bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Blood Pressure–Lowering Treatment in Different Subtypes of Acute Ischemic Stroke
Authors: Sandset Else Charlotte , Jusufovic Mirza , Sandset Per Morten , Bath Philip M.W. , Berge Eivind 
Published: February 2015

Background and Purpose—
The Scandinavian Candesartan Acute Stroke Trial (SCAST) found no benefits of blood pressure–lowering treatment with candesartan in acute stroke. We have investigated whether the effect of treatment is different in different subtypes of ischemic stroke.

Methods—
SCAST was a randomized- and placebo-controlled trial of candesartan in 2029 patients presenting within 30 hours of ischemic or hemorrhagic stroke and systolic blood pressure ≥140 mm Hg. Ischemic stroke subtype was categorized by the Oxfordshire Community Stroke Project classification. There were 2 primary effect variables: the composite vascular end point of vascular death, myocardial infarction, or stroke during the first 6 months and functional outcome at 6 months.

Results—

A total of 1733 patients with ischemic stroke were included: total anterior circulation infarcts in 129, partial anterior in 850, posterior in 236, and lacunar in 510 patients. For functional outcome there was a significant trend toward a better effect of candesartan in patients with larger infarcts (total anterior circulation or partial anterior circulation) than in patients with smaller infarcts (lacunar infarction;
P
=0.02). For the composite vascular end point, there were no differences in treatment effect.

Conclusions—
The results suggest that the effect of blood pressure–lowering treatment with candesartan may differ according to different types of acute ischemic stroke, but this needs to be confirmed in future trials.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00120003.
Large-Eddy Simulation of Turbulent Barotropic Flows in Spectral Space on a Sphere
Authors: Azadani L. N. , Staples A. E. 
Published: February 2015

Abstract
Numerical simulations of atmospheric circulation models are limited by their finite spatial resolution, so large-eddy simulation (LES) is a preferred approach to study these models. In LES, a low-pass filter is applied to the flow field to separate the large- and small-scale motions. In implicitly filtered LES, the computational mesh and discretization schemes are considered to be the low-pass filter, while in the explicitly filtered LES approach, the filtering procedure is separated from the grid and discretization operators and allows for better control of the numerical errors. The aim of this paper is to study and compare implicitly filtered and explicitly filtered LES of atmospheric circulation models in spectral space. To achieve this goal, the results of implicitly filtered and explicitly filtered LES of a barotropic atmosphere circulation model on a sphere in spectral space are presented and compared with the results obtained from direct numerical simulation (DNS). Different numerical experiments are performed to investigate the efficiency of explicit filtering over implicit filtering under different dissipation terms and rotation rates. The study shows that explicit filtering increases the accuracy of the computations and improves the results, particularly where the location of coherent structures is concerned, a topic of particular importance in LES of atmospheric flows for climate and weather applications.
Variation of Lightning and Convective Rain Fraction in Mesoscale Convective Systems of the MJO
Authors: Virts Katrina S. , Houze Robert A. 
Published: February 2015

Abstract
Characteristics of mesoscale convective systems (MCSs) in regions affected by the Madden–Julian oscillation (MJO) are investigated using a database of MCSs observed by the Moderate Resolution Imaging Spectroradiometer (MODIS) and the Advanced Microwave Scanning Radiometer for Earth Observing System (AMSR-E). Lightning occurrence detected by the World-Wide Lightning Location Network (WWLLN) is composited in a framework centered on the MCSs. During MJO active periods, MCSs are more numerous and larger, as the convective features persist and attain greater horizontal scales. Anomalies of the lifted index, derived from the European Centre for Medium-Range Weather Forecasts (ECMWF) interim reanalysis (ERA-Interim) fields, indicate that MCS environments are more stable during MJO active periods.
Over the Indian Ocean, Maritime Continent, and western Pacific, lightning density in an MCS maximizes during the time that the total number of systems begins to increase as the MJO is beginning to be more active, implying both more vigorous convection and less extensive stratiform rain areas at this transitional time of the MJO. The peak in MJO precipitation coincides with peak occurrence of interconnected MCSs with larger stratiform rain fraction, shown by the Tropical Rainfall Measuring Mission satellite, while composites of lightning frequency show that during MJO active periods the zone of lightning is contracted around the centers of MCSs, and flashes are less frequent.
Determining the Origins of Advective Heat Transport Convergence Variability in the North Atlantic
Authors: Buckley Martha W. , Ponte Rui M. , Forget Gaël , Heimbach Patrick 
Published: February 2015

AbstractA recent state estimate covering the period 1992–2010 from the Estimating the Circulation and Climate of the Ocean (ECCO) project is utilized to quantify the roles of air–sea heat fluxes and advective heat transport convergences in setting upper-ocean heat content anomalies H in the North Atlantic Ocean on monthly to interannual time scales. Anomalies in (linear) advective heat transport convergences, as well as Ekman and geostrophic contributions, are decomposed into parts that are due to velocity variability, temperature variability, and their covariability. Ekman convergences are generally dominated by variability in Ekman mass transports, which reflect the instantaneous response to local wind forcing, except in the tropics, where variability in the temperature field plays a significant role. In contrast, both budget analyses and simple dynamical arguments demonstrate that geostrophic heat transport convergences that are due to temperature and velocity variability are anticorrelated, and thus their separate treatment is not insightful. In the interior of the subtropical gyre, the sum of air–sea heat fluxes and Ekman heat transport convergences is a reasonable measure of local atmospheric forcing, and such forcing explains the majority of H variability on all time scales resolved by ECCO. In contrast, in the Gulf Stream region and subpolar gyre, ocean dynamics are found to be important in setting H on interannual time scales. Air–sea heat fluxes damp anomalies created by the ocean and thus are not set by local atmospheric variability.
A Dynamical Climate Model–Driven Hydrologic Prediction System for the Fraser River, Canada
Authors: Shrestha Rajesh R. , Schnorbus Markus A. , Cannon Alex J. 
Published: February 2015

AbstractRecent improvements in forecast skill of the climate system by dynamical climate models could lead to improvements in seasonal streamflow predictions. This study evaluates the hydrologic prediction skill of a dynamical climate model–driven hydrologic prediction system (CM-HPS), based on an ensemble of statistically downscaled outputs from the Canadian Seasonal to Interannual Prediction System (CanSIPS). For comparison, historical and future climate traces–driven ensemble streamflow prediction (ESP) was employed. The Variable Infiltration Capacity model (VIC) hydrologic model setup for the Fraser River basin, British Columbia, Canada, was used as a test bed for the two systems. In both cases, results revealed limited precipitation prediction skill. For streamflow prediction, the ESP approach has very limited or no correlation skill beyond the months influenced by initial hydrologic conditions, while the CM-HPS has moderately better correlation skill, attributable to the enhanced temperature prediction skill that results from CanSIPS’s ability to predict El Niño–Southern Oscillation (ENSO) and its teleconnections. The root-mean-square error, bias, and categorical skills for the two methods are mostly similar. Hydrologic modeling uncertainty also affects the prediction skill, and in some cases prediction skill is constrained by hydrologic model skill. Overall, the CM-HPS shows potential for seasonal streamflow prediction, and further enhancements in climate models could potentially to lead to more skillful hydrologic predictions.
Transport of Surface Freshwater from the Equatorial to the Subtropical North Atlantic Ocean
Authors: Foltz Gregory R. , Schmid Claudia , Lumpkin Rick 
Published: February 2015

AbstractThe transport of low-salinity water northward in the tropical and subtropical North Atlantic Ocean influences upper-ocean stratification, vertical mixing, and sea surface temperature (SST). In this study, satellite and in situ observations are used to trace low-salinity water northward from its source in the equatorial Atlantic and to examine its modification through air–sea fluxes and vertical mixing. In contrast to gridded climatologies, which depict a gradual northward dispersal of surface freshwater from the equatorial Atlantic, satellite observations and direct measurements from four moorings in the central tropical North Atlantic show a distinct band of surface freshwater moving northward from the equatorial Atlantic during boreal fall through spring, with drops in sea surface salinity (SSS) of 0.5–2.5 psu in the span of one to two weeks as the low SSS front passes. The ultimate low-latitude source of the low SSS water is found to be primarily Amazon River discharge west of 40°W and rainfall to the east. As the low-salinity water moves northward between 8° and 20°N during October–April, 70% of its freshwater in the upper 20 m is lost to the combination of evaporation, horizontal eddy diffusion, and vertical turbulent mixing, with an implied rate of SSS damping that is half of that for SST. During 1998–2012, interannual variations in SSS along 38°W are found to be negatively correlated with the strength of northward surface currents. The importance of ocean circulation for interannual variations of SSS and the small damping time scale for SSS emphasize the need to consider meridional freshwater advection when interpreting SSS variability in the tropical–subtropical North Atlantic.
Ensemble-Based Error and Predictability Metrics Associated with Tropical Cyclogenesis. Part II: Wave-Relative Framework
Authors: Komaromi William A. , Majumdar Sharanya J. 
Published: February 2015

Abstract
The predictability of selected variables associated with tropical cyclogenesis is examined using 10-day ECMWF ensemble forecasts for 21 events from the 2010 Atlantic hurricane season. Variables are associated with the strength of the pregenesis disturbance, quantified via circulation and thickness anomaly, and the favorability of the immediate environment via moisture and vertical wind shear.
For approximately half of the cases, the predicted strength of the genesis signal is directly related to the predicted favorability of the environment. For the remainder of the cases, predictability is more directly associated with the strength and location of the analyzed disturbance. Some commonalities among the majority of the sample are also observed. Forecast joint distributions demonstrate that 700-hPa relative humidity of less than 60% within 300 km of the circulation center is a limiting factor for genesis. Genesis is also predicted and found to occur in the presence of significant wind shear (~15 m s−1), but almost exclusively when the core and environment of the wave are both very moist.
The ensemble also demonstrates the potential to predict error standard deviation of variables averaged within 300- and 1000-km radii about individual tropical waves. Forecasts with greater ensemble standard deviation tend to be, on average, associated with greater mean error, especially for forecasts of less than 7 days. However, model biases, particularly a dry core and weak circulation bias, become pronounced at longer lead times. Overall, these results demonstrate that both the environmental conditions favorable to genesis and the genesis events themselves may be predictable to a week or more.
Evaluation of Forecast Performance of Asian Summer Monsoon Low-Level Winds Using the TIGGE Dataset
Authors: Niu Ruoyun , Zhai Panmao , Zhou Baiquan 
Published: February 2015

Abstract
The forecast performances of the East Asian summer monsoon (EASM) and South Asian summer monsoon (SASM) by six THORPEX Interactive Grand Global Ensemble (TIGGE) centers during the summers of 2008–13 were evaluated to reflect the current predictability of state-of-the-art numerical weather prediction. The results show that the EASM is overestimated by all TIGGE centers except the Canadian Meteorological Centre (CMC). The SASM is overestimated by the European Centre for Medium-Range Weather Forecasts (ECMWF), the China Meteorological Administration (CMA), and the CMC, but is underpredicted by the Japan Meteorological Agency (JMA). Additionally, the SASM is overestimated for early lead times and underestimated for longer lead times by the National Centers for Environmental Prediction (NCEP) and the Met Office (UKMO). Further analysis suggests that such biases are likely associated with land–sea thermal contrasts. The EASM surge is overestimated by the NCEP and CMA and mainly underestimated by the others. The bias predictabilities for the SASM surge are similar to those of the SASM. The peaks of the SASM and EASM, including their surges, are mainly underestimated, whereas the valleys are mostly overestimated. Overall, the ECMWF and UKMO have the highest forecast skill in predicting the SASM and EASM and both have respective advantages. The TIGGE centers generally show higher skill in predicting the SASM than the EASM, and their skill in forecasting the SASM and EASM is superior to that for their respective surges. Moreover, bias-correction forecast skills show improvement with higher correlation coefficients in raw forecast verification.
Tea consumption and the risk of depression: A meta-analysis of observational studies
Authors: Dong Xiaoxin , Yang Chen , Cao Shiyi , Gan Yong , Sun Huilian , Gong Yanhong , Yang Huajie , Yin Xiaoxu , Lu Zuxun 
Published: February 2015

Objective: Whether tea consumption decreases the risk of depression remains controversial. We performed a meta-analysis of findings from observational studies to evaluate the association between tea consumption and depression risk. Method: Embase, PubMed, and Chinese National Knowledge Infrastructure databases were searched from their inception through August 2014 for observational studies that had reported the association between tea consumption and depression risk. We used a fixed effects model when heterogeneity was negligible and a random effect model when heterogeneity was significant to calculate the summary relative risk estimates (RRs) and 95% confidence intervals (CIs). Results: Eleven studies with 13 reports were eligible for inclusion in the meta-analysis (22,817 participants with 4,743 cases of depression). Compared to individuals with lower tea consumption, those with higher tea consumption had a pooled RR of depression risk at 0.69 (95% CI: 0.63–0.75). Eight reports were included in the dose–response analysis of tea consumption and depression risk (10,600 participants with 2,107 cases). There was a linear association between tea consumption and the risk of depression, with an increment of 3 cups/day in tea consumption associated with a decrease in the risk of depression of 37% (RR = 0.63, 95% CI: 0.55–0.71). Conclusion: Tea consumption is associated with a decreased risk of depression.
Flexible OGD for Symptomatic Laryngopharyngeal Reflux?
Authors: Narayan Jeena , Mitchell‐Innes Alistair , Rockey Jason 
Published: February 2015

Objective1) To evaluate the flexible oesophagogastroduodenoscopy (FOGD) service offered by an ENT department in a university teaching hospital. 2) To determine whether FOGD has significant benefit in patients with LPR. 3) Is TNE (transnasal esophagoscopy) an alternative in this group of patients?MethodStudy designed as service evaluation of esophagogastroduodenoscopy performed by the otolaryngologist. Retrospective data were collected from the endoscopy and ENT departments over 2½ years. Included were esophagogastroduodenoscopy performed by an otolaryngologist for laryngopharyngeal reflux. Patients were on proton pump inhibitors (PPI), and some had speech therapy.ResultsData will be analyzed with regard to presenting symptoms, endoscopy findings, management, and follow‐up. Outcomes were measured in terms of how many underwent the full procedure as defined by the JAG (Joint Advisory Group) guidelines; accuracy of records; and whether endoscopy findings guided treatment. Was symptom control achieved, and were other treatments required? Outcomes were compared with the literature. The majority of patients benefited in terms of symptom control from initial medical treatment. About 30% required further investigations and/or treatment. The local cost‐benefit of flexible esophagogastroduodenoscopy and the possibility of transnasal esophagoscopy as an alternative service are discussed.ConclusionThis project will provide further insight into the flexible esophagogastroduodenoscopy service provided by the ENT team. It is anticipated that recommendations will be beneficial to stakeholders in improving the service to patients, and areas for future research will be identified.
New Healthcare Model: Citywide Care Management
Authors: Duncan Beth R. 
Published: February 2015

ObjectivePatient‐centered healthcare and its components of human interaction in an era of accountable healthcare and healthcare reform enables proactive preventive healthcare, saves millions in public funds, and decreases unnecessary emergency room (ER) visits; it comports with 2010 Accountable Care Act (ACA) mandates to establish patient‐centered medical homes (PCMH) and accountable care organizations (ACO) which limit diagnostic testing and some treatments and hold physicians accountable for care outcomes.MethodThe Camden Healthcare Coalition (CHCC) analyzed patient usage of ER resources and applied this to set up cost‐effective PCMHs and ACOs. Electronic medical record (EMR) data were shared with Camden hospitals and a profile of “super‐utilizers” was developed: 20% of patients generated 90% of costs; the top 1% of super‐utilizers made between 24 and 324 emergency room visits/five years; one patient was hospitalized 113 times in one year; 30 patients accounted for one‐third of Camden’s medical costs; and nearly $375 million in uncompensated care was provided.ResultsWith a modest grant and state legislation, CHCC developed a PCMH without walls for super‐utilizers: Teaching and treatment teams led by nurse practitioners visited patients in shelters and on streets. There were 40% fewer monthly ER visits, 56% less charges; reimbursements increased 50% because of enrollment of super‐utilizers in insurance programs.ConclusionThe CHCC model for proactive care for super‐utilizers provided better care—not withdrawal of care. Other cities could effectively share data and utilize the teams approach to healthcare management for super‐utilizers and other patient groups. Our model is now being considered nationally.
Failure in Oral or Oropharyngeal Cancer with Single‐Node Metastasis
Authors: Koh Yoon Woo , Lee Hyoung Shin , Kim Won Shik , Hong HyunJun , Lee So‐Yoon , Chung Hyun Pil , Choi Eun Chang 
Published: February 2015

Objective1) Analyze the oncologic results and related clinicopathologic factors of patients with oral and oropharyngeal squamous cell carcinoma (OOSCC) who presented as clinically single lymph node metastasis, nd underwent surgery. 2) To find out a rationale for optimal management in these selected cases.MethodStudy design: Retrospective. Year study conducted: 10 years. Disease studied: Oral or oral cavity carcinoma with clinically single lymph node metastasis. Subjects: 54 patients. Setting: Tertiary center. Outcome measurement: Patterns of treatment failure, related clinicopathologic factors.ResultsThere was no metastasis in level V as clinical presentation, and only 1 case showed occult metastasis. Among the 15 cases (28%) of treatment failure, recurrence of lymph node metastasis was identified in only 1 case (1.9%). The most common cause of treatment failure or death was distant metastasis, which occurred in 10 patients (18.5%). Clinical (P =. 005) and pathologic (P =. 003) T stage were risk factors for the distant metastasis.ConclusionNodal recurrence was rare, and distant metastasis was the main cause of failure and death with OOPSCC with single lymph node metastasis. While there is feasibility to save level V in these cases, distant metastasis should be considered in adjuvant therapy and follow up for patients with advanced T stage.
FAMM FLAP in Head and Neck Surgery
Authors: Gobel Yves , Valette Gerald , Abgral Ronan , Rousset Jean , Potard Gael , Marianowski Remi 
Published: February 2015

ObjectiveFacial artery mucosa musclar (FAMM) flap is mainly used in head and neck oncologic surgery for primary reconstruction after resection in oral cavity and in surgical treatment of osteoradionecrosis of the mandible. Some benefits are ease of use, good vitality, and no aesthetic prejudice. Recently, robotic surgery has made removal of the flap inside the mouth cavity easier, thanks to a wider field of view and smaller surgical instruments.MethodRetrospective study. Forty cases were analyzed in ENT and head and neck center of Brest University Hospital, between April 2007 and June 2011, in both indications primary reconstruction and surgical treatment of osteoradionecrosis. Complications such as infection, hematoma, necrosis, time within pedicle weaning, and resumption of feeding were studied.ResultsEighteen cases for primary reconstruction and 22 cases for surgical treatment of osteoradionecrosis were analyzed. After radiotherapy, pedicle weaning was delayed (average of 11 more days) and enteral nutrition period lasted longer (average of 22 days vs 7 days). However, no infection and only 1 case of hematoma (2.5%) and 2 cases of necrosis (5%) were identified. Revision surgery for flap removal was necessary in 1 case (2.5%). After 1 month, oral feeding was possible in 35 cases (85%). Eighty percent of bad results occurred after radiotherapy.ConclusionThanks to its reliability, the FAMM flap is a good solution in head and neck cancer surgery, even after radiotherapy. However, the size of this flap remains relatively small. For a medium size loss of substance, it is a good alternative between controlled wound healing and bigger flaps.