bluuebunny/crossref_metadata_2025 huggingface dataset:
Multimodel Estimation of Snow Microwave Emission during CLPX 2003 Using Operational Parameterization of Microphysical Snow Characteristics
Authors: Wójcik Rafał , Andreadis Konstantinos , Tedesco Marco , Wood Eric , Troy Tara , Lettenmeier Dennis
Published: April 2008

Existing forward snow emission models (SEMs) are limited by knowledge of both the temporal and spatial variability of snow microphysical parameters, with grain size being the most difficult to measure or estimate. This is due to the sparseness of in situ data and the lack of simple operational parameterizations for the evolution of snowpack properties. This paper compares snow brightness temperatures predicted by three SEMs using, as inputs, predicted snowpack characteristics from the Variable Infiltration Capacity (VIC) model. The latter is augmented by a new parameterization for the evolution of snow grain morphology and density. The grain size dynamics are described using a crystal growth equation. The three SEMs used in the study are the Land Surface Microwave Emission Model (LSMEM), the Dense Media Radiative Transfer (DMRT) model, and the Microwave Emission Model of Layered Snowpacks (MEMLS). Estimated brightness temperature is validated against the satellite [Advanced Microwave Scanning Radiometer for Earth Observing System (AMSR-E)] data at two sites from the Cold Land Processes Experiment (CLPX), conducted in Colorado in the winter of 2003. In addition, a merged multimodel estimate, based on Bayesian model averaging, is developed and compared to the measured brightness temperatures. The advantages of the Bayesian approach include the increase in the mean prediction accuracy as well as providing a nonparametric estimate of the error distributions for the brightness temperature estimates.
Vertical Velocity and Vertical Heat Flux Observed within Loop Current Eddies in the Central Gulf of Mexico
Authors: Rivas David , Badan Antoine , Sheinbaum Julio , Ochoa José , Candela Julio
Published: April 2008

Sixteen months of observations from a surface-to-bottom mooring in the central Gulf of Mexico show that acoustic Doppler current profilers (ADCPs) are useful for directly measuring the vertical velocity within mesoscale anticyclonic eddies, such as those shed from the Loop Current; and combining simultaneous temperature measurements, vertical heat flux can also be estimated (as a covariance of both variables). There is evidence of significant and coherent signals of vertical velocity ∼2–3 mm s−1 and vertical heat (temperature) transport ∼10−3 °C m s−1 during the presence of three anticyclones. A simple analysis shows downward flow near the eddies’ centers above 350 m and essentially upward flow in the peripheries, but below 700-m depth the pattern is indeed the opposite; however, further study is necessary to determine the eddies’ interior structures. The observations also suggest the existence of a vertical convergence of heat somewhere around 600-m depth, and estimations of adiabatic heat flux suggest that part of the converged heat, which is not recirculated within the eddy, must escape from the eddy and flow upward along the isopycnals up to the surface layers. This is in good agreement with previous results that have suggested that an excess heat gained by the Gulf in the intermediate levels through exchanges with the Caribbean Sea must be exported to the upper layers by an upward mean heat flux.
Ground Clutter as a Monitor of Radar Stability at Kwajalein, RMI
Authors: Silberstein David S. , Wolff David B. , Marks David A. , Atlas David , Pippitt Jason L.
Published: April 2008

There are many applications in which the absolute and day-to-day calibrations of radar sensitivity are necessary. This is particularly so in the case of quantitative radar measurements of precipitation. While fine calibrations may be made periodically by a variety of techniques such as the use of antenna ranges, standard targets, and solar radiation, knowledge of variations that occur between such checks is required to maintain the accuracy of the data. This paper presents a method for this purpose using the radar on Kwajalein Atoll to provide a baseline calibration for the control of measurements of rainfall made by the Tropical Rainfall Measuring Mission (TRMM). The method uses echoes from a multiplicity of ground targets. The daily average clutter echoes at the lowest elevation scan have been found to be remarkably stable from hour to hour, day to day, and month to month within better than ±1 dB. They vary significantly only after either deliberate system modifications, equipment failure, or other unknown causes. A cumulative distribution function (CDF) of combined precipitation and clutter reflectivity (Ze in dBZ) is obtained on a daily basis, regardless of whether or not rain occurs over the clutter areas. The technique performs successfully if the average daily area mean precipitation echoes (over the area of the clutter echoes) do not exceed 45 dBZ, a condition that is satisfied in most locales. In comparison, reflectivities associated with the most intense clutter echoes can approach 70 dBZ. Thus, the level at which the CDF reaches 95% is affected only by the clutter and reflects variations only in the radar sensitivity. Daily calculations of the CDFs have recently been made beginning with August 1999 data and are used to correct 7.5 yr of measurements, thus enhancing the integrity of the global record of precipitation observed by TRMM. The method is robust and may be applicable to other ground-based radars.
A Variational Correction Method as an Alternative to Forced Rejection of Sidelobe-Contaminated Bistatic Doppler Measurements
Authors: Chong Michel , Lamrani Nabil , Hagen Martin
Published: April 2008

The problem of sidelobe contamination of bistatic apparent Doppler velocity measurements involved in a bistatic Doppler radar network is examined. So far in the context of 3D wind field analysis, by combining a traditional Doppler radar with one or more bistatic receivers, identification and hence removal of regions of high degrees of contamination were necessarily crucial steps to obtaining reliable wind fields. This study proposes an alternative solution to the forced rejection of bistatic Doppler data suspected to be contaminated by sidelobe echoes, on the basis of restoring the nonmeasured “actual” (i.e., noncontaminated) bistatic Doppler velocity from both monostatic radar and bistatic receiver measurements. The correction method is based on a modeled expression of the observed bistatic apparent Doppler velocity defined as the reflectivity-weighted average of actual Doppler velocity of particles within individual volume samples, including the antenna gain pattern of both transmitting and receiving radars. The searched actual Doppler velocity is a solution of an underdetermined inverse problem that can be handled as a constrained linear inversion problem, through a variational least squares analysis method.

The performances of the proposed method are analyzed, using simulated radar observations involving one remote receiver. An example of application to experimental data collected by the Deutsches Zentrum für Luft und Raumfahrt (DLR) bistatic Doppler radar network within a moderate precipitation system observed on 8 May 2000 in Germany is also presented. Pseudo-Doppler observations of a tropical squall-line system are used to quantify the effective improvement of the correction method on the bistatic Doppler velocity and hence the retrieved 3D wind field. Statistics of the differences are presented between observed and idealized (sidelobe free) velocity structures on the one hand, and corrected and idealized velocity structures on the other hand. Clearly shown is the very low level of the corrected minus idealized differences (mean and standard deviation) against the significantly high level of the observed minus idealized differences. As previously observed, maximum correction occurs in regions of potentially high gradients of reflectivity. It is also found that regions of low observed minus idealized differences remain unchanged after correction, which means that the sidelobe-correction method only acts on needed regions and does not introduce any artificial modification.
Impact of Atmospheric Infrared Sounder Data on the Numerical Simulation of a Historical Mumbai Rain Event
Authors: Singh Randhir , Pal P. K. , Kishtawal C. M. , Joshi P. C.
Published: April 2008

In this paper, the three-dimensional variational data assimilation scheme (3DVAR) in the fifth-generation Pennsylvania State University–National Center for Atmospheric Research (Penn State–NCAR) Mesoscale Model (MM5) is used to study the impact of assimilating Atmospheric Infrared Sounder (AIRS) retrieved temperature and moisture profiles on board Aqua, a satellite that is part of NASA’s Earth Observing System. A record-breaking heavy rain event that occurred over Mumbai, India, on 26 July 2005 with 24-h rainfall exceeding 94 cm was used for the simulation.

By analyzing the data from the NCEP–NCAR reanalysis, possible causes of this heavy rainfall event were investigated. The temporal evolution of meteorological fields clearly indicates the formation of midtropospheric mesoscale vortices over Mumbai that exactly coincides with the duration of the intense rainfall. Analysis also indicated the midlevel dryness with higher temperature and moisture in the lower levels. This midlevel dryness with high temperature and moisture in the lower levels increases the conditional instability, which was conducive for the development of very severe local thunderstorms. The midtropospheric mesoscale vortices existed over Mumbai together with lower-level instability and the active monsoon conditions over the west coast resulted in intense rainfall, on the order of 94 cm in 24 h.

Numerical experiments were conducted, with two nested domains (45- and 15-km grid spacing). The assimilation of the AIRS-retrieved temperature and moisture profiles produced significant impacts on the location and intensity of the simulated rainfall. It is seen from the numerical experiments that the assimilation of AIRS data could produce the structure of mesoscale vortices, and lower-level thermodynamics and convergence much more realistically compared with the control simulation. The spatial distribution of the rainfall from the simulation using AIRS data was more realistic than that without AIRS data. To make the quantitative comparison of the predicted rainfall with the observed one, the equitable threat score and bias were calculated for different threshold values of rainfall. Inclusion of AIRS data significantly improved the precipitation as indicated by the equitable threat scores and biases for almost all of the threshold rainfall categories.
A Comparison of Trapeziectomy Via Anterior and Posterior Approaches
Authors: RITCHIE J. F. S. , BELCHER H. J. C. R.
Published: April 2008

Forty-three hands in 41 adults with osteoarthrosis of the trapeziometacarpal joint were allocated randomly to undergo a trapeziectomy through either an anterior approach or the posterior (dorsoradial) approach. Forty hands were available for review at a median of 33 months postoperatively. The demographic characteristics, severity of disease and pre-operative measurements of the two groups were indistinguishable. Trapeziectomy resulted in significantly improved objective and subjective function in both groups, but the anterior approach group had better outcomes for power, scar tenderness and satisfaction. Scar-related complications were three times more common in the posterior group. Trapeziectomy is a good method of treating osteoarthritis of the thumb base, but outcomes for the anterior approach are equally good or better than with the posterior.
A Possible Mechanism of Direct Injury to the EPL Tendon at Lister’s Tubercle During Falls with the Wrist Fully Extended
Authors: FERRERES A. , LLUSÁ M. , GARCÍA-ELÍAS M. , LLUCH A.
Published: April 2008

We present three cases of pathology of the extensor pollicis longus tendon at the level of Lister’s tubercle after falls with the wrist fully extended. A small anatomical study demonstrates the possibility of the base of the third metacarpal impacting this area in hyperextension. This mechanism of injury to the tendon may explain the clinical findings.
Neurolysis of the Distal Superficial Radial Nerve for Dysaesthesia Due to Nerve Tethering
Authors: CALFEE R. P. , SHIN S. S. , WEISS A. -P. C.
Published: April 2008

The subcutaneous course of the superficial radial nerve over the radial border of the wrist and hand renders it very susceptible to injury. Both traumatic and iatrogenic injury can produce tethering of this nerve, presenting as dysaesthesia. This study was designed to evaluate the efficacy of neurolysis of the distal superficial radial nerve for this condition. Twenty-five cases of tethered superficial radial nerves underwent neurolysis. At final follow-up (mean 3.5 years), fourteen cases reported symptomatic resolution while eleven continued to experience dysaesthesia. Intra-operatively, evidence of external abnormality, scarring, or compression was identified in only six cases, and its presence did not correlate with symptomatic outcome. Although the majority of patients were improved postoperatively, the success rate was lower than anticipated. Therefore, while neurolysis of the superficial radial nerve offers the opportunity for pain relief, it does not reliably produce success.
Age-Dependent Development Of Chronic Neuropathic Pain, Allodynia and Sensory Recovery after Upper Limb Nerve Injury in Children
Authors: ATHERTON DUNCAN D , TAHERZADEH OMEED , ELLIOT DAVID , ANAND PRAVEEN
Published: April 2008

Forty-nine children with distal upper limb nerve injury were studied at a mean follow-up of 2 years 3 months. Patients who were aged 5 years or younger at the time of nerve injury (15/49) had no chronic neuropathic pain symptoms or allodynia. Patients with allodynia on quantitative sensory testing but no spontaneous pain (8/49) were all older than 5 years and those reporting spontaneous chronic neuropathic pain (5/49) were all older than 12 years at the time of injury. Previous studies of adults with similar nerve injuries report chronic hyperaesthesia in up to 40% of cases. Semmes–Weinstein monofilament testing showed a positive correlation between age at injury and abnormal sensory threshold ( r = 0.60, P<0.0001). These findings indicate that young children show better sensory recovery and are less likely to develop long-term chronic neuropathic pain syndromes than adults following nerve injury.
Treatment of Scaphoid Non-Unions of the Proximal third with Conventional Bone Grafting and Mini-Herbert Screws: an Analysis of Clinical and Radiological Results
Authors: MEGERLE KAI , KEUTGEN XAVIER , MÜLLER MIRIAM , GERMANN GÜNTER , SAUERBIER MICHAEL
Published: April 2008

This study assessed the clinical and radiological outcomes after treatment of scaphoid non-union of the proximal third by non-vascularised bone grafts and stabilisation by Mini-Herbert Screws from a dorsal approach. Thirty-one patients, one woman and 30 men, were reviewed retrospectively at a mean of 42 (12–77) months. All patients received pre- and postoperative CT scans to assess bone union. In addition to demographic data, the range of motion, grip strength, DASH score, Krimmer score, Mayo wrist score and radiological parameters (carpal height, scapholunate and radiolunate angles) were recorded. Bone union was achieved in 21 patients. The average DASH score in patients with bone union was 12 and that in patients with persistent non-union it was 30. No progression into carpal collapse or increase of scapholunate angles was detected. Our study demonstrates that acceptable union rates can be achieved with non-vascularised bone grafts, and this technique compares favourably with other reports in the literature.
Key Pinch in Healthy Adults: Normative Values
Authors: GÜNTHER C. M. , BÜRGER A. , RICKERT M. , SCHULZ C. U.
Published: April 2008

Intra-individual and inter-individual variations of key pinch strength were analysed in a standardised manner for healthy Caucasian adults (female n = 403; male n = 366) aged between 20 and 95 years. The mean strength was less in women (right 6.6 kg; left 6.1 kg) than in men (right 10.4 kg; left 9.7 kg). Independently of hand dominance or gender, the right side was about 7% stronger. Constitutional variables such as forearm length, forearm circumference and hand size showed a positive correlation with key pinch strength. Since the correlation between age and key pinch was similar in both genders, showing a continuous decrease of strength from the fifth decade of life on, key pinch seems independent from gender-specific hormonal changes. In conclusion, we recommend to side adjust measured values and to include information regarding constitutional characteristics for intra-individual comparison.
The Role of the Musculocutaneous and Radial Nerves in Elbow Flexion and Forearm Supination: A Biomechanical Study
Authors: ROUKOZ S. , NACCACHE N. , SLEILATY G.
Published: April 2008

The intention of this prospective study was to evaluate the role of the musculocutaneous and radial nerves in elbow flexion and forearm supination. The study included 29 patients having loco-regional anaesthesia for minor hand surgery. Elbow flexion and forearm supination forces were evaluated before and after an isolated musculocutaneous nerve block in one group and an isolated radial nerve block in another group. The results showed that the biceps tendon is responsible for 47% of the forearm supination force and the combination of brachioradialis and the supinator for 64% of this force. It showed also that the musculocutaneous and radial nerves contribute by 42% and 27.5%, respectively, to the flexion force of the elbow. These results are intended to help surgeons in decision making when treating chronic biceps tendon rupture, in repair of traumatic brachial plexus neuropathy and in using tendon transfers, such as the Steindler transfer, around the elbow.
The Preliminary Results of Treatment of Symptomatic Carpal Boss by Wedge Joint Resection, Radial Bone Grafting and Arthrodesis with a Shape Memory Staple
Authors: LORÉA PATRICK , SCHMITZ SERGE , ASCHILIAN MIHAI , CHIRILA-DOBREA AURA , PETREA ADINA D.
Published: April 2008

There is no consensus regarding the aetiology or treatment of carpal boss. Recurrences or carpometacarpal instability is reported after simple resection. Carpometacarpal arthrodesis has been proposed as a primary treatment and after failure of simple resection. This paper reports the results at a mean follow-up of 17 (range 13–28) months of treatment by wedge-shaped joint resection, corticocancellous radial bone graft and arthrodesis with a shape memory staple of seven of 32 patients who presented with a painful carpal boss. The study group included five women and two men of mean age at operation 29 (range 18–40) years. Fusion was achieved in all cases and all patients were pain free at follow-up. No complications occurred and all the patients were pleased with the aesthetic aspect of the treatment.
The ‘‘Two Fleck Sign’’ for an Occult Stener Lesion
Authors: THIRKANNAD SUNIL , WOLFF THOMAS W.
Published: April 2008

We report a case of distal pull-off of the ulnar collateral ligament of the metacarpophalangeal joint of the thumb with two fracture fragments. The more obvious fracture fragment, seen on plain X-ray to be lying adjacent to the expected location of the attachment of the ulnar collateral ligament of the metacarpophalangeal joint of the thumb, was, in fact, unassociated with it and was part of the attachment of the adductor pollicis muscle. A second smaller fleck of bone which was attached to the displaced collateral ligament was only observed on plain X-ray on retrospective review. This second fleck of bone identified that this was a Stener lesion, requiring surgical reattachment of the ligament. Similar cases in the literature are reviewed and the use of MRI in detecting these lesions is discussed.
The Reliability of the “Scratch Test”
Authors: BUDOFF JEFFREY E. , HICKS JOHN M. , AYALA GUSTAVO , KRAUSHAAR BARRY S.
Published: April 2008

The “Scratch Test” uses a sharp scalpel to scrape areas of suspected tendinosis in the management of lateral and medial epicondylitis. As claimed in the literature, this tissue is friable and peels off, whereas normal tendon does not. The purpose of this study was to determine whether, or not, the “Scratch Test” is able to differentiate between tendinosis and more normal adjacent tendon. Nineteen specimens from patients treated for tendinosis about the elbow were examined histologically. Three groups of specimens were compared: (1) grossly abnormal tendon, (2) tendon that was scraped out using the “Scratch Test” and (3) tendon that remained behind following the “Scratch Test”. There was no significant histological difference between visibly degenerated tendon (group 1) and that which was scraped out using the “Scratch Test” (group 2). There was, however, a significant histological difference between both these groups and the more normal tendon tissue that the “Scratch Test” left behind (group 3).
Proximal Row Carpectomy Versus Four-Corner Arthrodesis as a Treatment for SLAC (Scapholunate Advanced Collapse) Wrist
Authors: VANHOVE W. , DE VIL J. , VAN SEYMORTIER P. , BOONE B. , VERDONK R.
Published: April 2008

Four-corner arthrodesis and proximal row carpectomy are motion-preserving salvage solutions for the scapholunate advanced collapse wrist. We compared both procedures in a non-randomised, retrospective study of 30 cases with a mean follow-up of 3½ years. Pain relief and functional gain were equal in both treatment groups. However, the complication rate was higher in the four-corner arthrodesis group, partly because of the need for internal fixation. The higher incidence of carpal tunnel syndrome following four-corner arthrodesis is intriguing. We also found significant differences in the duration of hospital stay and of postoperative sick leave in favour of proximal row carpectomy. If the cartilage on the capitate head is well preserved (Stages I–II), we prefer proximal row carpectomy because of the socio-economic benefits, the lower complication rate and the ease of the procedure. Degenerative changes following proximal row carpectomy may be a concern in young manual labourers, but have not been observed.
Use of the Stanley Jig for Large Ulnar Shortenings
Authors: HARRISON J. W. K. , STANLEY J. K. , HAYTON M. J.
Published: April 2008

We describe the use of a readily available ulnar shortening guide to perform large ulnar shortenings.
Absence of Flexor Digitorum Superficialis Tendon in the Little Finger is not Associated with Decreased Grip Strength
Authors: PUHAINDRAN M. E. , SEBASTIN S. J. , LIM A. Y. T. , XU W. X. , CHEN Y. M.
Published: April 2008

We examined the little finger in 402 normal subjects for the presence or absence of the flexor digitorum superficialis. All subjects also had their grip strength measured. No statistically significant difference was seen in the grip strength measurements between subjects who had a flexor digitorum superficialis tendon to the little finger and those who did not. This study demonstrates that absence of the flexor digitorum superficialis to the little finger is not associated with decreased grip strength. The implications of this in terms of repair of the flexor digitorum superficialis of the little finger are considered.
Creation of a “Dorsal Transverse Intermetacarpal Ligament” to Prevent Scissoring Deformity in Central Ray Amputation
Authors: GONG H. S. , SHIN S. I. , BAEK G. H.
Published: April 2008

An adjunctive technique of ray approximation after central ray amputation is presented. This procedure creates a “dorsal transverse intermetacarpal ligament” by using a free tendon graft from the amputee to help prevent scissoring of the fingers, without the need for bony transposition or dorsal dermodesis.
Endometriosis and Infertility
Authors: Ozkan Sebiha , Murk William , Arici Aydin
Published: April 2008

Endometriosis is an estrogen‐dependent disorder defined as the presence of endometrial tissue outside of the uterine cavity. A leading cause of infertility, endometriosis has a prevalence of 0.5–5% in fertile and 25–40% in infertile women. The optimal choice of management for endometriosis‐associated infertility remains obscure. Removal or suppression of endometrial deposits by medical or surgical means constitutes the basis of endometriosis management. Current evidence indicates that suppressive medical treatment of endometriosis does not benefit fertility and should not be used for this indication alone. Surgery is probably efficacious for all stages of the disease. Controlled ovarian hyperstimulation with intrauterine insemination is recommended in early‐stage and surgically corrected endometriosis when pelvic anatomy is normal. In advanced cases, in vitro fertilization is a treatment of choice, and its success may be augmented with prolonged gonadotropin‐releasing hormone analog treatment. Further randomized clinical trials focusing on diverse etiopathogenic mechanisms and therapeutic innovation are necessary to find more conclusive, evidence‐based answers regarding this enigmatic disease.
The Ovary
Authors: Oktem Ozgur , Oktay Kutluk
Published: April 2008

A prerequisite to the understanding of the ovarian diseases and infertility is a thorough understanding of normal embryology and physiology of the ovary. Therefore, the objective of this review article is to provide brief and updated information on the molecular basis of the events that control gonadal development, germ cell formation, folliculogenesis, and ovulation.
Decidual Cell‐expressed Tissue Factor in Human Pregnancy and Its Involvement in Hemostasis and Preeclampsia‐related Angiogenesis
Authors: Lockwood Charles J. , Krikun Graciela , Caze Rebeca , Rahman Mizanur , Buchwalder Lynn F. , Schatz Frederick
Published: April 2008

During extravascular trophoblast (EVT) invasion of the decidua, thrombin generated from decidual cell–expressed tissue factor (TF) forms a “hemostatic envelope” that protects against hemorrhage during the initial breaching of capillaries by EVTs and subsequent invasion and remodeling of the spiral arteries and arterioles. Preeclampsia, the world's leading cause of fetal and maternal morbidity and mortality, stems from shallow trophoblast invasion leading to incomplete vascular remodeling that impairs uteroplacental blood flow. A considerable subset of cases of preeclampsia is associated with decidual hemorrhage and maternal thrombophilias, which form excess thrombin from decidual cell–expressed TF. Thrombin affects several cell functions by binding to protease‐activated receptors. In first‐trimester decidual cells, thrombin enhances expression of sFlt‐1, which can block the angiogenic effects of vascular endothelial growth factor (VEGF) and placental growth factor. By contrast, thrombin does not affect decidual cell VEGF expression. Thrombin‐enhanced sFlt‐1 expression by decidual cells, the predominant cell type encountered by invading cytotrophoblasts, could promote preeclampsia by interfering with angiogenesis‐dependent vascular remodeling to reduce uteroplacental blood flow.
The Placental Syncytium and the Pathophysiology of Preeclampsia and Intrauterine Growth Restriction
Authors: Guller Seth , Ma Yula Y. , Fu Han‐Hsuan , Krikun Graciela , Abrahams Vikki M. , Mor Gil
Published: April 2008

Preeclampsia is associated with an increased release of factors from the placental syncytium into maternal blood, including the antiangiogenic factors soluble fms‐like tyrosine kinase‐1 and soluable endoglin, the antifibrinolytic factor plasminogen activator inhibitor‐1, prostanoids, lipoperoxides, cytokines, and microparticles. These factors are suggested to promote maternal endothelium dysfunction and are associated with placental damage in pregnancies also complicated with intrauterine growth restriction (IUGR). In this report, we briefly describe the interaction of syncytial factors with hypoxia, reactive oxygen species, and apoptosis in the pathophysiology of preeclampsia and IUGR. Given the critical role of the syncytium in these complications of pregnancy, we also present a novel methodology in which laser capture microdissection followed by Western blotting is used to assess levels of syncytial Fas ligand, a key protein in the apoptotic cascade.
The Analgesic Effect of Betamethasone Administered to Outpatients before Conscious Sedation in Gynecologic and Obstetric Surgery
Authors: Pace Maria Caterina , Palagiano Antonio , Passavanti Maria Beatrice , Iannotti Mario , Sansone Pasquale , Maistro Massimo , Pace Leonardo , Bulletti Carlo , Aurilio Caterina
Published: April 2008

Conscious sedation, used with or without peripheral or central blocks, is an elective anesthetic technique used for many outpatient procedures. The aim of this study was to evaluate the effects of a single pre‐anesthetic dose of betamethasone (4 mg) on intraoperative and postoperative pain in 380 women, 18 to 75 years old, undergoing gynecologic and obstetric surgery (diagnostic curettage, operative and diagnostic hysteroscopy, conization, minilaparoscopy, cone biopsy, endometrial ablation, assisted reproduction techniques, and induced and therapeutic abortion) in a outpatient service. In this randomized, double‐blind, placebo‐controlled study, the patients were divided into two equal groups according to a computer‐generated randomized list. One group received 4 mg of betamethasone i.v. as a premedication (group B), whereas the placebo group (group P) received only saline. All patients underwent the same sedation, associated with a peripheral block. Pain was evaluated using a 5‐point verbal rating scale during surgery, after 2 h, and on discharge. In group B, intraoperative and postoperative pain was significantly less frequent than in group P (P < 0.001). Consequently, fewer women belonging to group B requested additional analgesic drugs during and after surgery (P < 0.01). Patients in group B also experienced a greater degree of satisfaction (P < 0.01). Briefly, a single dose of betamethasone seemed to reduce the incidence and severity of perioperative pain after gynecologic outpatient surgery.
Pelvic Factor Infertility: Diagnosis and Prognosis of Various Procedures
Authors: Bulletti Carlo , Panzini I. , Borini A. , Coccia E. , Setti Paolo Levi , Palagiano Antonio
Published: April 2008

Infertile women are examined to exclude tubal occlusion or a pelvic factor through indirect tests, such as hysterosalpingography (HSG), sonohysterosalpingography/hysterosalpingosonography (SH), and/or laparoscopy (Lps). Assisted reproductive technologies (ART) are proposed to resolve infertility according to the results of the above‐mentioned diagnostic procedures. Today, Lps still represents the second option after several failures of in vivo attempts and before moving to conceive in vitro. The aim of this study was to establish the diagnostic power of HSG and SH compared with that of Lps and the efficacy of ART when each single test is used as an inclusion criterion. We recruited 2560 infertile women (aged 20 to 35) to undergo diagnostic and therapeutic procedures to address their infertility in our clinical theatre. Of these, 1080 women underwent Lps and hysteroscopy (Group 1), 525 underwent HSG (Group 2), and 955 underwent SH (Group 3). The positive and negative predictive values of sonosalpingosonography were 75.8% and 91.2% and those of hysterosalpingography were 71.8% and 88.2%, respectively. Endometriosis (stage II–IV of the revised American Society for Reproductive Medicine [ASRM] classification) was diagnosed laparoscopically in 344 out of 1080 women (32%). Only 44 women (13%) with endometriosis showed bilateral tubal occlusion. Pelvic factors other than tubal occlusions are neither diagnosed nor treated in a timely manner by indirect tubal patency tests. The conventional use of HSG and/or SH may increase the time required to find an adequate treatment by which to achieve a successful pregnancy.
Medication recommendations to physicians by pharmacists for seniors: expected clinical impact in relation to implementation and expected time frame to effect
Authors: Dolovich Lisa , Howard Michelle , Sellors Connie , Kaczorowski Janusz , Rodriguez M Christine , Goeree Ron , Haq Mahbubul , Patel Payal , Sellors John
Published: April 2008

Aims and objectives

To describe recommendations made by pharmacists in a trial that had found no improvements in selected clinical outcomes (the Seniors Medication Assessment Research Trial, SMART) in terms of expected impact on clinical outcomes and whether they had been implemented by the end of the 5-month period of follow-up.

Setting

SMART was conducted in a non-academic community practice setting.

Method

Recommendations made by the pharmacists during SMART, a cluster-randomised controlled trial conducted in family physician offices, were evaluated in this descriptive study. All recommendations to physicians were evaluated independently by two assessors using criteria established a priori and without knowledge of patient outcomes. Each recommendation was evaluated on likely strength and time to impact the patient's health and whether the recommendation was based on published evidence. Relationships between these criteria were analysed.

Key findings

Overall, the pharmacists made 1099 recommendations for 431 patients randomly assigned to the intervention group or a mean of 2.6 recommendations (standard deviation, 2.1) per patient. A moderate or marked impact on patient health within the 5-month follow-up period would have been expected for 15.5% of all recommendations. At study end, physicians fully implemented 45.8% of the recommendations. Among the recommendations that had been fully implemented, 64.5% of those expected to have a marked impact and 27.5% of those expected to have a moderate impact were anticipated to have the effect on patients' health beyond the 5-month period of follow-up reported in the study results.

Conclusion

It is likely that one of the contributing factors to not finding statistically significant differences in the SMART study was that only a small proportion of recommendations (15.5%) made by the SMART pharmacists would have an expected clinical effect within the study's follow-up period.
A cross-media analysis of educational information content of advertisements for over-the-counter medicines in a Nigerian urban setting
Authors: Yusuff Kazem B , Yusuf Akeem
Published: April 2008

Objective

To analyse the educational information content of adverts for over-the-counter (OTC) medicines on radio, television and billboards in a Nigerian urban setting.

Method

A cross-sectional coding of educational information content of adverts for OTC medicines broadcast on radio and television and shown on billboards in a Nigerian urban setting within a 3-month study period. Two coders independently assessed 1492 adverts comprising 49 brands for information on targeted medical conditions and OTC medicines advertised as treatment.

Results

Inter-rater reliability among the two coders, determined with Cohen’s Kappa, was 0.81 (95% confidence interval, 0.77–0.90). Analgesics, multi-vitamins/hematinics and anti-malarial drugs were the most frequently advertised OTC drug classes on all media. Symptoms and underlying cause/risk factors of targeted medical conditions were contained in a minority of adverts. The majority (81.5–100%) of the adverts projected the name of the medical condition for which the OTC medicines were advertised, whereas the symptoms and underlying cause/risk factors of these medical conditions were contained in only a minority of adverts. Name and identification features were the most frequently projected educational information (100%) pertaining to OTC medicines in advertised treatments. Information on the time to onset of action was contained in 40–80% of adverts, but this information was provided with the use of qualitative words such as fast and rapid. Information on dose, frequency, duration, side effects and precautions were provided in a minority of adverts in all media. Adverts for OTC medicines on television had the highest combined educational information scores of 5.0, followed by billboards (4.1) and radio (3.0). The combined educational information scores of adverts for OTC medicines on the three media fell short of the maximum obtainable score of 11. Adverts for anti-malarial drugs (100%) and OTC analgesics projected inaccurate information with regards to the efficacy of the advertised medicines.

Conclusion

The majority of adverts for OTC medicines on radio, television and billboards in a Nigerian urban setting contained insufficient educational information to guide informed drug purchase and rational use of medicines during self-medication. Promotional efforts appeared focused on high consumer awareness of the targeted medical conditions and the name/identification of the OTC medicines advertised as treatments. This may further worsen the well-documented irrational use of medicines in Nigeria.
A study of unprevented dispensing incidents in Welsh NHS hospitals
Authors: James K Lynette , Barlow Dave , Burfield Robin , Hiom Sarah , Roberts Dave , Whittlesea Cate
Published: April 2008

Objective

To monitor unprevented dispensing incidents in NHS hospitals by identifying incident types, drugs involved and factors that may have contributed to the occurrence of incidents.

Setting

All 20 Welsh NHS hospitals (15 district general; 2 teaching; 2 psychiatric and 1 other specialist hospital).

Method

Unprevented dispensing incidents that occurred between January 2003 and December 2004 were reported and analysed using a validated method. Incident rate was calculated for those hospitals that provided both incident and issue data. Incident rate was compared with previous research using a two-sample t-test. Reported incident types and contributory factors were compared with previous research using chi-square analysis.

Key findings

A total of 1005 unprevented dispensing incidents were reported by 20 hospitals. The overall incident rate, based on data from 17 hospitals, was 16 incidents per 100000 items dispensed (range 0.2–46 incidents per 100000 items dispensed). The overall dispensing incident rate was less than previously reported (18 incidents per 100000 items dispensed).This finding was not statistically significant (t = 0.421, P = 0.676). The most common incidents reported were dispensing the wrong strength of drug (n = 241, 24%), wrong drug (n = 168, 17%), wrong form (n = 134, 13%) and printing the wrong warnings/directions on the label (n = 112, 11%). A statistically significant finding was that fewer incidents involving dispensing the wrong drug were reported by Welsh hospitals (17%) compared to previous research in the UK (23%; P = 0.01). Drugs most commonly involved in incidents were insulin (n = 34; 6 incidents per 10000 issues of insulin), nifedipine (n = 16; 10 incidents per 10000 issues of nifedipine) and carbamazepine (n = 10; 5 incidents per 10000 issues of carbamazepine).

Conclusion

The overall unprevented dispensing incident rate was less than previously reported. Dispensing the wrong strength of the correct drug is a problem. Staff should be aware of the risk of dispensing incidents involving insulin, nifedipine and carbamazepine. Strategies for minimising dispensing incidents include using shelf labels to highlight different strengths or formulations of the same drug, and educating staff about easily confused drugs.
Highly Active Copolymerization of Ethylene and Dicyclopentadiene with [(η1-t-BuN)SiMe2(η1-C29H36)]TiMe2(THF) Complex
Authors: Nishii Kei , Hayano Shigetaka , Tsunogae Yasuo , Cai Zhengguo , Nakayama Yuushou , Shiono Takeshi
Published: April 2008

A new ansa-fluorenylamidodimethyltitanium complex 1 was synthesized and applied for ethylene–dicyclopentadiene copolymerization using modified methylaluminoxane (MMAO) as a cocatalyst at 50 °C. 1–MMAO exhibited the remarkable catalytic activity for the copolymerization and gave a copolymer with high glass-transition temperature of 191 °C.
The Effects of Hybridization and Hyperconjugation in the Intramolecular Blue-shifted H-Bonds N–H···O
Authors: Li An Yong
Published: April 2008

Theoretical study of an example of intramolecular blue-shifted H-bond N–H···O shows that the blue shift of the N–H bond is caused by an increase in s-character of the N-hybrid AO of the N–H bond upon formation of the H-bond. The effect of hyperconjugation was also analyzed.
Irregularly Shaped Gold Nanoparticles as Secondary Labels for Enhanced Electrochemical Sandwich-type Enzyme Immunoassay for the Determination of Biomarkers
Authors: Sun Ai Li , Qi Qing An , Dong Zhuang Long
Published: April 2008

This letter describes a dual-amplified electrochemical sandwich-type enzyme immunoassay for the cancer antigen 125 (CA125) by using irregularly shaped gold nanoparticle-labeled horseradish peroxidase (HRP)-bound anti-CA125 as secondary antibodies. Compared with conventional sandwich-type immunoassays, the proposed immunoassay exhibits a low detection limit and wide linear range.
Prevalent Vertebral Fractures in Black Women and White Women
Authors: Cauley Jane A , Palermo Lisa , Vogt Molly , Ensrud Kristine E , Ewing Susan , Hochberg Marc , Nevitt Michael C , Black Dennis M
Published: April 2008

Vertebral fractures are the most common osteoporotic fracture. Hip and clinical fractures are less common in black women, but there is little information on vertebral fractures. We studied 7860 white and 472 black women ≥65 yr of age enrolled in the Study of Osteoporotic Fractures. Prevalent vertebral fractures were identified from lateral spine radiographs using vertebral morphometry and defined if any vertebral height ratio was >3 SD below race-specific means for each vertebral level. Information on risk factors was obtained by questionnaire or examination. Lumbar spine, total hip, and femoral neck BMD and BMC were measured by DXA. The prevalence of vertebral fractures was 10.6% in black and 19.1% in white women. In age-adjusted logistic regression models, a 1 SD decrease in femoral neck BMD was associated with 47% increased odds of fracture in black women (OR = 1.47; 95% CI, 1.12–1.94) and 80% increased odds in white women (OR = 1.80; 95% CI, 1.68–1.94; interaction p = 0.14). The overall lower odds of fracture among black women compared with white women was independent of femoral neck BMD and other risk factors (OR = 0.51; 95% CI, 0.37–0.72). However, the prevalence of vertebral fractures increased with increasing number of risk factors in both groups. The prevalence of vertebral fractures is lower in black compared with white women but increases with age, low BMD, and number of risk factors.
Quantitative Trait Loci for BMD in an SM/J by NZB/BlNJ Intercross Population and Identification of Trps1 as a Probable Candidate Gene
Authors: Ishimori Naoki , Stylianou Ioannis M , Korstanje Ron , Marion Michael A , Li Renhua , Donahue Leah Rae , Rosen Clifford J , Beamer Wesley G , Paigen Beverly , Churchill Gary A
Published: April 2008

Identification of genes that regulate BMD will enhance our understanding of osteoporosis and could provide novel molecular targets for treatment or prevention. We generated a mouse intercross population and carried out a quantitative trait locus (QTL) analysis of 143 female and 124 male F2 progeny from progenitor strains SM/J and NZB/BlNJ using whole body and vertebral areal BMD (aBMD) as measured by DXA. We found that both whole body and vertebral aBMD was affected by two loci on chromosome 9: one with a significant epistatic interaction on distal chromosome 8 and the other with a sex-specific effect. Two additional significant QTLs were identified on chromosome 12, and several suggestive ones were identified on chromosomes 5, 8, 15, and 19. The chromosome 9, 12, and 15 loci have been previously identified in other crosses. SNP-based haplotype analysis of the progenitor strains identified blocks within the QTL region that distinguish the low allele strains from the high allele strains, significantly narrowing the QTL region and reducing the possible candidate genes to 98 for chromosome 9, 31 for chromosome 12, and only 2 for chromosome 15. Trps1 is the most probable candidate gene for the chromosome 15 QTL. The sex-specific effects may help to elucidate the BMD differences between males and females. This study shows the power of statistical modeling to resolve linked QTLs and the use of haplotype analysis in narrowing the list of candidates.
PPARG by Dietary Fat Interaction Influences Bone Mass in Mice and Humans
Authors: Ackert-Bicknell Cheryl L , Demissie Serkalem , Marín de Evsikova Caralina , Hsu Yi-Hsiang , DeMambro Victoria E , Karasik David , Cupples L Adrienne , Ordovas Jose M , Tucker Katherine L , Cho Kelly , Canalis Ernesto , Paigen Beverly , Churchill Gary A , Forejt Jiri , Beamer Wesley G , Ferrari Serge , Bouxsein Mary L , Kiel Douglas P , Rosen Clifford J
Published: April 2008

Adult BMD, an important risk factor for fracture, is the result of genetic and environmental interactions. A quantitative trait locus (QTL) for the phenotype of volumetric BMD (vBMD), named Bmd8, was found on mid-distal chromosome (Chr) 6 in mice. This region is homologous to human Chr 3p25. The B6.C3H-6T (6T) congenic mouse was previously created to study this QTL. Using block haplotyping of the 6T congenic region, expression analysis in the mouse, and examination of nonsynonymous SNPs, peroxisome proliferator activated receptor γ (Pparg) was determined to be the most likely candidate gene for the Bmd8 QTL of the 630 genes located in the congenic region. Furthermore, in the C3H/HeJ (C3H) strain, which is the donor strain for the 6T congenic, several polymorphisms were found in the Pparg gene. On challenge with a high-fat diet, we found that the 6T mouse has a lower areal BMD (aBMD) and volume fraction of trabecular bone (BV/TV%) of the distal femur compared with B6 mice. Interactions between SNPs in the PPARG gene and dietary fat for the phenotype of BMD were examined in the Framingham Offspring Cohort. This analysis showed that there was a similar interaction of the PPARG gene and diet (fat intake) on aBMD in both men and women. These findings suggest that dietary fat has a significant influence on BMD that is dependent on the alleles present for the PPARG gene.
Automated Time-Resolved Immunofluorometric Assay for Progastrin-Releasing Peptide
Authors: Nordlund Marianne S , Warren David J , Nustad Kjell , Bjerner Johan , Paus Elisabeth
Published: April 2008

Background: Small cell lung cancer accounts for approximately 20% of new cases of lung cancer, and advanced disease is prevalent at the time of diagnosis. Neuron-specific enolase (NSE) has been the primary tumor marker in small cell lung cancer but it has relatively low sensitivity in early-stage disease. Progastrin-releasing peptide (proGRP) is a promising alternative or complementary marker for NSE. We have previously described a time-resolved immunofluorometric assay (TR-IFMA) for proGRP that lacked the necessary sensitivity and robustness for use in the routine clinical laboratory. Herein we describe the development of an improved assay using a novel monoclonal antibody pair.

Methods: Mice were immunized with different conjugated proGRP peptides, including residues 31–98, 1–98, and preproGRP(-23–125). Pair combinations of the resulting monoclonal antibodies (mAb) were tested. The improved TR-IFMA was compared with the only other available proGRP assay, the proGRP ELISA (IBL).

Results: A panel of 12 high-affinity mAbs was produced. The best assay combination was between our original E146 mAb as solid-phase antibody and the new mAb M16 as tracer. The new TR-IFMA had a linear dose-response curve, a wide dynamic range (13–13 500 ng/L), and a limit of detection of 2.8 ng/L. Total CV was <5.6% over the whole measuring range. Bland-Altman difference analysis indicated a significant positive bias between the IFMA and the ELISA.

Conclusions: We describe a sensitive and robust mAb-based TR-IFMA for proGRP. The assay is fully automated and displays high quality performance.