bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring Subtropical Stratocumulus Multiple Equilibria Using a Mixed-Layer Model
Authors: Salazar Andrea M. , Tziperman Eli 
Published: January 2023

Abstract
Stratocumulus clouds cover about a fifth of Earth’s surface, and due to their albedo and low-latitude location, they have a strong effect on Earth’s radiation budget. Previous studies using large-eddy simulations have shown that multiple equilibria (both stratocumulus-covered and cloud-free/scattered cumulus states) exist as a function of fixed SST, with relevance to equatorward advected air masses. Multiple equilibria have also been found as a function of atmospheric CO2, with a subtropical SST nearly 10 K higher in the cloud-free state and with suggested relevance to warm climate dynamics. In this study, we use a mixed-layer model with an added surface energy balance and the ability to simulate both the stratocumulus (coupled) and cloud-free/scattered cumulus (decoupled) states using a “stacked” mixed-layer approach to study both types of multiple equilibria and the corresponding hysteresis. The model’s simplicity and computational efficiency allow us to qualitatively explore the mechanisms critical to the stratocumulus cloud instability and hysteresis as well as isolate key processes that allow for multiple equilibria via mechanism-denial experiments not possible with a full-complexity model. For the hysteresis in fixed SST, we find that decoupling can occur due to either enhanced entrainment warming or a reduction in cloud-top longwave cooling. The critical SST at which decoupling occurs is highly sensitive to precipitation and entrainment parameterizations. In the CO2 hysteresis, decoupling occurs in the simple model used even without the inclusion of SST–cloud cover feedbacks, and the width of the hysteresis displays the same sensitivities as the fixed SST case. Overall, the simple model analysis and results motivate further studies using higher complexity models.
Predictive Value of the Modified Mehran Score for Contrast-Induced Nephropathy After Transcatheter Aortic Valve Implantation
Authors: Özdemir Emre , Akçay Filiz Akyıldız , Esen Saban , Emren Sadık Volkan , Karaca Mustafa , Nazlı Cem , Kırış Tuncay 
Published: January 2023

Considering the increasing use of the transcatheter aortic valve implantation (TAVI) procedure, the relationship of contrast-induced nephropathy (CIN) with post-TAVI mortality has become important. The Mehran score was developed to detect the risk of CIN development after cardiac intervention. We aimed to compare the role of the modified Mehran score, which can be calculated pre-procedure, in predicting CIN development and compare it with the original Mehran score. We retrospectively collected data from TAVI procedures at our institution between December 2016 and June 2021; of 171 patients, 44 (25.7%) had CIN. We found no association between contrast media volume and CIN (387 ± 120 vs 418 ± 139 mL, P = .303). High and very high modified Mehran score and preoperative C-reactive protein (CRP) level were independent risk factors for CIN development after TAVI procedure. The area under curve (AUC) was .686 with 95% CI: .591-.780 and P < .001, and also, with a cut-off point of >7.5 points, there was 79.5% sensitivity and 63.0% specificity; otherwise, with a cut-off point of >9.5 points, there was 54.5% sensitivity and 71.7% specificity, for the modified Mehran score. The modified Mehran score comes into prominence compared with the original Mehran score since it can be calculated pre-procedure.
No social distancing from food: How the COVID-19 pandemic shaped student food-related activities in the Western Balkans
Authors: Ben Hassen Tarek , El Bilali Hamid , Allahyari Mohammad S. , Berjan Sinisa , Radosavac Adriana , Cvijanovic Drago , Bogevska Zvezda , Despotovic Aleksandra , Vaško Željko 
Published: January 2023

Background The COVID-19 pandemic has influenced food preparation and consumption habits, as well as food wastage. The pandemic also affected the lives of university students worldwide; their learning and living environments changed, influencing their eating habits. Aim The purpose of this study was to evaluate the repercussions of the COVID-19 pandemic on students’ food-related activities in four countries in the Western Balkans: Bosnia and Herzegovina, Serbia, North Macedonia, and Montenegro. Methods The research draws upon an online survey gathered through the SurveyMonkey platform in four Balkan countries—viz. Bosnia and Herzegovina, Serbia, North Macedonia, and Montenegro—and used a structured questionnaire. The information was collected during the second wave of COVID-19 in October–November 2020. A total of 1658 valid responses were received. Descriptive statistics and nonparametric tests were used to analyze the survey findings. Results The research results suggest that the pandemic influenced students’ food purchase habits, diets, and food-related behaviors and practices such as food preparation, cooking, and food waste management at the household level. In particular, students have been eating healthier and shopping less frequently during the pandemic. Meanwhile, the pandemic improved their attitude toward food wastage. Conclusion This study is the first to examine how students in the Balkan region perceive the impact of the COVID-19 pandemic on their eating habits, laying the groundwork for future studies into the disease's consequences. This and other studies will assist in preparing students and education institutions for future calamities and pandemics. The findings will also help develop evidence-based postpandemic recovery options targeting youth and students in the Western Balkans.
Reduction in caffeine withdrawal after open-label decaffeinated coffee
Authors: Mills Llewellyn , Lee Jessica C. , Boakes Robert , Colagiuri Ben 
Published: January 2023

Background: Withdrawal from addictive drugs can be reduced by administering placebo deceptively, but in the clinic it is unethical to deceive the patient. Open-label placebo effects have been observed across a range of psychophysiological phenomena, and may also apply to drug withdrawal. Method: 24-hour abstinent heavy coffee drinkers ( N = 61) rated their caffeine withdrawal symptoms before being allocated to one of three groups. The Deceptive group was given decaffeinated coffee (decaf) and told it was caffeinated, the Open-Label group given decaf and told it was decaf and the Control group given water and told it was water. After 45 min, caffeine withdrawal was measured again. All participants rated their expectancies of withdrawal reduction from caffeinated coffee, decaf and water prior to being randomised and the end of the study. Results: There was a significant 9.5-point reduction in caffeine withdrawal in the Open-Label group (95% confidence interval (CI): 4.7, 14.3; p = 0.002), which was 8.6 points less than the Deceptive group (95%CI: 0.4, 16.8; p = 0.014) but 8.9 points greater than the Control group (95%CI: 0.6, 17.2; p = 0.012). Pre-randomisation, participants expected caffeinated coffee to reduce their withdrawal symptoms the most, followed by water and decaf, Pre-randomisation expectancy of withdrawal was only associated with amount of withdrawal reduction in the Deceptive group. Conclusion: It appears as if open-label placebo caffeine (i.e. decaf) can reduce caffeine withdrawal symptoms, even when people do not hold a conscious expectancy it will do so. There may be ways to integrate open-label placebo procedures into clinical interventions for drug dependence without violating informed consent.
Selection and recruitment of pre-registration occupational therapy students in the United Kingdom: Exploring entry criteria across education providers
Authors: McGinley Sarah Louise , Hamilton Sukhbinder , Bradley Alexander 
Published: January 2023

Introduction: Since widening access to higher education became a United Kingdom (UK) governmental priority in the 1990’s, occupational therapy has made little progress in diversifying student and workforce populations that mirror increasingly diverse service user populations. This research aims to, for the first time, map entry criteria across UK pre-registration programmes, while considering fair access and exploring who might be missing at the point of enquiry and entry. Method: A cross-sectional quantitative content analysis was conducted of all UK university websites, identifying programme type, academic, professional and alternative entry criteria for 2021/2022. Findings: Five entry routes via undergraduate and post-graduate programmes ( n = 73) offer limited part-time opportunities (n = 11). Visible academic entry criteria appear weighted towards ‘traditional’ qualifications, while assessment of professional skills at application and selection is explicit for over 75% of programmes. 86% (n = 63) utilise interviews at selection, with 33% (n = 24) not publicly acknowledging alternative access routes into the profession. Conclusion: If the profession is to avoid continued stagnation in diversity amongst student populations and successfully reflect service user diversity in the workforce, it is essential UK universities increase parity across academic entry criteria, ensure the visibility of acceptable skills for alternative access and substantially improve flexibility for part-time study.
Clinical Effect of Isolated Lateral Closing Wedge Distal Femoral Osteotomy Compared to Medial Opening Wedge High Tibial Osteotomy for the Correction of Varus Malalignment: A Propensity Score–Matched Analysis
Authors: Rupp Marco-Christopher , Lindner Felix , Winkler Philipp W. , Muench Lukas N. , Mehl Julian , Imhoff Andreas B. , Siebenlist Sebastian , Feucht Matthias J. 
Published: January 2023

Background: Recent evidence questions the role of medial opening wedge high tibial osteotomy (mowHTO) in the correction of femoral-based varus malalignment because of the potential creation of an oblique knee joint line. However, the clinical effectiveness of alternatively performing an isolated lateral closing wedge distal femoral osteotomy (lcwDFO), in which the mechanical unloading effect in knee flexion may be limited, is yet to be confirmed. Purpose/Hypothesis: The purpose of this article was to compare clinical outcomes between patients undergoing varus correction via isolated lcwDFO or mowHTO, performed according to the location of the deformity, in a cohort matched for confounding variables. It was hypothesized that results from undergoing isolated lcwDFO for symptomatic varus malalignment would not significantly differ from the results after mowHTO. Study Design: Cohort study; Level of evidence, 3. Methods: Consecutive patients who underwent isolated mowHTO or lcwDFO according to a tibial- or femoral-based symptomatic varus deformity between January 2010 and October 2019 were enrolled. Confounding factors, including age at surgery, sex, body mass index, preoperative femorotibial axis, and postoperative follow-up, were matched using propensity score matching. The International Knee Documentation Committee (IKDC) Subjective Knee Form, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Lysholm score, Tegner Activity Scale, and visual analog scale (VAS) for pain were collected preoperatively and at a minimum of 24 months postoperatively. Results: Of 535 knees assessed for eligibility, 50 knees (n = 50 patients, n = 25 per group) were selected by propensity score matching. Compared with preoperatively, both the mowHTO group (IKDC, 55.1 ± 16.5 vs 71.3 ± 14.7, P = .002; WOMAC, 22.0 ± 18.0 vs 9.6 ± 10.8, P < .001; Lysholm, 55.2 ± 23.1 vs 80.7 ± 16, P < .001; VAS, 4.1 ± 2.4 vs 1.6 ± 1.8, P < .001) and the lcwDFO group (IKDC, 49.4 ± 14.6 vs 66 ± 20.1, P = .003; WOMAC, 25.2 ± 17.0 vs 12.9 ± 17.6, P = .003; Lysholm, 46.5 ± 15.6 vs 65.4 ± 28.7, P = .011; VAS, 4.5 ± 2.2 vs 2.6 ± 2.5, P = .001) had significantly improved at follow-up (80 ± 20 vs 81 ± 43 months). There were no significant differences between the groups at baseline, at final follow-up, or in the amount of clinical improvement in any of the outcome parameters ( P > .05; respectively). Conclusion: Performing both mowHTO or lcwDFO yields significant improvement in clinical outcomes if performed at the location of the deformity of varus malalignment. These findings confirm the clinical effectiveness of performing an isolated lcwDFO in femoral-based varus malalignment, which is comparable with that of mowHTO in the correction of varus malalignment.
Recurrent Falls over Three Years among Older Adults Age 70+: Associations with Physical and Mental Health Status, Exercise, and Hospital Stay
Authors: Choi Namkee G. , Marti C. Nathan , Choi Bryan Y. , Kunik Mark M. 
Published: January 2023

We used the 2019–2021 U.S. National Health and Aging Trend Study ( N = 3,063, age 70+) and multinomial logistic regression and generalized linear models with Poisson and log link to identify correlates of (1) recurrent falls (2 + falls) over 3 years (2019–2021); and (2) any subsequent fall among those who had a fall in 2019. We also examined the associations between falls and hospitalization in 2021. Results show that those with recurrent falls had greater physical/functional and psychological health problems in 2019, while single fallers over the 3 years were not significantly different from those without a fall. Exercise was associated with a lower likelihood of a subsequent fall among those who fell in 2019. Both a single fall and recurrent falls over the 3 years were associated with a higher risk of hospitalization in 2021. Multifactorial fall preventions including exercise and depression/anxiety treatment are needed to mitigate recurrent fall risks.
Women’s Employment–Family Trajectories and Well-Being in Later Life: Evidence From France
Authors: Beaufils Constance , Barbuscia Anna , Cambois Emmanuelle 
Published: January 2023

Objective: Previous research in various countries has found that employment–family trajectories characterized by early or single motherhood, or weak ties to employment, are associated with poor well-being among older women. Our paper explores whether this differs (1) in France, characterized by a high female employment rate and supportive family policies; (2) across dimensions of well-being. Method: We used the Health and Occupational Itinerary survey to identify 10 common patterns of employment–family trajectories (derived from multi-channel sequence analysis) and analysed their association with six indicators of well-being in 2010 ( N = 2882 50–78 years old women). Results: Continuous full-time employment is associated with better well-being, except for women who had a first child around 24 years old, who reported increased anxiety and lack of support. Discussion: Employed mothers’ well-being seems to be protected in a context of family friendly policies, but we identified one group with lower well-being, which merits further study.
Domestic abuse and violence reporting by service users of an online sexually transmitted infection testing service, during the Coronavirus-19 pandemic
Authors: Day Sara , Kellett Chris , Jones Sophie 
Published: January 2023

Background Following increased rates of domestic abuse/violence (DAV) reporting during the pandemic, London’s online sexually transmitted infection (STI) testing service (Sexual Health London, SHL) introduced routine DAV enquiry and directed survivors to supportive online information. SHL evaluated this adaptation. Method SHL’s database identified the first individuals that ordered a test-kit between 17.8.21-28.2.22 and triggered questions disclosing DAV. SHL clinicians only contacted these individuals if positive/abnormal STI results required communicating. Within these interactions DAV was opportunistically discussed and further counselling/support offered. Results 3846/231460 (1.7%) service users triggered DAV question(s). The first 202 individuals were: median age 28 yrs (18–73 yrs); 66% (134/202) female; 72% (145/202) heterosexual; 75% (152/202) UK born. 27% (55/202) reported physical/emotional abuse, 81% (164/202) coercive control, and 22% (45/202) sexual abuse. 26% (52/202) had never visited a clinic. Telephonic discussion occurred with 10% (20/202) individuals: 10/20 accepted counselling/signposting; 2/20 referred to independent DAV advocate, 6/20 stated historic abuse, 2/20 mistakenly triggered, 2/10 declined support or disengaged. Of 29% (58/202) individuals that ordered another e-kit, 38% disclosed ongoing DAV and 9% sexual assault. Conclusion 1.7% e-service users reported DAV. Telephonic DAV discussion was accepted by 80% individuals contacted. Despite providing online support 38% experienced ongoing/escalating abuse. Further engagement and support for DAV survivors using e-services is required.
The pathogenic role of lupus-specific autoantibodies and Interleukin-6 on demyelination of the brainstem and spinal cord in systemic lupus erythematosus
Authors: Hasegawa Yasuhiro , Arinuma Yoshiyuki , Muramatsu Takumi , Kondou Junichi , Matsueda Yu , Kanayama Yoshiro , Ino Kazuma , Tanaka Tomoki , Wada Tatsuhiko , Oku Kenji , Yamaoka Kunihiro 
Published: January 2023

Objectives Demyelinating syndromes that result in brainstem and/or spinal cord lesions similar to those observed in neuromyelitis optica spectrum disorder (NMOSD) as neuropsychiatric syndromes in systemic lupus erythematosus (NPSLE) occasionally develop in patients with SLE. Cerebrospinal fluid (CSF) interleukin (IL)-6 is a known biomarker for NMOSD; however, its application in patients with SLE with brainstem and/or spinal cord lesions is unknown. Additionally, the breakdown of blood–brain barrier (BBB) integrity by autoantibodies is another mechanism of NMOSD; however, it is not elucidated in SLE. Therefore, this study was designed to clarify the use of CSF IL-6 and investigate whether autoantibodies contribute to BBB breaches and the development of brainstem and/or spinal cord lesions. Methods Data from patients with NPSLE who had NMOSD-like demyelinating lesions in the central nervous system (CNS), including brainstem and/or spinal cord lesions, were retrospectively analyzed. We retrospectively investigated the interval changes in CSF IL-6 and clinical and serological factors related to BBB permeability using CSF/serum albumin ratio (QAlb). Results Twelve patients with NPSLE who had demyelinating lesions in the brainstem and/or spinal cord were recruited. Before treatment, CSF IL-6 levels were 29.1 pg/mL and significantly decreased to 3.8 pg/mL by treatment ( p = 0.008). Before treatment, CSF IL-6 was significantly correlated with the anti-dsDNA antibody titer ( p = 0.027). Furthermore, before treatment, QAlb was significantly correlated with the serum anti-Smith antibody titer. In patients with atypical NMOSD who had specific lesions defined in the NMOSD diagnostic criteria but were negative for antiaquaporin four antibody, a significant correlation was observed between the serum anti-Smith antibody titer and CSF IL-6 ( p = 0.025) and QAlb ( p = 0.033) values before treatment. Conclusion CSF IL-6 could be a surrogating marker for disease activity, and serum anti-Smith antibody permeabilizes the BBB in patients with NPSLE, supporting the development of NMOSD-like CNS lesions.
Piloting a novel medical student virtual discharge counseling process in the time of the COVID-19 pandemic
Authors: Leybov Victoria , Ross Joshua , Smith Silas W , Ciardiello Amber , Maheshwari Sana , Caspers Christopher , Wittman Ian , Kuhner Christopher , Stark Stephen , Conroy Nancy 
Published: January 2023

Background During the COVID-19 pandemic, we identified a gap in adequate discharge counseling for COVID-19 patients in the Emergency Department. This was due to high patient volumes and lack of patient education regarding a novel disease. Medical students were also restricted from clinical areas due to safety concerns, compromising their clinical experience. We piloted a novel program in which medical students served as virtual discharge counselors for COVID-19 patients via teleconference. We aimed to demonstrate an impact on patient care by examining the patient bounce back rate as well as assessing medical student education and experience. Methods This program was piloted in a tertiary care Emergency Department. Medical student volunteers served as virtual discharge counselors. Students were trained in discharge counseling with a standardized protocol and a discharge script. Eligible patients for virtual discharge counseling were 18 years old or greater with a diagnosis of confirmed or suspected COVID-19 and no impediment precluding them from participating in a telemedicine encounter. Counseling was provided via secure teleconference in the patient's preferred language. Counseling included diagnosis, supportive care with medication dosing, quarantine instructions, return precautions, follow up, and time to ask questions. Duration of counseling was recorded and medical students were anonymously surveyed regarding their experience. Results Over an 18-week period, 45 patients were counseled for a median of 20 min. The 72-hr ED revisit rate was 0%, versus 4.2% in similarly-matched, not counseled COVID-19 patients. 90% of medical students believed this project increased their confidence when speaking with patients while 80% indicated this was their first telemedicine experience. Conclusion Our pilot discharge program provided patients with an extensive discharge counseling experience that would not otherwise be possible in an urban ED setting and demonstrated benefit to patient care. Medical students received a safe clinical experience that improved their communication skills.
Education guidelines, frameworks and resources for building virtual care capacity: An integrative review
Authors: Palesy Debra , Forrest Gail , Crowley Margaret E 
Published: January 2023

Introduction Despite its reported benefits, the accelerated adoption of virtual care since the COVID-19 pandemic has occurred without critical consideration of clinician education and training. This integrative review aims to better understand the necessary education guidelines, frameworks and resources for building the confidence and capability of the workforce for virtual care delivery. Methods Whittemore and Knafl's (2005) five-stage methodological framework informed this review. Using a clearly articulated search strategy and reporting process, over 8000 pieces of literature were analysed. A final 46 publications comprising 26 scholarly papers and 20 pieces of grey literature were included for review. Results A set of key curriculum inclusions under three domains: clinical, administrative and technical are proposed. Many publications emphasise a domain-specific approach as the most effective means of translating virtual care knowledge and skills to practice. A number of new domain frameworks have been tailormade for specific disciplines, while well-established frameworks such as the ACGME, CanMEDS, AAMC and IPEC have been adapted for virtual care education. Virtual care checklists, clinical champions and models that involve frontline clinicians, content experts and care recipients are considered useful resources for virtual care education. Discussion Moving beyond the COVID-19 pandemic, virtual care education for current and future clinicians requires a cohesive, interprofessional approach. This approach should be rigorously evaluated as part of a continuous quality improvement process.