bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Internal-Wave-Driven Meridional Overturning Circulation
Authors: Kunze Eric 
Published: September 2017

AbstractThe upwelling diapycnal limb of the ocean’s meridional overturning circulation is driven by divergence of diabatic turbulent buoyancy fluxes 〈w′b′〉 across density surfaces. A global assessment of zonally averaged internal-wave-driven turbulent diapycnal buoyancy fluxes from a strain-based finescale parameterization is used to infer mean diapycnal transports in the interior and near the bottom boundary. Bulk interior diabatic transports dominate above 2500-m depth (buoyancies |B| = gγn/ρ0 < 0.267 m s−2, neutral densities γn < 27.9 kg m−3), upwelling at 10–11 Sv (1 Sv = 106 m3 s−1); 2, 5, and 3–4 Sv in the Indian, Pacific, and Atlantic, respectively, but are weak in the abyss. Boundary water-mass transformations peak at 18–25 Sv (4–6, 10–14, and 4–5 Sv in the Indian, Pacific, and Atlantic) near buoyancy |B| ~ 0.268 m s−2 (γn ~ 28.1 kg m−3, 4500-m depth) between bottom and lower deep waters, consistent with published 20–30-Sv global Antarctic Bottom Water (AABW) transport estimates. Interior transports above 2500-m depth fall below inverse estimates, consistent with a more adiabatic ocean interior where diapycnal mixing occurs at Southern Hemisphere high-latitude surface density outcrops.
Regional Impacts of the Westerly Winds on Southern Ocean Mode and Intermediate Water Subduction
Authors: Downes Stephanie M. , Langlais Clothilde , Brook Jordan P. , Spence Paul 
Published: September 2017

AbstractSubduction processes in the Southern Ocean transfer oxygen, heat, and anthropogenic carbon into the ocean interior. The future response of upper-ocean subduction, in the Subantarctic Mode Water (SAMW) and Antarctic Intermediate Water (AAIW) classes, is dependent on the evolution of the combined surface buoyancy forcing and overlying westerly wind stress. Here, the recently observed pattern of a poleward intensification of the westerly winds is divided into its shift and increase components. SAMW and AAIW formation occurs in regional “hot spots” in deep mixed layer zones, primarily in the southeast Indian and Pacific. It is found that the mixed layer depth responds differently to wind stress perturbations across these regional formation zones. An increase only in the westerly winds in the Indian sector steepens isopycnals and increases the local circulation, driving deeper mixed layers and increased subduction. Conversely, in the same region, a poleward shift and poleward intensification of the westerly winds reduces heat loss and increases freshwater input, thus decreasing the mixed layer depth and consequently the associated SAMW and AAIW subduction. In the Pacific sector, all wind stress perturbations lead to increases in heat loss and decreases in freshwater input, resulting in a net increase in SAMW and AAIW subduction. Overall, the poleward shift in the westerly wind stress dominates the SAMW subduction changes, rather than the increase in wind stress. The net decrease in SAMW subduction across all basins would likely decrease anthropogenic carbon sequestration; however, the net AAIW subduction changes across the Southern Ocean are overall minor.
How adolescents perceive that community-based exercise improves their well-being
Authors: Rourke Kevin , Wilson Coralie J 
Published: September 2017

Objectives: To determine if adolescents perceive community-based exercise as beneficial to their well-being and in what ways. Methods: A New South Wales Police Citizens Youth Club ran a four-week fitness course. The classes involved: 1) sports including basketball and soccer, 2) non-contact boxing drills, and 3) games, both team games such as dodgeball and non-team games such as line tag. Parental consent to offer a survey at the completion of the course was requested during registration. The survey was the Warwick Edinburgh Mental Well-being Scale; it was minimally modified to measure perceived benefit to mental well-being instead of actual benefit. Results: Thirty-one high school adolescents, ages 13–18, completed the survey. As a group, participants reported that they believed their well-being had improved after the course. The mean score for each survey item showed an improvement in every area of mental well-being for this sample of adolescents. Thirty-two per cent of adolescents reported having less energy. Survey scores indicated a statistically significant improvement in perceived well-being ( p<0.0001). Conclusions: The results of this study suggest that four weeks of community-based exercise improves perceived mental well-being in adolescent participants.
Pyrexia in cats: Retrospective analysis of signalment, clinical investigations, diagnosis and influence of prior treatment in 106 referred cases
Authors: Spencer Sarah E , Knowles Toby , Ramsey Ian K , Tasker Séverine 
Published: September 2017

Objectives: The main aim of the study was to describe the features and diagnoses of a population of cats referred with pyrexia. Other aims were to report and evaluate the utility of clinical investigations performed, and describe any effect of treatment before referral on temperature at presentation and ability to make a diagnosis. Methods: Clinical records of cats with pyrexia (⩾39.2°C) documented at least twice were retrospectively reviewed. Cases were assigned to disease categories (infectious, inflammatory, immune-mediated, neoplastic, miscellaneous and no diagnosis [pyrexia of unknown origin, PUO]) based on diagnosis. The overall value of clinical investigations was assessed by classifying them as ‘enabling’, ‘assisting’ or ‘no assistance’ in achieving each diagnosis. The effect of treatment before referral was assessed for any association with temperature at presentation and ability to make a diagnosis (PUO vs other disease categories). Results: One hundred and six cases were identified. The most common cause of pyrexia was feline infectious peritonitis (22 cats, 20.8%) and the largest disease category was infectious (41/106, 38.7%). Inflammatory conditions were found in 19 (17.9%) cats, neoplasia in 13 (12.3%), miscellaneous causes in 11 (10.4%) and immune-mediated disease in six (5.7%). No diagnosis was reached in 16 (15.0%) cats, often despite extensive diagnostic investigations. Cytology and histopathology most often ‘enabled’ or ‘assisted’ in obtaining a diagnosis. Most cats (91, 85.8%) received treatment before referral, with antimicrobial treatment given to 87 (82.1%). Prior treatment before referral was not associated with temperature at presentation nor with success in establishing a diagnosis. Conclusions and relevance: This is the first study investigating causes of pyrexia in cats. Infectious diseases were most common and immune-mediated diseases were comparatively rare.
Inhaled Steroids and Active Smoking Drive Chronic Obstructive Pulmonary Disease Symptoms and Biomarkers to a Greater Degree Than Airflow Limitation
Authors: Silkoff Philip E , Singh Dave , FitzGerald J Mark , Eich Andreas , Ludwig-Sengpiel Andrea , Chupp Geoffrey C , Backer Vibeke , Porsbjerg Celeste , Girodet Pierre-Olivier , Dransfield Mark T , Baribaud Frederic , Susulic Vedrana S , Loza Matthew J 
Published: September 2017

Rationale: Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease, and development of novel therapeutics requires an understanding of pathophysiologic phenotypes. Objectives: The purpose of the Airways Disease Endotyping for Personalized Therapeutics (ADEPT) study was to correlate clinical features and biomarkers with molecular characteristics in a well-profiled COPD cohort. Methods: A total of 67 COPD subjects (forced expiratory volume in the first second of expiration [FEV1]: 45%-80% predicted) and 63 healthy smoking and nonsmoking controls underwent multiple assessments including patient questionnaires, lung function, and clinical biomarkers including fractional exhaled nitric oxide (FENO), induced sputum, and blood. Measurements and main results: The impact of inhaled corticosteroids (ICSs), and to a lesser extent current smoking, was more associated with symptom control, exacerbation rates, and clinical biomarkers, than severity by FEV1. The ICS-treated smoking subjects were most symptomatic, with significantly elevated scores on patient-reported outcomes and more annual exacerbations ( P < .05). Inhaled corticosteroid users had greater airflow obstruction and air trapping compared with non-ICS users, regardless of smoking status. Smoking, regardless of ICS use, was associated with significantly lower FENO ( P < .05). Smoking, in non-ICS users, was associated with an elevated proportion of sputum neutrophils and reduced sputum macrophages. Increased serum C-reactive protein was observed in smokers but not in ICS and nonsmoking ICS users ( P < .05). In contrast, only air trapping and neutrophilic inflammation increased with severity, defined by postbronchodilator FEV1. Conclusions: Compared with COPD severity by FEV1, ICS use and current smoking were better determinants of clinical characteristics and biomarkers. Use of the ADEPT COPD data promises to prove useful in defining biological phenotypes to facilitate personalized therapeutic approaches.
A Medial Malleolar “Fleck Sign” May Predict Ankle Instability in Ligamentous Supination External Rotation Ankle Fractures
Authors: Nwosu Kenneth , Schneiderman Brian Andrew , Shymon Stephen Joseph , Harris Thomas 
Published: September 2017

Background. Ankle joint stability dictates treatment in ligamentous supination external rotation ankle injuries (LSERAI). Investigation of the medial structures that support the ankle mortise is critical, and a small avulsion fracture, or “fleck”, of the medial malleolus is occasionally encountered. This study aimed to assess the utility of this medial malleolus fleck sign (MMFS) in diagnosing instability requiring surgery in LSERAI. Methods. This retrospective observational study examined 166 LSERAI at a single level I trauma center. A standardized diagnostic and treatment protocol for ankle fractures was followed. LSERAI at presentation were reported as having a normal, dynamically wide, or statically wide medial clear space. Patient demographics, MMFS characteristics, and the use of operative management were recorded. Results. MMFS incidence in the cohort was 16 (10%) of 166 and was present in 25% of patients with unstable LSERAI. Fifteen (94%) of 16 patients with a MMFS were deemed to have an unstable LSERAI (P < .005). MMFS had a 25% sensitivity and 99% specificity in diagnosing an unstable LSERAI. For the subgroup of patients without a statically wide medial clear space, MMFS had a 50% sensitivity and 99% specificity in determining instability. Conclusion. A MMFS may be indicative of an unstable LSERAI. With previous MRI studies demonstrating complete deltoid disruption in unstable LSERAI, we deduce the MMFS may be associated with extensive deltoid incompetence. The MMFS may help to diagnose a complete deltoid injury in LSERAI with a normal medial clear space, which could influence treatment and reduce patient morbidity, radiation exposure, and healthcare costs. Levels of Evidence: Level III: Retrospective Cohort Study
Contraceptive counseling among pediatric primary care providers in Western Pennsylvania: A survey-based study
Authors: Papas Beth Ann , Shaikh Nader , Watson Katherine , Sucato Gina S 
Published: September 2017

Objectives: Data suggest that adolescents in the United States receive inadequate contraceptive counseling. This study sought to determine factors affecting pediatricians’ discussion of contraception with adolescent patients, with a specific focus on long-acting reversible contraception—implantable contraception and intrauterine devices. Methods: A cross-sectional survey was sent via email to a convenience sample of pediatric residents and pediatric primary care providers in Western Pennsylvania. Self-reported contraceptive counseling and prescribing practices in response to clinical vignettes were assessed. Results: Of potential participants (287), 88 (31%) responded. Younger providers and providers who had received contraceptive training were significantly more likely to discuss long-acting reversible contraception methods. Discussion of contraceptive methods also varied by both the age and the sexual history of the patient. Conclusion: Variation in contraceptive counseling potentially results in missed opportunities to counsel about and provide the most effective contraceptive methods. More uniform, universal provider training might alleviate some of these inconsistencies.
Anti-inflammatory roles of p38α MAPK in macrophages are context dependent and require IL-10
Authors: Raza Abbas , Crothers Jessica W , McGill Mahalia M , Mawe Gary M , Teuscher Cory , Krementsov Dimitry N 
Published: September 2017

Abstract
The p38 MAPK pathway was originally identified as a master regulator of proinflammatory cytokine production by myeloid cells. Numerous drugs targeting this kinase showed promise in preclinical models of inflammatory disease, but so far, none have shown efficacy in clinical trials. The reasons behind this are unclear, but may, in part, be explained by emerging anti-inflammatory functions of this kinase or overly refined selectivity of second-generation pharmacologic inhibitors. Here, we show that p38α signaling in macrophages plays pro- and anti-inflammatory functions in vivo and in vitro, with the outcome depending on the stimulus, output, kinetics, or mode of kinase inhibition (genetic vs. pharmacologic). Different pharmacologic inhibitors of p38 exhibit opposing effects, with second-generation inhibitors acting more specifically but inhibiting anti-inflammatory functions. Functionally, we show that the anti-inflammatory functions of p38α in macrophages are critically dependent on production of IL-10. Accordingly, in the absence of IL-10, inhibition of p38α signaling in macrophages is protective in a spontaneous model of colitis. Taken together, our results shed light on the limited clinical efficacy of drugs targeting p38 and suggest that their therapeutic efficacy can be significantly enhanced by simultaneous modulation of p38-dependent anti-inflammatory mediators, such as IL-10.
Preoperative predicting malignancy in breast mass-like lesions: value of adding histogram analysis of apparent diffusion coefficient maps to dynamic contrast-enhanced magnetic resonance imaging for improving confidence level
Authors: Liu Hong-Li , Zong Min , Wei Han , Lou Jian-Juan , Wang Si-Qi , Zou Qi-Gui , Shi Hai-Bin , Jiang Yan-Ni 
Published: September 2017

Objective:
This study aims to find out the benefits of adding histogram analysis of apparent diffusion coefficient (ADC) maps onto dynamic contrast-enhanced MRI (DCE-MRI) in predicting breast malignancy.

Methods:
This study included 95 patients who were found with breast mass-like lesions from January 2014 to March 2016 (47 benign and 48 malignant). These patients were estimated by both DCE-MRI and diffusion-weighted imaging (DWI) and classified into two groups, namely, the benign and the malignant. Between these groups, the DCE-MRI parameters, including morphology, enhancement homogeneity, maximum slope of increase (MSI) and time-signal intensity curve (TIC) type, as well as histogram parameters generated from ADC maps were compared. Then, univariate and multivariate logistic regression analyses were conducted to determine the most valuable variables in predicting malignancy. Receiver operating characteristic curve analyses were taken to assess their clinical values.

Results:
The lesion morphology, MSI and TIC Type (p &lt; 0.05) were significantly different between the two groups. Multivariate logistic regression analyses revealed that irregular morphology, TIC Type II/III and ADC10 were important predictors for breast malignancy. Increased area under curve (AUC) and specificity can be achieved with Model 2 (irregular morphology + TIC Type II/III + ADC10 &lt; 1.047 ×10−3 mm2 s–1) as the criterion than Model 1 (irregular morphology + TIC Type II/III) only (Model 2 vs Model 1; AUC, 0.822 vs 0.705; sensitivity, 68.8 vs 75.0%; specificity, 95.7 vs 66.0%).

Conclusion:
Irregular morphology, TIC Type II/III and ADC10 are indicators for predicting breast malignancy. Histogram analysis of ADC maps can provide additional value in predicting breast malignancy.

Advances in knowledge:
The morphology, MSI and TIC types in DCE-MRI examination have significant difference between the benign and malignant groups. A higher AUC can be achieved by using ADC10 as the diagnostic index than other ADC parameters, and the difference in AUC based on ADC10 and ADCmean was statistically significant. The irregular morphology, TIC Type II/III and ADC10 were significant predictors for malignant lesions.
Single-incision laparoscopic surgery in gynecologic surgery: a single-institutional experience from Saudi Arabia
Authors: Salamah Kareemah , Abuzaid Mohammed , Abu-Zaid Ahmed 
Published: September 2017

Background: Laparoscopy is rapidly replacing laparotomy in the field of gynecologic surgery. Generally, there are limited data concerning the utility of single-incision laparoscopic surgery (SILS) in gynecologic surgery. Specifically, in Saudi Arabia, a third-world country, data are further limited; only one related study has been conducted so far. The purpose of this study is to retrospectively report our single-institutional experience of SILS in terms of feasibility, safety and perioperative outcomes in the management of various gynecologic conditions.Methods:The study took place at the Women’s Specialized Hospital, King Fahad Medical City, Riyadh, Saudi Arabia. From January 2012 to May 2016, all gynecologic patients who underwent SILS procedures were analyzed for pre-, intra- and post-operative details. SILS was performed using a single multi-port trocar and standard laparoscopic instruments.Results: A total of 54 patients underwent 66 SILS procedures. The median age and body mass index (BMI) were 36 years and 28.2 kg/m2, respectively. Fourteen patients (26%) had ≥ 1 previous abdominal and/or pelvic surgeries. Twenty-four patients (44.4%) were nulliparous. The three most commonly performed SILS procedures were unilateral salpingo-oophorectomy (45.5%) and unilateral ovarian cystectomy (27.3%) and adhesiolysis (6.1%). The median operative time, estimated blood loss and hospital stay were 74 min, 50 ml and 1 day, respectively. Three patients required conversion to laparotomy, as follows: unidentified non-stopping bleeding source (n=1) and endometriosis stage IV resulting in difficult dissection (n=2). One patient developed post-operative incisional hernia that was treated surgically. The median patients’ post-operative pain (according to Wong-Baker FACES Foundation pain rating scale) within 4 hours was 2. At 4-week post-operatively, the median wound scar length (measured at outpatient clinic) was 2 cm.Conclusions: SILS is feasible, safe and associated with acceptable clinical and surgical outcomes.
Radiological Justification Of Radionuclide Inventory Control In The Context Of The Long-Term Safety Of Radioactive Waste Disposal Facilities
Authors: Блохин П. , Blohin P. , Самойлов А. , Samoylov A. 
Published: September 2017

Purpose: this paper concentrates on the development and validation of an approach enabling to identify radiologically relevant radionuclides in radioactive waste at different stages of their management, as well as to implement their direct instrumental control.
Material and methods: The research was carried out by comparing relevant radiological effects produced by radionuclides contained in activation RW from VVER-440 unit (reactor vessel, vessel internals and fuel rod cladding) on human at different stages of RW management. AKDAM-2.0 complex was used to evaluate the changes in the radionuclide inventory of materials during their irradiation and cooling.
Results: The study enabled to calculate relevant contribution of different radionuclides to the overall activity and dose rate from external and internal human exposure at different stages of RW management. This paper proposes a novel approach to identify radiologically relevant radionuclides based on a comparative evaluation of their contribution to the dose rate their activity, half-lives and migration properties. Relevant lists of radionuclides were developed for the studied materials. These radionuclides should be considered in the safety assessments of RW management practices and the post-closure safety demonstration for deep geological disposal facilities (DGDF). The study suggests that direct instrumental control is feasible for a number of radionuclides along with the use of an integrated approach enabling to evaluate the content of other radionuclides.
Conclusions: Further validation proved the viability of the proposed approach in the development of lists of radiologically relevant radionuclides. It has been found that the generated list is consistent with international practice used to demonstrate DGDF safety. It should be noted that only a small number of radionuclides should be considered radiologically relevant notwithstanding a variety of radionuclides generated due to material activation. In some cases, certain radionuclides are required to be added to the lists specified in the appendices to Radiation Safety Standards (RSS). However, the direct instrumental control covering the entire list of radiologically relevant radionuclides (for each RW management stage) is considered not feasible and hard to implement. The study shows that an integrated approach combining direct instrumental control for certain radionuclides, periodic destructive tests and inventory calculations is a preferred option. At the stage of periodic radiation monitoring in the disposal facility, such instrumental control should be focused on the evaluation of disposal system properties affecting its safety (hydrogeochemical, hydrogeological characteristics and etc.).
Dimensions based data clustering and zone maps
Authors: Ziauddin Mohamed , Witkowski Andrew , Kim You Jung , Potapov Dmitry , Lahorani Janaki , Krishna Murali 
Published: September 2017

In recent years, the data warehouse industry has witnessed decreased use of indexing but increased use of compression and clustering of data facilitating efficient data access and data pruning in the query processing area. A classic example of data pruning is the partition pruning, which is used when table data is range or list partitioned. But lately, techniques have been developed to prune data at a lower granularity than a table partition or sub-partition. A good example is the use of data pruning structure called zone map. A zone map prunes zones of data from a table on which it is defined. Data pruning via zone map is very effective when the table data is clustered by the filtering columns.
The database industry has offered support to cluster data in tables by its local columns, and to define zone maps on clustering columns of such tables. This has helped improve the performance of queries that contain filter predicates on local columns. However, queries in data warehouses are typically based on star/snowflake schema with filter predicates usually on columns of the dimension tables joined to a fact table. Given this, the performance of data warehouse queries can be significantly improved if the fact table data is clustered by columns of dimension tables together with zone maps that maintain min/max value ranges of these clustering columns over zones of fact table data. In recognition of this opportunity of significantly improving the performance of data warehouse queries, Oracle 12c release 1 has introduced the support for dimension based clustering of fact tables together with data pruning of the fact tables via dimension based zone maps.