bluuebunny/crossref_metadata_2025 huggingface dataset:
Propionic Acidemia Revisited: A Workshop Report
Authors: Sass J. O. , Hofmann M. , Skladal D. , Mayatepek E. , Schwahn B. , Sperl W.
Published: April 2006

Propionic acidemia (PA) is one of the most frequent organic acidurias, but information on the outcome of individuals with PA is rather limited. We present data of 49 patients with PA, which were gathered from 18 metabolic centers throughout Central Europe on the occasion of an international workshop. All patients were identified by selective metabolic screening, and 86% of them were classified as having early-onset PA owing to their presentation with clinical symptoms within the first 90 days of life. Mortality rate was one third, and details of symptoms and treatment of the surviving patients are discussed. The great variation of phenotypic expression of the disease and different therapeutic strategies (especially in regard to the degree of protein restriction) used at the various institutions involved in this study imply the need for a registry of PA patients and for a multicenter prospective treatment study.
Home Country Teachers’ Advice to Non-Home Country Teachers
Authors: Crozier Nicola , Kleinsasser Robert C.
Published: April 2006

This study explores educational and sociocultural advice home country teachers offer non-home country teachers instructing English. It reviews various professional literature including documents (e.g. news releases), websites, and various literature (books, journals, journal articles) pertaining to the preparation of teachers who plan to teach English in non-home country learning environments. The 30 participants representing 14 countries completed a written questionnaire and provide advice on the personal qualities and L1 abilities of non-home country teachers, English language teaching, English home country students, preferred variety of English, and sociocultural challenges.
English and Multiculturalism— from the Language User’s Perspective
Authors: Tanaka Shigenori
Published: April 2006

This paper aims to reconsider the status of ‘English as an international language’ from the language user’s perspective. Accepting a shift in focus from ‘English’ to ‘Englishes’, we argue that the concept of ‘Englishes’, which assumes the pluralization of linguistic and cultural norms, still remains a collective concept, and to discuss English from the language user’s point of view, the notion of ‘my English’—a notion motivated by the distinction between ‘English one learns’ and ‘English one uses’—should be introduced. We also argue that if a personal perspective of ‘my English’ is taken, then, we must also draw a distinction between ‘culture out there’ and ‘culture one encounters’ to discuss the context in which English is used. In this paper, we introduce the perspective of ‘living multiculturalism’, and discuss some of the major cultural issues from that perspective. All in all, this paper is an attempt at advancing a theory of world Englishes from the perspective of the user of the language, suggesting pedagogical implications for understanding the notion of communicative competence.
Learning Vocabulary in Group Work in Vietnam
Authors: Huong Le Pham Hoai
Published: April 2006

This study investigated learning vocabulary in group work at university in Vietnam. The students were studied in two kinds of group settings, ‘unassisted’ and ‘assisted’, the first consisting of five students from the same class level and the second of four from the same class and a student from a higher class. Differences were observed in both the procedures and the outcomes of vocabulary learning in the two settings. The negotiation of word meanings and forms were collaborative in the unassisted groups and expert-novice in the assisted groups. The unassisted groups used the first language to code-mix their English utterances with Vietnamese words to express their ideas. The presence of a senior student in the assisted groups virtually eliminated the use of the first language in explaining new English words. Students in the two group settings reported that they learned new words and the group discussions helped them recall and remember English words.
Using Online Discussion Groups in a CALL Teacher Training Course
Authors: Son Jeong-Bae
Published: April 2006

This paper reports the results of a study that examined an online discussion group established for a computer-assisted language learning (CALL) course and investigated patterns of interactions generated through the online discussion and participants’ attitudes toward the computer-mediated communication (CMC) activity. The participants in the study were 24 English as a second/foreign language (ESL/EFL), 1 French and 1 Japanese in-service teachers. The findings indicate that individual postings consisted of a large number of fully task-focused messages with a small number of partially task-focused contributions and very few off-task contributions. From the content of the postings, six message types were identified. Among these types, interactive messages were exchanged between the teachers, mainly for the purposes of giving opinions/ideas and expressing support. The teachers’ overall reactions to the online discussion group activities were positive. Most teachers considered the activities to be constructive, enjoyable and valuable. They agreed that online discussions were a good way of learning CALL and CMC could facilitate collaborative learning. This study confirms that CMC can provide teachers with communication channels for sharing ideas and resources and collaborating with their fellow teachers.
Challenges and Strategies of Instrument Translation
Authors: Wang Wen-Ling , Lee Hwei-Ling , Fetzer Susan Jane
Published: April 2006

The often-cited back translation procedure used for the translation of research instruments has not been consistently described in cross-cultural literature. Translation errors resulting in conceptually dissimilar instruments can compromise comparisons of cross-cultural health initiatives. This report describes a five-step translation procedure and equivalence and reliability testing process used to develop the High School Questionnaire: Profile of Experiences (HSQ) in Mandarin. Each step of the translation process provided additional information and detected discrepancies between the English and Mandarin versions of the HSQ. Issues related to grammatical translation, cultural usage and experience, syntax, and concept interpretation were exposed by the translation process. The procedures used in this 18-month study were rigorous enough to create an instrument that was both linguistically appropriate and culturally relevant.
Development of the Purposeful Action Medication-Taking Questionnaire
Authors: Johnson Mary Jayne , Rogers Sandra
Published: April 2006

This three-phase study describes the development and psychometric properties of the Medication-Taking Questionnaire (MTQ) to measure the purposeful action domain (reasons individuals decide to accept medication treatment) in the medication adherence model for hypertension. During Phase I, items were evaluated for content validity and clarity. Item analysis, internal consistency, and exploratory factor analysis were preformed during Phase II to finalize the MTQ: Purposeful Action as 12 items and 2 subscales (treatment benefits and medication safety). Phase III evaluated the MTQ: Purposeful Action for temporal stability and construct validity. The final version MTQ: Purposeful Action demonstrated good internal consistency, temporal stability, and construct validity. The MTQ: Purposeful Action appears to have good psychometric characteristics that represent the decision-making process for adherence in medication treatment for hypertension.
Organo-Soluble Fluorinated Polyimides Derived from 4,4′-Bis (3-amino-5-tri uoromethylphenoxy)-3,3′,5,5′-tetramethyl biphenyl (TFMDA) and Aromatic Dianhydrides
Authors: Liu Jin-Gang , Zhao Xiao-Juan , Fan Lin , Yang Shi-Yong , Wu Gui-Long , Zhang Fu-Qiang , Li Zuo-Bang
Published: April 2006

A series of organo-soluble polyimides based on a new fluorinated diamine, 4,4′-bis(3-amino-5-trifluoromethylphenoxy)-3,3′,5,5′-tetramethyl biphenyl (3,5-TFMDA) and various aromatic dianhydrides, were synthesized and characterized. The structures of the obtained polyimides were affirmed by Fourier transform infrared measurement and the properties were evaluated by wide-angle X-ray diffraction measurement, ultraviolet-visible analysis, thermogravimetry (TG), differential scanning calorimetry (DSC), tensile and electrical tests, and solubility tests. It was shown that the polyimides have good solubility not only in polar aprotic solvents, but in many common solvents, such as cyclopentanone, chloroform, and even in toluene for PI-4, derived from TFMDA and 2,2′-bis(3,4-dicarboxyphenyl) hexafluoropropane dianhydride (6FDA). The polyimide solutions could be cast into flexible and tough films, which exhibited good thermal stability up to 500° C and showed glass transition temperatures in the range of 250–280° C. The films also showed acceptable tensile properties and good electrical insulating properties. Furthermore, the polyimide films exhibited good transparency in the visible light region with transmittance higher than 80% at 450 nm and a cut-off wavelength lower than 360 nm.
Structural Characterization and Properties of Organo-soluble Polyimides, Bismaleimide and Polyaspartimides Based on 4,4′-Dichloro-3,3′-Diamino Benzophenone
Authors: Hariharan R. , Bhuvana S. , Sarojadevi M.
Published: April 2006

A novel chlorinated diamine monomer with keto group, 4,4′-dichloro-3,3′-diamino benzophenone (DADCB) was prepared through the nitration of dichloro benzophenone (DNDCB) followed by catalytic reduction with SnCl4 and HCl. Chlorinated polyimides (IVa-e) were synthesized from the above diamine with various commercially available dianhydrides via one-step and two-step methods. Polyimides IVa-e have inherent viscosity in the range 0.98–1.42 dL g° 1 in the one-step method and 0.70–0.95 dL g° 1 (thermal imidization) and 0.84–1.33 dL g° 1(chemical imidization) in the two-step method. The polyimidesprepared by the one-step method and chemical imidization method exhibited excellent solubility, but those prepared via thermal imidization exhibited limited solubility. Polyimide° lms exhibited tensile strength 95–121MPa, percentage elongation 8–13% and tensile modulus 1.6–2.4 GPa. The T g of the polyimides are in the range 272–297° C and T10 values are in the range 510–542° C in N2 and 460–498° C in air with more than 40% char yield at 800° C in N2 atmosphere. The prepared polyimides have cutoff wavelength in the range of 360–398 nm and percentage transmittance at 500 nm is in the range 80.9–94.2%. The dielectric constant of the polyimide films are in the range of 2.90–3.82 at 1 kHz and 2.85–3.68 at 10 kHz with moisture absorption in the range 0.38–0.88%. Bismaleimide (BMCB) was also synthesized using the synthesized diamine and maleic anhydride and further treated with various diamines to form linear polyaspartimides and their properties such as viscosity, solubility and thermal properties were also studied.
Radical Copolymerization of Functional N-Substituted Maleimides with N-Vinyl-2-Pyrrolidone
Authors: Morariu Simona , Hulubei Camelia
Published: April 2006

Two functional N-substituted maleimide monomers, namely N-(4-carboxyphenyl)maleimide (CPMI) and N-(4-formylphenoxy-4′-carbonylphenyl) maleimide (FCPMI), were copolymerized with N Vinyl-2-pyrrolidone (NVP) at 90° C in the presence of 2,2′-azobisisobutyronitrile as initiator in dimethylformamide. The monomers reactivity ratios were calculated by extended Kelen–Tüdös and Mao–Huglin methods. The average reactivity ratios and Alfrey–Price Q and e Values were found to be r1 = 0.028, r2 = 0.347, Q1 = 0.035, e1 = 1.013 for CPMI/NVP system and r1 = 0.044, r2 = 0.060, Q1 = 0.145, e1 = 1.297 for the FCPMI/NVP system. The distribution of monomer sequences along the copolymer chain was calculated using a statistical method based on the obtained reactivity ratios. The thermal properties of the resulting copolymers were also investigated. These copolymers exhibit fairly high thermal stability with decomposition temperatures above 230° C. The effect of the N-substituents on the radical copolymerization of the above functional maleimides with NVP is discussed.
Synthesis and Properties of an Addition-type Imide Oligomer having Pendent Phenylethynyl Groups: Investigation of Curing Behavior
Authors: Sasaki Takeshi , Yokota Rikio
Published: April 2006

A phenylethynyl-terminated imide oligomer having pendent phenylethynyl groups (20 mol%) was synthesized using a novel pendent diamine, 2,4-diamino-1-(1-fluoro-4-phenylethynylphenoxy) benzene. The imide oligomer exhibited excellent solubility in NMP and solutions up to 40% solids were obtainable. A detailed cure study was performed on the oligomer by staged heating to final cure temperatures of 370, 400, 420, and 450 C. Complete cure was accomplished by heating at 450 C for 10 min. In comparison phenylethynyl terminated oligomers typically require curing for 1 h or more at 370 C. The cure reaction was studied using DSC by following the disappearance of exothermic peak corresponding to the cleavage of the triple bond (i.e. phenylethynyl group). DMA showed an increase in T g and a decrease in the drop of storage modulus ( E) with increasing post-cure temperature. Likewise, thin film tensile specimens exhibited a decrease in the elongation to break with increasing post-cure temperature. Post-cure time (370 C for 1 and 2 h) did not achieve full cure.
Studies on Photoreactive Polyesters Containing α, β-Unsaturated Carbonyl Group in the Main Chain
Authors: Muthusamy Athianna , Murugavel Salemchandrasekaran C.
Published: April 2006

A series of polyesters containing °-unsaturated carbonyl group in the main chain was synthesized from 1,3-bis(4-hydroxyphenyl)propenone and 3-(4-hydroxy-3-methoxyphenyl)-1-(4-hydroxyphenyl)propenone with various aliphatic and aromatic acid chlorides by an interfacial polycondensation method using a phase transfer catalyst. The structure of the synthesized monomers and polyesters was confirmed by IR, 1H NMR, 13C NMR and UV spectroscopy. These polyesters were studied for their thermal and photochemical properties. The thermal properties of polyesters were evaluated by thermogravimetric analysis and differential scanning calorimetry. The polyesters synthesized from aromatic acid chlorides have shown higher thermal stability than the polyesters from aliphatic acid chlorides. Moreover, the results revealed that the polyesters bearing methoxy substituent on the phenyl ring group possess lower thermal stability than non-substituted polyesters. The photoreactive property of the polyesters was studied by UV and IR spectrophotometer. It is observed that on exposure to UV light the polymers undergo photocrosslinking reaction. The photocrosslinking proceeds through the dimerization of olefinic chromophore via 2 + 2 cycloaddition reaction.
Sustainability and infrastructure planning in South Africa: a Cape Town case study
Authors: Swilling Mark
Published: April 2006

This paper highlights the importance of considering ecological sustainability issues in any city's infrastructure plans and investments. It reviews the South African government's current and planned investment in urban infrastructure, both to enhance economic growth and to contribute to poverty reduction, and what this implies for Cape Town. It highlights the lack of attention given to ecological issues and the dangers of assuming that the resources will be available to support it, and that prices for fresh water, fossil fuels and food will not rise. It also points to Cape Town's large ecological footprint (comparable to that of Canada, per person) and its heavy dependence on non-renewable resources, especially oil – which means that every oil price rise transfers money from the Cape Town economy to national and global financial circuits. Housing lower-income groups in conventional housing with no attention to a more compact, less automobile-dependent city form exposes them to high water and energy costs. The paper ends by pointing to the advantages for the city and for lower-income groups of including ecological issues, and outlines the possibilities for doing so.
Goa 2100: the transition to a sustainable RUrban design
Authors: Revi A , Prakash S , Mehrotra R , Bhat G K , Gupta K , Gore R
Published: April 2006

This paper describes how the city of Panjim (capital of Goa, in India) and its wider region could meet the multiple goals that sustainable development requires – combining high quality living conditions, a successful economy, and sustainable levels of resource use and waste generation. It outlines the methodologies used and describes the changes needed in the use and management of water and land, infrastructure, buildings and transport systems, and in the governance framework needed to underpin such changes. It uses the term “RUrban” to highlight how this requires a sustainable integration of rural and urban communities, where rural living standards come to match those in urban areas and where cities become net producers of ecological services rather than relying on regional and global resources and waste sinks.
The eco-city: ten key transport and planning dimensions for sustainable city development
Authors: Kenworthy Jeffrey R
Published: April 2006

Making existing cities and new urban development more ecologically based and liveable is an urgent priority in the global push for sustainability. This paper discusses ten critical responses to this issue and summarizes them in a simple conceptual model that places the nexus between transport and urban form at the heart of developing an eco-city. This involves compact, mixed-use urban form, well-defined higher-density, human-oriented centres, priority to the development of superior public transport systems and conditions for non-motorized modes, with minimal road capacity increases, and protection of the city's natural areas and food-producing capacity. These factors form the framework in which everything else is embedded and must operate, and if they are not addressed only marginal changes in urban sustainability can be made. Within this framework, environmental technologies need to be extensively applied. Economic growth needs to emphasize creativity and innovation and to strengthen the environmental, social and cultural amenities of the city. The public realm throughout the city needs to be of a high quality, and sustainable urban design principles need to be applied in all urban development. All these dimensions need to operate within two key processes involving vision-oriented and reformist thinking and a strong, community-oriented, democratic sustainability framework for decision-making.
Towards adaptive town environmental planning: the experience from Xiamen, China
Authors: Fang Qinhua , Zhang Luoping , Hong Huasheng
Published: April 2006

In China, concern is growing with regard to environmental issues related to the growth of peri-urban towns. Rapid urbanization and the backlog in constructing needed environmental infrastructure have resulted in severe environmental issues for many peri-urban towns, affecting their sustainable development. In Xiamen, a coastal city, town-level environmental planning was proposed in 2003 as an important tool to control pollution and conserve ecosystems. But for environmental planning to work, it needs to be more adaptable to local circumstances and decision-making processes. This paper presents a framework for adaptive environmental management and discusses how it was implemented in Dongfu Town, one of the peri-urban towns around Xiamen. It describes the principles of adaptive peri-urban town environmental planning and how this process integrates information from multiple sources and different stakeholders. This experience shows how science can be integrated into the decision-making process, avoiding both the narrow-minded viewpoints of planners and the natural resource use conflicts among a variety of stakeholders. It also shows how the environmental planning process can propose results that are acceptable to local communities and decision makers, even when they suggest directions that were not in accordance with the public's initial priorities. Finally, it shows that sustainable development of targeted areas can be achieved through well-designed environmental planning.
Planning with Ecological Footprints: a sympathetic critique of theory and practice
Authors: Mcmanus Phil , Haughton Graham
Published: April 2006

The concept of the Ecological Footprint has become a popular and increasingly used approach in environmental policy and planning, for western cities in particular. The concept is useful not least as a metaphor that effectively communicates the message that environmental impacts extend beyond the built area of cities. However, the use of Ecological Footprint analysis as a measuring tool is problematic, particularly when it is used as a tool for comparisons between jurisdictions. This paper sets out the benefits of the concept, indicates its history and use, and offers a sympathetic critique of both the theory and practice of Ecological Footprints. We believe this is necessary so that policy makers thinking of adopting this approach are aware of its strengths and limitations, and avoid using the concept in a manner that may be misleading.
Water, society and environment in the history of one Mexican city
Authors: Garcia Patricia Avila
Published: April 2006

This paper reviews the problems in the city of Morelia over a period of four centuries in providing and financing provision for water, sanitation and wastewater management. It documents when and how innovations were introduced to improve and extend supplies, to draw water from new sources and manage wastewater. It also explains who took responsibility for this, how it was funded and who benefited. Although provision improved greatly throughout this period, the financial difficulties in addressing these problems and also the differential access to water related to deficient infrastructure and to social and political inequalities still remain today. Problems of water scarcity and water pollution have also become more serious. This review shows how historical studies can contribute to a better understanding of the influence of different social actors on changes in water use and management. It also helps identify those processes and social relationships that lead to conflict and environmental deterioration. The paper notes that such problems must be addressed not only by the State directly but also through a greater degree of participation and involvement by the wider society in decision-making and problem-solving related to water.
Addressing congestion and transport-related air pollution in Saharanpur, India
Authors: Fazal Shahab
Published: April 2006

Rapid growth in the use of private motor vehicles in high-income nations has created serious problems of congestion in most cities, and has also contributed to a high dependence on oil, to air pollution and to high levels of greenhouse gas emissions per person. But rapid growth in the use of motor vehicles, and congestion and air pollution are also evident in cities in low-income nations – where transport infrastructure and management has been unable to cope with this upsurge in traffic. This paper considers the problems faced by a relatively small city in India, Saharanpur, where rapid growth in private motor vehicle use combines with limited local investment capacity and a high use of non-motorized vehicles, including bullock carts. It presents the findings of field surveys for the city's five main roads, and highlights the high levels of congestion and air pollution. The paper also presents an alternative scenario, emphasizing the promotion of public transport.
“Positive” urban futures in sub-Saharan Africa: HIV/AIDS and the need for ABC (A Broader Conceptualization)
Authors: Van Donk Mirjam
Published: April 2006

This paper takes issue with the narrow conceptualization of HIV/AIDS in urban development planning as primarily (if not exclusively) a behavioural and health issue, with at best an added focus on a few apparent impacts of the epidemic. Apart from oversimplifying a complex reality, the simple message “ABC” (Abstain, Be faithful, use a Condom) is likely to disempower and stigmatize those who are unable to heed its call. Instead, this paper calls for a different kind of ABC, A Broader Conceptualization, based on an understanding of HIV/AIDS as a complex and dynamic development issue. The paper explores factors in the urban environment that are associated with increased vulnerability to HIV infection and the likely implications of the epidemic for urban development, with specific reference to the region that is currently the epicentre of the global epidemic, sub-Saharan Africa. It concludes that “good”, equitable development possibly offers the most effective protection for individuals and urban areas against the spread of HIV and the consequences of the epidemic. At the same time, HIV/AIDS makes the realization of equitable urban development all the more difficult – and thus more urgent.
A Guide for Visiting Clinicians to Guatemala: Common Presenting Symptoms and Treatment
Authors: Chickering William H.
Published: April 2006

For volunteer clinicians from North America and Europe, treating patients for the first time in remote areas of Guatemala can be a challenge. Radiology and laboratory facilities are usually lacking, and the cultural and linguistic barriers are huge. This article provides clinicians working in Guatemala with a description and ranking of the most common presenting complaints, as determined from a chart review of 1,500 patients. Unfamiliar diagnoses, empiric treatment, and pertinent cultural factors, including the fading but still-present hot-cold paradigm, are also included.
Perceptions of Graduating Nursing Students Regarding Life Experiences That Promote Culturally Competent Care
Authors: Reeves Joan S. , Fogg Catherine
Published: April 2006

This article describes a qualitative study that explored the perceptions of graduating students from a northeast baccalaureate nursing program regarding their life experiences with cultural diversity. Thirteen students were interviewed using an interview guide, and interviews were recorded on audiotape. Information obtained included participants’ cultural heritage, life experiences before entering a nursing program, educational and clinical experiences in the nursing program, knowledge about cultural competence, and the students’ reflections on their ability to provide culturally competent care. Primarily qualitative methods were used to gather and analyze data. This article focuses on one of the major themes that emerged: defining life experiences related to cultural diversity. Data were reanalyzed focusing on this theme, and three life patterns emerged: positive, neutral, and conflicted. These patterns affected the students’ interest and desire to provide culturally competent care. Implications for further research and nursing education are discussed.
The Role of the African Traditional Healer in Women’s Health
Authors: Nelms Linda W. , Gorski June
Published: April 2006

Traditional healers provide an important link between the rural people of Africa and primary health care. The purpose of this article is to review more recent literature and contemporary practices related to the role of the traditional healer in Africa and the move toward collaboration with an introduction of Western-style medicine and health care, especially for women. African women, particularly older ones in rural communities, utilize the traditional healer’s timeless and ancient caregiving when faced with symptoms of mental and physical illness. The concept of training traditional healers and medical personnel to deliver traditional and Western health care to communities requires further consideration and a plan of implementation.
Community Transformation Through Culturally Competent Nursing Leadership: Application of Theory of Culture Care Diversity and Universality and Tri-Dimensional Leader Effectiveness Model
Authors: Shapiro Mina L. , Miller June , White Kathleen
Published: April 2006

Transcultural knowledge and competency have become a critical need for nurses to accommodate the global trends in cultural diversity and health care disparities. Today, nurses are increasingly taking on leadership roles in community settings. This article addresses the application of Leininger’s culture care theory with the sunrise model and Hersey and Blanchard’s tri-dimensional leader effectiveness model as potential collaborating theories for capacity building and community transformation from a global, transcultural nursing perspective. The two theories, used in collaboration, view the provision of competent leadership as the delivery of effective, culturally congruent nursing care in promoting health and health equity at the community level.
Strategies for Developing Cultural Competency in an RN-BSN Program
Authors: Eshleman Jane , Davidhizar Ruth E.
Published: April 2006

It is crucial for nurses to acquire skills and a knowledge base to care for increasingly diverse cultural populations. Many nurses returning to school did not receive theoretical information relative to culture. This article describes some of the teaching strategies utilized in the RN-BSN program at Bethel College in Mishawaka, Indiana. This “how we did it” discussion is presented to provide ideas for teaching strategies that may be used to promote attainment of a program outcome related to cultural sensitivity and competency.
The Level of Cultural Self-Efficacy Among a Sample of Spanish Nurses in Southeastern Spain
Authors: Jimenez Jose Angel Vargas , Contreras Jose Luis Molino , Shellman Juliette , Gonzalez M. Lourdes Cantero , Bernal Henrietta
Published: April 2006

A collaborative study between faculty from the United States and Spain was undertaken to investigate levels of cultural self-efficacy among a sample of Spanish nursing students and nurses. Bandura’s self-efficacy theory provided the conceptual framework for this descriptive study. The Spanish version of the Cultural Self-Efficacy Scale (CSES-S) was translated from the original developed by Bernal and Froman using the back-translation technique recommended by Brislin. The CSES-S was administered to 113 Spanish nurses and students. Alpha coefficient results for the CSES-S ranged from .90 to .95. Low to neutral levels of confidence in caring for four ethnic groups were found. Regression analyses showed significant relationships between cultural exposure and cultural self-efficacy for the practicing nurses. Results will assist this collaborative transcultural nursing research effort between the United States and Spain to develop and implement programs and experiences to increase cultural self-efficacy among Spanish nurses and improve care provided to Spain’s diverse population.
Minimal Involvement of Sentinel Lymph Node in Breast Carcinoma: Prevailing Concepts and Challenging Problems
Authors: Rivera Michael , Merlin Scott , Hoda Rana S. , Gopalan Anuradha , Hoda Syed A.
Published: April 2006

Sentinel lymph node biopsy has attained “standard of care” status in the management of breast carcinoma. However, the pathological interpretation and clinical consequences of “minimally involved” sentinel lymph nodes remain controversial. Herein, we present some of the complex and challenging pathological problems inherent in this evolving setting. Clearly, at least some of our current concepts regarding “minimally involved” sentinel lymph nodes need reappraisal.
Real-Time PCR Quantification of c-erbB-2 Gene is an Alternative for Fish in the Clinical Management of Breast Carcinoma Patients
Authors: Suo Zhenhe , Daehli Kathinka U. , Lindboe Christian Fr. , Borgen Elin , Bassarova Assia , Nesland Jahn M.
Published: April 2006

Evaluation of gene amplification and protein expression of the c-erbB-2/neu in breast carcinomas has been an important task in breast cancer management. Although immunohistochemistry is widely applied, fluorescence in situ hybridization (FISH) technology shows its advantage in discriminating tumors in an objective manner. More recently, development of LightCycler technology permits evaluation of gene amplification with a small volume of DNA run in a 20 µL glass capillary. In this study, a series of 87 breast carcinomas were chosen for evaluation of c-erbB-2/neu gene amplification detected by both LightCycler technology and FISH. Real-time polymerase chain reaction (PCR) was performed in LightCycler capillaries with 10 ng sample DNA. By using LightCycler Relative Quantification Software version 1 (Light-Cycler, Roche, Mannheim, Germany), the amount of c-erbB-2 DNA was calculated as a ratio of c-erbB-2/reference gene quantity in a sample, and then the ratio was divided by the ratio of c-erbB-2 gene/reference gene quantities of a calibrator DNA (a standard DNA provided in the kit), which was run with each sample reaction in parallel. Dualcolor FISH was performed on sections of the formalin-fixed, paraffin-embedded tissue array samples using the DAKO HER2 FISH pharmDX™ kit (DAKO A/S, Glostrup, Danmark) according to the manufacturer’s instructions. Furthermore, immunohistochemistry was performed in parallel, with both the NCL-CB11 and HercepTest antibodies. Both the FISH technology and the LightCycler-PCR identified a similar percentage of tumors with c-erbB-2 gene amplification in our present study, 16% (14/87) and 15% (13/87), respectively, whereas immunohistochemistry demonstrated 32% and 34% c-erbB-2 overexpression with the NCL-CB11 and HercepTest antibodies, respectively. In addition, FISH and PCR were highly correlated in detecting tumors mainly with 3+++ c-erbB-2 protein expression by immunohistochemistry, indicating that LightCycler real-time quantification of c-erbB-2 gene may be an alternative to FISH in breast cancer clinical application.
Endometrial Glandular Dysplasia: A Putative Precursor Lesion of Uterine Papillary Serous Carcinoma. Part II: Molecular Features
Authors: Liang Sharon X. , Chambers Setsuko K. , Cheng Liang , Zhang Shaopo , Zhou Yi , Zheng Wenxin
Published: April 2006

Endometrial glandular dysplasia (EmGD) may be a newly defined precursor lesion of uterine papillary serous carcinoma (UPSC) by morphology. In this report, we studied molecular changes present in EmGD by the loss of heterozygosity (LOH) approach using laser capture microdissected tissue samples. Nineteen uteri showing at least 1 focus of EmGD by morphology were selected. These cases were 12 UPSC, 2 clear cell carcinomas, 1 mixed uterine papillary serous and endometrioid carcinoma, 1 uterine carcinosarcoma, 1 serous endometrial intraepithelial carcinoma (EIC), and 2 EmGD involving endometrial polyps. Seven microsatellite polymorphic DNA markers (TP53 at 17p, D1S211, and D1S162 at 1p32, D17S1323 at 17q21, D17S1330 at 17q25, D5S346 at 5q, and D2S123 at 2p) were utilized. A total of 123 laser-captured microdissection samples from 19 cases was studied with LOH method. The frequencies and patterns of LOH were analyzed and compared among benign resting endometrium (RE), EmGD, serous EIC, and UPSC. LOH was observed for at least 1 of the 7 markers in all categories of lesions, EmGD, serous EIC, and UPSC. The frequency of LOH for EmGD ranged from 4.2% to 31.3%; the range for serous EIC was 5.9% to 78.6%; and that for UPSC was 7.7% to 62.5%. The most frequent LOH in the 3 above-cited categories of lesions was identified at 17p (TP53) and 1p (D1S162). The frequency of LOH in EmGD with markers of TP53 and D1S162 was significantly higher than in RE (p < 0.05). With markers of D1S211 and D2S123, LOH in EmGD was higher than RE, approaching to a statistically significant level. Compared with foci of serous EIC and UPSC, however, the rate of LOH in EmGD was significantly lower only with TP53 locus (31.3% vs more than 60%, p < 0.05). The difference of LOH frequency with other chromosomal markers between EmGD and serous EIC/UPSC did not reach a statistically significant level. A significantly high concordant LOH pattern was found between foci of EmGD and serous EIC/UPSC (p = 0.05). We conclude that EmGD frequently shows LOH at multiple chromosomal loci, particularly at 17p and 1p. Significantly high concordant LOH frequency between EmGD and paired serous EIC or UPSC strongly suggests that EmGD is a noncancerous precursor lesion of UPSC, probably also of serous EIC. The clinical significance of EmGD needs further studies.
KI-67 Antigen Expression Predicts Survival and Correlates with Histologic Subtype in the WHO Classification of Thymic Epithelial Tumors
Authors: Comin Camilla E. , Messerini Luca , Novelli Luca , Boddi Vieri , Dini Sergio
Published: April 2006

We performed an immunohistochemical study with monoclonal antibodies to Ki-67 antigen and p53 protein on 45 cases of thymic epithelial tumors classified according to the recent World Health Organization (WHO) classification system to evaluate whether there is correlation between the expression of these markers and prognosis, histologic subtype, and myasthenia gravis (MG). We also correlated histologic subtype with sex, age, MG, and survival. Ki-67 and p53 labeling indices (LIs) were expressed as a percentage of positive nuclear immunostaining by counting 1,000 epithelial tumor cells. Statistically significant differences were found between Ki-67 LI and survival (p = 0.007), whereas the prognostic implication of p53 could not be demonstrated, although there appeared a trend that patients with tumors of higher LIs had worse survival. Significant correlations were also found between Ki-67 (p < 0.0005) and p53 (p < 0.0005) LIs and histologic subtypes. No correlation was found between these parameters and MG. Histologic subtypes of the WHO classification also correlated with survival (p = 0.01), whereas no correlation was found with sex, age, and MG. In conclusion, our results indicate that the proliferative activity, assessed by Ki-67 LI, and the histologic pattern, according to WHO classification system, seems to represent reliable parameters in the prognosis of thymic epithelial tumors.
Peripheral Lymphadenopathy as the Initial Manifestation of Pericardial Mesothelioma
Authors: Yakirevich Evgeny , Sova Yanina , Drumea Karen , Bergman Irena , Quitt Miriam , Resnick Murray B.
Published: April 2006

Lymphadenopathy is an unusual initial presentation of malignant mesothelioma. We describe a case of extrathoracic lymphadenopathy as the only initial manifestation of primary pericardial malignant mesothelioma. The diagnosis of metastatic malignant mesothelioma was made by excisional biopsy of the supraclavicular lymph node and later confirmed by cytologic examination of pericardial fluid. The clinical and pathological features of this case, including positron-emission tomography (PET), immunohistochemistry, and electron microscopy, are discussed.
Gastric Metaplasia and Small Bowel Ulcerogenesis in a Case of Ulcerative Jejunitis Not Related to Celiac Disease
Authors: Canavese G. , Villanacci V. , Zambelli C. , Bernardi A. , Candelaresi G. , Berardengo E. , Pennazio M. , Rossini F. P.
Published: April 2006

The possible relationship between gastric metaplasia and ulcerative lesions in an anusual case of ulcerative jejunitis not related to celiac disease and with extensive gastric meta-plasia is discussed. Previous studies have described gastric metaplasia in duodenal ulcers on the basis of endoscopic data, and some authors maintain that acid secretion in meta-plastic mucosa could represent a pathogenetic factor of ulcerogenesis, with a self-amplifying mechanism. In the absence of functional evidence, we could provide data, in a case of ulcerative jejunitis, about morphologic signs of acid secretion in gastric metaplastic epithelium using an antibody against HMFG-1, a good marker of acid-secreting fundic cells. Metaplastic areas demonstrated a focal positivity for HMFG-1, and these finding are suggestive of local acid secretion.
Indices for Continuity of Care: A Systematic Review of the Literature
Authors: Jee Sandra H. , Cabana Michael D.
Published: April 2006

This article systematically reviews published literature on different continuity of care (COC) indices that assess the physician-patient relationship and the applicability of such indices to pediatric and chronic-disease patient populations. Frequency and visit type may vary for pediatric and chronically ill patients versus healthy adult patients. Two investigators independently examined 5,070 candidate articles and identified 246 articles related to COC. Forty-four articles were identified that include 32 different indices used to measure COC. Indices were classified into those that calculated COC primarily based on duration of provider relationship (n = 2), density of visits (n = 17), dispersion of providers (n = 8), sequence of providers (n = 1), or subjective estimates (n = 4). The diversity of COC indices reflect differences in how this measure is conceptualized. No index takes into account the visit type. A unique index that reflects continuity in the physicianpatient relationship for pediatric and chronic disease populations is needed.
Self-Reported Utilization of Health Care Services: Improving Measurement and Accuracy
Authors: Bhandari Aman , Wagner Todd
Published: April 2006

Self-report is often used to estimate health care utilization. However, the accuracy of such data is of paramount concern. The authors conducted a systematic review of 42 studies that evaluated the accuracy of self-report utilization data, where utilization was defined as a visit to a clinical provider or entity. They also present a broad conceptual model that identifies major issues to consider when collecting, analyzing, and reporting such data. The results show that self-report data are of variable accuracy. Factors that affect accuracy include (1) sample population and cognitive abilities, (2) recall time frame, (3) type of utilization, (4) utilization frequency, (5) questionnaire design, (6) mode of data collection, and (7) memory aids and probes.
Validating CPT Typical Times for Medicare Office Evaluation and Management (E/M) Services
Authors: Cromwell Jerry , Hoover Sonja , McCall Nancy , Braun Peter
Published: April 2006

Every 5 years, the federal government reviews the Medicare Fee Schedule for changes in the work effort physicians personally devote to office visits. Using physician face-to-face times reported in the Centers for Disease Control and Prevention's National Ambulatory Care Survey (NAMCS), guideline office visit times associated with the 1997-1998 mix of Medicare claims averaged 9 percent longer versus NAMCS; Medicare billed visits with new patients were 32 percent longer. Surgeons and dermatologists had the largest discrepancies in Medicare versus NAMCS times. If CPT guideline times currently in use are now overstated, then intraservice work effort is likely overstated given the high correlation of time with work effort, and Medicare payment levels need to be reduced. Upcoding visit content to higher paid CPT visit codes may also explain seemingly longer Medicare billed times and call for payment reductions as well.
Some Thoughts on Frame Indifference
Authors: Rivlin Ronald S.
Published: April 2006

Frame indifference is intimately related to the idealization, in conventional continuum mechanics, of the surface on which the surface forces act as a two-dimensional continuum devoid of mass. In the kinetic theory of gases, the surface is effectively a layer with thickness of the order of magnitude of the mean free path. The calculated pressure matrix contains a frame dependent term that represents the Coriolis forces that emerge in this layer when the applied forces are transformed from a fixed to a rotating reference frame.
Microbiology of Fresh-cut Mangoes Prepared from Fruit Sanitised in Hot Chlorinated Water
Authors: Ngarmsak M. , Delaquis P. , Toivonen P. , Ngarmsak T. , Ooraikul B. , Mazza G.
Published: April 2006

Whole mangoes ( Mangifera indica, cv. Chok Anun) were washed in water with or without chlorine (100 mg total chlorine/L) at 11.7 ºC and 50 ºC before slicing and packaging. Microbiological analysis of the whole fruit showed that the stem scar contained larger populations of microorganisms than the skin. Washing reduced populations at both sites and the effect was enhanced by the addition of chlorine and heating of the wash water. None of the treatments prevented transfer of contaminants to the flesh during slicing, and evidence of spoilage in the form of discrete fungal colonies was observed in samples stored for 1 week at 5 ºC. Several species of bacteria, yeast and mould were recovered from packaged slices, but yeast and moulds accounted for the bulk of the spoilage of microflora. Barriers to the growth of these microorganisms may be necessary to reduce the risk of microbial spoilage of mango slices manufactured under commercial conditions.
Isolation and Partial Characterisation of Milk-clotting Aspartic Protease from Streblus asper
Authors: Senthilkumar S. , Ramasamy D. , Subramanian S.
Published: April 2006

A rennin-like milk-clotting protease from the twigs of Streblus asper was purified by a factor of 65 times with 36% recovery using ethanol precipitation, ion-exchange and size-exclusion chromatographic techniques. The enzyme was found to be monomeric in nature having a molecular mass of 55kDa. The enzyme acts optimally at 55°C and was stable in the temperature range of 30–40°C. Easy enzyme inactivation by moderate heating, makes this protease extract potentially useful for cheese production. The purified enzyme is an acid protease with an optimum pH of 5.5 and it retained 96% of its residual activity between pH 5.0 and 6.0. Pepstatin A inhibited the proteinase activity, whereas iodoacetamide, phenylmethyl sulphonyl fluoride, β-mercaptoethanol and ethylenediaminetetraacetic acid had no significant inhibitory effect suggesting the presence of aspartic acid residue at the active site. The milkclotting aspartic protease showed predominant α-helical conformation in phosphate buffer as evidenced from circular dichroic spectroscopy.
Effect of Plasticizer Type and Concentration on the Properties of Edible Film from Water-Soluble Fish Proteins in Surimi Wash-Water
Authors: Bourtoom T. , Chinnan M. S. , Jantawat P. , Sanguandeekul R.
Published: April 2006

Edible film made from water-soluble fish proteins present in surimi wash-water were developed based on formulation conditions explored in a previous study. Type and concentration of plasticizer significantly ( p < 0.05) affected the mechanical and barrier properties of the films. Sorbitol (SOR) plasticized films were the most brittle, with the highest tensile strength (TS, 3.14MPa) however its effect on water vapour permeability (WVP) was low (30.41g/mm/m2/d/kPa). In contrast, glycerol (GLY) and polyethylene glycol (PEG) plasticized films exhibited flexible structure despite a low TS (2.13MPa and 1.80MPa, respectively) resulting in higher WVP (125.8g/mm/m2/d/kPa and 89.52g/mm/m2/d/kPa). As plasticizer concentration increased, TS decreased concomitant with an increase in elongation as break (E) and higher WVP. SOR plasticized films, showed higher film solubility (FS) and protein solubility (PS) compared to GLY and PEG plasticized films. Increasing the plasticizer concentration, overall, resulted in both higher FS and PS. The colour of films was more affected by the nature of the plasticizer used than by its concentration.
Note. The Effect of Citrus Fibre on the Physical, Chemical and Sensory Properties of Ice Cream
Authors: Dervisoglu M. , Yazici F.
Published: April 2006

The effects of citrus fibre on the physical, chemical and sensory properties of ice cream were evaluated. Three types of ice creams were compared; ice creams with stabiliser/emulsifier (0.4%, 0.8% and 1.2%), ice creams with citrus fibre (0.4%, 0.8% and 1.2%) and ice creams with 0.4% stabiliser/emulsifier and citrus fibre (0.4%, 0.8% and 1.2%). Citrus fibre as a single stabiliser could not improve the viscosity, overrun and sensory properties of ice cream samples, but had a positive effect on the melting resistance. A combination of citrus fibre and stabiliser/emulsifier produced desirable ice cream properties.