bluuebunny/crossref_metadata_2025_split huggingface dataset:
Twenty-First-Century Snowfall and Snowpack Changes over the Southern California Mountains
Authors: Sun Fengpeng , Hall Alex , Schwartz Marla , Walton Daniel B. , Berg Neil 
Published: October 2015

Abstract
Future snowfall and snowpack changes over the mountains of Southern California are projected using a new hybrid dynamical–statistical framework. Output from all general circulation models (GCMs) in phase 5 of the Coupled Model Intercomparison Project archive is downscaled to 2-km resolution over the region. Variables pertaining to snow are analyzed for the middle (2041–60) and end (2081–2100) of the twenty-first century under two representative concentration pathway (RCP) scenarios: RCP8.5 (business as usual) and RCP2.6 (mitigation). These four sets of projections are compared with a baseline reconstruction of climate from 1981 to 2000. For both future time slices and scenarios, ensemble-mean total winter snowfall loss is widespread. By the mid-twenty-first century under RCP8.5, ensemble-mean winter snowfall is about 70% of baseline, whereas the corresponding value for RCP2.6 is somewhat higher (about 80% of baseline). By the end of the century, however, the two scenarios diverge significantly. Under RCP8.5, snowfall sees a dramatic further decline; 2081–2100 totals are only about half of baseline totals. Under RCP2.6, only a negligible further reduction from midcentury snowfall totals is seen. Because of the spread in the GCM climate projections, these figures are all associated with large intermodel uncertainty. Snowpack on the ground, as represented by 1 April snow water equivalent is also assessed. Because of enhanced snowmelt, the loss seen in snowpack is generally 50% greater than that seen in winter snowfall. By midcentury under RCP8.5, warming-accelerated spring snowmelt leads to snow-free dates that are about 1–3 weeks earlier than in the baseline period.
Understanding Bjerknes Compensation in Atmosphere and Ocean Heat Transports Using a Coupled Box Model
Authors: Yang Haijun , Zhao Yingying , Liu Zhengyu 
Published: October 2015

AbstractA coupled box model is used to study the compensation between atmosphere and ocean heat transports. An analytical solution to the Bjerknes compensation (BJC) rate, defined as the ratio of anomalous atmosphere heat transport (AHT) to anomalous ocean heat transport (OHT), is obtained. The BJC rate is determined by local feedback between surface temperature and net heat flux at the top of atmosphere (TOA) and the AHT efficiency. In a stable climate that ensures global energy conservation, the changes between AHT and OHT tend to be always out of phase, and the BJC is always valid. This can be demonstrated when the climate is perturbed by freshwater flux. The BJC in this case exhibits three different behaviors: the anomalous AHT can undercompensate, overcompensate, or perfectly compensate the anomalous OHT, depending on the local feedback. Stronger negative local feedback will result in a lower BJC rate. Stronger positive local feedback will result in a larger overcompensation. If zero climate feedback occurs in the system, the AHT will compensate the OHT perfectly. However, the BJC will fail if the climate system is perturbed by heat flux. In this case, the changes in AHT and OHT will be in phase, and their ratio will be closely related to the mean AHT and OHT. In a more realistic situation when the climate is perturbed by both heat and freshwater fluxes, whether the BJC will occur depends largely on the interplay among meridional temperature and salinity gradients and the thermohaline circulation strength. This work explicitly shows that the energy conservation is the intrinsic mechanism of BJC and establishes a specific link between radiative feedback and the degree of compensation. It also implies a close relationship between the energy balance at the TOA and the ocean thermohaline dynamics.
Role of Near-Inertial Internal Waves in Subthermocline Diapycnal Mixing in the Northern Gulf of Mexico
Authors: Jing Zhao , Chang Ping , DiMarco Steven F. , Wu Lixin 
Published: October 2015

AbstractMoored ADCP data collected in the northern Gulf of Mexico are analyzed to examine near-inertial internal waves and their contribution to subthermocline diapycnal mixing based on a finescale parameterization of deep ocean mixing. The focus of the study is on the impact of near-inertial internal waves generated by an extreme weather event—that is, Hurricane Katrina—and by month-to-month variation in weather patterns on the diapycnal mixing. The inferred subthermocline diapycnal mixing exhibits pronounced elevation in the wake of Katrina. Both the increased near-inertial (0.8–1.8f, where f is the Coriolis frequency) and superinertial (>1.8f) shear variances contribute to the elevated diapycnal mixing, but the former plays a more dominant role. The intense wind work on near-inertial motions by the hurricane is largely responsible for the energetic near-inertial shear variance. Energy transfer from near-inertial to superinertial internal waves, however, appears to play an important role in elevating the superinertial shear variance. The inferred subthermocline diapycnal mixing in the region also exhibits significant month-to-month variation with the estimated diffusivity in January 2006 about 3 times the values in November and December 2005. The subseasonal change in the diapycnal mixing mainly results from the subseasonal variation of the near-inertial wind work that causes intensification of the near-inertial shear in January 2006.
An Inductive Charging and Real-Time Communications System for Profiling Moorings
Authors: Alford Matthew H. , McGinnis Tim , Howe Bruce M. 
Published: October 2015

AbstractThis paper describes a system for providing power and communications to moored profiling vehicles. A McLane Moored Profiler (MP) was equipped with a rechargeable battery pack and an inductive charging system to allow it to move periodically to a charging dock at the top of a subsurface mooring. Power was provided from a large bank of alkaline batteries housed in two 0.94-m steel spheres. Data were transferred inductively from the profiler to a mooring controller, and from there back to shore via radio and Iridium satellite modems housed in a small surface communications float on an “L” tether. An acoustic modem provided backup communications to a nearby ship in the event of loss or damage to the surface float. The system was tested in a 180-m-deep fjord (Puget Sound, Washington) and at Station ALOHA (A Long-Term Oligotrophic Habitat Assessment), a 4748-m-deep open-ocean location north of Hawaii. Basic functionality of the system was demonstrated, with the profiler repeatedly recharging at about 225 W (with an overall efficiency of about 70%). Data were relayed back to shore via Iridium and to a nearby ship via the radio and acoustic modems. The system profiled flawlessly for the entire 6-week test in Puget Sound, but charging at the deep site stopped after only 9 days in the deep-ocean deployment owing to damage to the charging station, possibly by surface wave action.
Knowledge of metabolic syndrome in Chinese adults: Implications for health education
Authors: Lo Sally Wai Sze , Chair Sek Ying , Lee Iris Fung Kam 
Published: October 2015

Objective: The objective of this study was to assess knowledge of metabolic syndrome (MS) among Chinese adults and provide directions for designing healthcare promotion schemes for improving MS awareness in the community. Design: The study adopted a cross-sectional design and a convenience sampling method. Method: Chinese adults aged 18–65 years and living in the community completed a self-administered questionnaire, providing socio-demographic information and indicating their knowledge of MS using a validated knowledge of MS (K-MS) scale comprising 10 multiple-choice questions. The scores of K-MS can range from 0 to 100. Results: A total of 297 participants were recruited (mean age = 51.3 ± 8.9 years), 66.7% of whom were women. More than half of all participants ( n = 154) were identified as having MS and numerous participants were obese ( n = 158). The mean K-MS score was 44.9 out of 100; most participants (61%) scored below 50, indicating a poor level of MS knowledge. Participants who were older, had a lower level of education or were unemployed scored the lowest. Conclusion: Acquiring knowledge of MS is crucial for preventing the development of type 2 diabetes and cardiovascular diseases. However, Chinese adults in a community setting exhibited poor understanding of MS. Public health efforts regarding primary prevention of cardiovascular diseases should be targeted at improving MS knowledge. Additional measures are needed to assist people in the low socioeconomic classes.
Increasing knowledge about obsessive compulsive disorder and support for parents and schools: Evaluation of initiatives
Authors: Jassi Amita D , Kolvenbach Sarah , Heyman Isobel , Macleod Trish , Rose Joel , Diamond Holly 
Published: October 2015

Objective: Obsessive compulsive disorder (OCD) in children can be difficult to detect. Schools and families need to be made aware of the signs and symptoms of OCD in order to facilitate access to treatment. Parents of children with OCD may require support as well as knowledge. This study evaluated two initiatives aimed at increasing knowledge and support for parents and teachers. Method: This study was carried out in two parts. First, to raise awareness of the signs and symptoms of OCD, 266 schools in London were supplied with information packs. Knowledge of OCD was evaluated using a quiz before and after the dissemination of the packs. Second, groups of parents were given the opportunity to log into specially designed webinars that made it possible for them to learn about OCD and interact with other families. Feedback on webinars was collected through a survey. Results: Both the information packs and webinars were well received. One hundred and twenty seven teachers completed the quiz on OCD; knowledge of OCD increased after reading information packs. Twenty six parents attended webinars; parents reacted positively to being able to ask specialists questions and receive support from other families. Conclusion: Overall, the initiatives evaluated in this study appeared to lead to an increase in knowledge of OCD in teachers and provided access to further support for parents of children with OCD.
Inconsistency in the Reporting of Adverse Events in Total Ankle Arthroplasty
Authors: Mercer Jeff , Penner Murray , Wing Kevin , Younger Alastair S. E. 
Published: October 2015

Background: Systems for classifying complications have been proposed for many surgical subspecialties. The goal of this systematic review was to analyze the number and frequency of different terms used to identify complications in total ankle arthroplasty. We hypothesized that this terminology would be highly variable, supporting a need for a standardized system of reporting. Methods: Studies that met predefined inclusion/exclusion criteria were analyzed to identify terminology used to describe adverse events. All terms were then tabulated and quantified with regard to diversity and frequency of use across all included studies. Terms were also grouped into 10 categories, and the number of reported occurrences of each adverse event was calculated. A reporting tool was then developed. Results: Of 572 unique terms used to describe adverse outcomes in 117 studies, 55.9% (320/572) were used in only a single study. The category that was most frequently reported was revision surgery, with 86% of papers reporting on this event using 115 different terms. Other categories included “additional non-revision surgeries” (74% of papers, 93 terms), “loosening/osteolysis” (63% of papers, 86 terms), “fractures” (60% of papers, 53 terms), “wound problems” (52% of papers, 27 terms), “infection” (52% of papers, 27 terms), “implant problems” (50% of papers, 57 terms), “soft tissue injuries” (31% of papers, 30 terms), “heterotopic ossification” (22% of papers, 17 terms), and “pain” (18% of papers, 11 terms). Conclusion: The reporting of complications and adverse outcomes for total ankle arthroplasty was highly variable. This lack of consistency impedes the accurate reporting and interpretation of data required for the development of cohesive, evidence-based treatment guidelines for end-stage ankle arthritis. Standardized reporting tools are urgently needed. This study presents a prototype worksheet for the standardized assessment and reporting of adverse events. Level of Evidence: Level-III, decision analyses, systematic review of Level III studies and above.
Prolonged Infusions of Low-Dose Thrombolytics in Elderly Patients With Prosthetic Heart Valve Thrombosis
Authors: Gündüz Sabahattin , Özkan Mehmet , Yesin Mahmut , Kalçık Macit , Gürsoy Mustafa Ozan , Karakoyun Süleyman , Astarcıoğlu Mehmet Ali , Aykan Ahmet Çağrı , Gökdeniz Tayyar , Biteker Murat , Duran Nilüfer Ekşi , Yıldız Mustafa 
Published: October 2015

Background: The outcomes of thrombolytic therapy (TT) in elderly patients with prosthetic valve thrombosis (PVT) have not been evaluated previously. We investigated the outcomes of low-dose and slow infusion TT strategies in elderly patients with PVT. Methods: Twenty-seven (19 female) patients aged ≥65 years (median: 70 years, range: 65-82 years) were treated with repeated TT agents for PVT. The TT regimens included 24-hour infusion of 1.5 million units of streptokinase in 2 patients, 6-hour infusion of 25 mg recombinant tissue plasminogen activator (t-PA) in 12 patients, and 25-hour infusion of 25 mg t-PA in 13 patients. Treatment success and adverse event rates were assessed. Results: The initial and cumulative success rates were 40.7% and 85.2%, respectively. Adverse events occurred in 6 (22.2%) patients including 4 (14.8%) major (1 death, 1 rethrombosis, and 2 failed TT) and 2 (7.4%) minor (1 transient ischemic attack and 1 access site hematoma) events. Higher thrombus burden (thrombus area ≥1.1 cm2 by receiver operating characteristics analysis, sensitivity: 83.3%, specificity: 85%, area under the curve: 0.86, P = .008) and New York Heart Association class (0% vs 15.4% vs 25% vs 100% for classes I-IV, respectively, P = .02) predicted adverse events. By multiple variable analysis, thrombus area was the only independent predictor of adverse events (odds ratio: 13.8, 95% confidence interval: 1.02-185, P = .04). Conclusion: Slow infusion of low doses of TT agents (mostly t-PA) with repetition is successful and safe in elderly patients with PVT. However, excessive thrombus burden may predict adverse events.
Routine proteinuria monitoring for bevacizumab in patients with gynecologic malignancies
Authors: Lee Catherine S , Alwan Laura M , Sun Xiaocui , McLean Katherine A , Urban Renata R 
Published: October 2015

Background Proteinuria leading to nephrotic syndrome is a rare adverse event arising from treatment with bevacizumab. There is limited evidence to guide the frequency and appropriate test for monitoring for proteinuria. The purpose of this study was to determine the prevalence and severity of proteinuria during bevacizumab administration to patients with gynecologic malignancies, and to evaluate risk factors associated with this toxicity; a secondary objective was to evaluate the cost of routine proteinuria monitoring to assess for opportunities of cost containment that could change clinical practice. Methods A retrospective chart review was performed at an academic gynecologic oncology clinic. Women over 18 years of age with a diagnosed gynecologic malignancy were evaluated for the development of proteinuria while receiving bevacizumab treatment as measured by a urine protein-to-creatinine ratio. Patient and disease-specific risk factors were evaluated using logistic regression to determine correlations of risk factors to development of proteinuria. Cost assessment was performed using institution-specific data for urine laboratory tests. Results Eighty-nine patients were identified, and the overall prevalence of proteinuria of any grade was 35%. The mean number of bevacizumab cycles was 13 (2–64 cycles). The majority of patients experienced grade 1 proteinuria (70%, 62 patients). Grade 3 proteinuria was observed in two patients (2%). There was a trend toward increased bevacizumab cycles associated with increased grade proteinuria ( p = 0.053), however there were no factors significantly associated with the development of proteinuria as measured by urine protein-to-creatinine ratio. Conclusion Monitoring of urine protein-to-creatinine ratios with each cycle may be unnecessary due to the low prevalence of grade 3 proteinuria observed. Additionally, urine protein-to-creatinine ratios may not provide adequate assessment of proteinuria toxicity associated with bevacizumab therapy. Potential cost savings opportunities for the institution can be realized with a cost-reductive monitoring algorithm that will utilize less costly laboratory techniques for patients at high risk of developing proteinuria.
Progranulin genetic polymorphisms influence progression of disability and relapse recovery in multiple sclerosis
Authors: Vercellino Marco , Fenoglio Chiara , Galimberti Daniela , Mattioda Alessandra , Chiavazza Carlotta , Binello Eleonora , Pinessi Lorenzo , Giobbe Dario , Scarpini Elio , Cavalla Paola 
Published: October 2015

Background: Progranulin ( GRN) is a multifunctional protein involved in inflammation and repair, and also a neurotrophic factor critical for neuronal survival. Progranulin is strongly expressed in multiple sclerosis (MS) brains by macrophages and microglia. Methods: In this study we evaluated GRN genetic variability in 400 MS patients, in correlation with clinical variables such as disease severity and relapse recovery. We also evaluated serum progranulin levels in the different groups of GRN variants carriers. Results: We found that incomplete recovery after a relapse is correlated with an increased frequency of the rs9897526 A allele (odds ratio (OR) 4.367, p = 0.005). A more severe disease course (Multiple Sclerosis Severity Score > 5) is correlated with an increased frequency of the rs9897526 A allele (OR 1.886, p = 0.002) and of the rs5848 T allele (OR 1.580, p = 0.019). Carriers of the variants associated with a more severe disease course (rs9897526 A, rs5848 T) have significantly lower levels of circulating progranulin (80.5 ± 9.1 ng/mL vs. 165.7 ng/mL, p = 0.01). Conclusion: GRN genetic polymorphisms likely influence disease course and relapse recovery in MS.
Performance Evaluation of Three Blood Glucose Monitoring Systems Using ISO 15197
Authors: Bedini José Luis , Wallace Jane F. , Pardo Scott , Petruschke Thorsten 
Published: October 2015

Background: Blood glucose monitoring is an essential component of diabetes management. Inaccurate blood glucose measurements can severely impact patients’ health. This study evaluated the performance of 3 blood glucose monitoring systems (BGMS), Contour® Next USB, FreeStyle InsuLinx®, and OneTouch® Verio™ IQ, under routine hospital conditions. Methods: Venous blood samples (N = 236) obtained for routine laboratory procedures were collected at a Spanish hospital, and blood glucose (BG) concentrations were measured with each BGMS and with the available reference (hexokinase) method. Accuracy of the 3 BGMS was compared according to ISO 15197:2013 accuracy limit criteria, by mean absolute relative difference (MARD), consensus error grid (CEG) and surveillance error grid (SEG) analyses, and an insulin dosing error model. Results: All BGMS met the accuracy limit criteria defined by ISO 15197:2013. While all measurements of the 3 BGMS were within low-risk zones in both error grid analyses, the Contour Next USB showed significantly smaller MARDs between reference values compared to the other 2 BGMS. Insulin dosing errors were lowest for the Contour Next USB than compared to the other systems. Conclusions: All BGMS fulfilled ISO 15197:2013 accuracy limit criteria and CEG criterion. However, taking together all analyses, differences in performance of potential clinical relevance may be observed. Results showed that Contour Next USB had lowest MARD values across the tested glucose range, as compared with the 2 other BGMS. CEG and SEG analyses as well as calculation of the hypothetical bolus insulin dosing error suggest a high accuracy of the Contour Next USB.
Evaluating Intention and Effect
Authors: Alvaro Celeste , Wilkinson Andrea J. , Gallant Sara N. , Kostovski Deyan , Gardner Paula 
Published: October 2015

Objective: This post occupancy evaluation (POE) assessed the impact of architectural design on psychosocial well-being among patients and staff in the context of a new complex continuing care and rehabilitation facility. Background: Departing from typical POEs, the hospital design intentions formed the theoretical basis to assess outcomes. Intentions included creating an environment of wellness; enhancing connection to the community, the city, and nature; enhancing opportunities for social interaction; and inspiring activity. Methods: A pretest–posttest quasi experiment, including quantitative surveys, assessed the impact of the building design on well-being outcomes across three facilities—the new hospital, the former hospital, and a comparison facility with a similar population. Results: With the exception of connection to neighborhood (for patients) and opportunities to visit with others (for staff) and wayfinding (for patients and staff), impressions of the new hospital mirrored the design intentions relative to the former hospital and the comparison facility among patients and staff. Perceptions of improvement in mental health, self-efficacy in mobility, satisfaction, and interprofessional interactions were enhanced at the new hospital relative to the former hospital, whereas optimism, depressive symptoms, general well-being, burnout, and intention to quit did not vary. Interestingly, patients and staff with favorable impressions of the building design fared better on most well-being-related outcomes relative to those with less favorable impressions. Conclusions: Beyond the value of assessing the impact of the design intentions on outcomes, the approach used in this study would benefit evaluation strategies across a diversity of health and other public and large-scale buildings.
Activation of the erythroid K-Cl cotransporter Kcc1 enhances sickle cell disease pathology in a humanized mouse model
Authors: Brown Fiona C. , Conway Ashlee J. , Cerruti Loretta , Collinge Janelle E. , McLean Catriona , Wiley James S. , Kile Ben T. , Jane Stephen M. , Curtis David J. 
Published: October 2015

Key Points
A missense mutation in the cytoplasmic tail of Kcc1 activates K-Cl cotransporter activity by impairing phosphorylation of nearby threonines. In vivo evidence shows that activation of Kcc1 directly contributes to the pathogenesis of sickle cell disease.