bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Ensemble Adjustment Kalman Filter for the CCSM4 Ocean Component
Authors: Karspeck Alicia R. , Yeager Steve , Danabasoglu Gokhan , Hoar Tim , Collins Nancy , Raeder Kevin , Anderson Jeffrey , Tribbia Joseph 
Published: May 2013

Abstract
The authors report on the implementation and evaluation of a 48-member ensemble adjustment Kalman filter (EAKF) for the ocean component of the Community Climate System Model, version 4 (CCSM4). The ocean assimilation system described was developed to support the eventual generation of historical ocean-state estimates and ocean-initialized climate predictions with the CCSM4 and its next generation, the Community Earth System Model (CESM). In this initial configuration of the system, daily subsurface temperature and salinity data from the 2009 World Ocean Database are assimilated into the ocean model from 1 January 1998 to 31 December 2005. Each ensemble member of the ocean is forced by a member of an independently generated CCSM4 atmospheric EAKF analysis, making this a loosely coupled framework. Over most of the globe, the time-mean temperature and salinity fields are improved relative to an identically forced ocean model simulation without assimilation. This improvement is especially notable in strong frontal regions such as the western and eastern boundary currents. The assimilation system is most effective in the upper 1000 m of the ocean, where the vast majority of in situ observations are located. Because of the shortness of this experiment, ocean variability is not discussed. Challenges that arise from using an ocean model with strong regional biases, coarse resolution, and low internal variability to assimilate real observations are discussed, and areas of ongoing improvement for the assimilation system are outlined.
Evaluating Surface Water Cycle Simulated by the Australian Community Land Surface Model (CABLE) across Different Spatial and Temporal Domains
Authors: Zhang Huqiang , Pak Bernard , Wang Ying Ping , Zhou Xinyao , Zhang Yongqiang , Zhang Liang 
Published: May 2013

Abstract
The terrestrial water cycle in the Australian Community Atmosphere Biosphere Land Exchange (CABLE) model has been evaluated across a range of temporal and spatial domains. A series of offline experiments were conducted using the forcing data from the second Global Soil Wetness Project (GSWP-2) for the period of 1986–95, but with its default parameter settings. Results were compared against GSWP-2 multimodel ensembles and a range of observationally driven datasets. CABLE-simulated global mean evapotranspiration (ET) and runoff agreed well with the GSWP-2 multimodel climatology and observations, and the spatial variations of ET and runoff across 150 large catchments were well captured. Nevertheless, at regional scales it underestimated ET in the tropics and had some significant runoff errors. The model sensitivity to a number of selected parameters is further examined. Results showed some significant model uncertainty caused by its sensitivity to soil wilting point as well as to the root water uptaking efficiency and canopy water storage parameters. The sensitivity was large in tropical rain forest and midlatitude forest regions, where the uncertainty caused by the model parameters was comparable to a large part of its difference against the GSWP-2 multimodel mean. Furthermore, the discrepancy among the CABLE perturbation experiments caused by its sensitivity to model parameters was equivalent to about 20%–40% of the intermodel difference among the GSWP-2 models, which was primarily caused by different model structure/processes. Although such results are model dependent, they suggest that soil/vegetation parameters could be another source of uncertainty in estimating global surface energy and water budgets.
Seasonal Variability of the Tyrrhenian Sea Surface Geostrophic Circulation as Assessed by Altimeter Data
Authors: Iacono R. , Napolitano E. , Marullo S. , Artale V. , Vetrano A. 
Published: May 2013

AbstractNew insights into the structure and variability of the Tyrrhenian Sea's surface circulation are obtained through the analysis of a very long series of altimetric observations (1993–2010). In late winter and part of spring, a consistent mean flow is individuated in the eastern Tyrrhenian Sea, formed by a stream of Atlantic water that meanders around four anticyclonic structures located along the Italian coast, which have smaller cyclonic companions offshore. The signatures of these vortices are also found in images of chlorophyll and sea surface temperature, as well as in modeling results, both from a high-resolution operational model of the Tyrrhenian Sea's circulation and from a dedicated numerical simulation. Analysis of the energy exchange between eddies and mean flow, together with numerical evidence, suggests that this winter–spring circulation pattern may result from basin-scale instability of the Atlantic stream. In summer, the dynamic is dominated by a well-known dipole located to the east of the Bonifacio Strait. However, in the eastern part of the basin, an anticyclonic cell is also found, probably driven by the negative wind stress curl present in summer in this region. The cell encompasses two anticyclonic vortices located in the areas of the Vavilov and Marsili Seamounts. A multichannel singular spectral analysis of the altimetric time series reveals that, besides the expected, dominant seasonal mode, a significant low-frequency mode of variability is also present. This mode has a period of about six years and is mostly localized in the western part of the basin.
Axis Ratios and Flutter Angles of Cloud Ice Particles: Retrievals from Radar Data
Authors: Melnikov Valery , Straka Jerry M. 
Published: May 2013

Abstract
A novel method of retrieving the mean axis ratio (width/length) and standard deviation of orientation angles (σθ, which is called herein the intensity of fluttering) of ice cloud particles from polarimetric radar data is described. The method is based on measurements of differential reflectivity ZDR and the copolar correlation coefficient in cloud areas with ZDR &gt; 4 dB. In three analyzed cases, the values of the retrieved axis ratio were in an interval from 0.15 to 0.4 and σθ found in an interval from 2° to 20°. The latter values indicate that the particles experienced light to moderate fluttering. Ambiguities in the retrievals because of uncertainties in the bulk ice density of the particles and possible presence of columnar crystals are considered. The retrieval method is applicable for centimeter-wavelength radars; the analyzed data were collected with the dual-polarization S-band Weather Surveillance Radar-1988 Doppler (WSR-88D).
Evaluation of Cold-Season Precipitation Forecasts Generated by the Hourly Updating High-Resolution Rapid Refresh Model
Authors: Ikeda Kyoko , Steiner Matthias , Pinto James , Alexander Curtis 
Published: May 2013

Abstract
The hourly updating High-Resolution Rapid Refresh (HRRR) model is evaluated with regard to its ability to predict the areal extent of cold-season precipitation and accurately depict the timing and location of regions of snow, rain, and mixed-phase precipitation on the ground. Validation of the HRRR forecasts is performed using observations collected by the Automated Surface Observing System (ASOS) stations across the eastern two-thirds of the United States during the 2010–11 cold season. The results show that the HRRR is able to reliably forecast precipitation extent during the cold season. In particular, the location and areal extent of both snow and rain are very well predicted. Depiction of rain-to-snow transitions and freezing rain is reasonably good; however, the associated evaluation scores are significantly lower than for either snow or rain. The analyses suggest the skill in accurately depicting precipitation extent and phase (i.e., rain, snow, and mixed phase) depends on the size and organization of a weather system. Typically, larger synoptically forced weather systems are better predicted than smaller weather systems, including the associated rain-to-snow transition or freezing-rain areas. Offsets in space or time (i.e., causing misses and false alarms) have a larger effect on the model performance for smaller weather systems.
A Multilevel Dyadic Study of the Impact of Retirement on Self-Rated Health
Authors: Curl Angela L. , Townsend Aloen L. 
Published: May 2013

Objectives: This study examined the effects of retirement on self-rated health for married couples, using interdependence and social stratification theoretical frameworks. Method: Dyadic multilevel modeling of data ( N = 2,213 non-Hispanic couples) from 1992 to 2010 of the Health and Retirement Survey. Results: Retirement was associated with worse self-ratings of health (SRH) short term (ST) for both husbands and wives during the first couple of years of retirement. In addition, the longer the husbands (but not wives) were retired, the worse was their SRH. Cross-spouse effects varied by gender: When wives retired, their husbands’ SRH improved ST, but when husbands retired their wives’ SRH improved long term. Spouse education moderated the relationship between years since spouse’s retirement and SRH for wives. Discussion: Practitioners can use this information to help married couples through retirement planning and transitions. Results suggest that models of retirement in couples should pay greater attention to gender and other social stratification factors, spousal interdependence, and length of time since retirement.
Comparison of survival analysis and palliative care involvement in patients aged over 70 years choosing conservative management or renal replacement therapy in advanced chronic kidney disease
Authors: Hussain Jamilla A , Mooney Andrew , Russon Lynne 
Published: May 2013

Background: There are limited data on the outcomes of elderly patients with chronic kidney disease undergoing renal replacement therapy or conservative management. Aims: We aimed to compare survival, hospital admissions and palliative care access of patients aged over 70 years with chronic kidney disease stage 5 according to whether they chose renal replacement therapy or conservative management. Design: Retrospective observational study. Setting/participants: Patients aged over 70 years attending pre-dialysis clinic. Results: In total, 172 patients chose conservative management and 269 chose renal replacement therapy. The renal replacement therapy group survived for longer when survival was taken from the time estimated glomerular filtration rate <20 mL/min ( p < 0.0001), <15 mL/min ( p < 0.0001) and <12 mL/min ( p = 0.002). When factors influencing survival were stratified for both groups independently, renal replacement therapy failed to show a survival advantage over conservative management, in patients older than 80 years or with a World Health Organization performance score of 3 or more. There was also a significant reduction in the effect of renal replacement therapy on survival in patients with high Charlson’s Comorbidity Index scores. The relative risk of an acute hospital admission (renal replacement therapy vs conservative management) was 1.6 ( p < 0.05; 95% confidence interval = 1.14–2.13). A total of 47% of conservative management patients died in hospital, compared to 69% undergoing renal replacement therapy (Renal Registry data). Seventy-six percent of the conservative management group accessed community palliative care services compared to 0% of renal replacement therapy patients. Conclusions: For patients aged over 80 years, with a poor performance status or high co-morbidity scores, the survival advantage of renal replacement therapy over conservative management was lost at all levels of disease severity. Those accessing a conservative management pathway had greater access to palliative care services and were less likely to be admitted to or die in hospital.
The Liverpool Care Pathway for cancer patients dying in hospital medical wards: A before–after cluster phase II trial of outcomes reported by family members
Authors: Costantini Massimo , Pellegrini Fabio , Di Leo Silvia , Beccaro Monica , Rossi Carla , Flego Guia , Romoli Vittoria , Giannotti Michela , Morone Paola , Ivaldi Giovanni P , Cavallo Laura , Fusco Flavio , Higginson Irene J 
Published: May 2013

Background: Hospital is the most common place of cancer death but concerns regarding the quality of end-of-life care remain. Aim: Preliminary assessment of the effectiveness of the Liverpool Care Pathway on the quality of end-of-life care provided to adult cancer patients during their last week of life in hospital. Design: Uncontrolled before–after intervention cluster trial. Settings/participants: The trial was performed within four hospital wards participating in the pilot implementation of the Italian version of the Liverpool Care Pathway programme. All cancer patients who died in the hospital wards 2–4 months before and after the implementation of the Italian version of Liverpool Care Pathway were identified. A total of 2 months after the patient’s death, bereaved family members were interviewed using the Toolkit After-Death Family Interview (seven 0–100 scales assessing the quality of end-of-life care) and the Italian version of the Views of Informal Carers - Evaluation of Services (VOICES) (three items assessing pain, breathlessness and nausea-vomiting). Results: An interview was obtained for 79 family members, 46 (73.0%) before and 33 (68.8%) after implementation of the Italian version of Liverpool Care Pathway. Following Italian version of Liverpool Care Pathway implementation, there was a significant improvement in the mean scores of four Toolkit scales: respect, kindness and dignity (+16.8; 95% confidence interval = 3.6–30.0; p = 0.015); family emotional support (+20.9; 95% confidence interval = 9.6–32.3; p < 0.001); family self-efficacy (+14.3; 95% confidence interval = 0.3–28.2; p = 0.049) and coordination of care (+14.3; 95% confidence interval = 4.2–24.3; p = 0.007). No significant improvement in symptom’ control was observed. Conclusions: These results provide the first robust data collected from family members of a preliminary clinically significant improvement, in some aspects, of quality of care after the implementation of the Italian version of Liverpool Care Pathway programme. The poor effect for symptom control suggests areas for further innovation and development.
Impact of type 1 diabetes mellitus on academic performance
Authors: Meo Sultan Ayoub , Alkahlan Mohammad Abdulaziz , Al-mubarak Mohammed Abdulrahman , Al-obayli Mohammed Saad , Melaibary Bader Abdullah , Dous Abdullah Nasser Bin , Alhassoun Asim Ibrahim 
Published: May 2013

Objective To examine the effect of type 1 diabetes on academic performance. Methods Ethnically Saudi students with type 1 diabetes, and age, sex, ethnicity and socio-economic status-matched nondiabetic control students were recruited from eight schools. Overall academic grades were recorded, based on the scores obtained in written examinations in English, mathematics, physics, chemistry, biology and humanities. Results Students with type 1 diabetes ( n = 36) obtained significantly lower academic grades compared with their nondiabetic control classmates ( n = 36) (86.58 ± 1.48 vs 90.62 ± 1.36). Conclusions Overall academic performance is significantly lower in students with type 1 diabetes compared with their nondiabetic classmates. This decline in academic performance may be explained by an association between diabetes and cognitive function.
Single-port access compared with three-port laparoscopic adnexal surgery in a randomized controlled trial
Authors: Yoo Eun-Hee , Shim Eunjung 
Published: May 2013

Objective Scar-related cosmetic outcomes were compared prospectively between conventional three-port and single-port access laparoscopic adnexal gynaecological surgery. Methods Enrolled patients were randomly assigned to a single- or three-port surgery group. Scar-related outcomes were evaluated at 1 month, 6 months and 1 year. Scars were assessed by an independent observer using the modified Vancouver Scar Scale (mVSS). All patients were asked about pain related to the scar and scar satisfaction; results were recorded using a numerical rating scale. Results Seventy-three patients were enrolled between June 2010 and June 2011. Demographic and surgical outcomes did not differ between the groups. mVSS results were similar in the two groups at each follow-up point. The scar satisfaction profile measured at 1 month showed no significant difference between the groups, but the single-port access group had better results than the conventional group at all other follow-up timepoints. Conclusion Cosmetic outcome was better for single-port than for three-port adnexal gynaecological surgery at 6-month and 1-year follow-up.
High prevalence of sickness absence and disability pension among multiple sclerosis patients: a nationwide population-based study
Authors: Tinghög Petter , Hillert Jan , Kjeldgård Linnea , Wiberg Michael , Glaser Anna , Alexanderson Kristina 
Published: May 2013

Introduction: Although multiple sclerosis (MS) often implies substantial disability, there is little knowledge about sick leave and disability pension among MS patients. Objectives: The purpose of this study was to estimate the prevalence rates of sick leave and disability pension among MS patients and to explore how socio-demographics are associated with such rates. Methods: The register data of all people who lived in Sweden in 2005 and were 16–64 years old was used to identify 9721 MS patients and matched controls. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated and effect modifications were evaluated with Wald X2 tests. Results: In 2005, 61.7% of the MS patients were on partial or full disability pension compared to 14.2% among the controls. Of the others, 36.8% had ≥1 sick-leave spell for >14 days during that year. Socio-demographics were similarly associated with sick leave and disability pension among MS patients and controls, with the noteworthy exceptions that female gender and immigration status were less potent risk factors in the MS population ( p<0.05). Conclusion: In spite of widespread access to modern health care including disease-modifying drugs, the majority of MS patients of working ages were on a disability pension. Strategies enabling MS patients to retain their footing in the labour market are needed.
Assessing the validity of a computer-generated cognitive screening instrument for patients with multiple sclerosis
Authors: Lapshin Helen , Lanctôt Krista L , O’Connor Paul , Feinstein Anthony 
Published: May 2013

Background: Neuropsychological testing requires considerable time, expense, and expertise to administer. These factors can limit patient access. Computerized cognitive testing has been proposed as an alternative. Objectives: The objective of this paper is to validate a brief, simple-to-use computer-generated cognitive assessment screening battery for multiple sclerosis (MS) patients that has minimal motor involvement. Methods: A sample of 96 MS patients and 98 healthy controls completed a computer-generated battery that included the Stroop, Symbol Digit Modalities Test (C-SDMT), a two- and four-second visual analog of the Paced Auditory Serial Addition Test (PVSAT-2, PVSAT-4), and simple and choice reaction time tests. The Minimal Assessment of Cognitive Function in MS was used to define cognitive impairment in the MS sample. Results: Each newly developed test successfully distinguished between cognitively impaired patients and healthy controls as well as cognitively intact patients. A combination of three computerized tests (C-SDMT, PVSAT-2, PVSAT-4) with a mean administration time of 10 minutes had a sensitivity of 82.5% and specificity of 87.5% in detecting cognitive impairment. Good test-retest reliability was obtained for each measure. Conclusions: Good sensitivity and specificity, brevity, ease of administration, and a limited motor component highlight the feasibility of introducing this computer-generated cognitive screening instrument in a busy MS clinic.
Clinical outcomes using a faecal immunochemical test for haemoglobin as a first‐line test in a national programme constrained by colonoscopy capacity
Authors: Steele Robert JC , McDonald Paula J , Digby Jayne , Brownlee Linda , Strachan Judith A , Libby Gillian , McClements Paula L , Birrell Janice , Carey Francis A , Diament Robert H , Balsitis Margaret , Fraser Callum G 
Published: May 2013

IntroductionBecause of their many advantages, faecal immunochemical tests (FIT) are superseding traditional guaiac‐based faecal occult blood tests in bowel screening programmes.MethodsA quantitative FIT was adopted for use in two evaluation National Health Service (NHS) Boards in Scotland using a cut‐off faecal haemoglobin concentration chosen to give a positivity rate equivalent to that achieved in the Scottish Bowel Screening Programme. Uptake and clinical outcomes were compared with results obtained contemporaneously in two other similar NHS Boards and before and after the evaluation in the two evaluation NHS Boards.ResultsDuring the evaluation, uptake was 58.5%. This was higher than in the same NHS Boards both before and after the evaluation, higher than in the other two NHS Boards and higher than the 53.7% achieved overall in Scotland. The overall positivity rate was higher in men than in women and increased with age in both genders. Positive predictive values for cancer (4.8%), high‐risk adenoma (23.3%), all adenoma (38.2%) and all neoplasia (43.0%) in the two test NHS Boards were similar in all groups.ConclusionsIn summary, this evaluation of the FIT supports the introduction of FIT as a first‐line test, even when colonoscopy capacity is limited.
How I treat NK/T-cell lymphomas
Authors: Tse Eric , Kwong Yok-Lam 
Published: May 2013

AbstractNatural killer (NK)/T-cell lymphomas and NK-cell leukemias are aggressive malignancies. Occurring worldwide, they show a predilection for Asian and South American populations. Neoplastic cells are surface CD3−, cytoplasmic CD3ε+, CD56+, cytotoxic-molecule positive, Epstein-Barr virus (EBV) positive, with germline T-cell receptor gene. Lymphomas occur commonly in the nasal and upper aerodigestive region. Occasional cases present in the skin, salivary gland, testis, and gastrointestinal tract. Rare cases are disseminated with lymphadenopathy, hepatosplenomegaly, and a leukemic phase. Positron emission tomography computed tomography is useful in staging, as lymphomas are 18-fluorodeoxyglucose avid. Quantification of circulating EBV DNA is an accurate biomarker of tumor load. Nasal NK/T-cell lymphomas present mostly with stage I/II disease. Concomitant/sequential chemotherapy and radiotherapy is standard treatment. Radiotherapy alone is inadequate because of high systemic failure rate. For stage III/IV nasal, nonnasal, and disseminated lymphomas, systemic chemotherapy is indicated. Regimens containing l-asparaginase and drugs unaffected by P-glycoprotein are most effective. Hematopoietic stem cell transplantation (HSCT) is not indicated for early-stage nasal lymphomas. HSCT for lymphomas not in remission has poor results. In advanced-stage nasal, nonnasal, disseminated, or relapsed lymphomas, HSCT may be considered when remission is achieved. Prognostic modeling and EBV DNA monitoring may be useful in risk stratification for HSCT.