Different Times Of Measurement Research Articles

Effects of Salicylic Acid Concentration and Post-Treatment Time on the Direct and Systemic Chemical Defense Responses in Maize (Zea mays L.) Following Exogenous Foliar Application.

Salicylic acid (SA) plays a critical role in allergic reactions of plants to pathogens and acquired systemic resistance. Thus far, although some research has been conducted on the direct effects of different concentrations of SA on the chemical defense response of treated plant parts (leaves) after at multiple post-treatments times, few research has reported on the systematic effects of non-treated parts (roots). Therefore, we examined direct and systemic effects of SA concentration and time following foliar application on chemical defense responses in maize variety 5422 with two fully expanded leaves. In the experiments, maize leaves were treated with different SA concentrations of 0.1, 0.5, 1.0, 2.5, 5.0 mM, and then, the presence of defense chemicals and enzymes in treated leaves and non-treated roots was measured at different time points of 3, 12, 24, 48, 72 h following SA foliar application. The results showed that direct and systemic effects of SA treatment to the leaf on chemical defense responses were related to SA concentration and time of measurement after spraying SA. In treated leaves, total phenolics content increased directly by 28.65% at the time point of 12 h following foliar application of 0.5 mM SA. DIMBOA (2,4-dihydroxy-7-methoxy-2H, 1, 4-benzoxazin-3 (4H)-one) content was directly enhanced by 80.56~551.05% after 3~72 h following 0.5~5.0 mM SA treatments. Polyphenol oxidase and superoxide dismutase activities were directly enhanced after 12~72 h following 0.5~5.0 mM SA treatments, whereas peroxidase and catalase activities were increased after 3~24 h following application of 1.0~5.0 mM SA. In non-treated roots, DIMBOA content and polyphenol oxidase activity were enhanced systematically after 3~48 h following 1.0~5.0 mM SA foliar treatments. Superoxide dismutase activities were enhanced after 3~24 h following 0.5~2.5 mM SA applications, but total phenolics content, peroxidase and catalase activity decreased in some particular concentrations or at the different times of measurement in the SA treatment. It can be concluded that SA foliar application at 1.0 and 2.5 mM produces strong chemical defense responses in maize, with the optimal induction time being 24 h following the foliar application.

A Clinical Trial of Comparing Dexmedetomidine and Remifentanil on the Oximetry Parameters in the Patients with End-Stage Renal Disease Undergoing Arteriovenous Fistula Formation

Background: Oximetry is a method for measuring the arterial hemoglobin saturation (SpO2) using pulse oximeter and is essential in any type of anesthetic procedures. The growing population of geriatrics in the recent decades in combination with an increase in the prevalence of chronic diseases including diabetes and hypertension are some of the leading causes for an increase in the prevalence of chronic kidney disease and end-stage renal disease (ESRD). The definite treatment for ESRD is renal transplant but unfortunately, it may take a long time to find a suitable kidney and continuing the patient's life may depend on dialysis. Arteriovenous fistula (AVF) formation is one of the first steps to prepare the patient for hemodialysis. ESRD itself is a reason for physical and psychosocial issues. Preparing a favorable condition for AVF surgery is essential to decrease the burden of the underlying disease. An efficient respiratory supply is necessary in all parts of an anesthetic procedures. Aims and Objectives: This study is a double-blind clinical trial to compare two anesthetic agents, dexmedetomidine and remifentanil in patients with ESRD who underwent AVF formation. Materials and Methods: SpO2 was measured on different phases including the time of initial incision, and after 10, 30, 60, 90, and 120 min of finishing the surgery. The data were analyzed using SPSS version 22, two-way repeated measures (ANOVA), and independent t-test. Results: This study showed that there was no any significant difference in using any of these two agents with regard to SpO2 in the different times of measurements during the anesthetic procedure and after the surgery in the recovery phase. Conclusion: This study showed that there is not any superiority in using DEX or REM in the patients undergo AVF formation. More studies on the other groups of the patients with different surgeries.

Sex and Affective Education at University: Evaluation of the Training of Students

There is currently a scarcity of training proposals at university related with sex and affective education. The present work analyzes the impact on university students of an intervention in sex education implemented through training programs, in both virtual and in-person formats. A study was conducted with 143 participants enrolled in different university degrees, following a quasi-experimental (pre–post) method with three groups, through the administration of a questionnaire composed by 138 items organized into five scales and was collected at three different times of measurement (previous evaluation, evaluation after the training period, and a final evaluation three months after the training). The results indicate that the students experienced a significant improvement on their knowledge about sexuality, with a ceiling effect detected in the scores of concepts such as attitude towards sex education, gender-based violence, intercultural sentimental relationships, and self-esteem. The conclusions revealed the need to introduce sex and affective education training in the teaching and learning processes in university contexts, through the official curricula of the undergraduate and post-graduate degrees that focus on human groups.

Does the COVID-19 pandemic take its toll? The influence of COVID-19 induced anxiety on the social-emotional development of 12- to 13-year-olds in Austria

Schülerinnen und Schüler waren in der COVID-19-Pandemie stark von Maßnahmen wie Schulschließungen und Homeschooling betroffen. Dass sich diese Maßnahmen auf die Leistungen der Schülerinnen und Schüler auswirken, liegt auf der Hand. Es besteht allerdings auch Grund zur Annahme, dass sich die Situation auf die sozial-emotionale Entwicklung der Kinder und Jugendlichen auswirkt.Die vorliegende Studie untersucht, (1) inwiefern sich Schülerinnen und Schüler der österreichischen Sekundarstufe (12- bis 13-Jährige) durch die COVID-19-Pandemie belastet fühlen (anhand der erfragten Häufigkeit von durch COVID-19 induziertem Angsterleben) und (2) wie sich die unterschiedlichen Belastungslevels auf die sozial-emotionale Entwicklung auswirken. Es wird dabei ein Fokus auf die Entwicklung von problematischen Verhaltensweisen einerseits (internalisierte und externalisierte Verhaltensprobleme) und auf prosoziales Verhalten andererseits gelegt. Insgesamt nahmen 774 Schülerinnen und Schüler an der Studie teil. Von 650 liegen die Daten zu drei Messzeitpunkten vor, wobei der letzte Messzeitpunkt kurz vor der zweiten Schulschließung als Maßnahme in der COVID-Pandemie abgehalten wurde.Knapp 20 % der Befragten weisen erhöhte Scores in Bezug auf durch COVID-19 induzierter Angst auf. Vor allem bei den internalisierten Verhaltensproblemen schienen die Schülerinnen und Schüler, die höhere Scores bei durch COVID-19 induzierter Angst zeigten, sich negativ zu entwickeln. Ebenso konnte bei den externalisierten Verhaltensproblemen ein Trend in diese Richtung nachgewiesen werden, jedoch weniger stark ausgeprägt. Schülerinnen und Schüler, die höhere Scores in Bezug auf durch COVID-19 ausgelöste Angst aufwiesen, gaben augenscheinlich auch positivere Selbsteinschätzungen hinsichtlich prosozialer Verhaltensweisen an. Allerdings konnte aufgrund von Voraussetzungsverletzungen keine weitere statistische Überprüfung dieser Verhaltensdimension stattfinden.

Effect of Educational Program about Head nurses Authentic Leadership Style on Staff Nurses Empowerment and Motivation

Background: Nurses form the largest group of healthcare professionals and are on the front-line of care for patients in hospitals. More excellent patient outcomes result from nurses working in a supportive setting. Organizational leaders necessity to demonstrate trust and independence to encourage nurse motivation, as these behaviors are congruent with intrinsically held nursing values. Authentic leadership has been introduced as the root element of productive leadership needed to develop healthier work environments because there is particular attention to the development of empowering leader-follower relationships. Aim: The study aims to examine the effect of the authentic Leadership training program on staff nurses' motivation and empowerment. Research design Quasi-experimental research design was utilized in this study. Setting: The study was conducted at the Health Insurance Hospital – Minia governorate. Subjects: All head nurses worked in the inpatient and outpatient units (n = 23) and all staff nurses worked in the same units (n = 208) are included in the study. Tools: four tools were used in this study; Authentic Leadership knowledge questionnaire, Authentic Leadership Self-Assessment scale, Empowerment Scale, and Motivation Scale. Results: The total knowledge score and levels of authentic leadership style among head nurses were low before the program implementation; after the program implementation they had higher scores with statistically significant differences; also the staff nurse empowerment score and motivation score was increased after implementing authentic leadership education program for head nurses. Conclusions: Authentic leadership training program provided in this study had a positive effect on head nurses through increasing their knowledge and their self-assessment about authentic leadership style after the program implementation during the different times of measurement. As well as staff nurses' motivation and empowerment score increased after implementing authentic leadership educational program. Recommendations: Periodical seminars and programs for head nurses are required to develop their leadership style competencies to be more motivated and empowered for their nurses.

Nasal Function Changes at High Altitude.

An ever-increasing number of people are involved in sport activities at high altitude. This study aimed to evaluate the pulmonary and nasal functions, including nasal cytology, in healthy volunteers moving for 1 week from an altitude of 2000 m to another of 3400 m. Peak nasal inspiratory flow (PNIF), pulmonary function, including peak expiratory flow (PEF), mucociliary transport time (MCTt), nasal cytology, and oxygen saturation (O2 sat) were studied in 5 different occasions-T1: at base camp (2000 m); T2: at the mountain refuge (3400 m); T3: after 7 days at 3400 m; T4: after the return at the base camp (2000 m); and T5: at the base camp (2000 m) after 15 days. With respect to T1, PEF values decreased at T2 (P = .004), T3 (P = .004), T4 (P = .000), and T5 (P = .001). Forced expiratory volume in the first second and forced vital capacity did not differ among the 5 different times of measurements. In regard to T1, PNIF values increased at T2 (P = .003) and T3 (P = .001). MCTt and O2 sat showed similar but opposite changes with MCTt increased at T2 and T3 in respect to T1 (P = .000 for both), while O2 sat decreased at T2 and T3 in respect to T1 (P = .000 for both). At nasal cytology, the number of neutrophils increased at T2 in respect to T1 (P = .008). At multivariate analysis, PNIF changed with altitude from T1 to T4 even accounting for the effect of all the other variables (T1 vs T2 PNIF, P = .009; T1 vs T3 PNIF, P = .007; T1 vs T4 PNIF, P = .021). Although the study has some limitations, being conducted on a small cohort and at no controlled environmental conditions, data seem to support the utility of MCTt for studying nasal mucosa damage induced by high altitude. Nasal cytology seems to be able to identify the inflammation of the nasal mucosa exposed to hypoxia. Further investigations on larger series and possibly conducted in hypobaric chamber at controlled standardized conditions are necessary in order to confirm these results and, most importantly, the improvement of PNIF at high altitude.

Assessment of Neurone-Specific Enolase, Glial Fibrillary Acidic Protein and S100 B as Spinal Cord Ischemia Biomarkers in Patients Undergoing Open and Endovascular Complex Aortic Surgery: A Single-Center Experience

Despite all efforts, spinal cord ischemia (SCI) is a relevant and feared complication after open and endovascular thoracoabdominal aortic aneurysm (TAAA) repair. Besides the established correlation of motor evoked potentials (MEPs) and SCI, the usage of biomarkers for early detection of SCI intraoperatively and postoperatively after TAAA surgery is scarcely described in literature. The methods include retrospective assessment of 33 patients (48.48% male) undergoing open and endovascular TAAA repair between January 2017 and January 2018. Levels of the biomarkers neurone-specific enolase (NSE), glial fibrillary acidic protein (GFAP), and S100B were correlated with a decrease of the amplitude of the MEPs of more than 50%, indicating SCI. Linear mixed models were applied to test for differences in the biomarker levels between open and endovascular surgery and between different times of measurement. Post hoc analyses were performed using Tukey's multiple comparisons test. Logistic regression models were used to investigate the association between GFAP, NSE, and S100B levels at different times and a significant decrease in MEP or in-hospital mortality. Altogether, 19 patients were treated by endovascular repair; 14 patients were treated by open repair; 5 patients were treated because of a type I TAAA; 7 received treatment because of a type II TAAA; 7, 10, and 4 patients received type III, IV, or V TAAA repair, respectively. In-hospital mortality was 18.18% (n=6); 5 of these patients were treated because of symptomatic TAAA. MEP decrease could be observed in 18 cases (54.5%), with 16 (48.4%) recovering during the intervention. SCI could be observed in 9.09% (n=3), 2 endovascular repairs leading to paraplegia and one open repair leading to paraparesis. All biomarkers showed increasing levels over time, with no statistically significant difference between open and endovascular repair. The difference in NSE and S100B levels between the different times of measurements was statistically significant (P<0.0001, P=0.0017, respectively). In a univariable logistic regression analysis, no correlation with the end points "significant decrease in MEP" or "in-hospital mortality" was observed for any of the assessed biomarkers. SCI-related biomarkers, namely NSE and S100B, show a relevant increase directly after open and endovascular TAAA surgery, while no clear association between these biomarker levels and an intraoperatively measurable indicator for SCI could be observed.

Effects of prophylactic atropine in prevention of spinal anesthesia induced hypotension and bradycardia in geriatrics undergoing urological surgeries at a resource limited setting in central Ethiopia, 2018; prospective cohort study

BackgroundSpinal anesthesia induced hypotension and bradycardia are common and hazardous in elderly patients. Many techniques are being tried to prevent and treat these problems even if there is a controversy. The effects of prophylactic atropine on prevention of spinal anesthesia induced hypotension and bradycardia in geriatrics for urologic surgeries are not well-established. ObjectiveTo assess the effects of prophylactic atropine in prevention of spinal anesthesia induced hypotension and bradycardia in geriatrics undergoing urological surgeries at a resource limited setting in Central Ethiopia from December 1, 2017 to February 28, 2018 G C. MethodsThis is a prospective cohort study that recruits 76 patients who underwent elective urological surgeries. Independent t-test and Manny Whitney tests were used for numeric data while Chi-Square or Fisher exact test was used for categorical variables. P-values < 0.05 were considered as statistically significant. ResultsThere was no significant difference in baseline heart rate, mean arterial pressure, type & duration of surgery and total fluid administrations. There was a statistically significant difference in mean heart rate and mean arterial pressure at different times of measurement between the exposed and un-exposed groups. Total 1 h vasopressor consumption was minimal in the exposed group (P = 0.038). ConclusionProphylactic atropine with in 1 min of induction of spinal anesthesia in elderly patients undergoing urological surgery might reduce the incidence of hypotension and bradycardia.

Installation design of on-line near infrared spectroscopy for the production of compound fertilizer

Low-analysis fertilizer composition highly poses risk to soil infertility, crop yield and farmer livelihood. Fertilizer testing via traditional laboratory methods is a tool for quality control but with the significantly high cost of investment and maintenance in the long run. Physiochemical data from vibrational spectra obtained from the near-infrared reflectance (NIR) analyzer shows successful installation design for real-time quality monitoring of compound fertilizer production in this study overcoming exhaustive laboratory methods offering competitive advantages to the fertilizer industry becoming a great tool for product development and lower the risk of farmers buying the low-analysis fertilizer. The NIR analyzer was designed for on-line analysis of nutrient contents of the fertilizer before bagging. Total nitrogen (TN%), available phosphorus (available P2O5%), water-soluble potassium (water-soluble K2O%), total organic matter (TOM%), moisture content (TMC%) including pH were required to be monitored to ensure final product release being within limits legislatively established. Spectral variations across different times of measurement over a day of the production was investigated in the condition of on-line system instead of a controlled condition to confirm the measurement will be reliable and in good reproducibility. Calibration models were developed using Partial Least Squares (PLS) regression with a series of data pretreatments on individual model per nutrient. Precision and accuracy figures of NIR results were obtained considerably good enough to the manufacturing practice. NIR prediction results were later designed for threshold and feed-back to the process control.

Dietary supplementation with papaya (Carica papaya L.) leaf affects abundance of rumen methanogens, fermentation characteristics and blood plasma fatty acid composition in goats

The objective of this study was to test the effect of feeding papaya leaf (PL) on rumen microbial population, fermentation characteristics, blood fatty acid composition and antioxidant activity in goats. Three rumen fistulated male goats were assigned in a 3×3 latin square design using three levels of PL: no addition of PL in basal diet (control, CON, 50% concentrate + 50% alfalfa hay), 25% of alfalfa hay in basal diet replaced by PL (medium PL, MPL) and 50% of alfalfa hay in basal diet replaced by PL (high PL, HPL). Rumen fluid and blood plasma were sampled from the animals at the end of feeding trial (third week). Papaya leaf treatments (MPL and HPL) showed significant differences (p&lt;0.05) in terms of rumen fermentation parameters as compared to the CON group at different times of measurement. The concentration of methanogenic archaea (log10cell/L) decreased (p&lt;0.05) in both PL treatment groups as compared with CON group at all sampling times. The concentration of α-linolenic acid and total conjugated linoleic acid (CLA) were also higher (p&lt;0.05) in the blood of goats fed PL especially HPL, compared to the CON. Blood plasma malondialdehyde concentration (mM/mL) of PL treatment groups showed a significant reduction as compared with CON. Supplementation of PL allowed the modulation of rumen characteristics which might represent a feeding strategy to reduce methane emission by directly inhibiting methanogens while improving the health benefits of ruminant products.

Role of Radiofrequency in the Management of Chronic Low Back Pain

Background: low back pain (LBP) is related to disability and work absence and accounts for high economical costs. The management of LBP comprises a range of different intervention strategies including surgery, drug therapy, and non-medical interventions. Failed back surgery syndrome is a common problem with enormous costs to patients, insurers, and society, defined as persistent back and/ or leg pain after spine surgery. The etiology of failed back surgery can be poor patient selection, incorrect diagnosis, suboptimal selection of surgery, poor technique, failure to achieve surgical goals, and/or recurrent pathology. Aim of the Work: to evaluate the efficacy, safety and outcome of radiofrequency as a method for management of patients with chronic low back pain. Subjects and Methods: thisprospective study was conducted at El Galaa Military Hospital starting from January 2017. Twenty-five patients with chronic low back pain with mal-response to medical treatment justified for receiving interventional pain management as a conservative method of treatment of low back pain. They were subjected to radiofrequency neurotomy as a method for managing low back pain. Results: there was highly statistically significant decrease in pain score immediately, 1 week, 1 month and 3 months than pain score before RF with p-value < 0.01and there was highly statistically significant difference between daily living activities before RF and daily living activities at different times of measurement with p-value < 0.01. Conclusion: low back pain is a medical, social and economical problem. Radiofrequency neurotomy had advantage regarding the long term follow up but the costs and equipment-wised problem still make it less prevailed. Recommendations: longer follow up and randomized study if could be conducted the results may indicate much clues.

Incontinence in nursing home residents with dementia : Influence of an educational program and nursing case conferences.

Up to 90 % of nursing home residents with dementia suffer from urinary incontinence with adverse effects on the quality of life. Nurses are often insufficiently prepared for incontinence management and their knowledge is incomplete. Urinary incontinence management for people with dementia is complex due to the multifactorial nature of the disease and cognitive impairment. This study explored the effects of an educational program and subsequent nursing case conferences on urinary incontinence and quality of life of nursing home residents with dementia. The stepped-wedge trial design was used and seven nursing homes were included. In total 140people were included in the study. The intervention consisted of an educational program and six case conferences at each ward. Urinary incontinence and quality of life were measured at baseline, after 2 and 6 months as well as at the end of the study. Univariate analysis of variance (ANOVA), repeated measures ANOVA and linear regression were used to compare the groups and the results at different times of measurement. The responsible ethics committees approved the study. After 6 months urinary incontinence decreased or was approximately equal to the initial measurement. At the end of the study urinary incontinence was slightly but not significantly higher. In the whole sample the quality of life increased in seven out of nine categories up to the end of the study. Urinary incontinence management for people with dementia is complex and an educational program and case conferences during 6 months proved to be effective in reducing urinary incontinence and improve the quality of life in nursing home residents with dementia.

Fatigue in patients following traumatic brain injury and stroke

Fatigue may be defined as an experience of long-term or recurrent tiredness and reduced capacity for mental and/or physical activity, and is common following acquired brain injury. This article provides an overview of the status of knowledge on fatigue following stroke and traumatic brain injury. An assessment of the existing literature, including a literature search, as well as the authors' own clinical experience form the basis for the content of this article. Existing studies use varying definitions of fatigue and apply different survey tools. The prevalence of fatigue following stroke or traumatic brain injury is uncertain due to varying inclusion criteria and survey methods, and because different times of measurement can result in different prevalence figures. Several studies estimate the prevalence to be between 50 and 70%. Our knowledge of the pathologic mechanisms is very limited; premorbid, sociodemographic, stroke/trauma-related and comorbid factors all play a role in the experience of fatigue. Therapeutic interventions include psychoeducation, regulation of activity, physical exercise and treatment of comorbid conditions. Trials have also been conducted on drug treatment, so far without convincing results. Fatigue occurs frequently in stroke patients and patients with traumatic brain injuries, and often significantly restricts daily functioning for these patients. Our knowledge of pathologic mechanisms and evidence with regard to therapeutic interventions is deficient, and the patient population is heterogeneous. The treatment is adapted to the individual and its objective is to enable individuals to use their limited capacity in the most appropriate way possible.

Influence of swallowing saliva repeatedly on oral moisture

The aim of this study was to examine the influence of repetitive saliva-swallowing for the level of oral moisture using an oral-moisture checking device. Subjects were 24 healthy adults (HA) and 20 patients with oral dryness, 10 of whom had Sjögren syndrome or who had undergone radiation therapy (ODSR) and 10 who had not experienced ODSR (ODNSR). Oral moisture was measured before swallowing saliva (B), and after swallowing saliva once (F), twice (S), and three times (T). Oral moisture was measured at the lingual mucosa using an oral-moisture checking device. Statistical analysis was performed using the Friedman test. Oral moisture of the lingual mucosa of the HA differed significantly between B and T, and F and T, and the oral moisture level tended to be higher the more times saliva was swallowed. However, oral moisture of lingual mucosa in the ODSR was not different at the different times of measurement, but the level of oral moisture tended to be lower the more times saliva was swallowed. Oral moisture of the lingual mucosa in the ODNSR differed significantly between B and T. The trends for the changes of the oral moisture level in the ODNSR were similar to those in the HA. The results of this study show that swallowing saliva repeatedly could lead the increase of oral moisture in HA and ODNSR not in ODSR.

Prognostic Implications of Procalcitonin and NT-ProBNP in Neutropenic Patients.

Abstract 4743 BackgroundProcalcitonin (PCT) has been increasingly used as an inflammatory marker to identify patients with systemic infection. N-terminal pro brain natriuretic peptide (NT-proBNP) elevation can be used to predict future cardiac events and survival. The aim of this study was to evaluate the role of PCT and NT-proBNP measurements in febrile neutropenic patients in terms predicting outcomes in these patients. MethodsNeutropenia was defined as neutrophil count of 500 cells/mm3 or less or a count of < 1,000 cells/mm3 with a predicted decrease to < 500 cells/mm3. Fever in a neutropenic patient is defined as a single measurement of oral temperature of more than 38.3 °C or a temperature of 38.0 °C for 1 hr. From July 2008 and May 2009, immunocompromized patients with neutropenia were screened for PCT, NT-proBNP at the time of diagnosis, 3 days later and 3 days after fever subsided. ResultsA total of 32 patients aged between 2.5 and 13.5 years (17 boys and 15 girls) were admitted because of neutropenic fever at the Chungnam National University Hospital. PCT levels were not significantly different among 3 different times of measurements, but NT-proBNP was significantly higher at 3 days after admission compared with those of at diagnosis and after fever was subsided. PCT and NT-proBNP levels at the time of diagnosis were significantly correlated with each other. Three patients with higher NT-proBNP showed symptoms of heart failure and arrhythmia but PCT was not significantly elevated in these patients. ConclusionPCT and NT-proBNP at the time of diagnosis were correlated with each other. PCT levels were not significantly changed among 3 different times of measurements but NT-proBNP was significant index of heart failure especially 3 days after fever developed. Disclosures:No relevant conflicts of interest to declare.

The true‐change model with individual method effects: Reliability issues

The true intra-individual change model is generalized by defining individual method effects. This allows the analysis of non-congeneric test-retest variables assumed to measure a common, possibly (temporally) transient, attribute. Temporal change in the attribute between different times of measurement is modelled by the true-change variable. Individual causal method effects, due to heterogeneity of the measurement methods, account for the imperfect correlation of the true-score variables at each time of measurement. The reliability of the composite scores, at each time of measurement, and the reliability of the difference composite score may be estimated with appropriate coefficients derived from the model. Measurements of daily life tension in adult females serve to illustrate how the model can be used empirically.

Evaluation of internal lung motion for respiratory-gated radiotherapy using MRI: Part II—margin reduction of internal target volume

To analyze the relationship between lung motion and skin surface motion during respiration, determine the uncertainties and variability of such a relationship, and assess the potential of reducing internal target margin for gated radiotherapy. Three healthy volunteers and four lung cancer patients were recruited in a prospective imaging study using MRI to track the internal lung and external skin motion during breathing. The relationship between the lung and skin motion was modeled using linear regression analysis. The slope of the linear fit and its confidence interval were analyzed for different lung locations, skin surface locations, and breathing patterns from separate imaging sessions. The margins of the internal target volume were calculated based on the residual lung motion during gating and its uncertainties from multiple treatment fractions for the gated treatment. The slope and confidence interval of the linear regression from the motion analysis were uniquely defined by the locations of the lung, skin surface, and breathing patterns. Statistically significant differences were observed among individuals and between different times of measurement. The normal free-breathing motion averaged from all volunteer and patient data was 13.4 +/- 7.4 mm along the superior-inferior (SI) direction and 6.9 +/- 2.6 mm along the anterior-posterior (AP) direction. With simulated respiratory gating, the average margin reduction was 5.5 +/- 4.8 mm and 1.6 +/- 1.0 mm, respectively, along the SI and AP directions (or 36% +/- 15% and 25% +/- 14%, respectively, relative to free-breathing motion). Because respiratory movement is rather complex, the relationship between the lung and skin surface motion is affected by many anatomic and physiologic factors. The reduction of internal target margin and efficacy of the free-breathing gating technique should be assessed for individual cases.

The Stability and Change in the Social Support Networks of Widowers following Spousal Bereavement

Although much progress has been made in our understanding of the nature of social support, the majority of this research has involved older women and has been studied cross-sectionally. The present study comes from a life-span developmental perspective on stability and change over time that examines sex differences in the social support networks of widows (170) and widowers (25) that are compared across 12 months post-bereavement. Most levels of positive support increased from B to W1 in what appears to be a response to spousal bereavement. Sex differences generally demonstrate that widowers receive less support using various measures and across different times of measurement. These findings point to change over time, sex differences, and heterogeneity as important issues when discussing bereavement and social support.

Taking the law into one's own hands on ideological grounds

This study presents a model in which the willingness to take the law into one's own hands on ideological grounds is predicted by non-commitment to the law, perceptions of procedural justice, and alienation. The model was examined using data from three identical surveys, conducted in three consecutive years, of Israeli citizens from the following groups: a representative sample of the general Jewish population ( N=2680), ultra-orthodox Jews ( N=400), settlers in the occupied territories ( N=889), and Israeli Arabs ( N=1507). Willingness to take the law into one's own hands was examined in relation to conflict between the law and moral and religious values, national security, and minority group rights. Structural equation modeling shows that non-commitment mediated the relationship between willingness to violate the law, on one hand, and perceptions of injustice and alienation, on the other. The model was found to be valid across the different social groups included in the study, different times of measurement, and different types of values.

Upper airway reactivity and upper respiratory tract infection: effect of nebulized lidocaine

Patients presenting for elective anaesthesia and surgery may be suffering with, or recovering from, a recent upper respiratory tract infection. Airway reflexes are heightened and these individuals may be more likely to suffer airway complications on administration of general anaesthesia. We have examined the effect of nebulized lidocaine on upper airway reflexes in such subjects. Using dilute ammonia as a chemical stimulus to the upper airway, we measured upper airway reactivity in 15 volunteers (aged 22-43 yr) with symptoms of an upper respiratory tract infection for 4 days or less. The threshold concentration of ammonia producing a brief reduction in inspiratory flow was determined. Measurements were made before and after administration of a nebulized solution of 4% lidocaine 4 ml or saline. After a 2-h interval the procedure was repeated with the alternative solution. The order of administration was randomized. The observer was blind to the solution given. Ammonia threshold was found to increase in subjects after nebulized lidocaine, from a median value of 327 (range 76-878) ppm to 878 (251-1620) ppm (P = 0.0007, Wilcoxon); there was no significant change after nebulized saline. After a convalescence period of at least 4 weeks, with no return of symptoms in the preceding 2 weeks, ammonia threshold was reassessed. It was found to be increased in all 15 subjects. Comparison of the five different times of measurement showed a highly significant difference (P < 0.001, Friedman). Subsequent analysis showed significant differences (P < 0.05, Wilcoxon) between convalescent ammonia threshold and both baseline and post-saline nebulizer values. There was no significant difference between convalescent and post-lidocaine ammonia threshold. We conclude that in adult subjects, nebulized lidocaine attenuated the heightened airway reflex sensitivity associated with symptoms and signs of upper respiratory tract infection.