bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intraseasonal Modulation of Synoptic-Scale Disturbances and Tropical Cyclone Genesis in the Eastern North Pacific
Authors: Crosbie Ewan , Serra Yolande 
Published: April 2014

Abstract
The influence of the Madden–Julian oscillation (MJO) on synoptic-scale waves, important precursors to tropical cyclones and tropical cyclogenesis, is investigated using a regional model of the eastern North Pacific basin. Cyclogenesis frequency is evaluated with respect to the MJO using a combination of the regional model and the archive best-track data. The statistics of the regional model compare well to the data and suggest that the MJO predominantly deters cyclogenesis during the suppressed phase rather than enhances it during the active phase when compared to neutral conditions. Synoptic-scale variability of cloudiness and eddy kinetic energy and analysis of vortex track statistics show a consistent enhancement of wave strength during the active phases of the MJO supported by both barotropic energetics and tropospheric moisture availability. Vertical wind shear, of critical importance to cyclone development, also exhibits strong variability associated with the phase of the MJO but, contrary to synoptic activity and moisture, results in unfavorable conditions for cyclogenesis during the active phase of the MJO in the region. The result is for the MJO to enhance cyclogenesis frequency relative to neutral conditions during the early active phase but otherwise to result in suppressed activity. In addition to the basinwide longitudinal structure, the local MJO exhibits a distinct north–south structure not apparent in the global pattern but in agreement with recent studies of tropical eastern North Pacific subseasonal variability.
Northern Hemisphere Climatology and Trends of Statistical Moments Documented from GHCN-Daily Surface Air Temperature Station Data from 1950 to 2010
Authors: Cavanaugh Nicholas R. , Shen Samuel S. P. 
Published: April 2014

Abstract
The first four statistical moments and their trends are calculated for the average daily surface air temperature (SAT) from 1950 to 2010 using the Global Historical Climatology Network–Daily station data for each season relative to the 1961–90 climatology over the Northern Hemisphere. Temporal variation of daily SAT probability distributions are represented as generalized linear regression coefficients on the mean, standard deviation, skewness, and kurtosis calculated for each 10-yr moving time window from 1950–59 to 2001–10. The climatology and trends of these statistical moments suggest that daily SAT probability distributions are non-Gaussian and are changing in time. The climatology of the first four statistical moments has distinct spatial patterns with large coherent structure for mean and standard deviation and relatively smaller and more regionalized patterns for skewness and kurtosis. The linear temporal trends from 1950 to 2010 of the first four moments also have coherent spatial patterns. The linear temporal trends in the characterizing statistical moments are statistically significant at most locations and have differing spatial patterns for different moments. The regionalized variations specific to higher moments may be related to the climate dynamics that contribute to extremes. The nonzero skewness and kurtosis makes this detailed documentation on the higher statistical moments useful for quantifying climate changes and assessing climate model uncertainties.
A Low-Cost System for Measuring Horizontal Winds from Single-Engine Aircraft
Authors: Conley Stephen A. , Faloona Ian C. , Lenschow Donald H. , Karion Anna , Sweeney Colm 
Published: April 2014

Abstract
The implementation and accuracy of a low-rate (~1 Hz) horizontal wind measurement system is described for a fixed-wing aircraft without modification to the airframe. The system is based on a global positioning system (GPS) compass that provides aircraft heading and a ground-referenced velocity, which, when subtracted from the standard true airspeed, provides estimates of the horizontal wind velocity. A series of tests was performed flying “L”-shaped patterns above the boundary layer, where the winds were assumed to be horizontally homogeneous over the area bounded by the flight (approximately 25 km2). Four headings were flown at each altitude at a constant airspeed. Scaling corrections for both heading and airspeed were found by minimizing the variance in the 1-s wind measurements; an upper limit to the error was then computed by calculating the variance of the corrected wind measurements on each of the four headings. A typical uncertainty found in this manner tends to be less than 0.2 m s−1. The measurement system described herein is inexpensive and relatively easy to implement on single-engine aircraft.
Comparison of cardiac TnI outliers using a contemporary and a high-sensitivity assay on the Abbott Architect platform
Authors: Ryan JB , Southby SJ , Stuart LA , Mackay R , Florkowski CM , George PM 
Published: April 2014

Background Assays for cardiac troponin (cTn) have undergone improvements in sensitivity and precision in recent years. Increased rates of outliers, however, have been reported on various cTn platforms, typically giving irreproducible, falsely higher results. We aimed to evaluate the outlier rate occurring in patients with elevated cTnI using a contemporary and high-sensitivity assay. Methods All patients with elevated cTnI (up to 300 ng/L) performed over a 21-month period were assayed in duplicate. A contemporary assay (Abbott STAT Troponin-I) was used for the first part of the study and subsequently a high-sensitivity assay (Abbott STAT High-Sensitive Troponin-I) was used. Outliers exceeded a calculated critical difference (CD) (CD = z × √2 × SDAnalytical) where z = 3.5 (for probability of 0.0005) and critical outliers also were on a different side of the decision level. Results The respective outlier and critical outlier rates were 0.22% and 0.10% for the contemporary assay ( n = 4009) and 0.18% and 0.13% for the high-sensitivity assay ( n = 3878). There was no significant reduction in outlier rate between the two assays ( χ2 = 0.034, P = 0.854). Fifty-six percent of outliers occurred in samples where cTn was an ‘add-on’ test (and was stored and refrigerated prior to assay). Conclusion Despite recent improvements in cTn methods, outliers (including critical outliers) still occur at a low rate in both a contemporary and high-sensitivity cTnI assay. Laboratory and clinical staff should be aware of this potential analytical error, particularly in samples with suboptimal sample handling such as add-on tests.
Do Interruptions Affect Quality of Work?
Authors: Foroughi Cyrus K. , Werner Nicole E. , Nelson Erik T. , Boehm-Davis Deborah A. 
Published: April 2014

Objective: The aim of this study was to determine if interruptions affect the quality of work. Background: Interruptions are commonplace at home and in the office. Previous research in this area has traditionally involved time and errors as the primary measures of disruption. Little is known about the effect interruptions have on quality of work. Method: Fifty-four students outlined and wrote three essays using a within-subjects design. During Condition 1, interruptions occurred while participants were outlining. During Condition 2, interruptions occurred while they were writing. No interruptions occurred in Condition 3. Results: Quality of work was significantly reduced in both interruption conditions when compared to the non-interruption condition. The number of words produced was significantly reduced when participants were interrupted while writing the essay but not when outlining the essay. Conclusion: This research represents a crucial first step in understanding the effect interruptions have on quality of work. Our research suggests that interruptions negatively impact quality of work during a complex, creative writing task. Since interruptions are such a prevalent part of daily life, more research needs to be conducted to determine what other tasks are negatively impacted. Moreover, the underlying mechanism(s) causing these decrements needs to be identified. Finally, strategies and systems need to be designed and put in place to help counteract the decline in quality of work caused by interruptions.
Occult Intra-articular Knee Injuries in Children With Hemarthrosis
Authors: Askenberger Marie , Ekström Wilhelmina , Finnbogason Thröstur , Janarv Per-Mats 
Published: April 2014

Background: Hemarthrosis after acute knee trauma is a sign of a potentially serious knee injury. Few studies have described the epidemiology and detailed injury spectrum of acute knee injuries in a general pediatric population. Purpose: To document the current injury spectrum of acute knee injuries with hemarthrosis in children aged 9 to 14 years and to describe the distribution of sex, age at injury, type of activity, and activity frequency in this population. Study Design: Descriptive epidemiology study. Methods: All patients in the Stockholm County area aged 9 to 14 years who suffered acute knee trauma with hemarthrosis were referred to Astrid Lindgren Children’s Hospital, Karolinska University Hospital, from September 2011 to April 2012. The patients underwent clinical examination, radiography, and magnetic resonance imaging (MRI). The type of activity when injured, regular sports activity/frequency, and patient sex and age were registered. The diagnoses were classified into minor and serious injuries. Results: The study included 117 patients (47 girls and 70 boys; mean age, 13.2 years). Seventy percent had a serious knee injury. Lateral patellar dislocations, anterior cruciate ligament ruptures, and anterior tibial spine fractures were the most common injuries, with an incidence of 0.6, 0.2, and 0.1 per 1000 children, respectively. The sex distribution was equal up to age 13 years; twice as many boys were seen at the age of 14 years. The majority of injuries occurred during sports. Forty-six patients (39%) had radiographs without a bony injury but with a serious injury confirmed on MRI. Conclusion: Seventy percent of the patients aged 9 to 14 years with traumatic knee hemarthrosis had a serious intra-articular injury that needed specific medical attention. Fifty-six percent of these patients had no visible injury on plain radiographs. Physicians who treat this group of patients should consider MRI to establish the diagnosis when there is no or minimal radiographic findings. The most common serious knee injury was a lateral patellar dislocation. This should be taken into consideration to improve prevention strategies and treatment algorithms in pediatric knee injuries.
Rotator Cuff Repair
Authors: McElvany Matthew D. , McGoldrick Erik , Gee Albert O. , Neradilek Moni Blazej , Matsen Frederick A. 
Published: April 2014

Background: Rotator cuff tears are common, and rotator cuff repair represents a major health care expense. While patients often benefit from rotator cuff repair, anatomic failure of the repair is not unusual. Purpose: To identify the published evidence on the factors associated with retears and with suboptimal clinical outcomes of rotator cuff repairs. Study Design: Systematic review and meta-analysis of articles with evidence levels 1-4. Methods: A total of 2383 articles on rotator cuff repairs published between 1980 and 2012 were identified. Only 108 of these articles, reporting on over 8011 shoulders, met the inclusion criteria of reporting quantitative data on both imaging and clinical outcomes after rotator cuff repair. Factors related to the patients, their shoulders, the procedures, and the results were systematically categorized and submitted for meta-analysis. Results: While the number of relevant articles published per year increased dramatically over the period of the study, the clinical and anatomic results did not show improvement over this period. The weighted mean retear rate was 26.6% at a mean of 23.7 months after surgery. Retears were associated with more fatty infiltration, larger tear size, advanced age, and double-row repairs. Clinical improvement averaged 72% of the maximum possible improvement. Patient-reported outcomes were generally improved whether or not the repair restored the integrity of the rotator cuff. The inconsistent and incomplete data in the published articles limited the meta-analysis of factors affecting the outcome of rotator cuff repair. Conclusion: In spite of a dramatic increase in the number of publications per year, there is little evidence that the results of rotator cuff repair are improving. The information needed to guide the management of this commonly treated and costly condition is seriously deficient. To accumulate the evidence necessary to inform practice, future clinical studies on the outcome of rotator cuff repair must report important data relating to each patient’s condition, the surgical technique, the outcome in terms of integrity, and the change in patient self-assessed comfort and function.
Systematic Review and Meta-Analysis of End-Tidal Carbon Dioxide Values Associated With Return of Spontaneous Circulation During Cardiopulmonary Resuscitation
Authors: Hartmann Silvia M. , Farris Reid W. D. , Di Gennaro Jane L. , Roberts Joan S. 
Published: April 2014

Objective: End-tidal carbon dioxide (ETCO2) measurements during cardiopulmonary resuscitation (CPR) reflect variable cardiac output over time, and low values have been associated with decreased survival. The goals of this review are to confirm and quantify this relationship and to determine the mean ETCO2 value among patients with return of spontaneous circulation (ROSC) as an initial step toward determining an appropriate target for intervention during resuscitation in the absence of prospective data. Data Sources and Study Selection: The PubMed database was searched for the key words “end-tidal carbon dioxide” or “capnometry” or “capnography” and “resuscitation” or “return of spontaneous circulation.” Randomized controlled trials, cohort studies, or case–control studies that reported ETCO2 values for participants with and without ROSC were included. Data Extraction and Synthesis: Twenty-seven studies met the inclusion criteria for qualitative synthesis. Twenty studies were included in determination of average ETCO2 values. The mean ETCO2 in participants with ROSC was 25.8 ± 9.8 mm Hg versus 13.1 ± 8.2 mm Hg ( P = .001) in those without ROSC. Nineteen studies were included in a meta-analysis. The mean difference in ETCO2 was 12.7 mm Hg (95% confidence interval: 10.3-15.1) between participants with and without ROSC ( P < .001). The mean difference in ETCO2 was not modified by the receipt of sodium bicarbonate, uncontrolled minute ventilation, or era of resuscitation guidelines. The overall quality of data by Grades of Recommendations, Assessment, Development and Evaluation criteria is very low, but no prospective data are currently available. Conclusions: Participants with ROSC after CPR have statistically higher levels of ETCO2. The average ETCO2 level of 25 mm Hg in participants with ROSC is notably higher than the threshold of 10 to 20 mm Hg to improve delivery of chest compressions. The ETCO2 goals during resuscitation may be higher than previously suggested and further investigation into appropriate targets during resuscitation is needed to diminish morbidity and mortality after cardiorespiratory arrest.
A Model for Identifying Patients Who May Not Need Neurologic Intensive Care Unit Admission
Authors: Sadaka Farid , Cytron Margaret A. , Fowler Kimberly , Javaux Victoria M. , O’Brien Jacklyn 
Published: April 2014

Purpose: Limited resources, neurointensivists, and neurologic intensive care unit (neuro-ICU) beds warrant investigating models for predicting who will benefit from admission to neuro-ICU. This study presents a possible model for identifying patients who might be too well to benefit from admission to a neuro-ICU. Methods: We retrospectively identified all patients admitted to our 16-bed neuro-ICU between November 2009 and February 2013. We used the Acute Physiology and Chronic Health Evaluation (APACHE) outcomes database to identify patients who on day 1 of neuro-ICU admission received 1 or more of 30 subsequent active life-supporting treatments. We compared 2 groups of patients: low-risk monitor (LRM; patients who did not receive active treatment [AT] on the first day and whose risk of ever receiving AT was ≤10%) and AT (patients who received at least 1 of the 30 ICU treatments on any day of their ICU admission). Results: There were 873 (46%) admissions in the LRM group and 1006 (54%) admissions in the AT group. The ICU length of stay in days was 1.7 (±1.9) for the LRM group versus 4.5 (±5.5) for the AT group. The ICU mortality was 0.8% for the LRM group compared to 14% for the AT group (odds ratio [OR] = 17.6; 95% confidence interval [CI], 8.2-37.8, P < .0001). Hospital mortality was 1.9% for the LRM group compared to 19% for the AT group (OR = 9.7; 95% CI, 5.8-16.1, P < .0001). Conclusion: The outcome for LRM patients in our neuro-ICU suggests they may not require admission to neurologic intensive care. This may provide a measure of neuro-ICU resource use. Improved resource use and reduced costs might be achieved by strategies to provide care for these patients on floors or intermediate care units. This model will need to be validated in other neuro-ICUs and prospectively studied before it can be adopted for triaging admissions to neuro-ICUs.
Lack of confirmation of anti-inward rectifying potassium channel 4.1 antibodies as reliable markers of multiple sclerosis
Authors: Nerrant Elodie , Salsac Céline , Charif Mahmoud , Ayrignac Xavier , Carra-Dalliere Clarisse , Castelnovo Giovanni , Goulabchand Radjiv , Tisseyre Julie , Raoul Cédric , Eliaou Jean-François , Labauge Pierre , Vincent Thierry 
Published: April 2014

Background: auto-antibodies against the potassium channel inward rectifying potassium channel 4.1 (Kir4.1) have previously been identified in 46% of patients with multiple sclerosis (MS). Objectives: to confirm these findings. Methods: we evaluated the presence of anti-Kir4.1 antibodies by enzyme-linked immunosorbent assay (ELISA) and immunofluorescence in 268 MS patients, 46 patients with other neurological diseases (OND) and 45 healthy controls. Results: anti-Kir4.1 antibodies were found in 7.5% of MS patients, 4.3% of OND patients and 4.4% of healthy controls. Immunofluorescence analysis did not identify any specific staining. Conclusions: we confirmed the presence of anti-Kir4.1 antibodies in MS patients, but at a much lower prevalence than previously reported.
Adherence in multiple sclerosis (ADAMS): Classification, relevance, and research needs. A meeting report
Authors: Heesen Christoph , Bruce Jared , Feys Peter , Sastre-Garriga Jaume , Solari Alessandra , Eliasson Lina , Matthews Vicki , Hausmann Bettina , Ross Amy Perrin , Asano Miho , Imonen-Charalambous Kaisa , Köpke Sascha , Clyne Wendy , Bissell Paul 
Published: April 2014

Background: Adherence to medical interventions is a global problem. With an increasing amount of partially effective but expensive drug treatments adherence is increasingly relevant in multiple sclerosis (MS). Perceived lack of efficacy and side effects as well as neuropsychiatric factors such as forgetfulness, fatigue and depression are major determinants. However, research on adherence to behavioural interventions as part of rehabilitative interventions has only rarely been studied. Methods: In a one-day meeting health researchers as well as patient representatives and other stakeholders discussed adherence issues in MS and developed a general draft research agenda within a focus group session. Results: The focus group addressed four major areas: (1) focussing patients and their informal team; (2) studying health care professionals; (3) comparing practice across cultures; and (4) studying new adherence interventions. Conclusions: A focus on patient preferences as well as a non-judgemental discussion on adherence issues with patients should be at the core of adherence work.
Cold intolerance assessment: A reappraisal
Authors: Davey H , Belcher HJCR 
Published: April 2014

Introduction: The cold intolerance symptom severity (CISS) questionnaire is frequently used for the assessment of cold intolerance (CI) in patients following hand trauma. Its practical and conceptual limitations prompted the development of a new cold intolerance questionnaire (CIQ). The CIQ assesses and gives equal weighting to five components of CI, severity, frequency, extent, duration and prevention. An optional impact score can be included as the CIQ+. Method: Data were collected over a five-month period from adult hand trauma patients. Each patient completed the CISS, CIQ and the Quick DASH questionnaires during their assessment. A total of 51 patients (34 men and 17 women) were examined at a median interval of 14 months (3–48) after injury. Their mean age was 42 years (SE = 2, range 18–81). Results: The median (range) scores were CIQ = 16 (0–27), CIQ + = 18 (0–33), CISS = 56 (0–89) and Quick DASH = 44 (2–86). The scores were significantly correlated. The majority of patients had symptoms localised to the digit or point of injury. All but one of the five selected components of the CIQ and the separate impact score were significantly correlated. Conclusion: The authors found the CIQ to be a simple scoring system that is suited to clinical use. The CIQ has value as a research tool as it provides a method of categorising patients and of identifying patients suited to certain treatment methods. Furthermore, it may be a more informative tool in monitoring treatment as it is able to assess changes in pattern as well as overall score.
Comparison Between One-Point Calibration and Two-Point Calibration Approaches in a Continuous Glucose Monitoring Algorithm
Authors: Mahmoudi Zeinab , Johansen Mette Dencker , Christiansen Jens Sandahl , Hejlesen Ole 
Published: April 2014

Background: The purpose of this study was to investigate the effect of using a 1-point calibration approach instead of a 2-point calibration approach on the accuracy of a continuous glucose monitoring (CGM) algorithm. Method: A previously published real-time CGM algorithm was compared with its updated version, which used a 1-point calibration instead of a 2-point calibration. In addition, the contribution of the corrective intercept (CI) to the calibration performance was assessed. Finally, the sensor background current was estimated real-time and retrospectively. The study was performed on 132 type 1 diabetes patients. Results: Replacing the 2-point calibration with the 1-point calibration improved the CGM accuracy, with the greatest improvement achieved in hypoglycemia (18.4% median absolute relative differences [MARD] in hypoglycemia for the 2-point calibration, and 12.1% MARD in hypoglycemia for the 1-point calibration). Using 1-point calibration increased the percentage of sensor readings in zone A+B of the Clarke error grid analysis (EGA) in the full glycemic range, and also enhanced hypoglycemia sensitivity. Exclusion of CI from calibration reduced hypoglycemia accuracy, while slightly increased euglycemia accuracy. Both real-time and retrospective estimation of the sensor background current suggest that the background current can be considered zero in the calibration of the SCGM1 sensor. Conclusions: The sensor readings calibrated with the 1-point calibration approach indicated to have higher accuracy than those calibrated with the 2-point calibration approach.