bluuebunny/crossref_metadata_2025_split huggingface dataset:
Two Characteristic Patterns of the Summer Indian Ocean Dipole
Authors: Fan Lei , Fu Hui-Huang , Liang Yu 
Published: May 2024

Abstract
This study identifies two distinct patterns of the summer Indian Ocean dipole (IOD)—the coastal IOD and the offshore IOD—named based on the proximity of their eastern pole to Sumatra. Their spatial characteristics, evolutionary mechanisms, relationships with ENSO, impacts on precipitation, and the factors controlling the simulation performances of climate models are discussed. The coastal IOD has the same eastern pole as the conventional IOD, which is located off the coast of Sumatra, but its western pole is situated in the central region of the tropical Indian Ocean (TIO). In contrast, the offshore IOD shares the same western pole as the conventional IOD, which is located off the coast of Somalia, whereas its eastern pole is positioned in the central TIO. Regarding their evolutions, while they initially develop similarly, their later evolutions differ due to their distinct pole locations: The offshore IOD peaks in summer, while the coastal IOD can be sustained into autumn. The coastal IOD correlates to preceding and late ENSO states, but the offshore IOD does not, making it an independent internal mode of TIO. The two IODs affect climate differently, with only the coastal IOD affecting Australian rainfall. Climate models exhibit varied levels of performance in simulating the two IODs. Specifically, a stronger link between spring TIO rainfall and ENSO, as well as stronger southeasterly monsoon winds in the southern TIO, can enhance the coastal IOD modeling, while a stronger summer Somali jet benefits the simulation of the offshore IOD. Distinguishing these two IODs has implications for accurate diagnosis and prediction of the summer climate surrounding the TIO.

Significance Statement
The Indian Ocean dipole (IOD) significantly influences the monsoon climate. Previous studies use a unified IOD index based on all-season sea surface temperature (SST) data of tropical Indian Ocean (TIO), resulting in a representation biased toward the autumn peak season. However, understanding SST patterns during summer is crucial for Asian summer monsoon precipitation, and what are the characteristic patterns of summer IOD remains unclear. This study fundamentally advances the understanding of the IOD’s seasonal diversity by identifying two distinct dipole patterns in the summer TIO. These patterns differ from the conventional IOD in terms of spatial characteristics, evolutions, ENSO relationships, and precipitation impacts. Distinguishing between these two IODs is anticipated to improve the diagnosis and prediction of summer monsoon rainfall.
Implications of Organizational Climate and Ethical Leadership on Reengineering in Municipal Government
Authors: Daly John L. 
Published: May 2024

For the past two decades, increasing demands have been placed on government to "do more with less." These pressures have resulted in innovative searches by officials to "find" practical solutions that enhance organizational productivity within stable to declining operational resource environments. Business Process Reengineering has been touted recently by organizational theorists as an innovative method for improving organizational cost-effectiveness, increasing responsiveness to clients, and enhancing service delivery (Hammer and Champy, 1993' Manganelli and Klein, 1994; Linden, 1994; Hyde, 1995). The advent and application of reengineering in government, however, has not been without fierce debate. Offsetting the positive aspects of its utilization, reengineering has been criticized as resulting in dehumanizing workforce reductions and increasing workloads for downsizing survivors. In environments of substantial dynamic change, concern exists for damaging cooperative relationships of management and labor. This study examines survey responses obtained from managers and supervisors in four Florida smaller sized municipal governments. It assesses the influence that organizational climate and ethical leadership have on instituting governmental process changes. The research results indicate a strong relationship between positive organizational climate and successful process reengineering. Less evidence exists to support a similar impact of ethical practices on reengineering outcomes.
Not as Easy as it Sounds? Delivering the National Integrity System Approach in Practice – the Case Study of the National Anti-Corruption Programme in Lithuania
Authors: Doig Alan 
Published: May 2024

The article takes forward some of the issues deriving from the Transparency International concept of the National Integrity System [NIS]. The NIS is a framework approach developed by Jeremy Pope when he was with TI that proposes assessing corruption and reform holistically. The NIS not only looks at separate institutions, or separate areas of activity, or separate rules and practices, but also bases its perspective on institutional and other inter-relationships, inter-dependence and combined effectiveness. It provides a framework for the development of comprehensive country-wide anti-corruption plans. This article assesses the NIS approach in the light of the main themes raised by two research studies into the NIS in practice – one funded by the Dutch Government and the other by the UK Department for International Development – in some 40 countries, involving 18 countries, including transitional countries. One such country – Lithuania – is used to illustrate the NIS in practice and, in particular, issues concerning the delivery of an NIS in practice. The implementation of the Lithuanian anticorruption programme is used to assess how easy or difficult it is both to deliver a comprehensive reform process that reflects the purpose of an NIS in practice and to implement its core components. Such issues should inform the nature of the support provided by donor agencies and also what expectations other transnational agencies may have of transitional countries as they seek to implement an appropriate and integrated framework to address corruption. Overall, the use of the NIS is seen as a useful framework within which to assess corruption and deliver reform. Seeking to implement a comprehensive programme without the use of such a methodology or framework does create issues of effective implementation.
Sole Hospital Commitment to Health Promotion and Disease Prevention (HPDP) Services: Does Ownership Matter?
Authors: Zhao Mei , Carretta Henry J. , Hurley Robert E. 
Published: May 2024

Hospitals have been increasingly involved in health promotion and disease prevention (HPDP) in the last two decades. Concurrent with this trend, environmental changes and market pressures have resulted in more hospital consolidations and conversions from not-for-profit (NFP) to for-profit (FP) organizations. The emergence of a large number of sole community hospitals has attracted the attention of policy-makers and community stakeholders because sole community hospitals have more power in the local market and may discontinue unprofitable services to pursue profit maximization. This may be especially true when the sole hospital is a FP organization. On the other hand, sole community hospitals are confronted with a variety of expectations to offer community-oriented services that promote community population health, regardless of ownership. There is relatively little literature that has attempted to examine the behavior of sole community hospitals. This study depicts the profile of sole hospitals’ involvement in HPDP services and estimates the possible influence of community constituencies on hospitals with respect to their providing community-oriented services. The results indicate that typically, when there is only one hospital in the community, hospital ownership has no significant influence on hospital HPDP services than their NPD counterparts. Implications for policy-makers and health care leaders are also discussed.
An Ethnographic Study of Nursing Home Culture to Define Organizational Realities of Culture Change
Authors: Deutschman Marian T. 
Published: May 2024

The current system of delivery of nursing home care is costly both in dollars and in human terms. Culture change may provide solutions to both issues. Culture change has a different meaning for different organizations depending on where they are in the continuum of change. Detailed observation of staff members “in action” in three long-term care facilities over a period of several months was supplemented by formal and informal interviews of organization members to gain an understanding of the culture of the nursing home organization. Four three-hour observations in each of three facilities, representing privately-held and not-for-profit organizations in urban, suburban, and rural locations yielded insights into the routine, recruitment, training, teamwork, activities, leadership, role-modeling, mentoring, staff and resident satisfaction, weekend staffing and activities, bureaucratic structure, and sharing of best practices. Discussion of each of these issues may provide a starting point for all those facilities that are contemplating significant culture change. If the objective is to have facilities truly embrace a new set of values, then the change begins with the owners and administrators of nursing homes who need to focus on building new relationships with all the stakeholders. In-depth interviews of organization members and six chief executive officers in long-term care in the Western New York area culminated the study with the development of a fifty-question survey for decision makers.
Racial Differences in Health Care Use among Medicare Only and Dual Eligibles
Authors: Moon Sangho , Shin Jaeun 
Published: May 2024

It has been an important financial issue in the U.S. Medicare expenditures that health care expenses of Medicaid-Medicare dual eligibles (MMDE) are much higher than those of Medicare only beneficiaries (MOB). This paper compares health care use and health status of MMDEs and MOBs who are either Afro-American or white recipients. Using total health care use information from the Medical Expenditure Panel Survey (MEPS) 2000, we find that the proportion of dual eligibles with chronic health conditions is higher by 4% than that of the Medicare only beneficiaries and that dual eligibles make more frequent uses of various health care services. The number of office-based physician visits and outpatient physician visits are higher for Afro-American dual eligibles than white dual eligibles. This finding seems to be contributed to by relatively high medical needs among dual eligibles. Higher utilization of agency-related home health services among Afro-American dual eligibles than among white dual eligibles is considered as a consequence of different ethnicity-specific responses to insurance coverage.
Diabetes Self Management: Are Cuban Americans Receiving Quality Health Care?
Authors: Huffman Fatma G. , Vaccaro Joan A. , Nath Subrata , Zarini Gustavo G. 
Published: May 2024

Objectives We investigated the relationship among factors predicting inadequate glucose control among 182 Cuban-American adults (Females=110, Males=72) with type 2 diabetes mellitus (CAA). Study Design Cross-sectional study of CAA from a randomized mailing list in two counties of South Florida. Methods Fasted blood parameters and anthropometric measures were collected during the study. BMI was calculated (kg/m2). Characteristics and diabetes care of CAA were self-reported Participants were screened by trained interviewers for heritage and diabetes status (inclusion criteria: self-reported having type 2 diabetes; age ≥ 35 years, male and female; not pregnant or lactating; no thyroid disorders; no major psychiatric disorders). Participants signed informed consent form. Statistical analyses used SPSS and included descriptive statistic, multiple logistic and ordinal logistic regression models, where all CI 95%. Results Eighty-eight percent of CAA had BMI of ≥ 25 kg/ m2. Only 54% reported having a diet prescribed/told to schedule meals. We found CAA told to schedule meals were 3.62 more likely to plan meals (1.81, 7.26), p<0.001) and given a prescribed diet, controlling for age, corresponded with following a meal plan OR 4.43 (2.52, 7.79, p<0.001). The overall relationship for HbA1c < 8.5 to following a meal plan was OR 9.34 (2.84, 30.7. p<0.001). Conclusions The advantage of having a medical professional prescribe a diet seems to be an important environmental support factor in this sample's diabetes care, since obesity rates are well above the national average. Nearly half CAA are not given dietary guidance, yet our results indicate CAA may improve glycemic control by receiving dietary instructions.
Arabic Translation and Adaptation of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Patient Satisfaction Survey Instrument
Authors: Dockins James , Abuzahrieh Ramzi , Stack Martin 
Published: May 2024

Objective. To translate and adapt an effective, validated, benchmarked, and widely used patient satisfaction measurement tool for use with an Arabic-speaking population. Design. Translation of survey's items, survey administration process development, evaluation of reliability, and international benchmarking Setting. Three hundred-bed tertiary care hospital in Jeddah, Saudi Arabia. Participants. 645 patients discharged during 2011 from the hospital's inpatient care units. Interventions. the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) instrument was translated into Arabic, a randomized weekly sample of patients was selected, and the survey was administered via telephone during 2011 to patients or their relatives. Main outcome measures. Scores were compiled for each of the HCAHPS questions and then for each of the six HCAHPS clinical composites, two non-clinical items, and two global items. Results. Clinical composite scores, as well as the two non-clinical and two global items were analyzed for the 645 respondents. Clinical composites were analyzed using Spearman's correlation coefficient and Cronbach's alpha to demonstrate acceptable internal consistency for these items and scales demonstrated acceptable internal consistency for the clinical composites. (Spearman's correlation coefficient = 0.327 – 0.750, P<0.01; Cronbach's alpha = 0.516 – 0.851) All ten HCAHPS measures were compared quarterly to US national averages with results that closely paralleled the US benchmarks. Conclusion. The Arabic translation and adaptation of the HCAHPS is a valid, reliable, and feasible tool for evaluation and benchmarking of inpatient satisfaction in Arabic speaking populations.
Perspectives on Multidisciplinary Team Processes among Healthcare Executives: Processes that Facilitate Team Effectiveness
Authors: Landry Amy , Erwin Cathleen 
Published: May 2024

Background Multidisciplinary teams (MDTs) are used in healthcare organizations to address both clinical and managerial functions. Despite their prevalence, little is known about how team processes work to facilitate effectiveness among MDT leadership teams. Purpose This study explores perceptions of MDT participation experienced by organizational leaders in healthcare organizations in the United States. Methodology/Approach A survey of American College of Healthcare Executives members was conducted to assess involvement and perceptions of MDTs among health care management professionals. Descriptive statistics, independent T-Tests and Chi-square analyses were used to examine participation in MDTs, perception of MDT processes, and the association of participation and perceived processes with employee and organizational characteristics. Findings The survey yielded a sample comprised of 492 healthcare executive or executive-track employees. An overwhelming majority indicated participation in MDTs. The study identified team processes that could use improvement including communication, cooperation, and conflict resolution. Practice Implications The study provides evidence that can help guide the development of training programs that focus on providing managerial leaders with strategies aimed at improving communication, coordination, and conflict resolution that will improve the effectiveness of MDT functioning in healthcare organizations.
A Method to Reduce Tension Differences in Pull/Push Manipulation for a Robot in Fluorescence Emission-Guided Surgical Microscopy
Authors: Lee Sangyun , Yoon Kicheol , Lee Won-Suk , Kim Kwang Gi 
Published: May 2024

Motivation A fluorescence emission-guided microscope used to monitor the outcome of cancer removal surgery is highly effective when employing a manipulator to motorize and switch the observation direction. It is necessary to minimize the alignment of looper tension between the stands for pull/push to change the direction of the manipulator and reduce the error rate caused by tension differences. This paper presents a method to minimize the error rate of looper tension between the stands. Methods \The looper is inserted between the stands of the manipulator to minimize the difference in tension and make the stress on the pull and push of the looper constant. The constant stress allows the manipulator to move stably in left/right, up/down, and left/right movements, which will be effective for full-camera observation and close-up shots of the end effector. Results Reducing the tolerance for differences in the manipulator’s looper tension (angle and tension) is crucial. When the input value of the looper tension angle is 50°, the output should closely match 50°. Consequently, the measured response has a tolerance of ±49.98%, resulting in an error rate of .02% (1/50th level). Conclusion A method is proposed to minimize the error rate of the manipulator’s looper tension in a robot-based fluorescence emission-guided microscope used to observe the status of cancer surgery. As a result, a stable manipulator with a minimal error rate can achieve a 3.986x magnification for close-up observation by switching between high and low orientations.
Extraction of γ-chitosan from insects and fabrication of PVA/γ-chitosan/kaolin nanofiber wound dressings with hemostatic properties
Authors: Lee Hakyong , Kim Jinkyeong , Myung Suwan , Jung Tae-Gon , Han Dong-Wook , Kim Bongju , Lee Jae-Chang 
Published: May 2024

AbstractA nanofiber-based composite nonwoven fabric was fabricated for hemostatic wound dressing, integrating polyvinyl alcohol (PVA), kaolin, and γ-chitosan extracted from three type of insects. The γ-chitosan extracted from Protaetia brevitarsis seulensis exhibited the highest yield at 21.5%, and demonstrated the highest moisture-binding capacity at 535.6%. In the fabrication process of PVA/kaolin/γ-chitosan nonwoven fabrics, an electrospinning technique with needle-less and mobile spinneret was utilized, producing nanofibers with average diameters ranging from 172 to 277 nm. The PVA/kaolin/γ-chitosan nonwoven fabrics demonstrated enhanced biocompatibility, with cell survival rates under certain compositions reaching up to 86.9% (compared to 74.2% for PVA). Furthermore, the optimized fabric compositions reduced blood coagulation time by approximately 2.5-fold compared to PVA alone, highlighting their efficacy in hemostasis. In other words, the produced PVA/kaolin/γ-chitosan nonwoven fabrics offer potential applications as hemostatic wound dressings with excellent biocompatibility and improved hemostatic performance.
Graphical abstract
Long term care facilities in England during the COVID-19 pandemic—a scoping review of guidelines, policy and recommendations
Authors: Collingridge Moore Danni , Garner Alex , Cotterell Natalie , Harding Andrew J. E. , Preston Nancy 
Published: May 2024

Abstract
Background
The disproportionate effect of COVID-19 on long term care facility (LTCF) residents has highlighted the need for clear, consistent guidance on the management of pandemics in such settings. As research exploring the experiences of LTCFs during the pandemic and the implications of mass hospital discharge, restricting staff movement, and limiting visitation from relatives are emerging, an in-depth review of policies, guidance and recommendations issued during this time could facilitate wider understanding in this area.

Aims
To identify policies, guidance, and recommendations related to LTCF staff and residents, in England issued by the government during the COVID-19 pandemic, developing a timeline of key events and synthesizing the policy aims, recommendations, implementation and intended outcomes.

Method
A scoping review of publicly available policy documents, guidance, and recommendations related to COVID-19 in LTCFs in England, identified using systematic searches of UK government websites. The main aims, recommendations, implementation and intended outcomes reported in included documents were extracted. Data was analysed using thematic synthesis following a three-stage approach: coding the text, grouping codes into descriptive themes, and development of analytical themes.

Results
Thirty-three key policy documents were included in the review. Six areas of recommendations were identified: infection prevention and control, hospital discharge, testing and vaccination, staffing, visitation and continuing routine care. Seven areas of implementation were identified: funding, collaborative working, monitoring and data collection, reducing workload, decision making and leadership, training and technology, and communication.

Discussion
LTCFs remain complex settings, and it is imperative that lessons are learned from the experiences during COVID-19 to ensure that future pandemics are managed appropriately. This review has synthesized the policies issued during this time, however, the extent to which such guidance was communicated to LTCFs, and subsequently implemented, in addition to being effective, requires further research. In particular, understanding the secondary effects of such policies and how they can be introduced within the existing challenges inherent to adult social care, need addressing.