bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cancer Prevention with Resistant Starch in Lynch Syndrome Patients in the CAPP2-Randomized Placebo Controlled Trial: Planned 10-Year Follow-up
Authors: Mathers John C. , Elliott Faye , Macrae Finlay , Mecklin Jukka-Pekka , Möslein Gabriela , McRonald Fiona E. , Bertario Lucio , Evans D. Gareth , Gerdes Anne-Marie , Ho Judy W.C. , Lindblom Annika , Morrison Patrick J. , Rashbass Jem , Ramesar Raj S. , Seppälä Toni T. , Thomas Huw J.W. , Sheth Harsh J. , Pylvänäinen Kirsi , Reed Lynn , Borthwick Gillian M. , Bishop D. Timothy , Burn John ,   on behalf of the CAPP2 Investigators
Published: July 2022

Abstract
The CAPP2 trial investigated the long-term effects of aspirin and resistant starch on cancer incidence in patients with Lynch syndrome (LS). Participants with LS were randomized double-blind to 30 g resistant starch (RS) daily or placebo for up to 4 years. We present long-term cancer outcomes based on the planned 10-year follow-up from recruitment, supplemented by National Cancer Registry data to 20 years in England, Wales, and Finland. Overall, 463 participants received RS and 455 participants received placebo. After up to 20 years follow-up, there was no difference in colorectal cancer incidence (n = 52 diagnosed with colorectal cancer among those randomized to RS against n = 53 on placebo) but fewer participants had non-colorectal LS cancers in those randomized to RS (n = 27) compared with placebo (n = 48); intention-to-treat (ITT) analysis [HR, 0.54; 95% confidence interval (CI), 0.33–0.86; P = 0.010]. In ITT analysis, allowing for multiple primary cancer diagnoses among participants by calculating incidence rate ratios (IRR) confirmed the protective effect of RS against non–colorectal cancer LS cancers (IRR, 0.52; 95% CI, 0.32–0.84; P = 0.0075). These effects are particularly pronounced for cancers of the upper GI tract; 5 diagnoses in those on RS versus 21 diagnoses on placebo. The reduction in non–colorectal cancer LS cancers was detectable in the first 10 years and continued in the next decade. For colorectal cancer, ITT analysis showed no effect of RS on colorectal cancer risk (HR, 0.92; 95% CI, 0.62–1.34; P = 0.63). There was no interaction between aspirin and RS treatments. In conclusion, 30 g daily RS appears to have a substantial protective effect against non–colorectal cancer cancers for patients with LS.

Prevention Relevance:
Regular bowel screening and aspirin reduce colorectal cancer among patients with LS but extracolonic cancers are difficult to detect and manage. This study suggests that RS reduces morbidity associated with extracolonic cancers.
See related Spotlight, p. 557
Mortality and Cardiovascular Outcomes in Patients Presenting With Non–ST Elevation Myocardial Infarction Despite No Standard Modifiable Risk Factors: Results From the SWEDEHEART Registry
Authors: Figtree Gemma A. , Vernon Stephen T. , Hadziosmanovic Nermin , Sundström Johan , Alfredsson Joakim , Nicholls Stephen J. , Chow Clara K. , Psaltis Peter , Røsjø Helge , Leósdóttir Margrét , Hagström Emil 
Published: July 2022

Background
A significant proportion of patients with ST‐segment–elevation myocardial infarction (MI) have no standard modifiable cardiovascular risk factors (SMuRFs) and have unexpected worse 30‐day outcomes compared with those with SMuRFs. The aim of this article is to examine outcomes of patients with non–ST‐segment–elevation MI in the absence of SMuRFs.

Methods and Results

Presenting features, management, and outcomes of patients with non–ST‐segment–elevation MI without SmuRFs (hypertension, diabetes, hypercholesterolemia, smoking) were compared with those with SmuRFs in the Swedish MI registry SWEDEHEART (Swedish Web‐System for Enhancement and Development of Evidence‐Based Care in Heart Disease Evaluated According to Recommended Therapies; 2005–2018). Cox proportional hazard models were used. Out of 99 718 patients with non–ST‐segment–elevation MI, 11 131 (11.2%) had no SMuRFs. Patients without SMuRFs had higher all‐cause and cardiovascular mortality at 30 days (hazard ratio [HR], 1.20 [95% CI, 1.10–1.30],
P
<0.0001; and HR, 1.25 [95% CI, 1.13–1.38]), a difference that remained after adjustment for age and sex. SMuRF‐less patients were less likely to receive secondary prevention statins (76% versus 82%); angiotensin‐converting enzyme inhibitors/angiotensin receptor blockade (54% versus 72%); or β‐blockers (81% versus 87%,
P
for all <0.0001), with lowest rates observed in women without SMuRFs. In patients who survived to 30 days, rates of all‐cause and cardiovascular death were lower in patients without SMuRFs compared with those with risk factors, over 12 years.

Conclusions
One in 10 patients presenting with non–ST‐segment–elevation MI present without traditional risk factors. The excess 30‐day mortality rate in this group emphasizes the need for both improved population‐based strategies for prevention of MI, as well as the need for equitable evidence‐based treatment at the time of an MI.
Incidence and Risk Factors for Residual Adverse Events Despite Anticoagulation in Atrial Fibrillation: Results From Phase II/III of the GLORIA‐AF Registry
Authors: Ding Wern Yew , Lane Deirdre A. , Gupta Dhiraj , Huisman Menno V. , Lip Gregory Y. H. ,   the GLORIA‐AF Investigators
Published: July 2022

Background
Residual risk of ischemic stroke despite anticoagulation in patients with atrial fibrillation (AF) represents a significant clinical issue that remains unaddressed. We aimed to evaluate the incidence and risk factors for residual adverse events in AF.

Methods and Results

Using data from phase II/III of the prospective GLORIA‐AF (Global Registry on Long‐Term Oral Anti‐thrombotic Treatment in Patients With Atrial Fibrillation) registry, we studied anticoagulated patients with newly diagnosed AF and an increased risk of stroke (CHA
2
DS
2
‐VASc ≥1). The primary outcome of interest was ischemic stroke. Secondary outcomes were all‐cause death, cardiovascular death and myocardial infarction. A total of 22 410 patients were included; median age 65 (interquartile range 71–78) and 10 044 (44.8%) were female. During a median follow‐up period of 3.0 (interquartile range 2.2–3.1) years, the incidence of ischemic stroke was 0.60 (95% CI, 0.54–0.67) per 100‐PYs, all‐cause death 3.22 (95% CI, 3.08–3.37) per 100‐PYs, cardiovascular death 1.08 (95% CI, 1.00–1.16) per 100‐PYs and myocardial infarction 0.59 (95% CI, 0.53–0.66) per 100‐PYs. Using multivariable Cox proportional hazards analysis, independent predictors of residual ischemic stroke were age (HR 1.05 [95% CI, 1.03–1.07]), diabetes (HR 1.42 [95% CI, 1.08–1.87]), prior thromboembolism (HR 2.27 [95% CI, 1.73–2.98]) and use of antiarrhythmic drugs (HR 0.66 [95% CI, 0.47–0.92]). The incidence of ischemic stroke was comparable among patients treated with nonvitamin K antagonist oral anticoagulants versus vitamin K antagonist; however, there were differences in the independent predictors between both groups.

Conclusions
Patients with AF remain at significant residual risk of developing complications including ischemic stroke despite anticoagulation therapy. Further efforts among these patients should be directed at the management of modifiable risk factors that contribute to this risk.

Registration

URL:
http://www.clinicaltrials.gov
; Unique identifiers: NCT01468701, NCT01671007 and NCT01937377.
Drivers of Biases in the CMIP6 Extratropical Storm Tracks. Part II: Southern Hemisphere
Authors: Priestley Matthew D. K. , Ackerley Duncan , Catto Jennifer L. , Hodges Kevin I. 
Published: July 2022

Abstract
The Southern Hemisphere storm tracks are commonly simulated too far equatorward in climate models for the historical period. In the latest generation of climate models from phase 6 of the Coupled Model Intercomparison Project (CMIP6), the equatorward bias that was present in CMIP5 models still persists, although it is reduced considerably. A further reduction of the equatorward bias is found in atmosphere-only simulations. Using diagnostic large-scale fields, we propose that an increase in the midlatitude temperature gradients contributes to the reduced equatorward bias in CMIP6 and AMIP6 models, reducing the biases relative to ERA5. These changes increase baroclinicity in the atmosphere and are associated with a storm track that is situated farther poleward. In CMIP6 models, the poleward shift of the storm tracks is associated with an amelioration of cold midlatitude SST biases in CMIP5 and not through a reduction of the long-standing warm Southern Ocean SST bias. We propose that increases in midlatitude temperature gradients in the atmosphere and ocean are connected to changes in the cloud radiative effect. Persistent track density biases to the south of Australia are shown to be connected to an apparent standing-wave pattern originating in the tropics, which modifies the split jet structure near Australia and subsequently the paths of cyclones.
Analysis of Daytime Cloud Fraction Spatiotemporal Variation over the Arctic from 2000 to 2019 from Multiple Satellite Products
Authors: Liu Xinyan , He Tao , Sun Lin , Xiao Xiongxin , Liang Shunlin , Li Siwei 
Published: July 2022

Abstract
Insufficient understanding of complex Arctic cloud properties introduced large errors in estimating radiant energy balance parameters at the regional and global scales. Comprehensive and reliable cloud information is necessary for improving the accuracy of flux inversion. This study evaluated daytime cloud fraction (CF) uncertainties from 16 available satellite products and estimated the spatiotemporal distributions of Arctic daytime CF during 2000–19. Our results show that the differences among multiple products had significant temporal and spatial heterogeneities. Temporally, the maximum and minimum interproduct discrepancies occurred in April and the summer months, respectively. Spatially, the largest uncertainties were seen over Greenland. Substantial inconsistency also occurred on the central and Pacific sides of the Arctic Ocean. The active satellite product tended to capture more clouds in these two regions. We found that the inconsistencies caused by sensor differences were smaller than those caused by algorithm differences; that is, for MODIS based CF products, the inconsistencies caused by different sensors and different algorithms are ±2% and ±5%, while for AVHRR-based products, these inconsistencies are ±6% and ±15%, respectively. The annual average daytime CF in sunlit months was 70.9% ± 2.93% and increased over the Arctic during study periods. These upward trends might cool the Arctic by approximately 0.05–0.5 W m−2 decade−1. In terms of the spatiotemporal distributions, the CF over the ocean is higher than that over the land, and the former increased significantly while the latter decreased; the CF trends of most products are positive in June and July but are opposite in other months. From this study, the findings based on multiple products would be more robust than that based on a single or few datasets.

Significance Statement
This study aimed to comprehensively understand and obtain more robust general characteristics of the temporal and spatial distributions of Arctic daytime cloud fraction by comparing and analyzing the consistencies and discrepancies of multisource satellite products. It is important because the cloud fraction is a nonnegligible modulator of Earth’s energy budget and climate change. Although the Arctic is the most climate-sensitive region, existing studies lack a comprehensive assessment of the cloud fraction over the entire Arctic. We analyzed 16 different cloud products and found that although the inconsistencies were inevitable, most products showed similar spatiotemporal distribution and trend distribution of daytime CF. This study provided a new idea for Arctic CF research under the existing conditions.
Runoff Regime, Change, and Attribution in the Upper Syr Darya and Amu Darya, Central Asia
Authors: Huang Jingheng , Su Fengge , Yao Tandong , Sun He 
Published: July 2022

Abstract
The upper Syr Darya (USD) and Amu Darya (UAD) basins are the two biggest flow formation zones in central Asia and the only water supply sources for the Aral Sea. Upstream snow and ice reserves of those two basins, important in sustaining seasonal water availability, are highly sensitive and prone to climate change, but their importance and changes are still uncertain and poorly understood due to data scarcity, inaccessibility, harsh climate, and even geopolitics. Here, an improved forcing dataset of precipitation and temperature was developed and used to drive a physically based hydrological model, which was thoroughly calibrated and validated to quantify the contributions of different runoff components to total flow and the controlling factors for total runoff variations for 1961–2016. Our analysis reveals divergent flow regimes exist across the USD and UAD and an ongoing transition from nival–pluvial toward a volatile pluvial regime along with rising temperatures. Annual total runoff has weakly increased from 1961 to 2016 for the entire USD and UAD, while the subbasins displayed divergent flow changes. Spring runoff significantly increased in all the USD and UAD basins primarily due to increased rainfall and early snow melting, tending to shift the peak flow from June–July to April–May. In contrast, distinct runoff changes were presented in the summer months among the basins primarily due to the trade-off between the increase in rainfall and the decrease in snowmelt and glacier runoff. These findings are expected to provide essential information for policymakers to adopt strategies and leave us better poised to project future runoff changes in ongoing climate change.
Shear Instability in Internal Solitary Waves in the Northern South China Sea Induced by Multiscale Background Processes
Authors: Huang Siwei , Huang Xiaodong , Zhao Wei , Chang Zeyu , Xu Xing , Yang Qingxuan , Tian Jiwei 
Published: July 2022

Abstract
Instability within internal solitary waves (ISWs), featured by temperature inversions with vertical lengths of dozens of meters and current reversals in the upper shoreward velocity layer, was observed in the northern South China Sea at a water depth of 982 m by using mooring measurements between June 2017 and May 2018. Regions of shear instability satisfying Ri < 1/4 were found within those unstable ISWs, and some large ISWs were even possibly in the breaking state, indicated by the ratio of Lx (wave width satisfying Ri < 1/4) to λη/2 (wavelength at half amplitude) larger than 0.86. Wave stability analyses revealed that the observed wave shear instability was induced by strong background current shear associated with multiscale dynamic processes, which greatly strengthened wave shear by introducing sharp perturbations to the fine-scale vertical structures of ISWs. During the observational period, wave shear instability was strong in summer (July–September) while weak in winter (January–March). Sensitivity experiments revealed that the observed shear instability was prone to be triggered within large ISWs by the background current shear and sensitive to the pycnocline depth in the background stratification. However, shear instability within ISWs was observed to be promoted during mid-January, as the near-inertial waves trapped inside an anticyclonic eddy resulted in enhanced background current shear between 150 and 300 m. This work emphasizes the notable impacts of multiscale background processes on ISWs in the oceans.
A Deep Learning Model for Improved Wind and Consequent Wave Forecasts
Authors: Yevnin Yuval , Toledo Yaron 
Published: July 2022

Abstract
The paper presents a combined numerical–deep learning (DL) approach for improving wind and wave forecasting. First, a DL model is trained to improve wind velocity forecasts by using past reanalysis data. The improved wind forecasts are used as forcing in a numerical wave forecasting model. This novel approach, used to combine physics-based and data-driven models, was tested over the Mediterranean. The correction to the wind forecast resulted in ∼10% RMSE improvement in both wind velocity and wave height over reanalysis data. This significant improvement is even more substantial at the Aegean Sea when Etesian winds are dominant, improving wave height forecasts by over 35%. The additional computational costs of the DL model are negligible compared to the costs of either the atmospheric or wave numerical model by itself. This work has the potential to greatly improve the wind and wave forecasting models used nowadays by tailoring models to localized seasonal conditions, at negligible additional computational costs.

Significance Statement
Wind and wave forecasting models solve a set of complicated physical equations. Improving forecasting accuracy is usually achieved by using a higher-resolution, empirical coefficients calibration or better physical formulations. However, measurements are rarely used directly to achieve better forecasts, as their assimilation can prove difficult. The presented work bridges this gap by using a data-driven deep learning model to improve wind forecasting accuracy, and the resulting wave forecasting. Testing over the Mediterranean Sea resulted in ∼10% RMSE improvement. Inspecting the Aegean Sea when the Etesian wind is dominant shows an outstanding 35% improvement. This approach has the potential to improve the operational atmospheric and wave forecasting models used nowadays by tailoring models to localized seasonal conditions, at negligible computational costs.
Turbulent Thermal-Wind-Driven Coastal Upwelling: Current Observations and Dynamics
Authors: Lentz S. J. 
Published: July 2022

Abstract
A remarkably consistent Lagrangian upwelling circulation at monthly and longer time scales is observed in a 17-yr time series of current profiles in 12 m of water on the southern New England inner shelf. The upwelling circulation is strongest in summer, with a current magnitude of ∼1 cm s−1, which flushes the inner shelf in ∼2.5 days. The average winter upwelling circulation is about one-half of the average summer upwelling circulation, but with larger month-to-month variations driven, in part, by cross-shelf wind stresses. The persistent upwelling circulation is not wind-driven; it is driven by a cross-shelf buoyancy force associated with less-dense water near the coast. The cross-shelf density gradient is primarily due to temperature in summer, when strong surface heating warms shallower nearshore water more than deeper offshore water, and to salinity in winter, caused by fresher water near the coast. In the absence of turbulent stresses, the cross-shelf density gradient would be in a geostrophic, thermal-wind balance with the vertical shear in the along-shelf current. However, turbulent stresses over the inner shelf attributable to strong tidal currents and wind stress cause a partial breakdown of the thermal-wind balance that releases the buoyancy force, which drives the observed upwelling circulation. The presence of a cross-shelf density gradient has a profound impact on exchange across this inner shelf. Many inner shelves are characterized by turbulent stresses and cross-shelf density gradients with lighter water near the coast, suggesting turbulent thermal-wind-driven coastal upwelling may be a broadly important cross-shelf exchange mechanism.

Significance Statement
A remarkably consistent upwelling circulation at monthly time scales is observed in a 17-yr time series of current profiles in shallow water off southern New England. This is not the traditional wind-driven coastal upwelling; instead, it is forced by cross-shelf buoyancy (density) gradients, released by turbulent stresses in shallow water. The persistent upwelling circulation is strongest in summer, when wind and wave forcing are weak, and flushes the inner portion of the continental shelf in a few days. Consequently, this buoyancy-driven coastal upwelling is important for cooling the inner shelf and provides a reliable mechanism for cross-shelf exchange. Many inner shelves are characterized by cross-shelf density gradients and turbulent stresses, suggesting this may be a broadly important cross-shelf exchange mechanism.
Transnational Corporations and Capitalists from the Global South: Natura & Co. and the IEDI
Authors: Aguiar Thiago , Micussi Pedro 
Published: July 2022

The Brazil-based company Natura & Co. became a transnational corporation, the world’s fourth-largest cosmetics corporation, by restructuring its Brazilian operations, becoming a publicly traded corporation, and expanding its international presence with the acquisition of the Australian company Aesop, the British company The Body Shop, and the iconic Avon International. The political action of one of the company’s founders, Pedro Passos, as president of Brazil’s most important business think tank, the Instituto de Estudos para o Desenvolvimento Industrial (IEDI), helped shift the stance of that institute toward transnationalization strategies, structural adjustment and economic opening policies that benefited transnational corporations, revealing tensions within the Brazilian capitalist class. A Natura & Co. tornou-se uma corporação transnacional sediada no Brasil, a quarta maior empresa de cosméticos do mundo, após reestruturar suas operações brasileiras, abrir seu capital e expandir sua presença internacional com a aquisição da companhia australiana Aesop, da britânica The Body Shop e da icônica Avon International. A ação política de Pedro Passos, um dos fundadores da empresa, como presidente do mais importante think tank empresarial brasileiro, o Instituto de Estudos para o Desenvolvimento Industrial (IEDI), contribuiu para alterar a orientação desse instituto em favor da promoção de estratégias de transnacionalização, de políticas de ajuste estrutural do Estado e de abertura econômica que beneficiaram corporações transnacionais, revelando tensões no interior da classe capitalista brasileira.
Reconstruction of an orbital defect in rabbits using a silk fibroin–bone microparticle complex
Authors: Jiang Yi , Lin Hailiang , Shao Zhengzhong , Chen Xin , Li Wen , Ni Yusu 
Published: July 2022

Objective: To construct a silk fibroin–bone microparticle composite based on a porous silk fibroin membrane and to study its feasibility as a material to reconstruct an orbital bone defect. Methods: A 3D porous silk fibroin membrane scaffold was constructed with a defined pore size and incorporated with bone microparticles from a New Zealand rabbit orbital bone defect. The silk fibroin–bone microparticle composite was then implanted into the orbital bone defect to promote osteogenesis along the surface of the porous silk fibroin membrane. The feasibility of constructing an ideal orbital defect repair material and the silk fibroin–bone micronucleus complex was evaluated by animal experiments, molecular biology, histomorphology, imaging, raw molecular mechanisms, and the biological behavior of the material in vivo. Results: The silk fibroin–bone microparticle composite promotes angiogenesis and osteogenesis to repair bone defects in vivo. Moreover, SF (silk fibroin)/BD (bone dust) complex promotes osteogenesis and angiogenesis by activating FGF2 (Fibroblast Growth Factor 2) and SF scaffolds can bind and restore FGF2. Conclusion: Silk fibroin is biocompatible and the silk fibroin–bone microparticle complex successfully repaired orbital bone defects. Additionally, fibroblast growth factor expression around or within the remaining incompletely degraded silk fibroin materials was observed in vivo.