bluuebunny/crossref_metadata_2025 huggingface dataset:
Translating a National Laboratory Strategic Plan into action through SLMTA in a district hospital laboratory in Botswana
Authors: Ntshambiwa Keoratile , Ntabe-Jagwer Winnie , Kefilwe Chandapiwa , Samuel Fredrick , Moyo Sikhulile
Published: November 2014

Background: The Ministry of Health (MOH) of Botswana adopted Strengthening Laboratory Management Toward Accreditation (SLMTA), a structured quality improvement programme, as a key tool for the implementation of quality management systems in its public health laboratories. Coupled with focused mentorship, this programme aimed to help MOH achieve the goals of the National Laboratory Strategic Plan to provide quality and timely clinical diagnosis.Objectives: This article describes the impact of implementing SLMTA in Sekgoma Memorial Hospital Laboratory (SMHL) in Serowe, Botswana.Methods: SLMTA implementation in SMHL included trainings, improvement projects, site visits and focused mentorship. To measure progress, audits using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist were conducted at baseline and exit of the programme, with scores corresponding to a zero- to five-star scale.Turnaround times and customer satisfaction were tracked.Results: The laboratory scored 53% (zero stars) at the baseline audit and 80% (three stars) at exit. Nearly three years later, the laboratory scored 85% (four stars) in an official audit conducted by the African Society for Laboratory Medicine. Turnaround times became shorter after SLMTA implementation, with reductions ranging 19% to 52%; overall patient satisfaction increased from 56% to 73%; and clinician satisfaction increased from 41% to 72%. Improvements in inventory management led to decreases in discarded reagents, reducinglosses from US $18 000 in 2011 to $40 in 2013.Conclusion: The SLMTA programme contributed to enhanced performance of the laboratory,which in turn yielded potential positive impacts for patient care at the hospital.
Using standard and institutional mentorship models to implement SLMTA in Kenya
Authors: Makokha Ernest P. , Mwalili Samuel , Basiye Frank L. , Zeh Clement , Emonyi Wilfred I. , Langat Raphael , Luman Elizabeth T. , Mwangi Jane
Published: November 2014

Background: Kenya is home to several high-performing internationally-accredited research laboratories, whilst most public sector laboratories have historically lacked functioning quality management systems. In 2010, Kenya enrolled an initial eight regional and four national laboratories into the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme. To address the challenge of a lack of mentors for the regional laboratories, three were paired, or ‘twinned’, with nearby accredited research laboratories to provide institutional mentorship, whilst the other five received standard mentorship.Objectives: This study examines results from the eight regional laboratories in the initial SLMTA group, with a focus on mentorship models.Methods: Three SLMTA workshops were interspersed with three-month periods of improvement project implementation and mentorship. Progress was evaluated at baseline, mid-term, and exit using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) audit checklist and scores were converted into a zero- to five-star scale.Results: At baseline, the mean score for the eight laboratories was 32%; all laboratories were below the one-star level. At mid-term, all laboratories had measured improvements. However, the three twinned laboratories had increased an average of 32 percentage points and reached one to three stars; whilst the five non-twinned laboratories increased an average of 10 percentage points and remained at zero stars. At exit, twinned laboratories had increased an average 12 additional percentage points (44 total), reaching two to four stars; non-twinned laboratories increased an average of 28 additional percentage points (38 total), reaching one to three stars.Conclusion: The partnership used by the twinning model holds promise for future collaborations between ministries of health and state-of-the-art research laboratories in their regions for laboratory quality improvement. Where they exist, such laboratories may be valuable resources to be used judiciously so as to accelerate sustainable quality improvement initiated through SLMTA.
Decentralised facility-based training as an alternative model for SLMTA implementation: The Cameroon experience
Authors: Ndasi Juliana , Dimite Laura , Mbome Victor , Awasom Charles , Ngale Elive , Akuro Sidney , Leonard Ewane , Bolu Omotayo , Asong Terrence , Njukeng Patrick , Shang Judith
Published: November 2014

Background:The Strengthening Laboratory Management Toward Accreditation (SLMTA) programme is designed to build institutional capacity to help strengthen the tiered laboratorysystem. Most countries implement the SLMTA three-workshop series using a centralised model, whereby participants from several laboratories travel to one location to be trained together.Objectives: We assessed the effectiveness and cost of conducting SLMTA training in adecentralised manner as compared to centralised training.Methods: SLMTA was implemented in five pilot laboratories in Cameroon between October 2010 and October 2012 by means of a series of workshops, laboratory improvement projects and on-site mentorship. The first workshop was conducted in the traditional centralised approach. The second and third workshops were decentralised, delivered on-site at each of the five enrolled laboratories. Progress was monitored by repeated audits using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist.Results: Audit scores for all laboratories improved steadily through the course of the programme. Median improvement was 11 percentage points after the first (centralised) training and an additional 24 percentage points after the second (decentralised) training. Estimated per-laboratory cost of the two training models was approximately the same at US$21 000. However, in the decentralised model approximately five times as many staff members were trained, although it also required five times the amount of trainer time.Conclusion: Decentralised SLMTA training was effective in improving laboratory qualityand should be considered as an alternative to centralised training.
Imaging in pancreatic transplants
Authors: Heller Matthew T , Bhargava Puneet
Published: November 2014

Pancreatic transplantation, performed alone or in conjunction with kidney transplantation, is an effective treatment for advanced type I diabetes mellitus and select patients with type II diabetes mellitus. Following advancements in surgical technique, postoperative management, and immunosuppression, pancreatic transplantation has significantly improved the length and quality of life for patients suffering from pancreatic dysfunction. While computed tomography (CT) and magnetic resonance imaging (MRI) have more limited utility, ultrasound is the preferred initial imaging modality to evaluate the transplanted pancreas; gray-scale assesses the parenchyma and fluid collections, while Doppler interrogation assesses vascular flow and viability. Ultrasound is also useful to guide percutaneous interventions for the transplanted pancreas. With knowledge of the surgical anatomy and common complications, the abdominal radiologist plays a central role in the perioperative and postoperative evaluation of the transplanted pancreas.
Education and Gender
Authors: Dhar Debotri
Published: October 2014

Education and Gender draws on international research from the USA, the UK, India, Mexico, Sub-Saharan Africa and the Caribbean, to provide a comprehensive global overview of the relationship between gender and education. Rooting constructions of gender and sexuality in specific geographical contexts, the contributors consider a range of issues. Themes discussed include the gender gap in educational attainment; pedagogical strategies; stereotyping in curricula; and education policy. Drawing on best practices worldwide, the contributors identify the current gaps and propose solutions to promote gender-just, equitable and pluralistic societies. Each chapter includes key questions to encourage active engagement with the subject and a list of further reading to support taking the exploration further.
Thin current sheets with strong bell-shape guide field: Cluster observations and models with beams
Authors: Vasko I. Y. , Artemyev A. V. , Petrukovich A. A. , Malova H. V.
Published: October 2014

Abstract. We study the kinetic structure of intense ion-scale current sheets with strong electron currents and the guide field having a bell-shape profile. We consider four crossings of the Earth magnetotail current sheet by the Cluster mission in 2003. The thickness of these current sheets is about the ion inertial length and significantly smaller than the characteristic ion gyroradius. We analyze the asymmetry of the electron velocity distribution functions and show that the electron current is provided by the small electron subpopulation interpreted as an electron beam or two counter-streaming electron beams. The beam (counter-streaming beams) has a bulk velocity of the order of the electron thermal velocity and a density (difference of beam densities) of about 1–5% of the plasma density. To describe the observed current sheets we develop a kinetic model with particle beams. The model predicts different thickness of the current sheet for different types of current carriers (one electron beam or two counter-streaming electron beams). The observed ion-scale current sheets can be explained assuming that the current is carried by one electron beam and a co-streaming ion beam. Although the ion beam does not carry a significant current, this beam is required to balance the electron current perpendicular to the current sheet neutral plane. The developed model explains the dominance of the electron current and the ion scales of the current sheets.
Nitrate sources and dynamics in a salinized river and estuary – a δ15N–NO3− and δ18O–NO3− isotope approach
Authors: Xue D. , Boeckx P. , Wang Z.
Published: October 2014

Abstract. To trace NO3− sources and assess NO3− dynamics in salinized rivers and estuaries, three rivers (Haihe River: HH River, Chaobaixin River: CB River and Jiyun River: JY River) and two estuaries (HH Estuary and CJ Estuary) along the Bohai Bay (China) have been selected to determine dissolved inorganic nitrogen (DIN: NH4+, NO2− and NO3−. Upstream of the HH River, NO3− was removed 30.9 ± 22.1% by denitrification, resulting from effects of the floodgate: limiting water exchange with downstream and prolonging water residence time to remove NO3−. Downstream of the HH River NO3− was removed 2.5 ± 13.3% by NO3− turnover processes. Conversely, NO3− was increased 36.6 ± 25.2% by external N source addition in the CB River and 34.6 ± 35.1% by in-stream nitrification in the JY River. The HH and CY Estuaries behaved mostly conservatively excluding the sewage input in the CJ Estuary. Hydrodynamics in estuaries has been changed by the ongoing reclamation projects, aggravating the loss of the attenuation function of NO3− in the estuary.
Partial coupling and differential regulation of biologically and photochemically labile dissolved organic carbon across boreal aquatic networks
Authors: Lapierre J.-F. , del Giorgio P. A.
Published: October 2014

Abstract. Despite the rapidly increasing volume of research on the biological and photochemical degradation of DOC (dissolved organic carbon) in aquatic environments, little is known of the large-scale patterns in biologically and photochemically degradable DOC (BDOC and PDOC, respectively) in continental watersheds, and on the links that exist between these two key properties that greatly influence the flow of carbon from continents to oceans. Here we explored the patterns in the concentrations and proportions of BDOC and PDOC across hundreds of boreal lakes, rivers and wetlands spanning a large range of system trophic status and terrestrial influence, and compared the drivers of these two reactive pools of DOC at the landscape level. Using standardized incubations of natural waters, we found that the concentrations of BDOC and PDOC covaried across all systems studied but were nevertheless related to different pools of dissolved organic matter (DOM; identified by fluorescence analyses) in ambient waters. Concentrations of nutrients and protein-like fluorescent DOM (FDOM) explained nearly half of the variation in BDOC, whereas PDOC was exclusively predicted by DOM optical properties, consistent with the photochemical degradability of specific FDOM pools that we experimentally determined. The concentrations of colored DOM (CDOM), which we use here as a proxy of terrestrial influence, almost entirely accounted for the observed relationship between FDOM and the concentrations of both BDOC and PDOC. The concentrations of CDOM and of the putative biolabile fluorescence component shifted from complete decoupling in clear-water environments to strong coupling in darker streams and wetlands. This suggests a baseline autochthonous BDOC pool fueled by internal production that is gradually overwhelmed by land-derived BDOC as terrestrial influence increases across landscape gradients. The importance of land as a major source of both biologically and photochemically degradable DOC for continental watersheds resulted in a partial coupling of those carbon pools in natural freshwaters, despite fundamental contrasts in terms of their composition and regulation.
Biophsyical constraints on gross primary production by the terrestrial biosphere
Authors: Wang H. , Prentice I. C. , Davis T. W.
Published: October 2014

Abstract. Persistent divergences among the predictions of complex carbon-cycle models include differences in the sign as well as the magnitude of the response of global terrestrial primary production to climate change. Such problems with current models indicate an urgent need to reassess the principles underlying the environmental controls of primary production. The global patterns of annual and maximum monthly terrestrial gross primary production (GPP) by C3 plants are explored here using a simple first-principles model based on the light-use efficiency formalism and the Farquhar model for C3 photosynthesis. The model is driven by incident photosynthetically active radiation (PAR) and remotely sensed green-vegetation cover, with additional constraints imposed by low-temperature inhibition and CO2 limitation. The ratio of leaf-internal to ambient CO2 concentration in the model responds to growing-season mean temperature, atmospheric dryness (indexed by the cumulative water deficit, Δ E) and elevation, based on an optimality theory. The greatest annual GPP is predicted for tropical moist forests, but the maximum (summer) monthly GPP can be as high, or higher, in boreal or temperate forests. These findings are supported by a new analysis of CO2 flux measurements. The explanation is simply based on the seasonal and latitudinal distribution of PAR combined with the physiology of photosynthesis. By successively imposing biophysical constraints, it is shown that partial vegetation cover – driven primarily by water shortage – represents the largest constraint on global GPP.
Global patterns of annual actual evapotranspiration with land-cover type: knowledge gained from a new observation-based database
Authors: Ambrose S. M. , Sterling S. M.
Published: October 2014

Abstract. The process of evapotranspiration (ET) plays a critical role in the earth system, driving key land-surface processes in the energy, water and carbon cycles. Land-cover (LC) exerts multiple controls on ET, yet the global distribution of ET by LC and the related physical variables are poorly understood. The lack of quantitative understanding of global ET variation with LC begets considerable uncertainties regarding how ET and key land-surface processes will change alongside ongoing anthropogenic LC transformations. Here we apply statistical analysis and models to a new global ET database to advance our understanding of how annual actual ET varies with LC type. We derive global fields for each LC using linear mixed effect models (LMMs) that use geographical and meteorological variables as possible independent regression variables. Our inventory of ET observations reveals important gaps in spatial coverage that overlie hotpots of global change. There is a spatial bias of observations towards the mid latitudes, and LCs with large areas in the high latitudes (lakes, wetlands and barren land) are poorly represented. From the distribution of points as well as the uncertainty analysis completed by bootstrapping we identify high priority regions in need of more data collection. Our analysis of the new database provides new insights into how ET varies globally, providing more robust estimates of global ET rates for a broad range of LC types. Results reveal that different LC types have distinct global patterns of ET. Furthermore, zonal ET means among LCs reveal new patterns: ET rates in low latitudinal bands are more sensitive to LC change than in higher latitude bands; LCs with a higher evaporation component show higher variability of ET at the global scale; and LCs with dispersed rather than contiguous global locations have a higher variability of ET at the global scale. Results from this study indicate two major advancements are required to improve our ability to predict how ET will vary with global change. First, further collection of ground truth observations of ET is needed to fill gaps in LC types and spatial location identified in this paper. Second, LC types need to be de-aggregated into finer categories to better characterize ET, to reduce uncertainty and weakened strength to predictor variables, associated by aggregation of heterogeneous LC types into one group; this will require the development of higher-resolution LC databases.
Recent advances and applications of WRF–SFIRE
Authors: Mandel J. , Amram S. , Beezley J. D. , Kelman G. , Kochanski A. K. , Kondratenko V. Y. , Lynn B. H. , Regev B. , Vejmelka M.
Published: October 2014

Abstract. Coupled atmosphere–fire models can now generate forecasts in real time, owing to recent advances in computational capabilities. WRF–SFIRE consists of the Weather Research and Forecasting (WRF) model coupled with the fire-spread model SFIRE. This paper presents new developments, which were introduced as a response to the needs of the community interested in operational testing of WRF–SFIRE. These developments include a fuel-moisture model and a fuel-moisture-data-assimilation system based on the Remote Automated Weather Stations (RAWS) observations, allowing for fire simulations across landscapes and time scales of varying fuel-moisture conditions. The paper also describes the implementation of a coupling with the atmospheric chemistry and aerosol schemes in WRF–Chem, which allows for a simulation of smoke dispersion and effects of fires on air quality. There is also a data-assimilation method, which provides the capability of starting the fire simulations from an observed fire perimeter, instead of an ignition point. Finally, an example of operational deployment in Israel, utilizing some of the new visualization and data-management tools, is presented.
Nonmydriatic Fundus Camera for Diabetic Retinopathy Screening in a Safety Net Hospital: Effectiveness, Prevalence, and Risk Factors
Authors: Schwartz Shulamit , Harasawa Mariana , Baldivieso Valeria , Sabel Allison L. , Mandava Naresh , Quiroz-Mercado Hugo
Published: November 2014

Purpose

To evaluate diabetic retinopathy (DR) prevalence and risk factors, and the effectiveness of nonmydriatic fundus camera as a screening tool for the detection of DR, in a safety net hospital.

Methods

This was a retrospective, population-based, cross-sectional study. Diabetic patients, referred by their primary care physicians to a DR community screening program, were included. A Topcon TRC NW-6S camera was used to obtain 45-degree digital color fundus images. Images were interpreted by retina specialists using a quality rating system. Patients with retinal findings or unreadable photographs were referred for a complete examination. Outcome measures were attendance rates, photograph quality, DR prevalence, and associated risk factors.

Results

A total of 948 diabetic patients were sent for camera screening, with an attendance rate of 65.6%, which increased during the study period. The mean age was 55.8 ± 11.6 years, the majority (56.9%) were Hispanic, and 43.5% were uninsured. Overall photograph quality rating was relatively high, with 81.7% graded as good or fair. Thirty photographs (2.9%) were unreadable. The prevalence of newly diagnosed DR was 11.1%. Independent DR-associated risk factors included Hispanic race (odds ratio [OR] = 2.29), lack of health insurance (OR = 2.49), longer duration of diabetes (OR = 1.07), higher HbA1c levels (OR = 1.19), presence of diabetic complications (OR = 2.93), and lack of previous eye examination (OR = 13.22).

Conclusions

Nonmydriatic fundus camera is an effective and feasible screening tool for the early detection of DR in a safety net institution. It should be considered in areas with limited access to health care to improve quality of care and potentially reduce vision loss rates.
Posterior Polymorphous Corneal Dystrophy Concomitant to Large Colloid Drusen
Authors: Del Turco Claudia , Pierro Luisa , Querques Giuseppe , Gagliardi Marco , Corvi Federico , Manitto Maria Pia , Bandello Francesco M.
Published: November 2014

Purpose

To describe the previously unreported concomitance of 2 uncommon ocular conditions: posterior polymorphous corneal dystrophy (PPCD) and large colloid drusen (LCD).

Methods

A 45-year-old woman underwent a complete ophthalmologic examination with slit-lamp biomicroscopy and blue fundus autofluorescence with spectral-domain optical coherence tomography, as well as complete systemic examination and renal function investigation.

Results

On slit-lamp biomicroscopy, a corneal lesion located at Descemet membrane was observed in the right eye. The clinical features of deep posterior stromal-endothelial linear bands with vesicles and irregular opacities of posterior corneal surface were consistent with the diagnosis of PPCD. Fundus biomicroscopy and blue fundus autofluorescence showed LCD.

Discussions

We report the unusual coexistence of PPCD and LCD in a young, healthy subject. Posterior polymorphous corneal dystrophy and LCD share morphologic similarities and dysfunctions of collagen architecture in the basement membrane layer, which suggests a possible common pathogenic pathway.
Posteriorly Enclavated Iris Claw Intraocular Lens for Aphakia: Long-Term Corneal Endothelial Safety Study
Authors: Anbari Anas , Lake Damian B.
Published: November 2014

Purpose

To report 2 years follow-up experience, corneal endothelial cell loss results, and A constant used in retroiridis-fixated iris-claw aphakic intraocular lens (IOL) secondary implantation to correct aphakia in eyes without adequate capsule support.

Methods

In this prospective, interventional, clinical case series, 16 consecutive eyes of 14 patients (13 adults and 1 child) underwent retroiridis implantation of Artisan iris-claw aphakic IOL (Ophtec BV, Groningen, the Netherlands). Outcome measures included spherical equivalent (SE) of refractive error, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA) expressed as the logarithm of the minimum angle of resolution (logMAR), endothelial cell density (ECD), and complications, including raised intraocular pressure (IOP) and pigment dispersion.

Results

All eyes were followed up for 2 years postoperatively. Postoperative SE of refractive error was between −1.25 and +1.63 D in all eyes at last follow-up. The mean CDVA was 0.27 ± 0.30 logMAR preoperatively and 0.13 ± 0.21 logMAR at 2 years postoperatively (p = 0.0188). Postoperative UDVA mean was 0.31 ± 0.26 logMAR at last follow-up. Preoperative manual ECD mean of 2269 ± 611 cells/mm2 decreased postoperatively to 2002 ± 532 cells/mm2 at 2 years (p = 0.0005) (mean endothelial cell loss of 11.9 ± 2.0%). No intraoperative complications occurred. There was no significant postoperative IOP increase throughout the follow-up. Iris pigment precipitates on the IOLs occurred in 1 eye (6.3%). No other serious complications occurred.

Conclusions

Two-year results show that retroiridis-fixated iris-claw aphakic IOL implantation is an effective and safe method with regards to corneal endothelial cell loss, and a new A constant is suggested.
Direct Complications of the Avalon Bicaval Dual-Lumen Cannula in Respiratory Extracorporeal Membrane Oxygenation (ECMO): Single-Center Experience
Authors: Rubino Antonio , Vuylsteke Alain , Jenkins David P. , Fowles Jo-anne , Hockings Lisen , Valchanov Kamen
Published: October 2014

Purpose

Cannulation for veno-venous extracorporeal membrane oxygenation (VVECMO) may involve a single site when using a dual-lumen cannula. Benefits include a decrease in blood recirculation, easier patient mobilization, and lower risk of dislodgment. We aimed to review all complications related to the cannula.

Methods

The study included all adult patients admitted to a single intensive care unit (ICU), between November 2009 and September 2013, requiring VVECMO in whom an Avalon Cannula was inserted. The list of patients, complications, and patient data were retrieved from the local ECMO database and the intensive care Clinical Information System (CIS).

Results

Seventy two patients were cannulated with an Avalon cannula between November 1, 2009 and September 31, 2013. Forty-four patients had no cannula-related complications. A total of 35 complications were recorded in 28 patients, 6 of whom required further intervention.

Conclusions

Successful cannulation was possible in all patients with the majority of complications graded as minor.
Influence of Different Oxygenator Types on Changing Frequency, Infection Incidence, and Mortality in Ards Patients on Veno-Venous Ecmo
Authors: Robak Oliver , Lakatos Philipp K.S. , Bojic Andja , Hermann Alexander , Laczika Klaus-Felix , Chiari Astrid , Hiesmayr Jörg M. , Staudinger Thomas , Locker Gottfried J.
Published: November 2014

Purpose

Veno-venous extracorporeal membrane oxygenation (vv-ECMO) is pivotal in the treatment of patients suffering from acute respiratory distress syndrome (ARDS). Comparative data with different oxygenator models have not yet been reported. The aim of this retrospective investigation was therefore to assess whether different oxygenator types might influence changing frequency, infection incidence, and mortality in patients on vv-ECMO.

Methods

42 patients undergoing vv-ECMO between 1998 and 2009 were identified. In 20 out of these patients, a polypropylene (PP) microporous hollow fiber membrane oxygenator, and in 22 patients a nonmicroporous polymethylpentene (PMP) diffusion membrane oxygenator was used. Infection incidence, changing frequency, and mortality were documented.

Results

In the PMP group, an oxygenator change was necessary less often than in the PP group (p<0.001). The incidence of bacterial, viral, or fungal growth was similar in the groups, thus independent of the frequency of oxygenator change. Irrespective of the groups, the occurrence of Candida sp. tended to correlate with death (p = 0.06). In general, there was a trend towards a higher infection incidence in the subgroup with pulmonary ARDS (p = 0.07). Moreover, infection incidence was associated with a longer ICU stay (p = 0.03) and longer ECMO therapy (p = 0.03). ICU mortality was lower in the PMP group than in the PP group, although not statistically significant (p = 0.10).

Conclusions

The PMP oxygenator membranes showed benefits with regards to changing frequency, but not infection incidence, length of ICU stay, and length of ECMO therapy. There was a trend towards a lower ICU mortality in patients with PMP oxygenators.
The Optimal Timing to Perform 18F/11C-Choline PET/CT in Patients with Suspicion of Relapse of Prostate Cancer: Trigger PSA versus PSA Velocity and PSA Doubling Time
Authors: Calabria Ferdinando , Rubello Domenico , Schillaci Orazio
Published: November 2014

In the present short communication we considered the main publications focused on trigger prostate-specific antigen (PSA) and PSA kinetics that systematically compared 18F to 11C-choline PET/CT in order to establish the optimal time to perform choline PET/CT in relation to the trigger values and velocity, as well as doubling time of PSA serum levels.
Value of Oncogenes for the Prediction of Brain Metastases at Initial Diagnosis: A Review of Published Data
Authors: Huang Qian , Ouyang Xuenong
Published: November 2014

Identifying cancer patients who are at high risk of developing brain metastases at initial diagnosis and applying effective intervention or monitoring strategies is of vital importance. Recent advances in the biology of brain metastases revealed that some oncogenes from primary tumors may be potential markers for identifying cancer patients likely to metastasize to the brain. We here summarize data on the mechanisms of brain metastases supporting the involvement of oncogene changes in the brain metastatic evolution. We also review the available evidence on clinical studies of oncogenes in the prediction of cancer patients with high incidence of brain metastases.
Development of Web Tools to Predict Axillary lymph Node Metastasis and Pathological Response to Neoadjuvant Chemotherapy in Breast Cancer Patients
Authors: Sugimoto Masahiro , Takada Masahiro , Toi Masakazu
Published: November 2014

Nomograms are a standard computational tool to predict the likelihood of an outcome using multiple available patient features. We have developed a more powerful data mining methodology, to predict axillary lymph node (AxLN) metastasis and response to neoadjuvant chemotherapy (NAC) in primary breast cancer patients. We developed websites to use these tools. The tools calculate the probability of AxLN metastasis (AxLN model) and pathological complete response to NAC (NAC model). As a calculation algorithm, we employed a decision tree–based prediction model known as the alternative decision tree (ADTree), which is an analog development of if-then type decision trees. An ensemble technique was used to combine multiple ADTree predictions, resulting in higher generalization abilities and robustness against missing values. The AxLN model was developed with training datasets (n=148) and test datasets (n=143), and validated using an independent cohort (n=174), yielding an area under the receiver operating characteristic curve (AUC) of 0.768. The NAC model was developed and validated with n=150 and n=173 datasets from a randomized controlled trial, yielding an AUC of 0.787. AxLN and NAC models require users to input up to 17 and 16 variables, respectively. These include pathological features, including human epidermal growth factor receptor 2 (HER2) status and imaging findings. Each input variable has an option of “unknown,” to facilitate prediction for cases with missing values. The websites developed facilitate the use of these tools, and serve as a database for accumulating new datasets.
Predictive SNPs for radiation-induced damage in lung cancer patients with radiotherapy: a potential strategy to individualize treatment
Authors: Huang Qian , Xie Fangwei , Ouyang Xuenong
Published: November 2014

In the treatment of lung cancer, radiotherapy has become one of the most important therapies, despite its sometimes unpredictable side effects. As such, identifying lung cancer patients who are at high risk of developing severe radiation-induced damage (mainly radiation pneumonitis and radiation-induced esophageal toxicity) and applying effect intervention or monitoring techniques are important. Although human diversity to a certain amount is explained by clinical and dosimetric factors, the presence of specific genetic determinants also influences the occurrence of radiation-induced damage. Here we summarize the data on mechanisms of radiation pneumonitis and radiation-induced esophageal toxicity supporting the involvement of variances of genes in the evolution of radiation-induced damage. Furthermore, the available evidence from current clinical studies of genetic polymorphisms for the prediction of radiation pneumonitis and radiation-induced esophageal toxicity is discussed. Eventually, this may help to truly individualize radiotherapy, using a personal genetic profile of the most relevant genes for each lung cancer patient.
Growth trends and relationships with environmental factors for scots pine [Pinus sylvestris (L.)] in Brandemburg
Authors: Pérez P. J. , Kahle H. P. , Spiecker H.
Published: October 2014

Scots pine growth trends have been determined in Brandenburg (eastern Germany) since the early 1960s. We investigated the interactions between recognized causal factors such temperature, precipitation and foliage nutrient contents in Scots pine and radial and height growth. We performed height stem analysis on 63 Scots pine (Pinus sylvestris L.) trees on seven sites from long-term research plots. Variations in the nutritional condition of the seven stands have been recorded by means of needle analysis. The relationship between thermal, mean monthly temperature, and pluvial conditions, total monthly precipitation, and tree radial increments was analysed, using methods of correlation, response function and principal components analysis. Temporal trends of height growth changes in relation to levels of foliar nitrogen and phosphorous contents were analysed. Evapotranspiration index was correlated with height growth deviation values, with indications of different stands behaviour. A distinct rise in N-levels and in the dry weight of needles has become evident. N and P ratio from declining plots was found to have significantly higher values as compared to that from non-declining plots.
Spatial analysis techniques applied in forest ecology: point pattern analyses
Authors: Rozas V. , Camarero J. J.
Published: October 2014

Several methods for analyzing uni- and bivariate point patterns, commonly used in ecology, are reviewed in this work. The refined nearest neighbor method, the Ripley’s K function and the SADIE technique were used to analyze simulated and real spatial point patterns. A random pattern, three clumped patterns with radius of 3, 5 and 10 m, and three random patterns with inhibition distances of 2, 4 and 6 m, were simulated to check the efficiency of the methods. Real patterns were measured in two deciduous forests in the Cantabrian lowlands and a coniferous forest in the Cebollera-Urbión Range. All techniques were able to distinguish between random, clumped and regular patterns. Nearest neighbor method and K function displayed inhibition distances in regular patterns, but K function alone detected the clump size. Juveniles showed clumped spatial patterns, while adults displayed a random distribution. For bivariate analyses, some simulated patterns displayed significant evidence of spatial attraction or repulsion. Real patterns indicated spatial repulsion between juveniles and adults, and attraction between differently sized juveniles. The results were interpreted according to the available information on forest ecology. The use of appropriate methods for edge effect correction, and null models alternative to the complete spatial randomness, is also discussed.
A system of accounts for valuing commercial and environmental public spending effects on mitigation forest fires in Mediterranean areas
Authors: Campos Palacín P. , Oviedo Pro J. L. , Caparrós Gass A.
Published: October 2014

This paper proposes an economic accounting system for measuring the commercial and environmental effects of public spending in mitigation of forest fires in Mediterranean areas. It describes the application of this system (Agroforestry Accounts System) in the Alcornocales Natural Park. The habitat of this natural area is very important for the breeding and recovery of Mediterranean wildlife in danger of extinction or with conservation problems, and is considered by the public visitors and the private owners with a high environmental value. The level of public spending in the fight against forest fires of the Andalucía region (INFOCA) is quite significant in the Alcornocales Natural Park. The reduction of hectares of cork oaks trees destroyed by fire since the introduction of the INFOCA programme and the simultaneous increase in public funding provided for that purpose make it appropriate the design of an accounting tool to conduct an economic analysis of the contribution made by the INFOCA to the total social income generated in the Natural Park. The results make it possible to reach conclusions concerning the benefits of such public spending on society as a whole, which must be gained to offset the cost involved.
The forest incentive policy in Argentina. Case-study: Santiago del Estero
Authors: De Renolfi M. C. , Ortuño Perez S. F.
Published: October 2014

The development of planted forests in Argentina was brought about by a range of State-maintained incentive programmes throughout the 1990s. These initiatives sought to relieve pressure on native forests and reduce dependence on imported wood by subsidising actually attained plantations of fast-growing species. In many regions of the country, the policy generated real and effective responses. There are today over a million hectares of forest under cultivation. The benefits of forest incentives went to waste in the province of Santiago del Estero, however, despite its having a large surface apt for forestry uses in both irrigable and dry areas. There appears to be insufficient information and, therefore, scant producer response to the incentives. Also in evidence is a need to update the value of the subsidy in the light of the realities faced by producers in the province. This paper pursues two aims: (a) to analyse the social and economic consequences of the forest incentive policy at the national level, and (b) to evaluate the response of producers in Santiago del Estero to those incentives.
Contribution of the Forest Map of Spain to the chorology of woody plant species
Authors: Gastón González A. , Soriano Martín C.
Published: October 2014

Usually, common species sites are not thoroughly recorded in floristic studies. This kind of studies frequently focuses on rare species chorology. Woody plant surveys for the whole Spanish territory can be found in Ruiz de la Torre’s Forest Map of Spain. Five chorological maps based on herbarium and floristic publications data have been compared to those obtained from the Forest Map, using a 10 km UTM grid. After joining the maps, 50 to 95% of UTM squares are exclusive Forest Map contributions. Before adding Forest Map data, known distribution areas were at most 50% of the real area. Therefore, the contribution of the Forest Map to the chorology of woody plant species in Spain can be considered of great magnitude.
The Forest Map of Spain 1:200,000. Methodology and analysis of general results
Authors: Ruiz del Castillo y Navascues J. , López Leiva C. , García Viñas J. I. , Villares Muyo J. M. , Tostado Rivera P. , García Rodríguez C.
Published: October 2014

First of all, the main descriptive elements of vegetation used in the Spanish Forest Map on scale 1:200,000 (MFE2C) are put forward. Secondly, this paper includes an explanation of how plant cover maps are a supplementary tool for forest inventories in order to evaluate the actual state of vegetation. As an example, there is a description of characteristics of the current Spanish vegetation regarding the 4 descriptive elements of MFE2C: large climatic domains, structure, evolution level and dominant plant communities.
On some theoretical and practical features of forestal maps
Authors: Montserrat P. , Villar L.
Published: October 2014

The authors comment on the evolution of the Spanish vegetation charts over the XXth century. First of all some forestal maps were published, exclusively based on field work, at an scale of 1:200,000 for some provinces (1930); later, a complete forestal map of Spain (inland and islands) was achieved by Ceballos in 1966 (scale 1:400,000). Following the air photograms interpretation, many other vegetation maps appeared, until the publication of Rivas Martínez’s «Map of vegetation series of Spain» in 1987 (1:400,000). Recently, during the last 20 years, planty of regional and local maps appeared —even at an scale of 1:50,000 or 1:25,000—, but the most important was the new Ruiz de la Torre’s «Forestal map of Spain» at an scale of 1:200,000. This is in our opinion an essential work not only for management purposes but also as a reference for the modern cartography by means of teledetection and numerical information.
Residual nucleus of pinsapo firs extinct in Andalucía during the 20th century
Authors: Soto García D.
Published: October 2014

Eight stenotopes of Abies pinsapo, from Málaga and Cádiz, which were destroyed during the 20th century are described.
Structural diversification in artificial forest stands. Results of experiment plots in eastern Andalusia
Authors: Carreras Egaña C.
Published: October 2014

Results of experiments of diversification of stands of Pinus halepensis Mill. are presented, sixteen years after the plots installation. In the plots strip cuts of differents widths were made in order to begin natural regeneration, and shrub and tree species were introduced by sowing and planting. Differences in survival and growth of the introduced species and the natural regeneration, in relation to canopy gaps dimensions are shown. Sowings below gaps with widths less than one fourth of the stand height turned out to be useless. Gap widths greater than one third of the stand height have permitted acceptable growth of some of the introduced species, a few of them, e.g. Coronilla juncea L, are begining to regenerate. Planted seedlings have presented high percentajes of mortality and very low growth. Viable regeneration of Pinus halepensis has been limited to gaps with diameter greater than stand height. Analogous results obtained in plots on Pinus pinaster stands are also referred.
Physiography potentiality of Spanish fir forests (Abies pinsapo Boiss.) in Andalucía
Authors: Navarro Cerrillo R. Mª. , Lara Fernández A. , Blanco Oyonarte P. , Calzado Martínez C. , López Quintanilla J. , Fernández Cancio A. , Guzmán Álvarez J. R. , Sánchez Salguero R.
Published: October 2014

Spanish fir (Pinsapo) forests (Abies pinsapo Boiss.) are one of the most outstanding formations in the south of Spain. To find out their potentiality, a regression model (MARS®) based on logistic regression has been used. Physiography variables used as predictors were: altitude, insolation, and the Compound Topographic Index. The dependent variable used was the present distribution of the species, for which the largest number possible of locations in their principal nuclei were reviewed, i.e. Sierra de las Nieves (Málaga), and Serranía de Ronda and Grazalema (Málaga-Cádiz). The potentiality model has shown an optimal area of 1,332 ha and a mean potentiality area of 18,048 ha. The distribution pattern obtained was fairly irregular and was adapted to the complex physiography of the mountains in south-eastern Spain. The main inconsistency of the model presented with previous potential vegetation models lay in the absence of Spanish fir forests in the most basal and warmest parts of Yunquera and the Sierra de Grazalema.
The genus Sorbus in Spain
Authors: Oria de Rueda Salgueiro J. A. , Martinez de Azagra Paredes A. , Alvarez Nieto A.
Published: October 2014

Species of the genus Sorbus are studied in Spain, including uses, forestry, conservation and corological, ecological, cultural and linguistics aspects.
Introduction
Authors: Editors SRF
Published: October 2014

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The Territorial Intelligence Process: Ecology of Communication for Development of Hybrid Territories
Authors: Bertacchini Yann , Déprez Paul , Rasse Paul
Published: October 2014

Aims: This article aims providing structural, and deeper, answers to the words used in titled, how “The Territorial intelligence process can be considered as necessary Ecology of Communication for development of “hybrid territories” and because in first part, we have been working, researching, for more decades in territorial intelligence field and secondly, because we have seen from the TICs development that territorial organizations in 21st Century are becoming hybrid, a mix made of physical (geographical) territory and digital territory and call for appropriate path to think about their future. Study design, Methodology & Place and Duration of Study: We illustrate our arguments by drawing on five situations of specific PhD research conducted in the interval from 2000 to 2014 throughout E.U in general and in France, in particularly. Reflecting the past six years, (2008-2014), they were fueled from the exercise of two local mandates. Results & Conclusion: All aspects encountered during these years need extracting additional points for consideration in the future. In conclusion, we propose structural elements for a response, and perhaps, for a future program of hybrid territories to be developed with the help of territorial intelligence process because of exposed territory to an insular development potentially breaking their continuum.
Mathematics Lessons from “A Place of Light”
Authors: Plummer Ashley , Chahine Iman C.
Published: October 2014

A visit to South Africa inspires investigation of the mathematical ideas inherent in the architecture of various dwellings.
Mathematics Teaching as a Narrative Art
Authors: George Michael
Published: October 2014

Mystery and improvisation, tools of the narrative arts, can be incorporated into mathematics instruction to leave a lasting impression.
What is the Best Option?
Authors: Taylor Cynthia , Buchheister Kelley , Jackson Christa
Published: November 2014

This department showcases students' in-depth thinking and work on previously published problems. The November 2013 problem offers elementary school students an opportunity to work with decimals in an authentic problem-solving situation. The questions on the activity sheet will guide students as they determine the cost of three different electric plans during several months.
Building Squares and Discovering Patterns
Authors: Whitin David J. , Whitin Phyllis
Published: November 2014

Encourage fourth graders to engage in rich mathematical tasks with these specific teacher moves that integrate several Standards for Mathematical Practice in meaningful ways.
Motivating Play Using Statistical Reasoning
Authors: Francis Dionne I. Cross , Hudson Rick A. , Lee Mi Yeon , Rapacki Lauren , Vesperman Crystal Marie
Published: November 2014

This project-based unit is designed to support sixth-grade students in authentic inquiry through solving a problem they faced in their school environment.
Using Weather to Teach Graphing
Authors: Lee Mi Yeon
Published: November 2014

This multipurpose activity can be used in STEM education with elementary school students to reinforce scientific concepts of such weather components as temperature, precipitation, clouds, and wind by integrating manipulation of online apps (technology), knowledge of graphing and data analysis (mathematics), and creation of a wind vane (engineering). iSTEM: Integrating Science Technology Engineering in the Mathematics authors share ideas and activities that stimulate student interest in the integrated fields of science, technology, engineering, and mathematics (STEM) in K—grade 6 classrooms.
Estimation of Origin-Destination Trip Matrices for Small Cities
Authors: Novačko Luka , Šimunović Ljupko , Krasić Davor
Published: November 2014

This paper presents a model of data assessment for the requirements of a classical four-step model of traffic demand in individual traffic in small cities. The procedure is carried out by creating an initial origin-destination trip matrix using data from the traffic count and by defining the average rate of trip generation within single households. The research applied fuzzy logic for the correction of the initial trip matrix. The paper also presents the recommendations for defining the borders of traffic zones, as well as the locations of traffic counts. A flowchart has been used to show a summarized presentation of the proposed model. In the last part of the paper the model was tested on an example of a smaller city in the Republic of Croatia.