bluuebunny/crossref_metadata_2025 huggingface dataset:
Allergy Skin Test Responses During Experimental Infection With Respiratory Syncytial Virus
Authors: Lester Mitchell R.
Published: November 2007

Skoner DP, Gentile DA, Angelini B, Doyle WJ. Ann Allergy Asthma Immunol. 2006;96:834–839

PURPOSE OF THE STUDY. To determine if a viral upper respiratory infection affects allergy skin-test responsiveness.

STUDY POPULATION. Sixteen adults experimentally exposed to respiratory syncytial virus (RSV).

METHODS. Subjects without concurrent upper or lower airway disease were cloistered and inoculated with 106 plaque-forming units of RSV type B. Daily physical examination and symptom scores were recorded. Nasal lavages were performed and stored at −70°C for RSV-antigen assay and culture. Blood samples were obtained for immunoglobulin E (IgE) measurement on days 0, 2, 4, 6, 8, 10, and 21. Skin-prick testing was performed for 17 locally relevant aeroallergens and controls on days 0, 3, 6, and 21.

RESULTS. Eight patients had ≥1 positive skin-test result at baseline and were considered atopic. Eleven (5 atopic, 6 nonatopic) had evidence of postinoculation RSV infection. Atopic patients had a higher IgE level at baseline as compared with nonatopic subjects (123 ± 80 vs 45 ± 36 IU/mL; P < .01). There was no change in total IgE level in those in the nonatopic group, but the atopic subjects had a nonsignificant increase in IgE level on days 8 and 10 (146 ± 112 IU/mL). Of the 8 nonatopic patients, only 3 had negative skin-test results to all antigens on all 3 postinoculation test days. The mean number of positive wheal responses to allergens for all patients was 1.7 ± 2.3, 4.4 ± 3.8, 3.6 ± 3.5, and 3.9 ± 3.6 at baseline and days 3, 6, and 21, respectively (P < .01 versus baseline for all pairings). For patients with positive skin-test results at baseline, mean wheal and flare area provoked by those allergens increased after RSV exposure. The increased number of positive responses to skin testing was noted for both seasonal and perennial aeroallergens.

CONCLUSIONS. The results may have some implication in explaining complications of RSV infection such as otitis media, asthma exacerbation, and subsequent development of asthma.

REVIEWER COMMENTS. There has long been a chicken-and-egg question when it comes to RSV infection in childhood and subsequent development of asthma. That is, does RSV predispose to later recurrent wheezing illnesses, or does the predisposition to wheeze lead to worse outcomes with RSV infection? Are children with an atopic predisposition more likely to have a severe RSV infection, or are those with severe infection more likely to develop atopy? This small study did not answer the question, but it provides a hint that RSV infection itself might affect immunologic responsiveness to aeroallergens, at least in the short-term. The study results cannot be extrapolated to make any long-term conclusions. Furthermore, the study was undertaken in healthy adults. It would be unethical to intentionally infect infants and toddlers with RSV at an age when they might be most susceptible to the risks of environmental influences on the development of atopy and to the risks of the infection itself.
Wait-and-See Prescription for the Treatment of Acute Otitis Media: A Randomized Controlled Trial
Authors: Adinoff Allen
Published: November 2007

Spiro DM, Tay KY, Arnold DH, Dziura JD, Baker MD, Shapiro ED. JAMA. 2006;296:1235–1241

PURPOSE OF THE STUDY. Acute otitis media (AOM) is the most common diagnosis for which antibiotics are prescribed for children. Previous trials that have evaluated a “wait-and-see prescription” (WASP) for antibiotics, with which parents are asked not to fill the prescription unless the child either is not better or is worse in 48 hours, have excluded children with severe AOM. None of these trials were conducted in an emergency department. The purpose of this study was to determine if treatment of AOM using a WASP significantly reduces use of antibiotics compared with a standard prescription (SP) and to evaluate the effects of this intervention on clinical symptoms and adverse outcomes related to antibiotic use.

STUDY POPULATION. Children with AOM aged 6 months to 12 years seen in an emergency department in 1 year.

METHODS. A randomized, controlled trial was conducted; patients were randomly assigned to receive either a WASP or an SP. All patients received ibuprofen and otic analgesic drops for use at home. A research assistant who was blinded to group assignment conducted structured telephone interviews 4 to 6, 11 to 14, and 30 to 40 days after enrollment to determine outcomes and monitor filling of the antibiotic prescription and clinical course.

RESULTS. Overall, 283 patients were randomly assigned to either the WASP (n = 138) or SP (n = 145) group. Substantially more parents in the WASP group did not fill the antibiotic prescription (62% vs 13%; P < .001). There was no statistically significant difference between the groups in the frequency of subsequent fever, otalgia, or unscheduled visits for medical care. Within the WASP group, both fever (relative risk: 2.95; 95% confidence interval: 1.75–4.99; P < .001) and otalgia (relative risk: 1.62; 95% confidence interval: 1.26–2.03; P < .001) were associated with filling the prescription.

CONCLUSIONS. The WASP approach substantially reduced unnecessary use of antibiotics in children with AOM seen in an emergency department and may be an alternative to routine use of antimicrobial agents for treatment of such children.

REVIEWER COMMENTS. This study added a few new twists to 2 previous, similar studies: (1) the patients had no previous relationship with the prescribing physician; (2) the patients, overall, were sicker, being seen in an ED; and (3) otic analgesics and ibuprofen were allowed. The use of antibiotics by those in the WASP group was 56% less than those in the SP group. We try in our practice to use a similar approach in our patients who also present with symptoms of acute sinusitis. Still, I wonder how many patients who do not use their prescription just save it for their next episode.
Particulate Levels Are Associated With Early Asthma Worsening in Children With Persistent Disease
Authors: Mahr Todd A.
Published: November 2007

Rabinovitch N, Strand M, Gelfand EW. Am J Respir Crit Care Med. 2006;173:1098–1105

PURPOSE OF THE STUDY. To determine if exposure to particulate matter has immediate effects on asthma control in children with persistent disease.

STUDY POPULATION. Seventy-three schoolchildren (aged 6–13 years) with physician-diagnosed asthma in Denver, Colorado, were studied.

METHODS. Over 2 consecutive winters, the subjects were followed daily. The association among ambient fine-particulate levels, bronchodilator use, and urinary leukotriene E4 levels was assessed.

RESULTS. Fine-particulate concentrations peaked in the morning hours during hours when children were commuting to school. Children with severe asthma had a stronger association (+8.1%) than those with mild-to-moderate disease (+1.6%), with increased bronchodilator usage at school on days with an increase of 1 interquartile range in morning maximum fine-particulate levels. Morning maximum fine-particulate levels were also associated with urinary leukotriene E4 measured during school hours (average increase of 6.2% per interquartile-range increase).

CONCLUSIONS. Peak concentrations of ambient fine particulate are associated with early increases in bronchodilator use and urinary leukotriene E4 levels among children with persistent asthma, despite the use of controller medications.

REVIEWER COMMENTS. Managing patients with asthma requires knowing possible triggers. This study examined the timing of particulate associations with disease control in children with moderate or severe asthma who were taking controller medications. The interval between exposure and initiation of health effects was seen to occur within the first few minutes or hours after exposure. The effects were strongest in children with more severe asthma. This effect plus the increase in urinary leukotriene E4 levels suggest that in children with persistent asthma, particulate exposure may lead to early release of mediators related to asthma worsening. This study suggests that in children with poorly controlled asthma, air-pollution effects (well below National Ambient Air Quality standards) may be observed despite the use of daily controller medications.
Lack of Tolerance to the Protective Effect of Montelukast in Exercise-Induced Bronchoconstriction in Children
Authors: Rangsithienchai Pitud A. , Phipatanakul Wanda
Published: November 2007

de Benedictis FM, del Giudice MM, Forenza N, Decimo F, de Benedictis D, Capristo A. Eur Respir J. 2006;28:291–295

PURPOSE OF THE STUDY. To evaluate montelukast's ability to inhibit exercise-induced bronchoconstriction in children at various time points over a treatment period of 28 days.

STUDY POPULATION. Thirty-two children, ranging in age from 6 to 12 years, with mild-to-moderate asthma.

METHODS. This study was designed as a multicenter, double-blind, randomized, parallel-group, placebo-controlled study. Subjects received either montelukast 5 mg or a placebo given once daily in the evening for 4 weeks. Exercise challenge and a pulmonary-function test were performed at baseline and then again at days 3, 7, and 28.

RESULTS. Montelukast provided significantly more protection against exercise-induced bronchoconstriction than placebo at each time point after treatment began. In addition, there was no significant difference in the percentage decrease of forced expiratory volume in 1 second for each drug at each of the days measured.

CONCLUSIONS. Montelukast provided significant protection for children with mild-to-moderate asthma against exercise-induced bronchoconstriction for a period of 28 days with no tolerance observed to the medication's effects.

REVIEWER COMMENTS. The results of this study parallel those that were run in adults. Montelukast offered effective protection against exercise-induced bronchoconstriction in children as well. The study also confirmed that long-term use is not required for results to be seen, and the protection conferred does not diminish for at least a 28-day period. Longer studies up to ≥12 weeks, paralleling adult studies, are warranted for further evaluation of montelukast's effects. This study was also limited in its sample size and involved only subjects with mild-to-moderate asthma. It would be worthwhile to determine if montelukast would be of the same benefit to severely asthmatic patients. It should be noted that approximately a quarter of the children in the study were taking inhaled steroids on a regular basis, and these patients responded to montelukast in the same way as those who were not on any such medications. This study makes a case for montelukast to be a preferential therapeutic option in children.
Asthma Severity and Atopy: How Clear Is the Relationship?
Authors: Kelso John M.
Published: November 2007

Carroll WD, Lenney W, Child F, et al. Arch Dis Child. 2006;91:405–409

PURPOSE OF THE STUDY. The term “atopy” can refer to allergic conditions such as allergic rhinitis, asthma, eczema, and food allergy, which cluster in families. It can also be defined as the tendency to generate an immunoglobulin E (IgE) response to specific allergens. Is there a relationship between such IgE responses and the severity of asthma?

STUDY POPULATION. The study included 400 children (aged 7–18 years) with asthma (documented episodes of wheezing in the previous 12 calendar months and physician diagnosis).

METHODS. Patients completed a standardized observer-administered International Study of Asthma and Allergies in Childhood questionnaire and underwent baseline spirometry, skin-prick testing (SPT) to dust mites, grass mix, cat, dog, cockroach and Alternaria, and measurement of total serum IgE level. Atopy was defined as at least 1 SPT wheal >3 mm or a total serum IgE level of >100 IU/mL.

RESULTS. Total IgE was associated with increased asthma-severity score, decreased forced expiratory volume in 1 second (FEV1) (mean IgE with FEV1 < 80% predicted: 812; mean IgE with FEV1 > 80%: 449), and risk of hospital admission (mean IgE with hospitalization in last year: 726; no hospitalization: 392). Increasing skin-prick–test reactivity was associated with increased risk of hospital admission (mean sum of SPT wheals with hospitalization in last year: 12.1 mm; no hospitalization: 6.5 mm).

CONCLUSIONS. In children with asthma, increasing atopy is associated with increasing asthma severity.

REVIEWER COMMENTS. The majority of children with asthma have allergy, and the more allergy they have, the worse their asthma is. This is almost certainly a causal relationship; not surprisingly, inhaling things to which you are allergic can worsen your asthma. This reinforces the importance of assessing the allergic status of all children with asthma and reducing the exposure for those whose allergies are amenable to environmental control (dust mites, furry pets, mold, and cockroach).
The Atopy Patch Test in the Diagnostic Workup of Suspected Food-Related Symptoms in Children
Authors: Nowak-Wegrzyn Anna
Published: November 2007

Mehl A, Rolinck-Werninghaus C, Staden U, et al. J Allergy Clin Immunol. 2006;118:923–929

PURPOSE OF THE STUDY. To determine the utility of atopy patch tests (APTs) in the diagnostic evaluation of food allergy.

STUDY POPULATION. A cohort of 437 children (median age: 13 months; 90% with atopic dermatitis) who were referred for evaluation of suspected food allergy.

METHODS. Specific serum immunoglobulin E (sIgE) measurements, skin-prick tests (SPTs), APTs, and controlled oral food challenges were performed.

RESULTS. The outcomes of 873 oral challenges with cow's milk, hen's egg, wheat, and/or soy were analyzed. One thousand seven hundred single APTs were performed. As a single parameter, the APTs showed the best specificity compared with sIgE measurements, SPTs, or both. Combining the APT with either the SPT or sIgE measurement resulted in improved sensitivity and specificity. Decision points for sIgE measurement and for the SPT showed lower values when combined with a positive APT result. By including the APT in the evaluation, only between 0.5% and 7.0% (99% predicted probability) and between 6% and 14% (using 95% predicted probability) of children would fulfill the criteria for avoiding an oral food challenge.

CONCLUSIONS. Although the predictive capacity of the APT is improved when combined with sIgE measurement or the SPT, oral food challenges become superfluous in only 0.5% to 14.0% of study patients. In addition, the APT is time-consuming and demands a highly experienced test evaluator. For daily clinical practice, the APT adds only a small predictive value to the standard SPT and sIgE measurement in the diagnostic workup of suspected food-related symptoms in children with atopic dermatitis.

REVIEWER COMMENTS. The APT is presumed to reflect late-phase clinical reactions. However, even with late onset of symptoms (>2 hours after food ingestion), the performance of the APT was not consistent in the children with atopic dermatitis. The question that remains unanswered is whether the APT could be used to diagnose non–IgE-mediated gastrointestinal reactions to foods, such as allergic eosinophilic esophagitis/gastroenteritis or food protein–induced enterocolitis syndrome.
Cysteinyl Leukotrienes Regulate Th2 Cell-Dependent Pulmonary Inflammation
Authors: Sharma Hemant P. , Matsui Elizabeth C.
Published: November 2007

Kim DC, Hsu FI, Barrett NA, et al. J Immunol. 2006;176:4440–4448

PURPOSE OF THE STUDY. The cysteinyl leukotrienes (cysLTs), derived from the 5-lipoxygenase pathway, play an important role in asthma as smooth muscle constrictors of airways and microvasculature. This study investigated a potential additional role of cysLTs in T-helper 2 (Th2) cell-dependent pulmonary inflammation using an ovalbumin-sensitization and -challenge protocol with mice that lacked LTC4 synthase (LTC4S), the terminal pathway enzyme for cysLT biosynthesis.

METHODS. LTC4S-null mice and wild-type mice underwent intraperitoneal ovalbumin sensitization, followed on days 40, 43, and 46 by intranasal ovalbumin or saline challenge. Pulmonary histology was examined 48 hours after the last challenge. Total and ovalbumin-specific serum immunoglobulin (Ig) levels, cytokine mRNA expression in the lung, cytokine production by parabronchial lymph node cells after in vitro ovalbumin restimulation, delayed-type hypersensitivity, and airway hyperresponsiveness to methacholine 24 hours after the last challenge were measured also.

RESULTS. In the LTC4S-null mice, antigen-induced pulmonary inflammation (eosinophil infiltration and goblet and mast cell hyperplasia) and airway hyperresponsiveness to methacholine were significantly reduced. In addition, antigen-specific serum immunoglobulin E and G1 and Th2 cell cytokine messenger RNA expression in the lung were reduced in LTC4S-null mice compared with wild-type controls. The production of Th2 cytokines by antigen-restimulated parabronchial lymph node cells from LTC4S-null mice was also significantly reduced compared with those from wild-type controls; however, there was no suppression of cutaneous delayed-type hypersensitivity in LTC4S-null mice.

CONCLUSIONS. These findings support a role for cysLTs in the development and/or amplification of a pulmonary Th2 response.

REVIEWER COMMENTS. Two types of leukotriene-based medications have been used to treat patients with bronchial asthma: (1) leukotriene inhibitors that block the actual synthesis of leukotrienes and (2) leukotriene antagonists that inhibit leukotriene function by blocking leukotriene-receptor sites. Previous studies suggested that the main role of cysLTs was smooth muscle constriction of airways and microvasculature. This study, as well as other growing evidence, points to a unique and broader role for cysLTs in the initiation and amplification of the Th2 response in the lung. Future studies should assess the mechanism of this role, specifically the impact of cysLTs on dendritic-cell and T-cell function. Therefore, the therapeutic benefit of leukotriene antagonists may be additionally derived from this broader physiologic role of cysLTs in pulmonary Th2 responses.
Evaluation and Treatment of Community-Acquired Staphylococcus aureus Infections in Term and Late-Preterm Previously Healthy Neonates
Authors: Fortunov Regine M. , Hulten Kristina G. , Hammerman Wendy A. , Mason Edward O. , Kaplan Sheldon L.
Published: November 2007

OBJECTIVE. We describe the evaluation and treatment of neonatal community-acquired Staphylococcus aureus disease in the era of community-acquired methicillin-resistant S aureus.

METHODS. We retrospectively reviewed the evaluation and treatment of 126 community-acquired S aureus infections of term and late-preterm previously healthy neonates who were ≤30 days of age between August 2001 and July 2006 at Texas Children's Hospital.

RESULTS. S aureus infections included 43 pustulosis, 68 cellulitis/abscess, and 15 invasive infections. We found 84 methicillin-resistant and 42 methicillin-susceptible S aureus isolates. Twenty-one patients received outpatient antibiotics before hospital presentation. Systemic infection evaluation included urine, blood, and cerebrospinal fluid cultures in 79, 102, and 84 neonates, respectively. Culture revealed S aureus urinary tract infections in 1, S aureus bacteremias in 6, and aseptic cerebrospinal fluid pleocytosis of unclear cause in 11 neonates. Physicians admitted 106, transferred 5 to other hospitals, and discharged 15 afebrile patients with topical or oral antibiotics. Clindamycin was the predominant antistaphylococcal intravenous and oral antibiotic for pustulosis and cellulitis/abscess infections. One patient with systemic S aureus and herpes simplex virus infection died. At discharge after inpatient treatment, physicians prescribed no antibiotics for 43 patients and oral or topical antibiotics for 62 patients. Outpatient treatment failed for 1 patient who was discharged after intravenous therapy and was readmitted. Eighty percent (16 of 20) of patients with mastitis alone completed treatment with outpatient oral antibiotics.

CONCLUSIONS. Evaluation and treatment strategies for neonatal community-acquired S aureus disease are varied at our hospital. Prospective studies are needed to determine optimal management strategies.
Guidelines for Adolescent Depression in Primary Care (GLAD-PC): I. Identification, Assessment, and Initial Management
Authors: Zuckerbrot Rachel A. , Cheung Amy H. , Jensen Peter S. , Stein Ruth E.K. , Laraque Danielle ,   and the GLAD-PC Steering Group
Published: November 2007

OBJECTIVES. To develop clinical practice guidelines to assist primary care clinicians in the management of adolescent depression. This first part of the guidelines addresses identification, assessment, and initial management of adolescent depression in primary care settings.

METHODS. By using a combination of evidence- and consensus-based methodologies, guidelines were developed by an expert steering committee in 5 phases, as informed by (1) current scientific evidence (published and unpublished), (2) a series of focus groups, (3) a formal survey, (4) an expert consensus workshop, and (5) draft revision and iteration among members of the steering committee.

RESULTS. Guidelines were developed for youth aged 10 to 21 years and correspond to initial phases of adolescent depression management in primary care, including identification of at-risk youth, assessment and diagnosis, and initial management. The strength of each recommendation and its evidence base are summarized. The identification, assessment, and initial management section of the guidelines includes recommendations for (1) identification of depression in youth at high risk, (2) systematic assessment procedures using reliable depression scales, patient and caregiver interviews, and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria, (3) patient and family psychoeducation, (4) establishing relevant links in the community, and (5) the establishment of a safety plan.

CONCLUSIONS. This part of the guidelines is intended to assist primary care clinicians in the identification and initial management of depressed adolescents in an era of great clinical need and a shortage of mental health specialists but cannot replace clinical judgment; these guidelines are not meant to be the sole source of guidance for adolescent depression management. Additional research that addresses the identification and initial management of depressed youth in primary care is needed, including empirical testing of these guidelines.
Contraception and Adolescents
Authors:   Committee on Adolescence
Published: November 2007

Although adolescent pregnancy rates in the United States have decreased significantly over the past decade, births to adolescents remain both an individual and public health issue. As advocates for the health and well-being of all young people, the American Academy of Pediatrics strongly supports the recommendation that adolescents postpone consensual sexual activity until they are fully ready for the emotional, physical, and financial consequences of sex. The academy recognizes, however, that some young people will choose not to postpone sexual activity, and as health care providers, the responsibility of pediatricians includes helping teens reduce risks and negative health consequences associated with adolescent sexual behaviors, including unintended pregnancies and sexually transmitted infections. This policy statement provides the pediatrician with updated information on contraception methods and guidelines for counseling adolescents.
Role of the Medical Home in Family-Centered Early Intervention Services
Authors:   Council on Children With Disabilities
Published: November 2007

There is growing evidence that early intervention services have a positive influence on the developmental outcome of children with established disabilities as well as those who are considered to be “at risk” of disabilities. Various federal and state laws now mandate the establishment of community-based, coordinated, multidisciplinary, family-centered programs that are accessible to children and families. The medical home, in close collaboration with the family and the early intervention team, can play a critical role in ensuring that at-risk children receive appropriate clinical and developmental early intervention services. The purpose of this statement is to assist the pediatric health care professional in assuming a proactive role with the interdisciplinary team that provides early intervention services.
Writing Buddhist Histories from Landscape and Architecture
Authors: Blackburn Anne M.
Published: November 2007

This essay offers a preliminary account of the ways in which alterations to the landscape of fourteenth- and fifteenth-century Sukhothai and Chiang Mai figured within the micro-politics of these city-states. I show how landscape alterations inspired by Lanka and mainland South Asia served the consolidation and projection of royal power within the context of local and regional competition, and how such alterations formed part of strategic royal engagement with Buddhist monastic lineages.
Bhikkhuni Ordination Debate
Authors: Kawanami Hiroko
Published: November 2007

This paper examines the recent events following the bhikkhuni revival in Sri Lanka, and looks at the position of the Burmese Sangha, which has traditionally seen itself as the custodian of an ‘authentic’ Buddhist legacy, thrown into a debate by the action of a Burmese bhikkhuni who was recently ordained in Sri Lanka. It introduces the early initiatives of revivalist monks in Burma as well as the viewpoints of Burmese Sangha and the nuns in regard to the bhikkhuni issue. Since most debate on the position of nuns take place without much reference to the local political contexts in which they stand, the state monastic organization in Burma is introduced to aid understanding of the framework in which the nuns operate today. At another level, the paper draws attention to the tension created between the international bhikkhunis who promote liberal ideologies of gender equality, individual rights and universalism into a faith based community, and local nuns who adhere to the traditional norms of religious duty, moral discipline and service to the community, and questions the ultimate aim in endorsing such secular ideals.
Donors of Longmen: Faith, Politics, and Patronage in Medieval Chinese Buddhist Sculpture, Amy McNair
Authors: Kieschnick John
Published: November 2007

Donors of Longmen: Faith, Politics, and Patronage in Medieval Chinese Buddhist Sculpture, Amy McNair (Honolulu, HI: University of Hawai’i Press, 2007), 230 pp., $52/£33.50, ISBN 0-8248-2994-8
Brannon Wheeler. Mecca and Eden: Ritual, Relics, and Territory in Islam
Authors: Dickson Rory
Published: November 2007

Brannon Wheeler. Mecca and Eden: Ritual, Relics, and Territory in Islam. Chicago: University of Chicago Press, 2006. xi + 333 p. Paper ISBN 978-0-226-88804-0 US $25.00
John Updike’s Rabbit, Run
Authors: Fekete David J
Published: November 2007

This article considers the powerful role of language and imaginative literature in cultural and self-formation. Drawing on Richard Rorty’s description of narrative forms as vehicles for meaning, I describe leading metaphors in representative literature of the Modern period. I suggest that Modernism exhibits a cultural loss of meaning, and a “death of God” zeitgeist. Works of that period also show pessimism about erotic relationships. I proceed with a close reading of John Updike’s Rabbit, Run, which was written just as the Modern period closes. In Updike, the protagonist intuits a strong spirituality and finds rich erotic experience. But in the wake of Modernism’s spiritual vacuity, and erotic pessimism, the protagonist in Rabbit, Run desperately seeks a vocabulary to voice his intuitions which his own culture cannot sustain.
Tale of Three Women
Authors: Young Susan M
Published: November 2007

Lady Anne Conway (1631–1679) and Margaret Fell Fox (1614–1702) used what Audrey Lorde has called the tools of the Master’s House, in this instance philosophy and religion, as instruments of self-expression and definition rather than silence and oppression. Through rational argument, Conway challenged philosophic and religious positions about the nature of God and his relationship with the natural world. Through disembodied spirit, Fell Fox and the Quakers pushed Protestant doctrine beyond its belief in the authority of the scriptural Word as interpreted by the individual to the authority of Christ speaking within the individual. Drawing on my own experience as both a feminist and a spiritual seeker, I argue that their primary motivation was not political, religious, or social dissent, but rather a determination to walk a radical spiritual path towards self-transformation.
Bad Side to The Good Story
Authors: Vanast Walter
Published: November 2007

Between 1909 and 1913, the Inuit of the Mackenzie Delta (or Eskimos as they were then known) were all baptized and joined the Anglican Church. These conversions were both sudden and surprising given that evangelization had failed for decades. Why conversion happened and how it changed them—as perceived at the time by ethnologist Vilhjalmur Stefansson and Anglican cleric Charles E. Whittaker—is what follows here, drawn primarily from diaries, and archival resources.
Isolation and Molecular Characterization of Cancer Stem Cells in MMTV-Wnt-1 Murine Breast Tumors
Authors: Cho Robert W. , Wang Xinhao , Diehn Maximilian , Shedden Kerby , Chen Grace Y. , Sherlock Gavin , Gurney Austin , Lewicki John , Clarke Michael F.
Published: November 2007

In human breast cancers, a phenotypically distinct minority population of tumorigenic (TG) cancer cells (sometimes referred to as cancer stem cells) drives tumor growth when transplanted into immunodeficient mice. Our objective was to identify a mouse model of breast cancer stem cells that could have relevance to the study of human breast cancer. To do so, we used breast tumors of the mouse mammary tumor virus (MMTV)-Wnt-1 mice. MMTV-Wnt-1 breast tumors were harvested, dissociated into single-cell suspensions, and sorted by flow cytometry on Thy1, CD24, and CD45. Sorted cells were then injected into recipient background FVB/NJ female syngeneic mice. In six of seven tumors examined, Thy1+CD24+ cancer cells, which constituted approximately 1%–4% of tumor cells, were highly enriched for cells capable of regenerating new tumors compared with cells of the tumor that did not fit this profile (“not-Thy1+CD24+”). Resultant tumors had a phenotypic diversity similar to that of the original tumor and behaved in a similar manner when passaged. Microarray analysis comparing Thy1+CD24+ tumor cells to not-Thy1+CD24+ cells identified a list of differentially expressed genes. Orthologs of these differentially expressed genes predicted survival of human breast cancer patients from two different study groups. These studies suggest that there is a cancer stem cell compartment in the MMTV-Wnt-1 murine breast tumor and that there is a clinical utility of this model for the study of cancer stem cells.

Disclosure of potential conflicts of interest is found at the end of this article.
Ex Vivo Culture of Human Cord Blood Hematopoietic Stem/Progenitor Cells Adversely Influences Their Distribution to Other Bone Marrow Compartments After Intra-Bone Marrow Transplantation
Authors: Yamamura Kentaro , Ohishi Kohshi , Masuya Masahiro , Miyata Eri , Sugimoto Yuka , Nakamura Shiho , Fujieda Atsushi , Araki Hiroto , Katayama Naoyuki
Published: November 2007

Intra-bone marrow injection is a novel strategy for hematopoietic stem cell transplantation. Here, we investigated whether ex vivo culture of cord blood hematopoietic stem/progenitor cells influences their reconstitution in bone marrow after intra-bone marrow transplantation. Freshly isolated AC133+ cells or cells derived from AC133+ cells cultured with cytokines (stem cell factor, flt-3 ligand, and thrombopoietin) for 5 days were injected into the bone marrow of the left tibia in irradiated NOD/SCID mice. In the bone marrow of the injected left tibia, the engraftment levels of human CD45+ cells at 6 weeks after transplantation did not differ considerably between transplantation of noncultured and cytokine-cultured cells. However, the migration and distribution of transplanted cells to the bone marrow of other, noninjected bones were extremely reduced for cytokine-treated cells compared with noncultured cells. Similar findings were observed for engraftment of CD34+ cells. Administration of granulocyte colony-stimulating factor to mice after transplantation induced the migration of cytokine-cultured cells to the bone marrow of previously aspirated bone but not to other intact bones. These data suggest that ex vivo manipulation of hematopoietic progenitor/stem cells significantly affects their migration properties to other bone marrow compartments after intra-bone marrow transplantation. Our data raise a caution for future clinical applications of the intra-bone marrow transplantation method using ex vivo-manipulated hematopoietic stem cells.

Disclosure of potential conflicts of interest is found at the end of this article.
Concise Review: Isolation and Characterization of Cells from Human Term Placenta: Outcome of the First International Workshop on Placenta Derived Stem Cells
Authors: Parolini Ornella , Alviano Francesco , Bagnara Gian Paolo , Bilic Grozdana , Bühring Hans-Jörg , Evangelista Marco , Hennerbichler Simone , Liu Bing , Magatti Marta , Mao Ning , Miki Toshio , Marongiu Fabio , Nakajima Hideaki , Nikaido Toshio , Portmann-Lanz C. Bettina , Sankar Venkatachalam , Soncini Maddalena , Stadler Guido , Surbek Daniel , Takahashi Tsuneo A. , Redl Heinz , Sakuragawa Norio , Wolbank Susanne , Zeisberger Steffen , Zisch Andreas , Strom Stephen C.
Published: November 2007

Placental tissue draws great interest as a source of cells for regenerative medicine because of the phenotypic plasticity of many of the cell types isolated from this tissue. Furthermore, placenta, which is involved in maintaining fetal tolerance, contains cells that display immunomodulatory properties. These two features could prove useful for future cell therapy-based clinical applications. Placental tissue is readily available and easily procured without invasive procedures, and its use does not elicit ethical debate. Numerous reports describing stem cells from different parts of the placenta, using nearly as numerous isolation and characterization procedures, have been published. Considering the complexity of the placenta, an urgent need exists to define, as clearly as possible, the region of origin and methods of isolation of cells derived from this tissue. On March 23–24, 2007, the first international Workshop on Placenta Derived Stem Cells was held in Brescia, Italy. Most of the research published in this area focuses on mesenchymal stromal cells isolated from various parts of the placenta or epithelial cells isolated from amniotic membrane. The aim of this review is to summarize and provide the state of the art of research in this field, addressing aspects such as cell isolation protocols and characteristics of these cells, as well as providing preliminary indications of the possibilities for use of these cells in future clinical applications.

Disclosure of potential conflicts of interest is found at the end of this article.
Transforming growth factor-β receptor III downregulation in prostate cancer: is inhibin B a tumor suppressor in prostate?
Authors: Sharifi Nima , Lechleider Robert J , Farrar William L
Published: November 2007

The transforming growth factor-β (TGF-β) pathway plays dual roles in cancer, inhibiting epithelial cell growth under normal physiologic conditions, but promoting invasion and metastasis once growth inhibitory responses are lost. Two recent papers show that TGF-β receptor III is the most common TGF-β pathway component downregulated in prostate cancer. Here, we discuss the implications of these findings and what it may mean about the biology of this disease.
Lap splice over a grouted joint in a lattice girder system
Authors: Lundgren K.
Published: November 2007

Load-carrying in two directions in lattice girder slab systems by complementing with lapped reinforcement across the joints at the construction site was studied. A detailing of load-carrying joints without any reinforcement across the cast joint was considered. The behaviour of the cast joint between the precast concrete and the in situ cast concrete is very important. Two different surface treatments were tested in two types of detail tests of the cast joint: one type in which the cast joint was loaded in shear, and one in tension. Furthermore, the detailing of the joint between two precast concrete panels was tested in bending in full-scale tests. The detail tests were used to calibrate a friction model of the cast joint, which was then used in finite-element analyses (FEAs) of the full-scale tests. In the full-scale tests, the joints were strong enough to carry the applied load; thus, the failure mode was rupture of the reinforcement in all full-scale tests, and only one crack occurred—in the in situ cast concrete above the joint between the precast elements. However, the FEAs of the full-scale tests revealed that the detailing was sensitive to secondary cracking.
Pozzolanic activity tests as a measure of pozzolans' performance. Part 1
Authors: Gava G. P. , Prudêncio L. R.
Published: November 2007

The current methodologies used for the selection and classification of pozzolans present certain chemical and physical requirements that may restrict their use. A good example of this is the use of the pozzolanic activity index as the main parameter in the selection and classification of pozzolans. This is determined by several different methodologies that do not take into account a number of factors that influence pozzolanic reaction. The current paper presents a comparison of the pozzolanic activity index results obtained from several test procedures prescripted by Brazilian, American and British Standards to evaluate three types of pozzolan: fly ash, silica fume and rice-husk ash. Two ordinary Portland cements of different brands were used in the tests. It was noted that in most cases the current standard test procedures led to some distinct and sometimes conflicting results. It is suggested that a complementary investigation is needed to determine which methodologies are most suitable for the selection of pozzolans to be used in mortar and concrete; this is presented in Part 2 of the current paper.
Propagation of flexural and shear cracks through reinforced concrete beams by the bridged crack model
Authors: Carpinteri A. , Carmona J. R. , Ventura G.
Published: November 2007

The bridged crack model has been developed for modelling the flexural behaviour of reinforced concrete beams and related size effects explaining brittle–ductile–brittle failure mode transitions. In the present paper the model is extended to analyse shear cracks, introducing a given shape for the hypothetical crack trajectory and determining the initial crack position and the load plotted against crack length curve for three-point bending problems. The proposed formulation reproduces the pure mode I flexural behaviour as a particular case, so that the flexural and the diagonal tension (shear) failure modes can be immediately compared to detect which one dominates and to determine the relevant failure load. The model can predict all the mutual transitions between the different collapse mechanisms. In the current paper these transitions are shown by varying the governing non-dimensional parameters.
Tie-confined fibre-reinforced high-strength concrete short columns
Authors: Sharma U. K. , Bhargava P. , Sheikh S. A.
Published: November 2007

An experimental study was carried out to investigate the behaviour of steel fibre-reinforced high-strength concrete (HSC) short columns confined by square ties under monotonically increasing concentric compression. A total of 72 confined and 24 unconfined specimens were tested in this test programme. The test variables included aspect ratio and volume fraction of crimped steel fibres, volumetric ratio, yield strength and configuration of transverse tie reinforcement and concrete strength. The effects of these variables on the uniaxial behaviour of HSC short columns are presented and discussed. The results indicate that the addition of fibres to the HSC mix prevented the early spalling of the cover and increased the load-carrying capacity and ductility of the specimens over that of comparable non-fibre columns. The effect of mixed aspect ratio of fibres on the stress–strain behaviour of confined HSC was also studied by blending the short and long fibres. It is shown that a higher gain in column strength can be affected by the addition of shorter fibres, and longer fibres can provide better enhancements in the post-peak deformability.
Assessing the Quality of Dissolved Organic Matter in Forest Soils Using Ultraviolet Absorption Spectrophotometry
Authors: Jaffrain J. , Gérard F. , Meyer M. , Ranger J.
Published: November 2007

Ultraviolet spectrophotometry was used to investigate the effects, 30 yr after planting, of tree species substitution on the aromatic C content and related properties of dissolved organic carbon (DOC). Precautions were taken to correct measurements for the absorbance of NO3 and dissolved Fe. In litter leachates, a significant reduction in the aromatic content of DOC was found in the Douglas‐fir [Pseudotsuga menziesii (Mirb.) Franco] plantation but not in the beech (Fagus sylvatica L.) plantation. The disturbance of short‐term C dynamics thus revealed agreed well with field observations. Significant differences in aromatic content were also found in capillary soil solutions from the two planted stands. Overall, these modifications, produced by the substitution of trees 30 yr previously, mostly concerned the beech plantation. Soil processes, and probably adsorption, played a central role in controlling the quality of DOC in this soil and appeared to be influenced by the species planted. In low‐capillary solutions, located in larger pores, changes to the aromatic content were only detectable in the surface soil of the beech plantation. We found a more pronounced effect of tree substitution in high‐capillary solutions filling soil micropores, where the aromatic content of DOC might be tightly controlled by soil organic matter. It is difficult to say, however, whether the planting of Douglas‐fir had actually accelerated soil recovery, or whether there will be future changes to attain a completely new equilibrium.
Short‐Term Fates of Carbon‐13‐Depleted Cowpea Shoots in No‐Till and Standard Tillage Soils
Authors: Minoshima H. , Jackson L. E. , Cavagnaro T. R. , Ferris H.
Published: November 2007

The fate of C from 13C‐depleted cowpea [Vigna unguiculata (L.) Walp. ssp. unguiculata] shoots was examined to assess factors affecting residue C dynamics in soil cores taken from plots under no‐till (NT) vs. standard tillage (ST). Intact soil cores were incubated in the greenhouse after removing them from field plots, and then 13C‐depleted residue was incorporated at 0‐ to 15‐cm depth in ST cores, or laid on the surface of NT cores. Cores were taken from both the planted and unplanted zones in NT, and from an intermediate position in the ST system, where residues had always been evenly incorporated. Cores without soil were used as a control. After 31 d, more C from the residue was retained as microbial biomass C (MBC) and more nematodes were found in the 0‐ to 15‐cm layer in ST than in NT cores. For NT treatments, after 31 d, higher C from residue was observed in microbial biomass in the 0‐ to 5‐cm layer in cores from planted than in those from the unplanted zones. Despite the low assimilation of newly added residue C in NT soil, similar amounts of CO2 were emitted from ST and NT, probably due to high activity of microbes in the phyllosphere of the residue in NT. In the short term, ST more effectively assimilated shoot residue into soil microbial and nematode C than NT. These results were unexpected given the typical increase in soil C that is observed in the surface layer of NT systems, and suggest that lack of disturbance, changes in microenvironment, or the composition of soil biota in NT must enhance C storage from shoot residue during longer time periods than measured here.
Degradation of Pedogenic Calcretes in West Texas
Authors: Hirmas D. R. , Allen B. L.
Published: November 2007

Calcretes (petrocalcic horizons) are widespread indurated accumulations of carbonate in arid and semiarid regions of the world. Many studies have detailed the formation of these calcretes; however, little direct attention has been given to their degradation. The primary objective of this study was to evaluate the continuity of calcrete on the Llano Estacado as a step toward understanding processes of calcrete degradation across the region. The Llano Estacado is a tableland spanning eastern New Mexico and West Texas with a well‐developed calcrete, known as the “caprock,” exposed as an escarpment around most of its perimeter. We excavated several deep pits along a transect between the caprock on the eastern margin of the Llano Estacado and a similar outcrop on a playa slope. We documented degradation features in the calcrete and compared the extent of degradation with a calcrete in a more arid region (Diablo Plateau). Our findings show a lack of continuity of the calcrete on the Llano Estacado even in a relatively short transect (220 m) between the two outcrops. Individual calcrete fragments showed evidence of partial dissolution. These observations were confirmed in road cuts and pits excavated for road material across the area. Geomorphic position and surface slope control water movement across the landscape and apparently explain both the variation in the presence of degradational features and the distribution of calcrete fragments in the transect. Observations from the more arid Diablo Plateau suggest that calcrete degradation is widespread. The degradation of calcrete on the Llano Estacado makes the caprock unreliable in some areas as a stratigraphic marker in distinguishing the Ogallala and Blackwater Draw Formations.
Rotation Effects of Potato, Maize, and Winter Wheat on Soil Erosion by Water
Authors: Fiener P. , Auerswald K.
Published: November 2007

The effects of cultivating different crops or applying different management practices on water erosion have been widely evaluated in plot or field experiments. While these experiments have focused on the direct effects of a certain crop, there is comparably little information on how crops influence soil loss during the following years. Our objectives were to evaluate the extent to which water erosion differs between potato (Solanum tuberosum L.) and maize (Zea mays L.), and how these crops influence soil loss of a following winter wheat (Triticum aestivum L.) crop. Soil erosion was measured in four small neighboring watersheds (0.8–4.2 ha in size) during 198 rainfall–runoff events (1994–2001). Each watershed included one field with a crop rotation of winter wheat, potato, winter wheat, and maize. This rotation was shifted by 1 yr for each field, and hence a comparison between the fields as well as a comparison over two crop rotations was possible. Runoff and soil loss from potato and maize differed only slightly because the better protection by cover during maize years was compensated by a better protection by contouring with potato ridges. Both effects were adequately described by the cover management and support practice (C and P) factors of the Revised Universal Soil Loss Equation. A clear difference in soil loss depending on the preceding crop occurred in the succeeding winter wheat fields. Especially in October, November, and February, soil loss after the potato crop was significantly higher. This could be explained by little residue cover, disintegration of large aggregates, and low stability of small aggregates following the potato crop. Carryover effects should be taken into account, optimizing crop rotations with respect to soil conservation. Moreover, they are highly relevant for modeling of water erosion from agricultural areas.