Preoperative anxiety and fear: a comparison of assessments by patients and anesthesia and surgery residents

We sought to compare self-assessment of preoperative anxiety levels and selection of worst fears by surgical patients with the assessments made by the anesthesia and surgery residents providing intraoperative care for those patients. One hundred inpatients at a Veterans Affairs hospital (Group 1) and 45 patients at a University hospital (Group 2) were asked to complete a brief questionnaire; the residents were asked to complete the same questionnaire. Group 1 results showed that median patient visual analog scale (VAS) scores were lower for anxiety about anesthesia compared to surgery (16 vs 22, P < or = 0.05). Anesthesia resident VAS scores were higher than patient or surgery resident scores. Neither type of resident was able to predict their individual patient's VAS score (Kendall's tau). The fear chosen with the greatest incidence by Group 1 patients and residents was "whether surgery would work". A significant number of residents (34%, anesthesia or surgery, P < or = 0.05) matched their patient's fear choice. Residents commonly chose fears related to their specialty (e.g., anesthesia residents chose anesthesia-related fears more often than surgery residents, 50% vs 28%, P < or = 0.001). In Group 2, residents demonstrated an improved ability to predict patient scores. For instance, both surgery and anesthesia residents were able to predict individual University patient VAS scores (P < or = 0.01). The fear chosen with the greatest frequency by Group 2 patients was "pain after the operation". Sixty percent of anesthesia residents matched their patients' fear choice (P < or = 0.001). This study indicates a variable ability of anesthesia and surgery residents to predict patient anxiety and fear which may be due, in part, to difficulty in understanding a Veterans Affairs hospital patient population.     

The lateral retromalleolar groove: a radio-anatomic study]

The anatomy of the malleolar peroneal groove is presented. The results are based on a coupled osteological and CTscan study of 20 samples of fibulae. The average distal fibular torsion was 64 degrees. The peroneal groove was oriented posteriorly (mean value: 78 degrees). Three types of morphological variations were found: concave, flat, convex (the convex shaped groove was the most frequent one: 70%). The average width of the groove was 9 mm. These morphometric results were compared to "clinical" ones performed on patients with a peroneal tendons dislocation syndrome: CTscan study showed an osseous dysplasia concerning the groove depth (flat or convex) and/or a torsional insufficiency. Hypothesis of a bone dysplasia in peroneal dislocation syndrome is discussed.     

A high quality and small shadow size visual secret sharing scheme based on hybrid strategy for grayscale images

Many secret sharing schemes for digital images have been developed in recent decades. Traditional schemes typically must deal with the problem of computational complexity, and other visual secret sharing schemes come with a higher transmission cost and storage cost; that is, each shadow size is m times as big as the original secret image. The new (2,n) secret sharing scheme for grayscale images proposed in this paper is based a combination of acceptable image quality using block truncation coding (BTC), high compression ratio discrete wavelet transform (DWT) and good subjective performance of the vector quantization (VQ) technique. Experimental results confirm that our proposed scheme not only generates a high quality reconstructed original image but also generates small, random-like grayscale shadows.     

Hybrid wet paper coding mechanism for steganography employing n-indicator and fuzzy edge detector

Data hiding technique can facilitate security and the safe transmission of important information in the digital domain, which generally requires a high embedding payload and good stego image quality. Recently, a steganographic framework known as wet paper coding has been utilized as an effective strategy in image hiding to achieve the requirements of high embedding payload, good quality and robust security. In this paper, besides employing this mechanism as a fundamental stage, we take advantage of two novel techniques, namely, an efficient n-indicator and a fuzzy edge detector. The first is to increase the robustness of the proposed system to guard against being detected or traced by the statistics methods while allowing the receiver without knowledge of secret data positions to retrieve the embedded information. The second is to improve the payload and enhance the quality of stego image. The experimental results show that our proposed scheme outperforms its ability to reduce the conflict among three steganography requirements.     

Handedness in native Amazonians

Using selected incubation conditions we have identified intermediate steps, between the first glucose transferred to protein and the appropriate substrate for glycogen synthase. Mn2+ stimulates the addition of the first, and probably, the second glucose molecule to the acceptor protein but inhibits further elongation. In the presence of Mn2+ only one radioglucosylated protein band of M(r) 42 kDa was evident. In the absence of Mn2+, two bands of 60.7 and 64.6 kDa were obtained indicating elongation of the glucan chains. After Glc6P addition a family of glucosylated proteins with higher M(r) was obtained, as reported previously. Mn2+ inhibition of the second step, is reversed by PMSF+Glc6P addition. Under these conditions a family of radioglucosylated protein bands with M(r) far in excess of 42 kDa, similar to that obtained without Mn2+, was obtained. Therefore, two different transglucosylating activities were necessary, at least, to prepare the appropriate substrate for glycogen synthase. Based on these observations the model we proposed earlier for glycogen biogenesis is modified. The original "Glycogen Initiator" implies at present two enzymatic activities, Glycogen Initiator 1 (activated by Mn2+) and Glycogen Initiator 2 (inhibited by Mn2+).     

Analysis of patients referred to the gastroenterology service of a VA medical center

We recorded clinical information over a 12-month period on consecutive consultations to the gastroenterology service of the Durham VA Medical Center. Of 902 consultations, 789 were prospectively collected. Eighty-five percent of the patients were between 40 and 70 years old. Seventy-five percent of the referrals were from the internal medicine service. The most frequent reasons for consultation were abdominal pain (19%), GI bleeding (active, 16%; occult, 9%), abnormal results of liver tests (18%), and request for a procedure (11%). Diseases of the liver (32%) and "peptic diseases" (30%) were the most common diagnoses. One or more procedures were done in 71% of consultations. When these data are compared with those of a practicing gastroenterologist, using an identical instrument, it is apparent that trainees' experience with structurally identifiable gastroenterologic disease and with a variety of procedures was similar in scope. There were, however, differences in that the physicians at the VA saw substantially fewer patients with so-called "functional" illness. If these data are applicable to other VA Medical Centers, then the training of physicians in gastroenterology at a VA Medical Center should probably be broadened.     

Methods of combined antenatal diagnosis of maturity

A combined diagnosis of maturity is described, which is harmless in a correct technique. The method can be carried out in each of obstetrical hospital together with a routine laboratory. By means of the combined diagnosis a "maturity-index" is performed, which permits a certain assessment of the survival-chance of the praemature delivered children. In connection with the ultrasound-cephalometrie also there is an exact evidence to the duration of pregnancy and the tendence of intrauterine growth of the fetus.     

Simultaneous quantification of free fatty acids,free sterols,squalene, and acylglycerol molecular species in palm oil by high-temperature gas chromatography-flame ionization detection

This paper discusses a rapid GC-FID technique for the simultaneous quantitative analysis of FFA, MAG, DAG, TAG, sterols, and squalene in vegetable oils, with special reference to palm oil. The FFA content determined had a lower SE compared with a conventional titrimetric method. Squalene and individual sterols, consisting of β-sitosterol, stigmasterol, campesterol, and cholesterol, were accurately quantified without any losses. This was achieved through elimination of tedious conventional sample pretreatments, such as saponification and preparative TLC. With this technique, the separation of individual MAG, consisting of 16∶0, 18∶0, and 18∶1 FA, and the DAG species, consisting of the 1,2(2,3)- and 1,3-positions, was sufficient to enable their quantification. This technique enabled the TAG to be determined according to their carbon numbers in the range of C₄₄ to C₅₆. Comparisons were made with conventional methods, and the results were in good agreement with those reported in the literature.     

Comments on “Performances of a Fully Integrated All-Optical Pulse Reshaper Based on Cascaded Coupled Nonlinear Microring Resonators” [Sep 07 2417-2426]

In the above paper we did not accurately evaluate the Q-factors given in Table I. We give in the present table the corrected values. Captions of figures 11, 12, 13 and 15 must be changed using these new values: in the caption of Fig. 11 Q_in ^t 4.81, Q_out = 11.61 and Q_out ^t = 3.18; in the caption of Fig. 12 Q_out = 9.71 and Q_out ^t = 1.85; in the caption of Fig. 13 Q_out = 6.01 and Q_out ^t 4.64; in the caption of Fig. 15 Q_out = 5.86 and Q_out ^t = 2.11. In the text, the best Q-factor increase in the lossly case of 4.72 dB obtained at 10 Gbit/s.