bluuebunny/crossref_metadata_2025 huggingface dataset:
Time and Diffusion Lesion Size in Major Anterior Circulation Ischemic Strokes
Authors: Hakimelahi Reza , Vachha Behroze A. , Copen William A. , Papini Giacomo D.E. , He Julian , Higazi Mahmoud M. , Lev Michael H. , Schaefer Pamela W. , Yoo Albert J. , Schwamm Lee H. , González R. Gilberto
Published: September 2014

Background and Purpose—

Major anterior circulation ischemic strokes caused by occlusion of the distal internal carotid artery or proximal middle cerebral artery or both account for about one third of ischemic strokes with mostly poor outcomes. These strokes are treatable by intravenous tissue-type plasminogen activator and endovascular methods. However, dynamics of infarct growth in these strokes are poorly documented. The purpose was to help understand infarct growth dynamics by measuring acute infarct size with diffusion-weighted imaging (DWI) at known times after stroke onset in patients with documented internal carotid artery/middle cerebral artery occlusions.

Methods—

Retrospectively, we included 47 consecutive patients with documented internal carotid artery/middle cerebral artery occlusions who underwent DWI within 30 hours of stroke onset. Prospectively, 139 patients were identified using the same inclusion criteria. DWI lesion volumes were measured and correlated to time since stroke onset. Perfusion data were reviewed in those who underwent perfusion imaging.

Results—

Acute infarct volumes ranged from 0.41 to 318.3 mL. Infarct size and time did not correlate (
R
2
=0.001). The majority of patients had DWI lesions that were <25% the territory at risk (<70 mL) whether they were imaged <8 or >8 hours after stroke onset. DWI lesions corresponded to areas of greatly reduced perfusion.

Conclusions—

Poor correlation between infarct volume and time after stroke onset suggests that there are factors more powerful than time in determining infarct size within the first 30 hours. The observations suggest that highly variable cerebral perfusion via the collateral circulation may primarily determine infarct growth dynamics. If verified, clinical implications include the possibility of treating many patients outside traditional time windows.
Cost-Effectiveness of Recombinant Tissue-Type Plasminogen Activator Within 3 Hours of Acute Ischemic Stroke
Authors: Boudreau Denise M. , Guzauskas Gregory F. , Chen Er , Lalla Deepa , Tayama Darren , Fagan Susan C. , Veenstra David L.
Published: September 2014

Background and Purpose—

Despite the availability of results from multiple newer clinical trials and changing healthcare costs, the cost-effectiveness of recombinant tissue-type plasminogen activator (r-tPA) for treatment of acute ischemic stroke within 0 to 3 hours of symptom onset was last evaluated in 1998 for the United States Using current evidence, we evaluate the long-term cost-effectiveness of r-tPA administered 0 to 3 hours after acute ischemic stroke onset versus no r-tPA.

Methods—

A disease-based decision model to project lifetime outcomes of patients after acute ischemic stroke by r-tPA treatment status from the US payer perspective was developed. Model inputs were derived from a recent meta-analysis of r-tPA trials, cohort studies, and health state preference studies. Cost data, inflated to 2013 dollars, were based on drug wholesale acquisition cost and the literature. To compare r-tPA to no r-tPA, we calculated incremental total direct costs, incremental quality-adjusted life years, and incremental cost-effectiveness ratios. We performed 1-way and probabilistic sensitivity analyses to evaluate uncertainty in the results.

Results—

r-tPA resulted in a gain of 0.39 quality-adjusted life years (95% confidence range, 0.16–0.66) on average per patient and a lifetime cost-saving of $25 000 (95% confidence range, −$42 500 to −$11 000) compared with no r-tPA. In probabilistic sensitivity analyses, r-tPA was dominant compared with no r-tPA in ≈100% of simulations. The model was sensitive to inputs for r-tPA efficacy, healthcare costs for disabled patients, mortality rates for disabled and nondisabled patients, and quality of life estimates.

Conclusions—

Our analysis supports earlier economic evaluations that r-tPA is a cost-effective method to treat stroke. Appropriate use of r-tPA should be prioritized nationally.
Acute Ischemic Stroke and Long-Term Outcome After Thrombolysis
Authors: Schmitz Marie Louise , Simonsen Claus Z. , Hundborg Heidi , Christensen Hanne , Ellemann Karsten , Geisler Karin , Iversen Helle , Madsen Charlotte , Rasmussen Mary-Jette , Vestergaard Karsten , Andersen Grethe , Johnsen Soeren P.
Published: September 2014

Background and Purpose—

Data on long-term outcome after intravenous tissue-type plasminogen activator (tPA) in ischemic stroke are limited. We examined the risk of long-term mortality, recurrent ischemic stroke, and major bleeding, including intracranial and gastrointestinal bleeding, in intravenous tPA-treated patients when compared with intravenous tPA eligible but nontreated patients with ischemic stroke.

Methods—

We conducted a register-based nationwide propensity score–matched follow-up study among patients with ischemic stroke in Denmark (2004–2011). Cox regression analysis was used to compute adjusted hazard ratios for all outcomes.

Results—

Among 4292 ischemic strokes (2146 intravenous tPA-treated and 2146 propensity score–matched nonintravenous tPA-treated patients), with a follow-up for a median of 1.4 years, treatment with intravenous tPA was associated with a lower risk of long-term mortality (adjusted hazard ratio, 0.66; 95% confidence interval, 0.49–0.88). The long-term risk of recurrent ischemic stroke (adjusted hazard ratio, 1.05; 95% confidence interval, 0.68–1.64) and major bleeding (adjusted hazard ratio, 0.59; 95% confidence interval, 0.24–1.47) did not differ significantly between the intravenous tPA-treated and nontreated patients.

Conclusions—

Treatment with intravenous tPA in patients with ischemic stroke was associated with improved long-term survival.
Eubostrichus fertilis sp. n., a new marine nematode (Desmodoridae: Stilbonematinae) with an extraordinary reproductive potential from Belize, Central America
Authors: Ott Jörg A. , Leisch Nikolaus , Gruber-Vodicka Harald R.
Published: September 2014

Eubostrichus fertilissp. n. is described from fine subtidal sands in the Belize Barrier Reef system using LM and SEM illustrations and the sequence of the 18S rRNA gene. The new species is one of the smallest (mature specimens ranging from 1.88 to 3.03 mm) and the stoutest (a = 36-80) of all previously describedEubostrichusspecies. The closest relatives areE. parasitiferusandE. hopperi. It differs from the former in the more posterior position of the vulva and the postanal porids, and from the latter in the smaller size of the amphids, the shorter cephalic setae and the shape of the tail. Furthermore, it is remarkable for the prominent extent of the female genital system. Females have up to 18 eggs of similar size in their uteri. The body of the worm is covered by large (up to 45 μm long) crescent-shaped bacteria attached with both poles to the cuticle of the worm in a spiral pattern. The genusEubostrichusis phylogenetically well supported on the basis of the 18S rRNA gene sequence.Eubostrichus gerlachinom. nov. (= E. parasitiferusapudGerlach, 1963necChitwood, 1936) is proposed.
Plant-parasitic nematodes in sugarcane fields in Kitadaito Island (Okinawa), Japan, as a potential sugarcane growth inhibitor
Authors: Kawanobe Masanori , Miyamaru Naoko , Yoshida Koichi , Kawanaka Takeshi , Toyota Koki
Published: September 2014

Sugarcane is the main industrial crop in Kitadaito Island (Okinawa), Japan, and the objective of this study was to estimate potential damage to sugarcane by plant-parasitic nematodes (PPN). We selected 15 sugarcane fields with the same cultivar and cropping type in Kitadaito Island. Various kinds of PPN were found in all the fields and the proportion of PPN to the total nematode number was ca 50%, which is relatively high compared to other Japanese upland fields. Lesion (Pratylenchus sp.), stunt (Tylenchorhynchus sp.) and spiral (Helicotylenchus sp.) nematodes were detected at mean densities of 48, 22 and 6 (20 g soil)−1, respectively, from all the fields, and lance (Hoplolaimus sp.) and ring nematodes from half of the fields. The results suggested that sugarcane fields in Kitadaito Island were ubiquitously infested with a variety of PPN with a relatively high abundance. One of the fields was studied further to examine the potential relationship between PPN and sugarcane plant growth. Since no nematicide is registered for sugarcane fields in Japan, an appropriate agrochemical was selected by testing its efficacy against PPN before evaluating the relationship between a PPN community and sugarcane growth. The results of a 10-week pot experiment for sugarcane growth showed that the number of PPN decreased by applying a nematicide fosthiazate, and that sugarcane seedling biomass was significantly greater by 34-63% in soils with applied nematicide than in non-applied control soils, suggesting that PPN may suppress sugarcane growth in Kitadaito Island.
The Motion of Intellect On the Neoplatonic Reading of Sophist 248e-249d
Authors: Perl Eric D.
Published: September 2014

This paper defends Plotinus’ reading ofSophist248e-249d as an expression of the togetherness or unity-in-duality of intellect and intelligible being. Throughout the dialogues Plato consistently presents knowledge as a togetherness of knower and known, expressing this through the myth of recollection and through metaphors of grasping, eating, and sexual union. He indicates that an intelligible paradigm is in the thought that apprehends it, and regularly regards the forms not as extrinsic “objects” but as the contents of living intelligence. A meticulous reading ofSophist248e-249d shows that the “motion” attributed to intelligible being is not temporal change but the activity of intellectual apprehension. Aristotle’s doctrines of knowledge as identity of intellect and the intelligible, and of divine intellect as thinking itself, are therefore in continuity with Plato, and Plotinus’ doctrine of intellect and being is continuous with both Plato and Aristotle.
The Erlangen Papyrus 4 and Its Socratic Origins
Authors: Luz Menahem
Published: September 2014

P. Erlangen 4 is papyrus fragment of an ancient Greek, “Socratic” dialogue discussing cures for the (desire) of the beautiful—and, by implication, the meaning of moral beauty itself. Previous discussions have made general comparisons with the works of Plato, Xenophon and Aeschines. Prior to its philosophical analysis, I will re-examine the fragment, suggesting new reconstructions of the text, accompanied by an English translation. Although the precise authorship still remains a mystery, I will attempt to show that its philosophical language, argument and dramatic background are closer to the remains of Antisthenes than other Socratic writers and in particular to one of his Alcibiades compositions. The possibility will then be considered that it originated in one of his works or with one of his immediate followers.
Barriopsis tectonae sp. nov. a new species of Botryosphaeriaceae from Tectona grandis (teak) in Thailand
Authors: DOILOM MINGKWAN , SHUTTLEWORTH LUCAS A. , ROUX JOLANDA , CHUKEATIROTE EKACHAI , KEVIN HYDE D.
Published: September 2014

Tectona grandis (teak) is an increasingly important timber resource globally. It is native to Asia, including Thailand. In this paper a new species of Barriopsis, B. tectonae sp. nov., is described from a dead T. grandis branch collected in Thailand. Barriopsis tectonae can be differentiated from the two previously described species of Barriopsis; B. fusca and B. iraniana, by its ascospore and conidial dimensions. Phylogenetic evaluation of the ITS, TEF1-α and BT genomic regions provide further evidence that B. tectonae is a novel species.
A re-assessment of Elsinoaceae (Myriangiales, Dothideomycetes)
Authors: JAYAWARDENA RUVISHIKA S. , ARIYAWANSA HIRAN A. , SINGTRIPOP C. , LI YAN MEI , YAN JIYE , LI XINGHONG , NILTHONG S. , HYDE KEVIN D.
Published: September 2014

The family Elsinoaceae is a relatively poorly known, but important family within Myriangiales, Dothideomycetes. The genera of this family are mostly plant pathogens and causes disease, such as apple and grape scab. In this paper we revisit the family by examining generic types and analysis of molecular sequence data available in GenBank. Elsinoaceae and Myriangeaceae are morphologically and phylogenetically well-supported families in Myriangiales. In Elsinoaceae, 3 to 10 asci form in locules in light coloured pseudoascostromata, which form typical scab-like blemishes on leaf or fruit surfaces, while Myriangeaceae forms raised, superficial, black ascostromata with single asci in each locule, genera may or may not form scab-like lesions. Elsinoe is the type of the family Elsinoaceae and is characterized by forming scab-like blemishes on leaves with few to numerous bitunicate, fissitunicate, globose asci forming inside each locule with a pseudoascostroma containing fungal and host tissues. Following examination of generic type material, Molleriella is retained in Elsinoaceae as it has characters similar to Elsinoe in forming scab-like lesions with pseudoascostromata containing few to numerous bitunicate asci inside each locule. Beelia, Butleria, Hemimyriangium, Hyalotheles, Micularia, Saccardinula, Stephanatheca and Xenodium are excluded from Elsinoaceae and their relative placement in Dothideomycetes is discussed. Fresh collections of these genera are needed so that molecular sequence data can be obtained and analysed to resolve their placement in families or orders of Dothidoemycetes.
Englerulaceae (Dothideomycetes)
Authors: DAI DONG-QIN , BOONMEE SARANYAPHAT , TIAN QING , XIAO YUAN-PIN , BHAT D. JAYARAMA , CHUKEATIROTE EKACHAI , ALIAS S. AISYAH , ZHAO RUI-LIN , WANG YONG , HYDE KEVIN D.
Published: September 2014

The family Englerulaceae presently includes seven genera that produce brown to dark-brown colonies on living leaves. Ascomata are superficial and scattered on the colonies and lack ostioles. Asci are 2–8-spored, bitunicate, ovate to globose and ascospores are multi-seriate, oblong to ellipsoid, brown, and smooth-walled with a single septum. This paper brings all genera of the family together in one place with descriptions and illustrations and discusses their current taxonomic placement. The type species of Englerula, Parenglerula, Rhizotexis, Rhytidenglerula, Schiffnerula and a new species of Thrauste are redescribed and illustrated with light photomicrographs, in this paper. It is suggested that Butleria should be accommodated in Myriangiaceae. Rhizotexis is excluded from the family and moved to Dothideomycetes genera incertae sedis, as morphological characters are not similar to type genus and other genera in the family. The type specimen of Goosia is missing and is redrawn from the protologue. By illustrating and redescribing the genera we expect renewed interest for recollection and molecular study so that these dothideomycetous genera can be placed in a natural taxonomic framework.
A reappraisal of Microthyriaceaea
Authors: WU HAI-XIA , TIAN QIN , LI WEN JING , HYDE KEVIN D.
Published: September 2014

Asterinella, Cirsosiopsis, Phragmaspidium, Platypeltella, Trichopeltella, Trichopeltum and Trichothyrinula are poorly known ascomycete genera, presently included in the family Microthyriaceae. In this paper the type species of each of these genera were examined and the taxa are redescribed and illustrated with photomicrographs. The taxonomic placement of each genus and their familial position is discussed. Asterinella and Platypeltella has superficial, flattened thyriothecia and superficial hyphae with hyphopodia; the thyriothecia opens by splitting to release the ascospores and these genera should be placed in Asterinaceae. Cirsosiopsis, has strongly flattened, discoid or pulvinate to elongate, carbonaceous ascomata and is transferred to Parmulariaceae. Phragmaspidium has an upper wall comprising neatly arranged radiating cells; the basal layer is poorly developed and thus the genus should be retained in Microthyriaceae. Trichopeltella, Trichopeltum and Trichothyrinula are foliar epiphytes forming extremely thin, relatively large, brown to black, circular to irregular, or root-like, spreading thalli, which cover the thyriothecia and should be placed in Trichopeltinaceae.
A new species of Microthyrium from Yunnan, China
Authors: Wu HaiXia , Li YanMei , Ariyawansa Hiran A , Li WenJing , Yang Hui , Hyde Kevin D.
Published: September 2014

A new species, Microthyrium propagulensis, collected in Yunnan Province, southwestern China is introduced. The species is typical of Microthyriaceae (Microthyriales) in having superficial thyriothecia with a poorly developed basal layer and a prominent darker central ostiole, bitunicate asci and 1-septate ascospores. It is similar to the generic type, M. microscopicum, but differs in having relatively small ascospores, with two apical cilia, which lie downloads from the ascospore apex at a 45° angle. Phylogenetic analysis based on combined LSU and SSU gene sequence data clearly place this species in Microthyrium, but distinguishes it from Microthyrium microscopicum. This second sequence from a Microthyrium species indicates that the putative sequence of the type of this genus is CBS has been correctly named and supports the distinctiveness of Microthyriales and Microthyriaceae.
Trichopeltinaceae (Dothideomycetes), an earlier name for Brefeldiellaceae, with a new species of Trichopeltina
Authors: HONGSANAN SINANG , BAHKALI ALI H. , MCKENZIE ERIC H.C. , CHUKEATIROTE EKACHAI , HYDE KEVIN D.
Published: September 2014

The family Trichopeltinaceae is poorly known. This is due to an unclear history, few modern morphological studies and lack of sequence data in GenBank. The family was introduced in 1914 as Trichopeltaceae to accommodate the subfamilies Trichopeltinae and Brefeldiineae. In 1958 the spelling of the family was corrected to Trichopeltinaceae, as it was presumably based on the genus Trichopeltina. The family Brefeldiellaceae was introduced in 1962. Both Brefeldiellaceae and Trichopeltinaceae contain morphologically similar epiphgytic foliar taxa, the only difference being that the thallus is linear in Trichopeltinaceae and rounded in Brefeldiellaceae. In both families the thallus forms a neatly arranged, “skin-like”, palisade of cells over the flattened thyriothecia, pseudoparaphyses are mostly lacking, asci are bitunicate and saccate and ascospores are ellipsoidal, muriform of trans-septate and hyaline to brown. Trichopeltinaceae is the earliest name for these taxa. The family can be confused with Trichothyriaceae and this is discussed. A new species of Trichopeltina is also introduced and illustrated.
Towards a natural classification of Dothideomycetes 4: The genera Bryopelta, Bryorella, Bryosphaeria, Lophiosphaerella and Maireella (Dothideomycetes incertae sedis)
Authors: Wen-jing Li , BHAT JAYARAMA D. , HYDE KEVIN D. , WANG YONG
Published: September 2014

In the latest classification of Ascomycota with 365 genera in the Dothideomycetes, most taxa are poorly known. In this paper we re-examine the type species of Bryopelta, Bryorella, Bryosphaeria, Lophiosphaerella and Maireella. By studying the generic types we suggest higher level placement and better understanding of morphology of these genera. It is hoped that this will stimulate fresh collections and sequence data for these genera so that we can place the taxa in a natural classification system.
Phylogenetic position of the diatom genus Geissleria Lange-Bertalot & Metzeltin and description of two new species from Siberian mountain lakes
Authors: Kulikovskiy Maxim Sergeevich , Gusev Evgeniy , Andreeva Svetlana , Annenkova Natalia
Published: September 2014

Two new Geissleria species from Siberian mountain lakes Baikal and Frolikha are described based on molecular and morphological data. The two new species are Geissleria baicalosimilis Kulikovskiy, Gusev, Andreeva & Annenkova sp. nov. and G. frolikhiensis Kulikovskiy, Gusev, Andreeva & Annenkova sp. nov. According to partial 18S rDNA and rbcL gene fragment analyses, Geissleria does not belong to the large catch-all genus Navicula as it was previously thought.  Morphological features such as slit like areolae without hymenes, presence of one isolated pore near the central nodule and presence of props in areolae and an annulus structure support this conclusion. Plastid morphology of Geissleria species is typical for the Cymbellales, with one large chloroplast divided into two plates lying one against each valve, connected by a broad column. All of our data show that Geissleria is most closely to the genus Placoneis, with which they share naviculoid symmetry. Given these results, Geissleria should be included in the order Cymbellales.
Callianthe montana, a new combination for Abutilon montanum (Malvaceae, Malvoideae), a rediscovered species endemic to the state of Minas Gerais, Brazil
Authors: Takeuchi Cátia , Donnell Aliya A. , Júnior Aluisio José Fernandes
Published: September 2014

Since its description in 1827, Abutilon montanum was previously known exclusively from the type collection. Its rediscovery is reported here 180 years after its description in Serra Negra, Minas Gerais. An expanded species description, unpublished illustrations, comments about the distribution and commentaries on IUCN conservation status of this species are presented. The new combination Callianthe montana is also proposed here.
More species of the Agononida incerta complex revealed by molecules and morphology (Crustacea: Decapoda: Anomura: Munididae)
Authors: POORE GARY C. B. , ANDREAKIS NIKOS
Published: September 2014

Squat lobsters from Madagascar, Vanuatu, Papua New Guinea, Fiji, eastern Australia and French Polynesia belonging to the Agononida incerta (Henderson, 1888) species complex are described as four new species: A. madagascerta, A. polycerta, A. tasmancerta and A. vanuacerta. This brings to ten the number of species in this complex. All species are morphologically distinguishable only on the basis of the shape of the anterolateral margin of the telson and setation of the dactyli of pereopods 2–4. The morphological delineation of nine of the species and their taxonomic status are robustly supported by phylogenetic analysis of the partial 16S rDNA gene and the partial mitochondrial cytochrome oxidase subunit 1 genes, and in some cases by colour. A phylogenetic analysis of the nine species for which molecular data are available grouped the species in two clades, one of four species with facial spines on the upper surface of pereopod 4 and the other of five species lacking facial spines.
A new species of Eucosma Hübner and two new species of Cydia Hübner (Lepidoptera: Tortricidae) from the United States
Authors: BROWN RICHARD L. , JAEGER CHRISTI
Published: September 2014

Three new species of Olethreutinae (Lepidoptera: Tortricidae) from the United States are described and illustrated. Eucosma paregoria Brown, n. sp., is associated with prairies and glades, primarily in midwestern U.S. Cydia marita Brown, n. sp., is common in southeastern U.S., ranging from Texas to Florida and north along the eastern seaboard to Virginia. Cydia timara Brown, n. sp., occurs in the southwestern U.S. (Arizona and New Mexico). Both species of Cydia are associated with habitats that support Pinus species, the probable larval hosts.
Schistura andrewi, a new species of loach (Teleostei: Nemacheilidae) from Mizoram, northeastern India
Authors: SOLO BEIHROSA , LALRAMLIANA LALRAMLIANA , LALRONUNGA SAMUEL , LALNUNTLUANGA LALNUNTLUANGA
Published: September 2014

Schistura andrewi, a new species of loach, is described from a tributary of Kaladan River in Mizoram, northeastern India. It is distinguished from its congeners in having the following combination of characters: long axillary pelvic lobe; complete lateral line with 82–95 pores; 2 unbranched dorsal and anal fin rays; 6–7 broad, wider than interspace, black bars on the body; 2 rows of black spots horizontally across the dorsal fin; a deeply emarginate caudal fin, with 2 vertical rows of black spots across the fin, and 9 + 8 branched caudal fin rays.
CLSM anatomy of internal genitalia of Mackiella reclinata n. sp. and systematic remarks on eriophyoid mites from the tribe Mackiellini Keifer, 1946 (Eriophyoidea: Phytoptidae)
Authors: CHETVERIKOV PHILIPP E. , CRAEMER CHARNIE , VISHNYAKOV ANDREY E. , SUKHAREVA SOGDIANA I.
Published: September 2014

A new mackielline mite, Mackiella reclinata n. sp., from a South African indigenous palm-tree, Phoenix reclinata, is described in detail using different microscopy techniques. A CSLM study of M. reclinata n. sp. internal genitalia shows that mites of this genus possess teardrop shaped spermathecae, sausage-like spermathecal tubes directed anteriad and a subtrapezoidal anterior genital apodeme with a peculiar apical plate, orthogonal to the anterior-posterior body axis. Pairwise angles between the spermatheca, spermathecal tube and the longitudinal bridge of M. reclinata n. sp. females were measured. The angle between the spermathecal tube and longitudinal bridge is a quite stable morphometric character and thus is considered to be appropriate for comparison of different eriophyoid taxa. LTSEM and CLSM study shows that M. reclinata n. sp. possesses a unique, broadened frontal lobe of the prodorsal shield comprised of apical and basal parts entirely covering the dorsal palpcoxae. The incompletely described mite species Mackiella borasis Mohanasundaram, 1981 does not conform to the diagnosis of Mackiella and herein is transferred to the subfamily Phytoptinae incertae sedis.
Aerosol Effects on Idealized Supercell Thunderstorms in Different Environments
Authors: Kalina Evan A. , Friedrich Katja , Morrison Hugh , Bryan George H.
Published: September 2014

Idealized supercell thunderstorms are simulated with the Weather Research and Forecasting (WRF) Model at 15 cloud condensation nuclei (CCN) concentrations (100–10 000 cm−3) using four environmental soundings with different low-level relative humidity (RH) and vertical wind shear values. The Morrison microphysics scheme is used with explicit prediction of cloud droplet number concentration and a variable shape parameter for the raindrop size distribution (results from simulations with a fixed shape parameter are also presented). Changes in the microphysical process rates with CCN concentration are negligible beyond CCN ≈ 3000 cm−3. Changes in cold pool characteristics with CCN concentration are nonmonotonic and highly dependent on the environmental conditions. In moist conditions with moderate vertical wind shear, the cold pool area is nearly constant with respect to CCN concentration, while the area is reduced by 84% and 22% in the soundings with dry RH and large vertical wind shear, respectively. With the exception of the dry RH sounding, domain-averaged precipitation peaks between 500 and 5000 cm−3, after which it remains constant or slowly decreases. For the dry RH sounding, the domain-averaged precipitation monotonically decreases with CCN concentration. Accumulated precipitation is enhanced (by up to 25 mm) in the most polluted cases near the updrafts, except for the dry RH sounding. The different responses for moist and dry soundings are mostly due to increased (decreased) low-level latent cooling from melting hail (evaporating rain) with increasing CCN concentration in the moist soundings. This compensating effect does not exist when the low-level RH is dry.
Are Eyewall Replacement Cycles Governed Largely by Axisymmetric Balance Dynamics?
Authors: Abarca Sergio F. , Montgomery Michael T.
Published: September 2014

The authors question the widely held view that radial contraction of a secondary eyewall during an eyewall replacement cycle is well understood and governed largely by the classical theory of axisymmetric balance dynamics. The investigation is based on a comparison of the secondary circulation and derived tangential wind tendency between a full-physics simulation and the Sawyer–Eliassen balance model. The comparison is made at a time when the full-physics model exhibits radial contraction of the secondary eyewall during a canonical eyewall replacement cycle. It is shown that the Sawyer–Eliassen model is unable to capture the phenomenology of secondary eyewall radial contraction because it predicts a net spindown of the boundary layer tangential winds and does not represent the boundary layer spinup mechanism that has been articulated in recent work.
Double Diffusion in Saline Powell Lake, British Columbia
Authors: Scheifele Benjamin , Pawlowicz Rich , Sommer Tobias , Wüest Alfred
Published: September 2014

Powell Lake contains a deep layer of relic seawater separated from the ocean since the last ice age. Permanently stratified and geothermally heated from below, this deep layer is an isolated geophysical domain suitable for studying double-diffusive convection. High-resolution CTD and microstructure measurements show several double-diffusive staircases (Rρ = 1.6 to 6) in the deep water, separated vertically by smooth high-gradient regions with much larger density ratios. The lowest staircase contains steps that are laterally coherent on the basin scale and have a well-defined vertical structure. On average, temperature steps in this staircase are 4 mK, salinity steps are 2 mg kg−1, and mixed layer heights are 70 cm. The CTD is capable of measuring bulk characteristics of the staircase in both temperature and salinity. Microstructure measurements are limited to temperature alone, but resolve the maximum temperature gradients in the center of selected laminar interfaces. Two different algorithms for characterizing the staircase are compared. Consistent estimates of the steady-state heat flux (27 mW m−2) are obtained from measurements above and below the staircase, as well as from microstructure measurements in the center of smooth interfaces. Estimates obtained from bulk interface gradients underestimate the steady-state flux by nearly a factor of 2. The mean flux calculated using a standard 4/3 flux law parameterization agrees well with the independent estimates, but inconsistencies between the parameterization and the observations remain. These inconsistencies are examined by comparing the underlying scaling relationship to the measurements.
Comparing Forecast Skill
Authors: DelSole Timothy , Tippett Michael K.
Published: September 2014

A basic question in forecasting is whether one prediction system is more skillful than another. Some commonly used statistical significance tests cannot answer this question correctly if the skills are computed on a common period or using a common set of observations, because these tests do not account for correlations between sample skill estimates. Furthermore, the results of these tests are biased toward indicating no difference in skill, a fact that has important consequences for forecast improvement. This paper shows that the magnitude of bias is characterized by a few parameters such as sample size and correlation between forecasts and their errors, which, surprisingly, can be estimated from data. The bias is substantial for typical seasonal forecasts, implying that familiar tests may wrongly judge that differences in seasonal forecast skill are insignificant. Four tests that are appropriate for assessing differences in skill over a common period are reviewed. These tests are based on the sign test, the Wilcoxon signed-rank test, the Morgan–Granger–Newbold test, and a permutation test. These techniques are applied to ENSO hindcasts from the North American Multimodel Ensemble and reveal that the Climate Forecast System, version 2, and the Canadian Climate Model, version 3 (CanCM3), outperform other models in the sense that their squared error is less than that of other single models more frequently. It should be recognized that while certain models may be superior in a certain sense for a particular period and variable, combinations of forecasts are often significantly more skillful than a single model alone. In fact, the multimodel mean significantly outperforms all single models.
Nurses' Perceptions Regarding the Prevalence, Detection, and Causes of Malnutrition in Canadian Hospitals
Authors: Duerksen Donald R. , Keller Heather H. , Vesnaver Elisabeth , Laporte Manon , Jeejeebhoy Khursheed , Payette Hélène , Gramlich Leah , Bernier Paule , Allard Johane P.
Published: September 2014

Objectives: Given the high prevalence of malnutrition in hospitalized patients, nurses frequently encounter patients with significantly impaired nutrition status. The objective of this study was to determine nurses' attitudes and perceptions regarding the prevalence, detection, and causes of malnutrition in Canadian tertiary care and community hospitals. Materials and Methods: In this descriptive study, a survey that focused on guidelines for nutrition support of hospitalized patients was completed by Canadian nurses working on medical and surgical wards in 11 hospitals participating in the Canadian Malnutrition Task Force study. Results: The survey was completed by 346 of 723 nurses (response rate 48%). Over 50% of nurses underestimated the documented prevalence of malnutrition in hospitalized patients. Nurses considered identification of malnourished patients very relevant (mean 8.4 on a 10‐point scale) and would integrate a 3‐question nutrition screen into their admission histories (92.5%). Nurses perceived lack of assistance with eating as a significant contributor to hospital malnutrition (17% felt this was a major contributor). While only 39% of nurses reported access to nutrition‐related education, 92% were interested in receiving this form of updating. Conclusions: Nurses consider nutrition assessment important and relevant and require access to training to improve their capacity to detect malnutrition in their patients. Nurses are vital to the nutrition care of hospitalized patients and are well positioned to screen for nutrition risk and assist in nutrition management. The role of nurses in nutrition care needs to be linked to hospital policy.
Characteristic of martensite–austenite constituents in coarse grained heat affected zone of HSLA steel with varying Al contents
Authors: Yu L. , Wang H. H. , Hou T. P. , Wang X. L. , Wan X. L. , Wu K. M.
Published: September 2014

The fine microstructure of martensite–austenite (M–A) constituents in simulated coarse grained heat affected zone (HAZ) of high strength low alloy steel with varying aluminium content (0·038 and 0·070 wt-%) at 100 kJ cm−1 heat input welding was investigated. The result shows that M–A constituents with 0·038%Al consisted of lath martensite and retained austenite. The retained austenite was distributed along the martensite lath. Whereas, the M–A constituents with 0·070%Al consisted of lath martensite and retained austenite, as well as a small amount of twinned martensite. The amount of retained austenite in M–A constituents with 0·070%Al was becoming higher slightly than that with 0·038%Al. Accordingly, the volume fraction of M–A constituents was reduced with 0·070%Al. Appropriate aluminium addition could decrease not only the area fraction but also the size of M–A constituents, which are beneficial for improving the toughness of HAZ.
Effects of use of higher strength interlayer and external cooling on properties of friction stir welded AA6061-T6 joints
Authors: Çam G. , İpekoğlu G. , Tarık Serindağ H.
Published: September 2014

Although sound AA6061-T6 joints can be produced by friction stir welding, a loss in strength takes place in the weld region. In this study, it was demonstrated that the strength of the nugget could be increased by the use of a higher strength interlayer during friction stir welding. This strength recovery cannot, however, be attainable in the heat affected zone. Although an external cooling was applied during welding in order to increase strength in the heat affected zone, it was not sufficient for achieving the required cooling condition for improved strength.
Biphalangeal/triphalangeal fifth toe and impact in the pathology of the fifth ray
Authors: Gallart Jose , González David , Valero Jose , Deus Javier , Serrano Pedro , Lahoz Manuel
Published: September 2014

Background

Having reviewed the studies on the biphalangeal fifth toe, we have observed a great disparity of data depending on the research center. We have investigated the frequency of biphalangeal toes and also its handedness. We have also analyzed the relationship of pathological deviations of fifth toe with this feature and with the fifth metatarsal.

Methods

We performed a descriptive prospective study, which analyzed 2494 feet (1247 people) with bilateral dorsoplantar radiographs. We studied the number of phalanges of the fifth toe, the deviations in the sagittal and transverse plane, and the state of the fifth metatarsal phalangeal joint.

Results

After analyzing the data we found the presence of biphalangeal fifth toe in 46.3% of the feet, presenting this feature bilaterally in 97.4% of them. A statistically significant higher percentage of pathological toes was found in people with triphalangeal fifth toe (pathological in 29.91%) than in the biphalangeal toes (pathological in 15.60%). We found that these differences are accentuated in the alterations of the fifth toe in the sagittal plane.

Conclusions

It is almost 4 times more likely to suffer a fifth hammer toe if the fifth toe is triphalangeal (OR = 3.98 to p =0.000). Alterations in the coronal plane of the fifth toe are associated with tailor’s bunion (p =0.000). We did not find any significant differences regarding the need for surgery of the fifth toe of the biphalangeal (39.1%) versus triphalangeal toes (60.9%). Clinical relevance: There may be an association between pathologic deviations and bigger mobility of the triphalangeal fifth toes. However, biphalangeal fifth toes show bigger rigidity leading to smaller accommodation inside the shoe, which may lead to less painful feet and decreased proportion of surgery.
Consequences of tumor planning target volume reduction in treatment of T2-T4 laryngeal cancer
Authors: Vugts Cornelia AJM , Terhaard Chris HJ , Philippens Marielle EP , Pameijer Frank A , Kasperts Nicolien , Raaijmakers Cornelis PJ
Published: September 2014

Background and purpose

Since lymph nodes volumes are generally four times the volume of the primary PTV, the advantage of using tight margins around the primary PTV is not clear. Therefore treatment margins of T2-T4 laryngeal carcinoma for IMRT are generally chosen in such a way that the PTV is comparable to that in conventional radiotherapy. The aim of this study is to quantify the effect of volume reduction of the primary PTV of T2-T4 laryngeal carcinoma with regard to late toxicity despite elective irradiation of lymph node levels II to IV.

Methods

Two treatment plans based on conservative (GTV-PTV = 15 mm and 20 mm cranial), and on evidence-based tight margins (GTV-PTV = 8 mm) were calculated for 16 patients. Toxicity effects were estimated based on the dose distributions.

Results

Compared to conservative margins, using tight margins resulted in: 1) significant reduction of the normal tissue complication probability (NTCP) for swallowing muscles and submandibular glands, 2) significant reduction of the mean dose in all organs at risk (OAR), 3) a mean dose smaller than 60 Gy for all OARs except for the laryngeal cartilages. When the lymph node levels II to IV were prescribed with an elective dose, an NTCP reduction of 53% for the swallowing muscles and of 23% for the submandibular glands was found by using tight instead of conservative margins. When positive nodes were present, NTCP reduction amounted to 29% and 15%, respectively.

Conclusions

There is a potential benefit in realizing evidence-based tight margins for laryngeal cancer patients despite elective irradiation of lymph node levels II to IV.
Hypouricemic effect and safety of febuxostat used for prevention of tumor lysis syndrome
Authors: Maie Koichiro , Yokoyama Yasuhisa , Kurita Naoki , Minohara Hideto , Yanagimoto Shintaro , Hasegawa Yuichi , Homma Masato , Chiba Shigeru
Published: September 2014

Purpose

We evaluated the efficacy and safety of febuxostat, a non-purine xanthine oxidase inhibitor, used for prevention of hyperuricemia associated with tumor lysis syndrome (TLS).

Methods

Records of adult patients with newly diagnosed or relapsed hematologic malignancies who received febuxostat within 7 days before initiation of chemotherapy were retrieved retrospectively at a single institute. The changes in serum uric acid levels from before and 7 days after initiation of febuxostat were evaluated and compared with the historical control group of patients who received allopurinol. We also evaluated non-hematological adverse events during the study period.

Results

A total of 78 patients’ records were analyzed, 38 in the febuxostat group and 39 in the allopurinol group. There were no significant differences in the incidence of treatment failure, defined as development of clinical TLS or receiving rasburicase, between the febuxostat and allopurinol group (5.2% vs 5.1%, P>0.99). The mean serum uric acid levels were significantly decreased, compared to the baseline (5.6 ± 2.1 mg/dL), at 7 days after initiation of febuxostat (3.1 ± 1.5 mg/dL, last observation carried forward, P<0.001). There were no statistically significant differences in the percent change in the serum uric acid levels between the 40 mg/day febuxostat and the 300 mg/day allopurinol groups (P = 0.57). Grade 3–4 liver dysfunctions were observed in both the febuxostat and allopurinol groups, without significant differences in incidence between the two groups (2.6% vs 5.1%, P>0.99). Neither gout flare nor skin rash occurred in any patients.

Conclusions

Febuxostat is feasible for prevention of hyperuricemia associated with TLS.
Update of the trauma risk adjustment model of the TraumaRegister DGU™: the Revised Injury Severity Classification, version II
Authors: Lefering Rolf , Huber-Wagner Stefan , Nienaber Ulrike , Maegele Marc , Bouillon Bertil
Published: September 2014

Introduction

The TraumaRegister DGU™ (TR-DGU) has used the Revised Injury Severity Classification (RISC) score for outcome adjustment since 2003. In recent years, however, the observed mortality rate has fallen to about 2% below the prognosis, and it was felt that further prognostic factors, like pupil size and reaction, should be included as well. Finally, an increasing number of cases did not receive a RISC prognosis due to the missing values. Therefore, there was a need for an updated model for risk of death prediction in severely injured patients to be developed and validated using the most recent data.

Methods

The TR-DGU has been collecting data from severely injured patients since 1993. All injuries are coded according to the Abbreviated Injury Scale (AIS, version 2008). Severely injured patients from Europe (ISS ≥4) documented between 2010 and 2011 were selected for developing the new score (n = 30,866), and 21,918 patients from 2012 were used for validation. Age and injury codes were required, and transferred patients were excluded. Logistic regression analysis was applied with hospital mortality as the dependent variable. Results were evaluated in terms of discrimination (area under the receiver operating characteristic curve, AUC), precision (observed versus predicted mortality), and calibration (Hosmer-Lemeshow goodness-of-fit statistic).

Results

The mean age of the development population was 47.3 years; 71.6% were males, and the average ISS was 19.3 points. Hospital mortality rate was 11.5% in this group. The new RISC II model consists of the following predictors: worst and second-worst injury (AIS severity level), head injury, age, sex, pupil reactivity and size, pre-injury health status, blood pressure, acidosis (base deficit), coagulation, haemoglobin, and cardiopulmonary resuscitation. Missing values are included as a separate category for every variable. In the development and the validation dataset, the new RISC II outperformed the original RISC score, for example AUC in the development dataset 0.953 versus 0.939.

Conclusions

The updated RISC II prognostic score has several advantages over the previous RISC model. Discrimination, precision and calibration are improved, and patients with partial missing values could now be included. Results were confirmed in a validation dataset.
Continuous control of tracheal cuff pressure: an effective measure to prevent ventilator-associated pneumonia?
Authors: Rouzé Anahita , Jaillette Emmanuelle , Nseir Saad
Published: September 2014

In a previous issue of Critical Care, Lorente and colleagues reported the results of a prospective observational study aiming at evaluating the effect of continuous control of cuff pressure (Pcuff ) on the incidence of ventilator-associated pneumonia (VAP). The results suggest a beneficial impact of this intervention on VAP prevention, which is in line with the results of a recent randomized controlled study. However, another randomized controlled study found no significant impact of continuous control of Pcuff on VAP incidence. Several differences regarding the device used to control Pcuff, study population, and design might explain the different reported results. Future randomized multicenter studies are needed to confirm the beneficial effect of continuous control of Pcuff on VAP incidence. Furthermore, the efficiency and cost-effectiveness of different available devices should be compared. Meanwhile, given the single-center design and the limitations of the available studies, no strong recommendation can be made regarding continuous control of Pcuff as a preventive measure of VAP.
A Stochastic Model for Virus Growth in a Cell Population
Authors: Björnberg J. E. , Britton T. , Broman E. I. , Natan E.
Published: September 2014

In this work we introduce a stochastic model for the spread of a virus in a cell population where the virus has two ways of spreading: either by allowing its host cell to live and duplicate, or by multiplying in large numbers within the host cell, causing the host cell to burst and thereby let the virus enter new uninfected cells. The model is a kind of interacting Markov branching process. We focus in particular on the probability that the virus population survives and how this depends on a certain parameter λ which quantifies the ‘aggressiveness’ of the virus. Our main goal is to determine the optimal balance between aggressive growth and long-term success. Our analysis shows that the optimal strategy of the virus (in terms of survival) is obtained when the virus has no effect on the host cell's life cycle, corresponding to λ = 0. This is in agreement with experimental data about real viruses.
Minimal Clade Size in the Bolthausen-Sznitman Coalescent
Authors: Freund Fabian , Siri-Jégousse Arno
Published: September 2014

In this article we show the asymptotics of distribution and moments of the sizeXnof the minimal clade of a randomly chosen individual in a Bolthausen-Sznitmann-coalescent forn→ ∞. The Bolthausen-Sznitmann-coalescent is a Markov process taking states in the set of partitions of {1, …,n}, where 1, …,nare referred to as individuals. The minimal clade of an individual is the equivalence class the individual is in at the time of the first coalescence event this individual participates in. We also provide exact formulae for the distribution ofXn. The main tool used is the connection of the Bolthausen-Sznitmann-coalescent with random recursive trees introduced by Goldschmidt and Martin (2005). With it, we show thatXn- 1 is distributed as the size of a uniformly chosen table in a standard Chinese restaurant process withn- 1 customers.