bluuebunny/crossref_metadata_2025 huggingface dataset:
Wind-Driven Mixing below the Oceanic Mixed Layer
Authors: Grant Alan L. M. , Belcher Stephen E.
Published: April 2011

This study describes the turbulent processes in the upper ocean boundary layer forced by a constant surface stress in the absence of the Coriolis force using large-eddy simulation. The boundary layer that develops has a two-layer structure, a well-mixed layer above a stratified shear layer. The depth of the mixed layer is approximately constant, whereas the depth of the shear layer increases with time. The turbulent momentum flux varies approximately linearly from the surface to the base of the shear layer.

There is a maximum in the production of turbulence through shear at the base of the mixed layer. The magnitude of the shear production increases with time. The increase is mainly a result of the increase in the turbulent momentum flux at the base of the mixed layer due to the increase in the depth of the boundary layer. The length scale for the shear turbulence is the boundary layer depth. A simple scaling is proposed for the magnitude of the shear production that depends on the surface forcing and the average mixed layer current. The scaling can be interpreted in terms of the divergence of a mean kinetic energy flux.

A simple bulk model of the boundary layer is developed to obtain equations describing the variation of the mixed layer and boundary layer depths with time. The model shows that the rate at which the boundary layer deepens does not depend on the stratification of the thermocline. The bulk model shows that the variation in the mixed layer depth is small as long as the surface buoyancy flux is small.
Baroclinic Turbulence in the Ocean: Analysis with Primitive Equation and Quasigeostrophic Simulations
Authors: Venaille Antoine , Vallis Geoffrey K. , Smith K. Shafer
Published: April 2011

This paper examines the factors determining the distribution, length scale, magnitude, and structure of mesoscale oceanic eddies in an eddy-resolving primitive equation simulation of the Southern Ocean [Modeling Eddies in the Southern Ocean (MESO)]. In particular, the authors investigate the hypothesis that the primary source of mesoscale eddies is baroclinic instability acting locally on the mean state. Using local mean vertical profiles of shear and stratification from an eddying primitive equation simulation, the forced–dissipated quasigeostrophic equations are integrated in a doubly periodic domain at various locations. The scales, energy levels, and structure of the eddies found in the MESO simulation are compared to those predicted by linear stability analysis, as well as to the eddying structure of the quasigeostrophic simulations. This allows the authors to quantitatively estimate the role of local nonlinear effects and cascade phenomena in the generation of the eddy field.

There is a modest transfer of energy (an “inverse cascade”) to larger scales in the horizontal, with the length scale of the resulting eddies typically comparable to or somewhat larger than the wavelength of the most unstable mode. The eddies are, however, manifestly nonlinear, and in many locations the turbulence is fairly well developed. Coherent structures also ubiquitously emerge during the nonlinear evolution of the eddy field. There is a near-universal tendency toward the production of grave vertical scales, with the barotropic and first baroclinic modes dominating almost everywhere, but there is a degree of surface intensification that is not captured by these modes. Although the results from the local quasigeostrophic model compare well with those of the primitive equation model in many locations, some profiles do not equilibrate in the quasigeostrophic model. In many cases, bottom friction plays an important quantitative role in determining the final scale and magnitude of eddies in the quasigeostrophic simulations.
Structure of a Warm Front: Helsinki Testbed Observations and Model Simulation
Authors: Kemppi Mirja L. , Sinclair Victoria A.
Published: April 2011

The purpose of this study is to document the structure of a warm front in northeast Europe, identify the effects that the Finnish coastline has on the evolution of the front, and investigate factors that influence the speed that the warm front moves at within, and above, the boundary layer. The warm front formed over Estonia, traveled northward across the Gulf of Finland, and then crossed the southern coastline of Finland. Surface-based measurements from the Helsinki Testbed are analyzed together with output from a high-resolution numerical weather prediction model, Application of Research to Operations at Mesoscale (AROME). During the early stages of development, the warm front interacted with a stationary baroclinic zone and, consequently, evolved into an S shape. As the front approached the southern coast of Finland, the temperature gradient at 1000 hPa increased, as it merged with a diabatically generated temperature gradient. At 1000 hPa, the front stalled at the coastline due to friction-enhanced convergence, while the front’s speed at 860 hPa was almost uniform and unaffected by the coastline. At both 860 and 1000 hPa, the front moved slower than the wind speed. Hence, the front’s movement had a propagating component that was directed in the opposite direction to that of the front’s movement. The distribution of the ageostrophic winds showed that the front’s propagation component was produced by the front’s secondary circulation and surface friction. These results highlight the importance of surface sensible heat fluxes and friction on the evolution and movement of warm fronts.
Conservative Transport Schemes for Spherical Geodesic Grids: High-Order Flux Operators for ODE-Based Time Integration
Authors: Skamarock William C. , Gassmann Almut
Published: April 2011

Higher-order finite-volume flux operators for transport algorithms used within Runge–Kutta time integration schemes on irregular Voronoi (hexagonal) meshes are proposed and tested. These operators are generalizations of third- and fourth-order operators currently used in atmospheric models employing regular, orthogonal rectangular meshes. Two-dimensional least squares fit polynomials are used to evaluate the higher-order spatial derivatives needed to cancel the leading-order truncation error terms of the standard second-order centered formulation. Positive definite or monotonic behavior is achieved by applying an appropriate limiter during the final Runge–Kutta stage within a given time step.

The third- and fourth-order formulations are evaluated using standard transport tests on the sphere. The new schemes are more accurate and significantly more efficient than the standard second-order scheme and other schemes in the literature examined by the authors. The third-order formulation is equivalent to the fourth-order formulation plus an additional diffusion term that is proportional to the Courant number. An optimal value for the coefficient scaling this diffusion term is chosen based on qualitative evaluation of the test results. Improvements using the higher-order scheme in place of the traditional second-order centered approach are illustrated within 3D unstable baroclinic wave simulations produced using two global nonhydrostatic models employing spherical Voronoi meshes.
The Characteristics of Numerically Simulated Supercell Storms Situated over Statically Stable Boundary Layers
Authors: Nowotarski Christopher J. , Markowski Paul M. , Richardson Yvette P.
Published: April 2011

This paper uses idealized numerical simulations to investigate the dynamical influences of stable boundary layers on the morphology of supercell thunderstorms, especially the development of low-level rotation. Simulations are initialized in a horizontally homogeneous environment with a surface-based stable layer similar to that found within a nocturnal boundary layer or a mesoscale cold pool. The depth and lapse rate of the imposed stable boundary layer, which together control the convective inhibition (CIN), are varied in a suite of experiments.

When compared with a control simulation having little surface-based CIN, each supercell simulated in an environment having a stable boundary layer develops weaker rotation, updrafts, and downdrafts at low levels; in general, low-level vertical vorticity and vertical velocity magnitude decrease as initial CIN increases (changes in CIN are due only to variations in the imposed stable boundary layer). Though the presence of a stable boundary layer decreases low-level updraft strength, all supercells except those initiated over the most stable boundary layers had at least some updraft parcels with near-surface origins. Furthermore, the existence of a stable boundary layer only prohibits downdraft parcels from reaching the lowest grid level in the most stable cases. Trajectory and circulation analyses indicate that weaker near-surface rotation in the stable-layer scenarios is a result of the decreased generation of circulation coupled with decreased convergence of the near-surface circulation by weaker low-level updrafts. These results may also suggest a reason why tornadogenesis is less likely to occur in so-called elevated supercell thunderstorms than in surface-based supercells.
Lightning and Severe Weather: A Comparison between Total and Cloud-to-Ground Lightning Trends
Authors: Schultz Christopher J. , Petersen Walter A. , Carey Lawrence D.
Published: April 2011

Many studies over the past several decades have attempted to correlate trends in lightning (e.g., rates, polarity) to severe weather occurrence. These studies mainly used cloud-to-ground (CG) lightning information due to the ease of data availability, high detection efficiency, and broad coverage across the United States, with somewhat inconclusive results. Conversely, it has been demonstrated that trends in total lightning are more robustly correlated to severe weather occurrence, with rapid increases in total lightning observed 10s of minutes prior to the onset of severe weather. Unfortunately, total lightning observations are not as numerous, or available over the same areal coverage domain, as provided by CG networks. Relatively few studies have examined concurrent trends in both total and CG lightning within the same severe thunderstorm, or even large sets of thunderstorms using an objective lightning jump algorithm. Multiple studies have shown that the total flash rate rapidly increases prior to the onset of severe weather. What is untested within the same framework is the use of CG information to perform the same task. Herein, total and CG lightning trends for 711 thunderstorms occurring in four regions of the country were examined to demonstrate the increased utility that total lightning provides over CG lightning, specifically within the framework of developing a useful lightning-based severe weather warning decision support tool. Results indicate that while both lightning datasets demonstrate the presence of increased lightning activity prior to the onset of severe weather, the use of total lightning trends was more effective than CG trends [probability of detection (POD), 79% versus 66%; false alarm rate (FAR), 36% versus 53%; critical success index (CSI), 55% versus 38%; Heidke skill score (HSS), 0.71 versus 0.55]. Moreover, 40% of false alarms associated with total lightning, and 16% of false alarms with CG lightning trends, occurred when a lightning jump associated with a severe weather “warning” was already in effect. If these false alarms are removed, the FAR drops from 36% to 22% for total lightning and from 53% to 44% for CG lightning. Importantly, average lead times prior to severe weather occurrence were higher using total lightning as compared with CG lightning (20.65 versus 13.54 min). The ultimate goal of this study was to demonstrate the increased utility of total lightning information that the Geostationary Lightning Mapper (GLM) will provide to operational meteorology in anticipation of severe convective weather on a hemispheric scale once Geostationary Operational Environmental Satellite-R (GOES-R) is deployed in the next decade.
The Real-Time Mesoscale Analysis at NOAA’s National Centers for Environmental Prediction: Current Status and Development
Authors: De Pondeca Manuel S. F. V. , Manikin Geoffrey S. , DiMego Geoff , Benjamin Stanley G. , Parrish David F. , Purser R. James , Wu Wan-Shu , Horel John D. , Myrick David T. , Lin Ying , Aune Robert M. , Keyser Dennis , Colman Brad , Mann Greg , Vavra Jamie
Published: April 2011

In 2006, the National Centers for Environmental Prediction (NCEP) implemented the Real-Time Mesoscale Analysis (RTMA) in collaboration with the Earth System Research Laboratory and the National Environmental, Satellite, and Data Information Service (NESDIS). In this work, a description of the RTMA applied to the 5-km resolution conterminous U.S. grid of the National Digital Forecast Database is given. Its two-dimensional variational data assimilation (2DVAR) component used to analyze near-surface observations is described in detail, and a brief discussion of the remapping of the NCEP stage II quantitative precipitation amount and NESDIS Geostationary Operational Environmental Satellite (GOES) sounder effective cloud amount to the 5-km grid is offered. Terrain-following background error covariances are used with the 2DVAR approach, which produces gridded fields of 2-m temperature, 2-m specific humidity, 2-m dewpoint, 10-m U and V wind components, and surface pressure. The estimate of the analysis uncertainty via the Lanczos method is briefly described. The strength of the 2DVAR is illustrated by (i) its ability to analyze a June 2007 cold temperature pool over the Washington, D.C., area; (ii) its fairly good analysis of a December 2008 mid-Atlantic region high-wind event that started from a very weak first guess; and (iii) its successful recovery of the finescale moisture features in a January 2010 case study over southern California. According to a cross-validation analysis for a 15-day period during November 2009, root-mean-square error improvements over the first guess range from 16% for wind speed to 45% for specific humidity.
Epidemiology and Profile of Pediatric Burns in a Large Referral Center
Authors: Shah Ami , Suresh Srinivasan , Thomas Ronald , Smith Sue
Published: April 2011

Background: Burns are a preventable cause of pediatric injury with over 100 000 annual hospitalizations. The authors hypothesize that analysis of injury patterns can generate age-specific and injury-specific prevention strategies to reduce these injuries. Methods: Data from the burn registry were collected over a 9-year period. Cross-tabulations were employed to examine associations. An analysis of variance model was used to examine differences in injury pattern. Results: Burns in children less than 1 year accounted for 16% of all admissions. The most common mechanism of injury was scalds (48.4%). Electrical and chemical burns occurred more often in older children. Suspected abuse (N = 142) accounted for 6.7% of all admissions. House fire injuries (N = 94) had a higher mean total burn surface area (18.2%). Smoke detectors were present in two thirds of the cases. Conclusions: These predictors can form the basis for targeted public health initiatives with a potential reduction in the number of burn injuries.
A carbon nanotube/polymer strain sensor with linear and anti-symmetric piezoresistivity
Authors: Gang Yin  , Ning Hu  , Karube Yoshifumi , Yaolu Liu  , Yuan Li  , Fukunaga Hisao
Published: April 2011

In this article, a strain sensor made from an epoxy-based nanocomposite using a kind of multi-walled carbon nanotubes (MWNTs), i.e., LMWNT-10, was investigated. It was found that the piezoresistivity of this strain sensor is linear and anti-symmetric in tensile and compressive states within a large strain range, which is different from that of the strain sensor using another type of MWNTs, i.e., MWNT-7, in our previous reports. This linear and anti-symmetric piezoresistivity is very suitable for practical sensor applications. In our experiments, both static and dynamic responses of the two sensors were measured. The experimental results indicate that the completely different piezoresistivity characteristics of the two sensors are probably due to the complete different working mechanisms. For the sensor made from LMWNT-10, the present experimental investigations reveal that its working mechanism should be the piezoresistivity of MWNTs due to deformation of MWNTs. On the other hand, for the strain sensor made from MWNT-7, the dominant working mechanism of this sensor is the tunneling effect caused by the distance changes among carbon nanotubes.
Durability performance of fiber-reinforced concrete in severe environments
Authors: Kim B. , Boyd A.J. , Lee J.-Y.
Published: April 2011

Polypropylene (PP; 0.5%), polyvinyl alcohol (PVA; 0.75%), and hooked-end steel (1%) fibers were investigated to evaluate the durability performance of fiber-reinforced concrete (FRC) exposed to severe environments. Conventional beam specimens (100 × 100 × 360 mm3) were prepared and exposed to three types of conditioning systems for 27 months, in both un-cracked and pre-cracked conditions. Degradation of the FRC was evaluated using visual or photographic inspection, change in permeable pore space, destructive beam testing, scanning electron microscopy analysis, and depth of carbonation measurements. For each of the fiber types and mixtures evaluated, significant surface degradation and carbonation only appeared in specimens exposed to immersion in a low pH solution designed to simulate swamp water. These specimens also exhibited significant degradation in both average residual strength (ARS) and toughness. On the other hand, difficulties in the comparison between pre-cracked specimens and un-cracked specimens were found due to re-adhered or healed pre-cracked specimens from dissolved materials (salt or lime) in solutions. A relatively good resistance to saltwater immersion and w/d conditioning was observed for all fiber types. Among fiber types, steel fibers showed the highest strength to conditioning compared with PP and PVA fibers.
The fabrication and properties of short carbon fiber reinforced copper matrix composites
Authors: Li Weiwei , Liu Lei , Shen Bin
Published: April 2011

Short carbon fibers (SCFs) reinforced copper matrix composites, fiber volume fraction of which ranged from 10% to 30%, were prepared by electroless copper plating plus cold press and sintering technique. SCFs were copperized directly by electroless plating using hypophosphite as reducing agent. The effects of SCFs volume fraction on mechanical, thermal, and electrical properties of the composites were discussed. The results indicated that the microhardness and thermal expansion property of Cu/SCFs composites increased with increasing fibers content, owing to the high strength of SCF. However, thermal conductivity and electrical conductivity reversed, it was attributed to the performance of carbon fiber itself; furthermore, more defects and interfaces in the matrix acted as barriers to heat and electronic transfer.
Impact behavior of carbon fiber/epoxy composite manufactured by vacuum-assisted compression resin transfer molding
Authors: Aurrekoetxea J. , Agirregomezkorta A. , Aretxaga G. , Sarrionandia M.
Published: April 2011

Carbon fiber reinforced epoxy composites were successfully manufactured by a new compression resin transfer molding process. The main innovation is that the injection stage is vacuum assisted. The high fiber volume fraction and low void content are promising properties for structural applications. The samples were tested under instrumented falling weight impact loading. Based on the contact time and delamination plots, the damage initiation energy threshold has been found to be 1.42 J, and from the energy plot a 30.25 J penetration energy threshold is deduced. Damage propagation is more energy dissipative process than the initiation one, since the ductility index takes a value of 1.97.
Humor in Romantic Contexts: Do Men Participate and Women Evaluate?
Authors: Wilbur Christopher J. , Campbell Lorne
Published: April 2011

Several lines of research illustrate that humor plays a pivotal role in relationship initiation. The current article applies sexual selection theory to argue that humor production is a fitness indicator, allowing men to transmit information tacitly about their underlying qualities. And whereas prior research has emphasized women’s appreciation of humor as a signal of interest, the focus here is on how women evaluate prospective suitors’ humorous offerings. Two studies, including an ecologically valid study of online dating advertisements, provided evidence for men’s production and women’s evaluation of humor in romantic contexts. A third study revealed that women’s evaluations of potential mates’ humor are predictive of their romantic interest. Moreover, this article shows that preferences for and perceptions of humor are associated with preferences for and perceptions of intelligence and warmth, consistent with the argument that one function of humor is as a fitness indicator that provides information about underlying mate quality.
African-American philosophy: Through the lens of socio-existential struggle
Authors: Yancy George
Published: April 2011

In this article I argue that African-American philosophy emerges from a socio-existential context where persons of African descent have been faced with the absurd in the form of white racism. The concept of struggle, given the above, functions as both descriptive and heuristic vis-à-vis the meaning of African-American philosophy. Expanding upon Charles Mills’ concept of non-Cartesian sums, I demonstrate the inextricable link between Black lived experience, struggle, and the morphology of meta-philosophical assumptions and philosophical problems specific to African-American philosophy. Then, I provide a sketch of two early African-American philosophers whose philosophical work is, though neglected, indispensable to African-American philosophical legitimating practices and whose work is informed by the defining motif of struggle. Lastly, I demonstrate the efforts of Africana philosophers at creating philosophical sites that nurture a sense of shared struggle and community.
Cold, cold, warm: Autonomy, intimacy and maturity in Adorno
Authors: Macdonald Iain
Published: April 2011

When Adorno refers to the concept of maturity (Mündigkeit), he generally means having the courage and the ability to use one’s own understanding independently of dominant heteronomous patterns of thought. This Kantian-sounding claim is essentially an exhortation: maturity demands self-liberation from heteronomy, i.e. autonomy. The problem, however, is that in spite of Adorno’s general endorsement of Kant’s definition of maturity, he ultimately rejects the corresponding Kantian definition of autonomy. Yet Adorno does not simply discard the Kantian concept of autonomy. On the contrary, he will try to correct it by returning to it what it lacks, namely, intimacy or ‘live contact with the warmth of things’. In this gesture, he aims to restore to autonomy its ethical substance or lived ethical context, not as a mere supplement to the purity of duty, but rather as necessary to the very process of becoming mature. This article examines Adorno’s concept of maturity in the context of the dialectical relationship between autonomy and intimacy.
Challenges and Opportunities in the Management of the Aging Voice
Authors: Johns Michael M. , Arviso Lindsey Clemson , Ramadan Fadi
Published: April 2011

Presbyphonia, or age‐related dysphonia, is a diagnosis of exclusion, and other comorbidities must be considered in a complete evaluation of elderly patients with dysphonia. The aging voice can have a significant effect on the quality of life of the patient. In addition to the molecular effects of aging on the laryngeal tissues, the etiology of presbyphonia is often multifactorial because of comorbidities in the other organ systems involved in phonation. After a comprehensive evaluation, presbyphonia may be treated conservatively with voice therapy or with a range of interventions. Research into tissue engineering and electrical reanimation offers future options for treatment of presbyphonia. Currently, a multidisciplinary approach offers the most complete improvement in the vocal quality of life in this patient population.
Is a Single Miniplate at the Inferior Border Adequate in the Management of an Angle Fracture of the Mandible?
Authors: Singh Virendra , Gupta Manisha , Bhagol Amrish
Published: April 2011

Objective

This prospective study evaluates the efficacy of using a single miniplate at the inferior border in the management of a displaced angle fracture.

Study Design

Case series with chart review.

Setting

Pt. B.D. Sharma University of Health Sciences.

Subjects and Methods

Fifty‐two patients with angle fracture of the mandible were evaluated. All fractures were displaced. The displacement of fracture was assessed on panoramic radiography by measuring the displacement of the inferior alveolar canal. Fractures with displacement greater than 2 mm were included in the study. Fixation with a 4‐hole noncompression miniplate along the inferior border and 2 bicortical screws on each side of the fracture was done.

Results

Among these 52 patients, 20 sustained isolated angle fracture, 2 sustained bilateral angle fracture, and 30 sustained angle fracture associated with contralateral parasymphysis or body fracture. Five patients (9.5%) experienced complications. All were considered minor and did not require hospitalization. Two had a slight occlusal discrepancy requiring selective occlusal grinding, and 2 minor infections were managed by incision and drainage. One patient suffered from paresis of the facial nerve that resolved itself after 3 months.

Conclusion

Based on this single study, at a single institution, we can conclude that outcomes are acceptable in our patients, but there is very limited ability to generalize the results to different practice settings. Because of these limitations, a multicenter study with an appropriate comparison group is required to substantiate a more generalizable conclusion of efficacy of this single miniplate at inferior border.
Transcervical Drainage for Descending Necrotizing Mediastinitis May Be Sufficient
Authors: Hsu Ruey‐Fen , Wu Pei‐Yin , Ho Chi‐Kung
Published: April 2011

Objective

Descending necrotizing mediastinitis (DNM) is a serious form of mediastinitis with a high mortality rate. It is caused by the downward spread of an oropharyngeal or cervicofascial infection. The optimal surgical approach for this often fatal disease is controversial. This article describes the authors’ experience and characterizes the surgical strategies and treatment outcomes of patients with DNM.

Study Design

Case series with chart review.

Setting

A tertiary referral medical center.

Subjects and Methods

This study conducted a retrospective chart review of patients with deep neck infections treated at a medical center from 1994 to 2007 and identified 29 patients with DNM. The clinical characteristics and outcomes were compared between patients treated with transcervical drainage alone (group I) and those with both cervical and thoracic drainage (group II).

Results

There were 20 patients in group I and 9 patients in group II. The overall mortality rate was 10.3%. The mean duration of the hospital stay was 29.3 ± 15.5 days. There was no statistically significant difference in age, sex distribution, or duration from the appearance of symptoms to hospital admission between the 2 groups. The duration of hospital stay, tracheotomy rate, and mortality rate also did not differ significantly between the 2 groups. However, the numbers of surgeries were significantly higher in group II than in group I.

Conclusion

Transthoracic mediastinal drainage is not a compulsory therapy, but timely, aggressive, transcervical mediastinal drainage with extensive debridement is very important for a good outcome when treating DNM patients.
Resident Physicians’ Perspectives on Health Care Reform
Authors: Frake Paul C. , Cheng Alex Y. , Howell Rebecca J. , Patel Nitin J.
Published: April 2011

Objective

To investigate the perspectives of resident physicians, in otolaryngology and other specialties, with respect to various health care reform proposals. Also, to determine if these opinions vary between residents training to become general medical doctors versus surgeons and specialists and between those with various levels of educational debt.

Study Design and Participants

Survey of resident physicians across the United States.

Methods

Opinions of participants were measured on a 5‐point Likert scale.

Results

Of the 1576 respondents, the majority agreed that tort reform and electronic medical records would improve quality of care and help contain health care costs. However, few residents agreed that bundling of services (BOS), hospital‐acquired conditions penalties (HACP), and quality‐based reimbursement (QBR) would improve the quality of care. Specialists and surgeons, in comparison to generalists, were (1) less likely to agree that BOS, HACP, or QBR would improve the quality of care; (2) more likely to agree that tort reform would help contain health care costs; and (3) more likely to believe that BOS, HACP, or QBR would decrease physician compensation. Higher educational debt burden was also an independent predictor of increased skepticism about health care reforms effects on physician compensation.

Conclusions

Residents in general medicine and surgery/specialty training programs agreed that tort reform and electronic medical records would help improve the quality of health care and help contain costs. However, both groups expressed strong concern that certain elements of the Patient Protection and Affordable Care Act would not achieve these goals.
Curvature Inversion Technique
Authors: Yañez Carlos , Pirrón José Antonio , Mora Nallely
Published: April 2011

Objective

To assess the laser‐assisted curvature inversion technique for the treatment of patients with patulous Eustachian tube (PET).

Study Design

Case series with planned data collection.

Setting

Tertiary care medical center.

Subjects and Methods

Eleven patients with Eustachian tube dysfunction underwent laser‐assisted curvature inversion technique (CIT) of the medial and lateral lamina of the Eustachian tube. A KTP laser is used to cross‐hatch the medial and lateral lamina of the tube to modify the curvature and to alter the spring of the posterior cushion. A change in the direction of the cartilaginous structure curvature is created to promote full closure of the patulous gap without interfering with the tube’s muscular activity. None of the patients had any concurrent disease or additional surgical procedure.

Results

There were no surgical complications. Following CIT, subjective symptoms of autophony on nasal breathing improved in 9 of 11 patients (81.8%), while voice autophony improved in 8 patients (72.7%); posterior cushion curvature became inverted and less wide, and the valve was seen more closed postoperatively on simple endoscopy and slow‐motion video‐endoscopic analysis. On otoscopy, abnormal tympanic membrane excursions disappeared in 10 of 11 patients (90.9%). Mean immittance changes in tympanometric measurements for the forced respiration conditions improved postoperatively at least 0.05 mmhos in 9 of 11 patients (81.1%; P =. 015). The follow‐up period was 24 months.

Conclusion

CIT appears to be a promising and relatively feasible technique for the treatment of PET.
A Multilayer Cartilaginous Tip‐Grafting Technique for Improved Nasal Tip Refinement in Asian Rhinoplasty
Authors: Jang Yong Ju , Min Jin‐Young , Lau Bedy Chung
Published: April 2011

Objective

Tip surgery remains the most difficult part of rhinoplasty in Asian patients because of the lower lateral cartilage characteristics and thick skin. The objective of this study was to evaluate the multilayer cartilaginous tip‐grafting technique used for tip refinement in Korean patients undergoing rhinoplasty.

Study Design

Case series with chart review.

Setting

Academic tertiary care medical center.

Subjects and Methods

A retrospective study of 99 Korean patients who underwent open rhinoplasty involving multilayer cartilaginous tip‐grafting for tip refinement was performed. Autologous septal, conchal, costal, or homologous costal cartilage, or a combination of these materials was used as grafting materials. Preoperative and postoperative photographs were reviewed for objective and subjective assessment of aesthetic outcomes.

Results

Among patients, 7 had undergone previous rhinoplasty (7.1%), and removal of the previously placed silicone graft was required in 5 patients (5.1%). Two (6.7%), 3 (61.5%), 4 (28.8%), and 5 (3.0%) layers of cartilaginous graft were used. Postoperative aesthetic outcomes were graded as excellent in 63.6%, fair in 28.3%, and no change/worse in 8.1% of cases. Preoperative and postoperative objective measurements showed that the procedure resulted in increased nasal tip projection (0.52 ± 0.06 vs 0.57 ± 0.05; P <. 05) and improved nasolabial angle (92.98° ± 9.95° vs 95.34° ± 8.20°; P <. 05). The overall complication rate was 12.1%, and 8 patients required revision surgery (8.1%). Complications included infection (5.1%), visible graft contour (1.0%), nostril deformity (1.0%), overprojection (2.0%), and visible hypertrophic scar at the marginal incision site (3.0%).

Conclusions

The multilayer cartilaginous tip‐grafting technique was found to be effective for aesthetic refinement of the nasal tip when used in rhinoplasty for Korean patients.
Can Otolaryngology Compete with Larger Fields Regarding Impact Factor?
Authors: Labadie Robert F. , Fitzpatrick J. Michael
Published: April 2011

Impact factor (IF) consists of reporting the number of references an average article in a given journal receives over a 2‐year period. Despite several valid criticisms, IF has become an important component of academic advancement. The authors sought to investigate the possible relationship between size of specialty field and IF. The top 10 journals of 13 specialty fields were selected based on IF as reported by Journal Citations Reports on the Web of Science. Specialty field population was obtained from the American Board of Medical Specialties. A highly positive correlation (r = 0.9) was noted with smaller fields (eg, otolaryngology) having lower IFs. To overcome this population bias, a percentile‐based impact factor (PIF) may be used where the top journal within a field is given 100%, the worst 0%, and all other journals’ IFs are proportionately scaled in between the 2 extremes. PIF acts to “level the playing field,” allowing between–specialty field comparisons.
Bacterial Pattern in Chronic Sinusitis and Cystic Fibrosis
Authors: Godoy Jose M. , Godoy Andres N. , Ribalta Gloria , Largo Isabel
Published: April 2011

Objective

To assess the association between pathogenic bacteria found in bronchoalveolar lavages and paranasal cavity cultures in patients with cystic fibrosis (CF) who underwent endonasal endoscopic sinus surgery. The authors hypothesized that the pathogenic bacterial pattern of the upper airway would be associated with that of the lower airway.

Study Design

Prospective case series with planned data collection.

Setting

Tertiary referral center.

Subjects and Methods

A group of 16 patients with diagnosis of CF who underwent endonasal endoscopic sinus surgery from July 2001 to August 2009 participated in the study. Culture samples were obtained from bronchoalveolar lavages and paranasal cavities. A Fisher exact test was performed to examine the significance of the association between upper airway and lower airway cultures.

Results

The most frequent microorganisms in cultures of para‐nasal cavities and bronchoalveolar lavages were Pseudomonas aeruginosa, Staphylococcus aureus, and Streptococcus viridans. Statistical analysis revealed a significant association between upper airway cultures (paranasal cavities) and lower airway cavities (bronchoalveolar lavages) for the 2 most frequent microorganisms, P aeruginosa and S aureus (P =. 007 and P =. 030, respectively).

Conclusion

The authors confirmed their initial hypothesis that a significant association between bronchoalveolar lavages and sinus cultures was established, once more confirming the idea of a unified airway. They found chronic rhinosinusitis with polyps to be a common clinical presentation in patients with CF. Further studies are required to indicate the role of antibiotics and the pathogenesis of the microorganisms as a manifestation of clinical severity.
Complementary and Alternative Medicine Use in the Thyroid Patients of a Head and Neck Practice
Authors: Brake Maria K. , Bartlett Clark , Hart Robert D. , Trites Jonathon R. B. , Taylor S. Mark
Published: April 2011

Objective

To investigate the prevalence of complementary and alternative medicine (CAM) use among patients being investigated for thyroid nodules in a head and neck oncology practice. Subsequently, to determine whether the common therapies used were likely to interfere with the planned patient’s care and whether the predominance was significant to warrant inclusion in routine history assessments.

Study Design

Cross‐sectional survey.

Setting

Dalhousie University, Halifax, Nova Scotia, Canada.

Subjects and Methods

A survey regarding CAM use was completed by 100 patients being investigated for thyroid nodules upon their initial presentation to a head and neck oncology practice.

Results

Preliminary results showed that 79% of participants have a history of CAM use and 51% of participants were actively using oral supplements. Thirty‐one percent of participants reported using supplements known to have hemostasis‐affecting properties.

Conclusion

Medical professionals should incorporate CAM questioning in any thyroid patient assessment to reduce patient risk and optimize medical and surgical outcomes.
Entrepreneurial learning in the international new high-technology venture
Authors: Voudouris Irini , Dimitratos Pavlos , Salavou Helen
Published: April 2011

We examine entrepreneurial learning in a high-technology firm that internationalized its activities from inception. Based on the small firm learning process model of Zhang et al. (2006), we seek to contribute to theory through examining the process of entrepreneurial learning as this applies to international new high-technology ventures (INHTVs). Towards this objective, we draw upon evidence from a single case study conducted over a seven-year period. The evidence suggests that entrepreneurial within an INHTV is a continuous learning process made of multiple learning epochs, which are learning loops rooted in similar learning mechanisms. We advance three research propositions associated with entrepreneurial learning in INHTVs. First, entrepreneurial learning in the INHTV is a process that starts at the individual level and progressively encompasses the whole organization and its networks. Second, the INHTV learning process is affected by the industry, technological and international learning orientations in which it operates; these, in turn, are contingent on the entrepreneurial team’s industry, technological and international learning orientations. Third, international learning orientation defines the business scope and critically affects the discovery of opportunities of the INHTV.
Determinants of microenterprise performance in Nigeria
Authors: Adekunle Bamidele
Published: April 2011

This article examines the factors that affect microenterprise performance in Nigeria. Specific attention is focused on the impact of membership of Cooperative Thrift and Credit Societies (CTCS) and personal agency belief on microenterprise performance. The results suggest that the entrepreneurial ability and business success of people in Cooperative Thrift and Credit Societies are better as compared to non-members, and personal agency belief is a significant predictor of microenterprise performance.
The role of (transnational) social capital in the start-up processes of immigrant businesses: The case of Chinese and Turkish restaurant businesses in Finland
Authors: Katila Saija , Wahlbeck Östen
Published: April 2011

The article focuses on the business start-up process of Chinese and Turkish restaurant owners in Finland. Of particular interest are the role of social capital in establishing restaurant businesses and how variations in access to bonding and bridging social capital can explain differences between the two groups. The study is based on two sets of research: one which concentrates on Chinese restaurant owners and the other on the owners of Turkish, kebab fast-food outlets in southern Finland. Regardless of the general similarities of the groups, a closer look at the start-up processes and business activities reveals distinct patterns and processes associated with the entry pattern in Finland: that is, who entered Finland, why they entered the country and how. The two studies indicate that relevant social capital can be accumulated in different ways depending on the migration pattern of the group.
Measuring Risk Perceptions
Authors: Bruine de Bruin Wändi , Carman Katherine G.
Published: April 2011

Objectives. Risk perceptions are central to good health decisions. People can judge valid probabilities but use 50% disproportionately. The authors hypothesized that 50% is more likely than other responses to reflect not knowing the probability, especially among individuals with low education and numeracy, and evaluated the usefulness of eliciting “don’t know” explanations. Methods. Respondents ( n = 1020) judged probabilities for living or dying in the next 10 years, indicating whether they gave a good estimate or did not know the chances. They completed demographics, medical history, and numeracy questions. Results. Overall, 50% was more likely than other probabilities to be explained as “don’t know” (v. “a good estimate”). Correlations of using 50% with low education and numeracy were mediated by expressing “don’t know.” Judged probabilities for survival and mortality explained as “don’t know” had lower correlations with age, diseases, and specialist visits. Conclusions. When judging risks, 50% may reflect not knowing the probability, especially among individuals with low numeracy and education. Probabilities expressed as “don’t know” are less valid. Eliciting uncertainty could benefit theoretical models and educational efforts.
Hyper Norms
Authors: Laczniak Gene R. , Kennedy Ann-Marie
Published: April 2011

As organizations continue to increase their level of operations across international borders, their ethical conduct becomes a greater social concern. A global code of ethics allows organizations to follow one code for all countries rather than creating and administering multiple separate codes. Currently, there are several thoughtful global codes of ethics developed by different stakeholders. This paper provides an analysis of some of the major global codes of ethics available to multinational corporations. Their shared norms are identified and synthesized into three Hyper Norms that can both aid marketing organizations in formulating their core principles and be applied to research dealing with macromarketing systems.
Taking Care of a Dying Grandparent
Authors: Boquet Jaime R. , Oliver Debra Parker , Wittenberg-Lyles Elaine , Doorenbos Ardith Z. , Demiris George
Published: April 2011

This study aims to provide insight into the role of grandchildren as informal hospice caregivers. It presents 4 cases that highlight the challenges and perceptions of grandchildren who care for a grandparent at the end of life. A researcher met regularly with family caregivers to discuss the problems or challenges during hospice caregiving. Although each caregiver presented unique individual experiences, several themes are common among the family caregivers including fatigue, stress, guilt, and loss of the “grandchild” identity. Grandchildren caregivers often take care of 3 generations (grandparents, parents, and children) and in many cases need additional assistance to help them overcome the challenges associated with managing a household, career, family, and caregiving roles.
Managing Unused Pharmaceuticals in a Hospice Setting
Authors: Kreisberg Joel , Zheng Connie
Published: April 2011

With the escalating use of pharmaceuticals in health care, there has been increasing anxiety over the potential health risks associated with pharmaceutical waste accumulating in the environment. This research provided nurses in a hospice care facility in Concord, California, with education and training to offer patients a medication disposal service through the use of mail-back envelopes. Over the 6-month study period, 160 of the 400 distributed mailers were returned for disposal. The total weight of pharmaceuticals diverted for incineration was 107 pounds, with an average weight of 0.66 pounds per mailer. This study suggests that the mailer system and proper education of medical staff have the potential to improve medical waste management, but alternative approaches may be necessary to increase the rate of envelop return.
Counselors Helping Service Veterans Re-Enter Their Couple Relationship After Combat and Military Services: A Comprehensive Overview
Authors: Jordan Karin
Published: April 2011

This article provides an overview of the unique challenges combat service veterans deployed in Afghanistan and/or Iraq are dealing with today, and how these challenges can impact veterans’ reintegration into civilian life. Focus is also given to attachment; more specifically how the attachment bond between the combat service veteran and his or her spouse/partner often is impacted by the trauma of combat re-deployment/deployment/separation. The importance of couple counseling using Emotion-Focused Therapy (EFT) is addressed, as is a careful assessment at the onset of counseling.
Vietnamese American Immigrant Parents: A Pilot Parenting Intervention
Authors: Wong Y. Joel , Tran Kimberly K. , Schwing Alison E. , Cao Lien H. , Ho Phoenix Phung-Hoang , Nguyen Quynh-Tram
Published: April 2011

The main goal of this mixed-methods study was to examine the perceived effectiveness of a brief, community-based parenting intervention for Vietnamese American immigrant parents. A key component of the intervention involved participants listening to Vietnamese American adolescents’ discussions about their relationships with their parents utilizing a fishbowl group format. After the parenting intervention, a focus group interview was conducted with eight participants to examine their reactions to the intervention. The following qualitative themes emerged from the focus group: (a) increased insight on parent—child relations, (b) need for improvement in communication skills, (c) parent—child cultural gaps, (d) issues of trust between parent and child, and (e) benefits from participation in the workshop. Quantitative findings revealed that after the intervention, participants reported greater intention to show expressive love to their children as well as increased parental empathy.
Policy Workaround Stories Are Valuable Evaluative Indicators
Authors: Campbell David
Published: April 2011

In evaluating local policy implementation, workaround stories—accounts of deliberate efforts to evade, subvert, or even break rules or procedures in order to get the job done—are valuable evaluative indicators. By “backward mapping” ( Elmore, 1979 ) from frequently mentioned workarounds, we can identify flawed elements of policy- or grant-making systems. However, workaround stories captured in confidential interviews pose an ethical dilemma for evaluators. If reported intact, these stories potentially expose their tellers to repercussions from compliance-oriented superiors in the bureaucratic chain of command. But unless these stories—in all their vivid details—are told, it is less likely that those superiors will be motivated to fix the often intricate implementation problems which create the need for workarounds in the first place. We explore options for resolving this dilemma in light of the American Evaluation Association guiding principles and the trade-off between the competing public goods of innovation and accountability.