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The simulation study investigated the relationship between the local linear trend model’s data-comparison accuracy, baseline-data variability, and changes in level and slope after introducing the N-of-1 intervention. Contour maps were constructed, which included baseline-data variability, change in level or slope, and percentage of non-overlapping data between the state and forecast values by the local linear trend model. Simulation results showed that baseline-data variability and changes in level and slope after intervention affect the data-comparison accuracy based on the local linear trend model. The field study investigated the intervention effects for actual field data using the local linear trend model, which confirmed 100% effectiveness of previous N-of-1 studies. These results imply that baseline-data variability affects the data-comparison accuracy using a local linear trend model, which could accurately predict the intervention effects. The local linear trend model may help assess the intervention effects of effective personalized interventions in precision rehabilitation.

Background Medial elbow apophysitis is a traction apophysitis observed in the medial epicondyle of the elbow in preadolescent baseball players. The purpose of this study was to determine the relationship between medial elbow apophysitis and elbow valgus instability in preadolescent baseball players. Methods The participants were classified into a control group and an injury group; the injury group included participants diagnosed with a medial elbow injury (inclusion criteria were only symptoms of the elbow joint or positive findings on physical examinations, or both). Elbow valgus instability was assessed by measuring the differences in ulnohumeral joint gapping width, with and without gravity stress induced by weight loading of the forearm using ultrasonography. Results The control and injury groups consisted of 81 and 23 preadolescent baseball players, respectively. In the throwing elbow, valgus instability in the injury group was significantly greater than that in the control group (1.07 vs. 0.57 mm, P = .001). In the non-throwing elbow, valgus instability in the injury group was significantly greater than that in the control group (0.57 vs. 0.37 mm, P = .011). The area under the curve for valgus instability of the throwing elbow was 0.89 mm (95% confidence interval, 0.64-0.77), and the cut-off value for elbow pain appearance was 0.80 mm. Conclusion The increased elbow valgus instability in the injury group was associated with a medial elbow injury. For the elbow valgus instability of the non-throwing side in the injury group, we considered that players with medial elbow apophysitis inherently have elbow laxity.

Background: Subacromial impingement syndrome is a common disorder associated with functional impairment and disability of the shoulder. Internal/external glenohumeral rotation is important for shoulder function. However, because it is difficult to measure the glenohumeral joint rotation angle physically, the relationship between this angle and the clinical symptoms of subacromial impingement syndrome is still largely unknown. Using advanced cine-magnetic resonance imaging techniques, we designed a study to improve our understanding of the nature of this relationship. Methods: We evaluated 100 shoulders with subacromial impingement syndrome. Patients underwent cine-magnetic resonance imaging during axial rotation with the arm adducted. During imaging, patients rotated their shoulder from maximum internal rotation to maximum external rotation over 10 seconds and then to maximum internal rotation over 10 seconds. The rotation angles were then evaluated using a series of axial images. The Constant–Murley (Constant) and UCLA scores for each patient were determined, and the correlation between the scores and rotational angles was assessed. Patients were divided into 3 groups according to the Constant pain score, and the rotational angles of each group were compared. Rotational angles were also compared between shoulders with and without night pain. Results: The external rotation angle showed a significant but low correlation with the Constant and UCLA scores (ρ = 0.24 and 0.24, respectively), whereas the internal rotation angle did not. In comparing the pain groups of Constant score and UCLA score, the external rotation angle significantly decreased as pain increased (P

[Purpose] We report our experience with a patient with a central spinal cord injury who showed improved finger and upper limb functions after long-term treatment with a combination of rehabilitation and botulinum toxin type A. [Participants and Methods] The patient had spasms and pain that gradually became more profound and was given botulinum toxin type A at 1 year 3 months after sustaining a spinal cord injury. We administered 14 botulinum toxin type A injections periodically for 7 years 4 months after the injury. We administered the injections at an average interval of 5.6 months. Splints that allowed extension and improved finger muscle tone and contracture were made for the patient. [Results] The patient experienced gradual alleviation of the spasms in the proximal upper limb muscles and improved range of motion after receiving five doses of botulinum toxin type A. The spasms and range of motion in the fingers gradually improved around 4 years after the injury through splint therapy and a combination of botulinum toxin type A administration and rehabilitation. [Conclusion] The combination of botulinum toxin type A, splint, and rehabilitation therapies can lead to positive improvements in finger spasticity and range of motion and is recommended for hypertonia cases with severe contractures.

[Purpose] We followed-up patients who underwent arthroscopic rotator cuff repair (ARCR) for 2 years to assess the prognosis of rotator cuff tears and compared the outcomes of the patients with and without re-rupture. We also examined the usefulness of Shoulder36, a self-assessment tool, for assessing the long-term prognosis in patients undergoing ARCR. [Participants and Methods] We included 28 patients who received occupational therapy pre- and post-ARCR between April 2012 and August 2015 and categorized them based on the occurrence of re-rupture. We followed-up on their prognoses for 2 years using physical examination and Shoulder36 assessment. [Results] Re-rupture occurred in five patients within 3 months of treatment. During the 2 year follow-up, the control group showed a significant improvement in pain and bi-directional active range of motion during physical assessment and in five out of six domains during Shoulder36 assessment. In contrast, the re-rupture group showed significant differences for only three domains of the Shoulder36 assessment twelve months after surgery. [Conclusion] We confirmed the long-term functional improvement and maintenance in the re-rupture group, suggesting that continued rehabilitation, compensatory movements, and detailed guidance on daily life activities are required for patients after ARCR. Furthermore, Shoulder36 can be useful for assessing the prognosis of patients with and without re-rupture.

In the ensemble data assimilation, the background error covariance is estimated from perturbations of the ensemble forecast, while characteristics of the ensemble forecast strongly depend on how the initial ensemble is generated. The ensemble transform is a popular perturbation method that widely used as an ensemble perturbation generator, however, linear combinations of different perturbations in the ensemble transform (off-diagonal components of the transform matrix) may harm the global balance of the meteorological field. In this paper, we discuss this issue and show the structure of initial perturbations. Results of forecast experiments using the local ensemble transform Kalman filter (LETKF) for a simplified global model and a regional NWP model are shown. The spin-up issue in a cloud resolving model is shown with the comparison to an alternative method (diagonal LETKF).

The Tokyo Metropolitan Area Convection Study for Extreme Weather Resilient Cities (TOMACS) began as a Japanese domestic research project in 2010 and aimed to elucidate the mechanisms behind local high-impact weather (LHIW) in urban areas, to improve forecasting techniques for LHIW, and to provide high-resolution weather information to end-users (local governments, private companies, and the general public) through social experiments. Since 2013, the project has been expanded as an international Research and Development Project (RDP) of the World Weather Research Programme (WWRP) of the World Meteorological Organization (WMO). Through this project, the following results were obtained: 1) observation data for LHIW around Tokyo were recorded using a dense network of X-band radars, a C-band polarimetric radar, a Ku-band fast-scanning radar, coherent Doppler lidars, and the Global Navigation Satellite System; 2) quantitative precipitation estimation algorithms for X-band polarimetric radars have been developed as part of an international collaboration; 3) convection initiation by the interaction of sea breezes and urban impacts on the occurrence of heavy precipitation around Tokyo were elucidated by a dense observation network, high-resolution numerical simulations, and different urban surface models; 4) an “imminent” nowcast system based on the vertically integrated liquid water derived from the X-band polarimetric radar network has been developed; 5) assimilation methods for data from advanced observation instruments such as coherent Doppler lidars and polarimetric radars were developed; and 6) public use of high-resolution radar data were promoted through the social experiments.

In this paper we report the first close, high-resolution observations of downward-directed terrestrial gamma-ray flashes (TGFs) detected by the large-area Telescope Array cosmic ray observatory, obtained in conjunction with broadband VHF interferometer and fast electric field change measurements of the parent discharge. The results show that the TGFs occur during strong initial breakdown pulses (IBPs) in the first few milliseconds of negative cloud-to-ground and low-altitude intracloud flashes, and that the IBPs are produced by a newly-identified streamer-based discharge process called fast negative breakdown. The observations indicate the relativistic runaway electron avalanches (RREAs) responsible for producing the TGFs are initiated by embedded spark-like transient conducting events (TCEs) within the fast streamer system, and potentially also by individual fast streamers themselves. The TCEs are inferred to be the cause of impulsive sub-pulses that are characteristic features of classic IBP sferics. Additional development of the avalanches would be facilitated by the enhanced electric field ahead of the advancing front of the fast negative breakdown. In addition to showing the nature of IBPs and their enigmatic sub-pulses, the observations also provide a possible explanation for the unsolved question of how the streamer to leader transition occurs during the initial negative breakdown, namely as a result of strong currents flowing in the final stage of successive IBPs, extending backward through both the IBP itself and the negative streamer breakdown preceding the IBP., Comment: Typo fixed and reference added. Manuscript is 36 pages. Supplemental Information is 42 pages. This paper is to be published in the Journal of Geophysical Research: Atmospheres. Online data repository: Open Science Framework DOI: 10.17605/OSF.IO/Z3XDA

Bursts of gamma ray showers have been observed in coincidence with downward propagating negative leaders in lightning flashes by the Telescope Array Surface Detector (TASD). The TASD is a 700~square kilometer cosmic ray observatory located in southwestern Utah, U.S.A. In data collected between 2014 and 2016, correlated observations showing the structure and temporal development of three shower-producing flashes were obtained with a 3D lightning mapping array, and electric field change measurements were obtained for an additional seven flashes, in both cases co-located with the TASD. National Lightning Detection Network (NLDN) information was also used throughout. The showers arrived in a sequence of 2--5 short-duration ($\le$10~$\mu$s) bursts over time intervals of several hundred microseconds, and originated at an altitude of $\simeq$3--5 kilometers above ground level during the first 1--2 ms of downward negative leader breakdown at the beginning of cloud-to-ground lightning flashes. The shower footprints, associated waveforms and the effect of atmospheric propagation indicate that the showers consist primarily of downward-beamed gamma radiation. This has been supported by GEANT simulation studies, which indicate primary source fluxes of $\simeq$$10^{12}$--$10^{14}$ photons for $16^{\circ}$ half-angle beams. We conclude that the showers are terrestrial gamma-ray flashes (TGFs), similar to those observed by satellites, but that the ground-based observations are more representative of the temporal source activity and are also more sensitive than satellite observations, which detect only the most powerful TGFs.

Verification in the presence of observation errors is approached form the Bayesian point of view. Like data assimilation (DA), Bayesian verification is shown to have a robust foundation established by Bayesian inference. Together, DA and Bayesian verification form two difference levels of Bayesian inference. Evaluation of a model is equivalent to inference on the plausibility of this model given observations. Relative performances between different models are measured by ratios of posterior plausibilities, which becomes ratios of likelihoods in case of no prior information. These ratios are called the Bayes factors and are the standard verification method in Bayesian model comparison. Since verification scores are used intensively in numerical weather prediction, the verification scores derived from likelihoods are proposed to replace the Bayes factors in Bayesian verification. With two requirements that the verification scores are both strictly proper and local, the logarithm score, i.e. log-likelihood, and its linear transformation are shown to be the unique class. Log-likelihoods in Bayesian verification are determined by the form of forecast probability distributions from models. The empirical form is preferable since its flexibility in incorporating not only observation errors but also other uncertainties in observation biases or observation error variances into calculation to obtain closed forms for log-likelihoods. When applied for observations with Gaussian errors, the logarithm score induces the weighted mean squared error which is non-dimensional and can be used for both univariate and multivariate observations. The most interesting application of Bayesian verification is to offer a new explanation for rank histograms and quantify the flatness of rank histograms by a metric which turns out to be the Kullback-Leibler divergence between the rank distribution observed in reality and a uniform rank distribution. It is worthy of note that the two very different metrics come from the logarithm score.

The fifth Workshop on Systematic Errors (WSE) in weather and climate models was hosted by Environment and Climate Change Canada (ECCC) on under the auspices of the Working Group on Numerical Experimentation (WGNE), jointly sponsored by the Commission of Atmospheric Sciences of the World Meteorological Organization (WMO) and the World Climate Research Programme (WCRP). This major event welcomed over 200 scientists from the weather and climate communities. The workshop primary goal was to increase the understanding of the nature and cause of systematic errors in numerical models across timescales. Out of 240 abstracts submitted to the workshop, 48 talks and 132 posters were presented.

In the hybrid variational–ensemble data assimilation schemes preconditioned on the square root of background covariance , is a linear map from the model space to a higher-dimensional space. Because of the use of the nonsquare matrix , the transformed cost function still contains the inverse of . To avoid this inversion, all studies have used the diagonal quadratic form of the background term in practice without any justification. This study has shown that this practical cost function belongs to a class of cost functions that come into play whenever the minimization problem is transformed from the model space to a higher-dimension space. Each such cost function is associated with a vector in the kernel of (Ker), leading to an infinite number of these cost functions in which the practical cost function corresponds to the zero vector. These cost functions are shown to be the natural extension of the transformed one from the orthogonal complement of Ker to the full control space. In practice, these cost functions are reduced to a practical form where calculation does not require a predefined vector in Ker, and are as valid as the transformed one in the control space. That means the minimization process is not needed to be restricted to any subspace, which is contrary to the previous studies. This was demonstrated using a real observation data assimilation system. The theory justifies the use of the practical cost function and its variant in the hybrid variational–ensemble data assimilation method.

Context: Many patients report poor therapeutic outcomes following mallet finger fracture surgery. A more reliable technique is urgently needed. Objective: To present a novel treatment for mallet finger fractures using a 2-step orthosis method. Design: Prospective, observational study. Setting: Hospital. Participants: Patients with mallet finger fractures. Interventions: The finger is fixed with splints for 6 weeks, including 3 weeks for the proximal interphalangeal joint in the flexion position and the distal interphalangeal joint in the hyperextension position (first splint) and 3 weeks for the distal interphalangeal joint in the hyperextension position (second splint). Up to week 8, the second splint was attached at night and during physical exertion. Main Outcome Measures: Crawford criteria, Abouna–Brown criteria, bone fusion, grip strength, Doyle classification, Ishiguro classification. Results: Sufficient bone fusion was achieved 12 weeks after fixation; at which time, the range of motion with the distal interphalangeal joint flexed, and extended in the 3 patients was 50° and 0°, 70° and −3°, and 60° and 0°, respectively. The right and left hand grip strengths in the 3 patients were 58 and 55 kg, 62 and 58 kg, and 31 and 29 kg, respectively; there were no problems with respect to function or work. The first 2 patients could start sports again with partial return after 1 week and complete return after 12 weeks and 8 weeks, respectively. For the third patient, rehabilitation was complete after 16 weeks. Evaluation of the fracture sites based on the Crawford criteria showed the condition to be perfect, and evaluation based on the Abouna–Brown criteria showed success. Conclusions: This method provides satisfactory fixation and can prevent proximal interphalangeal joint contracture. Favorable long-term outcomes were confirmed in all patients, suggesting that this method may be effective for previously untreated mallet finger fractures with little displacement.

We present an upper limit on the flux of ultra-high-energy down-going neutrinos for $E > 10^{18}\ \mbox{eV}$ derived with the nine years of data collected by the Telescope Array surface detector (05-11-2008 -- 05-10-2017). The method is based on the multivariate analysis technique, so-called Boosted Decision Trees (BDT). Proton-neutrino classifier is built upon 16 observables related to both the properties of the shower front and the lateral distribution function., 10 pages, 4 figures, accepted to JETP

The surface detector (SD) of the Telescope Array (TA) experiment allows one to indirectly detect photons with energies of order $10^{18}$ eV and higher and to separate photons from the cosmic-ray background. In this paper we present the results of a blind search for point sources of ultra-high energy (UHE) photons in the Northern sky using the TA SD data. The photon-induced extensive air showers (EAS) are separated from the hadron-induced EAS background by means of a multivariate classifier based upon 16 parameters that characterize the air shower events. No significant evidence for the photon point sources is found. The upper limits are set on the flux of photons from each particular direction in the sky within the TA field of view, according to the experiment's angular resolution for photons. Average 95% C.L. upper limits for the point-source flux of photons with energies greater than $10^{18}$, $10^{18.5}$, $10^{19}$, $10^{19.5}$ and $10^{20}$ eV are $0.094$, $0.029$, $0.010$, $0.0073$ and $0.0058$ km$^{-2}$yr$^{-1}$ respectively. For the energies higher than $10^{18.5}$ eV, the photon point-source limits are set for the first time. Numerical results for each given direction in each energy range are provided as a supplement to this paper., Comment: accepted to MNRAS, 11 pages, 4 figures, 2 tables; results in text-file format are supplemented to paper source

This paper presents a study on short-term ensemble flood forecasting specifically for small dam catchments in Japan. Numerical ensemble simulations of rainfall from the Japan Meteorological Agency nonhydrostatic model (JMA-NHM) are used as the input data to a rainfall–runoff model for predicting river discharge into a dam. The ensemble weather simulations use a conventional 10 km and a high-resolution 2 km spatial resolutions. A distributed rainfall–runoff model is constructed for the Kasahori dam catchment (approx. 70 km2) and applied with the ensemble rainfalls. The results show that the hourly maximum and cumulative catchment-average rainfalls of the 2 km resolution JMA-NHM ensemble simulation are more appropriate than the 10 km resolution rainfalls. All the simulated inflows based on the 2 and 10 km rainfalls become larger than the flood discharge of 140 m3 s−1, a threshold value for flood control. The inflows with the 10 km resolution ensemble rainfall are all considerably smaller than the observations, while at least one simulated discharge out of 11 ensemble members with the 2 km resolution rainfalls reproduces the first peak of the inflow at the Kasahori dam with similar amplitude to observations, although there are spatiotemporal lags between simulation and observation. To take positional lags into account of the ensemble discharge simulation, the rainfall distribution in each ensemble member is shifted so that the catchment-averaged cumulative rainfall of the Kasahori dam maximizes. The runoff simulation with the position-shifted rainfalls shows much better results than the original ensemble discharge simulations.

This work quantifies the benefits of using a high-resolution atmosphere–ocean coupled model in tropical cyclone (TC) intensity forecasts in the vicinity of Japan.To do so, a large number of high-resolution calculations were performed by running the Japan Meteorological Agency (JMA) nonhydrostatic atmospheric mesoscale model (AMSM) and atmosphere–ocean coupled mesoscale model (CMSM). A total of 281 3-day forecasts were compiled for 34 TCs fromApril 2009 to September 2012 for eachmodel. The performance of thesemodels is compared with the JMA global atmospheric spectral model (GSM) that is used for the operational TC intensity guidance. The TC intensities are better predicted by CMSM than the other models. The improvement rates in CMSM relative toGSMandAMSMgenerally increasewith increasing forecast time (FT).CMSMis better thanGSMand AMSM by 27.4% and 21.3% at FT 5 48 h in terms of minimum sea level pressure, respectively. Regarding the maximum wind speed, CMSM is better than GSM and AMSM by 12.8% and 19.5% at FT 5 48 h, respectively. This is due to smaller initial intensity errors and sea surface cooling consistent with in situ observations that suppress erroneous TC intensification. Thus, a high-resolution coupled model is promising for TC intensity prediction in the area surrounding Japan, where most of the TCs are in a decay stage. In contrast, coupling to the upper-ocean model yields only a negligible difference in the TC track forecast skill on average., 論文

The Pierre Auger Collaboration (Auger) recently reported a correlation between the arrival directions of cosmic rays with energies above 39 EeV and the flux pattern of 23 nearby starburst galaxies (SBGs). In this Letter, we tested the same hypothesis using cosmic rays detected by the Telescope Array experiment (TA) in the 9-year period from May 2008 to May 2017. Unlike the Auger analysis, we did not optimize the parameter values but kept them fixed to the best-fit values found by Auger, namely 9.7% for the anisotropic fraction of cosmic rays assumed to originate from the SBGs in the list and 12.9{\deg} for the angular scale of the correlations. The energy threshold we adopted is 43 EeV, corresponding to 39 EeV in Auger when taking into account the energy-scale difference between two experiments. We find that the TA data is compatible with isotropy to within 1.1{\sigma} and with the Auger result to within 1.4{\sigma}, meaning that it is not capable to discriminate between these two hypotheses., Comment: More accurate title, fixed an inconsistency in the declination range used, with a few figures slightly changing as a result, other minor revisions

International audience; Since the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident in March 2011, atmospheric simulation models have improved our understanding of the atmospheric behavior of radionuclides. Model intercomparisons provide valuable and useful information for evaluating the validity and variability of individual model results. In this study, we compared results of seven atmospheric transport models used to simulate 137Cs released from the FDNPP to the atmosphere. All model results used in this analysis had been submitted for a model intercomparison project of the Science Council of Japan (2014, http//www.scj.go.jp/en/report/index.html). Here we assessed model performance by comparing model results with observed hourly atmospheric concentrations of 137Cs, with a particular focus on nine plumes over the Tohoku and Kanto regions. The intercomparison results showed that model performance in reproducing 137Cs concentrations was highly variable among different models and plumes. In general, models better reproduced plumes that passed over many observation stations. The performance among the models was consistent with the simulated wind fields and the source terms used. We also assessed model performance in relation to accumulated 137Cs deposition. Simulated areas of high 137Cs deposition were consistent with the simulated 137Cs plume pathways, though the models that best simulated atmospheric 137Cs concentrations were different from those that best simulated deposition. The ensemble mean of all models consistently reproduced atmospheric 137Cs concentrations and deposition well, suggesting that use of a multimodel ensemble results in more effective and consistent model performance. ©2018. American Geophysical Union. All Rights Reserved.

One of the uncertainties in interpretation of ultra-high energy cosmic ray (UHECR) data comes from the hadronic interaction models used for air shower Monte Carlo (MC) simulations. The number of muons observed at the ground from UHECR-induced air showers is expected to depend upon the hadronic interaction model. One may therefore test the hadronic interaction models by comparing the measured number of muons with the MC prediction. In this paper, we present the results of studies of muon densities in UHE extensive air showers obtained by analyzing the signal of surface detector stations which should have high $\it{muon \, purity}$. The muon purity of a station will depend on both the inclination of the shower and the relative position of the station. In 7 years' data from the Telescope Array experiment, we find that the number of particles observed for signals with an expected muon purity of $\sim$65% at a lateral distance of 2000 m from the shower core is $1.72 \pm 0.10{\rm (stat.)} \pm 0.37 {\rm (syst.)}$ times larger than the MC prediction value using the QGSJET II-03 model for proton-induced showers. A similar effect is also seen in comparisons with other hadronic models such as QGSJET II-04, which shows a $1.67 \pm 0.10 \pm 0.36$ excess. We also studied the dependence of these excesses on lateral distances and found a slower decrease of the lateral distribution of muons in the data as compared to the MC, causing larger discrepancy at larger lateral distances.