bluuebunny/crossref_metadata_2025 huggingface dataset:
Responses of soil physico-chemical properties to combustion: a space for time substitution study to infer how changes in climate are likely to affect response of topsoil to fires
Authors: Araya Samuel N. , Meding S. Mercer , Berhe Asmeret Asefaw
Published: February 2016

Abstract. Fire is a common ecosystem perturbation that affects many soil properties. As global fire regimes continue to change with climate change, we investigated the effect of fire heating temperatures on the physical and chemical properties of soils across a climosequence transect along the Western slope of the Sierra Nevada that spans from 210 to 2865 m.a.s.l. All the soils we studied were formed on a granitic parent material and have sign ificant differences in soil organic matter (SOM) concentration and mineralogy owing to the effects of climate on soil development. The dominant vegetation from lowest to highest elevation across the transect range from oak woodland, oak/mixed-conifer forest, mixed-conifer forest and subalpine mixed-conifer forest. Topsoils (0–5 cm depth) from the Sierra Nevada climosequence were heated in a muffle furnace at six set temperatures that cover the range of major fire intensity classes (150, 250, 350, 450, 550 and 650 °C). We determined the effects of fire heating temperature on soil aggregate strength, aggregate size distribution, specific surface area (SSA), mineralogy, pH, cation exchange capacity (CEC), and carbon (C) and nitrogen (N) concentrations. With increase of temperature, we found significant reduction of total C, N and CEC. Aggregate strength also decreased with further implications for loss of C protected inside aggregates. Soil pH and SSA increased with increase in temperature. Most of the statistically significant changes (p < 0.05) occurred at temperature ranges of 350 to 450 °C. We observed relatively smaller changes at typical temperature ranges of prescribed fires (i.e. less than 250 °C). This study identifies critical combustion temperature thresholds for significant physico-chemical changes in soils that developed under different climate regimes, allowing inferences for how soils are likely to respond to different fire intensities under anticipated climate change scenarios.
Determining the susceptibility of soils materials to erosion by rain-impacted flows
Authors: Kinnell P. I. A.
Published: February 2016

Abstract. Conceptually, rain has a capacity to cause erosion (rainfall erosivity) and soils have a susceptibility to erosion by rainfall (soil erodibility) but no absolute measure of rainfall erosivity exists. Consequently, soil erodibility is nothing more than an empirical coefficient in the relationship between an index of rainfall erosivity and soil loss. Erosion by rain-impacted flow is influenced by the size, velocity and impact frequency of the raindrops but also flow depth and velocity. Experiments with artificial rainfall falling on sloping surfaces in the field usually do not enable flow depth and velocity to be well measured or controlled. Also, sprays produce artificial rainfall where the spatial uniformity in rainfall intensity, drop size and frequency is often less than desirable. Artificial rainfall produced by pendant drop formers can produce rainfall that has better spatial uniformity. Equipment for controlling flow depth and velocity over eroding surfaces has been developed and used to calibrate the effect of flow depth on the discharge of sediment by rain-impacted flow using artificial rainfall having a uniform drop-size distribution under laboratory conditions. Once calibrated, laboratory experiments can be conducted to rank soils according to their susceptibility to erosion under the flows impacted by the artificial rainfall under conditions where the erosive stress applied to the eroding surface is well controlled.
Effects of bryophyte and lichen cover on permafrost soil temperature at large scale
Authors: Porada P. , Ekici A. , Beer C.
Published: February 2016

Abstract. Bryophyte and lichen cover on the forest floor at high latitudes exerts an insulating effect on the ground. In this way, the cover decreases mean annual soil temperature and can protect permafrost soil. Climate change, however, may change bryophyte and lichen cover, with effects on the permafrost state and related carbon balance. It is therefore crucial to predict how the bryophyte and lichen cover will react to environmental change at the global scale. To date, current global land surface models contain only empirical representations of the bryophyte and lichen cover, which makes it impractical to predict the future state and function of bryophytes and lichens. For this reason, we integrate a process-based model of bryophyte and lichen growth into the global land surface model JSBACH. We thereby take into account the dynamic nature of the thermal properties of the bryophyte and lichen cover and their relation to environmental factors. Subsequently, we compare simulations with and without bryophyte and lichen cover to quantify the insulating effect of the organisms on the soil. We find an average cooling effect of the bryophyte and lichen cover of 2.7 K on temperature in the topsoil for the study region under current climate. Locally, a cooling of up to 5.7 K may be reached. Moreover, we show that using a simple, empirical representation of the bryophyte and lichen cover without dynamic properties only results in an average cooling of around 0.5 K. This suggests that (a) bryophytes and lichens have a significant impact on soil temperature in high-latitude ecosystems and (b) a process-based description of their thermal properties is necessary for a realistic representation of the cooling effect. The advanced land surface scheme including a dynamic bryophyte and lichen model will be the basis for an improved future projection of land–atmosphere heat and carbon exchange.
ACCURACY OF SNOW DEPTH ESTIMATION IN MOUNTAIN AND PRAIRIE ENVIRONMENTS BY AN UNMANNED AERIAL VEHICLE
Authors: Harder Phillip , Schirmer Michael , Pomeroy John , Helgason Warren
Published: February 2016

Abstract. The quantification of the spatial distribution of snow is crucial to predict and assess snow as a water resource and understand land-atmosphere interactions in cold regions. Typical remote sensing approaches to quantify snow depth have focused on terrestrial and airborne laser scanning and recently airborne (manned and unmanned) photogrammetry. In this study photography from a small unmanned aerial vehicle (UAV) was used to generate digital surface models (DSMs) and orthomosaics for snowcovers at a cultivated agricultural Canadian Prairie and a sparsely-vegetated Rocky Mountain alpine ridgetop site using Structure from Motion (SfM). The ability of this method to quantify snow depth, changes in depth and its spatial variability was assessed for different terrain types over time. Root mean square errors in snow depth estimation from the DSMs were 8.8 cm for a short prairie grain stubble surface, 13.7 cm for a tall prairie grain stubble surface and 8.5 cm for an alpine mountain surface. This technique provided meaningful information on maximum snow accumulation and snow-covered area depletion at all sites, while temporal changes in snow depth could also be quantified at the alpine site due to the deeper snowpack and consequent higher signal-to noise-ratio. The application of SfM to UAV photographs can estimate snow depth in areas with snow depth > 30 cm – this restricts its utility for studies of the ablation of shallow, windblown snowpacks. Accuracy varied with surface characteristics, sunlight and wind speed during the flight, with the most consistent performance found for wind speeds < 6 m s−1, clear skies, high sun angles and surfaces with negligible vegetation cover. Relative to surfaces having greater contrast and more identifiable features, snow surfaces present unique challenges when applying SfM to imagery collected by a small UAV for the generation of DSMs. Regardless, the low cost, deployment mobility and the capability of repeat-on-demand flights that generate DSMs and orthomosaics of unprecedented spatial resolution provide exciting opportunities to quantify previously unobservable small-scale variability in snow depth and its dynamics.
Patterns of Pseudophakic Retinal Detachment in a Referral Tertiary Care Center and the Need for Improving Cataract Surgical Training
Authors: Wadhwani Meenakshi , Venkatesh Pradeep , Gogia Varun , Gupta Shikha , Sharma Yograj , Pandey Veena
Published: February 2016

Purpose

To determine the risk factors associated with development of rhegmatogenous retinal detachment (RRD) in patients undergoing different types of cataract surgery.

Methods

Records of 200 patients presenting with pseudophakic retinal detachment (PRD) between January 2012 and July 2013 at a tertiary care center were reviewed. Duration and type of cataract surgery (phacoemulsification, extracapsular cataract extraction [ECCE], and small-incision cataract surgery [SICS]) and history of YAG capsulotomy with risk factors were recorded. Presence or absence of these risk factors was analyzed and their association with type of cataract surgery was evaluated.

Results

Of these 200 patients, 137 were male and 63 were female. The mean age of the patients was 55.19 ± 12.60 years and mean duration of cataract surgery to diagnosis of RRD was 8.64 ± 5.15 months. Most patients underwent phacoemulsification (45%), followed by ECCE (31.5%) and SICS (23.5%). Most of the patients with PRD had complicated cataract surgery with intraocular lens (IOL) in sulcus in 63%, anterior chamber IOL in 3%, and aphakia in 0.5%. There was no difference among the 3 types of surgery performed in mean presenting visual acuity, duration between cataract surgery and YAG capsulotomy, or number of posterior chamber IOLs. Incidence of posterior capsular rent (p = 0.02) and presence of vitreous in anterior chamber (p = 0.01) were significantly higher for patients with retinal detachment (RD) who underwent SICS.

Conclusions

Many risk factors are associated with RD development after cataract surgery. More stringent efforts at improving the quality of cataract surgical training are likely to help in reducing the risk of PRD.
Patient Perceptions and Experiences of Stereotactic Radiotherapy for Wet Age-Related Macular Degeneration
Authors: Senra Hugo , Joseph Sobha , Balaskas Konstantinos , Horani Mania , Aslam Tariq
Published: February 2016

Purpose

Wet age-related macular degeneration (ARMD) is a leading cause of visual impairment. Anti-vascular endothelial growth factor (VEGF) injections are the mainstay of treatment but require monthly injections and frequent hospital visits. A novel approach to treatment with the use of stereotactic radiotherapy (Oraya IRay) as an adjunct to ranibizumab injections has shown promising results. We explored patients’ experiences of receiving Oraya therapy for wet ARMD.

Methods

We present a consecutive case series with objective and detailed reporting of the personal experiences of 5 patients with active wet ARMD treated with Oraya radiotherapy in our unit. We provided all patients who had received one Oraya treatment with a standardized survey composed of 10 questions addressing the experience of receiving this treatment.

Results

Generally, patients reported positive experiences of receiving Oraya treatment and perceived this treatment as a better option in comparison with anti-VEGF injections. However, the patients’ perceptions of Oraya treatment varied according to patients’ previous experiences of anti-VEGF injections and expectations of treatment.

Conclusions

Patients mainly justified their decision to receive Oraya treatment by expecting fewer intravitreal injections, but more research on this topic is needed to suggest new evidence-based treatment protocols for patients with wet ARMD.
The OECI Model: The CRO Aviano Experience
Authors: Da Pieve Lucia , Collazzo Raffaele , Masutti Monica , De Paoli Paolo
Published: February 2016

In 2012, the “Centro di Riferimento Oncologico” (CRO) National Cancer Institute joined the accreditation program of the Organisation of European Cancer Institutes (OECI) and was one of the first institutes in Italy to receive recognition as a Comprehensive Cancer Center. At the end of the project, a strengths, weaknesses, opportunities, and threats (SWOT) analysis aimed at identifying the pros and cons, both for the institute and of the accreditation model in general, was performed. The analysis shows significant strengths, such as the affinity with other improvement systems and current regulations, and the focus on a multidisciplinary approach. The proposed suggestions for improvement concern mainly the structure of the standards and aim to facilitate the assessment, benchmarking, and sharing of best practices. The OECI accreditation model provided a valuable executive tool and a framework in which we can identify several important development projects. An additional impact for our institute is the participation in the project BenchCan, of which the OECI is lead partner.
OECI Accreditation of the European Institute of Oncology of Milan: Strengths and Weaknesses
Authors: Deriu Pietro L. , Basso Silvia , Mastrilli Fabrizio , Orecchia Roberto
Published: February 2016

The European Institute of Oncology began the process to reach the accreditation promoted by the Organisation of European Cancer Institutes (OECI) in 2012. This accreditation integrates the quality and safety path started in 2001 with accreditation by the Joint Commission International. Despite the presence of diversified accreditations and certifications and the clear need of time, effort, and commitment, the models are complementary. Each model is not to be considered as an end but as a tool for improvement: e.g., mixing accreditation standards led to an improvement in the quality and safety of processes. The present article details the OECI accreditation experience of the European Institute of Oncology, in particular the following strengths of OECI standards: collaboration among several involved parties (patient, volunteer, patient's general practitioner) in the clinical and quality/safety processes; a larger involvement of support personnel (psycho-oncologists, dieticians, physical therapists); and the development of clinical/translational research and innovation in prevention, diagnosis, and treatment to guarantee the best available practice in diagnosis and treatment. The OECI accreditation is specific to oncology and therefore its standards are tailored to a cancer center, both in terms of language used in the standards manual and in terms of patient needs. The OECI accreditation system puts an auditor team with a standards manual in charge of verifying quality and confirms the definition of IEO as a Comprehensive Cancer Center.
The Regina Elena National Cancer Institute Process of Accreditation according to the Standards of the Organisation of European Cancer Institutes
Authors: Canitano Stefano , Di Turi Annunziata , Caolo Giuseppina , Pignatelli Adriana C. , Papa Elena , Branca Marta , Cerimele Marina , De Maria Ruggero
Published: February 2016

The accreditation process is, on the one hand, a tool used to homogenize procedures, rendering comparable and standardized processes of care, and on the other, a methodology employed to develop a culture of quality improvement. Although not yet proven by evidence-based studies that health outcomes improve as a result of an accreditation to excellence, it is undeniable that better control of healthcare processes results in better quality and safety of diagnostic and therapeutic pathways. The Regina Elena National Cancer Institute underwent the accreditation process in accordance with the standards criteria set by the Organisation of European Cancer Institutes (OECI), and it has recently completed the process, acquiring its designation as a Comprehensive Cancer Center (CCC). This was an invaluable opportunity for the Regina Elena Institute to create a more cohesive environment, to widely establish a culture of quality, to implement an institutional information system, and to accelerate the process of patient involvement in strategic decisions. The steps of the process allowed us to evaluate the performance and the organization of the institute and put amendments in place designed to be adopted through 26 improvement actions. These actions regarded several aspects of the institute, including quality culture, information communication technology system, care, clinical trials unit, disease management team, nursing, and patient empowerment and involvement. Each area has a timeline. We chose to present the following 3 improvement actions: clinical trial center, computerized ambulatory medical record, and centrality of patient and humanization of clinical pathway.
The Value of Accreditation for Cancer Patients: From End Users to Partners
Authors: Florindi Francesco , De Lorenzo Francesco
Published: February 2016

The Organisation of European Cancer Institutes (OECI) accreditation program is a resource for European cancer patients, insofar as it certifies the quality and organization of cancer care in European cancer centers. As the report on the accreditation program implementation in Italy showed, cancer patient organizations and their volunteers play a fundamental role within the cancer institute, particularly in informing and guiding cancer patients. This article explores Italian best practices and suggests embedding the lessons learned in the OECI accreditation program. Furthermore, the article launches the concept of a European Cancer Patients Bill of Rights in cancer institutes, to be used as a tool by both OECI centers and European Cancer Patient Coalition members to enhance the quality of the collaboration between cancer centers and patient organizations.
Health Systems, Quality of Health Care, and Translational Cancer Research: The Role of the Istituto Superiore Sanità -Rome
Authors: Ricciardi Walter
Published: February 2016

Faced with the challenge of ensuring high-quality and cost-effective health systems in the context of persistent financial crisis, a global strategy for cancer prevention and treatment represents a priority for public health bodies and governments. The key goals for the initiative are to define standards of cancer prevention and care while leveraging the continuous progress of biomedical research in the interest of public health. In Italy, the establishment of a network of Comprehensive Cancer Centres (CCC) named the Alliance Against Cancer (ACC) is an important initiative taken by the Ministry of Health to foster common strategies for enhancing the quality of oncology research and care at the national level. The Istituto Superiore di Sanità (ISS) has played an important role in supporting ACC activities through a special national program called ISS for ACC, launched by the Italian Ministry of Health in 2006. A similar role has been pursued in subsequent initiatives, including ISS support for a project aimed at providing international accreditation of the CCC of the ACC, funded by the Italian Ministry of Health. The results of this initiative, reported in the current issue of Tumori, are especially significant since specific indicators of quality for research and cancer care have been successfully defined for all the participating institutes. As the leading technical and scientific body of the Italian National Health Service, the ISS will continue to play a proactive role in supporting national networks and strategic national and international initiatives aimed at promoting public health.
Bay of Bengal Maritime Boundary
Authors: Anderson D. H.
Published: February 2016

On July 7, 2014, an ad hoc arbitral tribunal (Tribunal) rendered its award on the dispute between Bangladesh and India concerning the delimitation of their entire maritime boundary in the northern part of the Bay of Bengal. The award established the course of the boundary line in the territorial sea, the exclusive economic zone (EEZ), and the continental shelf within and beyond 200 nautical miles, ending a dispute that had persisted between the neighbors for more than three decades.
European Communities—Measures Prohibiting the Importation and Marketing of Seal Products
Authors: Shaffer Gregory , Pabian David
Published: February 2016

On May 22, 2014, the World Trade Organization’s Appellate Body (AB) issued its report on the controversial “ECSeal Products” dispute, finding that a European Union (EU or Union) prohibition on the importation and sale of seal products violated the General Agreement on Tariffs and Trade 1994 (GATT). It did so, however, in a way that largely upheld the Union”s defense on animal welfare grounds, so that the prohibition remains effective. The decision marks the first time that the Appellate Body has found that a trade ban on animal welfare grounds falls within the exception under GATT Article XX(a) for measures necessary to protect public morals. This determination implicates the legality of future trade restrictions on animal welfare grounds, as well as restrictions imposed on human rights grounds, such as labor rights.
Technische Universitaät Darmstadt v. Eugen Ulmer KG
Authors: Carstens Anne-Marie
Published: February 2016

In Technische Universität Darmstadt v. Eugen Ulmer KG, the Court of Justice of the European Union (ECJ or Court) addressed several important copyright issues stemming from a practice that continues to confound many legal practitioners and adjudicators: the mass digitization of library collections. The judgment adds to an emerging body of jurisprudence decided in the context of a trend toward greater digitization that could ultimately facilitate the development of a global, digital library. To date, the jurisprudence has largely been formed by cases challenging mass digitization that are percolating through the United States courts and have attracted international attention and criticism. The ECJ decision thus provides an important point of reference for evaluating how different jurisdictions balance the rights of authors against the public interest, as served by relevant fair use exceptions consistent with their international obligations under traditional copyright treaties, the 1996 WIPO Copyright Treaty, and the 1994 Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPs) applicable to all WTO member states.
Economic “Necessity” in International Law
Authors: Sykes Alan O.
Published: February 2016

Exigent circumstances can extinguish or suspend a wide range of legal obligations. They may empower governments to seize property or quarantine individuals. They may excuse the nonperformance of private or public contractual obligations. And, of especial interest here, they may permit governments to deviate from their obligations under treaties or customary international law (CIL).
Comparative International Law at the ICTY: The General Principles Experiment
Authors: Jain Neha
Published: February 2016

For a significant period of time, the comparativist and the international lawyer were considered to inhabit different worlds: the former scrutinized similarities and differences between domestic legal systems while the latter focused on the universal realm of international law that overlays these systems. This comfortably segregated image has been conclusively shattered by numerous studies demonstrating the multiple areas of interaction between international and comparative law. of these, one of the ripest areas for further reflection is the “general principles of law” as a source of international law. Puzzlingly, given the traditional domestic law origins of the general principles of law, comparative law and methodology have rarely featured in the scholarship and jurisprudence on the general principles. Thus, the attempt of the International Criminal Tribunal for the Former Yugoslavia (Icty) to use the general principles as a freestanding source of international criminal law provides a particularly intriguing opportunity to study the interaction between international and comparative law.
Why Do National Court Judges Refer to Human Rights Treaties? A Comparative International Law Analysis of CEDAW
Authors: McCrudden Christopher
Published: February 2016

Comparative international law promises to bring fresh attention to the similarities and differences in how international law is understood and approached at the domestic level. Comparative internationalhuman rightslaw applies this focus to similarities and differences in the ways that international human rights law is, for example, interpreted at the domestic level by courts.
The Crime of Aggression as Custom and the Mechanisms for Determining Acts of Aggression
Authors: Jia Bing Bing
Published: February 2016

The fallout from the 2010 Kampala Review Conference for the United States has been explained by Harold Koh and Todd Buchwald, who were officially involved in the negotiations at the conference. The concerns they enumerate serve to implicate, inter alia, two issues of broad importance for the international community: the definition of the crime of aggression, and the clear divide between the positions of the permanent members of the UN Security Council and the rest of the Kampala participants with respect to the Councils role in implementing the Rome Statute’s new provisions on the crime of aggression. This Note, which focuses on those two issues, is partly a response to some of their criticisms and partly an independent assessment of the consequences of the Review Conference. It also evaluates the Kampala amendments to the Rome Statute’in particular, Articles 8 bis, 15bis, and 15ter—from the perspective of customary law and considers their impact on the role assigned to the Council under the UN Charter.
Konaté v. Burkina Faso
Authors: Shelton Dinah
Published: February 2016

In only its second merits judgment, the African Court on Human and Peoples’ Rights (Court) placed strict limits on penalizing expression, especially that of journalists, in states party to the African Charter on Human and Peoples Rights (African Charter). In doing so, the African Court narrowly interpreted the often-criticized “clawback clauses” in the African Charter and relied instead on the tests of necessity, proportionality, and legitimate aim applied by other human rights tribunals to determine the legality of restrictions on rights.
Zivotofsky ex rel. Zivotofsky v. Kerry
Authors: Wuerth Ingrid
Published: February 2016

In Zivotofsky v. Kerry, decided June 8, 2015, the United States Supreme Court (Court) held unconstitutional a federal statute that permitted U.S. citizens born in Jerusalem to designate “Israel” as their place of birth on their passports, notwithstanding the secretary of state’s decision that such passports should designate “Jerusalem” as the place of birth. The opinion resolved a relatively narrow question of law (the constitutionality of an unusual statute), but the justices’ reasoning and language are of potentially broad significance and will provide fodder for many doctrinal debates in U.S. foreign relations law.
Tarakhel v. Switzerland (Eur. Ct. H.R.)
Authors: Cerna Christina M.
Published: February 2016

On November 4, 2014, the Grand Chamber of the European Court of Human Rights (the Court) held in Tarakhel v. Switzerland, in a 14 to 3 decision, that Swiss authorities would violate Article 3 (prohibition of torture/inhuman and degrading treatment) of the European Convention on Human Rights (European Convention) if the applicants were to be expelled to Italy, in application of the Dublin Regulation, without Switzerland having first obtained assurances from the Italian authorities that “the applicants would be taken charge of in a manner adapted to the age of the children and that the family would be kept together.”
Achmea B.V. v. Slovak Republic (PCA)
Authors: Babiak Otylia , Garel Benjamin
Published: February 2016

In Achmea B.V. v. Slovak Republic, an arbitration proceeding under the 1976 United Nations Commission on International Trade (UNCITRAL) Arbitration Rules, seated in Geneva, Switzerland, the Tribunal analyzed Achmea’s claims under the Netherlands-Slovak Republic Bilateral Investment Treaty (BIT) and the Slovak Republic’s objections that Achmea’s claim manifestly lacked legal merit due to the inexistence of a “dispute” within the scope of the BIT. The Tribunal found that while an arbitrable “dispute” did exist between the parties, the claimant had not established a prima facie violation of the BIT, leading the Tribunal to decline jurisdiction.
Fag og Arbejde v. Kommunernes Landsforening (CJEU)
Authors: Schefer Krista Nadakavukaren
Published: February 2016

On December 18, 2014, the Court of Justice of the European Union (CJEU or the Court) issued its judgment of the case Fag og Arbejde (FOA) v. Kommunernes Landsforening (KL).1 The CJEU’s decision is notable for being the first in which the Court directly rules on the question of whether discrimination based on body weight is prohibited under European law. Finding that there is no general prohibition on obesity discrimination in the employment context, the Court of Justice of the European Union nevertheless considers that in some cases, obesity can be a cause of disability. As a result, unequal treatment of obese persons could be a violation of the protections of non-discrimination enjoyed by persons with disabilities.
Fractures of facial bones in benghazi
Authors: Gaballah K.Y.
Published: February 2016

Four hundred and thirty three patients with various types of fractures of facial bones were studied and analysed together with statistics related to the etiology, site, age and sex. Sixty per cent of the cases were below 30 years of age. The male to female ratio was 5.5:1.

Sixty four per cent had fracture of the mandible alone, with fracture of the body of the mandible accounting for a quarter of the total number of cases. Only twenty per cent had fractures of the middle third of the face.

Injuries from road traffic accidents were the major causes of fractures in 258 patients (59.6%), followed by fights in 99 cases (22.9%) and falls in 69 cases (16%).
Finger ischemia following a jelly fish sting: A surgical approach
Authors: El Khatib H.A. , Al Basti H. B.
Published: February 2016

A 15-year-old girl sustained a jelly fish sting to her left hand and subsequently developed acute vascular insuffi-ciency of the left index and middle fingers with a threat of distal gangrene.

Jelly fish venoms are complex mixtures of polypeptides and enzymes pathogenic to man by means of their anti-genic properties. Fatal reactions can be caused by hy-persensitivity of the toxins on the heart, respiratory center or kidneys. Local or generalized skin eruption, exagger-ated local oedema, local fat atrophy and pigmentary changes are also features of the jelly fish sting. A direct neurotoxic effect of the jelly fish venom on big nerves as radial, median and ulnar nerve palsies has been reported by Peel.
Walker-Warburg syndrome: A case report of a qatari patient
Authors: Fawzi M. , Bessisso M. , Omar F.
Published: February 2016

A Qatari boy presented at birth with muscular weakness and was diagnosed as a case of Walker Warburg syndrome (WWS) on the basis of muscular dystrophy, eye abnormalities and brain anomalies. This is believed to be the first case of WWS reported from the Arab countries. Other similar muscular dystrophies associated with brain anomalies are described and discussed.
One stage pull through for hirschsprung's disease
Authors: Ismail A.
Published: February 2016

In order to compare one-stage versus multiple-stage pull-through for Hirschsprung disease (HD) and comment on transanal pull-through without laparotomy, we reviewed 35 patients operated on for HD in the last six years. Ages ranged from 1 week to 14 years with 16 patients presenting neonatally. Sixteen patients had multiple-stage and 19 single-stage pull-through. Twenty-one patients had the Swenson procedure, five the Duhamel, seven the Soave pull-through and two the Lister Martin procedure for total colonic aganglionosis.

We conclude that the one stage pull-through is effec-tive, saves the patient multiple operations, recurring costs and long hospital stays, and also saves both the patient and family the psychological trauma of colostomy.
Prevalence of Hepatitis Virus Infection and Immunogenicity of HBV Vaccine in Children with Down's Syndrome
Authors: Al Rawi F. , Al Marri A. , Al Musailhy S. , Jaber M. , Al Dabbagh  , Tawfiq F. A.
Published: February 2016

The prevalence of Hepatitis A, B and C infection was assessed in sixty children with Down's syndrome (DS) and compared with sixty children with normal mentality by screening for HBsAg, HBeAg, anti-HBe, anti-HBc, anti-HBs and anti-HCVand HAV-Ig. Both groups had received three doses of recombinant DNA hepatitis vaccine at 0,1 and 6 months of age.

None of the children in either group were found to have any hepatitis viral antiginaemia, hepatitis marker or to have chronic viral hepatitis.

Hepatitis B vaccine protective efficacy which was es-tablished by the presence of anti-HBs >10 mil], was sig-nificantly lower in the DS than the control group (28.3% Vs 85%,p < 0.001).

None of the children in the DS group, after the age of seven years, had protective anti-HBs level as compared to 79% of the children in the control group.

Booster doses are not recommended for normal chil-dren even if they lose their antibody to HBV vaccine be-cause of the presence of immune memory. However, in children with DS, because of their immune deficiency, low vaccination response, and their predisposition to chronic hepatitis infection especially at school age, we recommend booster HBV vaccination for them at school entry.
Factors Influencing Job Satisfaction Among Primary Health Care Physicians in Qatar
Authors: Al Marri S. A. , Al Taweel A. A. , Elgar F.
Published: February 2016

Occupational stressors associated with compromised job satisfaction amongst general practitioners (e.g. time constraints, burdensome patient loads and interruptions in personal life) have been found to adversely affect the quality of primary health care services.

A cross-sectional survey of 128 physicians in 22 pri-mary health care centers in Qatar used a self-administered questionnaire on factors associated with job satisfaction. Most physicians reported time pressures attributable to large patient loads that appeared to affect the quality of work and personal life. Younger and female physicians reported frustration at not having time to read about new research and advances.

Methods of addressing these problems, such as an appointment system, were favorably received by most physicians. Strategies to reduce occupational stress on most of the physicians may involve allowing them greater control over their work environment and providing time for Continuing Medical Education and postgraduate studies. This, in turn, should lead to improved primary health care.
Xanthogranulomatous Cholecystitis A Surgical Challenge
Authors: Bestoun H. A. , Al Ali A. Y. , Abu Sabib A. R.
Published: February 2016

Xanthogranulomatous cholecystitis is a severe inflammatory process, which gives rise to dense adhesions that complicate cholecystectomy. Four cases of significant injuries to the main biliary passages and surrounding structures are discussed. We suggest greater caution in the dissection of the gall bladder; a lower threshold for early conversion, examining frozen sections in suspicious cases and accurate preoperative diagnosis whenever possible.
Developmental Dysplasia of the Hip before and after Increasing Community Awareness of the Harmful Effects of Swaddling
Authors: Chaarani M. W. , Al Mahmeid M. S. , Salman A. M.
Published: February 2016

Qatar is a small country with a population of around 580,000. Over a period of 14 months a study was conducted on 520 infant hips to compare the results of ultra sound scanning of 260 high risk” babies; half of them (130) scanned before and the others scanned after increasing public awareness of the possible serious consequences of swaddling on neonate hips. Before this public awareness, of 130 babies scanned in a six months period 26 showed a form of acetabular dysplasia (20%), eighteen mild, four moderate and four severe. Two months after the public was made aware that swaddling could cause harmful effects on infants’ hips, 130 babies were scanned in a six months period. The number of babies with hip dysplasia was reduced to eight (6%), six mild, one moderate and another had severe acetabular dysplasia.
Professional Stress During Medical Internship
Authors: Al Sultan A. I. , Parashar S. K. , Wahass S. H. , Al Soweilem L. S.
Published: February 2016

One hundred and one interns who completed internship during the year 2000 were surveyed by questionnaire to study the factors, manifestations and management strategies of stresses affecting them. Factors considered included personal and family, work and working conditions, training and interpersonal matters.

Approximately one out of three interns reported significant stress from not having enough time for family, insecurity about future and career; long working hours, frequent duties, lack of encouragement and supervision, lack of feedback, no one caring, and discriminations in gender and evaluations. Marriage did not seem to add significant stress during training.

It is concluded that medical internship is a stressful training period and it is suggested that support groups or advisory committees are needed to help and counsel interns about professional stress and provide psychological assistance when necessary.
Spotaneous Rupture of Spleen Due to Plasmodium Vivax Malaria
Authors: Al Owinati B. I. , Al Soub H. , Abdul Sattar H. A.
Published: February 2016

Spontaneous rupture of the spleen is a rare complication of Plasmodium vivax malaria which may be under diagnosed. Recently we encountered such a case in an expatriate a few days after arriving from his country. The presentation was of fever; abdominal pain and vomiting. Computed tomographic scan and ultrasound were not helpful in making an initial diagnosis but the development of hypotension and a significant drop in hemoglobin later pointed to the diagnosis. The rupture was sufficiently severe to necessitate splenectomy. The case is described, treatment options are discussed and pertinent literature is reviewed.
Diagnosis and Treatment of Cutaneous Facial Sinus Tract of Dental Origin
Authors: Al Kaabi M. , Al Kubaisi S.
Published: February 2016

Intermittently draining cutaneous sinus tracts in the area of the face and neck may be caused by chronic dental infection. Diagnosis of the causes may be challenging but is the key to successful therapy. A case of cutaneous facial sinus tract related to a mandibular molar is presented. Non-surgical endodontic treatment was performed. Healing was rapid and uneventful
Intramuscular Hydatid Cyst A Case Report and Literature Review
Authors: Abu Salem O. T.
Published: February 2016

Enchinococus granulosus is endemic in many parts of the world where sheep and cattle are raised with the help of dogs. Dogs are the principal host and sheep are the most common intermediate host, Dogs acquire the infestation by ingesting hydatid scolices from infected sheep organs. The parasite develops into a tapeworm in the dog intestine and tapeworm eggs are then excreted in dog feces and transmitted to humans via the fecal-oral route. Ingested eggs develop into hydatid cysts in the intermediate host to complete the life cycle of the parasite. The patient in this study lived next to a sheep ranch
From Qatar to the World” Abstracts Presented at International Conferences
Authors: Gehani A. A. , Hammoudeh M.
Published: February 2016

This study aimed to investigate the effect of oral pilocarpine (OP) in reducing the incidence of chemotherapy-induced oral mucositis. Thirty two adult patients completed a total of 82 courses of chemotherapy in which either OP or placebo was given pro-phylactically in a double-blind cross-over design to prevent mucositis. Mucositis was documented in 20 out of 41 courses in which patients were given placebo, whereas mucositis was documented in only six out of 41 courses when patients were given OP (P<0.005). OP treatment was found to significantly reduce the mucositis score when assessed by the method of Donnelly and colleagues (Donnelly JP, Muus P, Schatttenberg A, De Witte T, Horrevorts A, De Pauw BE. Bone Marrow Transplant 1992, 9, 409–413). Using this score, all patients scored a total of 52 when they were given the placebo versus eleven when they were treated with OP (P<0.001). A similar reduction in mucositis score was noticed using the World Health Organization (WHO) mucositis score; the total patient score was 25 for the placebo-treated group versus 6 for the OP group (PcO.OOl). We therefore conclude that oral pilocarpine is highly effective in the prevention of oral mucositis when given prophylactically to adult patients receiving a variety of cancer chemotherapy regimens
Helicobacter Pylori Gastritis in Qatar A Clinico-Histopathological Study
Authors: Latif A. , Azadeh B.
Published: February 2016

The presence of Helicobacter pylori (HP) was studied histologically in 574patients who underwent Oesophagogastroduodenoscopy. The most common gastroscopic findings were gastritis in 300patients (52.2%) followed by normal gastroscopy in 119 patients (20.7%), duodenal ulcer in 67 patients (11.7%), gastric ulcer in 20 patients (3.5%), duodenitis in 59patients (10.3%) and other findings in nine patients (1.6%).

Histological examination of all574patients showed that 442 (77%) with positive HP tests had different histological abnormalities. Negative tests for HP occurred in 132 patients (23%) of whom 51 (38.6%) had normal histology, 39 (29.6%) had active chronic gastritis and 42patients (31.8%) had inactive chronic gastritis.
The Efficiency of Duodenal Aspirate in the Diagnosis of Parasitosis and Candidiasis
Authors: Mahdi N. K. , Taha S. A.
Published: February 2016

A hundred patients presenting with dyspepsia and/or symptoms suggesting parasitosis/candidiasis were subjected to oesophago-gastroduodenoscopy (OGD) in the Endoscopy Unit of Basrah Teaching Hospital Duodenal ulcers were found in 23% of them. Duodenal aspirate and stool samples were taken and examined microscopically for parasitosis and candidiasis. Examination of duodenal aspirates revealed the presence of Giardia lamblia in 15% of the cases, B. hominis in 5%, C. parvum in 4% and Candida spp. in 16%; the respective figures for those microorganisms in stool samples were 8%, 12%y 2% and 7%. There was no characteristic pH level of the duodenal aspirate in relation to parasitosis, candidiasis or endoscopic findings.
Selective Arterial Embolization of the Vesical Arteries in the Management of Intractable Bladder Hemorrhage
Authors: Abu Qamar A. A. , Habboub H. , Zoubi M. A.
Published: February 2016

Bleeding from a bladder tumor is a common presentation. Most bleeding can be managed conservatively but on certain occasions bleeding can be severe and hard to control. Sixteen patients who were presented with severe intractable bleeding secondary to bladder tumors and failed conservative management, underwent embolization of branches of the hypogastric arteries to control bleeding. Effective control of bleeding was achieved in 15 patients (94%).

In this review we present our experience in the management of intractable bleeding from bladder tumors by percutanous emobolization in respect of technical success, technique and complications
Diagnostic Value of Fiberoptic Bronchoscopy in Suspected Pulmonary Tuberculosis in the State of Qatar
Authors: Mobayedh H. M. S. , Sattar H. A. , Ghadban W. K. , Al Khal A. L. , Al Soub H. , Al Alousi F. S. , Al Mohammed A. A.
Published: February 2016

To assess the diagnostic value of fiberoptic bronchoscopy (FOB) in patients with abnormal chest radiographs suggestive of pulmonary tuberculosis (PTB) but with negative sputum smears for acid fast bacilli (AFB), a retrospective study was made of all such cases referred to the Pulmonary Diseases Service at Hamad Medical Corporation between July 1997 and June 2000. It included patients unable to produce any sputum sample. From 193 FOB procedures, active pulmonary tuberculosis was diagnosed in 58 patients (30 %). The diagnosis was confirmed either by finding acid fast bacilli in a smear or by culture of bronchial washings or bronchoalveolar lavage (BAL), or by demonstrating caseating granulomata on transbronchial or endobronchial biopsy. In 19 of58 (33%) positive cases, the diagnosis was rapidly established by demonstrating AFB in smears of bronchial aspirate or by positive histopathology. It is concluded that FOB is still the gold-standard procedure in the diagnosis of pulmonary tuberculosis in those patients in whom the diagnosis cannot be established by sputum examination, thus allowing early diagnosis in a significant proportion of them. The results are in agreement with similar studies.
Evaluation of Loading Dose of IFN in HCV Patients: Prospective, Uncontrolled Study
Authors: Derbala M. , Al Kaabi S. , Al Marri A. , Yakoob R. , Al Dweik N. , Butt M. , Pasic F.
Published: February 2016

Current treatment regimens with either long-term interferon (IFN) monotherapy or interferon-ribavirin combination achieve a sustained response of 6-21%. To improve the efficacy of IFN several strategies have been devised, including the use of higher doses of IFN, prolonged courses or pegylated IFN. Some recent reports have suggested that daily administration of IFN in the early phase of therapy (induction dose) may be more efficacious than the classic thrice-weekly regimen. There is no available data about the combination of induction dose regimen of IFN and ribavirin.

Our objective was to evaluate prospectively the efficacy and safety of a 5mu IFN induction dose in combination with ribavirin in HCV patients. End treatment response (ETR) was 36.7% of the 30 patients included in the study, while 81.1% ofresponders could remain viral negative for one year after discontinuation of treatment (sustained response). Though responders had higher pretreatment levels of viraemia and ALT, it was still without statistical signficance. Also, there was no statistical histological difference between both groups. There was a significant correlation between response rate and post induction viraemia level (p < 0.05) but no similar relation to post-induction ALT level. We conclude that induction dose regimen seems to have no effect on ETR but may improve sustained response. Also, post-induction viral load level is a good predictor for both ET and sustained responses.
Laparoscopic Splenectomy Review of Five Cases
Authors: Hussein A. A. , Al Azawi D.
Published: February 2016

Laparascopic splenectomy is one of the advanced surgical procedures with indications gradually increasing in hematological diseases. This is a review of five cases operated upon over two years. All were female patients, three with ITP and two with thalassemia. In one with gall bladder stones, laparascopic cholecystectomy was done with splenectomy. The mean operative time was 3 hours and 30 minutes. No case was converted to open technique. There were no intra-operative or post-operative complications with optimum patient response over the six month follow up; no steroids were required for the ITP patients and no more blood transfusions for the thalassemia patients.
Leiomyosarcoma of the Urinary Bladder (4 Cases)
Authors: Al Ali M. , Samalia K. P.
Published: February 2016

Non-epithelial tumors of the bladder of mesenchymal origin are very rare, comprising 1% or less of all bladder tumors(l), 50% of which are sarcomas of one type or another, and are generally classified as leiomyosarcomas, rhabdomyosarcomas and carcinosarcomas. Leiomyosarcomas arise from the muscularis mucosae and invade the lamina propria towards the outer muscular wall.
Resuscitation Guidelines Updates: Adult Advanced Life Support
Authors: Salam A. M. , Al Musleh A. W. , Gehani A. A.
Published: February 2016

The International Guidelines 2000 Conference on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care was the world's first international conference to produce evidence- based international resuscitation guidelines.