The investigation of business problems; technique and procedure,

"Selected references": p. 321-330.

Recommended Guidelines for Submission, Trimming, Margin Evaluation, and Reporting of Tumor Biopsy Specimens in Veterinary Surgical Pathology

Neoplastic diseases are typically diagnosed by biopsy and histopathological evaluation. The pathology report is key in determining prognosis, therapeutic decisions, and overall case management and therefore requires diagnostic accuracy, completeness, and clarity. Successful management relies on collaboration between clinical veterinarians, oncologists, and pathologists. To date there has been no standardized approach or guideline for the submission, trimming, margin evaluation, or reporting of neoplastic biopsy specimens in veterinary medicine. To address this issue, a committee consisting of veterinary pathologists and oncologists was established under the auspices of the American College of Veterinary Pathologists Oncology Committee. These consensus guidelines were subsequently reviewed and endorsed by a large international group of veterinary pathologists. These recommended guidelines are not mandated but rather exist to help clinicians and veterinary pathologists optimally handle neoplastic biopsy samples. Many of these guidelines represent the collective experience of the committee members and consensus group when assessing neoplastic lesions from veterinary patients but have not met the rigors of definitive scientific study and investigation. These questions of technique, analysis, and evaluation should be put through formal scrutiny in rigorous clinical studies in the near future so that more definitive guidelines can be derived.

Technique and outcomes about a new laparoscopic procedure: the Pelvic Organ Prolapse Suspension (POPS)

Pelvic organ prolapse suspension (POPS) is a recent surgical procedure for one-stage treatment of multiorgan female pelvic prolapse. This study evaluates the preliminary results of laparoscopic POPS in 54 women with a mean age of 55.2 and a BMI of 28.3. Patients underwent at the same time stapled transanal rectal resection (STARR) to correct the residual rectal prolapse. We had no relapses and the preliminary results were excellent. We evaluated the patients after 1 year follow-up and we confirmed the validity of our treatment. The technique is simplier than traditional treatments with an important reduction or completely disappearance of the pre-operative symptomatology.

A circuit-breaker restrike diagnostic algorithm using ATP and wavelet transforms

Circuit breaker restrikes are unwanted occurrence, which can ultimately lead to breaker. Before 2008, there was little evidence in the literature of monitoring techniques based on restrike measurement and interpretation produced during switching of capacitor banks and shunt reactor banks. In 2008 a non-intrusive radiometric restrike measurement method, as well a restrike hardware detection algorithm was developed. The limitations of the radiometric measurement method are a band limited frequency response as well as limitations in amplitude determination. Current detection methods and algorithms required the use of wide bandwidth current transformers and voltage dividers. A novel non-intrusive restrike diagnostic algorithm using ATP (Alternative Transient Program) and wavelet transforms is proposed. Wavelet transforms are the most common use in signal processing, which is divided into two tests, i.e. restrike detection and energy level based on deteriorated waveforms in different types of restrike. A ‘db5’ wavelet was selected in the tests as it gave a 97% correct diagnostic rate evaluated using a database of diagnostic signatures. This was also tested using restrike waveforms simulated under different network parameters which gave a 92% correct diagnostic responses. The diagnostic technique and methodology developed in this research can be applied to any power monitoring system with slight modification for restrike detection.

Convergent interviewing : a qualitative diagnostic technique for researchers

Purpose – This paper aims to widen knowledge of and explore how convergent interviewing can be used to identify key issues within an organization.
Design/methodology/approach – This paper introduces the convergent interviewing technique and describes the method of selecting the interview subjects. The construction of a round of interviews is explained. The content of the interviews is described and the particular probing nature of the questions demanded by the convergent interview process is explained. The ways to analyze the full set of interviews for groupings or categories is also described. The case study example of a broad research question about influences on work behaviors in a local government council is used to illustrate the convergent interviewing technique.
Findings – The key issues revealed by using the technique can be subsequently used for a variety of research and consulting purposes and settings. Convergent interviewing is an effective research method, which conserves resources.
Originality/value – Convergent interviewing enables researchers to determine the most important and/or key issues within a population rather than a full list of issues in an organization or barriers to change in a particular organizational context.

Chronic Pain after Cesarean Section. Influence of Anesthetic/Surgical Technique and Postoperative Analgesia

Cancado TO, Omais M, Ashmawi HA, Torres MLA - Chronic Pain after Cesarean Section. Influence of Anesthetic/Surgical Technique and Postoperative Analgesia. Background and objectives: Brazil ranks second among countries with the highest rates of cesarean section in the world. Little is known about the future consequences of this procedure on maternal health. This study investigated the influence of anesthetic/surgical technique and postoperative analgesia on the onset of chronic pain after three months of cesarean section. Method: This is a prospective randomized study of 443 patients undergoing cesarean section (elective and emergency), with different doses of hyperbaric bupivacaine 0.5% and opioids in spinal anesthesia. Patients were alocated into five groups as follow: G1 received hyperbaric bupivacaine (8 mg), sufentanil (2.5 mu g), and morphine (100 mu g); G2 received hyperbaric bupivacaine (10 mg), sufentanil (2.5 mu g), and morphine (100 mu g); G3 received hyperbaric bupivacaine (12.5 mg) and morphine (100 mu g); G4 received hyperbaric bupivacaine (15 mg) and morphine (100 mu g); G5 received hyperbaric bupivacaine (12.5 mg) and morphine (100 mu g), without perioperative anti-inflammatory. Pain at rest and in movement were evaluated in the immediate postoperative period. Phone contact was made after three months of surgery for identification of patients with chronic pain. Results: The incidence of chronic pain in the groups was G1 = 20%; G2 = 13%; G3 = 7.1%; G4 = 2.2%, and G5 = 20.3%. Patients who reported higher pain scores in the postoperative period had a higher incidence of chronic pain (p < 0.05). Conclusion: The incidence of chronic pain decreases with higher doses of local anesthetics and use of anti-inflammatory drugs. The higher pain scores in the postoperative period were associated with chronic pain development after three months of cesarean section.

Radiographic technique and anatomy of the equine sacroiliac region

Radiography is part of evaluating horses with poor performance and pelvic limb lameness; however, the radiographic appearance of the sacroiliac region is poorly described. The goal of the present study was to describe the use of a simple technique to obtain radiographs of the sacroiliac region in the anesthetized horse and to describe the radiographic appearance of this region. Seventy-nine horses underwent radiography of the pelvis under general anesthesia in dorsal recumbency. During a 5s exposure time the horse was actively ventilated to blur the abdominal viscera, which allowed assessment of individual bone structures in 77 horses. A large variation in the shape of the sacral wings, their articulation with the transverse processes of L6, and the relation of the sacrum to the ilium were observed. Females had significantly narrower width of the sacral wings. Broad sacral wings and bony proliferations at the caudal aspect were commonly observed features and their size was highly correlated with gender. In males, caudal osteophytes were significantly larger than in females. Five horses had transitional or hemitransitional vertebrae. Radiography with the ventilation-induced blurring technique is a simple approach that results in diagnostic quality radiographs and delineation of the highly variable bone structures of the sacroiliac region.

An implantable carotid sinus baroreflex activating system: surgical technique and short-term outcome from a multi-center feasibility trial for the treatment of resistant hypertension

OBJECTIVES: To assess perioperative outcomes and blood pressure (BP) responses to an implantable carotid sinus baroreflex activating system being investigated for the treatment of resistant hypertension. METHODS: We report on the first seventeen patients enrolled in a multicenter study. Bilateral perivascular carotid sinus electrodes (CSL) and a pulse generator (IPG) are permanently implanted. Optimal placement of the CSL is determined by intraoperative BP responses to test activations. Acute BP responses were tested postoperatively and during the first four months of follow-up. RESULTS: Prior to implant, BP was 189.6+/-27.5/110.7+/-15.3 mmHg despite stable therapy (5.2+/-1.8 antihypertensive drugs). The mean procedure time was 202+/-43 minutes. No perioperative strokes or deaths occurred. System tests performed 1 or up to 3 days postoperatively resulted in significant (all p < or = 0.0001) mean maximum reduction, with standard deviations and 95% confidence limits for systolic BP, diastolic BP and heart rate of 28+/-22 (17, 39) mmHg, 16+/-11 (10, 22) mmHg and 8+/-4 (6, 11) BPM, respectively. Repeated testing during 3 months of therapeutic electrical activation demonstrated a durable response. CONCLUSIONS: These preliminary data suggest an acceptable safety of the procedure with a low rate of adverse events and support further clinical development of baroreflex activation as a new concept to treat resistant hypertension.

Transdiaphragmatic Resuscitative Open Cardiac Massage: Description of the Technique and a First Case-Series of an Alternative Approach to the Heart

Abstract BACKGROUND: The purpose of this paper is to describe the transdiaphragmatic approach to the heart for open CPR in patients that arrest at laparotomy and to present a first case series of patients that have undergone this procedure. METHODS: All patients who had undergone intraperitoneal transdiaphragmatic open CPR between January 1, 2002 and December 31, 2012 were retrieved from the operation registry at Bern University Hospital, Switzerland. Transdiaphragmatic access to the heart is initiated with a 10-cm-long anterocaudal incision in the central tendon of the diaphragm--approximately at 2 o'clock. Internal cardiac compression through the diaphragmatic incision can be performed from both sides of the patient. From the right side of the patient, cardiac massage is performed with the right hand and vice versa. RESULTS: A total of six patients were identified that suffered cardiac arrest during laparotomy with open CPR performed through the transdiaphragmatic approach. Four patients suffered cardiac arrest during orthotopic liver transplantation and two trauma patients suffered cardiac arrest during damage control laparotomy. In three patients, cardiac activity was never reestablished. However, three patients regained a perfusion heart rhythm and two of these survived to the ICU. One patient ultimately survived to discharge. CONCLUSIONS: In patients suffering cardiac arrest during laparotomy, the transdiaphragmatic approach allows for a rapid, technically easy, and almost atraumatic access to the heart, with excellent CPR performance. After this potentially life-saving procedure, pulmonary or surgical site complications are expected to occur much less compared with the conventionally performed emergency department left-sided thoracotomy.

Study of infectious haematopoietic necrosis disease in some hatcheries and farmed rainbow trout in Iran using immunohistochemical technique and to comparing the obtained results with the PCR works

To detect rainbow trout hatcheries for infectious hematopoietic necrosis virus, samples of kidney, liver, spleen, muscle, intestine, heart and gills of trout larvae were obtained from a number of trout hatcheries from different provinces. Also tissue samples were obtained for molecular works using RT- PCR procedure. Tissue samples were processed using standard histotechnique and the obtained sections were stained using immunohistochemical procedure. From 100 examined samples 35 were positive for IHN by immunohistochemical test. Also, from 100 samples examined, 43 were positive in RT- PCR studies. The obtained results show that some rainbow trout hatcheries are contaminated in different regions of country. Therefore, a definition of prevention and eradication criteria are now critical to protect the unaffected areas within the country.

Quantifying variability within technique and performance in elite fast bowlers : is technical variability dysfunctional or functional?

In fast bowling, cricketers are expected to produce a range of delivery lines and lengths while maximising ball speed. From a coaching perspective, technique consistency has been typically associated with superior performance in these areas. However, although bowlers are required to bowl consistently, at the elite level they must also be able to vary line, length and speed to adapt to opposition batters’ strengths and weaknesses. The relationship between technique and performance variability (and consistency) has not been investigated in previous fast bowling research. Consequently, the aim of this study was to quantify both technique (bowling action and coordination) and performance variability in elite fast bowlers from Australian Junior and National Pace Squads. Technique variability was analysed to investigate whether it could be classified as functional or dysfunctional in relation to speed and accuracy.

Practice and Procedure. Self-executing order - construction - whether further judicial at required for self-executing order to take effect

In Mango Boulevard Pty Ltd v Spencer [2010] QCA 207, a self-executing order had been made in consequence of continuing default by parties to the proceedings in meeting their disclosure obligations. The case involved several questions about the construction and implications of the self-executing order. This note focuses on the aspects of the case relating to that order.

Practice and procedure : a recent Court of Appeal case examines the meaning of 'third party payer' in terms of Part 3.4 of the Legal Profession Act 2007.

In Legal Services Commissioner v Wright [2010] QCA 321 the Queensland Court of Appeal allowed an appeal from the first instance decision. The decision involved the construction of “third party payer” in Part 3.4 of the Legal Profession Act 2007 (Qld).

Practice and procedure : an application under r367 of the Uniform Civil Procedure Rules may be of use in obtaining copies of otherwise unavailable documents held by government agencies.

In Bowenbrae Pty Ltd v Flying Fighters Maintenance and Restoration [2010] QDC 347 Reid DCJ made orders requiring the plaintiffs to make application under the Freedom of Information Act 1982 (Cth) (“the FOI Act”) for documents sought by the defendant.

Practice and Procedure: Worker's Compensation and Rehabilitation Act 2003 (Qld) s275

In Australian Meat Holdings Pty Ltd v Sayers [2007] QSC 390 Daubney J considered the obligation imposed on a claimant under s 275 of the Workers’ Compensation and Rehabilitation Act 2003 (Qld) to provide the insurer with an authority to obtain information and documents. The decision leads to practical results.