bluuebunny/crossref_metadata_2025_split huggingface dataset:
High vertical shear and dissipation in equatorial topographic wakes
Authors: Srinivasan Kaushik , McWilliams James C. , Jagannathan Arjun 
Published: February 2021

AbstractSubmesoscale coherent vortices (SCVs) are a ubiquitous feature of topographic wakes in the extratropical oceans. Recent studies demonstrate a mechanism wherein high vorticity bottom boundary layers (BBLs) on the slopes of the topography separate (forming shear layers), undergo instabilities, and subsequently merge in the horizontal and align in the vertical to form vertically coherent, columnar, SCVs (i.e. with low vertical shear). Background rotation is critical to the vertical alignment of unstable vortical filaments into coherent SCVs. In the tropics, however, the weakening of rotation prevents this alignment. Employing an idealized framework of steady barotropic flow past an isolated seamount in a background of constant stratification N and rotation rate f, we examine the wake structure for a range of f values spanning values from the poles to the tropics. We find a systematic increase in the interior vertical shear with decreasing f that manifests as a highly layered wake structure consisting of vertically thin, ‘pancake’ SCVs possessing a high vertical shear. A monotonic increase in the wake energy dissipation rate is concomitantly observed with decreasing f. By examining the evolution equations for the vertical shear and vertical enstrophy, we find that the interior shear generation is an advective process, with the location of peak shear generation approximately colocated with maximum energy dissipation. This leads to the inference that high wake dissipation in tropical tropographic wakes is caused by parameterized shear instabilities induced by interior advective generation of vertical shear in the near wake region.
An Hourly Climatology of Operational MRMS MESH-Diagnosed Severe and Significant Hail with Comparisons to Storm Data Hail Reports
Authors: Wendt Nathan A. , Jirak Israel L. 
Published: February 2021

AbstractThe Multi-Radar Multi-Sensor (MRMS) system generates an operational suite of derived products in the National Weather Service useful for real-time monitoring of severe convective weather. One such product generated by MRMS is the maximum estimated size of hail (MESH) that estimates hail size based on the radar reflectivity properties of a storm above the environmental 0°C level. The MRMS MESH product is commonly used across the National Weather Service (NWS), including the Storm Prediction Center (SPC), to diagnose the expected hail size in thunderstorms. Previous work has explored the relationship between the MRMS MESH product and severe hail (≥25.4 mm or 1 in.) reported at the ground. This work provides an hourly climatology of severe MRMS MESH across the contiguous United States from 2012 to 2019, including an analysis of how the MESH climatology differs from the severe hail reports climatology. Results suggest that the MESH can provide beneficial hail risk information in areas where population density is low. Evidence also shows that the MESH can provide potentially beneficial information about severe hail occurrence during the night in locations that are climatologically favored for upscale convective growth and elevated convection. These findings have important implications for the use of MESH as a verification dataset for SPC probabilistic hail forecasts as well as severe weather watch decisions in areas of higher hail risk but low population density.
Radiographic Reread Protocols to Identify Clinically Relevant Errors in Initial Trauma Evaluations
Authors: Morgan Madison E. , Brown Catherine T. , Vernon Tawnya M. , Gross Brian W. , Wu Daniel , Bradburn Eric H. , Werley Mark , Rogers Frederick B. 
Published: February 2021

Introduction Diagnostic radiology interpretive errors in trauma patients can lead to missed diagnoses, compromising patient care. Due to this, our level II trauma center implemented a reread protocol of all radiographic imaging within 24 hours on our highest trauma activation level (Code T). We sought to determine the efficacy of this reread protocol in identifying missed diagnoses in Code T patients. We hypothesized that a few, but clinically relevant errors, would be identified upon reread. Methods All radiographic study findings (initial read and reread) performed for Code T admissions from July 2015 to May 2016 were queried. The reviewed radiological imaging was given one of four designations: agree with interpretation, minor (non-life threatening) nonclinically relevant error(s)—addendum/correction required or clinically relevant error(s) (major [life threatening] and minor)—addendum/correction required, and trauma surgeon notified. The results were compiled, and the number of each type of error was calculated. Results Of the 752 radiological imaging studies reviewed on the 121 Code T patients during this period, 3 (0.40%) contained minor clinically relevant errors, 11 (1.46%) contained errors that were not clinically relevant, and 738 (98.1%) agreed with the original interpretation. The three clinically relevant errors included a right mandibular fracture found on X-ray and a temporal bone fracture that crossed the clivus and bilateral rib fractures found on computerized tomography. Discussion Clinically relevant errors, although minimal, were discovered during rereads for Code T patients. Although the clinical errors were significant, none affected patient outcomes. We propose that the implementation of reread protocols should be based upon institution-specific practices.
Amantadine Associated Myoclonus: Case Report and Review of the Literature
Authors: Poon Linda H. , Lee Audrey J. , Vuong Mai , Zuzuarregui Jose Rafael 
Published: February 2021

Purpose: Amantadine is commonly used to treat Parkinson’s disease. A case of myoclonus and asterixis was associated with amantadine is reported. Case Summary: An 80-year-old man with Parkinson’s disease diagnosed in 2015 was started on amantadine for treatment of progressive tremor and orofacial dyskinesias induced by levodopa. He took amantadine 100mg orally daily for 7 days, then increased to 100mg twice a day thereafter. The patient complained of “worsening tremor” after 9 days and amantadine was decreased to 100mg daily. After 1 month on this dose, the patient reported that his “tremor” persisted and experienced visual hallucinations. His examination demonstrated diffuse myoclonus throughout his extremities and trunk, as well as asterixis when attempting to stand or holding his arms antigravity. Laboratory testing for renal and hepatic failure was unrevealing. Amantadine was reduced to 50mg daily for 4 days and then discontinued. Myoclonus resolved 3 days after discontinuation of amantadine. Conclusion: While amantadine-induced myoclonus is rare, health care providers should be vigilant in monitoring for signs and symptoms of myoclonus following amantadine initiation.
Ageism as a Modifying Influence on COVID-19 Health Beliefs and Intention to Social Distance
Authors: Graf Allyson S. , Knepple Carney Amy 
Published: February 2021

Objectives: Commentaries have suggested that initial emphasis on the higher susceptibility and mortality rates of older adults to COVID-19 has instigated ageism within the public discourse and policy decisions. Using the health belief model, the current study examined ageism in interaction with other factors influencing intention to social distance. Methods: Threat of contracting COVID-19, benefits and barriers to social distancing, benevolent and hostile ageism, and intention to social distance were examined in 960 adults ( M = 37.81 years, SD = 11.65). Results: Benevolent and hostile ageism were significant moderators for both perceived threat and barriers on intent to social distance; hostile ageism also moderated benefits on intent to social distance. Discussion: The current study demonstrates how ageism influences behavior during a pandemic. With initial reports of COVID-19 presenting older adults as a homogenous group, ageism negatively interacted with intention to social distance and may place older adults at greater risk.
Prevalence of condomless anal intercourse and associated risk factors among men who have sex with men in Bamako, Mali
Authors: Knox Justin , Patnaik Padmaja , Hakim Avi J , Telly Nouhoum , Ballo Tako , Traore Bouyagui , Doumbia Seydou , Lahuerta Maria 
Published: February 2021

Background Men who have sex with men (MSM) are disparately impacted by HIV in sub-Saharan Africa and condomless anal intercourse (CAI) is a major driver of HIV transmission. The objective of the current study was to identify factors associated with CAI among MSM in Bamako, Mali, among whom HIV prevalence was 13.7%. Methods A bio-behavioral survey was conducted between October 2014 and February 2015 using respondent-driven sampling to recruit 552 adult MSM. Weighted statistical analyses were conducted to determine the prevalence of CAI with one’s most recent male partner and survey logistic procedures were used to identify associated factors. Results The prevalence of CAI with one’s most recent male partner was 40.7%. Associated factors included: inability to get a condom when needed (aOR = 5.8, 95%CI: 2.7–12.3) and believing CAI is acceptable under some circumstances (aOR = 8.4, 95%CI: 4.4–16.2). Conclusions Programs addressing HIV among MSM in Mali should aim to increase access to condoms and education about HIV prevention through consistent condom use during anal intercourse.
Perceptions Regarding the Academic and Cognitive Performance of Individuals With Cleft Lip and/or Palate
Authors: Kara İlkem , Dumbak Aydan Baştuğ , Kayıkcı Maviş Emel Kulak 
Published: February 2021

Introduction: Factors such as teachers’ appropriate support and social interactions have an impact on the academic performance of children with cleft lip and/or palate (CL/P). This study was designed to investigate the perceptions of the teachers and the general public about the academic and cognitive performance of individuals with CL/P. Methods: This study was included 360 (male/female = 102/258) teachers and 640 (male/female = 259/381) participants that represent the general public. Anonymized web-based and paper-and-pencil self-administered questionnaire that included multiple-choice and yes/no questions were administered. Within-group differences and intergroup differences were analyzed in terms of academic and cognitive performance. Results: Most of the teachers and the general public indicated that the academic and cognitive performance of individuals with CL/P is the same as their unaffected peers. A significantly higher proportion of the teachers indicated that the academic performance of children with CL/P is the same as their unaffected peers than the general public. Conclusion: Considering that the general public’s attitudes and appropriate teacher support are crucial to prevent adverse impacts on the lives of individuals with CL/P, it is important to support teachers with the appropriate information and to encourage the public to recognize that everybody with a facial difference should be treated as an individual rather than a disability.
Surgical correction of severe congenital ptosis using a modified frontalis muscle advancement technique: A single-arm trial
Authors: Zhang Lei , Ren Mingyu , Yan Yuqing , Zhai Wenjuan , Yang Lihong , Sun Chunhua , Pan Ye , Zhao Hong 
Published: February 2021

Purpose: To describe our experience with a modified frontal muscle advancement flap to treat patients with severe congenital ptosis. Methods: Analysis of the clinical charts of 154 patients who underwent a modified frontal muscle advancement flap. The FM was exposed by a crease incision. The FM flap was created by deep dissection between the orbicularis muscle and orbital septum from the skin crease incision to the supraorbital margin and subcutaneous dissection from the inferior margin of the eyebrow to 0.5 cm above the eyebrow. No vertical incision was made on the FM flap to ensure an intact flap wide enough to cover the entire upper tarsal plate. Contour, symmetry of height, marginal reflex distance (MRD1), and complications were assessed. Mean follow-up was 10 months. Results: The mean patient age was 7.6 ± 5.6 (range, 2–18) years. The mean MRD1 was 3.2 ± 1.3 mm after the operation. All bilateral cases achieved symmetry and optimal lid contour; 17 unilateral cases were under corrected, with a success rate of 89.0%. Complications such as entropion, exposure keratitis, FM paralysis, frontal hypoesthesia, severe haematoma, and entropion were not observed in our series. Conclusion: A modified frontal muscle advancement flap produced a high success rate with a clear field of vision, mild trauma, and few complications. This technique is relatively simple and should be considered for correcting severe congenital ptosis. Date of registration: 29-03-2020 Trial registration number: ChiCTR2000031364 Registration site: http://www.chictr.org/
Curricular Limitations and Recommendations for Training Health Care Providers to Respond to Intimate Partner Violence: An Integrative Literature Review
Authors: Ambikile Joel Seme , Leshabari Sebalda , Ohnishi Mayumi 
Published: February 2021

Background: Intimate partner violence (IPV) is a well-known public health problem occurring worldwide. With a multisectoral approach being emphasized in addressing IPV, the health sector has a key role to play due to many IPV victims who appear in health facilities without their needs being met. A well-designed and implemented IPV curriculum is necessary for effectively training health care professionals to provide quality IPV care and related services. This integrative review was conducted to establish evidence for existing curricular limitations and recommendations for training health care providers to respond to IPV. Methods: A systematic literature search was conducted for studies published from 2000 to 2020 in five databases (PubMed, Science Direct, Cochrane Library, Google, and Scholar). As a criterion, studies that reported curricular limitations in training health care providers/professionals to address IPV were included. A total of 198 studies were identified for screening, with 16 studies meeting the inclusion criteria and included in the review. Findings: Curricular limitations for IPV response training for health care providers were reported in the following areas (themes): time allocated for the training, amount of content in the existing curricula, institutional endorsement for the content, IPV response teachers/facilitators, teaching and learning strategies, and funding to support curricular implementation. Various recommendations to improving IPV response training were provided including guaranteeing the training in all courses, increasing academic capability to teach the content, allocation of funding to improve infrastructure for curriculum development and implementation, comprehensive approaches to teaching, and continuing education for health care providers.
Traumatic Arterio-Enteric Fistula—A Report of 2 Cases With Review of Literature
Authors: James Joses Dany , Agarwal Harshit , Kumar Vignesh , Kumar Atin , Hemachandran Naren , Gupta Amit 
Published: February 2021

Background: Traumatic arterio-enteric fistula is predominantly seen after penetrating trauma with only 21 reported cases documented in the past 25 years. They may present in an acute or delayed manner with upper or lower gastrointestinal bleed. A detailed clinical examination with requisite imaging can help in detecting such injuries. Case Description: Case 1: A 20-year-old gentleman, presented with penetrating stab injury to the gluteal region with bleeding per rectum. Imaging revealed evidence of injury to the inferior rectal artery which was found to be communicating with the extraperitoneal portion of the rectum. He was managed with a combination of endovascular and open surgery with a successful outcome. Case 2: A 29-year-old gentleman, presented in a delayed manner 2 weeks after a gunshot wound to the gluteal region, which was managed operatively in another hospital. He developed a massive lower gastrointestinal bleed 2 weeks after presentation. Imaging revealed evidence of a pseudoaneurysm of the inferior gluteal artery which had a fistulous communication with the gastrointestinal tract leading to bleeding. It was managed by endovascular techniques successfully. Conclusion: Arterio-enteric fistulas following trauma are rare phenomena and they need a high index of suspicion for diagnosis. Once diagnosed, they can be managed based on their location and patient physiology by interventional techniques, surgery, or a combination of the two.
Preoperative Levels of the Soluble Urokinase-Type Plasminogen Activator Receptor as Predictor for New Episodes of Atrial Fibrillation After Vascular Surgery
Authors: Lazarević Milan , Golubović Mladjan , Milić Dragan , Stanojević Dragana , Kostić Tomislav , Đorđević Miodrag , Marjanović Vesna , Perić Velimir 
Published: February 2021

Introduction: The soluble urokinase-type plasminogen activator receptor (suPAR) in uPAR soluble form is produced when the uPAR is cleaved from the cell membrane during the inflammatory process. Postoperative atrial fibrillation (AF) is the most common perioperative cardiac arrhythmia. It is speculated that elevated suPAR has a role in the development of AF. The aim of our study was to investigate the predictive role of preoperative suPAR in the occurrence of AF during the first 6 months after major vascular surgery. Methods: We included 119 male and 63 female patients with an average age of 67.19 ± 6.02 years, without permanent/persistent AF. Basic predictive model (BASIC) included traditional risk factors for AF: age, gender, body mass index-BMI, smoking status, presence of arterial hypertension, diabetes mellitus and dyslipidemia. Results: Over the 6-month period, 19 (10.4%) patients had one new episode of atrial fibrillation and 2 patients (1.1%) had 2 episodes of paroxysmal atrial fibrillation. Paroxysms of AF were significantly more frequent in patients who had a resection of an abdominal aneurysm than in patients with other types of major vascular surgery. BASIC had good discriminatory ability in the prediction of AF paroxysms during the first 6 months after surgery (AUC = 0.715, 95%CI 0.590-0.840). Adding suPAR to the basic model significantly improved the discriminative ability of the predictive model for AF episodes (ΔAUC = 0.238, p < 0.001). The predictive performance of the model BASIC+CRP+suPAR, measured using AUC, NRI and IDI statistics, was very similar to the model BASIC+suPAR. Conclusion: AF is a common complication in surgical patients with high mortality and morbidity. suPAR could improve the ability of traditional risk factors to predict its occurrence up to 6 months after major vascular surgery.
How much does fat mass change affect serum uric acid levels among apparently clinically healthy Korean men?
Authors: Ahn Joong Kyong , Hwang Jiwon , Lee Mi Yeon , Kang Mira , Hwang Junghye , Koh Eun-Mi , Cha Hoon-Suk 
Published: February 2021

Objective: The aim of this study was to examine the impact of fat mass alteration on serum uric acid (SUA) levels in apparently clinically healthy men. Methods: We evaluated 27,387 men who consecutively underwent health check ups between 2015 and 2017. We assessed the likelihood of achieving a SUA level of <0.41 mmol/L and compared the SUA levels according to fat mass changes. Results: Compared with those without fat mass change (the reference group), the odds ratios (95% confidence interval) of achieving a SUA level of <0.41 mmol/L for fat mass decreases of ⩾2.5, 1.5–2.5, and 0.5–1.5 kg were 1.63 (1.45–1.82), 1.19 (1.06–1.34), and 1.07 (0.97–1.18), respectively, while those for a fat mass increase of ⩾2.5, 1.5–2.5, and 0.5–1.5 kg were 0.71 (0.64–0.78), 0.87 (0.79–0.97), and 0.95 (0.86–1.04), respectively. The corresponding beta-coefficients of SUA levels (mmol/L) were –0.26 [–0.29–(–0.23)], –0.12 [–0.16–(–0.09)], and –0.09 [–0.12–(–0.06)] for fat mass decreases of ⩾2.5, 1.5–2.5, and 0.5–1.5 kg, respectively. Every 1-kg fat mass reduction was associated with 9% increased odds of achieving the target SUA level. The multivariate SUA level difference per 1-kg fat mass gain was 2.97 µmol/L. Similar levels of association persisted among the prespecified subgroups. Conclusion: We quantitatively demonstrated that fat mass reduction contributes to a clinically relevant decrease in SUA levels and a significant increase in the likelihood of achieving target SUA levels. Our findings may help to provide clear clinical guidance on fat mass alteration to reduce SUA levels in patients with hyperuricemia.
Relationship between long head of the biceps tendon histopathology and long-term functional results in smokers. A time to reevaluate the Bonar score?
Authors: Zabrzyński Jan , Gagat Maciej , Łapaj Łukasz , Paczesny Łukasz , Yataganbaba Alper , Szwedowski Dawid , Huri Gazi 
Published: February 2021

Aim: The purpose of this study was to investigate whether there is an association between smoking, the extent of the degeneration process in the biceps tendinopathy, including cells and extracellular matrix (ECM) alterations, and long-term surgical results. Methods: This study comprised 40 consecutive patients admitted for shoulder arthroscopy due to symptomatic biceps tendinopathy and classified into three groups based on smoking status: active smokers, former smokers, and non-smokers. According to the classical Bonar score criteria, the histopathologic evaluation of the harvested intra-articular portion of the tendon was done. The follow-up examination was based on the American Shoulder and Elbow Surgeons Score (ASES). Results: A cohort of 32 patients was enrolled in the final follow-up examination; mean 37.56 months. Histopathological evaluation according to the classical Bonar score revealed degeneration of the tendinous tissue in each group but there was no correlation between the extent of degeneration, smoking indexes and the ASES. After revision of Bonar scale within the vascularity criterion, we found a correlation between the extent of degeneration of tendinous tissue, smoking data, ASES score, and the severity of rotator cuff injury. Conclusion: In this paper, we indicate the ambiguous role of the neovascularization in the biceps tendinopathy, and it was used for modification of the classical Bonar score. Consequently, recalculated, modified Bonar score was correlated positively with smoking indexes and functional outcomes. Furthermore, the morphological alterations of rotator cuff tendons also correlated positively with the extent of biceps tendon degeneration, measured according to the modified scoring system.
Quality of life in multiple sclerosis: The differential impact of motor and cognitive fatigue
Authors: David Ruban Sabina , Christina Hilt Claudia , Petersen Thor 
Published: February 2021

Background Multiple sclerosis is a chronic disease leading to reduced quality of life. Objectives To investigate whether motor and cognitive fatigue impact differently on aspects of quality of life among patients with multiple sclerosis, independently from bodily disability. Methods 79 patients with multiple sclerosis from Aalborg University Hospital, Denmark were included in an observational, cross-sectional study. Each subject completed two separate questionnaires regarding fatigue (Fatigue Scale for Motor and Cognitive Functions and Modified Fatigue Impact Scale) and one regarding quality of life (Short Form 36). Disability was measured with the Expanded Disability Status Scale (EDSS)-scores obtained from patient records. Results All fatigue scores were significantly correlated to all areas of quality of life (p < 0,05). This remained significant after adjustment for age, disease duration and EDSS-score. When looking at each type of fatigue separately, cognitive fatigue correlated mainly with mental health aspects of quality of life and motor fatigue with physical health areas of quality of life. Conclusion Increased motor and cognitive fatigue lead to a differential reduction in physical and mental quality of life, independently of bodily disability. This underlines the importance of proper assessment and treatment of fatigue among patients with multiple sclerosis.