bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increased Frequency of Summer Extreme Heat Waves over Texas Area Tied to the Amplification of Pacific Zonal SST Gradient
Authors: Deng Kaiqiang , Ting Mingfang , Yang Song , Tan Yaheng 
Published: April 2018

AbstractSummer extreme heat waves (EHWs) over the Texas area and their trend are investigated using observations and atmospheric general circulation model (AGCM) output. There is a positive linear trend in Texas EHW days for the period 1979–2015. While the interannual variability of the Texas EHWs is linked to ENSO conditions, the upward trend in Texas EHWs is found to be significantly associated with the tropical Pacific zonal SST gradient (PZSSTG). The amplification of PZSSTG leads to both enhanced convection in the western Pacific and suppressed convection in the central-eastern Pacific (i.e., La Niña–like pattern), both of which can induce anomalous anticyclones over the Texas area through two distinct planetary wave trains in the antecedent spring. As a result, anomalously sinking motions and divergent water vapor flux appear over the Texas area, which reduce precipitation and increase downward solar radiation, leading to dry and hot soil that favors the occurrence of Texas summer EHWs. In addition, all AGCMs using observed SSTs as boundary conditions were able to simulate the observed decreasing trend in Texas summer precipitation and the observed increasing trend in Texas summer surface air temperature. The observed relationships between winter PZSSTG and the following spring–summer Texas precipitation/temperature were also reproduced by these models, where the intensified PZSSTG tended to reduce the Texas precipitation while increasing the surface air temperature.
Warming is Driving Decreases in Snow Fractions While Runoff Efficiency Remains Mostly Unchanged in Snow-Covered Areas of the Western United States
Authors: McCabe Gregory J. , Wolock David M. , Valentin Melissa 
Published: April 2018

Abstract
Winter snowfall and accumulation is an important component of the surface water supply in the western United States. In these areas, increasing winter temperatures T associated with global warming can influence the amount of winter precipitation P that falls as snow S. In this study we examine long-term trends in the fraction of winter P that falls as S (Sfrac) for 175 hydrologic units (HUs) in snow-covered areas of the western United States for the period 1951–2014. Because S is a substantial contributor to runoff R across most of the western United States, we also examine long-term trends in water-year runoff efficiency [computed as water-year R/water-year P (Reff)] for the same 175 HUs. In that most S records are short in length, we use model-simulated S and R from a monthly water balance model. Results for Sfrac indicate long-term negative trends for most of the 175 HUs, with negative trends for 139 (~79%) of the HUs being statistically significant at a 95% confidence level (p = 0.05). Additionally, results indicate that the long-term negative trends in Sfrac have been largely driven by increases in T. In contrast, time series of Reff for the 175 HUs indicate a mix of positive and negative long-term trends, with few trends being statistically significant (at p = 0.05). Although there has been a notable shift in the timing of R to earlier in the year for most HUs, there have not been substantial decreases in water-year R for the 175 HUs.
Influence of a Great Plains Urban Environment on a Simulated Supercell
Authors: Reames Larissa J. , Stensrud David J. 
Published: April 2018

Abstract
The effect of urban areas on weakly forced precipitation systems has been studied extensively. However, interactions between urban areas and strongly forced convection, such as supercells, remain relatively unexamined. The present study uses simulations of a supercell to quantify the impacts of a large plains urban area on the evolution and strength of a supercell. An initial ensemble of simulations (CTRLE) of a supercell over homogeneous land use is performed using the WRF-ARW Model. Additionally, 108 simulations are conducted in which the land-use pattern of Dallas–Ft. Worth, Texas, is placed inside the model domain, with the city center shifted to be in or near the path of the supercell. Simulations with urban areas are compared to CTRLE, with the aid of hierarchical clustering analysis to form statistically similar groups of simulations. Clustering analyses identify groups of ensemble members with closely located urban areas that have similar patterns of 0–1-km updraft helicity and near-surface minimum temperature and maximum wind speeds. Comparison of these groups of ensemble members to CTRLE suggests the urban area has a significant impact on storm characteristics, particularly on low-level rotation and mesocyclone track. Simulations where the storm passes to the north of or directly over the city center late in its life cycle deviate most significantly from CTRLE. In these members, low-and midlevel mesocyclone strength increases, and the mesocyclone tracks farther south when compared to CTRLE.
The Effects of Social Connections on Evacuation Decision Making during Hurricane Irma
Authors: Collins Jennifer , Ersing Robin , Polen Amy , Saunders Michelle , Senkbeil Jason 
Published: April 2018

AbstractThis study investigates the influence of individuals’ social connections in their decision to either evacuate or not evacuate in the days preceding the landfall of Hurricane Irma. Using Hurricane Irma in September 2017 as a case study, a survey was conducted on two groups (those who evacuated and those who did not evacuate) to assess people’s social connections specifically examining three dimensions: dependability, density, and diversity. These variables, together with socioeconomic variables (e.g., race/ethnicity, age, education), were considered in order to better explain the influences on evacuation decision-making. To collect accurate ephemeral decision-making data from evacuees, the surveys were completed during the evacuation for those who evacuated and shortly after the passage of Hurricane Irma for those who did not evacuate. Through statistical analyses, it was concluded that density and diversity of people’s social networks played a significant role in the decision to evacuate or not, with evacuees having more dense and diverse relationships. On the other hand, the perceived dependability of a person’s social connections (i.e., their perceived access to resources and support) did not significantly impact the decision to evacuate for Hurricane Irma. This study has important implications for adding to the knowledge base on community-based sustainable disaster preparedness and resilience.
A new simplified method for decreasing contaminants in underground enclosed parking lots
Authors: Aminian Javad , Maerefat Mehdi , Heidarinejad Ghassem 
Published: April 2018

One of the main concerns in large enclosed vehicular spaces such as parking lots is air contaminant management. Mechanical ventilation systems are typically used to decrease the contaminants and enhance indoor air quality in such spaces. International standards have suggested the amount of ventilation air and have emphasized that the ventilation system should be able to effectively reduce the contaminants, but the reduction in contaminants has not been quantitatively described. This study develops a simplified method for the quantification of contaminant removal and its effect on the enhancement of indoor air quality. This method is based on the numerical calculation of contaminant removal effectiveness in parking lots and changing the location of outlet vents. The results of this work indicate that using a constant ventilation rate, outlet vents are installed at an appropriate height, the flow pattern is improved and contaminant removal effectiveness is enhanced significantly. The numerical results show that the outlet vents should be installed between 50 and 70% of the parking lot ceiling height. By adopting this criterion, a displacement flow pattern is developed in the parking lot, and improvement in both contaminant removal effectiveness and indoor air quality is achieved.Practical application: This paper helps ventilation designers to enhance the air quality of enclosed parking lots by a simple practical method. The designer should only install the outlet vents at the range of heights proposed in this paper to develop displacement flow in the parking lot, which leads to an effective decrease in contaminants and reduce energy consumption. So, the aim of this research is to maximize the contaminant removal capacity and minimize the energy consumption of the ventilation system.
The involvement of cancer patients in the four stages of decision-making preceding continuous sedation until death: A qualitative study
Authors: Robijn Lenzo , Seymour Jane , Deliens Luc , Korfage Ida , Brown Jayne , Pype Peter , Van Der Heide Agnes , Chambaere Kenneth , Rietjens Judith 
Published: April 2018

Background: Involving patients in decision-making is considered to be particularly appropriate towards the end of life. Professional guidelines emphasize that the decision to initiate continuous sedation should be made in accordance with the wishes of the dying person and be preceded by their consent. Aim: To describe the decision-making process preceding continuous sedation until death with particular attention to the involvement of the person who is dying. Design: Qualitative case studies using interviews. Setting/participants: Interviews with 26 physicians, 30 nurses and 24 relatives caring for 24 patients with cancer who received continuous sedation until death in Belgium, the United Kingdom and the Netherlands. Results: We distinguished four stages of decision-making: initiation, information exchange, deliberation and the decision to start continuous sedation until death. There was wide variation in the role the patient had in the decision-making process. At one end of the spectrum (mostly in the United Kingdom), the physician discussed the possible use of sedation with the patient, but took the decision themselves. At the other end (mostly in Belgium and the Netherlands), the patient initiated the conversation and the physician’s role was largely limited to evaluating if and when the medical criteria were met. Conclusion: Decision-making about continuous sedation until death goes through four stages and the involvement of the patient in the decision-making varies. Acknowledging the potential sensitivity of raising the issue of end-of-life sedation, we recommend building into clinical practice regular opportunities to discuss the goals and preferences of the person who is dying for their future medical treatment and care.
Transarterial embolization for postpartum hemorrhage: lessons learned
Authors: Fu Chen-Ju , Irama Wiwan , Wong Yon-Cheong , Tseng Hsiao-Jung , Wang Li-Jen , Yeow Kee-Min , Wu Cheng-Hsien 
Published: April 2018

Background Although transarterial embolization (TAE) can powerfully control postpartum hemorrhage (PPH), clinical failure of TAE is not uncommon. Purpose To discover whether any parameters could predict timely clinical failure of TAE, then whether a supplementary intervention could be promptly initiated. Material and Methods We retrospectively analyzed 118 TAE procedures in 113 patients with PPH performed at our institution between January 2012 and May 2015. The patients were divided into the following groups: clinically successful TAE and failed TAE. Successful TAE was defined as obviation of supplementary embolization or surgical intervention for hemostasis. Gestational conditions, angiographic factors, maternal vital signs, and laboratory data were compared between the two groups. Results In total, 100 (84.8%) TAEs were clinically successful. Multivariate logistic regression analyses revealed independent risk factors of TAE clinical failure, including the requirement for augmented embolic agents, placental retention, and international normalized ratio > 1.3 ( P = 0.009, 0.001, and 0.005, respectively). The post-TAE shock index was significantly associated with TAE failure, using a cut-off value of 0.8. Conclusion The discovered independent risk factors of TAE clinical failure existed before or during the TAE procedure and could not reflect the post-TAE conditions. Although the post-TAE shock index was not an independent factor, it reflected the conditions after TAE and could indicate TAE clinical failure timely.
Potential occupational exposures in diagnostic and interventional radiology: statistical modeling based on Finnish national dose registry data
Authors: Pekkarinen Antti , Siiskonen Teemu , Lehtinen Maaret , Savolainen Sauli , Kortesniemi Mika 
Published: April 2018

Background Radiation worker categorization and exposure monitoring practices must be proportional to the current working environment. Purpose To analyze exposure data of Finnish radiological workers and to estimate the magnitude and frequency of their potential occupational radiation exposure, and to propose appropriate radiation worker categorization. Material and Methods Estimates of the probabilities of annual effective doses exceeding certain levels were obtained by calculating the survival function of a lognormal probability density function (PDF) fitted in the measured occupational exposure data. Results The estimated probabilities of exceeding annual effective dose limits of 1 mSv, 6 mSv, and 20 mSv were in the order of 1:200, 1:10,000, and 1:500,000 per person, respectively. Conclusion It is very unlikely that the Category B annual effective dose limit of 6 mSv could even potentially be exceeded using modern equipment and appropriate working methods. Therefore, in terms of estimated effective dose, workers in diagnostic and interventional radiology could be placed into Category B in Finland. Current national personal monitoring practice could be replaced or supplemented using active personal dosimeters, which offer more effective means for optimizing working methods.
The efficacy of using computer-aided detection (CAD) for detection of breast cancer in mammography screening: a systematic review
Authors: Henriksen Emilie L , Carlsen Jonathan F , Vejborg Ilse MM , Nielsen Michael B , Lauridsen Carsten A 
Published: April 2018

Background Early detection of breast cancer (BC) is crucial in lowering the mortality. Purpose To present an overview of studies concerning computer-aided detection (CAD) in screening mammography for early detection of BC and compare diagnostic accuracy and recall rates (RR) of single reading (SR) with SR + CAD and double reading (DR) with SR + CAD. Material and Methods PRISMA guidelines were used as a review protocol. Articles on clinical trials concerning CAD for detection of BC in a screening population were included. The literature search resulted in 1522 records. A total of 1491 records were excluded by abstract and 18 were excluded by full text reading. A total of 13 articles were included. Results All but two studies from the SR vs. SR + CAD group showed an increased sensitivity and/or cancer detection rate (CDR) when adding CAD. The DR vs. SR + CAD group showed no significant differences in sensitivity and CDR. Adding CAD to SR increased the RR and decreased the specificity in all but one study. For the DR vs. SR + CAD group only one study reported a significant difference in RR. Conclusion All but two studies showed an increase in RR, sensitivity and CDR when adding CAD to SR. Compared to DR no statistically significant differences in sensitivity or CDR were reported. Additional studies based on organized population-based screening programs, with longer follow-up time, high-volume readers, and digital mammography are needed to evaluate the efficacy of CAD.
Motion artifacts, lesion type, and parenchymal enhancement in breast MRI: what does really influence diagnostic accuracy?
Authors: Clauser Paola , Dietzel Matthias , Weber Michael , Kaiser Clemens G , Baltzer Pascal AT 
Published: April 2018

Background Motion artifacts can reduce image quality of breast magnetic resonance imaging (MRI). There is a lack of data regarding their effect on diagnostic estimates. Purpose To evaluate factors that potentially influence readers’ diagnostic estimates in breast MRI: motion artifacts; amount of fibroglandular tissue; background parenchymal enhancement; lesion size; and lesion type. Material and Methods This Institutional Review Board-approved, retrospective, cross-sectional, single-center study included 320 patients (mean age = 55.1 years) with 334 histologically verified breast lesions (139 benign, 195 malignant) who underwent breast MRI. Two expert breast radiologists evaluated the images considering: motion artifacts (1 = minimal to 4 = marked); fibroglandular tissue (BI-RADS FGT); background parenchymal enhancement (BI-RADS BPE); lesion size; lesion type; and BI-RADS score. Univariate (Chi-square) and multivariate (Generalized Estimation Equations [GEE]) statistics were used to identify factors influencing sensitivity, specificity, and accuracy. Results Lesions were: 230 mass (68.9%) and 59 non-mass (17.7%), no foci. Forty-five lesions (13.5%) did not enhance in MRI but were suspicious or unclear in conventional imaging. Sensitivity, specificity, and accuracy were 93.8%, 83.4%, and 89.8% for Reader 1 and 95.4%, 87.8%, and 91.9% for Reader 2. Lower sensitivity was observed in case of increased motion artifacts ( P = 0.007), non-mass lesions ( P < 0.001), and small lesions ≤ 10 mm ( P < 0.021). No further factors (e.g. BPE, FGT) significantly influenced diagnostic estimates. At multivariate analysis, lesion type and size were retained as independent factors influencing the diagnostic performance ( P < 0.033). Conclusion Motion artifacts can impair lesion characterization with breast MRI, but lesion type and small size have the strongest influence on diagnostic estimates.
Nocardia rubra cell wall skeleton accelerates cutaneous wound healing by enhancing macrophage activation and angiogenesis
Authors: Wang Yi , Hu Ying , Ma Ben , Wang Fei , Liu Sheng , Xu Jing , Chen Xu-Lin , Lü Xiong-Wen 
Published: April 2018

Objective This study was performed to investigate the effect of Nocardia rubra cell wall skeleton (N-CWS) on wound healing of full-thickness skin defects. Methods Two 2- × 2-cm full-thickness wounds, one on each side of the midline, were made on the back of 12 rats. One wound was covered with Vaseline gauze soaked in normal saline, whereas the other was covered with Vaseline gauze and N-CWS. Wound dressings were changed every other day from day 0 (wound creation) to day 11. Four of the 12 rats were killed on day 7, and biopsy samples were obtained for biochemical and histopathological analyses. The expression levels of CD31, CD68, and F4/80 in the tissues were examined immunohistologically. The expression of transforming growth factor (TGF)-β1 in the wound was determined by western blot. Results N-CWS increased the wound healing rate, reduced the complete wound healing time, and increased the expression levels of CD31, CD68, and F4/80 on day 7. The TGF-β1 expression level in the wound was significantly higher in the N-CWS group than in the control group on day 7. Conclusions N-CWS can activate macrophages, increase TGF-β1 expression, and enhance angiogenesis and thus accelerate cutaneous wound healing.
Prognostic role of PIK3CA and TP53 in human papillomavirus–negative oropharyngeal cancers
Authors: Resteghini Carlo , Perrone Federica , Miceli Rosalba , Bergamini Cristiana , Alfieri Salvatore , Orlandi Ester , Guzzo Marco , Granata Roberta , Galbiati Donata , Cavalieri Stefano , Locati Laura , Licitra Lisa , Bossi Paolo 
Published: April 2018

Background: Human papilloma virus (HPV)–negative oropharyngeal squamous cell carcinomas (OPCs) have a poorer prognosis and best management is an unmet need. We studied the prognostic role of epidermal growth factor receptor (EGFR) and PIK3CA amplifications and TP53 functional status. Methods: Between 1992 and 2000, 90 consecutive patients with OPCs were treated with surgery, followed by radiotherapy in case of high-risk pathologic features. Of those, 73 cases were HPV-negative and therefore were selected for molecular analysis ( PIK3CA and EGFR fluorescent in situ hybridization [FISH] analysis and TP53 mutation analysis). Results: FISH analyses of EGFR and PIK3CA were successfully conducted on 69 and 63 of 73 tumor samples, respectively. EGFR alterations were detected in 43% of patients but just 7% showed amplification. Seven cases (11%) carried PIK3CA amplification and 18 (29%) gene gain or high polysomy. TP53 was detected as nonfunctional in 24 of 67 (36%) successfully analyzed cases. Both univariable and multivariable analysis showed statistically significantly worse disease-free survival (DFS) for patients with PIK3CA disomy compared to those with gene gain or high polysomy. No differences in overall survival or DFS for EGFR and TP53 alteration were evident. The combined evaluation of PIK3CA and TP53 showed that PIK3CA gene copy number gain separated a population with better outcome, defining an overall worse prognosis population (disomy) now clearly further divided according to TP53 functional status. Conclusion: PIK3CA gene copy number increase is associated with a favorable clinical outcome in HPV-negative OPCs treated with surgery ± postoperative radiotherapy. In patients without PIK3CA alteration, TP53 nonfunctional mutations are associated with poor prognosis.