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Thrombotic Occlusion of a Microvascular Anastomosis in a Resistance to Activated Protein C (APC) Patient with Incomplete Wound Healing after High Doses of Ascorbic Acid (Vitamin C)  [PDF]
Martijn P. J. Loonen, Bob De Frene, Bob Casaer
Modern Plastic Surgery (MPS) , 2012, DOI: 10.4236/mps.2012.23015
Abstract: A 45-year-old woman underwent a delayed breast reconstruction with a free Deep Inferior Epigastric Perforator Flap (DIEP flap) with total flap failure on the fourth postoperative day. Hematological investigation to exclude thrombofilia revealed a resistance to activated protein C (APC) with a factor V Leiden heterozygous mutation. The postoperative course was further complicated by delayed wound healing probably due to ascorbic acid (Vitamin C) related cytotoxic activity to fibroblasts. The surgeon must be aware of the use of preoperative nutritional supplement administration among patients. Future cost-effectiveness analyses should be made to warrant preoperative thrombophilia screening to prevent free flap failures.
About the Causes of the Koror Bridge Collapse  [PDF]
Corneliu Bob
Open Journal of Safety Science and Technology (OJSST) , 2014, DOI: 10.4236/ojsst.2014.42013
This paper has been prepared from basic works published, mainly, after 2008 when the collapse investigation was made available. The main contributions of the paper are: a proper model for the deflections at mid-span of the bridge, the state of stress in elastic and post elastic stage for same phases of behavior, the stage of cracked of the top of cantilever beams, the repair effect on the structure of Koror Bridge, the probabilistic evaluation. The present study is based on well known and simple engineer tools: the one-dimensional beam-type was analyzed.
Climate Shifts and the Role of Nano Structured Particles in the Atmosphere  [PDF]
Bob Ursem
Atmospheric and Climate Sciences (ACS) , 2016, DOI: 10.4236/acs.2016.61005
Abstract: A global net sum equilibrium in heat exchange is a fact and thus a global climate change doesn’t exist, but climate shifts in climate cells, especially in the northern temperate cell, do. The global climate has been ever since homeostatic, and has recuperated far huger climate impacts in the past. Current climate models need a drastically revision on the focus of carbon dioxide as main driver. Carbon dioxide and other carbon gasses do influence albedo patterns, but provide globally a homeostatic effect with a commonly accepted increase impact of 0.3 degrees Celsius. Carbon dioxide does not trigger the climate shifts, but is an indicator of exhaust of combustion processes that emit very small particles which drive these climate shifts. They are the fine dust and nano structured particles that cause the shifts of the climate in cells, as demonstrated in this article and results i.e. in more thunder and lightning, extreme weather, distinct droughts and precipitation patterns. The causes underlying these shifts are nano structured particles in the upper troposphere and lower stratosphere, especially largely produced and remain in the temperate climate northern hemisphere cell and get dispersed by jet streams and low and high pressure areas. However, because of electrical charge, caused by friction or due to anthropogenic negatively charged nano structured particle, emissions will travel up to the lower stratosphere and become neutralized at the electro sphere level, and they do also have a tendency to move to the Arctic. The southern hemisphere climate faces limited anthropogenic emissions, because only 10 percent of the world population can contribute with less pollutant providing activities, and hasn’t changed, but that could well be because it is equally influenced and driven, like the northern hemisphere, by the variation of sun activity in diverse cycles. The present problem is that we produce huge amounts of air borne nano structured particles from combustion processes that never exist before. The only nano particles known in nature are those who are limited produced from volcano eruptions and natural forest fires. The natural feedback systems that moderate climate shifts and influence global climate are: convection by cumulonimbus clouds, sea currents and vegetation adaptation. A novel ultra-fine dust electric reduction device (UFDRS-System), created by the author, diminishs to a size of less than 10 nano particles in diameter and thus prevents major electrical drift of nano structured particulates in the upper troposphere and lower
Source Code Comparison of DOS and CP/M  [PDF]
Bob Zeidman
Journal of Computer and Communications (JCC) , 2016, DOI: 10.4236/jcc.2016.412001
Abstract: In a previous paper [1], I compared DOS from Microsoft and CP/M from Digital Research Inc. (DRI) to determine whether the original DOS source code had been copied from CP/M source code as had been rumored for many years [2] [3]. At the time, the source code for CP/M was publicly available but the source code for DOS was not. My comparison was limited to the comparison of the DOS 1.11 binary code and the source code for CP/M 2.0 from 1981. Since that time, the Computer History Museum in Mountain View, California received the source code for DOS 2.0 from Microsoft and was given permission to make it public. The museum also received the source code for DOS 1.1 from Tim Paterson, the developer who was originally contracted by Microsoft to write DOS. In this paper, I perform a further analysis using the newly accessible source code and determine that no code was copied. I further conclude that the commands were not copied but that a substantial number of the system calls were copied.
The Scientific Evidence That “Intent” Is Vital for Healthcare  [PDF]
Bob Johnson
Open Journal of Philosophy (OJPP) , 2017, DOI: 10.4236/ojpp.2017.74022
Abstract: THINKING cannot occur without electrons, a point philosophically, scientifically and irrefutably confirmed for all, by the Electroencephalogram (EEG). However for 100 years, electrons and their ilk have scrupulously obeyed the Uncertainty Principle. Probability rules. The way human beings reason is by concluding that if event B is seen to follow cause A, it will do so again tomorrow—electrons don’t even support this today. Hume’s critique of causality which Kant failed to refute, gains traction from Quantum Mechanics. Despite needing to insert the word “probably” into every human reasoning, healthcare demonstrates an element of unexpected stability. The label “intent” is expanded to cover this anomaly, endeavouring to highlight how living cells cope with the impact of this unknowability, this Uncertainty. Mental health follows suit, though here the uncertainty comes additionally from “blockage” of the frontal lobes consequent upon trauma/terror. The collapse of today’s psychiatry is pathognomonic, and medically solipsistic. The role of “intent”, and its close relative, consent, are offered as remedies, not only for mental disease, relabelled here “social defeat”, but also for the global disease of violence, culminating in the biggest health threat of them all, thermonuclear war.
Enteral nutrition: better navigation, yet unknown destination?
Michael P Casaer, Dieter Mesotten
Critical Care , 2011, DOI: 10.1186/cc10538
Abstract: In their article in the present issue of Critical Care, Wierdsma and colleagues validated a novel and feasible method to measure the degree to which enteral nutrition (EN) is absorbed by the gastrointestinal tract. The accuracy of simply weighing daily faecal production to identify gastrointestinal dysfunction was validated against three reference methods [1]. Energy losses in faeces were measured by laboratory-based bomb calorimetry. The contribution of protein and fat to the faecal nutritional losses were estimated by labour-intensive chemical analyses [2,3]. The authors identified a daily faecal weight above >350 g as a reliable indicator for gastrointestinal malabsorption. The correlation between intestinal energy malabsorption and measured faecal weight was highly significant [1]. Of course, these results need to be confirmed in a larger study population, including the most critically ill and those with known gastrointestinal problems.The present study is of methodological and conceptual importance to nutritional research and clinical nutrition management. First, the validation of this new assessment technique has been done in a very accurate and complete way and thereby provides a new reliable tool. Secondly, these results focus on a rarely addressed problem in the critically ill: is the EN administered to a patient truly absorbed? In 9 out of the 48 stable patients in this trial, the nutrition was only partially absorbed. This 19% represents a high incidence of gastrointestinal dysfunction since patients with known gastrointestinal problems were not included [1]. Previous studies assessed and treated diarrhoea in critically ill patients, measuring the frequency, liquidity and volume of stools but not the proportion of EN energy, proteins and fat lost by the patient [4,5].Whether studying the effect of nutritional interventions or managing nutrition in clinical practice, we will have to take into account these data on gastrointestinal energy losses. It is also
The Sociology of Knowledge, Citizenship and the Purification of Politics  [PDF]
Jed Donoghue, Bob White
Sociology Mind (SM) , 2013, DOI: 10.4236/sm.2013.31003

We reinterpret citizenship using Mannheim’s classical sociology of knowledge and through a more recent variant on them in Latour’s argument that “we have never been modern” (Latour, 1991). On that basis, we understand citizenship as a recursive effect of disputes over belonging and membership (Isin, 2002), where those disputes entail the three forms of political rationality or “thought styles” which Mannheim and Latour variously suggested: the linearly individual rationality of liberalism; dialectically collective socialism; and culturally collective conservatism. Marshall defines citizenship as a “status bestowed on those who are full members of a community” (Marshall, 1973). He presents an image of evolutionary progress, from civil to political rights and finally to the social form, in Britain. We argue that Marshall was entangled in evolutionary and teleological images of citizenship. We reinterpret citizenship using Mannheim’s classical sociology of knowledge. We suggest that sociologies of knowledge allow a re-reading of “citizenship” that can accommodate conceptual difficulties. Mannheim called into question the “progress” implied or stated in theories of “stages”. He stressed instead the continuing interaction between different ways of knowing social reality, or between what he called “thought styles”. We apply Mannheim to “citizenship” in order to lift two “purifications”, so that humanity is both natural and political.

The Impact of Computer Mediated Communication (CMC) on Productivity and Efficiency in Organizations: A Case Study of an Electrical Company in Trinidad and Tobago  [PDF]
Kenrick Bob, Prahalad Sooknanan
Advances in Journalism and Communication (AJC) , 2014, DOI: 10.4236/ajc.2014.22005
Abstract: This study investigates how computer mediated communication (CMC) and the electronic mailing system in particular have impacted on productivity and efficiency not to mention interpersonal interaction and increased use of technology in the organization. An electricity company was chosen for the case study since it had achieved approximately 78% computerization and networking of its office staff. Following the judgemental sampling technique to identify the organization, random sampling was used to select a sample size of 100 respondents. A questionnaire survey with sixteen items was self-administered over a one-week period. The results showed that 73% of the respondents agreed that CMC enhanced their overall productivity and efficiency while 27% differed. However, while the findings revealed that the introduction of CMC increased its use as a whole, it impacted negatively on interpersonal relationships among respondents.
Correction: Does artificial nutrition improve outcome of critical illness
Miet Schetz, Michael Casaer, Greet Van den Berghe
Critical Care , 2013, DOI: 10.1186/cc12509
Abstract: On page 4 under the subheading "Recent randomized controlled trials", the text currently reads "However, both ICU and hospital stays were shorter in the tight-calorie group, clearly introducing the statistical problem of informative censoring/competing risk that we discussed earlier." The ICU and hospital stays are in fact longer in the tight-calorie group, and this statement should therefore read "However, both ICU and hospital stays were longer in the tight-calorie group, clearly introducing the statistical problem of informative censoring/competing risk that we discussed earlier."On page 5 also under the subheading "Recent randomized controlled trials", the text currently reads "The EN amount did not differ between groups and reached ±50% of target at day 7." In fact, the EN amount reached ±20% of target at day 7, and this statement should therefore read "The EN amount did not differ between groups and reached ±20% of target at day 7."The authors declare that they have no competing interests.
Bench-to-bedside review: Metabolism and nutrition
Micha?l P Casaer, Dieter Mesotten, Miet RC Schetz
Critical Care , 2008, DOI: 10.1186/cc6945
Abstract: Patients with acute kidney injury (AKI) have a high prevalence of malnutrition, a condition that is associated with morbidity and mortality [1]. AKI develops mostly in the context of critical illness and multiple organ failure, which are associated with major changes in substrate metabolism and body composition, overwhelming the alterations induced by AKI itself. Key effectors of these changes are inflammatory mediators and neuroendocrine alterations. The development of AKI further adds fluid overload, azotemia, acidosis, and electrolyte disturbances. In addition, AKI is associated with increased inflammation and oxidative stress [2]. The most severe cases of AKI require renal replacement therapy (RRT), with continuous treatments (continuous renal replacement therapy, CRRT) being the modality of choice in most intensive care units (ICUs) [3]. These extracorporeal treatments facilitate nutritional support but may, on the other hand, induce derangements of nutrient balances. The rationale for nutrition during critical illness is mainly to attenuate the catabolism and the loss of lean body mass in the hypermetabolic critically ill patient. However, the concept of improving clinical outcome by improving energy and nitrogen balance is still being challenged [4]. The purposes of this paper were to review the metabolic alterations underlying critical illness and AKI, to discuss nutritional and metabolic support in these patients, and to address the nutritional implications of CRRT. The reader is also referred to several other reviews on this subject [5-10].Critical illness is generally recognized as a hypermetabolic state, with energy expenditure (EE) being proportional to the amount of stress [11,12]. Although active solute transport in a functioning kidney is an energy-consuming process, the presence of AKI by itself (in the absence of critical illness) does not seem to affect resting EE (REE) [13]. EE in AKI patients is therefore determined mainly by the underlying cond
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