bluuebunny/crossref_metadata_2025 huggingface dataset:
Physician Aid-in-Dying: Toward A “Harm Reduction” Approach
Authors: Heilig Steve , Jamison Stephen
Published: July 2009

As a bioethical and social issue, euthanasia has become in the 1990s what abor- tion was in the 1960s. Around the world, a de facto taboo on open discussion of the practice is seemingly falling by the wayside, as recognition increases that “active” euthanasia is taking place in spite of social and legal prohibitions. Euthanasia, or more specifically physician-assisted suicide, has become the most visible bioethical issue of the present era; and in the United States the debate has taken on a prominence and urgency unprecedented in our nation's history.
CQ Interview: Margaret Battin, Howard Brody, Patricia Marshall, and Robyn Shapiro on Physician-Aided Death
Authors: Swartzberg Dana
Published: July 2009

In The Netherlands, the close relationship between doctor and patient over time can be viewed as an advantage in protecting the patient. Is it possible to implement this aspect of euthanasia in the United States?
Situation Ethics and Incremental Reform of American Health Delivery Systems
Authors: D'Oronzio Joseph C.
Published: July 2009

The classic formulation of situation ethics in the 1960s was the result of the contention that the deductive application of general rules and principles in ethics was inherently flawed by the uniqueness of every situation. Quite often, ethical problems are problems precisely because existing rules do not apply four square to the singular situation at hand. There is a need, the argument ran, to assert the primacy of the special situation and to formulate a resolution of the unsettling circumstances appropriately attuned to it. Situation ethics is, in a sense, a moral theory equivalent to case law in a legal system devoid of rule by law.
How Important Is Consent for Controlled Clinical Trials?
Authors: MacKinnon Barbara
Published: July 2009

The Nuremberg Code of ethical principles for experiments involving human beings has as its first requirement that “the voluntary consent of the human subject is absolutely essential.” Since the time of the trials that supplied its motivation the principles have been amplified and detail and distinctions have been added. For example, the Declaration of Helsinki, adopted by the World Medical Association in 1964, again laid down general principles related to voluntariness, balance of risk and benefit, and scientific soundness. However, it also noted that the ethical issues with regard to two distinctly different types of human experiment vary. These two types are clinical research (i.e., “medical research combined with profession care”) and nonclinical biomedical research (i.e., “nontherapeutic biomedical research involving human subjects”). In actuality, we may distinguish three types of human biomedical experimentation. Two of these are therapeutic and nontherapeutic experimentation. The first is directed primarily to the benefit of the experimental subjects who are being treated with some new experimental therapy for their ailment. In the second an experiment is designed to increase medical knowledge and uses volunteers who are healthy or whose illness is not related to the experimental study. One key difference between the ethical requirements specified by the Declaration of Helsinki for therapeutic and nontherapeutic experimentation was that the second approach required participation only by volunteers whom we assume are able to and do give their informed consent. However, in the first approach if consent were not obtained, the physician must specify the reasons and present these before an independent committee.
Informed Consent Issues in International Research Concerns
Authors: Porter Joan P.
Published: July 2009

No discussion of the informed consent process would be adequate without attention to dilemmas and challenges arising in research in foreign countries, particularly in the less developed countries. In an era of the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), for example, much attention to research issues concerning devastating health conditions in developed and less developed countries has occurred with renewed vigor.
Measurement of Moral Development in Medicine
Authors: Self Donnie J. , Davenport Evi
Published: July 2009

The past two decades have been a time of heightened interest in the moral aspects of the practice of medicine. This interest has been reflected in medical education by the establishment of medical humanities programs in both preclinical and clinical education in many medical schools. It has also been reflected in the literature with a dramatic increase in journal articles on medical ethics as well as the development of medical ethics in textbooks. A number of journals have developed that are specifically devoted to medical ethics, includingThe Journal of Medical Ethics, The Journal of Medicine and Philosophy, The Journal of Medical Humanities, Theoretical Medicine, Cambridge Quarterly of Healthcare Ethics, just to name a few. The literature includes both theoretical foundations and conceptual analyses of particular issues as well as practical advice and general suggestions for how to implement programs in medical humanities.
Orphan Tests
Authors: Biesecker Leslie G.
Published: July 2009

An urgent need for standards and guidelines on genetic testing has arisen because of swift advances in research, facilitated by the Human Genome Project. The goals of the Human Genome Project include the identification of all genes and sequencing of the human genome. The project is currently ahead of schedule and under budget. We can expect an avalanche of genetic information, much of which will be relevant to human disease. In addition to the Human Genome Project, investigator-initiated research projects and commercial biotechnology laboratories are discovering human disease genes at a breathtaking pace. Technology transfer has been rapid and has led to the availability of numerous clinical tests within only a few years since the first disease gene yielded to the technique of positional cloning. Disease genes are selected for study for a number of reasons. Genes for rare diseases may be studied before more common disorders because they elucidate an important area of pathogenesis. Unfortunately, technology transfer to the clinic for rare tests is hindered by several factors. Standards need to be established to assure that genetic tests for rare diseases are not ignored or mismanaged in the rush to commercialize tests for more common human genetic diseases.
The Canadian Question: What's So Great About Intelligence?
Authors: Koch Tom
Published: July 2009

A personable teenager with Down's syndrome became a Canadian cause célèbre a few months ago when University Hospital in Edmonton, Alberta, denied him a position on the organ transplantation waiting list. Terry Urquart lacked “reasonable” intelligence, hospital officials said, a criterion for all transplant candidates at that hospital. Protests by the boy's family, and by groups active in the cause of those with developmental disabilities, became well-photographed stories on the nightly television news and in the nation's newspapers. It did not hurt the Urquart cause one bit that the 17-year-old teenager had won a gold medal in skiing at the International Special Olympics.
Public Science and Norms of Truthfulness
Authors: Guenin Louis M.
Published: July 2009

The phenomenon of misconduct in scientific research illustrates how great can be the social damage of not knowing the incidence of a malady. Many urgings about such phenomenon have predicated views about the extent of institutional and governmental vigilance on observers' differing surmises about how frequently misconduct occurs. Such is the measurement error of extant data about incidence1 that one can venture little more than the deliberately imprecise conclusion that “misconduct is neither common nor rare.”
Patient Access to Experimental Drugs and AIDS Clinical Trial Designs: Ethical Issues
Authors: Schüklenk Udo , Hogan Carlton
Published: July 2009

Today's clinical AIDS research is in trouble. Principal investigators are confronted with young and frequently highly knowledgeable patients. Many of these people with AIDS (PWAs) are often unwilling to adhere to the trial protocols. These PWAs believe they are ethically justified in breaching trial protocols because they do not consider themselves true volunteers in such trials. PWAs argue that they do not really volunteer because existing legislation prevents them from buying and using experimental drugs or from testing alternative treatment strategies. Their only access to such agents is participation in clinical trials.
The Ethical Problems of the Open Label Extension Study
Authors: Micetich Kenneth Craig
Published: July 2009

The institutional review board (IRB) Is charged with assessing the risks and benefits of research projects Involving human subjects. Ethical considerations and federal regulations require that an IRB, in part, must find that the potential risks of participation are proportional to the potential benefits (If any) and to the Importance of the knowledge that may be learned before the IRB can approve the voluntary assumption of risk by a research participant. Adequate assessment of the risks and benefits requires careful scrutiny of the study design In relation to the study objectives.
Except in Emergencies: AMA Ethics and Physician Autonomy
Authors: Clark Chalmers C.
Published: July 2009

In this paper I will argue that in emergency cases, physician autonomy issoci-etallyconstrained under Principle VI of the American Medical Association's (AMA) “Principles of Medical Ethics”1 The issue will be seen to turn on whether the contextual use of “emergency” should be construed narrowly or broadly; I argue for a broadened rendering. Although a societal emergency is not defined here, I recommend that the condition of inner city healthcare presents a paradigm “patient” for such emergency care. I further urge that because societal constraints on physician autonomy are ambiguous and only derived indirectly in the AMA document, further AMA comment on physician autonomy and societal responsibility would advance clarity on the profession's commitment to the public trust.
Further Exploration of the Relationship Between Medical Education and Moral Development
Authors: Self Donnie J. , Baldwin DeWitt C. , Wolinsky Fredric D.
Published: July 2009

In the wake of a pilot study that indicated that the experience of medical education appears to Inhibit moral development In medical students, increased attention needs to be given to the structure of medical education and the Influence it has on medical students. Interest in ethics and moral reasoning has become widespread in many aspects of professional and public life. Society has exhibited great interest in the ethical issues confronting physicians today. Considerable effort has been undertaken to train medical students, interns, and residents In how to reason through medical-ethical dilemmas. Media attention has focused on Issues such as abortion, euthanasia, care of severely handicapped infants, organ transplantation, and so forth, producing heated debates in both the professional and lay literature over the morality of the various positions. The curriculum of medical education has paralleled and reflected this general Interest in medical ethics. Most medical schools now offer, and frequently require, course work in ethics. However, further research Is needed to better characterize and understand the relationship of medical education to moral development.
The Eclipse of the Individual in Policy (Where is the Place for Justice?)
Authors: Bliton Mark J. , Finder Stuart G.
Published: July 2009

Several inquires about healthcare over the past several decades have shown that the evolution of healthcare practices exhibit their own microcosm of local and political influences. Likewise, other studies have shown clearly the ways in which both external and internal institutional factors establish the sectors within which healthcare is delivered. Although restrictions have always been present in some form, it seems obvious that whatever the precise form of healthcare delivery that results from current changes in its organization, there are going to be broader restrictions not only on the choices that providers will be able to make about individual patients' care and needs, but also regarding the character of their clinical judgments. Indeed, there are already reports of instances where physicians' contracts with managed care organizations forbid them to disclose the existence of services not covered by a plan.
The Economic Attributes of Medical Care: Implications for Rationing Choices in the United States and United Kingdom
Authors: Banks Dwayne A.
Published: July 2009

The healthcare systems of the United States and United Kingdom are vastly different. The former relies primarily on private sector incentives and market forces to allocate medical care services, while the latter is a centrally planned system funded almost entirely by the public sector. Therefore, each nation represents divergent views on the relative efficacy of the market or government in achieving social objectives in the area of medical care policy. Since its inception in 1948, the National Health Services (NHS) of the United Kingdom has consistently emphasized equity in the allocation of medical services. It has done so by creating a system whereby services are universally free of charge at the point of entry. Conversely, the United States has relied upon the evolution of a perplexing array of public and private sector insurance schemes centered more around consumer choice than equity in allocation.
Approaches Responsive to Reproductive Technologies: A Need for Critical Assessment and Directions for Further Study
Authors: Kondratowicz Diane M.
Published: July 2009

Since its inception decades ago, technological intervention in human reproduction has been the subject of considerable attention and controversy. After identifying two focal points of debate, I focus in this paper upon an emerging body of literature responsive to a host of problematic issues that, scholars claim, reproductive technologies pose. Maintaining that critical assessment of this literature is necessary, I identify two areas of inquiry which deserve attention and, correspondingly, sketch directions which might guide further study.
Physician-Assisted Suicide in Psychiatry: Developments in the Netherlands
Authors: Legemaate Johan , Gevers J.K.M.
Published: July 2009

For more than two decades euthanasia and assisted suicide have been openly debated in the Netherlands. This development started in 1973 when the Regional Court in Leeuwarden decided a case in which a physician had administered a deadly dose of morphine to her terminally ill mother on the mother's serious and persistent request. In this case the court concluded that the average Dutch physician no longer considered it his or her duty to prolong a patient's life under all circumstances. The court accepted that in specific cases a physician is allowed to prevent serious and irreversible suffering, even if the patient's life is short ened. This case was the first in which a legal opening for euthanasia or assisted suicide was created. In this specific case the physician was formally declared guilty, but the court gave her a suspended sentence of one week imprisonment. This decision started a debate on euthanasia and assisted suicide throughout all levels of Dutch society.
End-of-Life Care in the Netherlands and the United States: A Comparison of Values, Justifications, and Practices
Authors: Quill Timothy E. , Kimsma Gerrit
Published: July 2009

Voluntary active euthanasia (VAE) and physician-assisted suicide (PAS) remain technically illegal in the Netherlands, but the practices are openly tolerated provided that physicians adhere to carefully constructed guidelines. Harsh criticism of the Dutch practice by authors in the United States and Great Britain has made achieving a balanced understanding of its clinical, moral, and policy implications very difficult. Similar practice patterns probably exist in the United States, but they are conducted in secret because of a more uncertain legal and ethical climate. In this manuscript, we plan to compare end-of-life care in the United States and the Netherlands with regard to underlying values, justifications, and practices. We will explore the risks and benefits of each system for a real patient who was faced with a common end-of-life clinical dilemma, and close with challenges for public policies in both countries.
Genetic Engineering and Environmental Ethics
Authors: Dobson Andrew
Published: July 2009

When God gave humankind dominion over the earth he may not have known exactly what we would be able to do with it. The technical capacities to which the production and reproduction of our everyday life have given rise have grown at an astonishing and, it seems, ever-increasing rate. The instruments that we use to do work on the world have become sharper and more refined, and the implications of human interventions in the nonhuman environment are much more far-reaching than could have been imagined even forty years ago. It has become something of a cliche to say that our technical abilities have outstripped the wisdom to know when, where, and how we should appropriately use them, but techniques such as genetic engineering invite the dusting-off of the cliche and the asking of the question implicit in it: We know we can splice genes, but should we splice them? We might of course come to the conclusion that we should only splice some of them some of the time, but even arriving at that conclusion presupposes that the ethical question has been asked and answered.
Developing Habits and Knowing What Habits to Develop: A Look at the Role of Virtue in Ethics
Authors: Loewy Erich H.
Published: July 2009

Virtue ethics attempts to identify certain commonly agreed-upon dispositions to act in certain ways, dispositions that would be accepted as ‘good’ by those affected, and to locate the goodness or badness of an act internal to the agent. Basically, virtue ethics is said to date back to Aristotle, but as Alisdair MacIntyre has pointed out, the whole idea of ‘virtue ethics’ would have been unintelligible in Greek philosophy for “a virtue (arete) was an excellence and ethics concerned excellence of character; all ethics was virtue ethics.” Virtue ethics as a method to approach problems in medical ethics is said by some to lend itself to working through cases at the bedside or, at least, is better than the conventional method of handling ethical problems. In this paper I want to explore some of the shortcomings of this approach, examine other traditional approaches, indicate some of their limitations, and suggest a different conceptualization of the approach.
The Economics of Clinical Ethics Programs: A Quantitative Justification
Authors: Bacchetta Matthew D. , Fins Joseph J.
Published: July 2009

The restructuring of the healthcare marketplace has exerted pressure directly and indirectly on clinical ethics programs. The fiscal orientation and emphasis on efficiency, outcome measures, and cost control have made it increasingly difficult to communicate arguments in support of the existence or growth of ethics programs. In the current marketplace, arguments that rely on the claim that ethics programs protect patient rights or assist in the professional formation of practitioners often result in minimal levels of funding and preclude program growth. Where ethics programs could once sustain themselves on goodwill alone and values arguments in an expanding healthcare market they are now encountering—at least by anecdotal reports—cutbacks and even elimination. To respond to these challenges, we offer an economic model that can be used to demonstrate the “value” of an institutionally based ethics program.
Principles and Purpose: The Patient Surrogate's Perspective and Role
Authors: Koch Tom
Published: July 2009

The critical role of surrogates—commonly if erroneously called “Informal caregivers”—has been generally ignored by clinical and bioethical literatures. While assumed to provide no more than ancillary support, these patient representatives directly or indirectly affect patient care to the extent they inhibit or facilitate both home-based care and patient decisions regarding treatment alternatives. Members of this group include relatives and neighbors who may or may not act in consort as advisors, assistants, care providers, and surrogate decisionmakers acting on the patient's behalf with members of the medical community. Not only do they often possess a critical voice strongly influencing both patient care decisions and, after discharge, home care and rehabilitation, this paper argues they do so from a perspective that is often radically different from one endorsed by medical professionals.
Health Policy Watch: Ethical Obligations in the Body Politic: The Case of Normalization Policy for Marginal Populations
Authors: d'Oronzio Joseph C.
Published: July 2009

A common tale of moral cacophony and euphemism on the city streets:

Each day, an owner of a small business decides, “once and for all,” how to respond to the “homeless person” panhandling for “spare change” as she makes her way to work in the morning. Today, she looks the other way and holds more tightly to her purse. Nearby, a building contractor waits impatiently for the traffic light to change as his van is approached by a small and shabby band of “street people” demanding to clean his windshield. He turns his wipers on to signal them away. Sometimes this works. At the next light, a woman carrying an infant swaddled to her torso offers a tube of three roses for a dollar. The driver smiles pleasantly, but does not stop. The businesswoman, now close to work, buys two tubes of roses and does not wait for the change from the five-dollar bill she earnestly presses into the mother's hand.
Jaqueline Tyrwhitt and transnational discourse on modern urban planning and design, 1941–1951
Authors: SHOSHKES ELLEN
Published: July 2009

This paper illuminates the significant contributions that Jaqueline Tyrwhitt, a British town planner, editor and educator, made to transnational discourse on modern urban planning and design from 1941 to 1951. This is when she formulated her synthesis of utopian planning ideals, grounded in the bio-regionalism of the Scottish visionary Patrick Geddes and informed by European modernism. Her hybrid grew into the Geddessian branch of the planning arm of the post-war modern movement. In addition to uncovering Tyrwhitt's hidden voice, the article also uses the biography of a transnational actor as a vehicle to analyse the emergence of the concept that urbanism encompasses both the global and the local.
The European Paediatric Cardiac Code Long List: structure and function — the first revision
Authors: Franklin Rodney C. G.
Published: July 2009

The Long List

The Long List is a comprehensive hierarchical system of coding and classification for the diagnosis and treatment of cardiac disease. The list was first published in 2000, as part of the standard coding system recommended by the Association for European Paediatric Cardiology for use across Europe. It embraces the entirety of the diagnosis and therapy of children with congenital and acquired cardiac disease. The Long List, as a whole, was adopted by the Association in 1998. Its development and expansion has been detailed previously. In essence, it grew from a list of 507 purely diagnostic terms published in 1985, through to a 1,777 item, hierarchical 12 tree structure in the Netherlands by 1988, and then to a single hierarchical structure of over 4,300 items in London by 1994. Although originally aimed at the clinician or surgeon treating cardiac disease first appearing in infancy or childhood, during this time it was enlarged to encompass abnormalities first diagnosed in fetal life, as well as cardiac disease first acquired during adult life. The list published in 2000 was composed of 4,777 items. These were made up of 3,906 individual terms, most of whom were mutually exclusive and unambivalent, given the constraints of clinical ambiguities and differing cultures of practice.
A prospective study to determine the significance of ventricular late potentials in children with mitral valvar prolapse
Authors: Bobkowski Waldemar , Siwińska Aldona , Zachwieja Jacek , Mroziński Bartłomiej , Rzeźnik-Bieniaszewska Alina , Maciejewski Janusz
Published: July 2009

We aimed prospectively to determine the incidence of ventricular arrhythmias and ventricular late potentials in children with mitral valvar prolapse, and to assess whether signal-averaged electrocardiography could identify which such children were at high risk of developing ventricular tachycardia. In all, we examined 151 children with mitral valvar prolapse, at an age of 12.2 ± 3.1 years, and 164 healthy subjects aged 12.3 ± 3.7 years. All children underwent 24-hour ambulatory Holter monitoring and echocardiography. The children with mitral valvar prolapse were followed prospectively for a mean of 64 months. There was a significantly higher prevalence of ventricular arrhythmias in those with prolapse than in the controls (p < 0.0001). Runs of ventricular tachycardia were observed in 3 children with mitral valvar prolapse compared with one from the control group. Late potentials were more frequently observed in the children with mitral valvar prolapse than in those who were healthy (p < 0.0001), and also in those with prolapse suffering ventricular arrhythmias compared with those without ventricular arrhythmias (p < 0.02). During follow-up, 24 children with prolapsing mitral valves developed non-sustained ventricular tachycardia, giving a frequency of 3.1/100 subject-years. The sensitivity of late potentials was low, at 52%, for the identification of children with mitral valvar prolapse who developed ventricular tachycardia, although the specificity was high at 90%. This gave a positive predictive value of 50%, and a negative predictive value of 91%. We conclude that prolapse of the mitral valve predisposes to the development of ventricular arrhythmias and late potentials in children. An abnormal signal-averaged electrocardiogram is a specific, but not very sensitive, predictor for the development of ventricular tachycardia in such children.
The molecular basis of frontotemporal dementia
Authors: Neumann Manuela , Tolnay Markus , Mackenzie Ian R.A.
Published: July 2009

Frontotemporal dementia (FTD) is a clinical syndrome with a heterogeneous molecular basis. Familial FTD has been linked to mutations in several genes, including those encoding the microtubule-associated protein tau (MAPT), progranulin (GRN), valosin-containing protein (VCP) and charged multivescicular body protein 2B (CHMP2B). The associated neuropathology is characterised by selective degeneration of the frontal and temporal lobes (frontotemporal lobar degeneration, FTLD), usually with the presence of abnormal intracellular protein accumulations. The current classification of FTLD neuropathology is based on the identity of the predominant protein abnormality, in the belief that this most closely reflects the underlying pathogenic process. Major subgroups include those characterised by the pathological tau, TDP-43, intermediate filaments and a group with cellular inclusions composed of an unidentified ubiquitinated protein. This review will focus on the current understanding of the molecular basis of each of the major FTLD subtypes. It is anticipated that this knowledge will provide the basis of future advances in the diagnosis and treatment of FTD.
New roller crimper concepts for mechanical termination of cover crops in conservation agriculture
Authors: Kornecki T.S. , Price A.J. , Raper R.L. , Arriaga F.J.
Published: July 2009

Rollers crimpers have been used in conservation agriculture to terminate cover crops; however, excessive vibration generated by the original straight-bar roller design has delayed adoption of this technology in the United States. To avoid excessive vibration, producers generally reduce operating speeds that increase the time needed to perform the field operation. The objectives of this research were to identify roller crimper designs that terminated rye cover crops consistently, resulted in soil moisture conservation after use, and minimized vibrations when operated in the field. Six different roller types were developed and tested at 3.2 and 6.4 km h−1in Alabama field experiments during the 2006, 2007 and 2008 growing seasons. All roller types were used alone and one also in combination with glyphosate. Rye mortalities were evaluated 1, 2 and 3 weeks after rolling and compared with the check (non-rolled standing rye). Soil volumetric moisture content (VMC) was measured at the day of rolling, and then at 1, 2 and 3 weeks after rolling. Vibration was measured on the rollers' and tractor's frames during operation. Mortality for rolled rye 2 weeks after rolling was at least 98% compared with 96% for the check in 2006, 93% for rolling compared with 75% for the check in 2007, and 94% for rolling compared with 60% for the check in 2008 (P<0.10). There were no consistent differences in rye mortality across roller types (without glyphosate) and speeds. VMC for soil in non-rolled rye plots was consistently lower than in rolled rye plots, averaging 3% compared with 7% 2 weeks after rolling in 2006, and 4% compared with 8% in 2008. During 2007, VMC was affected by severe drought conditions, and differences between roller treatments were detected but minor. The straight-bar roller generated the highest vibration on the tractor's frame at 6.4 km h−1(0.71 m s−2, RMS), which exceeded International Standards (International Standard Office (ISO)). At 6.4 km h−1, new roller designs generated significantly lower acceleration levels from 0.12 to 0.32 m s−2on the tractor's frame and were below detrimental effects on health ‘health limits’ classified by ISO. Overall, 2 weeks after rolling, all roller designs effectively terminated rye above 90%, which is the recommended termination level of rye to plant a cash crop into residue mat, while protecting soil surface from water loss. New roller designs generate less vibration than the original design and can be used safely at higher operating speeds.
Use of an integrative soil health test for evaluation of soil management impacts
Authors: Idowu O.J. , van Es H.M. , Abawi G.S. , Wolfe D.W. , Schindelbeck R.R. , Moebius-Clune B.N. , Gugino B.K.
Published: July 2009

Understanding the response of soil quality indicators to changes in management practices is essential for sustainable land management. Soil quality indicators were measured for 2 years under established experiments with varying management histories and durations at four locations in New York State. The Willsboro (clay loam) and Aurora (silt loam) experiments were established in 1992, comparing no-till (NT) to plow-till (PT) management under corn (Zea maysL.)–soybean (Glycine maxL.) rotation. The Chazy (silt loam) trial was established in 1973 as a factorial experiment comparing NT versus PT and the crop harvesting method (corn silage versus corn grain). The Geneva (silt loam) experiment was established in 2003 with vegetable rotations with and without intervening soil building crops, each under three tillage methods (NT, PT and zone-till (ZT)) and three cover cropping systems (none, rye and vetch). Physical indicators measured were wet aggregate stability (WAS), available water capacity (AWC) and surface hardness (SH) and subsurface hardness (SSH). Soil biological indicators included organic matter (OM), active carbon (AC), potentially mineralizable nitrogen (PMN) and root disease potential (RDP). Chemical indicators included pH, P, K, Mg, Fe, Mn and Zn. Results from the Willsboro and Aurora sites showed significant tillage effects for several indicators including WAS, AWC, OM, AC, pH, P, K, Mg, Fe and Mn. Generally, the NT treatment had better indicator values than the PT treatments. At the Chazy site, WAS, AWC, OM, AC, pH, K and Mg showed significant differences for tillage and/or harvest method, also with NT showing better indicator values compared to PT and corn grain better than corn silage. Aggregate stability was on average 2.5 times higher in NT compared to PT treatments at Willsboro, Aurora and Chazy sites. OM was also 1.2, 1.1 and 1.5 times higher in NT compared to PT treatments at Willsboro, Aurora and Chazy sites, respectively. At the Geneva site WAS, SH, AC, PMN, pH, P, K and Zn showed significant tillage effects. The cover crop effect was only significant for SH and PMN measurements. Indicators that gave consistent performance across locations included WAS, OM and AC, while PMN and RDP were site and management dependent. The composite soil health index (CSHI) significantly differentiated between contrasting management practices. The CSHI for the Willsboro site was 71% for NT and 59% for PT, while at the Aurora site it was 61% for NT and 48% for PT after 15 years of tillage treatments.
Vernetzte Betreuung bei Patienten mit Herzinsuffizienz in der Schweiz: Eine Kostenstudie
Authors: Eichler  , Krass  , Fendl  , Thüring  , Brügger
Published: July 2009

In einer Pilot-Studie untersuchten wir die Auswirkungen einer vernetzten Betreuung auf die Behandlungskosten am Beispiel eines Disease-Management-Programms (DMP) bei Patienten mit Herzinsuffizienz aus der Schweizer Grundversorgung. Methodik: Die direkten medizinischen Kosten vor Teilnahme am DMP (Zeitintervall 1:365 Tage) wurden mit den direkten medizinischen Kosten während der Teilnahme am Programm (Zeitintervall 2: 365 Tage) verglichen. Eventuelle Einsparungen wurden den Programmkosten des DMP gegenübergestellt. Resultate: Bei 71 Patienten mit Herzinsuffizienz nahmen die durchschnittlichen direkten medizinischen Kosten pro Jahr nach Einschluss in das DMP um 2268 CHF ab (95%-CI: –5922 bis +1386). Die mittleren Programmkosten betrugen 2100 CHF pro Patient. Schlussfolgerung: Das untersuchte DMP dürfte im Startjahr keine relevanten Nettoeinsparungen generieren, kann aber kostenneutral sein. Zukünftige Studien zu DMP bei Herzinsuffizienz sollten mehr Patienten einbeziehen.
Chronische Niereninsuffizienz in der Hausarztpraxis
Authors: Bonani  , Fehr
Published: July 2009

Immer mehr Menschen leiden an einer arteriellen Hypertonie und/oder einem Diabetes mellitus. Diese beiden Erkrankungen repräsentieren die häufigsten Ursachen, welche zu einer chronischen Niereninsuffizienz führen. Für das Management von Patienten mit chronischer Niereninsuffizienz dient die Abschätzung der Nierenfunktion mittels Formeln als Grundlage zur weiteren Entscheidungsfindung. Die Therapie beinhaltet einerseits die Behandlung der Grundkrankheit und allfälliger akuter und reversibler Ursachen einer Nierenfunktionsstörung, andererseits die Verlangsamung der Progression von Nierenerkrankungen (Nephroprotektion) und die Korrektur von Komplikationen (renale Hypertonie, renale Anämie, sekundärer Hyperparathyreoidismus). Werden diese Therapiemassnahmen rechtzeitig und korrekt umgesetzt, kann das Stadium der terminalen Niereninsuffizienz um Jahre herausgezögert werden. Idealerweise geschieht dies ab Stadium CKD 3 (glomeruläre Filtrationsrate <60 ml/min) in konsiliarischer Zusammenarbeit mit einem Nephrologen.
Investigations of the March 2006 African dust storm using ground‐based column‐integrated high spectral resolution infrared (8–13 μm) and visible aerosol optical thickness measurements: 2. Mineral aerosol mixture analyses
Authors: Thomas M. , Gautier C.
Published: July 2009

The mineral aerosol mixture composition for the March 2006 Saharan dust storm is assessed in this paper on the basis of the analysis of visible to near‐infrared (VIS‐NIR) and infrared (IR) aerosol optical thickness (AOT) spectra obtained during the Portable Infrared Aerosol Transmission Experiment (PIRATE). The AOT spectra from 8 to 13 μm were determined using column‐integrated solar transmission measurements using a Fourier transform infrared spectrometer. To determine the mineralogy and mixture composition of the dust, we determined the expected mineralogy of dust from the Algerian source region in a dust storm environment. Then we computed the modeled VIS‐IR AOT spectra using Mie theory for external and internal mixtures. We compared the modeled VIS‐NIR AOT spectra and derived index of refraction and single‐scattering albedo with the measured values from AERONET and compared the modeled IR AOT spectra with the values from our IR measurements. The fit between the measured and modeled values was best when we used an extinction resonance correction to the Mie theory results to better account for the exact wavelengths and shapes of some of the AOT peaks for mineral particles. The mineralogy and mixture composition of the best dust model includes external mixtures, internal mixtures, and mineralogy dominated by quartz, illite, and calcite. The modeled mean radius was determined, and several modes were computed in agreement with AERONET results.
Analysis of regional meteorology and surface ozone during the TexAQS II field program and an evaluation of the NMM‐CMAQ and WRF‐Chem air quality models
Authors: Wilczak James M. , Djalalova Irina , McKeen Stuart , Bianco Laura , Bao Jian‐Wen , Grell Georg , Peckham Steven , Mathur Rohit , McQueen Jeff , Lee Pius
Published: July 2009

This study examines meteorological conditions associated with regional surface ozone using data collected during the summer Second Texas Air Quality Experiment, and the ability of the Nonhydrostatic Mesoscale Model–Community Multi‐scale Air Quality Model (NMM‐CMAQ) and the Weather Research and Forecast (WRF) model coupled with Chemistry (WRF‐Chem) models to simulate the observed meteorology and surface ozone. The surface ozone data consist of 118 sites that are part of the U.S. Environmental Protection Agency Aerometric Information Retrieval Now (AIRNow) network, while the meteorological data came from a network of eleven 915‐MHz wind profilers with RASS temperatures and supporting surface meteorological stations. High and low 8‐h maximum ozone occurrences most frequently develop as regional events, with similar ozone concentration patterns across all of east Texas, allowing for a separate analysis of high‐ and low‐ozone day conditions. The ability of the NMM‐CMAQ and WRF‐Chem models to simulate the meteorologically distinct high‐ and low‐ozone events is analyzed. Histograms of surface ozone show that both the NMM‐CMAQ and WRF‐Chem models underpredict the full range found in the observations. For low ozone values, the analysis indicates that the models have a positive bias because of too large of an ozone inflow boundary condition value over the Gulf of Mexico. In contrast, the models have a negative bias for very high ozone values that occur mostly in Houston and Dallas, which suggests that the urban emissions and/or chemistry is misrepresented in the models.
Fitting the Viking lander surface pressure cycle with a Mars General Circulation Model
Authors: Guo Xin , Lawson W. Gregory , Richardson Mark I. , Toigo Anthony
Published: July 2009

We present a systematic attempt to fit the Viking lander surface pressure cycle using a Mars General Circulation Model, MarsWRF. Following the earlier study by Wood and Paige (1992) using a one‐dimensional model, high‐precision fitting was achieved by tuning five time‐independent parameters: the albedo and emissivity of the seasonal caps of the two hemispheres and the total CO2 inventory in the atmosphere frost system. We used a linear iterative method to derive the best fit parameters: albedo of the northern cap = 0.795, emissivity of the northern cap = 0.485, albedo of the southern cap = 0.461, emissivity of the southern cap = 0.785, and total CO2 mass = 2.83 × 1016 kg. If these parameters are used in MarsWRF, the smoothed surface pressure residual at the VL1 site is always smaller than several Pascal through a year. As in other similar studies, the best fit parameters do not match well with the current estimation of the seasonal cap radiative properties, suggesting that important physics contributing to the energy balance not explicitly included in MarsWRF have been effectively aliased into the derived parameters. One such effect is likely the variation of thermal conductivity with depth in the regolith due to the presence of water ice. Including such a parameterization in the fitting process improves the reasonableness of the best fit cap properties, mostly improving the emissivities. The conductivities required in the north to provide the best fit are higher than those required in the south. A completely physically reasonable set of fit parameters could still not be attained. Like all prior published GCM simulations, none of the cases considered are capable of predicting a residual southern CO2 cap.
Fluvial erosion/transport equation of landscape evolution models revisited
Authors: Davy Philippe , Lague Dimitri
Published: July 2009

We present a mesoscale erosion/deposition model, which differs from previous landscape evolution models equations by taking explicitly into account a mass balance equation for the streamflow. The geological and hydrological complexity is lumped into two basic fluxes (erosion and deposition) and two averaged parameters (unit width discharge q and stream slope s). The model couples the dynamics of streamflow and topography through a sediment transport length function ξ(q), which is the average travel distance of a particle in the flow before being trapped on topography. This property reflects a time lag between erosion and deposition, which allows the streamflow not to be instantaneously at capacity. The so‐called ξ‐q model may reduce either to transport‐limited or to detachment‐limited erosion modes depending on ξ. But it also may not. We show in particular how it does or does not for steady state topographies, long‐term evolution, and high‐frequency base level perturbations. Apart from the unit width discharge and the settling velocity, the ξ(q) function depends on a dimensionless number encompassing the way sediment is transported within the streamflow. Using models of concentration profile through the water column, we show the dependency of this dimensionless coefficient on the Rouse number. We discuss how consistent the ξ‐q model framework is with bed load scaling expressions and Einstein's conception of sediment motion.
Variations of oceanic pCO2 and air‐sea CO2 flux in the eastern Indian sector of the Southern Ocean for the austral summer of 2001–2002
Authors: Nakaoka Shin‐ichiro , Nakazawa Takakiyo , Yoshikawa‐Inoue Hisayuki , Aoki Shuji , Hashida Gen , Ishii Masao , Yamanouchi Takashi , Odate Tsuneo , Fukuchi Mitsuo
Published: July 2009

We examined pCO2air and pCO2sea observed in the eastern Indian sector of the Southern Ocean (south of 50°S, 140°–150°E) during austral spring‐summer from November 2001 to March 2002 using 4 research vessels. pCO2sea changed by as much as 200 μatm over the 5‐month period in the Seasonal Sea Ice Zone (SSIZ), due mostly to very low values in January caused by stratification of water column and strong biological activity. In the SSIZ, the air‐sea CO2 flux showed large temporal variations, from −2.9 g m−2 month−1 in January 2002 to −0.65 g m−2 month−1 in February 2002. The monthly oceanic CO2 uptake in the area covered by this study (1.5 × 1012 km2) was estimated to be in a range of 1.0 × 10−3 to 1.7 × 10−3 PgC month−1, with a mean value of 1.3 × 10−3 PgC month−1.
Barents Sea inflow shutdown: A new mechanism for rapid climate changes
Authors: Semenov Vladimir A. , Park Wonsun , Latif Mojib
Published: July 2009

A new mechanism for rapid climate transitions in the high latitudes is presented which involves complex ocean‐sea ice‐atmosphere interactions. A shutdown of the Barents Sea Inflow (BSI) which carries a vast amount of heat into the Arctic Ocean is at the heart of the mechanism. The BSI shutdown is studied in a multi‐millennium integration with a global climate model forced by periodically (1000 yr) varying solar constant (±2 W/m2). A positive feedback between the inflow and sea ice cover is revealed in the model, which triggers rapid climate changes. The BSI shutdown events are associated with strong cooling in the northern latitudes and subsequent rearrangement of the Arctic Ocean surface current system. The results reveal the existence of a bifurcation point in the Arctic climate system and demonstrate that rapid climate transitions may be caused by local feedbacks and restricted to confined areas without significant global impacts.
Mars W cloud: Evidence of nighttime ice depositions
Authors: Moudden Y. , Forbes J. M.
Published: July 2009

Water clouds on Mars, their current and past connections with other forms of water, along with surface features that suggest the early existence of flowing water, continue to be intriguing aspects of the red planet. Discrete afternoon mountain clouds were one of the earliest atmospheric features to be observed on Mars. Their exclusive formation near the high mountains led to the common belief that air lifting associated with local circulation induced by the mountains underlies their formation. We demonstrate that an additional local source of water vapor is needed for the formation of opaque discrete afternoon clouds on the mountains of Mars, including the so‐called W‐formation. We suggest that the possible deposition of ice from the thick aphelion cloud belt during the night is capable of providing this additional source. This direct cloud water deposition on mountains on Mars bears many similarities with the well‐known interception of water by mountains frequently immersed in fogs on Earth.
Explaining microbial population genomics through phage predation
Authors: Rodriguez-Valera Francisco , Martín-Cuadrado Ana-Belén , Rodriguez-Brito Beltrán , Pasic Lejla , Thingstad T. Frede , Rohwer Forest , Mira Alex
Published: July 2009

The remarkable diversity of genes within the pool of prokaryotic genomes belonging to the same species or pan-genome is difficult to reconcile with the widely accepted paradigm which asserts that periodic selection within bacterial populations would regularly purge genomic diversity by clonal replacement. Recent evidence from metagenomics indicates that even within a single sample a large diversity of genomes can be present for a single species. We have found that much of the differential gene content affects regions that are potential phage recognition targets. We therefore propose the operation of Constant-Diversity dynamics in which the diversity of prokaryotic populations is preserved by phage predation. We provide supporting evidence for this model from metagenomics, mathematical analysis and computer simulations. Periodic selection and phage predation dynamics are not mutually exclusive; we compare their predictions to indicate under which ecological circumstances each dynamics could predominate.
Evolution of the Sequence Ontology terms and relationships
Authors: Eilbeck Karen , Mungall Christopher
Published: July 2009

The Sequence Ontology is undergoing reform to meet the standards of the OBO Foundry. Here we report some of the incremental changes and improvements made to SO. We also propose new relationships to better define the mereological, spatial and temporal aspects of biological sequence.
An Advanced Clinical Ontology
Authors: Mizoguchi Riichiro , Kozaki Kouji , Kou Hiroko , Imai Ken , Ohe Kazuhiko
Published: July 2009

This article discusses a fundamental issues of medical ontology based on ontological theory. We focus on "anatomical structure of organs" and "abnormal states in the human body". On the basis of the investigation, we distinguish organ-specific types from those independent of any organ to maximize the explicitness of ontology. The next feature of our ontology is to allow on-demand reorganization of is-a hierarchy of diseases instead of one fixed hierarchy to cope with various viewpoints which physician might have. We also take care of the notorious issue related to conflict of is-a and part-of relations.