bluuebunny/crossref_metadata_2025_split huggingface dataset:
Climatological Features of the Weakly and Very Stably Stratified Nocturnal Boundary Layers. Part III: The Structure of Meteorological State Variables in Persistent Regime Nights and across Regime Transitions
Authors: Abraham Carsten , Monahan Adam H. 
Published: August 2019

Abstract
The evolution of profiles of meteorological state variables during nights with and without transitions in the nocturnal stably stratified boundary layer (SBL) between weakly stable (wSBL) and very stable (vSBL) regimes, as classified by a hidden Markov model, is examined at nine different tower sites. During wSBL-to-vSBL transitions, inversion strengths increase, near-surface winds decelerate, and atmospheric layers vertically decouple. Turbulence kinetic energy (TKE) steadily decreases before wSBL-to-vSBL transitions and fluctuations of the vertical velocity become weak. In contrast to land-based sites where wSBL-to-vSBL transitions are normally caused by surface cooling, at sea-based stations the transitions generally are initiated by advection of warm air aloft. The vSBL-to-wSBL transition is characterized by a fast breakdown of the inversion strength, acceleration of wind profiles, and a restored vertical coupling of the atmospheric flow. TKE recovers on time scales of minutes first in atmospheric levels between 50 and 100 m. Profiles of state variables for the two different regimes during very persistent nights (nights without SBL regime transitions) are clearly separated and similar to structures during nights with transitions away from transition times. During very persistent nights the wind conditions stay relatively steady. Similarly, the temperature is steady after an initial adjustment time at sunset (wSBL) or shortly after sunset (vSBL). Even though nights with and without transitions are a common feature of the SBL, there is no clear indicator in Reynolds-averaged mean variables that distinguishes very persistent nights from nights with transitions.
A Study of the Interaction between Typhoon Francisco (2013) and a Cold-Core Eddy. Part I: Rapid Weakening
Authors: Ma Zhanhong 
Published: August 2019

AbstractTyphoon Francisco (2013) experienced unusually rapid weakening (RW) with its maximum surface wind decreasing by 45 kt (1 kt ≈ 0.51 m s−1) over 24 h as measured from the satellite-derived advanced Dvorak technique (ADT) dataset, which is more than twice the weakening rate defined as RW by DeMaria. The mechanisms leading to the extreme RW event of Francisco are examined based on observational analysis and simulations by coupling the Weather Research and Forecasting (WRF) Model, version 3.7, with the Stony Brook Parallel Ocean Model (sbPOM). The RW of Francisco took place in a relatively favorable atmospheric environment while passing over detrimental oceanic conditions, dominated by the presence of a cold-core eddy. The passages of two prior typhoons apparently intensified the cold-core eddy, contributing to a major role of eddy feedback on RW for Francisco. The structural changes in Francisco accompanying eddy interaction are characterized by a substantially enlarged eye size, which evolved from ~20 to ~100 km in diameter, as indicated from satellite images. Numerical simulations suggest that the eddy is prominent in weakening the intensity of Francisco during the storm–eddy interaction, with its role less significant but still comparable to that of the cold wake. Both the cooler water and stronger upward motion in the eddy lead to a larger sea surface temperature decrease induced by Francisco, which results in a nearly 50% decrease of surface enthalpy flux, suppressed convective bursts, and a 50% reduction in latent heat release. These results underscore the potential importance of open-ocean, cold-core eddies in contributing to the RW of tropical cyclones.
A Climatology of Quasi-Linear Convective Systems and Their Hazards in the United States
Authors: Ashley Walker S. , Haberlie Alex M. , Strohm Jacob 
Published: August 2019

Abstract
This research uses image classification and machine learning methods on radar reflectivity mosaics to segment, classify, and track quasi-linear convective systems (QLCSs) in the United States for a 22-yr period. An algorithm is trained and validated using radar-derived spatial and intensity information from thousands of manually labeled QLCS and non-QLCS event slices. The algorithm is then used to automate the identification and tracking of over 3000 QLCSs with high accuracy, affording the first, systematic, long-term climatology of QLCSs. Convective regions determined by the procedure to be QLCSs are used as foci for spatiotemporal filtering of observed severe thunderstorm reports; this permits an estimation of the number of severe storm hazards due to this morphology. Results reveal that nearly 32% of MCSs are classified as QLCSs. On average, 139 QLCSs occur annually, with most of these events clustered from April through August in the eastern Great Plains and central/lower Mississippi and Ohio River Valleys. QLCSs are responsible for a spatiotemporally variable proportion of severe hazard reports, with a maximum in QLCS-report attribution (30%–42%) in the western Ohio and central Mississippi River Valleys. Over 21% of tornadoes, 28% of severe winds, and 10% of severe hail reports are due to QLCSs across the central and eastern United States. The proportion of QLCS-affiliated tornado and severe wind reports maximize during the overnight and cool season, with more than 50% of tornadoes and wind reports in some locations due to QLCSs. This research illustrates the utility of automated storm-mode classification systems in generating extensive, systematic climatologies of phenomena, reducing the need for time-consuming and spatiotemporal-limiting methods where investigators manually assign morphological classifications.
The role of cardiac surgeons in online prenatal counselling for congenital heart disease
Authors: Zhu Yaobin , Zhang Yaping , Ding Nan , Zhao Yudong , Ye Zankai , Fan Xing , Liu Yang , Shen Lei , Yi Hanlu , Li Zhiqiang 
Published: August 2019

Objective To explore the role of cardiac surgeons in prenatal online counselling for congenital heart disease. Methods From January 2014 to December 2017, the author consulted on 400 cases of foetal cardiovascular abnormalities through the Good Doctor Online and WeChat online platforms. The author made appropriate pregnancy recommendations to patients and families using patient ultrasound reports and medical histories. Followed-up patients who chose to continue their pregnancy received postnatal advice. Results There were 248 simple cardiac abnormalities and 152 complex cardiac abnormalities. Foetal chromosome examination detected 2 cases of trisomy 21 syndrome and 26 normal cases. Two mothers (0.8%) of simple cardiac abnormality foetuses and 103 (67.8%) mothers of complex cardiac abnormality foetuses chose induced abortion. A total of 246 mothers of simple cardiac abnormality foetuses chose to continue pregnancy and had good postnatal prognosis. Twenty-six mothers of complex cardiac abnormality foetuses chose to continue pregnancy; among these, there were 4 intrauterine deaths, 22 births, 4 deaths while awaiting surgery and 18 successful surgeries. Conclusion The Good Doctor Online and WeChat platforms facilitate communication with a wide audience. Cardiac surgeons can reduce the birth incidence and improve prenatal consultations for severe congenital heart disease through these platforms.
Anatomic study of the lumbar lamina for safe and effective placement of lumbar translaminar facet screws
Authors: Hu Yong , Zhu Bing-ke , Yuan Zhen-shan , Dong Wei-xin , Sun Xiao-yang , Xu Jian-zhong , Chen Xu-guo 
Published: August 2019

Objective To evaluate the anatomic characteristics of the lumbar lamina and suggest a safe and effective strategy for setting lumbar translaminar facet screws. Methods The width and length of the lumbar lamina, screw path, lateral angle of the lamina, and maximum and minimum caudal angles of the lamina from L3 to L5 were measured with Mimics software using 32 patients’ computed tomographic data. Results The optimal screw entry point was located at the median of the spinous process base or slightly lower. The ideal screw trajectory was from the entry point to the base of the transverse process and across the center of the facet joint. A length of 35 to 45 mm was suitable for L3 to L4 in most cases, and a length of 45 to 50 mm was safe for L5 in most cases. The screw should be inserted at an angle of 49.4° to 59.29° laterally and 43.68° to 57.58° caudally at L3 to L5. For the ideal caudal angle, error of <3° was considered safe. Conclusion The optimal entry point, ideal screw trajectory, ideal screw-setting angles, and safest range of the angle and length of the lumbar lamina were identified in this anatomical study.
Tools for the assessment of neuropsychomotor profile in the rehabilitation of children with central nervous system tumor: a systematic review
Authors: Pellegrini Chiara , Caraceni Augusto T. , Bedodi Livia I.E. , Sensi Raffaella , Breggiè Simona , Gariboldi Fulvia A. , Brunelli Cinzia 
Published: August 2019

Objective: This study reviews the scientific literature to identify and describe which assessment tools (ATs) are used in pediatric oncology and neuro-oncology rehabilitation and which development neuropsychomotor (DNPM) ATs were built for children with central nervous system (CNS) tumors. Methods: A systematic review was performed searching PubMed, CINAHL, PEDro, Science Direct, and Catalog of National Institute of Tumors databases and specialized journals. The search covered 7 years (2010–2017) and used relevant keywords in different combinations. A further search was carried out on DNPM rehabilitation manuals and academic thesis. Results: The review retrieved 35 eligible articles containing 63 ATs. The most common ATs were the Behavioral Rating Inventory of Executive Function (BRIEF) and the Wechsler Intelligence Scale for Children (WISC). Most of the ATs covered a single area of child development among behavioral/psychological, cognitive, and motor areas. A total of 159 ATs were found in manuals and thesis, and only 17 of them were already identified in the journal search. None of the ATs identified in both searches had been specifically developed for children with CNS tumor. Conclusion: The results highlight the need to develop and validate a global multidimensional AT for children with CNS tumor, overcoming the fragmentation of the assessment procedures and promoting standardized rehabilitation protocols.
Long-term survival between total colectomy versus proctocolectomy in patients with FAP: a registry-based, observational cohort study
Authors: Ardoino Ilaria , Signoroni Stefano , Malvicini Enzo , Ricci Maria Teresa , Biganzoli Elia M. , Bertario Lucio , Occhionorelli Savino , Vitellaro Marco 
Published: August 2019

Background: The best surgical choice for patients with familial adenomatous polyposis (FAP) is still debated. No prospective trials have been carried out to evaluate the pros and cons of the recommended procedures: total colectomy (ileorectal anastomosis [IRA]) vs restorative proctocolectomy (ileal pouch–anal anastomosis [IPAA]). The aim of this study was to provide a basis for tailored precision surgery in patients with FAP. Methods: We conducted a retrospective review of patients with FAP who underwent surgery and were registered in a dedicated database in Milan, Italy. Twenty-year survival related to surgical approach and prognostic factors were investigated using a Cox regression model. Results: A total of 925 patients underwent surgery between 1947 and 2015: 340 (36.8%) IPAA and 585 (63.2%) IRA. Colorectal cancer (CRC) at surgery was diagnosed in 28.6% of patients and a pathogenic APC variant was identified in 88%. During a median follow-up of 129 months, 150 patients died. The survival probability was significantly higher in the IRA than the IPAA group: 0.82 vs 0.75 (hazard ratio [HR] 0.6, 95% confidence interval [CI] 0.42–0.84). Multivariable regression modeling adjusted for propensity scores showed a similar difference, although no longer significant. Multivariable analysis indicated as independent risk factors CRC (HR 4.68, 95% CI 3.04–7.20) and age at surgery (HR 1.03, 95% CI 1.02–1.06). Among patients without cancer, the main risk factor for shorter survival was older age (HR 1.06, 95% CI 1.04–1.09). Conclusion: The study confirms excellent long-term results of surgical approaches with IRA and IPAA, suggesting that the best surgical choice may be an individually and clinically tailored approach, preferably at a young age.
Obesity is a predictor in prostate cancer patients receiving prostatectomy after neoadjuvant hormonal therapy
Authors: Sun Lijiang , Xu Ting , Yuan Xiaoliang , Liu Feng , Guan Fengju , Ye Dingwei , Zhang Guiming 
Published: August 2019

Objective: This study aimed to investigate the relationship between obesity and pathologic features and biochemical recurrence in patients with prostate cancer (PCa) undergoing radical prostatectomy (RP) after neoadjuvant hormonal therapy (NHT). Methods: A total of 422 consecutive patients with clinically localized PCa who received NHT before RP were retrospectively analyzed. Unconditional multiple logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) regarding probability. A receiver operating characteristic (ROC) curve was used to assess the efficacy of the predictive variables. Castration resistance free survival curves were obtained using the Kaplan-Meier method, and were compared using the log-rank test. Results: Being overweight was associated with an increased risk of positive margins (OR 2.281; 95% CI 1.292–4.028) after adjusting for potential confounders. The area under the ROC curve for overweight patients was larger than that for patients in the normal weight range. There was no significant difference between the overweight and normal weight groups regarding castration resistance free survival. Conclusions: Being overweight was associated with positive margins in patients with PCa undergoing RP after NHT.
PGC-1α activator–induced fatty acid oxidation in tumor-infiltrating CTLs enhances effects of PD-1 blockade therapy in lung cancer
Authors: Wan Huan , Xu Bin , Zhu Ni , Ren Baozhong 
Published: August 2019

Purpose: The present study aims to investigate the efficacy and mechanisms of peroxisome proliferator-activated receptor γ coactivator 1-α agonist, as adjuvant to programmed death-1 (PD-1) blockade in hyporesponsive lung cancer cells–derived in vivo tumor model, using bezafibrate. Methods: Mouse Lewis lung carcinoma (LLC) xenograft models were established and treated with programmed death-ligand 1 (PD-L1) monoclonal antibodies with or without bezafibrate. Tumors or peripheral blood of mice were harvested to investigate the quality, quantity, and function as well as energetic metabolism of cytotoxic T lymphocytes (CTLs) by flow cytometry or quantitative real-time polymerase chain reaction. Results: The combination of bezafibrate plus anti-PD-L1 reached synergistic tumoricidal effect in LLC xenograft mouse models, even though bezafibrate alone had no effect on tumor growth. Bezafibrate significantly facilitated CD8+ T cells infiltrating into tumor tissues by enhancing the expression of CXCL9 and CXCL10 within tumors as well as the receptor CXCR3 in infiltrating CTLs. Activated CTLs within tumors were also significantly upregulated by bezafibrate. Further data demonstrated that bezafibrate treatment could maintain the survival and functional capacity of tumor-infiltrating CTLs. Moreover, cellular reactive oxygen species in infiltrating CTLs and fatty acid oxidation (FAO)–related genes (PGC-1α, Cpt1a, and LCAD) expression within tumors were significantly increased after treatment with bezafibrate. Conclusions: Bezafibrate synergized the tumoricidal effect of PD-1 blockade in hyporesponsive lung cancer by expansion of effector CTLs within tumor microenvironment. The potential mechanism may relate to the capacity of bezafibrate in regulating FAO of tumor-infiltrating CTLs.
High Levels of Polypharmacy in Rheumatoid Arthritis—A Challenge Not Covered by Current Management Recommendations: Data From a Large Real-Life Study
Authors: Gomides Ana Paula M. , Albuquerque Cleandro P. , Santos Ana B.V. , Amorim Rodrigo B. C. , Bértolo Manoel B. , Júnior Paulo L. , Santos Isabela A. , Giorgi Rina D. , Sacilotto Nathália C. , Radominski Sebastião C. , Borghi Fernanda M. , Guimarães Maria F. B. R. , Pinto Maria R. C. , Resende Gustavo G. , Bonfiglioli Karina R. , Carriço Henrique , Sauma Maria F. L. C. , Sauma Marcel L. , Medeiros Júlia B. , Pereira Ivânio A. , Castro Gláucio R. W. , Brenol Claiton V. , Xavier Ricardo M. , Mota Licia M. H. , Pinheiro Geraldo R. C. 
Published: August 2019

Background: Rheumatoid arthritis (RA) is associated with high frequency of comorbidities and increased risk of polypharmacy. Although there is a great potential for complications, there is a gap in literature on polypharmacy in patients with rheumatic arthritis. Objective: To evaluate the prevalence and factors associated with polypharmacy in a population in a real-life setting. Methods: A cross-sectional multicenter study was conducted in Brazil. Patients underwent clinical evaluation and medical records analysis. Polypharmacy was considered as a dependent variable. To test independent variables, we used Poisson regression. Results: We evaluated 792 patients (89% female, median age 56.6 years). Median duration of disease was 12.7 years, 78.73% had a positive rheumatoid factor. The median of disease activity score-28 was 3.5 (disease with mild activity), median of the clinical disease activity index score was 9, and median of health assessment questionnaire-disability index was 0.875; 47% used corticosteroids, 9.1% used nonsteroidal anti-inflammatory drugs, 90.9% used synthetic disease-modifying antirheumatic drugs, 35.7% used biologic disease-modifying antirheumatic drugs (DMARDs). In total, 537 (67.9%) patients used 5 or more drugs. Polypharmacy showed a relationship with a number of comorbidities and use of specific drugs (corticosteroids, methotrexate, and biological DMARDs). Conclusion: We found a high prevalence of polypharmacy (67.9%) in RA. Solutions to management this problem should be stimulated.
Direct anterior versus posterolateral approach for bipolar hip hemiarthroplasty in femoral neck fractures: a prospective randomised study
Authors: Verzellotti Simone , Candrian Christian , Molina Mauro , Filardo Giuseppe , Alberio Riccardo , Grassi Federico A 
Published: August 2019

Introduction: Femoral neck fractures are a major problem in orthopaedic practice, having a huge impact on society, and involving a large number of elderly patients for whom early recovery is paramount. Thus, the aim of this study was to compare 2 surgical approaches, direct anterior (DA group) versus posterolateral (PL group), used for bipolar hip hemiarthroplasty (BHA) with femoral neck fractures in order to assess pain recovery after surgery. Our hypothesis was that early pain recovery would be faster in the DA group. Methods: 100 patients were randomised to surgery using either a DA group or PL group approach, and were then followed up for 6 months. Surgical time, intra- and postoperative complications were recorded for each patient. The main outcome, pain, was recorded using an NRS scale at 3 days, 1, 3 and 6 months after surgery. At the same time, patient status was evaluated using Activities of Daily Living and Cumulated Ambulation Score scales. Results: Surgical time was longer in the DA group ( p  < 0.0001). Pain perception at 3 days and at 1 month after surgery was significantly lower in DA group patients ( p  < 0.0001). The results of the other scales were comparable in the 2 groups (at 3 days, 1 and 3 months after surgery). Discussion: The DA approach offers a significant advantage in terms of pain perception up to 1 month after the operation. Early recovery in terms of pain perception is an important finding. Future studies should explore whether this early pain reduction could translate into a faster rehabilitation programme for an earlier recovery of full function. Clinical trial registration: Protocol 423/CE; Study n. CE 41/15.
Sonographic visualization and cannulation of the axillary vein in two arm positions during mechanical ventilation: A randomized trial
Authors: T Sivashanmugam , Kulandyan Indu , Velraj Jaya , Murugesan Ravishankar , Srinivasan Parthasarathy 
Published: August 2019

Background: Abduction of the arm has been used for ultrasound-guided infraclavicular axillary vein cannulation. We evaluated the influence of arm position on sonographic visualization and cannulation of the axillary vein in patients receiving mechanical ventilation. Methods: Sixty patients scheduled to undergo surgery under general anaesthesia with controlled mechanical ventilation were included in this prospective randomized study. The depth, size and distance of axillary vein to the pleura were recorded at three points: Point A, the most proximal part of the axillary vein visualized with adduction; Point A′, Point A in abduction; and Point B, the most proximal part of axillary vein visualized in abduction. Cephalic movement of the clavicle at Point A′ and the distance between Point A and Point B were noted. In Group A, cannulation was performed at Point A in the adducted arm and at Point B with the abducted arm in Group B after randomization. Results: Abduction moved the clavicle cephalad by 2.2 ± 0.6 cm and increased sonographic visualization of the axillary vein by 2.2 ± 0.5 cm in length, when compared with adduction. The distance from the vein to pleura was higher in Point A′ (p < 0.001). No differences were found during cannulation in terms of first-pass success rate or number of attempts. Conclusion: Abducted position moved the clavicle cephalad and allowed sonographic visualization of infraclavicular axillary vein approximately 2 cm more proximally than with the adducted arm, with a comparable rate of cannulation success.
Health-Information Seeking and Intention to Quit Smoking: Do Health Beliefs Have a Mediating Role?
Authors: Upadhyay Soumya , Lord Justin , Gakh Maxim 
Published: August 2019

Background: Smoking is a leading cause of preventable deaths. Smoking cessation can reduce the risk of smoking-associated disease and death. But smoking cessation involves behaviour change. Existing research indicates that health-information seeking and health-promoting behaviours can be positively associated. However, in the context of smoking, the relationship between seeking health information and intending to quit smoking remains only partially understood. Aim: This study aimed to examine the relationship between seeking health information and intending to quit smoking and to determine whether this relationship is mediated by health beliefs. Methods: We used data from the fourth cycle of the US National Cancer Institute’s Health Information National Trends Survey (HINTS). Logistic regression was used to assess the independent variable (ie, health-information seeking) and dependent variable (ie, intention to quit smoking) as mediated by health belief. Results: Our findings suggest that smokers who seek health information have a 2.67 times higher odds of intending to quit smoking than smokers who do not seek health information. However, health beliefs do not have an intervening effect between seeking health information and intending to quit smoking. Discussion: Seeking health information is important in predicting attempts to quit smoking, regardless of the smokers’ pre-existing health beliefs. Our findings support cessation efforts that encourage smokers to seek health information. Determining optimal ways to encourage smokers to seek smoking-related information could support achieving and maintaining smoking cessation. Conclusion: Cessation programmes and policies should encourage smokers to seek health information. Additional research should further examine smokers’ motivators and cues for health-information seeking and should further probe smokers’ beliefs about the risks of smoking.