between 2015 and 2018, on women aged 40+ who underwent breast cancer screening at two large volume multisite radiology groups to compare metrics one year prior and one year after DBT + DM implementation. Comparisons between modalities were carried out within age groups, within breast density categories, and for initial vs. subsequent screens. Results A total of 125,432 DM and 128,912 DBT + DM screening exams were performed. For women aged 50–74, the DBT + DM group had a higher ACR ( p < 0.01) but lower annual return to screens ( p < 0.01). CDR was higher post-DBT + DM implementation for women with scattered (6.0 per 1000 vs. 4.4 per 1000; p = 0.001) or heterogeneously dense breasts (6.5 per 1000 vs. 4.2 per 1000; p < 0.001). PPV was higher with DBT + DM for all age groups, with women 50–74 having a PPV of 8.3% using DBT + DM vs. 7.1% with DM ( p = 0.009). Conclusion All metrics improved or stayed the same after switching to DBT + DM except for ACR. However, the increase in ACR could be attributed to a trend already occurring prior to the switch. Longer term monitoring is needed to confirm these findings.
Is trauma informed care possible in the current public mental health system?
Authors: Isobel Sophie 
Published: July 2021

Objectives: As mental health services move towards implementing ‘Trauma-informed care’, there is a need to consider the challenges posed within services and systems. This paper raises some of the challenges associated with integrating TIC into the current public mental health system. . Conclusion: The lack of clarity about expectations of trauma-informed approaches causes difficulties for its integration into services, but the wider political context of mental health services is also of relevance. Transparent and ongoing debate is required about approaches to mental health care, to ensure the system meets the needs of those who require it, while questioning what other purposes it may be serving at social and political levels.
Programmed Death Ligand 1 Expression and Related Markers in Pleuropulmonary Blastoma
Authors: Alipour Zahra , Schultz Kris Ann P , Chen Ling , Harris Anne K , Gonzalez Ivan A , Pfeifer John , Hill D Ashley , He Mai , Dehner Louis P 
Published: July 2021

Introduction Pleuropulmonary blastoma (PPB), a rare childhood neoplasm of the lung, is linked to pathogenic DICER1 variants. We investigated checkpoint inhibitor markers including Programmed Death Ligand 1 (PD-L1), PD1, CD8 and tumor mutational burden (TMB) in PPB. Material and Methods Cases were collected from departmental archives and the International PPB/ DICER1 Registry. Immunohistochemistry (IHC) for PD-L1, PD-1, CD8 and DNA mismatch repair (MMR) genes were performed. In addition, normal-tumor paired whole exome sequencing (WES) was performed in two cases. Results Twenty-five PPB cases were studied, consisting of Type I (n = 8, including 2 Ir), Type II (n = 8) and Type III (n = 9). PD-L1 combined positive score (CPS) of 1, 4 and 80 was seen in three (3/25, 12.0%) cases of Type II PPB with negative staining in the remaining cases. PD-1 and CD8 stains demonstrated positive correlation ( P < .05). The density of PD1 and CD8 in the interface area was higher than within tumor ( P < .05). The MMR proteins were retained. TMB was 0.65 mutations/Mb in type II PPB with high expression of PD-L1, and 0.94 mutations/Mb in one negative PD-L1 case with metastatic tumor. Conclusion A small subpopulation of PPB patient might benefit from checkpoint immunotherapy due to positive PD-L1 staining.
Transepithelial photorefractive keratectomy on the same day of the initial consultation for the correction of myopia
Authors: Reitblat Olga , Gershoni Assaf , Mimouni Michael , Livny Eitan , Nahum Yoav , Bahar Irit 
Published: July 2021

Purpose: To examine the clinical outcomes, efficacy, safety, and predictability of transepithelial photorefractive keratectomy (Trans-PRK) operations performed on the day of the first screening visit in comparison with operations scheduled at a following appointment. Methods: Data of consecutive patients with myopia of various degrees, who underwent Trans-PRK, were retrospectively analyzed. Findings were compared between patients who underwent Trans-PRK on the same day of first consultation to patients that underwent surgery at subsequent visits, following initial consultation on a different day. Results: The study included 599 eyes treated on the initial visit day and 1936 eyes treated on a subsequent visit. Mean final spherical equivalent was close to emmetropia in both groups ( p = 0.183). Efficacy indices were 0.928 ± 0.192 in the initial-visit group and 0.945 ± 0.163 in the second-visit group ( p = 0.152). Safety indices were 0.954 ± 0.156 and 0.955 ± 0.151 ( p = 0.707), respectively. No differences between the groups were seen in uncorrected visual acuity (UDVA) of ⩾20/20, ⩾20/25, and ⩾20/32. Only the sub-analysis of patients reaching UDVA of 20/40 or better was slightly lower in the first-visit (95.5%) compared with the second-visit group (97.9%, p = 0.001). Results of attempted correction within ±0.50 D were: 63.3% and 69.0%, respectively ( p = 0.009). Complications profiles in the two groups were comparable. Conclusions: Trans-PRK completed on the day of the first screening appointment demonstrated a similar safety outcome compared with subsequent-visits procedures, and slightly lower, yet comparable, results regarding efficacy and predictability.