bluuebunny/crossref_metadata_2025_split huggingface dataset:
Why Seasonal Prediction of California Winter Precipitation Is Challenging
Authors: Jiang Xianan , Waliser Duane E. , Gibson Peter B. , Chen Gang , Guan Weina 
Published: December 2022

Abstract
Despite an urgent demand for reliable seasonal prediction of precipitation in California (CA) due to the recent recurrent and severe drought conditions, our predictive skill for CA winter precipitation remains limited. October hindcasts by the coupled dynamical models typically show a correlation skill of about 0.3 for CA winter (November–March) precipitation. In this study, an attempt is made to understand the underlying processes that limit seasonal prediction skill for CA winter precipitation. It is found that only about 25% of interannual variability of CA winter precipitation can be attributed to influences by El Niño–Southern Oscillation (ENSO). Instead, the year-to-year CA winter precipitation variability is primarily due to circulation anomalies independent from ENSO, featuring a circulation center over the west coast United States as a portion of a short Rossby wave train pattern over the North Pacific. Analyses suggest that dynamical models show nearly no skill in predicting these ENSO-independent circulation anomalies, thus leading to limited predictive skill for CA winter precipitation. Low predictability of these ENSO-independent circulation anomalies is further demonstrated by a large ensemble of atmospheric-only climate model simulations. While low predictability of the ENSO-independent circulation anomalies could be due to chaotic internal atmospheric processes over the mid- to high latitudes, possible underexploited predictability sources for CA precipitation in models are also discussed. This study pinpoints an urgent need for improved understanding of the formation mechanisms of ENSO-independent circulation anomalies over the U.S. West Coast for a breakthrough in seasonal prediction of CA winter precipitation.
Characteristics of poisonings involving ketamine in the United States, 2019–2021
Authors: Palamar Joseph J. , Fitzgerald Nicole D. , Grundy David J. , Black Joshua C. , Jewell Jennifer S. , Cottler Linda B. 
Published: December 2022

Background: The use of ketamine, a controlled dissociative anesthetic, has become more widespread in recent years with recreational/nonmedical use increasing and ketamine becoming more widely available in clinics to treat depression. Aims: We examined recent trends in adverse effects related to ketamine use. Methods: US National Poison Control data were examined, focusing on ketamine exposures among those aged ⩾13 between 2019 and 2021 ( n = 758). We examined quarterly trends in exposure and delineated correlates of patients experiencing a major adverse effect or death. Results: The number of reported exposures increased 81.1% from 2019 Quarter 1 through 2021 Quarter 4, from 37 to 67 ( p = 0.018). The majority of patients were male (57.1%), and the plurality of cases involved intentional misuse or “abuse” (39.5%), followed by suspected suicide attempt (19.7%) and unintentional exposure (18.9%). A fifth (19.6%) experienced a major adverse effect or death. A third (33.4%) co-used other drugs; the drugs most commonly co-used were benzodiazepines (14.6%), alcohol (10.3%), and opioids (8.7%). Co-use of gamma-hydroxybutyrate (GHB; adjusted prevalence ratio (aPR) = 3.43, 95% confidence interval (CI): 1.57–7.46) and opioids (aPR = 2.44, 95% CI: 1.46–4.08) was associated with increased risk for a major adverse effect or death, as was injection-only administration (aPR = 2.68, 95% CI: 1.21–5.92). Conclusions: Although still rare, poisonings involving ketamine have increased in recent years. Polydrug use—particularly with opioids or GHB—appears to be a particular risk factor for more serious adverse effects. As prevalence of use increases, it is important to monitor adverse effects and co-occurring behaviors to inform timely prevention and harm reduction as needed.
Journal Authorship by Gender: A Comparison of Economic Education, General Interest, and Fields From 2009 to 2019
Authors: Marshall Emily C. , O’Roark Brian 
Published: December 2022

Economic education has emerged as an important subfield in economics over the last several decades. This paper explores the author gender breakdown found in economic education journals compared to top-tier, general-interest economics journals and some field journals. We find that from 2009 to 2019, the percentage of articles published by women in general interest and selected field journals has remained relatively constant, while female publications in economic education journals have grown to match the percentage of women in the discipline. JEL codes: A20, A29
Burden Experienced by Primary Caregivers of Children With Psychotic Disorders and at Clinical High Risk for Psychosis
Authors: Carroll Devon , Wales Meghan , Rintell L. Sophia , Hojlo Margaret , Gonzalez-Heydrich Joseph , Berbert Laura , Fitzpatrick Molly , D’Angelo Eugene , Reed Mary P. 
Published: December 2022

Background: Despite the existing research exploring caregiver burden in adult psychosis, few studies have examined the experience of providing care to children diagnosed with psychotic disorders (PDs) and those identified as having clinical high risk for psychosis (CHR-P). Aim: This study measured the level of burden in caregivers of children with PD and CHR-P and examined associated risk factors, including social support, caregiver–child relationship, severity of illness, and frequency of psychiatric hospitalizations. Methods: A total of 56 caregivers completed validated measures and provided demographic information. Measures included the Zarit Burden Interview, the Multidimensional Scale of Perceived Social Support, the Behavior Assessment System for Children, Third Edition, Parenting Relationship Questionnaire–Child and Adolescent Form (BASC-3 PRQ-CA), and the Clinical Global Impression–Severity scale. Results: The majority of caregivers were women (86%), mothers (84%), White (63%), married (66%), working full-time (50%), college-educated (79%), and whose mean age was 45.7 years ( SD = 8.09). Nearly half of the caregivers (45%) reported a high level of caregiver burden, 39% rated their burden in the mild to moderate range, and 16% reported little to no burden. There was no significant difference in mean burden between PD and CHR-P groups. Higher caregiver burden was associated with lower levels of social support ( r = −.408, p = .002), lower levels of parenting confidence ( r = −.514, p < .001), higher levels of relational frustration ( r = .612, p < .001), and higher severity of illness ( r = .316 p = .025). Conclusions: These findings underscore the critical unmet need for support for caregivers of children with PD and CHR-P. Applications to clinical practice are discussed.
Effectiveness of an Uncertainty Management Psychoeducation Program for Schizophrenia Caregivers: A Randomized Controlled Trial
Authors: Bora Sultan Taş , Buldukoğlu Kadriye , Bailey Donald Etheridge 
Published: December 2022

Background: The inconsistent course of schizophrenia causes a long-term experience of uncertainty for individuals and their families. In Turkey, no studies yet exist that have attempted to address this constant uncertainty that is experienced by caregivers of schizophrenic patients. Aims: To evaluate the effects of the Uncertainty Management Psychoeducation Program on reducing uncertainty and intolerance to uncertainty, improving psychological well-being, and coping styles in caregivers of patients with schizophrenia. Method: Single-blinded randomized controlled trial. Caregivers of schizophrenia inpatients were recruited from the psychiatry clinic of a university-affiliated hospital. Data were collected between April 2019 and August 2020. Eligible individuals were randomly allocated to one of the two groups: intervention or control. The intervention group had five individual psychoeducation sessions: “Recognizing Uncertainty,” “Cognitively Reframing Uncertainty,” “Solving Uncertainty-Related Issues,” “Dealing with Uncertainty Using Communication Skills,” and the “Closing Session.” Participants in the control group received the usual care. Uncertainty, intolerance to uncertainty, psychological well-being, and stress coping strategies were measured at two points: at baseline and immediately following the intervention. Hypotheses were tested using the Mann–Whitney U and Wilcoxon tests. Results: A total of 54 participants were recruited. The intervention group’s ratings for “seeking social support” and “optimistic approach” were higher than the control group’s ratings. Significant within-group changes in terms of “uncertainty” and “optimistic approach” were reported for the intervention group in the post-intervention. In the control group, significant changes were seen in terms of “uncertainty” and “psychological well-being” over time. Conclusion: The Uncertainty Management Psychoeducation Program was found to be effective in reducing the level of uncertainty, increasing their optimistic approach, and seeking social support of caregivers of schizophrenic patients.
Age and Five-Year Outcomes After Carotid Artery Stenting in Symptomatic Carotid Stenosis: A Retrospective Cohort Study
Authors: Liu Yun-e , Zhu Xianjin , Ma Yinghao , Tang Haiyan , Jin Min 
Published: December 2022

Background Several clinical trials have reported that periprocedural risk of carotid artery stenting (CAS) increase with age. China is experiencing one of the most rapid transitions to an aging society, while the clinical outcomes of CAS in real-world China are still limited. The study aimed to compare the periprocedural and an extending 5-year event rates between younger and older patients treated by CAS to testify the safety of CAS in older patients in China. Methods This is a single center, retrospective cohort study. Symptomatic patients who underwent CAS from Nov 2011 to June 2014 were retrospectively included in this study, The population was divided into two age groups: <70 and ≥70. The main primary endpoint was stroke, myocardial infarction or death occurring at 30 days, or ipsilateral stroke over 5-year after stenting. Results A total of 103 symptomatic patients (<70: 68%; ≥70: 32%) with CAS included in the study. During the 30-day period, the rate of primary outcome was 1.0% with only one stroke in patients younger than 70 years old ( P = 1.000). After five years, the rate of primary outcome was low (10.9%, 10/92) despite some of the patients had major stroke or underwent bilateral C1 stenting. There was no significant difference in the 5-year rates of the primary outcome between the young and old groups (12.3% vs 7.4%, P = .718). Kaplan-Meier estimates of the proportion of study participants with a primary endpoint showed that there was no significant age-dependent difference of the stroke and death outcome in symptomatic patients. Conclusions Age (<70 vs ≥ 70) had no influence on the risk of stroke or death in symptomatic patients either in the short or long term. CAS is an optimal treatment for older patients with cervical carotid artery stenosis, and CAS was safe for those with major stroke or bilateral C1 stenting.
Age-Associated Changes in Proximal Femur Morphology Affect Femoral Component Sizing in Cementless Hip Arthroplasty
Authors: Veldman Hidde D. , Boymans Tim A. E. J. , van Steenbergen Liza N. , Heyligers Ide C. 
Published: December 2022

Background In cementless hip arthroplasty, the femoral component should obtain firm fixation within the endosteal bone and achieve adequate reconstruction of hip joint biomechanics simultaneously. Previous anatomical studies described age-related changes of the proximal femoral canal, such as canal widening, which theoretically necessitates the use of larger stem sizes in elderly patients. This study examines a potential association between patients’ age at surgery and the implant size of a cementless femoral component. Material and methods A total of 13,423 primary hip arthroplasties with a single cementless stem registered in the Dutch Arthroplasty Register (LROI) were included. Patient characteristics (ie patients’ age, sex, height and weight at time of surgery) and femoral component size were derived. A one-way ANCOVA was used to compare the mean stem size between age groups, and multivariable linear regression analysis was used in order to investigate to which extent ageing impacted stem size. Results Each subsequent age- group (ten-year intervals) had a significantly larger mean stem size than the prior age- group. Multivariable linear regression analysis revealed that age is positively correlated with stem size and that this correlation is more prominent in females than in males (beta = .046, P < .001 and beta = .028, P < .001 respectively). Interpretation Implant size is positively correlated with age, in particular in females and independently from investigated anthropometric characteristics. The present study endorses that the femoral canal morphology is related to patients’ characteristics such as age and sex. The morphology will subsequently influence implant sizing and therefore may have biomechanical and clinical implications.
Quality in stroke care during the early phases of the COVID-19 pandemic: A nationwide study
Authors: Blauenfeldt Rolf A , Hedegaard Jakob N , Kruuse Christina , Gaist David , Wienecke Troels , Modrau Boris , Damgaard Dorte , Johnsen Søren P , Andersen Grethe , Simonsen Claus Z 
Published: December 2022

Introduction: Evidence-based early stroke care as reflected by fulfillment of process performance measures, is strongly related to better patient outcomes after stroke and transient ischemic attack (TIA). Detailed data on the resilience of stroke care services during the COVID-19 pandemic are limited. We aimed to examine the quality of early stroke care at Danish hospitals during the early phases of the COVID-19 pandemic. Materials and methods: We extracted data from Danish national health registries in five time periods (11 March, 2020–27 January, 2021) and compared these to a baseline pre-pandemic period (13 March, 2019–10 March, 2020). Quality of early stroke care was assessed as fulfilment of individual process performance measures and as a composite measure (opportunity-based score). Results: A total of 23,054 patients were admitted with stroke and 8153 with a TIA diagnosis in the entire period. On a national level, the opportunity-based score (95% confidence interval [CI]) at baseline for ischemic patients was 81.1% (80.8–81.4), for intracerebral hemorrhage (ICH) 85.5% (84.3–86.6), and for TIA 96.0% (95.3–96.1). An increase of 1.1% (0.1–2.2) and 1.5% (0.3–2.7) in the opportunity-based score was observed during the first national lockdown period for AIS and TIA followed by a decline of −1.3% (−2.2 to −0.4) in the gradual reopening phase for AIS indicators. We found a significant negative association between regional incidence rates and quality-of-care in ischemic stroke patients implying that quality decreases when admission rates increase. Conclusion: The quality of acute stroke/TIA care in Denmark remained high during the early phases of the pandemic and only minor fluctuations occurred.
HLA-E–restricted immune responses are crucial for the control of EBV infections and the prevention of PTLD
Authors: Vietzen Hannes , Furlano Philippe L. , Cornelissen Jan J. , Böhmig Georg A. , Jaksch Peter , Puchhammer-Stöckl Elisabeth 
Published: December 2022

Abstract
Primary Epstein-Barr virus (EBV) infections may cause infectious mononucleosis (IM), whereas EBV reactivations in solid organ and hematopoietic stem cell transplant recipients are associated with posttransplantation lymphoproliferative disorders (PTLDs). It is still unclear why only a minority of primary EBV-infected individuals develop IM, and why only some patients progress to EBV+PTLD after transplantation. We now investigated whether nonclassic human leukocyte antigen E (HLA-E)–restricted immune responses have a significant impact on the development of EBV diseases in the individual host.
On the basis of a large study cohort of 1404 patients and controls as well as on functional natural killer (NK) and CD8+ T-cell analyses, we could demonstrate that the highly expressed HLA-E∗0103/0103 genotype is protective against IM, due to the induction of potent EBV BZLF1-specific HLA-E–restricted CD8+ T-cell responses, which efficiently prevent the in vitro viral dissemination.
Furthermore, we provide evidence that the risk of symptomatic EBV reactivations in immunocompetent individuals as well as in immunocompromised transplant recipients depends on variations in the inhibitory NKG2A/LMP-1/HLA-E axis. We show that EBV strains encoding for the specific LMP-1 peptide variants GGDPHLPTL or GGDPPLPTL, presented by HLA-E, elicit strong inhibitory NKG2A+ NK and CD8+ T-cell responses. The presence of EBV strains encoding for both peptides was highly associated with symptomatic EBV reactivations. The further progression to EBV+PTLD was highly associated with the presence of both peptide-encoding EBV strains and the expression of HLA-E∗0103/0103 in the host. Thus, HLA-E–restricted immune responses and the NKG2A/LMP-1/HLA-E axis are novel predictive markers for EBV+PTLD in transplant recipients and should be considered for future EBV vaccine design.
A systematic review of randomisation method use in RCTs and association of trial design characteristics with method selection
Authors: Bruce Cydney L. , Juszczak Edmund , Ogollah Reuben , Partlett Christopher , Montgomery Alan 
Published: December 2022

Abstract
Background
When conducting a randomised controlled trial, there exist many different methods to allocate participants, and a vast array of evidence-based opinions on which methods are the most effective at doing this, leading to differing use of these methods. There is also evidence that study characteristics affect the performance of these methods, but it is unknown whether the study design affects researchers’ decision when choosing a method.

Methods
We conducted a review of papers published in five journals in 2019 to assess which randomisation methods are most commonly being used, as well as identifying which aspects of study design, if any, are associated with the choice of randomisation method. Randomisation methodology use was compared with a similar review conducted in 2014.

Results
The most used randomisation method in this review is block stratification used in 162/330 trials. A combination of simple, randomisation, block randomisation, stratification and minimisation make up 318/330 trials, with only a small number of more novel methods being used, although this number has increased marginally since 2014. More complex methods such as stratification and minimisation seem to be used in larger multicentre studies.

Conclusions
Within this review, most methods used can be classified using a combination of simple, block stratification and minimisation, suggesting that there is not much if any increase in the uptake of newer more novel methods. There seems to be a noticeable polarisation of method use, with an increase in the use of simple methods, but an increase in the complexity of more complex methods, with greater numbers of variables included in the analysis, and a greater number of strata.
Challenges of middle-aged men in utilizing new health services from primary health care providers' perspective: a qualitative study
Authors: Fadaei Dehcheshmeh Nayeb , Emamian Fard Seyed Mehdi , Roghani Tayebeh , Mohammadi Parvin , Faraji-Khiavi Farzad 
Published: December 2022

AbstractBackgroundDespite its special importance among different age groups, the middle-aged male group has often been neglected in the Iranian health system. The aim of this study was to examine, from the perspective of primary health care providers, the challenges of middle-aged men in utilizing health services.MethodsThis is a qualitative research that was conducted using semi-structured interviews in 2020 in Shoushtar Faculty of Medical Sciences, Iran. The research population included 60 managers and staff of the health sector. To collect the data, a group discussion method was used based on purposive sampling method. Data analysis was done manually using the conventional content analysis method with data reduction. Lincoln & Guba’s four criteria of credibility, dependability, confirmability, and transferability were used to assess the trustworthiness of the results.ResultsThe challenges of middle-aged men to receive modern health services were identified in 35 codes, 9 categories and three main themes. These themes included Context, Content, and Process. The Context theme comprised the following three categories: personal, economic and sociocultural, and geographic factors. The Content theme contained two categories of staff and facilities. Finally, the Process theme included four categories of service quality, program management, system of information registration and follow-up, and health education and publicizing.ConclusionPromoting middle-aged men’s benefits from modern health services calls for overcoming three categories of challenges related to: context, content, and process. Time and place restrictions on access to services should be alleviated by empowering health care workers, improving their working conditions, and strengthening the facilities of comprehensive health service centers. In addition, with proper management of the family physician program and service provision at different levels, the coverage of services for middle-aged men can also be extended.
Trends in hepatitis B notification rates in Guangzhou, China, between 2009 and 2020: an epidemiological study
Authors: Liu Wei , Dong Zhiqiang , Hu Wensui , Li Ke , Sun Lili , Hou Jianrong , Jia Shijie , Liu Yuan 
Published: December 2022

Abstract
Background
Although the prevalence of hepatitis B in Guangzhou, China, is high, the epidemiological trends are not well-documented. We aimed to analyse newly reported hepatitis B cases in Guangzhou between 2009 and 2020 to explore the epidemiological trends and provide insights for the development of control measures.

Methods
Information on the population and new cases of hepatitis B in Guangzhou between 2009 and 2020 was obtained from the China Information System for Disease Control and Prevention, which was used to calculate the annual notification rates of hepatitis B by sex, age group (0–9; 10–19; 20–29; 30–39; 40–49; 50–59; ≥ 60 years), and location (urban or rural). Joinpoint regression analysis was used to analyse the temporal trends and calculate the average annual percentage change (AAPC) and annual percentage change (APC) for each identified trend line segment.

Results
Between 2009 and 2020, 287,034 new cases of hepatitis B were cumulatively reported. The average annual notification rate was 181.13/100,000, and the notification rate showed a long-term downward trend during the period 2009–2020, with an annual decrease of 6.30% (APC − 6.30%; 95% CI − 7.56 to − 5.02%). Men had a significantly higher notification rate than women; however, the sex ratio decreased from a maximum of 2.34 in 2010 to a minimum of 1.54 in 2020. A downward trend in the notification rate was observed in urban areas and an upward trend was observed in rural areas, with an increase in the rural/urban ratio from 0.46 in 2012 to 1.57 in 2020. The notification rate for all age groups showed a decreasing trend from 2009, with the exception of the 50–59 years and ≥ 60 years groups, whose notification rates began to decrease from 2014 and 2015, respectively.

Conclusions
Although the overall notification rate of hepatitis B in Guangzhou decreased annually, it remained high. Further, in rural areas, the notification rate has been increasing, and effective measures should be taken to control hepatitis B infection in Guangzhou.