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1

Kamin, Lawrence F. "Using a Five-Step Procedure for Inferential Statistical Analyses." American Biology Teacher 72, no. 3 (March 1, 2010): 186–88. http://dx.doi.org/10.1525/abt.2010.72.3.11.

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Many statistics texts pose inferential statistical problems in a disjointed way. By using a simple five-step procedure as a template for statistical inference problems, the student can solve problems in an organized fashion. The problem and its solution will thus be a stand-by-itself organic whole and a single unit of thought and effort. The described procedure can be used for both parametric and nonparametric inferential tests. The example given is a chi-square goodness-of-fit test of a genetics experiment involving a dihybrid cross in corn that follows a 9:3:3:1 ratio. This experimental analysis is commonly done in introductory biology labs.
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2

Krystal, G., HR Pankratz, NM Farber, and JE Smart. "Purification of human erythropoietin to homogeneity by a rapid five- step procedure." Blood 67, no. 1 (January 1, 1986): 71–79. http://dx.doi.org/10.1182/blood.v67.1.71.71.

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Abstract Human urinary erythropoietin (Ep) has been purified using a simple five- step procedure to yield preparations with potencies of 80,000 U/mg in 25% yield. The five steps involve: (1) affinity chromatography on CM Affi-Gel Blue, (2) chromatofocusing, (3) wheat germ lectin (or hydroxylapatite) chromatography, (4) reverse-phase high-performance liquid chromatography (HPLC) using a phenyl column, and (5) preparative sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Ep activity was determined at each stage using a highly sensitive and specific in vitro assay that measures [3H]-thymidine incorporation into erythroid cells from spleens of phenylhydrazine-treated mice. The step 5 material was also tested with the in vivo polycythemic mouse assay procedure and was found to have a similar potency to that obtained in the [3H]-thymidine in vitro assay. SDS-PAGE analysis of the step 5 material revealed a single 38.5-kd band that comigrated with Ep bioactivity. Homogeneity was confirmed by amino acid sequence analysis. Starting with urine containing approximately 13 U/mg of protein, the cumulative degrees of purification achieved with each step were: step 1,25-fold; step 2, 75-fold; step 3, 300-fold; step 4, 1,500-fold; and step 5, 5,000-fold. Corresponding overall recoveries after each step were: greater than 100%, 70%, 45%, 30%, and 25%. These recoveries could be obtained when as little as 5,000 U of starting urinary Ep were processed because of the introduction of Tween 20 and SDS into buffers used at various stages of the purification procedure. In addition, a rapid method for determining Ep purity which involves reverse-phase HPLC of trypsinized 125I-labeled Ep is presented. This allows the establishment of purity with far less material than is required for amino acid sequencing.
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3

Krystal, G., HR Pankratz, NM Farber, and JE Smart. "Purification of human erythropoietin to homogeneity by a rapid five- step procedure." Blood 67, no. 1 (January 1, 1986): 71–79. http://dx.doi.org/10.1182/blood.v67.1.71.bloodjournal67171.

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Human urinary erythropoietin (Ep) has been purified using a simple five- step procedure to yield preparations with potencies of 80,000 U/mg in 25% yield. The five steps involve: (1) affinity chromatography on CM Affi-Gel Blue, (2) chromatofocusing, (3) wheat germ lectin (or hydroxylapatite) chromatography, (4) reverse-phase high-performance liquid chromatography (HPLC) using a phenyl column, and (5) preparative sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Ep activity was determined at each stage using a highly sensitive and specific in vitro assay that measures [3H]-thymidine incorporation into erythroid cells from spleens of phenylhydrazine-treated mice. The step 5 material was also tested with the in vivo polycythemic mouse assay procedure and was found to have a similar potency to that obtained in the [3H]-thymidine in vitro assay. SDS-PAGE analysis of the step 5 material revealed a single 38.5-kd band that comigrated with Ep bioactivity. Homogeneity was confirmed by amino acid sequence analysis. Starting with urine containing approximately 13 U/mg of protein, the cumulative degrees of purification achieved with each step were: step 1,25-fold; step 2, 75-fold; step 3, 300-fold; step 4, 1,500-fold; and step 5, 5,000-fold. Corresponding overall recoveries after each step were: greater than 100%, 70%, 45%, 30%, and 25%. These recoveries could be obtained when as little as 5,000 U of starting urinary Ep were processed because of the introduction of Tween 20 and SDS into buffers used at various stages of the purification procedure. In addition, a rapid method for determining Ep purity which involves reverse-phase HPLC of trypsinized 125I-labeled Ep is presented. This allows the establishment of purity with far less material than is required for amino acid sequencing.
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4

Papavassiliou, G. C., G. A. Mousdis, and G. C. Anyfandis. "An Improved Synthesis of Nickel-bis[5,6-dihydro-1,4-dioxine- 2,3-dithiolate], Ni(edo)2." Zeitschrift für Naturforschung B 57, no. 6 (June 1, 2002): 707–8. http://dx.doi.org/10.1515/znb-2002-0618.

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5

Sherwood, Alexander M., Poncho Meisenheimer, Gary Tarpley, and Robert B. Kargbo. "An Improved, Practical, and Scalable Five-Step Synthesis of Psilocybin." Synthesis 52, no. 05 (January 8, 2020): 688–94. http://dx.doi.org/10.1055/s-0039-1691565.

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Described herein is an improved synthesis of 3-[2-(dimethylamino)ethyl]-1H-indol-4-yl dihydrogen phosphate (psilocybin). The protocol outlines: synthesis of multigram quantities of psilocybin, identification of critical in-process parameters, and isolation of psilocybin without the use of chromatography, TLC, or aqueous workup. The synthesis furnishes psilocybin in five steps in 23% overall yield from an inexpensive acetoxyindole starting material. With specific focus on process control and impurity fate and removal, the improved procedure is amenable to providing high-quality psilocybin.
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6

Ariza Abdullah, Mohd Hilmi Abdullah, Taj Rijal Muhamad Romli,. "PROCEDURES IN STRUCTURING VERBAL SENTENCES IN TEACHING AND LEARNING MALAY-ARABIC TRANSLATION COURSE." Psychology and Education Journal 58, no. 2 (February 1, 2021): 1538–44. http://dx.doi.org/10.17762/pae.v58i2.2307.

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This paper discusses the procedures used in teaching and learning Malay-Arabic translation courses for students of Bachelor of Arabic Studies with Education.This procedure is designed to facilitate the problem of students in structuring Arabic sentences based on the correct method of translation. Referring to the natural translation theory by Nida and Taber that prioritizes message delivery despite changes to the original text. This method was introduced as an alternative to students to construct Arabic sentences when translating according to the procedure that has been designed systematically for teaching and learning (T&L). This procedure is divided into five steps. The first step is understanding the text through intensive reading. Next, in the second step is finding the meaning of difficult phrases by using dictionary and discussion. The third step, which is the main basis of the procedure is breaking the paragraphs of text into short sentences based on verb phrases. The fourth step is categorizing each sentence into the Arabic syntax structure for verb phrases. The fifth step is compiling and building a draft sentence which is translated directly through the translation text based on the steps above. The outcome of using this procedure increases the quality of Malay-Arabic translation and making it more understandable as students apply the structure of a correct Arabic sentence. This procedure will be used as an alternative for students in practising scientific translation in accordance with translation procedures.
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7

Palermo, Michele, Stefano Silvestri, Luca Landi, Giada Gasparini, and Tomaso Trombetti. "Peak velocities estimation for a direct five-step design procedure of inter-storey viscous dampers." Bulletin of Earthquake Engineering 14, no. 2 (October 16, 2015): 599–619. http://dx.doi.org/10.1007/s10518-015-9829-8.

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8

Palermo, Michele, Stefano Silvestri, Giada Gasparini, and Tomaso Trombetti. "A Direct Five-Step Procedure for the Dimensioning of Viscous Dampers to Be Inserted in Frame Structures." Applied Mechanics and Materials 847 (July 2016): 233–39. http://dx.doi.org/10.4028/www.scientific.net/amm.847.233.

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Many design methods for the design of viscous dampers to be inserted in building structures are available in the scientific literature and building codes. Among others, the authors proposed a five-step procedure guiding the practioner from the choice of a target reduction in the seismic response of the structural system (with respect to the response of a structure without any additional damping devices), to the identification of the corresponding damping ratio and the mechanical characteristics of the commercially available viscous dampers. The original procedure required the development of numerical simulations for the evaluations of the peak inter-storey velocity profiles, necessary for the evaluation of the non-linear damping coefficient. More recently, a fully analytical version of the 5-step procedure (direct) has been also introduced. In the present work, an application of the direct procedure for a three-storey school building is presented.
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9

Dai, Qing-xia, Noriharu Ae, Takeshi Suzuki, Mani Rajkumar, Shoko Fukunaga, and Nobuhide Fujitake. "Assessment of potentially reactive pools of aluminum in Andisols using a five-step sequential extraction procedure." Soil Science and Plant Nutrition 57, no. 4 (August 1, 2011): 500–507. http://dx.doi.org/10.1080/00380768.2011.598445.

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10

Silvestri, Stefano, Giada Gasparini, and Tomaso Trombetti. "A Five-Step Procedure for the Dimensioning of Viscous Dampers to Be Inserted in Building Structures." Journal of Earthquake Engineering 14, no. 3 (March 2010): 417–47. http://dx.doi.org/10.1080/13632460903093891.

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11

Palermo, Michele, Stefano Silvestri, Luca Landi, Giada Gasparini, and Tomaso Trombetti. "A “direct five-step procedure” for the preliminary seismic design of buildings with added viscous dampers." Engineering Structures 173 (October 2018): 933–50. http://dx.doi.org/10.1016/j.engstruct.2018.06.103.

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12

Neisskenwirth, F. "Rehydration of Dried-Out Specimens: a New Approach." Collection Forum 34, no. 1 (January 1, 2020): 73–86. http://dx.doi.org/10.14351/0831-4985-34.1.73.

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Abstract Different procedures are proposed in the literature for the rehydration of dried-out specimens. These procedures vary greatly in their efficiency and application. This work describes a new procedure that is inspired by the literature but that avoids heating the specimens. This method was applied to reconditioning dried-out specimens from a historical collection (Swiss freshwater fishes, bird brains, and bird eyes), stored at the Naturhistorisches Museum Bern in Switzerland. The procedure consists of five steps. The first step is the softening of hardened soft tissue with benzaldehyde and demineralized water. The second step is an indirect rehydration with water vapor. The third step is a chemically induced direct hydration using a trisodium phosphate solution that allows the specimen to swell in size before being washed with water to remove all additives. Finally, the rehydrated specimen is transferred into new preserving fluid. Because the dehydrating properties of ethanol as a preservative are problematic, this paper presents the results of an experimental case study using a glycerol solution as a preservation fluid.
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13

Corves, Burkhard, Guido Lonij, and Mathias Hüsing. "Kinematic Synthesis of a Step Mechanism Based on a Five Bar Linkage." Applied Mechanics and Materials 162 (March 2012): 1–10. http://dx.doi.org/10.4028/www.scientific.net/amm.162.1.

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On the basis of a five bar linkage it is possible to generate actinomorphic coupler curves if certain conditions, related to the kinematic dimensions and the gear ratio between the two cranks, are fulfilled. These symmetric coupler curves can then be used to realize a step mechanism by adding two additional links, taking advantage of the typical curvature characteristics of the generated coupler curve The following article starts with a short literature survey about five bar linkages in general and their use as dwell or step mechanisms in particular. Then it will be shown how the curvature properties of the coupler curves generated by five bar linkages can be determined by graphical means. It will be shown how this procedure can be advantageously applied with the help of an interactive geometry program, using the geometric determination of the curvature properties, such that an optimal step mechanism can be derived.
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14

Jiang, Mo, and Richard D. Braatz. "Designs of continuous-flow pharmaceutical crystallizers: developments and practice." CrystEngComm 21, no. 23 (2019): 3534–51. http://dx.doi.org/10.1039/c8ce00042e.

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This review of recent research advances in continuous-flow crystallization includes a five-step general design procedure, generally applicable process intensification strategies, and practical insights.
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15

Palermo, Michele, Stefano Silvestri, Luca Landi, Giada Gasparini, and Tomaso Trombetti. "Erratum to: Peak velocities estimation for a direct five-step design procedure of inter-storey viscous dampers." Bulletin of Earthquake Engineering 14, no. 2 (December 14, 2015): 621. http://dx.doi.org/10.1007/s10518-015-9849-4.

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16

Michnik, Jerzy. "Scenario Planning + MCDA Procedure For Innovation Selection Problem." Foundations of Computing and Decision Sciences 38, no. 3 (September 1, 2013): 207–20. http://dx.doi.org/10.2478/fcds-2013-0010.

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Abstract Selecting the proper set of innovation projects is the vital point of the innovation management in a firm. To make a good decision, managers have to consider many conicting objectives in a highly uncertain environment. In this article, the comprehensive decision procedure based on scenario planning and multiple criteria analysis is presented. The main part of the procedure is a two-step model in which Hurwicz's rule and VIKOR-S method are employed to gain the selection of alternatives. To build up the decision base, the classification of the criteria involved in the innovation project selection into five categories is proposed.
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17

Ghassemieh, M., A. A. Gholampour, and S. R. Massah. "Application of Weight Functions in Nonlinear Analysis of Structural Dynamics Problems." International Journal of Computational Methods 13, no. 01 (February 2016): 1650005. http://dx.doi.org/10.1142/s0219876216500055.

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This paper presents a weighted residual method with several weight functions for solving differential equation of motion in nonlinear structural dynamics problems. Order of variation of acceleration is assumed to be quadratic in each time step in which polynomial of displacement would contain five unknown coefficients. Five equations are required for determination of these coefficients in each time step. These equations are obtained from initial conditions, satisfying equation of motions at both ends, and weighted residual integration. In this study, four procedures are considered for weight function to be used in the weighted residual integration as; unit weight function, Petrov–Galerkin’s weight function, least square weight function, and collocation weight function. Due to higher order of acceleration in the proposed method, the results indicate better and more accurate responses. Among the tested functions, the unit weighted function method demonstrated to be non-dissipative and its numerical dispersion showed to be clearly less than the common Newmark’s linear acceleration method. Also critical time step duration in stability investigation for weighted function procedure showed to be larger than the critical time step duration obtained by other methods used in the nonlinear structural dynamics problems.
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18

Palladino, SJ. "Fixation of the Austin procedure with the Herbert screw. A modified technique." Journal of the American Podiatric Medical Association 80, no. 10 (October 1, 1990): 526–30. http://dx.doi.org/10.7547/87507315-80-10-526.

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Although the Austin osteotomy is intrinsically stable, some surgeons use fixation to enhance stability. One form of fixation that may be used for this procedure is the Herbert screw. The author presents a modification of a previously reported technique, and describes it as a five-step process. The advantages and potential disadvantages of the use of the Herbert screw with the presented technique are discussed.
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19

Paolone, Gaetano, Salvatore Scolavino, Enrico Gherlone, Gianrico Spagnuolo, and Giuseppe Cantatore. "The “Pre-Finishing” Approach in Direct Anterior Restorations. A Case Series." Dentistry Journal 9, no. 7 (July 7, 2021): 79. http://dx.doi.org/10.3390/dj9070079.

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In esthetic restorations of anterior teeth the clinician has to manage several aspects in order to have a predictable outcome. A deep knowledge of the anatomy as well as the adhesive procedures and the optical properties of resin-based composites are mandatory to achieve esthetic results. Contemporary restorative materials present either several shades and different translucency properties and therefore they are able to mimic teeth’s optical behavior thus providing a natural aspect to anterior restorations. The wrong thickness of different composite layers may provide unpleasant results such as low value (grayish) restorations that often requires reintervention. A precise step-by-step procedure is therefore mandatory to provide the proper shade at the correct place. There is therefore the need of some corrections and adjustments during the layer procedure in order to avoid errors in shade positioning that could affect final result. The authors present a case series (six clinical cases) treated with the proposed technique with up to five years follow-up.
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20

Yin, Wanhong, Yi Li, Shouping Wang, Xueying Zeng, Yao Qin, Xiaoting Wang, Yangong Chao, Lina Zhang, Yan Kang, and Chinese Critical Ultrasound Study Group (CCUSG). "The PIEPEAR Workflow: A Critical Care Ultrasound Based 7-Step Approach as a Standard Procedure to Manage Patients with Acute Cardiorespiratory Compromise, with Two Example Cases Presented." BioMed Research International 2018 (June 11, 2018): 1–14. http://dx.doi.org/10.1155/2018/4687346.

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Critical care ultrasound (CCUS) has been widely used as a useful tool to assist clinical judgement. The utilization should be integrated into clinical scenario and interact with other tests. No publication has reported this. We present a CCUS based “7-step approach” workflow—the PIEPEAR Workflow—which we had summarized and integrated our experience in CCUS and clinical practice into, and then we present two cases which we have applied the workflow into as examples. Step one is “problems emerged?” classifying the signs of the deterioration into two aspects: acute circulatory compromise and acute respiratory compromise. Step two is “information clear?” quickly summarizing the patient’s medical history by three aspects. Step three is “focused exam launched”: (1) focused exam of the heart by five views: the assessment includes (1) fast and global assessment of the heart (heart glance) to identify cases that need immediate life-saving intervention and (2) assessing the inferior vena cava, right heart, diastolic and systolic function of left heart, and systematic vascular resistance to clarify the hemodynamics. (2) Lung ultrasound exam is performed to clarify the predominant pattern of the lung. Step four is “pathophysiologic changes reported.” The results of the focused ultrasound exam were integrated to conclude the pathophysiologic changes. Step five is “etiology explored” diagnosing the etiology by integrating Step two and Step four and searching for the source of infection, according to the clues extracted from the focused ultrasound exam; additional ultrasound exams or other tests should be applied if needed. Step six is “action” supporting the circulation and respiration sticking to Step four. Treat the etiologies according step five. Step seven is “recheck to adjust.” Repeat focused ultrasound and other tests to assess the response to treatment, adjust the treatment if needed, and confirm or correct the final diagnosis. With two cases as examples presented, we insist that applying CCUS with 7-step approach workflow is easy to follow and has theoretical advantages. The coming research on its value is expected.
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Becker, Wolfgang, Anne Scherer, Christine Faust, David Kornblüh Bauer, Simone Scholtes, Ercole Rao, Joachim Hofmann, Rolf Schauder, and Thomas Langer. "A fully automated three-step protein purification procedure for up to five samples using the NGC chromatography system." Protein Expression and Purification 153 (January 2019): 1–6. http://dx.doi.org/10.1016/j.pep.2018.08.003.

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22

Parenty, Alexis D. C., Yu-Fei Song, Craig J. Richmond, and Leroy Cronin. "A General and Efficient Five-Step One-Pot Procedure Leading to Nitrogen-Bridgehead Heterocycles Containing an Imidazole Ring." Organic Letters 9, no. 12 (June 2007): 2253–56. http://dx.doi.org/10.1021/ol070263z.

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23

Clement, Bernd, Christopher Meier, Philip Sömmer, and Ulrich Girreser. "Synthesis of Pyrido[3,4-c][1,9]phenanthroline - A Five-Step Procedure to a Novel N-Containing Ring Skeleton." Synthesis 45, no. 07 (February 27, 2013): 893–95. http://dx.doi.org/10.1055/s-0032-1318365.

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24

Wijesundara, K. K., C. Negulescu, and E. Foerster. "Estimation of Modal Properties of Low-Rise Buildings Using Ambient Excitation Measurements." Shock and Vibration 2015 (2015): 1–18. http://dx.doi.org/10.1155/2015/173450.

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Continuous wavelet transform (CWT) has recently emerged as a promising tool for identification of modal properties through ambient excitation measurements of structures. However, it is difficult to obtain an accurate estimation of damping ratio directly from time-frequency decomposition of ambient vibration measurements using CWT. The main objective of this study is to introduce a new method called two-step procedure in the estimation of damping ratios using ambient vibration measurements. The two-step procedure involves the development of random decrement (RD) signature from the ambient vibration measurements, which is equivalent to the damped free vibration response of a structure under a given initial displacement and subsequently decomposition of time domain RD signature into time-frequency domain using CWT. The secondary objective of the study is to show that CWT is capable of identifying the natural periods and mode shapes of low-rise buildings using ambient vibration measurements. Furthermore, the two-step procedure is validated with two practical applications in a five-storey reinforced concrete structure with masonry infill walls and a three-storey masonry structure. Finally, a conclusion can be drawn that the two-step procedure yields a reasonably good estimation of damping ratio.
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25

Zhong, Zhen Yu, Ze Yi Guo, Huan Lei, and Bo Kuang. "Research and Application of Compound CNC Five Axis Five Linkage Milling-Grinding-All-in-One Machine." Applied Mechanics and Materials 331 (July 2013): 281–85. http://dx.doi.org/10.4028/www.scientific.net/amm.331.281.

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Lightweight sections are widely used in furniture, but the manufacturing procedure for these irregular shaped wood workpieces is very complex. Domestic workers usually use manual equipment to do the milling and then grinding and polishing step by step, with quite low efficiency. So author of this article develops a compound CNC five axes five linkage milling-grinding-all-in-one machine to realize once-molding of wood sections automatically, which will increase efficiency by 200%. The article introduces the structure of the machine and then discusses some key technology in the processing. For example, how to do graphics pretreatment and reorder processing path, and how to keep smooth processing speed during the multi-axis working, in order to avoid the problem of workpiece being scratched or burned out.
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26

Qu, Yang, and George A. Kraus. "Synthesis of an Antileukemic Pyrone from Alternaria phragmospora." Natural Product Communications 12, no. 10 (October 2017): 1934578X1701201. http://dx.doi.org/10.1177/1934578x1701201022.

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Antileukemic pyrone 1 was synthesized by way of a five-step procedure from 4-Hydroxy-5-methoxycarbonyl-6-methyl-2-pyrone (8). This is the first synthesis of 4-methoxy-6-methyl-5-(3-oxobutyl)-2H-pyran-2-one (1).
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27

Zheng, Zhi-Fang, Jun Lu, Chao-Hui Zheng, and Chang-Ming Huang. "“Five-step” laparoscopic lymph node dissection for remnant gastric cancer following Billroth-II gastrectomy: A safe and feasible procedure." Surgical Oncology 32 (March 2020): 115–16. http://dx.doi.org/10.1016/j.suronc.2019.09.007.

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28

Steen, Gerard. "Towards a procedure for metaphor identification." Language and Literature: International Journal of Stylistics 11, no. 1 (February 2002): 17–33. http://dx.doi.org/10.1177/096394700201100103.

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This article aims to demonstrate the possibility of a stepwise procedure for metaphor identification. It is situated against the background of a more encompassing and complete five-step procedure for deriving conceptual metaphorical mappings from linguistic metaphors. The mainly cognitive linguistic assumptions of this overall approach are explicated first, with an emphasis on the purpose of identifying metaphor in language rather than in language behaviour. The compatibility between this cognitive-linguistic and a more generally cognitive psychological approach to metaphor is guaranteed by then introducing the notion of metaphorical propositions as the bridge between linguistic metaphors and metaphorical mappings. Moreover, reliability is hopefully increased by adopting the strategy of beginning with clear cases, which means that the initial focus is on all nominal, verbal, adjectival and adverbial concepts. As a result of this, a minimal procedure for finding metaphorically used words and concepts may be presented in the form of a list of seven instructions. A demonstration of this procedure is finally provided in the form of a detailed analysis of Robert Browning’s ‘Parting at Morning’.
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29

Aljarbou, Fahd A. "Five-Year Recall after Treatment of External Cervical Resorption." Case Reports in Dentistry 2019 (December 20, 2019): 1–5. http://dx.doi.org/10.1155/2019/4957408.

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The management of external cervical resorption can be challenging. This study described a two-step procedure for the treatment of external cervical resorption. It involved nonsurgical root canal treatment and a dental amalgam core buildup, followed by a surgical approach to restore the root structure using resin-modified glass ionomer (Geristore®). The patient was recalled for a period of five years, and the overall outcome was successful.
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Vizzielli, Giuseppe, Emanuele Perrone, Alessandro Gioè, Giovanni Tinelli, and Giovanni Scambia. "Inguino-abdominal combined approach for laterally extended pelvic resection: a step by step procedure." International Journal of Gynecologic Cancer 29, no. 2 (February 2019): 444–45. http://dx.doi.org/10.1136/ijgc-2018-000094.

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This video article demonstrates an inguino-abdominal combined approach for laterally extended pelvic resection, a major surgical procedure for locally advanced primary or recurrent gynecological cancer infiltrating the pelvic sidewall, for which palliative therapy is the only alternative.1 After local institutional review board approval (protocol No CICOG 02/03/62), we made a step by step surgical video of an inguino-abdominal combined approach for laterally extended pelvic resection , defined as an en bloc resection of a pelvic tumor with pelvic sidewall structures, including the iliopsoas and/or obturator internus muscles.2 3 The patient, a 48-year-old woman, diagnosed with single pelvic platinum resistant recurrence after five lines of chemotherapy for serous ovarian cancer G3, International Federation of Gynecology and Obstetrics (FIGO) stage IIIC, BRCA wild type. The preoperative positron emission tomography/computed tomography scan detected uptake on the right side at the level of the external iliac region and obturator fossa: the tumor surrounded the right external iliac vessels by more than 50% of their circumferences, with possible involvement of the vascular wall and venous vascular compression (Tinelli’s score=4).4 The tumor extended towards the obturator fossa, with possible involvement of the inguinal canal. Due to an uncertain pathological response, the size of the recurrence, and its close contiguity with the ureter and bowel, we decided to avoid radiation therapy as it could result in a ureteral or intestinal fistula. We performed a laterally extended pelvic resection, as shown step by step in the video.The procedure was conducted until complete removal of recurrence (R0). Estimated blood loss was 1000 mL and total operative time was 240 min. The patient was discharged after 15 days; we reported a urinary infection, a likely postoperative complication. The pathology report described a lymphnodal relapse of ovarian cancer (diameter=6 cm) with infiltration of surrounding tissue and in the sano margins. Six months after surgery, the patient is alive without evidence of relapse.The borders of pelvic surgical anatomy are continually extending, requiring surgeons to use a personalized approach and to continually update their anatomic knowledge. In this context, laterally extended pelvic resection could be a feasible surgical procedure, representing a salvage treatment in recurrent or persistent primary gynecological malignancies infiltrating the pelvic sidewall, when other approaches have failed. However, additional clinical trials are needed to confirm these results.3
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31

Guyonnet, D., C. Fremaux, Y. Cenatiempo, and J. M. Berjeaud. "Method for Rapid Purification of Class IIa Bacteriocins and Comparison of Their Activities." Applied and Environmental Microbiology 66, no. 4 (April 1, 2000): 1744–48. http://dx.doi.org/10.1128/aem.66.4.1744-1748.2000.

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ABSTRACT A three-step method was developed for the purification of mesentericin Y105 (60% yield) from the culture supernatant ofLeuconostoc mesenteroides Y105. The same procedure was successfully applied to the purification of five other anti-Listeria bacteriocins identified by mass spectrometry. Specific activities of the purified bacteriocins were compared.
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32

Gottwald, G. A., and A. J. Majda. "A mechanism for catastrophic filter divergence in data assimilation for sparse observation networks." Nonlinear Processes in Geophysics 20, no. 5 (September 25, 2013): 705–12. http://dx.doi.org/10.5194/npg-20-705-2013.

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Abstract. We study catastrophic filter divergence in data assimilation procedures whereby the forecast model develops severe numerical instabilities leading to a blow-up of the solution. Catastrophic filter divergence can occur in sparse observational grids with small observational noise for intermediate observation intervals and finite ensemble sizes. Using a minimal five-dimensional model, we establish that catastrophic filter divergence is a numerical instability of the underlying forecast model caused by the filtering procedure producing analyses which are not consistent with the true dynamics, and stiffness caused by the fast attraction of the inconsistent analyses towards the attractor during the forecast step.
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33

Abts, André, Antonino Mavaro, Jan Stindt, Patrick J. Bakkes, Sabine Metzger, Arnold J. M. Driessen, Sander H. J. Smits, and Lutz Schmitt. "Easy and Rapid Purification of Highly Active Nisin." International Journal of Peptides 2011 (September 18, 2011): 1–9. http://dx.doi.org/10.1155/2011/175145.

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Nisin is an antimicrobial peptide produced and secreted by several L. lactis strains and is specifically active against Gram-positive bacteria. In previous studies, nisin was purified via cation exchange chromatography at low pH employing a single-step elution using 1 M NaCl. Here, we describe an optimized purification protocol using a five-step NaCl elution to remove contaminants. The obtained nisin is devoid of impurities and shows high bactericidal activity against the nisin-sensitive L. lactis strain NZ9000. Purified nisin exhibits an IC50 of ~3 nM, which is a tenfold improvement as compared to nisin obtained via the one-step elution procedure.
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34

Souza, Ricardo Krause Martinez de, Samanta Fabrício Blattes da Rocha, Rodrigo Tomazini Martins, Pedro André Kowacs, and Ricardo Ramina. "Gait in normal pressure hydrocephalus: characteristics and effects of the CSF tap test." Arquivos de Neuro-Psiquiatria 76, no. 5 (May 2018): 324–31. http://dx.doi.org/10.1590/0004-282x20180037.

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ABSTRACT Normal pressure hydrocephalus (NPH), described by Hakim and Adams in 1965, is characterized by gait apraxia, urinary incontinence, and dementia. It is associated with normal cerebrospinal fluid (CSF) pressure and ventricular dilation that cannot be attributed to cerebral atrophy. Objectives: To evaluate gait characteristics in patients with idiopathic NPH and investigate the effect of the CSF tap test (CSF-TT) on gait. Methods: Twenty-five patients diagnosed with probable idiopathic NPH were submitted to the CSF-TT. The procedure aimed to achieve changes in gait parameters. Results: Fifteen gait parameters were assessed before and after the CSF-TT. Five showed a statistically significant improvement (p < 0.05): walking speed (p < 0.001), cadence (p < 0.001), step length (p < 0.001), en bloc turning (p = 0.001), and step height (p = 0.004). Conclusion: This study demonstrated that gait speed was the most responsive parameter to the CSF-TT, followed by cadence, step length, en bloc turning, and step height.
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35

Neill, Sara, Lisa Martin, and Lisa Harris. "Is clinical expertise a conflict of interest in research?" Women's Health 16 (January 2020): 174550652096961. http://dx.doi.org/10.1177/1745506520969616.

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Purpose: Doctors who research and provide abortion care have had their work characterized as a conflict of interest. We investigated whether surgeons who perform medical procedures other than abortion also routinely conduct research on that procedure and whether they disclose this as a relevant “conflict of interest.” Method: We conducted a two-step literature review of five medical procedures—abortion, rhinoplasty, Mohs micrographic surgery, transurethral resection of the prostate, and laminectomy. We identified articles published between June 2011 and May 2012, and we calculated the proportion of articles authored by clinicians who also perform that procedure as well as the percentage that reported clinical care as a conflict of interest. We then screened conflict of interest statements on publications on said procedures from the same journals between 2012 and 2019 and calculated the proportion of publications that reported clinical work as a conflict of interest. Results: We identified 135 publications that met inclusion criteria. We calculated that 100% of publications on rhinoplasty, transurethral resection of the prostate, and Mohs included a clinician who performs that procedure. Seventy-five percent of publications on laminectomy and 78% of publications on abortion included a clinician. None of the reviewed research articles included a disclosure that the authors also performed the procedure. From 2012 to 2019, there were 1,903 published articles on these procedures. None included a conflict of interest that disclosed clinical work as a conflict of interest. Conclusion: Although abortion providers publish as clinician-researchers at rates similar to surgeons in other areas of medicine, they alone face accusations that their clinical expertise is a potential conflict of interest. This stigmatizing practice could have wide-ranging consequences including delegitimization of the scientific method and peer review process broadly.
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36

Šenk, Mateja, Peter Metlikovič, Matjaž Maletič, and Boštjan Gomišček. "Development of New Product/Process Development Procedure for SMEs." Organizacija 43, no. 2 (March 1, 2010): 76–86. http://dx.doi.org/10.2478/v10051-010-0009-y.

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Development of New Product/Process Development Procedure for SMEsThe result of our research is a developed and implemented set of activities for new process or product development (NPD procedure) for SMEs environment in the plastic processing industry, which enables the production of products and services with a high value added.The developed NPD procedure consists of five consecutive and overlapping steps: attracting orders, designing a project, developing a product, developing a process and zero production series. Each distinct step is further divided into sub-activities supported by adequate methods and managed in an information system. Investigated and included were three different methodologies use for NPD procedure in the automotive industry such as Advanced Product Quality Planning (APQP), Design for Six Sigma (DFSS) and Stage/Gate methodology.The results presented in the paper show that the developed NPD procedure significantly improved NPD in terms of cost management and time-effectiveness.
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37

Thullen, Scott, David Rubush, and Tomislav Rovis. "A Photochemical Two-Step Formal [5+2] Cycloaddition: A Condensation–Ring-Expansion Approach to Substituted Azepanes." Synlett 28, no. 20 (June 29, 2017): 2755–58. http://dx.doi.org/10.1055/s-0036-1589049.

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Seven-membered nitrogen-containing heterocycles are considerably underrepresented in the literature compared to their five- and six-membered analogues. Herein, we report a relatively understudied photochemical rearrangement of N-vinylpyrrolidinones to azepin-4-ones in good yields. This transformation allows for the conversion of readily available pyrrolidinones and aldehydes to densely functionalized azepane derivatives in a facile two-step procedure.
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38

Artidiello, Santiago, Alicia Cordero, Juan R. Torregrosa, and María P. Vassileva. "Design of High-Order Iterative Methods for Nonlinear Systems by Using Weight Function Procedure." Abstract and Applied Analysis 2015 (2015): 1–12. http://dx.doi.org/10.1155/2015/289029.

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We present two classes of iterative methods whose orders of convergence are four and five, respectively, for solving systems of nonlinear equations, by using the technique of weight functions in each step. Moreover, we show an extension to higher order, adding only one functional evaluation of the vectorial nonlinear function. We perform numerical tests to compare the proposed methods with other schemes in the literature and test their effectiveness on specific nonlinear problems. Moreover, some real basins of attraction are analyzed in order to check the relation between the order of convergence and the set of convergent starting points.
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39

Kim, Kyeongjin, and Jaeha Lee. "Fragility of Bridge Columns under Vehicle Impact Using Risk Analysis." Advances in Civil Engineering 2020 (February 14, 2020): 1–14. http://dx.doi.org/10.1155/2020/7193910.

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In this study, risk analysis was conducted to evaluate the vulnerability of bridge columns to vehicle impact. A three-step risk analysis procedure was used. The first step involved a Preliminary Risk Analysis (PRA), which was an initial screening step to determine whether a bridge column requires second-step analysis or not. The second step was a Simplified Risk Analysis (SRA), which involved determining the level of risk (low, moderate, or high) for a bridge column. The third step comprised a Detailed Risk Analysis (DRA). Computer simulation was based on the results of SRA. In this study, the risk level of 8,267 bridges in South Korea was evaluated, and a resulting total of 58 bridge columns in the Risk Level High (RLH) category were selected as a result of SRA. These bridge columns were classified into five types based on their slenderness ratio. Using these five types of bridge column, DRA was conducted. As expected, larger deformations of the bridge column were observed if the vehicle velocity and slenderness ratio were both increased. Using the bridge columns in the categories of response high and response moderate under vehicle impact, fragility curves were proposed using statistical data of material strength and the few results of the numerical analysis.
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40

Wang, Jun, Weiwei Wu, Xudong Wang, Min Wang, and Fuan Wu. "An effective GC method for the determination of the fatty acid composition in silkworm pupae oil using a two-step methylation process." Journal of the Serbian Chemical Society 80, no. 1 (2015): 9–20. http://dx.doi.org/10.2298/jsc140401073w.

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In search of an accurate and effective method to determine fatty acid composition in silkworm pupae oils, five methylation methods were evaluated for use in the gas chromatographic (GC) quantitation of fatty acid methyl esters (FAMEs), including one-step esterification catalyzed by an acidic (H2SO4 and BF3) or alkali catalyst (KOH and NaOCH3) and a two-step procedure catalyzed successively by KOH and H2SO4. These methods were comparatively adopted to quantify FAMEs in silkworm pupae oil using GC-MS and GC and then validate their precision, stability and average recovery rates. The results indicated that compared with the other four methyl esterification methods, two-step methylation effectively improves the synthesis yield of FAMEs, conserves agents, and eliminates the usage of potential harmful reagents. The proposed GC method has been validated, shows good accuracy and precision, and has been applied successfully to the quantification of FAMEs in several varieties of silkworm pupae oils. The short analytical run time leads to low costs and a fast chromatographic procedure. In summary, two-step pretreatment had superior performance, providing technical references for the determination and analysis of fatty acids in other oils.
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41

Wang, Qian, Xia-li Liao, Cheng Xiang, and Jian Yang. "A Practical Synthesis of the Flavone, Scutellarein." Journal of Chemical Research 41, no. 3 (March 2017): 157–59. http://dx.doi.org/10.3184/174751917x14873588907765.

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A practical and economical five-step synthesis of the flavone scutellarein has been achieved in 60% overall yield using the available and cheap 2,6-dimethoxy-1,4-benzoquinone as starting material. The reaction sequence involved reduction to the corresponding quinol, Friedel-Crafts acetylation, Claisen-Schmidt condensation with p-methoxybenzaldehyde, cyclisation and demethylation. The procedure is operationally simple and amenable to scale-up synthesis.
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42

Alzate-Marin, Ana Lilia, Marcela Corbo Guidugli, Hilda Hildebrand Soriani, Carlos Alberto Martinez, and Moacyr Antônio Mestriner. "An efficient and rapid DNA minipreparation procedure suitable for PCR/SSR and RAPD analyses in tropical forest tree species." Brazilian Archives of Biology and Technology 52, no. 5 (October 2009): 1217–24. http://dx.doi.org/10.1590/s1516-89132009000500020.

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An efficient and rapid DNA minipreparation modified method for frozen samples was developed for five tropical tree species: Copaifera langsdorffii, Hymenaea courbaril, Eugenia uniflora, Tabebuia roseo alba and Cariniana estrellensis. This procedure that dispenses the use of liquid nitrogen, phenol and the addition of proteinase K, is an adaptation of the CTAB-based DNA extraction method. The modifications included the use of PVP to eliminate the polyphenols, only one chloroform-isoamyl alcohol step and the addition of RNase immediately after extraction with chloroform. The yields of the DNA samples ranged from 25.7 to 42.1 µg from 100 mg leaf tissue. The DNA samples extracted by this method were successfully used for PCR (SSR and RAPD) analyses in these five and other twelve tropical tree species.
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43

Huynh, Nhan Thanh Thien, Kyung Won Lee, Jin Ku Cho, Yong Jin Kim, Se Won Bae, Jong Shik Shin, and Seunghan Shin. "Conversion of D-fructose to 5-acetoxymethyl-2-furfural Using Immobilized Lipase and Cation Exchange Resin." Molecules 24, no. 24 (December 17, 2019): 4623. http://dx.doi.org/10.3390/molecules24244623.

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5-Acetoxymethyl-2-furfural (AMF) was prepared from D-fructose via 1,6-diacetylfructose (DAF) through a simple two-step reaction pathway. Immobilized enzyme (Novozym 435) was found to be the best enzymatic catalyst for the trans-esterification step (yielding 94.6% DAF). In the dehydration step, while soluble H2SO4 was found to be the best acidic catalyst (yielding 86.6% AMF), we opted to utilize heterogeneous cation exchange resin (Amberlyst 15) together with recyclable industrial solvents (1,4-dioxane) for a more sustainable AMF synthesis procedure. Although the total yield of AMF was a little lower, both the enzyme and the solid acid catalyst could be recycled for five cycles without a significant loss of activity, which has a major contribution to the cost-efficient aspect of the entire process.
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44

Leandri, Massimo, and Alberto Gottlieb. "Trigeminal evoked potential—monitored thermorhizotomy: a novel approach for relief of trigeminal pain." Journal of Neurosurgery 84, no. 6 (June 1996): 929–39. http://dx.doi.org/10.3171/jns.1996.84.6.0929.

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✓ This paper presents a complete method for performing trigeminal thermorhizotomy, guided by neurophysiological data, to relieve tic douloureux. The method involves the use of trigeminal evoked potentials (TEPs) produced by stimulation of the supraorbital, infraorbital, and mental nerves and recorded from electrodes at both the scalp and the trigeminal nerve. To perform the thermorhizotomy, a cannula is modified to produce a concentric bipolar electrode that is suitable for both recording and lesion making. The operating procedure is divided into five steps: Step 1, recording of baseline scalp TEPs from the derivation of the cervical vertex to C-7 to ensure that all stimulating electrodes are correctly placed; Step 2, recording of TEPs from the trigeminal electrode after stimulation of the peripheral nerve trunks to ascertain the electrode's position relative to the root bundles; Step 3, fine positioning of the trigeminal electrode by recording the root activity evoked by stimulation of cutaneous trigger points or of the most painful areas; Step 4, assessing the position of the trigeminal electrode relative to the motor root by stimulating the nerve via the electrode and observing the masseter motor responses; and Step 5, recording scalp TEPs immediately before and after each thermolesion. Thermolesions are made until the scalp-recorded wave W2 decreases its amplitude by 20% to 50% of the original value or until it is delayed by 0.30 msec. This procedure has the potential to enable extremely precise monitoring of the position of the trigeminal electrode relative to the activated fibers and provides very effective monitoring of the extent of the lesion. The authors have performed this procedure with very satisfactory results in 30 patients with trigeminal neuralgia in the second branch.
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45

García-Ureña, Miguel Ángel, Javier López-Monclús, Daniel Melero-Montes, Luis Alberto Blázquez-Hernando, Camilo Castellón-Pavón, Enrique Calvo-DurÁN, Federico Gordo-Vidal, and Luis Felipe Aguilera-Del Hoyo. "Video-assisted Laparoscopic Débridement for Retroperitoneal Pancreatic Collections: A Reliable Step-up Approach." American Surgeon 79, no. 4 (April 2013): 429–33. http://dx.doi.org/10.1177/000313481307900434.

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Several minimal access routes have been implemented as a step-up approach to treat infected pancreatic necrosis. We evaluate our experience with a series of consecutive patients with pancreatic collections treated with video-assisted retroperitoneal débridement (VARD). Seven patients were consecutively treated with VARD: five patients after acute necrotizing pancreatitis, one chronic pancreatitis, and one patient with perforation after endoscopic sphincterotomy. The indication for VARD was: development of sepsis, positive direct culture of the necrosis, and compartment syndrome. The procedure was performed under general anesthesia and modified lateral decubitus. There were four left, two right, and one bilateral VARD. Mean hospital stay since admission to VARD procedure was 30 days (range, 12 to 72 days). Mean operative time was 63 minutes. There were no intraoperative complications. Two patients needed a second procedure to control sepsis. Most patients had a long intensive care unit (ICU) stay with 6.1 days (range, 2 to 22 days) mean postoperative ICU stay. One patient had a hypernatremia as a consequence of saline lavage and three patients presented pancreatic fistula that were managed with conservative treatment. There was no mortality. VARD approach is a recommended step-up approach to treat infected pancreatic necrosis, and its indication may be extended to treat other retroperitoneal collections.
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46

Vaidya, H. C., B. A. Wolf, N. Garrett, W. J. Catalona, R. V. Clayman, and M. H. Nahm. "Extremely high values of prostate-specific antigen in patients with adenocarcinoma of the prostate; demonstration of the "hook effect"." Clinical Chemistry 34, no. 10 (October 1, 1988): 2175–77. http://dx.doi.org/10.1093/clinchem/34.10.2175.

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Abstract We reviewed 721 consecutive samples submitted for measurement of prostate-specific antigen (PSA) over five months. We identified three patients with extremely high PSA concentrations: 650, 1840, and 3280 micrograms/L (their acid phosphatase activities were 3.2, 1337, and 2.8 U/L, respectively), and present case reports for the latter two. Serial dilutions of samples obtained from the patient with the highest PSA concentration indicated that the one-step Tandem-PSA assay gave falsely low values for high concentrations of PSA, an observation consistent with the phenomenon of the "hook effect." This effect was not observed when the sample was reanalyzed for PSA by a two-step procedure.
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47

Chu, Chen-Yao, and Tzu-Hsing Ko. "Evaluation of Acid Leaching on the Removal of Heavy Metals and Soil Fertility in Contaminated Soil." Journal of Chemistry 2018 (June 4, 2018): 1–8. http://dx.doi.org/10.1155/2018/5036581.

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Heavy metal-contaminated soils were leached with various acid reagents, and a series of treatments was assessed to understand soil fertility after acid leaching. Aqua regia digestion and a five-step sequential extraction procedure were applied to determine heavy metal distribution. The average total concentrations of Zn, Cd, Cu, and Pb for contaminated soil were 1334, 25, 263, and 525 mg·kg−1 based on the ICP/AES quantitative analysis. Other than Pb extracted by H2SO4, over 50% removal efficiency of other heavy metals was achieved. A five-step sequential extraction revealed that the bound-to-carbonate and bound-to-Fe-Mn oxides were the major forms of the heavy metals in the soil. The addition of organic manure considerably promoted soil fertility and increased soil pH after acid leaching. Seed germination experiments demonstrated that after acid leaching, the soil distinctly inhibited plant growth and the addition of manure enhanced seed germination rate from 35% to 84%. Furthermore, the procedure of soil turnover after acid leaching and manure addition greatly increased seed germination rate by 61% and shortened the initial germination time. Seed germination in untreated soil was superior to that in acid-leached soil, illustrating that the phytotoxic effect of acid leaching is more serious than that of heavy metals.
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48

Farsa, Oldřich, Milan Dockal, Jana Kováciková, and Mária Benesová. "Synthesis of 2-{[2-(2-oxo-1-azacycloalkyl)acetamido]phenoxy}acetic acids and their activity as aminopeptidase M inhibitors." Journal of the Serbian Chemical Society 73, no. 8-9 (2008): 771–80. http://dx.doi.org/10.2298/jsc0809771f.

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A series of 9 phenoxyacetic acids substituted in the o-, m-, and p-position of benzene ring with 2-(2-oxo-1-azacycloalkyl)acetamidic moiety containing 5-7-membered ?-lactam ring was prepared by a 4-step synthetic procedure. Five selected substances of this series were tested in vitro for inhibition of porcine kidney aminopeptidase M. 2-{4-[2-(2-Oxoperhydroazepin-1-yl)acetamido]phenoxy}acetic acid exhibited the highest activity with Ki = 243.6 ?M.
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49

Vosa, Carlo, Paolo Arciprete, Giuseppe Caianiello, and Gaetano Palma. "Pulmonary atresia with intact ventricular septum: Is it possible to improve survival?" Cardiology in the Young 2, no. 4 (October 1992): 391–94. http://dx.doi.org/10.1017/s1047951100008003.

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SummaryBetween February 1986 and December 1991, 41 patients with pulmonary atresia and intact ventricular septum were treated in our institution following a multistage protocol of management. In all cases, the first step was to construct a right modified Blalock-Taussig shunt during the neonatal period regardless of the right ventricular anatomy. Then, in patients with well-developed right ventricles possessing all three components, we proceeded to early surgical repair. In contrast, in patients with right ventricles having obliteration of some components, yet deemed to be recoverable, the next step was to provide palliative relief of obstruction in the right ventricular outflow tract followed, if possible, by subsequent repair. Fontan's operation was performed in patients with right ventricles considered unsuitable from the outset to support the pulmonary circulation. Only one patient died following the initial shunt procedure (mortality of 2.43%). The subsequent program of treatment has now been concluded in 22 patients. In all those deemed to have favorable native anatomy (10 cases), the subsequent complete repair was successful. Among the 24 patients who required palliation of the outflow tract, five died while total repair was subsequently performed in eight. Fontan's operation was performed without mortality in five patients with small right ventricles, although one patient died while waiting for surgery. In all, 89 procedures were performed with an overall mortality of 14%.
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50

Sari, Mustafa Erkan, Ibrahim Yalcin, Hanifi Sahin, Mehmet Mutlu Meydanli, and Tayfun Gungor. "“Three-Step Approach” Versus “See-and-Treat Procedure” in women with “High Grade Squamous Intraepithelial Lesion” (HSIL) or “Atypical Squamous Cells cannot exclude HSIL” (ASC-H) Cytology." Gynecology Obstetrics & Reproductive Medicine 24, no. 3 (December 25, 2018): 151. http://dx.doi.org/10.21613/gorm.2017.743.

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<p><strong>Objective:</strong> The purpose of this study was to examine the correlation between histological findings in women with HSIL or ASC-H who have undergone loop electrosurgical excisional procedure with “Three-Step Approach” and “See-and-Treat Procedure".</p><p><strong>Study Design:</strong> A retrospective review was performed in 171 women with cytologically detected HSIL or ASC-H. Sixty five women with HSIL cytology and 35 women with ASC-H cytology were managed by “Three-Step Approach”, 35 women with ASC-H and 36 women with HSIL cytology were managed by "See-and-Treat Procedure”. Rates of histopathological findings were compared in two strategies with respect to previous cytology.</p><p><strong>Results:</strong> Fifteen women with ASC-H (42.9%), and 24 women with HSIL (68.5%) had CIN 2-3 at loop electrosurgical excisional procedure specimens in the “See-and-Treat” group whereas 14 women with ASC-H (38.8%), and 43 women with HSIL (66.2%) had CIN 2-3 at loop electrosurgical excisional procedure specimens in the “Three-Step Approach” group. There was no significant difference in the rate of CIN 2+ lesions when two strategies were compared in women with HSIL and ASC-H (p=0.71 and p=0.72, respectively). The overtreatment rates were 22.9% and 48.6% for HSIL and ASC-H cytology, respectively in the “See and Treat” group.</p><p><strong>Conclusion:</strong> In the ASC-H group, the rate of CIN 2+ lesions is significantly high (51.4%). It seems rational to perform “See-and-Treat procedure” in the setting of ASC-H smears although the overtreatment rate seems to be high. Because of the rate of overtreatment, the “Three-Step Approach” seems to be more reasonable in women with ASC-H cytology who also have fertility concerns. After a cytological diagnosis of HSIL, “see and treat” approach seems to be a safe and time saving strategy.</p>
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