La?nnec, re-inventor of the stethoscope?

According to our common medical culture, some facts are simply unquestionable, for instance La?nnec invented the stethoscope. But was he the first one? On a recent trip to Egypt we visited the temple of Kom Ombo, built prior to the roman period and renowned as a medical care center. Today, the tourist is fascinated by the magnificent hieroglyphics on the well-preserved walls testifying to significant advances in various fields of medicine including ophthalmology and gynecology. We were particularly interested by the basreliefs presenting vivid drawings of some of the first medical instruments. We easily identified curettes, scissors, a balance, forceps for dental extraction, and a surgical saw, but were captivated by two other instruments. The first one looked a lot like what La?nnec invented around 1820. The second one was amazingly similar to the instrument we use everyday, with a distal opening and flexible tubes (woven papyrus?) leading to proximal ear pieces. Our Egyptian guide was formal: the stethoscope was invented in Egypt. The scientific impact of our observations leaves something to be desired, but did make us think about the huge gap between the advancement of medical knowledge in ancient Egypt and La?nnec's (re)-invention. Exposed to a similar gap in history, what would our documents stored on CD and video tapes have to say to future touring doctors?     

A reflective approach to career trajectory in advanced practice nursing

In response to a university mandate and general faculty dissatisfaction with work assignments, faculty developed a faculty work load formula. The authors discuss the development of the teaching portion of the formula. Implementation of the formula and publication of teaching work loads has resulted in greater awareness of other's responsibilities, improved faculty morale, increased accountability, and a greater sense of control. Some problem areas are also discussed.     

Determination of cisapride and norcisapride in human plasma using high-performance liquid chromatography with ultraviolet detection

A simple, rapid and reproducible high-performance liquid chromatographic assay for cisapride and norcisapride in human plasma is described. Samples of plasma (150 microl) were extracted using a C18 solid-phase cartridge. Regenerated tubes were eluted with 1.0 ml of methanol, dried, redissolved in 150 microl of methanol and injected. Chromatography was performed at room temperature by pumping acetonitrile-methanol-0.015 M phosphate buffer pH 2.2-2.3 (680:194:126, v/v/v) at 0.8 ml/min through a C18 reversed-phase column. Cisapride, norcisapride and internal standard were detected by absorbance at 276 nm and were eluted at 4.3, 5.3 and 8.1 min, respectively. Calibration plots in plasma were linear (r>0.998) from 10 to 150 ng/ml. Intraday precisions for cisapride and norcisapride were 3.3% and 5.4%, respectively. Interday precisions for cisapride and norcisapride were 9.6% and 9.0%, respectively. Drugs used which might be coadministered were tested for interference.     

德惠断陷下白垩统碎屑岩储层特征及控制因素分析

德惠断陷下白垩统登娄库组、营城组、沙河子组储层物性差,勘探风险大.利用岩心观察、铸体薄片鉴定、扫描电镜分析、黏土X线衍射分析等方法,分析储层基本特征、储层成岩作用和控制因素.结果表明:德惠断陷下白垩统碎屑岩储层成分成熟度和结构成熟度较低,储层孔隙类型主要有残余原生孔、次生孔和混合孔,储层物性和孔隙结构较差;压实作用是导致储层物性变差的主要原因,溶蚀作用改善储层物性;纵向上发育2个次生孔隙带,主要形成于中成岩期,次生孔隙带的形成与有机质生烃排酸和断裂有关.研究结果为德惠断陷下白垩统进一步油田勘探提供地质依据,对其他地区类似储层研究有一定借鉴意义.     

Retrieving ocean surface current by 4-D variational assimilation of sea surface temperature images

In this article we propose a new method to estimate ocean mesoscale structures of the surface current velocity by processing sea surface satellite images. Assuming that the intensity level can be described by a transport-diffusion equation, the proposed approach is based on variational assimilation of image observations within a simple transport-diffusion model. This approach permits to retrieve the current velocity field from a sequence of satellite images. Results of processing synthetic data and real NOAA-AVHRR satellite images are presented and commented.     

High Q 2D-length extension mode resonators for potential time–frequency applications

Microsystem Technologies - This paper presents recent advances on two dimensional length-extension mode (2D-LEM) quartz resonators providing high quality (Q) factor on resonances at a few MHz. The...     

Biosynthesis of progesterone derived neurosteroids by developing avian CNS: in vitro effects on the GABAA receptor complex

Although enthusiasm for measuring health-related quality of life (HRQL) in clinical trials exists, information is limited on the meaning of scores. We examined the relation between scores from the 34-item Medical Outcomes Study HIV Health Survey (MOS-HIV) and the more detailed HIV Overview of Problems-Evaluation System (HOPES) using the responses of 318 HIV-infected outpatients being treated in Los Angeles and Baltimore. With the HOPES problem statements as independent variables, statistically significant predictors of the variation in MOS-HIV scores for the Physical Function, Mental Health, and Energy/Fatigue scales were identified using stepwise regression. Approximately 60% to 70% of the variation in each of the scores was explained by five to seven different HOPES problem statements, with a single item explaining 47% to 59% of the variation. We created illustrative profiles for each of the three MOS-HIV scales using the HOPES items identified in the regressions. Independent of the scale, persons scoring in the top MOS-HIV quartile tended to report few if any problems, whereas a decline in score to the next quartile was characterized by functional difficulties (e.g., "HIV interferes with work"). The onset of specific problems might trigger further evaluation and potential intervention from health care providers to help maintain patient functioning.