bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multiscale Analysis of Surface Heterogeneity–Induced Convection on Isentropic Coordinates
Authors: Chen Jingyi , Hagos Samson , Xiao Heng , Fast Jerome , Feng Zhe 
Published: December 2022

Abstract
This study uses semi-idealized simulations to investigate multiscale processes induced by the heterogeneity of soil moisture observed during the 2016 Holistic Interactions of Shallow Clouds, Aerosols, and Land-Ecosystems (HI-SCALE) field campaign. The semi-idealized simulations have realistic land heterogeneity, but large-scale winds are removed. Analysis on isentropic coordinates enables the tracking of circulation that transports energy vertically and facilitates the identification of the primary convective processes induced by realistic land heterogeneity. The isentropes associated with upward motion are found to connect the ground characterized by high latent heat flux to cloud bases directly over the ground with high sensible heat flux, while isentropes associated with downward motion connect precipitation to the ground characterized by high sensible heat fluxes. The mixing of dry, warm parcels ascending from the ground with high sensible heat fluxes and moist parcels from high latent heat regions leads to cloud formation. This new mechanism explains how soil moisture heterogeneity provides the key ingredients such as buoyancy and moisture for shallow cloud formation. We also found that the submesoscale dominates upward energy transport in the boundary layer, while mesoscale circulations contribute to vertical energy transport above the boundary layer. Our novel method better illustrates and elucidates the nature of land atmospheric interactions under irregular and realistic soil moisture patterns.

Significance Statement
Models that resolve boundary layer turbulence and clouds have been used extensively to understand processes controlling land–atmosphere interactions, but many of their configurations and computational expense limit the use of variable land properties. This study aims to understand how heterogeneous land properties over multiple spatial scales affect energy redistribution by moist convection. Using a more realistic land representation and isentropic analyses, we found that high sensible heat flux regions are associated with relatively higher vertical velocity near the surface, and the high latent heat flux regions are associated with relatively higher moist energy. The mixing of parcels rising from these two regions results in the formation of shallow clouds.
Modulation of the Influence of ENSO on Northward-Moving Tropical Cyclones in the Western North Pacific by the North Atlantic Tripole SST Anomaly Pattern
Authors: Li Shuang , Xiao Ziniu , Zhao Yuchun 
Published: December 2022

Abstract
The frequency characteristics of northward-moving tropical cyclones (NTCs) in the western North Pacific (WNP) are analyzed, and the possible combined effect of El Niño–Southern Oscillation (ENSO) and the North Atlantic tripole (NAT) sea surface temperature anomaly (SSTA) is investigated. Results show that the NTC frequency in summer shows obvious interannual and decadal variations. The SSTA in the eastern tropical Pacific has an effect on the NTC frequency, but this relationship is modulated by the NAT on the decadal time scale. During positive NAT phases, the effect of ENSO on NTCs is clear. There are fewer NTCs in El Niño–following years, whereas in La Niña–following years the NTC frequency is higher. However, during negative NAT phases, only El Niño has an effect on the NTC frequency, whereas there is no obvious feature found for La Niña, which may be related to the asymmetry of ENSO. The combined effect of La Niña and positive NAT phases presents an anomalous meridional dipole circulation at the low latitudes and mid–high latitudes near East Asia, which leads to TCs moving northward. The cold SSTA response in the tropical Indian Ocean may contribute to an anomalous cyclone in the WNP. The negative–positive–negative NAT SSTA mode can persist into the ensuing summer and favor wave pattern propagating eastward along the high-level jet waveguide so that there exists an anomalous anticyclone in Northeast Asia, which helps TCs move farther north. The influence of El Niño modulated by negative NAT phases is roughly opposite.
Extraction and characterization of novel natural fiber from Centaurea melitensis plant
Authors: Raouf KHALDOUNE Abd , ROKBI Mansour 
Published: December 2022

In this work a new cellulosic fibers extracted from Centaurea Melitensis plant to the prospect of employing them as a source of reinforcement in composite materials. In this investigation, morphological, chemical, physical and mechanical features of Centaurea Melitensis fibers are investigated. The morphological characteristics using anatomical technique and scanning electron microscopy revealed the presence of a large percentage of fibroblasts in the fibers that allow adhesion with the matrix when manufacturing of composite materials. The fiber density is 1.269 ± 0.018 g/cm3 and the diameter is 187.11 ± 60.41 μm depending on the physical properties. The chemical properties revealed that the Centaurea Melitensis fiber has a crystalline size of 16.92 nm and a crystallinity index of 47.69% using XRD. The results of FTIR analysis proved on major components such as cellulose, hemicelluloses and lignin, by TGA the thermal stability was found up to 210°C and the maximum temperature up to 317.86°C. The mechanical properties have shown that the value of the tensile strength of the fibers is 336.87 ± 59.94 MPa, Young’s modulus is 23.87 ± 5.21 GPa, and the strain at failure is 1.27 ± 0.36%, and the interfacial shear strength is 9.82 ± 2.35 MPa. The statistical approach, Weibull distribution was used with two and three parameters to examine the experimental data due to their dispersion. WEIBULL statistical analytical test was used with 2 and 3 parameters are used to examine the experimental data due to their dispersion. All the findings from this investigation reveal that Centaurea Melitensis fibers can be a qualified candidate to be used as reinforcement in low density composite materials.
An introduction to the Cornell Note system
Authors: Saran Manick , Krentz Gober Madeline , McCarty E Berryhill 
Published: December 2022

Objective The success of note writing has been a topic of research dating back to the days of Plato. Students now have access to complete libraries of books and notes on computers, tablets, and even phones. Modern note-taking methods use premade handouts, “Chalk Talk” lectures with faculty, and prescribed note-taking strategies. Here, we discuss one such strategy, the Cornell Note system. Methods This is an updated review of the original Cornell Note system originally outlined in How to Study in College. Results A detailed outline of how to construct and use Cornell Note System and how to apply to medical training. Conclusion The outline and unique aspects of the Cornell Note system are discussed, along with how this system can be incorporated into the modern-day curriculum.
Rehabilitation potential: A critical review of its meaning and validity
Authors: Wade Derick T. 
Published: December 2022

Background The concept of rehabilitation potential emerged in 1950 as a way to select people for rehabilitation; it is also used to limit access to services. Objective To elucidate the meaning(s) of rehabilitation potential and whether it is valid in selecting patients for rehabilitation, whether as an inpatient, outpatient, or in the community. Method A non-systematic review of how it has been used, a structured discussion of its potential meanings, an exploration of the evidence in support of selecting people who might benefit from rehabilitation, and a discussion of the concept of rehabilitation potential. Findings It has been used in several ways with two primary meanings: predicting a person's function at some later time; predicting who will gain additional improvement in outcome from being seen by a rehabilitation service. The concept is flawed because rehabilitation is a process, not a specific action; the effects anticipated after rehabilitation are not restricted to functional improvement; patient characteristics do not determine many essential outcomes. There is no evidence to guide the selection of patients for an assessment and formulation by a rehabilitation team. Conclusion Rehabilitation potential, defined as data that gives the likelihood of additional benefit from receiving input from an expert rehabilitation service, is an illusion lacking any coherent definition, description, or evidence. Its use to limit access to rehabilitation is invalid. The solution is to offer all people not recently seen by an expert multi-professional rehabilitation team a full rehabilitation assessment and formulation, which will reveal what rehabilitation might achieve.
Comparison of rotational and standard methods of i-gel® insertion in patients of advanced age undergoing general anesthesia: a randomized clinical trial
Authors: Duan Jinjuan , Sun Linglu , Lu Yao , Wang Shengbin 
Published: December 2022

Objective This study was performed to compare the performance of rotational versus standard insertion of the i-gel® (Intersurgical, Wokingham, Berkshire, England) in patients of advanced age. Methods This single-center, randomized, double-blind trial involved 140 patients of advanced age undergoing general anesthesia. The patients were randomized into the standard group and rotational group. The primary objective of this study was to compare the success rate of the first attempt. The secondary outcome indicators were the insertion time and postoperative complications. Results The placement success rate on the first attempt was significantly higher in the rotational group than in the standard group (92% vs. 73%, respectively). The overall success rate was 100% for the rotational method and 95% for the standard method. The mean ± standard deviation insertion times were similar (15 ± 7.34 vs. 14 ± 7.26 s, respectively). The incidence rates of blood staining of the i-gel®, hoarseness, and sore throat did not increase with the rotational technique and were not significantly different from those of the standard method. Conclusion Compared with the standard method, the rotational method of i-gel® insertion had a higher success rate and did not increase the insertion time and complications in patients of advanced age. Trial registration: This trial was registered at the Chinese Clinical Trial Registry (ChiCTR2000038763, Date of registration: 30/09/2020).
Moral distress, moral courage, and career identity among nurses: A cross-sectional study
Authors: Peng Mengyun , Saito Shinya , Guan Hong , Ma Xiaohuan 
Published: December 2022

Background The concept of career identity is integral to nursing practices and forms the basis of the nursing professions. Positive career identity is essential for providing high-quality care, optimizing patient outcomes, and enhancing the retention of health professionals. Therefore, there is a need to explore potential influencing variables, thereby developing effective interventions to improve career identity. Objectives To investigate the relationship between moral distress, moral courage, and career identity, and explore the mediating role of moral courage between moral distress and career identity among nurses. Design A quantitative, cross-sectional study. Methods A convenient sample of 800 nurses was recruited from two tertiary care hospitals between February and March 2022. Participants were assessed using the Moral Distress Scale-revised, Nurses’ Moral Courage Scale, and Nursing Career Identity Scale. This study was described in accordance with the STROBE statement. Ethical consideration Research ethics approval was obtained from the researcher’s university and hospital where this study was conducted prior to data collection. Findings Moral distress is negatively associated while moral courage is positively associated with career identity among nurses. Moral courage partially mediates the relationship between moral distress and career identity ( β = −0.230 to −0.163, p < 0.01). Discussion The findings reveal a relationship between moral distress, moral courage, and career identity among nurses. Conclusion By paying attention to nurses’ moral distress and courage, healthcare providers can contribute to the development of effective interventions to improve career identity, and subsequently performance, among nurses.
Studies on the optimization of decontamination protocol for surfaces contaminated with cytotoxic drugs in PIVAS
Authors: Yuan Zhongzhen , Li Qiaoqiao , Tang Tiantian , Zhang Min , Liu Yu , Liu Ling 
Published: December 2022

Purpose The goal of this study was to create a cleaning procedure by comparing the performance of six different cleaning methods on the surfaces in pharmacy intravenous admixture service (PIVAS) work area. Method A stainless steel plate was simulating contaminated by gemcitabine, cyclophosphamide, epirubicin, etoposide, and paclitaxel, which was then dried and cleaned by per current cleaning protocols. The residues were collected and quantified by ultra-performance liquid chromatography–tandem mass spectrometry (UPLC–MS/MS). Based on the most appropriate cleaning protocol, three cleaning variables were optimized: (1) use of dry gauze after cleaning agent application; (2) cleaning paths (inside-out vs. outside-in); (3) cleaning times (once or twice). Best conditions were tested with real samples from a hospital PIVAS. Results This 10–2 M sodium dodecyl sulfate (SDS) and dry gauze cleaning protocol increases cleaning efficiency as well as saves time. Different from the traditional cleaning manner, we found that cleaning from outside to inside can not only improve the cleaning efficiency but also overcome the uneven distribution of drug residues caused by cleaning action. When simulating contamination at a high dose (4 mg/mL) level, it was found that the decontamination efficacy increased with repeating one more time. Conclusion The 10–2 M SDS and dry gauze cleaning protocol could obtain the best cleaning effect. The success of cytotoxic drug decontamination is determined not only by the cleaning solution, but also by the cleaning route and frequency. Compared with the traditional cleaning manner, there was a significant reduction in the contamination levels in the PIVAS work area after the cleaning protocol with 10–2 M SDS and dry gauze.
Etoposide hypersensitivity reactions associated with in-line filter use: A retrospective cohort study at CHU de Québec-Université Laval
Authors: Dodier Kelly , Laverdière Isabelle , Roy Marie-Julie 
Published: December 2022

Introduction A case series of hypersensitivity reactions (HSRs) during intravenous administration of etoposide was observed following the introduction of in-line filters (ILFs) at a specialized university-affiliated center. This raised questions about the possible involvement of filters in these reactions. Despite there being very little published evidence to inform clinical decision making in this potentially clinically significant situation, the use of ILFs was discontinued at this center pending further investigation. The aims of this study were to evaluate the cumulative incidence of etoposide-related HSR with and without the use of ILF and to describe the reactions in adult and pediatric patients with cancer. Methods A retrospective cohort study was performed among all pediatric and adult patients treated with intravenous etoposide at a maximal concentration of 0.4 mg/mL at our center between 30 September 2015 and 16 August 2018. This covered periods of time during which ILFs were used, as well as 6 months before their implementation and after their withdrawal. Data were extracted from medical records and cumulative incidence was calculated for each of the time periods (pre-ILF, ILF, and post-ILF) as the proportion of patients who recorded an HSR (one or more). Confidence intervals were calculated for each proportion using Fisher's Exact 95%. Comparisons of proportions between time periods were performed using Exact Pearson Chi-squared tests. Data were stratified by a number of perfusion cycles (single cycle or multiple cycles) and by patient population (adult and pediatric). Results A total of 284 patients were included in the study. The overall cumulative incidence of etoposide HSR was 9.9%. The cumulative incidence of HSR tended to be higher during ILF use when compared with combined pre- and post-ILF periods (12.2% [95% CI: 7.9–17.8] vs. 5.2% [95% CI: 1.7–11.7], p  =  0.09). In patients who received multiple cycles of etoposide, the cumulative incidence of HSRs was higher during ILF use when compared with combined pre- and post-ILF periods (15.0% [95% CI: 9.6–21.8] vs. 3.9% [95% CI: 0.8–11.0], p  =  0.01). The majority of HSRs' maximal severity were grade 1 or 2 (85.7%) according to Common Terminology Criteria for Adverse Events ( CTCAE) version 4.0. Conclusions This study suggests a link between the use of ILFs and increased incidence of HSR during etoposide perfusion.
Human Health Risk Assessment due to Heavy Metals in Ground and Surface Water and Association of Diseases With Drinking Water Sources: A Study From Maharashtra, India
Authors: Mawari Govind , Kumar Naresh , Sarkar Sayan , Frank Arthur L , Daga Mradul Kumar , Singh Mongjam Meghachandra , Joshi Tushar Kant , Singh Ishwar 
Published: December 2022

Background: Contamination of freshwater sources can be caused by both anthropogenic and natural processes. According to Central Pollution Control Board, Maharashtra along with 2 other states, contribute 80% of hazardous waste generated in India, including heavy metal pollution. Hence, it is important to quantify heavy metal concentrations in drinking water sources in such areas. Materials and methods: Water samples were analyzed for toxic elements (F, As, Cd, Hg, Pb, Ni, Cu, Zn, Mn, and Cr) using Inductively Coupled Plasma-Mass Spectrometry (ICP-MS) Agilent 7500. Health risks due to ingestion and dermal contact was assessed. A total of 557 people were randomly selected, with consumers from all 4 types of water sources that is surface water, hand pump, wells, and municipal water. Spot urine samples were collected from 47 people after considering inclusion and exclusion criteria. Urine was collected for estimating mercury and arsenic levels in the study participants. Results: Arsenic contributes the most health risk from ingestion from water. Among surface water users, 14 people (32%) reported frequent loose stool ( P-value < .05) (OR 2.5), and 11 people (23%) reported frequent abdominal pain (OR 1.9). Hand pump and well water users reported frequent abdominal pain (27%) (OR 1.4) and gastric discomfort (31%) ( P-value < .05) (OR 3) respectively. The mean value of urinary Hg and As were 4.91 ± 0.280 and 42.04 ± 2.635 µg/L respectively. Conclusion: Frequent loose stool, gastric discomfort, and frequent abdominal pain were associated with the various sources of drinking water. Urine Hg levels were found higher than the NHANES (USA) Survey. It is recommended that frequent monitoring of drinking water should be enforced around the industrial hub, so that appropriate actions can be taken if present in excess.
Trends in the Surgical Management of Thoracic Outlet Syndrome
Authors: Issa Tariq Z. , Lin Jasmine S. , Herrera Fernando , Mailey Brian 
Published: December 2022

Background: The operative treatment for thoracic outlet syndrome (TOS) varies in the United States. This may be due to differences in specialty training of the provider. We sought to identify which procedures are primarily performed by specialty, identify patient characteristics presenting for different neurogenic TOS surgical interventions, and describe the safety of TOS surgery. Methods: Patients treated for neurogenic TOS between 2016 and 2018 were identified from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP). Patient characteristics, surgeon details, intraoperative variables, and complication outcomes were abstracted. Patient cohorts were stratified by type of operative intervention and by treating specialty. Results: Transthoracic first rib resection was the most common procedure performed for TOS relief (46.1%), followed by division of the scalene muscles with rib resection (23.9%) and brachial plexus exploration with decompression (19.4%). Vascular surgeons performed 87% of TOS repairs. Thirty-day complication rate was 3.5%. Addition of scalenectomy to first rib resection was common and resulted in increased operative time but did not increase early complication rate or readmission rate. Conclusion: Patient characteristics and dispositions are similar between the various TOS operative approaches. All major surgical treatments for TOS have low complication rates. Transthoracic first rib resection performed by vascular surgeons remains the most common surgical treatment for patients with TOS in the United States. Despite neurogenic symptoms representing most cases, less than 10% of operations are performed by peripheral nerve specialists, highlighting a potential need for greater incorporation of TOS release into peripheral nerve practices.
Pain Control and Satisfaction With Peripheral Nerve Blocks for Upper Extremity Surgery
Authors: Wu Caroline M. , Gary Cyril S. , Karim Kristin E. , Sanghavi Kavya K. , Murphy Michael S. , Hobelmann J. Todd , Giladi Aviram M. 
Published: December 2022

Background: Regional anesthesia (“block”) is an important component of upper extremity (UE) surgery pain control. However, little is known about patient experience related to perioperative opioid use. This study assessed patient-reported pain control and satisfaction with UE blocks and evaluated how opioid consumption impacted these outcomes before the block “wore off.” Methods: A postoperative phone survey was administered to patients who underwent outpatient UE surgery at a surgery center for more than 16 months. It assessed pain scores (scale 1-10), satisfaction with block duration (scale 1-5), duration until return of UE function, and opioid consumption. Analyses used Mann-Whitney U tests, Fisher exact tests, and bivariate and multivariable linear and ordered logistic regressions to understand relationships between opioid use and outcomes. Results: A total of 509 patients (61%) completed the survey, and 441 (88%) were satisfied with block duration. Initial and final pain scores were significantly higher in patients who took opioids prior to the block wearing off (6 and 4.5, P = .04 and 3.5 and 2, P = .002, respectively). Although satisfaction with block duration was not different in group comparisons (ie, patients who premedicated vs those who did not), in a multivariable analysis, patients who premedicated with opioids had 78% increased odds of reporting the highest level of satisfaction compared with the lower 4 levels ( P = .03). Conclusions: Upper extremity blocks are associated with high overall patient satisfaction and postsurgical pain control. Premedicating before the block wears off may increase patient satisfaction with block duration even if pain is not notably impacted.