bluuebunny/crossref_metadata_2025_split huggingface dataset:
Discrepant effects of atmospheric adjustments in shaping the spatial pattern of SST anomalies between extreme and moderate El Niños
Authors: Ying Jun , Lian Tao , Huang Ping , Huang Gang , Chen Dake , Chen Shangfeng 
Published: March 2021

AbstractThe surface heat flux anomalies during El Niño events have always been treated as an atmospheric response to sea surface temperature anomalies (SSTAs). However, whether they play roles in the formation of SSTAs remain unclear. In this study, we find that the surface net heat flux anomalies in different El Niño types have different effects on the development of the spatial pattern of SSTAs. By applying the fuzzy clustering method, El Niño events during 1982–2018 are classified into two types: extreme (moderate) El Niños with strong (moderate) positive SSTAs, with the largest SSTAs in the eastern (central) equatorial Pacific. The surface net heat flux anomalies in extreme El Niños generally display a “larger warming gets more damping” zonal paradigm, and essentially do not impact the formation of the spatial pattern of SSTAs. Those in moderate El Niños, however, can impact the formation of the spatial pattern of SSTA, by producing more damping effects in the eastern than in the central equatorial Pacific, thus favoring the largest SSTAs being confined to the central equatorial Pacific. The more damping effects of net heat flux anomalies in the eastern equatorial Pacific in moderate El Niños are contributed by the surface latent heat flux anomalies, which are mainly regulated by the negative relative humidity–SST feedback and the positive wind–evaporation–SST feedback. Therefore, we highlightthat these two atmospheric adjustments should be considered during the development of moderate El Niños in order to obtain a comprehensive understanding of the formation of El Niño diversity.
Incidence of Communicable and Non-communicable Diseases in India: Trends, Distributional Pattern and Determinants
Authors: Yadav Arvind Kumar , Paltasingh Kirtti Ranjan , Jena Pabitra Kumar 
Published: March 2021

The recent trends and distributional patterns of communicable diseases (CD) and non-communicable diseases (NCD) in India are analysed in this study. Utilising the unit-level health-specific data from three rounds (1995, 2004 and 2014) of the National Sample Survey Office, it is found that the incidence of CDs is declining while that of NCDs increasing over time. The state-wise pattern shows that both the least-developed states and relatively developed states have a high incidence of diseases. But the incidence of CDs is relatively high in backward states like Rajasthan, Odisha, Assam, Bihar and UP, whereas the prevalence of NCDs is high in advanced states like Kerala, Maharashtra, Tamil Nadu and others. The multinomial logistic regression results also confirm that income, sex and availability of safe drinking water are key determinants of the presence of diseases. Thus, the policy implication of the study calls for the availability and accessibility of adequate medical facilities at affordable costs, development of a strong network of public health facilities in rural India primarily. Bringing the rural as well as urban poor into the fold of health insurance schemes would ensure a huge benefit to the masses who struggle to get the basic treatment. The development of an effective ‘health information system’ can be a better policy instrument in arresting the rising incidence of NCDs. JEL Classification codes: C12, C51, I15, I18
The Utility of Glasgow Prognostic Score and Palliative Prognostic Index in Patients With Head and Neck Squamous Cell Carcinoma Under Palliative Care
Authors: Kishino Takehito , Mori Terushige , Miyashita Takenori , Ouchi Yohei , Samukawa Yasushi , Fukumura Takashi , Takahashi Satoshi , Monden Nobuya , Akisada Naoki , Hayashi Yuji , Nakamura Masataka , Hoshikawa Hiroshi 
Published: March 2021

Objectives: Palliative care patients with head and neck squamous cell carcinoma (HNSCC) often experience dysphagia and airway trouble; thus, each patient requires a specific palliative care plan based on their prognostication. However, no established specific prognostic tool performed on the day of starting end-of-life care is available for such patients. We assessed the accuracy of Glasgow prognostic score (GPS) and palliative prognostic index (PPI) and their combination to establish a specified prognostic tool for patients with HNSCC in end-of-life setting. Methods: A retrospective clinical chart review was undertaken on patients with HNSCC in end-of life setting who were decided in Kagawa University Hospital and National Hospital Organization Shikoku Cancer Center between April 2011 and March 2019. The patients were divided into 2 categories according to GPS (0-1 and 2) and PPI (groups A-B and C). These were combined into 4 categories (PPI group A-B and GPS score 0-1: good; PPI group A-B and GPS score 2: intermediate; PPI group C and GPS score 2: poor; and PPI group C and GPS score 0-1: others). The survival curves were compared for the former 3 categories. Results: The median survival of the scores 0-1 and 2 on GPS were 114 (72-148) and 39 (25-52) days, respectively ( P < .01). These of groups A-B and C on PPI were 79 (64-99) and 16 (9-29) days, respectively ( P < .01). The median survival of the good, intermediate, and poor categories was 127 (73-149), 64 (44-80), and 15 (9-27) days, respectively ( P < .01 among all categories). Conclusions: In this study, the survival of terminally ill patients with HNSCC can be predicted by the GPS, PPI, and their combination with sufficient probability.
Culturally Competent Clinical Care for Older Sexual Minority Adults: A Scoping Review of the Literature
Authors: MacCarthy Sarah , Darabidian Biayna , Elliott Marc N. , Schuster Mark A. , Burton Carl , Saliba Debra 
Published: March 2021

Study Objective: As recent efforts to improve culturally competent clinical care (CCCC) have largely overlooked older LGB adults, we conducted a scoping review of position statements, empirical, and non-empirical research and suggest action steps. Methods: We followed PRISMA Extension for Scoping Reviews Guidelines and searched for articles 1/1/11-3/14/19 (n = 1210) and other resources (n = 52), deduplicating, dually screening abstracts (n = 1,156), reviewing full-text (n = 107), and conducted a content analysis to identify distinct and cross-cutting domains (n = 44). Main Findings: Most research was based on simple pre/post-training differences in provider knowledge. A majority of sources were non-empirical. We identified three distinct domains (education & staffing, physical environment, and inclusive language & communication) and three cross-cutting domains (subgroup differences, research, and policy). Principal Conclusions: Sparse empirical data that specify best approaches to improve CCCC exist; nevertheless, providers, in collaboration with researchers and policy makers, can initiate improved practices aimed at increasing CCCC for older LGB patients.
Acute Budd Chiari syndrome in an ECMO patient
Authors: Butzko Ryan , Narasimhan Mangala 
Published: March 2021

Introduction: Point-of-care ultrasound (POCUS) is widely utilized to make timely decisions regarding patient care. This approach allowed us to diagnose the cause of acutely rising transaminases in a patient in severe ARDS secondary to influenza pneumonia requiring veno-venous extracorporeal membrane oxygenation (VV-ECMO). Case report: A 36-year-old female presented with acute hypoxemic respiratory failure secondary to influenza A infection. Within 24 hours, she required intubation and met severe ARDS criteria with a PaO2/FiO2 ratio of 62. She was managed with high PEEP and low tidal volume ventilation strategy, however her clinical status continued to deteriorate and the decision was made to pursue VV-ECMO. Within hours of cannulation her aspartate aminotransferase (AST) dramatically increased from 736 to 4512 µ/L, with concurrent mild increases in alanine aminotransferase (ALT) and creatine phosphokinase (CPK). Point-of-care ultrasound was performed which revealed a complete absence of flow in the hepatic vein, secondary to acute obstruction by an 25-French drainage catheter for the ECMO circuit. The catheter was exchanged with a smaller French catheter and the patient’s transaminases and CPK levels quickly decreased and returned to normal within several days. Discussion: Budd-Chiari syndrome (BCS) is a rare but potentially life-threatening condition caused by acute obstruction of hepatic vein blood flow that can lead to fulminant liver failure if left untreated. BCS is usually caused by a hepatic vein thrombus, however any mechanical obstruction can lead to the same pathology. Point-of-care ultrasound lead to a prompt diagnosis and allowed for quick action to correct the obstruction. Although BCS is not a common problem with VV-ECMO, the syndrome should always be on the differential of any patient on VV-ECMO with acutely rising transaminases. Conclusion: Ultrasound played an integral role in providing a crucial diagnosis of BCS secondary to obstruction by an ECMO drainage catheter.
Sexual Orientation Among Unmarried Final Year University Students in Osun State: Distribution, Determinants and Level of Satisfaction
Authors: Omisore Akinlolu G. , Oyerinde Ifeoluwa A. , Abiodun Omoniyi M. , Aderemi Zainab A. , Adewusi Titilayo B. , Ajayi Iseoluwa C. , Fagbolade Temitope M. , Miskilu Sukura A. 
Published: March 2021

Background Sexual Orientation is an enduring pattern of romantic or sexual attraction, with the attractions broadly incorporated under heterosexuality and non-heterosexuality. Societal and other factors seem to affect individuals’ perception of their self-identified orientation. Thus, this study sets out to document the distribution of sexual orientation, level of self-reported satisfaction, and factors associated with sexual orientation among unmarried university students. Methods A cross-sectional study involving 550 respondents sampled using a multi-stage sampling technique. Data collected via a self-administered questionnaire and analyzed via IBM SPSS version 20.0. Results Most respondents (93.6%) were heterosexuals, 4.7% bisexuals, 1.3% lesbian women and 0.40% gay men. More heterosexuals (80.4%) were fully satisfied with their self-identified sexual orientation compared to 57.2% of non-heterosexuals. Respondents who had religious upbringing and those whose parents were currently married were less likely to have sexual orientation outside of heterosexuality. Conclusion The most prevalent sexual orientation was heterosexuality, with more heterosexuals also expressing satisfaction than others. With the level of dissatisfaction expressed by those who are not heterosexuals as well as the factors associated with heterosexuality, it is plausible to conclude that societal values and/or prejudices constitute major factors in individuals self-identifying with some particular sexual orientation and the satisfaction derived therein.
Co-transfection with BMP2 and FGF2 via chitosan nanoparticles potentiates osteogenesis in human adipose-derived stromal cells in vitro
Authors: Hu Ying , Zhao Qing-Wei , Wang Zheng-Cai , Fang Qing-Qing , Zhu He , Hong Dong-Sheng , Liang Xing-Guang , Lou Dong , Tan Wei-Qiang 
Published: March 2021

Objective To investigate if co-transfection of human bone morphogenetic protein 2 (BMP-2, BMP2) and human fibroblast growth factor 2 (FGF2, FGF2) via chitosan nanoparticles promotes osteogenesis in human adipose tissue-derived stem cells (ADSCs) in vitro. Materials and Methods Recombinant BMP2 and/or FGF2 expression vectors were constructed and packaged into chitosan nanoparticles. The chitosan nanoparticles were characterized by atomic force microscopy. Gene and protein expression levels of BMP-2 and FGF2 in ADSCs in vitro were evaluated by real-time polymerase chain reaction (PCR), western blot, and enzyme-linked immunosorbent assay. Osteocalcin (OCN) and bone sialoprotein (BSP) gene expression were also evaluated by real-time PCR to assess osteogenesis. Results The prepared chitosan nanoparticles were spherical with a relatively homogenous size distribution. The BMP2 and FGF2 vectors were successfully transfected into ADSCs. BMP-2 and FGF2 mRNA and protein levels were significantly up-regulated in the co-transfection group compared with the control group. OCN and BSP mRNA levels were also significantly increased in the co-transfection group compared with cells transfected with BMP2 or FGF2 alone, suggesting that co-transfection significantly enhanced osteogenesis. Conclusions Co-transfection of human ADSCs with BMP2/FGF2 via chitosan nanoparticles efficiently promotes the osteogenic properties of ADSCs in vitro.
A failure of imagination: Competing narratives of 9/11 truth
Authors: Fenster Mark 
Published: March 2021

AbstractThis essay describes the emergence of the 9/11 attacks on the World Trade Center and Pentagon as an object of conspiratorial intrigue and imagination, offering a snapshot of the “9/11 truth movement” and its various theories as they began to reach full bloom. Theories about the attacks have come to constitute the dominant conspiratorial present – a present that looks remarkably like the mid- and late-twentieth-century past, despite significant changes in information technology and the continuing institutionalization and ironization of conspiracy theory as an influential form of popular politics. In addition to the 9/11 conspiracy community, the essay considers the battle over the 9/11 Commission's review of the government's failure to anticipate the terrorist attacks. The Commission engaged in knowing and savvy efforts to respond to conspiracy theories and to preempt popular belief in them, offering an authoritative narrative (or, more precisely, set of narratives) to explain what occurred. Meanwhile, the 9/11 truth movement made equally knowing and savvy efforts to critique the official account, responding with its own efforts to reinterpret and re-narrate the attacks, their causes, and what they signify about the contemporary world. While the 9/11 Commission may have criticized the federal government and its intelligence services for their failures of imagination prior to the attacks, the truth movement criticized the Commission either for a failure of imagination – an explanation for the attacks that could see through the “official” account – or for a quite imaginative cover-up of the hidden truths of 9/11. By considering the clash between official authorities and an active conspiracy community, this essay considers how the movement attempted to form a collective political and scholarly community, producing a blizzard of texts offering narratives that compete with the ones told by the Commission that seek the impossible grail of conspiracy theory: the truth. The essay also considers the effects, if any, of the state's attempt to preempt and respond to conspiracy theories.
First Metatarsal Rotation in Hallux Valgus Deformity
Authors: Steadman Jesse , Barg Alexej , Saltzman Charles L. 
Published: March 2021

Rotation of the first metatarsal (M1) as a potential etiological factor of hallux valgus (HV) deformity was described relatively early in the description of HV pathoanatomy. However, because biplanar radiographs have been the standard method for imaging HV, clinicians primarily developed measurement methods and corrective operations confined to 2 dimensions, medial-lateral and inferior-superior. Recently, as our understanding of HV pathoanatomy has further developed, aided in part by advanced imaging technology, M1 rotation about its axis (“axial rotation”) and its implications for HV deformity and treatment has reemerged. The goal of this review is to summarize M1 rotation in HV from a historical perspective, to present the current understanding of its potential role in the etiology/pathogenesis of HV, and to summarize relevant imaging and operative considerations with respect to M1 rotation. Level of Evidence: Level III, systematic review.
Subthreshold micropulse laser for adult onset Coats’ associated exudative maculopathy
Authors: Kumar Ashok , Kumar Poninder , Ambiya Vikas , Mishra Sanjay Kumar 
Published: March 2021

Purpose: To report subthreshold micropulse laser as novel treatment modality for exudative maculopathy associated with adult Coats’ disease. Methods: A 27-year old, young male presented with exudative maculopathy in adult onset Coat’s disease with profound diminution of vision. Spectral domain-optical coherence tomogram (SD-OCT) revealed macular oedema with significant subfoveal hard exudates with massive subretinal exudations temporal to macula. He was planned for anti-VEGF injection to treat macular oedema in order to preserve vision but developed conjunctivitis which made any interventional procedure impossible. Patient was managed with subthreshold micro pulse laser using 532 nm green laser. Results: Patient had significant improvement in vision, resolution of macular oedema as well as hard exudate without any adverse effects on fovea. Conclusion: Novel treatment approach in form of subthreshold micro pulse laser could be an alternative treatment modality for exudative maculopathy associated with adult onset Coat’s disease, especially in cases where other available interventional treatment options are not possible.
Percutaneous endoscopic gastrostomy feeding effects in patients with neurogenic dysphagia and recurrent pneumonia
Authors: Lee Jung Hwan , Kwon Hea Yoon , Kwon Kye Sook , Park Soo-Hyun , Suh Young Ju , Kim Jung-Soo , Kim Hyungkil , Shin Yong Woon 
Published: March 2021

Background: Percutaneous endoscopic gastrostomy (PEG) feeding provides enteral nutrition to patients with neurological dysphagia. However, the conditions in which PEG should be applied to prevent pneumonia remain unclear. We aimed to evaluate the effect of PEG for patients with neurological dysphagia in preventing pneumonia. Methods: We undertook a retrospective data review of 232 patients with neurological dysphagia who had undergone PEG from January 2008 to December 2018 at Inha University Hospital, in Incheon, Korea. We excluded patients who had not been followed up 6 months pre- and post-PEG feeding. In total, our study comprised 42 patients. We compared pneumonia episodes and incidence pre- and post-PEG. Results: During the median post-PEG follow-up period, the 6-month pneumonia incidence among patients who had undergone PEG had decreased [median 0.3 (interquartile range (IQR) 0.0–0.7) versus 0.1 (IQR 0.1–0.3) episodes, p = 0.04]. In a multiple mixed model, PEG did not decrease the incidence of pneumonia ( p = 0.76). However, the association between PEG and the incidence of pneumonia differed significantly depending on the presence or absence of recurrent pneumonia ( p < 0.001). Conclusions: PEG could effectively reduce the incidence of pneumonia in patients with neurogenic dysphagia, especially in those who had experienced recurrent pneumonia. The reviews of this paper are available via the supplemental material section.
The use of an automated electronic registry for bladder cancer surveillance during the SARS-CoV-2 pandemic
Authors: O’Meara S , Byrnes KG , Nic An Ríogh AU , Little DM , Davis NF 
Published: March 2021

Introduction: We aimed to develop and compare the utility of an automated registry of all patients undergoing surveillance for non-muscle invasive bladder cancer (NMIBC) during the severe acute respiratory virus coronavirus 2 (SARS-CoV-2) pandemic. Methods: We populated an electronic register of all patients undergoing bladder tumour surveillance (July–September 2019). The computerised ‘traffic-light’ system was implemented in September 2019 marking the beginning of phase 2. The register was audited at two- and six-months intervals during phase 2 (November 2019 and April 2020). Audit of the system In April 2020 allowed review of care given during the peak of the SARS-CoV-2 pandemic in Ireland. The primary outcome variable was the number of patients who had delayed surveillance cystoscopy in each group. Results: A total of 278 cases were reviewed, 96 in the first cohort and 91 at both intervals of second phase. During the first phase of the audit 17 patients (17.7%) had a missed cystoscopy. Phase 2 showed a sustained decrease in the number of patients with missed surveillance, with eight (8.8%) missing their procedure in both the November and April (SARS-CoV-2) cohorts (17 v. 8, X2 = 10.76, p = 0.0004). Overall, most patients had their procedure done within the recommended time interval (245, 88%). Conclusion: A centralised accessible computerised registry of patients with NMIBC undergoing surveillance is superior to traditional manual surveillance methods, especially during the period of SARS-CoV-2. Going forward we aim to have all patients undergo surveillance within schedule with a long-term goal of a centralised national registry. Level of evidence: Level 2c: “Outcomes Research”.
Implementing an Electronic Medical Record Osteoporosis Self-Assessment Tool Score Which Identifies Patients at Risk for Osteoporosis Promotes Osteoporosis Evaluation
Authors: Johnson Taylor , Fox Edward , Hassanbein Sue 
Published: March 2021

Introduction: Osteoporosis affects nearly half of the U.S. population. Screening methods are improving but remain inadequate, leaving the disease underdiagnosed and undertreated. The purpose of this study is to determine the effectiveness of an EMR implemented system that identifies patients at risk for osteoporosis via an OST (osteoporosis screening tool) score in prompting patients toward osteoporosis evaluation. Methods: OST scores are generated on every patient 50 years of age and older that is admitted to the Penn State Hershey Medical Center (PSHMC) and recorded in their electronic medical record. An OST score < 2 indicates that a patient has a potential risk for osteoporosis. Information Technology (IT) implemented the EMR OST calculation, which currently generates a daily filtered list of all patients with an OST score <2; patients with an OST score < 2 are then mailed letters approximately 3 months after their admission informing them of their risk for osteoporosis and suggesting that they schedule a follow-up appointment with a physician for further evaluation. To test the effectiveness of this system in prompting patients toward osteoporosis evaluation, approximately 3 months after letters were mailed, the patients were contacted via telephone and asked a series of questions to determine if the patients had sought osteoporosis evaluation. Results: In the intervention group, 67 (58.26%) of 115 did not schedule a follow-up, while the remaining 48 (41.74%) did seek a follow-up. Thus, the patient follow-up response rate improved with letter intervention using the OST score as an indicator (P < .0001) compared to historical controls (14.29%). Conclusion: Implementing an EMR OST score which identifies patients at risk for osteoporosis, which generates an automatic letter to the patient, significantly promotes patient driven osteoporosis evaluation compared to historical controls.