bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transcranial Doppler and Magnetic Resonance in Tanzanian Children With Sickle Cell Disease
Authors: Kija Edward N. , Saunders Dawn E. , Munubhi Emmanuel , Darekar Angela , Barker Simon , Cox Timothy C.S. , Mango Mechris , Soka Deogratias , Komba Joyce , Nkya Deogratias A. , Cox Sharon E. , Kirkham Fenella J. , Newton Charles R.J.C. 
Published: June 2019

Background and Purpose—
We determined prevalences of neurological complications, vascular abnormality, and infarction in Tanzanian children with sickle cell disease.

Methods—
Children with sickle cell disease were consecutively enrolled for transcranial Doppler; those with slightly elevated (>150 cm/s), low (<50 cm/s) or absent cerebral blood flow velocity (CBFv) were invited for brain magnetic resonance imaging and magnetic resonance angiography.

Results—

Of 200 children (median age 9; range 6–13 years; 105 [2.5%] boys), 21 (11%) and 15 (8%) had previous seizures and unilateral weakness, respectively. Twenty-eight (14%) had elevated and 39 (20%) had low/absent CBFv, all associated with lower hemoglobin level, but not higher indirect bilirubin level. On multivariable analysis, CBFv>150 cm/s was associated with frequent painful crises and low hemoglobin level. Absent/low CBFv was associated with low hemoglobin level and history of unilateral weakness. In 49 out of 67 children with low/absent/elevated transcranial Doppler undergoing magnetic resonance imaging, 43% had infarction, whereas 24 out of 48 (50%) magnetic resonance angiographies were abnormal. One had hemorrhagic infarction; none had microbleeds. Posterior circulation infarcts occurred in 14%. Of 11 children with previous seizure undergoing magnetic resonance imaging, 10 (91%) had infarction (5 silent) compared with 11 out of 38 (29%) of the remainder (
P
=0.003). Of 7 children with clinical stroke, 2 had recurrent stroke and 3 died; 4 out of 5 had absent CBFv. Of 193 without stroke, 1 died and 1 had a stroke; both had absent CBFv.

Conclusions—
In one-third of Tanzanian children with sickle cell disease, CBFv is outside the normal range, associated with frequent painful crises and low hemoglobin level, but not hemolysis. Half have abnormal magnetic resonance angiography. African children with sickle cell disease should be evaluated with transcranial Doppler; those with low/absent/elevated CBFv should undergo magnetic resonance imaging/magnetic resonance angiography.
High-Sensitivity CRP (C-Reactive Protein) Is Associated With Incident Carotid Artery Plaque in Chinese Aged Adults
Authors: Xu Renying , Zhang Yanan , Gao Xiang , Wan Yanping , Fan Zhuping 
Published: June 2019

Background and Purpose—
CRP (C-reactive protein) is an inflammatory biomarker which predicts the risk of cardiovascular diseases. However, whether CRP is associated with carotid artery plaque (CAP) remains unclear.

Methods—
The current retrospective study was performed in 8229 Chinese aged adults (aged 65–99 years; 4677 men and 3552 women). hs-CRP (high-sensitivity CRP) concentrations were measured at baseline (2013), and further classified into 3 groups: low risk (<1.0 mg/L), intermediate risk (1.0–3.0 mg/L), and high risk (≥3.0 mg/L). Ultrasound B-mode imaging was repeatedly performed annually to detect CAP during 5-year follow-up (2013–2018). Potential confounders, including body mass index, blood pressure, fasting blood glucose, alanine transferase, aspartate transferase, alkaline phosphatase, gamma-glutamyl transferase, total bilirubin, direct bilirubin, blood urea nitrogen, creatinine, and uric acid, lipid profiles, were also collected at baseline. White blood cell was collected as well. We used a logistic regression model for the cross-sectional relation between CRP concentration and CAP status and proportional hazardous Cox model for prospective analyses.

Results—
Comparing to the low-risk group, the adjusted odds ratios for CAP was 1.66 (95% CI, 1.43–1.92) in the intermediate-risk group and 1.72 (95% CI, 1.39–2.13) in the high-risk group, after adjustment for potential confounders. We identified 512 incident CAP cases during 5-year follow-up. Each mg/L increase of hs-CRP was associated with a hazard ratio of 1.1 (95% CI, 1.03–1.17) to developing CAP. Sensitivity analysis generated similar results with prospective analyses after excluding participants with overweight and obesity, with elevated fasting blood glucose, LDL (low-density lipoprotein) cholesterol, and white blood cell. The association lost significant when we excluded participants with elevated blood pressure, however, few cases of CAP (n=41) was recruited in participants with normal blood pressure during follow-up.

Conclusions—
High hs-CRP concentration was associated with the high risk of developing CAP in Chinese aged adults.
A New Method to Diagnose Cyclone–Cyclone Interaction and Its Influences on Precipitation
Authors: Cao Zuohao , Xu Qin , Zhang Da-Lin 
Published: June 2019

AbstractUnlike the classical point vortex model, a new method is developed to extract flows induced not only by vorticity but also by divergence in a well-defined vortex core area of a cyclone. This new method is applied to diagnosing the interactions of three midlatitude cyclones (called A, B, and C) that account for a missed summer severe rainfall forecast, in which the daily precipitation predicted by the Canadian operational model is an order of magnitude smaller than the rain gauge and radar measurements. In this event, cyclone B, responsible for the severe rainfall occurrence, was advected largely by flows induced by two neighboring cyclones: A and C to the west and east, respectively. This work attempts to assess whether and to what degree the vertical tilt of the observed cyclone versus that of the forecast cyclone B is caused by advections of the environmental flows (including A- and C-induced flows) at 500 and 1000 hPa. Results show that the observed cyclone B was advected mainly by the cyclone A–induced flow at 500 hPa into a vertically tilted structure that was northwestward against the vertical shear of the environmental flow and thus favorable for upward motion and cyclone intensification around the time of severe rainfall. However, the forecast cyclone B was advected largely by the cyclone A–induced flow at 500 hPa and the cyclone C–induced flow at 1000 hPa into an increasingly northward-tilted structure that was along the vertical shear of the environmental flow and thus unfavorable for upward motion and cyclone intensification, leading to the missed forecast of severe rainfall. Suggestions are made for future improvements of model forecasts.
Insights into Decadal North Atlantic Sea Surface Temperature and Ocean Heat Content Variability from an Eddy-Permitting Coupled Climate Model
Authors: Moat B. I. , Sinha B. , Josey S. A. , Robson J. , Ortega P. , Sévellec F. , Holliday N. P. , McCarthy G. D. , New A. L. , Hirschi J. J.-M. 
Published: June 2019

Abstract
An ocean mixed layer heat budget methodology is used to investigate the physical processes determining subpolar North Atlantic (SPNA) sea surface temperature (SST) and ocean heat content (OHC) variability on decadal to multidecadal time scales using the state-of-the-art climate model HadGEM3-GC2. New elements include development of an equation for evolution of anomalous SST for interannual and longer time scales in a form analogous to that for OHC, parameterization of the diffusive heat flux at the base of the mixed layer, and analysis of a composite Atlantic meridional overturning circulation (AMOC) event. Contributions to OHC and SST variability from two sources are evaluated: 1) net ocean–atmosphere heat flux and 2) all other processes, including advection, diffusion, and entrainment for SST. Anomalies in OHC tendency propagate anticlockwise around the SPNA on multidecadal time scales with a clear relationship to the phase of the AMOC. AMOC anomalies lead SST tendencies, which in turn lead OHC tendencies in both the eastern and western SPNA. OHC and SST variations in the SPNA on decadal time scales are dominated by AMOC variability because it controls variability of advection, which is shown to be the dominant term in the OHC budget. Lags between OHC and SST are traced to differences between the advection term for OHC and the advection–entrainment term for SST. The new results have implications for interpretation of variations in Atlantic heat uptake in the CMIP6 climate model assessment.
Role of Sea Surface Salinity Feedback in MJO Predictability: A Study with CFSv2
Authors: Zhu Jieshun , Kumar Arun 
Published: June 2019

Abstract
While previous studies suggested that salinity could feed back onto MJO variability via modulating upper ocean stratification and further on SST, there is no direct evidence yet proving (or disproving) the importance of this feedback in MJO evolution and its predictability. This study is an initial attempt to quantify the role of SSS feedback on MJO predictability, based on a “perfect model” framework with the CFSv2. Specifically, the SSS feedback is isolated by nudging model SSS to climatological states during forecasts. For comparison, two more experiments were done, one as a benchmark experiment by estimating MJO predictability in CFSv2 and another one for estimating the role of SST feedback. Analyses of these experiments indicate that SSS feedback exerts negligible influences on MJO predictability within the constraints of the model, in contrast to significant impacts from SST feedback. Further analysis showed that a lack of SSS influence in MJO predictability can be attributed to marginal changes in SST associated with the SSS nudging. However, there is a caveat to the conclusion about SSS feedback. Because the barrier layer (BL) acts as a “bridge” for possible SSS influences on SST over the tropical Indian and western Pacific oceans, its simulation in CFSv2 is further explored. Analyses indicate that, in spite of realistic simulations of the MJO and intraseasonal SSS variability in CFSv2, significant BL simulation biases are present in the tropical oceans, including too thin a climatological thickness, too small intraseasonal variations, and an unrealistic intraseasonal BL–SST relationship. Thus, our predictability experiments cannot reject the hypothesis that SSS does play a role in MJO predictability; it is possible that biases in CFSv2 influence its ability to capture such signals.
A Changing Climatology of Precipitation Persistence across the United States Using Information-Based Measures
Authors: Goodwell Allison E. , Kumar Praveen 
Published: June 2019

Abstract
The sequencing, or persistence, of daily precipitation influences variability in streamflow, soil moisture, and vegetation states. As these factors influence water availability and ecosystem health, it is important to identify spatial and temporal trends in precipitation persistence and predictability. We take an information theoretic perspective to address regional and temporal trends in daily patterns, based on the Climate Prediction Center (CPC) gridded gauge-based dataset of daily precipitation over the continental United States from 1948 to 2018. We apply information measures to binary sequences of precipitation occurrence to quantify uncertainty, predictability in the form of lagged mutual information between the current state and two time-lagged histories, and associated dominant time scales. We find that this information-based predictability is highest in the western United States, but the relative influence of longer lagged histories in comparison to a 1-day history is highest in the east. Information characteristics and time scales vary seasonally and regionally and constitute an information climatology that can be compared with traditional indices of precipitation and climate. Trend analyses over the 70-yr time period also show varying regional characteristics that differ between seasons. In addition to increasing precipitation frequency over most of the country, we detect increasing and decreasing predictability in western and eastern regions, respectively, with average trend magnitudes corresponding to shifts in predictability ranging from −50% to 110%. This new perspective on precipitation persistence has broad potential to link shifts in climate and weather to patterns and predictability of related environmental factors.
Spatiotemporal Variability of the Global Ocean Internal Processes Inferred from Satellite Observations
Authors: Yang Yang , San Liang X. 
Published: June 2019

AbstractUsing a new analysis tool, namely, multiscale window transform (MWT), and the MWT-based theory of canonical transfer, this study investigates the spatiotemporal variations of the nonlinear interactions among the mean flows, interannual variabilities, quasi-annual fluctuations, and eddies in the global ocean. It is found that the canonical kinetic energy (KE) transfers are highly inhomogeneous in space, maximized in the western boundary current (WBC), Southern Ocean, and equatorial regions. In contrast to the equatorial and WBC regions where the temporal KE cascades are mainly forward, the Southern Ocean is the very place where coherent large-scale patterns of inverse KE cascade take place. The canonical transfers are also found to be highly variable in time. Specifically, in the Kuroshio Extension, the transfer from the mean flow to the interannual variability is in pace with the external winds from the eastern North Pacific; in the subtropical gyre, the mean flow-to-eddy transfer is responsible for the variability of the eddy kinetic energies (EKE) at both interannual and seasonal scales; in the tropics, the downscale transfers to the eddies from the other three scales all contribute to the interannual modulation of the EKE, and these transfers tend to decrease (increase) during El Niño (La Niña) events. In the Southern Ocean, the high-frequency eddies are found to feed KE to the low-frequency variability through temporal inverse cascade processes, which have been strengthened due to the enhanced eddy activities in the recent decade. Also discussed here is the relation between the seasonal EKE variability and the eddy–quasi-annual fluctuation interaction.
Social Capital and Tobacco Retail Outlet Density: An Empirical Test of the Relationship
Authors: Gonzalez Mariaelena , Sanders-Jackson Ashley , Henriksen Lisa 
Published: June 2019

Purpose: To examine the relationship between tobacco outlet density and social capital. Participants: Parents of at least one teen (N = 2734) in a representative sample of US households with teens (ages 13-16). Design: Population-based, cross-sectional survey of a web panel of adolescent–parent pairs matched with spatial data for address to characterize household neighborhoods. Setting: US households identified by latitude and longitude with a 50-ft random shift. Measures: Perceived social capital (trust and informal social control as reported by parents), tobacco outlet density (retailers per land area in 1/2-mile buffer around each household), neighborhood demographics (derived from American Community Survey), and parent demographics. Analysis: Multivariable regression examined the relationship between tobacco outlet density and social capital controlling for household buffer and individual-level covariates, including correlates of social capital. Results: Tobacco outlet density was inversely correlated with perceived trust in neighbors ( B = −1.12, P = .0004), but not social control ( B = 0.11, P = .731). Conclusion: This study is the first we are aware of to find that social capital is related to tobacco outlet density. The results imply that individuals with low social capital may benefit from policies regulating tobacco outlet density and may benefit from policies that address neighborhood inequality by increasing social capital and reducing poverty.
Cleft and Craniofacial Multidisciplinary Team Clinic: A Look at Attrition Rates for Patients With Complete Cleft Lip and Palate and Nonsyndromic Single-Suture Craniosynostosis
Authors: Cooper Danielle C. , Peterson Erin C. , Grellner Cheryl G. , Naidoo Sybill D. , Skolnick Gary B. , Pfeifauf Kristin D. , Smyth Matthew D. , Snyder-Warwick Alison K. , Patel Kamlesh B. 
Published: June 2019

Objective: To evaluate attrition rates prior to expected completion of team care for children with complete cleft lip and palate (cleft) or nonsyndromic single-suture craniosynostosis (synostosis). Design: A single-institution retrospective review of attendance data from 2002 to 2016. Setting: Single cleft and craniofacial center in the United States. Patients/Participants: A sample of 983 patients with either cleft or synostosis. Patients who were more than 2 to 3 years from their last visit were considered lost to follow-up. Patients with cleft older than 16 years or synostosis over 11 years were considered graduated from team care. Results: Survival analysis shows that in our patients with cleft, 25% leave before age 8 and over 60% are lost from team by age 16. In patients with synostosis, 25% leave before age 6 and 45% are lost by age 11. Cox regression showed underrepresented minorities being 1.7 times more likely to become lost in the cleft group (hazard ratio: 1.66, 95% confidence interval [CI]: 1.01-2.74). Conclusions: Overall, attrition rates were high at our institution. Many patients are lost to follow-up prior to receiving key medical interventions. Improved family education and personalized care are needed to help ensure continuity of care.
Multivariate Index Assay Is Superior to CA125 and HE4 Testing in Detection of Ovarian Malignancy in African-American Women
Authors: Dunton Charles , Bullock Rowan G , Fritsche Herbert 
Published: June 2019

Objective: To review and analyze the serum values of risk of ovarian malignancy algorithm (ROMA) and multivariate index assay (MIA) in subgroups of women who underwent surgery for adnexal masses to determine sensitivity, specificity, and positive and negative predictive values for the detection of malignancy in different ethnic populations. Methods: Serum samples from 2 prospective trials of 1029 women in which 274 women diagnosed with malignancy were analyzed for ROMA scores and MIA results. Biomarker data were obtained from the previous prospective studies that validated the MIA test. Of these, 250 women were Caucasian (C) and 24 were African-American (AA). Sensitivity, specificity, positive and negative predictive values, and confidence intervals for preoperative test results were calculated using DTComPair package of the R programming language. In premenopausal women, a ROMA value equal to or greater than 1.14 indicates a high risk of finding epithelial ovarian cancer. In premenopausal women, MIA values greater than 5.0 are associated with a greater risk of malignancy. In postmenopausal women, a ROMA value equal to or greater than 2.99 indicates a high risk of finding epithelial ovarian cancer. In postmenopausal women, MIA values greater than 4.4 are associated with a greater risk of malignancy. Results: Primary ovarian malignancy was diagnosed in 179 cases (167 C/12 AA) and metastatic disease to the ovary in an additional 27 cases (22 C/5 AA). Overall results are shown below. Conclusions: Our results demonstrate that ROMA in AA women with adnexal masses have lower sensitivity for the detection of malignancy than does MIA. Implementation of MIA in the evaluation of adnexal masses will increase the sensitivity of the detection of malignancy compared with ROMA, with the most marked results in AA women.
Understanding L2 word learning outcomes: The roles of semantic relations, input, and language dissimilarity
Authors: Malt Barbara C 
Published: June 2019

Aims and objectives: This study contributes to understanding L2 word learning and why “semantic accent” persists. It examines the impact of L1–L2 semantic relations, input conditions, and L1–L2 dissimilarity on learning outcomes. Methodology: Mandarin-speaking learners of English labeled actions in 26 brief videos, typically called carrying or holding by native speakers. The labeling pattern is simpler in English than in Mandarin but requires a shift to different semantic dimensions. Further, hold is a higher frequency term than carry. The learners were resident in either China (N = 34) or the United States (N = 25), with somewhat higher proficiency in the US sample. Twenty native English speakers in the United States also responded. Data and analysis: Learner groups’ name choices were compared to each other and those of native speakers. Findings/conclusions: The dissimilarity between Mandarin and English did not block importing L1 meanings to L2, but progress was seen across sub-groups. Input variables did impact progress: immersion (mediated by proficiency) was better than classroom learning, and use of the higher frequency term was greater than of the lower. Notably, however, many learners narrowed to domain-relevant vocabulary without using the words in native-like ways despite the simplicity of the target L2 system. They appeared to update knowledge at the level of word form-to-domain mappings without updating word form-to-meaning associations. Originality: Semantic accent has been documented previously, but the L2 word learning trajectory and factors that contribute to semantic accent have not been well understood. This study advances that understanding. Significance/implications: Imported meanings are difficult to reshape even for dissimilar languages and even with immersion. Enhanced learning may require sensitizing learners to L2 semantic content via either explicit instruction or intensive exposure to discrepancies between L1 and L2 meanings.
EGFR-AS1/HIF2A regulates the expression of FOXP3 to impact the cancer stemness of smoking-related non-small cell lung cancer
Authors: Qi Haolong , Wang Shanshan , Wu Juekun , Yang Shucai , Gray Steven , Ng Calvin S.H. , Du Jing , Underwood Malcolm J. , Li Ming-Yue , Chen George G 
Published: June 2019

Background: Early data showed that FOXP3 could induce epithelial-mesenchymal transition by stimulating the Wnt/β-catenin signaling pathway in non-small cell lung cancer (NSCLC). However, how the expression of FOXP3 is regulated in NSCLC remains unknown. We thus explored the impacts of the long noncoding RNA EGFR antisense RNA 1 (EGFR-AS1) and hypoxia-inducible factor-2A (HIF2A) on FOXP3 expression and the cancer stemness of NSCLC. Methods: Lung tissues samples from 87 patients with NSCLC and two NSCLC cell lines were used in this study. The regulation of FOXP3 and lung cancer cell stemness by EGFR-AS1 and HIF2A was determined at molecular levels in NSCLC tissue samples and cultured cells in the presence/absence of the smoking carcinogen, 4-(N-methyl-N-nitrosamino)-1-(3-pyridyl)-1-butanone (NNK) (also known as nicotine-derived nitrosamine ketone). The results were confirmed in tumor xenograft models. Results: We found that NNK decreased the expression of EGFR-AS1 in the long term, but increased the expression of HIF2A and FOXP3 to stimulate lung cancer cell stemness. EGFR-AS1 significantly inhibited FOXP3 expression and NSCLC cell stemness, whereas HIF2A obviously promoted both. The enhancement of lung cancer stemness by FOXP3 was, at least partially, via stimulating Notch1, as the inhibition of Notch1 could markedly diminish the effect of FOXP3. Conclusions: FOXP3, the expression of which is under the fine control of EGFR-AS1, is a critical molecule that promotes NSCLC cancer cell stemness through stimulating the Notch1 pathway.