bluuebunny/crossref_metadata_2025_split huggingface dataset:
Midlatitude Winter Extreme Temperature Events and Connections with Anomalies in the Arctic and Tropics
Authors: Rudeva Irina , Simmonds Ian 
Published: February 2021

AbstractFor the last few decades the Northern Hemisphere midlatitudes have seen an increasing number of temperature extreme events. It has been suggested that some of these extremes are related to planetary wave activity. In this study we identify wave propagation regions at 300 hPa using the ERA-Interim dataset from 1980 to 2017 and link them to temperature extremes in densely populated regions of the Northern Hemisphere. Most studies have used background flow fields at monthly or seasonal scale to investigate wave propagation. For a phenomenon that is influenced by threshold incidents and nonlinear processes, this can distort the net Rossby wave signal. A novel aspect of our investigation lies in the use of daily data to study wave propagation allowing it to be diagnosed for limited but important periods across a wider range of latitudes, including the polar region. We show that winter temperature extremes in the midlatitudes can be associated with circulation anomalies in both the Arctic and the tropics, while the relative importance of these areas differs according to the specific midlatitude region. In particular, wave trains connecting the tropical Pacific and Atlantic may be associated with temperature anomalies in North America and Siberia. Arctic seas are markedly important for Eurasian regions. Analysis of synoptic temperature extremes suggests that pre-existing local temperature anomalies play a key role in the development of those extremes, as well as amplification of large-scale wave trains. We also demonstrate that warm Arctic regions can create cold outbreaks in both Siberia and North America.
Protected Convection as a Metric of Dry Air Influence on Precipitation
Authors: Ahmed Fiaz , Neelin J. David 
Published: February 2021

AbstractEntrainment of dry tropospheric air can dilute cloud buoyancies and strongly affect the occurrence and intensity of convection. To measure this dry air influence on tropical precipitation, rainfall values that would occur when convection is “protected” from dry air dilution are estimated. An empirical relationship between tropical oceanic precipitation and entraining buoyancy in the lower troposphere (from the surface to 600 hPa) is leveraged. Protected buoyancies are computed by allowing a plume model to entrain saturated air at environmental temperature. These buoyancies are then used to estimate precipitation from protected convection. In most regions, the protected precipitation greatly exceeds the observed precipitation. Warm waters adjoining continents display striking disparities between observed and protected rainfall pointing to rainfall climatologies severely limited by dry air. The most prominent of these regions include the Red Sea and the Persian Gulf, followed by the Caribbean Sea, the Gulf of Mexico, and the seas surrounding the Maritime Continent. We test if similar large precipitation values are realizable in the Community Atmospheric Model (CAM5), wherein the parameterized convection in small (~2° × 2°) pockets is allowed to only entrain saturated air. The precipitation within these pockets shows strong enhancement that is maintained over time, and is compensated by slight reductions in neighboring regions. In the model, protecting convection yields larger precipitation values over ocean than over land; protected precipitation also intensifies in a uniform SST warming experiment. The model experiments suggest that protected pockets in numerical simulations could be used to mimic the consequences of meteorological protection—from closed circulation or moisture shielding effects—that generate extreme precipitation.
Assessing ENSO Summer Teleconnections, Impacts, and Predictability in North America
Authors: Jong Bor-Ting , Ting Mingfang , Seager Richard 
Published: February 2021

AbstractDuring the summer when an El Niño event is transitioning to a La Niña event, the extratropical teleconnections exert robust warming anomalies over the U.S. Midwest threatening agricultural production. This study assesses the performance of current climate models in capturing the prominent observed extratropical responses over North America during the transitioning La Niña summer, based on atmospheric general circulation model experiments and coupled models from the North American Multimodel Ensemble (NMME). The ensemble mean of the SST-forced experiments across the transitioning La Niña summers does not capture the robust warming in the Midwest. The SST-forced experiments do not produce consistent subtropical western Pacific (WP) negative precipitation anomalies and this leads to the poor simulations of extratropical teleconnections over North America. In the NMME models, with active air–sea interaction, the negative WP precipitation anomalies show better agreement across the models and with observations. However, the downstream wave train pattern and the resulting extratropical responses over North America exhibit large disagreement across the models and are consistently weaker than in observations. Furthermore, in these climate models, an anomalous anticyclone does not robustly translate into a warm anomaly over the Midwest, in disagreement with observations. This work suggests that, during the El Niño to La Niña transitioning summer, active air–sea interaction is important in simulating tropical precipitation over the WP. Nevertheless, skillful representations of the Rossby wave propagation and land–atmosphere processes in climate models are also essential for skillful simulations of extratropical responses over North America.
Examining the Compatibility of Aircraft Moisture Observations and Operational Radiosondes
Authors: Williams Skylar S. , Wagner Timothy J. , Petersen Ralph A. 
Published: February 2021

AbstractThe addition of moisture observations via the Water Vapor Sensing System (WVSS) from about 150 aircraft available operationally through the World Meteorological Organization (WMO) Aircraft Meteorological Data Relay (AMDAR) program now provides highly reliable thermodynamic profiles of the troposphere. The nearly 900 profiles available daily provide greater temporal and spatial density than the operational radiosonde network over many parts of the United States. Previous studies comparing WVSS reports with specially collocated radiosondes have documented the quality and consistency of the WVSS observations. These studies, however, have been limited for short periods at a single location. This study expands on the earlier evaluations by using operational U.S. radiosondes from 2015 in a variety of locations, seasons, and climates. Comparison profiles at radiosonde sites were calculated in pressure layers and then interpolated to terrain-following sigma coordinates to account for the differences in elevations of comparison sites and provide a better means of integrating the higher vertical resolution of AMDAR observations taken in the boundary layer. Overall, systematic differences between the WVSS and radiosondes are smallest just above the surface, with the WVSS observations being slightly moister than the radiosondes aloft, with WVSS reports being moister during ascent than descent—possibly the result of small hysteresis effects. Standard deviations averaged 1.3 g kg−1 near the surface over the yearlong period. Differences varied by season and region. Overall, the results indicate that WVSS observations are compatible with radiosonde reports and can be used with high confidence to fill temporal and spatial data gaps.
Diagnostic Lobectomy for Bethesda III Thyroid Nodules: Pathological Outcomes and Risk Factors for Malignancy
Authors: Walters Benjamin K. , Garrett Samuel L. , Aden James K. , Williams Grant M. , Butler-Garcia Samantha L. , Newberry Travis R. , Mckinlay Alex J. 
Published: February 2021

Objective: An indeterminate thyroid nodule fine-needle aspiration (FNA) presents a unique dilemma. We evaluated our institution’s experience with Bethesda III thyroid nodules, including the risk of malignancy (ROM) of these nodules removed for diagnostic lobectomy and radiologic and clinical risk factors for malignancy. Study design: Retrospective chart review. Setting: San Antonio Military Medical Center (SAMMC; 483 bed Military Treatment Facility and Level 1 Trauma Center). Methods: We identified all patients with a Bethesda III thyroid FNA at our institution from 2010 to 2018 and determined which nodules were removed. The final histological diagnosis was recorded. Whether or not age, gender, body mass index (BMI), race, nodule size, margin regularity, rate of nodule growth, vascularity, internal calcifications, family history of thyroid cancer, personal history of radiation, and history of repeated AUS/FLUS on FNA had a significant impact on malignancy risk was evaluated with chi square and rank sum Wilcoxon tests. Results: 492 patients had 1 or more AUS result. 52% (258/492) underwent repeat FNA. This resulted in Bethesda II or III in 90% (232/258). In 10% (26/258), the repeat FNA resulted in a higher Bethesda grade. 183 lobectomies were performed on the side containing an AUS nodule. The malignancy percentage was 38.3% (70/183). Age less than 30 was the only variable showing statistical significance for increased risk of malignancy ( P = .04). Conclusion: The ROM of nodules characterized as AUS/FLUS on FNA may be higher than expected. Age may be a better predictor of malignancy than repeat FNA.
Performance of the Plantation Sector During the COVID-19 Pandemic
Authors: Abraham Vinoj , Madhavan Mithesh 
Published: February 2021

This study explores the impact that COVID-19 and its preventive measures would have on the plantation sector, covering four important crops—tea, coffee, rubber and cardamom. The study traces the channels through which the pandemic and the lockdown measures would impact the sector. These channels are the disruptions in seasonal operations, in factor and resource supplies; transport, storage and processing; marketing and sales; and demand conditions. These disruptions get manifested in price, quantity and revenue. These are estimated for the four crops separately. The total unrealised revenue due to the lockdown is estimated to be ₹38.4364 billion for the lockdown period from 24 March to 31 May 2020. This does not include the losses that are to be incurred due to the demand decline, supply chain disruptions and price fall that is to be manifested in future. This massive economic disaster is bound to have a severe impact on the plantation economy, especially the small growers and the labourers. Urgent measures need to be taken up to arrest the losses and revive the sector. Yet there is very little in the ‘Atmanirbhar Bharat’ package that would help tide over this economic crisis. Immediate measures aimed at demand rejuvenation, arrest of price fall, restarting of plantation operations and restoring of supply chains is called for. The vantage point of the commodity boards must be exploited to reach out to the stakeholders. JEL classification: M38, Q11, Q13, R11
Emergency care to ‘persons with confused behavior’: Lived experiences of, and collaboration between, police and members of a mobile crisis team – A hermeneutic-phenomenological study
Authors: Daggenvoorde Thea H , van Eerden Miranda , van den Heuvel Silvio CGH , Gijsman Harm J , Vermeulen Hester , Goossens Peter JJ 
Published: February 2021

Background: Police officers and members of a mobile crisis team (MCT) are the two actors who respond to nuisance in Dutch society related to ‘persons with confused behavior’ and serious violent incidents. Their collaboration creates tension and dissatisfaction about roles and responsibilities. Aim: To explore the lived experiences of, and collaboration between, police officers and members of a MCT. Methods: A hermeneutic-phenomenological study with unstructured in-depth interviews of eight police officers and eight members of a MCT. Findings: The main findings in this study are that in the emergency care of ‘persons with confused behavior’ two very different professions are forced to work together, and that this collaboration is quite challenging. It becomes clear that different visions and expectations cause frustration in the collaboration. Police want the participation of the MCT as soon as possible after they are called in. The MCT wants to be easily accessible for police and can identify the great diversity of problems adequately but cannot solve all problems. There are shortcomings in adequate follow-up care provided by other health-care facilities. Conclusion: It turns out that it is extremely important for police officers that members of the MCT explain to them why a crisis assessment has a certain outcome. The exposed frictions and stagnation in the collaboration should be discussed openly as part of the process in order to acknowledge this and resolve it together. A recently started project called ‘street triage’, in which the police and MCT work together as one team and give a joint response, seems to remove a lot of the friction and stagnation. Further studies are needed to explore the effects of street triage by testing the validity of the hypothesis that street triage can close the gap between the two professions.
Syllabus Tone, More Than Mental Health Statements, Influence Intentions to Seek Help
Authors: Gurung Regan A. R. , Galardi Noelle R. 
Published: February 2021

Background: Mental health issues are increasing in higher education and finding ways for students to get help when needed is important. Objective: We tested if the tone of a short syllabus and the presence of a special statement addressing mental health would increase intentions to approach instructors for help. Method: We used a 2 (Tone: warm vs. cold) × 2(Statement: present vs. absent) experimental design. Participants (N = 257) read one of four, two-page syllabi, and rated intentions to reach out for help and the instructor. Results: We found a main effect for tone on three Reach Out statements and ratings of the instructor. Presence of the statement influenced likelihood to reach out for help with personal problems. Conclusions: Both the tone of a short syllabus and the presence of statements normalizing reaching out for help can influence student intentions to contact instructors for help. Teaching Implications: Writing a warm toned syllabus and addressing stress and mental health with a university statement may increase student’s intentions to ask for help.
Acid-fast bacilli smear test of a blood culture sample for the diagnosis of disseminated Mycobacterium genavense infection: A case report
Authors: Murata Yo , Mori Nobuaki , Kagawa Narito , Okuma Kentaro , Yoshida Shinji , Ohkusu Kiyofumi , Honda Miwako 
Published: February 2021

Mycobacterium genavense, a nontuberculous Mycobacterium, is found in immunosuppressed patients, particularly in those with HIV. Mycobacterium genavense incubation under standard culture conditions is difficult, and its identification is challenging using routine culture methods. Herein, we report the case of a 40-year-old Japanese man with HIV presenting with disseminated M. genavense infection. An analysis using an automated blood culture system did not show positive signals during 6 weeks of incubation. However, an acid-fast bacilli smear of his blood sample was positive for the bacterium. Mycobacterium genavense was identified using sequencing analysis, targeting the heat shock protein 65 gene. The patient recovered from the infection, following antibiotic therapy for 18 months. Under suspicion of disseminated M. genavense infection and the absence of bacterial growth in blood culture samples, an acid-fast bacilli smear test of the sample may be useful for timely diagnosis.
Frequency of pregnant women who accept HIV screening using rapid detection test and factors associated with acceptance
Authors: Khatoon Aisha , Husain Samia , Husain Sonia , Hussain Saba 
Published: February 2021

To assess the frequency of pregnant women who accept HIV screening using rapid detection test and factors associated with acceptance we undertook a cross-sectional study conducted from July to December 2018. Women aged 20–45 years, who were pregnant and planned to deliver at the facility, were included. Women were counseled and offered about Human Immunodeficiency virus (HIV) screening. A total of 718 women were included in the study. The screening was accepted by 32.3% of women. Six women tested positive in the study giving a seroprevalence of 0.8% in the population studied. Acceptance of counseling and screening varied significantly with age range, educational status, socioeconomic status, and employment status. Women aged 30 years and above ( p = 0.023) and women with higher education ( p < 0.001) were more likely to refuse counselling. Similarly, employed women (p = 0.041) and women of higher socioeconomic class ( p = 0.039) refused counselling. However, when logistic regression was conducted, only educational status ( p < 0.001) and occupational status ( p = 0.039) were significantly associated with acceptance of counseling and screening. The acceptance of counselling and testing for HIV in antenatal care attendees was low. Women of higher educational status and having some employment refused counselling and testing more commonly.
The Nexus Of Foreign Reserves, Exchange Rate And Inflation: Recent Empirical Evidence From Sri Lanka
Authors: Ariyasinghe Ayesh , Cooray N. S. 
Published: February 2021

The conventional mandates of the central banks on meeting stability objectives and maintaining a growth-maximizing inflation rate have come under some criticism since the global financial crises. Maintaining adequate foreign reserves is seen as a viable solution to foreign exchange liquidity needs during crisis periods. Since the end of 2011, many Asian economies, including China and Japan, led from the forefront in central bank-led reserves build-up. However, reserves build-up remains challenging and sensitive for small open economies. Such policies help create ‘risk-neutral’ buffers for monetary and fiscal authorities to absorb transitory current account shocks and foreign exchange stress to smoothen the balance of payments. This study is motivated by the importance of identifying the inflation–foreign reserves nexus that may affect inflation in a manner counterproductive to the central bank mandate of maintaining price stability. It probes the debate of the sustainability of reserves build-up in the long and the short term. The outcome of the study poses several vital questions for fiscal and monetary policymakers concerning their respective mandates. The reserves–inflation nexus and its magnitude is determined using monthly data spanning two decades, through engaging an autoregressive distributed lag (ARDL) model and relevant bounds-testing techniques proposed by Pesaran et al. The vector autoregression (VAR), error correction and Johansen cointegration methods supplement the robustness checks. Exchange rate is introduced to enrich the discussion on the reserves–inflation nexus and shows a cointegration relationship in the long run. The study provides an insight into the influence of exchange rate on reserves and inflation. The variance decomposition shows the presence of a lukewarm response from foreign reserves and exchange rate on inflation. Policymakers concerned with inflationary expectations in the medium-to-long term need to consider these signals, as reserves build-up is one of the important policy-driven objectives for a number of economies. JEL: C50, C32, E31, E52, E58, F30, F31, F39
Transseptal Puncture Learning Curve for Transcatheter Edge-to-Edge Mitral Valve Repair
Authors: Quinn Rachael W. , Vesely Mark R. , Dawood Murtaza , Benitez Michael , Holmes Sari D. , Gammie James S. 
Published: February 2021

Objective This study examined the learning curve for transseptal puncture (TSP) during transcatheter edge-to-edge mitral valve repair (TEER) performed by a dedicated mitral valve structural heart team. Effective TSP is mandatory for TEER but can be time-consuming and associated with complications including pericardial effusion and cardiac tamponade. Methods TSP was performed on 107 consecutive patients (76 ± 1 years, 52% male) undergoing TEER between 2014 and 2019. TSP was performed by each structural heart team member (1 cardiologist, 2 cardiac surgeons) on a rotating case-by-case basis. No team member had prior independent TSP experience. Data collected included total procedure time, TSP time (time elapsed between procedure start and septal crossing), and number of TSP attempts before successful puncture. Cumulative sum (CUSUM) of deviations from the mean across sequential cases were used to examine learning curves. Results Median total procedure time was 107 min, and the median TSP time was 14 min. Greater case number was significantly associated with both lower TSP time ( r s = −0.22, P = 0.022) and lower total procedure time ( r s = −0.29, P = 0.003). The majority of patients required only 1 TSP attempt (79%). There was a significant quadratic relationship between case number and the CUSUM for TSP time, with the learning curve peaking at 49 cases. Conclusions TSP for TEER has a substantial learning curve, requiring >50 cases to achieve acceptable efficiency. Even once proficiency is demonstrated, TSP remains a time-consuming component of TEER. Improvements in transseptal access technology may significantly decrease the time needed to master TSP and may improve the safety and precision of the procedure.
Reducing the incidence of pin site infection in hand surgery with the use of a protocol from Ilizarov
Authors: Solari Mattia , Kapur Benjamin , Benjamin-Laing Harry , Klass Benjamin R. , Cheung Graham , Brown Daniel J. 
Published: February 2021

Reported pin site infection rates in Kirschner wire fixation in the hand and wrist vary from 2% to 35%. In our unit we follow a strict pin site management protocol adapted from the Russian Ilizarov Scientific Centre. This study aims to identify if our current protocol reduces the incidence of pin site infection in hand and wrist surgery, and improves wire survival rates, to a level where exposed wires can be used safely. A retrospective review of 200 patients, treated with 369 percutaneous wires, in our hand surgery department over a 6-year period was carried out. Nine patients (4.5%) were diagnosed with a pin site infection with a wire survival rate of 99.5%.In our unit using our current protocol, results support the safe use of exposed wires with appropriate pin site care initiated in theatre. Adherence to this protocol allows wires to remain in-situ throughout treatment with minimal complications. Level of evidence: IV