bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variability of monsoon low‐level jet and associated rainfall over India
Authors: Viswanadhapalli Yesubabu , Dasari Hari Prasad , Dwivedi Sanjeev , Madineni Venkat Ratnam , Langodan Sabique , Hoteit Ibrahim 
Published: July 2019

AbstractThe structure and climatology of the monsoon low‐level jet (MLLJ) is studied based on dynamically downscaled simulations over a 37‐year period (1980–2016) using the Weather Research Forecasting (WRF) model. The simulations are conducted by adopting a continuous initialization method with daily re‐initializations using ERA‐Interim data as initial and boundary conditions. Validation of the downscaled fields with radiosonde data shows that the model has reasonable skill in reproducing MLLJ characteristics. Analysis of the simulations suggests that the MLLJ exhibits systematic diurnal variation: maximum winds of the synoptically induced large‐scale monsoon jet occur during the daytime, and the orographic channelled winds through the mountains of East Africa, Hejaz, and Western Ghats in the night‐time. These diurnal changes in monsoon winds modulate the moisture convergence process and the associated evolution of rainfall over India. Seasonal and monthly climatology of monsoon winds shows that the model accurately reproduces the spatial pattern of winds and slightly overestimates (2–3 m/s) the mean monthly winds over the Bay of Bengal and Arabian Seas. Analysis of wind variability and the trends using 37 years simulations suggests that the MLLJ exhibits an increasing trend in wind speed on both seasonal and monthly scales, except for August which shows a decreasing trend. The weakening of the MLLJ in August has a profound influence on the number of monsoon depressions forming over the Bay of Bengal (which are decreasing), and on the number of break days (which are increasing) and associated precipitation reduction over the central Indian region.
Comparing Outcomes of Women‐Only and Mixed‐Gender Intensive Posttraumatic Stress Disorder Treatment for Female Veterans
Authors: Stefanovics Elina A. , Rosenheck Robert A. 
Published: July 2019

AbstractAlthough most female veterans treated in specialized intensive Veterans Health Administration (VHA) posttraumatic stress disorder (PTSD) programs receive services in settings in which over 95% of participants are men, two programs include only women. Whether outcomes for women with PTSD are superior in women‐only programs has not been evaluated. National program evaluation data on 1,357 women veterans from 57 sites were collected at program entry and 4 months after discharge. With adjustment for differences in baseline characteristics, outcomes of women in two women‐only programs (n = 469) were compared with those from 55 mixed‐gender programs (n = 888), using mixed models with random effect for site. The primary outcome was total PTSD symptom level, with supplementary information on PTSD assessment subscales, substance use, and other outcomes. At program entry, female veterans in women‐only programs had lower scores on measures of total PTSD symptoms, p = .013, d = −0.24, and on several subscales. Adjusting for these differences, there were no significant differences between program types in terms of PTSD total score or scores on secondary measures. In women‐only programs, veterans had longer lengths of stay and were rated by their clinicians to have a higher level of commitment to therapy at discharge. Thus, women‐only programs did not show superior outcomes; however, compared to participants in mixed‐gender programs, those in women‐only programs had longer lengths of stay, higher levels of commitment to therapy, and were more likely to participate in posttreatment outcome assessments following discharge.
Predictive value of the ACS NSQIP calculator for head and neck reconstruction free tissue transfer
Authors: Tierney William , Shah Janki , Clancy Kate , Lee Maxwell Y. , Ciolek Peter J. , Fritz Michael A. , Lamarre Eric D. 
Published: July 2019

BackgroundPredictive models to forecast the likelihood of specific outcomes after surgical intervention allow informed shared decision‐making by surgeons and patients. Previous studies have suggested that existing general surgical risk calculators poorly forecast head and neck surgical outcomes. However, no large study has addressed this question while subdividing subjects by surgery performed.ObjectivesTo determine the accuracy of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Surgical Risk Calculator in estimating length of hospital stay and risk of postoperative complications after free tissue transfer surgery.Study DesignA retrospective chart review of patients at one institution was performed using Current Procedural Terminology codes for anterolateral thigh (ALT) flap, fibula free flap (FFF), and radial forearm free flap (RFFF) reconstruction. Output data from the ACS NSQIP surgical risk calculator were compared with the observed rates in our patients.MethodsIncidences of cardiac complications, pneumonia, venous thromboembolism, return to the operating room, and discharge to skilled nursing facility (SNF) were compared to predicted incidences. Length of stay was also compared to the predicted length of stay.ResultsThree hundred thirty‐six free flap reconstructions with 197 ALT flaps, 85 RFFFs, and 54 FFFFs were included. Brier scores were calculated using ACS NSQIP forecast and actual incidences. No Brier score was <0.01 for the entire sample or any subgroup, which indicates that the NSQIP risk calculator does not accurately forecast outcomes after free tissue reconstruction.ConclusionThe ACS NSQIP failed to accurately forecast postoperative outcomes after head and neck free flap reconstruction for the entire sample or subgroup analyses.Level of Evidence4Laryngoscope, 130:679–684, 2020
Awake thyroidectomy
Authors: Haugen Thorsen W. , Andera Luke N. , LaMadrid Archie B. 
Published: July 2019

ObjectiveIn this article, we present a series of 28 patients who underwent thyroid surgery using local anesthesia. We describe our technique, report outcomes, and assess how well the procedure was tolerated from a patient perspective.MethodsThree surgeons performed awake thyroidectomies and recorded data, including the patient's age and gender, surgery being performed, operative time, weight of the surgical specimen, quantity and type of local anesthetic used, additional medications, patient‐reported pain assessment, and any complications.ResultsTwenty‐seven of 28 patients (96%) successfully underwent awake thyroidectomy. One patient had to be converted to general anesthesia due to airway concerns. There were no complications; however, one patient had a panic attack. Based on a 0 to 10 scaled pain score, the average amount of pain reported was 3.4. The amount of pain the patient reported was significantly dependent on the amount of experience the operating surgeon had with this technique. Seventy‐one percent of patients tolerated surgery with local anesthesia only and did not require additional medications.ConclusionAwake thyroidectomy is a well‐tolerated and safe procedure in appropriately selected patients, with many potential benefits over general anesthesia. In most cases, only local anesthesia is required. Increased experience with this technique may be associated with increased patient comfort.Level of Evidence4Laryngoscope, 130:685–690, 2020
Injection laryngoplasty as adjunct treatment method for muscle tension dysphonia: Preliminary findings
Authors: Novakovic Daniel , Nguyen Duong Duy , Chacon Antonia , Madill Catherine 
Published: July 2019

ObjectivesThis study examined the effectiveness of injection laryngoplasty (IL) in muscle tension dysphonia (MTD) patients who did not fully respond to voice therapy. It was hypothesized that IL would improve voice quality and voice‐related quality of life measures in MTD.MethodsA retrospective review was conducted on 37 patients with a primary diagnosis of MTD who underwent IL following a suboptimal response to voice therapy (mean age = 43.0 years; standard deviation [SD] = 13.4; range = 23 to 71). Outcome measures included laryngoscopic signs of supraglottic constriction, Voice Handicap Index‐10 (VHI‐10) scores, maximal phonation time, vowel fundamental frequency (F0), standard deviation of F0 (F0SD), harmonics‐to‐noise ratio (HNR), and smoothed cepstral peak prominence. These were compared between baseline and within 3 months following the IL procedure.ResultsThere was significant decrease in supraglottic constriction. Mean (SD) of VHI‐10 scores decreased from 25.4 (5.7) at baseline to 15.3 (9.3) following IL. This improvement in VHI‐10 was observed in patients with and without baseline glottal insufficiency (GI). Mean (SD) of HNR (decibels) increased from 21.1 (5.4) at baseline to 22.8 (4.3) after IL. Only patients with GI demonstrated a significant improvement in HNR from baseline to post‐IL. No statistically significant differences in other acoustic measures were observed.ConclusionsIL resulted in positive changes in voice‐related quality of life in MTD patients with and without GI. Acoustically, only those with GI demonstrated an increase in HNR following IL. Further studies are needed to examine the effects of IL in MTD.Level of Evidence4 Laryngoscope, 130:980–985, 2020
Inducible laryngeal obstruction: Endoscopic quantitative analysis of glottic aperture
Authors: Henrique Peitl Gregorio Paulo , Teixeira Gomes Juliana , Rodrigues Roberto , Jacomelli Marcia , Samara Santos Ellen , Gervilla Gregorio Marcelo 
Published: July 2019

ObjectivesUsing a method developed for this study, the objective was to perform a quantitative analysis of glottic aperture during the respiratory cycle in subjects suspected of having inducible laryngeal obstruction (ILO) and to compare results to healthy individuals. Correlations between glottic aperture and spirometric parameters were assessed.MethodsSubjects with high clinical suspicion of ILO and atypical inspiratory findings in spirometry had the images of their laryngoscopy displayed alongside a respiratory flow chart and both were recorded simultaneously. This method allowed detailed analysis of the glottic aperture by measuring the angle of the anterior commissure during inspiration and expiration. Healthy volunteers who performed the same tests and agreed to provide data to this study were used as a control group.ResultsAll 15 subjects with ILO and 16 healthy participants were evaluated successfully using the proposed method. Measures of the anterior commissure angle in the ILO versus control group were significantly different in all observed parameters and just three ILO subjects had an anterior commissure closure greater than 50% during the respiratory cycle. Inspired volume (FIF50) and mid‐vital capacity ratio (FEF50/FIF50) had a significant correlation with glottic aperture parameters when considering the evaluation of the subjects all together.ConclusionThe proposed method provided precise and quantitative analysis of glottic aperture during the respiratory cycle thus indicating that the usage of equipment that allows for such assessment should be encouraged. Also, the threshold of vocal cords closure accepted as indicative of ILO should be reconsidered, especially during the intercritical period of the disease.Level of Evidence4Laryngoscope, 130:E349–E356, 2020
How Do I Assess Tremor Using Novel Technology?
Authors: Longardner Katherine , Undurraga Felipe Vial , Nahab Fatta B. , Hallett Mark , Haubenberger Dietrich 
Published: July 2019

AbstractTransducers are defined as any sensor that converts a physiological signal of tremor into an electrical signal. Evolving technologies have utilized transducers to develop devices for tremor measurement that are more convenient, accurate, and capable of continuous recording. Transducer‐based methods provide valuable diagnostic tools for the clinician that can distinguish between different tremor syndromes and differentiate tremor from other hyperkinetic movement disorders. Transducers are also used to objectively quantify and track tremor symptom severity over time and assess clinical response to intervention (e.g., pharmaceutical treatments or DBS). This video highlights the utility of transducer‐based methods in characterizing and quantifying tremor and reviews the available technologies for measuring tremor. We provide case examples that demonstrate how different technology‐based measures for tremor direct the approach to diagnosis and management of symptoms.
Revising rapid‐onset dystonia–parkinsonism: Broadening indications for ATP1A3 testing
Authors: Haq Ihtsham U. , Snively Beverly M. , Sweadner Kathleen J. , Suerken Cynthia K. , Cook Jared F. , Ozelius Laurie J. , Miller Charlotte , McCall William V. , Whitlow Christopher T. , Brashear Allison 
Published: July 2019

AbstractBackground and ObjectivesRapid‐onset dystonia–parkinsonism (RDP) is caused by mutations in the ATP1A3 gene, which codes for the α‐3 subunit of the Na+/K+ ATPase. It has been characterized by rapid‐onset bulbar dysfunction, limb dystonia, bradykinesia, and a rostrocaudal spatial gradient of expression, usually after a physiologic trigger. We reexamined whether these features were in fact characteristic.MethodsWe characterized phenotypic variation within a cohort of 50 ATP1A3 mutation‐positive individuals (carriers) and 44 mutation‐negative family members (noncarriers). Potential participants were gathered through referral for clinical suspicion of RDP or alternating hemiplegia of childhood. Inclusion criteria were having a ATP1A3 mutation or being a family member of such an individual.ResultsWe found RDP is underdiagnosed if only “characteristic” patients are tested. Rapid onset and bulbar predominance were not universally present in carriers. Among those with at least mild symptoms of dystonia, rostrocaudal severity gradient was rare (7%). Symptoms began focally but progressed to be generalized (51%) or multifocal (49%). Arm (41%) onset was most common. Arms and voice were typically most severely affected (48% and 44%, respectively). Triggers preceded onset in 77% of the participants. Rapid onset, dystonia, parkinsonism, bulbar symptoms, headaches, seizures, frontal impairment, and a history of mood disorder and a history of psychosis were more common in carriers. Approximately half of the proband mutations occurred de novo (56%).ConclusionsOur findings suggest that patients should not be excluded from ATP1A3 testing because of slow onset, limb onset, absent family history, or onset in middle adulthood. RDP should be strongly considered in the differential for any bulbar dystonia. © 2019 International Parkinson and Movement Disorder Society
Therapeutic strategies for targeting telomerase in cancer
Authors: Chen Xing , Tang Wen‐Jian , Shi Jing Bo , Liu Ming Ming , Liu Xin‐Hua 
Published: July 2019

AbstractTelomere and telomerase play important roles in abnormal cell proliferation, metastasis, stem cell maintenance, and immortalization in various cancers. Therefore, designing of drugs targeting telomerase and telomere is of great significance. Over the past two decades, considerable knowledge regarding telomere and telomerase has been accumulated, which provides theoretical support for the design of therapeutic strategies such as telomere elongation. Therefore, the development of telomere‐based therapies such as nucleoside analogs, non‐nucleoside small molecules, antisense technology, ribozymes, and dominant negative human telomerase reverse transcriptase are being prioritized for eradicating a majority of tumors. While the benefits of telomere‐based therapies are obvious, there is a need to address the limitations of various therapeutic strategies to improve the possibility of clinical applications. In this study, current knowledge of telomere and telomerase is discussed, and therapeutic strategies based on recent research are reviewed.
Sine‐cosine wavelet method for fractional oscillator equations
Authors: Saeed Amir , Saeed Umer 
Published: July 2019

PurposeIn this article, a novel computational method is introduced for solving the fractional nonlinear oscillator differential equations on the semi‐infinite domain. The purpose of the proposed method is to get better and more accurate results.Design/methodology/approachThe proposed method is the combination of the sine‐cosine wavelets and Picard technique. The operational matrices of fractional‐order integration for sine‐cosine wavelets are derived and constructed. Picard technique is used to convert the fractional nonlinear oscillator equations into a sequence of discrete fractional linear differential equations. Operational matrices of sine‐cosine wavelets are utilized to transformed the obtained sequence of discrete equations into the systems of algebraic equations and the solutions of algebraic systems lead to the solution of fractional nonlinear oscillator equations.FindingsThe convergence and supporting analysis of the method are investigated. The operational matrices contains many zero entries, which lead to the high efficiency of the method, and reasonable accuracy is achieved even with less number of collocation points. Our results are in good agreement with exact solutions and more accurate as compared with homotopy perturbation method, variational iteration method, and Adomian decomposition method.Originality/valueMany engineers can utilize the presented method for solving their nonlinear fractional models.
On calculating kerma, collision kerma and radiative yields
Authors: Rogers D. W. O. , Townson Reid W. 
Published: July 2019

PurposeTo study the relationships between dose (D), kerma (K), and collision kerma () in photon beams and to investigate total radiative yields for electrons and positrons as a function of energy. To do this accurately required calculating collision kerma directly as a function of position in a phantom and making changes to the EGSnrc package (including DOSRZnrc and g applications).MethodsChanges were made to the EGSnrc system to allow the user to distinguish events according to their initiating process, most importantly relaxation particles initiated by electron impact ionization as opposed to initiated by photons, especially those events depositing energy below energy cutoffs after relaxation events. Appropriate changes were made to the applications DOSRZnrc and g and a new application, DOSRZnrcKcol, was written.ResultsThe modified codes are much more robust against changes in simulation parameters such as ECUT and AE and whether or not electron impact ionization is included in the simulation. The radiative yields for electrons generally differ from values in ICRU Report 371 (1984) which only account for radiative losses due to bremsstrahlung. The Monte Carlo calculated g(brems) values are generally greater than the ICRU 37 values due to energy‐loss straggling. Plots of D, K and vs depth in megavoltage photon beams show that some “conventional wisdom” does not hold in general (e.g., D is not always greater than K past ) and in general at 10 cm depth it is found that D≈K and . The beam radius at which reaches its saturation value depends strongly on the threshold used to define reaching saturation and is generally greater than the radius for lateral charged particle equilibrium used in the TRS‐483 Code of Practice for small beam dosimetry2 (Palmans et al, Med Phys. 2018;45:e1123–e1145).ConclusionsThe changes to EGSnrc make kerma calculations more accurate but previous calculations with electron impact ionization turned off gave close to correct results. The application DOSRZnrcKcol makes calculating collision kerma more efficient and avoids various approximations used in the past although those approximations are shown to be justified. Including energy‐loss straggling when calculating bremsstrahlung radiation yield increases the value. Fluorescence losses and annihilation in flight further increase the radiation yield of electrons and positrons. Results demonstrate the effects of EGSnrc using electron bremsstrahlung production cross sections for positrons and failing to model positron impact ionization.
Ultrasound in the diagnosis and management of fibular mononeuropathy
Authors: Bucklan Julie N. , Morren John A. , Shook Steven J. 
Published: July 2019

AbstractIntroductionUltrasound (US) evaluation of peripheral nerves is a noninvasive, cost‐effective approach to diagnosing focal mononeuropathies and guiding surgical management. We used the intranerve ratio to evaluate for possible cut‐off values in diagnosis of fibular mononeuropathies (FNs).MethodsA retrospective analysis of FN confirmed by electrodiagnosis (EDx) was performed to identify intranerve ratio values between affected and unaffected limbs at the fibular head and popliteal fossa.ResultsThe optimal fibular head/popliteal fossa intranerve ratio to discriminate between limbs with and without disease was 1.25 (sensitivity, 51%; specificity, 71%). There was no statistically significant difference between affected vs unaffected limbs (ratio, 1.13; P = .15) nor in subgroup analyses. However, 25% of patients had structural lesions amenable to surgery.DiscussionThe utility of US in diagnosis of FN is limited using intranerve ratio data, but US has a distinct advantage over EDx for identifying treatable structural lesions.
One‐year results with selective bladder denervation in women with refractory overactive bladder
Authors: Rovner Eric S. , Versi Eboo , Le Mai Tu , Dmochowski Roger R. , De Wachter Stefan 
Published: July 2019

AbstractAims: To report 1‐year results with selective bladder denervation (SBD) of the trigone in women with refractory overactive bladder (OAB).Methods: In this prospective, international, multicenter case series, women with refractory OAB underwent a single SBD treatment of the bladder subtrigone region using temperature‐controlled radiofrequency. Patients were followed for 1 year and evaluated for changes in OAB symptoms and adverse events.Results: Among 35 women, 29 (83%) returned for 1‐year follow up. Median symptom reductions based on 3‐day bladder diaries were 68% for urgency urinary incontinence (
P < .001), 67% for urinary incontinence (
P < .001), 43% for urgency episodes (
P < .001), 5% for urinary frequency (
P = .19), and 33% for the total urgency and frequency score (
P < .001), with the majority of treatment benefit realized in the first month. Treatment benefit was reported in 72% of patients, the clinical success rate (≥50% reduction in urgency urinary incontinence) was 69%, and the dry rate was 10%. Statistically significant improvements occurred on Symptom Bother and Health‐related Quality of Life scales on the Overactive Bladder questionnaire, and on 6 of 9 King's Health Questionnaire domains. Patients with less severe baseline symptoms had similar quality of life improvements as those with more severe baseline symptoms. Device‐ or procedure‐related adverse events were reported in 6 (17%) patients.Conclusions: A single treatment with selective bladder denervation is durable for 1‐year in a significant proportion of women with refractory overactive bladder.