bluuebunny/crossref_metadata_2025_split huggingface dataset:
An IMERG-Based Optimal Extended Probabilistic Climatology (EPC) as a Benchmark Ensemble Forecast for Precipitation in the Tropics and Subtropics
Authors: Walz Eva–Maria , Maranan Marlon , van der Linden Roderick , Fink Andreas H. , Knippertz Peter 
Published: June 2021

AbstractCurrent numerical weather prediction models show limited skill in predicting low-latitude precipitation. To aid future improvements, be it with better dynamical or statistical models, we propose a well-defined benchmark forecast. We use the arguably best currently high-resolution, gauge-calibrated, gridded precipitation product, the Integrated Multi-Satellite Retrievals for GPM (Global Precipitation Measurement) (IMERG) “final run” in a ± 15-day window around the date of interest to build an empirical climatological ensemble forecast. This window size is an optimal compromise between statistical robustness and flexibility to represent seasonal changes. We refer to this benchmark as Extended Probabilistic Climatology (EPC) and compute it on a 0.1°×0.1° grid for 40°S–40°N and the period 2001–2019. In order to reduce and standardize information, a mixed Bernoulli-Gamma distribution is fitted to the empirical EPC, which hardly affects predictive performance. The EPC is then compared to 1-day ensemble predictions from the European Centre for Medium-Range Weather Forecasts (ECMWF) using standard verification scores. With respect to rainfall amount, ECMWF performs only slightly better than EPS over most of the low latitudes and worse over high-mountain and dry oceanic areas as well as over tropical Africa, where the lack of skill is also evident in independent station data. For rainfall occurrence, EPC is superior over most oceanic, coastal, and mountain regions, although the better potential predictive ability of ECMWF indicates that this is mostly due to calibration problems. To encourage the use of the new benchmark, we provide the data, scripts, and an interactive webtool to the scientific community.
Patients With Invasive Breast Cancer Who Refuse Treatment: An Analysis of Associated Factors and Impact on Survival
Authors: Moya Jackelyn J. , Moazzez Ashkan , Ozao-Choy Junko J. , Dauphine Christine 
Published: June 2021

Background Completion of surgical resection and adjuvant/neoadjuvant treatments (chemotherapy, radiation, and endocrine therapy) is necessary to achieve optimal outcomes in invasive breast cancer. The objective of this study was to determine the characteristics of patients refusing treatment and to analyze the impact of refusal on survival. Study Design A retrospective cohort study of invasive breast cancer cases diagnosed 2004-2016 was performed utilizing the National Cancer Database. Results Of 2 058 568 cases comprising the study cohort, .6% refused recommended surgery, 14.1% refused chemotherapy, 5.5% refused radiation, and 6.3% refused endocrine therapy. Patients refusing therapy were older and more likely uninsured; they did not live farther from the treating hospital. Racial disparities were also associated with refusal. Surgery refusal had the highest hazard ratio for mortality (2.7; 95% CI: 2.5-3.0, P < .001) compared to chemotherapy (1.3; 95% CI: 1.3-1.4, P < .001), radiation (1.8; 95% CI: 1.7-1.9, P < .001), and endocrine therapy (1.5; 95% CI: 1.4-1.6, P < .001) independent of race, insurance, receptor status, and stage. Conclusion This study demonstrates significant associations with refusal of breast cancer treatment and quantifies the impact on mortality, which may help to identify at-risk groups for whom interventions could prevent increases in mortality associated with declining treatment.
The Fellow’s Perspective: The Impact of the COVID-19 Pandemic on Fellowship Training and Job Appointment
Authors: Truong Adam , Amersi Farin , Chau Van , Imai Taryne 
Published: June 2021

Background Fellows have been uniquely affected by the widespread changes in educational structure, mandatory limitations in elective procedural volume, and hiring freezes during the COVID-19 global pandemic. Study Design A voluntary and anonymous survey was distributed to all Graduate Medical Education fellows at a tertiary medical center querying perspectives on clinical and didactic training and job placement. Results A total of 47 of 121 fellows (39%) completed the survey. The majority were in a medical (43%) or surgical specialty (34%) followed by critical care (13%) and procedure-based (11%) fellowships. Approximately 59% of surveyed fellows felt their programs were providing a virtual curriculum that would train them just as well as the in-person curriculum. Twenty-eight (60%) fellows were in their final or only year of training. Of the 25 fellows who were seeking employment, 52% have experienced difficulty in finding a job due to hiring freezes and 40% have encountered challenges with job interview cancellations and changes to virtual interview formats. Conclusion Almost half of surveyed fellows reported an educational deterioration due to COVID-19 and graduating fellows seeking employment felt hindered by both the virtual interview format and widespread hiring freeze. Fellows are both unique and vulnerable as they balance the solidification of clinical training with securing employment during these tumultuous and unprecedented times.
Nationwide Analysis of Dog Bite Injuries: Different Age Groups, Different Injury Patterns
Authors: Tam Benjamin , Matsushima Kazuhide , Chiba Hiroto , Park Timothy , Slocum Charles , Lam Lydia , Inaba Kenji , Demetriades Demetrios 
Published: June 2021

Background As the number of households with dogs in the United States has increased, so has the incidence of dog bites. Contemporary analysis of nationwide epidemiological data regarding such injuries is scarce. The purpose of this study is to describe dog bite injury patterns and related surgical interventions with a focus on differences between pediatric and adult age groups. Study Design This is a retrospective study (2015-2017) using the National Trauma Data Bank. 10 569 patients were included. Results Of these, 4729 (44.7%) qualified as pediatric (age ≤ 12 years) and 5840 (55.3%) qualified as adults (age ≥ 13 years). Pediatric patients were more frequently admitted with facial injuries (78.1% vs. 29.3%, P < .01) and facial fractures (4.8% vs. 2.5%, P < .01), and had a higher incidence of facial bone surgical procedures (1.3% vs. .5%, P < .01). Adult patients were more frequently admitted with upper extremity injuries (65.8% vs. 21.2%, P < .01) and upper extremity vascular arterial injuries (2.3% vs. .2%, P < .01) with a higher incidence of upper extremity arterial procedures (1.3% vs. .2%, P < .01). Conclusion This study demonstrates the contrast in injury patterns from dog bite between adults and children. These findings can dictate injury prevention policies and prepare clinicians to treat dog bite victims.
Hypoglycemia in a Surgical Intensive Care Unit
Authors: Switzer Emily , Schellenberg Morgan , Lewis Meghan , Owattanapanich Natthida , Lam Lydia , Inaba Kenji 
Published: June 2021

Background Glycemic control is an important aspect of critical care because derangements are associated with morbidity and mortality. Patients at highest risk for hypoglycemia in the surgical intensive care unit (SICU) are incompletely described by existing literature. Our objective was to delineate this high-risk patient population in our SICU. Study Design In this single-center, retrospective, observational study, SICU patients admitted from June 1, 2019 to July 31, 2020 with ≥1 episode of hypoglycemia (blood glucose <60 mg/dL) were included. Results There were 41 hypoglycemic events in 27 patients, comprising an incidence of 1.5% among SICU patients. The most common admission diagnoses were cirrhosis (n = 13, 48%), polytrauma (n = 12, 44%), multisystem organ failure (n = 11, 41%), diabetes mellitus (n = 9, 33%), and soft tissue infection (n = 8, 30%). Four high-risk populations were identified: patients in multisystem organ failure (MSOF) (n = 11, 41%); those who were nil per os (NPO) (n = 10, 37%); patients receiving long acting subcutaneous insulin, for example, Lantus (n = 3, 11%); and those on continuous intravenous insulin infusions (n = 3, 11%). After multi-disciplinary peer review, most hypoglycemic events (n = 16, 59%) were deemed iatrogenic. Conclusions Hypoglycemia is rare in surgical critical care. When it does occur, patients are typically in MSOF, NPO, on long acting subcutaneous insulin or continuous insulin infusions, have soft tissue infections, or have acute or chronic liver failure. Increased vigilance with frequent blood glucose monitoring in these high-risk patients may reduce the risk of hypoglycemia in the SICU.
Occupational Outcomes of a Physical Activity Intervention for Post-Secondary Student Mental Health
Authors: Nesbitt Amy E. , Collins Kristina J. , Nalder Emily , Sabiston Catherine M. 
Published: June 2021

Background. Physical activity (PA) is a therapeutic approach to address post-secondary student mental health, yet the effect of PA on occupational outcomes has been understudied among students. Purpose. This study (1) identified and described occupational performance issues (OPIs) among post-secondary students seeking mental health support and (2) assessed pre- and post-intervention differences in occupational performance and performance satisfaction. Method. Using a single group pre-test post-test pilot study design, participants ( N = 20) completed a 6-week, 1-hour PA intervention. The Canadian Occupational Performance Measure was administered pre- and post-intervention. Findings. The most commonly reported OPIs included academics, PA, and sleep hygiene. There were significant improvements in participants’ occupational performance (mean change: 2.7, p < .001; dz = 2.28) and performance satisfaction (mean change: 3.7, p < .001; dz = 3.04). Implications. Results provide an initial demonstration of the benefits of PA for occupational outcomes within a post-secondary mental health context.
Long-term inhibition of UCHL1 decreases hypertension and retinopathy in spontaneously hypertensive rats
Authors: Liu Shasha , Wang Chengfang , Lu Jianmin , Dai Guangzheng , Che Huixin , He Wei 
Published: June 2021

Objective To investigate the role of the deubiquitinase ubiquitin C-terminal hydrolase L1 (UCHL1) in hypertension and retinopathy in the spontaneously hypertensive rat (SHR). Methods Wistar–Kyoto (WKY) rats and SHRs were administered the UCHL1 inhibitor LDN57444 (20 μg/kg/day) for 4 months. Pathological changes were detected with hematoxylin and eosin, immunofluorescence, and dihydroethidium staining. The mRNA and protein expression of UCHL1 were examined by real-time PCR and immunoblotting analysis. Results At 6 months of age, SHRs showed significantly increased mRNA and protein levels of UCHL1 in the retina compared with WKY rats. Moreover, SHRs exhibited significantly increased central retinal thickness, inflammation, and reactive oxygen species production compared with WKY rats, and these effects were markedly attenuated by systemic administration of the UCHL1 inhibitor LDN57444. The beneficial effects of LDN57444 were possibly associated with reduced blood pressure and the inactivation of several signaling pathways. Conclusion UCHL1 is involved in hypertension and retinopathy in SHRs, suggesting that UCHL1 may be used as a potential therapeutic target for treating hypertensive retinopathy.
Association and genetic overlap between clinical chemistry tests and migraine
Authors: Tanha Hamzeh M , Martin Nicholas G , Whitfield John B , Nyholt Dale R ,   The International Headache Genetics Consortium (IHGC)
Published: June 2021

Introduction In this paper, we studied several serum clinical chemistry tests of cardiovascular disease (CVD), iron deficiency anemia, liver and kidney disorders in migraine. Methods We first explored the association of 22 clinical chemistry tests with migraine risk in 697 migraine patients and 2722 controls. To validate and interpret association findings, cross-trait genetic analyses were conducted utilising genome-wide association study (GWAS) data comprising 23,986 to 452,264 individuals. Results Significant associations with migraine risk were identified for biomarkers of CVD risk, iron deficiency and liver dysfunction (odds ratios = 0.86–1.21; 1 × 10−4 <  p < 3 × 10−2). Results from cross-trait genetic analyses corroborate the significant biomarker associations and indicate their relationship with migraine is more consistent with biological pleiotropy than causality. For example, association and genetic overlap between a lower level of HDL-C and increased migraine risk are due to shared biology rather than a causal relationship. Furthermore, additional genetic analyses revealed shared genetics among migraine, the clinical chemistry tests, and heart problems and iron deficiency anemia, but not liver disease. Conclusions These findings highlight common biological mechanisms underlying migraine, heart problems and iron deficiency anemia and provide support for their investigation in the development of novel therapeutic and dietary interventions.
Evaluation of Facial Appearance–Related Quality of Life in Young Japanese Patients With Cleft Lip and/or Palate
Authors: Oka Ayaka , Tanikawa Chihiro , Isogai Yukako , Mihara Kiyomi , Yamashiro Takashi 
Published: June 2021

Objective: (1) To confirm the reliability of a Japanese version of the Youth Quality of Life Instrument-Facial Differences Module (YQOL-FD); (2) to assess the quality of life (QoL) related to facial difference in Japanese youths with cleft lip and/or palate (CL/P) using this instrument; and (3) to examine the QoL differences according to age, sex, and cleft type. Design: A cross-sectional study. Setting: Japanese youths with CL/P were recruited through our hospital and asked to complete the YQOL-FD. Participants: Sixty-nine Japanese youths (age, 11-18 years) with CL/P. Outcome Measures: The domain scores of stigma, negative consequences, negative self-image, positive consequences, and coping in the YQOL-FD, and the reliability of such scores were evaluated. Results: The instrument showed an acceptable internal consistency (Cronbach α = 0.74-0.92) and test–retest reliability (intraclass correlation coefficient = 0.94-0.98), except for the coping domain. The individual’s domain scores were spread out from the lowest score to the high scores among all domains, thus indicating the negative and positive impacts of living with facial differences regarding their QoL may vary among individuals with CL/P. All domain scores in the 15- to 18-year-old group were significantly higher than those in 11- to 14-year-old group; there were no significant differences according to sex or cleft type. Conclusions: The instrument showed acceptable reliability, except for the coping domain. There were individual variations in QoL concerning the facial difference among Japanese youths with CL/P as measured by the YQOL-FD, suggesting the importance of individual evaluations. Perceptions were influenced by age, but not sex or cleft type.
Effectiveness of Tele-rehabilitation Programs in Heart Failure: A Systematic Review and Meta-analysis
Authors: Cavalheiro Ana Helena , Silva Cardoso José , Rocha Afonso , Moreira Emília , Azevedo Luís Filipe 
Published: June 2021

Background: Tele-rehabilitation (TR) may be an effective alternative or complement to centre-based cardiac rehabilitation (CBCR) with heart failure (HF) patients, helping overcome accessibility problems to CBCR. The aim of this study is to systematically review the literature in order to assess the clinical effectiveness of TR programs in the management of chronic HF patients, compared to standard of care and standard rehabilitation (CBCR). Methods and Results: We conducted a systematic review and meta-analysis of randomized controlled trials on the effect and safety of TR programs in HF patients, regarding cardiovascular death, heart failure-related hospitalizations, functional capacity and quality of life. We searched 4 electronic databases up until May 2020, reviewed references of relevant articles and contacted experts. A quantitative synthesis of evidence was performed by means of random-effects meta-analyses. We included 17 primary studies, comprising 2206 patients. Four studies reported the number of hospitalizations (TR: 301; Control: 347). TR showed to be effective in the improvement of HF patients’ functional capacity in the 6 Minute Walk-Test (Mean Difference (MD) 15.86; CI 95% [7.23; 24.49]; I2 = 74%) and in peak oxygen uptake (pVO2) results (MD 1.85; CI 95% [0.16; 3.53]; I2 = 93%). It also improved patients’ quality of life (Minnesota Living with Heart Failure Questionnaire: MD −6.62; CI 95% [−11.40; −1.84]; I2 = 99%). No major adverse events were reported during TR exercise. Conclusion: TR showed to be superior than UC without CR on functional capacity improvement in HF patients. There is still scarce evidence of TR impact on hospitalization and cv death reduction. Further research and more standardized protocols are needed to improve evidence on TR effectiveness, safety and cost-effectiveness.
Magnitude, Trends, and Determinants of Iodized Salt Availability among Households in Ethiopia: Analysis of Ethiopian Demographic and Health Surveys (2000–2016)
Authors: Tareke Amare Abera , Zerfu Taddese Alemu 
Published: June 2021

Background: Iodine deficiency causes various health problems such as mental defects, goiter, reproductive damage, hypo and hyperthyroidism, stillbirth, abortion, congenital abnormalities, cretinism, mental retardation, muscle anomalies, and reduced work output. Although the adverse effects on health and socio-economic development are well known, they persisted as a public health problem worldwide. Salt iodization is recommended as a simple cost-effective method to prevent iodine deficiency disorders. This study aimed to determine the magnitude, trends, and determinants of iodized salt availability in the household in Ethiopia. Methods: The current study used the Ethiopian Demographic and Health Surveys conducted from 2000 to 2016 with a total of 57 939 households. Descriptive statistics were performed on selected background characteristics to provide an overall picture of the sample after considering sample weights. To ensure the representativeness of the sample we applied a complex sample design considering household weights, primary sampling units, and the strata associated with it. The Cochran–Armitage test was performed to assess the trend of iodized salt availability in the household. Multivariate logistic regression was used to determine the association between the dependent variable and independent variables. A significance level of .05 was chosen for all analyses. Results: The magnitude of iodized salt availability in the household was 28.45% in 2000, 54.34% in 2005, 15.42% in 2011, and 89.28% in 2016. Iodized salt availability increased from 28.45% [95% CI: 27.69-29.21] in 2000 to 89.28% [95% CI: 88.79-89.75] in 2016. Despite the decline from 2005 to 2011 in the percentage of households with iodized salt, overall, there was a significant increment from 2000 to 2016 in Ethiopia ( P-value <.001). There were differences in the status of salt iodization in the administrative region, wealth, family size, and ownership of radio or television. Conclusion: Remarkable progress has been made in Ethiopia regarding iodized salt availability in recent years. Besides the current efforts to achieve universal salt iodization, future interventions should prioritize specific groups like those with lower socioeconomic status and geographic areas with lower availability of iodized salt in the household.
Fetal renal artery blood flow – Normal ranges
Authors: Brennan Sonja , Watson David , Schneider Michal , Rudd Donna , Kandasamy Yogavijayan 
Published: June 2021

Introduction The study objectives were to develop standard charts for fetal renal artery blood flow to define normal ranges and to assess the reliability of the measurements. Methods This prospective, longitudinal study reviewed 72 low-risk singleton pregnancies who had serial ultrasound examinations. Pulse wave Doppler was used to obtain the resistivity and pulsatility indices of the fetal renal arteries. Standard charts of the fetal renal arteries were created using mixed effects modelling and the intra- and interobserver reliability for the renal blood flow measurements was analysed. Results Standard charts of the normal ranges of the renal artery resistive index (RI) and pulsatility index (PI) of the fetal renal arteries were created. The 3rd, 5th, 10th, 50th, 90th, 95th and 97th centiles were calculated. The intraclass correlation coefficient was acceptable for intraobserver reliability (RI = 0.66, PI = 0.88) and poor for interobserver reliability (RI = 0.11, PI = −0.56). Conclusions These novel charts demonstrate the change of the fetal renal artery blood flow during pregnancy. These may be used in clinical practice to detect variations from these normal ranges and be useful in future studies of kidney function projection.
Addressing high cervical cancer rates in the Rio Grande Valley along the Texas–Mexico border: a community-based initiative focused on education, patient navigation, and medical provider training/telementoring
Authors: Salcedo MP , Gowen R , Rodriguez AM , Fisher-Hoch S , Daheri M , Guerra L , Toscano PA , Gasca M , Morales J , Reyna-Rodriguez FE , Cavazos B , Marin E , Perez C , Guerra M , Milbourne A , Varon ML , Reininger B , Fernandez ME , Ogburn T , Castle PE , McCormick J , Baker E , Hawk E , Schmeler KM 
Published: June 2021

Aims: Cervical cancer incidence and mortality rates are approximately 55% higher in the Rio Grande Valley (RGV) along the Texas–Mexico border compared with the average rates in the US. Our aim was to improve cervical cancer prevention efforts in the RGV through a comprehensive multilevel intervention initiative focused on community education, patient navigation, and training of local providers. Methods: We initiated a program in the RGV which consisted of (1) community education, (2) patient navigation, and (3) a training/mentoring program for local medical providers including hands-on training courses coupled with telementoring using Project ECHO® (Extension for Community Health Outcomes). We assessed the number of women undergoing cervical cancer screening, diagnosis, and treatment at three participating clinics caring for underserved women in the region. Results: From November 2014 to October 2018, 14,846 women underwent cervical cancer screening. A total of 2030 (13.7%) women underwent colposcopy for abnormal results (179% increase over baseline) and 453 women underwent loop electrosurgical excision procedures (LEEPs) for treatment of cervical dysplasia. Invasive cancer was diagnosed in 39 women who were navigated to a gynecologic oncologist for treatment. Seven local medical providers were trained to perform colposcopy and/or LEEP. Project ECHO telementoring videoconferences were held every 2 weeks for a total 101 sessions with an average of 22 participants per session and a total of 180 patient cases presented and discussed. Conclusions: Our program led to a large number of women undergoing diagnosis and treatment of cervical dysplasia in the RGV. If sustained, we anticipate these efforts will decrease cervical cancer rates in the region. The program is currently being expanded to additional underserved areas of Texas and globally to low- and middle-income countries.