bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clarifying remotely-retrieved precipitation of shallow marine clouds from the NSF/NCAR Gulfstream V
Authors: Sarkar Mampi , Zuidema Paquita , Ghate Virendra 
Published: July 2021

AbstractPrecipitation is a key process within the shallow cloud lifecycle. The Cloud System Evolution in the Trades (CSET) campaign included the first deployment of a 94 GHz Doppler radar and 532 nm lidar. Despite a larger sampling volume, initial mean radar/lidar retrieved rain rates (Schwartz et al. 2019) based on the upward-pointing remote sensor datasets are systematically less than those measured byin-situprecipitation probes in the cumulus regime. Subsequent retrieval improvements produce rainrates that compare better toin-situvalues, but still underestimate. Retrieved shallow cumulus drop sizes can remain too small and too few, with an overestimated shape parameter narrowing the raindrop size distribution too much. Three potential causes for the discrepancy are explored: the gamma functional fit to the dropsize distribution, attenuation by rain and cloud water, and an underaccounting of Mie dampening of the reflectivity. A truncated exponential fit may represent the dropsizes below a showering cumulus cloud more realistically, although further work would be needed to fully evaluate the impact of a different dropsize representation upon the retrieval. The rain attenuation is within the measurement uncertainty of the radar. Mie dampening of the reflectivity is shown to be significant, in contrast to previous stratocumulus campaigns with lighter rain rates, and may be difficult to constrain well with the remote measurements. An alternative approach combines an aprioridetermination of the dropsize distribution width based on thein-situdata with the mean radar Doppler velocity and reflectivity. This can produce realistic retrievals, although a more comprehensive assessment is needed to better characterize the retrieval errors.
Environmental change perception and engagement of mountainous people in Western Himalayas, at Rajouri District, Jammu and Kashmir, India
Authors: Zeeshan Mohd , Zhang Huanyuan , Sha Liqing , Palingamoorthy Gnanamoorthy , Phyo Zayar , Chen Ziwei , Quadros Goldin , Azeez P A 
Published: July 2021

AbstractSubstantial temperature rise is reported in the Himalayas and the vulnerability of the region to climate change is well recognized. Apt adaptation strategy to cope with climate change calls for informed peoples’ participation, which was rarely investigated in Western Himalaya. Having been better informed, people in developed areas adopt better actions against climate change well guided by their perception. In contrast, Rajouri in Jammu and Kashmir represents a relatively impoverished and climate change vulnerable region. We, therefore, gauge people’s perceptions and actions in this area based on a household survey from 717 randomly selected individuals. Further, consistency of perception was compared with meteorological records on temperature, humidity, wind speed, rainfall, and aboveground biomass from 1983 - 2013. The findings revealed that temperature increases significantly, while changes in rainfall, wind speed, and relative humidity were insignificant. Although people sensed a rise in temperature and deforestation right, most of them differ with respect to rainfall, wind speed, and humidity. They reported rising pollution and traffic, but no change in crop productivity or crop varieties. Of the respondents, 91% considered climate change as a risk, 86.8% reported reactive actions to it and 82.8% reported proactive actions. Locals from varied socio-economic backgrounds are not much informed about climate change; hence, the reasonability of their responses and positive adaptation actions needs further research. To engage people in climate adaptation actions, we suggest disseminating precise scientific information about local climate through awareness programs and by engaging them in climate change activities through suitable organizations.
Percutaneous mechanical thrombectomy device assisted TIPS recanalization: a feasibility study
Authors: Thurner Annette , Augustin Anne Marie , Götze Oliver , Bley Thorsten A , Kickuth Ralph 
Published: July 2021

Background Despite improved shunt patency, transjugular intrahepatic portosystemic shunt (TIPS) occlusion remains a serious complication, and effective debulking of the existing tract is needed to restore sufficient blood flow. Purpose To evaluate the technical and clinical success of percutaneous mechanical thrombectomy in restoring patency of acutely and chronically thrombosed covered TIPS using the Aspirex®S and Rotarex®S system. Material and Methods We evaluated mechanical thrombectomy-assisted revisions in five patients between January 2012 and April 2021. Two patients had to be revised twice due to recurrent occlusion. We designated thrombosis within 10 days after shunt creation or revision as acute. Insidious deterioration of portal hypertension related symptoms for at least 6–8 weeks was recorded in chronic cases. We treated four acute and three chronic occlusions. After transjugular lesion crossing, we performed two mechanical thrombectomy device passages. If indicated, balloon dilatation, covered stent placement, or variceal embolization were added. Results The technical success rate was 100%. No procedure-related complications occurred. In one patient with acute decompensation of Budd–Chiari syndrome and acute-on-chronic liver failure, early re-thrombosis occurred twice with patency intervals of up to eight days. In contrast, stable patency was achieved in the other four patients with documented patency intervals of at least five months and improvement of portal hypertension-related symptoms, resulting in a patient based clinical success rate of 80%. Conclusion In five patients, percutaneous mechanical thrombectomy assisted TIPS recanalization of four acute and three chronic occlusions proved to be technically feasible and safe with a high clinical success rate.
The small molecule kobusone can stimulate islet β-cell replication in vivo
Authors: Choi Jin woo , Joo Jin-deok , In Jang hyeok , Kim Daewoo , Kim Yongshin , Choi Seung Tae , Kim Jung Han , Jung Hong Soo 
Published: July 2021

Objective To investigate the ability of kobusone to reduce high glucose levels and promote β-cell proliferation. Methods Four-week-old female db/db mice were assigned to the kobusone (25 mg/kg body weight, intraperitoneally twice a day) or control group (same volume of PBS). Glucose levels and body weight were measured twice a week. After 6 weeks, intraperitoneal glucose tolerance tests and immunohistochemical studies were performed, and insulin levels were determined. The expression of mRNAs involved in cell proliferation, such as PI3K, Akt, cyclin D3 and p57Kip 2 , was measured by quantitative reverse transcription polymerase chain reaction (RT-qPCR). Results Kobusone reduced blood glucose levels after 3 weeks and more strongly increased serum insulin levels than the vehicle. Immunohistochemistry illustrated that kobusone increased 5-bromo-2′-deoxyuridine incorporation into islet β-cells, suggesting that it can stimulate islet β-cell replication in vivo. RT-qPCR indicated that kobusone upregulated the mRNA expression of PI3K, Akt, and cyclin D3 and downregulated that of p57Kip2. Conclusion Our findings suggest that kobusone is a potent pancreatic islet β-cell inducer that has the potential to be developed as an anti-diabetic agent.
Through Her Eyes: The Impact of War on Syrian Refugee Families
Authors: Al-Natour Ahlam , Morris Edith J. , Mohammad Al-Ostaz Samar 
Published: July 2021

Background The Syrian war conflict ended with devastating impact on Syrian refugee women and their children. A few studies have been done that explored the impact of the civil war and displacement of Syrian families from a cultural perspective. The purpose of this study was to highlight the experiences of the Syrian war–refugee families who have sought shelter in a host country. Method A descriptive phenomenological study was conducted using a semistructured interview approach among 16 Syrian refugee women who were approached from two Jordanian health care centers. Results The main themes discussed how the war ended with financial and social stress, family violence, and hazardous effects on women and children health. Conclusion This article introduced how culture and religion influence how family unit and members responded to war stressors. This study provided transcultural nursing knowledge, allowing nurses to be grounded in individualized culturally specific care.
Outcomes of radiocephalic arteriovenous fistula in octogenarians
Authors: Mauro Raffaella , Pini Alessia , Pini Rodolfo , Abualhin Mohammad , Mascoli Chiara , La Manna Gaetano , Chiocchini Anna Laura , Donati Gabriele , Faggioli Gianluca , Gargiulo Mauro 
Published: July 2021

Background: Current guidelines recommend radiocephalic arteriovenous fistula (RCAVF) as a first choice access for hemodialysis, without specific indication for octogenarians .This study was undertaken to assess the efficacy of RCAVF in octogenarians compared with younger patients. Material and methods: All patients treated by RCAVF from January 2013 to December 2017 were included in a prospective database for a retrospective analysis. Patient demographics, comorbidities, and dialytic treatment data were collected prospectively and compared in patients <80 year-old and ⩾80 years-old. Clinical surveillance was performed during each dialysis session. The main endpoints were primary (PP) and assisted patency (AP). Results: Within the study period, a total of 294 RCAVF were analyzed: 245 (83.3%) RCAVF were performed in <80 year-old and 49 (16.7%) ⩾80 years old. The overall PP and AP at 2-year was 69% ± 2% and 73% ± 3%, respectively. Patients ⩾ 80 years-old had a significantly reduced 2-year PP, AP of RCAVF compared with the younger patients: 50% ± 8% and 62% ± 7% versus 73% ± 3% and 75% ± 3%, p = 0.01 and p = 0.03, respectively. The analysis for possible risk factors for reduction of PP in patients ⩾80 years identified in the central venous catheter(CVC) a predictor of earlier RCAVF failure: HR 3.03(95% CI 1.29–7.13), p = 0.01.Kaplan–Meier curve confirms the reduction of PP in ⩾80 years old patients at 2-year follow-up with previous CVC compared patients without history of CVC: 59% ± 10% versus 24% ± 11%, p = 0.01. A comparison between the two groups was made in order to evaluate the impact of previous history of CVC .In absence of a history of CVC use older patients had a similar 2-year PP compared with younger patients: 59% ± 10% versus 72% ± 4%, p = 0.46. Otherwise, the history of a previous CVC reduced significantly the 2-year PP in ⩾80 years old patients compared the younger: 24% ± 12% versus 75% ± 5%, p = 0.0001. Conclusions: Despite lower overall primary and primary assisted patency, RCAVF are associated with satisfactory results also in octogenarians if performed in absence of history of CVC. Under these circumstances RCAVF can be considered a first choice treatment.
A Randomized Placebo-Controlled Trial of Efficacy and Safety: Drug-Free Gel Containing Ultra-Deformable Phospholipid Vesicles (TDT 064) in Osteoarthritic Knees
Authors: Yuenyongviwat Varah , Iamthanaporn Khanin , Tuntarattanapong Pakjai , Hongnaparak Theerawit , Tangtrakulwanich Boonsin 
Published: July 2021

Background: There are a number of topical agents that are used for treatment of knee osteoarthritis. Drug-free gels, containing ultra-deformable phospholipid vesicles (TDT 064) are one such topical therapy, which have been stated to act as a bio lubricant. However, the evidence of TDT 064 in treatment of knee osteoarthritis is limited. Hence, the aim of this study was to evaluate the efficacy of pain control as a primary outcome and safety of TDT 064 compared with a topical placebo. Methods: Sixty-four patients with primary osteoarthritis, with radiographic showing Kellgren and Lawrence classification grade II to III, were randomized into 2 groups. In the first group of 32 patients TDT 064 was used as topical agent, whilst in the second group of 32 patients a placebo identical in appearance was used instead. The verbal numerical rating scale (VNRS) was used for recording pain levels, Self-reported Knee Injury and Osteoarthritis Outcome Scores (KOOS) as well as amounts of rescue medication were also recorded. The data were recorded at the start of the study, and then at follow-up appointments of 14 days, 6 weeks, and 3 months. Results: The mean VNRS for pain in both groups were significantly improved, when compared to the start of treatment ( P < .0001); however, there were no differences between groups at any follow up visit. KOOS in all subscales were not significantly different between both groups at baseline and at the end of treatment. However, the average amount of NSAIDs in the TDT 064 group was 26.39 ± 22.11 tabs, which was significantly lower than the control group; which used an average 37.03 ± 19.22 tabs in 3 months ( P = .047). Conclusions: There were no differences in the VNRS for pain and KOOS scores between the active and placebo groups. Although, TDT 064 could decrease usage of rescue medication the difference with use of a placebo was minimal. Further, larger trials would also be beneficial to demonstrate any differences between TDT 064 and a placebo. Trial Registration: TCTR, TCTR 20190302001. Registered 1 March, 2019: http://www.clinicaltrials.in.th
Effect of Digital-Tool-Supported Basal Insulin Titration Algorithm in Reaching Glycemic Control in Patients with Type 2 Diabetes in Mexico
Authors: Tamez-Pérez Hector Eloy ,   Deceased Author, Cantú-Santos Oscar Manuel , Gutierrez-González Dalia , González-Facio Rosalinda , Romero-Ibarguengoitia Maria Elena 
Published: July 2021

Background: My Dose Coach (MDC) is a mobile application combined with a web portal that can suggest optimized basal insulin (BI) injection doses using Self-Measured Plasma Glucose (SMPG) and hypoglycemia data. This study aimed to evaluate its efficacy on patients reaching SMPG and Fasting blood glucose (FBG) target range 90-130 mg/dl (5-7.2 mmol/L) goals without severe hypoglycemic episodes. We also addressed the mean reduction in glycated hemoglobin (A1C), FBG, and SMPG and the improvement in the WHO’s Five Well Being Index (WBI). Methods: This prospective pilot study involved the use of MDC in outpatients with type 2 diabetes (T2DM) from a Hospital in Northern Mexico. Patients on treatment with any BI were included in the study. The follow-up was of 16 weeks. Student t-tests or McNemar test were used for effect comparisons. Results: We included 158 patients (46.8% women), mean (SD) age 51 (10.3) years. We achieved SMPG target range in 58.9% [mean (95CI) reduction of 30.9 mg/dl (22.5-37.7; P < .001)] of the patients [66(28) days], with no severe hypoglycemia events. FBG goal was reached in 55.7% [mean (95CI) reduction of 63.4 mg/dl (49.6-77.2; P < .001)]. The mean (95CI) reduction of A1C was 1.78% (1.47-2, P < .01) with the last observation carried forward. There was a mean (95CI) increase of 2.23 (−3, −1.4, P < .01) points in WBI scale. Conclusions: MDC successfully helped to achieve FBG and SMPG goals, reduced A1C, and increased WBI with no severe hypoglycemia events.
Septic Arthritis in Paediatric Patients: A 10-year Experience at a Single Institution
Authors: Ng Stacy Wei Ling , Teo Nicole , Lee Nicole Kim Luan , Lim Kevin Boon Leong 
Published: July 2021

Background We evaluated the clinical presentation and microbiological profile of a cohort of paediatric patients with septic arthritis at a tertiary institution in Singapore. Methods After obtaining institutional board approval, records of all patients below 18 years presenting with septic arthritis between 2010 and 2019 were reviewed. Patient demographic and medical data were analysed. Results Of 24 patients with 26 infected joints with a mean age of 7.1 years, 50.0% had pre-existing atopic dermatitis. The most common site infected was the hip ( n = 11, 42.3%). The most common pathogen isolated from tissue cultures was methicillin-sensitive-Staphylococcus aureus (MSSA) ( n = 9, 37.5%). Twenty-three (95.8%) of the patients underwent surgical drainage. Conclusions The skin of patients with atopic dermatitis has been shown to be more frequently colonised with Staphylococcus aureus compared to healthy individuals. The prevalence of atopic dermatitis in our cohort was higher compared to the reported national average of 20.8%. MSSA was the most commonly reported pathogen, and the hip joint most commonly affected. Less than half of the cohort had positive tissue or blood cultures. In paediatric patients with known atopic dermatitis who present with a fever, a painful joint and limited range of motion, septic arthritis should be considered and early drainage and antibiotics instituted.
Obesity is a risk factor for epidural lipomatosis: a meta-analysis
Authors: Zhang Bi , Yuan Haifeng , Hu Lihong , Saad Muhammad 
Published: July 2021

Purpose: The purpose of this meta-analysis was to summarize the evidence of associations between obesity factors and spinal epidural lipomatosis (SEL) and to evaluate the strength and validity of these associations. Methods: Electronic databases such as Wiley Online Library, PubMed, Embase, Cochrane Library were searched and manual retrieval of references, the time limit was from the establishment of the database to May 2020. Methodological quality evaluations of the included studies were assessed using the bias risk assessment tool recommended by the Cochrane Guidelines. The RevMan 5.3 software was used for meta-analysis. Results: Finally, seven studies were included for meta-analysis, all of which were observational studies with mixed bias risk. These studies involved 807 patients, with an average age of 64 to 73.6 years, and 59.4 percent of the participants were male. The sample sizes for the included studies ranged from 28 to 288. The results of meta-analysis showed that high body mass index (BMI) was one of the factors affecting SEL ( P < 0.01, MD 1.37, 95% CI [0.81, 1.92]). All reviews had a high risk of bias, and the most common source of bias was that there was no strict unified case diagnosis standard between researches, and some studies (four items) did not clearly describe the confounders that they controlled. Conclusions: We suggest that physicians should consider high BMI as a factor leading to SEL, and to control body weight actively should be considered as the preferred treatment strategy before surgical intervention is conducted.
Short-Term Trends in Elbow Ulnar Collateral Ligament Surgery in Collegiate Baseball Players: An Analysis of 25,587 Player-Years
Authors: Rothermich Marcus A. , Fleisig Glenn S. , Conte Stan A. , Hart Karen M. , Cain E. Lyle , Dugas Jeffrey R. 
Published: July 2021

Background: Trends over time in the incidence of ulnar collateral ligament (UCL) surgeries in National Collegiate Athletic Association Division I baseball players are currently unknown. Purpose/Hypothesis: The purpose of this study was to evaluate the trends in UCL surgeries over 3 years in Division I baseball programs. We hypothesized that surgical injuries would be consistently high over the course of the study. Study Design: Descriptive epidemiology study. Methods: Athletic trainers from Division I baseball programs were invited to participate in an electronic survey over 3 seasons. A total of 155 baseball programs agreed to participate in 2017, 294 programs participated in 2018, and 296 programs participated in 2019. After each of the 3 collegiate baseball seasons, the athletic trainer from each program entered anonymous, detailed descriptive data and surgical information on injured players into a secured database. Results: During the 3 years of this study, 100% of the enrolled programs successfully completed the survey (155/155 in year 1, 294/294 in year 2, and 296/296 in year 3). This registry of 745 completed surveys over 3 years represented 25,587 player-years from Division I collegiate baseball. The percentage of programs with at least 1 UCL surgery during this time was 57% in 2017, 51% in 2018, and 49% in 2019. The majority of these players were pitchers (84% overall from the 3 years). Seniors underwent a significantly lower percentage of the UCL surgeries (8% in 2017, 10% in 2018, and 13% in 2019) than did underclassmen. Surgeries were performed most often in-season and least often during the preseason. A slight majority of players undergoing surgery originated from warm-weather states, but the number of these players was never significantly higher than was the number of players from cold-weather states. Most surgeries performed each year were UCL reconstruction, but the percentage of UCL repair with ligament augmentation increased each year (10% UCL repairs in 2017, 20% in 2018, and 25% in 2019). Conclusion: UCL injuries requiring surgery were found to be a major source of morbidity in Division I collegiate baseball, supporting our hypothesis. This study can serve as a baseline for tracking long-term trends in UCL surgeries in collegiate baseball.
Trends in Medical and Surgical Admission Length of Stay by Race/Ethnicity and Socioeconomic Status: A Time Series Analysis
Authors: Ghosh Arnab K. , Unruh Mark A. , Soroka Orysya , Shapiro Martin 
Published: July 2021

Background: Length of stay (LOS), a metric of hospital efficiency, differs by race/ethnicity and socioeconomic status (SES) and longer LOS is associated with adverse health outcomes. Historically, projects to improve LOS efficiency have yielded LOS reductions by 0.3 to 0.7 days per admission. Objective: To assess differences in average adjusted length of stay (aALOS) over time by race/ethnicity, and SES stratified by discharge destination (home or non-home). Method: Data were obtained from 2009-2014 Healthcare Cost and Utilization Project State Inpatient Datasets for New York, New Jersey, and Florida. Multivariate generalized linear models were used to examine trends in aALOS differences by race/ethnicity, and by high vs low SES patients (defined first vs fourth quartile of median income by zip code) controlling for patient, disease and hospital characteristics. Results: For those discharged home, racial/ethnic and SES aALOS differences remained stable from 2009 to 2014. However, among those discharged to non-home destinations, Black vs White aALOS differences increased from 0.21 days in Q1 2009, (95% confidence interval (CI): 0.13 to 0.30) to 0.32 days in Q3 2013, (95% CI: 0.23 to 0.40), and for low vs high SES patients from 0.03 days in Q1 2009 (95% CI: -0.04 to 0.1) to 0.26 days, (95% CI: 0.19 to 0.34). Notably, for patients not discharged home, racial/ethnic and SES aALOS differences increased and persisted after Q3 2011, coinciding with the introduction of the Affordable Care Act (ACA). Conclusion: Further research to understand the ACA’s policy impact on hospital efficiencies, and relationship to racial/ethnic and SES differences in LOS is warranted.
Building resilience and performance in turbulent times: The influence of shared leadership and passion at work across levels
Authors: Salas-Vallina Andrés , Rofcanin Yasin , Las Heras Mireia 
Published: July 2021

The COVID-19 pandemic has tested health care professionals to the extreme. This study investigated the re-enchanting effect of shared leadership and passion at work in the context of public health care. This study advances on the Self-Determination Theory to suggest that shared leadership has a positive effect on resilience and performance through passion at work at different levels of analysis. A sample of 518 physicians working in Spanish public hospitals was used. The results showed that shared leadership was associated with team and individual outcomes via passion at work at team level, while no significant mediating effect was found for passion at work at the individual level. The theoretical and practical implications of the findings are discussed, limitations are considered, and future research directions are suggested. JEL CLASSIFICATION: M12, M54