bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Role of Medical Directors in Dialysis Facilities Series Editor: Robert A. Gutman: Medical Director Responsibilities Regarding Disruptive Behavior in the Dialysis Center—Leading Effective Conflict Resolution
Authors: Goldman Richard S. 
Published: May 2008

AbstractMedical directors are directly or indirectly responsible for everything that occurs in a dialysis facility. The proposed Conditions of Coverage require medical directors to oversee the process resulting in involuntary discharges from the facility. Involuntary discharges result in high costs to the patient, family, facility and payers. Consequently, End Stage Renal Disease (ESRD) Networks oversee individual facility involuntary discharge rates. A large national survey found that involuntary discharges were due to disruptive behaviors, most commonly nonadherence to medical advice. Medical directors should create an environment designed to assure that disruptive behavior and conflict can be resolved. This is best done by using positive interventions before involuntary discharge, by developing policies and procedures that are implemented continuously and by continually teaching these principles. There are two excellent references about dialysis‐related disruptive behavior and conflict resolution: (1) the Renal Physician Association’s second guideline, “Shared Decision Making in the Appropriate Initiation and Withdrawal from Dialysis,” and (2) The Dialysis Patient Provider Conflict Project. Both will aid medical directors meet their conflict‐resolving responsibilities under the proposed, federal regulations.
A comparison of five fMRI protocols for mapping speech comprehension systems
Authors: Binder Jeffrey R. , Swanson Sara J. , Hammeke Thomas A. , Sabsevitz David S. 
Published: May 2008

SummaryAims: Many fMRI protocols for localizing speech comprehension have been described, but there has been little quantitative comparison of these methods. We compared five such protocols in terms of areas activated, extent of activation, and lateralization.Methods: fMRI BOLD signals were measured in 26 healthy adults during passive listening and active tasks using words and tones. Contrasts were designed to identify speech perception and semantic processing systems. Activation extent and lateralization were quantified by counting activated voxels in each hemisphere for each participant.Results: Passive listening to words produced bilateral superior temporal activation. After controlling for prelinguistic auditory processing, only a small area in the left superior temporal sulcus responded selectively to speech. Active tasks engaged an extensive, bilateral attention, and executive processing network. Optimal results (consistent activation and strongly lateralized pattern) were obtained by contrasting an active semantic decision task with a tone decision task. There was striking similarity between the network of brain regions activated by the semantic task and the network of brain regions that showed task‐induced deactivation, suggesting that semantic processing occurs during the resting state.Conclusions: fMRI protocols for mapping speech comprehension systems differ dramatically in pattern, extent, and lateralization of activation. Brain regions involved in semantic processing were identified only when an active, nonlinguistic task was used as a baseline, supporting the notion that semantic processing occurs whenever attentional resources are not controlled. Identification of these lexical‐semantic regions is particularly important for predicting language outcome in patients undergoing temporal lobe surgery.
Continuous phenobarbital treatment leads to recurrent plantar fibromatosis
Authors: Strzelczyk Adam , Vogt Heinrich , Hamer Hajo M. , Krämer Günter 
Published: May 2008

Summary Despite contrary recommendations by expert opinion and international guidelines phenobarbital remains the most widely prescribed anticonvulsant worldwide. Although associated connective tissue disorders were described in a timely way after its introduction, the association between plantar fibromatosis—also called Ledderhose syndrome—and phenobarbital seems not to be well known in general. Our case series uniquely demonstrates that continuous phenobarbital treatment leads to recurrent plantar fibromatosis and may result in long‐term disability and numerous unnecessary operations. In general, the association between connective tissue disorders and phenobarbital most prominently appears in adult patients of northern European descent. However, our case series and data from the literature suggest that patient groups less susceptible to connective tissue disorders may as well develop Ledderhose syndrome or other associated syndromes as Dupuytren's contractures, frozen shoulder, Peyronie's disease or complex regional pain syndrome in the course of phenobarbital treatment.
Residual Limbs of Amputees Are Significantly Cooler than Contralateral Intact Limbs
Authors: Harden R. Norman , Gagnon Christine M. , Gallizzi Michael , Khan Anjum S. , Newman Devon 
Published: May 2008

▪ Abstract: Objective:  To test the hypothesis that distal residual limbs (DRLs) have significant vasomotor abnormalities.Design:  Comparative surface temperature studies of DRLs using paired samples (DRL vs. similar site on intact contralateral limb).Subjects/Patients:  Thirty‐six volunteer subjects with unilateral, upper or lower limb amputations were recruited and evaluated at a pain research center in an urban academic rehabilitation facility.Methods:  Our main outcomes were subjects’ residual limb temperature as measured by quantitative infrared telethermography (qIRT), temperature strips, and examiner's palpation, compared with the contralateral limb.Results:  The qIRT showed that the DRLs were significantly cooler than the corresponding area of the contralateral intact limbs (P < 0.01). The difference using temperature strips supported this finding (P < 0.05); while on physical examination, 39% of the residual limbs were perceived by the examiner as cooler than the corresponding unaffected limbs.Conclusions:  DRLs as measured by qIRT were significantly cooler than the corresponding area of the contralateral intact limbs. A better understanding of these findings may be important in elucidating the pathophysiology of relevant clinical features such as a potential sympathetic component of postamputation pain. ▪
Systems biology approaches for the study of multiple sclerosis
Authors: Quintana Francisco J. , Farez Mauricio F. , Weiner Howard L. 
Published: May 2008

Introduction
Genomics
Transcriptomics
Proteomics
Metabolomics
Integration of data from different ‘omics' approaches
New experimental models
Conclusions
AbstractMultiple sclerosis (MS) is a progressive neurological disease caused by an autoimmune attack to the central nervous system (CNS). MS is thought to result from a complex interaction between genetic and environmental factors. In this review, we analyse the contribution of genomics, trancriptomics and proteomics in delineating these factors, as well as their utility for the monitoring of disease progression, the identification of new targets for therapeutic intervention and the early detection of individuals at risk.
The Lower River Roding Regeneration
Authors: Gray Joanna , Hawkes Jennifer , Martin Peter 
Published: May 2008

AbstractThe Lower River Roding Regeneration (LRRR) project was funded by the Office of the Deputy Prime Minister (ODPM) with a contribution from the Environment Agency and was charged with achieving environmental and social gains along the highly urbanised lower 4.4 km of the River Roding. The funding allowed £1.5 million for all elements of work within a 2‐year‐period. Of the four sites constructed, two allowed significant river restoration to be achieved: Creekmouth Open Space and Frogmore Frontage. In the former, an existing flood defence was set back to create a tidal backwater. In the latter, a concrete river wall was demolished and a graded riverbank was created. A total of 1 ha of new saltmarsh was created on these two sites. The project demonstrates how multiple objectives of river restoration, flood defence, habitat creation, improved public amenity and urban regeneration can be achieved in an industrial urban area.
Estimation of sewer leakage to urban groundwater using depth‐specific hydrochemistry
Authors: Rueedi J. , Cronin A. A. , Morris B. L. 
Published: May 2008

AbstractThe contribution of sewer leakage to urban groundwater recharge remains poorly characterised. There has been a tendency to focus on estimating leakage from pipe network characteristics rather than its impact on the receiving environment. Indeed, pipeline leakage simulation models are frequently used to analyse sewage systems and optimise maintenance efforts. Here a mass balance approach employing groundwater geochemistry is presented to estimate sewer leakage rates; this is done using depth‐specific groundwater quality measurements from multilevel monitoring piezometers, specially installed in the Sherwood Sandstone aquifer underlying Doncaster (UK). The results show that leakage rates from the foul sewage system are up to 10% of flow per annum (30–40% of urban recharge) and highlight the utility of groundwater quality monitoring (in particular depth‐specific sampling) as an alternative means to assess sewage ingress to urban groundwater.
The WFD dreams: between ecology and economics
Authors: Bouleau Gabrielle 
Published: May 2008

AbstractThe enactment of the Water Framework Directive (WFD) in the European Union (EU) triggers intense activity among Member States and raises some criticism. The good status of waters may include an ecological dream that is difficult to achieve. Moreover, criteria for derogations require strong economic arguments. This challenge raises the debate on whether the WFD is part of an incremental process, embedded in prior European water law, with feasible goals, or whether it is a dramatic change of policy towards an ecological dream that emerged during late negotiations, and therefore was hardly achievable. I will state that although the high ecological ambition of the WFD is unprecedented within the EU's water law, it has several precedents in other arenas, notably long enforced in the United States of America. I will argue that the major challenge of the directive is the combination of the ecological dream with an economic ideal, which has no equivalent in the United States.
Deconstructing public participation in the Water Framework Directive: implementation and compliance with the letter or with the spirit of the law?
Authors: Ker Rault Ph. A. , Jeffrey P. J. 
Published: May 2008

AbstractThis article offers a fresh reading of the Water Framework Directive (WFD) and of the Common Implementation Strategy guidance document number 8 on public participation (PP) aimed at identifying the conditions required for successful implementation. We propose that a central barrier to implementing Article 14 is that Integrated Water Resources Management (IWRM) problems are complex in character and that participation is a wicked process in practice. This article highlights some ambiguous interpretations of the WFD comparing and contrasting the ‘letter of the law’ and its ‘spirit’, based on a critical review of the nature of PP, who it concerns and when it takes place. First we articulate a complex system interpretation of IWRM in the context of the WFD. Second, we explain the difficulty to define blueprint for PP in IWRM. Finally, we present five interpretative challenging readings in order to highlight tensions between the ‘spirit’ and the ‘letter’ of the WFD.
Role of F4/80+Mac‐1high adherent non‐parenchymal liver cells in concanavalin A‐induced hepatic injury in mice
Authors: Mabuchi Ayako , Nagao Tomokazu , Koshio Osamu , Ishiwata Toshiyuki , Yano Akihiko , Suzuki Kazuo , Yokomuro Kozo , Wheatley Antony M. 
Published: May 2008

Aim:  Non‐parenchymal liver cells (NPLC) play an important role in the regulation of immune responses and the inflammatory process. In this study, we hypothesized that F4/80+Mac‐1high+ cells were involved in the regulative feedback‐modulated regulation of inflammatory responses during concanavalin A (Con A)‐induced hepatitis.Methods:  Hepatitis was induced in BALB/c mice by the intravenous injection of Con A. Liver injury was assessed using serum aminotransferase and pathology. The function of NPLC was assessed by FACS analysis. Accessory cell function of adherent Con A NPLC was performed with an ovalbumin specific T‐helper 1 (Th1) clone proliferation assay. The culture supernatant nitric oxide (NO) content was quantified by the Griess reaction. Inducible NO synthase (iNOS) expression was demonstrated by immunohistochemistry and Western blot analysis.Results:  The number of hepatic F4/80+Mac‐1high+cells increased in a time‐dependent manner after Con A administration, which consequently suppressed Th1 cell proliferation by a mechanism likely to involve NO. The iNOS expression of NPLC was elevated at 24 h post‐Con A injection. In nude mice, F4/80+Mac‐1high+cells did not increase in the Con A‐treated liver; the NPLC did not suppress Th1 clone proliferation.Conclusion:  These findings suggest that the in vivo activation of F4/80+Mac‐1high+cells by Con A administration suppresses Th1 cell proliferation by increasing NO, and subsequently reducing liver injury.
Response of a Thin Airfoil Encountering a Strong Density
Discontinuity
Authors: Marble F. E. 
Published: May 2008

Abstract
Airfoil theory for unsteady motion has been developed extensively assuming the undisturbed medium to be of uniform density, a restriction accurate for motion in the atmosphere, Glauert (1929), Burgers (1935), Theodorsen (1935), Kussner (1936), Karman and Sears (1938), Kinney and Sears (1975). In some instances, notably for airfoils comprising fan, compressor and turbine blade rows, the undisturbed medium may carry density variations or “spots,” resulting from non-uniformities in temperature or composition, of a size comparable to the blade chord. This condition exists for turbine blades, Marble (1975), Giles and Krouthen (1988), immediately downstream of the main burner of a gas turbine engine where the density fluctuations of the order of 50 percent may occur. Disturbances of a somewhat smaller magnitude arise from the ingestion of hot boundary layers into fans, Wortman (1975), and exhaust into hovercraft. Because these regions of non-uniform density convect with the moving medium, the airfoil experiences a time varying load and moment which we propose to calculate.
Sensitivity of Global Mixing and Fluxes to Isolated Transport Barriers
Authors: Nakamura Noboru 
Published: May 2008

Abstract
Effects of isolated transport barriers on the global mixing and fluxes of a tracer are investigated, where a barrier is defined as a local minimum in effective diffusivity. An idealized 1D model with a prescribed diffusivity profile, with or without forcing, is used to show that the structure, flux, and decay rates of the tracer are all very sensitive to the barrier geometry, particularly when it is deep and narrow. Although the tracer gradients and the variance dissipation are concentrated to the barrier region, the flux shows a more global response to the barrier, decreasing everywhere. The harmonic mean of effective diffusivity is proposed as a useful first-order predictor of the global transport. This 1D model is used to diagnose the isentropic transport in the upper troposphere and lower stratosphere with offline transport calculations driven by the Met Office winds. The global tracer variance in these calculations decays approximately exponentially, and the time-mean decay rate and tracer structure are well captured by the gravest 1D eigenmode with the time-averaged effective diffusivity. However, the decay rate and the flux of the full solution are 15%–20% smaller than those of the eigenmode because of a negative temporal correlation between the effective diffusivity and the gradient. The vertical and decadal variations of the decay rates are consistent with the corresponding variations in the harmonic mean effective diffusivity. To the extent that the global mixing is sensitive to the local barrier properties, and to the extent that the latter are sensitive to the errors in advecting winds and model numerics, modeling of global atmospheric transport remains a challenge. This may explain, at least partially, the disparate model estimates reported in the literature.
Vortex-Driven Sensitivity in Deformation Flow
Authors: Liu Zhiyuan , Roebber Paul J. 
Published: May 2008

Abstract
A sensitivity mechanism for the interaction of two vortices in a two-dimensional deformation background flow is explored. A nonlinear model describing the vortex interaction up to a critical merging distance is developed. This model shows that in a confluent or diffluent background flow, two vortices can obtain a global minimum distance by counterclockwise turning and a local minimum distance by clockwise turning about each other. In a major portion of the phase space, the global minimum distance is smaller than the local minimum distance. Therefore, vortex merger is more likely to occur during the process in which the two vortices approach their global smallest distance. Analysis of the governing equations shows that there exists a “most sensitive line” of initial vortex positions. When an initial state is on one side of the most sensitive line, the two vortices can obtain their global smallest distance and thus have a higher chance for merger. Conversely, when an initial state is on the other side relative to the most sensitive line, the two vortices can only obtain their local smallest distance. Consequently, they have a lower chance for merger. When an initial state is close to the most sensitive line, a very small initialization error can put this initial state on the wrong side of the most sensitive line, and the forecast evolution of the pair of vortices may be very different from the observed evolution. Numerical simulations that support these theoretical results are shown.
Detection and Attribution of Temperature Changes in the Mountainous Western United States
Authors: Bonfils Céline , Santer Benjamin D. , Pierce David W. , Hidalgo Hugo G. , Bala Govindasamy , Das Tapash , Barnett Tim P. , Cayan Daniel R. , Doutriaux Charles , Wood Andrew W. , Mirin Art , Nozawa Toru 
Published: May 2008

Abstract
Large changes in the hydrology of the western United States have been observed since the mid-twentieth century. These include a reduction in the amount of precipitation arriving as snow, a decline in snowpack at low and midelevations, and a shift toward earlier arrival of both snowmelt and the centroid (center of mass) of streamflows. To project future water supply reliability, it is crucial to obtain a better understanding of the underlying cause or causes for these changes. A regional warming is often posited as the cause of these changes without formal testing of different competitive explanations for the warming. In this study, a rigorous detection and attribution analysis is performed to determine the causes of the late winter/early spring changes in hydrologically relevant temperature variables over mountain ranges of the western United States. Natural internal climate variability, as estimated from two long control climate model simulations, is insufficient to explain the rapid increase in daily minimum and maximum temperatures, the sharp decline in frost days, and the rise in degree-days above 0°C (a simple proxy for temperature-driven snowmelt). These observed changes are also inconsistent with the model-predicted responses to variability in solar irradiance and volcanic activity. The observations are consistent with climate simulations that include the combined effects of anthropogenic greenhouse gases and aerosols. It is found that, for each temperature variable considered, an anthropogenic signal is identifiable in observational fields. The results are robust to uncertainties in model-estimated fingerprints and natural variability noise, to the choice of statistical downscaling method, and to various processing options in the detection and attribution method.
Does an Increase in Air Quality Models’ Resolution Bring Surface Ozone Concentrations Closer to Reality?
Authors: Valari Myrto , Menut Laurent 
Published: May 2008

Abstract
A persistent challenge for small-scale air quality modeling is the assessment of health impact and population exposure studies. Despite progress in computation and in the quality of model input (i.e., high-resolution information on land use and emission patterns), the uncertainty associated with input parameters cannot be eliminated. The aim of this paper is to study different sources of uncertainty that affect model results as the resolution increases. Mesoscale chemistry transport simulations at different resolutions are used and modeled 03 concentrations are compared with surface measurements. The case study consists of CHIMERE model simulations over the city of Paris. It is shown that the principal source of noise in model results is the resolution of the input emission fluxes. The O3 concentrations modeled with simulations forced by several horizontal resolutions of input emission data (from Δx = 48 km to Δx = 6 km) indicate that model results do not improve monotonously with resolution, but that after a certain point discrepancies become larger. Based on this result and as an alternative to the deterministic downscaling that resolves explicitly the finer scale (beyond the 1-km range), the authors propose a subgrid-scale approach that uses a statistical description of spatial scales finer than model resolution. As an example, the subgrid variability of modeled O3 concentration has been quantified, when modeled dry deposition processes occur over subgrid surfaces (land use fractions). The implementation of this modified calculation gives access to subgrid fluxes and subgrid surface concentrations instead of the mean values provided by the commonly used model calculation.
Single- and Dual-Doppler Analysis of a Tornadic Vortex and Surrounding Storm-Scale Flow in the Crowell, Texas, Supercell of 30 April 2000
Authors: Marquis James , Richardson Yvette , Wurman Joshua , Markowski Paul 
Published: May 2008

Abstract
Fine-resolution single- and dual-Doppler data were collected in the tornadic region of a supercell storm intercepted by two Doppler-on-Wheels radars on 30 April 2000 near Crowell, Texas. Eleven dual-Doppler analyses characterize the 2D and 3D near-surface wind fields associated with a tornado during a 13-min period. An interesting evolution of the low-level rotation is observed. Initially concentric “tornado” (∼500 m wide) and “tornado–cyclone” (∼2 km wide) radar velocity couplets make a transition into a solitary intermediate-sized (∼750 m wide) circulation that widens and makes a further transition into a two-celled multiple-vortex structure with an asymmetric distribution of vertical vorticity. The asymmetry and eventual disruption of the multiple-vortex structure may have been partially controlled by locally strong outflow winds that affect the convergence fields in its vicinity. A smaller (∼500 m wide) tornado embedded in a broad area of rotation is subsequently observed. The dual-Doppler wind fields are also used to characterize aspects of the storm-scale flow. Locally surging outflow winds result in a double rear-flank gust front structure. The tornado and tornado–cyclone are completely surrounded by outflow at all observation times and air parcels traced within the inflow to the storm rise along the gust front rather than enter the tornado near the ground.