bluuebunny/crossref_metadata_2025_split huggingface dataset:
Future Changes in Seasonality in East Africa from Regional Simulations with Explicit and Parameterized Convection
Authors: Wainwright Caroline M. , Marsham John H. , Rowell David P. , Finney Declan L. , Black Emily 
Published: December 2020

AbstractThe East African precipitation seasonal cycle is of significant societal importance, and yet the current generation of coupled global climate models fails to correctly capture this seasonality. The use of convective parameterization schemes is a known source of precipitation bias in such models. Recently, a high-resolution regional model was used to produce the first pan-African climate change simulation that explicitly models convection. Here, this is compared with a corresponding parameterized-convection simulation to explore the effect of the parameterization on representation of East Africa precipitation seasonality. Both models capture current seasonality, although an overestimate in September–October in the parameterized simulation leads to an early bias in the onset of the boreal autumn short rains, associated with higher convective instability and near-surface moist static energy. This bias is removed in the explicit model. Under future climate change both models show the short rains getting later and wetter. For the boreal spring long rains, the explicit convection simulation shows the onset advancing but the parameterized simulation shows little change. Over Uganda and western Kenya both simulations show rainfall increases in the January–February dry season and large increases in boreal summer and autumn rainfall, particularly in the explicit convection model, changing the shape of the seasonal cycle, with potential for pronounced socioeconomic impacts. Interannual variability is similar in both models. Results imply that parameterization of convection may be a source of uncertainty for projections of changes in seasonal timing from global models and that potentially impactful changes in seasonality should be highlighted to users.
Multi-Aspect Assessment of CMIP6 Models for Arctic Sea Ice Simulation
Authors: Long Mengyuan , Zhang Lujun , Hu Siyu , Qian Shimeng 
Published: December 2020

AbstractThis paper evaluates the ability of 35 models from phase 6 of the Coupled Model Intercomparison Project (CMIP6) to simulate Arctic sea ice by comparing simulated results with observation from the aspects of spatial patterns and temporal variation. The simulation ability of each model is also quantified by the Taylor score and e score from these two aspects. Results show that biases between observed and simulated Arctic sea ice concentration (SIC) are mainly located in the East Greenland, Barents, and Bering Seas and the Sea of Okhotsk. The largest difference between the observed and simulated SIC spatial patterns occurs in September. Since the beginning of the twenty-first century, the ability of most models to simulate summer SIC spatial patterns has decreased. We also find that models with the Sea Ice Simulator (SIS) sea ice component in CMIP6 show a consistent larger positive simulation biases of SIC in the East Greenland and Barents Seas. In addition, for most models, the higher the model resolution is, the better the match between the simulated and observed spatial patterns of winter Arctic SIC is. Furthermore, this paper makes a detailed assessment for temporal variation of Arctic sea ice extent (SIE) with regard to climatological average, seasonal SIE, multiyear linear trend, and detrended standard deviation of SIE. The sensitivity of September Arctic SIE to a given change of Arctic surface air temperature over 1979–2014 in each model has also been investigated. Most models simulate a smaller loss of September Arctic SIE per degree of warming than is observed (1.37 × 106 km2 K−1).
Making Choices from the Choices we have: The Contextual-Embeddedness of Occupational Choice
Authors: Hammell Karen Whalley 
Published: December 2020

Background. “Choice” is central to occupational therapy’s theoretical tradition, which maintains that individuals can impact their well-being through wisely choosing their occupations. However, the assumption that opportunities to choose are universally available is negated by research evidence. Purpose. To review the ideology of “choice” in occupational therapy theory, and to encourage more critical approaches toward determinants of occupational opportunity and choice. Key Issues. Evidence indicates that within Canada, and throughout the world, opportunities to make occupational choices are inequitably distributed among people of different socioeconomic classes, castes, genders, races, abilities, sexualities, citizenship statuses, and experiences of colonialism. Implications. Because occupation is a determinant of health and well-being, social injustices that create inequitable occupational choices are unfair violations of occupational rights. The occupational therapy profession’s espoused aim of enhancing well-being through occupation demands theories that explicitly recognize the socially structured and inequitable shaping of choice, and consequent impact on people’s occupational rights.
Full-size experimental assessment of the aerodynamic sealing of air curtains for particulate matter
Authors: Viegas João Carlos , Kaluzny Pascal , Durand Alexandra , Fluchaire Lisa , Franco Dulce , Saldanha Carlos , Morais João , Morais Paulo , Carrasco Levi , Pinto Luis 
Published: December 2020

An air curtain is used to ensure an adequate separation between two compartments that is aimed to restrict, a clean one and a contaminated one. The air curtain performance is improved with the use of an air extraction from the “contaminated” compartment. The aerodynamic sealing of an optimized air curtain is assessed regarding particulate matter. The evaluation using visual assessment of the aerodynamic sealing using a cold smoke source is validated against PM 10 detection. It is shown that the air curtain presents a good aerodynamic sealing for the particulate of PM10 and PM2.5 classes and that the visual assessment method can lead to similar results. An equation was obtained with a view to be used to predict the level of aerodynamic sealing of the air curtain when the exhaust rate becomes too low. Another equation was obtained for predicting the average velocity through the door protected by the air curtain required to obtain an aerodynamic sealing, as a function of the jet parameters (nozzle average velocity and thickness). These test results prove that the air curtain, complemented with an air exhaust from the “contaminated compartment”, is suitable to provide an acceptable aerodynamic sealing for the particulate matter. Practical application: The findings of this research are applicable when it is necessary to retain the contamination due to particulate matter using a soft boundary, as air plane jets. This is applicable to medical care centres to reduce the possibility of contamination due to bacteria between different compartments or in pharmaceutical process units to avoid cross contamination among them.
Factors affecting the occurrence of proximal endoleak after endovascular abdominal aortic repair for abdominal aneurysms
Authors: Mazzaccaro Daniela , Mazzeo Girolomina , Zuccon Gianmarco , Modafferi Alfredo , Malacrida Giovanni , Righini Paolo C. , Marrocco-Trischitta Massimiliano M. , Nano Giovanni 
Published: December 2020

Objective This retrospective study was performed to assess the clinical and radiological variables associated with proximal type IA endoleak (EL) in patients treated with elective endovascular repair for abdominal aortic aneurysms. Methods The chi-square test, t-test, and logistic regression analysis were performed as appropriate. A P value of <0.05 was considered statistically significant. Results The data of 79 patients were analyzed. No mortality occurred. During follow-up (median, 28.5 months; interquartile range, 12.8–43.0 months), 10 patients developed type IA EL. In the logistic regression analysis, undersizing of the endograft diameter by <10% significantly affected the occurrence of type IA EL. When the diameter was used for measurements, less oversizing was significantly associated with a higher risk of type IA EL. When the area was used for measurements, oversizing of >20% significantly affected the occurrence of type IA EL. Conclusion When sizing endografts, a discrepancy was noted between the measurements of the diameter and area of the proximal neck. The area might represent a more accurate measurement than the axial diameter to optimize the proximal sealing and lower the risk of developing type IA EL.
Hip Arthroscopy for Femoroacetabular Impingement in Adolescents: 10-Year Patient-Reported Outcomes
Authors: Menge Travis J. , Briggs Karen K. , Rahl Michael D. , Philippon Marc J. 
Published: December 2020

Background: Previous studies have demonstrated hip arthroscopy to be an effective treatment for femoroacetabular impingement (FAI) in individuals 18 years of age and older. Long-term outcome data in the adolescent population, however, are limited. Purpose: To report 10-year outcomes after hip arthroscopy in adolescents with symptomatic FAI. Study Design: Case series; Level of evidence, 4. Methods: Prospectively collected data were analyzed on adolescent patients younger than 18 years of age who had hip arthroscopy between March 2005 and 2009 with a minimum 10-year follow-up. Patients were included if they were diagnosed with symptomatic FAI and an associated labral tear that was treated with repair. Patients were excluded if they had previous hip procedures, acetabular dysplasia (lateral center-edge angle, <20°), avascular necrosis, previous hip fracture or dislocation, or Legg-Calve-Perthes disease, or refused to participate. The primary patient-reported outcome measure was the Hip Outcome Score (HOS) Activities of Daily Living (ADL) subscale. In addition, the HOS—Sport, modified Harris Hip Score (mHHS), 12-Item Short Form Health Survey (SF-12), and patient satisfaction were collected. Failure was defined as patients having to undergo revision arthroscopy. Results: There were 60 patients (70 hips) who met inclusion criteria and had a 10-year follow-up. The mean age of the cohort was 16 ± 1.2 years, with 21 male and 49 female hips. Seven hips (10%) required revision hip arthroscopy. All revisions occurred in female patients and were associated with global laxity as well as longer duration of symptoms before time of surgery. At a mean follow-up of 12 years (range, 10-14 years), patients who did not undergo revision surgery had significant improvements from preoperatively to postoperatively in HOS-ADL (from 64 to 92; P < .01), HOS–Sport (from 40 to 86; P < .01), mHHS (from 56 to 88; P < .01), and SF-12 Physical Component Summary (from 41 to 54; P < .01). The median patient satisfaction was 10 out of 10 (very satisfied). Conclusion: Hip arthroscopy for FAI with labral repair resulted in excellent patient-reported outcomes and satisfaction at a minimum of 10 years of follow-up. There was a 10% rate of revision surgery, which was associated with global laxity and longer duration of symptoms before surgery, which should be considered in patient selection.
Utilization of CMS pre-ESRD Kidney Disease Education services and its associations with the home dialysis therapies
Authors: Shukla Ashutosh M , Bozorgmehri Shahab , Ruchi Rupam , Mohandas Rajesh , Hale-Gallardo Jennifer L , Ozrazgat-Baslanti Tezcan , Orozco Tatiana , Segal Mark S , Jia Huanguang 
Published: December 2020

Background: Kidney Disease Education (KDE) has been shown to improve informed dialysis selection and home dialysis use, two long-held but underachieved goals of US nephrology community. In 2010, the Center for Medicare and Medicaid Services launched a policy of KDE reimbursements for all Medicare beneficiaries with advanced chronic kidney disease. However, the incorporation of KDE service in real-world practice and its association with the home dialysis utilization has not been examined. Methods: Using the 2016 US Renal Data System linked to end-stage renal disease (ESRD) and pre-ESRD Medicare claim data, we identified all adult incident ESRD patients with active Medicare benefits at their first-ever dialysis during the study period (1 January 2010 to 31 December 2014). From these, we identified those who had at least one KDE service code before their dialysis initiation (KDE cohort) and compared them to a parsimoniously matched non-KDE control cohort in 1:4 proportions for age, gender, ESRD network, and the year of dialysis initiation. The primary outcome was home dialysis use at dialysis initiation, and secondary outcomes were home dialysis use at day 90 and anytime through the course of ESRD. Results: Of the 369,968 qualifying incident ESRD Medicare beneficiaries with their first-ever dialysis during the study period, 3469 (0.9%) received KDE services before dialysis initiation. African American race, Hispanic ethnicity, and the presence of congestive heart failure and hypoalbuminemia were associated with significantly lower odds of receiving KDE services. Multivariate analyses showed that KDE recipients had twice the odds of initiating dialysis with home modalities (15.0% vs. 6.9%; adjusted odds ratio (aOR):95% confidence interval (CI) 2.0:1.7–2.4) and had significantly higher odds using home dialysis throughout the course of ESRD (home dialysis use at day 90 (17.6% vs. 9.9%, aOR:CI 1.7:1.4–1.9) and cumulatively (24.7% vs. 15.1%, aOR:CI 1.7:1.5–1.9)). Conclusions: Utilization of pre-ESRD KDE services is associated with significantly greater home dialysis utilization in the incident ESRD Medicare beneficiaries. The very low rates of utilization of these services suggest the need for focused systemic evaluations to identify and address the barriers and facilitators of this important patient-centered endeavor.
The Leadership Characteristics Model of Primary Public Health Administrators in Chachoengsao Province, Thailand
Authors: Wongprasit Nawasanan , Seangsawang Wichit , Chourwong Prawach , Prapatson Chatchai , Poolsawas Kasempat , Klinhom Vipawan 
Published: December 2020

The objectives of this research were aimed to study the leadership characteristics model of primary public health administrators in Chachoengsao Province, Thailand. The data of this qualitative research were collected by an in-depth interview. The instrument used in this research was semi-structured interview form designed by the researcher. Derived from purposive sampling, the key informants were comprised of 30 primary public health administrators or directors of the subdistrict health-promoting hospitals. The data were analysed by content analysis approach and interpreted in accordance with the research objectives. The findings revealed that the main leadership characteristics of primary public health administrators consisted of (a) the administrational integration, (b) the time management, (c) love for work, (d) the holistic health model, (e) the human resource management and (f) the ethics. These results were presented as a leadership characteristics model of primary public health administrators in Chachoengsao Province, Thailand, or the HEALTH model. For problems and obstacles, it was found that the problem of the mental condition of the caregivers of the in-bed patients had increased. The personal development following the central government’s policy was not in accordance with the genuine work need. The ineffective disease control obviously appeared because of the frequent immigration of alien labourers. Moreover, some Thai people in this area had bias to open the country. By this, they ignored to develop themselves. For suggestion and application, it was found that the staff responsible for the in-bed patients had increasingly encountered with a mental condition. The primary public health administrators should find solutions under participation of all related sectors in order to be ready and go forward to the perfect ageing society. As a result, the caregivers of the elderly were effective.
Left Ventricular Thrombus Therapy With Direct Oral Anticoagulants Versus Vitamin K Antagonists: A Systematic Review and Meta-Analysis
Authors: Saleiro Carolina , Lopes João , De Campos Diana , Puga Luís , Costa Marco , Gonçalves Lino , Teixeira Rogério 
Published: December 2020

Background: Current guidelines recommend vitamin K antagonists (VKAs) for left ventricular thrombus (LVT) resolution. Direct oral anticoagulants (DOACs) are increasingly evaluated as alternatives to the standard of care in anticoagulation. Methods: We performed a systematic review and meta-analysis to assess the use of DOACs vs VKAs for LVT treatment. The occurrence of LVT resolution, systemic embolism (SE) or stroke, and bleeding events were compared during follow-up using random-effects analysis. Results: The 5 included studies were all observational (a total of 828 patients). Of these, 284 patients (34%) were treated with DOACs, and 544 (66%) treated with VKAs. Thrombus resolution was similar for both methods (pooled odds ratio [OR], 0.91; 95% CI, 0.47-1.75; I 2 = 63%; P = .78). The incidence of SE or stroke was also similar (pooled OR, 1.59; 95% CI, 0.85-2.97; I 2 = 0%; P = .14). Clinically relevant bleeding incidence was similar for both groups (pooled OR, 0.66; 95% CI, 0.31-1.40; I 2 = 0%; P = .28), although all bleeding events were less frequent in the DOAC group (pooled OR, 0.49; 95% CI, 0.26-0.90; I 2 = 0%; P = .02). Conclusion: Our systematic review and meta-analysis suggests DOACs were as effective as VKAs for LVT resolution, with a similar risk of systemic embolism/stroke and clinically relevant bleeding. These results, obtained from observational studies, are not definitive and hence randomized controlled trials are needed. Nevertheless, our analysis identifies key experimental features required in future studies.
Sympathetic ophthalmia: Report of a case series and comprehensive review of the literature
Authors: Yang Jing , Li Yan , Xie Ruotian , Li Xiaorong , Zhang Xiaomin 
Published: December 2020

Purpose: To evaluate the factors related to sympathetic ophthalmia (SO) in a series of patients in our ophthalmology center and previously published cases. Methods: A retrospective and noncomparative review was performed on 16 patients with SO attending our ophthalmology center from 2013 to 2019. A total of 87 previously published cases of SO were identified by searching the Medline database from 2009 to 2019. Results: Sixteen patients were included in the analysis, and six cases were induced by transscleral cyclophotocoagulation (TCP). All patients had achieved controlled inflammation at their last follow-up visit. Thirteen patients (81.3%) had improved best-corrected visual acuity (BCVA). A review of the literature revealed 87 previously reported cases of SO. Shared clinical features and treatment outcomes were summarized. Conclusion: Ocular therapies, including both penetrating ocular therapy and non-penetrating ocular intervention, have become increasingly prevalent risk factors for SO, and the latent period has increased compared to past reports. Visual prognosis with appropriate medical management is relatively good.
New method to estimate femoral head size from the trochanteric length of the femur
Authors: Akinmokun Olasode I , Alabi Eyitayo O , Enweluzo George O , Akinsulire Adewole T , Ibeabuchi Nwachukwu M 
Published: December 2020

Introduction: Preoperative planning is an important step before any joint replacement surgery. In developing countries standardised radiographs and planning tools might not be available but nevertheless hemiarthroplasties are performed in certain trauma cases. An equation should be devised to allow a preoperative estimation of the expected femoral head size dimensions in those situations. Materials and methods: 35 lower limbs of human cadavers were studied. The estimated femoral head (EFH) size of each femur was obtained by measuring the trochanteric length (TL) (in cm) and using the equation ‘EFH = 16 + (0.7 × TL)’. The hip joint was dissected, and the actual size of the femoral head (AFH) was measured on the specimen. Results: There was a correlation between the EFH and AFH ( p = 0.0001). Accepting a range of ±3 mm the femoral head size was predicted correctly in 31 hips (89%), for ±4 mm in 33 hips (94%) and for ±5 mm in 35 hips (100%), respectively. Conclusions: A simple tape measurement and the equation Femoral head size = {16 + (0.7 × Trochanteric Length)} ±5 mm gives a rather reliable guess for the expected femoral head size. It might be useful as pre-operative planning tool if no standardised radiographs are available.
Knowledge, attitude and practice towards health research and its utilization among health professionals in Bhutan: Results of a nationwide cross-sectional survey in 2019
Authors: Dorji Thinley , Wangmo Shacha , Gurung Mongal Singh , Tenzin Karma , Penjore Tashi , Lucero-Prisno Don Eliseo 
Published: December 2020

Objectives Research is an important tool for sustainable development and the advancement of health. In Bhutan, the need for strengthening the national health research effort has been recognized only in recent years. As a part of research capacity building, this study was conducted to assess the knowledge, attitude and practices of the country’s health care professionals towards research. Methods This was a nationwide cross-sectional study. Simple random sampling was used to obtain a proportionate composition of health professionals. A self-administered questionnaire was developed to assess knowledge through 10 multiple-choice questions, attitude through rating statements, and practices through assessing experiences with research. Knowledge was scored out of 10. Besides analysing proportions, correlation and simple linear regression coefficients were calculated to assess the association of knowledge score with age, work experience, qualification, and the number of research projects undertaken. Results A total of 420 valid questionnaires were collected (response rate = 95.2%). The mean knowledge score was 6.2 (±2.0) out of 10. There was a negative correlation between the knowledge score and the participant’s age (r = –0.15, p = 0.002) and work experience (r = –0.17, p < 0.001). Participants’ knowledge score increased by 0.58 (95% CI: 0.50–0.65, p < 0.001) for each unit increase in qualification level and by 0.75 (95%CI: 0.64–0.87, p < 0.001) for every research project conducted. The majority believed that local research would contribute to better clinical decision making (92.8%) by building local evidence (90.3%). Four out of five participants expressed interest in conducting research. However, only 27.4% had ever conducted research, 6.0% had published in journals and 4.3% had presented in scientific conferences. Less than half of the respondents had read (35.2%) or participated in discussions (42.1%) of research articles in their workplace. The major challenges were lack of knowledge (61.2%), time (49.9%) and resources to undertake literature searches (42.6%). Conclusions Self-reported knowledge about health research was fair, and the conduct of research and utilization of research articles were poor. However, the majority hold positive attitudes and there is a need for supporting professional development in this area.