bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characterizing Climate-Change Impacts on the 1.5-yr Flood Flow in Selected Basins across the United States: A Probabilistic Approach
Authors: Walker John F. , Hay Lauren E. , Markstrom Steven L. , Dettinger Michael D. 
Published: December 2010

Abstract
The U.S. Geological Survey Precipitation-Runoff Modeling System (PRMS) model was applied to basins in 14 different hydroclimatic regions to determine the sensitivity and variability of the freshwater resources of the United States in the face of current climate-change projections. Rather than attempting to choose a most likely scenario from the results of the Intergovernmental Panel on Climate Change, an ensemble of climate simulations from five models under three emissions scenarios each was used to drive the basin models.
Climate-change scenarios were generated for PRMS by modifying historical precipitation and temperature inputs; mean monthly climate change was derived by calculating changes in mean climates from current to various future decades in the ensemble of climate projections. Empirical orthogonal functions (EOFs) were fitted to the PRMS model output driven by the ensemble of climate projections and provided a basis for randomly (but representatively) generating realizations of hydrologic response to future climates. For each realization, the 1.5-yr flood was calculated to represent a flow important for sediment transport and channel geomorphology. The empirical probability density function (pdf) of the 1.5-yr flood was estimated using the results across the realizations for each basin. Of the 14 basins studied, 9 showed clear temporal shifts in the pdfs of the 1.5-yr flood projected into the twenty-first century. In the western United States, where the annual peak discharges are heavily influenced by snowmelt, three basins show at least a 10% increase in the 1.5-yr flood in the twenty-first century; the remaining two basins demonstrate increases in the 1.5-yr flood, but the temporal shifts in the pdfs and the percent changes are not as distinct. Four basins in the eastern Rockies/central United States show at least a 10% decrease in the 1.5-yr flood; the remaining two basins demonstrate decreases in the 1.5-yr flood, but the temporal shifts in the pdfs and the percent changes are not as distinct. Two basins in the eastern United States show at least a 10% decrease in the 1.5-yr flood; the remaining basin shows little or no change in the 1.5-yr flood.
The Partitioning of Poleward Heat Transport between the Atmosphere and Ocean
Authors: Czaja Arnaud , Marshall John 
Published: December 2010

Abstract
Observations of the poleward heat transport of the earth (H) suggest that the atmosphere is the primary transporting agent poleward of 30°, that oceanic (HO) and atmospheric (HA) contributions are comparable in the tropical belt, and that ocean transport dominates in the deep Tropics.
To study the partition we express the ratio HA/HO aswhere Ψ (with subscripts A and O denoting atmosphere and ocean, respectively) is the meridional mass transport within θ layers (moist potential temperature for the atmosphere, potential temperature for the ocean), and CΔθ (C being the specific heat) is the change in energy across the circulation defined by Ψ.
It is argued here that the observed partitioning of heat transport between the atmosphere and ocean is a robust feature of the earth's climate and reflects two limits: (i) dominance of atmospheric mass transport in mid-to-high latitudes (ΨA ≫ ΨO with CAΔθA ∼ COΔθO and hence HA/HO ≫ 1) and (ii) dominance of oceanic energy contrast in the Tropics (COΔθO ≫ CAΔθA with ΨA ∼ ΨO and hence HA/HO ≪ 1).
Motivated by simple dynamical arguments, these ideas are illustrated through diagnosis of atmospheric reanalyses, long simulations of an ocean model, and a coupled atmosphere–ocean model of intermediate complexity.
Synthesis and Photoisomerization of Highly Fluorescent Stilbene Ionic Liquids
Authors: Tamura Hiroyasu , Shinohara Yoshihiro , Arai Tatsuo 
Published: December 2010

Abstract
Photoresponsive stilbenes with imidazolium cation directly attached to the para-position of the phenyl ring were prepared and their properties were examined. Although the cis isomer was liquid at room temperature and practically gave no fluorescence, the trans isomer was solid and gave fluorescence emission with quantum yield as high as ca. 0.2. Furthermore photoisomerization from pure cis isomer in the liquid state to trans isomer in the solid state was observed.
Ultrasensitive and Highly Selective Detection of Testosterone Using a Surface Plasmon Resonance Sensor Combined with Molecularly Imprinted Films
Authors: Wei Qingquan , Wei Tianxin , Wu Xiaoguang 
Published: December 2010

Abstract
An ultrasensitive and highly selective testosterone detection method by surface plasmon resonance (SPR) combined with molecularly imprinted films (MIFs) was developed. The coupling angle shifts were highly selective to testosterone and showed a linear relationship to the logarithmic concentrations (from 10−15 to 10−10 mol L−1) of the testosterone in the acetonitrile. The selectivity of the thin testosterone-imprinted films was examined by 10−4 mol L−1 progesterone acetonitrile solution, no observable binding was detected.
Stable Transport of Gas-born Ag Nanoparticles into Liquid Phase Mediated by Poly(vinylpyrrolidone) Molecules
Authors: Hashimoto Naomi , Nishida Naoki , Murayama Haruno , Tanaka Hideki 
Published: December 2010

Abstract
We demonstrate that gas-born nanoparticles can be transported into solution successfully. Our results show that Ag nanoparticles produced in gas phase are introduced into poly(vinylpyrrolidone) solution without structural changes such as nanoparticle aggregation. It is also shown that Ag nanoparticles in solution show surface plasmon resonance, suggesting that the optical properties of nanoparticles are not impaired by the transport from gas to liquid.
Pre-operative patient education reduces length of stay after knee joint arthroplasty
Authors: Jones Samantha , Alnaib Mustafa , Kokkinakis Michail , Wilkinson Michael , St Clair Gibson Alan , Kader Deiary 
Published: December 2010

INTRODUCTION The aim of this study was to evaluate the impact of a pre-operative education programme on length of hospital stay after surgery for primary and revision knee arthroplasty patients. The programme was introduced at our hospital in October 2006 to encourage patients to play an active role in their recovery process after surgery. PATIENTS AND METHODS A multidisciplinary team educated knee arthroplasty patients about their care pathway, knee surgery, pain management, expected discharge goals, in-patient and out-patient arthroplasty rehabilitation. Prospective data were collected from 472 consecutive patients who underwent (primary or revision) knee arthroplasty in the period between January 2006 and November 2007. Patients were separated into two groups, one that received conventional pre-operative treatment (n = 150; Conventional group) and another that received the pre-operative education (n = 322; Education group). Length of hospital stay was compare using the Mann Whitney U test. In-patient complications, hospital re-admissions within 24 h and 3 months of hospital discharge were compared using the chi-squared test. RESULTS The mean length of stay was significantly reduced from 7 days in the Conventional group to 5 days in the Education group (P < 0.01). In addition, 20% more patients were discharged early (within 1–4 days) in the Education group compared to the Conventional group (P < 0.01). There was no difference in the percentage of in-patient complications and re-admissions in 24 h (P = 1.00) and 3 months of discharge (P = 0.92) between the two groups. CONCLUSIONS The results suggest that pre-operative education is a safe and effective method of reducing length of stay for knee arthroplasty patients.
Evolution in the management of Hirschsprung’s disease in the UK and Ireland: a national survey of practice revisited
Authors: Bradnock TJ , Walker GM 
Published: December 2010

INTRODUCTION The management of Hirschsprung’s disease continues to evolve. This questionnaire survey aimed to determine current surgical management strategies for Hirschsprung’s disease in Britain. SUBJECTS AND METHODS The survey was sent electronically to all British paediatric surgeons. Initial questions explored individual experience and regional service provision. Additional questions, reserved for surgeons who perform definitive Hirschsprung’s disease surgery, addressed specific clinical scenarios. RESULTS Surveys were sent to 142 surgeons yielding 85 responses. After exclusions, 64 surveys from 21 centres were analysed. Forty-seven respondents worked in centres with designated ‘Hirschsprung’s disease surgeons’. Forty respondents perform definitive Hirschsprung’s disease surgery. In a well neonate with left-sided Hirschsprung’s disease, 34 of 40 surgeons favour primary pull-through following bowel decompression with rectal washouts; 35 of 40 surgeons aim to perform definitive surgery at less than 3 months of age, with 17 favouring laparoscopic-assisted Soave–Boley and 15 favouring an open Duhamel pull-through. Of the 40 surgeons, 36 use a staged approach to right-sided/total colonic Hirschsprung’s disease with 23 favouring a Duhamel or Long Duhamel pull-through. CONCLUSIONS The primary pull-through, using an open Duhamel or laparoscopic-assisted Soave–Boley technique, during the first 3 months of life, has become the operative strategy of choice in rectosigmoid Hirschsprung’s disease in Britain. Marked variation in practice remains for right-sided Hirschsprung’s disease.
Recurrent laryngeal nerve and voice preservation: routine identification and appropriate assessment – two important steps in thyroid surgery
Authors: Mohil Ravindra Singh , Desai Pragnesh , Narayan Nitisha , Sahoo Maheswar , Bhatnagar Dinesh , Venkatachalam VP 
Published: December 2010

INTRODUCTION The aims of this study were to assess and compare vocal cord functions before and after thyroid surgery after intra-operative identification of recurrent laryngeal nerve. PATIENTS AND METHODS Recurrent laryngeal nerve (RLN) is seen intra-operatively in all cases undergoing thyroid surgeries. Vocal cord functions including any voice change were evaluated by indirect laryngoscopy (I/L) and direct laryngoscopy (D/L) before and after surgery. RESULTS Prospective study on 100 patients over 18 months with a total of 146 nerves at risk (NAR). Majority were women (n = 86) with mean age of 37.48 years (range, 13–60 years). RLN was seen in all patients and 19 patients complained of some change in quality of their voice after surgery. Evaluation by I/L and D/L at 6 weeks showed recurrent laryngeal nerve palsy (RLNP) in nine (47.36%) and five (26%) of these 19 patients respectively. Analysed according to total NAR, the incidence of voice change and temporary RLN palsy (I/L and D/L) at 6 weeks was still less at 13.01%, 6.16% and 3.42%, respectively. Voice change improved in all cases at 3 months with no RLNP palsy by I/L or D/L. All these 19 patients had undergone difficult or extensive surgery for malignancy, large gland, extratyhroidal spread or fibrosis. CONCLUSIONS Despite identification and preservation of RLN, patients can develop postoperative voice change and RLNP although all voice change cannot be attributed to damaged RLN. Proper assessment of vocal cord functions by I/L and D/L laryngoscopy is required to rule out injuries to these nerves. Risk of damage is higher in patients undergoing more difficult surgery.
Safety and application of laparoscopic gastrectomy for benign gastric disease and gastric cancer
Authors: Zia MK , Morris-Stiff G , Luhmann A , Jeffries R , Ehsan O , Hassn A 
Published: December 2010

INTRODUCTION Laparoscopic gastrectomy is rapidly expanding despite reservations by some surgeons regarding its safety and radicality. The aim of this study was to evaluate patients undergoing laparoscopic gastrectomy for both benign and malignant disease with particular emphasis on technical feasibility, safety, effectiveness and complications. PATIENTS AND METHODS Review of prospectively collected data of patients who underwent laparoscopic gastrectomy from May 2005 to September 2009 under the care of one consultant surgeon. RESULTS A total of 61 laparoscopic gastrectomies were performed (35 men and 26 women) with a median age of 68 years (range, 41–90 years). There were 39 distal gastrectomies (19 adenocarcinoma, 6 gastrointestinal stromal tumour [GIST], 4 benign gastric outlet obstruction, 4 high-grade dysplasia in gastric adenomas, 4 non-healing ulcers, 2 gastric antral vascular ectasia [GAVE]); 15 sub-total gastrectomies (13 adenocarcinomas, 2 GIST); and 7 total gastrectomies (5 adenocarcinomas, 1 GIST, 1 carcinoid). Median follow-up was for 48 months (range, 1–72 months). There was one death, two major and six minor complications. All patients with complications made a satisfactory recovery. CONCLUSIONS Laparoscopic gastrectomy is associated with a low mortality (1.75%) and major morbidity (3.50%). Although technically demanding, especially when a D2 lymphadenectomy is performed, our results have shown that tailored laparoscopic resection based on tumour characteristics with either D1 or D2 lymphadenectomy results in good surgical and oncological outcomes.
Factors affecting wound ooze in total knee replacement
Authors: Butt U , Ahmad R , Aspros D , Bannister GC 
Published: December 2010

INTRODUCTION Wound ooze is common following total knee arthroplasty (TKA) and persistent wound infection is a risk factor for infection, and increased length and cost of hospitalisation. PATIENTS AND METHODS We undertook a prospective study to assess the effect of tourniquet time, peri-articular local anaesthesia and surgical approach on wound oozing after TKA. RESULTS The medial parapatellar approach was used in 59 patients (77%) and subvastus in 18 patients (23%). Peri-articular local anaesthesia (0.25% Bupivacaine with 1:1,000,000 adrenalin) was used in 34 patients (44%). The mean tourniquet time was 83 min (range, 38–125 min). We found a significant association between cessation of oozing and peri-articular local anaesthesia (P = 0.003), length of the tourniquet time (P = 0.03) and the subvastus approach (P = 0.01). CONCLUSIONS Peri-articular local anaesthesia, the subvastus approach and shorter tourniquet time were all associated with less wound oozing after total knee arthroplasty.
Hip fractures: public perceptions
Authors: McBride TJ , Panrucker S , Clothier JC 
Published: December 2010

INTRODUCTION Hip fractures are common injuries in elderly patients presenting to the trauma surgeon. Mortality following such injuries approaches 10% at one month, rising to 30% at one year. Of those who survive, most experience a decrease in mobility and independence. The authors believe that the general public are not aware of these facts and in particular do not perceive hip fractures to be injuries of serious consequence. SUBJECTS AND METHODS This study aims to assess the perception of hip fractures amongst the general public. Subjects were recruited from a population attending a general orthopaedic clinic in a district general hospital during March 2008. All participants were asked to fill out a questionnaire relating to their perception of hip fracture epidemiology, aetiology, presentation, treatment and both physical and social outcomes. RESULTS A total of 142 people completed a questionnaire. Of those, 27 (19%) had been filled out by either hip fracture patients or their relatives. A significant majority of subjects underestimated both the hospital length of stay and mortality figures; however, most people did know that some form of surgery would be required. CONCLUSIONS This study underlines the need for detailed counselling of the patient and relatives following a hip fracture in order to create realistic expectations and to allow those involved to prepare for potential outcomes. Written patient information may also be useful to allow patients and relatives the opportunity to digest relevant information and to pose questions relating to what they have read.
The correlation between ultrasonography and histology in the search for gallstones
Authors: Ahmed M , Diggory R 
Published: December 2010

INTRODUCTION The majority of published data on the sensitivity and specificity of ultrasound in the diagnosis of gallbladder pathology was conducted over 30 years ago and, since the 1990s, ultrasound imaging has been the accepted gold standard. The quality and resolution of ultrasonography has improved significantly since then and we have, therefore, set out to assess whether the progression in technology has translated into improved diagnostic accuracy. PATIENTS AND METHODS In the period December 2005 to December 2008, a total of 2100 patients underwent laparoscopic cholecystectomy for symptoms related to gallbladder disease. All patients underwent ultrasound examination prior to their surgery and histopathological analysis of their gallbladder postoperatively. We undertook a retrospective analysis of these patients comparing their pre-operative ultrasound scan and their histopathology report for the presence or absence of gallstones. Ultrasound scans were performed by a combination of radiologists and ultrasonographers. RESULTS The study identified a sensitivity of 0.85 and a specificity of 1 for ultrasound in the identification of gallstones. We found a sensitivity of 0.84 and 0.83 for the radiologists and ultrasonographers, respectively. CONCLUSIONS This study suggests that, despite an evolution in the resolution of ultrasound imaging, there has not been a corresponding improvement in sensitivity. There is a false positive rate of 16% which remains unchanged since the early 1990s.
Minimising the risk of extensor pollicis longus rupture following volar plate fixation of distal radius fractures: a cadaveric study
Authors: Perry DC , Machin DMG , Casaletto JA , Brown DJ 
Published: December 2010

INTRODUCTION Rupture of extensor pollicis longus (EPL) tendon is a recognised complication following volar plate fixation of distal radius fractures, usually from attrition caused by prominent screws. We sought to identify the screw holes in some of the most commonly used plates which may precipitate tendon injury. SUBJECTS AND METHODS Three fixed-angle volar locking plates were sequentially positioned into 18 cadaveric arms. A wire was passed through each of the holes in the plates using a locking guide and the dorsal relationships noted. RESULTS Each plate had specific ‘high-risk’ holes which directed the wire towards the EPL groove. The central screw holes appeared mostly implicated in EPL injury. CONCLUSIONS Awareness of ‘high-risk’ holes and appropriate minor alterations in surgical technique may consequently decrease the incidence of EPL irritation and rupture.
Prospective audit of cross-sectional imaging and radiation exposure in general surgical patients
Authors: Cadwallader RA , Walsh SR , Burrows B , Chappell CL , Cousins C 
Published: December 2010

INTRODUCTION Most patients admitted with an acute surgical problem undergo some imaging during their in-patient stay. As computed tomography (CT) scanning becomes more readily available, it is becoming the mainstay of assessment. Recent studies have commented on the potential adverse effects of early cross-sectional imaging. This audit aimed to determine the use of early cross-sectional imaging and associated radiation dose in an acute surgical cohort. PATIENTS AND METHODS Data from 500 acute surgical patients were prospectively collected over a 3-month period. CT scans were undertaken, the effect on subsequent diagnostic and management decisions and the potential associated risks were evaluated. RESULTS Almost 40% of subjects underwent CT scanning. Of these, 20% did not alter management and could be deemed unnecessary. The radiation exposure equated to an age- and gender-specific risk of fatal cancer induction between 1 in 1675 and 1 in 7130. CONCLUSIONS Early-cross sectional imaging provides a valuable diagnostic adjunct. Decisions to expose patients to potentially hazardous radiation need to acknowledge the anticipated benefits versus risks.
Variation in Diagnosis of Apnea in Moderately Preterm Infants Predicts Length of Stay
Authors: Eichenwald Eric C. , Zupancic John A. F. , Mao Wen-Yang , Richardson Douglas K. , McCormick Marie C. , Escobar Gabriel J. 
Published: December 2010

OBJECTIVE:Apnea of prematurity is one of the most common diagnoses in the NICU. Because resolution of apnea is a usual precondition for discharge from the hospital, different monitoring practices might affect length of stay for premature infants. Our objective was to compare the proportion of 33 to 34 weeks' gestational age infants diagnosed with apnea in different NICUs and to assess whether variability in length of stay would be affected by the rate of documented apnea.METHODS:This was a prospective cohort study of moderately preterm infants who survived to discharge in 10 NICUs in Massachusetts and California.RESULTS:The study population comprised 536 infants born between 33 and 3467 weeks of which 264 (49%) were diagnosed with apnea. The mean postmenstrual age at discharge was higher in infants diagnosed with apnea compared with those without apnea (36.4 ± 1.3 vs 35.7 ± 0.8; P &lt; .001, analysis of variance). Significant inter-NICU variation existed in the proportion of infants diagnosed with apnea (range: 24%–76%; P &lt; .001). Postmenstrual age at discharge also varied between NICUs (range: 35.5 ± 0.6 to 36.7 ± 1.5 weeks; P &lt; .001). As much as 28% of the variability in postmenstrual age at discharge between NICUs could be explained by the variability in the proportion of infants diagnosed with apnea.CONCLUSIONS:NICUs vary in the proportion of moderately preterm infants diagnosed with apnea, which significantly affects length of stay. Standardization of monitoring practices and definition of clinically significant cardiorespiratory events could have a significant impact on reducing the length of stay in moderately preterm infants.
Clinical Prediction Rule for RSV Bronchiolitis in Healthy Newborns: Prognostic Birth Cohort Study
Authors: Houben Michiel L. , Bont Louis , Wilbrink Berry , Belderbos Mirjam E. , Kimpen Jan L. L. , Visser Gerard H. A. , Rovers Maroeska M. 
Published: December 2010

OBJECTIVE:Our goal was to determine predictors of respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) among healthy newborns.METHODS:In this prospective birth cohort study, 298 healthy term newborns born in 2 large hospitals in the Netherlands were monitored throughout the first year of life. Parents kept daily logs and collected nose/throat swabs during respiratory tract infections. The primary outcome was RSV LRTI, which was defined on the basis of the combination of positive RSV polymerase chain reaction results and acute wheeze or moderate/severe cough.RESULTS:Of the 298 children, 42 (14%) developed RSV LRTI. Independent predictors for RSV LRTI were day care attendance and/or siblings, high parental education level, birth weight of &gt;4 kg, and birth in April to September. The area under the receiver operating characteristic curve was 0.72 (95% confidence interval: 0.64–0.80). We derived a clinical prediction rule; possible scores ranged from 0 to 5 points. The absolute risk of RSV LRTI was 3% for children with scores of ≤2 (20% of all children) and 32% for children with all 4 factors (scores of 5; 8% of all children). Furthermore, 62% of the children with RSV LRTI experienced wheezing during the first year of life, compared with 36% of the children without RSV LRTI.CONCLUSIONS:A simple clinical prediction rule identifies healthy newborns at risk of RSV LRTI. Physicians can differentiate between children with high and low risks of RSV LRTI and subsequently can target preventive and monitoring strategies toward children at high risk.