bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Distant Organized Convection on Forecasts of Widespread Clear-Air Turbulence
Authors: Trier Stanley B. , Sharman Robert D. , Muñoz-Esparza Domingo , Keller Teddie L. 
Published: June 2022

Abstract
Two cases of observed widespread moderate-or-greater (MOG) clear-air turbulence (CAT) in different synoptic patterns are investigated using a nested high-resolution NWP model. Both of these cases occurred in confluent entrance regions of upper-tropospheric–lower-stratospheric (UTLS) jet streaks, where large-scale anticyclonic outflow from distant organized moist convection strengthened the UTLS jet. Both the strength and vertical sharpness of the resulting jet influence the altitudes of MOG turbulence and the details of simulated turbulence onset mechanisms. In a strong and narrow UTLS jet downstream of a weak synoptic ridge, MOG turbulence arises from Kelvin–Helmholtz (KH) waves that overturn in opposite directions on the vertical flanks of the jet. In broader UTLS jets, MOG turbulence arising from KH waves was favored in strong vertical shear layers beneath the wind maximum, but was inhibited above it due to static stability increases near the tropopause. However, vertically propagating internal gravity waves initiated above KH wave breaking beneath the UTLS jet amplify within the lower stratosphere above the jet, constituting another possible source of turbulence. Turbulence onset mechanisms were often apparent in simulations with minimum horizontal grid spacings of Δx = 1 km. However, amplitudes of the associated grid-resolved vertical motions were unreliable when compared with simulations having minimum horizontal grid spacings of Δx = 1/3 km. In spite of this, turbulence forecasting systems driven by input from coarser-resolution operational NWP models are demonstrated to provide good diagnoses of this type of convectively influenced CAT when the NWP model accurately forecasts upstream convection.

Significance Statement
In this study we document the role of distant convection on observed widespread strong clear-air turbulence near upper-level jet streams in different weather patterns. Results from nested NWP model simulations, together with similar examples from previous case studies, suggest a strong association of widespread turbulence with jet stream enhancements related to outflow from upstream convection. We also demonstrate how model horizontal grid spacings of <1 km are required to adequately resolve common turbulence onset mechanisms (e.g., Kelvin–Helmholtz instability, gravity wave breaking). Nevertheless, examples are provided showing that turbulence forecasting systems driven by lower-resolution operational NWP models can provide potentially valuable guidance on these widespread turbulence events when those models accurately forecast the timing and locations of upstream convection.
Early Cholecystectomy in Gallstone Pancreatitis Patients With and Without End Organ Dysfunction: A NQSIP Analysis
Authors: Liu Jessica K. , Braschi Caitlyn , de Virgilio Christian M. , Ozao-Choy Junko , Kim Dennis Y. , Moazzez Ashkan 
Published: June 2022

IntroductionWhile literature widely supports early cholecystectomy for mild gallstone pancreatitis (GSP), this has not been reflected in clinical practice. Early cholecystectomy for GSP with end organ dysfunction remains controversial.ObjectiveThis study aims to evaluate the rate and outcomes of early cholecystectomy (<3 days from admission) in mild GSP patients with end organ dysfunction (+EOD) and without (–EOD).MethodsPatients with GSP without necrosis were identified from 2017 to 2019 NSQIP database and categorized into GSP±EOD. Coarsened Exact Matching was used to match patients based on preoperative risk factors in each group, and outcomes were compared.ResultsThere was a total of 3104 patients –EOD and 917 +EOD in the aggregate cohort. Early cholecystectomy was performed in 1520 (49.0%) of GSP-EOD and in 407 (44.4%) of GSP+EOD. In the matched cohorts, there were no significant differences in 30-day mortality, morbidity, or reoperation for early cholecystectomy in either group. In GSP-EOD, early cholecystectomy was associated with shorter LOS (2.9 ± 1.5 vs. 5.6 ± 3.0 days, P < .001), shorter operative time (69.7 ± 34.4 vs. 73.3 ± 36.6 min, P = .045), and more concurrent biliary procedures (52.1% vs. 35.4%, P < .001). Similarly, early cholecystectomy in GSP+EOD was associated with shorter LOS (3.3 ± 1.8 vs. 6.9 ± 6.6 days, P < .001), shorter operative time (65.9 ± 32.1 vs. 76.0 ± 40.7, P < .001), and more concurrent biliary procedure (46.0% vs. 34.9%, P = .002).ConclusionsThis study supports early cholecystectomy in patients with mild GSP. Even with end organ dysfunction, early cholecystectomy appears to be safe given there is no difference in morbidity and mortality, and the potential benefit of reduced LOS.
Coping Strategies and Their Relationship With Subjective Distress due to the COVID-19 Pandemic in Brazil
Authors: Campos Juliana Alvares Duarte Bonini , Campos Lucas Arrais , Martins Bianca Gonzalez , Marôco João 
Published: June 2022

Objectives To identify the strategies used by Brazilian adults for coping with the COVID-19 pandemic and to verify the effect of these strategies on subjective distress. Methods This was a cross-sectional observational study with online data collection in May/June 2020, November/December 2020, and May/June 2021. The BriefCOPE Inventory and the Impact of Event Scale (IES-R) were used. The prevalence of strategies used at different time points was estimated with a 95% confidence interval and compared with a z-test. A multiple logistic regression model was constructed and the odds ratio (OR, 95%CI) was calculated to verify the probability of subjective distress according to the coping strategy used. Results Younger individuals had a lower prevalence of adaptive strategies, which increased significantly with age. Participants with higher income levels had a higher prevalence of adaptive strategies, as did those who were never diagnosed with a mental health disorder. The prevalence of using only maladaptive strategies ranged from 6.1% to 5.4% ( p > 0.05). The use of problem-centered strategies (Active Coping and Planning), venting of emotions, and substance use increased with time, while acceptance and behavioral disengagement decreased. In general, the population used problem-centered strategies, but the high prevalence of problem avoidance was striking. Positive reinterpretation and acceptance were protective factors for subjective distress, whereas maladaptive strategies increased the chance of distress. The presence of a negative valence component (problem- or emotion-centered) increased the chance of subjective distress, whereas strategies based on Problem Solving acted as a protective factor. Conclusion Coping strategies were significantly associated to subjective distress and have changed since the beginning of the pandemic. Strategies focused on emotion regulation may be relevant to minimize distress.
The most important components of out-of-hours community care for patients at the end of life: A Delphi study of healthcare professionals’ and patient and family carers’ perspectives
Authors: Goodrich Joanna , Tutt Lydia , Firth Alice M , Evans Catherine J , Murtagh Fliss EM , Harding Richard 
Published: June 2022

Background: Community services for palliative patients outside normal working hours are variable and the best evidence-based models of care have not been determined. Aim: To establish expert consensus on the most important components of out-of-hours community palliative care services. Design: Delphi study. The first round listed 68 components generated from systematic literature reviewing, focus groups with healthcare professionals and input from the project’s patient and public involvement advisory group. The components deemed ‘essential’ by over 70% of participants in the first round were refined and carried forward to a second round, asking participants to rank each on a five-point Likert scale (5 highest to 1 lowest). The consensus threshold was median of 4 to 5 and interquartile range of ⩽1. Participants: Community specialist palliative care health professionals, generalist community health professionals and patients and family carers with experience of receiving care out-of-hours at home. Results: Fifty-four participants completed round 1, and 44 round 2. Forty-five components met the threshold as most important for providing out-of-hours care, with highest consensus for: prescription, delivery and administration of medicines; district and community nurse visits; and shared electronic patient records and advance care plans. Conclusions: The Delphi method identified the most important components to provide community palliative care for patients out-of-hours, which are often provided by non-specialist palliative care professionals. The importance placed on the integration and co-ordination with specialist palliative care through shared electronic records and advance care plans demonstrates the reassurance for patients and families of being known to out-of-hours services.
Predictive value of intravoxel incoherent motion combined with diffusion kurtosis imaging for breast cancer axillary lymph node metastasis: a retrospective study
Authors: Zhou Zhe , Chen Yueqin , Zhao Fan , Sun Zhanguo , Zhu Laimin , Yu Hao , Wang Weiwei 
Published: June 2022

Background Non-invasive imaging technologies for assessing axillary lymph node (ALN) metastasis of breast cancer are needed in clinical practice. Purpose To explore the clinical value of intravoxel incoherent motion (IVIM) and diffusional kurtosis imaging (DKI) for predicting ALN metastasis of breast cancer. Material and Methods A total of 194 patients with pathologically confirmed breast cancer who underwent IVIM and DKI examination were reviewed retrospectively. The IVIM derived parameters of D, D*, and f and DKI-derived parameters of MD and MK were measured. The independent samples t-test was used to compare the parameters between the ALN metastasis and non-ALN metastasis groups. Receiver operating characteristic (ROC) curve analysis was also performed. Results The D and MD in the ALN metastasis group were significantly lower than those in the non-ALN metastasis group ( P < 0.001, P < 0.001). The D*, f, and MK were higher in the ALN metastasis group than in the non-ALN metastasis group ( P = 0.015, P  = 0.014, and P  = 0.001, respectively). The area under the ROC curve (AUC) of D (0.768) was highest. In addition, the diagnostic efficiency of both IVIM and DKI were higher than that of the conventional MRI ( P = 0.002, P = 0.048). The diagnostic efficiency of IVIM + DKI were higher than that of the IVIM or DKI alone ( P = 0.021, P = 0.004). Conclusion IVIM and DKI can be used for predicting breast cancer ALN metastasis with D as the most meaningful parameter.
Changes in stiffness at active myofascial trigger points of the upper trapezius after dry needling in patients with chronic neck pain: a randomized controlled trial
Authors: Valera-Calero Juan Antonio , Sánchez-Jorge Sandra , Buffet-García Jorge , Varol Umut , Fernández-de-las-Peñas César , Álvarez-González Javier 
Published: June 2022

Background/objective: Since, to our knowledge, the effects of dry needling (DN) on active myofascial trigger point (MTrP) stiffness have not been analyzed previously with shear wave elastography (SWE), our aim was to compare the effects of a single session of DN and sham DN applied to the most active MTrP located in the upper trapezius muscle on clinical outcomes. Methods: A randomized, double-blinded sham-controlled trial was conducted; 60 patients were randomized into an experimental (DN) or sham (sham DN) group. Baseline data including sociodemographic and clinical characteristics were collected. SWE and pain pressure thresholds (PPTs) at the MTrP and a control point located 3 cm laterally were the main outcomes assessed before and 10 min after the interventions. Results: Patients receiving DN interventions experienced greater increases in the control point PPTs immediately after receiving the intervention compared with sham DN ( p < 0.05), but no differences were found for the MTrP ( p > 0.05). Post-intervention PPT improvements were found at both locations for both groups ( p < 0.01). No significant changes for either MTrP or control locations were found for SWE outcomes in either group (all ps > 0.05). No significant within-group SWE differences were found in the DN or sham DN groups ( p > 0.05). Conclusion: A single session of DN or sham DN applied to active MTrPs located in the upper trapezius muscle produced no detectable changes in stiffness at the MTrP or control locations. Real DN induced an immediate analgesic response at both MTrP and control locations, while sham DN induced an immediate MTrP response. Trial registration number: NCT04832074 (ClinicalTrials.gov).
Spousal Family Planning Communication Dynamics in Harar, Eastern Ethiopia
Authors: Zelalem Desalew , Worku Alemayehu , Alemayehu Tadese , Dessie Yadeta 
Published: June 2022

Background: Previous experiences show that family planning programs have focused on women’s attitudes, behaviours and determinants ignoring the role of men. This lack of active involvement and approval of husbands to family planning often hampers effective and continuous use of family planning methods. Couples can make better reproductive decisions if they discuss family planning matters more openly and frequently. The objective of this study was to assess the level of spousal family planning communication in Harar, Eastern Ethiopia. Methods: A community-based cross-sectional survey was conducted in 12 kebeles of Harar Urban Health and Demographic Surveillance System. A total of 2,700 currently married couples of whose wives were in the reproductive age participated in the study. The selection of the study participants was made using simple random sampling, and data were collected using an interviewer administered structured questionnaire. Data were analysed using Stata version 12. Results: The level of spousal family planning communication was high (89.6%) (95% CI, 89%, 91%). However, the level of effective spousal family planning communication was low (38%) (95% CI, 36%, 40%). Frequency of spousal family planning communication was also very low, that is, 8.6% women and 8.4% men reported frequent communication. The major reasons for absence of spousal family planning communication were religious prohibition, belief that it is not necessary to discuss about family planning and cultural taboos. Conclusion: Policies and programmes aimed at promoting family planning should give due emphasis for men and husband-wife effective communication about family planning. Family planning information, education and communication programmes should be strengthened.
Leisure, employment, community participation and quality of life in caregivers of autistic children: A scoping review
Authors: Davy Gemma , Unwin Katy L , Barbaro Josephine , Dissanayake Cheryl 
Published: June 2022

Parenting an autistic child can reduce the time parents have to participate in their own interests, but the impact this has on caregiver quality of life is not well understood. The aim in undertaking this scoping review was to examine and describe current research about occupational participation and quality of life among parents of autistic children. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension guidelines, a comprehensive search of multiple databases was conducted with a systematic selection process resulting in a final set of 70 articles. These included publications related to leisure, community and employment occupations, and quality of life in parents and caregivers of autistic children or children with additional needs. The review revealed the impact of caregiving demands and challenges in raising an autistic child that often take priority over the caregiver’s own needs and desires, particularly in occupational participation, which impacts their quality of life. Gaps were identified in the literature on parental occupations and the relationship with quality of life among caregivers of autistic children, particularly fathers. Further investigation into caregiving experiences and examination of the relationship between parental occupations and quality of life in caregivers of autistic children is needed, as the findings can inform the development of suitable supports for them. Lay abstract We searched a wide range of academic journals for published information on the participation levels of caregivers of autistic children in activities relating to leisure, social, community and employment contexts, and the impact that participation may have on caregiver quality of life. Overall, we found that the impact of parenting an autistic child is broad with caregivers often prioritising their child’s needs over their own, particularly in occupational participation, which impacts their quality of life. Findings also highlighted a need for further research to investigate the experience of caregivers, and the relationship between participation and quality of life in caregivers of autistic children, as the results can inform the development of better supports for them.
Alternative Application Technique for the MANTA Vascular Closure Device for Percutaneous Large-Bore Arterial Access Closure: The Fluoroscopic DOT Technique
Authors: Memon Sehrish , Goldman Scott , Rodriguez Roberto , Ramlawi Basel , Coady Paul M. , Gnall Eric M. 
Published: June 2022

Background: Vascular complications are a cause of increased morbidity and mortality when performing percutaneous procedures requiring large-bore arterial access. MANTA vascular closure device (VCD) is currently the only large-bore VCD using an intraluminal foot plate and an extraluminal collagen plug. The traditional depth locator approach might be compromised in; emergent cases without the required measurements, cases of hematoma formation, or other patient, procedure, or operator-specific variables. Furthermore, this technique can be used for postclosure in cases without the required measurement of depth. We describe vascular outcomes using fluoroscopy (fluoroscopic DOT technique) rather than traditional depth locator approach for vascular closure with the MANTA VCD. Methods: Fifty patients who underwent transcatheter aortic valve implantation (TAVI) were retrospectively analyzed using fluoroscopic DOT technique with 18F MANTA VCD between May and August 2021. All patients >18 years of age who qualified for transfemoral TAVI were included. Access was obtained with ultrasound guidance with vessel diameter of at least > 6 mm and free from anterior vessel wall calcification. Patient related factors and primary outcomes of access site bleeding and acute flow-limited limb ischemia requiring intervention were prospectively analyzed. Furthermore, 1 patient who failed hemostasis with suture-mediated VCD had successful hemostasis with fluoroscopic DOT technique as dry postclosure after balloon aortic valvuloplasty. Results: In total, 50 patients were analyzed with a mean age of 81 years and majority were male (56%). Majority had comorbidities of hypertension (88%) and hyperlipidemia (94%), 24% had peripheral arterial disease, 38% coronary artery disease, and 58% were former smokers. Importantly, 40% were obese with an average body mass index (BMI) of 29 kg/m2. There were no bleeding or ischemic limb complications post MANTA VCD deployment using the fluoroscopic DOT technique. Furthermore, none of the patients required peripheral intervention from index procedure to 1 month post verified during their 1-month post TAVR follow-up. Conclusion: Fluoroscopic DOT technique using the MANTA VCD is highly reproducible and allows hemostasis in a predictable manner for procedures requiring large-bore arterial access in the absence of MANTA depth measurement.
The impact of previous surgery on scaphoid nonunion reconstruction: a retrospective study of 95 cases
Authors: Diehm Yannick F. , Thomé Julia , Siegwart Laura C. , Bickert Berthold , Kneser Ulrich , Hirche Christoph 
Published: June 2022

We retrospectively compared 64 scaphoid reconstructions in cases that had not undergone previous surgery with 31 cases in which previous surgery had been performed. The characteristics of the groups were similar except that there were more smokers in the group without previous surgery and a more frequent use of vascularized bone grafts in the group with previous surgery. At final follow-up, 66 and 65 months, respectively, after reconstruction, union incidence was 89% and 90%. In patients with previous surgery, grip strength was higher but not when expressed in percent of the contralateral hand. There were no differences in pinch strength, active wrist motion, functional scores, carpal height or scapholunate angle. We conclude that repeat surgery to the scaphoid did not seem to be a major risk factor for the overall outcomes, keeping in mind that a vascularized bone graft was more frequently used for secondary reconstructions. Level of evidence: III
Trends and projections in sexually transmitted infections in people aged 45 years and older in England: analysis of national surveillance data
Authors: Camacho C , Camacho EM , Lee DM 
Published: June 2022

Aims: We describe the epidemiology of sexually transmitted infections (STIs) and HIV in people aged ⩾45 years in England and provide future projections about the burden of STIs in this age group. Methods: Analysis of national surveillance data in England from 2014 to 2019 for chlamydia, gonorrhoea, herpes, syphilis, anogenital warts and HIV was carried out. Time trends were assessed by the Poisson regression and reported using incidence rate ratios (IRRs). Two scenarios were modelled to predict the number of new STI diagnoses and associated costs in 2040. Results: In 2019, there were 37,692 new STI diagnoses in people ⩾45 years in England. Between 2014 and 2019, there was a significant increase in the rate of new STI diagnoses in men (IRR = 1.05, p = .05) and those aged 45–64 years (IRR = 1.04, p = .05). Absolute numbers of new STI diagnoses in men who have sex with men increased by 76% between 2014 and 2019 (IRR = 1.15, p < .001). In adults aged ⩾50 years, the number of episodes of care for HIV increased over time (age = 50–64 years, IRR = 1.10; age = 65+ years, IRR = 1.13; p <.001). The modelled scenarios predicted an increase in STI diagnoses and costs in older people by 2040. Conclusion: STI rates in England are increasing in people aged ⩾45 years. The population is ageing and older people will contribute an increasing burden to STI costs if this trend continues. The reasons for this trend are not fully understood and further longitudinal epidemiological research is needed. Sexual health promotion campaigns and healthcare interventions targeted at older people should be prioritised.