bluuebunny/crossref_metadata_2025 huggingface dataset:
Typical and Atypical Manifestation of Scrub Typhus in Children
Authors: Dr Haseeb Ul Haq  , Dr Raghunath S.V.  , Dr Sushma.V
Published: April 2024

Introduction: Scrub typhus is grossly under-diagnosed or lately diagnosed in India because of its non-specific clinical presentation, a limited awareness about the disease, a low index of suspicion among clinicians, and a lack of diagnostic facilities. Absence of typical features may create diagnostic dilema among physicians thereby delaying the diagnosis which may lead to complications & high mortality. Material and method: A hospital based Cross sectional study which was conducted in the Department of Paediatrics, PRM Medical College, Baripada, Odisha from July 2021 to December 2021. Children from 1 month to 14 years of age presenting with fever in whom rickettsia infection is suspected included. All children who are found to be Elisa or IgM positive for scrub typhus even if admitted for other disease included. All fever cases with rash /oedema/ pallor/icterus/lymphadenopathy/hepatosplenomegaly and or any other systemic features with or without eschar was included. Results: The laboratory parameters of the cases are shown in Table 4. The total leukocyte count was elevated in 30.6% of the cases. An elevated serum creatinine level or a change in the serum creatinine level greater than 0.3 mg/dl, which is a diagnostic of AKI, was observed in 20% of cases. Hyponatremia was found in 6.9% of the cases. The serum CPK level (total and MB fraction) was elevated in 8.9% of cases. Conclusion: Pediatric scrub typhus is a common infection and should be suspected in cases with fever for more than 5 days and non-specific signs and symptoms. Early detection and timely management lead to a higher recovery rate. Hypotension, hypoxia, azotemia, altered sensorium, and bleeding manifestations on admission were associated with unfavorable outcomes.
Socio Clinical Profile of MDR TB Cases: A Study at DR –TB Center, SCB Medical College & Hospital
Authors: Dr Ashok kumar Nayak  , Dr Chandra Sekhar Behera  , Dr. Sanjeev Supakar
Published: April 2024

Introduction India accounts for about one-fourth of the global burden of MDR-TB. This study aims to evaluate clinical profile and factors associated with tuberculosis drug resistance among patients from eastern India. Method All the MDR-TB cases registered under RNTCP PMDT services were included in the study between 1st April-2013 to 31st March 2014. This observational study was carried out by the Department of Pulmonary Medicine, SCB Medical College, Cuttack. Result Between April 2013 and March 2014, the IRL ATDC Center collected a total of 2205 sputum samples. Out of 2205, 245 (11%) had both INH and Rifampicin, 68 (3%), INH resistance, 359 (16.3%), and 51 (2.3%) had sputum contaminated with report awaiting. Mean age MDR TB was 35.6 (Standard deviation 13.769). The study shows 14.3% of the TB patients were illiterate. Out of 126 cases of MDR-TB presented with 140 co- morbidities at DR-TB Center. Discussion High rate of drug resistance pattern was found among the new sputum smear positive pulmonary tuberculosis patients and also high MDR tuberculosis. Risk factors such as age, sex, smoking, and alcoholism were independently associated with pulmonary MDR-TB. Our study concluded that young age, male sex, smear positivity, treatment failure, and the combination of smoking and alcoholism were identified as risk factors for Tuberculosis mortality.
Serum NT-proBNP Levels in predicting severity of Covid19 infection
Authors: Dr Navikala K  , Dr. Nandan K  , Dr. Ashwin K
Published: April 2024

Background - Patients with COVID commonly have mild symptoms or even be asymptomatic, a notable proportion of patients may develop severe pneumonia, acute respiratory distress syndrome, multiorgan failure and, death. NT-proBNP reflects haemodynamic stress and has proven useful for risk stratification in heart failure (HF) and other conditions such as pulmonary embolism and pneumonia. NT-proBNP is an important biomarker for the diagnosis and estimation of prognosis in cardiac insufficiency. Therefore, in the current study, we are aiming to investigate the association between the serum NT pro BNP levels in covid-19 patients and to correlate the same with the severity of COVID-19 infection. Methods: A cohort study involving 68 covid patients whose NT pro BNP levels was estimated at the time of admission and compared with other covid biomarkers. Patients classified as moderate and severe according to ICMR guidelines were included. Serum NT-proBNP levels & other covid biomarkers like CRP, IL6, Ddimer, Ferritin, LDH were estimated. Results: Serum NT pro BNP levels were high in severely ill covid patients compared to moderately ill covid 19 patients and was found statistically significant. Serum NT pro BNP levels was positively correlating with other biomarkers. Mortality rate of 4.41% was reported. Conclusion: Serum NT-proBNP levels of COVID 19 patients can be used to predict the prognosis of covid which can help in early diagnosis and management of complications.
Depression and the Caregiver Burden for Schizophrenia Patients
Authors: Dr. Azarudeen MJ  , Dr. Srinath Ramamurthy  , Dr. Swetha Chandrasekar  , Dr. Bandi Siva Gopal
Published: April 2024

Background and objectives: Schizophrenia is a recurring psychiatric condition that severely impairs patients' ability to function in all major spheres of their lives. Since the deinstitutionalization policy, families, especially the primary caregiver who bears a heavy physical and emotional strain, are responsible for providing care. According to estimates, caregivers' rates of depression are higher than those of the general population. The primary caregivers' burden of care, their level of depression, and related caregiver factors were all examined in this crosssectional study. Methods: After gathering socio-demographic and caregiving information, 60 consenting primary caregivers of patients with an ICD-10 diagnosis of schizophrenia were evaluated for burden of care and depression using the Burden Assessment Schedule and the Patient Health Questionnaire–9. Results: A majority of the 35 female and 25 male carers reported experiencing moderate to severe depression, and all had moderate to high levels of burden. More burden was felt by spouses (p=0.0038), older carers (p=0.01), and those with lower educational levels (p=0.01). Depression and caregiving burden had a statistically significant positive connection (p=0.000). Conclusion: Despite the ease with which psychiatric therapies are accessible in one of India's largest metropolitan areas, caregivers continue to experience stress and depression. This may affect not only the caregiver but also the patient's care and the course of the sickness.
A Syudy on Comparative Evaluation of Four Different Methods to Quantify Proteinuria in Pre-Eclampsia in a Tertiary Care Hospital
Authors: Dr. Samrat Chakrabarti  , Dr. Sujoy Biswas  , Dr. Rakhi Sardar  , Dr. B. N. Shil
Published: April 2024

Background: Preeclampsia is a progressive, multisystem disorder due to spasm of small blood vessels of all organ systems characterized by new-onset hypertension and end- organ dysfunction in the last half of pregnancy. Objectives: Estimation of proteinuria by sulphosalicylic acid test in women with preeclampsia. Material & Methods: Prospective hospital based clinical study. Study conducted in the Department of Obstetrics and Gynaecology, Murshidabad Medical college, Berhampore, Murshidabad, West Bengal. Sep. 2021 - Aug. 2022. Pregnant women after 20weeks of gestation diagnosed as preeclampsia and admitted in antenatal ward in obstetrics and gynaecology department, Murshidabad Medical college, Berhampore, Murshidabad, West Bengal. Study consisted a total of 100 subjects. Simple Random sampling method. The pregnant women diagnosed as preeclampsia meeting the inclusion and exclusion criteria included in the study. The study comprised of pregnant women who are more than 20 weeks of gestation diagnosed as preeclampsia fulfilling the inclusion and exclusion criteria. Written and informed consent was taken from all pregnant women participating in the study. The pregnant women in the study were subjected to a detailed history and general abdominal and pelvic examination. A first voided morning urine sample was obtained for sulphosalicylic acid test, dipstick test, spot urine PCR. Subsequent urine samples were collected for 24 h, including a next-day first-morning voided sample for the 24-h urine protein estimation. Results: On assessment of the ROC curve to assess the predictability of three methods for spot urine compared against the 24hr urine protein estimation, the AUC for the Sulphosalicylic acid was found to be significantly better (AUC=0.970, p<0.05) compared to the urinary PCR (AUC=0.964, p<0.05) and for urinary dipstick it was AUC=0.784, p<0.05. Conclusion: This study concluded that spot urine sulphosalicylic acid and urine protein creatinine ratio are reliable investigations compared to the dipstick method to assess the proteinuria in hypertensive pregnant women or for diagnosis of pre-eclampsia. So, spot urine Sulphosalicylic acid and urine protein-creatinine ratio can be used for detection of proteinuria in pregnant women with suspected pre-eclampsia with high accuracy, which is more rapid than time consuming 24-hour urine protein estimation
Study of Serum Magnesium Levels in Migraine Patients During the Ictal and Interictal Phases
Authors: Dr. M. ShyamSundar  , Dr. Hemalatha Rendocharakula  , Dr. C. Sreenivasulu
Published: April 2024

Background and objectives: Migraine is among the most common headaches, with a 15% worldwide incidence. It is distinguished by neurovascular dysfunction and recurring headaches. Magnesium (Mg), as a controller of synaptic activity, is hypothesised to play a role in migraine pathogenesis. The cerebral cortex's hyperexcitability has been identified as a key feature in the pathophysiology of migraine, and magnesium (Mg) is a known neuronal excitability regulator. To evaluate the serum magnesium levels of migraine patients during and between attacks to those of healthy controls. Methods: Sixty migraine patients who met the inclusion criteria and the equal number of healthy controls were enrolled in the study. For the diagnosis of migraine, the International Classification of Headache Disorders, 3rd Edition, 2013 (ICHD-III) criteria were applied. Result: The mean serum magnesium levels of migraine patients throughout the interictal phase were significantly lower than those of healthy controls (1.849 0.135 vs 2.090 0.205, P 0.001, statistically significant). During attacks, the mean serum magnesium concentration was substantially lower than between attacks (P = 0.003, 1.822 0.149 vs 1.849 0.135, respectively). In migraine patients, serum magnesium levels exhibited an inverse linear relationship with attack frequency. Conclusion: The relatively low serum magnesium levels in migraine patients compared to healthy controls and the inverse relationship between serum magnesium levels and the frequency of migraine attacks suggest that magnesium plays a significant role in the pathogenesis of migraine and may be a viable therapeutic option.
Parkinsonism and Its Clinical Subtypes - An Observational Study in a Tertiary Care Hospital
Authors: Dr. M. Shyam Sundar  , Dr. Hemalatha Rendocharakula
Published: April 2024

Background: The term Parkinsonism is defined by any combination of six specific motor features: tremors at rest, bradykinesia, rigidity, loss of postural reflexes, flexed posture, and the freezing phenomenon (where the feet are transiently “glued to the ground”). Not all six of these cardinal features need be present, but at least two should be before the diagnosis of Parkinsonism is made, with at least one of them being tremors at rest or bradykinesia. This study is a hospital based Observational study to understand the prevalence and rank order of subtypes of Parkinsonism. Material and Method: Subjects are enrolled after written and informed consent. Details were recorded in a predesigned proforma after detailed history and clinical examination. If the patient was found to have akinetic rigid state/features of Parkinsonism, detailed history relevant to various Parkinsonian syndromes were taken to know the kind of Parkinsonian syndrome he/she belongs to. Standard criteria of each of the Parkinsonian syndromes are applied to confirm about the type of Parkinsonian syndrome the patient is suffering with. Data entered and analysed in Microsoft Excel 2007 and presented in the form of frequencies and percentages. Results: The prevalence of Parkinsonism in this study is 42 per 10000 population. The different types of Parkinsonism in the order high to low are Idiopathic Parkinson’s Disease (62.50%), Progressive Supranuclear Palsy (16.67%), Vascular Parkinsons Disease (12.50%), Multi System Atrophy (3.33%), Cortico-Basal Degeneration (2.50%), Drug induced Parkinsons Disease (1.67%) and Dementia with LewyBodies (0.83%). Conclusions: A total of 120 patients were found to have features of Parkinsonism out of 28800 patients. The prevalence of Parkinsonism in this study is 42 per 10000 population.
Comparative Efficacy of Fentanyl Vs Dexmedetomidine Intrathecally as an Adjuvent to Isobaric Levo-Bupivacaine in Infra-Umbilical Surgery: A Prospective Randomized Study
Authors: Dr. Leena Goel  , Dr. Naveen Singh  , Dr. Deepak Agarwal
Published: April 2024

Background: Fentanyl is a potent, highly lipophilic, synthetic opioid analgesic used as an adjuvant in spinal anaesthesia. Dexmedetomidine is also a potent, lipophilic, selective α2-adrenergic agonist. Compared to Dexmedetomidine, it has an earlier onset of block, better intraoperative analgesia with increased side effects(such as, nausea, vomiting or respiratory depression). Aim: To compare Fentanyl(25 ug) versus Dexmedetomidine(10 ug) as an adjuvant with 0.5% isobaric Levo-Bupivacaine in infra-umbilical surgeries. Material & Methods: A prospective, randomized, controlled study. Department of Anaesthesia, K. D. Medical College, Hospital and Research Centre in Mathura. Patients between 20-60 years of either sex, ASA Grade I – II, scheduled for elective infra-umbilical procedures with no co-morbid conditions. Simple random method(sealed envelope). Results: The sensory block duration is 7.71±0.31 hrs in D group and 3.78±0.83 hrs in group F with p value <0.05. The mean time taken for attaining motor blockade is 2.06 ± 1.17 mins in D group, 2.45 ± 1.39mins in F group. but statistically not significant between group D and in F group (p=0.2). The motor block duration is 7.33 ± 0.28hrs in group D and 3.39 ± 0.91 hrs in F group which suggestive of statistically highly significant (p=0.001). Conclusion: In infra-umbilical surgery, levo-Bupivacaine with adjuvant dexmedetomidine (10 ug) intrathecally has a longer duration of sensory and motor block with preserved hemodynamic stability and lesser adverse effects in comparison to adjuvant fentanyl(25 ug). However, onset of sensory block is earlier with fentanyl.
Urbanization and Heat Island Effect: A Comparative Study in Egypt
Authors: Mohamed Mostafa
Published: April 2024

Purpose: The aim of the study was to analyze urbanization and heat island effect: a comparative study
Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries.
Findings: A comparative study in Egypt investigated the impact of urbanization on the heat island effect. Findings indicated that highly urbanized areas, like Cairo, exhibited more pronounced heat island effects due to extensive infrastructure and limited vegetation. Rapid urbanization and land use changes were identified as significant contributors to increased heat island intensity. The study emphasizes the importance of urban planning strategies to mitigate these effects and calls for further research to better understand the urbanization-heat island relationship in Egypt.
Unique Contribution to Theory, Practice and Policy: Theory of urban heat island effect, theory of land use and land cover change & theory of socioeconomic drivers of urbanization may be used to anchor future studies on urbanization and heat island effect: a comparative study. Integrate green spaces, such as parks, urban forests, and green roofs, into urban planning and design to mitigate the heat island effect. Implement urban planning regulations and building codes that mandate the incorporation of heat mitigation measures in new developments and retrofits.
Corporate Governance Mechanisms and Financial Performance: An Analysis of Listed Companies in Brazil
Authors: Oliveira Juliana Costa
Published: April 2024

Purpose: The aim of the study was to investigate the corporate governance mechanisms and financial performance: an analysis of listed companies in Brazil.
Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries.
Findings: The analysis of listed companies in Brazil found that strong corporate governance practices are associated with improved financial performance. Factors such as board independence, transparency, and shareholder rights positively influence profitability, liquidity, and market valuation. This highlights the vital role of effective corporate governance mechanisms in fostering investor confidence and driving sustainable financial success in Brazil.
Unique Contribution to Theory, Practice and Policy: Agency theory, stakeholder theory & resource dependency theory may be used to anchor future studies on the corporate governance mechanisms and financial performance: an analysis of listed companies in Brazil. By emphasizing the pivotal role of board independence, transparency, and shareholder engagement, the study provides tangible guidance on governance practices that can be effectively implemented to bolster financial performance. Policymakers tasked with overseeing the corporate governance landscape in Brazil
Creatividad en la investigación científica
Authors: Crespo Antepara Delia Narcisa
Published: April 2024

En este trabajo se presentan los resultados de una revisión bibliográfica a estudios realizados en el último quinquenio sobre la creatividad en la investigación y su influencia en el desarrollo humano, reconociendo la investigación como una actividad creativa. Además, se aborda la inteligencia de la creatividad como el desarrollo de las potencialidades humanas y las técnicas de trabajo humano intelectual, enfatizando los paradigmas y paradogmas que retrasan el desarrollo de las organizaciones. Es un tema de importancia puesto que la creatividad e innovación en el mundo globalizado requieren de profesionales vanguardistas, responsables de la transformación de la sociedad, acción que demanda la asimilación de estas competencias en la cultura, en el contexto educativo y en la investigación; estimulando el cambio de paradigmas para dar paso a modelos centrados en la solución de problemas. El pensamiento creativo lo utiliza el investigador cuando son insuficientes los métodos de solución de los cuales dispone y es necesario buscar otros nuevos, de ahí que el pensamiento productivo resultaría imposible sin la creatividad.
Skin graft ing on amputated lower limb,norepinephrine-induced ischemic limbnecrosis – case report
Authors: Efthymiou Kleanthia , Kaťuchová Jana , Radoňák Jozef , Kňazovický Miloš , Iľková Jana , Tomašurová Diana
Published: April 2024

Ischemic limb necrosis due to high dose of norepinephrine (NE) in a patient with septic shock is uncommon. Unfortunately, amputation of necrotic parts is the only available treatment. Reconstruction with skin autografts for defects resulting from the amputation of the lower limbs is challenging. Herein we report a case of digit necrosis in the upper and lower limbs after administration of a high dose of NE > 1 μcg/kg/min in a patient with septic shock. The source of infection that led to septic shock was not detected. Surgical amputation was performed as it was impossible to repair impaired vasculature and patients’ life was endangered. Large defects were covered with skin autografts from the patient’s thighs. The included figures demonstrate the extremities’ appearance before, after amputation, during and after skin graft transplantation.
LEADERSHIP IN GLOBAL HEALTH: NAVIGATING CHALLENGES AND OPPORTUNITIES FOR IMPACTFUL OUTCOMES IN AFRICA AND SRI LANKA
Authors: Tolulope Odugbose  , Bisola Oluwafadekemi Adegoke  , Christiana Adeyemi
Published: April 2024

Effective leadership is paramount in addressing the complex challenges and harnessing the opportunities in global health, particularly in regions such as Africa and Sri Lanka. This review explores the multifaceted dimensions of leadership within the context of global health, highlighting the unique challenges and opportunities faced by these regions. In Africa, leadership in global health is confronted with a myriad of challenges including limited resources, political instability, and infrastructural deficiencies. The burden of infectious diseases, inadequate healthcare access, and socio-economic disparities further exacerbate the complexities. However, amidst these challenges lie opportunities for transformative leadership. Visionary leaders can leverage partnerships, innovative technologies, and community engagement to strengthen health systems, promote preventive healthcare, and address the root causes of health inequities. Similarly, in Sri Lanka, leadership in global health faces its own set of challenges and opportunities. Despite notable achievements in healthcare infrastructure and disease control, the country grapples with emerging health threats, non-communicable diseases, and disparities in healthcare access. Effective leadership is essential in mobilizing resources, fostering intersectoral collaboration, and implementing evidence-based interventions to ensure equitable health outcomes for all segments of the population. In both regions, transformative leadership in global health necessitates a multidisciplinary approach that integrates political commitment, scientific innovation, and community participation. Leaders must possess strong communication skills, cultural competence, and a deep understanding of local contexts to navigate the intricate socio-political landscapes. Furthermore, fostering leadership capacity at all levels of the healthcare system is crucial for sustainability and resilience in the face of evolving health challenges. By examining the challenges and opportunities for leadership in global health within the contexts of Africa and Sri Lanka, this review underscores the importance of visionary leadership in driving impactful outcomes. Empowering leaders to navigate complexities, foster collaboration, and innovate solutions is essential for advancing the global health agenda and achieving health equity on a global scale.

Keywords:  Leadership, Global Health, Africa, Sri Lanka, Healthcare, Review
HARNESSING DATA INSIGHTS FOR CRISIS MANAGEMENT IN U.S. PUBLIC HEALTH: LESSONS LEARNED AND FUTURE DIRECTIONS
Authors: Arenike Patricia Adekugbe  , Chidera Victoria Ibeh
Published: April 2024

The effective management of crises in U.S. public health relies heavily on harnessing insights from data. This paper examines the lessons learned from past crises and outlines future directions for leveraging data to enhance crisis management efforts. Drawing on case studies of significant events such as the COVID-19 pandemic and natural disasters, we analyze the role of data in informing decision-making, identifying challenges, and deriving best practices. Despite the advancements in data infrastructure, including real-time monitoring systems and predictive analytics, there remain significant challenges in data collection, integration, and analysis. The paper highlights the importance of improving data governance, investing in technology, and fostering interdisciplinary collaboration to address these challenges. Additionally, considerations such as equity and privacy are crucial in the development and implementation of data-driven strategies. Looking ahead, the paper provides recommendations for enhancing crisis management practices, including the adoption of standardized data protocols, the development of early warning systems, and the promotion of data-driven decision-making processes. By prioritizing data-driven approaches and embracing continuous learning, stakeholders can better prepare for and respond to future public health crises. This paper serves as a roadmap for policymakers, public health officials, and researchers to optimize data utilization in crisis management, ultimately safeguarding the well-being of communities across the United States.

Keywords:  Data Insights, Crisis Management, in U.S. Public Health, Lessons Learned, Future Directions.
Follow-Up Care for Neurological Outpatients
Authors: Тютюнник В. Б. , Сазиков Р. С. , Тунян Э. Г. , Клюс Л. Г.
Published: April 2024

исследование фокусируется на анализе проблематики амбулаторного наблюдения за неврологическими пациентами, подчеркивая трудности, возникающие при долгосрочном мониторинге и обмене информацией между пациентом и лечащим врачом. Особое внимание уделено промежуткам времени между визитами к специалисту, так называемому «темному периоду», который может способствовать ряду проблем, негативно сказывающихся на эффективности терапии и благополучии пациента. В работе обозначены недостатки привычных методик и предложены новаторские решения, включая применение телемедицины и мобильных приложений, целью которых является усовершенствование ухода и улучшение мониторинга состояния больных. Анализируется использование смартфонов с многочисленными датчиками для сбора актуальных данных о здоровье пациента и их последующей передачи медицинским работникам для получения всесторонней клинической картины. Несмотря на отсутствие готовой специализированной платформы, рассмотрение и потенциальное использование существующих технологических решений открывает значительные перспективы для оптимизации лечебного процесса и минимизации рисков, ассоциированных с неврологическими расстройствами

this study investigates the challenges associated with outpatient care for neurological patients, with a particular focus on the obstacles encountered in long-term management and communication between patients and their healthcare providers. It highlights the ”dark period” between specialist visits, a time that may lead to various issues adversely affecting the efficacy of treatments and patient health. The research critiques traditional approaches and introduces innovative strategies for enhancing care and continuous patient observation. These include leveraging telemedicine and mobile technologies for better care delivery and utilizing smartphones with integrated sensors to collect and transmit real-time health data to medical professionals, thereby offering a more complete clinical overview. The paper concludes by noting the current lack of a dedicated platform but underscores the promising potential of existing solutions to improve therapeutic outcomes and reduce the risks associated with neurological conditions
PELAKSANAAN PELAYANAN UMUM DI KANTOR CAMAT
Authors: Kaja Kaja
Published: April 2024

According to the Republik of Indonesia’s Constitution, serving the community has become the duty of the government. Public, servants carry out this duty by providing services that are straightforward, certain, secure,transparent, efficient,ecomical, fair and timely in accordance with establishhed protocols. The purpose of this study is to outline and evaluate how public service are being implemented at the sub-district office. This study employed a descriptive qualitative methodology with two different data sets : perimary and secondary. The study’s findings demonstrate that service standards align with the primary responsibilities and activities of the public services divisions, including data and material gathering and task execution for the public servicec division.
Uncertainties in temperature statistics and fluxes determined by sonic anemometer due to wind-induced vibrations of mounting arms
Authors: Gao Zhongming , Liu Heping , Li Dan , Yang Bai , Walden Von , Li Lei , Bogoev Ivan
Published: April 2024

Abstract. Accurate air temperature measurements are essential in eddy covariance systems, not only for determining sensible heat flux but also for applying the density effect corrections (DEC) to water vapor and CO2 fluxes. However, the influence of wind-induced vibrations of mounting structures on temperature fluctuations remains a subject of investigation. This study examines 30-min average temperature variances and fluxes using eddy covariance systems, combining Campbell Scientific Anemometer Thermometry (CSAT3B) with closely co-located fine-wire thermocouples alongside LI-COR CO2/H2O gas analyzers at multiple heights above a sagebrush ecosystem. The variances of sonic temperature after humidity corrections (Ts) and sensible heat fluxes derived from are underestimated (e.g., by approximately 5 % for temperature variances and 4 % for sensible heat fluxes at 40.2 m, respectively) as compared with those measured by a fine-wire thermocouple (Tc). Spectral analysis illustrates that these underestimated variances and fluxes are caused by the lower energy levels in the Ts spectra than the Tc spectra in the low frequency range (natural frequency < 0.02 Hz). This underestimated Ts spectra in the low frequency range become more pronounced with increasing as wind speeds, especially when wind speed exceeds 10 m s-1. Moreover, the underestimated temperature variances and fluxes cause overestimated water vapor and CO2 fluxes through DEC. Our analysis suggests that these underestimations when using Ts are likely due to wind-induced vibrations affecting the tower and mounting arms, altering the time of flight of ultrasonic signals along three sonic measurement paths. This study underscores the importance of further investigations to develop corrections for these errors.
Post-fire Variability in Sediment Transport by Ravel in the Diablo Range
Authors: Jacobson Hayden L. , Roth Danica L. , Walton Gabriel , Zimmer Margaret , Johnson Kerri
Published: April 2024

Abstract. Post-fire changes to the transport regime of dry ravel, which describes the transport of individual particles downslope, are poorly constrained on a regional level but critical to understand as ravel may contribute to elevated sediment fluxes and associated debris-flow activity observed post-fire in the western United States. In this study, we evaluated post-fire variability in dry ravel travel distance exceedance probabilities and disentrainment rates through a series of field experiments simulating ravel with particles collected in situ. We conducted experiments between March 2021 and March 2022 on soil-mantled hillslopes in the Diablo Range of central coastal California following the Santa Clara Unit Lightning Complex fire of August 2020 with the goal of identifying a regime of “bounded” (light-tailed) or “runaway” (heavy-tailed or nonlocal) motion for different particle sizes between 3 and 35 mm. We conducted this study on both grassy south-facing slopes and oak woodland north-facing slopes. We tracked the post-fire evolution of particle transport regimes by fitting a probabilistic Lomax distribution model to the empirical travel distance exceedance probabilities of different particle sizes on a range of experimental slopes. Our experimental results indicated that a general transition from more runaway to more bounded transport occurred for our largest experimental particles (median intermediate axis of 28 mm) on south-facing slopes as vegetation recovered within the first year post-fire, while small and medium particles (median intermediate axes of 6 and 13 mm respectively) on south- or north-facing slopes and large particles on north-facing slopes did not experience notable changes in transport behavior. After the first year, seasonal variation in vegetation characteristics, such as grass density, appeared to control particle motion.
The Connection Between North Atlantic Storm Track Regimes and Eastern Mediterranean Cyclonic Activity
Authors: Sandler Dor , Saaroni Hadas , Ziv Baruch , Tamarin-Brodsky Talia , Harnik Nili
Published: April 2024

Abstract. A unique chain connects the flow over the North Atlantic and the development of cyclones within the Mediterranean basin. One typical mechanism includes several successive processes: upper-level flow perturbations upstream cause Rossby wave breaking (RWB) events along the jet stream, which in turn develop into potential vorticity streamers. These streamers reach the Mediterranean, and through increased baroclinicity they enhance cyclonic activity in the region. Using ERA5 reanalysis data and rain gauge measurements, we provide a systematic analysis connecting wintertime North Atlantic storm track regimes and Eastern Mediterranean cyclones and rainfall. To do so, we use different detection algorithms for each element in the chain (RWBs, streamers and cyclones). A cluster analysis of upper tropospheric eddy kinetic energy reveals a favorable configuration of the storm track where North Atlantic storms are able to propagate farther northeast. This results in upper-level potential vorticity streamers forming more eastward alongside above-average precipitation over the Levant. Meanwhile, other latitudinal positions of the storm track (southward or northward) were found to hinder cyclonic activity in the region and reduce rainfall there. The intense rainy winter of 1991–1992 is brought as a test case to exemplify this mechanism in its extreme. We show that the rain-enhancing storm track regime was prominent throughout most of this season, alongside frequent streamers in the Eastern Mediterranean.
Evolution of crystallographic preferred orientations of ice sheared to high strains by equal-channel angular pressing
Authors: Wang Qinyu , Fan Sheng , Richards Daniel H. , Worthington Rachel , Prior David J. , Qi Chao
Published: April 2024

Abstract. Plastic deformation of polycrystalline ice 1 h induces crystallographic preferred orientations (CPOs), which give rise to anisotropy in the viscosity of ice, thereby exerting a strong influence on the flow of glaciers and ice sheets. The development of CPOs is governed by two pivotal mechanisms: recrystallization dominated by subgrain/lattice rotation and by strain-induced grain boundary migration (GBM). To examine the impact of strain on the transition of the dominant mechanism, synthetic ice (doped with ∼1 vol.% graphite) was deformed using equal-channel angular pressing technique, enabling multiple passes to accumulate substantial shear strains. Nominal shear strains up to 6.2, equivalent to a nominal von Mises strain of ε′ ≈ 3.6, were achieved in samples at a temperature of −5 °C. Cryo-electron backscatter diffraction analysis reveals a primary cluster of crystal c axes perpendicular to the shear plane in all samples, accompanied by a secondary cluster of c axes at an oblique angle to the primary cluster antithetic to the shear direction. With increasing strain, the primary c-axis cluster strengthens, while the secondary cluster weakens. The angle between the clusters remains within the range of 45° to 60°. The c-axis clusters are elongated perpendicular to the shear direction, with this elongation intensifying as strain increases. Subsequent annealing of the highest-strain sample reveals the same CPO patterns as observed prior to annealing, albeit slightly weaker. A synthesis of various experimental data suggest that the CPO pattern, including the orientation of the secondary cluster, results from a balance of two competing mechanisms: lattice rotation due to dislocation slip, which fortifies the primary cluster while rotating and weakening the secondary one, and grain growth by strain-induced GBM, which reinforces both clusters while rotating the secondary cluster in the opposite direction. As strain increases, GBM contributes progressively less. This investigation supports the previous hypothesis that a single cluster of c axes could be generated in high-strain experiments, while further refining our comprehension of CPO development in ice.
Pollution affects Arabian and Saharan dust optical properties in the Eastern Mediterranean
Authors: Teri Marilena , Gasteiger Josef , Heimerl Katharina , Dollner Maximilian , Schöberl Manuel , Seibert Petra , Tipka Anne , Müller Thomas , Aryasree Sudharaj , Kandler Konrad , Weinzierl Bernadett
Published: April 2024

Abstract. Uncertainties in the mineral dust’s direct radiative effect arise from the variability in its optical properties. The optical properties can also be influenced by mixing processes with anthropogenic aerosols, such as black carbon or fine particles (called "pollution" in this study). We aimed to investigate the effect of mixing pollution with mineral dust aerosols from different source regions on the intensive aerosol optical properties. Thus, the Ångström exponents of scattering and absorption (i.e., their wavelength dependence), the single scattering albedo, and the asymmetry parameter were determined from direct optical measurements performed during the A-LIFE aircraft field experiment over the Eastern Mediterranean. This location provided access to Arabian and Saharan dust layers mixed with pollution. Our findings indicated significant changes in all the intensive aerosol optical properties with increasing pollution content within mineral dust layers. Interestingly, the differences between Arabian and Saharan dust’s intensive aerosol optical properties were negligible. We discussed the implications of these results for identifying mineral dust events and for their direct radiative effect. First, the mixing with pollution masked the mineral dust signal, suggesting that caution is needed when using the Ångström exponents for identifying mineral dust events. However, the Ångström exponents can help estimate the amount of pollution once a mineral dust event is confirmed. Second, our measurements of the asymmetry parameter and single scattering albedo changed from pure to polluted mineral dust layers (e.g., at 525 nm, the median values decreased from 0.67 to 0.56 and from 0.96 to 0.89, respectively). These changes have 15 opposing effects on the short-wave direct radiative effect efficiency (i.e., the direct radiative effect per unit of aerosol optical depth) and may partly cancel out each other. Nevertheless, the impact of mixing with pollution on the mineral dust’s direct radiative effect efficiency can differ depending on the surface albedo. In conclusion, accurate quantification of the pollution content within mineral dust layers is crucial. The pollution significantly impacts mineral dust event identification, its optical properties, and the local direct radiative effect.
Temporal stability of a new 40-year daily AVHRR Land Surface Temperature dataset for the Pan-Arctic region
Authors: Dupuis Sonia , Göttsche Frank-Michael , Wunderle Stefan
Published: April 2024

Abstract. Land surface temperature (LST) gained increased attention in cryospheric research. While various global satellite LST products are available, none of them is specially designed for the Pan-Arctic region. Based on the recently published EUMETSAT Advanced Very High Resolution Radiometer (AVHRR) fundamental data record (FDR), a new LST product (1981–2021) with daily resolution is developed for the Pan-Arctic region. Validation shows good accuracy with an average mean absolute error (MAE) of 1.71 K and a MAE range of 0.62–3.07 K against in situ LST data from the Surface Radiation Budget Network (SURFRAD) and Karlsruhe Institute of Technology (KIT) sites. Long-term stability, a strong requirement for trend analysis, is assessed by comparing LST with air temperatures from ERA5-Land (T2M) and air temperature data from the EUSTACE (www.eustaceproject.org) global station dataset. Long-term stability might not be fulfilled mainly due to the orbit drift of the NOAA satellites. Therefore, the analysis is split into two periods: the arctic winter months, which are unaffected by solar illumination and, therefore, orbital drift, and the summer months. The analysis for the winter months results in correlation values (r) of 0.44–0.83, whereas for the summer months (r) ranges between 0.37–0.84. Analysis of anomaly differences revealed instabilities for the summer months at a few stations. The same stability analysis for the winter months revealed only one station with instabilities in comparison to station air temperature. Discrepancies between the temperature anomalies recorded at the stations and ERA5-Land T2M were also found. This highlights the limited influence of orbital drift on the LST product, with the winter months presenting good stability across all stations, which makes these data a valuable source for studying LST changes in the Pan-Arctic region over the last 40 years. This study concludes by presenting LST trend maps (1981–2021) for the entire region, revealing distinct warming and cooling patterns.
A flux tower site attribute dataset intended for land surface modeling
Authors: Shi Jiahao , Yuan Hua , Lin Wanyi , Dong Wenzong , Liang Hongbin , Liu Zhuo , Zeng Jianxin , Zhang Haolin , Wei Nan , Wei Zhongwang , Zhang Shupeng , Liu Shaofeng , Lu Xingjie , Dai Yongjiu
Published: April 2024

Abstract. Land surface models (LSMs) should have reliable forcing, validation, and surface attribute data as the foundation for effective model development and improvement. Eddy covariance flux tower data are considered the benchmarking data for LSMs. However, currently available flux tower datasets often require multiple aspects of processing to ensure data quality before application to LSMs. More importantly, these datasets lack site-observed attribute data, limiting their use as benchmarking data. Here, we conducted a comprehensive quality screening of the existing reprocessed flux tower dataset, including the proportion of gap-filled data, external disturbances, and energy balance closure (EBC), leading to 90 high-quality sites. For these sites, we collected vegetation, soil, topography information, and wind speed measurement height from literature, regional networks, and Biological, Ancillary, Disturbance, and Metadata (BADM) files. Then we obtained the final flux tower attribute dataset by global data product complement and plant functional types (PFTs) classification. This dataset is provided in NetCDF format complete with necessary descriptions and reference sources. Model simulations revealed substantial disparities in output between the attribute data observed at the site and the defaults of the model, underscoring the critical role of site-observed attribute data and increasing the emphasis on flux tower attribute data in the LSM community. The dataset addresses the lack of site attribute data to some extent, reduces uncertainty in LSMs data source, and aids in diagnosing parameter as well as process deficiencies. The dataset is available at https://doi.org/10.5281/zenodo.10939725 (Shi et al., 2024).
Decision Support System version 1.0 (DSS v1.0) for air quality management in Delhi, India
Authors: Govardhan Gaurav , Ghude Sachin D. , Kumar Rajesh , Sharma Sumit , Gunwani Preeti , Jena Chinmay , Yadav Prafull , Ingle Shubhangi , Debnath Sreyashi , Pawar Pooja , Acharja Prodip , Jat Rajmal , Kalita Gayatry , Ambulkar Rupal , Kulkarni Santosh , Kaginalkar Akshara , Soni Vijay K. , Nanjundiah Ravi S. , Rajeevan Madhavan
Published: April 2024

Abstract. This paper discusses the newly developed Decision Support System version 1.0 (DSS v1.0) for air quality management activities in Delhi, India. In addition to standard air quality forecasts, DSS provides the contribution of Delhi, its surrounding districts, and stubble-burning fires in the neighboring states of Punjab and Haryana to the PM2.5 load in Delhi. DSS also quantifies the effects of local and neighborhood emission-source-level interventions on the pollution load in Delhi. The DSS-simulated Air Quality Index for the post-monsoon and winter seasons of 2021–2022 shows high accuracy (up to 80 %) and a very low false alarm ratio (∼ 20 %) from day 1 to day 5 of the forecasts, especially when the ambient air quality index (AQI) is > 300. During the post-monsoon season (winter season), emissions from Delhi, the rest of the National Capital Region (NCR)'s districts, biomass-burning activities, and all other remaining regions on average contribute 34.4 % (33.4 %), 31 % (40.2 %), 7.3 % (0.1 %), and 27.3 % (26.4 %), respectively, to the PM2.5 load in Delhi. During peak pollution events (stubble-burning periods or wintertime), however, the contribution from the main sources (farm fires in Punjab–Haryana or local sources within Delhi) could reach 65 %–69 %. According to DSS, a 20 % (40 %) reduction in anthropogenic emissions across all NCR districts would result in a 12 % (24 %) reduction in PM2.5 in Delhi on a seasonal mean basis. DSS is a critical tool for policymakers because it provides such information daily through a single simulation with a plethora of emission reduction scenarios.
A Comprehensive Review: Drug Interactions and Polypharmacy
Authors: Dua Fatima  , Faiza Waseem  , Iqbal Nadia , Tehseen Riaz  , Irfan Bashir  , Tooba Mehboob
Published: April 2024

The aim of our study is to identify the drug interactions due to polypharmacy. We tried to identify the possible risk factors, outcomes and management of polypharmacy especially in older patients. A medication interaction happens when the impact of one medication is changed by the presence of another. Many interfacing drugs can be controlled securely without making any mischief to the patient through cautious checking and dose change. Notwithstanding, prescriptions should possibly be regulated together if the outcomes are perceived and the danger of mischief is exceeded by the helpful benefits. Polypharmacy is portrayed as "the utilization of various meds or potentially the combination of a greater number of prescriptions than are clinically prescribed, speaking to superfluous medication use." Polypharmacy includes the number of meds taken by the patient, the provision of at least one wrong meds, or a combination of both, which can expand the danger for adverse medication occasions (ADEs), underutilization of drug, and redundancy of medication. Polypharmacy Management is an entire framework approach that upgrades the consideration of multimorbid patients through amplifying advantage while decreasing the dangers of improper polypharmacy. Prescription review and assessment is an intercession that should be ordinarily performed by clinical drug specialists to improve medicine harmlessness and drug therapy results, and guarantee ideal prescription use. There should be a proper and strong role and communication of Physicians, Pharmacists, and Patients in society, especially in developing countries. The potential risk factors should be identified like dietary factors interact with the drug therapy sothat adverse reactions can be identified and avoided.