bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Relationship between Equatorial Mixed Rossby–Gravity and Eastward Inertio-Gravity Waves. Part II
Authors: Dias Juliana , Kiladis George N. 
Published: March 2016

Abstract
Space–time spectral analysis of tropical cloudiness data shows strong evidence that convectively coupled n = 0 mixed Rossby–gravity waves (MRGs) and eastward inertio-gravity waves (EIGs) occur primarily within the western/central Pacific Ocean. Spectral filtering also shows that MRG and EIG cloudiness patterns are antisymmetric with respect to the equator, and they propagate coherently toward the west and east, respectively, with periods between 3 and 5 days, in agreement with Matsuno’s linear shallow-water theory. In contrast to the spectral approach, in a companion paper it has been shown that empirical orthogonal functions (EOFs) of 2–6-day-filtered cloudiness data within the tropical Pacific Ocean also suggest an antisymmetric pattern, but with the leading EOFs implying a zonally standing but poleward-propagating oscillation, along with the associated tropospheric flow moving to the west. In the present paper, these two views are reconciled by applying an independent approach based on a tracking method to assess tropical convection organization. It is shown that, on average, two-thirds of MRG and EIG events develop independently of one another, and one-third of the events overlap in space and time. This analysis also verifies that MRG and EIG cloudiness fields tend to propagate meridionally away from the equator. It is demonstrated that the lack of zonal propagation implied from the EOF analysis is likely due to the interference between eastward- and westward-propagating disturbances. In addition, it is shown that the westward-propagating circulation associated with the leading EOF is consistent with the expected theoretical behavior of an interference between MRGs and EIGs.
Tropical Upper-Tropospheric Potential Vorticity Intrusions during Sudden Stratospheric Warmings
Authors: Albers John R. , Kiladis George N. , Birner Thomas , Dias Juliana 
Published: March 2016

Abstract
The intrusion of lower-stratospheric extratropical potential vorticity into the tropical upper troposphere in the weeks surrounding the occurrence of sudden stratospheric warmings (SSWs) is examined. The analysis reveals that SSW-related PV intrusions are significantly stronger, penetrate more deeply into the tropics, and exhibit distinct geographic distributions compared to their climatological counterparts. While climatological upper-tropospheric and lower-stratospheric (UTLS) PV intrusions are generally attributed to synoptic-scale Rossby wave breaking, it is found that SSW-related PV intrusions are governed by planetary-scale wave disturbances that deform the extratropical meridional PV gradient maximum equatorward. As these deformations unfold, planetary-scale wave breaking along the edge of the polar vortex extends deeply into the subtropical and tropical UTLS. In addition, the material PV deformations also reorganize the geographic structure of the UTLS waveguide, which alters where synoptic-scale waves break. In combination, these two intrusion mechanisms provide a robust explanation describing why displacement and split SSWs—or, more generally, anomalous stratospheric planetary wave events—produce intrusions with unique geographic distributions: displacement SSWs have a single PV intrusion maximum over the Pacific Ocean, while split SSWs have intrusion maxima over the Pacific and Indian Oceans. It is also shown that the two intrusion mechanisms involve distinct time scales of variability, and it is highlighted that they represent an instantaneous and direct link between the stratosphere and troposphere. This is in contrast to higher-latitude stratosphere–troposphere coupling that occurs indirectly via wave–mean flow feedbacks.
The Effect of Eddy–Eddy Interactions on Jet Formation and Macroturbulent Scales
Authors: Chemke Rei , Kaspi Yohai 
Published: March 2016

Abstract
The effect of eddy–eddy interactions on zonal and meridional macroturbulent scales is investigated over a wide range of eddy scales, using high-resolution idealized GCM simulations with and without eddy–eddy interactions. The wide range of eddy scales is achieved through systematic variation of the planetary rotation rate and thus multiple-jet planets. It is found that not only are eddy–eddy interactions not essential for the formation of jets, but the existence of eddy–eddy interactions decreases the number of eddy-driven jets in the atmosphere. The eddy–eddy interactions have little effect on the jet scale, which in both types of simulations coincides with the Rhines scale through all latitudes. The decrease in the number of jets in the presence of eddy–eddy interactions occurs because of the narrowing of the latitudinal region where zonal jets appear. This narrowing occurs because eddy–eddy interactions are mostly important at latitudes poleward of where the Rhines scale is equal to the Rossby deformation radius. Thus, once eddy–eddy interactions are removed, the conversion from baroclinic to barotropic eddy kinetic energy increases, and eddy–mean flow interactions intrude into these latitudes and maintain additional jets there. The eddy–eddy interactions are found to increase the energy-containing zonal scale so it coincides with the jets’ scale and thus make the flow more isotropic. While the conversion scale coincides with the most unstable scale, the Rossby deformation radius does not provide a good indication to these scales in both types of simulations.
Effects of Irrigation on Summer Precipitation over the United States
Authors: Pei Lisi , Moore Nathan , Zhong Shiyuan , Kendall Anthony D. , Gao Zhiqiu , Hyndman David W. 
Published: March 2016

Abstract
Irrigation’s effects on precipitation during an exceptionally dry summer (June–August 2012) in the United States were quantified by incorporating a novel dynamic irrigation scheme into the Weather Research and Forecasting (WRF) Model. The scheme is designed to represent a typical application strategy for farmlands across the conterminous United States (CONUS) and a satellite-derived irrigation map was incorporated into the WRF-Noah-Mosaic module to realistically trigger the irrigation. Results show that this new irrigation approach can dynamically generate irrigation water amounts that are in close agreement with the actual irrigation water amounts across the high plains (HP), where the prescribed scheme best matches real-world irrigation practices. Surface energy and water budgets have been substantially altered by irrigation, leading to modified large-scale atmospheric circulations. In the studied dry summer, irrigation was found to strengthen the dominant interior high pressure system over the southern and central United States and deepen the trough over the upper Midwest. For the HP and central United States, the rainfall amount is slightly reduced over irrigated areas, likely as a result of a reduction in both local convection and large-scale moisture convergence resulting from interactions and feedbacks between the land surface and atmosphere. In areas downwind of heavily irrigated regions, precipitation is enhanced, resulting in a 20%–100% reduction in the dry biases (relative to the observations) simulated over a large portion of the downwind areas without irrigation in the model. The introduction of irrigation reduces the overall mean biases and root-mean-square errors in the simulated daily precipitation over the CONUS.
Metal artifact reduction (MAR) based on two-compartment physical modeling: evaluation in patients with hip implants
Authors: Boos Johannes , Sawicki Lino Morris , Lanzman Rotem Shlomo , Thomas Christoph , Aissa Joel , Schleich Christoph , Heusch Philipp , Antoch Gerald , Kröpil Patric 
Published: March 2016

Background Artifacts from metallic implants can hinder image interpretation in computed tomography (CT). Image quality can be improved using metal artifact reduction (MAR) techniques. Purpose To evaluate the impact of a MAR algorithm on image quality of CT examinations in comparison to filtered back projection (FBP) in patients with hip prostheses. Material and Methods Twenty-two patients with 25 hip prostheses who underwent clinical abdominopelvic CT on a 64-row CT were included in this retrospective study. Axial images were reconstructed with FBP and five increasing MAR levels (M30–34). Objective artifact strength (OAS) (SIart-SInorm) was assessed by region of interest (ROI) measurements in position of the strongest artifact (SIart) and in an osseous structure without artifact (SInorm) (in Hounsfield units [HU]). Two independent readers evaluated subjective image quality regarding metallic hardware, delineation of bone, adjacent muscle, and pelvic organs on a 5-point scale (1, non-diagnostic; 5, excellent image quality). Artifacts in the near field, far field, and newly induced artifacts due to the MAR technique were analyzed. Results OAS values were: M34: 243.8 ± 155.4 HU; M33: 294.3 ± 197.8 HU; M32: 340.5 ± 210.1 HU; M31: 393.6 ± 225.2 HU; M30: 446.8 ± 224.2 HU and FBP: 528.9 ± 227.7 HU. OAS values were significantly lower for M32–34 compared to FBP ( P < 0.01). For overall subjective image quality, results were: FBP, 2.0 ± 0.2; M30, 2.3 ± 0.8; M31, 2.6 ± 0.5; M32, 3.0 ± 0.6; M33, 3.5 ± 0.6; and M34, 3.8 ± 0.4 ( P < 0.001 for M30–M34 vs. FBP, respectively). Increasing MAR levels resulted in new artifacts in 17% of reconstructions. Conclusion The investigated MAR algorithm led to a significant reduction of artifacts from metallic hip implants. The highest MAR level provided the least severe artifacts and the best overall image quality.
Occupational therapy roles and responsibilities: Evidence from a pilot study of time use in an integrated health and social care trust
Authors: Wilberforce Mark , Hughes Jane , Bowns Ian , Fillingham Joanne , Pryce Faye , Symonds Eileen , Paddock Katie , Challis David 
Published: March 2016

Introduction Occupational therapists undertake a broad spectrum of activities, yet no mechanism exists to record how working time is distributed across them. This is a hindrance to research, evaluation and evidence-based practice. Method A new diary schedule was piloted by 151 qualified and assistant-grade practitioners working in multiple adult health and social care settings in an integrated NHS and social care trust in England. Time use relating to 37 occupational therapy tasks was recorded in 30 minute intervals for one week. Results Almost 5000 hours of activity were recorded. For the average working week, 39% of time was spent in direct care with clients, 31% involved undertaking indirect casework such as liaison and administration, whilst a further 22% was in team/service activity. Only modest differences were observed between qualified and assistant-grade respondents, whilst occupational therapists in traditional social care roles spent significantly longer in liaison and administrative duties. Individual tasks capturing ‘therapeutic activity’ accounted for just 10% of practitioner time. Conclusion The new diary tool is a viable data collection instrument to evaluate practice and the impact of service redesign. However, further work is needed to evaluate its measurement properties in more detail.
Effectiveness of preventive and treatment interventions for primary headaches in the workplace: A systematic review of the literature
Authors: Lardon Arnaud , Girard Marie-Pier , Zaïm Chérine , Lemeunier Nadège , Descarreaux Martin , Marchand Andrée-Anne 
Published: March 2016

Aim The purpose of this systematic literature review is to assess the benefits of workplace-based occupational therapies and interventions, including acute and preventive medication, on headache intensity and frequency, related disability as well as work-related outcomes. Methods A search of the literature was conducted in PubMed, MEDLINE, Cochrane library, CINAHL and Embase using terms related to headache, workplace and occupational health. The Cochrane Collaboration’s risk of bias assessment tool was used on individual studies to assess internal validity and the Grading of Recommendations Assessment, Development, and Evaluation system was applied to studies by clinical outcome and used to rate quality of evidence. Results Fifteen articles were included in the systematic review. None of them were classified as low risk of bias according to the Cochrane Collaboration’s tool for assessing risk of bias. This systematic review found preliminary low-quality evidence suggesting that exercise and acupuncture can reduce workers’ headache pain intensity, frequency and related disability. Conclusion Although this systematic review provided preliminary low evidence in favour of work-based intervention, studies with more rigorous designs and methodologies are needed to provide further evidence of the effectiveness of workplace-based headache management strategies.
Community pharmacy rapid influenza A and B screening
Authors: Papastergiou John , Folkins Chris , Li Wilson , Young Leslie 
Published: March 2016

Objective: To investigate the impact and feasibility of community pharmacist-directed influenza screening and to evaluate the proportion of influenza-positive cases that resulted in the initiation of antiviral therapy by pharmacists. Methods: Patients aged 5 and older with symptoms suggestive of influenza were recruited at 2 Shoppers Drug Mart locations in Toronto, Ontario, from December 12, 2014, to February 4, 2015. Nasal swabs were collected by pharmacists and screened using the BD Veritor system for Rapid Detection of Flu A+B. Positive tests for influenza were reported to patients’ physicians and recommendations for antiviral therapy were made when indicated. Supportive care recommendations and telephone follow-up within 48 hours of assessment were provided to all patients. Results: A total of 59 patients participated in the influenza screening program. Sixty-one percent of patients were at high risk for influenza-related complications, while 15% had more than one risk factor. Thirty-four percent of patients screened positive for influenza, of which 100% were influenza A. Of the patients who screened positive, a prescription for oseltamivir was obtained in 40% of cases. The majority of prescriptions were provided directly to the pharmacy (63%), while the balance was provided after the patients underwent medical examination at the request of their physicians (37%). The pharmacy team offered supportive care to all patients for symptom management. Over-the-counter pharmacotherapy was provided to 85% of patients. Conclusion: These results highlight the readiness of community pharmacists to participate in the management of patients with influenza and their ability to implement screening into pharmacy workflow. Community pharmacy–based influenza screening may facilitate prompt access to pharmacologic treatment for patients with influenza, as well as decrease burden on the health care system by redirecting influenza-negative patients from physicians’ offices and hospitals. Timely physician communication remains a barrier to access to treatment, suggesting a potential key role for advanced pharmacist prescribing. Can Pharm J (Ott) 2016;149:83-89.
Economic Evaluation Plan (EEP) for A Very Early Rehabilitation Trial (AVERT): An international trial to compare the costs and cost-effectiveness of commencing out of bed standing and walking training (very early mobilization) within 24 h of stroke onset with usual stroke unit care
Authors: Sheppard Lauren , Dewey Helen , Bernhardt Julie , Collier Janice M , Ellery Fiona , Churilov Leonid , Tay-Teo Kiu , Wu Olivia , Moodie Marj ,   on behalf of The AVERT Trial Collaboration Group
Published: March 2016

Rationale A key objective of A Very Early Rehabilitation Trial is to determine if the intervention, very early mobilisation following stroke, is cost-effective. Resource use data were collected to enable an economic evaluation to be undertaken and a plan for the main economic analyses was written prior to the completion of follow up data collection. Aim and hypothesis To report methods used to collect resource use data, pre-specify the main economic evaluation analyses and report other intended exploratory analyses of resource use data. Sample size estimates Recruitment to the trial has been completed. A total of 2,104 participants from 56 stroke units across three geographic regions participated in the trial. Methods and design Resource use data were collected prospectively alongside the trial using standardised tools. The primary economic evaluation method is a cost-effectiveness analysis to compare resource use over 12 months with health outcomes of the intervention measured against a usual care comparator. A cost-utility analysis is also intended. Study outcome The primary outcome in the cost-effectiveness analysis will be favourable outcome (modified Rankin Scale score 0-2) at 12 months. Cost-utility analysis will use health-related quality of life, reported as quality-adjusted life years gained over a 12 month period, as measured by the modified Rankin Scale and the Assessment of Quality of Life. Discussion Outcomes of the economic evaluation analysis will inform the cost-effectiveness of very early mobilisation following stroke when compared to usual care. The exploratory analysis will report patterns of resource use in the first year following stroke.
Orthogeriatric Service Reduces Mortality in Patients With Hip Fracture
Authors: Stenqvist Charlotte , Madsen Christian Medom , Riis Troels , Jørgensen Henrik Løvendahl , Duus Benn Rønnow , Lauritzen Jes Bruun , van der Mark Susanne 
Published: March 2016

Introduction: Orthogeriatric service has been shown to improve outcomes in patients with hip fracture. The purpose of this study is to evaluate the effect of orthogeriatrics at Bispebjerg University Hospital, Denmark. The primary outcome is mortality inhospital and after 1, 3, and 12 months for patients with hip fracture. The secondary outcome is mortality for home dwellers and nursing home inhabitants. Materials and Methods: This is a retrospective clinical cohort study with an historic control group including all patients with hip fracture admitted from 2007 to 2011. Patients with hip fracture are registered in a local database, and data are retrieved retrospectively using the Danish Civil Registration Number. Results: We included 993 patients in the intervention group and 989 patients in the control group. A univariate analysis showed only significantly decreased mortality inhospital 6.3% vs 3.1% ( P = .009) after orthogeriatrics. However, when adjusting for age, gender, and American Society of Anaesthesiologists (ASA) score in a multivariate analysis, including all patients with hip fracture, we find significantly reduced mortality inhospital (odds ratio [OR] 0.35), after 30 [OR 0.66] and 90 days [OR 0.72] and 1 year [OR 0.79]). When using a univariate analysis for home-dwelling patients, we found significantly reduced mortality inhospital (8.3-2.0%, P < .0001), after 30 days (12.2-6.8%, P = .004) and 90 days (20.5-13.0%, P = .002). One-year mortality was not significant. Patients from nursing homes had no significant decreasing mortality at any point of time in the univariate analysis. Conclusion: We have shown significant decreases for inhospital, 30 day, 90 day, and 1-year mortality after implementation of orthogeriatric service at Bispebjerg Hospital when adjusting for age, gender, and ASA score. Future trials should include frail patients with other fracture types who can benefit from orthogeriatrics.
20 year Outcomes and Risks of Re-Injury in Patients with Multiple ACL Ruptures
Authors: Roe Justin , Ahmed Isaac , Salmon Lucy , Pinczewski Leo 
Published: March 2016

Objectives: Long term clinical outcomes following modern anterior cruciate ligament (ACL) reconstruction are well established and reported in the literature. Despite this very little is known about the long term outcomes of patients who go on to suffer multiple ACL ruptures and the factors that remain a persistent influence on further re ruptures and contralateral ACL injuries Methods: We identified 36 patients (20 males and 16 females, mean age at time of primary ACL reconstruction 21.6 years) who had a further ACL rupture from a consecutive series of 200 patients who underwent primary ACL reconstruction with hamstring tendon autografts with titanium interference screws between 1993 and 1996. Patients were reviewed prospectively at 1, 2, 7, 15 and 20 years after their original ACL reconstruction. Primary outcome measures were the number of ACL ruptures (including contralateral ruptures) and subsequent revision procedures following primary ACL reconstruction. Posterior tibial slope was assessed on lateral radiographs. Functional and radiological outcomes, assessed using the International Knee Documentation Committee (IKDC) score were compared with an age and sex matched cohort of patients who underwent primary ACL reconstruction. Results: At a median follow up of 19 years (range 14.3 to 20.2 years) 29 patients had undergone revision surgery and 11 patients had sustained 3 or more ACL ruptures (range 3 to 6). The mean age at the time of revision ACL reconstruction was 26.4 years (range 14 to 54 years). The mean posterior tibial slope of those who sustained 3 or more ACL injuries was 12.4, compared to a mean of 9.5 for those who sustained 2 ACL ruptures (p=0.002) and a mean of 8.5 in the control group (p=0.01). There was a significant difference (p=0.003) in the mean IKDC score for those patients who underwent revision surgery (84 points +/- SD 13) compared to an age and sex matched cohort of patients (control group) who had a primary ACL reconstruction (94 points +/- SD 9). Radiological degenerative change was seen in 64% of the revision group compared to 35% of patients within the control group (p=0.015). Conclusion: The causes of a further ACL injury are likely to be multifactorial but increased PTS appears to have a significant association with those patients who suffer recurrent ACL injuries. These patients have poorer functional and radiological outcomes when compared to an age and sex matched cohort of patients undergoing primary reconstruction.