Addition of Sodium Bicarbonate to Irrigation Solution May Assist in Dissolution of Uric Acid Fragments During Ureteroscopy

Introduction: We hypothesized that adding sodium bicarbonate (bicarb) to normal saline (NS) irrigation during ureteroscopy in patients with uric acid (UA) nephrolithiasis may assist in dissolving small stone fragments produced during laser lithotripsy. In vitro testing was performed to determine whether dissolution of UA fragments could be accomplished within 1 hour. Materials and Methods: In total 100% UA renal calculi were fragmented, filtered, and separated by size. Fragment sizes were <0.5 mm and 0.5 to 1 mm. Similar amounts of stone material were agitated in solution at room temperature. Four solutions were tested (NS, NS +1 ampule bicarb/L, NS +2, NS +3). Both groups were filtered to remove solutions after fixed periods. Filtered specimens were dried and weighed. Fragment dissolution rates were calculated as percent removed per hour. Additional testing was performed to determine whether increasing the temperature of solution affected dissolution rates. Results: For fragments <0.5 mm, adding 2 or 3 bicarb ampules/L NS produced a dissolution rate averaging 91% ± 29% per hour. This rate averaged 226% faster than NS alone. With fragments 0.5 to 1 mm, addition of 2 or 3 bicarb ampules/L NS yielded a dissolution rate averaging 22% ± 7% per hour, which was nearly five times higher than NS alone. There was a trend for an increase in mean dissolution rate with higher temperature but this increase was not significant (p = 0.30). Conclusions: The addition of bicarbonate to NS more than doubles the dissolution rate of UA stone fragments and fragments less than 0.5 mm can be completely dissolved within 1 hour. Addition of bicarb to NS irrigation is a simple and inexpensive approach that may assist in the dissolution of UA fragments produced during ureteroscopic laser lithotripsy. Further studies are needed to determine whether a clinical benefit exists

Key pedagogic thinkers: Jean Baudrillard

Jean Baudrillard was born in Reims, France, in 1929, and completed his undergraduate work at the Sorbonne, taking a degree in German. Upon graduation, he taught high school. In the early 1960s, he began graduate studies at the University of Paris, Nanterre, earning his doctorate in sociology in 1966. Baudrillard published 30 books in which he examined various facets of modern society: gender, race, consumerism, politics, the media, and so forth. His focus was semiological—how objects and signs reflect the current human condition. Although Baudrillard did not write about education, his work is nevertheless relevant if we recognize that our educational system is a reflection of society. A Baudrillardian perspective raises the following question: What effect has consumerism had on education? To address this question, we offer some background information related to Baudrillard’s philosophical inquiries. This is followed by our brief analysis of how Baudrillard’s work may provide some potential answers to the above question and of how it can help us interpret the changes that have occurred in education during the modern period. We give special emphasis to The Consumer Society and Simulacra and Simulation

Development of a SimpleProbe real-Time PCR Assay for rapid detection and identification of the US novel urethrotropic clade of Neisseria meningitidis ST-11 (US_NmUC)

Urethritis, or inflammation of the urethra, is one of the most common reasons men seek clinical care. Sexually transmitted pathogens including Neisseria gonorrhoeae are responsible for over half of the symptomatic urethritis cases in U.S. men. Recently, clinics in Indianapolis, Columbus, Atlanta, and other U.S. cities began to note increasing numbers of men presenting with urethritis and Gram-negative intracellular diplococci in their urethral smears who test negative for N. gonorrhoeae. Many of these discordant cases, which have periodically reached highs of more than 25% of presumed gonococcal cases in some sexually transmitted infection clinics in the U.S. Midwest, are infected with strains in a novel urethrotropic clade of Neisseria meningitidis ST-11 (US_NmUC). However, no cultivation-independent tests are available for the US_NmUC strains, and prior studies relied on microbial culture and genome sequencing to identify them. Here, we describe a PCR test that can identify the US_NmUC strains and distinguish them from commensal and invasive N. meningitidis strains as well as N. gonorrhoeae. Our SimpleProbe®-based real-time PCR assay targets a conserved nucleotide substitution in a horizontally acquired region of US_NmUC strain genomes. We applied the assay to 241 urine specimens whose microbial compositions had previously been determined by deep shotgun metagenomic sequencing. The assay detected the single US_NmUC positive case in this cohort, with no false positives. Overall, our simple and readily adaptable assay could facilitate investigation of the pathogenesis and epidemiology of the US_NmUC clade

GLObal Backscatter Experiment (GLOBE) Pacific survey mission

NASA conducted the GLObal Backscatter Experiment (GLOBE) Survey Mission over the near coastal and remote Pacific Ocean during 6 to 30 Nov. 1989 (GLOBE 1) and 13 May to 5 Jun. 1990 (GLOBE 2). These missions studied the optical, physical, and chemical properties of atmospheric aerosols. Particular emphasis was given to the magnitude and spatial variability of aerosol backscatter coefficients at mid-infrared wavelengths, and to the remote middle and upper troposphere, where these aerosol properties are poorly understood. Survey instruments were selected to provide either direct beta measurements at the key wavelengths, empirical links with long term or global scale aerosol climatologies, or aerosol microphysics data required to model any of these quantities. The survey deployment included both long distance 6 to 8 hour transit flights and detailed 4 to 6 hour local flights. Several general features were observed from preliminary Survey data analyses. Validation and intercomparison results have shown good agreement, usually better than a factor of two. Atmospheric aerosols frequently exhibited a three layer vertical structure, with (1) high and fairly uniform backscatter in the shallow cloud capped marine boundary layer; (2) moderate and highly variable backscatter in a deeper overlaying cloud pumped layer; and (3) low, regionally uniform, but seasonally and latitudinally variable backscatter in the middle and upper troposphere. The survey missions represent two isolated snapshots of a small portion of the global aerosol system. Consequently, Survey results can best be understood by synthesizing them with the more comprehensive GLOBE data base, which is being compiled at NASA-Marshall

The Business of Bribery: Globalization, Economic Liberalization, and the ‘Problem’ of Corruption

This paper is intended as a critical response to the emerging consensus within both academic and policy literatures that we are currently facing an epidemic of corruption which threatens to undermine the stability of economic and political development on both a national and global scale, and which requires both immediate and wide-ranging policy interventions. Based on a review of the publications and policy statements of the leading anti-corruption crusaders — namely the OECD, the IMF, and the World Bank — it will be argued that the recent concern with corruption is attributable, not to any substantive increase incorrupt practices, but rather, to the re-framing of corruption in light of broader shifts and transformations within the global economy

The Business of Bribery: Globalization, Economic Liberalization, and the ‘Problem’ of Corruption

This paper is intended as a critical response to the emerging consensus within both academic and policy literatures that we are currently facing an epidemic of corruption which threatens to undermine the stability of economic and political development on both a national and global scale, and which requires both immediate and wide-ranging policy interventions. Based on a review of the publications and policy statements of the leading anti-corruption crusaders — namely the OECD, the IMF, and the World Bank — it will be argued that the recent concern with corruption is attributable, not to any substantive increase incorrupt practices, but rather, to the re-framing of corruption in light of broader shifts and transformations within the global economy

Quantum phases of bosons in double-well optical lattices

We study the superfluid to Mott insulator transition of bosons in a two-legged ladder optical lattice, of a type accessible in current experiments on double-well optical lattices. The zero-temperature phase diagram is mapped out, with a focus on its dependence upon interchain hopping and the tilt between double wells. We find that the unit-filling Mott phase exhibits a non-monotonic behavior as a function of the tilt parameter, producing a reentrant phase transition between Mott insulator and superfluid phases.Comment: 5 pages, 5 figure

What can the microstructure of stones tell us?

How stones are retained within the kidney while small in size is still not fully understood. In this paper, we show two examples of how stones are retained during early growth: one is growth on Randall's (interstitial) plaque, and the other is growth on mineral that has formed as a luminal plug in a terminal collecting duct. These two mechanisms of stone retention during early growth have distinctive morphologic features that can be seen by methods that show the microscopic structure of the stones. Stones growing on Randall's plaque display an apatite region that is typically not large in size (1 mm long and >0.5 mm wide), and they are solid, without spaces running through them. We propose that knowing the mechanisms of stone retention during early stone formation could allow for better treatment of stone diseases

The Distribution and Origin of Bottom Sediments in Timbalier Bay, Louisiana, and the Adjacent Offshore Area

Paper by James I. Jones and Sam E. William

Extinctions of North American Fishes During the past Century

Extinctions of 3 genera, 27 species, and 13 subspecies of fishes from North America are documented during the past 100 years. Extinctions are recorded from all areas except northern Canada and Alaska. Regions suffering the greatest loss are the Great Lakes, Great Basin, Rio Grande, Valley of Mexico, and Parras Valley in Mexico. More than one factor contributed to the decline and extinction of 82% of the fishes. Physical habitat alteration was the most frequently cited causal factor (73%). Detrimental effects of introduced species also were cited in 68% of the extinctions. Chemical habitat alteration (including pollution) and hybridization each were cited in 38% of the extinctions, and overharvesting adversely affected 15% of the fishes. This unfortunate and unprecedented rate of loss of the fishery resource is expected to increase as more of the native fauna of North America becomes endangered or threatened.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141989/1/fsh0022.pd