bluuebunny/crossref_metadata_2025_split huggingface dataset:
Teleconnections between Rainfall in Equatorial Africa and Tropical Sea-Surface Temperatures: A Focus on Western Uganda
Authors: Diem Jeremy E. , Salerno Jonathan D. , Palace Michael W. , Bailey Karen , Hartter Joel 
Published: June 2021

AbstractSubstantial research on the teleconnections between rainfall and sea-surface temperatures (SSTs) has been conducted across equatorial Africa as a whole, but currently no focused examination exists for western Uganda, a rainfall transition zone between eastern equatorial Africa (EEA) and central equatorial Africa (CEA). This study examines correlations between satellite-based rainfall totals in western Uganda and SSTs – and associated indices – across the tropics over 1983-2019. It is found that rainfall throughout western Uganda is teleconnected to SSTs in all tropical oceans, but much more strongly to SSTs in the Indian and Pacific Oceans than the Atlantic Ocean. Increased Indian Ocean SSTs during boreal winter, spring, and autumn and a pattern similar to a positive Indian Ocean Dipole during boreal summer are associated with increased rainfall in western Uganda. The most spatially complex teleconnections in western Uganda occur during September-December, with northwestern Uganda being similar to EEA during this period and southwestern Uganda being similar to CEA. During boreal autumn and winter, northwestern Uganda has increased rainfall associated with SST patterns resembling a positive Indian Ocean Dipole or El Niño. Southwestern Uganda does not have those teleconnections; in fact, increased rainfall there tends to be more associated with La Niña-like SST patterns. Tropical Atlantic Ocean SSTs also appear to influence rainfall in southwestern Uganda in boreal winter as well as in boreal summer. Overall, western Uganda is a heterogeneous region with respect to rainfall-SST teleconnections; therefore, southwestern Uganda and northwestern Uganda require separate analyses and forecasts, especially during boreal autumn and winter.
Regime Behavior in the Upper Stratosphere as a Precursor of Stratosphere-Troposphere Coupling in the Northern Winter
Authors: Lu Hua , Gray Lesley J. , Martineau Patrick , King John C. , Bracegirdle Thomas J. 
Published: June 2021

AbstractA new regime index is constructed to capture the seasonal development of the stratospheric polar vortex in the northern winter, based on the standard deviation of Ertel’s potential vorticity in the upper stratosphere in November-December. The narrow-jet flow regime is characterized by a polar vortex that is more confined to high latitudes in the early winter upper stratosphere. This upper-level vortex configuration is more susceptible to the disturbances of upward propagating planetary-scale Rossby waves; the stratospheric polar vortex thus weakens earlier and is vertically shallower. The wide-jet flow regime is characterized by a broader-than-average polar vortex that extends further into the subtropics in the early-winter upper stratosphere. The polar night jet then gradually strengthens, moves poleward and penetrates deep into the lowermost stratosphere, with a sharply-defined polar vortex edge accompanied due to more frequent Rossby wave breaking.Composite differences analyses show that the wide and narrow jet regimes, defined in the uppermost stratosphere in November-December, lead to different circulation anomalies of the lower-stratosphere and the troposphere in January-February, offering the potential for improved predictability of sub-seasonal to seasonal forecasts up to two months ahead. The lower tropospheric responses in January-February are zonally asymmetric. The narrow-jet regime projects most strongly over the North Atlantic, with an equatorward-shifted, and/or broader mid-latitude westerly jet. The wide-jet-regime response is characterized by a weakened mid-latitude westerly jet over the North Pacific. The two flow regimes also differ in their impacts on the storm track over Western Europe and the east coast of America, which may have implications for extreme weather events in those regions.
Safety verification of genetically modified rice morphology, hereditary nature, and quality
Authors: Jeon Dong Won , Park Jae-Ryoung , Jang Yoon-Hee , Kim Eun-Gyeong , Ryu Taehun , Kim Kyung-Min 
Published: June 2021

Abstract
Background
The drought environment occurs frequently due to the unpredictable future climate change, and drought has a direct negative impact on crops, such as yield reduction. Drought events are random, frequent, and persistent. Molecular breeding can be used to create drought-tolerant food crops, but the safety of genetically modified (GM) plants must be demonstrated before they can be adopted. In this research, the environmental risk of drought-tolerant GM rice was explored by assessing phenotype and gene flow. Drought resistance genes CaMsrB2 inserted HV8 and HV23 were used as GM rice to analyze the possibility of various agricultural traits and gene flow along with non-GM rice.

Results
When the traits 1000-grain weight, grain length/width, and yield, were compared with GM rice and non-GM rice, all agricultural traits of GM rice and non-GM rice were the same. In addition, when the germination rate, viviparous germination rate, pulling strength, and bending strength were compared to analyze the possibility of weediness, all characteristic values of GM rice and non-GM rice were the same. Protein, amylose, and moisture, the major nutritional elements of rice, were also the same.

Conclusions
The results of this research are that GM rice and non-GM rice were the same in all major agricultural traits except for the newly assigned characteristics, and no gene mobility occurred. Therefore, GM rice can be used as a means to solve the food problem in response to the unpredictable era of climate change in the future.
Responses of cutaneous C-fiber afferents and spinal microglia after hindlimb cast immobilization in rats
Authors: Ota Hiroki , Takebe Haruna , Mizumura Kazue , Taguchi Toru 
Published: June 2021

AbstractPrevious studies have shown that persistent limb immobilization using a cast increases nociceptive behavior to somatic stimuli in rats. However, the peripheral neural mechanisms of nociception remain unclear. Using single-fiber electrophysiological recordings in vitro, we examined the general characteristics of cutaneous C-fiber afferents in the saphenous nerve and their responsiveness to mechanical and heat stimuli in a rat model of immobilization-induced pain by subjecting the rats to hindlimb cast immobilization for 4 weeks. The mechanical response of C-fibers appeared to increase in the model; however, statistical analysis revealed that neither the response threshold nor the response magnitude was altered. The general characteristics and heat responses of the C-fibers were not altered. The number of microglia and cell diameters significantly increased in the superficial dorsal horn of the lumbar spinal cord. Thus, activated microglia-mediated spinal mechanisms are associated with the induction of nociceptive hypersensitivity in rats after persistent cast immobilization.
Learning health systems in primary care: a systematic scoping review
Authors: Nash Danielle M. , Bhimani Zohra , Rayner Jennifer , Zwarenstein Merrick 
Published: June 2021

Abstract
Background
Learning health systems have been gaining traction over the past decade. The purpose of this study was to understand the spread of learning health systems in primary care, including where they have been implemented, how they are operating, and potential challenges and solutions.

Methods
We completed a scoping review by systematically searching OVID Medline®, Embase®, IEEE Xplore®, and reviewing specific journals from 2007 to 2020. We also completed a Google search to identify gray literature.

Results
We reviewed 1924 articles through our database search and 51 articles from other sources, from which we identified 21 unique learning health systems based on 62 data sources. Only one of these learning health systems was implemented exclusively in a primary care setting, where all others were integrated health systems or networks that also included other care settings. Eighteen of the 21 were in the United States. Examples of how these learning health systems were being used included real-time clinical surveillance, quality improvement initiatives, pragmatic trials at the point of care, and decision support. Many challenges and potential solutions were identified regarding data, sustainability, promoting a learning culture, prioritization processes, involvement of community, and balancing quality improvement versus research.

Conclusions
We identified 21 learning health systems, which all appear at an early stage of development, and only one was primary care only. We summarized and provided examples of integrated health systems and data networks that can be considered early models in the growing global movement to advance learning health systems in primary care.
Gliosarcoma vs. glioblastoma: a retrospective case series using molecular profiling
Authors: Dardis Christopher , Donner David , Sanai Nader , Xiu Joanne , Mittal Sandeep , Michelhaugh Sharon K. , Pandey Manjari , Kesari Santosh , Heimberger Amy B. , Gatalica Zoran , Korn Michael W. , Sumrall Ashley L. , Phuphanich Surasak 
Published: June 2021

Abstract
Background
Gliosarcoma (GS) refers to the presence of mesenchymal differentiation (as seen using light microscopy) in the setting of glioblastoma (GB, an astrocytoma, WHO Grade 4). Although the same approach to treatment is typically adopted for GS and GB, there remains some debate as to whether GS should be considered a discrete pathological entity. Differences between these tumors have not been clearly established at the molecular level.

Methods
Patients with GS (n=48) or GB (n=1229) underwent molecular profiling (MP) with a pan-cancer panel of tests as part of their clinical care. The methods employed included next-generation sequencing (NGS) of DNA and RNA, copy number variation (CNV) of DNA and immunohistochemistry (IHC). The MP comprised 1153 tests in total, although results for each test were not available for every tumor profiled. We analyzed this data retrospectively in order to determine if our results were in keeping with what is known about the pathogenesis of GS by contrast with GB. We also sought novel associations between the MP and GS vs. GB which might improve our understanding of pathogenesis of GS.

Results
Potentially meaningful associations (p<0.1, Fisher’s exact test (FET)) were found for 14 of these tests in GS vs. GB. A novel finding was higher levels of proteins mediating immuno-evasion (PD-1, PD-L1) in GS. All of the differences we observed have been associated with epithelial-to-mesenchymal transition (EMT) in other tumor types. Many of the changes we saw in GS are novel in the setting of glial tumors, including copy number amplification in LYL1 and mutations in PTPN11.

Conclusions
GS shows certain characteristics of EMT, by contrast with GB. Treatments targeting immuno-evasion may be of greater therapeutic value in GS relative to GB.
Evaluation of body-surface-area adjusted dosing of high-dose methotrexate by population pharmacokinetics in a large cohort of cancer patients
Authors: Arshad Usman , Taubert Max , Seeger-Nukpezah Tamina , Ullah Sami , Spindeldreier Kirsten C. , Jaehde Ulrich , Hallek Michael , Fuhr Uwe , Vehreschild Jörg Janne , Jakob Carolin 
Published: June 2021

Abstract
Background
The aim of this study was to identify sources of variability including patient gender and body surface area (BSA) in pharmacokinetic (PK) exposure for high-dose methotrexate (MTX) continuous infusion in a large cohort of patients with hematological and solid malignancies.

Methods
We conducted a retrospective PK analysis of MTX plasma concentration data from hematological/oncological patients treated at the University Hospital of Cologne between 2005 and 2018. Nonlinear mixed effects modeling was performed. Covariate data on patient demographics and clinical chemistry parameters was incorporated to assess relationships with PK parameters. Simulations were conducted to compare exposure and probability of target attainment (PTA) under BSA adjusted, flat and stratified dosing regimens.

Results
Plasma concentration over time data (2182 measurements) from therapeutic drug monitoring from 229 patients was available. PK of MTX were best described by a three-compartment model. Values for clearance (CL) of 4.33 [2.95–5.92] L h− 1 and central volume of distribution of 4.29 [1.81–7.33] L were estimated. An inter-occasion variability of 23.1% (coefficient of variation) and an inter-individual variability of 29.7% were associated to CL, which was 16 [7–25] % lower in women. Serum creatinine, patient age, sex and BSA were significantly related to CL of MTX. Simulations suggested that differences in PTA between flat and BSA-based dosing were marginal, with stratified dosing performing best overall.

Conclusion
A dosing scheme with doses stratified across BSA quartiles is suggested to optimize target exposure attainment. Influence of patient sex on CL of MTX is present but small in magnitude.
Quantifying prescribed high dose opioids in the community and risk of overdose
Authors: Schofield Joe , Steven Deborah , Foster Rebecca , Matheson Catriona , Baldacchino Alexander , McAuley Andrew , Parkes Tessa 
Published: June 2021

Abstract
Background
Opioid prescribing for a range of health issues is increasing globally. The risk of fatal and non-fatal overdose is increased among people prescribed strong opioids: in high doses in the context of polypharmacy (the use of multiple medications at the same time), especially with other sedatives; and among people with multiple morbidities including cardiorespiratory, hepatic and renal conditions. This study described and quantified the prescribing of strong opioids, comorbidities and other overdose risk factors among those prescribed strong opioids, and factors associated with high/very high opioid dosage in a regional health authority in Scotland as part of a wider service improvement exercise.

Methods
Participating practices ran searches to identify patients prescribed strong opioids and their characteristics, polypharmacy, and other overdose risk factors. Data were anonymised before being analysed at practice and patient-level. Morphine Equivalent Doses were calculated for patients based on drug/dose information and classed as Low/Medium/High/Very High. Descriptive statistics were generated on the strong opioid patient population and overdose risk factors. The relationship between the prescribing of strong opioids and practice/patient-level factors was investigated using linear and logistic regression models.

Results
Eighty-five percent (46/54) of GP practices participated. 12.4% (42,382/341,240) of individuals in participating practices were prescribed opioids and, of these, one third (14,079/42,382) were prescribed strong opioids. The most common comorbidities and overdose risk factors among strong opioid recipients were pain (67.2%), cardiovascular disease (43.2%), and mental health problems (39.3%). There was a positive significant relationship between level of social deprivation among practice caseload and level of strong opioid prescribing (p < 0.001). People prescribed strong opioids tended to be older (mean 59.7 years) and female (8638, 61.4%) and, among a subset of patients, age, gender and opioid drug class were significantly associated with prescribing of High/Very High doses.

Conclusions
Our findings have identified a large population at potential risk of prescription opioid overdose. There is a need to explore pragmatic models of tailored interventions which may reduce the risk of overdose within this group and clinical practice may need to be tightened to minimise overdose risk for individuals prescribed high dose opioids.
Investigation of the relationships between perceived causes of COVID-19, attitudes towards vaccine and level of trust in information sources from the perspective of Infodemic: the case of Turkey
Authors: Karabela Şemsi Nur , Coşkun Filiz , Hoşgör Haydar 
Published: June 2021

AbstractBackgroundThe main purpose in this study carried out from the perspective of infodemic was to investigate the relationships between individuals’ perceived causes of COVID-19, their attitudes towards vaccine and their levels of trust in information sources in terms of various descriptive characteristics.MethodsIn this cross-sectional and correlational study conducted with 1216 individuals from different provinces of Turkey, the Perception of Causes of COVID-19 (PCa-COVID-19) Scale was used. In addition, a questionnaire including the participants’ descriptive characteristics, their attitudes towards vaccine and their level of trust in information sources about Covid-19 was used.ResultsThe mean age of the participants was 35.9 ± 12.3 years. Of them, 62.5% were women, 59.0% were married, and 62.1% were university graduates. As for their view of having the Covid-19 vaccine, 54.1% thought to have it, 16.2% did not think, and 29.7% were undecided. Although the correlation was not significant, of the participants, those who considered having vaccination mostly trusted YouTube as their source of information. Of the participants, those whose level of trust in government institutions and health professionals was high displayed significantly more favorable attitudes towards vaccine. The participants obtained the highest mean score from the Conspiracy Theories subscale of the PCa-COVID-19 scale. There was a positive and low-level relationship between attitudes towards COVID-19 vaccine, and the Conspiracy Theories (r: 0.214) and Faith Factors (r: 0.066) sub-dimensions of the PCa-COVID-19 Scale.ConclusionsThe level of vaccine hesitancy in Turkey is at an alarming level, and the virus is defined by moderate conspiracy theories. In this context, in the fight against infodemic, it is critical to implement mechanisms that can reveal misinformation and to plan initiatives that can increase the health literacy levels of societies.
Risk factors associated with infection recurrence of posttraumatic osteomyelitis treated with Ilizarov bone transport technique—a retrospective study of 149 cases
Authors: Yalikun Ainizier , Yushan Maimaiaili , Li Wenqiang , Abulaiti Alimujiang , Yusufu Aihemaitijiang 
Published: June 2021

Abstract
Background
Post-traumatic tibial osteomyelitis is considered as complex clinical problem due to its unique characteristics such as prolonged course, multi-staged treatment and high recurrence rate. The purpose of this study is to identify and analyze the causes and risk factors associated with infection recurrence of tibial osteomyelitis treated with Ilizarov technique.

Methods
From January 2011 to January 2019, a total of 149 patients with post-traumatic tibial osteomyelitis treated with Ilizarov bone transport technique were included in this study. Demographic and clinical data were collected and analyzed. Univariate analysis and logistic regression analysis were used to analyze the factors that may affect the recurrence or reinfection of post-traumatic tibial osteomyelitis after treated with Ilizarov bone transport technique.

Results
All included patients were successfully followed up with an average of 37.5 month (18–78 month), among them, 17 patients (11.4%) occurred with recurrence or reinfection of tibial osteomyelitis in which 2 cases were in distraction area and 15 cases in docking site. Among them, 5 patients were treated successfully with appropriate intravenous antibiotic, the remaining 12 patients were intervened by surgical debridement or bone grafting after debridement. Univariate analysis showed that Pseudomonas aeruginosa infection, bone exposure, number of previous operations (> 3 times), blood transfusion during bone transport surgery, course of osteomyelitis > 3 months, diabetes was associated with recurrence or reinfection of postoperative tibial osteomyelitis. According to the results of logistic regression analysis, Pseudomonas aeruginosa infection, bone exposure, and the number of previous operations (> 3 times) are risk factors for recurrence or reinfection of posttraumatic tibial osteomyelitis treated with Ilizarov bone transport technique, with odds ratios (OR) of 6.055, 7.413, and 1.753, respectively.

Conclusion
The number of previous operations (> 3 times), bone exposure, and Pseudomonas aeruginosa infection are risk factors for infection recurrence of posttraumatic tibial osteomyelitis treated with Ilizarov bone transport technique.
Correlation and responsiveness of global health, upper extremity-specific, and shoulder-specific functional outcome measures following reverse total shoulder arthroplasty for proximal humerus fracture
Authors: Barger James , Zhang Dafang , Stenquist Derek S. , Ostergaard Peter , Hall Matthew , Dyer George S. M. , Earp Brandon E. , von Keudell Arvind 
Published: June 2021

Abstract
Purpose
Reverse total shoulder arthroplasty (rTSA) is effective and increasingly utilized for the management of proximal humerus fracture (PHF). However, the optimal patient-reported outcome metrics (PROMs) for the evaluation of patient outcomes after this surgery are unclear. We investigated the correlation among global, upper extremity-specific, and shoulder-specific PROMs in patients undergoing rTSA for PHF as well as the responsiveness of these PROMs as assessed by floor and ceiling effects. We hypothesized that patients’ post-operative outcome would be best reflected by a combination of these metrics.

Methods
Thirty patients with a history of rTSA for ipsilateral PHF filled out the following outcomes questionnaires at a minimum of 3 years post-op: EQ-5D, EQ-5D VAS, PROMIS physical function, DASH, SSV, SPADI, and ASES. Correlation between metrics was assessed using the Spearman correlation coefficient. Responsiveness was assessed by comparing the proportion of patients reaching floor or ceiling values using McNemar’s test.

Results
Global health metrics (EQ-5D and PROMIS physical function) were strongly correlated with the upper extremity-specific metric (DASH). Shoulder-specific outcomes (SPADI, ASES, and ASES) were moderately correlated with both the global metrics and DASH. There was no significant difference between PROMs with regards to floor and ceiling effects.

Conclusions
The DASH score has been shown to be valid and responsive for shoulder interventions, and our data demonstrate that it correlates strongly with overall quality of life. Shoulder-specific metrics are valid and responsive for shoulder interventions but correlate less with global quality of life. An optimal PROM strategy in rTSA for PHF might involve both DASH and a shoulder-specific score. Based on our assessment of floor and ceiling effects, none of these metrics should be excluded for poor responsiveness.