bluuebunny/crossref_metadata_2025 huggingface dataset:
MICRU: an effective cloud fraction algorithm designed for UV–vis satellite instruments with large viewing angles
Authors: Sihler Holger , Beirle Steffen , Dörner Steffen , Gutenstein-Penning de Vries Marloes , Hörmann Christoph , Borger Christian , Warnach Simon , Wagner Thomas
Published: June 2021

Abstract. Clouds impact the radiative transfer of the Earth's atmosphere and strongly influence satellite measurements in the ultraviolet–visible (UV–vis) and infrared (IR) spectral ranges. For satellite measurements of trace gases absorbing in the UV–vis spectral range, particularly clouds ultimately determine the vertical sensitivity profile, mainly by reducing the sensitivity for trace-gas columns below the cloud. The Mainz iterative cloud retrieval utilities (MICRU) algorithm is specifically designed to reduce the error budget of trace-gas retrievals, such as those for nitrogen dioxide (NO2), which strongly depends on the accuracy of small cloud fractions (CFs) in particular. The accuracy of MICRU is governed by an empirical parameterisation of the viewing-geometry-dependent background surface reflectivity taking instrumental and physical effects into account. Instrumental effects are mainly degradation and polarisation effects; physical effects are due to the anisotropy of the surface reflectivity, e.g. shadowing of plants and sun glitter. MICRU is applied to main science channel (MSC) and polarisation measurement device (PMD) data collected between April 2007 and June 2013 by the Global Ozone Monitoring Experiment 2A (GOME-2A) instrument aboard the MetOp-A satellite. CFs are retrieved at different spectral bands between 374 and 758 nm. The MICRU results for MSC and PMD at different wavelengths are intercompared to study CF precision and accuracy, which depend on wavelength and spatial correlation. Furthermore, MICRU results are compared to FRESCO (fast retrieval scheme for clouds from the oxygen A band) and OCRA (optical cloud recognition algorithm) operational cloud products. We show that MICRU retrieves small CFs with an accuracy of 0.04 or better for the entire 1920 km wide swath with a potential bias between −0.01 and −0.03. CFs retrieved at shorter wavelengths are less affected by adverse surface heterogeneities. The comparison to the operational CF algorithms shows that MICRU significantly reduces the dependence on viewing angle, time, and sun glitter. Systematic effects along coasts are particularly small for MICRU due to its dedicated treatment of land and ocean surfaces. The MICRU algorithm is designed for spectroscopic instruments ranging from the GOME to Sentinel-5P/Tropospheric Monitoring Instrument (TROPOMI) but is also applicable to UV–vis imagers like the Advanced Very High Resolution Radiometer (AVHRR), the Moderate Resolution Imaging Spectroradiometer (MODIS), the Visible Infrared Imaging Radiometer Suite (VIIRS), and Sentinel-2.
Simulating shrubs and their energy and carbon dioxide fluxes in Canada's Low Arctic with the Canadian Land Surface Scheme Including Biogeochemical Cycles (CLASSIC)
Authors: Meyer Gesa , Humphreys Elyn R. , Melton Joe R. , Cannon Alex J. , Lafleur Peter M.
Published: June 2021

Abstract. Climate change in the Arctic is leading to shifts in vegetation communities, permafrost degradation and alteration of tundra surface–atmosphere energy and carbon (C) fluxes, among other changes. However, year-round C and energy flux measurements at high-latitude sites remain rare. This poses a challenge for evaluating the impacts of climate change on Arctic tundra ecosystems and for developing and evaluating process-based models, which may be used to predict regional and global energy and C feedbacks to the climate system. Our study used 14 years of seasonal eddy covariance (EC) measurements of carbon dioxide (CO2), water and energy fluxes, and winter soil chamber CO2 flux measurements at a dwarf-shrub tundra site underlain by continuous permafrost in Canada’s Southern Arctic ecozone to evaluate the incorporation of shrub plant functional types (PFTs) in the Canadian Land Surface Scheme Including Biogeochemical Cycles (CLASSIC), the land surface component of the Canadian Earth System Model. In addition to new PFTs, a modification of the efficiency with which water evaporates from the ground surface was applied. This modification addressed a high ground evaporation bias that reduced model performance when soils became very dry, limited heat flow into the ground, and reduced plant productivity through water stress effects. Compared to the grass and tree PFTs previously used by CLASSIC to represent the vegetation in Arctic permafrost-affected regions, simulations with the new shrub PFTs better capture the physical and biogeochemical impact of shrubs on the magnitude and seasonality of energy and CO2 fluxes at the dwarf-shrub tundra evaluation site. The revised model, however, tends to overestimate gross primary productivity, particularly in spring, and overestimated late-winter CO2 emissions. On average, annual net ecosystem CO2 exchange was positive for all simulations, suggesting this site was a net CO2 source of 18 ± 4 g C m−2 yr−1 using shrub PFTs, 15 ± 6 g C m−2 yr−1 using grass PFTs, and 25 ± 5 g C m−2 yr−1 using tree PFTs. These results highlight the importance of using appropriate PFTs in process-based models to simulate current and future Arctic surface–atmosphere interactions.
University of Nebraska unmanned aerial system (UAS) profiling during the LAPSE-RATE field campaign
Authors: Islam Ashraful , Shankar Ajay , Houston Adam , Detweiler Carrick
Published: June 2021

Abstract. This paper describes the data collected by the University of Nebraska-Lincoln (UNL) as part of the field deployments during the Lower Atmospheric Process Studies at Elevation – a Remotely-piloted Aircraft Team Experiment (LAPSE-RATE) flight campaign in July 2018.
The UNL deployed two multirotor unmanned aerial systems (UASs) at multiple sites in the San Luis Valley (Colorado, USA) for data collection to support three science missions: convection initiation, boundary layer transition, and cold air drainage flow.
We conducted 172 flights resulting in over 21 h of cumulative flight time.
Our novel design for the sensor housing onboard the UAS was employed in these flights to meet the aspiration and shielding requirements of the temperature and humidity sensors and to separate them from the mixed turbulent airflow from the propellers.
Data presented in this paper include timestamped temperature and humidity data collected from the sensors, along with the three-dimensional position and velocity of the UAS.
Data are quality-controlled and time-synchronized using a zero-order-hold interpolation without additional post-processing.
The full dataset is also made available for download at https://doi.org/10.5281/zenodo.4306086 (Islam et al., 2020).
A case study of wind farm effects using two wake parameterizations in the Weather Research and Forecasting (WRF) model (V3.7.1) in the presence of low-level jets
Authors: Larsén Xiaoli G. , Fischereit Jana
Published: June 2021

Abstract. While the wind farm parameterization by Fitch et al. (2012) in the Weather Research and Forecasting (WRF) model has been used and evaluated frequently, the explicit wake parameterization (EWP) by Volker et al. (2015) is less well explored. The openly available high-frequency flight measurements from Bärfuss et al. (2019a)
provide an opportunity to directly compare the simulation results from the EWP and Fitch scheme with in situ measurements. In doing so, this study aims to complement the recent study by Siedersleben et al. (2020) by (1) comparing the EWP and Fitch schemes in terms of turbulent kinetic energy (TKE) and velocity deficit, together with FINO 1 measurements and synthetic aperture radar (SAR) data, and (2) exploring the interactions of the wind farm with low-level jets (LLJs). This is done using a bug-fixed WRF version that includes the correct TKE advection, following Archer et al. (2020). Both the Fitch and the EWP schemes can capture the mean wind field in the presence of the wind farm consistently and well. TKE in the EWP scheme is significantly underestimated, suggesting that an explicit turbine-induced TKE source should be included in addition to the implicit source from shear. The value of the correction factor for turbine-induced TKE generation in the Fitch scheme has a significant impact on the simulation results. The position of the LLJ nose and the shear beneath the jet nose are modified by the presence of wind farms.
Design and analysis of an innovative flapping wing micro aerial vehicle with a figure eight wingtip trajectory
Authors: Jiang Shan , Hu Yong , Li Qiang , Ma Long , Wang Yang , Zhou Xiaoqin , Liu Qiang
Published: June 2021

Abstract. A multi-mode flapping wing micro air vehicle (FWMAV) that uses a figure eight wingtip motion trajectory with wing flapping, rotation, and swing motion is presented in this paper. The flapping wing vehicle achieves three active degrees of freedom (DOF) wing movements only with one driving micromotor which has a good balance in the mechanism design (that is inspired by natural fliers) and total weight. Owing to these characteristics being integrated into the simple mechanism design, the aerodynamic force is improved. The aerodynamic performance of the thrust force is improved by 64.3 % compared to one that could only flap up and down with one active DOF under the condition of routine flapping frequency.
Assessing climate-change-induced flood risk in the Conasauga River watershed: an application of ensemble hydrodynamic inundation modeling
Authors: Dullo Tigstu T. , Darkwah George K. , Gangrade Sudershan , Morales-Hernández Mario , Sharif M. Bulbul , Kalyanapu Alfred J. , Kao Shih-Chieh , Ghafoor Sheikh , Ashfaq Moetasim
Published: June 2021

Abstract. This study evaluates the impact of potential future climate change on flood
regimes, floodplain protection, and electricity infrastructures across the
Conasauga River watershed in the southeastern United States through ensemble
hydrodynamic inundation modeling. The ensemble streamflow scenarios were
simulated by the Distributed Hydrology Soil Vegetation Model (DHSVM) driven
by (1) 1981–2012 Daymet meteorological observations and (2) 11 sets of
downscaled global climate models (GCMs) during the 1966–2005 historical and
2011–2050 future periods. Surface inundation was simulated using a
GPU-accelerated Two-dimensional Runoff Inundation Toolkit for Operational
Needs (TRITON) hydrodynamic model. A total of 9 out of the 11 GCMs exhibit an
increase in the mean ensemble flood inundation areas. Moreover, at the 1 %
annual exceedance probability level, the flood inundation frequency curves
indicate a ∼ 16 km2 increase in floodplain area. The
assessment also shows that even after flood-proofing, four of the
substations could still be affected in the projected future period. The
increase in floodplain area and substation vulnerability highlights the need
to account for climate change in floodplain management. Overall, this study
provides a proof-of-concept demonstration of how the computationally
intensive hydrodynamic inundation modeling can be used to enhance flood
frequency maps and vulnerability assessment under the changing climatic
conditions.
Analisis Manfaat Ekonomi Di Hulu Das Jeneberang Periode 2006-2026
Authors: Kardika Adelia Juli
Published: June 2021

Perubahan penggunaan lahan dalam dekade terakhir sangat cepat. Hal ini berdampak pada penurunan kualitas lingkungan. Padahal, hutan memiliki manfaat ekonomi, ekologi, dan sosial. Penilaian manfaat ekonomi suatu lahan dalam kurun waktu tertentu dapat dilakukan melalui analisis Net Present Value (NPV). Hulu DAS Jeneberang  merupakan pemasok utama kebutuhan air bersih Kota Makassar dan Sungguminasa dan pengendali banjir. Penelitian ini bertujuan menghitung manfaat ekonomi penutupan/penggunaan lahan di hulu DAS Jeneberang yang meliputi sawah, pertanian lahan kering dan kebun menggunakan REDD Abacus di tahun 2006-2026. Metode yang digunakan dalam penelitian ini adalah ground check, pembagian kuisioner untuk menghitung manfaat ekonomi, dan melakukan skenario manfaat ekonomi dari tahun 2006-2026 menggunakan REDD ABACUS. nilai NPV pertanian lahan kering adalah nilai NPV terbesar dibandingkan dengan nilai NPV kebun dan nilai NPV sawah yaitu Rp 94.511.966,00. Hal  ini menunjukkan bahwa penggunaan/penutupan lahan pertanian lahan kering memiliki nilai manfaat ekonomi jauh lebih besar dibandingkan yang lainnya. Nilai total biaya manfaat ekonomi dihitung dari tiga penutupan/penggunaan lahan yaitu sawah, pertanian lahan kering dan kebun. Dengan memperhatikan luasan ketiga penutupan/penggunaan lahan tersebut masyarakat mendapat nilai total biaya manfaat ekonomi sebesar Rp 23.056.324,00 per-Ha luasan yang elijibel ($/(ha.tahun)) pada tahun 2010 dan diperkirakan akan meningkat menjadi Rp 119.235.425,00 per-Ha luasan yang elijibel ($/(ha.tahun)) pada tahun 2026.
If “Ifs” and “Buts” Were Candy and Nuts
Authors: Ivy Veronica
Published: June 2021

It’s relatively easy to say that the debates about whether trans and intersex women athletes deserve full and equal inclusion in women’s sport is a contentious contemporary issue. I’ve already argued for the legal, ethical, and scientific basis for full and equal inclusion of trans and intersex women in women’s sport. In this paper, I want to analyze what I take to be a representative selection of recent arguments against full and equal inclusion of trans and intersex women in women’s sport. In short, these arguments tend to be based on mere assumption, unsupported “common sense,” straw arguments, fallacious question begging, and a number of hypotheticals and unsupported counterfactuals rather than established fact. Essentially, they’re based on a lot of “ifs.”
Dibujar en pandemia
Authors: López Fdz. Cao Marián
Published: June 2021

El texto aborda una reflexión sobre el acto de dibujar en relación al proceso creador ocurrido durante el confinamiento derivado de la COVID19, entre abril y junio de 2020. Elementos como atención, mirada, cuidado, sostenimiento, vínculo y placer surgen en el acto creador, máxime cuando la vulnerabilidad y la impredecibilidad surge alrededor. A partir de referentes teóricos como Jean-Luc Nancy se aborda una reflexión sobre la potencialidad creadora en tiempos de incertidumbre
Protokol HTTPS, Apakah Benar-benar Aman?
Authors: Prayama Deddy , Yuhefizar  , Amelia Yolanda
Published: June 2021

In particular, the method used in this research is a case study where previously the p3m.pnp.ac.id website still uses the http protocol. However http protocol does not have a method of securing data in its communication. The final result of this research is the design and implementation of the https protocol for data communication security that occurs between visitors and the p3m.pnp.ac.id website. The https protocol that has been implemented is tested to ensure the data traffic on the p3m.pnp.ac.id website is guaranteed to be safe and protected from possible piracy and data theft.
Organsing learners’ guided self-study in teaching Math in Vietnamese high schools
Authors: Pham Quang Duc , Bui Lam Hanh Thi
Published: June 2021

In Vietnamese high schools, learning in general and self-study in particular plays a very important role in helping learners to deeply understand, expand, consolidate and memorise lessons profoundly thanks to the ability to self-analyze, synthesize and apply existing knowledge in solving new learning tasks. The article presents some issues on guided self-studying and the method to facilitate students with math instructions at high school. To organize the implementation of guided self-studying for students effectively, teachers are required to invest considerable time as well as flexibility in the design of instructional guides to help them access the question the fastest and most suitable way to their capabilities.
Topic choice for a STEM lesson with local practice context
Authors: Nguyen Chung Kim Thi , Huynh Thuy Phuong Thi , Dao Huong Xuan , Dinh Lai Bich Thi , Mai Hao Thi , Ngo Diep Hong
Published: June 2021

One of the main features of STEM education is to be oriented towards practical activities and knowledge application to solve real-life problems. However, in the first step of deployment, teachers often use copied problem contexts from abroad. There are many difficulties in approaching, creating excitement and motivation for students when it is not close to their real life. The more relevant the topic to the real local context is, the more important it is to motivate students to participate and at the same time make it easy for teachers to find topics for the STEM educational model. In this study, when choosing a topic associated with a real local context, both teachers and students easily reach and achieve goals with the STEM educational model.
Training and fostering the contingent of police cadres of Hai Phong city to meet the requirements and missions of ensuring security and order in the new situation
Authors: Nguyen Tinh Dang
Published: June 2021

Training, fostering and improving professional qualifications for the contingent of cadres is an important requirement of the People’s Public Security force in the period of accelerating the industrialization, modernization and international integration of the country. The article proposes solutions to improve the quality of training and fostering the contingent of public security officers with dedication, a high sense of responsibility at work, and the qualifications and capabilities that satisfy the increasing requirements of developing the People’s Public Security force of Hai Phong city to meet the requirements and tasks of ensuring security and order in the new situation.
Immunohistochemical Profiles of Breast Cancer Patients at MRCCC Siloam Semanggi Hospital in 2018
Authors: Gultom Fajar Lamhot , Nurprilinda Marliana , Hutami Ryani Nur Cahyaning
Published: June 2021

Immunohistochemistry examination (IHC) is one of the additional tests to diagnose and determine breast cancer subtype. IHC examination is a method to check intracellular protein using a monoclonal and polyclonal antibody to detect the antigen in tissue. IHC examination determined by hormone receptor markers (ER and PR), HER-2/Neu expression, and apoptotic and proliferation markers (Ki-67 and p53) can be used to determine therapy and prognosis. This study aims to determine the hormonal status of breast cancer patient at Siloam Semanggi Hospital in 2018, in the form of age, gender, pathology diagnose, and the result of IHC (ER, PR, HER2, and Ki-67). This study is a retrospective descriptive study using pathological anatomy laboratory results of breast cancer in MRCCC Siloam Semanggi Hospital and 208 patients following inclusion and exclusion criteria. The result obtained is that the age group with the highest frequency is 50-59 years, with 34.1%. The highest frequency by gender is a woman with 99.5%. Carcinoma mammae NST with grade II and III was found in 38.0% of patients. The hormonal receptor with ER and PR positive was found in 51.0% of patients. HER2 expression negative was found in 56.7% of patients. High proliferation Ki-67 was found in 82.7% of patients. Luminal B with HER2 negative subtype was found in 32.2% of patients. Patients in 50-59 years with Luminal B with HER2 negative subtype was found in 26 patients. Patients in carcinoma mammae NST with grade II with Luminal B with HER2 negative subtype was found in 27 patients.

Keywords: Breast cancer, pathologic anatomy, immunohistochemistry, breast cancer subtype
Apuntes al derecho desde la investigación
Authors:   CUA - Medellín
Published: June 2021

La investigación en el área disciplinar del derecho representa una faceta por potenciar en profesores y estudiantes y sin dudas ocupa en este tiempo un lugar preponderante para el aprendizaje y la exposición clara de ideas, conceptos, metodologías y resultados. Es por ello que se presenta esta obra titulada Apuntes al derecho desde investigación, cuya autoría corresponde a connotados especialistas en esta área y que sin duda corresponde a un material de excelente calidad para mostrar resultados de investigación. En este sentido, y ante los cambios acelerados en los diferentes campos del conocimiento, se requiere de estudios que den respuesta a una realidad compleja y dinámica como la actual; en los que se adopte una posición crítica y reflexiva en función de indagar esa realidad y transformarla creativamente. Así, se hace indispensable la investigación en derecho, y para ello es fundamental introducir las metodologías y herramientas en investigación que permitan el estudio de situaciones determinadas y relacionadas con el ámbito jurídico, para un posterior análisis teórico-reflexivo y la implementación de estrategias y de los resultados para superarlas. Es así como, en el campo del derecho, la investigación se ha convertido en una actividad de relevante importancia, de forma que la generación de conocimiento y la búsqueda del mismo sea un pilar para su avance y para el reconocimiento de formas complementarias al análisis normativo. De esta forma, vemos como el investigar en el derecho brinda herramientas fundamentales que facilitan la labor docente y de campo en el área, contribuyendo a través de los resultados para la intervención de las problemáticas propias y transdisciplinares y al abordaje de nuevas líneas y campos de investigación que conllevan a descubrir, explicar, comprender, criticar e interpretar los modos de proceder en el ámbito jurídico. Todos estos pasos representan las acciones concretas y detalladas de una investigación y que constituyen un llamado a la práctica de la misma, como una forma diferente de intervenir la realidad y como una manera de generar disciplina y método para el abordaje de ella. Finalmente, es necesario que el lector comprenda que al adentrarse en el contenido de esta obra podrá encontrar los resultados de investigaciones desde distintos enfoques, lo que le permite al lector consultar y visualizar de manera independiente los contenidos de cada capítulo, que es lo que representa la riqueza temática y utilidad de la obra. Sin duda alguna, este libro será de gran utilidad para quienes buscan conocer cómo, desde la investigación, se abren nuevos caminos para entender la realidad e intervenirla con fundamento y método.
A case discussion on osteomyelitis: A Case Report
Authors: Kolarkar Rajesh , Kolarkar Rajshree
Published: June 2021

Leeches found very effective and 100% curative role in various non curable diseases by other pathies. Jaloka is a treasure and blessing of Ayurveda never says no to any problem thatâ€™s why it is accepted worldwide for various disorders. Acharya Sushruta and Vagbhata advised various diseases for Jalokavcharan. Ashtishotha (Ostetomylitis) is one of them considering this, we tried on the case of osteomylitis and we got miracle result.
WANKEL MOTORUNUN PERFORMANSININ NUMERİK OLARAK İNCELENMESİ
Authors: ALTIPARMAK Bekir , ALTAY Merve , SÜRMEN Ali
Published: June 2021

Küçük motor hacminden yüksek güç üretimine imkân sağlayan Wankel tipi döner pistonlu motorlar; düşük titreşim, hafiflik, daha az parça sayısı, atalet kuvvetlerinin kolay dengelenebilir olması, gazların geçiş kesitlerinin daha geniş yapılabilmesi gibi özelliklere sahiptirler. Böylece daha yüksek volumetrik verim, vuruntuya daha az bağımlılık ve güç/ağırlık oranının yüksek olması gibi pek çok avantajları sayesinde başta insansız hava araçları, hibrit araç uygulamaları, binek araçlar olmak üzere pek çok uygulama alanında tercih edilmektedir.

Bu çalışmada, ilk olarak dört zamanlı Wankel motorunun geometrik hesaplamaları yapılarak motorun katı modeli oluşturulmuştur. Daha sonra, bu veriler kullanılarak GT SUITE yazılımı yardımıyla 1 boyutlu performans analiz yapılmış ve raporlanmıştır. 1 boyutlu performans analizi verilerinin sınır koşulu olarak kullanıldığı Hesaplamalı Akışkanlar Dinamiği (HAD) analizleri ise devam etmektedir. Çalışma tamamlandığında tam yük koşulunda farklı hızlar için moment ve volumetrik verim yönünden karşılaştırılarak çevrim sürecine etki eden parametreler incelenmiş olacaktır.
Effect of K2SO4 and KNO3 Foliar Application on Wheat Growth
Authors: Arshadullah Muhammad , Ali Arshad , Hyder Syed Isthiaq , Mahmood Imdad Ali , Zaman Badar-uz-
Published: June 2021

A field experiment was conducted to investigate the effect of different concentrations of K2SO4 and KNO3 foliar application (2 and 4%) on the growth of wheat (cv. Watan) at Soil Salinity Research Institute (SSRI) farm, Pindi Bhattian, Punjab, Pakistan during Rabi season, 2007. Treatments were: soil application K2SO4 , KNO3, 2 and 4% K2SO4, 2% KNO3 + 2% K2SO4, 4% KNO3 +2% K2SO4, 2% KNO3 + 4% K2SO4 ,4% KNO3+4% K2SO4 . Treatments were assigned using randomised complete block design with three replications. The crop was harvested at maturity, data on tillering, plant height, spike length, number of grains/spike, 1000-grain weight, straw and wheat yields were recorded. Tillering, number of grains/spike, 1000-grain weight and wheat yield significantly (P £ 0.05) increased by different levels of doses. 2% K2SO4 and 4% K2SO4 improved the tillering capacity of wheat compared with the control. The combination of 2% KNO3 + 4% K2SO4 attained the highest grain yield (2825 kg/ha) which was statistically at par with 2% K2SO4 (2795 kg/ha). The lowest grain yield (2129 kg/ha) was received by the control (soil applied K2SO4). Grain yield after spraying was up to 31% higher than in the control.
Application of Extrusion Technology to Prepare Bread Crumb, A Comparison with Oven Method
Authors: Pasha Imran , Chughtai Muhammad Farhan Jahangir , Sarwar Arsalan , Shabbir Muhammad Asim , Ahmed Shabbir
Published: June 2021

The current research project was designed to conclude the upshot of extrusion cooking temperature on the properties and acceptability of bread crumb. Bread crumbs were obtained by drying the bread, maintaining moisture up to 3-8% and then broken down using hammer mill or crusher which breaks the bread into bread crumbs. Significantly highest moisture contents 7.26% was observed in oven baked bread crumb as compared to 6.25% in bread crumb prepared by extrusion cooking method. The highest bulk density (28.13 g/100 L) was observed in extruded bread crumb  whereas, the oven baked bread crumbs showed lower bulk density (7.03 g/100 L). The fat uptake of extruded and oven baked bread crumbs werefound 0.516 mg/g and 0.493 mg/g, respectively. The extruded bread crumb showed higher water binding capacity as 34.76 g H2O/kg as compared to oven baked bread crumb which showed 27.92 g H2O/kg. Sensory evaluation of extruded and oven baked bread crumbs depicted that bread crumbs prepared from extrusion cooking methods got significantly higher scores for taste, flavour and over all acceptability as compared to those prepared by oven baked method. As far as crispiness is concerned oven baked bread crumbs got comparatively higher scores. Moreover, it was concluded that the treatment T2 of extruded bread crumbs got more sensory scores than oven baked bread crumbs.
Distribution and Abundance of Marine Debris Along the Coast of Karachi (Arabian Sea), Pakistan
Authors: Qari Rashida , Shaffat Moniba
Published: June 2021

This study reports the first assessment of distribution and abundance of marine debris along the coast of Karachi (Arabian Sea), Pakistan. The quadrate method was used for estimating the debris material. Total 40 quadrates were made for collecting the debris on 4 beaches: Sandspit, Buleji, Paradise Point and Korangi Creek in the year of 2012. Nine different types of debris comprising of plastics, glasses, thermopore, clothing, rubber, paper, pot pieces and cigarette filters were collected. The study revealed that, plastic was found in high quantity at all four beaches of Karachi. Other most common items were as follow: plastic at Paradise Point and Sandspit; pot pieces at Korangi Creek and rubber at Buleji. A total weight of 12277.45 g debris was recorded during the whole study period. It was also noted that Paradise Point is the dirtiest beach (5612.6 g) when compared with other studied beaches.
Evaluation of the Impact of Continuously Regenerating Trap on Volatile Organic Compounds Emitted from Turbocharged Diesel Engine
Authors: Shah Asad Naeem , Shan Ge Yun- , Bhutta Muhammad Mehmood Aslam , Rehman Anees Ur , Naveed Ahmad , Masood Muhammad Imran
Published: June 2021

In this study a continuously regenerating trap (CRT) was evaluated on the basis of its performance to control the volatile organic compounds (VOCs) emitted from the diesel engine exhaust. The engine wasoperated on a test bench by coupling it through an AC electrical dynamometer under the auspices of an 8-mode steady-state cycle. VOCs in their gaseous phase were trapped in Tenax TA® cartridge, and then extracted by thermal desorber (TD) for the subsequent analysis through gas chromatograph-mass spectrometer (GC/MS). According to the results, VOCs were preponderant during both maximum as well as minimum load modes owing to the incomplete combustion. Benzene and toluene were in abundance with respective maximum relative contribution (RC) of 40.3 and 34.7% in upstream of CRT, while toluene and ethyl benzene were the dominant species with respective maximum RC of 38.2 and 30.8% in downstream of CRT. Styrene and butyl acetate were the least contributors to total VOCs in both upstream as well as downstream of CRT. The CRT unit revealed a good control on VOCs with maximum reduction rate (RR) of 45%. The RR of VOCs was decreased with the decrease in NO2/NOx ratio, while the RR of benzene was reduced with the reduction in downstream temperature leading to strong correlations between them. Moreover, the RR trend of both benzene and ethyl benzene led to an important finding that when former was substantially reduced with maximum RR, the latter remained elevated with higher negative RR. Hence, an anti-correlation was found between benzene and ethyl benzene.
Infectious Mononucleosis Hepatitis – An Unwelcome Present for Father Christmas
Authors:   Royal Cornwall Hospital Truro, Hussaini Syed H , Pilkington Nicola ,   Anaesthesia Starship Children’s Hospital Auckland New Zealand, Barnes John N ,   Royal Cornwall Hospital Truro Cornwall
Published: June 2021

We describe a case of infectious mononucleosis (IM) hepatitis occurring in an elderly thespian, who had recently played the role of ‘Father Christmas’. We discuss the importance of differing clinical manifestations in older and younger age groups, the changing epidemiology of Epstein Barr (EB) infection within the United Kingdom and the role of different virology tests in establishing a diagnosis. Raised awareness of this changing pattern of disease could prevent unnecessary investigation and consequent potential iatrogenic complications.
A Case of Newly Diagnosed Primary Hypothyroidism with Deteriorating Consciousness that did not Respond to Thyroxine – What Else should be Considered?
Authors:   Wrexham Maelor Hospital, Williams Aled , Green Nikki ,   Wrexham Maelor Hospital, Phyu Cho Thae ,   Wrexham Maelor Hospital, Bondugulapati L N Rao ,   Wrexham Maelor Hospital, Dixon AN ,   Wrexham Maelor Hospital, Harvey John ,   Wrexham Maelor Hospital
Published: June 2021

We present an unusual case of a 60 year old male who was noted to have primary hypothyroidism and decreased consciousness which did not respond to Levothyroxine. Further investigations revealed a diagnosis of Hashimoto’s Encephalopathy which responded well to steroids. We describe the case in detail and discuss the available relevant literature on this topic.
Journal Watch January – May 2013
Authors:   North Tees and Hartlepool NHS Foundation Trust, Clayton Elizabeth
Published: June 2021

In this article I have reviewed 4 articles of interest to acute physicians from literature covering the period January to May 2013 in the New England Journal of Medicine, British Medical Journal, Journal of the American Medical Association and the Lancet.
No substitute for experience: do consultants that have been practising for longer lead faster post-take medical ward rounds?
Authors:   Hammersmith Hospital, London, Gill Dipender , Gaunt Robert ,   The Queen’s College, University of Oxford, Oxford, Hamdulay Shahir ,   General Internal Medicine and Rheumatology, Northwick Park Hospital, Watford Road, Harrow
Published: June 2021

Aim: To ascertain whether consultants that have been practising for longer lead faster post-take medical ward rounds. Method: Single-centre observational study of nine consultant physicians at morning post-take medical ward rounds at a district general hospital in the North West of London. Results: Data were gathered from 25 post-take medical ward rounds. Multivariate regression analysis revealed that less time is spent per patient when consultants have been practising for longer (p<0.01), or have spent more time on the specialist register (p<0.01), with no discernible relation to the outcomes for the patients seen. This time is further reduced when a greater number of patients are seen on the ward round. Conclusion: More experienced consultant physicians conduct faster post-take medical ward rounds.
Trainee Update September 2013
Authors:   Society for Acute Medicine, Conway Nerys , Johnson R ,   Society for Acute Medicine
Published: June 2021

We hope you all enjoyed this summer’s hot spell and that those who moved jobs in August have now settled in. We would like to extend a very warm welcome to all the new acute medicine trainees, and look forward to representing your interests in this ‘new and vibrant’ speciality over the coming years.
Summary Care Records in Urgent and Emergency Care in England
Authors:   Summary Care Records Service, Wyn Jones Emyr
Published: June 2021

Summary Care Records (SCRs) have been created for more than 50% of the population of England. The number is increasing at about 100,000 records a week. Fewer than 1.5% of people have elected not to have a SCR. SCRs contain updated details of patient medication, allergies and adverse reactions, electronically extracted from the GP record. A patient and their GP can also agree to have additional information included. SCRs are being viewed by authorised healthcare staff in urgent and emergency care settings all over England. Benefits are being reported in relation to increased patient safety, improved clinical decision making, improved efficiency and improved quality of care. NHS England strongly supports the uptake and adoption of SCRs by Trusts in England.
Trainee Update January 2014
Authors:   Society for Acute Medicine National Trainees’ Representatives, Conway Nerys , Johnson R ,   Society for Acute Medicine
Published: June 2021

We hope you all had a lovely Christmas and New Year. Apart from making all the usual resolutions, New Year is always a time to think about our careers, look at our CV’s and strive to improve ourselves towards our ARCP or CCT. Our spring conference will take place in Amsterdam this May on 1st-2nd May and there is plenty of opportunity for you to get involved! This year we will be joined by the Dutch Medical Society (DAM). The SAM conferences always provides us with an opportunity for networking, presenting our hard work and meeting other trainees throughout the UK (and in this case Holland). It will be interesting to hear what the Dutch trainees think about their training and how it is structured. There is a dedicated session on acute medical education and training. It will be useful to certainly combine and share ideas with our Dutch colleagues. We certainly could learn a lot from each other and therefore improve our training. Our acute awareness week will take place on 14th-20th July. This is a huge chance for us to raise awareness of our speciality to the public and other hospital workers. You often find that people don’t understand what acute medicine actually is or what an acute medical registrar or consultant actually does. This is an opportunity for us to ‘celebrate’ our speciality and enjoy team bonding. The junior doctors enjoy getting involved and this often encourages them to think about a career in acute medicine. Full details and information packs will be available via our website shortly. We will be interested to hear what you are all planning as we both have a huge part to play in this year’s acute awareness week. Perhaps one day we could have a training awareness day? It would be great if you got in touch with us to let us know your plans or suggestions! We hope to see as many of you in Amsterdam. Please feel free to contact us with any suggestions, ideas or concerns
The Patient with Ataxia
Authors:   Acute Medicine, Royal United Hospital, Bath, Maggs Fenella G
Published: June 2021

In this article we look at the causes of ataxia, and how the patient presenting with ataxia should be managed. One of the difficulties in managing the patient with ataxia is that acute ataxia has many causes, but usually these can be teased out by means of a careful history and examination. Investigations can then be targeted at confirming or disproving the differential diagnosis. Some patients with ataxia need to be managed in hospital, but many can be investigated, and receive therapy, as an outpatient.
ST-Segment Elevation in Patients With Cocaine Abuse and Chest Pain
Authors:   Section of Cardiology, University of Tennessee, School of Medicine, Memphis TN, USA, Shah Rahman , J Duncan Scott ,   Section of Cardiology, University of Tennessee, School of Medicine, Memphis TN, USA, B Ramanathan Kodangudi ,   Section of Cardiology, University of Tennessee, School of Medicine, Memphis TN, USA
Published: June 2021

Use of cocaine may complicate the diagnosis of myocardial infarction (MI) and may influence treatment strategy. Patients with symptoms suggestive of acute coronary syndrome (ACS) should be questioned about the use of cocaine. Initial management of cocaine users presenting with chest pain and ST segment elevation should include administration of glyceryl trinitrate (GTN). Assessment for resolution of chest discomfort and ECG changes should be undertaken before fibrinolytic therapy or angiography is considered. We present a case of patient with chest pain (CP) and ST elevation after cocaine use, whose symptoms and ST changes promptly resolved after medical therapy. Our case highlights the importance of medical therapy in patient with CP and ST elevation after cocaine abuse, before activating cardiac catheterization laboratory for emergent angiography.
How to follow the NEWS
Authors:   Department of Emergency Medicine, Hospital of South West Jutland, Esbjerg, Denmark, Kellett John , Murray Alan ,   Dundalk Institute of Technology, Dundalk, Ireland
Published: June 2021

Background: it is not known how best to respond to changes in the National Early Warning Score (NEWS) after hospital admission. This report manipulates and extrapolates previously published data on the trajectories of the abbreviated early warning score (AbEWS i.e. NEWS that does not include mental status). Methods: trajectories of averaged AbEWS for patients for their first 5 days in hospital and their last 5 days in hospital were combined to obtain an approximation of what happens to the average patient while in hospital. Results: the trajectories of patients admitted with a low score are different from those admitted with a high score. Patients should be observed for 12 to 24 hours before their outcome can be predicted. The score of most patients who die in hospital trends upward on the second or third day after admission. Patients admitted with a score of 0-2 who raise their score to >=3 have a ten-fold increase in-hospital mortality. Conclusions: the trajectories of early warning scores after admission are of prognostic importance, and escalation protocols should relate changes in the score to its initial value on admission.
An avoidable cause of cardioembolic stroke
Authors:   Northampton General Hospital, O’Kane Declan , Pusalkar Aparna ,   East and North Hertfordshire NHS Trust, Topping Will ,   Cardiothoracic Radiologist East and North Hertfordshire NHS Trust, Spooner Oliver ,   East and North Hertfordshire NHS Trust, Roantree Emma ,   East and North Hertfordshire NHS Trust
Published: June 2021

Left Atrial Ablation for Atrial Fibrillation is safe and effective for most patients. However a rare complication is thermal damage to the integrity of the normal physical barriers between the left atrium and the adjacent oesophagus due to the ablation process. This can lead to formation of an Atrial-Oesophageal fistula with sepsis, haemorrhage and systemic cardioembolism occurring even up to 2 months post procedure. The presentation is similar to endocarditis but localised instrumentation specifically Transoesophageal echocardiography (TOE) can provoke systemic cardioembolism. This is an important differential in those presenting acutely with a Pyrexia of Unknown Origin or endocarditis-like picture within 2 months of ablation therapy.
Are the skills of neurological assessment in need of resuscitation?
Authors:   Dept of Neurology, City Hospital, Birmingham, B18 7QH, Nicholl David J
Published: June 2021

The aim of this paper is to outline the background to several recent papers which highlight deficiencies in acute neurological care- all of which highlight (to differing degrees) issues in relation to neurological assessment with some proposed solutions. Given that 10% of acute emergency admissions are for neurological conditions (up to 20% if stroke included), this should be of concern to all acute medical physicians.
Are hospital admissions reduced by Acute Medicine consultant telephone triage of medical referrals?
Authors:   Department of Acute Medicine Ipswich Hospital, Heath Road, Ipswich, Suffolk IP4 5PD UK, Westall Christopher , Spackman Robert ,   Department of Acute Medicine Ipswich Hospital, Heath Road, Ipswich, Suffolk IP4 5PD UK, Nadarajah Channa Vasanth ,   Department of Acute Medicine Ipswich Hospital, Heath Road, Ipswich, Suffolk IP4 5PD UK, Trepte Nicola ,   Department of Acute Medicine Ipswich Hospital, Heath Road, Ipswich, Suffolk IP4 5PD UK
Published: June 2021

The NHS in England is facing well-documented pressures related to increasing acute hospital admissions at a time when the acute medical bed-base is shrinking, doctors working patterns are increasingly fragmented and many acute hospital trusts are operating a financial deficit. Novel strategies are required to reduce pressure on the acute medical take. We conducted a prospective cohort study to assess the impact of acute medicine consultant triage of referrals to the acute medical take on the number of acute hospital admissions as compared to a historical control cohort. The introduction of an acute medicine consultant telephone triage service was associated with a 21% reduction in acute medical admissions during whole the study period. True admission avoidance was achieved for 28.5% of referrals triaged by an acute medicine consultant. The greatest benefit was seen for consultant-triage of GP referrals; 43% of all GP referrals resulted in a decision not to admit and in 25% the referral was avoided by giving advice alone. Consultant telephone triage of referrals to the acute medical take substantially reduces the number of acute medical admissions as compared to triage by a trained band 6 or higher nurse coordinator. Our service is cost effective and can be job-planned using 6 full-time equivalent acute medicine consultants. The telephone triage service also provides additional benefits to admission numbers beyond its hours of operation and the general management of the acute medical take.
What is an acute medicine registrar? A qualitative investigation into trainee self-perception and identity
Authors:   Acute Medicine, University College London Hospitals, London, Lovell Ben
Published: June 2021

Objectives: This paper explores the experiences and attitudes of acute medicine trainees regarding their own identity and function within hospital medicine, with a view to developing a coherent theoretical framework describing the identity of the acute medicine registrar. Methods: Three focus groups involving 17 acute medicine registrars were carried out. Video recordings of the discussions were analysed for the purpose of thematic analysis. Results: Qualitative analysis revealed 5 key aspects to the identity of acute medicine trainees. Novel findings were of trainees’ perceptions of being poorly understood by other specialties, and of being the lead decision maker, particularly out-of-hours. Conclusions: By gaining insight into the identity and core beliefs of AIM trainees, we are better equipped to make decisions regarding the future of acute medicine.
Pulmonary embolism in a patient with “isolated syncope”, a diagnostic challenge
Authors:   Department of Internal Medicine, Weiss Memorial Hospital, affiliate of the University of Illinois at Chicago, Chicago,, Blum Franziska E , Idowu Olympia ,   Department of Internal Medicine, Weiss Memorial Hospital, affiliate of the University of Illinois at Chicago, Chicago, IL, Danciu Sorin ,   Department of Internal Medicine, Weiss Memorial Hospital, affiliate of the University of Illinois at Chicago, Chicago, IL
Published: June 2021

Syncope is a recognized presenting symptom in patients with pulmonary embolism (PE), and is more common in older patients and following a large embolus. Isolated syncope, in the absence of dyspnea or tachycardia, is uncommon in this setting, and may be misdiagnosed as cardiac in origin, leading to a delay in appropriate treatment. We present a case which illustrates the importance of consideration of pulmonary embolism in the differential diagnosis of patients presenting with syncope, and the value of echocardiography in its diagnosis.
Low Oxygen Affinity Variant Haemoglobin in an elderly woman presenting with low oxygen saturation
Authors:   Haematology & Core Medicine, Brighton and Sussex Medical School, University of Brighton, E. Igbineweka Norris , A. Horne Gillian ,   Haematology Research, Institute of Cancer Sciences, University of Glasgow, Glasgow, Basil Jackson Mark ,   Respiratory Physiology, Brighton and Sussex Medical School, University of Brighton, J. Chevassut Timothy ,   Department of Haematology, Brighton and Sussex Medical School, University of Brighton
Published: June 2021

An asymptomatic 81-year-old woman was referred by her general practitioner regarding a pulse-oximetry oxygen saturation (SpO2) of 74%. An arterial blood gas analysis (ABG) on air showed PaO2 12.9 kPa, oxygen saturation 80%, with normal pH, PaCO2, methaemoglobin and carboxyhaemoglobin levels. After a normal chest x-ray, tinzaparin was administered empirically for possible occult pulmonary embolus. This diagnosis was subsequently excluded with an unremarkable computed tomography pulmonary angiogram (CTPA). She was further investigated as an out patient. DNA globin-gene analysis identified a variant haemoglobin revealed to be haemoglobin Saint Mande (HbSM). Following reassurance regarding the benign nature of her condition, she has remained well.
Trainee Update May 2015
Authors:   Society for Acute Medicine, Conway Nerys , Smallwood Nicholas ,   Acute Internal Medicine, Surrey and Sussex NHS Trust
Published: June 2021

It was lovely to catch up with so many Acute Internal Medicine trainees at our spring meeting in Bristol and great to see such a positive response towards our specialty. I hope that many of you will join us for the autumn meeting in Manchester which will be held on the 10-11th September; registration and abstract submissions are already live on the SAM website.
HaNDL with care
Authors:   Royal Bolton Hospital, Fernandez Nicholas , Wijeyekoon Ruwani ,   John van Geest Centre for Brain Repair, University of Cambridge, Richardson Anna ,   Greater Manchester Neurosciences Centre, Salford Royal Foundation Trust, Jones Matthew ,   Greater Manchester Neurosciences Centre, Salford Royal Foundation Trust
Published: June 2021

Headache with neurological deficit and cerebrospinal fluid (CSF) lymphocytosis (HaNDL) syndrome is an important diagnosis to consider in patients presenting with the relevant features to acute medicine. Investigations should aim to exclude more serious differential diagnoses such as infectious, inflammatory and neoplastic causes prior to making a formal diagnosis of HaNDL. Increased awareness and early consideration of HaNDL would help to avoid unnecessary prolonged courses of antimicrobial therapy and invasive investigations such as cerebral angiography.