bluuebunny/crossref_metadata_2025_split huggingface dataset:
Benefits of a Fourth Ice Class in the Simulated Radar Reflectivities of Convective Systems Using a Bulk Microphysics Scheme
Authors: Lang Stephen E. , Tao Wei-Kuo , Chern Jiun-Dar , Wu Di , Li Xiaowen 
Published: June 2014

Abstract
Current cloud microphysical schemes used in cloud and mesoscale models range from simple one-moment to multimoment, multiclass to explicit bin schemes. This study details the benefits of adding a fourth ice class (frozen drops/hail) to an already improved single-moment three-class ice (cloud ice, snow, graupel) bulk microphysics scheme developed for the Goddard Cumulus Ensemble model. Besides the addition and modification of several hail processes from a bulk three-class hail scheme, further modifications were made to the three-ice processes, including allowing greater ice supersaturation and mitigating spurious evaporation/sublimation in the saturation adjustment scheme, allowing graupel/hail to transition to snow via vapor growth and hail to transition to graupel via riming, wet graupel to become hail, and the inclusion of a rain evaporation correction and vapor diffusivity factor. The improved three-ice snow/graupel size-mapping schemes were adjusted to be more stable at higher mixing ratios and to increase the aggregation effect for snow. A snow density mapping was also added.
The new scheme was applied to an intense continental squall line and a moderate, loosely organized continental case using three different hail intercepts. Peak simulated reflectivities agree well with radar for both the intense and moderate cases and were superior to earlier three-ice versions when using a moderate and large intercept for hail, respectively. Simulated reflectivity distributions versus height were also improved versus radar in both cases compared to earlier three-ice versions. The bin-based rain evaporation correction affected the squall line more but overall the agreement among the reflectivity distributions was unchanged. The new scheme also improved the simulated surface rain-rate histograms.
Seasonal Tropical Cyclone Predictions Using Optimized Combinations of ENSO Regions: Application to the Coral Sea Basin
Authors: Ramsay Hamish A. , Richman Michael B. , Leslie Lance M. 
Published: June 2014

Abstract
This study examines combining ENSO sea surface temperature (SST) regions for seasonal prediction of Coral Sea tropical cyclone (TC) frequency. The Coral Sea averages ~4 TCs per season, but is characterized by strong interannual variability, with 1–9 TCs per season, over the period 1977–2012. A wavelet analysis confirms that ENSO is a key contributor to Coral Sea TC count (TCC) variability. Motivated by the impact of El Niño Modoki on regional climate anomalies, a suite of 38 linear models is constructed and assessed on its ability to predict Coral Sea seasonal TCC. Seasonal predictions of TCC are generated by a leave-one-out cross validation (LOOCV). An important finding is that models made up of multiple tropical Pacific SST regions, such as those that comprise the El Niño Modoki Index (EMI) or the Trans-Niño Index (TNI), perform considerably better than models comprising only single regions, such as Niño-3.4 or Niño-4. Moreover, enhanced (suppressed) TC activity is expected in the Coral Sea when the central Pacific is anomalously cool (warm) and the eastern and western Pacific are anomalously warm (cool) during austral winter. The best cross-validated model has persistent and statistically significantly high correlations with TCC (r &gt; 0.5) at lead times of ~6 months prior to the mean onset of the Coral Sea TC season, whereas correlations based heavily on the widely used Niño-3.4 region are not statistically significant or meaningful (r = 0.09) for the same lead times. Of the 38 models assessed, several optimized forms of the EMI and of the TNI perform best.
Voice, Speech, and Laryngeal Features of Primary Sjögren’s Syndrome
Authors: Heller Amanda , Tanner Kristine , Roy Nelson , Nissen Shawn L. , Merrill Ray M. , Miller Karla L. , Houtz Daniel R. , Ellerston Julia , Kendall Katherine 
Published: June 2014

Objective: This study examined voice, speech, and laryngeal characteristics in primary Sjögren’s syndrome (pSS). Methods: Eleven patients (10 female, 1 male; mean [SD] age = 57 [14] years) from The University of Utah Division of Rheumatology provided connected speech and sustained vowel samples. Analyses included the Multi-Dimensional Voice Profile, the Analysis of Dysphonia in Speech and Voice, and dysphonia severity, speech clarity, and videolaryngostroboscopy ratings. Results: Shimmer, amplitude perturbation quotient, and average fundamental frequency differed significantly from normative values ( P < .01). Cepstral Spectral Index of Dysphonia values indicated mild-to-moderate dysphonia in connected speech (mean [SD] = 20.26 [8.36]) and sustained vowels (mean [SD] = 16.91 [11.08]). Ratings of dysphonia severity and speech clarity using 10-cm visual analog scales suggested mild-to-moderate dysphonia in connected speech (mean [SD] = 2.11 [1.72]) and sustained vowels (mean [SD] = 3.13 [2.20]) and mildly reduced speech clarity (mean [SD] = 1.46 [1.36]). Videolaryngostroboscopic ratings indicated mild-to-moderate dryness and mild reductions in overall laryngeal function. Voice Handicap Index scores indicated mild-to-moderate voice symptoms (mean [SD] = 43 [23]). Conclusion: Individuals with pSS may experience dysphonia and articulatory imprecision, typically in the mild-to-moderate range. These findings have implications for diagnostic and referral practices in pSS.
Effects of Radiofrequency Thermal Ablation on the Nasal Cycle Measured Using Rhinomanometry
Authors: Tatar Arzu , Altas Enver 
Published: June 2014

Objective: This study was designed to research the effects of radiofrequency thermal ablation (RFTA) surgery on the nasal cycle, with anterior rhinomanometry being used for assessment. Methods: Thirty patients with inferior concha hypertrophy and 13 healthy volunteers were included in this study. An anterior rhinomanometry was performed on each of the patients before surgery and at 1 month and 6 months after surgery, and on the volunteers in the control group, simultaneously. Results: Nineteen of the 30 patients and 8 of the 13 healthy participants showed a distinct type of nasal cycle at different periods of measurement. The mean of the total nasal airflow of the patients was lower before RFTA surgery but increased at a rate of 71.07%, closer to the value of the control group, after RFTA surgery. After RFTA, the unilateral nasal airflow (fmin and fmax) values increased at ratios of 22.36% and 94.44%, respectively. The amplitude (fmax-fmin) showed a statistically significant decrease in the postoperative period (108.43 ± 54.37), when compared with that of the preoperative period (202.80 ± 81.24) ( P < .01). Conclusion: We conclude that the RFTA is a useful method for treating inferior concha hypertrophy, because it positively affects the nasal physiology, increasing the total nasal airflow without changing the nasal cycle time.
A Rapid and Accurate Technique for the Identification of the Recurrent Laryngeal Nerve
Authors: Liu Shao-Cheng , Chou Yi-Fan , Su Wan-Fu 
Published: June 2014

Objective: We studied the anatomic relationship between the recurrent laryngeal nerve (RLN) and the third tracheal ring, which was very important for rapid identification of RLN in our hands. Methods: This study was initially performed using 8 fresh cadavers (4 female and 4 male). The transverse nerve location from the third trachea and the depth from its anterior surface were measured. We further observed the topography of RLN in relation to the trachea in 60 patients, between November 2008 and January 2011, at the Tri-Service General Hospital and Buddhist Tzu Chi General Hospital, Taipei Branch, Taiwan, with 46 lobo-isthmectomies and 14 total thyroidectomies. The time spent in identifying the RLN was also recorded. Results: Among cadaver groups, the transverse distance (width) and the vertical distance (depth) averaged 3.3 and 17.6 mm, respectively. Among the clinical cases, the width and depth averaged 4.4 and 14.6 mm, respectively. The depth measured in males was significantly deeper than that in females (22.3 vs 13.2 mm) ( P < .05). The time spent in identifying the RLN after starting dissection in the RLN triangle was not statistically significantly different between the cadaver group and the clinical group (10.6 ± 5.7 seconds and 15.5 ± 17.7 seconds, respectively; P > .05). The median time was 9 and 10 seconds, respectively. There was no statistically significant side-to-side difference in terms of the time spent in searching for the RLN. Conclusion: Using the third ring as guidance, our inferior-superior technique offers an extra benefit in identifying the RLN safely and quickly, as compared to the conventional inferior approach.
Correlation of Maximum Phonation Time and Vocal Intensity With Intraluminal Esophageal and Pharyngoesophageal Pressure in Total Laryngectomees
Authors: Takeshita-Monaretti Telma Kioko , Dantas Roberto Oliveira , Ricz Hilton , Aguiar-Ricz Lílian Neto 
Published: June 2014

Objective: This study aimed to correlate maximum phonation time, vocal intensity, and dynamic extension with intraluminal esophageal and pharyngoesophageal segment pressure during tracheoesophageal phonation. Design: Prospective analysis. Setting: Tertiary academic hospital. Methods: The study was conducted on 20 total laryngectomees with alaryngeal speech and with secondary insertion of a tracheoesophageal prosthesis who were submitted to vocal recording of maximum phonation time and vocal intensity (minimum, habitual, and maximum). The participants were then submitted to manometry for the determination of the amplitude of intraluminal esophageal (proximal, middle, and distal) and pharyngoesophageal segment pressure during phonation. Results: A significant positive correlation was detected between habitual vocal intensity and the middle (0.004) and distal (0.05) esophagus, in addition to a correlation of maximum intensity with the middle esophageal portion (0.03). Dynamic extension showed correlation with the amplitude of esophageal pressure. There was no significant correlation between the variables studied and pressure of the pharyngoesophageal segment or between maximum phonation time and esophageal pressure amplitude. Conclusion: The middle and distal regions of the esophagus were found to be compliant, permitting an adjustment of vocal intensity. There was no correlation between maximum phonation time and the amplitude of esophageal and pharyngoesophageal segment pressure.
A Modified Transoral Approach for Carotid Artery Type Eagle Syndrome
Authors: Torres Arnulfo C. , Guerrero Jaime S. , Silva Helen C. 
Published: June 2014

Objective: This article aimed to summarize our clinical experience with a standardized tonsil-sparing transoral surgical approach used for treatment of styloid process-carotid artery Eagle’s syndrome. Methods: Eleven consecutive patients, from 2007 to 2013, underwent surgical treatment to remove elongated styloid apophyses transorally. Outcomes were assessed in terms of intraoperative and postoperative complications and patients’ evolution. Results: No patient experienced any intraoperative or postoperative complications. All patients have been followed up to present and 10 of them have shown complete relief of the symptoms and improvement of functional ability. Conclusion: The tonsil-sparing transoral surgical approach described is suitable for treating patients with elongated styloid apophyses.
The Psychometrics of Mental Workload
Authors: Matthews Gerald , Reinerman-Jones Lauren E. , Barber Daniel J. , Abich Julian 
Published: June 2014

Objective: A study was run to test the sensitivity of multiple workload indices to the differing cognitive demands of four military monitoring task scenarios and to investigate relationships between indices. Background: Various psychophysiological indices of mental workload exhibit sensitivity to task factors. However, the psychometric properties of multiple indices, including the extent to which they intercorrelate, have not been adequately investigated. Method: One hundred fifty participants performed in four task scenarios based on a simulation of unmanned ground vehicle operation. Scenarios required threat detection and/or change detection. Both single- and dual-task scenarios were used. Workload metrics for each scenario were derived from the electroencephalogram (EEG), electrocardiogram, transcranial Doppler sonography, functional near infrared, and eye tracking. Subjective workload was also assessed. Results: Several metrics showed sensitivity to the differing demands of the four scenarios. Eye fixation duration and the Task Load Index metric derived from EEG were diagnostic of single-versus dual-task performance. Several other metrics differentiated the two single tasks but were less effective in differentiating single- from dual-task performance. Psychometric analyses confirmed the reliability of individual metrics but failed to identify any general workload factor. An analysis of difference scores between low- and high-workload conditions suggested an effort factor defined by heart rate variability and frontal cortex oxygenation. Conclusions: General workload is not well defined psychometrically, although various individual metrics may satisfy conventional criteria for workload assessment. Application: Practitioners should exercise caution in using multiple metrics that may not correspond well, especially at the level of the individual operator.
Thermal ablation of saphenous veins is feasible and safe in patients older than 75 years: A prospective study (EVTA study)
Authors: Hamel-Desnos C , Desnos P , Allaert F-A , Kern P ,   the “Thermal group” for the French Society of Phlebology and the Swiss Society of Phlebology
Published: June 2014

Objectives To investigate the tolerance and safety of thermal ablation (TA), consisting of radiofrequency or endovenous laser (EVLA) of saphenous veins (SV) in elderly (group 1 ≥75 years), compared with a control group (group 2 <75 years). Method An Observational multicenter-prospective study was conducted, under the aegis of the French and Swiss Societies of Phlebology (18 centers). Ninety patients were included in group 1, 617 in group 2 (mean age 80 years and 53 years; 69% women in both groups), representing 863 SV. Mean trunk diameters were similar in both groups (small SV: 6 mm; great SV: 7 mm). In group 1, comorbidities were more frequent, particularly cardiac insufficiency, diabetes, history of thrombosis, and CEAP clinical class was significantly higher. Results EVLA was used in 86% of cases. Settings used were similar in both groups for each technique. Only 6% of TA was performed in an operating room for group 1 (14% group 2). Tumescent local anaesthesia (TLA) alone was used in 91% of cases in group 1 (85% group 2). The mean pain score was only 1.6 for the procedure itself (VASP 0–10; 10 max.) and 1.4 for the 10 days following the procedure. Side effects were few, but rate of paraesthesia was higher when general anaesthesia was used (11.8%) compared with TLA alone (2.2%). At three months, 100% of SV was occluded in group 1 (99.5% group 2), with high satisfaction score (9.3/10). Conclusion TA is safe and effective in elderly; it should be performed strictly under TLA to minimize side effects.
Do people who consciously attend to their movements have more self-reported knee pain? An exploratory cross-sectional study
Authors: Selfe James , Dey Paola , Richards Jim , Cook Neil , Chohan Ambreen , Payne Katherine , Masters Rich 
Published: June 2014

Objectives: This study explored the relationship between propensity for conscious control of movement (assessed by the Movement-Specific Reinvestment Scale) and self-reported knee pain. Design: Cross-sectional study. Setting: General population. Subjects: Adults aged 18 to 55 years of age. Measures: Participants completed the movement-specific reinvestment scale and a self-report questionnaire on knee pain at the same time on one occasion. Results: Data was collected on 101 adults of whom 34 (33.7%) self-reported knee pain. Mean scores on the conscious motor processing subscale of the movement-specific reinvestment scale, but not the movement self-consciousness subscale, were significantly higher for participants who reported knee pain within the previous year compared with those who did not (mean difference 3.03; t-test 2.66, df = 97, P = 0.009; 95% confidence interval (CI) 0.77 to 5.30). The association between self-reported knee pain and propensity for conscious motor processing was still observed, even after controlling for movement self-consciousness subscale scores, age, gender and body mass index (adjusted odds ratio 1.16, 95% CI 1.04 to 1.30). Conclusions: Propensity for conscious control of movement may play a role in knee pain.
The effect of using high facilitation when implementing the Gold Standards Framework in Care Homes programme: A cluster randomised controlled trial
Authors: Kinley Julie , Stone Louisa , Dewey Michael , Levy Jean , Stewart Robert , McCrone Paul , Sykes Nigel , Hansford Penny , Begum Aysha , Hockley Jo 
Published: June 2014

Background: The provision of quality end-of-life care is increasingly on the national agenda in many countries. In the United Kingdom, the Gold Standards Framework for Care Homes programme has been promoted as a national framework for improving end-of-life care. While its implementation is recommended, there are no national guidelines for facilitators to follow to undertake this role. Aim: It was hypothesised that action learning alongside high facilitation when implementing the Gold Standards Framework for Care Homes programme will result in a reduced proportion of hospital deaths for residents and improvement in the care home staff ability to facilitate good end-of-life care. Design: A cluster randomised controlled trial where 24 nursing homes received high facilitation to enable them to implement the Gold Standards Framework for Care Homes programme. The managers of 12 nursing homes additionally took part in action learning sets. A third group (14 nursing homes) received the ‘standard’ Gold Standards Framework for Care Homes facilitation available in their locality. Setting/participants: In total, 38 nursing homes providing care for frail older people, their deceased residents and their nurse managers. Results: A greater proportion of residents died in those nursing homes receiving high facilitation and action learning but not significantly so. There was a significant association between the level of facilitation and nursing homes completing the Gold Standards Framework for Care Homes programme through to accreditation. Year-on-year change occurred across all outcome measures. Conclusion: There is a danger that without national guidelines, facilitation of the Gold Standards Framework for Care Homes programme will vary and consequently so will its implementation. The nurse manager of a care home must be actively engaged when implementing the Gold Standards Framework for Care Homes programme.
How do general end-of-life treatment goals and values relate to specific treatment preferences? A population-based study
Authors: Evans Natalie , Pasman H Roeline , Deeg Dorly , Onwuteaka-Philipsen Bregje ,   on behalf of EURO IMPACT, Van den Block Lieve , De Groote Zeger , Brearley Sarah , Caraceni Augusto , Cohen Joachim , Francke Anneke , Harding Richard , Higginson Irene J , Kaasa Stein , Linden Karen , Miccinesi Guido , Onwuteaka-Philipsen Bregje , Pardon Koen , Pasman Roeline , Pautex Sophie , Payne Sheila , Deliens Luc 
Published: June 2014

Background: There is a lack of research on the relationship between general end-of-life goals and values and preferences for specific life-sustaining treatments. Aim: To examine agreement between Dutch older people’s general end-of-life goals and specific life-sustaining treatment preferences. Design: Participants identified general end-of-life goals in an interview and preferences for four life-sustaining treatments in hypothetical cancer and dementia scenarios in a separate questionnaire. Agreement between general goals and specific treatment preferences was calculated. Setting/participants: In total, 1818 older people from 11 representative Dutch municipalities participated in the study. Results: In total, 1168 (response rate 73%) answered questions on general end-of-life and specific treatment preferences. Agreement between a desire to live as long as possible, irrespective of health problems, and a preference for life-sustaining treatments ranged from 51% to 76% in cancer and 41% to 60% in dementia scenarios, depending on the treatment. Agreement between a desire for a shorter life, if without major health problems, and a preference to forgo treatments ranged from 61% to 79% in cancer and 75% to 88% in dementia scenarios. Conclusion: For a sizable minority of participants, specific treatment preferences did not agree with their general end-of-life goals. The more frequent desire to forgo treatments in case of dementia than cancer suggests that physical deterioration is more acceptable than cognitive decline. The findings underline the importance of discussing general care goals, different end-of-life scenarios and the risks and burdens of treatments to frame discussions of more specific treatment preferences.
Hypnic headache: A review of clinical features, therapeutic options and outcomes
Authors: Liang Jen-Feng , Wang Shuu-Jiun 
Published: June 2014

Background Hypnic headache (HH), first reported in 1988, is a rare sleep-related headache disorder. In 2013 a new diagnostic criteria was proposed for HH in the International Classification of Headache Disorders, the third version beta (ICHD-3β). Purpose This review aimed to update the clinical characteristics, therapeutic options and clinical outcomes in patients with HH and also validate the new diagnostic criteria. Methods Based on a literature search in the major medical databases, we analyzed all case reports or case series on HH that have been published since the first description by Raskin. Except for symptomatic patients, all reported patients were included regardless of which diagnostic criteria were adopted. Four studies that reported the field-testing results of the ICHD-2 criteria were selected to validate the new ICHD-3β criteria. Results In total, 250 adult and five childhood patients are described in this review. The majority of patients were elderly and their ages of onset were typically more than 50 years old (92%). Approximately 7.7% of patients had some trigeminal autonomic features, which are not permitted in the ICHD-3β criteria. Compared with the ICHD-2 criteria, the diagnostic rate under the new criteria increased from 65% to 85% in recently reported cases. Randomized control trials both for acute and prophylactic treatment are lacking. Based on observational studies, the most effective acute treatment is caffeine and prophylactic medications in use are lithium, caffeine and indomethacin. Without treatment, the disease course is usually protracted but spontaneous remission did occur in 12 patients (4.8%). In those treated with prophylactic agents, no recurrence was noted in 43% of patients, even following withdrawal of medication. Conclusions The new ICHD-3β criteria are more sensitive and exhaustive for HH than the ICHD-2 criteria. Prophylactic treatment provides better outcomes; however, randomized controlled studies for treatment are needed to further verify the efficacy of the different drugs.