bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aortic Body Chemoreceptors Regulate Coronary Blood Flow in Conscious Control and Hypertensive Sheep
Authors: Pen Dylan , Shanks Julia , Barrett Carolyn , Abukar Yonis , Paton Julian F.R. , Ramchandra Rohit 
Published: May 2022

Background:
Peripheral arterial chemoreceptors monitor the chemical composition of arterial blood and include both the carotid and aortic bodies (ABs). While the role of the carotid bodies has been extensively studied, the physiological role of the ABs remains relatively under-studied, and its role in hypertension is unexplored. We hypothesized that activation of the ABs would increase coronary blood flow in the normotensive state and that this would be mediated by the parasympathetic nerves to the heart. In addition, we determined whether the coronary blood flow response to stimulation of the ABs was altered in an ovine model of renovascular hypertension.

Methods:
Experiments were conducted in conscious and anesthetized ewes instrumented to record arterial pressure, coronary blood flow, and cardiac output. Two groups of animals were studied, one made hypertensive using a 2 kidney one clip model (n=6) and a sham-clipped normotensive group (n=6).

Results:

Activation of the ABs in the normotensive animals resulted in a significant increase in coronary blood flow, mediated, in part by a cholinergic mechanism since it was attenuated by atropine infusion. Activation of the ABs in the hypertensive animals also increased coronary blood flow (
P
<0.05), which was not different from the normotensive group. Interestingly, the coronary vasodilation in the hypertensive animals was not altered by blockade of muscarinic receptors but was attenuated after propranolol infusion.

Conclusions:
Taken together, these data suggest that the ABs play an important role in modulating coronary blood flow and that their effector mechanism is altered in hypertension.
Improved Diagnostic Accuracy of Clonidine Suppression Testing Using an Age-Related Cutoff for Plasma Normetanephrine
Authors: Remde Hanna , Pamporaki Christina , Quinkler Marcus , Nölting Svenja , Prejbisz Aleksander , Timmers Henri J.L.M. , Masjkur Jimmy , Fuss Carmina T. , Fassnacht Martin , Eisenhofer Graeme , Deutschbein Timo 
Published: May 2022

Background:
Moderately elevated plasma normetanephrine (NMN) levels are frequent among patients with suspected pheochromocytoma and paraganglioma (PPGL). Clonidine suppression testing (CST) is recommended to distinguish patients with from those without PPGL. We aimed at evaluating the diagnostic outcome of CST in patients with moderate NMN elevations.

Methods:
Data from patients participating in the PMT study (Prospective Monoamine-Producing Tumor) and the ENSAT (European Network for the Study of Adrenal Tumours) registry in 6 European reference centers were analyzed retrospectively. Eighty-nine patients with suspected PPGL and moderate NMN elevations upon screening were included. During follow-up, PPGL was confirmed in 16 and excluded in 73 cases. Plasma NMN was measured by liquid chromatography tandem mass spectrometry before and 180 minutes after oral clonidine. Receiver operating characteristic analysis was performed to identify optimal cutoffs.

Results:
If published diagnostic criteria for CST (ie, NMN ≥112 ng/L and NMN suppression <40%) were applied, a sensitivity of 88% (CI, 61%–98%) and a specificity of 97% (CI, 90%–100%) were observed. An improved cutoff for plasma NMN 180 minutes after clonidine was established at 80% of the age-related upper limit of normal, resulting in a sensitivity of 94% and a specificity of 97%. False-negative CST results occurred in 2 patients with small PPGL.

Conclusions:
This study, involving one of the largest cohorts of patients with suspected PPGL and moderately elevated NMN, confirmed the diagnostic accuracy of CST. The application of an adapted cutoff further improved sensitivity.
Vascular Disorders of Pregnancy Increase Susceptibility to Neonatal Pulmonary Hypertension in High-Altitude Populations
Authors: Heath-Freudenthal Alexandra , Toledo-Jaldin Lilian , von Alvensleben Inge , Lazo-Vega Litzi , Mizutani Rodrigo , Stalker Margaret , Yasini Hussna , Mendizabal Fanny , Dorado Madera Jesus , Mundo William , Castro-Monrroy Melany , Houck Julie A. , Moreno-Aramayo Any , Miranda-Garrido Valquiria , Su Emily J. , Giussani Dino A. , Abman Steven H. , Moore Lorna G. , Julian Colleen G. 
Published: May 2022

Background:
Preeclampsia and fetal growth restriction increase cardiopulmonary disease risk for affected offspring and occur more frequently at high-altitude (≥2500 m). Retrospective studies indicate that birth to a preeclampsia woman at high altitude increases the risk of pulmonary hypertension (PH) in later life. This prospective study asked whether preeclampsia with or without fetal growth restriction exaggerated fetal hypoxia and impaired angiogenesis in the fetal lung, leading to neonatal cardiopulmonary circulation abnormalities and neonatal or infantile PH.

Methods and Results:
We studied 79 maternal-infant pairs (39 preeclampsia, 40 controls) in Bolivia (3600–4100 m). Cord blood erythropoietin, hemoglobin, and umbilical artery and venous blood gases were measured as indices of fetal hypoxia. Maternal and cord plasma levels of angiogenic (VEGF [vascular endothelial growth factor]) and antiangiogenic (sFlt1 [soluble fms-like tyrosine kinase]) factors were determined. Postnatal echocardiography (1 week and 6–9 months) assessed pulmonary hemodynamics and PH. Preeclampsia augmented fetal hypoxia and increased the risk of PH in the neonate but not later in infancy. Pulmonary abnormalities were confined to preeclampsia cases with fetal growth restriction. Maternal and fetal plasma sFlt1 levels were higher in preeclampsia than controls and positively associated with PH.

Conclusions:
The effect of preeclampsia with fetal growth restriction to increase fetal hypoxia and sFlt1 levels may impede normal development of the pulmonary circulation at high altitude, leading to adverse neonatal pulmonary vascular outcomes. Our observations highlight important temporal windows for the prevention of pulmonary vascular disease among babies born to highland residents or those with exaggerated hypoxia in utero or newborn life.
Mechanisms for Extreme Precipitation Changes in a Tropical Archipelago
Authors: Argüeso Daniel , Luca A. Di , Jourdain N. C. , Romero R. , Homar V. 
Published: May 2022

Abstract
The Maritime Continent is one of the most challenging regions for atmospheric models. Processes that modulate deep convection are poorly represented in models, which affects their ability to simulate precipitation features accurately. Thus, future projections of precipitation over the region are prone to large uncertainties. One of the key players in modeling tropical precipitation is the convective representation, and hence convection-permitting experiments have contributed to improve aspects of precipitation in models. This improvement creates opportunities to explore the physical processes that govern rainfall in the Maritime Continent, as well as their role in a warming climate. Here, we examine the response to climate change of models with explicit and parameterized convection and how that reflects in precipitation changes. We focus on the intensification of spatial contrasts as precursors of changes in mean and extreme precipitation in the tropical archipelago. Our results show that the broad picture is similar in both model setups, where islands will undergo an increase in mean and extreme precipitation in a warmer climate and the ocean will see less rain. However, the magnitude and spatial structure of such changes, as well as the projection of rainfall percentiles, are different across model experiments. We suggest that while the primary effect of climate change is thermodynamical and it is similarly reproduced by both model configurations, dynamical effects are represented quite differently in explicit and parameterized convection experiments. In this study, we link such differences to horizontal and vertical spatial contrasts and how convective representations translate them into precipitation changes.
An Investigation of the Effective Climate Sensitivity in GFDL’s New Climate Models CM4.0 and SPEAR
Authors: Zhao Ming 
Published: May 2022

Abstract
Despite a relatively low climate sensitivity indicated by atmospheric-only simulations with uniform sea surface temperature (SST) warming, GFDL’s new climate model CM4.0 participating in CMIP6 and the seasonal-to-decadal prediction system SPEAR, both of which use an identical atmospheric model AM4.0, produce relatively high effective climate sensitivity (EffCS). The substantial increase in CM4.0’s EffCS is found to be caused by additional positive forcing associated with the CO2 fertilization effect on vegetation, enhanced positive feedback due to stronger reduction in Southern Hemisphere (SH) sea ice concentration (SIC), and clouds whose feedback depends on SST warming patterns. Compared to a SPEAR run using a static vegetation model (SPEAR-SV), CM4.0 produces roughly 30% larger EffCS, among which roughly 1/3 of the increase is due to dynamical vegetation with the rest due primarily to changes in SIC. Although cloud feedback does not explain the key feedback differences among CM4.0, SPEAR, and SPEAR-SV, it is the primary cause of the models’ increase (less negative) in TOA net feedback during the later period of their quadrupling CO2 simulations due to changes in their SST warming patterns. Moreover, CM4.0’s SST warming pattern and its effects on cloud feedback appear to be the leading cause of CM4.0’s EffCS increase compared to the earlier generation GFDL model ESM2M, which produces one of the lowest EffCS values among CMIP5 models. In comparison, CM4.0’s enhanced reduction in SH SICs plays a slightly less important role in its increase in EffCS compared to ESM2M.
Remotely Monitored Buoys for Observing the Growth and Development of Sea Ice In Situ
Authors: Obbard Rachel W. , Bradley Alice C. , Rigor Ignatius 
Published: May 2022

Abstract
This paper describes a remotely monitored buoy that, when deployed in open water prior to freeze up, permits scientists to monitor not only temperature with depth, and hence freeze up and sea ice thickness, but also the progression of sea ice development—e.g., the extent of cover at a given depth as it grows (solid fraction), the brine volume of the ice, and the salinity of the water just below, which is driven by brine expulsion. Microstructure and In situ Salinity and Temperature (MIST) buoys use sensor “ladders” that, in our prototypes, extend to 88 cm below the surface. We collected hourly measurements of surface air temperature and water temperature and electrical impedance every 3 cm to track the seasonal progression of sea ice growth in Elson Lagoon (Utqiaġvik, Alaska) over the 2017/18 ice growth season. The MIST buoy has the potential to collect detailed sea ice microstructural information over time and help scientists monitor all parts of the growth/melt cycle, including not only the freezing process but the effects of meteorological changes, changing snow cover, the interaction of meltwater, and drainage.

Significance Statement
There is a need to better understand how an increasing influx of freshwater, one part of a changing Arctic climate, will affect the development of sea ice. Current instruments can provide information on the growth rate, extent, and thickness of sea ice, but not direct observations of the structure of the ice during freeze up, something that is tied to salinity and local air and water temperature. A first deployment in Elson Lagoon in Utqiaġvik, Alaska, showed promising results; we observed fluctuations in ice temperatures in response to brief warmings in air temperature that resulted in changes in the conductivity, liquid fraction, and brine volume fraction within the ice.
Skill Assessment of NCEP Three-Way Coupled HWRF–HYCOM–WW3 Modeling System: Hurricane Laura Case Study
Authors: Kim Hyun-Sook , Meixner Jessica , Thomas Biju , G. Reichl Brandon , Liu Bin , Mehra Avichal , Wallcraft Alan 
Published: May 2022

Abstract
In this research, we develop a three-way coupled prediction system to advance the realization of air–sea interaction processes. This study considers the sea-state-dependent momentum flux and nonlinear interactions between waves, winds, and ocean currents using the U.S. National Centers for Environmental Prediction’s operational Hurricane Weather Research and Forecasting (HWRF)-Hybrid Coordinate Ocean Model (HYCOM) coupled modeling system. Wave feedback is performed through the air–sea interaction module (ASIM) added to WAVEWATCH III (WW3), which employs the wave boundary layer to parameterize unresolved high-frequency tail spectra by using the mean flux profile constructed from the conservation of total momentum and wave energy. The atmospheric momentum flux is updated using the sea-state-dependent Charnock coefficient, wave-induced stress, and ocean surface currents before being passed to HYCOM. Wave coupling in HYCOM includes Coriolis–Stokes forcing to simulate wave–current interactions and to enhance mixing to account for Langmuir turbulence. The fully coupled system is tested for Hurricane Laura (2020). This paper examines the forecast skills of the individual component models by comparing simulations with observations. Without skill degradation of HYCOM and WW3, the three-way coupling method improves the track and intensity forecast skills by 5% each over those of HWRF-HYCOM coupling, and 27% and 17% over those of uncoupling, respectively. Importantly, this fully coupled system outperforms rapid intensification by reducing the intensification magnitude and matching the occurrence and duration. Overall, the forecast performance evaluated in the study establishes a baseline for the next-generation hurricane prediction system.

Significance Statement
This study is the documentation of the numerical advancement of tropical cyclone (TC) forecasting and the demonstration of the improvement of the TC intensity forecast. A key asset is the importance of wave coupling and inclusion of the nonlinear interactions in the air–sea interaction zone, and is to advance the current U.S. NCEP operational coupled hurricane modeling system. By assessing simulations for Hurricane Laura (2020), we demonstrate skill improvement of the storm structure, and intensity forecasts, especially for rapid intensification (RI) by correcting the timing and the magnitude of RI simulated by uncoupling and two-way coupling.
Laparoscopic Heller Myotomy With EGD and Balloon Dilation: A Durable Solution for Achalasia
Authors: Zambetti Benjamin R. , Murphy William G. , Craner Domenic , Wong Denise L. , Pettigrew Benjamin D. , Webb David L. , Voeller Guy R. , Stoikes Nathaniel F. N. 
Published: May 2022

Background Laparoscopic Heller myotomy (LHM) and esophageal balloon dilation (BD) are the two mainstays of achalasia treatment—this study examines the outcomes when they are performed simultaneously without fundoplication. Methods All patients undergoing LHM&BD were reviewed for demographic and procedural data, and to see if additional procedures for achalasia had been performed. Patients were surveyed using the Eckardt score and the GERD quality-of-life score (GERD-HRQL) to assess the durability of repair. Results From 2013-2020, 66 patients underwent LHM&BD. There were no esophageal perforations and a median LOS of 1 day. Seven patients have required additional operations or procedures at median 4-years follow up. 31 patients (47%) responded to the survey. The average Eckardt score was 2.9 (goal<4) with mean GERD-HRQL of 14.4 (goal<25). Conclusions LHM&BD allows for a safe, durable repair of achalasia. Reflux symptoms are manageable with PPI without fundoplication and the re-intervention rate similar to published values.
Mariátegui, Race, and the Comintern’s National Question
Authors: Becker Marc 
Published: May 2022

José Carlos Mariátegui’s open engagement with Marxist theory and his adaptation of its ideas to his Latin American reality brought him into conflict with other leftists. At a continental conference of communist parties in Buenos Aires in 1929, he criticized the Comintern’s proposal to carve up the Americas into independent African-descent and Quechua and Aymara republics, arguing that conceptualizing the struggle in ethnic rather than class terms was a mistake. From documents preserved in the Comintern archives it appears that these comments had echoes in Moscow. Two newly translated Spanish-language documents on the “national question” challenge notions that Comintern officials were unaware of or ill-informed about developments in Latin America and are important to understanding their responses and challenges to his ideas on race and oppressed nationalities. El compromiso abierto de José Carlos Mariátegui con la teoría marxista y su adaptación de estas ideas a la realidad latinoamericana lo pusieron en conflicto con otras y otros de la izquierda. En una conferencia continental de partidos comunistas en Buenos Aires en 1929, criticó la propuesta de la Internacional Comunista de dividir las Américas en repúblicas independientes afrodescendientes y quechuas y aymaras, argumentando que conceptualizar la lucha en términos étnicos en lugar de términos de clase era un error. Los documentos conservados en los archivos de la Internacional Comunista sugieren que estos comentarios hicieron eco en Moscú. Dos documentos en español recientemente traducidos en torno a la “cuestión nacional” desafían las nociones de que los funcionarios de la Internacional Comunista no estaban al tanto o estaban mal informados sobre los acontecimientos en América Latina, asunto que resultan importante para comprender sus respuestas y desafíos a las ideas de Mariátegui sobre raza y nacionalidades oprimidas.
ECMO simulation training during a worldwide pandemic: The role of ECMO telesimulation
Authors: Wong Alfred SK , Marwali Eva M , Maclaren Graeme , Ogino Mark , Fraser John , Chi Keung Peter Lai , Fitria Liza , Adriane Prieta , Sin Simon WC 
Published: May 2022

Background: Extracorporeal membrane oxygenation (ECMO) is a supportive therapy used in the most severe forms of acute respiratory distress syndrome. Due to its intrinsic complexity and relatively low annual volume, simulation is essential for efficient and appropriate ECMO management. COVID-19 has limited the opportunities for high-fidelity in-person simulation training when many hospitals are looking to expand their ECMO services to battle the ongoing pandemic. To meet this demand, the National Cardiovascular Center Harapan Kita, Jakarta, Indonesia, conducted a 3-day ECMO course entailing online didactic lectures (adult and paediatric stream), water drills and telesimulation. Purpose: The purpose of the study is to report the evaluation result of this novel model of education during COVID-19 outbreak. Data collection: Participants were given an ECMO knowledge pre-course and post-course test and a telesimulation evaluation survey at the conclusion and these data were collected. Results: The course was attended by 104 physicians, critical care nurses and perfusionists. Pre-course and post-course assessments showed a significant improvement in ECMO knowledge (60.0% vs 73.3%, respectively). Overall, the participants rated the telesimulation positively, and most found it acceptable to in-person simulation training considering the pandemic restrictions. Conclusion: Despite the complexities of ECMO, our recent experience demonstrates ECMO education and simulation delivered online is feasible, welcomed and supportive of a change in ECMO training course format. As we incorporate more innovative digital technologies, telesimulation may further enhance the quality of future ECMO training.
Development of Perceived Family Support and Positive Mental Health in Junior High School Students: A Three-Year Longitudinal Study
Authors: Hu Shiyue , Cai Dan 
Published: May 2022

The study aimed to explore the development trend of positive mental health and the interaction between adolescents’ perceived family support and positive mental health. A 3-year longitudinal survey of perceived family support and positive mental health (resilience and self-efficacy) for four waves was conducted with 564 junior high school students (297 girls, mean age = 11.12 ± 0.38 years at baseline). The Latent Growth Curve Modeling indicated that adolescents’ resilience and general self-efficacy showed a curve upward trend, which increased first and then decreased. The development rate decreased each year. The cross-lagged panel model and a random intercept cross-lagged panel model concluded that perceived family support was strongly associated with positive mental health of junior high school students. Family support was important for developing positive mental health in early adolescence. Therefore, attention and interventions targeting positive mental health changes in early adolescence are particularly effective. And, it is important to encourage parents of adolescents to continue to provide support and guidance.
Communication of Code Status Escalation for Nurses and Physicians in the Intensive Care Unit: A Case Study
Authors: Paddley Brianna , Espin Sherry , Indar Alyssa , Rose Don , Bookey-Bassett Sue 
Published: May 2022

Background Interprofessional teams working in the Intensive Care Unit (ICU) care for patients requiring varying degrees of life sustaining therapy. A patient's code status can help clinicians to understand the appropriate life support measures to deliver to patients in this setting. Members of the interprofessional team, such as physicians and nurses, can experience challenges related to communication when the code status is unclear. Purpose The purpose of this study was to explore how nurses and physicians in the ICU experience communication of code status escalations. Methods A qualitative case study approach was used. Participants were physicians and nurses, working in the medical-surgical ICU of a large, urban academic hospital. Data were collected using semi-structured interviews, observations of health care rounds and a chart review. Data were analyzed using qualitative content analysis. Results Thematic findings include: (1) engaging in an interprofessional discussion, (2) finding consistent documentation, (3) revisiting the code status, and (4) telling the patient story. The study findings also provide contextual information about participants’ experiences of code status communication during the first wave (February 2020 to May 2020) of the COVID-19 pandemic. Conclusions The results of this study could inform standard communication frameworks or practices related to dissemination of code status decisions among members of the ICU team.