bluuebunny/crossref_metadata_2025 huggingface dataset:
A inclusão escolar vista sob a ótica de professores da escola básica
Authors: Zucchetti Dinora Tereza
Published: February 2012

Este artigo apresenta os resultados de uma pesquisa interinstitucional que se ocupou dos discursos de professores da escola básica, do Vale do Sinos, Região Metropolitana de Porto Alegre/RS. Os informantes são acadêmicos de uma universidade da região que, por meio de entrevistas e/ou respondendo a um questionário, manifestaram suas representações sobre a inclusão social, em especial, a de sujeitos marcados por diferenças. O texto, mais do que produzir interpretações conclusivas, pretende descrever os discursos docentes relativamente às diferenças e à inclusão, tratando-os como fenômenos sociais visíveis na escola. A análise compartilha a ideia de que há desconforto, por parte dos docentes, no que se refere à diferença e à diversidade e, talvez por isso, a prática de professores seja um espaço de múltiplas resistências e reivindicações. Algumas aproximações com o currículo do curso de Pedagogia da universidade servem meramente para fins de exemplificação.
Greenhouse gas fluxes in southeastern U.S. coastal plain wetlands under contrasting land uses
Authors: Morse Jennifer L. , Ardón Marcelo , Bernhardt Emily S.
Published: February 2012

Whether through sea level rise or wetland restoration, agricultural soils in coastal areas will be inundated at increasing rates, renewing connections to sensitive surface waters and raising critical questions about environmental trade‐offs. Wetland restoration is often implemented in agricultural catchments to improve water quality through nutrient removal. Yet flooding of soils can also increase production of the greenhouse gases nitrous oxide and methane, representing a potential environmental trade‐off. Our study aimed to quantify and compare greenhouse gas emissions from unmanaged and restored forested wetlands, as well as actively managed agricultural fields within the North Carolina coastal plain, USA. In sampling conducted once every two months over a two‐year comparative study, we found that soil carbon dioxide flux (range: 8000–64 800 kg CO2·ha−1·yr−1) comprised 66–100% of total greenhouse gas emissions from all sites and that methane emissions (range: −6.87 to 197 kg CH4·ha−1·yr−1) were highest from permanently inundated sites, while nitrous oxide fluxes (range: −1.07 to 139 kg N2O·ha−1·yr−1) were highest in sites with lower water tables. Contrary to predictions, greenhouse gas fluxes (as CO2 equivalents) from the restored wetland were lower than from either agricultural fields or unmanaged forested wetlands. In these acidic coastal freshwater ecosystems, the conversion of agricultural fields to flooded young forested wetlands did not result in increases in greenhouse gas emissions.
When a Patient Presents With a Present: Quantitative and Qualitative Assessment of Gifts Given to Psychiatrists
Authors: Patel Richard M. , Miller Raquel
Published: February 2012

Objective: This article reviews the issue of patients giving gifts to psychiatrists and mental health providers. Method: Anonymous survey of 100 academic psychiatrists measured prevalence of receiving gifts, type and estimated dollar value of gifts given, and psychiatrists’ reactions to gifts. Case vignettes illustrate clinical situations associated with gift giving and how failure to recognize motivation of gift giving may lead to situations requiring immediate intervention. Results: 71% of psychiatrists surveyed received (were offered & accepted) at least one gift in prior year (average 0.36 per month and 3.6 per year; $11.40 average [estimated] amount per gift). Group comparisons achieving at least ap< 0.05 significance: outpatient psychiatrists received gifts twice as often as inpatient, female and outpatient groups’ gifts were estimated as more expensive, a positive correlation was found between psychiatrists receiving gifts and psychiatrists giving a positive response to gifts, there was significantly more negative responses to high cost gifts (>$100) than to low cost (<$20), and outpatient psychiatrists reported interpreting gift’s meaning more often than inpatient. Conclusions: Psychiatrists are commonly offered and accept gifts from patients. Gifts communicate patient information and response to treatment. Although the act of gift giving sends important data to the receiving psychiatrist, including boundary violation issues, there are no agreed upon guidelines regarding how to respond. Future study should explore the meanings and appropriateness of a gift regarding type, cost, timing, frequency, intent, as well as how providers can respond to the gesture.
Historical Development and Performance of Airborne Magnetic and Electromagnetic Systems for Mapping and Detection of Unexploded Ordnance
Authors: Doll William E. , Gamey T. Jeffrey , Bell David T. , Beard Les P. , Sheehan Jacob R. , Norton Jeannemarie , Holladay J. Scott , Lee James L. C.
Published: February 2012

Over the past fifteen years, notable progress has been made in the performance of airborne geophysical systems for mapping and detection of unexploded ordnance in terrestrial and shallow marine environments. For magnetometer systems, the most significant improvements include development of boom-mounted platforms, and implementation of higher sample rates, denser magnetometer arrays, and vertical gradient configurations. Nine magnetometer-based systems are described and their performance summarized. In prototype analyses and recent U.S. Department of Defense Environmental Security Technology Certification Program (ESTCP) assessments using new production systems, the best performance has been achieved with a vertical gradient configuration.

As effective as magnetometer systems have proven to be at many sites, they are inadequate at sites where basalts and other ferrous geologic formations or soils produce anomalies that approach or exceed those of target ordnance items. Additionally, magnetometer systems are ineffective where detection of non-ferrous ordnance items is of primary concern. We discuss the development of airborne time-domain electromagnetic systems over the past ten years.

Overall, improvements in airborne geophysical systems have led to more consistent detection of smaller ordnance. These trends should continue as additional technological advances are made.
Using Borehole Prospecting Technologies to Determine the Correlation between Fracture Properties and Hydraulic Conductivity: A Case Study in Taiwan
Authors: Lo Hung-Chieh , Chou Po-Yi , Hsu Shih-Meng , Chao Chi-Hung , Wang Chun-Te
Published: February 2012

This study conducted different borehole prospecting techniques for hydrogeological investigations of fractured rock at three active landslide sites in southern Taiwan. Borehole televiewer logging, flowmeter logging, and packer hydraulic tests were performed to quantify various hydrogeological parameters including fracture width, fracture angle, flow velocity and hydraulic conductivity. The dependence of hydraulic conductivity on fracture properties was evaluated by correlation analysis. While a high positive correlation was found between hydraulic conductivity and fracture width ([Formula: see text]), and flow velocity ([Formula: see text]), no correlation with fracture angle was observed. In addition, it is worthwhile to note that the product of fracture width and flow velocity showed a strong correlation with hydraulic conductivity ([Formula: see text]). The regression analysis also revealed that a power law relationship, with a coefficient of determination of 0.83, exists between the hydraulic conductivity and the product of fracture width and flow velocity. The rationality of this relationship was carefully verified by using another group of geophysical borehole measurements. The results demonstrated that it is capable of predicting the hydraulic conductivity of fractured rock based on borehole televiewer and flowmeter logging results.
A Hardware Decoding Algorithm for Long-distance Transmission for Well Logging
Authors: Cao Ping , Song Ke-Zhu , Yang Jun-Feng
Published: February 2012

Long-distance data transmission plays an important role in geophysical applications. This paper introduces a chip-encoded version of the Manchester-II decoding algorithm that can be used for long-distance transmission for well logging. It can be realized easily in a field programmable gate array (FPGA) hardware chip. We designed a wave tracking technique to optimize the algorithm's real-time decoding, adaptive capacity, and robust decoding. The algorithm could be divided into two modules, a data pre-processing module and a data decoding module, which is comprised of AMI code extraction and Manchester-II decoding. With the help of this algorithm, Manchester-II data transmitted via a 7,000 meter armored cable can be decoded in real time. Measurements in the lab and in situ show that communication systems based on this algorithm decoded correctly and achieved good bit error rate specifications. Compared to traditional methods using some specified encoding chips or digital signal processors, transmissions realized with this algorithm are less expensive and showed better adaptability and real-time performance. In addition to borehole geophysical applications, this algorithm can be used in environmental and engineering geophysical applications where data transmission over long distances is needed, whether on the surface or deep into the Earth.
Comparative Analysis of Optimal Oil Production Strategy Using Royalty & Tax and Production Sharing Petroleum Fiscal Models
Authors: Gaspar Ravagnani A. T. , Costa Lima G. A. , Barreto C. E. , Munerato F. P. , Schiozer D. J.
Published: February 2012

After recent discoveries of large oil reserves in pre-salt areas of Brazil, the government has proposed a change in the current fiscal regime from Royalty & Tax to Production Sharing Contracts. The government wishes to implement the production sharing system to earn higher revenues, believing that this is the best policy to improve State gains to be transferred to society. In this new environment and focusing on the oil production strategy selection process, it is required to know if: 1) the production strategies are the same or different for both models 2) the same technical-economic indicators are suitable to be used to select the optimal production strategy in both systems. Nowadays, there is no clear convergence of points of view to answer these issues, although some debates among professionals and government are taking place. The aim of this paper is to present a comparative analysis of the optimum exploitation strategy for both fiscal models, regarding number of injection and production wells and, their allocation in the reservoir. This objective is accomplished following a production-strategy optimization that combines manual and automatic procedures to maximize the company NPV accounting for the assumption of a known behavior of oil prices. Sensitivity analyses of government take to oil price and cost recovery limits are carried out. The results show that the choice of the optimal-production strategy to maximize NPV depends on the fiscal regime. In addition, the government take is reduced with the increase of oil prices. For any oil price, the government take in the production sharing contract system is higher than in R&T, so that it is one of the reasons why it is more interesting from the government's point of view. Besides, the increase of cost recovery limit implies in a reduction of the government take up to a stable value.
A Practical Method of Achieving Good Well Production Allocations from Well Test Data in the Prudhoe Bay Field
Authors: Chadwick Kenneth F.
Published: February 2012

A curve fitting technique has been developed for use in the West Operating Area of the Prudhoe Bay Field Unit that allows the operators to make daily well allocations for accounting purposes to an accuracy of better than +0/−5%.

The data required to allow the use of this curve fitting technique are obtained from a series of three well tests run at different production rates.

In order to maintain the above allocation accuracy, quality control criteria were evolved in order to determine the acceptability of well tests for this purpose.
Detailed Reservoir Delineation by Interactive Seismic Stratigraphic Extrapolation
Authors: Poggiagliolmi E.
Published: February 2012

The application of the seismic reflection method to detect stratigraphic changes away from well locations is beginning to gain acceptance among Reservoir Engineers. Unfortunately one of the limitations of this method is the inherent low resolution of seismic data as compared to well log data. Several approaches have been proposed to produce well log-like or pseudo log traces from seismic reflection data. Although there is no improvement in the resolution, the pseudo log traces provide a more convenient way of visually corelating well data to seismic data.

A new stratigraphic extrapolation method designed to overcome some of the drawbacks of low resolution is presented. This method consists of relating a model trace (initially derived from well information) to an actual seismic trace by varying the parameters of the model trace within well defined constraints until best match is achieved between them. Extrapolation of the stratigraphy away from the well is performed from trace to trace, the starting model for each trace being determined either from the final model for the previous trace or from an independently postulated model. An interactive computer program is employed for this purpose which allows the incorporation of additional information to the initial model. In this way the final stratigraphic model of the reservoir is the one which best matches the seismic data.

Several examples showing the application of the method will be discussed.
Derived flood frequency distribution and sensitivity analysis to variations in model parameters
Authors: Vornetti Alejandra I. , Seoane Rafael S.
Published: February 2012

In this paper we propose a new derived flood frequency distribution approach using the Nash instantaneous unit hydrograph (IUH) as the catchment's response model and analyze the sensitivity of flood frequency distributions to variations in the model parameters. We analyzed the effect of applying the Nash IUH to estimate peak flows in two basins in the province of Buenos Aires (Argentina). For the new flood frequency distribution, the Nash IUH parameters were estimated using the method of moments and a technique that relates the IUH parameters to the basin geomorphologic and hydraulic features. After applying the proposed derived flood frequency distributions to the basins, it is concluded that the new model (which includes the Nash IUH) yields similar results to those attained with a model developed by Raines and Valdés; the new model parameters can be estimated using a technique for ungauged basins. Also observed is a change in the shape of the flood frequency curves according to the IUH parameter estimation technique and to the set of infiltration parameters used.
Nitrous oxide emissions from a waterbody in the Nenjiang basin, China
Authors: Sun Qiao-Qi , Whitham Charlotte , Shi Kun , Yu Guo-Hai , Sun Xiao-Wei
Published: February 2012

Using static, closed chambers and gas chromatography techniques, nitrous oxide (N2O) emissions have been monitored for 1 year (2009–2010) on an inland running waterbody downstream of the Nenjiang basin, China. During the freezing period, holes were dug in the ice in order to obtain nitrous oxide samples. Here, we have focused on water-air gas exchange and factors which might influence N2O emissions and flux. Initial results indicate: (1) N2O flux rates reach peak emission in January and the annual emissions of N2O were low, being estimated at 0.35 ± 0.20 μgm–2 h−1; significant seasonal differences only appeared between January and July; (2) N2O flux rates have strong regularity and ice has been the main barrier to nitrous oxide release during winter; (3) 24-hour monitoring revealed that N2O flux remained steady during 9:00–17:00; (4) N2O emissions have significant relationships with ammonium nitrogen and total phosphorus concentrations in water (r = 0.4467, p = 0.020 and r = 0.4793, p = 0.011, respectively). The N2O flux released from the waterbody is determined by the chemical concentrations in the water. Following these results, we suggest that moderate use of N and P fertilizer at intensive agricultural areas will be beneficial in decreasing greenhouse gas emissions from this waterbody.
Modelling and statistical analysis of catchment water balance and discharge in Finland in 1951–2099 using transient climate scenarios
Authors: Veijalainen Noora , Korhonen Johanna , Vehviläinen Bertel , Koivusalo Harri
Published: February 2012

In this study climate change impacts on water balance components were estimated from transient climate scenarios for 1951–2099 in Finland. The future changes in evapotranspiration and discharge in annual and seasonal scales as well as annual mean high and low flows were projected for four catchments in different parts of Finland. The assessment was carried out using temperature and precipitation series simulated by four regional climate models (RCMs) as input to a conceptual hydrological model. The daily data from RCMs was bias corrected with the quantile–quantile mapping method and statistical properties of the simulated discharges were analysed to detect trends over time. Without bias correction the simulated discharges in the control period did not match the observed discharges, but the fit was improved considerably after bias correction. The results showed that seasonal changes, most importantly increase in winter runoff, were clearly visible and consistent in different climate scenarios and catchments. Individual scenarios also produced changes in annual mean, high and low flows, but without consistency in scenarios. The use of bias corrected RCM data as input to the hydrological model enables transient simulations, but the simulation results aggregate considerable uncertainties from the climate modelling, bias correction and the hydrological model.
An investigation into a treatment strategy for the Berg River water at the Voëlvlei water treatment plant
Authors: Swarts R. J. , Schoeman J. J.
Published: February 2012

The main aim of this study was to determine a treatment strategy for the Berg River water at the Voëlvlei water treatment plant (WTP). Jar tests were conducted using ferric and aluminium sulphate as coagulants to determine the optimum treatment parameters of the Berg River water and the Voëlvlei WTP raw water. The results for the Voëlvlei WTP raw water and the Berg River water with ferric sulphate as the coagulant showed an optimum Fe3+ dosage of 3.0–4.0 mg/L and 4.0–6.0 mg/L, respectively, with an optimum coagulation pH range of 6.6–9.5 and 5.0–10.0, respectively. The results with aluminium sulphate as the coagulant showed an optimum Al3+ dosage of 2.5–3.0 mg/L and 4.0–5.0 mg/L, respectively, with an optimum coagulation pH of 6.0–7.0 and 6.0, respectively. This study concluded that the Berg River water cannot be effectively treated at the Voëlvlei WTP using the plants treatment parameters, even if it is blended with the Voëlvlei WTP raw water. The best treatment strategy for the Berg River water would be pre-treatment using either ferric sulphate or the MIEX® resin on its own, or in conjunction with one another.
Hydrogenotrophic denitrification in an attached growth reactor under various operating conditions
Authors: Khanitchaidecha Wilawan , Kazama Futaba
Published: February 2012

To study the performance of an attached growth reactor on nitrate-nitrogen (NO3-N) removal by a hydrogenotrophic denitrification process, the reactor was operated under various H2 flow rates (30, 50 and 70 mL/min), hydraulic retention times (HRTs) (2.6, 3.1, 4.7 and 6.7 h) and inorganic carbon (IC) concentrations (excess and no IC addition). Synthetic NO3-N water was prepared in accordance with the groundwater quality of the study area: Chyasal in Kathmandu Valley, Nepal. The results show an increase in denitrification efficiency with H2 flow rate and HRT. Further, for effective denitrification, the dissolved hydrogen (DH) during operation should be maintained at greater than 0.1 mg/L. A sharp decrease in the denitrification efficiency from ∼96% (under excess IC) to 10–35% (under no IC) suggested occurrence of denitrification inside the attached growth reactor by a hydrogenotrophic process (using H2) as well as heterotrophic process (using internal organic carbon). The good performance of the attached growth reactor in terms of high efficiency, low H2 supply and short HRT requirement indicates the reactor's appropriateness for groundwater remediation through NO3-N removal.
The removal and degradation of pharmaceutical compounds during membrane bioreactor treatment
Authors: Schröder H. Fr. , Tambosi J. L. , Sena R. F. , Moreira R. F. P. M. , José H. J. , Pinnekamp J.
Published: February 2012

Pharmaceutical compounds such as non-steroidal anti-inflammatory drugs (NSAIDs) and antibiotics have been detected in sewage treatment plant (STP) effluents, surface and ground water and even in drinking water all over the world, and therefore have developed as compounds of concern. Membrane bioreactor (MBR) treatment has gained significant popularity as an advanced wastewater treatment technology and might be effective for an advanced removal of these pollutants. This paper evaluates the treatment of wastewater containing three NSAIDs (acetaminophen, ketoprofen and naproxen) and three antibiotics (roxithromycin, sulfamethoxazole and trimethoprim) performed in two MBRs with sludge retention times (SRTs) of 15 (MBR-15) and 30 (MBR-30) days over a period of four weeks. It was observed that NSAIDs were removed with higher efficiencies than the antibiotics for both MBRs, and the MBR-30 presented higher removal efficiencies for all the compounds than obtained by MBR-15. Removal rates ranged from 55% (sulfamethoxazole) up to 100% (acetaminophen, ketoprofen). Besides mineralisation biological transformation products of ketoprofen and naproxen produced by wastewater biocoenosis were identified in both MBR permeates using liquid chromatography coupled with mass spectrometry (LC-MS). The results indicated the importance of investigating the environmental fate of pharmaceuticals and their transformation products reaching the environment.
Membrane bioreactor application within the treatment of high-strength textile effluent
Authors: De Jager D. , Sheldon M. S. , Edwards W.
Published: February 2012

A pilot-scale dual-stage membrane bioreactor (dsMBR) incorporating two ultra-filtration (UF) side-stream membrane modules was designed, constructed, operated and evaluated on-site for treating high-strength textile effluent. The effluent stream was characterised by a COD range of between 45 to 2,820 mg/L and an average BOD of 192.5 mg/L. The dsMBR achieved an average COD reduction of 75% with a maximum of 97% over the 9 month test period. The COD concentration obtained after dsMBR treatment averaged at 190 mg/L, which was well within the discharge standard. The average reduction in turbidity and TSS were 94% and 19.6%, respectively, during the UF-MBR stage of the system. Subsequent treatment of the UF-permeate with nanofiltration (NF) and reverse osmosis (RO) removed both the residual colour and remaining salt. A consistent reduction in the color of the incoming effluent was evident. The ADMI was reduced from an average of 659 to ∼20, a lower ADMI and colour compared to the potable water. An average conductivity rejection of 91% was achieved with conductivity being reduced from an average of 7,700 to 693 μS/cm and the TDS reduced from an average of 5,700 to 473 mg/L, which facilitated an average TDS rejection of 92%.
WEF/WERF study of BNR plants achieving very low N and P limits: evaluation of technology performance and process reliability
Authors: Bott Charles B. , Parker Denny S. , Jimenez Jose , Miller Mark W. , Neethling J. B.
Published: February 2012

The Water Environment Research Foundation (WERF) funded a two-year comprehensive study of nutrient removal plants designed and operated to meet very low effluent total nitrogen (TN) and total phosphorus (TP) concentrations. WERF worked with the Water Environment Federation (WEF) to solicit participation of volunteers and provide a forum for information exchange at workshops at its annual conferences. Both existing and new technologies are being adapted to meet requirements that are as low as 3.0 mg/L TN and 0.1 mg/L TP, and there is a need to define their capabilities and reliabilities in the real world situation of wastewater treatment plants. A concern over very low daily permits for ammonia caused the work to be extended to include nitrification reliability. This effort focused on maximizing what can be learned from existing technologies in order to provide a database that will inform key decision makers about proper choices for both technologies and rationale bases for statistical permit writing. To this end, managers of 22 plants, 10 achieving low effluent TP, nine achieving low effluent TN, and three achieving low effluent NH3-N, provided three years of operational data that were analyzed using a consistent statistical approach. Technology Performance Statistics (TPSs) were developed as three separate values representing the ideal, median, and reliably achievable performance. Technological conclusions can be drawn from the study in terms of what can be learned by comparing the different nutrient removal and nitrification processes employed at these 22 plants.
Physician Prescribing Patterns of Innovative Antidepressants in the United States: The Case of MDD Patients 1993–2007
Authors: Lin Hsien-Chang , Erickson Steven R. , Balkrishnan Rajesh
Published: February 2012

Objective:

Innovative antidepressants such as SSRIs and SNRIs have been widely adopted. However, the differences in their adoption across patients' and physicians' characteristics, geographic regions, and insurance status need to be further explored. This study was trying to disentangle the patterns of physician antidepressant prescribing and medication choice for major depressive disorder treatment.

Method:

A retrospective cross-sectional study was conducted using the 1993–2007 National Ambulatory Medical Care Survey database. A multinomial logistic regression with the Heckman two-step selection procedure was applied to capture the two-step nature of physician prescription decision making.

Results:

The weighted logistic regression indicated that patients' race/ethnicity and primary source of payment for services, physician ownership status, and physicians' practice regions were associated with differential likelihood of physician' antidepressant prescribing. Non-Hispanic white patients were more likely to be prescribed antidepressants compared to Hispanic patients (OR=1.52, 95% CI 1.24–1.87). Physicians' choice on antidepressant varied across with patient age and health insurance status. Compared to private insurance, patients who were primarily covered by Medicare were less likely to be prescribed only SSRIs/SNRIs or other newer antidepressants (RRRs=0.42 and 0.39; 95% CIs 0.21–0.83 and 0.18–0.84, respectively).

Conclusions:

We observed strong associations between sociological factors and physicians' antidepressant prescribing patterns. Possible health disparities and gaps between optimal and suboptimal healthcare for patient mental health caused by systematic differences in sociological factors need to be mitigated. We need policy makers to design effective policy interventions to improve physician practice guidelines adherence to eliminate possible variations among physician practices.
Simultaneous Pancreas Kidney Transplant versus Other Kidney Transplant Options in Patients with Type 2 Diabetes
Authors: Wiseman Alexander C. , Gralla Jane
Published: February 2012

Background and objectives

Current organ allocation policy prioritizes placement of kidneys (with pancreas) to patients listed for simultaneous pancreas–kidney transplantation (SPK). Patients with type 2 diabetes mellitus (T2DM) may undergo SPK, but it is unknown whether these patients enjoy a survival advantage with SPK versus deceased-donor kidney transplantation alone (DDKA) or living-donor kidney transplantation alone (LDKA).

Design, setting, participants, & measurements

Using the Scientific Registry of Transplant Recipients database, patients with T2DM, age 18–59 years, body mass index 18–30 kg/m2, who underwent SPK, DDKA, or LDKA from 2000 through 2008 were identified. Five-year patient and kidney graft survival rates were compared, and multivariable analysis was performed to determine donor, recipient, and transplant factors influencing these outcomes.

Results

Of 6416 patients identified, 4005, 1987, and 424 underwent DDKA, LDKA, and SPK, respectively. On unadjusted analysis, patient and kidney graft survival rates were superior for LDKA versus SPK, whereas patient but not graft survival was higher for SPK versus DDKA. On multivariable analysis, survival advantage for SPK versus DDKA was related not to pancreas transplantation but younger donor and recipient ages in the SPK cohort.

Conclusions

Good outcomes can occur with SPK in selected patients with T2DM, but no patient or graft survival advantage is provided by added pancreas transplantation compared with DDKA; outcomes were superior with LDKA. These results support cautious use of SPK in T2DM when LDKA is not an option, with close oversight of the effect of kidney (with pancreas) allocation priority over other transplant candidates.
Academic Interventional Nephrology
Authors: Roy-Chaudhury Prabir , Yevzlin Alexander , Bonventre Joseph V. , Agarwal Anil , Almehmi Ammar , Besarab Anatole , Dwyer Amy , Hentschel Dirk M. , Kraus Michael , Maya Ivan , Pflederer Timothy , Schon Donald , Wu Steven , Work Jack
Published: February 2012

Dialysis vascular access dysfunction is currently a huge clinical problem. We believe that comprehensive academic-based dialysis vascular access programs that go all the way from basic and translational science investigation to clinical research to a dedicated curriculum and opportunities in vascular access for nephrologists in training are essential for improving dialysis vascular access care. This paper reviews the fundamental concepts and requirements for us to move toward this vision.
Impact of a Patient Education Program on Disparities in Kidney Transplant Evaluation
Authors: Patzer Rachel E. , Perryman Jennie P. , Pastan Stephen , Amaral Sandra , Gazmararian Julie A. , Klein Mitch , Kutner Nancy , McClellan William M.
Published: February 2012

Background and objectives

In 2007, the Emory Transplant Center (ETC) kidney transplant program implemented a required educational session for ESRD patients referred for renal transplant evaluation to increase patient awareness and decrease loss to follow-up. The purpose of this study was to evaluate the association of the ETC education program on completion of the transplant evaluation process.

Design, setting, participants, & measurements

Incident, adult ESRD patients referred from 2005 to 2008 were included. Patient data were abstracted from medical records and linked with data from the United States Renal Data System. Evaluation completion was compared by pre- and posteducational intervention groups in binomial regression models accounting for temporal confounding.

Results

A total of 1126 adult ESRD patients were examined in two transplant evaluation eras (75% pre- and 25% postintervention). One-year evaluation completion was higher in the post- versus preintervention group (80.4% versus 44.7%, P<0.0001). In adjusted analyses controlling for time trends, the adjusted probability of evaluation completion at 1 year was higher among the intervention versus nonintervention group (risk ratio=1.38, 95% confidence interval=1.12–1.71). The effect of the intervention was stronger among black patients and those patients living in poor neighborhoods (likelihood ratio test for interaction, P<0.05).

Conclusions

Standardizing transplant education may help reduce some of the racial and socioeconomic disparities observed in kidney transplantation.
Epidemiology and Pathophysiology of Nephrotic Syndrome–Associated Thromboembolic Disease
Authors: Kerlin Bryce A. , Ayoob Rose , Smoyer William E.
Published: February 2012

After infections, thromboembolism is considered by many experts to be the most significant life-threatening complication of nephrotic syndrome. The purpose of this review is to summarize the epidemiology, clinical and molecular pathophysiology, and management of this complication. Children (2.8%) are less likely than adults (26.7%) with nephrotic syndrome to develop thromboembolism. However, infants and children aged >12 years are at much greater risk. Membranous histologic changes increase thromboembolic risk at all ages; in particular, adults with membranous nephropathy have the highest reported risk (37.0%) and children with membranous histology have a rate (25%) that approaches the overall adult rate. There are striking, but variable, pathologic alterations of molecular hemostasis associated with nephrotic syndrome. No clear molecular therapeutic targets have been identified, but most studies show that the major pathologic changes involve antithrombin, fibrinogen, and factors V and VIII. There is inadequate evidence to support routine prophylactic therapy. Therapy includes anticoagulation in all cases, with thrombolysis reserved for those with the most severe thromboembolic disease. Future hemostatic research in nephrotic syndrome should focus on identifying cohorts at highest risk for thrombosis through the use of clinical markers and biomarkers as well as searching for molecular targets to correct the prothrombotic pathophysiology of this disease.
Metformin Prevents the Development of Chronic Heart Failure in the SHHF Rat Model
Authors: Cittadini Antonio , Napoli Raffaele , Monti Maria Gaia , Rea Domenica , Longobardi Salvatore , Netti Paolo Antonio , Walser Marion , Samà Mariateresa , Aimaretti Gianluca , Isgaard Jörgen , Saccà Luigi
Published: February 2012

Insulin resistance is a recently identified mechanism involved in the pathophysiology of chronic heart failure (CHF). We investigated the effects of two insulin-sensitizing drugs (metformin and rosiglitazone) in a genetic model of spontaneously hypertensive, insulin-resistant rats (SHHF). Thirty SHHF rats were randomized into three treatment groups as follows: 1) metformin (100 mg/kg per day), 2) rosiglitazone (2 mg/kg per day), and 3) no drug. Ten Sprague-Dawley rats served as normal controls. At the end of the treatment period (12 months), the cardiac phenotype was characterized by histology, echocardiography, and isolated perfused heart studies. Metformin attenuated left ventricular (LV) remodeling, as shown by reduced LV volumes, wall stress, perivascular fibrosis, and cardiac lipid accumulation. Metformin improved both systolic and diastolic indices as well as myocardial mechanical efficiency, as shown by improved ability to convert metabolic energy into mechanical work. Metformin induced a marked activation of AMP-activated protein kinase, endothelial nitric oxide synthase, and vascular endothelial growth factor and reduced tumor necrosis factor-α expression and myocyte apoptosis. Rosiglitazone did not affect LV remodeling, increased perivascular fibrosis, and promoted further cardiac lipid accumulation. In conclusion, long-term treatment with metformin, but not with rosiglitazone, prevents the development of severe CHF in the SHHF model by a wide-spectrum interaction that involves molecular, structural, functional, and metabolic-energetic mechanisms.
Postprandial Administration of Intranasal Insulin Intensifies Satiety and Reduces Intake of Palatable Snacks in Women
Authors: Hallschmid Manfred , Higgs Suzanne , Thienel Matthias , Ott Volker , Lehnert Hendrik
Published: February 2012

The role of brain insulin signaling in the control of food intake in humans has not been thoroughly defined. We hypothesized that the hormone contributes to the postprandial regulation of appetite for palatable food, and assessed the effects on appetite and snack intake of postprandial versus fasted intranasal insulin administration to the brain in healthy women. Two groups of subjects were intranasally administered 160 IU insulin or vehicle after lunch. Two hours later, consumption of cookies of varying palatability was measured under the pretext of a taste test. In a control study, the effects of intranasal insulin administered to fasted female subjects were assessed. Compared with placebo, insulin administration in the postprandial but not in the fasted state decreased appetite as well as intake and rated palatability of chocolate chip cookies (the most palatable snack offered). In both experiments, intranasal insulin induced a slight decrease in plasma glucose but did not affect serum insulin concentrations. Data indicate that brain insulin acts as a relevant satiety signal during the postprandial period, in particular reducing the intake of highly palatable food, and impacts peripheral glucose homeostasis. Postprandial intranasal insulin administration might be useful in curtailing overconsumption of snacks with accentuated rewarding value.
Abdominal Superficial Subcutaneous Fat
Authors: Golan Rachel , Shelef Ilan , Rudich Assaf , Gepner Yftach , Shemesh Elad , Chassidim Yoash , Harman-Boehm Ilana , Henkin Yaakov , Schwarzfuchs Dan , Ben Avraham Sivan , Witkow Shula , Liberty Idit F. , Tangi-Rosental Osnat , Sarusi Benjamin , Stampfer Meir J. , Shai Iris
Published: February 2012

OBJECTIVE

Unlike visceral adipose tissue (VAT), the association between subcutaneous adipose tissue (SAT) and obesity-related morbidity is controversial. In patients with type 2 diabetes, we assessed whether this variability can be explained by a putative favorable, distinct association between abdominal superficial SAT (SSAT) (absolute amount or its proportion) and cardiometabolic parameters.

RESEARCH DESIGN AND METHODS

We performed abdominal magnetic resonance imaging (MRI) in 73 patients with diabetes (mean age 58 years, 83% were men) and cross-sectionally analyzed fat distribution at S1-L5, L5-L4, and L3-L2 levels. Patients completed food frequency questionnaires, and subgroups had 24-h ambulatory blood pressure monitoring and 24-h ambulatory electrocardiography.

RESULTS

Women had higher %SSAT (37 vs. 23% in men; P < 0.001) despite a similar mean waist circumference. Fasting plasma glucose (P = 0.046) and HbA1c (P = 0.006) were both lower with increased tertile of absolute SSAT. In regression models adjusted for age, waist circumference, and classes of medical treatments used in this patient population, increased %SSAT was significantly associated with decreased HbA1c (β = −0.317; P = 0.013), decreased daytime ambulatory blood pressure (β = −0.426; P = 0.008), and increased HDL cholesterol (β = 0.257; P = 0.042). In contrast, increased percent of deep SAT (DSAT) was associated with increased HbA1c (β = 0.266; P = 0.040) and poorer heart rate variability parameters (P = 0.030). Although total fat and energy intake were not correlated with fat tissue distribution, increased intake of trans fat tended to be associated with total SAT (r = 0.228; P = 0.05) and DSAT (r = 0.20; P = 0.093), but not with SSAT.

CONCLUSIONS

Abdominal SAT is composed of two subdepots that associate differently with cardiometabolic parameters. Higher absolute and relative distribution of fat in abdominal SSAT may signify beneficial cardiometabolic effects in patients with type 2 diabetes.
Metabolic Effects of Aerobic Training and Resistance Training in Type 2 Diabetic Subjects
Authors: Bacchi Elisabetta , Negri Carlo , Zanolin Maria Elisabetta , Milanese Chiara , Faccioli Niccolò , Trombetta Maddalena , Zoppini Giacomo , Cevese Antonio , Bonadonna Riccardo C. , Schena Federico , Bonora Enzo , Lanza Massimo , Moghetti Paolo
Published: February 2012

OBJECTIVE

To assess differences between the effects of aerobic and resistance training on HbA1c (primary outcome) and several metabolic risk factors in subjects with type 2 diabetes, and to identify predictors of exercise-induced metabolic improvement.

RESEARCH DESIGN AND METHODS

Type 2 diabetic patients (n = 40) were randomly assigned to aerobic training or resistance training. Before and after 4 months of intervention, metabolic phenotypes (including HbA1c, glucose clamp–measured insulin sensitivity, and oral glucose tolerance test–assessed β-cell function), body composition by dual-energy X-ray absorptiometry, visceral (VAT) and subcutaneous (SAT) adipose tissue by magnetic resonance imaging, cardiorespiratory fitness, and muscular strength were measured.

RESULTS

After training, increase in peak oxygen consumption (VO2peak) was greater in the aerobic group (time-by-group interaction P = 0.045), whereas increase in strength was greater in the resistance group (time-by-group interaction P < 0.0001). HbA1c was similarly reduced in both groups (−0.40% [95% CI −0.61 to −0.18] vs. −0.35% [−0.59 to −0.10], respectively). Total and truncal fat, VAT, and SAT were also similarly reduced in both groups, whereas insulin sensitivity and lean limb mass were similarly increased. β-Cell function showed no significant changes. In multivariate analyses, improvement in HbA1c after training was independently predicted by baseline HbA1c and by changes in VO2peak and truncal fat.

CONCLUSIONS

Resistance training, similarly to aerobic training, improves metabolic features and insulin sensitivity and reduces abdominal fat in type 2 diabetic patients. Changes after training in VO2peak and truncal fat may be primary determinants of exercise-induced metabolic improvement.
Maternal Gastric Adenocarcinoma with Placental Metastases: What is the Fetal Risk?
Authors: Miller Keith , Zawislak Agnes , Gannon Caroline , Millar David , Loughrey Maurice B.
Published: February 2012

The incidence of maternal cancer during pregnancy is low, and metastatic disease involving the placenta is rare. We present a case of rapidly progressive and fatal gastric carcinoma presenting during pregnancy, with spread to the maternal blood space within the placenta but no chorionic villous invasion and no evidence of fetal transmission at the time of delivery or on 12-month follow up. To the best of our knowledge, there have been only 5 previous single case reports of gastric carcinoma metastatic to the placenta. This case highlights the need for clinical vigilance against dismissing gastrointestinal symptoms as pregnancy related and for pathologists to carefully examine the placenta in the setting of maternal malignancy. When placental metastases are present but with no villous invasion, the risk of fetal metastasis may be extremely low, even in the setting of aggressive, terminal malignancy in the mother.
Decreased Aggressive and Locomotor Behaviors in Betta Splendens after Exposure to Fluoxetine
Authors: Kohlert Jess G. , Mangan Brian P. , Kodra Christine , Drako Linsay , Long Emily , Simpson Holly
Published: February 2012

The failure of sewage treatment plants to remove pharmaceuticals such as fluoxetine from waste water has become a concern given that these products are being detected in the surface waters of many countries of the world. The effects of fluoxetine in sub-lethal doses on the neural systems and behaviors of aquatic life are worthy of investigation. This study investigated the effects of sub-lethal amounts fluoxetine dissolved in water on the aggressive and locomotor behaviors of 44 male Betta splendens. Fish treated with 705 μg/1 of fluoxetine and 350 μg/1 of fluoxetine generally demonstrated significant decreases in locomotion and number of aggressive attacks compared to 0 μg/1 of fluoxetine (controls) on Days 11 and 19 of drug exposure and persisted for at least 13 days after removal of fluoxetine. Consistent with decreases in the number of aggressive attacks, there was a significant increase in aggression-response time to a perceived intruder for treated males on Days 11 and 19 and persisted for 6 days following removal of fluoxetine. However, the differences in aggressive and locomotor behaviors seen in the fluoxetine-treated groups were indistinguishable from controls three weeks following drug removal.
Initial Development of a Brief Measure of Psychological Distress
Authors: Elkins Gary R. , Fisher William I. , Johnson Aimee K. , Kendrick Cassie , Koep Lauren , Bunn Jennifer , Perfect Michelle
Published: February 2012

This paper addresses the preliminary development, construct validity, and psychometric properties of a brief self-report measure of psychological distress. 40 items were originally generated by doctoral level psychologists for use in the preliminary clinical sample. Inpatients from a psychiatric unit ( N = 125) completed the items, and a principal-components analysis with a direct oblimin rotation was used to evaluate construct validity. The study indicated a four-factor solution, using the constructs of Depression, Hopelessness, Anxiety, and Anger, with good estimates of reliability. After evaluation of factor structure, item analyses, and reliability estimates, a redacted 19-item scale was identified.
Conditioned Withdrawal in Goldfish: A Simple and Inexpensive Preparation for the Study of Classical Fear Conditioning in Vertebrates
Authors: Barela Peter B.
Published: February 2012

A preparation for the study of classical fear conditioning in vertebrates is described. Its unique features are that it is inexpensive and easy to construct and operate. The following classical conditioning phenomena are demonstrated using this preparation: excitatory conditioning, extinction, contextual conditioning, blocking, a conditioned inhibition discrimination, and latent inhibition.
Pressure-temperature-fluid constraints for the Emmaville-Torrington emerald deposit, New South Wales, Australia: Fluid inclusion and stable isotope studies
Authors: Loughrey Lara , Marshall Dan , Jones Peter , Millsteed Paul , Main Arthur
Published: February 2012

The Emmaville-Torrington emeralds were first discovered in 1890 in quartz veins hosted within a Permian metasedimentary sequence, consisting of meta-siltstones, slates and quartzites intruded by pegmatite and aplite veins from the Moule Granite. The emerald deposit genesis is consistent with a typical granite-related emerald vein system. Emeralds from these veins display colour zonation alternating between emerald and clear beryl. Two fluid inclusion types are identified: three-phase (brine+vapour+halite) and two-phase (vapour+liquid) fluid inclusions. Fluid inclusion studies indicate the emeralds were precipitated from saline fluids ranging from approximately 33 mass percent NaCl equivalent. Formational pressures and temperatures of 350 to 400 °C and approximately 150 to 250 bars were derived from fluid inclusion and petrographic studies that also indicate emerald and beryl precipitation respectively from the liquid and vapour portions of a two-phase (boiling) system. The distinct colour zonations observed in the emerald from these deposits is the first recorded emerald locality which shows evidence of colour variation as a function of boiling. The primary three-phase and primary two-phase FITs are consistent with alternating chromium-rich ‘striped’ colour banding. Alternating emerald zones with colourless beryl are due to chromium and vanadium partitioning in the liquid portion of the boiling system. The chemical variations observed at Emmaville-Torrington are similar to other colour zoned emeralds from other localities worldwide likely precipitated from a boiling system as well.