Legal basis of vaccine prophylaxis in Russia]

As a complementary modality, therapeutic touch is gaining increasing recognition. Not only are nurses incorporating therapeutic touch into their daily patient care, but patients also are requesting this healing modality. Nurse leaders also use this nursing intervention to weave their vision of healing into their managerial role.     

Motility related protein 1 (MRP1/CD9) expression in colon cancer

STUDY OBJECTIVES: To examine the incidence and clinical significance of prolonged air leak (PAL) in patients undergoing radical upper lobectomy and to determine potential risk factors for PAL in this group of patients. DESIGN: Retrospective review of a prospective database. SETTING: Experience of one thoracic surgeon at a tertiary care cancer center. PATIENTS: One hundred consecutive patients undergoing right upper lobectomy and mediastinal lymph node dissection for non-small cell lung cancer over an 11-year period. MEASUREMENTS: PAL was defined as an air leak lasting >7 days. Preoperative, intraoperative, and postoperative clinical data were collected and analyzed to determine the factors associated with PAL. RESULTS: PAL was the most prevalent postoperative complication, comprising 25.5% of all complications seen, and lasting an average of 12.1+/-5.3 days. In 21 of the 26 patients with PAL, this complication was the only morbidity identified. There was no statistically significant difference in patient age, gender, preoperative FEV1 and diffusion of carbon monoxide, exposure to neoadjuvant chemotherapy, status of pulmonary fissures, or pathologic stage between the PAL group vs the remaining 74 patients without this complication. A significantly greater proportion of patients with PAL had FEV1/FVC ratio < or =50% (6/26 vs 5/74; p=0.02). Patients with PAL had significantly longer median length of hospital stay (11 vs 7 days; p=0.0001). Moreover, PAL was the single most common reason for an extended length of hospitalization (21/58, 36% of all causes). CONCLUSION: PAL is an alarmingly common postoperative complication and is the most frequent cause of an extended length of hospital stay in patients undergoing radical upper lobectomy. Severe obstructive pulmonary disease predisposes patients to the development of this complication.     

Comparison between TRH-stimulated TSH and basal TSH measurement by a commercial immunoradiometric assay in the management of thyroid disease

In order to assess the current diagnostic role of the TRH test following the introduction of more sensitive "second generation" TSH assays, we studied a series of 259 outpatients, 237 women and 22 men, mean age 44.7 years (range 12-82), 91 of whom (35%) with untreated simple goiter, 133 (51%) with simple nodular goiter on steady state I-thyroxine treatment, 18 (7%) with overt or subclinical hyperthyroidism and 17 (7%) with overt or subclinical hypothyroidism, compared to a control group of 26 euthyroid healthy subjects. Serum TSH was measured by a commercial immunoradiometric assay (clinical sensitivity 0.1 microU/ml). TSH response to TRH was evaluated 30 minutes after giving 200 micrograms TRH i.v. bolus, the results being analyzed both as absolute increase (delta-TSH=stimulated TSH minus basal TSH) and as relative increase (R-TSH stimulated TSH/basal TSH). Using cut-off values of 0.3-3.2 microU/ml, basal TSH measurement was able to detect hypothyroidism (specificity = 100%) and to exclude hyperthyroidism (sensivity = 96.9%), but failed to accurately prove hyperthyroidism (specificity = 93.4%) and, above all, to exclude hypothyroidism (sensitivity = 35.3%) in our ambulatory patients. The delta-TSH values showed a basal TSH dependent linear increase (r = + 0.87, p < 0.001) both including only patients (n = 139) with basal TSH level in the euthyroidism range and including all patients (n = 223) having TSH responsive to TRH. All the patients with detectable basal TSH level displayed detectable TSH response to TRH, as did 19 (= 23.5%) of 81 patients with undetectable (< 0.1 microU/ml) basal value. In particular: a) for subnormal but detectable basal TSH ranging between 0.1 and 0.2 microU/ml, TSH was always hyporesponsive (delta-TSH < or = 2.5 microU/ml), while between 0.2 and 0.3 microU/ml TSH was hyporesponsive in 72.2% and normoresponsive (delta-TSH > 2.5 and < or = 11.9 microU/ml) in the remaining 27.8%; b) for basal TSH values within the normal range (0.3-3.2 microU/ml). TSH was hyporesponsive in 13.7%, normoresponsive in 74.8% and hyperresponsive in 11.5%; c) for high basal TSH values TSH was always hyperresponsive. The analysis of R TSH showed relatively constant values in the range of euthyroidism and hypothyroidism (m +/- SD: 7.4 +/- 2.3 and 7.7 +/- 3.1, respectively), and a marked differentiation of hyperthyroid patients whose R-TSH values were significantly lower (4.2 +/- 3.4) but had a wide individual variability. Linear regression analysis of basal or stimulated TSH and circulating thyroid hormones showed a close negative relationship, being highly significant between delta-TSH and T4 (r = 0.57, p < 0.001) and delta-TSH and FT4 (r = 0.46, p < 0.001). In conclusion, after the introduction of current second generation TSH immunoradiometric assay, the diagnostic role of the TRH test is greatly limited but not to be excluded: it can provide additional information to that obtained with simple basal TSH measurement in the diagnosis of subclinical hypothyroidism and in the precise evaluation of the degree of TSH suppression in patients with a subnormal basal TSH, either for endogenous thyrotoxicosis or I.-thyroxine treatment.     

Multistage particle windows for fast and accurate object detection

The common paradigm employed for object detection is the sliding window (SW) search. This approach generates grid-distributed patches, at all possible positions and sizes, which are evaluated by a binary classifier: The tradeoff between computational burden and detection accuracy is the real critical point of sliding windows; several methods have been proposed to speed up the search such as adding complementary features. We propose a paradigm that differs from any previous approach since it casts object detection into a statistical-based search using a Monte Carlo sampling for estimating the likelihood density function with Gaussian kernels. The estimation relies on a multistage strategy where the proposal distribution is progressively refined by taking into account the feedback of the classifiers. The method can be easily plugged into a Bayesian-recursive framework to exploit the temporal coherency of the target objects in videos. Several tests on pedestrian and face detection, both on images and videos, with different types of classifiers (cascade of boosted classifiers, soft cascades, and SVM) and features (covariance matrices, Haar-like features, integral channel features, and histogram of oriented gradients) demonstrate that the proposed method provides higher detection rates and accuracy as well as a lower computational burden w.r.t. sliding window detection.     

Leucaena (Leucaena leucocephala (Lam) de Wit) prunings as nitrogen source for maize (Zea mays L.)

The effectiveness ofLeucaena leucocephala (Lam.) de Wit, prunings as N source for maize (Zea mays L.) was evaluated in field and pot trials at Ibadan, southern Nigeria. An N deficient, sandy Apomu soil (Psammentic Usthorthent) was used. The prunings significantly increased N uptake of seedlings and N percentage in ear leaves of maize. High maize gain yield was obtained with application of 10 tons fresh prunings or a combination of 5 tons fresh prunings and N at 50 kg ha^–1. The prunings as N source, appeared to be more effective when incorporated in the soil than when applied as mulch. In the pot trial, prunings applied two weeks before planting was more effective than when applied at time of planting maize. Under screen house conditions, the apparent N recovery from prunings with early incorporation about equals that of fertilizer N.     

Neighbor cache prefetching for multimedia image and video processing

Cache performance is strongly influenced by the type of locality embodied in programs. In particular, multimedia programs handling images and videos are characterized by a bidimensional spatial locality, which is not adequately exploited by standard caches. In this paper we propose novel cache prefetching techniques for image data, called neighbor prefetching, able to improve exploitation of bidimensional spatial locality. A performance comparison is provided against other assessed prefetching techniques on a multimedia workload (with MPEG-2 and MPEG-4 decoding, image processing, and visual object segmentation), including a detailed evaluation of both the miss rate and the memory access time. Results prove that neighbor prefetching achieves a significant reduction in the time due to delayed memory cycles (more than 97% on MPEG-4 with respect to 75% of the second performing technique). This reduction leads to a substantial speedup on the overall memory access time (up to 140% for MPEG-4). Performance has been measured with the PRIMA trace-driven simulator, specifically devised to support cache prefetching.     

Coping strategies and collective efficacy as mediators between stress appraisal and quality of life among rescue workers.

Fire-fighters, paramedics, and emergency medical technicians routinely confront potentially traumatic events in the course of their jobs. The mediation role of coping strategies and collective efficacy in the relationship between stress appraisal and quality of life was examined (compassion satisfaction, compassion fatigue, and burnout) in a correlational study. Participants were 463 Italian rescue workers (fire fighters and different categories of emergency health care professionals). Participants filled out measures of stress appraisal, collective efficacy, coping strategies, and quality of life. The results showed that emotion and support coping, self-blame coping, and self-distraction mediated the relationship between stress appraisal and compassion fatigue. Moreover, collective efficacy, self-blame coping, and religious coping mediated the relationship between stress appraisal and burnout. Finally, collective efficacy, self-blame coping, and problem-focused coping mediated the relationship between stress appraisal and compassion satisfaction. Cognitive restructuring and denial did not mediate the relation between stress appraisal and any of the quality of life dimensions. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Tracheal intubation in infants

BACKGROUND: So far only a few cases of carcinoma in situ of the fallopian tube have been reported, but its detailed clinical and pathologic findings, including cytology, have not been fully described. CASE: A 70-year-old female was admitted to our hospital because of irregular genital bleeding. Endometrial smear revealed a small number of atypical cells with a clear background. Hysterectomy, bilateral salpingo-oophorectomy and omentectomy were performed. Grossly, a grayish white papillary tumor, measuring 1.5 x 1.0 cm, was observed within the lumen of the left fallopian tube. Microscopically, the diagnosis of papillary adenocarcinoma in situ of the left fallopian tube was made according to 1992 International Federation of Gynecologists and Obstetricians fallopian tube staging. CONCLUSION: Although endometrial brush cytology is not sensitive enough to detect a primary carcinoma of the fallopian tube, our case indicates that it may contribute useful information on extrauterine diseases and can detect a stage 0 cancer of the fallopian tube. Clinicians, as well as pathologists, should consider the possibility of fallopian tube cancer if cervical or endometrial cytology shows atypical cells with papillary patterns with a clear background but endometrial curettage cannot prove malignancy.     

Potentially avoidable hospitalizations: inequalities in rates between US socioeconomic groups

OBJECTIVES: The National Hospital Discharge Survey (NHDS) was used to evaluate potentially avoidable hospital conditions as an indicator of equity and efficiency in the US health care system. METHODS: With the use of 1990 data from the NHDS, the National Health Interview Survey, and the census, national rates of hospitalization were calculated for avoidable conditions by age, race, median income of zip code, and insurance status. RESULTS: An estimated 3.1 million hospitalizations were for potentially avoidable conditions. This was 12% of all hospitalizations in 1990 (excluding psychiatric admissions, women with deliveries, and newborns). Rates of potentially avoidable hospitalizations were higher for persons living in middle- and low-income areas than for persons living in high-income areas, and were higher among Blacks than among Whites. These class and racial differences were also found among the privately insured. Differences among income and racial groups for persons aged 65 and over were not significant. CONCLUSIONS: Inequalities in potentially avoidable hospitalizations suggest inequity and inefficiency in the health care delivery system. Avoidable hospital conditions are a useful national indicator to monitor access to care.