bluuebunny/crossref_metadata_2025_split huggingface dataset:
Land Surface Influence on Convective Available Potential Energy (CAPE) Change during Interstorms
Authors: Zhang Lily N. , Short Gianotti Daniel J. , Entekhabi Dara 
Published: August 2023

Abstract
Changes in surface water and energy balance can influence weather through interactions between the land and lower atmosphere. In convecting atmospheres, increases in convective available potential energy (CAPE) at the base of the column are driven by surface turbulent fluxes and can lead to precipitation. Using two global satellite datasets, we analyze the impact of surface energy balance partitioning on convective development by tracking CAPE over soil moisture drydowns (interstorms) during the summer, when land–atmosphere coupling is strongest. Our results show that the sign and magnitude of CAPE development during summertime drydowns depends on regional hydroclimate and initial soil moisture content. On average, CAPE increases between precipitation events over humid regions (e.g., the eastern United States) and decreases slightly over arid regions (e.g., the western United States). The soil moisture content at the start of a drydown was found to only impact CAPE evolution over arid regions, leading to greater decreases in CAPE when initial soil moisture content was high. The effect of these factors on CAPE can be explained by their influence principally on surface evaporation, demonstrating the importance of evaporative controls on CAPE and providing a basis for understanding the soil moisture–precipitation relationship, as well as land–atmosphere interaction as a whole.

Significance Statement
Land–atmosphere coupling is a long-standing topic with growing interest within the climate and modeling communities. Understanding and characterizing the feedbacks between the land surface and lower atmosphere has important implications for weather and climate prediction. One component of land–atmosphere coupling not yet fully understood is the soil moisture–precipitation relationship. Our work quantifies the land influence on one pathway for precipitation, convection, by tracking the evolution of atmospheric convective energy as soils dry between storms. Using global satellite observations, we find clear spatial and temporal trends that link summertime convective development to soil moisture content and evaporation. Our observational results provide a benchmark for evaluating how well weather and climate models capture the complex coupling between land and atmosphere.
Current Operative Approaches to the Diseased Gallbladder. Diagnosis and Management Updates for General Surgeons
Authors: Jacoby Harel , Rayman Shlomi , Oliphant Uretz , Nelson Daniel , Ross Sharona , Rosemurgy Alexander , Sucandy Iswanto 
Published: August 2023

Cholecystitis is a common diagnosis which requires management by general surgeons. Morbidity from cholecystitis is often life-threatening, especially in patients with underlying liver cirrhosis or other medical comorbidities. Diagnosis and management of this disease can vary among providers and hospitals. The decision to utilize a radiological or endoscopic temporizing maneuver in severe acute cholecystitis and the timing of later definitive cholecystectomy are relevant points of discussion within general surgery societies. In the last 5 years, the use of intraoperative ductal imaging by conventional vs fluorescence cholangiography had gained significant interest due to the widespread availability of indocyanine green. Finally, the operative strategies and how to manage intra-/postoperative complications are very important to optimizing patient outcomes. In this review paper, we discuss all treatment aspects of cholecystitis and provide updates in its management.
Metastatic and Malignant Phyllodes Tumors of the Breast: An Update for Current Management
Authors: Goodwin Brandon , Oyinlola Adejumoke Fisayo , Palhang Meejan , Lehman Danielle , Platoff Rebecca , Atabek Umur , Spitz Francis , Hong Young 
Published: August 2023

Metastatic, malignant phyllodes tumor (PT) of the breast is a rare and aggressive neoplasm. Currently, there is no agreed upon consensus as to best management practices. A systematic review of literature was conducted investigating surgical, chemotherapeutic, and radiotherapeutic management for metastatic PT. Databases employed to identify articles included Embase, PubMed, and SAGE Journals. Diagnosis of metastatic PT has been of significant difficulty to radiologists as it is often confused with fibroadenomas. Surgically, metastatectomy has been correlated with increased overall survival (of 25.9 versus 9.9 months; P = .01). Radiotherapy has often been associated with palliation and pain control in metastatic, malignant neoplasia. However, one study showed that in malignant PT, radiation was associated with significantly lower rates of local recurrence (OR: 0.048 versus 0.209). Anthracycline containing chemotherapy regimens has been associated with improved overall survival (22.4 months versus 13.2 months; P = .040). Further research must be conducted into this rare malignancy to elucidate accurate diagnosis and care for patients with advanced metastatic or malignant phyllodes tumors.
Indications and Short-Term Outcomes for In-Office Therapeutic Superior Laryngeal Nerve Block
Authors: Gray Alan J. , Hoffman Matthew R. , Yang Zao M. , Vandiver Beau , Purvis Joshua , Morgan Jake P. , Hapner Edie R. , Dominguez Laura , Tibbetts Kathleen , Simpson C. Blake 
Published: August 2023

Objective: Superior laryngeal nerve (SLN) block consists of injection of steroid and anesthetic at the internal branch of the SLN entry site. Prior case series have demonstrated beneficial effects on neurogenic cough. SLN blocks have also recently shown benefit for paralaryngeal pain. We describe short-term outcomes for multiple symptoms of irritable larynx syndrome (ILS) including neurogenic cough, dysphonia related to laryngeal hypersensitivity, inducible laryngeal obstruction (ILO), paralaryngeal pain, and isolated globus. Methods: Retrospective review from 2 institutions of patients undergoing a single SLN block for the indications listed. Variables include age, sex, indication(s), known vagus neuropathy, and patient-reported outcomes at short-term follow-up. Results: A total of 209 patients were included (59 males, 150 females; age: 58 ± 13 years). Twenty-six patients (12%) had a history of a vagus nerve injury. Indications included neurogenic cough (n = 149), dysphonia related to laryngeal hypersensitivity (n = 66), paralaryngeal pain (n = 50), ILO (n = 23), and isolated globus (n = 3). Some patients had multiple indications. Significant improvements in patient-reported measures occurred after a single SLN block within 2 to 4 weeks for neurogenic cough (cough severity index; 25.2 ± 11.2 to 19.0 ± 12.8; P < .001), dysphonia (voice handicap index-10; 22.1 ± 12.2-18.0 ± 13.3; P = .005), and ILO (dyspnea index; 21.0 ± 14.9-14.7 ± 15.7; P = .017). Subjective pain improved in 23 of 39 patients with paralaryngeal pain. There was no observed improvement for isolated globus. Presence of known vagal neuropathy or therapy around the time of SLN block did not affect outcome. Conclusion: SLN block can be an effective component of treatment for a variety of ILS symptoms. Patients may experience some improvement after 1 injection. Lay Summary: Symptoms of irritable larynx syndrome, such as neurogenic cough, paralaryngeal pain, inducible laryngeal obstruction, and dysphonia related to laryngeal hypersensitivity can be challenging to manage. In-office Superior Laryngeal Nerve blocks can serve as a quick, well tolerated, adjunctive treatment with positive short-term outcomes. Level of evidence: 4
Gender Differences in Quality of Life of Adolescent Patients With Chronic Rhinosinusitis
Authors: Dundervill Caroline , Al-Asadi Zayd , Behnke John , Tumlin Parker , Chaiban Rafka , Ramadan Hassan H. , Makary Chadi A. 
Published: August 2023

Objectives: To identify the differences in the impact of chronic rhinosinusitis (CRS) between female and male adolescent patients at presentation. Study Design: Cross sectional study. Methods: Adolescent patients, age 12 to 18 years old, presenting to our Otolaryngology clinic between August 2020 and April 2023 for CRS were asked to fill both the SNOT-22 and the SN5 forms. Female and male cohorts were compared regarding their demographics, comorbidities, subjective and objective disease measurements, and choice of treatment. Results: Sixty-six patients were included, 30 female and 36 male patients. There were no differences in age, allergic rhinitis, asthma, obstructive sleep apnea, presence of nasal septal deviation, and objective disease severity ( P > .05 for all). At presentation, mean overall SNOT-22, ear/facial, sleep, and psychological domains were all higher in female patients (43vs 30.9, P = .02; 9.1vs 6, P = .03; 11.8vs 8.3, P = .07; 14.1vs 8.8, P = .02 respectively). SN5 scores and overall QoL visual analog scale were similar in females and males. Conclusion: Female patients with CRS show higher subjective disease burden. Incorporating data on gender-specific differences may be important to personalize treatment decision making.
A grounded theory study exploring palliative care healthcare professionals’ experiences of managing digital legacy as part of advance care planning for people receiving palliative care
Authors: Stanley Sarah , Higginbotham Karen , Finucane Anne , Nwosu Amara Callistus 
Published: August 2023

Background: Digital legacy refers to the online content available about someone following their death. This may include social media profiles, photos, blogs or gaming profiles. Some patients may find it comforting that their digital content remains online, and those bereaved may view it as a way to continue bonds with the deceased person. Despite its growing relevance, there is limited evidence worldwide around the experiences of palliative care professionals in supporting patients to manage their digital legacy. Aim: To identify palliative care healthcare professionals’ experiences of supporting patients receiving palliative care in managing digital legacy as part of advance care planning discussions. Design: A constructivist grounded theory approach was used to understand healthcare professionals’ experiences of managing digital legacy. Semi-structured interviews were carried out. Setting and participants: Participants were 10 palliative care healthcare professionals from across the multidisciplinary team working in a hospice in the North-West of England. Results: Four theoretical categories were found to revolve around an emergent theory ‘understanding the impact of digital legacy’ which describe the experiences of palliative care healthcare professionals managing digital legacy as part of advance care planning. These were ‘ accessing digital legacy’; ‘ becoming part of advance care planning’; ‘ impacting grief and bereavement’; and ‘ raising awareness of digital legacy’. Conclusions: The emerging theory ‘ understanding the impact of digital legacy’ offers insight into the knowledge and experiences of healthcare professionals working in a palliative care setting. Digital assets were viewed as being equally as important as physical assets and should be considered as part of advance care planning conversations.
Internal versus external biliary drainage in malignant biliary obstructions: is there a difference in the rate of infection?
Authors: Ongen Gokhan , Nas Omer Fatih , Hacikurt Kadir , Dundar Halit Ziya , Ozkaya Guven , Kaya Ekrem , Hakyemez Bahattin 
Published: August 2023

Background Percutaneous biliary drainage is a frequently used method to provide biliary decompression in patients with biliary obstruction. Purpose To investigate the between drainage type and infection risk in patients treated with internal-external and external biliary drainage catheterization for malignant biliary obstruction. Material and Methods A total of 410 patients with malignant biliary obstruction who underwent internal-external or external biliary drainage catheterization between January 2012 and October 2016 were retrospectively evaluated. We investigated the correlation between percutaneous biliary drainage technique and infection frequency by evaluating patients with clinical findings, bile and blood cultures, complete blood counts, and blood biochemistry. Results There was no statistically significant difference between the selected patient groups (internal-external or external biliary drainage catheter placed) in terms of age, sex, primary diagnosis, receiving chemotherapy, catheter sizes, and outpatient-patient status. After catheterization, catheter-related infection was observed in 49 of 216 (22.7%) patients with internal-external and 18 of 127 (14.2%) patients with external biliary drainage catheters, according to the defined criteria. There was no difference in infection rate after the biliary drainage in the two groups ( P > 0.05). There was also no difference concerning frequently proliferating microorganisms in bile cultures. Conclusion Internal-external biliary drainage catheter placement does not bring an additional infection risk for uninfected cholestatic patients whose obstruction could be passed easily in the initial drainage.
A framework for lean implementation in preoperative assessment: Evidence from a high complexity hospital in Italy
Authors: Goretti Giulia , Pisarra Martina , Capogreco Maria Rosaria , Meroni Patrizia 
Published: August 2023

Purpose: A routine preoperative assessment is considered both ineffective and inefficient. Despite the widespread application of lean thinking in healthcare, there is little evidence of successful experiences in preoperative admissions in order to reduce “No value added” activities. A conceptual framework reporting the drivers (clinic, tools, innovation, organization, and governance) and impacts (patient, efficiency, sustainability, time, learning and growth) was developed. Methodology: Drawing on the experience of an Italian high complexity hospital, this paper analyzes the case study by reporting evidence on how to implement lean in preoperative assessment and how to evaluate the positive results obtained. Results: Applying lean principles, the identification of value improved the appropriateness of care by creating 40 personalized pathways; the value stream resulted in a reduction of “No Value Added Time” from 37% to 28%, chest X-rays from 41% to 14% and cardiac visits from 49% to 37%; the pursuit of continuous flow through innovation contributed to increase the use of digitalization; the new pull organization helped to reduce the average time spent per year by 1.5 h; the continuous improvement was ensured through the governance of results. Conclusion: The proposed framework should be used to improve the quality of care in preoperative admissions by adopting the lean drivers for successful implementation and reporting the impacts.
D’un entre-soi permissif à un sport inclusif : l’évolution du roller derby en France
Authors: Messey Orlane 
Published: August 2023

Résumé Le roller derby est une discipline sportive américaine, apparue en France en 2009 sous une forme carnavalesque. L’anti-conformisme alors affiché participait à attribuer à ce sport un caractère permissif : tout semblait y être permis. Dix ans plus tard, mon enquête sociologique menée auprès d’équipes s’est confrontée à l’euphémisation des marqueurs subversifs et à l’adoption des codes du milieu sportif fédéral. Afin de comprendre cette normalisation sportive, la mobilisation du concept de « scène » de Erving Goffman m’a permis de dissocier ce qui appartient à l’espace public, le front stage, dans lequel les équipes défendent la valeur sportive du derby, des coulisses, le back stage, où la défense de l’inclusif encourage la préservation de l’ancrage permissif disparu de la scène sportive.
Expression patterns of T cells-specific long noncoding RNAs in systemic lupus erythematosus patients carrying HLA risk/nonrisk alleles
Authors: Tahamoli-Roudsari Ahmad , Rahmani Fatemeh , Afshar Saeid , Hajilooi Mehrdad , Solgi Ghasem 
Published: August 2023

Background Long noncoding RNAs (LncRNAs) play key roles in the regulation of gene expression and subsequently in the pathogenesis of several autoimmune diseases. This study aimed to explore the peripheral expression levels of T-cells-specific LncRNAs and transcription factors in systemic lupus erythematosus (SLE) patients carrying either human leukocyte antigens (HLA) risk or non-risk alleles. Methods Genotypes of HLA-DRB1 and HLA-DQB1 loci for 106 SLE patients were determined by PCR-SSP. In the next step, patients were stratified based on the presence of HLA-DRB1*03 and/or DRB1*16 allele groups (HLA risk alleles positive or HLA-R Pos) or carrying other DRB1 allele groups (HLA-R Neg). Then, transcript levels of LncRNAs ( IFNG-AS1, RMRP, Th2LCR, and DQ786243) and mRNAs for transcription factors ( Foxp3, Gata3, and Tbx21) were measured using qRT-PCR and compared between two subgroups of patients. Results Totally, 47 cases were classified as HLA-R Pos and 59 cases as HLA-R Neg patients. The HLA-R Pos patients showed decreased transcript levels of DQ786243 ( p = .001) and elevated expression of IFNG-AS1 ( p = .06) and T-bet mRNA ( p = .03) compared to the HLA-R Neg group. We observed significantly lower expression of Th2LCR ( p < .0001) and DQ786243 ( p = .001) and higher expression of Tbx21 ( p = .009) and Foxp3 ( p = .02) in DR3-positive versus DR3-negative patients. Likewise, decreased transcript levels of DQ786243 ( p = .02) and RMRP ( p = .003) were observed in DR16-positive versus DR16-negative patients. ROC curve analysis revealed the potential of DQ786243 and RMRP as biomarkers in SLE disease based on the carriage of HLA risk alleles. Conclusions Our results indicate that the contribution of multiple T cell subsets in SLE disease progression as judged by expression analysis of LncRNAs and transcription factors can be inspired by the inheritance of HLA risk/nonrisk alleles is SLE patients.
Ultrasound-detected tibial artery calcification as a marker of cardiovascular and lower-limb risk in asymptomatic patients with type-2 diabetes
Authors: Salle Laurence , Magne Julien , Kenne Malaha Angeladine , Chastaingt Lucie , Galinat Sophie , Drutel Anne , Lacroix Philippe , Teissier-Clément Marie-Pierre , Aboyans Victor 
Published: August 2023

Background: Medial arterial calcification (MAC) is a vascular disease distinct from atherosclerosis. Recently, several studies have demonstrated that MAC is an important marker of cardiovascular events. We aim to assess the presence of MAC during ultrasound screening of lower-limb vasculature and its association with both cardiovascular (CV) and lower-limb events in patients with type-2 diabetes. Methods: A retrospective cohort study was conducted on 1119 patients with type-2 diabetes free from CV disease. A CV work-up, including vascular ultrasound, was performed for each patient. The presence of MAC was assessed on posterior tibial arteries and ankle–brachial index (ABI) was measured. Major acute CV events (MACEs) and lower-limb events (MALEs) were recorded as a composite endpoint for a 5-year period. Results: We identified MAC among 212 (18.9%) patients. The independent determinants of MAC were age and diabetic retinopathy. Over a period of 5 years, 125 MACEs and 22 MALEs occurred. MAC was significantly associated with the composite outcome MACE + MALE (HR = 1.94; 95% CI: 1.23, 3.08, p = 0.005) or with MACE (HR = 1.85; 95% CI: 1.16, 2.95, p = 0.010). Adjusted for ABI and diabetic foot wound, MAC remained a determinant of MALE (HR = 5.49; 95% CI: 2.19, 13.76, p < 0.001). Considering each ABI group, MAC was associated with both MACE and MALE in the normal ABI group. Conclusions: Ultrasound-detected MAC on tibial arteries seems to be a determinant of both CV and lower-limb events, independent from ABI. MAC helps to refine the CV risk in patients with normal ABI.
Who is at risk of clinical deterioration? Adverse events among trauma patients undergoing intra-hospital transport for emergent computerized tomography
Authors: Li Winny , Beckett Andrew , Ditkofsky Noah , Lebovic Gerald , Pierce Michael , Petrosoniak Andrew 
Published: August 2023

Introduction Computerized tomography is an essential element of the early diagnostic stages of trauma care for hemodynamically stable patients. However, there are inherent challenges and risks associated with the intra-hospital transport of critically injured trauma patients to the radiology suite and during the scanning process itself. We examined the frequency and nature of adverse events during computerized tomography among critically injured patients. Methods This is a retrospective cohort study of adverse event in critically injured adult (>18 years old) trauma patients who underwent emergent computerized tomographic scan following evaluation in the trauma bay over a 22-month period who were either admitted to the intensive care unit or the operating room post computerized tomography. Data was abstracted from the hospital's trauma registry and chart review of electronic medical records. The frequency of adverse events during computerized tomography and the associated patient transport phases was recorded. Multivariable logistic regression was performed to assess the impact of adverse event on 7-day in-hospital mortality. Results Of the 526 critically injured trauma patients who underwent computerized tomographic scan during the study period, 17.3% (91/526) experienced one or more adverse event. The most common adverse events were hypotension n = 50 (9.5%), hypertension n = 18 (3.4%), initiation of vasopressors n = 11 (2.1%) and vomiting n = 8 (1.5%). One patient required re-intubation following endotracheal tube dislodgement and one patient required intubation following hypoxia post-sedation for agitation. Patient factors independently associated with adverse event were mechanical ventilation and blood product administration. When adjusted for injury severity score and age, patients who experienced adverse event were at increased odds of death (odds ratio: 2.2, 95% confidence interval: 1.11–4.36) compared to those who did not experience adverse event. Conclusion Adverse events occur frequently in critically injured patients undergoing emergent trauma computerized tomography and may significantly impact clinical outcomes. This study provides important information to guide system and process-level improvements including optimized designs of the built environment and safety-informed protocols for high-risk patients undergoing emergent trauma computerized tomography.