bluuebunny/crossref_metadata_2025 huggingface dataset:
A Case History of Heavy-Oil Separation in Northern Alberta: A Singular Challenge of Demulsifier Optimization and Application
Authors: Wylde Jonathan J. , Coscio Steven , Barbu Victor
Published: September 2009

This case history tracks the continual improvement cycle for the fluid-separation process of a heavy-oil/oil-sands production facility in northern Alberta over a period of 3 years. The major challenge posed by the operator of this 13 to 16°API crude oil was to move away from injection of two separate demulsifier formulations to injection of a single product. This was not an easy task because of the very different conditions that existed at the two injection locations. The first location was at a series of injection points upstream of the gathering stations before separation where temperatures could reach subzero conditions, and the second was at the battery receiving facility where heating increased temperatures to 100°C. Water cut and shear were also very different, and the operator required a very strict 0.2% basic sediments and water (BS&W) on the crude exiting any of the four treater tanks. To complicate issues further, crude-oil viscosity ranged from 500 to 5,000 cp.

A unique bottle testing method was developed and used to simulate the field conditions as accurately as possible. Details are given on the chemistry of the individual components of the demulsifier determined to be so crucial to adequate performance and how this was optimized in the field after being identified from the bottle tests.

Results show how careful consideration was given to the concentration of the demulsifier bases in the blends, and show the curious observation that dilution of the final product made a big difference to the final performance in the field. Elaboration is given on potential mechanisms explaining the dilution effect, and this paper will conclude with observations on how careful design of field testing followed by field implementation can indeed solve complex separation issues and address individual well, battery, and field requirements.
δ-Fibonacci numbers
Authors: Wituła Roman , Słota Damian
Published: September 2009

The scope of the paper is the definition and discussion of the polynomial generalizations of the Fibonacci numbers called here ?-Fibonacci numbers. Many special identities and interesting relations for these new numbers are presented. Also, different connections between ?-Fibonacci numbers and Fibonacci and Lucas numbers are proven in this paper.
Chromatic zeros and generalized Fibonacci numbers
Authors: Alikhani Saeid , Peng Yee-Hock
Published: September 2009

In this article we consider the problem whether generalized Fibonacci constants can be zeros of chromatic polynomials. We prove that all 2n-anacci numbers and all their natural powers cannot be zeros of any chromatic polynomial. Also we investigate (2n + 1)-anacci numbers as chromatic zeros.
More on the Laplacian Estrada index
Authors: Zhou Bo , Gutman Ivan
Published: September 2009

Let G be a graph with n vertices and let ?1, ?2, . . . , ?n be its Laplacian eigenvalues. In some recent works a quantity called Laplacian Estrada index was considered, defined as LEE(G)?n1 e?i. We now establish some further properties of LEE, mainly upper and lower bounds in terms of the number of vertices, number of edges, and the first Zagreb index.
Influence of aflatoxin B1 on mRNA levels of acute-phase proteins and oncoproteins in albino rat liver
Authors: Strelic Natasa , Magic Zvonko , Trutic Natasa , Krtolica Koviljka
Published: September 2009

Background: The effect of aflatoxin B1 (AFB1) administration on expression of genes coding for acute-phase proteins, and nuclear protooncogenes c-fos and c-jun, and alpha-fetoprotein gene has been studied in rats. Methods: AFB1 was administered to male Albino Oxford (AO) rats as a single intraperitoneal dose (1 mg/kg body weight). The expression of genes for albumin, cystein protease inhibitor, fibrinogen, haptoglobin, a1-acid glycoprotein and for c-Fos, c-Jun and alpha-fetoprotein in rat liver was measured by Northern hybridization. Results: The mild increase in the levels of mRNA for acute-phase proteins after AFB1 administration was observed during the first 24 hours. The exceptions were the mRNA levels in liver for cystein protease inhibitor, which were 50%, decreased as compared to the control values. In addition, mild increase of the expression of c-fos protooncogene with two peaks were noted at three (1.3 fold) and 72 hours (1.5 fold) after injection AFB1 to rats. The expression of nuclear protooncogene c-jun at 1 hour and 72 hour after acute poisoning was 2.6 fold and 3.7 fold increased as compared to control values, respectively. The mRNA levels in liver for the alpha-fetoprotein reached a maximum at 1 hour after AFB1 injection and it was 1.8 times higher than the levels in the livers of nontreated animals. Conclusion: Single administration of AFB1 induced increased transcription of c-jun and c-fos genes while typical acute-phase response was not found.
Micronuclei and chromosomal aberrations in healthy tobacco chewers and controls: A study from Gujarat, India
Authors: Patel Beena , Trivedi Pina , Brahmbhatt Manisha , Shukla Shilin , Shah Pankaj , Bakshi Sonal
Published: September 2009

Background: Tobacco chewing is attributed to oral cancer. Prediction of cancer development by genotoxicity analysis is a major challenge to identify tobacco users at greater risk. Therefore, present study aimed to analyze tobacco related genotoxic effects in chewers monitoring micronuclei (MN) and chromosome aberrations (CA). The biomarkers were compared with non chewer to (i) predict risk for genotoxicity, (ii) estimate synergistic effect of tobacco exposure with level of biomarkers, and (iii) identify best cellular site of measurements for genotoxicity assessment. Methods: Healthy tobacco chewers (n=47); and controls (n=48) were enrolled in the study. The peripheral blood lymphocyte and exfoliated buccal mucosa cells were studied for CA and micro nucleated cell count (MNC) respectively. An arbitrary unit was obtained for Lifetime Tobacco Exposure (LTE) using frequency/day multiplied by duration of years of tobacco use. Data were analyzed using SPSS statistical software. Results: MNC was significantly higher (p=0.001) in chewers than controls. CA was higher in chewers than controls. MNC can differentiate higher tobacco exposure in chewers than CA. Controls having MNC above cutoff level have greater risk of genotoxic exposition (95% C.I.; 1.462-23.26, p=0.012). Conclusion: The present study concludes that MNC is a better surrogate biomarker to predict genotoxicity than CA for tobacco exposure and DNA damage index in tobacco chewers.
Application of modified Wingate anaerobic test in maximal power measurement
Authors: Popadic-Gacesa Jelena , Karaba-Jakovljevic Dea , Barak Otto , Drapsin Miodrag
Published: September 2009

INTRODUCTION Wingate anaerobic test is an all-out test, which gives information about maximal anaerobic power. The aim of the study was to show characteristics of standard and modified versions of Wingate anaerobic test (WAnT), and to determine and explain the differences in observed parameters due to the measurement protocol applied. MATHERIAL AND METHODS The testing was conducted on 30 male non sportsmen, who performed usual everyday activities. The following parameters were measured: peak power or anaerobic power, mean power as a mean value of power during the whole test and explosive power or acceleration. Modified versions were performed with 5 s or 10 s delay of maximal cycling activity, during which the person was slowly pedaling. RESULTS The average values of parameters Peak power and Explosive power in our participants were 622.20?134.57 W and 89.26 ?28.57 W/s, respectively. In modification 1 Peak Power and Explosive Power were 680.25?133.43 W and 100.60?12.77 W/s, and in modification 2 they were 685.95?135.68 W and 100.30?10.09 W/s. Significant differences were found in both parameters between the standard and modified versions, but there was no significant difference between two modified versions. The mean power parameter was not considered in the discussion, because of the fact that modified versions were shortened, and it was not a valid measurement for this parameter. DISCUSION AND CONCLUSION The difference between standard and modified versions can be explained by the difference between test and retest probes, and also because of modification of protocol which can partially influence the results of testing.
Placental complications after a previous cesarean section
Authors: Milosevic Jelena , Lilic Vekoslav , Tasic Marija , Radovic-Janosevic Dragana , Stefanovic Milan , Antic Vladimir
Published: September 2009

Introduction The incidence of cesarean section has been rising in the past 50 years. With the increased number of cesarean sections, the number of pregnancies with the previous cesarean section rises as well. The aim of this study was to establish the influence of the previous cesarean section on the development of placental complications: placenta previa, placental abruption and placenta accreta, as well as to determine the influence of the number of previous cesarean sections on the complication development. Material and methods The research was conducted at the Clinic of Gynecology and Obstetrics in Nis covering 10-year-period (from 1995. to 2005.) with 32358 deliveries, 1280 deliveries after a previous cesarean section, 131 cases of placenta previa and 118 cases of placental abruption. The experimental groups was presented by the cases of placenta previa or placental abruption with prior cesarean section in obstetrics history, opposite to the control group having the same conditions but without a cesarean section in medical history. RESULTS The incidence of placenta previa in the control group was 0.33%, opposite to the 1.86% incidence after one cesarean section (p<0.001), 5.49% after two cesarean sections and as high as 14.28% after three cesarean sections in obstetric history. Placental abruption was recorded as placental complication in 0.33% pregnancies in the control group, while its incidence was 1.02% after one cesarean section (p<0.001) and 2.02% in the group with two previous cesarean sections. The difference in the incidence of intrapartal hysterectomy between the group with prior cesarean section (0.86%) and without it (0.006%) shows a high statistical significance (p<0.001). CONCLUSION The previous cesarean section is an important risk factor for the development of placental complications.
Prognostic significance of macrosatellite instability in patients under 50 years of age suffering from colorectal cancer
Authors: Fenjvesi Atila
Published: September 2009

Introduction Colorectal cancer (CRC) can arise through two distinct mutational pathways: microsatellite instability or chromosomal instability. High-frequency microsatellite instability (MSI) occurs in approximately 15 percent of sporadic cases of CRCs. Many studies have well established that MSI, the hallmark of defective DNA mismatch repair, is associated with prolonged survival of CRC patients compared with tumors that are microsatellite stable. CRCs in patients under 50 years of age are rare and represent about 5% of the total number of tumors. The aim of this study was to analyze the prognostic significance of MSI in CRC patients younger than 50 at the time of diagnosis. Material and methods 31 patients with CRC under 50 years of age were tested for the presence of MSI, and compared with 35 patients aged 50 or more at the time of diagnosis. CRC-specific survival five-year- follow-up period was analyzed in relation to MSI status. Results The frequency of MSI among the young patients was 35.48%, which was significantly higher than the rate of 11.43% noted in older patients with CRCs (p<0.042). This study revealed no difference in survival in patients with CRCs aged less than 50 compared with those over 50 years of age. The five-years survival of young CRCs patients with MSI 81.82%, was better than that of the patients with cancers with microsatellite stability, 60%, but there was no significant difference in statistics. Discussion and conclusion In our study there was no statistically detectable significant difference between tumor microsatellite status and survival in young patients, although we confirmed the previous observations that MSI is associated with better prognosis. We found that the pathological stage of CRC was an independent and powerful predictor of the clinical outcome.
Effect of hyperbaric oxygen treatment on oxidative stress in patients having diabetes mellitus type 2
Authors: Tepic Sandra , Zivkovic Miodrag , Terzic Negra , Krivokuca Radmila , Ljesevic Biljana , Jakovljevic Vladimir
Published: September 2009

Introduction The aim of our study was to investigate the influence of breathing oxygen under high pressure on potential prooxidative activity in diabetic patients with serious vascular complications. Material and methods 24 patients with diabetes mellitus type 2, were divided into two groups, 12 patients each, by degree of peripheral vascular complications (by Wagner's scale). The group I was composed of 4 women and 8 men, their average age being 70 years, and average Diabetes duration of 12 years, without clinically manifest peripheral vascular complication (Wagner 0). The group II was composed of 4 women and 8 men, their average age being 74 years, and average illness duration of 17 years, having peripheral vascular complications, classified by Wagner's scale 1-5. Blood samples for biochemical analysis were taken before the therapy, then on the 3rd, 5th, 7th and 10th day of hyperbaric oxygenation treatment. The values of superoxide anion radical (O-), hydrogen peroxide (H2O2) and TBARS as a parameter of lipid peroxidation were measured during the HBOt. All examined patients were treated with the same therapy protocol (10 HBO treatments, under pressure of 1.7-2.2 bar, in duration of 60 minutes). The therapy was provided in monoplace oxygen hyperbaric chamber. Results The obtained results show no statistically significant increase in the values of O2-, H2O2, TBARS during the HBOt compared to the values before the HBOt. However, O2-, H2O2 were significantly reduced after HBOt. Conclusion On the basis of these data, we can conclude that the use of oxygen under high pressure has no influence on the increased prooxidative activities in diabetic patients during and after HBOt, disregarding the degree of the present vascular damages.
Effects of rehabilitation and arthroplasty on the hip isometric muscle strength in patients with osteoarthritis of the hip
Authors: Jandric Slavica
Published: September 2009

Introduction Periarticular muscles have a significant role in keeping the mobility and integrity of the hip joint. The aim of this article was to investigate the effects of the total hip arthroplasty and early rehabilitation on the muscle strength. Patients Three groups of examined persons (matched in relation to musculosceletal conditions, sex, age and occupation) were included in the investigation. The first group (40 of the involved hip) and the second group (with 33 involved hips) were groups of patients with late-stage of osteoarthritis of the hip. The first group of patients was managed conservatively and the second group operatively (total cemented hip endoprosthesis was performed). The third group was control group with 123 healthy hips. Material and methods The maximal voluntary isometric strength was measured with dynamometer. The muscle strength was tested in all three groups: in the first group of patients at the beginning and at the end of the therapy and in patients of the second group 6?3 months postoperatively. Results A significant improvement of the muscle strength was noted for the flexors (t=2.45, p<0.05), musculus tensor fasciae latae (t=2.35, p<0.05), extensors (t=2.85, p<0.01), adductors (t=3.02, p<0.01), external rotators (t=3.1, p<0.01), m. gluteus medius (t=5.28, p<0.001) and internal rotators (t=5.77, p<0.001) after total hip arthroplasty and early rehabilitation in comparison to the conservatively treated group. Conclusion The muscle strength in the patients with osteoarthritis of the hip after arthroplasty was significantly higher than after rehabilitation for all hip muscles but did not reach values of the strength of the muscles in the corresponding control group.
Radial artery in myocardial revascularization
Authors: Redzek Aleksandar , Jonjev Zivojin
Published: September 2009

In the past decade, the use of the radial artery as a coronary artery bypass graft has been revitalized. However, there has been controversy regarding harvest techniques, antispasm protocols, and selection of target vessels. It is widely accepted that the patency of radial-artery grafts depends on the severity of native-vessel stenosis. Thus, radial artery grafts should be preferentially used for target vessels with high-grade (>75% stenosis) lesions. In this review article, we analyzed the current status of radial artery grafts as a coronary bypass conduit based on our personal experience and recently published literature data.
Patients' falls and injuries during hospitalization as quality indicators of work in hospitals
Authors: Milutinovic Dragana , Martinov-Cvejin Mirjana , Simic Svetlana
Published: September 2009

The number of patients' falls and injuries happening during their hospital treatment is a good quality indicator of safety of in-patients. A fall is of multifactorial etiology, and its causes are usually classified into intrinsic and extrinsic factors. According to Jenise Morse there are three categories of falls among inpatients: accidental, non-anticipated physiologic and anticipated physiologic fall. Fall induced injuries in clinical and hospital settings are mostly categorized into five groups: no injury, minor injury, moderate injury, severe injury and lethal injury. The number of in-patient falls can be reduced by implementing a prevention programme in order to improve the quality of the specific health care and health care in general. The key preventive strategies aimed at safe and efficient health care include: a regular assessment of the risk for falls using predictive scales, visual identification of patients at high risk for falls, communication with patients and education of patients, their family members and staff about fall prevention interventions.
The comparative analysis of clinical symptomatology before and after the operation of otosclerosis
Authors: Terzic Negra , Zivic Ljubica
Published: September 2009

Introduction Otosclerosis is a progressive osteodystrophic disease of the osseous capsule of the labyrinth which leads to the fixation of the stapes and partial deafness. The progressive hearing loss followed by ear tingling - tinitus and vertigo is of great importance for this disease. The aim of the work was to determine the changes of clinical symptomatology before and after the operative treatment of otosceloris. Material and methods The study included 32 subjects between 25 and 60 years of age affected by otosclerosis who had undergone surgical treatment at the VMA (Military Medical Academy) Clinic, Department of Otolaryngology in Belgrade. Besides the clinical examination and detailed case history, audiometry and tympanometry examinations were performed. During the postoperative period the clinical symptomatology was evaluated and audiometry examinations were performed in order to determine the effect of the surgical intervention. Results Of the total number of 32 subjects, partial deafness was present in all of them before the operation, whereas tinitus, vertiginous disturbances and otalgia were found in a certain number of the subjects. During the postoperative period a partial recovery was found in a larger number of the subjects in relation to the total hearing recovery. During the postoperative period tinitus of lower intensity was found in a greater number of the subjects, whereas the number of those without tinitus was smaller. The problem of vertiginous disturbances as well as otalgia were not found during the postoperative period. Conclusion By following the changes of the clinical symptomatology we came to the conclusion that surgical treatment of otosclerosis results in the reduction and disappearance of subjective disturbances, tinitus, vertigo and otalgia and leads to the partial or complete hearing recovery.
Ultrasound in screening of endometrial carcinoma in asymptomatic postmenopausal women
Authors: Curcic Aleksandar , Djurdjevic Srdjan , Mladenovic-Segedi Ljiljana , Grujic Zorica , Visnjevac Nemanja
Published: September 2009

Introduction The aim of this prospective study was to investigate whether there was a significant difference in ultrasound detection of pathologic states of endometrium between asymptomatic postmenopausal women and postmenopausal women with uterine bleeding in whom the thickness of endometrium was greater than 3 mm at ultrasound examination. Material and methods The study included 128 postmenopausal women with uterine bleeding and 29 asymptomatic posmenopausal women who underwent gynecological examination, transvaginal ultrasound examination, fractional explorative curettage and histopathological examination of the endometrium. Results The results showed no statistically significant difference between the examined groups of women in relation to the detection of pathologic states of the endometrium (polyps, hyperplasias and carcinomas) as well as between individual pathologic states, although the research showed that the asymptomatic women were more frequently presented with well-differentiated carcinoma versus the medium-differentiated carcinoma in the symptomatic group of women. Conclusion It can be concluded that the transvaginal ultrasound examination in postmenopausal women could be an adequate screening method for detection of endometrial carcinoma in early asymptomatic stage of the disease, whereas in the women with ultrasound finding of the thickened endometrium, the final diagnosis should be established by histopathological examination of the endometrium samples obtained by hysteroscopy, instead of previously used explorative curettage.
Friendship functions and personality traits
Authors: Zeleskov-Djoric Jelena , Pedovic Ivana , Hedrih Vladimir
Published: September 2009

The goal of our study was exploration of the factor structure of the MFQ-FF inventory on a sample from Serbian population, and the relations of measures from this inventory (friendship functions) with personality traits, as operationalized by the seven factor model proposed by Tellegen and Waller. For this purpose 154 University of Nis students completed the Serbian version of the MFQ-FF inventory and Lexi-70. The results show that factor structures of certain MFQ-FF scales deviate somewhat from theoretical expectations. Confirmatory factor analysis produced relatively poor levels of fit, while exploratory factor analysis showed that loadings of five items differ substantially from theoretical expectations. As for correlations with personality traits, evaluative dimensions and negative emotionality were found to correlate with the MFQ-FF general factor, and correlations of specific functions with Openness to experience, Positive emotionality and Consciousness were also found. All obtained correlations were low.
Additive Effects of Genetic Variation in GCK and G6PC2 on Insulin Secretion and Fasting Glucose
Authors: Li Xia , Shu Yu-Hsiang , Xiang Anny H. , Trigo Enrique , Kuusisto Johanna , Hartiala Jaana , Swift Amy J. , Kawakubo Miwa , Stringham Heather M. , Bonnycastle Lori L. , Lawrence Jean M. , Laakso Markku , Allayee Hooman , Buchanan Thomas A. , Watanabe Richard M.
Published: September 2009

OBJECTIVE

Glucokinase (GCK) and glucose-6-phosphatase catalytic subunit 2 (G6PC2) regulate the glucose-cycling step in pancreatic β-cells and may regulate insulin secretion. GCK rs1799884 and G6PC2 rs560887 have been independently associated with fasting glucose, but their interaction on glucose-insulin relationships is not well characterized.

RESEARCH DESIGN AND METHODS

We tested whether these variants are associated with diabetes-related quantitative traits in Mexican Americans from the BetaGene Study and attempted to replicate our findings in Finnish men from the METabolic Syndrome in Men (METSIM) Study.

RESULTS

rs1799884 was not associated with any quantitative trait (corrected P > 0.1), whereas rs560887 was significantly associated with the oral glucose tolerance test 30-min incremental insulin response (30′ Δinsulin, corrected P = 0.021). We found no association between quantitative traits and the multiplicative interaction between rs1799884 and rs560887 (P > 0.26). However, the additive effect of these single nucleotide polymorphisms was associated with fasting glucose (corrected P = 0.03) and 30′ Δinsulin (corrected P = 0.027). This additive association was replicated in METSIM (fasting glucose, P = 3.5 × 10−10 30′ Δinsulin, P = 0.028). When we examined the relationship between fasting glucose and 30′ Δinsulin stratified by GCK and G6PC2, we noted divergent changes in these quantitative traits for GCK but parallel changes for G6PC2. We observed a similar pattern in METSIM.

CONCLUSIONS

Our data suggest that variation in GCK and G6PC2 have additive effects on both fasting glucose and insulin secretion.
Addressing Literacy and Numeracy to Improve Diabetes Care
Authors: Cavanaugh Kerri , Wallston Kenneth A. , Gebretsadik Tebeb , Shintani Ayumi , Huizinga Mary Margaret , Davis Dianne , Gregory Rebecca Pratt , Malone Robb , Pignone Michael , DeWalt Darren , Elasy Tom A. , Rothman Russell L.
Published: September 2009

OBJECTIVE

Diabetic patients with lower literacy or numeracy skills are at greater risk for poor diabetes outcomes. This study evaluated the impact of providing literacy- and numeracy-sensitive diabetes care within an enhanced diabetes care program on A1C and other diabetes outcomes.

RESEARCH DESIGN AND METHODS

In two randomized controlled trials, we enrolled 198 adult diabetic patients with most recent A1C ≥7.0%, referred for participation in an enhanced diabetes care program. For 3 months, control patients received care from existing enhanced diabetes care programs, whereas intervention patients received enhanced programs that also addressed literacy and numeracy at each institution. Intervention providers received health communication training and used the interactive Diabetes Literacy and Numeracy Education Toolkit with patients. A1C was measured at 3 and 6 months follow-up. Secondary outcomes included self-efficacy, self-management behaviors, and treatment satisfaction.

RESULTS

At 3 months, both intervention and control patients had significant improvements in A1C from baseline (intervention −1.50 [95% CI −1.80 to −1.02]; control −0.80 [−1.10 to −0.30]). In adjusted analysis, there was greater improvement in A1C in the intervention group than in the control group (P = 0.03). At 6 months, there were no differences in A1C between intervention and control groups. Self-efficacy improved from baseline for both groups. No significant differences were found for self-management behaviors or satisfaction.

CONCLUSIONS

A literacy- and numeracy-focused diabetes care program modestly improved self-efficacy and glycemic control compared with standard enhanced diabetes care, but the difference attenuated after conclusion of the intervention.
Aspirin for the Primary Prevention of Cardiovascular Events
Authors: Calvin Andrew D. , Aggarwal Niti R. , Murad Mohammad Hassan , Shi Qian , Elamin Mohamed B. , Geske Jeffrey B. , Fernandez-Balsells M. Merce , Albuquerque Felipe N. , Lampropulos Julianna F. , Erwin Patricia J. , Smith Steven A. , Montori Victor M.
Published: September 2009

OBJECTIVE

The negative results of two randomized controlled trials (RCTs) have challenged current guideline recommendations for using aspirin for primary prevention of cardiovascular events among patients with diabetes. We therefore sought to determine if the effect of aspirin for primary prevention of cardiovascular events and mortality differs between patients with and without diabetes.

RESEARCH DESIGN AND METHODS

We conducted a systematic search of MEDLINE, EMBASE, Cochrane Library, Web of Science, and Scopus since their inceptions until November 2008 for RCTs of aspirin for primary prevention of cardiovascular events. Blinded pairs of reviewers evaluated studies and extracted data. Random-effects meta-analysis and Bayesian logistic regression were used to estimate the ratios of relative risks (RRs) of outcomes of interest among patients with and without diabetes. A 95% CI that crosses 1.00 indicates that the effect of aspirin does not differ between patients with and without diabetes.

RESULTS

Nine RCTs with moderate to high methodological quality contributed data to the analyses. The ratios of RRs comparing the benefit of aspirin among patients with diabetes compared with patients without diabetes for mortality, myocardial infarction, and ischemic stroke were 1.12 (95% CI 0.92–1.35), 1.19 (0.82–1.17), and 0.70 (0.25–1.97), respectively.

CONCLUSIONS

Whereas estimates of benefit among patients with diabetes remain imprecise, our analysis suggests that the relative benefit of aspirin is similar in patients with and without diabetes.
Sage Tea Drinking Improves Lipid Profile and Antioxidant Defences in Humans
Authors: Sá Carla  M. , Ramos Alice  A. , Azevedo Marisa  F. , Lima Cristovao  F. , Fernandes-Ferreira Manuel , Pereira-Wilson Cristina
Published: September 2009

Salvia officinalis (common sage) is a plant with antidiabetic properties. A pilot trial (non-randomized crossover trial) with six healthy female volunteers (aged 40-50) was designed to evaluate the beneficial properties of sage tea consumption on blood glucose regulation, lipid profile and transaminase activity in humans. Effects of sage consumption on erythrocytes’ SOD and CAT activities and on Hsp70 expression in lymphocytes were also evaluated. Four weeks sage tea treatment had no effects on plasma glucose. An improvement in lipid profile was observed with lower plasma LDL cholesterol and total cholesterol levels as well as higher plasma HDL cholesterol levels during and two weeks after treatment. Sage tea also increased lymphocyte Hsp70 expression and erythrocyte SOD and CAT activities. No hepatotoxic effects or other adverse effects were observed.
The Vitamin Nicotinamide: Translating Nutrition into Clinical Care
Authors: Maiese Kenneth , Chong Zhao  Zhong , Hou Jinling , Shang Yan  Chen
Published: September 2009

Nicotinamide, the amide form of vitamin B3 (niacin), is changed to its mononucleotide compound with the enzyme nicotinic acide/nicotinamide adenylyltransferase, and participates in the cellular energy metabolism that directly impacts normal physiology. However, nicotinamide also influences oxidative stress and modulates multiple pathways tied to both cellular survival and death. During disorders that include immune system dysfunction, diabetes, and aging-related diseases, nicotinamide is a robust cytoprotectant that blocks cellular inflammatory cell activation, early apoptotic phosphatidylserine exposure, and late nuclear DNA degradation. Nicotinamide relies upon unique cellular pathways that involve forkhead transcription factors, sirtuins, protein kinase B (Akt), Bad, caspases, and poly (ADP-ribose) polymerase that may offer a fine line with determining cellular longevity, cell survival, and unwanted cancer progression. If one is cognizant of the these considerations, it becomes evident that nicotinamide holds great potential for multiple disease entities, but the development of new therapeutic strategies rests heavily upon the elucidation of the novel cellular pathways that nicotinamide closely governs.
A Non-Intrusive GMA Welding Process Quality Monitoring System Using Acoustic Sensing
Authors: Cayo Eber  Huanca , Alfaro Sadek C. Absi
Published: September 2009

Most of the inspection methods used for detection and localization of welding disturbances are based on the evaluation of some direct measurements of welding parameters. This direct measurement requires an insertion of sensors during the welding process which could somehow alter the behavior of the metallic transference. An inspection method that evaluates the GMA welding process evolution using a non-intrusive process sensing would allow not only the identification of disturbances during welding runs and thus reduce inspection time, but would also reduce the interference on the process caused by the direct sensing. In this paper a nonintrusive method for weld disturbance detection and localization for weld quality evaluation is demonstrated. The system is based on the acoustic sensing of the welding electrical arc. During repetitive tests in welds without disturbances, the stability acoustic parameters were calculated and used as comparison references for the detection and location of disturbances during the weld runs.
Sensing Landscape History with an Interactive Location Based Service
Authors: Van Lammeren Ron , Goossen Martin , Roncken Paul
Published: September 2009

This paper introduces the STEAD approach for interpreting data acquired by a “human sensor”, who uses an informal interactive location-based service (iLBS) to sense cultural-historic facts and anecdotes of, and in the landscape. This user-generated data is collected outdoors and in situ. The approach consists of four related facets (who, what, where, when). Three of the four facets are discussed and illustrated by user generated data collected during a Dutch survey in 2008. These data represent the personal cultural-historic knowledge and anecdotes of 150 people using a customized iLBS for experiencing the cultural history of a landscape. The “who” facet shows three dominant mentality groups (cosmopolitans, modern materialists and post modern hedonists) that generated user content. The “what” facet focuses on three subject types of pictures and four picture framing classes. Pictures of the place type showed to be dominant and foreground framing class was slightly favourite. The “where” facet is explored via density, distribution, and distance of the pictures made. The illustrations of the facets indirectly show the role of the “human sensor” with respect to the domain of interest. The STEAD approach needs further development of the when-facet and of the relations between the four facets. Finally the results of the approach may support data archives of iLBS applications.
Detection and Classification of Human Body Odor Using an Electronic Nose
Authors: Wongchoosuk Chatchawal , Lutz Mario , Kerdcharoen Teerakiat
Published: September 2009

An electronic nose (E-nose) has been designed and equipped with software that can detect and classify human armpit body odor. An array of metal oxide sensors was used for detecting volatile organic compounds. The measurement circuit employs a voltage divider resistor to measure the sensitivity of each sensor. This E-nose was controlled by in-house developed software through a portable USB data acquisition card with a principle component analysis (PCA) algorithm implemented for pattern recognition and classification. Because gas sensor sensitivity in the detection of armpit odor samples is affected by humidity, we propose a new method and algorithms combining hardware/software for the correction of the humidity noise. After the humidity correction, the E-nose showed the capability of detecting human body odor and distinguishing the body odors from two persons in a relative manner. The E-nose is still able to recognize people, even after application of deodorant. In conclusion, this is the first report of the application of an E-nose for armpit odor recognition.
Malignant neuroectodermal tumor with melanocytic and rhabdomyoblastic differentiation
Authors: Tanas Munir R , Rubin Brian P
Published: September 2009

Malignant melanoma can metastasize widely and vary significantly in its histological appearance; it rarely presents as a deep-seated mass without an obvious primary site elsewhere. Malignant peripheral nerve sheath tumor (MPNST) is a high-grade sarcoma characterized by conventional and epithelioid subtypes. MPNST can demonstrate heterologous differentiation, usually in the form of osteosarcomatous, chondrosarcomatous, or rhabdomyosarcomatous differentiation. MPNST does not harbor true melanocytic differentiation, although epithelioid MPNST typically is diffusely S-100 protein positive and superficially can resemble malignant melanoma. An unusual intra-abdominal mass was recently encountered with features of both melanoma and conventional or epithelioid MPNST containing a fascicular spindle cell component, an epithelioid component with melanocytic differentiation, as well as a rhabdomyosarcomatous component. The terminology “malignant neuroectodermal tumor with melanocytic and rhabdomyoblastic differentiation” is proposed to describe this neoplasm, reflecting the unusual concomittant lines of differentiation as well as offering a possible rationale for nosologically challenging aspects of this neoplasm.
A case of primary renal angiosarcoma
Authors: Yoshida Kazuhiko , Ito Fumio , Nakazawa Hayakazu , Maeda Yoshiko , Tomoe Hikaru , Aiba Motohiko
Published: September 2009

A 78-year old man was diagnosed with a left bleeding renal cyst from CT scan results. Serial CT scans revealed the left kidney mass to be increasing in size and a new lesion in the liver. Renal cell carcinoma with liver metastasis was diagnosed and a radical nephrectomy performed. The initial pathological diagnosis was a benign chronic hematoma. However, the liver mass increased in size and multiplied, while another mass emerged in the twelfth thoracic vertebra with spinal paralysis and was immediately removed. Pathological findings for that specimen showed malignancy of stromal cell origin but low atypia. The renal specimen was re-evaluated using whole cross-section analysis and immunohistochemistry, and diagnosed as a primary renal angiosarcoma. Recombinant interleukin-2 therapy was started immediately; however, the patient died of metastatic disease 13 months after the initial operation. Although contrast imaging depicted the primary lesion as a non-specific hematoma with little focal pooling, and low-grade cytological atypia was shown pathologically, the angiosarcoma was extremely aggressive.
Tussen katedrale en kastele: Oor die teologies-politieke probleem
Authors: Goosen Daniël P.
Published: September 2009

Flanked by cathedrals and castles: Theology and its political problemThis article is a reflection on the theological-political problem (i.e. the question about the relationship between religion and politics) in modern society. It presupposes that this problem was created by modernism. Because modernism distinguished in a reductive fashion between religion and politics, modern society was left with the burning question of how to mediate between them. The first part of the article focuses on a critical appraisal of the modern distinction. In different sub-sections it is argued that the modern distinction led to a reduction in meaning of both the religious and the political. However, the modern distinction cannot be maintained. Contrary to the modern distinction it is argued that the political is always already infiltrated by the theological. Modernism cannot deliver on its promises. In the concluding section the argument is raised that the theological-political problem can be addressed if we as are willing to listen to the voice of tradition. According to tradition, desire (eros) reaches out from the lowest to the highest levels of reality. The relationship between the political and the theological is inscribed within the erotic curve of desire. While eros reaches out to and also finds fulfilment in active political participation, this does not represent the end of its journey. Eros even reaches further, to the transcendent realms of philosophical contemplation and theological wisdom. In the concluding sections it is argued that both the political and the religious can again be experienced as glorious phenomena due to their erotic mutuality. Their mutuality is not (pace modernism) an argument against their own integrity, but precisely an argument in favour thereof. Die moderne wêreld staan in spanning met alle stede uit die oudheid, met alles wat kultuur verteenwoordig, met alles wat tot ’n stad behoort.(Charles Péguy)
Selecting a Venous Catheter for Medium- to Long-Term Use
Authors: Chopra Vineet
Published: February 2025

This JAMA Insights discusses selection of catheters for medium- or long-term use in 4 clinical settings.
Aortic Valve Replacement for Asymptomatic Severe Aortic Stenosis—The Time Has Come
Authors: Lindman Brian R. , Braunwald Eugene , Pellikka Patricia A.
Published: February 2025

This Viewpoint advocates for prompt aortic valve replacement (rather than clinical surveillance) as the default strategy for patients with asymptomatic severe aortic stenosis.
Attention-Deficit/Hyperactivity Disorder in Medicaid-Enrolled Autistic Adults
Authors: Yerys Benjamin E. , Tao Sha , Shea Lindsay , Wallace Gregory L.
Published: February 2025

Importance

Autistic adults experience suboptimal health outcomes. Likewise, attention-deficit/hyperactivity disorder (ADHD) is linked to poor health outcomes in the general population, yet little is known about co-occurring ADHD and its links with poor health outcomes among autistic adults.

Objective

To determine the prevalence of ADHD and ADHD medication prescriptions and to examine associations between health outcomes and both ADHD co-occurrence and ADHD medication prescriptions among autistic adults.

Design, Setting, and Participants

Population-based cohort study of US Medicaid-enrolled adults aged 18 years and older, including autistic adults with and without co-occurring intellectual disability (ID), adults with ID without autism, and adults from a random sample of Medicaid-enrolled individuals from 2008 to 2019. Analyses were completed September 2023 to September 2024.

Exposures

Autism, ADHD, and ID using validated algorithms from the Chronic Conditions Warehouse.

Main Outcomes and Measures

Prevalence rates of co-occurring ADHD, ADHD medication prescriptions, substance use, cardiovascular conditions, injury in autism without ID, ID without autism, autism with ID, and the general population.

Results

The study included 3 506 661 patients (mean [SD] age, 33.5 [15.6] years; 1 854 892 [52.9%] female; 702 694 [20.0%] Black, 587 048 [16.7%] Hispanic, and 1 786 703 [60.0%] White). Compared with the general Medicaid-enrolled population (1 846 102 patients), which had 49 523 patients (2.7%) with co-occurring ADHD diagnoses, this study found elevated rates of ADHD in autism without ID (280 195 patients [26.7%]; prevalence ratio [PR], 5.1; 95% CI, 4.4-5.9), autism with ID (261 061 patients [40.2%]; PR, 6.8; 95% CI, 6.0-7.7), and ID without autism (1 119 303 patients [19.0%]; PR, 4.4; 95% CI, 4.0-5.0). A total of 117 704 adults (26.6%) with ADHD received an ADHD medication prescription. The study identified that rates of substance use were higher among clinical groups with co-occurring ADHD. For example, 9886 of 74 675 autistic adults with ADHD (13.2%) had substance use disorder, compared with 11 782 of 205 520 autistic adults with no ADHD (5.7%). ADHD diagnoses were associated with higher rates of all health outcomes, regardless of group. Substance use was higher in both ID groups with ADHD diagnoses and ADHD medications, whereas injury and cardiovascular condition rates were lower in all ADHD groups who received ADHD medications.

Conclusions and Relevance

In this cohort study of Medicaid-enrolled adults, autistic adults experienced high rates of co-occurring ADHD and were more likely to receive ADHD medication prescriptions than adults in the general population. Negative health outcome rates are higher among autistic people with co-occurring ADHD, although ADHD medication prescriptions are associated with lower rates of negative health outcomes. Treating ADHD may improve health among autistic adults.
Challenges to Video Visits for Patients With Non–English Language Preference
Authors: Kong Marianna , Rios-Fetchko Francine , Olmos-Rodriguez Madelyn , Branagan Linda , Iott Bradley , Chan Tack Therese , Yarbrough Carol , Grumbach Kevin , Fernandez Alicia
Published: February 2025

Importance

Patients with non–English language preference (NELP) participate in video visits considerably less often than their English-speaking counterparts. Understanding the capability, opportunities, and motivation of patients with NELP to use video visits is key to determining how this technology may benefit their care.

Objective

To investigate the perceptions of patients with NELP regarding the facilitators and barriers to usage of video visits.

Design, Setting, and Participants

This qualitative analysis of semistructured interviews of patients with NELP from an ambulatory clinic network of a large, urban, academic health system in California serving a linguistically diverse population was conducted from November 2022 to September 2023. Electronic health data were used to identify Spanish- and Cantonese-speaking patients with at least 1 clinic visit but no video visits in the prior 12 months. Data were analyzed from September 2023 to February 2024.

Main Outcomes and Measures

One-on-one semistructured interviews were conducted by telephone to capture perceptions on facilitators and barriers to video visit use. Interviews were audio-recorded until reaching thematic saturation, deidentified, transcribed and translated, and analyzed using rapid qualitative analysis. Common themes were identified and matched to relevant domains of the capability, opportunities, and motivation model.

Results

Of the 31 patients successfully contacted by telephone, 27 participants (mean [SD] age, 66 [15] years; 18 women [67%]), including 16 Spanish-speaking and 11 Cantonese-speaking participants, were interviewed. Four major themes emerged, including (1) video visits creating additional communication challenges and potentially exacerbating communication difficulties for patients who face language barriers; (2) video visits perceived as having some drawbacks for medical evaluations as well as some appealing benefits; (3) limited digital literacy, device and data access, and non–user-friendly video visit processes as important barriers; and (4) in-person teaching, simpler technologic processes, opportunities to repetitively practice video use, troubleshooting support, and language-concordant instructions, clinicians, and clinic staff as facilitators of video visits. For some, the disadvantages were sufficient to deter use of video visits, while for others, they were counterbalanced by the ease of access provided by video visits.

Conclusions and Relevance

In this qualitative study, participants with NELP perceived multiple barriers to video visits, including greater communication difficulties, lower medical evaluation quality, and technical issues. These findings suggest that addressable technical challenges associated with language barriers hamper access to video visits and decrease motivation for use and that interventions are needed to increase telehealth equity.