bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interannual Variability of Springtime Extreme Heat Events over the Southeastern Edge of the Tibetan Plateau: Role of A Spring-type Circum-global Teleconnection Pattern
Authors: Zhang Tuantuan , Jiang Xingwen , Chen Junwen , Yang Song , Deng Yi , Wei Wei , Hu Peng , Gao Peng 
Published: October 2021

AbstractDue to the high mountains to the west and north of the plateau, and the control by westerly mean flow in spring, hot and dry conditions are often observed over the southeastern edge of the Tibetan Plateau (SETP), and hence favoring occurrences of extreme heat events there. Indeed, maximum centers and remarkable increasing trends of extreme heat (EH) days in spring are found over the region. Springtime EH events over the SETP also exhibit strong interannual variability and are closely linked to a spring-type circum-global teleconnection (SCGT) pattern, which is the second leading mode of 200-hPa meridional wind over the North Hemisphere in spring. This SCGT shows distinctive features from the traditional circum-global teleconnection patterns found in boreal summer and winter. It is revealed by a circum-globally navigated Rossby wave train along the mid-high latitudes, which splits to a north branch along the polar jet and a south branch along the subtropical jet over Eurasia after propagating through the North Atlantic. The two branches eventually reach the SETP, forming an anomalous anticyclonic circulation over the region. Hence, conditions in the SETP are controlled by significant anomalous subsidence and a clearer sky, resulting in below-normal rainfall and above-normal air temperature, in favor of more EH events in the region. The SETP EH events are also closely linked to the spring-type CGT-like pattern in April and May, but not in March. In addition, the influence of the foehn effect on the SETP EH is discussed.
“Gray Zone” Simulations Using a Three-Dimensional Planetary Boundary Layer Parameterization in the Weather Research and Forecasting Model
Authors: Juliano Timothy W. , Kosović Branko , Jiménez Pedro A. , Eghdami Masih , Haupt Sue Ellen , Martilli Alberto 
Published: October 2021

Abstract
Generating accurate weather forecasts of planetary boundary layer (PBL) properties is challenging in many geographical regions, oftentimes due to complex topography or horizontal variability in, for example, land characteristics. While recent advances in high-performance computing platforms have led to an increase in the spatial resolution of numerical weather prediction (NWP) models, the horizontal gridcell spacing (Δx) of many regional-scale NWP models currently fall within or are beginning to approach the gray zone (i.e., Δx ≈ 100–1000 m). At these gridcell spacings, three-dimensional (3D) effects are important, as the most energetic turbulent eddies are neither fully parameterized (as in traditional mesoscale simulations) nor fully resolved [as in traditional large-eddy simulations (LES)]. In light of this modeling challenge, we have implemented a 3D PBL parameterization for high-resolution mesoscale simulations using the Weather Research and Forecasting Model. The PBL scheme, which is based on the algebraic model developed by Mellor and Yamada, accounts for the 3D effects of turbulence by calculating explicitly the momentum, heat, and moisture flux divergences in addition to the turbulent kinetic energy. In this study, we present results from idealized simulations in the gray zone that illustrate the benefit of using a fully consistent turbulence closure framework under convective conditions. While the 3D PBL scheme reproduces the evolution of convective features more appropriately than the traditional 1D PBL scheme, we highlight the need to improve the turbulent length scale formulation.

Significance Statement
The spatial resolution of weather models continues to increase at a rapid rate in accordance with the enhancement of computing power. As a result, smaller-scale atmospheric features become more explicitly resolved. However, most numerical models still ignore the impact of horizontal weather variations on boundary layer flows, which becomes more important at these smaller spatial scales. To address this issue, we have implemented a new modeling approach, using fundamental principles, which accounts for horizontal variability. Our results show that including three-dimensional effects of turbulence is necessary to achieve realistic boundary layer characteristics. This novel technique may be useful for many applications including complex terrain flows, pollutant dispersion, and surface–atmosphere interaction studies.
The time Interval Between the End of Radiotherapy and Surgery Does Not Affect Outcomes in Rectal Cancer
Authors: Qwaider Yasmeen Z. , Sell Naomi M. , Stafford Caitlin E. , Kunitake Hiroko , Ricciardi Rocco , Bordeianou Liliana G. , Goldstone Robert N. , Cauley Christy E. , Berger David L. 
Published: October 2021

Introduction The ideal time interval between the completion of chemoradiotherapy and subsequent surgical resection of advanced stage rectal tumors is highly debated. Our aim is to study the effect of the time interval between the completion of chemoradiotherapy and surgical resection on postoperative and oncologic outcomes in rectal cancer. Methods Patients who underwent neoadjuvant chemoradiotherapy for resected locally advanced rectal tumors between 2004 and 2015 were included in this analysis. The time interval was calculated from the date of radiation completion to date of surgery. Patients were split into 2 groups based on the time interval (<8 weeks and >8 weeks). Postoperative outcomes (anastomotic leak, pathologic complete response (pCR), and readmission) and survival were assessed with multivariable logistic regression and Cox regression models while adjusting for relevant confounders. Results 200 patients (62% male) underwent resection with a median time interval of 8 weeks from completion of radiotherapy. On multivariable logistic regression, there was no significant increase in odds between time interval to surgery and anastomotic leak (aOR = .8 [.27-2.7], P = .8), pCR (aOR = 1.2[.58-2.6] P = .6), or readmission (aOR = 1.02, 95% CI:0.49-2.24, P = .9). Time interval to surgery was not an independent prognostic factor for overall (HR = 1.04 CI = .4-2.65, P = .9) and disease-free survival (HR = 1.2 CI = .5-2.9, P = .6). Conclusion The time interval between neoadjuvant radiotherapy completion and surgical resection does not affect anastomotic leak rate, achievement of pCR, or overall and disease-free survival in patients with rectal cancer. Extended periods of time to surgical resection are relatively safe.
A comparison of experiences of care and expressed emotion among caregivers of young people with first-episode psychosis or borderline personality disorder features
Authors: Cotton Sue M , Betts Jennifer K , Eleftheriadis Dina , Filia Kate , Seigerman Mirra , Rayner Victoria K , McKechnie Ben , Hulbert Carol Anne , McCutcheon Louise , Jovev Martina , Bendall Sarah , Burke Emma , McNab Catharine , Mallawaarachchi Sumudu , Alvarez-Jimenez Mario , Chanen Andrew M , Gleeson John FM 
Published: October 2021

Objective: Caregivers of individuals with severe mental illness often experience significant negative experiences of care, which can be associated with higher levels of expressed emotion. Expressed emotion is potentially a modifiable target early in the course of illness, which might improve outcomes for caregivers and patients. However, expressed emotion and caregiver experiences in the early stages of disorders might be moderated by the type of severe mental illness. The aim was to determine whether experiences of the caregiver role and expressed emotion differ in caregivers of young people with first-episode psychosis versus young people with ‘first-presentation’ borderline personality disorder features. Method: Secondary analysis of baseline (pre-treatment) data from three clinical trials focused on improving caregiver outcomes for young people with first-episode psychosis and young people with borderline personality disorder features was conducted (ACTRN12616000968471, ACTRN12616000304437, ACTRN12618000616279). Caregivers completed self-report measures of experiences of the caregiver role and expressed emotion. Multivariate generalised linear models and moderation analyses were used to determine group differences. Results: Data were available for 265 caregivers. Higher levels of negative experiences and expressed emotion, and stronger correlations between negative experiences and expressed emotion domains, were found in caregivers of young people with borderline personality disorder than first-episode psychosis. Caregiver group (borderline personality disorder, first-episode psychosis) moderated the relationship between expressed emotion and caregiver experiences in the domains of need to provide backup and positive personal experiences. Conclusion: Caregivers of young people with borderline personality disorder experience higher levels of negative experiences related to their role and expressed emotion compared with caregivers of young people with first-episode psychosis. The mechanisms underpinning associations between caregiver experiences and expressed emotion differ between these two caregiver groups, indicating that different supports are needed. For borderline personality disorder caregivers, emotional over-involvement is associated with both negative and positive experiences, so a more detailed understanding of the nature of emotional over-involvement for each relationship is required to guide action.
Risk factors of contrast extravasation and subsequent hemorrhagic transformation after thrombectomy
Authors: Liu Keqin , Jiang Lin , Zhao Yuqi , Xia Wenqing , Ruan Jie , Huang Huan , Niu Guozhong , Yan Shenqiang , Yin Congguo 
Published: October 2021

Objective The risk factors associated with iodine contrast extravasation immediately after endovascular thrombectomy (EVT) and subsequent hemorrhagic transformation within 24 hours remain unclear. Methods Mixed images, iodine overlay maps, and virtual non-contrast images were reconstructed from 106 consecutive acute ischemic stroke patients who underwent dual energy computed tomography immediately and 24 hours after EVT. Multivariate analyses of clinical and radiological data were performed to explore independent predictors of iodine contrast extravasation and hemorrhagic transformation. Results Sixty-eight (64.2%) patients exhibited pure iodine contrast extravasation after EVT; 30.9% developed hemorrhagic transformation within 24 hours after EVT. The number of stent retriever passes was independently associated with both iodine contrast extravasation (odds ratio 1.608; 95% confidence interval (CI) 1.047–2.469) and subsequent hemorrhagic transformation (odds ratio 1.477; 95% CI 1.003–2.175). Patients with more than two stent retriever passes were more likely to exhibit iodine contrast extravasation (sensitivity = 68.2%, specificity = 81.5%), while those with more than three stent retriever passes more often exhibited hemorrhage after iodine contrast extravasation (sensitivity = 64.6%, specificity = 87.2%). Conclusions The number of stent retriever passes was an independent predictor for both iodine contrast extravasation and subsequent hemorrhagic transformation.
Securing Transplanted Meniscal Allografts Using Bone Plugs Results in Lower Risks of Graft Failure and Reoperations: A Meta-analysis
Authors: Ow Zachariah Gene Wing , Cheong Chin Kai , Hai Hao Han , Ng Cheng Han , Wang Dean , Krych Aaron J. , Saris Daniel B.F. , Wong Keng Lin , Lin Heng An 
Published: October 2021

Background: Meniscal allograft transplant (MAT) is an important treatment option for young patients with deficient menisci; however, there is a lack of consensus on the optimal method of allograft fixation. Hypothesis: The various methods of MAT fixation have measurable and significant differences in outcomes. Study Design: Meta-analysis; Level of evidence, 4. Methods: A single-arm meta-analysis of studies reporting graft failure, reoperations, and other clinical outcomes after MAT was performed. Studies were stratified by suture-only, bone plug, and bone bridge fixation methods. Proportionate rates of failure and reoperation for each fixation technique were pooled with a mixed-effects model, after which reconstruction of relative risks with confidence intervals was performed using the Katz logarithmic method. Results: A total of 2604 patients underwent MAT. Weighted mean follow-up was 4.3 years (95% CI, 3.2-5.6 years). During this follow-up period, graft failure rates were 6.2% (95% CI, 3.2%-11.6%) for bone plug fixation, 6.9% (95% CI, 4.5%-10.3%) for suture-only fixation, and 9.3% (95% CI, 6.2%-13.9%) for bone bridge fixation. Transplanted menisci secured using bone plugs displayed a lower risk of failure compared with menisci secured via bone bridges (RR = 0.97; 95% CI, 0.94-0.99; P = .02). Risks of failure were not significantly different when comparing suture fixation to bone bridge (RR = 1.02; 95% CI, 0.99-1.06; P = .12) and bone plugs (RR = 0.99; 95% CI, 0.96-1.02; P = .64). Allografts secured using bone plugs were at a lower risk of requiring reoperations compared with those secured using sutures (RR = 0.91; 95% CI, 0.87-0.95; P < .001), whereas allografts secured using bone bridges had a higher risk of reoperation when compared with those secured using either sutures (RR = 1.28; 95% CI, 1.19-1.38; P < .001) or bone plugs (RR = 1.41; 95% CI, 1.32-1.51; P < .001). Improvements in Lysholm and International Knee Documentation Committee scores were comparable among the different groups. Conclusion: This meta-analysis demonstrates that bone plug fixation of transplanted meniscal allografts carries a lower risk of failure than the bone bridge method and has a lower risk of requiring subsequent operations than both suture-only and bone bridge methods of fixation. This suggests that the technique used in the fixation of a transplanted meniscal allograft is an important factor in the clinical outcomes of patients receiving MATs.
Adsorption and reduction of carcinogenic organics by ordered semi-crystalline poly-m-chloroaniline
Authors: Gupta Pankaj , Singh Nakshatra Bahadur , Sahni Mohit 
Published: October 2021

Poly-m-chloroaniline has been synthesized by chemical oxidative polymerization of m-chloroaniline and confirmed by spectroscopic studies. Powder X-ray diffraction and FESEM studies confirmed ordered arrangement in poly-m-chloroaniline. The peak at lower angle such as 7.09° having d spacing of 12.53 Å shows ordered structure of PmClA which was further confirmed by layered morphology in the FESEM images. FTIR spectra confirm the stretching and vibration mode of polymeric m-chloroaniline ring. BET surface area and pore diameter of PmClA were found to be 121 m2/g and 15.184 nm. Poly-m-chloroaniline was found to have better adsorption capacity toward anionic dyes over cationic dyes. The anionic dye (IC and EY) was 98 and 99% removed in just 25 min, whereas the cationic dye (MG and Rh6G) was 87 and 83% removed in 30 min. Langmuir adsorption isotherm model and pseudo second-order kinetic equation fitted the data best. Mechanism of adsorption has also been proposed. This is suggested that polymeric materials can be used for purification of water. The reduction of aromatic nitro compounds to amino compounds using organocatalyst has been done for the first time.
Facilitating primary care non-antiretroviral drug prescribing in people living with HIV: The ‘THINK ARV’ initiative
Authors: Knox Chloe , Leak Date Heather , Lim Su S , Shaw Mark , Flynn Brian , Kendall Lucy , Vera Jaime 
Published: October 2021

Objectives: Older people living with HIV (PLWH) have higher rates of multimorbidity, polypharmacy and an associated increased risk of potential drug–drug interactions (DDIs). We describe the development, implementation and evaluation of an intervention to increase community prescribers’ access to specialist prescribing advice. Methods: Phase One: a survey evaluating General Practitioners’ (GPs’) knowledge of, and confidence detecting DDIs affecting PLWH, was circulated to eight General Practices in one UK city. Phase Two: co-production was used to develop the THINK ARV intervention for prescribers in city-wide General Practices: a dedicated mobile phone and e-mail advice service staffed by HIV specialist pharmacists. Queries were audited for 6 months pre- and post-intervention. A user-satisfaction survey was emailed to enquirers. Results: Phase One: 42 GPs responded, of whom 62% requested further support identifying DDIs among PLWH. Phase Two: the number of queries received increased from 25 (6 months before ‘THINK ARV’ launch) to 63 in the following 6 months (152% increase). 94% of the queries were specifically about DDIs. Conclusions: Increasing community prescribers’ access to specialist telephone and e-mail advice resulted in increased awareness and detection of DDIs. Similar interventions could be embedded within different healthcare settings to optimise medicines and avoid potential patient harm.
Construction and Validation of a Novel Nomogram to Predict the Overall Survival of Patients With Combined Small Cell Lung Cancer: A Surveillance, Epidemiology, and End Results Population-Based Study
Authors: Jiang Aimin , Liu Na , Zhao Rui , Liu Shihan , Gao Huan , Wang Jingjing , Zheng Xiaoqiang , Ren Mengdi , Fu Xiao , Liang Xuan , Tian Tao , Ruan Zhiping , Yao Yu 
Published: October 2021

Introduction Combined small cell lung cancer (C-SCLC) represents a rare subtype of all small cell lung cancer cases, with limited studies investigated its prognostic factors. The aim of this study was to construct a novel nomogram to predict the overall survival (OS) of patients with C-SCLC. Methods In this retrospective study, a total of 588 C-SCLC patients were selected from the Surveillance, Epidemiology, and End Results database. The univariate and multivariate Cox analyses were performed to identify optimal prognostic variables and construct the nomogram, with concordance index (C-index), receiver operating characteristic curves, and calibration curves being used to evaluate its discrimination and calibration abilities. Furthermore, decision curve analysis (DCA), integrated discrimination improvement (IDI), and net reclassification index (NRI) were also adopted to assess its clinical utility and predictive ability compared with the classic TNM staging system. Results Seven independent predictive factors were identified to construct the nomogram, including T stage, N stage, M stage, brain metastasis, liver metastasis, surgery, and chemotherapy. We observed a higher C-index in both the training (.751) and validation cohorts (.736). The nomogram has higher area under the curve in predicting 6-, 12-, 18-, 24-, and 36-month survival probability of patients with C-SCLC. Meanwhile, the calibration curves also revealed high consistencies between the actual and predicted OS. DCA revealed that the nomogram could provide greater clinical net benefits to these patients. We found that the NRI for 6- and 12-month OS were .196 and .225, and the IDI for 6- and 12-month OS were .217 and .156 in the training group, suggesting that the nomogram can predict a more accurate survival probability. Similar results were also observed in the validation cohort. Conclusion We developed and verified a novel nomogram that can help clinicians recognize high-risk patients with C-SCLC and predict their OS.
Clinical experience with a chlorhexidine-coated PICC: A prospective, multicenter, observational study
Authors: Winkler Michael A , Spencer Timothy R , Siddiqi Nasir , Wallace Jessica E , Gallien John Z , Elbalasi Hossam , Issa Mohamed , Yu Qian , Raissi Driss 
Published: October 2021

Introduction: This study evaluated a chlorhexidine-coated peripherally inserted central catheter (PICC) and the incidence of associated complications within both inpatient and outpatient populations. Methods: This IRB-approved, multicenter, prospective observational study was performed at three large teaching hospitals in the US. All adults who required a PICC for ⩾14 days were considered. Patients were monitored throughout entire catheter dwell. Duplex venous ultrasounds were performed before insertion, after 10 to 14 days of dwell time, and upon removal. Data was collected from the hospital, outpatient clinic, and patient PICC diary records. Results: A total of 103 patients, 56% male, with mean BMI 29 ± 8.8, were enrolled. The majority (79%) of patients were from high-risk groups—cancer, infectious diseases, transplant, and trauma. Primary treatment indications were antibiotics (66.99%) and chemotherapy (25.24%). Double lumen PICCs (59.2%) were favored clinically, as was basilic vein placement (71.84%). Mean catheter dwell was 47.01 ± 25.82 days. Three (3, 2.9%) central line-associated bloodstream infections (CLABSI) were reported. Four patients (4.6%) reported symptomatic catheter-related thrombosis (CRT), confirmed with ultrasound. Three patients (3.4%) had ultrasound-confirmed fibroblastic sleeve (FS). Eight patients (9.2%) who entered the study with pre-existing superficial thrombosis, had complete resolution at the time of catheter removal. The incidence of CLABSI was 0.82/1000 days. The combined CRT and FS rate was 6.9%. Conclusion: Based upon the observational findings of this study, chlorhexidine-coated PICC technology may be considered for use in patient populations who are at moderate to high-risk for catheter-related complications in both inpatient and outpatient settings.
A meta-analysis on the effect of telemedicine on the management of attention deficit and hyperactivity disorder in children and adolescents
Authors: Bemanalizadeh Maryam , Yazdi Maryam , Yaghini Omid , Kelishadi Roya 
Published: October 2021

Introduction This study aims to report the effect sizes of telemedicine treatments on the symptom domains of paediatric ADHD. Methods In this systematic review and meta-analysis, electronic databases, i.e. PubMed, Scopus, Web of Science and Embase, were searched for articles published up to December 2020. The inclusion criteria were as follows: children or adolescents diagnosed for ADHD or other hyperkinetic disorders; randomized controlled trials (RCTs); efficacy established with parents and teachers or self-rating scales at least for one of the following domains: inattention, cognitive function, hyperactivity, hyperactivity/impulsivity or oppositional behaviours. The risk of bias was assessed using the Cochrane risk of bias tool for RCTs. Results From 310 records reduced to 228 after removing duplicates, overall 12 studies were fulfilled our inclusion criteria. They consisted of 708 participants (358 with telemedicine intervention and 350 controls). The telemedicine interventions varied from computerized training programmes with phone calls to videoconferencing programmes, virtual reality classrooms or games. The most applicable method consisted of computerized training programmes with phone calls. Pooling results of all studies with available data on each subscale showed a significant effect of telemedicine on inattention/cognitive function (standardized mean difference (SMD) = 0.26, 95% CI: 0.16, 0.36), hyperactivity/impulsivity (SMD = 0.29, 95% CI: 0.06, 0.52), and oppositional behaviours (SMD = 0.72, 95% CI: 0.24, 1.20) subscales in ADHD. Almost all studies had an overall unclear risk of bias. The source of outcome assessment (parents, teachers or self-report questionnaire) was addressed as a potential confounding factor. In almost all symptom domains, the satisfaction from the treatment was higher in parents than in teachers. Conclusions The clinical effects of telemedicine on the treatment of ADHD showed a small effect size for inattention/cognitive function, hyperactivity/impulsivity and oppositional behaviours.