bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Hybrid Stochastically Perturbed Parametrization Scheme in a Convection-Permitting Ensemble
Authors: Wastl Clemens , Wang Yong , Atencia Aitor , Wittmann Christoph 
Published: April 2019

AbstractModel error in ensemble prediction systems is often represented by either a tendency perturbation approach or a process-based parameter perturbation scheme. In this paper a novel hybrid stochastically perturbed parameterization (HSPP) scheme is proposed and implemented in the Convection Permitting Limited Area Ensemble Forecasting (C-LAEF) system developed at the Zentralanstalt für Meteorologie und Geodynamik (ZAMG). In HSPP, the individual parameterization tendencies of the physical processes radiation, shallow convection, and microphysics are perturbed stochastically by a spatially and temporally varying pattern. Uncertainties in the turbulence scheme are considered by perturbing key parameters on the process level. The proposed scheme HSPP features several advantages compared to the popular stochastically perturbed parameterization tendencies (SPPT) scheme: it considers a more physically consistent relationship between different parameterization schemes, deals with uncertainties especially adapted to the individual physical processes, respects conservation laws of energy and moisture, and eliminates the tapering function that has to be introduced to the SPPT scheme because of mainly numerical reasons. The hybrid scheme HSPP is evaluated over one summer and one winter month and compared to a reference ensemble without any stochastic physics perturbations and to two versions of the SPPT scheme. The results show that HSPP significantly increases the ensemble spread of temperature, humidity, wind speed, and pressure, especially in the lower levels of the atmosphere where a tapering function is active in the original SPPT approach. Precipitation verification yields a generally improved probabilistic performance of the HSPP scheme in summer when convection is dominating, which has also been demonstrated in a case study.
Changes of iron metabolism during pregnancy and the establishment of reference intervals for pregnant Chinese women
Authors: Yang Yuanqing , Wang Rong , Jiang Hongmin , Hu Min , Tang Aiguo , Xiang Zhongyuan 
Published: April 2019

Background Abnormalities of iron metabolism in pregnancy pose risks for maternal and fetal health. Robust reference intervals for iron metabolism indices have not been established in a pregnant Chinese population. The purpose of this study was to derive reference intervals for indices of iron metabolism during pregnancy in a Chinese population. Methods A total of 360 healthy pregnant women were recruited and divided into three groups of 120 by gestational age: first trimester (1–13 weeks), second trimester (14–27 weeks) and third trimester (≥28 weeks). An additional 120 healthy non-pregnant women were recruited as the non-pregnant control group. Serum ferritin was measured by electrochemiluminescence immunoassay. Serum iron and total iron-binding capacity were measured by a direct bathophenanthroline method. Transferrin saturation value was calculated with formula TS = SI/TIBC. The reference intervals were established using a non-parametric method. Results In first and second trimesters (combined), the reference intervals for serum ferritin, serum iron, total iron-binding capacity and transferrin saturation are 14.7–184.3 mg/L, 14.50–33.45 µmol/L, 36.53–68.81 µmol/L and 19.04–64.76%, respectively. In the third trimester, the reference intervals for serum ferritin, serum iron, total iron-binding capacity and transferrin saturation are 7.2–122.2 mg/L, 5.83–21.52 µmol/L, 49.40–122.76 µmol/L and 8.22–52.75%, respectively. Conclusion The reference intervals for iron metabolism indices for healthy pregnant Chinese women were established in accordance with CLSI C28-A3 guidelines. This will be a valuable tool for clinical practice and research.
Mental health issues among indigenous communities and the role of traditional medicine
Authors: Cianconi Paolo , Lesmana Cokorda Bagus Jaya , Ventriglio Antonio , Janiri Luigi 
Published: April 2019

Introduction: Mental health in indigenous communities is a relevant issue for the World Health Organization (WHO). These communities are supposed to live in a pure, clean and intact environment. Their real condition is far different from the imaginary; they are vulnerable populations living in difficult areas, exposed to pollution, located far from the health services, exposed to several market operations conducted to extract natural resources, facing criminal groups or illegal exploitation of land resources. These factors may have an impact on mental health of indigenous population. Methods: We reviewed all papers available on PubMed, EMBASE and The Cochrane Library until December 2018. We focused on those factors affecting the changes from a traditional to a post-modern society and reviewed data available on stress-related issues, mental distress affecting indigenous/aboriginal communities and the role of Traditional Medicine (TM). We reviewed articles from different countries hosting indigenous communities. Results: The incidence of mental distress and related phenomena (e.g. collective suicide, alcoholism and violence) among indigenous populations is affected by political and socio-economic variables. The mental health of these populations is poorly studied and described even if mental illness indicators are somewhat alarming. TM still seems to have a role in supporting affected people and may reduce deficiencies due to poor access to medical insurance/coverage, psychiatry and psychotherapy. It would be helpful to combine TM and modern medicine in a healthcare model to face indigenous populations’ health needs. Conclusion: This review confirms the impact of societal changes, environmental threats and exploitation of natural resources on the mental health of indigenous populations. Global Mental Health needs to deal with the health needs of indigenous populations as well as psychiatry needs to develop new categories to describe psychopathology related to social variance as recently proposed by the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5).
Otolaryngology Resident Well-Being and Perceptions of the Clinical Learning Environment
Authors: Dodson Kelley M. , Appelbaum Nital P. , Lee Nathaniel , Amendola Michael , Kaplan Brian 
Published: April 2019

Objective: To measure the current state of organizational and well-being factors in otolaryngology residency programs and associate these perceptions with demographics, pursuit of subspecialty fellowships, and performance on the Otolaryngology Training Examination (OTE). Materials and Methods: Anonymous mail and online survey study of otolaryngology residents from the Southern, Mid-Atlantic, and East South-Central Regions of the United States. Summary of Results: A total of 46 otolaryngology residents across 14 residency training programs (22% resident response rate) completed our survey. Residents who scored above the 80th percentile on the OTE perceived greater organizational support (median = 3.84) than residents who scored below the 40th percentile (median = 3.31), U = 48.00, P = .047, η2 = 0.14. Residents interested in fellowship reported less burnout (median = 2.44) compared to those who did not plan to pursue fellowship (median = 3.56), U = 105.00, P = .010, η2 = 0.05. Residents pursuing fellowship also reported less work–life strain (median = 2.56) than those forgoing fellowship (median = 2.89), U = 126.00, P = .044, η2 = 0.10. Residents with children reported greater work–life strain (median = 3.11) compared to those without (median = 2.56), U = 60.50, P = .008, η2 = 0.15. Conclusion: For otolaryngology residents in this survey sample, the perception of organizational support and well-being may influence resident performance (on OTE examinations) and ultimate career goals (fellowship applications). Program directors and coordinators can use this information to strengthen the perceptions of organizational support as well as improve the clinical learning environment to optimize training conditions for their residents. Residency program directors can also use the identified study measures to assess resident perceptions of the clinical learning environment and well-being for annual evaluation and improvement purposes.
Action observation therapy for improving arm function, walking ability, and daily activity performance after stroke: a systematic review and meta-analysis
Authors: Peng Tzu-Hsuan , Zhu Jun-Ding , Chen Chih-Chi , Tai Ruei-Yi , Lee Chia-Yi , Hsieh Yu-Wei 
Published: April 2019

Objective: This study was to investigate the effectiveness of action observation therapy on arm and hand motor function, walking ability, gait performance, and activities of daily living in stroke patients. Design: Systematic review and meta-analysis of randomized controlled trials. Data sources: Searches were completed in January 2019 from electronic databases, including PubMed, Scopus, the Cochrane Library, and OTseeker. Review methods: Two independent reviewers performed data extraction and evaluated the study quality by the PEDro scale. The pooled effect sizes on different aspects of outcome measures were calculated. Subgroup analyses were performed to examine the impact of stroke phases on treatment efficacy. Results: Included were 17 articles with 600 patients. Compared with control treatments, the action observation therapy had a moderate effect size on arm and hand motor outcomes (Hedge’s g = 0.564; P < 0.001), a moderate to large effect size on walking outcomes (Hedge’s g = 0.779; P < 0.001), a large effect size on gait velocity (Hedge’s g = 0.990; P < 0.001), and a moderate to large effect size on activities of daily function (Hedge’s g = 0. 728; P = 0.004). Based on subgroup analyses, the action observation therapy showed moderate to large effect sizes in the studies of patients with acute/subacute stroke or those with chronic stroke (Hedge’s g = 0.661 and 0.783). Conclusion: This review suggests that action observation therapy is an effective approach for stroke patients to improve arm and hand motor function, walking ability, gait velocity, and daily activity performance.
Effects of interval training on risk markers for arrhythmic death: a randomized controlled trial
Authors: Boidin Maxime , Gayda Mathieu , Henri Christine , Hayami Doug , Trachsel Lukas D , Besnier Florent , Lalongé Julie , Juneau Martin , Nigam Anil 
Published: April 2019

Objective: To compare the effects of high-intensity interval training versus moderate-intensity continuous training on risk markers of arrhythmic death in patients who recently suffered from an acute coronary syndrome. Design: Double-blind (patient and evaluator) randomized controlled trial. Setting: Cardiovascular Prevention and Rehabilitation Centre (EPIC Centre) of the Montreal Heart Institute, Montreal, Canada. Subjects: A total of 43 patients were randomized following an acute coronary syndrome. Interventions: Patients were assigned to either high-intensity interval training (n = 18) or isocaloric moderate-intensity continuous training (n = 19), three times a week for a total of 36 sessions. Main measures: Heart rate recovery for 5 minutes, heart rate variability for 24 hours, occurrence of ventricular arrhythmias, and QT dispersion were measured before and after the 36 sessions of training. Results: Among the 43 patients randomized, 6 participants in the high-intensity interval training group stopped training for reasons unrelated to exercise training and were excluded from the analyses. Heart rate recovery improved solely in the high-intensity interval training group, particularly at the end of recovery period ( p < 0.05). There were no differences in heart rate variability, occurrence of ventricular arrhythmias, or QT dispersion parameters between the groups at study end. Conclusion: Despite the lack of power to detect any large difference between the two interventions with respect to risk markers of arrhythmic death, high-intensity interval training appears safe and may be more effective at improving heart rate recovery relative to moderate-intensity continuous training in our patients following acute coronary syndrome.
Poverty, Neighbourhood Antisocial Behaviour, and Children’s Mental Health Problems: Findings from the 2014 Ontario Child Health Study
Authors: Boyle Michael H. , Georgiades Katholiki , Duncan Laura , Wang Li , Comeau Jinette ,   2014 Ontario Child Health Study Team
Published: April 2019

Objectives: To determine if levels of neighbourhood poverty and neighbourhood antisocial behaviour modify associations between household poverty and child and youth mental health problems. Methods: Data come from the 2014 Ontario Child Health Study—a provincially representative survey of 6537 families with 10,802 four- to 17-year-olds. Multivariate multilevel modelling was used to test if neighbourhood poverty and antisocial behaviour interact with household poverty to modify associations with children’s externalizing and internalizing problems based on parent assessments of children (4- to 17-year-olds) and self-assessments of youth (12- to 17-year-olds). Results: Based on parent assessments, neighbourhood poverty, and antisocial behaviour modified associations between household poverty and children’s mental health problems. Among children living in households below the poverty line, levels of mental health problems were 1) lower when living in neighbourhoods with higher concentrations of poverty and 2) higher when living in neighbourhoods with more antisocial behaviour. These associations were stronger for externalizing versus internalizing problems when conditional on antisocial behaviour and generalized only to youth-assessed externalizing problems. Conclusion: The lower levels of externalizing problems reported among children living in poor households in low-income neighbourhoods identify potential challenges with integrating poorer households into more affluent neighbourhoods. More important, children living in poor households located in neighbourhoods exhibiting more antisocial behaviour are at dramatically higher risk for mental health problems. Reducing levels of neighbourhood antisocial behaviour could have large mental health benefits, particularly among poor children.
Prevalence and Correlates of Youth Suicidal Ideation and Attempts: Evidence from the 2014 Ontario Child Health Study
Authors: Georgiades Katholiki , Boylan Khrista , Duncan Laura , Wang Li , Colman Ian , Rhodes Anne E. , Bennett Kathryn , Comeau Jinette , Manion Ian , Boyle Michael H. ,   2014 Ontario Child Health Study Team
Published: April 2019

Objectives: To present the 12-month prevalence and correlates of suicidal ideation and attempts in a sample of youth in Ontario. Methods: Data come from the 2014 Ontario Child Health Study, a provincially representative survey of families with children in Ontario. Youth aged 14 to 17 y ( n = 2,396) completed a computer-assisted, self-administered questionnaire in their home to assess the occurrence of suicidal ideation, suicidal attempts, and associated correlates, including non-suicidal self-injury, mental disorders, substance use, peer victimization and exposure to child maltreatment. Socio-demographic information was collected from the parent. Logistic regression models were used to identify correlates that distinguished between youth reporting: 1) no suicidal ideation or attempts, 2) suicidal ideation but no attempts, and 3) suicidal ideation and attempts. Results: The 12-month prevalence of suicidal ideation and attempts was 8.1% and 4.3%, respectively. All clinical and behavioural correlates were significantly higher among youth reporting suicidal ideation or attempts, as compared with non-suicidal youth. In adjusted models, depression and non-suicidal self-injury were each independently associated with elevated odds of suicidal ideation (OR = 4.84 and 4.19, respectively) and suicidal attempt (OR = 7.84 and 22.72, respectively). Among youth who reported suicidal ideation, the only variable that differentiated youth who attempted suicide v. those who did not, in adjusted models, was non-suicidal self-injury (OR = 3.89). Conclusions: Suicidal ideation and attempts are common among youth in Ontario, often co-occurring with mental disorders and high-risk behaviours. These findings underscore the need for effective prevention and intervention strategies, particularly for youth depression and non-suicidal self-injury.
Changes in the Prevalence of Child and Youth Mental Disorders and Perceived Need for Professional Help between 1983 and 2014: Evidence from the Ontario Child Health Study
Authors: Comeau Jinette , Georgiades Katholiki , Duncan Laura , Wang Li , Boyle Michael H. ,   2014 Ontario Child Health Study Team
Published: April 2019

Objectives: To examine: 1) changes in the prevalence of mental disorders and perceived need for professional help among children (ages 4 to 11) and youth (ages 12 to 16) between 1983 and 2014 in Ontario and 2) whether these changes vary by age and sex, urban-rural residency, poverty, lone-parent status, and immigrant background. Methods: The 1983 ( n = 2836) and 2014 ( n = 5785) Ontario Child Health Studies are provincially representative cross-sectional surveys with identical self-report checklist measures of conduct disorder, hyperactivity, and emotional disorder, as well as perceived need for professional help, assessed by integrating parent and teacher responses (ages 4 to 11) and parent and youth responses (ages 12 to 16). Results: The overall prevalence of perceived need for professional help increased from 6.8% to 18.9% among 4- to 16-year-olds. An increase in any disorder among children (15.4% to 19.6%) was attributable to increases in hyperactivity among males (8.9% to 15.7%). Although the prevalence of any disorder did not change among youth, conduct disorder decreased (7.2% to 2.5%) while emotional disorder increased (9.2% to 13.2%). The prevalence of any disorder increased more in rural and small to medium urban areas versus large urban areas. The prevalence of any disorder decreased for children and youth in immigrant but not nonimmigrant families. Conclusions: Although there have been decreases in the prevalence of conduct disorder, increases in other mental disorders and perceived need for professional help underscore the continued need for effective prevention and intervention programs.
Children’s Mental Health Need and Expenditures in Ontario: Findings from the 2014 Ontario Child Health Study
Authors: Duncan Laura , Georgiades Katholiki , Birch Stephen , Comeau Jinette , Wang Li , Boyle Michael H. ,   2014 Ontario Child Health Study Team
Published: April 2019

Objective: To estimate the alignment between the Ontario Ministry of Children and Youth Services (MCYS) expenditures for children’s mental health services and population need, and to quantify the value of adjusting for need in addition to population size in formula-based expenditure allocations. Two need definitions are used: “assessed need,” as the presence of a mental disorder, and “perceived need,” as the subjective perception of a mental health problem. Methods: Children’s mental health need and service contact estimates (from the 2014 Ontario Child Health Study), expenditure data (from government administrative data), and population counts (from the 2011 Canadian Census) were combined to generate formula-based expenditure allocations based on 1) population size and 2) need (population size adjusted for levels of need). Allocations were compared at the service area and region level and for the 2 need definitions (assessed and perceived). Results: Comparisons were made for 13 of 33 MCYS service areas and all 5 regions. The percentage of MCYS expenditure reallocation needed to achieve an allocation based on assessed need was 25.5% at the service area level and 25.6% at the region level. Based on perceived need, these amounts were 19.4% and 27.2%, respectively. The value of needs-adjustment ranged from 8.0% to 22.7% of total expenditures, depending on the definition of need. Conclusion: Making needs adjustments to population counts using population estimates of children’s mental health need (assessed or perceived) provides additional value for informing and evaluating allocation decisions. This study provides much-needed and current information about the match between expenditures and children’s mental health need.
Ritonavir- or cobicistat-boosted antiretroviral therapy and direct oral anticoagulants: A case for apixaban
Authors: Nisly Sarah A , Stevens Brooke N 
Published: April 2019

Summary The potential for drug–drug interactions (DDIs) between direct oral anticoagulants and antiretroviral therapy (ART) is vast. Ritonavir and cobicistat are used as pharmacokinetic enhancers with either concurrent protease inhibitors or the integrase strand transfer inhibitor, elvitegravir, to optimize therapeutic concentrations by cytochrome P450 (CYP) inhibition. To date, only rivaroxaban and dabigatran have reported cases of use with ritonavir-boosted ART. Apixaban is metabolized similarly to rivaroxaban, but offers a dose reduction in the case of major DDIs. We report the successful use of reduced-dose apixaban to treat and prevent thromboembolic complications in six persons living with human immunodeficiency virus (HIV) on ritonavir- or cobicistat-boosted ART. This case series and available literature support the use of apixaban or dabigatran, depending on the boosted ART regimen.
Nurses experiences of ethical dilemmas: A review
Authors: Haahr Anita , Norlyk Annelise , Martinsen Bente , Dreyer Pia 
Published: April 2019

Background: Nursing care is rapidly evolving due to the advanced technological and medical development, and also due to an increased focus on standardization and the logic of production, permeating today’s hospital cultures. Nursing is rooted in a holistic approach with an ethical obligation to maintain and respect the individual’s dignity and integrity. However, working within time limits and heavy workload leads to burnout and ethical insensitivity among nurses, and may challenge nurses’ options to act on the basis of ethical and moral grounds in the individual care situation. Aim: The aim of this study is to describe and discuss ethical dilemmas described and experienced by nurses in clinical practice today. Method: The study was performed as a literature review following the matrix method allowing to synthesize literature across methodological approaches. A literature search was performed, including relevant studies published between 2011 and 2016. A total of 15 articles were included and analyzed focusing on their description of ethical dilemmas. Ethical consideration: We have considered and respected ethical conduct when performing a literature review, respecting authorship and referencing sources. Results: The analysis revealed three themes, relating to important aspects of nursing practice, such as the nurse–patient relationship, organizational structures, and collaboration with colleagues. The findings are summarized in the following three themes: (1) balancing harm and care, (2) work overload affecting quality, and (3) navigating in disagreement. Ethically difficult situations are evident across settings and in very diverse environments from neonatal care to caring for the older people. Organizational structures and being caught in-between professional values, standardization, and busyness was evident, revealing the complexity of nursing practice and the diversity of ethical dilemmas, concerns, and distress experienced by clinical nurses. Conclusion: Nursing practice is challenged by organizational structures and the development of the health care system, inhibiting nurses’ professional decision-making and forcing them to compromise basic nursing values.