bluuebunny/crossref_metadata_2025 huggingface dataset:
Reanalysis of a ten year record (2004–2013) of seasonal mass
balances at Langenferner/Vedretta Lunga, Ortler-Alps, Italy
Authors: Galos Stephan Peter , Klug Christoph , Maussion Fabien , Covi Federico , Nicholson Lindsey , Rieg Lorenzo , Gurgiser Wolfgang , Mölg Thomas , Kaser Georg
Published: January 2017

Abstract. Records of glacier mass balance represent important data in climate science and their uncertainties affect calculations of sea level rise and other societally relevant environmental projections. In order to reduce and quantify uncertainties in mass balance series obtained by direct glaciological measurements, we present a detailed reanalysis work-flow which was applied to the ten year record (2004 to 2013) of seasonal mass balance of Langenferner, a small glacier in the European Eastern Alps. The approach involves a methodological homogenization of available point values and the creation of pseudo-observations of point mass balance for years and locations without measurements by the application of a process-based model constrained by snow line observations. We examine the uncertainties related to the extrapolation of point data using a variety of methods, and consequently present a more rigorous uncertainty assessment than is usually reported in the literature. Results reveal that the reanalyzed balance record considerably differs from the original one mainly for the first half of the observation period. For annual balances these misfits reach the order of > 300 kg m−2 and could primarily be attributed to a lack of measurements in the upper glacier part and to the use of outdated glacier outlines. For winter balances respective differences are smaller (up to 233 kg m−2) and they originate primarily from methodological inhomogeneities in the original series. Remaining random uncertainties in the reanalized series are mainly determined by the extrapolation of point data to the glacier scale and are in the order of ±80 kg m−2 for annual and ±52 kg m−2 for winter balances with values for single years/seasons reaching ±13 kg m−2. A comparison of the glaciological results to those obtained by the geodetic method for the period 2005 to 2013 based on airborne laser scanning data, reveals that no significant bias of the reanalyzed record is detectable.
A multiphysical ensemble system of numerical snow modelling
Authors: Lafaysse Matthieu , Cluzet Bertrand , Dumont Marie , Lejeune Yves , Vionnet Vincent , Morin Samuel
Published: January 2017

Abstract. Physically based multilayer snowpack models suffer from various modelling errors. To represent these errors, we built the new multi-physical ensemble system ESCROC (Ensemble System Crocus) by implementing new representations of different physical processes in the deterministic coupled multi-layer ground/snowpack model SURFEX/ISBA/Crocus. This ensemble was driven and evaluated at Col de Porte (1325 m a.s.l., French alps) over 18 years with a high quality meteorological and snow dataset. 7776 simulations were evaluated separately accounting for the uncertainties of evaluation data. The ability of the ensemble to capture the uncertainty associated to modelling errors is assessed for snow depth, snow water equivalent, bulk density, albedo and surface temperature. Different sub-ensembles of the ESCROC system were studied with probabilistic tools to compare their performance. Results show that optimal members of the ESCROC system are able to explain more than half of the total simulation errors. Integrating members with biases exceeding the range corresponding to observations uncertainties is necessary to obtain an optimal dispersion, but this issue can also be a consequence of the fact that meterorological forcing uncertainties were not accounted for. ESCROC is a promising system to integrate numerical snow modelling errors in ensemble forecasting and ensemble assimilation systems in support of avalanche hazard forecasting and other snowpack modelling applications.
Reviewer Acknowledgements
Authors: Young Daisy
Published: January 2017

Business and Economic Research (BER) would like to thank the following reviewers for reviewing manuscripts from December 1, 2014, to June 1, 2015. Their comments and suggestions were of great help to the authors in improving the quality of their papers. Many authors, regardless of whether Ber publishes their work, appreciate the helpful feedback provided by the reviewers. Macrothink Publishing appreciates the following reviewers’ rigorous and conscientious efforts for this journal. Each of the reviewers listed below returned at least one review during this period. Antonio Ruiz-PorrasBratu (Simionescu) MihaelaDavide ScaltritoEyup DoganFrantisek SvobodaGerasimos T. SoldatosPiotr SiemiątkowskiPriyono IyonRenata KorsakieneSahar BahmaniSaid JaouadiSandip SarkerTudor Ciumara
Reviewer Acknowledgements
Authors: Young Daisy
Published: January 2017

Business and Economic Research (BER) would like to thank the following reviewers for reviewing manuscripts from June 1, 2015, to December 1, 2015. Their comments and suggestions were of great help to the authors in improving the quality of their papers. Many authors, regardless of whether BER publishes their work, appreciate the helpful feedback provided by the reviewers. Macrothink Publishing appreciates the following reviewers’ rigorous and conscientious efforts for this journal. Each of the reviewers listed below returned at least one review during this period.Ajmer SinghAngela WrightBratu (Simionescu) MihaelaEyup DoganFouad JamaaniGerasimos T. SoldatosHengky Sumisto HalimJudy LiLateef Ademola OlatunjiMohd Rizal MuwazirNana Osei-BonsuPiotr SiemiątkowskiPriyono IyonRenata KorsakieneSahar BahmaniSandip SarkerSocrates O. BallaisUqbah IqbalSaid Jaouadi
Beauty in Creation: John Wesley's Natural Philosophy
Authors: Rainey David
Published: January 2017

John Wesley's compendium on natural philosophy is comparable to a second book of revelation about God; the first book is scripture. In light of this, scripture can only function as a hermeneutic for creation; it is not a textbook for the discovery of creation. Wesley used the language of Thomas Aquinas to explain that there is a revealed cause and effect, which leads to a First Cause. With this understanding, creation reveals a beauty that is derivative from God and this type of beauty is an interconnected relationship within all of creation. Because of humanity's limitation of knowledge, empiricism cannot assume a primary source of knowledge for natural philosophy since it can become a misleading source. Natural philosophy, as a result, remains its own objective source of knowledge.
Tubular duplication of the esophagus
Authors: Alenazi Fahad , Alenazi Ebtisam , Asaad Ziad , Alqoaer Khaled
Published: January 2017

Esophageal duplication (ED) is a rare congenital anomaly, representing 10%-15% of all foregut duplications. Neonates may present with respiratory distress, while older children usually present with dysphagia. We report here a rare case of tubular duplication of the esophagus presenting with dysphagia in a 12-year-old Saudi boy.
Fractality in Manufacturing Industry
Authors: Montano-Alvarez Miguel , Salazar-Medina Marcos , Morales-Acoltzi Tomas , Guzman-Aguilar Leydi , Machorro-Rodriguez Angel , Romero-Flores Edna Araceli
Published: January 2017

Fractal theory, a topic first introduced by Mandelbrot in 1970, has nevertheless witnessed a great boom in the field of science in this last decade. In this article, we analyze time series (TS), behavior of the variable, cost of that sold (CS), and we assume and demonstrate that there is fractality in the system for manufacturing companies in Mexico. We analyzed 30 companies that are listed on the Mexican stock exchange, obtaining 23 data for each organization, taking a period stretching from the first quarter of 2010 to the third quarter of 2015, and obtaining a total of 704 data. We only selected 512 for each one of the 30 TS, using fractal interpolation (FI) as the method for generating data in TS. TS 30 was characterized from the point of view of Visual Recurrence Analysis (VRA) software. It is apparent that in 80% of the companies analyzed, the dynamics of the CS system were elucidated using 4 variables.
Low-carbon Development of Urban Logistics Based on Principal Component Analysis —A Case Study of Lanzhou City
Authors: Bai Huifang , Tan Kedong , Huang Kaishun , Guo Qian
Published: January 2017

The Low-carbon economy is a sustainable economic model advocated by many countries all over the world. Urban logistics, as an important source of urban environmental pollution, is in an urgent demand for the development. This paper takes Lanzhou City as the research object to find out the key factors of urban logistics carbon emissions through the construction of carbon emission index system, the principal component analysis of the impact indicators from 2005 to 2014. And by evaluating the carbon emission level of logistics in Lanzhou City, it provides the corresponding solutions for the low carbon logistics development in Lanzhou City.
Therapeutic genome editing with engineered nucleases
Authors: Haas Simone , Dettmer Viviane , Cathomen Toni
Published: January 2017

Targeted genome editing with designer nucleases, such as zinc finger nucleases, TALE nucleases, and CRISPR-Cas nucleases, has heralded a new era in gene therapy. Genetic disorders, which have not been amenable to conventional gene-addition-type gene therapy approaches, such as disorders with dominant inheritance or diseases caused by mutations in tightly regulated genes, can now be treated by precise genome surgery. Moreover, engineered nucleases enable novel genetic interventions to fight infectious diseases or to improve cancer immunotherapies. Here, we review the development of the different classes of programmable nucleases, discuss the challenges and improvements in translating gene editing into clinical use, and give an outlook on what applications can expect to enter the clinic in the near future.
Relationship between Corporate Social Responsibility and Marketing Performance: The Mediating Effect of Customer Value and Corporate Image
Authors: Alrubaiee Laith Salman , Aladwan Sami , Abu Joma Mahmoud Hussein , Idris Wael Mohamed , Khater Saja
Published: January 2017

Although Corporate Social Responsibility, Customer Value, Corporate Image and Marketing Performance have become attractive research topics in the business literature, not much is known about their interrelationships. Hence Prior research has examined the relationships within subsets of these concepts. Therefore, this study aims to address this gap by developing a causal model incorporating these concepts to investigate the relationships among them in the context of hospitals. However, main objective of the study is to investigate the mediating effect of Customer Value and Corporate Image on the relationship between Corporate Social Responsibility and Marketing Performance. The proposed model was tested on data were obtain through survey conducted on managers and consultant physicians of private Jordanian hospitals in Amman. A structural equation model analysis was conducted using AMOS 22.0 and PLS 7.0 to verify the reliability and validity of the multi-item scales and to test the hypothesized relationships. However, the results indicate a positive direct effect of Corporate Social Responsibility on Customer Value, Corporate Image and Marketing Performance. Result also indicates a positive directs effect of Customer Value on Corporate Image as well as Marketing Performance. Findings also indicate that Corporate Image has positive direct effects on Marketing Performance. Furthermore, result indicates a partial mediation effect of corporate image and customer value. However, Findings indicate that Corporate Social Responsibility did enhance hospital performance, yet this effect was direct and indirect .Thus, the result positions customer value and corporate image as the primary mechanism through which the beneficial effects of Corporate Social Responsibility are realized. The study concludes with a discussion of the research and managerial implications of these findings.
Reviewer Acknowledgements for International Business Research, Vol. 9, No. 12
Authors: Duran Kevin
Published: January 2017

International Business Research wishes to acknowledge the following individuals for their assistance with peer review of manuscripts for this issue. Their help and contributions in maintaining the quality of the journal are greatly appreciated.International Business Research is recruiting reviewers for the journal. If you are interested in becoming a reviewer, we welcome you to join us. Please find the application form and details at http://recruitment.ccsenet.org and e-mail the completed application form to ibr@ccsenet.org.Reviewers for Volume 9, Number 12Alina BadulescuAlireza AthariAmran AwangAnna Helena JankowiakAnna Paola MicheliAntonella PetrilloArash RiasiAshford C CheaAurelija BurinskieneBadar Nadeem AshrafBenjamin James InyangCelina Maria OlszakCheng JingCristian Marian BarbuFabio De FeliceFadi AlkaraanFrancesco CiampiGeorgeta DragomirGuillaume MarceauHanna TrojanowskaIonela-Corina ChersanIvo De LooIwona Gorzeń-MitkaJabbouri ImadJanusz WielkiManlio Del GiudiceMansour Esmaeil ZaeiManuela Rozalia GaborMarcelino José JorgeMaria do Céu Gaspar AlvesMaria J. Sanchez-BuenoMaria Teresa BianchiMaria-Madela AbrudanMichaela Maria Schaffhauser-LinzattiMihaela SimionescuMiriam JankalováModar AbdullatifMonika WieczorekMuath EleswedRadoslav JankalRoberto Campos da Rocha MirandaRoxanne Helm StevensSumathisri BhoopalanValeria StefanelliVincent GrèzesWejdene Yangui
Reviewer Acknowledgements for International Business Research, Vol. 9, No. 3
Authors: Duran Kevin
Published: January 2017

International Business Research wishes to acknowledge the following individuals for their assistance with peer review of manuscripts for this issue. Their help and contributions in maintaining the quality of the journal are greatly appreciated.International Business Research is recruiting reviewers for the journal. If you are interested in becoming a reviewer, we welcome you to join us. Please find the application form and details at http://www.ccsenet.org/reviewer and e-mail the completed application form to ibr@ccsenet.org.
Reviewer Acknowledgements for International Business Research, Vol. 9, No. 5
Authors: Duran Kevin
Published: January 2017

International Business Research wishes to acknowledge the following individuals for their assistance with peer review of manuscripts for this issue. Their help and contributions in maintaining the quality of the journal are greatly appreciated.Reviewers for Volume 9, Number 5 Aurelija BurinskieneCristian Marian BarbuFlorin IonitaLadislav MuraLaura DanilescuMiriam JankalováRafiuddin AhmedRoxanne StevensSang-Bing Tsai            Kevin DuranOn behalf of,The Editorial Board of International Business ResearchCanadian Center of Science and Education
Information Resources Usage in Project Management Digital Learning System
Authors: Davidovitch Nitza , Belichenko Margarita , Kravchenko Yurii
Published: January 2017

The article combines a theoretical approach to structuring knowledge that is based on the integrated use of fuzzy semantic network theory predicates, Boolean functions, theory of complexity of network structures and some practical aspects to be considered in the distance learning at the university. The paper proposes a methodological approach that takes into account these features. The paper deals with the structuring of project management programs of academic mobility. The features of these projects show their impact on the progress and results of the implementation.It is shown that traditional approaches to solving the problems of academic mobility management applications to integrate the process of setting objectives and planning projects. But due to the complexity of academic mobility programs to solve these problems effectively without decomposing it into components can be managed quite difficult. Therefore, the main idea of this paper is that an increasing the efficiency of the university on the basis of a possible application of rational structuring of academic mobility programs. The features of these projects shows their impact on the progress and results of their implementation and the ways of construction of project management Digital learning systems.The experience of universities of many countries shows that an effective tool to overcome these obstacles is Digital learning, which allows to get all necessary knowledge at any time and in any place. The identity of urgency takes in terms of academic mobility when students and teachers work in another country. The paper presents the analyse of the structure of scientific and methodological basis of project management systems. The model determines the effect of academic mobility project management tools through knowledge of business administration at the progress of the educational projects. In this structure are identified two parts: creation tool to identify knowledge users and how they change, and the creation of information tools effect on these people.
De leer van de Hoge Raad over onrechtmatig bewijs (‘zozeer indruist’-criterium) door het EU Handvest op de schop?
Authors: van der Hulle R. , de Bree R.
Published: January 2017

De leer van de Hoge Raad over onrechtmatig bewijs (‘zozeer indruist’-criterium) door het EU Handvest op de schop?

In een arrest van 20 maart 2015 heeft de belastingkamer van de Hoge Raad het toetsingskader voor het gebruik van strafrechtelijk onrechtmatig verkregen bewijs in belastingprocedures uiteengezet. De houdbaarheid van dit toetsingskader is echter in de literatuur ter discussie gesteld naar aanleiding van het WebMindLicenses-arrest van het Hof van Justitie van 17 december 2015. In deze bijdrage wordt beoordeeld of het toetsingskader van de belastingkamer van de Hoge Raad daadwerkelijk aanpassing behoeft.

HR 20 maart 2015, nr. 13/03959, ECLI:NL:HR:2015:643.

HvJ EU 17 december 2015, zaak C-419/14, ECLI:EU:C:2015:832.
Naar een Europees wetboek voor elektronische communicatie
Authors: van Duijvenvoorde G.P.
Published: January 2017

Naar een Europees wetboek voor elektronische communicatie Kroniek Telecommunicatie

In deze kroniek wordt ingegaan op de ontwikkelingen in het Europese telecommunicatiekader in de afgelopen drie jaren. Het bevorderen van connectiviteit was een thema uit de voorstellen voor een ‘Connected Continent’ van Commissaris Kroes in 2013. Opnieuw is toegang tot snelle internetconnectiviteit een belangrijke doelstelling van regulering in het voorstel voor een geheel nieuw Europees wetboek voor elektronische communicatie dat de Europese Commissie in september 2016 publiceerde. Het voorstel betekent een algehele herziening van het Europees telecommunicatiekader dat gevolgen zal hebben voor de Nederlandse Telecommunicatiewet.
Infecções relacionadas à assistência em saúde em unidades de terapia intensiva neonatal: uma revisão integrativa
Authors: Oliveira Paula Angélica , Marques Salge Ana Karina , Prado Palos Marinésia Aparecida
Published: January 2017

Revisión integradora, con el objetivo de analizar las evidencias científicas sobre las infecciones asociadas a la atención en salud (IAAS) en Unidades de Cuidados Intensivos Neonatales (UCIN). Los datos fueron obtenidos a partir de bases de datos electrónica MEDLINE y LILACS, desde 2000 hasta 2015. Se analizaron 36 publicaciones sobre IAAS, con exclusión de las infecciones virales. Los principales microorganismos que causan infecciones hospitalarias son: Staphylococcus (30%), Candida (23,3%), Klebsiella pneumoniae y Pseudomonas aeruginosa (13,3%), Acinetobacter y Serratia marcescens (6,7%), Enterobacter y Enterococcus (3,3%). Entre las causas de septicemia incluyen: Staphylococcus (50%), Candida (30%) y Acinetobacter baumannii (20%). Las IAAS principales en la UCIN se producen por transmisión cruzada de microorganismos de la mano de profesionales de la salud, de las superficies ambientales, equipos y elementos no críticos contaminados. Para la prevención y control de infecciones hospitalarias en la UCIN es necesario formación de los profesionales para adecuada higiene de manos y la limpieza y desinfección de superficies ambientales, equipos y artículos no críticos.
Fatores associados ao nível de dor na admissão e na alta em vítimas de trauma
Authors: Soares Jamyle Rubio , Martin Andrea Regina , Arruda Guilherme Oliveira de , Marcon Sonia Silva , Barreto Mayckel Da Silva
Published: January 2017

Introducción: Diferentes factores pueden estar asociados a la génesis y mantenimiento del cuadro de dolor en víctimas de trauma. La baja evaluación y el bajo tratamiento del dolor agudo en las unidades de urgencia han llevado a una atención descalificada, aumentando la morbilidad y el tiempo de internación. El objetivo de esta investigación fue verificar los factores asociados al nivel de dolor en la admisión y en el alta en víctimas de trauma.

Metodología: Estudio transversal, realizado con 92 víctimas de trauma atendidas en una unidad de urgencia en el Sur de Brasil. La intensidad y ubicación del dolor fueron evaluadas, respectivamente, por medio de la escala numérica de dolor y diagrama corporal. Los datos fueron analizados con ayuda de la estadística no paramétrica.

Resultados: Los hallazgos indicaron asociación del dolor más intenso en la admisión o en el alta a características como: sexo masculino, edad más joven, color de la piel no blanca, presencia de compañero, heridas ocasionadas por quemadura, presencia de prescripción medicamentosa, administración analgésica por vía endovenosa y tiempo superior a 30 minutos para mejora del dolor con la farmacoterapia.

Conclusión: La institución de protocolos o algoritmos de medición y tratamiento del dolor por los profesionales de salud en las unidades de urgencia debe considerar tales características a fin de prestar una asistencia resolutiva y de calidad.
Saateks
Authors: Laak Marin , Labi Kanni
Published: January 2017

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Näitamise ambivalentne poeetika: J. G. Ballardi „Crash” / The Ambivalent Poetics of Showing in J. G. Ballard's „Crash“
Authors: Tomberg Jaak
Published: January 2017

Teesid: Artiklis käsitlen värske pilguga 1991. aastal ajakirjas Science Fiction Studies aset leidnud debatti J. G. Ballardi skandaalse romaani „Crash“ ümber. Toona küsiti, kas selles esitatud tehnoloogiat ja inim­kehi segustava maailma puhul on tegu allegoorilise moraalse hoiatuse või iselaadse perversse realismiga. Täiendan seda debatti poeetilisest küljest – vaatlen põhjalikult romaani näitavat esituslaadi, loetelulisust, tehnilist sõnavara, transtsendentsusele osutavat kujundlikkust ning peategelase-, jutustaja- ja autori-tasandi ühtsust – ning järeldan, et „Crashi“ läbinisti ambivalentne poeetika jätab teose võrdselt avatuks mõlemale tõlgendusvõimalusele.S U M M A R YMy article revisits a well-known discussion about morality in J. G. Ballard's ”Crash“ that surrounded the appearance of Jean Baudrillard's essay of the same name in a special section of Science Fiction Studies (Nov 1991). In this debate N. Katherine Hayles and Vivian Sobchack strongly oppose Baudrillard's claim that there ”is no affectivity behind [the world that Crash depicts]: no psychology, no ambivalence or desire, no libido or death drive“ to Ballard's novel, and, accordingly, no moral point or warning either. In contrast, Hayles and Sobchack argue that the novel warns us about the transformative influence of contemporary technology.To shed new light on this opposition (whose sides I briefly introduce), I undertake a thorough analysis of ”Crash's“ main poetic features: the prevalence of showing over telling, the recurrence of accounts over descrip­tions, the thoroughly technical vocabulary, allusions towards transcendence, and the interpretive anxiety created by a first-person narrator that bears the author's name. I map the contrast between Ballard's disinte­rested style of writing and the apparent affective charge of his characters while showing how this contrast generates a deep ambivalence that enables both moral and morally indifferent interpretations of the novel. The reader is never told what to think about the obscene events that occur and this provokes him to make difficult moral decisions about the novel. The ambivalence of ”Crash's“ poetics has the subversive potential to dislocate and reconsider the so far predominantly marginalized role of psychopathology and perversion in contemporary techno-culture.
Värss ja proosa
Authors: Lotman Juri , Lotman, tlk Maria-Kristiina
Published: January 2017

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Erich Auerbachi maailmakirjanduse filoloogia. Saatesõna tõlkele / Erich Auerbach’s Philology of World Literature
Authors: Lukas Liina
Published: January 2017

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Maailmakirjanduse paabel kutsub teisi keeli kuulama. ICLA konverents Viinis, 21.07–27.07.2016 / The Babel of World Literature and a Call to Listen to Other Languages. ICLA Congress in Vienna, 21.07–27.07.2016
Authors: Sapunjan Inga
Published: January 2017

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Contrasting molecular and morphological evidence for the identification of an anomalousButeo: a cautionary tale for hybrid diagnosis
Authors: Clark William S. , Galen Spencer C. , Hull Joshua M. , Mayo Megan A. , Witt Christopher C.
Published: January 2017

An adultButeowas found dead as a road-kill south of Sacramento, California, and was thought to represent the first state record of the eastern Red-shouldered Hawk (B. lineatus lineatus;). It is now a specimen in the Museum of Wildlife and Fisheries Biology (WFB 4816) at the University of California, Davis. We examined this specimen and found that many of its plumage characters differed from all other adult Red-shouldered Hawks examined, including nominate adults. Plumage markings and measurements were intermediate between Red-tailed Hawk (Buteo jamaicensis,sspcalurus) and Red-shouldered Hawk (sspelegans), leading us to hypothesize that the bird was a hybrid. However, mtDNA sequences and nuDNA microsatellites proved definitively that the bird was a Red-shouldered Hawk, most likely of eastern origin. This case illustrates that apparent hybrids or apparent vagrants could be individuals with anomalous phenotypes caused by rare genetic variation or novel epigenetic effects.
Saline infusion sonohysterography in nonpregnant women with previous cesarean delivery: the "niche" in the scar.
Authors: Monteagudo A , Carreno C , Timor-Tritsch I E
Published: January 2017

To apply an existing diagnostic imaging test (saline infusion sonohysterography) to characterize the "filling defect" of a previous cervical cesarean delivery scar in the nonpregnant uterus.

Forty‐four patients with histories of cesarean delivery who underwent saline infusion sonohysterography for a variety of gynecologic indications were included. During the procedure, the area below the bladder recess was examined using transvaginal sonography. A filling defect or "niche" was defined as a triangular anechoic structure at the presumed site of a previous cesarean delivery scar. The depth of the niche was measured. Uterine size, the presence of fibroids and polyps, and the number of previous cesarean deliveries were noted.

All patients had a niche indenting the anterior uterine‐cervical wall. The mean +/‐ SD depth of the niche was 6.17 +/‐ 3.6 mm. There was no correlation between the number of cesarean deliveries and the depth of the niche. Thirty‐six percent of our patients had fibroids, and 18% had endometrial polyps.

Saline infusion sonohysterography was able to detect filling defects in women who previously had cesarean deliveries. We hope that by focusing our attention on the transvaginal sonographic appearance of the detectable uterine scar (niche) with or without the use of saline infusion sonohysterography in the nonpregnant uterus, it will train our eyes to look for the scar in the pregnant uterus. In addition, our study patients had a high prevalence of abnormal uterine bleeding. The role of the cesarean delivery scar in women with unscheduled bleeding needs to be further evaluated.
Effectiveness of transcranial and transthoracic ultrasound and microbubbles in dissolving intravascular thrombi.
Authors: Porter T R , Kricsfeld D , Lof J , Everbach E C , Xie F
Published: January 2017

To examine the effectiveness of 1 ‐MHz and 40‐kHz ultrasound with and without microbubbles in fragmenting thrombi in attenuated conditions.

First, an vitro transcranial model was used to examine the ability of these frequencies to fragment thrombi in the presence or absence of perfluorocarbon‐exposed sonicated dextrose albumin microbubbles. Second, an in vivo transthoracic model was used to test the effectiveness of these same frequencies with intravenous perfluorocarbon‐exposed sonicated dextrose albumin in fragmenting left circumflex coronary thrombotic occlusions.

In the in vitro model, both transcranial 1‐MHz and 40‐kHz ultrasonic frequencies were effective at fragmenting thrombi only in the presence of microbubbles. In the in vivo model, 1‐MHz ultrasound with intravenous perfluorocarbon‐exposed sonicated dextrose albumin angiographically recanalized only 4 of 14 occlusions but was consistently effective at improving myocardial blood flow to the risk area even in the absence of angiographic recanalization. Both 40‐kHz and 1‐MHz ultrasound with perfluorocarbon‐exposed sonicated dextrose albumin improved regional wall‐thickening and electrocardiographic abnormalities (P < .05 compared with control or ultrasound alone).

Transcranial and transthoracic ultrasound in the presence of intravenous microbubbles can improve flow to ischemic regions and should be considered as a supplement to current pharmacologic therapy.
Intravascular ultrasonographic findings in May‐Thurner syndrome (iliac vein compression syndrome).
Authors: Ahmed H K , Hagspiel K D
Published: January 2017

The objective of this series was to describe the findings in 2 types of iliac vein compression syndrome on intravascular ultrasonography. We conducted a retrospective review of the intravascular ultrasonographic findings in 2 patients with iliac vein compression syndrome due to 2 different types of venous spur and correlated those findings with the contrast‐enhanced venographic findings. Intravascular ultrasonography allowed differentiation of the 2 different types of iliac vein compression syndrome in analogy to the venographic classification. Both cases had compression of the left common iliac vein between the right common iliac artery and the vertebral bodies. In addition, hyperechogenic eccentric wall thickening, the presence of multiple vascular channels separated by hyperechogenic structures, and the presence of sequelae of deep venous thrombosis such as synechiae and organized thrombus can be seen on intravascular ultrasonography. The ability to perform exact measurements of the venous dimensions is an added benefit of intravascular ultrasonography. Intravascular ultrasonography can assist in the diagnosis and classification of iliac vein compression syndrome, allows assessment of its complications, and can be potentially helpful for planning endovascular treatment.
Prenatal ultrasonographic diagnosis of Sprengel's deformity.
Authors: Chinn D H
Published: January 2017

Sprengel's deformity is the congenital failure of descent of the scapula. Eulenburg first described this in 1863. Sprengel described 4 cases in 1891; hence, the anomaly has been called Sprengel's deformity. Other terms for this entity are Sprengel's anomaly, Sprengel's shoulder, congenital high scapula, and undescended scapula. In this entity, varying degrees of scapula elevation and scapula hypoplasia occur. In approximately one third of cases, Sprengel's deformity is accompanied by an accessory ossicle, the omovertebral bone, which articulates between the medial border of the scapula and 1 or more of the cervical vertebrae. In the absence of an omovertebral bone, a fibrous fascial sheath extends from the superior angle of the scapula to the spinous process, the lamina, or the transverse process of 1 or more lower cervical vertebrae. This fixation accounts for the medial position and elevation of the scapula. I report a case of prenatal ultrasonographic detection of Sprengel's deformity.
Sonographically guided renal mass biopsy: indications and efficacy.
Authors: Johnson P T , Nazarian L N , Feld R I , Needleman L , Lev-Toaff A S , Segal S R , Halpern E J
Published: January 2017

To review the clinical indications, pathologic results, and success rate of all our sonographically guided solid renal mass biopsies over a 5‐year period.

Between 1993 and 1998, 44 consecutive patients underwent sonographically guided percutaneous biopsy of a solid renal mass. Indications included prior history of nonrenal malignancy, metastatic disease of unknown primary origin, previous contralateral nephrectomy for a renal cell neoplasm, a renal transplant mass, suspected renal lymphoma, history of tuberous sclerosis, and poor surgical candidacy. Aspiration biopsies were initially performed with 22‐ to 18‐gauge spinal needles. If the initial cytologic evaluation findings were nondiagnostic, core biopsies were then performed with 20‐ to 18‐gauge core biopsy guns. Dictated sonographic reports of the biopsies were reviewed to determine the following: indication for biopsy, location and size of the renal mass, needle gauge and type, number of needle passes, and complications. Final cytologic and surgical pathologic records were reviewed.

Thirty‐six (82%) of the 44 biopsy specimens were diagnostic. Aspirated smears were diagnostic in 24 (67%) of these cases, with the diagnosis made on the basis of cell block alone in an additional 2 (6%). A definitive diagnosis came from core biopsy alone in 10 cases (28%). The 18‐gauge core needle yielded diagnostic results more reliably than the 20‐gauge core needle, and a significant correlation was seen between core biopsy needle size and the rate of diagnostic core samples (P = .017). Pathologic diagnoses included renal cell carcinoma (n = 18), lymphoma (n = 4), oncocytic neoplasm (n = 4), transitional cell carcinoma (n = 2), angiomyolipoma (n = 1), papillary cortical neoplasm (n = 1), and metastatic carcinoma (n = 6). Complications were seen in 4 (9%) of 44 cases; all were treated conservatively.

For specific clinical indications, sonographically guided fine‐needle aspiration and core biopsy of a solid renal mass can be performed safely. In many cases, a definitive diagnosis can be made on the basis of fine‐needle aspiration alone. However, diagnosis may ultimately require core biopsy, for which 18‐gauge core needles would be more reliably diagnostic than 20‐gauge needles.
A pilot study of time allocation and reimbursement for routine obstetric ultrasonography.
Authors: Stewart K S , Treadwell M C , Zador I E
Published: January 2017

To evaluate time allocation during initial and repeated ultrasonography and to formulate recommendations to improve unit efficiency.

Over a 2‐year period, 51 comprehensive ultrasonographic examinations between 14 and 38 weeks' gestational age were observed by a single reviewer. Each patient‐sonographer interaction was divided into timed segments, including setup, examination time, review, and turnover. Statistical analysis using descriptive statistics, Student ttest, and analysis of variance was performed to determine the effect of the number of ultrasonographic examinations, sonographer experience, estimated gestational age, and patient body mass index on examination time.

The average time spent with each patient was 15 minutes 22 seconds: 2 minutes 10 seconds for setup, 9 minutes 38 seconds for examination, 1 minute 50 seconds for review, and 1 minute 44 seconds for turnover. Examination length was not significantly affected by estimated gestational age, body mass index, ultrasonography experience, or the number of ultrasonographic examinations (P > .05). No statistical significance in the duration of scanning was found between initial (15 minutes 3 seconds) and repeated (16 minutes 1 second) examinations (P = .609). Nonexamination activities, such as data entry and room cleanup, consumed 37% of the sonographer's time.

Resource use within the ultrasonography department may be improved by reassigning clerical and custodial duties from sonographers to other personnel. Although differential reimbursement exists, no statistically significant difference in resource use between initial and repeated examinations was found.
Safety levels for exposure of cornea and lens to very high‐frequency ultrasound.
Authors: Silverman R H , Lizzi F L , Ursea B G , Cozzarelli L , Ketterling J A , Deng C X , Folberg R , Coleman D J
Published: January 2017

Very high‐frequency (50‐MHz) ultrasound is widely used for imaging the anterior segment of the eye. Our aim was to determine whether exposures to ultrasound at and above those used in diagnostic imaging systems might cause bioeffects in ocular tissues.

We characterized the output parameters of a polyvinylidene difluoride transducer using a needle hydrophone. We exposed sites on the cornea or lens of rabbits for up to 30 minutes at a 10‐kHz pulse repetition frequency. Tissue obtained immediately or 24 hours after exposure was examined by light microscopy. A numeric model was implemented to calculate expected temperature elevations in the cornea and lens under experimental conditions.

No tissue changes were observed directly or by slit lamp. Light microscopy showed no abnormalities attributable to ultrasound exposure. Simulations showed that even long‐term exposures should produce temperature elevations of less than 1 degree C in both the cornea and lens.

With the use of exposure parameters 4 to 5 orders of magnitude greater than encountered in a clinical situation, no tissue changes were observed. This is consistent with the small (0.2 degrees C) temperature rises computed in simulations. The lack of biological effects is attributable to the small dimensions of the focal zone, allowing rapid dissipation of heat, and the low total acoustic power produced by the transducer.
Maxillofacial Cysticercosis
Authors: Sidhu Ravinder , Nada Ritambhra , Palta Anshu , Mohan Harsh , Suri Sudha
Published: January 2017

Objective. To highlight the sonographic appearances of cysticercosis involving uncommon muscular sites. Methods. Two patients with nodular swelling involving the tongue and maxillary region were examined with high‐resolution sonography. Results. Sonographic examination revealed an anechoic area with a small calcified scolex suggesting cysticercus infection. Conclusions. High‐resolution sonography is a noninvasive and nonionizing imaging modality that plays an important role in establishing the diagnosis of cysticercosis.
Fetal Lateral Ventricular Width: What Should Be Its Upper Limit?
Authors: Almog Benny , Gamzu Ronni , Achiron Reuven , Fainaru Ofer , Zalel Yaron
Published: January 2017

Objective. The upper limit of the fetal atrial width in normal fetuses is debated. This was a prospective cohort evaluation of the lateral ventricular width with special regard to the upper limit of its size. Methods. Measurements of fetal atrial ventricular size were obtained by abdominal ultrasonography in 427 male and female fetuses between 20 and 40 weeks' gestation of normal singleton pregnancies. In addition, reanalysis of previous data (8 studies) and the current data was performed to produce a pooled mean and SD. Results. The mean ventricular width ± SD was 6.2 ± 1.2 mm. The ventricular width did not show significant modification throughout gestation. Reanalysis of the current and previous studies (8216 cases) yielded a pooled mean of 6.4 ± 1.2. Conclusions. According to the current and previous studies, the upper cutoff of fetal ventricular atrium width should be 10 mm. This cutoff represents a range of approximately 3 SDs above the pooled mean, corresponding to a 99.74% confidence interval.
Sonographic Imaging of Maternal Complications of Pregnancy
Authors: Di Salvo Donald N.
Published: January 2017

Objective. To show the role of diagnostic sonography in delineating pathologic conditions occurring during and immediately after pregnancy. Methods. Cases illustrative of a broad range of pathologic conditions were collected primarily from personal experience in a busy ultrasound clinic serving high‐ and low‐risk pregnancies over the past 15 years, with supplemental cases drawn from departmental teaching files. Sonography was the primary diagnostic tool, with confirmation obtained from other imaging modalities in select instances. Results. Cases were organized on an anatomic and time‐of‐onset basis. For conditions occurring during pregnancy, the following anatomic areas are considered: the liver and biliary tree, urinary tract, bowel, ovary, and uterus and placenta. For postpartum complications, the following conditions are discussed: subfascial and bladder flap hematomas, retained products of conception, and ovarian vein thrombophlebitis. Although the main imaging modality in these conditions was sonography, correlation with computed tomography and magnetic resonance imaging was also made in several cases. Conclusions. A broad variety of conditions can affect the pregnant patient, both during and immediately after pregnancy. Sonography can show many of these disease processes, with computed tomography and magnetic resonance imaging useful selectively as supplementary tools.
Three‐dimensional Ultrasonography in Gynecology
Authors: Bega George , Lev-Toaff Anna S. , O'Kane Patrick , Becker Eduardo , Kurtz Alfred B.
Published: January 2017

Objective. The aim of this work was to review the technical aspects and clinical applications of three‐dimensional ultrasonography in gynecologic imaging. Methods. With the use of a computerized database (MEDLINE), articles on three‐dimensional ultrasonography were reviewed. Other pertinent references were obtained from the references cited in these articles. In addition, we reviewed our own clinical experience over the past 7 years. Results. Numerous applications of three‐dimensional ultrasonography have been reported, including imaging of the uterus, the endometrial cavity, adnexa, and the pelvic floor and color and power Doppler applications. The accuracy of volume calculations and the networking opportunities with three‐dimensional ultrasonography have also been reported. Technical problems and limitations of this technique are summarized. Conclusions. Three‐dimensional ultrasonography has proved to be a useful imaging tool for clinical problem solving in gynecology, especially in imaging the uterus and uterine cavity.
Color Doppler Sonohysterography of Endometrial Polyps and Submucosal Fibroids
Authors: Fleischer Arthur C. , Shappell Heidi W.
Published: January 2017

Objective. To describe the typical sonographic findings and clinical applications of color Doppler sonohysterography and to correlate the vascularity of lesions seen on color Doppler sonohysterography to microvessel density and the presence of vessels greater than 0.5 mm. Methods. Color Doppler sonohysterography was performed on 25 women with abnormal uterine bleeding. The vascularity (number of vessels >0.5 mm) and their configuration seen on color Doppler sonohysterography were compared with those obtained on the excised specimen. Microvessel density and histologic features were correlated to the visualization of vessels greater than 0.5 mm and their arrangement on color Doppler sonography. Results. The color Doppler sonographic findings in 18 polyps, 3 submucosal fibroids, and 1 clot showed distinct vascularity patterns. Polyps typically contained a single feeding vessel, whereas fibroids had several vessels, which arose from the inner myometrium. Lesions with higher microvessel density tended to have more vessels greater than 0.5 mm as depicted on color Doppler sonography. Conclusions. Color Doppler sonohysterography may be useful in distinguishing polyps from submucosal fibroids based on the vascularity of the lesions. The number of vessels seen on color Doppler sonography approximates microvessel density within the lesions.
Saline Infusion Sonohysterography
Authors: Berridge Debra L. , Winter Thomas C.
Published: January 2017

Objective. To review the technique, indications, and common imaging findings regarding saline infusion sonohysterography. Methods. The literature on saline infusion sonohysterography was reviewed. Pertinent images from our institution are presented to illustrate common imaging findings. Results. From the literature review, we summarize the various clinical scenarios in which saline infusion sonohysterography is useful and give examples from our clinical practice. Conclusions. Saline infusion sonohysterography is a useful procedure for evaluation of endometrial and subendometrial abnormalities.
Analysis of the Thymus in 151 Healthy Infants From 0 to 2 Years of Age
Authors: Yekeler Ensar , Tambag Ahmet , Tunaci Atadan , Genchellac Hakan , Dursun Memduh , Gokcay Gulbin , Acunas Gulden
Published: January 2017

Objective. A prospective sonographic study of the normal thymus was performed to determine the size changes with age and to compare the results according to some clinical conditions, such as sex, breast versus formula feeding, and term or preterm status. Methods. One hundred fifty‐one healthy infants underwent thymic sonography. Maximal transverse and longitudinal dimensions and anteroposterior dimensions of the right and left lobes were measured, and thymic indices were calculated. Mean values of thymic measurements for each group (sex, age, breast or formula feeding, and term or preterm status) were determined. The results were statistically evaluated. Results. Thymic dimensions showed the maximal values at about 4 to 6 months and gradually decreased after 6 to 8 months. No significant differences were found between mean values of thymic dimensions according to the sex and formula‐ versus breast‐fed groups. As expected, the term group had greater thymic size values than the preterm group, probably because of positive correlations between thymus size, birth weight, and height. Conclusions. The thymus is clearly and easily visualized on sonography in the 0‐ to 2‐year age period. This may be useful for evaluating qualitative and quantitative properties of the thymus and determining size changes according to age in various clinical conditions.
Drug Delivery Into the Eye With the Use of Ultrasound
Authors: Zderic Vesna , Clark John I. , Vaezy Shahram
Published: January 2017

Objective. To evaluate ultrasound enhancement of drug delivery through the cornea and the histologic appearance of the cornea up to 24 hours after treatment. Methods. Corneas were exposed to ultrasound at a frequency of 880 kHz and intensities of 0.19 to 0.56 W/cm2 (continuous mode) with an exposure duration of 5 minutes. The aqueous humor concentration of a topically applied hydrophilic dye, sodium fluorescein, was determined quantitatively in ultrasound‐ and sham‐treated rabbit eyes in vivo. Gross and light microscopic examinations were used to observe structural changes in the cornea 0 to 24 hours after ultrasound exposure. Cavitation activity was measured with a passive cavitation detector. Results. Most cells with an appearance different from that of the normal cells were present in the surface layer of the corneal epithelium. No structural changes were observed in the stroma. The increase in dye concentration in the aqueous humor (relative to sham treatment), after the simultaneous application of ultrasound and the dye solution, was 2.4 times at 0.19 W/cm2, 3.8 times at 0.34 W/cm2, and 10.6 times at 0.56 W/cm2 (P < .05). Dye delivery was found to increase with increasing ultrasound intensity, which corresponded to an increase in cavitation activity. Corneal pits, observed in the ultrasound‐treated epithelium, completely disappeared within 90 minutes. Conclusions. Application of 880‐kHz ultrasound provided up to 10‐fold enhancement in the delivery of a hydrophilic compound through the cornea while producing minor changes in the corneal epithelium.