bluuebunny/crossref_metadata_2025_split huggingface dataset:
Idealized Large-Eddy Simulations of Stratocumulus Advecting over Cold Water. Part I: Boundary Layer Decoupling
Authors: Zheng Youtong , Zhang Haipeng , Rosenfeld Daniel , Lee Seoung-Soo , Su Tianning , Li Zhanqing 
Published: October 2021

Abstract
We explore the decoupling physics of a stratocumulus-topped boundary layer (STBL) moving over cooler water, a situation mimicking warm-air advection (WADV). We simulate an initially well-mixed STBL over a doubly periodic domain with the sea surface temperature decreasing linearly over time using the System for Atmospheric Modeling large-eddy model. Due to the surface cooling, the STBL becomes increasingly stably stratified, manifested as a near-surface temperature inversion topped by a well-mixed cloud-containing layer. Unlike the stably stratified STBL in cold-air advection (CADV) that is characterized by cumulus coupling, the stratocumulus deck in the WADV is unambiguously decoupled from the sea surface, manifested as weakly negative buoyancy flux throughout the subcloud layer. Without the influxes of buoyancy from the surface, the convective circulation in the well-mixed cloud-containing layer is driven by cloud-top radiative cooling. In such a regime, the downdrafts propel the circulation, in contrast to that in CADV regime for which the cumulus updrafts play a more determinant role. Such a contrast in convection regime explains the difference in many aspects of the STBLs including the entrainment rate, cloud homogeneity, vertical exchanges of heat and moisture, and lifetime of the stratocumulus deck, with the last being subject to a more thorough investigation in Part II. Finally, we investigate under what conditions a secondary stratus near the surface (or fog) can form in the WADV. We found that weaker subsidence favors the formation of fog whereas a more rapid surface cooling rate does not.
Significant Statement
The low-lying blanketlike clouds, called stratocumulus (Sc), reflect much incoming sunlight, substantially modulating Earth’s temperature. While much is known about how the Sc evolves when it moves over warmer water, few studies examine the opposite situation of Sc moving over colder water. We used a high-resolution numerical model to simulate such a case. When moving over cold water, the Sc becomes unambiguously decoupled from the water surface, distinctive from its warm counterpart in which the Sc interacts with the water surface via intermittent cauliflower-like clouds called cumulus clouds. Such decoupling influences many aspects of the Sc–sea surface system, which combine to alter the ability of the Sc to reflect sunlight, thereby influencing the climate. This work laid the foundation for future work that quantifies the contribution of such a decoupled Sc regime to Earth’s radiative budget and climate change.
High Failure Rate Following Restorative Surgery for Rectal Prolapse in Systemic Sclerosis Patients
Authors: Kahana Noam , Freund Michael R. , Koslowsky Benjamin , Blich Ori , Reissman Petachia , Yellinek Shlomo 
Published: October 2021

Introduction Systemic sclerosis (SSc) is a rare autoimmune connective tissue disorder. Colonic disorders are reported in 70% of patients. Only a few cases of rectal prolapse surgical repair in SSc patients were published, demonstrating high recurrence rate following any restorative surgery. The aim of this study is to present our surgical experience combined with the reported cases of SSc patients who underwent surgical interventions for rectal prolapse. Methods We reviewed our data and the published reports in the English literature of patients with SSc who underwent surgery for rectal prolapse. We located 6 case reports, in addition to 3 patients who were operated in our center. Results A total of 19 procedures (9 patients) were included, among them 17 restorative surgeries and 2 low anterior resections (LAR) with end-colostomy. All patients were female (mean age 70.3). Index surgery was perineal rectosigmoidectomy in 5, abdominal resection rectopexy in 3, and LAR with colostomy in 1 patient. All patients following restorative surgery suffered from fecal incontinence. 5 patients (62.5%) who underwent restorative surgery required at least 1 re-operation. The 2 patients who underwent LAR and colostomy reported a complete resolution of anorectal symptoms with a major improvement in their quality of life. Conclusion High recurrence rate is expected in SSc patients with rectal prolapse who undergo a restorative procedure. Low anterior resection and permanent colostomy provide an alternative surgical option to patients with SSc and prolapse in contrast to restorative surgery. We believe that this surgical approach should be offered for these patients.
Commission on Cancer CP3R Compliance Rates for Treatment of Patients With Triple Negative and HER2+ Breast Cancer: A National Cancer Database Analysis
Authors: Mohan Srivarshini C. , Tseng Joshua , Srour Marissa , Chung Alice , Marumoto Ashley , Angarita Stephanie , Giuliano Armando E. , Amersi Farin 
Published: October 2021

Background Cancer Program Practice Profile Reports (CP3R) metrics were released by the Commission on Cancer to provide standards for high-quality care. One metric is the recommendation of combination chemotherapy or chemo-immunotherapy (CIT) within 120 days of diagnosis for women under 70 with AJCC T1cN0M0 or Stage IB-III HER2+ or hormone receptor negative breast cancer ([Multi-agent chemotherapy] MAC). Our study assesses national concordance rates for MAC and CIT. Methods The National Cancer Database was queried from 2004-2014. Results 122,045 patients met criteria, of whom treatment for 101,800 (83.4%) patients was concordant with MAC and CIT. Treatment concordance increased from 75.7% in 2004 to 89.5% in 2014. For HER2+ patients, use of CIT treatment downtrended with progression of pathological stage, from 70.1% (stage I) to 58.1% (stage III). Mean overall survival of patients whose treatment was concordant with MAC and CIT was longer than that of patients who were non-concordant (146.6 vs 143.8 months, P <.01). On Cox regression, there was a survival benefit for concordant patients who were treated at academic hospitals (HR .89, 95% CI 0.802-.976) and had private insurance (HR .76, 95% CI 0.65-.89). Conclusion Compliance with MAC and CIT has improved over the past decade and is associated with a significant improvement in overall survival.
Field investigations on operational performance of a novel radiant floor heating equipment applied in a typical office building
Authors: Qiao Guinan , Wang Yu , Yu Haiyang , Li Yanju , Guo Chunmei 
Published: October 2021

Low-temperature radiant heating systems are widely used in buildings with significant energy conservation, and they are convenient for the utilization of low-grade energy resources and household metering. In this study, the practical application of a novel radiant floor heating system (RFHS) in cold regions is investigated via construction of an experimental platform for energy consumption and thermal comfort in an office building in Tianjin, China. The results indicated that the novel radiant floor exhibits higher heating capacity and heat transfer coefficient than that of a traditional radiant floor. During the experiment, the average indoor temperature was 25.0°C in the office room and 22.7°C in the conference room, and all instantaneous indoor temperatures exceeded 21°C. To avoid local thermal discomfort, the supply water temperature of the floor can be appropriately decreased by 2–3°C for operation. Additionally, the power consumption of the system is decreased by approximately 11.4% if the indoor temperature is decreased to 20°C. Hence, a 10-h operation mode per day can be adopted in the office building for energy conservation given that the novel radiant floor exhibits superior initial response to intermittent operation. Practical application: In this study, the practical application effect of a new type of water-passing floor is examined in cold regions to provide a design reference for engineering applications. Therefore, it is expected that the results will be helpful to researchers for indoor environments, heating, ventilating, and air conditioning engineers, system manufacturers, and those who want to analyze the operational performance of a radiant floor heating system.
Emotion differentiation during the transition to parenthood—Concurrent and prospective positive effects
Authors: Lazarus Gal , Pshedetzky-Shochat Rony , Zahavi-Lupo Tara , Gleason Marci EJ , Rafaeli Eshkol 
Published: October 2021

Emotion differentiation, the extent to which same-valenced emotions are experienced as distinct, has been found to be associated with various positive outcomes. However, little is known about its role in relational contexts. The present work examines couples in the transition to parenthood, a particularly emotionally demanding period, and explores the associations between emotion differentiation and both concurrent (3-month post-partum) and prospective (6-month post-partum) relationship quality adjusting for pre-partum relationship quality. Both negative emotion differentiation (NED) and positive emotion differentiation (PED) were computed from daily affect ratings completed over 21 days by both partners in 88 couples. They were then examined as predictors of relationship quality (relationship satisfaction and perceived partner responsiveness) using actor–partner interdependence models. NED was found to be concurrently associated with elevated perceived partner responsiveness for one’s self and for one’s partner, and with elevated relationship satisfaction when the partner’s NED was low. Positive emotion differentiation was found to be concurrently associated with relationship satisfaction for one’s self and one’s partner. Prospectively, partner NED and partner PED were associated with greater relationship satisfaction. The findings suggest that NED may function as a compensatory or shared dyadic resource, and that PED, whose effects in previous studies have been mixed, may also be constructive. Individuals undergoing emotionally demanding periods (such as the transition to parenthood) may benefit from developing more nuanced emotional experiences.
Malian Thick Porridges (tô) of Pearl Millet Are Made Thinner in Urban Than Rural Areas and Decrease Satiety
Authors: Diarra Mohamed , Torres-Aguilar Pablo , Hayes Anna M. R. , Cisse Fatimata , Nkama Iro , Hamaker Bruce R. 
Published: October 2021

Background: Changes in preparation, preference, and consumption of traditional staple foods between rural and urban areas in sub-Saharan Africa may be associated with the nutrition transition. Objective: Millet porridge thickness and postprandial hunger were investigated in Mali with the aim of understanding consumer preference and satiety properties. Methods: Rural and urban residents from 3 regions (N = 60) were surveyed regarding their porridge consumption frequency and thickness preference. Influence of millet porridge thickness on satiety was investigated. Ten participants consumed 4 porridges of different thicknesses (3 of millet and 1 thin porridge of rice) and rated their subjective hunger on 4 different days. Results: Thicker porridges were consumed more frequently in rural areas than in urban ( P < .05). For the satiety study, thicker porridges induced higher satiety than thinner ones at 2 and 4 hours postconsumption ( P < .05; Visual Analog Scale rating). A greater amount of flour, but not volume, was consumed for the thicker porridges ( P < .05). Conclusions: Urban participants preferred and consumed porridges that are less satiating, potentially contributing to higher food consumption related to the nutrition transition in Africa.
Assisted peritoneal dialysis across Europe: Practice variation and factors associated with availability
Authors: van Eck van der Sluijs Anita , van Jaarsveld Brigit C , Allen Jennifer , Altabas Karmela , Béchade Clémence , Bonenkamp Anna A , Burkhalter Felix , Clause Anne-Lorraine , Corbett Richard W , Dekker Friedo W , Eden Gabriele , François Karlien , Gudmundsdottir Helga , Lundström Ulrika Hahn , de Laforcade Louis , Lambie Mark , Martin Heike , Pajek Jernej , Panuccio Vincenzo , Ros-Ruiz Silvia , Steubl Dominik , Vega Almudena , Wojtaszek Ewa , Davies Simon J , Van Biesen Wim , Abrahams Alferso C 
Published: October 2021

Background: In Europe, the number of elderly end-stage kidney disease patients is increasing. Few of those patients receive peritoneal dialysis (PD), as many cannot perform PD autonomously. Assisted PD programmes are available in most European countries, but the percentage of patients receiving assisted PD varies considerably. Hence, we assessed which factors are associated with the availability of an assisted PD programme at a centre level and whether the availability of this programme is associated with proportion of home dialysis patients. Methods: An online survey was sent to healthcare professionals of European nephrology units. After selecting one respondent per centre, the associations were explored by χ 2 tests and (ordinal) logistic regression. Results: In total, 609 respondents completed the survey. Subsequently, 288 respondents from individual centres were identified; 58% worked in a centre with an assisted PD programme. Factors associated with availability of an assisted PD programme were Western European and Scandinavian countries (OR: 5.73; 95% CI: 3.07–10.68), non-academic centres (OR: 2.01; 95% CI: 1.09–3.72) and centres with a dedicated team for education (OR: 2.87; 95% CI: 1.35–6.11). Most Eastern & Central European respondents reported that the proportion of incident and prevalent home dialysis patients was <10% (72% and 63%), while 27% of Scandinavian respondents reported a proportion of >30% for both incident and prevalent home dialysis patients. Availability of an assisted PD programme was associated with a higher incidence (cumulative OR: 1.91; 95% CI: 1.21–3.01) and prevalence (cumulative OR: 2.81; 95% CI: 1.76–4.47) of patients on home dialysis. Conclusions: Assisted PD was more commonly offered among non-academic centres with a dedicated team for education across Europe, especially among Western European and Scandinavian countries where higher incidence and prevalence of home dialysis patients was reported.
Hemodynamic Effects of Ketamine Compared With Propofol or Dexmedetomidine as Continuous ICU Sedation
Authors: Atchley Evan , Tesoro Eljim , Meyer Robert , Bauer Alexia , Pulver Mark , Benken Scott 
Published: October 2021

Background Ketamine has seen increased use for sedation in the intensive care unit. In contrast to propofol or dexmedetomidine, ketamine may provide a positive effect on hemodynamics. Objective The objective of this study was to compare the development of clinically significant hypotension or bradycardia (ie, negative hemodynamic event) between critically ill adults receiving sedation with ketamine and either propofol or dexmedetomidine. Methods This was a retrospective cohort study of adults admitted to an intensive care unit at an academic medical center between January 2016 and January 2021. Results Patients in the ketamine group (n = 78) had significantly less clinically significant hypotension or bradycardia compared with those receiving propofol or dexmedetomidine (n = 156) (34.6% vs 63.5%; P < 0.001). Patients receiving ketamine also experienced smaller degree of hypotension observed by percent decrease in mean arterial pressure (25.3% [17.4] vs 33.8% [14.5]; P < 0.001) and absolute reduction in systolic blood pressure (26.5 [23.8] vs 42.0 [37.8] mm Hg; P < 0.001) and bradycardia (15.5 [24.3] vs 32.0 [23.0] reduction in beats per minute; P < 0.001). In multivariate logistic regression modeling, receipt of propofol or dexmedetomidine was the only independent predictor of a negative hemodynamic event (odds ratio [OR]: 3.3, 95% confidence interval [CI], 1.7 to 6.1; P < 0.001). Conclusion and Relevance Ketamine was associated with less clinically relevant hypotension or bradycardia when compared with propofol or dexmedetomidine, in addition to a smaller absolute decrease in hemodynamic parameters. The clinical significance of these findings requires further investigation.
Age Under 30 Years As a Predictor of Poor Survival in a Cohort of Mexican Women With Breast Cancer
Authors: Alvarez-Bañuelos María T. , Segura-Jaramillo Kevin A. , Gómez-Rivera Elba del C. , Alarcón-Rojas Carlos A. , Morales-Romero Jaime , Sampieri Clara L. , Guzmán-García Raúl E. 
Published: October 2021

Introduction Young women under 30 years with breast cancer (BC) are an emerging challenge. The purpose is to identify prognostic factors for survival in young women under 30 years of age with BC. Material and methods A retrospective cohort study was conducted among women younger than or equal to 40 years with BC and who were treated at the State Cancer Center during the period 2012–2017. Overall survival was assessed using the Kaplan–Meier method and the log-rank test. Univariate and multivariate analysis assessed survival predictors using Cox proportional hazards regression model. Results 282 young women were included. The >30-year-old subgroup showed a significant association with excess weight ( P = .002) compared to the <30-year-old group. The <30-year-old subgroup showed a poor overall survival (56.7%), as well as highly significant values in advanced clinical stages, metastatic nodules, metastasis, and neoadjuvant therapy ( P < .001). In Model 3 of the multivariate analysis, age <30 years (HR = 3.0; 95% CI 1.1 to 8.6), triple negative subtype (HR = 2.6; 95% CI 1.1 to 6.0), tumor size >5 cm HR = 2.3; 95% CI 1.03 to 5.1), and advanced clinical stages (HR = 6.6 95% CI 1.3 to 35.5) persisted as predictors. Conclusions Being very young (<30 years) is a predictor for limited survival compared to the age of 30–40 years, as well as the tumor covariates for a worse prognosis: triple negative subtype, advanced stages, positive lymph nodes, and distant metastases in liver.
A Model of an Integrative Approach to Breast Cancer Patients
Authors: Rossi Cristina , Maggiore Claudia , Rossi Maria Maddalena , Filippone Alessio , Guarino Donatella , Di Micco Annalisa , Forcina Luana , Magno Stefano 
Published: October 2021

Background: Breast cancer (BC) survivors have physical and psychological needs that require convincing responses by health care providers. The quality of life issue and clinical unmet needs are among the main reasons pushing a number of patients toward “natural” therapies that are often misleading and alternative to mainstream cancer care. Integrative Oncology (IO) tries to respond to many of those needs, by combining lifestyle counseling, body-mind activities, and complementary evidence-informed therapies with anticancer standard treatments. Methods: In our model at Fondazione Policlinico Gemelli (FPG), every woman diagnosed with a BC waiting for surgery or candidate to neoadjuvant chemotherapy undergoes a preliminary psycho-oncological distress evaluation and a brief lifestyle interview. Anthropometric measurements, body composition analysis, and individual levels of physical activity are recorded. Patients are given evidence based recommendations about the advisable diet and physical activity in a prehabilitation setting. A physician provides patients with information about integrative care plans to treat symptoms related to the disease or its treatments. Therapeutic approaches include acupuncture, mindfulness-based protocols, qigong, massage therapy, and classes of music/art therapy. Results: Between September 2018 and February 2020, the Center for Integrative Oncology at FPG has carried out 1249 lifestyle counseling sessions, 1780 acupuncture treatments, 1340 physiotherapy sessions, 3261 psycho-oncological consultations, 218 herbal medicine counseling sessions. Moreover, 90 BC patients completed the mindfulness based stress reduction (MBSR) protocol and 970 patients participated in qigong, art therapy, and music therapy classes. Conclusions: Our integrative approach aims to achieve a person-centered medicine by improving symptoms management, adherence to oncological protocols, and eventually overall quality of life.
Traditional Herbal Medicine, Sipjeondaebo-Tang, for Cancer-Related Fatigue: A Randomized, Placebo-Controlled, Preliminary Study
Authors: Lee Jee Young , Kim Eun Hye , Yoon Jee-Hyun , Eo Wankyu , Yoon Seong Woo 
Published: October 2021

Purpose: Sipjeondaebo-tang (SDT) is a widely used traditional herbal medicine for relieving fatigue. This randomized, placebo-controlled, preliminary study evaluated SDT for cancer-related fatigue, which is the most common symptom experienced by patients with cancer. Patients and Methods: Patients with a Brief Fatigue Inventory (BFI) score of at least 4 were randomly assigned in a double-blinded manner to receive SDT (3 g 3 times daily) or placebo orally for 3 weeks. The BFI was the primary outcome measure and secondary outcome measures included the Hospital Anxiety and Depression Scale (HADS), the European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire (EORTC QLQ-C30), immunoregulatory tests, and safety. Results: A total of 50 participants were randomly assigned and 48 patients completed the trial. Based on intention-to-treat analysis, fatigue, which was the primary outcome, was improved in both arms compared with the baseline, and was significantly better in the SDT group than in the placebo group at week 3 (3.56 ± 1.18 vs 4.63 ± 1.83, P = .019). Secondary outcomes, including anxiety, depression, and immunoregulatory tests, did not improve significantly in either group. However, quality of life measured using the EORTC QLQ-C30 improved in both arms compared with the baseline, and the global health subscale was significantly better in the SDT group than in the placebo group ( P = .02). No significant toxicities were observed. Conclusion: SDT may improve cancer-related fatigue and quality of life in patients with cancer. A further randomized clinical trial with large sample size is warranted.
Opponensplasty using the extensor indicis proprius tendon for severe carpal tunnel syndrome in 40 patients
Authors: Matsuki Hiroyuki , Nakatsuchi Yukio , Momose Toshimitsu 
Published: October 2021

The aim of this study was to assess the clinical results after extensor indicis proprius opponensplasty in patients with carpal tunnel syndrome and severe thenar muscle atrophy. Forty patients who underwent this procedure during open carpal tunnel releases. The mean follow-up period was 17 months (range 10 to 36). Kapandji scores significantly improved from 5.5 before surgery to 9.6 at final follow-up. Thumb pronation angle also significantly improved from 111° before surgery to 149°. Side and pulp pinch strength significantly improved postoperatively, as well as DASH scores at final follow-up. In conclusion, the extensor indicis proprius tendon transfer technique represents a reliable opponensplasty procedure to achieve consistent results in patients with severe carpal tunnel syndrome. Level of evidence: IV