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A brief background discussion. Nanoparticle albumin-bound paclitaxel (nab-PTX) has been developed under the concept of improved drug delivery. nab-PTX has been shown to significantly increase progression-free survival compared with solvent-based paclitaxel (PTX) in metastatic breast cancer. However, the long-term outcomes of nab-PTX induced peripheral neuropathy (nPIPN) have not yet been fully elucidated. Trial design: observational cohort study (UMIN20852) Primary objective: The long-term outcome of nPIPN Secondary objectives (1)The validity of the Neuropathic Pain Screening Questionnaire (Japan–Q, Ishikawa et al. Pain Research 2016 ) (2) To evaluate the effect of frozen gloves and elastic stockings for nPIPN nPIPN was assessed by the Japan-Q (J-Q) and Common Toxicity Criteria for Adverse Events ver 4.0 (CTC). The J-Q is an assessment tool for patient-reported pain severity, which consists of seven items, each rated on a five-point scale 0-4; grade 0 (no symptoms) to grade 4 (verysevere symptoms). Pricking pain, electric shock pain, burn like pain, tingling pain with numbness, allodynia, reduced or hyper sensitivity and hand-foot syndrome. Assessment was performed every day during chemotherapy, six months and one year after completion of nab-PTX therapy. Total of 28 points for each day and 588 points for each cycle, higher point correlates with severity. Frozen gloves during administration of nab-PTX and/or elastic stockings were optionally used. Statistical methods Kruskal Wallis test was used and p RESULTS: Between May 2013, and April 2016, 105 patients were enrolled from 7 hospitals. In 73 patients (69.5%) nab-PTX was administered as primary and in 32 patients (30.5%) as adjuvant therapy. Forty three (41.0%) patients received nab-PTX as first line and 62 (59.0%) received after anthracycline contained regimen. Trastuzumab was administered as combination therapy with nab-PTX for Her2 positive patients. Both frozen gloves and stockings were used in 21 patients (20.0%) and frozen gloves only were used in 21 patients (20.0%) according to patient preference. One hundred patients (95.2%) completed four courses, and overall relative dose intensity was 91.4%. During chemotherapy, J-Q scores go elevated from day 1 to day 5 and gradually declined throughout the rest of the cycle. Without using frozen gloves, there was a significant increase according to courses (1st: 45.0 ± 5.7, 2nd: 76.7 ± 8.6, 3rd: 94.3 ± 11.8, 4th: 95.4 ± 11.8). Using frozen gloves, there was a significant increase from 1st course to 2nd, but no further increase was observed(1st: 37.4 ± 8.1, 2nd: 61.9 ± 12.4, 3rd: 62.9 ± 10.4, 4th: 55.3 ± 10.6). After six month and one year, the scores were significantly lower compared with the last day of the fourth cycle (4.28 ± 0.50, 2.53 ± 0.25, 2.85 ± 0.39, respectively). CTC, grade 2 or more sensory disturbance was observed in 57.9% after four cycles, but improved to 9.5% and 5.4% after six month and one year respectively. CONCLUSIONS: Patient-reported nPIPN was significantly getting worse without frozen gloves during chemotherapy, however be largely reversible within 1 year of PST or adjuvant treatment. The J-Q findings support that nab-PTX treatment is tolerable. Citation Format: Yoshidome K, Morimoto T, Matsunami N, Tsunashima R, Tsukamoto F, Ryo T, Nishida Y, Shimo T, Anno K, Shimada M, Udo M, Kagawa M, Morishima H, Oda N. Nanoparticle albumin-bound paclitaxel-induced peripheral neuropathy in patients receiving neoadjuvant or adjuvant chemotherapy for breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-11-17.

Culture is essential for humans to exist. Yet surprisingly little attention has been paid to identifying how culture works or developing standards to guide the application of this concept in health research. This paper describes a multidisciplinary effort to find consensus on essential elements of a definition of culture to guide researchers in studying how cultural processes influence health and health behaviors. We first highlight the lack of progress made in the health sciences to explain differences between population groups, and then identify 10 key barriers in research impeding progress in more effectively and rapidly realizing equity in health outcomes. Second, we highlight the primarily mono-cultural lens through which health behavior is currently conceptualized, third, we present a consensus definition of culture as an integrating framework, and last, we provide guidelines to more effectively operationalize the concept of culture for health research. We hope this effort will be useful to researchers, reviewers, and funders alike.

Introduction Chemotherapy induced peripheral neuropathy (CIPN) is a major problem for patients who receive chemotherapy, and it sometimes deteriorate patients' QOL. Many CIPN prevention trials have been conducted, but no one succeeded to date. Objectives To investigate if frozen glove (FG) prevents peripheral neuropathy induced by nanoparticle albumin-bound paclitaxel (nab-PTX). Methods We conducted CIPN prevention study using FG, as part of multi-institutional phase II study which analyze efficacy and safety of nab-PTX (260mg/m2 q3w) followed by FEC (500/100/500 mg/m2, q3w) in pre-operative setting (KBCSG-TR 1213 trial). Each patient wore an FGs for a total of 60 minutes (15mins before and after nab-PTX treatment) on both hands. CIPN were assessed during treatment period with nab-PTX by the Patient Neurotoxicity Questionnaire (PNQ) and the FACT/GOG (Gynecologic Oncology Group) Neurotoxicity (Ntx) subscale. Patients were asked to access PNQ and FACT/GOG Ntx on a daily basis and recorded in the CIPN diary. Results Sixty two patients were registered for KBCSG-TR 1213 trial. And forty two pts (68%) who turned in the diary were analyzed. Median age and median body mass index (BMI) was 48 years old and 21.6 kg/m2, respectively. We analyzed following 6 categories, 1) symptoms of hands and arms, 2) symptoms of foots, 3) symptoms of general, 4) symptoms of ears 5) muscle weakness of hands and arms and 6) muscle weakness of foots. Median time to each event was 1) 25.5 days, 2) 5days, 3) 3days, 4) not available, 5) 46.5days, 6)4 days. By using FG, time to event of hands and arms was much longer compared with that of foots. Conclusions CIPN could be prevented or lessened by FG. Randomized phase II CIPN prevention study has been just launched. Citation Format: Nakayama T, Yasojima H, Morimoto T, Yoshidome K, Mizutani M, Takashima T, Matsunami N, Enami A, Kagawa M, Nomura T, Shiba E, Nishi T, Kamigaki S, Kozuma Y, Yoshinami T, Masuda N. Frozen glove could be a new hope for prevention of chemotherapy induced peripheral neuropathy. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-10-26.

Recent ground networks and satellite remote-sensing observations have provided useful data related to spatial and vertical distributions of mineral dust particles in the atmosphere. However, measurements of temporal variations and spatial distributions of mineral dust deposition fluxes are limited in terms of their duration, location, and processes of deposition. To ascertain temporal variations and spatial distributions of mineral dust deposition using wet and dry processes, weekly deposition samples were obtained at Sapporo, Toyama, Nagoya, Tottori, Fukuoka, and Cape Hedo (Okinawa) in Japan during October 2008–December 2010 using automatic wet and dry separating samplers. Mineral dust weights in water-insoluble residue were estimated from Fe contents measured using an X-ray fluorescence analyser. Wet and dry deposition fluxes of mineral dusts were both high in spring and low in summer, showing similar seasonal variations to frequency of aeolian dust events (Kosa) in Japan. For wet deposition, highest and lowest annual dust fluxes were found at Toyama (9.6 g m−2 yr−1) and at Cape Hedo (1.7 g m−2 yr−1) as average values in 2009 and 2010. Higher wet deposition fluxes were observed at Toyama and Tottori, where frequent precipitation (> 60% days per month) was observed during dusty seasons. For dry deposition among Toyama, Tottori, Fukuoka, and Cape Hedo, the highest and lowest annual dust fluxes were found respectively at Fukuoka (5.2 g m−2 yr−1) and at Cape Hedo (2.0 g m−2 yr−1) as average values in 2009 and 2010. The average ratio of wet and dry deposition fluxes was the highest at Toyama (3.3) and the lowest at Hedo (0.82), showing a larger contribution of the dry process at western sites, probably because of the distance from desert source regions and because of the effectiveness of the wet process in the dusty season. Size distributions of refractory dust particles were obtained using four-stage filtration: > 20, > 10, > 5, and > 1 μm diameter. Weight fractions of the sum of > 20 μm and 10–20 μm (giant fraction) were higher than 50% for most of the event samples. Irrespective of the deposition type, the giant dust fractions generally decreased with increasing distance from the source area, suggesting the selective depletion of larger giant particles during atmospheric transport. Based on temporal variations of PMc (2.5 < D < 10 μm), ground-based lidar, backward air trajectories, and vertical profiles of potential temperatures, transport processes of dust particles are discussed for events with high-deposition and low-deposition flux with high PMc. Low dry dust depositions with high PMc concentrations were observed under stronger (5 K km−1) stratification of potential temperature with thinner and lower (< 2 km) dust distributions because the PMc fraction of dust particles only survived after depletion of giant dust particles by rapid gravitational settling at the time they reach Japan. In contrast, transport through a thicker (> 2 km) dust layer with weak vertical gradient of potential temperature carry more giant dust particles to Japan. Because giant dust particles are an important mass fraction of dust accumulation, especially in the North Pacific, which is known as a high-nutrient, low-chlorophyll (HNLC) region, the transport height and fraction of giant dust particles are important factors for studying dust budgets in the atmosphere and their role in biogeochemical cycles.

To compare fetal outcomes among grand multiparous (para 5-9) and multiparous (para 2-4) delivering in Mulago hospital, Uganda.Prospective cohort study.Mulago hospital, Uganda.One hundred and fifty six grand multiparous and multiparous women were recruited on admission in labourward and followedup through labour and immediate postpartum period. Fetal outcomes among the two groups were collected and analyzed.The admissions to SCU were similar in the two groups i.e. 11(7%) GMP vs. 11(7%) MP, the number of fresh still births was higher among the grandmultiparas 13(8.3%) GMP vs. 7(4.5%) MP though this was not statistically significant. The fetal weight did not significantly differ in the two groups.There was no difference in fetal outcomes among GMPs when compared to MPs.

To ascertain the temporal and spatial distribution of mineral dust deposition by wet processes, weekly deposition samples were obtained at Sapporo, Toyama, Nagoya, Tottori, Fukuoka, and Cape Hedo (Okinawa) during October 2008-January 2010 using automatic wet-dry separating samplers. Mineral dust weights in water-insoluble residue mixed with pollen were estimated from Fe contents measured using an X-ray fluorescence analyzer. Highest and lowest annual dust fluxes were found respectively at Toyama (8.7 g m-2 yr-1) and at Cape Hedo (1.1 g m-2 yr-1) in 2009, although their annual levels of precipitation were almost equal (ca. 2300 mm). Wet deposition flux was high in spring and low in summer. Simultaneous wet deposition events were observed five times among the sites, but these events were limited to regional scale. Based on the spatial distribution of dust represented as a mosaic of true color images from MODIS/Terra and vertical distributions of dust concentration from lidar observations, a high wet-dust-deposition event occurring in mid-March at Toyama was attributed to a combination of high dust concentration in the atmosphere during precipitation. Higher wet dust deposition at Toyama and Tottori was ascribed to frequent precipitation during the dusty season.

DXA instruments are now widely used for the assessment of fat mass (FM) and fat-free mass (FFM), as well as bone mineral content (BMC). Surprisingly, there are few studies comparing soft tissue composition data between instruments from different manufacturers despite differences in BMC measurements being widely reported. The aim of this study was to cross-validate body composition data for three commercially available DXA instruments. These data clearly demonstrate that DXA instruments cannot be used interchangeably for the analysis of body composition. However, the generally high correlations observed between instruments for each of the three variables, allows the derivation of inter-instrument conversion algorithms.© 2010 Dietitians Association of Australia

In this paper, 160-Gb/s optical-time-division-multiplexing (OTDM) techniques employing electroabsorption (EA)-modulator-based optical multiplexer are described. The optical multiplexer integrates four EA modulators with free-space optics and enables, stably, to generate an authentic 160-Gb/s OTDM signal. The optical multiplexer possesses a switching capability of modulation format, which originates in the thermo-optic effect in EA waveguide, so that it is possible to generate various phase-coded OTDM signals such as carrier-suppressed return-to-zero (CS-RZ) signal by tuning operation temperatures of the EA modulators. By employing the novel 160-Gb/s optical multiplexer, prototypes of 160-Gb/s OTDM transmitter and receiver were developed. EA modulators are also adopted to optical short pulse source at transmitter side, optical time division demultiplexer, and phase-locked loop (PLL) circuit for clock recovery at the receiver side. The 160-Gb/s system prototype exhibited a superior performance maintaining high stability, and its applicability to practical use is discussed, showing experimental results of 160-Gb/s 635 km field trial on Japan Gigabit Network II (JGN II) optical testbed

A direct HPLC method for the determination of acetyl-D-carnitine in acetyl-L-carnitine was investigated. The enantiomers were successfully separated on a SUMICHIRAL OA-6100 column, which has a ligand-exchange type of chiral moiety. The mobile phase consisted of an aqueous solution of copper (II) sulfate and sodium perchlorate. Successful enantioseparation seems to be achieved through the formation of not only the complex with copper (II) ion but also by ion-pairing with the perchlorate ion, because no enantioseparation was observed with the usual copper (II) mobile phase alone. Employing 2 mM aqueous CuSO4 solution containing 500 mM NaClO4, the enantiomers of acetylcarnitine eluted in the order of D- and L-forms within 15 min with R s = 1.92 and α = 1.11. The obtained LOQ and LOD values were 0.15 and 0.1%, respectively. The validated results were satisfactory for a practical quality control method for the enantiomeric purity determination of acetyl-L-carnitine.

The critical layer masks for 14 nm and 10 nm logic nodes are typically bright field, and the key features are opaque structures on the mask. In order to meet the tight critical dimension (CD) requirements on these opaque features the use of a high quality negative tone chemically amplified e-beam resist (NCAR) is required. Until very recently the only negative tone e-beam resists available for use by the mask industry were the traditional cross linking type in which ebeam exposure cross links the material and makes it insoluble in developer. In this paper we will describe the performance of a new polarity switching type of NCAR resist that works by changing the solubility of the exposed resist without cross linking. This has the advantage of significantly reduced swelling and scumming and resulted in major improvements in the resolution of heavily nested features and small clear features on the mask. Additional detailed characterization results will be described.

Ultrafine powders of the binary (Cr2O3, Fe2O3, SnO2)–Al2O3 systems were synthesized by introducing aqueous solutions containing metal salts into a high temperature inductively coupled plasma, and the distribution of component oxides was investigated by transmission electron microscopy and electrophoretic mobility measurements. For the Cr2O3–Al2O3 system, each component independently constituted its particles that were homogeneously distributed in the powder. With the Fe2O3Al2O3, the two components formed solid solutions. In the SnO2–Al2O3, each component comprised the powders where SnO2 had a strong tendency to occupy the particle surface.

Transoceanic transmission at 80 Gb/s was successfully demonstrated by introducing an optical retiming, reshaping, reamplifier (3R)-signal regenerator using cross-absorption-modulation gate and self-phase-modulation-based wavelength converter. At the 3R repeater spacing of 160 km, 80-Gb/s error-free transmission over 5600 km was achieved. The power penalty at 5600 km was 2 dB, and very clear eye-opening was observed even after 11 200-km transmission.

Summary What is known and objective Patients' poor adherence to medications is reported to be related to the individual patients' beliefs and cognitions and their trust of the medical staff. However, the causes of the two forms of non-adherence, intentional and unintentional behaviours, have yet to be clarified. This study compared psychological latent factors associated with intentional and unintentional non-adherence to chronic medication regimens, focusing on the potential effects of (i) patients' dissatisfaction with treatment and their relationships with the medical staff and (ii) patients' subliminal rational thinking processes, which weighed the positive values such as their expectations of benefits from treatment against negative values such as their dissatisfaction. Methods Two cross-sectional surveys were undertaken of patients given medications for chronic diseases, using a questionnaire developed and validated in this study. One survey was undertaken in three hospitals and the other survey, online throughout Japan. We scored the individual latent factors using the questionnaire and calculated the differential score between two negatively correlated latent factors to quantify patients' subliminal rational thinking process. We compared the adjusted odds ratio (OR) of latent factors between intentional and unintentional non-adherence to medication in both surveys. Results and discussion Of the eligible subjects, 149 hospitalized patients and 524 survey participants completed the questionnaire. Intentional non-adherence was associated with patient dissatisfaction with treatment including interpersonal relationships with medical staff in both hospitalized patients and online survey participants (95% confidence interval of adjusted OR for Dissatisfaction, 1·20–16·26 in the hospital-based survey and 1·33–3·45 in the online survey). In both surveys, intentional non-adherence was significantly associated with the differential score between two negatively correlated latent factors, Willingness and Dissatisfaction (P = 0·02 in the hospital-based survey and P

What is already known about this subject? Compared with their healthy-weight peers, children with obesity have; impaired physical health-related quality of life reduced physical activity levels reduced capacity to perform certain weight-bearing tasks in field-based fitness tests What this study adds? First investigation of obesity-related disability in children using the International Classification for Functioning, Disability and Health framework for Children and Youth. Obesity in children appears to be associated with disability impacting basic locomotor skills and physical health-related quality of life. Children's participation in key life areas related to physical functioning appears to be minimally impacted by obesity.The aim of this study was to investigate whether obesity is related to impaired day-to-day physical functioning and disability in children.An observational case-control study was conducted in three Australian states. Obese (n = 107) and healthy-weight (n = 132) 10- to 13-year-olds (132 male, 107 female) were recruited via media advertisements. Assessment of body composition (dual energy X-ray absorptiometry), locomotor capacity (six-minute walk test [6MWT], timed up and down stairs test [TUDS] and timed up and go [TUG]) and child-reported physical health-related quality of life (HRQoL) were undertaken. Participants wore an accelerometer for 8 days and completed two use-of-time telephone interviews to assess participation in key life areas.Compared with their healthy-weight counterparts, obese children had lower physical HRQoL scores (P0.01) and reduced locomotor capacity (TUDS z-score, TUG and 6MWT; P0.01). Higher percent body fat was significantly related to lower physical HRQoL scores (r = -0.48, P0.01), slower performance times for the TUDS and TUG (r = 0.59 and 0.26 respectively, P0.01), shorter 6MWT distances (r = -0.51, P0.01) and reduced time spent in community participation activities (r = -0.23, P0.01).As anticipated, obesity appears to undermine physical functioning in children, including the capacity to perform basic locomotor skills yet, unexpectedly, participation in key life areas related to physical functioning appeared largely unaffected.

(110)-oriented thin films and ultrafine powders of La 2 NiO 4 and La 1.5 Sr 0.5 NiO 4 were prepared by a spray-ICP technique. The composition of the powder showed excess La compared with the starting mother solution. La 2 NiO 4 and La 1.5 Sr 0.5 NiO 4 thin films exhibited metallic electrical resistivity.

Flow studies using dynamic CT and xenon (Xe) CT were carried out in 25 patients with ischaemic stroke in the territory of the middle cerebral artery to define the clinical characteristics of cerebral ischaemia at a chronic stage. The parameter of peak height/mean transit time (PH/MTT) obtained from dynamic CT can provide an accurate index for blood circulation in the cerebral vascular bed. Xe CT measurements revealed various kinds of ischaemia around the infarction even in the chronic stages. In mild ischaemia of more than 30 ml/100 g/min, reduction of cerebral blood flow (CBF) was well correlated to the PH/MTT. However, in severe ischaemia between 20 and 30 ml/100 g/min, changes of CBF were no longer correlated with the PH/MTT. There were cases showing severe reduction of CBF but which showed sufficient blood circulation (moderate value of PH/MTT). Mild reductions of CBF in parallel with decreased blood supply were often found in the peri-infarct area of infarctions in the centrum semiovale. On the other hand, infarctions in the cortico-subcortical region showed severe ischaemia, in even where blood circulation was relatively well sustained.

The patients presented in this paper were being treated for cancer. None denied the diagnosis, and all were adhering to the medical regimen. Yet these patients also said that they were healthy in the face of the implications of their disease and the physical toll imposed by the treatments. The definition of health currently used by the American health care system is too restrictive to encompass the perception voiced by these individuals. This paper proposes to broaden the concept of health to help provide a legitimate place in society for individuals with chronic, life-threatening illnesses. A theoretical framework is proposed which might explain how these patients could still see themselves as healthy despite their disease. The core concept of health in this model is a sense of self-integrity, and the construct of health has two dimensions, Physical Status and Social Function. Individuals with chronic, life-threatening diseases like cancer use both of these dimensions simultaneously in order to negotiate and reestablish a sense of self-integrity based on their continued social functioning even in light of their acknowledged physical condition. Implications for restructuring our thinking about health, disease, and the mechanisms used to cope with cancer are outlined in order to develop a more realistic definition of health which is contextually based in the lives of the individuals with the disease. The criteria for assessment would not be biologic integrity alone, but a complex compromise between personal needs, social obligations, and physical abilities.

This report presents a rare case of noninvasive adenocarcinoma, which occurred in Brunner’s gland hyperplasia in the third portion of the duodenum after an 8-year follow-up. The patient’s vague sympto

By using novel stabilizing and control technique of bit-wise phase correlation based on 1-bit delay interferometers, we demonstrated stable generation of bitwisely phase-controlled 160-Gb/s signals with different modulation formats such as carrier-suppressed return-to-zero (CS-RZ), pair-alternate-phase CS-RZ (PAP-CSRZ), π/2-altenate-phase RZ (π/2- APRZ), and periodical APRZ. Furthermore, novel performance monitoring technique for 160 Gbit/s OTDM signal using an asynchronous electro-absorption modulator (EAM) prescaler is proposed. This performance monitor can detect waveform distortion caused by chromatic dispersion, polarization mode dispersion (PMD) and optical signal-to-noise ratio (OSNR) degradation separately. And the feasibility of the monitor was examined by an optical test-bed in JGNII network.

We demonstrate highly stable field transmission of 160-Gb/s signal utilizing adaptive PMD compensator, which employing variable DGD generator with ultra high time-resolution of 0.053 fs.

A novel channel identifying technique of 4 × 40 Gbit/s OTDM signal using optical phase index and 40 Gbit/s clock recovery is proposed, and its effectiveness is verified through 160 km transmission experiment. (2 pages)

PURPOSE To determine whether a required ambulatory care block rotation for categorical medicine residents improved their ambulatory care skills and altered their outpatient gatekeeping referral patterns. METHOD In 1991-92 a prospective cohort study was conducted of 39 categorical medicine residents at the University of California, San Francisco, and their continuity clinic patients. Before and after the residents participated in an ambulatory care block rotation, the residents were surveyed about their ambulatory care skills, and the frequencies and indications for referral of their continuity clinic patients were obtained. Statistical methods consisted of Student's t-test, the Wilcoxon rank-sum test, and Mantel-Haenszel analysis. RESULTS The 39 residents reported significant improvement in ambulatory care skills. Yet the proportions of the residents' 4,276 patients referred before and after the intervention were 14.2% and 12.4%, respectively (adjusted odds ratio 1.02, p > .9). One-fourth of the referrals were for procedures both before and after the intervention (adjusted odds ratio 1.06, p > .5). CONCLUSION Despite improvements in the ambulatory care skills of the categorical medicine residents, the residents' gatekeeping referral patterns remained unchanged. Ambulatory care curriculum changes need to be evaluated from the perspective of the trainee and from the perspective of whether these changes influence patient care.

A study of the different volume and infusion rates of a new maintenance fluid, Veen 3G, on the general conditions of rats was investigated during the 14 days after infusion. In Experiment I, 100 ml/kg and 200 ml/kg of Veen 3G were infused at a rate of 300 ml/kg/h in male and female rats. Results were compared with those for Gurunon Ringer solution (GRS) in male and female rats. We observed only transient polyuria in animals administered by each dose of Veen 3G and GRS for 0-15 min after infusion. Necropsy was not observed in any of the animals tested 14 days after infusion. In Experiment II, 200 ml/kg of Veen 3G was infused at rates of 200, 400, 800 and 1600 ml/kg/h in male rats. At 800 and 1600 ml/kg/h, irregular respiration and decrease in movement were observed concomitantly with polyuria. Three out of 4 rats died immediately after the infusion of Veen 3G at a rate of 1600 ml/kg/h, and one rat was still alive 14 days after the infusion. In this experiment, 200 ml/kg Veen 3G was safe when we infused at a rate of less than 400 ml/kg/h in male rats. Since this rate is about 27-80 times higher than that used clinically in maintenance treatment, Veen 3G is suggested to be safe, with the exception of polyuria, in clinical situations at the standard infusion rate (5-15 ml/kg/h).

A description is presented of the application of an object-oriented approach to software development for the VDU (visual display unit) system in the DRMASS (digital ratio multiple access subscriber system) project. In this development, design and prototyping were accomplished using Smalltalk, and then afterward the production system was coded in C++ based on this design. The applied developmental process is described, and the effects and problems of the process are clarified from three points of view: the application of object-oriented paradigm, design and prototyping in Smalltalk, and a translation of Smalltalk into C++. The object-oriented development future is examined. >

The local irritating effect of Veen 3G Inj. (glucose-added acetic acid maintenance infusion solution) was examined in male rabbits. We studied the local irritating effect of the infusion solution compared with that of Ringer's solution, 5% sulfobromophthalein sodium injection, distilled water for injection or glucose-added Ringer's solution. In the vascular irritation test, macroscopical and histopathological changes induced by the infusion solution were not observed in the vessels. Moreover, in the hemolytic test, hemolysis of rabbit erythrocyte was not observed in the mixture with the infusion solution. In the present study, no change suggesting irritation by the infusion solution was observed in the in vivo vascular irritation test using the auricular vein of rabbits or in the in vitro hemolytic test using rabbit erythrocyte. In conclusion, in clinical use the infusion solution produces extremely slight adverse effects, such as vessel pain and phlebitis on the injection site.

The purpose of this paper is to provide assistance to clinicians in the treatment of infectious diseases of the central nervous system. Antibiotic therapy should be initiated as soon as the diagnosis is made and should not be delayed until the next scheduled dose or until investigations have been performed. The infecting organism is usually unknown when treatment is initiated and often remains so, and therefore empirical therapy should always cover the most common suspected organisms. The choice of antibiotics, dosage, and route of administration depends upon the severity of illness. Likely pathogens and the known sensitivities of pathogens of the central nervous system are discussed.

Barium hexaaluminate (BaAl 12 O 19 ) was deposited on yttrium stabilized zirconia by introducing atomized aqueous solutions of BaCl 2 and AlCl 3 (Ba:Al = 1:12 in molar ratio) into an inductively coupled plasma generated under ambient pressure. Deposits revealed a c -axis orientation, and had porous structures composed of pillars with diameters of 0.3–2 μm.

This paper describes the Asian Pacific Partners for Empowerment and Leadership (APPEAL) Stages of Community Readiness Model, a framework for assessing and evaluating tobacco control in the diverse Asian American and PaCific Islander (AAPI) communities.This model extends the work of existing community capacity models by applying a "stage of readiness" continuum of the five stages of pre-contemplation, contemplation, preparation, action and maintenance in terms of developing, launching and sustaining AAPI tobacco control efforts.The APPEAL Model allows communities to diagnose, then address their unique needs through appropriate technical assistance, training and resources. The APPEAL Model benefits both communities and funders through its ability to better understand their readiness to conduct tobacco control and have realistic expectations on the outcomes of those efforts.This paper describes the elements of the Readiness model for AAPIS, particularly those addressing research and data issues, current applications of the model in specific AAPI ethnic communities, and the lessons learned thus far regarding the model's applicability to, and support of, the development of AAPI tobacco control efforts nationally.

Breast cancer is the leading cause of cancer incidence and mortality among Asian American and Pacific Islander (AAPI) women in the United States. Hmong women are among those at the highest risk for health problems, due to high rates of poverty, language isolation, and cultural barriers.One-on-one survey interviews were completed with 201 Hmong women aged 20 years and older in Fresno, Long Beach, Orange County, and San Diego to determine their breast cancer screening behaviors--breast self-examination (BSE), clinical breast examination (CBE), and mammography.Overall, 51% of all respondents had ever performed BSE. Among respondents aged 40 or older, 52% had ever had a CBE and only 30% had ever had mammography.Significant correlates of CBE and mammography screening are presented, and implications of findings for research and education are discussed.

The purpose of this study was to evaluate the relationship between acute and subacute toxicity and blood levels of theophylline in dogs. Theophylline was administered intravenously into dogs once (at doses of 50, 100 and 150 mg/kg) or for 4 weeks (at doses of 20, 35 and 70 mg/kg/day). In the single dose toxicity study, by increasing the dose of theophylline, plasma concentration increased and the severity of toxic symptoms were intensified. After a single dosing of theophylline, accentuated heart rate and vomiting were observed at a concentration of more than 67 micrograms/ml, and excitement, spasm and hyperpnea were observed at more than 130 micrograms/ml. Animals died after tonic convulsion at 180 micrograms/ml. In the repeated dose toxicity study, the plasma concentration of theophylline increased dependent on dosage, and was not affected by repeated dosing. Even under these conditions, the toxic symptoms were quite similar to those of the single dose, except for an additional decrease in movement, body weight reduction and myocardial lesion. These present results suggest that the severity of theophylline toxicity is dependent on its plasma concentrations rather than accumulated dosages. The blood concentration of theophylline-treated patients should be maintained within the therapeutic range in order to diminish risk.

Tibolone is a synthetic steroid with tissue-specific estrogenic, progestogenic, and androgenic properties. The therapeutic effects of tibolone on bone mass and strength, bone metabolic markers, and indices of histomorphometry were investigated in ovariectomized (ovx) rats on a low (0.1%)-calcium diet in comparison with 17alpha-ethynylestradiol (EE) or 1alpha-hydroxyvitamin D3 [1alpha(OH)D3]. Tibolone (0.1-3 mg/kg/day), EE (0.1 mg/kg/day), or 1alpha(OH)D3 (0.5 microg/kg/day) was administered orally once a day for 16 weeks, starting 12 weeks after ovariectomy, when the bone mineral density (BMD) of lumbar vertebrae (L4-5) and femur (global, proximal, and distal regions) had already been decreased by the combination of ovariectomy and low dietary calcium. The BMD of the lumbar vertebrae and the femur were higher in the groups treated with tibolone, EE, or 1alpha(OH)D3 than in the ovx control group. The BMD of the mid-diaphysial regions of femur and tibia, which consist mainly of cortical bone, were decreased 28 weeks after ovariectomy in the ovx control group. The BMD of the mid-diaphysial femur was higher in the groups treated with 1alpha-(OH)D3, and the BMD of mid-diaphysial tibia was higher in the groups treated with tibolone or 1alpha(OH)D3 than in the ovx control group. Like BMD, the compressive strength of the vertebral body of L2, corrected for the volume of each individual vertebra tested, was higher in the groups treated with tibolone, EE, or 1alpha(OH)D3 than in the ovx control group. Trabecular bone volume and trabecular number were reduced 12 and 28 weeks after ovariectomy but there was no change in trabecular thickness. These reduced indices were increased in the groups treated with tibolone, EE, or 1alpha(OH)D3 when compared with the ovx control group. Tibolone or EE decreased serum levels of osteocalcin and bone alkaline phosphatase and urinary levels of deoxypyridinoline and pyridinoline compared with the ovx control group. Furthermore, tibolone or EE decreased the mineralizing surface and bone formation rate as well as the osteoclast surface and osteoclast numbers. 1Alpha(OH)D3, however, did not affect these serum and urinary parameters. These data suggest that tibolone suppresses the accelerated bone turnover induced by a combination of ovariectomy and low dietary calcium, and indicate that tibolone may be a potentially useful drug for the treatment of postmenopausal osteoporosis.

This paper investigated the nature of social support for Asian- and Anglo-American women post breast cancer treatment. Forty-six Anglo- and Asian-American (13 Anglo-American, 18 Chinese-American and 15 Japanese-American women) women were assessed 6 months to 3 years post-treatment. Assessments consisted of a semi-structured interview plus standardized psychological tests. Three major hypotheses were developed and tested in the study. Results showed: (1) Anglo-American women indicated a greater need for social support than either of the two Asian-American groups in 66% of the categories; (2) no differences were found between the three ethnic groups in receipt of emotional or tangible social support; and (3) the network size and composition differed significantly in 83% of the categories between the Anglo group and at least one of the Asian groups. These differences were in size, mode, and perceived adequacy of social support. Implications for culturally-based clinical practice which emerge from these findings are discussed.

We clearly determined the key to managing patients with brain abscess by retrospectively evaluating the factors affecting poor outcome in these patients. This study included 113 patients with brain abscess diagnosed in the CT era. Basic characteristics and therapeutic parameters were estimated as independent predictors of poor outcome by using univariate and multivariate logistic regression analysis. Patients with poor outcomes more frequently had deeply-located abscesses (p0.02), IVROBA (intraventricular rupture of brain abscess (p0.001) and were in a severely deteriorated neurological state (p0.001) than those with good outcomes. Multiple logistic regression analysis predicted that IVROBA (ORs, 24.5; 95% CI, 3.04 to 197.9) and severely deteriorated cases (ORs, 13.7; 95% CI, 2.34 to 80.8) resulting from IVROBA increased the relative risk of poor outcome. Patients with IVROBA more frequently had also deeply-located abscesses (p0.005), positively immunocompromised states (p0.05) and were in a severely deteriorated condition (p0.003) than those without IVROBA. Patients with metastatic abscess had also IVROBA (p0.006). Multiple logistic regression analysis anticipated that deeply-located abscess (ORs, 3.90; 95% CI, 1.38 to 11.04), and metastatic abscess (ORs, 12.26; 95% CI, 1.35 to 111.2) increased the relative risk of IVROBA. Patients in an obtunded state and with marked neurological deficit had IVROBA more often than patients in an alert state and/or mild neurological deficit (ORs, 3.23; 95% CI, 1.17 to 8.86, p0.03) before treatment. Our findings suggest that IVROBA strongly influences poor outcome in patients with brain abscess. The key to decreasing poor outcomes may be the prevention and management of IVROBA, by evaluating intracranial pressure pathophysiology. IVROBA should be aggressively treated by aspiration methods for the abscess coupled with appropriate intravenous and intrathecial administration of antibiotics.

To focus on the universal tasks of coping with the loss of a loved one and describe how various cultures have designed rituals to channel this grief.Published articles, books, and clinical experience.Death is the final life transition and often is surrounded by culturally specific rituals to assist the bereaved in their expression of grief and mourning and in caring for the dying. These culturally unique rituals and mourning practices serve to facilitate completion of universal tasks of grief resolution and support the healing process.In developing an awareness and appreciation for the continuity of life for all patients and families, nurses must understand that variations among rituals and mourning practices surrounding death in different cultures provide a meaningful cultural context for patients, families, and friends. This context provides them with a sense of security and coherence as well as the emotional, social, and physical resources to navigate this final journey with integrity and peace of mind.Nurses in the United States need to gain a better understanding of the elements and patterns that make up a specific culture's beliefs and practices and integrate this information with an individual patient's and family's personal interpretations of their cultural heritage before prescribing one particular intervention to support the expression of grief and mourning of the bereaved. Culturally informed and tailored care increases the quality of care provided.

To describe advance directives and the Patient Self-Determination Act (PSDA), to explore the European American sociocultural values underlying advance directives, and to describe the ethical and cultural issues that arise when attempting to encourage and use advance directives in culturally diverse populations.Research articles, case studies, and theoretical articles from clinical and bioethical literature.An overview of advance directives and the PSDA is provided. The European American cultural values underlying advance directives are reviewed and contrasted with sociocultural values of culturally diverse groups to raise the question of cross-cultural applicability of advance directives and European-based bioethics.The sociocultural values of many culturally diverse groups conflict with the values on which the use of advance directives is based. Thus, working with end-of-life decisions and advance directives for people from culturally diverse groups may be problematic.Nurses should be sensitive to sociocultural beliefs that influence decisions affecting end-of-life care, especially the use of advance directives. Practitioners must incorporate this knowledge to increase flexibility of institutional practices and standards of care in the application of advance directives.

To describe the process of establishing a multisite team to conduct research with a multicultural focus on fatigue.Articles, book chapters, personal experience.Teamwork facilitated development of a productive professional working group, sharing of resources, and data collection culminating in a research proposal for studying cancer-related fatigue in a multicultural population.Establishing a common goal by investing time, committing to the process, and establishing trust was the secret to effective team functioning.The prospect of multi-institutional collaboration has implications for oncology nurses in the areas of research and practice. Goals that could not be achieved easily in the setting of a single institution are reached more easily with multisite collaboration and teamwork.

This pilot study constitutes the first exploration of the impact of breast cancer on Asian American women. Three hypotheses guided this study: (1) Asian American women would choose breast conserving therapy and breast reconstruction at a lower rate than the Anglo American women due to cultural differences in body image, (2) Asian American women with breast cancer would express psychological distress somatically and Anglo American women would express distress emotionally, and acculturation levels of the Asian American women would modify the expressions of distress such that women with high acculturation will express distress more emotionally and less acculturated women would express distress more somatically, and (3) Asian American women would seek assistance for psychosocial problems at a significantly lower rate than Anglo women. Ethnicity, age, and levels of acculturation were found to be significant variables that had to be considered simultaneously. The three hypotheses were only partially supported: (1) Asian American women chose breast conserving therapy and adjuvant therapy at a significantly lower rate than the Anglo American women, (2) Contrary to the hypothesis, somatization did not appear to be a dominant form of symptom presentation for Asian American women regardless of level of acculturation, and (3) Asian American women sought professional assistance for psychosocial problems at a significantly lower rate than Anglo women. Asian American women reported using different modes of help-seeking behavior for emotional concerns and receiving different sources of social support than the Anglo American women. Cultural interpretations of the findings are offered to explain the differences in the physical, emotional, and social responses to the breast cancer experience of Asian American women compared with the Anglo Americans, and notably between the Chinese- and Japanese Americans as well. The findings of this study warrant more refined exploration in order to improve the medical, psychological and social outcomes for Asian American women with breast cancer.