bluuebunny/crossref_metadata_2025_split huggingface dataset:
Numerical Investigation of Bidirectional Mode-1 and Mode-2 Internal Solitary Wave Generation from North and South of Batti Malv Island, Nicobar Islands, India
Authors: Raju N. Jithendra , Dash Mihir K. , Bhaskaran Prasad Kumar , Pandey P. C. 
Published: September 2020

AbstractStrong bidirectional internal solitary waves (ISWs) generate from a shallow channel between Car Nicobar and Chowra Islands of Nicobar Islands, India, and propagate toward the Andaman Sea (eastward) and Bay of Bengal (westward). Batti Malv Island separates this shallow channel into two ridges, north of Batti Malv (NBM) and south of Batti Malv (SBM). First, this study identifies the prominent mode-1 and mode-2 ISWs emerging from NBM and SBM using synthetic aperture radar images and then explores their generation mechanism(s) using a nonlinear, unstructured, and nonhydrostatic model, SUNTANS. During spring tide, flow over NBM is supercritical with respect to mode-1 internal wave. Model simulations reveal that mode-1 ISWs are generated at NBM by a “lee wave mechanism” and propagate both in the east and west directions depending on the tidal phases. However, the flow over SBM is subcritical with respect to mode-1 internal wave. The bidirectional propagating mode-1 ISWs evolve from a long-wave disturbance induced by “upstream influence.” But, during spring tide, with an increased tidal flow over SBM, it is observed that the westward propagating ISWs are formed by a dispersed hydraulic jump observed over the ridge. Moreover, the bidirectional mode-2 waves from SBM are generated by a lee wave mechanism. An energy budget comparison reveals that the region surrounding NBM is efficient in radiating low-mode baroclinic energy (0.98 GW), while SBM is highly efficient in converting barotropic to baroclinic energy (4.1 GW).
Potential of Dual-Frequency Radar and Microwave Radiometer Synergy for Water Vapor Profiling in the Cloudy Trade Wind Environment
Authors: Schnitt Sabrina , Löhnert Ulrich , Preusker René 
Published: September 2020

AbstractHigh-resolution boundary layer water vapor profile observations are essential for understanding the interplay between shallow convection, cloudiness, and climate in the trade wind atmosphere. As current observation techniques can be limited by low spatial or temporal resolution, the synergistic benefit of combining ground-based microwave radiometer (MWR) and dual-frequency radar is investigated by analyzing the retrieval information content and uncertainty. Synthetic MWR brightness temperatures, as well as simulated dual-wavelength ratios of two radar frequencies are generated for a combination of Ka and W band (KaW), as well as differential absorption radar (DAR) G-band frequencies (167 and 174.8 GHz, G2). The synergy analysis is based on an optimal estimation scheme by varying the configuration of the observation vector. Combining MWR and KaW only marginally increases the retrieval information content. The synergy of MWR with G2 radar is more beneficial due to increasing degrees of freedom (4.5), decreasing retrieval errors, and a more realistic retrieved profile within the cloud layer. The information and profile below and within the cloud is driven by the radar observations, whereas the synergistic benefit is largest above the cloud layer, where information content is enhanced compared to an MWR-only or DAR-only setup. For full synergistic benefits, however, G-band radar sensitivities need to allow full-cloud profiling; in this case, the results suggest that a combined retrieval of MWR and G-band DAR can help close the observational gap of current techniques.
Environmental Controls on the Climatological Scaling of Tornado Frequency with Intensity
Authors: Lepore Chiara , Tippett Michael K. 
Published: September 2020

AbstractThe scaling of U.S. tornado frequency with enhanced Fujita (EF)-rated intensity is examined for the range EF1–EF3. Previous work has found that tornado frequency decreases exponentially with increasing EF rating and that many regions around the world show the same exponential rate of decrease despite having quite different overall tornado frequencies. This scaling is important because it relates the frequency of the most intense tornadoes to the overall tornado frequency. Here we find that U.S. tornado frequency decreases more sharply with increasing intensity during summer than during other times of the year. One implication of this finding is that, despite their rarity, when tornadoes do occur during the cool season, the relative likelihood of more intense tornadoes is higher than during summer. The environmental driver of this scaling variability is explored through new EF-dependent tornado environmental indices (TEI-EF) that are fitted to each EF class. We find that the sensitivity of TEI-EF to storm relative helicity (SRH) increases with increasing EF class. This increasing sensitivity to SRH means that TEI-EF predicts a slower decrease in frequency with increasing intensity for larger values of SRH (e.g., cool season) and a sharper decrease in tornado frequency in summer when wind shear plays a less dominant role. This explanation is also consistent with the fact that the fraction of supercell tornadoes is smaller during summer.
The Isolation of Health Services in Society: Development and Consequences
Authors: Gannik Dorte , Launsø Laila 
Published: September 2020

That there exists an isolation of health services today is a consequence of important structural changes in society, especially the structure of both the family and occupations and increased professional dominance within the health field. The crisis of the health care system is due to its demand for increased economic resources and political support, a demand which is not met by the broader society, i.e. we are dealing with a failure of legitimacy, resulting among other things from the fact that health professionals have not publicly discussed the aims and methods of their field. Due to the failure of legitimacy we see a diversity of popular movements and activities, which can be described as individuals involved in organized protest. Some of these movements result in a certain strengthening of individual resources, thereby restraining the growing inequality of resources between professionals and patients. The article deals with what could be called the crisis in the health care system. The general economic crisis of society adds to and sharpens this development, but we will here argue the existence of a separate and independent crisis in the health field, which would have developed anyway. The background of the health care crisis is the separation of health services from society in ways that will be described, and the increasing inequality of resources between the agents of the health care system and the people. We will describe an economic-political aspect of the crisis as well as an aspect of legitimacy bound up with it. Finally we point to the reactions of the population in the face of the health care crisis. The authors work with analyses of the primary health care system (authorized as well as unauthorized),1 as relates to people's illness and illness behavior. This is the basis of the article. The research data available in this area are scarce, and we would like to point out that the paper as a whole aims to present a hypothesis rather than established facts. We think this has a value in itself and hope that the readers will accept the limitations of this approach. The article confines itself to the health services of Denmark, though similar tendencies could be described as regards the social services.
Massive Transfusion Protocol and Subsequent Development of Venous Thromboembolism: Statewide Analysis
Authors: Bradburn Eric H. , Ho Kwok M. , Morgan Madison E. , D’Andrea Lauren , Vernon Tawnya M. , Rogers Frederick B. 
Published: September 2020

Background Massive transfusion protocols (MTP) are a routine component of any major trauma center’s armamentarium in the management of exsanguinating hemorrhages. Little is known about the potential complications of those that survive a MTP. We sought to determine the incidence of venous thromboembolism (VTE) following MTP. We hypothesized that MTP would be associated with a higher risk of VTE when compared with a risk-adjusted control population without MTP. Methods The Pennsylvania Trauma Outcome Study database was retrospectively queried from 2015 to 2018 for trauma patients who developed VTE and survived until discharge at accredited trauma centers in Pennsylvania. Patient demographics, injury severity, and clinical outcomes were compared to assess differences in VTE development between MTP and non-MTP patients. A multivariate logistic regression model assessed the adjusted impact of MTP on VTE development. Results 176 010 patients survived until discharge, meeting inclusion criteria. Of those, 1667 developed a VTE (pulmonary embolism [PE]: 662 [0.4%]; deep vein thrombosis [DVT]: 1142 [0.6%]; PE and DVT: 137 [0.1%]). 1268 patients (0.7%) received MTP and, of this subset of patients, 171 (13.5%) developed a VTE during admission. In adjusted analysis, patients who had a MTP and survived until discharge had a higher odds of developing a VTE (adjusted odds ratio: 2.62; 95% CI: 2.13-3.24; P < .001). Discussion MTP is a harbinger for higher risk of VTE in those patients who survive. This may, in part, be related to the overcorrection of coagulation deficits encountered in the hemorrhagic event. A high index of suspicion for the development of VTE as well as aggressive VTE prophylaxis is warranted in those patients who survive MTP.
Type D Personality and Myocardial Infarction: A Case-Control Study
Authors: Manoj MT , Joseph KA , Vijayaraghavan Govindan 
Published: September 2020

Background: Coronary heart disease (CHD) is an impending global pandemic in developed countries as well as developing countries and economies in transition, such as India. A significant increase in the incidence of myocardial infarction (MI), one of the most common types of CHD, is being reported in India, and the incidence and severity of the disease are more among the youth in Kerala. Studies assessing the association between psychological factors and MI are few in India. Methods: We adopted a case-control study design. A total of 150 cases (with MI) and 150 controls (without MI and matched for age and gender) from a tertiary care hospital in Trivandrum, Kerala, India, were selected using convenient sampling method, between September 2016 and August 2017. Results: As compared to 33.3% of the controls, 50.7% of patients with MI had type D personality characteristics. Multivariate logistic regression analysis after adjusting for the confounders indicated a positive and statistically significant association between type D personality and MI: OR = 4.14, 95% CI = 2.19–8.85, P = 0.003. Conclusion: Type D personality is associated with MI.
Telepsychiatry and the Role of Artificial Intelligence in Mental Health in Post-COVID-19 India: A Scoping Review on Opportunities
Authors: M Thenral , Annamalai Arunkumar 
Published: September 2020

Background: COVID-19 has a profound impact on people with existing mental disorders, augmenting the prevailing inequalities in mental health. Methods: In order to understand the status of telepsychiatry in India and the role of artificial intelligence (AI) in mental health and its potential applications, a scoping review was done between March 2020 and May 2020. The literature review revealed 253 papers, which were used to derive the primary framework for analysis. The information was then reviewed for ideas and concepts, which were integrated with evidence from gray literature and categorized under broader themes based on the insights derived. Finally, a thematic framework was developed for discussion to tailor scientific information for decision-makers’ needs. Results: Review findings are summarized under the following headings: changing patterns of health-seeking behavior, origin and evolution of telepsychiatry, possible applications of telepsychiatry and AI, technological features, and AI models in mental health. Conclusions: Though there are several potential opportunities, the time is not yet ripe for telepsychiatry and AI to be adopted fully in the field of mental health care. But it is time that we develop indigenous proprietary technology and test and validate it. With many solutions offered by telepsychiatry and AI, psychiatrists must choose an appropriate tool based on their requirements, availability of resources, and feasibility of deployment. Harmony between conventional care and technology-based care must be reached gradually.
ECMO support in SARS-CoV2 multisystem inflammatory syndrome in children in a child
Authors: Kaushik Shubhi , Ahluwalia Neha , Gangadharan Sandeep , Esperenza Maria , Murthy Raghav , Ofori-Amanfo George , Aydin Scott I 
Published: September 2020

In this report, we describe the case of a 5-year-old male with SARS-CoV-2 associated MIS-C with progressive respiratory failure and vasoplegic shock requiring extracorporeal support. At presentation, reverse transcription-polymerase chain reaction (RT-PCR) testing for SARS-CoV-2 was negative, however, SARS-CoV2 antibody testing was positive. Multiple inflammatory markers and cardiac biomarkers were elevated. Echocardiogram demonstrated mildly depressed left ventricular function and no coronary anomalies noted. The patient required mechanical ventilation, vasopressors, and eventually extracorporeal membrane oxygenation (ECMO) for profound circulatory shock and progressive respiratory failure. During his clinical course, recovery of cardiac function was demonstrated however, a middle cerebral artery infarct and left frontal subarachnoid hemorrhage was suffered which ultimately the patient succumbed to. To the best of our knowledge, this is the youngest previously healthy child who had multi-system hyperinflammatory syndrome requiring ECMO support and the first case of SARS-CoV-2 related pediatric stroke. Clinical Trial Registration: None
Endothermal ablation for the treatment of clinically significant incompetent lower limb perforating veins: factors influencing the early outcomes
Authors: Woodburn Kenneth R 
Published: September 2020

Background To review the clinical experience and early outcomes of endothermal perforator ablation. Method Retrospective review of an endovenous practice from 2007-2019. Clinically significant incompetent perforators were treated by Endovenous Laser Ablation (EVLA), or segmental radiofrequency ablation (RFA). Result Complete data were available for 110 of the 116 symptomatic incompetent perforating veins treated. Radiofrequency ablation of 20 perforators produced a 55% perforator closure rate, while 90 EVLA perforator ablations resulted in a closure rate of 80%. Closure rates with EVLA varied by location and perforator length. Closure rates for truncal ablation were 95.5% for RFA and 97.2% for EVLA. Conclusion Early closure rates following endothermal ablation of incompetent lower limb perforating veins are lower than those obtained for truncal ablation. EVLA perforator closure appears to be more effective than segmental RFA in most situations but short treatment lengths and location at the ankle are associated with the poorest outcomes.
Antidepressant responses in direct comparisons of melancholic and non-melancholic depression
Authors: Undurraga Juan , Vázquez Gustavo H , Tondo Leonardo , Baldessarini Ross J 
Published: September 2020

Background: Efforts to develop less heterogeneous, more clinically useful diagnostic categories for depressive disorders include renewed interest in the concept of melancholia (Mel). However, clinical or biological differentiation of Mel from other (nonMel) episodes of depression has been questioned, and it remains unclear whether pharmacological responses proposed to be characteristic of Mel are supported by available research. Methods: We carried out a systematic review seeking treatment trials reports comparing Mel and nonMel depressed subjects for meta-analyses of their differences in responses (a) to antidepressants overall, (b) to tricyclic (TCAs) or serotonin-enhancing agents (serotonin reuptake inhibitors/serotonin–norepinephrine reuptake inhibitors) and (c) with placebo treatment. Results: We identified 25 trials in 16 reports comparing 2597 Mel with 5016 nonMel subjects. Overall, responses to antidepressant treatment did not differ between Mel (39.4%) and nonMel (42.2%) subjects. However, all subjects responded better to TCAs (50.6%) than SRIs (30.0%; p<0.0001). Mel subjects also responded less well with placebo, but also were significantly more severely depressed at intake. Conclusions: Antidepressant responses were similar in Mel and nonMel depressed patients. Mel subjects responded 25% less with placebo but were more severely depressed initially, and there was preferential response to TCAs in both Mel and nonMel subjects. The findings provide little support for proposed differences in responses to particular treatments among Mel versus nonMel depressed patients, and underscore the need to match for illness severity in making such comparisons.
Anxiolytic effects of acute and maintenance ketamine, as assessed by the Fear Questionnaire subscales and the Spielberger State Anxiety Rating Scale
Authors: Truppman Lattie Dylan , Nehoff Hayley , Neehoff Shona , Gray Andrew , Glue Paul 
Published: September 2020

Background: Ketamine has rapid anxiolytic effects in treatment-resistant obsessive compulsive, post-traumatic stress, generalised anxiety and social anxiety disorders. Objectives: This study aimed to assess changes following acute and maintenance ketamine therapy on the Fear Questionnaire (FQ) subscales and the Spielberger State Anxiety Inventory (SSAI). Methods: This secondary analysis used data from a mixed open-label and double-blinded placebo-controlled study. A total of 24 patients received short-term ascending subcutaneous doses of ketamine and were then eligible to enter a 3-month maintenance phase of 1 mg/kg ketamine dosed once or twice weekly. FQ and SSAI data were analysed using mixed models to identify between-dose differences and to describe trends during maintenance. Results: Acute ketamine dosing showed a rapid dose-related reduction in all three FQ subscales (agoraphobia, social phobia and blood-injury phobia) and in the SSAI. A progressive decrease in pre-dose rating-scale scores was evident during the 3 months of maintenance therapy. Conclusions: Ketamine demonstrated dose-related improvements in all FQ subscales and in the SSAI. Both scales appear to be suitable tools to assess the anxiolytic effects of ketamine in patients with treatment-resistant anxiety. Furthermore, ketamine appears to have broad, dose-related anti-phobic effects. These findings raise the possibility that ketamine may have therapeutic potential in the treatment of other phobic states, such as specific phobia.
Study of Adolescents’ Puberty, Adolescence Training Program: The Application of Intervention Mapping Approach
Authors: Ziapour Arash , Sharma Manoj , NeJhaddadgar Nazila , Mardi Afrouz , Tavafian Sedigheh Sadat 
Published: September 2020

Background Adolescence is a significant period of life which is crucial for life long health. The purpose of the study was to develop a puberty intervention-training program using an intervention mapping approach (IMA). Methods The present study was a study protocol where IMA was used as a planning framework for developing a puberty intervention-training program (PITP). Six intervention mapping steps have been described in this protocol. As the first step, needs assessment was performed by reviewing the studies, qualitative evaluation, and interviews. In the second step, the matrix of change objectives was designed from the intersection of performance goals and determinants. Later on, after designing the program and planning the program implementation, the program evaluation plan was developed. Results IMA guided us in designing and implementing a control-oriented training program with the participation of the participants along with the definition of outcomes, performance goals and determinants, theoretical methods and practical applications, intervention program, implementation and step by step assessment. Conclusion Intervention mapping is a control-oriented, systematic, participation-based approach to design and implement targeted and on-going health promotion programs.
Diagnostic performance of diffusion-weighted imaging combined with dynamic contrast-enhanced magnetic resonance imaging for prostate cancer: a systematic review and meta-analysis
Authors: Yang Lu , Tan Yuchuan , Dan Hanli , Hu Lin , Zhang Jiuquan 
Published: September 2020

Background The diagnostic performance of diffusion-weighted imaging (DWI) combined with dynamic contrast-enhanced (DCE)-magnetic resonance imaging (MRI) for the detection of prostate cancer (PCa) has not been studied systematically to date. Purpose To investigate the value of DWI combined with DCE-MRI quantitative analysis in the diagnosis of PCa. Material and Methods A systematic search was conducted through PubMed, MEDLINE, the Cochrane Library, and EMBASE databases without any restriction to language up to 10 December 2019. Studies that used a combination of DWI and DCE-MRI for diagnosing PCa were included. Results Nine studies with 778 participants were included. The combination of DWI and DCE-MRI provide accurate performance in diagnosing PCa with pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratios of 0.79 (95% confidence interval [CI] = 0.76–0.81), 0.85 (95% CI = 0.83–0.86), 6.58 (95% CI = 3.93–11.00), 0.24 (95% CI = 0.17–0.34), and 36.43 (95% CI = 14.41–92.12), respectively. The pooled area under the summary receiver operating characteristic curve was 0.9268. Moreover, 1.5-T MR scanners demonstrated a slightly better performance than 3.0-T scanners. Conclusion Combined DCE-MRI and DWI could demonstrate a highly accurate area under the curve, sensitivity, and specificity for detecting PCa. More studies with large sample sizes are warranted to confirm these results.
Understanding people’s experiences of using the SaeboFlex® following a stroke
Authors: Millard Hayley , Gustafsson Louise , Molineux Matthew , Richards Katherine 
Published: September 2020

Introduction This qualitative interpretive phenomenological study sought to understand the experiences of people using the SaeboFlex®, within an outpatient setting, following a stroke. Method Five adults who had experienced a stroke and had received the SaeboFlex® from occupational therapists in one outpatient service within the previous 12 months were recruited using convenience sampling. Semi-structured interviews were conducted, recorded, transcribed verbatim, and analysed using Braun and Clarke’s thematic analysis. Results Three themes emerged from the data: (a) hope for upper limb recovery: ‘you have got nothing to lose’; (b) the everyday experience of the SaeboFlex®: ‘just keeping it in a routine’; (c) the self-reported outcomes: ‘I can do more things you know … but there haven’t been any miracles’. Conclusion The findings highlight the important role of hope in the recovery of people following a stroke, and that participants continue to use the device despite limited goal achievement. The reports of limited transfer of training into everyday occupations, either with or without the device, is something that should be carefully considered. The SaeboFlex® is a tool that is promoted for upper limb rehabilitation, but which has limited evidence of effectiveness and mixed client experiences. Further research is required.