bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Intercomparison of Acoustic Current Meter Measurements in Low to Moderate Flow Regions
Authors: Drozdowski Adam , Greenan Blair J. W. 
Published: March 2013

Abstract
Instrumented, subsurface moorings deployed in the Scotian shelf and slope regions of the North Atlantic provide data in low to moderate flows for a current meter intercomparison. The primary instruments being evaluated are two acoustic Doppler single-point current meters, the Aanderaa Seaguard (SG) and the Teledyne RD Instruments (RDI) Doppler volume sampler (DVS), which are compared against older-generation single-point current meters and acoustic Doppler current profilers. Analysis showed that the root-mean-square (RMS) of the speed difference between concurrent instrument combinations was in the range of 1.0–1.6 cm s−1, which is about 3%–6% of the upper limit of speeds observed at these sites. Best agreement was between the DVS and the nearby Seaguard (RMS speed difference of 1.2 cm s−1), during the shelf deployment, and between the Aanderaa recording current meter 11 (RCM11) and the nearby Seaguard (1.0 cm s−1), during the slope deployment. Speed differences larger than 4 cm s−1 were uncommon, occurring less than 1.5% of the time. Slight overspeeding of one of the Seaguards is traced to an intentional alteration in the instruments' sampling strategy. The DVS compass had a slight meandering tendency that caused it to routinely disagree with other instruments by as much as 15° for hours at a time. The disagreement was random in direction and had no impact on most of the comparisons, but it did produce a 15% smaller magnitude of mean current. Subsequent to this field test, Teledyne RDI redesigned the DVS and replaced the compass with a new sensor.
Environmental Flow Impacts on Tropical Cyclone Structure Diagnosed from Airborne Doppler Radar Composites
Authors: Reasor Paul D. , Rogers Robert , Lorsolo Sylvie 
Published: March 2013

Abstract
Following a recent demonstration of multicase compositing of axisymmetric tropical cyclone (TC) structure derived from airborne Doppler radar measurements, the authors extend the analysis to the asymmetric structure using an unprecedented database from 75 TC flights. In particular, they examine the precipitation and kinematic asymmetry forced by the TC's motion and interaction with vertical wind shear. For the first time they quantify the average magnitude and phase of the three-dimensional shear-relative kinematic asymmetry of observed TCs through a composite approach. The composite analysis confirms principal features of the shear-relative TC asymmetry documented in prior numerical and observational studies (e.g., downshear tilt, downshear-right convective initiation, and a downshear-left precipitation maximum). The statistical significance of the composite shear-relative structure is demonstrated through a stratification of cases by shear magnitude. The impact of storm motion on eyewall convective asymmetry appears to be secondary to the much greater constraint placed by vertical wind shear on the organization of convection, in agreement with prior studies using lightning and precipitation data.
Influence of Mesonet Observations on the Accuracy of Surface Analyses Generated by an Ensemble Kalman Filter
Authors: Knopfmeier Kent H. , Stensrud David J. 
Published: March 2013

Abstract
The expansion of surface mesoscale networks (mesonets) across the United States provides a high-resolution observational dataset for meteorological analysis and prediction. To clarify the impact of mesonet data on the accuracy of surface analyses, 2-m temperature, 2-m dewpoint, and 10-m wind analyses for 2-week periods during the warm and cold seasons produced through an ensemble Kalman filter (EnKF) approach are compared to surface analyses created by the Real-Time Mesoscale Analysis (RTMA). Results show in general a similarity between the EnKF analyses and the RTMA, with the EnKF exhibiting a smoother appearance with less small-scale variability. Root-mean-square (RMS) innovations are generally lower for temperature and dewpoint from the RTMA, implying a closer fit to the observations. Kinetic energy spectra computed from the two analyses reveal that the EnKF analysis spectra match more closely to the spectra computed from observations and numerical models in earlier studies. Data-denial experiments using the EnKF completed for the first week of the warm and cold seasons, as well as for two periods characterized by high mesoscale variability within the experimental domain, show that mesonet data removal imparts only minimal degradation to the analyses. This is because of the localized background covariances computed for the four surface variables having spatial scales much larger than the average spacing of mesonet stations. Results show that removing 75% of the mesonet observations has only minimal influence on the analysis.
Does Elastic Resistance Affect Finger Pinch Discrimination?
Authors: Han Jia , Waddington Gordon , Anson Judith , Adams Roger 
Published: March 2013

Objective: The sensitivity of pinch movement discrimination between the thumb and index finger was assessed with and without elastic resistance. Background: Researchers have examined the effect of elastic resistance on control of single upper-limb movements; however, no one has explored how elastic resistance affects proprioceptive acuity when using two digits simultaneously in a coordinated movement. Method: For this study, 16 right-handed, healthy young adults undertook an active finger pinch movement discrimination test for the right and left hands, with and without elastic resistance. We manipulated pinch movement distance by varying the size of the object that created the physical stop to end the pinch action. Results: Adding elastic resistance from a spring to the thumb–index finger pinch task did not affect accuracy of pinch discrimination measured as either the just noticeable difference, F(1, 15) = 1.78, p = .20, or area under the curve, F(1, 15) = 0.07, p = .80. Conclusion: Having elastic resistance to generate lever return in pincers, tweezers, and surgical equipment or in virtual instruments is unlikely to affect pinch movement discrimination. Application: Elastic resistance did not affect finger pinch discrimination in the present study, suggesting that return tension on equipment lever arms has a practical but not perceptual function. An active finger pinch movement discrimination task, with or without elastic resistance, could be used for hand proprioceptive training and as a screening tool to identify those with aptitude or decrements in fine finger movement control.
Return to Competitive Sports After Medial Epicondyle Fractures in Adolescent Athletes
Authors: Lawrence J. Todd R. , Patel Neeraj M. , Macknin Jonathan , Flynn John M. , Cameron Danielle , Wolfgruber Hayley C. , Ganley Theodore J. 
Published: March 2013

Background: The optimal treatment of medial epicondyle fractures in pediatric athletes remains unclear. Purpose: To evaluate the outcomes of operative and nonoperative management of medial epicondyle fractures in young athletes. Study Design: Case series; Level of evidence, 4. Methods: The records of all children with fractures of the medial epicondyle over a 5-year period, with a minimum 2 years of follow-up at a pediatric tertiary referral center, were reviewed. Patients with intra-articular entrapment of the fracture fragment or ulnar nerve entrapment were excluded. Treatment decisions were made primarily based on injury mechanism and elbow laxity or instability. Patients were contacted and asked to complete a modified Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Results: Complete data with 2-year follow-up were available for 20 athletes: 6 treated nonoperatively and 14 treated operatively. At the latest follow-up, both groups achieved excellent DASH scores. Half of each cohort required physical therapy, and 6 of 14 patients who received operative treatment reported numbness. All patients were either very or completely satisfied with their treatment. Fourteen patients were overhead athletes (8 treated operatively, 6 nonoperatively). Excellent DASH scores were achieved in both groups, and all overhead athletes were able to return to their sport at the next appropriate level. Seven patients were baseball pitchers and sustained a fracture while throwing (4 treated operatively, 3 nonoperatively). None felt their performance was limited after treatment, and excellent DASH scores were achieved in both groups. Conclusion: These data demonstrate that nonoperative treatment can be successful in young athletes with low-energy medial epicondyle avulsions, a stable elbow, and minimal fracture displacement. Surgical management can be successful in athletes who sustain more significant trauma, who have elbow laxity or instability, or who have significant fracture fragment displacement after a fracture of the medial epicondyle.
Articular Chondral Damage of the First Metatarsal Head and Sesamoids
Authors: Doty Jesse F. , Coughlin Michael J. , Schutt Shane , Hirose Christopher , Kennedy Michael , Grebing Brett , Smith Bertil , Cooper Truitt , Golano Pau , Viladot Ramon , Remington Richard 
Published: March 2013

Background: Evidence of successful correction on postoperative hallux valgus imaging studies may not always correlate with patient satisfaction. Recent attention to the association of cartilaginous degeneration and hallux valgus may provide new insight into treatment algorithms and patient expectations. The purpose of this cadaveric study was to evaluate the degree of chondral damage as it relates to increasing hallux valgus deformity. Methods: A total of 39 cadaver first metatarsophalangeal joints were evaluated by radiography, and then dissected to evaluate for chondral damage. Chondral lesion grade, size, and location were recorded and then analyzed based on patient demographics and hallux valgus angle. Results: Twenty-nine of 39 specimens were considered to have hallux valgus characterized by a hallux valgus angle of 15 degrees or greater. Four of 39 (10%) specimens revealed absence of chondral lesions, and 3 of those were found in the group with a hallux valgus angle of less than 15 degrees. Chondral lesions of increasing size and grade were seen more commonly with a more severe hallux valgus deformity. Particular locations on the metatarsal head appeared to be more prone to cartilaginous lesions when compared to other locations. Conclusion: Assessment of first metatarsophalangeal joint articular damage with regard to hallux valgus may be an important clinical parameter for consideration. Clinical Relevance: Operative intervention to realign the first metatarsophalangeal joint may correct malalignment and relieve pressure on the widened forefoot, but residual pain within the joint may emanate from preexisting articular cartilaginous lesions. These findings support the concept that earlier intervention with operative realignment of a hallux valgus deformity and specifically the sesamoid complex may diminish degenerative changes.
Virtual Reality Simulator Training of Laparoscopic Cholecystectomies — A Systematic Review
Authors: Ikonen T. S. , Antikainen T. , Silvennoinen M. , Isojärvi J. , Mäkinen E. , Scheinin T. M. 
Published: March 2013

Background and Aims: Simulators are widely used in occupations where practice in authentic environments would involve high human or economic risks. Surgical procedures can be simulated by increasingly complex and expensive techniques. This review gives an update on computer-based virtual reality (VR) simulators in training for laparoscopic cholecystectomies. Materials and Methods: From leading databases (Medline, Cochrane, Embase), randomised or controlled trials and the latest systematic reviews were systematically searched and reviewed. Twelve randomised trials involving simulators were identified and analysed, as well as four controlled studies. Furthermore, seven studies comparing black boxes and simulators were included. Results: The results indicated any kind of simulator training (black box, VR) to be beneficial at novice level. After VR training, novice surgeons seemed to be able to perform their first live cholecystectomies with fewer errors, and in one trial the positive effect remained during the first ten cholecystectomies. No clinical follow-up data were found. Optimal learning requires skills training to be conducted as part of a systematic training program. No data on the cost-benefit of simulators were found, the price of a VR simulator begins at EUR 60 000. Conclusions: Theoretical background to learning and limited research data support the use of simulators in the early phases of surgical training. The cost of buying and using simulators is justified if the risk of injuries and complications to patients can be reduced. Developing surgical skills requires repeated training. In order to achieve optimal learning a validated training program is needed.
Single-Incision Laparoscopic Colectomy Using the Gelport System for Early Colon Cancer
Authors: Egi H. , Okajima M. , Hinoi T. , Takakura Y. , Kawaguchi Y. , Shimomura M. , Tokunaga M. , Adachi T. , Hattori M. , Urushihara T. , Itamoto T. , Ohdan H. 
Published: March 2013

Background Laparoscopic surgery has spread quickly during the past twenty years, and has become one of the important treatments in the field of colorectal surgery. Recently, natural orifice transluminal endoscopic surgery (NOTES) has been studied as the next generation of minimally-invasive surgery, but the feasibility and safety of the NOTES method have not been evaluated. In such a situation, single-incision laparoscopic surgery has attracted interest from surgeons worldwide. However, single-incision laparoscopic colorectal surgery has not yet been standardized. Methods From February 2010, single-incision laparoscopic colectomy was performed for 7 patients presenting with early colon cancer. All procedures were performed by two experts with the License of Endoscopic Surgical Skill Qualification System (ESSQS) of Japan Society for Endoscopic Surgery (JSES) in the field of colorectal Surgery. Results We used the Gelport system (Applied Medical, Rancho Santa Margarita, CA, USA) as the access port and 3 trocars of different sizes (Ethicon, Inc., Cincinnati, OH, USA). Using this technique, we did not experience any difficulties or use any articulated instruments. All of the present 7 patients underwent the single-incision laparoscopic colectomy successfully and had no complications. Conclusion: Single-incision laparoscopic surgery using the Gelport was performed safely in the present cases. The use of the Gelport as an access port can address the technical difficulty associated with this new technique.
Distal Pancreatectomy Using a No-Touch Isolation Technique
Authors: Hirota M. , Hashimoto D. , Ishiko T. , Satoh N. , Takamori H. , Chikamoto A. , Tanaka H. , Sugita H. , Sand J. , Nordback I. , Baba H. 
Published: March 2013

Background and Aims: Distal pancreatectomy is the only effective treatment for cancers of the pancreatic body and tail. The recurrence rate after DPhas remained high. In an effort to overcome this problem, we developed a no-touch surgical technique for DP. This is a pilot study to see if distal pancreatectomy can be technically done using a no-touch surgical technique without deteriorating the post-operative prognosis. Patients and Methods: From November 2000 through May 2011, 16 pancreatic ductal adenocarcinoma patients have been operated on using a no-touch technique by a single operator. We described the surgical technique, and we reported our preliminary experience. During the procedure, the pancreatic body and tail is neither grasped nor squeezed by the surgeon. And all drainage vessels from the pancreatic body and tail are ligated and divided during the early phase of the operation. Furthermore, for improved dissection of the retroperitoneal tissue (rightward and posterior margins), we use a hanging and clamping maneuver and dissection behind Gerota's fascia. Results: In the current series, the posterior and rightward resection margins were free in all patients, although seven were positive for anterior serosal invasion. The post-operative prognosis was not deteriorated with this technique. Conclusion: No-touch distal pancreatectomy technique may have some theoretical advantages, which merit future investigation in randomized controlled trials.
Predictors of Failure of Endovascular Revascularization for Critical Limb Ischemia
Authors: Korhonen M. , Halmesmäki K. , Lepäntalo M. , Venermo M. 
Published: March 2013

Background and Aims: To characterize predictors of failure when treating critical limb ischemia (CLI) patients with an endovascular intervention as the first-line strategy. Patients and Methods: This retrospective, registry-based study included 217 consecutive patients with 240 chronic critically ischemic limbs treated with infrainguinal percutaneous transluminal angioplasty (PTA) during 2006–2007 at Helsinki University Central Hospital, Finland. The primary outcome measures were death, major (above-ankle) amputation, and the need for surgical re-intervention within 6 months after the primary procedure. The secondary outcome measures were overall major amputation and survival rates as well as the overall need for surgical or any other (surgical or endovascular) type of re-intervention. Predictors of outcome endpoints were identified with a univariate screen, and a Cox regression model was used in the multivariate analysis. Results: Compared to ulcer, gangrene was significantly more strongly associated with amputation within 6 months post-procedurally as well as during the whole follow-up period (p ≤ 0.028). The patient's inability to walk upon hospital arrival was a significant predictor of death, amputation and surgical re-intervention. Mediasclerotic ankle-brachial index (ABI) was an independent predictor of amputation as well as endovascular re-interventions. Conclusions: The strong predictors of poor outcome after endovascular revascularization for patients with CLI are cardiac morbidity, the inability to ambulate upon hospital arrival, and gangrene as a manifestation of CLI. The risk of amputation seems to be significantly higher for gangrene than for ulcer and this matter should be taken into account in the clinical classifications for CLI.
Gender Differences in Outcome after Stent Treatment of Lesions in the Femoropopliteal Segment
Authors: Lindgren H. , Gottsäter A. , Hermansson K. , Qvarfordt P. , Bergman S. 
Published: March 2013

Background and Aims: Although endovascular stent treatment is increasingly used in infrainguinal atherosclerotic occlusive disease, outcome with focus on gender differences has not been reported in detail. Material and Methods: One hundred and twelve consecutive patients (67 [60%]) women, undergoing endovascular nitinol stent treatment of atherosclerotic lesions in the femoropopliteal segment were analysed concerning improvement in ankle brachial index (ABI), reinterventions, complications, amputation and survival rates up to 12 months after intervention. Risk factors for amputation and death were analyzed with logistic regression. Results: At presentation, women showed critical limb ischemia (CLI) more often than men (87% vs. 58 %; P = 0.001). After 12 months ABI had improved (from 0.40 ± 0.26 at baseline to 0.86 ± 0.22 after 12 months, P < 0.001), but 16 patients (15%) had been amputated and 27 patients (24 %) had died. After adjustment for age, diabetes mellitus and smoking, female gender was an independent risk factor for amputation (OR 9.0; 95% CI 1.1–76.5; P = 0.045). Conclusions: Stent treatment of lesions in the femoropopliteal segment had favourable effects on ABI and limb salvage. Treated women more often had CLI and ran a higher risk for amputation within 12 months than men. This might reflect failure of clinicians to adequately appreciate symptoms of atherosclerotic leg artery disease in women.
Does Preoperative Radiotherapy with Postoperative Chemotherapy Increase Acute Side-Effects and Postoperative Complications of Total Mesorectal Excision? Report of the Randomized Finnish Rectal Cancer Trial
Authors: Salmenkylä S. , Kouri M. , Österlund P. , Pukkala E. , Luukkonen P. , Hyöty M. , Pääkkönen M. , Mäkelä J. , Mustonen H. , Järvinen H. J. ,   The Finnish Rectal Cancer Trial Group
Published: March 2013

Background and Aims: In a randomized trial the effect of short-term preoperative radio therapy and postoperative chemotherapy was studied in patients undergoing total mesorectal excision (TME) for clinically resectable rectal cancer. The primary endpoint was overall survival. The secondary endpoints published herein were the incidence of postoperative complications and adverse events with perioperative adjuvant therapy. Material and Methods: In 1995–2002, 278 eligible patients with stage II and stage III rectal cancer were randomly assigned to TME alone (surgery group) or to preoperative 25Gy radiotherapy in 5 fractions and postoperative 5-fluorouracil and leucovorin chemotherapy in addition (RT+CTgroup). Results: Anastomotic leakage rate did not significantly differ between the surgery and the RT + CT group, 20.6% vs. 27.4%. Postoperative infections (15.5 vs. 26.2%, p = 0.037) and perineal wound dehiscence (15.9 vs. 38.5%, p = 0.045) were more common after radiotherapy. Grade 3–5 adverse events were uncommon with preoperative radiotherapy (one, 0.7% with reversible lumbar plexopathy) and postoperative chemotherapy (hematologic in 10.8%, with one septic death, and gastrointestinal in 4.8%). Conclusions: Perioperative adjuvant therapy was generally well tolerated and did not lead to an increase in serious surgical complications. Wound infections and perineal wound dehiscence were more common in irradiated patients.
Allograft Juvenile Articular Cartilage Transplantation for Treatment of Talus Osteochondral Defects
Authors: Giza Eric , Howell Stacey 
Published: March 2013

Osteochondral (OCD) lesions of the talus are frequent sequelae of traumatic ankle injuries such as ankle sprains, fractures, and recurrent ankle instability. Initial management of talus lesions in most cases involves arthroscopy and microfracture/curettage. Tissue resulting from the microfracture is fibrocartilage. Clinical improvement in pain is seen in approximately 75% to 85% of people in a number of studies with long-term follow-up. Often, large lesions (>1 cm2) or those with cystic changes require secondary procedures such as talus allograft/autograft or autologous chondrocyte implantation. The use of a juvenile articular chondrocyte allograft is an option for large or refractory lesions and has the advantage of obviating the need for a tibial or fibular osteotomy. The purpose of this article is to describe a novel arthroscopic surgical technique for transplantation of juvenile chondrocytes as a treatment for talus OCD defects. Levels of Evidence: Level IV