bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of Multiphase Meters in Gas Condensate Wells with High Flow
Authors: Navarrete C. , Gamboa E.
Published: December 2010

This paper presents the experience of Camisea project, the largest complex of Gas-Condensate fields developed in Peru, with the application of multiphase meters in high productivity wells in remote locations where the continuous supervision and monitoring of the main production variables of each well are essential, above all volumes of gas and liquids without separation.

Thus, the technology of multiphase meters helps making decisions with its information as online well performance, trend analyses, quick diagnostics and the optimization of the production. Lessons learned are presented based on field tests in different wells in Camisea. What's more, we share experiences with the use of this technology in different applications.
Microporosity and Laminations in Non-Archie Reservoirs Create Challenges for Water-Saturation Computation and Reserves Evaluation: Camisea, Peru
Authors: Markley M. , Seminario F. , Gabulle J. , Luquez J.
Published: December 2010

The Camisea-area gas reservoirs are world-class reservoirs with production from 15 wells producing more than 1.2 Bcf/day and 85000 BCPD from the jungles of Peru. These reservoirs consist of stacked dune and marine sands that have undergone substantial diagenesis. The salinities in these reservoirs are low by "Archie-standards". Extensive coring has been done in all of the reservoir intervals in the three main fields of San Martin, Pagoreni and Cashiriari. These cores show macro, meso and micro porosity distributions. The upper-most sands, Cretaceous Vivian and Chonta are shallow marine and tidal depositions, while the pre-Cretaceous Nia and Permian Noi-Ene sands are continental deposits mainly composed of eolian facies. Resistivities vary widely and gamma ray responses are both high and low in reservoir intervals. In some intervals there is very poor correlation between the gamma ray and the very low clay volumes due to feldspar content. The micro-porosity creates a "low-resistivity" pay effect and irreducible water content in the reservoir that is not related to clay porosity. High iron residues also may cause some complications for the interpretation. A combined approach of cores and logs was used to minimize uncertainty and maximize confidence in the results. Special core analysis was done to analyze the Archie exponents of "m" and "n" in the different formations. Core capillary pressures were also measured in conjunction with nuclear magnetic resonance core measurements to analyze irreducible water volumes. All three measurements were used to guide computation of water saturations from the logs in these environments, formation-by-formation. The objective was to use the core analysis parameters as a guide to validate computation of saturations and reserves in the most appropriate and accurate manner. Small errors in saturation would cause very large uncertainties in producible reserves from this mammoth field. Examples of the special core analysis results, SEM analysis, complex pore structure, and log analysis approach will be used to show the integration of the data to make the most accurate computation of reserves.
New Inert Tubing-Conveyed Large-Bore Sampling System for Deep-Water Cased-Hole Applications
Authors: Barros R. , Irani C. , Delano F. , Araripe P. , Filho H.
Published: December 2010

A number of extremely promising deep water hydrocarbon plays have been identified off the East coast of Brazil that continue to pose technical challenges in the collection of accurate reservoir characterization information. Early exploratory programs have identified the large potential of these opportunities, and national oil companies (NOCs) as well as international oil companies (IOCs) have begun significant activity directed at exploiting these reserves. Because of water depths and significant strata depths that have to be penetrated to reach these reserves, considerable effort has been expended to keep costs under control without compromising the quality of the information collected. Additionally, operational issues and the opportunity for improved reservoir characterization have prompted the use of large-bore strings that will allow an increase in production rates and improved fluid hydraulics, while also facilitating the exploitation of various zonal isolation mechanisms crucial for multi-zone investigations.

This paper discusses a sampling system that was modified to meet stringent bottomhole single-phase sampling requirements in this challenging environment. The new system was developed from a well-established, proven five-in. sampling system that was adapted to a larger-bore configuration for use in deepwater applications. The resulting bottomhole sampling system is ideally suited for extreme HPHT (400°F and 20,000 psi) applications in cased-hole environments. All the samplers are inert to facilitate a representative hydrogen-sulfide analysis, and the multiple samplers can collectively deliver a significant volume (3,600 cc) of single-phase reservoir fluid. The sample carrier is also equipped to accommodate memory gauges that can provide a quantitative measure of the sampler's representative status during recovery.

The large bore sampling system has already demonstrated its exceptional performance in deep-water field applications, and a number of field studies will be presented. The availability of this large-bore sampling system has significantly impacted the present capability to successfully collect representative bottomhole samples in demanding offshore environments. Also significant for most of the clients is the larger volume of sample collected, since there has been a strong push for sampling tools that offer larger-volume capacity as well as reliability and improved economic efficiency.
Characteristics of Suspended Solids, Microorganisms, and Chemical Water Quality in Event‐Based Stormwater Runoff from an Urban Residential Area
Authors: He Jianxun , Valeo Caterina , Chu Angus , Neumann Norman F.
Published: November 2010

Temporal evolution of microbiological, physical, and chemical quality of stormwater runoff from a stormwater drain in an urban residential area in Calgary, Canada, was investigated from May to September, 2006 and 2007. Investigating event mean concentrations and their correlations with rainfall characteristics revealed that intensive rainfall events produced highly polluted stormwater runoff when pollutant source limitation did not occur. Inconsistent event‐based correlations between total suspended solids (TSS) concentrations and water quality parameters were observed. During storms, the loading of TSS exhibited a flow‐dependent nature, whereas microorganism discharge appeared to be governed by a flow‐independent mechanism. No strong first‐flush effect was observed in either TSS or microorganisms, on average. No correlations of first‐flush loads of TSS with rainfall characteristics were identified. Moderate negative correlations between first‐flush loads of microorganisms and rainfall depth and intensity indicated that first flush of microorganisms tended to occur in small storms.
Synthesis of Silica Chemically Bonded with Poly(Ethylene Oxide) 4‐Arm, Amine‐Terminated for Copper Cation Removal
Authors: Kurczewska Joanna , Schroeder Grzegorz
Published: November 2010

Chemically modified silica containing a poly(ethylene oxide) 4‐arm, amine‐terminated unit has been obtained in the multi‐step synthesis. The synthesized material was characterized by elemental, thermogravimetric analysis and infrared spectroscopy. The surface morphology was analyzed by scanning electron microscopy. The support studied was applied for selective extraction of copper(II) [Cu(II)] from water solutions. The influence of different parameters (pH, amount of the support studied, and contact time) on the copper extraction was investigated. At the optimum conditions, the copper extraction was approximately 90%, significantly greater than that of the other coexisting ions—nickel(II) [Ni(II)], cobalt(II) [Co(II)], and manganese(II) [Mn(II)]. The exception was calcium(II) [Ca(II)], which reached 30% of the extraction percentage. The solid support retained its properties after treatment with different organic and inorganic solvents. The recovery of adsorbed Cu(II) ions was approximately 97%. The sorbent studied can be applied effectively for the pre‐concentration of a low level of Cu(II) in the different water samples.
Catheter Management in Hemodialysis Patients
Authors: Besarab Anatole , Pandey Rahul
Published: November 2010

Over 330,000 individuals in the United States depend on hemodialysis (HD), the majority as a result of end-stage renal disease. Sustainable vascular access can be achieved through arteriovenous fistulas, arteriovenous grafts, or tunneled catheters. Tunneled dialysis catheters (TDCs) often remain in use for months or even years, long beyond their initial intended use as a bridging device. Research efforts are focused on identifying strategies to prevent/minimize the risk of the most common catheter-related complications: thrombotic occlusion and infection. Thrombotic occlusion of TDCs prevents adequate dialysis but can be managed successfully through thrombolytic agents to restore/improve blood flow in the majority of patients, allowing immediate HD delivery and prolonging usability of the TDC. Occasionally, catheter exchange with fibrin sheath disruption is needed to preserve the site. Surface-treated catheters could improve the morbidity and mortality associated with HD delivery via an indwelling catheter, but results from studies have been disappointing to date. We review the etiology of catheter-based access failure and the monitoring and interventional steps that should be taken to maintain the patency and safety of catheters for HD. Wherever possible we note the areas in which there is scant data where further randomized clinical trials are needed.
Contemporary Management of Shoulder Dystocia
Authors: Gittens-Williams Lisa
Published: December 2010

Shoulder dystocia is an uncommon but potentially catastrophic intrapartum event. Although risk factors such as maternal diabetes, obesity and macrosomia can be identified, shoulder dystocia most frequently occurs in patients who lack risk factors. Many maneuvers have been described to assist the operator in the safe release of the shoulder and subsequent delivery; however, no prospective trials have compared these maneuvers in such a way to suggest that one maneuver is superior to another. This article describes the identification of patients at risk for shoulder dystocia, clinical management of the shoulder dystocia, event documentation and the contemporary use of drills and simulation training to improve team preparedness for this unpredictable and usually unavoidable event.
Global Consequences of Unsafe Abortion
Authors: Singh Susheela
Published: December 2010

Unsafe abortion is a significant cause of death and ill health in women in the developing world. A substantial body of research on these consequences exists, although studies are of variable quality. However, unsafe abortion has a number of other significant consequences that are much less widely recognized. These include the economic consequences, the immediate costs of providing medical care for abortion-related complications, the costs of medical care for longer-term health consequences, lost productivity to the country, the impact on families and the community, and the social consequences that affect women and families. This article will review the scientific evidence on the consequences of unsafe abortion, highlight gaps in the evidence base, suggest areas where future research efforts are needed, and speculate on the future situation regarding consequences and evidence over the next 5–10 years. The information provided is useful and timely given the current heightened interest in the issue of unsafe abortion, growing from the recent focus of national and international agencies on reducing maternal mortality by 75% by 2015 (as one of the Millennium Development Goals established in 2000).
Comparison of homogeneous and heterogeneous catalysis for synthesis of biodiesel from M. indica oil
Authors: Singh B. , Bux Faizal , Sharma Y.C.
Published: December 2010

Biodiesel was developed by transesterification of Madhuca indica oil by
homogeneous and heterogeneous catalysis. KOH and CaO were taken as
homogeneous and heterogeneous catalyst respectively. It was found that the
homogeneous catalyst (KOH) took 1.0 h of reaction time, 6:1 methanol to oil
molar ratio, 0.75 wt% of catalyst amount, 55?0.5?C reaction temperature for
completion of the reaction. The heterogeneous catalyst (CaO) was found to
give optimum yield in 2.5 h of reaction time at 8:1 methanol to oil molar
ratio, 2.5 wt% of catalyst amount, at 65?0.5?C. A high yield (95-97%) and
conversion (>96.5%) was obtained from both the catalysts. CaO was found to
leach to some extent in the reactants and a biodiesel conversion of 27-28%
was observed as a result of leaching.
Option-based valuation of mortgage-backed securities
Authors: Manola Ana , Urosevic Branko
Published: November 2010

Pure econometric approaches to pricing mortgage-backed securities (MBSs) -
principal pricing vehicles used by financial practitioners - fail to capture
their true risks. This point was powerfully driven home by the global
financial crisis. Since prior to the crisis default rates of MBSs were quite
modest, econometric pricing models systematically underestimated the
possibility of default. As a result, MBSs were severely overvalued. It is
widely believed that the global crisis was largely triggered by incorrect
valuation of mortgage-backed securities. In the aftermath, it is important to
revisit the foundations for pricing MBSs and to pay much closer attention to
default risk. This paper introduces a comprehensive model for valuation of
fixed-rate pass-through mortgagebacked securities in a simple option-based
framework. In the model, we use bivariate binomial tree approach to
simultaneously model prepayment and default options. Our simulation results
demonstrate that the proposed model has sufficient flexibility to capture the
two principal risks.
The legitimacy of increasing marginal utility in social services: The case of university examinations
Authors: Filipic Petar
Published: November 2010

The concept of utility became rightfully recognized in economic theory with
the introduction of decreasing marginal utility. However a question that
arises is: does an increasing consumption of goods always and without
exception lead to diminishing marginal utility? It is quite possible that in
some cases marginal utility of goods and services actually increases. If
this fact is true, it might additionally strengthen the utility theory and
make it applicable in numerous cases of economic and social reality. This
paper uses the example of the utility of studying at university (i.e. the
utility of university examinations), and tries to add a few arguments in
favour of the statement that the law of increasing utility exists.
Justification of criticism of the international financial institutions
Authors: Djonlagic Dzenan , Kozaric Amra
Published: November 2010

As more than half a century has passed since the establishment of the
international financial institutions (IMF, World Bank), this paper analyzes
the opinion that these institutions have not accomplished their mission. They
generally admit that they have not succeeded in the activities that they set
out to accomplish, a propos of gathering funds for countries faced with
economic gaps and helping them to maintain long term economic growth and
development. We show that these financial institutions have done nothing to
reduce poverty and financial disparities, to increase their own transparency,
responsibility and management, especially with the public participation of
developing countries, or to create a more effective loans system. In this
paper the main goal of research is to explore the arguments pro and contra
the strategic effect, policy, and working methodology of the international
financial institutions in view of finding a solution to the global financial
crisis and global prevalent financial problems, and also to consider the
reasons for the justification or otherwise of their being part of the global
financial system.
Complexity in Vocational Education and Training Governance
Authors: Oliver Damian
Published: December 2010

Complexity is a feature common to all vocational education and training (VET) governance arrangements, due to the wide range of students VET systems caters for, and the number of stakeholders involved in both decision making and funding and financing. In this article, Pierre and Peter's framework of governance is used to examine complexity in VET governance models. Criticism has been made of complex decision-making processes in VET governance models, whether stemming from co-determination with social partners or shared responsibilities in federations between national and sub-national governments, with the contention being that such complex processes reduce system adaptability. This article argues that the focus on decision-making processes is misguided and the effects of other complex system processes should be considered. First, debate needs to be broadened to take into account how governance frameworks emerge from historical and political differences, such as the impact of federal structures of government. Adaptability depends on more than decision-making processes. Second, international comparisons suggest that complex policy instruments, whether the result of convoluted decision-making or not, may demonstrate greater adaptability in the system but also threaten system coherence. Finally, complex processes for allocating resources and generating feedback seem to increase system accountability, although unintended consequences for other system outcomes may yet emerge.
Tensions in the Canadian Apprenticeship Sector: Rethinking Bourdieu's Analysis of Habitus, Field, and Capital
Authors: Watt-Malcolm Bonnie , Barabasch Antje
Published: December 2010

The authors explore governance and related policies that shape Canada's vocational education and training (VET) system and trends that have the potential to fundamentally change accepted practices. The conceptual framework derived from Bourdieu's theoretical concepts of field, habitus, and capital is applied to the description of Canada's apprenticeship system within its particular political, economic and social contexts and current power relations. The authors further contemplate how policy changes may be undermining this system and negatively influencing individuals' work and learning opportunities. Lastly, proposed policy directions for Canada's apprenticeship system are critically examined.
The Information Content of the SG&A Ratio
Authors: Baumgarten Daniel , Bonenkamp Ute , Homburg Carsten
Published: December 2010

ABSTRACT: An increase in the ratio of SG&A costs to sales is associated with contradictory interpretations, namely a negative one due to deficient cost control and a positive one derived primarily from “cost stickiness.” Based on these conflicting explanations, we argue that it is crucial to distinguish between whether an increase in the ratio of SG&A costs to sales is actually intended by management in order to enhance future profitability. We regard an increase as intended if a company’s past SG&A ratio was below its industry average, representing efficiency in SG&A cost management. Indeed, these intended increases significantly enhance future earnings. We attribute this positive impact to lower future cost of goods sold and show that it is particularly strong if there is ample latitude for reduction of these costs. This finding suggests that intended SG&A expenditures partially represent investments in operating efficiency.
Consensus and Link Structure in Strategic Performance Measurement Systems: A Field Study
Authors: Aranda Carmen , Arellano Javier
Published: December 2010

ABSTRACT: For a strategy to be effective it must be communicated and widely understood throughout the organization. Our study addresses which of two Strategic Performance Measurement Systems (SPMSs) approaches is more successful at communicating strategy and generating consensus on strategy among managers: (1) the BSC, which makes explicit the links among measures and categories in a hierarchical mode, and (2) an alternative SPMS design, which splits measures into financial and nonfinancial, but lacks this hierarchical structure of links.

We conducted a field experiment in a savings bank and monitored two groups of middle managers working with each of the two SPMS designs. Our results show that (1) middle managers treated with the BSC exhibit a statistically significantly greater effect regarding consensus with respect to top management than those treated with the alternative SPMS, (2) this increased consensus is more pronounced as we move down the list of the BSC perspectives, where the majority of nonfinancial and long term measures are found, and finally (3) some of the managers treated with the nonlinked SPMS experience a loss in consensus.

The implications for the SPMS design process are: (1) the reporting of the performance measures links in a hierarchical mode matters when it comes to designing an effective strategy communication device, and (2) the dispersion in managers’ interpretation of the strategy generated by lacking a linked structure is greater than the tension created by confronting managers’ views with the disclosed link structure.
Nonfinancial Performance Measures and Physician Compensation
Authors: Evans John Harry , Kim Kyonghee , Nagarajan Nandu J. , Patro Sukesh
Published: December 2010

ABSTRACT: This study utilizes a national survey of physicians in the United States, administered four times between 1996 and 2005, to examine the use of nonfinancial performance measures in physician compensation contracts. Consistent with agency theory, we find that nonfinancial measures are used more frequently when the measures are more informative; when alternative control mechanisms are complements rather than substitutes; and when external pressures for quality of care and cost containment are greater. Further, we find that contractual relationships in the health care value chain are interrelated; nonfinancial measures are more likely to be used to evaluate physician performance when the physicians’ practice is compensated based on fixed rate payments (i.e., capitation). We also find that physicians’ compensation contracts are more likely to incorporate nonfinancial performance measures when productivity in revenue generation is also used to evaluate performance. Taken together, the results suggest that nonfinancial performance measures play a significant role in physician compensation, acting to balance incentives tied to individual physician productivity.
Nonfinancial Performance Measures and Physician Compensation
Authors: Dikolli Shane S.
Published: December 2010

ABSTRACT: The Evans et al. (2010; hereafter EKNP) study maps rich survey data into plausible proxies for an array of conceptual variables of interest. It documents novel empirical evidence of determinants of the use of contractible performance measures and demonstrates the importance of nonfinancial performance measures (NPMs) in compensating physicians. The study also highlights the importance to future NPM researchers of a clear definition of NPMs and the application of that definition consistently throughout a given study. In addition, it is conceivable that the variables the EKNP study uses as moderators of the pay-for-performance relation might also moderate pay-for-complexity and pay-for-size relations. Finally, a further path forward from the study’s context is that physician attributes, which can be measured in creative ways, likely affect physician compensation.
Item generation and design testing of a questionnaire to assess degenerative joint disease–associated pain in cats
Authors: Zamprogno Helia , Hansen Bernie D. , Bondell Howard D. , Sumrell Andrea Thomson , Simpson Wendy , Robertson Ian D. , Brown James , Pease Anthony P. , Roe Simon C. , Hardie Elizabeth M. , Wheeler Simon J. , Lascelles B. Duncan X.
Published: December 2010

Objective—To determine the items (question topics) for a subjective instrument to assess degenerative joint disease (DJD)–associated chronic pain in cats and determine the instrument design most appropriate for use by cat owners.

Animals—100 randomly selected client-owned cats from 6 months to 20 years old.

Procedures—Cats were evaluated to determine degree of radiographic DJD and signs of pain throughout the skeletal system. Two groups were identified: high DJD pain and low DJD pain. Owner-answered questions about activity and signs of pain were compared between the 2 groups to define items relating to chronic DJD pain. Interviews with 45 cat owners were performed to generate items. Fifty-three cat owners who had not been involved in any other part of the study, 19 veterinarians, and 2 statisticians assessed 6 preliminary instrument designs.

Results—22 cats were selected for each group; 19 important items were identified, resulting in 12 potential items for the instrument; and 3 additional items were identified from owner interviews. Owners and veterinarians selected a 5-point descriptive instrument design over 11-point or visual analogue scale formats.

Conclusions and Clinical Relevance—Behaviors relating to activity were substantially different between healthy cats and cats with signs of DJD-associated pain. Fifteen items were identified as being potentially useful, and the preferred instrument design was identified. This information could be used to construct an owner-based questionnaire to assess feline DJD-associated pain. Once validated, such a questionnaire would assist in evaluating potential analgesic treatments for these patients.
Evaluation of an in vitro telomeric repeat amplification protocol assay to detect telomerase activity in canine urine
Authors: McCleary-Wheeler Angela L. , Williams Laurel E. , Hess Paul R. , Suter Steven E.
Published: December 2010

Objective—To evaluate the usefulness of a PCR-based telomeric repeat amplification protocol (TRAP) assay for detecting telomerase activity in cells from a canine transitional cell carcinoma (TCC) cell line and, ultimately, in the urine of dogs with TCC.

Animals—11 dogs with histologic or cytologic evidence of TCC, 10 dogs with benign lower urinary tract disease, and 9 healthy dogs.

Procedures—Telomerase activity was initially evaluated in cells from canine TCC (K9TCC) and telomerase-negative (WI-38) cell lines. Following assay optimization, telomerase stability was evaluated at various storage durations and temperatures. Urine samples were then obtained prospectively from study dogs.

Results—Telomerase activity was detected in the K9TCC cell line. The TRAP assay detected telomerase activity in as few as 10 K9TCC cells alone and as low as 2% of a total cell population in K9TCC and WI-38 mixing experiments. A loss of telomerase activity was detected with increasing urine storage durations at various temperatures. Telomerase activity was clearly detected in samples collected from 10 of 11 dogs with TCC, 2 of 10 dogs with benign lower urinary tract disease, and none of the 9 healthy dogs.

Conclusions and Clinical Relevance—The TRAP-based assay detected telomerase activity in the canine TCC cell line and revealed that the telomerase ribonucleoprotein complex was inherently unstable at various storage durations and conditions. Telomerase activity was also detectable in urine samples obtained from dogs with TCC, which suggested the TRAP assay may be useful in diagnosing TCC in dogs.
Diurnal hormonal responses in exercise and sports medicine research: range effect adjustments
Authors: Hackney Anthony
Published: November 2010

Diurnal hormonal responses in exercise and sports medicine research: range effect adjustments

The paper discusses the means in which exercise hormonal data are transformed and expressed as a way to deal with the inherent variability in endocrine measurements. Specifically, the aim of the paper is to present an alterative transformation adjustment method for expressing the exercise responses of hormones, especially those which exhibit a diurnal behaviour in their circulating concentrations. The suggested alterative adjustment method attempts to account for the influence of the "range effect" on diurnal hormonal data and the subsequent effects it may have on statistical, and perhaps physiological, outcomes and data interpretation.
Treatment of Recurrent Sinonasal Polyposis with Steroid-Infused Carboxymethylcellulose Foam
Authors: Pletcher Steven D. , Goldberg Andrew N.
Published: November 2010

Background

Recurrence of sinonasal polyposis after endoscopic sinus surgery can be difficult to manage. Topical steroid sprays and irrigations may not provide adequate treatment and systemic steroid therapy is limited by side effects. This study was designed to evaluate the efficacy of steroid-infused carboxymethylcellulose (CMC) foam as a treatment for recurrence of chronic rhinosinusitis with nasal polyposis after endoscopic sinus surgery.

Methods

A prospective cohort study was performed enrolling patients with recurrent sinonasal polyposis after endoscopic sinus surgery. All patients had development of symptomatic polyp disease despite aggressive postoperative topical steroid treatment. The study treatment entailed endoscopic placement of 4 mL of CMC foam hydrated with triamcinolone, 40 mg/mL (Kenalog 40; Bristol-Myers Squibb, New York, NY), into the ethmoid cavities bilaterally. Patients were evaluated using videoendoscopy and the Sino-Nasal Outcomes Test 20 (SNOT-20) at three time points: immediately before treatment, 7–14 days after treatment, and 28–35 days after treatment. The videoendoscopies were randomized and scored in a blinded fashion using a modification of the perioperative sinus endoscopy (POSE) scoring system.

Results

Ten treatments were performed in eight patients; two patients underwent two treatments each. Mean SNOT-20 score improved at both 1 week and 1 month after treatment (2.44 versus 1.65, p < 0.05, and 2.44 versus 1.36, p < 0.01, respectively). Videoendoscopy also revealed improvement when evaluated with the modified POSE score at 1 week (11.8 versus 8.2, p < 0.001), and 1 month (11.8 versus 7.9, p < 0.001).

Conclusion

Endoscopic placement of steroid-infused CMC foam improves symptoms and endoscopic findings in patients with recurrent sinonasal polyposis after endoscopic sinus surgery.
Endonasal Endoscopic Medial Maxillectomy with Preservation of the Inferior Turbinate
Authors: Weber Rainer K. , Werner Jochen A. , Hildenbrand Tanja
Published: November 2010

Background

Endonasal endoscopic medial maxillectomy usually includes removal of the inferior turbinate (IT) even if it is not involved in the disease. A surgical approach is presented in which the IT is temporarily excised and then reinserted, followed by postoperative occlusion of the nose for at least 2 weeks.

Methods

A retrospective case series of 12 patients with inverted papilloma (IP) of the maxillary sinus (Krouse II–III) and 2 patients with 3 mucoceles of the maxillary sinus after a Caldwell-Luc operation were reviewed. After a follow-up period of 12–80 months (28 months on average) all patients underwent endoscopy, and in four cases, additionally, an MRI was performed.

Results

There was no recurrence of tumor or mucocele after 12–80 months. The IT and its important function for warming and humidifying the inhaled air could be preserved up to now in all 15 operated sides. The patients did not have any specific pain postoperatively and there was no postoperative bleeding. They all tolerated occlusion for 2–4 weeks. Two patients developed mucoceles due to the formation of scar tissue after endonasal tumor surgery. In three cases of endonasal endoscopic Denker operation patients reported some degree of numbness or irritation of the ipsilateral frontal teeth.

Conclusion

The IT can be preserved in endonasal endoscopic medial maxillectomy for treatment of IP without a higher incidence of tumor recurrence. Aftercare should specifically focus on preventing the development of mucoceles caused by scarring.
Does Maxillary Arch Remodeling Exist in Nasal Polyposis?
Authors: Gunhan Kivanc , Can Fatma , Uz Uzdan , Serter Selim , Unlu Halis
Published: November 2010

Background

The potential transformation in the maxillary complex morphology is mostly complete during childhood. Recent studies suggest a nasal tissue remodeling both in the overlying mucosa and in the underlying sinus bone in nasal polyposis (NP). Our evaluation of computed tomography (CT) revealed that the maxillary arch is more flat and shallow in patients with chronic rhinosinusitis with NP. The purpose of this study was to determine the possible effects of NP to the maxillary arch morphology in adulthood and to investigate a possible remodeling of the maxillary bone during the course of NP.

Methods

A prospective study was performed on 25 patients. Grading of the polyps, acoustic rhinometry and rhinomanometry assessments, and CT scans were documented initially, 1 year after diagnosis, and 2 years postoperatively. Twenty-five subjects’ CT scans randomly selected from our CT database formed the comparison group. The plane angle between the maxillary alveolar processes (MAP) and the palatine process of the maxillary bone (MPP), and the depth of the maxillary arch of both groups were compared.

Results

The results pointed out that the maxillary arch was shallower and the bilateral angles between MAP and MPP were significantly greater than those of the comparison group in all evaluation periods. This difference was less at the end of the postoperative follow-up period.

Conclusion

Although it is a common belief that maxillofacial formation expires in childhood, this may not be the case under some special conditions such as NP in adulthood. NP might cause maxillary arch remodeling in adults.
Rhinolithiasis: Review of 21 Cases
Authors: Özdemir Süleyman , Akbas Yücel , Görgülü Orhan , Selçuk Tahsin , Sayar Çağdas
Published: November 2010

Background

Rhinolithiasis is masses that result from the deposition of salts around an intranasal foreign body. Rhinoliths are rare and rhinolithiasis is generally reported in the literature in single case studies. This study presents 21 cases of rhinolithiasis with a large series of clinical findings, diagnosis, and treatment.

Methods

A total of 21 patients diagnosed with rhinolithiasis were identified. Clinical presentations, signs, and symptoms of the patients with radiological findings are presented, and x-ray diffraction analyses of three of the removed rhinoliths were performed to assess their mineralogical composition.

Results

A total of 21 patients (9 male and 12 female patients; age range, 4–63 years) diagnosed with rhinolithiasis were reviewed in this study. The most common symptoms were noted as purulent rhinorrhea and nasal obstruction. The other symptoms were headache, oral malodor, and recurrent epistaxis. Nasal endoscopic examination was used for diagnosis of all patients. Endoscopic nasal examinations and computerized tomography (CT) findings revealed that rhinolithiasis was accompanied by sinusitis, chronic vestibulitis, allergic rhinitis, septum deviation, and squamous cell carcinoma. Rhinoliths were fully excised by using endoscopic nasal surgery. Mineralogical analyses of the three removed stones revealed dahllite [Ca5(PO4, CO3)3OH].

Conclusion

Cases of rhinolithiasis are seen rarely. It should always be considered in patients complaining from long-term unilateral nasal obstruction and unilateral purulent rhinorrhea. The treatment involves the removal of the rhinolith and the use of appropriate antibiotic therapy to control local infection. Rigid nasal endoscopy is the most important method to be used in diagnosis and treatment.
Goodness of Fit and Misspecification in Quantile Regressions
Authors: Furno Marilena
Published: December 2010

The article considers a test of specification for quantile regressions. The test relies on the increase of the objective function and the worsening of the fit when unnecessary constraints are imposed. It compares the objective functions of restricted and unrestricted models and, in its different formulations, it verifies (a) forecast ability, (b) structural breaks, and (c) exclusion restrictions. The quantile-based tests are more informative than their ordinary least squares (OLS) analogues because they allow to analyze the model not only at the center but also in the tails of the conditional distribution. In this example, contrarily to the OLS findings, the quantile-based test uncovers in (a) the forecast weakness of the selected model at the upper quantile; (b) a break occurring in the tails and not in the center of the conditional distribution; and (c) that the excluded variable has a relevant impact at the upper quantile. Monte Carlo experiments analyze the behavior of the different definitions of the test with non-normal errors, comparing least squares and quantile regression results.
Outcomes of an Early Intervention Program for Children with Disruptive Behaviour
Authors: Hayes Louise , Giallo Rebecca , Richardson Kate
Published: November 2010

Objective: Outcomes are presented from a public mental health early intervention program for children aged 5–9 years with disruptive behaviours.

Method: This was a school-based intervention initiative, delivered within a psychiatric child and adolescent mental health service and includes child, parent and teacher components. Participants were 235 children selected via school-based population assessments.

Results: A baseline period was used as a form of control that would demonstrate the stability of problem behaviours. Results showed that during a 26-week baseline period, teachers reported increasing levels of problem behaviour, and that the behaviour was creating increased difficulty in the classroom. The shorter 7-week baseline also showed the difficult behaviours were ongoing. Following the intervention, significant improvements in children's behaviour were seen on the Strengths and Difficulties Questionnaire reported by parents (η2 = 0.30) and teachers (η2 = 0.23), and on the parent Eyberg Child Behaviour Inventory (η2 = 0.35), and teacher Sutter-Eyberg Student Behaviour Inventory (η2 = 0.22).

Conclusion: The outcomes show promising results from an early intervention program delivered in schools by a public mental health service and are discussed within the context of dissemination of evidence-based programs though mental health services.
Missed Diagnosis of Autism in an Australian Indigenous Psychiatric Population
Authors: Roy Meera , Balaratnasingam Sivasankaran
Published: November 2010

Objective: The aim of this paper is to review the diagnosis among adult Indigenous patients from the Kimberley region of Western Australia who had an existing diagnosis of schizophrenia. A visit from a psychiatrist specializing in intellectual disability provided the opportunity for conducting psychiatric assessments from a developmental perspective.

Method: Selected patients with schizophrenia were assessed from an intellectual disability perspective from an active case load of 215 patients.

Result: Thirteen out of 14 selected patients were considered to have a diagnosis of autism when a developmental history was undertaken. Case studies are presented to illustrate the overlap in symptoms and potential for the diagnosis of autism to be missed.

Conclusions: Autism spectrum disorders may be missed in Indigenous population groups. This has implications for treatment and service provision. Clinicians need to be mindful of the diagnostic possibility that an autism spectrum disorder might be masquerading as schizophrenia in the context of intellectual disability and atypical presentation.
A Partnership Evaluation: Public Mental Health and Dental Services
Authors: Wieland Beth , Lau Geoffrey , Seifert Dianne , Siskind Dan
Published: November 2010

Objective: This study evaluates the partnership between a mental health service and a public dental hospital in providing timely and efficient access to dentistry to patients with a mental illness. In addition, the factors that contributed to the sustainability of the partnership were examined.

Method: The partnership was appraised using a survey-based evaluation with 20 patients, 43 community mental health staff and 14 dental staff, and focus groups with mental health and dental staff.

Results: The partnership between the services is the key element to the success of improving access to dental services for patients. Overall feedback received from mental health staff highlighted the importance of the partnership and its role in meeting the oral health needs of patients. Generally, patients were satisfied with the treatment they received and valued the dental service. Results highlighted an ongoing problem of poor dietary and lifestyle choices. Dental staff felt that mental health patients were less likely to take care of their teeth and were more likely to cancel appointments. Dental staff also acknowledged frustration with patients with a mental illness not attending appointments or following through with a recommended course of treatment.

Conclusions: The partnership with the local dental hospital has created a sustainable way to ensure improved dental health outcomes for patients of mental health services. This partnership has led to increased access to dental services and improved follow-up.
How to Tackle a Giant: Creating a Genuine Evaluation of the Better Access Program
Authors: Rosenberg Sebastian , Hickie Ian
Published: November 2010

Objective: This paper proposes a framework for a systematic evaluation of the Better Access Program, the largest single component of mental health reform announced under the Council of Australian Governments National Action Plan on Mental Health 2006–11.

Method: The article explores the genesis of the Program and considers extant data sets and information available with which to establish the impact of the Program on consumers and service providers.

Results: There are useful data available in Australia from which to derive pre- and post-implementation analysis about the impact of the Better Access Program. There is doubt as to whether these data form part of the Federal Government's current approach to evaluation of the Program.

Conclusions: Anything less than a genuine and comprehensive evaluation will leave Australia unable to assess the real impact of the Better Access Program. The merit of further expenditure in the vital area of primary mental health care will be in doubt as a consequence.
Cervicothoracic junction kyphosis: surgical reconstruction with pedicle subtraction osteotomy and Smith-Petersen osteotomy
Authors: Samudrala Srinath , Vaynman Shoshanna , Thiayananthan Ty , Ghostine Samer , Bergey Darren L. , Anand Neel , Pashman Robert S. , Johnson J. Patrick
Published: December 2010

Object

Sagittal plane deformities can be subdivided into kyphotic and lordotic forms and further characterized according to their global or regional (focal) presentation. Regional deformities of a significant magnitude constitute a gibbous deformity. Pedicle subtraction osteotomy (PSO) and interlaminar Smith-Petersen osteotomies have been used to correct sagittal plane deformities in the cervical, thoracic, and lumbar spine. By resecting a portion of the vertebral body and closing in the gap of this vertebra, the spine is placed in local lordosis and kyphosis is corrected. These osteotomies have generally been carried out in the lumbar or less frequently in the thoracic area. While PSO has been performed in the mid and lower thoracic spine, there have been no case series of patients undergoing PSO at the CTJ. Specifically, a PSO approach that addresses the challenges of the CTJ is needed. Here, the authors review their case series of PSOs performed in the CTJ. Their goal in the treatment of these patients was to correct the regional CTJ kyphosis, restore forward gaze, and reduce the pain associated with the deformity.

Methods

Eight patients (5 males and 3 females, mean age 63 years) underwent PSO for the correction of CTJ kyphosis. Pedicle subtraction osteotomy was performed at C-7 or the upper thoracic vertebrae and was facilitated by a computer-guided intraoperative monitoring system. Surgical indications included postlaminectomy kyphosis, spinal cord tumor resection, posttraumatic kyphosis, and degenerative cervical spondylosis.

Results

The mean follow-up was 15.3 months (range 12–20 months), and the mean preoperative CTJ kyphosis was 38.67° (range 25°–60°). Clinically satisfactory correction of the regional deformity was accomplished in all patients, achieving a mean correction of 35.63° (range 15°–66°) at the CTJ, with restoration of forward gaze and significant reduction in pain.

Conclusions

A CTJ deformity is a distinctive form of kyphosis that presents as a variable local deformity and requires complex spinal reconstructive techniques to restore sagittal balance and forward gaze. Pedicle subtraction osteotomy allows for significant correction through one spinal segment, and it can be used safely to correct the regional sagittal alignment of the cervical spine and head in relation to the pelvis. Pedicle subtraction osteotomy can be used alone or in combination with other techniques as some patients may require multistage procedures with anterior and posterior spinal reconstruction to obtain stable sagittal correction. All deformities in these patients were kyphotic in nature with only mild elements of scoliosis or coronal plane deformity. This is unlike lumbar and thoracic curves where the kyphosis is frequently associated with scoliosis.