bluuebunny/crossref_metadata_2025 huggingface dataset:
The Influence of Climate Model Biases on Projections of Aridity and Drought
Authors: Ficklin Darren L. , Abatzoglou John T. , Robeson Scott M. , Dufficy Anna
Published: December 2015

Global climate models (GCMs) have biases when simulating historical climate conditions, which in turn have implications for estimating the hydrological impacts of climate change. This study examines the differences in projected changes of aridity [defined as the ratio of precipitation (P) over potential evapotranspiration (PET), or P/PET] and the Palmer drought severity index (PDSI) between raw and bias-corrected GCM output for the continental United States (CONUS). For historical simulations (1950–79) the raw GCM ensemble median has a positive precipitation bias (+24%) and negative PET bias (−7%) compared to the bias-corrected output when averaged over CONUS with the most acute biases over the interior western United States. While both raw and bias-corrected GCM ensembles project more aridity (lower P/PET) for CONUS in the late twenty-first century (2070–99), relative enhancements in aridity were found for bias-corrected data compared to the raw GCM ensemble owing to positive precipitation and negative PET biases in the raw GCM ensemble. However, the bias-corrected GCM ensemble projects less acute decreases in summer PDSI for the southwestern United States compared to the raw GCM ensemble (from 1 to 2 PDSI units higher), stemming from biases in precipitation amount and seasonality in the raw GCM ensemble. Compared to the raw GCM ensemble, bias-corrected GCM inputs not only correct for systematic errors but also can produce high-resolution projections that are useful for impact analyses. Therefore, changes in hydroclimate metrics often appear considerably different in bias-corrected output compared to raw GCM output.
An Airborne and Ground-Based Study of a Long-Lived and Intense Atmospheric River with Mesoscale Frontal Waves Impacting California during CalWater-2014
Authors: Neiman Paul J. , Moore Benjamin J. , White Allen B. , Wick Gary A. , Aikins Joshua , Jackson Darren L. , Spackman J. Ryan , Ralph F. Martin
Published: December 2015

The wettest period during the CalWater-2014 winter field campaign occurred with a long-lived, intense atmospheric river (AR) that impacted California on 7–10 February. The AR was maintained in conjunction with the development and propagation of three successive mesoscale frontal waves. Based on Lagrangian trajectory analysis, moist air of tropical origin was tapped by the AR and was subsequently transported into California. Widespread heavy precipitation (200–400 mm) fell across the coastal mountain ranges northwest of San Francisco and across the northern Sierra Nevada, although only modest flooding ensued due to anomalously dry antecedent conditions. A NOAA G-IV aircraft flew through two of the frontal waves in the AR environment offshore during a ~24-h period. Parallel dropsonde curtains documented key three-dimensional thermodynamic and kinematic characteristics across the AR and the frontal waves prior to landfall. The AR characteristics varied, depending on the location of the cross section through the frontal waves. A newly implemented tail-mounted Doppler radar on the G-IV simultaneously captured coherent precipitation features. Along the coast, a 449-MHz wind profiler and collocated global positioning system (GPS) receiver documented prolonged AR conditions linked to the propagation of the three frontal waves and highlighted the orographic character of the coastal-mountain rainfall with the waves’ landfall. A vertically pointing S-PROF radar in the coastal mountains provided detailed information on the bulk microphysical characteristics of the rainfall. Farther inland, a pair of 915-MHz wind profilers and GPS receivers quantified the orographic precipitation forcing as the AR ascended the Sierra Nevada, and as the terrain-induced Sierra barrier jet ascended the northern terminus of California’s Central Valley.
Lost in the detail: Prosecutors' perceptions of the utility of video recorded police interviews as rape complainant evidence
Authors: Westera Nina J , Powell Martine B , Milne Becky
Published: December 2015

This study explored the perceptions of ten Crown Prosecutors about the utility of police interviews as video evidence-in-chief for adult sexual assault complainants to determine how to improve these interviews. A themed analysis of prosecutors' responses indicated three major concerns about these interviews: the interviewer using wordy instructions, the lack of chronology and logical structure, and the relentless pursuit of unnecessary detail. These findings suggest that prosecutors' concerns are primarily due to police using cognitive interview methods that attempt to enhance the amount of detail recalled by a complainant. The authors discuss why generating large amounts of detail may be problematic in interviews with sexual assault complainants and provide recommendations for how police can adapt interview practices to better meet evidential needs.
From Pyramids to Diamonds
Authors: Kuruvilla Sarosh , Noronha Ernesto
Published: December 2015

In this article, the authors argue that offshoring of legal work from the United States has contributed to the fracturing of the long-established internal labor market arrangements in large U.S. law firms. Drawing on evidence from the United States and India on legal employment, the growth of offshoring, and the rapidly changing nature of work that is offshored, the authors contend that the changes in employment systems in law firms are likely to be permanent, in contrast to other researchers who suggest they are temporary adjustments to the financial crisis. As U.S. law firms are dismantling their internal labor market systems, Indian law firms are partially recreating them.
Epoxy nanocomposites with carbon nanotubes and montmorillonite: Mechanical properties and electrical insulation
Authors: Zhang Mingyan , Zhai Zhaohui , Li Mingchuan , Cheng Tonglei , Wang Chen , Jiang Dawei , Chen Lei , Wu Zijian , Guo Zhanhu
Published: December 2015

Multiwalled carbon nanotubes have been widely used as mechanical reinforcement fillers for polymers during the past few decades. However, high electrical conductivity of raw multiwalled carbon nanotubes hampers their application in some fields demanding not only good mechanical properties and/or high thermal conductivity but also electrical insulation. In this research, carboxyl functionalized multiwalled carbon nanotubes and organically modified montmorillonite were introduced to prepare epoxy nanocomposites with anhydride as curing agent. The obtained epoxy nanocomposites possessed improved impact toughness, and the electrical insulation was maintained. Compared to the volume resistivity of the raw multiwalled carbon nanotubes (0.6 wt%)/epoxy nanocomposites, the volume resistivity of the organically modified montmorillonite/carboxyl functionalized multiwalled carbon nanotubes (0.6 wt%)/epoxy nanocomposites increased more than four order of magnitude. These excellent properties were attributed to the synergistic effect of carboxyl functionalized multiwalled carbon nanotubes and organically modified montmorillonite on toughening epoxy, as well as the suppression of electron transport by multiwalled carbon nanotubes surface modification and the organically modified montmorillonite layer in the multiwalled carbon nanotubes conductive network. The effects of adding nanofillers on the dielectric constant and dielectric loss values of epoxy nanocomposites were also studied. This work has demonstrated the feasibility of using multiwalled carbon nanotubes as mechanical reinforcement fillers, while simultaneously giving electrical insulation in the polymer nanocomposites.
FT-Raman Spectroscopy Study of the Remineralization of Microwave-Exposed Artificial Caries
Authors: Kerr J.E. , Arndt G.D. , Byerly D.L. , Rubinovitz R. , Theriot C.A. , Stangel I.
Published: December 2015

Dental caries is a microbially mediated disease that can result in significant tooth structure degradation. Although the preponderance of lesions is treated by surgical intervention, various strategies have been developed for its noninvasive management. Here, we use a novel approach for noninvasive treatment based on killing Streptococcus mutans with high-frequency microwave energy (ME). The rationale for this approach is based on modulating the pH of caries to a physiological state to enable spontaneous tooth remineralization from exogenous sources. In the present study, after demonstrating that ME kills >99% of S. mutans in planktonic cultures, 8 enamel slabs were harvested from a single tooth. Baseline mineral concentration at each of 12 points per slab was obtained using Fourier transform (FT)–Raman spectroscopy. Surface demineralization was subsequently promoted by subjecting all samples to an S. mutans acidic biofilm for 6 d. Half of the samples were then exposed to high-frequency ME, and the other half were used as controls. All samples were next subjected to a remineralization protocol consisting of two 45-min exposures per 24-h period in tryptic soy broth followed by immersion in a remineralizing solution for the remaining period. After 10 d, samples were removed and cleaned. FT-Raman spectra were again obtained at the same 12 points per sample, and the mineral concentration was determined. The effect of the remineralization protocol on the demineralized slabs was expressed as a percentage of mineral loss or gain relative to baseline. The mineral concentration of the microwave-exposed group collectively approached 100% of baseline values, while that of the control group was in the order of 40%. Differences between groups were significant ( P = 0.001, Mann-Whitney U test). We concluded that killing of S. mutans by ME promotes effective remineralization of S. mutans–demineralized enamel compared with controls.
Effects of fabric construction and shear thickening fluid on yarn pull-out from high-performance fabrics
Authors: Majumdar Abhijit , Laha Animesh
Published: December 2015

Yarn pull-out is one of the major modes of fabric failure during an event of impact. In this article, the effects of weave and fabric sett on yarn pull-out force have been investigated for untreated and shear thickening fluid (STF) treated p-aramid fabrics. Further, the effect of different fluid treatments on yarn pull-out behavior has been analyzed using p-aramid and ultra-high molecular weight polyethylene (UHMWPE) fabrics. For all levels of fabric sett, plain woven fabrics exhibited higher yarn pull-out force compared to twill, matt and satin weaves. STF impregnation increased the yarn pull-out force considerably for p-aramid and UHMWPE fabrics and this was found for all the weaves in the case of the former. However, increase in fabric sett beyond a threshold level caused yarn breakage before yarn pull-out in case of STF-treated plain woven p-aramid fabrics. Yarn pull-out force was found to have good association with the energy absorption by the high-performance fabrics during low-velocity impact (6 m s–1). The normalized yarn pull-out force was higher for two consecutive yarns than for two yarns with a single gap.
Deprived neighbourhoods in transition: Divergent pathways of change in the Greater Manchester city-region
Authors: Hincks Stephen
Published: December 2015

Many studies of neighbourhood change adopt a ‘bookend’ mode of analysis in which a baseline year is identified for a chosen outcome variable from which the magnitude of change is calculated to a determined endpoint typically over bi-decadal or decadal timeframes. However, this mode of analysis smoothes away short-run change patterns and neighbourhood dynamics. The implications of this practice could be far reaching if it is accepted that as neighbourhoods change they are liable to cross a threshold and transition from one state to another in the short- as well as longer-term. In a case study of deprived neighbourhoods in the Greater Manchester city-region, this paper aims to contribute to neighbourhood change debates in two ways. The first is by isolating transition pathways for individual neighbourhoods using annual change data. The second is by testing the thesis that the more deprived a neighbourhood is, the more likely it is to respond with greater volatility to short-run shocks when compared with less-deprived neighbourhoods. Four indicators collected annually between 2001 and 2010 are used to develop a typology of neighbourhood change and a subsequent typology of neighbourhood transition. The analysis exposed 260 different transition pathways that deprived neighbourhoods followed over the study period. Multinomial logistic regression was then used to determine the odds of a neighbourhood undergoing transition along a specific pathway owing to its level of deprivation. The model revealed that the most deprived neighbourhoods were likely to follow more volatile transition pathways compared with the less-deprived neighbourhoods especially during periods of economic difficulty.
Open Source Meets Virtual Reality—An Instructor’s Journey Unearths New Opportunities for Learning, Community, and Academia
Authors: O’Connor Eileen A.
Published: December 2015

Opening with the history, recent advances, and emerging ways to use avatar-based virtual reality, an instructor who has used virtual environments since 2007 shares how these environments bring more options to community building, teaching, and education. With the open-source movement, where the source code for virtual environments was made available to the public, greatly reduced prices and increased options are shifting dramatically the utility of virtual environments for developing student competencies as virtual creators; supporting faculty and organizational needs; enabling comprehensive curriculum, assessment, and design; and allowing for multipurpose virtual environments. Reporting changes to how she taught the development of virtual environments, the author explains the enhanced learning observed within a newly designed course and the improvements she will make in the future. Additional recommendations address how education, communication, and learning organizations can use improvements to implement multipurpose virtual environments and can support technology-facilitated design in general.
Building Innovative Online Korean and Japanese Courses
Authors: Sato Eriko , Sohn Heejeong , Chen Julian ChengChiang , Adebowale Kayode C. V. , Jourdain Sarah
Published: December 2015

Our pilot project created blended/online courses to accommodate the growing needs of precollegiate and collegiate students interested in learning Korean and Japanese. In the initial phase, we conducted a survey of students’ experiences with and perceptions about blended/online Asian language learning. We found a general lack of familiarity with, and moderate resistance toward, online language learning modes. With learner attitudes in mind, we developed online modules for beginning Korean and Japanese courses. In this article, we report the survey results and the process of developing these innovative blended and online modalities of content delivery, focusing on the strengths of the modules and the unforeseen development challenges. The impacts that these technology-enhanced environments may have on student perceptions of transactional distance and tele-/copresence are explored. We suggest that transforming conventional East Asian language courses into blended/online modes is not only feasible but also beneficial for foreign language teaching and learning.
Using Computer Simulations and Games to Prevent Student Plagiarism
Authors: Bradley Elizabeth G.
Published: December 2015

In this increasingly digital age, student plagiarism is rampant. Roughly half of college students admit to plagiarizing using content found online, directly copying and pasting the work of others. Digital technology and social media have greatly changed the landscape of how knowledge is acquired and disseminated; thus, students must be explicitly taught digital literacy skills and how to correctly utilize information they find online. Computer simulations are an active, engaging, and efficient way of explicitly teaching students about plagiarism and how to avoid academic dishonesty. A number of colleges and universities provide free open source games and simulations, which can be utilized as course assignments or activities in order to explicitly teach students proper citation procedures. This article reviews 10 plagiarism prevention computer games and simulations, with details about each program, including access information.
Effect of gamma radiation on physico-mechanical properties of vulcanized natural rubber/carbon fiber composites
Authors: Hassan Medhat M , El-Nemr Khaled F , El-Megeed Anhar A Abd
Published: December 2015

Natural rubber was reinforced with a short carbon fibers (SCFs) at different concentrations (0–20 part per hundred part of rubber (phr)). The composites were vulcanized by sulfur, then subjected to gamma radiation at different doses up to 40 kGy. Physico-mechanical properties of composites were studied. Also, thermogravimetric analysis was used to investigate the influence of the incorporation of SCF on the thermal properties of prepared composites. It was observed that the mechanical properties like tensile strength increases with increasing irradiation dose up to 30 kGy and fiber loading up to 15 phr, meanwhile the hardness and modulus increase with increasing fiber loading, but not affected by irradiation dose. Thermal stability of composites was increased by fiber loading content at constant irradiation dose. The morphological studies were made by means of scanning electron microscopy to investigate the structure change caused by the incorporation of SCF.
Acceleration harmonic estimation for a hydraulic shaking table by using particle swarm optimization
Authors: Yao Jianjun , Yu Han , Dietz Matt , Xiao Rui , Chen Shuo , Wang Tao , Niu Qingtao
Published: December 2015

The acceleration response of a servo-hydraulic shaking table to a sinusoidal input motion is inevitably distorted by parasitic harmonic content caused by inherent non-linearities within the system. Herein, an algorithm is developed to characterize these parasitic motions in order to facilitate harmonic cancellation. The proposed algorithm is based on particle swarm optimization (PSO). Optimization is achieved by each particle’s movement, updated by its local best-known position and global best-known position according to a fitness function, which itself is a function of the estimation error between the identified acceleration and the original acceleration response. The estimation scheme is validated by experiments on a servo-hydraulic shaking table and results are compared with a more traditional harmonic analysis.
Depression and Rural Environment Are Associated With Poor Oral Health Among Pregnant Women in Northern Appalachia
Authors: McNeil Daniel W. , Hayes Sarah E. , Randall Cameron L. , Polk Deborah E. , Neiswanger Kathy , Shaffer John R. , Weyant Robert J. , Foxman Betsy , Kao Elizabeth , Crout Richard J. , Chapman Stella , Brown Linda J. , Maurer Jennifer L. , Marazita Mary L.
Published: December 2015

Both oral health problems and depression among pregnant women contribute to maternal–infant health outcomes. Little is known, however, about the potential effects of clinically significant depression on the oral health status of pregnant women. The purpose of the present study was to determine the influence of clinically significant depression and rural- or urban-dwelling status on oral health outcomes among pregnant women. Pregnant women ( N = 685) in rural (i.e., West Virginia) and urban (i.e., Pittsburgh, PA) areas of northern Appalachia were assessed by calibrated examiners regarding gingivitis, oral hygiene, and DMFT (decayed, missing, and filled teeth), completed the Center for Epidemiologic Studies–Depression Scale (CES-D) and provided demographics. Participants were categorized based on clinically significant depressive symptoms (CES-D ≥ 16) and rural/urban domicile. Women with depression and those living in rural areas had worse oral health on all three indices than their non-depressed and urban counterparts. Depression, particularly among women in rural areas, affects certain oral health indices and represents a modifiable target for intervention. Moreover, treatments designed specifically for rural populations may be of particular utility. Women who are pregnant or planning to become pregnant may benefit from regular depression screenings from their dental and medical health care providers.
Gelatin Facial Skin Simulator for Cutaneous Reconstruction
Authors: Taylor Steven R. , Chang C. W. David
Published: December 2015

Reconstruction of facial defects can be an intimidating endeavor, especially to resident physicians. When local flap reconstruction is preferred, design of the optimal flap can be a difficult choice. Poor selection can lead to unsightly scarring as well as increased morbidity. A low‐cost, easy‐to‐fabricate gelatin prosthetic facial skin simulator is presented to offer training experience in wound closure, local tissue rearrangement, and facial defect reconstruction for resident instruction. In conjunction with a didactic lecture, 10 participants were asked to perform a Z‐plasty, bilobed, rhomboid, and paramedian forehead flap, followed by an 18‐question survey. While initial impressions are favorable, further validation studies are warranted.
Assessment of Abdominal Fat Graft to Repair Anterior Skull Base after Malignant Sinonasal Tumor Extirpation
Authors: Fonmarty David , Bastier Pierre‐Louis , Lechot Amandine , Gimbert Edouard , de Gabory Ludovic
Published: December 2015

Objective

Adult abdominal fat, which is known to contain pluripotent stem cells, is frequently used to treat cerebrospinal fluid leak. The aim of this study was to assess the efficacy and reliability of abdominal fat graft to close large skull base defects after extirpation of malignant sinonasal tumors.

Study Design

Case series with chart review performed between 2009 and 2014.

Subjects and Methods

Twenty‐nine cases were included of consecutive patients who were suffering from malignant sinonasal tumors, operated by an endoscopic endonasal approach with anterior skull base extirpation and surgically induced cerebrospinal fluid leak. Skull base was repaired by 1 layer of “en bloc” autologous fat graft used as a plug in the onlay position. Epidemiologic data, medical history, defect size, length of hospitalization, and morbidity were analyzed.

Results

Radiotherapy was given pre‐ and postoperatively in 4 (13.8%) and 23 (79.3%) patients, respectively. Mean defect size was 4.47 ± 2.9 cm2 (range, 0.24‐9.1 cm2). Mean operative time was 210 ± 86 minutes. Mean length of hospitalization was 8.6 ± 3.7 days and 4.9 ± 2 days in the intensive care unit. No lumbar drain was used in this study. There was 1 case of cerebrospinal fluid leak (3.5%) and 2 cases of meningitis (6.9%), which resolved after medical treatment. Mean follow‐up was 17 ± 13 months (range, 3‐53 months).

Conclusion

Abdominal fat graft is a safe and reliable material to close the anterior skull base after extirpation of malignant sinonasal tumors.
How Does TeamSTEPPS Affect Operating Room Efficiency?
Authors: Shams Alexandra , Ahmed Mostafa , Scalzitti Nicholas J. , Stringer Matthew , Howard N. Scott , Maturo Stephen
Published: December 2015

Objective

To evaluate the effect of TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) on operating room efficiency for the otolaryngology service at a tertiary care medical center.

Study Design

Retrospective database review.

Setting

Otolaryngology department at tertiary care medical center.

Subjects and Methods

To assess the impact of implementing an evidence‐based patient safety initiative, TeamSTEPPS, on operating room efficiency in the otolaryngology department, the operative times, time lost to delayed starts, and turnover times during the year following the implementation of TeamSTEPPS were compared with the values from the prior year.

Results

The study compared 1322 cases and 644 turnovers in the year prior to TeamSTEPPS implementation with 1609 cases and 769 turnovers in the following year. There were no statistically significant decreases in operating room efficiency in the year after the TeamSTEPPS rollout.

Conclusion

Operating room efficiency was preserved after the rollout of a rigorous evidence‐based patient safety initiative that requires active participation from all operating room team members.
Beyond individualisation: The German ‘activation toolbox’
Authors: Eversberg Dennis
Published: December 2015

This article discusses recent debates on ‘activating’ labour market policies in light of German reforms since 2003. Beckian and Giddensian theories of modernity, political economy, and the governmentality school all argue within a common paradigm of individualisation, assuming the ‘responsibilised’ and isolated individual to be the focal point of activation policies. This paradigm is questioned, as the exclusive focus on the individual obscures something else, namely that ‘activation’ policies can also be seen as contributing to a dynamic of dividualisation, i.e. of making the subject of labour power fundamentally divisible. It is demonstrated that in the recent German reforms, dividualisation provides an organising logic pervading the instruments of activating labour market policies and the ways in which they are articulated in a policy programme. It is concluded that dividualisation, particularly evident in the German case, may provide a useful frame for analysing labour market reforms in other advanced capitalist economies.
Vertical consolidation and financial sustainability: evidence from English local government
Authors: Andrews Rhys
Published: December 2015

Proponents of the vertical consolidation of lower-tier units into a smaller number of single-tier local governments suggest that it improves the financial sustainability of governments by generating economies of scale and scope. However, critics suggest that such structural change is beset with disruptive and unanticipated costs that outweigh any potential efficiency savings. I investigate the validity of these contrasting arguments by analysing the expenditure and fiscal health of English county councils before and after the consolidation of the lower-tier units within several counties that took place in 2009. Levels of financial sustainability are modelled using a difference-in-difference estimator for the years 2003–2012. The results suggest that in the short run the consolidated governments have been able to realize administrative economies, but their fiscal health has weakened. These findings appear to be robust to the possibility of selection effects. Theoretical and practical implications are discussed.
Effect of extracorporeal CO2 removal on right ventricular and hemodynamic parameters in a patient with acute respiratory distress syndrome
Authors: Cherpanath Thomas G.V. , Landburg Pearl P. , Lagrand Wim K. , Schultz Marcus J. , Juffermans Nicole P.
Published: December 2015

We present a female patient with severe acute respiratory distress syndrome (ARDS) necessitating intubation and mechanical ventilation on the intensive care unit (ICU). High ventilatory pressures were needed because of hypoxia and severe hypercapnia with respiratory acidosis, resulting in right ventricular dysfunction with impaired haemodynamic stability. A veno-venous extracorporeal CO2 removal (ECCO2R) circuit was initiated, effectively eliminating carbon dioxide while improving oxygenation and enabling a reduction in applied ventilatory pressures. We noted a marked improvement of right ventricular function with restoration of haemodynamic stability. Within one week, the patient was weaned from both ECCO2R and mechanical ventilation. Besides providing adequate gas exchange, extracorporeal assist devices may be helpful in ameliorating right ventricular dysfunction during ARDS.
Creative industries and urban regeneration – The Maboneng precinct, Johannesburg
Authors: Gregory James J
Published: December 2015

Over the past 15 years, creative industries have emerged as a popular focus in urban policy discourses and have been used as a lever for several urban regeneration initiatives in Northern cities. Minimal scholarship exists on creative industries and urban regeneration in the global South. Notwithstanding that in South Africa creative industries have been recognised in policy frameworks, limited scholarly research exists on creative industries and their relationship with the urban landscape. In terms of geography most creative enterprises in Johannesburg are scattered across the northern suburbs of the city. Over the past few years, however, there is evidence of creative enterprises re-centralising and clustering in inner-city fringe areas such as the Maboneng precinct. Using interviews with creative entrepreneurs and stakeholders the purpose of this paper is to analyse the case of the Maboneng precinct Johannesburg in terms of the role of creative industries in urban regeneration.
A double-blind, placebo-controlled, randomized withdrawal study of lurasidone for the maintenance of efficacy in patients with schizophrenia
Authors: Tandon Rajiv , Cucchiaro Josephine , Phillips Debra , Hernandez David , Mao Yongcai , Pikalov Andrei , Loebel Antony
Published: December 2015

Objective:

To evaluate the effectiveness of lurasidone as maintenance treatment for schizophrenia.

Method:

Adults experiencing an acute exacerbation of schizophrenia initially received 12–24 weeks of open-label treatment with lurasidone (40–80 mg/d, flexibly dosed). Patients who maintained clinical stability for ⩾12 weeks were randomized in double-blind fashion to placebo or lurasidone (40–80 mg/d, flexibly dosed) for an additional 28-week treatment period. The primary efficacy endpoint was time to relapse (based on Kaplan–Meier survival analysis).

Results:

A total of 676 patients enrolled in the open-label phase; 285 met protocol-specified stabilization criteria and were randomized to lurasidone ( N=144) or placebo ( N=141). During the open-label phase, mean Positive and Negative Syndrome Scale total score decreased from 90.1 to 54.4 in patients who met clinical stability criteria and were randomized. In the double-blind phase, lurasidone significantly delayed time to relapse compared with placebo (log-rank test, p=0.039), reflecting a 33.7% reduction in risk of relapse (Cox hazard ratio (95% confidence interval), 0.663 (0.447–0.983); p=0.041). Probability of relapse at the double-blind week 28 endpoint (based on Kaplan–Meier analysis) was 42.2% in the lurasidone group and 51.2% in the placebo group. Minimal changes in weight, lipid, glucose, and prolactin were observed throughout the study.

Conclusions:

This multicenter, placebo-controlled, randomized withdrawal study demonstrated the efficacy of lurasidone for the maintenance treatment of patients with schizophrenia.
Effect of short-term escitalopram treatment on neural activation during emotional processing
Authors: Maron Eduard , Wall Matt , Norbury Ray , Godlewska Beata , Terbeck Sylvia , Cowen Philip , Matthews Paul , Nutt David J
Published: December 2015

Recent functional magnetic resonance (fMRI) imaging studies have revealed that subchronic medication with escitalopram leads to significant reduction in both amygdala and medial frontal gyrus reactivity during processing of emotional faces, suggesting that escitalopram may have a distinguishable modulatory effect on neural activation as compared with other serotonin-selective antidepressants. In this fMRI study we aimed to explore whether short-term medication with escitalopram in healthy volunteers is associated with reduced neural response to emotional processing, and whether this effect is predicted by drug plasma concentration. The neural response to fearful and happy faces was measured before and on day 7 of treatment with escitalopram (10mg) in 15 healthy volunteers and compared with those in a control unmedicated group ( n=14). Significantly reduced activation to fearful, but not to happy facial expressions was observed in the bilateral amygdala, cingulate and right medial frontal gyrus following escitalopram medication. This effect was not correlated with plasma drug concentration. In accordance with previous data, we showed that escitalopram exerts its rapid direct effect on emotional processing via attenuation of neural activation in pathways involving medial frontal gyrus and amygdala, an effect that seems to be distinguishable from that of other SSRIs.
Integrated multidisciplinary care of headache disorders: A narrative review
Authors: Gaul Charly , Liesering-Latta Eva , Schäfer Benjamin , Fritsche Günther , Holle Dagny
Published: December 2015

Background

Recent evidence shows that multidisciplinary treatment is effective in chronic pain syndromes, especially in headache disorders.

Aim

The aim of this review is to summarize current knowledge on integrative care concepts in headache patients regarding the optimal and necessary treatment parts, optimal duration and setting.

Methods

We present a narrative review reporting current literature and personal experience.

Results and conclusion

Based on current knowledge, multidisciplinary treatment programs appear to be reasonable and efficient in headache disorders. Sufficient controlled studies regarding the need for individual parts of the integrative care approach are missing as yet. Recommendations are therefore at least partly based on personal experiences. It seems to be unambiguous that patients should be referred to a specialized headache center offering such a program instead of being sent sequentially to various medical specialists. The extent and kind of required therapy (e.g. personal consultation versus group sessions) is not known yet. All patients should learn relaxation training, although it is unclear yet which training is the best for which patient. Physiotherapy with guidance on more activity and individual exercises should be used in all patients. Some patients might benefit from cognitive behavioral therapy. However, therapies often depend more on country-specific health care systems than on clinical needs or scientific data.
Premonitory symptoms in migraine: A cross-sectional study in 2714 persons
Authors: Laurell Katarina , Artto Ville , Bendtsen Lars , Hagen Knut , Häggström Johan , Linde Mattias , Söderström Lars , Tronvik Erling , Wessman Maija , Zwart John Anker , Kallela Mikko
Published: December 2015

Aim

To describe the frequency and number of premonitory symptoms (PS) in migraine, the co-occurrence of different PS, and their association with migraine-related factors.

Methods

In this cross-sectional study, a validated questionnaire was sent to Finnish migraine families between 2002 and 2013 to obtain data on 14 predefined PS, migraine diagnoses, demographic factors, and migraine characteristics. The estimated response rate was 80%.

Results

Out of 2714 persons, 2223 were diagnosed with migraine. Among these, 77% reported PS, with a mean number of 3.0 symptoms compared to 30% ( p < 0.001) and 0.5 symptoms ( p < 0.001) among 491 persons with non-migraine headaches. Yawning was the most commonly reported symptom (34%) among migraineurs. Females reported PS more frequently than males (81 versus 64%, p < 0.001) and experienced a higher number of different symptoms (mean 3.3 versus 1.8, p < 0.001). All measures of migraine severity were associated with a higher burden of PS. Light and sound sensitivity showed the highest co-occurrence (kappa = 0.51, 95% CI 0.47–0.55). In a generalized linear model, age, gender, higher frequency, duration and intensity of headache, reduced working capacity, most aura symptoms, and associated symptoms of the headache phase were significantly associated with an increased in the number of PS.

Conclusion

PS are experienced by a majority of migraineurs. More severe migraine is associated with a higher burden of PS. Since the material was not entirely representative of the general population of migraineurs, caution should be exercised in generalizing the results.
Susceptible genes of restless legs syndrome in migraine
Authors: Fuh Jong-Ling , Chung Ming-Yi , Yao Shu-Chih , Chen Ping-Kun , Liao Yi-Chu , Hsu Chia-Lin , Wang Po-Jen , Wang Yen-Feng , Chen Shih-Pin , Fann Cathy S-J , Kao Lung-Sen , Wang Shuu-Jiun
Published: December 2015

Objective

Several genetic variants have been found to increase the risk of restless legs syndrome (RLS). The aim of the present study was to determine if these genetic variants were also associated with the comorbidity of RLS and migraine in patients.

Methods

Thirteen single-nucleotide polymorphisms (SNPs) at six RLS risk loci ( MEIS1, BTBD9, MAP2K5, PTPRD, TOX3, and an intergenic region on chromosome 2p14) were genotyped in 211 migraine patients with RLS and 781 migraine patients without RLS. Association analyses were performed for the overall cohort, as well as for the subgroups of patients who experienced migraines with and without aura and episodic migraines (EMs) vs. chronic migraines (CMs). In order to verify which genetic markers were potentially related to the incidence of RLS in migraine patients, multivariate regression analyses were also performed.

Results

Among the six tested loci, only MEIS1 was significantly associated with RLS. The most significant SNP of MEIS1, rs2300478, increased the risk of RLS by 1.42-fold in the overall cohort ( p = 0.0047). In the subgroup analyses, MEIS1 augmented the risk of RLS only in the patients who experienced EMs (odds ratio (OR) = 1.99, p = 0.0004) and not those experiencing CMs. Multivariate regression analyses further showed that rs2300478 in MEIS1 (OR = 1.39, p = 0.018), a CM diagnosis (OR = 1.52, p = 0.022), and depression (OR = 1.86, p = 0.005) were independent predictors of RLS in migraine.

Conclusions

MEIS1 variants were associated with an increased risk of RLS in migraine patients. It is possible that an imbalance in iron homeostasis and the dopaminergic system may represent a link between RLS incidence and migraines.
A Novel Repair Method for Radial Tears of the Medial Meniscus
Authors: Bhatia Sanjeev , Civitarese David M. , Turnbull Travis Lee , LaPrade Christopher M. , Nitri Marco , Wijdicks Coen A. , LaPrade Robert F.
Published: December 2015

Background:

Complete radial tears of the medial meniscus have been reported to be functionally similar to a total meniscectomy. At present, there is no consensus on an ideal technique for repair of radial midbody tears of the medial meniscus. Prior attempts at repair with double horizontal mattress suture techniques have led to a reportedly high rate of incomplete healing or healing in a nonanatomic (gapped) position, which compromises the ability of the meniscus to withstand hoop stresses.

Hypothesis:

A newly proposed 2-tunnel radial meniscal repair method will result in decreased gapping and increased ultimate failure loads compared with the double horizontal mattress suture repair technique under cyclic loading.

Study Design:

Controlled laboratory study.

Methods:

Ten matched pairs of male human cadaveric knees (average age, 58.6 years; range, 48-66 years) were used. A complete radial medial meniscal tear was made at the junction of the posterior one-third and middle third of the meniscus. One knee underwent a horizontal mattress inside-out repair, while the contralateral knee underwent a radial meniscal repair entailing the same technique with a concurrent novel 2-tunnel repair. Specimens were potted and mounted on a universal testing machine. Each specimen was cyclically loaded 1000 times with loads between 5 and 20 N before experiencing a load to failure. Gap distances at the tear site and failure load were measured.

Results:

The 2-tunnel repairs exhibited a significantly stronger ultimate failure load (median, 196 N; range, 163-212 N) than did the double horizontal mattress suture repairs (median, 106 N; range, 63-229 N) ( P = .004). In addition, the 2-tunnel repairs demonstrated decreased gapping at all testing states ( P < .05) with a final measured gapping of 1.7 mm and 4.1 mm after 1000 cycles for the 2-tunnel and double horizontal mattress suture repairs, respectively.

Conclusion:

The 2-tunnel repairs displayed significantly less gapping distance after cyclic loading and had significantly stronger ultimate failure loads compared with the double horizontal mattress suture repairs.

Clinical Relevance:

Complete radial tears of the medial meniscus significantly decrease the ability of the meniscus to dissipate tibiofemoral loads, predisposing patients to early osteoarthritis. Improving the ability to repair medial meniscal radial tears in a way that withstands cyclic loads and heals in an anatomic position could significantly improve patient healing rates and result in improved preservation of the articular cartilage of the medial compartment of the knee. The 2-tunnel repair may be a more reliable and stronger repair option for midbody radial tears of the medial meniscus. Clinical studies are warranted to further evaluate these repairs.
Surgical Results of Delaminated Rotator Cuff Repair Using Suture-Bridge Technique With All-Layers or Bursal Layer–Only Repair
Authors: Kim Sung-Jae , Choi Yun-Rak , Lee Hyun-Hee , Chun Yong-Min
Published: December 2015

Background:

There are no known studies that have investigated the effect on delaminated rotator cuff tears of bursal layer–only repair when full-thickness repair would put the articular layer under tension, compared with all-layers repair when full-thickness repair is feasible.

Hypothesis:

Better outcomes will be seen in the bursal layer–only repair, as the articular layer would be under tension when repaired onto its footprint during the all-layers repair.

Study Design:

Cohort study; Level of evidence 3.

Methods:

This study included 112 patients who underwent arthroscopic rotator cuff repair for posteriorly delaminated tears of either all layers (group A) or the bursal layer alone (group B). If the articular layer was able to be reduced onto its footprint, the patient was assigned to group A; if such reduction was not possible or was only marginally possible under significant tension, the patient was assigned to group B. Pain scored on a visual analog scale (VAS) was assessed, as were subjective shoulder value (SSV), University of California, Los Angeles (UCLA) shoulder score, American Shoulder and Elbow Surgeons (ASES) score, and shoulder active range of motion (ROM). Postoperative magnetic resonance arthrography (MRA) or computed tomographic arthrography (CTA) was undertaken 6 months postoperatively for structural integrity assessment.

Results:

After 2 years, the VAS pain score (group A, from 6.5 to 1.2; group B, from 6.4 to 1.2), SSV (group A, from 38.3 to 89.4; group B, from 38.0 to 90.1), ASES score (group A, from 36.4 to 90.4; group B, from 38.0 to 90.8), UCLA shoulder score (group A, from 15.3 to 30.7; group B, from 15.0 to 31.3), and ROM improved significantly in both groups compared with preoperative values ( P < .001). However, none of these values differed significantly between groups. On follow-up MRA or CTA images, there was no significant difference in the retear rate between group A (28%; 16/57) and group B (24%; 11/45).

Conclusion:

The all-layers repair did not produce better clinical outcomes or structural integrity than the bursal layer–only repair. The study findings indicate that if repair of the articular layer is possible only under significant tension or is not reparable, rather than all-layers repair by force, bursal-layer repair without incorporating the articular layer may produce comparable clinical outcomes and structural integrity in the delaminated rotator cuff tear.
Critical Issues in Specific Learning Disability Identification
Authors: McGill Ryan J. , Styck Kara M. , Palomares Ronald S. , Hass Michael R.
Published: December 2015

As a result of the upcoming Federal reauthorization of the Individuals With Disabilities Education Improvement Act (IDEA), practitioners and researchers have begun vigorously debating what constitutes evidence-based assessment for the identification of specific learning disability (SLD). This debate has resulted in strong support for a method that appraises an individual’s profile of cognitive test scores for the purposes of determining cognitive processing strengths and weaknesses, commonly referred to as patterns of strengths and weaknesses (PSW). Following the Fuchs and Deshler model, questions regarding the psychometric and conceptual integrity of the PSW model are addressed. Despite the strong claims made by many PSW proponents, the findings by this review demonstrate the need for additional information to determine whether PSW is a viable alternative to existing eligibility models and worthy for large scale adoption for SLD identification. Implications for public policy and future SLD research are also discussed.
Immobilization of trace elements in municipal solid waste incinerator (MSWI) fly ash by producing calcium sulphoaluminate cement after carbonation and washing
Authors: Wang Lei , Jamro Imtiaz Ali , Chen Qi , Li Shaobai , Luan Jingde , Yang Tianhua
Published: December 2015

The possibility of producing calcium sulphoaluminate cement (CSA) by adding municipal solid waste incinerator (MSWI) fly ash to raw meal was investigated. After subjecting MSWI fly ash to accelerated carbonation and washing with water (ACW), various amounts (i.e. 5, 10 and 15 wt%) of the treated ash were added to raw meal composed of a mixture of bauxite, limestone and gypsum. The mixtures were sintered in a laboratory-scale muffle furnace at temperatures of 1250°, 1300°, 1325° and 1350°C for various durations. The influence of different quantities of MSWI fly ash on the mineralogy, major phase composition and strength development of the resulting clinker was studied, as was the effect of ash treatments on leaching and volatilization of trace elements. The ACW treatment reduced the volatilization ratio of trace elements during the clinkerization process. Volatilization ratios for lead, cadmium and zinc were 21.5%, 33.6% and 16.3%, respectively, from the ACW fly ash treatment, compared with ratios of 97.5%, 93.1% and 85.2% from untreated fly ash. The volatilization ratios of trace elements were ordered as follows: untreated fly ash > carbonated fly ash > carbonated and water-washed fly ash. The ACW process also reduced the chloride content in the MSWI fly ash by 90 wt% and prevented high concentrations of trace elements in the effluents.