bluuebunny/crossref_metadata_2025_split huggingface dataset:
Detailed dual-Doppler structure of Kelvin-Helmholtz waves from an airborne profiling radar over complex terrain. Part II: Evidence for precipitation enhancement from observations and modeling
Authors: Grasmick Coltin , Geerts Bart , Chu Xia , French Jeffrey R. , Rauber Robert M. 
Published: August 2021

AbstractKelvin-Helmholtz (KH) waves are a frequent source of turbulence in stratiform precipitation systems over mountainous terrain. KH waves introduce large eddies into otherwise laminar flow, with updrafts and downdrafts generating small-scale turbulence. When they occur in-cloud, such dynamics influence microphysical processes that impact precipitation growth and fallout. Part I of this paper used dual-Doppler, 2D wind and reflectivity measurements from an airborne cloud radar to demonstrate the occurrence of KH waves in stratiform orographic precipitation systems and identified four mechanisms for triggering KH waves. In Part II, we use similar observations to explore the effects of KH wave updrafts and turbulence on cloud microphysics. Measurements within KH wave updrafts reveal the production of liquid water in otherwise ice-dominated clouds, which can contribute to snow generation or enhancement via depositional and accretional growth. Fallstreaks beneath KH waves contain higher ice water content, composed of larger and more numerous ice particles, suggesting that KH waves and associated turbulence may also increase ice nucleation.A Large-Eddy Simulation (LES), designed to model the microphysical response to the KH wave eddies in mixed phase cloud, shows that depositional and accretional growth can be enhanced in KH waves, resulting in more precipitation when compared to a baseline simulation. While sublimation and evaporation occur in KH downdrafts, persistent supersaturation with respect to ice allows for net increase in ice mass. These modeling results and observations suggest that KH waves embedded in mixed-phase stratiform clouds may increase precipitation, although the quantitative impact remains uncertain.
Role of cloud feedback in continental warming response to CO2 physiological forcing
Authors: Park So-Won , Kug Jong-Seong , Jun Sang-Yoon , Jeong Su-Jong , Kim Jin-Soo 
Published: August 2021

AbstractStomatal closure is a major physiological response to the increasing atmospheric carbon dioxide (CO2), which can lead to surface warming by regulating surface energy fluxes—a phenomenon known as CO2physiological forcing. The magnitude of land surface warming caused by physiological forcing is substantial and varies across models. Here we assess the continental warming response to CO2physiological forcing and quantify the resultant climate feedback using carbon–climate simulations from phases 5 and 6 of the Coupled Model Intercomparison Project, with a focus on identifying the cause of inter-model spread. It is demonstrated that the continental (40°–70°N) warming response to the physiological forcing in summer (~0.55 K) is amplified primarily due to cloud feedback (~1.05 K), whereas the other climate feedbacks, ranged from –0.57 K to 0.20 K, show relatively minor contributions. In addition, the strength of cloud feedback varies considerably across models, which plays a primary role in leading large diversity of the continental warming response to the physiological forcing.
Glucocorticoids in acute pancreatitis: a propensity score matching analysis
Authors: Wang Meng , Jiang Zongxing , Liang Hongyin 
Published: August 2021

Abstract
Background
There are few reports about the effect of glucocorticoids in the treatment of acute pancreatitis in humans. This study aims to evaluate the effect of glucocorticoids in the treatment of acute pancreatitis by propensity score matching analysis.

Results
Acute pancreatitis patients admitted between 2014 and 2019 were collected from the database and analyzed. Included patients were divided into the glucocorticoids-used group (GC group) and the non-glucocorticoids-used group (NGC group) according to whether glucocorticoids were used. A total of 818 eligible patients were included in the final analysis. Seventy-six patients were treated with glucocorticoids, and 742 patients were treated without glucocorticoids. Before propensity score matching, the triglyceride levels (38.2 ± 18.5 vs. 20.2 ± 16.8, P < 0.05) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores (7.1 ± 2.5 vs. 4.5 ± 2.1, P < 0.05) at admission were significantly higher in the GC group than in the NGC group. The incidence of multi-organ failure (33.3% vs. 11.9%, P < 0.05) was significantly higher in the GC group than in the NGC group. Patients in the GC group showed a positive balance of fluid intake and output over 72 h. After 1:1 propensity score matching, 59 patients from each group (GC and NGC) were included in the analysis. There were no significant differences in age, sex, body mass index, triglycerides, or APACHE II scores between the two groups (P > 0.05), and the patients’ clinical outcomes were reversed. The proportion of patients with organ failure (40.7% vs. 52.5%, p < 0.05) and multi-organ failure (35.0% vs. 67.7%, P < 0.05) was significantly lower in the GC group than in the NGC group. Furthermore, patients in the GC group had significantly shorter lengths of hospital stay (12.9 ± 5.5 vs. 16.3 ± 7.7, P < 0.05) and costs (25,348.4 ± 2512.6vs. 32,421.7 ± 2813.3, P < 0.05) than those in the NGC group.

Conclusions
This study presents preliminary confirmation of the beneficial effect of glucocorticoids in the treatment of acute pancreatitis. More high-quality prospective studies are needed in the future.
Neuroblastoma xenograft models demonstrate the therapeutic potential of 177Lu-octreotate
Authors: Romiani Arman , Spetz Johan , Shubbar Emman , Lind Dan E. , Hallberg Bengt , Palmer Ruth H. , Forssell-Aronsson Eva 
Published: August 2021

Abstract
Background
Neuroblastoma (NB) is one of the most frequently diagnosed tumors in infants. NB is a neuroendocrine tumor type with various characteristics and features, and with diverse outcome. The most malignant NBs have a 5-year survival rate of only 40–50%, indicating the need for novel and improved treatment options. 177Lu-octreotate is routinely administered for treatment of neuroendocrine tumors overexpressing somatostatin receptors (SSTR). The aim of this study was to examine the biodistribution of 177Lu-octreotate in mice bearing aggressive human NB cell lines, in order to evaluate the potential usefulness of 177Lu-octreotate for treatment of NB.

Methods
BALB/c nude mice bearing CLB-BAR, CLB-GE or IMR-32 tumor xenografts (n = 5–7/group) were i.v. injected with 0.15 MBq, 1.5 MBq or 15 MBq 177Lu-octreotate and sacrificed 1 h, 24 h, 48 h and 168 h after administration. The radioactivity concentration was determined for collected tissue samples, tumor-to-normal-tissue activity concentration ratios (T/N) and mean absorbed dose for each tissue were calculated. Immunohistochemical (IHC) staining for SSTR1–5, and Ki67 were carried out for tumor xenografts from the three cell lines.

Results
High 177Lu concentration levels and T/N values were observed in all NB tumors, with the highest for CLB-GE tumor xenografts (72%IA/g 24 h p.i.; 1.5 MBq 177Lu-octreotate). The mean absorbed dose to the tumor was 6.8 Gy, 54 Gy and 29 Gy for CLB-BAR, CLB-GE and IMR-32, respectively, p.i. of 15 MBq 177Lu-octreotate. Receptor saturation was clearly observed in CLB-BAR, resulting in higher concentration levels in the tumor when lower activity levels where administered. IHC staining demonstrated highest expression of SSTR2 in CLB-GE, followed by CLB-BAR and IMR-32.

Conclusion
T/N values for all three human NB tumor xenograft types investigated were high relative to previously investigated neuroendocrine tumor types. The results indicate a clear potential of 177Lu-octreotate as a therapeutic alternative for metastatic NB.
Causes of death and effect of non-cancer-specific death on rates of overall survival in adult classic Hodgkin lymphoma: a populated-based competing risk analysis
Authors: Gao Jie , Chen Yingying , Wu Pengqiang , Wang Fujue , Tao Huan , Shen Qianqing , Wang Shuoting , Gong Shuaige , Zhang Xue , Zhou Zhencang , Song Xianmin , Jia Yongqian 
Published: August 2021

Abstract
Background
The improved prognosis of classic Hodgkin lymphoma (cHL) has been accompanied by elevated risks of non–cancer-specific death (non-CSD). The aim of this study was to verify the occurrence of non-CSD and its effect on rates of overall survival among adult patients with cHL.

Methods
To ensure sufficient follow-up time, we analyzed retrospective data from patients aged ≥20 years with cHL that was diagnosed between 1983 and 2005 in the Surveillance, Epidemiology, and End Results (SEER) database. Logistic regression was applied to analyze the non-CSD occurrence in relation to all factors. Using Fine-Gray’s method, we calculated the cumulative incidences of CSD and non-CSD. Stacked cumulative incidence plots and ratio of non-CSD to all causes of death were applied to evaluate the effect of non-CSD on rates of overall survival. Finally, we analyzed long-term mortality through Cox proportional hazard regression analysis and competing risk regression analysis to emphasize a more appropriate model of survival for patients with cHL.

Results
Among the 18,518 patients included, there were 3768 cases of CSD (20.3%) and 3217 of non-CSD (17.4%). Older age, earlier period, male sex, unmarried status, mixed cellularity (MC) and lymphocyte-depletion (LD) histological subtype, and patients received radiotherapy (RT) only were associated with more non-CSD according to binary logistic analysis. The cumulative incidence of non-CSD exceeded CSD after approximately 280 months follow-up. The most common causes of non-CSDs were cardiovascular disease, subsequent primary neoplasms, infectious diseases, accidents, and suicide. In a Cox proportional hazards model, patients who were black, unmarried, at an advanced stage or underwent chemotherapy (CT) alone were at greater risk of mortality than were white patients, who were married, at an early stage, and underwent combined modality; these populations were also found to be at greater risk for CSD in a competing risk model, but the risk of non-CSD did not differ significantly according to race and marital status, patients with early-stage disease and who underwent RT only were found to be at higher risk of non-CSD instead.

Conclusions
Lymphoma was the cause of death in most patients who died, but non-CSD was not unusual. Patients with cHL should be monitored closely for signs of cardiovascular disease and malignant tumors. Rates of overall survival of patients were diminished by non-CSD, and a competing risk model was more suitable for establishing the prognosis than was the Cox proportional hazards model.
Dental caries in children and adolescents with juvenile idiopathic arthritis and controls: a multilevel analysis
Authors: Gil Elisabeth G. , Åstrøm Anne N. , Lie Stein Atle , Rygg Marite , Fischer Johannes , Rosén Annika , Bletsa Athanasia , Luukko Keijo , Shi Xie-Qi , Halbig Josefine , Frid Paula , Cetrelli Lena , Tylleskär Karin , Rosendahl Karen , Skeie Marit S. 
Published: August 2021

Abstract
Background
Optimal utilization of dental caries data is crucial in epidemiological research of individuals with juvenile idiopathic arthritis (JIA). The aims were to: explore whether caries is more prevalent among children and adolescents with JIA compared to controls; examine presence of caries according to JIA group, socio-behavioral and intraoral characteristics, and the extent to which surface-specific caries varies between and within individuals; assess whether surface-specific caries varies according to JIA group and dentition; and investigate whether disease-specific clinical features of JIA are associated with presence of caries.

Methods
In this comparative cross-sectional study, calibrated dentists examined index teeth (primary 2. molars, 1. permanent molars) of 4–16-year-olds with JIA (n = 219) and matched controls (n = 224), using a detailed caries diagnosis system (including enamel caries). JIA-specific characteristics were assessed by pediatric rheumatologists and socio-behavioral information collected by questionnaires. Multilevel mixed-effect logistic regressions reporting odds ratios (OR) with 95% confidence interval (CI) were applied (caries at surface level as outcome variable). Potential confounders were adjusted for, and the effect of dependency of surface-specific caries data was estimated by calculating intra-class correlation coefficients (ICC).

Results
At individual level, no significant difference in caries prevalence was found between individuals with JIA and controls, regardless of inclusion of enamel caries. Proportion of enamel lesions exceeded dentine lesions. JIA was not associated with presence of caries, but in both groups, low maternal educational level was associated with presence of caries (OR: 2.07, 95% CI: 1.24–3.46). Occlusal and mesial surfaces, compared to buccal surfaces, had generally higher OR according to presence of caries than distal and lingual surfaces (ICC = 0.56). Surface-specific caries in the permanent dentition differed significantly according to group affiliation. Some JIA disease-specific variables were suggested to associate with presence of caries.

Conclusions
No overall difference in caries prevalence between individuals with JIA and controls was observed, but for both groups, low maternal educational level and tooth surface associated with presence of caries. Associations between JIA disease-specific variables and presence of caries cannot be excluded. Due to predominance of enamel lesions, the potential of preventative dental strategies is considerable.
Exploring the impact of rural health system factors on physician burnout: a mixed-methods study in Northern Canada
Authors: Hansen Nathaniel , Jensen Kennedy , MacNiven Ian , Pollock Nathaniel , D’Hont Thomsen , Chatwood Susan 
Published: August 2021

Abstract
Background
Burnout among physicians is a consequence of chronic occupational stresses and emotionally intense work demands. However, much of the evidence exploring burnout is derived from urban settings and may not reflect the work and social contexts of physicians in Indigenous communities or in rural and resource-constrained areas. We sought to characterize health system factors that influence burnout among physicians practicing in the three northern territories of Canada.

Methods
We conducted a mixed-methods study that included an online survey and qualitative interviews with physicians practicing in Nunavut, Northwest Territories, or Yukon in 2019. The survey adapted content from the Maslach Burnout Inventory. Results were analyzed with logistic regression to assess the association between health system factors and burnout. We conducted in-depth interviews with 14 physicians. Qualitative data was coded and analyzed for themes using the ATLAS.ti software.

Results
Thirty-nine percent of survey respondents (n = 22/57) showed features associated with burnout. Factors associated with burnout included use of electronic medical records (β = − 0.7, p < .05), inadequate financial remuneration (β = − 1.0, p < .05), and cross-cultural issues (β = − 1.1, p < .05). Qualitative analysis further identified physician perceptions of lack of influence over health system policies, systemic failures in cultural safety, discontinuity of care, administrative burden, and physician turnover as important drivers of burnout.

Conclusions
Physicians practicing in northern regions in Canada experience stress and burnout related to health system factors and cross-cultural issues. The relationship between cross-cultural issues and burnout has not previously been reported. This work may have implications for physician wellbeing and workforce attrition in other resource-constrained or culturally diverse clinical settings.
Online survey among maritime pilots: job-related stress and strain and the effects on their work ability
Authors: Oldenburg Marcus , Herzog Jan , Barbarewicz Filip , Harth Volker , Jensen Hans-Joachim 
Published: August 2021

Abstract
Background
Maritime pilots often navigate ships through challenging waterways. The required 24 h standby rotation system (ROS) poses a stressful working situation. This study aims to describe the current job-related stress and strain among maritime pilots and the effects on their work ability, taking into account the different rotation systems.

Methods
Within a cross-sectional survey, pilots of all German pilots’ associations were asked to complete an online questionnaire. The 1-week ROS (port pilots) was compared with the 4-month ROS (sea and canal pilots). The pilots’ subjective perception of stress and strain was assessed using an established ship-specific questionnaire. Daily sleepiness and work ability were examined respectively using the Epworth Sleepiness Scale (ESS) and the Work Ability Index (WAI).

Results
The study group consisted of 401 male German pilots with an average age of 48.5 years (participation rate 46.9%). More than 50% of the pilots evaluated irregular working hours as the main stressor in their job. 79.8% of the pilots (especially 4-month ROS) experienced high psychological demands in their workplace. 83.3% stated having regularly neglected their private obligations due to job assignments. Pilots from the 4-month ROS experienced insufficiently predictable free time and long operation times at a stretch as stressors (p < 0.001 and p = 0.037). Elevated daily sleepiness was found in 41.9% of the pilots. The overall evaluation of the WAI questionnaire showed good to very good work ability at 77.3%. Additionally, no significant differences in the daily sleepiness or the work ability were observed between the pilots of the different two ROS.

Conclusions
Due to their subjectively higher job-related mental demands, their disturbed work-life balance, and their long operation times at a stretch, it is likely that pilots from the 4-month ROS have significantly higher job stress compared to those in the 1-week ROS. However, this does not lead to more sleepiness or reduced work ability, which suggests that the pilots of this ROS are highly adapted to their working situation. Nevertheless, intervention measures with shortened ROS amongst sea and canal pilots’ associations should be tested in respect of benefit, practicability and acceptance by the pilots.
Retrospective Case Series Analysis ofRAFFamily Alterations in Pancreatic Cancer: Real-World Outcomes From Targeted and Standard Therapies
Authors: Hendifar Andrew , Blais Edik M. , Wolpin Brian , Subbiah Vivek , Collisson Eric , Singh Isha , Cannon Timothy , Shaw Kenna , Petricoin Emanuel F. , Klempner Samuel , Lyons Emily , Wang-Gillam Andrea , Pishvaian Michael J. , O'Reilly Eileen M. 
Published: August 2021

PURPOSEIn pancreatic cancer (PC), the RAF family alterations define a rare subset of patients that may predict response to inhibition of the BRAF/MEK/ERK signaling pathway. A comprehensive understanding of the molecular and clinical characteristics of RAF-mutated PC may support future development of RAF-directed strategies.METHODSClinical outcomes were assessed across a multi-institutional case series of 81 patients with RAF family-mutated PC. Mutational subgroups were defined on the basis of RAF alteration hotspots and therapeutic implications.RESULTSThe frequency of RAF alterations in PC was 2.2% (84 of 3,781) within a prevalence cohort derived from large molecular databases where BRAF V600E (Exon 15), BRAF ΔNVTAP (Exon 11), and SND1-BRAF fusions were the most common variants. In our retrospective case series, we identified 17 of 81 (21.0%) molecular profiles with a BRAF V600/Exon 15 mutation without any confounding drivers, 25 of 81 (30.9%) with BRAF or RAF1 fusions, and 18 of 81 (22.2%) with Exon 11 mutations. The remaining 21 of 81 (25.9%) profiles had atypical RAF variants and/or multiple oncogenic drivers. Clinical benefit from BRAF/MEK/ERK inhibitors was observed in 3 of 3 subjects within the V600 subgroup (two partial responses), 4 of 6 with fusions (two partial responses), 2 of 6 with Exon 11 mutations (one partial response), and 0 of 3 with confounding drivers. Outcomes analyses also suggested a trend favoring fluorouracil-based regimens over gemcitabine/nab-paclitaxel within the fusion subgroup ( P = .027).CONCLUSIONProspective evaluation of RAF-directed therapies is warranted in RAF-mutated PC; however, differential responses to targeted agents or standard regimens for each mutational subgroup should be a consideration when designing clinical trials.
Natural History and Aesthetic Truth inAesthetic Theory
Authors: Pensky Max 
Published: August 2021

AbstractTheodor W. Adorno’s claim in Aesthetic Theory that artworks have a truth content, and that this truth content in turn depends on philosophical interpretation, is among the work’s most challenging and obscure claims. This article argues that “The Idea of Natural History,” Adorno’s lecture dating to 1932, offers important resources for interpreting the claim of art’s truth content. Reading the lecture’s core idea of transience, the article proposes that the form of philosophical interpretation Adorno develops there illuminates one way to clarify what Adorno means, in Aesthetic Theory, by the interpretation of art’s truth content. While far from definitive, this conclusion does support interpretations of art’s truth content that foreground art’s function as a critique of ideology, that is, of having a field of application that moves beyond the sphere of the aesthetic and toward the disclosure of conditions of social domination.
Teddie’sLandschaft
Authors: Lee Sherry 
Published: August 2021

AbstractThis article considers the concept of cultural landscape (Kulturlandschaft) from Theodor W. Adorno’s Aesthetic Theory, exploring how the philosophy of natural beauty in relation to historical built environments resonates with ideas of musical landscape and experiences of peripatetic listening. If Adorno’s mature thought is marked by the fractured experience of exile, his late evocations of displacement actually echo youthful experiences on holiday—notably, the striking volcanic terrain of a summer vacation in Italy, which is transformed soon thereafter into a reflection on landscape, alienation, and song. Throughout the recurrences of the trope of landscape in Adorno’s writings before Aesthetic Theory, the philosophy of nature and history and experiences of tourism and exile constellate into an aesthetic that contemplates sublimity and kitsch side by side: modernist philosophy as shaped by experiences of music, travel, and landscapes of distance and estrangement.
Kant and Adorno on Mind and World: From Wild Beauties to Spiral Jetty
Authors: Bernstein J. M. 
Published: August 2021

Abstract
Theodor W. Adorno’s governing procedure in Aesthetic Theory is to reconstruct the terms and concepts of traditional aesthetics and the philosophy of art through the actuality of artistic modernism in its various guises. The necessity of this procedure turns on the recognition that modernist art has become a stand-in for the now-wrecked authority of living nature. Adorno contends that “natural beauty,” as elaborated by Immanuel Kant, is the recognition of that now-lost experience of nature, and that art beauty must be thereby interpreted as becoming the reconstructed afterimage of natural beauty. The article tracks the development of this thought from Kant’s account of “wild beauties” through Adorno’s chapter “Natural Beauty” to its actualization in Robert Smithson’s Spiral Jetty.