bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using Artificial Neural Networks for Generating Probabilistic Subseasonal Precipitation Forecasts over California
Authors: Scheuerer Michael , Switanek Matthew B. , Worsnop Rochelle P. , Hamill Thomas M. 
Published: July 2020

AbstractForecast skill of numerical weather prediction (NWP) models for precipitation accumulations over California is rather limited at subseasonal time scales, and the low signal-to-noise ratio makes it challenging to extract information that provides reliable probabilistic forecasts. A statistical postprocessing framework is proposed that uses an artificial neural network (ANN) to establish relationships between NWP ensemble forecast and gridded observed 7-day precipitation accumulations, and to model the increase or decrease of the probabilities for different precipitation categories relative to their climatological frequencies. Adding predictors with geographic information and location-specific normalization of forecast information permits the use of a single ANN for the entire forecast domain and thus reduces the risk of overfitting. In addition, a convolutional neural network (CNN) framework is proposed that extends the basic ANN and takes images of large-scale predictors as inputs that inform local increase or decrease of precipitation probabilities relative to climatology. Both methods are demonstrated with ECMWF ensemble reforecasts over California for lead times up to 4 weeks. They compare favorably with a state-of-the-art postprocessing technique developed for medium-range ensemble precipitation forecasts, and their forecast skill relative to climatology is positive everywhere within the domain. The magnitude of skill, however, is low for week-3 and week-4, and suggests that additional sources of predictability need to be explored.
Ensemble Variability in Rainfall Forecasts of Hurricane Irene (2011)
Authors: Smith Molly B. , Torn Ryan D. , Corbosiero Kristen L. , Pegion Philip 
Published: July 2020

AbstractTropical cyclones (TCs) moving into the midlatitudes can produce extreme precipitation, as was the case with Hurricane Irene (2011). Despite the high-impact nature of these events, relatively few studies have explored the sensitivity of TC precipitation forecasts to model initial conditions. Here, the physical processes that modulate precipitation forecasts over the Northeast United States during Irene are investigated using an 80-member 0.5° Global Forecasting System (GFS) ensemble. The members that forecast the highest total precipitation over the Catskill Mountains in New York (i.e., wet members) are compared with the members that predicted the least precipitation (i.e., dry members). Results indicate that the amount of rainfall is tied to storm track, with the wetter members forecast to move farther west than the dry members. This variability in storm track appears to be associated with variability in analyzed upper-tropospheric potential vorticity (PV), such that the wetter members feature greater cyclonic PV southwest of Irene when Irene is off the Carolina coast. By contrast, the wetter members of a 3-km Weather Research and Forecasting (WRF) Model ensemble, initialized from the same GFS ensemble forecasts, show little sensitivity to track. Instead, the wetter members are characterized by stronger lower-tropospheric winds perpendicular to the eastern face of the Catskills, allowing maximum upslope forcing and horizontal moisture flux convergence during the period of heaviest rainfall. The drier members, on the other hand, have the greatest quasigeostrophic forcing for ascent, implying that the members’ differences in mesoscale topographic forcing are the dominant influence on rainfall rate.
The Effect of Employee Desire and Employee Engagement on Organizational Performance: Evidence from ICT Sector in Kerala, India
Authors: Sabu V.G.  , Manoj M.  
Published: July 2020

This study analyses the multivariate effect of employee desire (ED) and employee engagement (EE) on organizational performance (OP). The data were collected from 352 executive employees belonging to public and private information and communications technology (ICT) sector organizations in Kerala, India. The stratified random sampling technique was applied for selecting the samples and the data were collected using a structured questionnaire. The structural equation modeling (SEM) technique was applied to study the causal linkage among the variables. The analysis revealed that OP is positively influenced by ED and EE. The study further confirms the mediation effect of EE in the relationship between ED and OP. The effects are statistically significant. The study furnishes beneficial inputs for practising managers, which can encourage EE and strengthen OP. JEL Code: M54
Multidisciplinary team approach for Merkel cell carcinoma: the European Institute of Oncology experience with focus on radiotherapy
Authors: Zerini Dario , Patti Filippo , Spada Francesca , Fazio Nicola , Pisa Eleonora , Pennacchioli Elisabetta , Prestianni Pierpaolo , Cambria Raffaella , Pepa Matteo , Grana Chiara Maria , Bonomo Guido , Funicelli Luigi , Jereczek-Fossa Barbara Alicja , Orecchia Roberto 
Published: July 2020

Objective: To review the therapeutic strategy in Merkel cell carcinoma (MCC) treated with radiotherapy (RT) discussed in a multidisciplinary tumour board. Methods: Clinical records of patients with a diagnosis of MCC and with an indication to undergo RT at the European Institute of Oncology between 2003 and 2018 were reviewed retrospectively. Results: Twenty-six patients were included in the analysis (median age 65 years, range 42–87). Nineteen received adjuvant RT, 4 exclusive RT, and the remainder palliative RT. Intensity-modulated RT was used in 13 cases, a 3D conformal technique in 11 cases, and stereotactic RT in 2 cases. No major toxicities were recorded. The median relapse-free survival (RFS) after adjuvant RT was 20.5 months, while for unknown primary MCC, it was 23 months. In the adjuvant setting, median polyomavirus-positive RFS was 21.5 months (range 1–49) and median polyomavirus-negative RFS was only 14 months (range 4–45). Overall, RFS of polyomavirus-positive and polyomavirus-negative patients was 10.5 and 8 months, respectively. After adjuvant RT, only 1 out of 10 patients had a recurrence in the RT field. At the time of data collection, 16 patients were alive with no evidence of disease, 1 patient was alive with advanced status of disease, 8 patients died of disease progression, and 1 patient died of other causes. Conclusions: The management of unknown primary and polyomavirus-positive cases, which had a better prognosis in our series, may benefit from a multidisciplinary approach, given the limited data available regarding optimal treatment.
Comparative Evaluation of Fluoride Release From Chemically Cured and Light-Cured Orthodontic Bonding Agents and Surface Alteration of Enamel: An in vitro Study
Authors: Barik Ashish Kumar , Duggal Ritu 
Published: July 2020

Introduction: Fluoride is known to reduce demineralization and enhance remineralization which is desirable around orthodontic brackets. Material and methods: This study was carried out to determine the rate of fluoride release, fluoride content of enamel, and surface alteration of enamel from orthodontic bonding agents. Thirty extracted maxillary first premolars were divided into 2 groups of 15 teeth each. Group A—teeth were bonded with a chemically cured orthodontic bonding agent containing fluoride (Rely-a-Bond, Reliance, Itasca) and group B—teeth were bonded with a light-cured orthodontic bonding agent containing fluoride (Light Bond Reliance, Itasca). All individual sample teeth were used to estimate fluoride release and fluoride content of enamel. The same samples were also used to evaluate enamel surface alterations. The rate of fluoride release from the above 2 orthodontic bonding agents were measured in artificial saliva on day 1, 2, 3, 4, 5, 6, 7, 14, 30, 60, and 90. The fluoride content of the enamel was evaluated on day “0” and day “90” of bonding. The samples were also evaluated for the surface changes in enamel using scanning electron microscope (SEM). Results: The results showed that (a) chemically cured and light-cured bonding agent showed a dramatic decrease in the concentration of fluoride release from day “1” to day “2,” (b) the concentration of fluoride release kept decreasing from day “1” to day “90” of measurement in both the groups, and (c) SEM of the bracket margins bonded with chemically cured bonding agent and light-cured bonding agent revealed particle depositions of irregular shape and size on day “90.” Conclusion: Light-cured bonding agent (Light Bond) released higher concentration of fluoride as compared to chemically cured bonding agent (Rely-a-Bond). Light-cured bonding agent (Light Bond) showed higher increase in fluoride content of enamel than chemically cured bonding agent (Rely-a-Bond).
Description of Pharmacogenomic Testing Among Patients Admitted to the Intensive Care Unit After Cardiovascular Surgery
Authors: Peterson Pamela E. , Nicholson Wayne T. , Moyer Ann M. , Arendt Christopher J. , Smischney Nathan J. , Seelhammer Troy G. , Krecke Catherine A. , Haney Rory M. , Yaw Elissa J. , Chlan Linda L. 
Published: July 2020

Background: Pharmacogenomic (PGx) testing has the potential to provide information on specific drug-metabolizing enzymes that may lead to an absence, reduction, or increase in medication effect in patients. There is a paucity of prospective studies examining PGx testing in the intensive care unit (ICU) setting. Research Aims: To (1) obtain a PGx panel in a sample of cardiovascular (CV) surgical patients with a planned ICU stay and identify phenotypes, and (2) identify PGx variants that may inform treatment regimens and may warrant prescribing adjustments. Design and Methods: Descriptive, single cohort cross-sectional design. Adult (≥18 years) CV patients with an anticipated postoperative ICU stay were enrolled from a large Midwestern tertiary academic medical center. Eligible patients provided informed consent at the time of their CV clinic appointment; PGx testing was then ordered. Pharmacogenomic testing consisted of the Focused Pharmacogenomics panel which included 10 genes and 55 medications. Results: Of the 272 patients screened, 100 (68% male) patients completed PGx testing (mean age 66.2 ± 9.6 years, mean Acute Physiology, Age and Chronic Health Evaluation III score 76.1 ± standard deviation). Pharmacogenomic results were available in the medical record within a median of 52.4 hours (interquartile range: 33.4-80.3). Pharmacogenomic testing results identified 5 CYP2C19 poor metabolizers, 26 CYP2C19 rapid metabolizers, 5 CYP2C19 ultrarapid metabolizers, 6 CYP2D6 poor metabolizers, 5 CYP2D6 poor to intermediate metabolizers, and 2 CYP2D6 rapid metabolizers identified. Overall, 98% of patients had actionable or potentially actionable PGx results, including 82% for warfarin, 65% for propafenone, 65% for tramadol, 46% for oxycodone, 45% for metoprolol, 33% for clopidogrel, 32% for proton pump inhibitors, 25% for statins, and 12% for haloperidol. Conclusions: A significant portion of patients had identified genetic variants that may warrant changes in medication management during and after CV-ICU stay. It remains to be seen if PGx testing leads to improvements in ICU patient outcomes.
Lactating Women’s Knowledge and Attitudes About Donor Human Milk in China
Authors: Tian Ce , Li Yamin , Soowon Lee , Xu Ying , Zhu Qin , Zhao Hong 
Published: July 2020

Background Donor milk is the preferred substitute to mother’s own milk, which can protect high-risk infants from many complications. Several milk banks have been established in China. However, the small number of donors and insufficient milk donated have become the primary obstacles for these milk banks. Research aims To explore the level of, and the factors influencing, knowledge and attitude about donor milk among currently lactating women across mainland China and to provide a reference for the development of Chinese milk banks. Methods A brief, self-reporting, prospective, cross-sectional, online survey was conducted in 2018 using The Knowledge and Attitude Questionnaire of Human Donor Milk for Hospitalized Women. Lactating women aged >18 years and willing to consent to study participation were recruited throughout China. Results All completed questionnaires ( N = 489) were included. 40.1% ( n = 196) of the participants had heard of donor milk or milk banks, and 76.7% ( n = 375) were willing to donate their milk. In the multiple linear regression analysis, educational level, cohabitation status, parity, history of delivering preterm or low-birth-weight infants, education provided by health professionals, and infants’ gestational age, weight, and feeding patterns were associated with the participants’ knowledge about donor milk ( F = 12.387, p < .001). The parity, delivery mode, mothers’ milk production, history of delivering preterm or low-birth-weight infants, education provided by health professionals, and infants’ age were associated with their attitude ( F = 9.420, p < .001). Conclusion The participants’ attitudes about donor milk were positive. However, there were gaps in their knowledge about donor milk.
Influences over Italian nurses’ job satisfaction and willingness to recommend their workplace
Authors: Vainieri Milena , Seghieri Chiara , Barchielli Chiara 
Published: July 2020

Background Nurses’ perception towards job satisfaction and willingness to recommend their workplace are relevant to a number of areas including the quality of nursing care delivery. Hence, an increasing number of scholars seek to understand the factors that influence these two concepts. Yet, inclusiveness and openness to innovation are under-investigated. Purpose The paper focuses on the relative importance that factors like propensity towards innovation, working conditions and inclusion have on nurses’ job satisfaction and their willingness to recommend their workplace. Methods A large sample of nurses was extracted from the organizational climate survey carried out in all healthcare authorities of nine Italian Regions through the years 2016–2018. Descriptive and multilevel regressions were carried out to investigate the factors that influence nurses’ job satisfaction and their willingness to recommend the hospital in which they work in, analysing both overall and in specific age classes. Results When recommending a workplace, nurses tend to recommend units showing higher propensity to innovate (OR 2.83), while the most important factor related to job satisfaction is the encouragement after a failure (OR 2.23). Inclusiveness is a key factor for both job satisfaction and willingness to recommend, whilst innovation prone organizations appear to be the most attractive for nurses. The levers mix is slightly different among the age classes. Findings identify the levers to be used in order to attract nurse workforce and increase nurses’ job satisfaction. These levers are partially different for young and senior nurses.
How Does Public Debt Affect the Indian Macroeconomy? A Structural VAR Approach
Authors: Mohanty Ranjan Kumar , Panda Sidheswar 
Published: July 2020

The study investigates the macroeconomic effects of public debt in India during 1980–2017 using a structural vector autoregression framework. The objective is to examine the impact of public debt on the interest rate, investment, inflation and economic growth in India. The results of the impulse response functions show that public debt has an adverse impact on economic growth but a positive impact on the long-term interest rate in the short run and a mixed effect (both negative and positive) on investment and inflation. We also find that domestic debt has a more adverse impact on the economy than external debt. The estimated variance decomposition analysis finds that much of the variation in selected macro variables are explained by public debt and growth in India. This study suggests that public debt especially domestic debt should be controlled and channelled productively to have a favourable impact on the economy. JEL Classification: H63, O40, C40
Cultivating Cultural Competence: How Are Hospice Staff Being Educated to Engage Racially and Ethnically Diverse Patients?
Authors: Boucher Nathan A. , Johnson Kimberly S. 
Published: July 2020

Background: Compared to Whites, racial/ethnic minorities are less likely to enroll in hospice and if they enroll, more likely to experience poor quality care. Building cultural competence (CC) among hospice staff is a strategy that may reduce disparities. Objective: To describe the state of CC training across hospices. Design: National survey of hospices’ practices to promote CC. Results: A total of 197 hospices participated; most were not-for-profit (80%) with an average daily census less than 100 (47%); 73% offered staff cultural competence training (CCT). There were no differences in characteristics of hospices who offered CCT and those that did not. Of hospices offering CCT, 61% held it annually. Most trainings were 1 hour (60%); content was delivered via web (58%) and/or lecture (58%). While over 90% of staff (i.e., nurses, social workers, chaplains) completed CCT, a smaller proportion of medical directors (64%), senior leaders (71%) and board members (26%) did so. Most common topics were: cross-cultural communication, death/illness beliefs, spirituality’s role, and healthcare disparities. The majority focused on African-Americans (83%), Hispanics (76%), and Asians (62%)—the most common U.S. minority groups. Almost 30% reported no effectiveness assessment of CCT, while 51% reported a quiz at the end of training. Most hospices offered some CCT. Conclusions: CCT has been shown to improve healthcare providers’ knowledge and skills in caring for diverse patients and it is associated with increased patient satisfaction. Future research should evaluate effectiveness of CCT in improving the ability of hospices to deliver high quality end-of-life care to diverse groups of older adults.
Predictors of mortality in inflammatory bowel disease patients treated for pneumonia
Authors: Ukashi Offir , Barash Yifatch , Segel Michael J. , Ungar Bella , Soffer Shelly , Ben-Horin Shomron , Klang Eyal , Kopylov Uri 
Published: July 2020

Background: Community-acquired pneumonia is among the most common infections affecting ulcerative colitis and Crohn’s disease patients. Data regarding epidemiology and outcomes of pneumonia in inflammatory bowel disease patients is lacking. We aimed to identify predictors of adverse outcomes among inflammatory bowel disease patients treated for pneumonia. Methods: This was a retrospective cohort study that included adult patients admitted to Sheba Medical Center for pneumonia between 2012 and 2018. Data was collected from an electronic repository of all emergency department admissions and included tabular demographic and clinical variables and free-text physician records. Pneumonia cases were extracted using the International Classification of Diseases (ICD-10) coding. Results: Of 16,732 admissions with pneumonia, 97 were inflammatory bowel disease patients (45 Crohn’s disease; 52 ulcerative colitis). We found a similar rate of 30-day mortality among inflammatory bowel disease and non-inflammatory bowel disease patients (12.1% versus 11.3%, p = 0.824) and between Crohn’s disease and ulcerative colitis patients (11.1% versus 11.5%, p = 0.947). There was an increased hospitalization rate among inflammatory bowel disease patients (92.8% versus 85.6%, p = 0.045), but similar hospitalization duration (4 versus 4 days, p = 0.384). Crohn’s disease patients had a shorter hospitalization duration compared with ulcerative colitis patients (3 versus 5.5 days, p = 0.029). Bronchiectasis (adjusted odds ratio 60.95, 95% confidence interval 2.72–1364.39, p = 0.01) and opioids use (adjusted odds ratio 13.21, 95% confidence interval 1.29–135.18, p = 0.03) were associated with an increased 30-day mortality rate in inflammatory bowel disease patients. Conclusion: This is the first study to identify predictors of mortality in inflammatory bowel disease patients with pneumonia. The rate of mortality and hospitalization duration of stay were similar among inflammatory bowel disease and non-inflammatory bowel disease patients. Use of opioids and presence of bronchiectasis were associated with a higher risk of mortality in inflammatory bowel disease patients with pneumonia.
Assessment of lateral hindfoot impingement with weightbearing multiplanar imaging in a flatfoot
Authors: Yoshida Yasuhisa , Matsubara Hidenori , Kawashima Hiroki , Aikawa Takao , Ugaji Shuhei , Hamada Tomo , Tsuchiya Hiroyuki 
Published: July 2020

Background Estimation of the lateral hindfoot impingement in the standing position in conventional radiography can be difficult due to superimposition of different bones. Patients with flat feet frequently suffer from pain around the lateral malleolus and sinus tarsi caused by osseous impingement in the lateral hindfoot. Weightbearing multiplanar images (tomosynthesis) yield tomographic images and can be taken while full weightbearing. Purpose To assess the availability of tomosynthesis to determine hindfoot lateral impingement. Material and Methods A total of 14 feet (in 13 patients) with acquired flatfoot deformity and lateral hindfoot pain were included (mean age 64 years; age range 55–80 years). All patients underwent tomosynthesis, radiography, and computed tomography (CT) (non-weightbearing). Talofibular, calcaneofibular, and talocalcaneal impingement were determined. To compare the number of impingements or to determine the area between each image, statistical evaluations were analyzed using the Mann–Whitney U-test ( P < 0.05). Results On tomosynthesis, we clearly found talofibular impingement in three feet, calcaneofibular impingement in seven feet, and talocalcaneal impingement in 11 feet. Therefore, we could identify most impingements as “positive” compared to those on normal radiographs and CT images. The number of impingements in the calcaneofibular and talocalcaneal regions was significantly higher using tomosynthesis than when using CT ( P < 0.05). Conclusion Tomosynthesis imaging makes it easier to obtain CT-like images in a short period of time, in a free position, including while standing, and provides useful information to assess lateral pain in patients with flatfoot deformity.