bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of KRAS and EGFR As Biomarkers of Response to Erlotinib in National Cancer Institute of Canada Clinical Trials Group Study BR.21
Authors: Zhu Chang-Qi , da Cunha Santos Gilda , Ding Keyue , Sakurada Akira , Cutz Jean-Claude , Liu Ni , Zhang Tong , Marrano Paula , Whitehead Marlo , Squire Jeremy A. , Kamel-Reid Suzanne , Seymour Lesley , Shepherd Frances A. , Tsao Ming-Sound
Published: July 2008

Purpose

To evaluate the effect of KRAS and epidermal growth factor receptor (EGFR) genotype on the response to erlotinib treatment in the BR.21, placebo-controlled trial.

Patients and Methods

We analyzed 206 tumors for KRAS mutation, 204 tumors for EGFR mutation, and 159 tumors for EGFR gene copy by fluorescent in situ hybridization (FISH). We reanalyzed EGFR deletion/mutation using two highly sensitive techniques that detect abnormalities in samples with 5% to 10% tumor cellularity. KRAS mutation was analyzed by direct sequencing.

Results

Thirty patients (15%) had KRAS mutations, 34 (17%) had EGFR exon 19 deletion or exon 21 L858R mutations, and 61 (38%) had high EGFR gene copy (FISH positive). Response rates were 10% for wild-type and 5% for mutant KRAS (P = .69), 7% for wild-type and 27% for mutant EGFR (P = .03), and 5% for EGFR FISH-negative and 21% for FISH-positive patients (P = .02). Significant survival benefit from erlotinib therapy was observed for patients with wild-type KRAS (hazard ratio [HR] = 0.69, P = .03) and EGFR FISH positivity (HR = 0.43, P = .004) but not for patients with mutant KRAS (HR = 1.67, P = .31), wild-type EGFR (HR = 0.74, P = .09), mutant EGFR (HR = 0.55, P = .12), and EGFR FISH negativity (HR = 0.80, P = .35). In multivariate analysis, only EGFR FISH-positive status was prognostic for poorer survival (P = .025) and predictive of differential survival benefit from erlotinib (P = .005).

Conclusion

EGFR mutations and high copy number are predictive of response to erlotinib. EGFR FISH is the strongest prognostic marker and a significant predictive marker of differential survival benefit from erlotinib.
Tumor Metabolism and Blood Flow Changes by Positron Emission Tomography: Relation to Survival in Patients Treated With Neoadjuvant Chemotherapy for Locally Advanced Breast Cancer
Authors: Dunnwald Lisa K. , Gralow Julie R. , Ellis Georgiana K. , Livingston Robert B. , Linden Hannah M. , Specht Jennifer M. , Doot Robert K. , Lawton Thomas J. , Barlow William E. , Kurland Brenda F. , Schubert Erin K. , Mankoff David A.
Published: July 2008

Purpose

Patients with locally advanced breast carcinoma (LABC) receive preoperative chemotherapy to provide early systemic treatment and assess in vivo tumor response. Serial positron emission tomography (PET) has been shown to predict pathologic response in this setting. We evaluated serial quantitative PET tumor blood flow (BF) and metabolism as in vivo measurements to predict patient outcome.

Patients and Methods

Fifty-three women with primary LABC underwent dynamic [18F]fluorodeoxyglucose (FDG) and [15O]water PET scans before and at midpoint of neoadjuvant chemotherapy. The FDG metabolic rate (MRFDG) and transport (FDG K1) parameters were calculated; BF was estimated from the [15O]water study. Associations between BF, MRFDG, FDG K1, and standardized uptake value and disease-free survival (DFS) and overall survival (OS) were evaluated using the Cox proportional hazards model.

Results

Patients with persistent or elevated BF and FDG K1 from baseline to midtherapy had higher recurrence and mortality risks than patients with reductions. In multivariable analyses, BF and FDG K1 changes remained independent prognosticators of DFS and OS. For example, in the association between BF and mortality, a patient with a 5% increase in tumor BF had a 67% higher mortality risk compared with a patient with a 5% decrease in tumor BF (hazard ratio = 1.67; 95% CI, 1.24 to 2.24; P < .001).

Conclusion

LABC patients with limited or no decline in BF and FDG K1 experienced higher recurrence and mortality risks that were greater than the effects of clinical tumor characteristics. Tumor perfusion changes over the course of neoadjuvant chemotherapy measured directly by [15O]water or indirectly by dynamic FDG predict DFS and OS.
Development of a stair-climbing robot using springs and planetary wheels
Authors: Han I
Published: July 2008

This paper presents a self-propelled travelling mechanism capable of climbing stairs without a sensor or judging algorithm. The developed leg-wheeled mobile robot, which is a type of mechanism to be adaptable to obstacles and to overcome the gravity, uses springs and planetary wheels. The spring is effective when the front wheels start climbing a stair and the planetary wheels with the functions to roll, walk, and jump, thereby passing through stairs and obstacles. A detail design has been performed and a test model has been constructed with a vast range of simulation analysis results. Also, the validity of the constructed test model has been verified through the experiments in climbing the stairs of high step.
Demonstrator to show the effects of negative stiffness on the natural frequency of a simple oscillator
Authors: Carrella A , Brennan M J , Waters T P
Published: July 2008

This article describes a demonstrator to show the effects of negative stiffness on the free vibration of a simple oscillator. The test rig consists of a horizontal beam that is hinged at one end and is supported by two coil springs to form a single-degree-of-freedom system. Additional correction springs, which provide negative stiffness, can be attached to lower the natural frequency of the system. The effect of the change in natural frequency can be easily seen visually, and it is shown that for one of the configurations of correction springs, the natural frequency can be reduced by a factor of about 4.
Central film thickness in time-varying normal approach of rolling elastohydrodynamically lubricated contacts
Authors: Morales-Espejel G E
Published: July 2008

The effects of time-varying normal approach on the film formation of rolling elastohydrodynamically lubricated (EHL) contacts are studied by means of an inlet analysis. A modified Ertel—Grubin scheme is used to calculate the variation of central film thickness as a response of time-varying normal approach. The inlet shape approximation from Crook is used to derive simple analytical and semi-analytical solutions for the calculation of central film thickness and inlet pressures for situations of prescribed normal rigid-body displacement or prescribed load variation. The methodology is also adopted to model the pressure and clearance wave transport phenomenon shown earlier only with the use of full numerical solutions.
Piece-wise linear dynamic analysis of serpentine belt drives with a one-way clutch
Authors: Zhu F , Parker R G
Published: July 2008

A prototypical three-pulley serpentine belt drive with belt bending stiffness is extended to include a one-way clutch in order to understand the non-linear dynamics of the system with the one-way clutch performance. The clutch is modelled based on the relative velocity of the driven pulley and its accessory. The clutch locks (engages) the pulley and accessory for zero relative velocity and produces a positive inner clutch torque. Zero clutch torque initiates clutch disengagement, allowing unequal velocities of the two components. This model leads to a piece-wise linear system. The transition matrix is used to evaluate the system response in discrete time series for the two linear configurations, saving significant computational time. The system dynamics including response and dynamic tension drop are examined for varying excitation frequencies, inertia ratio of the pulley and accessory, and external load. The investigation of vibration reduction because of the single-direction power transmission of the clutch provides design guidelines in practice.
Development of a robot simulator using a modified trajectory generation algorithm oriented towards the palletizing task
Authors: Yu S-N , Lim S-J , Han C-S , Kang M-K , Kim S-R
Published: July 2008

Palletizing tasks are necessary to promote the efficient storage and shipping of boxed products. These tasks, however, involve some of the most monotonous and physically demanding tasks in the factory. Thus, many types of robot palletizing systems have been developed, although many robot motion commands still depend on the teach pendant. That is, the operator inputs the motion command lines one by one. This is very troublesome and, most importantly, the user must know how to type the code. To solve these problems, this paper proposes a combination of an optimized pallet pattern generation algorithm, an industrial robot simulator, and a modified trajectory optimization algorithm. To integrate these modules and to define the position of the boxes, the robot and its peripherals, as well as the system layout and its coordinates, were defined. Finally, the proposed path generation algorithm, the ‘overlap method’, was tested in the designed offline programming S/W, and its computational efficiency was proven.
Experimental measurement of axial clearance in scroll compressor using eddy current displacement sensor
Authors: Yang Q , Li L , Zhao Y , Shu P
Published: July 2008

This paper describes a method by using eddy current displacement sensor for the measurement of axial clearance in a water-lubricated scroll air compressor. The basic physical principle of the sensor is reviewed. An effective experimental configuration is established and the test procedure is designed to acquire proper data. The output signal which gives us useful waveforms is obtained by the data acquisition program based on virtual instrument technology. The actual tested results show that the eddy current sensor has high sensitivity and preferable static and dynamic performances. The actual axial clearance of the scroll air compressor under a working condition was measured and the tested results showed that the axial clearance is larger than that in refrigeration scroll compressor. In addition, the frequencies of signal pulse also reflect the change in rotational speed by analysing the output voltage signals. The actual experimental results could reflect the real situation of axial clearance of the scroll air compressor. It is of significance to further study on the relationship between the axial clearance and the performance of the scroll air compressor.
Flow and heat transfer of the axisymmetric stagnation flow passing through irregular wafer
Authors: Wang C-C , Hu H-P , Lee Z-Y
Published: July 2008

A theoretical model for the two-dimensional, incompressible, and steady-state laminar forced convective flow over the irregular wafer is examined. Starting from the full Navier—Stokes equations and converting this into the boundary layer equations by the simple coordinate transformation. The resulting parabolic equations are solved using the cubic spline approximation. The numerical result shows that the local flow and local heat transfer characters of a wafer surface are greatly affected by the tiny concaves and convexes on the surface and have a frequency similar to that of surface geometry. The effect becomes obvious with the increase of radius, whereas the mean heat transfer efficiency remains slightly less than that of flat wafer.
On the incompatibility between the equivalent shear force concept and the integral formulation of contact problems between Kirchhoff plates and irregular linear supports
Authors: Strozzi A , Monegato G
Published: July 2008

It is shown that, when employing the integral formulation to describe contact problems between Kirchhoff plates and irregular linear supports, the equivalent shear force concept may be incompatible with the integral approach. In such circumstances the equivalent shear force concept has to be abandoned in favour of an equivalent twisting moment approach. A classical example of an infinite plate resting on a linear central segment is revisited in the light of the equivalent twisting moment concept, where all the computations are carried out in exact form. An additional example is developed to show that the usefulness of an integral approach based upon the equivalent twisting moment concept remains valid even when the equivalent twisting moment is applied at a plate border along which the twisting moment must be null, as it occurs in a partially clamped border. The reaction singularity at the endpoints of a linear support is examined with the Williams asymptotic method. Finally, a physical interpretation is proposed for the adoption of a distributed twisting moment among the contact reactions.
A new minimum description length based pruning technique for rule induction algorithms
Authors: Pham D T , Afify A A
Published: July 2008

When learning is based on noisy data, the induced rule sets have a tendency to overfit the training data, and this degrades the performance of the resulting classifier. Consequently, the ability to tolerate noise is a necessity for robust, practical learning methods. Pruning is a common way of handling noisy data. This paper presents a new pruning technique built on the sound foundation of the minimum description length principle. The proposed pruning technique has the advantage that it does not require the set of examples employed for pruning to be distinct from the set used to build the rule set. The new technique is designed to improve the performance of the RULe Extraction System (RULES) family of inductive learning algorithms, but can be used for pruning rule sets created by other learning algorithms. It was tested in RULES-6, the latest algorithm in the family, and showed significant performance improvements.
Effect of friction stir processing on electrical conductivity and corrosion resistance of AA6063-T6 Al alloy
Authors: Mahmoud T S
Published: July 2008

The aim of this paper is to study the effect of friction stir processing (FSP) on electrical conductivity and corrosion resistance of AA6063-T6 Al alloy. Also, the microstructural and mechanical characteristics were examined. Different samples were structured by employing a constant feed rate (ν) of 120 mm/min and different rotating speeds (ω) of 250, 315, 400, 500, 630, and 800 r/min. The results showed that FSP significantly refines the microstructure of the AA6063-T6 Al alloy. Increasing the rotational speed increases the grain size in the centres of stirred zones (SZ). The FSP significantly increases the electrical conductivity of the alloy. The highest electrical conductivities were observed at the centres of the SZ for the alloys processed with varying rotational speeds between 315 and 500 r/min. Increasing the rotational speed above this range tends to reduce the electrical conductivity, but it is still higher than the base material. In contrast, the corrosion resistance was found to decrease due to FSP of the AA6063-T6 aluminium alloy. It has been found that, increasing the rotational speed decreases the corrosion resistance of the SZ in 1 M HCl solution.
Meshing analysis and design of rotundity-datum-aperture Hy-Vo silent chain
Authors: Meng F , Liu X , Xu S
Published: July 2008

The proper meshing design of rotundity-datum-aperture Hy-Vo silent chain and involute sprockets is of vital importance to ensure the favourable transmission properties of the system consisting of the silent chain and involute sprockets. Based on the study of the meshing theory of rotundity-datum-aperture Hy-Vo silent chain and involute sprockets and the rolling cutting theory between sprocket and hob, the meshing design system is built among rotundity-datum-aperture Hy-Vo silent chain, sprocket, and hob, and the resolved expressions are put forward, which may instruct meshing design and calculation of Hy-Vo silent chain and sprocket. The paper also discusses the variation of the equivalent side-heart distance and the effect of the sprocket pressure angle on the meshing between Hy-Vo silent chain and sprocket. The application in real engineering proves that the new design method is scientific and feasible.
Natural convection analysis for both protruding and flush-mounted heaters located in triangular enclosure
Authors: Koca A , Oztop H F , Varol Y
Published: July 2008

A numerical was performed analysis on laminar natural convection heat transfer and fluid flow in both protruding heaters (PHs) and flush-mounted heaters (FMHs) located in a triangular enclosure using finite-difference technique. The heaters were isothermal and the temperature of the inclined wall was lower than that of the heaters while the remaining walls of the triangular enclosure were adiabatic. Results are presented according to the location of the heaters in two cases. In the first case, the PH was located near the vertical wall and the FMH near the right corner. In the second case, the PH was located near the right corner of the enclosure, whereas the FMH was located close to the vertical wall. The governing parameters on natural convection were Rayleigh number (104≤Ra≤106), dimensionless length of the PH ( W1), dimensionless length of the FMH ( W2), dimensionless height of the PH (Hp), dimensionless distance between the heater and the vertical wall ( S1), dimensionless distance between the PH and the FMH ( S2), and aspect ratio of the triangular enclosure (0.25 ≤AR≤ 1.0). It was found that better heat transfer occured when the PH was located near the right corner of the triangular enclosure, while the other heater was mounted near the left vertical wall. Heaters behaved as a single heater when they were close to each other.
Two-dimensional numerical investigation of film cooling by a cool jet injected at various angles for different blowing ratios
Authors: Bayraktar S , Yilmaz T
Published: July 2008

This paper presents the thermal and flow characteristics of a cold transverse jet, injected at five different angles (α = 30°, 45°, 60°, 75°, and 90°) into a hot crossflow with four different blowing ratios ( M = 0.1, 0.3, 0.5, and 0.8). Three turbulence models, namely, standard k−∊, renormalization group (RNG) k−∊, and realizable k−∊ are tested for obtaining the accurate turbulence model to predict the effectiveness of film cooling. The tested turbulence models were compared with available experimental data in the literature. The results evinced that the RNG k−∊ turbulence model is the most appropriate among the three. It is also observed that maximum cooling efficiency is obtained at α = 30° and M = 0.8.
The drag force on a collapsing bubble
Authors: Kendoush A A
Published: July 2008

Equations were derived for the prediction of the drag coefficient of a collapsing bubble during its flow in liquid. Expressions were obtained analytically for the drag coefficient in terms of Reynolds, Peclet, and Jakob numbers as well as a dimensionless time for the collapse of a thermally controlled bubble. Equations were derived for the drag coefficient and virtual mass coefficient for a collapsing bubble under inertia-controlled and mass-diffusion-controlled processes. The flow and thermal parameters were obtained by solving the viscous dissipation integral around the bubble surface. These new theoretical results showed agreement with previously reported numerical solutions and experimental data. Some avenues for further research were pointed out.
Model-based development for an electric power steering system
Authors: Ren W , Chen H , Song J
Published: July 2008

A model-based development method for electric power steering (EPS) system has been explored. A practicable model for the EPS system has been established in a full vehicle mechanical system environment. The performance of the electric control system of the EPS system has been evaluated in this static analysis environment. The model has then been used in a dynamic test environment based on dSPACE hardware and software, including Software-in-the-Loop and Hardware-in-the-Loop. The test result validates the simulation model, and shows that this development method can be used to evaluate the conceptual design of the EPS system as well as the control software design and testing.
Nanohandling automation: Trends and current developments
Authors: Fatikow S , Eichhorn V
Published: July 2008

Automated robot-based nanomanipulation is one of the key challenges in microsystem technology and nanotechnology, which has recently been addressed by a rising number of R&D groups and companies all over the world. Controlled, reproducible assembly processes at the nanoscale will enable high-throughput manufacturing of revolutionary products and open up new application fields. The ultimate goal of these research activities is the development of automated nanomanipulation processes to build a bridge between existing precise handling strategies for micro and nanoscale objects and aspired high-throughput fabrication of microsystems and nanosystems. Despite the growing interest in automated nanomanipulation, there is hardly any publication that treats this research in a coherent and comprehensive way. This paper is an attempt to provide the researcher with an overview of the most important trends and developments in this rapidly expanding technology. It also informs the practising engineer and the engineering student about automation at the nanoscale level as well as about the promising fields of application. The latter can be of a very different nature as nanohandling is strongly interdisciplinary in character. This paper offers a deeper insight into nanohandling aspects of carbon nanotubes.
Comparison of numerical and ultrasonic techniques for quantifying interference fit pressures
Authors: Lewis R , Yoxall A , Marshall M B
Published: July 2008

Press fits are commonly used in manufactured assemblies, components, and machines. For example railway wheels are press or shrink fitted onto axles. Railway axles occasionally fail by fatigue resulting from the alternating rotating bending loading. The site of the fatigue crack initiation is commonly at the location of the press fit. Therefore, a good understanding is needed of the press-fit region, particularly where stress-raising effects are caused by, for example, large changes in geometry. Analytical techniques are unable to predict stresses in these areas.

In this work, an ultrasonic technique was used to measure the contact stresses in a real shaft—sleeve contact. The results were compared with finite-element models of the same components. The results from the two techniques compared well both in the centre of the fit and around the edges where the stresses were raised. Both showed good correlation with the analytical Lamé solution away from the edges. The two techniques could therefore be combined in a design tool to help remove problems with edge effects that could lead to mechanical failures.
A compact and flexible actuator based on shape memory alloy springs
Authors: Yang K , Gu C L
Published: July 2008

A new structure of compact flexible actuator based on shape memory alloy (SMA) springs is presented. Three SMA springs, which are trained to shrink as the phase transition occurs, are embedded off-axially and movably in a silicone rubber rod solidified at room temperature. The spatial bending, which is accomplished through heating SMA springs by suitable current, could restore flexibly as soon as heating is stopped. Thus, the compact, flexible, integrative actuator is built. Being possessed of the merits such as high load—weight ratio, low energy dissipation, and direct driving, the actuators can implement simple drive, precise operation, and flexible movement. On the basis of the analysis of an elastic rod with distributed and concentrated loads, the design of the rod and SMA springs is investigated. Subsequently, the manufacture of the prototype is carried out and the control system is implemented. Finally, the experiments are carried out to validate the virtues of the actuators.
Self-learning control systems using identification-based adaptive iterative learning controller
Authors: Ashraf S , Muhammad E , Al-Habaibeh A
Published: July 2008

One of the promising algorithms for self-learning control systems is iterative learning control (ILC), which is an algorithm capable of tracking a desired trajectory within a specific period of time. Conventional ILC algorithms have the problem of relatively slow convergence rate and because of their fixed control laws they are unable to adapt to changes in performance requirements and system changes. This paper suggests a novel approach by combining system identification techniques with the proposed ILC approach to overcome such problems. Several practical simulation examples are presented to illustrate the design procedure and to confirm the effectiveness and robustness of the algorithm. The optimal gain matrices values are calculated using the steepest descent approach. Convergence condition for the approach is also derived. Declining cost and increasing power of computers and embedded systems makes the implementation of such schemes highly feasible.
Traditional medicine, delays and hospital mortality of children under five years of age in the rural district of Kigoma, western Tanzania: an observational hospital-based study
Authors: Blanke Christoph H , Naisabha Godson B , Lange Christine R
Published: July 2008

The use of traditional medicine in the treatment of 596 children aged 0–60 months before admission was common (41.4 %). Children were more likely to die if they had first been treated with traditional medicine (50/244; 20.5% vs 29/342; 8.5%) or were younger (median 9 vs 12 months old.) Children who had received traditional medicine were younger (median 11 vs. 13 months), came later for hospital treatment (median three vs. five days), had a longer journey on foot to reach the health centre (3.4 vs. 2.9 h), and died from common diseases and not from an obvious toxic syndrome.
Seroprevalence of human immunodeficiency virus among blood donors in a rural Ethiopian Hospital
Authors: Ramos Jose Manuel , Reyes Francisco , Tesfamariam Abraham
Published: July 2008

We describe our experience of the HIV seroprevalence among blood donors in a rural general hospital in Ethiopia during an eight-year period (January 1998–December 2006). From 3305 blood donors screened, 51 (1.4%) were positive for HIV antibodies.
Quality of life for families with spina bifida in Kenya
Authors: van't Veer Toos , Meester Hanneke , Poenaru Dan , Kogei Agnes , Augenstein Kimberly , Bransford Richard
Published: July 2008

Spina bifida (SB) affects children worldwide. Studies from developed nations have explored the impact of SB on the quality of life of children and their parents. However, there are no such studies available from developing countries. We have therefore undertaken to document the impact of the disability on the families of affected children in Kenya. A questionnaire was administered to 40 mothers and their children, who were receiving treatment for SB at our institution. The results of this study should indicate where community and governmental resources and educational efforts for the disabled should be directed.
Baseline assessment of collaborative tuberculosis/HIV activities in Kinshasa, the Democratic Republic of Congo
Authors: Martinot Amanda , Van Rie Annelies , Mulangu Sabue , Mbulula Marie , Jarrett Nikki , Behets Frieda , Bola Valentin , Bahati Etienne
Published: July 2008

Ninety-two clinics were surveyed in 2005 as part of a baseline assessment of HIV activities in Tuberculosis (TB) clinics in Kinshasa, Democratic Republic of Congo. Some HIV activities were implemented in 58% of TB clinics. The majority of health had ≥ 1 health care worker (HCW) trained in either HIV counseling or testing (71%). Fifty-three clinics offered counseling and testing to TB patients; twenty-two (42%) routinely offered HIV CT to all patients, while others used selective criteria. While most offered on-site counseling (92%) and testing (77%), not all 53 clinics had a HCW trained in counseling and only 31 had access to a counseling room. Cotrimoxazole prophylaxis was offered in 51% of clinics; antiretroviral treatment in 17%. Shortcomings in human resources, infrastructure and quality of services were revealed. Strengthening those clinics already implementing HIV activities could be prioritized to achieve the goals set forward by the Global Plan to Stop TB.
HIV and obstetric complications and fetal outcomes in Vellore, India
Authors: Lionel Jessie , Aleyamma T K , Varghese Lilly , Buck Jessica , Gopalakrishnan Geetha , Chaguturu Sreekanth , Cu-Uvin Susan , Mayer Kenneth
Published: July 2008

Antenatal prevalence is more than 1% in parts of India, yet little is known about the complications and fetal outcomes in this region. We reviewed the records of 23,386 women who delivered at the Christian Medical College Hospital in Vellore, India from 2000 through 2002. HIV-infected women were more likely than HIV-uninfected women to have pregnancy-induced hypertension, anaemia, breech presentations, stillborn babies and fetal deaths. HIV-infected women who did not receive mother-to-child transmission prophylaxis or had breech fetal presentation were more likely to have fetal deaths ( P = 0.001). HIV prophylaxis and optimal prenatal care should be a priority for HIV-infected pregnant women in resource-limited countries.
An audit of obstetric fistulae in a teaching hospital in South Africa
Authors: Ramphal S R , Kalane G , Fourie T , Moodley J
Published: July 2008

Obstetric fistulae are still common in the rural areas of South Africa. This study describes the demographic and clinical characteristics of 41 women with obstetric urinary fistulae. All were from poor socioeconomic backgrounds and had limited or no access to antenatal care.
Haemolytic uraemic syndrome in children admitted to a rural district hospital in Kenya
Authors: Olotu Ally Ibrahim , Mithwani S , Newton C R J C
Published: July 2008

We studied children admitted to Kilifi District Hospital, Kenya, between 1997 and 2005 with haemolytic uraemic syndrome (HUS) and reviewed their records in order to determine the clinical features and outcomes of the disease. Thirty-one children fulfilled the criteria: 21 (68%) had diarrhoea-associated HUS (D + HUS), the remainder did not (D-HUS); five had involvement of the central nervous system. Those with D-HUS had lower haemoglobin and platelet counts when compared with those with D + HUS. The overall mortality rate was 55% (17/31) with no significant difference between the two groups. Severe hyponatraemia ([Na+] <120 mmol/L) predicted a poor outcome. Shigella dysenteriae was the most common isolated organism in the stool and Escherichia coli and S. dysenteriae were the most common blood isolates. HUS carries a high mortality rate and D-HUS is as common as D + HUS.
The proctoscope
Authors: Ray Dipankar
Published: July 2008

A cheaper version of a self-illuminated proctoscope which suitable for use in developing countries designed for diagnosis and intervention in anorectal diseases is described.
The unreported morbidity of suicidal poisonings during an insurgency: a 16-year Kashmir experience
Authors: Wani Zaid Ahmed , Dhar Shabir Ahmed , Hussain Arshad , Qureshi Waseem
Published: July 2008

Around a million people commit suicide, and at least 10 times this number attempt suicide, worldwide every year. No nationwide epidemiological studies have been undertaken in India but a significant rise in suicides has been observed in Kashmir in recent years. This study was carried out on patients reporting to the Government SMHS Hospital in Srinagar with a history of suicidal poisoning.
Prevalence of opportunistic infections in AIDS patients in Mangalore, Karnataka
Authors: Saldanha Dominic , Gupta Nitika , Shenoy Shalini , Saralaya Vishwas
Published: July 2008

A study was conducted to determine the prevalence of opportunistic infections in HIV-seropositive patients at Kasturba Medical College Hospital, Mangalore. Three hundred and seven HIV-positive patients were screened for various opportunistic pathogens. Tuberculosis was the most common infection followed by candidiasis, cryptosporidiosis and cryptococcal meningitis.
From home delay to institutional neglect: an emerging trend in obstructed labour
Authors: Abiodun O M , Aboyeji A P
Published: July 2008

Analysis of 146 patients managed for obstructed labour at a referral tertiary hospital in South West Nigeria shows that labour became obstructed in a lower cadre health facility among majority (76.7%) of the women. This calls for improved maternity service delivery in our locality.
Histopathology slide projector a simple improvisation
Authors: Agarwal Akhilesh KR , Bhattacharya Nirjhar
Published: July 2008

The ability to examin histopathology and other hematological slides under microscope is a necessary and important service which should be available in every health facility. The slides need to be projected on to a screen. We describe an inexpensive and eaily constructed technique for projecting magnified images of slides using a simple microscope. It is effective both for making observations and for use as a teaching aid.
Bullous erythema multiforme after treatment with Malarone®, a combination antimalarial composed of atovaquone and proguanil hydrochloride
Authors: Remich Shon A , Otieno Walter , Polhemus Mark E , Ogutu Bernhards , Walsh Douglas S
Published: July 2008

We report on a Kenyan woman who developed bullous erythema multiforme, in association with Malarone treatment.
Paralytic poliomyelitis during the pre-, peri- and post-suspension periods of a polio immunization campaign
Authors: Lamina S , Hanif S
Published: July 2008

A total of 744 paralytic poliomyelitis patients (0–59 months old) were reviewed and results showed a critical and perpetual surge during 2003 (20.2%), 2004 (27.4%) and 2005 (41%). A slight male predominance (56%) was reported and a high incidence was reported in the low socioeconomic (68.3%) and urban setting (60.3%) groups. It was concluded that the polio eradication campaigning programmes in Nigeria had not been successful and that legislation on poliomyelitis was required.
Prevalence of depressive symptoms among Nigerian medical undergraduates
Authors: Aniebue P N , Onyema G O
Published: July 2008

This study assessed the epidemiology of depressive symptoms in Nigerian medical students. A cross-sectional study of 262 medical students from University of Nigeria, Enugu campus, one of the foremost medical schools in Nigeria was studied. Data were collected using structured self-administered questionnaires and the Zung self-rating depression scale developed by Zung as an instrument, which measures the subjective experience of depression. The age range of students was 16–30 years. The prevalence of depression among the students was 23.3%. Students aged 16–20, females, and those who had a professional examination during the period of the study had higher levels of depression, although these findings were not significant. However, students who smoked regularly had significantly higher levels of depression than those who did not smoke. Medical educators in Nigeria need to be aware of the vulnerability of medical students to depression.
Predictors of survival in very low birth weight infants at the University Hospital of the West Indies, Jamaica
Authors: Trotman H , Lord C
Published: July 2008

The use of prenatal steroids is an effective, simple clinical intervention that can be implemented in developing countries to help decrease mortality in very low birth weight infants.
Clinico-laboratory findings of patients during dengue outbreak from a tertiary care hospital in Delhi
Authors: Rai Sumit , Chakravarti Anita , Matlani Monika , Bhalla Preena , Aggarwal Vijay , Singh N , Diwan R
Published: July 2008

There are outbreaks of dengue every year in India. They vary in the predominant serotype involved, clinical features and predominant laboratory findings. This study of the 2006 outbreak in Delhi highlights clinical features and laboratory parameters of dengue cases and compares the clinical features among the adult and paediatric age groups. The 2006 outbreak had higher bleeding manifestations and a greater involvement of the adult male population than in previous outbreaks. No correlation was observed between platelet count and different bleeding manifestations until they dropped <20,000 per μL. Few patients developed a florid picture before seroconversion, highlighting a greater stress on the haematological rather than immunological profile of such patients. Atypical symptoms, such as diarrhoea, menorrhagia and seizures were often the presenting complaints rather than the typical clinical features of dengue.
Neurocysticercosis in a north Indian hospital
Authors: Mohanty Srujana , Deb Monorama , Aggarwal Pushpa
Published: July 2008

In endemic regions, neurocysticercosis (NCC) is the most commonly diagnosed parasitic disease of the central nervous system, and the most common cause of convulsions and hydrocephalus in adults. During January 2000–December 2006, serum samples collected from patients presenting with various manifestations with a clinical diagnosis of cysticercosis and/or relevant computed tomography findings were subjected to an enzyme-linked immunosorbent assay test for NCC. Anti-cysticercus antibodies were detected in 155 of the 1096 (14.1%) cases. Generalized seizure (33.9%) was the most common presenting symptom. Solitary lesion (74.2%) was the most common radiological finding. This study provides an assessment of the epidemiology of NCC in Delhi and stresses the need for its prevention.
World Health Organization Clinical Stage 3 disease conditions in HIV-infected patients who start antiretroviral therapy in Malawi
Authors: Ngoma Damas , Makombe Simon D , Kamoto Kelita , Harries Anthony D
Published: July 2008

There is little information about disease conditions that are diagnosed in patients diagnosed as having World Health Organization Clinical Stage 3 HIV who are started on antiretroviral therapy (ART) in Africa. We therefore conducted an audit in the central region of Malawi of patients registered for ART between January and September 2006. There were 4299 patients in Stage 3 of whom 4154 had data about their disease conditions. Only one condition was listed for 3880 patients. Of these, 1892 (48.8%) had unexplained weight loss, chronic fever or chronic diarrhoea, 822 (21.2%) had active/previous tuberculosis (TB) and 671 (17.3%) had a severe presumed bacterial infection. No patient was diagnosed as having haematological abnormalities. Nearly half the patients started on ART had a symptomatic, unspecified disease, (which may be obscuring important pathologies such as TB) and almost no laboratory assessment had taken place before the commencement of ART. These two areas need to be addressed in order to improve the management of patients starting on ART.
The sixteen-year trend of syphilis in Turkey: data from blood donors
Authors: Oncul Oral , Emekdas Gurol , Cavuslu Saban , Artuk Cigdem , Aksoy Ali
Published: July 2008

This study was conducted in order to determine the prevalence and trends of antibodies to syphilis among Turkish blood donors (BDs) at the 22 National Blood Transfusion Service, Kizilay, between 1989 and 2004. Among the 6,240,130 BDs, a reactive result was obtained with the rapid plasma reagin test for 6864 donors (0.11%). A serious increasing trend was observed between 1989 and 1992 (41/100.000 versus 92/100.000 cases, P = 0.003, CI 95, 33–107), in 1998, the rates were observed to have increased approximately 4.01 times compared with that of 1989 (41/100,000 versus 168/000,000, P = 0.001, CI 95, 28–183). After 2002, syphilis seropositivity showed a marked decreasing trend ( P = 0.002, CI 95, 36–118). However, as this survey shows, the rate of seropositive donors for syphilis has been greatly reduced but it is believed that a more thorough management strategy is necessary in order to cause a further reduction in Turkey.
Visceral leishmanisis in paediatrics: a study of 367 cases in southwest Iran
Authors: Ashkan Moslehi Mohammad , Rahim Kadivar Mohammad
Published: July 2008

Kala-azar (visceral leishmaniasis [VL]) is endemic in southern Iran. We retrospectively evaluated 367 infants and children suffering from VL at hospitals affiliated to the Shiraz University of Medical Sciences in Fars Province, southwest Iran). Seasonal variations were observed with more cases presenting in late winter, spring and fewer in summer. The predominant clinical features in these patients were chronic fever, pallor, weight loss, abdominal distention and hepatosplenomegaly. Lymphadenopathy was less common. Common laboratory abnormalities included anaemia, leukopenia, thrombocytopenia, hypoalbuminaemia and hypergammaglobulinaemia. Liver function tests were deranged in two-thirds of the patients. The immunofluorescence antibody test was positive in all patients and all of them had a positive bone marrow smear or a culture for Leishmania donovani. Patients responded well to glucantim therapy with a cure rate of 96.7%. Relapse was observed in 8.2% (30). Mortality in this series was 7.3%. Twenty patients died during their therapy period. Jaundice and grossly deranged liver function tests were found to be bad prognostic signs.
Clinical analysis of 52 cases of neurocysticercosis
Authors: Chaoshuang Lin , Zhixin Zhao , Xiaohong Wang , Zhanlian Huang , Zhiliang Gao
Published: July 2008

We studied 52 cases of neurocysticercosis from January 1991 to December 2006 in order to increase our understanding of the diagnosis and treatment of the disease. The majority of patients were between 18 and 45 years old (78.8%). Men were more subject to the disease than women. The urban population was more at risk than the rural population. The treatment involved the use of mannitol, dexamethasone and oral administrations of albendazole or praziquantel. The effectiveness rate was 57.7% (30), the improvement rate was 28.8% (15), and the inefficacy rate was 14.0% (6). Neurocysticercosis was easy to misdiagnose. Praziquantel and albendazole are effective drugs for neurocysticercosis.
Non-doctor anaesthesia in Nepal: developing an essential cadre
Authors: Zimmerman Mark , Lee Maurice , Retnaraj Samson
Published: July 2008

Nepal is a mountainous country of 27 million people where the widespread lack of access to operative services is a major cause of morbidity and mortality. One critical reason for this is the lack of trained, appropriately distributed anaesthesia providers. We discuss the evolution of the ‘anaesthesia assistant’ in Nepal, review the international literature concerning the development of non-doctor anaesthetists, and invite links with others working in this field.
Seeking the perfect balance: Perfectionism and work–family conflict
Authors: Mitchelson Jacqueline K.
Published: July 2008

This study considers the relationship between perfectionism and perceptions of work–family conflict. A situational component to perfectionism was found, with higher standards and a higher perceived discrepancy between standards and performance at home versus at work. Findings suggest perfectionism predicts work–family conflict, beyond the effects of the Big Five, trait affectivity and achievement. Further, findings indicate those with adaptive perfectionism (AP; work and home) tend to have lower strain and time‐based family interfering with work and lower behaviour‐based work interfering with family, compared with maladaptive perfectionists (home) and non‐perfectionists (work and home). Gender differences were found and considered in a more exploratory manner.
Michail Šolochovs Realismus
Authors: Beitz Willi
Published: July 2008

Mikhail Sholokhov's realism must be seen not only, as usual, in the classic tradition (especially that of Lev Tolstoy), but also in its connection to art and philosophy of modern age. The analysis of the novel The Quiet Don indicates not only certain elements of impressionism, but also a certain affinity to Nietzschean philosophy – especially in the daring life of Grigory Melekhov, the main hero, with extreme situations handled in Dionysian spirit. Based on a moral sensibility of high degree and on a sharpened perception the author puts out central questions of human being and humanity in the Age of Extremes (Hobsbawm).
Studien zu den Namen der Melisse im Bulgarischen, im Vergleich mit anderen slawischen Sprachen
Authors: Theißen Ulrich
Published: July 2008

The botanical name of Lemon Balm (Melissa) and most names for this old medicinal plant in Slavonic languages refer to beekeeping, bees and the production of honey: in antiquity and Middle Ages Lemon Balm was used as attractant and for healing insect bites. Soon the curative properties on heart and nervous system were also discovered. The names for Melissa in Bulgarian and in other Slavonic langues, if not derived from this botanical term, refer to the citrus flavour of the leaves, to the queen bee, the beehive and the beehive maker, to honey and the attracting of bees. But these popular names are also used for other labiates.
Zum Stand der in Moskau erscheinenden beiden altrussischen Wörterbücher
Authors: Eckert Rainer
Published: July 2008

The article deals with the history and the current situation of the edition of the Old Russian historical dictionaries. In the last years since prof. V. B. Krys'ko took on the editorship of both dictionaries a lot of measures had been undertaken to improve and to accelerate the editorial work. As additions to the dictionaries are mentioned two phraseological units from the 15 th century sokolom vorony imatь and kudy socha chodila i toporъ, i kosa, i ženь are mentioned.
Ditransitive Verben – ein Problemfall im Bulgarischen?1
Authors: Junghanns Uwe , Lenertová Denisa
Published: July 2008

Slavic languages show differences in the syntactic realization of arguments of ditransitive verbs as, e.g., give. While Czech and Russian use dative indirect objects (IOs) which precede the direct object (DO), IOs of ditransitives in Bulgarian are marked by a preposition-like element na and follow the DO. Within a framework assuming that Argument Structure is a component part of verbal lexical entries (cf. Bierwisch 1996, a.o.) and syntactic structure of the VP is projected from the lexicon depending on the argument hierarchy, the question arises what is the basic linearization of arguments of ditransitives in Russian, Czech, and Bulgarian. We will argue that the two structures attested in the languages under investigation do not correspond to what has become known as Dative Alternation in English and that there is no need for specific semantic representations for Bulgarian ditransitives. In the relevant cases, the hierarchy of argument variables is changed through application of a semantic template. This accounts for the unmarked DO > IO order in Bulgarian.
Evidenz für syntaktische Nullen aus dem Burgenlandkroatischen, Polnischen, Russischen und Slovenischen: Merkmalsausstattung, Merkmalshierarchien und morphologische Defaults
Authors: Szucsich Luka
Published: July 2008

In the present paper, I investigate different types of impersonal sentences in Slavic languages focusing on impersonal sentences with accusative internal arguments (objects). These constructions pose various questions concerning selectional properties of the categories involved in the syntactic derivation of the respective sentences and concerning the licensing of morphological markers, esp. of the accusative of internal arguments and of the dative of quasi-subjects with certain types of reflexive impersonals. I will discuss these issues in the first two sections following the introduction claiming that at least the main (verbal) predicates of impersonals sentences with accusative internal arguments also select a semantically bleached, phonetically null external argument. The arguments for this analysis involve both theoretical and empirical considerations. In section 4, I will briefly turn to the impersonal morphological markers of verbal and nominal predicates. I will propose a default mechanism for the impersonal variant relying on feature hierarchies and markedness rejecting an agreement analysis with the phonetically null external argument.