bluuebunny/crossref_metadata_2025 huggingface dataset:
New Fluorescent Method (PLT-F) on Sysmex XN2000 Hematology Analyzer Achieved Higher Accuracy in Low Platelet Counting
Authors: Schoorl Margreet , Schoorl Marianne , Oomes Jeanette , van Pelt Johannes
Published: September 2013

Objectives:

In thrombocytopenia, high accuracy and precision of low platelet count is essential for appropriate decisions. The recently introduced Sysmex XN2000 analyzer (Sysmex, Kobe, Japan) offers 3 methods for platelet counting: impedance (PLT-I), optical (PLT-O), and a new fluorescence method (PLT-F). The precision of the PLT-F method in blood samples with platelet counts less than 50 ×103/μL (50 × 109/L) was investigated and compared with the ICSH CD61-ImmunoPLT reference method. For comparison, PLT-I and PLT-O were determined on the Sysmex XN2000 and Sysmex XE2100 analyzer.

Methods:

Blood samples with platelet counts less than 50 ×103/μL (50 × 109/L) (n = 37) were analyzed on the Sysmex XN2000 and XE2100 analyzers. The CD61-ImmunoPLT method was performed on a Beckman Coulter FC-500 flow cytometer (Miami, FL).

Results:

At a platelet count of 20 ×103/μL (20 × 109/L), reproducibility for PLT-I, PLT-O, and PLT-F on the XN2000 demonstrated coefficients of variation of 9.3%, 8.5%, and 3.0%, respectively. Correlation between PLT-O on the XN2000 and XE2100 yielded an r value of more than 0.977. Linear regression analysis between the PLT-F and CD61-ImmunoPLT methods resulted in a PLT-F of 0.71*CD61 – 0.8 (r = 0.988). Linear regression between PLT-F and PLT-O on the XN2000 resulted in a PLT-F of 1.05*PLT-O – 2 (r = 0.975), and using the transfusion threshold of 20 × 109/L platelets resulted in a PLT-F of 0.90*PLT-O – 0.4 (r = 0.956).

Conclusions:

The new PLT-F method demonstrated excellent results for reproducibility in samples with platelet counts less than 50 × 109/L. PLT-F could be helpful in making better decisions for platelet transfusions.
Learning styles and motives of postgraduate distance learners undertaking a United Kingdom professional doctorate.
Authors: Sheppard Amy Louise
Published: September 2013

Purpose: To investigate the learning styles and motives for study of students enrolled on an online distance learning professional doctorate programme. The data are required to ensure that both current and potential future programmes meet students’ needs and provide the best possible learning experiences.Methodology: All 66 current students enrolled on a UK professional doctorate programme were invited to participate in this online questionnaire-based study. Participants completed the 44-item Index of Learning Styles questionnaire to describe learning preferences along 4 dimensions; active-reflective, sensing-intuitive, visual-verbal and sequential-global. Fourteen subsequent items explored students’ motives for study in three areas; intrinsic factors, extrinsic factors and career-related factors. Potential differences in motives for study between UK and non-UK students were explored.Results: The cohort displayed balanced learning preferences along the active-reflective, sensing-intuitive and sequential-global dimensions, but a significant preference for visual learning was identified along the visual-verbal dimension. A moderate or strong preference for visual learning was identified in 79.2 % of respondents. Regarding the motives for study, intrinsic and career-related factors were most important, with extrinsic factors being poor motivators for respondents. No significant differences in motives for study were identified between UK and non-UK students.Discussion: Learning styles may be easily studied amongst distance learners, and has the potential to reveal preferences that educators should consider in their teaching activities. In line with some previously published work, intrinsic factors were the most important motives for study in this cohort of mature learners, with extrinsic factors being of low importance. No evidence was found to support the assertion that East Asian students are more likely to be affected by extrinsic push factors.
Edgy humour in the classroom: a case study of risks and rewards
Authors: Carver Mark
Published: September 2013

The purpose of this study was to explore the role of humour in the classroom from a learning climate perspective, allowing for greater risk and spontaneity. A case study was devised in a UK primary school where the teacher would give humour top priority in planning, without any self-censoring or limitations placed on ideas of taste or appropriateness. Such an extreme situation was made possible by opt-in participation. Evaluation was by a mixed-methods approach, drawing on video analysis of laughter responses in the class, teacher observation, and student evaluations. Arguing that humour research has previously focussed too much on positivist experimental approaches at one extreme and polemic anecdotal evidence at the other, the study aimed to strike a balance and explore approaches useful to action researchers. The exploratory nature of the research was also posited on the idea that a case study in which humour use was exaggerated would help to provide a measure of transferability for practitioners wishing to experiment with humour. Humour used in the classroom is therefore categorised according to whether it is produced by the teacher or a student, related to the learning goal of the lesson, or if it could be considered potentially offensive. The results indicate that an overcautious approach can limit the effectiveness of humour in the classroom. Moreover, an element of edginess can contribute to a learning climate in which students and teachers both feel more excited by the lesson, engage in spontaneous generation of content-relevant humour, and express greater ratings for satisfaction, enjoyment and perceptions of learning. Appreciation and usefulness of humour in education is presented as both supported by, and a vehicle towards, a learning climate which rewards risk and spontaneity whilst at the same time encouraging an inclusive enjoyment of the learning experience.
Finding a Way to Participate
Authors: Dunedin Alexander
Published: September 2013

An opinion piece on the aims of the Ragged Project.
Chromogranin A, Ki-67 index and IGF-related genes in patients with neuroendocrine tumors
Authors: van Adrichem R C S , Hofland L J , Feelders R A , De Martino M C , van Koetsveld P M , van Eijck C H J , de Krijger R R , Sprij-Mooij D M , Janssen J A M J L , de Herder W W
Published: September 2013

Chromogranin A (CgA) and the Ki-67 proliferation index are considered as important biochemical and pathological markers for clinical behaviour of gastroenteropancreatic neuroendocrine tumors (GEP NETs), respectively. The IGF system has been suggested as an important regulator of GEP NET proliferation and differentiation. A possible relationship between serum CgA (sCgA), Ki-67 proliferation index, and expression of IGF-related genes in patients with GEP NETs has not been demonstrated yet. This study investigates the relationship between sCgA, the Ki-67 proliferation index, and the expression of IGF-related genes in GEP NET tissues and their relation with 5-year survival. Tumor and blood samples from 22 GEP NET patients were studied. Tumoral mRNA expression of IGF-related genes (IGFs: IGF1, IGF2; IGF receptors: IGF1R, IGF2R; insulin receptors: subtype A (IR-A) and B (IR-B); IGF-binding proteins (IGFBPs): IGFBP1, IGFBP2, IGFBP3, and IGFBP6) was measured using quantitative RT-PCR. Ki-67 proliferation index was determined using immunohistochemistry. sCgA was measured with ELISA. Five-year survival in patients with nonelevated sCgA (n=11) was 91 vs 46% in patients with elevated sCgA (n=11) (P=0.006). IR-A mRNA expression was significantly higher in tumors obtained from patients with elevated sCgA than in those from patients with nonelevated sCgA (6.42±2.08 vs 2.60±0.40; P=0.04). This data suggests that sCgA correlates well with 5-year survival of GEP NET patients, and that IR-A mRNA expression correlates well with tumor mass in GEP NET patients.
Evidence for the Management of Adolescent Depression
Authors: Lewandowski R. Eric , Acri Mary C. , Hoagwood Kimberly E. , Olfson Mark , Clarke Greg , Gardner William , Scholle Sarah Hudson , Byron Sepheen , Kelleher Kelly , Pincus Harold A. , Frank Samantha , Horwitz Sarah M.
Published: September 2013

Adolescent depression is a prevalent and disabling condition resulting in emotional suffering and social and educational dysfunction. Care for adolescent depression is suboptimal and could be improved through the development and use of quality indicators (QIs). This article reports on the development of a care pathway and QIs for the primary and specialty care management of adolescent depression from case identification through symptom remission. It presents evidence from a review of adolescent clinical practice guidelines and research literature to support QIs at critical nodes in the pathway, and describes implications for practice based on existing evidence. Barriers to measure development are identified, including gaps in empirical evidence, and a research agenda is suggested.
Disparities in Health Insurance Among Children With Same-Sex Parents
Authors: Gonzales Gilbert , Blewett Lynn A.
Published: September 2013

OBJECTIVES:

The objectives of this study were to examine disparities in health insurance coverage for children with same-sex parents and to investigate how statewide policies such as same-sex marriage and second-parent adoptions affect children’s private insurance coverage.

METHODS:

We used data from the 2008–2010 American Community Survey to identify children (aged 0–17 years) with same-sex parents (n = 5081), married opposite-sex parents (n = 1 369 789), and unmarried opposite-sex parents (n = 101 678). We conducted multinomial logistic regression models to estimate the relationship between family type and type of health insurance coverage for all children and then stratified by each child’s state policy environment.

RESULTS:

Although 77.5% of children with married opposite-sex parents had private health insurance, only 63.3% of children with dual fathers and 67.5% with dual mothers were covered by private health plans. Children with same-sex parents had fewer odds of private insurance after controlling for demographic characteristics but not to the extent of children with unmarried opposite-sex parents. Differences in private insurance diminished for children with dual mothers after stratifying children in states with legal same-sex marriage or civil unions. Living in a state that allowed second-parent adoptions also predicted narrower disparities in private insurance coverage for children with dual fathers or dual mothers.

CONCLUSIONS:

Disparities in private health insurance for children with same-sex parents diminish when they live in states that secure their legal relationship to both parents. This study provides supporting evidence in favor of recent policy statements by the American Academy of Pediatricians endorsing same-sex marriage and second-parent adoptions.
The effects of gamma irradiation on diclofenac sodium, liposome and niosome ingredients for rheumatoid arthritis
Authors: Özer A. , Turker Selcan , Çolak Seyda , Korkmaz Mustafa , Kiliç Ekrem , Özalp Meral
Published: September 2013

The use of gamma rays for the sterilization of pharmaceutical raw materials and dosage forms is an alternative method for sterilization. However, one of the major problems of the radiosterilization is the production of new radiolytic products during the irradiation process. Therefore, the principal problem in radiosterilization is to determine and to characterize these physical and chemical changes originating from high-energy radiation. Parenteral drug delivery systems were prepared and in vitro characterization, biodistribution and treatment studies were done in our previous studies. Drug delivery systems (liposomes, niosomes, lipogelosomes and niogelosomes) encapsulating diclofenac sodium (DFNa) were prepared for the treatment of rheumatoid arthritis (RA). This work complies information about the studies developed in order to find out if gamma radiation could be applied as a sterilization method to DFNa, and the raw materials as dimyristoyl phosphatidylcholine (DMPC), surfactant I [polyglyceryl-3-cethyl ether (SUR I)], dicethyl phosphate (DCP) and cholesterol (CHOL) that are used to prepare those systems. The raw materials were irradiated with different radiation doses (5, 10, 25 and 50 kGy) and physicochemical changes (organoleptic properties pH, UV and melting point), microbiological evaluation [sterility assurance level (SAL), sterility and pyrogen test] and electron spin resonance (ESR) characteristics were studied at normal (25 °C, 60% relative humidity) and accelerated (40 °C, 75% relative humidity) stability test conditions.
Immunohistochemical clue for the histological overlap of salivary adenoid cystic carcinoma and polymorphous low-grade adenocarcinoma
Authors: El-Nagdy Sherif , Salama Naglaa , Mourad Mohamed
Published: September 2013

It remains difficult to distinguish adenoid cystic carcinoma (ACC) from polymorphous low-grade adenocarcinoma (PLGA). Although these neoplasms exhibit nearly similar histologic patterns, their biologic behavior is significantly different. This study was carried out in an attempt to overcome the histological overlap between these tumors using immunohistochemical method for c-kit and galectin-3 proteins on twenty cases of salivary gland tumors including twelve ACC and eight PLGA. Results revealed positive cytoplasmic reactivity for c-kit in 100% of ACC cases and only in 25% of PLGA. On the other hand, galectin-3 expression was observed in 100% of both ACC and PLGA cases. Moreover, solid variant of ACC showed overexpression of both proteins than cribriform and tubular subtypes. Significant positive correlation between the two studied proteins in ACC and PLGA was also observed (p< 0.05). Upon these results, over expression of c-kit and galectin-3 in ACC cases supports the concept of solid variant as a high-grade tumor. Moreover, c-kit may be used as a helpful marker to distinguish ACC from PLGA in cases where the diagnosis can be challenging.
Fatal arterial hemorrhage after microwave ablation of multiple liver metastases: The lessons learned
Authors: Hatzidakis Adam , Zervakis Nikolaos , Krokidis Miltiadis
Published: September 2013

We report the case of a 71-year-old female patient with previous history of rectal cancer. The primary cancer was resected and three cycles of chemotherapy were completed. Excision of metastatic lesions was also performed from the left liver lobe. Due to the presence of new liver lesions on the right lobe, intra-operative microwave ablation was decided. Three hours post ablation the patient bled massively and angiography revealed extravasation from a peripheral branch of the right hepatic artery. Successful embolization was performed; however, the patient died 5 days later on liver failure. We would like to present the case and discuss the technical options and the key points to help avoiding similar complications in the future.
Deficiencia de vitamina A e fatores associados em criancas de areas urbanas
Authors: de Queiroz Daiane , Paiva Adriana de Azevedo , Pedraza Dixis Figueroa , Cunha Maria Auxiliadora Lins da , Esteves Gustavo Henrique , de Luna Joao Gil , Diniz Alcides da Silva
Published: September 2013

OBJETIVO: Analisar a prevalência da deficiência de vitamina A em crianças e os fatores associados. MÉTODOS: Estudo de corte transversal de base populacional realizado com 1.211 crianças de seis a 59 meses de idade, de ambos os sexos, procedentes da área urbana de nove cidades do estado da Paraíba, Brasil. O estado nutricional de vitamina A foi avaliado pelas concentrações séricas de retinol e presença de infecção subclínica avaliada pelas concentrações de proteína C-reativa. Foram investigadas as condições socioeconômicas, demográficas, de saneamento, além da suplementação prévia com vitamina A. Foram consideradas com deficiência de vitamina A as crianças com concentrações de retinol sérico < 0,70 µmol/L. Níveis séricos de vitamina A < 0,70 µmol/L com prevalência ≥ 20% foram considerados como grave problema de saúde pública. Análises uni e multivaridas foram conduzidas para testar associações estatísticas (p < 0,05). RESULTADOS: A prevalência de deficiência de vitamina A foi de 21,8% (IC95% 19,6;24,2), mostrando associação com a presença de infecção subclínica e ausência de água no domicílio. A prevalência de deficiência de vitamina A foi de 21,8% (IC95% 19,6;24,2). Após ajuste para confundimento, a deficiência de vitamina A mostrou-se associada com a presença de infecção subclínica e com a ausência de água no domicílio. A ocorrência da deficiência de vitamina A foi quatro vezes maior (IC95% 1,49;10,16) em crianças com infecção subclínica e sem água no domicilio, comparativamente às crianças sem infecção e com água no domicílio. CONCLUSÕES: Apesar das ações de prevenção e controle da deficiência de vitamina A, a hipovitaminose A ainda configura-se como um problema de saúde pública preocupante entre as crianças menores de cinco anos.
Prevalencia de quedas de idosos em situacao de fragilidade
Authors: Fhon Jack Roberto Silva , Rosset Idiane , Freitas Cibele Peroni , Silva Antonia Oliveira , Santos Jair Licio Ferreira , Rodrigues Rosalina Aparecida Partezani
Published: September 2013

OBJETIVO: Analisar a prevalência de quedas em idosos frágeis, suas consequências e fatores demográficos associados. MÉTODOS: Estudo epidemiológico e transversal com amostra probabilística de 240 idosos em Ribeirão Preto, SP. A coleta de dados foi realizada no período de novembro de 2010 a fevereiro de 2011. Foi aplicado questionário que incluiu dados sociodemográficos, avaliação de quedas e a Escala de Fragilidade de Edmonton. Foram realizadas análises uni e bivariada. RESULTADOS: A média de idade foi de 73,5 (dp=:8,4) anos, maior no sexo feminino; 25% dos entrevistados tinham idade ≥ 80 anos; 11,3% apresentaram fragilidade moderada e 9,6% fragilidade severa. A prevalência de quedas no idoso frágil foi de 38,6%, maior no sexo feminino e nos idosos mais jovens (60 a 79 anos); 26,8% sofreram de uma a duas quedas, 27,1% ocorreram no dormitório, 84,7% caíram da própria altura, 55,9% apresentaram alteração do equilíbrio, 54,2% sofreram escoriações e 78% apresentaram medo de sofrer nova queda; houve maior chance de queda no idoso frágil 1,973 (1,094;3,556) quando comparado ao não frágil. CONCLUSÕES: É necessária a abordagem da saúde do idoso frágil, principalmente quanto ao risco de quedas, maior investimento nas estratégias de prevenção dessas síndromes e na formação de recursos humanos preparados para melhor atender essa população.
Arte, cultura e cuidado nos centros de atencao psicossocial
Authors: Galvanese Ana Tereza Costa , Nascimento Andreia de Fatima , DOliveira Ana Flavia Pires Lucas
Published: September 2013

OBJETIVO: Analisar o processo de cuidado desenvolvido por meio de arte e cultura em centros de atenção psicossocial. MÉTODOS: Estudo integrado à pesquisa de avaliação dos centros de atenção psicossocial, em São Paulo, SP. Foram analisados os relatos da observação de tipo etnográfico de 126 atividades grupais de arte e cultura realizadas em 21 desses centros, entre 2007 e 2008. A análise incluiu depoimentos de coordenadores sobre os objetivos das atividades observadas. Baseado em referenciais teóricos da atenção psicossocial, utilizou-se da técnica de análise de conteúdo para investigar relações entre meios terapêuticos (enquadres, atividades e vínculos) e objetivos das atividades. RESULTADOS: Três tendências de cuidado foram identificadas: (1) estritamente clínica, predominante e marcada por atividades realizadas dentro dos centros com foco em competências pessoais e interações grupais; (2) psicossocial, que incluiu atividades no território, ampliação dos repertórios culturais e da circulação social; e (3) residual, minoritária e sem ganhos psicossociais. CONCLUSÕES: A realização de atividades de arte e cultura que produzam cuidado na perspectiva da reabilitação psicossocial depende do acesso dos profissionais a bens culturais e a processos criativos, do reconhecimento dessas atividades como trabalho integrado a toda a equipe e da consideração de todos os atores envolvidos como produtores de fatos de cultura.
Dilemas morais e praticas de saude
Authors: Guimaraes Reinaldo
Published: September 2013

Discute-se a emergência de dilemas morais nas práticas de saúde, tendo em vista a acelerada transição demográfica nos países em desenvolvimento e os crescentes custos dos sistemas públicos de saúde. São focalizadas duas dimensões do cuidado à saúde que têm ocupado um lugar importante na geração desses dilemas: a tensão entre as estratégias comerciais que contornam o mercado de produtos de saúde e a expansão do acesso a esses produtos, por um lado, e o aumento da importância das tecnociências nas práticas de cuidado à saúde, por outro. Em conclusão, é discutida a importância da arbitragem política, social e jurídica na codificação ética desses dilemas e o papel do Estado Democrático de Direito nessa arbitragem.
Decline of ectomycorrhizal fungi following a mountain pine beetle epidemic
Authors: Treu Roland , Karst Justine , Randall Morgan , Pec Gregory J. , Cigan Paul W. , Simard Suzanne W. , Cooke Janice E. K. , Erbilgin Nadir , Cahill James F.
Published: September 2013

Forest die‐off caused by mountain pine beetle (MPB; Dendroctonus ponderosa) is rapidly transforming western North American landscapes. The rapid and widespread death of lodgepole pine (Pinus contorta) will likely have cascading effects on biodiversity. One group particularly prone to such declines associated with MPB are ectomycorrhizal fungi, symbiotic organisms that can depend on pine for their survival, and are critical for stand regeneration. We evaluated the indirect effects of MPB on above‐ (community composition of epigeous sporocarps) and belowground (hyphal abundance) occurrences of ectomycorrhizal fungi across 11 forest stands. Along a gradient of mortality (0–82% pine killed), macromycete community composition changed; this shift was driven by a decrease in the species richness of ectomycorrhizal fungi. Both the proportion of species that were ectomycorrhizal and hyphal length in the soil declined with increased MPB‐caused pine mortality; <10% of sporocarp species were ectomycorrhizal in stands with high pine mortality compared with >70% in stands without MPB attacks. The rapid range expansion of a native insect results not only in the widespread mortality of an ecologically and economically important pine species, but the effect of MPB may also be exacerbated by the concomitant decline of fungi crucial for recovery of these forests.
EMDR and CBT for Cancer Patients: Comparative Study of Effects on PTSD, Anxiety, and Depression
Authors: Capezzani Liuva , Ostacoli Luca , Cavallo Marco , Carletto Sara , Fernandez Isabel , Solomon Roger , Pagani Marco , Cantelmi Tonino
Published: September 2013

This pilot study examined the efficacy of eye movement desensitization and reprocessing (EMDR) treatment compared with cognitive behavioral therapy (CBT) in treating posttraumatic stress disorder (PTSD) in oncology patients in the follow-up phase of the disease. The secondary aim of this study was to assess whether EMDR treatment has a different impact on PTSD in the active treatment or during the follow-up stages of disease. Twenty-one patients in follow-up care were randomly assigned to EMDR or CBT groups, and 10 patients in the active treatment phase were assigned to EMDR group. The Impact of Event Scale—Revised (IES-R) and Clinician-Administered PTSD Scale (CAPS) were used to assess PTSD at pretreatment and 1 month posttreatment. Anxiety, depression, and psychophysiological symptoms were also evaluated. For cancer patients in the follow-up stage, the absence of PTSD after the treatment was associated with a significantly higher likelihood of receiving EMDR rather than CBT. EMDR was significantly more effective than CBT in reducing scores on the IES-R and the CAPS intrusive symptom subscale, whereas anxiety and depression improved equally in both treatment groups. Furthermore, EMDR showed the same efficacy both in the active cancer treatment and during the follow-up of the disease.
Brain Activity Measured With Near-Infrared Spectroscopy During EMDR Treatment of Phantom Limb Pain
Authors: Amano Tamaki , Seiyama Akitoshi , Toichi Motomi
Published: September 2013

This report describes a female client with phantom limb pain (PLP), who was successfully treated by eye movement desensitization and reprocessing (EMDR) using a PLP protocol, as well as her cerebral activities, measured by near-infrared spectroscopy (NIRS), throughout the therapeutic session. She suffered from paralysis in the left lower limb because of sciatic nerve damage caused by a surgical accident, in which she awoke temporarily from anesthesia during surgery and felt intense fear. When recalling this experience, the superior temporal sulcus was activated. However, at the end of the session, her PLP was almost eliminated, with a generalized decrease in cerebral blood flow. This case suggests the possibility of involvement of a posttraumatic stress disorder (PTSD)-like mechanism in the pathogenesis of PLP, as well as the possible efficacy of EMDR for this type of PLP.
Understanding the Steam-Hammer Mechanism in Steam-Assisted-Gravity-Drainage Wells
Authors: Irani Mazda
Published: September 2013

Steam-assisted gravity drainage (SAGD) is one of the successful thermal-recovery techniques applied in Alberta oil-sands reservoirs. When considering in-situ production from bitumen reservoirs, viscosity reduction is necessary to mobilize bitumen, thereby flowing toward the production well. Steam injection is currently the most effective thermal-recovery method. Although steamflooding is commercially viable, condensation-induced water hammer (CIWH) resulting from rapid steam-pocket condensation can be a challenging operational problem. In steamflooding, steam is injected through a well down to the reservoir, warming it to temperatures of 150 to 270°C (302 to 518°F) to liquefy the bitumen inside the reservoir (Garnier et al. 2008; Xie and Zahacy 2011). The liquefied bitumen then drains to a lower well through which it is produced to the surface. In this process, steam pockets can become entrapped in subcooled condensate inside either the injection or the production tubing, causing a rapid collapse of the steam pocket. This type of rapid condensation is commonly referred to as "steam hammer."

In this study, three different scenarios are explored to better understand steam-hammer situations in SAGD wells. These scenarios are at injectors or producers during the startup phase (or circulation phase), in the injection tubing during the injection phase, and in the production tubing during the injection phase. Modeling each of these scenarios indicates that a steam-hammer occurrence is likely in two of the three scenarios, but that its incidence can be mitigated. The likely scenarios for a steam-hammer occurrence are in either the injection or the production tubing during the startup phase, and in the injection tubing during the injection phase. Steam-hammer occurrences during the circulation period can be controlled by lowering the injection pressure and controlling water drainage into the reservoir. Flow shocks that occur as a result of countercurrent flow limiting (CCFL) are very likely to take place in the injection tubing during the injection phase but can be controlled by injecting at a higher steam quality. The least likely scenario for a steam-hammer occurrence is in the production tubing during the injection phase. This is because the produced (or breakthrough) steam temperature would need to be more than 20°C higher than the produced-liquid temperature to start a water-hammer condition.
Benjamin Franklin
Authors: Cockburn Forrester
Published: September 2013

On the evening of Tuesday, the 29th of January 1957, Mr Eldred D. Kuppinger, United States Consul General in Edinburgh, presented the Franklin Commemorative Medal to the Society on behalf of The Congress of the United States of America. The ceremony took place in the Society’s premises at 7 Melbourne Place where the Senior President, Mr T. Ramsay McCall, received the medal on behalf of the Royal Medical Society.
North American Kaleidoscope
Authors: Macgregor Alastair G
Published: September 2013

I have called these brief remarks a kaleidoscope because inevitably the impressions left after a brief three months spent travelling, visiting and lecturing from New York to San Francisco and from Vancouver to Boston are those of an ever changing, ever fascinating pattern of personalities and scenery, hospitals and research institutions. I can but discuss a few aspects of general rather than of particular interest.Undoubtedly, for those of us fortunate enough to have been allowed to travel thus widely, the impact of the different environment is such that, in retrospect, much of it seems unreal. The American culture, the whole fascinating mechanism of living, is so indescribably different from anything that we have at home, that to experience it for even a few months is to broaden one’s outlook and widen one’s own horizon to an extent which previously one would have thought unnecessary. It is in the very nature of us all that we have a self-conceit that we are already broadminded, well travelled and appreciative of other cultures than our own. Nobody’s medical or social education is complete until he has at least sampled American and Canadian life, and a generalisation such as this is not as platitudinous as it sounds.
Opera Occulta
Authors: Ruckley C Vaughan
Published: September 2013

With a mixture of pride and humility I began to turn the pages of the great leather-backed volumes which enclose the early Dissertations of the Royal Medical Society. It was something to be done with care, for the pages are brittle and cachetic. The regular, flowing, almost copper-plate writing is only s lightly faded and is eminently legible. We, who can achieve immaculate script only through the medium of machinery, might pause and consider the scholarship of our predecessors who wrote Greek, Latin or English with artists’ hands.
Editorial
Authors: Clark David J.
Published: September 2013

It seems to the student of medicine that arguments about the method by which his education can be accomplished with most effect, will never cease. Thus he is perpetually hearing, from this source or from that, that one system is better and another worse, one more and another less suited to turn a doctor loose upon an unsuspecting and at times positively unfortunate public. The system of teaching students in small tutorial groups has many advantages, and the existence or an intimate student-teacher relationship will always rank high amongst them. This system of education which is practised in a number of English universities is in marked contrast to the Scottish university system which consists of a formal lecture course, accompanied by clinical instruction in scarcely less formal cliniques. The lecture course tends to be authoritative and up to date since it is usually shared out amongst a number of lecturers, each dealing with that aspect of the whole subject in which he is specially interested. Further, in contrast to the Tutorial system the course can be carefully planned in advance, and each aspect treated in due perspective since the student cannot divert his teacher’s attention from the main stream of thought. None the less it must be admitted that there are many students who find the process of expressing their own views before an intelligent audience, or equally of criticising the expressed views of their fellows, an instructive and a stimulating exercise. It is of course true that when in clinique, the student is often allowed, sometimes even encouraged, to discuss his teacher’s views in a critical fashion, but, unfortunately, time is limited and the cliniques manifestly overcrowded. Here is a deficiency in our education for which the Royal Medical Society attempts to compensate, and it is our claim that we provide facilities for the student to become a more able speaker and a more critical thinker.
The Diagnosis of Hysteria
Authors: Craddock A B
Published: September 2013

I must confess at the outset that the subject of hysteria still awaits an adequate definition but the following one is as good as any so far produced. "Hysteria is a person's response to environmental difficulties, which makes it impossible for that person to perform his duties." Hysteria can be considered as subconscious malingering, but this concept too, fails to be comprehensive. In making the diagnosis of hysteria the following aspects should be considered:   The personality of the patient.   Dissociation.   Suggestion.   The actual clinical features.   The role of organic and psychological factors.Perhaps the most salient feature of hysteria is its propensity to occur more commonly in people with what is known as a hysterical personality.
Goings-on During the 22nd Session
Authors: Malcolm-Smith Nigel
Published: September 2013

During the 222nd session the Public Business Committee has provided us with a varied programme of outside activities, apart from the usual Friday evening meetings.In November the Presidents' Annual Dinner was held in the Hall of the Royal College of Surgeons of Edinburgh. We were pleased to have as our Guest of Honour Mr Thomas McW. Millar, a well-known and well-liked personality throughout the Edinburgh medical school. As usual. undergraduate members went back to Melbourne Place afterwards where the party was continued well into the night. We look forward to next year's Dinner when we will be pleased to have Sir Stanley Davidson with us as Guest of Honour.
An Appraisal of Ulcerative Colitis
Authors: Mailer C M
Published: September 2013

In writing about a subject like ulcerative colitis, it would be comforting to imagine oneself to be somewhere near the "growing edge," if not just exactly in the front line. And yet, this "growing edge" is so often disappointing, if not positively misleading, for too many of the new advances are reminiscent of the Seed which fell on stony ground:''and because it had no root it withered away."This is particularly true about researches into the aetiology and nature of ulcerative colitis. The fact that the disease is a cruel scourge of healthy young people, treatable to some extent, and yet imperfectly understood, has produced the attitude of mind that ulcerative colitis is a challenge. Although many valuable advances have resulted, it is probable that more pet theories have gained hold in this disease than in any other, and consequently there is considerable diversity of opinion regarding its nature and its treatment. Ideally, there should be a team, consisting of physician, surgeon and psychiatrist, each with something to offer in the treatment of the patient, but, in the international congress on ulcerative colitis, co-operation was curiously lacking, and the individual members seemed unable to concern themselves with approaches which were not their own.
Health-related quality of life and depression in Rett syndrome caregivers
Authors: Sarajlija Adrijan , Djuric Milena , Kisic-Tepavcevic Darija
Published: September 2013

Background/Aim. Rett syndrome (RTT) is a severe neurodevelopmental disorder
primarily affecting females with an estimated incidence of 1 : 10,000-15,000
female births. Currently, there is no specific treatment that halts or
reverses the progression of RTT. Therefore, management was mainly
symptomatic, focussed on optimising patient's abilities. The aim of this
study was to investigate factors influencing health-related quality of life
(HRQoL) and depression in mothers who care for children with Rett syndrome
(RTT) in Serbia. Methods. The cross-sectional study was conducted on 49
mothers giving care to females with RTT. Caregivers` HRQoL was assessed by
using the SF-36 questionnaire. Clinical severity score (CSS) of RTT patients
and Beck Depression Inventory II (BDI -II) scale were used to quantify RTT
severity and mothers` depression, respectively. Statistical assessment
included descriptive statistics, ttest, Pearson correlation coefficient and
multiple logistic regression. Results. The age of mothers ranged from 22 to
55 years and of their affected children from 3 to 29 years. Severe depression
was observed in 15 (30.6%) participants. CSS and BDI - II scores correlated
negatively with all SF- 36 domains and composite scores. Lowest scoring
domains of HRQoL in mothers giving care to RTT children were mental health,
vitality and role functioning emotional. Multiple linear regression analysis
revealed that severity of RTT patients` disability (CSS) and caregivers` age
are factors with strongest influence to HRQoL and depression in care giving
mothers. Conclusion. Mothers giving care to children with RTT are at high
risk of severe depression and lower HRQoL scores of domains that reflect
mental well-being. Results of this study can help in planning subsequent
interventions directed at families dealing with Rett syndrome.
Laparoscopy in gynecologic oncology: A review of literature
Authors: Mandic Aljosa , Golubovic Andrija , Majdevac Ivan
Published: September 2013

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Rapidly vanishing lung pseudotumor in a patient with acute bilateral bronchopneumonia
Authors: Lazovic Biljana , Stajic Zoran , Putnikovic Biljana
Published: September 2013

Introduction. Rapidly vanishing lung pseudotumor (phantom tumor) refers to
the transient well-demarcated accumulation of pleural fluid in the interlobar
pulmonary fissures. Most frequently their appearance is associated with
congestive heart failure, but also other disorders like hypoalbuminemia,
renal insufficiency or pleuritis. Its rapid disappearance in response to the
treatment of the underlying disorder is a classical feature of this clinical
entity. Case report. A 47-yearold woman, chronic smoker with symptoms of
shortness of breath, orthopnea, chills, cough, weakness and the temperature
of 39.2?C was admitted to our hospital. A posteroanterior chest X-ray
revealed cardiomegaly with the cardiothoracic ratio of > 0.5, blunting of
both costophrenic angles and an adjacent 6 x 5 cm well-defined, rounded
opacity in the right interlobar fissure. Transthoracic 2-dimensional
echocardiography demonstrated left ventricular hyperthrophy with a systolic
ejection fraction of 25% and moderate mitral regurgitation. The patient?s
symptoms resolved rapidly after diuresis, and repeated chest X-ray four days
later showed that the right lung opacity and pleural effusions had vanished.
Conclusion. The presented case underlines the importance of the possibility
of vanishing lung tumor in patients with left ventricular failure and a sharp
oval lung mass on the chest X-ray. This is the way to avoid incorrect
interpretation of this finding causing additional, unnecessary, costly or
invasive imaging, interventions and drugs.
Public versus Private Firm Responses to the Tax Rate Reduction in China
Authors: Lin Kenny Z. , Mills Lillian F. , Zhang Fang
Published: September 2013

This study examines how public and private firms in China respond to the 2008 statutory tax rate reduction from 33 percent to 25 percent. Using a proprietary dataset of private firms, we find that private firms report significantly more income-decreasing current accruals than do public firms in 2007, the year prior to the tax rate reduction. These negative accruals were substantial and material, both compared with public firms and compared with 2008 accruals. By shifting their taxable income from a high- to a low-tax year, private firms save about 8.58 percent of their total tax expenses in 2007. Our results suggest that countries contemplating tax rate changes should expect material inter-temporal income shifting by private firms when they predict the short-term effects of changes in the tax rate on revenue.

JEL Classifications: H25; M41.
Endocrine Secretory Reserve and Proinsulin Processing in Recipients of Islet of Langerhans Versus Whole Pancreas Transplants
Authors: Elkhafif Nabeel M. , Borot Sophie , Morel Philippe , Demuylder-Mischler Sandrine , Giovannoni Laurianne , Toso Christian , Bosco Domenico , Berney Thierry
Published: September 2013

OBJECTIVE

β-Cells have demonstrated altered proinsulin processing after islet transplantation. We compare β-cell metabolic responses and proinsulin processing in pancreas and islet transplant recipients with respect to healthy control subjects.

RESEARCH DESIGN AND METHODS

We studied 15 islet and 32 pancreas transplant recipients. Islet subjects were subdivided into insulin-requiring (IR-ISL, n = 6) and insulin-independent (II-ISL, n = 9) groups. Ten healthy subjects served as control subjects. Subjects were administered an intravenous arginine stimulation test, and insulin, C-peptide, total proinsulin, intact proinsulin, and proinsulin fragment levels were determined from serum samples. Acute insulin response (AIR) and proinsulin processing rates were calculated.

RESULTS

We found that basal insulin and C-peptide levels were higher in the pancreas group than in all other groups. II-ISL patients had basal insulin and C-peptide levels similar to healthy control subjects. The IR-ISL group had significantly lower AIRs than all other groups. Basal processing rates were higher in the pancreas and II-ISL groups than in healthy control subjects and the IR-ISL group. After arginine stimulation, all groups had elevated processing rates, with the exception of the IR-ISL group.

CONCLUSIONS

Our data suggest that II-ISL transplant recipients can maintain basal metabolic parameters similar to healthy control subjects at the cost of a higher rate of proinsulin processing. IR-ISL transplant recipients, on the other hand, demonstrate both lower insulin response and lower basal rates of proinsulin processing even after arginine stimulation.
CDH13 Genotype–Dependent Association of High–Molecular Weight Adiponectin With All-Cause Mortality: The J-SHIPP Study
Authors: Uetani Eri , Tabara Yasuharu , Kawamoto Ryuichi , Onuma Hiroshi , Kohara Katsuhiko , Osawa Haruhiko , Miki Tetsuro
Published: September 2013

OBJECTIVE

Despite its anti-inflammatory and antiatherogenic effects, adiponectin is potentially associated with adverse clinical outcomes, such as all-cause mortality. As plasma adiponectin levels are strongly influenced by single nucleotide polymorphisms in the gene encoding T-cadherin (CDH13), we conducted a longitudinal study to investigate the possible link between the CDH13 genotype, plasma adiponectin levels, and all-cause mortality.

RESEARCH DESIGN AND METHODS

This longitudinal study evaluated 2,020 Japanese subjects. Baseline clinical parameters were obtained from subjects’ personal health records as evaluated at annual medical check-ups. Plasma high–molecular weight adiponectin (HMWA) levels were measured by an ELISA assay, and genotyping was performed by a TaqMan probe assay.

RESULTS

Mean follow-up duration was 6.5 years. Kaplan-Meier analysis showed that HMWA levels were positively associated with mortality (P < 0.001). HMWA levels were associated with older age, lower body weight, lower plasma triglyceride and glucose levels, and higher plasma HDL cholesterol. However, the Cox regression analysis showed that the positive association between HMWA and all-cause mortality was independent of these covariates (hazard ratio [HR] 1.92, P = 0.006). The CDH13 rs4783244 genotype was strongly associated with baseline HMWA levels (per-allele effect size 1.65 μg/mL, P < 0.001). In a separate analysis by the CDH13 genotype, the HR for all-cause mortality was linearly increased with the number of G alleles (P value for HMWA–CDH13 genotype interaction = 0.023).

CONCLUSIONS

Higher plasma HMWA level was an independent prognostic factor for all-cause mortality in a general population. The CDH13 genotype may be a factor that affects not only the plasma level of HMWA but also the prognostic significance of HMWA.
Use of Video Modeling and Video Prompting Interventions for Teaching Daily Living Skills to Individuals with Autism Spectrum Disorders: A Review
Authors: Gardner Stephanie , Wolfe Pamela
Published: September 2013

Identifying methods to increase the independent functioning of individuals with autism spectrum disorders (ASD) is vital in enhancing their quality of life; teaching students with ASD daily living skills can foster independent functioning. This review examines interventions that implement video modeling and/or prompting to teach individuals with ASD daily living skills. The findings suggest that daily living skills can effectively be taught through technology-enhanced methods, with video prompting reported as being an effective intervention method and video modeling being somewhat effective at increasing skill acquisition for students with ASD. Future research must address the effect that various components of the interventions (e.g., model type, perspective, length of video, error correction procedures, prompting fading, voiceover, method of viewing the video) have on student performance.
An Emergent Approach to Text Analysis Based on a Connectionist Model and the Web
Authors: Cimino Mario , Vaglini Gigliola
Published: September 2013

In this paper, we present a method to provide proactive assistance in text checking, based on usage relationships between words structuralized on the Web. For a given sentence, the method builds a connectionist structure of relationships between word n-grams. Such structure is then parameterized by means of an unsupervised and language agnostic optimization process. Finally, the method provides a representation of the sentence that allows emerging the least prominent usage-based relational patterns, helping to easily find badly-written and unpopular text. The study includes the problem statement and its characterization in the literature, as well as the proposed solving approach and some experimental use.
Formation of Apatite Coatings on an Artificial Ligament Using a Plasma- and Precursor-Assisted Biomimetic Process
Authors: Mutsuzaki Hirotaka , Yokoyama Yoshiro , Ito Atsuo , Oyane Ayako
Published: September 2013

A plasma- and precursor-assisted biomimetic process utilizing plasma and alternate dipping treatments was applied to a Leed-Keio artificial ligament to produce a thin coating of apatite in a supersaturated calcium phosphate solution. Following plasma surface modification, the specimen was alternately dipped in calcium and phosphate ion solutions three times (alternate dipping treatment) to create a precoating containing amorphous calcium phosphate (ACP) which is an apatite precursor. To grow an apatite layer on the ACP precoating, the ACP-precoated specimen was immersed for 24 h in a simulated body fluid with ion concentrations approximately equal to those in human blood plasma. The plasma surface modification was necessary to create an adequate apatite coating and to improve the coating adhesion depending on the plasma power density. The apatite coating prepared using the optimized conditions formed a thin-film that covered the entire surface of the artificial ligament. The resulting apatite-coated artificial ligament should exhibit improved osseointegration within the bone tunnel and possesses great potential for use in ligament reconstructions.
SBA-15 Mesoporous Silica as Catalytic Support for Hydrodesulfurization Catalysts—Review
Authors: Huirache-Acuña Rafael , Nava Rufino , Peza-Ledesma Carmen , Lara-Romero Javier , Alonso-Núez Gabriel , Pawelec Barbara , Rivera-Muñoz Eric
Published: September 2013

SBA-15 is an interesting mesoporous silica material having highly ordered nanopores and a large surface area, which is widely employed as catalyst supports, absorbents, drug delivery materials, etc. Since it has a lack of functionality, heteroatoms and organic functional groups have been incorporated by direct or post-synthesis methods in order to modify their functionality. The aim of this article is to review the state-of-the-art related to the use of SBA-15-based mesoporous systems as supports for hydrodesulfurization (HDS) catalysts.