bluuebunny/crossref_metadata_2025_split huggingface dataset:
Large-Scale Circulations and Dry Tropical Cyclones in Direct Numerical Simulations of Rotating Rayleigh–Bénard Convection
Authors: Velez-Pardo Martin , Cronin Timothy W. 
Published: July 2023

Abstract
The organization of convection into relatively long-lived patterns of large spatial scales, like tropical cyclones, is a common feature of Earth’s atmosphere. However, many key aspects of convective aggregation and its relationship with tropical cyclone formation remain elusive. In this work, we simulate highly idealized setups of dry convection, inspired by the Rayleigh–Bénard system, to probe the effects of different thermal boundary conditions on the scale of organization of rotating convection, and on the formation of tropical cyclone–like structures. We find that in domains with sufficiently high aspect ratios, moderately turbulent (), moderately rotating () convection organizes more persistently and at larger scales when thermal boundary conditions constrain heat fluxes rather than temperatures. Furthermore, for some thermal boundary conditions with asymmetric heat fluxes, convection organizes into persistent vortices with the essential properties of mature tropical cyclones: a warm core, high axisymmetry, a strong azimuthal circulation, and substantially larger size than individual buoyant plumes. We argue that flux asymmetry results in a persistent and localized input of buoyancy, which allows spatially aggregated convection to sustain a warm core in a developing large-scale vortex. Crucially, the most intense and axisymmetric cyclone forms for setups where the bottom heat flux is enhanced by the nearby flow and the top boundary is insulating, as long as the convective Rossby number is higher than about 1. Our results demonstrate the great potential for dialogue between classical turbulence research and the study of convective aggregation and tropical cyclones.

Significance Statement
On Earth, atmospheric convection frequently organizes into large spatial patterns that persist for several days, like tropical cyclones. However, many aspects of this process of organization and its link to tropical cyclone formation are not fully understood. In this work, we use numerical simulations of simple setups of rotating convection without moisture to study the minimal conditions that produce large-scale convective organization, and the spontaneous formation of tropical cyclone–like structures. We find that the latter form more readily for a particular set of controlling parameters and thermal boundary conditions. Our approach seeks to narrow the disciplinary gap between tropical cyclone physics and traditional turbulence research, by bringing together methods, questions, and results that are of potential interest to both.
Continuous textile manufacturing method for twisted coiled polymer artificial muscles
Authors: Mersch Johannes , Witham Nicholas S , Solzbacher Florian , Gerlach Gerald 
Published: July 2023

Twisted, coiled polymer actuators (TCPAs) are a promising type of fiber-based actuators with high energy density, low material costs, and good recyclability; however, current manufacturing methods limit the length and stability of TCPAs, hampering their potential for large-scale textile applications. To overcome this limitation, we propose a textile manufacturing method based on the false-twisting principle, allowing for continuous and rapid production of highly twisted monofilaments. Additionally, this process enables the plying of two or more twisted monofilaments together, as well as the integration of wires for heating and sensing purposes. The resulting twist-stable plies can then be mandrel-coiled and annealed to create a new class of TCPAs with three superimposed levels of helicity, in contrast to the usual two levels. In this study, we investigate the impact of the additional helix level and various factors, including twist density, annealing temperature, cooling speed, and chirality, on the contractility of these TCPAs. Furthermore, due to the twist-stability of the plied yarns, they can be processed on standard textile machines, enabling the manufacture of TCPAs with multiple active yarns that can form contracting artificial muscles using a circular braiding machine. Our key findings reveal that the twisted monofilament coils can contract up to 60%, and higher twist density leads to improved performance for monofilament TCPAs. Notably, this phenomenon is not observed in plied-yarn TCPAs, where varying levels of twist on the monofilament and yarn helix level result in enhanced contractile performance. Overall, this work presents a novel textile manufacturing method for producing twist-stable TCPAs with good contractile performance, providing insights into the design and fabrication of advanced fiber-based actuators for potential applications in large-scale textiles, robotics, and biomedical devices.
Acceptance and Commitment Therapy (ACT) for people with advanced progressive illness, their caregivers and staff involved in their care: A scoping review
Authors: Gibson Watt Tilly , Gillanders David , Spiller Juliet A , Finucane Anne M 
Published: July 2023

Background: People with an advanced progressive illness and their caregivers frequently experience anxiety, uncertainty and anticipatory grief. Traditional approaches to address psychological concerns aim to modify dysfunctional thinking; however, this is limited in palliative care, as often concerns area valid and thought modification is unrealistic. Acceptance and Commitment Therapy is a mindfulness-based behavioural therapy aimed at promoting acceptance and valued living even in difficult circumstances. Evidence on its value in palliative care is emerging. Aims: To scope the evidence regarding Acceptance and Commitment Therapy for people with advanced progressive illness, their caregivers and staff involved in their care. Design: Systematic scoping review using four databases (Medline, PsychInfo, CINAHL and AMED), with relevant MeSH terms and keywords from January 1999 to May 2023. Results: 1,373 papers were identified and 26 were eligible for inclusion. These involved people with advanced progressive illness ( n = 14), informal caregivers ( n = 4), palliative care staff ( n = 3), bereaved carers ( n = 3), and mixed groups ( n = 2). Intervention studies ( n = 15) showed that Acceptance and Commitment Therapy is acceptable and may have positive effects on anxiety, depression, distress, and sleep in palliative care populations. Observational studies ( n = 11) revealed positive relationships between acceptance and adjustment to loss and physical function. Conclusion: Acceptance and Commitment Therapy is acceptable and feasible in palliative care, and may improve anxiety, depression, and distress. Full scale mixed-method evaluation studies are now needed to demonstrate effectiveness and cost-effectiveness amongst patients; while further intervention development and feasibility studies are warranted to explore its value for bereaved carers and staff.
Hyaluronic Acid Fillers to Correct Cleft Lip Asymmetry in Adults: Description of Technique and Patient Reported Outcome Measure Using CLEFT-Q
Authors: Thomson Richard M , Jovic Thomas H , Eckhardt Charlotte , O’Neill Tomás 
Published: July 2023

Objective To determine the efficacy of hyaluronic acid (HLA) lip filler to correct subtle cleft lip asymmetries in adults using a validated patient reported outcome measure (PROM). Design Prospective cross sectional. Setting UK National Health Service. Patients, Participants Over 18 years old with repaired cleft lip and dissatisfaction of their lip appearance. Interventions HLA lip filler injection. Main Outcome Measures A validated, cleft specific PROM, the lip module of CLEFT-Q™ prior to treatment and again after six weeks. Results 24 patients included. A mean total CLEFT-Q™ score pre-procedure was 14.9 (Stand deviation (SD) = 4.91) and 24 (SD = 6.08) post-procedure. Difference in mean total score pre- and post-procedure were statically significant ( P = .0001) in all domains on the CLEFT-Q™. No adverse outcomes. Conclusion HLA filler to correct subtle cleft lip asymmetries in adults is a simple low risk technique, which can significantly improve the patient's perception of lip appearance. Conclusion HLA lip filler to correct subtle cleft lip asymmetries in adults is a simple technique, low risk procedure which can significantly improve the patient's perception of lip appearance.
Sphenoid Sinus Volumes of Patients with Unilateral Cleft Lip and Palate
Authors: Erturk Ahmet Faruk , Goksel Sevde , Yelken Kendirci Merve , Ozcan Ilknur 
Published: July 2023

Objective There is only one study in the literature in which 3D evaluation of sphenoid sinus volume in patients with cleft lip and palate was used. This shows that this issue has not been adequately evaluated. The present study aimed to compare the volume of the sphenoid sinuses in patients with cleft lip and palate on cone-beam computed tomography images, and to compare them with healthy controls. The high variability of sphenoid sinus volumes poses a risk for iatrogenic lesions during surgical procedures. Because the degree of pneumatization due to increased volume increases the likelihood of exposure of vital neurovascular structures such as the internal carotid artery, maxillary nerves, and optic nerves. Design Retrospective cohort study. Setting University Hospital. Patients A total of 64 patients (32 cleft palate, 32 controls) over 18 years of age who had sphenoid sinuses in the image area were included in our study. Outcomes Sphenoid Sinus Volume. Results When the groups were compared in terms of total sinus volume, there was a statistically significant difference between them. Total sinus volume was significantly mean 2.806,87 mm lower in patients with cleft lip and palate compared to the healthy group ( P = .015). Conclusion To be aware this lower volume of the sphenoid sinus in cleft lip and palate patients will be useful for the surgical approach to sphenoid sinus. However, the literature on the subject is insufficient, more comprehensive clinical and radiological studies are needed on a larger sample.
Efficacy and Safety of Immune Checkpoint Inhibitors Combined With Chemotherapy as First-line Treatment for Recurrent or Metastatic Nasopharyngeal Carcinoma: A Network Meta-analysis of Randomized Controlled Trials
Authors: Sun Hong , Bu Fengjiao , Li Ling , Zhang Xiuwen , Xin Xiu , Yan Jingchao , Huang Taomin 
Published: July 2023

Background Different clinical trials for recurrent or metastatic nasopharyngeal carcinoma have studied different combinations of immuno-oncology in first-line treatment, but the optimal choice has not been determined. Objective To systematically examine and compare the efficacy and safety of different immune checkpoint inhibitors (ICIs) combined with chemotherapy as first-line treatment for recurrent or metastatic nasopharyngeal carcinoma. Methods Several electronic databases were systematically searched up to February 2023. Articles meeting the inclusion criteria were included. Results Three RCTs were eligible in the study. Compared with placebo plus gemcitabine-cisplatin (GP), toripalimab plus GP (HR = 0.59, 95% CI: 0.37-0.95) was significantly associated with a better OS. Tislelizumab plus GP generated best progression-free survival (PFS) benefit (HR = 0.50, 95% CI: 0.37-0.67), greatest improvement in 1-year PFS rate (RR = 3.00, 95% CI: 1.84-5.22), and objective response rate (ORR) (RR = 1.26, 95% CI: 1.04-1.53) over the placebo plus GP. Furthermore, tislelizumab plus GP appeared to be safer than toripalimab plus GP and camrelizumab plus GP in terms of adverse events (AEs)-grade ≥3, treatment-related AEs (TRAEs)-grade ≥3, serious AEs (SAEs), treatment-related SAEs (TRSAEs), and AEs leading to discontinuation of treatment. Conclusion and Relevance In recurrent or metastatic nasopharyngeal carcinoma, programmed death 1 (PD-1) inhibitors plus GP as first-line treatment have better survival outcomes than placebo plus GP with comparable toxicity. Toripalimab plus GP shows the best OS benefit over placebo plus GP, while tislelizumab plus GP generates the best PFS, 1-year PFS rate, ORR, and safety. Tislelizumab plus GP could be the best choice among the ICIs combined with chemotherapy regimens as first-line treatment in recurrent or metastatic nasopharyngeal carcinoma.
Assessing floor contamination by antineoplastic agents in a Japanese medical institution specializing in cancer treatment
Authors: Maeda Akimitsu , Hori Kyoko , Sone Yumiko , Hashimoto Naoya , Uchida Kosaku 
Published: July 2023

Introduction This study investigated the extent of contamination with antineoplastic agents on floor surfaces of the ward and the outpatient chemotherapy center of a Japanese cancer center to evaluate healthcare workers’ risk of occupational exposure to antineoplastic agents outside of the designated drug preparation areas. Methods In this study conducted at Aichi Cancer Center, the amount of fluorouracil detected on various floor surfaces was measured using liquid chromatography—tandem quadrupole mass spectrometry. Areas around the toilets were cleaned with a surfactant two or three times a day, whereas other floor surfaces were cleaned only with dry and wet mops. Results Fluorouracil was detected on all surveyed floor surfaces, with particularly high amounts detected around the toilet areas in the ward. Additionally, areas with more human traffic tended to have higher fluorouracil contamination. Conclusions This survey suggested that antineoplastic agent contamination occurring through patient excretions might spread throughout the hospital with human traffic. Therefore, controlling the spread of antineoplastic agent contamination in hospitals should include the review of measures to mitigate contamination around toilets and to implement effective cleaning methods for floor surfaces.
Carfilzomib-induced life-threatening lung injury in refractory multiple myeloma
Authors: Ghasoub Rola , Benkhadra Maria , Kassem Nancy , Alshurafa Awni , Elsabah Hesham 
Published: July 2023

Introduction Carfilzomib is a second-generation selective proteasome inhibitor that is commonly used in the treatment of relapsed or refractory multiple myeloma. Carfilzomib is associated with respiratory side effects, such as cough, dyspnea, and upper respiratory tract infection. However, severe pulmonary toxicity is rare and is only reported in a few case reports. Case report Here, we present a case of a 65-year-old male with refractory multiple myeloma who developed a life-threatening lung injury during his third cycle of carfilzomib. The patient presented with a decreased level of consciousness and was found to have Type I respiratory failure. He was admitted to the intensive care unit, where he was intubated. Blood cultures and viral panel were negative. The patient received a prolonged course of antibiotics with 2 days of hydrocortisone. Management and outcomes After discharge, repeated myeloma workup showed disease progression and carfilzomib was reintroduced. The next day, he presented with fever, vomiting, and hypoxia. Chest x-ray showed congestive lung changes with patchy airspace opacities. Repeated echocardiography showed normal ejection fraction with moderate pulmonary hypertension (RVSP 46 mm Hg). The patient was transferred again to the ICU and kept on continuous positive airway pressure. Antibiotics were started, and blood cultures and respiratory viral panels were negative for any infectious organism. The patient improved in terms of inflammatory markers and oxygen requirements. Treatment with carfilzomib was stopped permanently. Discussion Pulmonary toxicity associated with carfilzomib in patients with multiple myeloma can be potentially life-threatening. The mechanism with which carfilzomib induces lung-related AEs is still not fully understood. In our patient, carfilzomib-induced lung injury was evident after rechallenging the patient with carfilzomib, in the radiographic x-ray changes and the new onset moderate pulmonary hypertension. Healthcare providers should be encouraged to report rare adverse events in order to identify the risk factors that can predispose patients to the development of these adverse events.
Large-scale epidemiological study on feline autosomal dominant polycystic kidney disease and identification of novel PKD1 gene variants
Authors: Shitamori Fumitaka , Nonogaki Ayaka , Motegi Tomoki , Matsumoto Yuki , Sakamoto Mika , Tanizawa Yasuhiro , Nakamura Yasukazu , Yonezawa Tomohiro , Momoi Yasuyuki , Maeda Shingo 
Published: July 2023

Objectives Autosomal dominant polycystic kidney disease (ADPKD) is a common inherited disease in cats. In most cases, the responsible abnormality is a nonsense single nucleotide polymorphism in exon 29 of the PKD1 gene (chrE3:g.42858112C>A, the conventional PKD1 variant). The aim of this study was to conduct a large-scale epidemiological study of ADPKD caused by the conventional PKD1 variant in Japan and to search for novel polymorphisms by targeted resequencing of the PKD1 using a next-generation sequencer. Methods A total of 1281 cats visiting the Veterinary Medical Center of the University of Tokyo were included in this study. DNA was extracted from the blood of each cat. We established a novel TaqMan real-time PCR genotyping assay for the conventional PKD1 variant, and all cases were examined for the presence of this variant. Targeted resequencing of all exons of the PKD1 was performed on the DNA of 23 cats with the conventional PKD1 variant, six cats diagnosed with cystic kidneys but without this variant, and 61 wild-type normal cats. Results Among the 1281 cats examined in this study, 23 (1.8%) harboured the conventional PKD1 variant. The odds of having the conventional PKD1 variant were significantly higher in Persian cats, Scottish Folds and Exotic Shorthairs than in the other breeds, although the number of cases in each breed was small. Furthermore, we identified four variants unique to cats with cystic kidneys that were not found in wild-type normal cats, all of which were in exon 15. In particular, two (chrE:g.42848725delC, pGly1641fs and chrE:g.42850283C>T, pArg2162Trp) were candidate variants. Conclusions and relevance This study revealed that the conventional PKD1 variant was prevalent in Scottish Fold, Persian and Exotic Shorthair breeds in Japan, and variants in exon 15 of PKD1, in addition to the conventional variant in exon 29, would be key factors in the pathogenesis of ADPKD in cats.
Understanding Hurley Stage III Hidradenitis Suppurativa Patients’ Experiences With Pain: A Cross-Sectional Analysis
Authors: Johnston Leah , Dupuis Elaine , Lam Lauren , Poelman Susan 
Published: July 2023

Background More than 90% of patients with hidradenitis suppurativa (HS) report that pain interferes with their quality of life (QoL) and pain may have a larger impact on QoL than disease severity alone. Objectives The purpose of this study was to understand the impact of pain on the daily lives of patients with Hurley stage III HS. Methods This was a single-center, prospective cross-sectional study that was conducted at Beacon Dermatology in Calgary, AB. Patients ≥ 18 years old with Hurley stage III HS in at least one area of the body were prospectively invited to participate in this study. The study consisted of survey questions on patients’ demographic information, past medical histories, HS-related pain histories, and previous therapies for pain management. Additionally, patients completed a series of standardized rating scales on their pain and overall QoL. Results Of the 10 patients that participated in the study, 90% (9/10) expressed a desire for more counselling on pain management options. Many patients (8/10, 80%) reported routine use of over-the-counter pain medications and 70% (7/10) used complementary and alternative medicines (CAMs) to manage their pain. Patients’ efficacy ratings of HS treatments in controlling their pain revealed that topical treatments provided minimal or no relief, while surgical interventions had the highest efficacy for reducing pain. Patients’ average worst pain over the preceding 24 hrs was 6.3 +/- 2.5 (2-9) on the Numerical Rating Scale for pain and the mean Dermatology Life Quality Index score was 19.5 +/- 8.2 (5-29). Conclusions Patients with Hurley stage III HS report high levels of daily pain and QoL impairment and many individuals use over-the-counter treatments and CAMs to manage their pain. Physicians involved in the care of HS patients should consider implementing routine counselling on pain management into their clinical practices, especially for patients with severe HS.
“We Have Outgrown Our Space; Our Facility Is Old and Falling Apart”: Physical Design Implications to Address the Needs and Priorities of a Critical Access Hospital (CAH)
Authors: Zamani Zahra , Joy Teri , Gobel Daniel 
Published: July 2023

Objective: This exploratory study examines a rural critical access hospital (CAH) staff’s perception of current obstacles and needs concerning the physical environment. Background: CAH intends to improve access to healthcare, coordinate with experts and providers, and serve as the rural population’s healthcare hub. It is imperative to understand environmental qualities that impact the quality of care to develop effective policies and design guidelines for rural healthcare. Nevertheless, a limited number of studies have focused on user or organizational outcomes related to the physical environment of rural healthcare settings. Methods: This cross-sectional exploratory qualitative case study was conducted as part of the facility planning process for a CAH in rural North Carolina. Hospital staff participated in a survey exploring their satisfaction with the overall physical environment privacy, space allocation, and department adjacency. An open-ended question asked staff to elaborate on needed improvements and changes in their department. Results: Findings show low satisfaction levels for space allocations for emergency department, lab, surgery, and wound care. Safety and quality were the two emerging outcomes of the physical environment’s shortcomings. Two clusters emerged from the content analysis, representing facility needs (rightly sized spaces, functional needs, COVID-19 needs, and improved access) and ambient conditions (clutter, visibility, flooring quality, noise, privacy, cleanliness, aesthetics, and temperature). Conclusion: The findings from this study suggest that the interior and exterior facility and ambient conditions of the CAH play a key role in quality and safety outcomes.
Novel prosthetic ligament repair of a shoulder luxation in a cat using a bone anchor and ligament prosthesis
Authors: Wong Nadia , Yu Jane , McCracken Blaine D 
Published: July 2023

Case summary A 7-year-old male castrated Ragdoll cat was presented for chronic shoulder instability after a previous medial luxation of the right shoulder. Upon examination, there was palpable instability of the glenohumeral joint and an increased abduction angle. Surgical stabilisation was elected due to lameness and instability after closed reduction, rest and medical management. A low-profile bone-anchor and a ligament prosthesis were used to stabilise the glenohumeral joint with minimal disruption to the cat’s natural shoulder stabilisers. Clinical signs resolved after surgery and the cat remained non-symptomatic at the 12-month follow-up. Relevance and novel information Feline shoulder luxation is rarely described in the veterinary literature. To the authors’ knowledge, this is the first report describing stabilisation of the glenohumeral joint in a cat using a bone anchor and a ligament prosthesis.