bluuebunny/crossref_metadata_2025 huggingface dataset:
Impaired Basophil Induction Leads to an Age-Dependent Innate Defect in Type 2 Immunity during Helminth Infection in Mice
Authors: Nel Hendrik J. , Hams Emily , Saunders Sean P. , Mangan Niamh E. , Smith Philip , Atzberger Ann , Flavell Richard A. , Akira Shizuo , McKenzie Andrew N. , Fallon Padraic G.
Published: March 2011

Parasitic-infection studies on rhesus macaque monkeys have shown juvenile animals to be more susceptible to infection than adults, but the immunological mechanism for this is not known. In this study, we investigated the age-dependent genesis of helminth-induced type 2 immune responses using adult (6–8-wk-old) and juvenile (21–28-d-old) mice. Following infection with the parasitic nematode Nippostrongylus brasiliensis, juvenile mice had increased susceptibility to infection relative to adult mice. Juvenile mice developed a delayed type 2 immune response with decreased Th2 cytokine production, IgE Ab responses, mouse mast cell protease 1 levels, and intestinal goblet cell induction. This innate immune defect in juvenile mice was independent of TLR signaling, dendritic cells, or CD4+ cell function. Using IL-4–eGFP mice, it was demonstrated that the numbers of IL-4–producing basophil and eosinophils were comparable in young and adult naive mice; however, following helminth infection, the early induction of these cells was impaired in juvenile mice relative to older animals. In nonhelminth models, there was an innate in vivo defect in activation of basophils, but not eosinophils, in juvenile mice compared with adult animals. The specific role for basophils in this innate defect in helminth-induced type 2 immunity was confirmed by the capacity of adoptively transferred adult-derived basophils, but not eosinophils, to restore the ability of juvenile mice to expel N. brasiliensis. The defect in juvenile mice with regard to helminth-induced innate basophil-mediated type 2 response is relevant to allergic conditions.
CD5 Promotes IL-10 Production in Chronic Lymphocytic Leukemia B Cells through STAT3 and NFAT2 Activation
Authors: Garaud Soizic , Morva Ahsen , Lemoine Sébastien , Hillion Sophie , Bordron Anne , Pers Jacques-Olivier , Berthou Christian , Mageed Rizgar A. , Renaudineau Yves , Youinou Pierre
Published: March 2011

B lymphocytes from chronic lymphocytic leukemia (CLL) display some CD5 transcripts for CD5 containing the known exon 1 (E1A) and other CD5 transcripts containing the new exon 1 (E1B). These malignant B cells, as well as B cell lines transfected with cDNA for E1A-cd5 or with cDNA for E1B-cd5 produce IL-10, raising the possibility that CD5 participates in the secretion of IL-10. We identified transcription factors involved in this production in CD5+ B lymphocytes from CLL patients and in E1A-cd5–transfected or E1B-cd5–transfected Jok cells. STAT3 is activated via phosphorylation of serine 727 but also NFAT2 through its translocation into the nucleus. Chromatin immunoprecipitation experiments confirmed the role of STAT3 and allowed the discovery of a role for NFAT2 in IL-10 production. Both transcription factors bind not only to the enhancer of the Il-10 gene but also to the promoter of the Il-5 and Il-13 genes. Furthermore, transfection of B cell lines with E1A-cd5 or E1B-cd5 established that activation of STAT3 and NFAT2 is regulated by CD5. The same holds true for the production of IL-10, IL-5, and IL-13 and the expression of the receptors for these cytokines. This interpretation was confirmed by two experiments. In the first, downregulation of CD5 by small interfering RNAs lowered the production of IL-10. In the second experiment, transfection of the GFP-NFAT2 gene into B lymphocytes induced nuclear translocation of NFAT2 in CD5+ but not in CD5− B cells. Thus, CD5 expression is associated with NFAT2 activity (and mildly STAT3 activity), indicating that CD5 controls IL-10 secretion.
Cutting Edge: Ku70 Is a Novel Cytosolic DNA Sensor That Induces Type III Rather Than Type I IFN
Authors: Zhang Xing , Brann Terrence W. , Zhou Ming , Yang Jun , Oguariri Raphael M. , Lidie Kristy B. , Imamichi Hiromi , Huang Da-Wei , Lempicki Richard A. , Baseler Michael W. , Veenstra Timothy D. , Young Howard A. , Lane H. Clifford , Imamichi Tomozumi
Published: March 2011

Cytosolic foreign DNA is detected by pattern recognition receptors and mainly induces type I IFN production. We found that transfection of different types of DNA into various untreated cells induces type III IFN (IFN-λ1) rather than type I IFN, indicating the presence of uncharacterized DNA sensor(s). A pull-down assay using cytosolic proteins identified that Ku70 and Ku80 are the DNA-binding proteins. The knockdown studies and the reporter assay revealed that Ku70 is a novel DNA sensor inducing the IFN-lambda1 activation. The functional analysis of IFNL1 promoter revealed that positive-regulatory domain I and IFN-stimulated response element sites are predominantly involved in the DNA-mediated IFNL1 activation. A pull-down assay using nuclear proteins demonstrated that the IFN-λ1 induction is associated with the activation of IFN regulatory factor-1 and -7. Thus, to our knowledge, we show for the first time that Ku70 mediates type III IFN induction by DNA.
Three Trocars Laparoscopic Resection of Angiomyolipoma of the Liver
Authors: Ramia J. M. , De la Plaza R. , Quiñones J. , Sanchez-Tembleque M. D. , Caminoa A. , Veguillas P. , García Parreño J.
Published: March 2011

Angiomyolipoma of the liver (AML) is an infrequent neoplasm composed of three tissues (adipose, muscle and vessels). In spite of advances in radiology, preoperative correct diagnosis is difficult. Clasically, a conservative management strategy was adopted in patients with asymptomatic tumors less than 5 cm with undoubtful diagnosis. But after publishing some few cases of malignant angiomyolipoma a more radical has been advocated. Laparoscopic resection of liver tumors is becoming a excellent approach for operating on benign liver tumors. Usually is performed using five trocars but in some cases a less invasive technique with three trocars could be used. We present a laparoscopic resection of liver angiomyolipoma in a 65 year-old male using only three trocars and also discuss the optimal management of AML and technical tips of three-trocar technique.
Descriptive currents in philosophy of religion for Hebrew Bible studies
Authors: Gericke Jacobus W.
Published: March 2011

This article argued that the utilisation of philosophy of religion in the study of the Hebrew Bible is possible if we look beyond the stereotype of erroneously equating the auxiliary field with natural theology, apologetics or atheological criticism. Fruitful possibilities for interdisciplinary research are available in the form of descriptive varieties of philosophy of religion primarily concerned with understanding and the clarification of meaning rather than with the stereotypical tasks of propositional justification or critical evaluation. Three examples are discussed in the article: analytic traditions (Wittgensteinianism and ordinarylanguage philosophy), phenomenological perspectives involving reduction (bracketing) and comparative philosophy of religion that works in tandem with the history of religion and comparative religion.
Carbonaceous species in PM2.5 at a pair of rural-urban sites in Beijing, 2005–2008
Authors: Yang F. , Huang L. , Duan F. , Zhang W. , He K. , Ma Y. , Brook J. R. , Tan J. , Zhao Q. , Cheng Y.
Published: March 2011

Abstract. One-week integrated PM2.5 samples were collected at a pair of rural (MY)-urban (TH) sites in Beijing over four years between 2005 and 2008. Weekly OC and EC in PM2.5 were compared to investigate their respective levels and temporal patterns at the two sites, and differences in the factors contributing to them were discussed. A systematic decrease of annual mean concentration of OC and an opposite trend for EC at both sites, and the significantly lower fractions of TCM (total carbonaceous mass) in PM2.5 mass than those measured at TH in 1999, indicate that the relative importance of carbonaceous species in PM2.5 was probably weakened whereas that of EC in TC was steadily enhanced. Clear seasonal variations were found for both OC and EC concentrations (varying seasonally by factors of 1.35~3.0) at TH with higher weekly concentrations and fluctuations in winter and much lower values in summer and spring. The minimum seasonal urban excesses of OC (3.0 μg m−3) and EC (1.2 μg m−3), which were only one-ninth to one-eighth of their corresponding maxima, both occurred in 2008 summer. The noticeably more positive stable carbon isotope values (δ13C) of EC at TH in that summer relative to the preceding summers puts in new evidence that the contribution to carbonaceous particles from mobile sources was substantially reduced due to a concerted effort to reduce emissions from new and existing vehicles before, during and after the Summer Olympics. No consistent seasonal patterns of OC and EC concentrations without strong correlations and their high ratios (OC/EC) at the MY site reflect their complex and variable major sources and formation/production in the rural area compared to the urban area in Beijing, such as biomass burning during the harvest seasons, widely used high-polluting family stoves and small boiler for cooking and heating, and high potential formation of SOA.
Cloud condensation nuclei closure study on summer arctic aerosol
Authors: Martin M. , Chang R. Y.-W. , Sierau B. , Sjogren S. , Swietlicki E. , Abbatt J. P. D. , Leck C. , Lohmann U.
Published: March 2011

Abstract. We present an aerosol – cloud condensation nuclei CCN) closure study on summer high Arctic aerosol based on measurements that were carried out in summer 2008 during the Arctic Summer Cloud Ocean Study (ASCOS) on board the Swedish ice breaker Oden. The data presented here were collected during a three-week time period in the pack ice (>85° N) when the icebreaker Oden was moored to an ice floe and drifted passively during the most biological active period into autumn freeze up conditions. CCN number concentrations were obtained using two CCN counters measuring at different supersaturations. The directly measured CCN number concentration is then compared with a CCN number concentration calculated using both bulk aerosol mass composition data from an aerosol mass spectrometer and aerosol number size distributions obtained from a differential mobility particle sizer, assuming κ-Köhler theory and an internally mixed aerosol. For the two highest measured supersaturations, 0.73 and 0.41%, closure could not be achieved with the investigated settings concerning hygroscopicity and density. The calculated CCN number concentration was always higher than the measured one. One possible explanation is that the smaller particles that activate at these supersaturations have a relative larger insoluble organic mass fraction and thus are less good CCN than the larger particles. At 0.20, 0.15 and 0.10% supersaturation, the measured CCN number can be represented with different parameters for the hygroscopicity and density of the particles. For the best agreement of the calculated CCNnumber concentration with the measured one the organic fraction of the aerosol needs to be nearly insoluble (қorg=0.02). However, this is not unambigious and қorg=0.2 is found as an upper limit at 0.1% supersaturation.
Long-term stability of TES satellite radiance measurements
Authors: Connor T. C. , Shephard M. W. , Payne V. H. , Cady-Pereira K. E. , Kulawik S. S. , Luo M. , Osterman G. , Lampel M.
Published: March 2011

Abstract. The utilization of Tropospheric Emission Spectrometer (TES) Level 2 (L2) retrieval products for the purpose of assessing long term changes in atmospheric trace gas composition requires knowledge of the overall radiometric stability of the Level 1B (L1B) radiances. The purpose of this study is to evaluate the stability of the radiometric calibration of the TES instrument by analyzing the difference between measured and calculated brightness temperatures in selected window regions of the spectrum. The Global Modeling and Assimilation Office (GMAO) profiles for temperature and water vapor and the Real-Time Global Sea Surface Temperature (RTGSST) are used as input to the Optimal Spectral Sampling (OSS) radiative transfer model to calculate the simulated spectra. The TES reference measurements selected cover a 4-year period of time from mid 2005 through mid 2009 with the selection criteria being; observation latitudes greater than −30° and less than 30°, over ocean, Global Survey mode (nadir view) and retrieved cloud optical depth of less than 0.01. The TES cloud optical depth retrievals are used only for screening purposes and no effects of clouds on the radiances are included in the forward model. This initial screening results in over 55 000 potential reference spectra spanning the four year period. Presented is a trend analysis of the time series of the residuals (observation minus calculations) in the TES 2B1, 1B2, 2A1, and 1A1 bands which demonstrates that the trend in the residuals is not significantly different from zero over the 4-year period. This is one method used to demonstrate that the relative radiometric calibration is stable over time, which is very important for any longer term analysis of TES retrieved products (L2) particularly well-mixed species such as carbon dioxide and methane.
Impact of a new condensed toluene mechanism on air quality model predictions in the US
Authors: Sarwar G. , Appel K. W. , Carlton A. G. , Mathur R. , Schere K. , Zhang R. , Majeed M. A.
Published: March 2011

Abstract. A new condensed toluene mechanism is incorporated into the Community Multiscale Air Quality Modeling system. Model simulations are performed using the CB05 chemical mechanism containing the existing (base) and the new toluene mechanism for the western and eastern US for a summer month. With current estimates of tropospheric emission burden, the new toluene mechanism increases monthly mean daily maximum 8-h ozone by 1.0–3.0 ppbv in Los Angeles, Portland, Seattle, Chicago, Cleveland, northeastern US, and Detroit compared to that with the base toluene chemistry. It reduces model mean bias for ozone at elevated observed ozone concentrations. While the new mechanism increases predicted ozone, it does not enhance ozone production efficiency. A sensitivity study suggests that it can further enhance ozone if elevated toluene emissions are present. While it increases in-cloud secondary organic aerosol substantially, its impact on total fine particle mass concentration is small.
Snow cover dynamics and hydrological regime of the Hunza River basin, Karakoram Range, Northern Pakistan
Authors: Tahir A. A. , Chevallier P. , Arnaud Y. , Ahmad B.
Published: March 2011

Abstract. A major proportion of flow in the Indus River is contributed by its snow- and glacier-fed river catchments situated in the Himalaya, Karakoram and Hindukush ranges. It is therefore essential to understand the cryosphere dynamics in this area for water resource management. The MODIS MOD10A2 remote-sensing database of snow cover products from March 2000 to December 2009 was selected to analyse the snow cover changes in the Hunza River basin (the snow- and glacier-fed sub-catchment of the Indus River). A database of daily flows for the Hunza River at Dainyor Bridge over a period of 40 years and climate data (precipitation and temperature) for 10 years from three meteorological stations within the catchment was made available to investigate the hydrological regime in the area. Analysis of remotely sensed cryosphere (snow and ice cover) data showed a slight expansion of snow cover in the area in contrast to most of the regions in the world where glaciers are melting rapidly. This increase in snow cover may be the result of an increase in winter precipitation caused by westerly circulation. The impact of global warming is not effective because a large part of the basin area lies under high altitudes where the temperature remains negative throughout most of the year.
Gravity wave amplification and phase crest re-organization over a shoal
Authors: Jarry N. , Rey V. , Gouaud F. , Lajoie D.
Published: March 2011

Abstract. In this experimental work, both wave amplification and phase evolution, due to a submerged mound, are studied. In addition to the classical surface wave measurements, the experimental study takes advantage of photographs that underline crest re-organization above and down-wave the shoal. In particular, together with wave amplification up to more than twice the incident wave, a wave steepening is observed in certain conditions in both the wave direction and in the cross-section. Due to a phase crest separation downstream of the shoal, steepening in the cross-shore direction is enhanced (up to 30% above the steepening along the main direction of propagation). Physical aspects are discussed through the analysis of the diffraction effects on the wave properties.
Reference Intervals for Serum Alpha-Fetoprotein and Carcinoembryonic Antigen in Chinese Han Ethnic Males from the Fangchenggang Area Male Health and Examination Survey
Authors: Qin Xue , Lin Liwen , Mo Zengnan , Lv Hui , Gao Yong , Tan Aihua , Yang Xiaobo , Li Shan , Zhao Jinmin
Published: March 2011

Objectives

We calculated upper 95% reference limits for serum alpha-fetoprotein (AFP)and carcinoembryonic antigen (CEA) according to the CLSI/NCCLS C28-A3 guideline.

Material and methods

Serum samples from 1400 healthy male subjects were collected from the Fangchenggang Area Male Health and Examination Survey (FAMHES). Serum AFP and CEA values were measured by electrochemiluminescence immunoassay on COBAS 6000 system E601 (Elecsys module) immunoassay analyzers.

Results

Serum AFP and CEA values were not normally distributed but log normally distributed. The upper 95% reference limits of the reference intervals were ≤4.76 IU/mL (nonparametric) or ≤4.56 IU/mL (parametric) for AFP and ≤5.57 ng/mL (nonparametric) or ≤5.82 ng/mL (parametric) for CEA. The distribution of AFP levels was found to be consistent between the non-smoking and smoking (p=0.740) and non-drinking and drinking groups (p=0.698). The distribution of serum CEA levels was significantly higher in the smoking than the non-smoking group (p<105), whereas there was no significant difference in this respect between the non-drinking and drinking groups (p=0.147). A significant increase with age was found both for serum AFP and CEA levels, and the age-dependent reference intervals were calculated.

Conclusions

The reference intervals for serum AFP and CEA show a slight deviation compared to previously reported reference levels. Distinct reference intervals of serum CEA must be established for smoking and non-smoking populations. In addition, age-dependent reference intervals should be implemented in clinical laboratories.
Developing Recommendations for Vascular Access for Hemodialysis: Vascular Access Working Group of the Italian Society of Nephrology
Authors: Tazza Luigi , Mandolfo Salvatore , Carbonari Luciano , Forneris Giacomo , Di Dio Michele , Palumbo Roberto , Gallieni Maurizio , Bonforte Giuseppe , Carnabuci Antonio , Cavatorta Fosco , Aloisi Mauro , Galli Franco
Published: March 2011

This paper presents an overview of the project carried out by the Vascular Access (VA) Working Group of the Italian Society of Nephrology with the aim of developing 4 position papers at the national level on how to choose, use, and implant the different, possible types of vascular access. The topics of the project are: 1) recommendations on the use of prosthetic arteriovenous fistulas for vascular access in hemodialysis, 2) recommendations on the use of venous catheters for hemodialysis, 3) infections induced by a venous catheter for hemodialysis, and 4) how to create and maintain a vascular access for hemodialysis.

This paper also gives an explanation of the difficulties existing in Italy in the implementation of international guidelines, mostly due to significant differences in the procedures for the creation of VA, compared with the countries where most of the literature on the subject has been published. Individual position papers were drafted for each of the different topics. A list of recommendations was produced based on existing guidelines. Then these recommendations were critically reviewed by experts working in Italy, who expressed their opinion on their inclusion in position papers. The working method used to gather the opinions of the various experts is described.

The final target is to provide clinicians interested in VA with updated documents on selected topics. Such documents will be updated periodically, and they will present a thorough overview of expert opinions.
Psalm 29 as Semiotic System: A Linguistic Reading
Authors: Kennedy James M.
Published: March 2011

This study is an attempt to read Psalm 29 through the interpretive lens of insights taken from Czech structuralist and Russian Formalist literary theory. These two perspectives on literature share the theoretical perspective that a poetic work may be analyzed on the analogy of a structuralist approach to the study of a natural language. The article advocates a reading of Psalm 29 in which its own internal structure—its own set (Einstellung)—expresses not so much what it means but how it means.
God-Talk for a Disillusioned Pilgrim in Psalm 121
Authors: Becking Bob
Published: March 2011

In Psalm 121, a post-exilic Psalm of Ascent, a shift is observable from “I”-forms to “you”-forms that refer to the pilgrim. This transition is best explained by (1) interpreting the ‘mountains’ in verse 1 as symbols of threat, (2) construing verse 2 as an expression of traditional faith that has became obsolete, and (3) reading verses 3-8 as Gold-talk by someone else to help the disillusioned pilgrim to cope with the fragility of human life.
Lamentations 5: The Seventh Acrostic
Authors: Guillaume Philippe
Published: March 2011

Six complete alphabetic acrostics structure the first chapters of the book of Lamentations. Midrash Eikhah Rabbah suggests that there are seven acrostics. In the footsteps of Siegfried Bergler and of Azriel Rosenfeld, this article identified another four letters of the puzzle.
In Conversation With Thomas Römer, The So-Called Deuteronomistic History: A Sociological, Historical And Literary Introduction (London: T. & T. Clark, 2005)
Authors: Person Jr. Raymond F. , Nelson Richard D. , McKenzie Steven L. , Otto Eckart , Amit Yairah , Römer Thomas
Published: March 2011

This conversation with Thomas Römer, The So-Called Deuteronomistic History: A Sociological, Historical and Literary Introduction (London: T. & T. Clark, 2005) began in a special session of the Deuteronomistic History section of the Society of Biblical Literature at the SBL annual meeting held in November 2008, in Boston, MA. It includes an introduction by the editor and contributions by Richard Nelson, Steven McKenzie, Eckart Otto, and Yairah Amit. It concludes with a response by Thomas Römer.
אני ולבי - The Syntactic Encoding of the Collaborative Nature of Qohelet's Experiment
Authors: Holmstedt Robert D.
Published: March 2011

The language of the book of Qohelet has both intrigued and frustrated generations of scholars due to its abundant orthographic, morphological, syntactic, and lexical peculiarities. One linguistic feature that has not received proper attention, however, is the presence and syntactic position of the first-person subject pronoun אני, e.g., 1:16דברתי אני עם־לבי. The independent subject pronoun is variously described as pleonastic, a strategy for emphasizing the subject, and a strategy for marking an important narrative point. However, none of these descriptions accurately describe its use in the book, and so in this essay I will address the syntax and function of Qohelet's use of the first-person subject pronouns.
Persian Period Finds from Jerusalem: Facts and Interpretations
Authors: Lipschits Oded
Published: March 2011

The Babylonian, Persian and early Hellenistic periods are unique in the history of Judah. They represent a kind of "interlude" between two periods of greatness and political independence. This article discusses the archaeological finds from Jerusalem in the Persian and Early Hellenistic periods. It includes an assessment of the scope of the built-up area of the city, and an estimate of the city's population, on the basis of the archaeological data. This article's emphasis on the importance of the Ophel hill as the main built-up area in the Persian and Early Hellenistic period is unique in present archaeological and historical research of ancient Jerusalem.
A Response to G. Aichelle, P. Miscall and R. Walsh, “An Elephant in the Room: Historical-Critical and the Postmodern Interpretations of the Bible”
Authors: Van Seters John
Published: March 2011

Van Seters's personal response to the recent article by G. Aichele, P. Miscall and R. Walsh, “An Elephant in the Room: Historical-Critical and Postmodern Interpretations of the Bible” (JBL 128 [2009], pp. 383–404) and to the authors's invitation for a conversation among historical-critical and postmodern biblical scholars.
Arguing under the Qiqayon: An Introduction to a Set of Articles on Jonah
Authors: Guillaume Philippe
Published: March 2011

As per title, an introduction to the following six articles that deal with the Book of Jonah. All but the final essay in the series reflect issues hotly debated at the conference of the European Association of Biblical Studies at Lisbon in August 2008. The final essay (article 9 in this volume of JHS) is based on a paper presented at the Society of Biblical Literature conference at Boston in November 2008.
Jonah 4:11 and the Metaprophetic Character of the Book of Jonah
Authors: Ben Zvi Ehud
Published: March 2011

The present study reaffirms the double ending, and above all, double reading of the book of Jonah. This double reading contributed much to the metaprophetic character of the book of Jonah, by which I mean, a book that—within the discourse of the relevant historical literati—provided a key for, and reflected an understanding of prophetic literature.
Rhetorical Reading Redundant: A Response to Ehud Ben Zvi
Authors: Guillaume Philippe
Published: March 2011

Ehud Ben Zvi's claim, in the preceding article, that the final verse of Jonah must be read both as a question and an affirmation is welcomed. Yet, it is argued here that reading a rhetorical question contributes little to the metaprophetic character of Jonah. In fact, a final rhetorical question destroys the open-endedness of the book while YHWH's unambiguous affirmation that he will show no pity for Nineveh faces readers with a deeper meaning of prophecy. Like the Elohim in chapter 3, Jonah in chapter 4 is invited to come out of the circle of anger. Destructions and reversals of fortune occur, but humans are not privy to the divine council.
The Intertextual Israelite Jonah Face À L’empire: The Post-Colonial Significance of The Book’s Cotexts and Purported Neo-Assyrian Context
Authors: Timmer Daniel
Published: March 2011

Jonah's use of various antecedent HB texts and its purported Neo-Assyrian setting are prominent hermeneutical signposts that are integral to the book. Until now, however, the former question has not received sustained attention and the latter has been obscured by disagreement over the book's historical veracity. This paper broadens the scope of postcolonialist discussion by considering empire through the Israelite perspective that Jonah affords and through the Neo-Assyrian literature dealing with its conquest of nation-states in the first half of the first millennium BCE. Special attention is given to how Jonah the prophet and Jonah the book attribute different identities to the different groups that appear in the book and to the book's intertextual connections to other parts of the Hebrew Bible. The paper closes by reflecting on ways that different means of identification entail different responses to power.
Radiological Incident Preparedness: Planning at the Local Level
Authors: Tan Clive M. , Barnett Daniel J. , Stolz Adam J. , Links Jonathan M.
Published: March 2011

Radiological terrorism has been recognized as a probable scenario with high impact. Radiological preparedness planning at the federal and state levels has been encouraging, but translating complex doctrines into operational readiness at the local level has proved challenging. Based on the authors' experience with radiological response planning for the City of Baltimore, this article describes an integrated approach to municipal-level radiological emergency preparedness planning, provides information on resources that are useful for radiological preparedness planning, and recommends a step-by-step process toward developing the plan with relevant examples from the experience in Baltimore. Local governmental agencies constitute the first line of response and are critical to the success of the operation. This article is intended as a starting framework for local governmental efforts toward developing a response plan for radiological incidents in their communities.

(Disaster Med Public Health Preparedness. 2011;5:S151-S158)
Social, Psychological, and Behavioral Responses to a Nuclear Detonation in a US City: Implications for Health Care Planning and Delivery
Authors: Dodgen Daniel , Norwood Ann E. , Becker Steven M. , Perez Jon T. , Hansen Cynthia K.
Published: March 2011

A nuclear detonation in a US city would have profound psychological, social, and behavioral effects. This article reviews the scientific literature on human responses to radiation incidents and disasters in general, and examines potential behavioral health care provider (BHCP) contributions in the hours and days after a nuclear detonation. In the area directly affected by the blast, the immediate overarching goal of BHCP interventions is the support of lifesaving activities and the prevention of additional casualties from fallout. These interventions include 6 broad categories: promoting appropriate protective actions, discouraging dangerous behaviors, managing patient/survivor flow to facilitate the best use of scarce resources, supporting first responders, assisting with triage, and delivering palliative care when appropriate. At more distant sites, BHCP should work with medical providers to support hospitalized survivors of the detonation. Recommendations are also made on BHCP interventions later in the response phase and during recovery.

(Disaster Med Public Health Preparedness. 2011;5:S54-S64)
Medical Response to a Nuclear Detonation: Creating a Playbook for State and Local Planners and Responders
Authors: Murrain-Hill Paula , Coleman C. Norman , Hick John L. , Redlener Irwin , Weinstock David M. , Koerner John F. , Black Delaine , Sanders Melissa , Bader Judith L. , Forsha Joseph , Knebel Ann R.
Published: March 2011

For efficient and effective medical responses to mass casualty events, detailed advanced planning is required. For federal responders, this is an ongoing responsibility. The US Department of Health and Human Services (DHHS) prepares playbooks with formal, written plans that are reviewed, updated, and exercised regularly. Recognizing that state and local responders with fewer resources may be helped in creating their own event-specific response plans, subject matter experts from the range of sectors comprising the Scarce Resources for a Nuclear Detonation Project, provided for this first time a state and local planner's playbook template for responding to a nuclear detonation. The playbook elements are adapted from DHHS playbooks with appropriate modification for state and local planners. Individualization by venue is expected, reflecting specific assets, populations, geography, preferences, and expertise. This playbook template is designed to be a practical tool with sufficient background information and options for step-by-step individualized planning and response.

(Disaster Med Public Health Preparedness. 2011;5:S89-S97)
Radiation Injury After a Nuclear Detonation: Medical Consequences and the Need for Scarce Resources Allocation
Authors: DiCarlo Andrea L. , Maher Carmen , Hick John L. , Hanfling Dan , Dainiak Nicholas , Chao Nelson , Bader Judith L. , Coleman C. Norman , Weinstock David M.
Published: March 2011

A 10-kiloton (kT) nuclear detonation within a US city could expose hundreds of thousands of people to radiation. The Scarce Resources for a Nuclear Detonation Project was undertaken to guide community planning and response in the aftermath of a nuclear detonation, when demand will greatly exceed available resources. This article reviews the pertinent literature on radiation injuries from human exposures and animal models to provide a foundation for the triage and management approaches outlined in this special issue. Whole-body doses >2 Gy can produce clinically significant acute radiation syndrome (ARS), which classically involves the hematologic, gastrointestinal, cutaneous, and cardiovascular/central nervous systems. The severity and presentation of ARS are affected by several factors, including radiation dose and dose rate, interindividual variability in radiation response, type of radiation (eg, gamma alone, gamma plus neutrons), partial-body shielding, and possibly age, sex, and certain preexisting medical conditions. The combination of radiation with trauma, burns, or both (ie, combined injury) confers a worse prognosis than the same dose of radiation alone. Supportive care measures, including fluid support, antibiotics, and possibly myeloid cytokines (eg, granulocyte colony-stimulating factor), can improve the prognosis for some irradiated casualties. Finally, expert guidance and surge capacity for casualties with ARS are available from the Radiation Emergency Medical Management Web site and the Radiation Injury Treatment Network.

(Disaster Med Public Health Preparedness. 2011;5:S32-S44)
Prenatal Radiation Exposure: Background Material for Counseling Pregnant Patients Following Exposure to Radiation
Authors: Donnelly Elizabeth H. , Smith James M. , Farfán Eduardo B. , Ozcan Ibrahim
Published: March 2011

Fetal sensitivity to radiation-induced health effects is related to gestational age, and it is highly dependent on fetal dose. Typical fetal doses from diagnostic radiology are usually below any level of concern. Although rare, significant fetal radiation doses can result from interventional medical exposures (fluoroscopically guided techniques), radiation therapy, or radiological or nuclear incidents, including terrorism. The potential health effects from these large radiation doses (possibly large enough to result in acute radiation syndrome in the expectant mother) include growth retardation, malformations, impaired brain function, and neoplasia. If exposure occurs during blastogenesis (and the embryo survives), there is a low risk for congenital abnormalities. (In all stages of gestation, radiation-induced noncancer health effects have not been reported for fetal doses below about 0.05 Gy [5 rad].) The additional risk for childhood cancer from prenatal radiation exposure is about 12% per Gy (0.12%/rad) above the background incidence.

(Disaster Med Public Health Preparedness. 2011;5:62-68)
Rural and Suburban Population Surge Following Detonation of an Improvised Nuclear Device: A New Model to Estimate Impact
Authors: Meit Michael , Redlener Irwin , Briggs Thomas W. , Kwanisai Mike , Culp Derrin , Abramson David M.
Published: March 2011

Background: The objective of the study was to model urban evacuation into surrounding communities after the detonation of an improvised nuclear device (IND) to assist rural and suburban planners in understanding and effectively planning to address the effects of population surges.

Methods: Researchers developed parameters for how far evacuees would travel to escape disasters and factors that would influence choice of destination from studies of historical evacuations, surveys of citizens' evacuation intentions in hypothetical disasters, and semistructured interviews with key informants and emergency preparedness experts. Those parameters became the inputs to a “push-pull” model of how many people would flee in the 4 scenarios and where they would go.

Results: The expanded model predicted significant population movements from the New York City borough of Manhattan and counties within 20 km of Manhattan to counties within a 150-mi radius of the assumed IND detonation. It also predicted that even in some communities located far from Manhattan, arriving evacuees would increase the population needing services by 50% to 150%.

Conclusions: The results suggest that suburban and rural communities could be overwhelmed by evacuees from their center city following an IND detonation. They also highlight the urgency of educating and communicating with the public about radiation hazards to mitigate panic and hysteria, anticipating the ways in which a mass exodus may disrupt or even cripple rescue and response efforts, and devising creative ways to exercise and drill for an event about which there is great denial and fatalism.

(Disaster Med Public Health Preparedness. 2011;5:S143-S150)
Long-term Radiation-Related Health Effects in a Unique Human Population: Lessons Learned from the Atomic Bomb Survivors of Hiroshima and Nagasaki
Authors: Douple Evan B. , Mabuchi Kiyohiko , Cullings Harry M. , Preston Dale L. , Kodama Kazunori , Shimizu Yukiko , Fujiwara Saeko , Shore Roy E.
Published: March 2011

For 63 years scientists in the Atomic Bomb Casualty Commission and its successor, the Radiation Effects Research Foundation, have been assessing the long-term health effects in the survivors of the atomic bombings of Hiroshima and Nagasaki and in their children. The identification and follow-up of a large population (approximately a total of 200 000, of whom more than 40% are alive today) that includes a broad range of ages and radiation exposure doses, and healthy representatives of both sexes; establishment of well-defined cohorts whose members have been studied longitudinally, including some with biennial health examinations and a high survivor-participation rate; and careful reconstructions of individual radiation doses have resulted in reliable excess relative risk estimates for radiation-related health effects, including cancer and noncancer effects in humans, for the benefit of the survivors and for all humankind. This article reviews those risk estimates and summarizes what has been learned from this historic and unique study.

(Disaster Med Public Health Preparedness. 2011;5:S122-S133)
Triage and Treatment Tools for Use in a Scarce Resources-Crisis Standards of Care Setting After a Nuclear Detonation
Authors: Coleman C. Norman , Weinstock David M. , Casagrande Rocco , Hick John L. , Bader Judith L. , Chang Florence , Nemhauser Jeffrey B. , Knebel Ann R.
Published: March 2011

Based on background information in this special issue of the journal, possible triage recommendations for the first 4 days following a nuclear detonation, when response resources will be limited, are provided. The series includes: modeling for physical infrastructure damage; severity and number of injuries; expected outcome of triage to immediate, delayed, or expectant management; resources required for treating injuries of varying severity; and how resource scarcity (particularly medical personnel) worsens outcome. Four key underlying considerations are: 1.) resource adequacy will vary greatly across the response areas by time and location; 2.) to achieve fairness in resource allocation, a common triage approach is important; 3.) at some times and locations, it will be necessary to change from “conventional” to “contingency” or “crisis” standards of medical care (with a resulting change in triage approach from treating the “sickest first” to treating those “most likely to survive” first); and 4.) clinical reassessment and repeat triage are critical, as resource scarcity worsens or improves. Changing triage order and conserving and allocating resources for both lifesaving and palliative care can maintain fairness, support symptomatic care, and save more lives. Included in this article are printable triage cards that reflect our recommendations. These are not formal guidelines. With new research, data, and discussion, these recommendations will undoubtedly evolve.

(Disaster Med Public Health Preparedness. 2011;5:S111-S121)
Allocation of Scarce Resources After a Nuclear Detonation: Setting the Context
Authors: Knebel Ann R. , Coleman C. Norman , Cliffer Kenneth D. , Murrain-Hill Paula , McNally Richard , Oancea Victor , Jacobs Jimmie , Buddemeier Brooke , Hick John L. , Weinstock David M. , Hrdina Chad M. , Taylor Tammy , Matzo Marianne , Bader Judith L. , Livinski Alicia A. , Parker Gerald , Yeskey Kevin
Published: March 2011

The purpose of this article is to set the context for this special issue of Disaster Medicine and Public Health Preparedness on the allocation of scarce resources in an improvised nuclear device incident. A nuclear detonation occurs when a sufficient amount of fissile material is brought suddenly together to reach critical mass and cause an explosion. Although the chance of a nuclear detonation is thought to be small, the consequences are potentially catastrophic, so planning for an effective medical response is necessary, albeit complex. A substantial nuclear detonation will result in physical effects and a great number of casualties that will require an organized medical response to save lives. With this type of incident, the demand for resources to treat casualties will far exceed what is available. To meet the goal of providing medical care (including symptomatic/palliative care) with fairness as the underlying ethical principle, planning for allocation of scarce resources among all involved sectors needs to be integrated and practiced. With thoughtful and realistic planning, the medical response in the chaotic environment may be made more effective and efficient for both victims and medical responders.

(Disaster Med Public Health Preparedness. 2011;5:S20-S31)
State-Level Emergency Preparedness and Response Capabilities
Authors: Watkins Sharon M. , Perrotta Dennis M. , Stanbury Martha , Heumann Michael , Anderson Henry , Simms Erin , Huang Monica
Published: March 2011

Background: Prior assessments of public health readiness had identified gaps in radiation preparedness. In recent years, preparedness planning has involved an “all-hazards” approach. Current assessment of the national status related to radiation public health emergency preparedness capabilities at the state and local health department levels was needed.

Methods: A survey of state health departments related to radiation readiness was undertaken in 2010 by the Council of State and Territorial Epidemiologists (CSTE). States with nuclear power plants were instructed to consider their responses exclusive of capabilities and resources related to the plants given that the emergency response plans for nuclear power plants are specific and unique.

Results: Thirty-eight (76%) state health departments responded to the survey, including 26 of the 31 states with nuclear power plants. Specific strengths noted at the state level included that the majority of states had a written radiation response plan and most plans include a detailed section for communications issues during a radiation emergency. In addition, more than half of the states indicated that their relationship with federal partners is sufficient to provide resources for radiation emergencies, indicating the importance states placed on federal resources and expertise. Specific weaknesses are discussed and include that most states had completed little to no planning for public health surveillance to assess potential human health impacts of a radiation event; less than half had written plans to address exposure assessment, environmental sampling, human specimen collection and analysis, and human health assessment. Few reported having sufficient resources to do public health surveillance, radiation exposure assessment, laboratory functions and other capabilities.

Discussion: Levels of planning, resources and partnerships varied among states, those with nuclear power plants were better prepared. Gaps were evident in all states; however and additional training and resources are needed to ensure adequate levels of preparedness.

Conclusion: Overall results of this assessment indicate that in most measures of public health capacity and capability, states are poorly prepared to adequately respond to a major radiation emergency event. Specific recommendations are noted in the discussion.

(Disaster Med Public Health Preparedness. 2011;5:S134-S142)
Health Care System Planning for and Response to a Nuclear Detonation
Authors: Hick John L. , Weinstock David M. , Coleman C. Norman , Hanfling Dan , Cantrill Stephen , Redlener Irwin , Bader Judith L. , Murrain-Hill Paula , Knebel Ann R.
Published: March 2011

The hallmark of a successful response to a nuclear detonation will be the resilience of the community, region, and nation. An incident of this magnitude will rapidly become a national incident; however, the initial critical steps to reduce lives lost, save the lives that can be saved with the resources available, and understand and apply resources available to a complex and dynamic situation will be the responsibility of the local and regional responders and planners. Expectations of the public health and health care systems will be met to the extent possible by coordination, cooperation, and an effort to produce as consistent a response as possible for the victims. Responders will face extraordinarily stressful situations, and their own physical and psychological health is of great importance to optimizing the response. This article illustrates through vignettes and supporting text how the incident may unfold for the various components of the health and medical systems and provides additional context for the discipline-related actions outlined in the state and local planners’ playbook.

(Disaster Med Public Health Preparedness. 2011;5:S73-S88)
The Institute of Medicine's Forum on Medical and Public Health Preparedness for Catastrophic Events: Regional Workshop Series on the 2009 H1N1 Influenza Vaccination Campaign
Authors: Stroud Clare , Altevogt Bruce M. , Butler Jay C. , Duchin Jeffrey S.
Published: March 2011

In response to the 2009 H1N1 influenza pandemic, public health authorities launched an ambitious vaccination program to protect tens of millions of Americans from the virus. In April and May 2010, the Institute of Medicine Forum on Medical and Public Health Preparedness for Catastrophic Events hosted a series of 3 regional workshops to examine the 2009 H1N1 vaccination campaign. The workshops brought together stakeholders involved in distributing and dispensing H1N1 vaccine to discuss successes and challenges and to identify strategies to improve future vaccination programs and other medical countermeasure dispensing campaigns. On the basis of the presentations and the discussions that followed, several themes and opportunities for future efforts were identified in the following areas: vaccine supply and demand; state and local implementation of Centers for Disease Control and Prevention/Advisory Committee on Immunization Practices recommendations, including prioritization for vaccination; vaccine formulations and priority groups; opportunities for developing partnerships; opportunities to increase seasonal vaccination rates among pregnant women and health care workers and to increase acceptance of live attenuated nasal spray vaccine; standardization and improvement of immunization information management systems; opportunities to simplify, systematize, and automate processes and practices; and research needs and opportunities.

(Disaster Med Public Health Preparedness. 2011;5:81-86)
The
R
eformatsky Reaction
Authors: Shriner Ralph L.
Published: March 2011

The reaction which takes place between a carbonyl compound such as an aldehyde, ketone, or an ester, and an alpha‐haloester in the presence of zinc is commonly known as the Reformatsky reaction. It represents an extension of the reactions of carbonyl compounds with a dialkylzinc or an alkylzinc halide, but possesses the advantage that the isolation of the organozinc compound is unnecessary. The process creates a new carbon‐carbon linkage and involves the following: Formation of an organozinc halide; addition to the carbonyl group of the aldehyde or ketone, decomposition by dilute acids.