bluuebunny/crossref_metadata_2025 huggingface dataset:
Mapping exposed and buried lava flows using synthetic aperture and ground-penetrating radar in Craters of the Moon lava field
Authors: Khan Shuhab D. , Heggy Essam , Fernandez Jaime
Published: November 2007

The Craters of the Moon (COM) lava field has a multiple eruptive history. Burial of older flows has resulted in complex subsurface stratigraphy. For the older eruptive periods, the locations of source vents and the extension of lava flows are either speculative or unknown, because they are buried under more recent pyroclastics. In this study, we used surface and subsurface backscatter characteristics of the P- and L-band polarimetric airborne synthetic aperture radar (AIRSAR) data and ground-penetrating radar (GPR) soundings to resolve different exposed and buried lava flows. Our primary objective is to define the most effective polarization and frequency for mapping, resolving, and characterizing different lava types in the volcanic field. Polarimetric analysis of AIRSAR images from COM allows a clear recognition of the aa and pahoehoe lava types as a result of the variability in their roughness. Our results suggest that the HV cross-polarized, AIRSAR L-band is capable of producing a detailed map delineating surface lava with different surface backscattering properties. An accuracy assessment utilizing the geological map of the Inferno Cone area was performed to quantify the reliability of differentiating lava types and mapping the lava flows extension below loose pyroclastics using AIRSAR data. Results shows an ability of P-band SAR to map buried structures up to 3 meters deep under loose cinder and ash deposits, resolving buried fissures, outcrops, and lava flows that were validated with ground-truth GPR surveys. The techniques used in this study provide a tool to assess volcanic hazards in remote and inaccessible places. Also it could be an aid in the study of other planets and planetary bodies in the solar system.
This issue of GEOPHYSICS
Authors: Sun Yonghe
Published: November 2007

In this article, the Editor of Geophysics provides an overview of all technical articles in this issue of the journal.
‘Anti‐Aging Medicine’ and the Cultural Context of Aging in Australia
Authors: CARDONA BEATRIZ
Published: November 2007

Abstract:  This paper explores the management of the aging body within the anti‐aging discourse and its implications on notions of “successful” and “healthy” aging policies. By looking at some of the preliminary findings of our current study of ‘anti‐aging medicine’ in Australia, including interviews conducted with stakeholders in the anti‐aging debate, this study explores some recurrent values and perceptions regarding ‘anti‐aging medicine,’ the renegotiation of boundaries between illness and health, and the social, cultural, and economic forces shaping understandings and practices around aging and decisions to use anti‐aging technologies.
Are We Getting Healthier As We Grow Older?
Authors: SCHOFIELD DEBORAH J. , PASSEY MEGAN E. , EARNEST ARUL , GLOOR IAN C. , SHRESTHA RUPENDRA
Published: November 2007

Abstract:  The Intergenerational Report (IGR) released by the Department of the Treasury of the Commonwealth of Australia in 2002 highlighted pressures that in the future would threaten the sustainability of the Australian government's budget balance. These pressures result from the growing needs of an aging population and labor shortages that will limit economic growth and taxation revenue. The IGR has become a driving force in planning government policy. The Treasurer has recently said that “the whole economic agenda of the government at the moment is drawn from the IGR.” In response, the Prime Minster and Treasurer have promoted deferred or gradual retirement as part of the solution. However, about 50% of men and 20% of women retire early as a result of ill health, indicating that poor health is potentially a limiter of economic growth. This paper reports lower labor force participation among persons with poorer health and that these persons move out of the labor force at a faster rate as they age. A range of measures suggests some decline in health in the pre‐retirement age group (those aged from 40 to 64 years).
This indicates that better health may be a facilitator of greater labor force participation in the baby boomer cohort. However, there is evidence that improving economic conditions in Australia leading to low unemployment has created an environment more favorable to the employment of older workers with health problems as there has been a rise in labor force participation in these groups, and measures to prevent chronic disease may further increase the employment prospects.
Patients with Dementia and Their Carers
Authors: BRIDGES‐WEBB CHARLES , GILES BELINDA , SPEECHLY CATHERINE , ZURYNSKI YVONNE , HIRAMANEK NAVAZ
Published: November 2007

Abstract:  Clinical guidelines for general practitioners' care of patients with dementia still living in the community (not in hostels or nursing homes) were used in an educational program for general practitioners. At the same time information was obtained about the current health status, needs, and management of such patients and their carers. Eight general practitioners audited a total of 25 patients. Carer questionnaires were returned from 30 carers recruited by the general practitioners and 77 recruited by Alzheimer's Australia NSW. Many of the audit results are as expected, but some raise important issues. The diagnosis was not fully established for 20% of patients and the MMSE score not known by the general practitioner for 56%. Home safety had not been assessed for 44%. Legal matters such as driving or guardianship had not been considered for more than half. Most carers felt supported by their general practitioner in their role as carer, but services that would have been useful were not available to 23%, and most felt that being a carer had affected their own health. The small number of participants means that the audit results come from too few general practitioners to be reliably representative, but they do provide an indication of likely general results, and indicate priority areas for improved care.
A Management‐Control System to Assist with the Development, Contracting, and Monitoring of New Services for Older People
Authors: JACOBS STEPHEN
Published: November 2007

Abstract:  Implementing community services can be a very complex process where people end up “not seeing the wood for the trees” and then accepting a compromise nobody wants. Neither agency theory nor stewardship theory is particularly robust when explaining the reality that funders and managers of community health service for older people face in managing contracts. There are particular difficulties with goal divergence between policy directives and implementation practices, which result from goals not being well understood and performance requirements being ambiguously defined and infrequently monitored. This leads to accountability issues for public managers, and raises efficiency and effectiveness issues. This paper provides an interim report on a project developing a management‐control system to provide a process for health planners and funders to use when developing and contracting services. A major focus is inviting stakeholders into a process of communication that ensures that they have shared understandings of where they want to get to, and what has to be done to get there.
Age‐Related Changes in Strength and Somatosensation during Midlife
Authors: LOW CHOY NANCY L. , BRAUER SANDRA G. , NITZ JENNIFER C.
Published: November 2007

Abstract:  Age‐related changes in strength and somatosensation have a negative impact on balance with advanced age. Knowledge of the decades of life when strength and somatosensation show initial and subsequent reductions could inform balance assessment and targeted preventive intervention. We report a cross‐sectional study investigating strength and somatosensation of 316 healthy women aged 20–80 years. Demographics, health profile, and activity level were recorded. Strength of quadriceps, hip abductors and adductors, and lower limb somatosensation (tactile acuity, vibration threshold, and joint position error) were measured. Significant age‐related changes in strength and somatosensory function were identified, even when demographic variables of activity level, weight, number of reported conditions, medications used, and history of falls were included as covariates. Tested muscles achieved peak force in women in their 40s and then trending reductions presented for those in their 50s and 60s, with significant reductions by the 70s. Tactile acuity, vibration sensitivity, and joint position sense for a non–weight‐bearing toe‐matching task were significantly reduced by the 40s or 50s, with further reductions by either the 60s or 70s. For the weight‐bearing replication task, joint position error was significantly increased by the 60s. A main effect of activity level and body weight was identified for strength measures, and weight also had a main effect for most of the somatosensory modalities. These findings can inform health professionals to use knowledge of early and any subsequent reductions in muscle strength and somatosensation, along with effects of demographics, to develop targeted, innovative programs across the mid‐life, a preclinical change period for balance, to promote healthier aging.
The New Caring
Authors: TILSE CHERYL , WILSON JILL , SETTERLUND DEBORAH , ROSENMAN LINDA
Published: November 2007

Abstract:  Increasing longevity and the growing proportion of the aged in the population in most countries have served to focus on the question of how governments and older people can finance living, health, and care options in retirement. Prudent management of income and assets is an increasingly complex and important aspect of aging as assets and expectations of self‐financing increase. Although many informal caregivers act as asset managers and/or substitute decision‐makers for older people, little attention has been paid to this increasingly important aspect of care. This paper summaries key findings of a broad research program exploring family involvement in the management of older people's assets and the practices that constitute good practice as well as financial mismanagement and abuse. It identifies multi‐level and multi‐strategy responses needed to address the issues raised by the research and outlines an innovative community demonstration project aimed at improving financial management practices in relation to older people's assets.
Living Well until You Die
Authors: SMALL NEIL
Published: November 2007

Abstract: The incidence and prevalence of dementia across the world is increasing, carrying crucial implications for the discourse about healthy aging and longevity. For such a discourse to progress, it must engage with the challenge of dementia. If we live into our 80s, then every fifth one of us will have dementia. Of the four who do not, another one is likely to be sharing their life with someone who does. Existing care regimes have failed to consistently act upon best practice in dementia care. That best practice can be pursued via mutual learning between palliative care and person‐centered dementia care. Even with cognitive disability and life‐limiting illness, it is possible to live well, and it should be an imperative that people be supported to have a better quality of life than they do now. Implementing evidence‐based best practice is not enough—it is also necessary to engage with social attitudes toward dementia. Otherwise there is the danger that a significant proportion of older people will be marginalized from a newly emerging ontology of old age.
The Role of Autophagy in Aging
Authors: BERGAMINI ETTORE , CAVALLINI GABRIELLA , DONATI ALESSIO , GORI ZINA
Published: November 2007

Abstract:  Aging denotes a postmaturational deterioration of cells and organisms with the passage of time, an increased vulnerability to challenges and prevalence of age‐associated diseases, and a decreased ability to survive. Causes of this deterioration
may be found in an enhanced production of reactive oxygen species (ROS) and oxidative damage and incomplete “housekeeping.” Caloric restriction is the most robust anti‐aging intervention known so far. Similar beneficial effects on median and maximum life span were obtained by feeding animals a 40%‐reduced diet or by every‐other‐day ad libitum feeding. In both instances, animals are forced to spend a great part of their time in a state of fasting and activated autophagy. Autophagy is a highly conserved process in eukaryotes, in which the cytoplasm, including excess or aberrant organelles, is sequestered into double‐membrane vesicles and delivered to the lysosome/vacuole, for breakdown and eventual recycling of the resulting macromolecules. This process has an essential role in adaptation to fasting and changing environmental conditions, cellular remodeling during development, and accumulation of altered ROS‐hypergenerating organelles in older cells. Several pieces of evidence show that autophagy is involved in aging and is an essential part of the anti‐aging mechanism of caloric restriction. As an application, intensification of autophagy by the administration of an antilipolytic drug rescued older cells from accumulation of altered mtDNA in less than 6 hours. It is concluded that the pharmacologic intensification of autophagy (PISA treatment) has anti‐aging effects and might prove to be a big step toward retardation of aging and prevention of age‐associated diseases in humans.
Potential Roles for Estrogen Regulation of Telomerase Activity in Aging
Authors: BAYNE SHARYN , JONES MARGARET E.E. , LI HE , LIU JUN‐PING
Published: November 2007

Abstract:  Estrogen regulates tissue development, function, and aging by regulating expression of critical genes. Recent studies suggest that estrogen promotes cell proliferation by stimulating telomerase activity, an enzyme that plays a key role in extending cell life span. In some estrogen‐responsive tissues, estrogen appears important in regulating telomerase activity in vivo. Further characterization will provide a greater understanding of the link between estrogen, telomerase, and aging.
Lifestyle of the Elderly in Rural and Urban Malaysia
Authors: SELVARATNAM DORIS PADMINI , TIN POO BEE
Published: November 2007

Abstract:  Malaysia is steadily progressing toward an aging population demographic pattern. While aging is a natural process, its impact can be painful individually as well as for the nation. Individually there is a loss of a paying job after retirement, loss of physical and mental fitness, and also occasionally the loss of social integration due to lack of mobility. For a nation, an aging population means a growing dependency ratio, a greater need of care, and more medical facilities for this age group. This article looks at the various economic and social implications of the aging population in Malaysia in general, and in the rural and urban setting specifically. The paper focuses on a research sample of 132 (66 rural, 66 urban) elderly persons. The findings suggest that the demographic patterns of the elderly vary from the rural to the urban setting, with differing issues that need to be addressed to alleviate problems encountered related to loneliness, lack of financial stability, and emotional strain. Policy suggestion will be geared toward providing a solution to problems at hand as well as aiding the working group members to prepare and sustain a comfortable livelihood for the aged in their later years.
Fit and Well at Eighty
Authors: BYLES JULIE E.
Published: November 2007

Abstract:  While aging is associated with physical decline and increased risk of illness, older age is not inevitably a time of ill‐being. Data from the Australian Longitudinal Study on Women's Health challenge negative stereotypes of aging and illness. While an accelerating decline in average physical health was observed over the first 6 years of the study, an important and large proportion of the women experienced minimal change in their physical health during this period. Also, while chronic disease was a strong risk factor for declining health, many women aged well in spite of longstanding medical conditions. This paper presents trends in health and illness as women age and explores some of the many physical, social, and healthcare factors that mark out those women who remain “fit and well.”
Complementary and Alternative Medicine Use by Older Australians
Authors: ZHANG ANTHONY L. , XUE CHARLIE C. L. , LIN VIVIAN , STORY DAVID F.
Published: November 2007

Abstract:  Complementary and alternative medicine (CAM) use by Australians is substantial and increasing, but little is known about its use by the elderly. We here present the findings for the elderly cohort in our recently conducted national survey on CAM use by adult Australians. In May and June 2005, computer‐assisted telephone interviews, using random‐digit telephone dialing, were employed to gather data on CAM use in the last 12 months. Of 1067 adult participants interviewed, 178 were 65 or older. More than half of these (57.8%; 95% CI, 50.7%–64.9%) had used at least one of 17 common forms of CAM and 60.4% of the CAM users had consulted CAM practitioners. Clinical nutrition, chiropractic, massage therapy, meditation, and herbal medicine were the most common forms of CAM used by the elderly. A higher proportion of the elderly had always used both CAM and conventional medical treatments (37.9%) than had those aged 18–34 (15.7%) and 35–64 (26.9%). Elderly CAM users (60.2%) were more likely than younger users to discuss their use with their doctors. Of those who did not do so, 24.1% were not asked by their doctors and 16.0% considered that their doctor would disapprove. In conclusion, we found that a substantial proportion of older Australians use CAM. The elderly are also more likely than younger adults to discuss their use of CAM with their doctors, but doctors need to play a more active role in initiating such communication.
Community Attitudes to the Regulation of Life Extension
Authors: UNDERWOOD MAIR , BARTLETT HELEN , HALL WAYNE
Published: November 2007

Abstract:  Technologies purported to extend human life are already being marketed widely, and are being used by community members, despite a lack of evidence on their efficacy or safety: in fact, the use of some putative anti‐aging technologies (e.g., human growth hormone) is illegal. Existing regulation is proving to be ineffective, especially in the face of Internet sales. Further advances in the field of life extension are a distinct possibility, exacerbating the need for a policy response. This paper presents the preliminary results of a study of community attitudes to life extension, with a focus on attitudes to the control and availability of strong life‐extending technologies.
Building an Infrastructure to Prevent Falls in Older Californians
Authors: ROSE DEBRA J. , ALKEMA GRETCHEN E. , CHOI IN HEE , NISHITA CHRISTY M. , PYNOOS JON
Published: November 2007

Abstract:  The Fall Prevention Center of Excellence (Center), a consortium of federal, state, and private organizations, was established in 2005 to guide the implementation of a statewide initiative to prevent falls among older Californians. The process began with the convening of a representative group of recognized leaders in California's health and human services in 2003. This group engaged in a 2‐day strategic planning process that culminated in the development of the California Blueprint for Fall Prevention. The overarching goal of the Blueprint is to build a statewide infrastructure for fall prevention services and programs that will serve as a model for the rest of the country. The specific goals of the Center are to establish fall prevention as a key public health priority in California; create, test, and evaluate effective and sustainable fall prevention programs; and build a comprehensive and sustainable fall prevention system in California. To accomplish these goals, the Center is currently engaged in developing and disseminating fall prevention tools and informational resources directed at the needs of both consumer and professional audiences; linking organizations involved in fall prevention while increasing awareness of fall prevention as an important public health issue; and helping communities build their capacity to effectively address falls in older adults through the delivery of integrated fall prevention services and “best practice” programs.
Dietary Polyunsaturated Fatty Acids and Age‐Related Membrane Changes in the Heart
Authors: PEPE SALVATORE
Published: November 2007

Abstract:  Age‐associated modification of cardiac membrane composition and related metabolic processes are major factors underlying the reduced capacity for invoking intrinsic cardioprotective survival mechanisms. In this brief review we examine some of these key membrane lipid modifications, which include alterations in the type and proportion of long–carbon chain polyunsaturated fatty acids (PUFAs). These changes have profound consequences on the efficacy of membrane proteins and lipids involved with numerous processes including ion homeostasis, intracellular signal transduction, free radical metabolism, and mitochondrial energy production. The resultant postoxidative modification of lipids, proteins, and DNA leads to a reduction in capacity for repair and ultimately worsening cellular dysfunction. However, some age‐related detrimental adaptations may be counteracted by selectively manipulating membrane lipid and protein composition via dietary treatment with key omega‐3 PUFAs. Such pervasive treatment results in manipulation of cellular function at multiple levels from cell membrane to the genome.
Pursuing the Longevity Dividend
Authors: OLSHANSKY S. JAY , PERRY DANIEL , MILLER RICHARD A. , BUTLER ROBERT N.
Published: November 2007

Abstract:  The aging of humanity is about to experience a radical change as the demographic transformation to an older world is approaching its final stage. In recent decades, scientists have learned enough about the biological aging processes that many believe it will become possible to slow aging in humans. We contend that the social, economic, and health benefits that would result from such advances may be thought of as “longevity dividends,” and that they should be aggressively pursued as the new approach to health promotion and disease prevention in the 21st century. The time has arrived for governments and national and international healthcare organizations to make research into healthy aging a major research priority.
Significance of Multifocality in Ductal Carcinoma In Situ: Outcomes of Women Treated With Breast-Conserving Therapy
Authors: Rakovitch Eileen , Pignol Jean-Philippe , Hanna Wedad , Narod Steven , Spayne Jacqueline , Nofech-Mozes Sharon , Chartier Carole , Paszat Lawrence
Published: November 2007

Purpose

There is concern that women with multifocal ductal carcinoma in situ (DCIS; confined to one quadrant) who are treated with breast-conserving surgery face a high risk of local recurrence; therefore, many are treated with mastectomy. The objective of this study is to evaluate the significance of multifocality and the outcomes of women with multifocal DCIS treated with breast-conserving therapy.

Methods

The records of patients treated with breast-conserving surgery for DCIS between 1982 and 2000 were reviewed. Multivariate analyses were performed to evaluate the effects of multifocality and other prognostic factors on the rate of local recurrence.

Results

Of 615 cases of DCIS reviewed, 310 (41%) received breast-conserving surgery and 305 (40%) received breast-conserving surgery plus radiation (n = 260 with multifocality, n = 314 without multifocality, and n = 31 focality unreported). On multivariate analysis, multifocality (hazard ratio [HR] = 1.80; 95% CI, 1.15 to 2.80; P = .01), radiation treatment (HR = 0.46; 95% CI, 0.29 to 0.74; P = .001), margin width 4 mm or smaller (HR = 1.74; 95% CI, 1.03 to 2.92; P = .04), and high nuclear grade (HR = 1.65; 95% CI, 1.02 to 2.65; P = .04) were associated with risk of local recurrence. The detrimental effect of multifocality was limited to women who did not receive radiotherapy; the local recurrence–free survival rate at 10 years was 59% for women with multifocal disease and 80% for women without multifocality (P = .02). Among women treated with breast-conserving surgery plus radiation, there was no difference in 10-year local recurrence–free survival (80% v 87%; P = .35). There was no association between multifocality and the development of invasive recurrence.

Conclusion

Multifocality is a significant predictor of local recurrence in women who receive breast-conserving surgery for DCIS without radiotherapy; however, low recurrence rates can be achieved if adjuvant radiation is administered.
Involved-Field Radiation Therapy for Inoperable Non–Small-Cell Lung Cancer
Authors: Rosenzweig Kenneth E. , Sura Sonal , Jackson Andrew , Yorke Ellen
Published: November 2007

Purpose

Dose escalation has been shown to improve local control in non–small-cell lung cancer (NSCLC) treated with definitive radiation therapy, but with increased complications. We implemented the use of involved-field radiotherapy (IFRT) in an effort to reduce toxicity while treating the gross tumor to higher doses. This analysis reports failure rates in uninvolved nodal regions with the use of IFRT.

Patients and Methods

A total of 524 patients with NSCLC treated with three-dimensional conformal radiotherapy at Memorial Sloan-Kettering Cancer Center between 1991 and 2005 were reviewed. Only lymph node regions initially involved with tumor by either biopsy or radiographic criteria were included in the clinical target volume. Elective nodal failure (ENF) was defined as a recurrence in an initially uninvolved lymph node in the absence of local failure.

Results

Only 32 patients (6.1%) with ENF were identified. The 2-year actuarial rates of elective nodal control and primary tumor control were 92.4% and 51%, respectively, with a median follow-up of 41 months in survivors. In patients who achieved local disease control, the 2-year elective nodal control rate was 91%. The median time to ENF was 6 months (range, 0 to 56 months). Many patients experienced treatment failure in multiple lymph node regions simultaneously.

Conclusion

The use of IFRT did not cause a significant amount of failure in lymph node regions not included in the tumor volume. Therefore, IFRT remains an acceptable method of treatment that allows for dose escalation while minimizing toxicity.
A True Virtualized Infrastructure for Grid Computing
Authors: Rasool Raihan Ur , Qingping Guo
Published: November 2007

Grid technology allows organizations to utilize numerous computers to solve problems by sharing computing resources. At its current stage, grid computing is still not broadly accessible to non-computing users and continues to be user unfriendly. A normal user spends too much time on procedures for accessing a resource and too little time on using the resource itself. So abstraction of various Grid capabilities is needed. In this paper we have presented a virtualized infrastructure which eliminates the concept of job-submission, and supplies the computing power invisibly. It includes a personal agent mediated resource trading system. A working prototype of one part of this project is ready and has been demonstrated here.
Juries and Extraneous Material: A Question of Integrity
Authors: Haralambous Nicola
Published: November 2007

This article challenges the unconditional faith seemingly placed on juries by the judiciary. Despite the prohibition on investigation into jury deliberations, a number of important cases have come to light which invite questions on the extent to which we can be sure that juries follow judicial directions. This article explores the recent case law in which juries may have relied upon extraneous material or other external influences and, finally, briefly compares such impropriety with the use of jurors with specialised knowledge.
"Go [expletive] a girl for me": Bivalent Meaning, Cultural Miscues and Verbal Play in Ukrainian Migrant Labor Stories
Authors: Dickinson Jennifer A.
Published: November 2007

Since the breakup of the Soviet Union, migrant labor has become an increasingly important source of income for workers in the southwest Zakarpattia region of Ukraine. This article explores how locally constructed meanings of migrant labor emerge through bilingual verbal play in narratives focused on cultural differences between Zakarpattia villagers' life at home and the situations and people they encounter abroad. In my analysis of jokes and humorous narratives about migrant labor gathered in the field I focus on narrators' use of bivalent and near‐bivalent words and phrases as a resource for the expression and representation of the complex relationship of villagers toward their position in the post‐socialist cultural, linguistic, and economic landscape.
Racing and Erasing the Playboy: Slang, Transnational Youth Subculture, and Racial Discourse in Brazil
Authors: Roth‐Gordon Jennifer
Published: November 2007

This article explores the complex negotiation of race, class, and space that surrounds the Brazilian Portuguese slang term 'playboy.' It is argued that youth use this slang term to grapple with transnational debates around race and to make sense of their nation's situation of stark inequality. Poor black male youth, in particular, use this social label to challenge their marginalization from the Brazilian nation‐state, constructing themselves as more empowered racial and political subjects. Yet their more controversial semantic shifts are reinterpreted by dominant society, erasing the race of the playboy and diffusing their critique of Brazil's alleged racial democracy.
Book Reviews
Authors: Augsburger Deborah
Published: November 2007

Medical Interpreting and Cross‐Cultural Communication. Claudia Angelelli. Cambridge: Cambridge University Press, 2004. 167 pp.
Book Reviews
Authors: Johnson J. Cale
Published: November 2007

The First Writing: Script Invention as History and Process. Stephen Houston, ed., Cambridge: Cambridge University Press, 2004. xvii. 417 pp.
Book Reviews
Authors: Manning Paul
Published: November 2007

. World of Others' Words: Cross‐Cultural Perspectives on Intertextuality. Richard Bauman. Malden, MA: Blackwell Publishing, 2004. ix. 184pp.
Book Reviews
Authors: Smith‐Hefner Nancy J.
Published: November 2007

Language, Identity, and Stereotype among Southeast Asian American Youth: The Other Asian. Angela Reyes. Mahwah. NJ: Lawrence Erlbaum Associates, Inc., 2007. xii. 183 pp.
Az álműtét és annak orvosi és etikai kérdéseir
Authors: Antal János
Published: November 2007

Absztrakt

Etikai érvekkel nem tartható álláspont az álműtétnek mint klinikai, vizsgálati, kontrollcsoportnak a kategorikus elutasítása.

A bevezetés előtt álló, új sebészeti eljárás esetében az evidencián alapuló orvoslás alapelveinek alkalmazásával kell eldönteni, hogy az adott invazív technika rendelkezik-e a megfelelő, tudományos bizonyítékokkal, valamint azt is, hogy az új, invazív eljárás objektív megítéléséhez az álműtétes csoport vagy más viszonyítási alap fogadható-e el. Az álműtéti csoporttal végzett klinikai vizsgálatok szakmai szükségszerűsége és orvosszakmai, etikai elfogadhatósága mindig eseti döntést igényel.

Az (álműtéttel) kontrollált sebészeti beavatkozás kockázatának megítélésekor mérlegre kell tennünk azt is, hogy mi a következménye annak, ha nem végzünk a szakmai szabályai szerinti, kontrollált vizsgálatot az invazív beavatkozás hatásosságának és biztonságosságának megállapítására.

Közös nevezőre lehet és kell hozni két alapvetően fontos orvosi feladatot: az egyén gyógyítását, valamint a közösség igényét a bizonyított, hatásos és biztonságos eljárásokra.
Extrém nagy hasfali sérvek előkészítése preoperatív pneumoperitoneum képzésévelr
Authors: Szekeres Pál , Krémer Ildikó , Bukovácz Róbert , Varga János
Published: November 2007

Absztrakt

A kifejezetten nagy hasfali sérvek gondos preoperatív előkészítésével megelőzhetők olyan posztoperatív szövődmények, mint az abdominal compartment syndroma, légzési elégtelenség, befolyásolhatatlan keringési elégtelenség. Osztályaink évek óta foglalkoznak az extrém nagy hasfali sérvekhez társuló kóros állapotok (eventration disease) vizsgálatával és a rekonstrukció okozta kóros zsigeri következmények-szövődmények megelőzésével. Két eset kapcsán mutatjuk be a progresszív preoperatív pneumoperitoneumképzés indikációját, technikáját és eredményeit.
Pneumonectomiát követően végzett pulmonalis metastasectomiákr
Authors: Vincze Károly , Balogh Gábor , Bátor Győző , Kecskés László , Patak Krisztina , Muskát Judit
Published: November 2007

Absztrakt

Szerzők 2 hazai mellkassebészeti osztályon malignus betegség miatt végzett pneumonectomiákat követő pulmonalis metastasectomiás gyakorlatukat ismertetik.

Hat beteget operáltak pneumonectomiát követően a residualis tüdőfélen észlelhető egy vagy több áttét miatt. A betegek átlagéletkora 52,5 év volt, köztük 3 férfi és 3 nő szerepelt. Ismertetik az alkalmazott diagnosztikai módszereket (mellkas-rtg, CT, MR, PET-CT, perfúziós tüdőscintigraphia, bronchologiai, terheléses légzésfunkciós és EKG-vizsgálat, szív-UH-, vérgáz- és laborvizsgálat). A műtétre történő kiválogatás érdemi onkológiai és cardiorespiratoricus kritériumainak felhasználásával döntöttek a műtétek elvégezhetőségéről. Ismertetik az alkalmazott műtéttechnikát (atípusos gépi resectio).

A műtétek után az intenzív ápolás tartama 3–7 nap volt (átlag 5 nap). A kórházi ápolás ideje 13–18 nap (átlag 15,2 nap). Egy beteg szorult átmeneti – 5 napig tartó – mesterséges gépi lélegeztetésre. Két elveszített betegük 18, illetve 25 hónappal élte túl a tüdőáttétel eltávolítását. A 4 jelenleg is élő beteg átlag túlélése 33,5 hónap. Onkológiai ellenőrzés, illetve kezelés alatt állnak, állapotuk, életvitelük megfelelőnek mondható.

A ritkán, nagyfokú szelekciót követő metastasectomiák sikerének titka a betegek teherbíró képességének gondos, egyénre szabott megtélése, melyben a betegek “thoracotomiaképes” állapota, stabil cardiopulmonalis funkciói, a residualis tüdőfél épsége meghatározó jelentőségű. A gyors, kíméletes atípusos gépi resectio, valamint az anaesthesiologiai és intenzív terápiás szakemberek összehangolt munkája vezethet sikerre, s adhat reményt a megoperáltak számára elfogadható életminőségű és időtartamú túlélésre.
Eventos adversos a antibióticos em pacientes internados em um hospital universitário
Authors: Louro Estela , Romano-Lieber Nicolina Silvana , Ribeiro Eliane
Published: November 2007

OBJETIVO: Antibióticos são os medicamentos que mais causam eventos adversos, gerando problemas aos pacientes e custos adicionais ao sistema de saúde. Assim, objetivou-se analisar a ocorrência de eventos adversos a antibióticos em pacientes internados em um hospital. MÉTODOS: Realizou-se monitoramento intensivo do uso de antibióticos em pacientes adultos internados no município de Maringá, Paraná, de setembro de 2002 a fevereiro de 2003. Foram pesquisadas variáveis relativas aos medicamentos em uso, em particular aos antibióticos e aos eventos adversos. Com base em critérios para a avaliação do uso correto dos antibióticos, os eventos observados foram classificados como reações adversas, erros de medicação e "quase erros". Para relação de causalidade entre a administração do fármaco e o surgimento dos eventos utilizou-se o algoritmo de Naranjo. RESULTADOS: Foram acompanhados 87 pacientes e identificados 91 eventos adversos, sendo três deles (3,3%) reações adversas a medicamentos, sete (7,7%) erros de medicação, e 81 (89,0%) "quase erros". As reações a medicamentos ocorreram devido ao uso de quinolonas e foram consideradas "prováveis" utilizando-se o algoritmo de Naranjo. Os sete erros de medicação ocorreram devido a quatro prescrições incorretas de dose e três interações medicamentosas. CONCLUSÕES: Os resultados sugerem que a falta de conhecimento do medicamento ou a falta de informação sobre o paciente no momento da prescrição tenham sido os principais fatores envolvidos na ocorrência das reações a medicamentos.
Neural network–genetic programming for sediment transport
Authors: Singh A. K. , Deo M. C. , Sanil Kumar V.
Published: November 2007

The planning, operation, design and maintenance of almost all harbour and coastal engineering facilities call for an estimation of the longshore sediment transport rate. This is currently and popularly done with the help of empirical equations. In this paper an alternative approach based on a combination of two soft computing tools, namely neural networks and genetic programming, is suggested. Such a combination was found to produce better results than the individual use of neural networks or genetic programming. The ability of the neural network to approximate a non-linear function coupled with the efficiency of the genetic programming to make an optimum search over the solution domain seems to result in a better prediction.
A simple method for estimating flood flow around bridges
Authors: Seckin G. , Haktanir T. , Knight D. W.
Published: November 2007

The software program HEC-RAS from the Hydrologic Engineering Center (HEC) of the US Army Corps of Engineers is probably one of the most commonly used methods in the world for computing water surface profiles in rivers. The energy method (one of the four bridge subroutines within HEC-RAS) computes the bridge backwater (the upstream surface increase) by applying standard step calculations five times from the end of the expansion reach up to the beginning of the contraction reach, using two different transition loss coefficients and different reach lengths. The aim of this study was to estimate the backwater in a less cumbersome and practical way, without sacrificing accuracy. A one-step energy method is suggested, based on a comprehensive set of laboratory bridge backwater data from compound channels. The proposed method gives an absolute mean error of 10% when applied to these laboratory data and an absolute mean error of 25% when applied to field data collected by the United States Geological Survey including actual flood profiles through many bridges.
Modelling water distribution systems with deficient pressure
Authors: Hayuti M. H. , Burrows R. , Naga D.
Published: November 2007

The pressure dependency of withdrawals from water distribution systems under conditions of abnormal stress, such as mains failure or fire fighting, is well accepted. A simple sequential solution seeking iterative approach to obtain a solution for pressure constrained outflows (including leakage) based on repetitive substitution into conventional computational algorithms, where demands are generally predetermined, has been developed. The methods are presently configured to use the computational efficiency and versatility of the widely used EPANET-2 software routine, offering the benefits of full network operational specifications at the level of ‘commercial’ network applications. Application of the new algorithm to UK water networks under various partial failure conditions has given insight into the ‘true’ extent and scale of supply deficiency as a consequence of pressure shortfall. The failures of one link of the network at a time have been simulated. The results suggest that, in terms of the nodes (properties) affected by shortfall in pressure, the more rigorous approach reduces the zone of deficient service compared with that flagged by conventional investigations. A case study used the methodology to investigate loss of resilience arising from pressure management and to assess the susceptibility to supply interruption of sensitive customers.
Wastewater Disinfection Alternatives: Chlorine, Ozone, Peracetic Acid, and UV Light
Authors: Mezzanotte V. , Antonelli M. , Citterio S. , Nurizzo C.
Published: November 2007

Disinfection tests were carried out at pilot scale to compare the disinfection efficiency of ozone, sodium hypochlorite (NaOCl), peracetic acid (PAA), and UV irradiation. Total coliforms, fecal coliforms, and Escherichia coli were monitored as reference microorganisms. Total heterotrophic bacteria (THB) were also enumerated by cytometry. At similar doses, NaOCl was more effective than PAA, and its action was less affected by contact time. The results obtained by ozonation were comparable for total coliforms, fecal coliforms, and E. coli. On the contrary, some differences among the three indicators were observed for NaOCl, PAA, and UV. Differences increased with increasing values of the disinfectant concentration times contact time (C· t) and were probably the result of different initial counts, as total coliforms include fecal coliforms, which include E. coli. The UV irradiation lead to complete E. coli removals, even at low doses (10 to 20 mJ/cm 2). Total heterotrophic bacteria appeared to be too wide a group to be a good disinfection indicator; no correlation was found among THB inactivation, dose, and contact time.
Degradation of X‐Ray Contrast Media Compounds by Combined Ozone and Ultrasound
Authors: Ning Bo , Graham Nigel J. D. , Lickiss Paul D.
Published: November 2007

The aqueous degradation of iodinated X‐ray contrast media (ICM) by the combination of ozone and ultrasound has been studied. Experiments were conducted at a constant ultrasound frequency of 20 kHz, at five power densities up to 0.235 W/mL, and various ozone centrations. In experiments involving dissolved ozone in solution, the addition of ultrasound significantly decreased the oxidation performance of the dissolved ozone, while the combination of dissolved oxygen and ultrasound gave a greater oxidation performance than ultrasound alone. However, the combination of gaseous ozone and ultrasound was found to give a higher degree of compound degradation than either ozone or ultrasound alone. In the experiments with final effluent, the degradation of ICM compounds by gaseous ozone and ultrasound was found to depend on the ozone dose applied. The degradation of ICM compounds in final effluent was modeled, which was found to moderately overestimate the observed compound degradation.
Biodecolorization of the Azo Dye Reactive Red 2 by a Halotolerant Enrichment Culture
Authors: Beydilli M. Inan , Pavlostathis Spyros G.
Published: November 2007

The decolorization of the azo dye Reactive Red 2 (RR2) under anoxic conditions was investigated using a mesophilic (35°C) halotolerant enrichment culture capable of growth at 100 g/L sodium chloride (NaCl). Batch decolorization assays were conducted with the unacclimated halotolerant culture, and dye decolorization kinetics were determined as a function of the initial dye, biomass, carbon source, and an externally added oxidation–reduction mediator (anthraquinone‐2,6‐disulphonic acid) concentrations. The maximum biomass‐normalized RR2 decolorization rate by the halotolerant enrichment culture under batch, anoxic incubation conditions was 26.8 mg dye/mg VSS·d. Although RR2 decolorization was inhibited at RR2 concentrations equal to and higher than 300 mg/L, the halotolerant culture achieved a 156‐fold higher RR2 decolorization rate compared with a previously reported, biomass‐normalized RR2 decolorization rate by a mixed mesophilic (35°C) methanogenic culture in the absence of NaCl. Decolorization kinetics at inhibitory RR2 levels were described based on the Haldane model (Haldane, 1965). Five repetitive dyeing/decolorization cycles performed using the halotolerant culture and the same RR2 dyebath solution demonstrated the feasibility of biological renovation and reuse of commercial‐strength spent reactive azo dyebaths.
Use of T-plates for the stabilisation of supracotyloid ilial fractures in 18 cats and five dogs
Authors: Viguier E. , Troger J.-C.
Published: November 2007

The use of the AO (Arbeitgemeinschaft fur Osteosynthe- senfragen) veterinary T-plates (1.5/2 mm and 2.7/3.5 mm) forstabilisation ofsupracotyloid ilial fractures in 18 cats and five dogs was evaluated in a retrospective study. The distal fragment from the coxofemoral joint ranged from 0.5 cm to 1 cm with a mean distance of 0.85 cm. Twenty out of 23 (87%) ilial fractures healed in original alignment. Three out of 23 (13%) animals had two loosened screws of the distal fragment with fracture malunion and minor medial displacement of the acetabular fragment. Screw or plate breakage was not observed and the implants were not removed. The clinical result was ‘excellent’ for 18 animals (78%), ‘good’ for four animals (17%), and ‘poor’ for one animal (5%). The use of T-plates permits good correction ofsupracotyloid fractureswith minimal approach and minimizes post-operative complications.
Radiographic examination and outcome in consecutive feline trauma patients
Authors: Kaser-Hotz B. , Hässig M. , Voss K. , Montavon P. M. , Zulauf D.
Published: November 2007

Using univariate analysis, the correlation between signalment, history, outcome and radiographic diagnosis made on whole-body radiographs was investigated in 100 consecutive feline trauma patients of an urban clinic. The radiographic findings included: 53 thoracic injuries, 39 abdominal injuries, 34 pelvic injuries, 28 soft tissue injuries, 26 spinal injuries, and 19 cases with signs of hypovolemia. Only four radiographs were considered normal. Surgical intervention was carried out in 51 cases. Of the 100 cases, 73 survived, 23 were euthanatized, and four died. A significant positive correlation with euthanasia was found when compared to patient age (p=0.0059), abdominal trauma (P=0.0500), spinal fractures (P=0.0468), and soft tissue injuries (P=0.0175). A significant negative correlation with survival was found when compared to patient age (P=0.0358), abdominal trauma (P=0.0439), intraperitoneal free air (P=0.0041), and soft tissue injury (P=0.0288). The results of this study indicate that whole-body radiographs are useful in detecting injury in the thorax, abdomen, spine, pelvis and soft tissues, and are valuable in the diagnostic work-up of feline trauma patients.
Vertebral canal location of a broken drill bit
Authors: Etchepareborde S. , Mills J.
Published: November 2007

A 2 mm drill broke during plate fixation of an ilial fracture. Postoperative radiographs showed the tip of the drill bit to be within the L7 vertebral canal. It was retrieved 10 days later via dorsal laminectomy, immediately restoring weight bearing.
Magnetic Nanoparticle‐Supported Morita–Baylis–Hillman Catalysts
Authors: Luo Sanzhong , Zheng Xiaoxi , Xu Hui , Mi Xueling , Zhang Long , Cheng Jin‐Pei
Published: November 2007

A magnetic nanoparticle‐supported quinuclidine was prepared and evaluated as a recoverable Morita–Baylis–Hillman catalyst. The supported catalyst 2 demonstrated comparable activity with that of DABCO and could be simply recycled with the assistance of an external magnet. The thus recycled catalyst could be reused for 7 times without significant loss of activity.
Chiral Bicyclic Guanidine as a Versatile Brønsted Base Catalyst for the Enantioselective Michael Reactions of Dithiomalonates and β‐Keto Thioesters
Authors: Ye Weiping , Jiang Zhiyong , Zhao Yujun , Goh Serena Li Min , Leow Dasheng , Soh Ying‐Teck , Tan Choon‐Hong
Published: November 2007

A chiral bicyclic guanidine was developed as a versatile Brønsted base catalyst for the enantioselective Michael reactions of dithiomalonates and β‐keto thioesters using a range of acceptors including maleimides, cyclic enones, furanone and acyclic 1,4‐dicarbonylbutenes.