bluuebunny/crossref_metadata_2025 huggingface dataset:
How Feasible Is Baby-Led Weaning as an Approach to Infant Feeding? A Review of the Evidence
Authors: Cameron Sonya , Heath Anne-Louise , Taylor Rachael
Published: November 2012

Baby-Led Weaning (BLW) is an alternative method for introducing complementary foods to infants in which the infant feeds themselves hand-held foods instead of being spoon-fed by an adult. The BLW infant also shares family food and mealtimes and is offered milk (ideally breast milk) on demand until they self-wean. Anecdotal evidence suggests that many parents are choosing this method instead of conventional spoon-feeding of purées. Observational studies suggest that BLW may encourage improved eating patterns and lead to a healthier body weight, although it is not yet clear whether these associations are causal. This review evaluates the literature with respect to the prerequisites for BLW, which we have defined as beginning complementary foods at six months (for safety reasons), and exclusive breastfeeding to six months (to align with WHO infant feeding guidelines); the gross and oral motor skills required for successful and safe self-feeding of whole foods from six months; and the practicalities of family meals and continued breastfeeding on demand. Baby-Led Weaning will not suit all infants and families, but it is probably achievable for most. However, ultimately, the feasibility of BLW as an approach to infant feeding can only be determined in a randomized controlled trial. Given the popularity of BLW amongst parents, such a study is urgently needed.
Modelling and Analysis of a New Piezoelectric Dynamic Balance Regulator
Authors: Du Zhe , Mei Xue-Song , Xu Mu-Xun
Published: November 2012

In this paper, a new piezoelectric dynamic balance regulator, which can be used in motorised spindle systems, is presented. The dynamic balancing adjustment mechanism is driven by an in-plane bending vibration from an annular piezoelectric stator excited by a high-frequency sinusoidal input voltage. This device has different construction, characteristics and operating principles than a conventional balance regulator. In this work, a dynamic model of the regulator is first developed using a detailed analytical method. Thereafter, MATLAB is employed to numerically simulate the relations between the dominant parameters and the characteristics of the regulator based on thedynamic model. Finally, experimental measurements are used to certify the validity of the dynamic model. Consequently, the mathematical model presented and analysed in this paper can be used as a tool for optimising the design of a piezoelectric dynamic balance regulator during steady state operation.
Modern Micro and Nanoparticle-Based Imaging Techniques
Authors: Ryvolova Marketa , Chomoucka Jana , Drbohlavova Jana , Kopel Pavel , Babula Petr , Hynek David , Adam Vojtech , Eckschlager Tomas , Hubalek Jaromir , Stiborova Marie , Kaiser Jozef , Kizek Rene
Published: November 2012

The requirements for early diagnostics as well as effective treatment of insidious diseases such as cancer constantly increase the pressure on development of efficient and reliable methods for targeted drug/gene delivery as well as imaging of the treatment success/failure. One of the most recent approaches covering both the drug delivery as well as the imaging aspects is benefitting from the unique properties of nanomaterials. Therefore a new field called nanomedicine is attracting continuously growing attention. Nanoparticles, including fluorescent semiconductor nanocrystals (quantum dots) and magnetic nanoparticles, have proven their excellent properties for in vivo imaging techniques in a number of modalities such as magnetic resonance and fluorescence imaging, respectively. In this article, we review the main properties and applications of nanoparticles in various in vitro imaging techniques, including microscopy and/or laser breakdown spectroscopy and in vivo methods such as magnetic resonance imaging and/or fluorescence-based imaging. Moreover the advantages of the drug delivery performed by nanocarriers such as iron oxides, gold, biodegradable polymers, dendrimers, lipid based carriers such as liposomes or micelles are also highlighted.
Apoptosis Induction by OTA and TNF-α in Cultured Primary Rat Hepatocytes and Prevention by Silibinin
Authors: Essid Ebtisam , Dernawi Yousef , Petzinger Ernst
Published: November 2012

In cultures of primary rat hepatocytes, apoptosis occurred after application of 20 ng/mL tumor necrosis factor alpha (TNF-α). However, this was only in the presence of 200 ng/mL of the transcriptional inhibitor actinomycin D (ActD). This toxic effect was completely prevented in the presence of 25 µg/mL soluble TNF-α receptor I (sTNFR I) in the supernatant of hepatocyte cell cultures. Apoptosis also occurred after application of 12.5 µmol/L ochratoxin A (OTA). However, that was not prevented by up to 500 µg/mL sTNFR I, indicating that TNF-α/TNFR I is not involved in OTA mediated apoptosis in hepatocytes. The antioxidative flavanolignan silibinin in doses from 130 to 260 µmol/L prevented chromatin condensation, caspase-3 activation, and apoptotic DNA fragmentation that were induced by OTA, by 10 mmol/L hydrogen peroxide (H2O2) and by ultraviolet (UV-C) light (50 mJ/cm2), respectively. To achieve protection by silibinin, the drug was applied to the cell cultures for 2 h in advance. OTA stimulated lipid peroxidation on cultured immortalized rat liver HPCT cells, as was revealed by malondialdehyde (MDA) production. Lipid peroxidation occurred further by H2O2 and ActD/TNF-α incubation. These reactions were also suppressed by silibinin pretreatment. We conclude that the anti-apoptotic activity of silibinin against OTA, H2O2 and ActD/ TNF-α is caused in vitro by the antioxidative effects of the flavanolignan. Furthermore, cytotoxicity of the pro-apoptotic toxins was revealed by MTT-test. When applied separately, ActD and TNF-α showed no cytotoxic effects after 24 h, but were cytotoxic if applied in combination. The used concentrations of OTA, H2O2 and the dose of UV-C caused a substantial decrease in viability within 36 h that was prevented mostly by silibinin. We conclude that silibinin is a potent protective compound against apoptosis and cytotoxicity caused by OTA and the investigated compounds.
Evolution of morphological traits in Verbenaceae
Authors: O'Leary Nataly , Calviño Carolina Isabel , Martínez Susana , Lu‐Irving Pat , Olmstead Richard G. , Múlgura Maria Ema
Published: November 2012

• Premise of the study: A new infrafamilial circumscription of the Verbenaceae with eight tribes: Casselieae, Citharexyleae, Duranteae, Lantaneae, Neospartoneae, Petreeae, Priveae, and Verbeneae, has been recently proposed, on the basis of molecular phylogenetic studies. Two genera, Dipyrena and Rhaphithamnus, remain unplaced. The aim of this work is to reconstruct the evolutionary history of morphological characters traditionally employed in the classification of the Verbenaceae, with special attention to tribes Verbeneae and Lantaneae.

• Methods: Twenty‐one characters, related to habit and vegetative morphology, inflorescence and floral morphology, ovary and fruit morphology, as well as chromosome number, were optimized over a molecular phylogeny of Verbenaceae.

• Key Results: All tribes are supported by at least one morphological trait except tribes Duranteae and Citharexyleae. Suffrutescent habit, sessile flowers, and four cluses are synapomorphies for tribe Verbeneae. Gynoecium with short style and entire stigma are synapomorphic traits for tribe Lantaneae. Sessile flowers and unicarpellate ovaries are morphological synapomorphies for the new tribe Neospartoneae. Suffrutescent habit is a synapomorphic trait for tribe Priveae. Homothetic pleiobotrya and absence of the adaxial staminode are synapomorphic traits for tribe Casselieae. Undivided fleshy fruits are probably a synapomorphic trait for tribe Petreeae. Putative plesiomorphies for the ancestor of the Verbenaceae are discussed as well as synapomorphic traits within other Verbenaceae clades.

• Conclusions: Many of the characters traditionally employed in classification have proven to be very homoplastic, or have been shown not to support relationships within the family. Moreover, traditional assumptions concerning character polarity have in some cases been shown to be incorrect.
Association between the geographic distribution during the last glacial maximum of Asian wild rice, Oryza rufipogon (Poaceae), and its current genetic variation
Authors: Huang Pu , Schaal Barbara A.
Published: November 2012

• Premise of the study: The combination of traditional population genetic studies and species distribution modeling (SDM) provides many new insights in detecting phylogeographic signals. In Asian wild rice (Oryza rufipogon), the progenitor of cultivated Asian rice, geographical subdivision has been documented in many genetic studies although the root cause of this subdivision remains unknown. Surprisingly, environmental factors associated with the spatial and temporal distribution of O. rufipogon have rarely been examined. The aim of this study is to understand the historical distribution of O. rufipogon and its relationship to the current geographical pattern of genetic variation.

• Methods: We used SDM to examine the present, past, and future distribution of O. rufipogon. The estimated distribution during the Last Glacial Maximum was then compared with genetic data from our previous work.

• Key results: The predicted paleodistribution of O. rufipogon at the Last Glacial Maximum was separated into disconnected east and west ranges. This past distribution is consistent with the current geographic pattern of genetic variation, with two genetic groups that intergrade. Annual precipitation is the single factor that contributes most to SDM estimates. SDM predictions for 2080 indicate a general trend of increasing probability of presence and range expansion.

• Conclusions: (1) The historically disjunct distribution potentially contributes to the current genetic subdivision of O. rufipogon. (2) Water availability is an important factor that limits the distribution of O. rufipogon. (3) Global warming is a lesser threat than other human‐mediated factors to the conservation of this endangered species.
Zamia(Cycadales: Zamiaceae) on Puerto Rico: Asymmetric genetic differentiation and the hypothesis of multiple introductions
Authors: Meerow Alan W. , Francisco‐Ortega Javier , Calonje Michael , Griffith M. Patrick , Ayala‐Silva Tomás , Stevenson Dennis W. , Nakamura Kyoko
Published: November 2012

•Premise of the Study:This study ofZamiain Puerto Rico is the most intensive population genetics investigation of a cycad to date in terms of number of markers, and one of few microsatellite DNA studies of plants from the highly critical Caribbean biodiversity hotspot. Three distinctiveZamiataxa occur on the island:Z. erosaon the north coast, andZ. portoricensisandZ. pumila, both in the south. Their relationships are largely unknown. We tested three hypotheses about their genetic diversity, including the possibility of multiple introductions.

•Methods:We used 31 microsatellite loci across 10 populations and analyzed the data with AMOVA, Bayesian clustering, and ABC coalescent modeling.

•Key Results:Puerto Rican zamias exhibit an amalgam of patterns of genetic differentiation that have been reported for cycads. Overall, the taxa are slightly inbred, with high infra‐populational variation and little evidence of recent bottlenecks.Zamia erosaexhibits a more than threefold greater degree of population differentiation than the other two taxa. Admixture is evident only betweenZ. portoricensisandZ. pumila.Zamia portoricensisis inferred to be the youngest taxon on the island, on the basis of estimates of coalescence time and effective population size. A selective sweep may be underway in a small population ofZ. erosain a saline environment.

•Conclusions: Zamia erosamay represent an independent introduction into Puerto Rico;Z. portoricensisandZ. pumilafit a scenario of allopatric speciation. This will be explored further in the context of genetic analysis across the entire Caribbean region.
Peritoneal Fibrosis and High Transport are Induced in Mildly Pre-Injured Peritoneum by 3,4-Dideoxyglucosone-3-Ene in Mice
Authors: Yokoi Hideki , Kasahara Masato , Mori Kiyoshi , Kuwabara Takashige , Toda Naohiro , Yamada Ryo , Namoto Shinji , Yamamoto Takashi , Seki Nana , Souma Nozomi , Yamaguchi Taku , Sugawara Akira , Mukoyama Masashi , Nakao Kazuwa
Published: November 2012

Peritoneal dialysis (PD) solution contains high concentrations of glucose and glucose degradation products (GDPs). One of several GDPs—3,4-dideoxyglucosone-3-ene (3,4-DGE)—was recently identified as the most reactive and toxic GDP in PD fluids. In vitro, 3,4-DGE has been shown to induce mesothelial cell damage; however, its role in peritoneal fibrosis in vivo remains unclear. In the present study, we intraperitoneally administered chlorhexidine gluconate (CG) for mild peritoneal injury, and we then injected 3,4-DGE [38μmol/L (low concentration) or 145μmol/L (high concentration)] 5 times weekly for 4 weeks. Significant thickening of the parietal peritoneal membrane was observed only when treatment with low or high concentrations of 3,4-DGE occurred after CG administration, but not when either CG or 3,4-DGE alone was given. The combination of CG and 3,4-DGE also caused upregulation of messenger RNA expression of transforming growth factor β1, connective tissue growth factor, fibronectin, collagen type 1 α1 chain, alpha smooth muscle actin (α–SMA), vascular endothelial growth factor 164, NADPH oxidase 1 and 4, p22phox, p47phox, and gp91phox in peritoneal tissue. Treatment with CG alone was sufficient to cause significant F4/80-positive macrophage infiltration, appearance of α–SMA-positive cells, and vessel formation in the submesothelial layer. Addition of 3,4-DGE markedly enhanced those changes and induced apoptosis, mainly in leukocytes. The concentration of 3,4-DGE in the abdominal cavity declined more rapidly in CG-treated mice than in PBS-treated mice. Peritoneal membrane permeability determined by peritoneal equilibration test showed high transport conditions in peritoneum treated with both CG and 3,4-DGE. These results indicate that, when mild peritoneal damage is already present, 3,4-DGE causes peritoneal thickening and fibrosis, resulting in deterioration of peritoneal membrane function.
Neutral Solution Low in Glucose Degradation Products is Associated with Less Peritoneal Fibrosis and Vascular Sclerosis in Patients Receiving Peritoneal Dialysis
Authors: Kawanishi Kunio , Honda Kazuho , Tsukada Misao , Oda Hideaki , Nitta Kosaku
Published: November 2012

Background

The effects of novel biocompatible peritoneal dialysis (PD) solutions on human peritoneal membrane pathology have yet to be determined. Quantitative evaluation of human peritoneal biopsy specimens may reveal the effects of the new solutions on peritoneal membrane pathology.

Methods

Peritoneal specimens from 24 PD patients being treated with either acidic solution containing high-glucose degradation products [GDPs ( n = 12)] or neutral solution with low GDPs ( n = 12) were investigated at the end of PD. As controls, pre-PD peritoneal specimens, obtained from 13 patients at PD catheter insertion, were also investigated. The extent of peritoneal fibrosis, vascular sclerosis, and advanced glycation end-product (AGE) accumulation were evaluated by quantitative or semi- quantitative methods. The average densities of CD31-positive vessels and podoplanin-positive lymphatic vessels were also determined.

Results

Peritoneal membrane fibrosis, vascular sclerosis, and AGE accumulation were significantly suppressed in the neutral group compared with the acidic group. The neutral group also showed lower peritoneal equilibration test scores and preserved ultrafiltration volume. The density of blood capillaries, but not of lymphatic capillaries, was significantly increased in the neutral group compared with the acidic and pre-PD groups.

Conclusions

Neutral solutions with low GDPs are associated with less peritoneal membrane fibrosis and vascular sclerosis through suppression of AGE accumulation. However, contrary to expectation, blood capillary density was increased in the neutral group. The altered contents of the new PD solutions modified peritoneal membrane morphology and function in patients undergoing PD.
Perspectives of Patients, Families, and Health Care Professionals on Decision-Making about Dialysis Modality—the Good, the Bad, and the Misunderstandings!
Authors: Griva Konstadina , Li Zhi Hui , Lai Alden Yuanhong , Choong Meng Chan , Foo Marjorie Wai Yin
Published: November 2012

Objectives

This study explored the factors influencing decision-making about dialysis modality, integrating the perspectives of patients, their families, and health care professionals within an Asian population. The study further sought to understand the low penetration rate of peritoneal dialysis (PD) in Singapore.

Methods

A sample of 59 participants comprising pre-dialysis patients, dialysis patients, caregivers, and health care professionals (HCPs) participated in semi-structured interviews to explore the decision-making process and their views about various dialysis modalities. Data were thematically analyzed using NVivo9 (QSR International, Doncaster, Australia) to explore barriers to and facilitators of various dialysis modalities and decisional support needs.

Results

Fear of infection, daily commitment to PD, and misperceptions of PD emerged as barriers to PD. Side effects, distance to dialysis centers, and fear of needling and pain were barriers to hemodialysis (HD). The experiences of other patients, communicated informally or opportunistically, influenced the preferences and choices of patients and family members for a dialysis modality. Patients and families value input from HCPs and yet express strong needs to discuss subjective experiences of life on dialysis (PD or HD) with other patients before making a decision about dialysis modality.

Conclusions

Pre-dialysis education should expand its focus on the family as the unit of care and should provide opportunities for interaction with dialysis patients and for peer-led learning. Barriers to PD, especially misperceptions and misunderstandings, can be targeted to improve PD uptake.
Longterm Effects of Endothelin Receptor Antagonism on Microvascular Damage Evaluated by Nailfold Capillaroscopic Analysis in Systemic Sclerosis
Authors: CUTOLO MAURIZIO , ZAMPOGNA GIUSEPPE , VREMIS LAURA , SMITH VANESSA , PIZZORNI CARMEN , SULLI ALBERTO
Published: November 2012

Objective.

Systemic sclerosis (SSc) is characterized by microvascular injury, fibrosis, and hypoxia of involved tissues. The vasoactive peptide endothelin-1 (ET-1) seems to be implicated in these events. Using nailfold videocapillaroscopy (NVC), we evaluated longterm effects of ET-1 antagonist treatment on nailfold microvascular damage in patients with SSc, over a 3-year followup period.

Methods.

Thirty patients with SSc (mean age 64 ± 5 yrs, mean disease duration 8 ± 1 yrs) were recruited during their programmed standard treatment protocols. At baseline (T0), 15 patients with SSc (mean age 63 ± 15 yrs, mean disease duration 7 ± 3 yrs), already receiving cyclic intravenous infusion of iloprost (5 continuous days, average 80 μg/day, every 3 mo), continued the treatment for a further 3 years (ILO group). The remaining 15 patients with SSc (mean age 68 ± 13 yrs, mean disease duration 8 ± 4 yrs), although they continued the same cyclic intravenous iloprost treatment as the previous group, also received bosentan 125 mg twice a day for 3 years (ILO+BOS group). Qualitative analysis (scleroderma patterns) and semiquantitative scoring of the microvascular damage were performed by validated routine NVC methods.

Results.

During followup, a statistically significant increase of capillary number was observed in the ILO+BOS group (p < 0.02), with a significant and progressive increase of angiogenesis (p < 0.01). In contrast, the ILO group showed a statistically significant decrease of capillary number (p < 0.05). After 3 years the number of capillaries was significantly higher in the ILO+BOS group than in the ILO group (p < 0.05). The score for giant capillaries decreased significantly in both groups of patients with SSc (p < 0.05).

Conclusion.

In this open study, longterm treatment with ET-1 receptor antagonist in combination with iloprost was found to interfere with progression of nailfold microvascular damage in patients with SSc, as assessed by NVC over a 3-year followup period.
Safety and Efficacy of Infliximab and Adalimumab for Refractory Uveitis in Juvenile Idiopathic Arthritis: 1-year Followup Data from the Italian Registry
Authors: ZANNIN MARIA E. , BIROLO CAROLINA , GERLONI VALERIA M. , MISEROCCHI ELISABETTA , PONTIKAKI IRENE , PAROLI MARIA P. , BRACAGLIA CLAUDIA , SHARDLOW ALISON , PARENTIN FULVIO , CIMAZ ROLANDO , SIMONINI GABRIELE , FALCINI FERNANDA , CORONA FABRIZIA , VIOLA STEFANIA , DE MARCO RICCARDO , BREDA LUCIANA , LA TORRE FRANCESCO , VITTADELLO FABIO , MARTINI GIORGIA , ZULIAN FRANCESCO
Published: November 2012

Objective.

To evaluate safety and efficacy of adalimumab (ADA) and infliximab (IFX) for the treatment of juvenile idiopathic arthritis-related anterior uveitis (JIA-AU).

Methods.

Starting January 2007, patients with JIA-AU treated with IFX and ADA were managed by a standard protocol and data were entered into the National Italian Registry (NIR). At baseline, all patients were refractory to standard immunosuppressive treatment and/or were corticosteroid-dependent. Data recorded every 3 months included uveitis course, number/type of ocular complications, drug-related adverse events (AE), treatment change or withdrawal, and laboratory measures. Data of patients treated for at least 1 year were retrieved from the NIR and analyzed using descriptive statistics. Treatment efficacy was based on change in uveitis course and in number of ocular complications.

Results.

Up to December 2009, data for 108 patients with JIA-AU treated with anti-tumor necrosis factor-α agents were recorded in the NIR and data from 91, with at least 12 months’ followup, were included in the study. Forty-eight patients were treated with IFX, 43 with ADA. Forty-seven patients (55.3%) achieved remission of AU, 28 (32.9%) had recurrent AU, and 10 (11.8%) maintained a chronic course. A higher remission rate was observed with ADA (67.4% vs 42.8% with IFX; p = 0.025). Ocular complications decreased from 0.47 to 0.32 per subject. Five patients experienced resolution of structural complications. No patient reported serious AE; 8 (8.8%) experienced 11 minor AE (9 with IFX, 2 with ADA).

Conclusion.

IFX and ADA appear to be effective and safe for treatment of refractory JIA-related uveitis, with a better performance of ADA in the medium-term period.
Fascin-expressing Dendritic Cells Dominate in Polymyositis and Dermatomyositis
Authors: GENDEK-KUBIAK HANNA , GENDEK EWA G.
Published: November 2012

Objective.

Dendritic cells (DC) have been reported among inflammatory infiltrating cells in muscle tissue in idiopathic inflammatory myopathies (IIM), but to our knowledge no studies concerning the expression of langerin (CD207) or fascin (markers of immature and mature DC, respectively) in IIM have been published.

Methods.

Immunohistochemical analyses of langerin and fascin expression were performed on specimens from normal muscles, as well as those affected by polymyositis (PM) and dermatomyositis (DM). The results were analyzed by Mann-Whitney U test.

Results.

In PM and DM, fascin-positive cells were numerous in the majority of the studied samples in perimysial, endomysial, and perivascular cellular infiltrates. Sporadic langerin-positive cells were detected.

Conclusion.

Fascin-positive DC predominance in inflammatory infiltrates in myositic muscles confirms the prevalence of mature forms and indicates that there are conditions stimulating DC maturation in both PM and DM. The induction of immunological tolerance by inhibiting DC maturation may be a promising direction for studies of myositis treatment.
Methotrexate and Injectable Tumor Necrosis Factor-α Inhibitor Adherence and Persistence in Children with Rheumatic Diseases
Authors: RINGOLD SARAH , GRANT SHANNON , GIRDISH CHARMAINE , WALLACE CAROL A. , SULLIVAN SEAN D.
Published: November 2012

Objective.

To measure adherence and persistence with methotrexate (MTX) and injectable tumor necrosis factor-α (iTNF-α) inhibitors (etanercept, adalimumab) among children prescribed these medications by a rheumatologist.

Methods.

Data were obtained from a US pharmacy benefits management firm. Children were included if they were < 18 years of age, had ≥ 1 prescription claim between January 2009 and December 2010 for MTX or an iTNF-α inhibitor that was prescribed by an adult or pediatric rheumatologist. The medication possession ratio (MPR) was calculated for each medication, with MPR ≥ 80% indicating good adherence. MPR were compared by route of administration, age, and by new users versus continuing users. Persistence was measured for new users of each medication from initiation until discontinuation, or for a maximum of 1 year.

Results.

A total of 1964 children were included. The majority of children had MPR < 80%. Children taking subcutaneous MTX had the lowest mean MPR [46.9%; median 44.9%; interquartile range (IQR) 23%–69.6%] and the lowest persistence, with 26% of children continuing the medication at 1 year. Mean MPR was highest for iTNF-α (65.7%; median 70.1%; IQR 46%–89.3%), as was persistence, with 52% of children continuing the medication at 1 year. Children age < 13 years tended to have higher MPR, but this was statistically significant only for oral MTX (61.1% vs 54.9% in children age ≥ 13 yrs; p = 0.02).

Conclusion.

Adherence and persistence in this cohort varied by medication and route of administration. Both outcomes are important considerations for physicians prescribing these medications in routine clinical care and for the assessment of treatment effectiveness in the research setting.
Huge pelvic parachordoma: fine needle aspiration cytology and histological differential diagnosis
Authors: Samaka Rehab M. , Kandil Mona A.
Published: November 2012

Parachordoma is an extremely rare soft tissue tumor of unknown lineage. Parachordoma develops most often on the extremities. Only 2 cases have been reported as pelvic parachordoma. A 46-year old Egyptian woman with a huge painful pelvic mass was found to have a parachordoma with ectopic pelvic right kidney. There is only one report in the literature of fine needle aspiration cytology in this setting. The microscopic picture of parachordoma is not new to pathologists but the gross picture of this rare tumor has not previously been published; not even in the World Health Organization classification of soft tissues tumors. Diagnosis was confirmed by immunohistochemistry. The patient is in good clinical condition without any evidence of recurrence or metastasis after 84 months of follow up.
Bilateral multifocal renal oncocytoma in pregnancy
Authors: Wentzel Schalk W. , Vermeulen Lodewikus P.
Published: November 2012

Renal oncocytomas are the most common benign solid renal tumor, accounting for 3–7% of renal neoplasms. Oncocytomas are multifocal in 2–12% and bilateral in 4–14% of cases. Multifocal bilateral oncocytomas represent only 1.4% of renal cases. We present an extraordinary case of a patient with multifocal bilateral renal oncocytomas during pregnancy. An electronic literature search revealed fewer than 30 reports of on cases of bilateral multifocal renal oncocytomas, none of them occurring in pregnancy. The management of this patient differed from the recommended guidelines for renal masses suspected to be malignant because elective caesarean section and nephrectomy in the second trimester was refused.
The amazing growth of the early church
Authors: Dreyer Wim A.
Published: November 2012

The church grew rapidly during the first centuries. The question is: Why? Generations of scholars approached this question from different perspectives and with different methods. Historical research, analysis of early Christian texts and theological reflection were the most common methods used to shed light on the growth of the church. In this contribution five different models of growth were discussed, using the approach of A.M. Schor as a point of departure. These models of church growth were put under the headings of an apostolic mission model, values reproduction model, social reaction model, network model with an institutional model added.
Wintertime particulate pollution episodes in an urban valley of the Western US: a case study
Authors: Chen L.-W. A. , Watson J. G. , Chow J. C. , Green M. C. , Inouye D. , Dick K.
Published: November 2012

Abstract. This study investigates the causes of elevated PM2.5 episodes and potential exceedences of the US National Ambient Air Quality Standards (NAAQS) in Truckee Meadows, Nevada, an urban valley of the Western US, during winter 2009/2010, an unusually cold and snowy winter. Continuous PM2.5 mass and time-integrated chemical speciation data were acquired from a central valley monitoring site, along with meteorological measurements from nearby sites. All nine days with PM2.5 > 35 μg m−3 showed 24-h average temperature inversion of 1.5–4.5 °C and snow cover of 8–18 cm. Stagnant atmospheric conditions limited wind ventilation while highly reflective snow cover reduced daytime surface heating creating persistent inversion. Elevated ammonium nitrate (NH4NO3) and water associated with it are found to be main reasons for the PM2.5 exceedances. An effective-variance chemical mass balance (EV-CMB) receptor model using locally-derived geological profiles and inorganic/organic markers confirmed secondary NH4NO3 (27–37%), residential wood combustion (RWC; 11–51%), and diesel engine exhaust (7–22%) as the dominant PM2.5 contributors. Paved road dust and de-icing materials were minor, but detectable contributors. RWC is a more important source than diesel for organic carbon (OC), but vice versa for elemental carbon (EC). A majority of secondary NH4NO3 is also attributed to RWC and diesel engines (including snow removal equipment) through oxides of nitrogen (NOx) emissions from these sources. Findings from this study may apply to similar situations experienced by other urban valleys.
How does deposition of gas phase species affect pH at frozen salty interfaces?
Authors: Wren S. N. , Donaldson D. J.
Published: November 2012

Abstract. Chemical processes occurring on snow and ice surfaces play an important role in controlling the oxidative capacity of the overlying atmosphere. However, efforts to gain a better, mechanistic understanding of such processes are impeded by our poor understanding of the chemical nature of the air-ice interface. Here we use glancing-angle laser induced fluorescence in conjunction with harmine – a surface-active, pH-sensitive fluorescent dye – to investigate how the nature of the ice, whether frozen freshwater, salt water or seawater, influences pH changes at the surface. Deposition of HCl(g) leads to a very different pH response at the frozen freshwater surface than at the frozen salt water surface indicating that these two surfaces present different chemical environments. Importantly, the sea ice surface is buffered against pH changes arising from deposition of gas phase species. These results have important implications for understanding pH-sensitive processes occurring at the air-ice boundary, such as bromine activation.
Robust extraction of baseline signal of atmospheric trace species using local regression
Authors: Ruckstuhl A. F. , Henne S. , Reimann S. , Steinbacher M. , Vollmer M. K. , O'Doherty S. , Buchmann B. , Hueglin C.
Published: November 2012

Abstract. The identification of atmospheric trace species measurements that are representative of well-mixed background air masses is required for monitoring atmospheric composition change at background sites. We present a statistical method based on robust local regression that is well suited for the selection of background measurements and the estimation of associated baseline curves. The bootstrap technique is applied to calculate the uncertainty in the resulting baseline curve. The non-parametric nature of the proposed approach makes it a very flexible data filtering method. Application to carbon monoxide (CO) measured from 1996 to 2009 at the high-alpine site Jungfraujoch (Switzerland, 3580 m a.s.l.), and to measurements of 1,1-difluoroethane (HFC-152a) from Jungfraujoch (2000 to 2009) and Mace Head (Ireland, 1995 to 2009) demonstrates the feasibility and usefulness of the proposed approach. The determined average annual change of CO at Jungfraujoch for the 1996 to 2009 period as estimated from filtered annual mean CO concentrations is −2.2 ± 1.1 ppb yr−1. For comparison, the linear trend of unfiltered CO measurements at Jungfraujoch for this time period is −2.9 ± 1.3 ppb yr−1.
Factors controlling interannual variability of vertical organic matter export and phytoplankton bloom dynamics – a numerical case-study for the NW Mediterranean Sea
Authors: Bernardello R. , Cardoso J. G. , Bahamon N. , Donis D. , Marinov I. , Cruzado A.
Published: November 2012

Abstract. Mid-latitude spring blooms of phytoplankton show considerable year-to-year variability in timing, spatial extent and intensity. It is still unclear to what degree the bloom variability is connected to the magnitude of the vertical flux of organic matter. A coupled three-dimensional hydrodynamic-biogeochemical model is used to relate interannual variability in phytoplankton spring-bloom dynamics to variability in the vertical export of organic matter in the NW Mediterranean Sea. Simulation results from 2001 to 2010, validated against remote-sensing chlorophyll, show marked interannual variability in both timing and shape of the bloom. Model results show a tendency for the bloom to start later after cold and windy winters. However, the onset of the bloom occurs often when the mixed layer is still several hundred metres deep while the heat flux is already approaching zero and turbulent mixing is low. Frequency and intensity of wind episodes control both the timing and development of the bloom and the consequent export flux of organic matter. The wintertime flux is greater than zero and shows relatively low interannual variability. The magnitude of the interannual variability is mainly determined in March when the frequency of windy days positively correlates with the export flux. Frequent wind-driven mixing episodes act to increase the export flux and, at the same time, to interrupt the bloom. Perhaps counterintuitively, our analysis shows that years with discontinuous, low-chlorophyll blooms are likely to have higher export flux than years with intense uninterrupted blooms. The NW Mediterranean shows strong analogy with the North Atlantic section within the same latitude range. Hence, our results may also be applicable to this quantitatively more important area of the world ocean.
Measuring the biosphere-atmosphere exchange of total reactive nitrogen by eddy covariance
Authors: Ammann C. , Wolff V. , Marx O. , Brümmer C. , Neftel A.
Published: November 2012

Abstract. The (net) exchange of reactive nitrogen (Nr) with the atmosphere is an important driver for ecosystem productivity and greenhouse gas exchange. The exchange of airborne Nr includes various trace compounds that usually require different specific measurement techniques, and up to now fast response instruments suitable for eddy covariance measurements are only available for few of these compounds. Here we present eddy covariance flux measurements with a recently introduced converter (TRANC) for the sum of all Nr compounds (∑Nr). Measurements were performed over a managed grassland field with phases of net emission and net deposition of ∑Nr and alternating dominance of oxidized (NOX) and reduced species (NH3). Spectral analysis of the eddy covariance data exhibited the existence of covariance function peaks at a reasonable time lag related to the sampling tube residence time under stationary conditions. Using ogive analysis, the high-frequency damping was quantified to 19%–26% for a low measurement height of 1.2 m and to about 10% for 4.8 m measurement height. ∑Nr concentrations and fluxes were compared to parallel NO and NO2 measurements by dynamic chambers and NH3 measurements by the aerodynamic gradient technique. The average concentration results indicate that the main compounds NO2 and NH3 were converted by the TRANC system with an efficiency of near 100%. With an optimised sample inlet also the fluxes of these compounds were recovered reasonably well including net deposition and net emission phases. The study shows that the TRANC system is suitable for fast response measurements of oxidized and reduced nitrogen compounds and can be used for continuous eddy covariance flux measurements of total reactive nitrogen.
Phosphorus recycling in sediments of the Central Baltic Sea
Authors: Viktorsson L. , Ekeroth N. , Nilsson M. , Kononets M. , Hall P. O. J.
Published: November 2012

Abstract. Benthic fluxes of dissolved inorganic phosphorus (DIP) were measured in situ in the Eastern Gotland Basin (EGB), Central Baltic Sea, using benthic landers. A total of 40 flux measurements on 13 stations at water depths ranging from 30–210 m and under different oxygen regimes were carried out on three cruises during three consecutive years (2008–2010) in August–September. Our study is the first to report in situ DIP fluxes in the Baltic Proper, and it provides the most comprehensive data set of benthic DIP fluxes in the Baltic Proper existing to date. DIP fluxes increased with increasing water depth and with decreasing bottom water oxygen concentration. Average fluxes were calculated for oxic bottom water conditions (−0.003 ± 0.040 mmol m−2 d−1), hypoxic conditions (0.027 ± 0.067 mmol m−2 d−1) and anoxic conditions (0.376 ± 0.214 mmol m−2 d−1). The mean flux on anoxic bottoms was ca. 5–10 times higher than previous estimates based on ex situ measurements, but agreed well with previous flux estimations from changes in the basin water DIP pool. The DIP flux was positively correlated with the organic carbon inventory of sediment and the benthic flux of dissolved inorganic carbon (DIC) on anoxic stations, but these variables were uncorrelated on oxic stations. The positive correlation between DIP and DIC fluxes suggests that the benthic DIP flux on anoxic bottoms in the Baltic Proper is mainly controlled by rates of deposition and degradation of organic matter. The flux from anoxic sediment was very P rich in relation to both C and N, and the average C:P ratio in fluxes on anoxic accumulation bottoms was 69 ± 15, which is well below the Redfield C:P ratio of 106:1. On oxic stations, however, the C:P flux ratio was much higher than the Redfield ratio, consistent with well-known P retention mechanisms associated with iron and bacteria in oxidized sediment. Using a benthic mass balance approach, a burial efficiency of 4% was calculated for the anoxic part of the EGB, which suggests that anoxic Baltic sediments are very efficient in recycling deposited P. Based on the measured fluxes and recent estimates of the areal extent of anoxic and hypoxic bottoms, an internal load of 146 kton yr−1 was calculated. This is 7–12 times higher than recent estimates of the external load and clearly highlights the dominance of anoxic sediments as a P source in the Baltic Sea.
GloFAS – global ensemble streamflow forecasting and flood early warning
Authors: Alfieri L. , Burek P. , Dutra E. , Krzeminski B. , Muraro D. , Thielen J. , Pappenberger F.
Published: November 2012

Abstract. Anticipation and preparedness for large-scale flood events have a key role in mitigating their impact and optimizing the strategic planning of water resources. Although several developed countries have well-established systems for river monitoring and flood early warning, figures of population affected every year by floods in developing countries are unsettling. This paper presents the Global Flood Awareness System, which has been set up to provide an overview on upcoming floods in large world river basins. The Global Flood Awareness System is based on distributed hydrological simulation of numerical ensemble weather predictions with global coverage. Streamflow forecasts are compared statistically to climatological simulations to detect probabilistic exceedance of warning thresholds. In this article, the system setup is described, together with an evaluation of its performance over a two-year test period and a qualitative analysis of a case study for the Pakistan flood, in summer 2010. It is shown that hazardous events in large river basins can be skilfully detected with a forecast horizon of up to 1 month. In addition, results suggest that an accurate simulation of initial model conditions and an improved parameterization of the hydrological model are key components to reproduce accurately the streamflow variability in the many different runoff regimes of the Earth.
The use of Haemostatic Agents in Urology
Authors: Tiroli Marco , Conti Alessandro , Muzzonigro Giovanni
Published: November 2012

Intra- and post-operative bleedings are frequent complications of all surgical procedures and can represent a severe risk for patients. Beginning from the second half of the 20th century, with an important spur from the development of laparoscopy, great efforts were made in the field of surgical research, aiming at improving hemostatic techniques. The development of mechanical and thermic hemostatic devices, in addition to the improvement of new suturing materials, already improved the possibility of bleeding control; yet a very important contribution in this field has been represented by the introduction in the surgical setting of chemical/biological agents capable of empowering locally blood hemostatic capacity. Currently, there are more chemical hemostatic agents surgeons can make use of in order to minimize bleedings: we reviewed the most important classes, considered their advantages, disadvantages and risks, and tried to look forward to those that will offer, in our view, the best options - for surgeons and patients - for an efficient and safe prevention and control of surgical bleedings, either in open or minimally invasive surgery.
Laparoscopic Ureteral Reimplantation Surgery According to Lich-Gregoir
Authors: Corona Andrea , Serra Simona , De Lisa Antonello
Published: November 2012

Introduction

Terminal ureteral stenosis can occur as a consequence of gynecological diseases or surgical treatment of simple or radical hysterectomy and pelvic endometriosis.

Materials and Methods

We evaluated 5 patients aged between 30 and 52 years, who underwent ureterocystoneostomy for ureteral stenosis due to several factors: 2 cases of pelvic endometriosis; 2 cases of surgery treatment of pelvic endometriosis, and 1 case of simple hysterectomy. Patients were placed supine in Trendelemburg position of about 30°. After pneumoperitoneum induction, the following equipment was introduced through four different laparoscopic accesses: the optic tool into the umbilicus access, 5-mm operative accesses on the lesion side, and one of 10–11mm in the contralateral site. Once we incised the peritoneum and isolated the distal ureter until the stenotic tract, we proceeded with the dissection, performing a 2cm serum-muscle incision of the bladder, showing the mucosa after previous distension with 200mL of saline. A little operculum in the mucosa was created by a spatula. After applying a DJ ureteral catheter with the distal end introduced into the bladder, the direct ureteral-vesical anastomosis was made. The application of serum-detrusor sutures next to the ureter created the antireflux barrier. The peritoneum was closed.

Results

Surgery was performed by laparoscopy without conversion into open surgery. Average performing time was 205min. Clinical stay was 5 days and DJ ureteral catheter was removed after 3 weeks following cystography and absence of spillage around the bladder. The ultrasound controls performed after three and six months did not show any complication.

Conclusions

Laparoscopy is a valid alternative to open surgery, also yielding better esthetic results, particularly in cases where the classical approach is difficult to perform, as for example in obese patients.
Level of Acuity in Pediatric Patients with Recurrent Emergency Department Visits
Authors: Claudius Ilene , Lam Chun Nok
Published: November 2012

Introduction: Recurrent ED utilizers account for a substantial proportion of ED visits, yet little data exists on children with multiple visits. The objective of this study was to compare the need for interventions and triage acuity of recurrent utilizers of a pediatric emergency department to that of non-recurrent utilizers. Methods: This is a retrospective analysis of children presenting to a pediatric emergency department. Children were classified as recurrent utilizers if they had 4 or more visits to the ED per year and non-recurrent utilizers if they had less than 4 visits. Data was collected and inter-group comparison performed on critical interventions received (admission, consultation, intravenous fluid therapy, observation, and performance of procedures), all interventions received (including critical interventions as well as laboratories, radiographs, and medications), and triage acuity for the index visit. Results: Two-hundred thirty patients were included, of whom, 15% were classified as recurrent utilizers. This group had significantly lower rates of requiring a critical intervention (8.6% vs. 51.4%, p=.001), lower rates of any intervention (51.4% vs. 74.4%, p=.007), and less urgent triage acuity (3.3 vs. 3.1, p=.029). Conclusions: Recurrent utilizers of the pediatric emergency department had significantly lower need for intervention and less urgent mean triage acuity when compared with non-recurrent utilizers.
Get to Know a Circle
Authors: Neel-Romine LeAnn E. , Paul Sara , Shafer Kathryn G.
Published: November 2012

While working within the framework of van Hiele levels and handling Play-doh®, students write and critique definitions of a circle.
Sizing Up the Grinch's Heart
Authors: Cox Dana C. , Edwards Michael Todd
Published: November 2012

How do middle school students interpret the phrase “two sizes too small”? Examining students' responses will re-form your thinking about teaching similarity and using nonstandard shapes.
Math for Real: And the Winner Is. …
Authors: White Vicki
Published: November 2012

Ways of scoring Academy Award winners, such as through a plurality-with-elimination vote count, are discussed and compared.
Free online CCSSM Toolbox
Authors: Noddin Christine A.
Published: November 2012

Share news about happenings in the field of elementary school math education, views on matters pertaining to teaching and learning mathematics in the early childhood or elementary school years, and reactions to previously published opinion pieces or articles.
Social Justice at the Animal Shelter
Authors: Vega Stephanie
Published: November 2012

Engaging in an analysis of social justice issues through the lens of mathematics allows students to deepen their understanding of social issues and play a more active role in society. This set of problems is intended to help students better understand issues that affect local animal shelters and make informed decisions by applying mathematics. Included in these problems are researched facts that could accurately represent a shelter.
Technology from the classroom: The new “kid magnet”
Authors: Mueller Kimberly D.
Published: November 2012

Three preservice teachers use virtual manipulatives during clinical interviews with students of elementary school age. The technology exposes students' problem-solving strategies and mathematical understanding, promoting just-in-time teaching about the target content. The process of completing and reflecting on the interviews contributed to growth of the preservice teachers' technological, as well as pedagogical content, knowledge.