bluuebunny/crossref_metadata_2025_split huggingface dataset:
Arctic Lower-Tropospheric Warm and Cold Extremes: Horizontal and Vertical Transport, Diabatic Processes, and Linkage to Synoptic Circulation Features
Authors: Papritz Lukas 
Published: October 2019

AbstractThe thermodynamic processes and synoptic circulation features driving lower-tropospheric temperature extremes in the high Arctic (>80°N) are investigated. Based on 10-day kinematic backward trajectories from the 5% most intense potential temperature anomalies, the contributions of horizontal and vertical transport, subsidence-induced warming, and diabatic processes to the generation of the Arctic temperature anomaly are quantified. Cold extremes are mainly the result of sustained radiative cooling due to a sheltering of the Arctic from meridional airmass exchanges. This is linked to a strengthening of the tropospheric polar vortex, a reduced frequency of high-latitude blocking, and in winter also a southward shift of the North Atlantic storm track. The temperature anomaly of 60% of wintertime extremely warm air masses (90% in summer) is due to transport from a potentially warmer region. Subsidence from the Arctic midtroposphere in blocking anticyclones is the most important warming process with the largest contribution in summer (70% of extremely warm air masses). In both seasons, poleward transport of already warm air masses contributes around 20% and is favored by a poleward shift of the North Atlantic storm track. Finally, about 40% of the air masses in winter are of an Arctic origin and experience diabatic heating by surface heat fluxes in marine cold air outbreaks. Our study emphasizes the importance of processes in the Arctic and the relevance of anomalous blocking—in winter in the Barents, Kara, and Laptev Seas and in summer in the high Arctic—for the formation of warm extremes.
Intergyre Salt Transport in the Climate Warming Response
Authors: Levang Samuel J. , Schmitt Raymond W. 
Published: October 2019

ABSTRACTRegional connectivity is important to the global climate salinity response, particularly because salinity anomalies do not have a damping feedback with atmospheric freshwater fluxes and may therefore be advected over long distances by ocean circulation, resulting in nonlocal influences. Climate model intercomparison experiments such as CMIP5 exhibit large uncertainty in some aspects of the salinity response, hypothesized here to be a result of ocean dynamics. We use two types of Lagrangian particle tracking experiments to investigate pathways of exchange for salinity anomalies. The first uses forward trajectories to estimate average transport time scales between water cycle regimes. The second uses reverse trajectories and a freshwater accumulation method to quantitatively identify remote influences in the salinity response. Additionally, we compare velocity fields with both resolved and parameterized eddies to understand the impact of eddy stirring on intergyre exchange. These experiments show that surface anomalies are readily exchanged within the ocean gyres by the mean circulation, but intergyre exchange is slower and largely eddy driven. These dynamics are used to analyze the North Atlantic salinity response to climate warming and water cycle intensification, where the system is broadly forced with fresh surface anomalies in the subpolar gyre and salty surface anomalies in the subtropical gyres. Under these competing forcings, strong intergyre eddy fluxes carry anomalously salty subtropical water into the subpolar gyre which balances out much of the local freshwater input.
Securing Decarbonisation and Growth
Authors: Zenghelis Dimitri 
Published: October 2019

Executive SummaryThe need to decarbonise the economy in order to slow the pace of climate change is now recognised as one of the most pressing international policy challenges. While the UK cannot by itself materially affect global climate change, it has an opportunity to play an influential role, both by persuading others of the need for action but also by reshaping its domestic economy to benefit from a low-carbon transition.Far from hampering competitiveness, adoption of a coordinated policy approach to climate change today would generate positive benefits for the UK economy, especially if it addresses the multiple market failures that promote pollution and places decarbonisation at the heart of structural economic policy.Desirable strategies would include public support for research, development, and deployment of new technologies, and measures to foster an environment where innovation can rapidly shift the economy from dirty to clean production systems. Focusing UK industrial strategy on securing strong domestic supply chains for green products and services, for example, could help create an early mover advantage in rapidly growing global market sectors. Interventions could include the establishment of a National Infrastructure Bank to support decarbonisation in crucial sectors such as energy and transport, and would also need to encompass measures to assist structural adjustment in affected industries and their workforces.
Long-term training in diabetes-related knowledge, attitudes, and self-reported practice among diabetes liaison nurses
Authors: Zhou Wen , Huang Jin , Yang Lingfeng , Qiu Tieying , Zhang Yan , Liu Fang , Zhou Zhiguang 
Published: October 2019

Objective We aimed to investigate whether long-term regular training of diabetes liaison nurses (DLNs) could improve their diabetes-related knowledge, attitudes, and self-reported practice. Methods We enrolled 45 diabetes liaison nurses (DLNs) and 45 non-specialist nurses (controls). DLNs received 11 days of qualifying training, followed by regular theory classes and practice sessions for 4 years. All nurses were administered a questionnaire assessing demographic characteristics, knowledge about diabetes mellitus (DM), attitudes toward DM, and DM management practices, before and after the 4-year DLN training period. Results At baseline, there were no significant differences between the DLN and control groups for sex, age, educational level, nurse title/grade, work experience, hospital department, or questionnaire scores. At 4 years, the DLN group had a higher overall questionnaire score and higher scores for knowledge about DM, attitudes toward DM, and DM management practices, as compared with baseline scores. Conclusion Long-term regular training provided by a multidisciplinary diabetes care team can improve the knowledge, attitudes, and self-reported practice levels of DLNs.
An Insight into the Role of the Maxillary Labial Frenum in the Growth of the Maxilla: A Systematic Review
Authors: Rajagopalan Rajani Elayadath , Padmaprabha Biswas Palakunnu 
Published: October 2019

Background: The review attempts to provide synthesis of published studies evaluating the influence of an aberrant frenum attached close to the gingival margin or with inadequate width of attached gingiva on the growth of the maxilla. Methodology: This review was reported using the PRISMA checklist as a template. PubMed, EBSCO and Google scholar were searched for in earlier publications up to January 2019. In addition, reference lists of the included studies were hand searched. The eligibility criteria were listed out based on Population, Intervention, Comparison, Outcome, Study type (PICOS) concept. Results: A total of 148 articles were found by database search strategies and 27 additional studies by hand search. Finally three cross sectional and one longitudinal study were selected based on the eligibility criteria. A meta-analysis was not justified. Risk of bias was assessed using AXIS tool for cross sectional studies and Newcastle-Ottawa scale for longitudinal study. Common weaknesses of the studies were failure to justify or calculate the sample size and insufficient statistical reporting. Conclusion: This review reveals that there is a need for methodologically standardized studies that will throw light on to the physiological importance of labial frenum in the growth of the nasomaxillary complex.
Effects of Reinforced Oral Hygiene Instruction Program With and Without Professional Tooth Cleaning on Plaque Control and Gingival Health of Orthodontic Patients Wearing Multibracket Appliances
Authors: Singla Sapna , Gupta Priyanka , Lehl Gurvanit , Talwar Manjit 
Published: October 2019

Introduction: Fixed orthodontic therapy is considered to be one of the important risk factor for plaque accumulation, since various orthodontic components serves as the retentive areas for plaque accumulation and thus increasing the risk of caries and periodontitis. Therefore these patients must be encouraged to maintain good oral health throughout the treatment. Objective: To investigate the effects of reinforced oral hygiene instruction programme with and without professional tooth cleaning on the plaque accumulation and gingival health of orthodontic patients wearing fixed multibracket appliances. Material and Methods: Forty patients with fixed orthodontic appliances in the age range of 12–28 years were divided randomly into Group I (n=20) and Group II (n=20). Group I received oral hygiene instructions and Group II received similar instructions supplemented with one sitting of professional tooth cleaning. The plaque and gingival index were recorded at the baseline (before the instructions), after 4 and 8 weeks in both the groups. At each visit all the instructions were reinforced in both the groups. Results: Intergroup comparison showed significant decrease in the mean plaque score at 4 weeks in Group II (p<0.01), but no significant difference in the mean plaque score at 8 weeks and mean gingival scores at 4 and 8 weeks between both the groups. Within the group comparison, showed that the mean values of both the indices showed significant decrease after 8 weeks in both the groups (p<0.01). Conclusion: Reinforced oral hygiene instruction programme with or without professional prophylaxis can lead to efficient control of plaque accumulation as well as improvement in the gingival health of orthodontic patients wearing multibracket appliances. However, provision of professional tooth cleaning should be based on individual plaque control needs.
Release of partial syndactyly using a trident flap without skin grafting
Authors: Guero Stéphane 
Published: October 2019

We reviewed outcomes of a modified trident flap technique in 83 patients for a series of partial syndactyly releases performed by a single operator over 30 years. Only patients with at least 3 years of follow-up (range 3 to 27 years) were included. One-hundred and twenty-seven procedures were performed for 83 patients, and no cases of flap necrosis occurred. Three hands had Grade 1 web creep on Withey’s semi-quantitative scoring system, and two had Grade 2 web creep. Revision surgery was required for one minor contracture and one intermediate contracture. Abduction angles of up to 30° were measured for operated adjacent fingers. The mean satisfaction score of the child or parents on the visual analogue scale was 1.1. The trident flap is a safe procedure, with excellent functional and cosmetic outcomes. The residual scarring is limited to the web, and there is no scarring on the dorsum of the hand. Level of evidence: IV
Performance and Return to Sport After Anterior Cruciate Ligament Reconstruction in Professional Baseball Players
Authors: Erickson Brandon J. , Chalmers Peter N. , D’Angelo John , Ma Kevin , Dahm Diane L. , Romeo Anthony A. , Ahmad Christopher S. 
Published: October 2019

Background: Anterior cruciate ligament reconstruction (ACLR) is the gold standard treatment for ACL tears to allow baseball players to return to sport (RTS). The optimal graft type and femoral tunnel drilling technique are currently unknown. Hypothesis: There is a high rate of RTS in professional baseball players after ACLR, with no significant difference in RTS rates or performance between cases and controls or between graft types or femoral drilling techniques. Study Design: Cohort study; Level of evidence, 3. Methods: All professional baseball players who underwent ACLR between 2010 and 2015 were included. Demographic and performance data (pre- and postoperative) for each player were recorded. Performance metrics were then compared between cases and matched controls. Results: A total of 124 players (mean age, 23.7 ± 4.1 years; 83% minor league players) underwent ACLR. Of these, 80% returned to sport (73% to the same or higher level) at a mean 310 ± 109 days overall and 333 ± 126 days at the same or higher level. The most common graft type was an ipsilateral bone–patellar tendon–bone (BTB) autograft (n = 87; 70%). A total of 91 players underwent concomitant meniscal debridement or repair. No significant difference in any of the primary performance metrics existed from before to after ACLR. Compared with matched controls, no significant difference existed in RTS rates or any performance metrics after ACLR. No significant difference existed in RTS rates or primary performance outcome measures between graft types or femoral drilling techniques. Conclusion: The RTS rate for professional baseball players after ACLR was 80%. No significant difference in performance metrics existed between BTB and hamstring autografts or between femoral drilling techniques. Furthermore, no significant difference in performance or RTS rates existed between cases and matched controls. Femoral drilling technique and graft type did not affect performance and RTS rates in professional baseball players after ACLR.
ACL Reconstruction Using Autologous Hamstrings Augmented With the Ligament Augmentation and Reconstruction System Provides Good Clinical Scores, High Levels of Satisfaction and Return to Sport, and a Low Retear Rate at 2 Years
Authors: Ebert Jay R. , Annear Peter T. 
Published: October 2019

Background: There are a number of surgical methods for undertaking anterior cruciate ligament (ACL) reconstruction (ACLR), although relatively high rates of ipsilateral retears and contralateral tears exist, with only 65% of patients returning to their preinjury level of sport. ACLR techniques adopting synthetic augmentation have been proposed in an attempt to improve clinical outcomes and reduce reinjury rates. Purpose: To determine the efficacy of ACLR using autologous hamstrings augmented with the Ligament Augmentation and Reconstruction System (LARS). Study Design: Case series; Level of evidence, 4. Methods: A total of 65 patients were prospectively treated with arthroscopically assisted single-bundle ACLR using hamstrings augmented with the LARS, of whom 50 were available for 1- and 2-year reviews. Patient-reported outcome measures (PROMs), KT-1000 arthrometer testing, knee range of motion, peak isokinetic knee strength testing, and a battery of 4 hop tests were employed. Limb symmetry indices (LSIs) were calculated. Analysis of variance was used to evaluate differences over time and between limbs. Data on return to the preinjury level of sport, retears, and reoperations were collected. Results: High PROM scores were demonstrated at 1 and 2 years. Before the injury, 47 patients (94%) were actively participating in level 1 or 2 sports, with 38 (76%) and 43 (86%) patients having returned at 1 and 2 years, respectively. Normal (<3 mm; 90%) or nearly normal (3-5 mm; 10%) KT-1000 arthrometer side-to-side differences were observed at 2 years. Apart from knee flexion ( P < .0001), extension ( P = .001), and the 6-m timed hop ( P = .039), there were no between-limb differences at 1 year, and there were no differences on any objective measures at 2 years (all P > .05). Mean LSIs across all measures were ≥90%. At 2 years, 84% to 90% of patients were ≥90% on the hop tests, with 72% and 76% of patients having ≥90% for extension and flexion strength, respectively. Two reoperations were undertaken for meniscal tears (7 and 8.5 months), 1 patient (2%) suffered a retear at 7 months, and 2 patients (3%) suffered a contralateral tear (8 and 12 months). Conclusion: This augmented ACLR technique demonstrated good clinical scores, a high rate of return to sport, and low rates of secondary ruptures and contralateral ACL tears at 2 years. Some caution should be noted in interpreting these results, as 15 of 65 patients (23%) were not included in the 2-year follow-up.
The Value of Agile Ways of Working in a Non-Profit Network Organization
Authors: Kramer Willemijn , Heuvel Jaap van den 
Published: October 2019

Agile ways of working have been applied to single organizations and corporations. But cases on agility for non-profit associations dealing with a multitude of members, geographies and their own boards are scarce. Can agility also be applied in a non-profit networked organizational setting in a way that creates value, rather than destroying it? The focus of this article will be on the outcomes of piloting agility with a virtual long-distance team across Europe, including benefits and pitfalls. Value should be created through virtual teams of the association: both for the benefit of members and the association itself. If there is no or little value created there, the members will be unlikely to participate in these groups, undermining the added value of the association. Currently, these teams do not all create value for the membership, and sometimes even destroy value by costing the membership time and money and not delivering relevant output. In this pilot study, one virtual group was followed, interviews with the group members have been held and the members of the association were surveyed about the existing situation in the focal organization. We found that an agile way of working is beneficial for a virtual team and implementing this in an ailing virtual team can give it new élan. This way, the teams can deliver value to the membership, and thus to the association, instead of the groups not functioning well leading to value destruction for the association, as members might turn away from the association for their sought added value. Further, the network organization itself partially shows traits of organizational agility, which could be improved to fully support virtual teams.
Psychosexual Dysfunctions Among Alcohol-Dependent Individuals: A Cross-Sectional Study from a Tertiary Care Center of Southern India
Authors: Nair Priya R. , Sam Sivin P. , Kallivayalil Roy Abraham 
Published: October 2019

Background: Chronic alcohol dependence is known to cause psychosexual dysfunction, which leads to marked psychiatric morbidity. There is a dearth of studies from India in this area. Aim: To estimate the frequency of psychosexual dysfunction in individuals with alcohol dependence and to explore the association between psychosexual dysfunction and various socio-demographic and alcohol-related variables. Materials and Methods: This is a cross-sectional descriptive study conducted on 50 male patients in a tertiary care center. The evaluation was conducted using a specially designed intake pro forma and tools such as the severity of alcohol dependence questionnaire, checklist for sexual dysfunction and International Classification of Disease, Tenth Revision, and diagnostic criteria for research. Results: Sexual dysfunction was present in 66% of alcohol-dependent individuals. The most common among them was found to be aversion to sex (32%) followed by erectile dysfunction (24%). In most of the cases, patients having erectile dysfunction were also found to have aversion to sex. Conclusion: Sexual dysfunction is highly prevalent in male patients with alcohol dependence. The study highlights the detrimental effects of alcohol on sexual function apart from other etiological factors.
Results of the standard set for pulmonary sarcoidosis: feasibility and multicentre outcomes
Authors: Kampstra Nynke A. , van der Nat Paul B. , Dijksman Lea M. , van Beek Frouke T. , Culver Daniel A. , Baughman Robert P. , Renzoni Elisabetta A. , Wuyts Wim , Kouranos Vasilis , Zanen Pieter , Wijsenbeek Marlies S. , Eijkemans Marinus J.C. , Biesma Douwe H. , van der Wees Philip J. , Grutters Jan C. 
Published: October 2019

Our study presents findings on a previously developed standard set of clinical outcome data for pulmonary sarcoidosis patients. We aimed to assess whether changes in outcome varied between the different centres and to evaluate the feasibility of collecting the standard set retrospectively.This retrospective observational comparative benchmark study included six interstitial lung disease expert centres based in the Netherlands, Belgium, the UK and the USA. The standard set of outcome measures included 1) mortality, 2) changes in pulmonary function (forced vital capacity (FVC), forced expiratory volume in 1 s, diffusing capacity of the lung for carbon monoxide), 3) soluble interleukin-2 receptor (sIL-2R) change, 4) weight changes, 5) quality-of-life (QoL) measures, 6) osteoporosis and 7) clinical outcome status (COS). Data collection was considered feasible if the data were collected in ≥80% of all patients.509 patients were included in the retrospective cohort. In total six patients died, with a mean survival of 38±23.4 months after the diagnosis. Centres varied in mean baseline FVC, ranging from 110 (95% CI 92–124)% predicted to 99 (95% CI 97–123)% pred. Mean baseline body mass index (BMI) of patients in the different centres varied between 27 (95% CI 23.6–29.4) kg·m−2and 31.8 (95% CI 28.1–35.6) kg·m−2. 310 (60.9%) patients were still on systemic therapy 2 years after the diagnosis. It was feasible to measure mortality, changes in pulmonary function, weight changes and COS. It is not (yet) feasible to retrospectively collect sIL-2R, osteoporosis and QoL data internationally.This study shows that data collection for the standard set of outcome measures for pulmonary sarcoidosis was feasible for four out of seven outcome measures. Trends in pulmonary function and BMI were similar for different hospitals when comparing different practices.
A randomised single-centre trial of inhaled liposomal cyclosporine for bronchiolitis obliterans syndrome post-lung transplantation
Authors: Iacono Aldo , Wijesinha Marniker , Rajagopal Keshava , Murdock Natalia , Timofte Irina , Griffith Bartley , Terrin Michael 
Published: October 2019

IntroductionNo proven treatments exist for bronchiolitis obliterans syndrome (BOS) following lung transplantation. Inhaled liposomal cyclosporine (L-CsA) may prevent BOS progression.MethodsA 48-week phase IIb randomised clinical trial was conducted in 21 lung transplant patients with BOS assigned to either L-CsA with standard-of-care (SOC) oral immunosuppression (L-CsA group) or SOC (SOC-alone group). Efficacy end-points were BOS progression-free survival (defined as absence of ≥20% decline in forced expiratory volume in 1 s (FEV1) from randomisation, re-transplantation or death) and BOS grade change.ResultsBOS progression-free survival was 82% for L-CsAversus50% for SOC-alone (p=0.1) and BOS grade worsened in 18% for L-CsAversus60% for SOC-alone (p=0.05). Mean changes in ΔFEV1and forced vital capacity, respectively, stabilised with L-CsA: +0.005 (95% CI −0.004– +0.013) and −0.005 (95% CI −0.015– +0.006) L·month−1, but worsened with SOC-alone: −0.023 (95% CI −0.033– −0.013) and −0.026 (95% CI −0.039– −0.014) L·month−1(p<0.0001 and p=0.009). Median survival (4.1versus2.9 years; p=0.03) and infection rate (45%versus60%; p=0.7) improved with L-CsAversusSOC-alone; creatinine and tacrolimus levels were similar.ConclusionsL-CsA was well tolerated and stabilised lung function in lung transplant recipients affected by BOS without systemic toxicity, providing a basis for a global phase III trial using L-CsA.