bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnosing Flavors of Tropospheric Rossby Wave Breaking and Their Associated Dynamical and Sensible Weather Features
Authors: LaChat Grant , Bowley Kevin A. , Gervais Melissa 
Published: December 2023

Abstract
Rossby wave breaking (RWB) can be manifested by the irreversible overturning of isentropes on constant potential vorticity (PV) surfaces. Traditionally, the type of breaking is categorized as anticyclonic (AWB) or cyclonic (CWB) and can be identified using the orientation of streamers of high potential temperature (θ) and low θ air on a PV surface. However, an examination of the differences in RWB structure and their associated tropospheric impacts within these types remains unexplored. In this study, AWB and CWB are identified from overturning isentropes on the dynamic tropopause (DT), defined as the 2 potential vorticity unit (PVU; 1 PVU = 10−6 K kg−1 m2 s−1) surface, in the ERA5 dataset during December, January, and February 1979–2019. Self-organizing maps (SOM), a machine learning method, is used to cluster the identified RWB events into archetypal patterns, or “flavors,” for each type. AWB and CWB flavors capture variations in the θ minima/maxima of each streamer and the localized meridional θ gradient (∇θ) flanking the streamers. Variations in the magnitude and position of ∇θ between flavors correspond to a diversity of jet structures leading to differences in vertical motion patterns and troposphere-deep circulations. A subset of flavors of AWB (CWB) events are associated with the development of strong surface high (low) pressure systems and the generation of extreme poleward moisture transport. For CWB, many events occurred in similar geographical regions, but the precipitation and moisture patterns were vastly different between flavors. Our findings suggest that the location, type, and severity of the tropospheric impacts from RWB are strongly dictated by RWB flavor.

Significance Statement
Large-scale atmospheric waves ∼15 km above Earth’s surface are responsible for the daily weather patterns that we experience. These waves can undergo wave breaking, a process that is analogous to ocean waves breaking along the seashore. Wave breaking events have been linked to extreme weather impacts at the surface including cold and heat waves, strong low pressure systems, and extreme precipitation events. Machine learning is used to identify and analyze different flavors, or patterns, of wave breaking events that result in differing surface weather impacts. Some flavors are able to generate notable channels of moisture that result in extreme high precipitation events. This is a crucial insight as forecasting of extreme weather events could be improved from this work.
A rapid, sensitive method for clinical monitoring of ketamine and norketamine by ultra-high-performance reverse-phase liquid chromatography tandem mass spectrometry
Authors: Armfield Nicholas , Frank Bernhard , Chadwick Carrie 
Published: December 2023

Background Ketamine is an NMDAR antagonist with aggregating use across many areas of medicine. P450 enzymes heavily metabolise ketamine, where norketamine is a first pass formed metabolite following initial N-demethylation. Serum ketamine monitoring is becoming increasingly important, requiring a sensitive method with a robust lower limit of quantitation. Methods Samples were prepared using protein precipitation or solid phase extraction. Ion suppression was investigated to optimise sample preparation technique, followed by reverse-phase chromatography coupled with tandem mass spectrometry to analyse extractions using a Waters Xevo TQ-S Micro and associated Acquity chromatography systems. Performance characteristics were analysed to validate the assay. Results Ketamine and norketamine retention times were 1.28 and 1.23 min, respectively. Ketamine and norketamine precursor ions fragmented into 2 distinguishable product ions (238.14 > 207.18/125.06 and 224.1 > 178.96/124.86). Performance characteristics include an assay recovery of 103.7% (ketamine) and 96.3% (norketamine), lower limit of quantitation 36.2 µg/L (ketamine) and 38.9 µg/L (norketamine), and intra-assay imprecision ≤ 7.04% on average. Conclusions A robust and reproducible assay with limited sample preparation has been designed and validated. The linearity of the assay covers all ranges of interest reported in the literature. Ion suppression was clearly reduced via use of solid phase extraction. The method will form the basis of ketamine monitoring and providing valuable patient information on tolerance and metabolism.
Development of a plasma maltose assay method as a screening test for upper gastrointestinal disorders
Authors: Komene Tetsuya , Kai Kotoko , Kinpara Kiyoko , Sato Tomoaki , Hokazono Eisaku , Shimosawa Tatsuo , Osawa Susumu , Seimiya Masanori 
Published: December 2023

Background and objective The disaccharide loading test is a method to assess gastric mucosal damage. Since Trelan-G75, which is used for the sugar tolerance test, contains disaccharide maltose, if maltose is detected at a high sensitivity in the sample blood used in the sugar tolerance test, screening for upper gastrointestinal mucosal damage can be made simultaneously with the sugar tolerance test for the diagnosis of diabetes. Methods Glucose-6-phosphate is generated by treating maltose with maltose phosphorylase, β-phosphoglucomutase, and glucose-1,6-bisphosphate. Then, change in the absorbance at 405 nm is measured by the enzymatic cycling method using Thio-NADP, β-NADPH, and Glucose-6-phosphate dehydrogenase. After evaluating the optimal condition for this method, it is mounted on an automatic biochemical analyzer, and samples after the sugar tolerance test were assayed. Results Regarding the performance of this method, the repeatability was 10–50 μmol/L with a CV of ≤1.1%. Concerning the assay range, a curve passing the origin with a range of linearity up to 120 μmol/L was obtained. No effect of dyes or sugars in the blood was noted. As a result of application to patients with gastric mucosal disorders (those who had a health checkup), significant differences were observed depending on the stage of atrophic gastritis. Discussion This method has a high sensitivity and a high precision and can be used for high-speed analysis on an automatic analyzer. It has the potential to be used as a screening test for gastric mucosal damage.
Disparities in Rates of Death From HIV or Tuberculosis Before Age 65 Years, by Race, Ethnicity, and Sex, United States, 2011-2020
Authors: Adekoya Nelson , Chang Man-Huei , Wortham Jonathan , Truman Benedict I. 
Published: December 2023

Objective: Death from tuberculosis or HIV among people from racial and ethnic minority groups who are aged <65 years is a public health concern. We describe age-adjusted, absolute, and relative death rates from HIV or tuberculosis from 2011 through 2020 by sex, race, and ethnicity among US residents. Methods: We used mortality data from the Centers for Disease Control and Prevention online data system on deaths from multiple causes from 2011 through 2020 to calculate age-adjusted death rates and absolute and relative disparities in rates of death by sex, race, and ethnicity. We calculated corresponding 95% CIs for all rates and determined significance at P < .05 by using z tests. Results: For tuberculosis, when compared with non-Hispanic White residents, non-Hispanic American Indian or Alaska Native residents had the highest level of disparity in rate of death (666.7%). Similarly, as compared with non-Hispanic White female residents, American Indian or Alaska Native female residents had a high relative disparity in death from tuberculosis (620.0%). For HIV, the age-adjusted death rate was more than 8 times higher among non-Hispanic Black residents than among non-Hispanic White residents, and the relative disparity was 735.1%. When compared with non-Hispanic White female residents, Black female residents had a high relative disparity in death from HIV (1529.2%). Conclusion: Large disparities in rates of death from tuberculosis or HIV among US residents aged <65 years based on sex, race, and ethnicity indicate an ongoing unmet need for effective interventions. Intervention strategies are needed to address disparities in rates of death and infection among racial and ethnic minority populations.
Investigation of the fire hazard of underground space fire scenarios in urban metro tunnels under natural ventilation: Analysis of the impact of tunnel slope on smoke back-layering length
Authors: Su Zhihe , Li Yanfeng , Zhong Hua , Li Junmei , Yang Shi , Du Tianmei , Huang Youbo 
Published: December 2023

The smoke back-layering length is a crucial parameter for evacuating people in both road and subway tunnel fires. This study investigates the fire hazard induced by carriage fire in inclined metro tunnels under natural ventilation. The parameter ‘transition slope’ is defined to measure the smoke flow from the carriage head in the upstream direction to the tunnel or not due to the stack effect of the tunnel slope. The aim of this paper is to analyse the effects of changes in cross-section, downstream length, tunnel slope, and carriage side-door coupling on smoke behaviour characteristics by experiment and simulation methods. A piecewise function expression between dimensionless smoke back-layering length, downstream length, and tunnel slope for carriage fires in an inclined tunnel under natural ventilation is proposed by theoretical analysis. At the same time, a 1:15 scale model experiment was conducted to initially analyse the characteristics of smoke movement. Following this, full-scale numerical simulations were employed to complement the model experiment and quantify the principles governing smoke movement. The experimental results show that the tunnel slope has a significant effect on the smoke back-layering length. In contrast, the influence of the heat release rate was found to be relatively minor. In addition, simulation results show that the tunnel slope has no significant effect on the smoke back-layering length when the fire location is approximately 20 m from the train head, and the tunnel slope is in the range of 2.29° ∼ 3.43° (4% ∼ 6%). For small tunnel slopes, smoke spreads in the tunnel, and the smoke back-layering length produced by the virtual fire source shows a different law from the previous study model. Finally, the correlation coefficient of the piecewise function in theoretical analysis is fitted by combining the experimental and numerical simulation results. Practical application This study provides valuable insights into the practical implications of controlling and mitigating the impact of fires in inclined metro tunnels. By understanding the critical role of tunnel slope and providing a quantitative tool for smoke spread law assessment, this study contributes to the enhancement of safety measures and the protection of lives in tunnel environments during fire incidents.
Does early exposure to cardiothoracic surgery increase interest in the specialty?
Authors: Punjabi Karan , Almohtadi Ahmad , Singh Ayushi , Singh Ishan , Salha Ahmad , Seyedzenouzi Golnoush 
Published: December 2023

Introduction The number of applications for cardiothoracic surgery has been steadily dropping over the past decades. We aim to assess whether a 1-day cardiothoracic surgical skills conference could increase interest into the speciality. Methods Participants included in the study had to be medical students or junior doctors. Out of 57 delegates that attended the conference, 52 were enrolled in the study, and completed the pre-conference and post-conference questionnaires. Three introductory lectures were delivered by consultants in cardiothoracic surgery or cardiology in the morning, followed by three practical surgical workshops. We assessed demographics, confidence in and knowledge of procedures, and the change in participants’ interest in the speciality pre- and post-conference. This study was conducted at St George’s University of London. Results The interest to pursue a career in cardiothoracic surgery increased by 23% post-conference ( p = .035). Confidence and knowledge in all procedures taught improved significantly after the conference ( p < .05), with the highest increase seen in anastomosis of vessels ( p < .0001). Preclinical students made up 57.7% of participants, majority of whom had not seen more than three surgical procedures. Conclusion Our conference has shown to increase interest in cardiothoracic surgery and improve exposure to surgical skills, especially to those in early years of medical school. The surgical workshops improved student confidence and knowledge in procedures used within the field and the use of animal tissue improved participant experience. Further research is needed at other medical schools to assess whether a change in surgical skills teaching should be made to medical school curriculums.
Could emergency admission plasma D-dimer level predict first pass effect of stent retriever thrombectomy in acute ischemic stroke?
Authors: Xie Ting , Tang Wen-wei 
Published: December 2023

BackgroundEvidence on plasma biomarkers to identify first pass effect (FPE) in patients with acute ischemic stroke (AIS) with large vessel occlusion (LVO) treated with thrombectomy is limited.PurposeTo evaluate whether plasma D-dimer could predict FPE.Material and MethodsConsecutive patients with LVO who underwent first-line stent retriever thrombectomy at our center between January 2018 and August 2021 were enrolled. Patients were classified into the FPE (modified Thrombolysis in Cerebral Infarction [mTICI] ≥2c) group or non-FPE (mTICI 0–2b) group based on angiographic outcomes. Logistic regression analysis was performed to determine the predictors of FPE. The overall ability of D-dimer levels in predicting FPE was evaluated using receiver operating characteristic (ROC) curves.ResultsIn total, 313 patients were included; 88 (28.1%) patients achieved FPE. Compared to those with non-FPE, patients with FPE had more diabetes mellitus history, lower D-dimer levels, higher clot burden score, a higher proportion of M1 middle cerebral artery, and a higher proportion of main stem occlusion pattern ( P <0.05). After adjusting for potential variables, D-dimer levels (OR=0.81, 95% CI=0.52–0.96), clot burden score (OR=1.76, 95% CI=1.38–2.87), and main stem occlusion pattern (OR=1.85, 95% CI=1.19–2.62) remained independently associated with FPE. Based on the ROC analysis, the D-dimer as a predictor for predicting FPE presented with a specificity of 79%, a negative predictive value of 87%, and an area under the curve of 0.761.ConclusionLow emergency admission plasma D-dimer level is an independent predictor of FPE in patients with AIS treated with stent retriever thrombectomy.
Adjuvant treatment in hormone receptor-positive early breast cancer: New approaches of endocrine therapy
Authors: Nardin Simone , Ruelle Tommaso , Giannubilo Irene , Del Mastro Lucia 
Published: December 2023

Breast cancer is the most common cancer in women, and luminal breast cancer is the predominant subtype, characterized by the presence of estrogen receptors and/or progesterone receptors in tumor cells. Adjuvant endocrine therapy is the pivotal approach in the management of luminal early breast cancer. Hence, new therapeutic approaches have been studied during the last few years, especially in patients with high risk of recurrence. Here we provide a summary of the most recent clinical trials evaluating adjuvant treatment in hormone-receptors-positive early breast cancer. First, the main cornerstone is related to the role of extended endocrine treatment, which has been widely investigated to access a benefit in disease-free survival and overall survival (only the GIM4 trial has positive feedback about survival) and to tailor the treatment according to patient compliance. The results highlighted an advantage in extending the use of endocrine treatment for at least seven full years, considering aromatase inhibitors as principal drugs. Second, the shift of CDK4/6 inhibitors (CDK4/6i) from advanced to early setting reported positive outcomes, with favorable results from MonarchE and NATALEE trials, using Abemaciclib and Ribociclib respectively, even if non-negligible toxicities have been reported. Last, the use of PARP inhibitors for BRCA1/2 mutated patients has been evaluated in the OlympiA trial (Olaparib), observing a comparable benefit between hormone-receptors-positive and triple-negative early breast cancer. However, more data are still required to better select patients that could benefit more from CDK4/6i considering side effects too, and sequential treatments are still not codified.
Targeted poverty alleviation and corporate financial performance: The CSR strategy perspective
Authors: He Chang , Zhang Junzhi , Wang Liukai , Wang Weiqing , Li Fei 
Published: December 2023

As an emerging way for firms to fulfil social responsibility in China, targeted poverty alleviation (TPA) helps the Chinese government to achieve its sustainable development goals. Although the effect of TPA on poor areas has been deeply explored, the influence of firms’ participation in TPA on themselves and its mechanism is unclear. We analyse the performance of listed firms which engaged in TPA from 2016 to 2021 by adopting a causal steps approach model, which indicate that firm engagement in TPA has a significant positive effect on corporate finance performance (CFP), and the mediating effect of financing constraints and media attention is verified. Our findings contribute to corporate social responsibility (CSR) practices from the new strategy perspective of TPA. JEL Classification: G18, M14, M41
Microstructural differences in migraine: A diffusion-tensor imaging study
Authors: Dobos Dóra , Kökönyei Gyöngyi , Gyebnár Gyula , Szabó Edina , Kocsel Natália , Galambos Attila , Gecse Kinga , Baksa Dániel , Kozák Lajos R. , Juhász Gabriella 
Published: December 2023

Background Diffusion-tensor imaging can be applied to describe the microstructural integrity of the whole brain. As findings about microstructural alterations in migraine are inconsistent, we aimed to replicate the most frequent results and assess a relationship between migraine parameters and changes in microstructure. Methods Diffusion-weighted MRI data of 37 migraine patients and 40 controls were collected. Two indices of diffusion of water molecules, fractional anisotropy and mean diffusivity were used in a voxel-wise analysis. Group comparisons were carried out in SPM12 using age and sex as covariates. Statistically significant results survived family-wise error correction (pFWE < 0.05). Migraine intensity, frequency, and duration were self-reported and correlated with mean fractional anisotropy and mean diffusivity values across clusters. Results Migraine patients showed significantly lower fractional anisotropy in occipital regions, and significantly higher fractional anisotropy in thirteen clusters across the brain. Mean diffusivity of migraine patients was significantly decreased in the cerebellum and pons, but it was not increased in any area. Correlation between migraine duration and fractional anisotropy was significantly positive in the frontal cortex and significantly negative in the superior parietal lobule. Conclusion We suggest that microstructural integrity of the migraine brain is impaired in visual areas and shows duration-related alterations in regions of the default mode network.
Non-pharmacological rehabilitation interventions for individuals with antiphospholipid syndrome: A scoping review
Authors: Harper Alexandra E , Chen Yen T , Tancer Stephanie , Rodgers Kyla R , Crumb Amber D , Townsend Whitney A , Knight Jason S , Murphy Susan L 
Published: December 2023

Objective The objective of this study was to explore what non-pharmacological interventions have been examined for individuals with antiphospholipid syndrome (APS). Methods We conducted a systematic literature search of the databases PubMed, Embase, Scopus, Web of Science, CINAHL, and ClinicalTrials.gov from 1983–Feb. 2023. Our scoping review included studies that examined non-pharmacological interventions for individuals with APS using patient-reported outcome measures. We excluded studies that reported physiological outcomes only. Results The review yielded one case study on the safety and efficacy of an exercise program for a 15-year-old male with secondary APS using physiological and patient-reported outcome measures. Despite the lack of evidence of non-pharmacological interventions for individuals with APS, one excluded study reported that individuals with APS want guidance about physical activity and exercise. We also found several types of potentially relevant non-pharmacological interventions for individuals with lupus, a disease that often co-occurs with APS. Conclusions Non-pharmacological interventions may offer a solution for addressing some non-thrombotic or non-obstetric APS symptoms, such as neurological, physical, and cognitive symptoms that are not well-controlled by anticoagulation. Due to the unique risks associated with APS, research is needed to determine the safety and efficacy of non-pharmacological interventions, particularly those involving exercise. Adopting a comprehensive, multidisciplinary approach to managing patients with APS and involving rehabilitation professionals, who are experts in the design and delivery of non-pharmacological interventions, may provide a foundation for developing and testing novel interventions that improve health outcomes while also fulfilling unmet needs reported by patients.
Moral learning through caring stories of nursing staff
Authors: van den Eijnde Charlotte , Dohmen Marleen DW , Groot Barbara C , Huijg Johanna M , Abma Tineke A 
Published: December 2023

Background Implementing person-centred care (PCC) in nursing homes is challenging due to a gap between theory and practice. Bridging this gap requires suitable education, which focuses on learning how to attune care to the values and preferences of residents and take moral, relational, and situational aspects into account. Staff’s stories about the care they provide (i.e. caring stories) may deliver valuable insights for learning about these aspects. However, there is limited research on using staff's narratives for moral learning. Objective This study aims to provide insight into the perspectives of nursing staff on using their caring stories to learn about PCC. Research design In this qualitative research, we conducted two rounds of interviews with 17 participants working in nursing homes. We wanted to obtain nursing staff’s perceptions of working with their caring stories and the impact on PCC. Ethical considerations Participation was voluntary, and participants provided written consent. The study protocol is approved by The Institutional Review Board of the Medical Ethical Committee Leiden-Den Haag-Delft. Findings Working with caring stories enables nursing staff to provide PCC and improves job satisfaction. It increases awareness of what matters to residents, fosters information rich in context and meaning, and enhances voice and vocabulary. Through in-depth team reflections, nursing staff discussed the significant moments for residents, which centralizes the discussions on the moral quality of care. Discussion Working with caring stories fosters dialogue on PCC and enhances reflection on ethical situations in daily encounters, contributing to the moral development of nursing staff. Putting nursing staff’s narratives at the centre of learning suits their daily practice and intrinsic motivation. Therefore, the outcomes of this study are an addition to the existing literature about using narratives in long-term care. Conclusion Using nursing staff's narratives contributes to PCC and positively impacts nursing staff. We recommend using staff's caring stories as a vehicle for moral learning in the transition to PCC.