bluuebunny/crossref_metadata_2025 huggingface dataset:
Etiology, clinical presentation, diagnosis and management of lower gastrointestinal bleed in a Tertiary Care Hospital in India: A retro-prospective study
Authors: Dar Imtiyaz Ahmad , Dar Waseem Raja , Khan Mushtaq Ahmad , Kasana Basharat Ahmad , Sofi Najeeb Ullah , Hussain Moomin , Arshad Faheem , Wani Manzoor Ahmad , Latief Muzamil , Sodhi Jaswinder Singh
Published: September 2015

Introduction: Lower gastrointestinal bleeding (LGIB) is one of the leading causes for hospital admissions in gastroenterology wards all over the world. Patients usually present with hematochezia or bloody diarrhea. Colonoscopy is usually the initial diagnostic intervention followed by other more sophisticated tests. Bleeding may stop spontaneously, but evaluation is important because patients may harbor a sinister lesion like cancer. Aim of the Study: To determine the various etiologies, clinical presentations, a diagnostic test used and treatments received by LGIB patients admitted in our department. Materials and Methods: A total of 300 cases were studied which included 180 retrospective cases and 120 prospective cases. For retrospective cases, all the information was obtained by analyzing their case records while as prospective patients were managed as per a predefined protocol and details of various investigations and treatments documented. Results: Most commonly affected was elderly population (>60 years), constituting 40% (120/300) of studied population. Males constituted 59% (177/300) and females 41% (123/300). The most common clinical presentation of LGIB in our patients was hematochezia (63.6%, 191/300). Growth/polyp was the most common finding on colonoscopic examination seen in 29.3% (n = 88) patients. Inflammatory lesions were seen in 77 out of 239 (25.7%) patients. Wireless capsule endoscopy was positive in 13 out of 24 patients (54%). Computed tomography (CT) enterography showed positive results in 6 out of 25 (24%) cases. Red blood cell scan was done in seven patients while as CT angiography in in four patients. Therapeutic endoscopy was successful in 115 out of 239 patients with positive colonoscopy, polypectomy was the commonest procedure performed. Medical management was carried out in 34.6% patients. Surgical treatment was offered to 21% patients. Conclusion: Colonoscopy is the initial and most common investigation used in the evaluation of GI bleed. A polyp is the most common diagnosis while as polypectomy the most common therapeutic procedure.
Yield of colonoscopy with special reference to lower gastrointestinal bleeding in a tertiary referral center in Eastern India
Authors: Ray Gautam
Published: September 2015

Background: Little data exist on the yield of colonoscopy in its different indications, especially gastrointestinal (GI) bleeding. Furthermore, there are no formal guidelines regarding the timing of its performance in the work up for lower GI bleeding. Methods: In a retrospective study, spanning from January 2007 to December 2013, the clinical data of all the patients undergoing colonoscopy were retrieved from the hospital records including the predominant symptom which mandated colonoscopy and results of the other tests done before colonoscopy including upper GI endoscopy (esophagogastroduodenoscopy [EGD]). The type of GI bleed (overt or occult) along with the presence or absence of iron deficiency anemia (IDA) was noted. The yield of EGD in the corresponding years in those having a presentation with lower GI bleed and/or IDA was also noted for comparison. Results: Overall yield of colonoscopy was low (25.7%) like for all its indications except lower GI bleed where its yield was highest (45.2%). 81.2% of the cases with a diagnosis presented with lower GI bleed, highest for colon cancer (90%), and polyps (86.1%). Cases of occult bleed more often had a positive diagnosis than overt bleed (P = 0.02). EGD yielded positive findings in more cases (43.2%, P = 0.00) than colonoscopy (except piles). Colonic cancers and polyps were presented with hematochezia when compared to gastric cancer which presented more often with occult bleed and other clinical symptoms. Conclusion: EGD should be done first in lower GI bleeding to exclude upper GI source and select subsequent colonoscopy. For hematochezia and occult bleed, colonoscopy is important whether IDA is present or not.
Cytomegalovirus infection in gastrointestinal tract: A case series of three patients and review of literature
Authors: Ranjan Piyush , Gupta Varun , Goyal Mohan , Dhawan Shashi , Gupta Pallav , Kumar Mandhir , Sachdeva Munish
Published: September 2015

Cytomegalovirus disease can involve any site of gastrointestinal tract from oral cavity to rectum. CMV disease most frequently occurs in patients’ with immune deficiency, such as the acquired immunodeficiency syndrome, after organ transplantation, after cancer chemotherapy and in patients on immunosuppressive medications. The number of patients with immune deficiency has increased in recent years and has lead to a substantial increase in incidence of opportunistic CMV virus. Gastrointestinal CMV infection has also been reported in immunocompetent adults. Symptoms and signs depend on part of the gastrointestinal tract involved. Diagnosis depends either on a positive mucosal biopsy or by serology, quantitative PCR or CMV antigenemia. We report three cases of CMV infection in patients with three different underlying conditions and discuss the clinical features, diagnostic approach and treatment. All patients had positive serology with high viral load on PCR. Histology with immunohistochemistry was positive for CMV in two of the three cases. Ganciclovir response was seen in all patients in respect to clinical improvement, endoscopic resolution of lesions and clearing of the virus load.
Endoscopic ultrasound guided emergency coil and glue for actively bleeding duodenal varix after failed endoscopy
Authors: Choudhary Narendra S. , Rai Rahul , Rajesh Puri , Randhir Sud
Published: September 2015

Management of ectopic variceal bleed may be difficult at times due to anatomical location or presence of collaterals. We present a case of an elderly cirrhotic male with acute upper gastrointestinal bleed due to a large duodenal varix successfully managed by endoscopic ultrasound guided coil placement along with glue (N-butyl-2-cyanoacrylate) injection.
The role of tranexamic acid in prevention of hemorrhage in major spinal surgeries
Authors: Seddighi Afsoun , Nikouei Amir , Seddighi Amir , Zali Alireza , Tabatabaei Seyed , Yourdkhani Fatemeh , Naimian Shoeib , Razavian Iman
Published: September 2015

Background: Blood loss that necessitates blood transfusion is one of the most frequent complications of major spinal surgeries. This study has been designed to evaluate the efficacy and safety of prophylactic tranexamic acid (TA) in decreasing perioperative blood loss. Materials and Methods: From January to August 2011, all the patients who needed major spinal surgeries and aged between 18 and 60-year-old were divided into two groups randomly, the experimental group received 10 mg/kg of TA 20 min after inducing the anesthesia as loading dose followed by 0.5 mg/kg/h until skin closure and the control group received equal amounts of normal saline as placebo. Intraoperative blood loss was recorded by estimating blood with the suction tube plus the number of bloody gasses. The amounts compared between the 2 groups and analyzed. Results: Forty patients were enrolled in this study in the first group intraoperative, the 1st and 2nd postoperative days, the mean blood loss were 574 ml, 80.5 ml, and 669.5 ml while in the second group were 797 ml, 124 ml, and 921.5 ml. Conclusion: TA seems to be safe and can be considered in spinal surgeries with significant excepted blood loss especially in female patients and instrumental procedures. We suggest further studies on TAs efficacy and safety in larger scales.
Perimesencephalic subarachnoid hemorrhage: Etiologies, risk factors, and necessity of the second angiogram
Authors: Sahin Soner , Delen Emre , Korfali Ender
Published: September 2015

Aim: In this paper, we aim to present our experience with a series of patients with PMSAH. In addition, the clinical course of perimesencephalic subarachnoid hemorrgade (PMSAH) is discussed with an evaluation of etiologies, risk factors, and the necessity for a second angiogram on follow-up. Materials and Methods: The data for this study were obtained retrospectively from patients who were treated at the Uludag University, School of Medicine, Department of Neurosurgery, Division of Neurovascular Surgery's clinic with a diagnosis of PMSAH between January 1980 and March 2002. Results: We identified a total of 24 patients, 12 male. The mean age at the time of hemorrhage was 53 ± 12 years. In all patients, the onset was typical with a sudden severe headache. Five of the patients were Hunt-Hess Grade I, 15 were Grade II, and 4 were Grade III. The initial 4-vessel angiography was normal in 23 cases. Twenty-two had a second 4-vessel angiography, and all were normal. We observed acute hydrocephalus in 5 patients (20.8%). We did not observe re-bleeding during the follow-up of our patients. Conclusion: Patients with PMSAH have a particularly excellent outcome, and there is no need to evaluate these patients with repeat angiography.
A novel technique to practice using a high-speed burr for spinal anterior cervical discectomy and fusion
Authors: Baliga Santosh , Frost Andrew
Published: September 2015

Background: Anterior cervical discectomy and fusion has been a successful procedure in terms of patient satisfaction in the management of cervical myelopathy and radiculopathy. The procedure involves an anterior approach to the cervical vertebral column and decompression of the neural elements. Aim: A key part of the procedure is the removal of the posterior osteophyte. This is usually performed using a high-speed burr. In inexperienced hands, this part of the procedure can be a challenging one. Materials: Egg, egg cup, zinc oxide tape and high-speed burr. Conclusion: We describe a simple and cost effective method of practicing this manoeuver, enabling the trainee to gain sufficient confidence in handling the tool around delicate tissues.
Misery of neurosurgeon: Gauzoma causing foreign body granuloma-role of radiologist
Authors: Kumar Ravi , Nadarajah Jeyaseelan , Kumar Atin , Gamanagatti Shivanand
Published: September 2015

Materials used in neurosurgery to achieve hemostasis may be of resorbable or nonresorbable substance and may cause foreign body granuloma if left at the operative site. Foreign body granuloma depending on clinical history may be indistinguishable from an abscess, resolving infarction, and hematoma. Here we present two cases, who had decompressive craniectomy following road traffic accident. Follow-up computerized tomography (CT) scan revealed hyperdense lobulated lesion with peripheral rim enhancement. On magnetic resonance imaging (MRI), lesions were predominantly hypointense on T1-weighted images, and hyperintense on T2-weighted images and showed a lack of restricted diffusion. In view of recent craniectomy and imaging findings diagnosis of foreign body granuloma was made. Both patients underwent surgery, intraoperatively gauze pieces were retrieved from lesions which confirmed preoperative diagnosis. The combination of CT and MRI can diagnose foreign body granuloma, especially in trauma settings. Thus, we can help the surgeon by providing the probable diagnosis for proper management.
Relationship between demography, etiology, level of consciousness, and outcome of surgical intracranial suppurations of bacterial origin in a tropical tertiary center
Authors: Idowu Olufemi , Majekodunmi Adetinuwe
Published: September 2015

Introduction: Intracranial suppurations (ICS) of bacterial origin are associated with significant mortality and morbidity. This study aimed to review demography, etiology, level of consciousness, and outcome of surgical ICS in a tropical tertiary hospital. Materials and Methods: All patients admitted to the neurosurgical unit within the study period of 7 years that had a surgical intervention for their ICS were prospectively included in the study. In accordance with the unit protocol, all patients in whom there was clinical suspicion of ICS had a preoperative computed tomography scan and/or magnetic resonance imaging done. The following data among others were documented and recorded electronically: demography, clinical and radiological diagnosis, etiology of ICS, admission Glasgow Coma Scale (GCS) score, type of neurosurgical intervention, mode of anesthesia, and outcome. Results: Forty-nine patients were included in the study. There were 33 males with a male-to-female ratio of 2.1:1. All patients presented at least a week after the use of antibiotics. The most common type of ICS was cerebral abscess (33 patients, 67.3%). There was no statistical significant association between outcome and age group (P = 0.630), gender (P = 0.999), diagnosis (P = 0.464), etiology of ICS (P = 0.169), solitary or multiplicity of ICS (P = 0.485), or type of offending organism (P = 0.278). Conclusions: ICS usually follows otorhinological infections in our center. The surgical outcome is dependent on the admission GCS score.
Comparison of intravenous labetalol and bupivacaine scalp block on the hemodynamic and entropy changes following skull pin application: A randomized, open label clinical trial
Authors: Bharne Sidhesh , Bidkar Prasanna , Badhe Ashok , Parida Satyen , Ramesh Andi
Published: September 2015

Background: The application of skull pins in neurosurgical procedures is a highly noxious stimulus that causes hemodynamic changes and a rise in spectral entropy levels. We designed a study to compare intravenous (IV) labetalol and bupivacaine scalp block in blunting these changes. Patients and Methods: Sixty-six patients undergoing elective neurosurgical procedures were randomized into two groups, L (labetalol) and B (bupivacaine) of 33 each. After a standard induction sequence using fentanyl, propofol and vecuronium, patients were intubated. Baseline hemodynamic parameters and entropy levels were noted. Five minutes before, application of the pins, group L patients received IV labetalol 0.25 mg/kg and group B patients received scalp block with 30 ml of 0.25% bupivacaine. Following application of the pins, heart rate (HR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), and response entropy (RE)/state entropy (SE) were noted at regular time points up to 5 min. Results: The two groups were comparable with respect to their demographic characteristics. Baseline hemodynamic parameters and entropy levels were also similar. After pinning, the HR, SAP, DAP, MAP, and RE/SE all increased in both groups but were lower in the scalp block group patients. HR increased by 19.8% in group L and by 11% in group B. SAP increased by 11.9% in group L and remained unchanged in group B. DAP increased by 19.7% in group L and by 9.9% in group B, MAP increased by 15.6% in group L and 5% in group B (P < 0.05). No adverse effects were noted. Conclusion: Scalp block with bupivacaine is more effective than IV labetalol in attenuating the rise in hemodynamic parameters and entropy changes following skull pin application.
Unusual cord transection in a patient with traumatic spondylolisthesis
Authors: Baliyan Vinit , Shylendran Sudhin , Ajay K , Kumar Atin , Gamanagatti Shivanand , Sinha Sumit
Published: September 2015

Spinal cord injury is one of the most debilitating injuries in patients with spinal trauma. Cord injury may range from simple cord edema to frank transection. Cord transection is the most severe form of cord injury as it results in complete and irreversible loss of all neural functions. Generally, it is a result of unstable spinal fractures with associated spondylolisthesis or spondyloptosis. Generally, the level of cord transection corresponds to the level of spinal fracture/spondylolisthesis. However, here we are presenting a case having a traumatic spinal fracture with spondylolisthesis where the level of cord transection was much higher than the level of the spinal fracture. Due to the traumatic traction, the cord distal to transection is displaced inferior leaving behind a long segment of the empty thecal sac.
Elevated fracture of skull in pediatric age group: A series of five patients with review of literature
Authors: Kumar Jayendra , Prakash Anand , Harsh Viraat , Kumar Anil
Published: September 2015

Elevated fractures of skull in pediatric age group are rarely reported in the literature. In view of rarity, we present a series of five cases of elevated skull fracture in pediatric age group. Over a period of 1-year, we operated on five such cases. In this article, we have discussed the mode, mechanism and extent of injury, its clinico-radiological findings, course of the disease, and the management outcome. Four out of five cases improved after surgery and did not suffer any complications. Early recognition and appropriate management of compound elevated fracture in pediatric age group comes with good outcome and prevents unwanted morbidity and mortality.
Evaluation of Microstructural Effects on the Degree of Sensitization (DOS) of a UNS S31803 Duplex Stainless Steel Aged at 475°C
Authors: de Melo Evelin Barbosa , Magnabosco Rodrigo
Published: September 2015

In this study, microstructural and electrochemical behavior of a UNS S31803 duplex stainless steel aged at 475°C were investigated. Hardness values increased with aging at 475°C and evidence of alpha prime (α′) phase formation was confirmed by transmission electron microscopy analysis. Double loop electrochemical potentiokinetic reactivation measurements in a 2 M H2SO4 + 0.5 M NaCl + 0.01 M KSCN solution showed an increase in the degree of sensitization values, mainly for the sample aged for 360 h at 475°C. Moreover, the results suggest that α′ phase formation occurred via spinodal decomposition mechanism.
Nitrogen speciation in various types of aerosol in spring over the northwestern Pacific Ocean
Authors: Luo L. , Yao X. H. , Gao H. W. , Hsu S. C. , Li J. W. , Kao S.-J.
Published: September 2015

Abstract. The cumulative atmospheric nitrogen deposition has been found to profoundly impact the nutrient stoichiometry of the East China seas (ECSs) and the northwestern Pacific Ocean (NWPO). In spite of the potential significance of dry deposition in those regions, ship-board observations of atmospheric aerosols remain insufficient, particularly, for compositions of water-soluble nitrogen species (nitrate, ammonium and water-soluble organic nitrogen – WSON). We conducted a cruise covering the ECSs and the NWPO during the spring of 2014 and observed three types of atmospheric aerosols. Al content, air mass backward trajectory, weather condition, and ion stoichiometry allowed us to discern dust aerosol patches and sea fog modified aerosols (widespread on the ECSs) from background aerosols (open ocean). Among the three types, sea fog modified aerosols contained the highest concentrations of nitrate (536 ± 300 nmol N m−3), ammonium (442 ± 194 nmol N m−3) and WSON (147 ± 171 nmol N m−3); moreover, ammonium and nitrate together occupied ~ 65 % molar fraction of total ions. The dust aerosols also contained significant amounts of nitrate (100 ± 23 nmol N m−3) and ammonium (138 ± 24 nmol N m−3) which were obviously larger than those in background aerosols (26 ± 32 and 54 ± 45 nmol N m−3, respectively, for nitrate and ammonium), yet this was not the case for WSON. It appeared that dust aerosols had less of a chance to contact WSON during its transport. In the open ocean, we found that sea salt (e.g. Na+, Cl−, Mg2+), as well as WSON, correlates positively with wind speed. Apparently, marine WSON was emitted during breaking waves. Regardless of the variable wind speeds from 0.8 to as high as 18 m s−1 nitrate and ammonium, by contrast, remained in narrow ranges implying that some supply and consumption processes of nitrate and ammonium were required to maintain such a quasi-static condition. Mean dry deposition of total dissolved nitrogen (TDN) for sea fog modified aerosols (1090 ± 671 μmol N m−2 d−1) was 5 times higher than dust aerosols (190 ± 41.6 μmol N m−2 d−1) and around 20 times higher than background aerosols (56.8 ± 59.1 μmol N m−2 d−1). Apparently, spring sea fog on the ECSs played an important role in removing atmospheric reactive nitrogen from the Chinese mainland and depositing it into the ECSs, thus effectively preventing its seaward export to the NWPO.
Synchronous polar winter starphotometry and lidar measurements at a High Arctic station
Authors: Baibakov K. , O'Neill N. T. , Ivanescu L. , Duck T. J. , Perro C. , Herber A. , Schulz K.-H. , Schrems O.
Published: September 2015

Abstract. We present recent progress on nighttime retrievals of aerosol and cloud optical properties over the PEARL (Polar Environmental Atmospheric Research Laboratory) station at Eureka (Nunavut, Canada) in the High Arctic (80° N, 86° W). In the spring of 2011 and 2012, a star photometer was employed to acquire aerosol optical depth (AOD) data, while vertical aerosol and cloud backscatter profiles were measured using the CANDAC Raman Lidar (CRL). We used a simple backscatter coefficient threshold (βthr) to distinguish aerosols from clouds and, assuming that aerosols were largely fine mode (FM)/sub-micron, to distinguish FM aerosols from coarse mode (CM)/super-micron cloud or crystal particles. Using prescribed lidar ratios, we computed FM and CM AODs that were compared with analogous AODs estimated from spectral star photometry. We found (βthr dependent) coherences between the lidar and star photometer for both FM events and CM cloud and crystal events with averaged, FM absolute differences being
Aerosol mass spectrometry: particle–vaporizer interactions and their consequences for the measurements
Authors: Drewnick F. , Diesch J.-M. , Faber P. , Borrmann S.
Published: September 2015

Abstract. The Aerodyne aerosol mass spectrometer (AMS) is a frequently used instrument for on-line measurement of the ambient sub-micron aerosol composition. With the help of calibrations and a number of assumptions on the flash vaporization and electron impact ionization processes, this instrument provides robust quantitative information on various non-refractory ambient aerosol components. However, when measuring close to certain anthropogenic or marine sources of semi-refractory aerosols, several of these assumptions may not be met and measurement results might easily be incorrectly interpreted if not carefully analyzed for unique ions, isotope patterns, and potential slow vaporization associated with semi-refractory species. Here we discuss various aspects of the interaction of aerosol particles with the AMS tungsten vaporizer and the consequences for the measurement results: semi-refractory components – i.e., components that vaporize but do not flash-vaporize at the vaporizer and ionizer temperatures, like metal halides (e.g., chlorides, bromides or iodides of Al, Ba, Cd, Cu, Fe, Hg, K, Na, Pb, Sr, Zn) – can be measured semi-quantitatively despite their relatively slow vaporization from the vaporizer. Even though non-refractory components (e.g., NH4NO3 or (NH4)2SO4) vaporize quickly, under certain conditions their differences in vaporization kinetics can result in undesired biases in ion collection efficiency in thresholded measurements. Chemical reactions with oxygen from the aerosol flow can have an influence on the mass spectra for certain components (e.g., organic species). Finally, chemical reactions of the aerosol with the vaporizer surface can result in additional signals in the mass spectra (e.g., WO2Cl2-related signals from particulate Cl) and in conditioning or contamination of the vaporizer, with potential memory effects influencing the mass spectra of subsequent measurements. Laboratory experiments that investigate these particle–vaporizer interactions are presented and are discussed together with field results, showing that measurements of typical continental or urban aerosols are not significantly affected, while measurements of semi-refractory aerosol in the laboratory, close to anthropogenic sources or in marine environments, can be biased by these effects.
Dynamics of air–sea CO2 fluxes in the northwestern European shelf based on voluntary observing ship and satellite observations
Authors: Marrec P. , Cariou T. , Macé E. , Morin P. , Salt L. A. , Vernet M. , Taylor B. , Paxman K. , Bozec Y.
Published: September 2015

Abstract. From January 2011 to December 2013, we constructed a comprehensive pCO2 data set based on voluntary observing ship (VOS) measurements in the western English Channel (WEC). We subsequently estimated surface pCO2 and air–sea CO2 fluxes in northwestern European continental shelf waters using multiple linear regressions (MLRs) from remotely sensed sea surface temperature (SST), chlorophyll a concentration (Chl a), wind speed (WND), photosynthetically active radiation (PAR) and modeled mixed layer depth (MLD). We developed specific MLRs for the seasonally stratified northern WEC (nWEC) and the permanently well-mixed southern WEC (sWEC) and calculated surface pCO2 with uncertainties of 17 and 16 μatm, respectively. We extrapolated the relationships obtained for the WEC based on the 2011–2013 data set (1) temporally over a decade and (2) spatially in the adjacent Celtic and Irish seas (CS and IS), two regions which exhibit hydrographical and biogeochemical characteristics similar to those of WEC waters. We validated these extrapolations with pCO2 data from the SOCAT and LDEO databases and obtained good agreement between modeled and observed data. On an annual scale, seasonally stratified systems acted as a sink of CO2 from the atmosphere of −0.6 ± 0.3, −0.9 ± 0.3 and −0.5 ± 0.3 mol C m−2 yr−1 in the northern Celtic Sea, southern Celtic sea and nWEC, respectively, whereas permanently well-mixed systems acted as source of CO2 to the atmosphere of 0.2 ± 0.2 and 0.3 ± 0.2 mol C m−2 yr−1 in the sWEC and IS, respectively. Air–sea CO2 fluxes showed important inter-annual variability resulting in significant differences in the intensity and/or direction of annual fluxes. We scaled the mean annual fluxes over these provinces for the last decade and obtained the first annual average uptake of −1.11 ± 0.32 Tg C yr−1 for this part of the northwestern European continental shelf. Our study showed that combining VOS data with satellite observations can be a powerful tool to estimate and extrapolate air–sea CO2 fluxes in sparsely sampled area.
Global warming projections derived from an observation-based minimal model
Authors: Rypdal K.
Published: September 2015

Abstract. A simple conceptual model for the global mean surface temperature (GMST) response to CO2 emissions is presented and analysed. It consists of linear long-memory models for the GMST anomaly response ΔT to radiative forcing and atmospheric CO2-concentration response ΔC to emission rate. The responses are connected by the standard logarithmic relation between CO2 concentration and its radiative forcing. The model depends on two sensitivity parameters, αT and αC, and two "inertia parameters", the memory exponents βT and βC. Based on observation data, and constrained by results from the Climate Model Intercomparison Project Phase 5 (CMIP5), the likely values and range of these parameters are estimated, and projections of future warming for the parameters in this range are computed for various idealised, but instructive, emission scenarios. It is concluded that delays in the initiation of an effective global emission reduction regime is the single most important factor that influences the magnitude of global warming over the next two centuries. The main value of this study is the simplicity and transparency of the conceptual model, which makes it a useful tool for communicating the issue to non-climate scientists, students, policy-makers, and the general public.
FPLUME-1.0: An integrated volcanic plume model accounting for ash aggregation
Authors: Folch A. , Costa A. , Macedonio G.
Published: September 2015

Abstract. Eruption Source Parameters (ESP) characterizing volcanic eruption plumes are crucial inputs for atmospheric tephra dispersal models, used for hazard assessment and risk mitigation. We present FPLUME-1.0, a steady-state 1-D cross-section averaged eruption column model based on the Buoyant Plume Theory (BPT). The model accounts for plume bent over by wind, entrainment of ambient moisture, effects of water phase changes, particle fallout and re-entrainment, a new parameterization for the air entrainment coefficients and a model for wet aggregation of ash particles in presence of liquid water or ice. In the occurrence of wet aggregation, the model predicts an "effective" grain size distribution depleted in fines with respect to that erupted at the vent. Given a wind profile, the model can be used to determine the column height from the eruption mass flow rate or vice-versa. The ultimate goal is to improve ash cloud dispersal forecasts by better constraining the ESP (column height, eruption rate and vertical distribution of mass) and the "effective" particle grain size distribution resulting from eventual wet aggregation within the plume. As test cases we apply the model to the eruptive phase-B of the 4 April 1982 El Chichón volcano eruption (México) and the 6 May 2010 Eyjafjallajökull eruption phase (Iceland).
Evaluation of the updated regional climate model RACMO2.3: summer snowfall impact on the Greenland Ice Sheet
Authors: Noël B. , van de Berg W. J. , van Meijgaard E. , Kuipers Munneke P. , van de Wal R. S. W. , van den Broeke M. R.
Published: September 2015

Abstract. We discuss Greenland Ice Sheet (GrIS) surface mass balance (SMB) differences between the updated polar version of the RACMO climate model (RACMO2.3) and the previous version (RACMO2.1). Among other revisions, the updated model includes an adjusted rainfall-to-snowfall conversion that produces exclusively snowfall under freezing conditions; this especially favours snowfall in summer. Summer snowfall in the ablation zone of the GrIS has a pronounced effect on melt rates, affecting modelled GrIS SMB in two ways. By covering relatively dark ice with highly reflective fresh snow, these summer snowfalls have the potential to locally reduce melt rates in the ablation zone of the GrIS through the snow-albedo-melt feedback. At larger scales, SMB changes are driven by differences in orographic precipitation following a shift in large-scale circulation, in combination with enhanced moisture to precipitation conversion for warm to moderately cold conditions. A detailed comparison of model output with observations from automatic weather stations, ice cores and ablation stakes shows that the model update generally improves the simulated SMB-elevation gradient as well as the representation of the surface energy balance, although significant biases remain.
An Exploration of Three Peer Tutoring Cases in the School Orchestra Program
Authors: Webb Richard S.
Published: September 2015

The purpose of this multiple case study was to explore the choices, thought processes, and evidence of knowledge construction of high school string players in their role as peer tutors. Three high school students served as participants and were observed and video-recorded while teaching private lessons to sixth grade students from within their district’s orchestra program. Lesson data were supplemented by pre- and postlesson interviews with, and written reflections by, each of the participants. After a cross-case analysis of the data, four themes emerged: (a) choices from experiences, (b) reorganization and communication, (c) enjoyment and value, and (d) perception of roles. Interviews with the participants suggested that the act of teaching younger peers might contribute to an increased motivational interest for learning on the part of the tutors. Student-centered learning experiences such as peer tutoring may also foster an increased sense of ownership, both of the music program in which the tutors participate and of the tutors’ own learning. Findings supported the results of prior studies in the areas of communication, responsibility, altruism, selfconfidence, self-efficacy, and other cognitive-affective aspects of tutoring. Implications for informing music education practice, and suggestions for further research into peer teaching and learning in the music classroom, are offered.
Revision of AWWA C651‐14: The Water Main Disinfection Standard
Authors: Reilley Betsy , Burlingame Gary A. , Gordhamer Robert
Published: September 2015

A review of AWWA standards is required every five years; AWWA C651's revisions add clarification and reflect new technologies, mandates, and research findings.
Strength in Numbers
Authors: Leiman Jonathan
Published: September 2015

The State of Montana dedicates sizeable portions of its annual budget to collect, analyze, and store water quality data. This information resource is used by the Montana Department of Environmental Quality (DEQ) to decide (1) whether water bodies support their beneficial uses, (2) if discharges are in compliance with permits, (3) whether water quality is improving or declining, and (4) what the causes and sources of impairment of water bodies are. At present this information is neither readily available nor easily accessible for many prospective end users. But this resource has tremendous potential and value for citizen‐based groups working to restore and maintain water quality.
Cyanotoxins: Practical Solutions Needed
Authors: Roberson J. Alan , Carpenter Adam T.
Published: September 2015

On June 17, 2015, the US Environmental Protection Agency (USEPA) released health advisories for two cyanotoxins (2015c). The 10‐day health advisory levels for microcystins are 0.3 Μg/L for children of preschool age or younger and 1.6 Μg/L for ages 6 and up. Similarly, the 10‐day health advisory levels for cylindrospermopsin are 0.7 Μg/L for children of preschool age or younger and 3.0 Μg/L for ages 6 and up. At the same time, USEPA also released a set of recommendations for public water systems on the basis of these health advisories (2015d). Depending on how state primacy agencies use these advisories and recommendations, a fair number of “do not drink/do not boil water” orders may have occurred over the summer as a result of warmer temperatures and algal blooms. So these four numbers and the related recommendations create a complicated situation that needs some practical solutions for the drinking water community.
Providing the Taste of Learning: Nadia Boulanger’s Lasting Imprint on Canadian Music
Authors: Boivin Jean
Published: September 2015

This article traces the rich Canadian legacy of the twentieth-century French musical legend Nadia Boulanger (1887–1979). Through teaching her more than seventy Canadian students, both French- and English-speaking, the renowned French pedagogue played a crucial role in the development of concert art music in this country from the 1920s, notably in Montreal and Toronto. Her numerous Canadian students went on to distinguish themselves as composers, teachers, performers, musicologists, theorists, administrators, and radio producers. Drawing on extensive archival and primary research, this study demonstrates the decisive impact Boulanger had on the development of musical styles and compositional practices in Canada in the last century.
“The Spectacle of a Young Man”: Glenn Gould, Graham Steed, and an Unpublished Concert Review for the Windsor Star
Authors: Reul Barbara M.
Published: September 2015

This article focuses on the content, intent, and historical context of an unpublished review of a concert performed by Glenn Gould and the Detroit Symphony Orchestra in Detroit, Michigan, on 13 October 1960. The review is preserved at the Library and Archives Canada and was written by Graham Steed (1913–1999). This respected British-Canadian organist and scholar served as the Windsor Star’s music critic from 1959 to 1965. Interestingly, Steed’s American colleagues reviewed Gould’s performance favourably. In contrast, Steed’s own highly controversial critique was deemed unfit for public consumption by the editor of the Windsor Star.
Neglected Canadian Orchestral Music
Authors: Elliott Robin
Published: September 2015

This article examines neglected orchestral works by six Canadian composers: Rodolphe Mathieu, Colin McPhee, John Weinzweig, Harry Somers, Istvan Anhalt, and R. Murray Schafer. Despite the considerable professional accomplishments and career achievements of these composers, each has at least one orchestral work in his catalogue that failed to make a good impression with the musical public or has never been heard in live performance. The article attempts to find why these compositions did not win a place in the repertoire and also considers how these works illustrate broader issues relating to the Canadian orchestral repertoire.
Barriers and facilitators adolescent females living with HIV face in accessing contraceptive services: a qualitative assessment of providers’ perceptions in western Kenya
Authors: Hagey Jill M , Akama Eliud , Ayieko James , Bukusi Elizabeth A , Cohen Craig R , Patel Rena C
Published: September 2015

Introduction

Avoiding unintended pregnancies is important for the health of adolescents living with HIV and has the additional benefit of preventing potential vertical HIV transmission. Health facility providers represent an untapped resource in understanding the barriers and facilitators adolescents living with HIV face when accessing contraception. By understanding these barriers and facilitators to contraceptive use among adolescent females living with HIV, this study aimed to understand how best to promote contraception within this marginalized population.

Methods

We conducted structured in‐depth interviews with 40 providers at 21 Family AIDS Care & Education Services ‐ supported clinics in Homabay, Kisumu and Migori counties in western Kenya from July to August 2014. Our interview guide explored the providers’ perspectives on contraceptive service provision to adolescent females living with HIV with the following specific domains: contraception screening and counselling, service provision, commodity security and clinic structure. Transcripts from the interviews were analyzed using inductive content analysis.

Results

According to providers, interpersonal factors dominated the barriers adolescent females living with HIV face in accessing contraception. Providers felt that adolescent females fear disclosing their sexual activity to parents, peers and providers, because of repercussions of perceived promiscuity. Furthermore, providers mentioned that adolescents find seeking contraceptive services without a male partner challenging, because some providers and community members view adolescents unaccompanied by their partners as not being serious about their relationships or having multiple concurrent relationships. On the other hand, providers noted that institutional factors best facilitated contraception for these adolescents. Integration of contraception and HIV care allows easier access to contraceptives by removing the stigma of coming to a clinic solely for contraceptive services. Youth‐friendly services, including serving youth on days separate from adults, also create a more comfortable setting for adolescents seeking contraceptive services.

Conclusions

Providers at these facilities identified attitudes of equating seeking contraceptive services with promiscuity by parents, peers and providers as barriers preventing adolescent females living with HIV from accessing contraceptive services. Health facilities should provide services for adolescent females in a youth‐friendly manner and integrate HIV and contraceptive services.
Program allocation process improvement by an assignment model
Authors: IŞIK Okay , BİLGE Muhammet , KILIÇARSLAN Yıldırım
Published: September 2015

As the only source of jet pilot candidates for Turkish Air Force, Air Force Academy (TuAFA) applies several screening processes in order to acquire an average group of 150 cadets from civilian high school graduates each year. Besides the nationwide examinations (YGS-LYS), there are several others such as medical, flight, athletics evaluations and etc. Because the number of criteria for screening is large, the spread of the distribution of YGS-LYS scores of the candidates, which is assumed to be the aptitude towards college education, is a lot wider than those of other universities. Although admission to faculty for civilian high school students is regulated by the YGS-LYS score; in order to provide a balance distribution among different programs in terms of YGS-LYS score, placement to aerospace, electronics, computer and Industrial engineering programs of the Faculty is governed by a special directive. Although the directive considers candidates’ preferences, the ultimate goal of the algorithm in the directive is to keep the balance of academic success among different programs in the allocation process. In this study, we propose an alternative assignment model which tries to minimize the deviations from students’ preferences while maintaining the balance of the distribution among programs. Through simulation from different preference distributions with different number of students, it has been showed that regardless of the number of students and distribution of preferences,first choice allocation performance of the proposed model is significantly better than the directive’s algorithm.
Campus Open Access Funds: Experiences of the KU “One University” Open Access Author Fund
Authors: Gyore Rachel , Reeve Allison C. , Cameron-Vedros Crystal , Ludwig Deborah , Emmett Ada
Published: September 2015

INTRODUCTION In the summer of 2012, librarians from the Lawrence and Kansas City campuses of the University of Kansas (KU) proposed the creation of a KU “One University” Open Access Fund (OA Author Fund) to support open access publishing for its faculty, students, and staff. KU is a major public research and teaching institution of 28,000 students and 2,600 faculty on five campuses (Lawrence, Kansas City, Overland Park, Wichita, and Salina) (http://ku.edu/about), and has been a leader in open access initiatives for many years. A working group of librarians came together to create and implement a pilot project to explore the administration and impact of an open access publishing fund on KU authors, and the fund was launched in October 2012. DESCRIPTION OF PROJECT This report documents the group’s experience in developing eligibility criteria and administering the OA Fund. Here we provide insight into our efforts implementing the project, funding results, and plans for continuation. We share the results of the first two years of the OA Author Fund pilot and the lessons learned about open access fund administration. NEXT STEPS At the close of the pilot in May 2014, the OA fund review team solicited feedback from a faculty advisory group regarding grant recipients, allocation of funds by discipline, and the application process. Based on our findings, we revised eligibility criteria to create a more equitable funding opportunity for the second pilot. The fund was re-launched using these new criteria in Fall of 2014.
Vertical Movements, Behavior and Habitat Utilization of Adult Yellowfin Tuna (Thunnus albacares) Tagged in West Philippine Sea, Mindoro Island, Philippines
Authors: Macusi Edison D. , Babaran Ricardo P. , Ingles Jose T.
Published: September 2015

This paper describes the vertical movements, behavior and habitat utilization of an electronically tagged adult yellowfin tuna (Thunnus albacares) after 17 days of liberty in the Philippines based on analyses of 23,845 datapoints recorded from a recovered electronic popup tag. The exhaustive set provides a way to describe the vertical movement as well as a range of behaviors exhibited by the fish. We used the daily time records of depth and temperature from the vertical dives of the fish at different times of the day (nocturnal, dawn, diurnal, dusk) to describe fish behavior and to characterize its three deep dives. The fish stayed 23% and 24% of its time at warmer waters of 28 0C and 30 0C. It also spent 15% of its time at 26 0C and 10% of its time at colder waters of 20 0C and 22 0C. The daily differences in temperatures fluctuated from 12.10C to 30.1 0C with the daily average temperature of 24.2 0C. Swimming speeds determined show the maximum vertical ascent speed that the fish registered reached 1.53m/s swimming from a depth of 195m to 104m during a dusk. The maximum vertical descent speed reached 1.38m/s from a depth of 78m down to 161m. The deepest dive of the fish started from a U-shaped diving profile that lasted for almost 32 minutes and then followed by another U-shaped dive for 12 minutes before a deep dive and fast vertical ascent. The total duration of its dives differ with water depth: 0-50m (1.89 hours), 50-75m (4.78 hours), 75-100m (3.35 hours), 100-125m (1.69 hours), 125-150m (1.69 hours). Such swimming behavior provides valuable information on the vulnerability of tunas particularly the juvenile fishery.   Keywords - Archival tag, fish aggregating device (FAD), Mindoro Island, West Philippine Sea, Yellowfin tuna, Philippines
Gap Analysis of Accident Investigation Methodology in the Indian Mining Industry - an Application of Swiss Cheese Model and 5-Why Model
Authors: Dash Ashish Kumar , Bhattacharjee Ram Madhab , Paul Partha Sarathi
Published: September 2015

Workplace accidents are investigated mainly for the purpose of identifying the causes that contributed to the occurrence of the accident and thereby providing recommendations to prevent recurrence of such accidents. The human factor has always been a critical element in the accident causation model applied in various industries. However, it is equally important to identify other parameters like task environment, task conditions, organizational culture and other organizational factors that influence human behavior in most of the cases. In this paper, an effort has been made to discuss some of the investigation models used for identification of root causes leading to an incident or accident. This paper highlighted the gaps in the investigation procedure in the Indian mining industry where too much focus is being given to human error and contravention of the health and safety statute application to mining activities. The authors emphasized the importance of using suitable investigation methodology for investigating into Indian mining accidents. A case study accident has been presented to highlight the necessity of using suitable accident investigation methodology like Swiss Cheese Model for identifying root causes of such accident. Keywords - Ecology, accident investigation, mining industry, human factor, task environment, organizational factors, investigation model, India
Prevention, Diagnosis, and Treatment of Hepatocellular Carcinoma
Authors: Park Sarah , Davis Andrew M. , Pillai Anjana A.
Published: August 2024

This JAMA Clinical Guidelines Synopsis summarizes the 2023 American Association for the Study of Liver Diseases practice guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma.
Sub-Tenon Triamcinolone and Anti-HIV Medication–Induced Cushing Syndrome
Authors: Purt Boonkit , Nugent Alexander , Wu Patricia S. , Paulus Yannis M.
Published: August 2024

This case report describes a diagnosis of iatrogenic Cushing syndrome as a result of sub-Tenon triamcinolone injection in a patient receiving treatment for HIV who presented with decreased visual acuity in both eyes.