Video-assisted thoracoscopic surgery （VATS） for bilateral primary spontaneous pneumothorax

Objective:To review our experience of the treatment of bilateral primary spontaneous pneumothorax (PSP) by video-assisted thoracoscopic surgery (VATS). Materials and methods: Retrospective chart review was followed by an on-clinic or telephone interview. Patients were cared for by one thoracic surgeon in four medical centers or community hospitals in Northern and Central Taiwan. Thirteen patients with bilateral PSP underwent bilateral VATS simultaneously or sequentially from July 1994 to December 2005. Results: Twelve males and one female, with age ranging from 15 to 36 years (mean 23.1 years), were treated with VATS for bilateral PSP, under the indications of bilateral pneumothoracis simultaneously (n=4) or sequentially (n=9). The interval between the first and second contra-lateral VATS procedure for non-simultaneous PSP patients ranged from 7 d to 6 years. Eleven of 13 patients (84.6%) had prominent pulmonary bullae/blebs, and underwent bullae resection with mechanical or chemical pleurodesis. The mean operative time was (45.6±18.3) min (range 25-96 min) and (120.6±28.7) min (range 84-166 min) respectively for the non-simultaneous (second VATS for the recurrence of contralateral side after first VATS) and simultaneous (bilateral VATS in one operation) procedures. There was no postoperative mortality. However, prolonged air leakage (>7 d) occurred in one patient (7.7%) who recovered after conservative treatment. The mean duration of chest tube drainage was 3.1 d and the median follow up period was 3.4 years. Conclusions: VATS is a safe and effective procedure in the treatment of bilateral PSP. Bilateral VATS is only recommended for patients with simultaneously bilateral PSP, because the incidence of recurrence, even with visible bullae, was not so high in my group and in some previous literature. Bilateral VATS in a supine position should only be used in selective cases, because of possible pleural adhesion or hidden bullae on the posterior side.     

The easy-to-hard effect: Transfer along the dimension of orientation in the rat

Long-Evans rats were trained on an easy simultaneous discrimination problem and then transferred to a hard discrimination problem. The discriminanda were different orientations of stripes. In Experiment I, transfer was intradimensional with stimulus generalization controlled. The easy-to-hard effect was not found. In Experiment II transfer was intradimensional and either compatible (nonreversal) or incompatible (reversal). With compatible transfer, rats trained on a prior easy problem learned the hard problem faster than rats trained only on the hard problem. Persistent negative transfer was found with incompatible transfer. Attention was not supported as underlying the easy-to-hard effect. Explanations based on specific sources of intradimensional transfer, such as stimulus generalization or adaptation level, are suggested.     

The Many Faces of Human-Machine Interaction

Interactive processes are fundamental to all forms of training and learning activity. Within educational technology increasing use is being made of both simple and sophisticated machines as instructional aids. Because of their growing applicability in all areas of educational practice it is important to understand the basic nature of the interactive processes involved in using such machines. This paper provides an overview of the techniques and mechanisms of human-machine interaction and outlines the status of some ongoing research trends in this area.     

Career Counseling for Longevity: Self-Care and Burnout Prevention Strategies for Counselor Resilience

Balancing self-care and other-care is often a struggle for career counselors and others in the helping professions. The process of caring is made up of a constant series of empathic attachments, active involvements, and felt separations. The ability to continually engage in the caring cycle is important for success. However, the constant need to re-create the cycle of caring can lead to counselor depletion and burnout. This article provides a developmental framework for assisting career counselors to avoid depleted caring while prolonging their professional longevity. The model of self-care includes recognizing the hazards of high touch work, such as limited resources and constant one-way caring. Also addressed are specific means of professional and personal sustenance, such as maximizing experiences of professional success and balancing personal wellness throughout one's career.     

A Methylome‐Wide Association Study of Trajectories of Oppositional Defiant Behaviors and Biological Overlap With Attention Deficit Hyperactivity Disorder

In 671 mother–child (49% male) pairs from an epidemiological birth cohort, we investigated (a) prospective associations between DNA methylation (at birth) and trajectories (ages 7–13) of oppositional defiant disorder (ODD), and the ODD subdimensions of irritable and headstrong; (b) common biological pathways, indexed by DNA methylation, between ODD trajectories and attention deficit hyperactivity disorder (ADHD); (c) genetic influence on DNA methylation; and (d) prenatal risk exposure associations. Methylome‐wide significant associations were identified for the ODD and headstrong, but not for irritable. Overlap analysis indicated biological correlates between ODD, headstrong, and ADHD. DNA methylation in ODD and headstrong was (to a degree) genetically influenced. DNA methylation associated with prenatal risk exposures of maternal anxiety (headstrong) and cigarette smoking (ODD and headstrong).     

Blood zinc protoporphyrin, serum total protein, and total cholesterol levels in automobile workshop workers in relation to lead toxicity: Our experience

Blood zinc protoporphyrin (ZPP), serum total protein (TP), and total cholesterol (TC) levels in automobile workshop workers in relation to lead toxicity were analysed. In the present study, automobile workshop workers (healthy male workers at an age between 28 and 35 from four major automobile workshops in Kottayam, Kerala State, India) and the control (male healthy adults at an age between 28 and 35 residing at Aymanam, a distant village at Kottayam District, Kerala having reduced or no chance of lead exposure) displayed significant difference in blood lead (BPb) and blood ZZP (BZPP) level. The mean value of BPb in automobile workshop workers was 15.76±0.33 μg/dl, while in the control it was 8.20±0.15 μg/dl. In automobile workshop workers, the mean value of BZPP was 34.2±0.62 μg/dl. The control group exhibited a mean of 11.5±0.22 μg/dl. Automobile workshop workers exhibited significant increase in BZPP was corresponding to the increase in BPb level. The total protein levels estimated in automobile workshop workers showed significant decrease compared to control individuals, but was within the reference range of healthy individuals. The mean value of TP level in automobile workshop workers and control was 6.9±0.13 g/dl and 7.71±0.18 g/dl, respectively. There was no significant difference in blood haemoglobin (BHb) level among the automobile workshop workers and control. The serum TC level in automobile workshop workers showed significant decrease compared to the control individuals, but was with in the reference range of healthy individuals. The mean level of serum TC in automobile workshop workers was 162.00±3.44 mg/dl and the same in control was 172.86±4.32 mg/dl. The present study affirms occupational lead toxicity in automobile workshop workers and its effect on serum protein and cholesterol levels.     

Opportunity knocks

Research on technological opportunity has typically focused on the impact of broad industry characteristics on R&D intensity of firms. This study complements such approaches by examining the impact of a multidimensional vector that measures technological opportunity on independent inventors’ decisions to patent and commercialize inventions. Using data from 559 inventions and controlling for demand, appropriability, and competitive conditions, we found two of four tested dimensions of technological opportunity - technical performance and technical uncertainty - to be significant and important determinants of the likelihood of commercialization. Technical feasibility appears important in affecting patenting but unimportant in affecting commercialization. Technical significance carries a negative, although insignificant, sign conditioning commercialization.