bluuebunny/crossref_metadata_2025 huggingface dataset:
Randomly correcting model errors in the ARPEGE-Climate v6.1 component of CNRM-CM: applications for seasonal forecasts
Authors: Batté Lauriane , Déqué Michel
Published: February 2016

Abstract. Stochastic methods are increasingly used in global coupled model climate forecasting systems to account for model uncertainties. In this paper, we describe in more detail the stochastic dynamics technique introduced by Batté and Déqué (2012) in the ARPEGE-Climate atmospheric model. We present new results with an updated version of CNRM-CM using ARPEGEClimate v6.1, and show that the technique can be used both as a means of analysing model error statistics and accounting for model inadequacies in a seasonal forecasting framework. The perturbations are designed as corrections of model initial tendency errors estimated from a preliminary nudged reforecast run over an extended reference period of 34 boreal winter seasons. Perturbations are then drawn randomly in forecast mode, but consistently for all three prognostic variables perturbed. Statistical analysis of these model corrections show that they are mainly made of intra-month variance, justifying the use of these corrections as in-run perturbations of the model in seasonal forecasts. However, the inter-annual and systematic error correction terms cannot be neglected. We explore therefore the impact of using monthly mean perturbations throughout a given forecast month in a first ensemble re-forecast SMM. Time correlation of the errors is limited, but some consistency is found between the errors of two or three consecutive days. This leads us to explore the use of five-day sequences of perturbations in a second ensemble re-forecast S5D. Both experiments are compared in the light of a REF reference ensemble with initial perturbations only. A comprehensive forecast quality analysis is then provided. Results are contrasted depending on the region and variable of interest, but very few areas exhibit a clear degradation of forecasting skill with the introduction of stochastic dynamics. We highlight some positive impacts of the method, mainly on Northern Hemisphere extra-tropics. The 500 hPa geopotential height bias is reduced, and improvements seem to project onto the representation of North Atlantic weather regimes in S5D. A modest impact on ensemble spread is found over most regions, which suggests that this method could be complemented by other stochastic perturbation techniques in seasonal forecasting mode.
Observing river stages using unmanned aerial vehicles
Authors: Niedzielski Tomasz , Witek Matylda , Spallek Waldemar
Published: February 2016

Abstract. We elaborated a new method for observing water surface areas and river stages using unmanned aerial vehicles (UAVs). It is based on processing multitemporal m orthophotomaps produced from the UAV-taken visual-light photographs of n sites of the river, acquired with a sufficient overlap in each part. Water surface areas are calculated in the first place, and subsequently expressed as fractions of total areas of water-covered terrain at a given site of the river recorded on m dates. The logarithms of the fractions are later calculated, producing m samples of size n. In order to detect statistically significant increments of water surface areas between two orthophotomaps we apply the asymptotic and bootstrapped versions of the Student's t-test, preceded by other tests that aim to check model assumptions. The procedure is applied to five orthophotomaps covering nine sites of the Ścinawka river (SW Poland). The data have been acquired during the experimental campaign, at which flight settings were kept unchanged over nearly 3 years (2012–2014). We have found that it is possible to detect transitions between water surface areas produced by all characteristic water levels (low, mean, intermediate and high stages). In addition, we infer that the identified transitions hold for characteristic river stages as well. In the experiment we detected all increments of water level: (1) from low stages to: mean, intermediate and high stages; (2) from mean stages to: intermediate and high stages; (3) from intermediate stages to high stages. Potential applications of the elaborated method include verification of hydrodynamic models and the associated predictions of high flows using on-demand UAV flights performed in near real-time as well as monitoring water levels of rivers in ungauged basins.
Rapport in EFL Classrooms with a Mobile Application in Everyday Context
Authors: Khubyari Leila , Haddad Narafshan Mehry
Published: February 2016

Technology especially, using mobile considered a booming future trend, facilitates education anywhere and anytime, and increases rapport among the growing number of second language learners. Consequently, this study probes the impact of Mobile Assisted Language Learning (MALL) on rapport in EFL classrooms. The population of this study was intermediate female EFL students (15-20 years old) at English Language institutes located in Kerman, district 2. A Cambridge Placement Test (CPT) was used to have almost homogenous groups. After administrating the CPT, 40 students who were randomly and equally assigned to the experimental and control groups (20 students in each group) were selected as the sample of this study. To see the impact of MALL on EFL learners' classroom rapport, the researcher utilized quantitative research method. The instrument applied in this study was a classroom rapport questionnaire. The result revealed that regular and immediate text messages can act as an effective way of establishing rapport between the teacher and the students.
Pupil Response to Tropicamide following Corneal Crosslinking
Authors: Kymionis George D. , Paraskevopoulos Theodore A. , Liakopoulos Dimitrios A. , Grentzelos Michael A. , Kouroupaki Anna I. , Tsoulnaras Konstantinos I. , Panagopoulou Sophia I. , Mazzotta Cosimo , Detorakis Efstathios T.
Published: February 2016

Purpose

To evaluate the effect of corneal crosslinking (CXL) with ultraviolet A (UVA) irradiation on pupil response to tropicamide 0.5% instillation.

Methods

This prospective interventional study enrolled 17 patients (19 eyes) with progressive keratoconus who underwent CXL with UVA irradiation. Central corneal thickness (CCT) was evaluated with the use of anterior segment optical coherence tomography (Visante OCT 3.0). Pupil diameter was measured with the use of Colvard infrared pupillometer before the instillation of tropicamide 0.5% and after the instillation of tropicamide every 5 minutes for total duration of 30 minutes. Corneal epithelial integrity was examined with the use of fluorescein dye staining. Measurements were performed 1 day preoperatively and 1 month postoperatively, with emphasis on simulating the same light conditions regarding the pupil measurements.

Results

No intraoperative or postoperative complications were observed in any of the patients. Mean CCT decreased significantly (p<0.001) 1 month postoperatively. Mean postoperative pupil size did not change significantly at any time point compared to the mean preoperative measurements.

Conclusions

The CXL procedure seems not to impair effectiveness of topical drugs, using pupil size measurements after tropicamide 0.5% instillation.
OECI Accreditation at Veneto Institute of Oncology IOV - IRCCS, General Framework and Multidisciplinary Approach
Authors: Chiusole Daniela , Cioffredi Piero , Basso Umberto , Bortolami Alberto , Crivellari Gino , Gennaro Gisella , Spina Romina , Opocher Giuseppe
Published: February 2016

The aim of this article is to describe the accreditation process of the Veneto Institute of Oncology (IOV-IRCCS) according to the Organisation of European Cancer Institutes (OECI) model, with particular reference to the standards for the multidisciplinary approach. Through the analysis of the process and the activities of each multidisciplinary team (MDT) and the development, at a regional level, of diagnostic, therapeutic, and care pathways (PDTA), all the necessary steps to meet the OECI standards have been determined. Adjustment is ongoing. We are working on the inclusion of the MDT registration forms in the electronic medical records and on the possibility to extend the OECI model to the MDT not based at IOV, but participated in by IOV professionals. The sarcoma MDT has achieved results demonstrating that the OECI framework has allowed the professionals involved in the multidisciplinary meeting to systematically share the clinical information of the patient, who can benefit from better continuity of care. The model has also provided greater clarity in the management of patients who are enrolled in clinical trials and deviate from Guide Lines (GL)/PDTA. The accreditation process according to the OECI model has added value to the IOV's already well-developed multidisciplinary activities.
Achievement of European Standards by CROB-IRCCS
Authors: Gallicchio Rosj , Scapicchio Daniele , Musto Pellegrino , Storto Giovanni
Published: February 2016

The Organisation of European Cancer Institutes (OECI) has recently endorsed a program for the accreditation of Italian cancer institutes. Any cancer center that aims to provide research, education, and care services to cancer patients should undergo an evaluation process in order to become OECI accredited. On a center basis, the task turned out to be challenging, and required commitment and increased workload. The timing is an adjunctive constraint, especially when dealing with bureaucracy. Once undertaken, the accreditation process goes through preparation and completion of the self-evaluation, peer review, report, and final designation. This process constitutes an unrepeatable opportunity for improvement. It is required to implement the necessary changes in order to improve policies, procedures, and employee training. Sharing the highlighted general remarks, strengths, and opportunities provided by the different audit teams (on a cancer center basis) will constitute a significant instrument to enhance cancer care.
The Comprehensive Cancer Care Network of Romagna: The Opportunities Generated by the OECI Accreditation Program
Authors: Ancarani Valentina , Bernabini Marna , Zani Chiara , Altini Mattia , Amadori Dino
Published: February 2016

Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS is a public-private partnership among 3 public sector bodies and 6 private nonprofit organizations and represents the hub of the Oncology Network of Romagna, which provides a wide range of services for the population ranging from primary prevention to palliative care. In 2012, IRST took part in the ministerial research project of the Organisation of European Cancer Institutes (OECI) accreditation program for Comprehensive Cancer Centers. The self-assessment period lasted 6 months and was coordinated by a multidisciplinary project team headed by a project leader. Each project team member coordinated a subgroup whose task was to analyze specific standards from qualitative and quantitative questionnaires. During the self-assessment period for the areas in which IRST did not meet OECI requirements, the project team outlined several improvement plans. At the end of the self-assessment period, the OECI Accreditation & Designation Board approved the documentation presented by IRST and a peer review visit was scheduled. The OECI report suggested establishing a more specific and stronger centralized management and leadership of all the oncologic activities carried out in other centers. In accordance with these suggestions, IRST and the Local Health Authority of Romagna laid the foundations for a new management model for the Oncology Network of Romagna: the Comprehensive Cancer Care Network (CCCN). The CCCN is a territory-oriented model (population approach) based on a principle of cooperation and collaboration among the network nodes.
Alleanza Contro il Cancro: The Accreditation System of the Excellence Network of Italian Cancer Centers in the Precision Medicine Era
Authors: Palombo Fabio , De Paoli Paolo , De Maria Ruggero
Published: February 2016

Alleanza Contro il Cancro (Alliance Against Cancer (ACC)) is a network of excellence comprising cancer centers with high standard patient care and research supervised by the Italian Ministry of Health. Founded in 2002, ACC has recently entered a renovation process in order to further increase quality procedures and international standing of the network. The Organization of European Cancer Institutes (OECI) accreditation system contributes significantly to this renovation process, which is generally directed towards all the main activities of cancer care and research, but has a particular attention to the treatment of advanced cancers that cannot be cured by standard procedures in conventional hospitals.
Participation of Italian Cancer Centres of the Alleanza Contro Il Cancro (ACC) in the Organisation of European Cancer Institutes (OECI) Accreditation and Designation Program: A Successful First National Initiative
Authors: Oberst Simon , Boomsma Femke , Lombardo Claudio , Docter Marjet , Blaauwgeers Harriët , De Paoli Paolo , de Valeriola Dominique , Paradiso Angelo , Saghatchian Mahasti
Published: February 2016

The Organisation of European Cancer Institutes (OECI) launched a program for accreditation and designation (A&D) of cancer centers in Europe based on voluntary participation in 2008. In 2012, the Italian Ministry of Health decided to fund cancer centers in Italy, members of the Alleanza Contro il Cancro (ACC), to go through the OECI accreditation program. Ten centers participated in the program and 10 completed the full cycle of the OECI A&D process in consecutive series over a 2-year period. The process was successfully completed within the planned timeline and the overall findings were presented to the Italian Ministry of Health and representatives of all the participating centers in November 2015. The program had a considerable team-building effect, which will likely continue as the improvement plans are implemented. Centers fed back to OECI that the A&D program had led to better formal organization of multidisciplinary teams (MDTs) and cancer care pathways, and had helped them to harmonize the integration of research into clinical practice. Centers also concluded that they benefited from recognition through an international accreditation system, and that it had led to them developing better patient information and involvement. The importance of the improvement plans that each center had to produce following the audit reviews cannot be underestimated. The OECI concludes that implementation of the A&D program at the national level is feasible despite national peculiarities related to health planning and organization in each member state. This is a good example of an EU project working well, with member states helping each other and learning from best practice, to improve the overall quality of cancer care and research and to establish consistency. The initial accreditation is the first part of an ongoing process of improving comprehensive cancer care, integrating bench to bedside.
The Experience of Accreditation of the Reggio Emilia Research Hospital with the OECI Model
Authors: Mazzini Elisa , Cerullo Loredana , Mazzi Giorgio , Costantini Massimo
Published: February 2016

The research hospital Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) of Reggio Emilia has a unique organization that involves a recently recognized IRCCS in oncology within a preexisting general hospital. The IRCCS of Reggio Emilia joined the “Tailored Accreditation Model for Comprehensive Cancer Centers: Validation through the Applicability of the Experimental OECI-based Model to the Network of Cancer IRCCS of the Alliance Against Cancer” and applied the accreditation & designation (A&D) Organisation of European Cancer Institutes (OECI) model in 2013. Before that accreditation, it had never been accredited according to international accreditation systems concerning cancer. By December 2015, the IRCCS of Reggio Emilia completed the first steps of the A&D OECI process (self-assessment period, peer review visit, implementation of the improvement plan). In December 2014, OECI confirmed the accreditation of our IRCCS and its designation as a Clinical Cancer Center and proposed a revisit at 2 years for upgrading the designation to Comprehensive Cancer Center (CCC). On the whole, the results given by adhesion to the A&D-OECI project are numerous and positive, under different points of view, formal (European accreditation and designation as a Clinical Cancer Center with possible upgrade to CCC) and substantial (involvement of professionals, attention to ongoing improvement, work on the sectors mainly of interest). The balance between the advantages and disadvantages linked to this accreditation model was positive. Following our experience, we conclude that the model was useful also for our kind of IRCCS, with its features useful for investigating all the sectors of the patient care pathway and research and necessity to stimulate change.
The OECI Model: The Experience of INT Milan with a Focus on the Integration of Psycho-oncology Support
Authors: Roli Anna , Borreani Claudia , Bosisio Marco , Bianchi Elisabetta , Montefusco Vittorio , Gobbi Giorgia , Platania Marco , Lavecchia Filomena , Milanesi Marco , Anselmi Valeria , Melani Cecilia , De Leo Giuseppe
Published: February 2016

The procedure for Organisation of European Cancer Institutes (OECI) accreditation identified the formation of MDTs for the diagnosis and scheduling of primary treatment with integration of supportive care as a key strength at Istituto Nazionale Tumori (INT). The opportunities for improvement highlighted by the OECI peer review inspired a study on the evaluation of psychological distress, with a view to integrating this evaluation into global patient management and to defining standardized criteria for the provision of psychological services. This article describes the OECI accreditation experience at INT and the study conducted between January and May 2015 on the evaluation of patients’ distress levels during cancer treatment, defining a score-based cutoff point that triggers the intervention of a psychologist. The Distress Thermometer was used as a tool for evaluating psychological distress, performed by nurses on admitting the patient. A total of 261 questionnaires were completed by patients admitted to the medical oncology and hematology departments, with an average distress value of 4.1, and 60% of patients experiencing clinically detectable emotional distress. Emotion-related problems had a significant association with a greater level of distress, while there were few reports of relationship issues as a cause of distress. As a result of the improvement initiative supported by the psychological distress evaluation study, we validated the screening questionnaire to be included at the initial patient evaluation stage with a cutoff point triggering the intervention by a psychologist at a score of ≥7.
Annexation of Crimea
Authors: Grant Thomas D.
Published: February 2016

The Russian Federation, by a municipal law act dated March 21, 2014, annexed Crimea, an area of Ukraine. This act followed armed intervention by forces of the Russian Federation, a referendum, and a declaration of independence in Crimea. Outside the context of decolonization, few claims of annexation following the use of force have been made during the United Nations era; this is the first by a permanent member of the Security Council against a United Nations member. The present article examines the annexation of Crimea in view of the legal arguments that the Russian Federation has articulated in defense of its actions. It then considers the international response and the possible consequences of nonrecognition.
Georgia v. Russia (I)
Authors: Arp Bjorn
Published: February 2016

On July 3, 2014, the Grand Chamber of the European Court of Human Rights (Court) rendered its judgment in Georgia v. Russia, concerning Russia’s collective expulsion of a large number of Georgian nationals between October 2006 and January 2007. The Court held that Russia had violated several provisions of the 1950 European Convention for the Protection of Human Rights and Fundamental Freedoms (Convention or ECHR), in particular Article of Protocol No. 4 to the ECHR (prohibition of collective expulsions). Because the Russian government had failed to cooperate with the Court by providing relevant information, the Court also found a violation of Article 38 of the ECHR, which obliges states to furnish “all necessary facilities” for the effective conduct of the Court’s investigation of the case. The Court deferred its decision on the question of “just satisfaction” under Article 41 pending further submissions by the parties. This was the first of three interstate proceedings that Georgia has brought against Russia under the special procedure of Article 33, and it is the first decision on the merits of these cases.
Maritime Dispute
Authors: Jain Abhimanyu George
Published: February 2016

On January 27, 2014, the International Court of Justice (Court) rendered its judgment in a dispute between Peru and Chile concerning the maritime boundary between them. The Court held that a partial maritime boundary already existed between the parties, and it proceeded to analyze both its nature and its extent on the basis of agreements between the parties, their practice, and other evidence. For the remainder of the boundary extending up to 200 nautical miles, the Court applied the rule of equitable delimitation found in Article 74 of the United Nations Convention on the Law of the Sea (UNCLOS).
Comparative International Law Within, Not Against, International Law: Lessons from the International Law Commission
Authors: Forteau Mathias
Published: February 2016

Public international law and comparative law have so far been regarded as largely distinct fields, with little to no overlap between them. The degree of separation between the two disciplines is rendered in particularly stark relief by the absence in practice or scholarship of any real inquiry into the relationship between comparative law on the one hand and customary international law and general principles of international law on the other. Some eminent international lawyers go so far as to claim that it would be both unnecessary and unrealistic to have recourse to comparative law in the context of the identification of customary international law and general principles of law, pointing to the case law of the Permanent Court of International Justice and the International Court of Justice, which, according to them, “show[s] a clear disinclination towards the use of the comparative method.”
Response to Koh and Buchwald’s Article: Don Quixote and Sancho Panza Tilt at Windmills
Authors: Pellet Alain
Published: February 2016

In their eagerness to justify the “United States perspective” on the Kampala definition of the crime of aggression and on the International Criminal Court (ICC), Koh and Buchwald tend to invent imaginary enemies and to ascribe to them views that they do not actually hold. In so doing, the authors weaken a thesis that, in some respects, is not devoid of interest. From at least two points of view, however, their article is paradoxical, if not pathetic—exactly like the U.S. position.
ChinaMeasures Related to the Exportation of Rare Earths, Tungsten, and Molybdenum
Authors: Trujillo Elizabeth
Published: February 2016

In a proceeding brought against the People’s Republic of China by the United States (in which Japan and the European Union joined), the Appellate Body of the World Trade Organization (WTO) ruled that China violated its obligations under the General Agreement on Tariffs and Trade 1994 (GATT)1 by imposing export restrictions on “rare earths,” minerals used in mobile phones, hybrid cars, and other high-tech products. In upholding the earlier decision of a WTO dispute settlement panel, the Appellate Body rejected China’s argument that export duties, quotas, and other restrictions could be justified by health and environmental concerns.
Surgical treatment of congenital clubfoot deformity: The Qatar experience
Authors: Bakdash M. M. , Al Yazidi S. , Al Said M. N.
Published: February 2016

This was a retrospective study analyzing surgical treat-ment of rigid, non-teratologic talipes equinovarus (club foot deformity) in Qatar in the ten year period from 1990 to 1999. Treatment started early (as soon as the patient was referred, usually during the first two - three weeks of de-livery) with serial manipulation and adhesive strapping or plaster of paris casting. When clinically indicated, soft tis-sue release was performed.

One hundred and twenty one feet were operated upon in Hamad General Hospital during that period. (73 patients, 46 male, 27 female). Postero-medial release was done in 73 feet; Achilles tendon lengthening in eight feet; posterior release in 32 feet. Most primary soft tissue procedures were performed between two and ten months of age. Primary bony procedures were done for eight feet with late presentation.

Posterior release alone resulted in a higher rate of secondary procedures (53%), whereas postero-medial release resulted in only 22%. Therefore we recommend postero-medial release whenever in doubt about the adequacy of posterior release.
Koro-Like symptoms and transient Post-Ictal psychosis
Authors: Bayer R.S.
Published: February 2016

Report of a rare occurrence of koro-like symptoms as a part of transient post-ictal schizophrenia-like psychosis in a Jordanian patient The etiology is reviewed in relation to the literature.
Thirty Successful Percutaneous Dilatational Tracheostomy in Surgical and Trauma Intensive Care Patients
Authors: Ahmed A. H. A. , El Boursaly I.
Published: February 2016

Tracheostomy is a procedure commonly undertaken in critically ill patients since it has several advantages over prolonged translaryngeal intubation. For critically ill patients bedside tra-cheostomy can be performed by a percutaneous approach using either an incisional or a dilatational techniques. The major advantages of bedside percutaneous dilatational tracheostomy are that it is easy to perform, more rapid and less expensive.
Resuscitation Guidelines Update: Adult Basic Life Support
Authors: Salam A. M. , AI Musleh A. W. , Gehani A. A.
Published: February 2016

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

Herein, we summarize the changes in these guidelines as it applies to Adult Basic Life Support (BLS). This interpretation is basically similar to that of the European Resuscitation Coun-cil (ERC). The changes have been incorporated into the cur-riculum of our Advanced Life Support (ALS) provider courses and the new 2001 ERC ALS manual.
The Outcome of In-Vitro Fertilization/Intracytoplasmic Sperm Injection (IVF/ICSI) Cycles Complicated by Moderate-Severe Ovarian Hyperstimulation Syndrome (OHSS)
Authors: Al Inizi S. T. , Asaad M. , Schick J.
Published: February 2016

A retrospective study was used in the Fertility Clinic of the Department of Obstetrics & Gynecology, Tawam Hospital, Al Ain, Abu Dhabi, United Arab Emirates to determine the outcome of IVF/ICSI cycles complicated by OHSS.

Materials & Methods: In the period between January 1994 and August 2000, 3174 IVF/ICSI cycles were performed and 2918 cycles had reached embryo transfer, 564 women achieved pregnancy (19.33%). 92 women (3.15%) developed moderate-severe OHSS and were hospitalized and their medical and IVF records were reviewed. Supportive management whilst waiting for the condition to resolve spontaneously together with follow-up by ultrasound scan and blood tests was applied to all patients included in the study. Pregnancy test was performed 17 days after ovum pick-up.

Results: Ninety-two women developed moderate-severe OHSS, 37 women of them had a clinical pregnancy (40.2%). 51.4% were singletons and 48.6% were multiple pregnancies; including 13 sets of twins, 4 sets of triplets and one set of quadruplets. The miscarriage rate was 32.4% and the spontaneous fetal reduction rate was 16.6%. 25 women continued pregnancy (67.6%); eleven women had preterm delivery (44%), low birth weight rate was 44% and take home baby rate was 59.4%. The Cesarean section rate was 24%. Pregnancy-induced hypertension rate was only 8% and gestational diabetes 4%. There were no cases of ectopic pregnancy or placental abruption.

Conclusion: The pregnancy rate and the rate of multiple pregnancy, miscarriage, prematurity, low birth weight and Cesarean section rate are significantly higher than those reported previously for pregnancies conceived with the use of assisted reproductive techniques without the development of OHSS. The incidence of other obstetric complications such as pregnancy-induced hypertension, gestational diabetes, abruptio placentae and ectopic pregnancy are not significantly different.
Isolated Tuberculous Liver Abscess in an Immunocompetent Patient
Authors: Al Soub H.
Published: February 2016

Tuberculous liver abscesses are rare and are usuallyassociated with disease involving other organs. In 1952 Leader made an extensive review of the world literature and documented 80 cases of hepatic tuberculosis with large abscesses or nodules. In most of these cases tuberculosis was present elsewhere in the body. An isolated tuberculous liver abscess is very rare and only 20 cases have been reported in the English language literature to date. Diagnosis is often delayed or missed because of nonspecific symptomatology and the rare occurrence. We describe a case of an isolated tuberculous liver abscess in an immunocompetent patient.
Laparoscopic Supracervical Hysterectomy (L-SH)
Authors: Abdel Monem A. M. , Ismail S. A. , Mohammed S. M. , Abdellah M. A. , Pasic R. P.
Published: February 2016

Laparoscopic supracervical hysterectomy is a viable alternative with putative advantages over the same procedure performed via laparotomy for those individuals requiring uterine extirpation without indication for cervical removal. The laparoscopic approach to this procedure provides even lower morbidity and therefore can enhance clinical outcomes. The risk of subsequent cervical cancer, an uncommon and largely preventable occurrence, may not outweigh the benefits of supracervical hysterectomy, which should be offered as an option for selected patients. Therefore it seems likely that, in a woman with a history of regular screening with negative cytology, there will be a minimal risk of future malignant change in a cervical remnant, even this risk would be reduced to near zero if the transition zone and part or all of the endocervical cana were to be removed.
C-Reactive Protein in the Premature Rupture of the Membranes
Authors: El Taher F. T. , Afifi N. M. , Khadija A. H. , Al Saad A. H.
Published: February 2016

Premature rupture of the membranes (PROM) defined as a rupture of membranes before onset of labor, which is one of the most complications of pregnancy that leads to significant maternal and neonatal morbidity and mortality. These complications depend on the gestational age to which it occurred. The aim of this study is to determine diagnostic value of CRP during pregnancy complicated by PROM. Retrospective study performed at Hamad Women's Hospital in Qatar. Data collected from files in the Medical Records over a two period from 27/11/2000 to 27/11/2002. One hundred and fifty cases were chosen and divided into: Group (la) 50 patients with PROM before 37 wks. Group (lb) 50 patients with PROM after 37 wks. Group (2) 50 patients as control. Statistical analysis showed high incidence of Oligohydroamnios and polyhydramnios in the group 1 compared with control Measurement of maternal blood CRP early before 37 weekindicated significant relation between the prevalence of premature rupture of the membranes, associated oligohydramnios with the incidence of positive results of CRP. We recommend that further investigations needed to document our data and to prove the beneficial effect of the test especially before 37 week of gestations.
“From Qatar to the World” Abstracts Presented at International Conferences
Authors: Gehani Abdurrazak A.
Published: February 2016

This study aimed to investigate the effect of oral pilocarpine (OP) in reducing the incidence of chemotherapy-induced oral mucositis. Thirty two adult patients completed a total of 82 courses of chemotherapy in which either OP or placebo was given pro-phylactically in a double-blind cross-over design to prevent mucositis. Mucositis was documented in 20 out of 41 courses in which patients were given placebo, whereas mucositis was documented in only six out of 41 courses when patients were given OP (P<0.005). OP treatment was found to significantly reduce the mucositis score when assessed by the method of Donnelly and colleagues (Donnelly JP, Muus P, Schatttenberg A, De Witte T, Horrevorts A, De Pauw BE. Bone Marrow Transplant 1992, 9,409–413). Using this score, all patients scored a total of 52 when they were given the placebo versus eleven when they were treated with OP (P<0.001). A similar reduction in mucositis score was noticed using the World Health Organization (WHO) mucositis score; the total patient score was 25 for the placebo-treated group versus 6 for the OP group (P<0.001). We therefore conclude that oral pilocarpine is highly effective in the prevention of oral mucositis when given prophylactically to adult patients receiving a variety of cancer chemotherapy regimens.
Surgical Precautions to Maintain Quality of Life in Patients Aged more than 80 Years with Benign Brain Tumors
Authors: Al Anazi A.
Published: February 2016

As the average life expectancy is gradually increasing, more elderly patients are seen in neurosurgical clinics but those aged 80 years or more pose significant medical and ethical dilemmas for neurosurgeons. A retrospective study of eleven patients assessed the post-operative short term outcome in very old patients with benign brain tumors. Six had total surgical excision and five had partial resection. The outcome was good for six, unchanged in one and four died. Post-operative intracranial complications were not tolerated and resulted in a poor outcome in this age group. However; it is suggested that carefully selected patients over the age of 80 years with symptomatic benign brain tumors can be considered for surgical intervention.
Selected Abstracts From Other Journals
Authors: Hammoudeh M. , Gehani A. A.
Published: February 2016

Context: There is a paucity of effective, well-tolerated drugs available for migraine prophylaxis.

Objective: To determine whether treatment with the angiotensin II receptor blocker candesartan is effective as a migraine-prophylactic drug.

Design and Setting: Randomized, double-blind, placebo-controlled crossover study performed in a Norwegian neurological outpatient clinic from January 2001 to February 2002.

Patient: Sixty patients aged 18 to 65 years with 2 to 6 migraine attacks per month were recruited mainly from newspaper advertisements.

Interventions: A placebo run-in period of 4 weeks was followed by two 12-week treatment periods separated by 4 weeks of placebo washout. Thirty patients were randomly assigned to receive one 16-mg candesartan cilexetil tablet daily in the first treatment period followed by 1 placebo tablet daily in the second period. The remaining 30 received placebo followed by candesartan.
A Population Based Study on Mishaps During Laparoscopic Cholecystectomy in Qatar: 10 Years Experience
Authors: Hussein A. A. , Allam H. , Kassem H. , Sholeik N.
Published: February 2016

In order to determine the national incidence of adverse events following laparoscopic cholecystectomy (LC) the records were reviewed retrospectively of4861 patients who underwent LC over a period often years (1993-2003).

The most serious non-biliary complication was trocar injury of major vessels in three cases. Other non-biliary complications included duodenal perforation during dis-section of the Calot's triangle, small bowel injury while inserting the umbilical port and trocar site hernia. Adverse biliary events included common bile duct injury, common hepatic duct injury, bile leakage from the cystic duct and one instance of the migration of an endoloop into the com-mon bile duct. Conversion to open cholecystectomy was required in 109 cases.

Although LC may be associated with various adverse sequelae, these are rare and should not deter surgeons and patients.
Pachydermoperiostosis: Report of two cases
Authors: Al Emadi S. , Mehdi S.
Published: February 2016

We report two patients with pachydermoperiostosis. Both patients presented with pain and swelling of the large joints, characteristic facial features, clubbing and enlargement of distal parts of the extremities.
“From Qatar to the World” Abstracts
Authors: Hammoudeh M. , Gehani A. A.
Published: February 2016

Diagnostic procedures performed on patients with multiple myeloma typically reveal lytic bone lesions, osteopenia or osteoporosis, bone marrow infiltration by plasma cells as well as overproduction of immunoglobulin or light chains in the serum or urine. Skeletal manifestations are extremely variable and the unusual forms have been described extensively. Extramedullar plasma-cell tumours (plasmocytoma) are found in about 5% of newly diagnosed patients with multiple myelomas. In this paper we present eight patients with atypical forms of multiple myeloma.
Agenesis of Right Lobe of Liver: Role of Multislice Computed Tomography
Authors: Garg K. C. , Venkatraman B. , Chacko K. C.
Published: February 2016

Congenital anomalies of the liver are rare. Agenesis of the right lobe of liver is a rare anomaly with 43 cases reported so far in the English literature. Hypoplasia and agenesis occur more on left side. Agenesis of right lobe of liver is presented in this case report. Role of multislice computed tomography is highlighted in diagnosis. A brief literature review is made along with discussions on differential diagnosis.
A Giant Oncocytoma Arising from Retroperitoneal Heretopic Adrenal Tissue: A case report and literature review
Authors: El Malik E. M. , Prasad V. K. , Al Said S. , Jyothi C. R. , Omar A.
Published: February 2016

A 56-year-old male presented with a history of right loin pain of two months duration. Physical examination showed a firm non-tender mass in the left upper quadrant. Blood and urinary investigations including serum Cortisol and urinary cathecholamines were normal. CT scan showed an oval, welldefined, heterogeneous mass measuring 14-10 cm. in the region of the left suprarenal gland(Fig. 1).There was no evidence of infiltration into the surrounding tissue. In view of the size and supra-renal location of the mass it was decided to remove the retroperitoneal tumor and the ipsilateral adrenal gland through a left thoraco-abdominal incision to permit adequate exposure and vascular control.
Micu Quiz
Authors: Kamha A. , Younis M.
Published: February 2016

The patient was admitted to Medical ICU because of severe shortness of breath and fever. The patient is known case of renal transplant using immunosuppressant medications. Deep endotracheal tube aspirate reported as, Gram's stain showed delicate, filamentous, branching gram positive rods. Acid-fast staining showed partially acid fast filamentous branching rods.
Non-Enhanced Spiral CT Versus Excretory Urography in Acute Renal Colic
Authors: Uraiqat A. , Al Khateeb M. , Al Shishani J.
Published: February 2016

Objective: To evaluate the usefulness of non-enhanced spiral CT (NECT) and compare it with that of excretory urography (EU) in patients with acute flank pain.

Methods: Ninety five patients presenting with acute flank pain underwent both NECT and EU. Both techniques were used to determine the presence, size, and location of urinary stone, and the presence or absence of secondary signs was also evaluated. The existence of ureteral stone was confirmed by its removal or spontaneous passage during follow-up. The absence of a stone was determined on the basis of the clinical and radiological evidence.

Result: Seventy eight of the 95 patients had one or more ureteral stones and 17 had no stones. CT depicted 79 of 83 calculi in the 78 patients with a stone and no calculus in all seventeen without a stone. The sensitivity and specificity of NECT were 95% and 100%, respectively. EU disclosed 73 calculi in the 78patients with a stone and no calculus in fifteen of the seventeen without a stone, with sensitivity and specificity 89% and 88% respectively.

Conclusion: For the evaluation of patients with acute flank pain, NECT is an excellent modality with high sensitivity and specificity. In near future it may replace EU.
An Assessment of Five Year Experience in Amniocentesis in Qatar
Authors: Al Tamimi H. , Al Sakka M. , Lilia A. R. , Selmy O.
Published: February 2016

Objective: The purpose of this study is to evaluate the risk of foetal loss attributable to amniocentesis and to assess the experience in technique, successful fluid aspiration in amniocentesis performed in our hospital Study Design: Medical record of 123 women who underwent amniocentesis between September 1996 till March 2002 were reviewed for indication, maternal, age, nationality, maternal age, parity, nationality, gestational age at procedure, physician operator, amniotic fluid reports and pregnancy outcome.

Result: Within 30 days of amniocentesis there were tow (2.2%) foetal lossess, 91 patients (74%) for genetic amniocentesis, 32 patients (26%) Rh. Isoimmunization, 4 cases (3.2%) no fluid aspiration and in 10 patients procedure repeated one week later for successful aspiration.

Conclusion: Amniocentesis-related total pregnancy loss rate was 2.2%. Successful aspiration of clear amniotic fluid increases with amniocentesis experience.
Survey of Hepatitis Markers Among Donors in the State of Qatar
Authors: Fawzi Z. , Al Hilali A. , Al Malki A. , Al Matawa H. , Yousef B. , Ali Bin Ali A. , Al Mansour S.
Published: February 2016

A total of 78,428 blood units collected by the Blood Donor Unit, Hamad Medical Corporation, Doha, from the multinational donors of Qatar (28,622 Qatari nationals donors and 49,806 Non-Qatari donors) in the period January 1994 to Dececember 2001 were screened for hepatitis markers. About 10,382 units (13.2%) were discarded because of positivity for one or more hepatitis markers; 769 units (0.9%) were positive for hepatitis-B surface antigen (HBsAg), 8516 units (10.9%) were positive for hepatitis-B core antibodies (HBcAb) and 1097 units (1.39%) were positive for hepatitis C (HCV) antibodies. There was no significant difference between the rate of positivity for HBcAb and HBsAg in indigenous Qataris and Non-Qataris despite a slightly higher rate ofpositivity for HCV antibodies in the Non-Qatari group. An outstanding finding was the significantly high rate of positivity for HCV antibodies in Egyptian donations (11.2%), which accounted for 31.2% of all discards for the Non-Qatari group. As the Blood Donor Unit at HMC is the only blood collection center in Qatar it is assumed that the results could be representative of the country as a whole.
Brugada Syndrome and Anesthesia
Authors: Koraichi N. , Louon A. , Nidal A. , Numan M.
Published: February 2016

Brugada Syndrome is a distinct form of an arrhythmic disease characterized by right bundle branch block an ST segment elevation in the right pericardial leads (VI - V3) of the electrocardiogram (ECG). This syndrome is clinically important because of the high incidence of sudden death by ventricular fibrillation (VF) without any structural heart disease, and is seen especially in the Asian population including Japanese people. Recently, it has been demonstrated that Brugada Syndrome is generally linked to the mutation of the alpha subunit of the sodium channel gene, SCNSA, and the use of certain anti-arrhythmic sodium channel blockers (Class IA au IC) is the sole the Medical intervention which effectively protects patients with Brugada Syndrome from sudden cardiac death.
Epidural Angiopomatosis of the Thoracic Spine: Case report and literature review
Authors: Nasser M. , Al Anazi A. , Moghazy K.
Published: February 2016

Spinal epidural angiolipomatosis (SEA) is a rare benign neoplasm of adipose tissue with a prominent vascular component. Classified as either idiopathic or secondary to chronic steroid therapy it accounts for 0.14% of all spinal axis tumours. The clinical and radiological features and treatment of a case in a 24-year-old male are described and discussed together with a review of the literature and previous reports.
Tuberculous Tenosynovitis: A rare presentation of miliary TB
Authors: Errayes M. , Yassin M. , Khan F. Y.
Published: February 2016

We present, as a rare manifestation of miliary TB, a case of tuberculous tenosynovitis, preceding by two weeks onset of tuberculous meningitis. A gradual progressive onset of a painless swelling of the right forearm was followed by high-grade fever, headache and neck pain. A suspected diagnosis of tuberculous meningitis based upon analysis of cerebrospinal fluid (CSF) was confirmed later by positive CSF polymerase chain reaction (PCR) for mycobacterium tuberculosis. Although the patient had a positive Mantoux test of 20 mm, there was no evidence of pulmonary TB and a negative CSF smear for acid fast bacilli but a positive smear from a fine needle aspirate of the swelling of the right forearm. The antituberculous therapy led to a successful outcome.
“From Qatar to the World” Abstracts Presented at International Conferences lor Published in Medical Journals
Authors: Gehani A. A. , Hammoudeh M.
Published: February 2016

Objective: To review the incidence of ruptured uteri at the Women's Hospital, Hamad Medical Corporation (HMC) and to analyze the causative factors of uterine rupture with the view to its prevention and to highlight the management approach taken to preserve the patient's reproductive potential.
Intravitreal Injection of Triamcinolone Acetonide for the Treatment of Refractory Diabetic Macular Edema
Authors: El Shafei M. M. , Martinez F. E. , Al Hashimi M. , Allaftah F. W. , Farouq M.
Published: February 2016

A prospective! descriptive! non-comparative pilot study was used to evaluate the efficacy of intravitreal injection of triamcinolone acetonide (TA) for the treatment of patients with refractory diabetic macular edema that had not responded to laser treatment. Forty eyes of 35 patients with visual acuity (VA) < 6/12 were infected with TA 4 mgl 0.1 cc under topical anesthesia. Results were assessed and analyzed using changes in visual acuity (VA), retinal thickness (RT) and macular volume measured by optical coherence tomography (OCT). In 62.85 % of cases the VA improved by more than two Snellen's lines, the initial VA (mean! log MAR) being 0.67 changing to 0.31 after six months (p = 0.008). RT improved in all patients, having the most remarkable improvement in the Macular Volume, with a decrease of 2.7 mm3 at the end of the study (p = 0.009). Both improvement ofVA and RT were more marked during the early follow-up. The most common complication was ocular hypertension (OHT) in 22.5 % of eyes, all of which responded to medical antiglaucoma treatment. Intravitreal injection ofTA looks to be a useful option for the treatment of refractory diabetic macular edema.
Solitary Arteriovenous Hemangioma of the Lung without Fistula: Report of a case and literature review
Authors: Al Rikabi A. C. , Chaikhouni A. , Ibrahim W. H. , Muslamani N.
Published: February 2016

Arterio-venous hemangiomas (also called vascular malformations) are uncommon lesions in general and very rarely reported as solitary lung tumors with no evidence of fistula formation or clinical evidence of shunting. We report the case of a 49 year old Indian male who presented to our institution with a right hilar lung mass which was histologically proven to be a classical arteriovenous hemangioma (vascular malformation). The patient did not have clinical or radiological evidence of fistula or shunts formation.