Annular Pancreatitis and Gastric Cancer

Annular pancreas can present in adult life, usually when inflammation of the pancreatic ring causes duodenal stenosis. Although peptic ulcer is often associated with annular pancreas, an association with gastric carcinoma has not been previously described. Here we report a patient with annular pancreas, chronic alcoholic pancreatitis and gastric carcinoma, who was successfully treated by radical proximal pancreatoduodenectomy

Case Report:False-negative HIV-1 polymerase chain reaction in a 15-month-old boy with HIV-1 subtype C infection

Polymerase chain reaction (PCR) testing is the gold standard for determining the HIV status in children <18 months of age. However, when clinical manifestations are not consistent with laboratory results, additional investigation is required. We report a 15-month-old HIV-exposed boy referred to our hospital after he had been admitted several times for infectious diseases. A rapid antibody test on the child was positive, while routine diagnostic HIV PCRs using the Roche COBAS Ampliprep/COBAS TaqMan HIV Qual Test were negative at 6 weeks, 6 months, 7 months and 15 months. In addition, the same PCR test performed on the HIV-infected mother was also negative. Alternative PCR and viral load assays using different primer sets detected HIV RNA or proviral DNA in both child and mother. Gag sequences from the child and his mother classified both infections as HIV-1 subtype C, with very rare mutations that may have resulted in PCR assay primer/probe mismatch. Consequently, the child was commenced on antiretroviral therapy and made a remarkable recovery. These findings indicate that more reliable PCR assays capable of detecting a wide range of HIV subtypes are desirable to circumvent the clinical problems created by false-negative PCR results

A note on brain actuated spelling with the Berlin brain-computer interface

Brain-Computer Interfaces (BCIs) are systems capable of decoding neural activity in real time, thereby allowing a computer application to be directly controlled by the brain. Since the characteristics of such direct brain-tocomputer interaction are limited in several aspects, one major challenge in BCI research is intelligent front-end design. Here we present the mental text entry application ‘Hex-o-Spell’ which incorporates principles of Human-Computer Interaction research into BCI feedback design. The system utilises the high visual display bandwidth to help compensate for the extremely limited control bandwidth which operates with only two mental states, where the timing of the state changes encodes most of the information. The display is visually appealing, and control is robust. The effectiveness and robustness of the interface was demonstrated at the CeBIT 2006 (world’s largest IT fair) where two subjects operated the mental text entry system at a speed of up to 7.6 char/min

Roughness-induced critical phenomena in a turbulent flow

I present empirical evidence that turbulent flows are closely analogous to critical phenomena, from a reanalysis of friction factor measurements in rough pipes. The data collapse found here corresponds to Widom scaling near critical points, and implies that a full understanding of turbulence requires explicit accounting for boundary roughness

Coherent frequentism

By representing the range of fair betting odds according to a pair of confidence set estimators, dual probability measures on parameter space called frequentist posteriors secure the coherence of subjective inference without any prior distribution. The closure of the set of expected losses corresponding to the dual frequentist posteriors constrains decisions without arbitrarily forcing optimization under all circumstances. This decision theory reduces to those that maximize expected utility when the pair of frequentist posteriors is induced by an exact or approximate confidence set estimator or when an automatic reduction rule is applied to the pair. In such cases, the resulting frequentist posterior is coherent in the sense that, as a probability distribution of the parameter of interest, it satisfies the axioms of the decision-theoretic and logic-theoretic systems typically cited in support of the Bayesian posterior. Unlike the p-value, the confidence level of an interval hypothesis derived from such a measure is suitable as an estimator of the indicator of hypothesis truth since it converges in sample-space probability to 1 if the hypothesis is true or to 0 otherwise under general conditions.Comment: The confidence-measure theory of inference and decision is explicitly extended to vector parameters of interest. The derivation of upper and lower confidence levels from valid and nonconservative set estimators is formalize

An evaluation of a nurse led unit: an action research study

This study is an exemplar of working in a participatory way with members of the public and health and social care practitioners as co-researchers. A Nurse Consultant Older People working in a nurse-led bed, intermediate care facility in a community hospital acted as joint project lead with an academic researcher. From the outset, members of the public were part of a team of 16 individuals who agreed an evaluation focus and were involved in all stages of the research process from design through to dissemination. An extensive evaluation reflecting all these stakeholders’ preferences was undertaken. Methods included research and audit including: patient and carer satisfaction questionnaire surveys, individual interviews with patients, carers and staff, staff surveys, graffiti board, suggestion box, first impressions questionnaire, patient tracking and a bed census. A key aim of the study has been capacity building of the research team members which has also been evaluated. In terms of impact, the co-researchers have developed research skills and knowledge, grown in confidence, developed in ways that have impacted elsewhere in their lives, developed posters, presented at conferences and gained a better understanding of the NHS. The evaluation itself has provided useful information on the processes and outcomes of intermediate care on the ward which was used to further improve the service

A Coastal Transect of McMurdo Dry Valleys (Antarctica) Snow and Firn: Marine and Terrestrial Influences on Glaciochemistry

Samples of snow and firn from accumulation zones on Clark, Commonwealth, Blue and Victoria Upper Glaciers in the McMurdo Dry Valleys (similar to 77-78 degrees S, 161-164 degrees E), Antarctica, are evaluated chemically and isotopically to determine the relative importance of local (site-specific) factors vs regional-scale influences in defining glaciochemistry. Spatial variation in snow and firn chemistry confirms documented trends within individual valleys regarding major-ion deposition relative to elevation and to distance from the coast. Sodium and methylsulfonate (MS-), for example, follow a decreasing gradient with distance from the coast along the axis of Victoria Valley (350-119 mu gL(-1) for Na+; 33-14 mu gL(-1) for MS-); a similar pattern exists between Commonwealth and Newall Glaciers in the Asgaard Range. When comparing major-ion concentrations (e.g. Na-+,Na- MS-, Ca2+) or trace metals (e.g. Al, Fe) among different valleys, however, site-specific exposures to marine and local terrestrial chemical sources play a dominant role. Because chemical signals at all sites respond to particulates with varying mixtures of marine and terrestrial sources, each of these influences on site glaciochemistry must be considered when drawing temporal climate inferences on regional scales