Relevant bibliographies by topics / BMCC

Contents

  1. Journal articles
  2. Dissertations / Theses
  3. Books
  4. Book chapters
  5. Conference papers
  6. Reports

Academic literature on the topic 'BMCC'

Author: Grafiati
Published: 7 June 2025
Last updated: 17 July 2025

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Journal articles on the topic "BMCC"

1

Auldist, Martin J., Stephen J. Coats, Brian J. Sutherland, John F. Hardham, Graham H. McDowell, and Graeme L. Rogers. "Effect of somatic cell count and stage of lactation on the quality and storage life of ultra high temperature milk." Journal of Dairy Research 63, no. 3 (1996): 377–86. http://dx.doi.org/10.1017/s0022029900031903.

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SummaryThe effects of bulk milk cell count (BMCC) and stage of lactation on the quality and storage characteristics of UHT milk were investigated. The UHT milk was manufactured in a pilot plant using milk of low BMCC from early and late lactation, and milk of high BMCC from early and late lactation. Upon storage at 20°C, early lactation UHT milk gelled far ahead of late lactation milk. Within each stage of lactation, high BMCC milk tended to gel first. Few differences in the organoleptic properties of the UHT milks were observed. It was apparent that the onset of age gelation may not always be related directly to the level of proteolysis, and that other factors influencing milk composition and the reactions between milk components may play more important roles. At a particular stage of lactation, proteolysis induced by mastitis may hasten the onset of gelation.
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Tierney, Kieran D., Ingo O. Karpen, and Kate Westberg. "Brand meaning cocreation: toward a conceptualization and research implications." Journal of Service Theory and Practice 26, no. 6 (2016): 911–32. http://dx.doi.org/10.1108/jstp-06-2015-0137.

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Purpose The purpose of this paper is to consolidate and advance the understanding of brand meaning and the evolving process by which it is determined by introducing and explicating the concept of brand meaning cocreation (BMCC). Design/methodology/approach In-depth review and integration of literature from branding, cocreation, service systems, and practice theory. To support deep theorizing, the authors also examine the role of institutional logics in the BMCC process in framing interactions and brand meaning outcomes. Findings Prior research is limited in that it neither maps the process of cocreation within which meanings emerge nor provides theoretical conceptualizations of brand meaning or the process of BMCC. While the literature acknowledges that brand meaning is influenced by multiple interactions, their nature and how they contribute to BMCC have been overlooked. Research limitations/implications This paper reveals a significant gap in knowledge of how brand meaning is cocreated, despite the essential role of brand meaning for firm success and increasing academic interest in the notion of cocreation. Ultimately, this paper builds a conceptual foundation for empirical research in this regard. Originality/value This paper proposes that brand meaning is cocreated through the interconnection of different social and service systems, across system levels, time, and geographic space. Marketing theory is advanced by outlining a set of research propositions pertaining to the BMCC process. The authors consider how discrete actor-based brand meanings contribute to an overall brand gestalt and how such a gestalt potentially evolves along a continuum. Additionally, the authors provide a managerially and theoretically relevant research agenda to guide much needed empirical research into BMCC.
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Auldist, Martin J., Stephen Coats, Brian J. Sutherland, Jeffery J. Mayes, Graham H. McDowell, and Graeme L. Rogers. "Effects of somatic cell count and stage of lactation on raw milk composition and the yield and quality of Cheddar cheese." Journal of Dairy Research 63, no. 2 (1996): 269–80. http://dx.doi.org/10.1017/s0022029900031769.

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SummaryThe effects of somatic cell count and stage of lactation on the yield and quality of Cheddar cheese were investigated. Cheese was manufactured in a pilotscale factory using milk of low bulk milk cell count (BMCC) from herds in early (LE) and late (LL) lactation, and milk of high BMCC from herds in early (HE) and late (HL) lactation. The deleterious effect of an elevated BMCC on product yield and quality in late lactation was clear. Cheese made from LL milk was significantly superior to that made from HL milk for most yield and quality characteristics measured. Stage of lactation also affected cheese yield and quality, as evidenced by the lower recovery of fat and poorer flavour score for cheese from LL milk compared with that manufactured from LE milk. The observed differences could be explained largely by differences in raw milk composition. We conclude that the effect of stage of lactation was magnified by an elevated BMCC, and that many of the problems encountered when processing late season milk could be overcome by containing mastitis at this time.
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Irwin, Diana, Dong-Hoon Shin, Sheng Zhang, et al. "Roles of the Catalytic Domain and Two Cellulose Binding Domains of Thermomonospora fusca E4 in Cellulose Hydrolysis." Journal of Bacteriology 180, no. 7 (1998): 1709–14. http://dx.doi.org/10.1128/jb.180.7.1709-1714.1998.

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ABSTRACT Thermomonospora fusca E4 is an unusual 90.4-kDa endocellulase comprised of a catalytic domain (CD), an internal family IIIc cellulose binding domain (CBD), a fibronectinlike domain, and a family II CBD. Constructs containing the CD alone (E4-51), the CD plus the family IIIc CBD (E4-68), and the CD plus the fibronectinlike domain plus the family II CBD (E4-74) were made by using recombinant DNA techniques. The activities of each purified protein on bacterial microcrystalline cellulose (BMCC), filter paper, swollen cellulose, and carboxymethyl cellulose were measured. Only the whole enzyme, E4-90, could reach the target digestion of 4.5% on filter paper. Removal of the internal family IIIc CBD (E4-51 and E4-74) decreased activity markedly on every substrate. E4-74 did bind to BMCC but had almost no hydrolytic activity, while E4-68 retained 32% of the activity on BMCC even though it did not bind. A low-activity mutant of one of the catalytic bases, E4-68 (Asp55Cys), did bind to BMCC, although E4-51 (Asp55Cys) did not. The ratios of soluble to insoluble reducing sugar produced after filter paper hydrolysis by E4-90, E4-68, E4-74, and E4-51 were 6.9, 3.5, 1.3, and 0.6, respectively, indicating that the family IIIc CBD is important for E4 processivity.
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Kleman-Leyer, K. M., N. R. Gilkes, R. C. Miller, and T. K. Kirk. "Changes in the molecular-size distribution of insoluble celluloses by the action of recombinant Cellulomonas fimi cellulases." Biochemical Journal 302, no. 2 (1994): 463–69. http://dx.doi.org/10.1042/bj3020463.

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Specific patterns of attacks of cotton, bacterial cellulose and bacterial microcrystalline cellulose (BMCC) by recombinant cellulases of Cellulomonas fimi were investigated. Molecular-size distributions of the celluloses were determined by high-performance size-exclusion chromatography. Chromatography of cotton and bacterial celluloses revealed single major peaks centered over progressively lower molecular-mass positions during attack by endoglucanase CenA. In advanced stages, a second peak appeared at very low average size (approx. 11 glucosyl units); ultimate weight losses were approximately 30%. The isolated catalytic domain of CenA, p30, gave results very similar to those with complete CenA. CenA did not effectively depolymerize or solubilize BMCC significantly. Molecular-size distributions of cotton and bacterial cellulose incubated with endoglucanases CenB or CenD exhibited one major peak regardless of incubation time; low-molecular-mass fragments did not accumulate. Weight losses were 40 and 35% respectively. The single peak shifted to lower-molecular-mass positions as incubation continued, but high-molecular-mass material persisted. CenB and CenD readily attacked and solubilized BMCC (approx. 70%). We conclude that CenA attacks cellulose by preferentially cleaving completely through the cellulose microfibrils at the amorphous sites, and much more slowly by degrading the crystalline surfaces. Conversely, CenB and CenD cleave the amorphous regions much less efficiently while vigorously degrading the surfaces of the crystalline regions of the microfibrils.
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Phuektes, Patchara, Glenn F. Browning, Garry Anderson, and Peter D. Mansell. "Multiplex polymerase chain reaction as a mastitis screening test for Staphylococcus aureus, Streptococcus agalactiae, Streptococcus dysgalactiae and Streptococcus uberis in bulk milk samples." Journal of Dairy Research 70, no. 2 (2003): 149–55. http://dx.doi.org/10.1017/s0022029903006010.

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Effective diagnostic tools for screening herds for mastitis pathogens are important in development and monitoring of mastitis control programmes. A multiplex polymerase chain reaction (PCR) assay for simultaneous detection of Staphylococcus aureus, Streptococcus agalactiae, Streptococcus dysgalactiae and Streptococcus uberis was used in preliminary studies to assess its applicability as an alternative method for monitoring mastitis caused by these organisms at the herd level. PCR was used to detect the presence of these organisms in bulk milk samples. Correlations with bulk milk somatic cell counts (BMCC), total bacteria counts and thermoduric bacteria counts were evaluated. A total of 176 bulk milk samples were collected from 42 herds on five consecutive occasions at approx. 10-d intervals. Str. uberis was the most common organism in these bulk milk samples. There was no relationship between presence of either Staph. aureus, Str. dysgalactiae or Str. uberis and BMCC, total bacteria counts or thermoduric bacteria counts. However, presence of Str. agalactiae was associated with high BMCC and total bacteria counts. The results of this study show that regular analysis of bulk milk using this multiplex PCR assay may be a useful tool for monitoring herd status with respect to Str. agalactiae, but is of less value for monitoring occurrence of Staph. aureus, Str. dysgalactiae and Str. uberis. Further investigations are needed to clarify the relationship between positive PCR results and the prevalence of infected cows in the herd.
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Kataeva, Irina A., Ronald D. Seidel, Xin-Liang Li, and Lars G. Ljungdahl. "Properties and Mutation Analysis of the CelK Cellulose-Binding Domain from the Clostridium thermocellum Cellulosome." Journal of Bacteriology 183, no. 5 (2001): 1552–59. http://dx.doi.org/10.1128/jb.183.5.1552-1559.2001.

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ABSTRACT The family IV cellulose-binding domain of Clostridium thermocellum CelK (CBDCelK) was expressed inEscherichia coli and purified. It binds to acid-swollen cellulose (ASC) and bacterial microcrystalline cellulose (BMCC) with capacities of 16.03 and 3.95 μmol/g of cellulose and relative affinities (K r) of 2.33 and 9.87 liters/g, respectively. The CBDCelK is the first representative of family IV CBDs to exhibit an affinity for BMCC. The CBDCelKalso binds to the soluble polysaccharides lichenin, glucomannan, and barley β-glucan, which are substrates for CelK. It does not bind to xylan, galactomannan, and carboxymethyl cellulose. The CBDCelK contains 1 mol of calcium per mol. The CBDCelK has three thiol groups and one disulfide, reduction of which results in total loss of cellulose-binding ability. To reveal amino acid residues important for biological function of the domain and to investigate the role of calcium in the CBDCelK four highly conserved aromatic residues (Trp56, Trp94, Tyr111, and Tyr136) and Asp192 were mutated into alanines, giving the mutants W56A, W94A, Y111A, Y136A, and D192A. In addition 14 N-terminal amino acids were deleted, giving the CBD-NCelK. The CBD-NCelK and D192A retained binding parameters close to that of the intact CBDCelK, W56A and W94A totally lost the ability to bind to cellulose, Y136A bound to both ASC and BMCC but with significantly reduced binding capacity and K rand Y111A bound weakly to ASC and did not bind to BMCC. Mutations of the aromatic residues in the CBDCelK led to structural changes revealed by studying solubility, circular-dichroism spectra, dimer formation, and aggregation. Calcium content was drastically decreased in D192A. The results suggest that Asp192 is in the calcium-binding site of the CBDCelK and that calcium does not affect binding to cellulose. The 14 amino acids from the N terminus of the CBDCelK are not important for binding. Tyr136, corresponding to Cellulomonas fimi CenC CBDN1Y85, located near the binding cleft, might be involved in the formation of the binding surface, while Y111, W56A, and W94A are essential for the binding process by keeping the CBDCelK correctly folded.
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DeLoe, Dylan, and Ashlei Emmons. "Little Box in the Corner: Chat Widgets Offer Safe and In-Depth Reference." OLA Quarterly 27, no. 2 (2022): 11–16. http://dx.doi.org/10.5399/osu/1093-7374.27.02.4.

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Those of us working in libraries, including university and college libraries, know the challenges the COVID-19 pandemic brought to light. However, we also know that many (if not all) of these challenges existed pre-pandemic and will continue to exist when we have reached a post-pandemic future. Issues of connectedness and access to services—and to people—will continue to be a concern for any institution aiming for improved equity and outcomes for those they serve. Blue Mountain Community College (BMCC) in Pendleton, Oregon, implemented LibChat, an online live chat service made for libraries and hosted by Springshare. Since its implementation in April 2020, LibChat has already assisted the BMCC Library and its wider community with these issues, as it applies to everything from internal communication, flexible work schedules and environments and, of course, response to student, faculty, staff, and community needs. Additionally, LibChat can continue to assist with these issues as we move forward and evolve with our community and its needs.
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Sayers, Adrian, and Jonathan H. Tobias. "Fat Mass Exerts a Greater Effect on Cortical Bone Mass in Girls than Boys." Journal of Clinical Endocrinology & Metabolism 95, no. 2 (2010): 699–706. http://dx.doi.org/10.1210/jc.2009-1907.

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Abstract Context: It is unclear whether fat mass (FM) and lean mass (LM) differ in the way they influence cortical bone development in boys and girls. Objective: The aim of the study was to investigate the contributions of total body FM and LM to parameters related to cortical bone mass and geometry. Design/Setting: We conducted a longitudinal birth cohort study, the Avon Longitudinal Study of Parents and Children. Participants: A total of 4005 boys and girls (mean age, 15.5 yr) participated in the study. Outcome Measures: We measured cortical bone mass, cortical bone mineral content (BMCC), cortical bone mineral density, periosteal circumference (PC), and endosteal circumference by tibial peripheral quantitative computed tomography. Results: LM had a similar positive association with BMCC in boys and girls [regression coefficients with 95% confidence interval (CI); P for gender interactions: boys/girls, 0.952 (0.908, 0.997); P = 0.85]. However, the mechanisms by which LM influenced bone mass differed according to gender because LM was positively associated with PC more strongly in girls [boys, 0.579 (0.522, 0.635); girls, 0.799 (0.722, 0.875); P < 0.0001], but was only associated with cortical bone mineral density in boys [boys, 0.443 (0.382, 0.505); girls, 0.014 (−0.070, 0.097); P < 0.0001]. There was a stronger positive association between FM and BMCC in girls [boys, 0.227 (0.185, 0.269); girls, 0.355 (0.319, 0.392); P < 0.0001]. This reflected both a greater positive association of FM with PC in girls [boys, 0.213 (0.174, 0.253); girls, 0.312 (0.278, 0.347); P = 0.0002], and a stronger negative association with endosteal circumferencePC [boys, −0.059 (−0.096, 0.021); girls, −0.181 (−0.215, −0.146); P < 0.0001]. Conclusions: Whereas LM stimulates the accrual of cortical bone mass to a similar extent in boys and girls, FM is a stronger stimulus for accrual of cortical bone mass in girls, reflecting a greater tendency in females for FM to stimulate periosteal growth and suppress endosteal expansion.
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Kurtz, Geoffrey. "Two Kinds of Public Talk: Foreword to BMCC Symposium." Socialism and Democracy 26, no. 2 (2012): 33–34. http://dx.doi.org/10.1080/08854300.2012.686286.

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Dissertations / Theses on the topic "BMCC"

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Fonseca, Alyne Souza Félix. "Transplante de células de medula óssea (BMCs) de camundongos em modelo experimental para o desenvolvimento de aterosclerose: aspectos estruturais, ultraestrutuais e moleculares da aorta." Universidade do Estado do Rio de Janeiro, 2015. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=9524.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior<br>Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro<br>As células tronco são caracterizadas pela sua capacidade de se diferenciar em várias linhagens de células e exibir um pontente efeito parácrino. O objetivo deste trabalho foi avaliar o efeito da terapia com células da medula óssea (BMCs) na glicose sanguínea, no metabolismo lipídico e remodelamento da parede da aorta em um modelo experimental para aterosclerose. Camundongos C57BL/6 foram alimentados com uma dieta controle (grupo CO) ou uma dieta aterogênica (grupo AT - 60% gordura). Após 16 semanas, o grupo AT foi dividido em quatro sub grupos: grupo AT 14 dias e o grupo AT 21 dias receberam uma injeção de PBS na veia caudal e mortos 14 e 21 dias após respectivamente; grupo AT-BMC 14 dias e AT-BMC 21 dias que receberam uma injeção com BMCs na veia caudal e mortos 14 e 21 dias após, respectivamente. O grupo CO foi sacrificado juntamente com outros grupos. O transplante BMCs reduziu os niveis de glicose, triglicerídeos e colesterol total no sangue. Não houve diferença significativa em relação à massa corporal entre os grupos transplantados e não transplantados, sendo todos diferentes do grupo CO. Não houve diferença significativa na curva glicemica entre os grupos AT 14 dias, AT-BMC 14 dias e AT 21 dias e estes diferentes do grupo CO e do grupo AT-BMC 21 dias. O Qa (1/mm2) foi quantitativamente reduzido no grupo AT 14 dias e AT 21 dias quando comparado ao grupo CO. Este Qa se mostrou elevado no grupo AT-BMC 21 dias quando comparado a todos os grupos. O aumento da expessura da parede da aorta foi observado em todos os grupos aterogênicos, entretanto o aumento da espessura foi significativamente menor no grupo AT-BMC 21 dias em relação ao grupo AT 14 dias e AT 21 dias. A percentagem de fibras elásticas se apresentou significativamente maior no grupo AT 21 dias quando comparado ao CO e AT-BMC 21 dias. Não houve diferença significativa entre o grupo CO e AT-BMC 21 dias. Vacúolos na túnica média, delaminação e o adelgaçamento das lamelas elásticas foram observados nos grupos AT-14 dias e AT-21 dias. O menor número destes foi visualizado no grupo AT-BMC 14 dias e AT-BMC 21 dias. A imunomarcação para alfa actina de músculo liso (&#945;-SMA) e fator de crescimento vascular e endotelial (VEGF) mostrou menor marcação em grupos transplantados com BMCs. A marcação para antígeno nuclear de proliferação celular (PCNA) mostrou-se mais expressiva no grupo AT-BMC 21 dias grupo. Marcação para CD105, CD133 e CD68 foi observada nos grupos AT 14 dias e AT 21 dias. Estas marcações não foram observadas nos grupos AT-BMC 14 dias e AT-BMC 21 dias. Nas eletromicrografias observamos o remodelamento benéfico no grupo AT-BMC14 dias e AT-BMC 21 dias, com a organização estrutural similar ao grupo CO. Vesículas de pinocitose, projeção da célula muscular lisa e a delaminação da lamina elástica interna são observados nos grupos AT 14 dias e AT 21 dias. Célula endotelial preservada, com lamina elástica interna de contorno regular e contínua é observada no grupo CO e nos grupos AT-BMC 14 dias e AT-BMC 21 dias. Como conclusão, os nossos resultados reforçam o conceito de que, em um modelo aterosclerótico utilizando camundongos e dieta aterogênica, a injeção de BMCs melhora os níveis de glicose, metabolismo lipídico e ocasiona um remodelamento benéfico na parede da aorta.<br>Stem cells are characterized by their ability to differentiate into multiple cell lineages and display the paracrine effect. The aim of this work was to evaluate the effect of therapy with bone marrow cells (BMCs) on blood glucose, lipid metabolism and aortic wall remodeling in mice through the administration of a high fat diet and subsequent BMCs transplantation. C57BL/6 mice were fed a control diet (CO group) or an atherogenic diet (AT group). After 16 weeks, the AT group was divided into four groups: an AT 14 days group and AT 21 days group, that were given an injection of vehicle and sacrificed at 14 and 21 days after, respectively; AT-BMC 14 days group and AT-BMC 21 days group that was given an injection of BMCs and sacrificed at 14 and 21 days after. The CO group was sacrificed along with other groups. The BMCs transplant had reduced blood glucose, triglycerides and total cholesterol. There was no significant difference in relation to body mass between the transplanted groups and non-transplanted groups, with all are different to CO group. There was no significant difference in the glycemic curve between AT 14 days group, AT-BMC 14 days group and AT 21 days group and these are different to CO and the AT-BMC 21 days group. The Qa (1 / mm2) was quantitatively reduced in the AT 14 days group and AT 21 days group when compared to the CO group. This Qa proved high in AT-BMC 21 days BMC compared to all groups. The increased thickness of the aortic wall was observed in all atherogenic groups, but was significantly smaller in group AT-BMC 21 days compared to AT 14 days group and AT 21 days group. The percentage of elastic fibers was significantly higher in the AT 21 days group when compared to the CO and AT-BMC 21 days. There was no significant difference between the CO and AT-BMC 21 days. Vacuoles in the media tunic, delamination and the thinning of the elastic lamellae were observed in AT 14 days group and AT 21 days group. The smallest number of these apresentation were displayed on the AT-BMC 14 days group and and AT-BMC 21 days. The immunostaining for &#945;-SMA and VEGF showed lower in AT-BMC 14 days group and AT-BMC 21 days group. The markup for PCNA appears to be greater in the AT-BMC 21 days group. Marking to CD105, CD133 and CD68 were observed in AT 14 days group and AT 21 days group. These markings were not observed in AT-BMC 14 days group and AT-BMC 21 days group. In electron micrographs observed the beneficial remodeling in AT-BMC 14 day group and AT-BMC 21 days, with the structural organization was similar to the CO group. Vesicles of pinocytosis, projection of smooth muscle cell and delamination of the internal elastic lamina are seen in groups AT 14 days group and AT 21 days group. Endothelial cell preserved, regular and continuous contour in internal elastic lamelae is observed in the CO group, AT-BMC 14 days group and AT-BMC 21 days group. In conclusion, our results support the concept that an atherosclerotic model using mice and atherogenic diet, the injection of BMCs improve glucose, lipid metabolism and causes a beneficial remodeling of the aortic wall.
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Carmical, Jennifer, and Stacy D. Brown. "The Impact of Phospholipids and Phospholipid Removal on Bioanalytical Method Performance." Digital Commons @ East Tennessee State University, 2016. https://doi.org/10.1002/bmc.3686.

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Phospholipids (PLs) are a component of cell membranes, biological fluids and tissues. These compounds are problematic for the bioanalytical chemist, especially when PLs are not the analytes of interest. PL interference with bioanalysis highly impacts reverse-phase chromatographic methods coupled with mass spectrometric detection. Phospholipids are strongly retained on hydrophobic columns, and can cause significant ionization suppression in the mass spectrometer, as they out-compete analyte molecules for ionization. Strategies for improving analyte detection in the presence of PLs are reviewed, including in-analysis modifications and sample preparation strategies. Removal of interfering PLs prior to analysis seems to be most effective at moderating the matrix effects from these endogenous cellular components, and has the potential to simplify chromatography and improve column lifetime. Products targeted at PL removal for sample pre-treatment, as well as products that combine multiple modes of sample preparation (i.e. Hybrid SPE), show significant promise in mediating the effect on PL interference in bioanalysis.
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Pickering, Matthew K., and Stacy D. Brown. "Assays for Determination of Ertapenem for Applications in Therapeutic Drug Monitoring, Pharmacokinetics, and Sample Stability." Digital Commons @ East Tennessee State University, 2014. https://doi.org/10.1002/bmc.3301.

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Carbapanems are a class of β-lactam antibiotics with broad-spectrum potency and high β-lactamase resistance. Ertapenem, a member of this class, sold under the trade name Invanz™, has been of interest in the world of antibiotic therapeutic drug monitoring owing to its highly standardized 1 g dose and its high degree of plasma protein binding. Owing to the relative newness of this drug, fewer than 30 methods for ertapenem quantification have been published. Among these about half utilize biological matrices at the sample type. Liquid-liquid extraction and protein precipitation prevail as the most frequently used sample preparation techniques, despite their low recoveries compared with solid-phase extraction. Additionally, high-performance liquid chromatography with ultraviolet detection (HPLC-UV) is the instrumentation choice for most ertapenem assays. While these approaches may not achieve the highest possible sensitivity for ertapenem quantification, they provide clinically relevant tools for monitoring ertapenem in real patients. Sample stability is an ongoing concern for laboratories that handle ertapenem analysis, with buffering being of paramount importance, as well as low temperature (
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Kyle, Amy Redmond, Jennifer Carmical, Darshan Shah, Jason Pryor, and Stacy D. Brown. "UHPLC-MS/MS Quantification of Buprenorphine, Norbuprenorphine, Methadone, and Glucuronide Conjugates in Umbilical Cord Plasma." Digital Commons @ East Tennessee State University, 2015. https://doi.org/10.1002/bmc.3460.

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Opioid use during pregnancy can result in the newborn being physically dependent on the substance, thus experiencing drug withdrawal, termed neonatal abstinence syndrome (NAS). Buprenorphine and methadone are two drugs used to treat opioid withdrawal and are approved for use in pregnancy. Quantification of these compounds in umbilical cord plasma would help assess in utero exposure of neonates in cases of buprenorphine or methadone use during pregnancy. An LC-MS/MS method using solid-phase extraction sample preparation was developed and validated for the simultaneous quantification of methadone, buprenorphine, norbuprenorphine, and glucuronide metabolites in umbilical cord plasma. The average accuracy (percentage error) and precision (relative standard deviation) were
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Archibald, Timothy L., Derek Edward Murrell, and Stacy D. Brown. "Chromatographic Methods in Hiv Medicine: Application to Therapeutic Drug Monitoring." Digital Commons @ East Tennessee State University, 2018. https://doi.org/10.1002/bmc.4170.

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HIV antiretroviral therapy spans several different drug classes, meant to combat various aspects of viral infection and replication. Many authors have argued the benefits of therapeutic drug monitoring (TDM) for the HIV patient including compliance assurance and assessment of appropriate drug concentrations; however, the array of drug chemistries and combinations makes TDM an arduous task. HPLC-UV and LC-MS/MS are both frequent instruments for the quantification of HIV drugs in biological matrices with investigators striving to balance sensitivity and affordability. Plasma, the dominant matrix for these analyses, is prepared using protein precipitation, liquid-liquid extraction or solid-phase extraction depending on the specific complement of analytes. Despite the range of polarities found in drug classes relevant to HIV therapeutics, most chromatographic separations utilize a hydrophobic column (C18 ). Additionally, as the clinically relevant samples for these assays are infected with HIV, along with possible co-infections, another important aspect of sample preparation concerns viral inactivation. Although not routine in clinical practice, many published analytical methods from the previous two decades have demonstrated the ability to conduct TDM in HIV patients receiving various medicinal combinations. This review summarizes the analytical methods relevant to TDM of HIV drugs, while highlighting respective challenges.
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Combs, Carolyn C., Erin L. Hankins, Cara L. Copeland, Stacy D. Brown, and Brooks B. Pond. "Quantitative Determination of D- and L- Enantiomers of Methylphenidate in Brain Tissue by Liquid Chromatography-Mass Spectrometry." Digital Commons @ East Tennessee State University, 2013. https://doi.org/10.1002/bmc.2975.

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Methylphenidate, a psychostimulant used for the treatment of attention deficit hyperactivity disorder and narcolepsy, is administered as a 50:50 racemic mixture, despite the fact that d‐methylphenidate has been shown to have greater pharmacologic activity. This paper presents a validated LC‐MS/MS approach to separation and quantification of methylphenidate enantiomers using a vancomycin column and triethylammonium acetate to enhance the chiral separation. The method is applicable to the monitoring of these enantiomers in mouse brain, with a limit of detection of 0.5 ng/mL and a lower limit of quantification of 7.5 ng/mL.
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Brown, Stacy D., and Tyler C. Melton. "Trends in Bioanalytical Methods for Club Drugs: 2000-2010." Digital Commons @ East Tennessee State University, 2011. https://doi.org/10.1002/bmc.1549.

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The term 'club drug' can be loosely defined as any substance used to enhance social settings. Such drugs are commonly found at raves or similar all-night dance parties and include methamphetamine, 3,4-methylenedioxymethamphetamine, gamma-hydroxybutyrate (GHB), ketamine (KET), and flunitrazepam (FLU). These drugs have potentially dangerous side effects including hallucinations, paranoia, amnesia and hyperthermia. In addition, GHB, KET and FLU are considered predatory drugs due to their roles in drug-facilitated sexual assault. Forensic and regulatory agencies routinely have the need for determination and accurate quantification of these drugs in biological fluids, especially in cases of mortality or criminal investigations. This review presents the chromatographic and spectroscopic methods published for such analyses over the last decade, including sample preparation techniques and validation data.
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Mauzac, Christine. "Etude du collage d'un composite BMC." Mulhouse, 1994. http://www.theses.fr/1994MULH0445.

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Dans le but de réduire le poids des véhicules, l'industrie automobile remplace de plus en plus la tôle par des matériaux composites à matrice polyester renforcée par des fibres de verre et chargée en carbonate de calcium. Ces composites sont généralement assemblés par collage. Ainsi, afin d'appréhender les mécanismes à l'origine de l'adhésion entre un adhésif polyuréthane modifié acrylique et différents composites BMC (Bulk Molding Compound), les deux matériaux ont été caractérisés. Différentes techniques d'analyse de surface complémentaires (MEB, ESCA, SIMS et TOFSIMS, SDL, mouillabilité) ont permis d'acquérir une bonne connaissance de la surface des BMC. En particulier, l'influence de la concentration et de la nature des démoulants internes du BMC (stéarate de calcium ou de zinc) a été mise en évidence tant sur les propriétés de surface que sur le comportement adhésif En effet, il est apparu que même en faible proportion les démoulants favorisent l'adhésion BMC/adhésif polyuréthane et améliorent le comportement des assemblages en vieillissement humide. Différentes hypothèses sont évoquées pour expliquer l'amélioration de l'adhésion liée à la présence du démoulant en surface, notamment la nature et le nombre de groupements de type COO en surface du composite et le rôle de connecteurs des molécules de stéarate.
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Holden, Natasha. "Emotional response to a therapeutic technique : broad minded affective coping (BMAC)." Thesis, University of Liverpool, 2014. http://livrepository.liverpool.ac.uk/18613/.

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This thesis focuses on a model of affect regulation; Gilbert’s (2005) three systems model, to explore emotional reactions to mental imagery. Compassion focussed imagery (CFIm) is the focus of the literature review as this is a specific type of mental imagery which is grounded in a coherent model of affect regulation. The empirical paper then aims to explore individuals’ emotional reactions to the mental imagery of a positive social memory. The three systems model, along with findings from the literature review are drawn upon to inform the hypotheses for the empirical paper. A concluding chapter, which includes a lay summary and a future research proposal then follows.
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Škramlík, Jan. "Solution Delivery Process Framework for BMC Remedy Products." Master's thesis, Vysoká škola ekonomická v Praze, 2015. http://www.nusl.cz/ntk/nusl-193121.

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The goal of this thesis is creation of methodology for repeatable transformation of customer business needs and goals resulting from company IT strategy to system functionality and process implementation in Business/IT Service Management projects using BMC Atrium and Remedy products. This methodology will be based on existing project management methodologies PRINCE2 and SCRUM. In the thesis I also refer to parts of ITIL v3 process framework. The aim of the thesis is to provide a project delivery framework for IT Consultancy organizations. The framework will foster efficient planning, tracking and communication of requirements and deliverables between IT Consultancy and their customer during entire project lifecycle and will therefore enable repeatable and consistent high quality delivery of customer success.
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Books on the topic "BMCC"

1

Graham, Robson. The cars of BMC. Guild Publishing, 1987.

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Indian Institute of Management, Bangalore., ed. Routing strategies for BMTC buses decision evaluation using simulation. Indian Institute of Management, Bangalore, 2007.

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Rashid, Harun-ar. Concise bibliography of research projects funded by BMRC, 1972-1989. Bangladesh Medical Research Council, 1991.

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Ghanie, S. Common reasons for beef carcase condemnations at BMC. s.n.], 1993.

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Chambers, Marcus. Works wonders: Rallying and racing with BMC, Rootes andChrysler. Motor Racing Publications, 1995.

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Mentiplay, Gary. BMC Leyland in Western Australia: The people, the cars, the dealerships. Hesperian Press, 2019.

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Anderson, John Barry. Building cars in Australia: Morris, Austin, BMC and Leyland 1950 - 1975. Halstead Press, 2011.

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BMC Symposium on the Children's Market (1987 London). Proceedings of the BMC Symposium on the Children's Market: 6 March 1987. Publishers Association Book Marketing Council, 1987.

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1965-, Matthews Sebastian, and Black Mountain College Museum + Arts Center, eds. From BMC to NYC: The tutelary years of Ray Johnson, 1943-1967. Black Mountain College Museum + Arts Center, 2010.

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British Machine Vision Conference (13th 2002 Cardiff University). BMVC 2002: Proceedings of the 13th British Machine Vision Conference : 2nd-5th September 2002, Cardiff University. BMVA, 2002.

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Book chapters on the topic "BMCC"

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Gooch, Jan W. "BMC." In Encyclopedic Dictionary of Polymers. Springer New York, 2011. http://dx.doi.org/10.1007/978-1-4419-6247-8_1445.

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Vizel, Yakir, Arie Gurfinkel, and Sharad Malik. "Fast Interpolating BMC." In Computer Aided Verification. Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-21690-4_43.

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Reddy, J. N. "Micromechanics of BMC." In Solid Mechanics and Its Applications. Springer Netherlands, 1994. http://dx.doi.org/10.1007/978-94-017-2233-9_32.

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Hahn, Ernst Moritz, Mateo Perez, Sven Schewe, Fabio Somenzi, Ashutosh Trivedi, and Dominik Wojtczak. "Model-Free Reinforcement Learning for Branching Markov Decision Processes." In Computer Aided Verification. Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-81688-9_30.

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AbstractWe study reinforcement learning for the optimal control of Branching Markov Decision Processes (BMDPs), a natural extension of (multitype) Branching Markov Chains (BMCs). The state of a (discrete-time) BMCs is a collection of entities of various types that, while spawning other entities, generate a payoff. In comparison with BMCs, where the evolution of a each entity of the same type follows the same probabilistic pattern, BMDPs allow an external controller to pick from a range of options. This permits us to study the best/worst behaviour of the system. We generalise model-free reinforcement learning techniques to compute an optimal control strategy of an unknown BMDP in the limit. We present results of an implementation that demonstrate the practicality of the approach.
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Metta, Ravindra, Raveendra Kumar Medicherla, and Hrishikesh Karmarkar. "VeriFuzz: Good Seeds for Fuzzing (Competition Contribution)." In Fundamental Approaches to Software Engineering. Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-030-99429-7_20.

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AbstractWe present VeriFuzz 1.2 with two new enhancements: (1) unroll the given program to a short depth and use BMC to produce incomplete test inputs, which are extended into complete inputs, and (2) if BMC fails for this short unrolling, automatically identify the reason and rerun BMC with a corresponding remedial strategy.
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Weiss, Jeffrey N. "BMAC Use with Labral Repair." In Orthopedic Stem Cell Surgery. Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-73299-8_54.

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Guadagni, Alessandro, and Umberto Pascucci. "Business Model Canvas: an introduction." In Manuali – Scienze Tecnologiche. Firenze University Press, 2020. http://dx.doi.org/10.36253/978-88-5518-044-3.45.

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The Business Model Canvas is a strategic tool that uses visual language to create and develop high-value innovative business models. The goal of this lesson is to give a clear and precise definition of BMC and see how this concept can fit into the world of SPA. In this sense, in the previous months the 3 farmers have developed, with the help of external collaborators, their BMC, visually representing the process of creating, distributing and capturing value for their customers. The results are presented as "good practices". The BMC is completed with the presentation of the "external forces framework" . Furthermore, one slide presents the difference between BMC and Business Plan.
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Hsu, Tzu-Han, César Sánchez, Sarai Sheinvald, and Borzoo Bonakdarpour. "Efficient Loop Conditions for Bounded Model Checking Hyperproperties." In Tools and Algorithms for the Construction and Analysis of Systems. Springer Nature Switzerland, 2023. http://dx.doi.org/10.1007/978-3-031-30823-9_4.

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AbstractBounded model checking (BMC) is an effective technique for hunting bugs by incrementally exploring the state space of a system. To reason about infinite traces through a finite structure and to ultimately obtain completeness, BMC incorporates loop conditions that revisit previously observed states. This paper focuses on developing loop conditions for BMC of – a temporal logic for hyperproperties that allows expressing important policies for security and consistency in concurrent systems, etc. Loop conditions for are more complicated than for , as different traces may loop inconsistently in unrelated moments. Existing BMC approaches for only considered linear unrollings without any looping capability, which precludes both finding small infinite traces and obtaining a complete technique. We investigate loop conditions for BMC, for formulas that contain up to one quantifier alternation. We first present a general complete automata-based technique which is based on bounds of maximum unrollings. Then, we introduce alternative simulation-based algorithms that allow exploiting short loops effectively, generating SAT queries whose satisfiability guarantees the outcome of the original model checking problem. We also report empirical evaluation of the prototype implementation of our BMC techniques using .
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Hsu, Tzu-Han, César Sánchez, and Borzoo Bonakdarpour. "Bounded Model Checking for Hyperproperties." In Tools and Algorithms for the Construction and Analysis of Systems. Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-72016-2_6.

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AbstractThis paper introduces a bounded model checking (BMC) algorithm for hyperproperties expressed in HyperLTL, which — to the best of our knowledge — is the first such algorithm. Just as the classic BMC technique for LTL primarily aims at finding bugs, our approach also targets identifying counterexamples. BMC for LTL is reduced to SAT solving, because LTL describes a property via inspecting individual traces. Our BMC approach naturally reduces to QBF solving, as HyperLTL allows explicit and simultaneous quantification over multiple traces. We report on successful and efficient model checking, implemented in our tool called , of a rich set of experiments on a variety of case studies, including security, concurrent data structures, path planning for robots, and mutation testing.
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Frohn, Florian, and Jürgen Giesl. "Integrating Loop Acceleration Into Bounded Model Checking." In Lecture Notes in Computer Science. Springer Nature Switzerland, 2024. http://dx.doi.org/10.1007/978-3-031-71162-6_4.

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AbstractBounded Model Checking (BMC) is a powerful technique for proving unsafety. However, finding deep counterexamples that require a large bound is challenging for BMC. On the other hand, acceleration techniques compute “shortcuts” that “compress” many execution steps into a single one. In this paper, we tightly integrate acceleration techniques into SMT-based bounded model checking. By adding suitable “shortcuts” on the fly, our approach can quickly detect deep counterexamples. Moreover, using so-called blocking clauses, our approach can prove safety of examples where BMC diverges. An empirical comparison with other state-of-the-art techniques shows that our approach is highly competitive for proving unsafety, and orthogonal to existing techniques for proving safety.
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Conference papers on the topic "BMCC"

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Yao, Liuquan, Zhichao Liu, Yuan Li, et al. "New Partial Orders of Polar Codes for BMSC." In 2024 IEEE International Symposium on Information Theory (ISIT). IEEE, 2024. http://dx.doi.org/10.1109/isit57864.2024.10619254.

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Kapse, Jitendra Kumar, Ashfaque KP, and Surendra C. "Automating Ground System Using Baseband Monitoring and Control Software (BMCS)." In 2024 IEEE Space, Aerospace and Defence Conference (SPACE). IEEE, 2024. http://dx.doi.org/10.1109/space63117.2024.10668205.

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Wang, Jiapeng, Zhihan Zheng, Kefan Qiu, Yu-an Tan, Chen Liang, and Wenjuan Li. "A Framework for BMC Firmware Vulnerability Analysis and Exploitation." In 2024 IEEE International Conferences on Internet of Things (iThings) and IEEE Green Computing & Communications (GreenCom) and IEEE Cyber, Physical & Social Computing (CPSCom) and IEEE Smart Data (SmartData) and IEEE Congress on Cybermatics. IEEE, 2024. http://dx.doi.org/10.1109/ithings-greencom-cpscom-smartdata-cybermatics62450.2024.00026.

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Ping, Zhuochen, Yong Wang, Yubing Lin, Weifeng Gong, Wei Gong, and Yan Li. "Design of Server Fault Diagnosis and Prediction Based on BMC." In 2024 China Automation Congress (CAC). IEEE, 2024. https://doi.org/10.1109/cac63892.2024.10865647.

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Yang, Dongrui, Omar Rosas, and Homero Castaneda. "Comparison of the Corrosion Inhibiting Properties of Imidazole Based Ionic Liquids on API X52 Steel in Carbon Dioxide Saturated NaCl Solution." In CORROSION 2014. NACE International, 2014. https://doi.org/10.5006/c2014-4357.

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Abstract The aim of this work is to investigate the corrosion inhibiting efficiency of four imidazolium ionic liquids in carbon dioxide saturated NaCl Brine solution by using electrochemical and surface analysis testing methods. The four compounds are 1-Ethyl-3-methylimidazolium chloride (Emc), 1-Butyl-3-methylimidazolium chloride (Bmc), 1-Hexyl-3-methylimidazolium chloride (Hmc), and 1-Decyl-3-methylimidazolium chloride (Dmc). Under the testing conditions, compound Dmc showed the highest inhibition efficiency. After 24 hours of immersion time in the inhibiting solution, the inhibiting efficiency reached 99%; SEM photos showed that the steel surface was well protected from uniform corrosion. The solution with Dmc showed an Open circuit potential (OCP) 70 mV higher than the one in blank solution. The testing results of Hmc also show inhibition properties in some degree. Compound Emc and Bmc showed no obvious corrosion-prevention properties, though the OCP changes indicated a slight influence. Scanning Electron Microscope (SEM) was used to characterize and support steel surface changes following the chemical (inhibitor) addition and electrochemical testing.
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Roy, Soumik Guha, Adriz Chanda, Prateek Ganguli, et al. "BMC Engine Sequencing with Graph Neural Network Embeddings of Hardware Circuits." In 2025 38th International Conference on VLSI Design and 2025 24th International Conference on Embedded Systems (VLSID). IEEE, 2025. https://doi.org/10.1109/vlsid64188.2025.00041.

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Gao, Yang, Peng Ma, Minhua Ren, and Hangping Gu. "Implementation and Optimization of a KVM Video Subsystem Based on BMC." In 2025 6th International Conference on Electrical, Electronic Information and Communication Engineering (EEICE). IEEE, 2025. https://doi.org/10.1109/eeice65049.2025.11033935.

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Zhai, Yujia, Fei Cao, Ping Zhang, Guimin Zhang, Weiping Yao, and Yue Hao. "A survey of Out-of-band Management Vulnerability Analysis based on BMC." In 2024 7th International Conference on Electronics Technology (ICET). IEEE, 2024. http://dx.doi.org/10.1109/icet61945.2024.10673073.

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Yang, Hanru, Tianrui Lyu, Xiao Huang, and Jianping Guo. "A 2.0-to-4.9 ppm/°C Bandgap Voltage Reference with Source-Sink Current Compensation for BMIC." In 2024 IEEE International Conference on Integrated Circuits, Technologies and Applications (ICTA). IEEE, 2024. https://doi.org/10.1109/icta64028.2024.10860702.

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Wang, Zehao, Han Zhang, and Jingchuan Wang. "K-BMPC: Derivative-based Koopman Bilinear Model Predictive Control For Tractor-trailer Trajectory Tracking With Unknown Parameters." In 2024 IEEE International Conference on Robotics and Automation (ICRA). IEEE, 2024. http://dx.doi.org/10.1109/icra57147.2024.10610320.

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Reports on the topic "BMCC"

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Hariri, Salim, Geoffrey C. Fox, Balaji Thiagarajan, and Manish Parashar. Parallel Software Benchmarks for High Performance BMC3/IS Systems. Defense Technical Information Center, 1994. http://dx.doi.org/10.21236/ada282329.

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Pagano, Nicholas J., G. P. Tandon, and R. Y. Kim. Failure Modes in Brittle Matrix Composites (BMC). Defense Technical Information Center, 1998. http://dx.doi.org/10.21236/ada342734.

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Salvi, A., M. Ostrowska, and G. Dotelli. Mechanical recycling of bulk molding compound: a technical and environmental assessment. Universidad de los Andes, 2024. https://doi.org/10.51573/andes.pps39.ss.cep.7.

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This study evaluates the technical and environmental feasibility of mechanically recycling post-industrial bulk molding compound (BMC) waste from the manufacturing of low voltage circuit breakers. Testing reveals that incorporating up to 10% recycled BMC as filler substitute maintains the required mechanical and electrical properties. A life cycle assessment shows that while replacing virgin fillers with recycled BMC has limited effects on the carbon footprint of the material, the overall product system benefits significantly by avoiding waste incineration. Moreover, optimized scenarios like maximizing recycled content and reducing transportations substantially reduce the environmental impacts. This study underscores the potential of circular production models to enhance sustainability in the thermoset composite industry
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Aldrich, Susan. BMC Software’s CONTROL-SA 3.2 User Provisioning Solution. Patricia Seybold Group, 2003. http://dx.doi.org/10.1571/pr7-10-03cc.

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Mshelia, Arhyel. Prevalence, risk factors, and antimicrobial resistance of Streptococcus suis and Campylobacter species in pigs: a systematic review. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, 2023. http://dx.doi.org/10.37766/inplasy2023.3.0053.

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Review question / Objective: What are the global prevalence, risk factors, and antimicrobial resistance of Streptococcus suis and Campylobacter species in pigs? /To determine the occurrence, associated factors, and antimicrobial resistance of the isolates of Streptococcus suis and Campylobacter species of Pigs worldwide. Information sources: The intended information sources are 20 electronic databases: MEDLINE® - (Mesh, Ovid Medline, Ovid PsycINFO, PubMed), Scopus®, ProQuest®, Google Scholar®, Web of Science® (ISI), EBSCO®, SciELO®, Wiley®, Compendex® - Engineering Village, Emerald®, Embase® - Emtree, Directory of Open Access Journals (DOAJ)®, Gale Academic OneFile®, DataCite®, J-STAGE®, SpringerLink Journals®, Journals Ovid complete®, BioMed Central Opens Access®, Nature®, Taylor &amp; Francis®], 9 periodical titles (Journal of Veterinary Science, Antibiotics, BMC Veterinary Research, Canadian Journal of Veterinary Research, Journal of Veterinary Medical Science, Journal of Veterinary Medical Science B, PLoS One, Scientific Reports, Veterinary Microbiology), and the grey literature databases.
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Morville, Anne-Le, Janice Jones, Michal Avrech-Bar, et al. A scoping review protocol on Occupational Science Research in European Contexts. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, 2022. http://dx.doi.org/10.37766/inplasy2022.7.0056.

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Review question / Objective: Researchers may conduct scoping reviews instead of systematic reviews where the purpose of thereview is to identify knowledge gaps, scope a body of literature, clarify concepts or to investigate research conduct. While useful in their own right, scoping reviews may also be helpful precursors to systematic reviews and can be used to confirm the relevance of inclusion criteria and potential questions. (Munn et al. BMC Medical Research Methodology (2018) 18:143) The aim of this review is to scope the empirical-based and peer-reviewed European OS research literature and map identified research methods, theories or theoretical concepts, and target groups to obtain a status quo overview of OS research undertaken in Europe between 2015 and 2020. Research questions: • What recent development is seen when mapping the empirical-based and peer-reviewed European OS research literature in accordance with publication volume, publication date and geographical context? • What characterizes the identified research methods, theories or theoretical concepts, and target groups applied in the peer-reviewed OS research literature?
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Travis, Amanda, Margaret Harvey, and Michelle Rickard. Adverse Childhood Experiences and Urinary Incontinence in Elementary School Aged Children. University of Tennessee Health Science Center, 2021. http://dx.doi.org/10.21007/con.dnp.2021.0012.

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Purpose/Background: Adverse Childhood Experiences (ACEs) have an impact on health throughout the lifespan (Filletti et al., 1999; Hughes et al., 2017). These experiences range from physical and mental abuse, substance abuse in the home, parental separation or loss, financial instability, acute illness or injury, witnessing violence in the home or community, and incarceration of family members (Hughes et al., 2017). Understanding and screening for ACEs in children with urinary incontinence can help practitioners identify psychological stress as a potentially modifiable risk factor. Methods: A 5-month chart review was performed identifying English speaking patients ages 6-11 years presenting to the outpatient urology office for an initial visit with a primary diagnosis of urinary incontinence. Charts were reviewed for documentation of individual or family risk factors for ACEs exposure, community risk factors for ACEs exposures, and records where no related documentation was included. Results: For the thirty-nine patients identified, no community risk factors were noted in the charts. Seventy-nine percent of patients had one or more individual or family risk factors documented. Implications for Nursing Practice This chart review indicates that a significant percentage of pediatric, school-aged patients presenting with urinary incontinence have exposure to ACEs. A formal assessment for ACEs at the time of initial presentation would be helpful to identify those at highest risk. References: Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the adverse childhood experiences (ACE) study. Am J Prev Med. 1998;14:245–258 Hughes, K., Bellis, M.A., Hardcastle, K.A., Sethi, D., Butchart, D., Mikton, C., Jones, L., Dunne, M.P. (2017) The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. Lancet Public Health, 2(8): e356–e366. Published online 2017 Jul 31.doi: 10.1016/S2468-2667(17)30118-4 Lai, H., Gardner, V., Vetter, J., &amp; Andriole, G. L. (2015). Correlation between psychological stress levels and the severity of overactive bladder symptoms. BMC urology, 15, 14. doi:10.1186/s12894-015-0009-6
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MacFarlane, Andrew. 2021 medical student essay prize winner - A case of grief. Society for Academic Primary Care, 2021. http://dx.doi.org/10.37361/medstudessay.2021.1.1.

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As a student undertaking a Longitudinal Integrated Clerkship (LIC)1 based in a GP practice in a rural community in the North of Scotland, I have been lucky to be given responsibility and my own clinic lists. Every day I conduct consultations that change my practice: the challenge of clinically applying the theory I have studied, controlling a consultation and efficiently exploring a patient's problems, empathising with and empowering them to play a part in their own care2 – and most difficult I feel – dealing with the vast amount of uncertainty that medicine, and particularly primary care, presents to both clinician and patient. I initially consulted with a lady in her 60s who attended with her husband, complaining of severe lower back pain who was very difficult to assess due to her pain level. Her husband was understandably concerned about the degree of pain she was in. After assessment and discussion with one of the GPs, we agreed some pain relief and a physio assessment in the next few days would be a practical plan. The patient had one red flag, some leg weakness and numbness, which was her ‘normal’ on account of her multiple sclerosis. At the physio assessment a few days later, the physio felt things were worse and some urgent bloods were ordered, unfortunately finding raised cancer and inflammatory markers. A CT scan of the lung found widespread cancer, a later CT of the head after some developing some acute confusion found brain metastases, and a week and a half after presenting to me, the patient sadly died in hospital. While that was all impactful enough on me, it was the follow-up appointment with the husband who attended on the last triage slot of the evening two weeks later that I found completely altered my understanding of grief and the mourning of a loved one. The husband had asked to speak to a Andrew MacFarlane Year 3 ScotGEM Medical Student 2 doctor just to talk about what had happened to his wife. The GP decided that it would be better if he came into the practice - strictly he probably should have been consulted with over the phone due to coronavirus restrictions - but he was asked what he would prefer and he opted to come in. I sat in on the consultation, I had been helping with any examinations the triage doctor needed and I recognised that this was the husband of the lady I had seen a few weeks earlier. He came in and sat down, head lowered, hands fiddling with the zip on his jacket, trying to find what to say. The GP sat, turned so that they were opposite each other with no desk between them - I was seated off to the side, an onlooker, but acknowledged by the patient with a kind nod when he entered the room. The GP asked gently, “How are you doing?” and roughly 30 seconds passed (a long time in a conversation) before the patient spoke. “I just really miss her…” he whispered with great effort, “I don’t understand how this all happened.” Over the next 45 minutes, he spoke about his wife, how much pain she had been in, the rapid deterioration he witnessed, the cancer being found, and cruelly how she had passed away after he had gone home to get some rest after being by her bedside all day in the hospital. He talked about how they had met, how much he missed her, how empty the house felt without her, and asking himself and us how he was meant to move forward with his life. He had a lot of questions for us, and for himself. Had we missed anything – had he missed anything? The GP really just listened for almost the whole consultation, speaking to him gently, reassuring him that this wasn’t his or anyone’s fault. She stated that this was an awful time for him and that what he was feeling was entirely normal and something we will all universally go through. She emphasised that while it wasn’t helpful at the moment, that things would get better over time.3 He was really glad I was there – having shared a consultation with his wife and I – he thanked me emphatically even though I felt like I hadn’t really helped at all. After some tears, frequent moments of silence and a lot of questions, he left having gotten a lot off his chest. “You just have to listen to people, be there for them as they go through things, and answer their questions as best you can” urged my GP as we discussed the case when the patient left. Almost all family caregivers contact their GP with regards to grief and this consultation really made me realise how important an aspect of my practice it will be in the future.4 It has also made me reflect on the emphasis on undergraduate teaching around ‘breaking bad news’ to patients, but nothing taught about when patients are in the process of grieving further down the line.5 The skill Andrew MacFarlane Year 3 ScotGEM Medical Student 3 required to manage a grieving patient is not one limited to general practice. Patients may grieve the loss of function from acute trauma through to chronic illness in all specialties of medicine - in addition to ‘traditional’ grief from loss of family or friends.6 There wasn’t anything ‘medical’ in the consultation, but I came away from it with a real sense of purpose as to why this career is such a privilege. We look after patients so they can spend as much quality time as they are given with their loved ones, and their loved ones are the ones we care for after they are gone. We as doctors are the constant, and we have to meet patients with compassion at their most difficult times – because it is as much a part of the job as the knowledge and the science – and it is the part of us that patients will remember long after they leave our clinic room. Word Count: 993 words References 1. ScotGEM MBChB - Subjects - University of St Andrews [Internet]. [cited 2021 Mar 27]. Available from: https://www.st-andrews.ac.uk/subjects/medicine/scotgem-mbchb/ 2. Shared decision making in realistic medicine: what works - gov.scot [Internet]. [cited 2021 Mar 27]. Available from: https://www.gov.scot/publications/works-support-promote-shared-decisionmaking-synthesis-recent-evidence/pages/1/ 3. Ghesquiere AR, Patel SR, Kaplan DB, Bruce ML. Primary care providers’ bereavement care practices: Recommendations for research directions. Int J Geriatr Psychiatry. 2014 Dec;29(12):1221–9. 4. Nielsen MK, Christensen K, Neergaard MA, Bidstrup PE, Guldin M-B. Grief symptoms and primary care use: a prospective study of family caregivers. BJGP Open [Internet]. 2020 Aug 1 [cited 2021 Mar 27];4(3). Available from: https://bjgpopen.org/content/4/3/bjgpopen20X101063 5. O’Connor M, Breen LJ. General Practitioners’ experiences of bereavement care and their educational support needs: a qualitative study. BMC Medical Education. 2014 Mar 27;14(1):59. 6. Sikstrom L, Saikaly R, Ferguson G, Mosher PJ, Bonato S, Soklaridis S. Being there: A scoping review of grief support training in medical education. PLOS ONE. 2019 Nov 27;14(11):e0224325.
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BMC{trademark}: Baseline report. Office of Scientific and Technical Information (OSTI), 1997. http://dx.doi.org/10.2172/650202.

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BMC{trademark}: Baseline report; Summary. Office of Scientific and Technical Information (OSTI), 1997. http://dx.doi.org/10.2172/650204.

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