Naresuan University Journal
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A Study Comparing Videocapillaroscopy and Dermoscopy in the Assessment of Nailfold Capillaries in Patients with Systemic Sclerosis-Spectrum Disorders
No full textOBJECTIVES: Nailfold videocapillaroscopy (NVC), the current gold standard for detection of capillary abnormalities suggestive of an SSc-spectrum disorder, is not widely available: a key question is whether lower-magnification, easy-to-use dermoscopy compares favourably. This is especially relevant given the inclusion of capillaroscopic abnormality within the 2013 classification criteria for SSc. Our objectives were to examine the ability to classify capillaries and to evaluate abnormality (severity), by both NVC and dermoscopy, to determine whether these differ between general and specialist rheumatologists, and to compare intra- and interrater reliability of both techniques. METHODS: NVC and dermoscopy images were acquired from all 10 nailbeds of 32 subjects with a range of capillary abnormalities. Images were graded (using a web-based interface) on a 0-3 scale of severity: normal (0), mildly (1), definitely (2) and grossly abnormal (3), and an unclassifiable category. Raters graded images from four subjects (40 nailbeds) using each technique, with five repeated images to estimate intrarater reliability. RESULTS: Forty-eight rheumatologists from 12 countries participated in the study (22 generalists, 26 specialists). While most images could be graded by both techniques, more were graded by NVC (84% vs 70%) and were systematically scored higher by NVC (mean difference 0.43 between the ratings). Agreement between the techniques was moderate. Intra- and interrater reliability were comparable for the two techniques in the classifiability of images and the grading of severity. CONCLUSION: Our results suggest that dermoscopy is comparable to NVC, although NVC images were more likely to be classifiable and were graded more severely
Review article on Tales of Futures Past: Anticipation and the Ends of Literature in Contemporary China, by Paola Iovene
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Toward continuous quantification of lava extrusion rate: Results from the multidisciplinary analysis of the 2 January 2010 eruption of Piton de la Fournaise volcano, La Reunion
No full textThe dynamics of the 2-12 January 2010 effusive eruption at Piton de la Fournaise volcano were examined through seismic and infrasound records, time-lapse photography, SO2 flux measurements, deformation data, and direct observations. Digital elevation models were constructed for four periods of the eruption, thus providing an assessment of the temporal evolution of the morphology, the volume and the extrusion rate of the lava flow. These data were compared to the continuous recording of the seismic and infrasonic waves, and a linear relationship was found between the seismic energy of the tremor and the lava extrusion rate. This relationship is supported by data from three other summit eruptions of Piton de la Fournaise and gives total volume and average lava extrusion rate in good agreement with previous studies. We can therefore provide an estimate of the lava extrusion rate for the January 2010 eruption with a very high temporal resolution. We found an average lava extrusion rate of 2.4m(3)s(-1) with a peak of 106.6m(3)s(-1) during the initial lava fountaining phase. We use the inferred average lava extrusion rate during the lava fountaining phase (30.23m(3)s(-1)) to estimate the value of the initial overpressure in the magma reservoir, which we found to range from 3.7x10(6)Pa to 5.9x10(6)Pa. Finally, based on the estimated initial overpressure, the volume of magma expelled during the lava fountaining phase and geodetic data, we inferred the volume of the magma reservoir using a simple Mogi model, between 0.25 km(3) and 0.54 km(3), which is in good agreement with previous studies
Emotions and identity in the figured world of becoming a doctor.
No full textCONTEXT: There is little room in clerkship curricula for students to express emotions, particularly those associated with the development of a caring identity. Yet it is recognised that competence, alone, does not make a good doctor. We therefore set out to explore the relationship between emotions and identity in clerkship education. Our exploration was conceptually oriented towards Figured Worlds theory, which is linked to Bakhtin's theory of dialogism. METHODS: Nine female and one male member of a mixed student cohort kept audio-diaries and participated in both semi-structured and cognitive individual interviews. The researchers identified 43 emotionally salient utterances in the dataset and subjected them to critical discourse analysis. They applied Figured Worlds constructs to within-case and cross-case analyses, supporting one another's reflexivity and openness to different interpretations, and constantly comparing their evolving interpretation against the complete set of transcripts. RESULTS: Students' emotions were closely related to their identity development in the world of medicine. Patients were disempowered by their illnesses. Doctors were powerful because they could treat those illnesses. Students expressed positive emotions when they were granted positions in the world of medicine and were able to identify with the figures of doctors or other health professionals. They identified with doctors who behaved in caring and professionally appropriate ways towards patients and supportively towards students. Students expressed negative emotions when they were unable to develop their identities. CONCLUSIONS: Critical discourse analysis has uncovered a link between students' emotions and their identity development in the powerful world of becoming and being a doctor. At present, identity development, emotions and power are mostly tacit in undergraduate clinical curricula. We speculate that helping students to express emotions and exercise power in the most effective ways might help them to develop caring identities
Identification of biomarkers involved in differential profiling of hypertrophic and keloid scars versus normal skin.
No full textAmong raised dermal scar types, keloid (KS) and hypertrophic scars (HS) are considered to present clinical similarities, but there are no known specific biomarkers that allow both scar types to be easily distinguished. Development and progression of raised dermal scars comprises the activation of several molecular pathways and cell defence mechanisms leading to elevated extracellular matrix component synthesis, delayed apoptosis, altered migration and differentiation. Therefore, the aim here was to identify biomarkers that may differentiate between KS and HS compared to normal skin (NS). To achieve this aim, NS (n = 14), KS (n = 14) and HS (n = 14) biopsies were evaluated using histology by H&E staining. Tissue biopsies and primary fibroblasts (passages 0-4) were employed to assess the gene expression levels of 21 biomarkers selected from our previous microarray studies using qRT-PCR. Finally, protein expression was evaluated using In-Cell Western Blotting in primary fibroblasts (p 0-4). Our results demonstrated that out of the 21 biomarkers screened at mRNA and protein levels, α2β1-integrin, Hsp27, PAI-2, MMP-19 and CGRP showed significantly higher expression (p <0.05) in KS compared to NS and HS. Additionally, these five key biomarkers were found to be significantly higher (p <0.05) at mRNA level in KS taken from the sternum, a region known to be subjected to high mechanical forces in the body during the performance of daily movements. In conclusion, our findings offer potential molecular targets in raised dermal scars differentiation. Future targeted research may allow provision of diagnostic and prognostic markers in keloid versus hypertrophic scars
Why do people engage in interpersonal emotion regulation at work?
No full textPeople in organizations often try to change the feelings of those they interact with. Research in this area has to date focused on how people try to regulate others’ emotions, with less attention paid to understanding the reasons why. This paper presents a theoretical framework that proposes three overarching dimensions of motivations for interpersonal emotion regulation at work, relating to the extent to which regulation is motivated by autonomy (intrinsic vs. extrinsic), relatedness (prosocial vs. egoistic), and competence (performance- vs. pleasure-oriented). Combining these dimensions suggests eight possible categories of motives that underlie interpersonal emotion regulation. The framework enables new predictions about how motives influence the types of emotions elicited in others, the strategies employed, and the effectiveness of interpersonal emotion regulation in organizations
The use of organic extractants in solvent extraction processes in the partitioning of spent nuclear fuels
No full textActigraphic investigation of circadian rhythm functioning and activity levels in children with mucopolysaccharidosis type III (Sanfilippo syndrome).
No full textBACKGROUND: Sleep disturbance is part of the behavioural phenotype of the rare genetic condition mucopolysaccharidosis (MPS) type III. A growing body of evidence suggests that underlying disturbance in circadian rhythm functioning may explain sleep problems within the MPS III population. METHODS: Actigraphic data were recorded in eight children with MPS III over 7-10 days and compared to age-matched typically developing controls. Parameters of circadian rhythmicity and activity levels across a 24-h period were analysed. RESULTS: Statistically and clinically significant differences between the two groups were noted. Analysis indicated that children with MPS III showed significantly increased fragmentation of circadian rhythm and reduced stability with external cues (zeitgebers), compared to controls. Average times of activity onset and offset were indicative of a phase delayed sleep-wake cycle for some children in the MPS III group. Children with MPS III had significantly higher activity levels during the early morning hours (midnight-6 am) compared to controls. CONCLUSIONS: Results are consistent with previous research into MPS III and suggest that there is an impairment in circadian rhythm functioning in children with this condition. Implications for clinical practice and the management of sleep difficulties are discussed