bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Synoptic-Scale Wave Breaking on the NAO and Its Connection with the Stratosphere in ERA-40
Authors: Kunz Torben , Fraedrich Klaus , Lunkeit Frank
Published: April 2009

This observational study investigates the impact of North Atlantic synoptic-scale wave breaking on the North Atlantic Oscillation (NAO) and its connection with the stratosphere in winter, as derived from the 40-yr ECMWF Re-Analysis (ERA-40). Anticyclonic (AB) and cyclonic wave breaking (CB) composites are compiled of the temporal and spatial components of the large-scale circulation using a method for the detection of AB and CB events from daily maps of potential vorticity on an isentropic surface. From this analysis a close link between wave breaking, the NAO, and the stratosphere is found: 1) a positive feedback between the occurrence of AB (CB) events and the positive (negative) phase of the NAO is suggested, whereas wave breaking in general without any reference to AB- or CB-like behavior does not affect the NAO, though it preferably emerges from its positive phase. 2) AB strengthens the North Atlantic eddy-driven jet and acts to separate it from the subtropical jet, while CB weakens the eddy-driven jet and tends to merge both jets. 3) AB (CB) events are associated with a stronger (weaker) lower-stratospheric polar vortex, characterized by the 50-hPa northern annular mode. During persistent weak vortex episodes, significantly more frequent CB than AB events are observed concurrently with a significant negative NAO response up to 55 days after the onset of the stratospheric perturbation. Finally, tropospheric wave breaking is related to nonannular stratospheric variability, suggesting an additional sensitivity of wave breaking and, thus, the NAO to specific distortions of the stratospheric polar vortex, rather than solely its strength.
Quantifying Carbon Cycle Feedbacks
Authors: Gregory J. M. , Jones C. D. , Cadule P. , Friedlingstein P.
Published: April 2009

Perturbations to the carbon cycle could constitute large feedbacks on future changes in atmospheric CO2 concentration and climate. This paper demonstrates how carbon cycle feedback can be expressed in formally similar ways to climate feedback, and thus compares their magnitudes. The carbon cycle gives rise to two climate feedback terms: the concentration–carbon feedback, resulting from the uptake of carbon by land and ocean as a biogeochemical response to the atmospheric CO2 concentration, and the climate–carbon feedback, resulting from the effect of climate change on carbon fluxes. In the earth system models of the Coupled Climate–Carbon Cycle Model Intercomparison Project (C4MIP), climate–carbon feedback on warming is positive and of a similar size to the cloud feedback. The concentration–carbon feedback is negative; it has generally received less attention in the literature, but in magnitude it is 4 times larger than the climate–carbon feedback and more uncertain. The concentration–carbon feedback is the dominant uncertainty in the allowable CO2 emissions that are consistent with a given CO2 concentration scenario. In modeling the climate response to a scenario of CO2 emissions, the net carbon cycle feedback is of comparable size and uncertainty to the noncarbon–climate response. To quantify simulated carbon cycle feedbacks satisfactorily, a radiatively coupled experiment is needed, in addition to the fully coupled and biogeochemically coupled experiments, which are referred to as coupled and uncoupled in C4MIP. The concentration–carbon and climate–carbon feedbacks do not combine linearly, and the concentration–carbon feedback is dependent on scenario and time.
Western North Pacific Typhoons with Concentric Eyewalls
Authors: Kuo Hung-Chi , Chang Chih-Pei , Yang Yi-Ting , Jiang Hau-Jang
Published: April 2009

This study examines the intensity change and moat dynamics of typhoons with concentric eyewalls using passive microwave data and best-track data in the western North Pacific between 1997 and 2006. Of the 225 typhoons examined, 55 typhoons and 62 cases with concentric eyewalls have been identified. The data indicate that approximately 57% of category 4 and 72% of category 5 typhoons possessed concentric eyewalls at some point during their lifetime. While major typhoons are most likely to form concentric eyewalls, the formation of the concentric structure may not be necessarily at the lifetime maximum intensity. Approximately one-third of concentric eyewall cases are formed at the time of maximum intensity.

The moat is known to be heavily influenced by the subsidence forced by the two eyewalls. Rozoff et al. proposed that the rapid filamentation dynamics may also contribute to the organization of the moat. This paper examines the possibility of rapid filamentation dynamics by devising a filamentation moat width parameter. This parameter can be computed from the best-track typhoon intensity and the passive microwave satellite-estimated inner eyewall radius for each typhoon with concentric eyewalls. The filamentation moat width explains 40% of the variance of the satellite-observed moat width in the group with concentric eyewall formation intensity greater than 130 kt.

The typhoon intensity time series in both the concentric and nonconcentric composites are studied. The time series of intensity is classified according to the 24-h intensity change before and after the concentric eyewalls formation. The averaged concentric eyewall formation latitudes in the groups with negative intensity change before concentric eyewall formation are at higher latitudes than that of the positive intensity change groups. Intensity of the concentric typhoons tends to peak at the time of secondary eyewall formation, but the standard model of intensification followed by weakening is valid for only half of the cases. Approximately 74% of the cases intensify 24 h before secondary eyewall formation and approximately 72% of the cases weaken 24 h after formation. The concentric composites have a much slower intensification rate 12 h before the peak intensity (time of concentric formation) than that of the nonconcentric composites. For categories 4 and 5, the peak intensity of the concentric typhoons is comparable to that of the nonconcentric typhoons. However, 60 h before reaching the peak the concentric composites are 25% more intense than the nonconcentric composites. So a key feature of concentric eyewall formation appears to be the maintenance of a relatively high intensity for a longer duration, rather than a rapid intensification process that can reach a higher intensity.
A Case Study of a Ross Ice Shelf Airstream Event: A New Perspective*
Authors: Steinhoff Daniel F. , Chaudhuri Saptarshi , Bromwich David H.
Published: April 2009

A case study illustrating cloud processes and other features associated with the Ross Ice Shelf airstream (RAS), in Antarctica, is presented. The RAS is a semipermanent low-level wind regime primarily over the western Ross Ice Shelf, linked to the midlatitude circulation and formed from terrain-induced and large-scale forcing effects. An integrated approach utilizes Moderate Resolution Imaging Spectroradiometer (MODIS) satellite imagery, automatic weather station (AWS) data, and Antarctic Mesoscale Prediction System (AMPS) forecast output to study the synoptic-scale and mesoscale phenomena involved in cloud formation over the Ross Ice Shelf during a RAS event. A synoptic-scale cyclone offshore of Marie Byrd Land draws moisture across West Antarctica to the southern base of the Ross Ice Shelf. Vertical lifting associated with flow around the Queen Maud Mountains leads to cloud formation that extends across the Ross Ice Shelf to the north. The low-level cloud has a warm signature in thermal infrared imagery, resembling a surface feature of turbulent katabatic flow typically ascribed to the RAS. Strategically placed AWS sites allow assessment of model performance within and outside of the RAS signature. AMPS provides realistic simulation of conditions aloft but experiences problems at low levels due to issues with the model PBL physics. Key meteorological features of this case study, within the context of previous studies on longer time scales, are inferred to be common occurrences. The assumption that warm thermal infrared signatures are surface features is found to be too restrictive.
Object-Based Analysis of Satellite-Derived Precipitation Systems over the Low- and Midlatitude Pacific Ocean
Authors: Skok Gregor , Tribbia Joe , Rakovec Jože , Brown Barbara
Published: April 2009

The Method for Object-based Diagnostic Evaluation (MODE) developed by Davis et al. is implemented and extended to characterize the temporal behavior of objects and to perform a diagnostic analysis on the spatial distribution and properties of precipitation systems over the equatorial Pacific Ocean. The analysis is performed on two satellite-derived datasets [Tropical Rainfall Measuring Mission (TRMM) 3B42 and Precipitation Estimation from Remotely Sensed Information using Artificial Neural Networks (PERSIANN)]. A sensitivity analysis showed that temporal convolution produces an unwanted “spillover” effect and that a large spatial convolution radius produces too much smoothing, which results in unrealistically large objects. The analysis showed that the largest and most long-lived precipitation systems in the tropical Pacific are typically located in the western part. A good ability to track precipitation systems in the tropical Pacific was demonstrated: movement of precipitation systems in the ITCZ is both westward and eastward although westward movement is more frequent and in the eastern part of the Pacific ITCZ the westward movement is dominant. Movement of systems in the midlatitudes was predominantly eastward. These findings were common to both satellite products, despite the fact that the average rainfall accumulation can differ by 20%–30% and the occurrence of systems with long life spans can differ by 20%.
Content Analysis of Literature About LGB People of Color: 1998-2007
Authors: Huang Yu-Ping , Brewster Melanie E. , Moradi Bonnie , Goodman Melinda B. , Wiseman Marcie C. , Martin Annelise
Published: April 2009

This study provides a content analysis of the past decade (1998-2007) of psychological scholarship about lesbian, gay, and bisexual (LGB) people of color. Findings revealed that literature about LGB people of color is growing. But, findings also highlighted underused methods, underrepresented subpopulations, and understudied topics in the scholarship about LGB people of color. In addition, divergence found between the topics of focus represented in empirical and nonempirical literature suggested the need for empirical evaluation of themes and topics discussed in the conceptual literature. Finally, understudied topics seemed to reflect areas in which counseling psychologists have expertise and experience and can make substantial contributions to advance scholarship about LGB people of color.
The Impact of Advanced Curriculum on the Achievement of Mathematically Promising Elementary Students
Authors: Gavin M. Katherine , Casa Tutita M. , Adelson Jill L. , Carroll Susan R. , Sheffield Linda Jensen
Published: April 2009

The primary aim of Project M3: Mentoring Mathematical Minds was to develop and field test advanced units for mathematically promising elementary students based on exemplary practices in gifted and mathematics education. This article describes the development of the units and reports on mathematics achievement results for students in Grades 3 to 5 from 11 urban and suburban schools after exposure to the curriculum. Data analyses indicate statistically significant differences favoring each of the experimental groups over the comparison group on the ITBS (Iowa Tests of Basic Skills) Concepts and Estimation Test and on Open-Response Assessments at all three grade levels. Furthermore, the effect sizes range from 0.29 to 0.59 on the ITBS Concepts and Estimation Scale and 0.69 to 0.97 on the Open-Response Assessments. These results indicate that these units, designed to address the needs of mathematically promising students, positively affected their achievement.

Putting the Research to Use: To date, there is a paucity of research-based, challenging mathematics curriculum units designed specifically for mathematically promising elementary students. As a result, gifted programming for these students, if it exists within a district, often involves a collection of assorted math puzzles and problems or an above-grade-level textbook that was written for the average student. The findings from this curriculum study suggest to practitioners that mathematics curriculum units that are challenging and engaging with a focus on important math concepts and that encourage students to think and act like practicing mathematicians contribute to students' math achievement. The fact that this study was replicated with a second cohort strengthens the result. In addition, since almost 50% of the students came from economically disadvantaged backgrounds, the study illustrates that the curriculum was highly effective with this special population, while meeting the needs of all talented students.
Laboratory Simulation of Y-TZP All-ceramic Crown Clinical Failures
Authors: Coelho P.G. , Bonfante E.A. , Silva N.R.F. , Rekow E.D. , Thompson V.P.
Published: April 2009

Clinically, zirconia-supported all-ceramic restorations are failing by veneer-chipping without exposing the zirconia interface. We hypothesized that mouth motion step-stress-accelerated fatigue testing of standardized dental crowns would permit this previously unrecognized failure mode to be investigated. Using CAD software, we imported the average dimensions of a mandibular first molar crown and modeled tooth preparation. The CAD-based tooth preparation was rapid-prototyped as a die for fabrication of zirconia core porcelain-veneered crowns. Crowns were bonded to aged composite reproductions of the preparation and aged 14 days in water. Crowns were single-cycle-loaded to failure or mouth-motion step-stress- fatigue-tested. Finite element analysis indicated high stress levels below the load and at margins, in agreement with only single-cycle fracture origins. As hypothesized, the mouth motion sliding contact fatigue resulted in veneer chipping, reproducing clinical findings allowing for investigations into the underlying causes of such failures.
TNF-α Promotes an Odontoblastic Phenotype in Dental Pulp Cells
Authors: Paula-Silva F.W.G. , Ghosh A. , Silva L.A.B. , Kapila Y.L.
Published: April 2009

Dental pulp cells can differentiate toward an odontoblastic phenotype to produce reparative dentin beneath caries lesions. However, the mechanisms involved in pulp cell differentiation under pro-inflammatory stimuli have not been well-explored. Thus, we hypothesized that the pro-inflammatory cytokine tumor necrosis factor-α (TNF-α) could be a mediator involved in dental pulp cell differentiation toward an odontoblastic phenotype. We observed that TNF-α-challenged pulp cells exhibited increased mineralization and early and increased expression of dentin phosphoprotein (DPP), dentin sialoprotein (DSP), dentin matrix protein-1, and osteocalcin during a phase of reduced matrix metalloproteinase (MMP) expression. We investigated whether these events were related and found that p38, a mitogen-activated protein kinase, differentially regulated MMP-1 and DSP/DPP expression and mediated mineralization upon TNF-α treatment. These findings indicate that TNF-α stimulates differentiation of dental pulp cells toward an odontoblastic phenotype via p38, while negatively regulating MMP-1 expression.
The Role of Cognitive Ability in Socio-economic Inequalities in Oral Health
Authors: Sabbah W. , Watt R.G. , Sheiham A. , Tsakos G.
Published: April 2009

Studies have postulated a role for cognitive ability in socio-economic inequalities in general health. This role has not been examined for oral health inequalities. We examined whether cognitive ability was associated with oral health, and whether it influenced the relationship between oral health and socio-economic position. Data were from the Third National Health and Nutrition Examination Survey (1988–1994), for participants aged 20–59 years. Oral health was indicated by extent of gingival bleeding, extent of loss of periodontal attachment, and tooth loss. Simple reaction time test, symbol digit substitution test, and serial digit learning test indicated cognitive ability. Education and poverty-income ratio were used as markers of socio-economic position. Participants with poorer cognitive ability had poorer oral health for all indicators. The association between oral health and socio-economic position attenuated after adjustment for cognitive ability. Cognitive ability explained part, but not all, of the socio-economic inequalities in oral health.
Improving studio music teaching through understanding learning styles
Authors: Beheshti Setareh
Published: April 2009

The role of a studio music teacher is a delicate balance of creativity and organization. In a one-on-one setting a teacher must guide a student through the physical challenges of playing an instrument as well as conveying the abstract notions of music and aesthetics. The goal of guiding a student into becoming a fine musician is universal, but teaching approaches differ. In this article I propose using learning style models as a teaching framework. The use of learning style models in the classroom is not a new idea, but the music lesson provides a unique setting for the assessment and implementation of these models. By identifying a student's dominant learning style, a teacher can more effectively develop an individualized pedagogical approach for each student. The models can be used to organize a teacher's curriculum as well as provide a framework for new and creative teaching ideas.
An analysis of the elementary school music teaching course in Turkey
Authors: Özgül Ilhan
Published: April 2009

In this article, I discuss the Turkish elementary school music teaching course in terms of the requirements of the Turkish elementary music curriculum and those of other countries such as the USA, Ireland and Malta. I propose that a more effective and efficient method of elementary music teacher preparation be put in place based on findings from research conducted in Turkey, and what is currently considered sound practice within the field of education in general and the music education profession.
The use of gestural modes to enhance expressive conducting at all levels of entering behavior through the use of illustrators, affect displays and regulators
Authors: Mathers Andrew
Published: April 2009

In this article, I discuss the use of illustrators, affect displays and regulators, which I consider to be non-verbal communication categories through which conductors can employ a more varied approach to body use, gesture and non-verbal communication. These categories employ the use of a conductor's hands and arms, face, eyes and body in a way that is currently being missed by many conducting programs. By utilizing three gestural modes, declamatory, corrective and narrative, conductors have a framework to apply these nonverbal communication categories, dependent on the skill level of the ensemble, the level of experience the ensemble has of the work at hand and the requirements of the music. Although corrective mode gestures are important for conductors, as they emphasize clarity and precision, more use could be made of illustrators and affect displays by conductors at all levels of entering behavior in order to access the declamatory mode, and regulators and affect displays in order to access the narrative mode. These modes promote the enhancement of expressive conducting beyond the beat patterns.
Earthsongs: Indigenous ways of teaching and learning
Authors: Kennedy Mary Copland
Published: April 2009

Earthsongs was the third in a series of courses designed and facilitated by Dr. Lorna Williams, Canada Research Chair in Aboriginal Education at the University of Victoria. Subtitled Learning and teaching in an Indigenous world, these courses offer undergraduate and graduate students from the Faculty of Education and across the university, faculty members, and community members the opportunity to be engaged in an experiential educational practice and to learn first hand how teaching and learning occur in an Indigenous world. This paper provides an in-depth description of the course followed by a commentary section where the views of the writer, another faculty member, two students, and one of the artists-in-residence are discussed. The final section looks to the future, offering implications for music education both locally and globally.
Self- and manual mobilization improves spine mobility in men with ankylosing spondylitis — a randomized study
Authors: Widberg Kyllikki , Karimi Hossein , Hafström Ingiäld
Published: April 2009

Aims: To evaluate effects of physiotherapeutic intervention in terms of self- and manual mobilization on chest expansion, vital capacity, posture, spine mobility and experienced consequences of the disease in patients with ankylosing spondylitis.

Design: A prospective, randomized controlled study.

Methods: Thirty-two men, aged between 23 and 60 years, with ankylosing spondylitis were randomized to active or no treatment for eight weeks. Physiotherapeutic intervention included individualized self- and manual mobilization for 1 hour twice a week and individually adjusted home exercises. Two blinded investigators made the assessments of chest expansion, posture and spinal mobility before and after the treatment period. The patient filled in three and the physiotherapist one of the four Bath Ankylosing Spondylitis scales (BAS scales).

Results: In the treatment group chest expansion increased at the level of processus xiphoideus (P<0.01), with no difference in vital capacity compared with the control group. The posture improved in the cervical (C7—wall distance) (P<0.001) and in the thoracic spine (P<0.05). Thoracic and lumbar spine flexion improved (P<0.01) as did sagittal range of motion P<0.001 and P<0.01, respectively. The Bath Ankylosing Spondylitis Metrology Index total scoring improved (P<0.001) in the treatment group compared with the control group. The other three BAS scales showed no differences between groups. At four months follow-up of the treatment group, cervical spine posture, lumbar flexion and range of motion as well as BAS Metrology Index were still improved.

Conclusion: This study shows that eight weeks of self- and manual mobilization treatment improved chest expansion, posture and spine mobility in patients with ankylosing spondylitis.
Does assessing error in perceiving postural limits by testing functional reach predict likelihood of falls in hospitalized stroke patients?
Authors: Takatori Katsuhiko , Okada Yohei , Shomoto Koji , Shimada Tomoaki
Published: April 2009

Objective: To investigate the relationship between errors in perceiving postural limits and falls in hospitalized hemiplegic patients and to determine whether this relationship is useful for identifying patients at high risk of falls.

Design: Observational study.

Subjects: Seventy-six hemiplegic patients who were admitted to a rehabilitation hospital.

Methods: Error in perceiving postural limits was defined as the difference between the estimated maximum reach and actual reach distances, and its relationship to falls during hospitalization was investigated. Other measurements included Functional Ambulation Category, Brunnstrom's recovery stage, sensory disturbance, fear of falling and the Japanese version of the Montgomery-Åsberg Depression Rating Scale (MADRS-J).

Results: For the multiple fall group, the error in estimated distance (EED) was significantly greater than that for the zero/single fall group (P<0.01). Stepwise logistic regression analysis showed that EED (odds ratio 1.2, 95% confidence interval (CI) 1.1—1.4, P<0.01) and MADRS-J scores (odds ratio 1.1, 95% CI 1.0—1.3, P<0.05) were correlated with multiple falls. According to the receiver operating characteristic curve for EED, the cut-off value for discriminating multiple fallers was 6.3cm (sensitivity 81.0%, specificity 78.2%, area under the curve 0.8).

Conclusions: The results suggest that assessing error in perceiving postural limits by measuring the maximum reach of the non-affected side of hemiplegic patients is one way to identify those who are at high risk for falling.
Unilateral Palatal and Abducens Palsy in Childhood Hepatitis A Virus Infection
Authors: Thapa Rajoo , Biswas Biswajit , Ghosh Apurba , Mukherjee Swapan
Published: April 2009

Isolated cranial nerve paresis in childhood hepatitis A virus infection is rare. The authors report an instance of concomitant right-hand side palatal and abducens palsy, developing in the course of an otherwise uncomplicated hepatitis A virus infection in a 5-year-old girl. The neurological complications were transient, and she recovered completely with supportive therapy.
Decreased Seizure Activity in a Human Neonate Treated With Bumetanide, an Inhibitor of the Na+-K+-2Cl- Cotransporter NKCC1
Authors: Kahle Kristopher T. , Barnett Sarah M. , Sassower Kenneth C. , Staley Kevin J.
Published: April 2009

Neonatal seizures have devastating consequences for brain development and are inadequately treated by available antiepileptics. In neonates, g-aminobutyric acid (GABA) is an excitatory neurotransmitter due to elevated levels of intraneuronal chloride achieved by robust activity of the Na+-K+-2Cl - cotransporter (NKCC1). This depolarizing action of GABA likely contributes to the lowered seizure threshold, increased seizure propensity, and poor efficacy of GABAergic anticonvulsants among infants. The diuretic bumetanide inhibits NKCC1 and silences seizure activity in rodent models of neonatal seizures, but its effect on seizures in human neonates is unknown. Continuous electroencephalography (EEG) monitoring was used to quantify the number, duration, and frequency of seizures 2 hours before and after the administration of bumetanide in a neonate with intractable multifocal seizures. Significant reductions in mean seizure duration and frequency were noted following treatment, with no associated clinical side effects or metabolic imbalances. These results suggest bumetanide may exert antiepileptic effects in human neonates.
High-frequency Dispersion Characteristics of Smart Delaminated Composite Beams
Authors: Chrysochoidis Nikolaos A. , Saravanos D.A.
Published: April 2009

Many promising techniques for structural health monitoring rely on the usage of in situ piezoelectric actuators and sensors, which provide the ability of self-excitation and monitoring of the damage effect on the structural vibration and wave propagation. This article presents layerwise mechanics and a finite element capable of describing the response of delaminated composite beams with piezoelectric actuators and sensors. The layerwise beam theory approximates the through-thickness, in-plane displacements, and electrical field as a continuous assembly of piecewise linear layerwise fields through the thickness. This theory further describes the field discontinuities across the delamination as additional degrees of freedom. The introduction of a variable transverse displacement field provides the capability to capture important symmetric and antisymmetric high-frequency modes, guided waves, and other complex phenomena. Pseudo Wigner-Ville distributions provide the frequency dispersion characteristics of predicted and measured time responses of beams with single delaminations and an active piezoelectric sensor pair. Time—frequency plots obtained from the experimental and numerical data are correlated and their ability to reveal the presence and size of delamination is investigated.
A Comparison of Suitable Control Methods for Full Vehicle with Four MR Dampers Part II Controller Synthesis and Road Test Validation
Authors: Xiao Min Dong  , Miao Yu  , Zushu Li  , Changrong Liao  , Weimin Chen
Published: April 2009

The significant non-linearity and uncertainty in the behavior of magnetorheological (MR) suspension systems has been one of the main challenges in the application of this technology in the development of appropriate control algorithms. Here, four model-free control algorithms studied theoretically in prior work are applied to a full vehicle featuring four MR dampers and evaluated through road test to identify the most suitable control algorithm. The four model-free control algorithms include the well-known skyhook control, the hybrid control, the fuzzy logic control, and a newly proposed intelligent control algorithm, the human simulated intelligent control (HSIC). As the first step, four MR dampers (two for the front parts and two for the rear parts) are designed and manufactured based on the damping-force levels and mechanical dimensions of stock dampers of the test vehicle. After experimentally measuring the magnetic-field-dependent force property and controllability, a precise inverse model of MR damper is formulated. Subsequently, four controllers are developed and implemented using the rapid control prototyping technology. Then the road test with different control schemes is undertaken under various road conditions and vehicle speeds. For comparison purposes, the road test of the passive suspension system with four stock dampers is also carried out under the same conditions as that of the MR suspension system. Finally, the control responses for ride comfort and stability are evaluated in both time and frequency domains. The results support the conclusion made in the prior numerical analysis that the semi-active suspension system with each control algorithm can improve ride comfort and stability in some indexes, but HSIC algorithm is found to be the most suitable one with four MR dampers in the MR suspension system.
Integrating Sustainability Into Management Education
Authors: Walck Christa
Published: April 2009

The integration of sustainability and environmental ethics into management education has improved in the past decade. This is partly a response to external pressure, as societal concerns about sustainability grow and businesses have made greater efforts to green their processes and products. But it is also a response to internal pressure from faculty who have focused their research on the intersection of business and the natural environment. Academic administrators such as deans can encourage this integration in a number of ways, even if business school accreditors such as AACSB lag in their commitment to sustainability education.
A Case of Juxtaglomerular Cell Tumor With Novel Histologic Features
Authors: Onder Sevgen , Baydar Dilek Ertoy
Published: April 2009

Juxtaglomerular cell tumors constitute a very small group among the renal neoplasms. Most secrete renin, causing hypertension and hypokalemia due to secondary hyperaldosteronism. They have characteristic pathological features. For the accurate evaluation, diagnosis has to be confirmed by immunohistochemical staining for renin or electron microscopic demonstration of renin protogranules. This report presents a case of renal juxtaglomerular cell tumor in a 63-year-old man with previously unreported histological findings in addition to classic morphology.
Angiogenesis in the Progression of Breast Ductal Proliferations
Authors: Carpenter Philip M. , Chen Wen-Pin , Mendez Aaron , McLaren Christine E. , Su Min-Ying
Published: April 2009

Angiogenesis, the formation of blood vessels, is necessary for a tumor to grow, but when angiogenesis first appears in the progression of breast ductal carcinomas is unknown. To determine when this occurs, the authors examined microvessel density (MVD) by CD31 and CD105 immunostaining in normal ducts, 32 cases of usual hyperplasia, 19 cases of atypical hyperplasia, and 29 cases of ductal carcinoma in situ (DCIS). Simple hyperplasia had a 22-fold greater MVD than normal ducts ( P < .0001). An increase during the progression of ductal changes was highly significant ( P < .0001). To determine a possible mechanism, immunohistochemistry for vascular endothelial growth factor (VEGF) was evaluated. VEGF staining intensity of ductal epithelium increased during the progression from normal to hyperplastic to DCIS. This study shows that the first significant increase in angiogenesis occurs very early in the evolution of ductal proliferations as ductal cells become hyperplastic.
Review: Therapy for Alzheimer's disease: how effective are current treatments?
Authors: Lanctôt Krista L. , Rajaram Ryan D. , Herrmann Nathan
Published: April 2009

Available symptomatic therapies for the treatment of Alzheimer's disease (AD) have been based on known neurotransmitter dysfunctions associated with the illness. The second-generation cholinesterase inhibitors and the N-methyl D-aspartate receptor antagonist memantine have been widely prescribed and studied. Meta-analyses of these therapies were reviewed, focusing on effectiveness and tolerability. Although many of the meta-analyses demonstrate statistically significant improvements, some question if these benefits are sufficient to justify their current widespread and protracted use. This has spurred the development of new disease-modifying therapies that aim to have a greater impact on this debilitating illness.
Imatinib for refractory chronic graft-versus-host disease with fibrotic features
Authors: Olivieri Attilio , Locatelli Franco , Zecca Marco , Sanna Adele , Cimminiello Michele , Raimondi Roberto , Gini Guido , Mordini Nicola , Balduzzi Adriana , Leoni Pietro , Gabrielli Armando , Bacigalupo Andrea
Published: April 2009

We previously reported that patients with fibrotic, chronic graft-versus-host disease (cGVHD) have antibodies activating the platelet-derived growth factor receptor pathway. Because this pathway can be inhibited by imatinib, we performed a pilot study including 19 patients with refractory cGVHD, given imatinib at a starting dose of 100 mg per day. All patients had active cGVHD with measurable involvement of skin or other districts and had previously failed at least 2 treatment lines. Patient median age was 29 years (range, 10-62 years), and median duration of cGvHD was 37 months (range, 4-107 months). The organs involved were skin (n = 17), lung (n = 11), and bowel (n = 5); 15 patients had sicca syndrome. Imatinib-related, grade 3 to 4 toxicity included fluid retention, infections, and anemia. Imatinib was discontinued in 8 patients: in 3 because of toxicity and in 5 because of lack of response (n = 3) or relapse of malignancy (n = 2). Overall response rate at 6 months was 79%, with 7 complete remissions (CRs) and 8 partial remissions (PRs). With a median follow-up of 17 months, 16 patients are alive, 14 still in CR or PR. The 18-month probability of overall survival is 84%. This study suggests that imatinib is a promising treatment for patients with refractory fibrotic cGVHD.
Hematopoietic stem cell transplantation in Griscelli syndrome type 2: a single-center report on 10 patients
Authors: Pachlopnik Schmid Jana , Moshous Despina , Boddaert Nathalie , Neven Bénédicte , Dal Cortivo Liliane , Tardieu Marc , Cavazzana-Calvo Marina , Blanche Stéphane , de Saint Basile Geneviève , Fischer Alain
Published: April 2009

Allogeneic hematopoietic stem cell transplantation (HSCT) is the only curative treatment for Griscelli syndrome type 2, an inherited immune disorder causing fatal hemophagocytic lymphohistiocytosis (HLH). Optimal therapeutic modalities are not yet well known. We retrospectively analyzed the outcome for 10 patients who underwent HSCT in a single center between 1996 and 2008. Seven patients (70%) were cured of the primary immune defect (mean follow-up, 5.2 years; range, 0.8-12.0 years), 4 of them without neurologic sequelae. In the 3 deceased patients, death occurred within 110 days of HSCT and was probably due to adverse reaction to HSCT in 2 patients and to HLH relapse in one patient. One patient received 2 transplants because of graft failure. Clinical events included veno-occlusive disease (n = 5), acute (n = 7) or chronic (n = 1) graft-versus-host disease II-III, and Epstein-Barr virus–induced lymphoproliferative disease (n = 2). Of the 7 patients with neurologic involvement before HSCT, 4 survived and 2 presented sequelae. Furthermore, 1 patient lacking neurologic involvement before HSCT developed long-term sequelae. These results demonstrate the efficacy of HSCT in curing the immune disorder but also show that neurologic HLH before HSCT is a major factor, given the neurologic sequelae after otherwise successful HSCT. Additional studies are required to improve treatment.
Pre-operative pulmonary evaluation of lung cancer patients: a review of the literature
Authors: van Tilburg P. M. B. , Stam H. , Hoogsteden H. C. , van Klaveren R. J.
Published: April 2009

Complete anatomical resection of the primary tumour is still the standard of care in patients with early stage lung cancer. Because these patients are usually smokers who also suffer from chronic obstructive pulmonary disease, regional differences in pulmonary function due to lung tissue destruction exist.

The purpose of the present article is to evaluate the currently available guidelines and to discuss novel methods for the pre-operative functional and anatomical pulmonary evaluation in lung cancer patients.

Despite the fact that knowledge on the pre-operative evaluation of the pulmonary function has substantially increased during the past decade, the majority of the studies are small, underpowered and, with exception of a proposed algorithm, not prospectively validated in independent cohorts.

The future harmonisation of guidelines is required and novel imaging techniques should be incorporated in the pre-operative evaluation in chronic obstructive pulmonary disease patients with borderline pulmonary function.
The pulmonary vascular complications of hereditary haemorrhagic telangiectasia
Authors: Faughnan M. E. , Granton J. T. , Young L. H.
Published: April 2009

Hereditary haemorrhagic telangiectasia (HHT) is a rare autosomal dominant disorder, characterised by the presence of vascular malformations. The pulmonary vascular complications of HHT include pulmonary arteriovenous malformations, pulmonary hypertension associated with high-output heart failure and liver vascular malformations and, finally, pulmonary arterial hypertension secondary to HHT. In the present review, the authors describe the clinical presentation, diagnosis and management of all three pulmonary vascular presentations of HHT, as well as the underlying genetics and pathophysiology.
Cardiovascular disease in obstructive sleep apnoea syndrome: the role of intermittent hypoxia and inflammation
Authors: Garvey J. F. , Taylor C. T. , McNicholas W. T.
Published: April 2009

There is increasing evidence that intermittent hypoxia plays a role in the development of cardiovascular risk in obstructive sleep apnoea syndrome (OSAS) through the activation of inflammatory pathways. The development of translational models of intermittent hypoxia has allowed investigation of its role in the activation of inflammatory mechanisms and promotion of cardiovascular disease in OSAS. There are noticeable differences in the response to intermittent hypoxia between body tissues but the hypoxia-sensitive transcription factors hypoxia-inducible factor-1 and nuclear factor-κB appear to play a key role in mediating the inflammatory and cardiovascular consequences of OSAS. Expanding our understanding of these pathways, the cross-talk between them and the activation of inflammatory mechanisms by intermittent hypoxia in OSAS will provide new avenues of therapeutic opportunity for the disease.
Unusual microbes in asthma exacerbation:Alcaligenes xylosoxidansand Leishmania
Authors: Robibaro B. , Funk G-C. , Dekan G. , Demetriou D. , Ziesche R. , Winkler S. , Block L.H.
Published: April 2009

Asthma is a chronic inflammatory condition characterised by a variable degree of airflow limitation. Exacerbations during the course of asthma often occur due to environmental factors or infectious, mostly viral, aetiology.

The present study reports the case of a 61-yr-old male with severe asthma hospitalised due to increasing respiratory distress. Since recovery was delayed despite anti-obstructive/anti-inflammatory and antibiotic therapy, further diagnostic procedures, including bronchoscopy, were performed in order to attempt to identify the cause of the worsening respiratory condition.

The surprising finding consisted of a rare coincidence of concomitant infection with the bacterial pathogenAlcaligenes xylosoxidans, grown from bronchoalveolar lavage fluid, and the protozoan parasite Leishmania spp., revealed by histopathological examination of bronchial mucosal biopsy specimens. This is the first report of an isolated bronchial mucosal involvement of Leishmania in an HIV-negative asthma patient following brief exposure in Leishmania-endemic regions. Further, to the best of the present authors’ knowledge, this represents the first description ofA. xylosoxidansin asthma, although it is questionable whether it was an infection or colonisation.

The present observation identifies previously unreported microbial pathogens associated with asthma exacerbation. Further, the report highlights the importance of obtaining a thorough travel history and applying invasive diagnostic procedures in circumstances of treatment failure, even under unfavourable conditions.
Consort hypersensitivity pneumonitis
Authors: Merget R. , Sander I. , Ewig S. , Sennekamp J. , Bruening T.
Published: April 2009

To date, there is little information in the literature that hypersensitivity pneumonitis due to birds may occur without direct contact to birds.

A 62-yr-old pensioner developed mild flu-like symptoms, fatigue and polyuria several hours after each meeting with his new female partner, either in hotels or his apartment. After divorcing from her ex-husband, who was a canary fancier, the female had moved into a bungalow ∼6 months earlier. When the couple met for the first time at the bungalow, the patient's symptoms worsened and he developed shortness of breath. The patient had never entered the bird house or the married couple's house.

Hypersensitivity pneumonitis was demonstrated by chest radiography, computed tomography, a restrictive ventilatory defect, decreased diffusion capacity and hypoxaemia after physical exercise. Sensitisation to canaries was shown by immunoassays. Canary antigens were detected by a polyclonal immunoassay at different locations of the married couple's house and the female's bungalow, where no birds had ever been kept.

In conclusion, hypersensitivity pneumonitis should be recognised as a further consort disease,i.e.a disease that can be transmitted by partners.
Systemic manifestations and comorbidities of COPD
Authors: Barnes P. J. , Celli B. R.
Published: April 2009

Increasing evidence indicates that chronic obstructive pulmonary disease (COPD) is a complex disease involving more than airflow obstruction. Airflow obstruction has profound effects on cardiac function and gas exchange with systemic consequences. In addition, as COPD results from inflammation and/or alterations in repair mechanisms, the “spill-over” of inflammatory mediators into the circulation may result in important systemic manifestations of the disease, such as skeletal muscle wasting and cachexia. Systemic inflammation may also initiate or worsen comorbid diseases, such as ischaemic heart disease, heart failure, osteoporosis, normocytic anaemia, lung cancer, depression and diabetes. Comorbid diseases potentiate the morbidity of COPD, leading to increased hospitalisations, mortality and healthcare costs. Comorbidities complicate the management of COPD and need to be evaluated carefully. Current therapies for comorbid diseases, such as statins and peroxisome proliferator-activated receptor-agonists, may provide unexpected benefits for COPD patients. Treatment of COPD inflammation may concomitantly treat systemic inflammation and associated comorbidities. However, new broad-spectrum anti-inflammatory treatments, such as phosphodiesterase 4 inhibitors, have significant side-effects so it may be necessary to develop inhaled drugs in the future. Another approach is the reversal of corticosteroid resistance, for example with effective antioxidants. More research is needed on COPD comorbidities and their treatment.
Outpatient treatment and early discharge of symptomatic pulmonary embolism: a systematic review
Authors: Squizzato A. , Galli M. , Dentali F. , Ageno W.
Published: April 2009

The published literature regarding the safety of outpatient treatment of symptomatic pulmonary embolism (PE) was systematically summarised.

A literature search was performed using the PubMed and EMBASE databases. Studies in which patients had symptomatic PE and the antithrombotic treatment was administered completely at home or the patients were discharged early were selected. A scoring system was used to divide studies into three quality categories. Short- and long-term outcomes were extracted: all-cause mortality, death from PE or from major haemorrhage, recurrent venous thromboembolism, and major bleeding.

Eleven observational studies were included. No randomised controlled studies were identified. No study fulfilled the criteria for high quality. A total of 928 patients with symptomatic PE were treated completely as outpatients or discharged early; haemodynamic instability and hypoxia were the main exclusion criteria. No patient died during the first 7 days of antithrombotic treatment.

Outpatient treatment of symptomatic PE is not based on high-quality evidence. Although the published data suggest that certain subgroups of haemodynamically and respiratorily stable patients may be safely treated at home when a well-defined management programme is applied, further studies are warranted for a short-term prognostic risk stratification of this PE subgroup.
Extracellular Hsp72, an endogenous DAMP, is released by virally infected airway epithelial cells and activates neutrophils via Toll-like receptor (TLR)-4
Authors: Wheeler Derek S , Chase Margaret A , Senft Albert P , Poynter Sue E , Wong Hector R , Page Kristen
Published: April 2009

Background

Neutrophils play an important role in the pathophysiology of RSV, though RSV does not appear to directly activate neutrophils in the lower airways. Therefore locally produced cytokines or other molecules released by virally-infected airway epithelial cells are likely responsible for recruiting and activating neutrophils. Heat shock proteins (HSPs) are generally regarded as intracellular proteins acting as molecular chaperones; however, HSP72 can also be released from cells, and the implications of this release are not fully understood.

Methods

Human bronchial epithelial cells (16HBE14o-) were infected with RSV and Hsp72 levels were measured by Western blot and ELISA. Tracheal aspirates were obtained from critically ill children infected with RSV and analyzed for Hsp72 levels by ELISA. Primary human neutrophils and differentiated HL-60 cells were cultured with Hsp72 and supernatants analyzed for cytokine production. In some cases, cells were pretreated with polymyxin B prior to treatment with Hsp72. IκBα was assessed by Western blot and EMSA's were performed to determine NF-κB activation. HL-60 cells were pretreated with neutralizing antibody against TLR4 prior to Hsp72 treatment. Neutrophils were harvested from the bone marrow of wild type or TLR4-deficient mice prior to treatment with Hsp72.

Results

Infection of 16HBE14o- with RSV showed an induction of intracellular Hsp72 levels as well as extracellular release of Hsp72. Primary human neutrophils from normal donors and differentiated HL-60 cells treated with increasing concentrations of Hsp72 resulted in increased cytokine (IL-8 and TNFα) production. This effect was independent of the low levels of endotoxin in the Hsp72 preparation. Hsp72 mediated cytokine production via activation of NF-κB translocation and DNA binding. Using bone marrow-derived neutrophils from wild type and TLR4-mutant mice, we showed that Hsp72 directly activates neutrophil-derived cytokine production via the activation of TLR4.

Conclusion

Collectively these data suggest that extracellular Hsp72 is released from virally infected airway epithelial cells resulting in the recruitment and activation of neutrophils.