bluuebunny/crossref_metadata_2025 huggingface dataset:
"Learning the Lessons - Retrospective HAZOPs"
Authors: Herbert Ian L
Published: September 2011

This paper provides operators of up-stream oil and gas assets an over view of some of the lessons leant from a range of retrospective full Hazard and operability studies (HAZOPs).

The Baker report into the Texas City incident highlighted the need for robust Process Hazard Analysis. This strengthened an already growing understanding for the need to re-validate the hazard identification for existing assets. HAZOP is recognized as a systematic methodology for the identification and initial assessment of process hazards. As a result full retrospective HAZOPs have now been undertaken for a number of upstream oil and gas facilities over the past few years. This paper aims to share the learning from these retrospective HAZOPs of existing installations. Key areas are a) How to do it better: taking into consideration that HAZOP fits into a wider Process Safety Structure, need for plant /process experience, preparation and the raising of recommendations/actions, close out of recommendations/actions, etc and b) Some common themes identified from the HAZOP exercise: such as with, losses in knowledge, flare systems, Level instrumentation, Drainage/effluent systems, utility systems, methanol systems, redundant equipment, MOC failures, reliance on operators and procedure failures, aging equipment (isolation).

This paper also details potential ‘what next’ for PHA Hazard identification, as the effort and commitment to periodic full retrospective HAZOPs is considerable. However, the consequences for organizations in not remaining vigilant on changes to their asset Hazards can be significant.
Oil Field Developments-Long Tie-back Concepts UK Limited
Authors: Rivière L. , Decrin M-K. , Sibaud E. , Anres S.
Published: September 2011

With most of the world’s largest and easiest-to-exploit deepwater oil reservoirs already under development or producing, the industry is now facing new deep offshore challenges: the production of smaller fields that often contain more difficult oils.

The tie-back of new fields to existing facilities can be a viable method for developing such marginal offshore fields, which are often too small to be developed economically on their own.

The use of subsea processing and innovative field architectures as development solutions is fast becoming a reality. Such challenges are already being addressed in the development of certain fields in the Gulf of Mexico (King, Perdido...), Brazil (Marlim, BC-10...) and the Gulf of Guinea (Pazflor). However, long subsea tie-backs come with inherent complications.

The most demanding are the flow assurance issues arising from the different operating regimes, and these may be combined with more viscous fluids and/or reservoirs at low pressure or low temperature.

This paper examines the advantages and limitations of various field architectures that may be considered for long satellite tie-back lengths in deep waters.

The first part addresses production considerations such as turndown, preservation and restart management for each candidate architecture. The impact of tie-back length on operating modes is also evaluated. The second part examines the impact of these operating modes on the receiving facilities.
Reliable LWD Calliper Measurements
Authors: Market Jennifer , Parker Tim
Published: September 2011

While perhaps not so glamorous as other measurements, calliper measurements are nonetheless an essential component of formation evaluation. Not only do we need to know the hole size for environmental corrections to other logs, such as nuclear measurements and sonic dispersion analysis, but an accurate indication of hole shape will tell us much about wellbore stability and mud optimization. For example, an elliptical wellbore can indicate the maximum and minimum stress directions. Hole enlargement/washout can indicate that the mud is too heavy or too reactive with the formation. An under-gauge hole might indicate bit wear. We also need to know the hole size to determine how much cement should be used, which is an important environmental and safety concern.

This paper reviews the physics of LWD hole-size indicators, including ultrasonic, sonic, density, and resistivity tools. Design aspects, such as transducer geometry and processing techniques to determine standoff, hole size, hole shape, and tool position, will be considered. Operational factors, such as tool centralization, mud density, formation velocity, and tool location in the borehole assembly will be discussed. We will also consider what data can be transmitted in real time vs. what is stored in memory. Methods for determining the mud velocity, a critical factor in acoustic calliper measurements, will be considered.

Field examples of ultrasonic, sonic, and density-derived hole size are shown. Finally, we will conclude with a summary of conditions under which callipers can be expected to function well and where they might not as well as techniques to optimize calliper data acquisition.
Learning From Another Industry; Lessons From The International Media
Authors: Kain Andrew
Published: September 2011

When security, political or environmental conditions deter other industries from hostile and inaccessible locations, two sectors can be found staying put or moving in - upstream oil and gas, and the international media. Like the upstream sector, the international media deploys personnel to areas affected by insecurity, political risk and difficult climatic conditions. As we look to secure safe, smart and sustainable supply, the experience of the media offers valuable lessons applicable to the energy industry. In the late 1990s, a major global media company initiated a cultural change within its organisation that has helped to secure its success while protecting its employees. This network maintains the industry benchmark for safety and security, and this cultural revolution has spread organically throughout the wider media sector. Change began with the specific training of broadcast news crews deployed to challenging environments; however, this has since evolved to incorporate early planning for the mitigation of risk and fully integrated, tested crisis management planning. The evolution of security and risk mitigation in the media industry provides a useful case study with which to compare the requirements to safeguard the key asset of the energy sector – its staff – and on a macro level, assist in the ongoing endeavour to secure supply. Currently, the upstream industry is highly regulated for work in the North Sea but little more training or qualifications are required of staff or employers prior to deployment to the Niger Delta or Iraq. Highlighting the similarities between these two industries, this paper examines the background to this organic, dynamic change within the culture of the international media. While there are upstream companies championing the preparation of staff deployed to challenging environments, with such programmes as, risk mitigation and crisis management planning, much can be gleaned from the media, an industry that has learnt the hard way in terms of human, litigation and reputational cost.
Evaluation of Electrical Resistance Probes to Detect Pipeline Erosion and Sand Production in Low Liquid Loading Flow Conditions
Authors: Fan Chenliang , McLaury Brenton S. , Shirazi Siamack A.
Published: September 2011

Erosion arising from sand production is recognized as a significant problem in the oil and gas industry, which can a potential danger for operators and a cause for production downtime. In many offshore production systems, it is crucial to determine which well is producing sand so that preventive measures can be applied to minimize sand production. One type of sand detection equipment that is often used by oil and gas companies is an electrical resistance (ER) probe. ER probes are effective monitoring real-time "metal loss". But, there are many flow conditions for which sand may not be impacting and/or eroding these probes. Temperature changes can also obscure ER probe measurements. In this study, experiments were conducted mainly on a large scale multiphase flow loop utilizing 3-inch and 4-inch test sections under gas dominant low liquid loading conditions. The effects of superficial gas velocity, superficial liquid velocity, sand size, pipe size and flow orientation on erosion were also examined. Additionally, acoustic sand monitor was also used on the flow loop and the results are compared with ER probe data. A model that is developed for temperature compensation of ER probes shows significant promise for improving ER probe data for situations where temperature of the flowing fluid changes significantly. Furtheremore, understanding erosion rates that are measured by ER probes can help engineers determine the appropriate production rate in the field and initiate inspection and operation plans to ensure safety and continuous production.
The Happiness of Single Mothers after Welfare Reform
Authors: Ifcher John
Published: September 2011

U.S. welfare and tax policies targeting single mothers were transformed over a decade ago. What was the impact on single mothers’ happiness? Using data from the General Social Survey, difference in difference estimators are calculated. The results appear to indicate that the package of welfare and tax policy changes increased happiness. The results are largely consistent across three comparison groups and robust to various specification checks. This research nicely complements the literature by examining the impact of the welfare and tax policy changes on a novel outcome measure, self-reported happiness.
Abrogation of MMP-9 Gene Protects Against the Development of Retinopathy in Diabetic Mice by Preventing Mitochondrial Damage
Authors: Kowluru Renu A. , Mohammad Ghulam , dos Santos Julia M. , Zhong Qing
Published: September 2011

OBJECTIVE

In the development of diabetic retinopathy, mitochondrial dysfunction is considered to play an important role in the apoptosis of retinal capillary cells. Diabetes activates matrix metalloproteinase-9 (MMP-9) in the retina and its capillary cells, and activated MMP-9 becomes proapoptotic. The objective of this study is to elucidate the plausible mechanism by which active MMP-9 contributes to the mitochondrial dysfunction in the retina.

RESEARCH DESIGN AND METHODS

Using MMP-9 gene knockout (MMP-KO) mice, we investigated the effect of MMP-9 regulation on diabetes-induced increased retinal capillary cell apoptosis, development of retinopathy, mitochondrial dysfunction and ultrastructure, and mitochondrial DNA (mtDNA) damage. To understand how diabetes increases mitochondrial accumulation of MMP-9, interactions between MMP-9 and chaperone proteins (heat shock protein [Hsp] 70 and Hsp60) were evaluated. The results were confirmed in the retinal mitochondria from human donors with diabetic retinopathy, and in isolated retinal endothelial cells transfected with MMP-9 small interfering RNA (siRNA).

RESULTS

Retinal microvasculature of MMP-KO mice, diabetic for ∼7 months, did not show increased apoptosis and pathology characteristic of retinopathy. In the same MMP-KO diabetic mice, activation of MMP-9 and dysfunction of the mitochondria were prevented, and electron microscopy of the retinal microvasculature region revealed normal mitochondrial matrix and packed lamellar cristae. Damage to mtDNA was protected, and the binding of MMP-9 with Hsp70 or Hsp60 was also normal. As in the retina from wild-type diabetic mice, activation of mitochondrial MMP-9 and alterations in the binding of MMP-9 with chaperone proteins were also observed in the retina from donors with diabetic retinopathy. In endothelial cells transfected with MMP-9 siRNA, high glucose–induced damage to the mitochondria and the chaperone machinery was ameliorated.

CONCLUSIONS

Regulation of activated MMP-9 prevents retinal capillary cells from undergoing apoptosis by protecting mitochondrial ultrastructure and function and preventing mtDNA damage. Thus, MMP-9 inhibitors could have potential therapeutic value in preventing the development of diabetic retinopathy by preventing the continuation of the vicious cycle of mitochondrial damage.
Sensor-Augmented Pump Therapy for A1C Reduction (STAR 3) Study
Authors: Bergenstal Richard M. , Tamborlane William V. , Ahmann Andrew , Buse John B. , Dailey George , Davis Stephen N. , Joyce Carol , Perkins Bruce A. , Welsh John B. , Willi Steven M. , Wood Michael A. ,   for the STAR 3 Study Group
Published: September 2011

OBJECTIVE

To examine the effects of crossing over from optimized multiple daily injection (MDI) therapy to sensor-augmented pump (SAP) therapy for 6 months, and the effects of 18 months’ sustained use of SAP.

RESEARCH DESIGN AND METHODS

The 6-month, single-crossover continuation phase of Sensor-Augmented Pump Therapy for A1C Reduction (STAR 3) provided SAP therapy to 420 subjects who completed the 1-year randomized study. The primary outcome was change in A1C in the crossover group.

RESULTS

A1C values were initially lower in the continuing-SAP group than in the crossover group (7.4 vs. 8.0%, P < 0.001). A1C values remained reduced in the SAP group. After 3 months on the SAP system, A1C decreased to 7.6% in the crossover group (P < 0.001); this was a significant and sustained decrease among both adults and children (P < 0.05).

CONCLUSIONS

Switching from optimized MDI to SAP therapy allowed for rapid and safe A1C reductions. Glycemic benefits of SAP therapy persist for at least 18 months.
On the applicability of post-IR IRSL dating to Japanese loess
Authors: Thiel Christine , Buylaert Jan-Pieter , Murray Andrew , Tsukamoto Sumiko
Published: September 2011

Recent work on infrared stimulated luminescence (IRSL) dating has focussed on finding and testing signals which show less or negligible fading. IRSL signals measured at elevated temperature following IR stimulation at 50°C (post-IR IRSL) have been shown to be much more stable than the low temperature IRSL signal and seem to have considerable potential for dating. For Early Pleistocene samples of both European and Chinese loess natural post-IR IRSL signals lying in the saturation region of the laboratory dose response curve have been observed; this suggests that there is no significant fading in nature. As a contribution to the further testing of post-IR IRSL dating, we have used 18 samples from two Japanese loess profiles for which quartz OSL and tephra ages up to 600 ka provide age control. After a preheat of 320°C (60 s), the polymineral fine grains (4–11 μm) were bleached with IR at 50°C (200 s) and the IRSL was subsequently measured at 290°C for 200 s. In general, the fading uncorrected post-IR IRSL ages agree with both the quartz OSL and the tephra ages. We conclude that the post-IR IRSL signal from these samples does not fade significantly and allows precise and accurate age determinations on these sediments.
Constraints on the precision of SAR in equivalent dose estimations close to saturation in quartz
Authors: Athanassas Constantin
Published: September 2011

Difficulties in evaluating accurate equivalent doses for Late Quaternary sediments from the south coasts of Greece arose in the course of SAR measurements. Large scatter among apparent equivalent doses perplexed the evaluation of accurate mean estimates in circumstances where very large doses were involved. Besides, dose recovery experiments revealed that when intersection of the natural signal occurs onto the saturating segment of the growth curve, a distinct relationship between De and growth curve shape occurs. At very low slope angles, SAR tends to overestimate the recovered dose. The mechanism which controls the spread in equivalent dose estimation is investigated.
JAPANESE GARDENS OUTSIDE OF JAPAN: FROM THE EXPORT OF ART TO THE ART OF EXPORT
Authors: Stauskis Gintaras
Published: September 2011

Since the 19th century, a Japanese garden as a cultural phenomenon with a millennium-old history of religion and philosophy-based landscaping art has been exported to different regions of the globe and built in countries far from the land of its origin. The article focuses on two aspects of Japanese gardens: the basic and more specific principles of planning and design of a traditional Japanese garden, and the related discourse of a tradition of exporting its planning and design cultural tradition outside of Japan. Based on analysed international examples of Japanese-style gardens, the specific traits of planning the landscape of these gardens were identified. The narrative of multiple psycho-emotional effects that these gardens have on their users and visitors is disclosed in correlation with the specific aspects of their planning and design. The culture of exporting a Japanese garden tradition overseas is discussed and the important principles for introducing a Japanese garden to a remote cultural context are spotlighted. The concluding remarks on the user-oriented culture of exporting a Japanese garden as a complete planning and design system of landscape architecture, reflect author’s aspiration to open a wider cross-professional discussion and research on the topic.

Santrauka

Japonijos sodai – tai tūkstantmetes tradicijas turintis filosofija ir religija grįstas kraštovaizdžio architektūros kultūrinis reiškinys, kurio pavyzdžiai nuo XIX a. yra eksportuojami ir įrengiami skirtinguose pasaulio regionuose. Kraštovaizdžio architektūros požiūriu straipsnyje nagrinėjami du Japonijos sodų aspektai: esminiai šių sodų suplanavimo ir įrengimo principai bei specifiniai bruožai, taip pat Japonijos sodų meninės tradicijos eksporto ir sklaidos užsienyje klausimai. Visame pasaulyje garsių Japonijos sodų pavyzdžių apžvalga ir pasirinktų Baltijos jūros regiono pavyzdžių tyrimas atskleidžia esminius šių sodų suplanavimo principus, kurie sietini su lankytojams formuojamu psichologiniu emociniu poveikiu. Aptariant Japonijos sodų eksporto į kitus etninius ir geografinius regionus klausimus iškeliama jų integravimo į skirtingą kultūrinį kontekstą problema. Straipsnis apibendrinamas baigiamosiomis nuostatomis, kurios apibrėžia tolesnio Japonijos sodų meno diskurso lauką nuo vartotojo poreikių iki vientisos kraštovaizdžio sistemos eksporto galimybių, išreiškia autoriaus siekį atverti šia tema platesnį tyrimų ir diskusijų lauką.
Business history and family capitalism in Italy: new challenges for researchers
Authors: Segreto Luciano
Published: September 2011

Résumé L’histoire des entreprises pratiquée en Italie a longtemps été considérée comme une des plus riches et des plus fructueuses à l’échelle internationale. Cet article analyse les facteurs sociaux et intellectuels qui ont permis à une jeune génération d’historiens économistes du contemporain de conquérir dans les années 1970 et 1980 ce territoire nouveau pour l’historiographie italienne. L’ouverture croissante des archives des banques et des entreprises publiques, rendue possible par la convergence de différents groupes de pression (historiens contemporanéistes, services de l’administration chargés à différents niveaux de superviser et contrôler la politique des archives), a fourni l’occasion de lancer beaucoup de projets de recherche importants en histoire des entreprises (réunissant dans certains cas plusieurs dizaines de chercheurs). Une fois réalisée la première vague de travaux, il devint plus difficile de continuer dans la même voie. En effet, les archives de certains grands groupes industriels ou financiers sont encore fermées ou difficiles d’accès, tandis que les changements importants de la structure économique de l’Italie depuis 30 ans, avec le rôle accru des PME, surtout des firmes familiales, et la réticence culturelle de leurs propriétaires à garder ou à ouvrir les archives de la famille réduisent les possibilités de comprendre et d’expliquer à fond les tendances nouvelles des entreprises italiennes. Des défis inédits attendent la nouvelle génération des historiens italiens des entreprises, qui seront probablement contraints de recourir de plus en plus à des sources alternatives pour leurs recherches. Les premiers résultats sont prometteurs, et paraissent à même de confirmer le rôle pionnier des Italiens parmi les historiens des entreprises du temps présent.
Le Sahara entre espace de circulation et frontière migratoire de l'Europe
Authors: Brachet Julien , Choplin Armelle , Pliez Olivier
Published: September 2011

Les migrations internationales au Sahara représentent aujourd’hui un enjeu central des relations géopolitiques entre les États d’Afrique subsaharienne, d’Afrique du Nord et d’Europe. Elles ne constituent pas un phénomène nouveau puisque dès le milieu du XX e siècle des ressortissants des États sahéliens se rendaient au Maghreb pour y travailler, ces mobilités se réalisant en étroite relation avec la mise en valeur du Sahara. Pourtant, depuis le début des années 2000, la médiatisation des migrations à destination de l’Europe, très minoritaires au regard de l’ensemble des flux, a radicalement changé la donne. Chaque migrant de la région est suspecté d’être un « clandestin en transit vers l’Europe ». Les politiques migratoires depuis lors mises en œuvre dans les régions sahariennes perturbent l’ensemble des mobilités dans cet espace en passe de devenir une nouvelle frontière migratoire de l’Europe.
Corps, corps propre et affectivité de l'homme.
Authors: Novotný Karel , Bernard Marion
Published: September 2011

Il s’agit d’esquisser les réflexions de Jan Patočka sur la corporéité de l’homme qui deviennent centrales dans son oeuvre au cours des années soixante. L’article s’y attache en trois parties, distinguant les différents plans de réflexion du mode d’être originaire de l’homme dans le monde en tant qu’horizon ultime de sa pensée, où notamment le corps, le corps propre et l’affectivité peuvent être considérés comme les fonctions et conditions essentielles de l’existence humaine.
Acid Sphingomyelinase Is Required for Protection of Effector Memory T Cells against Glucocorticoid-Induced Cell Death
Authors: Tischner Denise , Theiss Jennifer , Karabinskaya Anna , van den Brandt Jens , Reichardt Sybille D. , Karow Ulrike , Herold Marco J. , Lühder Fred , Utermöhlen Olaf , Reichardt Holger M.
Published: September 2011

The activity of acid sphingomyelinase (aSMase) was previously reported to be involved in glucocorticoid-induced cell death (GICD) of T lymphocytes. This mechanism in turn is believed to contribute to the therapeutic efficacy of glucocorticoids (GCs) in the treatment of inflammatory diseases. In this study, we reassessed the role of aSMase in GICD by using aSMase knockout mice. The absence of aSMase largely abolished the partial protection that effector memory CD4+ T cells in wild-type mice possess against GICD. Reduced IL-2 secretion by aSMase-deficient CD4+ T cells suggested that a lack of this important survival factor might be the cause of these cells’ enhanced susceptibility to GICD. Indeed, addition of IL-2 restored the protection against GICD, whereas neutralization of IL-2 abrogated the otherwise protective effect seen in wild-type effector memory CD4+ T cells. The therapeutic implications of the altered sensitivity of aSMase-deficient T cells to GICD were assessed in models of inflammatory disorders; namely, experimental autoimmune encephalomyelitis and acute graft-versus-host disease. Surprisingly, GC treatment was equally efficient in both models in terms of ameliorating the diseases, regardless of the genotype of the T cells. Thus, our data reveal a hitherto unrecognized contribution of aSMase to the sensitivity of effector memory CD4+ T cells to GICD and call into question the traditionally attributed importance of GICD of T cells to the treatment of inflammatory diseases by GCs.
Cutting Edge: Expression of XCR1 Defines Mouse Lymphoid-Tissue Resident and Migratory Dendritic Cells of the CD8α+ Type
Authors: Crozat Karine , Tamoutounour Samira , Vu Manh Thien-Phong , Fossum Even , Luche Hervé , Ardouin Laurence , Guilliams Martin , Azukizawa Hiroaki , Bogen Bjarne , Malissen Bernard , Henri Sandrine , Dalod Marc
Published: September 2011

Subsets of dendritic cells (DCs) have been described according to their functions and anatomical locations. Conventional DC subsets are defined by reciprocal expression of CD11b and CD8α in lymphoid tissues (LT), and of CD11b and CD103 in non-LT (NLT). Spleen CD8α+ and dermal CD103+ DCs share a high efficiency for Ag cross-presentation and a developmental dependency on specific transcription factors. However, it is not known whether all NLT-derived CD103+ DCs and LT-resident CD8α+ DCs are similar despite their different anatomical locations. XCR1 was previously described as exclusively expressed on mouse spleen CD8α+ DCs and human blood BDCA3+ DCs. In this article, we showed that LT-resident CD8α+ DCs and NLT-derived CD103+ DCs specifically express XCR1 and are characterized by a unique transcriptional fingerprint, irrespective of their tissue of origin. Therefore, CD8α+ DCs and CD103+ DCs belong to a common DC subset which is unequivocally identified by XCR1 expression throughout the body.
Three Supernumerary Marker Chromosomes in a Patient with Developmental Delay, Mental Retardation, and Dysmorphic Features
Authors: Hu Jie , Madan-Khetarpal Suneeta , Serrano Russi Alvaro H. , Kochmar Sally , DeWard Stephanie J. , Sathanoori Malini , Surti Urvashi
Published: September 2011

We characterized three supernumerary marker chromosomes (SMCs) simultaneously present in a 2-year- and 10-month-old male patient with mental retardation and dysmorphic features. Peripheral blood chromosome analysis revealed two to three SMCs in 25/26 cells analyzed. The remaining one cell had one SMC. Microarray comparative genomic hybridization (aCGH) showed mosaicism for gains of 5q35.3, 15q11.2q13.3, and 18p11.21q11.1 regions. All three gains contain multiple OMIM genes. FISH studies indicated that one of the SMCs is a dicentric ring 15 with two copies of the 15q11.2q13.3 region including SNRPN/UBE3A and two copies of the 5q35.3 region. One of the der(18)s contains the 18 centromere and 18p11.2 regions, while the other der(18) has a signal for the 18 centromere only. The phenotype of the patient is compared with that of patients with tetrasomy 15q11.2q13.3, trisomy 5q35.3, and trisomy 18p11.2. Our study demonstrates that aCGH and FISH analyses are powerful tools, which complement the conventional cytogenetic analysis for the identification of SMCs.
Embryonic Stem Cell-Derived Cardiomyocyte Heterogeneity and the Isolation of Immature and Committed Cells for Cardiac Remodeling and Regeneration
Authors: Boheler Kenneth R. , Joodi Robert N. , Qiao Hui , Juhasz Ondrej , Urick Amanda L. , Chuppa Sandra L. , Gundry Rebekah L. , Wersto Robert P. , Zhou Rong
Published: September 2011

Pluripotent stem cells represent one promising source for cell replacement therapy in heart, but differentiating embryonic stem cell-derived cardiomyocytes (ESC-CMs) are highly heterogeneous and show a variety of maturation states. In this study, we employed an ESC clonal line that contains a cardiac-restrictedncx1promoter-driven puromycin resistance cassette together with a mass culture system to isolate ESC-CMs that display traits characteristic of very immature CMs. The cells display properties of proliferation, CM-restricted markers, reduced mitochondrial mass, and hypoxia-resistance. Following transplantation into rodent hearts, bioluminescence imaging revealed that immature cells, but not more mature CMs, survived for at least one month following injection. These data and comparisons with more mature cells lead us to conclude that immature hypoxia resistant ESC-CMs can be isolated in mass in vitro and, following injection into heart, form grafts that may mediate long-term recovery of global and regional myocardial contractile function following infarction.
A study of drug-drug interactions in cancer patients of a south Indian tertiary care teaching hospital
Authors: Kannan G , Anitha R , Rani Vanitha N , Thennarasu P , Alosh J , Vasantha J , Martin JR , Uma MRC
Published: September 2011

Background:

Drug interactions in oncology are of particular importance owing to the narrow therapeutic index and the inherent toxicity of anticancer agents. Interactions with other medications can cause small change in pharmacokinetics or pharmacodynamics of chemotherapeutic agents that could significantly alter their safety and efficacy.

Aim:

To identify and document the potential drug-drug interactions in prescriptions of patients receiving cancer chemotherapy.

Settings and Design:

A tertiary care teaching hospital based prospective study.

Materials and Methods:

Patients admitted in the medical oncology wards with different types of malignancies and receiving cancer chemotherapy during the period of June 2009 to November 2009 were included in the study. A detailed data collection was done in a specially designed proforma with ethical approval and consent of patients and their prescriptions were subjected to drug-drug interaction screening using Drug Interaction Fact Software Version-4 and standard references. Incidence of drug-drug interactions, their types, correlation between age, cancer type, number of drugs prescribed and incidence of drug interactions were analyzed.

Statistical Analysis:

Logistic regression analysis and Odds ratio were performed to identify the incidence of drug-drug interactions and their correlation with the factors above mentioned.

Results:

A total of 75 patients (32 males and 43 females; median age 56 years, age range 23-74) were enrolled in the study and their prescriptions were screened. 213 interactions were identified of which, 21 were major, 121 were moderate and 71 were minor. There were 13 (6.1%) clinically significant interactions between anticancer drugs and 14 (6.5%) drug-drug interactions between anticancer drugs and other drugs prescribed for co-morbidities. There was a positive correlation between number of drugs prescribed and drug interactions (P=0.011; OR 0.903).

Conclusion:

Though there was not any life threatening interactions, the potential interactions were brought to the oncologist purview for ensuring patients safety and to avoid undesirable effects.
A framework for healthcare quality improvement in India
Authors: Varkey P , Kollengode A
Published: September 2011

Healthcare in India has been undergoing rapid changes in the last decade. As demand outpaces supply, quality improvement (QI) initiatives and tools can be beneficial to enhance safe, effective, efficient, equitable and timely care. Healthcare quality is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge. This article discusses the framework for QI and reviews the Plan-Do-Study-Act (PDSA), Lean and Six Sigma methodologies, and briefly discusses key patient safety and quality measurement concepts. The PDSA cycle assists in testing the ideas through small tests of change or "pilots". Six Sigma aims at reducing variations in processes, and the Lean methodology predominantly focuses on enhancing process efficiency and eliminating non-value added steps in the process. It is likely that such structured problem solving approaches will provide an objective and systematic method of enhancing quality in healthcare institutions across India. As increasing attention being is paid on enhancing the quality of life through the Quality Council of India and accreditation of hospitals in India through the International Organization for standardization and National Accreditation Board for hospitals and healthcare providers, a focus on QI by institutional leaders and healthcare providers is key to enhancing the safety and quality of healthcare in India. Central to this also will be leadership buy-in, identification of a core faculty or team that will be the initiators of change, a respect for the need for faculty training and education in QI, measurement of issues to identify key priorities to focus on, and enhanced information systems where resources permit the same.
Recent advances in intestinal imaging
Authors: Sinha Rakesh
Published: September 2011

In recent years, advances in scanner technology and competition from other specialties have produced rapid changes in the way the intestines are imaged. MRI and CT scan along with the traditional enteroclysis examination have emerged at the forefront of intestinal imaging. Functional modalities such as diffusion and perfusion imaging are also changing the way tumors and inflammatory bowel diseases are evaluated. CT colonography is now a valid alterative to optical colonoscopy. Contrast-enhanced USG is being used for the assessment of inflammation and post-treatment changes. In this review, recent advances in intestinal imaging are described.
Multidetector CT evaluation of central airways stenoses: Comparison of virtual bronchoscopy, minimal-intensity projection, and multiplanar reformatted images
Authors: Sundarakumar Dinesh K , Bhalla Ashu S , Sharma Raju , Hari Smriti , Guleria Randeep , Khilnani Gopi C
Published: September 2011

Aims: To evaluate the diagnostic utility of virtual bronchoscopy, multiplanar reformatted images, and minimal-intensity projection in assessing airway stenoses. Settings and Design: It was a prospective study involving 150 patients with symptoms of major airway disease. Materials and Methods: Fifty-six patients were selected for analysis based on the detection of major airway lesions on fiber-optic bronchoscopy (FB) or routine axial images. Comparisons were made between axial images, virtual bronchoscopy (VB), minimal-intensity projection (minIP), and multiplanar reformatted (MPR) images using FB as the gold standard. Lesions were evaluated in terms of degree of airway narrowing, distance from carina, length of the narrowed segment and visualization of airway distal to the lesion. Results: MPR images had the highest degree of agreement with FB (Κ = 0.76) in the depiction of degree of narrowing. minIP had the least degree of agreement with FB (Κ = 0.51) in this regard. The distal visualization was best on MPR images (84.2%), followed by axial images (80.7%), whereas FB could visualize the lesions only in 45.4% of the cases. VB had the best agreement with FB in assessing the segment length (Κ = 0.62). Overall there were no statistically significant differences in the measurement of the distance from the carina in the axial, minIP, and MPR images. MPR images had the highest overall degree of confidence, namely, 70.17% (n = 40). Conclusion: Three-dimensional reconstruction techniques were found to improve lesion evaluation compared with axial images alone. The technique of MPR images was the most useful for lesion evaluation and provided additional information useful for surgical and airway interventions in tracheobronchial stenosis. minIP was useful in the overall depiction of airway anatomy.
Case Report: Floating fat globule within an arachnoid cyst
Authors: Sudhir Jayanand , Gopalakrishnan Chittur Viswanathan , Prabhu Sathia , Chinchure Swati
Published: September 2011

Intralesional floating fat globules have been reported in cystic lesions such as teratoma of the ovary and dermoid of the head and neck but not within intracranial lesions. Fat globules dispersed within the subarachnoid space are a known imaging finding of ruptured intracranial dermoid. We report a unique case of an intralesional solitary floating fat globule within a multicompartmental arachnoid cyst, with varying locations on serial imaging. We also put forward a hypothesis for the pathogenesis of fat within an arachnoid cyst. To the best of our knowledge, this is the first such report in the literature.
Testing assumptions of the eukaryotic inhibitor method for investigating interactions between aquatic protozoa and bacteria, applied to marine sediment
Authors: Shimeta Jeff , Cook Perran L.M.
Published: September 2011

Eukaryote‐metabolic inhibitors have been applied in published incubation experiments to inhibit protozoans and infer their impacts on bacteria. This method has been used with water‐column, sedimentary, biofilm, biofilter, soil, groundwater, wastewater, and sludge samples. The approach rests on assumptions that rarely have been tested: 1) the inhibitor is completely effective against all protozoans; 2) the inhibitor has no effects on other eukaryotes in the system (e.g., microalgae, metazoans) that could influence bacterial activity; and 3) the inhibitor has no effect on bacterial activity. We tested these assumptions for 10 inhibitors used in published studies (amphotericin B, anisomycin, colchicine, cycloheximide, cytochalasin B, fumagillin, griseofulvin, neutral red, nystatin, and thiram) and one combination of inhibitors (colchicine + cycloheximide) using marine sedimentary organisms. Only thiram was completely effective against the natural assemblages of ciliates and flagellates. With some inhibitors, partial inhibition of ciliates was followed by regrowth within 6–24 h or a bloom of a resistant species. Most inhibitors also killed infaunal invertebrates. Five inhibitors were further tested for direct effects on bacteria at concentrations that inhibited ciliates. Each inhibitor altered either esterase activity, denitrification, or both. All inhibitors thus violated one or more assumptions of the method. Conclusions in published work that did not demonstrate the validity of all assumptions underlying this method should not be accepted. Any future attempt to use a eukaryotic inhibitor against protozoans must confirm all assumptions of this method for the particular habitat, species, and processes to which the inhibitor will be applied.
Optimized routine flow cytometric enumeration of heterotrophic flagellates using SYBR Green I
Authors: Christaki Urania , Courties Claude , Massana Ramon , Catala Philippe , Lebaron Philippe , Gasol Josep M. , Zubkov Mikhail V.
Published: September 2011

Heterotrophic flagellates (HF) are the major consumers of bacteria in aquatic ecosystems and dominate heterotrophic nanoplankton in numbers and in biomass. A DNA‐staining based flow cytometry (FC) protocol to enumerate HF was described by Zubkov et al. (2007), but has not yet been widely adopted. We tested extensively the method and its limitations using a wide range of sample types and trying several fixation and conservation alternatives. We evaluated simplification of some steps of the method, seeking the best compromise between precision and the quality of distinction of HF from bacteria and phytoplankton in the cytograms. We found that a flow rate of 120–220 µL min−1 without using a syringe‐pump enhanced machine modification, and running times of 8–10 min allowed enumeration of HF even at values below 102 cells mL−1. SYBR Green I, at final concentrations of 1:10000 and a minimum staining time of 10 min at room temperature in the dark, was adequate for staining and detecting HF. No significant differences were found between cell numbers obtained from freshly analyzed samples and those previously frozen in liquid‐N. FC and epifluorescence microscopy (EpiM) were in good agreement and FC yielded lower variability between replicate samples than EpiM. One limitation we encountered was that, in the presence of large bacteria and/or bacterial aggregates, enumeration was difficult. However, in absence of bacterial aggregates samples with Bact/HF ratios > 1000, HF could be well‐enumerated.
Anammox, denitrification and fixed-nitrogen removal in sediments of the Lower St. Lawrence Estuary
Authors: Crowe S. A. , Canfield D. E. , Mucci A. , Sundby B. , Maranger R.
Published: September 2011

Abstract. Incubations of intact sediment cores and sediment slurries reveal that anammox is an important sink for fixed nitrogen in the Lower St. Lawrence Estuary (LSLE), where it occurs at a rate of 5.5 ± 1.7 μmol N m−2 h−1 in the sediment. Anammox is responsible for up to 33% of the total N2 production, and both anammox and denitrification are mostly (>95%) fueled by nitrate and nitrite produced in situ through benthic nitrification. Nitrification accounts for >15% of the benthic oxygen demand and contributes significantly to the development and maintenance of hypoxic conditions in the LSLE. The rate of dissimilatory nitrate reduction to ammonium is three orders of magnitude lower than denitrification and anammox and is therefore insignificant to N-cycling. Tests for NH4+ oxidation by sedimentary Fe(III) and Mn(III/IV), using slurry incubations with N isotope labels, revealed that it does not occur at measurable rates, and we found no evidence for NH4+ oxidation by added Mn(III)-pyrophosphate.
Sub-decadal- to decadal-scale climate cyclicity during the Holsteinian interglacial (MIS 11) evidenced in annually laminated sediments
Authors: Koutsodendris A. , Brauer A. , Pälike H. , Müller U. C. , Dulski P. , Lotter A. F. , Pross J.
Published: September 2011

Abstract. To unravel the short-term climate variability during Marine Isotope Stage (MIS) 11, which represents a close analogue to the Holocene with regard to orbital boundary conditions, we performed microfacies and time series analyses on a ~3200-yr-long record of annually laminated Holsteinian lake sediments from Dethlingen, northern Germany. These biogenic varves comprise two sub-layers: a light sub-layer, which is controlled by spring/summer diatom blooms, and a dark sub-layer consisting mainly of amorphous organic matter and fragmented diatom frustules deposited during autumn/winter. Time series analyses were performed on the thickness of the light and dark sub-layers. Signals exceeding the 95% and 99% confidence levels occur at periods that are near-identical to those known from modern instrumental data and Holocene palaeoclimatic records. Spectral peaks at periods of 90, 25, and 10.5 yr are likely associated with the 88-, 22- and 11-yr solar cycles, respectively. This variability is mainly expressed in the light sub-layer spectra, suggesting solar influence on the palaeoproductivity of the lake. Significant signals at periods between 3 and 5 yr and at ∼6 yr are strongest expressed in the dark sub-layer spectra and may reflect an influence of the El Niño-Southern Oscillation (ENSO) and the North Atlantic Oscillation (NAO) during autumn/winter. Our results suggest that solar forcing and ENSO/NAO-like variability influenced central European climate during MIS 11 similarly to the present interglacial, thus demonstrating the comparability of the two interglacial periods at sub-decadal to decadal timescales.
Total Hip Arthroplasties in young Patients under 50 Years: Limited Evidence for Current Trends. A Descriptive Literature Review
Authors: De Kam Daniël C.J. , Busch Vincent J.J.F. , Veth René P.H. , Schreurs B. Willem
Published: September 2011

We examined all reported outcomes of uncemented and cemented total hip arthroplasty in patients younger than 50 years of age listed in Medline (1966– 1 January 2009) and PubMed, and scrutinised reference lists of relevant papers. In addition, we evaluated relevant data in the Swedish hip arthroplasty register.

109 relevant articles were identified, 37 of which had a mean follow-up longer than 10 years.

Although uncemented implants are widely used in patients under 50 years of age, there are only 2 reports that fulfil the criteria published by the National Institute for Clinical Excellence (NICE) in the United Kingdom (follow-up of >10yrs and survival of ≥90%).

Current trends relating to implant selection remain unsupported by survival data, and additional information about the long-term results of newer implants is essential. As matters stand, the most reliable results relate to cemented implants.
Femoral Neck Narrowing following Hip Resurfacing using Posterior and Ganz Approaches at Two Years
Authors: Deans Victoria M. , Ho Ki Wai K. , Prakash Udai , Parsons Nick , Griffin Damian R. , Foguet Pedro
Published: September 2011

We report a retrospective review of femoral head/neck ratios on post-operative and two year follow-up radiographs following hip resurfacing arthroplasty. The patients were in two matched groups, having had surgery through a posterior approach or via a Ganz trochanteric flip.

There was no significant difference in femoral neck narrowing at follow up between the two surgical approaches. However, we found significant narrowing of the femoral neck in both groups by the time of the two year follow-up radiograph.
A Fluid Mechanical Interpretation of Hysteresis in Rhinomanometry
Authors: Groß T. F. , Peters F.
Published: September 2011

A hysteresis effect in the pressure/flow rate relationship of nasal breathing has frequently been observed in clinical tests and in lab investigations. Explanations that have been given in the literature are missing a fluid mechanic storage effect coming into play in reciprocating flows. This effect depends primarily on the way the rhinomanometric measurements are set up and not so much on the nose flow itself. This is to be shown by calculations and experiments. The experiments are carried out with orifices because they can represent nose flow and are often implemented in rhinomanometric equipment as flow gauges. To mimic reality also a 1 : 1 nose model is used. It is shown where the hysteresis comes from and what the key parameters for its prediction are. With these results hysteresis in nasal breathing appears in a new light.
Cytotoxic Activity of Peripheral Blood Mononuclear Leukocytes, Activated by Interleukin-2/β-Cyclodextrin Nanocomposition against Androgen Receptor-Negative Prostate Cancers
Authors: Anisimova Natalia Yu. , Sosnov Andrey V. , Ustyuzhanina Nadezhda E. , Baronzio Gianfranco , Kiselevsky Mikhail V.
Published: September 2011

Nanocomposition comprised of interleukin-2 in suboptimal noneffective concentration and β-cyclodextrin was studied in vitro. This preparation as well as interleukin-2 in optimal concentration was shown to increase natural killer activity to K-562 cells and cytotoxicity of activated peripheral blood mononuclear cells (PBMCs) against PC-3 and DU 145 cells. At the same time β-cyclodextrin or interleukin-2 in equimolar concentrations did not influence the spontaneous killer activity of PBMC. This combination of cyclodextrin + interleukin-2 led to the decrease of interleukin-2 effective concentration by an order. This phenomenon could be explained by cyclodextrins ability to promote the formation of nanoparticles with drugs, which results in enhancing their water solubility and bioavailability. Besides, interleukine-2/β-cyclodextrin nanocomposition as opposed to interleukin-2 alone led to increasing the number of not only lymphocytes, but also macrophages contained in activated PBMC population. Application of low concentration of interleukin-2 allowing for good clinical efficiency may significantly mitigate the side effects of the drug and enable to develop adoption of immunotherapy for patients with androgen-resistant prostate cancer.
Recent Clinical and Experimental Advances in Atrial Fibrillation
Authors: Miyagawa Shigeru , Sakaguchi Taichi , Nishi Hiroyuki , Yoshikawa Yasushi , Satsuki Fukushima  , Saito Shunsuke , Sawa Yoshiki
Published: September 2011

Atrial fibrillation (AF) is the most common arrhythmia in clinical settings (Fuster et al., 2001), and it is often associated with congestive heart diseases (Issac et al., 2007). Many studies in both laboratory and clinical settings have sought to analyze the mechanisms of AF, develop treatments based on these mechanisms, and examine atrial remodeling in chronic AF. The aim of this paper is to analyze recent findings regarding the atrial remodeling that occurs in AF. In particular, we will describe the electrical and structural changes that involve atrial myocytes and the extracellular matrix. We will also describe the general classification and basic pathophysiology of AF and its surgical treatments.