bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Methodology for Flash Drought Identification: Application of Flash Drought Frequency across the United States
Authors: Christian Jordan I. , Basara Jeffrey B. , Otkin Jason A. , Hunt Eric D. , Wakefield Ryann A. , Flanagan Paul X. , Xiao Xiangming 
Published: March 2019

Abstract
With the increasing use of the term “flash drought” within the scientific community, Otkin et al. provide a general definition that identifies flash droughts based on their unusually rapid rate of intensification. This study presents an objective percentile-based methodology that builds upon that work by identifying flash droughts using standardized evaporative stress ratio (SESR) values and changes in SESR over some period of time. Four criteria are specified to identify flash droughts: two that emphasize the vegetative impacts of flash drought and two that focus on the rapid rate of intensification. The methodology was applied to the North American Regional Reanalysis (NARR) to develop a 38-yr flash drought climatology (1979–2016) across the United States. It was found that SESR derived from NARR data compared well with the satellite-based evaporative stress index for four previously identified flash drought events. Furthermore, four additional flash drought cases were compared with the U.S. Drought Monitor (USDM), and SESR rapidly declined 1–2 weeks before a response was evident with the USDM. From the climatological analysis, a hot spot of flash drought occurrence was revealed over the Great Plains, the Corn Belt, and the western Great Lakes region. Relatively few flash drought events occurred over mountainous and arid regions. Flash droughts were categorized based on their rate of intensification, and it was found that the most intense flash droughts occurred over the central Great Plains, Corn Belt, and western Great Lakes region.
Decadal Sea Level Variability in the Pacific Ocean: Origins and Climate Mode Contributions
Authors: Meng Lingsheng , Zhuang Wei , Zhang Weiwei , Ditri Angela , Yan Xiao-Hai 
Published: March 2019

AbstractSea level changes within wide temporal–spatial scales have great influence on oceanic and atmospheric circulations. Efforts have been made to identify long-term sea level trend and regional sea level variations on different time scales. A nonuniform sea level rise in the tropical Pacific and the strengthening of the easterly trade winds from 1993 to 2012 have been widely reported. It is well documented that sea level in the tropical Pacific is associated with the typical climate modes. However, sea level change on interannual and decadal time scales still requires more research. In this study, the Pacific sea level anomaly (SLA) was decomposed into interannual and decadal time scales via an ensemble empirical mode decomposition (EEMD) method. The temporal–spatial features of the SLA variability in the Pacific were examined and were closely associated with climate variability modes. Moreover, decadal SLA oscillations in the Pacific Ocean were identified during 1993–2016, with the phase reversals around 2000, 2004, and 2012. In the tropical Pacific, large sea level variations in the western and central basin were a result of changes in the equatorial wind stress. Moreover, coherent decadal changes could also be seen in wind stress, sea surface temperature (SST), subtropical cells (STCs), and thermocline depth. Our work provided a new way to illustrate the interannual and decadal sea level variations in the Pacific Ocean and suggested a coupled atmosphere–ocean variability on a decadal time scale in the tropical region with two cycles from 1993 to 2016.
The Mechanism and Predictability of an Elevated Convection Initiation Event in a Weak-Lifting Environment in Central-Eastern China
Authors: Zhang Murong , Meng Zhiyong , Huang Yipeng , Wang Dongyong 
Published: March 2019

Abstract
An elevated convection initiation (CI) of a quasi-linear mesoscale convective system (MCS) that occurred in a weak-lifting environment in the early morning on 23 June 2016 in central-eastern China was investigated using observational analysis and convection-permitting numerical simulations. This MCS gradually developed into a surface-based MCS and eventually produced a strong supercell that spawned an EF4 tornado in Yancheng City of Jiangsu Province and killed 98 people. This elevated MCS was initiated ahead of a surface front without identifiable boundaries at the surface. An elevated moist absolutely unstable layer (MAUL) was found to be conducive to the CI. The MAUL provided negligible convective inhibition and contributed to CI without strong-lifting mechanisms. Numerical simulation results showed that the formation of the elevated MAUL was mainly attributed to adiabatic cooling by weak vertical ascent and sufficient horizontal moisture transport near the terminus of a low-level jet. The weak vertical ascent before the CI was sloping and was likely to be relevant to the layer-lifting process associated with the realization of potential instability. The results showed that the MAUL in this weak-lifting environment was characterized by a shallower depth, a weaker lapse rate, and a longer sustaining period than the conditions in a strong-lifting environment. The predictability of this elevated CI case was examined using a 10-member ensemble forecast. A total of 80% of the ensemble members captured the CI. Rather than a difference in lifting, whether having an elevated MAUL or not was the major difference between CI and non-CI members in the present case.
Postoperative Venous Thromboembolism after Extracranial Otologic Surgery
Authors: Song Yohan , Alyono Jennifer C. , Ali Noor‐E‐Seher , Blevins Nikolas H. 
Published: March 2019

ObjectiveTo determine the incidence of postoperative venous thromboembolism (VTE) in adults undergoing otologic surgery.Study DesignCross‐sectional retrospective study.SettingSingle tertiary academic center.Subjects and MethodsAdults undergoing nononcologic, extracranial otologic surgery from August 2009 to December 2016. Patients with postoperative diagnosis VTE codes were identified. Imaging and clinical documents were searched for VTE evidence within the first 30 postoperative days. Methods of thromboprophylaxis were documented, and Caprini risk scores were calculated.ResultsIn total, 1213 otologic surgeries were evaluated. No postoperative VTE events were identified (0/1268). Mean age was 51.0 ± 17.3 years (range, 18.1‐93.4 years). Average length of surgery was 136.0 ± 79.0 minutes (range, 5‐768 minutes). The average Caprini score in all patients was 4.0 ± 1.7 (range, 1‐15). Eighty‐five percent of patients had a Caprini score ≥3, the threshold at which chemoprophylaxis has been recommended in general surgery patients by the American College of Chest Physicians 2012 guidelines. Six patients had documented preoperative chemoprophylaxis and a Caprini score of 4.8 ± 1.7. This was not significantly different from that of patients who did not receive preoperative chemoprophylaxis (t test, P =. 3). The literature would estimate a rate of 3.7% VTE in adults with similar Caprini scores undergoing general surgery procedures with no VTE prophylaxis.ConclusionThe Caprini risk assessment model may overestimate VTE risk in patients undergoing extracranial otologic surgery. Postoperative VTE following otologic surgery is rare, even in patients traditionally considered moderate or high risk. Chemoprophylaxis guidelines in this group should be balanced against the potential risk of increased intraoperative bleeding and its associated effects on surgical visualization and morbidity.
A risk score for predicting respiratory complications after thoracic surgery
Authors: Pipanmekaporn Tanyong , Bunchungmongkol Nutchanart , Punjasawadwong Yodying , Lapisatepun Worawut , Tantraworasin Apichat , Saokaew Surasak 
Published: March 2019

Background Respiratory complications are some of the most common complications following thoracic surgery and can lead to higher perioperative morbidity and mortality. The purpose of this study was to develop a simple clinical score for prediction of respiratory complications after thoracic surgery, and determine the internal validity. Methods In this retrospective cohort study, all consecutive patients were aged 18 years and over and undergoing non-cardiac thoracic surgery at a tertiary-care university hospital. Respiratory complications included bronchospasm, atelectasis, pneumonia, respiratory failure, and adult respiratory distress syndrome within 30 days of surgery or before discharge. Results A total of 1488 patients were included over a 7-year period, and 15.8% (235 of 1488 patients) developed respiratory complications. The significant predictors of respiratory complications were chronic obstructive pulmonary disease, American Society of Anesthesiologist physical status ≥ 3, right-sided surgery, duration of surgery longer than 180 min, preoperative arterial oxygen saturation on room air < 96%, and open thoracotomy. The area under receiving operating characteristic curve was 0.78 (95% confidence interval: 0.75–0.82) and 0.76 (95% confidence interval: 0.70–0.83) for the derivation and validation cohorts, respectively. The model was well calibrated with a Hosmer-Lemeshow goodness-of-fit of 7.32 ( p = 0.293). Conclusions This study developed and internally validated a simple clinical risk score for prediction of respiratory complications following thoracic surgery. This score can be used to stratify high-risk patients, address modifiable risk factors for respiratory complications, and provide preventive strategies for improving postoperative outcomes.
‘So isolation comes in, discrimination and you find many people dying quietly without any family support’: Accessing palliative care for key populations – an in-depth qualitative study
Authors: Hunt Jenny , Bristowe Katherine , Chidyamatare Sybille , Harding Richard 
Published: March 2019

Background: Ensuring palliative care for all under a new global health policy must include key populations, that is, lesbian, gay, bisexual, transgender and intersex (LGBTI) people, and sex workers. Accessibility and quality of care have not been investigated in lower and middle-income countries where civil rights are the weakest. Aim: To examine the accessibility to, and experiences of, palliative care for key populations in Zimbabwe. Design: Qualitative study using thematic analysis of in-depth interviews and focus groups. Setting/participants: A total of 60 key population adults and 12 healthcare providers and representatives of palliative care and key population support organisations were interviewed in four sites (Harare, Bulawayo, Mutare and Masvingo/Beitbridge). Results: Participants described unmet needs and barriers to accessing even basic elements of palliative care. Discrimination by healthcare providers was common, exacerbated by the politico-legal-economic environment. Two dominant themes emerged: (a) minimal understanding of, and negligible access to, palliative care significantly increased the risk of painful, undignified deaths and (b) discriminatory beliefs and practices from healthcare providers, family members and the community negatively affected those living with life-limiting illness, and their wishes at the end of life. Enacted stigma from healthcare providers was a potent obstacle to quality care. Conclusion: Discrimination from healthcare providers and lack of referrals to palliative care services increase the risk of morbidity, mortality and transmission of infectious diseases. Untreated conditions, exclusion from services, and minimal family and social support create unnecessary suffering. Public health programmes addressing other sexually taboo subjects may provide guidance.
Field testing the diagnostic criteria of cluster headache in the third edition of the International Classification of Headache Disorders: A cross-sectional multicentre study
Authors: Moon Heui-Soo , Cho Soo-Jin , Kim Byung-Kun , Lee Mi Ji , Chung Pil-Wook , Sohn Jong-Hee , Kim Soo-Kyoung , Choi Yun-Ju , Song Tae-Jin , Kim Jae-Moon , Park Jeong Wook , Park Kwang-Yeol , Chung Jae-Myun , Ahn Jin-Young , Kim Byung-Su , Oh Kyungmi , Lee Kwang-Soo , Chung Chin-Sang , Chu Min Kyung 
Published: March 2019

Background *These authors are shared first authors. The recently published third edition of the International Classification of Headache Disorders (ICHD-3) revised the criteria for accompanying symptoms of cluster headache (CH) and the remission period of chronic cluster headache (CCH). This study aimed at testing the validity of the ICHD-3 criteria for CH by using data from the Korean Cluster Headache Registry. Methods Consecutive patients with CH and probable cluster headache (PCH) were prospectively recruited from 15 hospitals. We analysed the validity of the revised ICHD-3 criteria for CH against the beta version of the third edition of the ICHD (ICHD-3β). Results In total, 193 patients were enrolled: 140 (72.5%), 5 (2.6%) and 22 (11.4%) had episodic cluster headache (ECH), CCH, and PCH, respectively. The remaining 26 (13.5%) had CH with undetermined remission periods. One patient with ECH and one with PCH had only forehead and facial flushing and were diagnosed with PCH and non-cluster headache, respectively, according to the ICHD-3. Four participants with ECH according to the ICHD-3β had remission periods of > 1 month and between 1 and 3 months and were newly diagnosed with CCH according to the ICHD-3. Conclusion The change from ICHD-3β to ICHD-3 resulted in few differences in the diagnoses of CH and PCH.
Enfeeblement in Essential Tremor: Development and Validation of a New Psychometric Measure
Authors: Trujillo Diaz Daniel , Cersonsky Tess E. K. , Kellner Sarah , Zdrodowska Maria Anna , Hickman Ruby , Cosentino Stephanie , Monin Joan K. , Louis Elan D. 
Published: March 2019

Introduction: Despite a growing body of knowledge regarding essential tremor (ET), past studies have fallen short in capturing the full impact of ET on patients and caregivers. We propose enfeeblement (i.e., having the qualities of being prematurely old, helpless, or debilitated) as a novel clinical outcome measure in ET. Due to the lack of enfeeblement scales for ET in the literature, we developed and validated an enfeeblement scale for ET. Methods: The Essential Tremor Enfeeblement Survey (ETES) consists of eight 5-point Likert-type scale questions and is designed to be a caregiver-reported outcome. Results: Enfeeblement scores showed a floor effect of 15.3%, no ceiling effects, and demonstrated good overall test–retest reliability (intraclass correlation coefficient = 0.73), favorable internal consistency (Cronbach α coefficient = 0.92) and good convergent validity. Conclusion: The ETES has robust properties. Aside from future studies of enfeeblement in ET, enfeeblement should be explored more broadly as a psychometric measure across other neurological disorders.
Immediate effects of ultrasound-guided percutaneous neuromodulation versus physical exercise on performance of the flexor hallucis longus muscle in professional dancers: a randomised clinical trial
Authors: de la Cruz-Torres Blanca , Barrera-García-Martín Irene , Albornoz-Cabello Manuel 
Published: March 2019

Background:Ultrasound-guided percutaneous neuromodulation (US-guided PNM) is a minimally invasive intervention. This technique consists of the application of percutaneous electrical stimulation (PES) through an acupuncture needle-like electrode that is placed in close proximity to the nerve or motor point of the target muscle under ultrasound guidance.Objective:To examine the immediate effects of a stretching exercise, an eccentric exercise and US-guided PNM on the performance of the flexor hallucis longus (FHL) muscle in young dancers.Methods:Randomised clinical trial. A total of 45 dancers were divided into three groups: Stretching group, Eccentric group and PNM group. The following performance parameters were assessed: range of motion (ROM) of the first metatarsophalangeal joint, balance test and unilateral heel raise fatigue test.Results:There were no differences between these groups in baseline measurements; at the end of the study, mean balance and endurance values were only significantly higher for the PNM group compared to the Stretching (p = 0.007 and p < 0.001, respectively) and Eccentric groups (p = 0.003 and p < 0.001, respectively). The effect sizes were large for the balance (d = 0.8) and endurance (d = 1.83) tests in the PNM group. Both the Stretching and Eccentric groups exhibited improvements in ROM compared to their baseline values (p = 0.009 and p = 0.004, respectively), whereas there was no significant temporal improvement noted for the PNM group. The effect sizes with respect to ROM values were moderate for stretching (d = 0.6) and eccentric (d = 0.7) exercises.Conclusion:An isolated PES intervention provides a greater immediate increase in balance and muscular strength than an active stretching and eccentric exercise of the FHL muscle in young ballet dancers.
Role of SCO in the Eurasian Continent
Authors: Yussupzhanovich Ruslan Izimov , Tulkunovna Zamira Muratalieva 
Published: March 2019

With an official accession of India and Pakistan to Shanghai Cooperation Organisation (SCO), its capacity has considerably increased. The organisation has also faced new challenges, to which the member states must respond rapidly. Thus, the expansion of the list of members blurs to a large extent the SCO area of efforts application. A traditional spotlight, shining for a long time on Central Asia, will be now inevitably shifted towards South Asia. The task of maintaining the basic principles of the SCO functioning and the balance of forces between the major and other members in the Organization, as well as the need for solving the most topical issue for today, the creation of mechanisms for financing the SCO projects, remain no less important in the light of the SCO expansion. Besides, the fact of aggravation of the geopolitical situation in the world is directly reflected in the SCO activities. The rivalry between the big powers, including the SCO members, has moved on to a new footing. This article provides an analysis of the current state of the SCO activities as well as forecasts for the further development of the ‘Big Shanghai Eight’.
Determining Whether Hypertensive Status and Stress Level Are Associated With Inflammatory Markers
Authors: Kehler Stephanie , Rayens Mary Kay , Ashford Kristin 
Published: March 2019

Background: Hypertensive disorders are common pregnancy complications in the United States. Although the exact mechanism underlying hypertensive disorders in pregnancy is unknown, there is evidence of involvement of a maladaptive maternal inflammatory response. Psychological maternal stress experienced during pregnancy can increase the risk of a hypertensive disorder by altering the maternal inflammatory response. Objectives: The purpose of this analysis was to evaluate the relationships of hypertensive status and stress with inflammatory biomarkers throughout pregnancy. Method: A 1:2 case–control design was used to analyze secondary data longitudinally with repeated measures of a multicenter, culturally and ethnically diverse pregnant population. Demographic data, psychological stress, and serum inflammatory data were analyzed. The sample consisted of 30 pregnant women with hypertension and 61 normotensive women. Measurements were taken once in each trimester of pregnancy. Results: Trimester-specific levels of inflammatory biomarkers varied based on stress and hypertensive status. IL-6 was elevated in the hypertensive, high-stress group, while IL-8 was greater among those with high stress, regardless of hypertensive status or trimester. For IL-1α and IL-1β, there was a significant stress-by-trimester interaction, while IL-10 was associated with a significant three-way interaction among stress level, hypertension status, and trimester. Conclusions: The associations of stress and hypertensive status with inflammatory biomarkers are complex. Stress and hypertension were associated with changes in inflammatory response. Hypertensive women with high stress experienced a heightened anti-inflammatory response, potentially a compensatory mechanism. To better understand this relationship, further longitudinal studies are warranted.
Reproducibility of macular and optic nerve head vessel density measurements by swept-source optical coherence tomography angiography
Authors: Fernández-Vigo José Ignacio , Kudsieh Bachar , Macarro-Merino Ana , Arriola-Villalobos Pedro , Martínez-de-la-Casa José María , García-Feijóo Julián , Fernández-Vigo José Ángel 
Published: March 2019

Purpose: To assess the reproducibility of swept-source optical coherence tomography angiography (SS-OCTA) for macular and optic nerve head (ONH) vessel density (VD). Methods: Cross-sectional study using the Triton OCTA (Topcon, Tokyo, Japan), for VD (%) measurements in 40 eyes of 40 healthy subjects on two 6 × 6 mm scans of the macula and ONH across five subfields (central, superior, inferior, temporal, and nasal) at different segmentation levels: superficial capillary plexus (SCP), deep capillary plexus (DCP), outer retina, and choriocapillaris. Reproducibility values were summarized as intraclass correlation coefficients (ICCs) and coefficients of variations (CV). Results: ICCs for the macular VD measurements in the central zone were 0.874, 0.770, 0.575, 0.718 at the levels SCP, DCP, outer retina, and choriocapillaris, respectively, while worse ICCs were obtained for the parafoveal subfields (ICC ⩽ 0.589); CVs were 2.8%–6.7%. The reproducibility of the ONH superficial VD was ICC = 0.941 for the papillary region and was ICC = 0.499–0.853 for the peripapillary zone; CVs ranged from 4.8% to 17%. Peripapillary VD showed an ICC = 0.533–0.770 in the DCP layer, and 0.572–0.828 in the choriocapillaris. Lowest VD were obtained for the macular SCP and DCP (23% and 22%, respectively), in the foveal zone, while greatest VD were recorded in the nasal and temporal peripapillary subfields at the level of the choriocapillaris (both 68%). Conclusions: The new SS-OCTA software served to quantify macular and ONH VD with a reproducibility that was good in the central zones (foveal and papillary, respectively) and moderate in the peripheral zones (parafoveal and peripapillary).