bluuebunny/crossref_metadata_2025_split huggingface dataset:
Turbulence in The Marine Boundary Layer and Air Motions Below Stratocumulus Clouds at the ARM Eastern North Atlantic Site
Authors: Ghate Virendra P. , Cadeddu Maria P. , Zheng Xue , O’Connor Ewan 
Published: September 2021

AbstractMarine stratocumulus clouds are intimately coupled to the turbulence in the boundary layer and drizzle is known to be ubiquitous within them. Six years of data collected at the Atmospheric Radiation Measurement (ARM)’s Eastern North Atlantic site are utilized to characterize turbulence in the marine boundary layer and air motions below stratocumulus clouds. Profiles of variance of vertical velocity binned by wind direction (wdir) yielded that the boundary layer measurements are affected by the island when the wdir is between 90° and 310° (measured clockwise from North where air is coming from). Data collected during the marine conditions (wdir<90 or wdir>310) showed that the variance of vertical velocity was higher during the winter months than during the summer months due to higher cloudiness, wind speeds, and surface fluxes. During marine conditions the variance of vertical velocity and cloud fraction exhibited a distinct diurnal cycle with higher values during the nighttime than during the daytime. Detailed analysis of 32 cases of drizzling marine stratocumulus clouds showed that for a similar amount of radiative cooling at the cloud top, within the sub-cloud layer 1) drizzle increasingly falls within downdrafts with increasing rain rates, 2) the strength of the downdrafts increases with increasing rain rates, and 3) the correlation between vertical air motion and rain rate is highest in the middle of the sub-cloud layer. The results presented herein have implications for climatological and model evaluation studies conducted at the ENA site, along with efforts of accurately representing drizzle-turbulence interactions in a range of atmospheric models.
Communicating Through a Pandemic: Insights on Crisis Communication from Steel Authority of India Limited, Rourkela Steel Plant
Authors: Chattaraj Dipak , Mohanty Seemita , Satpathy Archana 
Published: September 2021

Executive Summary The year 2020 will go down in the annals of history as the year of COVID-19, the year the whole world was left devastated. Even in 2021, countries are being ravaged by the virus, with no immediate end in sight. In fast-moving and uncertain situations, leaders face many questions for which they might not have any answers ( Argenti, 2020 ). Therefore, the question is how leaders can manage the communication environment with clarity, consistency and empathy during this period of extreme disruption ( Glinska, 2020 ). Crisis communication is generally defined as the accumulation and dissemination of information during crisis situations to alleviate the severity of the crisis. This study outlines and analyses the communication strategies and measures adopted by the management of one of the biggest manufacturing industries of the country, the Steel Authority of India Limited, Rourkela Steel Plant (RSP), during this ongoing COVID-19 crisis. A survey on the efficacy of the communication measures adopted by the management was conducted on 345 employees. The results showed a high level of support for all the implemented communication measures. Yet employees at the junior level articulated a need for better communication exchange with the top management. They perceived their voices as going unheard and sought additional communication channels connecting them to the highest authority. Considering the feedback received from the employees, additional communication measures were adopted. RSP’s Mass Contact Exercise was revived in an online format. A mobile app was developed containing all information and guidelines that an employee would need regarding precautions, prevention, testing and treatment of COVID-19. Quick and clear communication at every juncture let RSP tide through arguably the toughest pandemic period. Thus, it should always be ensured that appropriate communication channels are effectively implemented for vital information to reach every corner of the organization.
Health System-Level Evaluation of Tele-Mental Health Services Among Children and Adolescents in Ontario, Canada
Authors: Toulany Alene , Kurdyak Paul , Gandhi Sima , Fu Longdi , Grewal Seena , Kulkarni Chetana , Saunders Natasha , Vigod Simone , Guttmann Astrid , Chiu Maria , Pignatiello Antonio 
Published: September 2021

Objective To describe the characteristics of children and adolescents receiving tele-mental health services in Ontario, Canada and examine access to a psychiatrist, in-person or via tele-mental health services, following a mental health and addictions (MHA)-related emergency department (ED) visit or hospitalization. Method Using linked health and administrative data, we described two cohorts: (1) children and adolescents (1–18 years) who used a provincial tele-mental health programme from January 1, 2013 to March 31, 2017, comparing their MHA-related service use (outpatient, ED, hospitalization) in the 1 year prior to and the 1 year following initial consultation; (2) children and adolescents with high mental health service needs, defined as those with an incident MHA-related ED visit or hospitalization between January 1, 2013 and December 31, 2016, examining their 1-year follow-up with telemedicine and other health care utilization. Results In the first cohort, 7,216 children and adolescents (mean age 11.8 [±3.8] years) received tele-mental health services. The proportion of MHA-related ED visits [15.1% pre vs. 12.6% post (test statistic 23.57, P < 0.001)] or hospitalizations [10.2% pre vs. 8.7% post (test statistic 11.96, P < 0.001)] declined in the year following tele-mental health consultation, while local psychiatry visits increased [8.4% pre vs. 17.0% post (test statistic 298.69, P < 0.001)]. In the second cohort ( n = 84,033), only 1.5% received tele-mental health services, 40.7% saw a psychiatrist in-person, and 32.5% received no MHA-related outpatient care in follow-up. Conclusions Tele-mental health services were rarely used in Ontario, even among high-needs children and adolescents, despite their association with increased access to care and less need for acute mental health care.
The development of National Safety and Quality Digital Mental Health Standards
Authors: Brown Peggy , Prest Ben , Miles Paul , Rossi Vanessa 
Published: September 2021

Objective: Digital mental health services offer innovative ways for individuals to access services but are not without risk. Our objective was to develop National Safety and Quality Digital Mental Health (NSQDMH) Standards that improve the quality of digital mental health service provision and protect service users from harm. Method: The NSQDMH Standards were developed by adapting the National Safety and Quality Health Service (NSQHS) Standards and adding components highlighted through a national consultation process as critical to the safety and quality of services. Further public consultation and pilot testing assisted in refining the NSQDMH Standards. Results: The NSQDMH Standards comprise three standards—Clinical and Technical Governance, Partnering with Consumers, and Model of Care—and were launched in November 2020. Conclusions: The NSQDMH Standards provide a quality assurance mechanism to improve digital mental health care in Australia.
Social Determinants of Health May Predict End of Life Portable Orders for Life Sustaining Treatment Form Completion and Treatment Selections
Authors: Gievers Ladawna , Khaki Sheevaun , Dotson Abby , Chen Zunqiu , Macauley Robert C. , Tolle Susan 
Published: September 2021

Background: End of life (EOL) care planning is important for aging adults given the growing prevalence of chronic medical conditions in the US. The Portable Orders for Life Sustaining Treatment (POLST) program promotes communication between clinicians and patients with advanced illness about EOL treatment preferences. Despite growing resources for EOL care, utilization remains unequal based on social determinants of health (SDOH), including race, language, urbanization, and education. We evaluated the relationship between POLST form selections and completion rates and SDOH. Methods: Oregon POLST Registry and American Community Survey data from 2013 to 2017 were analyzed retrospectively. POLST form completion rates and selections, and various SDOH, including age, income, insurance status, urbanization, etc. were recorded. Data were merged based on ZIP codes and analyzed using χ2 or Wilcoxon-Mann-Whitney tests. Logistic regression was performed. Results: 127,588 POLST forms from 319 ZIP codes were included. POLST form completion rates were highest among urban ZIP codes, and urban registrants more often selected CPR and full treatment. ZIP codes with higher incomes tended to select CPR. ZIP codes with higher rates of private insurance completed POLST forms, and selected CPR and full treatment more frequently. ZIP codes with higher rates of Bachelor’s degrees (or higher) completed POLST forms and selected full treatment more frequently. Conclusions: Various SDOH-specifically, urbanization, insurance status, income level and educational level achieved-may influence POLST form completion rates and selections. The expanding socioeconomic diversity and growth of urban communities, highlight the need for broader access to EOL planning and POLST.
Impact of Surgical Margin Status on Survival in Gastric Cancer: A Systematic Review and Meta-Analysis
Authors: Jiang Zhiyuan , Liu Chunyu , Cai Zhaolun , Shen Chaoyong , Yin Yuan , Yin Xiaonan , Zhao Zhou , Mu Mingchun , Yin Yiqiong , Zhang Bo 
Published: September 2021

Background It is inconclusive whether R1 margin determined by postoperative pathological examination indicates worse long-term survival in gastric cancer (GC) patients after curative intent resection (CIR). Hence, we aimed to systematically pool the conflicting evidence to fill this gap. Methods The present study was performed according to the published protocol and Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Published studies examining the impact of microscopic margin status on overall survival (OS) and 5-year OS rate in GC were systematically searched in PubMed, Embase, and Cochrane Library databases. RevMan 5.3 was used to conduct statistical analysis, and the Grading of Recommendations, Assessment, Development, and Evaluations approach was used to assess the certainty of evidence for each outcome. Results Twenty-three retrospective cohort studies including 19 992 patients were analyzed. The pooled hazard ratio for OS of 14 studies was 2.06 (95% confidence interval [CI]: 1.61–2.65, low certainty), indicating that R1 margin predicted inferior OS. Subgroup and sensitivity analyses upheld the statistical stability of this finding. The pooled odds ratio (OR) of 14 studies was .21 (95% CI: .17–.26, moderate certainty), demonstrating that the presence of R1 margins was associated with a poorer 5-year OS rate. Sensitivity analyses and most of the subgroup analyses confirmed this finding, except the “esophagogastric junction (EGJ) cancers” subgroup, which included two studies with a pooled OR of .41 (95% CI: .10–1.61). Conclusion R1 margin detected by pathological examination might exhibit a high correlation with poorer OS and 5-year OS rate in GC (except EGJ cancers) patients who underwent CIR. To figure out the effect of R1 margin on survival of different stages and histological types need prospective studies with large sample sizes and standardized methods. What is the best treatment for R1 margin patients also need more in-depth and special research.
Vessel Diameter Evaluated by Intravascular Ultrasound Versus Angiography
Authors: Iida Osamu , Takahara Mitsuyoshi , Soga Yoshimitsu , Fujihara Masahiko , Kawasaki Daizo , Hirano Keisuke , Choi Donghoon , Mano Toshiaki 
Published: September 2021

Purpose: Although reference vessel diameter (RVD) is conveniently measured by angiography during femoropopliteal (FP) endovascular therapy (EVT) in clinical practice, angiography will potentially underestimate RVD. On the other hand, intravascular ultrasound (IVUS) can measure RVD precisely. The aim of this study was to reveal the difference between angiography- and IVUS-assessed RVD in patients undergoing FP-EVT for symptomatic peripheral artery disease (PAD). Methods: We analyzed a prospective and multicenter database including 1967 limbs of 1725 patients with symptomatic PAD undergoing IVUS-supported FP-EVT. The study outcome measure was the difference between IVUS- and angiography-assessed distal RVD ( ΔRVD), calculated as angiography-assessed RVD subtracted from IVUS-assessed RVD. The clinically important difference was defined as 1 mm or larger. Results: IVUS-assessed RVD was significantly larger than angiography-assessed RVD (6.0±1.0 mm vs 5.0±1.0 mm; p<0.001). Mean ΔRVD (IVUS- minus angiography-assessed RVD) was 0.98 mm (95% CI, 0.94–1.03 mm). ΔRVD was 1 mm or larger in 48.8% (46.5%–51.0%) of the whole population. Multivariate analysis demonstrated that small angiography-assessed RVD, angiography-assessed bilateral calcification, and history of stent implantation were significantly associated with an increasing risk of ΔRVD ≥1mm, whereas presence of chronic total occlusion (CTO) was significantly associated with a decreasing risk of ΔRVD ≥1 mm. Conclusion: The current study revealed the difference between angiography-assessed reference lumen diameter and IVUS-assessed reference EEM diameter of FP lesions. About half of population had ΔRVD ≥1 mm. IVUS-assessed RVD was more likely to be different by angiography in cases with small vessels, CTO, bilateral calcification, and history of stent implantation.
Comparative Bioavailability and Pharmacokinetics Between the Solid Form of Metformin vs a Novel Liquid Extemporaneous Formulation in Children
Authors: Alemón-Medina Radamés , Altamirano-Bustamante Nelly , Lugo-Goytia Gustavo , García-Álvarez Raquel , Rivera-Espinosa Liliana , Torres-Espíndola Luz María , Chávez-Pacheco Juan Luis , Juárez-Olguín Hugo , Gómez-Garduño Josefina , Flores-Pérez Carmen , Fernández-Pérez Paola Gabriela 
Published: September 2021

Metformin pharmacokinetics in a liquid extemporaneous formulation from commercial tablets was determined in paediatric patients. A randomized, transversal clinical trial was conducted in 34 children and adolescents between 7 and 17 years of age. 17 children were randomized to take metformin in the liquid formulation and, after a 1-week wash period, a 500 mg metformin tablet was administered to them. Blood samples were obtained in Whatman 903® cards at 0, 1, 2, 4, 8, 12 and 24 hours. Extraction was made by direct precipitation with acetonitrile (ACN) and methanol, detection by UPLC and tandem mass spectrometry. The method was accurate, precise, selective and linear from 50 to 1000 ng/mL (r = .9982). Comparative pharmacokinetics, tablet vs formulation, were as follows: Cmax1503.2 ng/mL vs 1521.4, Tmax1.5 h vs 2.3, and half-life 8.2 vs 7.5 h. The liquid formulation of metformin showed similar pharmacokinetics to the tablet, and the ratios (90% CI) of geometric mean for metformin were 100.63% (89.13–113.6), 98.08% (88.04–109.2), and 97.52% (84.9–112.01), for Cmax, AUC0-t, and AUC 0-∞, respectively. Pharmacokinetics was determined using WinNonlin Pro 3.1 software. The liquid formulation of metformin showed similar pharmacokinetics to the tablet, allowing a more precise dose adjustment and ease of administration.
Posterior circulation collateral flow modifies the effect of thrombectomy on outcome in acute basilar artery occlusion
Authors: Broocks Gabriel , Faizy Tobias D , Meyer Lukas , Groffmann Maximilian , Elsayed Sarah , Kniep Helge , Flottmann Fabian , Bechstein Matthias , Rusche Thilo , Schön Gerhard , Nawabi Jawed , Sporns Peter , Fiehler Jens , Kemmling Andre , Hanning Uta 
Published: September 2021

Background In basilar artery occlusion stroke, the impact of the collateral circulation on infarct progression in the context of endovascular treatment is yet poorly studied. Aim This study investigates the impact of the posterior circulation collateral score (PCCS) on functional outcome according to the extent of early ischemic changes and treatment. We hypothesized that the presence of collaterals, quantified by the PCCS, mediates the effect of endovascular treatment on functional outcome in patients with acute basilar artery occlusion. Methods In this multicenter observational study, patients with basilar artery occlusion and admission computed tomography were analyzed. At baseline, Posterior circulation Acute Stroke Prognosis Early Computed Tomography score (pcASPECTS) was assessed and PCCS was quantified using an established 10-point grading system. Logistic regression analyses were performed to identify factors associated with good functional outcome (modified Rankin Scale scores 0–2 at day 90). Results A total of 151 patients were included, of which 112 patients (74%) underwent endovascular treatment. In patients with a better PCCS (>5), the rate of good outcome was significantly higher (55% vs. 11%; p = 0.001). After adjusting for PCCS, vessel recanalization was significantly associated with improved functional outcome (aOR: 4.53, 95%CI: 1.25–16.4, p = 0.02), while there was no association between recanalization status and outcome in univariable analysis. Patients with low pcASPECTS generally showed very poor outcomes (mean modified Rankin Scale score 5.3, 95%CI: 4.9–5.8). Conclusion PCCS modified the effect of recanalization on functional outcome, particularly in patients with less pronounced ischemic changes in admission computed tomography. These results should be validated to improve patient selection for endovascular treatment in basilar artery occlusion, particularly in uncertain indications, or to triage patients at risk for very poor outcomes.
Safety profile of GreenLight XPS laser photoselective vaporisation of the prostate in patients at high risk of bleeding
Authors: Waters Darragh K , Khalid Raihan , Mustafa Fatalla , Omeire Frederick , Jones Barry J 
Published: September 2021

Objective: This study aimed to assess the utility and safety profile of the GreenLight Xcelerated Performance System (XPS) photoselective vaporisation of the prostate (PVP) to treat benign prostatic hyperplasia (BPH) in high-risk patients. Patients and methods: A retrospective study of a prospectively managed database was carried out. The study reviewed a single surgeon’s experience of treating high-risk patients with GreenLight XPS PVP between two sites over a four-year period. Patients considered to be high risk were those who were at an increased risk of bleeding, those who had a prostate size >80 mL, those with preoperative urinary retention and/or those aged >80 years. Results: In total, 374 patients were identified as being high risk for GreenLight PVP. Patient age ranged from 44 to 96 years ( Mage=71 years). Of the 374 patients, 103 were aged >80 years. All 374 patients were considered to be at an increased risk of bleeding, as they underwent GreenLight PVP while taking antiplatelet agents (not including aspirin), anticoagulant agents or both. Ninety-one patients had preoperative urinary retention and indwelling urinary catheter. Fifty-four patients had a prostate size >80 mL. Length of stay varied from 1 to 14 days. Most patients ( n=270) were discharged on postoperative day 1. There were no perioperative blood transfusions. One patient developed acute coronary syndrome on postoperative day 4, requiring percutaneous coronary intervention. Twenty-two patients required readmission: 12 due to urinary retention with or without haematuria, and 10 due to haematuria without associated acute retention. Two patients required cystoscopy and bladder washout. There were two blood transfusions in the ‘readmission due to haematuria’ group. Outcomes for patients aged >80 years were favourable. The average length of stay was 2.7 days (range 1–14 days). This group was responsible for 12 of the 22 readmissions. There were no perioperative cardiovascular events. Conclusion: We conclude that GreenLight XPS PVP is a safe procedure in patients with one or more high-risk factors. The ability to proceed without the need to stop antiplatelets or anticoagulant agents also allows for high-risk medical patients to be treated without the additional risks of cardiovascular events. Level of evidence: Not applicable for this multicentre audit.
Modes and Trajectories of Shadow Education in Denmark and China: Fieldwork Reflections by a Comparativist
Authors: Zhang (张薇) Wei 
Published: September 2021

Purpose In the domain of shadow education (private supplementary tutoring), Denmark and China may be placed at opposite ends of a spectrum. Denmark has a recently emerged, small, and high-cost sector that mostly serves low achievers, while China has a more industrialized sector with a long history and economies of scale. The paper juxtaposes the two to shed light on each. Design/Approach/Methods The article is a personal narrative of the author's research experiences. She grew up and had initial education in China before moving to the Nordic realm for 2 years. This provided a set of initial lenses, which were subsequently deployed in research partnership from her current base in China with colleagues in Denmark. Findings The juxtaposition raises questions that might otherwise not have been asked and provides insights that might otherwise not have been gained. Danish families hesitate to use shadow education for advantages in the egalitarian society, in contrast to Chinese patterns that stress competition and achievement. These facets have implications for the modes of shadow education and even the names of tutorial companies. Originality/Value The paper has a methodological value in addition to its substantive insights on the trajectories of shadow education in the two countries.
The Impact of Corticosteroid Injection Timing on Infection Rates Following Spine Surgery: A Systematic Review and Meta-Analysis
Authors: Kazarian Gregory S. , Steinhaus Michael E. , Kim Han Jo 
Published: September 2021

Study Design/Setting: Systematic review/meta-analysis. Objectives: The objective of this review was to assess how the risk of infection following lumbar spine surgery varies as a function of the timing of preoperative corticosteroid spinal injections (CSIs). Methods: A systematic review and meta-analysis was performed in accordance with the PRISMA guidelines. PubMed and EMBASE databases were searched and data was pooled for meta-analysis. Results: Six studies were identified for inclusion. Two (33.3%) demonstrated a significant relationship between the timing of preoperative CSIs and the risk of postoperative infection, while 4 (66.7%) demonstrated no impact. A total of 2.5% (110/4,448) of patients who underwent CSI <1 month before surgery experienced a postoperative infection, as compared to 1.2% (1,466/120, 943) of controls, which was statistically significant (RR = 1.986 95% CI 1.202-3.282 P = 0.007). A total of 1.6% (25/1,600) of patients who underwent CSI 0-3 months before surgery experienced a postoperative infection, as compared to 1.6% (201/12, 845) of controls (RR = 0.887 95% CI 0.586-1.341, P = 0.569). A total of 1.1% (199/17 870) of patients who underwent CSI 3-6 months before surgery experienced a postoperative infection, as compared to 1.3% (1,382/102, 572) of controls (RR = 1.053 95% CI 0.704-1.575, P = 0.802). Differences in infection risk for 0-3 months and 3-6 months were not statistically significant. Conclusions: CSIs <1 month prior to lumbar spine surgery are a significant risk factor for infection, while CSIs beyond that point showed no such association. Surgeons should consider avoiding CSIs <1 month of the use of CSIs of the spine.