bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is the Modern Arctic Marginal Ice Zone More Susceptible to Summer Cyclones?
Authors: Mundi Claire , L’Ecuyer Tristan 
Published: October 2024

Abstract
As Arctic sea ice melts, cyclones potentially enhance the mechanical and thermodynamic forces that influence the vulnerable ice edge. However, examples can be found in satellite observations and reanalyses where cyclones either locally increase or decrease ice within the marginal ice zone (MIZ). Two case studies with these opposing ice responses are presented. Guided by the tendencies during these events, 264 strong (minimum surface pressure below 984 hPa) summer cyclones were sorted by prevailing wind direction and sea surface temperature (SST) changes within the MIZ to quantify the net ice impacts in the present-day Arctic (2010–19) and early satellite era (1982–91). By tracking the MIZ ice area from 1 week before the cyclone’s formation through 2 weeks after, we find cyclones that enhance southerly winds mostly decrease the ice area, whereas enhanced northerlies generally increase the ice area within the MIZ later in the season. Furthermore, early summer storms tend to decrease the MIZ ice area more than late summer storms. A shift toward more frequent early summer storms is observed from the 1980s to the 2010s, resulting in almost two-thirds of recent storms decreasing area. Consequently, recent summer cyclones have more negative impacts, resulting in a decline of more than 40 000 km2 of MIZ ice area on average, whereas 1980s cyclones had little aggregate impact. Wind direction and SST trends partially reconcile the wide range of MIZ ice area changes due to cyclone passage, yet considerable variations in individual cyclones’ impacts remain even when controlling for these factors. These bulk diagnostics therefore only explain part of the complex ice–cyclone relationship.

Significance Statement
The purpose of this study is to better understand how intense summer storms in the Arctic impact the underlying, low-concentration sea ice around the ice edge (where the ice is most vulnerable to external changes). Both enhanced decreases and increases in ice area within this region over the lifetime of a storm were observed, with late summer impacts dominated by differences in mean wind direction over the sea ice. Overall, storms earlier in the summer season were found to decrease ice area more than storms later in the season. We also found a shift in the distribution of storms to earlier in the summer when comparing the 1980s–2010s, causing more negative effects from cyclones overall in recent years.
Impacts of an Upper-Tropospheric Cold Low on Tropical Cyclone Intensity
Authors: Li Han , Ge Xuyang , Peng Melinda , Wang Zhuo 
Published: October 2024

Abstract
Following a previous study examining the influence of an upper-tropospheric cold low (CL) on the track of a nearby tropical cyclone (TC), this study investigates the impacts of a CL on TC intensity. The results suggest that the relative position and separation distance between the CL and the TC are the key factors affecting TC intensity. When located outside the CL’s radius of maximum winds (RMW) but within its circulation, TCs initially in the northwest quadrant of the CL intensify faster than those in the other quadrants. The β effect causes the CL to move northwestward toward the TC and enhances eddy angular momentum flux convergence. Meanwhile, the upper-level TC outflow erodes the CL and reduces the associated vertical wind shear, promoting TC intensification. In contrast, for TCs initially located southeast of the CL, the attraction of the Fujiwhara effect between the two entities counteracts the CL’s β drift and helps to maintain their separation distance. Moreover, Rossby wave energy dispersion induces an anticyclone southeast of the CL, which transports lower-θe air toward the TC and hinders the TC development. Furthermore, TCs within the CL’s RMW reach a similar intensity due to their PV superposition, irrespective of their relative positions to the CL. For TCs located outside the CL circulation, the CL’s impacts are largely negligible for TCs located northwest of the CL, but TCs located southeast of the CL may still be affected by the CL-induced anticyclone.

Significance Statement
This study examines the influence of an upper-tropospheric cold low on tropical cyclone intensity. The results illustrate that the relative position and separation distance between the cold low and tropical cyclone are crucial factors in determining tropical cyclone intensity. Tropical cyclones initially northwest of a cold low intensify faster than those to the southeast when located outside the cold low’s radius of maximum winds but still within its circulation. The main mechanisms are how the β steering and interactions between the two entities act together. The midlevel intrusion of cold, dry air and Rossby energy dispersion also contribute to their complex interaction. These insights provide a guide for forecasting the tropical cyclone intensity when influenced by a nearby upper-level cold low.
Interventions for the promotion of the ethical environment among health professionals: Scoping review
Authors: Carpes Lanes Taís , de Lima Dalmolin Graziele , Villagran Camila Antunez , Azevedo Wagner Benetti Sabrina , Ramos Flávia Regina Souza 
Published: October 2024

Background Education is a tool for the promotion of ethical skills that ensure the principles of conduct and the quality of care provided. The literature is still incipient in this theme; however, some studies point to education and ethical consultations as strategies to promote an ethical environment. Objective To map the interventions that aim to prospect the ethical environment in health services. Method Scoping review to answer the question “What interventions are being used by health professionals to prospect an ethical environment in health services?” It occurred in the Medline (PubMed), CINAHL with Full Text (EBSCO), Scopus, Embase (Elsevier), and Web of Science databases in January 2023 by two reviewers, via the Rayyan platform. Articles with health professionals addressing interventions to prospect the ethical environment in any health service were included, without time frame. A form was used for data extraction and analysis occurred via Bardin content analysis. The review protocol was registered in the Open Science Framework. Results 2429 records were found; however, only 12 articles were included for analysis, these being randomized, cross-sectional, descriptive, and qualitative studies. Among the interventions, it was noticed that 58.3% ( n = 7) is about ethical education, 16.7% ( n = 2) about ethical guidelines and codes, 16.7% ( n = 2) about ethical reflection and leadership, and 8.3% ( n = 1) of ethical consultations. A theoretical map was elaborated, and four types of interventions were identified, based on ethical consultation, ethical education, guidelines and codes of ethics, reflection, and ethical leadership. Conclusions The interventions were considered effective to prospect the ethical environment in health services, and their effectiveness was evaluated by validated instruments, as well as through interviews and focus groups.
A Nomogram for Predicting Cancer-Associated Venous Thromboembolism in Hospitalized Patients Receiving Chemoradiotherapy for Cancer
Authors: Sisi Yan , Genpeng Li , Yao Chen , Suting Song , Rongying Tang , Jiayi Du , Zhaoli Zhang , Chunyu Wang 
Published: October 2024

Purpose The aim of this study was to develop a novel nomogram to predict cancer-associated venous thromboembolism (CAT) in hospitalized patients with cancer who receive chemoradiotherapy. Methods This was a retrospective cohort study of hospitalized patients with cancer who received chemoradiotherapy between January 2010 and December 2022. Predictive factors for CAT were determined using univariate and multivariate logistic regression analyses, and a risk prediction model based on the nomogram was constructed and validated internally. Nomogram performance was assessed using receiver operating characteristic (ROC), calibration curve, and decision curve analysis (DCA). Results A total of 778 patients were eligible for inclusion in this study. The nomogram incorporated 5 independent risk factors: age, cancer stage, use of nonsteroidal anti-inflammatory drugs, D-dimer levels, and history of diabetes mellitus. The area under the curve (AUC) of the nomogram for the training and validation cohorts was 0.816 and 0.781, respectively, with 95% confidence intervals (CIs) of 0.770-0.861 and 0.703-0.860, respectively. The calibration and DCA curves also displayed good agreement and clinical applicability of the nomogram model. Conclusions The incidence of CAT was relatively high among patients with cancer receiving chemoradiotherapy. The nomogram risk model developed in this study has good prediction efficiency and can provide a reference for the clinical evaluation of the risk of adverse outcomes in patients with cancer receiving chemoradiotherapy.
Conversational topic maintenance and related cognitive abilities in autistic versus neurotypical children
Authors: Abbot-Smith Kirsten , Matthews Danielle , Bannard Colin , Nice Joshua , Malkin Louise , Williams David , Hobson William 
Published: October 2024

Keeping a conversation going is the social glue of friendships. The DSM criteria for autism list difficulties with back-and-forth conversation but does not necessitate that all autistic children will be equally impacted. We carried out three studies (two pre-registered) with verbally fluent school children (age 5–9 years) to investigate how autistic and neurotypical children maintain a conversation topic. We also investigated within-group relationships between conversational ability and cognitive and sociocognitive predictors. Study 1 found autistic children were more likely than neurotypical controls to give off-topic and generic minimal responses (e.g. ‘mm’, ‘oh’) and were less likely to give non-verbal responses (e.g. nodding or use of facial affect to respond). Nonetheless, the autistic group provided topic-supporting responses 62% of the time, indicating some aspects of conversation topic maintenance are a relative strength. Studies 2 and 3 found large individual differences in topic-supporting conversational responding among both neurotypical and autistic children. These were positively related to theory of mind ability and age in both groups. Conversational skills lie on a continuum for the general population and differences by diagnostic group are a matter of degree. Given the importance for peer relationships, we suggest a whole classroom approach to supporting conversation skills in all children. Lay abstract Children who struggle to maintain conversation with peers often have fewer friends and lower popularity ratings, which can affect wellbeing. Verbal social communication more broadly is linked to both behavioural difficulties and emotional problems. We carried out three studies to examine children’s ability to provide responses which keep a back and forth conversation going. The first study found that while autistic children had on average greater difficulties than their neurotypical peers with certain aspects of conversation topic maintenance, for other aspects the autistic group showed considerable strengths. Both studies 2 (neurotypical children) and 3 (autistic children) found relationships between, on the one hand, conversational ability, and on the other, the ability to consider another’s viewpoint and the ability to maintain and update information in short term memory. We suggest support for social conversation skills should be part of mainstream classroom curricula for autistic and neurotypical children alike.
Mobile chat messaging for preventing relapse among people who recently quit smoking: Study protocol for a randomized controlled trial
Authors: Su Xiaoyu , Wong Vanessa , Cheung Yee Tak Derek , Chan Helen Ching-han , Wong Grace Nga-ting , Lee John Ka Hong , Ho Sai Yin , Wang Man Ping , Luk Tzu Tsun 
Published: October 2024

Objective Most smokers who achieve short-term abstinence relapse even when aided by evidence-based cessation treatment. Mobile health presents a promising but largely untested avenue for providing adjunct behavioral support for relapse prevention. This paper presents the rationale and design of a randomized controlled trial aimed at evaluating the effectiveness of personalized mobile chat messaging support for relapse prevention among people who recently quit smoking. Methods This is a two-arm, assessor-blinded, randomized controlled trial conducted in two clinic-based smoking cessation services in Hong Kong. An estimated 586 daily tobacco users who have abstained for 3 to 30 days will be randomized (1:1) to intervention group or control group. Both groups receive standard-of-care smoking cessation treatment from the services. The intervention group additionally receives 3-month relapse prevention support via mobile chat messaging, including cessation advice delivered by a live counselor and access to a supportive chatbot via WhatsApp. The control group receives text messaging on generic cessation advice for 3 months as attention control. The primary outcome is tobacco abstinence verified by an exhaled carbon monoxide of <5 parts per million or a negative salivary cotinine test at 6 months after randomization. Secondary outcomes include self-reported 6-month prolonged tobacco abstinence, 7-day point-prevalent abstinence, and relapse rate. The primary analyses will be by intention-to-treat, assuming participants with missing data are non-abstinent. This trial is registered with ClinicalTrials.gov (NCT05370352) and follows CONSORT-EHEALTH. Conclusion This trial will provide new evidence on the effectiveness of mobile chat messaging as a scalable and accessible intervention for relapse prevention.
Clinical Frailty Scale score is a predictor of short-, mid- and long-term mortality in critically ill older adults (≥ 70 years) admitted to the emergency department: an observational study
Authors: Javadzadeh Dariush , Karlson Björn W , Alfredsson Joakim , Ekerstad Elin , Hellberg Jenny , Herlitz Johan , Ekerstad Niklas 
Published: October 2024

Abstract
Background
The estimated prognos of a patient might influence the expected benefit/risk ratio of different interventions. The main purpose of this study was to investigate the Clinical Frailty Scale (CFS) score as an independent predictor of short-, mid- and long-term mortality in critically ill older adults (aged ≥ 70) admitted to the emergency department (ED).

Methods
This is a retrospective, single-center, observational study, involving critically ill older adults, recruited consecutively in an ED. All patients were followed for 6.5–7.5 years. The effect of CFS score on mortality was adjusted for the following confounders: age, sex, Charlson’s Comorbidity Index, individual comorbidities and vital parameters. All patients (n = 402) were included in the short- and mid-term analyses, while patients discharged alive (n = 302) were included in the long-term analysis. Short-term mortality was analysed with logistic regression, mid- and long-term mortality with log rank test and Cox proportional hazard models. The CFS was treated as a continuous variable in the primary analyses, and as a categorical variable in completing analyses.

Results
There was a significant association between mortality at 30 days after ED admission and CFS score, adjusted OR (95% CI) 2.07 (1.64–2.62), p < 0.0001. There was a significant association between mortality at one year after ED admission and CFS score, adjusted HR (95% CI) 1.75 (1.53–2.01), p < 0.0001. There was a significant association between mortality 6.5–7.5 years after discharge and CFS score, adjusted HR (95% CI) 1.66 (1.46–1.89), p < 0.0001. Adjusted HRs are also reported for long-term mortality, when the CFS was treated as a categorical variable: CFS-score 5 versus 1–4: HR (95% CI) 1.98 (1.27–3.08); 6 versus 1–4: HR (95% CI) 3.60 (2.39–5.44); 7 versus 1–4: HR (95% CI) 3.95 (2.38–6.55); 8–9 versus 1–4: HR (95% CI) 20.08 (9.30–43.38). The completing analyses for short- and mid-term mortality indicated a similar risk-predictive value of the CFS.

Conclusions
Clinical frailty scale score was independently associated with all-cause short-, mid- and long-term mortality. A nearly doubled risk of death was observed in frail patients. This information is clinically relevant, since individualised treatment and care planning for older adults should consider risk of death in different time perspectives.
Left hand abscess as a paradoxical reaction during treatment of disseminated tuberculosis in immunocompetent patient: case report and review of literature
Authors: Alharbi Aisha , Aljahdali Aseel , Ahamed Mohamed Firoze , Almarhabi Hassan 
Published: October 2024

AbstractA paradoxical reaction (PR) during the treatment of tuberculosis was defined as the worsening of preexisting disease either clinically or radiologically or the appearance of a new tuberculous lesion. These reactions are frequently observed in patients coinfected with human immunodeficiency virus (HIV) upon the initiation of antiretroviral therapy (ART). Herein, we present a unique case of a paradoxical reaction in a previously healthy 19-year-old female who started anti-tuberculosis treatment for disseminated tuberculosis. Four weeks after treatment initiation, she developed two new swollen masses in her left dorsum of the hand, accompanied by fever and new right submandibular painful lymphadenopathy, with worsening of the preexisting left lower neck lymph node. The patient underwent needle aspiration from her new skin abscess on the dorsum of her left hand, which revealed positive polymerase chain reaction (PCR) for Mycobacterium tuberculosis. Anti-tuberculosis treatment was continued, and the patient fully recovered. We described an unusual presentation of paradoxical reaction manifested by a skin abscess at a site distant from her primary disease in an immunocompetent TB patient, which demonstrated the importance of considering paradoxical reactions in HIV-negative patients who present with worsening signs and symptoms after initial improvement following treatment initiation.
Receipt of social services intervention in childhood, educational attainment and emergency hospital admissions: longitudinal analyses of national administrative health, social care, and education data in Wales, UK
Authors: Lowthian Emily , Moore Graham , Evans Annette , Anthony Rebecca , Rahman Muhammad Azizur , Daniel Rhian , Brophy Sinead , Scourfield Jonathan , Taylor Chris , Paranjothy Shantini , Long Sara 
Published: October 2024

Abstract
Background
Research consistently finds poorer health and educational outcomes for children who have experienced out-of-home care relative to the general population. Few studies have explored differences between those in care and those in receipt of intervention from social services but not in care. Children receiving social services interventions often experience Adverse Childhood Experiences (ACEs), and deprivation, which are known to negatively impact outcomes. We aimed to estimate the association of different social services interventions with educational outcomes and hospital admissions, while adjusting for ACEs and deprivation.

Methods
We linked retrospective, routinely collected administrative records from health, education, and social care to create a cohort via the Secure Anonymised Information Linkage (SAIL) databank in Wales, UK. We analysed data for children and household members (N = 30,439) across four different groups: (1) no social care intervention; (2) children in need but not in care (CIN); (3) children on the Child Protection Register but not in care (CPR); (4) children in care - i.e. removed from the family home and looked after by the local authority (CLA). Our primary outcome was education outcomes at age 16 years. Secondary outcomes were all cause emergency hospital admissions, and emergency admissions for external causes/injuries.

Results
Children in receipt of social services intervention were more likely to not attain the expected level upon leaving statutory education at age 16 after adjusting for ACEs and other characteristics (for children who had been in out-of-home care (conditional OR: 1·76, (95%CI) 1·25 − 2·48), in need (2·51, 2·00–3·15) and those at risk (i.e., on the child protection register) (4·04, 2·44 − 6·68). For all-cause emergency admissions, all social care groups were at greater risk compared to children in the general population (children in care (conditional HR: 1·31, 1·01–1·68), children in need (1·62, 1·38 − 1·90), and children at risk (1·51, 1·11 − 2·04).

Conclusions
All groups receiving social service intervention experience poorer educational and health outcomes than peers in the general population. Children who remain with their home parents or caregivers but are identified as ‘in need’ or ‘at risk’ by social care practitioners require further research. Integrated support is needed from multiple sectors, including health, educational and social care.
Tongue microbiota in relation to the breathing preference in children undergoing orthodontic treatment
Authors: Marincak Vrankova Zuzana , Brenerova Petra , Bodokyova Lenka , Bohm Jan , Ruzicka Filip , Borilova Linhartova Petra 
Published: October 2024

Abstract
Background
Mouth breathing (MB), a risk factor of oral dysbiosis and halitosis, is linked with craniofacial anomalies and pediatric obstructive sleep apnea. Here, we aimed to analyze tongue microbiota in children from the perspective of their breathing pattern before/during orthodontic treatment.

Methods
This prospective case–control study included 30 children with orthodontic anomalies, 15 with MB and 15 with nasal breathing (NB), matched by age, sex, and body mass index. All underwent orthodontic examination and sleep apnea monitoring. Tongue swabs were collected before starting (timepoint M0) and approx. six months into the orthodontic therapy (timepoint M6). Oral candidas and bacteriome were analyzed using mass spectrometry technique and 16S rRNA sequencing, respectively.

Results
MB was associated with higher apnea–hypopnea index. At M0, oral candidas were equally present in both groups. At M6, Candida sp. were found in six children with MB but in none with NB. No significant differences in bacterial diversity were observed between groups and timepoints. However, presence/relative abundance of genus Solobacterium was higher in children with MB than NB at M0.

Conclusions
Significant links between MB and the presence of genus Solobacterium (M0) as well as Candida sp. (M6) were found in children with orthodontic anomalies, highlighting the risk of halitosis in them.