Cofilin immunolabelling correlates with depth of invasion in gastrointestinal endocrine cell tumors

Gastrointestinal endocrine cell tumors are a heterogeneous population of lesions believed to arise from neuroendocrine cells of the gastrointestinal mucosa. The current classification of these tumors is based on tumor size, microscopic features and clinical evidence of metastasis. Although diagnostic categories generally correlate with prognosis, molecular prognostic markers will be clinically useful adjuncts. Cofilin has been implicated in tumor invasion, and its immunolocalisation was studied in gastrointestinal endocrine cell tumors. The immunolocalisation of cofilin was studied by immunohistochemistry in 34 formalin-fixed, paraffin wax-embedded gastrointestinal endocrine cell tumors using a tissue microarray platform. A significant correlation was found between high cofilin immunolabelling and the depth of invasion (p

INCIDENCE AND CLINICAL IMPORTANCE OF PERIOPERATIVE HISTAMINE-RELEASE - RANDOMIZED STUDY OF VOLUME LOADING AND ANTIHISTAMINES AFTER INDUCTION OF ANESTHESIA

Although histamine release is recognised as a common event during anaesthesia and surgery, few clinicians judge the resultant cardiorespiratory disturbances serious enough to warrant prophylaxis with antihistamines. We have assessed the incidence and importance of histamine release in a randomised 2 x 2 factorial study.

A Non-Inferiority Randomized Controlled Trial Comparing the Clinical Effectiveness of Anesthesia Obtained by Application of a Novel Topical Anesthetic Putty With the Infiltration of Lidocaine for the Treatment of Lacerations in the Emergency Department

We test the hypothesis that anesthesia, measured as pain scores, induced by a novel topical anesthetic putty is non-inferior (margin=1.3) to that provided by conventional lidocaine infiltration for the repair of lacerations.

Neostigmine antagonism of rocuronium block during anesthesia with sevoflurane, isoflurane or propofol

Purpose: To examine the influence of continuing administration of sevoflurane or isoflurane during reversal of rocuronium induced neuromuscular block with neostigmine. Methods: One hundred and twenty patients, divided into three equal groups, were randomly allocated to maintenance of anesthesia with sevoflurane, isoflurane or propofol. Neuromuscular block was induced with rocuronium and monitored using train-of-four (TOF) stimulation of the ulnar nerve and recording the force of contraction of the adductor pollicis muscle. Neostigmine was administered when the first response in TOF had recovered to 25%. At this time the volatile agent administration was stopped or propofol dosage reduced in half the patients in each group (n = 20 in each group). The times to attain TOF ratio of 0.8, and the number of patients attaining this end point within 15 min were recorded. Results: The times (mean ± SD) to recovery of the TOF ratio to 0.8 were 12.0 ± 5.5 and 6.8 ± 2.3 min in the sevoflurane continued and sevoflurane stopped groups, 9.0 ± 8.3 and 5.5 ± 3.0 min in the isoflurane continued and isoflurane stopped groups, and 5.2 ± 2.8 and 4.7 ±1.5 min in the propofol continued and propofol stopped groups (P <0.5- 01). Only 9 and 15 patients in the sevoflurane and isoflurane continued groups respectively had attained a TOF ratio of 0.8 within 15 min (P <0.001 for sevoflurane). Conclusions: The continued administration of sevoflurane, and to a smaller extent isoflurane, results in delay in attaining adequate antagonism of rocuronium induced neuromuscular block.

The effects of sevoflurane and ketamine on intraocular pressure in children during examination under anesthesia

PURPOSE: We studied the effects on intraocular pressure (IOP) of anesthesia administered during examination under anesthesia (EUA) in children. DESIGN: Randomized clinical trial. METHODS: This randomized trial compared IOP after inhaled sevoflurane gas to that after intramuscular ketamine hydrochloride in children undergoing EUA. IOP was measured in 30 eyes with TonoPen XL (Mentor, Inc, Norwell, Massachusetts, USA) as soon as possible after anesthesia induction (T1) and two, four, six, and eight minutes thereafter. At the same times, we recorded systolic and diastolic blood pressure (SBP, DBP) and heart rate (HR). RESULTS: Compared with the mean IOP at T1, IOP in the sevoflurane group was significantly lower for all measurements from two to eight minutes thereafter (mean decrease in IOP: two minutes = 12%, four minutes = 19%; six minutes = 19%; eight minutes = 17%, all P < or = .01). In the ketamine group, mean IOP was not significantly changed from T1 through six minutes, whereas at eight minutes, it was 7% lower (P = .03). SBP and DBP were significantly lower for sevoflurane than for ketamine at all measurements from two minutes onward, and HR was lower for sevoflurane than for ketamine at two, four, and six minutes. CONCLUSIONS: IOP measured after ketamine sedation is more likely to represent the awake IOP than that after sevoflurane anesthesia. Changes in SBP, DBP, and HR caused by sevoflurane suggest that hemodynamic alterations may underlie its effects on IOP.

The contribution of qualitative research in designing a complex intervention for secondary prevention of coronary heart disease in two different healthcare systems

Background: Developing complex interventions for testing in randomised controlled trials is of increasing importance in healthcare planning. There is a need for careful design of interventions for secondary prevention of coronary heart disease (CHD). It has been suggested that integrating qualitative research in the development of a complex intervention may contribute to optimising its design but there is limited evidence of this in practice. This study aims to examine the contribution of qualitative research in developing a complex intervention to improve the provision and uptake of secondary prevention of CHD within primary care in two different healthcare systems.

Methods: In four general practices, one rural and one urban, in Northern Ireland and the Republic of Ireland, patients with CHD were purposively selected. Four focus groups with patients (N = 23) and four with staff (N = 29) informed the development of the intervention by exploring how it could be tailored and integrated with current secondary prevention activities for CHD in the two healthcare settings. Following an exploratory trial the acceptability and feasibility of the intervention were discussed in four focus groups (17 patients) and 10 interviews (staff). The data were analysed using thematic analysis.

Results: Integrating qualitative research into the development of the intervention provided depth of information about the varying impact, between the two healthcare systems, of different funding and administrative arrangements, on their provision of secondary prevention and identified similar barriers of time constraints, training needs and poor patient motivation. The findings also highlighted the importance to patients of stress management, the need for which had been underestimated by the researchers. The qualitative evaluation provided depth of detail not found in evaluation questionnaires. It highlighted how the intervention needed to be more practical by minimising administration, integrating role plays into behaviour change training, providing more practical information about stress management and removing self-monitoring of lifestyle change.

Conclusion: Qualitative research is integral to developing the design detail of a complex intervention and tailoring its components to address individuals' needs in different healthcare systems. The findings highlight how qualitative research may be a valuable component of the preparation for complex interventions and their evaluation.

The effect of anisotropic elasticity on the yielding characteristics of overconsolidated natural clay

Quantitative application of elastoplastic theory to the yielding behaviour of natural soils has always been uncertain. Part of the reason is that the theory was developed for reconstituted materials with isotropic structure, in contrast to natural soils that are usually anisotropic. The approach considered in this study assumes that pre-yielding behaviour is governed by the theory of linear anisotropic elasticity and that yield loci in the mean effective stress ( p') – deviator stress (q) plane are aligned approximately along the coefficient of earth pressure (K0) line. The assumption of a rotated yield locus associated with anisotropic elastic behaviour within the state boundary surface indicates that the elastic wall within the state boundary surface is inclined. The form of the state boundary surface has been determined mathematically in terms of anisotropic elastic and Cam-Clay soil parameters. Stress path tests were conducted on samples of Belfast Upper Boulder Clay removed from a depth of 28 m below ground surface. Good agreement was found between predicted and measured yield loci. The study also examined the influence of subsequent isotropic compression on the yielding characteristics of the natural clay. The indications are that the anisotropy developed during deposition disappears when the sample is loaded to a stress level at least twice the stress generated during the original deposition process. The methods developed in the paper have also been applied to test results reported previously on Winnipeg clay, and good agreement was obtained.

Flare X-ray Observations of AB Doradus: Evidence of Stellar Coronal Opacity

X-ray spectra of the late-type star AB Dor obtained with the XMM-Newton satellite are analyzed. AB Dor was particularly active during the observations. An emission measure reconstruction technique is employed to analyze flare and quiescent spectra, with emphasis on the Fe XVII 15 - 17 angstrom wavelength region. The Fe XVII 16.78 angstrom/ 15.01 angstrom line ratio increases significantly in the hotter flare plasma. This change in the ratio is opposite to the theoretical predictions and is attributed to the scattering of 15.01 angstrom line photons from the line of sight. The escape probability technique indicates an optical depth of approximate to 0.4 for the 15.01 angstrom line. During the flare, the electron density is 4.4(-1.6)(+2.7) x 10(10) cm(-3), and the fractional Fe abundance is 0.5 +/- 0.1 of the solar photospheric value Using these parameters, a path length of approximate to 8000 km is derived. There is no evidence of opacity in the quiescent X-ray spectrum of the star.

Manual versus target-controlled infusions of propofol

Summary Target-controlled infusion systems have been shown to result in the administration of larger doses of propofol, which may result in delayed emergence and recovery from anaesthesia. The aim of this study was to investigate if this was due to a difference in the depth of hypnosis (using the bispectral index monitoring) between the manual and target controlled systems of administration. Fifty unpremedicated patients undergoing elective surgery were randomly allocated to have their anaesthesia maintained with manual or target-controlled propofol infusion schemes. In both groups, the rate of propofol administration was adjusted according to the standard clinical criteria while bispectral index scores were recorded by an observer not involved in the delivery of anaesthesia. The total dose of propofol used was higher in the target controlled group (mean 9.9 [standard deviation 1.6] compared with 8.1 [1.0] mg.kg.h in the manual group [p

Development of sampling methods for Raman analysis of solid dosage forms of therapeutic and illicit drugs

The results of a study aimed at determining the most important experimental parameters for automated, quantitative analysis of solid dosage form pharmaceuticals (seized and model 'ecstasy' tablets) are reported. Data obtained with a macro-Raman spectrometer were complemented by micro-Raman measurements, which gave information on particle size and provided excellent data for developing statistical models of the sampling errors associated with collecting data as a series of grid points on the tablets' surface. Spectra recorded at single points on the surface of seized MDMA-caffeine-lactose tablets with a Raman microscope (lambda(ex) = 785 nm, 3 mum diameter spot) were typically dominated by one or other of the three components, consistent with Raman mapping data which showed the drug and caffeine microcrystals were ca 40 mum in diameter. Spectra collected with a microscope from eight points on a 200 mum grid were combined and in the resultant spectra the average value of the Raman band intensity ratio used to quantify the MDMA: caffeine ratio, mu(r), was 1.19 with an unacceptably high standard deviation, sigma(r), of 1.20. In contrast, with a conventional macro-Raman system (150 mum spot diameter), combined eight grid point data gave mu(r) = 1.47 with sigma(r) = 0.16. A simple statistical model which could be used to predict sigma(r) under the various conditions used was developed. The model showed that the decrease in sigma(r) on moving to a 150 mum spot was too large to be due entirely to the increased spot diameter but was consistent with the increased sampling volume that arose from a combination of the larger spot size and depth of focus in the macroscopic system. With the macro-Raman system, combining 64 grid points (0.5 mm spacing and 1-2 s accumulation per point) to give a single averaged spectrum for a tablet was found to be a practical balance between minimizing sampling errors and keeping overhead times at an acceptable level. The effectiveness of this sampling strategy was also tested by quantitative analysis of a set of model ecstasy tablets prepared from MDEA-sorbitol (0-30% by mass MDEA). A simple univariate calibration model of averaged 64 point data had R-2 = 0.998 and an r.m.s. standard error of prediction of 1.1% whereas data obtained by sampling just four points on the same tablet showed deviations from the calibration of up to 5%.

Angular distribution for the elastic scattering of electrons from Ar+(3s^2 3p^5 ^2P) above the first inelastic threshold

The measured angular differential cross section (DCS) for the elastic scattering of electrons from Ar+(3s2 3p5 2P) at the collision energy of 16 eV is presented. By solving the Hartree-Fock equations, we calculate the corresponding theoretical DCS including the coupling between the orbital angular momenta and spin of the incident electron and those of the target ion and also relaxation effects. Since the collision energy is above one inelastic threshold for the transition 3s2 3p5 2P–3s 3p6 2S, we consider the effects on the DCS of inelastic absorption processes and elastic resonances. The measurements deviate significantly from the Rutherford cross section over the full angular range observed, especially in the region of a deep minimum centered at approximately 75°. Our theory and an uncoupled, unrelaxed method using a local, spherically symmetric potential by Manson [Phys. Rev. 182, 97 (1969)] both reproduce the overall shape of the measured DCS, although the coupled Hartree-Fock approach describes the depth of the minimum more accurately. The minimum is shallower in the present theory owing to our lower average value for the d-wave non-Coulomb phase shift s2, which is due to the high sensitivity of s2 to the different scattering potentials used in the two models. The present measurements and calculations therefore show the importance of including coupling and relaxation effects when accurately modeling electron-ion collisions. The phase shifts obtained by fitting to the measurements are compared with the values of Manson and the present method.

An efficient method of radiation attenuation through aircraft cooling vents

Some critical avionic systems require cooling air via vents on the side of the aircraft, thus creating leakage points for high-intensity electromagnetic radiation. This paper presents a novel application of high-intensity radiated field (HIRF) shielding using a rectangular waveguide array, while maintaining cooling airflow requirements. Signal attenuation versus frequency and depth of the array has been calculated using closed-form equations. The simulation and measurement results are in good agreement with the calculated values. (C) 2004 Wiley Periodicals, Inc.

The effect of star-spots on eclipse timings of binary stars

We investigate the effects that star-spots have on the light curves of eclipsing binaries, and in particular how they may affect the accurate measurement of eclipse timings. Concentrating on systems containing a low-mass main-sequence star and a white dwarf, we find that if star-spots exhibit the Wilson depression they can alter the times of primary eclipse ingress and egress by several seconds for typical binary parameters and star-spot depressions. In addition, we find that the effect on the eclipse ingress/egress times becomes more profound for lower orbital inclinations. We show how it is possible, in principle, to determine estimates of both the binary inclination and the depth of the Wilson depression from light curve analysis.

Deep weathering of calcareous sedimentary rock and the redistribution of iron and manganese in soil and saprolite

Iron and Mn redistribute in soil and saprolite during weathering. The geological weathering fronts ofcalcareous sedimentary rock were investigated by examining the bulk density, porosity, and distribution ofCa, Fe, and Mn. Core samples were taken ofsoil, saprolite, and bedrock material from both summit (HHMS-4B) and sideslope (HHMS-5A) positions on an interbedded Nolichucky shale and Maryville limestone landform in Solid Waste Storage Area 6 (SWSA-6). This is a low-level radioactive solids waste disposal site on the Dept. ofEnergy (DOE) Oak Ridge Reservation in Roane County Tennessee. This work was initiated because data about the properties of highly weathered sedimentary rock on this site were limited. The core samples were analyzed for pH, calcium carbonate equivalence (CCE), hydroxylamine-extractable (HA) Mn, and dithionite-citrate (CBD)-extractable Fe and Mn. Low pH values occurred from the soil surface down to the depth of the oxidized and leached saprolite in both cores. The CCE and HA-extractable Mn results were also influenced by the weathering that has occurred in these zones. Extractable Mn oxide was higher at a lower depth in the oxidized and leached saprolite compared with the Fe oxide, which was higher in the overlying soil solum. Amounts of Mn oxides were higher in the sideslope core (HHMS-5A) than in the summit core (HHMS-4B). Iron was more abundant in the deeper weathered summit core, but the highest value, 39.4 g kg-1, was found at 1.8 to 2.4 m in the sideslope core. The zone encompassing the oxidized and partially leached saprolite down to the unoxidized and unleached bedrock had higher densities and larger quantities of CaCO3 than the soil solum and oxidized and leached saprolite. The overlying soil and oxidized and leached saprolite had lower pH and CCE values and were higher in Fe and Mn oxides than the oxidized and unleached saprolite. The distribution of Fe and Mn is important when evaluating soil and saprolite for hazardous waste disposal site assessment.

An empirical study of green supply chain management practices amongst UK manufacturers

Purpose: The purpose of this paper is to examine the extent and nature of greening the supply chain (SC) in the UK manufacturing sector; and the factors that influence the breadth and depth of this activity.

Design/methodology/approach: Based on the findings from a sample of manufacturing organisations drawn from the membership of The Chartered Institute for Purchasing and Supply. Data are collected using a questionnaire, piloted and pre-tested before distribution with responses from 60 manufacturing companies.

Findings: On average manufacturers perceive the greatest pressure to improve environmental performance through legislation and internal drivers (IDs). The least influential pressures are related to societal drivers and SC pressures from individual customers. Green supply chain management (GSCM) practices amongst this “average” group of UK manufacturing organisations are focusing on internal, higher risk, descriptive activities, rather than proactive, external engagement processes. Environmental attitude (EA) is a key predictor of GSCM activity and those organisations that have a progressive attitude are also operationally very active. EA shows some relationship to legislative drivers but other factors are also influential. Operational activity may also be moderated by organisational contingencies such as risk, size, and nationality.

Research limitations/implications: The main limitation to this paper is the relatively small manufacturing sample.

Practical implications: This paper presents a series of constructs that identify GSCM operational activities companies to benchmark themselves against. It suggests which factors are driving these operational changes and how industry contingencies may be influential.

Originality/value: This paper explores what is driving environmental behaviour amongst an “average” sample of manufacturers, what specific management practices take place and the relationships between them.

Keywords: Manufacturing industries, Environmental management, Supply chain management, Sustainable development, United Kingdom
Paper type: Research paper