bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serum Sphingosine-1-Phosphate Levels Are Associated With Severity and Outcome in Patients With Cerebral Ischemia
Authors: Schwedhelm Edzard , Schwieren Laura , Tiedt Steffen , von Lucadou Mirjam , Gloyer Nils-Ole , Böger Rainer , Magnus Tim , Daum Guenter , Thomalla Götz , Gerloff Christian , Choe Chi-un 
Published: September 2021

Background and Purpose:
The aim of this study was to examine whether sphingosine-1-phosphate (S1P) levels in patients with acute stroke are associated with stroke severity and outcome.

Methods:
In a prospective stroke cohort (MARK-STROKE), 374 patients with acute ischemic stroke or transient ischemic attack were enrolled (mean age: 67.9±13.0 years, sex: 64.7% male), and serum-S1P at admission was analyzed with tandem mass spectrometry. In addition to cross-sectional analyses, 79 adverse events (death, stroke, myocardial infarction, rehospitalization) were recorded in 270 patients during follow-up. Regression analyses were adjusted for age, sex, low-density lipoprotein cholesterol, and vascular risk factors. Results were validated in an independent stroke cohort with 219 patients with acute ischemic stroke (CIRCULAS).

Results:

Low serum-S1P was associated with higher National Institutes of Health Stroke Scale score at admission and with anterior circulation nonlacunar infarcts determined by multivariate regression analyses. During a follow-up of 294±170 days, patients with S1P in the lowest tertile (<1.33 µmol/L) had more adverse events (Kaplan-Meier analysis,
P
=0.048 for trend). In adjusted Cox regression analysis, the lowest S1P tertile was associated with a worse outcome after stroke (hazard ratio, HR 0.51 [95% confidence interval 0.28–0.92]). Results were confirmed in an independent cohort, ie, low S1P levels were associated with higher National Institutes of Health Stroke Scale, larger infarct volumes and worse outcome after 90 days (β-coefficient: –0.03,
P
=0.026; β-coefficient: −0.099,
P
=0.009 and odds ratio 0.52 [0.28–0.96], respectively).

Conclusions:
Our findings imply a detrimental role of low S1P levels in acute stroke and therefore underpin the therapeutic potential of S1P-mimics.
Mean flow and turbulence characteristics of a nocturnal downburst recorded on a 213 m tall meteorological tower
Authors: Romanic Djordje 
Published: September 2021

AbstractThis study presents rare measurements and analysis of a nocturnal thunderstorm downburst on the 213 m tall Cabauw tower in The Netherlands. The event occurred on 12 March 2008 between 02:00 and 03:00 UTC and was measured using four ultrasonic 10-Hz anemometers positioned at 3, 60, 100, and 180 m above ground level. 1-second gusts in the outflow exceeded 30 m s−1 at 60 m and above. This wind event was accompanied by an abrupt change of wind direction from southwest to west. While the shift in wind direction corresponded with the change of upwind surface roughness, the time series of turbulence intensity and other turbulence characteristics were not affected. The statistical properties of this event were compared against the largest European database of thunderstorm winds measured in the Mediterranean. The study also demonstrated that primary and secondary vortex structures—secondary vortex being rarely observed in actual downbursts—developed at the forward edge of the cold outflow. The estimated diameter of the downdraft was 1200 m at 70 m above ground. The measured velocity profiles and friction velocity were compared against theoretical predictions of the Monin-Obukhov Similarity Theory (MOST). MOST without stratification adjustment overestimated measured friction velocity twofold. Alternative values for surface roughness during the outflow were derived based on the measured friction velocity and MOST-based fit of measured velocity profiles. Ceilometer and radar measurements were supplementary data in this analysis.
Wave trains of 10–30-day meridional wind variations over the North Pacific during summer
Authors: Du Lei , Lu Riyu 
Published: September 2021

AbstractThe present study investigates the intraseasonal oscillations over the North Pacific during summer based on the ERA-Interim reanalysis dataset. It is shown that the main component of intraseasonal variations in meridional wind is dominated by 10–30-day variability. Zonally-oriented wave trains are identified over the North Pacific at this band, with a zonal wavenumber 6. The wave trains exhibit an equivalent-barotropic structure, with the maximum amplitude in the upper troposphere, and are manifested as quasi-stationary Rossby waves with the energy dispersing eastward. The wave trains do not show a phase-locking feature, that is, they have no preferred geographical locations in the zonal direction. Furthermore, energy analyses suggest that the intraseasonal waves gain energy through baroclinic energy conversion, while the barotropic energy conversion plays a negligible role. The present results have implications for better understanding and forecasting weather and climate in North America, since the intraseasonal waves over the North Pacific may act as precursory signals for extreme events occurring over North America.
Evaluation of Climate in CMIP6 Models over Two Third Pole Subregions with Contrasting Circulation Systems
Authors: Li Ying , Wang Chenghao , Su Fengge 
Published: September 2021

AbstractReliable simulations of historical and future climate are critical to assessing ecological and hydrological responses over the Third Pole (TP). In this study, we evaluate the historical and future temperature and precipitation simulations of 18 models from the Coupled Model Intercomparison Project Phase 6 (CMIP6) in southeastern TP (SETP) and the upstream of the Amu Darya and Syr Darya (UAS) regions, two typical TP subregions dominated by the Indian summer monsoon system and westerlies, respectively. Comparison against station observations suggests that CMIP6 models generally capture the intra-annual variability and spatial pattern of historical climate over both subregions. However, the wetting and cold biases observed in CMIP5 still persist in CMIP6; annual temperature is underestimated by most models and annual precipitation is overestimated by all models. Multi-model average cold biases in SETP and UAS are 1.18°C and 0.32°C, respectively, and wet biases in SETP and UAS are 119% and 46%, respectively. We further analyze climate projections under SSP1-2.6, SSP2-4.5, and SSP5-8.5 scenarios. Both SETP and UAS subregions are projected to experience significant warming in 2015–2100, with warming trends 34%–42% and 40%–50% higher than the global trend, respectively. Model projections suggest that the warming trend will slow down under SSP1-2.6 and SSP2-4.5 but further intensify under SSP5-8.5 in 2050–2100. Monsoon-dominated SETP is projected to experience a significant wetting trend stronger than UAS over the entire future period, especially in summer (cf. winter in westerlies-dominated UAS). Concurrently, a significant drying trend in summer is found in UAS during 2050–2100 under SSP5-8.5, suggesting the intensified uneven distributions of seasonal precipitation based on projections.
Inner-Core Sea Surface Cooling Induced by a Tropical Cyclone
Authors: Lu Zhumin , Wang Guihua , Shang Xiaodong 
Published: September 2021

AbstractAs a key to modulate the negative feedback to tropical cyclone (TC) intensity, the TC-induced inner-core sea surface cooling (SSCIC) is poorly understood. Using a linear two-layer theory and OGCM experiments, this study illustrates that the pattern of the inner-core mixing can be well interpreted by the wind-driven currents in the mixed layer (ML). This interpretation is based on 1) the mixing is triggered by the ML bulk shear instability and 2) the lag of upwelling makes the inner-core bulk shear equivalent to the inner-core wind-driven currents. Overall, the patterns of the inner-core bulk shear and mixing resemble the crescent body of a sickle. As an accumulative result of mixing, the SSCIC is clearly weaker than the maximum cold wake because of the weaker mixing ahead of the inner core and nearly zero mixing in a part of the inner core. The SSCIC induced by a rectilinear-track TC is mainly dominated by the inner-core mixing. Only for a slow-moving case, upwelling and horizontal advection can make minor contributions to the SSCIC by incorporating them with mixing. The SSCIC strength is inversely proportional to the moving speed, suggesting the mixing time rather than the mixing strength dominates the SSCIC. Despite inability in treating the mixing strength, this study elucidates the fundamental dynamical mechanisms of SSCIC, especially emphasizing the different roles of mixing, upwelling, and horizontal advection for fast- and slow-moving TCs, and thus provides a good start point to understand SSCIC.
Diurnal Variation in Surface Latent Heat Flux and the Effect of Diurnal Variability on the Climatological Latent Heat Flux over the Tropical Oceans
Authors: Yan Yunwei , Zhang Lei , Song Xiangzhou , Wang Guihua , Chen Changlin 
Published: September 2021

AbstractDiurnal variation in surface latent heat flux (LHF) and the effects of diurnal variations in LHF-related variables on the climatological LHF are examined using observations from the Global Tropical Moored Buoy Array. The estimated amplitude of the climatological diurnal LHF over the Indo-Pacific warm pool and the equatorial Pacific and Atlantic cold tongues is remarkable, with maximum values exceeding 20.0 W m−2. Diurnal variability of sea surface skin temperature (SSTskin) is the primary contributor to the diurnal LHF amplitude. Because the diurnal SSTskin amplitude has an inverse relationship with surface wind speed over the tropical oceans, an inverse spatial pattern between the diurnal LHF amplitude and surface wind speed results. Resolving diurnal variations in the SSTskin and wind improves the estimate of the climatological LHF by properly capturing the daytime SSTskin and daily mean wind speed, respectively. The diurnal SSTskin-associated contribution is large over the warm pool and equatorial cold tongues where low wind speeds tend to cause strong diurnal SSTskin warming, while the magnitude associated with the diurnal winds is large over the highly dynamic environment of the intertropical convergence zone. The total diurnal contribution is about 9.0 W m−2 on average over the buoy sites. There appears to be a power function (linear) relationship between the diurnal SSTskin-associated (wind-associated) contribution and surface mean wind speed (wind speed enhancement from diurnal variability). The total contribution from diurnal variability can be estimated accurately from high-frequency surface wind measurements using these relationships.
Skill, Predictability, and Cluster Analysis of Atlantic Tropical Storms and Hurricanes in the ECMWF Monthly Forecasts
Authors: Camargo Suzana J. , Vitart Frédéric , Lee Chia-Ying , Tippett Michael K. 
Published: September 2021

AbstractIn this paper we analyze Atlantic Ocean hurricane activity in the European Centre for Medium-Range Weather Forecasts (ECMWF) monthly hindcasts for the period 1998–2017. The main climatological characteristics of Atlantic tropical cyclone (TC) activity are considered at different lead times and across the entire ECMWF ensemble using three diagnostic variables: the number of tropical cyclones, the number of hurricanes, and the accumulated cyclone energy. The impacts of changing horizontal resolution and stochastic parameterization are clear in these diagnostic variables. The model skill scores for the number of tropical cyclones and accumulated cyclone energy by lead time are also computed. Using cluster analysis, we compare the characteristics of the forecast TC tracks with observations. Although four of the ECMWF clusters have similar characteristics to observed ones, one of the ECMWF clusters does not have a corresponding one in observations. We consider the predictability of each of these clusters, as well the modulation of their frequency by climate modes, such as the El Niño–Southern Oscillation and the Madden–Julian oscillation, taking advantage of the very large sample size of TC datasets in these hindcasts.
Using the (3N)-Dimensional Generalized Lorenz Systems as a Testbed for Data Assimilation: The Ensemble Kalman Filter
Authors: Moon Sungju , Baik Jong-Jin 
Published: September 2021

AbstractThe feasibility of using a (3N)-dimensional generalization of the Lorenz system in testing a traditional implementation of the ensemble Kalman filter is explored through numerical experiments. The generalization extends the Lorenz system, known as the Lorenz ’63 model, into a (3N)-dimensional nonlinear system for any positive integerN. Because the extension involves inclusion of additional wavenumber modes, raising the dimension allows the system to resolve smaller-scale motions, a unique characteristic of the present generalization that can be relevant to real modeling scenarios. Model imperfections are simulated by assuming a high-dimensional generalized Lorenz system as the true system and a generalized system of dimension less than or equal to the dimension of the true system as the model system. Different scenarios relevant to data assimilation practices are simulated by varying the dimensional differences between the model and true systems, ensemble size, and observation frequency and accuracy. It is suggested that the present generalization of the Lorenz system is an interesting and flexible tool for evaluating the effectiveness of data assimilation methods and a meaningful addition to the portfolio of testbed systems that includes the Lorenz ’63 and ’96 models, especially considering its relationship with the Lorenz ’63 model. The results presented in this study can serve as useful benchmarks for testing other data assimilation methods besides the ensemble Kalman filter.
How to deal with heat stress at an open-air event? Exploring visitors’ vulnerability, risk perception, and adaptive behavior with a multi-method approach
Authors: Heidenreich Anna , Buchner Martin , Walz Ariane , Thieken Annegret H. 
Published: September 2021

AbstractHeat waves are increasingly common in many countries across the globe, and also in Germany, where this study is set. Heat poses severe health risks, especially for vulnerable groups such as the elderly and children. This case study explores visitors’ behavior and perceptions during six weekends in the summer of 2018 at a six-month open-air horticultural show. Data from a face-to-face survey (n = 306) and behavioral observations (n = 2750) were analyzed via correlation analyses, ANOVA, and multiple regression analyses. Differences in weather perception, risk awareness, adaptive behavior, and activity level were observed between rainy days (maximum daily temperature < 25°C), warm summer days (25 - 30°C), and hot days (> 30°C). Respondents reported a high level of heat risk awareness, but most (90 %) were unaware of actual heat warnings. During hot days, more adaptive measures were reported and observed. Older respondents reported taking the highest number of adaptive measures. We observed the highest level of adaptation in children, but they also showed the highest activity level. Based on our results we discuss how to facilitate individual adaptation to heat stress at open-air events by taking the heterogeneity of visitors into account. In order to mitigate negative health outcomes for citizens in the future, we argue for tailored risk communication aimed at vulnerable groups.
Pulmonary Function Tests May Better Predict Dyspnea-Severity in Patients with Subglottic Stenosis Compared to Clinician-Reported Stenosis
Authors: Bhatt Neel K. , Huang Valerie P. , Bertelsen Caitlin , Gao William Z. , Reder Lindsay S. , Johns Michael M. , O’Dell Karla 
Published: September 2021

Objective:Patients with subglottic stenosis (SGS) present with varied degree of breathing complaints. The dyspnea index (DI) is a 10-question patient-reported outcome measure designed to measure the severity of upper airway obstruction. We set out to determine whether pulmonary function tests or clinician-reported degree of stenosis best predicted DI scores.Methods:Thirty patients with SGS were retrospectively reviewed over a 6-year period. One visit from each patient was included. Data including peak expiratory flow rate (PEFR), body-mass index (BMI), clinician-reported degree of stenosis, and DI scores were reviewed. Multiple linear regression was performed to determine how degree of stenosis and PEFR % predicted the variation in DI score.Results:PEFR % better predicted DI scores compared to degree of stenosis (partial correlation −0.32 vs 0.17). After stepwise elimination, PEFR % remained in the regression and was significantly associated with DI scores ( F[1, 29] = 9.38, P = .005). BMI did not demonstrate a linear relationship with DI scores and was not included in the regression ( r = −.02). The PEFR % unstandardized coefficient was −0.25 (95% CI: −0.42 to −0.08, P = .005). The model predicts that a 4% increase in the PEFR % results in a 1-point decrease in the DI score (95% CI: −1.68 to −0.32).Conclusion:This study suggests that pulmonary function tests may be a better in-office measure to substantiate the severity of symptoms in patients with SGS.
Is Revision Surgery Necessary for Patients With High Risk of Recurrence After Parotidectomy? A Multicenter Retrospective Study
Authors: Roch Médarine , Mauvais Olivier , Vergez Sebastien , Brenet Esteban , Lindas Pierre , Toussaint Bruno , Nguyen Duc Trung , Gauchotte Guillaume , Rumeau Cécile , Gallet Patrice 
Published: September 2021

Objectives:Close margin is a frequent situation after parotidectomy. The need for systematic prophylactic revision surgery is a question that arises regularly for malignant tumors, as it exposes to a high risk of facial palsy, while oncological benefits are unclear.Study Design:retrospective study.Setting:Multicentric.Subjects and Methods:We included all patients operated for systematic revision surgery in case of close margins after parotidectomy for a malignant tumor and analyzed the rate of tumor residue and its risk factors.Results:A tumor residue was identified in 43.5% of 23 cases, but none in case of initial complete excision with supra-millimetric margins. Invaded lymph nodes were identified in 6 cases, but none in case of low-grade tumors.Conclusions:Systematic revision seems mandatory in case of infra-millimetric margins and high-grade tumors or positive lymph node; further studies are needed to confirm whether it can be spared for T1-T2/N0 low-grade tumors, with close margins but complete initial excision.
Real-World Skills in a Virtual World: An Innovative Activity for Teaching Developmental Psychopathology
Authors: Koch Mary Kate , Mendle Jane 
Published: September 2021

Background Incorporating professional development into undergraduate psychology coursework is an ongoing area of improvement for educators. Objective We present a novel activity encouraging students to explore various professional skills and roles for which their psychology major prepares them through application to real-world issues. Method Students participated in one of two virtual mental health summits and formed working groups to present from different perspectives (e.g., public health, epidemiology, etc.). Students collectively voted on resolutions at the end of each summit (e.g., budgetary recommendations for a county health department). Results We examined student perceptions of confidence in their professional skills and content knowledge before and after summits. Students indicated that they wanted more applied assignments like the mental health summit in other psychology classes and preferred the activity to exams or papers in a virtual course. Teaching Implications The mental health summit represented a real-world application activity that students indicated wanting in their courses. Recommendations for how to adapt the presented activity for non-clinical psychology courses are discussed. Conclusion The mental health summit activity supported the real-world application that students desire. Future iterations of the activity can build on the model we describe to support greater skill improvement.
Assessment of venous leg symptoms in patients with hemorrhoidal disease (VEIN-HEMORRHOID study)
Authors: Cuglan Bilal , Ozturk Selcuk , Ozcan Fulya , Atmaca Hasan , Ensaroğlu Fatih , Saçıkara Alparslan , Yetkin Ertan 
Published: September 2021

Background Coexistence of dilating venous diseases in different vascular territories has raised the idea that they have similar vascular wall abnormality in their evolutionary process. Accordingly, we aimed to evaluate venous leg symptoms in patients with hemorrhoidal disease (HD) by means of VEINES-Sym questionnaire. Materials and methods The study involved 249 consecutive patients who underwent colonoscopy and met the inclusion criteria. Presence and grading of HD were made according to Goligher’s classification. All patients were examined for the existing of varicose vein and classified in respect of CEAP classiﬁcation. All participants were requested to answer the VEINES-Sym questionnaire. Results There was not statistically significant differences between the patients without HD (grade 0 or I) and with HD (Grade II or III) in respect to clinical characteristics except female predominance in hemorrhoid group (p = 0.07). Scores of heavy legs, swelling, burning sensation, restless leg, throbbing, tingling, and total VEINES score were significantly lower (ie: worse) in hemorrhoid group. Logistic regression analysis revealed that female gender and total VEINES score were independently associated with HD (OR: 2.03, 95% CI: 1.17-3.52, p = 0.01; OR: 0.96, 95% CI: 0.92-0.99, p = 0.02, respectively). Among all venous leg symptoms, severity of heavy legs, night cramps, swelling and aching were significantly correlated with the grades of HD. Conclusion We have shown significant association between the HD and venous leg symptoms reflected by total VEINES score and significant correlation between the HD grade and venous leg symptoms severity including heavy legs, swelling, night cramps and aching legs.
Combined high-resolution 3D CUBE T1-weighted imaging and non-contrast-enhanced magnetic resonance venography for evaluation of vein stenosis in May–Thurner syndrome
Authors: Shen Shanshan , Shan Chunhui , Lan Yanqin , Chen Yingmin , Li Jikuan , Guo Xiaowan , Ji Hong , Li Min , Cong MengDi 
Published: September 2021

Purpose To explore the feasibility of high-resolution MRI 3-dimensional (3D) CUBE T1-weighted magnetic resonance imaging (MRI) in combination with non-contrast-enhanced (NCE) magnetic resonance venography (MRV) for the assessment of lumen stenosis in May–Thurner syndrome. Methods Twenty-nine patients underwent computed tomography venography (CTV) and high-resolution MRI-CUBE T1, and NCE MRV acquisitions. ANOVA and LSD tests were used to compare the stenosis rate and narrowest and distal diameters of the vessel lumen. Results There were no significant differences in the estimated stenosis rate between CTV, CUBE T1, and NCE MRV (p = 0.768). However, there were significant differences in the measured stenosis diameters of the left common iliac vein (LCIV), with CTV giving the largest mean diameter and CUBE had the smallest mean diameter (p < 0.05). The measured normal LCIV diameters did not significantly differ between MRV and CUBE (p = 0.075) but were significantly larger on CTV than on MRV and CUBE (p < 0.05). Conclusions Compared with CTV, a combination of CUBE and MRV could provide an improved assessment of the degree of lumen stenosis in May–Thurner syndrome and demonstrate acute thrombosis. MRI underestimates the diameter of the vessel in comparison with CTV. MRI can be a substitute tool for Duplex ultrasound and CTV.