Synoptic Considerations Research Articles

A Drug Safety Concept (I) to Avoid Polypharmacy Risks in Transplantation by Individual Pharmacotherapy Management in Therapeutic Drug Monitoring of Immunosuppressants.

For several, also vital medications, such as immunosuppressants in solid organ and hematopoietic stem cell transplantation, therapeutic drug monitoring (TDM) remains the only strategy for fine-tuning the dosage to the individual patient. Especially in severe clinical complications, the intraindividual condition of the patient changes abruptly, and in addition, drug-drug interactions (DDIs) can significantly impact exposure, due to concomitant medication alterations. Therefore, a single TDM value can hardly be the sole basis for optimal timely dose adjustment. Moreover, every intraindividually varying situation that affects the drug exposure needs synoptic consideration for the earliest adjustment. To place the TDM value in the context of the patient's most detailed current condition and concomitant medications, the Individual Pharmacotherapy Management (IPM) was implemented in the posttransplant TDM of calcineurin inhibitors assessed by the in-house laboratory. The first strategic pillar are the defined patient scores from the electronic patient record. In this synopsis, the Summaries of Product Characteristics (SmPCs) of each drug from the updated medication list are reconciled for contraindication, dosing, adverse drug reactions (ADRs), and DDIs, accounting for defined medication scores as a second pillar. In parallel, IPM documents the resulting review of each TDM value chronologically in a separate electronic Excel file throughout each patient's transplant course. This longitudinal overview provides a further source of information at a glance. Thus, the applied two-arm concept of TDM and IPM ensures an individually tailored immunosuppression in the severely susceptible early phase of transplantation through digital interdisciplinary networking, with instructive and educative recommendations to the attending physicians in real-time. This concept of contextualizing a TDM value to the precise patient's condition and comedication was established at Halle University Hospital to ensure patient, graft, and drug safety.

American Writers and the Approach of World War II, 1935–1941: A Literary HistoryShell Shock, Memory, and the Novel in the Wake of World War I

American Writers and the Approach of World War II, 1935–1941: A Literary HistoryShell Shock, Memory, and the Novel in the Wake of World War I

Identification and Climatology of Southern Hemisphere Mobile Fronts in a Modern Reanalysis

AbstractPresented here is an objective approach to identify, characterize, and track Southern Hemisphere mobile fronts in hemispheric analyses of relatively modest resolution, such as reanalyses. Among the principles in its design were that it should be based on broadscale synoptic considerations and be as simple and easily understood as possible. The resulting Eulerian scheme has been applied to the European Centre for Medium-Range Weather Forecasts (ECMWF) Re-Analysis (ERA)–Interim and a climatology of frontal characteristics, at both the 10-m and 850-hPa levels, derived for the period 1 January 1989–28 February 2009. The knowledge of the character of these features is central to understanding weather and climate over the hemisphere.In both summer and winter the latitude belt 40°–60°S hosts the highest frequency of frontal points, but there are significant zonal asymmetries within this band. The climatology reveals that the longest fronts are in the Indian Ocean where mean lengths exceed 2000 km. The mean frontal intensity over the hemisphere tends to be greater at 850 hPa than at 10 m, and greater in winter than in summer. The frontal intensity also shows its maximum in the Indian Ocean. In the mean, the meridional tilt of these fronts is northwest–southeast over much of the midlatitudes and subtropics, and increases with latitude toward the equator. The tilts are of overwhelmingly opposite sign in the coastal Antarctic and subantarctic regions.Broadly speaking, the number of fronts and their mean length and mean intensity exhibit maxima in winter in the midlatitudes (30°–50°S), but show a sizeable semiannual variation (maxima in fall and spring) during the year at higher latitudes.

Reply to comment by Ben-Zvi, A., D. Rosenfeld and A. Givati on the paper: Levin, Z., N. Halfon and P. Alpert, “Reassessment of rain experiments and operations in Israel including synoptic considerations,” Atmos. Res. 97, 513–525. DOI: 10.1016/j.atmosres.2010.06.011

Levin et al. (2010; hereafter LHA) (Levin, Z., Halfon, N., Alpert, P., 2010. Reassessment of rain experiments and operations in Israel including synoptic considerations. Atmos. Res. 97, 513–525. DOI:10.1016/j.atmosres.2010.06.011.), reanalyzed the results of the operational seeding in northern Israel between 1975 and 2007 and the preceding Israel 2 cloud seeding experiment (1969–1975) and concluded that there is no net increase in precipitation over the target areas. Our analysis revealed that a synoptic bias during Israel 2 is one of the reasons for the apparent positive effect of seeding in the northern target area and the negative effect in the southern area both of which disappeared in the following experiment in the south (Israel 3; 1975–1995) and the operational seeding in the north.Ben-Zvi et al. (2010;hereafter BRG) criticized our paper primarily on the ground that we did not consider the positive results of Israel 1 experiment (1960–1967). It should be noted that in Israel 1 different seeding lines were used from those in both Israel 2 and the operational period. In addition, its raw data is not accessible anymore for reanalysis. Furthermore, Israel 2 had been designed as a confirmatory cross-over experiment to Israel 1 and failed to reproduce its promising results with double ratio (DR) of ~1.00, namely, zero rainfall enhancements. The same DR values were also found in Israel 3 and in the operational seeding. Therefore, because of the differences in the two experiments, the lack of access to the raw data and the disappointing results of the confirmatory experiment, we decided to concentrate our analysis on the more recent seeding activities.The attempt by BRG to explain the reduction of the DR to ~1.00 in the operational seeding period by the suppression due to pollution have been disproved by Alpert et al. (2008, 2009) and also fail to explain the sharp decline of the target/control ratio right at the beginning of the operational seeding period when the lucky draw in this area came to its end (see LHA).

Comment on “Reassessment of rain experiments and operations in Israel including synoptic considerations” by Zev Levin, Noam Halfon and Pinhas Alpert [Atmos. Res. 97 (2010) 513–525

Levin et al. (referred here as LHA) made a sweeping conclusion that cloud seeding has been ineffective in Israel. They claimed that the results of the Israel-2 experiment could be fully ascribed to synoptic bias. However, the cross over analysis of Israel-2 has shown the same already in 1990 by Gabriel and Rosenfeld. While LHA only showed differences in the 850hPa winds being stronger in the north seeded days of Israeli-2, Rosenfeld and Farbstein had already shown quantitatively in 1992 that this synoptic bias explains less than half of the indicated seeding effect in the north. Furthermore, accepting that a cross over design protects against synoptic bias means that the highly positive and statistically significant indicated seeding effect in Israeli-1, which was based on a cross-over design, cannot be explained by such synoptic bias. Instead, LHA completely ignored the Israeli-1 experiment.LHA's evaluation of the operational seeding used implied assumption that amounted to historical comparisons that have already been shown to be invalid, especially for the Israeli situation due to the decreasing trend of target–control ratio, especially over the eastern upper Galilee. For all of the above reasons, the conclusion of LHA that cloud seeding is ineffective in Israel is not supported by the data.Given the uncertainties, both physical and statistical, the Israeli water authority has embarked on the Israeli-4 randomized cloud seeding experiment, which is aimed at testing the hypothesis that cloud seeding might be affecting mainly the precipitation in the orographic clouds developing over the hills in the catchment of the Jordan River.

Reassessment of rain enhancement experiments and operations in Israel including synoptic considerations

A re-analysis of the results from cloud seeding in northern Israel is described. The analysis covers the period of the randomized Israel II experiment (1969–1975) and the subsequent period (1975 to the present) where operational seeding is being conducted. The evaluation is carried out using the double ratio method, as was done in the past. We analyzed the precipitation data in the north of Israel before and during the seeding period, stratified the data based on synoptic conditions and compared the results with an area to the south that had been unseeded during the seeded days in the north. The results show that during Israel II the rain enhancement in the target area in the north of Israel was about 12%, similar to the results reported previously. However, these results have two major problems: 1) During Israel II the rainfall ratio between the inland areas (target) and the coast (control) was unusually higher in comparison with the unseeded periods prior to the initiation of the experiment and also, in comparison with the seeded period following Israel II. 2) Comparison of the double ratio in the north during the Israel II experiment was found to be slightly lower than that in an equivalent unseeded area to the south on the same days (1.15 vs. 1.13). This implies that the high double ratio values in the north may not be a consequence of successful cloud seeding but of preferred synoptic conditions during seeding in which inland rainfall is relatively higher, i.e. deep cyclones over the E. Mediterranean. The analysis also shows that during Israel II the frequency of deep lows that accompanied the rainy days was higher on seeded days than during unseeded ones with stronger westerly winds. This can explain why on seeded days, rain clouds penetrated more efficiently towards inland areas resulting in higher rainfall ratios of target (inland mountainous)/control (coastal strip) on seeded days both inside and outside the seeding project area. Furthermore, the double ratio obtained for the whole study period (1.00) also strengthens the point that the high double ratio value during Israel II experiment is not the result of cloud seeding.

Norbert and Early Norbertine Spirituality (review)

Reviewed by: Norbert and Early Norbertine Spirituality Shelley Wolbrink Norbert and Early Norbertine Spirituality. Selected and introduced by Theodore J. AntryO. PraemCarol Neel. [The Classics of Western Spirituality.] (Mahwah, NJ: Paulist Press. 2007. Pp. xvi, 309. $27.95 paperback. ISBN 978-0-809-14468-6.) This book is long overdue. As Carol Neel and Theodore Antry point out in the introduction to their book Norbert and Early Norbertine Spirituality, studies of Norbert of Xanten and the Premonstratensians are “conspicuously underrepresented in modern scholarship” (p. 1). Ss. Bernard of Clairvaux, Hildegard of Bingen, and Francis of Assisi have long been the subject of historical analysis, and more recent studies have focused on Robert of Arbrissel and the wandering preachers of the twelfth century. By selecting and translating seven texts that illuminate Norbert and the Premonstratensian order, the editors provide an extraordinary service to monastic studies, as well as offer a wonderful entry point into the twelfth century. Published as part of the Paulist Press’s Classics in Western Spirituality series, the translations offer “some of the more important Premonstratensian works of the early decades and provide material for such synoptic consideration of their twelfth-century movement”(p. 3). Each text is preceded by helpful introductory remarks that supply important historical context. By presenting these texts in chronological order and in full translation, the translators demonstrate the emergence of a distinctive Premonstratensian spirituality. As Neel and Antry argue, the Premonstratensians were “astoundingly prolific” in contrast to other “networks of Augustinians” (p. 24). In critiquing monks for claiming superiority over “the true profession of the canons,” Anselm of Havelberg’s Apologetic Letter offers insights into the [End Page 122] active profession of the regular canons. Herman of Tournai’s Miracles of St. Mary of Laon is the only non-Premonstrensian view of Norbert and the early Premonstratensians in the volume; his comparisons of Norbert and Bernard of Clairvaux, as well as his descriptions of the status of women within the order, deserve more attention. Set among the dramatic political climate of northwestern Germany, The Life of Godfrey of Cappenberg reveals the origins of Premonstratensian monasteries in northwestern Germany, as well as illuminates early hagiography within the order. Both of Norbert’s vitae are included: Vita A, as the oldest surviving account of Norbert, is fully reproduced; parts of Vita B, where it differs from A, have also been included. The book concludes with two texts from the Premonstratensian abbot Philip of Harvengt. His “Knowledge of the Clerics” offers a detailed description of canonical life, while his Life of Oda celebrates the life of a young girl who thwarts an arranged marriage by mutilating her face and joining the Premonstratensian order. The editors frame these texts with an outstanding essay devoted to the life of Norbert, the twelfth-century reform movement, and recent scholarship on the order. Their aim “to facilitate intensive study of the early Premonstratensians” (p. 24) will surely be met. Because of its ease and simplicity, this book will find a wide audience. It is highly recommended for library purchase, use in the classroom, and general insights into the creative energy, spirituality, and passion of the earliest Premonstratensians. Shelley Wolbrink Drury University Copyright © 2009 The Catholic University of America Press

The contemporary museum and leisure: recreation as a museum function

Overview Today, the museum in modern society has acquired a significantly broader public role than its early predecessors. Underlying its present-day symbolic and utilitarian roles, therefore, is the goal of benefiting the wider public. This contribution first recapitulates the traditional view of the museum as partner in curating public education, and then moves to a more synoptic consideration of the museum's interaction with the public and advances the view that this broad public context facilitates the experiences of leisure. It proposes that the museum, without abdicating what it currently does, can usefully examine itself within the framework of leisure facilitation with the intention of enlarging its value (i.e. the museum's value) within contemporary society. Using that foundation, the museum can articulate and harness the possibilities of leisure (whose attributes the museum already embodies) as an added function in its mission of serving the contemporary public. This contribution concludes with ...

The Contemporary Museum and Leisure: Recreation As a Museum Function

Overview Today, the museum in modern society has acquired a significantly broader public role than its early predecessors. Underlying its present-day symbolic and utilitarian roles, therefore, is the goal of benefiting the wider public. This contribution first recapitulates the traditional view of the museum as partner in curating public education, and then moves to a more synoptic consideration of the museum's interaction with the public and advances the view that this broad public context facilitates the experiences of leisure. It proposes that the museum, without abdicating what it currently does, can usefully examine itself within the framework of leisure facilitation with the intention of enlarging its value (i.e. the museum's value) within contemporary society. Using that foundation, the museum can articulate and harness the possibilities of leisure (whose attributes the museum already embodies) as an added function in its mission of serving the contemporary public. This contribution concludes with a poetic look at the value of leisure in modern society and suggests that the functions of the museum discussed here can all be integrated.

Reactive lymphoid nodule or malignant lymphoma. A brief guideline for the differential diagnosis of bone marrow infiltrates in non-Hodgkin lymphomas

Differentiation of focal or extended lymphoid bone marrow infiltrates presents a diagnostic challenge and therefore warrants systematic evaluation of those features which affect this. One of the basic requirements is an appropriate technique of processing the bone marrow specimens. This includes the possibility of enzyme evaluation (naphthol-AS-D-chloroacetate esterase) and immunohistochemistry (set of monoclonal antibodies) and comparison with the corresponding lymph node histology. A number of histological parameters have emerged with a distinctive property for distinguishing between reactive focal lymphoid aggregates and malignant lymphomas. Amongst these the pattern of infiltrates, i.e., histotopography (subcortical infiltrates, paratrabcular-endosteal localization, margination, tandem-like extension between adipocytes and cribriform appearance), content of reticulin fibers, cytology (small lymphocytes versus large blast cells) and, finally, immunohistochemistry (monoclonal versus polyclonal expression of cytoplasmic immunoglobulins, uniform versus mixed population of B or T lymphocytes) are most important. In conclusion, synoptic consideration of several parameters, in particular histotopography and immunohistochemistry provides a most promising approach to differentiate neoplastic from reactive lymphoid lesions in the bone marrow.

Biological assays for irritant, tumor-initiating and tumor-promoting activities

A versatile standardized protocol of initiation/promotion of skin is described using 7,12-dimethylbenz[a]anthracene as initiator and diterpene esters as promoters in 28 female NMRI mice per promoter (or initiator) dose group including appropriate positive and negative controls ("standardized initiation/promotion protocol 28" or "protocol 28"). To monitor the weekly tumor responses, the tumor rate Tr and the tumor yield Ty were recorded per dose group collectively as a measure of the tumor-promoting (or initiating) activity of individual compounds; similarly the general health status of the group was controlled twice weekly by collective weighing of the dose group and recorded daily by the survival rate Sr. Synoptic consideration of Tr, Ty and the promoter dose (or initiator dose) at a set time period of exposure was used for the semiquantitative estimation of the relative tumor-promoting (or initiating) potency, referring to a high-potency promoter (or initiator) as standard. The full scope of utilization of "protocol 28" to determine comparable individual promoting activities and -at 24 weeks of exposure--relative tumor-promoting potencies (rtpp24) is demonstrated in typical examples with 12-O-tetradecanoylphorbol 13-acetate (TPA) as well as various other phorbol esters as promoters. For estimation of promoting potencies TPA is rated a rtpp24 of + + + +. The other phorbol derivatives exhibit rtpp24 between 0 and + + + +. In this manner, "protocol 28" was verified in 1000 promoter dose groups (i.e. 28,000 mice) to determine tumor-promoting activities of individual diterpene esters and partly also their rtpp24. Grading of tumor-promoting potencies of diterpene esters in skin by rtpp24 proved useful for evaluating the relative environmental risk involved in exposure to various diterpene esters as well as in comparative mechanistic investigations including structure/activity relationships. As an example, the correlation of irritancy and tumor-promoting potency of certain diterpene esters in epithelial tissue, postulated previously from essentially qualitative data, is verified in semiquantitative terms by comparison--as a typical example--of the irritancy of phorbol esters on the ear and of the corresponding rtpp24 on the back skin of NMRI mice.

Synoptic consideration of snowfall in Athens

AbstractIn this paper an attempt is made to study the synoptic evolution of the barometric systems which cause snowfall in Athens. Some simple statistical characteristics of the snowfall in Athens were found and related to the synoptic evolution.The study is based on the synoptic observations at the Hellinikon Meteorological Station for the period 1956–1973 and upon the mean charts and their anomalies, of 500 mb height, 500–1000 mb thickness and mean sea level (M.S.L.) pressure.Specifically, we examine the annual and monthly variations of snow days in Athens and their relation to the synoptic evolution of two synoptic types, A and B.In type A, the centre of action seems to be a quasi‐stationary wedge of a meridional block which, on the 500 mb charts, is located over the British Isles and NW Europe. This wedge is accompanied by a maximum of positive height anomalies and it steers, on its eastern flank, smaller perturbations which reach Greece accompanied by polar or arctic air.In type B, the centre of action is located over the north of Scandinavia with the form of an Omega block on the 500 mb charts. On the eastern flank of this system, a maximum of vorticity is created moving south‐south‐westwards, arriving over Greece from the northeast.

Integrated Dust Analysis by Physical Methods

AbstractEnvironmental analyses show that the air which we breathe, and which is so essential to life, is in general a mixture of gaseous, liquid, and solid components. The solid airborne particles, whose concentration, homogeneity, chemical composition, size, and shape can vary over wide ranges, and whose origin may be “natural” or “artificial” are referred to as “dust”. Dust particles can act, inter alia, as condensation nuclei, catalysts, and directly as hazardous materials. Unfortunately, we still know far too little about dust. Dust analysis is extremely difficult and challenging, even for modern analytical chemistry; it is still far from being fully automated. The simultaneous determination of as many “dust parameters” as possible, and particularly the synoptic consideration of all available data against a background of physicochemical and technological knowledge on the development, transformation, and effects of dust, are summarized as “integrated dust analysis”.

Die Stand Van Navorsing Op Die Gebied Van Massakommunikasie

Abstract It must be emphasized that the study of mass-communication is one of those areas of study where scientists from the different social sciences meet. It has not yet developed into a separate discipline. We would like to place Sociology as one of the basic disciplines bemuse of the concepts, theoretical principles and research methods which are applied in this field. A survey of empirical research which has been undertaken in the past three decades, especially in the U.S.A., will support these statements. This area of study has so far enjoyed the interest of sociologists, anthropologists, psychologists, economists, mathematicians and Linguists. In the synoptic consideration of research on this very broad sphere we will attempt to join in with the sociological-theoretical approach. We will inevitably have to do this by means of a number of abstractions. The following will thus de discussed consecutively: the communicator, the content, and the extent and effect of mass-communication. Research and study in the field of mass-communication can be seen as pre-eminently an area where various disciplines meet. Only then can the relevant scientific knowledge and empirical findings be usefully applied.

Quantitative precipitation forecasting over small catchment areas by the method synoptic typing

Study of heavy rainfall which occurred during the period 1961.67 in Ganga Barage catchment area has been made with a view to predict rainfall from synoptic considerations. The various synoptic situations that cause spells of heavy rainfall are broadly defined under four 'types' and the association of each type with quantitative distribution of rainfall over the concerned area has been examined from synoptic view-point. The study has revealed the possibility of rainfall prediction quantitatively in the area on the successive two to three days, once the synoptic situation is identified.

本州上空における,16ミリ映画撮影機による航空写真を使った雲の分布の予備的観測

An observation program was made to record cloud distribution over the Pacific Ocean, utilizing a 16mm time-lapse movie camera from an airplane along a routine flight course. As a test run for this observation flight, cloud distributions between Tokyo and Sado Island were observed. The result of the observation agrees very well with that predicted by synoptic considerations. It is therefore expected that the method planned will be useful in the observation of the cloud distribution over the Pacific Ocean where detailedweather maps are not available.

A Technique for Estimating Low-Level Wind Velocity from Satellite Photographs of Cellular Convection

Abstract A technique for estimating the low-level wind field from satellite photographs of cumuliform cellular cloud patterns is presented. This technique applies to areas of such patterns, which are frequently photographed behind major oceanic cyclones. The wind speed estimates are obtained by correlating the different cumuliform cellular patterns with three wind speed categories, 0–7, 8–22, and 23–37 knots. This categorization was suggested by results of laboratory experiments, performed by Chandra, in which convection occurred in a layer of air containing vertical shear. The wind direction can be estimated with at worst a ±180° ambiguity; larger scale synoptic considerations can frequently be used to eliminate this ambiguity. Illustrative examples comparing TIROS photographs of cumuliform cellular patterns and surface wind reports are presented.

Hailstorms of the Upper Great Plains of the United States

Abstract The paper presents results of a series of studies of Upper Midwest hailstroms made between 1957 and 1962. It discusses hailstorm frequency, incidence, origins and formation in the Upper Great Plains of the United States, but omits synoptic considerations since they were discussed in an earlier paper.

Synoptic and dynamic aspects of climatic change

AbstractThe changing pattern of world climate during the last hundred years is compared with the inferred pattern of the Pleistocene. Relatively cool climates at high latitudes appear to have been associated much of the time with reduced tropical sea‐surface temperatures, a lower snow‐line on tropical mountains, reduced aridity on the desert fringes and increased storm activity along continental east coasts in middle latitudes. Relatively warm climates at high latitudes tend to be associated with the opposite complex of conditions.Considerations of the water balance suggest that a small temperature decrease would be necessary and sufficient for the re‐establishment of glacial conditions in many regions. Increased snowfall would help but is not essential. Synoptic considerations indicate that glaciation was associated necessarily with strong upper westerlies at relatively low latitudes over the continents and probably with vigorous anticyclones over the subtropical oceans.An increased infra‐red cooling rate in the upper air, particularly over the tropics, could produce all the necessary conditions for the establishment of a glacial/pluvial phase. Possible causes for changes in the infra‐red cooling rate are discussed.