bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Emergence of a Summer Hemisphere Jet in Planetary Atmospheres
Authors: Guendelman Ilai , Waugh Darryn W. , Kaspi Yohai 
Published: August 2021

AbstractZonal jets are common in planetary atmospheres. Their character, structure, and seasonal variability depend on the planetary parameters. During solstice on Earth and Mars, there is a strong westerly jet in the winter hemisphere and weak, low-level westerlies in the ascending regions of the Hadley cell in the summer hemisphere. This summer jet has been less explored in a broad planetary context, both due to the dominance of the winter jet and since the balances controlling it are more complex, and understanding them requires exploring a broader parameter regime. To better understand the jet characteristics on terrestrial planets and the transition between winter- and summer-dominated jet regimes, we explore the jet’s dependence on rotation rate and obliquity. Across a significant portion of the parameter space, the dominant jet is in the winter hemisphere, and the summer jet is weaker and restricted to the boundary layer. However, we show that for slow rotation rates and high obliquities, the strongest jet is in the summer rather than the winter hemisphere. Analysis of the summer jet’s momentum balance reveals that the balance is not simply cyclostrophic and that both boundary layer drag and vertical advection are essential. At high obliquities and slow rotation rates, the cross-equatorial winter cell is wide and strong. The returning poleward flow in the summer hemisphere is balanced by low-level westerlies through an Ekman balance and momentum is advected upward close to the ascending branch, resulting in a midtroposphere summer jet.
Diurnal Variations of Coastal Boundary Layer Jets over the Northern South China Sea and Their Impacts on Diurnal Cycle of Rainfall over Southern China during the Early-Summer Rainy Season
Authors: Dong Fu , Zhi Xiefei , Zhang Ling , Ye Chengzhi 
Published: August 2021

ABSTRACTThe diurnal variations of coastal boundary layer jets (CBLJs) over the northern South China Sea (SCS) and their effects on the diurnal cycle of rainfall over southern China during the early-summer rainy season of 2010–16 are examined based on the merged hourly gauge and satellite rainfall dataset, ERA5 data, and numerical simulations. CBLJs over the northern SCS exhibit two high-frequency regions with different diurnal cycles: one shows a nocturnal peak, located at the Beibu Gulf (WCBLJ); the other shows a double peak in the early morning and late afternoon, located over the coastal area of Guangdong (ECBLJ). Both CBLJs are occurred more frequently near Hainan Island. The inertial oscillations triggered by the land–sea thermal contrast, dynamic effects of Hainan Island, and effects of mountains over Vietnam are mainly attributed to the nocturnal WCBLJs, whereas the inertial oscillations induced by the large-scale sea breezes are responsible for nocturnal ECBLJs. The formation of afternoon ECBLJs mainly result from the thermal effects of Hainan Island. Nocturnal and morning rainfall over southern China are pronounced near the coast and the windward slope, while the afternoon rainfall peaks over the inland region in Guangdong Province. Due to dynamically forced lifting and moisture transport, WCBLJs and ECBLJs are essential for the formation of nocturnal and morning rainfall over Guangxi and Guangdong Province, respectively. In addition to the effects of solar heating, the afternoon rainfall over inland Guangdong is mainly affected by the ECBLJs and eastward-propagating rainfall belts from Guangxi Province, which are highly related to the occurrence of WCBLJs.
Defending Against Medical Error: Personal Reflections on the Legacy of John Senders
Authors: Cafazzo Joseph A. , Sellen Abigail J. , Norman Don 
Published: August 2021

Objective To honor the legacy of John Senders, a distinguished member of the Human Factors and Ergonomics Society, by a short, personal history of him, but then to honor his legacy by extending it through our own professional opinions, with an emphasis on the study of human error and its implications for healthcare systems—two topics in which he excelled. Background The authors are familiar with the topic and subject matter. One was a friend of Senders for over 50 years. Another was a collaborator and joint author with Senders (as well as his stepdaughter). All three authors have extensive publications in the topic areas. Method, Results, and Conclusion The authors used personal accounts of interactions with Senders at conferences, experiences living and working with him, and a brief review of his most personal, notable publications in healthcare. The reflections indicate a strong resonance on Senders’ contributions to system design that are relevant today in healthcare’s most challenging period in its history.
How tissue T1-variability influences DCE-MRI perfusion parameters estimation of recurrent high-grade glioma after surgery followed by radiochemotherapy
Authors: Filice Silvano , Ortenzia Ornella , Crisi Girolamo 
Published: August 2021

Background Quantification of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) kinetic parameters (KPs) requires a determination of native tissue T1. Two approaches are adopted: (i) tissue T1-maps are acquired; and (ii) an a priori T1 value (fT1) is fixed for all patients (fT1-approach). Although it is more attractive, the fT1-approach might bias the results of KP calculations due to tissue T1 variability. Purpose To quantify the tissue T1 variability of recurrent high-grade glioma (HGG) and the error in KP estimation when the fT1-approach is adopted. Material and Methods We reviewed the postoperative MRI scans of 28 patients with recurrent HGG after radiochemotherapy. MRI study included T1-maps from multiple-dynamic multiple-echo imaging, DCE-MRI, and contrast enhanced T1-weighted images. KPs were calculated using T1-map and fT1-approach. Results The tissue T1 variability of recurrent HGG was relevant. The absolute error in KP estimation, as a function of the deviation of fT1 from the true value, was 8% every 100 ms. The difference between the KPs obtained with fT1-approach from fT1 values of 1300, 1390, and 1500 ms and their reference values were mostly within the 95% confidence interval (± 1.96 standard deviation). Conversely, using fT1 values of 900, 1200, 1600, and 1900 ms causes a significant error in KP estimation ( P<0.05). Conclusion Recurrent HGG is characterized by a substantial T1 variability. Although the fT1-approach does not account for this variability, it results in a minor effect on the KP estimations provided the fT1 value is in the range of 1300–1500 ms.
Clinical analysis of 52 adolescent patients with ovarian masses ≥10 cm in diameter
Authors: Zhang Bo , Zhang Lu , Meng Ge 
Published: August 2021

Objective To investigate the clinical characteristics and treatment of large ovarian masses in adolescents. Methods Adolescents with large ovarian masses (≥10 cm in diameter) who were treated in Beijing Obstetrics and Gynecology Hospital from March 2010 to December 2018 were retrospectively assessed. Results Fifty-two female patients (mean age: 16.17±2.04 years [11–19 years]) were included and 19 (36.5%) presented with abdominal pain. The blood flow signal rate in ultrasonography was significantly different among benign, borderline and malignant ovarian masses, unlike strong echo, dotted echo and septation rates. Carbohydrate antigen 125 positivity rates were significantly different among pathological types and the endometriotic cyst group showed the highest value (75.0%). Alpha-fetoprotein positivity rates were also different among pathological types. For ovarian cystectomy, 14 and 32 patients underwent laparotomy and laparoscopy, respectively. Mass diameters were significantly higher in the laparotomy group and the operative duration was significantly shorter in the laparoscopy group. There were no significant differences in intraoperative blood loss or postoperative recurrence rates between the two groups. Conclusion Teratomas constitute the greatest group of large ovarian masses in adolescents. Benign tumors should be treated by laparoscopic resection, while borderline or malignant tumors require individualized treatment of tumors and fertility-sparing treatments.
Protective effect of pyrrolidine dithiocarbamate against methotrexate-induced testicular damage
Authors: Delen Ozlem , Uz Yesim H 
Published: August 2021

The aim of the study was to investigate the protective effect of pyrrolidine dithiocarbamate (PDTC) against methotrexate (MTX)-induced testicular damage in rats. Forty Wistar albino male rats were divided into equally four groups: Control group (saline solution, IP), PDTC group (100 mg/kg PDTC,IP, 10 days), MTX group (20 mg/kg MTX, IP, single dose, on the 6th day) and MTX + PDTC group (100 mg/kg PDTC, IP, 10 days and 20 mg/kg MTX, IP, single dose, on the 6th day). After 10 days, testicular tissues were excised for morphometric, histological and immunohistochemical evaluations. Serum testosterone, follicle stimulating hormone (FSH), luteinizing hormone (LH) and prokineticin 2 (PK2) levels were determined. Body and testicular weights were measured. Testicular damage was assessed by histological evaluation. Nuclear factor kappa B (NFkB), nuclear factor erythroid 2 related factor 2 (Nrf2) and PK2 immunoreactivities were evaluated by HSCORE. Body and testicular weights, serum FSH, LH, testosterone levels, seminiferous tubule diameter and germinal epithelial thickness were significantly decreased in the MTX group. However, serum PK2 level, histologically damaged seminiferous tubules and interstitial field width were significantly increased. Additionally, there was an increase in NFkB and PK2 immunoreactivity, whereas there was a significant decrease in Nrf2 immunoreactivity. PDTC significantly improved hormonal, morphometric, histological and immunohistochemical findings. Taken together, we conclude that PDTC may reduce MTX-induced testicular damage via NFkB, Nrf2 and PK2 signaling pathways.
A Comparative Study of Non-performing Assets Using Non-parametric Test: Indian Scheduled Commercial Banks
Authors: Mishra Bhabani , Rath S. S. 
Published: August 2021

Galloping levels of impaired assets slowly destroy the economy by throwing it into a major financial crisis. The current article studies recent trends and compositions of stressed assets among 45 selected Indian commercial banks. The non-parametric test (Kruskal–Wallis) is applied to know whether there exists any difference in the movement of gross non-performing assets ratios and net non-performing assets ratios (NNPAs) among bank groups and individual banks. The group-wise comparative study shows that a significant difference exists in the movement of NNPA ratio only between foreign banks and public sector banks and between private banks and public sector banks. Significant differences also exist among the individual banks in foreign and private bank groups. The Games–Howell post-hoc test finds that some pairs of banks have significant differences. The current financial downswing attributed to pandemic has increased the chances of fraudulency and sporadic default events and enhanced the problem of bad loans. Amalgamations of State Bank of India with its associates in 2017 and Bank of Baroda with Dena Bank and Vijaya Bank in 2019 have shown falls in stressed assets that possibly foreshow the future furtherance in asset quality of other four anchor banks that are merged with six banks, with effect from April 2020. JEL: G21, G34
Increased Systolic Blood Pressure Mediates the Relationship Between Urate and Gout Risk in Indonesia: A Novel Application of a Partial Least Squares-Structural Equation Model
Authors: Dyah Kurniasari Maria , Karwur Ferry Fredy , Rayanti Rosiana Eva , Huruta Andrian Dolfriandra , Lin Yu Huei , Weng Shuen Fu , Tsai Hsiu Ting 
Published: August 2021

Background: Most Indonesians with hyperuricemia are less than 40 years old, which suggests an increasing gout risk in the country. Meanwhile, untreated hyperuricemia was also suggested to lead to hypertension. Yet, it is unclear whether blood pressure (BP) plays a mediating role between urate and gout. Objective: We investigated the mediating effect of BP between urate and gout risk in Indonesians using a partial least squares-structural equation model. Method: A community-based retrospective case-control study was conducted between July 1 and August 31, 2019 in Indonesia. We randomly recruited 397 participants, including 86 patients with gout and 311 healthy controls from seven community health service centers. Multivariate logistic regression was employed to analyze the adjusted odds ratios of the association between risk factors, such as urate level and BP, and gout risk after controlling for other covariates. A path analysis was utilized to analyze the mediating effect of systolic BP between urate and gout. The STROBE reporting guideline for the observational study is adopted in our reporting. Result: We found that a 1 mg/dL increase of urate level significantly increased gout risk with an OR of 4.97 (95% CI: 3.48–7.09) and an AOR of 4.44 (95% CI: 3.07 –6.42) after adjusting for covariates. The association between urate and gout was also significantly mediated by systolic BP (β = 0.05; 95% CI Bias Corrected [0.02–0.08], p < 0.001). Conclusion: Urate was significantly associated with gout risk and was possibly mediated by increased systolic BP in Indonesians. Controlling systolic BP could be one of the strategies to decrease the risk of gout for individuals with hyperuricemia. Health education can be carried out by community health nurses to individuals on controlling their urate level and systolic BP to decrease the gout risk among Indonesian.
Caregiver–provider communication about pain in persons with dementia
Authors: Riffin Catherine , Patrick Karlee , Lin Sylvia L. , Carrington Reid M. , Herr Keela , Pillemer Karl A. 
Published: August 2021

Background Pain in older persons with dementia is both under-detected and under-managed. Family caregivers can play an important role in addressing these deficiencies by communicating their care recipient’s symptoms and behaviors to medical providers, but little is known about how caregivers and providers approach pain-related discussions in the context of dementia. The goal of this study was to explore how ambulatory care providers and family caregivers of persons with dementia view pain communication. Methods In-depth, semi-structured interviews were conducted with family caregivers ( n = 18) and healthcare providers involved in dementia care ( n = 16). Interviews focused on three specific content areas: (1) caregivers’ roles in communicating about pain in persons with dementia, (2) challenges experienced when communicating about pain in persons with dementia, and (3) strategies and recommendations for optimizing communication in this context. All interviews were audio-recorded, transcribed, and analyzed using the constant comparative method of data analysis. Results Caregivers and providers described various roles that caregivers assumed in communication processes, such as serving as historians, interpreters, and advocates. They identified two key features of problematic communication—receipt of inadequate information and interpersonal conflict about the care recipient’s pain—and articulated how ambiguity around pain and dementia, as well as preexisting beliefs and emotions, contributed to communication challenges. They also offered several suggestions to improve caregiver–provider communication processes, including the use of (1) written records to enhance the accuracy of caregivers’ reports and ensure that providers had specific information to inform symptom management and treatment plans, (2) pain scales and follow-up discussions to establish baseline data and clarify treatment recommendations, and (3) collaboration and rapport-building strategies to validate the caregivers’ contributions and maximize a team-based decision-making. Conclusion Receipt of inadequate information and interpersonal conflict are key challenges to caregiver–provider communication regarding pain in persons with dementia. Written records, pain scales, and rapport-building strategies may help to address these challenges.
Adherence to a generic medicine policy: A developing country's experience
Authors: Nkansah Samuel , Bearden Frank C , Frempong-Ainguah Faustina , Nkansah Florence Amah 
Published: August 2021

Escalating pharmaceutical expenditure is a global phenomenon, and Ghana has not been spared. To attend to the increasing cost of healthcare resulting from the high cost of drugs, the government of Ghana took a strategic decision to reduce its expenditure on healthcare without compromising the quality of care. The government directed that all medicines be prescribed by their generic names only at all health facilities. The purpose of this study is to assess the extent to which physicians adhere to the policy by assessing physicians' generic medicine prescribing patterns across the healthcare system in selected facilities in the Greater Accra Region. Questionnaires were administered to 87 physicians in 13 selected health facilities in Ghana. The results were analyzed using SPSS. The study's findings revealed that 74.7% of physicians adhere to the policy, and there is a likely relationship between knowledge of the policy and its implementation. Also, there is no significant relationship between health facility, physician's experience, disease diagnosis stage, and the prescribing of generic medicines. There is a need for regular review of the policy with aggressive and wellstructured in-service training on the subject and the introduction of pharmacists' substitution rights.
Effects of Fluticasone Exhalation Delivery System in Patients With Chronic Rhinosinusitis With Nasal Polyps: A Systematic Review
Authors: Wu Dawei , Huang Tianhao , Wei Yongxiang 
Published: August 2021

Background Nasal sprays with corticosteroids deliver medication to the restricted areas including anterior and inferior parts of the nasal cavity. The fluticasone exhalation delivery system (EDS-FLU) has recently been proved to improve care by increasing superior/posterior intranasal corticosteroid deposition. Objective This study aims to evaluate the efficacy of EDS-FLU in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). Methodology A systematic literature review using Pubmed, Embase, Cochrane Library, and Web of Science was conducted to identify studies assessing the effect of EDS-FLU on outcomes in patients with CRSwNP. Results Of the initial 108 abstracts reviewed, 4 full-text articles were included. The 22-item sinonasal outcome test scores were significantly decreased in patients with CRSwNP after receiving EDS-FLU twice a day (93, 186, or 372 μg) for 16 weeks when compared with exhalation delivery system (EDS)-placebo (all P < .001). Patients with CRSwNP reported significant improvement of smell after receiving twice daily EDS-FLU twice a day (93, or 372 μg) for 4 weeks when compared with EDS-placebo (all P < .05). The proportions of patients achieving ≥1-point improvement in total polyp grade were significantly higher in EDS-FLU group and dose dependent, with the highest rates in the 372 μg group. The proportions of patients achieving polyp elimination were significantly higher in EDS-FLU group with the highest rates in the 372 μg group. Conclusion This is the first systematic review of the clinical outcomes in patients with CRSwNP treated with EDS-FLU. EDS-FLU produced significant improvements regarding the quality of life, smell, and endoscopic assessment of polyp grade.
Characterization of Macroporous Polycaprolactone/Silk Fibroin/Gelatin/Ascorbic Acid Composite Scaffolds and In Vivo Results in a Rabbit Model for Meniscus Cartilage Repair
Authors: Abpeikar Zahra , Moradi Lida , Javdani Moosa , Kargozar Saeid , Soleimannejad Mostafa , Hasanzadeh Elham , Mirzaei Seyed Abbas , Asadpour Shiva 
Published: August 2021

Objective Meniscus injuries in the inner avascular zone have weak intrinsic self-healing capacity and often progress to osteoarthritis. This study focused on evaluating the effects of polycaprolactone/silk fibroin/gelatin/ascorbic acid (PCL/SF/Gel/AA) composite scaffolds seeded with adipose-derived mesenchymal stem cells (ASCs), in the meniscus repair. Design To this end, composite scaffolds were cross-linked using N-hydroxysuccinimide and 1-ethyl-3-(3-dimethyl-aminopropyl)-1-carbodiimide hydrochloride. Scaffolds were then characterized by scanning electron microscope, mechanical tests, total antioxidant capacity, swelling, and toxicity tests. Results The PCL/SF/Gel/AA scaffolds exhibited suitable mechanical properties. Furthermore, vitamin C rendered them the highest antioxidant capacity. The PCL/SF/Gel/AA scaffolds also showed good biocompatibility and proliferation for chondrocytes. Moreover, the PCL/SF/Gel/AA scaffold seeded with allogeneic ASCs was engrafted in New Zealand rabbits who underwent unilateral punch defect in the medial meniscus of the right knee. After 2 months postimplantation, macroscopic and histologic studies for new meniscus cartilage were performed. Conclusions Our results indicated that the PCL/SF/Gel/AA composite scaffolds seeded with allogeneic ASCs could successfully improve meniscus healing in damaged rabbits.
Directed stimulation of the dentato-rubro-thalamic tract for deep brain stimulation in essential tremor: a blinded clinical trial
Authors: Middlebrooks Erik H , Okromelidze Lela , Carter Rickey E , Jain Ayushi , Lin Chen , Westerhold Erin , Peña Ashley B , Quiñones-Hinojosa Alfredo , Uitti Ryan J , Grewal Sanjeet S 
Published: August 2021

Objective Observational studies utilising diffusion tractography have suggested a common mechanism for tremor alleviation in deep brain stimulation for essential tremor: the decussating portion of the dentato-rubro-thalamic tract. We hypothesised that directional stimulation of the dentato-rubro-thalamic tract would result in greater tremor improvement compared to sham programming, as well as comparable improvement as more tedious standard-of-care programming. Methods A prospective, blinded crossover trial was performed to assess the feasibility, safety and outcomes of programming based solely on dentato-rubro-thalamic tract anatomy. Using magnetic resonance imaging diffusion-tractography, the dentato-rubro-thalamic tract was identified and a connectivity-based treatment setting was derived by modelling a volume of tissue activated using directional current steering oriented towards the dentato-rubro-thalamic tract centre. A sham setting was created at approximately 180° opposite the connectivity-based treatment. Standard-of-care programming at 3 months was compared to connectivity-based treatment and sham settings that were blinded to the programmer. The primary outcome measure was percentage improvement in the Fahn–Tolosa–Marín tremor rating score compared to the preoperative baseline. Results Among the six patients, tremor rating scores differed significantly among the three experimental conditions ( P=0.030). The mean tremor rating score improvement was greater with the connectivity-based treatment settings (64.6% ± 14.3%) than with sham (44.8% ± 18.6%; P=0.031) and standard-of-care programming (50.7% ± 19.2%; P=0.062). The distance between the centre of the dentato-rubro-thalamic tract and the volume of tissue activated inversely correlated with the percentage improvement in the tremor rating score (R2=0.24; P=0.04). No significant adverse events were encountered. Conclusions Using a blinded, crossover trial design, we have shown the technical feasibility, safety and potential efficacy of connectivity-based stimulation settings in deep brain stimulation for treatment of essential tremor.