bluuebunny/crossref_metadata_2025_split huggingface dataset:
Wintertime precipitation over the Australian Snowy Mountains: Observations from an Intensive Field Campaign 2018
Authors: Ackermann Luis , Huang Yi , Siems Steven , Manton Michael , Lang Francisco , Chubb Thomas , Peace Andrew , Speirs Johanna , Suzanne Kenyon , Protat Alain , Alexander Simon P. 
Published: July 2021

AbstractUnderstanding the key dynamical and microphysical mechanisms driving precipitation in the Snowy Mountains region of southeast Australia, including the role of orography, can help improve precipitation forecasts, which is of great value for efficient water management. An intensive observation campaign was carried out during the 2018 austral winter, providing a comprehensive range of ground-based observations across the Snowy Mountains. We used data from three vertically pointing rain radars, cloud radar, a PARSIVEL disdrometer, and a network of 76 pluviometers. The observations reveal that all of the precipitation events were associated with cold front passages. About half accumulated during the frontal passage associated with deep, fully glaciated cloud tops; while the rest occurred in the post-frontal environment and was associated with clouds with supercooled liquid water (SLW) tops. About three quarters of the accumulated precipitation were observed under blocked conditions, likely associated with blocked stratiform orographic enhancement. Specifically, more than a third of the precipitation resulted from moist cloudless air being lifted over stagnant air, upwind from the barrier, creating SLW-top clouds. These SLW-clouds then produced stratiform precipitation mostly over the upwind slopes and mountain tops, with hydrometeors reaching the mountain tops mostly as rimed snow. Two precipitation events were studied in detail, which showed that during unblocked conditions, orographic convection invigoration and unblocked stratiform enhancement were the two main mechanisms driving the precipitation; with the latter being more prevalent after the frontal passage. During these events, ice particle growth was likely dominated by vapor deposition and aggregation during the frontal periods, while riming dominated during the post-frontal periods.
Momentum Governors of California Undercurrent Transport
Authors: Chen Ru , McWilliams James C. , Renault Lionel 
Published: July 2021

AbstractThe California Undercurrent (CUC) transport, with significant variability ranging from weeks to decades, has consequences for both the climate and biogeochemistry of the California Current system. This study evaluates the governors of the CUC transport and its temporal variability from a momentum perspective, using a mesoscale-resolving regional model. From a 16-yr mean perspective, the along-isobath pressure gradient acts to accelerate the CUC, whereas eddy advection retards it. The topographic form stress, which is part of the volume integrated along-isobath pressure gradient, not only acts in the direction of the time-mean CUC, but also greatly modulates the temporal variability of the CUC transport. This temporal variability is also correlated with the eddy momentum advection. The eddy stress plays a role in transferring both the equatorward wind stress and poleward CUC momentum downward. A theory is formulated to show that, in addition to the conventional vertical redistribution of momentum, the eddy stress can also redistribute momentum horizontally in the area where the correlation between the pressure anomaly and isopycnal fluctuations has large spatial variability.
The Effects of Extreme High Temperature Day-Off on Electricity Conservation
Authors: Su Yu-Wen 
Published: July 2021

AbstractThe continuously increasing temperatures worldwide indicate the frequently extreme heat in summer will become a new normal. The extreme high temperature (EHT) could be dangerous to human health, especially for outdoor workers or commuters, and increase the risk of grid collapse. Thus, the possibility of a day-off due to EHT has started to be discussed in Taiwan, based on the experience of typhoon day-off, but not yet concluded. In this study, the effects of the EHT day-off on electricity consumption in the industrial, service, and residential sectors was investigated through two determinants: First, high temperature would increase the electricity consumption in space cooling. Second, a day-off would change people’s behavior of electricity consumption from workday to non-workday modes. Combining the effects of cooling hours and non-workdays, the net influence of the EHT day-off on electricity consumption can be evaluated. Estimated results indicated that an EHT day-off can reduce aggregate electricity consumption by between 0.41% and 1.08%. The reduction of electricity consumption due to the off-day offsets the increase driven by high temperatures. Thus, an EHT day-off will mitigate the pressure of power grid and be of benefit to electricity conservation.
The Effect of Lumpectomy and Cavity Shave Margin Status on Recurrence and Survival in Breast-Conserving Surgery
Authors: Abdelsattar Jad M. , Afridi Faryal G. , Dai Zheng , Yousaf Natasha , Seldomridge Ashlee , Battin Alexander O. , Wen Sijin , Gray Dana , Marsh J. Wallis , Cowher Michael S. , Partin Jessica F. , Hazard‐Jenkins Hannah , Lupinacci Kristin 
Published: July 2021

Background/Objective Cavity shave margins (CSMs) decrease rate of positive margins and need for re-excision. Recurrence data following breast-conserving surgery (BCS) are not always available in large cancer registries. We sought to define our recurrence and survival data in BCS with routine excision of CSMs. Methods A single institution, 10-year retrospective review of breast cancer patients who underwent BCS with routine CSMs was conducted. Cavity shave margin technique was standard. Cox proportional hazard analyses and the Kaplan-Meier method were used to estimate recurrence and survival. Results Breast-conserving surgery with CSM was performed in 839 patients. Re-excision rate to achieve negative margins was 8.5%. Fifty-two patients (75%) underwent margin re-excision vs 18 patients (25%) underwent salvage mastectomy. Positive margin rate stratified by tumor histology was highest for invasive lobular carcinoma followed by mixed invasive ductal carcinoma (IDC) and ductal carcinoma in situ (DCIS), followed by pure DCIS and lowest for IDC. Length of follow-up was (4.7 ± 2.6, years). Overall recurrence rate (locoregional and systemic) was 4.3%: highest in patients with negative lumpectomy margin but positive CSM (L−S+ = 15%) followed by positive lumpectomy and CSMs (L+S+ = 14%), followed by patients with positive lumpectomy margin but negative CSMs (L+S− = 13%) and lowest for negative lumpectomy and CSM (L−S− = 5%), ( P = .0008). There was no difference in 5-year breast cancer–specific survival between the 4 subgroups: 96% for L−S−, 86.7% L−S+, 94.7% L+S+ and 90% L+S− ( P = .094). Conclusions Recurrence following BCS with CSMs can be stratified based on both lumpectomy and cavity shave margin positivity. Routine excision of CSMs allows identification of these patient subsets.
Missing Data in Research on Youth and Family Programs
Authors: Ballard Jaime , Richmond Adeya , van den Hoogenhof Suzanne , Borden Lynne , Perkins Daniel Francis 
Published: July 2021

Background Multilevel data can be missing at the individual level or at a nested level, such as family, classroom, or program site. Increased knowledge of higher-level missing data is necessary to develop evaluation design and statistical methods to address it. Methods Participants included 9,514 individuals participating in 47 youth and family programs nationwide who completed multiple self-report measures before and after program participation. Data were marked as missing or not missing at the item, scale, and wave levels for both individuals and program sites. Results Site-level missing data represented a substantial portion of missing data, ranging from 0–46% of missing data at pre-test and 35–71% of missing data at post-test. Youth were the most likely to be missing data, although site-level data did not differ by the age of participants served. In this dataset youth had the most surveys to complete, so their missing data could be due to survey fatigue. Conclusions Much of the missing data for individuals can be explained by the site not administering those questions or scales. These results suggest a need for statistical methods that account for site-level missing data, and for research design methods to reduce the prevalence of site-level missing data or reduce its impact. Researchers can generate buy-in with sites during the community collaboration stage, assessing problematic items for revision or removal and need for ongoing site support, particularly at post-test. We recommend that researchers conducting multilevel data report the amount and mechanism of missing data at each level.
Limited Scar Resection for Chronic Achilles Tendon Repair: Use of a Rat Model
Authors: Counihan Matthew , Leahy Thomas , Nuss Courtney , Newton Joseph , Mohanty Sarthak , Soslowsky Louis J. , Farber Daniel 
Published: July 2021

Background: Achilles tendon rupture diagnosis is frequently missed, leading to the development of a chronic rupture that requires surgical intervention to remove scar tissue and return the elongated Achilles tendon to appropriate functional length. The limited scar resection (LSR) intervention strategy may provide an advantage over other techniques, as it is less invasive and nondestructive to other tissues, although there is little evidence comparing outcomes between intervention strategies. Hypothesis: The LSR technique would be a viable treatment option for chronic Achilles tendon ruptures and would perform comparably with a more clinically accepted procedure, the gastrocnemius fascial turndown (GFT), in postintervention functional outcome measures and tendon mechanical and histological properties. Study Design: Controlled laboratory study. Methods: Chronic Achilles tendon ruptures were induced in the right hindlimb of Sprague-Dawley rats by Achilles tendon transection without repair, immobilization in dorsiflexion, and 5 weeks of cage activity. Animals were randomly divided between the intervention strategy groups (LSR and GFT), received 1 week of immobilization in plantarflexion, and were sacrificed at 3 or 6 weeks postintervention. In vivo functional outcome measures (gait kinetics, passive joint function, tendon vascular perfusion) were quantified during healing, and tendon mechanical and histological properties were assessed postsacrifice. Results: When compared with the GFT, the LSR technique elicited a faster return to baseline in gait kinetics, although there were few differences between groups or with healing time in other functional outcome measures (passive joint function and vascular perfusion). Quasi-static mechanical properties were improved with healing in both surgical intervention groups, although only the LSR group showed an improvement in fatigue properties between 3 and 6 weeks postintervention. Histological properties were similar between intervention strategies, except for decreased cellularity in the LSR group at 6 weeks postintervention. Conclusion: The LSR technique is a viable surgical intervention strategy for a chronic Achilles tendon rupture in a rodent model, and it performs similarly, if not better, when directly compared with a more clinically accepted surgery, the GFT. Clinical Relevance: This study supports the increased clinical use of the LSR technique for treating chronic Achilles tendon rupture cases.
C3 glomerulonephritis and systemic lupus erythematosus: A report of a patient treated with eculizumab and review of the literature
Authors: Fernandez-Ruiz Ruth , Blank Rebecca B , Wu Ming , Belmont H Michael 
Published: July 2021

Introduction Activation of the complement pathway by immune complexes is a key feature of systemic lupus erythematosus (SLE) and SLE glomerulonephritis, which translates into low levels of C3 and C4 during active disease. C3 glomerulonephritis (C3GN) is part of a broader group of rare renal diseases, the C3 glomerulopathies, characterized by prominent C3 accumulation in the glomeruli with minimal to no immunoglobulin (Ig) deposition secondary to dysregulation of the alternative pathway of the complement system. Distinguishing lupus nephritis from other complement-mediated kidney disorders, including C3GN, represents a diagnostic challenge with potential therapeutic implications. Methods We report an unusual case of a 55-year-old woman with SLE and previous biopsy-proven class IV lupus nephritis, subsequently diagnosed with C3GN. Furthermore, we review the available literature published from January 2010—March 2021 on the clinical features and management of C3GN in the setting of SLE. Results In addition to our case, very few reports exist in the literature regarding C3GN in association with SLE. The underlying pathogenic mechanism of C3GN consists of dysregulation of the alternative pathway of the complement system, either due to genetic variation in complement-related genes or to acquired autoantibodies targeting C3 or C5 convertases; the latter mechanism could explain the occurrence of C3GN in the setting of autoimmune diseases, although it was not definitively identified in our patient or others with SLE. Similar to some of the previous reports, after suboptimal renal response on mycophenolate mofetil and rituximab, our patient has been successfully treated with eculizumab, thus far with >50% improvement in proteinuria. Conclusions C3GN represents an additional mechanism of renal injury in SLE mediated by alternative complement pathway dysregulation. Although rare, patients with SLE and persistent proteinuria with very low C3 would benefit from expedited renal biopsy to evaluate for C3GN as well as genetic testing, since this entity could require a different therapeutic approach.
Seeking Excellence in End of Life Care (SEE Care): A Multi-Centered Acute Hospitals Service Evaluation
Authors: Tavabie Simon , Berglund Anja , Barclay David , Bass Steve , Collins Naomi , Edwards Elaine , Malik Farida , Minton Ollie , Peters Deborah , Stewart Eleanor , Winter Jayne , Ford-Dunn Suzanne 
Published: July 2021

Context: A proportion of UK hospital inpatients have palliative care needs but do not access specialist services. Objectives: To contemporaneously evaluate the significance of unmet specialist palliative care needs within the hospital inpatient population. Methods: Prospective multi-centered service evaluation was conducted through 4 snapshots across 4 acute NHS hospital trusts. All patients identified as dying in each hospital were included. Data extraction included symptom burden, medications and completion of care plans. Results: End-of-life care plans were completed for 73%, symptom-focused prescribing present in 96%. Symptoms were not well managed for 22%, with 4% suffering moderate to severely. Specific intervention was triggered in 56% of patients, consisting of prescribing advice and holistic support. Conclusion: There are significant unmet specialist palliative care needs within the hospital inpatient population. Contemporaneous data collection coupled with an outreach approach helps palliative care services better understand the experiences of dying people, alongside where improvement is needed.
Utility of Palliative Prognostic Index in Predicting Survival Outcomes in Patients With Hematological Malignancies in the Acute Ward Setting
Authors: Lee Shu-Hui , Chou Wen-Chi , Yang Hsin-Yi , Chen Chia-Chia , Chang Hung , Wang Po-Nan , Kuo Ming-Chung , Kao Yu-Feng , Ho Lun-Hui , Hsueh Shun-Wen , Kao Chen-Yi , Hsueh William Harrison , Hung Chia-Yen , Hung Yu-Shin 
Published: July 2021

Background: The palliative prognostic index (PPI) predicts the life expectancy of patients with terminally ill cancer in hospice settings. This study aimed to evaluate PPI as a prognostic tool for predicting the life expectancy of patients with hematological malignancies admitted to the acute ward. Methods: A total of 308 patients with hematological malignancies admitted to the hematological ward at a medical center between January 2016 and December 2017 were consecutively enrolled. PPI was scored within 24 h of admission. All patients were categorized into 3 groups by PPI for comparing survival and in-hospital mortality rates. Results: The median survival times were 38.4, 3.6, and 1.1 months for patients with good, intermediate, and poor prognostic group, respectively. The hazard ratio was 2.31 (95% CI 1.59-3.35, p < 0.001) when comparing the intermediate and good prognosis groups, and 3.90 (95% CI 2.52-6.03, p < 0.001) when comparing the poor and good prognosis groups. Forty-five (14.6%) patients died at discharge; in-hospital mortality rates among the good, intermediate, and poor prognostic groups were 9.0%, 23.4%, and 46.4%, respectively. The adjusted odds ratio for in-hospital mortality was 1.96 (95% CI, 0.80-4.82, p = 0.14) and 5.25 (95% CI, 2.01-13.7, p < 0.001) for patients in the intermediate and poor prognostic groups compared to those in the good prognostic group. Conclusion: PPI is an accurate prognostic tool for predicting survival times and in-hospital mortality rates in patients with hematological malignancies in an acute ward setting. PPI could assist clinicians in discussing end-of-life issues and in referring patients with hematological malignancies to palliative care.
Recurrence and new tumor development after frontline intravenous chemotherapy for retinoblastoma: Risk factors and treatment results
Authors: Gündüz Ahmet Kaan , Mirzayev Ibadulla , Dinçaslan Handan , Özalp Ateş Funda Seher 
Published: July 2021

Purpose: To evaluate the risk factors leading to recurrence and new tumor (NT) development in patients with retinoblastoma after intravenous chemotherapy (IVC) and to review the treatment outcomes. Materials and methods: The records of 166 retinoblastoma cases (having 246 affected eyes) who underwent six-cycle IVC (vincristine, etoposide, and carboplatin) as primary treatment between October 1999 and August 2020 were reviewed retrospectively. Results: The mean ages at presentation were 9.0 (median: 8.0) and 9.2 (median: 8.5) months in cases with recurrence and NTs respectively. Recurrence was detected in 40 (16.3%) eyes, NTs in 29 (11.8%), and both recurrence/NTs in 24 (9.8%). The mean time elapsed till recurrence and NT was 10.7 months. Multivariable analysis showed that the factors predictive of recurrence were largest tumor base diameter (LTBD) >12 mm ( p = 0.039) and presence of subretinal seeds at diagnosis ( p = 0.043). Multivariable risk factors for the development of NTs were bilateral familial retinoblastoma ( p = 0.001) and presence of subretinal seeds at diagnosis ( p = 0.010). Mean follow-up was 80.1 (median: 72.5) months. By Kaplan-Meier analysis, the 1-, 3-, and 6-year recurrence and NT rates were 21.2%, 28.1%, and 28.7% and 14.9%, 22.6%, and 23.9% respectively. The most common treatment methods used for recurrent and/or NTs included cryotherapy, transpupillary thermotherapy, and intra-arterial chemotherapy. Enucleation was eventually required in 24/93 (25.8%) eyes. No patient developed metastasis. Discussion: Development of recurrence and/or NT after IVC was noted in 38% of all retinoblastoma eyes. Bilateral familial disease, LTBD >12 mm, and presence of subretinal seeds at baseline were risk factors for recurrence and NTs in this study.
Repeated Endovascular Interventions Are Worthwhile, Even After Thrombosis, to Maintain Long-Term Use of Autogenous Dialysis Fistulas
Authors: Richard Michele N. , Stroever Stephanie , Dowling Caitlin , Burton Timothy , Butler Amber , Plummer Dahlia , Dietzek Alan M. 
Published: July 2021

Objectives: Patients often require multiple access re-interventions to improve fistula patency and the overall usable lifespan of autogenous arteriovenous fistula (aAVF). There is no consensus on the appropriate number of re-interventions after which an access should be abandoned and new access placed. We evaluated whether repeated endovascular interventions for failing/failed aAVF are worthwhile or futile. Methods: A retrospective review was performed on aAVFs created between 2009-2014. Fistula function was evaluated until January 2017. Functional fistula patency (FFP) was defined as the total time of functional fistula use for hemodialysis, from time of cannulation to time of measurement or fistula abandonment, including all interventions performed to maintain/reestablish patency. Primary outcomes were FFP duration and number of post-dialysis interventions. Results: The study included 163 patients. Mean age was 67 (SD = 15.03). The only variable statistically different between functional fistulas and abandoned fistulas was obesity (p = 0.03). At the end of the study period, 145 (89.0%) patients continued to have functional fistulas, and 73 (44.8%) patients died, but had functional fistulas at time of death. Median FFP for the functional group was 3.18 years (range 0.01-7.01 years) and median number of interventions was 1 (range 0-13). In 18 patients (11%), the fistula was abandoned, most commonly due to thrombosis (47.1%), followed by infection (23.5%). No fistula was abandoned because of an unacceptable rate of reintervention. Median FFP in the abandoned group was 0.91 years (range 0.03-5.30 years), and median number of interventions was 0 (range of 0-5). Conclusions: Through repeated interventions on aAVFs, none of the patients in our study exhausted all hemodialysis access options prior to transplantation, death or loss to follow-up. These results may indicate repeated and/or more frequent revisions do not negatively affect the FFP nor do they increase the overall risk for abandonment of aAVFs.
Investigation on the contour and bone mineral density of the distal tibial cutting surface used for total ankle arthroplasty
Authors: Zhao Dahang , Zhang Gonghao , Huang Dichao , Yu Jian , Wang Kan , Wang Xu , Zhang Tiansong , Ma Xin 
Published: July 2021

Purpose: This study was designed to investigate (1) the contour of the distal tibial cutting surface, and (2) the bone mineral density (BMD) of the distal tibial cutting surface used during total ankle arthroplasty (TAA). Methods: Eight-four distal tibial models were created using foot and ankle computerized tomographic (CT) images taken from normal people. The distal tibial cutting surface for TAA was determined to be 10 mm proximal to the tibial plafond. The bony contour and BMD values were determined from the CT image at that level. A bounding box was made on the contour and the width and length of the contour was measured. Regional BMD was evaluated by Hounsfield units (HU) value measurement, with 7 regions of interest (ROI) on 8 different directions for all the 84 CT images. Two different observers made independent measurements and mean HU values for all the 56 ROIs were calculated. Results: Great variations were found among the contours of the cutting surface especially in term of the shape of the anterior and posterior tibial tubercle, and the fibular notch. These variations could be grouped into six categories. For the BMD of the cutting surface, the medial border of the cutting surface did not included cortical bone. The HU value of seven ROIs, which included cortical bone, were significantly greater than all the other ROIs. Few statistical differences were found by multiple comparisons among HU value of all the 49 ROIs without cortex. Conclusions: Great variability existed in the shape and the BMD of the distal tibial cutting surface.