bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Horizontal Geometrical Spreading on the Parameterization of Orographic Gravity Wave Drag. Part I: Numerical Transform Solutions
Authors: Eckermann Stephen D. , Ma Jun , Broutman Dave 
Published: April 2015

Abstract
Numerical transform solutions for hydrostatic gravity waves generated by both uniform and sheared flow over elliptical obstacles are used to quantify effects of horizontal geometrical spreading on amplitude evolution with height. Both vertical displacement and steepness amplitudes are considered because of their close connections to drag parameterizations in weather and climate models. Novel diagnostics quantify the location and value of the largest wavefield amplitudes most likely to break at each altitude. These horizontal locations do not stray far from the obstacle peak even at high altitudes. Resulting vertical profiles of wave amplitude are normalized to remove density and refraction effects, thereby quantifying the horizontal geometrical spreading contribution, currently absent from parameterizations. Horizontal geometrical spreading produces monotonic amplitude decreases with height through wave-action conservation as waves propagate into progressively larger horizontal areas. Accumulated amplitude reductions are appreciable for all but the most quasi-two-dimensional obstacles with long axes orthogonal to the flow, and even these are impacted appreciably if the obstacle is rotated by more than 20°–30°. Profiles are insensitive to the obstacle’s functional form but vary strongly in response to changes in its horizontal aspect ratio. Responses to background winds are captured by a vertical coordinate transformation that remaps profiles to a universal form for a given obstacle. These results show that horizontal geometrical spreading has comparable or larger effects on wave amplitudes as the refraction of vertical wavenumbers and thus is important for accurate parameterizations of wave breaking and drag.
Winter Extreme Flux Events in the Kuroshio and Gulf Stream Extension Regions and Relationship with Modes of North Pacific and Atlantic Variability
Authors: Ma Xiaohui , Chang Ping , Saravanan R. , Wu Dexing , Lin Xiaopei , Wu Lixin , Wan Xiuquan 
Published: April 2015

Abstract
Boreal winter (November–March) extreme flux events in the Kuroshio Extension region (KER) of the northwestern Pacific and the Gulf Stream region (GSR) of the northwestern Atlantic are analyzed and compared, based on NCEP Climate Forecast System Reanalysis (CFSR), NCEP–NCAR reanalysis, and NOAA Twentieth Century Reanalysis data, as well as the observationally derived OAFlux dataset. These extreme flux events, most of which last less than 3 days, are characterized by cold air outbreaks (CAOs) with an anomalous northerly wind that brings cold and dry air from the Eurasian and North American continents to the KER and GSR, respectively. A close relationship between the extreme flux events over KER (GSR) and the Aleutian low pattern (ALP) [east Atlantic pattern (EAP)] is found with more frequent occurrence of the extreme flux events during a positive ALP (EAP) phase and vice versa. A further lag-composite analysis suggests that the ALP (EAP) is associated with accumulated effects of the synoptic winter storms accompanied by the extreme flux events and shows that the event-day storms tend to have a preferred southeastward propagation path over the North Pacific (Atlantic), potentially contributing to the southward shift of the storm track over the eastern North Pacific (Atlantic) basin during the ALP (EAP) positive phase. Finally, lag-regression analyses indicate a potential positive influence of sea surface temperature (SST) anomalies along the KER (GSR) on the development of the extreme flux events in the North Pacific (Atlantic).
Spectral Transformation Using a Cubed-Sphere Grid for a Three-Dimensional Variational Data Assimilation System
Authors: Song Hyo-Jong , Kwon In-Hyuk 
Published: April 2015

Abstract
Atmospheric numerical models using the spectral element method with cubed-sphere grids (CSGs) are highly scalable in terms of parallelization. However, there are no data assimilation systems for spectral element numerical models. The authors devised a spectral transformation method applicable to the model data on a CSG (STCS) for a three-dimensional variational data assimilation system (3DVAR). To evaluate the 3DVAR system based on the STCS, the authors conducted observing system simulation experiments (OSSEs) using Community Atmosphere Model with Spectral Element dynamical core (CAM-SE). They observed root-mean-squared error reductions: 24% and 34% for zonal and meridional winds (U and V), respectively; 20% for temperature (T); 4% for specific humidity (Q); and 57% for surface pressure (Ps) in analysis and 28% and 27% for U and V, respectively; 25% for T; 21% for Q; and 31% for Ps in 72-h forecast fields. In this paper, under the premise that the same number of grid points is set, the authors show that the use of a greater polynomial degree, np, produces better performance than use of a greater element count, ne, on equiangular coordinates in terms of the wave representation.
Radiofrequency Coblation Versus Intramural Bipolar Cautery for the Treatment of Inferior Turbinate Hypertrophy
Authors: Shah Anil N. , Brewster Douglas , Mitzen Kelly , Mullin David 
Published: April 2015

Objective: Compare intramural bipolar electrocautery and radiofrequency coblation in the treatment of inferior turbinate hypertrophy with regards to objective and subjective improvement in nasal obstruction, rate and type of complications, experience during the procedure, and rate of recovery. Study Design: Prospective, single-blinded study. Setting: Single tertiary medical center from 2008 to 2010. Subjects and Methods: Forty-one adult patients with inferior turbinate hypertrophy refractory to medical management were treated with radiofrequency coblation in one nostril and intramural bipolar cautery in the other. Subjective and objective data, including use of a Visual Analog Scale (VAS) for subjective outcomes, acoustic rhinometry, and nasal endoscopy, were then obtained from each patient comparing the 2 techniques. Results: Radiofrequency coblation was significantly less painful than intramural bipolar cautery during the procedure ( P = .03) and during the early postoperative period ( P < .02) and produced less crusting at 3 weeks ( P = .009). Both interventions were similar in subjective and objective improvements in nasal obstruction as measured by acoustic rhinometry and subjective VAS outcomes. Conclusion: Radiofrequency coblation seems to offer an equivalent alternative to bipolar electrocautery for the treatment of inferior turbinate hypertrophy with less discomfort during the procedure and early post-operative period.
Reference intervals for plasma-free amino acid in a Japanese population
Authors: Yamamoto Hiroyuki , Kondo Kazuhiro , Tanaka Takayuki , Muramatsu Takahiko , Yoshida Hiroo , Imaizumi Akira , Nagao Kenji , Noguchi Yasushi , Miyano Hiroshi 
Published: April 2015

Background Plasma amino acid concentrations vary with various diseases. Although reference intervals are useful in daily clinical practice, no reference intervals have been reported for plasma amino acids in a large Japanese population. Methods Reference individuals were selected from 7685 subjects examined with the Japanese Ningen Dock in 2008. A total of 1890 individuals were selected based on exclusion criteria, and the reference samples were selected after the outlier samples for each amino acid concentration were excluded. The lower limit of the reference intervals for the plasma amino acid concentrations was set at the 2.5th percentile and the upper limit at the 97.5th percentile. Results By use of the nested analysis of variance, we analysed a large dataset of plasma samples and the effects of background factors (sex, age and body mass index [BMI]) on the plasma amino acid concentrations. Most amino acid concentrations were related to sex, especially those of branched-chained amino acid. The citrulline, glutamine, ornithine and lysine concentrations were related to age. The glutamate concentration was related to body mass index. Conclusions The concentrations of most amino acids are more strongly related to sex than to age or body mass index. Our results indicate that the reference intervals for plasma amino acid concentrations should be stratified by sex when the background factors of age and body mass index are considered.
Gender differences in depressive symptom profiles and patterns of psychotropic drug usage in Asian patients with depression: Findings from the Research on Asian Psychotropic Prescription Patterns for Antidepressants study
Authors: Park Seon-Cheol , Lee Min-Soo , Shinfuku Naotaka , Sartorius Norman , Park Yong Chon 
Published: April 2015

Objectives: The purpose of this study was to investigate whether there were gender-specific depressive symptom profiles or gender-specific patterns of psychotropic agent usage in Asian patients with depression. Method: Clinical data from the Research on Asian Psychotropic Prescription Patterns for Antidepressant study (1171 depressed patients) were used to determine gender differences by analysis of covariates for continuous variables and by logistic regression analysis for discrete variables. In addition, a binary logistic regression model was fitted to identify independent clinical correlates of the gender-specific pattern on psychotropic drug usage. Results: Men were more likely than women to have loss of interest (adjusted odds ratio = 1.379, p = 0.009), fatigue (adjusted odds ratio = 1.298, p = 0.033) and concurrent substance abuse (adjusted odds ratio = 3.793, p = 0.008), but gender differences in other symptom profiles and clinical features were not significant. Men were also more likely than women to be prescribed adjunctive therapy with a second-generation antipsychotic (adjusted odds ratio = 1.320, p = 0.044). However, men were less likely than women to have suicidal thoughts/acts (adjusted odds ratio = 0.724, p = 0.028). Binary logistic regression models revealed that lower age (odds ratio = 0.986, p = 0.027) and current hospitalization (odds ratio = 3.348, p < 0.0001) were independent clinical correlates of use of second-generation antipsychotics as adjunctive therapy for treating depressed Asian men. Conclusion: Unique gender-specific symptom profiles and gender-specific patterns of psychotropic drug usage can be identified in Asian patients with depression. Hence, ethnic and cultural influences on the gender preponderance of depression should be considered in the clinical psychiatry of Asian patients.
The humanistic and economic burden of providing care for a patient with schizophrenia
Authors: Csoboth Csilla , Witt Edward A , Villa Kathleen F , O’Gorman Cedric 
Published: April 2015

Background: Schizophrenia is a debilitating disorder that often requires the affected individual to receive part- or full-time care from a caregiver. Aims: The purpose of this study was to examine the humanistic and economic burden of caring for an individual with Schizophrenia with regard to the measures of quality of life (QoL), work productivity, healthcare resource use and estimated economic costs. Methods: Data for this study came from the 2012 US National Health and Wellness Survey (NHWS; n = 71,149). Specifically, this analysis focused on those individuals in the survey who indicated that they were currently the primary caregiver for an individual with Schizophrenia (C-SCZ; n = 174). These individuals were matched via two separate 1:2 propensity score matches with both caregivers of other disorders (C-Other; n = 294) and non-caregivers (Non-C; n = 294) on significant covariates. Individuals were then compared across the outcomes of QoL, work productivity, healthcare resource use and estimated economic costs. Results: C-SCZ respondents had worse outcomes on all outcomes measured than C-Other respondents and Non-C respondents even when controlling for significant differences between the groups on sociodemographic characteristics. However, due to the small sample sizes, these comparisons were only significant in most cases for the C-SCZ to Non-C comparisons. Conclusion: Results indicate that caregivers of those with Schizophrenia experience a heightened humanistic and economic burden, especially relative to the burden experienced by non-caregivers. The fact that Schizophrenia not only affects the individual but also those who care for that individual is underscored by these results.
Should English healthcare providers be penalised for failing to collect patient-reported outcome measures? A retrospective analysis
Authors: Gutacker Nils , Street Andrew , Gomes Manuel , Bojke Chris 
Published: April 2015

Summary Objective The best practice tariff for hip and knee replacement in the English National Health Service (NHS) rewards providers based on improvements in patient-reported outcome measures (PROMs) collected before and after surgery. Providers only receive a bonus if at least 50% of their patients complete the preoperative questionnaire. We determined how many providers failed to meet this threshold prior to the policy introduction and assessed longitudinal stability of participation rates. Design Retrospective observational study using data from Hospital Episode Statistics and the national PROM programme from April 2009 to March 2012. We calculated participation rates based on either (a) all PROM records or (b) only those that could be linked to inpatient records; constructed confidence intervals around rates to account for sampling variation; applied precision weighting to allow for volume; and applied risk adjustment. Setting NHS hospitals and private providers in England. Participants NHS patients undergoing elective unilateral hip and knee replacement surgery. Main outcome measures Number of providers with participation rates statistically significantly below 50%. Results Crude rates identified many providers that failed to achieve the 50% threshold but there were substantially fewer after adjusting for uncertainty and precision. While important, risk adjustment required restricting the analysis to linked data. Year-on-year correlation between provider participation rates was moderate. Conclusions Participation rates have improved over time and only a small number of providers now fall below the threshold, but administering preoperative questionnaires remains problematic in some providers. We recommend that participation rates are based on linked data and take into account sampling variation.
Normalizing
Authors: Babler Elizabeth , Strickland C. June 
Published: April 2015

Purpose The purpose of this research study was to gain a greater understanding of adolescents’ experiences living with diabetes and build a theoretical paradigm to inform interventional design. Methods Classical grounded theory was utilized; 15 in-depth interviews of 11 subjects were conducted with Caucasian adolescents’ ages 11 to 15 with type 1 diabetes. Interviews were recorded and transcribed verbatim. Data were analyzed using constant comparative analysis. Codes were linked to create the paradigm. Results A theoretical model was developed about the concept of “normalizing.” Normalizing is defined as the ability of the adolescents to integrate diabetes into the background of their daily life by creating routines to make diabetes “part of me.” Codes identified in normalizing included: (1) recognizing life is changing, (2) taking action to prevent a crisis, (3) disclosing to engage support, (4) taking on the burden of care, (5) accepting the “new normal,” and (6) hoping for a normal future. Conclusions Normal developmental tasks of adolescence were closely related and contribute to understanding why adolescents struggle with diabetes. These research findings place a different and positive perspective on diabetes management; the focus shifts to supporting wellness and maintaining a normal life rather than on illness. Findings are expected to be of value to health providers working with adolescents with type 1 diabetes, parents, nursing researchers, and adolescents facing the challenge of diabetes management.
Standardized Outcome and Reporting Measures in Pediatric Head and Neck Lymphatic Malformations
Authors: Balakrishnan Karthik , Bauman Nancy , Chun Robert H. , Darrow David H. , Grimmer J. Fredrik , Perkins Jonathan A. , Richter Gresham T. , Shin Jennifer J. , Shivaram Giridhar M. , Sidell Douglas R. , Elluru Ravindhra G. 
Published: April 2015

ObjectiveTo develop general and site‐specific treatment effect and outcome measures to standardize the reporting of head and neck lymphatic malformation (HNLM) treatments.Study DesignConsensus statement/expert opinion.SettingMultiple tertiary academic institutions.Subjects and MethodsThe modified Delphi method is an iterative process of collecting expert opinions, refining opinions through discussion and feedback, statistically aggregating opinions, and using these aggregates to generate consensus opinion in the absence of other data. The modified Delphi method was used by a multi‐institutional group of otolaryngology and interventional radiology experts in the field of vascular anomalies to formulate a list of recommended reporting outcomes for the study and treatment of head and neck lymphatic malformations.ResultsThrough 3 rounds of iteration, 10 expert panelists refined 98 proposed outcome measures and 9 outcome categories to a final consensus set of 50 recommended outcome measures in 3 global categories (general, demographics, and treatment complications) and 5 site‐specific categories (orbit, oral cavity, pharynx, larynx, and neck).ConclusionsWe propose the first consensus set of standardized reporting measures for clinical and treatment outcomes in studies of HNLMs. Consistent outcome measures across future studies will facilitate comparison of treatment options and allow systematic review. We hope that these guidelines facilitate the design and reporting of subsequent HNLM studies.
Identification of acquired coagulation disorders and effects of target-controlled coagulation factor substitution on the incidence and severity of spontaneous intracranial bleeding during veno-venous ECMO therapy
Authors: Kalbhenn J , Wittau N , Schmutz A , Zieger B , Schmidt R 
Published: April 2015

Introduction: Intracranial haemorrhage is a redoubtable complication during extracorporeal membrane oxygenation (ECMO) therapy. The underlying mechanisms of haemorrhagic diathesis are still not completely understood. This study was performed to evaluate a coagulation protocol for the regular analysis of acquired coagulation disorders and the systematic substitution of coagulation factors to reach predefined target values. We hypothesised that using this strategy would lead to the identification of acquired bleeding disorders which cannot be monitored with standard coagulation tests and that substitution of the respective factors in a target-controlled approach could have an impact on the incidence and severity of intracranial haemorrhage. Methods: A protocol for the analysis of acquired coagulation disorders and the subsequent administration of associated factor concentrates was introduced. Previously, coagulation management was mainly based on clinical bleeding signs as the trigger for the administration of blood products. In this investigation, nineteen consecutive patients before (control group) and twenty consecutive patients after the implementation of the protocol (intervention group) have been included in the study. Results: Eighty-eight percent of the patients developed factor XIII deficiency, 79% acquired von Willebrand syndrome, 40% fibrinogen deficiency and 54% of the patients showed a decline in platelet count >20% within the first 24 hours of ECMO therapy. In 6 out of 19 (31%) patients in the control group and in 2 patients out of 20 (10%) in the intervention group, intracranial haemorrhage was detected. Whilst 5 of 6 patients in the control group died because of fatal bleeding, both of the patients in the intervention group recovered with a favourable neurologic outcome. Conclusions: Veno-venous ECMO therapy leads to thrombocytopenia, factor XIII and fibrinogen deficiency as well as acquired von Willebrand syndrome. The implementation of a coagulation protocol including a standardized determination and target-controlled substitution of coagulation factors may have a beneficial impact on the incidence and severity of intracranial haemorrhage.
Patient and carer experiences of clinical uncertainty and deterioration, in the face of limited reversibility: A comparative observational study of the AMBER care bundle
Authors: Bristowe Katherine , Carey Irene , Hopper Adrian , Shouls Susanna , Prentice Wendy , Caulkin Ruth , Higginson Irene J , Koffman Jonathan 
Published: April 2015

Background: Clinical uncertainty is emotionally challenging for patients and carers and creates additional pressures for those clinicians in acute hospitals. The AMBER care bundle was designed to improve care for patients identified as clinically unstable, deteriorating, with limited reversibility and at risk of dying in the next 1–2 months. Aim: To examine the experience of care supported by the AMBER care bundle compared to standard care in the context of clinical uncertainty, deterioration and limited reversibility. Design: A comparative observational mixed-methods study using semi-structured qualitative interviews and a followback survey. Setting/participants: Three large London acute tertiary National Health Service hospitals. Nineteen interviews with 23 patients and carers (10 supported by AMBER care bundle and 9 standard care). Surveys completed by next of kin of 95 deceased patients (59 AMBER care bundle and 36 standard care). Results: The AMBER care bundle was associated with increased frequency of discussions about prognosis between clinicians and patients ( χ2 = 4.09, p = 0.04), higher awareness of their prognosis by patients ( χ2 = 4.29, p = 0.04) and lower clarity in the information received about their condition ( χ2 = 6.26, p = 0.04). Although the consistency and quality of communication were not different between the two groups, those supported by the AMBER care bundle described more unresolved concerns about caring for someone at home. Conclusion: Awareness of prognosis appears to be higher among patients supported by the AMBER care bundle, but in this small study this was not translated into higher quality communication, and information was judged less easy to understand. Adequately powered comparative evaluation is urgently needed.
How reliable is routine lumbar spine MRI for detection of renal cysts? Correlation with abdominal CT
Authors: Cho Hee Woo , Lee Young Han , Chung Soo Yoon , Park Jin-Oh , Suh Jin-Suck 
Published: April 2015

Background Incidental renal cysts are a very common finding in routine lumbar spine magnetic resonance imaging (MRI). However, there is no report of the renal cyst detection rate on routine lumbar spine MRI. Purpose To determine the renal cyst detection rate in routine lumbar spine MRI based on findings of abdominal computed tomography (CT), and to investigate if the largest renal cyst seen by abdominal CT could be also detected by routine lumbar spine MRI. Material and Methods A retrospective study was conducted of 70 patients who underwent both routine lumbar spine MRI and abdominal CT between December 2011 and January 2014. The detection rate of all renal cysts>5 mm as well as the largest renal cyst seen by abdominal CT were assessed in routine lumbar spine MRI. Results On routine lumbar spine MRI, the detection rate of renal cysts was 46.5% (73/157) for>5-mm renal cysts and 68.0% (34/50) for>10-mm renal cysts, correlating with abdominal CT. The detection rate of the largest renal cyst seen by abdominal CT was 60.0% (27/45). Non-detection of the largest renal cyst could be caused by upper positioning ( n = 7), lateral positioning ( n = 6), or relatively small cyst size ( n = 5). Conclusion Approximately half of renal cysts>5 mm and two-thirds of renal cysts>10 mm were detected on routine lumbar spine MRI. However, radiologists should be aware that kidney lesions may not be included in the scan coverage of routine lumbar spine MRI.