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Selected AbstractsEndoscopic band ligation for postpolypectomy gastric bleedingDIGESTIVE ENDOSCOPY, Issue 2 2003RYOSAKU TOMIYAMA We report a case of a patient in whom endoscopic band ligation was achieved for postpolypectomy gastric bleeding. A 76-year-old man visited our hospital because of anemia. Endoscopy revealed a gastric polyp, approximately 12 mm in diameter, on the lesser curvature in the distal gastric body. The polyp was considered to be the source of chronic anemia and was therefore removed by using standard careful snare-cautery polypectomy technique. Four days later, follow-up endoscopy was performed to evaluate the postpolypectomy site, and an active bleeding postpolypectomy ulcer was identified. Initial attempts to achieve hemostasis with ethanol injection were unsuccessful. Immediate hemostasis was obtained with a subsequent endoscopic band ligation device. There has been no recurrent bleeding. Endoscopic band ligation might be a good treatment modality for the treatment of a postpolypectomy gastric bleeding lesion. [source] An initial assessment of the use of gradient elution in microemulsion and micellar liquid chromatographyJOURNAL OF SEPARATION SCIENCE, JSS, Issue 17-18 2004Simon M. Bryant Abstract Novel microemulsion and micellar HPLC separations have been achieved using gradient elution and columns packed with reverse phase material. Initial attempts at gradient microemulsion liquid chromatography proved impossible on use of a microemulsion successfully used in capillary electrophoresis. Optimisation of the microemulsion composition allowed the generation of stable microemulsions to achieve separations in HPLC. The novel use of organic-solvent micellar chromatography in gradient elution mode was shown to give efficient separations. A range of efficient separations of pharmaceuticals and related impurities were obtained. Acidic, basic, and neutral solutes were resolved covering a wide range of water solubilities and polarities. Elution times were in the order of 4,15 minutes. Separations were briefly compared to those accomplished with a micellar HPLC system. It is proposed that gradient elution in both microemulsion and micellar HPLC can be regarded as a highly successful means of achieving resolution of complex mixtures and should be considered for routine analysis and further investigation. [source] Carbonate extraction process for the metabolic, isozymic and proteomic profiling of rose-scented geranium (Pelargonium sp.), a hyper-acidic plantPHYTOCHEMICAL ANALYSIS, Issue 2 2008Rajender Singh Sangwan Abstract Rose-scented geranium (Pelargonium sp.) is a valuable monoterpene-yielding plant. It has been well characterised phytochemically through the isolation of >270 secondary metabolites, however, there is hardly any biochemical or metabolic information concerning this plant. Initial attempts to investigate its metabolism failed to produce any enzyme activity in the tissue extracts prepared in routine extraction buffers owing to the intrinsic properties of the tissue matrix. It was recognised that cellular hyper-acidity (cell sap pH ,3.0) gave rise to very low protein levels in the extracts, thus prohibiting detection of activities of even primary metabolic enzymes that are usually abundantly present in plants. Tissue extraction in Tris solution without pH adjustment (as used for studies involving citrus and banana) led to little or no improvement. Therefore, a novel approach using sodium carbonate solution as an efficient extraction system for enzymes and proteins from the plant was studied. Functionality of the carbonate extraction has been demonstrated through its effectiveness, a several-fold superior performance, in yielding protein, monitoring primary metabolism and secondary metabolic enzymes, and isozymic and polypeptide profiling. The process may also be helpful in the reliable analysis of other acidic plant tissues. Copyright © 2007 John Wiley & Sons, Ltd. [source] A novel procedure for gentle isolation and separation of intact infected and uninfected protoplasts from the central tissue of Vicia faba L. root nodulesPLANT CELL & ENVIRONMENT, Issue 7 2003E. PEITER ABSTRACT The central tissue of Vicia faba L. root nodules is composed of cells infected with Rhizobium bacteroids and uninfected cells. For the study of various processes, such as plasma membrane transport, it is essential to separate both cell types. Initial attempts to isolate protoplasts according to protocols described in the literature resulted in non-spherical and osmotically inactive material, which is in agreement with previous descriptions. In the study reported herein, it was shown that the plasma membrane of non-spherical infected protoplasts is not intact. A new isolation and separation protocol was developed, based on dissection of the nodule prior to cell wall digestion, non-shaking digestion in hypertonic medium, and a combined procedure for release of protoplasts into slightly hypotonic medium and separation of protoplast fractions by isopycnic density gradient centrifugation. Infected and uninfected protoplasts that were isolated according to this protocol were spherical, osmotically active and excluded propidium iodide, confirming the intactness of their plasma membrane. The common fluorescein diacetate test was shown to be artefactual in infected cells, since viable bacteroids also stain in defective cells. Light and electron microscopic examination of infected protoplasts showed that protoplasts still contained starch after isolation and bacteroids in intact protoplasts had unusually high amounts of polyhydroxybutyrate. The vacuoles of infected protoplasts contained protein and membrane-enclosed structures, and were of non-acid pH; traits that are typical of protein storage vacuoles. [source] Structure of SRP14 from the Schizosaccharomyces pombe signal recognition particleACTA CRYSTALLOGRAPHICA SECTION D, Issue 5 2009Mark A. Brooks The signal recognition particle (SRP) Alu domain has been implicated in translation elongation arrest in yeasts and mammals. Fission yeast SRP RNA is similar to that of mammals, but has a minimal Alu -domain RNA lacking two stem-loops. The mammalian Alu -domain proteins SRP9 and SRP14 bind their cognate Alu RNA as a heterodimer. However, in yeasts, notably Saccaromyces cerevisiae, SRP14 is thought to bind Alu RNA as a homodimer, the SRP9 protein being replaced by SRP21, the function of which is not yet clear. Structural characterization of the Schizosaccharomyces pombe Alu domain may thus help to identify the critical features required for elongation arrest. Here, the crystal structure of the SRP14 subunit of S. pombe SRP (SpSRP14) which crystallizes as a homodimer, is presented. Comparison of the SpSRP14 homodimer with the known structure of human SRP9/14 in complex with Alu RNA suggests that many of the protein,RNA contacts centred on the conserved U-turn motif are likely to be conserved in fission yeast. Initial attempts to solve the structure using traditional selenomethionine SAD labelling failed. However, two As atoms originating from the cacodylate buffer were found to make cysteine adducts and strongly contributed to the anomalous substructure. These adducts were highly radiation-sensitive and this property was exploited using the RIP (radiation-damage-induced phasing) method. The combination of SAD and RIP phases yielded an interpretable electron-density map. This example will be of general interest to crystallographers attempting de novo phasing from crystals grown in cacodylate buffer. [source] Recognition of depressive symptoms in the elderly: What can help the patient and the doctorDEPRESSION AND ANXIETY, Issue 3 2002Ioannis A. Parashos M.D. Abstract The general public heavily underrecognizes depression and depressive symptoms. This underrecognition is more pronounced among elderly people, and this study is an initial attempt to quantify the problem in a Greek elderly sample. Additionally the authors attempt to identify patient-related factors, which can assist a subject to recognize the depressive symptoms and the general practitioner to note their existence. Members of senior citizen centers (n = 682) participated in presentations about "depression in the elderly" and completed a questionnaire including the GDS-4 scale, four questions concerning depression risk factors and a question concerning a recent visit to a physician for depressive symptoms. Amongst those participating, 35.8% presented depressive symptoms (GDS-4 , 2). The calculated rate for recognition of depression in the studied population was very low (17.3%). Patients with depressive symptoms were more often females and had a higher proportion of past history of depression and a lack of social support. Patients with a past history of depression and more severe forms of illness consulted a doctor more frequently. Finally, subjects suffering from depressive symptoms and comorbid medical illness were characterized by a higher proportion of past history, lack of support, and existence of multiple risk factors. The authors propose that the inclusion in public campaigns of activities with an experiential dimension, e.g., patient videos and the use of a very simple screening tool, such as the GDS-4 scale by general practitioners (GP), could be helpful in improving the recognition of depressive symptoms by the patient and his/her relatives and its diagnosis by the doctor. This proposition awaits formal proof in future studies. Depression and Anxiety 15:111,116, 2002. © 2002 Wiley-Liss, Inc. [source] The eyes have it: visual pop-out in infants and adultsDEVELOPMENTAL SCIENCE, Issue 2 2006Scott A. Adler Visual search studies with adults have shown that stimuli that contain a unique perceptual feature pop out from dissimilar distractors and are unaffected by the number of distractors. Studies with very young infants have suggested that they too might exhibit pop-out. However, infant studies have used paradigms in which pop-out is measured in seconds or minutes, whereas in adults pop-out occurs in milliseconds. In addition, with the previous infant paradigms the effects from higher cognitive processes such as memory cannot be separated from pop-out and selective attention. Consequently, whether infants exhibit the phenomenon of pop-out and have selective attention mechanisms as found in adults is not clear. This study was an initial attempt to design a paradigm that would provide a comparable measure between infants and adults, thereby allowing a more accurate determination of the developmental course of pop-out and selective attention mechanisms. To this end, we measured 3-month-olds' and adults' saccade latencies to visual arrays that contained either a + among Ls (target-present) or all Ls (target-absent) with set sizes of 1, 3, 5 or 8 items. In Experiment 1, infants' saccade latencies remained unchanged in the target-present conditions as set size increased, whereas their saccade latencies increased linearly in the target-absent conditions as set size increased. In Experiment 2, adults' saccade latencies in the target-present and target-absent conditions showed the same pattern as the infants. The only difference between the infants and adults was that the infants' saccade latencies were slower in every condition. These results indicate that infants do exhibit pop-out on a millisecond scale, that it is unaffected by the number of distractors, and likely have similar functioning selective attention mechanisms. Moreover, the results indicate that eye movement latencies are a more comparable and accurate measure for assessing the phenomenon of pop-out and underlying attentional mechanisms in infants. [source] Reciprocal relationships and potential feedbacks between biodiversity and disturbanceECOLOGY LETTERS, Issue 9 2007A. Randall Hughes Abstract Two major foci of ecological research involve reciprocal views of the relationship between biodiversity and disturbance: disturbance determines community diversity or diversity determines realized disturbance severity. Here, we present an initial attempt to synthesize these two approaches in order to understand whether feedbacks occur, and what their effects on patterns of diversity might be. Our review of published experiments shows that (i) disturbance severity can be both a cause and a consequence of local diversity in a wide range of ecosystems and (ii) shapes of the unidirectional relationships between diversity and disturbance can be quite variable. To explore how feedbacks between diversity and disturbance might operate to alter expected patterns of diversity in nature, we develop and then evaluate a conceptual model that decomposes the relationships into component parts, considering sequentially the effect of diversity on disturbance severity, and the effect of realized disturbance on diversity loss, subsequent recruitment, and competitive exclusion. Our model suggests that feedbacks can increase mean values of richness, decrease variability, and alter the patterns of correlation between diversity and disturbance in nature. We close by offering ideas for future research to help fill gaps in our understanding of reciprocal relationships among ecological variables like diversity and disturbance. [source] Effects of an occlusal splint compared with cognitive-behavioral treatment on sleep bruxism activityEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 1 2007Michelle A. Ommerborn The impact of an occlusal splint (OS) compared with cognitive-behavioral treatment (CBT) on the management of sleep bruxism (SB) has been poorly investigated. The aim of this study was to evaluate the efficacy of an OS with CBT in SB patients. Following a randomized assignment, the OS group consisted of 29, and the CBT group of 28, SB patients. The CBT comprised problem-solving, progressive muscle relaxation, nocturnal biofeedback, and training of recreation and enjoyment. The treatment took place over a period of 12 wk, and the OS group received an OS over the same time period. Both groups were examined pretreatment, post-treatment, and at 6 months of follow-up for SB activity, self-assessment of SB activity and associated symptoms, psychological impairment, and individual stress-coping strategies. The analyses demonstrated a significant reduction in SB activity, self-assessment of SB activity, and psychological impairment, as well as an increase of positive stress-coping strategies in both groups. However, the effects were small and no group-specific differences were seen in any dependent variable. This is an initial attempt to compare CBT and OS in SB patients, and the data collected substantiate the need for further controlled evaluations, using a three-group randomized design with repeated measures to verify treatment effects. [source] Nutrition, ecology and nutritional ecology: toward an integrated frameworkFUNCTIONAL ECOLOGY, Issue 1 2009David Raubenheimer Summary 1The science of nutritional ecology spans a wide range of fields, including ecology, nutrition, behaviour, morphology, physiology, life history and evolutionary biology. But does nutritional ecology have a unique theoretical framework and research program and thus qualify as a field of research in its own right? 2We suggest that the distinctive feature of nutritional ecology is its integrative nature, and that the field would benefit from more attention to formalizing a theoretical and quantitative framework for developing this. 3Such a framework, we propose, should satisfy three minimal requirements: it should be nutritionally explicit, organismally explicit, and ecologically explicit. 4We evaluate against these criteria four existing frameworks (Optimal Foraging Theory, Classical Insect Nutritional Ecology, the Geometric Framework for nutrition, and Ecological Stoichiometry), and conclude that each needs development with respect to at least one criterion. 5We end with an initial attempt at assessing the expansion of our own contribution, the Geometric Framework, to better satisfy the criterion of ecological explicitness. [source] The Thin End of the Wedge: Foreign Women Professors as Double Strangers in AcademiaGENDER, WORK & ORGANISATION, Issue 3 2008Barbara Czarniawska The impetus for this study was an observation that many of the first women to obtain chairs at European universities were foreigners. Our initial attempt to provide a statistical picture of this proved impossible, because there were numerous problems deciding the contents of such concepts as ,first', ,university professor' and ,foreigner'. We have therefore focused on four life stories. It turns out that being a ,double stranger', a woman in a masculine profession and a foreigner , is not, as one might think, a cumulative disadvantage. Rather, it seems that these two types of strangeness might cancel out one another, permitting these women a greater degree of success than was allowed their native sisters. This situation however, provides little psychological comfort, hence the metaphor of the wedge: opening the doors but suffering from double pressure. [source] Transillumination by light-emitting diode facilitates peripheral venous cannulations in infants and small childrenACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 8 2010K. HOSOKAWA Background: Transillumination facilitates the visualization of peripheral veins in infants and children. The clinical usefulness of light-emitting diode (LED)-powered devices has not been thoroughly studied. Methods: We randomly assigned 136 infants and children weighing <15 kg, undergoing general anesthesia, to red LED-powered transillumination (TM group, n=67) vs. the usual method (UM group, n=69) of peripheral venous cannulations. Venous puncture was performed following anesthesia induction with sevoflurane and nitrous oxide. The primary and secondary study endpoints were the rate of successful cannulations at initial attempt, and the duration of insertion attempts, respectively. Results: The median score of the estimated cannulation difficulty before attempted puncture was similar in both groups. The success rates at first attempt were 75% and 61% (NS) and mean±SD times to successful venous access were 47±34 and 68±66 s (NS) in the TM and UM groups, respectively. The cannulation procedures were completed significantly earlier in the TM group than in the UM group (hazard ratio, 1.59; 95% confidence interval, 1.03,2.47; P=0.03). In the subgroup of infants and children <2 years old, venous cannulation was successful at first attempt in 73% and 49% in the TM group (n=44) and in the UM group (n=47), respectively (P=0.03). Conclusions: LED-powered transillumination devices facilitated peripheral venous cannulations in small infants and children. [source] The integration of film-induced tourism and destination branding in Yorkshire, UKINTERNATIONAL JOURNAL OF TOURISM RESEARCH, Issue 5 2008Noelle O'Connor Abstract This paper identifies the integration of film induced tourism and destination branding on destinations featured in television series' such as Yorkshire, which is the film location for many popular English television series'. The review of the existing literature identified a gap in previous investigations and in response, a tourist survey and strategic conversations with the key stakeholders were an initial attempt to fill this gap. The issues which arose from these and the literature review highlighted some implications for the future development of these destinations, namely the use of destination branding in the promotion of a film location. Copyright © 2008 John Wiley & Sons, Ltd. [source] Understanding future ecosystem changes in Lake Victoria basin using participatory local scenariosAFRICAN JOURNAL OF ECOLOGY, Issue 2009Eric O. Odada Abstract Understanding future ecosystem changes is central to sustainable natural resource management especially when coupled with in-depth understanding of impacts of drivers, such as governance, demographic, economic and climate variations and land use policy. This offers comprehensive information for sustainable ecosystem services provision. A foresight process of systematic and presumptive assessment of future state and ecosystem integrity of Lake Victoria basin, as participatory scenario building technique, is presented. Four scenarios have been illustrated as possible future states of the basin over the next twenty years. Using a scenario building model developed in Ventana Simulation (VENSIM®) platform, the paper presents a scenario methodology for tracking changes in lake basin ecosystem status. Plausible trends in land use change, changes in lake levels and contribution of fisheries are presented. This is part of an initial attempt to setup long-term environmental policy planning strategies for Lake Victoria basin. The assumptions, driving forces, impacts and opportunities under each scenario depict major departure and convergence points for an integrated transboundary diagnosis and analysis of regional issues in the basin as well as strategic action planning for long-term interventions. The findings have been presented in terms of temporal, spatial, biophysical and human well-being dimensions. The attempts in this study can be embedded in a policy framework for basin management priority setting and may guide partnerships for environmental management. [source] Interdiffusional degradation of oxidation-resistant aluminide coatings on Fe-base alloysMATERIALS AND CORROSION/WERKSTOFFE UND KORROSION, Issue 10 2007Y. Zhang One of the potential degradation modes of oxidation-resistant iron aluminide coatings is the loss of Al from the coatings into Fe-base substrate alloys that typically contain no Al. To address this issue, interdiffusion between aluminide coatings and steel substrates was studied for times up to 10,000 h in the temperature range of 500,800,°C. Coatings were synthesized in a laboratory chemical vapor deposition (CVD) reactor on representative commercial ferritic alloy Fe-9Cr-1Mo and type 304L austenitic stainless steel. The microstructural and compositional changes after diffusion anneals were examined in detail. An initial attempt to model the interdiffusion behavior was carried out by applying an existing software program COSIM (coating oxidation and substrate interdiffusion model). Complementary work was conducted using a simple mathematic model developed by Heckel et al. Reasonable agreement was observed between the simulated and experimental composition profiles for the aluminide coatings on ferritic alloys. Model results were then applied to predict coating lifetime. [source] Considering student mobility in retention outcomesNEW DIRECTIONS FOR INSTITUTIONAL RESEARCH, Issue 131 2006Sutee Sujitparapitaya Director This case study represents an initial attempt by a university to employ data-mining techniques to study a ternary attrition variable produced by integrating multiple internal and external databases. [source] Electrical Characteristics of an Electronic Control Device Under a Physiologic Load: A Brief ReportPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 3 2010DONALD M. DAWES M.D. Background:,Law enforcement officers use electronic control devices (ECDs), such as the TASER X26 (TASER International, Inc., Scottsdale, AZ, USA), to control resisting subjects. Some of the debate on the safety of the devices has centered on the electrical characteristics of the devices. The electrical characteristics published by TASER International have historically based on discharges into a 400 , resistor. There are no studies that the authors are aware of that report the electrical characteristics under a physiologic load. In this study, we make an initial attempt to determine the electrical characteristics of the TASER X26 during a 5-second exposure in human volunteers. Methods:,Subjects received an exposure to the dry, bare chest (top probe), and abdomen (bottom probe) with a standard TASER X26 in the probe deployment mode for 5 seconds. There were 10,11 pulse captures during the 5 seconds. Resistance was calculated using the sum of the absolute values of the instantaneous voltage measurements divided by the sum of the absolute values of the instantaneous current measurements (Ohm's Law). Results:,For the eight subjects, the mean spread between top and bottom probes was 12.1 inches (30.7 cm). The mean resistance was 602.3 ,, with a range of 470.5,691.4 ,. The resistance decreased slightly over the 5-second discharge with a mean decrease of 8.0%. The mean rectified charge per pulse was 123.0 ,C. The mean main phase charge per pulse was 110.5 ,C. The mean pulse width was 126.9 ,s. The mean voltage per pulse was 580.1 V. The mean current per pulse was 0.97 A. The average peak main phase voltage was 1899.2 V and the average peak main phase current was 3.10 A. Conclusions:,The mean tissue resistance was 602.3 , in this study. There was a decrease in resistance of 8% over the 5-second exposure. This physiologic load is different than the 400 , laboratory load used historically by the manufacturer. We recommend future characterization of these devices use a physiologic load for reporting electrical characteristics. We also recommend that all the electrical characteristics be reported. (PACE 2010; 33:330,336) [source] Preparative separation of the saponin lancemaside a from Codonopsis lanceolata by centrifugal partition chromatographyPHYTOCHEMICAL ANALYSIS, Issue 5 2008Osamu Shirota Abstract Introduction. Lancemaside A is a saponin that inhibits decreases in blood testosterone level and thus prevents or ameliorates symptoms associated with male climacteric disorder. Our initial attempt to preparative isolation of lancemaside A from the saponin fraction of Codonopsis lanceolata roots by a preparative HPLC did not give a clear result. Objective. To develop a simple and efficient method for the preparative isolation of lancemaside A from the hot water extract of C. lanceolata roots using centrifugal partition chromatography (CPC). Methodology. The saponin fraction obtained from the hot water extract of C. lanceolata roots was used as the sample for preparative-scale separation of lancemasides by CPC using n -hexane:n -butanol:methanol:0.1% aqueous formic acid (3:4:1:6, v/v) as the two-phase solvent system. The upper phase (organic phase) of the two-phase solvent system was used as the mobile phase, and 0.5 g of saponin fraction was applied for separation by CPC. Each fraction that was separated by CPC was analysed by HPLC, and the fractions containing each of the separated compounds were pooled together, and then were purified by simple preparative HPLC. Results. The demonstrated separation sequence, hot water extraction, DIAION HP-20 column chromatography, CPC and preparative HPLC, yielded lancemaside A, foetidissimoside A and astersaponin Hb in their pure forms. Conclusion. The simple and efficient method for the preparative isolation of lancemaside A along with two other saponins, foetidissimoside A and astersaponin Hb, from the saponin fraction of C. lanceolata was established using CPC. [source] Consumer entitlement theory and measurementPSYCHOLOGY & MARKETING, Issue 3 2005Henry C. Boyd III Previous studies of personality observe that a healthy individual maintains a level of entitlement. Consumer entitlement concerns the extent to which a customer expects special treatment in retail environments. To date, marketing scholars have not investigated consumer entitlement at the buyer,seller interface. This article represents an initial attempt to examine this construct in a retailing context. The development of a scale, the consumer entitlement inventory (CEI), is reported. The scale's psychometric properties were examined, with the use of an undergraduate sample ( N = 410). Antecedents and implications for consumer entitlement are discussed. © 2005 Wiley Periodicals, Inc. [source] Learning and Retention Rates after Training in Posterior Epistaxis ManagementACADEMIC EMERGENCY MEDICINE, Issue 11 2008Richard L. Lammers MD Abstract Objectives:, The objective of the study was to compare the learning and retention rates of resident physicians trained in posterior epistaxis management with nasal gauze packing on a simulation model following two training methods. Methods:, This was a prospective, repeated-measures study. An objective, criterion-referenced performance standard, consisting of the number of major steps completed in the proper sequence, and the number of minor steps completed within a specified time, was used by an evaluator to assess performances. Subjects underwent two pretraining assessments 1 week prior to and the day of training and then were randomized to one of two training methods: the traditional "observation" method or a "pause-and-perfect" method. After training, both groups repeated the procedure until meeting the performance standard. Subjects were retested 1 and 3 months after training. Results:, Twenty-eight subjects participated. Baseline performance measures were similar between groups and did not change prior to training. During performance testing, experimental subjects completed a greater percentage of major steps (84%) and minor steps (86%) in less time (25 minutes) than the controls (65 and 68%, in 35 minutes) during the first attempt. All subjects met the standard within three attempts. There were no differences in major and minor steps completed between the two groups at either 1 week or 3 months after training, but performance times were shorter in the experimental group. After 3 months, 13% of control and none of experimental subjects met the performance standard. Conclusions:, The pause-and-perfect training method produced more rapid progress toward a performance standard during the initial attempt and better performance times after 3 months than the traditional, observational training method. Without further practice, this skill deteriorated after 3 months with both methods of training. [source] Tocolysis for repeat external cephalic version in breech presentation at term: a randomised, double-blinded, placebo-controlled trialBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 5 2005Lawrence Impey Background External cephalic version (ECV) reduces the incidence of breech presentation at term and caesarean section for non-cephalic births. Tocolytics may improve success rates, but are time consuming, may cause side effects and have not been proven to alter caesarean section rates. The aim of this trial was to determine whether tocolysis should be used if ECV is being re-attempted after a failed attempt. Objective To determine whether tocolysis should be used if ECV is being re-attempted after a failed attempt. Design Randomised, double-blinded, placebo-controlled trial. Setting UK teaching hospital. Population One hundred and twenty-four women with a breech presentation at term who had undergone an unsuccessful attempt at ECV. Methods Relative risks with 95% confidence intervals for categorical variables and a t test for continuous variables. Analysis was by intention to treat. Main outcome measures Incidence of cephalic presentation at delivery. Secondary outcomes were caesarean section and measures of neonatal and maternal morbidity. Results The use of tocolysis for a repeat attempt at ECV significantly increases the incidence of cephalic presentation at delivery (RR 3.21; 95% CI 1.23,8.39) and reduces the incidence of caesarean section (RR 0.33; 95% CI 0.14,0.80). The effects were most marked in multiparous women (RR for cephalic presentation at delivery 9.38; 95% CI 1.64,53.62). Maternal and neonatal morbidity remain unchanged. Conclusions The use of tocolysis increases the success rate of repeat ECV and reduces the incidence of caesarean section. A policy of only using tocolysis where an initial attempt has failed leads to a relatively high success rate with minimum usage of tocolysis. [source] Perceived Environmental Uncertainty, Entry Mode Choice and Satisfaction with EC-MNC PerformanceBRITISH JOURNAL OF MANAGEMENT, Issue 3 2000Lance Eliot Brouthers Previous theoretical and empirical research provides substantial support for a contingency approach toward international entry-mode selection. Similarly, additional empirical research supports the notion that different international ownership-based entry modes tend to be associated with varying performance levels. In this study we provide an initial attempt to use Werner, Brouthers and Brouthers' (1996) multiple measures of Perceived Environmental Uncertainty (PEU) to determine the entry mode choices of firms and link these risk-adjusted mode choices to managerial satisfaction with firm performance. We hypothesize and find that firms which make PEU risk-adjusted entry mode choices are significantly more satisfied with their firm's performance than firms whose entry mode choices cannot be predicted using multiple PEU risk measures. [source] Toward development of a generalized instrument to measure andragogyHUMAN RESOURCE DEVELOPMENT QUARTERLY, Issue 2 2009Elwood F. Holton III Andragogy has emerged as one of the dominant frameworks for teaching adults during the past 40 years. A major and glaring gap in andragogy research is the lack of a measurement instrument that adequately measures both andragogical principles and process design elements. As a result, no definitive empirical test of the theory has been possible. The purpose of this article is to report on initial attempts to develop a survey instrument that corrects this shortcoming in the andragogy research literature. The instrument developed for this study was part of a comprehensive examination of andragogical principles and process design elements and their effect on student satisfaction and learning outcomes in a postsecondary education setting. It was administered to 404 adults enrolled in an adult-oriented postgraduate degree program. Exploratory factor analysis revealed promising scales to measure five of the six andragogical principles and six of the eight process design elements. This instrument is the most successful attempt to date to measure andragogical principles and elements. It holds promise for advancing research on andragogy, and subsequently advancing the field of HRD by explaining affective and cognitive responses to andragogical instructional strategies across a spectrum of learning environments. Additional implications for future research to strengthen the instrument are also discussed. [source] Sheathless Implantation of Permanent Coronary Sinus-LV Pacing LeadsPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 2 2006PETER HOFFMEISTER Background: Implantation of CS-LV pacing leads is usually accomplished through specialized sheaths with additional use of contrast venography and other steps. Direct implantation at a target pacing site could provide a simplified procedure with appropriate leads. Methods: A progressive CS-LV lead implant protocol was used, with initial attempts made to place the lead directly using only fluoroscopy and lead stylet or wire manipulation. Coronary sinus (CS) sheaths were only used later if direct lead placement failed. Results: There were 105 attempted implants with 96% (101/105) success. Leads were implanted sheathlessly in 69% (70/101) cases. Pacing parameters and final lead position did not differ significantly between implants that did or did not require sheaths for implants. Three peri-procedural complications occurred in implants where sheaths were used. In 33% (33/101) of implants, the leads were placed without the use of sheaths or contrast venography in 20 minutes or less. Conclusions: Direct placement of the CS-LV pacing lead without sheaths can be accomplished successfully in a majority of implants and in ,20 minutes in a third, without inferior pacing parameters. This may provide for shorter or less technically difficult or expensive procedures with low risk. [source] Breast-Conservation Treatment Outcomes: A Community Hospital's ExperienceTHE BREAST JOURNAL, Issue 1 2009Barbara D. Florentine MD Abstract:, In the United States, the majority of early breast cancer patients choose breast-conserving treatment in the community setting, yet there is a paucity of literature describing outcomes. In this paper, we describe our experience with breast-conserving treatment in a small community hospital. Our hospital tumor registry was used to identify breast cancer cases diagnosed at our hospital between 1997 and 2003. We limited our study to those women with initial attempts at breast-conserving surgery (BCS) who had follow-up oncology treatment at on-campus affiliated oncological services. We looked at factors that influence survival for early stage 0,II disease such as tumor and patient characteristics, completeness of local surgical tumor excision, and adjuvant treatment. We also evaluated the percentage of cases in which the initial BCS did not achieve adequate surgical oncological results and the number and type of subsequent surgeries that were required to achieve this goal. There were 185 cases with a median patient age of 55 and a median follow-up time of 53 months. Most tumors were stage 0,I (68%) or stage II (23%). A single surgery was deemed sufficient to achieve the desired oncological outcome in 54% of cases; the remaining cases (46%) required additional surgeries. A final margin of 5 mm or greater was successfully achieved in 81% of cases. Ninety-two percent of the patients underwent radiotherapy, 65% received hormonal therapy, and 49% underwent chemotherapy. One hundred and sixty one patients had successful breast-conserving surgeries (87%) and 24 patients (13%) ultimately required mastectomy. There were four loco-regional recurrences and 19 deaths during the study period. Our disease-free survival rate for early-stage cancer (stage 0,II) was 91% at 5 years. Our study shows that high-quality patient outcomes for breast-conserving treatment can be achieved in the community setting. [source] Forcing the Issue: New Labour, New Localism and the Democratic Renewal of Police AccountabilityTHE HOWARD JOURNAL OF CRIMINAL JUSTICE, Issue 5 2005Eugene McLaughlin After providing a brief overview of New Labour's initial attempts to modernise British policing, I analyse why and how the broader political discourse of ,new localism' came to frame the unfolding debate about the need to revitalise police accountability. The article then offers a critical evaluation of the latest Home Office attempt to reorganise the democratic structure of police governance in the UK. [source] Purification, crystallization and preliminary X-ray analysis of the aspartate aminotransferase of Plasmodium falciparumACTA CRYSTALLOGRAPHICA SECTION F (ELECTRONIC), Issue 4 2010Rishabh Jain Aspartate aminotransferases (EC 2.6.1.1) catalyse the conversion of aspartate and ,-ketoglutarate to oxaloacetate and glutamate in a reversible manner. Thus, the aspartate aminotransferase of Plasmodium falciparum (PfAspAT) plays a central role in the transamination of amino acids. Recent findings suggest that PfAspAT may also play a pivotal role in energy metabolism and the de novo biosynthesis of pyrimidines. While therapeutics based upon the inhibition of other proteins in these pathways are already used in the treatment of malaria, the advent of multidrug-resistant strains has limited their efficacy. The presence of PfAspAT in these pathways may offer additional opportunities for the development of novel therapeutics. In order to gain a deeper understanding of the function and role of PfAspAT, it has been expressed and purified to homogeneity. The successful crystallization of PfAspAT, the collection of a 2.8,Å diffraction data set and initial attempts to solve the structure using molecular replacement are reported. [source] | ||||||||||||||||||||||