bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of the Medical Reserve Corps in Nursing Education
Authors: Culley Joan M.
Published: October 2010

Graduates of baccalaureate nursing programs are expected to demonstrate basic competency in responding to emergencies, including those related to emergency preparedness and disaster response. Faculty find it challenging to provide learning experiences that enable students to use appropriate assessment, clinical judgment, and decision making skills during disaster, mass casualty, and other emergency situations. This article describes a partnership between a school of nursing and a university health service to form a Medical Reserve Corps. The partnership resulted in unique and diverse learning experiences for nursing students in collaboration with volunteers from other professional disciplines and laypeople. The Medical Reserve Corps provides opportunities for students to experience emergency preparedness and disaster responses firsthand and to develop competencies required for generalist nursing practice.
Clinical Teachers’ Conceptions of Nursing
Authors: Forbes Helen
Published: October 2010

Lack of knowledge exists about clinical teachers’ understanding of nursing. A likely relationship between teachers’ conceptions of nursing and what they focus on when teaching nursing students in the clinical setting means that the identification of different conceptions of nursing is important. This study investigated clinical teachers’ experiences of nursing and clinical teaching of undergraduate nursing students. This article reports on clinical teachers’ conceptions of nursing. Semistructured interviews of 20 nurses employed as clinical teachers in Australian universities were conducted. Data were analyzed using a phenomenographic approach. The findings suggest that nursing is conceived as performing tasks; providing appropriate care; providing individualized patient care aimed at achieving patient outcomes; or collaborating with health care team members to provide appropriate, individualized patient care aimed at achieving patient outcomes. Insights will assist with future preparation and support of clinical teachers, the education of nursing students, and improved curriculum design.
Noise in Wavefront Error Measurement from Pupil Center Location Uncertainty
Authors: Applegate Raymond A. , Marsack Jason D. , Sarver Edwin J.
Published: October 2010

Purpose:

To examine the impact of pupil center location uncertainty in wavefront sensing on the variance in repeated measures of higher order root-mean-square (RMS) wavefront error (WFE).

Methods:

Dilated WFE for one normal eye and one eye with keratoconus of two patients were measured using a custom Shack-Hartmann wavefront sensor (lenslet spacing 400
μ
m). Twelve measurements for each patient were averaged to form the best estimate of each eye’s WFE and standard deviation. The percentage of the standard deviation of the actual measurements attributable to the uncertainty in pupil center location was modeled by inducing random offsets in the pupil center up to 50, 100, 150, and 200
μ
m.

Results:

The percentage of standard deviation of the actual measurements accounted for by pupil location uncertainty form a complex interaction between magnitude and distribution of the higher order WFE with the magnitude of pupil centering error. The larger the WFE and pupil center uncertainty, the greater the effect.

Conclusions:

As pupil center uncertainty increases, so does the WFE variation in repeated measurements. The larger the underlying WFE, the greater the impact on measurement variation. Increasing measurement variation decreases the ability to detect changes in WFE (eg, as a function of aging or clinical intervention) and decreases the accuracy with which wavefront-guided corrections can be made.
Stability of Simultaneous Topography-Guided Photorefractive Keratectomy and Riboflavin/UVA Cross-Linking for Progressive Keratoconus: Case Reports
Authors: Krueger Ronald R. , Kanellopoulos A. John
Published: October 2010

Purpose:

To follow the stability of a simultaneously delivered therapy that corrects aberrations and stiffens the corneal collagen of eyes with progressive keratoconus.

Methods:

Two patients with progressive keratoconus underwent partial treatment (70% cylinder and sphere up to 50-
μ
m central depth) with topographic customized photorefractive keratectomy (PRK) using the T-CAT module of the ALLEGRETTO WAVE Eye-Q excimer laser (Alcon Laboratories Inc), and then immediate corneal collagen cross-linking (CXL) with riboflavin 0.1% drops every 2 minutes while exposed to mean 365-nm ultraviolet A (UVA) light at 3.0 mW/cm
2
for 30 minutes (the Athens Protocol). Pre- and postoperative evaluations included manifest and cycloplegic refraction, Scheimpflug corneal tomography and pachymetry, and slit-lamp examination of corneal clarity with a minimum follow-up of 30 months.

Results:

Both treated eyes experienced rapid healing of the epithelial surface within 5 days and progressive improvement of vision. In the first case, partial treatment reduced the astigmatism and aberrations, allowing for successful soft contact lens wear at 3 months. Follow-up at 13, 19, 30, and 36 months showed progressive reduction of refractive myopia and keratometric power. In the second case, laser treatment led to a near emmetropic refraction with an uncorrected visual acuity of 20/20 at 3 months, which remained unchanged at 21 and 30 months postoperative.

Conclusions:

Partial topography-guided PRK followed by riboflavin/UVA CXL is a safe and effective therapy that halts the progression of keratoectasia and reduces the spherocylindrical refraction and aberrations to improve the visual function of patients with progressive keratoconus. Stability and progressive improvement over time is observed, although limitations may exist for steeper and thinner corneas.
Epithelial Thickness Profile as a Method to Evaluate the Effectiveness of Collagen Cross-Linking Treatment After Corneal Ectasia
Authors: Reinstein Dan Z. , Gobbe Marine , Archer Timothy J. , Couch Darren
Published: October 2010

Purpose:

To illustrate the hypothesis that epithelial thickness profile maps could be a useful adjunct to topography in monitoring patients after corneal collagen cross-linking (CXL) treatment.

Methods:

Epithelial thickness profile in vivo was measured by Artemis very high-frequency (VHF) digital ultrasound scanning (ArcScan Inc) across the central 10-mm corneal diameter of a patient before collagen CXL for corneal ectasia after LASIK and at intervals up to 2 years later. Manifest refraction, corneal topography, and corneal front-surface aberrations were also monitored. Epithelial thickness changes were cross-correlated with corneal topography changes and corneal front-surface aberration changes.

Results:

Corneal collagen CXL appeared effective in halting the progression of corneal ectasia. Manifest refraction showed a reduction in spherical equivalent over time after CXL in both eyes. Corneal topography demonstrated stable central keratometry in both eyes. Corneal wavefront aberrations demonstrated a reduction of higher order root-mean-square coma and spherical aberration in both eyes. The epithelial thickness profile was altered, with a slight reduction of the area of epithelial thinning and decreased peripheral thickening. This resulted in minimizing the difference between the thinnest and thickest epithelium and might indicate an improvement of the condition. There were no significant changes in minimum stromal and minimum corneal thicknesses.

Conclusions:

Epithelial thickness maps provide useful information for monitoring the progression of corneal ectasia after corneal collagen CXL, showing in this case, at least no further progression of the ectasia.
New Axis-Marking Method for a Toric Intraocular Lens: Mapping Method
Authors: Cha Deoksun , Kang Su Yeon , Kim Seung-Hyun , Song Jong-Suk , Kim Hyo-Myung
Published: October 2010

Purpose:

A new axis-marking method, the mapping method, for toric intraocular lens (IOL) implantation is described, and its accuracy is compared with that of conventional methods.

Methods:

For toric IOL implantation, the steepest corneal axis was determined by IOLMaster optical biometer measurement (Carl Zeiss Meditec). Three marking methods for accurate alignment of the IOL astigmatism axis to the steepest corneal axis were evaluated and compared. For method 1, the patient was seated at the surgical table and instructed to gaze at a distant target. Using a toric reference marker, the corneal limbus was marked at the 3-, 6-, and 9-o’clock positions. The goal axis was also marked using a toric axis marker. Method 2 used a horizontal slit beam for reference marking points at 3 and 9 o’clock. Method 3 was the new mapping method, in which an anterior segment photograph was used to identify several reference vessel points and axis marking points and to calculate actual lengths from the reference vessel points to the axis marking points. During surgery, the axis marking points were marked on the limbus of the eye using calipers. The accuracy of the three axis-marking methods was evaluated using anterior segment photographs.

Results:

With method 1, the average axis-marking error was 3.69±1.49°. With method 2, the average axis-marking error was 3.14±1.64°. With method 3, the new mapping method, the average axis-marking error was 2.29±1.06°. The new mapping method was more accurate than methods 1 and 2 (
P
<.01 and
P
=.016, respectively, paired
t
test). Axis-marking errors of the two conventional methods were not significantly different (
P
=.061).

Conclusions:

The new axis-marking method, which uses distinct conjunctival vessels as a reference point, showed less axis-marking error compared to the conventional methods examined in this study.
Limbal Relaxing Incisions Using a Reference Point and Corneal Topography for Intraoperative Identification of the Steepest Meridian
Authors: Miyata Kazunori , Miyai Takashi , Minami Keiichiro , Bissen-Miyajima Hiroko , Maeda Naoyuki , Amano Shiro
Published: October 2010

Purpose:

To examine the efficacy and safety of topography-based limbal relaxing incision (LRI) surgery.

Methods:

Forty-four eyes of 36 consecutive patients who underwent cataract surgery more than 1 month previously, had refractive against-the-rule astigmatism of ≥2.00 diopters (D), and were scheduled to undergo LRI surgery were enrolled in the study. Patients were randomized into two groups—a topography-based LRI group (19 eyes of 14 patients) and a conventional LRI group (25 eyes of 22 patients). The topography-based LRI procedure comprised 3 steps: placing a mark on the cornea and conjunctiva, identifying this mark in the topographic image, and performing LRI based on the location of the mark. In the conventional LRI group, the horizontal meridian was marked under a slit lamp and LRIs were made based on the position of the horizontal mark.

Results:

Corneal astigmatism in the topography-based LRI group before and 1 month after surgery was 2.03±0.92 D and 1.33±0.69 D, respectively (
P
=.014). Corneal astigmatism in the conventional LRI group before and 1 month after surgery was 2.36±0.77 D and 0.93±0.70 D, respectively (
P
<.0001). Fourier harmonic analysis of the topography data demonstrated that regular astigmatism was significantly decreased in the two groups. The mean regular astigmatism was not significantly different before and after LRI between groups, whereas the variances (mean of the deviation squared from its mean) of regular astigmatism were significantly different between groups 1 month after LRI.

Conclusions:

Compared with conventional LRI surgery, a topography-based procedure may reduce the deviation of the effect of LRIs.
Development of Subretinal Fibrosis After Anti-VEGF Treatment in Neovascular Age-Related Macular Degeneration
Authors: Hwang John C. , Del Priore Lucian V. , Freund K. Bailey , Chang Stanley , Iranmanesh Reza
Published: October 2010

Background and Objective:

To describe the development or progression of subfoveal fibrosis after anti-vascular endothelial growth factor (VEGF) therapy in the absence of significant subfoveal hemorrhage in neovascular age-related macular degeneration.

Patients and Methods:

Retrospective case series.

Results:

Seven eyes of seven patients with neovascular age-related macular degeneration developed subfoveal fibrosis after anti-VEGF therapy in the absence of significant subfoveal hemorrhage. Five of seven patients experienced vision loss of 0.3 logarithm of the minimum angle of resolution units or greater.

Conclusion:

Subfoveal fibrosis may develop or progress in neovascular age-related macular degeneration despite the absence of significant subfoveal hemorrhage and treatment with anti-VEGF. Development of anti-fibrotic therapeutics may be beneficial in reducing the incidence of subretinal fibrosis.
A Machine Vision Method for Automated Alignment of Fundus Imaging Systems
Authors: Moscaritolo Michele , Knezevich Frederick P. , Zimmer-Galler Ingrid , Jampel Henry , Zeimer Ran
Published: October 2010

Background and Objective:

To report a method to track the pupil in three axes simultaneously prior to imaging the fundus.

Patients and Methods:

The system is based on parallax optical alignment to detect the center of the pupil. The system consists of two cameras acquiring pupil images from two distinct directions and an operator-supervised algorithm to derive the coordinates of the pupil center and output of commands to drive a three-axes computer-controlled stage. The system was tested in a cohort of 45 individuals 61 ± 15 years of age, 26 with and 19 without glaucoma. The tracking was performed without pharmacologic pupil dilation.

Results:

The variability of the pupil center determination (assessed by the standard deviation) was ± 0.19 and ± 0.33 mm for the vertical and horizontal directions, respectively. The processing time of the algorithm was 0.75 msec. The tracking converged to within a preset tolerance of ± 0.5 mm in 45 of the 45 eyes.

Conclusion:

Image acquisition and processing of pupil images can be used to align fundus imaging systems rapidly, accurately, and with minimal operator intervention.
Optical Coherence Tomography/Scanning Laser Ophthalmoscopy Imaging of Optic Nerve Head Drusen
Authors: Patel Nandesh N. , Shulman Julia P. , Chin Kimberly J. , Finger Paul T.
Published: October 2010

Background and Objective:

To evaluate optical coherence tomography/scanning laser ophthalmoscopy (OCT/SLO) imaging for optic nerve head drusen (ONHD).

Patients and Methods:

Nine consecutive eyes with ONHD were imaged. Each underwent visual field testing, 20-MHz B-scan ultrasonography, photography, and OCT/SLO imaging of the nerve head. Similar evaluation was performed on 12 matched, disease-free control eyes for comparison.

Results:

OCT/SLO imaging of ONHD demonstrated lucencies (100%), variable amounts of displacement, and thickening of the overlying nerve fiber layer, as well as disorganization of the adjacent retinal pigment epithelium (44%). Optic nerve head topography was measured (using horizontal and vertical electronic calipers). Mean disc diameter was 1.81 mm (range: 1.49 to 2.12 mm). All ONHD demonstrated anterior displacement of the base of the optic nerve cup (shallowing) compared to controls. The cup base was a mean +0.32 mm anterior to the retinal pigment epithelium for ONHD versus −0.23 mm for normal controls.

Conclusion:

OCT/SLO revealed unique and clinically helpful views of ONHD.
Stanford University Network for Diagnosis of Retinopathy of Prematurity (SUNDROP): 36-Month Experience with Telemedicine Screening
Authors: Silva Ruwan A. , Murakami Yohko , Lad Eleonora M. , Moshfeghi Darius M.
Published: October 2010

Background and Objective:

To report the 36-month experience of the Stanford University Network for Diagnosis of Retinopathy of Prematurity (SUNDROP) telemedicine initiative.

Patients and Methods:

Retrospective analysis of the SUNDROP archival data between December 1, 2005, and November 30, 2008, to evaluate this diagnostic technology for retinopathy of prematurity (ROP) screening. A total of 230 consecutively enrolled infants meeting ROP examination criteria were screened with the Ret-Cam II (Clarity Medical Systems, Pleasanton, CA) and evaluated by the SUNDROP reading center at Stanford University. Outcomes included referral-warranted ROP, treatment-warranted ROP, and anatomic outcomes.

Results:

In the initial 36-month period, the SUNDROP telemedicine initiative did not miss any treatment-warranted ROP. A total of 230 infants (460 eyes) were imaged, resulting in 1,059 examinations and 10,921 unique images. Ten infants were identified with referral-warranted ROP: nine underwent laser photocoagulation and one regressed spontaneously. The sensitivity was 100% with a specificity of 99.5%. No patient progressed to retinal detachment or other adverse outcomes.

Conclusion:

The SUNDROP telemedicine screening initiative for ROP has demonstrated high reliability for identification of treatment-warranted disease. All cases of treatment-warranted disease were captured. There were no adverse outcomes.
Conversion to Deep Anterior Lamellar Keratoplasty (DALK): Learning Curve with Big-Bubble Technique
Authors: Ünal Mustafa , Bilgin Burak , Yucel Iclal , Akar Yusuf , Apaydin Cemil
Published: October 2010

Background and Objective:

To report the perioperative complications and clinical outcomes of 50 deep anterior lamellar keratoplasty (DALK) cases.

Patients and Methods:

Fifty eyes of 50 patients with pathologies involving the corneal stroma and sparing the Descemet’s membrane and endothelium were included consecutively in this prospective, noncomparative interventional case series study. DALK was performed using the big-bubble technique.

Results:

The most frequent indication for DALK surgery was keratoconus (26 eyes), followed by corneal dystrophy (10 eyes) and superficial corneal scar (14 eyes). The average follow-up period was 12.0 ± 3.9 months. DALK was completed in 41 cases (82%). A big bubble was achieved successfully in 37 cases (74%). Descemet’s membrane perforations occurred in 14 (28%) eyes, 8 of which were macroperforation and necessitated conversion to penetrating keratoplasty. Complications tended to decrease throughout the study. Postoperative best-corrected visual acuity of 0.5 or better was present in 30 of 41 (73.2%) eyes that underwent DALK. There was no episode of graft rejection.

Conclusion:

DALK big-bubble technique may be a valuable procedure during transition from penetrating keratoplasty to anterior lamellar keratoplasty. It provided acceptable visual and refractive outcome even during the learning period in a variety of corneal lesions.
Surgical Treatment of a Patient with Human Tail and Multiple Abnormalities of the Spinal Cord and Column
Authors: Cai Chunquan , Shi Ouyan , Shen Changhong
Published: October 2010

The dorsal cutaneous appendage, or so-called human tail, is often considered to be a cutaneous marker of underlying occult dysraphism. The authors present a case of human tail occurring in a 9-month-old infant with multiple abnormalities of the spinal cord and spine. Examination revealed unremarkable except for a caudal appendage and a dark pigmentation area in the low back. Neuroradiological scans revealed cleft vertebrae and bifid ribbon, split cord malformations, block vertebrae, and hemivertebra. Surgical excision of the tail and untethering the spinal cord by removal of the septum were performed. The infant had an uneventful postoperative period and was unchanged neurologically for 18 months of followup. To our knowledge, no similar case reports exist in the literature. The specific features in a rare case with a human tail treated surgically are discussed in light of the available literature.
Photocarcinogenicity of selected topically applied dermatological drugs: calcineurin inhibitors, corticosteroids, and vitamin D analogs
Authors: Lerche Catharina Margrethe , Wulf Hans Christian
Published: October 2010

Topical therapies constitute the mainstay of dermatological treatments for skin disorders, such as atopic dermatitis, contact dermatitis, psoriasis, or acne. Since some of these diseases are often chronic, treatment duration may last for years and may even last the patient’s entire lifetime. Obviously, such long-term therapy may raise safety concerns, which also include the potential photocarcinogenic effect. Most patients are exposed to ultraviolet radiation (UVR) during leisure, work, vacations, or in tanning beds. Additionally, the patients may receive UVR via UVB phototherapy or psoralens plus UVA radiation (PUVA). The use of immunosuppressant’s, such as corticosteroids and calcineurin inhibitors, has markedly increased. Patients with skin diseases have benefited from both systemic and topical treatment of both new and established drugs. The issue of a black box warning by the US Food and Drug Administration has increased concerns about photocarcinogenesis, which raises the question: “Are these drugs safe?” This review focuses on the mechanism of action and photocarcinogenic potential of commonly used topical treatments, such as corticosteroids, calcineurin inhibitors, and vitamin D analogs.
Detection of mental disorders with the Patient Health Questionnaire in primary care settings in Nigeria
Authors: Ogunsemi Olawale O. , Oluwole Francis A. , Abasiubong Festus , Erinfolami Adebayo R. , Amoran Olufemi E. , Ariba Adekunle J. , Alebiosu Christopher O. , Olatawura Michael O.
Published: October 2010

Mental disorders lead to difficulties in social, occupational and marital relations. Failure to detect mental disorder denies patients potentially effective treatment. This study aimed to assess the prevalence and nature of mental disorders at the primary care settings and the recognition of these disorders by the attending physicians. Over a period of eight weeks, consecutive and consenting patients who attended three randomly selected primary health care facilities in Sagamu Local Government Area of Ogun state were recruited and administered a questionnaire that included a socio-demographic section and Patient Health Questionnaire (PHQ). A total of 412 subjects took part in the study. Subject age ranged from 18-90 years with a mean age of 52.50±21.08 years. One hundred and seventy-six (42.7%) of the subjects were males. A total of 120 (29.1%) of the subjects had depressive disorder, 100 (24.3%) had anxiety disorder, 196 (47.6%) somatoform disorder and 104 (25.2%) met the criteria for an alcohol related problem. The PHC physicians were only able to diagnose disorders relating to mental health in 52 (12.6%) of the subjects. Health and work situations accounted for more than three-quarters of the causes of stress experienced by the subjects. We conclude that there is a high prevalence of mental disorders among patients seen in primary care settings and that a significant proportion of them are not recognized by the primary care physicians. Stress relating to health, work and financial problems is common among primary health care attendees. Physicians in primary health care should be alert to the possibility and the impact of undetected psychiatric morbidity.
ADHD-hyperactive/impulsive subtype in adults
Authors: Gibbins Christopher , Weiss Margaret D. , Goodman David W. , Hodgkins Paul S. , Landgraf Jeanne M. , Faraone Stephen V.
Published: October 2010

This is the first study to evaluate ADHD-hyperactive/impulsive subtype in a large clinical sample of adults with ADHD. The Quality of Life, Effectiveness, Safety and Tolerability (QuEST) study included 725 adults who received clinician diagnoses of any ADHD sub-type. Cross-sectional baseline data from 691 patients diagnosed with the hyperactive/impulsive (HI), inattentive (IA) and combined sub-types were used to compare the groups on the clinician administered ADHD-RS, clinical features and health-related quality of life. A consistent pattern of differences was found between the ADHD-I and combined subtypes, with the combined subtype being more likely to be diagnosed in childhood, more severe symptom severity and lower HRQL. Twenty-three patients out of the total sample of 691 patients (3%) received a clinician diagnosis of ADHD -hyperactive/impulsive subtype. Review of the ratings on the ADHD-RS-IV demonstrated, however, that this group had ratings of inattention comparable to the inattentive group. There were no significant differences found between the ADHD-HI and the other subtypes in symptom severity, functioning or quality of life. The hyperactive/impulsive subtype group identified by clinicians in this study was not significantly different from the rest of the sample. By contrast, significant differences were found between the inattentive and combined types. This suggests that in adults, hyperactivity declines and inattention remains significant, making the hyperactive/impulsive sub-type as defined by childhood criteria a very rare condition and raising questions as to the validity of the HI subtype in adults.
Phenotypical variability of post-partum reversible cerebral vasoconstriction syndrome
Authors: Matosevic Benjamin , Furtner Martin , Knoflach Michael , Schmidauer Christoph , Wille Georg , Gotwald Thaddaeus , Kiechl Stefan , Willeit Johann
Published: October 2010

Reversible cerebral vasoconstriction syndrome is recognized increasingly as a complication of the postpartum period. Our series of four cases illustrates its phenotypical variability, summarizes the diagnostic work-up, and outlines potential treatment strategies for this usually benign but sometimes disabling and life-threatening disease.
Correlation of cumulative corticosteroid treatment with magnetic resonance imaging assessment of avascular femoral head necrosis in patients with multiple sclerosis
Authors: Kale Nilufer , Agaoglu Jale , Tanik Osman
Published: October 2010

Increased risk of osteoporosis, fractures, and avascular necrosis (AVN) has been suggested in multiple sclerosis (MS). Patients with MS are often exposed to corticosteroid treatment (CST) during the disease course and conflicting reports exist regarding complications of CST. Our study aims to investigate the association between cumulative doses of CST and radiographic evaluation of AVN of the femoral head in MS. Twenty-six MS patients (mean age, 38.4±10 yr) were enrolled and prospectively evaluated for AVN by magnetic resonance imaging (MRI). The mean disease duration was 11.5±8.5 years and mean expanded disability status scale (EDSS) score was 3±2. The cumulative dosage of CST varied between 20 g and 60 g; patients were grouped into two categories: 1) CST between 20-40 g, 17 (65%) patients; 2) CST ≥40 g; 9 (35%) patients. The relationship between cumulative CST dosage and MRI diagnosis of AVN was stat­istically insignificant (P>0.9). Clarification of the cumulative effect of CST in the development of AVN is of great importance for future long-term steroid treatment strategies.
Predictive Value of Developmental Testing in the Second Year for Cognitive Development at Five Years of Age
Authors: Sutcliffe Alastair G. , Soo Audrey , Barnes Jacqueline
Published: October 2010

There is mixed evidence about the predictive validity of the Griffiths mental developmental scales. This study aimed to assess the predictive value of developmental assessments of children in their second year using the Griffiths mental development scales for neuro-developmental status at five years using the Wechsler preschool and primary scale of intelligence, revised (WPPSI-R). In a longitudinal study 253 children were assessed in their second year of life using the Griffiths scales and again at five years using the WPPSI-R. The scores were compared and the predictability of the WPPSI-R outcome on the basis of Griffiths scores was assessed. The WPPSI-R full scale IQ and the performance IQ at age five could be predicted moderately by the Griffiths general quotient (GQ) and by the personal/social scale. The Griffiths GQ was not a significant predictor of verbal IQ at age 5. The Griffiths performance scale predicted subsequent WPPSI-R performance IQ, and marginally the Full Scale IQ. For the early identification of children at risk for language delay, the Griffiths scales may not be suitable. However, a shortened form would be useful to predict overall cognitive development from the second year to school entry, focussing on the personal-social and performance scales.
Non-surgical treatment of primary female urethral cancer
Authors: Libby Bruce , Chao David , Schneider Bernard F
Published: October 2010

Primary carcinomas of the female urethra are extremely rare, with an annual incidence of less than ten in one million. Currently, there is no consensus regarding management of this malignancy. However, there have been several case reports demonstrating the efficacy of chemoradiation in the treatment of female urethral cancer. In this report we present two cases of female primary urethral adenocarcinoma that were treated by concomitant chemotherapy and external beam radiotherapy, followed by interstitial brachytherapy.
Comparison of in situ LAI retrieval of two instruments of four mature agricultural crops
Authors: White H P , Young E R
Published: October 2010

In contribution to the land-surface parameter-validation efforts of the Working Group on Calibration and Validation (WGCV) under the Committee on Earth Observation Satellites (CEOS), the Canada Centre for Remote Sensing - Natural Resources Canada participated in
a multinational field exercise led by the CEOS Land Product Validation (LPV) subgroup. The purpose of this exercise was to compare existing and commonly used field instruments and methodologies for determining effective leaf-area index (Le) for the purpose of integrating field Le information to
satellite-based Earth Observation (EO) imagery to provide geospatialmaps of Le over a large area. An investigation of integrating these field measurements to satellite imagery will be the focus of a separate report.

This study included (but was not limited to) comparisons between using hemispheric upward and downward photography and using the LICOR LAI-2000 and related methodology as tools for determining Le during an agricultural field campaign. Where possible, measurements were obtained subject to both direct
(near local solar noon) and diffuse (just after sunrise or just before sunset) illumination. Crop types evaluated included corn, sorghum, soybean, and alfalfa, all mature. All sites were located at the Manfredi Instituto Nacional de Tecnología Agropecuaria (INTA) station in the Cordoba province,
Argentina. The field exercise was carried out in early March, 2005.
Compensation crisis related to the onsite adequacy evaluation during FNA procedures-Urgent proactive input from cytopathology community is critical to establish appropriate reimbursement for CPT code 88172 (or its new counterpart if introduced in the future)
Authors: Dhillon Inderpreet , Pitman Martha B. , DeMay Richard M. , Archuletta Pamela , Shidham Vinod B.
Published: October 2010

The confusion centered around appropriate use of the CPT billing code 88172 is addressed in the commentary from the Economic and Government Affairs Committee of the American Society of Cytopathology (ASC) who have written a timely commentary in this issue of Cytojournal, “Adequate Reimbursement is Crucial to Support Cost-Effective Rapid Onsite Cytopathology Evaluations”. Currently, lack of standardized use within and between pathology departments is stirring unhealthy practices of denying reimbursements for this critical and legitimate cytopathology service. This editorial discusses the important concerns raised in this commentary and recommends immediate corrective action. (See also Al-Abbadi MA, et al. Adequate reimbursement is crucial to support cost-effective rapid on-site cytopathology evaluations. CytoJournal 2010;7:22)
Thermodynamics of climate change: generalized sensitivities
Authors: Lucarini V. , Fraedrich K. , Lunkeit F.
Published: October 2010

Abstract. Using a recent theoretical approach, we study how global warming impacts the thermodynamics of the climate system by performing experiments with a simplified yet Earth-like climate model. The intensity of the Lorenz energy cycle, the Carnot efficiency, the material entropy production, and the degree of irreversibility of the system change monotonically with the CO2 concentration. Moreover, these quantities feature an approximately linear behaviour with respect to the logarithm of the CO2 concentration in a relatively wide range. These generalized sensitivities suggest that the climate becomes less efficient, more irreversible, and features higher entropy production as it becomes warmer, with changes in the latent heat fluxes playing a predominant role. These results may be of help for explaining recent findings obtained with state of the art climate models regarding how increases in CO2 concentration impact the vertical stratification of the tropical and extratropical atmosphere and the position of the storm tracks.
Nitrogen oxides and PAN in plumes from boreal fires during ARCTAS-B and their impact on ozone: an integrated analysis of aircraft and satellite observations
Authors: Alvarado M. J. , Logan J. A. , Mao J. , Apel E. , Riemer D. , Blake D. , Cohen R. C. , Min K.-E. , Perring A. E. , Browne E. C. , Wooldridge P. J. , Diskin G. S. , Sachse G. W. , Fuelberg H. , Sessions W. R. , Harrigan D. L. , Huey G. , Liao J. , Case-Hanks A. , Jimenez J. L. , Cubison M. J. , Vay S. A. , Weinheimer A. J. , Knapp D. J. , Montzka D. D. , Flocke F. M. , Pollack I. B. , Wennberg P. O. , Kurten A. , Crounse J. , Clair J. M. St. , Wisthaler A. , Mikoviny T. , Yantosca R. M. , Carouge C. C. , Le Sager P.
Published: October 2010

Abstract. We determine enhancement ratios for NOx, PAN, and other NOy species from boreal biomass burning using aircraft data obtained during the ARCTAS-B campaign and examine the impact of these emissions on tropospheric ozone in the Arctic. We find an initial emission factor for NOx of 1.06 g NO per kg dry matter (DM) burned, much lower than previous observations of boreal plumes, and also one third the value recommended for extratropical fires. Our analysis provides the first observational confirmation of rapid PAN formation in a boreal smoke plume, with 40% of the initial NOx emissions being converted to PAN in the first few hours after emission. We find little clear evidence for ozone formation in the boreal smoke plumes during ARCTAS-B in either aircraft or satellite observations, or in model simulations. Only a third of the smoke plumes observed by the NASA DC8 showed a correlation between ozone and CO, and ozone was depleted in the plumes as often as it was enhanced. Special observations from the Tropospheric Emission Spectrometer (TES) also show little evidence for enhanced ozone in boreal smoke plumes between 15 June and 15 July 2008. Of the 22 plumes observed by TES, only 4 showed ozone increasing within the smoke plumes, and even in those cases it was unclear that the increase was caused by fire emissions. Using the GEOS-Chem atmospheric chemistry model, we show that boreal fires during ARCTAS-B had little impact on the median ozone profile measured over Canada, and had little impact on ozone within the smoke plumes observed by TES.
Sensitivity of stratospheric Bry to uncertainties in very short lived substance emissions and atmospheric transport
Authors: Schofield R. , Fueglistaler S. , Wohltmann I. , Rex M.
Published: October 2010

Abstract. We evaluate the sensitivity of Bry entering the stratosphere with a simplified model that allows calculations over a wide parameter range for parameters that are currently poorly quantified. The model examines the transport process uncertainties in the source concentrations and lifetimes, in the convective parameterization and in the inorganic bromine washout process due to dehydration. Source concentrations at the surface and lifetimes were found to have a slight effect on the resultant Bry (~2 ppt), however this was highly dependent upon, with increasing significance, the degree of efficiency of convective delivery. Efficiency of convective delivery of boundary layer (BL) air to the tropical tropopause layer (TTL) along with washout at the CPT were found to significantly affect Bry at 400 K – altering the delivered Bry by 3.3 ppt and 2.9 ppt, respectively. We find that the results critically depend on free tropospheric Bry concentrations due to dilution of convective updrafts, and the processes that control free tropospheric Bry require further attention.
The 2009–2010 Arctic polar stratospheric cloud season: a CALIPSO perspective
Authors: Pitts M. C. , Poole L. R. , Dörnbrack A. , Thomason L. W.
Published: October 2010

Abstract. Spaceborne lidar measurements from CALIPSO (Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observations) are used to provide a vortex-wide perspective of the 2009–2010 Arctic polar stratospheric cloud (PSC) season to complement more focused measurements from the European Union RECONCILE (reconciliation of essential process parameters for an enhanced predictability of Arctic stratospheric ozone loss and its climate interactions) field campaign. The 2009–2010 Arctic winter was unusually cold at stratospheric levels, especially from mid-December 2009 until the end of January 2010, and was one of only a few winters from the past 52 years with synoptic-scale regions of temperatures below the frost point. More PSCs were observed by CALIPSO during the 2009–2010 Arctic winter than in the previous three Arctic seasons combined. In particular, there were significantly more observations of high number density nitric acid trihydrate (NAT) mixtures (referred to as Mix 2-enh) and ice PSCs. We found that the 2009–2010 season could roughly be divided into four periods with distinctly different PSC optical characteristics. The early season (15–30 December 2009) was characterized by patchy, tenuous PSCs, primarily low number density liquid/NAT mixtures. The second phase of the season (31 December 2009–14 January 2010) was characterized by frequent mountain wave ice clouds that nucleated widespread NAT particles throughout the vortex, including Mix 2-enh. The third phase of the season (15–21 January 2010) was characterized by synoptic-scale temperatures below the frost point which led to a rare outbreak of widespread ice clouds. The fourth phase of the season (22–28 January) was characterized by a major stratospheric warming that distorted the vortex, displacing the cold pool from the vortex center. This final phase was dominated by supercooled ternary solution (STS) PSCs, although NAT particles may have been present in low number densities, but were masked by the more abundant STS droplets at colder temperatures. We also found distinct variations in the relative proportion of PSCs in each composition class with altitude over the course of the 2009–2010 Arctic season. Lower number density liquid/NAT mixtures were most frequently observed in the lower altitude regions of the clouds (below ∼18–20 km), which is consistent with CALIPSO observations in the Antarctic. Higher number density liquid/NAT mixtures, especially Mix 2-enh, were most frequently observed at altitudes above 18–20 km, primarily downstream of wave ice clouds. This pattern is consistent with the conceptual model whereby low number density, large NAT particles are precipitated from higher number density NAT clouds (i.e. mother clouds) that are nucleated downstream of mountain wave ice clouds.
Assessment of BSRN radiation records for the computation of monthly means
Authors: Roesch A. , Wild M. , Ohmura A. , Dutton E. G. , Long C. N. , Zhang T.
Published: October 2010

Abstract. The integrity of the Baseline Surface Radiation Network (BSRN) radiation monthly averages are assessed by investigating the impact on monthly means due to the frequency of data gaps caused by missing or discarded high time resolution data. The monthly statistics, especially means, are considered to be important and useful values for climate research, model performance evaluations and for assessing the quality of satellite (time- and space-averaged) data products. The study investigates the spread in different algorithms that have been applied for the computation of monthly means from 1-min values. The paper reveals that the computation of monthly means from 1-min observations distinctly depends on the method utilized to account for the missing data. The intra-method difference generally increases with an increasing fraction of missing data. We found that a substantial fraction of the radiation fluxes observed at BSRN sites is either missing or flagged as questionable. The percentage of missing data is 4.4%, 13.0%, and 6.5% for global radiation, direct shortwave radiation, and downwelling longwave radiation, respectively. Most flagged data in the shortwave are due to nighttime instrumental noise and can reasonably be set to zero after correcting for thermal offsets in the daytime data. The study demonstrates that the handling of flagged data clearly impacts on monthly mean estimates obtained with different methods. We showed that the spread of monthly shortwave fluxes is generally clearly higher than for downwelling longwave radiation. Overall, BSRN observations provide sufficient accuracy and completeness for reliable estimates of monthly mean values. However, the value of future data could be further increased by reducing the frequency of data gaps and the number of outliers. It is shown that two independent methods for accounting for the diurnal and seasonal variations in the missing data permit consistent monthly means to within less than one Wm−2 in most cases. The authors suggest using a standardized method for the computation of monthly means which addresses diurnal variations in the missing data in order to avoid a mismatch of future published monthly mean radiation fluxes from BSRN.
Percolation properties of 3-D multiscale pore networks: how connectivity controls soil filtration processes
Authors: Perrier E. M. A. , Bird N. R. A. , Rieutord T. B.
Published: October 2010

Abstract. Quantifying the connectivity of pore networks is a key issue not only for modelling fluid flow and solute transport in porous media but also for assessing the ability of soil ecosystems to filter bacteria, viruses and any type of living microorganisms as well inert particles which pose a contamination risk. Straining is the main mechanical component of filtration processes: it is due to size effects, when a given soil retains a conveyed entity larger than the pores through which it is attempting to pass. We postulate that the range of sizes of entities which can be trapped inside soils has to be associated with the large range of scales involved in natural soil structures and that information on the pore size distribution has to be complemented by information on a critical filtration size (CFS) delimiting the transition between percolating and non percolating regimes in multiscale pore networks. We show that the mass fractal dimensions which are classically used in soil science to quantify scaling laws in observed pore size distributions can also be used to build 3-D multiscale models of pore networks exhibiting such a critical transition. We extend to the 3-D case a new theoretical approach recently developed to address the connectivity of 2-D fractal networks (Bird and Perrier, 2009). Theoretical arguments based on renormalisation functions provide insight into multi-scale connectivity and a first estimation of CFS. Numerical experiments on 3-D prefractal media confirm the qualitative theory. These results open the way towards a new methodology to estimate soil filtration efficiency from the construction of soil structural models to be calibrated on available multiscale data.
Mass balance of the Greenland ice sheet – a study of ICESat data, surface density and firn compaction modelling
Authors: Sørensen L. S. , Simonsen S. B. , Nielsen K. , Lucas-Picher P. , Spada G. , Adalgeirsdottir G. , Forsberg R. , Hvidberg C. S.
Published: October 2010

Abstract. ICESat has provided surface elevation measurements of the ice sheets since the launch in January 2003, resulting in a unique data set for monitoring the changes of the cryosphere. Here we present a novel method for determining the mass balance of the Greenland ice sheet derived from ICESat altimetry data. Four different methods for deriving the elevation changes from the ICESat altimetry data set are used. This multi method approach gives an understanding of the complexity associated with deriving elevation changes from the ICESat altimetry data set. The altimetry can not stand alone in estimating the mass balance of the Greenland ice sheet. We find firn dynamics and surface densities to be important factors in deriving the mass loss from remote sensing altimetry. The volume change derived from ICESat data is corrected for firn compaction, vertical bedrock movement and an intercampaign elevation bias in the ICESat data. Subsequently, the corrected volume change is converted into mass change by surface density modelling. The firn compaction and density models are driven by a dynamically downscaled simulation of the HIRHAM5 regional climate model using ERA-Interim reanalysis lateral boundary conditions. We find an annual mass loss of the Greenland ice sheet of 210 ± 21 Gt yr−1 in the period from October 2003 to March 2008. This result is in good agreement with other studies of the Greenland ice sheet mass balance, based on different remote sensing techniques.
Diaphragmatic Hernia after Laparoscopic Esophagomyotomy for Esophageal Achalasia in Pregnancy
Authors: Khandelwal Meena , Krueger Chad
Published: October 2010

Background. The optimal treatment for management of esophageal achalasia in pregnancy is controversial. Little information exists about pregnancy outcome after successful myotomy. Case. Achalasia in pregnancy was diagnosed when a patient presented with pneumomediastinum from microrupture of the overdistended esophagus. An attempt at surgical correction failed due to the development of aspiration pneumonia with general anesthesia. Conservative medical therapy was undertaken, but fetal growth restriction developed. The patient underwent interval surgical correction, but subsequent pregnancy 6 months later was complicated by acute diaphragmatic hernia necessitating preterm delivery. Conclusion. Prior to surgery in pregnancy, emptying the dilated esophagus via nasoesophageal tube suctioning maybe warranted to avoid aspiration. Women, despite having undergone successful myotomy, should be counseled on the risks of pregnancy and to avoid pregnancy for at least 1 year thereafter.
Properties, Structure and Reactivity of Cobaloximes
Authors: Dreos Renata , Geremia Silvano , Randaccio Lucio , Siega Patrizia
Published: October 2010

Cobaloximes are bis(dioximate) cobalt complexes with the metal ion having different oxidation and coordination numbers. The most common cobaloximes are octahedral complexes of formula
trans
‐LCo(dioxH)
2
X, where dioxH is the dioxime monoanion, L a neutral ligand and X a monoanionic ligand. Due to the possibility to obtain and characterize Co
III
compounds with a large variety of dioxH, X and L ligands, they constitute a unique system of octahedral cobalt complexes. The availability of a large number of complexes has allowed to rationalize their structural properties in solution and in the solid state and their reactivity in term of
cis
and
trans
influences and effects. These studies were also prompted by the widely accepted proposal that cobaloximes are model systems of cobalamins, the cofactors of B
12
enzymes. Cobaloximes behave as functional models of cobalamin also towards the reductive dechlorination of chloroethylenes. Alkylcobaloximes have catalytic applications in organic chemistry and in polymerization reactions. Recently, inorganic cobaloximes have been studied as catalysts for the hydrogen evolution in the presence of a proton source. All these aspects of cobaloximes and of some related compounds, such as dioximate chlatrochelates, are presented in this chapter.