bluuebunny/crossref_metadata_2025_split huggingface dataset:
Delivering the unexpected—Information needs for PSA screening from Men's perspective: A qualitative study
Authors: Kuss Katrin , Adarkwah Charles Christian , Becker Miriam , Donner‐Banzhoff Norbert , Schloessler Kathrin 
Published: June 2021

AbstractBackgroundMaking decisions about PSA screening tests is challenging, as it requires both knowledge of the possible benefits and harms of screening and an individual assessment of the patient's values. Our research explores how much and what information men perceive to be necessary with regard to screening for prostate cancer.ObjectiveTo explore men's information and associated needs for decision making in PSA testing.DesignQualitative interview study.Setting and participantsWe interviewed 32 men (aged 55‐69) about their decision making on PSA screening following counselling with a Decision Aid at their GP’s or urologist's practice in Germany.Main Outcome MeasuresMen's expressed needs for decision making in PSA testing.MethodsAll interviews were transcribed verbatim and analysed by framework analysis.ResultsComprehensive pre‐screening counselling is needed. For the men in our study, information about test (in)accuracy, the benefit‐harm balance and consequences of the test were relevant and surprising. Additional needs were for interpretation support, a take‐home summary and time for deliberation. For several men, their physician's attitude was of interest. After being well‐informed, most men felt empowered to make a preference‐based decision on their own.DiscussionMen were surprised by what they learned, especially regarding the accuracy and possible harms of screening. There is large variation in the breadth and depth of information needed, and some controversy regarding the consequences of testing.Conclusion and patient contributionA core set of information should be offered before men make their first PSA screening decision. Information about biopsy and associated side‐effects could follow in a short form, with details only on request. Knowledge about a high rate of false‐positive test results beforehand might help men handle a suspicious test result.
Direct and size‐mediated effects of temperature and ration‐dependent growth rates on energy reserves in juvenile anadromous alewives (Alosa pseudoharengus)
Authors: Guo Lian W. , McCormick Stephen D. , Schultz Eric T. , Jordaan Adrian 
Published: June 2021

ABSTRACTGrowth rate and energy reserves are important determinants of fitness and are governed by endogenous and exogenous factors. Thus, examining the influence of individual and multiple stressors on growth and energy reserves can help estimate population health under current and future conditions. In young anadromous fishes, freshwater habitat quality determines physiological state and fitness of juveniles emigrating to marine habitats. In this study, the authors tested how temperature and food availability affect survival, growth and energy reserves in juvenile anadromous alewives (Alosa pseudoharengus), a forage fish distributed along the eastern North American continent. Field‐collected juvenile anadromousA. pseudoharenguswere exposed for 21 days to one of two temperatures (21°C and 25°C) and one of two levels of food rations (1% or 2% tank biomass daily) and compared for differences in final size, fat mass‐at‐length, lean mass‐at‐length and energy density. Increased temperature and reduced ration both led to lower growth rates, and the effect of reduced ration was greater at higher temperature. Fat mass‐at‐length decreased with dry mass, and energy density increased with total length, suggesting size‐based endogenous influences on energy reserves. Lower ration also directly decreased fat mass‐at‐length, lean mass‐at‐length and energy density. Given the fitness implications of size and energy reserves, temperature and food availability should be considered important indicators of nursery habitat quality and incorporated inA. pseudoharenguslife‐history models to improve forecasting of population health under climate change.
Soil carbon balance after the temporal cessation of cultivation under cool and subtropical humid climate in Japan
Authors: Shimoda Seiji 
Published: June 2021

AbstractThe decreasing number of farm households in Japan is beginning to affect soil carbon and nitrogen balance. At both cool and warm sites, the soil C level was the lowest in the second year of the experiment, and thereafter, it gradually increased. The change in soil C concentration was negative at the warmer site; however, the content reached 119 g C m−2 at the cooler site. Soil N showed a significant increase of 14.3 g N m−2 from the first year to over 4 years at the cooler site. At the cooler site, less soil decomposition contributed to the retention of soil C and N, and the dominant deciduous woody plants increased the supplemental C and N content. Land‐use management strategies involving conventional cultivation, abandonment and abandonment to recultivation did not affect the soil C and N balance for over 6 years. Fallow tillage to recultivation was less effective in retaining the C pool in the fifth year of the experiment, causing significantly lower soil C content (1.97 kg C m−2) than abandonment to recultivation (2.20 kg C m−2). Whereas the soil C content increased in the subsequent year (i.e. the sixth year), less productivity of recultivation crop (white mustard) contributed to a significant decrease in soil C, and abundant residue of winter wheat could recover the soil C and N in the subsequent year. The results suggest that agricultural abandonment can preserve soil C in cool regions and that the introduction of winter crops can maintain the C pool.
Video‐mediated breaking bad news simulation
Authors: Rivet Emily Burke , Cholyway Renee , Edwards Cherie , Wishnoff Matthew , Raza Omar , Haynes Susan , Feldman Moshe 
Published: June 2021

AbstractBackgroundCommunication between clinicians, patients, and families is a core component of medical care that requires deliberate practice and feedback to improve. In March 2020, the COVID‐19 pandemic caused a sudden transformation in communication practices because of new physical distancing requirements, necessitating physicians to communicate bad news via telephone and video‐mediated communication (VMC). This study investigated students’ experience with a simulation‐based communications training for having difficult conversations using VMC.MethodsThirty‐eight fourth‐year medical students preparing for their surgical residency participated in a simulated scenario where students discussed a new COVID‐19 diagnosis with a standardised family member (SFM) of a sick patient via VMC. Learners were introduced to an established communications model (SPIKES) by an educational video. After the simulation, SFM and course facilitators guided a debrief and provided feedback. Learners completed surveys evaluating reactions to the training, preparedness to deliver bad news, and attitudes about telehealth.ResultsTwenty‐three students completed evaluation surveys (response rate=61%). Few students had prior formal training (17%) or experience communicating bad news using telehealth (13%). Most respondents rated the session beneficial (96%) and felt they could express empathy using the VMC format (83%). However, only 57% felt ready to deliver bad news independently after the training and 52% reported it was more difficult to communicate without physical presence. Comments highlighted the need for additional practice.ConclusionThis pilot study demonstrated the value and feasibility of teaching medical students to break bad news using VMC as well as demonstrating the need for additional training.
Bienes y servicios ambientales que ofrece la microcuenca río Tamauca en Santiago (Putumayo) como posibilitadores de desarrollo sostenible de la comunidad indígena inga.
Authors: Aristizabal López Angela Maria , Orobio Rosero Harold Javier , Vargas Marín Luis Alberto 
Published: June 2021

En este artículo se describe la concepción o imaginario que tiene la comunidad indígena inga del desarrollo sostenible y se interpretan las relaciones entre la comunidad indígena inga y los bienes y servicios ambientales que ofrece la microcuenca río Tamauca. Los datos analizados reflejan la percepción de esta comunidad sobre el desarrollo sostenible, que, desde su cosmovisión, se asocia con el poder pervivir. Esta pervivencia la encuentran en la educación, en el ámbito de sus chagras, en el cultivo de sus productos alimenticios y en fortalecer sus saberes ancestrales de la medicina tradicional, con trascendencia oral, con conocimiento directo de la naturaleza y todo lo que se considere su medio ambiente. La comunidad inga tiene un fundamento de espiritualidad de los recursos que genera su territorio, es una relación muy íntima y racional. En esta cosmología se considera que existe un continuo enlace entre la sociedad, la naturaleza y el mundo espiritual.
Secondary Impact Protection for Locomotive Engineers – Improved Airbag Design
Authors: Gordon Jeffrey , Gantoi Florentina M. , Singh Som P. , Prabhakaran Anand 
Published: June 2021

Abstract
Under the locomotive cab occupant protection research program sponsored by the Federal Railroad Administration (FRA), Sharma & Associates, Inc. (SA) developed a Secondary Impact Protection System (SIPS) for locomotive engineers. The system uses a large, automotive-style, passenger airbag in combination with a deformable knee bolster to provide the level of protection needed for the locomotive engineer, without compromising the normal operating environment and egress.
A prior version of the system [1] was prototyped and tested in a dynamic sled test with a 23g crash pulse and was shown to meet most limiting human injury criteria defined in the Department of Transportation (DOT)’s Federal Motor Vehicle Safety Standards (FMVSS 208) [2] for the head, chest, neck, and femur. The system also showed marginal performance for the chest injury index and indicated potential for an improved airbag design to fully meet all requirements.
In the current study, simulations with an optimized airbag and higher capacity inflator system showed that SIPS can provide excellent occupant protection for an unbelted locomotive occupant in a frontal crash. Sled testing of SIPS confirmed the performance, and the system successfully met all eleven (11) criteria of the FMVSS 208 standard [2].
The shape and position of the airbag module and its attachments to the desk were generally the same as those presented in previous research. The key changes that helped meet all criteria were the higher capacity inflators, knee bolster system brackets moved forward, thicker knee plate, higher volume airbag and additional vents.
UK multisite evaluation of the impact of clinical educators in EDs from a learner’s perspective
Authors: Hemavathi Muniswamy , Huynh Chi , Phillips Eloise , Aiello Matthew , Kennedy Brian , Clancy Mike , Hamer Wayne , Rutherford Graham , Khan Aanika , Terry David 
Published: June 2021

BackgroundIn England, demand for emergency care is increasing while there is also a staffing shortage. The Royal College of Emergency Medicine (RCEM) suggested that appointment of senior doctors as clinical educators (CEs) would enable support and development of learners in EDs and improve retention and well-being. This study aimed to evaluate the impact of CEs in ED on learners.MethodsCEs were placed in 54 NHS Acute Trust EDs for a pilot beginning July 2018 and ending October 2020. Learners from multiple disciplines working at 54 NHS Acute Trust EDs where CEs were deployed were invited to complete an online survey designed to identify the impact of CEs in July of 2019, as part of an interim service evaluation.ResultsRespondents numbered 493 from 49 of 54 study sites, including 286 (58%) medical (non-consultant) and 72 (14.6%) all other nursing, allied health professionals. 9 out of 10 learners reported having experienced a change to their learning as a result of the deployment of CEs in their department. 49.9% (246/493) reported that CEs had a positive impact on their well-being. 95% (340/358) reported an improved accessibility to undertaking clinical based assessments. 78% (281/358) perceived that access to CEs increased likelihood of passing assessments. Of those responding, 80.9% (399/493) reported they would remain/return to the same ED with a CE, and 92.5% (456/493) responded that they would prefer to go to a Trust with a CE.ConclusionsAccording to survey respondents, deployment of CEs across NHS Trusts has resulted in improvement and increased accessibility of learning and assessment opportunities for learners within ED. The impact of CEs on well-being is uncertain with half reporting improvement and the remaining half unsure. Further evaluation within the project will continue to explore the service benefit and workforce impact of the CEED intervention.
Underutilisation of no-tobacco-sale orders against retailers that repeatedly sell to minors, 2015–2019, USA
Authors: Hemmerich Natalie , Jenson Desmond , Bowrey Brice L , Lee Joseph G L 
Published: June 2021

ImportanceResearch demonstrates that policies aimed at retailers who sell to minors must be strongly enforced to have an impact on youth usage rates.ObjectivesIn the USA, the Food and Drug Administration (FDA) conducts compliance checks, issues fines, and can order retailers to stop selling tobacco products (ie, no-tobacco-sale orders (NTSOs)) to enforce the Family Smoking Prevention and Tobacco Control Act. We sought to assess FDA’s utilisation of NTSOs.MethodsWe conducted a quantitative content analysis of FDA’s enforcement actions for inspections decided between 1 October 2015 and 29 March 2019. From the 536 134 inspection records we identified 148 NTSOs and 249 720 unique retailer locations, of which 2095 had three or more violations. We randomly sampled NTSOs (n=76) and retail locations (n=152) with frequent violations. We calculated the proportion of NTSOs that could have been issued earlier by FDA. We then calculated the proportion of retailers that could have been issued an NTSO, and the proportion actually issued an NTSO using FDA’s approach and a more stringent approach.ResultsAmong NTSOs, 94.7% (95% CI: 89.8% to 97.4%) of NTSOs could have been issued earlier under a more stringent approach. On average, when an NTSO could have been issued earlier, it could have been issued 453 days earlier (95% CI: 418 to 489; range: 89–1159). Among frequently violating retail locations, 73.6% (95% CI: 66.0% to 80.0%) were eligible for an NTSO. Of those, 1.9% (95% CI: 0.5% to 7.0%) had received an NTSO.ConclusionsThe FDA’s failure to fully leverage its powers to address retailers’ underage sales of tobacco products has weakened efforts to curb the youth e-cigarette epidemic.
The Three Conditions: Solving Complex Problems through Self-Governing Agreements
Authors: Franke Volker C. , Wolterstorff Eric , Wehlan Cody W. 
Published: June 2021

Abstract
Grounded in peacebuilding and negotiation literature, we propose a Three Conditions Model that promotes collaborative engagement and can help advance sustainable solutions to complex problems – domestic and international – through self-governing agreements based on the following three conditions: (1) inclusion of, (2) common understanding among, and (3) trust between all prime actors. Collectively, these conditions make the management of complex problems, and of the conflicts arising from them, more effective and sustainable. Using the coronavirus pandemic as an example, we briefly illustrate the nature of complex problems and self-governing agreements, address the inclusion-trust dilemma that mars many negotiations and assess the utility of each condition to address the coronavirus response in the United States more effectively.
The Failure of the International Community to Apply R2P and Atrocity Prevention in Myanmar
Authors: Mennecke Martin , Stensrud Ellen E. 
Published: June 2021

Abstract
The case of Myanmar has become one of the most glaring examples for the failure of the international community to realise the promise made with the adoption of the responsibility to protect (R2P) norm in 2005: ‘Never again’ has turned into again and again. A mix of unwillingness and inability to prevent atrocity crimes has in Myanmar over the past ten years led to several instances of atrocity crimes and genocidal violence against the Rohingya. Most recently, the military coup of February 2021 has showcased that the notion of an international community exercising a responsibility to protect the population of Myanmar against crimes against humanity and other atrocity crimes dissembles into a few states openly shielding the perpetrators, a few condemning and countering the newest cycle of violence, and many silent bystanders to the ongoing atrocities. This article discusses the role of the R2P norm in the case of Myanmar and introduces the different contributions that comprise the special issue on Myanmar and the failure of R2P.
The osce’s Special Monitoring Mission to Ukraine
Authors: Härtel André , Pisarenko Anton , Umland Andreas 
Published: June 2021

Abstract
The paper provides an analysis of the Organization of Security and Cooperation in Europe’s (OSCE) Special Monitoring Mission (SMM) to Ukraine within the multilateral attempt to manage or resolve the conflict in the Donets’ Basin (Donbas). It aims to tentatively assess the SMM’s influence on the de-escalation of the conflict during the Presidency of Petro Poroshenko, as a relatively closed political period. We explore the Mission’s mandate, various evaluations of its operations and effectiveness, as well as the conflict participants’ interaction with the Mission. The nature and dimension of the conflict have posed an, in its dimension, novel, yet, in its nature, not untypical challenge to the consensus-based OSCE. Despite the challenges of the Mission’s specific scope and the limits placed on it by both Russian sabotage and a lack of resources, the SMM nevertheless managed, in 2014-2019, to contribute to de-escalation in the Donbas. Determinants of the net positive contribution of the SMM include its continued and large presence on the spot, the improvement of its reports on the situation in the conflict zone, as well as the development of more sophisticated monitoring methodologies and technologies over time.
The European Court of Human Rights and (Framework Convention on) Tobacco Control
Authors: Tsampi Aikaterini 
Published: June 2021

Abstract
Unlike the current covid-19 pandemic, the tobacco pandemic has not been adequately assessed through a human rights law perspective, despite the fact that it raises compelling global health concerns. The ECtHR, in particular, holds a lot of potential for the promotion of the human rights-based fight against tobacco, which can be further tapped. It is for this that this article argues, on the basis of the systematisation and critical appraisal of the case law of the ECtHR on tobacco through the lens of the standards set by the who Framework Convention on Tobacco Control.
The Efficiency of Upward Wave Propagation near the Tropopause: Importance of the Form of the Refractive Index
Authors: Weinberger Israel , Garfinkel Chaim I. , White Ian P. , Birner Thomas 
Published: June 2021

AbstractThe connection between the polar stratospheric vortex and the vertical component of the Eliassen–Palm flux in the lower stratosphere and upper troposphere is examined in model level data from ERA5. The particular focus of this work is on the conditions that lead to upward wave propagation between the tropopause and the bottom of the vortex near 100 hPa. The ability of four different versions of the index of refraction to capture this wave propagation is evaluated. The original Charney and Drazin index of refraction includes terms ignored by Matsuno that are shown to be critical for understanding upward wave propagation just above the tropopause both in the climatology and during extreme heat flux events. By adding these terms to the Matsuno index of refraction, it is possible to construct a useful tool that describes wave flux immediately above the tropopause and at the same time also describes the role of meridional variations within the stratosphere. It is shown that a stronger tropopause inversion layer tends to restrict upward wave propagation. It is also shown that while only 38% of extreme wave-1 Eliassen–Palm flux vertical component (Fz) at 100 hPa events are preceded by extreme Fz at 300 hPa, there are almost no extreme events at 100 hPa in which the anomaly at 300 hPa is of opposite sign or very weak. Overall, wave propagation near the tropopause is sensitive to vertical gradients in buoyancy frequency, and these vertical gradients may not be accurately captured in models or reanalysis products with lower vertical resolutions.
Macular perfusion density evaluation in constant and intermittent exotropia by means of optical coherence tomography angiography
Authors: Zhai Jing , Fang Wei , Yu Xueting , Ye Xinjie , Hou Lijie 
Published: June 2021

Abstract
Background
To quantify and compare retinal microvascular features using optical coherence tomography angiography (OCTA) in constant (XT) and intermittent exotropia (IXT).

Methods
An observational cross-sectional study was conducted from September 2020 to November 2020 at the Affiliated Eye Hospital of Wenzhou Medical University. OCTA examination was performed to evaluate the macular perfusion density of the deep capillary plexus (DCP), superficial capillary plexus (SCP), and foveal avascular zone (FAZ) parameters in XT and IXT patients, and in age-matched controls. The study parameters were analyzed.

Results
A total of 76 participants, including 16 (21%) XT patients, 24 (32%) IXT patients, and 36 (47%) controls, were recruited. The exodeviation angle was 39.06 ± 10.38 prism degrees (PD) at near and 43.00 ± 9.74 PD at distance in the XT group, and 27.13 ± 18.28 PD at near and 31.04 ± 18.82 PD at distance in the IXT group. The macular perfusion density of the DCP in 6 × 6-mm scans and the SCP in 3 × 3-mm scans were lower in the deviating eyes than in the fixating eyes of XT patients (p < 0.001, p = 0.032, respectively). The macular perfusion density of the DCP in the deviating eyes of XT and IXT patients was significantly lower than that of the controls. There was no significant difference in the FAZ parameters among the groups.

Conclusions
In XT patients, OCTA revealed lower macular perfusion density in deviating eyes than in fixating eyes and control eyes. IXT patients showed no difference between the two eyes, but the macular perfusion density of the DCP was lower than that of the controls.