bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictability of Seasonal Streamflow and Soil Moisture in National Water Model and a Humid Alabama–Coosa–Tallapoosa River Basin
Authors: Duan Yanan , Kumar Sanjiv 
Published: May 2020

AbstractThis study investigates the potential predictability of streamflow and soil moisture in the Alabama–Coosa–Tallapoosa (ACT) river basin in the southeastern United States. The study employs the state-of-the-art National Water Model (NWM) and compares the effects of initial soil moisture condition with those of seasonal climate anomalies on streamflow and soil moisture forecast skills. We have designed and implemented seasonal streamflow forecast ensemble experiments following the methodology suggested by Dirmeyer et al. The study also compares the soil moisture variability in the NWM with in situ measurements and remote sensing data from the Soil Moisture Active and Passive (SMAP) satellite. The NWM skillfully simulates the observed streamflow in the ACT basin. The soil moisture variability is 46% smaller in the NWM compared with the SMAP data, mainly due to a weaker amplitude of the seasonal cycle. This study finds that initial soil moisture condition is a major source of predictability for the seasonal streamflow forecast. The contribution of the initial soil moisture condition is comparable or even higher than that of seasonal climate anomaly effects in dry seasons. In the boreal summer season, the initial soil moisture condition contributes to 65% and 48% improvements in the seasonal streamflow and soil moisture forecast skills, respectively. This study attributes a greater improvement in the streamflow forecast skill to the lag effects between the soil moisture and streamflow anomalies. The results of this study can inform the development and improvement of the operational streamflow forecasting system.
Assessing Tropical Cyclones’ Contribution to Precipitation over the Eastern United States and Sensitivity to the Variable-Resolution Domain Extent
Authors: Stansfield Alyssa M. , Reed Kevin A. , Zarzycki Colin M. , Ullrich Paul A. , Chavas Daniel R. 
Published: May 2020

AbstractTropical cyclones (TCs) can subject an area to heavy precipitation for many hours, or even days, worsening the risk of flooding, which creates dangerous conditions for residents of the U.S. East and Gulf Coasts. To study the representation of TC-related precipitation over the eastern United States in current-generation global climate models, a novel analysis methodology is developed to track TCs and extract their associated precipitation using an estimate of their dynamical outer size. This methodology is applied to three variable-resolution (VR) configurations of the Community Atmosphere Model, version 5 (CAM5), with high-resolution domains over the North Atlantic and one low-resolution conventional configuration, as well as to a combination of reanalysis and observational precipitation data. Metrics and diagnostics such as TC counts, intensities, outer storm sizes, and annual mean total and extreme precipitation are compared between the CAM5 simulations and reanalysis/observations. The high-resolution VR configurations outperform the global low-resolution configuration for all variables in the North Atlantic. Realistic TC intensities are produced by the VR configurations. The total North Atlantic TC counts are lower than observations but better than reanalysis.
Quantifying Value with Effective Complexity
Authors: Murialdo Maxwell , Cifuentes Arturo 
Published: May 2020

We present a new economic theory of value based on complexity theory. For simplicity, we call this theory ‘complexalism’ (a portmanteau of ‘complexity’ and ‘capitalism’). Complexalism is a framework that establishes valuations by quantifying the present and future complexities of objects and their surroundings. This framework reparameterises questions of economic value into more objectively addressable subcomponents. First, we motivate the importance of developing alternative frameworks for value. Next, we discuss a novel three-dimensional framework to analyse value and the use of effective complexity as a proxy metric of economic value. Finally, we propose explicit methods for quantifying complexity and simulating valuations. The resulting valuations may serve to benchmark prices and can be used in evaluating the market rules of engagement. JEL: B41, B59, C63, D63
Altered features of neurotransmitters: NPY, α-MSH, and AgRP in type 2 diabetic patients with hypertension
Authors: Li Baoxin , Ma Shuang , Guo Shuqin , Li Na , Liu Dandan , Wang He , Zhai Na , Zhang Yunliang 
Published: May 2020

Objective To investigate the features of neuropeptide Y (NPY), α-melanocyte stimulating hormone (α-MSH), and agouti-related protein (AgRP) in type 2 diabetes mellitus (T2DM) patients with hypertension. Methods Patients with T2DM (n = 384) and healthy volunteers (n = 80) were enrolled into this study. Serum NPY, α-MSH, and AgRP levels were detected using ELISA. Results Significantly higher NPY and lower α-MSH and AgRP levels were observed in patients with diabetes compared with those without diabetes, and the mean NPY levels increased, while α-MSH and AgRP levels decreased, with the development of hypertension compared with diabetic patients without hypertension. α-MSH and AgRP levels decreased with an increase in blood pressure in hypertension compared with the non-hypertension patients. Multiple stepwise linear regression analysis showed that NPY, α-MSH, and AgRP levels were closely associated with blood pressure and glucose control. Receiver operating characteristic (ROC) curve analyses indicated that α-MSH may be a better marker compared with NPY and AgRP for regulating glucose and blood pressure and to distinguish between T2DM patients with and without hypertension. Conclusion NPY, α-MSH, and AgRP might play different roles and be closely related to the occurrence and development of diabetes and hypertension.
Prognostic selection and long-term survival analysis to assess overdiagnosis risk in lung cancer screening randomized trials
Authors: Paci Eugenio , Puliti Donella , Carozzi Francesca Maria , Carrozzi Laura , Falaschi Fabio , Pegna Andrea Lopes , Mascalchi Mario , Picozzi Giulia , Pistelli Francesco , Zappa Marco ,   ITALUNG Working Group
Published: May 2020

Objectives Overdiagnosis in low-dose computed tomography randomized screening trials varies from 0 to 67%. The National Lung Screening Trial (extended follow-up) and ITALUNG (Italian Lung Cancer Screening Trial) have reported cumulative incidence estimates at long-term follow-up showing low or no overdiagnosis. The Danish Lung Cancer Screening Trial attributed the high overdiagnosis estimate to a likely selection for risk of the active arm. Here, we applied a method already used in benefit and overdiagnosis assessments to compute the long-term survival rates in the ITALUNG arms in order to confirm incidence-excess method assessment. Methods Subjects in the active arm were invited for four screening rounds, while controls were in usual care. Follow-up was extended to 11.3 years. Kaplan-Meyer 5- and 10-year survivals of “resected and early” (stage I or II and resected) and “unresected or late” (stage III or IV or not resected or unclassified) lung cancer cases were compared between arms. Results The updated ITALUNG control arm cumulative incidence rate was lower than in the active arm, but this was not statistically significant (RR: 0.89; 95% CI: 0.67–1.18). A compensatory drop of late cases was observed after baseline screening. The proportion of “resected and early” cases was 38% and 19%, in the active and control arms, respectively. The 10-year survival rates were 64% and 60% in the active and control arms, respectively ( p = 0.689). The five-year survival rates for “unresected or late” cases were 10% and 7% in the active and control arms, respectively ( p = 0.679). Conclusions This long-term survival analysis, by prognostic categories, concluded against the long-term risk of overdiagnosis and contributed to revealing how screening works.
Caregivers' perspectives on good care for nursing home residents with Korsakoff syndrome
Authors: Gerridzen Ineke J , Hertogh Cees MPM , Joling Karlijn J , Veenhuizen Ruth B , Verschuur Els ML , Janssen Tjeu , Depla Marja F 
Published: May 2020

Background: In the Netherlands, people with severe cognitive deficits due to Korsakoff syndrome are generally admitted to a specialized nursing home. Professional caregivers experience that these residents are often not aware of their deficits, and consequently, their willingness to accept care is relatively low. However, these residents need permanent support when performing daily tasks due to severe cognitive deficits. The combination of objective care needs and low subjective responsiveness makes caring for people with Korsakoff syndrome a complex undertaking. It is unknown how professional caregivers deal with this complex task and how they manage the associated ethical challenges. Objectives: The aim of this study was to explore the professional caregivers’ perspectives on good care for residents with Korsakoff syndrome. Methods: A qualitative study design was used. Data were collected via semi-structured interviews. The Framework Method was used for the thematic analyses of the interview data. Participants and research context: Five specialized nursing homes participated in this study. Twelve professional caregivers, including nurses, nursing assistants, and support workers, were selected based on the ability to provide rich information on the study topics and to capture a variety of demographic and professional characteristics. Ethical considerations: The institutional review board of the VU University Medical Center Amsterdam approved the research protocol. The study was conducted in accordance with the ethical principles for medical research involving human subjects. Findings: Three perspectives on good care emerged: (1) making daily life a joint effort, (2) being steadfast, and (3) treating with respect. Discussion and conclusion: Professional caregivers try to achieve responsiveness in people with Korsakoff syndrome in three different ways. These perspectives reflect fundamentally different views on the care relationship and the autonomy of the resident. By elucidating the three perspectives, we hope to promote the practitioners’ reflection on their own ideas about good care for people with Korsakoff syndrome.
Midwifery students’ reactions to ethical dilemmas encountered in outpatient clinics
Authors: Ejder Apay Serap , Gürol Ayşe , Gür Elif Yağmur , Church Sarah 
Published: May 2020

Background: Midwives are required to make ethical decisions with the support of respective codes of professional ethics which provide a framework for decision making in clinical practice. While each midwife should be ethically aware and sensitive to the ever-changing issues within reproduction, few empirical studies have examined the views of student midwives in relation to reproductive ethical dilemmas. Objective: The aim of this study was to explore midwifery students’ reactions to a number of ethical dilemmas relating to women’s experiences of reproductive decision making. Design: A series of focus groups were conducted with midwifery students who were asked to discuss five culturally significant scenarios including issues of knowledge acquisition regarding methods of family planning, removal or insertion of an intrauterine device, and abortion. Setting: A University in Turkey was the setting for this study. Participants: Purposeful sampling was adopted which resulted in five focus groups with a total of 57 midwifery students. Ethical considerations: The study was reviewed and granted formal ethical approval by an ethical committee at the Faculty of Health Science in Atatürk University. The head of the Faculty of Health Science approved the investigation. The participants received both oral and written information about the study and they gave their consent. Results: Five themes were identified from the analysis of the focus group data related to all five scenarios. These themes were ‘the right to information’, ‘choice and protection’, ‘parental rights and welfare of the women’, ‘make a decision’ and ‘women rights and sexual abuse’. Conclusion: This study has shown that while students respected women’s choice, they also expressed great ambivalence in some situations when personal values conflict with dominant societal beliefs and professional ethics. A focus on ethics education to include human rights is suggested as a means to enable students to explore their own social-value judgements, and as a means to limit the possible development of ethical confusion and moral distress.
Surgical intervention for upper extremity nerve compression related to arteriovenous hemodialysis accesses
Authors: Tordoir Jan HM , van Loon Magda M , Zonnebeld Niek , Snoeijs Maarten , van Nie Ferry 
Published: May 2020

Objective: Chronic renal failure patients with arteriovenous hemodialysis access may exhibit pain and neurological complaints due to local nerve compression by the access conduit vessels of autogenous arteriovenous fistulas or the prosthesis of arteriovenous grafts. In this study, we have examined the results of surgical intervention for vascular access–related nerve compression in the upper extremity. Methods: A single center retrospective study was performed of all patients referred for persistent pain and neurological complaints after vascular access surgery for hemodialysis. There were four brachial-cephalic, three brachial-basilic upper arm arteriovenous fistulas, and three prosthetic arteriovenous grafts. All patients had pain and sensory deficits in a distinct nerve territory (median nerve: 6; median + ulnar nerve: 1; medial cutaneous nerve: 1), and two patients had additional motor deficits (median nerve). Results: A total of 10 patients (mean age: 59 years; range: 25–73 years; 2 men; 4 diabetics) were treated by surgical nerve release alone (2 patients) or in combination with access revision (8 patients). Mean follow-up was 23 months (range: 8–46 months). Direct complete relief of symptoms was achieved in six patients. Three patients had minor complaints, and one patient had a reoperation with good success. Conclusion: Vascular access–related nerve compression is an uncommon cause for pain, sensory and motor deficits after vascular access surgery. Surgical nerve release and access revision have good clinical outcome with relief of symptoms and maintenance of the access site in the majority of patients.
The impact of the COVID-19 infection in dentistry
Authors: Passarelli Pier Carmine , Rella Edoardo , Manicone Paolo Francesco , Garcia-Godoy Franklin , D’Addona Antonio 
Published: May 2020

The novel Coronavirus pandemic defines a new risk for all dental practitioners, hygienists, and dental assistants. As an increasing number of dentists are now developing this disease, we wanted to provide some measures to manage this risk in the dental practice, by undergoing a review of the current literature. This minireview searches the literature for articles that both defined the infection risk in the dental practice and provided evidence on the efficacy of some procedures on reducing the infection risk. Several articles have already pointed out some necessary measures: fewer patients have to be admitted to the practice, a short triage should be carried out, and the appropriate measures of protection have to be used. On the basis of the literature collected, a short questionnaire and a flowchart is proposed to define the risk that each patient carries, and to appropriately adapt each procedure based on the patient’s risk. The literature is still limited on this subject, but on the basis of what is available, dental practices have to adapt to the situation in order to protect dental health professionals. Impact statement Dentists have always been taught how to protect themselves and their patients from potential blood-borne pathogens, but the Coronavirus pandemic has brought a new unprecedented challenge to the world of dentistry; we therefore reviewed the literature to provide suggestions on how to accordingly change dental practice prevention.
Fenestrated/Branched Endovascular Repair for Postdissection Thoracoabdominal Aneurysms: A Systematic Review with Pooled Data Analysis
Authors: He Yuan , Jia Senhao , Sun Guoyi , Cao Long , Wang Xinhao , Zhang Hongpeng , Jia Xin , Ma Xiaohui , Xiong Jiang , Liu Xiaoping , Guo Wei 
Published: May 2020

Purpose: Patients who have survived an acute aortic dissection remain at risk for postdissection thoracoabdominal aortic aneurysms (PD-TAAAs). Fenestrated/branched endovascular repair for PD-TAAA is increasingly used in some high-volume centers, but outcomes are still limited because of the additional challenges compared to atherosclerotic thoracoabdominal aneurysms. This study was performed to evaluate the literature on fenestrated/branched endovascular repair for PD-TAAAs. Methods: PubMed, Embase, and the Cochrane Database were searched for relevant studies published until September 2019. Outcome data were extracted to evaluate the technical success, 30-day mortality, later survival, major complications, endoleaks, target vessel patency, and reintervention. Studies were analyzed in a pooled proportion meta-analysis. Results: In total, 143 patients from 4 studies were identified for the pooled data analysis. The pooled technical success rate was 98% (95% CI: 86%-100%). After the treatment, the overall estimated 30-day mortality rate was 3% (95% CI: 1%-8%), early spinal cord ischemia rate was 10% (95% CI: 4%-21%), early renal injury rate was 5% (95% CI: 1%-19%), endoleak rate was 33% (95% CI: 22%-47%), reintervention rate at a median follow-up of 22.5 months was 34% (95% CI: 27%-42%), and all-cause mortality rate was 12% (95% CI: 6%-24%). Conclusions: The use of fenestrated/branched stent grafts for the treatment of PD-TAAA appears generally feasible based on the limited literature, but endoleaks and reinterventions are frequent.
Chronic Rhinosinusitis Patients With and Without Polyps Experience Different Symptom Perception and Quality of Life Burdens
Authors: Talat Rehab , Speth Marlene M. , Gengler Isabelle , Phillips Katie M. , Caradonna David S. , Gray Stacey T. , Sedaghat Ahmad R. 
Published: May 2020

Objective We sought to determine if chronic rhinosinusitis (CRS) patients with nasal polyps (CRSwNP) differentially perceived CRS symptom burden compared to patients without nasal polyps (CRSsNP) and to what extent CRS symptom severity was associated with quality of life (QOL) and patient-reported symptom control in the 2 groups. Methods A total of 600 patients (266 CRSwNP and 334 CRSsNP) presenting with CRS were recruited. CRS symptom burden was assessed with the 22-item Sinonasal Outcome Test (SNOT-22). SNOT-22 nasal, sleep, ear/facial discomfort, and emotional subdomain scores were calculated. General health-related QOL was assessed with the visual analog scale of the 5-dimensional EuroQol questionnaire (EQ-5D VAS). Patients rated their CRS symptom control on a 5-point scale. Results SNOT-22 scores did not differ between CRSwNP (mean: 35.6) and CRSsNP (mean: 36.3). There were no differences in nasal, sleep, and emotional subdomains of the SNOT-22. CRSsNP had higher ( P = .003) ear/facial subdomain scores than CRSwNP, while CRSwNP reported greater hyposmia ( P < .001). EQ-5D VAS was significantly lower ( P = .011) in CRSsNP (mean: 68.9) compared to CRSwNP (mean: 73.2). However, CRSwNP patients reported significantly less symptom control, compared to CRSsNP, in association with nasal and emotional symptoms. Conclusion CRSwNP and CRSsNP have differences in symptom profile, effect on health-related QOL, and patient-perceived symptom control. CRSsNP experience significantly greater burden of ear/facial discomfort, while CRSwNP report greater hyposmia. Although CRSsNP reports lower general health-related QOL overall, CRSwNP patients had lower levels of CRS symptom control for every incremental increase in symptom burden suggesting greater sensitivity/intolerance to CRS symptoms.
Analysis of Utility Assessment Scores to Objectify the Health Burden Caused by Breast Conservation Therapy
Authors: Blankensteijn Louise L. , Egeler Sabine A. , Sinno Hani H. , Ibrahim Ahmed M. S. , Izadpanah Ali , Vorstenbosch Joshua , Dionisopoulos Tassos , Tobias Adam M. , Lin Samuel J. , Lee Bernard T. 
Published: May 2020

Background: Lumpectomy followed by radiation, known as breast conservation therapy (BCT), is a viable surgical treatment option for early-stage breast cancer. However, the current literature suggests that patients prefer mastectomy over BCT, likely due to the wide variety of postmastectomy reconstructive options. Our aim is to investigate the objective health burden of living with BCT to help surgeons gain a better understanding of patient treatment preferences. Methods: Three validated health state utility tools were used to objectify the burden of living with post-BCT results: visual analogue scale (VAS), time trade-off (TTO), and standard gamble (SG). A prospective sample of the general population and medical students were recruited, and their responses analyzed to attain these scores. Results: Utility scores for living with BCT are VAS 0.81 ± 0.19, TTO 0.93 ± 0.10, and SG 0.92 ± 0.14. The TTO and SG suggest a willingness to trade 2.5 years of life years and an 8% chance of death undergoing reconstructive procedures to correct a BCT defect, respectively. Age, gender, race, education, and income were not statistically significant independent predictors for higher or lower utility scores. Conclusion: The impact of the health burden of BCT was ascertained using validated objective numeric utility scores. These indices demonstrate a willingness to trade less life years to undergo correction of a BCT defect than reconstruction following unilateral mastectomy. They can provide surgeons with the best objective understanding of patient preferences for shared decision-making in the management of breast cancer.
Donor Site Scar Preference in Patients Requiring Free Flap Reconstruction
Authors: McLeod Graham James , Islur Avinash 
Published: May 2020

Introduction: In traumatic reconstruction, surgeons frequently harvest flaps from donor sites that they are comfortable performing and with favourable tissue characteristics without determining the patients preferred site. The study’s goal was to determine participants free flap donor site preference based on aesthetics as it relates to the size of the defect being reconstructed. Methodology: Participants were asked to imagine that they were in a trauma that resulted in a wound of variable sizes. They were presented with a selection of common donor site scars produced from harvesting small, medium, and large free flaps. They were instructed to rank the donor sites in order of preference and score each donor site of 10. Results: Two hundred eighty-seven participants (mean age: 28, female: 62%) completed the survey. For small reconstructions, the preferred donor site scars were on the leg or back compared to arm or abdomen. For medium size reconstructions, scars on the back and upper thigh were preferred over scars on the abdomen and anterior thigh. In small and medium reconstructions, the midline abdominal scar scored significantly lower than other donor sites. Participants preferred donor sites on the back, the thigh, and lower abdomen for large reconstructions. Conclusion: Participants preferred back, thigh, and hip locations perhaps relating to the ability to conceal these scars under clothing. If multiple flaps sites could be harvested, providing options to trauma patients undergoing free tissue transfer may result in increased satisfaction.