bluuebunny/crossref_metadata_2025_split huggingface dataset:
NCA-LDAS: Overview and Analysis of Hydrologic Trends for the National Climate Assessment
Authors: Jasinski Michael F. , Borak Jordan S. , Kumar Sujay V. , Mocko David M. , Peters-Lidard Christa D. , Rodell Matthew , Rui Hualan , Beaudoing Hiroko K. , Vollmer Bruce E. , Arsenault Kristi R. , Li Bailing , Bolten John D. , Tangdamrongsub Natthachet 
Published: June 2019

Abstract
Terrestrial hydrologic trends over the conterminous United States are estimated for 1980–2015 using the National Climate Assessment Land Data Assimilation System (NCA-LDAS) reanalysis. NCA-LDAS employs the uncoupled Noah version 3.3 land surface model at 0.125° × 0.125° forced with NLDAS-2 meteorology, rescaled Climate Prediction Center precipitation, and assimilated satellite-based soil moisture, snow depth, and irrigation products. Mean annual trends are reported using the nonparametric Mann–Kendall test at p &lt; 0.1 significance. Results illustrate the interrelationship between regional gradients in forcing trends and trends in other land energy and water stores and fluxes. Mean precipitation trends range from +3 to +9 mm yr−1 in the upper Great Plains and Northeast to −1 to −9 mm yr−1 in the West and South, net radiation flux trends range from +0.05 to +0.20 W m−2 yr−1 in the East to −0.05 to −0.20 W m−2 yr−1 in the West, and U.S.-wide temperature trends average about +0.03 K yr−1. Trends in soil moisture, snow cover, latent and sensible heat fluxes, and runoff are consistent with forcings, contributing to increasing evaporative fraction trends from west to east. Evaluation of NCA-LDAS trends compared to independent data indicates mixed results. The RMSE of U.S.-wide trends in number of snow cover days improved from 3.13 to 2.89 days yr−1 while trend detection increased 11%. Trends in latent heat flux were hardly affected, with RMSE decreasing only from 0.17 to 0.16 W m−2 yr−1, while trend detection increased 2%. NCA-LDAS runoff trends degraded significantly from 2.6 to 16.1 mm yr−1 while trend detection was unaffected. Analysis also indicated that NCA-LDAS exhibits relatively more skill in low precipitation station density areas, suggesting there are limits to the effectiveness of satellite data assimilation in densely gauged regions. Overall, NCA-LDAS demonstrates capability for quantifying physically consistent, U.S. hydrologic climate trends over the satellite era.
Uncertainty of Reference Pixel Soil Moisture Averages Sampled at SMAP Core Validation Sites
Authors: Chen Fan , Crow Wade T. , Cosh Michael H. , Colliander Andreas , Asanuma Jun , Berg Aaron , Bosch David D. , Caldwell Todd G. , Collins Chandra Holifield , Jensen Karsten Høgh , Martínez-Fernández Jose , McNairn Heather , Starks Patrick J. , Su Zhongbo , Walker Jeffrey P. 
Published: June 2019

Abstract
Despite extensive efforts to maximize ground coverage and improve upscaling functions within core validation sites (CVS) of the NASA Soil Moisture Active Passive (SMAP) mission, spatial averages of point-scale soil moisture observations often fail to accurately capture the true average of the reference pixels. Therefore, some level of pixel-scale sampling error from in situ observations must be considered during the validation of SMAP soil moisture retrievals. Here, uncertainties in the SMAP core site average soil moisture (CSASM) due to spatial sampling errors are examined and their impact on CSASM-based SMAP calibration and validation metrics is discussed. The estimated uncertainty (due to spatial sampling limitations) of mean CSASM over time is found to be large, translating into relatively large sampling uncertainty levels for SMAP retrieval bias when calculated against CSASM. As a result, CSASM-based SMAP bias estimates are statistically insignificant at nearly all SMAP CVS. In addition, observations from temporary networks suggest that these (already large) bias uncertainties may be underestimated due to undersampled spatial variability. The unbiased root-mean-square error (ubRMSE) of CSASM is estimated via two approaches: classical sampling theory and triple collocation, both of which suggest that CSASM ubRMSE is generally within the range of 0.01–0.02 m3 m−3. Although limitations in both methods likely lead to underestimation of ubRMSE, the results suggest that CSASM captures the temporal dynamics of the footprint-scale soil moisture relatively well and is thus a reliable reference for SMAP ubRMSE calculations. Therefore, spatial sampling errors are revealed to have very different impacts on efforts to estimate SMAP bias and ubRMSE metrics using CVS data.
The Sydney Lindt café siege: The role of the consultant psychiatrist
Authors: Scott Russ 
Published: June 2019

Background:In December 2014, after a 16-hour siege of the Lindt café in Sydney, Iranian-born gunman Man Haron Monis shot dead a hostage precipitating the police action which broke the siege.Objective:This paper reviews the demographic and other factual details of Monis as documented by the NSW Coroner’s Inquest and critically analyses the published findings of the Coroner particularly in relation to the role of the psychiatrist who advised senior police and negotiators during the siege.Results:At the time of the siege, there was no formal protocol that delineated the role of a psychiatrist in hostage negotiations. Despite the psychiatrist’s credentials including his extensive experience with siege-hostage incidents and his counter-terrorist training, the Coroner was unfairly critical of the psychiatrist.Conclusion:The Coroner’s censure of the psychiatrist was clearly prejudiced by hindsight bias. During the siege, the psychiatrist properly considered and evaluated all the available intelligence and other information known about the gunman. As the psychiatrist advised, Monis was a narcissist and the siege was not an Islamic State-inspired terrorist attack. Given that he announced he was armed with a bomb, Monis represented a ‘ credible threat’ to the hostages. The psychiatrist’s endorsement of the police strategy to ‘ contain and negotiate’ was prudent in the circumstances. The Coroner’s disparagement of the senior psychiatrist may have the unintended consequence that psychiatrists may be reluctant to assist in hostage-sieges or other critical incidents.
Impact of a workplace holiday weight gain prevention program
Authors: Wilson Mark G , Padilla Heather M , Meng Lu , Daniel Carmen N 
Published: June 2019

Background: The average worker gains 2–3 lb (0.9–1.4 kg) a year, about half of which is gained during the fall holiday season (Halloween through New Year’s). Aim: The aim of the study was to conduct a pilot test of a weight gain prevention program that was implemented in a workplace setting during the fall holiday season. Methods: 239 state government employees participated in a weight gain prevention program offered during the fall holiday season. The program was a 10-week, team-based program that consisted of self-monitoring, regular weigh-ins, a team challenge, and organizational support. Weight was measured at baseline, every two weeks during the program, and post-program. Results: Participants lost a significant amount of weight (from 196.7 lb/89.2 kg to 192.3 lb/87.2 kg) during the program. Positive changes were observed in physical activity and eating behaviors. Conclusions: This study demonstrated that a weight gain prevention program during a high risk period (fall holiday season) can be effective.
High Risk of Tunnel Convergence in Combined Anterior Cruciate Ligament Reconstruction and Lateral Extra-articular Tenodesis
Authors: Jaecker Vera , Ibe Philip , Endler Christoph H. , Pfeiffer Thomas R. , Herbort Mirco , Shafizadeh Sven 
Published: June 2019

Background:Lateral extra-articular tenodesis (LET) is being increasingly added to primary and revision anterior cruciate ligament (ACL) reconstruction to address residual anterolateral rotatory instability. However, currently there is a lack of knowledge on how close the femoral tunnels are when combining these procedures.Purpose/Hypotheses:To assess the risk of tunnel convergence in combined ACL and LET procedures using 2 different surgical techniques (Lemaire and MacIntosh). It was hypothesized that the risk of tunnel convergence would be greater when using the more distally located Lemaire position. The authors further hypothesized that tunnel proximity would be influenced by knee size.Study Design:Controlled laboratory study.Methods:Ten fresh-frozen cadaveric knees were used for this study. In each specimen, an anatomic ACL femoral tunnel and 2 LET tunnels were drilled using the Lemaire and MacIntosh positions, respectively. After knee dissection, minimal distances between each ACL and LET tunnel were directly measured on the lateral femoral cortex. Furthermore, computed tomography scans were obtained to measure intertunnel convergence and lateral femoral condyle (LFC) width. On the basis of the average LFC width, knees were divided into large and small knees to determine a relationship between knee size and tunnel convergence.Results:Convergence of ACL and LET tunnels occurred in 7 of 10 cases (70%) using the Lemaire attachment position. All tunnel collisions occurred directly on the lateral femoral cortex, while intertunnel (intramedullary) conflicts were not observed. Collisions emerged in both small (n = 4) and large (n = 3) knees. Critical tunnel convergence did not occur using the MacIntosh position. The mean minimal distance between the LET and ACL tunnel using the Lemaire and MacIntosh positions was 3.1 ± 4.6 mm and 9.8 ± 5.4 mm, respectively.Conclusion:Tunnel convergence was more frequently observed in combined ACL and LET reconstruction using the Lemaire technique, independent of the knee size. LET femoral tunnel positioning according to the MacIntosh reconstruction was not associated with tunnel collision.Clinical Relevance:These findings help to raise the awareness for the risk of tunnel convergence in combined ACL and LET procedures. Surgeons may contemplate adjustments on the ACL femoral tunnel drilling technique or fixation device when applying an additional Lemaire procedure. However, in the absence of clinical outcome studies comparing different LET techniques, it remains unclear which technique is superior in a clinical setting.
Sex Differences in Clinical and Functional Outcomes among Patients Treated in an Early Intervention Service for Psychotic Disorders: An Observational Study
Authors: Dama Manish , Veru Franz , Schmitz Norbert , Shah Jai , Iyer Srividya , Joober Ridha , Malla Ashok 
Published: June 2019

Objective: It has been shown that men with a longstanding psychotic disorder have worse clinical and functional outcomes than women. Our objectives were to examine whether these sex differences are also present among patients treated in an early intervention service (EIS) for psychosis and to determine if these differences are related to risk factors other than sex. Method: Patients ( N = 569) were assessed for demographic/clinical characteristics at entry and for symptoms/functioning over 2 years of treatment. Clinical outcomes included remission of positive, negative, and total symptoms. Functional outcomes included good functioning and functional remission. Logistic regression models examined the relationship between sex and outcomes after 1 and 2 years of treatment while controlling for the influence of other risk factors. Results: Men reported to be less educated and have a longer duration of untreated psychosis, poorer childhood and early adolescent premorbid functioning, higher rates of substance abuse/dependence disorders, greater severity of baseline negative symptoms, and poorer baseline social/occupational functioning than women. Women were more likely to achieve symptom remission than men after 2 years of treatment (negative odds ratio [OR], 1.69; 95% confidence interval [CI], 1.02 to 2.78; total OR, 1.79; 95% CI, 1.08 to 2.98). Women were also more likely than men to exhibit good functioning (OR, 1.61; 95% CI, 1.04 to 2.49) after 1 but not after 2 years of treatment. These results did not persist after controlling for other risk factors that could confound these associations (i.e., childhood premorbid functioning and age at onset of psychosis). Conclusions: Sex differences seen in outcomes among patients treated in an EIS for psychosis may be largely influenced by the disparity of other risk factors that exist between the 2 sexes.
Deactivating a Pacemaker in Home Care Hospice: Experiences of the Family Caregivers of a Terminally Ill Patient
Authors: Kutcher Gregory R. , Soroka Jacek T. 
Published: June 2019

Objectives: Although the experiences of family members who care for relatives at the end of life have been researched extensively, little is known about the needs and experiences of families caring for hospice patients with pacemakers. Aim: To better understand the experiences of family caregivers of a terminally ill patient who received hospice care at home and chose deactivation of a pacemaker. Design: The exploratory, cross-sectional design involved semistructured, in-depth interviews. A narrative analysis focusing on form and content was chosen to analyze the data. Participants: Five bereaved caregivers from the Midwestern United States who provided care and participated in the deactivation of their family member’s pacemaker. Results: Four storylines that described, gave meaning to, and contextualized the caregivers’ experiences were identified: “I am done. I am not doing it anymore”; “Whatever you decide, I’ll support you”; “It is really difficult to watch, but you want to be there”; and “I will not have part of this.” Caregivers struggled with lack of support, understanding, and acceptance from medical providers when their family member decided to have her pacemaker deactivated, and they believed that the hospice model of care was appropriate to support and help them in that process. Conclusions: This research aids in understanding the ramifications of family-provided end-of-life care to a patient whose pacemaker has been deactivated. This can help to increase hospice clinicians’ knowledge regarding caregivers’ experiences facing deactivation of a pacemaker, before and after the patient’s death.
Incidence and Risk Factors for Pin Site Infection of Exposed Kirschner Wires Following Elective Forefoot Surgery
Authors: McKenzie James C. , Rogero Ryan G. , Khawam Sultan , McDonald Elizabeth L. , Nicholson Kristen , Shakked Rachel J. , Fuchs Daniel , Raikin Steven M. 
Published: June 2019

Background: Kirschner wires (K-wires) are commonly utilized for temporary metatarsal and phalangeal fixation following forefoot procedures. K-wires can remain in place for up to 6 weeks postoperatively and are at risk for complications. This study investigated the incidence of infectious complications of exposed K-wires after forefoot surgery and identifies risk factors for these complications. Methods: A single-surgeon retrospective chart review of forefoot surgeries from 2007 to 2017 was undertaken. Inclusion criteria were adult patients (≥18 years) undergoing elective forefoot surgery with the use of exposed K-wires. Incidence of pin site infectious complication, defined as cellulitis, or pin site drainage and/or migration/loosening of the pin was noted. Patient demographic and perioperative data were analyzed, along with the number of K-wires placed per procedure. Mann-Whitney U and chi-square tests were performed to determine predictive factors related to pin site infection rates, with a multivariable model with significant factors subsequently performed. Two-thousand seventeen K-wires in 1237 patients were analyzed. Results: There were 35 pin site infections for a rate of 1.74%. Combined forefoot procedures (507 pins in 229 patients) had a pin site infection rate of 4.93% (N = 25), followed by lesser metatarsal osteotomies (667 pins in 446 patients) at 1.05% (N = 7), then hammertoe corrections (694 pins in 421 patients) at 0.43% (N = 3), and no pin site infections with chevron osteotomies (149 pins in 141 patients). Male sex, body mass index (BMI), current smoker, and number of pins were significant risk factors ( P ≤ .05). Additionally, there were 23 non–infection-related K-wire complications. No long-term sequelae were encountered based on any complications. Conclusion: K-wires are commonly used for temporary immobilization of the smaller bones of the forefoot following deformity correction. Male sex, BMI, current smoker, and number of pins were significant risk factors for pin site infection, with a higher rate of infection with 2 or more pins placed. Level of Evidence: Level IV, case series.
Considerations of Conservative Treatment After a Partial Ulnar Collateral Ligament Injury in Overhead Athletes: A Systematic Review
Authors: Cascia Nicole , Picha Kelsey , Hettrich Carolyn M. , Uhl Tim L. 
Published: June 2019

Context: Ulnar collateral ligament (UCL) reconstructions continue to increase without consensus on an evidence-based treatment protocol for nonoperative management. Currently, there is no consensus on an effective nonoperative protocol for partial UCL injuries that uses return-to-play (RTP) rates in determining the outcome of conservative treatment. Objective: To systematically review RTP rates after conservative treatment of partial UCL injuries in overhead athletes along with descriptive components of each conservative intervention to identify an effective evidence-based nonoperative rehabilitation protocol. Data Sources: Articles in PubMed, CINAHL, MEDLINE, Academic Search Complete, and SPORTDiscus were identified in October 2018 based on the following terms: overhead athlete, ulnar collateral ligament, nonoperative treatment, and return to play. Study Selection: Seven retrospective, level 4 studies (n = 196) qualified for analysis. Study Design: Systematic review. Level of Evidence: Level 4. Data Extraction: Study design, level of evidence, demographics, sample size, sports involved, level of competition, grade or type of UCL diagnosis, conservative treatment components, and percentage RTP were extracted. Results: Overall, RTP rates after conservative treatment ranged between 42% and 100% (mean, 78% ± 20%). The most frequently reported components of rehabilitation protocols were (1) a period of rest, (2) stretching, (3) strengthening, and (4) a throwing program. Platelet-rich plasma injections were included in 5 (71%) of the 7 protocols with a rehabilitation period. Conclusion: Conservative treatment is a viable option for partial UCL tears in overhead athletes. A successful rehabilitation protocol includes the use of patient-reported outcomes, a sport-specific tailored treatment plan, kinetic chain strengthening, and an interval throwing program. Factors such as age, grading of tear, level of play, sport, and athlete’s perceived well-being should all be considered during treatment decisions.
Variability in the clinical management of iron deficiency anaemia in older adults: results from a survey of UK specialists in the care of older people
Authors: Donaldson Alison I.C. , Soiza Roy L. , Hands Katherine J. , Witham Miles D. , Myint Phyo K. 
Published: June 2019

Background: Iron deficiency anaemia in older adults is common, but its management presents unique challenges in diagnosis and management. Little is known about compliance with current best practice guidelines. Methods: We undertook an online survey of physician members of the British Geriatrics Society to ascertain how they managed older patients with potential iron deficiency anaemia. Results: There were 141 respondents (96% from UK). Almost a third indicated they would accept haemoglobin levels <100 g/dl without further investigation. A quarter said they would only occasionally or never check ferritin levels. Only 30% would sometimes or always use parenteral iron when oral supplements were not tolerated. Conclusions: Responses suggest a high level of variation in clinical practice and low adherence to best practice guidelines. Possible explanations include an inadequate evidence base to guide management and a lack of knowledge on the challenges of managing iron deficiency anaemia in this population.
Emirati women’s attitudes towards menopause: Implications for health care policy
Authors: Smail Linda , Jassim Ghufran A , Al-Shboul Qasim M , Hattawi Afaaf Saeed 
Published: June 2019

Objectives To investigate the attitudes of Emirati women aged 30–64 years towards menopause and determine the relationships between these attitudes and their sociodemographic and reproductive characteristics. Study design A community-based cross-sectional study was conducted with 497 Emirati women attending five primary health care centres in Dubai using a multistage stratified and clustered random sampling technique. Emirati women were interviewed face-to-face via a structured questionnaire with two parts: sociodemographic and reproductive characteristics and the attitudes towards menopause scale. Results The mean ± S.D. of age was 42.06 years ± 8.716 (median 40 years). Mean age at menopause for the study sample (N = 436) was 49.94 years ± 4.593 (median 50 years). Of the respondents, 36.6% had completed high school, and 41.4% had graduated from university. Approximately, 70.8% of the women were premenopausal, 13.1% were perimenopausal and 16.1% were postmenopausal. Sixty-four percent of the respondents had never used oral contraceptive pills, while 32.9% were past users; 44.6% were employed outside the home. Mean average attitudes score ± S.D. was 2.42 ± 0.26 (minimum score of 1 indicates very negative attitudes, maximum score of 4 indicates very positive attitudes). Statistically significant differences in mean average attitudes score were noted for employment and menopausal status, and mean average attitudes score was positively correlated with age. Premenopausal women held more positive attitudes towards menopause than peri- and postmenopausal women. Conclusions Emirati women displayed neutral to positive attitudes towards menopause and premenopausal women exhibited more negative attitudes towards menopause than postmenopausal women.
Research Inefficiency in Degenerative Cervical Myelopathy: Findings of a Systematic Review on Research Activity Over the Past 20 Years
Authors: Mowforth Oliver D. , Davies Benjamin M. , Goh Samuel , O’Neill Cormac P. , Kotter Mark R. N. 
Published: June 2019

Study Design: Scoping review. Objective: To describe activity, themes and trends in degenerative cervical myelopathy (DCM) research over the past 20 years with a view to considering DCM research inefficiency. Methods: A systematic review of MEDLINE and Embase for “Cervical” AND ”Myelopathy” was conducted following PRISMA guidelines. Full-text papers in English, exclusively studying DCM, published between January 1, 1995 and December 31, 2015 were considered eligible. Country of origin, number of papers published, number of patients studied, research theme, and year of publication were assessed. Comparison was made between developed and developing countries. Results: A total of 1485 papers and 4 117 051 patients were included. Japan published more papers (450) than any other country while the United States studied the greatest number of patients (3 674 737). Over 99.4% of papers and 78.6% of patients were from developed countries. The number of papers ( r = 0.96, P < .001) and patients ( r = 0.83 P < .001) studied each year increased significantly overall and for both developed ( r = 0.93, P < .001; r = 0.81, P < .001) and developing countries ( r = 0.90, P < .001; r = 0.87, P < .001). Surgery was the most prevalent theme (58.3% papers; 55.7% patients) for developed and developing countries. Research from developing countries showed greater thematic variability. Conclusions: DCM research activity is increasing internationally, with surgery remaining the focus. Research output has predominantly been from developed countries; however, the rate of growth for developed and developing countries is comparable.