bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mean Subsurface Upwelling Induced by Intraseasonal Variability over the Equatorial Indian Ocean
Authors: Ogata Tomomichi , Nagura Motoki , Masumoto Yukio 
Published: March 2017

AbstractA possible formation mechanism of mean subsurface upwelling along the equator in the Indian Ocean is investigated using a series of hierarchical ocean general circulation model (OGCM) integrations and analytical considerations. In an eddy-resolving OGCM with realistic forcing, mean vertical velocity in the tropical Indian Ocean shows rather strong upwelling, with its maximum on the equator in the subsurface layer below the thermocline. Heat budget analysis exhibits that horizontal and vertical heat advection by deviations (i.e., due to deviations of velocity and temperature from the mean) balances with vertical advection caused by mean equatorial upwelling. Horizontal heat advection is mostly associated with intraseasonal variability with periods of 3–91 days, while contributions from longer periods (>91 days) are small. Sensitivity experiments with a coarse-resolution OGCM further demonstrate that such mean equatorial upwelling cannot be reproduced by seasonal forcing only. Adding the intraseasonal wind forcing, especially meridional wind variability with a period of 15 days, generates significant mean subsurface upwelling on the equator. Further experiments with idealized settings confirm the importance of intraseasonal mixed Rossby–gravity (MRG) waves to generate mean upwelling, which appears along the energy “beam” of the MRG wave. An analytical solution of the MRG waves indicates that wave-induced temperature advection caused by the MRG waves with upward (downward) phase propagation results in warming (cooling) on the equator. This wave-induced warming (cooling) is shown to balance with the mean equatorial upwelling (downwelling), which is consistent with simulated characteristics in the OGCM experiments.
Synthesis of Observations from the Precision Atmospheric Marine Boundary Layer Experiment (PreAMBLE)
Authors: Rahn David A. , Parish Thomas R. , Leon David 
Published: March 2017

Abstract
Research flights during the Precision Atmospheric Marine Boundary Layer Experiment (PreAMBLE) in Southern California during May–June 2012 focused on three main features found in the nearshore marine boundary layer (MBL): the coastal jet (10 flights), the Catalina eddy (3 flights), and the initiation of a southerly surge (1 flight). Several topics were examined with case studies, but results from individual events may not represent typical conditions. Although these flights do not constitute a long-term set of data, observations from PreAMBLE are used to find common features. Two main topics are addressed: the MBL collapse into the expansion fan, and the subsequent transition into the Santa Barbara Channel (SBC). The midmorning to late afternoon flights occur during moderate to strong northerly wind. Slope of the MBL in the expansion fan varies and wave perturbations can be embedded within the expansion fan. As the cool MBL flow turns into the SBC, it moves underneath a deeper and warmer MBL that originates from the southeast over the warmer ocean. The temperature inversion between the cool and warm MBL erodes toward the east until there is only the inversion between the warm MBL and free troposphere. The dissipation of the lower layer into the SBC observed by the aircraft differs from previous conceptual models that depict a continuous MBL that thins and then deepens again in the SBC, which was inferred from sparse observations and numerical simulations. Only one flight within the SBC detected a hydraulic jump from 100 to 200 m above the surface.
Understanding Challenges, Strategies, and the Role of Support Networks in Medication Self-management Among Patients With Type 2 Diabetes
Authors: Bernhard Gerda , Ose Dominik , Baudendistel Ines , Seidling Hanna M. , Stützle Marion , Szecsenyi Joachim , Wensing Michel , Mahler Cornelia 
Published: March 2017

Purpose The purpose of this qualitative study was to investigate the challenges and strategies of patients with type 2 diabetes mellitus (T2DM) regarding daily management of their medication regimen focusing on the role of their support networks. Methods A purposeful sample of 25 patients with T2DM was recruited from local self-help groups, general practitioner practices, and a university hospital in southwestern Germany. Four semi-structured focus groups were conducted to identify the challenges patients experienced, the strategies they used, and their collaboration with support networks to assist them in self-managing their medication regimen. Sessions were audio- and video-recorded, fully transcribed, and subjected to computer-aided qualitative content analysis, guided by the Self- and Family Management Framework (SFMF). Results Patients with T2DM experienced numerous challenges affecting medication self-management arising from their personal situation, health status and resources, characteristics of their regimen, and how health care is currently organized. Patients’ self-initiated strategies included activating health care, community, social, and online resources; taking ownership of medication-related needs; and integrating medication-taking into daily life. Patients drew on self-help groups, family, and friends to discuss concerns regarding medication safety and receive experience-based information and advice for navigating within the health care system as well as practical hands-on support with daily medication self-management. Conclusions Understanding the challenges and building on strategies patients with T2DM devised help diabetes educators to better address patients’ needs and priorities and guide patient-centered interventions to support patients’ self-management activities. Community and social support networks operating in patients’ lives need to be engaged in the self-management support.
Expectations and Attitudes of Individuals With Type 1 Diabetes After Using a Hybrid Closed Loop System
Authors: Iturralde Esti , Tanenbaum Molly L. , Hanes Sarah J. , Suttiratana Sakinah C. , Ambrosino Jodie M. , Ly Trang T. , Maahs David M. , Naranjo Diana , Walders-Abramson Natalie , Weinzimer Stuart A. , Buckingham Bruce A. , Hood Korey K. 
Published: March 2017

Purpose The first hybrid closed loop (HCL) system, which automates insulin delivery but requires user inputs, was approved for treatment of type 1 diabetes (T1D) by the US Food and Drug Administration in September 2016. The purpose of this study was to explore the benefits, expectations, and attitudes of individuals with T1D following a clinical trial of an HCL system. Methods Thirty-two individuals with T1D (17 adults, 15 adolescents) participated in focus groups after 4 to 5 days of system use. Content analysis generated themes regarding perceived benefits, hassles, and limitations. Results Some participants felt misled by terms such as “closed loop” and “artificial pancreas,” which seemed to imply a more “hands-off” experience. Perceived benefits were improved glycemic control, anticipated reduction of long-term complications, better quality of life, and reduced mental burden of diabetes. Hassles and limitations included unexpected tasks for the user, difficulties wearing the system, concerns about controlling highs, and being reminded of diabetes. Conclusion Users are willing to accept some hassles and limitations if they also perceive health and quality-of-life benefits beyond current self-management. It is important for clinicians to provide a balanced view of positives and negatives to help manage expectations.
High Prevalence of Vitamin D Deficiency in Patients With Bone Marrow Edema Syndrome of the Foot and Ankle
Authors: Horas Konstantin , Fraissler Lukas , Maier Gerrit , Jakob Franz , Seefried Lothar , Konrads Christian , Rudert Maximilian , Walcher Matthias 
Published: March 2017

Background: Bone marrow edema syndrome (BMOS) is a phenomenon primarily affecting the lower extremity. It is characterized by a sudden onset of pain and an ill-defined osseous hyperintense signal in magnetic resonance imaging. The main cause of BMOS is still largely unknown. Its pathophysiology is presumably multifactorial and it has recently been demonstrated that it usually involves an increase in bone turnover and alterations within the bone microenvironment. Vitamin D plays a pivotal role in maintaining a healthy and well-balanced bone microenvironment. However, to date only limited information has been reported on vitamin D status in patients with BMOS. Moreover, it is still uncertain whether hypovitaminosis D is associated with the etiology and course of the disease. For this reason, the aim of this study was to determine serum vitamin D levels (25(OH)D) of patients diagnosed with BMOS of the foot and ankle. Methods: Patients were identified and laboratory results collected by retrospective review of the medical records between year 2011 and 2015. Diagnosis was based on clinical examination, the existence of prolonged foot pain, the presence of abnormal bone marrow signal intensity in T1- and T2-weighted magnetic resonance imaging, and the patient’s medical history. All patients who demonstrated other concomitant diagnoses were excluded from the study. Results: Overall, 31 patients were affected by BMOS with a mean age of 44.4 (range, 18-76) years. Notably, 84% of patients (26/31) had low vitamin D levels with a mean 25(OH)D level of 19.03 ng/mL. Specifically, 61% of patients (19/31) were vitamin D deficient, 23% (7/31) vitamin D insufficient, and only 5 patients (16%) had sufficient vitamin D levels. Statistical analysis showed no significant difference comparing vitamin D levels with patient age, sex, and time of diagnosis. Moreover, there was no correlation between vitamin D status and the number of bony foci or location of BMOS. Conclusion: We found a widespread rate of vitamin D deficiency in patients presenting with BMOS of the foot and ankle. Comparing these data to the vitamin D status of the general population in Germany and to patients living in comparable latitudes, this raises the possibility that BMOS might be associated with low vitamin D status. Level of Evidence: Level IV, retrospective case series.
West Nile Virus Chorioretinitis With Foveal Involvement
Authors: Yau Gary L. , Chin Eric K. , Parke D. Wilkin , Bennett Steven R. , Almeida David R. P. 
Published: March 2017

Purpose: To describe the clinical course of foveal West Nile virus (WNV) chorioretinitis with longitudinal spectral domain optical coherence tomography (SD-OCT) imaging. Methods: Case report. Results: A 41-year-old man with diabetes mellitus presented with flashes and floaters of both eyes (OU) and decreased vision of the right eye (OD) 2 weeks after being discharged from a local hospital. He had been treated for WNV meningoencephalitis, and he recovered systemically with supportive therapy. Ophthalmic examination revealed WNV chorioretinitis bilaterally, with predominantly foveal involvement OD. His best-corrected visual acuity (BCVA) was 8/200 OD and 20/20 of the left eye (OS). Spectral domain optical coherence tomography revealed 2 distinct lesion types—the “classic” outer retinal lesion and an intraretinal lesion. Both lesions had associated disruption of the normal outer hyperreflective retinal layers on SD-OCT. Longitudinal SD-OCT over the ensuing 6 weeks revealed a gradual reconstitution of these layers, with BCVA concurrently improving to 20/40 OD. Conclusion: We describe the consecutive findings seen on SD-OCT of retinal lesions in WNV chorioretinitis. The tomographic natural history of these lesions involved reconstitution of OCT deficits, with corresponding improvement in functional visual status.
Pilot Educational Intervention and Feasibility Assessment of Breast Ultrasound in Rural South Africa
Authors: Dickerson Lindsay K. , Rositch Anne F. , Lucas Susan , Harvey Susan C. 
Published: March 2017

Purpose Breast cancer is the leading cause of cancer death in women worldwide, with high mortality in low- and middle-income countries because of a lack of detection, diagnosis, and treatment. With mammography unavailable, ultrasound offers an alternative for downstaging. The literature reports successful training in various domains, but a focus on the breast is novel. We assessed the feasibility (knowledge acquisition, perceived usefulness, and self-efficacy) of breast ultrasound training for nonphysician providers. Methods Training was implemented for 12 providers at Hlokomela Clinic in Hoedspruit, South Africa, over 3 weeks. Didactic presentations and example cases were followed by a presurvey and test (n = 12). All providers received hands-on training with nurses as models; five providers trained with patients. A post-test (n = 12) assessed knowledge acquisition and a postsurvey (n = 10) assessed perceived program usefulness and provider self-efficacy. Results The pre- to post-test averages improved by 68% in total and in four competencies (foundational knowledge, descriptive categories, benign v malignant, and lesion identification). On the postsurvey, providers expressed that ultrasound could significantly influence breast cancer detection (9.1 out of 10), treatment (7.9 out of 10), and survival (8.7 out of 10) in their community and endorsed moderate confidence in their scanning (6.3 out of 10) and interpreting abilities (5.6 out of 10). Conclusion Our research supports the feasibility of breast ultrasound training as part of a breast education program in low- and middle-income countries. Pre- and post-test results and observed proficiency indicate that training nonphysician providers is achievable; postsurvey responses indicate program acceptance, community-based ownership, and provider self-efficacy with ultrasound. Future work may show that breast ultrasound is viable for early detection where mammography is unavailable.
Assessment, treatment goals and interventions for oedema/lymphoedema in palliative care
Authors: Cobbe Sinead , Real Shirley , Slattery Sinead 
Published: March 2017

Background: Little is known about the treatment of oedema in palliative care patients. Aim: To outline the assessment, goals, and interventions for patients with oedema. Method: A 6-month chart review of a specialist physiotherapy-led oedema service was carried out. Results: Of the sample group (n=63), 28.6% of patients had lymphoedema, 15.9% had non-lymphatic oedema, 46% had mixed oedema and 9.8% had lymphorrhoea; 58 patients (92%) had cancer. The most common interventions were providing education (100%, n=63), using compression garments (58%, n=37), bandaging (51%, n=32), exercise (38%, n=24), lymphatic massage and kinesio-taping (35%, n=22 each). Treatment regime differed depending on the type of oedema present. Treatment goals were pragmatic: the most common were to maintain skin quality (54%, n=34), reduce limb volume (52%, n=32), and improve quality of life (48%, n=30). Conclusion: Palliative care oedema can be treated using manual methods, including compression and massage. Goals differ from other oedema populations. Research is hampered by lack of suitable measures to record skin changes and quality of life.
The association between nurses' coordination with physicians and clients' place of death
Authors: Naruse Takashi , Yamamoto Natsuki , Sugimoto Takshi , Fujisaki-Sakai Mahiro , Nagata Satoko 
Published: March 2017

Aim: Over 60% of Japanese people hope to die at home; hence, assisting clients in achieving this outcome is an important responsibility of home care providers. This study investigated the effects of nurses' relational coordination with physicians on clients' place of death in home visiting nursing (HVN) agencies. Method: Secondary analysis of a public survey conducted in 2015 by local governments in Kurume city, Fukuoka prefecture, Western Japan. Manager nurses from 17 HVN agencies provided data about themselves and their relational coordination with community physicians and 85 deceased clients. Results: Among 85 deceased clients, 52 (61.2%) had died at home. Four regression models showed significant positive effects of HVN nurse managers' relational coordination on clients' home death (the odds ratios (95% CI) were 2.488 (1.442–4.293), 2.111 (1.014–4.396), 2.562 (1.409–4.658) and 2.275 (1.079–4.796) in models 1–4, respectively. Conclusion: Measuring relational coordination among HVN nursing managers and physicians indicated readiness for home death among HVN clients in an agency or community.
Understanding bladder management on a palliative care unit: a grounded theory study
Authors: Gutmanis Iris , Hay Melissa , Shadd Joshua , Byrne Janette , McCallum Sarah , Bishop Kristen , Whitfield Patricia , Faulds Cathy 
Published: March 2017

Background: Research regarding factors associated with nursing-initiated changes to bladder management at end-of-life is sparse. Objectives: To explore the process of Palliative Care Unit (PCU) nurses' approach to bladder management changes. Methods: Nursing staff from one PCU in London, Canada were interviewed regarding bladder management care practices. A constructivist grounded theory was generated. Results: Four interconnected themes emerged: humanity (compassionate support of patients); journey (making the most of a finite timeline); health condition (illness, functional decline); and context (orders, policies, supplies). These overlapping themes must be considered in light of ongoing changes which prompt recycling through the framework. While bladder management necessitates shared decision-making and individualised care, nurses' phronetic experience may serve to detect the presence of change and the need to consider other alternatives. Conclusion: End-of-life bladder management requires nurses to continually reconsider the significance of humanity, journey, health condition and context in light of ongoing changes.
Investigating longitudinal pragmatic development of complaints made by Chinese EFL learners
Authors: Yuan Zhou-min , Zhang Runhan 
Published: March 2017

AbstractFew studies have investigated the development of L2 complaints. This paper reports on a longitudinal study of L2 complaints produced by Chinese university English learners based on their performance of a discourse completion task consisting of 18 complaint scenarios in terms of power (+P, =P, −P) and social distance (−D, =D, +D), supplemented by a delayed retrospective verbal report. Data were collected twice, over two academic years. The results indicate that students in these two ‘phases’ showed broadly similar patterns of sociopragmatic competence in terms of their ability to calibrate complaints to complainees’ (addressees’) position on power and social distance continua. However, as to internal modifications, learners in Phase 2 used significantly more lexical and syntactic downgraders than in Phase 1 at all levels of power and social distance except for syntactic downgraders at +D and =D; they only used significantly more lexical upgraders at −D. As for external modifications, the findings also showed significantly different patterns in the use of pre-moves at all levels and post-moves at all levels except at −P. Increase of English proficiency and a certain degree of explicit pragmatic instruction may have contributed to Chinese EFL learners’ pragmatic development. Implications for pragmatic instruction are also discussed.
Biotechnological applications of the red alga Furcellaria lumbricalis and its cultivation potential in the Baltic Sea
Authors: Kersen Priit , Paalme Tiina , Pajusalu Liina , Martin Georg 
Published: March 2017

AbstractThere is a growing need for diversification of seaweed aquaculture practices in Europe. In the Baltic Sea, very few seaweed species are utilised commercially, and only the kelp
miRNA analysis in pancreatic cancer: the Dartmouth experience
Authors: Abreu Francine B. de , Liu Xiaoying , Tsongalis Gregory J. 
Published: March 2017

Abstract:Pancreatic cancer is considered one of the most lethal cancers being the fourth leading cause of cancer deaths in adults in the United States because of the lack of early signs and symptoms and the lack of early detection. Pancreatic ductal adenocarcinoma (PDAC) is the most common histological type among pancreatic cancers, representing 80%–90% of all solid tumors of the pancreas. The majority of PDAC develops from three precursor lesions: pancreatic intraepithelial neoplasia, intraductual papillary mucinous neoplasm and mucinous cystic neoplasm. Although histologic tissue evaluation remains the gold standard for diagnosis, endoscopic ultrasound-guided fine needle aspiration has become the preferred modality for obtaining pathologic confirmation. At Dartmouth-Hitchcock Medical Center (DHMC),we have developed and validated a microRNA (miRNA) panel for patients with pancreatic diseases that can be used in association with the gold standard method for diagnosis. miRNAs have an important role in biological processes, such as apoptosis, metabolism, cell growth and differentiation. In cancer, miRNAs can be classified as either oncogenic or tumor suppressor according to their function in the carcinogenic process. In this study, we describe the expression of many miRNA in benign and malignant pancreatic tissues as well as their clinical significance. For this reason, miRNAs have been considered potential biomarkers of pancreatic diseases that could potentially contribute to an early diagnosis, predict disease progression, accurately monitor disease, contribute to better treatment strategies and reduce mortality by improving disease management.
Chemical effects of a mild torrefaction on the wood of eightEucalyptusspecies
Authors: Araújo Solange de Oliveira , Neiva Duarte M. , Gominho Jorge , Esteves Bruno , Pereira Helena 
Published: March 2017

AbstractThe torrefaction is a thermal pre-treatment to improve biomass quality for biofuel applications. In this study, the effects of a mild torrefaction (T) on eight eucalypt species (Eucalyptus botryoides, E. globulus, E. grandis, E. maculata, E. propinqua, E. rudis, E. salignaandE. viminalis) have been compared. Namely, the mass loss (ML), the equilibrium moisture content (EMC), density and chemical composition were determined and FTIR spectra were recorded of the initial and torrefied woods (TWs). The average ML was 11% and the heat-treated woods had an overall 10% density decrement. All the TW had 50% lower EMC compared to untreated wood samples (W). Elemental composition showed that carbon content increased from 48% to 53% and the oxygen/carbon ratio decreased from 0.80 to 0.65. The chemical changes induced by T included an increment of extractives, a 20% higher lignin content and a 16% lower holocellulose content in relation to W. The hemicelluloses modification is manifested by a decrease of xylose, galactose, and acetyl groups in TWs. The fourier transform infrared (FTIR) spectra of the different wood species were very similar, and reflected in a uniform manner the chemical changes upon T. Because of the similar reaction of the eucalypt species, they can also be used in form of mixed eucalypt feedstock as biofuel.
The combined effects of initial microfibrillar angle and moisture contents on the tensile mechanical properties and angle alteration of wood foils during tension
Authors: Wang Hankun , Yu Zixuan , Zhang Xuexia , Ren Dan , Yu Yan 
Published: March 2017

Abstract
The combined effects of initial microfibril angle (MFA) and moisture content (MC) on the longitudinal tensile properties of Masson pine (Pinus massoniana Lamb.) wood foils has been investigated. Synchrotron X-ray diffraction (XRDsyn) combined with a custom-built microtensile device was applied for in situ monitoring of the MFA alterations in the foils under different initial MFAs and MCs conditions. The results demonstrate that the tensile properties are highly negatively correlated to both MFA and MC. Furthermore, the tensile modulus is more sensitive to MC change than tensile strength. At a higher MFA, the sensitivity of the two mechanical indicators to MC alteration is enhanced.