bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Influence of Climate Model Biases on Projections of Aridity and Drought
Authors: Ficklin Darren L. , Abatzoglou John T. , Robeson Scott M. , Dufficy Anna 
Published: December 2015

Abstract
Global climate models (GCMs) have biases when simulating historical climate conditions, which in turn have implications for estimating the hydrological impacts of climate change. This study examines the differences in projected changes of aridity [defined as the ratio of precipitation (P) over potential evapotranspiration (PET), or P/PET] and the Palmer drought severity index (PDSI) between raw and bias-corrected GCM output for the continental United States (CONUS). For historical simulations (1950–79) the raw GCM ensemble median has a positive precipitation bias (+24%) and negative PET bias (−7%) compared to the bias-corrected output when averaged over CONUS with the most acute biases over the interior western United States. While both raw and bias-corrected GCM ensembles project more aridity (lower P/PET) for CONUS in the late twenty-first century (2070–99), relative enhancements in aridity were found for bias-corrected data compared to the raw GCM ensemble owing to positive precipitation and negative PET biases in the raw GCM ensemble. However, the bias-corrected GCM ensemble projects less acute decreases in summer PDSI for the southwestern United States compared to the raw GCM ensemble (from 1 to 2 PDSI units higher), stemming from biases in precipitation amount and seasonality in the raw GCM ensemble. Compared to the raw GCM ensemble, bias-corrected GCM inputs not only correct for systematic errors but also can produce high-resolution projections that are useful for impact analyses. Therefore, changes in hydroclimate metrics often appear considerably different in bias-corrected output compared to raw GCM output.
An Airborne and Ground-Based Study of a Long-Lived and Intense Atmospheric River with Mesoscale Frontal Waves Impacting California during CalWater-2014
Authors: Neiman Paul J. , Moore Benjamin J. , White Allen B. , Wick Gary A. , Aikins Joshua , Jackson Darren L. , Spackman J. Ryan , Ralph F. Martin 
Published: December 2015

Abstract
The wettest period during the CalWater-2014 winter field campaign occurred with a long-lived, intense atmospheric river (AR) that impacted California on 7–10 February. The AR was maintained in conjunction with the development and propagation of three successive mesoscale frontal waves. Based on Lagrangian trajectory analysis, moist air of tropical origin was tapped by the AR and was subsequently transported into California. Widespread heavy precipitation (200–400 mm) fell across the coastal mountain ranges northwest of San Francisco and across the northern Sierra Nevada, although only modest flooding ensued due to anomalously dry antecedent conditions. A NOAA G-IV aircraft flew through two of the frontal waves in the AR environment offshore during a ~24-h period. Parallel dropsonde curtains documented key three-dimensional thermodynamic and kinematic characteristics across the AR and the frontal waves prior to landfall. The AR characteristics varied, depending on the location of the cross section through the frontal waves. A newly implemented tail-mounted Doppler radar on the G-IV simultaneously captured coherent precipitation features. Along the coast, a 449-MHz wind profiler and collocated global positioning system (GPS) receiver documented prolonged AR conditions linked to the propagation of the three frontal waves and highlighted the orographic character of the coastal-mountain rainfall with the waves’ landfall. A vertically pointing S-PROF radar in the coastal mountains provided detailed information on the bulk microphysical characteristics of the rainfall. Farther inland, a pair of 915-MHz wind profilers and GPS receivers quantified the orographic precipitation forcing as the AR ascended the Sierra Nevada, and as the terrain-induced Sierra barrier jet ascended the northern terminus of California’s Central Valley.
Epoxy nanocomposites with carbon nanotubes and montmorillonite: Mechanical properties and electrical insulation
Authors: Zhang Mingyan , Zhai Zhaohui , Li Mingchuan , Cheng Tonglei , Wang Chen , Jiang Dawei , Chen Lei , Wu Zijian , Guo Zhanhu 
Published: December 2015

Multiwalled carbon nanotubes have been widely used as mechanical reinforcement fillers for polymers during the past few decades. However, high electrical conductivity of raw multiwalled carbon nanotubes hampers their application in some fields demanding not only good mechanical properties and/or high thermal conductivity but also electrical insulation. In this research, carboxyl functionalized multiwalled carbon nanotubes and organically modified montmorillonite were introduced to prepare epoxy nanocomposites with anhydride as curing agent. The obtained epoxy nanocomposites possessed improved impact toughness, and the electrical insulation was maintained. Compared to the volume resistivity of the raw multiwalled carbon nanotubes (0.6 wt%)/epoxy nanocomposites, the volume resistivity of the organically modified montmorillonite/carboxyl functionalized multiwalled carbon nanotubes (0.6 wt%)/epoxy nanocomposites increased more than four order of magnitude. These excellent properties were attributed to the synergistic effect of carboxyl functionalized multiwalled carbon nanotubes and organically modified montmorillonite on toughening epoxy, as well as the suppression of electron transport by multiwalled carbon nanotubes surface modification and the organically modified montmorillonite layer in the multiwalled carbon nanotubes conductive network. The effects of adding nanofillers on the dielectric constant and dielectric loss values of epoxy nanocomposites were also studied. This work has demonstrated the feasibility of using multiwalled carbon nanotubes as mechanical reinforcement fillers, while simultaneously giving electrical insulation in the polymer nanocomposites.
Assessment of Abdominal Fat Graft to Repair Anterior Skull Base after Malignant Sinonasal Tumor Extirpation
Authors: Fonmarty David , Bastier Pierre‐Louis , Lechot Amandine , Gimbert Edouard , de Gabory Ludovic 
Published: December 2015

ObjectiveAdult abdominal fat, which is known to contain pluripotent stem cells, is frequently used to treat cerebrospinal fluid leak. The aim of this study was to assess the efficacy and reliability of abdominal fat graft to close large skull base defects after extirpation of malignant sinonasal tumors.Study DesignCase series with chart review performed between 2009 and 2014.Subjects and MethodsTwenty‐nine cases were included of consecutive patients who were suffering from malignant sinonasal tumors, operated by an endoscopic endonasal approach with anterior skull base extirpation and surgically induced cerebrospinal fluid leak. Skull base was repaired by 1 layer of “en bloc” autologous fat graft used as a plug in the onlay position. Epidemiologic data, medical history, defect size, length of hospitalization, and morbidity were analyzed.ResultsRadiotherapy was given pre‐ and postoperatively in 4 (13.8%) and 23 (79.3%) patients, respectively. Mean defect size was 4.47 ± 2.9 cm2 (range, 0.24‐9.1 cm2). Mean operative time was 210 ± 86 minutes. Mean length of hospitalization was 8.6 ± 3.7 days and 4.9 ± 2 days in the intensive care unit. No lumbar drain was used in this study. There was 1 case of cerebrospinal fluid leak (3.5%) and 2 cases of meningitis (6.9%), which resolved after medical treatment. Mean follow‐up was 17 ± 13 months (range, 3‐53 months).ConclusionAbdominal fat graft is a safe and reliable material to close the anterior skull base after extirpation of malignant sinonasal tumors.
How Does TeamSTEPPS Affect Operating Room Efficiency?
Authors: Shams Alexandra , Ahmed Mostafa , Scalzitti Nicholas J. , Stringer Matthew , Howard N. Scott , Maturo Stephen 
Published: December 2015

ObjectiveTo evaluate the effect of TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) on operating room efficiency for the otolaryngology service at a tertiary care medical center.Study DesignRetrospective database review.SettingOtolaryngology department at tertiary care medical center.Subjects and MethodsTo assess the impact of implementing an evidence‐based patient safety initiative, TeamSTEPPS, on operating room efficiency in the otolaryngology department, the operative times, time lost to delayed starts, and turnover times during the year following the implementation of TeamSTEPPS were compared with the values from the prior year.ResultsThe study compared 1322 cases and 644 turnovers in the year prior to TeamSTEPPS implementation with 1609 cases and 769 turnovers in the following year. There were no statistically significant decreases in operating room efficiency in the year after the TeamSTEPPS rollout.ConclusionOperating room efficiency was preserved after the rollout of a rigorous evidence‐based patient safety initiative that requires active participation from all operating room team members.
A double-blind, placebo-controlled, randomized withdrawal study of lurasidone for the maintenance of efficacy in patients with schizophrenia
Authors: Tandon Rajiv , Cucchiaro Josephine , Phillips Debra , Hernandez David , Mao Yongcai , Pikalov Andrei , Loebel Antony 
Published: December 2015

Objective: To evaluate the effectiveness of lurasidone as maintenance treatment for schizophrenia. Method: Adults experiencing an acute exacerbation of schizophrenia initially received 12–24 weeks of open-label treatment with lurasidone (40–80 mg/d, flexibly dosed). Patients who maintained clinical stability for ⩾12 weeks were randomized in double-blind fashion to placebo or lurasidone (40–80 mg/d, flexibly dosed) for an additional 28-week treatment period. The primary efficacy endpoint was time to relapse (based on Kaplan–Meier survival analysis). Results: A total of 676 patients enrolled in the open-label phase; 285 met protocol-specified stabilization criteria and were randomized to lurasidone ( N=144) or placebo ( N=141). During the open-label phase, mean Positive and Negative Syndrome Scale total score decreased from 90.1 to 54.4 in patients who met clinical stability criteria and were randomized. In the double-blind phase, lurasidone significantly delayed time to relapse compared with placebo (log-rank test, p=0.039), reflecting a 33.7% reduction in risk of relapse (Cox hazard ratio (95% confidence interval), 0.663 (0.447–0.983); p=0.041). Probability of relapse at the double-blind week 28 endpoint (based on Kaplan–Meier analysis) was 42.2% in the lurasidone group and 51.2% in the placebo group. Minimal changes in weight, lipid, glucose, and prolactin were observed throughout the study. Conclusions: This multicenter, placebo-controlled, randomized withdrawal study demonstrated the efficacy of lurasidone for the maintenance treatment of patients with schizophrenia.
Integrated multidisciplinary care of headache disorders: A narrative review
Authors: Gaul Charly , Liesering-Latta Eva , Schäfer Benjamin , Fritsche Günther , Holle Dagny 
Published: December 2015

Background Recent evidence shows that multidisciplinary treatment is effective in chronic pain syndromes, especially in headache disorders. Aim The aim of this review is to summarize current knowledge on integrative care concepts in headache patients regarding the optimal and necessary treatment parts, optimal duration and setting. Methods We present a narrative review reporting current literature and personal experience. Results and conclusion Based on current knowledge, multidisciplinary treatment programs appear to be reasonable and efficient in headache disorders. Sufficient controlled studies regarding the need for individual parts of the integrative care approach are missing as yet. Recommendations are therefore at least partly based on personal experiences. It seems to be unambiguous that patients should be referred to a specialized headache center offering such a program instead of being sent sequentially to various medical specialists. The extent and kind of required therapy (e.g. personal consultation versus group sessions) is not known yet. All patients should learn relaxation training, although it is unclear yet which training is the best for which patient. Physiotherapy with guidance on more activity and individual exercises should be used in all patients. Some patients might benefit from cognitive behavioral therapy. However, therapies often depend more on country-specific health care systems than on clinical needs or scientific data.
Premonitory symptoms in migraine: A cross-sectional study in 2714 persons
Authors: Laurell Katarina , Artto Ville , Bendtsen Lars , Hagen Knut , Häggström Johan , Linde Mattias , Söderström Lars , Tronvik Erling , Wessman Maija , Zwart John Anker , Kallela Mikko 
Published: December 2015

Aim To describe the frequency and number of premonitory symptoms (PS) in migraine, the co-occurrence of different PS, and their association with migraine-related factors. Methods In this cross-sectional study, a validated questionnaire was sent to Finnish migraine families between 2002 and 2013 to obtain data on 14 predefined PS, migraine diagnoses, demographic factors, and migraine characteristics. The estimated response rate was 80%. Results Out of 2714 persons, 2223 were diagnosed with migraine. Among these, 77% reported PS, with a mean number of 3.0 symptoms compared to 30% ( p < 0.001) and 0.5 symptoms ( p < 0.001) among 491 persons with non-migraine headaches. Yawning was the most commonly reported symptom (34%) among migraineurs. Females reported PS more frequently than males (81 versus 64%, p < 0.001) and experienced a higher number of different symptoms (mean 3.3 versus 1.8, p < 0.001). All measures of migraine severity were associated with a higher burden of PS. Light and sound sensitivity showed the highest co-occurrence (kappa = 0.51, 95% CI 0.47–0.55). In a generalized linear model, age, gender, higher frequency, duration and intensity of headache, reduced working capacity, most aura symptoms, and associated symptoms of the headache phase were significantly associated with an increased in the number of PS. Conclusion PS are experienced by a majority of migraineurs. More severe migraine is associated with a higher burden of PS. Since the material was not entirely representative of the general population of migraineurs, caution should be exercised in generalizing the results.
Susceptible genes of restless legs syndrome in migraine
Authors: Fuh Jong-Ling , Chung Ming-Yi , Yao Shu-Chih , Chen Ping-Kun , Liao Yi-Chu , Hsu Chia-Lin , Wang Po-Jen , Wang Yen-Feng , Chen Shih-Pin , Fann Cathy S-J , Kao Lung-Sen , Wang Shuu-Jiun 
Published: December 2015

Objective Several genetic variants have been found to increase the risk of restless legs syndrome (RLS). The aim of the present study was to determine if these genetic variants were also associated with the comorbidity of RLS and migraine in patients. Methods Thirteen single-nucleotide polymorphisms (SNPs) at six RLS risk loci ( MEIS1, BTBD9, MAP2K5, PTPRD, TOX3, and an intergenic region on chromosome 2p14) were genotyped in 211 migraine patients with RLS and 781 migraine patients without RLS. Association analyses were performed for the overall cohort, as well as for the subgroups of patients who experienced migraines with and without aura and episodic migraines (EMs) vs. chronic migraines (CMs). In order to verify which genetic markers were potentially related to the incidence of RLS in migraine patients, multivariate regression analyses were also performed. Results Among the six tested loci, only MEIS1 was significantly associated with RLS. The most significant SNP of MEIS1, rs2300478, increased the risk of RLS by 1.42-fold in the overall cohort ( p = 0.0047). In the subgroup analyses, MEIS1 augmented the risk of RLS only in the patients who experienced EMs (odds ratio (OR) = 1.99, p = 0.0004) and not those experiencing CMs. Multivariate regression analyses further showed that rs2300478 in MEIS1 (OR = 1.39, p = 0.018), a CM diagnosis (OR = 1.52, p = 0.022), and depression (OR = 1.86, p = 0.005) were independent predictors of RLS in migraine. Conclusions MEIS1 variants were associated with an increased risk of RLS in migraine patients. It is possible that an imbalance in iron homeostasis and the dopaminergic system may represent a link between RLS incidence and migraines.
A Novel Repair Method for Radial Tears of the Medial Meniscus
Authors: Bhatia Sanjeev , Civitarese David M. , Turnbull Travis Lee , LaPrade Christopher M. , Nitri Marco , Wijdicks Coen A. , LaPrade Robert F. 
Published: December 2015

Background: Complete radial tears of the medial meniscus have been reported to be functionally similar to a total meniscectomy. At present, there is no consensus on an ideal technique for repair of radial midbody tears of the medial meniscus. Prior attempts at repair with double horizontal mattress suture techniques have led to a reportedly high rate of incomplete healing or healing in a nonanatomic (gapped) position, which compromises the ability of the meniscus to withstand hoop stresses. Hypothesis: A newly proposed 2-tunnel radial meniscal repair method will result in decreased gapping and increased ultimate failure loads compared with the double horizontal mattress suture repair technique under cyclic loading. Study Design: Controlled laboratory study. Methods: Ten matched pairs of male human cadaveric knees (average age, 58.6 years; range, 48-66 years) were used. A complete radial medial meniscal tear was made at the junction of the posterior one-third and middle third of the meniscus. One knee underwent a horizontal mattress inside-out repair, while the contralateral knee underwent a radial meniscal repair entailing the same technique with a concurrent novel 2-tunnel repair. Specimens were potted and mounted on a universal testing machine. Each specimen was cyclically loaded 1000 times with loads between 5 and 20 N before experiencing a load to failure. Gap distances at the tear site and failure load were measured. Results: The 2-tunnel repairs exhibited a significantly stronger ultimate failure load (median, 196 N; range, 163-212 N) than did the double horizontal mattress suture repairs (median, 106 N; range, 63-229 N) ( P = .004). In addition, the 2-tunnel repairs demonstrated decreased gapping at all testing states ( P < .05) with a final measured gapping of 1.7 mm and 4.1 mm after 1000 cycles for the 2-tunnel and double horizontal mattress suture repairs, respectively. Conclusion: The 2-tunnel repairs displayed significantly less gapping distance after cyclic loading and had significantly stronger ultimate failure loads compared with the double horizontal mattress suture repairs. Clinical Relevance: Complete radial tears of the medial meniscus significantly decrease the ability of the meniscus to dissipate tibiofemoral loads, predisposing patients to early osteoarthritis. Improving the ability to repair medial meniscal radial tears in a way that withstands cyclic loads and heals in an anatomic position could significantly improve patient healing rates and result in improved preservation of the articular cartilage of the medial compartment of the knee. The 2-tunnel repair may be a more reliable and stronger repair option for midbody radial tears of the medial meniscus. Clinical studies are warranted to further evaluate these repairs.
Surgical Results of Delaminated Rotator Cuff Repair Using Suture-Bridge Technique With All-Layers or Bursal Layer–Only Repair
Authors: Kim Sung-Jae , Choi Yun-Rak , Lee Hyun-Hee , Chun Yong-Min 
Published: December 2015

Background: There are no known studies that have investigated the effect on delaminated rotator cuff tears of bursal layer–only repair when full-thickness repair would put the articular layer under tension, compared with all-layers repair when full-thickness repair is feasible. Hypothesis: Better outcomes will be seen in the bursal layer–only repair, as the articular layer would be under tension when repaired onto its footprint during the all-layers repair. Study Design: Cohort study; Level of evidence 3. Methods: This study included 112 patients who underwent arthroscopic rotator cuff repair for posteriorly delaminated tears of either all layers (group A) or the bursal layer alone (group B). If the articular layer was able to be reduced onto its footprint, the patient was assigned to group A; if such reduction was not possible or was only marginally possible under significant tension, the patient was assigned to group B. Pain scored on a visual analog scale (VAS) was assessed, as were subjective shoulder value (SSV), University of California, Los Angeles (UCLA) shoulder score, American Shoulder and Elbow Surgeons (ASES) score, and shoulder active range of motion (ROM). Postoperative magnetic resonance arthrography (MRA) or computed tomographic arthrography (CTA) was undertaken 6 months postoperatively for structural integrity assessment. Results: After 2 years, the VAS pain score (group A, from 6.5 to 1.2; group B, from 6.4 to 1.2), SSV (group A, from 38.3 to 89.4; group B, from 38.0 to 90.1), ASES score (group A, from 36.4 to 90.4; group B, from 38.0 to 90.8), UCLA shoulder score (group A, from 15.3 to 30.7; group B, from 15.0 to 31.3), and ROM improved significantly in both groups compared with preoperative values ( P < .001). However, none of these values differed significantly between groups. On follow-up MRA or CTA images, there was no significant difference in the retear rate between group A (28%; 16/57) and group B (24%; 11/45). Conclusion: The all-layers repair did not produce better clinical outcomes or structural integrity than the bursal layer–only repair. The study findings indicate that if repair of the articular layer is possible only under significant tension or is not reparable, rather than all-layers repair by force, bursal-layer repair without incorporating the articular layer may produce comparable clinical outcomes and structural integrity in the delaminated rotator cuff tear.
Exposure to Tobacco Metabolites via Breast Milk and Infant Weight Gain
Authors: Shenassa Edmond D. , Wen Xiaozhong , Braid Susan 
Published: December 2015

Background: Although the immutable benefits of breastfeeding are well documented, information on the potential consequences of exposure to tobacco metabolites specifically via breastfeeding is sparse. Objective: The aim was to conduct the first study of the association between exposure to tobacco metabolites specifically through breastfeeding and infant weight gain. Methods: We used historical data from the US Collaborative Perinatal Project. Mothers were classified as nonsmokers, light smokers (1-19 cigarettes/day), and heavy (20+ cigarettes/day) smokers. In-hospital feeding type was observed during a nursery stay after delivery. We conducted stratified analyses among average-for-gestational-age (AGA; N = 23 571) and small-for-gestational-age (SGA; N = 2552) infants. We isolated the effect of exposure to tobacco metabolites specifically through breastfeeding. Results: Overall, maternal smoking was associated with change in weight-for-length z-score in a dose-response manner. Change in weight z-score was most pronounced among SGA infants of heavy smokers (breastfed: 0.53; 95% confidence interval [CI], 0.12-0.94; formula fed: 0.17; 95% CI, 0.03-0.30). Exposure to tobacco metabolites specifically through breastfeeding was not associated with additional weight gain among AGA infants. Among the much smaller sample of SGA infants, exposure specifically through breastfeeding was associated with marginally significant additional weight gain (0.46; 95% CI, 0.00-0.91) among infants of heavy smokers. Conclusion: Our findings are in accord with recommendations by health agencies for smokers to breastfeed. However, SGA infants exposed to tobacco metabolites via breastfeeding by heavy smokers appear to gain weight more rapidly than other infants. Practical implications of our findings are discussed.