Cooldown time for simple cryogenic pipelines

Cooldown time for simple cryogenic pipeline

Adult-Child Sexual Contact: Examining Mental Health Trainees’ Perception of the Impact on Adult Psychological-Emotional Status

Thirty-eight graduate students enrolled in mental health-related programs completed the Brief Symptom Inventory (BSI) indicating anticipated impact of adult-child sexual contact on the psychological status of a young adult woman from positive family environment and one from a negative family environment. BSI subscale scores were significantly higher than the BSI general population’s mean scores in both cases. Multiple regression analyses found that: in the healthy family scenario, practitioners’ background variables (parent education, family of origin climate, prior childhood sexual contact with an adult, and education) did not contribute significantly to the variance in their prediction of expectation of client’s overall psychological distress; and, in the dysfunctional family case, practitioners’ background (childhood experience with adult sexual contact, education level, and professional experience) contributed to 40% of the variance in their prediction of the client’s emotional state. Results of qualitative analyses are presented, and implications for training and service delivery discussed

Genome annotation for clinical genomic diagnostics: strengths and weaknesses

The Human Genome Project and advances in DNA sequencing technologies have revolutionized the identification of genetic disorders through the use of clinical exome sequencing. However, in a considerable number of patients, the genetic basis remains unclear. As clinicians begin to consider whole-genome sequencing, an understanding of the processes and tools involved and the factors to consider in the annotation of the structure and function of genomic elements that might influence variant identification is crucial. Here, we discuss and illustrate the strengths and weaknesses of approaches for the annotation and classification of important elements of protein-coding genes, other genomic elements such as pseudogenes and the non-coding genome, comparative-genomic approaches for inferring gene function, and new technologies for aiding genome annotation, as a practical guide for clinicians when considering pathogenic sequence variation. Complete and accurate annotation of structure and function of genome features has the potential to reduce both false-negative (from missing annotation) and false-positive (from incorrect annotation) errors in causal variant identification in exome and genome sequences. Re-analysis of unsolved cases will be necessary as newer technology improves genome annotation, potentially improving the rate of diagnosis

Personal and sub-personal: a defence of Dennett's early distinction

Since 1969, when Dennett introduced a distinction between personal and sub‐personal levels of explanation, many philosophers have used ‘sub‐personal’ very loosely, and Dennett himself has abandoned a view of the personal level as genuinely autonomous. I recommend a position in which Dennett's original distinction is crucial, by arguing that the phenomenon called mental causation is on view only at the properly personal level. If one retains the commit‐’ ments incurred by Dennett's early distinction, then one has a satisfactory anti‐physicalistic, anti‐dualist philosophy of mind. It neither interferes with the projects of sub‐personal psychology, nor encourages ; instrumentalism at the personal level. People lose sight of Dennett’s personal/sub-personal distinction because they free it from its philosophical moorings. A distinction that serves a philosophical purpose is typically rooted in doctrine; it cannot be lifted out of context and continue to do its work. So I shall start from Dennett’s distinction as I read it in its original context. And when I speak of ‘the distinction’, I mean to point not only towards the terms that Dennett first used to define it but also towards the philosophical setting within which its work was cut out

The effect of underwater massage during hot water immersion on acute cardiovascular and mood responses

Purpose: There is emerging evidence that demonstrates the health benefits of hot water immersion including improvements to cardiovascular health and reductions in stress and anxiety. Many commercially available hot tubs offer underwater massage systems which purport to enhance many benefits of hot water immersion, however, these claims have yet to be studied. Methods: Twenty participants (4 females) completed three, 30-minute sessions of hot-water immersion (beginning at 39°C) in a crossover randomized design: with air massage (Air Jet), water massage (Hydro Jet) or no massage (Control). Cardiovascular responses comprising; heart rate, blood pressure and superficial femoral artery blood flow and shear rate were measured. State trait anxiety, basic affect, and salivary cortisol were recorded before and after each trial. Data were analysed using a mixed effects model.Results: Post immersion, heart rate increased (Δ31bpm, P &lt; 0.001, d = 1.38), mean arterial blood pressure decreased (Δ16 mmHg, P&lt;0.001, d = −0.66), with no difference between conditions. Blood flow and mean shear rate increased following immersion (P &lt; 0.001, Δ362 ml/min, d = 1.20 and Δ108 s−1, d = 1.00), but these increases were blunted in the Air Jet condition (P &lt; 0.001,Δ171 ml/min, d = 0.43 and Δ52 s−1, d = 0.52). Anxiety and salivary cortisol were reduced (P = 0.003, d = −0.20, P = 0.014, d = −0.11), but did not vary between conditions. Enjoyment did not vary between conditions.Conclusion: These data demonstrate positive acute responses to hot water immersion on markers of cardiovascular function, anxiety, and stress. There was no additional benefit of water-based massage, while air-basedmassage blunted some positive vascular responses due to lower heat conservation of the water. <br/

Variability Between Full-Length Lateral Radiographs and Standard Short Knee Radiographs When Evaluating Posterior Tibial Slope in Revision ACL Patients

BACKGROUND: Increased posterior tibial slope (PTS) has been identified as a risk factor for failure after anterior cruciate ligament (ACL) reconstruction. Correction of PTS may improve outcomes after revision ACL reconstruction. There are conflicting reports demonstrating the measurement of the PTS on standard short knee (SSK) radiographs versus full-length lateral (FLL) radiographs including the entire tibia. PURPOSE/HYPOTHESIS: To compare PTS measurements between SSK and FLL radiographs in patients who failed primary ACL reconstruction. It was hypothesized that there would be high variability between the SSK and FLL radiographic measurements. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 2. METHODS: The medial and lateral PTS were measured on the SSK and FLL radiographs of 33 patients with failed primary ACL reconstructions. All measurements were performed by 2 trained independent observers (A.A.M., J.S.), and inter- and intraobserver reliability were calculated using the intraclass correlation coefficient (ICC). Measurements recorded by the observer with the higher intraobserver ICC were used for comparison of the PTS on SSK versus FLL radiographs. RESULTS: Both the inter- and the intraobserver reliability values of the PTS measurements were excellent. There was a significant difference in mean PTS on the medial plateau as measured on the SSK and FLL radiographs (11.2°± 5.3° vs 12.5°± 4.6°; CONCLUSION: Results indicated that FLL and SSK radiographs are not interchangeable measurements for PTS associated with failed ACL reconstruction. Because FLL radiographs demonstrate less variability than SSK radiographs, we recommend obtaining them to evaluate these complex patients

Variability Between Full-Length Lateral Radiographs and Standard Short Knee Radiographs When Evaluating Posterior Tibial Slope in Revision ACL Patients.

BACKGROUND: Increased posterior tibial slope (PTS) has been identified as a risk factor for failure after anterior cruciate ligament (ACL) reconstruction. Correction of PTS may improve outcomes after revision ACL reconstruction. There are conflicting reports demonstrating the measurement of the PTS on standard short knee (SSK) radiographs versus full-length lateral (FLL) radiographs including the entire tibia. PURPOSE/HYPOTHESIS: To compare PTS measurements between SSK and FLL radiographs in patients who failed primary ACL reconstruction. It was hypothesized that there would be high variability between the SSK and FLL radiographic measurements. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 2. METHODS: The medial and lateral PTS were measured on the SSK and FLL radiographs of 33 patients with failed primary ACL reconstructions. All measurements were performed by 2 trained independent observers (A.A.M., J.S.), and inter- and intraobserver reliability were calculated using the intraclass correlation coefficient (ICC). Measurements recorded by the observer with the higher intraobserver ICC were used for comparison of the PTS on SSK versus FLL radiographs. RESULTS: Both the inter- and the intraobserver reliability values of the PTS measurements were excellent. There was a significant difference in mean PTS on the medial plateau as measured on the SSK and FLL radiographs (11.2°± 5.3° vs 12.5°± 4.6°; CONCLUSION: Results indicated that FLL and SSK radiographs are not interchangeable measurements for PTS associated with failed ACL reconstruction. Because FLL radiographs demonstrate less variability than SSK radiographs, we recommend obtaining them to evaluate these complex patients

Granulocyte-macrophage colony stimulating factor (GM-CSF) after high-dose melphalan in patients with advanced colon cancer.

Nine patients with progressive, metastatic disease from primary carcinoma of the colon were entered into a phase I/II study using continuous intravenous infusions of granulocyte-macrophage colony-stimulating factor (GM-CSF) and high dose melphalan (120 mg m-2). GM-CSF was given alone to six patients during the first part of the study to determine a dose that would produce a peripheral leucocyte count (WCC) greater than or equal to 50 X 10(9) 1(-1) and was initially given at 3 micrograms kg-1 day-1 and escalated to 10 micrograms kg-1 day-1 after 10 days. The infusion was discontinued when the WCC exceeded 50 X 10(9) 1(-1) and after a gap of one week, melphalan was given over 30 min. GM-CSF was recommenced 8 h later and was continued until the neutrophil count had exceeded 0.5 X 10(9) 1(-1) for greater than 1 week. One patient achieved a WCC greater than 50 X 10(9) 1(-1) with GM-CSF 3 micrograms kg-1 day-1, but the other five who entered this phase of the study required dose escalation to 10 micrograms kg-1. No toxicity attributed to GM-CSF was seen. After melphalan, the median times to severe neutropenia (less than 0.5 X 10(9) 1(-1] and thrombocytopenia (greater than 20 X 10(9) 1(-1] were 6 and 9 days respectively. The median durations of neutropenia and thrombocytopenia were 14 and 10 days respectively. All patients required intensive support with a median duration of inpatient stay of 24 days. There was one treatment related death due to renal failure. One complete and two partial remissions (33% response rate) were seen but these were of short duration (median of 10 weeks). This study demonstrates that GM-CSF given by continuous intravenous infusion produces significant increments of peripheral granulocyte counts at 3 and 10 micrograms kg-1 day-1 and is not associated with any toxicity. The duration of neutropenia and thrombocytopenia induced by high-dose melphalan appears to be reduced by the subsequent administration of GM-CSF to times which are at least as short as have been reported in historical series which have used autologous bone marrow rescue