bluuebunny/crossref_metadata_2025 huggingface dataset:
Benefits of a Fourth Ice Class in the Simulated Radar Reflectivities of Convective Systems Using a Bulk Microphysics Scheme
Authors: Lang Stephen E. , Tao Wei-Kuo , Chern Jiun-Dar , Wu Di , Li Xiaowen
Published: June 2014

Current cloud microphysical schemes used in cloud and mesoscale models range from simple one-moment to multimoment, multiclass to explicit bin schemes. This study details the benefits of adding a fourth ice class (frozen drops/hail) to an already improved single-moment three-class ice (cloud ice, snow, graupel) bulk microphysics scheme developed for the Goddard Cumulus Ensemble model. Besides the addition and modification of several hail processes from a bulk three-class hail scheme, further modifications were made to the three-ice processes, including allowing greater ice supersaturation and mitigating spurious evaporation/sublimation in the saturation adjustment scheme, allowing graupel/hail to transition to snow via vapor growth and hail to transition to graupel via riming, wet graupel to become hail, and the inclusion of a rain evaporation correction and vapor diffusivity factor. The improved three-ice snow/graupel size-mapping schemes were adjusted to be more stable at higher mixing ratios and to increase the aggregation effect for snow. A snow density mapping was also added.

The new scheme was applied to an intense continental squall line and a moderate, loosely organized continental case using three different hail intercepts. Peak simulated reflectivities agree well with radar for both the intense and moderate cases and were superior to earlier three-ice versions when using a moderate and large intercept for hail, respectively. Simulated reflectivity distributions versus height were also improved versus radar in both cases compared to earlier three-ice versions. The bin-based rain evaporation correction affected the squall line more but overall the agreement among the reflectivity distributions was unchanged. The new scheme also improved the simulated surface rain-rate histograms.
Seasonal Tropical Cyclone Predictions Using Optimized Combinations of ENSO Regions: Application to the Coral Sea Basin
Authors: Ramsay Hamish A. , Richman Michael B. , Leslie Lance M.
Published: June 2014

This study examines combining ENSO sea surface temperature (SST) regions for seasonal prediction of Coral Sea tropical cyclone (TC) frequency. The Coral Sea averages ~4 TCs per season, but is characterized by strong interannual variability, with 1–9 TCs per season, over the period 1977–2012. A wavelet analysis confirms that ENSO is a key contributor to Coral Sea TC count (TCC) variability. Motivated by the impact of El Niño Modoki on regional climate anomalies, a suite of 38 linear models is constructed and assessed on its ability to predict Coral Sea seasonal TCC. Seasonal predictions of TCC are generated by a leave-one-out cross validation (LOOCV). An important finding is that models made up of multiple tropical Pacific SST regions, such as those that comprise the El Niño Modoki Index (EMI) or the Trans-Niño Index (TNI), perform considerably better than models comprising only single regions, such as Niño-3.4 or Niño-4. Moreover, enhanced (suppressed) TC activity is expected in the Coral Sea when the central Pacific is anomalously cool (warm) and the eastern and western Pacific are anomalously warm (cool) during austral winter. The best cross-validated model has persistent and statistically significantly high correlations with TCC (r > 0.5) at lead times of ~6 months prior to the mean onset of the Coral Sea TC season, whereas correlations based heavily on the widely used Niño-3.4 region are not statistically significant or meaningful (r = 0.09) for the same lead times. Of the 38 models assessed, several optimized forms of the EMI and of the TNI perform best.
Voice, Speech, and Laryngeal Features of Primary Sjögren’s Syndrome
Authors: Heller Amanda , Tanner Kristine , Roy Nelson , Nissen Shawn L. , Merrill Ray M. , Miller Karla L. , Houtz Daniel R. , Ellerston Julia , Kendall Katherine
Published: June 2014

Objective:

This study examined voice, speech, and laryngeal characteristics in primary Sjögren’s syndrome (pSS).

Methods:

Eleven patients (10 female, 1 male; mean [SD] age = 57 [14] years) from The University of Utah Division of Rheumatology provided connected speech and sustained vowel samples. Analyses included the Multi-Dimensional Voice Profile, the Analysis of Dysphonia in Speech and Voice, and dysphonia severity, speech clarity, and videolaryngostroboscopy ratings.

Results:

Shimmer, amplitude perturbation quotient, and average fundamental frequency differed significantly from normative values ( P < .01). Cepstral Spectral Index of Dysphonia values indicated mild-to-moderate dysphonia in connected speech (mean [SD] = 20.26 [8.36]) and sustained vowels (mean [SD] = 16.91 [11.08]). Ratings of dysphonia severity and speech clarity using 10-cm visual analog scales suggested mild-to-moderate dysphonia in connected speech (mean [SD] = 2.11 [1.72]) and sustained vowels (mean [SD] = 3.13 [2.20]) and mildly reduced speech clarity (mean [SD] = 1.46 [1.36]). Videolaryngostroboscopic ratings indicated mild-to-moderate dryness and mild reductions in overall laryngeal function. Voice Handicap Index scores indicated mild-to-moderate voice symptoms (mean [SD] = 43 [23]).

Conclusion:

Individuals with pSS may experience dysphonia and articulatory imprecision, typically in the mild-to-moderate range. These findings have implications for diagnostic and referral practices in pSS.
Effects of Radiofrequency Thermal Ablation on the Nasal Cycle Measured Using Rhinomanometry
Authors: Tatar Arzu , Altas Enver
Published: June 2014

Objective:

This study was designed to research the effects of radiofrequency thermal ablation (RFTA) surgery on the nasal cycle, with anterior rhinomanometry being used for assessment.

Methods:

Thirty patients with inferior concha hypertrophy and 13 healthy volunteers were included in this study. An anterior rhinomanometry was performed on each of the patients before surgery and at 1 month and 6 months after surgery, and on the volunteers in the control group, simultaneously.

Results:

Nineteen of the 30 patients and 8 of the 13 healthy participants showed a distinct type of nasal cycle at different periods of measurement. The mean of the total nasal airflow of the patients was lower before RFTA surgery but increased at a rate of 71.07%, closer to the value of the control group, after RFTA surgery. After RFTA, the unilateral nasal airflow (fmin and fmax) values increased at ratios of 22.36% and 94.44%, respectively. The amplitude (fmax-fmin) showed a statistically significant decrease in the postoperative period (108.43 ± 54.37), when compared with that of the preoperative period (202.80 ± 81.24) ( P < .01).

Conclusion:

We conclude that the RFTA is a useful method for treating inferior concha hypertrophy, because it positively affects the nasal physiology, increasing the total nasal airflow without changing the nasal cycle time.
A Rapid and Accurate Technique for the Identification of the Recurrent Laryngeal Nerve
Authors: Liu Shao-Cheng , Chou Yi-Fan , Su Wan-Fu
Published: June 2014

Objective:

We studied the anatomic relationship between the recurrent laryngeal nerve (RLN) and the third tracheal ring, which was very important for rapid identification of RLN in our hands.

Methods:

This study was initially performed using 8 fresh cadavers (4 female and 4 male). The transverse nerve location from the third trachea and the depth from its anterior surface were measured. We further observed the topography of RLN in relation to the trachea in 60 patients, between November 2008 and January 2011, at the Tri-Service General Hospital and Buddhist Tzu Chi General Hospital, Taipei Branch, Taiwan, with 46 lobo-isthmectomies and 14 total thyroidectomies. The time spent in identifying the RLN was also recorded.

Results:

Among cadaver groups, the transverse distance (width) and the vertical distance (depth) averaged 3.3 and 17.6 mm, respectively. Among the clinical cases, the width and depth averaged 4.4 and 14.6 mm, respectively. The depth measured in males was significantly deeper than that in females (22.3 vs 13.2 mm) ( P < .05). The time spent in identifying the RLN after starting dissection in the RLN triangle was not statistically significantly different between the cadaver group and the clinical group (10.6 ± 5.7 seconds and 15.5 ± 17.7 seconds, respectively; P > .05). The median time was 9 and 10 seconds, respectively. There was no statistically significant side-to-side difference in terms of the time spent in searching for the RLN.

Conclusion:

Using the third ring as guidance, our inferior-superior technique offers an extra benefit in identifying the RLN safely and quickly, as compared to the conventional inferior approach.
Correlation of Maximum Phonation Time and Vocal Intensity With Intraluminal Esophageal and Pharyngoesophageal Pressure in Total Laryngectomees
Authors: Takeshita-Monaretti Telma Kioko , Dantas Roberto Oliveira , Ricz Hilton , Aguiar-Ricz Lílian Neto
Published: June 2014

Objective:

This study aimed to correlate maximum phonation time, vocal intensity, and dynamic extension with intraluminal esophageal and pharyngoesophageal segment pressure during tracheoesophageal phonation.

Design:

Prospective analysis.

Setting:

Tertiary academic hospital.

Methods:

The study was conducted on 20 total laryngectomees with alaryngeal speech and with secondary insertion of a tracheoesophageal prosthesis who were submitted to vocal recording of maximum phonation time and vocal intensity (minimum, habitual, and maximum). The participants were then submitted to manometry for the determination of the amplitude of intraluminal esophageal (proximal, middle, and distal) and pharyngoesophageal segment pressure during phonation.

Results:

A significant positive correlation was detected between habitual vocal intensity and the middle (0.004) and distal (0.05) esophagus, in addition to a correlation of maximum intensity with the middle esophageal portion (0.03). Dynamic extension showed correlation with the amplitude of esophageal pressure. There was no significant correlation between the variables studied and pressure of the pharyngoesophageal segment or between maximum phonation time and esophageal pressure amplitude.

Conclusion:

The middle and distal regions of the esophagus were found to be compliant, permitting an adjustment of vocal intensity. There was no correlation between maximum phonation time and the amplitude of esophageal and pharyngoesophageal segment pressure.
A Modified Transoral Approach for Carotid Artery Type Eagle Syndrome
Authors: Torres Arnulfo C. , Guerrero Jaime S. , Silva Helen C.
Published: June 2014

Objective:

This article aimed to summarize our clinical experience with a standardized tonsil-sparing transoral surgical approach used for treatment of styloid process-carotid artery Eagle’s syndrome.

Methods:

Eleven consecutive patients, from 2007 to 2013, underwent surgical treatment to remove elongated styloid apophyses transorally. Outcomes were assessed in terms of intraoperative and postoperative complications and patients’ evolution.

Results:

No patient experienced any intraoperative or postoperative complications. All patients have been followed up to present and 10 of them have shown complete relief of the symptoms and improvement of functional ability.

Conclusion:

The tonsil-sparing transoral surgical approach described is suitable for treating patients with elongated styloid apophyses.
Case Report
Authors: Berlucchi Marco , Barbieri Diego , Garofolo Sabrina , Stefini Stefania , Peretti Giorgio
Published: June 2014

Accidental caustic ingestion occurs mainly in the 2- to 3-year-old age group. Up to 33% of patients develop long-term complications that principally involve the gastroesophageal tract, whereas their occurrence at the level of pharyngeal and laryngeal structures is less frequent. When present, strictures are the main disorders that can be observed. In this pathological situation, surgery is the treatment of choice, and several procedures have been described. We report the history of a 3-year-old boy affected by pharyngolaryngeal stenosis due to accidental caustic ingestion. After careful diagnosis, the child underwent surgery by transoral CO2 laser. The patient had immediate improvement and restarted oral feeding 1 day after the surgical procedure. An analysis of diagnosis and treatment of this long-term complication is also presented.
The Psychometrics of Mental Workload
Authors: Matthews Gerald , Reinerman-Jones Lauren E. , Barber Daniel J. , Abich Julian
Published: June 2014

Objective:

A study was run to test the sensitivity of multiple workload indices to the differing cognitive demands of four military monitoring task scenarios and to investigate relationships between indices.

Background:

Various psychophysiological indices of mental workload exhibit sensitivity to task factors. However, the psychometric properties of multiple indices, including the extent to which they intercorrelate, have not been adequately investigated.

Method:

One hundred fifty participants performed in four task scenarios based on a simulation of unmanned ground vehicle operation. Scenarios required threat detection and/or change detection. Both single- and dual-task scenarios were used. Workload metrics for each scenario were derived from the electroencephalogram (EEG), electrocardiogram, transcranial Doppler sonography, functional near infrared, and eye tracking. Subjective workload was also assessed.

Results:

Several metrics showed sensitivity to the differing demands of the four scenarios. Eye fixation duration and the Task Load Index metric derived from EEG were diagnostic of single-versus dual-task performance. Several other metrics differentiated the two single tasks but were less effective in differentiating single- from dual-task performance. Psychometric analyses confirmed the reliability of individual metrics but failed to identify any general workload factor. An analysis of difference scores between low- and high-workload conditions suggested an effort factor defined by heart rate variability and frontal cortex oxygenation.

Conclusions:

General workload is not well defined psychometrically, although various individual metrics may satisfy conventional criteria for workload assessment.

Application:

Practitioners should exercise caution in using multiple metrics that may not correspond well, especially at the level of the individual operator.
On the longitudinal permeability of aligned fiber arrays
Authors: Shou Dahua , Ye Lin , Fan Jintu
Published: June 2014

In this work, we theoretically revisit the longitudinal permeability of aligned fiber arrays from ordered configuration (i.e. rectangular and staggered arrangements) to random pattern, based on a geometrical scaling rule. The scaling model on the basis of the characteristic length and the characteristic ratio quantifies the flow behaviors more accurately than the widely applied Kozeny-Carman equation. The model for actual fiber arrays composed of randomly located fibers is extended from the ordered case, and the randomness of fiber distribution is realized by the Voronoi tessellation method and quantified by a single parameter. The proposed compact and easy-use model is verified by experimental and numerical results throughout the range of fiber volume fractions (FVFs). The structural parameters, including FVF, fiber packing angle, and randomness of fiber distribution are also extensively analyzed.
Association between Serum Antibodies to Oral Microorganisms and Hyperglycemia in Adults
Authors: Merchant A.T. , Shrestha D. , Chaisson C. , Choi Y.H. , Hazlett L.J. , Zhang J.
Published: June 2014

We conducted a cross-sectional analysis to evaluate the relationship between serum antibody titers against 19 selected oral microorganisms and measures of hyperglycemia in a large, nationally representative data set. The study population consisted of 7,848 participants from the National Health and Nutrition Examination Survey III (1988-1994) who were at least 40 yrs old, with complete serum IgG antibody data against 19 oral microorganisms. The 19 antibody titers were grouped into 4 categories via cluster analysis—orange-red, yellow-orange, orange-blue, and red-green—named to reflect predominant antibody titers against microorganisms in Socransky’s classification scheme for oral microbes. Linear regression models weighted for complex survey design were used in which fasting blood glucose, fasting insulin, and HbA1c were outcomes and antibody cluster scores were exposures, adjusting for potential confounders. Higher orange-red cluster scores were associated with increased hyperglycemia, while higher orange-blue cluster scores were related with decreased hyperglycemia. A 1-unit-higher orange-red cluster score was associated with 0.46 mg/dL higher fasting blood glucose ( p = .0038), and a 1-unit-higher orange-blue cluster score was associated with 0.34% lower HbA1c ( p = .0257). Groups of antibody titers against periodontal microorganisms were associated with hyperglycemia independent of known risk factors.
“The Rock I Cling To”
Authors: Dye Meredith Huey , Aday Ronald H. , Farney Lori , Raley Jordan
Published: June 2014

A growing body of research—much of which has focused on male inmates—suggests that religion ameliorates many pains and problems of imprisonment. The purpose of this study is to examine the effects of religious engagement on prison adjustment among a sample of 214 females serving life sentences in a Southern state prison system. Results of multivariate analyses indicate that religious engagement is indirectly related to prison adjustment; however, the role that religious engagement plays seems to be through helping women deal with feelings of depression. Women’s personal accounts of prison adjustment corroborate these findings.
Moving beyond the dichotomy of workplace and community unionism: The challenges of organising migrant workers in London’s hotels
Authors: Alberti Gabriella
Published: June 2014

This article examines a joint effort by the union Unite and the community organisation London Citizens to unionise two migrant-rich hotels in London. The author explores the effectiveness of union and community strategies in the field of migrant organising drawing from the literature on union strategy and workers’ activism and focusing on workers’ own experiences of mobilisation. Gender, contractual and migration-related barriers to workers’ engagement in the campaign appeared determinant of the failure of the unionisation effort while the leaders eventually favoured a politics of incentive towards employers, ‘contracting out’ the protest to institutional actors in the community. The central argument is that neither workplace-based nor community unionism alone appears effective in terms of sustaining union activism among highly fragmented, migrant and precarious workforces. The renewal of industrial unionism in the UK rather requires unions to tackle the intersecting discriminations experienced by migrants across their communities and workplaces.
Hyper-mobile migrant workers and Dutch trade union representation strategies at the Eemshaven construction sites
Authors: Berntsen Lisa , Lillie Nathan
Published: June 2014

The EU regulatory regime and employers’ cross-border recruitment practices complicate unions’ ability to represent increasingly diverse and transnationally mobile workers. Even in institutional contexts where the industrial relations structure and labour law are favourable, such as the Netherlands, unions struggle with maintaining labour standards for these workers. This article analyses Dutch union efforts to represent hyper-mobile construction workers at the Eemshaven construction sites. It shows that the nexus of subcontracting, transnational mobility, legal insularity and employer anti-unionism complicate enforcement so that even well-resourced unions can, at best, improve employment conditions for a limited set of workers and only for a limited period of time.
High‐Fiber Orange Juice as a Nutrition Supplement in Women
Authors: Bergamasco Christiane , Horie Lilian Mika , Torrinhas Raquel Susana , Waitzberg Dan L.
Published: June 2014

Background: The daily consumption of dietary fiber is frequently below suggested recommendations. Using a double‐blind, controlled, randomized study, we assessed the efficiency and tolerance of a fiber‐enriched orange juice to supplement fiber intake in women. Materials and Methods: After 1 week of noninterventional observation, 192 healthy adult women ingested 400 mL of orange juice for 21 days, which either was not (placebo group) or was enriched with fiber (fiber group). Orange juice ingestion was registered daily and controlled for each week during the study period. Macronutrient, fiber, and energy intake were determined using a 3‐day food record, validated food chemical composition databases, and the “Pro Diet” software. Gastrointestinal symptoms were self‐evaluated daily by scoring 4 grades of symptom intensity and using a visual analog scale to grade pain severity. Results: No changes were observed for macronutrient and energy ingestion. For the placebo group (n = 97), the total fiber intake record was under the daily recommended value. In contrast, the fiber group (n = 95) displayed higher comparative values of total and soluble fiber consumption (P ≤ .001), achieving the daily recommended values of fiber intake. Both groups reported an increased frequency of slight bloating and rumbles over time (P ≤ .05). The fiber group also experienced a higher frequency of slight flatulence over time (P = .002). Conclusion: Consumption of fiber‐enriched orange juice was efficient to achieve the daily fiber intake recommendation for women, was not accompanied by intense adverse events, and may represent a suitable method to supplement fiber intake in woman.
Effect of Temporal Acquisition Parameters on Image Quality of Strain Time Constant Elastography
Authors: Nair Sanjay , Varghese Joshua , Chaudhry Anuj , Righetti Raffaella
Published: June 2014

Ultrasound methods to image the time constant (TC) of elastographic tissue parameters have been recently developed. Elastographic TC images from creep or stress relaxation tests have been shown to provide information on the viscoelastic and poroelastic behavior of tissues. However, the effect of temporal ultrasonic acquisition parameters and input noise on the image quality of the resultant strain TC elastograms has not been fully investigated yet. Understanding such effects could have important implications for clinical applications of these novel techniques. This work reports a simulation study aimed at investigating the effects of varying windows of observation, acquisition frame rate, and strain signal-to-noise ratio (SNR) on the image quality of elastographic TC estimates. A pilot experimental study was used to corroborate the simulation results in specific testing conditions. The results of this work suggest that the total acquisition time necessary for accurate strain TC estimates has a linear dependence to the underlying strain TC (as estimated from the theoretical strain-vs.-time curve). The results also indicate that it might be possible to make accurate estimates of the elastographic TC (within 10% error) using windows of observation as small as 20% of the underlying TC, provided sufficiently fast acquisition rates (>100 Hz for typical acquisition depths). The limited experimental data reported in this study statistically confirm the simulation trends, proving that the proposed model can be used as upper bound guidance for the correct execution of the experiments.
The Effects of a School-Based Atopy Care Program for School-Aged Children
Authors: Ryu Hosihn , Lee Youngjin
Published: June 2014

The aim of the present study was to evaluate the effectiveness of a school-based atopy care program (SACP) for children with atopic dermatitis (AD). The program is administered by health teachers who are also school nurses. The study compared groups using a pre- and post-test design. Participants were children with AD and their parents (98 dyads; 32 in the test group and 66 in the control group) sampled from four elementary schools in Seoul. After completing the SACP, parents in the test group had significantly increased knowledge of AD ( p = .04) and a greater sense of parental efficacy ( p = .02) when compared with the control group. This study derived guidelines that elementary health teachers can use in practice for school-aged children with AD. We concluded that there is sufficient evidence of effectiveness for the SACP to be used as a model for chronic disease management in school-aged children.
Information needs of prisoners in Southeast Nigerian prisons
Authors: Eze Jacintha U.
Published: June 2014

Information has been seen as a fundamental human right. Everybody in the world of today is supposed to have access to information to carry on with daily life activities. Prisoners as well have the right to information to be utilized while in prison as well as after imprisonment. This paper delved into the information needs and information seeking behavior of prisoners in the prisons of five states in Southeast Nigeria. The objectives of the study were to find out the various areas the prisoners need information, any available library and information services in place and the extent to which the information needs of these prisoners are being met. Three research questions and two null hypotheses were formulated to guide the study. A multiple-choice questionnaire was used to collect data from prison workers while Focus Group Discussion (FGD) was used to get information from the prisoners. Data was analyzed quantitatively using frequencies and mean scores while the data from the FGD was analyzed descriptively and qualitatively in line with the research questions. The two null hypotheses were tested using chi-square test at 0.5 level of significance. Results showed that there was no significant difference between the mean responses of prison workers from different states on the areas the prisoners need information and on the level of satisfaction of the information needs of the prisoners. Major findings showed that the prisoners have a good number of information needs ranging from educational, legal, vocational, spiritual, to recreational and financial information needs which are not provided for adequately through library and other information providers.
An empirical study of enterprise resource planning integration
Authors: Hwang Yujong , Grant Delvin
Published: June 2014

Enterprise Resource Planning (ERP) systems are very popular systems for information management in the global business environment. We investigate which of five levels of ERP integration contribute to a global or local ERP implementation strategy. The five levels of ERP integration are: system-specification, system-user, island of technology, organizational, and socio-organizational integration. We conducted an empirical study in the United States that included 102 ERP professionals from two user groups, global ERP system users and local ERP system users. We discovered that system-specification and organizational integration significantly influence the implementation of local ERP systems while system-specification and socio-organizational integration significantly influence global ERP service implementation. The model explains 44 percent and 52 percent respectively of ERP adoptions within the two groups.
Atlas reports: Global television constructions of economic crisis
Authors: Robertson Alexa
Published: June 2014

The setting of Rand’s dystopic classic Atlas Shrugged is a world in which people revolt against their governments and refuse to bow to attempts to regulate the economy. Rand borrowed the title for her 1957 paean to the philosophy of ‘objectivism’ from Greek mythology, and the name of the giant who bore the world on his shoulders. This article analyses the work of actors who carry the world in their broadcasts, rather than on their shoulders, and whose philosophy is a professional one of objectivity. It compares representations of crisis by broadcasters anchored in different parts of the global communicative sphere, with different financing solutions and relations to political power. The results show that not all global broadcasters are alike – or, for that matter, global in their narrative strategies. The differences between the four newsrooms’ reporting suggest a need for critical reconsideration of generalising claims made in the scholarly literature about how crises are depicted in global media, and particularly those about ‘homogenization’ and which see global news in terms of infotainment.
Thermal ablation of saphenous veins is feasible and safe in patients older than 75 years: A prospective study (EVTA study)
Authors: Hamel-Desnos C , Desnos P , Allaert F-A , Kern P ,   the “Thermal group” for the French Society of Phlebology and the Swiss Society of Phlebology
Published: June 2014

Objectives

To investigate the tolerance and safety of thermal ablation (TA), consisting of radiofrequency or endovenous laser (EVLA) of saphenous veins (SV) in elderly (group 1 ≥75 years), compared with a control group (group 2 <75 years).

Method

An Observational multicenter-prospective study was conducted, under the aegis of the French and Swiss Societies of Phlebology (18 centers). Ninety patients were included in group 1, 617 in group 2 (mean age 80 years and 53 years; 69% women in both groups), representing 863 SV. Mean trunk diameters were similar in both groups (small SV: 6 mm; great SV: 7 mm). In group 1, comorbidities were more frequent, particularly cardiac insufficiency, diabetes, history of thrombosis, and CEAP clinical class was significantly higher.

Results

EVLA was used in 86% of cases. Settings used were similar in both groups for each technique. Only 6% of TA was performed in an operating room for group 1 (14% group 2). Tumescent local anaesthesia (TLA) alone was used in 91% of cases in group 1 (85% group 2). The mean pain score was only 1.6 for the procedure itself (VASP 0–10; 10 max.) and 1.4 for the 10 days following the procedure. Side effects were few, but rate of paraesthesia was higher when general anaesthesia was used (11.8%) compared with TLA alone (2.2%). At three months, 100% of SV was occluded in group 1 (99.5% group 2), with high satisfaction score (9.3/10).

Conclusion

TA is safe and effective in elderly; it should be performed strictly under TLA to minimize side effects.
Do people who consciously attend to their movements have more self-reported knee pain? An exploratory cross-sectional study
Authors: Selfe James , Dey Paola , Richards Jim , Cook Neil , Chohan Ambreen , Payne Katherine , Masters Rich
Published: June 2014

Objectives:

This study explored the relationship between propensity for conscious control of movement (assessed by the Movement-Specific Reinvestment Scale) and self-reported knee pain.

Design:

Cross-sectional study.

Setting:

General population.

Subjects:

Adults aged 18 to 55 years of age.

Measures:

Participants completed the movement-specific reinvestment scale and a self-report questionnaire on knee pain at the same time on one occasion.

Results:

Data was collected on 101 adults of whom 34 (33.7%) self-reported knee pain. Mean scores on the conscious motor processing subscale of the movement-specific reinvestment scale, but not the movement self-consciousness subscale, were significantly higher for participants who reported knee pain within the previous year compared with those who did not (mean difference 3.03; t-test 2.66, df = 97, P = 0.009; 95% confidence interval (CI) 0.77 to 5.30). The association between self-reported knee pain and propensity for conscious motor processing was still observed, even after controlling for movement self-consciousness subscale scores, age, gender and body mass index (adjusted odds ratio 1.16, 95% CI 1.04 to 1.30).

Conclusions:

Propensity for conscious control of movement may play a role in knee pain.
The effect of using high facilitation when implementing the Gold Standards Framework in Care Homes programme: A cluster randomised controlled trial
Authors: Kinley Julie , Stone Louisa , Dewey Michael , Levy Jean , Stewart Robert , McCrone Paul , Sykes Nigel , Hansford Penny , Begum Aysha , Hockley Jo
Published: June 2014

Background:

The provision of quality end-of-life care is increasingly on the national agenda in many countries. In the United Kingdom, the Gold Standards Framework for Care Homes programme has been promoted as a national framework for improving end-of-life care. While its implementation is recommended, there are no national guidelines for facilitators to follow to undertake this role.

Aim:

It was hypothesised that action learning alongside high facilitation when implementing the Gold Standards Framework for Care Homes programme will result in a reduced proportion of hospital deaths for residents and improvement in the care home staff ability to facilitate good end-of-life care.

Design:

A cluster randomised controlled trial where 24 nursing homes received high facilitation to enable them to implement the Gold Standards Framework for Care Homes programme. The managers of 12 nursing homes additionally took part in action learning sets. A third group (14 nursing homes) received the ‘standard’ Gold Standards Framework for Care Homes facilitation available in their locality.

Setting/participants:

In total, 38 nursing homes providing care for frail older people, their deceased residents and their nurse managers.

Results:

A greater proportion of residents died in those nursing homes receiving high facilitation and action learning but not significantly so. There was a significant association between the level of facilitation and nursing homes completing the Gold Standards Framework for Care Homes programme through to accreditation. Year-on-year change occurred across all outcome measures.

Conclusion:

There is a danger that without national guidelines, facilitation of the Gold Standards Framework for Care Homes programme will vary and consequently so will its implementation. The nurse manager of a care home must be actively engaged when implementing the Gold Standards Framework for Care Homes programme.
How do general end-of-life treatment goals and values relate to specific treatment preferences? A population-based study
Authors: Evans Natalie , Pasman H Roeline , Deeg Dorly , Onwuteaka-Philipsen Bregje ,   on behalf of EURO IMPACT, Van den Block Lieve , De Groote Zeger , Brearley Sarah , Caraceni Augusto , Cohen Joachim , Francke Anneke , Harding Richard , Higginson Irene J , Kaasa Stein , Linden Karen , Miccinesi Guido , Onwuteaka-Philipsen Bregje , Pardon Koen , Pasman Roeline , Pautex Sophie , Payne Sheila , Deliens Luc
Published: June 2014

Background:

There is a lack of research on the relationship between general end-of-life goals and values and preferences for specific life-sustaining treatments.

Aim:

To examine agreement between Dutch older people’s general end-of-life goals and specific life-sustaining treatment preferences.

Design:

Participants identified general end-of-life goals in an interview and preferences for four life-sustaining treatments in hypothetical cancer and dementia scenarios in a separate questionnaire. Agreement between general goals and specific treatment preferences was calculated.

Setting/participants:

In total, 1818 older people from 11 representative Dutch municipalities participated in the study.

Results:

In total, 1168 (response rate 73%) answered questions on general end-of-life and specific treatment preferences. Agreement between a desire to live as long as possible, irrespective of health problems, and a preference for life-sustaining treatments ranged from 51% to 76% in cancer and 41% to 60% in dementia scenarios, depending on the treatment. Agreement between a desire for a shorter life, if without major health problems, and a preference to forgo treatments ranged from 61% to 79% in cancer and 75% to 88% in dementia scenarios.

Conclusion:

For a sizable minority of participants, specific treatment preferences did not agree with their general end-of-life goals. The more frequent desire to forgo treatments in case of dementia than cancer suggests that physical deterioration is more acceptable than cognitive decline. The findings underline the importance of discussing general care goals, different end-of-life scenarios and the risks and burdens of treatments to frame discussions of more specific treatment preferences.
Cutaneous Mucinosis in a Strain of Brown–Egg Laying Chickens
Authors: Palmieri C. , Anthenill L. , Shivaprasad H. L.
Published: June 2014

Cutaneous mucinosis is a cutaneous disorder described in humans, dogs, and rarely cats but never reported in birds. Twenty-six brown egg–laying chickens between ages 43 and 46 weeks had a history of feather loss, scaly, dry skin, weight loss, and decreased egg production. Microscopic findings in the skin included fragmentation of collagen bundles and interstitial, periadnexal, and perivascular dermal accumulation of wispy, mildly basophilic material that was also occasionally observed within the follicular epithelium. A moderate lymphoplasmacytic and heterophilic perivascular dermatitis was also observed. The wispy to granular material was diffusely Alcian blue positive and periodic acid–Schiff negative (consistent with mucin), suggesting a diagnosis of primary or secondary cutaneous mucinosis. The cause of this condition could not be determined.
Asymptotic analysis of an adhered complete contact between elastically dissimilar materials
Authors: Kim Hyung-Kyu , Hills David A , Paynter Robert JH
Published: June 2014

A complete contact problem between elastically dissimilar materials is studied using an asymptotic analysis. A quarter plane wedge on a half-plane represents the contact edge geometry. Two eigenvalues are obtained for pairs of contacting materials, and their characteristics are classified on the Dundurs parallelogram. Generalized stress intensity factors, KI and KII, are derived to use a two-term stress equation of dimensionless form with developing a mode separation angle. It is found that the order of stress singularity increases as the wedge becomes more rigid than the half-plane. Slipping characteristics on the contact interface are investigated in detail, especially for the case of KI < 0 < KII that represents a typical adhesive complete contact condition. An example case is given using a finite element model to provide calibration of the stress intensities for a specific material, geometry and load combination.
Hypnic headache: A review of clinical features, therapeutic options and outcomes
Authors: Liang Jen-Feng , Wang Shuu-Jiun
Published: June 2014

Background

Hypnic headache (HH), first reported in 1988, is a rare sleep-related headache disorder. In 2013 a new diagnostic criteria was proposed for HH in the International Classification of Headache Disorders, the third version beta (ICHD-3β).

Purpose

This review aimed to update the clinical characteristics, therapeutic options and clinical outcomes in patients with HH and also validate the new diagnostic criteria.

Methods

Based on a literature search in the major medical databases, we analyzed all case reports or case series on HH that have been published since the first description by Raskin. Except for symptomatic patients, all reported patients were included regardless of which diagnostic criteria were adopted. Four studies that reported the field-testing results of the ICHD-2 criteria were selected to validate the new ICHD-3β criteria.

Results

In total, 250 adult and five childhood patients are described in this review. The majority of patients were elderly and their ages of onset were typically more than 50 years old (92%). Approximately 7.7% of patients had some trigeminal autonomic features, which are not permitted in the ICHD-3β criteria. Compared with the ICHD-2 criteria, the diagnostic rate under the new criteria increased from 65% to 85% in recently reported cases. Randomized control trials both for acute and prophylactic treatment are lacking. Based on observational studies, the most effective acute treatment is caffeine and prophylactic medications in use are lithium, caffeine and indomethacin. Without treatment, the disease course is usually protracted but spontaneous remission did occur in 12 patients (4.8%). In those treated with prophylactic agents, no recurrence was noted in 43% of patients, even following withdrawal of medication.

Conclusions

The new ICHD-3β criteria are more sensitive and exhaustive for HH than the ICHD-2 criteria. Prophylactic treatment provides better outcomes; however, randomized controlled studies for treatment are needed to further verify the efficacy of the different drugs.
Prevalence and Clinical Characteristics of Osteochondritis Dissecans of the Humeral Capitellum Among Adolescent Baseball Players
Authors: Kida Yoshikazu , Morihara Toru , Kotoura Yoshihiro , Hojo Tatsuya , Tachiiri Hisakazu , Sukenari Tsuyoshi , Iwata Yoshio , Furukawa Ryuhei , Oda Ryo , Arai Yuji , Fujiwara Hiroyoshi , Kubo Toshikazu , Matsui Tomoyuki , Azuma Yoshikazu , Seo Kazuya , Hiramoto Machiko
Published: June 2014

Background:

The prevalence and clinical characteristics of osteochondritis dissecans (OCD) of the humeral capitellum among adolescent baseball players are unknown.

Purpose:

To determine the OCD prevalence in adolescent competitive baseball players and to investigate the clinical characteristics of these patients.

Study Design:

Cross-sectional and case-control study; Level of evidence, 3.

Methods:

A total of 2433 baseball players (mean age, 14.5 ± 1.5 years) belonging to junior high school and high school baseball clubs were enrolled. Players completed a questionnaire, and the elbow of each player’s throwing arm was assessed by ultrasonography. Participants with abnormal results on ultrasonography were further examined through radiographic study. The OCD lesions were classified into stages based on radiographic results, and demographic data were compared between players with and without OCD lesions.

Results:

Osteochondritis dissecans of the humeral capitellum was found in 82 (3.4%) elbows by ultrasonography. Players with an OCD lesion began playing baseball at an earlier age ( P = .016), had a longer duration of competitive play ( P = .0013), and had experienced more present ( P = .0025) and past ( P < .0001) elbow pain compared with players without a lesion. There were no differences between the 2 groups in the position played ( P = .26). Sixty-eight patients underwent further radiographic examination for OCD (radiography, computed tomography, magnetic resonance imaging). Of these players, 10 (14.7%) were classified as having stage I OCD (radiolucent stage); 26 (38.2%), stage II (fragmentation stage); 9 (13.2%), stage III (loose body stage); 9 (13.2%), stage IV (residual stage); and 14 (23.5%), stage V (postoperative stage).

Conclusion:

The prevalence of OCD of the humeral capitellum, including latent cases, was 3.4% among adolescent baseball players. Players with OCD lesions began playing baseball at earlier ages, had played for longer periods, and had experienced more elbow pain. The player’s current baseball position may not be related to the existence of OCD lesions in adolescents.
Improper Trunk Rotation Sequence Is Associated With Increased Maximal Shoulder External Rotation Angle and Shoulder Joint Force in High School Baseball Pitchers
Authors: Oyama Sakiko , Yu Bing , Blackburn J. Troy , Padua Darin A. , Li Li , Myers Joseph B.
Published: June 2014

Background:

In a properly coordinated throwing motion, peak pelvic rotation velocity is reached before peak upper torso rotation velocity, so that angular momentum can be transferred effectively from the proximal (pelvis) to distal (upper torso) segment. However, the effects of trunk rotation sequence on pitching biomechanics and performance have not been investigated.

Purpose:

The aim of this study was to investigate the effects of trunk rotation sequence on ball speed and on upper extremity biomechanics that are linked to injuries in high school baseball pitchers. The hypothesis was that pitchers with improper trunk rotation sequence would demonstrate lower ball velocity and greater stress to the joint.

Study Design:

Descriptive laboratory study.

Methods:

Three-dimensional pitching kinematics data were captured from 72 high school pitchers. Subjects were considered to have proper or improper trunk rotation sequences when the peak pelvic rotation velocity was reached either before or after the peak upper torso rotation velocity beyond the margin of error (±3.7% of the time from stride-foot contact to ball release). Maximal shoulder external rotation angle, elbow extension angle at ball release, peak shoulder proximal force, shoulder internal rotation moment, and elbow varus moment were compared between groups using independent t tests (α < 0.05).

Results:

Pitchers with improper trunk rotation sequences (n = 33) demonstrated greater maximal shoulder external rotation angle (mean difference, 7.2° ± 2.9°, P = .016) and greater shoulder proximal force (mean difference, 9.2% ± 3.9% body weight, P = .021) compared with those with proper trunk rotation sequences (n = 22). No other variables differed significantly different between groups.

Conclusion:

High school baseball pitchers who demonstrated improper trunk rotation sequences demonstrated greater maximal shoulder external rotation angle and shoulder proximal force compared with pitchers with proper trunk rotation sequences.

Clinical Relevance:

Improper sequencing of the trunk and torso alter upper extremity joint loading in ways that may influence injury risk. As such, exercises that reinforce the use of a proper trunk rotation sequence during the pitching motion may reduce the stress placed on the structures around the shoulder joint and lead to the prevention of injuries.