bluuebunny/crossref_metadata_2025_split huggingface dataset:
Late Twenty-First-Century Changes in the Midlatitude Atmospheric Circulation in the CESM Large Ensemble
Authors: Peings Y. , Cattiaux J. , Vavrus S. , Magnusdottir Gudrun 
Published: May 2017

AbstractProjected changes in the midlatitude atmospheric circulation at the end of the twenty-first century are investigated using coupled ocean–atmosphere simulations from the Community Earth System Model Large Ensemble (CESM-LENS). Different metrics are used to describe the response of the midlatitude atmospheric dynamics in 40 ensemble members covering the 1920–2100 period. Contrasted responses are identified depending on the season and longitudinal sector that are considered. In winter, a slowdown of the zonal flow and an increase in waviness is found over North America, while the European sector exhibits a reinforced westerly flow and decreased waviness. Extreme temperature events in midlatitudes are more sensitive to thermodynamical than dynamical changes, and a general decrease in the intensity of wintertime cold spells is found. Analyses of individual ensemble members reveal a large spread in circulation changes due to internal variability. Causes for this spread are found to be tied to the Arctic amplification in the Pacific–North American sector and to the polar stratosphere in the North Atlantic. A competition mechanism is also discussed between the midlatitude response to polar versus tropical changes. While the upper-tropospheric tropical warming pushes the jet stream poleward, in winter, Arctic amplification and the weaker polar vortex exert an opposite effect. This competition results in a narrowing of the jet path in the midlatitudes, leading to decreased/unchanged waviness/blockings. This interpretation somewhat reconciles conflicting results between the hypothesized effect of Arctic amplification and projected changes in midlatitude flow characteristics. This study also illustrates that further understanding of regional processes is critical for anticipating changes in the midlatitude dynamics.
Evolution of Mesoscale Convective System Organizational Structure and Convective Line Propagation
Authors: Bodine David J. , Rasmussen Kristen L. 
Published: May 2017

AbstractThis study examines organizational changes and periods of rapid forward propagation in an MCS on 6 July 2015 in South Dakota. The MCS case was the focus of a Plains Elevated Convection at Night (PECAN) IOP. Data from the Sioux Falls WSR-88D and a high-resolution WRF simulation are analyzed to examine two periods of rapid forward propagation (or surges) and organizational changes. During the first surge (surge A), the northern portion of the convective line propagates eastward faster than the southern portion, and the northern portion of the leading line transitions from a single convective core to a multicellular structure as it merges with convection initiation. Radar reflectivity factor Z and graupel concentrations decrease above the melting layer, while at lower altitudes Z increases. The MCS cold pool also intensifies and deepens beneath an expanded region of high rainwater content and subsaturated air. Throughout surge A, a mesoscale circulation with strong rear-to-front near-surface flow and front-to-rear midlevel flow is also evident. By the end of surge A, the leading edge of the MCS cold pool is beneath developing convection initiation ahead of the original convective line while the original convective updraft weakened and moved rearward. This MCS evolution is similar to discrete propagation events discussed in past studies, except with new convection developing along an intersecting convective band. During surge B, the MCS transitions from a multicellular structure to a single, intense updraft. Smaller microphysical and thermodynamic changes are observed within the MCS during surge B compared to surge A, and the mesoscale circulation continues to develop.
A 5-yr Climatology of Severe Convective Wind Events over China
Authors: Yang Xinlin , Sun Jianhua , Zheng Yongguang 
Published: May 2017

Abstract
A method using cloud-to-ground lightning was developed to retrieve severe convective wind (SCW) events from significant weather report data over China during the period 2010–14. The results showed that SCW events were a feature of local weather activity, and their distribution showed clear seasonal and diurnal variations. The SCW events mainly occurred over eastern China during the midafternoon in the warm season and rarely occurred over western China. The highest frequency of SCW events was recorded in north China and Guangdong Province. There was also a high frequency of SCW events in the middle and lower reaches of the Yangtze River. The most frequent occurrence of SCW events was in Guangdong Province in spring, while a high frequency of SCW events was observed in both north China and Guangdong Province during the summer months. The peak month for SCW events was July over the whole of China and June in north China. The pattern in Guangdong Province had a bimodal distribution, with the peak months being May and August. The majority of SCW events occurred between 1200 and 2000 local time.
An Evaluation of WRF Rainfall Forecasts in Taiwan during Three Mei-Yu Seasons from 2008 to 2010
Authors: Wang Chung-Chieh , Chien Fang-Ching , Paul Sahana , Lee Dong-In , Chuang Pi-Yu 
Published: May 2017

Abstract
The performance of the Weather Research and Forecasting (WRF) Model in quantitative precipitation forecasts (QPFs) across Taiwan during three mei-yu seasons between 2008 and 2010 is evaluated using observations from about 400 rain gauges. The QPFs, spanning a range of 12–36 h and run for two nested domains at grid sizes of 15 and 5 km, are verified. Both visual and statistical-based verification methods are used to provide complementary results. More emphasis is placed on intraseasonal variation and the diurnal cycle of mei-yu rainfall, as these aspects have been less well explored previously. While the categorical statistics indicate skill levels comparable to past studies, the model performs better for frontal rainfall in May than monsoon rainfall in June. The two WRF domains are found to capture the overall rainfall amount, its general spatial pattern, the increased rain from May to June, and the basic diurnal cycle to a reasonable extent. However, both domains exhibit a persistent eastward shift in rainfall areas throughout the season, from the upwind slope to near the ridge, mainly because of excessive daytime rainfall over the mountains that starts and ends too early (more so in June), combined with insufficient rainfall upstream (in plains and slopes) since the morning. Also, the 15-km domain has total rainfall amounts closer to the observations, but the 5-km domain suffers a larger underforecast with rainfall only at the resolvable scale. Despite this, the finer mesh is more capable of predicting the peak values and local variations in rainfall and, thus, has the same skill with higher hit percentages, especially toward the high thresholds.
Communication skills in the training of psychiatrists: A systematic review of current approaches
Authors: Ditton-Phare Philippa , Loughland Carmel , Duvivier Robbert , Kelly Brian 
Published: May 2017

Objectives: A range of communication skills training programmes have been developed targeting trainees in various medical specialties, predominantly in oncology but to a lesser extent in psychiatry. Effective communication is fundamental to the assessment and treatment of psychiatric conditions, but there has been less attention to this in clinical practice for psychiatrists in training. This review examines the outcomes of communication skills training interventions in psychiatric specialty training. Methods: The published English-language literature was examined using multiple online databases, grey literature and hand searches. The review was conducted and reported using Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Studies examining the efficacy of communication skills training were included. Randomised controlled trials, pseudo-randomised studies and quasi-experimental studies, as well as observational analytical studies and qualitative studies that met criteria, were selected and critically appraised. No limits were applied for date of publication up until 16 July 2016. Results: Total search results yielded 2574 records. Of these, 12 studies were identified and reviewed. Two were randomised controlled trials and the remaining 10 were one-group pretest/posttest designs or posttest-only designs, including self-report evaluations of communication skills training and objective evaluations of trainee skills. There were no studies with outcomes related to behaviour change or patient outcomes. Two randomised controlled trials reported an improvement in clinician empathy and psychotherapeutic interviewing skills due to specific training protocols focused on those areas. Non-randomised studies showed varying levels of skills gains and self-reported trainee satisfaction ratings with programmes, with the intervention being some form of communication skills training. Conclusion: The heterogeneity of communication skills training is a barrier to evaluating the efficacy of different communication skills training programmes. Further validation studies examining specific models and frameworks would support a stronger evidence base for communication skills training in psychiatry. It remains a challenge to develop research to investigate behaviour change over time in clinical practice or to measure patient outcomes due to the effects of communication skills training.
Early and Late Recurrent Epistaxis Admissions: Patterns of Incidence and Risk Factors
Authors: Cohen Oded , Shoffel‐Havakuk Hagit , Warman Meir , Tzelnick Sharon , Haimovich Yaara , Kohlberg Gavriel D. , Halperin Doron , Lahav Yonatan 
Published: May 2017

ObjectiveEpistaxis is a common complaint, yet few studies have focused on the incidence and risk factors of recurrent epistaxis. Our objective was to determine the patterns of incidence and risk factors for recurrent epistaxis admission (REA).Study DesignCase series with chart review.SettingsSingle academic center.Subjects and MethodsThe medical records of patients admitted for epistaxis between 1999 and 2015 were reviewed. The follow‐up period was defined as 3 years following initial admission. REAs were categorized as early (30 days) and late (31 days to 3 years) following initial admission. Logistic regression was used to identify potential predictors of REAs.ResultsA total of 653 patients were included. Eighty‐six patients (14%) had REAs: 48 (7.5%) early and 38 (6.5%) late. Nonlinear incidence curve was demonstrated for both early and late REAs. Based on logistic regression, prior nasal surgery and anemia were independent risk factors for early REAs. According to multivariate analysis, thrombocytopenia was significantly associated with late REAs.ConclusionEarly and late REAs demonstrate different risk predictors. Knowledge of such risk factors may help in risk stratification for this selected group of patients. All patients at risk should be advised on possible preventive measures. Patients at risk for early REA may benefit from a more proactive approach.
Declining Otolaryngology Resident Training Experience in Tracheostomies: Case Log Trends from 2005 to 2015
Authors: Lesko David , Showmaker Jason , Ukatu Ceisha , Wu Qiwei , Chang C. W. David 
Published: May 2017

ObjectiveTo evaluate recent tracheostomy surgical experience among otolaryngology residents and general surgery residents.Study DesignRetrospective database review.SettingAccreditation Council for Graduate Medical Education otolaryngology and general surgery programs.Subjects and MethodsAccreditation Council for Graduate Medical Education case log data from 2005 to 2015 for resident graduates in otolaryngology and general surgery were used to obtain mean graduate tracheostomy numbers, mean graduate composite case numbers, and number of graduating residents. Market share for each specialty was estimated through the derived metric of nationwide total tracheostomy graduate experience, calculated by multiplying the number of graduating residents by the mean number of graduate tracheostomies. Linear regression analysis was used to calculate trends. Multiple linear regression analysis was used for pairwise comparison of trends.ResultsFrom 2005 to 2015, mean graduate tracheostomy numbers for otolaryngology residents declined 2.3% per year, while those for general surgery residents increased 1.8% per year. Accounting for changes in number of resident graduates, market share of tracheostomy decreased 1.0% per year for otolaryngology and increased 3.0% per year for general surgery. Mean graduate composite case numbers increased significantly by 1.8% and 1.0% per year for otolaryngology and general surgery residents, respectively.ConclusionTracheostomy case volume in otolaryngology residency has decreased steadily in comparison with general surgery residency. However, current otolaryngology graduates have more experience in tracheostomy when compared with general surgery graduates. While otolaryngology residents have excellent exposure to tracheostomy, otolaryngology programs should be made aware of this declining trend as well as changing procedural trends, which may affect training needs.
What Drives Reticence? Reporting Bias from Monopolies and Distrustful Firm Managers
Authors: Malomo Fola 
Published: May 2017

This article examines the determinants of underreporting (reticence) on randomized response questions. A simple model is created to describe the interview process and draw some conclusion as to why people might misreport their true status despite given the assurance of institutional and statistical confidentiality. By looking at the relationship between firm-specific reticence and other firm-specific and industry-location-specific variables, it is found that (mis)trust (proxied by the proportion of contracts arranged before delivery) is a significant predictor of reticence. Underreporting does not seem to be significantly related to a misunderstanding of the procedure, education, profit levels or guilt. This seems to suggest that firms which are more cautious in their business dealings are also more cautious with the randomized response (RR) technique. In such cases, weighted estimates of the prevalence of sensitive traits might be derived without the use of the RR technique but through the use of variables relating to the nature of firm-level contracts. Moreover, more accurate data on sensitive topics can be extracted from large homogeneous populations. JEL: C81, C83, D81
Risk Factors and Time to Recurrent Ipsilateral and Contralateral Patellar Dislocations
Authors: Christensen Tyson C. , Sanders Thomas L. , Pareek Ayoosh , Mohan Rohith , Dahm Diane L. , Krych Aaron J. 
Published: May 2017

Background: Previous studies have reported variable rates of recurrent lateral patellar instability mainly because of limited cohort sizes. In addition, there is currently a lack of information on contralateral patellar instability. Purpose: To evaluate the rate of recurrent ipsilateral patellar dislocations and contralateral patellar dislocations after a first-time lateral patellar dislocation. Additionally, risk factors associated with recurrent dislocations (ipsilateral or contralateral) and time to recurrence were investigated. Study Design: Cohort study; Level of evidence, 3. Methods: This population-based study included 584 patients with a first-time lateral patellar dislocation occurring between 1990 and 2010. A retrospective review was conducted to gather information about the injury, subsequent dislocations (ipsilateral or contralateral), and structural characteristics including trochlear dysplasia, patella alta, and tibial tubercle to trochlear groove (TT-TG) distance. Risk factors were assessed to delineate associations with subsequent dislocations and time to recurrence. Results: At a mean follow-up of 12.4 years, 173 patients had ipsilateral recurrence, and 25 patients had a subsequent contralateral dislocation. At 20 years, the cumulative incidence of ipsilateral recurrence was 36.0%, while the cumulative incidence of contralateral dislocations was 5.4%. Trochlear dysplasia (odds ratio [OR], 18.1), patella alta (OR, 10.4), age <18 years at the time of the first dislocation (OR, 2.4), elevated TT-TG distance (OR, 2.1), and female sex (OR, 1.5) were associated with recurrent ipsilateral dislocations. Time to recurrence was significantly decreased in patients with trochlear dysplasia (23.0 months earlier time to recurrence; P < .001), elevated TT-TG distance (18.5 months; P < .001), patella alta (16.4 months; P = .001), and age <18 years at the time of the first dislocation (15.4 months; P < .001). Risk factors for subsequent contralateral dislocations included patella alta and trochlear dysplasia. Conclusion: At 20 years after a first-time lateral patellar dislocation, the cumulative incidence of recurrent ipsilateral patellar dislocations was 36.0%, compared with 5.4% for contralateral dislocations. Trochlear dysplasia, elevated TT-TG distance, patella alta, age <18 years at the time of the first dislocation, and female sex were associated with ipsilateral recurrence. Trochlear dysplasia, elevated TT-TG distance, patella alta, and age <18 years at the time of the first dislocation were predictive of a statistically significant decrease in time to recurrence.
A Dedicated Neurological Intensive Care Unit Offers Improved Outcomes for Patients With Brain and Spine Injuries
Authors: Jeong Jin-Heon , Bang JaeSeung , Jeong WonJoo , Yum KyuSun , Chang JunYoung , Hong Jeong-Ho , Lee Kiwon , Han Moon-Ku 
Published: May 2017

Background: Admission to an intensive care unit (ICU) specialized for brain and spine injury patients is associated with improved outcome. We investigated the effects of the first dedicated, combined neurological and neurosurgical ICU (NeuroICU) in Korea on patient outcomes. Methods: The first dedicated NeuroICU in Korea was established in March 2013. We retrospectively analyzed the clinical data and compared the outcomes between patients admitted to the ICU before and after NeuroICU establishment. The predicted mortality of NeuroICU patients was calculated using their Acute Physiology and Chronic Health Evaluation II scores. Patients’ functional outcomes were evaluated using their modified Rankin scale (mRS) scores at 6 months after ICU admission, which were obtained from medical records or telephone interviews. Results: We included 2487 patients, 1572 and 915 of whom were admitted prior to and after NeuroICU establishment, respectively. The demographic characteristics, Glasgow Coma Scale scores, and disease proportions did not differ significantly between the groups. The length of ICU stay and the number of days on ventilation were significantly lower in NeuroICU patients than they were in general ICU patients ( P = .024, P = .001). Intensive care unit mortality was significantly lower in NeuroICU patients (7.3% vs 4.7%, P = .012). The predicted mortality was obtained from 473 NeuroICU patients. The mortality ratio (observed mortality/predicted mortality) was 0.34 (8.9%/26.1%), and 228 (48.1%) patients showed good functional recovery (mRS, 0-2). Conclusion: Our findings suggest that admission to a dedicated NeuroICU significantly improves the neurological outcomes of patients with brain and spine injuries, including their postoperative care, in Korea.
A Randomized Controlled Trial of the Effects of Mindfulness-Based Stress Reduction (MBSR[BC]) on Levels of Inflammatory Biomarkers Among Recovering Breast Cancer Survivors
Authors: Reich Richard R. , Lengacher Cecile A. , Klein Thomas W. , Newton Cathy , Shivers Steve , Ramesar Sophia , Alinat Carissa B. , Paterson Carly , Le Alice , Park Jong Y. , Johnson-Mallard Versie , Elias Maya , Moscoso Manolete , Goodman Matthew , Kip Kevin E. 
Published: May 2017

Purpose: The purpose of this substudy of a large randomized controlled trial was to evaluate the efficacy of the Mindfulness-Based Stress Reduction (Breast Cancer) (MBSR[BC]) program compared to usual care (UC) in normalizing blood levels of pro-inflammatory cytokines among breast cancer survivors (BCS). Method: A total of 322 BCS were randomized to either a 6-week MBSR(BC) program or a UC. At baseline and 6 and 12 weeks, 10 ml of venous blood and demographic and clinical data were collected and/or updated. Plasma cytokines (interleukin [IL]-1β, IL-6, IL-10, tumor necrosis factor [TNF] α, transforming growth factor [TGF] β1, soluble tumor necrosis factor receptor [sTNFR] 1) were assayed. Linear mixed models were used to assess cytokine levels across three time points (baseline and 6 and 12 weeks) by group (MBSR[BC] vs. UC). Results: Of the six measured cytokines, three were nondetectable at rates greater than 50% (IL-10, IL-1β, TGF-β1) and, because of overall low prevalence, were not analyzed further. For the remaining cytokines (TNFα, IL-6, sTNFR1), results showed that TNFα and IL-6 increased during the follow-up period (between 6 and 12 weeks) rather than during the MBSR(BC) training period (between baseline and 6 weeks), while sTNFR1 levels did not change significantly across the 12-week period. Conclusions: Study results suggest that MBSR(BC) affects cytokine levels in BCS, mainly with increases in TNFα and IL-6. The data further suggest that B-cell modulation may be a part of immune recovery during breast cancer management and that increases in TNFα and IL-6 may be markers for MBSR(BC)-related recovery.
Comparison of Online 6 Degree-of-Freedom Image Registration of Varian TrueBeam Cone-Beam CT and BrainLab ExacTrac X-Ray for Intracranial Radiosurgery
Authors: Li Jun , Shi Wenyin , Andrews David , Werner-Wasik Maria , Lu Bo , Yu Yan , Dicker Adam , Liu Haisong 
Published: May 2017

Purpose: The study was aimed to compare online 6 degree-of-freedom image registrations of TrueBeam cone-beam computed tomography and BrainLab ExacTrac X-ray imaging systems for intracranial radiosurgery. Methods: Phantom and patient studies were performed on a Varian TrueBeam STx linear accelerator (version 2.5), which is integrated with a BrainLab ExacTrac imaging system (version 6.1.1). The phantom study was based on a Rando head phantom and was designed to evaluate isocenter location dependence of the image registrations. Ten isocenters at various locations representing clinical treatment sites were selected in the phantom. Cone-beam computed tomography and ExacTrac X-ray images were taken when the phantom was located at each isocenter. The patient study included 34 patients. Cone-beam computed tomography and ExacTrac X-ray images were taken at each patient’s treatment position. The 6 degree-of-freedom image registrations were performed on cone-beam computed tomography and ExacTrac, and residual errors calculated from cone-beam computed tomography and ExacTrac were compared. Results: In the phantom study, the average residual error differences (absolute values) between cone-beam computed tomography and ExacTrac image registrations were 0.17 ± 0.11 mm, 0.36 ± 0.20 mm, and 0.25 ± 0.11 mm in the vertical, longitudinal, and lateral directions, respectively. The average residual error differences in the rotation, roll, and pitch were 0.34° ± 0.08°, 0.13° ± 0.09°, and 0.12° ± 0.10°, respectively. In the patient study, the average residual error differences in the vertical, longitudinal, and lateral directions were 0.20 ± 0.16 mm, 0.30 ± 0.18 mm, 0.21 ± 0.18 mm, respectively. The average residual error differences in the rotation, roll, and pitch were 0.40°± 0.16°, 0.17° ± 0.13°, and 0.20° ± 0.14°, respectively. Overall, the average residual error differences were <0.4 mm in the translational directions and <0.5° in the rotational directions. ExacTrac X-ray image registration is comparable to TrueBeam cone-beam computed tomography image registration in intracranial treatments.