bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical Links from Atmospheric Circulation Patterns to Barents–Kara Sea Ice Variability from Synoptic to Seasonal Timescales in the Cold Season
Authors: Yu Feng Siew Peter , Wu Yutian , Ting Mingfang , Zheng Cheng , Clancy Robin , Kurtz Nathan T. , Seager Richard 
Published: August 2023

Abstract
Previous findings show that large-scale atmospheric circulation plays an important role in driving Arctic sea ice variability from synoptic to seasonal time scales. While some circulation patterns responsible for Barents–Kara sea ice changes have been identified in previous works, the most important patterns and the role of their persistence remain unclear. Our study uses self-organizing maps to identify nine high-latitude circulation patterns responsible for day-to-day Barents–Kara sea ice changes. Circulation patterns with a high pressure center over the Urals (Scandinavia) and a low pressure center over Iceland (Greenland) are found to be the most important for Barents–Kara sea ice loss. Their opposite-phase counterparts are found to be the most important for sea ice growth. The persistence of these circulation patterns helps explain sea ice variability from synoptic to seasonal time scales. We further use sea ice models forced by observed atmospheric fields (including the surface circulation and temperature) to reproduce observed sea ice variability and diagnose the role of atmosphere-driven thermodynamic and dynamic processes. Results show that thermodynamic and dynamic processes similarly contribute to Barents–Kara sea ice concentration changes on synoptic time scales via circulation. On seasonal time scales, thermodynamic processes seem to play a stronger role than dynamic processes. Overall, our study highlights the importance of large-scale atmospheric circulation, its persistence, and varying physical processes in shaping sea ice variability across multiple time scales, which has implications for seasonal sea ice prediction.

Significance Statement
Understanding what processes lead to Arctic sea ice changes is important due to their significant impacts on the ecosystem, weather, and shipping, and hence our society. A well-known process that causes sea ice changes is atmospheric circulation variability. We further pin down what circulation patterns and underlying mechanisms matter. We identify multiple circulation patterns responsible for sea ice loss and growth to different extents. We find that the circulation can cause sea ice loss by mechanically pushing sea ice northward and bringing warm and moist air to melt sea ice. The two processes are similarly important. Our study advances understanding of the Arctic sea ice variability with important implications for Arctic sea ice prediction.
Pediatric Ultrasound Appendicitis Score for the Diagnosis of Acute Appendicitis to Reduce Computed Tomography Scan Utilization
Authors: Nemeh Christopher , Hassan Irfan N. , Walsh Abigail , Iyer Sekhar , Gitzelmann Christopher A. 
Published: August 2023

Background Acute appendicitis is one of the most common reasons for pediatric surgical consultation in the emergency room. Although acute appendicitis is a clinical diagnosis, the use of imaging in the emergency department to assist with the diagnosis is very common. Ultrasound is frequently utilized in pediatrics because of the radiation risks associated with computed tomography (CT) scan. The risks of radiation in the pediatric population are much more significant than in adults. Reasons for this include smaller size so there is a relative higher radiation dose than for larger adults, radiosensitive organs such as thyroid, bone marrow, and gonads, and radiation exposure earlier in life allows for more time that a radiation induced cancer could develop. The risks of radiation from imaging are increased with cumulative dosing. Methods The purpose of this study was to incorporate the pediatric appendicitis score (PAS) and standardized ultrasound scoring system to provide a combined score that would assist with the clinical diagnosis of acute appendicitis and avoid the need for a CT scan. Results The presented data shows that for scores of 7 or more, the specificity and sensitivity is 90% and 90.2%, respectively for the diagnosis of acute appendicitis. Discussion This study validates the combined score, shows the specific cutoffs, and initiates the discussion that CT scan may not always be required for diagnosing acute appendicitis if this scoring system is used.
Alcohol consumption under lockdown measures during the COVID-19 pandemic in three Nordic countries
Authors: Gunnerlind Oscar , Lundqvist Robert , Ott Michael , Werneke Ursula 
Published: August 2023

Background: At the beginning of the COVID-19 pandemic, concerns arose about a possible rise in alcohol consumption. Early surveys, however, more commonly pointed towards a decrease of alcohol use. But studies based on self-reports may underestimate alcohol use. They also depend on the population sampled. Because of border closures and gastronomy restrictions, countries with centralised alcohol sales provided a unique opportunity to study total domestic consumption during the pandemic without influence of private import or reliance on self-reports. Aims: We examined the correlation between alcohol sales and national COVID-19 restrictions in three such countries, Finland, Norway and Sweden. Method: We conducted this study as a mirror image study, comparing alcohol sales during the first 2 years of the COVID-19 pandemic with the two preceding years. We explored hours of daylight/season as potential confounders. Results: We found no relevant change in alcohol sales during the pandemic years for Finland or Sweden. For Norway, there was a level-change in sales, which could be explained by decreased imports. Sales followed a seasonal pattern. In all three countries, the initial pandemic increase in alcohol sales coincided with an underlying annually recurring seasonal variation. Conclusions: The COVID-19 pandemic had less of an impact on alcohol consumption in the three Nordic countries than could intuitively be expected. The increase of alcohol sales at the beginning of the COVID-19 pandemic coincided with a seasonal rise following a pre-pandemic pattern. Therefore, caution should be exercised with drawing conclusions from data with a short time perspective to avoid attribution bias.
Extending the Capabilities Conception of the Individual in Economics: Relationality and Responsibility
Authors: Erasmo Valentina 
Published: August 2023

This article extends the capabilities conception of individuals developed by Davis, understanding capabilities as relationships. I first introduced the main concepts that are useful for this extension, namely those of agency and capabilities. Then, I showed that agency refers to a rational and responsible exercise of capabilities through Ricoeurs analysis of Sens earlier works. I successively developed the concept of capabilities as relationships through the distinction between intrapersonal and interpersonal relationships: in this framework, self-scrutiny and relationality, respectively, become the leading capabilities of these two relationships. From this extension of the capabilities conception of the individual, two concepts arise with a certain strength, namely those of responsibility and relationality. This extension of the capabilities conception of the individual in economics also in terms of interpersonal relationships emphasises that this social conception of the individual is characterised by relationality. Thanks to responsibility and relationality, the capabilities conception of the individual might be applied in fields such as contemporary civil economy and ecological economics. JEL Classifications: B31, B410, B59, Z13
Empiric Antibiotic Use and the Outcome in Infants at Risk of Early Onset Neonatal Sepsis in a Teaching Hospital in South India: A Retrospective Cohort Study
Authors: Kumar KC Sreejith , M Shafiq Ahamed , Balasundaran Karthik 
Published: August 2023

Background Neonatal sepsis continues to be an important cause of mortality and morbidity in low- and middle-income countries. The identification and early treatment of infants at risk of early-onset neonatal sepsis (EONS) with empiric antibiotics is a preventive strategy. Objectives To study the use of empiric antibiotics in infants at risk for EONS and assess their outcome in terms of the development of sepsis, mortality, and duration of hospital stay. Materials and Methods This retrospective cohort study was done at the Special Newborn Care Unit, GMC Thrissur. The data of babies at risk of EONS over a period of 3 years (2020–2022) was collected. One thousand two hundred and thirty-two babies with at least one risk factor for sepsis, as defined by the National Neonatology Forum (NNF) 2021 guidelines, were enrolled in the study. The antibiotic prescription pattern and the outcomes were measured. Results Empirical antibiotic treatment was received by 61.2% (754/1232) of infants, and of those, 39.5% (298/754) developed EONS. Infants treated with Piperacillin/Tazobactam and Amikacin had a higher incidence of sepsis and mortality than those started on Ampicillin and Gentamicin ( p < .001). In infants less than 32 weeks, the incidence of sepsis increased significantly with increase in number of risk factors ( p < .001). Infants with lower birth weight and gestational age were more susceptible to developing sepsis ( p < .001). EONS was significantly associated with neonatal resuscitation, umbilical vein catheterization, and invasive ventilation ( p < .001). Infants who received empirical antibiotics had a longer hospital stay, with a mean duration of 4.38 days more compared to the no antibiotics group. Conclusion In infants at risk of EONS, the empirical use of antibiotics alone did not show a favorable effect on the incidence of EONS or sepsis-related mortality.
Impact of health system specialty pharmacies on total cost of care in cancer treatment, a multisite review
Authors: Wink Scott , Schroader Bridgette Kanz , Giglio Toni , Ward Angela 
Published: August 2023

Introduction Integrated delivery networks can use medically integrated dispensing of oral oncolytics on site through health system specialty pharmacies. There is little published research examining cost savings. Our objective was to demonstrate the financial value of health system specialty pharmacies among patients receiving oral oncolytics dispensed through fully, partially, and non-integrated dispensing strategies. Methods This was a retrospective cohort study of adult patients from Symphony Health's Integrated Dataverse® repository who filled a prescription for an agent of interest from 7/1/16–6/30/20 that was written within 25 US health systems. Outcomes included costs, healthcare resource utilization, and duration of therapy. Results In total, 36,816 patients were included; 986 patients (2.7%) integrated, 1,822 (4.9%) partially integrated, and 34,008 (92.4%) non-integrated. Mean 6-month medical charge and oncolytic prescription costs were lower for the integrated group ($36,831; $55,786) than the partially integrated ($46,304, p = 0.053; $63,295, p = 0.071) and non-integrated groups ($54,261, p < 0.001; $65,005, p = 0.004). In most healthcare resource utilization categories, the integrated group had the lowest patient percentage utilizing medical care. Duration of therapy was lower on average by ∼3 months in the integrated vs non-integrated group, which may represent closer monitoring of patient medical records and need for fills vs autoship practices. Conclusions Patients receiving oral oncolytics through medically integrated dispensing at health system specialty pharmacies may have lower medical and pharmacy costs and decreased healthcare resource utilization. This study adds to the growing body of literature supporting integrated delivery networks and integrated dispensing. Further research is needed to demonstrate the value of medically integrated dispensing through health system specialty pharmacies in the delivery of treatment to patients with cancer and other high-cost diseases.
Quiescent caterpillar hair: A rare cause of localised lenticular opacity formation
Authors: Kapila Priya , Salhotra Sudhir , Agarwal Neetu , Karothiya Babita 
Published: August 2023

Purpose To report a rare case of a 65 year old patient with a single caterpillar hair with localised lenticular opacity around it and no active inflammation. Observations A single quiescent caterpillar hair embedded in the anterior lens capsule causing localised cataract around it. There was no other sign of ocular toxicosis and the patient was unaware of the presence of this intraocular foreign body. Conclusions Caterpillar hair (also known as setae) are a common cause of ophthalmia nodosa. These setae can penetrate intraocularly with ease to cause various forms of ocular toxicosis ranging from conjunctivitis, keratitis, pars planitis, chorioretinitis to even severe vitritis warranting enucleation. As per our knowledge and experience, no case of caterpillar hair without inflammation has been reported till date. We hereby report a rare case of a 65 year old patient with a single caterpillar hair embedded in the anterior lens capsule causing localised cataract around it without any active inflammation. In our opinion, if the eye is quiescent, the patient should be kept on close and long term follow-up and active intervention can be undertaken at the first instance of inflammation or if cataract progresses.
The contribution of indocyanine green angiography in a case of unilateral retinal pigment epithelium dysgenesis
Authors: Cervera-Taulet Enrique , Montero-Hernández Javier , Monferrer Adsuara Clara , Pulido Jose S. 
Published: August 2023

Purpose To further enhance understanding of the expanded clinical spectrum of unilateral retinal pigment epithelium dysgenesis (URPED) via numerous imaging modalities including novel markers of highly detailed indocyanine green angiography (ICGA) features. Methods Retrospective, observational, case report. Results URPED in this patient is expressed as a solitary, flat and pigmented lesion in the posterior pole with RPE hyperplasia and atrophic changes. An epiretinal membrane (ERM) causing fine, tortuous retinal vessels and retinal folds was observed. Green and blue excitation light fundus autofluorescence showed a biphasic appearance with hypoautofluorescent rounded lesions and a reticular configuration of normal RPE. Fundus fluorescein angiography revealed diffuse hypofluorescence and hyperfluorescent wisps of leakage in late-phases. Early-phase of ICGA evidenced diffuse hypocianescence and a delineated hypercianescent scalloped margin appeared in the late-phase, together with focal hypocianescent spots. SD-OCT demonstrated irregularity of the RPE with fibrosis and hyperplastic changes combined with atrophic areas. Flat RPE detachments intermingled with healthy-appearing RPE were also observed together with thinning of the outer retina. ERM with thickening and disorganization involving the whole retina was present. Optical coherence tomography angiography (14 × 14 mm) revealed an oval shape foveal avascular zone and vascular anomalies such as tortuosity and looping. Conclusion URPED is an extremely rare clinical entity with only a few cases reported. In this case the almost pathognomonic differential features of URPED were best appreciated with ICGA imaging. To our knowledge, this is the first reported case of URPED with these abnormal findings on ICGA meaning it could be part of the spectrum of the disease.
Fundus autofluorescence of retinal atrophy progression between fundus flavimaculatus and extensive macular atrophy with pseudo-drusen
Authors: Rabinovich Mark , Mehanna Carl-Joe , Lopez Juan Manuel , Souied Eric H 
Published: August 2023

Objective To analyze the progression of macular atrophy in Fundus Flavimaculatus (FFM) versus Extensive Macular Atrophy with Pseudo-drusen (EMAP), using Spectralis® RegionFinder™ tool. Methods Retrospective review of patients diagnosed with FFM and EMAP. Ophthalmic imaging features were reviewed by retina specialists for each patient in both eyes. The atrophic zones were measured on fundus autofluorescence acquisitions using the RegionFinder™ tool. Results FFM group included 16 eyes of 8 patients, whose mean age was 61.42 ± 10.76 years, with a mean 4.54 ± 2.73 years of follow-up. EMAP group contained 16 eyes of 8 patients, whose mean age was 67.81 ± 3.03 years ( p = 0.12), with a mean 3.62 ± 2.49 years of follow-up ( P = 0.63). The atrophy progression rates were 3.73 ± 6.75 and 0.70 ± 0.98 mm2/year, for EMAP and FFM respectively. The yearly rate of progression of the atrophic areas in EMAP was 5.3 times higher than in FFM (mm2/year) ( p = 0.03). Conclusion The progression of the atrophy in eyes with Extensive Macular Atrophy with Pseudo-drusen (EMAP) is significantly more rapid than in eyes with Fundus Flavimaculatus (FFM).
Use of a novel tapered, scoring balloon to treat juxta-anastomotic stenosis in AV fistula
Authors: Li Xiangjie , Wang Zhe , Zhao Xia , Sun Hao , Fu Qining 
Published: August 2023

Background: Juxta-anastomotic stenosis, the most common lesion in arteriovenous fistula, creates a dilemma for optimal balloon size choosing during PTA. Objectives: To descript the effect of a novel tapered scoring balloon catheter (DK Medtech, Suzhou, China) which has a conical shape with an increasing diameter from the front part of the balloon to the end, and three non-slip elements attached on the surface of the balloon. Research design: Case series of 10 patients used this balloon catheter was retrospectively analyzed. Subjects: Patients with juxta-anastomotic stenosis. Measures: A retrospective review of 10 cases using the novel tapered, scoring balloon catheter in our center was performed. Results: All cases were clinical technique success. The average total procedure time was 16.7 min with 2:14 of fluoroscopy time. No complications such as vascular rupture or dissection occurred. The primary patency rates at 6 and 12 month were 80% and 50% separately. Conclusions: This tapered scoring balloon provides an economical, safe, and efficient management for juxta-anastomotic stenosis.
Local Health Department Values and Organizational Authorities Guiding Cross-Sector Work During COVID-19
Authors: Johnson Karl , Biddell Caitlin B. , Gora Combs Katherine , Wiesman John , Valdes Lupi Monica , Hassmiller Lich Kristen 
Published: August 2023

Objective The COVID-19 pandemic highlighted the role that local health departments (LHDs) have in cross sector can address alone, including the work of value alignment and the strategic use of organizational authorities. The practices by which LHDs used their authorities to conduct cross-sector work during the pandemic need exploration. Method We conducted semi-structured interviews with 19 public health leaders from metropolitan LHDs across the United States. Our interview guide assessed the values that LHD leadership prioritized in their cross-sector work as well as the range of organizational authorities they leveraged to influence external decision-making in other sectors. Results We found that LHDs approached cross-sector work by leaning on diverse values and authorities, each with unique implications for their work. The LHDs emphasized their approach to value alignment on a sector-by-sector basis, strategically using diverse organizational authorities—economic, political, moral, scientific, and logistical. While each authority and value we assessed was present across all interviewees, how each shaped action varied. Internally, LHDs emphasized certain authorities more than others to the degree that they more closely aligned with prioritized core values. Conclusion Our findings highlight the ongoing need for LHD leadership to improve their ability to effectively communicate public health values and the unique authorities by which health-supporting work can be facilitated, including how this message must be adapted, depending on the specific sectors with which the LHD needs to partner and the governance arrangement in which the LHD is situated.
Longitudinal changes in objective sleep parameters during pregnancy
Authors: Guo Yuqing , Xu Qi , Dutt Nikil , Kehoe Priscilla , Qu Annie 
Published: August 2023

Background: Sleep disturbances are associated with adverse perinatal outcomes. Thus, it is necessary to understand the continuous patterns of sleep during pregnancy and how moderators such as maternal age and pre-pregnancy body mass index impact sleep. Objective: This study aimed to examine the continuous changes in sleep parameters objectively (i.e. sleep stages, total sleep time, and awake time) in pregnant women and to describe the impact of maternal age and/or pre-pregnancy body mass index as moderators of these objective sleep parameters. Design: This was a longitudinal observational design. Methods: Seventeen women with a singleton pregnancy participated in this study. Mixed model repeated measures were used to describe weekly patterns, while aggregated changes describe these three pregnancy periods (10–19, 20–29, and 30–39 gestational weeks). Results: For the weekly patterns, we found significantly decreased deep (1.26 ± 0.18 min/week, p < 0.001), light (0.72 ± 0.37 min/week, p = 0.05), and total sleep time (1.56 ± 0.47 min/week, p < 0.001) as well as increased awake time (1.32 ± 0.34 min/week, p < 0.001). For the aggregated changes, we found similar patterns to weekly changes. Women (⩾30 years) had an even greater decrease in deep sleep (1.50 ± 0.22 min/week, p < 0.001) than those younger (0.84 ± 0.29 min/week, p = 0.04). Women who were both overweight/obese and ⩾30 years experienced an increase in rapid eye movement sleep (0.84 ± 0.31 min/week, p = 0.008), but those of normal weight (<30 years) did not. Conclusion: This study appears to be the first to describe continuous changes in sleep parameters during pregnancy at home. Our study provides preliminary evidence that sleep parameters could be potential non-invasive physiological markers predicting perinatal outcomes.
How do digital range of motion measurement devices ‘measure-up’ to traditional goniometry in assessing shoulder range of motion? A systematic review and meta-analysis
Authors: Shepherd J , Hansjee S , Divall P , Raval P , Singh HP 
Published: August 2023

Background Shoulder range of motion (ROM) is traditionally measured using universal goniometry. However, novel devices to measure shoulder ROM digitally are becoming increasingly available. We aimed to synthesise the current evidence to answer: 1) what technologies are currently in use? 2) Are they reliable? 3) How do they compare to goniometry? Methods Systematic review of the literature was conducted according to PRISMA guidelines. MEDLINE, Embase, CINAHL, Emcare and Cochrane databases were searched to identify studies comparing a digital device measuring shoulder ROM to goniometry in participants > = 18years. Quality of studies was assessed using COSMIN risk of bias tool. End points included device validity compared to goniometry and intra-rater reliability. Results 15 articles were included, representing 372 participants and 608 shoulders, and reporting data for five device categories; infrared/RGB-D, 3D-motion-analysis, combined 3D/infra-red, 2D-video-analysis and virtual-reality. Nine studies reported mean bias and 95% limits of agreement (LOA) compared to goniometry. Pooled mean bias was −0.25 degrees (−1.25, 0.75 95% LOA, random effects model) overall. This did not differ by device type (p = 0.83), sensor or non-sensor-based devices (p = 0.62) or plane of movement (p = 0.91). Conclusions These devices compare well to goniometry and represent a possible means of increasing efficiency and facilitating telemedicine.