Final Exit Research Articles

Quality management and accreditation of research tissue banks: experience of the National Center for Tumor Diseases (NCT) Heidelberg

Tissue banks are key resource and technology platforms in biomedical research that address the molecular pathogenesis of diseases as well as disease prevention, diagnosis, and treatment. Due to the central role of tissue banks in standardized collection, storage, and distribution of human tissues and their derivatives, quality management and its external assessment is becoming increasingly relevant for the maintenance, acceptance, and funding of tissue banks. Little experience exists regarding formalized external evaluation of tissue banks, especially regarding certification and accreditation. Based on the accreditation of the National Center of Tumor Diseases (NCT) tissue bank in Heidelberg (Germany), criteria, requirements, processes, and implications were compiled and evaluated. Accreditation formally approved professional competence and performance of the tissue bank in all steps involved in tissue collection, storage, handling as well as macroscopic and histologic examination and final (exit) examination of the tissue and transfer supervised by board-certified competent histopathologists. Thereby, accreditation provides a comprehensive measure to evaluate and document the quality standard of tissue research banks and may play a significant role in the future assessment of tissue banks. Furthermore, accreditation may support harmonization and standardization of tissue banking for biomedical research purposes.

Selectivity mechanism of the nuclear pore complex characterized by single cargo tracking

The Nuclear Pore Complex (NPC) mediates all exchange between the cytoplasm and the nucleus. Small molecules can passively diffuse through the NPC, while larger cargos require transport receptors to translocate1. How the NPC facilitates the translocation of transport receptor/cargo complexes remains unclear. Here, we track single protein-functionalized Quantum Dot (QD) cargos as they translocate the NPC. Import proceeds by successive sub-steps comprising cargo capture, filtering and translocation, and release into the nucleus. The majority of QDs are rejected at one of these steps and return to the cytoplasm including very large cargos that abort at a size-selective barrier. Cargo movement in the central channel is subdiffusive and cargos that can bind more transport receptors diffuse more freely. Without Ran, cargos still explore the entire NPC, but have a markedly reduced probability of exit into the nucleus, suggesting that NPC entry and exit steps are not equivalent and that the pore is functionally asymmetric to importing cargos. The overall selectivity of the NPC appears to arise from the cumulative action of multiple reversible sub-steps and a final irreversible exit step.

Cutting-edge Discussions of Management, Policy, and Program Issues in Emergency Care

Cutting-edge Discussions of Management, Policy, and Program Issues in Emergency Care

Student performance in Introductory Microeconomics at an African open and distance learning institution

Introductory Microeconomics as offered by the University of South Africa (Unisa) is a compulsory module for a Bachelor of Commerce, a Bachelor of Accountancy or a Bachelor of Administration degree. Success or failure in Introductory Microeconomics directly impacts on the number of years students take to complete their degrees, and eventually also on the throughput subsidy to Unisa. A number of exceptional institutional rules and regulations impact on the teaching of Introductory Microeconomics at Unisa, as an open and distance learning (ODL) institution. Unlike many residential institutions, Unisa does not require Mathematics at school level for registration for Introductory Microeconomics. This article reports on research done at Unisa to determine how student success in Introductory Microeconomics is influenced by variables such as race, home language, whether the students passed mathematics at matriculation level, matriculation exemption1, gender and the passing of assignments. Although this research confirms previous research that home language and age do impact on student success, it finds that the successful passing of assignments has the greatest impact on student success. 1. Matriculation (“matric”): In South Africa, the final school exit certificate, which is awarded with or without university exemption (“endorsement”).

Evolution of the final fellowship examination

The Royal Australasian College of Surgeons Final Fellowship or exit examination, common to nine surgical specialties, has undergone substantial change since the beginning of formal assessment in 1934. These changes reflect the altered requirements of the different specialties and developments in examination techniques and technology. Although there is now some variation between specialties in the format of each segment of the examination, consistency remains with seven segments of the examination being common to all specialties--two written papers, two clinical segments and three vivas. Approval for Fellowship, indicating success in the examination, is the responsibility of the full Court of Examiners although guided by each Specialty Court. During the past decade the examination has become more structured and objective and all candidates experience similar assessment. Considerable work has been undertaken to ensure that the examination process is appropriate and fair. A review of examination outcomes 2001-2007 shows some variation between specialties. Although the basis for this is multifactorial, some differences between Specialty Courts of Examiners in the structure of the examination and the assessment process may be small contributory factors. With an increased emphasis on competence-based assessment during training the form of this exit examination will continue to evolve.

Whole genome sequencing in the undergraduate classroom: outcomes and lessons from a pilot course.

The BIO2010 report challenged undergraduate institutions to prepare the next generation of researchers for the changing direction of biology that increasingly integrates advanced technologies, digital information, and large-scale analyses. In response, the Microbiology and Cell Science Department at the University of Florida developed a research-based course, "Bacterial Genome Sequencing." The objectives were to teach undergraduates about genomics and original research by sequencing a bacterial genome, to develop scientific communication skills by writing and submitting the project results as a class effort, and to promote an interest in biological research, particularly genomics. The students worked together to sequence, assemble, and annotate the Enterobacter cloacae P101 genome. We assessed student learning, scientific communication skills, and student attitudes by a variety of methods including exams, writing assignments, oral presentations, pre- and postcourse surveys, and a final exit survey. Assessment results demonstrate student learning gains and positive attitudes regarding the course.

Transition From Work to Retirement: Evidence from LEED

Survey evidence suggests that the majority of New Zealanders would prefer to make a gradual transition from work to retirement, rather than move abruptly from full-time work to non-employment. This study describes the employment patterns and transitions of people who were aged in their 60s and moved from wage or salary employment to inactivity during the 1999-2005 period, using longitudinal data from the Linked Employer-Employee Dataset. Four different types o f transition to retirement were defined and the relative frequency o f each explored. We find that phased transitions, involving either part-time work or a number of transitions in and out of employment before the final exit, were far more common than discrete transitions from full-time work to non-employment. Men were more likely than women to take a traditional path from work to retirement. There were some significant variations in the frequency of different work-to-retirement paths across major industries, but phased transitions were more prevalent than traditional in all major industries.

Fibroblasts in Kidney Fibrosis Emerge via Endothelial-to-Mesenchymal Transition

Fibroblasts are key mediators of fibrosis in the kidney and other organs, but their origin during fibrosis is still not completely clear. Activated fibroblasts likely arise from resident quiescent fibroblasts via epithelial-to-mesenchymal transition and from the bone marrow. Here, we demonstrate that endothelial cells also contribute to the emergence of fibroblasts during kidney fibrosis via the process of endothelial-to-mesenchymal transition (EndMT). We examined the contribution of EndMT to renal fibrosis in three mouse models of chronic kidney disease: (1) Unilateral ureteral obstructive nephropathy, (2) streptozotocin-induced diabetic nephropathy, and (3) a model of Alport renal disease. Approximately 30 to 50% of fibroblasts coexpressed the endothelial marker CD31 and markers of fibroblasts and myofibroblasts such as fibroblast specific protein-1 and alpha-smooth muscle actin. Endothelial lineage tracing using Tie2-Cre;R26R-stop-EYFP transgenic mice further confirmed the presence of EndMT-derived fibroblasts. Collectively, our results demonstrate that EndMT contributes to the accumulation of activated fibroblasts and myofibroblasts in kidney fibrosis and suggest that targeting EndMT might have therapeutic potential.

Microbiology of Broiler Carcasses and Chemistry of Chiller Water as Affected by Water Reuse

A study was conducted to determine the effects of treating and reusing poultry chiller water in a commercial poultry processing facility. Broiler carcasses and chiller water were obtained from a commercial processing facility which had recently installed a TOMCO Pathogen Management System to recycle water in sections 2 and 3 of two 3-compartment chillers. In this system, reused water is blended with fresh water to maintain the chiller volume. Carcasses were sampled prechill and postchill (final exit), and chiller water was sampled from the beginning and end of each of the 3 sections. Carcasses were subjected to a whole carcass rinse (WCR) in 0.1% peptone. Numbers of Escherichia coli (EC), coliforms (CF), and Campylobacter (CPY) were determined from the WCR and chiller water samples. Prevalence of Salmonella (SAL) was also determined on the WCR and chiller water samples. On average, prechill levels of bacteria recovered from rinses were 2.6, 2.9, and 2.6 log10 cfu/mL for EC, CF, and CPY, respectively. Ten out of 40 (25%) prechill carcasses were positive for SAL. After chilling, numbers of EC, CF, and CPY recovered from carcass rinses decreased by 1.5, 1.5, and 2.0 log10 cfu/mL, respectively. However, 9 out of 40 (22%) postchill carcasses were positive for SAL. When the chiller water samples were tested, counts of EC, CF, and CPY were found only in water collected from the first section of the chiller (inlet and outlet). Two of 4 water samples collected from the inlet of the first section tested positive for SAL. This study shows that fresh and reused water can be used to cool poultry in chiller systems to achieve a reduction in numbers of bacteria (EC, CF, and CPY) or equivalent prevalence (SAL) of bacteria recovered from broiler carcasses.

CBPR as Community Health Intervention: Institutionalizing CBPR Within Community Based Organizations

A community-academy partnership was created with a commitment to developing a program for institutionalizing community-based participatory research (CBPR) capacity within community-based organizations (CBOs), with the intention to enhance CBOs' existing capabilities to understand and improve community health. This article presents the design and conceptual foundations for a year-long CBPR education and training program in which CBO teams learn research design, discuss the principles of CBPR, design and implement a community health-related research project tailored to their program and community, conduct analyses, and initiate integration of the results into the organization and community. One objective is to integrate a commitment to and the practice of CBPR within CBOs' program and policies. An initial partnership was created between the Center for Border Health, El Paso, and Texas A&M University School of Rural Public Health, College Station. Three additional CBOs then joined the partnership and participated in the CBPR education and training program consisting of four stages: (1)3 intensive months devoted to learning about and creating a research design; (2) 6 months for implementation of the design; (3) 2 months for analyses, interpretation, and consolidation of results into one or more final products; and (4) 1 month for development of protocols for integrating research results into community health development. In the first iteration, an interactive process evaluation was conducted during each program stage, plus a final year-end exit interview with each participating CBO. Evaluation demonstrated strong positive results and specific lessons learned. A proposal incorporating the lessons learned was presented to the funding source. A second iteration has been funded, with monies included to develop a formal outcome evaluation.

Finite Element Investigation of the Effect of Hardening Behavior of Alloys on Equal Channel Angular Pressing Performance

In most of the simulation studies of equal channel angular pressing (ECAP) it has been assumed that materials obey isotropic hardening law. However, in the case of precipitation hardenable alloys, an accurate prediction of the deformation behavior requires incorporation of kinematic hardening model. In this study, the influences of kinematic, isotropic and combined hardening laws on deformation behavior have been investigated. For this purpose, an ECAP die consisting of two 120° channels has been selected, and the effect of hardening law on the strain profile and ram pressure at the final exit channel has been studied. The simulation results showed that the hardening mechanism does not affect the strain profiles extensively; but, when kinematic hardening mechanism was considered the ram pressure decreases significantly due to less hardening of the material during reverse loading in the final exit channel.

Whole Genome Sequencing in the Undergraduate Classroom: Outcomes and Lessons from a Pilot Course

The BIO2010 report challenged undergraduate institutions to prepare the next generation of researchers for the changing direction of biology that increasingly integrates advanced technologies, digital information, and large-scale analyses. In response, the Microbiology and Cell Science Department at the University of Florida developed a research-based course, “Bacterial Genome Sequencing.” The objectives were to teach undergraduates about genomics and original research by sequencing a bacterial genome, to develop scientific communication skills by writing and submitting the project results as a class effort, and to promote an interest in biological research, particularly genomics. The students worked together to sequence, assemble, and annotate the Enterobacter cloacae P101 genome. We assessed student learning, scientific communication skills, and student attitudes by a variety of methods including exams, writing assignments, oral presentations, pre- and postcourse surveys, and a final exit survey. Assessment results demonstrate student learning gains and positive attitudes regarding the course.

Programmatic assessment of student experiences using a longitudinal survey.

The purpose of this study was to gather longitudinal data on a pharmacy class cohort concerning programmatic components as well as develop a profile of student experiences as they progress through the curriculum. The Class of 2006 (n = 67) completed a 2 page instrument at the conclusion of the first 3 professional years (PY) concerning hours spent in various activities, overall quality of various programmatic components, relationships with others in the college, and employment information. During senior week, a more extensive exit survey was administered. At the conclusion of PY1, 56.5% of the class was working as a pharmacy intern. By PY3 this increased to 88.1% with a decrease to 65.7% in the final year. The hourly range of hours worked followed the same pattern. The rating of Dean's Office Staff and interactions with faculty members remained constant across all 4 years. In the final exit survey the 2 lowest rated program components were the quality of the interaction with assigned faculty advisor and the availability of professional electives. There was no difference across the professional years for the quality of relationships with staff or faculty; however, the mean rating of the quality of relationships with other students was higher for PY4 when compared to PY1. College faculty, administrators, and committees have used the information gathered from students in program assessment and enhancement efforts. Longitudinal data collection allows for tracking of changes and interventions.

How Primary Care Kept Geriatrics

How Primary Care Kept Geriatrics

PCB decomposition and formation in thermal treatment plant equipment

In this study we investigated both the decomposition and unintentional formation of polychlorinated biphenyl congeners during combustion experiments of refuse-derived fuel (RDF) and automobile shredder residue (ASR) at several stages in thermal treatment plant equipment composed of a primary combustion chamber, a secondary combustion chamber, and other equipments for flue gas treatment. In both experiments, the unintentional formation of PCB occurred in the primary combustion chamber at the same time as the decomposition of PCB in input samples. By combusting RDF, non-ortho-PCB predominantly formed, whereas ortho-PCB and symmetric chlorinated biphenyls (e.g., #52/69, #87/108, and #151) tended to be decomposed. ASR formed the higher chlorinated biphenyls more than RDF. These by-products from ASR had no structural relation with ortho-chlorine. Lower chlorinated biphenyls appeared as predominant homologues at the final exit site, while all congeners from lower to higher chlorinated PCB were unintentionally formed as by-products in the primary combustion chamber. This result showed that the flue gas treatment equipments effectively removed higher chlorinated PCB. Input marker congeners of RDF were #11, #39, and #68, while those for ASR were #11, #101, #110/120, and #118. Otherwise, combustion marker congeners of RDF were #13/12, #35, #77, and #126, while those for ASR were #170, #194, #206, and #209. While the concentration of PCB increased significantly in the primary combustion chamber, the value of toxicity equivalency quantity for dioxin-like PCB decreased in the secondary combustion chamber and the flue gas treatment equipments.

The Recent Anti-Secession Law of the PRC

The Anti-Secession Law was adopted on 14 March 2005, the final day of the annual session of the National People's Congress of the PRC. This Taiwan-specific piece of legislation overshadowed Jiang Zemin's final exit from the political scene and can be considered as the most important business transacted at this session. This Chinese move has attracted considerable international attention in the media, amongst China scholars and from foreign governments. However, there is widespread divergence of views regarding the motivations for this action, its timing, its real import and potential consequences.

Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide for the Dying. 3rd edition

Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide for the Dying. 3rd edition

Attributable Effects in Case2‐Studies

In an effort to determine whether a particular treatment causes a particular outcome event, data are obtained from a database system that records events when they occur, and for such events, the system records exposure to the treatment. That is, the system records information about cases. The system provides no information about events that might have occurred but did not, that is, about units which are not cases. Roughly speaking, we know the number of successes for two proportions, treated and control, but not the numbers of trials or units for these proportions; indeed, the concept of a "trial" may be somewhat vague. With no further information, the situation is quite hopeless. However, an interesting strategy that is sometimes used entails identifying two types of cases whose origin is entirely different so that it is known the cases of the second type were definitely not affected by the treatment under study. This strategy--the case-case or case2-study--seems to have been reinvented independently many times, and has recently been offered as a general strategy for infectious disease epidemiology by McCarthy and Giesecke (1999, International Journal of Epidemiology 28, 764-768). Can this strategy permit estimation of the number of cases caused by the treatment? Using attributable effects in a new way, a method of exact inference is proposed, along with a large sample approximation. Two examples are discussed: one concerning the effects of daytime running lights (DRLs) on the risk of multivehicle accidents; the other concerning the origin of a Salmonella infection. A counterexample with superficially similar appearance is also discussed concerning suicide rates following the publication of Final Exit; here, the treatment may alter the outcome, or it may alter the type, and the attributable effect cannot be estimated.

Life After Death

Back to table of contents Previous article Next article Letters to the EditorFull AccessLife After DeathThomas N. Davis III, M.D.Thomas N. Davis IIISearch for more papers by this author, M.D.Published Online:4 Feb 2005https://doi.org/10.1176/pn.40.3.00400047cI was much interested in the December 3, 2004, article about the research of Dr. Ian Stevenson in regard to the “possibility of life after death.” After a religious experience I had in 1981, I have no doubt whatsoever that there is indeed life after this present life. My religious experience led to my writing a book on the subject, No Final Exit: A Psychiatrist's Rebuttal.West Plains, Mo. ISSUES NewArchived

French Missionary Expansion in Colonial Upper Tonkin

This article examines the circumstances and logic of French Catholic missionary expansion in Upper Tonkin. It explores how, over a few decades, the missionary push in the mountainous outskirts of the Red River Delta was conceived, how it unfolded, and how it came to a standstill in the 1920s before its decline towards the final exit of the French in the late 1940s.