Methane Flux in Cropland and Adjacent Riparian Buff ers with Different Vegetation Covers

While water quality functions of conservation buffers established adjacent to cropped fields have been widely documented, the relative contribution of these re-established perennial plant systems to greenhouse gases has not been completely documented. In the case of methane (CH(4)), these systems have the potential to serve as sinks of CH(4) or may provide favorable conditions for CH(4) production. This study quantifies CH(4) flux from soils of riparian buffer systems comprised of three vegetation types and compares these fluxes with those of adjacent crop fields. We measured soil properties and diel and seasonal variations of CH(4) flux in 7 to 17 yr-old re-established riparian forest buffers, warm-season and cool-season grass filters, and an adjacent crop field located in the Bear Creek watershed in central Iowa. Forest buffer and grass filter soils had significantly lower bulk density (P \u3c 0.01); and higher pH (P \u3c 0.01), total carbon (TC) (P \u3c 0.01), and total nitrogen (TN) (P \u3c 0.01) than crop field soils. There was no significant relationship between CH(4) flux and soil moisture or soil temperature among sites within the range of conditions observed. Cumulative CH(4) flux was -0.80 kg CH(4)-C ha(-1) yr(-1) in the cropped field, -0.46 kg CH(4)-C ha(-1) yr(-1) within the forest buffers, and 0.04 kg CH(4)-C ha(-1) yr(-1) within grass filters, but difference among vegetation covers was not significant. Results suggest that CH(4) flux was not changed after establishment of perennial vegetation on cropped soils, despite significant changes in soil properties

Proposed quality indicators and recommended standard reporting items in performance of EBUS bronchoscopy: An official world association for bronchology and interventional pulmonology expert panel consensus statement

Background: Since their introduction, both linear and radial endobronchial ultrasound (EBUS) have become an integral component of the practice of Pulmonology and Thoracic Oncology. The quality of health care can be measured by comparing the performance of an individual or a health service with an ideal threshold or benchmark. The taskforce sought to evaluate quality indicators in EBUS bronchoscopy based on clinical relevance/importance and on the basis that observed significant variation in outcomes indicates potential for improvement in health care outcomes. Methods: A comprehensive literature review informed the composition of a comprehensive list of candidate quality indicators in EBUS. A multiple-round modified Delphi consensus process was subsequently performed with the aim of reaching consensus over a final list of quality indicators and performance targets for these indicators. Standard reporting items were developed, with a strong preference for items where evidence demonstrates a relationship with quality indicator outcomes. Results: Twelve quality Indicators are proposed, with performance targets supported by evidence from the literature. Standardized reporting items for both radial and linear EBUS are recommended, with evidence supporting their utility in assessing procedural outcomes presented. Conclusion: This statement is intended to provide a framework for individual proceduralists to assess the quality of EBUS they provide their patients through the identification of clinically relevant, feasible quality measures. Emphasis is placed on outcome measures, with a preference for consistent terminology to allow communication and benchmarking between centres

Diagnosis of incomplete Kawasaki disease

Several authors suggested that the clinical characteristics of incomplete presentation of Kawasaki disease are similar to those of complete presentation and that the 2 forms of presentation are not separate entities. Based on this suggestion, a diagnosis of incomplete Kawasaki disease in analogy to the findings of complete presentation is reasonable. Currently, the diagnosis of incomplete Kawasaki disease might be made in cases with fewer classical diagnostic criteria and with several compatible clinical, laboratory or echocardiographic findings on the exclusion of other febrile illness. Definition of incomplete presentation in which coronary artery abnormalities are included as a necessary condition, is restrictive and specific. The validity of the diagnostic criteria of incomplete presentation by the American Heart Association should be thoroughly tested in the immediate future

Lack of significant association of an insertion/deletion polymorphism in the angiotensin converting enzyme (ACE) gene with tropical calcific pancreatitis

BACKGROUND: The genetic basis of tropical calcific pancreatitis (TCP) is different and is explained by mutations in the pancreatic secretory trypsin inhibitor (SPINK1) gene. However, mutated SPINK1 does not account for the disease in all the patients, neither does it explain the phenotypic heterogeneity between TCP and fibro-calculous pancreatic diabetes (FCPD). Recent studies suggest a crucial role for pancreatic renin-angiotensin system during chronic hypoxia in acute pancreatitis and for angiotensin converting enzyme (ACE) inhibitors in reducing pancreatic fibrosis in experimental models. We investigated the association of ACE gene insertion/deletion (I/D) polymorphism in TCP patients using a case-control approach. Since SPINK1 mutations are proposed a modifier role, we also investigated its interaction with the ACE gene variant. METHODS: We analyzed the I/D polymorphism in the ACE gene (g.11417_11704del287) in 171 subjects comprising 91 TCP and 80 FCPD patients and compared the allelic and genotypic frequency in them with 99 healthy ethnically matched control subjects. RESULTS: We found 46% and 21% of TCP patients, 56% and 19.6% of FCPD patients and 54.5% and 19.2% of the healthy controls carrying the I/D and D/D genotypes respectively (P>0.05). No significant difference in the clinical picture was observed between patients with and without the del allele at the ACE in/del polymorphism in both categories. No association was observed with the presence or absence of N34S SPINK1 mutation in these patients. CONCLUSION: We conclude that the ACE insertion/deletion variant does not show any significant association with the pathogenesis, fibrosis and progression of tropical calcific pancreatitis and the fibro-calculous pancreatic diabetes

Acupuncture for peripheral joint osteoarthritis

BACKGROUND: Peripheral joint osteoarthritis is a major cause of pain and functional limitation. Few treatments are safe and effective. OBJECTIVES: To assess the effects of acupuncture for treating peripheral joint osteoarthritis. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library 2008, Issue 1), MEDLINE, and EMBASE (both through December 2007), and scanned reference lists of articles. SELECTION CRITERIA: Randomized controlled trials (RCTs) comparing needle acupuncture with a sham, another active treatment, or a waiting list control group in people with osteoarthritis of the knee, hip, or hand. DATA COLLECTION AND ANALYSIS: Two authors independently assessed trial quality and extracted data. We contacted study authors for additional information. We calculated standardized mean differences using the differences in improvements between groups. MAIN RESULTS: Sixteen trials involving 3498 people were included. Twelve of the RCTs included only people with OA of the knee, 3 only OA of the hip, and 1 a mix of people with OA of the hip and/or knee. In comparison with a sham control, acupuncture showed statistically significant, short-term improvements in osteoarthritis pain (standardized mean difference -0.28, 95% confidence interval -0.45 to -0.11; 0.9 point greater improvement than sham on 20 point scale; absolute percent change 4.59%; relative percent change 10.32%; 9 trials; 1835 participants) and function (-0.28, -0.46 to -0.09; 2.7 point greater improvement on 68 point scale; absolute percent change 3.97%; relative percent change 8.63%); however, these pooled short-term benefits did not meet our predefined thresholds for clinical relevance (i.e. 1.3 points for pain; 3.57 points for function) and there was substantial statistical heterogeneity. Additionally, restriction to sham-controlled trials using shams judged most likely to adequately blind participants to treatment assignment (which were also the same shams judged most likely to have physiological activity), reduced heterogeneity and resulted in pooled short-term benefits of acupuncture that were smaller and non-significant. In comparison with sham acupuncture at the six-month follow-up, acupuncture showed borderline statistically significant, clinically irrelevant improvements in osteoarthritis pain (-0.10, -0.21 to 0.01; 0.4 point greater improvement than sham on 20 point scale; absolute percent change 1.81%; relative percent change 4.06%; 4 trials;1399 participants) and function (-0.11, -0.22 to 0.00; 1.2 point greater improvement than sham on 68 point scale; absolute percent change 1.79%; relative percent change 3.89%). In a secondary analysis versus a waiting list control, acupuncture was associated with statistically significant, clinically relevant short-term improvements in osteoarthritis pain (-0.96, -1.19 to -0.72; 14.5 point greater improvement than sham on 100 point scale; absolute percent change 14.5%; relative percent change 29.14%; 4 trials; 884 participants) and function (-0.89, -1.18 to -0.60; 13.0 point greater improvement than sham on 100 point scale; absolute percent change 13.0%; relative percent change 25.21%). In the head-on comparisons of acupuncture with the ‘supervised osteoarthritis education’ and the ‘physician consultation’ control groups, acupuncture was associated with clinically relevant short- and long-term improvements in pain and function. In the head on comparisons of acupuncture with ‘home exercises/advice leaflet’ and ‘supervised exercise’, acupuncture was associated with similar treatment effects as the controls. Acupuncture as an adjuvant to an exercise based physiotherapy program did not result in any greater improvements than the exercise program alone. Information on safety was reported in only 8 trials and even in these trials there was limited reporting and heterogeneous methods. AUTHORS' CONCLUSIONS: Sham-controlled trials show statistically significant benefits; however, these benefits are small, do not meet our pre-defined thresholds for clinical relevance, and are probably due at least partially to placebo effects from incomplete blinding. Waiting list-controlled trials of acupuncture for peripheral joint osteoarthritis suggest statistically significant and clinically relevant benefits, much of which may be due to expectation or placebo effects

Profiles and behavioral consequences of child abuse among adolescent girls and boys from Barbados and Grenada

The current study used latent class analysis to uncover groups of youths with specific abuse (physical, emotional, and sexual) profiles in and outside the family, and identify how membership in each abuse group is associated with behavioral outcomes. Data were collected among a sample of male (n = 662; M age = 13.02 years) and female (n = 689; M age = 12.95 years) children and adolescents (9 – 17 years old) from Barbados and Grenada. Selfreport surveys were completed by participants in school settings. Three latent classes of child abuse were distinguished among boys, including ‘low abuse’ (39.2% of the sample), ‘physical and emotional abuse high outside/medium in the family’ (43.2%), and ‘high overall abuse’ (17.6%). Among girls, four unique classes were recovered: ‘low abuse’ (40.7%), ‘high physical and emotional abuse outside the family’ (7.6%), ‘high emotional and moderate physical abuse’ (33.9%), and ‘high overall abuse’ (17.8%). Compared with members of low abuse groups, youths who reported having experienced high/moderate levels of various forms of violence, including those who were abused in multiple ways and across the two settings (‘high overall abuse’), were significantly more likely to engage in violent and hostile behavior. Abused and non-abused youths did not differ on non-violent conflict resolution skills. The significance of present findings for future research and practice is discussed

Genome Sequencing of SHH Medulloblastoma Predicts Genotype-Related Response to Smoothened Inhibition

SummarySmoothened (SMO) inhibitors recently entered clinical trials for sonic-hedgehog-driven medulloblastoma (SHH-MB). Clinical response is highly variable. To understand the mechanism(s) of primary resistance and identify pathways cooperating with aberrant SHH signaling, we sequenced and profiled a large cohort of SHH-MBs (n = 133). SHH pathway mutations involved PTCH1 (across all age groups), SUFU (infants, including germline), and SMO (adults). Children >3 years old harbored an excess of downstream MYCN and GLI2 amplifications and frequent TP53 mutations, often in the germline, all of which were rare in infants and adults. Functional assays in different SHH-MB xenograft models demonstrated that SHH-MBs harboring a PTCH1 mutation were responsive to SMO inhibition, whereas tumors harboring an SUFU mutation or MYCN amplification were primarily resistant

Gardens as Science Learning Contexts Across Educational Stages: Learning Assessment Based on Students' Graphic Representations

The educational use of daily-life contexts is considered a valuable strategy to promote meaningful science learning, since it facilitates the establishment of connections between previous knowledge, personal interests, and new learning. The aim of this work is to provide evidence to support the presence of gardens at educational centers, by assessing key science topics whose learning is promoted at the pre-school, primary, secondary, and university stages. To this end, we analyzed the paired graphic representations of "a garden" that students drew both before and after their participation in a garden-based learning program. Firstly, we obtained the frequency of appearance of every represented element, and afterward characterized the level of change between paired graphic representations. Sample size was of 24-19-25-29 pairs per stage, respectively. Across all stages, an overall improvement in students' graphic expression was observed, which can be attributed to their experience in the space. At the pre-school stage, the garden favored the establishment of some simple cause-effect relationships which were consolidated at the primary stage, and provided a climate of motivation and affectivity that was evident in the final drawings, given the enormous quantity of details represented, the level of the finished product, and the careful combination and variety of colors. The presence of elements related to water notably increased in final graphic representations from pre-school, primary, and secondary education, thus evidencing that the use of gardens facilitates an approach to responsible water management. At the university stage, students initially demonstrated good knowledge of conventional agriculture, while the gardening experience -which was based on permaculture practices- helped evolve their ideas toward an alternative model of cultivation. The most prevalent science learning across all stages was related to plant knowledge, particularly to their anatomical traits and diversity. Finally, the role of educational gardens as models for students was evidenced, which suggests the importance of teachers and institutions carefully considering which model to offer. Overall, our results support the legitimacy of incorporating gardens to educational centers, particularly for promoting contact with live plants and plant knowledge, and potentially for promoting contact with garden fauna and activities oriented toward learning about it