Laryngeal Hyperfunction During Whispering: Reality or Myth?

For years, otolaryngologists and voice therapists have warned voice patients that whispering causes more trauma to the larynx than normal speech. However, no large series of patients has ever been examined fiberoptically during whispering to test this hypothesis. As part of our routine examination, patients are asked to count from 1 to 10 in a normal voice and in a whispered voice. We reviewed recorded fiberoptic examinations of 100 patients who had voice complaints. We compared supraglottic hyperfunction and vocal fold closure during the normal and whispered phonation of each patient. Sixty-nine percent of the patients demonstrated increased supraglottic hyperfunction with whispered voice. Eighteen percent had no change, and 13% had less severe hyperfunction. The most common glottal configuration during whisper was an inverted Y, which resulted from compression of the anterior and middle thirds of the true vocal folds. However, 12 patients had no true vocal fold contact during whispered voice, despite having adequate glottic closure with normal voice. Although whispering involves more severe hyperfunction in most patients, it does not seem to do so in all patients. In some patients, it may be less traumatic than normal voice.     

大肠埃希菌高耐药率回顾性分析

目的了解和分析天津市泰达医院大肠埃希菌耐药情况,指导临床合理使用抗菌药物。方法对2010年至2012年间从临床标本中分离的859株大肠埃希菌的耐药情况进行回顾性总结分析。结果 859株大肠埃希菌对多种抗菌药物均产生不同程度的耐药性,其中对氨苄西林的耐药率达到85.0%,对碳青霉烯类抗菌药物如亚胺培南及四代头孢菌素的耐药率均低于5%。结论天津市泰达医院分离的大肠埃希菌存在严重的耐药性,耐药率达到50%的有11种,原因是滥用抗生素,应加强其耐药性监测,合理规范使用抗生素。     

Investigation of early antibiotic use in pediatric patients with acute respiratory infections by high-performance liquid chromatography

In this study, we developed and validated two reliable high-performance liquid chromatography (HPLC) methods for the qualitative detection of six oral β-lactams, which are commonly used in pediatric patients with acute respiratory infections (ARIs). Two distinct reverse-phase chromatographic separations of six β-lactams were obtained. Four β-lactams (cefadroxil, cephalexin, cefaclor and cefixime) in urine were separated using a gradient program with a mobile phase consisting of K₂HPO₄ buffer (20 mm , pH 2.8) and acetonitrile on a LichroCART 250 × 4.6 mm, Purospher STAR C₁₈ end-capped (5 μm) column. Two remained β-lactams (amoxicillin and cefuroxime) were analyzed using a gradient elution with the mobile phase containing K₂HPO₄ buffer (20 mm , pH 3.0) and acetonitrile on a LichroCart^® Purospher Star C₈ end-capped column (5 μm, 125 × 4.6 mm). Good linearity within the range of 0.3–30 μg/ml for cefadroxil, cephalexin, cefaclor and cefixime, and 0.2–20 μg/ml for amoxicillin and cefuroxime, was attained. The precisions were <14%. The accuracies ranged from 85.87 to 102.8%. The two validated methods were then applied to determine these six antibiotics in 553 urine samples of pediatric patients with ARIs. As a result, 32.2% were positive with one or more of six tested β-lactams. Cefixime was the most commonly detected agent, accounting for 9.8% of enrolled patients.     

Louis Pasteur,Chemical Linguist: Founding the Language of Stereochemistry

Pasteur’s major discovery in chemistry was the recognition of molecular chirality, in 1848. He understood that his new science needed its own language, and introduced new terminology and nomenclature, thereby launching modern stereochemical language. He was eminently prepared for this task as a refined user of language, skills recognized by his election to the Académie française, the supreme institution for the protection and promotion of the French language. The terms chiral and chirality did not exist at the time and he adopted the French word dissymmétrie (dissymmetry) for the phenomenon of handedness. Although in his time almost nothing was known about molecular constitution and configuration, his insights allowed him to create useful language some of which is still used today in stereochemistry, e. g., racemic for the 1 : 1 mixture of the two enantiomers, and the use of the prefixes levo‐ and dextro‐ in the names of optically active substances. On the other hand, the limitations in the knowledge of organic chemistry at the time prevented him from creating some needed terms, e. g., for the phenomenon of diastereoisomerism. He also failed to adopt the enantio terminology introduced in the 1850s by German mineralogist Carl Friedrich Naumann. Analysis of Pasteur’s linguistic innovations is of interest from the point of view of the history of chemistry and is also useful in throwing light on the fundamental nature of the concepts of stereochemistry. Such understanding has acquired a new relevance due to the considerable misuse and misunderstanding of this language seen in the literature today.     

Dynamics of the general factor of personality: A predictor mathematical tool of alcohol misuse

There are few studies developed about the general factor of personality (GFP) dynamics. This paper uses a dynamical mathematical model, the response model, to predict the short-term effects of a dose of alcohol on GFP and reports the results of an alcohol intake experiment. The GFP dynamical mechanism of change is based on the unique trait personality theory (UTPT). This theory proposes the existence of GFP, which occupies the apex of the hierarchy of personality. An experiment with 37 volunteers was performed. All the participants completed The five-adjective scale of the general factor of personality (GFP-FAS) in trait-format (GFP-T) and state-format (GFP-S) before alcohol consumption. The participants in the experimental group (28) received 26.51 g of alcohol and a slight food, while the participants in the control group (9) just received the food. Every participant filled the GFP-S each 7 minutes. The results show that GFP is modified by a single dose of alcohol: both the high scores of GFP-T and the high scores of GFP-S explain the most part of the alcohol impact. Moreover, they prove that the response model calibration to the GFP-S scores reproduces the biphasic GFP dynamics as a consequence of an alcohol dose intake described by the literature. In fact, the results also demonstrate that the response model provides the UTPT prediction: the high scores of GFP-T predict a stronger stimulant-like effect and a stronger inhibitor effect. Thus, the response model is a useful mathematical tool to predict those individuals inclined to the alcohol misuse.     

Identification and quantification of the plasma volume expander dextran in human urine by liquid chromatography-tandem mass spectrometry of enzymatically derived isomaltose

Plasma volume expanders are used in sports in order to control haematological parameters and/or to mask erythropoietin (EPO) misuse. A reliable method based on liquid chromatography-tandem mass spectrometry (LC-MS/MS) was developed for doping control purposes, enabling the identification and quantification of the plasma volume expander dextran in human urine. The dextran polymer was enzymatically hydrolysed by alpha-1,6-glucosidase (dextranase) followed by acetylation of the generated isomaltose subunits, allowing the chromatographic separation of different disaccharides, such as lactose, saccharose and isomaltose, as well as the identification and quantification of the analyte in human urine. The method was used to determine the basal concentration of isomaltose resulting from the enzymatic hydrolysis of polymeric 1,6-linked glucose in 238 routine doping control samples. In addition the concentration of dextran measured as isomaltose was estimated in seven urine specimens obtained from patients treated with dextran. Calibration curves for dextran were linear and reproducible. The inter- and intra-assay coefficients of variation for dextran ranged from 4.9 to 7.3% at three concentration levels between 53 and 1186 microg/mL. Recovery ranged from 97 to 112% (mean 106.9%). The assay limit of detection was 3.8 microg/mL and the lower limit of quantification was 12.5 microg/mL. In 96% of the investigated doping control samples, the concentrations of isomaltose were below the LLOQ of 12.5 microg/mL. Even the highest concentrations were approximately 100-300-fold lower than concentrations found in urine samples of patients after intravenous application of dextran. The presented results demonstrate the capability and reliability of the developed LC-MS/MS method for the identification and quantification of dextran in human urine and can be regarded as a method revealing the misuse of dextran in sports.     

Designing a recovery-orientated system of care: A community operational research perspective

Theory suggests health focused Community Operational Research (COR) projects and their participants can benefit from balancing a “glass half empty” concern for deficits, problems and weaknesses with a “glass half full” concern for identifying health assets and bringing them into use. We present a COR systemic intervention in the care of persons with addiction and substance use/ misuse problems in Clydeplace, Scotland (anonymised). Our research reveals how the Whole Person Recovery System is situated within a wider General Community Recovery System that offers a variety of health assets that can be mobilised to create and increase recovery capital. The project involved 20 semi-structured interviews, two asset mapping workshops, a certificated “health issues” course completed by seven “champions”, and action planning and implementation. In the interviews participants found gaps were more easily identified than assets. During the workshops participants identified 388 discrete assets and gaps, prioritised these using a simple voting system and developed a series of actions to mobilise health assets including bringing into use local facilities and amenities and involving a number of individuals and groups in local events and activities. Our study suggests that even in the impoverished system of Clydeplace, a “Community Catalyst” in the form of a Community Operational Researcher can act to stimulate the co-development of health assets, build relationships and enable the creation of social capital. It is not clear though when such systems become “self-catalysing.”     

入侵检测系统的研究现状及发展趋势

入侵检测系统（IDS）是一种基于主动策略的网络安全系统。本文针对目前网络发展现状，分析了入侵检测系统的现状存在的问题及发展趋势。