bluuebunny/crossref_metadata_2025 huggingface dataset:
Vineyard Floor Management Influences ‘Pinot noir’ Vine Growth and Productivity More than Cluster Thinning
Authors: Reeve Alison L. , Skinkis Patricia A. , Vance Amanda J. , Lee Jungmin , Tarara Julie M.
Published: November 2016

Vigor and crop level management are important practices for premium wine grape production. The implications of crop thinning ‘Pinot noir’(Vitis vinifera L.) vines of varying vigor were investigated in the Willamette Valley of Oregon in 2011 to 2013 to better understand the relationship between canopy size and yield within the framework of a cool-climate, premium production wine grape vineyard. To manipulate vigor, a competitive grass cover crop (Festuca rubra L.) was grown in both (Grass), alternating (Alternate), or neither side of the flanking alleyways (Tilled). Vines within each vineyard floor treatment had two crop levels applied, including cluster thinning to one cluster per shoot (Half Crop) or no crop thinning (Full Crop). Grass treatment had reduced leaf area and leaf nitrogen (N) concentrations during all years compared with Tilled treatments. Leaf photosynthesis was also lower in Grass treatments despite more light in the canopy interior. Grass treatments had lower yield than Tilled treatments in 2 of 3 years and lower yeast assimilable nitrogen (YAN) concentrations in fruit every year. There was limited impact of floor treatments on total soluble solids (TSS) and pH. Reduced yields through cluster thinning had limited impact on vegetative growth but increased TSS and pH, in 2 of 3 years. There were few floor management by crop level interactions in any year. Grass effectively reduced vegetative growth to moderate vigor levels with cane weights between 20 and 40 g. Using a competitive grass cover crop may be an effective strategy to reduce excessive vine growth and require less labor in canopy management and crop thinning without compromising basic fruit ripeness, although YAN levels need to be monitored.
Influence of Photoperiod Duration and Phloem Disruption through Scoring on Growth, Disease Symptoms, and Bacterial Titer in Citrus Graft Inoculated with Candidatus Liberibacter asiaticus
Authors: Stover Ed , Shatters Robert G. , Gruber Barrett , Kumar Prem , Moore Gloria A.
Published: November 2016

Plants inoculated with the huanglongbing (HLB)-associated bacterium, Candidatus Liberibacter asiaticus (CLas) typically must be monitored for 8–10 months to identify differences in susceptibility between genotypes. Continuous light is reported to accelerate development of HLB symptoms and field observations suggest that trees girdled by tags or tree ties showed greater symptoms. Therefore, an experiment was conducted assessing HLB susceptibility as influenced by light/dark periods of 12 hours: 12 hours and 24 hours: 0 hours, in combination with scoring tree trunks to disrupt phloem. Sixty trees of each of three citrus genotypes (‘Kuharske’, previously shown to be HLB resistant; rough lemon, previously shown to be HLB tolerant; and ‘Valencia’, highly HLB susceptible) were bud grafted using two CLas-infected buds (rough lemon and citron) per tree on 26 Mar. 2012, and were placed in controlled growth rooms (one 12 hour light: 12 hour dark and one constant light) on 4 June 2012. Ten trees of each genotype in each growth room were scored 10 cm above the soil (cutting through the bark but not the wood) with a knife on 18 July 2012 and the scoring was repeated at the same scoring wounds on 30 Aug. 2012. Trees were removed from growth rooms on 12 Dec. 2012 and subsequently maintained in a greenhouse. At two to three month intervals between June 2012 and May 2013, HLB symptoms and stem diameter at 5 cm above the soil were assessed, and three leaves per tree were collected for quantitative polymerase chain reaction (qPCR) determination of CLas titer. Six months after inoculation and 3 months following imposition of treatments, the ‘Valencia’ scored in the 12 hour light: 12 hour dark regime, the ‘Valencia’ non scored trees in 24 hours of light and the ‘Kuharske’ scored trees in 24 hours of light displayed higher CLas titers than most other trees. After an additional two months, both scored and non-scored trees of all three genotypes in 24 hours of light had significantly elevated CLas titers compared with trees in 12 hour light: 12 hour dark regime, but within most treatments all three genotypes had titers which were not statistically different from each other. Growth of ‘Kuharske’ and rough lemon was enhanced; whereas ‘Valencia’ growth was reduced when graft-inoculated plants were maintained in continuous light. Scoring enhanced early CLas development in ‘Kuharske’ when combined with continuous light, had no effect in rough lemon, and showed inconsistent effects in ‘Valencia’. Although continuous lighting enhanced disease progression, it did not reveal differences in HLB susceptibility.
Dry Leaf and Steviol Glycoside Productivity of Stevia rebaudiana in the Western United States
Authors: Parris Cheryl A. , Shock Clinton C. , Qian Michael
Published: November 2016

Stevia (Stevia rebaudiana Bertoni) is a perennial herbaceous plant native to Paraguay, where it was used by the native Guarani peoples for centuries. Although steviol glycosides from stevia are powerful natural noncaloric sweeteners, stevia has been cultivated and commercially available only for the past 50 years. Cultural practices are still in development, and productivity potential in the United States is largely unknown. Currently commercial growers and processors worldwide are seeking to maximize the productivity of rebaudioside A, a steviol glycoside. The trials reported here examined the effects of location, harvest strategy, and cultivar on stevia dry leaf yield, steviol glycoside content, and steviol glycoside yield. Six or seven stevia cultivars were grown for ≈5 months at four western U.S. locations, with an irrigation criterion of 20 kPa. Stevia at every location was subjected to two harvest strategies: either one harvest at the end of the season or two harvests, one midseason and another at the end of the season. The main plots at each location were the stevia cultivars, and the split plots were the harvest strategies in a randomized complete block, split-plot design with four replicates. Dry leaf yield, leaf steviol glycoside content, and leaf steviol glycoside yield varied by cultivar, location, and cultivar by location, but not by harvest strategy or interactions of harvest strategy with location or cultivar. Dry leaf yield averaged 4.12 Mg·ha−1 with significant differences by cultivar and location. One of the steviol glycosides, rebaudioside A yield averaged 300 kg·ha−1 with significant differences by cultivar and by interactions of location with cultivar. Leaf productivity was greater at Ontario, OR, than at Hanford, CA, Indio, CA, or Yuma, AZ. Dry leaf yield greater than 7 Mg·ha−1 and rebaudioside A yields greater than 500 kg·ha−1 were observed at Ontario. Stevia perenniated at Hanford and Indio, providing the option of multiyear harvests from a single planting.
Diffuse Flesh Browning in ‘Honeycrisp’ Apple Fruit is Associated with Low Temperatures during Fruit Growth
Authors: Tong Cindy B.S. , Chang Hsueh-Yuan , Boldt Jennifer K. , Ma Yizhou B. , DeEll Jennifer R. , Moran Renae E. , Bourgeois Gaétan , Plouffe Dominique
Published: November 2016

Multiple types of flesh browning can occur as storage disorders in ‘Honeycrisp’ apple (Malus ×domestica Borkh.) fruit. Predicting its occurrence is hindered by differing definitions of the types of browning, incomplete understanding of their etiologies, and difficulty in assessing harvest maturity of ‘Honeycrisp’ fruit. In 2013, of ‘Honeycrisp’ fruit grown, harvested over multiple weeks, and stored in Maine, Minnesota, Ontario, and Quebec, only the Quebec fruit developed diffuse flesh browning. A detailed comparison showed that the Quebec fruit differed in size, but not in other quality attributes, from fruit of the other locations. The Quebec fruit experienced lower temperatures during active fruit growth and were increasing in cell size up to harvest. Analyses of climate data from 2009 to 2015 indicated that accumulated growing degree-days (GDD) 50–60 day after full bloom (DAFB) could account for 31% of the variation in diffuse flesh browning, and seasonal GDD <500 are associated with a greater likelihood of injury. Fruit that exhibited diffuse flesh browning had higher magnesium and lower fructose levels than unaffected fruit. As these measurements were made after browning was assessed, the timing of the onset of these characteristics in relation to browning cannot be determined.
Leaving them speechless: a case of anaesthesia‐induced mutism
Authors: Morrison Benjamin , Stringer Kathryn
Published: November 2016

We present the case of a patient emerging from general anaesthesia who was found to be mute with other unexplained and unusual behaviour. We describe common factors between this case and those previously reported which may help our understanding of the possible aetiology behind this phenomenon.
Spatial distribution of heavy metals in groundwaters and health risks associated in the Ntem watershed, Yaoundé, Cameroon
Authors: Defo Célestin , Kfuban Yerima Bernard Palmer , Kaur Ravinder , Bemmo Nestor
Published: November 2016

The present study was aimed at bridging the gaps in the knowledge concerning heavy metals (Pb, Cd, Cr, Ni, Zn, Cu, Mn and Fe) concentrations in the groundwaters of the Ntem watershed in Yaoundé. Representative groundwater samples (25 numbers) were collected from five hand-dug wells, and their metal concentrations were assessed as per standard procedures, and deterministic interpolation techniques were used to perform the spatial distribution of heavy metal concentration maps. The ranges of concentrations of these metals in groundwaters were: Pb (0.11–0.34 mg/L > 0.025 mg/L); Cd (0.00–0.08 mg/L > 0.005 mg/L); Cr (0.12–1.33 mg/L > 0.05 mg/L) and Ni (0.11–0.46 mg/L > 0.05 mg/L). Besides, the average metal concentrations in the groundwaters of the sampling sites were in general higher than the prescribed World Health Organization (WHO) norms. The risk assessment indicated that the population concerned are considered unsafe, and are therefore exposed to non-carcinogenic and carcinogenic effects on health. The occurrence of more than permissible levels of heavy metals in the representative groundwaters and their spatial distribution indicate that there is a potential threat from these contaminants to the public health in the Ntem watershed.
MAIN CRITERIA IN THE DEVELOPMENT OF SMART CITIES DETERMINED USING ANALYTICAL METHOD
Authors: Tahir Zurinah , Abdul Malek Jalaluddin
Published: November 2016

A smart city is one that is highly developed, innovative, environment-friendly, and incorporates relevant aspects of the economy, technology, mobility, quality of life and other aspects that contribute to the well-being of its residents. To achieve the status of a smart city, several requirements, criteria or indicators need to be considered. Strategic decisions by planners of a smart city play an important role in determining how the city uses resources and opportunities through the harnessing of modern technology to build a framework of innovation that nurtures a healthy society in an economy that is dynamic and environment-conscious. Smart cities focus on various elements of humanity, learning, the environment, technological infrastructure, social development, and urban growth. The aim of this study is to examine these requisites of a smart city, and to use the Analytic Hierarchy Process (AHP) methodology in assigning weightage to each element that is considered essential to its development. Smart environment and smart mobility were found to be the top two important factors in the successful building of a smart city. The actual values that shape smart cities are based on a balance of factors such as smart environmental practices, smart governance, smart living, smart mobility, smart people, and smart economy. These principal key elements work together to exploit the technologies that help bring about the realization of a smart city.
SUSTAINABLE WELL-BEING: AN EMPIRICAL EXPLORATION ON HUMAN NEEDS AND HUMAN INTERDEPENDENCY
Authors: Abu Bakar Aisyah , Bachok Syahriah , Mohamed Osman Mariana , Ibrahim Mansor , Abdullah Muhammad Faris
Published: November 2016

This study is a part of an ongoing research to discover subjective indicators of sustainable well-being for Malaysia. Initial findings recognized two important notions of subjective measures of sustainable well-being. The first notion suggested that sustainable well-being manifested in human interdependency. The second notion suggested that human interdependency is attained when human needs are fulfilled. Maslow’s Hierarchy of Needs was adopted to indicate the stages and examples of each needs. There were eight stages of human needs which were adapted into 24 common human needs substituted under eight components of three human needs dimensions. The dimensions were (i) basic necessities, (ii) complimentary needs, and (iii) desired opportunities. It was hypothesized that human needs influence the level of human interdependency. This paper delivers an empirical analysis testing the effects of human needs on human interdependency. The study intends to determine the influence of human needs on human interdependency. Questionnaire survey was conducted and 894 reliable samples were gathered. 192 Independent Sample T-Tests were conducted to determine statistical difference in levels of eight components of human interdependency, between respondents who claimed difficult and respondents who claimed easy to attain 24 human needs in the past year. There were statistically significant differences in most of the components of human interdependency between groups of 24 human needs. The empirical study conducted in the central regions of a developing and multicultural country, Malaysia, is a useful reference to subjective well-being studies piloted in areas of similar characteristics.
INFORMATION QUALITY FOR FLOOD RISK REDUCTION IN SITE PLANNING: TOWN PLANNERS’ PERCEPTION
Authors: Afida Intan , Idrus Shaharudin , Hashim Halimaton Saadiah
Published: November 2016

One of the main tasks of a town planner in Malaysia is to prepare a Development Proposal Report (DPR) to be submitted together with the layout plan to get planning permission from the local planning authority (LPA). Incorporation of flood risk reduction aspects in site planning in the DPR is important to allow the LPA to make good and effective planning decisions. This study examines town planners’ perception on information quality for the incorporation of flood risk reduction in site planning in the context of five town planning reference instruments, namely the Town and Country Planning Act 1976, Selayang Municipal Council Local Plan 2020, Town and Country Planning Department Planning Guidelines, Selangor Manual and Planning Guidelines 2nd Edition and DPR Manual 2nd Edition that assist them to prepare the DPR for obtaining planning permission from Selayang Municipal Council, Selangor, Malaysia, where the study was carried out. The findings show that there is a need to improve existing town planning reference instruments and access to information to generally enhance town planners planning activities and specifically improve DPR quality in the future.
NEIGHBOURHOOD SATISFACTION AND QOUL IN MIDDLE-INCOME HOUSING IN KUALA LUMPUR CITY, MALAYSIA
Authors: Abdul Mohit Muhammad , Ali Mohamed Sajid
Published: November 2016

This paper is based on the subjective perception of the residents about the neighbourhood environment and their quality of urban life. The neighbourhood satisfaction provides a generalized view into the well-being of the residents, and it has been viewed as a significant aspect of the quality of urban life (QOUL). As a contributor to life satisfaction, neighbourhood satisfaction is influenced by individual and household socio-economic variables, along with the neighbourhood characteristics. However, there is limited understanding of how neighbourhood environments influence neighbourhood satisfaction and the quality of urban life. This paper intends to examine the relationship between residents’ neighbourhood satisfaction and their quality of urban life in a middle-income housing area in Kuala Lumpur City, Malaysia, by using 100 sample respondents that fulfilled a confidence level of 90% of the population. The findings of the study indicate that the residents are satisfied with their existing QOUL, but if no actions are taken it will deteriorate. Therefore, several recommendations are made for improving the residents’ QOUL.
IDENTIFYING FACTORS INFLUENCING URBAN SPATIAL GROWTH FOR THE GEORGE TOWN CONURBATION
Authors: Mahamud Mohd Amirul , Samat Narimah , Mohd Noor Norzailawati
Published: November 2016

Urban growth, which caused spatial land use and land cover changes has affected various physical environment, social, and economic activities. Thus, in order to understand the dynamic process of urban spatial growth, researchers throughout the world have implemented diverse approaches, where spatial models have been developed to predict and simulate future urban growth. Those models were developed based on the driving forces that stimulate urban spatial growth. Therefore, in ensuring reliable models to be developed will be able to forecast future changes and their potential environmental effects, the driving forces must be identified. The objective of this paper is to identify possible driving forces that promote urban spatial growth of the George Town Conurbation. The study was conducted based on reviewing recent publications in journals and an on-line survey. An on-line survey was generated and distributed to academicians and urban planners to identify factors influencing urban spatial growth and their weights. The findings indicated that distance to public amenities, cheap housing price, and distance to the workplace are among factors that are important determinants of urban development. The results provide valuable insights in modelling urban growth in future research.
THE CRITIQUES TO POSITIVISM DIRECTION OF INQUIRY IN COMPREHENDING THE COMPLEXITY OF GOVERNANCE IN MANAGING CITIES COMPETITIVENESS
Authors: Abdullah Faizul , Yusof Fatimah
Published: November 2016

The complexities in managing cities are real in the ethos of global cities competition and indeed, the governance of urban complexities are further compounded by the discoveries of new tangible and intangible determinants, vehemently contributed by the increased structural changes on a global scale ceased to be the main axes and reference points in societal organization. Whilst deterministic about deploying competitive cities interventions, the initiatives have always exposed local authorities to other related issues in the governance of complexity, which usually infers to their organizing capacity in attaining organizations competitiveness. For most modernists’ scholars, they tend to agreed that learning is associated with efficiency and thus, it exposed organizations to learn new impositions of social artefacts. Exaggerated from realist ontology definitive foundation of structural functionalism, it clearly underlined Weberian positivism bureaucratic efficiency, which echoed local authorities in attaining the balancing act between ‘de jure’ and ‘de facto’ that constitutionally empowered in managing cities in the ethos of globalization. On the contrary, the realism in local authorities suggested otherwise, which perhaps lead to epistemological debates on the governmentality. Apparently, local authorities are facing dramatic challenges not only reframing to achieving global interventions on cities competitiveness and urban sustainability interventions -de jure; but also intensely faced-off with severe ignorance, resentment and dissonance from the entire workforce itself - de facto. As such, it warrants this paper to explore the validity on the dominant used of positivism direction of inquiry among social sciences researchers’ on organizational bureaucratic efficiency, when most positivism line of inquiry researchers suggested that local authorities are learning organization entities, or is it so?
ENERGY EFFICIENCY POLICY FOR EXISTING TYPICAL CAMPUS BUILDINGS IN THE UNIVERSITY OF MALAYA
Authors: Ismail Muhammad Azzam , M. Al-Obaidi Karam , Sulaiman Raha
Published: November 2016

A very large component of the maintenance cost of any real estate property is the electricity consumption cost. The electricity consumption cost of a 700-acre university campus in Malaysia would reach an overall yearly operating expenditure of nearly RM 1 billion. Knowing this fact, the University of Malaya’s (UM) top management has conducted many projects at various scales to address energy efficiency (EE), including the replacement of old and inefficient mechanical and electrical (M&E) equipment and the installation of new EE technologies around the campus. In enhancing the overall EE effort, an energy management system is required to ensure that a calculated EE plan can be implemented and audited after it is completed to improve the overall sustainability of UM. Therefore, this study presents the formulation of an Energy Management System (EMS) for UM based on the ASEAN Energy Management Scheme (AEMAS) methodology. Results show that with the full support of the top management of the university, the EMS can be implemented with at least a 5% electricity consumption reduction per year. The formalization of the EMS is the most important step in ensuring any marked reduction in electricity consumption campus-wide.
Гастроезофагеальна рефлюксна хвороба і лужний рефлюкс: механізми розвитку і тактика лікування
Authors: Zviahintseva T.D. , Sharhorod I.I.
Published: November 2016

Стаття присвячена гастроезофагеальній рефлюксній хворобі (ГЕРХ) — патології, що займає провідне місце серед усіх кислотозалежних захворювань. Основним механізмом розвитку ГЕРХ є порушення моторно-евакуаторної функції шлунка — уповільнення шлункової евакуації і дуоденогастральний рефлюкс. Уповільнене спорожнення шлунка сприяє почастішанню рефлюксу, а наявність дуоденального вмісту в рефлюктаті — лужний рефлюкс — є агресивним для слизової оболонки стравоходу (СОС). Це обумовлено наявністю в рефлюктаті, що закидається в стравохід, жовчних кислот, лізолецитину і панкреатичних ферментів. Тривало існуючий контакт агресивних чинників у шлунку і стравоході призводить до розвитку запально-деструктивних уражень слизової оболонки цих органів. За даними багатьох дослідників, саме жовчні кислоти відіграють провідну роль у патогенезі шкідливого впливу на СОС. Медикаментозна корекція ГЕРХ із лужним рефлюксом включає поряд із призначенням інгібіторів протонної помпи прокінетики (ітоприду гідрохлорид) і препарати урсодезоксихолієвої кислоти.
Функціональна диспепсія у світлі PимскИх критеріїв IV
Authors: Tkach S.M.
Published: November 2016

Статтю присвячено проблемі функціональної дис­пепсії. Детально описана патофiзiологiя, наведені діагностичні критерії цієї патології, розглядаються аспекти лікування пацієнтів iз функціональною диспепсією. Препаратами першої лінії терапії функціональної диспепсії є прокiнетики і інгібітори протонної помпи. У статті приділено увагу комбінованому препарату, що містить домперидон (прокінетик) і омепразол (інгібітор протонної помпи), — Омез ДСР.
Визначення рівня мелатоніну у щурів різної статі та віку при виразковому ураженні шлунка
Authors: Hnatiuk V.V. , Kononenko N.M.
Published: November 2016

Метою дослідження було визначення рівня мелатоніну в сироватці крові у щурів різної статі та віку при виразковому ураженні шлунка. Матеріали та методи. Методом спирто-преднізолонового ушкодження моделювали виразкове ураження шлунка та за допомогою імуноферментного аналізу визначали рівні мелатоніну в сироватці крові у щурів різної статі, які були розподілені на групи за віком, а саме — 3, 9, 15 та 20 міс., що відповідає віку людини 14, 29–30, 43–44, 55–56 років відповідно. Результати. Встановлено, що на тлі виразкового ураження шлунка відбувається вірогідне зниження рівня мелатоніну як у самців, так і у самок у всіх вікових групах. Відносно групи контролю у щурів-самців найбільше зниження відбулося у тварин віком 9 та 20 міс. — на 39 та 43 % відповідно (р ≤ 0,05). У самок на тлі виразкового ураження шлунка зниження рівня мелатоніну відносно групи контролю було на 21–23 % (р ≤ 0,05). Обговорення. Отримані результати свідчать, що виразкове ураження шлунка, ймовірно, призводить до пошкодження ентерохромафінних клітин слизової оболонки шлунка, що супроводжується вірогідними зниженнями рівнів мелатоніну у щурів обох статей і всіх вікових груп, та дозволяють припустити, що саме у чоловіків віком 29–30 та 55–56 років виразкове ураження призводить до значного пошкодження екстрапінеальних джерел синтезу мелатоніну та більш тяжкого перебігу виразкової хвороби з розвитком ускладнень. Висновки. Таким чином, виразкове ураження шлунка призводить до зниження рівнів мелатоніну в сироватці крові у щурів різної статі та віку. Найбільше зниження рівнів мелатоніну при експериментальній виразці шлунка відбувається у щурів-самців віком 9 та 20 міс., що відповідає віку людини 29–30 та 55–56 років.
MITOS KECANTIKAN DALAM CERPEN-CERPEN DWI RATIH RAMADHANY
Authors: Julian Royyan
Published: November 2016

This study highlights the myth of beauty in short stories written by Dwi Ratih Ramadhany, which are “Janda Sungai Gayam” and “Perempuan Bisu dan Cermin Ratu”. The perspective utilized in this study is the myth of beauty by Naomi Wolf. The results are: (1) both the short stories illustrate standards of beauty identified by long black hair, long neck, sensual lips, body fragrant, white-toned-smooth-skin, and slim body; (2) in both short stories, the quality of beauty refers to behaviors that could arouse an excitement rather than merely consider physical appearance;(3) regarding beauty not as an intrinsic quality, it is affected by external factors, for instance cosmetic and supernatural powers. Myth of beauty in both short stories stands on the runway of men’s interest and taste, and women’s motive toachieve resources provided by men, which are called loyalty, recognition, praise and charm.Kajian ini mengangkat isu mitos kecantikan dalam cerpen-cerpen Dwi Ratih Ramadhany, yakni "Janda Sungai Gayam” dan “Perempuan Bisu dan Cermin Ratu”. Perspektif yang digunakan adalah mitos kecantikan Naomi Wolf. Hasilnya antara lain: (1) kedua cerpen tersebut menggambarkan bahwa cantik memiliki standar baku rambut hitam panjang, leher jenjang, bibir merekah, tubuh wangi, kulit kencang-putih-mulus, dan langsing; (2) dalam cerpen-cerpen tersebut, sesungguhnya kualitas cantik lebih merujuk pada perilaku yang dapat membangkitkan gairah daripada penampakan fisik; (3) karena cantik bukan merupakan kualitas instrinsik, ia dipengaruhi oleh faktor-faktor eksternal, yaitu kosmetik dan kekuatan supranatural. Mitos kecantikan dalam kedua cerpen tersebut berdiri di atas landasan kepentingan dan selera laki-laki, serta motif perempuan untuk mendapatkan sumber daya yang disediakan oleh laki-laki, yaitu kesetiaan, pengakuan, pujian, dan keterpesonaan.
Filtration Markers as Predictors of ESRD and Mortality: Individual Participant Data Meta-Analysis
Authors: Inker Lesley A. , Coresh Josef , Sang Yingying , Hsu Chi-yuan , Foster Meredith C. , Eckfeldt John H. , Karger Amy B. , Nelson Robert G. , Liu Xun , Sarnak Mark , Appel Lawrence J. , Grams Morgan , Xie Dawei , Kimmel Paul L. , Feldman Harold , Ramachandran Vasan , Levey Andrew S. ,   for the CKD Biomarkers Consortium
Published: November 2016

Background and objectives

Serum β-trace protein (BTP) and β-2 microglobulin (B2M) are associated with risk of ESRD and death in the general population and in populations at high risk for these outcomes (GP/HR) and those with CKD, but results differ among studies.

Design, setting, participants, & measurements

We performed an individual patient-level meta-analysis including three GP/HR studies (n=17,903 participants) and three CKD studies (n=5415). We compared associations, risk prediction, and improvement in reclassification of eGFR using BTP (eGFRBTP) and B2M (eGFRB2M) alone and the average (eGFRavg) of eGFRBTP, eGFRB2M, creatinine (eGFRcr), and cystatin C (eGFRcys), to eGFRcr, eGFRcys, and their combination (eGFRcr-cys) for ESRD (2075 events) and death (7275 events).

Results

Mean (SD) follow up times for ESRD and mortality for GP/HR and CKD studies were 13 (4), 6.2 (3.2), 14 (5), and 7.5 (3.9) years, respectively. Compared with eGFRcr, eGFRBTP and eGFRB2M improved risk associations and modestly improved prediction for ESRD and death even after adjustment for established risk factors. eGFRavg provided the most consistent improvement in associations and prediction across both outcomes and populations. Assessment of heterogeneity did not yield clinically relevant differences. For ESRD, addition of albuminuria substantially attenuated the improvement in risk prediction and risk classification with novel filtration markers. For mortality, addition of albuminuria did not affect the improvement in risk prediction with the use of novel markers, but lessened improvement in risk classification, especially for the CKD cohort.

Conclusions

These markers do not provide substantial additional prognostic information to eGFRcr and albuminuria, but may be appropriate in circumstances where eGFRcr is not accurate or albuminuria is not available. Educational efforts to increase measurement of albuminuria in clinical practice may be more cost-effective than measurement of BTP and B2M for improving prognostic information.
Integrating Quality Improvement Education into the Nephrology Curricular Milestones Framework and the Clinical Learning Environment Review
Authors: Prince Lisa K. , Little Dustin J. , Schexneider Katherine I. , Yuan Christina M.
Published: November 2016

The Accreditation Council for Graduate Medical Education requires that trainees show progressive milestone attainment in the practice–based learning and systems–based practice competencies. As part of the Clinical Learning Environment Review, sponsoring hospitals must educate trainees in health care quality improvement, provide them with specialty–specific quality data, and ensure trainee participation in quality improvement activities and committees. Subspecialty–specific quality improvement curricula in nephrology training programs have not been reported, although considerable curricular and assessment material exists for specialty residencies, including tools for assessing trainee and faculty competence. Nephrology–specific didactic material exists to assist nephrology fellows and faculty mentors in designing and implementing quality improvement projects. Nephrology is notable among internal medicine subspecialties for the emphasis placed on adherence to quality thresholds—specifically for chronic RRT shown by the Centers for Medicare and Medicaid Services Quality Incentive Program. We have developed a nephrology-specific curriculum that meets Accreditation Council for Graduate Medical Education and Clinical Learning Environment Review requirements, acknowledges regulatory quality improvement requirements, integrates with ongoing divisional quality improvement activities, and has improved clinical care and the training program. In addition to didactic training in quality improvement, we track trainee compliance with Kidney Disease Improving Global Outcomes CKD and ESRD quality indicators (emphasizing Quality Improvement Program indicators), and fellows collaborate on a yearly multidisciplinary quality improvement project. Over the past 6 years, each fellowship class has, on the basis of a successful quality improvement project, shown milestone achievement in Systems-Based Practice and Practice-Based Learning. Fellow quality improvement projects have improved nephrology clinical care within the institution and introduced new educational and assessment tools to the training program. All have been opportunities for quality improvement scholarship. The curriculum prepares fellows to apply quality improvement principals in independent clinical practice—while showing milestone advancement and divisional compliance with Clinical Learning Environment Review requirements.
Cidade, cultura e desenvolvimento: perspectivas e desafios para a economia cultural-criativa do samba-carnaval carioca
Authors: Grand Jr. João
Published: November 2016

O artigo discute as perspectivas de mobilização produtiva das culturas do samba e do carnaval na cidade do Rio de Janeiro à luz da atual agenda da economia criativa. A partir das noções de sistemas territoriais de produção (Maillat, 2002) e de ativos e recursos específicos (Pecqueur e Colletis, 2005), analisamos o papel do samba-carnaval como catalisador de interações estratégico para as dinâmicas de desenvolvimento territorial. Debatemos ainda, em linhas gerais, algumas das contradições derivadas das formas de apropriação do samba-carnaval no atual projeto de cidade e seus possíveis efeitos sobre as dinâmicas da criatividade social local. City, culture and development: prospects and challenges for the cultural and creative economy of Rio's samba carnival AbstractThe aim of this article is to discuss the prospects for productive mobilization of the cultures of samba and carnival in the city of Rio de Janeiro considering the current agenda of the creative economy. In view of the notions of territorial production systems (Maillat, 2002) and specific assets and resources (Pecqueur and Colletis, 2005), this study analyzes the role of samba carnival as a strategic catalyst for interactions to promote the dynamics of territorial development. Besides that, the article discusses some of the contradictions derived from forms of samba carnival appropriation in the current city planning and its possible effects on the dynamics of local social creativity.
O perfil do consumidor criativo
Authors: Chammas Adriana
Published: November 2016

A economia criativa desponta como a terceira maior indústria no cenário mundial. Relacionada à inovação, é fundamentada no poder intelectual, no desenvolvimento sustentável e na propulsão de talentos individuais. Com os avanços da tecnologia, a comunicação entre os consumidores (usuários) transformou o mercados e comportamentos. O consumo colaborativo evidencia essa alteração ao apontar para as modificações nesse cenário, onde consumidores (usuários) utilizam a tecnologia associada à criatividade para fazer amizades, gerar renda, criar empregos e economizar. O objetivo desse artigo é identificar o perfil do consumidor (usuário) na economia criativa atual, influenciado pelos canais de comunicação digitais e pelos avanços do consumo colaborativo. Além disso, pretende-se mapear algumas das motivações diretas dos consumidores na economia criativa atual e identificar tendências de negócios que se dediquem a explorá-las. The Creative Consumer Profile Abstract The creative economy has emerged as the third largest industry in the world scenario. Related to innovation, it is based on the intellectual power, sustainable development and individual talents. With advances in technology, communication between consumers (users) changed markets and behaviors. The collaborative consumption shows that by pointing out changes in this scenario, where consumers (users) use the technology associated with creativity to make personal and professional relations, generate income, create jobs and save money. The aim of this paper is identify the user profile in the current creative economy, driven by digital communication channels and the progress of the collaborative consumption.
Foucault as Virtue Ethicist
Authors: Levy Neil
Published: November 2016

In his last two books and in the essays and interviews associated with them, Foucault develops a new mode of ethical thought he describes as an aesthetics of existence. I argue that this new ethics bears a striking resemblance to the virtue ethics that has become prominent in Anglo-American moral philosophy over the past three decades, in its classical sources, in its opposition to rule-based systems and its positive emphasis upon what Foucault called the care for the self. I suggest that seeing Foucault and virtue ethicists as engaged in a convergent project sheds light on a number of obscurities in Foucault's thought, and provides us with a historical narrative in which to situate his claims about the development of Western moral thought.
Summer music and arts festivals as hot spots for measles transmission: experience from England and Wales, June to October 2016
Authors: le Polain de Waroux Olivier , Saliba Vanessa , Cottrell Simon , Young Nick , Perry Malorie , Bukasa Antoaneta , Ramsay Mary , Brown Kevin , Amirthalingam Gayatri
Published: November 2016

We report 52 cases of measles linked to music and arts festivals in England and Wales, between mid-June and mid-October 2016. Nearly half were aged 15 to 19 years. Several individuals who acquired measles at one festival subsequently attended another festival while infectious, resulting in multiple interlinked outbreaks. Transmission within festivals resulted in a geographical spread of cases nationally as well as internationally, which presents particular challenges for measles control.
Décès d'un membre de la société: Dr. Charles Auguste Gauthier
Authors: LeBlond Sylvio
Published: November 2016

Dr. Charles Auguste Gauthier was born in Quebec on March 15, 1901. His father, a doctor, practiced Otorhinolaryngology and ophthalmology. He studied classics at the séminaire de Québec and medicine at Laval. He received his medical degree in 1926. From 1926 to 1932, he specialized in neuropsychiatry in Montreal and then in New York. In 1944, he moved to the Mayo Clinic, and in 1949 in Paris.
Earle Parkhill Scarlett of Calgary: 1896-1982
Authors: Gardner J. S.
Published: November 2016

In the depths of the Depression, a Calgary physician persuaded his clinical group to permit him to create and edit a quarterly journal dedicated to the history of medicine. A more unlikely cause, at a more unpropitious time, in a more unlikely location, could scarcely be imagined. The man was Earle Parkhill Scarlett, the year was 1936, and the journal was the Calgary Associate Clinic Historical Bulletin (CACHB). Despite the precarious times, the enterprise succeeded so well that the CACHB appeared regularly into 1958, at which time Dr. Scarlett retired and decided that he could not maintain the publication.
Saturnism at Hudson's Bay: The York Factory complaint of 1833-1836
Authors: Roland Charles G.
Published: November 2016

The major problem facing historians of clinical medicine is the difficulty of retrospective diagnosis. What disease (or diseases) was the leprosy of the Bible? What was the English “sweating sickness”? What diagnosis should be given for the mysterious mal de la Baie St. Paul that ravaged rural Quebec in the 1780's? The problem arises for many reasons. Some diseases have changed over the years: long before the advent of antibiotics, scarlet fever began to be less fatal and less severe amongst survivors. Syphilis, although still a serious disorder, certainly is a different disease now than it was when it devastated Western Europe in the 1490's, killing thousands. But most diseases probably have changed infrequently within historical times.
Medicinal leeching: The golden age
Authors: Payton B.W.
Published: November 2016

Prior to the 19th century information that would allow one to judge how widespread or frequent the use of leeches in medical treatment is very sparse. Some ideas may be gained from the emphasis or inclusion of the topic in medical and surgical texts of the times. In this respect surgical works are the more informative. It was often the case that surgeons would be called upon by physicians to carry out bloodletting procedures, particularly as physicians were frequently forbidden by their codes of conduct to engage in practices that involved cutting. Earlier western medical works by physicians are philosophical in nature and mere regurgitations of Hippocratic and Galenic theory; surgeons were more practical.
The anterior temporal artery: an underutilized but robust donor for revascularization of the distal middle cerebral artery
Authors: Tayebi Meybodi Ali , Lawton Michael T. , Griswold Dylan , Mokhtari Pooneh , Payman Andre , Benet Arnau
Published: November 2016

OBJECTIVE

The anterior temporal artery (ATA) supplies an area of the brain that, if sacrificed, does not cause a noticeable loss of function. Therefore, the ATA may be used as a donor in intracranial-intracranial (IC-IC) bypass procedures. The capacities of the ATA as a donor have not been studied previously. In this study, the authors assessed the feasibility of using the ATA as a donor for revascularization of different segments of the distal middle cerebral artery (MCA).

METHODS

The ATA was studied in 15 cadaveric specimens (8 heads, excluding 1 side). First, the cisternal segment of the artery was untethered from arachnoid adhesions and small branches feeding the anterior temporal lobe and insular cortex, to evaluate its capacity for a side-to-side bypass to insular, opercular, and cortical segments of the MCA. Any branch entering the anterior perforated substance was preserved. Then, the ATA was cut at the opercular-cortical junction and the capacity for an end-to-side bypass was assessed.

RESULTS

From a total of 17 ATAs, 4 (23.5%) arose as an early MCA branch. The anterior insular zone and the frontal parasylvian cortical arteries were the best targets (in terms of mobility and caliber match) for a side-to-side bypass. Most of the insula was accessible for end-to-side bypass, but anterior zones of the insula were more accessible than posterior zones. End-to-side bypass was feasible for most recipient cortical arteries along the opercula, except for posterior temporal and parietal regions. Early ATAs reached significantly farther on the insular MCA recipients than non-early ATAs for both side-to-side and end-to-side bypasses.

CONCLUSIONS

The ATA is a robust arterial donor for IC-IC bypass procedures, including side-to-side and end-to-side techniques. The evidence provided in this work supports the use of the ATA as a donor for distal MCA revascularization in well-selected patients.
Ventriculo-ureteral shunt insertion using percutaneous nephrostomy: a novel minimally invasive option in a patient with chronic hydrocephalus complicated by multiple distal ventriculoperitoneal shunt failures
Authors: Pillai Ashok , Mathew Georgie , Nachimuthu Sivasankaran , Kalavampara Sanjeevan Vasudevan
Published: November 2016

The management of ventriculoperitoneal (VP) shunt failure is a common problem in neurosurgical practice. On occasion, extraperitoneal sites for CSF diversion are required when shunting to the peritoneal cavity has failed after multiple attempts. The authors report a novel minimally invasive procedure allowing cannulation of the ureter for the purpose of ventriculo-ureteral (VU) shunting. Sixteen years prior to presentation, this 46-year-old woman had contracted tuberculous meningitis and had chronic hydrocephalus, with multiple distal shunt failures in recent months. A percutaneous nephrostomy was used to pass the distal catheter based on intraoperative retrograde pyelography. Following successful placement of the VU shunt, the patient's hydrocephalus stabilized and she returned to her regular functional status. The only long-term complication noted within 36 months of follow-up was a transient episode of electrolyte disturbance and dehydration associated with a diarrheal illness that responded to adequate hydration and salt supplementation. By its minimally invasive nature, this approach offers a reasonable extraperitoneal alternative after multiple distal shunt catheter failures have occurred.
Trends in surgical treatment of Chiari malformation Type I in the United States
Authors: Wilkinson D. Andrew , Johnson Kyle , Garton Hugh J. L. , Muraszko Karin M. , Maher Cormac O.
Published: November 2016

OBJECTIVE

The goal of this analysis was to define temporal and geographic trends in the surgical treatment of Chiari malformation Type I (CM-I) in a large, privately insured health care network.

METHODS

The authors examined de-identified insurance claims data from a large, privately insured health care network of over 58 million beneficiaries throughout the United States for the period between 2001 and 2014 for all patients undergoing surgical treatment of CM-I. Using a combination of International Classification of Diseases (ICD) diagnosis codes and Current Procedural Terminology (CPT) codes, the authors identified CM-I and associated diagnoses and procedures over a 14-year period, highlighting temporal and geographic trends in the performance of CM-I decompression (CMD) surgery as well as commonly associated procedures.

RESULTS

There were 2434 surgical procedures performed for CMD among the beneficiaries during the 14-year interval; 34% were performed in patients younger than 20 years of age. The rate of CMD increased 51% from the first half to the second half of the study period among younger patients (p < 0.001) and increased 28% among adult patients between 20 and 65 years of age (p < 0.001). A large sex difference was noted among adult patients; 78% of adult patients undergoing CMD were female compared with only 53% of the children. Pediatric patients undergoing CMD were more likely to be white with a higher household net worth. Regional variability was identified among rates of CMD as well. The average annual rate of surgery ranged from 0.8 surgeries per 100,000 insured person-years in the Pacific census division to 2.0 surgeries per 100,000 insured person-years in the East South Central census division.

CONCLUSIONS

Analysis of a large nationwide health care network showed recently increasing rates of CMD in children and adults over the past 14 years.
Promotion of astrocytoma cell invasion by micro RNA–22 targeting of tissue inhibitor of matrix metalloproteinase–2
Authors: Ohnishi Yu-ichiro , Iwatsuki Koichi , Ishihara Masahiro , Ohkawa Toshika , Kinoshita Manabu , Shinzawa Koei , Fujimoto Yasunori , Yoshimine Toshiki
Published: November 2016

OBJECTIVE

Diffuse astrocytomas (DAs) have a high recurrence rate due to diffuse infiltration into the brain and spinal cord. Micro RNAs (miRNAs) are small noncoding RNAs that regulate gene expression by binding to complementary sequences of target messenger RNA (mRNA). It has been reported that miRNA-22 (miR-22) is involved in the invasion of some cancer cell lines. The aim of this study was to identify the biological effects of miR-22 in regard to the invasion of human DAs.

METHODS

The authors evaluated whether the level of miR-22 is elevated in human spinal DAs by using miRNA chips. Next, the role of miR-22 in 1321N1 human astrocytoma cells was investigated. Finally, to elucidate whether miR-22 promotes invasion by astrocytoma cells in vivo, the authors transplanted miR-22 overexpressed astrocytoma cells into mouse thoracic spinal cord.

RESULTS

The miR-22 significantly upregulated the invasion capacity of 1321N1 cells. Computational in silico analysis predicted that tissue inhibitor of matrix metalloproteinase–2 (TIMP2) is a target gene of miR-22. This was confirmed by quantitative reverse transcription polymerase chain reaction and Western blotting, which showed that miR-22 inhibited TIMP2 mRNA and protein expression, respectively. Luciferase reporter assays demonstrated that miR-22 directly bound the 3′-untranslated regions of TIMP2. The authors further showed that miR-22 promoted invasiveness in 1321N1 astrocytoma cells when transplanted into mouse spinal cord.

CONCLUSIONS

These data suggest that miR-22 acts to regulate invasion of 1321N1 astrocytoma cells by targeting TIMP2 expression. Additional studies with more cases and cell lines are required to elucidate the findings of this study for a novel treatment target for spinal DAs.