bluuebunny/crossref_metadata_2025 huggingface dataset:
Cooperative responding in rats maintained by fixed‐ and variable‐ratio schedules
Authors: de Carvalho Lucas Couto , dos Santos Letícia , Regaço Alceu , Barbosa Thiago Braga , da Silva Rafael Fernando , de Souza Deisy das Graças , Sandaker Ingunn
Published: June 2018

The present study investigated the effects of fixed‐ratio (FR) and variable‐ratio (VR) reinforcement schedules on patterns of cooperative responding in pairs of rats. Experiment 1 arranged FR 1, FR 10, and VR 10 schedules to establish cooperative responding (water delivery depended on the joint responding of two rats). Cooperative response rates and proportions were higher under intermittent schedules than under continuous reinforcement. The FR 10 schedule generated a break‐and‐run pattern, whereas the VR 10 schedule generated a relatively high and constant rate pattern. Experiment 2 evaluated the effects of parametric manipulations of FR and VR schedules on cooperative responding. Rates and proportions of cooperative responding generally increased between ratio sizes of 1 and 5 but showed no consistent trend as the ratio increased from 5 to 10. Experiment 3 contrasted cooperative responding between an FR6 schedule and a yoked control schedule. Coordinated behavior occurred at a higher rate under the former schedule. The present study showed that external consequences and the schedules under which the delivery of these consequences are based, select patterns of coordinated behavior.
ThedaCare Nutrition Risk Screen Improves the Identification of Non–Intensive Care Unit Patients at Risk for Malnutrition Compared With the Nutrition Risk Screen 2002
Authors: Hartz Lori L. K. , Stroup Bridget M. , Bibelnieks Tracy A. , Shockey Cheryl , Ney Denise M.
Published: June 2018

Background

Identification of patients at risk for malnutrition is important for timely nutrition intervention to reduce morbidity and mortality.Objective: The objective of this study was to compare the sensitivity and specificity of the Nutrition Risk Screen (NRS) 2002 and the ThedaCare NRS to identify patients at risk for malnutrition.

Methods

The NRS 2002 and ThedaCare NRS were administered to 594 patients, aged 63 ± 16 years (mean ± SD), in the non–intensive care unit hospital setting. Risk for malnutrition and malnutrition diagnosis were confirmed with the 6 malnutrition clinical characteristics defined by the Academy of Nutrition and Dietetics and the American Society for Parenteral and Enteral Nutrition and using the nutrition assessment that included the Nutrition Focused Physical Exam. Sensitivity, specificity, and κ coefficient were calculated.

Results

When compared with the NRS 2002, the ThedaCare NRS had higher sensitivity (98.8% vs 63.5%), indicating improved identification of patients at risk for malnutrition, but lower specificity (74.0% vs 93.4%), indicating that more patients at low risk for malnutrition were misclassified. ThedaCare NRS missed fewer patients at risk for malnutrition when compared with the NRS 2002. ThedaCare NRS had a higher κ coefficient when compared with the NRS 2002, indicating better agreement of results regardless of who administered the screen. The ThedaCare NRS required less time to complete when compared with the NRS 2002 (mean ± SE: ThedaCare, 17 ± 1 seconds; NRS 2002, 9 ± 1 minutes;P< .0001).

Conclusion

The ThedaCare NRS improves the identification of patients at risk for malnutrition in the non–intensive care unit hospital setting. This trial was registered atwww.clinicaltrials.govas NCT02585245.
The self‐concept of person with chronic schizophrenia in Japan
Authors: Sugawara Hiromi , Mori Chizuru
Published: June 2018

Aims

People with schizophrenia have some problems in terms of function of consciousness of the self. Therefore, what they are conscious of themselves remains unclear. The aim of this study was to elucidate the self‐concept of Japanese with schizophrenia.

Methods

We interviewed Japanese with a diagnosis of schizophrenia and analyzed the interview transcription by means of qualitative content analysis.

Results

Qualitative content analysis yielded 2001 meaning units and 53 codes from the transcription. The codes were classified into 6 categories: Present Cognition and Definition of the Self, Feeling Towards and Evaluation of the Self, The Self That Is Seen by Others, The Past Self‐Image, The Self‐Image About Possibility and the Future, and How I Should Be and the Ideal Self.

Conclusion

One of the categories, Feeling Towards and Evaluation of the Self, means self‐confidence, pride, and self‐acceptance. In this category, some participants could not accept themselves because they felt “this is not the true self.” Considering our finding and the background in Japan, psychiatric hospitalization is long, while hospitalized people with schizophrenia might be aware of the negative stereotypes about them. Therefore, staff should more focus on what people with schizophrenia want to be in their new life and develop new approaches to enhance rebuilding new goal in life and reduce the self‐stigma.
Dyadic stress of breast cancer survivors and their caregivers: Are there differences by sexual orientation?
Authors: Boehmer Ulrike , Stokes Jeffrey E. , Bazzi Angela R. , Winter Michael , Clark Melissa A.
Published: June 2018

Objective

The objective of the study is to assess dyadic stress among sexual minority cancer survivor and caregivers compared to heterosexual cancer survivors and their caregivers.

Methods

We recruited 167 survivors of nonmetastatic breast cancer of different sexual orientations and their caregivers, who were interviewed via telephone after obtaining consent. We used inverse propensity score weighting to account for differences by sexual orientation in age and length of the survivor‐caregiver relationship and simultaneous equation models consistent with the needs for analyzing dyadic data.

Results

Survivors and caregivers reported stress levels consistent with population norms, irrespective of survivors' sexual orientation. Accounting for covariates, survivors' and caregivers' stress did not mutually influence one another overall. However, differences by sexual orientation were noted such that caregivers' stress was influential for sexual minority survivors' stress, but not for heterosexual survivors' stress.

Conclusions

Careful consideration should be given to caregivers of sexual minority survivors, an underserved group for whom currently no interventions exist.
A non‐oscillatory multimoment finite‐volume global transport model on a cubed‐sphere grid using the WENO slope limiter
Authors: Tang Jie , Chen Chungang , Li Xingliang , Shen Xueshun , Xiao Feng
Published: June 2018

By using CSL3 multimoment interpolation, a piecewise cubic polynomial for spatial reconstruction can be obtained with four multimoment constraint conditions consisting of two point values at cell boundaries, one volume‐integrated average and one slope parameter at the cell center. The resulting multimoment finite‐volume scheme is of fourth‐order accuracy. A non‐oscillatory scheme can be derived by designing the proper formula to calculate the slope parameter at the cell center. A new strategy was recently proposed, using the Weighted Essentially Non‐Oscillatory (WENO) concept to determine the slope parameter. Using a WENO‐type limiter, the multimoment reconstruction can effectively remove nonphysical oscillations while keeping fourth‐order accuracy in smooth regions. In this study, a WENO‐type slope limiter is proposed and implemented in our multimoment finite‐volume global transport model based on the cubed‐sphere grid. The widely used benchmark tests, including both solid rotation and complicated deformational advection cases, are checked to verify the performance of the proposed global transport model. Numerical results reveal that a WENO‐type slope limiter can greatly improve the accuracy of the multimoment finite‐volume model compared with the former Total Variation Diminishing (TVD)‐type limiter. Furthermore, the proposed limiter is constructed over a compact stencil of only three adjacent cells. Without any user‐defined or problem‐dependent parameters, the present model is very promising for practical applications.
An intermediate‐complexity model for four‐dimensional variational data assimilation including moist processes
Authors: Zaplotnik Žiga , Žagar Nedjeljka , Gustafsson Nils
Published: June 2018

This article presents a new Moist Atmosphere Dynamics Data Assimilation Model (MADDAM), an intermediate‐complexity system for four‐dimensional variational (4D‐Var) data assimilation. The prognostic model equations simulate nonlinear moisture advection, precipitation, and the impact of condensational heating on circulation. The 4D‐Var assimilation applies the incremental approach and uses transformed relative humidity as a control variable. In contrast to the model dynamical variables, which are analyzed in multivariate fashion using equatorial wave theory, moisture data are assimilated univariately. MADDAM is applied to study the extraction of wind information from time series of moisture observations in the Tropics, where the lack of wind information is most critical.

Results show that wind tracing in the unsaturated atmosphere depends largely on the ability of the assimilation model to resolve spatial gradients in the moisture field, which is determined by the spatial density and accuracy of observations. In the saturated atmosphere, a combined assimilation of moisture and temperature data is shown to improve wind analyses significantly, as the intensity of the condensation process is susceptible to the slightest changes in saturation humidity and thus temperature. Moreover, a perfect‐model 4D‐Var with moisture observations can extract wind information even in precipitating regions and strongly nonlinear flow, provided sufficient observations of humidity gradients are available.

MADDAM is envisaged to serve as a testbed for new developments in 4D‐Var assimilation, with a focus on interactions between moist processes and dynamics across many scales.
Analytical solution to a thermodynamic model for the sensitivity of afternoon deep convective initiation to the surface Bowen ratio
Authors: Bhowmick Mansi , Parker Douglas J.
Published: June 2018

The tendency of convective rainfall to initiate over a wetter or drier land surface is a critical feedback process in the climate system, influencing the hydrological cycle on a variety of spatial scales, especially in parts of the world where water is limited. A simple algebraic solution is derived from fundamental physical equations, to predict the sign of this convective rainfall feedback with the surface. The tendency for convection to occur is evaluated by the rate at which the convective boundary‐layer top approaches the level of free convection. Well‐known integral models predict the rate of ascent of the boundary‐layer top, which tends to be faster over a dry surface. The associated changes in equivalent potential temperature in the boundary layer determine the rate at which the level of free convection descends, typically faster over a wet surface, as a function of the ambient profile, the thermodynamic forcing and the surface Bowen ratio. The resulting system is controlled by three parameters. Two nondimensional parameters determine whether there is wet or dry “advantage”; the Bowen ratio at the boundary‐layer top and a “convective instability parameter,” defined as the ratio of the vertical gradient of saturated equivalent potential temperature at the level of free convection to the profile stability just above the boundary layer. A dimensional function, dependent on the surface fluxes, the boundary‐layer depth, and the profile stability, provides the magnitude of the response. In comparison with previous work, the solution is both rigorously derived from physical principles and encapsulated in a simple algebraic form. A first evaluation of the theoretical framework has been made using data from a convection‐permitting numerical model simulation over India, and this indicates that the equations successfully determine the conditions under which convection is triggered over dry surfaces.
Diurnal variation in the intensity of nascent Tibetan Plateau vortices
Authors: Li Lun , Zhang Renhe , Wen Min
Published: June 2018

Tibetan Plateau vortices (TPVs) are major rain‐producing systems forming over the Tibetan Plateau, and the ones moving off the plateau can trigger heavy rainfall over eastern China. The survival probability of a nascent TPV is closely related to its intensity, which is important in the prediction of the precipitation over and to the east of the Tibetan Plateau. In this study, diurnal variation of the intensity of nascent TPVs (ITPV) occurring in four local time periods (hours 00–06 LT, 06–12 LT, 12–18 LT, 18–00 LT; LT = UTC + 6 h) during May–August of 2000–2016 was investigated. The average ITPV shows a robust diurnal variation, with the maximum from evening to midnight (18–00 LT) and minimum from morning to noon (06–12 LT). In 18–00 LT, the ratios of the strong and weak TPVs are 46 and 22.2%, respectively, while those in 06–12 LT are 26.3 and 42.4%. The strong TPVs occurring in 18–00 LT are mainly located over the western and central Tibetan Plateau, while in 06–12 LT over the central and eastern Tibetan Plateau. The dynamic and thermodynamic processes associated with the diurnal variation of ITPV are studied, revealing the important roles of large‐scale circulations and condensational latent heat related to precipitation. In 18–00 LT, the strongest convergence at 500 hPa, divergence at 200 hPa, and the accordingly strongest ascending motion, as well as the largest amount of net water vapour budget are observed, benefiting the precipitation and the related latent heat release. On the contrary, the situations in 06–12 LT result in little latent heat release. The diagnosis of potential vorticity budget further verifies the important effect of condensational latent heating on ITPV.
On the growth of intensity forecast errors in the operational hurricane weather research and forecasting (HWRF) model
Authors: Kieu Chanh , Keshavamurthy Kushal , Tallapragada Vijay , Gopalakrishnan Sundararaman , Trahan Samuel
Published: June 2018

This study examines the growth of tropical cyclone (TC) intensity forecast errors and related intensity predictability for the NOAA operational Hurricane Weather Research and Forecasting (HWRF) model. Using operational intensity forecasts during the 2012 to 2016 seasons, two conditions for a limited range of TC intensity predictability are demonstrated, which include (a) the existence of an intensity error saturation limit, and (b) the dependence of the intensity error growth rate on storm intensity during TC development. By stratifying intensity errors based on different initial intensity bins, it is shown that TC intensity error growth rate is relatively small (∼0.3 kt h−1) at the early stage of TC development, but it quickly increases to ∼1 kt h−1 during TC intensification. Of further importance is that the intensity error saturation varies in the range of 14–18 kt in different ocean basins, thus suggesting the potential dependence of the intensity predictability on large‐scale environment. Additional idealized experiments with the HWRF model confirm the saturation of intensity errors, even under a perfect model scenario. The existence of the intensity error saturation together with the finding of a faster error growth rate for higher intensity suggests that the TC dynamics possesses an inherent limited predictability, which prevents us from reducing the intensity errors in TC dynamical models below a certain threshold.
Spatio‐temporal variability of warm rain events over southern West Africa from geostationary satellite observations for climate monitoring and model evaluation
Authors: Young Matthew P. , Chiu J. Christine , Williams Charles J. R. , Stein Thorwald H. M. , Stengel Martin , Fielding Mark D. , Black Emily
Published: June 2018

This article presents the spatio‐temporal variability of warm rain events over southern West Africa (SWA) during the summer monsoon season for the first time, using Spinning Enhanced Visible Infrared Radiometer (SEVIRI) observations on the Meteosat geostationary satellites. The delineation of warm rain events is based on the principle that precipitating low‐level clouds are associated with either sufficient water content or large cloud droplet size. Capitalising on the ability of space‐borne radar to resolve vertical cloud structures and detect the presence of precipitation, the delineation is trained by collocated SEVIRI and CloudSat observations.

The resulting 12 years of observations from SEVIRI are used to examine the spatial, diurnal, seasonal and interannual variability of warm rain events over SWA. Warm rain events predominate during the monsoon in August, with little interannual variability, and persist over orography in the morning and the coasts after midday, likely enhanced by orographic lifting and land–sea breeze effects. Warm clouds have a much higher probability of precipitation along the coastlines of Liberia and Nigeria compared to the central SWA coastline and further inland. Finally, when evaluating an 8‐day yet high‐spatial resolution model simulation, we find that warm rain frequencies from the simulation agree well with SEVIRI near the coast but simulated warm cloud cover and thus warm rain frequencies are too low over the Gulf of Guinea. The probability of precipitation of warm clouds is also too low inland. The newly developed observations of warm rain create opportunities to further investigate the diurnal cycle of warm rain, study aerosol–cloud–precipitation interactions, and assess the role of warm rain in the water cycle across Africa and beyond.
The Perspective of the Affected: What People Confronted With Disasters Expect From Government Officials and Public Leaders
Authors: Jong Wouter , Dückers Michel L. A.
Published: June 2018

Despite available knowledge on appropriate psychosocial support for people confronted with death, loss, and severe stress in the context of major crises and disasters, it is crucial to understand what people affected expect from government officials and public leaders in the aftermath of an extreme event. Eight interviews with affected adult residents were conducted to explore their expectations and experiences in relation to government. This was done against the background of Park's () model on meaning making. Findings revealed that interviewees expected the government to help them in a fair, compassionate, equal, and reliable manner. They also expected support in fulfilling event‐related practical needs, and assumed that the government would use its capacity to align network partners and break down bureaucratic barriers. The affected individuals’ global beliefs and situational meaning may differ from the perceptions of the public leader who provides support.
Araucarian conifer from late Albian amber of northern Spain
Authors: Kvaček Jiří , Barrón Eduardo , Heřmanová Zuzana , Mendes Mário Miguel , Karch Jakub , Žemlička Jan , Dudák Jan
Published: June 2018

Araucarian pollen conesRabagostrobus hispanicusgen. et sp. nov. and their associated foliageBrachyphyllum obesumHeer are described from Lower Cretaceous (Albian) strata of northern Spain. Male cones consist of helically arranged microsporophylls bearing 5–8 elongate pollen sacs within situinaperturateAraucariacites‐type pollen. The new taxon is compared to material described previously from the Early Cretaceous of North and South Americas. Sterile twigs ofB. obesumbear helically arranged leaves with wrinkled margins. Its cuticle has files of predominantly transversely oriented stomata. Both twigs and pollen cones occur as inclusions in amber from the Peñacerrada 1 outcrop (Álava Province), and as compressions are recorded from the amber‐bearing strata sediments of the Rábago/El Soplao outcrop. Inclusions of araucariacean plant remains and the co‐occurrence of amber and male cone and twig compressions suggest that the amber in these two localities, or at least some of it, was produced by araucariacean plants.
High-Dimensional Quadratic Classifiers in Non-sparse Settings
Authors: Aoshima Makoto , Yata Kazuyoshi
Published: June 2018

In this paper, we consider high-dimensional quadratic classifiers in non-sparse settings. The quadratic classifiers proposed in this paper draw information about heterogeneity effectively through both the differences of growing mean vectors and covariance matrices. We show that they hold a consistency property in which misclassification rates tend to zero as the dimension goes to infinity under non-sparse settings. We also propose a quadratic classifier after feature selection by using both the differences of mean vectors and covariance matrices. We discuss the performance of the classifiers in numerical simulations and actual data analyzes. Finally, we give concluding remarks about the choice of the classifiers for high-dimensional, non-sparse data.
Routing and schedule simulation of a biomass energy supply chain through SimPy simulation package
Authors: Pinho T.M. , Coelho J.P. , Oliveira P.M. , Oliveira B. , Marques A. , Rasinmäki J. , Moreira A.P. , Veiga G. , Boaventura-Cunha J.
Published: June 2018

The optimisation of forest fuels supply chain involves several entities actors, and particularities. To successfully manage these supply chains, efficient tools must be devised with the ability to deal with stakeholders dynamic interactions and to optimize the supply chain performance as a whole while being stable and robust, even in the presence of uncertainties. This work proposes a framework to coordinate different planning levels and event-based models to manage the forest-based supply chain. In particular, with the new methodology, the resilience and flexibility of the biomass supply chain is increased through a closed-loop system based on the system forecasts provided by a discrete-event model. The developed event-based predictive model will be described in detail, explaining its link with the remaining elements. The implemented models and their links within the proposed framework are presented in a case study in Finland and results are shown to illustrate the advantage of the proposed architecture.
An exploratory study of Eastern Ugandan adolescents' descriptions of social withdrawal
Authors: Eggum‐Wilkens Natalie D. , Zhang Linlin , An Danming
Published: June 2018

Introduction

Researchers have identified a variety of motivations for solitude and for social withdrawal. These motivations may differ across cultures. The purpose of this study was to explore Ugandan adolescents' descriptions of solitude and social withdrawal, with the aim of guiding future research on social withdrawal in Uganda.

Methods

Ugandan adolescents' (M = 14.23 years old, SD = 1.63 years) descriptions of solitude and social withdrawal were investigated in a cross‐sectional, exploratory study. The sample (N = 219 [106 girls, 90 boys, 23 missing sex data]) was drawn from two primary schools and a secondary school in Eastern Uganda. Adolescents' responses to open‐ended questionnaire items about general solitude, conflicted motivations for social withdrawal, and non‐conflicted motivation for social withdrawal were coded and categorized.

Results

Some of the adolescents' descriptions were consistent with the literature. For example, they described shyness and internalizing emotions, externalizing and socially incompetent behaviors, and poor peer relationships. Some descriptions were unique and likely reflected Uganda's challenges, for instance, family or household factors such as being an orphan.

Conclusions

Results underscored the importance of exploring contextual processes (e.g., parental loss) that might affect Ugandan adolescents' solitude. More generally, the results suggested that solitude should be researched using a broad, synergistic lens that incorporates potential determinants from adolescents and their environments at multiple levels (e.g., person, peer, household, culture).
Social Brand Engagement: How Orientation Events Engage Students with the University
Authors: Altschwager Teagan , Dolan Rebecca , Conduit Jodie
Published: June 2018

Student engagement in the classroom is well recognised as crucial for student success; however, the importance of engaging students beyond the classroom, in the broader university context, is often overlooked. This study examines how students engage with the university through their interactions with other students, conceptualised as ‘social brand engagement’. Orientation events provide opportunities for students to interact in a way that is facilitated by, and relevant to, the university. This study investigates the role of four experiential components (intellectual, affective, behavioural, and sensory experiences) in facilitating social brand engagement and the subsequent effect on word-of-mouth behaviour. We surveyed 223 students across 10 orientation events held at an Australian university. Path analysis indicates that intellectual, sensory and behavioural experiences have a significant impact on social brand engagement, which in turn positively impacts word-of-mouth behaviour. Thus, this study utilises the construct of social brand engagement, establishes its antecedents and outcomes, and demonstrates its relevance for higher education management.
Dextromethorphan/Quinidine for Pseudobulbar Affect Following Stroke: Safety and Effectiveness in the PRISM II Trial
Authors: Zorowitz Richard D. , Alexander David N. , Formella Andrea E. , Ledon Fred , Davis Charles , Siffert Joao
Published: June 2018

Background

Dextromethorphan (DM) / quinidine (Q) was approved for pseudobulbar affect (PBA) treatment based on efficacy and safety trials in patients with PBA caused by amyotrophic lateral sclerosis or multiple sclerosis. The PRISM II trial evaluated DM/Q as PBA treatment in patients with stroke, dementia, or traumatic brain injury.

Objective

To report results from the stroke cohort of PRISM II, including the Stroke Impact Scale (SIS).

Design

Open‐label trial evaluating twice‐daily DM/Q over 90 days.

Study participants

Adults (n = 113) with a clinical diagnosis of PBA secondary to stroke; stable psychiatric medications were allowed.

Methods

PRISM II was an open‐label, 12‐week trial enrolling adults with PBA caused by dementia, stroke (reported here), or TBI. All study participants received DM/Q 20/10 mg twice daily. Study visits occurred at baseline and at days 30 and 90.

Setting

150 U.S. centers.

Main Outcome Measurements

Primary efficacy measure was changed from baseline to day 90 in Center for Neurologic Study‐Lability Scale (CNS‐LS) scores. Secondary outcomes included PBA episodes (estimated over 7 days), Clinical and Patient/Caregiver Global Impression of Change (CGI‐C and PGI‐C), Quality of Life‐Visual Analog Scale (QOL‐VAS), SIS, Patient Health Questionnaire (PHQ‐9), and Mini‐Mental State Examination (MMSE).

Results

Compared with baseline, CNS‐LS scores (SD) improved by −6.2 (6.1, P < 0.001) at day 30 and − 7.6 (6.7, P < 0.001) at day 90. PBA episodes were reduced by 65% and 75% at day 30 and 90, respectively. Seventy‐five percent of clinicians and 67% of patients/caregivers rated PBA as “much” or “very much improved.” All SIS items significantly improved from baseline (P < 0.05, all). Adverse events included diarrhea (4.4%), headache (3.5%), constipation (2.7%), and dizziness (2.7%); 5.3% had adverse events leading to study discontinuation.

Conclusions

DM/Q effectively treated PBA and was associated with global and functional improvement; adverse events were consistent with the known safety profile of DM/Q.

Level of Evidence

I
Botulinum Toxin: Techniques Within Pediatric Physiatry
Authors: Paulson Andrea , Zigler Christina K. , Houtrow Amy , Pruitt David
Published: June 2018

Background

Intramuscular botulinum toxin injections are used for treatment of focal spasticity in children, particularly in those with a diagnosis of cerebral palsy. There are a variety of techniques used when performing botulinum toxin injections without clear standards for pediatric providers.

Objective

To describe current practice techniques for botulinum toxin injections among pediatric physiatrists.

Design

Cross‐sectional survey using RedCap Software.

Setting

Pediatric physiatrists who perform botulinum toxin injections.

Participants

Survey of 307 pediatric physiatrists.

Methods

Analysis of data from the 2017 practice survey of pediatric physiatrists in the United States.

Main Outcome Measurements

Physicians were asked the primary botulinum toxin used, common dosing information, the role of localization, and the role of sedation and distraction in their practice.

Results

Nearly all pediatric physiatrists use OnabotulinumtoxinA as the primary formulation of botulinum toxin. The maximum dose per body weight used per injection series had a median of 15 units/kilogram and a median maximum total dose of 500 units. Sixty‐five percent of pediatric physiatrists report using sedation, of any type, for botulinum toxin injections. When using sedation, the most common primary method was general anesthesia (38.9%), followed by enteral or nasal anxiolytic with the patient awake (26.2%). The most common reported intended injection site for botulinum toxin was “in multiple sites spread throughout the muscle” (67.9%), and then “one site of the muscle at the motor point” (17.1%). Large muscles were injected using primarily anatomic guidance (75.6%) and electromyography (50.8%), and small muscles were primarily completed with electromyography (73.6%) and anatomic guidance (49.2%).

Conclusion

There is considerable variability present in one common procedure performed by pediatric physiatrists.

Level of Evidence

NA.
Cardiovascular Risk Factors Among Older Adults With Long‐Term Spinal Cord Injury
Authors: Jörgensen Sophie , Hill Mattias , Lexell Jan
Published: June 2018

Background

Individuals with spinal cord injury (SCI) now live longer, which increases the risk of cardiovascular disease. Knowledge of cardiovascular risk factors amenable to intervention are therefore needed to support their healthy aging.

Objective

To describe the occurrence of cardiovascular risk factors among older adults with long‐term SCI and investigate the association with sociodemographics and injury characteristics.

Design

Cross‐sectional descriptive cohort study.

Setting

Home settings.

Participants

In total, 123 individuals (71% men, injury levels C1–L5, American Spinal Injury Association Impairment Scale A–D), mean age 63 years, mean time since injury 24 years.

Methods

Data from the Swedish Aging with Spinal Cord Injury Study (SASCIS), collected through interviews and assessments during home visits and from medical records.

Main Outcome Measures

Anthropometric measurements, blood pressure, fasting plasma glucose and blood lipids, and data on cardiovascular comorbidity and tobacco use.

Results

One third had a previous diagnosis of hypertension, and 55% presented with a blood pressure ≥ 140/90 mm Hg at the time of assessment. Sixteen percent had a history of diabetes and in 15% fasting glucose levels were ≥ 7 mmol/L. Dyslipidemia was present in 76%, whereas 16% had prediagnosed dyslipidemia. Mean body mass index (BMI) was 27 kg/m2 and mean waist circumference was 101 cm. When SCI‐adjusted BMI cut‐off values were used, 93% were considered overweight (BMI ≥22 kg/m2), and 60% had a waist circumference associated with cardiometabolic risk. A total of 16% smoked regularly. The median number of cardiovascular risk factors was 3. No significant associations were found between the total number of risk factors and sociodemographics and injury characteristics.

Conclusions

The high occurrence of cardiovascular risk factors among older adults with long‐term SCI can pose additional consequences to their health. Regular assessments and interventions targeting cardiovascular risk in this population are therefore warranted. Further research is needed to identify modifiable factors associated with their risk profile.

Level of Evidence

III
Predictors of Performance on the American Board of Physical Medicine and Rehabilitation Maintenance of Certification Examination
Authors: Driscoll Sherilyn W. , Geis Carolyn C. , Raddatz Mikaela M. , Kinney Carolyn L. , Robinson Lawrence R.
Published: June 2018

Background

Maintenance of certification (MOC) in Physical Medicine and Rehabilitation is a process of lifelong learning that begins after successfully completing an Accreditation Council for Graduate Medical Education (ACGME)–accredited residency and passing the American Board of Physical Medicine and Rehabilitation (ABPMR) Part I and Part II Examinations. We seek to identify factors predictive of successful MOC Examination performance.

Objective

To identify characteristics predictive of successful completion on the ABPMR MOC Examination.

Design

Retrospective review.

Setting

American Board of Physical Medicine and Rehabilitation database review.

Participants

4,545 diplomates who completed the MOC Examination between January 2006 and December 2017.

Methods

MOC Examination performance was the primary outcome variable. Performance on Part I and Part II Examinations were independent variables. Additional potential predictors evaluated included year of MOC cycle in which examination was taken, years of practice since residency completion, age, and subspecialty certification.

Main Outcome Measures

Performance on MOC Examination.

Results

Age at time of MOC Examination was inversely correlated with examination score (r = –0.14, P < .001). Similarly, as time since completion of residency training increased, MOC scores declined. Passing the Part I Examination on first attempt predicted a 98% MOC pass rate, compared to 90% for those who failed initially. MOC performance was highly correlated with Part I performance (r = 0.59, P < .001) and Part II performance (r = 0.32, P < .001). Although MOC performance was similar for those taking the examination in years 7 – 10 of their cycle (97% pass rate), those taking the examination after more than 10 years of the cycle had a significantly lower performance (85% pass rate, P < .01).

Conclusions

Better performance on the MOC Examination is associated with better performance on Part I and Part II Examinations, taking the examination earlier in the 10 year cycle, younger age, and less time since completion of training. Diplomates who are at higher risk for failing the examination may need to prepare differently for MOC Exam than those who are more likely to pass.

Level of Evidence

III
An Experience of Improvised Laryngoscopy
Authors: Matthews Alison
Published: June 2018

Airway management in the wilderness runs the gamut from basic airway support to endotracheal intubation. Fortunately, direct laryngoscopy is a seldom called upon skill in expedition medicine. However, the medical skills required during a mission or expedition are never truly known in advance. Improvisation during evolving medical events is a mainstay of expedition medicine education and practice. It is unlikely, given constraints of weight and size of expedition medical kits, that a conventional laryngoscope would find its way into a standard “go bag.” Faced with the real but rare event of needing to intubate a patient in an austere environment, how can improvisation be used? Multiple ideas for improvised laryngoscopes can be found in the wilderness medicine literature, but which, if any, of these devices have true clinical utility? To this end, participants of a recent Wilderness Medical Society preconference in medical elements of light search and rescue were given the opportunity to devise and construct their own improvised laryngoscopes and attempt intubation of a training mannequin. Participants with varying degrees of intubating experience improvised effective laryngoscopes from provided materials and successfully intubated an airway mannequin.
Applying the Concept of Ecohydrological Equilibrium to Predict Steady State Leaf Area Index
Authors: Yang J. , Medlyn B. E. , De Kauwe M. G. , Duursma R. A.
Published: June 2018

Leaf area index (LAI) is a key variable in modeling terrestrial vegetation because it has a major impact on carbon and water fluxes. However, several recent intercomparisons have shown that modeled LAI differs significantly among models and between models and satellite‐derived estimates. Empirical studies show that LAI is strongly related to precipitation. This observation is predicted by the ecohydrological equilibrium theory, which provides an alternative means to predict steady state LAI. We implemented this theory in a simple optimization model. We hypothesized that, when water availability is limited, plants should adjust steady state LAI and stomatal behavior to maximize net canopy carbon export, under the constraint that canopy transpiration is a fixed fraction of total precipitation. We evaluated the predicted LAI (Lopt) for Australia against ground‐based observations of LAI at 135 sites and continental‐scale satellite‐derived estimates. For the site‐level data, the root‐mean‐square error of predicted Lopt was 1.07 m2 m−2, similar to the root‐mean‐square error of a comparison of the data against 9‐year mean satellite‐derived LAI (Lsat) at those sites. Continentally, Lopt had an R2 of 0.7 when compared to Lsat. The predicted Lopt increased continental‐wide with rising atmospheric [CO2] over 1982–2010, which agreed with satellite‐derived estimations, while the predicted stomatal behavior responded differently in dry and wet regions. Our results indicate that long‐term equilibrium LAI can be successfully predicted from a simple application of ecohydrological theory. We suggest that this theory could be usefully incorporated into terrestrial vegetation models to improve their predictions of LAI.
Upper Estuaries Found to Be Significant Blue Carbon Sink
Authors: Sidder Aaron
Published: June 2018

Inland from the seagrass and salt marsh ecosystems that border the ocean, upper estuaries store more carbon than previously realized and could play an important role in mitigating climate change.
Are We Prepared for an Asteroid Headed Straight to Earth?
Authors: Cartier Kimberly
Published: June 2018

A century after an asteroid crashed into Tunguska, Siberia, experts discuss the current lineup of missions to study asteroids and mitigate future disasters should another object from space hit Earth.
Diurnal Variation of Height‐Distributed Nitric Oxide Radiative Emission During November 2004 Superstorm
Authors: Bag Tikemani
Published: June 2018

The diurnal variation of height‐distributed nitric oxide (NO) radiative emission during November 2004 superstorm is studied using TIMED‐SABER satellite observations over 55°N–55°S geographic latitude region. The NO volume emission rate (VER), both during day and nighttime, shows an equatorial movement with descending peak emission altitude as one moves toward the equator. The NO VER from altitude of 100 to 280 km is integrated in steps of 30 km above 160 km (and from 100 to 160 km), obtaining the NO infrared radiative flux (IRF). The response of NO IRF depends on the altitude and time of consideration. The NO IRF in the lower altitude (<190 km) shows higher enhancement and a slower recovery as compared to altitude above it. It is observed that NO IRF during day and night responds differently to the November 2004 superstorm. The zonally averaged daytime NO IRF is mainly highest during weaker main phase (10 November, Dst =−263 nT). The maximum zonally averaged nighttime NO IRF is observed during stronger main phase (8 November, Dst =−374 nT) for all altitudes. The maximum relative daytime (RDE) and nighttime enhancement (RNE), which represent the relative variation of NO IRF during storm periods as compared to quiet time value, also exhibit different variations during this storm period. The minimum RDE is observed to show an equatorial movement as one moves downward in altitude. The minimum RDE occurs at about 35°N–40°N for 250–280 km, which decreases toward the equator, and minimum RDE is found near the equator for 100–160 km. The minimum of RNE is observed over the equator for all altitudes.
Modeling the Depletion and Recovery of the Outer Radiation Belt During a Geomagnetic Storm: Combined MHD and Test Particle Simulations
Authors: Sorathia Kareem A. , Ukhorskiy Aleksandr Y. , Merkin Viacheslav G. , Fennell Joseph F. , Claudepierre Seth G.
Published: June 2018

During geomagnetic storms the intensities of the outer radiation belt electron population can exhibit dramatic variability. Deep depletions in intensity during the main phase are followed by increases during the recovery phase, often to levels that significantly exceed their prestorm values. To study these processes, we simulate the evolution of the outer radiation belt during the 17 March 2013 geomagnetic storm using our newly developed radiation belt model (Conservative Hamiltonian Integrator for Magnetospheric Particles) based on test particle and coupled 3‐D ring current and global magnetohydrodynamic (MHD) simulations, and driven solely with solar wind and F10.7 flux data. Our approach differs from previous work in that we use MHD information to identify regions of strong, bursty, and azimuthally localized earthward convection in the magnetotail where test particles are then seeded. We validate our model using in situ Van Allen Probe electron intensities over a multiday period and show that our model is able to reproduce meaningful qualitative and quantitative agreement. Analysis of our model enables us to study the processes that govern the transition from the prestorm to poststorm outer belt. Our analysis demonstrates that during the early main phase of the storm the preexisting outer belt is largely wiped out via magnetopause losses, and subsequently, a new outer belt is created during a handful of discrete, mesoscale injections. Finally, we demonstrate the potential importance of magnetic gradient trapping in the transport and energization of outer belt electrons using a controlled numerical experiment.
Conformational sensitivity of surface selection rules for quantitative Raman identification of small molecules in biofluids
Authors: Li Lei , Wang Chao , Yang Lina , Su Mengke , Yu Fanfan , Tian Li , Liu Honglin
Published: June 2018

Raman selection rules in conformational reorientation with specificity for ratiometric SERS quantitation of small molecules in biofluids on a superhydrophobic surface.
Polymerization-induced self-assembly of liquid crystalline ABC triblock copolymers with long solvophilic chains
Authors: Huo Meng , Wan Zhengyi , Zeng Min , Wei Yen , Yuan Jinying
Published: June 2018

Polymerization-induced self-assembly was exploited to investigate the self-assembly behavior of liquid crystalline triblock copolymers with long solvophilic chains.
Solvent-induced framework-interpenetration isomers of Cu MOFs for efficient light hydrocarbon separation
Authors: Wang Yutong , Fan Weidong , Wang Xia , Han Yinfeng , Zhang Liangliang , Liu Di , Dai Fangna , Sun Daofeng
Published: June 2018

For a pair of Cu-paddlewheel framework-interpenetrating isomers, the interpenetrating framework exhibits a high adsorption and separation selectivity for light hydrocarbons.
Dynamically imaging collision electrochemistry of single electrochemiluminescence nano-emitters
Authors: Ma Cheng , Wu Wanwan , Li Lingling , Wu Shaojun , Zhang Jianrong , Chen Zixuan , Zhu Jun-Jie
Published: June 2018

Dynamically imaging stochastic collision electrochemistry of single nanoparticles by electrochemiluminescence microscopy enables visualization of diverse collision behaviours.
Synthesis of high-density and low-freezing-point jet fuel using lignocellulose-derived isophorone and furanic aldehydes
Authors: Xie Jiawei , Zhang Lei , Zhang Xiangwen , Han Peijuan , Xie Junjian , Pan Lun , Zou De-Rong , Liu Song-Hua , Zou Ji-Jun
Published: June 2018

Biofuels synthesized from lignocellulose-derived platform chemicals are very attractive for sustainable development.
Perylene diimide-diamine/carbon black composites as high performance lithium/sodium ion battery cathodes
Authors: Wu Dongqing , Zhang Guangfeng , Lu Deng , Ma Lie , Xu Zhixiao , Xi Xin , Liu Ruili , Liu Ping , Su Yuezeng
Published: June 2018

The electrochemical performances of perylene diimide-diamine/carbon black composites in both lithium ion batteries and sodium ion batteries demonstrate the importance of the manufacturing method and the molecular structures in organic secondary battery cathodes.
Ultrahigh open-circuit voltage for high performance mixed-cation perovskite solar cells using acetate anions
Authors: Fu Rui , Zhao Yicheng , Zhou Wenke , Li Qi , Zhao Yao , Zhao Qing
Published: June 2018

By an FAAc additive-engineering strategy, a high PCE of 21.9% with an ultrahigh VOC of up to 1.19 V was achieved.
450 × 580 µm2 Pixel incorporating TX and coherent RX in CMOS for mm‐wave active imaging using a single reflector
Authors: Choi W. , Byreddy P.R. , Chen Z. , Chen A.J. , Newman A.J. , O K.K.
Published: June 2018

A transceiver pixel for active imaging incorporating a transmitter (TX) and a coherent receiver (RX) is demonstrated in 65 nm CMOS at 260 GHz. The pixel occupies an area of 450 × 580µm2 and is the first demonstration of pixels incorporating a TX and a coherent RX which are smaller than λ/2 × λ/2. The pixel exhibits −21.3 dBm total radiated power and −79.5 dBm sensitivity at a 1 kHz noise bandwidth. This sensitivity is about 10 dB better than the state‐of‐the‐art pixel with only a coherent RX. The pixel consumes 18.7 mW of DC power.
Methodology for digital synthesis of ultra‐narrow pulses
Authors: Fu Zaiming , Liu Hanglin , Ren Nan
Published: June 2018

A precise method of controlling the pulse width using a digital synthesis system is proposed for measurements in the picosecond domain and gigahertz frequency domain. Unlike the traditional pulse synthesise method based on reshapers, the proposed method of synthesising a pulse waveform and adjusting the pulse width is entirely digital. The method realises an ultra‐narrow pulse width by breaking the limit of propagation delay of devices, and the width can be adjusted in fine steps over a wide range (e.g. from a few seconds to hundreds of picoseconds). Programmable delay lines and high‐speed triggers and digital counters within a field‐programmable gate array are used. Experimental results show that the proposed approach generates a pulse that is controllable in 1 ps steps from a minimum width of 100 ps to a maximum width of 1000 s.
Layout influence on microwave performance of graphene field effect transistors
Authors: Giambra M.A. , Benfante A. , Zeiss L. , Pernice R. , Miseikis V. , Pernice W.H.P. , Jang M.H. , Ahn J.‐H. , Cino A.C. , Stivala S. , Calandra E. , Busacca A.C. , Danneau R.
Published: June 2018

The authors report on an in‐depth statistical and parametrical investigation on the microwave performance of graphene FETs on sapphire substrate. The devices differ for the gate‐drain/source distance and for the gate length, having kept instead the gate width constant. Microwave S‐parameters have been measured for the different devices. Their results demonstrate that the cut‐off frequency does not monotonically increase with the scaling of the device geometry and that it exists an optimal region in the gate‐drain/source and gate‐length space which maximises the microwave performance.