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Adequate
Kinds of Adequate Terms modified by Adequate Selected AbstractsWithanolides from Withania adpressaHELVETICA CHIMICA ACTA, Issue 2 2007Hasna Abdeljebbar, Lalla Abstract From the leaves of Withania adpressa, a plant endemic to Sahara of Morocco and Algeria, the novel steroidal lactone (22R)-14,,15,,17,,20, -tetrahydroxy-1-oxowitha-2,5,24-trien-26,22-olide (=,(15S,17S)-14,15,17,20-tetrahydroxy-22,26-epoxyergosta-2,5,24-triene-1,26-dione; 1), was isolated, along with three known compounds, withanolides F (2), J (3), and oleanolic acid. Their structures were mainly solved by in-depth 1D- and 2D-NMR (including ADEQUATE) experiments, as well as by HR-MS analyses and chemical evidence. [source] ARE RECENT DEFENCES OF THE BRAIN DEATH CONCEPT ADEQUATE?BIOETHICS, Issue 2 2010ARI JOFFE ABSTRACT Brain death is accepted in most countries as death. The rationales to explain why brain death is death are surprisingly problematic. The standard rationale that in brain death there has been loss of integrative unity of the organism has been shown to be false, and a better rationale has not been clearly articulated. Recent expert defences of the brain death concept are examined in this paper, and are suggested to be inadequate. I argue that, ironically, these defences demonstrate the lack of a defensible rationale for why brain death should be accepted as death itself. If brain death is death, a conceptual rationale for brain death being equivalent to death should be clarified, and this should be done urgently. [source] Relational problems and psychiatric symptoms in couple therapyINTERNATIONAL JOURNAL OF SOCIAL WELFARE, Issue 4 2005Ann-Marie Lundblad This article describes couples attending family counselling in Sweden. The study group is compared with clinical groups and non-clinical groups. Self-rating instruments were com-pleted by 317 women and 312 men to evaluate the following: marital satisfaction (DAS), expressed emotion (QAFM), family climate (FC), psychiatric symptoms (SCL-90) and sense of coherence (SOC). This group had several problems: marital relationships, disrupted family functioning, dyadic interactions characterised by criticism and open arguments, and multiple psychological symptoms. The women were espe-cially discontent in the relationship, and they exhibited higher symptom strain and lower sense of coherence than the men did. Compared with non-clinical populations, this group was severely distressed and was similar to in-patient families in child psychiatric clinics. The low sense of coherence of the individuals in the group under study means that their sense of having a meaningful life and their ability to comprehend and manage problems were severely compromised. Adequate and comprehensive treatment within the framework of social pro-grammes should be made available to these couples and others in a similar situation. [source] Time-course changes in the liver of biliary atresia patients on magnetic resonance imagingPEDIATRICS INTERNATIONAL, Issue 1 2009Atsushi Takahashi Abstract Background:, Using magnetic resonance imaging (MRI), changes in the livers of postoperative biliary atresia (BA) patients were investigated. Methods:, Periodic MRI was performed in 32 postoperative BA patients. The findings were evaluated by calculating the near-normal liver tissue area that corresponded with normal- or high-signal regions on T1-weighted imaging. The patients were divided into three groups based on the extent of near-normal liver tissue on the final MRI: group A, n = 14; group B, n = 13; and group C, n = 5, included patients with >40%, 20,40%, and <20% area of near-normal liver tissue, respectively. The relationship among the macroscopic and histological findings in the liver at orthotopic living donor liver transplantation (OLDLT), patient outcomes, and MRI findings were investigated. Results:, In group A, 11 patients had no evidence of liver dysfunction. In group B, six patients either had undergone or were awaiting OLDLT. In group C, all patients had undergone OLDLT. All patients had either adequate or impaired bile drainage in each liver segment. The segmental changes corresponded with the liver architecture at OLDLT. The changes could be evaluated on MRI at 1,2 years after surgery. Conclusions:, Adequate and restricted areas of liver tissue with near-normal structure were indicative of good and poor prognoses, respectively. Shortly after portoenterostomy, these segmental changes occurred and/or developed in each liver segment and could be detected on MRI. It is emphasized that patients with >40% area of near-normal liver architecture at the initial stages did not require OLDLT, while those with <20% area did require OLDLT. [source] Targeted Tailored Management of the Breast Cancer Patient at Risk for Harboring a Germline Mutation,Current Trends Affecting the Selection of Patients Considering Surgical Prophylaxis for Breast CancerTHE BREAST JOURNAL, Issue 2009Edibaldo Silva MD Abstract:, Recent reports have documented the increasing use of mastectomy in women with breast cancer otherwise amenable to breast conservation. Similarly, other reports document an increase in the number of women undergoing contra-lateral prophylactic mastectomy for a single unilateral breast cancer. These trends are abetted by increasing use of MRI, inadequate risk counseling, and patient fear. Adequate and reliable risk assessment and genetic counseling are indispensable for the appropriate and personalized treatment of these individuals. In all of these instances, such counseling should be instituted well before the patients are submitted to any surgical intervention. An algorithm is presented which permits the orderly selection of patients who may benefit from such aggressive surgical intervention. [source] Rendering natural waters taking fluorescence into accountCOMPUTER ANIMATION AND VIRTUAL WORLDS (PREV: JNL OF VISUALISATION & COMPUTER ANIMATION), Issue 5 2004By E. Cerezo Abstract The aim of the work presented here is to generalize a system, developed to treat general participating media, to make it capable of considering volumetric inelastic processes such as fluorescence. Our system, based on the discrete ordinates method, is adequate to treat a complex participating medium such as natural waters as it is prepared to deal with not only anisotropic but also highly peaked phase functions, as well as to consider the spectral behaviour of the medium's characteristic parameters. It is also able to generate detailed quantitative illumination information, such as the amount of light that reaches the medium boundaries or the amount of light absorbed in each of the medium voxels. First, we present an extended form of the radiative transfer equation to incorporate inelastic volumetric phenomena. Then, we discuss the necessary changes in the general calculation scheme to include inelastic scattering. We have applied all this to consider the most common inelastic effect in natural waters: fluorescence in chlorophyll-a. Copyright © 2004 John Wiley & Sons, Ltd. [source] Effectiveness of Conservation Targets in Capturing Genetic DiversityCONSERVATION BIOLOGY, Issue 1 2003Maile C. Neel We used empirical data from four rare plant taxa to assess these consequences in terms of how well allele numbers ( all alleles and alleles occurring at a frequency openface>0.05 in any population ) and expected heterozygosity are represented when different numbers of populations are conserved. We determined sampling distributions for these three measures of genetic diversity using Monte Carlo methods. We assessed the proportion of alleles included in the number of populations considered adequate for conservation, needed to capture all alleles, and needed to meet an accepted standard of genetic-diversity conservation of having a 90,95% probability of including all common alleles. We also assessed the number of populations necessary to obtain values of heterozygosity within ±10% of the value obtained from all populations. Numbers of alleles were strongly affected by the number of populations sampled. Heterozygosity was only slightly less sensitive to numbers of populations than were alleles. On average, currently advocated conservation intensities represented 67,83% of all alleles and 85,93% of common alleles. The smallest number of populations to include all alleles ranged from 6 to 17 ( 42,57% ), but <0.2% of 1000 samples of these numbers of populations included them all. It was necessary to conserve 16,29 ( 53,93% ) of the sampled populations to meet the standard for common alleles. Between 20% and 64% of populations were needed to reliably represent species-level heterozygosity. Thus, higher percentages of populations are needed than are currently considered adequate to conserve genetic diversity if populations are selected without genetic data. Resumen: Cualquier acción de conservación que preserve algunas poblaciones y no otras tendrá consecuencias genéticas. Utilizamos datos empíricos de cuatro taxones de plantas raras para evaluar estas consecuencias en términos de lo bien representados que están los números de alelos ( todos los alelos ocurriendo a una frecuencia>0.05 en cualquier población ) y la heterocigosidad esperada cuando se conservan diferentes números de poblaciones. Las distribuciones de muestreo de estas tres medidas de la diversidad genética fueron determinadas utilizando métodos Monte Carlo. Evaluamos la proporción de alelos incluida en números de poblaciones: consideradas adecuadas para la conservación; requeridas para capturar todos los alelos; y las requeridas para alcanzar un estándar de conservación de diversidad genética aceptable del 90,95% de probabilidad de incluir todos los alelos comunes. También evaluamos el número de poblaciones necesarias para obtener valores de heterocigosidad que caigan dentro de ±10% del valor obtenido de todas las poblaciones. Los números de alelos fueron afectados significativamente por el número de poblaciones muestreadas. La heterocigosidad solo fue ligeramente menos sensible a los números de poblaciones de lo que fueron los alelos. Las intensidades de conservación propugnadas actualmente representaron en promedio el 67,83% de todos los alelos y el 85,93% de los alelos comunes. El menor número de poblaciones para incluir a todos los alelos varió de 6 a 17 ( 42,57% ), pero <0.2% de 1000 muestras de esos números de poblaciones los incluyó a todos. Fue necesario conservar de 16 a 29 ( 53,93% ) de las poblaciones muestreadas para alcanzar el estándar para los alelos comunes. Se requirió entre 20% y 64% de las poblaciones para representar la heterocigosidad a nivel de especie confiablemente. Por lo tanto, se requieren mayores porcentajes de poblaciones que los actualmente considerados adecuados para conservar la diversidad genética si las poblaciones son seleccionadas sin datos genéticos. [source] AMP-activated protein kinase , a sensor of glycogen as well as AMP and ATP?ACTA PHYSIOLOGICA, Issue 1 2009A. McBride Abstract The classical role of the AMP-activated protein kinase (AMPK) is to act as a sensor of the immediate availability of cellular energy, by monitoring the concentrations of AMP and ATP. However, the , subunits of AMPK contain a glycogen-binding domain, and in this review we develop the hypothesis that this is a regulatory domain that allows AMPK to act as a sensor of the status of cellular reserves of energy in the form of glycogen. We argue that the pool of AMPK that is bound to the glycogen particle is in an active state when glycogen particles are fully synthesized, causing phosphorylation of glycogen synthase at site 2 and providing a feedback inhibition of further extension of the outer chains of glycogen. However, when glycogen becomes depleted, the glycogen-bound pool of AMPK becomes inhibited due to binding to ,1,6-linked branch points exposed by the action of phosphorylase and/or debranching enzyme. This allows dephosphorylation of site 2 on glycogen synthase by the glycogen-bound form of protein phosphatase-1, promoting rapid resynthesis of glycogen and replenishment of glycogen stores. This is an extension of the classical role of AMPK as a ,guardian of cellular energy', in which it ensures that cellular energy reserves are adequate for medium-term requirements. The literature concerning AMPK, glycogen structure and glycogen-binding proteins that led us to this concept is reviewed. [source] Developing an attitude towards bullying scale for prisoners: structural analyses across adult men, young adults and women prisonersCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 1 2009Jane L. Ireland Background,Few studies have attempted to explore attitudes towards bullying among prisoners, despite acknowledgement that attitudes may play an important role. Aim,To evaluate the structure of a new attitudinal scale, the Prison Bullying Scale (PBS), with adult men and women in prison and with young male prisoners. Hypotheses,That attitudes would be represented as a multidimensional construct and that the PBS structure would be replicated across confirmatory samples. Method,The PBS was developed and confirmed across four independent studies using item parceling and confirmatory factor analysis: Study I comprised 412 adult male prisoners; Study II, 306 adult male prisoners; Study III, 171 male young offenders; and Study IV, 148 adult women prisoners. Results,Attitudes were represented as a multidimensional construct comprising seven core factors. The exploratory analysis was confirmed in adult male samples, with some confirmation among young offenders and adult women. The fit for young offenders was adequate and improved by factor covariance. The fit for women was the poorest overall. Conclusion,The study notes the importance of developing ecologically valid measures and statistically testing these measures prior to their clinical or research use. Implications,The development of the PBS holds value both as an assessment and as a research measure and remains the only ecologically validated measure in existence to assess prisoner attitudes towards bullying. Copyright © 2009 John Wiley & Sons, Ltd. [source] European guidelines for quality assurance in cervical cancer screening: recommendations for cytology laboratories,CYTOPATHOLOGY, Issue 2 2007H. G. Wiener The quality of a cervical cytology laboratory depends on adequate handling and staining of the samples, screening and interpretation of the slides and reporting of the results. These guidelines give an overview of procedures recommended in Europe to manage the balance between best patient care possible, laboratory quality assurance and cost effectiveness and will be published as a chapter 4 in the European Guidelines for Quality Assurance in Cervical Cancer Screening. The laboratory guidelines include protocols for personnel and organisation, material requirements, handling and analysing cervical samples, recording of results, quality management and communication. The section on quality management is comprehensive and includes protocols for all aspects of internal and external quality assurance. The guidelines are extensively referenced and as far as possible the recommendations are evidence-based. [source] In vivo determination of muscle viscoelasticity in the human legACTA PHYSIOLOGICA, Issue 4 2001S. Fukashiro The purpose of this study was to examine the methodological validity of the free vibration technique for determining individual viscoelastic characteristics of the human triceps surae muscle-tendon complex (MTC) in vivo. Six subjects sat with first phalangeal joint of the forefoot on the edge of a force-plate. The special frame on the knee was loaded with weight (0,40 kg) for testing. Oscillations of the triceps surae MTC system were initiated with a hand-held hammer by tapping the weight. In order to keep the same posture, the output of the force plate was displayed on the oscilloscope and subjects were asked to maintain the beam on the oscilloscope at a particular location in relation to a reference line. The damped oscillations in conjunction with the equation of motion of a damped mass-spring model were used to calculate the viscosity of muscle (b) and the elasticity of muscle fibres and tendon (k) in each subject, considering moment arm of the ankle joint. With this arrangement, we have obtained high reproducibility in this method. The coefficient of variations (CVs) of b and k in five trials at each weight were quite small (range: 0.5,18.7% in b and 1.0,15.1% in k). There were no significant differences in viscoelastic coefficients between right and left legs. Therefore, it appears that free vibration technique, used here, is adequate in describing the viscoelastic characteristics of the triceps surae in vivo in humans. [source] Knowledge of general practitioners dentists about the emergency management of dental avulsion in Curitiba, BrazilDENTAL TRAUMATOLOGY, Issue 1 2007Vania Portela Ditzel Westphalen Abstract,,, The prognosis of traumatized teeth in general and of avulsed teeth in particular depends on prompt and appropriate treatment. Management of traumatic injuries may be a challenge to the non-specialized dentist, as they may occur when dentists are least prepared for it. The objective of this research was to investigate the knowledge of general practitioner dentists about the emergency management of dental avulsion in Curitiba, PR, Brazil. A group of 250 professionals were interviewed. The questions were related to knowledge of how to treat traumatic avulsion of teeth. The results suggest that the level of knowledge on the management of dental avulsion of the general practitioners dentists in Curitiba is adequate. [source] An alternative method for splinting of traumatized teeth: case reportsDENTAL TRAUMATOLOGY, Issue 6 2006Gülsün Yildirim Öz Abstract,,, Injuries to the dentoalveolar complex are fairly common and can be caused by a number of reasons. There are many techniques for repositioning and stabilizing traumatically luxated or avulsed teeth. Many of the splinting techniques previously advocated were time-consuming. Not only were the splints difficult to fabricate and difficult to remove, they also contributed to injury of the soft and hard supporting tissues. Ribbond (Ribbond Inc., Seattle, Wash) is basically a reinforced ribbon which is made from ultrahigh molecular weight polyethylene fiber having an ultrahigh modulus. It is used in dentistry for various purposes. The use of Ribbond appears to be an adequate and easy method for stabilization and fixation. It can be used in the treatment of dental injuries. In this article the use of Ribbond for the treatment of dentoalveolar injuries is described. [source] Risk factors related to traumatic dental injuries in Brazilian schoolchildrenDENTAL TRAUMATOLOGY, Issue 5 2004Evelyne Pessoa Soriano Abstract,,, The aim of this pilot study was to analyse whether overjet, lip coverage and obesity represented risk factors associated with the occurrence of dental trauma in the permanent anterior teeth of schoolchildren in Recife, Brazil. It included a random sample of 116 boys and girls aged 12 years, attending both public and private schools. Data was collected through clinical examinations and interviews. Dental trauma was classified according to Andreasen's criteria (1994). Overjet was considered as risk factor when it presented values higher than 5 mm. Lip coverage was classified as adequate or inadequate, while obesity was considered according to National Center for Health Statistics (NCHS) procedures for the assessment of nutritional status. The prevalence of dental injuries was 23.3%. Boys experienced more injuries than girls, 30 and 16.1%, respectively (P > 0.05). There was a statistically significant difference between traumatic dental injuries and overjet (P < 0.05) and between traumatic dental injuries and lip coverage (P = 0.000). No statistical significant differences were found when obesity and dental trauma were analysed (P < 0.05). It was concluded that boys from lower social strata attending public schools, presenting an overjet size greater than 5 mm and an inadequate lip coverage, were more likely to have traumatic dental injuries in Recife, Brazil. Obesity was not a risk factor for dental trauma in this sample. [source] Risk factors for relapse after remission with repetitive transcranial magnetic stimulation for the treatment of depressionDEPRESSION AND ANXIETY, Issue 7 2009Roni B. Cohen M.D. Abstract Background: Several studies have shown that repetitive transcranial magnetic stimulation (rTMS) treatment is associated with a significant antidepressant effect that can last for several months. Methods: To investigate the mean remission time and the predictors associated with its duration; we performed a large retrospective, naturalistic study with 204 patients who underwent treatment with rTMS. During the periods from 2000 to 2006, we identified and collected the data on 204 patients who underwent rTMS treatment for major depression and who remitted their depression (defined as Hamilton Depression Rating Scores less or equal to 7). Patients were followed up to 6 months after this therapy. Results: Event-free remission with the end point defined as relapse (Hamilton Depression Rating Scores higher than 8) was 75.3% (73.7) at 2 months, 60.0% (74.5) at 3 months, 42.7% (74.8) at 4 months, and 22.6% (74.5) at 6 months. According to a multivariate analysis, only the age and number of sessions were independent predictors of outcome. Although depression severity and use of tricyclics also showed a significant relationship with remission duration, the model including these variables was not adequate to explain our data. Conclusions: The results of this study suggest that young age and additional rTMS sessions are associated with a ong duration of rTMS effects and therefore future trials investigating the effects of maintenance rTMS treatment need to explore further the implication of these factors for depression remission. Depression and Anxiety, 2009. © 2009 Wiley-Liss, Inc. [source] Obstetrician-gynecologists' screening patterns for anxiety during pregnancy,DEPRESSION AND ANXIETY, Issue 2 2008Victoria H. Coleman M.A. Abstract As obstetrician-gynecologists (ob-gyns) take on a greater role in women's healthcare, it is important that they are aware of the high prevalence of anxiety disorders in their patient population. Anxiety disorders present during pregnancy can have detrimental effects on both mother and child. In this study, we queried 1,193 ob-gyns on their screening rates, practice patterns, training, and knowledge as they relate to anxiety disorders during pregnancy. We achieved a 44% response rate (n=397) after three mailings. Physicians reported a moderate interest in screening for and diagnosing anxiety, but less interest in treatment. Only 20% of respondents (n=79) screen for anxiety during pregnancy, and they typically refer anxiety-disordered patients to mental health professionals. Ob-gyns with comprehensive or adequate training were significantly more likely to screen than those who stated that their training was inadequate. Having a friend who has been diagnosed with an anxiety disorder also significantly increased both the likelihood that these physicians would screen and the reported level of interest in screening of anxiety disorders during pregnancy. At present, the majority of ob-gyns feel that their training in this area was barely adequate to inadequate. Specifically, generalized anxiety disorder may be the least understood. Increased training in this area would allow ob-gyns to overcome what they list as the primary barrier to anxiety screening during pregnancy,that is, inadequate training about anxiety disorders. Depression and Anxiety 0:1,10, 2007. Published © 2007 Wiley-Liss, Inc. [source] Common infections in diabetes: pathogenesis, management and relationship to glycaemic controlDIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 1 2007Anton Y. Peleg Abstract Specific defects in innate and adaptive immune function have been identified in diabetic patients in a range of in vitro studies. However, the relevance of these findings to the integrated response to infection in vivo remains unclear, especially in patients with good glycaemic control. Vaccine efficacy seems adequate in most diabetic patients, but those with type 1 diabetes and high glycosylated haemoglobin levels are most likely to exhibit hypo-responsiveness. While particular infections are closely associated with diabetes, this is usually in the context of extreme metabolic disturbances such as ketoacidosis. The link between glycaemic control and the risk of common community-acquired infections is less well established but could be clarified if infection data from large community-based observational or intervention studies were available. The relationship between hospital-acquired infections and diabetes is well recognized, particularly among post-operative cardiac and critically ill surgical patients in whom intensive insulin therapy improves clinical outcome independent of glycaemia. Nevertheless, further research is needed to improve our understanding of the role of diabetes and glycaemic control in the pathogenesis and management of community- and hospital-acquired infections. Copyright © 2006 John Wiley & Sons, Ltd. [source] The Bech,Rafaelsen Melancholia Scale (MES) in clinical trials of therapies in depressive disorders: a 20-year review of its use as outcome measureACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2002P. Bech Bech P. The Bech,Rafaelsen Melancholia Scale (MES) in clinical trials of therapies in depressive disorders A 20-year review of its use as outcome measure. Acta Psychiatr Scand 2002: 106: 252,264. © Blackwell Munksgaard 2002. Objective:,To evaluate the psychometric properties of the Bech,Rafaelsen Melancholia Scale (MES) by reviewing clinical trials in which it has been used as outcome measure. Method:,The psychometric analysis included internal validity (total scores being a sufficient statistic), interobserver reliability, and external validity (responsiveness in short-term trials and relapse prevention in long-term trials). Results:,The results showed that the MES is a unidimensional scale, indicating that the total score is a sufficient statistic. The interobserver reliability of the MES has been found adequate both in unipolar and bipolar depression. External validity including both relapse, response and recurrence indicated that the MES has a high responsiveness and sensitivity. Conclusion:,The MES has been found a valid and reliable scale for the measurement of changes in depressive states during short-term as well as long-term treatment. [source] Coxsackie B virus serology and Type 1 diabetes mellitus: a systematic review of published case-control studiesDIABETIC MEDICINE, Issue 6 2004J. Green Abstract Background Enteroviruses, in particular Coxsackie B4, have been implicated in the aetiology of Type 1 diabetes mellitus, but the epidemiological evidence has not been systematically evaluated. Methods Systematic review of evidence from published controlled studies of the relationship between Coxsackie B virus serology and incident or prevalent Type 1 diabetes mellitus. Studies were identified through a Medline search (1966 to 2002), supplemented by references from identified papers and hand search of relevant journals. All studies (full papers, abstracts or letters) with data adequate for calculation of unadjusted odds ratios (with 95% confidence intervals) for Type 1 diabetes mellitus in relation to Coxsackie B virus serology were included. Results The review included 26 case-control studies; no cohort study met the inclusion criteria. Odds ratios for Type 1 diabetes mellitus in serology-positive vs. serology-negative subjects ranged from 0.2 to 22.3. For Coxsackie B (any serotype) 7/13 studies had point estimates significantly greater than 1.0 (P < 0.05). For Coxsackie B3, Coxsackie B4 and Coxsackie B5-specific assays, 1/11, 6/17 and 1/11 studies, respectively, had point estimates significantly greater than 1.0. Summary odds ratios were not calculated because of doubts about the validity of individual study estimates, heterogeneity between studies, and the possibility of publication bias. Conclusions The results of these studies are inconsistent and do not provide convincing evidence for or against an association between Coxsackie B virus infection and Type 1 diabetes mellitus. Better designed studies using effective assays are needed to resolve this important issue. [source] Making the diagnosis with only two levels of nongynecologic cell blocks as opposed to three is more cost effectiveDIAGNOSTIC CYTOPATHOLOGY, Issue 5 2010Gina Zanchelli-Astran D.O. Abstract Two hundred forty-three of 246 cases in phase I (98.8%) and 246 of 247 cases in phase II (99.6%) had adequate or the same material present on the level two cell blocks. Sixty-nine cases were malignant (28.1%), 20 were atypical (8.1%), 157 were benign (63.8), and 16 were signed out on the cell block only (6.5%) in phase I. In phase II, 69 (27.9%) cases were malignant, 22 (8.9%) were atypical, 156 (63.2%) were benign, and 18 (7.3%) were signed out based on material present in the cell block. Fifteen cases in phase I (6.1%) and 17 (6.9%) in phase II needed immunohistochemical staining for further evaluation. Twenty-four upper urinary tract (UUT) cases were signed out as malignant (49.0%), 10 were atypical (20.4%), and 15 were benign (30.6%) in phase I. In phase II, 18 (56.3%) UUT were malignant, 8 (25.0%) were atypical, and 6 (18.7%) were benign. In phase I, 13 (26.5%) and in phase II, 18 (56.3%) were graded on the cell block only. On comparing the two phases, there was no significant difference in the amount of diagnostic material present between the level three and level two cell blocks (98.8% and 99.6%, respectively) or the number of cases diagnosed based on the cell block (6.5% and 7.3%, respectively). Cases signed out as malignant, atypical, and benign were similar in both phases. Likewise, the cases that required immunohistochemical staining to aid in the diagnosis between phase one and phase two were similar (6.1% and 6.9%, respectively). respectively). Diagn. Cytopathol. 2010. © 2010 Wiley-Liss, Inc. [source] Preparation of thyroid FNA material for routine cytology and BRAF testing: A validation studyDIAGNOSTIC CYTOPATHOLOGY, Issue 3 2010Giancarlo Troncone M.D., Ph.D. Abstract V600E BRAF mutation is emerging as an independent marker of papillary thyroid carcinoma aggressive behavior. Papillary thyroid carcinomas harboring this mutation should be extensively resected. However, this requires an unquestionable cytological diagnosis of malignancy. Thus, cytological specimens should be properly handled to provide both morphological and molecular information. Here, we assessed whether our method of preparation of fine-needle aspiration material is suitable for both tests. A series of 128, routinely performed, fine-needle aspirations was analyzed. Each nodule was punctured three times. A representative Diff-Quik smear prepared from the first two passages was evaluated onsite. When microscopy was diagnostic (n = 44), the third needle pass was dedicated to harvest material for BRAF testing; in the remaining cases (n = 84), additional direct smears for cytology were prepared and the remaining material in the needle plus the needle rinsing was collected for BRAF testing. Cellularity was adequate in 126/128 (98%) cases. Cytological diagnoses were inadequate (2%), benign (85%), follicular lesion of undetermined significance (5%), follicular neoplasms (2%), suspicious for malignancy (2%), and malignant (4%). Higher average of extracted DNA concentration was observed in the dedicated pass group (25.9 vs 7.95 ng/,l). However, the rate of successful exon 15 BRAF amplification was similar with (43/44; 97.7%) or without (79/84; 94%) the dedicated pass. Thus, our protocol is suitable for both tests. Whenever necessary BRAF testing may also be performed on the residual samples of thyroid nodules, without interfering with routine cytology. Diagn. Cytopathol. 2010. © 2009 Wiley-Liss, Inc. [source] Buccal delivery of insulin: the time is nowDRUG DEVELOPMENT RESEARCH, Issue 7 2006*Article first published online: 16 NOV 200, Gerald Bernstein Abstract The burgeoning numbers of individuals with diabetes mellitus and prediabetes, in particular Type 2 including large numbers of children, open up not only the classic risks for microvascular disease but the earlier and incapacitating risk for macrovascular disease. Oral hypoglycemic agents and insulin sensitizers have not been adequate to control postprandial glucose. Prandial insulin is most desirable but resistance to injections limits its use. This has led to a battery of needle-free insulin delivery systems. Buccal delivery stands out as being safe, simple, fast, flexible, and familiar to patient and physician alike. Drug Dev. Res. 67:597,599, 2006. © 2006 Wiley-Liss, Inc. [source] One-year outcome of an early intervention in psychosis service: a naturalistic evaluationEARLY INTERVENTION IN PSYCHIATRY, Issue 3 2007Swaran P. Singh Abstract Aim: We conducted a 1-year prospective evaluation of an early intervention in psychosis service (Early Treatment and Home-based Outreach Service (ETHOS)) during its first 3 years of operation in South-west London, UK. Methods: All patients referred to ETHOS underwent structured assessments at baseline and at 1-year follow-up. In addition, hospitalization rates of ETHOS patients (intervention group) were compared with a non-randomized parallel cohort (comparison group) of first-episode patients treated by community mental health teams. Results: The Early Treatment and Home-based Outreach Servicepatients experienced significant improvements in symptomatic and functional outcomes, especially vocational recovery. The service received only a quarter of eligible patients from referring teams. ETHOS patients did not differ from the comparison group in number of admissions, inpatient days or detention rates. Although number of referrals increased over time, there was no evidence that patients were being referred earlier. Conclusions: There is now robust evidence for the effectiveness of specialist early intervention services. However, such services must be adequate resourced, including an early detection team and provision of their own inpatient unit. [source] Seismic performance and new design procedure for chevron-braced framesEARTHQUAKE ENGINEERING AND STRUCTURAL DYNAMICS, Issue 4 2006Edoardo M. Marino Abstract The paper is concerned with the seismic design of steel-braced frames in which the braces are configured in a chevron pattern. According to EuroCode 8 (EC8), the behaviour factor q, which allows for the trade-off between the strength and ductility, is set at 2.5 for chevron-braced frames, while 6.5 is assigned for most ductile steel moment-resisting frames. Strength deterioration in post-buckling regime varies with the brace's slenderness, but EC8 adopts a unique q value irrespective of the brace slenderness. The study focuses on reevaluation of the q value adequate for the seismic design of chevron-braced frames. The present EC8 method for the calculation of brace strength supplies significantly different elastic stiffnesses and actual strengths for different values of brace slenderness. A new method to estimate the strength of a chevron brace pair is proposed, in which the yield strength (for the brace in tension) and the post-buckling strength (for the brace in compression) are considered. The new method ensures an identical elastic stiffness and a similar strength regardless of the brace slenderness. The advantage of the proposed method over the conventional EC8 method is demonstrated for the capacity of the proposed method to control the maximum inter-storey drift. The q values adequate for the chevron-braced frames are examined in reference to the maximum inter-storey drifts sustained by most ductile moment-resisting frames. When the proposed method is employed for strength calculation, the q value of 3.5 is found to be reasonable. It is notable that the proposed method does not require larger cross-sections for the braces compared to the cross-sections required for the present EC8 method. Copyright © 2005 John Wiley & Sons, Ltd. [source] The Pocket Echocardiograph: Validation and FeasibilityECHOCARDIOGRAPHY, Issue 7 2010Benjamin C. Culp M.D. Background: A new, miniaturized ultrasound device, the pocket echocardiograph (PE), is highly portable and can be carried inside a lab-coat pocket. Studies of this device are limited and have not examined the use by novice echocardiographers. We hypothesize that a novice echocardiographer can use PE to produce interpretable cardiac images, and that both novice and expert echocardiographers can use PE to accurately quantify ejection fraction. Methods: Unselected subjects (n = 40) in an echocardiography laboratory underwent blinded formal transthoracic echocardiography (TTE) and PE (Acuson P10, Siemens, Mountain View, CA, USA). A cardiology fellow with 2 months of echocardiography training acquired PE images. The fellow and an experienced echocardiographer interpreted the PE studies offline in a blinded fashion. To assess adequacy, studies were graded as technically adequate, limited, or inadequate. A visual estimation of ejection fraction was made. Comparisons were made to the formal reported TTE. Results: Subjects were heterogeneous, 43% male; age 64 ± 17 years, and ejection fraction 52.4%± 12.3%. All PE studies were interpretable, and the vast majority of PE and TTE images were considered technically adequate (77.5% and 85% respectively; P = 0.32). Ejection fraction showed a good correlation, bias, and limits of agreement for the fellow's interpretation (r = 0.78, ,5.9%, ±16.6%) with stronger association for the experienced echocardiographer (r = 0.88, ,0.8%, ±11.4%). Conclusion: Novice echocardiographers using the PE can produce adequate quality images. Both expert and novice echocardiographers can use PE to quantify ejection fraction over a broad range of patients. The device's low cost and portability may greatly expand the availability of bedside echocardiography for routine or urgent cardiovascular assessment. (Echocardiography 2010;27:759-764) [source] Comparison of soil moisture and meteorological controls on pine and spruce transpirationECOHYDROLOGY, Issue 3 2008Eric E. Small Abstract Transpiration is an important component of the water balance in the high elevation headwaters of semi-arid drainage basins. We compare the importance of soil moisture and meteorological controls on transpiration and quantify how these controls are different at a ponderosa pine site and a spruce site in the Jemez river drainage basin of northern New Mexico, a sub-basin of the Rio Grande. If only soil moisture controls fluctuations in transpiration, then simple hydrologic models focussed only on soil moisture limitations are reasonable for water balance studies. If meteorological controls are also critical, then more complex models are required. We measured volumetric water content in the soil and sap velocity, and assumed that transpiration is proportional to sap velocity. Ponderosa sap velocity varies with root zone soil moisture. Nearly all of the scatter in the ponderosa sap velocity,soil moisture relationship can be predicted using a simple model of potential evapotranspiration (ET), which depends only on measured incident radiation and air temperature. Therefore, simple hydrologic models of ponderosa pine transpiration are warranted. In contrast, spruce sap velocity does not clearly covary with soil moisture. Including variations in potential evapotranspiration does not clarify the relationship between sap velocity and soil moisture. Likewise, variations in radiation, air temperature, and vapour pressure do not explain the observed fluctuations in sap velocity, at least according to the standard models and parameters for meteorological restrictions on transpiration. Both the simple and more complex models commonly used to predict transpiration are not adequate to model the water balance in the spruce forest studied here. Copyright © 2008 John Wiley & Sons, Ltd. [source] The Wealth of Nations at the Turn of the Millennium: A Classification System Based on the International Division of Labor,ECONOMIC GEOGRAPHY, Issue 2 2002Wolfgang Hoeschele Abstract: Simple dichotomies, such as First World,Third World, developed,developing countries, and north,south, are no longer adequate for understanding the complex economic geography of the world. Even the division into core, semi-periphery, and periphery groups diverse economies into an excessively limited number of categories. It is time to develop a new scheme that better classifies the countries of the world into coherent groups. This article constructs a new classification based on the international division of labor, using three fundamental dimensions. The first dimension is the success of the industrial and services economy in providing employment to the people within a country. The second is the export orientation of a country, concentrating either on natural-resource-intensive products (e.g., agricultural produce, food and beverages, minerals and metals) or on core industrial manufactures (from textiles to computers). The third is the presence of control functions in the world economy: countries that include the headquarters of major firms and are the source regions of major flows of foreign direct investments. The combination of these three dimensions leads to the creation of eight basic categories. I introduce a terminology that combines these basic categories into larger groups, depending on the context. This new conceptual scheme should facilitate a more informed analysis of world economic, political, social, and environmental affairs. [source] Financial markets can go mad: evidence of irrational behaviour during the South Sea Bubble1ECONOMIC HISTORY REVIEW, Issue 2 2005RICHARD S. DALE This paper explores investor behaviour during the South Sea Bubble,the first major speculative boom and bust on the stock markets. Previous literature debates whether investors during this episode acted rationally. Newly acquired data involving parallel markets for the South Sea Company's stock and subscription receipts are analysed, and widening valuation gaps are observed between these substitutable financial instruments. Rational explanations do not prove adequate, and the anomalies are explained by the biased decision-making of investors, and their tendency to view financial markets as wagering markets. The implications of these findings for the current debate on rationality in financial markets are identified. [source] The International Financial Crisis Viewed by ExpertsECONOMIC NOTES, Issue 1-2 2009Antonio Forte The occurrence of the international financial crisis and the spread out of its effects on the global economy prompted experts around the world to think about how to manage the crisis and which measures to implement in order to restore normal economic and financial conditions. In this paper, we present and discuss the results of an international expert survey. We use these experts' perceptions to pursue a twofold target to understand their perceptions about the causes of the crisis, and of the policies to solve it. Interestingly, experts seem to broadly concur on what caused the crisis but their perceptions diverge regarding the policies. Furthermore, substantial differences in perceptions emerge between the Euro Area and the United States. We also find that the Federal Reserve and the European Central Bank monetary policies during the crisis are judged barely adequate. Finally, different views distinguish academicians from other experts. [source] Biopolitical Utopianism in Educational TheoryEDUCATIONAL PHILOSOPHY AND THEORY, Issue 7 2007Tyson Lewis Abstract In this paper I shift the center of utopian debates away from questions of ideology towards the question of power. As a new point of departure, I analyze Foucault's notion of biopower as well as Hardt and Negri's theory of biopolitics. Arguing for a new hermeneutic of biopolitics in education, I then apply this lens to evaluate the educational philosophy of John Dewey. In conclusion, the paper suggests that while Hardt and Negri are missing an educational theory, John Dewey is missing a concept of democracy adequate to the biopolitical struggles of the multitude. Thus, I call for a synthesis of Dewey and Hardt and Negri in order to generate a biopedagogical practice beyond both traditional models of education as well as current standardization. [source] | |||||||||||||||||||||||||||||||||||||