bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maximizing the Population Benefit From Thrombolysis in Acute Ischemic Stroke
Authors: Monks Thomas , Pitt Martin , Stein Ken , James Martin 
Published: August 2012

Background and Purpose—
To maximize the benefits of thrombolysis, it is necessary not only to treat more patients, but to deliver treatment as early as possible. The aims of our study were to prospectively evaluate the clinical benefit from reducing delays in the emergency stroke pathway at our district hospital and examine outcomes from scenarios that include extension of the alteplase license.

Methods—
We developed a discrete-event simulation from prospective data for patients with stroke arriving at our large district hospital. We modeled current practice and assessed the impact on stroke outcomes of measures to reduce in-hospital delays to alteplase treatment and of extensions to the European license for alteplase from 3 to 4.5 hours and to people aged >80 years.

Results—
Extension of the time window to 4.5 hours increases the thrombolysis rate by 4%, yielding an additional 2 patients per year with minimal or no disability at 3 months. Time window extension is most effective when combined with a system of prealerts, achieving a thrombolysis rate of 15% and an additional 8 patients per year with minimal or no disability, increasing to 13 patients per year with extension of the license to patients >80 years.

Conclusions—
If implemented alone, extension of the time window for alteplase has only a modest additional population disability benefit, but this benefit can be increased 5-fold if time window extension is combined with substantial reductions to in-hospital delays.
Relationship Between Electrical Brain Responses to Motor Imagery and Motor Impairment in Stroke
Authors: Kaiser Vera , Daly Ian , Pichiorri Floriana , Mattia Donatella , Müller-Putz Gernot R. , Neuper Christa 
Published: August 2012

Background and Purpose—
New strategies like motor imagery based brain–computer interfaces, which use brain signals such as event-related desynchronization (ERD) or event-related synchronization (ERS) for motor rehabilitation after a stroke, are undergoing investigation. However, little is known about the relationship between ERD and ERS patterns and the degree of stroke impairment. The aim of this work was to clarify this relationship.

Methods—
EEG during motor imagery and execution were measured in 29 patients with first-ever monolateral stroke causing any degree of motor deficit in the upper limb. The strength and laterality of the ERD or ERS patterns were correlated with the scores of the European Stroke Scale, the Medical Research Council, and the Modified Ashworth Scale.

Results—
Mean age of the patients was 58±15 years; mean time from the incident was 4±4 months. Stroke lesions were cortical (n=8), subcortical (n=11), or mixed (n=10), attributable to either an ischemic event (n=26) or a hemorrhage (n=3), affecting the right (n=16) or left (n=13) hemisphere. Higher impairment was related to stronger ERD in the unaffected hemisphere and higher spasticity was related to stronger ERD in the affected hemisphere. Both were related to a relatively stronger ERS in the affected hemisphere.

Conclusion—
The results of this study may have implications for the design of potential poststroke rehabilitation interventions based on brain–computer interface technologies that use neurophysiological signals like ERD or ERS as neural substrates for the mutual interaction between brain and machine and, ultimately, help stroke patients to regain motor control.
Characterization of the Thermal Structure inside an Urban Canyon: Field Measurements and Validation of a Simple Model
Authors: Giovannini Lorenzo , Zardi Dino , de Franceschi Massimiliano 
Published: August 2012

AbstractThe results of measurement campaigns are analyzed to investigate the thermal structure in an urban canyon and to validate a simplified model simulating the air and surface temperatures from surface energy budgets. Starting from measurements at roof-top level, the model provides time series of air and surface temperatures, as well as surface fluxes. Two campaigns were carried out in summer 2007 and in winter 2008/09 in a street of the city of Trento (Italy). Temperature sensors were placed at various levels near the walls flanking the canyon and on a traffic light in the street center. Furthermore, the atmosphere above the mean roof-top level was monitored by a weather station on top of a tower located nearby. Air temperatures near the walls, being strongly influenced by direct solar radiation, display considerable contrasts between the opposite sides of the canyon. On the other hand, when solar radiation is weak or absent, the temperature field remains mostly homogeneous. Moreover, air temperature inside the canyon is generally higher than above roof level, with larger differences during summertime. Air temperatures from the above street measurements are well simulated by the model in both seasons. Furthermore, the modeled surface temperatures are tested against a dataset of wall surface temperatures from the Advanced Tools for Rational Energy Use Towards Sustainability–Photocatalytic Innovative Coverings Applications for Depollution (ATREUS–PICADA) experiment, and a very good agreement is found. Results suggest that the model is a reliable and convenient tool for simplified assessment of climatic conditions occurring in urban canyons under various weather situations.
Energy Dispersion in African Easterly Waves
Authors: Diaz Michael , Aiyyer Anantha 
Published: August 2012

Abstract
The existence of an upstream (eastward) group velocity for African easterly waves (AEWs) is shown based on single-point lag regressions using gridded reanalysis data from 1990 to 2010. The eastward energy dispersion is consistent with the direction of ageostrophic geopotential flux vectors. A local eddy kinetic energy (EKE) budget reveals that, early in the life cycle of AEWs, growth rate due to geopotential flux convergence exceeds baroclinic and barotropic growth rates. Later in the life cycle, EKE decay due to geopotential flux divergence cancels or exceeds baroclinic and barotropic growth. A potential vorticity (PV) budget is used to diagnose tendencies related to group propagation. Although both upstream and downstream group speeds are possible because of the reversal in the mean meridional PV gradient, upstream propagation associated with the positive poleward PV gradient dominates wave packet evolution. Analogous to the concept of downstream development of midlatitude baroclinic waves, new AEWs develop preferentially upstream of the older ones, thus providing a mechanism for seeding new waves. It is suggested that these results are also relevant to AEW intermittency and storm-track structure.
A New Look at the Physics of Rossby Waves: A Mechanical–Coriolis Oscillation
Authors: Cai Ming , Huang Bohua 
Published: August 2012

AbstractThe presence of the latitudinal variation of the Coriolis parameter serves as a mechanical barrier that causes a mass convergence for the poleward geostrophic flow and divergence for the equatorward flow, just as a sloped bottom terrain does to a crossover flow. Part of the mass convergence causes pressure to rise along the uphill pathway, while the remaining part is detoured to cross isobars out of the pathway. This mechanically excited cross-isobar flow, being unbalanced geostrophically, is subject to a “half-cycle” Coriolis force that only turns it to the direction parallel to isobars without continuing to turn it farther back to its opposite direction because the geostrophic balance is reestablished once the flow becomes parallel to isobars. Such oscillation, involving a barrier-induced mass convergence, a mechanical deflection, and a half-cycle Coriolis deflection, is referred to as a mechanical–Coriolis oscillation with a “barrier-induced half-cycle Coriolis force” as its restoring force. Through a complete cycle of the mechanical–Coriolis oscillation, a new geostrophically balanced flow pattern emerges to the left of the existing flow when facing the uphill (downhill) direction of the barrier in the Northern (Southern) Hemisphere. The β barrier is always sloped toward the pole in both hemispheres, responsible for the westward propagation of Rossby waves. The β-induced mechanical–Coriolis oscillation frequency can be succinctly expressed as , where , and λ is the angle of a sloped surface along which the unbalanced flow crosses isobars, α is the angle of isobars with the barrier’s slope, and k is the wavenumber along the direction of the barrier’s contours.
Attribution of Decadal Variability in Tropical Cyclone Passage Frequency over the Western North Pacific: A New Approach Emphasizing the Genesis Location of Cyclones
Authors: Yokoi Satoru , Takayabu Yukari N. 
Published: August 2012

Abstract
Variability in tropical cyclone (TC) activity is a matter of direct concern for affected populations. On interannual and longer time scales, variability in TC passage frequency can be associated with total TC frequency over the concerned ocean basin [basinwide frequency (BF)], the spatial distribution of TC genesis in the basin [genesis distribution (GD)], and the preferable track (PT) that can be considered as a function of genesis locations. To facilitate investigation of mechanisms responsible for the variability, the authors propose an approach of decomposing anomalies in the passage frequency into contributions of variability in BF, GD, and PT, which is named the Integration of Statistics on TC Activity by Genesis Location (ISTAGL) analysis. Application of this approach to TC best track data in the western North Pacific (WNP) basin reveals that overall distribution of the passage frequency trends over the 1961–2010 period is mainly due to the PT trends. On decadal time scales, passage frequency variability in midlatitudes is primarily due to PT variability, while the BF and GD also play roles in the subtropics. The authors further discuss decadal variability over the East China Sea in detail. The authors demonstrate that northward shift of the PT for TCs generated around the Philippines Sea and westward shift for TCs generated in the eastern part of the WNP contribute the variability with almost equal degree. The relationships between these PT shifts and anomalies in environmental circulation fields are also discussed.
The Atmospheric Response to Three Decades of Observed Arctic Sea Ice Loss
Authors: Screen James A. , Simmonds Ian , Deser Clara , Tomas Robert 
Published: August 2012

Abstract
Arctic sea ice is declining at an increasing rate with potentially important repercussions. To understand better the atmospheric changes that may have occurred in response to Arctic sea ice loss, this study presents results from atmospheric general circulation model (AGCM) experiments in which the only time-varying forcings prescribed were observed variations in Arctic sea ice and accompanying changes in Arctic sea surface temperatures from 1979 to 2009. Two independent AGCMs are utilized in order to assess the robustness of the response across different models. The results suggest that the atmospheric impacts of Arctic sea ice loss have been manifested most strongly within the maritime and coastal Arctic and in the lowermost atmosphere. Sea ice loss has driven increased energy transfer from the ocean to the atmosphere, enhanced warming and moistening of the lower troposphere, decreased the strength of the surface temperature inversion, and increased lower-tropospheric thickness; all of these changes are most pronounced in autumn and early winter (September–December). The early winter (November–December) atmospheric circulation response resembles the negative phase of the North Atlantic Oscillation (NAO); however, the NAO-type response is quite weak and is often masked by intrinsic (unforced) atmospheric variability. Some evidence of a late winter (March–April) polar stratospheric cooling response to sea ice loss is also found, which may have important implications for polar stratospheric ozone concentrations. The attribution and quantification of other aspects of the possible atmospheric response are hindered by model sensitivities and large intrinsic variability. The potential remote responses to Arctic sea ice change are currently hard to confirm and remain uncertain.
The Sensitivity of the Arctic Ocean Sea Ice Thickness and Its Dependence on the Surface Albedo Parameterization
Authors: Björk Göran , Stranne Christian , Borenäs Karin 
Published: August 2012

Abstract
In this study, the response of sea ice thickness to changes in the external forcing is investigated and particularly how this response depends on the surface albedo formulation by means of a one-dimensional coupled ocean–ice–atmosphere model. The main focus is on the thickness response to the atmospheric heat advection Fwall, solar radiation FSW, and amount of snow precipitation Sprec. Different albedo parameterization schemes [ECHAM5, CSIRO, and Community Climate System Model, version 3 (CCSM3)] representing albedos commonly used in global climate models are compared together with more simplified schemes. Using different albedo schemes with the same external forcing produces large differences in ice thickness. The ice thickness response is similar for all realistic albedo schemes with a nearly linear decrease with increasing Fwall in the perennial ice regime and with a steplike transition into seasonal ice when Fwall exceeds a certain threshold. This transition occurs at an annual-mean ice thickness of 1.7–2.0 m. Latitudinal differences in solar insolation generally leads to increasing ice thickness toward the North Pole. The snow response varies significantly depending on which albedo scheme is used. The ECHAM5 scheme yields thinner ice with Sprec, the CSIRO scheme gives ice thickness nearly independent of Sprec, and with the CCSM3 scheme the ice thickness decreases with Sprec. A general result is that the modeled ice cover is rather sensitive to positive perturbations of the external heat supply when it is close to the transition such that just a small increase of, for example, Fwall can force the ice cover into the seasonal regime.
Integration of Climate and Weather Information for Improving 15-Day-Ahead Accumulated Precipitation Forecasts
Authors: Wang Hui , Sankarasubramanian A. , Ranjithan Ranji S. 
Published: August 2012

Abstract
Skillful medium-range weather forecasts are critical for water resources planning and management. This study aims to improve 15-day-ahead accumulated precipitation forecasts by combining biweekly weather and disaggregated climate forecasts. A combination scheme is developed to combine reforecasts from a numerical weather model and disaggregated climate forecasts from ECHAM4.5 for developing 15-day-ahead precipitation forecasts. Evaluation of the skill of the weather–climate information (WCI)-based biweekly forecasts under leave-five-out cross validation shows that WCI-based forecasts perform better than reforecasts in many grid points over the continental United States. Correlation between rank probability skill score (RPSS) and disaggregated ECHAM4.5 forecast errors reveals that the lower the error in the disaggregated forecasts, the better the performance of WCI forecasts. Weights analysis from the combination scheme also shows that the biweekly WCI forecasts perform better by assigning higher weights to the better-performing candidate forecasts (reforecasts or disaggregated ECHAM4.5 forecasts). Particularly, WCI forecasts perform better during the summer months during which reforecasts have limited skill. Even though the disaggregated climate forecasts do not perform well over many grid points, the primary reason WCI-based forecasts perform better than the reforecasts is due to the reduction in the overconfidence of the reforecasts. Since the disaggregated climate forecasts are better dispersed than the reforecasts, combining them with reforecasts results in reduced uncertainty in predicting the 15-day-ahead accumulated precipitation.
Comparing the Convective Structure and Microphysics in Two Sahelian Mesoscale Convective Systems: Radar Observations and CRM Simulations
Authors: Guy Nick , Zeng Xiping , Rutledge Steven A. , Tao Wei-Kuo 
Published: August 2012

Abstract
Two mesoscale convective systems (MCSs) observed during the African Monsoon Multidisciplinary Analyses (AMMA) experiment are simulated using the three-dimensional (3D) Goddard Cumulus Ensemble model. This study was undertaken to determine the performance of the cloud-resolving model in representing distinct convective and microphysical differences between the two MCSs over a tropical continental location. Simulations are performed using 1-km horizontal grid spacing, a lower limit on current embedded cloud-resolving models within a global multiscale modeling framework. Simulated system convective structure and microphysics are compared to radar observations using contoured frequency-by-altitude diagrams (CFADs), calculated ice and water mass, and identified hydrometeor variables. Vertical distributions of ice hydrometeors indicate underestimation at the mid- and upper levels, partially due to the inability of the model to produce adequate system heights. The abundance of high-reflectivity values below and near the melting level in the simulation led to a broadening of the CFAD distributions. Observed vertical reflectivity profiles show that high reflectivity is present at greater heights than the simulations produced, thought to be a result of using a single-moment microphysics scheme. Relative trends in the population of simulated hydrometeors are in agreement with observations, though a secondary convective burst is not well represented. Despite these biases, the radar-observed differences between the two cases are noticeable in the simulations as well, suggesting that the model has some skill in capturing observed differences between the two MCSs.
Translating the Research in Insulin Injection Technique
Authors: Saltiel-Berzin Rita , Cypress Marjorie , Gibney Michael 
Published: August 2012

Purpose Glucose variability leading to suboptimal glycemic control is common among people using injection therapies. Advanced technology and new studies have identified important issues related to injection technique: needle length and gauge, body mass index, skin and subcutaneous tissue thickness, adequate resuspension of cloudy insulins, leakage, choice of injection site and rotation, pinching a skinfold, and lipohypertrophy. All these issues can affect pain and bruising, insulin absorption, and blood glucose levels. The purpose of this article is to review current and past research regarding insulin injection therapy and to provide practical, translational information regarding injection technique, teaching/learning techniques specific to insulin administration, and implications for diabetes self-management education and support. Conclusion International injection recommendations for patients with diabetes have recently been published and have identified specific recommendations for health care professionals. This article provides an evidence-based translational and practical review of the research regarding injection technique and teaching/learning theory. Diabetes educators need to reevaluate how they provide instruction for the administration of insulin and other injectable medications. Research regarding skin and subcutaneous thickness reveals that shorter needles may be appropriate for the majority of patients regardless of body mass index. Periodic reassessment of injection technique, including suspension of cloudy insulins and inspection of injection sites for lipohypertrophy, is a critical aspect of the role of the diabetes educator. An injection checklist is provided as a guide for diabetes educators.
Failed Healing of Rotator Cuff Repair Correlates With Altered Collagenase and Gelatinase in Supraspinatus and Subscapularis Tendons
Authors: Robertson Catherine M. , Chen Christopher T. , Shindle Michael K. , Cordasco Frank A. , Rodeo Scott A. , Warren Russell F. 
Published: August 2012

Background: Despite improvements in arthroscopic rotator cuff repair technique and technology, a significant rate of failed tendon healing persists. Improving the biology of rotator cuff repairs may be an important focus to decrease this failure rate. The objective of this study was to determine the mRNA biomarkers and histological characteristics of repaired rotator cuffs that healed or developed persistent defects as determined by postoperative ultrasound. Hypothesis: Increased synovial inflammation and tendon degeneration at the time of surgery are correlated with the failed healing of rotator cuff tendons. Study Design: Case-control study; Level of evidence, 3. Methods: Biopsy specimens from the subscapularis tendon, supraspinatus tendon, glenohumeral synovium, and subacromial bursa of 35 patients undergoing arthroscopic rotator cuff repair were taken at the time of surgery. Expression of proinflammatory cytokines, tissue remodeling genes, and angiogenesis factors was evaluated by quantitative real-time polymerase chain reaction. Histological characteristics of the affected tissue were also assessed. Postoperative (>6 months) ultrasound was used to evaluate the healing of the rotator cuff. General linear modeling with selected mRNA biomarkers was used to predict rotator cuff healing. Results: Thirty patients completed all analyses, of which 7 patients (23%) had failed healing of the rotator cuff. No differences in demographic data were found between the defect and healed groups. American Shoulder and Elbow Surgeons shoulder scores collected at baseline and follow-up showed improvement in both groups, but there was no significant difference between groups. Increased expression of matrix metalloproteinase 1 (MMP-1) and MMP-9 was found in the supraspinatus tendon in the defect group versus the healed group ( P = .006 and .02, respectively). Similar upregulation of MMP-9 was also found in the subscapularis tendon of the defect group ( P = .001), which was consistent with the loss of collagen organization as determined by histological examination. From a general linear model, the upregulation of MMP-1 and MMP-9 was highly correlated with failed healing of the rotator cuff ( R2 = .656). Conclusion: The upregulation of tissue remodeling genes in the torn rotator cuff at the time of surgery provides a snapshot of the biological environment surrounding the torn rotator cuff that is closely related to the healing of repaired rotator cuffs.