bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Numerical Study of Downbursts Using the BLASIUS Model
Authors: Liu Hongchao , Huang Qian , Chou Yan , Tian Hongying , Zhang Yunshuai , Wu Xixi , Zhang Junxia , Wang Minzhong 
Published: August 2022

Abstract
Downbursts can produce severe damage in near-ground areas and can also pose serious threats to aircraft in flight. In this study, a high-resolution boundary layer model—the Boundary Layer Above Stationary, Inhomogeneous Uneven Surface (BLASIUS) model—is used to simulate the evolution of a downburst. The observational data collected in Tazhong, China, located in hinterland of the Taklimakan Desert, during the Boundary Layer Comprehensive Observational Experiment on 27 July 2016 are used as the thermodynamic initial field for the BLASIUS model. In addition, the impacts of the terrain on the structure, turbulence intensity, and maximum wind speed of the downburst are also investigated. The results show that the BLASIUS model can simulate the structure and evolution characteristics of downbursts. The cold pool becomes warm if an isolated hill is implanted in the model under the same model conditions. Both the movement speed of the head and the average wind speed of the downburst decrease, while the maximum wind speed increases. The scale of the hill affects the dynamic and thermodynamic structures of the downburst through obstruction and entrainment mixing. The maximum wind speeds occur on the windward slope, and the downburst passes over the hill in the various tests with a hill. The head of the cold pool becomes narrow and tall for larger hill width cases. The Froude number generally decreases as the height of the hill increases, and the downburst can pass over the hill. The results are helpful to improve our understanding of the effects that terrain blocking on downburst structure and near-ground wind shear.

Significance Statement
Downbursts have the potential to cause significant damage to building structures and agricultural production and to cause unpredictable serious disasters. It is particularly important to understand the structure and evolution of downbursts. In addition, the influence of the topography on the structure and intensity of turbulent vortices during a downburst remain unclear. The results show that the Boundary Layer Above Stationary, Inhomogeneous Uneven Surface (BLASIUS) model can simulate the structure and evolution characteristics of downbursts. The cold pool becomes warm if an isolated hill is implanted in the model. The scale of the hill affects the dynamic and thermodynamic structures of the downburst through obstruction and entrainment mixing. The Froude number generally decreases as the height of the hill increases, and the downburst can pass over the hill.
Influences of Spring Land Surface Thermal Anomalies over West Asia on Indian Early Summer Monsoon Activity and Its Pathway
Authors: Yang Jingqiu , Chen Haishan 
Published: August 2022

Abstract
Exploring the premonsoonal land thermal predictor of the Indian summer monsoon is a hot topic under the background of global warming, and West Asia is one of the regions with the most significant warming in spring. In this study, we investigated the impact of anomalous spring land surface warming over West Asia on early summer (June) Indian monsoon precipitation as well as its possible mechanisms based on statistical analysis and numerical simulations. It has been found that spring land surface anomalous warming over West Asia corresponds to the enhancement of the leading mode of early summer precipitation in the Indian subcontinent, especially in its northern part. Further analysis indicates that an anomalously warm land surface over West Asia can advance the transition of atmospheric conditions toward the warm season by heating the atmosphere above. The increased land–sea meridional thermal contrast favors the intensification of the low-level jet and monsoon trough, further inducing anomalous moisture convergence and ascending motion over northern India. Additionally, the heat-driven anomalous upper-tropospheric anticyclone over West Asia favors the intensification of the tropical easterly jet and the northwestward development of the South Asian high (SAH). The enhanced SAH dynamically couples with the lower- to middle-level cyclonic circulation over northern India, resulting in a stronger monsoon and increased precipitation. These findings are helpful for better understanding and prediction of Indian early summer monsoon.

Significance Statement
The land surface thermal condition is critical to the monsoon activity and exploring the premonsoonal land thermal predictor of Indian summer monsoon remains a hot topic. The purpose of this study is to explore how spring land surface thermal anomalies over West Asia impact Indian monsoon activity in early summer (June). The anomalous land surface warming over West Asia can lead to a stronger Indian monsoon in early summer by heating and driving the atmosphere, which benefits the precipitation increase over northern India. Our results provide a further scientific basis for the prediction of early summer Indian precipitation.
Effect of Plastic Bag Extraction in Minimally Invasive Appendectomy
Authors: Moisés De Almeida Leite Rodrigo , de Souza Alexandre Venancio , Cauley Christy , Goldstone Rob , Francone Todd , Bay Camden P. , Ricciardi Rocco 
Published: August 2022

Background Evidence regarding the effects of plastic bag use for appendix removal during minimally invasive appendectomy remains scarce and conflicting. Objective This study aimed to analyze the effects of plastic bag use during minimally invasive appendectomy on preoperative infection risk, morbidity and mortality. Design This retrospective analysis of the prospective National Surgical Quality Improvement Program (NSQIP) cohort program. Setting This study included data from the NSQIP database between the years of 2016 and 2019. Patient Adult patients undergoing minimally invasive (laparoscopic or robotic) without unplanned conversion to open surgery. Intervention Use of plastic bag for specimen removal during appendectomy. Main Outcome Measures Risk ratios for the incidence of superficial surgical site infection, intra-abdominal abscess, overall medical morbidity, and overall mortality. Results There were 43 783 cases of minimally invasive appendectomy in the NSQIP database between the years of 2016 and 2019. Among those who reported information regarding use of plastic bag, 28 589 (91.87%) reported use of plastic bag for specimen removal. Use of plastic bag was associated with a significant decrease in superficial surgical site infection (RR .39 (95% CI: .31-.49), P < .001), and in the risk of postoperative intra-abdominal abscess (RR: 0.66 (.57-.77), P < .001)). We also observed a robust reduction in overall medical-related morbidity and overall mortality, even after adjusting for multiple confounders. Limitations Observational nature of the study cannot exclude residual bias. Also, there was a significant rate of missing values for plastic bag use, which may bias results. Conclusions In this global prospective cohort using NSQIP database, use of plastic bag for appendix removal during minimally invasive appendectomy was associated with a significant improvement in surgical related outcomes and reduction in morbidity and overall mortality.
Neck swelling 19 days after thyroidectomy: A case report of a rare chyle leak patient
Authors: Pan Huili , Jin Peile , Cao Jun , Yang Yan 
Published: August 2022

The occurrence of chyle leak after neck dissection for thyroid carcinoma is uncommon, but it usually occurs within 1–10 days after surgery. We encountered a 30-year-old patient with chyle leak 19 days after the operation for thyroid carcinoma. The initial symptom was swelling of the neck, which was quickly diagnosed as chyle leak by puncture. This report describes the patient’s presentation and discusses the conservative management of this complication. We highlight that more attention should be given to chyle leak in high-risk patients, and stricter dietary management for these patients after surgery may avoid this complication. In addition, timely diagnosis and rapid implementation of various conservative treatment measures play an important role in patient recovery.
Reducing waiting times from 65 to under 40 days for children and adolescents receiving mental health services using a new scheduling policy
Authors: Gullhav Anders N , Skomsvoll Johan F , Heimstad Runa , Schultz Joseph S 
Published: August 2022

The aim of this study is to conduct an intervention that tests whether a new scheduling policy designed to reduce waiting times actually will lead to a reduction in waiting times. The new scheduling policy was developed using mixed methods. Qualitative data was gathered to fully understand current planning processes, while quantitative methods were used to model and predict future waiting times. If current planning practices are continued, waiting times will only increase. Additionally, the findings show that simulation modeling can be used to predict the capacity needed for intakes (first appointment) to reduce and maintain target waiting times over time. In our study, this meant a slight increase in capacity for intakes. This new scheduling policy led to a reduction in waiting times from 65 days in 2016, to under 40 days post-intervention in 2017. Waiting times have been held under 40 days since implementation of the new policy, 2017–2020. Our study shows that setting appropriate (weekly) intake goals, will lead to maintaining acceptable levels of variation in waiting times. This theory was tested and proven to be effective.
Association between feline hyperthyroidism and thoracic radiographic evaluation of cardiomegaly and pulmonary hyperinflation
Authors: Young Victoria , Rao Sangeeta , Shropshire Sarah B , Marolf Angela J 
Published: August 2022

Objectives Hyperthyroidism frequently affects middle-to-older-aged cats that can present with cardiorespiratory signs. The effects of hyperthyroidism on cardiac size and function have been previously documented. Anecdotally, pulmonary hyperinflation identified on thoracic radiographs may also be associated with hyperthyroidism; however, there is no literature to support this claim. The goal of this study was to determine any association between hyperthyroidism, pulmonary hyperinflation and cardiomegaly with the following hypotheses: (1) hyperthyroid cats would not have evidence of radiographic pulmonary hyperinflation compared with control cats; and (2) hyperthyroid cats were more likely to have evidence of radiographic cardiomegaly than control cats. Methods In this retrospective case-control study, the thoracic radiographs of 52 hyperthyroid cats and 46 non-hyperthyroid cats were evaluated for subjective and objective measurements of pulmonary hyperinflation and cardiomegaly. Results There were no statistically significant differences between hyperthyroid and non-hyperthyroid cats for any variable indicative of pulmonary hyperinflation. The mean ± SD vertebral heart score on lateral views for hyperthyroid cats was 7.75 ± 0.53 and for control cats was 7.55 ± 0.54, which was significantly different ( P = 0.05). Among all cats, a more severe total elevation in thyroxine (T4) was correlated with a larger vertebral heart score on lateral views (Spearman’s correlation coefficient = 0.23, P = 0.02). Conclusions and relevance While the results of this study suggest that hyperthyroid cats are more likely to have a larger vertebral heart score on lateral views than control cats, the clinical relevance of this finding is unclear given the large degree of overlap between hyperthyroid and non-hyperthyroid cats. In addition, among all cats, a greater total T4 elevation was weakly correlated with a larger vertebral heart score. Hyperthyroidism is not associated with radiographic pulmonary hyperinflation and is an unlikely differential for this radiographic finding.
Engineering T cells to suppress acute GVHD and leukemia relapse after allogeneic hematopoietic stem cell transplantation
Authors: Mo Feiyan , Watanabe Norihiro , Omdahl Kayleigh I. , Burkhardt Phillip M. , Ding Xiaoyun , Hayase Eiko , Panoskaltsis-Mortari Angela , Jenq Robert R. , Heslop Helen E. , Kean Leslie S. , Brenner Malcolm K. , Tkachev Victor , Mamonkin Maksim 
Published: August 2022

Abstract
Acute graft-versus-host disease (aGVHD) limits the therapeutic benefit of allogeneic hematopoietic stem cell transplantation (allo-HSCT) and requires immunosuppressive prophylaxis that compromises antitumor and antipathogen immunity. OX40 is a costimulatory receptor upregulated on circulating T cells in aGVHD and plays a central role in driving the expansion of alloreactive T cells. Here, we show that OX40 is also upregulated on T cells infiltrating GVHD target organs in a rhesus macaque model, supporting the hypothesis that targeted ablation of OX40+ T cells will mitigate GVHD pathogenesis. We thus created an OX40-specific cytotoxic receptor that, when expressed on human T cells, enables selective elimination of OX40+ T cells. Because OX40 is primarily upregulated on CD4+ T cells upon activation, engineered OX40-specific T cells mediated potent cytotoxicity against activated CD4+ T cells and suppressed alloreactive T-cell expansion in a mixed lymphocyte reaction model. OX40 targeting did not inhibit antiviral activity of memory T cells specific to Epstein-Barr virus, cytomegalovirus, and adenoviral antigens. Systemic administration of OX40-targeting T cells fully protected mice from fatal xenogeneic GVHD mediated by human peripheral blood mononuclear cells. Furthermore, combining OX40 targeting with a leukemia-specific chimeric antigen receptor in a single T cell product provides simultaneous protection against leukemia and aGVHD in a mouse xenograft model of residual disease posttransplant. These results underscore the central role of OX40+ T cells in mediating aGVHD pathogenesis and support the feasibility of a bifunctional engineered T-cell product derived from the stem cell donor to suppress both disease relapse and aGVHD following allo-HSCT.
Phenotypic characteristics and variability in CHARGE syndrome: a PRISMA compliant systematic review and meta-analysis
Authors: Thomas Andrea T. , Waite Jane , Williams Caitlin A. , Kirk Jeremy , Oliver Chris , Richards Caroline 
Published: August 2022

AbstractBackgroundCHARGE syndrome (OMIM #214800) is a phenotypically complex genetic condition characterised by multi-system, multi-sensory impairments. Behavioural, psychological, cognitive and sleep difficulties are not well delineated and are likely associated with biopsychosocial factors.MethodsThis meta-analysis investigated the prevalence of clinical features, physical characteristics and conditions, behavioural, psychological, cognitive and sleep characteristics in CHARGE syndrome, and statistically evaluated directional associations between these characteristics. Pooled prevalence estimates were calculated using reliable, prespecified quality weighting criteria, and meta-regression was conducted to identify associations between characteristics.ResultsOf the 42 eligible studies, data could be extracted for 1675 participants. Prevalence estimates were highest for developmental delay (84%), intellectual disability (64%), aggressive behaviour (48%), self-injurious behaviour (44%) and sleep difficulties (45%). Meta-regression indicated significant associations between intellectual disability and choanal atresia, intellectual disability and inner ear anomalies, sleep difficulties and growth deficiency, and sleep difficulties and gross motor difficulties.ConclusionsOur comprehensive review of clinical features, behavioural, psychological, cognitive and physical characteristics, conditions and comorbidities in CHARGE syndrome provides an empirically based foundation to further research and practice.
Spinal cord infarction secondary to pulmonary embolism-induced cardiac arrest: a case report
Authors: Xu Jianfei , Zhou Xiaoyang , Liu Zhicheng , Xu Zhaojun 
Published: August 2022

Abstract
Background
Pulmonary embolism is a common cause of cardiac arrest. Pulmonary embolism-induced cardiac arrest typically suffers from ischemic injuries to various organs, including the central nervous system. However, spinal cord infarction is a rare complication of pulmonary embolism-induced cardiac arrest. At present, there is no case report on the occurrence of spinal cord infarction secondary to pulmonary embolism-induced cardiac arrest without accompanied cerebral complications.

Case presentation
A 72-year-old woman with dyspnea and chest tightness was admitted to the emergency room. Cardiac arrest occurred within a short period after admission. Subsequent computed tomographic pulmonary angiography revealed multiple pulmonary thromboses, which were highly suspected to be the cause of cardiac arrest. Thrombolytic therapy with alteplase was given after the return of spontaneous circulation. Unfortunately, she was found to be paraplegic in both lower extremities after regaining consciousness. Spinal cord infarction was confirmed by thoracic magnetic resonance imaging.

Conclusions
Despite receiving high-quality cardiopulmonary resuscitation, patients with cardiac arrest are at high risk of ischemic injury to the central nervous system. After the recovery of consciousness, clinicians should pay more attention to preclude the possibility of spinal cord infarction.
Premature ventricular contractions with acute successful radiofrequency catheter ablation near the atrioventricular node using reversed C curve technique
Authors: Hu Zhonghui , Jiang Yunsheng , Wang Su 
Published: August 2022

Abstract
Background
We sought to clarify the electrophysiological (EP) characteristics of premature ventricular contractions (PVCs) with acute successful radiofrequency catheter ablation (RFCA) near the atrioventricular node (AVN).

Methods and results
Eighteen patients with acute successful RFCA near the AVN were included in this study. Systematic mapping was performed with two mapping methods: antegrade mapping technique (group A) and reversed C curve mapping technique (group R). RFCA was preferentially performed underneath the tricuspid valve (TV) with reversed C curve technique in all patients. The a amplitude/v amplitude ratio during sinus rhythm in group A was significantly larger than in group B (0.19 ± 0.10 vs 0.06 ± 0.02, p < 0.01). The earliest bipolar activation preceded the QRS onset in group A was significantly smaller than in group R (19.6 ± 4.9 vs 24.4 ± 6.6 ms (ms), p < 0.01). Pace mapping in group A and group R demonstrated perfect QRS morphology (12/12) match only in 5.6% (one patient) and 16.7% (3 patients) of patients, respectively. The mean duration of successful RFCA was 8.2 ± 2.4 s in 13 patients (72.2%). Early (within 3 days) and late (one-year) recurrence rates were 5.6% (one patient) and 16.7% (3 patients), respectively. No atrioventricular block occurred during RFCA or the one-year follow up.

Conclusions
PVCs near the AVN are a subgroup of idiopathic PVCs with distinctive EP features. RFCA using reversed C curve technique is effective and safe for the acute elimination of these challenging AVN-PVCs.
Procalcitonin in early allograft dysfunction after orthotopic liver transplantation: a retrospective single centre study
Authors: Frick Katja , Beller Elisabeth A. , Kalisvaart Marit , Dutkowski Philipp , Schüpbach Reto A. , Klinzing Stephanie 
Published: August 2022

Abstract
Background
Ischemia–reperfusion injury (IRI) is the pathophysiological hallmark of hepatic dysfunction after orthotopic liver transplantation (OLT). Related to IRI, early allograft dysfunction (EAD) after OLT affects short- and long-term outcome. During inflammatory states, the liver seems to be the main source of procalcitonin (PCT), which has been shown to increase independently of bacterial infection. This study investigates the association of PCT, IRI and EAD as well as the predictive value of PCT during the first postoperative week in terms of short- and long-term outcome after OLT.

Methods
Patients ≥ 18 years undergoing OLT between January 2016 and April 2020 at the University Hospital of Zurich were eligible for this retrospective study. Patients with incomplete PCT data on postoperative days (POD) 1 + 2 or combined liver-kidney transplantation were excluded. The PCT course during the first postoperative week, its association with EAD, defined by the criteria of Olthoff, and IRI, defined as aminotransferase level > 2000 IU/L within 2 PODs, were analysed. Finally, 90-day as well as 12-month graft and patient survival were assessed.

Results
Of 234 patients undergoing OLT, 110 patients were included. Overall, EAD and IRI patients had significantly higher median PCT values on POD 2 [31.3 (9.7–53.8) mcg/l vs. 11.1 (5.3–25.0) mcg/l; p < 0.001 and 27.7 (9.7–51.9) mcg/l vs. 11.5 (5.5–25.2) mcg/l; p < 0.001] and impaired 90-day graft survival (79.2% vs. 95.2%; p = 0.01 and 80.4% vs. 93.8%; p = 0.033). IRI patients with PCT < 15 mcg/l on POD 2 had reduced 90-day graft and patient survival (57.9% vs. 93.8%; p = 0.001 and 68.4% vs. 93.8%; p = 0.008) as well as impaired 12-month graft and patient survival (57.9% vs. 96.3%; p = 0.001 and 68.4% vs. 96.3%; p = 0.008), while the outcome of IRI patients with PCT > 15 mcg/l on POD 2 was comparable to that of patients without IRI/EAD.

Conclusion
Generally, PCT is increased in the early postoperative phase after OLT. Patients with EAD and IRI have a significantly increased PCT maximum on POD 2, and impaired 90-day graft survival. PCT measurement may have potential as an additional outcome predictor in the early phase after OLT, as in our subanalysis of IRI patients, PCT values < 15 mcg/l were associated with impaired outcome.
Clinical characteristics of lacrimal drainage pathway disease-associated keratopathy
Authors: Inoue Hidenori , Toriyama Koji , Ikegawa Wakako , Hiramatsu Yukako , Mitani Arisa , Takezawa Yuki , Sakane Yuri , Kamao Tomoyuki , Hara Yuko , Shiraishi Atsushi 
Published: August 2022

Abstract
Purpose
To report the clinical characteristics of 13 cases of noninfectious corneal ulceration related to lacrimal drainage pathway disease.

Methods
Medical records of 13 patients with lacrimal drainage pathway disease-associated keratopathy who were examined at Ehime University Hospital between April 2007 and December 2021 were analyzed.

Results
The predisposing lacrimal drainage pathway diseases for corneal ulceration were chronic dacryocystitis in seven patients and lacrimal canaliculitis in six patients. The corneal ulcers were located at the peripheral cornea in 10 patients and the paracentral cornea in three patients. All patients indicated few cellular infiltrations of the ulcerated area at the slit-lamp examination. Corneal perforation was found in seven patients. The primary identified organisms were Streptococcus spp. in chronic dacryocystitis and Actinomycetes spp. in lacrimal canaliculitis. All patients showed rapid healing of the epithelial defects after treatment of the lacrimal drainage pathway disease. The mean time elapsed between treatment of the lacrimal drainage pathway disease and re-epithelialization of corneal ulcer was 14.5 ± 4.8 days.

Conclusion
Lacrimal drainage pathway disease-associated keratopathy may be characterized by peripheral corneal ulcer with few cellular infiltrations, occasionally leading to corneal perforation. Treatment of the lacrimal drainage pathway disease could be the most effective treatment for lacrimal drainage pathway disease-associated keratopathy.