bluuebunny/crossref_metadata_2025 huggingface dataset:
Establishing abiotic and biotic factors necessary for reliable male pheromone production and attraction to pheromones by female plum curculiosConotrachelus nenuphar(Coleoptera: Curculionidae)
Authors: Hock Virginia , Chouinard Gérald , Lucas Éric , Cormier Daniel , Leskey Tracy , Wright Starker , Zhang Aijun , Pichette André
Published: March 2014

The plum curculio (PC),Conotrachelus nenupharHerbst (Coleoptera: Curculionidae), is a key pest of stone and pome fruit in North America. Though grandisoic acid (GA) was identified as a male-produced aggregation pheromone for this species, other components likely exist, as have been identified for various curculionids. To better determine these components, an understanding of the conditions necessary for optimum pheromone production and attraction is needed, this is essential for the improvement of monitoring techniques and to achieve better biological control. The goal of this study was to determine the biotic and abiotic factors influencing both the response to pheromones and pheromone production. Tests were conducted in a dual-choice still-air vertical olfactometer using live male PCs as odour sources and live females as responders, to determine which physiological factors (age, number of males, mating status) influenced female response to males. Head-space collections of GA production under various conditions (airflow rate and frequency, collection zone strata, variation of humidity, temperature, and presence of a harbourage) were also done, as were electroantennograms (EAG) using synthetic pheromone mixtures. Results revealed that for both strains, the odour of two virgin mature males elicited significantly greater and more consistent attraction from mature virgin females than other ages and numbers of males when compared with the control. Head-space collections indicate that male PC have increased production of GA under high humidity in the presence of fruit, indicating that these conditions are necessary for optimal pheromone production and collection. EAG studies revealed significant responses to GrandLures I, II, III/IV and to the positive enantiomer of GA, and the amplitude of the signal varied with concentration. Our data identify the optimal physiological state and conditions at which pheromone collections should be performed, and what physiological life stages respond to these stimuli. These results have implications for optimising monitoring tools for this serious crop pest. This species has a northern univoltine strain and a southern multivoltine strain, both of which were examined in this study.
The expanded inframammary fold triangle: Improved results in large volume breast reductions
Authors: Chopra Karan , Tadisina Kashyap Komarraju , Conde-Green Alexandra , Singh Devinder P
Published: March 2014

Context: The inferior pedicle, Wise-pattern reduction mammaplasty is the most popular technique for breast reduction because of its reproducible results and reliability. However, complication rates in super obese patients or patients receiving large volume reductions are high, ranging from 35 to 78%. These complications include delayed healing, infection, seroma, nipple-areolar complex necrosis, fat necrosis and development of hypertrophic scars. Aims: This study aimed to determine whether a modification to the standard Wise-pattern reduction technique, an expanded inframammary fold skin triangle, produces improved outcomes in high-risk large volume breast reduction patients. We report that this modification leads to improved outcomes by decreasing wound complications and improving aesthetic appearance. Settings and Design: Twenty-two patients received the inferior pedicle Wise-pattern reduction mammaplasty, which was modified to include an 8 cm wide inferior pedicle. This pedicle was de-epithelialized and an 8 Χ 3 cm 2 triangle of skin was preserved at the inferior base to reduce tension at the triple point, inverted T-closure. Materials and Methods: A retrospective review was performed on all patients who underwent reduction mammaplasty with the expanded inframammary fold (eIMF) technique as well as all patients who received the standard wise pattern technique. Statistical Analysis Used: A student t-test was performed for both reduction populations using SPSS software package. Statistical significance was defined as P < 0.05. Results: The average patient age was 32.25 years old (range 18-59), average BMI was 35.0, and average tissue mass removed per breast was 1378.39 g. The modified technique was found to produce a statistically significant (P < 0.05) increase in the amount of breast tissue removed (693.96 g increase in the left and 571.21 g in the right) as well as a statistically significant (P < 0.05) reduction in dehiscence (75% reduction) and post-operative infection (44.10%). Conclusions: This method is an easily reproducible and reliable technique that produces a favourable cosmetic outcome with acceptable, sustainable results in high-risk reductions in obese patients.
Deviation of the penoscrotal median raphe: Is it a normal finding or within the spectrum of hypospadias?
Authors: Mohan Arvind , Ashton Laura , Dalal Milind
Published: March 2014

Introduction and Objectives: Hypospadias is the most common congenital abnormality of the penis, and is most commonly diagnosed during the postnatal physical examination. However, milder forms of the condition can be difficult to detect, leading to delayed referral to specialist teams. We aim to determine whether there is an association between hypospadias and the position of the penoscrotal raphe. Materials and Methods: A case — control study was performed where clinical photographs from children undergoing hypospadias correction were compared with a control group of children without the condition. The position of the penoscrotal raphe was documented as midline, left or right. Pearson’s chi squared test was used to determine significance. Results: Images for 80 children undergoing hypospadias correction were compared with 80 normal children in the maternity ward. 88.8% of the children with hypospadias had a penoscrotal raphe deviated from the midline compared with only 13.8% in the control group (P < 0.0003). Conclusions: Our study demonstrates a significant association between hypospadias and deviation of the penoscrotal raphe from the midline. Consideration should be given to whether to include this finding within the spectrum of abnormalities seen in hypospadias. Examination of the penoscrotal raphe is simple to perform and could aid in the early diagnosis in children with milder forms of the condition.
Successful combined approach to a severe fournier’s gangrene
Authors: Agostini Tommaso , Mori Francesco , Perello Raffaella , Dini Mario , Russo Giulia Lo
Published: March 2014

We present a case of a successful reconstruction of a severe Fournier’s gangrene (FG) involving the scrotum, the perineum, the right ischial area and extended to the lower abdomen. There are many different surgical techniques to repair and reconstruct the defect following debridement in FG. The authors treated this complex wound using negative pressure wound therapy (NPWT), dermal regeneration template and a split-thickness skin graft. Complete recovery was achieved and no major complications were observed. The patient showed a satisfying functional and aesthetic result.
Atmospheric CO2 Variations in Two Contrasting Environmental Sites Over India
Authors: Sharma Neerja , Dadhwal V.K. , Kant Y. , Mahesh P. , Mallikarjun K. , Gadavi Harish , Sharma Anand , Ali M.M.
Published: March 2014

We analyzed the influence of environmental parameters on the temporal variation of atmospheric carbon dioxide (CO2) mixing ratios in two environmentally contrasting Indian sites, Dehradun (30.1°N, 77.4°E, humid subtropical station) and Gadanki (13.5°N, 79.18°E, dry tropical station), from October 2010 to September 2011. The annual range of mixing ratios is low in Gadanki as compared to those of Dehradun because of relatively less monthly variation in temperature and relative humidity (RH) at Gadanki. At both the stations, the minimum mixing ratios are present during the high ecosystem productivity seasons in the afternoon hours. The maximum values are in the early morning hours. However, low wind speed conditions control the unexpected afternoon high mixing ratios in Gadanki during the pre-monsoon season. The early morning maximum is high during monsoon and post-monsoon seasons in Dehradun and Gadanki, respectively, whereas morning inflexion occurred earlier in Gadanki compared with Dehradun. The effect of cloudiness on the CO2 uptake depends on the canopy cover.
Spectrum of Echocardiography Abnormalities among 168 Consecutive Referrals to an Urban Private Hospital in South-Western Nigeria
Authors: Oyedeji Adebayo T. , Akintunde Adeseye A. , Owojori Olukolade O. , Peter Johnson O.
Published: March 2014

Trans-thoracic echocardiography (TTE) is an important non-invasive cardiac examination that provides structural and functional information. It is useful in the diagnosis of cardiac diseases and often guides the management and follow-up of patients with cardiovascular diseases (CVD).

The study aimed to present an audit of the echocardiograms performed in an urban private hospital over a two-year period in order to define the pattern of cardiac diseases in our center. Echocardiogram reports of 168 consecutive patients performed between May 2011 and April 2013 at an organized private sector hospital in Lagos, south-west Nigeria were reviewed. Studies were performed with a Toshiba Nemio XG ultrasound machine. The data obtained were analyzed for mean age, sex, clinical indications, and echocardiographic diagnosis in the study subjects.

A total of 168 echocardiography reports were examined, comprising of 92 males (54.8%) and 76 females (45.2%). The age range of the subjects was 10-76 years (mean 42.5 ± 12.1 years). The commonest indication for echocardiography was systemic hypertension and hypertension related causes (38.1%), followed by abnormal resting electrocardiogram (14.9%). Routine annual medical screening was the next most common indication, representing 13.1% of the indications for echocardiography. The other indications are as presented in Table 1 . The echocardiogram was normal in 64.3% of the subjects. The commonest abnormality detected was hypertensive heart disease (HHD); accounting for 9.6% of the subjects studied. Isolated atrial enlargement (left, right, or bi-atrial) was the next most common abnormality accounting for 6% of the echocardiographic diagnosis. Pulmonary hypertension was the next most common diagnosis accounting for 4.8% of our findings. The other echocardiographic diagnoses are as listed in Table 2 .

Hypertension represents the commonest indication for echocardiography. Normal echocardiogram was the commonest echocardiographic finding while HHD was the commonest echocardiographic abnormality. The prevalence of ischemic heart disease by echocardiography was 2.4%. There was no case of rheumatic heart disease (RHD). The prevalence of hypertrophic cardiomyopathy (HCM) was 1.2%. Ease of access to echocardiography may influence the findings in an echocardiographic audit and policy makers should incorporate appropriateness criteria into their guidelines for reimbursement.
Personality Disorders in Addiction Outpatients: Prevalence and Effects on Psychosocial Functioning
Authors: Casadio Paola , Olivoni Deanna , Ferrari Barbara , Pintori Cecilia , Speranza Elvira , Bosi Monica , Belli Valentina , Baruzzi Lucia , Pantieri Paola , Ragazzini Grazia , Rivola Filippo , Atti Anna Rita
Published: March 2014

Aim

To evaluate the prevalence of personality disorders (PDs) in the outpatients attending an addiction service, with particular attention to the effects of PDs on social and occupational functioning and on the intensity of treatment required.

Design

A cross-sectional epidemiological study with the assessment of 320 outpatients, through SCID-II (Structured Clinical Interview for DSM-IV Axis II PDs), SOGS (South Oaks Gambling Screen), and questionnaire extracted from EuropASI.

Results

The percentage prevalence of PDs was 62.2% (confidence interval at 95% (95% CI): 57–68). PDs were positively associated with placement in an addiction treatment community (odds ratio (OR) = 2.98, CI = 1.77–5.03), having received lifetime treatment at the mental health center (MHC) (OR = 3.67, CI = 1.67–8.07) or having attempted suicide (OR = 2.30, CI = 1.05–5.02). Furthermore, PDs were related to a reduced probability of keeping a job (OR = 0.54, CI = 0.31–0.95) or starting a family (OR = 0.51, CI = 0.30–0.87).

Conclusion

Axis II comorbidity occurs in 62% of addiction outpatients and has substantial effects on social and occupational functioning as well as on treatment programs.
Lawrence Hoba’s depiction of the post-2000 Zimbabwean land invasions in The Trek and Other Stories
Authors: Manase Irikidzayi
Published: March 2014

The article examines Lawrence Hoba’s The Trek and Other Stories (2009), which describes experiences from the post-2000 land invasions and fast-track land reform in Zimbabwe. It analyses selected short stories in relation to other Zimbabwean fictional works about land and the definition and restoration of dignified and other identities lost during Rhodesian colonialism. The article also discusses the significance of the narrative style, especially satire, and some of the themes, such as violence, dislocation, the position of women during the land reform and the multiple migration patterns in the land invasions, in an effort to foreground how all these link with Hoba’s cynicism and, at times, subversive perceptions on how the land issue has been handled in post2000 Zimbabwe. The argument here is that Hoba’s fictional writings about the post-2000 land invasions and fast track land redistribution programme are reflective of a marked departure from the pro-nationalist, ideological and backward looking fictional mappings of land and national belonging. These writings place the ‘now’ as critical in unpacking the ironies and contradictory impact of the land redistribution exercise on ordinary Zimbabweans.
Intercalibration of an acoustic technique, two optical ones, and a simple seston dry mass method for freshwater zooplankton sampling
Authors: Rahkola‐Sorsa Minna , Voutilainen Ari , Viljanen Markku
Published: March 2014

A thorough comparison is made of conventional and automated zooplankton sampling techniques. The findings offer tools for complementing netted and weighed zooplankton biomasses with estimates based on acoustic and optic techniques, and thereby fill a gap in our knowledge concerning the suitability of acoustic and optic techniques for freshwater zooplankton sampling. Plankton abundance in six large boreal lakes with varying characteristics was determined by four independent methods: one acoustic (Acoustic Doppler Current Profiler), two optic (laboratory versions of the Optic and Laser Optic Plankton Counter), and a simple seston dry mass (DM) method. The combined DM of Chaoborus and medium‐sized zooplankton (300‐500 µm) explained 63% of the original variability in the acoustic backscatter strength. The correspondence between the optical measurements and DM was especially good in the case of medium‐sized zooplankton. Thus the LOPC‐derived biomass (ESD 351‐500 µm) explained 90% of variation in the DM of zooplankton of size 300‐500 µm. The medium‐sized fraction consisted mainly of small Cyclopoida and copepodite stages of Eudiaptomus and Daphnia. Both optical devices, and particularly the LOPC, are reliable for analyzing preserved net samples of freshwater zooplankton, but in situ estimation of zooplankton abundances on the basis of ADCP results is not reliable without simultaneous net or optical sampling. Acoustic results can be calibrated by reference to DM or LOPC‐derived biomass estimates. The combined use of acoustic and optical techniques clearly improves the spatio‐temporal resolution of zooplankton measurements and can thus provide closer insights into ecosystem dynamics, including the forces which regulate plankton communities.
Performance of a lifetime‐based optode for measuring partial pressure of carbon dioxide in natural waters
Authors: Atamanchuk Dariia , Tengberg Anders , Thomas Peter J. , Hovdenes Jostein , Apostolidis Athanas , Huber Christian , Hall Per O.J.
Published: March 2014

This article reports the performance of an improved, newly developed, compact, low power, lifetime‐based optical sensor (optode) for measuring partial pressure of dissolved CO2 gas (pCO2) in natural waters. The results suggest that after preconditioning, these sensors are stable in water for time periods longer than 7 months. The wide dynamic range of about 0‐50000 µatm opens possibilities for numerous applications of which some are presented. In normal marine environments with pCO2 levels of 200‐1000 µatm, the best‐obtained precision was about ±2 µatm, and the absolute accuracy was between 2‐75 µatm, depending on the deployment and the quality of the collected reference water samples. One limitation is that these sensors will become irreversibly poisoned by H2S and should thus not be deployed in sulphidic environments.
An empirical algorithm to estimate spectral average cosine of underwater light field from remote sensing data in coastal oceanic waters
Authors: Talaulikar Madhubala , Suresh T , Desa Elgar , Inamdar A.
Published: March 2014

The underwater average cosine is an apparent optical property of water that describes the angular distribution of radiance at a given point in water. Here, we present a simple empirical algorithm to estimate spectral underwater average cosine µ̅(λ) where the wavelength λ ranges from 400 nm to 700 nm, based only on the apparent optical property, remote sensing reflectance, Rrs(λ), and solar zenith angle. The algorithm has been developed using the measured optical parameters from the coastal waters off Goa, India, and eastern Arabian Sea and the optical parameters derived using the radiative transfer code using these measured data. The algorithm was compared with two earlier reported empirical algorithms of Haltrin (1998, 2000), and the performance of the algorithm was found to be better than these two empirical algorithms. The algorithm is based on single optical parameter; remote sensing reflectance, which can be easily measured in‐situ, and is available from the ocean color satellite sensors; hence this algorithm will find applications in the ocean color remote sensing.
Mirando la Piedra Celta
Authors: Riera Jaime , Ballester Enrique , Ginestar Damián , Hueso José Luís
Published: March 2014

La Piedra Celta es un sólido que cuando se le hace girar como peonza exhibe un comportamiento sorprendente. Utilizando una cámara estereoscópica y técnicas de seguimiento digital, capturamos su movimiento. De acuerdo con las leyes clásicas de la mecánica, justificamos su evolución "traqueteante", y destacamos el alto potencial didáctico que para los alumnos de Ingeniería poseen estos sorprendentes sistemas.
Outcome of Teenage Pregnancy in Rural India with Particular Reference to Obstetrical Risk Factors and Perinatal Outcome
Authors: Joshi Prashant , Dutta Dilip Kumar
Published: March 2014

Objectives

The aim of the present study is to evaluate the outcome and complications in teenage primigravida when compared to primigravidae of adult age group.

Materials and methods

A massive study involving 984 patients was undertaken. It was a prospective case control study was done for 30 months from July 2010 to January 2013 at Rural Medical College-Hospital, Karnataka. During this period booked and unbooked cases were included in the study and for every teenage primigravidae one subsequent adult primigravidae were studied. Patients with major skeletal deformity, such as kyphoscoliosis, polio, pelvic fracture, diabetes mellitus, renal disorders, morbid obesity, All cases of molar pregnancy and primigravidas admitted for abortion were excluded.

Results

Among 492 teenage and equal adult primigravidae, 51.8% of teenage were unbooked compared to 13.6% of adults. 68.4% of teenage were anemic compared to 33.32% of adults, antenatal complications like anemia, Hypertensive disorders of pregnancy, oligohydramnios, hypothyroid were significantly more in teenagers (69.5%) compared to adults (19.3%), 33.7% of teenagers had preterm birth compared to 8.72% in adults. 48.3% of teenagers had LSCS compared to 21.9% of adults. Indication was CPD in majority of teenagers (45.4%). 31.74% of teenagers had low birth weight child compared to 16.6% in adults and 34.5% of teenage neonates required NICU admission compared to 12.4% in adults.

Interpretation and conclusion

It can be interpreted that teenagers had significant number of complications in pregnancy including leading cause being anemia, more preterm incidences and higher rate of LSCS followed by higher number of NICU admission. Pregnancy itself has a tremendous effect on teenage and her family. Teenage pregnancy is more common in low socioeconomic status, due to lack of education, awareness of complications of teenage pregnancy, and various other factors. Hence awareness and various programmes should be taken up to educate mainly the poor in our rural setup. As early marriage cannot be prevented in our culture so possibly the awareness regarding late conception can be taken up as of utmost importance.

How to cite this article

Dutta I, Dutta DK, Joshi P. Outcome of Teenage Pregnancy in Rural India with Particular Reference to Obstetrical Risk Factors and Perinatal Outcome. J South Asian Feder Obst Gynae 2013;5(3):102-106.
Cause of Neonatal Sepsis: Transplacental vs Environmental
Authors: Shiradkar Swati , Bapat Gauri N , Bhalchandra Manjushree H , Mande Shubhangi , Bansal Mangala
Published: March 2014

Objectives

To study the role of transplacental transmission and environmental factors in neonatal sepsis (0-3) days and incidence of early neonatal sepsis in obstetrics and gynecology wards of MGM Medical College Hospital.

Materials and methods

The study was carried out on 100 full term women and their babies who delivered in MGM hospital. Their cord blood cultures were done. The nasal carrier state for Staphylococcus aureus (S. aureus) in all the health professionals working in labor room was also studied.

Results

S. aureus was the most common organism grown in cord cultures of woman who delivered vaginally. None of the babies followed in wards showed any Sign of sepsis in first 72 hours. More than 50% of health professionals working in labor room were carriers of S. aureus.

Conclusion

S. aureus is having environmental source and it causes late neonatal sepsis so none of the babies developed any Sign of sepsis in first 72 hours of life. Other organisms isolated probably responded to intrapartum antibiotics or maternal immunity played its role and so babies did not showed any s/o sepsis in first 3 days.

How to cite this article

Bapat GN, Shiradkar S, Bhalchandra MH, Mande S, Bansal M. Cause of Neonatal Sepsis: Transplacental vs Environmental. J South Asian Feder Obst Gynae 2013;5(3):132-134.
Patterns of care and side effects for patients prescribed methadone for treatment of chronic pain
Authors: Macey, PhD Tara A. , Weimer, DO, MCR Melissa B. , Grimaldi, BA Elizabeth M. , Dobscha, MD Steven K. , Morasco, PhD Benjamin J.
Published: March 2014

Objectives. This manuscript evaluates physician monitoring practices and incidence of cardiac side effects following initiation of methadone for treatment of chronic pain as compared to patients who began treatment for chronic pain with morphine sustained release (SR).Design. We retrospectively reviewed medical record data on all new initiations of methadone and compared results of physician monitoring practices to patients with new initiations of morphine SR. A standardized chart tool was used to capture clinical data. Data related to health service utilization and clinical diagnoses were obtained from the VA clinical information system.Setting. A single VA Medical Center in the Pacific Northwest.Patients. Chronic pain patients prescribed methadone (n = 92) or morphine (n = 90) in the calendar year 2008.Results. There was no difference between patients prescribed methadone versus patients prescribed morphine SR in the likelihood of receiving an electrocardiogram (ECG) prior to initiating medication (53 percent versus 54 percent) or in the year after opioid initiation (37 percent versus 40 percent). The two groups also did not differ in rates of developing prolonged rate-corrected (QTc) intervals (>450 ms) (11 percent versus 17 percent). Seventy-two percent of all patients discontinued their long-acting opioid regimens before 90 days due to adverse effects or insufficient pain relief.Conclusion. Despite recommendations for standardized assessment and cardiac risk monitoring, few patients prescribed methadone received an ECG, and this occurred at a rate that did not differ from patients prescribed morphine SR. Patients discontinued both medications at high rates. Further research is needed to evaluate the clinical significance of QTc prolongation in patients treated with methadone.
Survey of naloxone legal status in opioid overdose prevention and treatment
Authors: Hewlett, PharmD Leanne , Wermeling, PharmD Daniel P.
Published: March 2014

Objective: To survey the federal and state-by-state legal status for prescribing, dispensing, and administering naloxone injection.Design: The survey was a review of legislation, which encompassed analyzing current and proposed laws regarding naloxone’s role in opioid overdose prevention and treatment.Main outcome measure(s): The primary study outcome was to evaluate the legal aspects of current naloxone overdose prevention and treatment. Aspects of the legislation studied included Food and Drug Administration (FDA) regulatory status, prescriber authorization, prescription requirements, defining the patient, authority to administer naloxone, status of lay person administration, and provisions for Good Samaritan protections from criminal and civil liability.Results: To date, 10 states have legislation implementing opioid overdose prevention programs including naloxone. Several states with high opioid overdose burdens are in the legislative process. Reasons for hesitation to initiate such programs include fear of liability, a proxy endorsement for drug abuse, and apprehension of increasing drug usage.Conclusions: A number of state legislatures have passed legislation permitting lay administration of naloxone to individuals in an attempt to revive a person with an apparent opioid overdose. These emerging state policy initiatives parallel similar laws and regulations governing lay person epinephrine administration for anaphylaxis and applying automated electric defibrillators for sudden cardiac arrest. Public health initiatives increasing access to naloxone will likely continue in states with high opioid overdose burdens. FDA approval of a new needle-free naloxone delivery system would facilitate greater public access.
A review of the use of ketamine in pain management
Authors: Tawfic, MBChB, FIBMS (Anesthesiology) Qutaiba A.
Published: March 2014

Ketamine is a noncompetitive antagonist of N-methyl-D-aspartate receptor. It has been widely used in anesthesia and pain management. Ketamine has been administered via the intravenous, intramuscular, subcutaneous, oral, rectal, topical, intranasal, sublingual, epidural, and caudal routes. Ketamine improves postoperative and posttrauma pain scores and reduces opioid consumption. It has special indication for patients with opioid tolerance, acute hyperalgesia, and neuropathic pain. It also has a role in the management of chronic pain including both cancer and noncancer pain. Recreational use of ketamine is increasing as well through different routes of administration like inhalation, smoking, or intravenous injection. Long-time exposure to ketamine, especially in the abusers, may lead to serious side effects. This review is trying to define the role of ketamine in pain management.
Opioid titration with sustained-release oxycodone and immediate-release morphine for moderate/severe cancer pain: A pilot assessment of the CoDem protocol
Authors: Samolsky Dekel, MD, PhD, MA Boaz Gedaliahu , Tomasi, MD Marco , Vasarri, MD Alessio , Gori, MD Alberto , Adversi, MD Marco , Castagnoli, MD Anna , Di Nino, MD GianFranco , Melotti, MD Rita Maria
Published: March 2014

Objectives: Opioid titration is the first challenging stage for rapid control of moderate/severe cancer pain. Evidence shows that sustained-release formulations may be used for opioid titration. We set a pilot assessment of the efficacy and tolerability of our in-house protocol (continuous and on demand opioids [CoDem]) of the association of sustained-release oxycodone and immediate-release morphine as rescue dose for opioid titration/rotation in opioid-naïve (NAOP, n = 13), tolerant to weak (WOP, n = 20), or strong opioids (STOP, n = 44) in-patients with moderate/severe cancer pain.Methods: Observational and retrospective analysis of cancer in-patients treated for ≥7 days with the CoDem protocol.Outcome measures: Pain intensity (patients self-reported pain with numerical rating scale [NRS] under static [NRSs] and dynamic [NRSd] conditions), amount of drug consumption, opioid adverse effects, and patient satisfaction.Efficacy endpoints: In more than 50 percent of the patients and in <72 hours, steady NRSs and NRSd score reduction of at least two points, NRSs ≤ 3 and NRSd ≤4; and mean daily morphine consumption < mean of one rescue dose and t1:t6 ratio of mean oxycodone daily dose < 1:2.Results: Endpoints were reached within 24 hours both within the sample and subgroups. Only NAOP patients reached NRSd ≤ 4 endpoint within 48 hours. Against moderate and transient adverse effects, most patients (84.4 percent) found pain treatment to be good or excellent.Conclusions: The CoDem protocol was shown to be effective and reasonably tolerated for titration for moderate/severe cancer pain relief in both opioid-naïve or opioid-tolerant cancer in-patients. This pilot assessment warrants prospective and comparative studies with larger samples for more generalized results.
Early postoperative patient-controlled analgesia ratio predicts 24-hour morphine consumption and pain in children undergoing scoliosis surgery
Authors: Matava, MBCHB Clyde T. , Crawford, MBBS Mark W. , Pehora, RN Carolyne , Naser, MD Basem , McDonnell, MBCHB Conor
Published: March 2014

Background: The identification of patients at risk for developing severe postoperative pain and/or opioid-related side effects is difficult due to a lack of sensitive indicators. The patient-controlled analgesia (PCA) ratio of demands to deliveries is a potential tool for early identification of patients who experience severe postoperative pain. The authors hypothesized that the PCA ratio is able to predict morphine requirement in the first 24 hours after scoliosis surgery.Methods: The authors performed a retrospective study of adolescents who had surgery for idiopathic scoliosis. They collected data describing PCA demands and deliveries, morphine consumption, numerical rating scale (NRS) pain scores, opioidrelated side effects, and duration of hospital stay. Spearman rank analysis assessed association among 4-hour PCA ratios, NRS pain score, and 24-hour morphine consumption. Patients were divided into groups on the basis of PCA ratios <1.5 and ≥1.5. Univariate analysis and multiple regression were used to identify independent factors predictive for increased 24-hour morphine. Mann-Whitney rank-sum and Fisher exact tests were used to compare data. p < 0.05 was considered statistically significant.Results: One hundred forty-seven patients were included in the analysis, mean (SD) age and weight were 15 (1.8) years and 55 (27) kg, respectively. There was a significant positive correlation between the 4-hour PCA ratio and initial 24-hour cumulative morphine consumption (r = 0.33, p = 0.0002). Patients with a 4-hour PCA ratio ≥1.5 demonstrated a significantly greater initial 24-hour morphine consumption (p = 0.0002), greater pain scores at 24 hours after surgery (p = 0.02), a greater incidence of at least one opioid-related side effect within the initial 24 hours after surgery, and a longer duration of hospital stay (p = 0.04) compared with those patients with a 4-hour PCA ratio <1.5. PCA ratio ≥1.5, age, and patient sex were predictive for 24-hour morphine consumption.Conclusions: The authors have demonstrated that a PCA ratio of demands/deliveries ≥1.5 is predictive of increased opioid requirements and is associated with greater pain scores in the initial 24 hours after surgery, an increased incidence of opioid-related side effects, and duration of hospital stay.
Monitoring oxycodone use in patients with chronic pain: Analysis of oxycodone and metabolite excretion in saliva and urine
Authors: Moy, MS Kathleen V. , Ma, PharmD Joseph D. , Morello, PharmD, CDE Candis M. , Atayee, PharmD, BCPS Rabia S. , Best, PharmD, MAS Brookie M.
Published: March 2014

Objective: Saliva is purported to have a close correspondence to plasma concentrations due to a passive diffusion process from plasma to saliva. However, limited data are available characterizing oxycodone and its metabolites in saliva. The purpose of this analysis was to evaluate the use of saliva monitoring in patients prescribed oxycodone and to compare the disposition of oxycodone in saliva and urine. Design: This retrospective analysis examined deidentified urine and saliva specimens collected from patients with chronic pain. These specimens were received at Millennium Laboratories between March and June 2012 and analyzed using LCMS/ MS to quantitate oxycodone, noroxycodone, and oxymorphone concentrations.Results: The geometric mean metabolic ratio (MR) of noroxycodone to oxycodone in saliva was 0.11, whereas the geometric mean MR in urine was 1.7. The geometric mean oxycodone concentration in saliva was 860 ng/mL (range, 1.5-8,600,000 ng/mL; 95% CI, 770-950 ng/mL), whereas the geometric mean noroxycodone concentration was 98 ng/mL (range, 2.3-8,800 ng/mL; 95% CI, 90-107 ng/mL). Fifty-four of the saliva specimens (6 percent) had oxycodone concentrations between 10,000 and 9,000,000 ng/mL.Conclusions: Oxycodone is predominant over noroxycodone in saliva (similar to plasma), while the reverse relationship exists in urine. Much greater oxycodone concentrations were found in saliva than are expected in plasma (up to a 1,000-fold difference). Saliva concentrations are lower than urine concentrations but still may not reflect plasma disposition. Possible explanations include medication residue in the mouth (recent medication use or misuse) or active secretion into saliva. Saliva analysis may be used for qualitative drug monitoring of oxycodone, with detection rates similar to urine; however, further characterization is needed for appropriate interpretation.
The 2013 severe haze over southern Hebei, China: model evaluation, source apportionment, and policy implications
Authors: Wang L. T. , Wei Z. , Yang J. , Zhang Y. , Zhang F. F. , Su J. , Meng C. C. , Zhang Q.
Published: March 2014

Abstract. Extremely severe and persistent haze occurred in January 2013 over eastern and northern China. The record-breaking high concentrations of fine particulate matter (PM2.5) of more than 700 μg m−3 on hourly average and the persistence of the episodes have raised widespread, considerable public concerns. During that period, 7 of the top 10 polluted cities in China were within the Hebei Province. The three cities in southern Hebei (Shijiazhuang, Xingtai, and Handan) have been listed as the top three polluted cities according to the statistics for the first half of the year 2013. In this study, the Mesoscale Modeling System Generation 5 (MM5) and the Models-3/Community Multiscale Air Quality (CMAQ) modeling system are applied to simulate the 2013 severe winter regional hazes in East Asia and northern China at horizontal grid resolutions of 36 and 12 km, respectively, using the Multi-resolution Emission Inventory for China (MEIC). The source contributions of major source regions and sectors to PM2.5 concentrations in the three most polluted cities in southern Hebei are quantified by aiming at the understanding of the sources of the severe haze pollution in this region, and the results are compared with December 2007, the haziest month in the period 2001–2010. Model evaluation against meteorological and air quality observations indicates an overall acceptable performance and the model tends to underpredict PM2.5 and coarse particulate matter (PM10) concentrations during the extremely polluted episodes. The MEIC inventory is proven to be a good estimation in terms of total emissions of cities but uncertainties exist in the spatial allocations of emissions into fine grid resolutions within cities. The source apportionment shows that emissions from northern Hebei and the Beijing-Tianjin city cluster are two major regional contributors to the pollution in January 2013 in Shijiazhuang, compared with those from Shanxi and northern Hebei for December 2007. For Xingtai and Handan, the emissions from northern Hebei and Henan are important. The industrial and domestic sources are the most significant local contributors, and the domestic and agricultural emissions from Shandong and Henan are non-negligible regional sources, especially for Xingtai and Handan. Even in the top two haziest months (i.e., January 2013 and December 2007), a large fraction of PM2.5 in the three cities may originate from quite different regional sources. These results indicate the importance of establishing a regional joint framework of policymaking and action system to effectively mitigate air pollution in this area, not only over the Beijing-Tianjin-Hebei area, but also surrounding provinces such as Henan, Shandong, and Shanxi.
Methane and carbon dioxide fluxes and their regional scalability for the European Arctic wetlands during the MAMM project in summer 2012
Authors: O'Shea S. J. , Allen G. , Gallagher M. W. , Bower K. , Illingworth S. M. , Muller J. B. A. , Jones B. , Percival C. J. , Bauguitte S. J-B. , Cain M. , Warwick N. , Quiquet A. , Skiba U. , Drewer J. , Dinsmore K. , Nisbet E. G. , Lowry D. , Fisher R. E. , France J. L. , Aurela M. , Lohila A. , Hayman G. , George C. , Clark D. , Manning A. J. , Friend A. D. , Pyle J.
Published: March 2014

Abstract. Airborne and ground-based measurements of methane (CH4), carbon dioxide (CO2) and boundary layer thermodynamics were recorded over the Fennoscandian wetlands in July 2012 as part of the MAMM (Methane and other greenhouse gases in the Arctic – Measurements, process studies and Modelling) field campaign. Employing these airborne measurements and a~simple boundary layer box model, net regional scale (~100 km) fluxes were calculated to be 1.2 ± 0.5 mg CH4 h−1 m−2 and −350 ± 143 mg CO2 h−1 m−2. These airborne fluxes were found to be relatively consistent with seasonally-averaged surface chamber (1.3 ± 1.0 mg CH4 h−1 m−2) and eddy covariance (1.3 ± 0.3 mg CH4 h−1 m−2 and −309 ± 306 mg CO2 h−1 m−2) flux measurements in the local area. The internal consistency of the aircraft-derived fluxes across a wide swath of Fennoscandia coupled with an excellent statistical comparison with local seasonally-averaged ground-based measurements demonstrates the potential scalability of such localised measurements to regional scale representivity. Comparisons were also made to longer term regional CH4 climatologies from the JULES (Joint UK Land Environment Simulator) and Hybrid8 land surface models within the area of the MAMM campaign. The average hourly emission flux output for the summer period (July–August) across the years 1980 to 2010 was 0.054 mg CH4 h−1 m−2 (minimum 0.0 and maximum 0.38 mg CH4 h−1 m−2) for the JULES model and 0.073 mg CH4 h−1 m−2 (minimum −0.0018 and maximum 4.62 mg CH4 h−1 m−2) for Hybrid8. Based on these observations both models were found to significantly underestimate the CH4 emission flux in this region, which was linked to the under prediction of the wetland extents generated by the models.
Non-agricultural ammonia emissions in urban China
Authors: Chang Y. H.
Published: March 2014

Abstract. The non-agricultural ammonia (NH3) emissions in cities have received little attention but could rival agricultural sources in term of the efficiency in PM formation. The starting point for finding credible solutions is to comprehensively establish a city-specific Non-agricultural Ammonia Emission Inventory (NAEI) and identify the largest sources where efforts can be directed to deliver the largest impact. In this paper, I present a NAEI of 113 national key cities targeted on environmental protection in China in 2010, which for the first time covers NH3 emissions from pets, infants, smokers, green land, and household products. Results show that totally 210 478 Mg, the NH3 emissions from traffic, fuel combustion, waste disposal, pets, green land, human, and household products are 67 671 Mg, 56 275 Mg, 44 289 Mg, 23 355 Mg, 7509 Mg, 7312 Mg, and 4069 Mg, respectively. The NH3 emission intensity from the municipal districts ranges from 0.08 to 3.13 Mg km−2 yr−1, with a average of 0.84 Mg km−2 yr−1. The high NH3 emission intensities in Beijing-Tianjin-Hebei region, Yangtze River Delta region and Pearl River Delta region support the view that non-agricultural NH3 sources play a key role in city-scale NH3 emissions and thus have potentially important implications for secondary PM formation (ammonium-sulfate-nitrate system) in urban agglomeration of China. Therefore, in addition to current SO2 and NOx controls, China also needs to allocate more scientific, technical, and legal resources on controlling non-agricultural NH3 emissions in the future.
Estimation of mineral dust longwave radiative forcing: sensitivity study to particle properties and application to real cases over Barcelona
Authors: Sicard M. , Bertolín S. , Mallet M. , Dubuisson P. , Comerón A.
Published: March 2014

Abstract. The aerosol radiative effect in the longwave (LW) spectral range is sometimes not taken into account in atmospheric aerosol forcing studies at local scale because the LW aerosol effect is assumed to be negligible. At regional and global scale this effect is partially taken into account: aerosol absorption is taken into account but scattering is still neglected. However, aerosols with strong absorbing and scattering properties in the LW region, like mineral dust, can have a non-negligible radiative effect in the LW spectral range (both at surface and top of the atmosphere) which can counteract their cooling effect occurring in the shortwave spectral range. The first objective of this research is to perform a sensitivity study of mineral dust LW radiative forcing (RF) as a function of dust microphysical and optical properties using an accurate radiative transfer model which can compute vertically-resolved shortwave and longwave aerosol RF. Radiative forcing simulations in the LW range have shown an important sensitivity to the following parameters: aerosol load, radius of the coarse mode, refractive index, aerosol vertical distribution, surface temperature and surface albedo. The scattering effect has been estimated to contribute to the LW RF up to 18% at the surface and up to 38% at the top of the atmosphere. The second objective is the estimation of the shortwave and longwave dust RF for 11 dust outbreaks observed in Barcelona. At the surface, the LW RF varies between +2.8 and +10.2 W m−2, which represents between 11 and 26% (with opposite sign) of the SW component, while at the top of the atmosphere the LW RF varies between +0.6 and +5.8 W m−2, which represents between 6 and 26% (with opposite sign) of the SW component.
Modeling global impacts of heterogeneous loss of HO2 on cloud droplets, ice particles and aerosols
Authors: Huijnen V. , Williams J. E. , Flemming J.
Published: March 2014

Abstract. The abundance and spatial variability of the hydroperoxyl radical (HO2) in the troposphere strongly affects atmospheric composition through tropospheric ozone production and associated HOx chemistry. One of the largest uncertainties in the chemical HO2 budget is its heterogeneous loss on the surface of cloud droplets, ice particles and aerosols. We quantify the importance of the heterogeneous HO2 loss at global scale using the latest recommendations on the scavenging efficiency on various surfaces. For this we included the simultaneous loss on cloud droplets and ice particles as well as aerosol in the Composition-Integrated Forecast System (C-IFS). We show that cloud surface area density (SAD) is typically an order of magnitude larger than aerosol SAD, using assimilated satellite retrievals to constrain both meteorology and global aerosol distributions. Depending on the assumed uptake coefficients, loss on liquid water droplets and ice particles accounts for ∼53–70% of the total heterogeneous loss of HO2, due to the ubiquitous presence of cloud droplets. This indicates that HO2 uptake on cloud should be included in chemistry transport models that already include uptake on aerosol. Our simulations suggest that the zonal mean mixing ratios of HO2 are reduced by ∼25% in the tropics and up to ∼50% elsewhere. The subsequent decrease in oxidative capacity leads to a global increase of the tropospheric carbon monoxide (CO) burden of up to 7%, and an increase in the ozone tropospheric lifetime of ∼6%. This increase results in an improvement in the global distribution when compared against CO surface observations over the Northern Hemisphere, although it does not fully resolve the wintertime bias in the C-IFS. There is a simultaneous increase in the high bias in C-IFS for tropospheric CO over the Southern Hemisphere, which constrains on the assumptions regarding HO2 uptake on a global scale. We show that enhanced HO2 uptake on aerosol types associated with anthropogenic sources could contribute to reductions in the low bias for CO simulated over the extra-tropical Northern Hemisphere.
Estimating the carbon dynamics of South Korean forests from 1954 to 2012
Authors: Lee J. , Yoon T. K. , Han S. , Kim S. , Yi M. J. , Park G. S. , Kim C. , Kim R. , Son Y.
Published: March 2014

Abstract. Forests play an important role in the global carbon (C) cycle, and the South Korean forests also contribute to this global C cycle. While the South Korean forest ecosystem was almost completely destroyed by exploitation and the Korean War, it has successfully recovered because of national-scale reforestation programs since 1973. There have been several studies on the estimation of C stocks and balances in the South Korean forests over the past decades. However, a retrospective long-term study including biomass and dead organic matter (DOM) C and validating DOM C is still insufficient. Accordingly, we estimated the C stocks and balances of both biomass and DOM C during 1954–2012 using a~process-based model, the Korean Forest Soil Carbon model, and the 5th Korean National Forest Inventory (NFI) report. Validation processes were also conducted based on the 5th NFI and statistical data. Simulation results showed that the biomass C stocks increased from 36.4 to 440.4 Tg C and sequestered C at a rate of 7.0 Tg C yr−1 during 1954–2012. The DOM C stocks increased from 386.0 to 463.1 Tg C and sequestered C at a rate of 1.3 Tg C yr−1 during the same period. The estimates of biomass and DOM C stocks agreed well with observed C stock data. The annual net biome production (NBP) during 1954–2012 was 141.3 g C m−2 yr−1, which increased from −8.8 to 436.6 g C m−2 yr−1 in 1955 and 2012, respectively. Compared to forests in other countries and global forests, the annual C sink rate of South Korean forests was much lower, but the NBP was much higher. Our results could provide the forest C dynamics in South Korean forests before and after the onset of reforestation programs.