bluuebunny/crossref_metadata_2025 huggingface dataset:
Measuring air–sea gas exchange velocities in a large scale annular wind-wave tank
Authors: Mesarchaki E. , Kräuter C. , Krall K. E. , Bopp M. , Helleis F. , Williams J. , Jähne B.
Published: June 2014

Abstract. In this study we present gas exchange measurements conducted in a large scale wind-wave tank. Fourteen chemical species spanning a wide range of solubility (dimensionless solubility, α = 0.4 to 5470) and diffusivity (Schmidt number in water, Scw = 594 to 1194) were examined under various turbulent (u10 = 0.8 to 15 m s−1 conditions. Additional experiments were performed under different surfactant modulated (two different concentration levels of Triton X-100) surface states. This paper details the complete methodology, experimental procedure and instrumentation used to derive the total transfer velocity for all examined tracers. The results presented here demonstrate the efficacy of the proposed method, and the derived gas exchange velocities are shown to be comparable to previous investigations. The gas transfer behaviour is exemplified by contrasting two species at the two solubility extremes, namely nitrous oxide (N2O) and methanol (CH3OH). Interestingly, a strong transfer velocity reduction (up to a factor of three) was observed for N2O under a surfactant covered water surface. In contrast, the surfactant affected CH3OH, the high solubility tracer only weakly.
Albedo over rough snow and ice surfaces
Authors: Lhermitte S. , Abermann J. , Kinnard C.
Published: June 2014

Abstract. Both satellite and ground-based broadband albedo measurements over rough and complex terrain show several limitations concerning feasibility and representativeness. To assess these limitations and understand the effect of surface roughness on albedo, firstly, an intrasurface radiative transfer (ISRT) model is combined with albedo measurements over different penitente surfaces on Glaciar Tapado in the semi-arid Andes of northern Chile. Results of the ISRT model show effective albedo reductions over the penitentes up to 0.4 when comparing the rough surface albedo relative to the albedo of the flat surface. The magnitude of these reductions primarily depends on the opening angles of the penitentes, but the shape of the penitentes and spatial variability of the material albedo also play a major role. Secondly, the ISRT model is used to reveal the effect of using albedo measurements at a specific location (i.e., apparent albedo) to infer the true albedo of a penitente field (i.e., effective albedo). This effect is especially strong for narrow penitentes, resulting in sampling biases of up to ±0.05. The sampling biases are more pronounced when the sensor is low above the surface, but remain relatively constant throughout the day. Consequently, it is important to use a large number of samples at various places and/or to locate the sensor sufficiently high in order to avoid this sampling bias of surface albedo over rough surfaces. Thirdly, the temporal evolution of broadband albedo over a penitente-covered surface is analyzed to place the experiments and their uncertainty into a longer temporal context. Time series of albedo measurements at an automated weather station over two ablation seasons reveal that albedo decreases early in the ablation season. These decreases stabilize from February onwards with variations being caused by fresh snowfall events. The 2009/2010 and 2011/2012 seasons differ notably, where the latter shows lower albedo values caused by larger penitentes. Finally, a comparison of the ground-based albedo observations with Landsat and MODIS (Moderate Resolution Imaging Spectroradiometer)-derived albedo showed that both satellite albedo products capture the albedo evolution with root mean square errors of 0.08 and 0.15, respectively, but also illustrate their shortcomings related to temporal resolution and spatial heterogeneity over small mountain glaciers.
The effect of climate forcing on numerical simulations of the Cordilleran ice sheet at the Last Glacial Maximum
Authors: Seguinot J. , Khroulev C. , Rogozhina I. , Stroeven A. P. , Zhang Q.
Published: June 2014

Abstract. We present an ensemble of numerical simulations of the Cordilleran ice sheet during the Last Glacial Maximum performed with the Parallel Ice Sheet Model (PISM), applying temperature offsets to the present-day climatologies from five different data sets. Monthly mean surface air temperature and precipitation from WorldClim, the NCEP/NCAR reanalysis, the ERA-Interim reanalysis, the Climate Forecast System Reanalysis and the North American Regional Reanalysis are used to compute surface mass balance in a positive degree-day model. Modelled ice sheet outlines and volumes appear highly sensitive to the choice of climate forcing. For three of the four reanalysis data sets used, differences in precipitation are the major source for discrepancies between model results. We assess model performance against a geomorphological reconstruction of the ice margin at the Last Glacial Maximum, and suggest that part of the mismatch is due to unresolved orographic precipitation effects caused by the coarse resolution of reanalysis data. The best match between model output and the reconstructed ice margin is obtained using the high-resolution North American Regional Reanalysis, which we retain for simulations of the Cordilleran ice sheet in the future.
Impact of snow cover on CO2 dynamics in Antarctic pack ice
Authors: Geilfus N.-X. , Tison J.-L. , Ackley S. F. , Rysgaard S. , Miller L. A. , Delille B.
Published: June 2014

Abstract. Temporal evolution of pCO2 profiles in sea ice in the Bellingshausen Sea, Antarctica, in October 2007 shows that the CO2 system in the ice was primarily controlled by physical and thermodynamic processes. During the survey, a succession of warming and cold events strongly influenced the physical, chemical and thermodynamic properties of the ice cover. Two sampling sites with contrasting characteristics of ice and snow thickness were sampled: one had little snow accumulation (from 8 to 25 cm) and larger temperature and salinity variations than the second site, where the snow cover was up to 38 cm thick and therefore better insulated the underlying sea ice. We confirm that each cooling/warming event was associated with an increase/decrease in the brine salinity, total alkalinity (TA), total dissolved inorganic carbon (TCO2), and in situ brine and bulk ice CO2 partial pressures (pCO2). Thicker snow covers muted these changes, suggesting that snow influences changes in the sea ice carbonate system through its impact on the temperature and salinity of the sea ice cover. During this survey, pCO2 was undersaturated with respect to the atmosphere both in situ, in the bulk ice (from 10 to 193 μatm), and in the brine (from 65 to 293 μatm), and the ice acted as a sink for atmospheric CO2 (up to 2.9 mmol m−2 d−1), despite the underlying supersaturated seawater (up to 462 μatm).
Spatially continuous mapping of snow depth in high alpine catchments using digital photogrammetry
Authors: Bühler Y. , Marty M. , Egli L. , Veitinger J. , Jonas T. , Thee P. , Ginzler C.
Published: June 2014

Abstract. Information on snow depth and its spatial distribution is crucial for many applications in snow and avalanche research as well as in hydrology and ecology. Today snow depth distributions are usually estimated using point measurements performed by automated weather stations and observers in the field combined with interpolation algorithms. However, these methodologies are not able to capture the high spatial variability of the snow depth distribution present in alpine terrain. Continuous and accurate snow depth mapping has been done using laser scanning but this method can only cover limited areas and is expensive. We use the airborne ADS80 opto-electronic scanner with 0.25 m spatial resolution to derive digital surface models (DSMs) of winter and summer terrains in the neighborhood of Davos, Switzerland. The DSMs are generated using photogrammetric image correlation techniques based on the multispectral nadir and backward looking sensor data. We compare these products with the following independent datasets acquired simultaneously: (a) manually measured snow depth plots (b) differential Global Navigation Satellite System (dGNSS) points (c) Terrestrial Laser Scanning (TLS) and (d) Ground Penetrating Radar (GPR) datasets, to assess the accuracy of the photogrammetric products. The results of this investigation demonstrate the potential of optical scanners for wide-area, continuous and high spatial resolution snow-depth mapping over alpine catchments above tree line.
How the Party of God Uses Media and Resources to Succeed in the 21st Century
Authors: Huffman Zachary
Published: June 2014

In July 2013, the Lebanese Shi'a group Hezbollah publically announced its participation in the Syrian Civil War at the battle of al-Qusayr. Long advertized as the protector of Lebanon, many analysts believed involvement in Syria on behalf of Bashar al-Assad's regime would ultimately damage Hezbollah's position at home. Nevertheless, the Party of God has been able to maintain its power in Lebanon. This paper will investigate how Hezbollah is able to autonomously pursue objectives that potentially run contrary to the wishes of its constituents, while still acting as a powerful, domestic political actor in Lebanon. I will first identify why Hezbollah insists on pursuing selfish objectives by considering Hezbollah's weapon supplies. Next, I will show that Hezbollah owes much of its success to its unique relationship with the Lebanese Shi'i. Finally, by examining Hezbollah's media apparatus and international financial and operational networks, I will illustrate how Hezbollah has adapted to trends in globalization to cement itself as one of the most dangerous sub-state organizations in the world.
Back in the Barracks But Not Forgotten: Lasting Cultural Legacies of the Turkish Armed Forces
Authors: Hamon Patrick
Published: June 2014

The proliferation and shifts of culture across generations is a topic that affects national policy, distribution of economic controls, and social norms that dictate what young people choose to do and what to not do. In the case of the Republic of Turkey, a large facet of culture has been built on the civil-military dynamic that puts the Turkish Armed Forces as guardians of the nation from both foreign threat and domestic cultural shifts. However, the recent emergence of civilian control over the military puts this cultural role in question. This paper examines the spheres of higher education, conscription, and media, three areas the military has typically used to socialize youth, and what the effect of civilian control has been. This research found that the AKP-led government has chosen to assimilate militarism in socialization of youth, and that has deep implications for the educational, vocational, and military structures young Turks will enter.
The Hashtag Generation: The Twitter Phenomenon in Saudi Society
Authors: Winder Bayly Philip Christopher
Published: June 2014

The objective of this paper is to describe and explain the extremely high usage of Twitter within the Kingdom of Saudi Arabia. This topic relates strongly to the current transformations that Saudi society is undergoing, and helps to demonstrate the growing desire of the youth to express their opinions in the public sphere via social media. Although the government has attempted to censor Twitter and hold individual users accountable, in addition to legislation further criminalizing speech against the state, it has become clear that regulating the Twittersphere is incredibly difficult. Consequently, in recent years, the regime has taken a different approach and attempted to engage with the population via Twitter, creating accounts for ministries, high-profile princes, and other officials. While Twitter is commonly used to criticize the monarchy in Riyadh and explore taboo subjects, such as the right of women to drive, Saudis are also using it to defend conservative values and support the preservation of traditions. This forum is providing Saudis with access to lively and engaging debates in a way that was not previously possible.
Art and the Economy in Amman
Authors: Katz Emma
Published: June 2014

This paper discusses the arts as an economic boon by evaluating the impact that the arts and art industries have had on three international cities' economies: Nantes in France, Asilah in Morocco, and Detroit in the United States. The paper then draws parallels between these cities and Amman, Jordan, concluding that the arts' positive impact on the aforementioned cities economies suggests similar beneficial potential for Amman, despite a number of political and economic challenges Jordan faces currently.
From Colonial Rule to the Modern Day: The Impact of Globalization on Sharia Resources Within the Female Algerian Youth
Authors: Tricic Merima
Published: June 2014

How has the rise of Algerian youth organizations providing legal resources to women impacted female involvement in politics, the media, and policy-making? The purpose of my research is to examine how French colonial “Family Law” and traditional Berber patriarchy in 19th century Algeria intersected, and how Islamic feminism and legal reformation grew out of that intersection with globalization. French law and Berber patriarchy aligned in such a way that women were prevented from accessing the political process until the rise of Algerian feminist organizations in the late 1900's that called for broader language interpretations. My research shows that the provision of legal resources by Algerian feminist groups has resulted in higher rates of education and alternate interpretations of Sharia, empowering women in the political arena. My data, including personal interviews I conducted and statistics collected on voting polls, show that women have reached high political offices in Algeria. They have served as Prime Ministers, run for the presidency and received a high percentage of the vote, and increased their political involvement. All this is a result of increased literacy and usage of alternate feminist interpretations of Islamic law. My research will include statistical data collected by the feminist organizations provided workshops on examining Islamic texts in the 1960's, as well as interviews and case studies of women that had fallen victim in between the jurisprudence of Islamic and French law. My intention is to demonstrate that Sharia law is often misinterpreted in today's media, and even fought against, which in turn has reaffirmed patriarchal views by avoiding open conversation rather than addressing the problem and providing resources on Islamic law interpretations.
Egypt's Panoptic Cinema: From Colonialism to Sobky
Authors: Helal Nada
Published: June 2014

Is Egypt witnessing the birth of a new revolutionary cinema after having undergone a wave of political consciousness and revitalization? This paper aims to trace the history of state censorship in Egypt with the aim of shedding light on the use of cinematic discourse as a tool of “Othering”. Beginning with the colonial years and ending with Anwar al-Sadat's rule, cinema in Egypt underwent slow yet complex development reflective of the sociopolitical reality of Egyptian society. How, in turn, has the scrutiny of Egyptian censorship, a rigid tool of discourse production and dissemination, been reflected on a more individualistic level? Through a Foucauldian analysis, the paper aims to explain the process of self-regulation and self-censorship performed by the Egyptian mainstream audience. More importantly, I aim to explore how hyper-sexualized, hyper-masculinized mainstream cinema has constantly escaped the scrutiny of the censorship bureau, the “patriarchal guard on morality”.
Incontinence after radical prostatectomy: Anything new in its management?
Authors: Caremel Romain , Corcos Jacques
Published: June 2014

Introduction: With the increasing number of radical prostatectomies (RP) performed, male stress urinary incontinence (SUI) has become common. The artificial urinary sphincter (AUS) is the gold standard to treat SUI post-RP, but new devices have recently been developed. We review the recent studies on the treatment of SUI post-RP; we also describe the surgical techniques, mechanisms of action and results of these new procedures.Methods: We conducted a literature review search in the PubMed/Medline and Embase databases. Our search was restricted to recent articles. We included studies even if the urinary incontinence was due to sphincter deficiency after RP in non-neurologic patients.Results: We found 8 cohort studies for the surgical procedure: 3 studies concerning slings, 1 involving balloons adjustable implant, and 4 involving new devices. The only randomized controlled trial (RCT) was a pharmacologic clinical trial comparing duloxetine to placebo. The social continence rates were analyzed for 6 studies and were up to 66%.Conclusion: New minimally invasive surgical procedures have emerged as the main alternative to AUS, with social continence rates up to 60% despite just 1 RCT studying the pharmacologic approach. There is an urgent need for well-designed clinical trials to clarify the role of new surgical alternatives in the management of SUI post-RP. New technologies should continue to be evaluated and compared with the AUS, which remains the gold standard.
A modification of the TIP procedure for distal hypospadias: The burrowing technique
Authors: Wishart Erin D. , Metcalfe Peter D.
Published: June 2014

Introduction: The tubularized incised plate urethroplasty (TIP) hypospadias repair is a commonly performed procedure for hypospadias. Multiple series document excellent cosmetic outcome in conjunction with low complication rates. We describe a modification that we have named the “burrowing technique.” We believe that this technique facilitates dissection of the glans, which improves mobility, decreases tension with closure, and potentially improves outcomes.Methods: A retrospective review was performed of 193 coronalor mid-shaft hypospadias repairs by a single surgeon. The first 98 were performed using the TIP procedure, then the burrowing technique was developed and a subsequent 95 were analyzed for outcomes using this modification. Urethral plate characteristics and glandular size did not influence the choice of surgical technique. Cases were selected to allow for a “learning curve,” and were consecutively accrued. None of the boys had undergone prior hypospadias surgery. Proximal 2 stage repairs and distal (glanular) repairs were excluded.Results: A total of 193 boys underwent repair, 98 with the traditional TIP procedure and 95 using the burrowing modification. In total, 37 (19.2%) patients required re-operation for either fistulas or dehiscence; 23 (23.5%) in the non-burrowing group and 14 (14.7%) in the burrowing group, odds ratio 0.54 (p = 0.10).Conclusions: The TIP procedure has revolutionized the management of distal hypospadias. The burrowing modification increases glandular mobility simplifying the procedure and demonstrates a non-statistically significant trend in reducing reoperation rates.
Royal College surgical objectives of urologic training: A survey of faculty members from Canadian training programs
Authors: Zakaria Ahmed Sayed , Haddad Richard , Dragomir Alice , Kassouf Wassim , Andonian Sero , Aprikian Armen Garo
Published: June 2014

Introduction: According to the Royal College objectives of training in urology, urologic surgical procedures are divided as category A, B and C. We wanted to determine the level of proficiency required and achieved by urology training faculty for Royal College accreditation.Methods: We conducted a survey that was sent electronically to all Canadian urology training faculty. Questions focused on demographics (i.e., years of practice, geographic location, subspecialty, access to robotic surgery), operating room contact with residents, opinion on the level of proficiency required from a list of 54 surgical procedures, and whether their most recent graduates attained category A proficiency in these procedures.Results: The response rate was 43.7% (95/217). Among respondents, 92.6% were full timers, 21.1% practiced urology for less than 5 years and 3.2% for more than 30 years. Responses from Quebec and Ontario formed 69.4% (34.7% each). Of the respondents, 37.9% were uro-oncologists and 75.7% reported having access to robotic surgery. Sixty percent of faculty members operate with R5 residents between 2 to 5 days per month. When respondents were asked which categories should be listed as category A, only 8 procedures received 100% agreement. Also, results varied significantly when analyzed by sub-specialty. For example, almost 50% or more of uro-oncologists believed that radical cystectomy, anterior pelvic exenteration and extended pelvic lymphadenectomy should not be category A. The following procedures had significant disagreement suggesting the need for re-classification: glanular hypospadias repair, boari flap, entero-vesical and vesico-vaginal fistulae repair. Overall, more than 80% of faculty reported that their recent graduating residents had achieved category A proficiency, in a subset of procedures. However, more than 50% of all faculty either disagreed or were ambivalent that all of their graduating residents were Category A proficient in several procedures.Conclusions: There is sufficient disagreement among Canadian urology faculty to suggest another revision of the current Royal College list of category A procedures.
Pyelonephritis can be a source of a life threatening necrotizing myofasciitis
Authors: Kamel Haytham , Awed Mohamed Soliman Edris , Kotb Ahmed Fouad
Published: June 2014

Necrotizing fasciitis is a progressive, rapidly spreading, inflammatory infection located in deep fascia. It may cause necrosis of skin and subcutaneous tissue and can even result in involvement of adjacent soft tissues such as muscles resulting in necrotizing myositis. We report the case of an adult male presenting with necrotizing myofasciitis secondary to left pyelonephritis. We also review the relevant literature.
Comparison between complication rates of laser prostatectomy electrocautery transurethral resection of the prostate: A population-based study
Authors: Larouche Alexandre , Becker Andreas , Schiffmann Jonas , Roghmann Florian , Gandaglia Giorgio , Hanna Nawar , Tian Zhe , Perrotte Paul , Schlomm Thorsten , Graefen Markus , Ahyai Sascha , Karakiewicz Pierre , Trinh Quoc-Dien , Sun Maxine
Published: June 2014

Introduction: We compare the complication rates and length of stay (LOS) of laser transurethral resection of the prostate (L-TURP) versus electrocautery transurethral resection of the prostate (E-TURP) in a population-based cohort. L-TURP has shown enhanced intraoperative safety and equivalent efficacy relative to E-TURP in several high volume centres.Methods: Relying on the Florida Datafile as part of the Healthcare Cost and Utilization Project State Inpatient Databases (SID) between 2006 and 2008, we identified 8066 men with benign prostate hyperplasia who underwent L-TURP or E-TURP. Chi-square and Mann-Whitney tests were used to compare baseline characteristics. A multivariable linear regression model was used to analyze the effect of L-TURP versus E-TURP on complication rates and LOS.Results: Overall complication rates did not differ significantly for L-TURP compared to E-TURP in univariable (8.8 vs. 7.4%, p = 0.1) and multivariable analyses (odds ratio [OR]: 1.06, confidence interval [CI]: 0.85-1.32, p = 0.6). Individuals undergoing E-TURP were less likely to experience a LOS in excess of 1 day (46.2 vs. 59.7%, p < 0.001). A lower risk to experience a LOS in excess of 1 day was confirmed for patients undergoing L-TURP after a multivariable linear regression model (OR: 0.37, CI: 0.23-0.58, p < 0.001), but not for a LOS in excess of 2 days (OR: 0.96, CI: 0.83-1.10, p = 0.2).Conclusions: Patient characteristics and perioperative safety were similar for L-TURP and E-TURP patients. However, LOS patterns demonstrated a modest benefit for L-TURP compared to E-TURP patients.
Hidden penile squamous cell carcinoma: A case report
Authors: Neufeld Sam , Kroczak Tadeusz , Drachenberg Darrel
Published: June 2014

Penile cancer is a rare malignancy that typically presents as a superficial lesion. We present an interesting case of subepithelial penile cancer presenting without superficial manifestation.
Surgeon-specific factors affecting treatment decisions among Canadian urologists in the management of pT1a renal tumours
Authors: Millman Alexandra Leora , Pace Kenneth T. , Ordon Michael , Lee Jason Young
Published: June 2014

Introduction: The ubiquitous use of diagnostic imaging has resulted in an increased incidental detection of small renal masses (SRM). Patient- and tumour-related factors affect treatment decisions greatly; however, with multiple treatment options available, surgeon-specific characteristics and biases may also influence treatment recommendations. We determine the impact of surgeon-specific factors on treatment decisions in the management of SRM in Canada.Methods: An online survey study was conducted among Canadian urologists currently registered with the Canadian Urological Association. The questionnaire collected demographic information and recommended treatments for 6 SRM index cases involving theoretical patients of various ages (51-80 years) and comorbidities.Results: A total of 110 urologists responded (17% response rate) to the survey. Of these, 18% were over 65 years old and 45% were from academic centres. With increasing patient age and comorbidity, active surveillance and thermal ablative therapies were more the recommended treatment. Laparoscopic/robotic surgery was more commonly recommended by academic urologists and those under 65. Recommending surgery (radical nephrectomy or partial nephrectomy) for both elderly (about 80 years old) index patients correlated with surgeon age (surgeons over 65, p < 0.001), surgeons with no oncologic fellowship training (p = 0.021), surgeons with a non-academic practice (p = 0.003), surgeons with a personal history of cancer (p = 0.038) and surgeons with a family history of cancer death in the last 10 years (p = 0.022).Conclusions: There are various factors that influence the management options offered to patients with SRMs. Our results suggest that surgeon age, personal history of cancer, practice-type and other surgeon-specific variables may affect treatments offered among urologists across Canada.
Pediatric vasitis: A rare complication of epididymitis
Authors: Weiser Giora , Ehrlichman Mattityahu , Cytter Kuint Ruth , Schurr Efrat
Published: June 2014

Vasitis represents an inflammation of the vas deferens. This is a rare entity seen mostly in adult males following local surgery (e.g., vasectomy, hernia repair). Children with groin masses have a wide differential diagnosis. We describe a child with a groin mass following epididymitis diagnosed with vasitis and review the known literature regarding diagnostic tools and treatment. Vasitis in children, although rare, can be seen as a complication of epididymitis.
Kidney cancer survivorship survey of urologists and survivors: The gap in perceptions of care, but agreement on needs
Authors: Moretto Patricia , Jewett Michael A.S. , Basiuk Joan , Maskens Deborah , Canil Christina Maria
Published: June 2014

Introduction: There is lack of evidence-based literature addressing comprehensive long-term care for kidney cancer (KC) survivors. Additionally, it is unclear if the concerns of KC patients/caregivers are being adequately addressed. Therefore, Kidney Cancer Canada (KCC), a patient-led support organization for Canadians diagnosed with KC, commissioned this first recorded survivorship survey specific to patients/caregivers diagnosed with localized KC. Methods: A cross-sectional on-line survey for Canadian patients/caregivers with non-metastatic KC at diagnosis, and a separate parallel survey of Canadian urologists were performed. The primary objective was to assess patient/caregivers’ and urologists’ perceptions of information provided, as well as the physical/psychological/emotional impact of KC treatment. Results: Urologists recalled providing information about surgical complications (90%) and their management (63%), while patients/caregiver recall was much less (33% and 35% respectively). Ninety-three percent of urologists recalled providing information on cancer recurrence, but only 42% of patients/caregivers remembered receiving this information. The concerns identified by patients/caregivers and urologists were similar: fear of recurrence, concerns about cancer, fatigue, and anxiety. Importantly, all agreed that survivorship information was important. Education of both patients/caregivers and physicians and the development of guidelines were factors identified to ensure optimal KC survivorship. Discussion/Conclusions: There was some discordance between urologists’ and patients/caregivers’ rates of recall of information provided. Patients/caregivers would have desired more information about their cancer, long-term follow-up, and potential complications. Provision of a survivorship care plan tailored to KC may be an effective measure to address these needs. The impact of such an intervention on the survivor outcomes should be rigorously assessed.
Pancake kidney: A rare developmental anomaly
Authors: Choudhary Anil Kumar , Tiwari Alok Kumar , Khowal Hemant , Chaudhary Poras , Arora Mohinder P.
Published: June 2014

There are many developmental anomalies of the kidney. Pancake kidney is one of the rarest types of renal ectopia. We report a case of pancake kidney which was detected incidentally while treating a female patient for a urinary tract infection. Although urinary system anomalies often coexist with malformations of other organs and systems, no associated anomalies could be detected in this case. Pancake kidney is usually managed by surgery, but this case was managed conservatively without any complication.
Robotic intra-abdominal vasectomy reversal: A new approach to a difficult problem
Authors: Barazani Yagil , Kaouk Jihad , Sabanegh Jr. Edmund S.
Published: June 2014

The management of obstructive azoospermia resulting from intra-abdominal vasal obstruction poses a formidable surgical challenge. A number of surgical methods have been described to address this problem, including both open and laparoscopic approaches to mobilize and sometimes even re-route the abdominal vas deferens prior to performing a re-anastamosis. We present the first report, to our knowledge, of robotic intra-abdominal vasectomy reversal used to repair obstructive azoospermia resulting from prior laparoscopic vasectomy. In doing so, we summarize the techniques described previously in the literature and build upon this body of surgical experience by combining robotic-assisted laparoscopic mobilization of the vas with robotic vasovasostomy. We believe this novel approach for repairing intra-abdominal vasal defects minimizes morbidity, while at the same time obviating the need for the operating microscope, and thus represents a practical alternative to existing techniques.
Lumbar artery branch injury secondary to ureteroscopic manipulation
Authors: Rothberg Michael B. , Monga Manoj , Gupta Mantu
Published: June 2014

Iatrogenic vascular injury in ureteroscopy is relatively uncommon and typically presents as a subcapsular hematoma. We report the case of an injury to a branch of the lumbar artery secondary to ureteral trauma during ureteroscopy. In the immediate postoperative period, the patient became hypotensive and tachycardic, prompting a workup that revealed an active hemorrhage. The patient then underwent subsequent angiogram and successful coil embolization.
Distal ureteral stricture: A unexpected complication of further adjuvant intravesical mitomycin C thermotherapy
Authors: Umul Mehmet , Altok Muammer , Gunes Mustafa , Sahin Ali , Divrik Taner
Published: June 2014

We present a case of distal ureteral obstruction in relation to further adjuvant intravesical thermochemotherapy with mitomycin C (MMC) for non-muscle invasive bladder cancer (NMIBC). We also discuss the diagnostic procedures and management of this recurrent case.
Study on Morbidity and Mortality Rates in Buffaloes in Pune Division of Maharashtra State in India
Authors: Bangar Y. C. , Khan T. A. , Dohare A. , Kolekar D. V. , Avhad S. R.
Published: June 2014

The present study was carried out to analyse morbidity and mortality rate in buffaloes and its associated factors in Pune division of Maharashtra state in India. Stratified two stages random sampling design was adopted & the data of total 564 buffaloes were collected through pre-tested modified schedule from 157 buffalo owners. The data were analysed statistically by SAS 9.3 software for evaluation of Chi-square and Logistic regression analysis. Overall morbidity (28.01%) and mortality (7.98%) rates were recorded in study area. Digestive diseases and respiratory diseases are major cause of the higher morbidity and mortality in buffaloes, respectively. Statistically, there wasn't significant association of overall disease incidence with age or sex. However, the Chi-square analysis of overall mortality rate showed significance (p<0.01) difference among age and sex. Logistic regression analysis also suggested the same results. Mortality rates were recorded higher in calves and male buffaloes as compared to their respective counterparts. It is suggested that digestive and respiratory problems may be reduced by improving feeding and management practices. This study provides the important tool for determining the health status of buffaloes and has special importance in planning of prevention and control strategies designed to reduce the incidences of diseases in livestock and therefore economic status of farmers.
Biomolecule Damage (DNA and Lipid) is Elevated in Patients with Type 1 Diabetes with and without Diabetic Complications
Authors: Hannon-Fletcher Mary P.A. , Weatherup Colin , O’Kane Maurice J. , Moles Ken W. , Barnett Yvonne A.
Published: June 2014

There is strong evidence that oxidative stress is involved in the aetiology and pathogenesis of diabetes and its complications. Increased production of reactive oxygen species in vivo can lead to cellular biomolecule damage, such as lipid peroxidation and DNA damage.The aim of this study was to determine the extent of this damage by measuring in vivo antioxidant status, levels of lipid peroxidation, and levels of neutrophil DNA damage in 50 participants with type 1 diabetes and 50 age- and sex-matched, healthy controls.Gylcaemic control (%HbA1c) was relatively good with a group mean of 7.71% which increased to 8.12 % in those with complications. Compared to the control group there were significantly elevated levels of neutrophil DNA damage (% tail DNA, p<0.0001) and plasma MDA levels (p<0.05) in the Type 1 group as a whole, this significance rose to p<0.01 in those with complications. There were significant alterations in markers of antioxidant status including, reduced levels of superoxide dismutase (p<0.0001), uric acid (p<0.05) and Vitamin C (p<0.05) and elevated levels of catalase (p<0.001).These results indicate that even with acceptable glycaemic control significant oxidative damage still occurs and this damage increases, in some indices, with the onset of complications.
Host-induced bacterial cell wall decomposition mediates pattern-triggered immunity in Arabidopsis
Authors: Liu Xiaokun , Grabherr Heini M , Willmann Roland , Kolb Dagmar , Brunner Frédéric , Bertsche Ute , Kühner Daniel , Franz-Wachtel Mirita , Amin Bushra , Felix Georg , Ongena Marc , Nürnberger Thorsten , Gust Andrea A
Published: June 2014

Peptidoglycans (PGNs) are immunogenic bacterial surface patterns that trigger immune activation in metazoans and plants. It is generally unknown how complex bacterial structures such as PGNs are perceived by plant pattern recognition receptors (PRRs) and whether host hydrolytic activities facilitate decomposition of bacterial matrices and generation of soluble PRR ligands. Here we show that Arabidopsis thaliana, upon bacterial infection or exposure to microbial patterns, produces a metazoan lysozyme-like hydrolase (lysozyme 1, LYS1). LYS1 activity releases soluble PGN fragments from insoluble bacterial cell walls and cleavage products are able to trigger responses typically associated with plant immunity. Importantly, LYS1 mutant genotypes exhibit super-susceptibility to bacterial infections similar to that observed on PGN receptor mutants. We propose that plants employ hydrolytic activities for the decomposition of complex bacterial structures, and that soluble pattern generation might aid PRR-mediated immune activation in cell layers adjacent to infection sites.
Ultrasound First, Second, and Last for Vascular Access
Authors: Moore Christopher L.
Published: June 2014

Vascular access is the most commonly performed invasive procedure in medicine. For more than 20 years, ultrasound has been shown to improve the success and decrease complications of central venous access; however, it is still not universally used for this procedure. Ultrasound may also be used to facilitate difficult peripheral vascular access, potentially avoiding other more invasive procedures such as central or intraosseus vascular access. This article reviews some of the indications and evidence for ultrasound‐guided vascular access, provides tips for successful ultrasound guidance, and discusses barriers to adoption.
Prenatal Diagnosis of Prevalence of the Right Heart
Authors: Peng Ruan , Xie Hong-Ning , Zhu Yun-Xiao , Li Li-Juan , Du Liu , Zheng Ju
Published: June 2014

Objectives

To analyze the characteristics, associations, and outcomes of prevalence of the right heart and to evaluate the use of sonography to predict the risk of a poor prognosis in fetuses with this condition.

Methods

We conducted a retrospective cohort study of 182 fetuses with prevalence of the right heart. At the initial evaluation, the left ventricle (LV) and right ventricle (RV) sizes, left atrium and right atrium sizes, great artery diameters, appearance of the aortic arch and ductus arteriosus arch, and flow direction across the foramen ovale and aortic arch were documented. Malformations were documented in fetuses with intracardiac anomalies, who were divided into groups with and without coexisting extracardiac defects. The RV‐LV diameter ratio and main pulmonary artery‐to‐aortic root diameter ratio were calculated and compared. The following variables were analyzed: coexisting intracardiac anomalies, associated extracardiac anomalies, diagnosis before 24 gestational weeks, fetal growth restriction, reversed flow across the foramen ovale, reversed flow in the aortic arch, and RV‐LV ratio greater than 2.0. Relationships between these sonographic findings and the prognosis were evaluated by multivariable logistic regression.

Results

Of the 182 fetuses, 1 (0.5%) had intrauterine death, and 25 (13.7%) had neonatal death; 1 (0.5%) had selective reduction, and 106 (58.2%) underwent termination of pregnancy; 49 (26.9%) survived at this writing. The mean RV‐LV ratio was 1.67. Multivariable logistic regression revealed that only 2 sonographic parameters, coexisting intracardiac anomalies (odds ratio, 17.75; 95% confidence interval, 4.18–75.26) and diagnosis before 24 weeks (odds ratio, 17.26; 95% confidence interval, 1.80–165.39) were significantly associated with a poor prognosis.

Conclusions

The sonographic parameters of coexisting intracardiac anomalies and diagnosis before 24 gestational weeks are significant independent predictors of a poor prognosis in fetuses with prevalence of the right heart. Combinations of these risk factors may be useful in prenatal consultation.
Biparietal Diameter–to–Crown‐Rump Length Disproportion in First‐Trimester Fetuses With Holoprosencephaly
Authors: Sepulveda Waldo , Wong Amy E. , Andreeva Elena , Odegova Natalia , Martinez-Ten Pilar , Meagher Simon
Published: June 2014

Objectives

To determine whether the biparietal diameter measurement is altered in first‐trimester fetuses with holoprosencephaly.

Methods

Cases of holoprosencephaly were collected retrospectively from 4 fetal medicine centers, and first‐trimester biparietal diameter measurements were reviewed. The diagnosis of holoprosencephaly was established sonographically by the detection of abnormal choroid plexus morphologic characteristics (absent “butterfly” sign) and the identification of a monoventricular cerebral cavity on axial views of the fetal brain. The proportion of fetuses with biparietal diameter measurements below the 5th percentile for crown‐rump length was determined.

Results

Among 45 cases of holoprosencephaly reviewed, 43 had information on both biparietal diameter and crown‐rump length measurements. The biparietal diameter was below the 5th percentile for crown‐rump length in 14 (32.6%) fetuses. Chromosomal analysis was available in 41; no statistically significant difference in biparietal diameter measurement between those with associated chromosomal anomalies and those without anomalies was noted. A supplementary analysis using head circumference measurement showed an even greater proportion of fetuses with holoprosencephaly with measurements below the 5th percentile for crown‐rump length (18 of 42 [42.9%]).

Conclusions

One‐third of first‐trimester fetuses with a sonographic diagnosis of holoprosencephaly had a biparietal diameter that was smaller than expected for crown‐rump length. In this subset of fetuses, the evaluation of intracranial anatomy for signs of holoprosencephaly may be more difficult to perform due to the smaller size of the brain. Therefore, the detection of a biparietal diameter below the 5th percentile as expected from crown‐rump length on the first‐trimester scan may be a warning sign of holoprosencephaly and should prompt a detailed examination of the intracranial anatomy.
Assessing the Impact of Twin Pregnancies on the Pelvic Floor Using 3‐Dimensional Sonography
Authors: Kubotani Juliana Sayuri , Júnior Edward Araujo , Zanetti Miriam Raquel Diniz , Passos Jurandir Piassi , de Jármy Di Bella Zsuzsanna Ilona Katalin , Júnior Julio Elito
Published: June 2014

Objectives

The purpose of this study was to compare the morphologic characteristics of the pelvic floor musculature between women with twin and singleton pregnancies.

Methods

We conducted a cross‐sectional case‐control study of 40 nulliparous women aged 20 to 38 years to compare women with singleton pregnancies (n = 23) to women with twin pregnancies (n = 17). Biometric measurements of the levator hiatus and the sagittal and coronal diameters were made by transperineal 3‐dimensional sonography between the 28th and 38th gestational weeks. Comparisons were statistically assessed by the unpaired Student t test and Mann‐Whitney U test.

Results

For the women with singleton pregnancies, the mean sagittal diameters at rest, during the Valsalva maneuver, and during pelvic floor contraction were 5.3, 5.7, and 4.5 cm, respectively, and the mean coronal diameters under these conditions were 3.8, 4.1, and 3.6 cm. For the women with twin pregnancies, the corresponding values were as follows: mean sagittal diameters, 5.3, 5.8, and 4.6 cm; and mean coronal diameters, 4.3, 4.3, and 3.8 cm. The differences in coronal diameters were statistically significant at rest (P < .01) and during contraction (P = .04). The mean levator hiatal areas for the women with singleton pregnancies were 14.6, 16.9, and 11.7 cm2 at rest, during Valsalva, and during contraction, respectively; for the women with twin pregnancies, these values were 16.0, 18.6, and 12.6 cm2.

Conclusions

Hiatal measurements were higher in twin than in singleton pregnancies, with coronal diameters reaching significance at rest and during contraction, suggesting that pelvic support undergoes greater changes during twin pregnancy.
Estimation of Spleen Size With Hand‐Carried Ultrasound
Authors: Lee Mitchell , Roberts J. Mark , Chen Luke , Chang Silvia , Hatala Rose , Eva Kevin W. , Meneilly Graydon S.
Published: June 2014

Objectives

Physical examination can identify palpable splenomegaly easily, but evaluating lesser degrees of splenomegaly is problematic. Hand‐carried ultrasound allows rapid bedside assessment of patients. We conducted this study to determine whether hand‐carried ultrasound can reliably assess spleen size.

Methods

Patients with varying degrees of splenomegaly were studied. Two sonographers blindly measured spleen size in each patient using either a hand‐carried or conventional ultrasound device in random order. Sonographers completed a data sheet indicating the adequacy of the image, clinical measurements of enlargement, and confidence in their observations.

Results

Sixteen patients (10 male and 6 female; mean age ± SEM, 60 ± 4 years) were recruited. Image quality was adequate or better in all scans with conventional ultrasound and in 15 of 16 scans with hand‐carried ultrasound. The greatest longitudinal measurement recorded was statistically equivalent across ultrasound techniques, with mean values of 16.4 cm (95% confidence interval, 14.8–18.0 cm) for conventional ultrasound and 15.8 cm (95% confidence interval, 14.1–17.4 cm) for hand‐carried ultrasound. The correlation between measurement techniques was r = 0.89 (P < .0001). Sonographers were somewhat or very confident in the outcomes of all scans with conventional ultrasound and in 15 of 16 cases with hand‐carried ultrasound. In general, it took longer for sonographers to obtain images with hand‐carried ultrasound.

Conclusions

We have shown that hand‐carried ultrasound can be used at the point of care by trained individuals to diagnose splenomegaly. However, hand‐carried ultrasound images were less likely to be judged excellent, were accompanied by less diagnostic certainty, and took longer to obtain.
Inter‐Rater Reliability of Carotid Atherosclerotic Plaque Quantification by 3‐Dimensional Sonography
Authors: Bar Michal , Roubec Martin , Farana Radim , Ličev Lacezar , Tomášková Hana , Školoudík David
Published: June 2014

Objectives

Embolization from atherosclerotic carotid plaques is the most common cause of ischemic stroke; therefore, identification of high‐risk plaques by sonography is important. The aim of this study was to investigate the agreement between 2 investigators in the evaluation of sonographic parameters relating to plaque stability.

Methods

The following plaque parameters were assessed: echogenicity, homogeneity, surface, maximum content, and total volume. Serial 2‐dimensional (2D) image sequences were obtained. Linear motion of the probe was automatically synchronized with the electrocardiogram. The edges of the plaque in each image were manually identified by the investigators. The total plaque volume was calculated after computer transformation of 2D images into a 3‐dimensinoal (3D) format. Inter‐rater reliability for echogenicity, homogeneity, and the surface was assessed by the weighted κ coefficient. Parametric values were tested by a paired t test.

Results

We enrolled 30 patients (22 male; mean age ± SD, 72 ± 13 years) in the study and evaluated 28 atherosclerotic plaques. Inter‐rater agreement values were as follows: homogeneity, 96% (κ = 0.84; P < .001); surface, 90% (κ = 0.77; P < .001); and echogenicity, 86% (κ = 0.60; P < .001). The significance values for plaque content and volume measurement agreement were P = .311 and .312, respectively, and the correlation coefficient was 0.808.

Conclusions

In our study, the agreement between 2 examiners in the evaluation of 2D and 3D sonographic parameters related to plaque stability was good to excellent. The sonographic measurement of plaque volume growth was the most accurate parameter; therefore, 3D sonography may be used for risk assessment of plaques in the future.