bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interactions between Mesoscale and Submesoscale Gravity Waves and Their Efficient Representation in Mesoscale-Resolving Models
Authors: Wilhelm Jannik , Akylas T. R. , Bölöni Gergely , Wei Junhong , Ribstein Bruno , Klein Rupert , Achatz Ulrich 
Published: March 2018

AbstractAs present weather forecast codes and increasingly many atmospheric climate models resolve at least part of the mesoscale flow, and hence also internal gravity waves (GWs), it is natural to ask whether even in such configurations subgrid-scale GWs might impact the resolved flow and how their effect could be taken into account. This motivates a theoretical and numerical investigation of the interactions between unresolved submesoscale and resolved mesoscale GWs, using Boussinesq dynamics for simplicity. By scaling arguments, first a subset of submesoscale GWs that can indeed influence the dynamics of mesoscale GWs is identified. Therein, hydrostatic GWs with wavelengths corresponding to the largest unresolved scales of present-day limited-area weather forecast models are an interesting example. A large-amplitude WKB theory, allowing for a mesoscale unbalanced flow, is then formulated, based on multiscale asymptotic analysis utilizing a proper scale-separation parameter. Purely vertical propagation of submesoscale GWs is found to be most important, implying inter alia that the resolved flow is only affected by the vertical flux convergence of submesoscale horizontal momentum at leading order. In turn, submesoscale GWs are refracted by mesoscale vertical wind shear while conserving their wave-action density. An efficient numerical implementation of the theory uses a phase-space ray tracer, thus handling the frequent appearance of caustics. The WKB approach and its numerical implementation are validated successfully against submesoscale-resolving simulations of the resonant radiation of mesoscale inertia GWs by a horizontally as well as vertically confined submesoscale GW packet.
Coping strategies and self-esteem in the high-risk offspring of bipolar parents
Authors: Goodday Sarah M , Bentall Richard , Jones Steven , Weir Arielle , Duffy Anne 
Published: March 2018

Objectives: This study investigated whether there were differences in coping strategies and self-esteem between offspring of parents with bipolar disorder (high-risk) and offspring of unaffected parents (control), and whether these psychological factors predicted the onset and recurrence of mood episodes. Methods: High-risk and control offspring were followed longitudinally as part of the Flourish Canadian high-risk bipolar offspring cohort study. Offspring were clinically assessed annually by a psychiatrist using semi-structured interviews and completed a measure of coping strategies and self-esteem. Results: In high-risk offspring, avoidant coping strategies significantly increased the hazard of a new onset Diagnostic and Statistical Manual of Mental Disorders, 4th Edition twice revised mood episode or recurrence (hazard ratio: 1.89, p = 0.04), while higher self-esteem significantly decreased this hazard (hazard ratio: 2.50, p < 0.01). Self-esteem and avoidant coping significantly interacted with one another ( p < 0.05), where the risk of a Diagnostic and Statistical Manual of Mental Disorders, 4th Edition twice revised new onset mood episode or recurrence was only significantly increased among high-risk offspring with both high avoidant coping and low self-esteem. Conclusion: A reduction of avoidant coping strategies in response to stress and improvement of self-esteem may be useful intervention targets for preventing the new onset or recurrence of a clinically significant mood disorder among individuals at high familial risk.
Friendship and money: A qualitative study of service users’ experiences of participating in a supported socialisation programme
Authors: Sheridan Ann , O’Keeffe Donal , Coughlan Barbara , Frazer Kate , Drennan Johnathan , Kemple Mary 
Published: March 2018

Background: Social opportunities can be limited in the lives of people with enduring mental illness (EMI) due to psychiatric stigma, restricted home environments and employment barriers. Supported socialisation programmes have the potential to redress the impact of social isolation. Aim: To explore the experiences of service users with EMI taking part in a supported socialisation programme, using written diary entries. Methods: This article reports on the qualitative component of a randomised controlled trial of supported socialisation for people with EMI (published previously in this journal). Trial participation involved (1) being matched with a volunteer partner and engaging in social/leisure activities while receiving a stipend of €20 or (2) receiving this stipend only and engaging in self-driven socialisation. Participants completed written diaries documenting their perspectives on their experiences of supported socialisation. Data were analysed using Thematic Analysis. Results: Experiences of participation were characterised by involvement ‘normalising’ life, fostering a sense of connectedness, improving physical health, and facilitating engagement with culture. Taking part helped participants integrate socialising into their identity, enhanced their perceived capacity to be social, and cemented/expanded social networks. Participants also experienced significant obstacles to socialisation. Conclusion: Supported socialisation can increase confidence, social competence and self-agency; buffer against psychiatric stigma; build social capital; and afford opportunities to enhance social integration, inclusion and belonging.
An Intersectional Exploration: Experiences of Stroke Prevention in Middle-Aged and Older Arab Muslim Immigrant Women in Canada
Authors: Salma Jordana , Hunter Kathleen F. , Ogilvie Linda , Keating Norah 
Published: March 2018

Background Arab immigrants have increasing rates of stroke and uncontrolled stroke risk factors coupled with minimal resources for stroke prevention. Purpose This article describes the results of an interpretive descriptive study about Arab immigrant women’s experiences of practicing stroke prevention. We use an intersectionality approach to discuss some of the factors that influenced women’s ability to manage their health. Methods Sixteen middle-aged and older Arab Muslim immigrant women were recruited between 2015 and 2016 from two religious centers in an urban Canadian center. Women were between the ages of 45 and 75 years, were living in the community, and had a combination of stroke risk factors. Semi-structured interviews lasting 2–3 h were conducted in Arabic by the primary bilingual researcher. Data analysis was completed in Arabic, with final themes and exemplars translated to English with the support of a certified translator. Results Study themes include relating life stressors to physical health, pursuing knowledge in the dark, negotiating medication and treatment options, making an effort to eat healthy and be active, and identifying triple ingredients for empowerment. Conclusion Economic status, access to transportation, language fluency, life stressors, and personal coping strategies influenced Arab women’s ability to manage personal health.
How Will New Media Affect Television?
Authors: Branigan Tony 
Published: March 2018

The next two decades will force major changes on existing media and leave them with a significantly smaller share of voice, mind and advertising dollars. Pay TV in various forms will be the main challenge, but the Internet and other interactive media also seem certain to change traditional media use and advertising practices. In the United States, cable television has taken large numbers of viewers from free-to-air TV, and is expanding its share of advertising revenue. Pay TV's prospects in Australia are promising, though the largely American program content of advertiser-supported channels may limit their appeal. Pay TV may be in as many as 20 per cent of homes within three years, but its impact on television viewing levels will be only a fraction of that. Free-to-air viewing may decline by as little as 4 per cent by 2000, while television revenue may be unaffected by Pay TV. In the medium term, digital technology will make various forms of interactivity practicable for both free-to-air and Pay TV. This may prove to be more significant than competition for advertising dollars, as it will allow both media to compete for marketing expenditure currently made outside normal advertising media.
The Importance of Intersocietal Commission for the Accreditation of Vascular Laboratories (ICAVL) Certification for Noninvasive Peripheral Vascular Tests: The Tennessee Experience
Authors: Stanley David G. 
Published: March 2018

Introduction Accurate, safe, and cost-effective noninvasive vascular tests (NIVTs) upon which vascular specialists can confidently base recommendations for treatment decisions are critically important for optimal patient care. Vascular surgeons are referred patients from many sources. These patients often present with NIVTs performed at a variety of facilities. A vascular specialist must be aware of the accuracy of NIVTs from his vascular lab as well as those sent from other facilities in order to make correct treatment recommendations. Without this knowledge, the consultant must either repeat the NIVT in a vascular lab with known quality assurance (QA) statistics or order arteriograms or other tests. Methods In order to determine the accuracy of studies from other facilities, the Vascular Diagnostic Center of Oak Ridge (VDC) and the vascular surgeons that practice at the Methodist Medical Center of Oak Ridge (MMC) developed an ongoing quality assurance program to address the quality and accuracy of NIVTs from other facilities. Since 1985, duplex vascular studies from other vascular laboratories, hospitals, and physician offices have been carefully compared with NIVTs performed at the VDC. We also compared all studies from VDC and other facilities to arteriograms and to pathology demonstrated in the operating room at MMC in patients who underwent surgery. Conclusions In the QA experience of VDC, studies from Intersocietal Commission for the Accreditation of Vascular Laboratories (ICAVL)-accredited laboratories were accurate in 83% of reviewed cases, whereas studies from facilities without ICAVL accreditation generated much lower correlation to quality and accuracy indices. This information is clearly valuable to physicians, patients, and third-party payers.
Are There Long-Term Consequences of Iliac Artery Trauma during Endograft Implantation? Results of Serial Duplex Ultrasound Follow-up
Authors: Mendoza Bernardo , Meier George H. , Carter Kathleen , Nelms Courtney , Chaler Dulcie , Beedie Felicia , Sprouse L. Richard 
Published: March 2018

Purpose The implantation of abdominal aortic endografts requires the insertion of large devices that have the potential to traumatize the iliac arteries, particularly on the ipsilateral side, where the main body of the endograft is introduced. The consequences of this potential trauma are unknown, but the possibility for significant injury remains. For this reason, a prospective measurement of iliac intimal medial thickness by serial duplex ultrasound was undertaken to determine the effect of endograft placement on iliac arteries. Methods A total of 117 patients had duplex evaluation of their iliac arteries after aortic endograft placement at an average follow-up of 18.8 months (range, 0 to 71 months). Ancure devices were used in 89, AneuRx in 11, Endologix in 12, Vanguard in 1, and unknown devices in 4. All endografts were scanned using Philips/ ATL HDI 5000 or ATL 3000 ultrasound machines with 7–4 MHz transducers and a standard protocol, with additional iliac artery measurements performed for the specifics of this study. Of these 117 patients, bilateral intimal medial thickness (IMT) was measured with a clearly determined ipsilateral (larger diameter sheath) implantation side defined in 66 patients. In these patients the ratio of ipsilateral (main introducer) IMT to contralateral (smaller diameter sheath) IMT was determined. Results Of the 66 patients with complete data available for review, the mean ipsilateral to contralateral IMT ratio was 1.41 (range, 0.3 to 16.4). Nonetheless, when evaluated more closely, only two patients had IMT ratios exceeding 2.0 (12.0 and 16.4). When these two patients are excluded, the IMT ratio averaged 1.01, suggesting an absence of significant intimal trauma secondary to aortic endograft implantation. If we presume that the cause of this increased intimal thickness is iliac trauma secondary to endograft placement, then the maximum incidence is 2/66 (3.0%). Analysis by follow-up intervals suggests no duration effect of significance. Conclusions Iliac artery trauma resulting in intimal hyperplasia or premature atherosclerosis appears to be a rare event after endograft abdominal aortic aneurysm repair. With current devices and current clinical selection, iliac artery pathology after endograft placement is not a significant concern.
Technical Aspects of Infrainguinal Arterial Duplex Guided Balloon Angioplasty
Authors: Marks Natalie , Ascher Enrico , Hingorani Anil , Schutzer Richard 
Published: March 2018

Purpose Duplex-guided balloon angioplasty (DGBA) has been reported in patients with short stenoses. We attempted to perform this procedure in patients with impaired renal function. Methods Over the course of 16 months, 37 lower-extremity DGBAs were performed at our institution in patients with renal insufficiency. Disabling claudication was the indication in 24 cases (65%) and critical ischemia in 13 cases. After duplex-guided common femoral artery (CFA) cannulation, a guide wire was directed into the origin of the superficial femoral artery, across the diseased segment and into the popliteal artery with the help of a guiding catheter under direct ultrasound visualization. The diseased segment was then dilated using a balloon. The balloon diameter and length were chosen according to arterial measurements obtained by duplex. Whenever indicated, stents were placed under duplex guidance. Results Thirty-day survival was 100%. Overall immediate technical success was achieved in all cases. Placement of intraluminal stents were deemed appropriate in 23 of 37 (62%) cases. The 1-month patency and limb salvage rates were 100%. Conclusion DGBA appears to be a feasible, safe, and effective technique for patients with renal insufficiency. Other advantages include guided puncture, accurate balloon and stent selection, and hemodynamic confirmation of the technique adequacy.
A Comparative Study of Ultrasound and Computed Tomography Scan for the follow-up of Abdominal Aortic Aneurysms after Endovascular Repair
Authors: Nerlekar Ruta , Warrier Ranjana , de Ryke Rex , Miller Robert , Hewitt Peter M. , Scott Alan 
Published: March 2018

Objective To date, computed tomography (CT) scanning has been the gold standard for follow-up of abdominal aortic aneurysms (AAA) after endovascular repair (EVR). However, with increasing durability of the minimally invasive procedure and longer survival of patients, there is concern over the expense of CT and its associated risks. For this reason, many now believe that ultrasound (US) may be an adequate substitute for surveillance of patients after EVR. The aim of this study was to compare ultrasound and CT scan in our practice to ascertain whether ultrasound alone would be sufficient for follow-up of AAA patients after EVR. Materials and Methods A total of 121 patients underwent EVR of AAAs during a 6-year period. All patients were followed up annually using both CT scanning and US. The parameters assessed included the presence/absence of endoleaks, as well as diameters of the aneurysm sac and neck. Results were plotted graphically to determine the change in size of aneurysms over time, and patients with endoleaks were compared with those who had no endoleaks. The sensitivity, specificity, positive, and negative predictive values for detecting endoleaks was also calculated for US and CT. Normally distributed data were analyzed using the Student's t-test and the Wilcox-signed rank test was used for nonparametric data. Results A total of 573 (CT and US) scans were analyzed. Of these, 391 scans (91 patients) did not show endoleaks. There were 64 scans (18 patients) in which both CT and US detected endoleaks; 6 scans (6 patients) in which CT detected leaks and US did not; and 5 scans (4 patients) in which US detected leaks and CT did not. The aneurysm sac size increased over time in the endoleak group and decreased over time in the nonendoleak group, whereas neck sizes did not change in either patient group. The sensitivity, specificity, positive, and negative predictive values of US and CT scan for detecting endoleak were 92.7%, 98.5%, 91.4%, and 98.7%; and 91.4%, 98.7%, 92.7%, and 98.5% respectively. Conclusion In our practice, US was comparable with CT scan for the detection of endoleaks, and similar trends were seen over time with regard to changes in aneurysm neck and body sizes for both modalities. We believe that US should be the primary modality for follow-up of patients after EVR and that CT scan should be reserved for confirmation of endoleak where this is suspected.
Ultrasonography in Saphenous Vein Conduit Selection
Authors: Cohn Joseph D. , Korver Keith F. 
Published: March 2018

Objective There are anatomic, histologic, and physiologic differences between great saphenous veins (GSVs) and accessory saphenous veins (ASVs). The GSV is deep to the saphenous fascia. ASVs are superficial to this layer and have thin walls with diminished muscle cells and elastic fiber. This study reviews the ultrasound characteristics of these veins, changes associated with varicose vein disease, and venous anomalies that impact on saphenous vein conduit selection. Methods Intraoperative ultrasound studies were performed before coronary artery bypass surgery in 83 patients without known venous disease, in 25 limbs with telangiectases, and in 25 limbs with varicosities. Vein characteristics and segment caliber in the proximal and distal thigh and calf were recorded. Results GSV segments of caliber and length suitable for use as coronary artery conduits are more common in men than women in the distal thigh (70% vs. 50%, p = 0.037), proximal calf (68% vs. 40%, p = 0.005), and distal calf (88% vs. 70%, p = 0.017). Dilated GSV segments are identified in 5% of normal limb segments, 21% in limbs with telangiectases ( p < 0.001), and 22% in limbs with varicosities ( p < 0.001). The incidence of absent or hypoplastic GSV segments is increased in limbs with varicosities compared with normal limbs (33% vs. 21%, p = 0.006). Conclusions GSVs are not uniform in caliber and gender differences are present. GSVs in limbs with telangiectases and varicosities have an increase in dilated and hypoplastic vein segments. Intraoperative ultrasound studies identify GSV segments for use as coronary conduits, avoiding ASVs and abnormal venous structures.
Acute and Isolated Dissection of the Superior Mesenteric Artery: Presentation and follow-up with Duplex Ultrasound
Authors: Oglesby Beverly , Sorrell Kathyrn 
Published: March 2018

Introduction Isolated dissection of the superior mesenteric artery (SMA) is a rare and often-fatal condition. Currently, only 47 cases of SMA dissection, in the absence of aortic dissection, have been reported in the literature. This report describes a case wherein the use of duplex ultrasound (DU) established the initial diagnosis and was used aggressively in follow-up care. Case Report A 51-year-old man presented to the emergency department (ED) complaining of severe abdominal pain. A DU of the mesenteric vessels was normal with the exception of a focal dilatation noted near the origin of the SMA that was later confirmed by computed tomography. Two days after admission, a second DU revealed a further increase in diameter of the proximal SMA and an intimal flap present in this segment. The patient was managed conservatively and discharged. Approximately 1 year later, the patient returned to the ED complaining of nausea and diarrhea for 3 weeks. DU revealed chronic dissection of the SMA as well as a stenosis in the celiac artery and inferior mesenteric artery (IMA). A stent was placed into the origin of the IMA to ensure collateral blood flow and anticoagulant therapy was continued. Before discharge, another DU was performed, which showed a patent IMA and well-perfused proximal SMA. One week later, the patient was asymptomatic and discharged home. Conclusions The use of DU provided a prompt and accurate diagnosis for a rare and unsuspected abnormality in the SMA that proved to be very beneficial in follow-up management decisions.
Predictors of a Technically Limited Renal Artery Duplex Study: A Retrospective Analysis
Authors: Lee Eugene S. , DelPizzo David , Murray Kristen , Harris Sean , Kuskowski Michael A. , Pevec William C. , Dawson David L. 
Published: March 2018

Objective A renal artery duplex study is the screening study to evaluate for renal artery stenosis. A nondiagnostic study from a renal artery duplex study can be frustrating and labor intensive, with diminished revenue for the vascular laboratory. The purpose of this study is to evaluate patient and environmental factors in predicting a limited study. Methods A retrospective chart review of patients who underwent a renal artery duplex study in an Intersocietal Commission for the Accreditation of Vascular Laboratories-accredited vascular laboratory from July 2005 through June 2008 was performed. Patient age, body mass index, technologist experience, and the patient location where imaging was performed (inpatient versus outpatient) were collected and evaluated. A univariate and multivariate analyses were performed by use of the continuous and proportional measures. A p value of less than 0.05 was considered significant. Results A total of 390 patients had a renal artery duplex performed during this time period. Of the 390 duplex studies that were performed, 66% (258/390) were considered complete studies. The average age of patients with complete studies was 62 ± 16 versus incomplete 62 ± 15 ( p = NS). In the univariate analysis, complete studies were more likely to be performed by experienced technicians ( p = 0.04), in an outpatient setting ( p < 0.001), in patients with a lower body mass index ( p = 0.01). In the multivariate analysis, only body mass index ( p = 0.01) and outpatient status ( p = 0.002) were found to be significant predictors of a complete study. Conclusions One-third of the renal artery duplex studies were limited in our retrospective review. Experience of the ultrasound technician, lower body mass index of the patient, and the outpatient setting for the study appear to play a crucial role in obtaining a complete study. A prospective analysis of the factors will be necessary to confirm these findings.