bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of the Indian Ocean Dipole on the Large-Scale Circulation in South America
Authors: Sena Ana C. T. , Magnusdottir Gudrun 
Published: April 2021

AbstractThe influence of each phase of the Indian Ocean dipole (IOD) on the large-scale circulation in South America is investigated using rainfall observations, fully coupled, large-ensemble, historical simulations (LENS), and forced experiments using the coupled model’s atmospheric component. IOD events often occur when El Niño–Southern Oscillation (ENSO), the largest source of interannual variability of precipitation in South America, is active. To distinguish from effects of ENSO, only cases during neutral ENSO conditions are analyzed in LENS and observations. During the positive IOD polarity, a perturbation in the local Walker circulation leads to increased convection over equatorial South America, resulting in wet anomalies in the Amazon basin. This signal is the opposite of what is expected during El Niño events. Tropical convection anomalies in the Indian Ocean also force an extratropical Rossby wave train that reaches subtropical South America. During positive IOD, the moisture flux from the Amazon to central and southeastern Brazil weakens, resulting in a drying of the area associated with the South Atlantic convergence zone. Meanwhile, the South Atlantic subtropical high strengthens, contributing to a drying in southeastern Brazil. During negative IOD, the induced wave train from the Indian Ocean leads to increased moisture transport to the La Plata basin, leading to wet anomalies in the region.
A Calibrated and Consistent Combination of Probabilistic Forecasts for the Exceedance of Several Precipitation Thresholds Using Neural Networks
Authors: Schaumann P. , Hess R. , Rempel M. , Blahak U. , Schmidt V. 
Published: April 2021

AbstractThe seamless combination of nowcasting and numerical weather prediction (NWP) aims to provide a functional basis for very-short-term forecasts, which are essential (e.g., for weather warnings). In this paper we propose a statistical method for precipitation using neural networks (NN) that combines nowcasting data from DWD’s radar-based RadVOR system with postprocessed forecasts of the high resolving NWP ensemble COSMO-DE-EPS. The postprocessing is performed by Ensemble-MOS of DWD. Whereas the quality of the nowcasting projections of RadVOR is excellent at the beginning, it declines rapidly after about 2 h. The postprocessed forecasts of COSMO-DE-EPS in contrast start with lower accuracy but provide meaningful information on longer forecast ranges. The combination of the two systems is performed for probabilities that the expected precipitation amounts exceed a series of predefined thresholds. The resulting probabilistic forecasts are calibrated and outperform both input systems in terms of accuracy for forecast ranges from 1 to 6 h as shown by verification. The proposed NN-model generalizes a previous statistical model based on extended logistic regression, which was restricted to only one threshold of 0.1 mm. The various layers of the NN-model are related to the conventional design elements (e.g., triangular functions and interaction terms) of the previous model for easier insight.
A Case-Control Study of Accidental Falls During Surgical Hospitalizations
Authors: Valencia Morales Diana J. , Laporta Mariana L. , Johnson Rebecca L. , Schroeder Darrell R. , Sprung Juraj , Weingarten Toby N. 
Published: April 2021

Background Postoperative falls are preventable complications. The study aims were to describe the rate and circumstances surrounding postoperative falls and explore potential associations with patient and procedural characteristics with emphasis on the use of sedative medications. Methods Medical records of hospitalized patients undergoing non-lower extremity surgery under general anesthesia from January 1, 2010, through April 30, 2018 were reviewed for falls within 72 postoperative hours. Perioperative use of sedatives, sleep aids, gabapentinoids, and opioids were abstracted. Each fall case was matched with two controls on age, sex, and procedure type. Descriptive statistics and multivariable analysis accounting for the matched design were performed. Results There were 343 falls among 200 186 hospitalized surgical patients (incidence of 17.1 [95% CI: 15.4, 19.0] falls per 10 000 procedures) with largest proportion of falls occurring on postoperative day 2 (n = 134, 39.1%). Most falls occurred in the general hospital wards (n = 304, 88.6%) and were unwitnessed (n = 186, 55.9%). The incidence of major injuries was 1.0 (95% CI: .1 – 3.6) per 100 000 procedures. Home use of non-benzodiazepine hypnotics (odds ratio 2.68, 95% CI: 1.47, 4.88, P=.001) and blood transfusions were associated with increased fall risk. Hospital stay was longer in patients who fall (7 [4, 15] vs. 5 [3, 9] days, P < .001). Conclusions The rate of postoperative falls in our institution was low and frequently unwitnessed. The use of non-benzodiazepine hypnotics is a modifiable risk factor associated with postoperative falls. Serious complications after falls were rare.
‘We must have a new VIPS meeting soon!’ Barriers and facilitators for implementing the VIPS practice model in primary health care
Authors: Røsvik Janne , Mjørud Marit 
Published: April 2021

Introduction Person-centred care is a philosophy of care rather than a method ready for implementation and utilisation in daily work. Internationally, few methods for the implementation of person-centred care have been widely adopted in clinical and care practice. In Norway, the VIPS practice model is a commonly used model for person-centred care implementation. Method Qualitative manifest content analysis was used. Managers and leaders in the municipalities, care institutions and domestic nursing care services were eligible for inclusion if their workplace had implemented the VIPS practice model and conducted the consensus meeting regularly for a minimum of 12 months. Seventeen respondents were included. Individual interviews were conducted either via FaceTime, Skype or telephone. Results Three global categories emerged describing the implementation process: (1) factors that impact the decision made at municipal level to implement person-centred care; (2) requirements for a good start at unit level and (3) factors that help to support the new routines in the unit. The categories were entwined; the results of one affected the results of the others. The informants from both domestic nursing care and institutions described the same factors as important for the implementation of the VIPS practice model. Conclusion To implement person-centred care by use of the VIPS practice model, the frontline staff need sufficient information about the rationale for implementing the model. The management’s vision and ethos of person-centred care must be followed by time set aside for staff training and regularly scheduled VIPS practice model consensus meetings. Head nurses are key to getting the new routines established and maintained and should be supported by the management.
Improvisation as a Teaching Tool for Improving Oral Communication Skills in Premedical and Pre-Biomedical Graduate Students
Authors: Phelps Marianne , White Catrina , Xiang Lin , Swanson Hollie I 
Published: April 2021

Objective: To evaluate the relationship between training in theatre improvisation and empathy, communication, and other professional skills. Methods: Undergraduate and graduate students who were participants of a 10-week summer undergraduate research program engaged in theatre improvisation techniques during a 3-hour workshop. In Study #1, a de-identified, self-report questionnaire (known as the Empathy Quotient) was administered prior to and following the workshop. Paired sample 2-tailed t-tests were performed to evaluate pre- and post-test scores. To identify additional benefits of engaging in theatre improvisation techniques, Study #2 was performed. Here, a survey was administered to the participants following their completion of the workshop to assess the impact on their personal growth and professional skills. An additional survey was administered at the end of the 10-week program to evaluate all program activities. Results: Study #1. Paired t-test analyses indicated that pre-test versus post-test Empathy Quotient scores were not significantly different, implying that participation in the theatre improvisation workshop did not impact empathy. Study #2. Survey results indicate that participation in the theatre improvisation workshop encouraged feelings of support by peers and creative thinking as well as increasing communication skills. Conclusion: Incorporating a theatre improvisation workshop into educational programs for pre-medical and pre-biomedical students is of value for enhancing self-confidence, oral communication skills and ability to think creatively.
Effects of comprehensive geriatric care models on postoperative outcomes in geriatric surgical patients: a systematic review and meta-analysis
Authors: Saripella Aparna , Wasef Sara , Nagappa Mahesh , Riazi Sheila , Englesakis Marina , Wong Jean , Chung Frances 
Published: April 2021

Abstract
Background
The elderly population is highly susceptible to develop post-operative complications after major surgeries. It is not clear whether the comprehensive geriatric care models are effective in reducing adverse events. The objective of this systematic review and meta-analysis is to determine whether the comprehensive geriatric care models improved clinical outcomes, particularly in decreasing the prevalence of delirium and length of hospital stay (LOS) in elderly surgical patients.

Method
We searched Medline, PubMed, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Emcare Nursing, Web of Science, Scopus, CINAHL, ClinicalTrials. Gov, and ICTRP between 2009 to January 23, 2020. We included studies on geriatric care models in elderly patients (≥60 years) undergoing elective, non-cardiac high-risk surgery. The outcomes were the prevalence of delirium, LOS, rates of 30-days readmission, and 30-days mortality. We used the Cochrane Review Manager Version 5.3. to estimate the pooled Odds Ratio (OR) and Mean Difference (MD) using random effect model analysis.

Results
Eleven studies were included with 2672 patients [Randomized Controlled Trials (RCTs): 4; Non-Randomized Controlled Trials (Non-RCTs): 7]. Data pooled from six studies showed that there was no significant difference in the prevalence of delirium between the intervention and control groups: 13.8% vs 15.9% (OR: 0.76; 95% CI: 0.30–1.96; p = 0.57). Similarly, there were no significant differences in the LOS (MD: -0.55; 95% CI: − 2.28, 1.18; p = 0.53), 30-day readmission (12.1% vs. 14.3%; OR: 1.09; 95% CI: 0.67–1.77; p = 0.73), and 30-day mortality (3.2% vs. 2.1%; OR: 1.34; 95% CI: 0.66–2.69; p = 0.42). The quality of evidence was very low.

Conclusions
The geriatric care models involved pre-operative comprehensive geriatric assessment, and intervention tools to address cognition, frailty, and functional status. In non-cardiac high-risk surgeries, these care models did not show any significant difference in the prevalence of delirium, LOS, 30-days readmission rates, and 30-day mortality in geriatric patients. Further RCTs are warranted to evaluate these models on the postoperative outcomes.

Trial registration
PROSPERO registration number - CRD42020181779.
Maxillary sinusitis developed as sequelae of accidental middle turbinectomy that occurred during nasotracheal intubation: a case report
Authors: Kim Joungmin , Pyeon Taehee , Lee Hyun Jung , Yang Hyung Chae 
Published: April 2021

Abstract
Background
Nasotracheal intubation is a very useful technique for orofacial or dental surgery. However, the technique itself can be more traumatic than that of orotracheal intubation. Complications such as turbinectomy or bleeding are often reported. However, little is known about the follow-up of patients after these complications.

Case presentation
The present case describes an accidental middle turbinectomy that led to endotracheal tube obstruction during nasotracheal intubation, and discusses its long-term follow-up. A 19-year-old man underwent mandibular surgery under general anesthesia and nasotracheal intubation. His right middle turbinate was completely avulsed and became firmly occluded within the tube during nasotracheal intubation. The nasotracheal intubation was performed again and the operation was completed safely. The patient was discharged without sequelae after postoperative care. However, he had symptoms of nasal obstruction and sleep disturbance for 3 months postoperatively. Synechiae were detected between the nasal septum and lateral nasal wall on a right rhinoscopic examination and facial computed tomography at 3 months postoperatively. Additionally, he showed ipsilateral maxillary sinusitis on facial computed tomography at the 2-year follow-up examination.

Conclusions
Nasotracheal intubation can cause late complications as well as early complications. Therefore, if nasotracheal intubation is to be performed, the anesthesiologist should identify the nasal anatomy of the patient accurately and prepare appropriately. In addition, if complications occur, follow-up observation should be performed.
Acute kidney injury predicts poor left ventricular function for patients with peripartum cardiomyopathy
Authors: Zhu Jiajia , Liu Wenxian 
Published: April 2021

AbstractBackgroundThe aim of this study was to explore the risk factors associated with a poor left ventricular (LV) function among patients with peripartum cardiomyopathy (PPCM) and to determine the influence of acute kidney injury (AKI) on the LV function of the patients.MethodsSixty patients with PPCM were recruited between January 2007 and June 2018, among which 11 had AKI. The participants were divided into two groups, the recovery group (32 cases) and the nonrecovery group (28 cases), with their clinical features, echocardiography and electrocardiogram findings, laboratory results, and treatments compared between groups. We further determined the risk factors associated with nonrecovery and the influence posed by AKI on the LV function of the patients.ResultsCompared with the patients in the recovery group, those in the nonrecovery group had higher proportions of multiparity [78.6% (22/28) vs. 43.8% (14/32)], function class III– IV heart failure [92.9% (26/28) vs. 71.9% (23/32)], and a higher incidence of AKI [35.7% (10/28) vs. 3.1% (1/32)]. Logistic regression analysis showed that having AKI [odds ratio (OR): 10.556; 95% confidence interval (CI) 1.177–94.654;P = 0.035] and left ventricular ejection fraction (LVEF) < 40% [OR: 4.533; 95% CI 1.118–18.382;P = 0.034] were independently associated with nonrecovery of PPCM.ConclusionsThe prognosis of patients with PPCM and AKI during hospitalization was poor compared to those without AKI; therefore, clinicians should pay more attention to this phenomenon.
Patterns of pathologic lymph nodes in anal cancer: a PET-CT-based analysis with implications for radiotherapy treatment volumes
Authors: Frennered Anna , Scherman Jonas , Buchwald Pamela , Johnsson Anders , Sartor Hanna , Zackrisson Sophia , Trägårdh Elin , Nilsson Martin P. 
Published: April 2021

Abstract
Background
This study investigates the patterns of PET-positive lymph nodes (LNs) in anal cancer. The aim was to provide information that could inform future anal cancer radiotherapy contouring guidelines.

Methods
The baseline [18F]-FDG PET-CTs of 190 consecutive anal cancer patients were retrospectively assessed. LNs with a Deauville score (DS) of ≥3 were defined as PET-positive. Each PET-positive LN was allocated to a LN region and a LN sub-region; they were then mapped on a standard anatomy reference CT. The association between primary tumor localization and PET-positive LNs in different regions were analyzed.

Results
PET-positive LNs (n = 412) were identified in 103 of 190 patients (54%). Compared to anal canal tumors with extension into the rectum, anal canal tumors with perianal extension more often had inguinal (P < 0.001) and less often perirectal (P < 0.001) and internal iliac (P < 0.001) PET-positive LNs. Forty-two patients had PET-positive LNs confined to a solitary region, corresponding to first echelon nodes. The most common solitary LN region was inguinal (25 of 42; 60%) followed by perirectal (26%), internal iliac (10%), and external iliac (2%). No PET-positive LNs were identified in the ischiorectal fossa or in the inguinal area located posterolateral to deep vessels. Skip metastases above the bottom of the sacroiliac joint were quite rare. Most external iliac PET-positive LNs were located posterior to the external iliac vein; only one was located in the lateral external iliac sub-region.

Conclusions
The results support some specific modifications to the elective clinical target volume (CTV) in anal cancer. These changes would lead to reduced volumes of normal tissue being irradiated, which could contribute to a reduction in radiation side-effects.
An atlas of the tissue and blood metagenome in cancer reveals novel links between bacteria, viruses and cancer
Authors: Borchmann Sven 
Published: April 2021

Abstract
Background
Host tissue infections by bacteria and viruses can cause cancer. Known viral carcinogenic mechanisms are disruption of the host genome via genomic integration and expression of oncogenic viral proteins. An important bacterial carcinogenic mechanism is chronic inflammation. Massively parallel sequencing now routinely generates datasets large enough to contain detectable traces of bacterial and viral nucleic acids of taxa that colonize the examined tissue or are integrated into the host genome. However, this hidden resource has not been comprehensively studied in large patient cohorts.

Methods
In the present study, 3025 whole genome sequencing datasets and, where available, corresponding RNA-seq datasets are leveraged to gain insight into novel links between viruses, bacteria, and cancer. Datasets were obtained from multiple International Cancer Genome Consortium studies, with additional controls added from the 1000 genome project. A customized pipeline based on KRAKEN was developed and validated to identify bacterial and viral sequences in the datasets. Raw results were stringently filtered to reduce false positives and remove likely contaminants.

Results
The resulting map confirms known links and expands current knowledge by identifying novel associations. Moreover, the detection of certain bacteria or viruses is associated with profound differences in patient and tumor phenotypes, such as patient age, tumor stage, survival, and somatic mutations in cancer genes or gene expression profiles.

Conclusions
Overall, these results provide a detailed, unprecedented map of links between viruses, bacteria, and cancer that can serve as a reference for future studies and further experimental validation.
The interrater reliability of a routine outcome measure for infants and pre-schoolers aged under 48 months: Health of the Nation Outcome Scales for Infants
Authors: Brann Peter , Culjak Gordana , Kowalenko Nick , Dickson Rosemary , Coombs Tim , Sved Williams Anne , Hoehn Elisabeth , Davies Simon , Hoyland Margaret , Burgess Philip 
Published: April 2021

BackgroundA review of Australian mental health services identified a gap in routine outcome measures addressing social, emotional and behavioural domains for pre-schoolers and infants. The Child and Adolescent Mental Health Information Development Expert Advisory Panel Working Group developed the Health of the Nation Outcome Scales for Infants (HoNOSI), a clinician-reported routine outcome measure for use with those aged under 4 years. Prior psychometric testing showed that the HoNOSI was considered to show face validity, and that it met the standards for concurrent validity and internal consistency.AimsWe aimed to investigate the interrater reliability of the HoNOSI.MethodForty-five infant mental health clinicians completed HoNOSI ratings on a set of five case vignettes.ResultsQuadratic weighted kappa interrater reliability estimates showed the HoNOSI to haveAlmost Perfectinterrater reliability for the HoNOSI total score. Of the 15 scales, one hadModerate, seven hadSubstantialand seven hadAlmost Perfectinterrater reliability. Ten of the fifteen scales and the total score exceeded the COnsensus-based Standards for the Selection of Health Measurement INstruments criteria for interrater reliability (κw≥ 0.7).ConclusionsThere has been a clear need for a routine outcome measure for use with infants and pre-schoolers. This study provides evidence of interrater reliability. The current findings, combined with the face and concurrent validity studies, support further examination of HoNOSI in real-world settings.
Literature, Powerlessness, and Modernity: A Reading of Takeuchi Yoshimi's “What Is Modernity?”
Authors: Wang Qin 
Published: April 2021

Abstract
While the Japanese sinologist Takeuchi Yoshimi is frequently mentioned in discussions of “alternative modernity” on the part of Asia, people have not sufficiently addressed the asymmetrical relationship between literature and politics in Takeuchi's thinking, as his literary analysis is oftentimes associated with a Hegelian reading of subjectivity. Through a reading of Takeuchi's “What Is Modernity?,” published in 1948, this article examines Takeuchi's discourses on politics from a literary standpoint that is radically nondialectical and “powerless” with regard to “politics” as he understands it. Takeuchi's critique of modernity as well as his idea of Asian nationalism cannot do without his idiosyncratic understanding of literature, especially his reading of Lu Xun, and his insistence on the powerlessness of literary resistance. Takeuchi's literary reshuffling of the political, the article argues, opens up a horizon where the very historico-political condition of possibility of existing political institutionalizations can be put into reexamination—it helps us reconsider the concepts of relation, otherness, and equality, which are still in operation to frame our understanding of the world.
Ideological Conversion: Mongolia's Transition from Socialism to Postsocialism
Authors: Sorace Christian 
Published: April 2021

AbstractAfter the collapse of socialism in Mongolia, democracy promised life after ideology. This article argues that what disappeared during the democratic transition was not ideology but a conceptualization of ideology as an explicit object, field of intervention, and responsibility. By analyzing the urban form as an invention of ideology, it is possible to locate ideology in material artifacts, cinematic representations, and the cultivation of embodied desires in Mongolia's capital city Ulaanbaatar that originated in the socialist era and continue today, albeit unacknowledged as ideology, and modified to fit the needs of capital and democratic legitimacy. The article concludes with a call to embrace ideology as a self-reflexive concept and practice on the grounds that there is still much to excavate and learn from the ruins of twentieth-century state socialism.
Humoral and Tissue Factors in Tissue Differentiation
Authors: Gaillard P. J. 
Published: April 2021

ABSTRACT
It was shown by Gaillard (1931,1935,1942) that pure strains of fibroblastic cells are very sensitive to those differences in the culture media which go hand in hand with the process of ageing of the donors used for preparing the media, the dimensional growth of the explants being used as a criterion. Moreover, strains of different origin reacted in a different way, thus demonstrating that cells which are morphologically alike can behave quite differently in vitro. When cultivating such a pure strain derived from the anlage of the frontal bone of a 15-day-old chicken embryo successively in a range of culture media prepared from 10-, 15-, and 18-day-old embryos, serum from a newly hatched chicken, and serum from an adult hen, histological bone formation occurred after 12 days of cultivation. This means that the realization of this obviously existing potentiality depended on the composition of the successive media.