Sample records for surgery current trends

  1. 67 Ambulatory Surgery: Current Status and Future Trends

    African Journals Online (AJOL)


    selected patients to hospital for a planned, non emergency, surgical procedure, returning home on the same day. Minor outpatient ... Some examples of the procedures of the basket are the following: • Hernia repair,. • Varicose vein surgery,. • Mastectomy,. • Cataract surgery,. • Tonsillectomy,. • Knee arthroscopy and ...

  2. Current Trend of Robotic Thoracic and Cardiovascular Surgeries in Korea: Analysis of Seven-Year National Data

    Directory of Open Access Journals (Sweden)

    Chang Hyun Kang


    Full Text Available Background: Robotic surgery is an alternative to minimally invasive surgery. The aim of this study was to report on current trends in robotic thoracic and cardiovascular surgical techniques in Korea. Methods: Data from the National Evidence-based Healthcare Collaborating Agency (NECA between January 2006 and June 2012 were used in this study, including a total of 932 cases of robotic surgeries reported to NECA. The annual trends in the case volume, indications for robotic surgery, and distribution by hospitals and surgeons were analyzed in this study. Results: Of the 932 cases, 591 (63% were thoracic operations and 340 (37% were cardiac operations. The case number increased explosively in 2007 and 2008. However, the rate of increase regained a steady state after 2011. The main indications for robotic thoracic surgery were pulmonary disease (n=271, 46%, esophageal disease (n=199, 34%, and mediastinal disease (n=117, 20%. The main indications for robotic cardiac surgery were valvular heart disease (n=228, 67%, atrial septal defect (n=79, 23%, and cardiac myxoma (n=27, 8%. Robotic thoracic and cardiovascular surgeries were performed in 19 hospitals. Three large volume hospitals performed 94% of the case volume of robotic cardiac surgery and 74% of robotic thoracic surgery. Centralization of robotic operation was significantly (p<0.0001 more common in cardiac surgery than in thoracic surgery. A total of 39 surgeons performed robotic surgeries. However, only 27% of cardiac surgeons and 23% of thoracic surgeons performed more than 10 cases of robotic surgery. Conclusion: Trend analysis of robotic and cardiovascular operations demonstrated a gradual increase in the surgical volume in Korea. Meanwhile, centralization of surgical cases toward specific surgeons in specific hospitals was observed.


    Directory of Open Access Journals (Sweden)

    R. I. Tamrazov


    Full Text Available The article describes the main stages of the development of sphincter-saving surgery for rectal cancer. An historical look at this issue from the standpoint of research of past years in our country and abroad, as well as analysis of current sphincter-preserving surgery and future directions in this area.

  4. Current Trend of Antimicrobial Prescription for Oral Implant Surgery Among Dentists in India. (United States)

    Datta, Rahul; Grewal, Yasmin; Batth, J S; Singh, Amandeep


    The aim of our study was to evaluate antimicrobial prescription behaviour amongst dentists performing oral implant surgery in India. Dentists performing oral implant surgery from different parts of India were personally approached during various national events such as conferences and academic meetings and information regarding their prescription habits for antimicrobial agents in routine oral implant surgery was collected using a structured questionnaire. Out of a total sample of 332 dentists, 85.5 % prescribed 17 different groups or combinations of antibiotics routinely for oral implant surgery in the normal healthy patient. Majority preferred the peri-operative protocol of drug therapy (72.2 %) with variable and prolonged duration of therapy after surgery, ranging from 3 to 10 days. An antimicrobial mouthwash was routinely prescribed by all the doctors (14.5 %) not in favour of prescribing antimicrobials in a normal healthy patient. Our findings suggest that there is a trend of antimicrobial agent misuse by dentists performing oral implant surgery in India, both in terms of drugs used and the protocols prescribed. The majority of these dentists prescribed a variety of antimicrobial agents for prolonged durations routinely even in the normal, healthy patients.

  5. Computer Assisted Surgery and Current Trends in Orthopaedics Research and Total Joint Replacements (United States)

    Amirouche, Farid


    Musculoskeletal research has brought about revolutionary changes in our ability to perform high precision surgery in joint replacement procedures. Recent advances in computer assisted surgery as well better materials have lead to reduced wear and greatly enhanced the quality of life of patients. The new surgical techniques to reduce the size of the incision and damage to underlying structures have been the primary advance toward this goal. These new techniques are known as MIS or Minimally Invasive Surgery. Total hip and knee Arthoplasties are at all time high reaching 1.2 million surgeries per year in the USA. Primary joint failures are usually due to osteoarthristis, rheumatoid arthritis, osteocronis and other inflammatory arthritis conditions. The methods for THR and TKA are critical to initial stability and longevity of the prostheses. This research aims at understanding the fundamental mechanics of the joint Arthoplasty and providing an insight into current challenges in patient specific fitting, fixing, and stability. Both experimental and analytical work will be presented. We will examine Cementless total hip arthroplasty success in the last 10 years and how computer assisted navigation is playing in the follow up studies. Cementless total hip arthroplasty attains permanent fixation by the ingrowth of bone into a porous coated surface. Loosening of an ingrown total hip arthroplasty occurs as a result of osteolysis of the periprosthetic bone and degradation of the bone prosthetic interface. The osteolytic process occurs as a result of polyethylene wear particles produced by the metal polyethylene articulation of the prosthesis. The total hip arthroplasty is a congruent joint and the submicron wear particles produced are phagocytized by macrophages initiating an inflammatory cascade. This cascade produces cytokines ultimately implicated in osteolysis. Resulting bone loss both on the acetabular and femoral sides eventually leads to component instability. As

  6. Plastic surgery: quo vadis? Current trends and future projections of aesthetic plastic surgical procedures in the United States. (United States)

    Broer, P Niclas; Levine, Steven M; Juran, Sabrina


    The objective of this article was to evaluate past and current trends regarding aesthetic operations in the United States and to project future changes regarding such procedures. Cosmetic surgery statistics from the American Society for Aesthetic Plastic Surgery from 1997 to 2012 were analyzed by sex, age, and ethnic group. Then, using population projections from the U.S. Census Bureau based on the 2010 census, two projection scenarios of the expected number of aesthetic plastic surgery procedures were generated. The scenarios included the presumed occurrence and nonoccurrence of a recession like that which occurred in 2007. Aesthetic procedures are expected to grow from 1,688,694 in 2012 to 3,847,929 by 2030, representing an average annual growth rate of 7.1 percent. Should another recession of similar degree to the one in 2007 occur, procedures would increase to only 2,086,994, displaying an average annual growth percentage rate of 1.3 percent. Because the age distribution of the patient population will change, preferences for specific procedures according to age influence-and thus are reflected in-future demand for those procedures. Furthermore, the ethnic profile of patients will change significantly, with 32 percent of all procedures being performed on patients other than Caucasians by 2030. Demand for aesthetic plastic surgical procedures is expected to continue to grow, while depending on the economic performance at the macro level and changing demographic dynamics of the U.S. population. Considering all investigated factors and trends among all patients, the most commonly requested procedures by 2030 are likely to be (1) breast augmentations, (2) lipoplasties, and (3) blepharoplasties.

  7. Changing Trends in Gastric Cancer Surgery

    Directory of Open Access Journals (Sweden)

    İlter Özer


    Full Text Available Gastric cancer is one of the most common causes of cancer-related death. It requires multimodal treatment and surgery is the most effective treatment modality. Radical surgery includes total or subtotal gastrectomy with lymph node dissection. The extent of lymphadenectomy still remains controversial. Eastern surgeons have performed D2 or more extended lymphadenectomy while their Western colleagues have performed more limited lymph node dissection. However, the trend has been changing in favour of D2 lymph node dissection in both hemispheres. Currently, D2 is the recommended type of lymphadenectomy in experienced centres in the west. In Japan, D2 lymph node dissection is the standard surgical approach. More extensive lymphadenectomy than D2 has not been found to be associated with improved survival and generally is not performed. Bursectomy and splenectomy are additional controversial issues in surgical performance, and trends regarding them will be discussed. The performance of bursectomy is controversial and there is no clear evidence of its clinical benefit. However, a trend toward better survival in patients with serosal invasion has been reported. Routine splenectomy as a part of lymph node dissection has largely been abandoned, although splenectomy is recommended in selected cases. Minimally invasive surgery has gained wide popularity and indications for minimally invasive procedures have been expanding due to increasing experience and improving technology. Neoadjuvant therapy has been shown to have beneficial effects and seems necessary to provide a survival benefit. Diagnostic laparoscopy should be kept in mind prior to treatment

  8. Suicide: current trends. (United States)

    Bailey, Rahn K; Patel, Tejas C; Avenido, Jaymie; Patel, Milapkumar; Jaleel, Mohammad; Barker, Narviar C; Khan, Jahanzeb Ali; Ali, Shahid; Jabeen, Shagufta


    Suicide is the act of a human being intentionally causing his or her own death. More than 1 million people commit suicide every year. It is the 13th leading cause of death worldwide, with China, India, and Japan accounting for almost half of all suicides. In less than 50 years, the rate of suicide among Sri Lankans has risen from a modest level to one of the highest in the world (118 per 100,000). Suicide is a major preventable cause of premature death. It is influenced by psychosocial, cultural, and environmental risk factors. The impact of suicide can be devastating for all concerned. It is common in people who are living with chronic mental illness. Individuals with severe clinical depression and alcohol use disorders are at highest risk if untreated. On an interpersonal level, friends and families of suicide victims require social support. On a national level, governments need to recognize the causes of suicide and protect those most vulnerable. If governments commit to defining national responses to prevent suicide, significant progress can be made. On a global scale, research and health organizations can identify global trends and encourage the sharing of information in effective prevention activities. In September 2010, World Suicide Prevention Day, with a theme of "Many faces, many places: suicide prevention across the world," encouraged public awareness worldwide to unite in commitment and action to promote understanding about suicide and removal of stigmatization'. There is compelling evidence that adequate prevention and awareness can reduce suicide rates.

  9. Trends in pediatric epilepsy surgery. (United States)

    Shah, Ritesh; Botre, Abhijit; Udani, Vrajesh


    Epilepsy surgery has become an accepted treatment for drug resistant epilepsy in infants and children. It has gained ground in India over the last decade. Certain epilepsy surgically remediable syndromes have been delineated and should be offered surgery earlier rather than later, especially if cognitive/behavioral development is being compromised. Advances in imaging, particularly in MRI has helped identify surgical candidates. Pre-surgical evaluation includes clinical assessment, structural and functional imaging, inter-ictal EEG, simultaneous video -EEG, with analysis of seizure semiology and ictal EEG and other optional investigations like neuropsychology and other newer imaging techniques. If data are concordant resective surgery is offered, keeping in mind preservation of eloquent cortical areas subserving motor, language and visual functions. In case of discordant data or non-lesional MRI, invasive EEG maybe useful using a two-stage approach. With multi-focal / generalized disease, palliative surgery like corpus callosotomy and vagal nerve stimulation maybe useful. A good outcome is seen in about 2/3rd of patients undergoing resective surgery with a low morbidity and mortality. This review outlines important learning aspects of pediatric epilepsy surgery for the general pediatrician.

  10. Current trends in nursing theories. (United States)

    Im, Eun-Ok; Chang, Sun Ju


    To explore current trends in nursing theories through an integrated literature review. The literature related to nursing theories during the past 10 years was searched through multiple databases and reviewed to determine themes reflecting current trends in nursing theories. The trends can be categorized into six themes: (a) foci on specifics; (b) coexistence of various types of theories; (c) close links to research; (d) international collaborative works; (e) integration to practice; and (f) selective evolution. We need to make our continuous efforts to link research and practice to theories, to identify specifics of our theories, to develop diverse types of theories, and to conduct international collaborative works. Our paper gives implications for future theoretical development in diverse clinical areas of nursing research and practice. © 2012 Sigma Theta Tau International.

  11. Changing trends in hair restoration surgery

    Directory of Open Access Journals (Sweden)

    Venkataram Mysore


    Full Text Available Androgenetic alopecia is an important and common cause for baldness. Despite recent advances, the drug therapy of this condition remains unsatisfactory. Surgical hair restoration is the only permanent method of treating this condition. Introduction of recent techniques such as follicular unit transplantation have improved the cosmetic results and patient satisfaction. This article discusses the latest trends in hair restoration surgery.

  12. New trends in minimally invasive urological surgery

    Directory of Open Access Journals (Sweden)

    Prabhakar Rajan


    Full Text Available Purpose: The perceived benefits of minimally-invasive surgery include less postoperative pain, shorter hospitalization, reduced morbidity and better cosmesis while maintaining diagnostic accuracy and therapeutic outcome. We review the new trends in minimally-invasive urological surgery. Materials and method: We reviewed the English language literature using the National Library of Medicine database to identify the latest technological advances in minimally-invasive surgery with particular reference to urology. Results: Amongst other advances, studies incorporating needlescopic surgery, laparoendoscopic single-site surgery , magnetic anchoring and guidance systems, natural orifice transluminal endoscopic surgery and flexible robots were considered of interest. The results from initial animal and human studies are also outlined. Conclusion: Minimally-invasive surgery continues to evolve to meet the demands of the operators and patients. Many novel technologies are still in the testing phase, whilst others have entered clinical practice. Further evaluation is required to confirm the safety and efficacy of these techniques and validate the published reports.

  13. Current trends in ion implantation

    International Nuclear Information System (INIS)

    Gwilliam, R.M.


    As semiconductor device dimensions continue to shrink, the drive beyond 250 nm is creating significant problems for the device processor. In particular, trends toward shallower-junctions, lower thermal budgets and simplified processing steps present severe challenges to ion implantation. In parallel with greater control of the implant process goes the need for a better understanding of the physical processes involved during implantation and subsequent activation annealing. For instance, the need for an understanding of dopant-defect interaction is paramount as defects mediate a number of technologically important phenomena such as transient enhanced diffusion and impurity gettering. This paper will outline the current trends in the ion implantation and some of the challenges it faces in the next decade, as described in the semiconductor roadmap. It will highlight some recent positron annihilation work that has made a contribution to addressing one of these challenges, namely the need for tighter control of implant uniformity and dose. Additionally, some vacancy-mediated processes are described with the implication that these may provide areas in which positron annihilation spectroscopy could make a significant contribution. (orig.)

  14. Current trends in plant breeding

    International Nuclear Information System (INIS)

    Jalani, B.S.; Rajanaidu, N.


    The current world population is 6 billion and it is likely to reach 7 billion in 2010 and 8 billion 2025. Sufficient food must be produced for the ever increasing human population. The available suitable land for intensive agriculture is limited. We have to produce more food from less land, pesticide, labour and water resources. Hence, increase in crop productivity are essential to feed the world in the next century. Plant breeding provides the avenue to increase the food production to feed the growing world population. Development of a cultivar involves (I) Construction of a genetic model (II) creating a gene pool (III) selection among plants and (IV) testing the selected genotypes for adaptation to the biotic and abiotic environments (Frey, 1999). This paper discusses the trends in plant breeding using the oil palm as a model. It covers (i) genetic resources (ii) physiological traits (III) exploitation of genotype x environment interaction (IV) oil palm clones, and (v) biotechnology application. (Author)

  15. Current Trends in Neonatal Tracheostomy. (United States)

    Isaiah, Amal; Moyer, Kelly; Pereira, Kevin D


    The indications for neonatal tracheostomy may have changed with current noninvasive respiratory therapies compared with previous decades. To study the current trends in neonatal tracheostomy and identify the primary indication for the procedure and risk factors for failed extubation. This retrospective medical record review included 47 neonates who underwent tracheostomy from January 1, 2009, to December 31, 2013, at the University of Maryland Children's Hospital. Group 1 included infants undergoing tracheostomy for the primary indication of upper airway obstruction; group 2, infants with primary pulmonary disease. Data on weight, gestational age, comorbid conditions, congenital abnormalities, complications, outcomes, and indications for tracheostomy were compared statistically between groups. Differences in gestational age, birth weight, and age at tracheostomy. Among the 47 infants included in the study (30 boys; 17 girls, mean [SD] age, 113 [73] days), 31 (66%) demonstrated anatomical causes of airway obstruction, and 16 (34%) had significant pulmonary disease. Among infants with anatomical causes, subglottic stenosis represented the largest group (11 of 31 [35%]). The mean age at the time of tracheostomy was significantly lower in the group with airway obstruction (98.9 vs 146.9 days; difference, 48 [95% CI, 4.8-91.2] days; P = .04). No procedure-related morbidity or mortality was encountered. Anatomical upper airway obstruction may be returning as the most common indication for a neonatal tracheostomy, thereby supporting the belief that current respiratory therapies have lowered the burden of chronic lung disease and the need for prolonged ventilatory care.

  16. Changing trends in plastic surgery training

    Directory of Open Access Journals (Sweden)

    Ramesh Kumar Sharma


    Full Text Available Background: The currently available training models are being put to scrutiny in India today, both by the residents and the teachers. Plastic surgery specialty was created primarily for reconstructive purposes but the society always perceived it from a cosmetic angle, particularly in the post second world war era. As a result, there is a need to redefine the goals of plastic surgery training in the present times so that the plastic surgeon is "future ready" to meet the needs of society and the market forces. Materials and Methods: The author has reviewed the currently available literature on plastic surgery training from India and the western countries. An attempt has been made to study opinions from the teachers and the trainees. The modules currently available in India and abroad have been analyzed and a suggestion has been made for drafting training programs that would meet the demands of the society as well as prepare the resident both for the aesthetic and reconstructive practice. Conclusions: The plastic surgery training needs to be more vibrant and in tune with the changing times. While maintaining its core nature, the current predominantly reconstructive modules need to incorporate the aesthetic content. The evaluation should be both knowledge and competence based. The teachers need to be educated in the various teaching methods that are more applicable to grown up residents. There is a need to find ways to attract talented people in the academic plastic surgery.

  17. Changing trends in plastic surgery training. (United States)

    Sharma, Ramesh Kumar


    The currently available training models are being put to scrutiny in India today, both by the residents and the teachers. Plastic surgery specialty was created primarily for reconstructive purposes but the society always perceived it from a cosmetic angle, particularly in the post second world war era. As a result, there is a need to redefine the goals of plastic surgery training in the present times so that the plastic surgeon is "future ready" to meet the needs of society and the market forces. The author has reviewed the currently available literature on plastic surgery training from India and the western countries. An attempt has been made to study opinions from the teachers and the trainees. The modules currently available in India and abroad have been analyzed and a suggestion has been made for drafting training programs that would meet the demands of the society as well as prepare the resident both for the aesthetic and reconstructive practice. The plastic surgery training needs to be more vibrant and in tune with the changing times. While maintaining its core nature, the current predominantly reconstructive modules need to incorporate the aesthetic content. The evaluation should be both knowledge and competence based. The teachers need to be educated in the various teaching methods that are more applicable to grown up residents. There is a need to find ways to attract talented people in the academic plastic surgery.

  18. Trends in adolescent bariatric surgery evaluated by UHC database collection. (United States)

    Pallati, Pradeep; Buettner, Shelby; Simorov, Anton; Meyer, Avishai; Shaligram, Abhijit; Oleynikov, Dmitry


    With increasing childhood obesity, adolescent bariatric surgery has been increasingly performed. We used a national database to analyze current trends in laparoscopic bariatric surgery in the adolescent population and related short-term outcomes. Discharge data from the University Health System Consortium (UHC) database was accessed using International Classification of Disease codes during a 36 month period. UHC is an alliance of more than 110 academic medical centers and nearly 250 affiliate hospitals. All adolescent patients between 13 and 18 years of age, with the assorted diagnoses of obesity, who underwent laparoscopic adjustable gastric banding (LAGB), sleeve gastrectomy (SG), and laparoscopic Roux-en-Y gastric bypass (LRYGB) were evaluated. The main outcome measures analyzed were morbidity, mortality, length of hospital stay (LOS), overall cost, intensive care unit (ICU) admission rate, and readmission rate. These outcomes were compared to those of adult bariatric surgery. Adolescent laparoscopic bariatric surgery was performed on 329 patients. At the same time, 49,519 adult bariatric surgeries were performed. One hundred thirty-six adolescent patients underwent LAGB, 47 had SG, and 146 patients underwent LRYGB. LAGB has shown a decreasing trend (n = 68, 34, and 34), while SG has shown an increasing trend (n = 8, 15, and 24) over the study years. LRYGB remained stable (n = 44, 60, and 42) throughout the study period. The individual and summative morbidity and mortality rates for these procedures were zero. Compared to adult bariatric surgery, 30 day in-hospital morbidity (0 vs. 2.2 %, p adolescent bariatric surgery, while the ICU admission rate (9.78 vs. 6.30 %, p adolescent laparoscopic bariatric surgery reveal the increased use of sleeve gastrectomy and adjustable gastric banding falling out of favor.


    Directory of Open Access Journals (Sweden)

    Ivica Batinić


    Full Text Available Hospitality industry is a complex product-service economic activity which besides accommodation, food and beverages offers a variety of complementary and ancillary services in order to meet modern needs, demands and desires of tourists consumers. Contemporary needs, demands and desires of tourists consumers (increased need for security and preservation of health; emphasis on ecology and healthy food; pure nature stay; growing demand for adventure activities and excitement; convention facilities and incentive offerings; visits to towns, big sports, cultural, religious, business events; new travel motivation have led to the emergence of new trends in hospitality offering design. Wellness and spa hotels, boutique hotels, all inclusive hotels, slow-food restaurants, and wine and lounge bars are just some of the main trends, and successful hoteliers and caterers will examine each of the trends and devise development politics in accordance with the new requirements and global market needs.


    Directory of Open Access Journals (Sweden)

    Evgeny V. Ryabinin


    Full Text Available The methodological bases of researchof international business are stated in the article. The great attention is focused on analysis of main trends in development of international. The comparison of competitiveness to of most used forms ofinternational business, as well as identified the main problems and barriers of theinternational business structures.

  1. Current Trends in and Indications for Endoscopy-Assisted Breast Surgery for Breast Cancer: Results from a Six-Year Study Conducted by the Taiwan Endoscopic Breast Surgery Cooperative Group (United States)

    Lai, Hung-Wen; Chen, Shou-Tung; Chen, Dar-Ren; Chen, Shu-Ling; Chang, Tsai-Wang; Kuo, Shou-Jen; Kuo, Yao-Lung; Hung, Chin-Sheng


    Background Endoscopy-assisted breast surgery (EABS) performed through minimal axillary and/or periareolar incisions is a possible alternative to open surgery for certain patients with breast cancer. In this study, we report the early results of an EABS program in Taiwan. Methods The medical records of patients who underwent EABS for breast cancer during the period May 2009 to December 2014 were collected from the Taiwan Endoscopic Breast Surgery Cooperative Group database. Data on clinicopathologic characteristics, type of surgery, method of breast reconstruction, complications and recurrence were analyzed to determine the effectiveness and oncologic safety of EABS in Taiwan. Results A total of 315 EABS procedures were performed in 292 patients with breast cancer, including 23 (7.8%) patients with bilateral disease. The number of breast cancer patients who underwent EABS increased initially from 2009 to 2012 and then stabilized during the period 2012–2014. The most commonly performed EABS was endoscopy-assisted total mastectomy (EATM) (85.4%) followed by endoscopy-assisted partial mastectomy (EAPM) (14.6%). Approximately 74% of the EATM procedures involved breast reconstruction, with the most common types of reconstruction being implant insertion and autologous pedicled TRAM flap surgery. During the six-year study period, there was an increasing trend in the performance of EABS for the management of breast cancer when total mastectomy was indicated. The positive surgical margin rate was 1.9%. Overall, the rate of complications associated with EABS was 15.2% and all were minor and wound-related. During a median follow-up of 26.8 (3.3–68.6) months, there were 3 (1%) cases of local recurrence, 1 (0.3%) case of distant metastasis and 1 (0.3%) death. Conclusion The preliminary results from the EABS program in Taiwan show that EABS is a safe procedure and results in acceptable cosmetic outcome. These findings could help to promote this under-used surgical technique

  2. Current Trends In Educational Technology: Implication On ...

    African Journals Online (AJOL)

    This paper presents the current trends in educational technology and the implication on educational managers in Nigeria. The current trends in the field of educational technology are centred on the influence of information and communication technology on the development of educational management. Various challenges ...

  3. Radiopharmaceuticals - current state and trends

    International Nuclear Information System (INIS)

    Muenze, R.


    The current state as well as the tendencies of modern radiopharmaceutical development and application is reviewed. After an evaluation of the fundamental preconditions of decay characteristics and pharmaceutical properties the problems concerning sup(99m)Tc-radiopharmaceuticals, metabolizable compounds and the use of specific biological interactions are discussed. (author)

  4. Current trends in geomorphological mapping (United States)

    Seijmonsbergen, A. C.


    Geomorphological mapping is a world currently in motion, driven by technological advances and the availability of new high resolution data. As a consequence, classic (paper) geomorphological maps which were the standard for more than 50 years are rapidly being replaced by digital geomorphological information layers. This is witnessed by the following developments: 1. the conversion of classic paper maps into digital information layers, mainly performed in a digital mapping environment such as a Geographical Information System, 2. updating the location precision and the content of the converted maps, by adding more geomorphological details, taken from high resolution elevation data and/or high resolution image data, 3. (semi) automated extraction and classification of geomorphological features from digital elevation models, broadly separated into unsupervised and supervised classification techniques and 4. New digital visualization / cartographic techniques and reading interfaces. Newly digital geomorphological information layers can be based on manual digitization of polygons using DEMs and/or aerial photographs, or prepared through (semi) automated extraction and delineation of geomorphological features. DEMs are often used as basis to derive Land Surface Parameter information which is used as input for (un) supervised classification techniques. Especially when using high-res data, object-based classification is used as an alternative to traditional pixel-based classifications, to cluster grid cells into homogeneous objects, which can be classified as geomorphological features. Classic map content can also be used as training material for the supervised classification of geomorphological features. In the classification process, rule-based protocols, including expert-knowledge input, are used to map specific geomorphological features or entire landscapes. Current (semi) automated classification techniques are increasingly able to extract morphometric, hydrological

  5. 24th Current Trends in Computational Chemistry (United States)


    Corps of Engineers Army Research Office Conference on Current Trends in Computational Chemistry 2016 NOVEMBER 11-12, 2016 JACKSON, MS... Chemistry and Biochemistry Jackson, MS 39217 U.S.A. Tel: 6019793723 E-mail: Richard Alo Dean College of Science, Engineering ...Report: 24th Current Trends in Computational Chemistry The views, opinions and/or findings contained in this report are those of the author(s) and should

  6. Surgery in current therapy for infective endocarditis (United States)

    Head, Stuart J; Mokhles, M Mostafa; Osnabrugge, Ruben LJ; Bogers, Ad JJC; Kappetein, A Pieter


    The introduction of the Duke criteria and transesophageal echocardiography has improved early recognition of infective endocarditis but patients are still at high risk for severe morbidity or death. Whether an exclusively antibiotic regimen is superior to surgical intervention is subject to ongoing debate. Current guidelines indicate when surgery is the preferred treatment, but decisions are often based on physician preferences. Surgery has shown to decrease the risk of short-term mortality in patients who present with specific symptoms or microorganisms; nevertheless even then it often remains unclear when surgery should be performed. In this review we i) systematically reviewed the current literature comparing medical to surgical therapy to evaluate if surgery is the preferred option, ii) performed a meta-analysis of studies reporting propensity matched analyses, and iii), briefly summarized the current indications for surgery. PMID:21603594

  7. Current perspectives in robotic assisted surgery. (United States)

    Binet, Aurélien; Ballouhey, Quentin; Chaussy, Yann; de Lambert, Guénolée; Braïk, Karim; Villemagne, Thierry; Becmeur, François; Fourcade, Laurent; Lardy, Hubert


    From classical surgery to Robotic Assisted Surgery, there is a long way allowed by Minimal Invasive Surgery' improvements. The last three decades have witnessed a prodigious development of minimally invasive surgery (MIS) and especially in the field of laparoscopic pediatric surgery but there are several limitations in the use of conventional laparoscopic surgery and Robotic Assisted Surgery was developed to relieve these drawbacks. This new technology enables today the performance of a wide variety of procedures in children with a minimally invasive approach. As for all new technologies, an objective evaluation is essential with the need to respond to several questions: Is the technology feasible? Is the technology safe? Is the technology efficient? Does it bring about benefits compared with current technology? What are the procedures derived from most benefits of robotic assistance? How to assume the transition from open surgery to Minimal Invasive access for RAS? In the first part of this article, the authors give details about technical concerns and then describe the implementation process with its organization, pitfalls, successes, and issues from human resources and financial standpoints. The learning curve is then described and a special focus on small children weighing less than 15 Kg is developed. Finally, the concept of evaluation of this emerging technology is evocated and financial concerns are developed.

  8. Trends in day surgery in the Netherlands

    NARCIS (Netherlands)

    Wasowicz-Kemps, D.K.


    Hospital care has been subject to important changes during the last century. In stead of treating patients with various diseases with bed rest, medical care has shifted from in hospital to an ambulatory or outpatient setting as much as possible. Admission time after surgery shortened and day surgery

  9. Digital library research : current developments and trends


    Shiri, Ali


    This column gives an overview of current trends in digital library research under the following headings: digital library architecture, systems, tools and technologies; digital content and collections; metadata; interoperability; standards; knowledge organisation systems; users and usability; legal, organisational, economic, and social issues in digital libraries.

  10. Virtual Universities: Current Models and Future Trends. (United States)

    Guri-Rosenblit, Sarah


    Describes current models of distance education (single-mode distance teaching universities, dual- and mixed-mode universities, extension services, consortia-type ventures, and new technology-based universities), including their merits and problems. Discusses future trends in potential student constituencies, faculty roles, forms of knowledge…

  11. Current Trends in Associate Degree Nursing Programs. (United States)

    Blackstone, Elaine Grant

    This study was designed to ascertain current trends in associate degree nursing programs and to discover innovative ideas and techniques which could be applied to the existing program at Miami-Dade Community College (Florida). Data was compiled from interviews with representatives of ten associate degree nursing programs in six states. Information…

  12. Current Trends in Higher Education Technology: Simulation (United States)

    Damewood, Andrea M.


    This paper is focused on how technology in use changes over time, and the current trend of simulation technology as a supported classroom technology. Simulation-based training as a learning tool is discussed within the context of adult learning theories, as is the technology used and how today's higher education technology administrators support…

  13. Current economic trends in equine practice. (United States)

    Clark, Andrew R


    Current economic trends in equine practice are trends of weakness. Most practices, after a decade of double-digit growth, have migrated to survival mode within a few months. Understanding that all regions and disciplines are affected differently, using the Porter five forces model, we can identify changes that must be made in our business models first to survive and then to position ourselves to prosper when the recession ends. If we are to avoid long-term damage to our practices, we must use cost control and work efficiency in addition to price concessions.

  14. Current trends in Bayesian methodology with applications

    CERN Document Server

    Upadhyay, Satyanshu K; Dey, Dipak K; Loganathan, Appaia


    Collecting Bayesian material scattered throughout the literature, Current Trends in Bayesian Methodology with Applications examines the latest methodological and applied aspects of Bayesian statistics. The book covers biostatistics, econometrics, reliability and risk analysis, spatial statistics, image analysis, shape analysis, Bayesian computation, clustering, uncertainty assessment, high-energy astrophysics, neural networking, fuzzy information, objective Bayesian methodologies, empirical Bayes methods, small area estimation, and many more topics.Each chapter is self-contained and focuses on

  15. Bibliometric trend analyses of plastic surgery research

    NARCIS (Netherlands)

    Loonen, M.P.J.


    The present thesis was designed to evaluate the qualitative and quantitative aspects of plastic surgery research by means of a bibliometric citation analysis of plastic surgical presentations and publications. Citations to such published work provides an indication of the impact and the relevance of

  16. Current trends in nuclear material transportation

    International Nuclear Information System (INIS)

    Ravenscroft, Norman; Oshinowo, Franchone


    The business of radioactive material transportation has evolved considerably in the past 40 years. Current practices reflect extensive international experience in handling radioactive cargo within a mature and tested regulatory framework. Nevertheless, new developments continue to have an impact on how shipments of nuclear material are planned and carried out. Entities involved in the transport of radioactive materials must keep abreast of these developments and work together to find innovative solutions to ensure that safe, smooth transport activities may continue. Several recent trends in the regulatory environment and political atmosphere require attention. There are four key trends that we'll be examining today: 1) the reduction in the pool of available commercial carriers; 2) routing restrictions; 3) package validation issues; and 4) increasing political sensitivities. Careful planning and cooperative measures are necessary to alleviate problems in each of these areas. (author)

  17. Geographic Trends in the Plastic Surgery Match. (United States)

    Silvestre, Jason; Lin, Ines C; Serletti, Joseph M; Chang, Benjamin


    The integrated plastic surgery match is among the most competitive residency matches in recent years. Although previous studies have correlated applicant characteristics with successful match outcomes, none have comprehensively investigated the role of geography in the match. This study elucidates regional biases in the match. Plastic surgery residents who matched during 2011-2015 were eligible for study inclusion. Names of residents were obtained from official residency program websites and cross-referenced with data obtained from the Student Doctor Network. For each resident, region of residency program and medical school were compared. From 67 programs, 622 residents were identified. Most graduated from US medical schools (97.9%). A total of 94 residents matched at a home institution (15.1%). Half of the residents matched in the same region as their medical school (48.9%). Programs in the South matched the greatest number of residents from the same region (60.8%), whereas West programs matched the least (30.8%, p < 0.001). No regional differences existed regarding residents matching at their home institution (p = 0.268). More women matched at West programs (43.1%) versus East programs (30.6%, p < 0.05). A significant number of residents matched at their home institution. Roughly, half matched at a program in the same region as their medical school. Whether this regional phenomenon stems from applicant or program factors remains unknown. Yet, given the limited number of interviews and the high costs of interviewing, applicants and programs can use these data to help optimize the match process. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  18. Current trends in context-aware applications

    Directory of Open Access Journals (Sweden)

    Andrea Loayza


    Full Text Available (Received: 2013/10/07 - Accepted: 2013/12/10Context-aware applications adapt their behavior and settings according to the environment conditions and to the user preferences. This state-of-the-art survey identifies the current trends related to the technics and tools for the development of this kind of software, as well as the areas of interest of the scientific community on the subject. It stands out the research on multimodal interfaces, localization, activity detection, interruptions control, predictive and wellbeing applications.

  19. Organizational Development of Russian SMEs: Current trends

    Directory of Open Access Journals (Sweden)

    Emil Velinov


    Full Text Available The research paper sheds a light on Russian SMEs transition and specifically on their current development and evolution. The paper attempts to explain what are the main drivers and antecedents on SMEs during the period 2010-2015. Along with it, it is applied detailed analysis of Russian SMEs in terms of key performance indicators, turnover and volume of sales. Further, are given potential developments and trends within SMEs in Russia. The paper draws attention to socio-economic and political factors influencing SMEs development.

  20. Prognostic trend in advanced implant surgery. (United States)

    Demitri, V; Polini, F; Robiony, M; Politi, M


    Implant surgery in association with bone grafting is generally considered less predictive than primary implant surgery. Many reports have been published about implant rehabilitation with bone grafts in atrophic patients. Most of these papers showed a lower implant success rate than primary implantology. The aim of this study is to verify if it's possible to warrant similar results between the two types of implantology, if such procedures are performed following effective protocols and criteria. From 1995 to 1999, 43 severely atrophic edentulous patients were treated in our Clinic with 63 autologous bone grafts and delayed implantology; 45 patients were treated with traditional implantology. 284 fixtures were positioned. The success rate in grafted implantology versus traditional implantology was compared for every maxillary and mandibular region. Furthermore, success rate in implantology of the anterior maxilla versus the poster maxilla in grafted patients was compared. The statistical considerations were performed with c2 test (p<0.05). The statistical analysis evidenced not significative difference in the implant success rate between grafted and not grafted patients in the anterior (p=0.23) and in the posterior maxilla (p=0.35). There was not significative difference in the implant success rate between grafted and not grafted patients in the anterior mandible (p=0.54) and in the posterior mandible (p=0.54). There was not significative difference in the implant success rate between the anterior and posterior grafted maxilla (p=0.21). The results obtained show that if close surgical protocol is performed it is possible to obtain no prognostic difference between the two METHODS.

  1. Current trends of tropical fruit waste utilization. (United States)

    Cheok, Choon Yoong; Mohd Adzahan, Noranizan; Abdul Rahman, Russly; Zainal Abedin, Nur Hanani; Hussain, Norhayati; Sulaiman, Rabiha; Chong, Gun Hean


    Recent rapid growth of the world's population has increased food demands. This phenomenon poses a great challenge for food manufacturers in maximizing the existing food or plant resources. Nowadays, the recovery of health benefit bioactive compounds from fruit wastes is a research trend not only to help minimize the waste burden, but also to meet the intensive demand from the public for phenolic compounds which are believed to have protective effects against chronic diseases. This review is focused on polyphenolic compounds recovery from tropical fruit wastes and its current trend of utilization. The tropical fruit wastes include in discussion are durian (Durio zibethinus), mangosteen (Garcinia mangostana L.), rambutan (Nephelium lappaceum), mango (Mangifera indica L.), jackfruit (Artocarpus heterophyllus), papaya (Carica papaya), passion fruit (Passiflora edulis), dragon fruit (Hylocereus spp), and pineapple (Ananas comosus). Highlights of bioactive compounds in different parts of a tropical fruit are targeted primarily for food industries as pragmatic references to create novel innovative health enhancement food products. This information is intended to inspire further research ideas in areas that are still under-explored and for food processing manufacturers who would like to minimize wastes as the norm of present day industry (design) objective.

  2. Computational approaches to analogical reasoning current trends

    CERN Document Server

    Richard, Gilles


    Analogical reasoning is known as a powerful mode for drawing plausible conclusions and solving problems. It has been the topic of a huge number of works by philosophers, anthropologists, linguists, psychologists, and computer scientists. As such, it has been early studied in artificial intelligence, with a particular renewal of interest in the last decade. The present volume provides a structured view of current research trends on computational approaches to analogical reasoning. It starts with an overview of the field, with an extensive bibliography. The 14 collected contributions cover a large scope of issues. First, the use of analogical proportions and analogies is explained and discussed in various natural language processing problems, as well as in automated deduction. Then, different formal frameworks for handling analogies are presented, dealing with case-based reasoning, heuristic-driven theory projection, commonsense reasoning about incomplete rule bases, logical proportions induced by similarity an...

  3. Management of infantile hemangiomas: Current trends

    Directory of Open Access Journals (Sweden)

    Gomathy Sethuraman


    Full Text Available Infantile hemangiomas (IH are common vascular tumours. IH have a characteristic natural course. They proliferate rapidly during the early infantile period followed by a period of gradual regression over several years. Most of the uncomplicated IH undergo spontaneous involution, with a small proportion of cases requiring intervention. These are children with IH in life-threatening locations, local complications like haemorrhage, ulceration and necrosis and functional or cosmetic disfigurements. Systemic corticosteroids have been the first line of treatment for many years. Recently, non-selective beta-blockers, such as oral propranalol and topical timolol, have emerged as promising and safer therapies. Other treatment options include interferon α and vincristine which are reserved for life-threatening haemangiomas that are unresponsive to conventional therapy. This review mainly focuses on the current trends and evidence-based approach in the management of IH.

  4. Neuroimaging in refractory epilepsy. Current practice and evolving trends

    International Nuclear Information System (INIS)

    Ramli, N.; Rahmat, K.; Lim, K.S.; Tan, C.T.


    Highlights: • Neuroimaging is imperative in diagnostic work up and therapeutic assessment of refractory epilepsy. • Identification of epileptogenic zone on EEG, MRI and functional imaging improves the success of surgery. • High performance MRI greatly enhanced metabolic information and elucidate brain functions. • Optimisation of epilepsy protocols in structural and functional MRI are presented in this article. - Abstract: Identification of the epileptogenic zone is of paramount importance in refractory epilepsy as the success of surgical treatment depends on complete resection of the epileptogenic zone. Imaging plays an important role in the locating and defining anatomic epileptogenic abnormalities in patients with medically refractory epilepsy. The aim of this article is to present an overview of the current MRI sequences used in epilepsy imaging with special emphasis of lesion seen in our practices. Optimisation of epilepsy imaging protocols are addressed and current trends in functional MRI sequences including MR spectroscopy, diffusion tensor imaging and fusion MR with PET and SPECT are discussed

  5. Neuroimaging in refractory epilepsy. Current practice and evolving trends

    Energy Technology Data Exchange (ETDEWEB)

    Ramli, N. [Department of Biomedical Imaging, University Malaya Research Imaging Centre (Malaysia); Rahmat, K., E-mail: [Department of Biomedical Imaging, University Malaya Research Imaging Centre (Malaysia); Lim, K.S.; Tan, C.T. [Neurology Unit, Department of Medicine, University Malaya, Kuala Lumpur (Malaysia)


    Highlights: • Neuroimaging is imperative in diagnostic work up and therapeutic assessment of refractory epilepsy. • Identification of epileptogenic zone on EEG, MRI and functional imaging improves the success of surgery. • High performance MRI greatly enhanced metabolic information and elucidate brain functions. • Optimisation of epilepsy protocols in structural and functional MRI are presented in this article. - Abstract: Identification of the epileptogenic zone is of paramount importance in refractory epilepsy as the success of surgical treatment depends on complete resection of the epileptogenic zone. Imaging plays an important role in the locating and defining anatomic epileptogenic abnormalities in patients with medically refractory epilepsy. The aim of this article is to present an overview of the current MRI sequences used in epilepsy imaging with special emphasis of lesion seen in our practices. Optimisation of epilepsy imaging protocols are addressed and current trends in functional MRI sequences including MR spectroscopy, diffusion tensor imaging and fusion MR with PET and SPECT are discussed.

  6. Discount cosmetic surgery: industry trends and strategies for success. (United States)

    Krieger, Lloyd M


    Discount cosmetic surgery is a topic of interest to plastic surgeons. To understand this trend and its effects on plastic surgeons, it is necessary to review the economics of cosmetic surgery, plastic surgery's practice environment, and the broader business principles of service industries. Recent work looked at the economics of the plastic surgery market. This analysis demonstrated that increased local density of plastic surgeons was associated with lower adjusted fees for cosmetic procedures. A survey of plastic surgeons about their practice environment revealed that 93 percent categorized the majority of their patients as very or moderately price-sensitive. Fully 98 percent described their business climate as very or moderately competitive and most plastic surgeons thought they lost a sizable number of cosmetic patients within the last year for reasons of price.A standard industry analysis, when applied to cosmetic surgery, reveals the following: an increased number of surgeons leads to lower fees (reducing their bargaining power as suppliers), patients are price-sensitive (increasing their bargaining power as buyers), and there are few barriers to entry among providers (allowing potential new entrants into the market). Such a situation is conducive to discounting taking hold-and even becoming the industry norm. In this environment, business strategy dictates there are three protocols for success: discounting, differentiation, and focus. Discounting joins the trend toward cutting fees. Success comes from increasing volume and efficiency and thus preserving profits. Differentiation creates an industrywide perception of uniqueness; this requires broadly positioning plastic surgeons as holders of a distinct brand identity separate from other "cosmetic surgeons." The final strategy is to focus on a particular buyer group to develop a market niche, such as establishing a "Park Avenue" practice catering to patients who demand a prestigious surgeon, although this is

  7. Current Trends in Science | Overview | Publications | Indian ...

    Indian Academy of Sciences (India)

    Emerging trends at the interface of Chemistry and Biology: Applications to the design of human therapeutics ... Interplay between multiple length and time scales in complex chemical systems ... A tutorial introduction to financial engineering.

  8. Current Trends in Nuclear and Radiation Sensing

    International Nuclear Information System (INIS)

    McHugh, Harold R.; Quam, William


    This paper provides a brief overview of radiation detector history, a summary of the present state of the art, and some speculation on future developments in this field. Trends in the development of radiation detectors over the years are analyzed. Rapid progress in detection technology was experienced between WWII and the 1970s. Since then, fewer dramatic improvements have been seen. The authors speculate about the reasons for this trend and where the technology might take us in the next 20 years. Requirements for radiation detection equipment have changed drastically since 9/11; this demand is likely to accelerate detector development in the near future

  9. Current and future trends in cloud CRM


    Nemček, Sebastian


    The diploma thesis is committed to mapping CRM applications available in cloud and trends within. The goal is to describe what CRM is, how it evolved into Cloud CRM, analyze main differences between the two approaches and analyze trends that can be observed in CRM market and CRM applications. This is coupled with description of the most common CRM solutions and products available both on-premises as well as on-demand. In the first part, the thesis introduces theory behind Customer Relationshi...


    Directory of Open Access Journals (Sweden)

    Adina IORGA


    Full Text Available The profound changes experienced by the Romanian society had a profound social impact on the structure and functions of the rural family. The paper aims to highlight the main trends recorded using a number of indicators: ruralization rate, birth rate, infant mortality rate, percentage of children born outside marriage, fertility rate, percentage of population aged 65 and over. Statistics from censuses and statistical yearbooks were processed to identify the trends of the Romanian rural family: changes in reproductive behavior, increased aging, declining birth rates.

  11. Current trends in free software research


    Navarro Bosch, Ramon; Vila Marta, Sebastià


    This report analyzes how scientific research is studying free software. We find which research is being done on free software by looking into scientific journals and conferences publications. The data thus obtained is analized and the most salient trends related to free software discovered. We also reviewed the main works published in each free software research area.

  12. Making Current Trends in School Design Feasible. (United States)

    North Carolina State Dept. of Public Instruction, Raleigh. Div. of School Support.

    This report describes new and innovative approaches to school facilities as they relate to their communities by exploring the trends towards smaller schools, presenting the pros and cons of smaller schools, and examining the solutions and strategies in smart growth planning. The report addresses the following questions: if school leaders,…

  13. The economics of plastic surgery practices: trends in income, procedure mix, and volume. (United States)

    Krieger, Lloyd M; Lee, Gordon K


    Anecdotally, plastic surgeons have complained of working harder for the same or less income in recent years. They also complain of falling fees for reconstructive surgery and increasing competition for cosmetic surgery. This study examined these notions using the best available data. To gain a better understanding of the current plastic surgery market, plastic surgeon incomes, fees, volume, and relative mix of cosmetic and reconstructive surgery were analyzed between the years 1992 and 2002. To gain a broader perspective, plastic surgeon income trends were then compared with those of other medical specialties and of nonmedical professions. The data show that in real dollars, plastic surgeon incomes have remained essentially steady in recent years, despite plastic surgeons increasing their surgery load by an average of 41 percent over the past 10 years. The overall income trend is similar to that of members of other medical specialties and other nonmedical professionals. The average practice percentage of cosmetic surgery was calculated and found to have increased from 27 percent in 1992 to 58 percent in 2002. This most likely can be explained by the findings that real dollar fees collected for cosmetic surgery have decreased very slightly, whereas those for reconstructive procedures have experienced sharp declines. This study demonstrates that plastic surgeons have adjusted their practice profiles in recent years. They have increased their case loads and shifted their practices toward cosmetic surgery, most likely with the goal of maintaining their incomes. The strategy appears to have been successful in the short term. However, with increasing competition and falling prices for cosmetic surgery, it may represent a temporary bulwark for plastic surgeon incomes unless other steps are taken.

  14. Evolving Practice Trends of Aortic Root Surgery in North America. (United States)

    Caceres, Manuel; Ma, Yicheng; Rankin, J Scott; Saha-Chaudhuri, Paramita; Gammie, James S; Suri, Rakesh M; Thourani, Vinod H; Englum, Brian R; Esmailian, Fardad; Czer, Lawrence S; Puskas, John D; Svensson, Lars G


    Aortic-valve sparing (AVS) techniques have emerged as alternatives to composite graft-valve replacement (CVR) for treatment of aortic root aneurysm. This study analyzed recent practice trends of aortic root surgery using the Society of Thoracic Surgeons database. From January 2000 through June 2011, 31,747, Overall patients received AVS (n=3,585/31,747; 11.3%) or CVR (n=28,162/31,747; 88.7%). A High-Risk Subgroup was defined as: age >75 years, endocarditis, aortic stenosis, dialysis, multi-valve surgery, valve reoperation, or emergency/salvage status, and high-risk patients were less likely to receive AVS (n=20,356/31,747 [64.1%]; 6% AVS; unadjusted operative mortality 10.5% AVS and 11.7% CVR). The remaining patients comprised a Low-Risk Subgroup, in which AVS was more common (n=11,388/31,747 [35.9%]; 21% AVS; unadjusted operative mortality 1.4% AVS and 3.1% CVR). Procedural changes over 3 equal time periods (P1-P2-P3) were evaluated by Cochran-Armitage trends analysis. Compared to AVS, Overall CVR patients had worse baseline risk profiles and higher unadjusted operative mortality. In High-Risk patients, AVS mortality was comparable to CVR (10.5% vs 11.7%, p=0.19), but AVS mortality was lower in the Low-Risk group (1.4% vs 3%, pAVS percentages and trend p-values were: High-Risk (6%/6%/7%, p=0.26) and Low-Risk (12%/21%/25%, pAVS increased over time in Low-Risk patients while bioprostheses increased in CVR. Favorable outcomes support the trend toward further expansion of AVS. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  15. Current trend of robotics application in medical

    International Nuclear Information System (INIS)

    Olanrewaju, O A; Faieza, A A; Syakirah, K


    The applications of robotics in recent years has emerged beyond the field of manufacturing or industrial robots itself. Robotics applications are now widely used in medical, transport, underwater, entertainment and military sector. In medical field, these applications should be emphasized in view of the increasing challenges due to the variety of findings in the field of medicine which requires new inventions to ease work process. The objective of this review paper is to study and presents the past and on-going research in medical robotics with emphasis on rehabilitation (assistive care) and surgery robotics which are certainly the two main practical fields where robots application are commonly used presently. The study found that, rehabilitation and surgery robotics applications grow extensively with the finding of new invention, as well as research that is being undertaken and to be undertaken. The importance of medical robot in medical industry is intended to offer positive outcomes to assist human business through a complicated task that involves a long period, accuracy, focus and other routines that cannot be accomplished by human ability alone.

  16. Sustainable Biomaterials: Current Trends, Challenges and Applications

    Directory of Open Access Journals (Sweden)

    Girish Kumar Gupta


    Full Text Available Biomaterials and sustainable resources are two complementary terms supporting the development of new sustainable emerging processes. In this context, many interdisciplinary approaches including biomass waste valorization and proper usage of green technologies, etc., were brought forward to tackle future challenges pertaining to declining fossil resources, energy conservation, and related environmental issues. The implementation of these approaches impels its potential effect on the economy of particular countries and also reduces unnecessary overburden on the environment. This contribution aims to provide an overview of some of the most recent trends, challenges, and applications in the field of biomaterials derived from sustainable resources.

  17. Sustainable Biomaterials: Current Trends, Challenges and Applications. (United States)

    Kumar Gupta, Girish; De, Sudipta; Franco, Ana; Balu, Alina Mariana; Luque, Rafael


    Biomaterials and sustainable resources are two complementary terms supporting the development of new sustainable emerging processes. In this context, many interdisciplinary approaches including biomass waste valorization and proper usage of green technologies, etc., were brought forward to tackle future challenges pertaining to declining fossil resources, energy conservation, and related environmental issues. The implementation of these approaches impels its potential effect on the economy of particular countries and also reduces unnecessary overburden on the environment. This contribution aims to provide an overview of some of the most recent trends, challenges, and applications in the field of biomaterials derived from sustainable resources.

  18. Prevailing Trends in Haptic Feedback Simulation for Minimally Invasive Surgery. (United States)

    Pinzon, David; Byrns, Simon; Zheng, Bin


    Background The amount of direct hand-tool-tissue interaction and feedback in minimally invasive surgery varies from being attenuated in laparoscopy to being completely absent in robotic minimally invasive surgery. The role of haptic feedback during surgical skill acquisition and its emphasis in training have been a constant source of controversy. This review discusses the major developments in haptic simulation as they relate to surgical performance and the current research questions that remain unanswered. Search Strategy An in-depth review of the literature was performed using PubMed. Results A total of 198 abstracts were returned based on our search criteria. Three major areas of research were identified, including advancements in 1 of the 4 components of haptic systems, evaluating the effectiveness of haptic integration in simulators, and improvements to haptic feedback in robotic surgery. Conclusions Force feedback is the best method for tissue identification in minimally invasive surgery and haptic feedback provides the greatest benefit to surgical novices in the early stages of their training. New technology has improved our ability to capture, playback and enhance to utility of haptic cues in simulated surgery. Future research should focus on deciphering how haptic training in surgical education can increase performance, safety, and improve training efficiency. © The Author(s) 2016.

  19. Overview of Facial Plastic Surgery and Current Developments (United States)

    Chuang, Jessica; Barnes, Christian; Wong, Brian J. F.


    Facial plastic surgery is a multidisciplinary specialty largely driven by otolaryngology but includes oral maxillary surgery, dermatology, ophthalmology, and plastic surgery. It encompasses both reconstructive and cosmetic components. The scope of practice for facial plastic surgeons in the United States may include rhinoplasty, browlifts, blepharoplasty, facelifts, microvascular reconstruction of the head and neck, craniomaxillofacial trauma reconstruction, and correction of defects in the face after skin cancer resection. Facial plastic surgery also encompasses the use of injectable fillers, neural modulators (e.g., BOTOX Cosmetic, Allergan Pharmaceuticals, Westport, Ireland), lasers, and other devices aimed at rejuvenating skin. Facial plastic surgery is a constantly evolving field with continuing innovative advances in surgical techniques and cosmetic adjunctive technologies. This article aims to give an overview of the various procedures that encompass the field of facial plastic surgery and to highlight the recent advances and trends in procedures and surgical techniques. PMID:28824978

  20. Current trends in Irish perinatal mortality.

    LENUS (Irish Health Repository)

    Mahony, R


    This was a retrospective review of normally formed perinatal deaths among 176,620 births at the National Maternity Hospital (1984-2007). Prelabor stillbirths were categorised by presumed cause of death including unexplained, intrauterine growth retardation (IUGR), placental abruption, red cell alloimmunisation (RCA) and deaths related to prematurity. Peripartum deaths included intrapartum and first week neonatal deaths. The post-mortem rate, initially almost 100%, fell to 60%. Data were analysed using the Mantel-Haenszel chi square test for trends. In the study period there was a significant reduction in the PNM, largely because of a fall in death related to prematurity, term peripartum death, death at 42 weeks or greater, placental abruption, death related to IUGR and RCA (P < 0.01). Overall the unexplained still birth rate was unchanged throughout the study period (p = 0.8) despite a highly significant (p < 0.001) increase in obstetric intervention particularly induction of labor and caesarean section.

  1. Nuclear standards: current issues and future trends

    International Nuclear Information System (INIS)

    Landis, J.W.


    A summary of the important issues that currently face the nuclear standards field is presented and a discussion of how each of these issues is being resolved is given. The economic benefits that properly developed standards produce are listed

  2. Medical Management of Uveitis ? Current Trends


    Babu, Kalpana; Mahendradas, Padmamalini


    Uveitis is a challenging disease to treat. Corticosteroids have been used in the treatment of uveitis for many years. Immunosuppressives are gaining momentum in recent years in the treatment of uveitis. In this article we present an overview of current treatment of uveitis and the major breakthroughs and advances in drugs and ocular drug delivery systems in the treatment of uveitis.


    Directory of Open Access Journals (Sweden)

    Ciprian Ionel HRETCANU


    Full Text Available In this paper we discuss various aspects of the current economy known as the knowledge economy. Also we will review two indicators of this new economy, because these indicators presents a general plan on access, use and degree of diffusion of knowledge. Then, based on these indicators and taking into account other aspects, we outline the structure relations between "new economy" and "digital economy". Finally we present the main types of business existing in the digital economy.

  4. Current Trends in the Russian Financial System


    Barisitz, Stephan; Bogetic, Zeljko; Fungacova, Zuzana; Solanko, Laura; Havlik, Peter; Invushin, Valery; Osakovsky, Vladimir V.; Revoltella, Debora; Lehmann, Alexander; Nowotny, Ewald; Pineau-Valencienne, Cyril; Sutela, Pekka


    The papers in the present SUERF Study is a selection of the papers presented at a SUERF Workshop and Special OeNB East Jour Fixe held at Oesterreichische Nationalbank in Vienna on 23 January 2009. In his opening remarks (chapter 2), Ewald Nowotny, Governor of the Oesterreichische Nationalbank referred to Austrian banks? engagement with neighbouring Central and Eastern European Countries. The current crisis should not make people forget the fact that Austrian banks? deep engagement with the ne...

  5. Medical telerobotic systems: current status and future trends. (United States)

    Avgousti, Sotiris; Christoforou, Eftychios G; Panayides, Andreas S; Voskarides, Sotos; Novales, Cyril; Nouaille, Laurence; Pattichis, Constantinos S; Vieyres, Pierre


    Teleoperated medical robotic systems allow procedures such as surgeries, treatments, and diagnoses to be conducted across short or long distances while utilizing wired and/or wireless communication networks. This study presents a systematic review of the relevant literature between the years 2004 and 2015, focusing on medical teleoperated robotic systems which have witnessed tremendous growth over the examined period. A thorough insight of telerobotics systems discussing design concepts, enabling technologies (namely robotic manipulation, telecommunications, and vision systems), and potential applications in clinical practice is provided, while existing limitations and future trends are also highlighted. A representative paradigm of the short-distance case is the da Vinci Surgical System which is described in order to highlight relevant issues. The long-distance telerobotics concept is exemplified through a case study on diagnostic ultrasound scanning. Moreover, the present review provides a classification into short- and long-distance telerobotic systems, depending on the distance from which they are operated. Telerobotic systems are further categorized with respect to their application field. For the reviewed systems are also examined their engineering characteristics and the employed robotics technology. The current status of the field, its significance, the potential, as well as the challenges that lie ahead are thoroughly discussed.

  6. Psychological assessment for bariatric surgery: current practices. (United States)

    Flores, Carolina Aita


    The prevalence of obesity on a global scale has alarmed health institutions, the general population and professionals involved in its treatment. Bariatric surgery has emerged as an effective and lasting alternative for weight reduction and improved general health. In this context and as part of a multidisciplinary team, psychologists are responsible for the preoperative psychological assessment of bariatric candidates. To investigate how psychological assessments are occurring, including the identification of utilized resources; factors that are addressed; the duration of the process; existing protocols; and to evaluate the importance of this practice. A systematic review of national and international literature, through PubMed and Scielo's databases, using "psychological assessment", "obesity" and "surgery", as keywords. There is an agreement about the main factors that should be investigated during the preoperative assessment, as well as the main contraindications for the surgical procedure. The importance of the psychological assessment is well established in the field of bariatric surgery. However, this area needs a standard protocol to guide the mental health professionals that deal with bariatric patients.

  7. Robot-assisted vitreoretinal surgery: current perspectives. (United States)

    Roizenblatt, Marina; Edwards, Thomas L; Gehlbach, Peter L


    Vitreoretinal microsurgery is among the most technically challenging of the minimally invasive surgical techniques. Exceptional precision is required to operate on micron scale targets presented by the retina while also maneuvering in a tightly constrained and fragile workspace. These challenges are compounded by inherent limitations of the unassisted human hand with regard to dexterity, tremor and precision in positioning instruments. The limited human ability to visually resolve targets on the single-digit micron scale is a further limitation. The inherent attributes of robotic approaches therefore, provide logical, strategic and promising solutions to the numerous challenges associated with retinal microsurgery. Robotic retinal surgery is a rapidly emerging technology that has witnessed an exponential growth in capabilities and applications over the last decade. There is now a worldwide movement toward evaluating robotic systems in an expanding number of clinical applications. Coincident with this expanding application is growth in the number of laboratories committed to "robotic medicine". Recent technological advances in conventional retina surgery have also led to tremendous progress in the surgeon's capabilities, enhanced outcomes, a reduction of patient discomfort, limited hospitalization and improved safety. The emergence of robotic technology into this rapidly advancing domain is expected to further enhance important aspects of the retinal surgery experience for the patients, surgeons and society.

  8. Sensing technology current status and future trends

    CERN Document Server

    Mukhopadhyay, Subhas; Jayasundera, Krishanthi; Bhattacharyya, Nabarun


    This book is written for academic and industry professionals working in the field of sensing, instrumentation and related fields, and is positioned to give a snapshot of the current state of the art in sensing technology, particularly from the applied perspective.  The book is intended to give a broad overview of the latest developments, in addition to discussing the process through which researchers go through in order to develop sensors, or related systems, which will become more widespread in the future.  

  9. Historical and Current Trends in Colon Trauma (United States)

    Causey, Marlin Wayne; Rivadeneira, David E.; Steele, Scott R.


    The authors discuss the evolution of the evaluation and management of colonic trauma, as well as the debate regarding primary repair versus fecal diversion. Their evidence-based review covers diagnosis, management, surgical approaches, and perioperative care of patients with colon-related trauma. The management of traumatic colon injuries has evolved significantly over the past 50 years; here the authors describe a practical approach to the treatment and management of traumatic injuries to the colon based on the most current research. However, management of traumatic colon injuries remains a challenge and continues to be associated with significant morbidity. Familiarity with the different methods to the approach and management of colonic injuries will allow surgeons to minimize unnecessary complications and mortality. PMID:24294119

  10. Chemical Engineering Education - Current and Future Trends

    DEFF Research Database (Denmark)

    Gani, Rafiqul

    topics (transport phenomena, separations, reaction engineering, etc.) must remain strong, should the applications that currently emphasize commodity chemicals also include new topics such as sustainability, and product design? In Europe, the European Federation of Chemical Engineering (EFCE) has taken...... has a product focus. With this shift of the chemical industry, what should be the curriculum of the chemical engineering degrees at the BSc- and MSc-levels, and, are the skill set of chemical engineers appropriate for this altered chemical industry? While the basic skill set, defined by the core...... a leading role to define the chemical engineering curriculum. The result has been a set of recommendations for the first (BSc), second (MSc) and third (PhD) cycle chemical engineering education aligned to the Bologna Process. They recommend that students studying towards bachelor and masters qualifications...

  11. Sagebrush ecosystems: current status and trends. (United States)

    Beever, E.A.; Connelly, J.W.; Knick, S.T.; Schroeder, M.A.; Stiver, S. J.


    The sagebrush (Artemisia spp.) biome has changed since settlement by Europeans. The current distribution, composition and dynamics, and disturbance regimes of sagebrush ecosystems have been altered by interactions among disturbance, land use, and invasion of exotic plants. In this chapter, we present the dominant factors that have influenced habitats across the sagebrush biome. Using a large-scale analysis, we identified regional changes and patterns in “natural disturbance”, invasive exotic species, and influences of land use in sagebrush systems. Number of fires and total area burned has increased since 1980 across much of the sagebrush biome. Juniper (Juniperus spp.) and pinyon (Pinus spp.) woodlands have expanded into sagebrush habitats at higher elevations. Cheatgrass (Bromus tectorum), an exotic annual grass, has invaded much of lower elevation, more xeric sagebrush landscapes across the western portion of the biome. Consequently, synergistic feedbacks between habitats and disturbance (natural and human-caused) have altered disturbance regimes, plant community dynamics and contributed to loss of sagebrush habitats and change in plant communities. Habitat conversion to agriculture has occurred in the highly productive regions of the sagebrush biome and influenced up to 56% of the Conservation Assessment area. Similarly, urban areas, and road, railroad, and powerline networks fragment habitats, facilitate predator movements, and provide corridors for spread of exotic species across the entire sagebrush biome. Livestock grazing has altered sagebrush habitats; the effects of overgrazing combined with drought on plant communities in the late 1880s and early 1900s still influences current habitats. Management of livestock grazing has influenced sagebrush ecosystems by habitat treatments to increase forage and reduce sagebrush and other plant species unpalatable to livestock. Fences, roads, and water developments to manage livestock movements have further

  12. Gastrointestinal robot-assisted surgery. A current perspective. (United States)

    Lunca, Sorinel; Bouras, George; Stanescu, Alexandru Calin


    Minimally invasive techniques have revolutionized operative surgery. Computer aided surgery and robotic surgical systems strive to improve further on currently available minimally invasive surgery and open new horizons. Only several centers are currently using surgical robots and publishing data. In gastrointestinal surgery, robotic surgery is applied to a wide range of procedures, but is still in its infancy. Cholecystectomy, Nissen fundoplication and Heller myotomy are among the most frequently performed operations. The ZEUS (Computer Motion, Goleta, CA) and the da Vinci (Intuitive Surgical, Mountain View, CA) surgical systems are today the most advanced robotic systems used in gastrointestinal surgery. Most studies reported that robotic gastrointestinal surgery is feasible and safe, provides improved dexterity, better visualization, reduced fatigue and high levels of precision when compared to conventional laparoscopic surgery. Its main drawbacks are the absence of force feedback and extremely high costs. At this moment there are no reports to clearly demonstrate the superiority of robotics over conventional laparoscopic surgery. Further research and more prospective randomized trials are needed to better define the optimal application of this new technology in gastrointestinal surgery.

  13. Virtual Inertia: Current Trends and Future Directions

    Directory of Open Access Journals (Sweden)

    Ujjwol Tamrakar


    Full Text Available The modern power system is progressing from a synchronous machine-based system towards an inverter-dominated system, with large-scale penetration of renewable energy sources (RESs like wind and photovoltaics. RES units today represent a major share of the generation, and the traditional approach of integrating them as grid following units can lead to frequency instability. Many researchers have pointed towards using inverters with virtual inertia control algorithms so that they appear as synchronous generators to the grid, maintaining and enhancing system stability. This paper presents a literature review of the current state-of-the-art of virtual inertia implementation techniques, and explores potential research directions and challenges. The major virtual inertia topologies are compared and classified. Through literature review and simulations of some selected topologies it has been shown that similar inertial response can be achieved by relating the parameters of these topologies through time constants and inertia constants, although the exact frequency dynamics may vary slightly. The suitability of a topology depends on system control architecture and desired level of detail in replication of the dynamics of synchronous generators. A discussion on the challenges and research directions points out several research needs, especially for systems level integration of virtual inertia systems.


    Directory of Open Access Journals (Sweden)

    Selin Yıldız


    Full Text Available The synergy of architecture and other disciplines in studies of developing tourism is  significant in terms of continuity of past and future. Now architects and urban designers are working in collaboration with social sciences disciplines in the field of urban tourism. Some examples of cultural, artistic and social activities can be listed as: re-transformation of port districts, opening of new museums, new additions to the fabric of the historic city, theme parks, coastal regulations, re-use of historic structures, innovative approaches to accommodation services, production of the metropolitan centers, architectural competitions organized by central and local governments, prestige landscapes, innovative, technological and ecological approaches in architecture, festivals, design and fashion weeks, guided tours, city walks, local meetings, lectures, courses in art education, concerts, sport events, fairs , the cultural capitals. The paper analyses these works companion to tourism in detail and in a holistic sese, questions these studies in urban,  economic, cultural and social movement axes. This inquiry aims to discuss current  projects being carried out in Istanbul which is an important city in the world, also to offer a wide range of tips for conducting a collaborative, multi-dimensional perspective studies carried out in the field of tourism.

  15. Current Trends in the Management of Retinoblastoma

    Directory of Open Access Journals (Sweden)

    Hayyam Kıratlı


    Full Text Available Retinoblastoma is the most common primary intraocular malignant tumor of early childhood, and 95% of all cases are diagnosed before the age of 5 years. Tumors are evaluated and classified based on laterality, genetic features, the number, location and size of foci. Currently, systemic and intaarterial chemotherapy are the most commonly used management options worldwide. Group A tumors are treated with focal techniques including transpupillary thermotherapy, cryotherapy, or laser photocoagulation. Groups B and C tumors are managed with systemic chemotherapy and focal consolidation techniques. Group D lesions are best treated with systemic chemotherapy, subtenon carboplatin injection or external beam radiotherapy. Alternatively, groups B, C and D tumors can be primarily treated with intraarterial chemotherapy. Intravitreal melphalan injection can be an alternative treatment for eyes with recurrent or persistent vitreous seeding. Group E eyes are often enucleated, however, depending on the fellow eye, systemic or intraarterial chemotherapy may be administered. Systemic chemotherapy is also mandatory if high-risk histopathological features are found after enucleation. (Turk J Ophthalmol 2014; 44: Supplement 22-8

  16. Current trends in the pharmacotherapy for obesity

    Directory of Open Access Journals (Sweden)

    Sanja Klobučar Majanović


    Full Text Available Obesity represents a major global challenge from both healthcare and economic perspectives. Although lifestyle modifications aimed at reducing calorie intake and increasing energy expenditure remain the cornerstone of obesity management, pharmacotherapy can serve as a useful adjunct. Until recently, orlistat was the only medication registered for the treatment of obesity in the European Union (EU. A deeper understanding of the complexity of energy homeostasis has resulted in new pharmacological options for weight reduction. In 2015, two new antiobesity drugs were approved in the EU. These are a fixed combination of naltrexone/bupropion (Mysimba® and liraglutide at a dose of 3.0 mg (Saxenda®. In addition, lorcaserin (Belviq® and a fixed combination of phentermine/topiramate (Qsymia® were introduced into the US market in 2012. However, the European Medicines Agency did not approve their use in the EU. The burden of previous weight loss agents that have been withdrawn due to safety concerns underlines the need for caution and close follow-up of patients undergoing pharmacological interventions for obesity treatment. This article provides an overview of the efficacy and safety of currently available weight loss pharmacotherapies.

  17. Current trends in methods for neutron diffusion calculations

    International Nuclear Information System (INIS)

    Adams, C.H.


    Current work and trends in the application of neutron diffusion theory to reactor design and analysis are reviewed. Specific topics covered include finite-difference methods, synthesis methods, nodal calculations, finite-elements and perturbation theory

  18. Refractive surgery trends and practice style changes in Germany over a 3-year period. (United States)

    Schmack, Ingo; Auffarth, Gerd U; Epstein, Daniel; Holzer, Mike P


    To study the current practice styles and preferences of refractive surgeons in Germany. In February 2008, a seven-item questionnaire regarding the practice of refractive surgery was mailed to 282 members of the German Society of Intra-ocular Lens Implantation, Interventional, and Refractive Surgery (DGII) and the Commission of Refractive Surgery (KRC). Most questions were identical to our 2005 German refractive surgery survey. All data were analyzed in a masked fashion. The response rate was 42.2%. The majority (68%) of respondents reported that they perform refractive surgery in laser centers (exclusively or partially) followed by general hospitals (19.4%) and universities (12.6%). Although LASIK was the predominant type of refractive surgery performed (80.6%), other refractive procedures included refractive lens exchange (60.2%), photorefractive keratectomy (47.6%), phakic intraocular lens implants (45.6%), laser-assisted subepithelial keratectomy (36.9%), epithelial laser in situ keratomileusis (15.5%), intracorneal rings (5.8%), and limbal relaxing incisions (2.9%). The volume of refractive surgery procedures and the preferred type of excimer laser systems, microkeratomes, and diagnostic devices varied at different institutions. Most respondents performed either wavefront-guided custom ablation or wavefront-optimized ablation (63.1%) compared with conventional excimer laser correction (36.9%). Refractive surgery practice styles and preferences in Germany are comparable to trends in other European countries. Although LASIK is the most commonly performed refractive procedure, the numbers of various surface ablation techniques and refractive intraocular lens procedures are increasing. Copyright 2010, SLACK Incorporated.

  19. Current status of pediatric minimal access surgery at Sultan Qaboos ...

    African Journals Online (AJOL)

    Keywords: current status, laparoscopy, minimal access surgery, thoracoscopy. Departments of ... Materials and methods ... procedures, the open technique was used for the creation ... operated for bilateral inguinal herniotomy had recurrence.

  20. Robotic bariatric surgery: A general review of the current status. (United States)

    Jung, Minoa K; Hagen, Monika E; Buchs, Nicolas C; Buehler, Leo H; Morel, Philippe


    While conventional laparoscopy is the gold standard for almost all bariatric procedures, robotic assistance holds promise for facilitating complex surgeries and improving clinical outcomes. Since the report of the first robotic-assisted bariatric procedure in 1999, numerous publications, including those reporting comparative trials and meta-analyses across bariatric procedures with a focus on robotic assistance, can be found. This article reviews the current literature and portrays the perspectives of robotic bariatric surgery. While there are substantial reports on robotic bariatric surgery currently in publication, most studies suffer from low levels of evidence. As such, although robotics technology is without a doubt superior to conventional laparoscopy, the precise role of robotics in bariatric surgery is not yet clear. Copyright © 2017 John Wiley & Sons, Ltd.

  1. Robotic technology in surgery: current status in 2008. (United States)

    Murphy, Declan G; Hall, Rohan; Tong, Raymond; Goel, Rajiv; Costello, Anthony J


    There is increasing patient and surgeon interest in robotic-assisted surgery, particularly with the proliferation of da Vinci surgical systems (Intuitive Surgical, Sunnyvale, CA, USA) throughout the world. There is much debate over the usefulness and cost-effectiveness of these systems. The currently available robotic surgical technology is described. Published data relating to the da Vinci system are reviewed and the current status of surgical robotics within Australia and New Zealand is assessed. The first da Vinci system in Australia and New Zealand was installed in 2003. Four systems had been installed by 2006 and seven systems are currently in use. Most of these are based in private hospitals. Technical advantages of this system include 3-D vision, enhanced dexterity and improved ergonomics when compared with standard laparoscopic surgery. Most procedures currently carried out are urological, with cardiac, gynaecological and general surgeons also using this system. The number of patients undergoing robotic-assisted surgery in Australia and New Zealand has increased fivefold in the past 4 years. The most common procedure carried out is robotic-assisted laparoscopic radical prostatectomy. Published data suggest that robotic-assisted surgery is feasible and safe although the installation and recurring costs remain high. There is increasing acceptance of robotic-assisted surgery, especially for urological procedures. The da Vinci surgical system is becoming more widely available in Australia and New Zealand. Other surgical specialties will probably use this technology. Significant costs are associated with robotic technology and it is not yet widely available to public patients.

  2. Educational Research in Mainland China: Current Situation and Developmental Trends (United States)

    Sun, Miantao


    The influence of Confucian culture in Chinese Mainland China is reflected in the current situation and contextual trends of educational research content of educational thought of Confucianism, educational issues grounded on theoretical views of Confucianism, and the influence of the inclusiveness of Confucianism. In terms of research method, the…

  3. Current trends in chloroplast genome research | Khan | African ...

    African Journals Online (AJOL)

    comprise of DOGMA for annotation, SCAN-SE, ARAGON and PREP suit for RNA analyses and CG viewer for circular map construction/comparative analysis. Faster algorithms for gene-order based phylogenetic reconstruction and bootstrap analysis have attracted the attention of research community. Current trends in ...

  4. Counseling in Malaysia: History, Current Status, and Future Trends (United States)

    See, Ching Mey; Ng, Kok-Mun


    This article presents an overview of the history of counseling in Malaysia, provides an update of its current status, and discusses some anticipated future trends for the profession in light of recent developments in the country. Counseling in Malaysia began with school guidance in the 1960s and has now achieved recognition as a profession in…

  5. Current Technology Trends for School Library Media Specialists


    Leticia Ekhaml; Joan Hubbard


    An overview of some of the current technology trends used in classroom instruction and school library media centers in provided in this article such as the use of handheld electronic organizers, CD recorders, digital video cameras, and interactive whiteboards. The article offers some suggestions or ideas on how to acquire new technologies to school library media centers that are low in budgetary funds.

  6. West Virginia Women Business Owners: Current Study and Trends Report. (United States)

    Holup, Linda L.; FitzGerald, Kathleen M.

    This report profiles current West Virginia women business owners and notes significant trends in the last eight years. It highlights a subgroup of women business owners, specifically low income, single women with children. These survey areas are discussed: industry sector, type of ownership, reasons for going/not going into business, planning…

  7. Current Trends in European Quality Assurance. ENQA Workshop Report 8 (United States)

    Bozo, Dhurata; Damian, Radu; Gonzalez, Cecilia de la Rosa; Helle, Emmi; Imoda, Franco; Kohler, Alexander; Papazoglou, Vassilios J.; Dalmau, Gemma Rauret; Shopov, Todor


    The present report is a product of two ENQA (European Association for Quality Assurance in Higher Education) seminars, held in 2007, on current trends in European Quality Assurance. The first seminar, hosted by the Bulgarian National Evaluation and Accreditation Agency (NEAA), examined the situation in South-Eastern Europe. The second seminar…

  8. Current Trends in Higher Education Learning and Teaching (United States)

    Singh, R. J.


    Current trends in higher education learning and teaching focuses on the use of technology, integrated learning through "blended learning" and writing for academic purposes. This introductory article initiates the debate around the context of South African higher education teaching and learning. It does so by contextualizing the South…

  9. Current Trends in Aerospace Engineering Education on Taiwan. (United States)

    Hsieh, Sheng-Jii

    A proposal for current trends in Aerospace Engineering Education on Taiwan has been drawn from the suggestions made after a national conference of "Workshop on Aerospace Engineering Education Reform." This workshop was held in January 18-20, 1998, at the Institute of Aeronautics and Astronautics, National Cheng Kung University, Tainan,…

  10. Research on Current Trends and Developments in Library Automation Systems. (United States)

    Clyde, Laurel A.

    A research project was undertaken in 1992 in order to identify, describe, and analyze current trends and developments in library automation systems and library software. The starting point is work conducted in 1988/1989 that formed the foundation of the book "Computer Software for School Libraries: A Directory." A 1992 survey of software…

  11. Five Aspects of Current Trends in German Library Science (United States)

    Steierwald, Ulrike


    The specialisation Library Science at the Hochschule Darmstadt/University of Applied Science Darmstadt is the newest academic program in Germany for the higher education of librarians. Five current trends in library science in Germany reflect the new "Darmstadt Model": (1) The delimitation of a specific professional field…

  12. Current status of cerebral glioma surgery in China. (United States)

    Wu, Jin-song; Zhang, Jie; Zhuang, Dong-xiao; Yao, Cheng-jun; Qiu, Tian-ming; Lu, Jun-feng; Zhu, Feng-ping; Mao, Ying; Zhou, Liang-fu


    The treatment of gliomas is highly individualized. Surgery for gliomas is essentially for histological diagnosis, to alleviate mass effect, and most importantly, to favor longer survival expectancy. During the past two decades, many surgical techniques and adjuvants have been applied to glioma surgery in China, which lead to a rapid development in the field of cerebral glioma surgery. This article broadly and critically reviewed the existing studies on cerebral glioma surgery and to portrait the current status of glioma surgery in China. A literature search was conducted covering major innovative surgical techniques and adjuvants for glioma surgery in China. The following databases were searched: the Pubmed (January 1995 to date); China Knowledge Resource Integrated Database (January 1995 to date) and VIP Database for Chinese Technical Periodicals (January 1995 to date). A selection criterion was established to exclude duplicates and irrelevant studies. The outcome measures were extracted from included studies. A total of 3307 articles were initially searched. After excluded by abstracts and full texts, 69 studies conducted in the mainland of China were included and went through further analysis. The philosophy of surgical strategies for cerebral gliomas in China is undergoing tremendous change. Nowadays Chinese neurosurgeons pay more attention to the postoperative neurofunctional status of the patients. The aim of the glioma surgery is not only the more extensive tumor resection but also the maximal safety of intervention. The well balance of longer overall survival and higher quality of life should be judged with respect to each individual patient.

  13. Robotic general surgery: current practice, evidence, and perspective. (United States)

    Jung, M; Morel, P; Buehler, L; Buchs, N C; Hagen, M E


    Robotic technology commenced to be adopted for the field of general surgery in the 1990s. Since then, the da Vinci surgical system (Intuitive Surgical Inc, Sunnyvale, CA, USA) has remained by far the most commonly used system in this domain. The da Vinci surgical system is a master-slave machine that offers three-dimensional vision, articulated instruments with seven degrees of freedom, and additional software features such as motion scaling and tremor filtration. The specific design allows hand-eye alignment with intuitive control of the minimally invasive instruments. As such, robotic surgery appears technologically superior when compared with laparoscopy by overcoming some of the technical limitations that are imposed on the surgeon by the conventional approach. This article reviews the current literature and the perspective of robotic general surgery. While robotics has been applied to a wide range of general surgery procedures, its precise role in this field remains a subject of further research. Until now, only limited clinical evidence that could establish the use of robotics as the gold standard for procedures of general surgery has been created. While surgical robotics is still in its infancy with multiple novel systems currently under development and clinical trials in progress, the opportunities for this technology appear endless, and robotics should have a lasting impact to the field of general surgery.

  14. Anesthesia for day-care surgeries: Current perspectives

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa


    Full Text Available Day-care surgery has become a popular modality of surgical intervention throughout the globe. Numerous factors including the economic and financial issues are driving this therapeutic modality to a widespread acceptance among surgeons and anesthesiologists. Advancements in anesthesia and surgical techniques as well as availability of newer drugs are largely responsible for the progress of day-care surgeries. Numerous challenges are still faced by anesthesiologists and surgeons in carrying out day-care surgeries, especially in spite of these advancements, at resource-limited setups. The first right step in successfully delivering the day-care surgical services includes proper selection of the patients. The preanesthetic evaluation is highly essential in determining the suitability of the patient for day-care anesthesia and surgery as well as the formulation of various anesthetic plans and strategies. The current review is intended to highlight inherent challenges and probable solutions to them for this rapidly progressing anesthesia.

  15. Modern trends in oesophageal surgery | Bremner | South African ...

    African Journals Online (AJOL)

    ... oesophageal disease, advances in instrumentation and the surge of molecular biological interests. The recent explosion of bariatric surgery in the USA has also opened new dimensions for investigation of the effects of bariatric procedures on oesophageal function. South African Journal of Surgery Vol.43(1) 2005: 13-16 ...

  16. The Canadian general surgery resident: defining current challenges for surgical leadership. (United States)

    Tomlinson, Corey; Labossière, Joseph; Rommens, Kenton; Birch, Daniel W


    Surgery training programs in Canada and the United States have recognized the need to modify current models of training and education. The shifting demographic of surgery trainees, lifestyle issues and an increased trend toward subspecialization are the major influences. To guide these important educational initiatives, a contemporary profile of Canadian general surgery residents and their impressions of training in Canada is required. We developed and distributed a questionnaire to residents in each Canadian general surgery training program, and residents responded during dedicated teaching time. In all, 186 surveys were returned for analysis (62% response rate). The average age of Canadian general surgery residents is 30 years, 38% are women, 41% are married, 18% have dependants younger than 18 years and 41% plan to add to or start a family during residency. Most (87%) residents plan to pursue postgraduate education. On completion of training, 74% of residents plan to stay in Canada and 49% want to practice in an academic setting. Almost half (42%) of residents identify a poor balance between work and personal life during residency. Forty-seven percent of respondents have appropriate access to mentorship, whereas 37% describe suitable access to career guidance and 40% identify the availability of appropriate social supports. Just over half (54%) believe the stress level during residency is manageable. This survey provides a profile of contemporary Canadian general surgery residents. Important challenges within the residency system are identified. Program directors and chairs of surgery are encouraged to recognize these challenges and intervene where appropriate.

  17. Cobalt 60 gamma irradiation current status, trends and insights

    International Nuclear Information System (INIS)

    Corley, John T.


    This paper discusses the current status, trends and insights into the continued, safe use of cobalt 60 gamma irradiation. Also presented are some of the many initiatives undertaken at MDS Nordion. Topics covered include our investment for the future supply of raw materials and the latest news from source production. Briefly presented are the tasks associated with the safe transport of cobalt 60 around the world. Discussed is cobalt 60 usage at the customer site; more specifically maintaining source integrity, source utilization and irradiator design trends. Highlighted are industry trends for North America, Europe and the rest of the world. Finally presented are the challenges and opportunities for the industry. Stressed in the paper is the need to work together

  18. Gender Authorship Trends of Plastic Surgery Research in the United States. (United States)

    Silvestre, Jason; Wu, Liza C; Lin, Ines C; Serletti, Joseph M


    An increasing number of women are entering the medical profession, but plastic surgery remains a male-dominated profession, especially within academia. As academic aspirations and advancement depend largely on research productivity, the authors assessed the number of articles authored by women published in the journal Plastic and Reconstructive Surgery. Original articles in Plastic and Reconstructive Surgery published during the years 1970, 1980, 1990, 2000, 2004, and 2014 were analyzed. First and senior authors with an M.D. degree and U.S. institutional affiliation were categorized by gender. Authorship trends were compared with those from other specialties. Findings were placed in the context of gender trends among plastic surgery residents in the United States. The percentage of female authors in Plastic and Reconstructive Surgery increased from 2.4 percent in 1970 to 13.3 percent in 2014. Over the same time period, the percentage of female plastic surgery residents increased from 2.6 percent to 32.5 percent. By 2014, there were more female first authors (19.1 percent) than senior authors (7.7 percent) (p < 0.001). As a field, plastic surgery had fewer female authors than other medical specialties including pediatrics, obstetrics and gynecology, general surgery, internal medicine, and radiation oncology (p < 0.05). The increase in representation of female authors in plastic surgery is encouraging but lags behind advances in other specialties. Understanding reasons for these trends may help improve gender equity in academic plastic surgery.

  19. Current Status of Single-incision Laparoscopic Surgery

    DEFF Research Database (Denmark)

    Ahmed, Irfan; Ciancio, Fabio; Ferrara, Vincenzo


    Recent advances in minimally invasive surgery have centered on reducing the number of incisions required, which has led to the development of the single-incision laparoscopic technique. A panel of European single-incision laparoscopy experts met to discuss the current status of, and the future...

  20. Computers in nuclear medicine - current trends and future directions

    International Nuclear Information System (INIS)



    Previously, a decision to purchase computing equipment for nuclear medicine usually required evaluation of the 'local' needs. With the advent of Pacs and state of the art computer techniques for image acquisition and manipulation, purchase and subsequent application is to become much more complex. Some of the current trends and future possibilities which may influence the choice and operation of computers within and outside the nuclear medicine environment is discussed. (author)

  1. Current Technology Trends for School Library Media Specialists

    Directory of Open Access Journals (Sweden)

    Leticia Ekhaml


    Full Text Available An overview of some of the current technology trends used in classroom instruction and school library media centers in provided in this article such as the use of handheld electronic organizers, CD recorders, digital video cameras, and interactive whiteboards. The article offers some suggestions or ideas on how to acquire new technologies to school library media centers that are low in budgetary funds.

  2. Evolution and Current Trends in Liquid and Supercritical Fluid Chromatography


    Fekete, Szabolcs; Grand-Guillaume-Perrenoud, Alexandre; Guillarme, Davy


    The current trend in high performance liquid chromatography (HPLC) tends toward the achievement of higher separation efficiency and shorter analysis time. Indeed, better performance in LC has become increasingly important in recent years mainly driven by the challenges of either analyzing more complex samples or increasing the numbers of samples per time unit. In the recent development of particle technology, the use of fully porous sub-2 m particles and sub-3 m shell particles have received ...

  3. Stress urinary incontinence surgery trends in academic female pelvic medicine and reconstructive surgery urology practice in the setting of the food and drug administration public health notifications. (United States)

    Rac, Goran; Younger, Austin; Clemens, James Q; Kobashi, Kathleen; Khan, Aqsa; Nitti, Victor; Jacobs, Ilana; Lemack, Gary E; Brown, Elizabeth T; Dmochowski, Roger; MacLachlan, Lara; Mourtzinos, Arthur; Ginsberg, David; Koski, Michelle; Rames, Ross; Rovner, Eric S


    To investigate the possible effects of the Food and Drug Administration (FDA) Public Health Notifications in 2008 and 2011 regarding surgical trends in transvaginal mesh (TVM) placement for stress urinary incontinence (SUI) and related mesh revision surgery in Female Pelvic Medicine & Reconstructive Surgery (FPMRS) practice in tertiary care academic medical centers in the United States. Surgical volume for procedures performed primarily by FPMRS surgeons at eight academic institutions across the US was collected using Current Procedural Terminology (CPT) codes for stress urinary incontinence repair and revision surgeries from 2007 to 2013. SAS statistical software was used to assess for trends in the data. There was a decrease in the use of synthetic mesh sling for the treatment of SUI at academic tertiary care centers over the past 7 years; however, this was not statistically significant. While the total number of surgical interventions for SUI remained stable, there was an increase in the utilization of autologous fascia pubovaginal slings (AFPVS). The number of mesh sling revision surgeries, including urethrolysis and removal or revision of slings, increased almost three-fold at these centers. These observed trends suggest a possible effect of the FDA Public Health Notifications regarding TVM on surgical practice for SUI in academic centers, even though they did not specifically warn against the use of synthetic mesh for this indication. Indications for surgery, complications, and outcomes were not evaluated during this retrospective study. However, such data may provide alternative insights into reasons for the observed trends. Neurourol. Urodynam. 36:1155-1160, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  4. Current trends in molecular diagnostics of chronic myeloid leukemia. (United States)

    Vinhas, Raquel; Cordeiro, Milton; Pedrosa, Pedro; Fernandes, Alexandra R; Baptista, Pedro V


    Nearly 1.5 million people worldwide suffer from chronic myeloid leukemia (CML), characterized by the genetic translocation t(9;22)(q34;q11.2), involving the fusion of the Abelson oncogene (ABL1) with the breakpoint cluster region (BCR) gene. Early onset diagnosis coupled to current therapeutics allow for a treatment success rate of 90, which has focused research on the development of novel diagnostics approaches. In this review, we present a critical perspective on current strategies for CML diagnostics, comparing to gold standard methodologies and with an eye on the future trends on nanotheranostics.

  5. Trends in the exchange current for hydrogen evolution

    DEFF Research Database (Denmark)

    Nørskov, Jens Kehlet; Bligaard, Thomas; Logadottir, Ashildur


    A density functional theory database of hydrogen chemisorption energies on close packed surfaces of a number of transition and noble metals is presented. The bond energies are used to understand the trends in the exchange current for hydrogen evolution. A volcano curve is obtained when measured...... exchange currents are plotted as a function of the calculated hydrogen adsorption energies and a simple kinetic model is developed to understand the origin of the volcano. The volcano curve is also consistent with Pt being the most efficient electrocatalyst for hydrogen evolution. (c) 2005...

  6. Changing trend in emergency surgery for perforated duodenal ulcer

    International Nuclear Information System (INIS)

    Gurteyik, E.


    Objective: To evaluate changes in the emergency surgery of the duodenal ulcer. Subjects and Methods: Hospital records of 523 surgically treated patients, with duodenal ulcer perforation, during the period of 25 years 91975-1999) in the same surgical department, was retrospectively analysed. Changing aspects of emergency surgery of peptic ulcer disease, in the recent period, were determined in respect to number of operations per year and in the choice of operative methods. Results: The average number of patients and emergency operations per year was 21. No significant change was observed during the study period. Elective operations gradually decreased in the last ten years, and none was performed in the last 4 years. On the other hand, 226 emergency interventions for duodenal ulcer perforation were performed in the last ten years and 84 interventions in the last 4 years. Definitive anti-ulcer surgery was performed in 42% of patients between 1985 and 1994. Simple closure of the perforation plus treatment with proton pump inhibitors and with anti-Helicobacter pylori medication was the method in 80% during the last year. Conclusion: Emergency surgery for perforated duodenal ulcer preserves its steady rate despite disappearance of elective operations after tremendous progress in medical control of peptic ulcer disease. There is an obvious return from definitive anti-ulcer surgery to simple closure of the perforation followed by antisecretory and antibacterial medications in the recent years. (author)

  7. Temporal trend of carpal tunnel release surgery: a population-based time series analysis.

    Directory of Open Access Journals (Sweden)

    Naif Fnais

    Full Text Available BACKGROUND: Carpal tunnel release (CTR is among the most common hand surgeries, although little is known about its pattern. In this study, we aimed to investigate temporal trends, age and gender variation and current practice patterns in CTR surgeries. METHODS: We conducted a population-based time series analysis among over 13 million residents of Ontario, who underwent operative management for carpal tunnel syndrome (CTS from April 1, 1992 to March 31, 2010 using administrative claims data. RESULTS: The primary analysis revealed a fairly stable procedure rate of approximately 10 patients per 10,000 population per year receiving CTRs without any significant, consistent temporal trend (p = 0.94. Secondary analyses revealed different trends in procedure rates according to age. The annual procedure rate among those age >75 years increased from 22 per 10,000 population at the beginning of the study period to over 26 patients per 10,000 population (p<0.01 by the end of the study period. CTR surgical procedures were approximately two-fold more common among females relative to males (64.9% vs. 35.1 respectively; p<0.01. Lastly, CTR procedures are increasingly being conducted in the outpatient setting while procedures in the inpatient setting have been declining steadily - the proportion of procedures performed in the outpatient setting increased from 13% to over 30% by 2010 (p<0.01. CONCLUSION: Overall, CTR surgical-procedures are conducted at a rate of approximately 10 patients per 10,000 population annually with significant variation with respect to age and gender. CTR surgical procedures in ambulatory-care facilities may soon outpace procedure rates in the in-hospital setting.

  8. Trends in Accreditation Council for Graduate Medical Education Accreditation for Subspecialty Fellowship Training in Plastic Surgery. (United States)

    Silvestre, Jason; Serletti, Joseph M; Chang, Benjamin


    The purposes of this study were to (1) determine the proportion of plastic surgery residents pursuing subspecialty training relative to other surgical specialties, and (2) analyze trends in Accreditation Council for Graduate Medical Education accreditation of plastic surgery subspecialty fellowship programs. The American Medical Association provided data on career intentions of surgical chief residents graduating from 2014 to 2016. The percentage of residents pursuing fellowship training was compared by specialty. Trends in the proportion of accredited fellowship programs in craniofacial surgery, hand surgery, and microsurgery were analyzed. The percentage of accredited programs was compared between subspecialties with added-certification options (hand surgery) and subspecialties without added-certification options (craniofacial surgery and microsurgery). Most integrated and independent plastic surgery residents pursued fellowship training (61.8 percent versus 49.6 percent; p = 0.014). Differences existed by specialty from a high in orthopedic surgery (90.8 percent) to a low in colon and rectal surgery (3.2 percent). From 2005 to 2015, the percentage of accredited craniofacial fellowship programs increased, but was not significant (from 27.8 percent to 33.3 percent; p = 0.386). For hand surgery, the proportion of accredited programs that were plastic surgery (p = 0.755) and orthopedic surgery (p = 0.253) was stable, whereas general surgery decreased (p = 0.010). Subspecialty areas with added-certification options had more accredited fellowships than those without (100 percent versus 19.2 percent; p < 0.001). There has been slow adoption of accreditation among plastic surgery subspecialty fellowships, but added-certification options appear to be highly correlated.

  9. Gender trends in authorship in oral and maxillofacial surgery literature: A 30-year analysis. (United States)

    Nkenke, Emeka; Seemann, Rudolf; Vairaktaris, Elefterios; Schaller, Hans-Günter; Rohde, Maximilian; Stelzle, Florian; Knipfer, Christian


    The aim of the present study was to perform a bibliometric analysis of the gender distribution of first and senior authorships in important oral and maxillofacial journals over the 30-year period from 1980 to 2010. Articles published in three representative oral and maxillofacial surgery journals were selected. The years 1980, 1990, 2000, and 2010 were chosen as representative points in time for article selection. Original research, case reports, technical notes, and reviews were included in the analysis. Case reports and technical notes were pooled in one group. For each article, the gender of the first author as well as that of the senior author was determined, based on the inspection of their first name. The type of article was determined and the country of origin of the article was documented. A total 1412 articles were subjected to the data analysis. A significant increase in female authorship in oral and maxillofacial surgery could be identified over the chosen 30-year period. However, the number of publications by male authors was still significantly higher at all points of time, exceeding those of female authors by at least 3.8 fold in 2010. As there is a trend towards feminization of medicine and dentistry, the results of the present study may serve as the basis for further analysis of the current situation, and the identification of necessary actions to accelerate the closure of the gender gap in publishing in oral and maxillofacial surgery. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  10. Cardiovascular disease mortality in the Americas: current trends and disparities. (United States)

    de Fatima Marinho de Souza, Maria; Gawryszewski, Vilma Pinheiro; Orduñez, Pedro; Sanhueza, Antonio; Espinal, Marcos A


    To describe the current situation and trends in mortality due to cardiovascular disease (CVD) in the Americas and explore their association with economic indicators. This time series study analysed mortality data from 21 countries in the region of the Americas from 2000 to the latest available year. Age-adjusted death rates, annual variation in death rates. Regression analysis was used to estimate the annual variation and the association between age-adjusted rates and country income. Currently, CVD comprised 33.7% of all deaths in the Americas. Rates were higher in Guyana (292/100 000), Trinidad and Tobago (289/100 000) and Venezuela (246/100 000), and lower in Canada (108/100 000), Puerto Rico (121/100 000) and Chile (125/100 000). Male rates were higher than female rates in all countries. The trend analysis showed that CVD death rates in the Americas declined -19% overall (-20% among women and -18% among men). Most countries had a significant annual decline, except Guatemala, Guyana, Suriname, Paraguay and Panama. The largest annual declines were observed in Canada (-4.8%), the USA (-3.9%) and Puerto Rico (-3.6%). Minor declines were in Mexico (-0.8%) and Cuba (-1.1%). Compared with high-income countries the difference between the median of death rates in lower middle-income countries was 56.7% higher and between upper middle-income countries was 20.6% higher. CVD death rates have been decreasing in most countries in the Americas. Considerable disparities still remain in the current rates and trends.

  11. Food and Health Some Current Issues and Future Trends


    Gormley, T. R. (Thomas Ronan)


    This paper deals with some of the many current issues and future trends in the area of food, diet and health in Europe. A complete coverage would be impossible in a short article in view of the extent and complexity of the food system and its major interaction with health. It is also important to stress at the outset that food/diet is only one component of health and other factors such as environment, overall lifestyle and genetics also play a major role. The genetic dimension is of particula...

  12. Current Trends in High-Level Synthesis of Asynchronous Circuits

    DEFF Research Database (Denmark)

    Sparsø, Jens


    This paper is a survey paper presenting what the author sees as two major and promising trends in the current research in CAD-tools and design-methods for asynchronous circuits. One branch of research builds on top of existing asynchronous CAD-tools that perform syntax directed translation, e...... a conventional synchronous circuit as the starting point, and then adds some form of handshake-based flow-control. One approach keeps the global clock and implements discrete-time asynchronous operation. Another approach substitutes the clocked registers by asynchronous handshake-registers, thus creating truly...

  13. Radiation sterilization of medical products- current trends and future prospects

    International Nuclear Information System (INIS)

    Sharma, G.


    In medical practice use of sterile pharmaceuticals and single use disposable medical devices is steadily increasing. Sterile pharmaceuticals like injections and ophthalmic ointments are required for therapy. Medical devices are employed for diagnostic, drug administration or corrective purposes, and as implants for temporary, short term or long term residence in the human system. All these products are made available in sterile form by treating them to a suitable process of sterilization i.e. dry/wet heat, ethylene oxide (EtO) gas or ionizing radiation. In this paper current trends and future prospects of radiation sterilization of medical products are given in detail. 9 refs., 7 tabs

  14. Oil development in China: Current status and future trends

    International Nuclear Information System (INIS)

    Ma Linwei; Fu Feng; Li Zheng; Liu Pei


    The future of oil has become an important topic of the discussion of energy policy in China. This paper attempts to present a full picture of the current status and future trends of China’s oil development through system analysis. First, we map a Sankey diagram of China’s oil flow to reveal the physical pattern of China’s oil supply and consumption. Then, we present the historical and ongoing trends of China’s oil flow from key aspects such as oil demand, oil resource availability, technology improvement, and policy adjustment. Based on these understandings, we design three scenarios of China’s oil demand in 2030, and analyze policy implications for oil saving, automotive energy development, and energy security. From the analysis, we draw some conclusions for policy decisions, such as to control the total oil consumption to avoid energy security risks, to enhance oil saving in all sectors with road transportation as the emphasis, and to increase the investment on oil production and refining to secure oil supply and reduce emissions. - Highlights: ► A Sankey Diagram to reveal the physical pattern of China’s oil supply and consumption. ► Present the ongoing trends of China’s oil development. ► Discuss important policy issues such as oil saving, energy security, and emissions reduction.

  15. Bariatric surgery interest around the world: what Google Trends can teach us. (United States)

    Linkov, Faina; Bovbjerg, Dana H; Freese, Kyle E; Ramanathan, Ramesh; Eid, George Michel; Gourash, William


    Bariatric surgery may prove an effective weight loss option for those struggling with severe obesity, but it is difficult to determine levels of interest in such procedures at the population level through traditional approaches. Analysis of Google Trend information may give providers and healthcare systems useful information regarding Internet users' interest in bariatric procedures. The objective of this study was to gather Google Trend information on worldwide Internet searches for "bariatric surgery", "gastric bypass", "gastric sleeve", "gastric plication", and "lap band" from 2004-2012 and to explore temporal relationships with relevant media events, economic variations, and policy modifications. Data were collected using Google Trends. Trend analyses were performed using Microsoft Excel Version 14.3.5 and Minitab V.16.0. Trend analyses showed that total search volume for the term "bariatric surgery" has declined roughly 25% since January 2004, although interest increased approximately 5% from 2011 to 2012. Interest in lap band procedures declined 30% over the past 5 years, while "gastric sleeve" has increased 15%. Spikes in search numbers show an association with events such as changing policy and insurance guidelines and media coverage for bariatric procedures. This report illustrates that variations in Internet search volume for terms related to bariatric surgery are multifactorial in origin. Although it is impossible to ascertain if reported Internet search volume is based on interest in potentially undergoing bariatric surgery or simply general interest, this analysis reveals that search volume appears to mirror real world events. Therefore, Google Trends could be a way to supplement understanding about interest in bariatric procedures. © 2013 American Society for Bariatric Surgery Published by American Society for Metabolic and Bariatric Surgery All rights reserved.

  16. Trends in workforce diversity in vascular surgery programs in the United States. (United States)

    Kane, Katherine; Rosero, Eric B; Clagett, G Patrick; Adams-Huet, Beverley; Timaran, Carlos H


    U.S. black and Hispanic populations are growing at a steady pace. In contrast, the medical profession lacks the same minority growth and representation. Women are also under-represented in many surgical disciplines. The purpose of this study was to assess trends in the proportion of women, blacks, and Hispanics admitted to vascular surgery (VS) and related specialties, and to compare them with each other and with a surgical specialty, orthopedic surgery (OS), with a formal diversity initiative. Data on the fellowship pool of VS, interventional radiology (IR), and interventional cardiology (IC), as well as the resident pools of general surgery (GS) and orthopedic surgery (OS), were obtained from U.S. graduate medical education reports for 1999 through 2005. Cochrane-Armitage trend tests were used to assess trends in the proportion of females, blacks, and Hispanics in relation to the total physician workforce for each subspecialty. No significant trends in the proportion of females, blacks, or Hispanics accepted into VS and IC fellowship programs occurred during the study period. In contrast, IR, GS, and OS programs revealed significant trends for increasing proportions of at least one of the underrepresented study groups. In particular, OS, which has implemented a diversity awareness program, showed a positive trend in female and Hispanic trainees (P workforce diversity.

  17. Current integrated cardiothoracic surgery residents: a Thoracic Surgery Residents Association survey. (United States)

    Tchantchaleishvili, Vakhtang; LaPar, Damien J; Stephens, Elizabeth H; Berfield, Kathleen S; Odell, David D; DeNino, Walter F


    After approval by the Thoracic Surgery Residency Review Committee in 2007, 6-year integrated cardiothoracic surgery (I-6) residency programs have gained in popularity. We sought to assess and objectively quantify the level of satisfaction I-6 residents have with their training and to identify areas of improvement for future curriculum development. A completely anonymous, electronic survey was created by the Thoracic Surgery Residents Association that asked the responders to provide demographic information, specialty interest, and lifestyle priorities, and to rate their experience and satisfaction with I-6 residency. The survey was distributed nationwide to all residents in I-6 programs approved by the Accreditation Council for Graduate Medical Education. Of a total of 88 eligible I-6 residents, 49 completed the survey (55.7%). Career choice satisfaction was high (75.5%), as was overall satisfaction with integrated training (83.7%). The majority (77.6%) were interested in cardiac surgery. Overall, the responders reported sufficient time for life outside of the hospital (57.1%), but experienced conflicts between work obligations and personal life at least sometimes (75.5%). Early exposure to cardiothoracic surgery was reported as the dominant advantage of the I-6 model, whereas variable curriculum structure and unclear expectations along with poor integration with general surgery training ranked highest among perceived disadvantages. Current I-6 residents are largely satisfied with the integrated training model and report a reasonable work/life balance. The focused nature of training is the primary perceived advantage of the integrated pathway. Curriculum variability and poor integration with general surgery training are identified by residents as primary areas of concern. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  18. Current role of mesh in vaginal prolapse surgery. (United States)

    Richter, Lee A; Carter, Charelle; Gutman, Robert E


    This report summarizes the latest literature on transvaginal mesh (TVM) for the treatment of pelvic organ prolapse, with a focus on indications for use and management of complications. We describe trends in TVM by reviewing the recent literature and summarizing national meeting presentations. Vaginal mesh complications are most often managed surgically, and the majority of patients experiencing mesh-related pain have symptom improvement after intervention. New efforts will focus on identifying variables associated with success after intervention for mesh-related complications, to aid reconstructive pelvic surgeons in outcome prediction and patient counselling. Although the use of TVM has plateaued in recent years, we are seeing an exponential rise in synthetic mesh implant removal. Reconstructive pelvic surgeons advising patients with TVM complications should report that surgical intervention is often necessary, improvement rates of pain-related symptoms after surgery are high, and up to a third may require multiple interventions.

  19. Bariatric surgery and the changing current scope of general surgery practice: implications for general surgery residency training. (United States)

    Mostaedi, Rouzbeh; Ali, Mohamed R; Pierce, Jonathan L; Scherer, Lynette A; Galante, Joseph M


    The scope of general surgery practice has evolved tremendously in the last 20 years. However, clinical experience in general surgery residency training has undergone relatively little change. To evaluate the current scope of academic general surgery and its implications on surgical residency. The University HealthSystem Consortium and Association of American Medical Colleges established the Faculty Practice Solution Center (FPSC) to characterize physician productivity. The FPSC is a benchmarking tool for academic medical centers created from revenue data collected from more than 90,000 physicians who practice at 95 institutions across the United States. The FPSC database was queried to evaluate the annual mean procedure frequency per surgeon (PFS) in each calendar year from 2006 through 2011. The associated work relative value units (wRVUs) were also examined to measure physician effort and skill. During the 6-year period, 146 distinct Current Procedural Terminology codes were among the top 100 procedures, and 16 of these procedures ranked in the top 10 procedures in at least 1 year. The top 10 procedures accounted for more than half (range, 52.5%-57.2%) of the total 100 PFS evaluated for each year. Laparoscopic Roux-en-Y gastric bypass was consistently among the top 10 procedures in each year (PFS, 18.2-24.6). The other most frequently performed procedures included laparoscopic cholecystectomy (PFS, 30.3-43.5), upper gastrointestinal tract endoscopy (PFS, 26.5-34.3), mastectomy (PFS, 16.5-35.0), inguinal hernia repair (PFS, 15.5-22.1), and abdominal wall hernia repair (PFS, 21.6-26.1). In all years, laparoscopic Roux-en-Y gastric bypass generated the highest number of wRVUs (wRVUs, 491.0-618.2), and laparoscopic cholecystectomy was regularly the next highest (wRVUs, 335.8-498.7). A significant proportion of academic general surgery is composed of bariatric surgery, yet surgical training does not sufficiently emphasize the necessary exposure to technical expertise

  20. Current status of natural orifice trans-endoscopic surgery (NOTES and laparoendoscopic single site surgery (LESS in urologic surgery

    Directory of Open Access Journals (Sweden)

    Rafael E. Sanchez-Salas


    Full Text Available Laparoendoscopic single site surgery (LESS and natural orifice transluminal endoscopic surgery (NOTES represent novel approaches in urological surgery. To perform a review of the literature in order describe the current status of LESS and NOTES in Urology. References for this manuscript were obtained by performing a review of the available literature in PubMed from 01-01-02 to 15-05-09. Search terms included single port, single site, NOTES, LESS and single incision. A total of 412 manuscripts were initially identified. Out of these, 64 manuscripts were selected based in their urological content. The manuscript features subheadings for experimental and clinical studies, as NOTES-LESS is a new surgical technique and its future evolution will probably rely in initial verified feasibility. A subheading for reviews presents information regarding common language and consensus for the techniques. The issue of complications published in clinical series and the future needs of NOTES-LESS, are also presented.

  1. Trends in Mediation Analysis in Nursing Research: Improving Current Practice. (United States)

    Hertzog, Melody


    The purpose of this study was to describe common approaches used by nursing researchers to test mediation models and evaluate them within the context of current methodological advances. MEDLINE was used to locate studies testing a mediation model and published from 2004 to 2015 in nursing journals. Design (experimental/correlation, cross-sectional/longitudinal, model complexity) and analysis (method, inclusion of test of mediated effect, violations/discussion of assumptions, sample size/power) characteristics were coded for 456 studies. General trends were identified using descriptive statistics. Consistent with findings of reviews in other disciplines, evidence was found that nursing researchers may not be aware of the strong assumptions and serious limitations of their analyses. Suggestions for strengthening the rigor of such studies and an overview of current methods for testing more complex models, including longitudinal mediation processes, are presented.

  2. Surgical adhesives in ophthalmology: history and current trends. (United States)

    Guhan, Samantha; Peng, Si-Liang; Janbatian, Hrag; Saadeh, Stephanie; Greenstein, Stephen; Al Bahrani, Faisal; Fadlallah, Ali; Yeh, Tsai-Chu; Melki, Samir A


    Tissue adhesives are gaining popularity in ophthalmology, as they could potentially reduce the complications associated with current surgical methods. An ideal tissue adhesive should have superior tensile strength, be non-toxic and anti-inflammatory, improve efficiency and be cost-effective. Both synthetic and biological glues are available. The primary synthetic glues include cyanoacrylate and the recently introduced polyethylene glycol (PEG) derivatives, while most biological glues are composed of fibrin. Cyanoacrylate has a high tensile strength, but rapidly polymerises upon contact with any fluid and has been associated with histotoxicity. Fibrin induces less toxic and inflammatory reactions, and its polymerisation time can be controlled. Tensile strength studies have shown that fibrin is not as strong as cyanoacrylate. While more research is needed, PEG variants currently appear to have the most promise. These glues are non-toxic, strong and time-effective. Through MEDLINE and internet searches, this paper presents a systematic review of the current applications of surgical adhesives to corneal, glaucoma, retinal, cataract and strabismus surgeries. Our review suggests that surgical adhesives have promise to reduce problems in current ophthalmic surgical procedures. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. Microsurgical reconstruction of the head and neck region: Current concepts of maxillofacial surgery units worldwide. (United States)

    Kansy, Katinka; Mueller, Andreas Albert; Mücke, Thomas; Koersgen, Friederike; Wolff, Klaus Dietrich; Zeilhofer, Hans-Florian; Hölzle, Frank; Pradel, Winnie; Schneider, Matthias; Kolk, Andreas; Smeets, Ralf; Acero, Julio; Haers, Piet; Ghali, G E; Hoffmann, Jürgen


    Microvascular surgery following tumor resection has become an important field of oral maxillofacial surgery (OMFS). Following the surveys on current reconstructive practice in German-speaking countries and Europe, this paper presents the third phase of the project when the survey was conducted globally. The DOESAK questionnaire has been developed via a multicenter approach with maxillofacial surgeons from 19 different hospitals in Germany, Austria and Switzerland. It was distributed in three different phases to a growing number of maxillofacial units in German-speaking clinics, over Europe and then worldwide. Thirty-eight units from Germany, Austria and Switzerland, 65 remaining European OMFS-departments and 226 units worldwide responded to the survey. There is wide agreement on the most commonly used flaps, intraoperative rapid sections and a trend towards primary bony reconstruction. No uniform concepts can be identified concerning osteosynthesis of bone transplants, microsurgical techniques, administration of supportive medication and postoperative monitoring protocols. Microsurgical reconstruction is the gold standard for the majority of oncologic cases in Europe, but worldwide, only every second unit has access to this technique. The DOESAK questionnaire has proven to be a valid and well accepted tool for gathering information about current practice in reconstructive OMFS surgery. The questionnaire has been able to demonstrate similarities, differences and global inequalities. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  4. Current Trends in Foreign Trade Theory and Policy

    Directory of Open Access Journals (Sweden)

    Zdzisław W. Puślecki


    Full Text Available In this research work, Author focus on the current analysis trends in foreign trade theory and policy. Accordance with the foreign trade policy theory further trade liberalisation and improved framework policies would increase trade and promote growth. It must be emphasized that openness to trade is associated with higher incomes and growth and there is the need for new approaches to trade cooperation in light of the forces that are currently re-shaping international business. What indicates the importance and innovativeness of the research is the presentation of the new models of the foreign trade policy and trade interests. First of all, it must underline that in the new theoretical terms in demand for trade policy very important is factor specificity. The low specificity of factors means that factor returns are equalized throughout a region’s economy. On the other hand, some factors are stuck in their present uses; therefore, factor returns are not equalized throughout a region’s economy but are industry specific. The main objective of the research task is to give a comprehensive analysis of current trends in foreign trade theory and policy and in particular models of foreign trade policy, trade interests indicated by export orientation and import sensitivity, foreign trade policy in different types of authoritarian regimes, protectionist pressures in different political system, the level of protectionist pressures, the tendencies to bilateralism in the foreign trade policy. It should be stressed that free trade in itself is not responsible for economic growth, but more significant are the determining macroeconomic stability and increasing investment.

  5. Academic plastic surgery: a study of current issues and future challenges. (United States)

    Zetrenne, Eleonore; Kosins, Aaron M; Wirth, Garrett A; Bui, Albert; Evans, Gregory R D; Wells, James H


    The objectives of this study were (1) to evaluate the role of a full-time academic plastic surgeon, (2) to define the indicators predictive of a successful career in academic plastic surgery, and (3) to understand the current issues that will affect future trends in the practice of academic plastic surgery. A questionnaire was developed to evaluate the role of current full-time academic plastic surgeons and to understand the current issues and future challenges facing academic plastic surgery. Each plastic surgery program director in the United States was sent the survey for distribution among all full-time academic plastic surgeons. Over a 6-week period, responses from 143 full-time academic plastic surgeons (approximately 31%) were returned. Fifty-three percent of respondents had been academic plastic surgeons for longer than 10 years. Seventy-three percent of respondents defined academic plastic surgeons as clinicians who are teachers and researchers. However, 53% of respondents believed that academic plastic surgeons were not required to teach or practice within university hospitals/academic centers. The 3 factors reported most frequently as indicative of a successful career in academic plastic surgery were peer recognition, personal satisfaction, and program reputation. Dedication and motivation were the personal characteristics rated most likely to contribute to academic success. Forty-four percent of respondents were unable to identify future academic plastic surgeons from plastic surgery residency applicants, and 27% were not sure. Most (93%) of the respondents believed that academic surgery as practiced today will change. The overall job description of a full-time academic plastic surgeon remains unchanged (teacher and researcher). Whereas peer recognition, personal satisfaction, and program reputation were most frequently cited as indicative of a successful plastic surgery career, financial success was rated the least indicative. Similarly, whereas the

  6. Minimally invasive glaucoma surgery: current status and future prospects

    Directory of Open Access Journals (Sweden)

    Richter GM


    Full Text Available Grace M Richter,1,2 Anne L Coleman11UCLA Stein Eye Institute, Department of Ophthalmology, University of California, Los Angeles, CA, USA; 2USC Eye Institute, Department of Ophthalmology, Keck School of Medicine of University of Southern California, Los Angeles, CA, USAAbstract: Minimally invasive glaucoma surgery aims to provide a medication-sparing, conjunctival-sparing, ab interno approach to intraocular pressure reduction for patients with mild-to-moderate glaucoma that is safer than traditional incisional glaucoma surgery. The current approaches include: increasing trabecular outflow (Trabectome, iStent, Hydrus stent, gonioscopy-assisted transluminal trabeculotomy, excimer laser trabeculotomy; suprachoroidal shunts (Cypass micro-stent; reducing aqueous production (endocyclophotocoagulation; and subconjunctival filtration (XEN gel stent. The data on each surgical procedure for each of these approaches are reviewed in this article, patient selection pearls learned to date are discussed, and expectations for the future are examined. Keywords: MIGS, microincisional glaucoma surgery, trabecular stent, Schlemm’s canal, suprachoroidal shunt, ab interno

  7. Cataract surgery in patients with pseudoexfoliation syndrome: current updates

    Directory of Open Access Journals (Sweden)

    Fontana L


    Full Text Available Luigi Fontana, Marco Coassin, Alfonso Iovieno, Antonio Moramarco, Luca Cimino Ophthalmology Unit, Arcispedale Santa Maria Nuova – IRCCS, Reggio Emilia, Italy Abstract: Pseudoexfoliation is a ubiquitous syndrome of multifactorial origin affecting elderly people by increasing the risk of cataract and secondary glaucoma development. Despite modern techniques and technologies for cataract surgery, pseudoexfoliation syndrome represents a challenge for surgeons because of the increased weakness of the zonular apparatus and limited pupil dilation. Due to the inherent difficulties during surgery, the risk of vitreous loss in these patients is several times higher than in cataract patients without pseudoexfoliation. Using currently available surgical devices (ophthalmic viscosurgical device, iris retractors and ring dilators, capsular tension ring, etc., the risk of intraoperative complications may be much reduced, allowing the surgeon to handle difficult cases with greater confidence and safety. This review analyzes the methodologic approach to the patient with zonular laxity with the aim of providing useful advices to limit the risks of intraoperative and postoperative complications. From the preoperative planning, to the intraoperative management of the small pupil and phacodonesis, and to the postoperative correction of capsule phimosis and intraocular lens dislocation, a step approach to the surgical management of pseudoexfoliation patients is illustrated. Keywords: pseudoexfoliation syndrome, cataract surgery, zonular laxity, intraocular lens implant, complications

  8. Current trends in gamma radiation detection for radiological emergency response (United States)

    Mukhopadhyay, Sanjoy; Guss, Paul; Maurer, Richard


    Passive and active detection of gamma rays from shielded radioactive materials, including special nuclear materials, is an important task for any radiological emergency response organization. This article reports on the current trends and status of gamma radiation detection objectives and measurement techniques as applied to nonproliferation and radiological emergencies. In recent years, since the establishment of the Domestic Nuclear Detection Office by the Department of Homeland Security, a tremendous amount of progress has been made in detection materials (scintillators, semiconductors), imaging techniques (Compton imaging, use of active masking and hybrid imaging), data acquisition systems with digital signal processing, field programmable gate arrays and embedded isotopic analysis software (viz. gamma detector response and analysis software [GADRAS]1), fast template matching, and data fusion (merging radiological data with geo-referenced maps, digital imagery to provide better situational awareness). In this stride to progress, a significant amount of inter-disciplinary research and development has taken place-techniques and spin-offs from medical science (such as x-ray radiography and tomography), materials engineering (systematic planned studies on scintillators to optimize several qualities of a good scintillator, nanoparticle applications, quantum dots, and photonic crystals, just to name a few). No trend analysis of radiation detection systems would be complete without mentioning the unprecedented strategic position taken by the National Nuclear Security Administration (NNSA) to deter, detect, and interdict illicit trafficking in nuclear and other radioactive materials across international borders and through the global maritime transportation-the so-called second line of defense.

  9. Recent national trends in the use of adolescent inpatient bariatric surgery: 2000 through 2009. (United States)

    Kelleher, Deirdre C; Merrill, Chaya T; Cottrell, Linda T; Nadler, Evan P; Burd, Randall S


    To determine the current rate of inpatient bariatric surgical procedures among adolescents and to analyze national trends of use from 2000 to 2009. Retrospective cross-sectional study. Discharge data obtained from the Healthcare Cost and Utilization Project Kids' Inpatient Database, 2000 through 2009. Adolescents (defined herein as individuals aged 10-19 years) undergoing inpatient bariatric procedures. Inpatient bariatric surgery. The primary outcome measure was the national population-based bariatric procedure rate. The secondary outcome measures were trends in procedure rates and type, demographics, complication rate, length of stay, and hospital charges from 2000 through 2009. The inpatient bariatric procedure rate increased from 0.8 per 100 000 in 2000 to 2.3 per 100 000 in 2003 (328 vs 987 procedures) but did not change significantly in 2006 (2.2 per 100 000) or 2009 (2.4 per 100 000), with 925 vs 1009 procedures. The use of laparoscopic adjustable gastric banding approached one-third (32.1%) of all procedures by 2009. The cohort was predominantly female and older than 17 years. The prevalence of comorbidities increased from 2003 (49.3%) to 2009 (58.6%) (P = .002), while the complication rate remained low and the in-hospital length of stay decreased by approximately 1 day (P bariatric procedures among adolescents has plateaued since 2003. The predominant procedure type has changed to minimally invasive techniques, including laparoscopic adjustable gastric banding and laparoscopic Roux-en-Y gastric bypass. Trends show low complication rates and decreasing length of stay, despite increasing comorbid conditions among patients.

  10. Current trends in electrochemical sensing and biosensing of DNA methylation. (United States)

    Krejcova, Ludmila; Richtera, Lukas; Hynek, David; Labuda, Jan; Adam, Vojtech


    DNA methylation plays an important role in physiological and pathological processes. Several genetic diseases and most malignancies tend to be associated with aberrant DNA methylation. Among other analytical methods, electrochemical approaches have been successfully employed for characterisation of DNA methylation patterns that are essential for the diagnosis and treatment of particular diseases. This article discusses current trends in the electrochemical sensing and biosensing of DNA methylation. Particularly, it provides an overview of applied electrode materials, electrode modifications and biorecognition elements applications with an emphasis on strategies that form the core DNA methylation detection approaches. The three main strategies as (i) bisulfite treatment, (ii) cleavage by restriction endonucleases, and (iii) immuno/affinity reaction were described in greater detail. Additionally, the availability of the reviewed platforms for early cancer diagnosis and the approval of methylation inhibitors for anticancer therapy were discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Current trends in radiation protection in Egypt. Vol. 1

    International Nuclear Information System (INIS)

    Gomma, M.A.


    The treatise presents the development of radiation protection in egypt over the past four decades. The contents will include a historical synopsis, and the current state of art regarding competent authorities, the hierarchy involved, and the respective responsibilities. The recent publications of the international trends in radiation protection are also mentioned. The efforts made towards the implementation of the new recommendations on radiation protection, and updating of the radiation protection legislations are also discussed. The 1994 international safety standards, and the collective opinion of the committee on radiation protection and public health (CRPPH) of the organization for economic Co-operation and development of the Nuclear energy agency OECD/NEA are also summarized

  12. Current trends in radiation protection in Egypt. Vol. 1

    Energy Technology Data Exchange (ETDEWEB)

    Gomma, M A [Atomic Energy Authority, Cairo (Egypt)


    The treatise presents the development of radiation protection in egypt over the past four decades. The contents will include a historical synopsis, and the current state of art regarding competent authorities, the hierarchy involved, and the respective responsibilities. The recent publications of the international trends in radiation protection are also mentioned. The efforts made towards the implementation of the new recommendations on radiation protection, and updating of the radiation protection legislations are also discussed. The 1994 international safety standards, and the collective opinion of the committee on radiation protection and public health (CRPPH) of the organization for economic Co-operation and development of the Nuclear energy agency OECD/NEA are also summarized.

  13. Mechanics of Biological Tissues and Biomaterials: Current Trends

    Directory of Open Access Journals (Sweden)

    Amir A. Zadpoor


    Full Text Available Investigation of the mechanical behavior of biological tissues and biomaterials has been an active area of research for several decades. However, in recent years, the enthusiasm in understanding the mechanical behavior of biological tissues and biomaterials has increased significantly due to the development of novel biomaterials for new fields of application, along with the emergence of advanced computational techniques. The current Special Issue is a collection of studies that address various topics within the general theme of “mechanics of biomaterials”. This editorial aims to present the context within which the studies of this Special Issue could be better understood. I, therefore, try to identify some of the most important research trends in the study of the mechanical behavior of biological tissues and biomaterials.

  14. Current technological trends in development of NPP systems

    International Nuclear Information System (INIS)

    Florescu, Gheorghe; Panaitescu, Valeriu


    The recent nuclear research issues look for new technologies and continuous progress in finding different and efficient solutions for sustained and upraising energy demand. The trend of increasing energy consumption and occurring of new and large consumers, especially from Asian countries, imposes finding of new means for clean, large scale and sustained energy production. NPPs availability was continuously monitored and improved; at the same time the safety of the nuclear energy production was under surveillance. The present development of the new technologies, the discoveries of new materials and development of efficient technological processes offer the opportunities for their appropriate implementation and use in the NPP system configurations and functioning/operation. The new technologies and scientific discoveries, and also the international cooperation, offer the opportunities to mitigate the actual barriers in order to cumulate and use advanced energy production, to find new energy sources and to build improved, reliable and safe power plants. The monitoring systems, intelligent sensors and SSCs, nanotechnologies and new/intelligent materials constitute the main ways for improvement of the NPP systems configuration and processes. The paper presents: - The state of the art in the level of the currently applied technologies for nuclear power systems development; - The actual technological limits that need to be over passed for improving the NPP systems ; - The main systems that need improvement and reconfiguration for development of currently operating NPPs as well as raising the operation efficiency, availability and total safety; - The actual energy production issues; - The key arguments in sustaining the R and D new NPP systems development; - Future trends in NPP development; - The limitations in industrial processes knowledge and use. Appropriate R and D in the field of NPP systems have specific characteristics that were considered in paper completion


    Directory of Open Access Journals (Sweden)



    Full Text Available Lifelong Learning (LLL has been a remarkable response to people-centered educational demand of 21st century. In order to provide effective formal, non-formal, and informal learning, immersive educational activities undertaken throughout life should be aimed to create a learning society in which people can experience individual and collective learning with no constrains of time or location. The concept of lifelong learning within the context of distance immersive education encompasses diverse 3D activities. The three dimensional, Web-based structured activities supported by distance learning technologies can be viewed as interactive tools which foster LLL. In this perspective, Second Life (SL can be regarded as one of the learning simulation milieus that allow learners to participate in various educational LLL activities in individual or group forms. The following paper examines how SL, taking advantage of its simulative nature and the possibility for creative interaction among participants, which are also common in games, allows the learners to participate in immersive constructivist learning activities. The article will also touch on the current uses of SL as a tool for LLL, as well as its potentials for further development according to the current trends in adult education. Further, the authors will discuss its limitations and will make suggestions towards a more complete pedagogical use.

  16. Trends in Joint Replacement Surgery in Patients with Rheumatoid Arthritis. (United States)

    Young, Bradley L; Watson, Shawna L; Perez, Jorge L; McGwin, Gerald; Singh, Jasvinder A; Ponce, Brent A


    This study analyzed trends in large total joint arthroplasties (TJA) and in the proportion of these procedures performed on patients with rheumatoid arthritis (RA). The US Nationwide Inpatient Sample (2002-2012) was used to identify the incidences of total shoulder (TSA), elbow (TEA), knee (TKA), hip (THA), and ankle (TAA) arthroplasty and the proportion of these performed with coexisting RA. The prevalence of RA among patients with TJA increased 3.0%. The prevalence of RA among cases of TEA and TSA decreased by 50% (p < 0.0001) and 18% (p = 0.0016), respectively; a 38.0% decrease occurred in the prevalence of RA among TAA (p = 0.06); and nonsignificant increases were seen among THA and TKA. The average age difference between RA and non-RA patients undergoing TJA narrowed by 2 years (p < 0.0001). There was a greater reduction in the proportion of TSA, TEA, and TAA groups among women with RA than men with RA. In the TSA and TEA groups, there was a reduction in the proportion of whites with RA, but not blacks. The proportion of privately insured TSA and TAA patients with RA decreased, while patients with RA undergoing TSA, TEA, or TAA who were receiving Medicaid (government medical insurance) remained relatively stable over time. The prevalence of RA has decreased among TSA and TEA patients. A nonsignificant decline occurred among TAA patients. The average age of TJA patients with RA is beginning to mirror those without RA. Sex ratios for TSA, TEA, and TAA patients are following a similar pattern. These results may be evidence of the success of modern RA treatment strategies.

  17. Current Trends in Adolescent Substance Use in Jamaica

    Directory of Open Access Journals (Sweden)

    U Atkinson


    Full Text Available Objective: National secondary school-based drug surveys facilitate the identification and understanding of patterns of substance use among adolescents, associated risk and protective factors which exist and inform prevention and treatment interventions and policies which are appropriate for resource constrained settings. This paper analyses current trends as well as reviews trends from the last National School Survey conducted by the National Council on Drug Abuse in 2006. Method: The study utilized a survey design that included a representative sample of secondary school students. Data were collected from 3365 students from 38 schools across the island. The study made specific reference to the prevalence of alcohol, tobacco cigarette, marijuana and inhalant use among secondary school students. Results: The most widely used substances among the sample were alcohol, tobacco cigarettes, marijuana and solvents/inhalants. A large number of students (64% reported a lifetime prevalence of alcohol use. Alcohol use was also the highest for one-year (44% and one-month (33.6% use. While lifetime use of tobacco cigarette was higher than marijuana, one-year and one-month use of marijuana was higher than that of tobacco cigarette. There has been a slight increase in the age of initiation for alcohol, tobacco cigarette and marijuana use. There has also been a significant decrease (approximately 50% in lifetime, past year and past month prevalence of inhalant use since the 2006 secondary school survey. Conclusions: Alcohol continues to be the substance most widely used by Jamaican adolescents, followed by tobacco, marijuana and inhalants. Though the average age of first use has slightly increased for all substances, prevalence remains a concern. As such, innovative school-based interventions are required to assist in reducing substance use among Jamaican adolescents.

  18. Current rates of publication for podium and poster presentations at the american society for surgery of the hand annual meetings. (United States)

    Abzug, Joshua M; Osterman, Meredith; Rivlin, Michael; Paryavi, Ebrahim; Osterman, A Lee


    Research projects are presented at the Annual Meetings of the American Society for Surgery of the Hand (ASSH). It is unknown how many achieve publication in peer-reviewed journals. We sought to determine current rates of publication of podium and poster presentations. All ASSH podium and poster presentations from 2000 to 2005 were reviewed, and an Internet-based search using PubMed and Google was conducted to determine whether the presented studies had been published. Times to publication and journal names were recorded. Data were analyzed with descriptive statistics. Fisher's exact test was conducted to compare current trends with previous trends. Of 1127 podium and poster presentations reviewed, 46% were published in peer-reviewed journals. Forty-seven percent of published presentations (242 presentations) were in Journal of Hand Surgery, and 11% (59 presentations) were in Journal of Bone and Joint Surgery. Forty-five percent of presentations were published within 2 years and 66% within 3 years. The publication rate for podium presentations was significantly higher than that previously reported for Journal of Hand Surgery, at 54% compared with 44% (P=0.004). Currently, fewer than half of the studies presented at Annual Meetings of the ASSH achieve publication in peer-reviewed journals. Presentations are most likely to be published within 3 years, and almost half are published in Journal of Hand Surgery.

  19. Current Trends in Internet Usage and Cyber Crimes against Youth

    Directory of Open Access Journals (Sweden)

    Divya Bansal


    Full Text Available Based on a written survey, this paper examines the current trends in internet use and cyber crime against youth for a given set of demographic conditions and presents suggestions for related safety measures and precautions. A written survey of young internet users aged between 10 and 17 years was conducted in the schools of Chandigarh, India. It showed that nearly 84 percent of the youth surveyed have internet connectivity at their homes. Seventy percent of the youth surveyed use the internet for social networking, the majority of whom share photographs, videos and personal information online. Fifteen percent of the youth reported online harassment, and approximately 30 percent reported online interaction with unknown people. According to the youth surveyed, the parents or guardians of more than 90 percent know about their browsing habits. In most cases parents or guardians had talked to their children about internet safety and possible threats. Schools and parents/guardians should ensure that the children are aware of internet dangers, including the dangers of sharing personal information and trusting unknown people online, and regulate their browsing activities.

  20. Current status and future trends of medical physics in Mexico (United States)

    Azorin Nieto, J.


    Medical Physics is an area that applies the principles of physics to medicine, particularly in the prevention, diagnosis and treatment of diseases using ionizing and nonionizing radiation. The main attractive of medical physics is that it has a direct impact on the quality and safety of medical care in humans; this social component with direct implications for the population is of high value for Mexico. This paper describes the concepts of medical physics, trends and the current status of this discipline as a profession, which is directly related to the efforts of clinical research. It is also described what is, in my opinion, the future of medical physics in Mexico, emphasizing the fact that this field requires a substantial boost from universities and hospitals to recruit highly qualified young medical physicists and the support from government agencies such as Secretaria de Salud, Instituto Mexicano del Seguro Social and Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado through clinical research projects that allow the necessary evolution of medical physics into the hospital setting.

  1. Current status and future trends of medical physics in Mexico

    International Nuclear Information System (INIS)

    Nieto, J Azorin


    Medical Physics is an area that applies the principles of physics to medicine, particularly in the prevention, diagnosis and treatment of diseases using ionizing and nonionizing radiation. The main attractive of medical physics is that it has a direct impact on the quality and safety of medical care in humans; this social component with direct implications for the population is of high value for Mexico. This paper describes the concepts of medical physics, trends and the current status of this discipline as a profession, which is directly related to the efforts of clinical research. It is also described what is, in my opinion, the future of medical physics in Mexico, emphasizing the fact that this field requires a substantial boost from universities and hospitals to recruit highly qualified young medical physicists and the support from government agencies such as Secretaria de Salud, Instituto Mexicano del Seguro Social and Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado through clinical research projects that allow the necessary evolution of medical physics into the hospital setting

  2. Current Trends in the Nuclear Power Global Market

    Directory of Open Access Journals (Sweden)

    Mariya Mikhailovna Osetskaya


    Full Text Available The review of the nuclear energy technologies market, namely the main processes of the initial and final stages of the nuclear fuel cycle (NTC was shown. The authors reveal key players in the markets of natural uranium mining, conversion, enrichment, fabrication of nuclear fuel, direct disposal, and reprocessing as well as determine their market shares. The article shows the fundamental factors influencing the development trends of the global nuclear power market such as: units’ commissioning in China, India, the Republic of Korea and other countries, the restart of the Japanese nuclear power plants, growth of uranium supplies long-term contracting planned for the period up to 2025, volatility of world prices of the NFC initial and final stages, political, economic and environmental reasons for the nuclear power generation choice. The article presents the results of analyses of Russian and world prices on the NFC initial and final stages main processes’ allowing to draw a conclusion about the current competitiveness of Russian nuclear energy technologies

  3. Analytical Chemistry: A retrospective view on some current trends. (United States)

    Niessner, Reinhard


    In a retrospective view some current trends in Analytical Chemistry are outlined and connected to work published more than a hundred years ago in the same field. For example, gravimetric microanalysis after specific precipitation, once the sole basis for chemical analysis, has been transformed into a mass-sensitive transducer in combination with compound-specific receptors. Molecular spectroscopy, still practising the classical absorption/emission techniques for detecting elements or molecules experiences a change to Raman spectroscopy, is now allowing analysis of a multitude of additional features. Chemical sensors are now used to perform a vast number of analytical measurements. Especially paper-based devices (dipsticks, microfluidic pads) celebrate a revival as they can potentially revolutionize medicine in the developing world. Industry 4.0 will lead to a further increase of sensor applications. Preceding separation and enrichment of analytes from complicated matrices remains the backbone for a successful analysis, despite increasing attempts to avoid clean-up. Continuous separation techniques will become a key element for 24/7 production of goods with certified quality. Attempts to get instantaneous and specific chemical information by optical or electrical transduction will need highly selective receptors in large quantities. Further understanding of ligand - receptor complex structures is the key for successful generation of artificial bio-inspired receptors. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  4. Review on the current trends in tongue diagnosis systems

    Directory of Open Access Journals (Sweden)

    Chang Jin Jung


    Full Text Available Tongue diagnosis is an essential process to noninvasively assess the condition of a patient's internal organs in traditional medicine. To obtain quantitative and objective diagnostic results, image acquisition and analysis devices called tongue diagnosis systems (TDSs are required. These systems consist of hardware including cameras, light sources, and a ColorChecker, and software for color correction, segmentation of tongue region, and tongue classification. To improve the performance of TDSs, various types TDSs have been developed. Hyperspectral imaging TDSs have been suggested to acquire more information than a two-dimensional (2D image with visible light waves, as it allows collection of data from multiple bands. Three-dimensional (3D imaging TDSs have been suggested to provide 3D geometry. In the near future, mobile devices like the smart phone will offer applications for assessment of health condition using tongue images. Various technologies for the TDS have respective unique advantages and specificities according to the application and diagnostic environment, but this variation may cause inconsistent diagnoses in practical clinical applications. In this manuscript, we reviewed the current trends in TDSs for the standardization of systems. In conclusion, the standardization of TDSs can supply the general public and oriental medical doctors with convenient, prompt, and accurate information with diagnostic results for assessing the health condition.

  5. Current Trends in Sustainability of Bitcoins and Related Blockchain Technology

    Directory of Open Access Journals (Sweden)

    Pasquale Giungato


    Full Text Available Bitcoin is a digital currency based on a peer-to-peer payment system managed by an open source software and characterized by lower transaction costs, greater security and scalability than fiat money and no need of a central bank. Despite criticisms about illegal uses and social consequences, it is attracting the interest of the scientific community. The purpose of this work is to define and evaluate the current trends of the literature concerned with the sustainability of bitcoin, considering the environmental impacts, social issues and economic aspects. From the analysis it emerges that the transition of the whole monetary system in the new cryptocurrency will result in an unacceptable amount of energy consumed to mine new bitcoins and to maintain the entire virtual monetary system, and probably bitcoin will remain a niche currency. Blockchain, which is the base for a distributed and democratically-sustained public ledger of the transactions, could foster new and challenging opportunities. Sharing the framework of medical data, energy generation and distribution in micro-grids at the citizen level, block-stack and new state-driven cryptocurrencies, may benefit from the wide spread of blockchain-based transactions. Under the perspective of its being a driver of social change, bitcoins and related blockchain technologies may overcome the issues highlighted by numerous detractors.

  6. Review on the current trends in tongue diagnosis systems. (United States)

    Jung, Chang Jin; Jeon, Young Ju; Kim, Jong Yeol; Kim, Keun Ho


    Tongue diagnosis is an essential process to noninvasively assess the condition of a patient's internal organs in traditional medicine. To obtain quantitative and objective diagnostic results, image acquisition and analysis devices called tongue diagnosis systems (TDSs) are required. These systems consist of hardware including cameras, light sources, and a ColorChecker, and software for color correction, segmentation of tongue region, and tongue classification. To improve the performance of TDSs, various types TDSs have been developed. Hyperspectral imaging TDSs have been suggested to acquire more information than a two-dimensional (2D) image with visible light waves, as it allows collection of data from multiple bands. Three-dimensional (3D) imaging TDSs have been suggested to provide 3D geometry. In the near future, mobile devices like the smart phone will offer applications for assessment of health condition using tongue images. Various technologies for the TDS have respective unique advantages and specificities according to the application and diagnostic environment, but this variation may cause inconsistent diagnoses in practical clinical applications. In this manuscript, we reviewed the current trends in TDSs for the standardization of systems. In conclusion, the standardization of TDSs can supply the general public and oriental medical doctors with convenient, prompt, and accurate information with diagnostic results for assessing the health condition.

  7. Type 2 Diabetes Mellitus: A Review of Current Trends

    Directory of Open Access Journals (Sweden)

    Abdulfatai B. Olokoba


    Full Text Available Type 2 diabetes mellitus (DM is a chronic metabolic disorder in which prevalence has been increasing steadily all over the world. As a result of this trend, it is fast becoming an epidemic in some countries of the world with the number of people affected expected to double in the next decade due to increase in ageing population, thereby adding to the already existing burden for healthcare providers, especially in poorly developed countries. This review is based on a search of Medline, the Cochrane Database of Systemic Reviews, and citation lists of relevant publications. Subject heading and key words used include type 2 diabetes mellitus, prevalence, current diagnosis, and current treatment. Only articles in English were included. Screening and diagnosis is still based on World Health Organization (WHO and American Diabetes Association (ADA criteria which include both clinical and laboratory parameters. No cure has yet been found for the disease; however, treatment modalities include lifestyle modifications, treatment of obesity, oral hypoglycemic agents, and insulin sensitizers like metformin, a biguanide that reduces insulin resistance, is still the recommended first line medication especially for obese patients. Other effective medications include non-sulfonylurea secretagogues, thiazolidinediones, alpha glucosidase inhibitors, and insulin. Recent research into the pathophysiology of type 2 DM has led to the introduction of new medications like glucagon-like peptide 1 analogoues: dipeptidyl peptidase-IV inhibitors, inhibitors of the sodium-glucose cotransporter 2 and 11ß-hydroxysteroid dehydrogenase 1, insulin-releasing glucokinase activators and pancreatic-G-protein-coupled fatty-acid-receptor agonists, glucagon-receptor antagonists, metabolic inhibitors of hepatic glucose output and quick-release bromocriptine. Inhaled insulin was licensed for use in 2006 but has been withdrawn from the market because of low patronage.

  8. Trends and Predictors of National Institutes of Health Funding to Plastic Surgery Residency Programs. (United States)

    Silvestre, Jason; Abbatematteo, Joseph M; Chang, Benjamin; Serletti, Joseph M


    Recent studies have demonstrated low levels of National Institutes of Health funding for surgical research. The authors compared the funding in plastic surgery with the funding for other surgical specialties. A query of National Institutes of Health grants awarded to departments of surgical specialties was performed using the National Institutes of Health RePORTER database (2008 to 2016). Trends in funding were compared by specialty and adjusted for the number of active physicians in each specialty. Plastic surgery residency program characteristics were correlated with funding procurement. Eight hundred eighty-nine faculty at 94 plastic surgery residency programs were queried. Forty-eight investigators (5.4 percent) at 23 programs (24.4 percent) had National Institutes of Health funding. From 2008 to 2016, a total of $84,142,138 was awarded through 81 grants. Funding supported translational (44.6 percent), clinical (26.4 percent), basic science (27.2 percent), and educational (1.7 percent) research. In 2016, plastic surgery received the least amount of National Institutes of Health funding per active physician ($1,530) relative to orthopedic surgery ($3124), obstetrics and gynecology ($3885), urology ($5943), otolaryngology ($9999), general surgery ($11,649), ophthalmology ($11,933), and neurologic surgery ($20,874). Plastic surgery residency program characteristics associated with National Institutes of Health funding were high ranking and had more than 10 clinical faculty (p < 0.05). Plastic surgery receives the least National Institutes of Health funding among the surgical specialties. Departments and divisions of plastic surgery should support investigators applying for research grants to increase future National Institutes of Health funding.

  9. Current and future trends in marine image annotation software (United States)

    Gomes-Pereira, Jose Nuno; Auger, Vincent; Beisiegel, Kolja; Benjamin, Robert; Bergmann, Melanie; Bowden, David; Buhl-Mortensen, Pal; De Leo, Fabio C.; Dionísio, Gisela; Durden, Jennifer M.; Edwards, Luke; Friedman, Ariell; Greinert, Jens; Jacobsen-Stout, Nancy; Lerner, Steve; Leslie, Murray; Nattkemper, Tim W.; Sameoto, Jessica A.; Schoening, Timm; Schouten, Ronald; Seager, James; Singh, Hanumant; Soubigou, Olivier; Tojeira, Inês; van den Beld, Inge; Dias, Frederico; Tempera, Fernando; Santos, Ricardo S.


    . Integration into available MIAS is currently limited to semi-automated processes of pixel recognition through computer-vision modules that compile expert-based knowledge. Important topics aiding the choice of a specific software are outlined, the ideal software is discussed and future trends are presented.

  10. Comprehensive management of pressure ulcers in spinal cord injury: Current concepts and future trends (United States)

    Kruger, Erwin A.; Pires, Marilyn; Ngann, Yvette; Sterling, Michelle; Rubayi, Salah


    Pressure ulcers in spinal cord injury represent a challenging problem for patients, their caregivers, and their physicians. They often lead to recurrent hospitalizations, multiple surgeries, and potentially devastating complications. They present a significant cost to the healthcare system, they require a multidisciplinary team approach to manage well, and outcomes directly depend on patients' education, prevention, and compliance with conservative and surgical protocols. With so many factors involved in the successful treatment of pressure ulcers, an update on their comprehensive management in spinal cord injury is warranted. Current concepts of local wound care, surgical options, as well as future trends from the latest wound healing research are reviewed to aid medical professionals in treating patients with this difficult problem. PMID:24090179

  11. Current trends in chaperone use by plastic and reconstructive surgeons. (United States)

    Choudry, Umar; Barta, Ruth J; Kim, Nicholas


    There is a paucity of literature regarding the use of chaperones by surgeons when examining patients. Use of a chaperone not only makes the patient comfortable but also potentially protects the surgeon from perceived misconduct. This is especially true for plastic surgeons who examine sensitive areas commonly. The purpose of this study was to determine the current trends in chaperone use by plastic surgeons when examining patients. A 23-question online survey was sent to all members of the American Society of Plastic Surgeons. Data collected online were analyzed using Student t test and Pearson χ test. A P use by plastic surgeons during all examinations of patients was 30%. This rate increased up to 60% while examining sensitive areas. Male surgeons reported a higher frequency of chaperone use than female surgeons (P use compared to reconstructive surgeons (P = 0.001). Similarly, surgeons who had been in practice for more than 20 years reported a higher rate of chaperone use compared to surgeons in practice for less than 20 years (P = 0.032). Sixty-one (7.6%; 56 male and 5 female) surgeons reported being accused of inappropriate behavior by patients, of whom 49 (80%) did not have a chaperone present. There was no significant difference among male and female surgeons in rates of being accused of inappropriate behavior (7.9% vs 4.2%, P = 0.19). There was a higher rate of chaperone use by male plastic surgeons, surgeons with more than 20 years experience, and cosmetic surgeons. Despite the difference in chaperone use between the sexes, both had similar rates of being accused of inappropriate behavior during examinations by patients, and although these incidents were quite low, most had no chaperone present during those examinations.

  12. Current trends in immunosuppressive therapies for renal transplant recipients. (United States)

    Lee, Ruth-Ann; Gabardi, Steven


    Current trends in immunosuppressive therapies for renal transplant recipients are reviewed. The common premise for immunosuppressive therapies in renal transplantation is to use multiple agents to work on different immunologic targets. The use of a multidrug regimen allows for pharmacologic activity at several key steps in the T-cell replication process and lower dosages of each individual agent, thereby producing fewer drug-related toxicities. In general, there are three stages of clinical immunosuppression: induction therapy, maintenance therapy, and treatment of an established acute rejection episode. Only immunosuppressive therapies used for maintenance therapy are discussed in detail in this review. The most common maintenance immunosuppressive agents can be divided into five classes: (1) the calcineurin inhibitors (CNIs) (cyclosporine and tacrolimus), (2) costimulation blockers (belatacept), (3) mammalian target of rapamycin inhibitors (sirolimus and everolimus), (4) antiproliferatives (azathioprine and mycophenolic acid derivatives), and (5) corticosteroids. Immunosuppressive regimens vary among transplantation centers but most often include a CNI and an adjuvant agent, with or without corticosteroids. Selection of appropriate immunosuppressive regimens should be patient specific, taking into account the medications' pharmacologic properties, adverse-event profile, and potential drug-drug interactions, as well as the patient's preexisting diseases, risk of rejection, and medication regimen. Advancements in transplant immunosuppression have resulted in a significant reduction in acute cellular rejection and a modest increase in long-term patient and graft survival. Because the optimal immunosuppression regimen is still unknown, immunosuppressant use should be influenced by institutional preference and tailored to the immunologic risk of the patient and adverse-effect profile of the drug.

  13. Positron Computed Tomography: Current State, Clinical Results and Future Trends (United States)

    Schelbert, H. R.; Phelps, M. E.; Kuhl, D. E.


    An overview is presented of positron computed tomography: its advantages over single photon emission tomography, its use in metabolic studies of the heart and chemical investigation of the brain, and future trends. (ACR)

  14. Current market trends in hospital/physician integration. (United States)

    Bauman, Randy R


    This article explores recent trends that are dramatically changing the landscape of typical hospital/physician integration models and provides the reader with useful insights to better evaluate this dynamically changing marketplace.

  15. Positron computed tomography: current state, clinical results and future trends

    Energy Technology Data Exchange (ETDEWEB)

    Schelbert, H.R.; Phelps, M.E.; Kuhl, D.E.


    An overview is presented of positron computed tomography: its advantages over single photon emission tomography, its use in metabolic studies of the heart and chemical investigation of the brain, and future trends. (ACR)

  16. Positron computed tomography: current state, clinical results and future trends

    International Nuclear Information System (INIS)

    Schelbert, H.R.; Phelps, M.E.; Kuhl, D.E.


    An overview is presented of positron computed tomography: its advantages over single photon emission tomography, its use in metabolic studies of the heart and chemical investigation of the brain, and future trends

  17. Beard transplants and facial hair trends: Why men are motivated to have surgery


    Zucchelli, F.


    Over the past few years, an increasing number of men have received surgery to enhance or restore facial hair. This came at a time when beards re-entered mainstream fashion. Drawing on the research literature, this article explores the apparent link between facial hair fashion and rates of beard transplants, and considers deeper-seated psychological explanations for the trend, including perceptions of masculinity, social dominance, age and attractiveness. The question of whether beard transpla...

  18. Metastatic Spine Tumor Epidemiology: Comparison of Trends in Surgery Across Two Decades and Three Continents. (United States)

    Wright, Ernest; Ricciardi, Federico; Arts, Mark; Buchowski, Jacob M; Chung, Chun Kee; Coppes, Maarten; Crockard, Alan; Depreitere, Bart; Fehlings, Michael; Kawahara, Norio; Lee, Chong Suh; Leung, Yee; Martin-Benlloch, Antonio; Massicotte, Eric; Mazel, Christian; Oner, Cumhur; Peul, Wilco; Quraishi, Nasir; Tokuhashi, Yasuaki; Tomita, Katsuro; Ulbricht, Christian; Verlaan, Jorrit-Jan; Wang, Mike; Choi, David


    Indications for surgery for symptomatic spinal metastases have become better defined in recent years, and suitable outcome measures have been established against a changing backdrop of patient characteristics, tumor behavior, and oncologic treatments. Nonetheless, variations still exist in the local management of patients with spinal metastases. In this study, we aimed to review global trends and habits in the surgical treatment of symptomatic spinal metastases, and to examine how these have changed over the last 25 years. In this cohort study of consecutive patients undergoing surgery for symptomatic spinal metastases, data were collected using a secure Internet database from 22 centers across 3 continents. All patients were invited to participate in the study, except those unable or unwilling to give consent. There was a higher incidence of colonic, liver, and lung carcinoma metastases in Asian countries, and more frequent presentation of breast, prostate, melanoma metastases in the West. Trends in surgical technique were broadly similar across the centers. Overall survival rates after surgery were 53% at 1 year, 31% at 2 years, and 10% at 5 years after surgery (standard error 0.013 for all). Survival improved over successive time periods, with longer survival in patients who underwent surgery in 2011-2016 compared with those who underwent surgery in earlier time periods. Surgical habits have been fairly consistent among countries worldwide and over time. However, patient survival has improved in later years, perhaps due to medical advances in the treatment of cancer, improved patient selection, and operating earlier in the course of disease. Copyright © 2018 Elsevier Inc. All rights reserved.

  19. Trend of environmental radiation protection and its current related studies

    International Nuclear Information System (INIS)

    Yoshida, Satoshi


    Reviewed are the international trend of environmental radiation protection (ERP), Japanese studies of radiation effects on environmental livings from aspects of ecosystem to molecular level, and the future view. ERP is particularly closed up toward promotion after its first involvement in the general global conference, UN Conference on Environment and Development (1992). International Commission of Radiological Protection (ICRP) has conducted such actions for the environment as establishing protection essentials for non-human species (2003), organizing Committee 5 (2005), and defining Reference Animals and Plants (2008) where Derived Consideration Reference Levels of 0.1-100 mGy/d are proposed, together with cooperative actions by United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), International Atomic Energy Agency (IAEA), The Organization for Economic Co-operation and Development (OECD)/Nuclear Energy Agency (NEA) and European projects. Japanese NIRS is now enrolled in the project of Environmental Modeling for Radiation Safety-II (IAEA). Major Japanese studies of radiation effects on environmental livings have utilized killifish (medaka: Oryzias latipes), springtail, earthworm, nematode, cultured plant cell (cedar), poplar, etc. Studies of the radiation effect on microcosm consisting of 3 livings have led to establishing a model for mathematical analysis and of 8 livings, have defined 50% affect dose of 5600 Gy gamma-ray. Irradiation of gamma-ray at 1 Gy/d for 5-10 days to the soil has been shown to result in alteration of the composition of natural earth bacterial population by denaturant gradient gel electrophoresis, which being a promising tool for evaluating the alteration of soil composition and function. At molecular levels, transcriptome analysis of various cells from yeast to man, is performed after irradiation of gamma-ray, neutron, heavy particles and others to reveal radiation-induced gene expression; and Hi-CEP (high

  20. Overview of robotic colorectal surgery: Current and future practical developments (United States)

    Roy, Sudipta; Evans, Charles


    Minimal access surgery has revolutionised colorectal surgery by offering reduced morbidity and mortality over open surgery, while maintaining oncological and functional outcomes with the disadvantage of additional practical challenges. Robotic surgery aids the surgeon in overcoming these challenges. Uptake of robotic assistance has been relatively slow, mainly because of the high initial and ongoing costs of equipment but also because of limited evidence of improved patient outcomes. Advances in robotic colorectal surgery will aim to widen the scope of minimal access surgery to allow larger and more complex surgery through smaller access and natural orifices and also to make the technology more economical, allowing wider dispersal and uptake of robotic technology. Advances in robotic endoscopy will yield self-advancing endoscopes and a widening role for capsule endoscopy including the development of motile and steerable capsules able to deliver localised drug therapy and insufflation as well as being recharged from an extracorporeal power source to allow great longevity. Ultimately robotic technology may advance to the point where many conventional surgical interventions are no longer required. With respect to nanotechnology, surgery may eventually become obsolete. PMID:26981188

  1. Laparoscopic major hepatectomies: current trends and indications. A comparison with the open technique. (United States)

    Ratti, Francesca; Cipriani, Federica; Ariotti, Riccardo; Giannone, Fabio; Paganelli, Michele; Aldrighetti, Luca


    Diffusion of laparoscopic major hepatectomies is experiencing a steady increasing trend, although slower compared to minor resections. The aim of this single-center study is to discuss current trends and indications in the application of minimally invasive techniques to major hepatic resections. Preoperative patients and disease characteristics of 49 laparoscopic major hepatectomies (LPS group), performed between 2005 and 2015, were compared with 585 open hepatectomies (Open group) to analyze differences in patients recruitment. Factors which were found to be differently distributed between groups were used as covariates in a propensity score-based case-matched analysis with a 1:3 ratio between LPS group and 147 patients from the Open group (constituting Open-mat group). Short-term outcome was analyzed in matched groups. ASA score, previous abdominal surgery, previous interventional procedures, indication, lesion size and associated procedures were significantly different between the LPS and the Open group. Short-term outcome analysis revealed that blood loss (200 vs 350 mL, p = 0.044) and time for functional recovery (3 vs 4 days, p = 0.05) were reduced in the LPS compared to the Open-mat group, in spite of longer length of surgery (260 vs 170 min, p = 0.041) and comparable oncological adequacy. Even though data on technical feasibility of laparoscopic major resections and their benefits in terms of blood loss and functional recovery support the diffusion of minimally invasive approach, the limit of the technique is still represented by the reduced pool of suitable candidates.

  2. International Medical Graduates in the US Physician Workforce and Graduate Medical Education: Current and Historical Trends. (United States)

    Ahmed, Awad A; Hwang, Wei-Ting; Thomas, Charles R; Deville, Curtiland


    Data show that international medical graduates (IMGs), both US and foreign born, are more likely to enter primary care specialties and practice in underserved areas. Comprehensive assessments of representation trends for IMGs in the US physician workforce are limited. We reported current and historical representation trends for IMGs in the graduate medical education (GME) training pool and US practicing physician workforce. We compared representation for the total GME and active practicing physician pools with the 20 largest residency specialties. A 2-sided test was used for comparison, with P  < .001 considered significant. To assess significant increases in IMG GME trainee representation for the total pool and each of the specialties from 1990-2015, the slope was estimated using simple linear regression. IMGs showed significantly greater representation among active practicing physicians in 4 specialties: internal medicine (39%), neurology (31%), psychiatry (30%), and pediatrics (25%). IMGs in GME showed significantly greater representation in 5 specialties: pathology (39%), internal medicine (39%), neurology (36%), family medicine (32%), and psychiatry (31%; all P  < .001). Over the past quarter century, IMG representation in GME has increased by 0.2% per year in the total GME pool, and 1.1% per year for family medicine, 0.5% for obstetrics and gynecology and general surgery, and 0.3% for internal medicine. IMGs make up nearly a quarter of the total GME pool and practicing physician workforce, with a disproportionate share, and larger increases over our study period in certain specialties.

  3. Assessment and E-Learning: Current Issues and Future Trends (United States)

    Cowie, Neil; Sakui, Keiko


    This paper describes different ways in which digital technology can be used for language learning. It then identifies some key trends connecting assessment and technology in language learning and higher education: the use of automated systems to enhance traditional assessment practices; the use of Web 2.0 tools to facilitate new assessment…

  4. Institutional Repositories at Small Institutions in America: Some Current Trends (United States)

    Nykanen, Melissa


    The research reported in this article was undertaken to determine the level of implementation of institutional repositories (IRs) at small institutions enrolling fewer than 10,000 students. The study analyzed quantitative and qualitative data from IRs at a number of small institutions with the aim of observing relevant patterns and trends that may…

  5. Ambulatory surgery for the patient with breast cancer: current perspectives

    Directory of Open Access Journals (Sweden)

    Pek CH


    Full Text Available Chong Han Pek,1 John Tey,2 Ern Yu Tan1 1Department of General Surgery, 2Department of Anaesthesiology, Intensive Care and Pain Medicine, Tan Tock Seng Hospital, Singapore, Singapore Abstract: Ambulatory breast cancer surgery is well accepted and is the standard of care at many tertiary centers. Rather than being hospitalized after surgery, patients are discharged on the day of surgery or within 23 hours. Such early discharge does not adversely affect patient outcomes and has the added benefits of better psychological adjustment for the patient, economic savings, and a more efficient utilization of health care resources. The minimal care needed post-discharge also means that the caregiver is not unduly burdened. Unplanned conversions to inpatient admission and readmission rates are low. Wound complications are infrequent and no issues with drain care have been reported. Because the period of postoperative observation is short and monitoring is not as intensive, ambulatory surgery is only suitable for low-risk procedures such as breast cancer surgery and in patients without serious comorbidities, where the likelihood of major perioperative events is low. Optimal management of pain, nausea, and vomiting is essential to ensure a quick recovery and return to normal function. Regional anesthesia such as the thoracic paravertebral block has been employed to improve pain control during the surgery and in the immediate postoperative period. The block provides excellent pain relief and reduces the need for opiates, which also consequently reduces the incidence of nausea and vomiting. The increasing popularity of total intravenous anesthesia with propofol has also helped reduce the incidence of nausea and vomiting in the postoperative period. Ambulatory surgery can be safely carried out in centers where there is a well-designed workflow to ensure proper patient selection, counseling, and education, and where patients and caregivers have easy access to


    Directory of Open Access Journals (Sweden)

    Yu. V. Korzh


    Full Text Available Today, nanotechnology has become one of the strategic directions of economic development of the leading countries. According to literary sources, it is established that more than 50 countries of the world are adopting national programs in this field of new knowledge, and various methods of nanotechnology have received the greatest development and application in microelectronics, aerospace, chemical, medical, pharmaceutical and cosmetic industries. It should be noted, that beauty is the most represented products with the use of nanotechnologies in the world. On the evaluation of the European Commission in 2009, the specific weight of cosmetics with nanoparticles amounted to 5%. The aim of the work was to assess the current trends of the market nanocosmetic photoprotectors development. In the last years in Ukraine the market of cosmetics is developing dynamically. Manufacturers of medical cosmetics invest heavily in scientific researches, patents, improvement of existing technologies. To determine the status of the security of the pharmaceutical market of Ukraine, we have analyzed the volume of sales and range of medical cosmetics, presented at the domestic market. In terms of sales volume in money terms of therapeutic cosmetics every year loses its position. Thus, the volume of sales in 2011, has decreased on 1,1 % in comparison with 2009. In Ukraine cosmetics of native production occupies 8% of the total volume of sales, cosmetics of foreign production - 92%. At the next stage of the research we have analyzed the medical cosmetic means, which are used for the prevention of photo-aging of the skin. In General, the Ukrainian market of medicinal cosmetics contains 125 trademarks of foreign and native manufacture. The largest share in the market of Ukraine belongs to the French medical cosmetics - 48,6 % of the total number of medical cosmetic means. It is represented by the various lines of medical cosmetics brands such: Vichy, Avene, RoC, Uriage

  7. Current and Future Trends in Game-Based Learning

    Directory of Open Access Journals (Sweden)

    Carlos Vaz de Carvalho


    Full Text Available The first number of the second volume of the EAI Transactions on Serious Games focuses on the results presented on the European Conference on Game-Based Learning. This event, already on the 8th edition, has set standards in terms of presentation of research and practice and in the pointing out of new and future trends in the development of Game-Based Learning. As such, we are quite thrilled to be able to report them here.

  8. Current research and development trends in floristic geography


    Hang Sun; Tao Deng; Yongsheng Chen; Zhuo Zhou


    This paper summarizes the research status, existing issues, and trends in floristic geography. There is now a wealth of research accumulation on floristic investigations, distribution types of genera, floristic regions, and regional floristic analysis. It is also noted that most of these studies utilize simple statistical analyses, comparative studies, traditional methods, and single subjects, to provide a basic understanding and description of the floristic phenomenon, which is lacking spati...

  9. Current status of indications for surgery in peptic ulcer disease. (United States)

    Jamieson, G G


    The eradication of Helicobacter pylori in patients with peptic ulcer disease has greatly diminished the need for antiulcer surgery. However, in societies where such drug therapy is considered too expensive and because occasional patients remain refractory to optimal medical therapy, elective surgery for duodenal ulcer disease is still carried out. If the required expertise is available, it can be undertaken laparoscopically. The advent of endoscopic therapies such as heater probe therapy and injection sclerotherapy has also greatly diminished the need for emergency surgery in bleeding peptic ulcer disease. Once again, however, when such therapy fails surgery is still indicated. Even with perforated peptic ulcer disease the role of surgery has receded somewhat, but here not because of changes in drug therapy. Nonoperative management of perforation is indicated in fit patients if the diagnosis is in doubt, in any patient when surgical facilities are unavailable (e.g., remote geographic areas, on board ship), or when a patient is extremely ill either because of co-morbidity or late presentation of the disease. Operation should be considered in all patients when the perforation is established to be unsealed, particularly after

  10. [Trends in thyroid surgery at the Instituto Nacional de la Nutrición Salvador Zubirán]. (United States)

    Herrera, M F; López, C M; Saldaña, J; Pérez, B; Rivera, R; González, O; Angeles, A; Letayf, V


    The diagnosis and treatment of thyroid disease has significantly changed with time. With the aim of analysing changes in thyroid surgery in our institution, a representative sample of patients from the first three years in four decades (1960-1992) were comparatively analysed. In the sixties, the diagnosis of thyroid cancer was made during surgery; by contrast, this diagnosis was correctly done by fine needle aspiration (FNA) in most patients of the last decade. Thyroid lobectomy, infrequently used in the treatment of differentiated thyroid carcinoma in earlier times, has now been abandoned and currently most patients undergo total or near-total thyroidectomy. Complications such as hypoparathyroidism and recurrent laryngeal nerve paralysis have importantly decreased with time and were not seen in the last decade. A trend toward an earlier diagnosis of thyroid carcinoma was also observed. In summary, the number of thyroidectomies for benign diseases has been importantly reduced by the use of FNA with the proportional increment of surgery for malignant disease.

  11. Current trends in nuclear borehole logging techniques for elemental analysis

    International Nuclear Information System (INIS)


    This report is the result of a consultants' meeting organized by the IAEA and held in Ottawa, Canada, 2-6 November 1987 in order to assess the present technical status of nuclear borehole logging techniques, to find out the well established applications and the development trends. It contains a summary report giving a comprehensive overview of the techniques and applications and a collection of research papers describing work done in industrial institutes. A separate abstract was prepared for each of these 9 papers. Refs, figs and tabs

  12. Current and Future Trends of the Automotive Industry

    Directory of Open Access Journals (Sweden)

    Dieter Hermann Schramm


    Full Text Available Mobility, and especially individual physical mobility, is still an essential component of nearly all societies.The combustion engine was for more than a hundred years, and is still today, the backbone of road-based mobility. However, the guarantor for the triumphant advance of the combustion engine was by far not its technical superiority over its electrical rival at the beginning of the automobile era, but the energy density and the easy worldwide availability of fossil fuels as a means of energy storage. So, e.g. to store theenergy equivalent of one kg Gasoline, a lithium ion battery with a mass of about 180 kg would be required (Schramm, 2012, even if the higher efficiency of the electric motor vs. the combustion engine is taken into account. Actually an electric motor is much better suited as a drive source for a motor vehicle as an internal combustion engine. Only the achievable energy density along with the cost of its chemical-process based storage, the battery, still prevent its immediate breakthrough in the automotive drive technology.Nevertheless, the German Government has set the target to bring at least a million electrified motor vehicles on Germany's roads by 2020, which is already impossible to reach from today’s perspective.However, strategies are needed to achieve a sustainable transition to electric mobility. This, in addition to continued research on high-efficiency batteries which also includes the development of vehicles that offer a good compromise between coverage, costs and consumption while satisfying the mobility needs of their users.Another trend that will lead to a paradigm shift in the use of individually-powered vehicles is the automation of the task of driving up to the highly automated or even autonomous vehicle. The technical prerequisites like sensors and actuators for these new systems are already available at least for application on motorways and rural regions, e.g. in Germany. More activities

  13. Current trends in the implementation of IAEA safeguards

    International Nuclear Information System (INIS)

    Adamson, A.; Bychkov, V.


    A practical goal, embodying the principle that a minimum amount of material is required in order to manufacture a nuclear explosive device, is that safeguards activities should enable the timely detection of the diversion of a significant quantity of nuclear material. It is important to note that the safeguards activities are not restricted to the International Atomic Energy Agency (the agency) but impose obligations on both state (and consequently on facility operators) and the agency. The beneficiaries are member states of the world community which have enhanced confidence in the competence and probity of states with safeguards agreements. Neither safeguards nor the nuclear industry have remained stationary. As new techniques have been developed, they have found applications, and as new challenges were encountered, the system has responded, for example, through improved measurements; through new or improved techniques for the operator, state or agency; and through new regulations. This paper details approaches, procedures and techniques developed for new complex nuclear facilities. Trends toward increase efficiency and effectiveness, and developments leading to more automated analysis and collection of data and the development of nondestructive assay methods are examined. Also important are trends in the presentation of safeguards results to the states and the general public

  14. Everyday, everywhere: alcohol marketing and social media--current trends. (United States)

    Nicholls, James


    To provide a snapshot content analysis of social media marketing among leading alcohol brands in the UK, and to outline the implications for both regulatory policies and further research. Using screengrab technology, the complete Facebook walls and Twitter timelines for 12 leading UK alcohol brands in November 2011 were captured and archived. A total of 701 brand-authored posts were identified and categorized using a thematic coding frame. Key strategic trends were identified and analysed in the light of contextual research into recent developments in marketing practice within the alcohol industry. A number of dominating trends were identified. These included the use of real-world tie-ins, interactive games, competitions and time-specific suggestions to drink. These methods reflect a strategy of branded conversation-stimulus which is favoured by social media marketing agencies. A number of distinct marketing methods are deployed by alcohol brands when using social media. These may undermine policies which seek to change social norms around drinking, especially the normalization of daily consumption. Social media marketing also raises questions regarding the efficacy of reactive regulatory frameworks. Further research into both the nature and impact of alcohol marketing on social media is needed.

  15. Current Rates of Publication for Podium and Poster Presentations at the American Society for Surgery of the Hand Annual Meetings

    Directory of Open Access Journals (Sweden)

    Joshua M. Abzug


    Full Text Available Background:  Research projects are presented at the Annual Meetings of the American Society for Surgery of the Hand (ASSH. It is unknown how many achieve publication in peer-reviewed journals. We sought to determine current rates of publication of podium and poster presentations.   Methods:  All ASSH podium and poster presentations from 2000 to 2005 were reviewed, and an Internet-based search using PubMed and Google was conducted to determine whether the presented studies had been published. Times to publication and journal names were recorded. Data were analyzed with descriptive statistics. Fisher’s exact test was conducted to compare current trends with previous trends. Results:  Of 1127 podium and poster presentations reviewed, 46% were published in peer-reviewed journals. Forty-seven percent of published presentations (242 presentations were in Journal of Hand Surgery , and 11% (59 entations were in Journal of Bone and Joint Surgery . Forty-five percent of presentations were published within 2 years and 66% within 3 years. The publication rate for podium presentations was significantly higher than that previously reported for Journal of Hand Surgery, at 54% compared with 44% (P=0.004.  Conclusions:  Currently, fewer than half of the studies presented at Annual Meetings of the ASSH achieve publication in peer-eviewed journals. Presentations are most likely to be published within 3 years, and almost half are published in Journal of Hand Surgery .

  16. Computer aided surgery. Current status and future directions

    International Nuclear Information System (INIS)

    Sato, Yoshinobu


    This review describes topics in the title in the order of 3D model reconstruction and therapeutic planning based on images before surgery; registration of the actual images in virtual physical space of the patient who is under surgical operation, to the preoperative ones with use of 3D-position sensor, ultrasonics, endoscopy and X-diaphanoscopy; and their accuracy analysis. Images before surgery usually obtained with CT and MR are reconstructed in 3D for the purpose of therapeutic planning by segmentation of the target organ/site, surrounding organs, bones and blood vessels. Navigation system at the surgery functions to make the images obtained before and during operation to be integrated for their registration and displaying. Usually, the optical marker and camera both equipped in the endoscope, and position sensor (tracker) are used for integration in the operation coordinate system. For this, the actual pictures at liver operation are given. For accuracy analysis there is a theory of target registration error, which has been established on FDA demands. In future, development of technology concerned in this field like that of robot, bio-dynamics, biomaterials, sensor and high performance computing together with 4D document of surgery for feed-back to technology are desirable for the systematic growing of this surgical technology. (T.I.)

  17. Current status of surgery for benign disorders of the esophagus

    NARCIS (Netherlands)

    Draaisma, Werner Adriaan


    This thesis aimed at exploring new techniques for the surgical treatment of benign disorders of the esophagus. Specifically, studies were performed on surgery for gastroesophageal reflux disease and large (type II-IV) hiatal hernia. The chapters presented in this thesis involve studies that have

  18. Current aspects of perioperative fluid handling in vascular surgery

    NARCIS (Netherlands)

    Jacob, Matthias; Chappell, Daniel; Hollmann, Markus W.


    Purpose of review Perioperative fluid management influences patient outcome. Vascular surgery unites various surgical procedures, mainly with a high impact on patients who often have relevant preexisting illnesses. There are only scarce data on this specialty, forcing the clinician to extrapolate

  19. Current status of robotic bariatric surgery: a systematic review (United States)


    Background Bariatric surgery is an effective treatment to obtain weight loss in severely obese patients. The feasibility and safety of bariatric robotic surgery is the topic of this review. Methods A search was performed on PubMed, Cochrane Central Register of Controlled Trials, BioMed Central, and Web of Science. Results Twenty-two studies were included. Anastomotic leak rate was 8.51% in biliopancreatic diversion. 30-day reoperation rate was 1.14% in Roux-en-Y gastric bypass and 1.16% in sleeve gastrectomy. Major complication rate in Roux-en-Y gastric bypass resulted higher than in sleeve gastrectomy ( 4,26% vs. 1,2%). The mean hospital stay was longer in Roux-en-Y gastric bypass (range 2.6-7.4 days). Conclusions The major limitation of our analysis is due to the small number and the low quality of the studies, the small sample size, heterogeneity of the enrolled patients and the lack of data from metabolic and bariatric outcomes. Despite the use of the robot, the majority of these cases are completed with stapled anastomosis. The assumption that robotic surgery is superior in complex cases is not supported by the available present evidence. The major strength of the robotic surgery is strongly facilitating some of the surgical steps (gastro-jejunostomy and jejunojejunostomy anastomosis in the robotic Roux-en-Y gastric bypass or the vertical gastric resection in the robotic sleeve gastrectomy). PMID:24199869


    Directory of Open Access Journals (Sweden)

    Г А Краснова


    Full Text Available The article is devoted to the main trends of development of e-learning in formal and non-formal education in different countries. The article discusses the main quantitative and qualitative characteristics of the market of e-learning education. The authors define main reasons the development of e-learning education in higher education. The authors note that the demand for e-learning by various groups of users will push the education authorities and educational institutions to develop different forms of e-learning and implement new business models of universities. In most universities in Europe and the United States adopted or will be adopted for the institutional strategy of development of e-learning.

  1. Current trends in development of explosives in world mining

    Energy Technology Data Exchange (ETDEWEB)

    Dobnikar, S.


    Surveys development of manufacturing industrial explosives in the 19th and 20th centuries, from first use of black powder, ammonium nitrate and TNT to the use of ANFO, slurries and water gel type explosives. Achievements of explosive producers with worldwide reputation (Ireco Chemicals, Du Pont, Atlas Powder Chemical, Nitro Nobel, Nippon Oil and Fats Co., Thermex Energy Co.) for manufacturing safe, reliable explosives used in surface and underground coal and ore mining (including gassy coal mines) and for quarrying are mentioned. Main characteristics of IREMITE, IREGEL, TOVEX, POURVEX, DRIVEX, Detagel, ANFO (both gel- and emulsion-type), Emulgite and Emulite are presented. A critical opinion about future trends in industrial explosive development is given. 10 refs., 7 tabs.

  2. Tianshuishi space breeding current situation and developing trend

    International Nuclear Information System (INIS)

    Wang Fuquan; Song Jianrong; Zhang Zhongping; Guo Zhenfang


    Tianshuishi is located in Xi'an to lanzhou among two big cities, the five space launch, has vegetables, food, grasses, flowers, rape, melon and fruit, Chinese traditional medicine, amount of 8 categories of crops, such as the 22 new material after carrying the ground breeding work. Only vegetables on identified 23 aerospace new varieties. After ten years of space breeding, summarizes the present situation of Tianshuishi space breeding, development experience, characteristic, trends, and puts forward the development space breeding Tianshuishi organization and breeding of talent from the matching policy and grow up incentive mechanism, strengthen the cooperation and all over the country, establishing fiscal policy support from the aspects such as advice. (authors)

  3. Readability Trends of Online Information by the American Academy of Otolaryngology-Head and Neck Surgery Foundation. (United States)

    Wong, Kevin; Levi, Jessica R


    Objective Previous studies have shown that patient education materials published by the American Academy of Otolaryngology-Head and Neck Surgery Foundation may be too difficult for the average reader to understand. The purpose of this study was to determine if current educational materials show improvements in readability. Study Design Cross-sectional analysis. Setting The Patient Health Information section of the American Academy of Otolaryngology-Head and Neck Surgery Foundation website. Subjects and Methods All patient education articles were extracted in plain text. Webpage navigation, references, author information, appointment information, acknowledgments, and disclaimers were removed. Follow-up editing was also performed to remove paragraph breaks, colons, semicolons, numbers, percentages, and bullets. Readability grade was calculated with the Flesch-Kincaid Grade Level, Flesch Reading Ease, Gunning-Fog Index, Coleman-Liau Index, Automated Readability Index, and Simple Measure of Gobbledygook. Intra- and interobserver reliability were assessed. Results A total of 126 articles from 7 topics were analyzed. Readability levels across all 6 tools showed that the difficulty of patient education materials exceeded the abilities of an average American. As compared with previous studies, current educational materials by the American Academy of Otolaryngology-Head and Neck Surgery Foundation have shown a decrease in difficulty. Intra- and interobserver reliability were both excellent, with intraclass coefficients of 0.99 and 0.96, respectively. Conclusion Improvements in readability is an encouraging finding and one that is consistent with recent trends toward improved health literacy. Nevertheless, online patient educational material is still too difficult for the average reader. Revisions may be necessary for current materials to benefit a larger readership.

  4. Current interest in careers in surgery and cardiothoracic surgery from the millennial generation. (United States)

    Ghannam, Michael; Zhao, Lili; Reddy, Rishindra M


    Interest in cardiothoracic surgery (CTS) as a career has decreased over the past decade. Anecdotal evidence suggests that many surgeons develop an interest in CTS before medical school and even before college. This study evaluates the interest of high-school students at a magnet high school, with regard to careers in medicine, in surgery, and in CTS. A survey assessing career interests and values was conducted among junior and senior high-school students. Students were given a 1-hour presentation by a cardiothoracic (CT) surgeon on the postgraduate training process and then completed a postpresentation survey. A magnet math and science high school, the Kalamazoo Area Mathematics and Science Center. Of 128 students, 117 (91% response rate) completed the survey. Overall, 38% of students reported having a high interest in medicine; of this group, 58% reported a high interest in surgery and 36% reported having a high interest in CTS. Men were more likely than women were to have a high interest in surgery and CTS (p < 0.001). Students with at least 1 family member as a physician vs those without were more likely to be interested in medicine, surgery, and CTS and also have a higher level of concern for postgraduation debt (p < 0.01). Women were more likely than men were to have a high level of concern about postgraduation debt (p = 0.018). After a presentation by a CT surgeon, students showed no changes in interest in medicine careers but did report an increased level of knowledge about the process of becoming a CT surgeon, going from 31% to 72%. There exists a large interest in both surgery and CTS at the high-school level, but there may be a need for more active outreach to maintain and foster their interest in surgery and CTS through undergraduate and medical school. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  5. Personal trainer demographics, current practice trends and common trainee injuries

    Directory of Open Access Journals (Sweden)

    Gregory R. Waryasz


    Full Text Available Increasing emphasis on maintaining a healthy lifestyle has led many individuals to seek advice on exercise from personal trainers. There are few studies to date that evaluate personal trainer education, practice trends, and injuries they have seen while training clients. A survey was distributed to personal trainers using Survey Monkey® (Palo Alto, CA, USA with 605 personal trainers accessing the survey. An exercise related bachelor’s degree was held by 64.2% of survey participants and a certification in personal training by 89.0%. The most common personal trainer certifications were from American College of Sports Medicine (59.2% and National Strength and Conditioning Association (28.9%. Only 2.9% of all personal trainers surveyed had no exercise-related bachelor’s degree and no personal trainer certification. The most common injuries seen by personal trainers during sessions were lumbar muscle strain (10.7%, rotator cuff tear/tendonitis (8.9%, shin splints (8.1%, ankle sprain (7.5%, and cervical muscle strain (7.4%. There is variability in the practices between different personal trainers when analyzing differences in collegiate education, personal trainer certifications, and strength and conditioning certifications. The clinical implication of the differences in practices is unknown as to the impact on injuries or exercise prescription effectiveness.

  6. Personal Trainer Demographics, Current Practice Trends and Common Trainee Injuries (United States)

    Waryasz, Gregory R.; Daniels, Alan H.; Gil, Joseph A.; Suric, Vladimir; Eberson, Craig P.


    Increasing emphasis on maintaining a healthy lifestyle has led many individuals to seek advice on exercise from personal trainers. There are few studies to date that evaluate personal trainer education, practice trends, and injuries they have seen while training clients. A survey was distributed to personal trainers using Survey Monkey® (Palo Alto, CA, USA) with 605 personal trainers accessing the survey. An exercise related bachelor’s degree was held by 64.2% of survey participants and a certification in personal training by 89.0%. The most common personal trainer certifications were from American College of Sports Medicine (59.2%) and National Strength and Conditioning Association (28.9%). Only 2.9% of all personal trainers surveyed had no exercise-related bachelor’s degree and no personal trainer certification. The most common injuries seen by personal trainers during sessions were lumbar muscle strain (10.7%), rotator cuff tear/tendonitis (8.9%), shin splints (8.1%), ankle sprain (7.5%), and cervical muscle strain (7.4%). There is variability in the practices between different personal trainers when analyzing differences in collegiate education, personal trainer certifications, and strength and conditioning certifications. The clinical implication of the differences in practices is unknown as to the impact on injuries or exercise prescription effectiveness. PMID:27761219

  7. Advanced fuel technology and performance: Current status and trends

    International Nuclear Information System (INIS)


    During the last years the Nuclear Fuel Cycle and Waste Management Division of the IAEA has been giving great attention to the collection, analysis and exchange of information in the field of reactor fuel technology. Most of these activities are being conducted in the framework of the International Working Group on Water Reactor Fuel Performance and Technology (IWGFPT). The purpose of this Advisory Group Meeting on Advanced Fuel Technology and Performance was to update and to continue the previous work, and to review the experience of advanced fuel technology, its performance with regard to all types of reactors and to outline the future trends on the basis of national experience and discussions during the meeting. As a result of the meeting a Summary Report was prepared which reflected the status of the advanced nuclear fuel technology up to 1990. The 10 papers presented by participants of this meeting are also published here. A separate abstract was prepared for each of these papers. Refs, figs and tabs

  8. FBG-Based Monitoring of Geohazards: Current Status and Trends

    Directory of Open Access Journals (Sweden)

    Hong-Hu Zhu


    Full Text Available In recent years, natural and anthropogenic geohazards have occured frequently all over the world, and field monitoring is becoming an increasingly important task to mitigate these risks. However, conventional geotechnical instrumentations for monitoring geohazards have a number of weaknesses, such as low accuracy, poor durability, and high sensitivity to environmental interferences. In this aspect, fiber Bragg grating (FBG, as a popular fiber optic sensing technology, has gained an explosive amount of attention. Based on this technology, quasi-distributed sensing systems have been established to perform real-time monitoring and early warning of landslides, debris flows, land subsidence, earth fissures and so on. In this paper, the recent research and development activities of applying FBG systems to monitor different types of geohazards, especially those triggered by human activities, are critically reviewed. The working principles of newly developed FBG sensors are briefly introduced, and their features are summarized. This is followed by a discussion of recent case studies and lessons learned, and some critical problems associated with field implementation of FBG-based monitoring systems. Finally the challenges and future trends in this research area are presented.

  9. FBG-Based Monitoring of Geohazards: Current Status and Trends. (United States)

    Zhu, Hong-Hu; Shi, Bin; Zhang, Cheng-Cheng


    In recent years, natural and anthropogenic geohazards have occured frequently all over the world, and field monitoring is becoming an increasingly important task to mitigate these risks. However, conventional geotechnical instrumentations for monitoring geohazards have a number of weaknesses, such as low accuracy, poor durability, and high sensitivity to environmental interferences. In this aspect, fiber Bragg grating (FBG), as a popular fiber optic sensing technology, has gained an explosive amount of attention. Based on this technology, quasi-distributed sensing systems have been established to perform real-time monitoring and early warning of landslides, debris flows, land subsidence, earth fissures and so on. In this paper, the recent research and development activities of applying FBG systems to monitor different types of geohazards, especially those triggered by human activities, are critically reviewed. The working principles of newly developed FBG sensors are briefly introduced, and their features are summarized. This is followed by a discussion of recent case studies and lessons learned, and some critical problems associated with field implementation of FBG-based monitoring systems. Finally the challenges and future trends in this research area are presented.

  10. Ectopic pregnancy: current clinical trends, a fifteen year study. (United States)

    Weekes, L R


    trimester. In cases such as this, there can be local excision and hemostasis. Idiopathic thrombocytopenic purpura was another encountered complication. Salpingectomy is inappropriate and even dangerous when used with an ectopic pregnancy. Early diagnosis and prompt surgery can help increase the survival rate. However, conservative surgery which preserves the tube is feasible and practical using salpingotomy and partial salpingectomy. Maternal death resulting from ectopic pregnancy is usually the result of sudden massive hemorrhage. The initiation of therapy prior to rupture is helpful. Ectopic pregnancy rate has remained fairly consistent among the white population but has decreased significantly in the nonwhite population. This is likely tied to an improvement in socioeconomic status, better patient education, and a greater awareness of medical needs. To decrease the maternal mortality rate from ectopic pregnancy, obstetricians and gynecologists must be more aggressive in research and treatment of ectopic pregnancy.

  11. Obesity in Nigeria: Current trends and management | Akpa ...

    African Journals Online (AJOL)

    The objective of the study is to review the current knowledge on the problems associated with obesity, as well as the measures and strategies that have evolved in its management. A review of the literature on the subject of obesity, its epidemiology, risk factors, clinical complications and treatment (using Medline computer ...

  12. Current trends in endodontic practice: emergency treatments and technological armamentarium. (United States)

    Lee, Michelle; Winkler, Johnathon; Hartwell, Gary; Stewart, Jeffrey; Caine, Rufus


    The current clinical practice of endodontics includes the utilization of a variety of new technological advances and materials. The last comprehensive survey that compared treatment modalities used in endodontic practices was conducted in 1990. The purpose of the current survey was to determine the frequency with which these new endodontic technologies and materials are being used in endodontic practices today. An e-mail questionnaire was sent to the 636 active diplomates of the American Board of Endodontics with current e-mail addresses. Two hundred thirty-two diplomates responded for a response rate of 35%. Calcium hydroxide was found to be the most frequently used intracanal medicament for all cases diagnosed with necrotic pulps. Ibuprofen was the most frequently prescribed medication for pain, and penicillin was the most frequently prescribed antibiotic when an active infection was present. Eighty-two percent of the respondents are still incorporating hand files in some fashion during the cleansing and shaping phase of treatment. Lateral condensation and continuous wave were the most common methods used for obturation. Digital radiography was reported as being used by 72.5% of the respondents, whereas 45.3% reported using the microscope greater than 75% of the patient treatment. Ultrasonics was used by 97.8% of the respondents. It appears from the results that new endodontic technology is currently being used in the endodontic offices of those who responded to the survey.

  13. Trends in Current Issues, Y2K-2005 (United States)

    Maltz, Leslie; DeBlois, Peter B.


    EDUCAUSE inaugurated its annual Current Issues Survey in 2000 by asking the primary representatives, typically CIOs, of its member institutions to identify up to three critical IT issues (five starting in 2004) from among 30 to 40 in response to each of four questions. The survey response rate has typically been 35 to 40 percent, with a…

  14. Inclusive Education in Georgia: Current Trends and Challenges (United States)

    Tchintcharauli, Tinatin; Javakhishvili, Nino


    This article presents the first comprehensive study of the Georgian inclusive education system launched nationwide in 2006. An internationally recognised tool, the "Pathway to Inclusion--Barometer of Inclusive Education", was applied within the country to highlight the current position of inclusive education in Georgia. The collected…

  15. The International Curriculum: Current Trends and Emerging Needs (United States)

    Richter, Jesse Jones


    This paper examines the current state of tertiary level international curricula and provides groundwork for future research aimed at ongoing needs. Recognized is the premise that existing international curricular programs require maintenance. Burn (1995) called for curriculum reform in international departments two decades ago with the rationale…

  16. Trends in Childspacing: June 1975. Current Population Reports: Population Characteristics. (United States)

    Moore, Maurice J.; And Others

    This report, largely statistical tables, presents data from the June 1975 Current Population Survey, on the timing and spacing of childbearing and discusses how such data is related to annual measures of fertility. By categorizing women according to their year of birth (birth cohort) or period of first marriage (marriage cohort), in addition to…

  17. Logging utilization in Idaho: Current and past trends (United States)

    Eric A. Simmons; Todd A. Morgan; Erik C. Berg; Stanley J. Zarnoch; Steven W. Hayes; Mike T. Thompson


    A study of commercial timber-harvesting activities in Idaho was conducted during 2008 and 2011 to characterize current tree utilization, logging operations, and changes from previous Idaho logging utilization studies. A two-stage simple random sampling design was used to select sites and felled trees for measurement within active logging sites. Thirty-three logging...

  18. Trends in Orbital Decompression Techniques of Surveyed American Society of Ophthalmic Plastic and Reconstructive Surgery Members. (United States)

    Reich, Shani S; Null, Robert C; Timoney, Peter J; Sokol, Jason A

    To assess current members of the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) regarding preference in surgical techniques for orbital decompression in Graves' disease. A 10-question web-based, anonymous survey was distributed to oculoplastic surgeons utilizing the ASOPRS listserv. The questions addressed the number of years of experience performing orbital decompression surgery, preferred surgical techniques, and whether orbital decompression was performed in collaboration with an ENT surgeon. Ninety ASOPRS members participated in the study. Most that completed the survey have performed orbital decompression surgery for >15 years. The majority of responders preferred a combined approach of floor and medial wall decompression or balanced lateral and medial wall decompression; only a minority selected a technique limited to 1 wall. Those surgeons who perform fat decompression were more likely to operate in collaboration with ENT. Most surgeons rarely remove the orbital strut, citing risk of worsening diplopia or orbital dystopia except in cases of optic nerve compression or severe proptosis. The most common reason given for performing orbital decompression was exposure keratopathy. The majority of surgeons perform the surgery without ENT involvement, and number of years of experience did not correlate significantly with collaboration with ENT. The majority of surveyed ASOPRS surgeons prefer a combined wall approach over single wall approach to initial orbital decompression. Despite the technological advances made in the field of modern endoscopic surgery, no single approach has been adopted by the ASOPRS community as the gold standard.

  19. Consciousness and working memory: Current trends and research perspectives. (United States)

    Velichkovsky, Boris B


    Working memory has long been thought to be closely related to consciousness. However, recent empirical studies show that unconscious content may be maintained within working memory and that complex cognitive computations may be performed on-line. This promotes research on the exact relationships between consciousness and working memory. Current evidence for working memory being a conscious as well as an unconscious process is reviewed. Consciousness is shown to be considered a subset of working memory by major current theories of working memory. Evidence for unconscious elements in working memory is shown to come from visual masking and attentional blink paradigms, and from the studies of implicit working memory. It is concluded that more research is needed to explicate the relationship between consciousness and working memory. Future research directions regarding the relationship between consciousness and working memory are discussed. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Current Trends in Implantable Left Ventricular Assist Devices

    Directory of Open Access Journals (Sweden)

    Jens Garbade


    Full Text Available The shortage of appropriate donor organs and the expanding pool of patients waiting for heart transplantation have led to growing interest in alternative strategies, particularly in mechanical circulatory support. Improved results and the increased applicability and durability with left ventricular assist devices (LVADs have enhanced this treatment option available for end-stage heart failure patients. Moreover, outcome with newer pumps have evolved to destination therapy for such patients. Currently, results using nonpulsatile continuous flow pumps document the evolution in outcomes following destination therapy achieved subsequent to the landmark Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure Trial (REMATCH, as well as the outcome of pulsatile designed second-generation LVADs. This review describes the currently available types of LVADs, their clinical use and outcomes, and focuses on the patient selection process.

  1. Current trends and future development in pharmacologic stress testing

    International Nuclear Information System (INIS)

    Bae, Jin Ho; Lee, Jae Tae


    Pharmacologic stress testing for myocardial perfusion imaging is a widely used noninvasive method for the evaluation of known or suspected coronary artery disease. The use of exercise for cardiac stress has been practiced for over 60 years and clinicians are familiar with its using. However, there are inevitable situations in which exercise stress is inappropriate. A large number of patients with cardiac problems are unable to exercise to their full potential due to comorbidity such as osteoarthritis, vascular disease and pulmonary disease and a standard exercise stress test for myocardial perfusion imaging is suboptimal means for assessment of coronary artery disease. This problem has led to the development of the pharmacologic stress test and to a great increase in its popularity. All of the currently used pharmacologic agents have well-documented diagnostic value. This review deals the physiological actions, clinical protocols, safety, nuclear imaging applications of currently available stress agents and future development of new vasodilating agents

  2. Survey of current trends in DNA synthesis core facilities. (United States)

    Hager, K M; Fox, J W; Gunthorpe, M; Lilley, K S; Yeung, A


    The Nucleic Acids Research Group of the Association of Biomolecular Resource Facilities (ABRF) last surveyed DNA synthesis core facilities in April 1995. Because of the introduction of new technologies and dramatic changes in the market, we sought to update survey information and to determine how academic facilities responded to the challenge presented by commercial counterparts. The online survey was opened in January 1999 by notifying members and subscribers to the ABRF electronic discussion group. The survey consisted of five parts: general facility information, oligonucleotide production profile, oligonucleotide charges, synthesis protocols, and trends in DNA synthesis (including individual comments). All submitted data were anonymously coded. Respondents from DNA synthesis facilities were primarily from the academic category and were established between 1984 and 1991. Typically, a facility provides additional services such as DNA sequencing and has upgraded to electronic ordering. There is stability in staffing profiles for these facilities in that the total number of employees is relatively unchanged, the tenure for staff averages 5.9 years, and experience is extensive. On average, academic facilities annually produce approximately 1/16 the number of oligonucleotides produced by the average commercial facilities, but all facilities report an increase in demand. Charges for standard oligonucleotides from academic facilities are relatively higher than from commercial companies; however, the opposite is true for modified phosphoramidites. Subsidized facilities charge less than nonsubsidized facilities. Synthesis protocols and reagents are standard across the categories. Most facilities offer typical modifications such as biotinylation. Despite the competition by large commercial facilities that have reduced costs dramatically, academic facilities remain a stable entity. Academic facilities enhance the quality of service by focusing on nonstandard

  3. Precarious Employment in the Vologda Oblast: Current State and Trends

    Directory of Open Access Journals (Sweden)

    Aleksandr Mikhailovich Panov


    Full Text Available The paper is devoted to the study of the phenomenon of precarious employment in Russian regions. Today, the socio-economic sciences lack a single concept of precarious employment applicable to Russian conditions. Despite the considerable amount of scientific and practical works of domestic and foreign authors on the issue of precarious employment, the criteria of its statistical evaluation as applied to Russian conditions have not been determined. At the same time, the development of precarious employment threatens the country’s socio-economic welfare, because it creates the risk of unwanted effects such as poor employment, hidden and open unemployment, lower labor productivity, degradation of human capital, etc. The paper provides a brief review of research on the problem stated, and defines precarious employment. The author makes an attempt to determine and substantiate the list of indicators available in official statistics for assessing precarious employment in the region. The study allocates three blocks of indicators: indicators of institutional regulation, conditions of employment and functioning of the labor market. Based on these indicators, the author analyzes the status and trends of precarious work in the Vologda Oblast in the period from 2001 to 2015. In some cases, the author presents a comparative analysis of the data for the Russian Federation and Northwestern Federal District. The analysis has helped identify positive and negative changes in the field of precarious employment in the Vologda Oblast. In particular, the author identifies the following problems: an increase in the share of those employed in the informal sector, a relative increase in the number of the working poor, an almost three-fold growth of overdue debts on wages in comparable prices per worker. On the basis of this analysis, the author identifies the directions of the state policy that can help reduce precarious employment: development of information

  4. Current trends in the management of Graves' disease

    Energy Technology Data Exchange (ETDEWEB)

    Solomon, B.; Glinoer, D.; Lagasse, R.; Wartofsky, L. (Walter Reed Army Medical Center, Washington, DC (USA))


    Members of the American Thyroid Association were invited to participate in a survey of the management of Graves' disease. One primary case and several variations were provided, which differed in respect to age, sex, goiter size, severity, etc. The questionnaire was based on the format used in a similar survey of members of the European Thyroid Association. The aim of the survey was to determine (1) how expert thyroidologist employ diagnostic procedures for this disorder, and (2) the choice of therapy of the three treatment options and its manner of implementation. Questionnaires were sent only to clinically active members. The overall response rate was 62%. Data analysis was possible on 52% of members surveyed and was performed using SPSS and a specific Fortran program. In the laboratory evaluation of the primary case a radioiodine uptake, scan, serum total T4, and basal TSH were requested by 92%, 47%, 83%, and 66%, respectively, with 84% of respondents using an ultrasensitive TSH assay. For management of the primary case, radioiodine treatment was the first choice of 69% of the respondents. Antithyroid drugs were used briefly (3-7 days) before 131I by 28%, whereas 41% said they would employ thioureas after 131I. Of those using 131I, 66% tailored the dose to achieve euthyroidism as the goal of therapy, while 34% aimed for hypothyroidism requiring T4 replacement. Only 30% of respondents chose thioureas as a first line of treatment (72% propylthiouracil; 28% tapazole). The duration of drug therapy was a predetermined fixed interval for 80% of the respondents, with 90% treating for 1-2 yr. Other specific trends in diagnostic approach and therapeutic preferences were identified for the eight variations on the primary case problem.

  5. Blood flow behavior in microchannels: past, current and future trends


    Lima, R.; Ishikawa, Takuji; Imai, Yohsuke; Yamaguchi, Takami


    Over the years, various experimental methods have been applied in an effort to understand the blood flow behavior in microcirculation. Most of our current knowledge in microcirculation is based on macroscopic flow phenomena such as Fahraeus effect and Fahraeus-Linqvist effect. The development of optical experimental techniques has contributed to obtain possible explanations on the way the blood flows through microvessels. Although the past results have been encouraging, detailed s...



    Sokolova, A. N.; Yurko, Т. S.; Klimenko, I. V.


    Globalization processes accelerate the pace of scientific and technological progress and innovation and require investment in innovation to enhance the efficiency of the national economy of our state and some of its branches, inter–industry complexes and sub–complexes at the level of developed countries.The article examines the current state of investment in agriculture of Ukraine. The main criteria to encourage capital investment taking into account regional peculiarities capital investment ...

  7. Global Trends and Current Status of Commercial Urban Rooftop Farming


    Devi Buehler; Ranka Junge


    The aim of this study was to analyze current practices in commercial urban rooftop farming (URF). In recent years, URF has been experiencing increasing popularity. It is a practice that is well-suited to enhancing food security in cities and reducing the environmental impact that results from long transportation distances that are common in conventional agriculture. To date, most URF initiatives have been motivated by social and educational factors rather than the aim of creating large sustai...

  8. Mechanics of Biological Tissues and Biomaterials: Current Trends


    Amir A. Zadpoor


    Investigation of the mechanical behavior of biological tissues and biomaterials has been an active area of research for several decades. However, in recent years, the enthusiasm in understanding the mechanical behavior of biological tissues and biomaterials has increased significantly due to the development of novel biomaterials for new fields of application, along with the emergence of advanced computational techniques. The current Special Issue is a collection of studies that address variou...

  9. Mechanics of Biological Tissues and Biomaterials: Current Trends (editorial)


    Zadpoor, A.A.


    Investigation of the mechanical behavior of biological tissues and biomaterials has been an active area of research for several decades. However, in recent years, the enthusiasm in understanding the mechanical behavior of biological tissues and biomaterials has increased significantly due to the development of novel biomaterials for new fields of application, along with the emergence of advanced computational techniques. The current Special Issue is a collection of studies that address variou...

  10. Google Trends as a Resource for Informing Plastic Surgery Marketing Decisions. (United States)

    Ward, Brittany; Ward, Max; Paskhover, Boris


    Celebrities have long influenced the medical decisions of the general population. By analyzing Google search data using Google Trends, we measured the impact of highly publicized plastic surgery-related events on the interest level of the general population in specific search terms. Additionally, we investigated seasonal and geographic trends around interest in rhinoplasties, which is information that physicians and small surgical centers can use to optimize marketing decisions. Google Trends was used to access search data histories for three separate areas of interest: Kylie Jenner and lip fillers, Joan Rivers and plastic surgery, and rhinoplasty, which were then analyzed using two-tailed, two-sample equal variance t-tests. The average interest level in fillers increased by 30.31 points after Kylie Jenner announced that she received Juvéderm lip injections. The interest level in plastic surgery was decreased by 21.3% the month after Joan Rivers' death. Between January 2004 and May 2017, the average interest level for rhinoplasty was significantly different in January/December (67.91 ± 20.68) and June/July (70.12 ± 18.89) from the remaining calendar months (63.58 ± 19.67). Los Angeles, New York City, and Miami showed consistently high interest levels throughout the time period, while Tulsa, OK, showed a major interest increase between 2015 to 2016 of 65 points. A noticeable impact was observed in both celebrity cases on search term volume, and a seasonal effect is apparent for rhinoplasty searches. As many surgeons already employ aggressive Internet marketing strategies, understanding and utilizing these trends could help optimize their investments, increase social engagement, and increase practice awareness by potential patients. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www

  11. Social media in plastic surgery practices: emerging trends in North America. (United States)

    Wheeler, Chad K; Said, Hakim; Prucz, Roni; Rodrich, Rod J; Mathes, David W


    Social media is a common term for web-based applications that offer a way to disseminate information to a targeted audience in real time. In the current market, many businesses are utilizing it to communicate with clients. Although the field of plastic surgery is constantly changing in response to innovative technologies introduced into the specialty, the utilization of social media in plastic surgery practices is currently unclear. The authors evaluate the current attitudes and practices of aesthetic surgeons to emerging social media technology and compare these to attitudes about more traditional modes of communication. A 19-question web-based survey was disseminated by e-mail to all board-certified or board-eligible American plastic surgeons (n = 4817). Respondents were asked to answer questions on three topics: (1) their use of social media in their personal and professional lives, (2) their various forms of practice marketing, and (3) their demographic information. There were 1000 responses (20.8%). Results showed that 28.2% of respondents used social media in their practice, while 46.7% used it in their personal life. Most plastic surgeons managed their social media themselves or through a staff member. The majority of respondents who used social media in their practice claimed that their efforts were directed toward patient referrals. The typical plastic surgery practice that used social media was a solo practice in a large city with a focus on cosmetic surgery. Local competition of plastic surgeons did not correlate with social media use. Most plastic surgeons (88%) advertised, but the form of marketing varied. The most common forms included websites, print, and search engine optimization, but other modalities, such as television, radio, and billboards, were still utilized. Social media represents a new avenue that many plastic surgeons are utilizing, although with trepidation. As social media becomes commonplace in society, its role in plastic surgery

  12. Current controversies in colorectal surgery: the way to resolve uncertainty and move forward

    DEFF Research Database (Denmark)

    Rosenberg, J; Fischer, A; Haglind, E


    for low rectal cancer, robotic surgery for various colorectal procedures, laparoscopic lavage without resection for Hinchey Stage III perforated sigmoid diverticulitis, and the use of the single port technique for laparoscopic surgery. Before general implementation the new modalities should ideally......The are currently a number of unsolved clinical questions in colorectal surgery with new surgical principles being introduced without proper scientific high-level evidence. These include complete mesocolic excision with central ligation for colonic cancer, extralevator abdominoperineal excision...

  13. Computational chemistry reviews of current trends v.4

    CERN Document Server


    This volume presents a balanced blend of methodological and applied contributions. It supplements well the first three volumes of the series, revealing results of current research in computational chemistry. It also reviews the topographical features of several molecular scalar fields. A brief discussion of topographical concepts is followed by examples of their application to several branches of chemistry.The size of a basis set applied in a calculation determines the amount of computer resources necessary for a particular task. The details of a common strategy - the ab initio model potential

  14. Valuable metals - recovery processes, current trends, and recycling strategies

    Energy Technology Data Exchange (ETDEWEB)

    Froehlich, Peter; Lorenz, Tom; Martin, Gunther; Brett, Beate; Bertau, Martin [Institut fuer Technische Chemie, TU Bergakademie Freiberg, Leipziger Strasse 29, 09599, Freiberg (Germany)


    This Review provides an overview of valuable metals, the supply of which has been classified as critical for Europe. Starting with a description of the current state of the art, novel approaches for their recovery from primary resources are presented as well as recycling processes. The focus lies on developments since 2005. Chemistry strategies which are used in metal recovery are summarized on the basis of the individual types of deposit and mineral. In addition, the economic importance as well as utilization of the metals is outlined. (copyright 2017 Wiley-VCH Verlag GmbH and Co. KGaA, Weinheim)

  15. Current Trends on Lean Management – A review

    Directory of Open Access Journals (Sweden)

    M. Shabeena Begam


    Full Text Available All manufacturing industry has put in continuous efforts for its survival in the current impulsive and competitive economy. In order to handle the critical situation, manufacturers are trying to implement new and innovative techniques in their manufacturing process by making it more effective and efficient. A detailed literature survey has been conducted to identify the lean practices in various manufacturing industry. The results revealed that the status of Lean Manufacturing (LM implementation in still in thriving stage. This paper will further assist the organizations to improve its process, align it to the requirements of its customers and relentless contribution to manufacturing sector to enhance productivity, quality and competitiveness is immense.

  16. Improve processes on healthcare: current issues and future trends. (United States)

    Chen, Jason C H; Dolan, Matt; Lin, Binshan


    Information Technology (IT) is a critical resource for improving today's business competitiveness. However, many healthcare providers do not proactively manage or improve the efficiency and effectiveness of their services with IT. Survival in a competitive business environment demands continuous improvements in quality and service, while rigorously maintaining core values. Electronic commerce continues its development, gaining ground as the preferred means of business transactions. Embracing e-healthcare and treating IT as a strategic tool to improve patient safety and the quality of care enables healthcare professionals to benefit from technology formerly used only for management purposes. Numerous improvement initiatives, introduced by both the federal government and the private sector, seek to better the status quo in IT. This paper examines the current IT climate using an enhanced "Built to Last" model, and comments on future IT strategies within the healthcare industry.

  17. Nuclear reactor fuel rod behavior modelling and current trends

    International Nuclear Information System (INIS)

    Colak, Ue.


    Safety assessment of nuclear reactors is carried out by simulating the events to taking place in nuclear reactors by realistic computer codes. Such codes are developed in a way that each event is represented by differential equations derived based on physical laws. Nuclear fuel is an important barrier against radioactive fission gas release. The release of radioactivity to environment is the main concern and this can be avoided by preserving the integrity of fuel rod. Therefore, safety analyses should cover an assessment of fuel rod behavior with certain extent. In this study, common approaches for fuel behavior modeling are discussed. Methods utilized by widely accepted computer codes are reviewed. Shortcomings of these methods are explained. Current research topics to improve code reliability and problems encountered in fuel rod behavior modeling are presented

  18. Renewable energy sources in Bulgaria: Current state and trends (United States)

    Kolev, K.

    The over-dependency of Bulgaria on imported fuel stressed the importance of developing a new energy strategy based on energy saving which includes also using renewable energy sources (RES). The target is the substitution of at least 2 percent of the real primary energy consumption with RES by 2010. The author gives a generalized analysis of the available RES in Bulgaria -solar, wind, geothermal, biomass and mini-hydraulic. The potentialities of each source for its usage as a suitable energy supply are pointed out, as well as the current status of research and implementation work, problems connected with legislation, financing and production of particular facilities. The governmental policy concerning RES is considered briefly. A description is given to the project 'Technical and Economical Assessment of Possibilities for Expansion of the RES-part in the Energy Balance of the Country' developed and started in 1994 in the framework of the PHARE program.

  19. Quantum Dots in the Therapy: Current Trends and Perspectives. (United States)

    Pohanka, Miroslav


    Quantum dots are an emerging nanomaterial with broad use in technical disciplines; however, their application in the field of biomedicine becomes also relevant and significant possibilities have appeared since the discovery in 1980s. The current review is focused on the therapeutic applications of quantum dots which become an emerging use of the particles. They are introduced as potent carriers of drugs and as a material well suited for the diagnosis of disparate pathologies like visualization of cancer cells or pathogenic microorganisms. Quantum dots toxicity and modifications for the toxicity reduction are discussed here as well. Survey of actual papers and patents in the field of quantum dots use in the biomedicine is provided. Copyright© Bentham Science Publishers; For any queries, please email at

  20. Preparative Purification of Recombinant Proteins: Current Status and Future Trends

    Directory of Open Access Journals (Sweden)

    Mayank Saraswat


    Full Text Available Advances in fermentation technologies have resulted in the production of increased yields of proteins of economic, biopharmaceutical, and medicinal importance. Consequently, there is an absolute requirement for the development of rapid, cost-effective methodologies which facilitate the purification of such products in the absence of contaminants, such as superfluous proteins and endotoxins. Here, we provide a comprehensive overview of a selection of key purification methodologies currently being applied in both academic and industrial settings and discuss how innovative and effective protocols such as aqueous two-phase partitioning, membrane chromatography, and high-performance tangential flow filtration may be applied independently of or in conjunction with more traditional protocols for downstream processing applications.

  1. Current state and trend of radiation regulation system in Japan

    International Nuclear Information System (INIS)

    Yonehara, Hidenori


    Japanese regulation system for safety against radiation essentially started from 'Atomic Energy Basic Law' enacted in 1955 and 'Law Concerning Prevention of Radiation Hazards due to Radioisotopes, etc' enacted in 1957, has been regarded as a central rule for radiation protection and safety. Related laws and regulations have been enacted together with their revision. Radiation Council, established in the Science and Technology Agency in 1962 and now belonging to the Ministry of Education, Culture, Sports, Science and Technology, has deliberated basically on International Commission of Radiological Protection (ICRP) statements for legal revision and has set up working groups for current problems. Activities of the groups have concerned ICRP Publication 60 (1990) and later related publications for incorporating the principle into laws as to concepts of dose limits, effective dose, and then of exemption and exclusion. International status of the Japanese regulation, problems and tasks in the regulation are also commented. (N.I.)

  2. [New Paradigms? Current Trends within National and International Psychotherapy Research]. (United States)

    Strauß, Bernhard


    This article is devoted to the question which paradigms currently determine psychotherapy and psychotherapy research, and if there are indicators of paradigm changes in this field. The question of the efficacy and effectiveness (including the effectiveness of a transfer of psychotherapeutic knowledge to service) is specifically focussed as well as the question of the central therapeutic factors and the significance of the person of the therapist. It is argued that there are really some signals of a paradigm switch, with a turn away from controlled outcome research, representing only a minor part of patients in need of psychotherapy, towards a more specific process oriented research, also considering differential effects of the therapist. The most prominent indicator of a paradigm change is reflected by an increasing influence of patient oriented psychotherapy research which - consequently - should also be supported by the insurances as well as the funding organisations. © Georg Thieme Verlag KG Stuttgart · New York.

  3. MALDI-TOF MS in the Microbiology Laboratory: Current Trends. (United States)

    Schubert, Sören; Kostrzewa, Markus


    Within less than a decade matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) has become a gold standard for microbial identification in clinical microbiology laboratories. Besides identification of microorganisms the typing of single strains as well as the antibiotic and antimycotic resistance testing has come into focus in order to speed up the microbiological diagnostic. However, the full potential of MALDI-TOF MS has not been tapped yet and future technological advancements will certainly expedite this method towards novel applications and enhancement of current practice. So, the following chapter shall be rather a brainstorming and forecast of how MALDI-TOF MS will develop to influence clinical diagnostics and microbial research in the future. It shall open up the stage for further discussions and does not claim for overall validity.

  4. Current Trends in Heparin Use During Arterial Vascular Interventional Radiology

    International Nuclear Information System (INIS)

    Durran, Alexandra C.; Watts, Christopher


    Purpose: This study was designed to assess the current use of heparinized saline and bolus doses of heparin in non-neurological interventional radiology and to determine whether consensus could be reached to produce guidance for heparin use during arterial vascular intervention. Methods: An interactive electronic questionnaire was distributed to members of the British Society of Interventional Radiology regarding their current practice in the use, dosage, and timing of heparin boluses and heparinized flushing solutions.ResultsA total of 108 completed questionnaires were received. More than 80% of respondents used heparinized saline with varying concentrations; the most prevalent was 1,000 IU/l (international units of heparin per liter) and 5,000 IU/l. Fifty-one percent of interventionalists use 3,000 IU as their standard bolus dose; however, the respondents were split regarding the timing of bolus dose with ∼60% administering it after arterial access is obtained and 40% after crossing the lesion. There was no consensus on altering dose according to body weight, and only 4% monitored clotting parameters. Conclusions: There seems to be some coherence among practicing interventionalists regarding heparin administration. We hypothesize that heparinized saline should be used at a recognized standard concentration of 1,000 IU/l as a flushing concentration in all arterial vascular interventions and that 3,000 IU bolus is considered the standard dose for straightforward therapeutic procedures and 5000 IU for complex, crural, and endovascular aneurysm repair work. The bolus should be given after arterial access is obtained to allow time for optimal anticoagulation to be achieved by the time of active intervention and stenting. Further research into clotting abnormalities following such interventional procedures would be an interesting quantifiable follow-up to this initial survey of opinions and practice.

  5. Global surgery: current evidence for improving surgical care. (United States)

    Fuller, Jennifer C; Shaye, David A


    The field of global surgery is undergoing rapid transformation, owing to several recent prominent reports positioning it as a cost-effective means of relieving global disease burden. The purpose of this article is to review the recent advances in the field of global surgery. Efforts to grow the global surgical workforce and procedural capacity have focused on innovative methods to increase surgeon training, enhance international collaboration, leverage technology, optimize existing health systems, and safely implement task-sharing. Computer modeling offers a novel means of informing policy to optimize timely access to care, equitably promote health and financial protection, and efficiently grow infrastructure. Tools and checklists have recently been developed to enhance data collection and ensure methodologically rigorous publications to inform planning, benchmark surgical systems, promote accurate modeling, track key health indicators, and promote safety. Creation of institutional partnerships and trainee exchanges can enrich training, stimulate commitment to humanitarian work, and promote the equal exchange of ideas and expertise. The recent body of work creates a strong foundation upon which work toward the goal of universal access to safe, affordable surgical care can be built; however, further collection and analysis of country-specific data is necessary for accurate modeling and outcomes research into the efficacy of policies such as task-sharing is greatly needed.

  6. Global development and current evidence of uniportal thoracoscopic surgery (United States)

    Tu, Cheng-Che


    In the era of video-assisted thoracoscopic surgery (VATS), uniportal and single incision thoracoscopic surgeries are gaining popularity. The spectrum of uniportal VATS indications is now almost equal to that of conventional VATS. For example, successful uniportal sleeve lobectomy, rib segmental resection, and management of intraoperative bleeding have all been reported. According to published data in the English-language literature, more than 9,545 uniportal VATS have been performed to date, including 1,293 lobectomies, 1,024 procedures for pneumothorax, and 6,845 sympathectomies. Of the 192 articles discussing this topic, 35 were conducted in Spain, and there were an increasing number of publications from China, Korea, and other Asian countries. There were 41 technical and review articles, all of which provided an excellent foundation of surgical concept and skill learning. The benefits of uniportal VATS include better surgical geometry and cosmetics. Regarding postoperative outcomes, thirteen out of the 15 articles reviewed showed that uniportal VATS has similar or superior outcomes to conventional VATS. Most studies demonstrated that uniportal VATS produced less postoperative pain and paresthesia. In conclusion, uniportal VATS can produce excellent operative outcome, which is becoming a mature surgical approach in thoracic disease, supported by fast-accumulating and abundant experience. PMID:27014479

  7. Current Trends in Malaysian Higher Education and the Effect on Education Policy and Practice: An Overview (United States)

    Grapragasem, Selvaraj; Krishnan, Anbalagan; Mansor, Azlin Norhaini


    Malaysia has evolved from a production-based to knowledge-based economy in order to stay relevant and compete in the global marketplace. Thus, the purpose of this article is to discuss current trends in Malaysian higher education and how these affect education policies and practices. Four main trends are discussed in this study: Globalization,…

  8. A Study of Current Trends and Issues Related to Technical/Engineering Design Graphics. (United States)

    Clark, Aaron C.; Scales Alice


    Presents results from a survey of engineering design graphics educators who responded to questions related to current trends and issues in the profession of graphics education. Concludes that there is a clear trend in institutions towards the teaching of constraint-based modeling and computer-aided manufacturing. (Author/YDS)

  9. Current Trends and Challenges in Satellite Laser Ranging (United States)

    Appleby, Graham M.; Bianco, Giuseppe; Noll, Carey E.; Pavlis, Erricos C.; Pearlman, Michael R.


    Satellite Laser Ranging (SLR) is used to measure accurately the distance from ground stations to retro-reflectors on satellites and on the Moon. SLR is one of the fundamental space-geodetic techniques that define the International Terrestrial Reference Frame (ITRF), which is the basis upon which many aspects of global change over space, time, and evolving technology are measured; with VLBI the two techniques define the scale of the ITRF; alone the SLR technique defines its origin (geocenter). The importance of the reference frame has recently been recognized at the inter-governmental level through the United Nations, which adopted in February 2015 the Resolution "Global Geodetic Reference Frame for Sustainable Development." Laser Ranging provides precision orbit determination and instrument calibration and validation for satellite-borne altimeters for the better understanding of sea level change, ocean dynamics, ice mass-balance, and terrestrial topography. It is also a tool to study the dynamics of the Moon and fundamental constants and theories. With the exception of the currently in-orbit GPS constellation, all GNSS satellites now carry retro-reflectors for improved orbit determination, harmonization of reference frames, and in-orbit co-location and system performance validation; the next generation of GPS satellites due for launch from 2019 onwards will also carry retro-reflectors. The ILRS delivers weekly realizations that are accumulated sequentially to extend the ITRF and the Earth Orientation Parameter series with a daily resolution. SLR technology continues to evolve towards the next-generation laser ranging systems and it is expected to successfully meet the challenges of the GGOS2020 program for a future Global Space Geodetic Network. Ranging precision is improving as higher repetition rate, narrower pulse lasers, and faster detectors are implemented within the network. Automation and pass interleaving at some stations is expanding temporal coverage and

  10. Current trends in small vocabulary speech recognition for equipment control (United States)

    Doukas, Nikolaos; Bardis, Nikolaos G.


    Speech recognition systems allow human - machine communication to acquire an intuitive nature that approaches the simplicity of inter - human communication. Small vocabulary speech recognition is a subset of the overall speech recognition problem, where only a small number of words need to be recognized. Speaker independent small vocabulary recognition can find significant applications in field equipment used by military personnel. Such equipment may typically be controlled by a small number of commands that need to be given quickly and accurately, under conditions where delicate manual operations are difficult to achieve. This type of application could hence significantly benefit by the use of robust voice operated control components, as they would facilitate the interaction with their users and render it much more reliable in times of crisis. This paper presents current challenges involved in attaining efficient and robust small vocabulary speech recognition. These challenges concern feature selection, classification techniques, speaker diversity and noise effects. A state machine approach is presented that facilitates the voice guidance of different equipment in a variety of situations.

  11. Rationing critical care medicine: recent studies and current trends. (United States)

    Ward, Nicholas S


    This paper reviews the literature on the rationing of critical care resources. Although much has been written about the concept of rationing, there have been few scientific studies as to its prevalence. A recent meta-analysis reviewed all previously published studies on rationing access to intensive care units but little is known about practices within the intensive care unit. Much literature in the past few years has focused on the growing use of critical care resources and projections for the future. Several authors suggest there may be a crisis in financial or personnel resources if some rationing does not take place. Other papers have argued that the methods of rationing critical care previously proposed, such as limiting the care of dying patients or using cost-effectiveness analysis to determine care, may not be effective or viewed as ethical by some. Finally, several recent papers review how critical care is practiced and allocated in India and Asian countries that already practice open rationing in their health care systems. There is currently no published evidence that overt rationing is taking place in critical care medicine. There is growing evidence that in the future, the need for critical care may outstrip financial resources unless some form of rationing takes place. It is also clear from the literature that choosing how to ration critical care will be a difficult task.

  12. Helicobacter pylori eradication therapy: A review of current trends. (United States)

    Olokoba, A B; Obateru, O A; Bojuwoye, M O


    Helicobacter pylori has been implicated in the formation of chronic gastritis, peptic ulcer disease, mucosa-associated lymphoid tissue lymphoma and gastric cancer. Eradication of H. Pylori has been recommended as treatment and prevention for these complications. This review is based on a search of Medline, the Cochrane Database of Systemic Reviews, and citation lists of relevant publications. Subject heading and key words used include H. Pylori, current treatment and emerging therapy. Only articles in English were included. There has been a substantial decline in the H. pylori eradication rates over the years, despite the use of proton pump inhibitor and bismuth salts for triple and quadruple therapies respectively. The reasons for eradication failure are diverse, among them, antibiotic resistance is an important factor in the treatment failure. Primary resistance to clarithromycin or metronidazole significantly affects the efficacy of eradication therapy. This has led to the introduction of second line, third line "rescue," and sequential therapies for resistant cases. Subsequently, new antibiotic combinations with proton-pump inhibitors and bismuth salts are being studied in the last decade, to find out the antibiotics that are capable of increasing the eradication rates. Some of these antibiotics include Levofloxacin, Doxycycline, Rifaximin, Rifampicin, Furazolidone based therapies. Studies are ongoing to determine the efficacy of Lactoferrin based therapy.

  13. Iran's petroleum policy: Current trends and the future outlook

    International Nuclear Information System (INIS)

    Pezeshki, S.; Fesharaki, F.


    The Iranian economy and political situation have undergone radical changes since the 1979 Islamic revolution. The excesses of the early years of the revolution have gradually given way to moderation and a more pragmatic economic policy--based on the principles of the free market. The petroleum policy, as a subset of the economic policies, has been somewhat affected by the political and economic developments in Iran. The petroleum policy has changed from a position of no foreign participation to a position that includes a desire for foreign participation, the text of a model contract, and an attempt to introduce new technologies in the upstream sector. This report provides an overview of the key issues facing the Iranian oil industry and the economic context in which the oil industry is operating in Iran. It describes the evolution of policies meant to move the oil industry toward the free market; it discusses Iran's oil trading partners, the outlook for refining and project investments, and current and likely future developments in the natural gas and petrochemical sectors. In short, the report provides an up-to-date assessment of the Iranian petroleum sector and its likely evolution in the future

  14. P300 brain computer interface: current challenges and emerging trends (United States)

    Fazel-Rezai, Reza; Allison, Brendan Z.; Guger, Christoph; Sellers, Eric W.; Kleih, Sonja C.; Kübler, Andrea


    A brain-computer interface (BCI) enables communication without movement based on brain signals measured with electroencephalography (EEG). BCIs usually rely on one of three types of signals: the P300 and other components of the event-related potential (ERP), steady state visual evoked potential (SSVEP), or event related desynchronization (ERD). Although P300 BCIs were introduced over twenty years ago, the past few years have seen a strong increase in P300 BCI research. This closed-loop BCI approach relies on the P300 and other components of the ERP, based on an oddball paradigm presented to the subject. In this paper, we overview the current status of P300 BCI technology, and then discuss new directions: paradigms for eliciting P300s; signal processing methods; applications; and hybrid BCIs. We conclude that P300 BCIs are quite promising, as several emerging directions have not yet been fully explored and could lead to improvements in bit rate, reliability, usability, and flexibility. PMID:22822397

  15. Participatory Sensing Marine Debris: Current Trends and Future Opportunities (United States)

    Jambeck, J.; Johnsen, K.


    The monitoring of litter and debris is challenging at the global scale because of spatial and temporal variability, disconnected local organizations and the use of paper and pen for documentation. The Marine Debris Tracker mobile app and citizen science program allows for the collection of global standardized data at a scale, speed and efficiency that was not previously possible. The app itself also serves as an outreach and education tool, creating an engaged participatory sensing instrument. This instrument is characterized by several aspects including range and frequency, accuracy and precision, accessibility, measurement dimensions, participant performance, and statistical analysis. Also, important to Marine Debris Tracker is open data and transparency. A web portal provides data that users have logged allowing immediate feedback to users and additional education opportunities. The engagement of users through a top tracker competition and social media keeps participants interested in the Marine Debris Tracker community. Over half a million items have been tracked globally, and maps provide both global and local distribution of data. The Marine Debris Tracker community and dataset continues to grow daily. We will present current usage and engagement, participatory sensing data distributions, choropleth maps of areas of active tracking, and discuss future technologies and platforms to expand data collection and conduct statistical analysis.

  16. Preemptive analgesia II: recent advances and current trends.

    LENUS (Irish Health Repository)

    Kelly, D J


    PURPOSE: This two-part review summarizes the current knowledge of physiological mechanisms, pharmacological modalities and controversial issues surrounding preemptive analgesia. SOURCE: Articles from 1966 to present were obtained from the MEDLINE databases. Search terms included analgesia, preemptive; neurotransmitters; pain, postoperative; hyperalgesia; sensitization, central nervous system; pathways, nociception; anesthetic techniques; analgesics, agents. Principal findings: In Part I of this review article, techniques and agents that attenuate or prevent central and peripheral sensitization were reviewed. In Part II, the conditions required for effective preemptive techniques are evaluated. Specifically, preemptive analgesia may be defined as an antinociceptive treatment that prevents establishment of altered central processing of afferent input from sites of injury. The most important conditions for establishment of effective preemptive analgesia are the establishment of an effective level of antinociception before injury, and the continuation of this effective analgesic level well into the post-injury period to prevent central sensitization during the inflammatory phase. Although single-agent therapy may attenuate the central nociceptive processing, multi-modal therapy is more effective, and may be associated with fewer side effects compared with the high-dose, single-agent therapy. CONCLUSION: The variable patient characteristics and timing of preemptive analgesia in relation to surgical noxious input require individualization of the technique(s) chosen. Multi-modal analgesic techniques appear more effective.

  17. Special education for intellectual disability: current trends and perspectives. (United States)

    Kauffman, James M; Hung, Li-Yu


    To inform readers of current issues in special education for individuals with intellectual disabilities and summarize recent research and opinion. Two issues dominate special education for students with intellectual disabilities in the early 21st century. First, what should be taught to such students and who should teach them? Second, where should such students be taught - in 'inclusive' settings alongside normal peers or in special settings dedicated to their special needs? Research on teaching reading, arithmetic, and functional daily living skills to students with disabilities suggests the superiority of direct, systematic instruction. Universal design is often seen as supportive of inclusion. Inclusion has been seen as the central issue in special education but is gradually giving way to concern for what students learn. Direct, systematic instruction in reading, arithmetic, and daily living skills is the most effective approach to teaching students with intellectual disabilities. Basic concepts and logic suggest that special and general education cannot be equivalent. We conclude that what students are taught should be put ahead of where they are taught. Our fundamental concern is that students with intellectual disabilities be respected and be taught all they can learn.

  18. Current trends in the diagnosis and treatment of tuboovarian abscess

    International Nuclear Information System (INIS)

    Landers, D.V.; Sweet, R.L.


    Tuboovarian abscess is a well-recognized complication of acute salpingitis and has been reported in as many as one third of hospital admissions for acute salpingitis. The incidence of tuboovarian abscess is expected to increase as a result of the current epidemic of sexually transmitted diseases and their sequelae. Patients with tuboovarian abscess most commonly present with lower abdominal pain and an adnexal mass(es). Fever and leukocytosis may be absent. Ultrasound, computed tomographic scans, laparoscopy, or laparotomy may be necessary to confirm the diagnosis. Tuboovarian abscess may be unilateral or bilateral regardless of intrauterine contraceptive device usage. Tuboovarian abscess is polymicrobial with a preponderance of anaerobic organisms. An initial conservative antimicrobial approach to the management of the unruptured tuboovarian abscess is appropriate if the antimicrobial agents used can penetrate abscesses, remain active within the abscess environment, and are active against the major pathogens in tuboovarian abscess, including the resistant gram-negative anaerobes such as Bacteroides fragilis and Bacteroides bivius. However, if the patient does not begin to show a response within a reasonable amount of time, about 48 to 72 hours, surgical intervention should be undertaken. Suspicion of rupture should remain an indication for immediate operation. Once operation is undertaken, a conservative approach with unilateral adnexectomy for one-side tuboovarian abscess is appropriate if future fertility or hormone production is desired

  19. Pathogenesis of peptic ulcer disease and current trends in therapy. (United States)

    Desai, J K; Goyal, R K; Parmar, N S


    Traditionally drugs used in peptic ulcer have been directed mainly against a single luminal damaging agent i.e. hydrochloric acid and a plethora of drugs like antacids, anticholinergics, histamine H2-antagonists etc. have flooded the market. An increase in 'aggressive' factors like acid and pepsin is found only in a minority of peptic ulcer patients. These factors do not alter during or after spontaneous healing. It is well-known that the gastric mucosa can resist auto-digestion though it is exposed to numerous 'insults' like high concentration of hydrochloric acid, pepsin, reflux of bile, spicy food, microorganisms and at times alcohol and irritant drugs. It is thus evident that the integrity of the gastric mucosa is maintained by defense mechanisms against these 'aggressive' damaging factors. Recently, attention has been focused more on gastroduodenal defense mechanisms leading to the concept of 'Cytoprotection'. The old dictum "no acid--no ulcer" now extends to "if acid--why ulcer"? as a fundamental question. During last decade more information has poured in about the prevalence and changing pattern of the disease, the influence of environmental factors and speculation on the role of a recently characterized bacterial organism, Helicobacter pylori which colonizes in the gastric mucosa, particularly the antral region. This review briefly describes current knowledge about the pathogenesis of peptic ulcer disease and discusses strategies for its treatment.

  20. Current trends to comprehend lipid metabolism in diatoms. (United States)

    Zulu, Nodumo Nokulunga; Zienkiewicz, Krzysztof; Vollheyde, Katharina; Feussner, Ivo


    Diatoms are the most dominant phytoplankton species in oceans and they continue to receive a great deal of attention because of their significant contributions in ecosystems and the environment. Due to triacylglycerol (TAG) profiles that are abundant in medium-chain fatty acids, diatoms have emerged to be better feed stocks for biofuel production, in comparison to the commonly studied green microalgal species (chlorophytes). Importantly, diatoms are also known for their high levels of the essential ω3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and are considered to be a promising alternative source of these components. The two most commonly exploited diatoms include Thalassiosira pseudonana and Phaeodactylum tricornutum. Although obvious similarities between diatoms and chlorophytes exist, there are some substantial differences in their lipid metabolism. This review provides an overview on lipid metabolism in diatoms, with P. tricornutum as the most explored model. Special emphasis is placed on the synthesis and incorporation of very long chain ω3 fatty acids into lipids. Furthermore, current approaches including genetic engineering and biotechnological methods aimed at improving and maximizing lipid production in P. tricornutum are also discussed. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. Current trends in pedicle screw stimulation techniques: lumbosacral, thoracic, and cervical levels. (United States)

    Isley, Michael R; Zhang, Xiao-Feng; Balzer, Jeffrey R; Leppanen, Ronald E


    Unequivocally, pedicle screw instrumentation has evolved as a primary construct for the treatment of both common and complex spinal disorders. However an inevitable and potentially major complication associated with this type of surgery is misplacement of a pedicle screw(s) which may result in neural and vascular complications, as well as impair the biomechanical stability of the spinal instrumentation resulting in loss of fixation. In light of these potential surgical complications, critical reviews of outcome data for treatment of chronic, low-back pain using pedicle screw instrumentation concluded that "pedicle screw fixation improves radiographically demonstrated fusion rates;" however the expense and complication rates for such constructs are considerable in light of the clinical benefit (Resnick et al. 2005a). Currently, neuromonitoring using free-run and evoked (triggered) electromyography (EMG) is widely used and advocated for safer and more accurate placement of pedicle screws during open instrumentation procedures, and more recently, guiding percutaneous placement (minimally invasive) where the pedicle cannot be easily inspected visually. The latter technique, evoked or triggered EMG when applied to pedicle screw instrumentation surgeries, has been referred to as the pedicle screw stimulation technique. As concluded in the Position Statement by the American Society of Neurophysiological Monitoring (ASNM), multimodality neuromonitoring using free-run EMG and the pedicle screw stimulation technique was considered a practice option and not yet a standard of care (Leppanen 2005). Subsequently, the American Association of Neurological Surgeons/Congress of Neurological Surgeons (AANS/CNS) Joint Section on Disorders of the Spine and Peripheral Nerves published their "Guidelines for the Performance of Fusion Procedures for Degenerative Disease of the Lumbar Spine" (Heary 2005, Resnick et al. 2005a, Resnick et al. 2005b). It was concluded that the "primary

  2. Global Trends and Current Status of Commercial Urban Rooftop Farming

    Directory of Open Access Journals (Sweden)

    Devi Buehler


    Full Text Available The aim of this study was to analyze current practices in commercial urban rooftop farming (URF. In recent years, URF has been experiencing increasing popularity. It is a practice that is well-suited to enhancing food security in cities and reducing the environmental impact that results from long transportation distances that are common in conventional agriculture. To date, most URF initiatives have been motivated by social and educational factors rather than the aim of creating large sustainable food production systems in cities. The commercial operation of urban rooftop farms, should they become profitable, is likely to attract notable private investment, allowing a significant level of high quality urban food production to be achieved. There is a reasonable amount of literature available on urban farming that deals with its potential, and its limitations. However, it does not focus on commercial operations. In contrast to other surveys and theoretical papers, this study of URF focuses on large and commercial operations. The analysis showed that commercial URFs can be grouped into two main types: Firstly, hydroponic systems in greenhouses where mostly leafy greens, tomatoes, and herbs are grown; secondly, soil-based open-air farms that grow a large variety of vegetables. Hydroponics is frequently seen as the key technology for commercial urban food production. While the technology is not in and of itself sustainable, hydroponic farms often make an effort to implement environmentally friendly technologies and methods. However, there is still untapped potential to systemically integrate farms into buildings. The findings of this study identified where future research is needed in order to make URF a widespread sustainable solution.

  3. Systemic Immunotherapy for Urothelial Cancer: Current Trends and Future Directions

    Directory of Open Access Journals (Sweden)

    Shilpa Gupta


    Full Text Available Urothelial cancer of the bladder, renal pelvis, ureter, and other urinary organs is the fifth most common cancer in the United States, and systemic platinum-based chemotherapy remains the standard of care for first-line treatment of advanced/metastatic urothelial carcinoma (UC. Until recently, there were very limited options for patients who are refractory to chemotherapy, or do not tolerate chemotherapy due to toxicities and overall outcomes have remained very poor. While the role of immunotherapy was first established in non-muscle invasive bladder cancer in the 1970s, no systemic immunotherapy was approved for advanced disease until the recent approval of a programmed death ligand-1 (PD-L1 inhibitor, atezolizumab, in patients with advanced/metastatic UC who have progressed on platinum-containing regimens. This represents a significant milestone in this disease after a void of over 30 years. In addition to atezolizumab, a variety of checkpoint inhibitors have shown a significant activity in advanced/metastatic urothelial carcinoma and are expected to gain Food and Drug Administration (FDA approval in the near future. The introduction of novel immunotherapy agents has led to rapid changes in the field of urothelial carcinoma. Numerous checkpoint inhibitors are being tested alone or in combination in the first and subsequent-line therapies of metastatic disease, as well as neoadjuvant and adjuvant settings. They are also being studied in combination with radiation therapy and for non-muscle invasive bladder cancer refractory to BCG. Furthermore, immunotherapy is being utilized for those ineligible for firstline platinum-based chemotherapy. This review outlines the novel immunotherapy agents which have either been approved, or are currently being investigated in clinical trials in UC.

  4. Novel trends in affinity biosensors: current challenges and perspectives

    International Nuclear Information System (INIS)

    Arugula, Mary A; Simonian, Aleksandr


    Molecular biorecognition processes facilitate physical and biochemical interactions between molecules in all crucial metabolic pathways. Perhaps the target analyte and the biorecognition element interactions have the most impactful use in biosensing applications. Traditional analytical sensing systems offer excellent biorecognition elements with the ability to detect and determine the presence of analytes. High affinity antibodies and DNA play an important role in the development of affinity biosensors based on electrochemical, optical and mass sensitive approaches. Advancements in this area routinely employ labels, label free, nanoparticles, multifunctional matrices, carbon nanotubes and other methods to meet the requirements of its own application. However, despite increasing affinity ceilings for conventional biosensors, the field draws back in meeting specifically important demands, such as long-term stability, ultrasensitivity, rapid detection, extreme selectivity, strong biological base, calibration, in vivo measurements, regeneration, satisfactory performance and ease of production. Nevertheless, recent efforts through this line have produced novel high-tech nanosensing systems such as ‘aptamers’ and ‘phages’ which exhibit high-throughput sensing. Aptamers and phages are powerful tools that excel over antibodies in sensibility, stability, multi-detection, in vivo measurements and regeneration. Phages are superior in stability, screening for affinity-based target molecules ranging from small to proteins and even cells, and easy production. In this review, we focus mainly on recent developments in affinity-based biosensors such as immunosensors, DNA sensors, emphasizing aptasensors and phage-based biosensors basing on novel electrochemical, optical and mass sensitive detection techniques. We also address enzyme inhibition-based biosensors and the current problems associated with the above sensors and their future perspectives. (topical review)

  5. Recent advances in addictive disorders. Prevention. Current research and trends. (United States)

    Kumpfer, K L; Hopkins, R


    The AOD prevention programs of the 1990s should be resiliency-focused and include interventions of sufficient dosage and strength. Although some child behavioral technology exists to tackle successfully changes in resiliency, additional prevention strategies need to be developed and studied. In some way, the prevention field is hampered by the lack of sufficient research in the child and adolescent psychiatry and psychology fields, that includes transactional research in parenting and child rearing for high-risk youth. We simply do not know enough to determine how parents and other adults can best foster resilience in children. Questions that arise include how much to protect children from environmental stressors and how much to push them to confront new life stressors in the form of challenges to develop new skills or talents. There are no simple answers to these questions, but a number of useful guidelines could help parents and teachers to increase resilience in youth. Some of the guidelines currently being stressed include developing in youth an increased sense of responsibility for their own success, helping them to identify their talents, motivating them to dedicate their lives to helping society rather than feeling their only purpose in life is to be consumers, providing realistic appraisals and feedback for youth rather than graciously building up their self-esteem, stressing multicultural competence in an ever-shrinking world, encouraging and valuing education and skills training, increasing cooperative solutions to problems rather than competitive or aggressive solutions, and increasing a sense of responsibility for others and caring for others. Clearly, these are important objectives for creating the type of citizens that can make American strong in the twentieth century.

  6. Current Trends in the Transhumant Cattle Sector in Greece

    Directory of Open Access Journals (Sweden)

    Athanasios Ragkos


    Full Text Available Bovine transhumance is characterized by the seasonal movement of livestock between winter and summer pastures. The system is well-known for Mediterranean countries, including Greece, where its role is multifunctional, because of its complex interactions with the environments and local societies. Unlike the dairy farming sector in Greece, whose salient features are the emergence of large-sized farms which are heavily dependent on fixed capital endowments and the provision of feedstuff, the transhumant system is much more flexible, by taking advantage of excessive family labor and by reducing feeding costs through grazing. The total number of transhumant farms in Greece has diminished during the last decades this farming system remains an essential activity in less favored areas of the country; the bovine cattle transhumant system, in particular, provides an efficient alternative to the capital-intensive dairy farming system. The purpose of this study is to provide a presentation of the current condition of the transhumant bovine cattle farming system in Greece. Through a survey of all relevant public services, data concerning the number of transhumant farms and animals as well as their movements in 2011 are presented. The survey reveals that the larger amount of transhumant farms is present in the lowlands of Thessaly and of East Macedonia-Thrace and move towards the mountainous rangelands of less favored areas, particularly those of West Macedonia. The mean transhumant bovine farm size does not exceed 100 animals, as nearly 76.1%, of the total rear less than 100 cattle. Thessaly is the region which accommodates the major part of transhumant farming in Greece; this is also the case for transhumant cattle, as 51.4% of all transhumant farms in the country have their winter domiciles in Thessaly.

  7. Oxytocin and Socioemotional Aging─Current Knowledge and Future Trends

    Directory of Open Access Journals (Sweden)

    Natalie C. Ebner


    Full Text Available The oxytocin (OT system is involved in various aspects of social cognition and prosocial behavior. Specifically, OT has been examined in the context of social memory, emotion recognition, cooperation, trust, empathy, and bonding, and─though evidence is somewhat mixed─intranasal OT appears to benefit aspects of socioemotional functioning. However, most of the extant data on aging and OT is from animal research and human OT research has focused largely on young adults. As such, though we know that various socioemotional capacities change with age, we know little about whether age-related changes in the OT system may underlie age-related differences in socioemotional functioning. In this review, we take a genetic-neuro-behavioral approach and evaluate current evidence on age-related changes in the OT system as well as the putative effects of these alterations on age-related socioemotional functioning. Looking forward, we identify informational gaps and propose an Age-Related Genetic, Neurobiological, Sociobehavioral Model of Oxytocin (AGeNeS-OT model which may structure and inform investigations into aging-related genetic, neural, and sociocognitive processes related to OT. As an exemplar of the use of the model, we report exploratory data suggesting differences in socioemotional processing associated with genetic variation in the oxytocin receptor gene (OXTR in samples of young and older adults. Information gained from this arena has translational potential in depression, social stress, and anxiety─all of which have high relevance in aging─and may contribute to reducing social isolation and improving well-being of individuals across the lifespan.

  8. Computer-assisted Orthopaedic Surgery: Current State and Future Perspective

    Directory of Open Access Journals (Sweden)

    Guoyan eZheng


    Full Text Available Introduced about two decades ago, computer-assisted orthopaedic surgery (CAOS has emerged as a new and independent area, due to the importance of treatment of musculoskeletal diseases in orthopaedics and traumatology, increasing availability of different imaging modalities, and advances in analytics and navigation tools. The aim of this paper is to present the basic elements of CAOS devices and to review state-of-the-art examples of different imaging modalities used to create the virtual representations, of different position tracking devices for navigation systems, of different surgical robots, of different methods for registration and referencing, and of CAOS modules that have been realized for different surgical procedures. Future perspectives will also be outlined.

  9. Labour Markets Trends, Financial Globalization and the current crisis in Developing Countries

    NARCIS (Netherlands)

    R.E. van der Hoeven (Rolph)


    textabstractThe current wave of globalization has profound labour market effects, accentuated, in many cases, by the current financial and economic crisis. This paper reviews general labour market trends and country examples, arguing that the current globalization process makes labour’s position

  10. Current trends in the pharmacotherapy of diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    B Kumar


    Full Text Available Diabetic retinopathy (DR is one of the most debilitating disorders of microvasculature of the retina and one of the leading causes of vision loss among the working class worldwide. At present, intravitreal anti-inflammatory (corticosteroids and anti-angiogenesis (anti-Vascular Endothelial Growth Factor agents are being used as wide options for the pharmacotherapy of DR and diabetic macular edema (DME. Anti-inflammatory agents (Triamcinolone acetonide and other agents have shown evidence-based clinical benefits in various randomized clinical trials for the treatment of DR and DME, and also shown improvement in best corrected visual acuity. However, direct intravitreal injections are associated with serious side-effects like cataract and elevation of Intra Ocular Pressure. Despite this, corticosteroid therapy has been effective for DR and DME, therefore current focus is on the development of novel intravitreal steroid delivery devices that release a small quantity over a prolonged period of time. In addition to corticosteroids, anti-angiogenic agents are found to be effective for the treatment of DR and DME. The most popular target of these agents is the subfamily of proteins known as VEGF, whose over-expression is believed to play a role in numerous diseases including DR and Age-related Macular Degeneration. Intravitreal bevacizumab (Avastin® and Ranibizumab (Lucentis® are gaining popularity as a clinical adjunct to panretinal photocoagulation in patients with proliferative DR. Moreover, Lucentis has been recently approved by the United States Food and Drug Administration for macular edema following retinal vein occlusion. Further, systemic agents (specially, hypoglycemic, hypolipidemic and anti-hypertensive agents have shown beneficial results in reducing the progression of DR. In conclusion, it can be stated that for the present scenario systematic use of available pharmacotherapy as an adjunct to laser photocoagulation, which is gold

  11. Corporate Social responsibility in the petrochemical industry: Exploring current trends in social and environmental disclosure


    Lei, Juan


    Current trends indicate that we are entering a new phase of corporate responsibility reporting that more emphasis is paid on social responsibility, but significant variation still remains in the maturity of reporting content and styles in industries, and even in the same industry. This study explores the current trend of corporate social and environmental reporting in petrochemical industry. It offers a detailed review of the development of corporate social responsibility reporting, and of th...

  12. Trends in oral drug bioavailability following bariatric surgery: examining the variable extent of impact on exposure of different drug classes. (United States)

    Darwich, Adam S; Henderson, Kathryn; Burgin, Angela; Ward, Nicola; Whittam, Janet; Ammori, Basil J; Ashcroft, Darren M; Rostami-Hodjegan, Amin


    Changes to oral drug bioavailability have been observed post bariatric surgery. However, the magnitude and the direction of changes have not been assessed systematically to provide insights into the parameters governing the observed trends. Understanding these can help with dose adjustments. Analysis of drug characteristics based on a biopharmaceutical classification system is not adequate to explain observed trends in altered oral drug bioavailability following bariatric surgery, although the findings suggest solubility to play an important role. To identify the most commonly prescribed drugs in a bariatric surgery population and to assess existing evidence regarding trends in oral drug bioavailability post bariatric surgery. A retrospective audit was undertaken to document commonly prescribed drugs amongst patients undergoing bariatric surgery in an NHS hospital in the UK and to assess practice for drug administration following bariatric surgery. The available literature was examined for trends relating to drug permeability and solubility with regards to the Biopharmaceutics Classification System (BCS) and main route of elimination. No significant difference in the 'post/pre surgery oral drug exposure ratio' (ppR) was apparent between BCS class I to IV drugs, with regards to dose number (Do) or main route of elimination. Drugs classified as 'solubility limited' displayed an overall reduction as compared with 'freely soluble' compounds, as well as an unaltered and increased ppR. Clinical studies establishing guidelines for commonly prescribed drugs, and the monitoring of drugs exhibiting a narrow therapeutic window or without a readily assessed clinical endpoint, are warranted. Using mechanistically based pharmacokinetic modelling for simulating the multivariate nature of changes in drug exposure may serve as a useful tool in the further understanding of postoperative trends in oral drug exposure and in developing practical clinical guidance. © 2012 The Authors

  13. Current status and future options for trauma and emergency surgery in Turkey. (United States)

    Taviloğlu, Korhan; Ertekin, Cemalettin


    The number of trauma victims in Turkey is expected to increase as a consequence of the increasing vehicular traffic, potential for earthquakes, and risk of terrorist attacks. The Turkish Association for Trauma and Emergency Surgery monitors trauma cases, publishes a quarterly journal, organizes trauma courses and seminars for various health personnel nationwide. It is also extending efforts to improve in-hospital care by establishing trauma and emergency surgery fellowships and trauma and emergency surgery centers nationwide, which is run by General Surgeons currently. Turkey faces the same dilemma as the rest of the developed world regarding the future of trauma surgeons in the current era of nonoperative trauma management. We suggest that the field of trauma and emergency surgery be redefined to include emergency general surgery and cavitary trauma.

  14. Current research trends in mountain biodiversity in NW Europe

    Directory of Open Access Journals (Sweden)

    Väisänen, Risto A.


    Full Text Available Focusing on four themes in relation to biodiversity (vegetation science, keystone grazers, long-term studies and protected areas, a synthesis of current research in the mountain areas of Fennoscandia, Iceland and Scotland is presented. Recent relevant advances in vegetation science include classifications of mountain habitats which together with species distribution maps offer new possibilities for analysis. Generalisations emerging from comparisons of the ecology and ecophysiology of plants between different mountain areas are greatly needed. Further studies on the ecological impacts of keystone grazers are urgently required because of the alarming rate of degradation of mountain habitats. The topics highlighted from northern Fennoscandia include (i the effect of overgrazing by reindeer on the cover of foliose lichens and on the regeneration of mountain birch, (ii the ecological interactions between the autumnal moth and mountain birch, and (Hi the effect of rodents on vegetation. Long-term studies of slow processes to capture rare but important events are needed to better understand the functioning of mountain ecosystems. Examples of such studies are presented for (i the moss Racomitrium lanuginosum as an indicator of airborne nitrogen pollution, (ii research based on cyclic oscillations of vole numbers, and (Hi the application of breeding birds in environmental assessment. The conservation of appropriate areas is important for mountain biodiversity. Mountain habitats have been protected extensively in northern Europe. The evaluation of how representative the existing areas are and how to use them for research need international co-ordination.

    [fr] On présente une synthèse de la recherche actuelle dans les régions de montagne de la Scandinavie, l'Islande et l'Ecosse, centrée sur quatre sujets autour de la biodiversité (science de la végétation, herbivores principaux, études à long terme et zones protégées. Les r

  15. Hypertrophic scars and keloids in surgery: current concepts. (United States)

    Song, Colin


    Hypertrophic scars and keloids remain a challenge in surgery. We appreciate that our understanding of the process at cellular and molecular level, profound as it is, when it comes to the clinical evidence much is left to be desired. Although the bench to bedside conundrum remains, the science of translational research calls for an even higher level of cooperation between the scientist and the clinician for the impetus to succeed.The clinicians alerted us to the possible theories in the pathogenesis of keloid formation, inter alia, the ischemia theory, mast cell theory, immune theory, transforming growth factor β interaction, mechanical theory, and the melanocyte stimulating hormone theory. All of the above presupposed a stimulus that would result in an uncontrolled upregulation of collagen and extracellular matrix expression in the pathogenesis of the keloid. This bedside to bench initiative, as in true science, realized more ponderables than possibilities.By the same token, research into the epidermal-mesenchymal signaling, molecular biology, genomics, and stem cell research holds much promise in the bench top arena. To assess efficacy, many scar assessment scores exist in the literature. The clinical measurement of scar maturity can aid in determining end points for therapeutics. Tissue oxygen tension and color assessment of scars by standardized photography proved to be useful.In surgery, the use of dermal substitutes holds some promise as we surmise that quality scars that arise from dermal elements, molecular and enzyme behavior, and balance. Although a systematic review shows some benefit for earlier closure and healing of wounds, no such review exists at this point in time for the use of dermal substitutes in scars.Adipose-derived stem cell, as it pertains to scars, will hopefully realize the potential of skin regeneration rather than by repair in which we are familiar with as well as the undesirable scarring as a result of healing through the inflammatory

  16. Current topics in the radiology of joint replacement surgery

    International Nuclear Information System (INIS)

    Weissman, B.N.


    Several methods of total hip joint replacement are currently used. Radiographic appearances after cemented, bone ingrowth, press-fit, and bipolar hip prostheses are reviewed. The roles of nuclear medicine and arthrographic procedures for identifying complications are discussed. Total knee prostheses and, in particular, complications related to the patellar component are described.115 references

  17. Time trends in prostate cancer surgery: data from an Internet-based multicentre database. (United States)

    Schostak, Martin; Baumunk, Daniel; Jagota, Anita; Klopf, Christian; Winter, Alexander; Schäfers, Sebastian; Kössler, Robert; Brennecke, Volker; Fischer, Tom; Hagel, Susanne; Höchel, Steffen; Jäkel, Dierk; Lehsnau, Mike; Krege, Susanne; Rüffert, Bernd; Pretzer, Jana; Becht, Eduard; Zegenhagen, Thomas; Miller, Kurt; Weikert, Steffen


    To report our experience with an Internet-based multicentre database that enables tumour documentation, as well as the collection of quality-related parameters and follow-up data, in surgically treated patients with prostate cancer. The system was used to assess the quality of prostate cancer surgery and to analyze possible time-dependent trends in the quality of care. An Internet-based database system enabled a standardized collection of treatment data and clinical findings from the participating urological centres for the years 2005-2009. An analysis was performed aiming to evaluate relevant patient characteristics (age, pathological tumour stage, preoperative International Index of Erectile Function-5 score), intra-operative parameters (operating time, percentage of nerve-sparing operations, complication rate, transfusion rate, number of resected lymph nodes) and postoperative parameters (hospitalization time, re-operation rate, catheter indwelling time). Mean values were calculated and compared for each annual cohort from 2005 to 2008. The overall survival rate was also calculated for a subgroup of the Berlin patients. A total of 914, 1120, 1434 and 1750 patients submitted to radical prostatectomy in 2005, 2006, 2007 and 2008 were documented in the database. The mean age at the time of surgery remained constant (66 years) during the study period. More than half the patients already had erectile dysfunction before surgery (median International Index of Erectile Function-5 score of 19-20). During the observation period, there was a decrease in the percentage of pT2 tumours (1% in 2005; 64% in 2008) and a slight increase in the percentage of patients with lymph node metastases (8% in 2005; 10% in 2008). No time trend was found for the operating time (142-155 min) or the percentage of nerve-sparing operations (72-78% in patients without erectile dysfunction). A decreasing frequency was observed for the parameters: blood transfusions (1.9% in 2005; 0.5% in 2008

  18. Trend, Risk Factors, and Costs of Clostridium difficile Infections in Vascular Surgery. (United States)

    Egorova, Natalia N; Siracuse, Jeffrey J; McKinsey, James F; Nowygrod, Roman


    Starting in December 2013, the Hospital Inpatient Quality Reporting Program included Clostridium difficile infection (CDI) rates as a new publically reported quality measure. Our goal was to review the trend, hospital variability in CDI rates, and associated risk factors and costs in vascular surgery. The rates of CDI after major vascular procedures including aortic abdominal aneurysm (AAA) repair, carotid endarterectomy or stenting, lower extremity revascularization (LER), and LE amputation were identified using Nationwide Inpatient Sample database for 2000-2011. Risk factors associated with CDI were analyzed with hierarchical multivariate logistic regression. Extra costs, length of stay (LOS), and mortality were assessed for propensity-matched hospitalizations with and without CDI. During the study period, the rates of CDI after vascular procedures had increased by 74% from 0.6 in 2000 to 1.05% in 2011, whereas the case fatality rate was stable at 9-11%. In 2011, the highest rates were after ruptured aortic abdominal aneurysm (rAAA) repair (3.3%), followed by lower extremity amputations (2.3%) and elective open AAA (1.3%). The rates of CDI increased after all vascular procedures during the 12 years. The highest increase was after endovascular LER (151.8%) and open rAAA repair (135.7%). In 2011, patients who had experienced CDI had median LOS of 15 days (interquartile range, 9-25 days) compared with 8.3 days for matched patients without CDI, in-hospital mortality 9.1% (compared with 5.0%), and $13,471 extra cost per hospitalization. The estimated cost associated with CDI in vascular surgery in the United States was ∼$98 million in 2011. Hospital rates of CDI varied from 0 to 50% with 3.5% of hospitals having infection rates ≥5%. Factors associated with CDI included multiple chronic conditions, female gender, surgery type, emergent and weekend hospitalizations, hospital transfers, and urban locations. Despite potential reduction of infection rates as evidenced

  19. Current state and development trends of inspections of steam generator tubes by eddy currents method

    International Nuclear Information System (INIS)

    Kubis, S.; Herman, M.


    The requirements are presented for steam generator tube testing and the factors are discussed affecting the accuracy of measurement by the eddy currents method. The individual types of the eddy currents method are described, such as the single-frequency method, the multi-frequency method and the pulse eddy currents method. The demands are summed up on manipulator systems whose design is adapted to the steam generator configuration conditions. (E.S.). 5 figs., 16 possu

  20. AMS-11 in Rome, 2008: Past achievements, current and future trends

    International Nuclear Information System (INIS)

    Fink, David


    The volume of scientific work and achievements of the international Accelerator Mass Spectrometry community over the past 30 years is presented by quantifying the annual increases in past AMS conference participation, trends in technical developments and applications, the rate of growth of new AMS facilities, sample throughput, publications and general scientific impact. Also a brief summary with some highlights of the International AMS-11 Rome Conference is presented with some flavour of current trends and future directions in AMS.

  1. Current Status of Nephron-Sparing Surgery (NSS) in the Management of Renal Tumours. (United States)

    Venkatramani, Vivek; Swain, Sanjaya; Satyanarayana, Ramgopal; Parekh, Dipen J


    Nephron-sparing surgery has emerged as the surgical treatment of choice for small renal masses over the past two decades, replacing the traditional teaching of radical nephrectomy for renal cell carcinoma. With time, there has been an evolution in the techniques and indications for partial nephrectomy. This review summarizes the current status of nephron-sparing surgery for renal carcinoma and also deals with the future of this procedure.

  2. Trends in a changing vascular practice environment for members of the Society for Vascular Surgery (United States)

    Matthews, Mika A. B.; Satiani, Bhagwan; Lohr, Joann M.


    Objective To survey the Society for Vascular Surgery (SVS) membership with regard to practice trends related to work effort, employment status, practice ownership, endovascular cases, and anticipated changes in practice in the near future. Methods A survey questionnaire was developed to gather information about member demographics and practice, hours worked, full-time (FT) or part-time status, employment status, practice ownership, competition for referrals, proportion of endovascular vs open procedures, and anticipated changes in practice in the next 3 years. We used SurveyMonkey and distributed the survey to all active vascular surgeon (VS) members of the SVS. Results The response rate was 207 of 2230 (10.7%). Two thirds were in private practice, and 21% were in solo practice. Twenty-four percent were employed by hospitals/health systems. Those VS under the age of 50 years were more likely to exclusively practice vascular surgery compared with VS over the age of 50 years (P = .0003). Sixty-eight of the physicians (32.7%) were between 50 and 59 years old, 186 (90.3%) were men, 192 (92.8%) worked FT (>36 hours of patient care per week), and almost two thirds worked >60 hours per week. Those in physician-owned practices worked >40 hours of patient care per week more often than did FT employed VS (P = .012). Younger VS (age 50% of their workload being endovascular compared with older VS (age ≥50 years; P 40 hours of patient care per week than are FT employed VS. Longitudinal surveys of SVS members are imperative to help tailor educational, training, and practice management offerings, guide governmental activities, advocate for issues important to members, improve branding initiatives, and sponsor workforce analyses. PMID:23254185

  3. Trends in statistical methods in articles published in Archives of Plastic Surgery between 2012 and 2017. (United States)

    Han, Kyunghwa; Jung, Inkyung


    This review article presents an assessment of trends in statistical methods and an evaluation of their appropriateness in articles published in the Archives of Plastic Surgery (APS) from 2012 to 2017. We reviewed 388 original articles published in APS between 2012 and 2017. We categorized the articles that used statistical methods according to the type of statistical method, the number of statistical methods, and the type of statistical software used. We checked whether there were errors in the description of statistical methods and results. A total of 230 articles (59.3%) published in APS between 2012 and 2017 used one or more statistical method. Within these articles, there were 261 applications of statistical methods with continuous or ordinal outcomes, and 139 applications of statistical methods with categorical outcome. The Pearson chi-square test (17.4%) and the Mann-Whitney U test (14.4%) were the most frequently used methods. Errors in describing statistical methods and results were found in 133 of the 230 articles (57.8%). Inadequate description of P-values was the most common error (39.1%). Among the 230 articles that used statistical methods, 71.7% provided details about the statistical software programs used for the analyses. SPSS was predominantly used in the articles that presented statistical analyses. We found that the use of statistical methods in APS has increased over the last 6 years. It seems that researchers have been paying more attention to the proper use of statistics in recent years. It is expected that these positive trends will continue in APS.

  4. Socioeconomic factors and mortality in emergency general surgery: trends over a 20-year period. (United States)

    Armenia, Sarah J; Pentakota, Sri Ram; Merchant, Aziz M


    Socioeconomic factors such as race, insurance, and income quartiles have been identified as independent risk factors in emergency general surgery (EGS), but this impact has not been studied over time. We sought to identify trends in disparities in EGS-related operative mortality over a 20-y period. The National Inpatient Sample was used to identify patient encounters coded for EGS in 1993, 2003, and 2013. Logistic regression models were used to examine the adjusted relationship between race, primary payer status, and median income quartiles and in-hospital mortality after adjusting for patients' age, gender, Elixhauser comorbidity score, and hospital region, size, and location-cum-teaching status. We identified 391,040 patient encounters. In 1993, Black race was associated with higher odds of in-hospital mortality (odds ratio [95% confidence interval]: 1.35 [1.20-1.53]) than White race, although this difference dissipated in subsequent years. Medicare, Medicaid, and underinsured patients had a higher odds of mortality than those with private insurance for the entire 20-y period; only the disparity in the underinsured decreased over time (1993, 1.63 [1.35-1.98]; 2013, 1.41 [1.20-1.67]). In 2003 (1.23 [1.10-1.38]) and 2013 (1.23 [1.11-1.37]), patients from the lowest income quartile were more likely to die after EGS than patients from the highest income quartile. Socioeconomic disparities in EGS-related operative morality followed inconsistent trends. Over time, while gaps in in-hospital mortality among Blacks and Whites have narrowed, disparities among patients belonging to lowest income quartile have worsened. Medicare and Medicaid beneficiaries continued to experience higher odds of in-hospital mortality relative to those with private insurance. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Pneumonia after Major Cancer Surgery: Temporal Trends and Patterns of Care

    Directory of Open Access Journals (Sweden)

    Vincent Q. Trinh


    Full Text Available Rationale. Pneumonia is a leading cause of postoperative complication. Objective. To examine trends, factors, and mortality of postoperative pneumonia following major cancer surgery (MCS. Methods. From 1999 to 2009, patients undergoing major forms of MCS were identified using the Nationwide Inpatient Sample (NIS, a Healthcare Cost and Utilization Project (HCUP subset, resulting in weighted 2,508,916 patients. Measurements. Determinants were examined using logistic regression analysis adjusted for clustering using generalized estimating equations. Results. From 1999 to 2009, 87,867 patients experienced pneumonia following MCS and prevalence increased by 29.7%. The estimated annual percent change (EAPC of mortality after MCS was −2.4% (95% CI: −2.9 to −2.0, P<0.001; the EAPC of mortality associated with pneumonia after MCS was −2.2% (95% CI: −3.6 to 0.9, P=0.01. Characteristics associated with higher odds of pneumonia included older age, male, comorbidities, nonprivate insurance, lower income, hospital volume, urban, Northeast region, and nonteaching status. Pneumonia conferred a 6.3-fold higher odd of mortality. Conclusions. Increasing prevalence of pneumonia after MCS, associated with stable mortality rates, may result from either increased diagnosis or more stringent coding. We identified characteristics associated with pneumonia after MCS which could help identify at-risk patients in order to reduce pneumonia after MCS, as it greatly increases the odds of mortality.

  6. The trend of quality of publications in endodontic surgery: a 10-year systematic survey of the literature. (United States)

    Del Fabbro, Massimo; Corbella, Stefano; Tsesis, Igor; Taschieri, Silvio


    The aims of the present systematic literature analysis were to evaluate, over a 10-year period, the trend of the proportion of RCT, SR, MA published on endodontic surgery, and to investigate if the impact factor (IF) of the main endodontic Journals correlates with the proportion of RCT, SR, MA they publish. An electronic search of the RCT, SR and MA published on the topic "endodontic surgery" from 2001 to 2010 was performed on Medline and Cochrane CENTRAL database using specific search terms combined with Boolean operators. Endodontic Journals impact factor was retrieved by the Thomson Scientific database. The proportion of each study type over the total number of articles on endodontic surgery published per year was estimated. The correlation between the number of high-evidence level studies published on the main endodontic Journals and the IF of such Journals per year was estimated. From a total of 900 articles published in 2001-2010 on endodontic surgery, there were 114 studies of high evidence level. A significant increase of the proportion of either RCT, SR and MA over the years was found. A modest to unclear correlation was found between the Journal IF and the number of high-evidence articles published. There is a positive trend over the years among researchers in performing studies of good quality in endodontic surgery. The impact factor of endodontic Journals is not consistently influenced by publication of high-evidence level articles. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Minimal invasive single-site surgery in colorectal procedures: Current state of the art

    Directory of Open Access Journals (Sweden)

    Diana Michele


    Full Text Available Background: Minimally invasive single-site (MISS surgery has recently been applied to colorectal surgery. We aimed to assess the current state of the art and the adequacy of preliminary oncological results. Methods: We performed a systematic review of the literature using Pubmed, Medline, SCOPUS and Web of Science databases. Keywords used were "Single Port" or "Single-Incision" or "LaparoEndoscopic Single Site" or "SILS™" and "Colon" or "Colorectal" and "Surgery". Results: Twenty-nine articles on colorectal MISS surgery have been published from July 2008 to July 2010, presenting data on 149 patients. One study reported analgesic requirement. The final incision length ranged from 2.5 to 8 cm. Only two studies reported fascial incision length. There were two port site hernias in a series of 13 patients (15.38%. Two "fully laparoscopic" MISS procedures with preparation and achievement of the anastomosis completely intracorporeally are reported. Future site of ileostomy was used as the sole access for the procedures in three studies. Lymph node harvesting, resection margins and length of specimen were sufficient in oncological cases. Conclusions: MISS colorectal surgery is a challenging procedure that seems to be safe and feasible, but the existing clinical evidence is limited. In selected cases, and especially when an ileostomy is planned, colorectal surgery may be an ideal indication for MISS surgery leading to a no-scar surgery. Despite preliminary oncological results showing the feasibility of MISS surgery, we want to stress the need to standardize the technique and carefully evaluate its application in oncosurgery under ethical committee control.

  8. The current waste generation and management trends in South Africa: A Review

    CSIR Research Space (South Africa)

    Nkosi, N


    Full Text Available This paper, a continuation and expansion of the work of Muzenda et al, 2012 [1] looks at the current waste generation and management trends in South Africa. The waste tyre problem in South Africa is also briefly discussed. Solid waste management...

  9. Perspectives on...Special Collections at ARL Libraries and K-12 Outreach: Current Trends (United States)

    Visser, Michelle


    This article examines the results of a survey sent to Association of Research Libraries (ARL) Special Collections requesting information on outreach to K-12 students. Over half of the respondents work with K-12 and many of those who currently do not are planning to. New pressures and changing philosophies contribute to this trend.

  10. Current research topics and trends in the software architecture community : ICSA 2017 Workshops summary

    NARCIS (Netherlands)

    Malavolta, Ivano; Capilla, Rafael


    This summary reports the workshops accepted in the 1st International Conference on Software Architecture (ICSA 2017), held by Chalmers University at Gothenburg (Sweden). We gather the description of current and new research trends in different software architecture topics to provide a wide view to

  11. Current Trends in Communication Graduate Degrees: Survey of Communications, Advertising, PR, and IMC Graduate Programs (United States)

    Quesenberry, Keith A.; Coolsen, Michael K.; Wilkerson, Kristen


    A survey of 61 master's degree advertising programs reveals significant trends in program titles, curriculum design, course delivery, and students served. The results provide insight for current and planned master's degree programs as research predicts a continued increase in demand for master's education over the next decade. Survey results are…

  12. Disability in the Classroom: Current Trends and Impacts on Music Education (United States)

    Abramo, Joseph


    This article covers current trends in disability rights and raises questions about how society's views of disability influence the music education of students in need of special education services. Brief overviews of the disability-rights movement in the United States and of federal laws pertaining to disabilities and education are included. Next,…

  13. Current research trends and perspectives on materials-based hydrogen storage solutions: A critical review

    CSIR Research Space (South Africa)

    Ren, Jianwei


    Full Text Available BrunauereEmmetteTeller (BET) surface areas and larger pore volumes . . . . 00 Tailoring reaction enthalpies... consumption. Re-produced ] with permission. this article in press as: Ren J, et al., Current research trends view, International Journal of Hydrogen Energy (2016), htcountries to think about energy security. Fossil fuels will one day be inevitably used up...

  14. Survey Exploring Views of Scientists on Current Trends in Chemistry Education (United States)

    Vamvakeros, Xenofon; Pavlatou, Evangelia A.; Spyrellis, Nicolas


    A survey exploring the views of scientists, chemists and chemical engineers, on current trends in Chemistry Education was conducted in Greece. Their opinions were investigated using a questionnaire focusing on curricula (the content and process of chemistry teaching and learning), as well as on the respondents' general educational beliefs and…

  15. Robotic surgery for rectal cancer: A systematic review of current practice (United States)

    Mak, Tony Wing Chung; Lee, Janet Fung Yee; Futaba, Kaori; Hon, Sophie Sok Fei; Ngo, Dennis Kwok Yu; Ng, Simon Siu Man


    AIM: To give a comprehensive review of current literature on robotic rectal cancer surgery. METHODS: A systematic review of current literature via PubMed and Embase search engines was performed to identify relevant articles from january 2007 to november 2013. The keywords used were: “robotic surgery”, “surgical robotics”, “laparoscopic computer-assisted surgery”, “colectomy” and “rectal resection”. RESULTS: After the initial screen of 380 articles, 20 papers were selected for review. A total of 1062 patients (male 64.0%) with a mean age of 61.1 years and body mass index of 24.9 kg/m2 were included in the review. Out of 1062 robotic-assisted operations, 831 (78.2%) anterior and low anterior resections, 132 (12.4%) intersphincteric resection with coloanal anastomosis, 98 (9.3%) abdominoperineal resections and 1 (0.1%) Hartmann’s operation were included in the review. Robotic rectal surgery was associated with longer operative time but with comparable oncological results and anastomotic leak rate when compared with laparoscopic rectal surgery. CONCLUSION: Robotic colorectal surgery has continued to evolve to its current state with promising results; feasible surgical option with low conversion rate and comparable short-term oncological results. The challenges faced with robotic surgery are for more high quality studies to justify its cost. PMID:24936229

  16. The Austrian breast implant register: recent trends in implant-based breast surgery. (United States)

    Wurzer, Paul; Rappl, Thomas; Friedl, Herwig; Kamolz, Lars-Peter; Spendel, Stephan; Hoflehner, Helmut; Parvizi, Daryousch


    Due to the fact that the number of breast implant surgeries for cosmetic and medical purposes is rising yearly, a discussion about the quality of service for both patients and physicians is more important than ever. To this end, we reviewed the Austrian Breast Implant Register with one specific question in mind: What are the trends? In the statistical analysis of the Austrian Breast Implant Register, we were able to identify 13,112 registered breast implants between 2004 and 2012. The whole dataset was then divided into medical and cosmetic groups. We focused on device size, surface characteristics, filling material, device placement and incision site. All factors were considered for all examined years. In summary, the most used device had a textured surface (97 %) and silicone gel as the filling material (93 %). The mean size of implants for the cosmetic group was 240 cc, placement was submuscular (58 %) and the incision site was inframammary (67 %). In the medical group, the mean size was 250 cc. Yearly registrations had their peak in 2008 (1,898 registered devices); from this year on, registrations decreased annually. A slight trend away from subglandular placement in the cosmetic group was noted. Also, the usage of implants with polyurethane surface characteristics has increased since 2008. The smooth surface implants had a peak usage in 2006 and their usage decreased steadily from then on whereas the textured surface was steady over the years. Keeping the problems related to the quality of breast implants in mind, we could recommend an obligatory national register. Organisations of surgeons and governments should develop and establish these registers. Furthermore, an all-encompassing international register should be established by the European Union and the American FDA (Food and Drug Administration); this might be useful in comparing the individual country registers and also would help in delivering "evidence based" medicine in cosmetic and medical procedures

  17. Bariatric surgery and nonalcoholic fatty liver disease: current and potential future treatments

    Directory of Open Access Journals (Sweden)

    Akira eSasaki


    Full Text Available Nonalcoholic fatty liver disease (NAFLD and nonalcoholic steatohepatitis (NASH are increasingly common cause of chronic liver disease worldwide. The diagnosis of NASH is challenging as most affected patients are symptom-free and the role of routine screening is not clearly established. Most patients with severe obesity who undergo bariatric surgery have NAFLD, which is associated insulin resistance, type 2 diabetes mellitus (T2DM, hypertension, and obesity-related dyslipidemia. The effective treatment for NAFLD is weight reduction through lifestyle modifications, antiobesity medication, or bariatric surgery. Among these treatments, bariatric surgery is the most reliable method for achieving substantial, sustained weight loss. This procedure is safe when performed by a skilled surgeon, and the benefits include reduced weight, improved quality of life, decreased obesity-related comorbidities, and increased life expectancy. Further research is urgently needed to determine the best use of bariatric surgery with NAFLD patients at high risk of developing liver cirrhosis and its role in modulating complications of NAFLD, such as T2DM and cardiovascular disease. The current evidence suggests that bariatric surgery for patients with severe obesity decreases the grade of steatosis, hepatic inflammation, and fibrosis. However, further long-term studies are required to confirm the true effects before recommending bariatric surgery as a potential treatment for nonalcoholic steatohepatitis.

  18. Current trends in the global tourism industry: evidence from the United States

    Directory of Open Access Journals (Sweden)

    Nejdet Delener


    Full Text Available Tourism is one of the largest U.S. industries, serving millions of international and domestic tourists yearly. Tourists visit the U.S. to see natural wonders, cities, historic landmarks, and entertainment venues. Americans seek similar attractions as well as recreation and vacation areas. Tourism competes in the global market, so it is important to understand current trends in the U.S. travel industry. Therefore, this article offers insight into important trends and suggests strategies for policy makers involved in the travel and tourism industry.

  19. Current practice of antiplatelet and anticoagulation management in post-cardiac surgery patients: a national audit. (United States)

    Hosmane, Sharath; Birla, Rashmi; Marchbank, Adrian


    The Audit and Guidelines Committee of the European Association for Cardio-Thoracic Surgery recently published a guideline on antiplatelet and anticoagulation management in cardiac surgery. We aimed to assess the awareness of the current guideline and adherence to it in the National Health Service through this National Audit. We designed a questionnaire consisting of nine questions covering various aspects of antiplatelet and anticoagulation management in post-cardiac surgery patients. A telephonic survey of the on-call cardiothoracic registrars in all the cardiothoracic centres across the UK was performed. All 37 National Health Service hospitals in the UK with 242 consultants providing adult cardiac surgical service were contacted. Twenty (54%) hospitals had a unit protocol for antiplatelet and anticoagulation management in post-cardiac surgery. Only 23 (62.2%) registrars were aware of current European Association for Cardio-Thoracic Surgery guidelines. Antiplatelet therapy is variable in the cardiac surgical units across the country. Low-dose aspirin is commonly used despite the recommendation of 150-300 mg. The loading dose of aspirin within 24 h as recommended by the guideline is followed only by 60.7% of surgeons. There was not much deviation from the guideline with respect to the anticoagulation therapy.

  20. Trends in Weight Regain Following Roux-en-Y Gastric Bypass (RYGB) Bariatric Surgery. (United States)

    Cooper, Timothy C; Simmons, Elizabeth B; Webb, Kirsten; Burns, James L; Kushner, Robert F


    The primary purpose of this study was to assess weight loss and occurrence of weight regain among patients who underwent Roux-en-Y gastric bypass (RYGB) using categorical analysis. Study participants were selected from patients who underwent RYGB from a single institution. Participants (n = 300, mean procedure age = 45.6 ± 9.9) completed surveys for self-reported preoperative weight, current weight, and subsequent weights over postoperative years. Measured weights and confirmed procedure dates were acquired from patient medical records. Mean preoperative weight and BMI were 140.8 kg ± 32.1 and 49.7 ± 9.9, respectively, and mean years since surgery was 6.9 ± 4.9. Study subjects were mostly Caucasian (56.7 %) and female (80.3 %). Participants were stratified a priori into four cohorts based on percent of weight loss at 1 year, 35 % (n = 113). General linear model analyses were conducted to assess the effect of year one weight loss on percent weight regain. The mean weight regain for all patients was 23.4 % of maximum weight loss. Using categorical analysis, mean weight regain in the 35 % weight loss cohorts was 29.1, 21.9, 20.9, and 23.8 %, respectively. Excessive weight regain, defined as ≥25 % of total lost weight, occurred in 37 % of patients. Weight gain is a common complication following RYGB surgery. Despite the percentage of weight loss over the first year, all cohort patient groups regained on average between 21 and 29 % of lost weight. Excessive weight gain was experienced by over one third of patients. Greater initial absolute weight loss leads to more successful long-term weight outcomes.

  1. Trends in refractive surgery at an academic center: 2007-2009


    Kuo, Irene C


    Abstract Background The United States officially entered a recession in December 2007, and it officially exited the recession in December 2009, according to the National Bureau of Economic Research. Since the economy may affect not only the volume of excimer laser refractive surgery, but also the clinical characteristics of patients undergoing surgery, our goal was to compare the characteristics of patients completing excimer laser refractive surgery and the types of procedures performed in t...

  2. Current approaches to journal club by general surgery programs within the Southwestern surgical congress. (United States)

    Shifflette, Vanessa; Mitchell, Chris; Mangram, Alicia; Dunn, Ernest


    Journal club (JC) is a well-recognized education tool for many postgraduate medical education programs. Journal club helps residents learn critical analytic skills and keep up to date with current medical practices. To our knowledge, there is minimal evidence in the current literature detailing modern JC practices of general surgery training programs. Our study attempts to define how general surgery residency programs are implementing JC in their training process. We distributed by mail a 14-question survey to general surgery program directors within the Southwestern Surgical Congress. These surveys were redistributed 1 month after the initial attempt. The responses were collected and analyzed. Survey questions aimed to define JC practice characteristics, such as where JC is held, when JC is held, who directs JC, what journals are used, the perceived importance of JC, and average attendance. The surveys were sent to 32 program directors (PDs), which included 26 university and 6 community-based programs. We received responses from 26 (81%) PDs. Ninety-two percent of the programs have a consistent journal club (JC). Most JCs meet monthly (64%) or weekly (16%). The meeting places ranged from conference rooms (60%), faculty homes (20%), restaurants (8%), or in the hospital (12%). The meeting times were divided between morning (29%), midday (29%), and evening (42%). Most JCs lasted between 1 and 2 hours (88%), reviewed 1-4 articles (88%), and are attended by more than 60% of residents routinely (75%). Half of the programs (50%) had 3-4 faculty members present during discussion; 29% of the programs had only 1-2 faculty present. The articles were selected from more than 10 different journals. Seventy-five percent of the programs used the American Journal of Surgery and Annals of Surgery to find articles; only 13% of the programs used evidence-based reviews in surgery. PDs believe JC is very beneficial (42%), moderately beneficial (42%), or only fairly beneficial (16

  3. Robotic surgery for rectal cancer: current immediate clinical and oncological outcomes. (United States)

    Araujo, Sergio Eduardo Alonso; Seid, Victor Edmond; Klajner, Sidney


    Laparoscopic rectal surgery continues to be a challenging operation associated to a steep learning curve. Robotic surgical systems have dramatically changed minimally invasive surgery. Three-dimensional, magnified and stable view, articulated instruments, and reduction of physiologic tremors leading to superior dexterity and ergonomics. Therefore, robotic platforms could potentially address limitations of laparoscopic rectal surgery. It was aimed at reviewing current literature on short-term clinical and oncological (pathological) outcomes after robotic rectal cancer surgery in comparison with laparoscopic surgery. A systematic review was performed for the period 2002 to 2014. A total of 1776 patients with rectal cancer underwent minimally invasive robotic treatment in 32 studies. After robotic and laparoscopic approach to oncologic rectal surgery, respectively, mean operating time varied from 192-385 min, and from 158-297 min; mean estimated blood loss was between 33 and 283 mL, and between 127 and 300 mL; mean length of stay varied from 4-10 d; and from 6-15 d. Conversion after robotic rectal surgery varied from 0% to 9.4%, and from 0 to 22% after laparoscopy. There was no difference between robotic (0%-41.3%) and laparoscopic (5.5%-29.3%) surgery regarding morbidity and anastomotic complications (respectively, 0%-13.5%, and 0%-11.1%). Regarding immediate oncologic outcomes, respectively among robotic and laparoscopic cases, positive circumferential margins varied from 0% to 7.5%, and from 0% to 8.8%; the mean number of retrieved lymph nodes was between 10 and 20, and between 11 and 21; and the mean distal resection margin was from 0.8 to 4.7 cm, and from 1.9 to 4.5 cm. Robotic rectal cancer surgery is being undertaken by experienced surgeons. However, the quality of the assembled evidence does not support definite conclusions about most studies variables. Robotic rectal cancer surgery is associated to increased costs and operating time. It also seems to be

  4. [Materials/Biomaterials in Clinical Practice - a Short Review and Current Trends]. (United States)

    Bolle, T; Meyer, F; Walcher, F; Lohmann, C; Jockenhövel, S; Gries, T; Hoffmann, W


    Biomaterials play a major role in interventional medicine and surgery. However, the development of biomaterials is still in its early phases in spite of the huge progress made within the last decades. On the one hand, this is because our knowledge of the molecular and cellular processes associated with biomaterials is still increasing exponentially. On the other hand, a wide variety of advanced materials with highly interesting properties is being developed currently. This review provides a short introduction into the variety of materials in use as well as their application in interventional medicine and surgery. Also the importance of biomaterials for tissue engineering in the field of regenerative medicine and the functionalisation of biomaterials, including sterilisation methods are discussed. For the future, an even broader interdisciplinary scientific collaboration is necessary in order to develop novel biomaterials and facilitate their translation into clinical practice. Georg Thieme Verlag KG Stuttgart · New York.

  5. The Effect of Current Trends in Mobile Marketing on Traditional Marketing Communications and Customer Relationship Management


    Hoffmann, Kristina


    As consumers increasingly prefer mobile devices as their main communication and entertainment channel, it becomes more and more important for marketers as well. Mobile marketing today does not only include sending SMS and E-mail but rather is becoming a whole new interactive, rich-media marketing channel with possibilities for direct engagement with ads and brands like never before. This research attempts to provide a greater understanding about the effects of current trends in mobile mark...

  6. Audiovisual quality assessment in communications applications: Current status, trends and challenges

    DEFF Research Database (Denmark)

    Korhonen, Jari


    Audiovisual quality assessment is one of the major challenges in multimedia communications. Traditionally, algorithm-based (objective) assessment methods have focused primarily on the compression artifacts. However, compression is only one of the numerous factors influencing the perception...... addressed in practical quality metrics is the co-impact of audio and video qualities. This paper provides an overview of the current trends and challenges in objective audiovisual quality assessment, with emphasis on communication applications...

  7. Information Technology in New Zealand: Review of Emerging Social Trends, Current Issues, and Policies


    Erturk, Emre; Fail, Derwyn


    This paper discusses the general state of information technology in New Zealand society, current issues, and policies. It is a qualitative study that reviews recent scholarly articles, periodicals, and surveys in order to create an understanding of some of the information technology issues and trends in New Zealand. After reviewing previous research, it assesses the potential existence and nature of a 'digital divide' in New Zealand society whilst also evaluating possible strategic responses ...

  8. Systematic review of 3D printing in spinal surgery: the current state of play. (United States)

    Wilcox, Ben; Mobbs, Ralph J; Wu, Ai-Min; Phan, Kevin


    Three-dimensional printing (3DP), also known as "Additive Manufacturing", is a rapidly growing industry, particularly in the area of spinal surgery. Given the complex anatomy of the spine and delicate nature of surrounding structures, 3DP has the potential to aid surgical planning and procedural accuracy. We perform a systematic review of current literature on the applications of 3DP in spinal surgery. Six electronic databases were searched for original published studies reporting cases or outcomes for 3DP surgical models, guides or implants for spinal surgery. The findings of these studies were synthesized and summarized. These searches returned a combined 2,411 articles. Of these, 54 were included in this review. 3DP is currently used for surgical planning, intra-operative surgical guides, customised prostheses as well as "Off-the-Shelf" implants. The technology has the potential for enhanced implant properties, as well as decreased surgical time and better patient outcomes. The majority of the data thus far is from low-quality studies with inherent biases linked with the excitement of a new field. As the body of literature continues to expand, larger scale studies to evaluate advantages and disadvantages, and longer-term follow up will enhance our knowledge of the effect 3DP has in spinal surgery. In addition, issues such as financial impact, time to design and print, materials selection and bio-printing will evolve as this rapidly expanding field matures.

  9. The trend of the research and development for the upgrade of the high current energy system

    International Nuclear Information System (INIS)


    The high current energy technology ranges from a basic technology of the electric power field to a state-of-the-art technology and has been used extremely variously. In addition, as the energy technology advances, the expansion of applied field, such as the nuclear fusion and the exhaust thing processing, etc., requires a further upgrade of the large current technology. In this report, the trend of the research and development for the upgrade of the high current energy technology are summarized. In the following, the elemental technology including arc/plasma phenomena and the pulse power system is described in Chapter 2. In Chapter 3, the trend of the research and development for the upgrade of various equipments and devices such as the nuclear fusion development, the superconducting applications of SMES and the maglev transportation system, and the arc application of the exhaust processing for a medical waste, the radio active waste and a detrimental gas and the next generation lithography system. In Chapter 4, the analysis and the measurement technology of the arc phenomenon and the standardization of current shunt, etc are described. We hope this research report can contribute to the promotion of technical exchanges in different fields, and offer guidelines for future development in this high current energy technology. (author)

  10. The current state and trends of the development of universities in Ukraine

    Directory of Open Access Journals (Sweden)

    O.B. Morhulets


    Full Text Available Education is the basis of social, political, economic, spiritual, and cultural development. Therefore, the study of the current state and trends of the development of Ukrainian universities is a significant factor of social and economic progress of the country.The paper reflects the general state of universities in Ukraine, in particular, the trends in dynamics: the number of students in terms of entry/graduation, sources of financing, education fields; the number of universities in the context of accreditation, types and forms of ownership; the number of outbound Ukrainian and inbound foreign students; quantitative and qualitative characteristics of teaching staff; spending on higher education and the cost of funding per student compared with other countries. The purpose of the study is the assessment of economic activity of higher educational establishments in Ukraine, the identification of problems and tendencies of their development in the context of national transformational processes in education and formation of the society of knowledge. The methodical base used in the study is analysis and synthesis, methods of comparison and generalization, extrapolation, index and graphical methods. The practical value of the study is based on the results of a thorough analysis of university activities. Such results reveal the current state and trends of the development of universities under conditions of higher education transformation in Ukraine and its integration into the European educational area. The results of research improve understanding of the state and problems of the universities and provide the foundations for further research in the field of the national education system development and for improving of the quality of young professionals’ training. The trends of the university development indicate that the reorganization of higher education which is being currently taken place, already results in the emergence of new competencies of

  11. A Review of Current Clinical Applications of Three-Dimensional Printing in Spine Surgery. (United States)

    Cho, Woojin; Job, Alan Varkey; Chen, Jing; Baek, Jung Hwan


    Three-dimensional (3D) printing is a transformative technology with a potentially wide range of applications in the field of orthopaedic spine surgery. This article aims to review the current applications, limitations, and future developments of 3D printing technology in orthopaedic spine surgery. Current preoperative applications of 3D printing include construction of complex 3D anatomic models for improved visual understanding, preoperative surgical planning, and surgical simulations for resident education. Intraoperatively, 3D printers have been successfully used in surgical guidance systems and in the creation of patient specific implantable devices. Furthermore, 3D printing is revolutionizing the field of regenerative medicine and tissue engineering, allowing construction of biocompatible scaffolds suitable for cell growth and vasculature. Advances in printing technology and evidence of positive clinical outcomes are needed before there is an expansion of 3D printing applied to the clinical setting.

  12. Using a clinical protocol for orthognathic surgery and assessing a 3-dimensional virtual approach: current therapy. (United States)

    Quevedo, Luis A; Ruiz, Jessica V; Quevedo, Cristobal A


    Oral and maxillofacial surgeons who perform orthognathic surgery face major changes in their practices, and these challenges will increase in the near future, because the extraordinary advances in technology applied to our profession are not only amazing but are becoming the standard of care as they promote improved outcomes for our patients. Orthognathic surgery is one of the favorite areas of practicing within the scope of practice of an oral and maxillofacial surgeon. Our own practice in orthognathic surgery has completed over 1,000 surgeries of this type. Success is directly related to the consistency and capability of the surgical-orthodontic team to achieve predictable, stable results, and our hypothesis is that a successful result is directly related to the way we take our records and perform diagnosis and treatment planning following basic general principles. Now that we have the opportunity to plan and treat 3-dimensional (3D) problems with 3D technology, we should enter into this new era with appropriate standards to ensure better results, instead of simply enjoying these new tools, which will clearly show not only us but everyone what we do when we perform orthognathic surgery. Appropriate principles need to be taken into account when implementing this new technology. In other words, new technology is welcome, but we do not have to reinvent the wheel. The purpose of this article is to review the current protocol that we use for orthognathic surgery and compare it with published protocols that incorporate new 3D and virtual technology. This report also describes our approach to this new technology. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  13. Current approach to diagnosis and treatment of delirium after cardiac surgery (United States)

    Evans, Adam S.; Weiner, Menachem M.; Arora, Rakesh C.; Chung, Insung; Deshpande, Ranjit; Varghese, Robin; Augoustides, John; Ramakrishna, Harish


    Delirium after cardiac surgery remains a common occurrence that results in significant short- and long-term morbidity and mortality. It continues to be underdiagnosed given its complex presentation and multifactorial etiology; however, its prevalence is increasing given the aging cardiac surgical population. This review highlights the perioperative risk factors, tools to assist in diagnosing delirium, and current pharmacological and nonpharmacological therapy options. PMID:27052077

  14. Tool Sequence Trends in Minimally Invasive Surgery: Statistical Analysis and Implications for Predictive Control of Multifunction Instruments

    Directory of Open Access Journals (Sweden)

    Carl A. Nelson


    Full Text Available This paper presents an analysis of 67 minimally invasive surgical procedures covering 11 different procedure types to determine patterns of tool use. A new graph-theoretic approach was taken to organize and analyze the data. Through grouping surgeries by type, trends of common tool changes were identified. Using the concept of signal/noise ratio, these trends were found to be statistically strong. The tool-use trends were used to generate tool placement patterns for modular (multi-tool, cartridge-type surgical tool systems, and the same 67 surgeries were numerically simulated to determine the optimality of these tool arrangements. The results indicate that aggregated tool-use data (by procedure type can be employed to predict tool-use sequences with good accuracy, and also indicate the potential for artificial intelligence as a means of preoperative and/or intraoperative planning. Furthermore, this suggests that the use of multifunction surgical tools can be optimized to streamline surgical workflow.


    Directory of Open Access Journals (Sweden)

    Angel Doraliyski


    Full Text Available One of the key components of the management system is the organizational structure of management. This report presents the current trends of development and improvement of organizational structures of management. The semantics of the term "organizational structure" used in the report is clarified. Key aspects of structural policy of organizations are discussed, as well as the introduction of flexible organizational forms. The main directions for analysis of organizational policy of organizations are also mentioned. It is stressed that the analysis of current trends for the future development of organizational structures of management should be an integral component of the management policy of every organization. The trends are flexibility and adaptability of the organizational structure, rational proportion between centralization and decentralization, an appropriate balance between the rights, duties and responsibilities, reducing regulations, rules and other normative documents. A recommendetaion is made that organizational governance structures must be adapted constantly in accordance with changes in the overall management system, as they are one of its main components.

  16. Health Information System Role-Based Access Control Current Security Trends and Challenges. (United States)

    de Carvalho Junior, Marcelo Antonio; Bandiera-Paiva, Paulo


    This article objective is to highlight implementation characteristics, concerns, or limitations over role-based access control (RBAC) use on health information system (HIS) using industry-focused literature review of current publishing for that purpose. Based on the findings, assessment for indication of RBAC is obsolete considering HIS authorization control needs. We have selected articles related to our investigation theme "RBAC trends and limitations" in 4 different sources related to health informatics or to the engineering technical field. To do so, we have applied the following search query string: "Role-Based Access Control" OR "RBAC" AND "Health information System" OR "EHR" AND "Trends" OR "Challenges" OR "Security" OR "Authorization" OR "Attacks" OR "Permission Assignment" OR "Permission Relation" OR "Permission Mapping" OR "Constraint". We followed PRISMA applicable flow and general methodology used on software engineering for systematic review. 20 articles were selected after applying inclusion and exclusion criteria resulting contributions from 10 different countries. 17 articles advocate RBAC adaptations. The main security trends and limitations mapped were related to emergency access, grant delegation, and interdomain access control. Several publishing proposed RBAC adaptations and enhancements in order to cope current HIS use characteristics. Most of the existent RBAC studies are not related to health informatics industry though. There is no clear indication of RBAC obsolescence for HIS use.

  17. In vivo microrobots for natural orifice transluminal surgery. Current status and future perspectives. (United States)

    Forgione, A


    The possibility to operate inside the peritoneal cavity through small holes performed in hollow organs that is presented by Natural Orifice Transluminal Endoscopic Surgery (NOTES) represents a major paradigm shift in general surgery. While this new approach seems very appealing from patients' perspectives because it eliminates completely abdominal wall aggression and promises to reduce postoperative pain, it is very challenging for surgeons because of the major constraints imposed by both the mode of access and the limited technology currently available. For this reason NOTES applications at the present time are performed by only a few surgeons and mainly to perform non-complex procedures. While new devices are under development, many of them are trying mainly to simply improve current endoscopic platforms and seem not to offer breakthrough solutions. The numerous challenges introduced by natural orifice approaches require a radical shift in the conception of new technologies in order to make this emerging operative access safe and reproducible. The convergence of several enabling technologies in the field of miniaturization, communication and micro-mechatronics brings the possibility to realize on a large scale the revolutionary concept of miniature in vivo co-operative robots. These robots provide vision and task assistance without the constraints of the entry incision and have been shown in experimental settings to possess many qualities that could be ideal to partner with Natural Orifice Surgery. This article explores the current status of microrobotics as well as presents potential future scenarios of their applications in NOTES.

  18. Deep-vein thrombosis prophylaxis in foot and ankle surgery: what is the current state of practice? (United States)

    Shah, Kalpesh; Thevendran, Gowreeson; Younger, Alastair; Pinney, Stephen J


    When contemplating thromboprophylaxis for patients undergoing elective foot and ankle surgery the potential for complications secondary to venous thromboembolism (VTE) must be balanced against the cost, risk, and effectiveness of prophylactic treatment. The incidence of pulmonary embolism (PE) following foot and ankle surgery is considerably lower than after hip or knee surgery. The purpose of this study was to assess current trends in practice regarding VTE prophylaxis among expert orthopaedic foot and ankle surgeons. An e-mail-based survey of active AOFAS (American Orthopaedic Foot and Ankle Society) committee members was conducted (n = 100). Surgeons were questioned as to their use, type, and duration of thromboprophylaxis following elective ankle fusion surgery. Scenarios included the following: (1) A 50-year-old woman with no risk factors; (2) a 50-year-old woman with a history of PE; and (3) a 35-year-old woman actively using birth control pills (BCPs). The response rate for the survey was 80% (80/100). Replies regarding the use of thromboprophylaxis were as follows: (1) in the absence of risk factors, 57% of respondents (45/80) answered, "No prophylaxis required"; (2) for the scenario in which the patient had experienced a previous PE, 97.5% of respondents (78/80) answered, "Yes" to prophylaxis use; (3) for the scenario in which the patient was on BCP, 61.3% of respondents (49/80) stated that they would give some type of thromboprophylaxis. The most commonly recommended methods of prophylaxis were aspirin, 49% (24/49), and low-molecular-weight heparin, 47% (23/49). The recommended length of time for thromboprophylaxis varied widely, from 1 day to more than 6 weeks. . There remains wide variation in the practice of deep-vein thrombosis thromboprophylaxis within the foot and ankle community. Because risks for foot and ankle patients differ from those in the well-studied areas of hip and knee, specific guidelines are needed for foot and ankle surgery. Level V

  19. Current trends in medical English education and the Japan College of Rheumatology International School. (United States)

    Jego, Eric Hajime; Amengual, Olga


    In light of the present revolution happening in medical education in Japan as medical schools implement new curricula to conform to global standards, there is a growing demand for more internationalization and higher quality practical medical English education. In response, many institutions including governmental organizations, universities and academic associations are moving ahead with new initiatives to adapt to these changing demands. This paper reviews the current trends and innovations in medical English education in Japan. This paper also describes one initiative by the Japan College of Rheumatology (JCR) known as the JCR International School held yearly in Karuizawa. By examining recent trends and innovations in medical English education in Japan, the most relevant and applicable can be elucidated to illuminate a path forward for improved medical English education within the JCR.

  20. Internet marketing of bariatric surgery: contemporary trends in the medicalization of obesity. (United States)

    Salant, Talya; Santry, Heena P


    In the context of political, economic, and scientific anxiety around the 'epidemic' rise in obesity in the US, the social and historical forces engendering the medicalization of obesity have been widely discussed. However, the recent growth of bariatric-weight loss-surgery and the expanding presence of advertising for bariatric surgery on the Internet suggest the possible emergence of new loci and languages of medicalization. We sought to identify the nature and extent to which web advertising of bariatric surgery contributes to the medicalization of obesity by examining the design and textual content of 100 bariatric surgery center websites. We found that websites, through strategic use of text and images, consistently describe obesity as a serious disease that requires professional ascertainment and supervision, entails substantial individual suffering, and is remedied through the transformative yet low risk effects of bariatric surgery. In the process, social normalcy and risk reduction come to replace physical criteria as the basis for determining health. Further, websites draw upon contradictory discourses of medicalization; that is, they insist upon 'external' (e.g. genetics, environment) causes of obesity to legitimize surgical intervention while implicating individual behaviors in surgical failure. From this, we suggest that the economic and professional motivations underlying website advertisements for bariatric surgery may result in confusing messages being sent to prospective patients as well as the perpetuation of gendered notions of obesity and the entrenchment of health disparities.

  1. Image-guided surgery and therapy: current status and future directions (United States)

    Peters, Terence M.


    Image-guided surgery and therapy is assuming an increasingly important role, particularly considering the current emphasis on minimally-invasive surgical procedures. Volumetric CT and MR images have been used now for some time in conjunction with stereotactic frames, to guide many neurosurgical procedures. With the development of systems that permit surgical instruments to be tracked in space, image-guided surgery now includes the use of frame-less procedures, and the application of the technology has spread beyond neurosurgery to include orthopedic applications and therapy of various soft-tissue organs such as the breast, prostate and heart. Since tracking systems allow image- guided surgery to be undertaken without frames, a great deal of effort has been spent on image-to-image and image-to- patient registration techniques, and upon the means of combining real-time intra-operative images with images acquired pre-operatively. As image-guided surgery systems have become increasingly sophisticated, the greatest challenges to their successful adoption in the operating room of the future relate to the interface between the user and the system. To date, little effort has been expended to ensure that the human factors issues relating to the use of such equipment in the operating room have been adequately addressed. Such systems will only be employed routinely in the OR when they are designed to be intuitive, unobtrusive, and provide simple access to the source of the images.

  2. Views of surgery program directors on the current ACGME and proposed IOM duty-hour standards. (United States)

    Willis, Ross E; Coverdill, James E; Mellinger, John D; Collins, J Craig; Potts, John R; Dent, Daniel L


    The purpose of this study was to survey the experiences of surgery program directors with the current Accreditation Council for Graduate Medical Education (ACGME) duty-hour standards and views of the Institute of Medicine (IOM) proposed duty-hour recommendations. A total of 118 program directors (47.6% of all surgery programs in the US) responded to the survey. Results showed that the current duty-hour standards have hindered clinical education opportunities by reducing or eliminating rotations on many services, didactic teaching conferences, and clinical bedside teaching opportunities. Additionally, patient safety has been compromised by frequent hand offs of care. Most IOM recommendations were perceived as extremely difficult or impossible to implement, with the exception of the moonlighting recommendation. The results indicated that adopting the IOM recommendations is not feasible given current workforce limitations, and most program directors supported maintaining the current duty-hour standards until such time as there is evidence-based outcomes research to direct change. The conclusion was that the current ACGME duty-hour standards have reduced teaching opportunities and narrowed the scope of training.

  3. World petrochemical outlook: Is the current weakness a trend or an aberration?

    International Nuclear Information System (INIS)

    Baggett, P.E.


    While the focus of this conference is methanol, a review of the general petrochemical industry might be enlightening and valuable to understanding the methanol market. Methanol is certainly a commodity with similarities to hydrocarbons such as gasoline and similarities to base petrochemicals such as ethylene. Methanol stands with one foot in the fuels market via MTBE and the other in the chemicals business for acetic acid and formaldehyde, among many others. Is the world petrochemical market moving into a new trend of weak prices and profits or is the strong growth seen in 1994 and 1995 continuing and the current situation an aberration? In order to determine whether the current market is a trend or aberration, the author looks at issues that he believes caused the current situation and then considers where the world's economies and petrochemical markets are heading. The issues discussed are: unusually high price increase in a short period; inventory increase/decrease because of price changes; reduction in demand caused by high prices; increase in capacity caused by high prices; changes in growth of world economies; and political/economic issues in China

  4. [Current status and changes of metabolic and bariatric surgery in China]. (United States)

    Liu, Jingang


    Through continuous development, metabolic and bariatric surgery (MBS) has become widely recognized in academic and medical circles. In China, the volume of MBS operations has increased year by year. Therapeutic goals of MBS have evolved from treating obesity to treating Type 2 diabetes mellitus, and further to treating a series of obesity-associated metabolic diseases (including conditions in the endocrine system, circulatory system, respiratory system, reproductive system, and etc). Surgical approach of MBS has also been evolving continuously. Currently the common surgical procedures include laparoscopic Roux-en-Y gastric bypass (LRYGB), laparoscopic sleeve gastrectomy (LSG), laparoscopic adjustable gastric banding (LAGB) and bilio-pancreatic diversion with duodenal switch (BPD-DS). All surgical procedures have pros and cons, and the choice of surgical procedures should be based on the conditions of patients, the surgeon's technical ability, and benefits and operative risks. With the development of MBS, the proportions of different surgical procedures also changed in China. In recent five years, the proportion of AGB has decreased continuously and LAGB is no longer a common procedure. The proportion of LSG has increased rapidly, rising from 9% in 2010 to 55% in 2015. The proportion of RYGB has increased from 57% to 64% between 2010 and 2013, and remained at 45% afterwards. Since 2010, most MBS operations are laparoscopic surgery. 3D Laparoscopic surgery, laparoendoscopic single-site surgery and da Vinci Robotic Surgery have also been introduced in MBS. This review discusses the status quo and changes of MBS in china, as well as the new technology in MBS, aiming to strengthen the information and comprehension of MBS in china.

  5. Current status of validation for robotic surgery simulators - a systematic review. (United States)

    Abboudi, Hamid; Khan, Mohammed S; Aboumarzouk, Omar; Guru, Khurshid A; Challacombe, Ben; Dasgupta, Prokar; Ahmed, Kamran


    To analyse studies validating the effectiveness of robotic surgery simulators. The MEDLINE(®), EMBASE(®) and PsycINFO(®) databases were systematically searched until September 2011. References from retrieved articles were reviewed to broaden the search. The simulator name, training tasks, participant level, training duration and evaluation scoring were extracted from each study. We also extracted data on feasibility, validity, cost-effectiveness, reliability and educational impact. We identified 19 studies investigating simulation options in robotic surgery. There are five different robotic surgery simulation platforms available on the market. In all, 11 studies sought opinion and compared performance between two different groups; 'expert' and 'novice'. Experts ranged in experience from 21-2200 robotic cases. The novice groups consisted of participants with no prior experience on a robotic platform and were often medical students or junior doctors. The Mimic dV-Trainer(®), ProMIS(®), SimSurgery Educational Platform(®) (SEP) and Intuitive systems have shown face, content and construct validity. The Robotic Surgical SimulatorTM system has only been face and content validated. All of the simulators except SEP have shown educational impact. Feasibility and cost-effectiveness of simulation systems was not evaluated in any trial. Virtual reality simulators were shown to be effective training tools for junior trainees. Simulation training holds the greatest potential to be used as an adjunct to traditional training methods to equip the next generation of robotic surgeons with the skills required to operate safely. However, current simulation models have only been validated in small studies. There is no evidence to suggest one type of simulator provides more effective training than any other. More research is needed to validate simulated environments further and investigate the effectiveness of animal and cadaveric training in robotic surgery. © 2012 BJU

  6. Current state of virtual reality simulation in robotic surgery training: a review. (United States)

    Bric, Justin D; Lumbard, Derek C; Frelich, Matthew J; Gould, Jon C


    Worldwide, the annual number of robotic surgical procedures continues to increase. Robotic surgical skills are unique from those used in either open or laparoscopic surgery. The acquisition of a basic robotic surgical skill set may be best accomplished in the simulation laboratory. We sought to review the current literature pertaining to the use of virtual reality (VR) simulation in the acquisition of robotic surgical skills on the da Vinci Surgical System. A PubMed search was conducted between December 2014 and January 2015 utilizing the following keywords: virtual reality, robotic surgery, da Vinci, da Vinci skills simulator, SimSurgery Educational Platform, Mimic dV-Trainer, and Robotic Surgery Simulator. Articles were included if they were published between 2007 and 2015, utilized VR simulation for the da Vinci Surgical System, and utilized a commercially available VR platform. The initial search criteria returned 227 published articles. After all inclusion and exclusion criteria were applied, a total of 47 peer-reviewed manuscripts were included in the final review. There are many benefits to utilizing VR simulation for robotic skills acquisition. Four commercially available simulators have been demonstrated to be capable of assessing robotic skill. Three of the four simulators demonstrate the ability of a VR training curriculum to improve basic robotic skills, with proficiency-based training being the most effective training style. The skills obtained on a VR training curriculum are comparable with those obtained on dry laboratory simulation. The future of VR simulation includes utilization in assessment for re-credentialing purposes, advanced procedural-based training, and as a warm-up tool prior to surgery.

  7. Rehabilitation strategies for partially edentulous-prosthodontic principles and current trends. (United States)

    D'Souza, Dsj; Dua, Parag


    The prosthetic considerations for treatment of partially edentulous patients involve evaluation of important aspects such as presence of certain functional or skeletal deficits, orientation of the occlusal plane, free-way space, size and location of edentulous areas, number, strategic location and quality of the likely abutment teeth, vertical dimension, and the type of occlusion. A comprehensive evaluation, multidisciplinary approach and a sequential treatment plan, worked out in harmony with the patient's perceptions are important factors to ensure a successful outcome. This article discusses the principles, current trends and importance of clinical decisions in designing a treatment strategy when confronted with complex situations of partial edentulism.

  8. Patient centric approach for clinical trials: Current trend and new opportunities. (United States)

    Sharma, Neha Shankar


    The clinical research industry today is undergoing a major facelift. Companies are continuously looking to adopt and implement effective and innovative ways to accelerate drug launches in the market. Companies today are more open and do not view patients as mere "subjects" who generate data, - but as informed collaborators whose participation is "core" to the overall success of trials leading to the emergence of the concept of "patient-centric trials." This paper is intended to highlight the current trends and new opportunities that can be seen in industry -indicative of crucial role patients today play in their own health care using technology, social media and self education.

  9. Patient centric approach for clinical trials: Current trend and new opportunities

    Directory of Open Access Journals (Sweden)

    Neha Shankar Sharma


    Full Text Available The clinical research industry today is undergoing a major facelift. Companies are continuously looking to adopt and implement effective and innovative ways to accelerate drug launches in the market. Companies today are more open and do not view patients as mere "subjects" who generate data, - but as informed collaborators whose participation is "core" to the overall success of trials leading to the emergence of the concept of "patient-centric trials." This paper is intended to highlight the current trends and new opportunities that can be seen in industry -indicative of crucial role patients today play in their own health care using technology, social media and self education.

  10. Special Issue: Current Trends in Research in Accounting Finance and Management Control


    Lassala, Carlos; Ripoll Feliu, Vicente


    On January 27, 2016, an agreement was signed with OmniaScience to select articles to be published in the journal Intangible Capital, in a special issue titled "Current Trends in Research in Accounting, Finance and Management Control." The agreement was reached within the framework of three events at the University of Valencia, from June 27 to 30, 2016: XXI Workshop on Accounting and Management Control. “Memorial Raymond Konopka”, X Iberoamerican Congress of Management Accounting, III  Int...

  11. Current Technologies and its Trends of Machine Vision in the Field of Security and Disaster Prevention (United States)

    Hashimoto, Manabu; Fujino, Yozo

    Image sensing technologies are expected as useful and effective way to suppress damages by criminals and disasters in highly safe and relieved society. In this paper, we describe current important subjects, required functions, technical trends, and a couple of real examples of developed system. As for the video surveillance, recognition of human trajectory and human behavior using image processing techniques are introduced with real examples about the violence detection for elevators. In the field of facility monitoring technologies as civil engineering, useful machine vision applications such as automatic detection of concrete cracks on walls of a building or recognition of crowded people on bridge for effective guidance in emergency are shown.

  12. Research on the Current Telecommuting Trends in United States and European Union Markets

    Directory of Open Access Journals (Sweden)

    Catalina Georgiana PICU


    Full Text Available In the context of globalization and due to the accelerated progress made in information and communication technology, more and more companies offer their employees the option of telecommuting. For the past twenty years, telecommuting has been on an asceding trend, an incresing number of people embracing the ability to work from home, using a computer and internet connection to communicate for their jobs. The goal of the paper is to explain the overall notion of telecommuting and to analyze the current trends in the United States and European Union markets. Another objective is to assess the advantages and disadvantages of telecommuting and the important role played by this concept within the striving purpose of corporations to achieve their strategic targets. The study is based upon specialized literature reviews regarding the emergence of telecommuting and the role it plays in organizations. A comparative analysis was conducted by the authors on two regional markets, United States and the European Union, in order to assess the trend in telecommuting and the factors that influence it. The outcome of the research shows that although the benefits of telecommuting are numerous, it does not come without challenges, both being applicable for both the employer, as well as for the employee. The research results of this study can be used by organizations when considering to offer their employees flexible work opportunities which can positively influence the long term business performance.

  13. Current Evidence for Clinical Efficacy of Platelet Rich Plasma in Aesthetic Surgery: A Systematic Review. (United States)

    Frautschi, Russell S; Hashem, Ahmed M; Halasa, Brianna; Cakmakoglu, Cagri; Zins, James E


    Platelet rich plasma (PRP) has attracted attention in a number of surgical fields due to a wide variety of potential clinical benefits. Yet PRP has not gained wide popularity in aesthetic surgery as a result of uncertainty surrounding objective clinical evidence. We aim to describe the current applications, define preparation and activation, explore effectiveness, and propose a classification system to facilitate comparisons across studies. A comprehensive review of the literature regarding the use of platelet rich plasma in aesthetic surgery was performed. Data gathered included: PRP application, study type, subject number, centrifugation, anticoagulation, activation, PRP composition, and outcomes. Thirty-eight reports were identified. Applications included injection into aging skin (29%), scalp alopecia (26%), lipofilling (21%), fractional laser (13%), and facial surgery (11%). The majority of studies (53%) were case series without controls. Leucocytes were sparsely defined (32%). The concentration of injected and/or baseline platelets was rarely clarified (18%). The mechanism of activation was described in 27 studies (71%), while anticoagulation was uncommonly elucidated (47%). While most studies (95%) claim effectiveness, objective measures were only utilized in 17 studies (47%). Current studies produce context-dependent results with a lack of consistent reporting of PRP preparation, composition, and activation in aesthetic applications, making meaningful meta-analysis unrealistic. Thus the method of PRP preparation warrants increased attention. We recommend a set of descriptors, FIT PAAW (described below), to produce scientifically grounded conclusions, facilitating a clearer understanding of the situations in which PRP is effective. 4 © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission:

  14. CALL FOR PAPERS: Special issue on Current Trends in Integrability and Nonlinear Phenomena Special issue on Current Trends in Integrability and Nonlinear Phenomena (United States)

    Gómez-Ullate, D.; Lombardo, S.; Mañas, M.; Mazzocco, M.; Nijhoff, F.; Sommacal, M.


    may be found at Contributions to the special issue should if possible be submitted electronically by web upload at, or by email to, quoting 'JPhysA Special Issue: Current Trends in Integrability and Nonlinear Phenomena' Submissions should ideally be in standard LaTeX form. Please see the website for further information on electronic submissions. Authors unable to submit electronically may send hard-copy contributions to: Publishing Administrators, Journal of Physics A, IOP Publishing, Dirac House, Temple Back, Bristol BS1 6BE, UK. Please quote 'JPhysA Special Issue—Current Trends in Integrability and Nonlinear Phenomena'. All contributions should be accompanied by a read-me file or covering letter giving the postal and e-mail addresses for correspondence. The Publishing Office should be notified of any subsequent change of address. This special issue will be published in the paper and online version of the journal.

  15. Acromioclavicular dislocation: treatment and rehabilitation. Current perspectives and trends among Brazilian orthopedists☆ (United States)

    Arliani, Gustavo Gonçalves; Utino, Artur Yudi; Nishimura, Eduardo Misao; Terra, Bernardo Barcellos; Belangero, Paulo Santoro; Astur, Diego Costa


    Objective To evaluate the approaches and procedures used by Brazilian orthopedic surgeons in treatment and rehabilitation of acromioclavicular dislocation of the shoulder. Methods A questionnaire comprising eight closed questions that addressed topics relating to treatment and rehabilitation of acromioclavicular dislocation was applied to Brazilian orthopedic surgeons over the three days of the 45th Brazilian Congress of Orthopedics and Traumatology, in 2013. Results A total of 122 surgeons completely filled out the questionnaire and formed part of the sample analyzed. Most of them came from the southeastern region of the country. In this sample, 67% of the participants would choose surgical treatment for patients with grade 3 acromioclavicular dislocation. Regarding the preferred technique for surgical treatment of acute acromioclavicular dislocation, a majority of the surgeons used subcoracoid ligature with acromioclavicular fixation and transfer of the coracoacromial ligament (25.4%). Regarding complications found after surgery had been performed, 43.4% and 32.8% of the participants, respectively, stated that residual deformity of the operated joint and pain were the complications most seen during the postoperative period. Conclusions Although there was no consensus regarding the treatment and rehabilitation of acromioclavicular dislocation, evolution had occurred in some of the topics analyzed in this questionnaire applied to Brazilian orthopedists. However, further controlled prospective studies are needed in order to evaluate the clinical and scientific benefit of these trends. PMID:26535196

  16. Acromioclavicular dislocation: treatment and rehabilitation. Current perspectives and trends among Brazilian orthopedists. (United States)

    Arliani, Gustavo Gonçalves; Utino, Artur Yudi; Nishimura, Eduardo Misao; Terra, Bernardo Barcellos; Belangero, Paulo Santoro; Astur, Diego Costa


    To evaluate the approaches and procedures used by Brazilian orthopedic surgeons in treatment and rehabilitation of acromioclavicular dislocation of the shoulder. A questionnaire comprising eight closed questions that addressed topics relating to treatment and rehabilitation of acromioclavicular dislocation was applied to Brazilian orthopedic surgeons over the three days of the 45th Brazilian Congress of Orthopedics and Traumatology, in 2013. A total of 122 surgeons completely filled out the questionnaire and formed part of the sample analyzed. Most of them came from the southeastern region of the country. In this sample, 67% of the participants would choose surgical treatment for patients with grade 3 acromioclavicular dislocation. Regarding the preferred technique for surgical treatment of acute acromioclavicular dislocation, a majority of the surgeons used subcoracoid ligature with acromioclavicular fixation and transfer of the coracoacromial ligament (25.4%). Regarding complications found after surgery had been performed, 43.4% and 32.8% of the participants, respectively, stated that residual deformity of the operated joint and pain were the complications most seen during the postoperative period. Although there was no consensus regarding the treatment and rehabilitation of acromioclavicular dislocation, evolution had occurred in some of the topics analyzed in this questionnaire applied to Brazilian orthopedists. However, further controlled prospective studies are needed in order to evaluate the clinical and scientific benefit of these trends.


    Directory of Open Access Journals (Sweden)

    Kostadin Valkov


    Full Text Available Thе analysis presented in current article deepens and summarizes the results of an economic study focused on the management of human resources in the sector "Tourism". The expected changes in organizational and technological terms are taken into account. The law on tourism in the Republic of Bulgaria and the types of taxes that directly and indirectly affect those employed in tourism are considered. Leading accents are the current trends and issues that arise from the lack of skilled workers in this sector and their deficit caused by the seasonal nature of employment. Growing gray economy is concerned as a major obstacle to development of the tourism industry and its future.

  18. eHealth in Saudi Arabia: Current Trends, Challenges and Recommendations. (United States)

    Alsulame, Khaled; Khalifa, Mohamed; Househ, Mowafa


    The purpose of this study is to explore the current status of eHealth in Saudi Arabia from the perspective of health informatics professionals. We used a case study approach and analyzed participant data using thematic analysis. The study took place between July and August 2013. Data collection included interviews with nine senior health information professionals in Saudi Arabia. The findings describe participant views on current eHealth trends in Saudi Arabia and show differences among Saudi healthcare organizations in terms of eHealth adoption. Participants also describe the challenges relating to organizational and cultural issues, end user attitudes towards eHealth projects, and the lack of specialized human resources to implement eHealth systems. Two main recommendations made by the participants were to form a new national body for eHealth and to develop a unified plan for the implementation of Saudi eHealth initiatives.

  19. Research trend in thermally stimulated current method for development of materials and devices in Japan (United States)

    Iwamoto, Mitsumasa; Taguchi, Dai


    Thermally stimulated current (TSC) measurement is widely used in a variety of research fields, i.e., physics, electronics, electrical engineering, chemistry, ceramics, and biology. TSC is short-circuit current that flows owing to the displacement of charges in samples during heating. TSC measurement is very simple, but TSC curves give very important information on charge behaviors. In the 1970s, TSC measurement contributed greatly to the development of electrical insulation engineering, semiconductor device technology, and so forth. Accordingly, the TSC experimental technique and its analytical method advanced. Over the past decades, many new molecules and advanced functional materials have been discovered and developed. Along with this, TSC measurement has attracted much attention in industries and academic laboratories as a way of characterizing newly discovered materials and devices. In this review, we report the latest research trend in the TSC method for the development of materials and devices in Japan.

  20. Current trends in degradation assesment on metallic materials of industrial components

    International Nuclear Information System (INIS)

    Herrera Palma, Victoria


    To needs to assess objectively a structural integrity analysis in nuclear and termal power-, oil- and chemical- industry system, represents a large challenge for engineer and researches related to Materials Science, equipment manufactures or users. These systems share many of their problems with regards to aging mechanism of components metallic materials, high replacement costs and increasing requirements on efficiency and safety. This paper makes an attempt to give an overview of the current trends on material damage and residual life assessment for installation of power-, oil- and chemical industry. Some of the currently existing ideas on components inspection, as an activity for damage detection are shown. A summary on mechanism of material damage and experimental techniques for their characterization is also presented. Finally, some analytical methods with wide appliance in materials damage evaluation and residual life assesment of components are described

  1. Nationwide trends in surgery and radioiodine treatment for benign thyroid disease during iodization of salt

    DEFF Research Database (Denmark)

    Cerqueira, C.; Knudsen, N.; Ovesen, L.


    Objective: Iodization of salt was introduced in Denmark in 1998 because of mild-to-moderate iodine deficiency (ID). The aim of this study was to analyze the utilization rate of surgery and radioiodine therapy for benign thyroid disorders before and after the introduction of iodization, and to stu...

  2. The Longitudinal Trend of Cardiac Surgery in Korea from 2003 to 2013

    Directory of Open Access Journals (Sweden)

    Kyeong Soo Lee


    Full Text Available Background: The purpose of this study was to investigate longitudinal changes of the utilization of operational and surgical medical care inside and outside a metropolitan area over 10 years, analyzing the residential areas of patients and the locations of medical facilities for major cardiovascular surgery. Methods: Data analysis was conducted by classifying the addresses of patients and the locations of medical care facilities of metropolitan cities and provinces, using data from the National Health Insurance Corporation from January 2003 to December 2013. Results: There is serious concentration of major heart surgery to medical facilities in Seoul; this problem has not improved over time. There were differences in percentages of surgical procedures performed in the metropolitan areas according to major diseases. In the case of Busan and Daegu provinces, at least 50% of the patients underwent surgery in medical facilities in the city, but there are other regions where the percentage is less than 50%. In the case of provinces, the percentage of surgical procedures performed in medical facilities in Seoul or nearby metropolitan cities is very high. Conclusion: Policies to strengthen the regional capabilities of heart surgery and to secure human resources are required to mitigate the concentration of patients in the capital area. Many regional multi-centers must be designated to minimize unnecessary competition among regional university hospitals and activate a win-win partnership model for medical services.

  3. Black Truffle Harvesting in Spanish Forests: Trends, Current Policies and Practices, and Implications on its Sustainability (United States)

    Garcia-Barreda, Sergi; Forcadell, Ricardo; Sánchez, Sergio; Martín-Santafé, María; Marco, Pedro; Camarero, J. Julio; Reyna, Santiago


    The European black truffle is a mycorrhizal fungus native to Spanish Mediterranean forests. In most Spanish regions it was originally commercially harvested in the second half of the 20th century. Experts agree that wild truffle yields suffered a sharp decline during the 1970s and 1980s. However, official statistics for Spanish harvest are scarce and seemingly conflicting, and little attention has been paid to the regime for the exploitation of truffle-producing forests and its implications on the sustainability of this resource. Trends in harvest from 1969 to 2013 and current harvesting practices were analyzed as a case study, taking into account that Spain is a major truffle producer worldwide, but at the same time truffles have only recently been exploited. The available statistical sources, which include an increasing proportion of cultivated truffles since the mid-1990s, were explored, with estimates from Truffle Harvesters Federation showing higher consistency. Statistical sources were then compared with proxies for wild harvest (rents from truffle leases in public forests) to corroborate time trends in wild harvesting. Results suggest that black truffle production is recovering in recent years thanks to plantations, whereas wild harvest is still declining. The implications of Spanish legal and institutional framework on sustainability of wild truffle use are reviewed. In the current scenario, the decline of wild harvest is likely to continue and eventually make commercial harvesting economically unattractive, thus aggravating sustainability issues. Strengthening of property rights, rationalization of harvesting pressure, forest planning and involvement of public stakeholders are proposed as corrective measures.

  4. Clinical negligence claims in pediatric surgery in England: pattern and trends. (United States)

    Thyoka, Mandela


    We hypothesized that there has been an increase in the number of successful litigation claims in pediatric surgery in England. Our aim was to report the incidence, causes, and costs of clinical negligence claims against the National Health Service (NHS) in relation to pediatric surgery. We queried the NHS Litigation Authority (NHSLA) on litigation claims among children undergoing pediatric surgery in England (2004-2012). We decided a priori to only examine closed cases (decision and payment made). Data included year of claim, year of payment of claim, payment per claim, paid-to-closed ratio, and severity of outcome of clinical incident. Out of 112 clinical negligence claims in pediatric surgery, 93 (83%) were finalized-73 (65%) were settled and damages paid to the claimant and 20 (18%) were closed with no payment, and 19 (17%) remain open. The median payment was £13,537 (600-500,000) and median total cost borne by NHSLA was £31,445 (600-730,202). Claims were lodged at a median interval of 2 (0-13) years from time of occurrence with 55 (75%) cases being settled within the 3 years of being received. The commonest reasons for claims were postoperative complications (n=20, 28%), delayed treatment (n=16, 22%), and/or diagnosis (n=14, 19%). Out of 73, 17 (23%) closed claims resulted in case fatality. Conclusion: Two-thirds of all claims in pediatric surgery resulted in payment to claimant, and the commonest reasons for claims were postoperative complications, delayed treatment, and/or diagnosis. Nearly a quarter of successful claims were in cases where negligence resulted in case fatality. Pediatric surgeons should be aware of common diagnostic and treatment shortfalls as high-risk areas of increased susceptibility to clinical negligence claims. Georg Thieme Verlag KG Stuttgart · New York.

  5. Current trends and controversies in the management of patients with splenic flexure tumours

    Directory of Open Access Journals (Sweden)

    Chan DS


    Full Text Available Aim: There exists a variation in practice in the management of tumours around the splenic flexure. We aim to determine the current opinion regarding the management of these tumours. Methods: An anonymised 10-part online questionnaire was sent to all members of the Association of Coloproctology of Great Britain and Ireland (ACPGBI. Results: The response rate was 24% (111/464 with approximately half of respondents performing laparoscopic surgery. Electively, an extended right hemicolectomy is the preferred option by 63% of respondents followed by left hemicolectomy (23% and segmental resection (14%. The upper sigmoid and rectosigmoid is the preferred site of anastomosis by 90% and 10% of respondents respectively. There were no significant differences in the type of operations performed by surgeons who practice laparoscopic or open surgery (p=0.10. A hand-sewn end-to-end anastomosis is most commonly performed (51% followed by a stapled side-to-side (36% and a stapled end-to-end (13% technique. Extended right hemicolectomy is also the preferred option in obstructing tumours. Of surgeons who perform segmental resections, 27% perform an on-table lavage and 9% perform a defunctioning stoma. Internal herniation following laparoscopic resection was only reported by a handful of surgeons. Conclusion: Opinion and practice in the management of patients with tumours around the splenic flexure are divided. Further trials are indicated to determine the best practice.

  6. Implications of current resident work-hour guidelines on the future practice of surgery in Canada. (United States)

    Maruscak, Adam A; VanderBeek, Laura; Ott, Michael C; Kelly, Stephen; Forbes, Thomas L


    Work-hour restrictions have had a profound impact on surgical training. However, little is known of how work-hour restrictions may affect the future practice patterns of current surgical residents. The purpose of this study is to compare the anticipated career practice patterns of surgical residents who are training within an environment of work-hour restrictions with the current practice of faculty surgeons. An electronic survey was sent to all surgery residents and faculty at 2 Canadian university-affiliated medical centers. The survey consisted of questions regarding expected (residents) or current (faculty) practice patterns. A total of 149 residents and 125 faculty members completed the survey (50.3% and 52.3% response rates, respectively). A greater proportion of males were in the faculty cohort than in the resident group (77.6% vs 62.4%, p = 0.0003). More faculty than residents believed that work-hour restrictions have a negative impact on both residency education (40.8% vs 20.8%, p = 0.008) and preparation for a surgical career (56.8% vs 19.5%, p implications and might require larger surgical groups and reconsideration of resource allocation. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  7. Current and emerging basic science concepts in bone biology: implications in craniofacial surgery. (United States)

    Oppenheimer, Adam J; Mesa, John; Buchman, Steven R


    Ongoing research in bone biology has brought cutting-edge technologies into everyday use in craniofacial surgery. Nonetheless, when osseous defects of the craniomaxillofacial skeleton are encountered, autogenous bone grafting remains the criterion standard for reconstruction. Accordingly, the core principles of bone graft physiology continue to be of paramount importance. Bone grafts, however, are not a panacea; donor site morbidity and operative risk are among the limitations of autologous bone graft harvest. Bone graft survival is impaired when irradiation, contamination, and impaired vascularity are encountered. Although the dura can induce calvarial ossification in children younger than 2 years, the repair of critical-size defects in the pediatric population may be hindered by inadequate bone graft donor volume. The novel and emerging field of bone tissue engineering holds great promise as a limitless source of autogenous bone. Three core constituents of bone tissue engineering have been established: scaffolds, signals, and cells. Blood supply is the sine qua non of these components, which are used both individually and concertedly in regenerative craniofacial surgery. The discerning craniofacial surgeon must determine the proper use for these bone graft alternatives, while understanding their concomitant risks. This article presents a review of contemporary and emerging concepts in bone biology and their implications in craniofacial surgery. Current practices, areas of controversy, and near-term future applications are emphasized.

  8. Age-dependent trends in postoperative mortality and preoperative comorbidity in isolated coronary artery bypass surgery

    DEFF Research Database (Denmark)

    Thorsteinsson, Kristinn; Fonager, Kirsten; Mérie, Charlotte


    OBJECTIVES: An increasing number of octogenarians are being subjected to coronary artery bypass grafting (CABG). The purpose of this study was to examine age-dependent trends in postoperative mortality and preoperative comorbidity over time following CABG. METHODS: All patients who underwent isol...

  9. Achilles tenotomy as an office procedure and current practising trends among New Zealand orthopaedic surgeons. (United States)

    Agius, Lewis; Wickham, Angus; Walker, Cameron; Knudsen, Joshua


    Percutaneous Achilles tenotomy (PAT) is performed during the final phase of casting with Ponseti method. Several settings have been proposed as venues for this procedure, however it is increasingly being performed in theatre under a general anaesthetic (GA). General anaesthesia, however, is expensive and not without risks. The purpose of the present study was to compare results of outpatient releases to theatre releases, and assess current practising trends among orthopaedic surgeons. Retrospective comparison of patients with idiopathic clubfoot managed by Ponseti method who had Achilles tenotomy performed in outpatient clinic and in theatre. Surveys were sent to all POSNZ members to determine current practising trends in New Zealand. Parental satisfaction surveys were performed. Comparative cost analysis was performed using hospital billing information. The current study includes 64 idiopathic congenital clubfeet (19 bilateral cases). PAT was performed on 26 clubfeet under local anaesthetic in an outpatient setting, and 33 clubfeet under GA in a theatre setting. There was no significant difference for post-operative complications, or recurrence (p=0.67). Those in theatre group were exposed to a greater number of general anaesthetics before the age of four. Among practising New Zealand paediatric orthopaedic surgeons, 77.78% perform this in theatre under general anaesthesia, while only 22.22% perform PAT in outpatient clinic. The main barriers included concerns regarding pain control, concerns regarding incomplete release, concerns regarding distress to family and concerns regarding sterility. Parental satisfaction surveys found pain management to be excellent. Financial data was analysed and indicative costs were $6,061 NZD per procedure in theatre, compared to $378 NZD per procedure in clinic. PAT performed in a clinic setting is both safe and efficacious with results comparative to that performed in theatre. There was no difference in post

  10. New trends in minimally invasive urological surgery: what is beyond the robot? (United States)

    Micali, Salvatore; Pini, Giovannalberto; Teber, Dogu; Sighinolfi, Maria Chiara; De Stefani, Stefano; Bianchi, Giampaolo; Rassweiler, Jens


    To review the minimal-invasive development of surgical technique in urology focusing on nomenclature, history and outcomes of Laparo-Endoscopic Single-site Surgery (LESS), Natural Orifice Translumenal Endoscopic Surgery (NOTES) and Computer-Assisted Surgery (CAS). A comprehensive literature search was conducted in order to find article related to LESS, NOTES and CAS in urology. The most relevant papers over the last 10 years were selected in base to the experience from the panel of experts, journal, authorship and/or content. Seven hundred and fifty manuscripts were found. Papers on LESS describe feasibility/safety in most of the procedures with a clinical experience of more than 300 cases and five compared results to standard laparoscopy without showing significant differences. NOTES accesses have been proved their feasibility/safety in experimental study. In human, the only procedures performed are on kidney and through a hybrid-Transvaginal route. New robots overcome the main drawbacks of the DaVinci® platform. The use of CAS is increasing its popularity in urology. LESS has been applied in clinical practice, but only ongoing technical and instrumental refinement will define its future role and overall benefit. The transition to a clinical application of NOTES seems at present only possible with multiple NOTES access and transvaginal access. Robot and Soft Tissue Navigation appear to be important to improve surgical skills. We are already witness to the advantages offered by the former even if costs need to be redefined based on pending long-term results. The latter will probably upgrade the quality of surgery in a near future.

  11. Recent Trends in Veteran Unemployment as Measured in the Current Population Survey and the American Community Survey

    National Research Council Canada - National Science Library

    Savych, Bogdan; Klerman, Jacob A; Loughran, David S


    This technical report explores recent trends in the unemployment of recent veterans as estimated from two nationally representative surveys, the Current Population Survey "CPS" and the American Community Survey "ACS...

  12. Primary energy use for heating in the Swedish building sector-Current trends and proposed target

    International Nuclear Information System (INIS)

    Johansson, P.; Nylander, A.; Johnsson, F.


    One goal of the Swedish energy policy is to reduce the amount of electricity used for heating in the building sector. This means to reduce the primary energy used for heating which in this paper is analyzed in the context of various heating technologies and CO 2 emissions. The analysis is applied to a region in Sweden (southern Sweden) for which detailed information on the energy infrastructure (the capital stock of the buildings and heating systems together with geographical variations in heat intensity) is available from a previous work [Johansson, P., Nylander, A., Johnsson, F., 2005. Electricity dependency and CO 2 emissions from heating in the Swedish building sector-current trends in conflict with governmental policy? Energy policy] and which is large enough to be assumed representative for Sweden as a whole. The detailed mapping of the energy infrastructure allows a good estimate on the rate at which the energy system can be expected to be replaced with respect to economical lifetime of the capital stock (the year 2025 in this case). Two scenarios are investigated; a target scenario for which energy savings are employed (e.g. improving climate shell in buildings) and oil and most of the electricity used for heating purposes are phased out and a second for which the current trend in the heating market continues. In the target scenario it is shown that although only applying commercially competitive heating technologies, it is possible to achieve a 47% reduction in primary energy use for heating with a 34% decrease in heat demand together with significant reduction in CO 2 emissions. However, the scenario which continues the current trends on the heating market instead yields an increase (of about 10%) in primary energy use (reduction in conversion efficiency) of the heating system of the region over the period studied, in spite of a slight decrease in heat demand (9%, mainly due to energy efficiency measures) as well as in CO 2 emissions. In light of the

  13. Current trends in treatment of obesity in Karachi and possibilities of cost minimization. (United States)

    Hussain, Mirza Izhar; Naqvi, Baqir Shyum


    Our study finds out drug usage trends in over weight and obese patients without any compelling indications in Karachi, looks for deviations of current practices from evidence based antihypertensive therapeutic guidelines and identifies not only cost minimization opportunities but also communication strategies to improve patients' awareness and compliance to achieve therapeutic goal. In present study two sets were used. Randomized stratified independent surveys were conducted in hospital doctors and family physicians (general practitioners), using pretested questionnaires. Sample size was 100. Statistical analysis was conducted on Statistical Package for Social Science (SPSS). Opportunities of cost minimization were also analyzed. One the basis of doctors' feedback, preference is given to non-pharmacologic management of obesity. Mass media campaign and media usage were recommended to increase patients awareness and patients' education along with strengthening family support systems was recommended for better compliance of the patients to doctor's advice. Local therapeutic guidelines for weight reduction were not found. Feedbacks showed that global therapeutic guidelines were followed by the doctors practicing in the community and hospitals in Karachi. However, high price branded drugs were used instead of low priced generic therapeutic equivalents. Patient's education is required for better awareness and improving patients' compliance. The doctors found preferring brand leaders instead of low cost options. This trend increases cost of therapy by 0.59 to 4.17 times. Therefore, there are great opportunities for cost minimization by using evidence-based clinically effective and safe medicines.

  14. 3D Printing: current use in facial plastic and reconstructive surgery. (United States)

    Hsieh, Tsung-Yen; Dedhia, Raj; Cervenka, Brian; Tollefson, Travis T


    To review the use of three-dimensional (3D) printing in facial plastic and reconstructive surgery, with a focus on current uses in surgical training, surgical planning, clinical outcomes, and biomedical research. To evaluate the limitations and future implications of 3D printing in facial plastic and reconstructive surgery. Studies reviewed demonstrated 3D printing applications in surgical planning including accurate anatomic biomodels, surgical cutting guides in reconstruction, and patient-specific implants fabrication. 3D printing technology also offers access to well tolerated, reproducible, and high-fidelity/patient-specific models for surgical training. Emerging research in 3D biomaterial printing have led to the development of biocompatible scaffolds with potential for tissue regeneration in reconstruction cases involving significant tissue absence or loss. Major limitations of utilizing 3D printing technology include time and cost, which may be offset by decreased operating times and collaboration between departments to diffuse in-house printing costs SUMMARY: The current state of the literature shows promising results, but has not yet been validated by large studies or randomized controlled trials. Ultimately, further research and advancements in 3D printing technology should be supported as there is potential to improve resident training, patient care, and surgical outcomes.

  15. Current robotic curricula for surgery residents: A need for additional cognitive and psychomotor focus. (United States)

    Green, Courtney A; Chern, Hueylan; O'Sullivan, Patricia S


    Current robot surgery curricula developed by industry were designed for expert surgeons. We sought to identify the robotic curricula that currently exist in general surgery residencies and describe their components. We identified 12 residency programs with robotic curricula. Using a structured coding form to identify themes including sequence, duration, emphasis and assessment, we generated a descriptive summary. Curricula followed a similar sequence: learners started with online modules and simulation exercises, followed by bedside experience during R2-R3 training years, and then operative opportunities on the console in the final years of training. Consistent portions of the curricula reflect a device-dependent training paradigm; they defined the sequence of instruction. Most curricula lacked specifics on duration and content of training activities. None clearly described cognitive or psychomotor skills needed by residents and none required a proficiency assessment before graduation. Resident-specific robotic curricula remain grounded in initial industrial efforts to train experienced surgeons, are non-specific regarding the type and nature of hands on experience, and do not include discussion of operative technique and surgical concepts. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Strategies to enhance biologically active-secondary metabolites in cell cultures of Artemisia - current trends. (United States)

    Ali, Mohammad; Abbasi, Bilal Haider; Ahmad, Nisar; Khan, Haji; Ali, Gul Shad


    The genus Artemisia has been utilized worldwide due to its immense potential for protection against various diseases, especially malaria. Artemisia absinthium, previously renowned for its utilization in the popular beverage absinthe, is gaining resurgence due to its extensive pharmacological activities. Like A. annua, this species exhibits strong biological activities like antimalarial, anticancer and antioxidant. Although artemisinin was found to be the major metabolite for its antimalarial effects, several flavonoids and terpenoids are considered to possess biological activities when used alone and also to synergistically boost the bioavailability of artemisinin. However, due to the limited quantities of these metabolites in wild plants, in vitro cultures were established and strategies have been adopted to enhance medicinally important secondary metabolites in these cultures. This review elaborates on the traditional medicinal uses of Artemisia species and explains current trends to establish cell cultures of A. annua and A. absinthium for enhanced production of medicinally important secondary metabolites.

  17. Metacognition fundaments, applications, and trends a profile of the current state-of-the-art

    CERN Document Server


    This book is devoted to the Metacognition arena. It highlights works that show relevant analysis, reviews, theoretical, and methodological proposals, as well as studies, approaches, applications, and tools that shape current state, define trends and inspire future research. As a result of the revision process fourteen manuscripts were accepted and organized into five parts as follows: ·     Conceptual: contains conceptual works oriented to: (1) review models of strategy instruction and tailor a hybrid strategy; (2) unveil second-order judgments and define a method to assess metacognitive judgments; (3) introduces a conceptual model to describe the metacognitive activity as an autopoietic system. ·     Framework: offers three works concerned with: (4) stimulate metacognitive skills and self-regulatory functions; (5) evaluate metacognitive skills and self-regulated learning at problem solving; (6) deal with executive management metacognition and strategic knowledge metacognition. ·     Studies: r...

  18. Current Trends in Discharge Disposition and Post-discharge Care After Total Joint Arthroplasty. (United States)

    Tarity, T David; Swall, Marion M


    The purpose of this manuscript is to review published literature over the last 5 years to assess recent trends and influencing factors regarding discharge disposition and post-discharge care following total joint arthroplasty. We evaluated instruments proposed to predict a patient's discharge disposition and summarize reports investigating the safety in sending more patients home by reviewing complications and readmission rates. Current literature supports decreased length of hospital stay and increased discharge to home with cost savings and stable readmission rates. Surgeons with defined clinical pathways and those who shape patient expectations may more effectively control costs than those without defined pathways. Further research is needed analyzing best practices in care coordination, managing patient expectations, and cost-effective analysis of home discharge while at the same time ensuring patient outcomes are optimized following total joint arthroplasty.

  19. Racial disparities in smoking knowledge among current smokers: data from the health information national trends surveys. (United States)

    Reimer, Rachel Ann; Gerrard, Meg; Gibbons, Frederick X


    Although African-Americans (Blacks) smoke fewer cigarettes per day than European-Americans (Whites), there is ample evidence that Blacks are more susceptible to smoking-related health consequences. A variety of behavioural, social and biological factors have been linked to this increased risk. There has been little research, however, on racial differences in smoking-related knowledge and perceived risk of lung cancer. The primary goal of the current study was to evaluate beliefs and knowledge that contribute to race disparities in lung cancer risk among current smokers. Data from two separate nationally representative surveys (the Health Information National Trends surveys 2003 and 2005) were analysed. Logistic and hierarchical regressions were conducted; gender, age, education level, annual household income and amount of smoking were included as covariates. In both studies, Black smokers were significantly more likely to endorse inaccurate statements than were White smokers, and did not estimate their lung cancer risk to be significantly higher than Whites. Results highlight an important racial disparity in public health knowledge among current smokers.

  20. Trends in refractive surgery at an academic center: 2007-2009

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    Kuo Irene C


    Full Text Available Abstract Background The United States officially entered a recession in December 2007, and it officially exited the recession in December 2009, according to the National Bureau of Economic Research. Since the economy may affect not only the volume of excimer laser refractive surgery, but also the clinical characteristics of patients undergoing surgery, our goal was to compare the characteristics of patients completing excimer laser refractive surgery and the types of procedures performed in the summer quarter in 2007 and the same quarter in 2009 at an academic center. A secondary goal was to determine whether the volume of astigmatism- or presbyopia-correcting intraocular lenses (IOLs has concurrently changed because like laser refractive surgery, these "premium" IOLs involve out-of-pocket costs for patients. Methods Retrospective case series. Medical records were reviewed for all patients completing surgery at the Wilmer Laser Vision Center in the summer quarter of 2007 and the summer quarter of 2009. Outcome measures were the proportions of treated refractive errors, the proportion of photorefractive keratectomy (PRK vs. laser-assisted in-situ keratomileusis (LASIK, and the mean age of patients in each quarter. Chi-square test was used to compare the proportions of treated refractive errors and the proportions of procedures; two-tailed t-test to compare the mean age of patients; and two-tailed z-test to compare proportions of grouped refractive errors in 2007 vs. 2009; alpha = 0.05 for all tests. Refractive errors were grouped by the spherical equivalent of the manifest refraction and were considered "low myopia" for 6 diopters (D of myopia or less, "high myopia" for more than 6 D, and "hyperopia" for any hyperopia. Billing data were reviewed to obtain the volume of premium IOLs. Results Volume of laser refractive procedures decreased by at least 30%. The distribution of proportions of treated refractive errors did not change (p = 0.10. The

  1. Trends in refractive surgery at an academic center: 2007-2009. (United States)

    Kuo, Irene C


    The United States officially entered a recession in December 2007, and it officially exited the recession in December 2009, according to the National Bureau of Economic Research. Since the economy may affect not only the volume of excimer laser refractive surgery, but also the clinical characteristics of patients undergoing surgery, our goal was to compare the characteristics of patients completing excimer laser refractive surgery and the types of procedures performed in the summer quarter in 2007 and the same quarter in 2009 at an academic center. A secondary goal was to determine whether the volume of astigmatism- or presbyopia-correcting intraocular lenses (IOLs) has concurrently changed because like laser refractive surgery, these "premium" IOLs involve out-of-pocket costs for patients. Retrospective case series. Medical records were reviewed for all patients completing surgery at the Wilmer Laser Vision Center in the summer quarter of 2007 and the summer quarter of 2009. Outcome measures were the proportions of treated refractive errors, the proportion of photorefractive keratectomy (PRK) vs. laser-assisted in-situ keratomileusis (LASIK), and the mean age of patients in each quarter. Chi-square test was used to compare the proportions of treated refractive errors and the proportions of procedures; two-tailed t-test to compare the mean age of patients; and two-tailed z-test to compare proportions of grouped refractive errors in 2007 vs. 2009; alpha = 0.05 for all tests. Refractive errors were grouped by the spherical equivalent of the manifest refraction and were considered "low myopia" for 6 diopters (D) of myopia or less, "high myopia" for more than 6 D, and "hyperopia" for any hyperopia. Billing data were reviewed to obtain the volume of premium IOLs. Volume of laser refractive procedures decreased by at least 30%. The distribution of proportions of treated refractive errors did not change (p = 0.10). The proportion of high myopes, however, decreased (p = 0

  2. Review: Current trends in coral transplantation – an approach to preserve biodiversity

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    Full Text Available Ammar MSA,El-Gammal F, Nassar M, Belal A, Farag W, El-Mesiry G, El-Haddad K, Orabi A, Abdelreheem A, Shaaban A. 2013. Review: Current trends in coral transplantation – an approach to preserve biodiversity. Biodiversitas 14: 43-53. The increasing rates of coral mortality associated with the rise in stress factors and the lack of adequate recovery worldwide have urged recent calls for actions by the scientific, conservation, and reef management communities. This work reviews the current trends in coral transplantation. Transplantation of coral colonies or fragments, whether from aqua-, mariculture or harvesting from a healthy colony, has been the most frequently recommended action for increasing coral abundance on damaged or degraded reefs and for conserving listed or “at-risk” species. Phytoplanktons are important for providing transplanted corals with complex organic compounds through photosynthesis. Artificial surfaces like concrete blocks, wrecks or other purpose-designed structures can be introduced for larval settlement. New surfaces can also be created through electrolysis. Molecular biological tools can be used to select sites for rehabilitation by asexual recruits. Surface chemistry and possible inputs of toxic leachate from artificial substrates are considered as important factors affecting natural recruitment. Transplants should be carefully maintained , revisited and reattached at least weekly in the first month and at least fortnightly in the next three months. Studies on survivorship and the reproductive ability of transplanted coral fragments are important for coral reef restoration. A coral nursery may be considered as a pool for local species that supplies reef-managers with unlimited coral colonies for sustainable management. Transplanting corals for making artificial reefs can be useful for increasing biodiversity, providing tourist diving, fishing and surfing; creating new artisanal and commercial fishing opportunities

  3. Employment and satisfaction trends among general surgery residents from a community hospital. (United States)

    Cyr-Taro, Amy E; Kotwall, Cyrus A; Menon, Rema P; Hamann, M Sue; Nakayama, Don K


    Physician satisfaction is an important and timely issue in health care. A paucity of literature addresses this question among general surgeons. To review employment patterns and job satisfaction among general surgery residents from a single university-affiliated institution. All general surgery residents graduating from 1986 to 2006, inclusive, were mailed an Institutional Review Board-approved survey, which was then returned anonymously. Information on demographics, fellowship training, practice characteristics, job satisfaction and change, and perceived shortcomings in residency training was collected. A total of 31 of 34 surveys were returned (91%). Most of those surveyed were male (94%) and Caucasian (87%). Sixty-one percent of residents applied for a fellowship, and all but 1 were successful in obtaining their chosen fellowship. The most frequent fellowship chosen was plastic surgery, followed by minimally invasive surgery. Seventy-one percent of residents who applied for fellowship felt that the program improved their competitiveness for a fellowship. Most of the sample is in private practice, and of those, 44% are in groups with more than 4 partners. Ninety percent work less than 80 hours per week. Only 27% practice in small towns (population job. Twenty-three percent agreed that they had difficulty finding their first job, and 30% had fewer job offers than expected. Thirty-five percent of the graduates have changed jobs: 29% of the residents have changed jobs once, and 6% have changed jobs at least twice since completing training. Reasons for leaving a job included colleague issues (82%), financial issues (82%), inadequate referrals (64%), excessive trauma (64%), and marriage or family reasons (55% and 55%, respectively). One half to three fourths of the graduates wished they had more teaching on postresidency business and financial issues, review of contracts, and suggestions for a timeline for finding a job. Although general surgical residencies prepare

  4. Prioritizing qualitative research in surgery: A synthesis and analysis of publication trends. (United States)

    Maragh-Bass, Allysha C; Appelson, Jessica R; Changoor, Navin R; Davis, W Austin; Haider, Adil H; Morris, Megan A


    Over the past 2 decades, researchers have recognized the value of qualitative research. Little has been done to characterize its application to surgery. We describe characteristics and overall prevalence of qualitative surgical research. We searched PubMed and CINAHL using "surgery" and 7 qualitative methodology terms. Four researchers extracted information; a fifth researcher reviewed 10% of abstracts for inter-rater reliability. A total of 3,112 articles were reviewed. Removing duplicates, 28% were relevant (N = 878; κ = 0.70). Common qualitative methodologies included phenomenology (34.3%) and grounded theory (30.2%). Interviews were the most common data collection method (81.9%) of patients (64%) within surgical oncology (15.4%). Postdischarge was the most commonly studied topic (30.8%). Overall, 41% of studies were published in nursing journals, while 8% were published in surgical journals. More than half of studies were published since 2011. Results suggest qualitative surgical research is gaining popularity. Most is published in nonsurgical journals, however, utilizing only 2 methodologies (phenomenology, grounded theory). The surgical journals that have published qualitative research had study topics restricted to a handful of surgical specialties. Additional surgical qualitative research should take advantage of a greater variety of approaches to provide insight into rare phenomena and social context. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Current use of imaging and electromagnetic source localization procedures in epilepsy surgery centers across Europe. (United States)

    Mouthaan, Brian E; Rados, Matea; Barsi, Péter; Boon, Paul; Carmichael, David W; Carrette, Evelien; Craiu, Dana; Cross, J Helen; Diehl, Beate; Dimova, Petia; Fabo, Daniel; Francione, Stefano; Gaskin, Vladislav; Gil-Nagel, Antonio; Grigoreva, Elena; Guekht, Alla; Hirsch, Edouard; Hecimovic, Hrvoje; Helmstaedter, Christoph; Jung, Julien; Kalviainen, Reetta; Kelemen, Anna; Kimiskidis, Vasilios; Kobulashvili, Teia; Krsek, Pavel; Kuchukhidze, Giorgi; Larsson, Pål G; Leitinger, Markus; Lossius, Morten I; Luzin, Roman; Malmgren, Kristina; Mameniskiene, Ruta; Marusic, Petr; Metin, Baris; Özkara, Cigdem; Pecina, Hrvoje; Quesada, Carlos M; Rugg-Gunn, Fergus; Rydenhag, Bertil; Ryvlin, Philippe; Scholly, Julia; Seeck, Margitta; Staack, Anke M; Steinhoff, Bernhard J; Stepanov, Valentin; Tarta-Arsene, Oana; Trinka, Eugen; Uzan, Mustafa; Vogt, Viola L; Vos, Sjoerd B; Vulliémoz, Serge; Huiskamp, Geertjan; Leijten, Frans S S; Van Eijsden, Pieter; Braun, Kees P J


    In 2014 the European Union-funded E-PILEPSY project was launched to improve awareness of, and accessibility to, epilepsy surgery across Europe. We aimed to investigate the current use of neuroimaging, electromagnetic source localization, and imaging postprocessing procedures in participating centers. A survey on the clinical use of imaging, electromagnetic source localization, and postprocessing methods in epilepsy surgery candidates was distributed among the 25 centers of the consortium. A descriptive analysis was performed, and results were compared to existing guidelines and recommendations. Response rate was 96%. Standard epilepsy magnetic resonance imaging (MRI) protocols are acquired at 3 Tesla by 15 centers and at 1.5 Tesla by 9 centers. Three centers perform 3T MRI only if indicated. Twenty-six different MRI sequences were reported. Six centers follow all guideline-recommended MRI sequences with the proposed slice orientation and slice thickness or voxel size. Additional sequences are used by 22 centers. MRI postprocessing methods are used in 16 centers. Interictal positron emission tomography (PET) is available in 22 centers; all using 18F-fluorodeoxyglucose (FDG). Seventeen centers perform PET postprocessing. Single-photon emission computed tomography (SPECT) is used by 19 centers, of which 15 perform postprocessing. Four centers perform neither PET nor SPECT in children. Seven centers apply magnetoencephalography (MEG) source localization, and nine apply electroencephalography (EEG) source localization. Fourteen combinations of inverse methods and volume conduction models are used. We report a large variation in the presurgical diagnostic workup among epilepsy surgery centers across Europe. This diversity underscores the need for high-quality systematic reviews, evidence-based recommendations, and harmonization of available diagnostic presurgical methods. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

  6. Perception versus reality: elucidating motivation and expectations of current fellowship council minimally invasive surgery fellows. (United States)

    Watkins, Jeffrey R; Pryor, Aurora D; Truitt, Michael S; Jeyarajah, D Rohan


    The aim of our study is to determine minimally invasive trainee motivation and expectations for their respective fellowship. Minimally Invasive Surgery (MIS) is one of the largest non-ACGME post-residency training pathways though little is known concerning the process of residents choosing MIS as a fellowship focus. As general surgery evolves, it is important to understand resident motivation in order to better prepare them for a surgical career. A survey invitation was sent to current trainees in the Minimally Invasive and related pathways through the Fellowship Council. The participants were asked to complete a web-based questionnaire detailing demographics, experiences preparing for fellowship, motivation in choosing an MIS fellowship, and expectations for surgical practice after fellowship. Sixty-seven MIS trainees responded to the survey out of 151 invitations (44%). The Fellowship Council website, mentors, and other fellows were cited as the most helpful source of information when applying for fellowship. Trainees were active in surgical societies as residents, with 78% having membership in the ACS and 60% in SAGES. When deciding to pursue MIS as a fellowship, the desire to increase laparoscopic training was the most important factor. The least important reasons cited were lack of laparoendoscopic training in residency and desire to learn robotic surgery. The majority of trainees believed their laparoscopic skill set was above that of their residency cohort (81%). The most desired post-fellowship employment model is hospital employee (46%) followed by private practice (27%). Most fellows plan on marketing themselves as MIS surgeons (90%) or General Surgeons (78%) when in practice. Residents who choose MIS as a fellowship have a strong exposure to laparoscopy and want to become specialists in their field. Mentors and surgical societies including ACS and SAGES play a vital role in preparing residents for fellowship and practice.

  7. Impact of novel techniques on minimally invasive adrenal surgery: trends and outcomes from a contemporary international large series in urology. (United States)

    Pavan, Nicola; Autorino, Riccardo; Lee, Hak; Porpiglia, Francesco; Sun, Yinghao; Greco, Francesco; Jeff Chueh, S; Han, Deok Hyun; Cindolo, Luca; Ferro, Matteo; Chen, Xiang; Branco, Anibal; Fornara, Paolo; Liao, Chun-Hou; Miyajima, Akira; Kyriazis, Iason; Puglisi, Marco; Fiori, Cristian; Yang, Bo; Fei, Guo; Altieri, Vincenzo; Jeong, Byong Chang; Berardinelli, Francesco; Schips, Luigi; De Cobelli, Ottavio; Chen, Zhi; Haber, Georges-Pascal; He, Yao; Oya, Mototsugu; Liatsikos, Evangelos; Brandao, Luis; Challacombe, Benjamin; Kaouk, Jihad; Darweesh, Ithaar


    To evaluate contemporary international trends in the implementation of minimally invasive adrenalectomy and to assess contemporary outcomes of different minimally invasive techniques performed at urologic centers worldwide. A retrospective multinational multicenter study of patients who underwent minimally invasive adrenalectomy from 2008 to 2013 at 14 urology institutions worldwide was included in the analysis. Cases were categorized based on the minimally invasive adrenalectomy technique: conventional laparoscopy (CL), robot-assisted laparoscopy (RAL), laparoendoscopic single-site surgery (LESS), and mini-laparoscopy (ML). The rates of the four treatment modalities were determined according to the year of surgery, and a regression analysis was performed for trends in all surgical modalities. Overall, a total of 737 adrenalectomies were performed across participating institutions and included in this analysis: 337 CL (46 % of cases), 57 ML (8 %), 263 LESS (36 %), and 80 RA (11 %). Overall, 204 (28 %) operations were performed with a retroperitoneal approach. The overall number of adrenalectomies increased from 2008 to 2013 (p = 0.05). A transperitoneal approach was preferred in all but the ML group (p Asia and South America reported the highest rate in LESS procedures, and RAL was adopted to larger extent in the USA. LESS had the fastest increase in utilization at 6 %/year. The rate of RAL procedures increased at slower rates (2.2 %/year), similar to ML (1.7 %/year). Limitations of this study are the retrospective design and the lack of a cost analysis. Several minimally invasive surgical techniques for the management of adrenal masses are successfully implemented in urology institutions worldwide. CL and LESS seem to represent the most commonly adopted techniques, whereas ML and RAL are growing at a slower rate. All the MIS techniques can be safely and effectively performed for a variety of adrenal disease.

  8. Recent Trends in Publications of US and European Directors in Vascular Surgery. (United States)

    Aurshina, Afsha; Hingorani, Anil; Hingorani, Amrit; Marks, Natalie; Ascher, Enrico


    We hypothesized that there may be significant differences between academic productivity of the vascular training programs in the United States (US) and Europe. In an effort to explore this theory, we reviewed the number of vascular publications listed in PubMed from 2010 to 2015 for US and European directors in vascular surgery. The list of program directors from the Association of Program Directors in Vascular Surgery (APDVS) and the European Union of Medical Specialists (EUMS) were queried for the names of the directors of vascular surgical training programs at the end of 2015. PubMed listed 5,474 citations published from 2010 to 2015. Three thousand five hundred sixty-one were from Europe while 1,912 were from the US. UK and German programs did not list their directors' names in the EUMS website and were thus not included in the European data. The average number of citations in PubMed per program director was 2.36 per year. In Europe, each of the 273 program directors averaged 2.17 publications per year, whereas each of the 114 US program directors averaged 2.80 publications per year (P = 0.37). Journal of Vascular Surgery (JVS) publications made up 24.0% (12.7% in Europe and 45.0% in the US). In the US, the top third produced 69% of the publications and 77% of the JVS publications, whereas in Europe, the top third produced 87% of the publications and 98% of the JVS publications. In the US, 5 program directors (4.4%) had no publications and 21 (18.4%) had no JVS publications. In Europe, 82 program directors (30.0%) had no publications, whereas 180 (65.9%) had no JVS publications. Abstracts were categorized by topic for comparison. In both Europe and the US, the top third produced more than two-thirds of the publications, with the disparity being even more pronounced in Europe where the top third produced almost 90% of the total publications. Comparing the topics of the publications from Europe and the US, it was found that the US program directors published a

  9. Investments of Banks in Securities: the Essence and Development Trends under Current Conditions

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    Ekaterina Vladimirovna Mazikova


    Full Text Available The implementation of modern banking activities involves the realization of investments. Investment is a complex discussion economic category, characterized by a number of features. The types and forms of investment are manifold and can be transformed with account of the state of the economy and the level of development of industrial relations. The faster growth of the financial sector in the economy has stipulated the development of financial investment. Banks as financial and lending institutions actively make financial investments in securities. Banks’ investment in securities pursues a number of purposes which determine the selection of securities for investment and their quality. The article identified the targets of bank investments in securities and their development trends under current conditions on the basis of the analysis of the actual data for 2010–2014. Negative revaluation and the actual decrease in the value of corporate securities of Russian issuers reduce their commercial appeal. Banks refuse to speculate on the stock market in favor of the securities that ensure liquidity. Banks’ investments aim to purchasing securities from the Lombard List of the Bank of Russia in order to obtain loans and participate in the repo transactions. Thus, during the analyzed period, banks’ investments in securities transformed from systemically important assets that generate substantial profit into the mechanism that provides liquidity. It should be noted that a significant part of investment resources of Russian banks services the debt obligations of Russia’s Government. The article also identified a trend of banks’ increasing investment in the participation portfolios of subsidiaries and associated joint stock companies. The official data of the Central Bank of the Russian Federation (Bank of Russia [15], and the Federal State Statistics Service [14] were used as the information base for the study

  10. Nutrition situation in Latin America and the Caribbean: current scenario, past trends, and data gaps

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    Luis Galicia

    Full Text Available ABSTRACT Objective To determine the current nutritional status in Latin America and the Caribbean (LAC and identify data gaps and trends in nutrition surveillance. Methods A systematic Internet search was conducted to identify official sources that allowed for monitoring of LAC countries’ nutritional status, including progress toward World Health Organization Global Nutrition Targets 2025. Reports from national nutrition surveillance systems and reports on nationally representative surveys were collected and collated to 1 analyze nutritional status, based on life-course anthropometric indicators and biomarkers, and 2 identify gaps in data availability and trends in nutritional deficiencies. Information on iron, vitamin A, iodine, folate, and vitamin B12 deficiency was also collected and collated. Results Twenty-two of the 46 LAC countries/territories (48% had information on undernutrition (stunting, underweight, and wasting in children under 5 years old and women of reproductive age (WRA. Seventeen countries (38% had information on anemia in children under 5 years old and WRA, and 12 (27% had information on anemia in pregnant women. Although overall nutritional status has improved in the past few decades in all countries in the region, some LAC countries still had a high prevalence of stunting and anemia in children and WRA. Overweight affected at least 50% of WRA in nine countries with available data, and was increasing in children. Data for school-age children, adolescents, adult males, and older adults were scarce in the region. Conclusions Overall nutritional status has improved in the LAC countries with available information, but more efforts are needed to scale up nutrition-sensitive and nutrition-specific interventions to tackle malnutrition in all its forms, as stunting, anemia, and vitamin A deficiency are still a public health problem in many countries, and overweight is an epidemic. Nutrition information systems are weak in the

  11. Current trends in local antibacterial therapy of periprosthetic infection and osteomyelitis

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    S. A. Bozhkova


    Full Text Available The rational use of antibiotics in the treatment of orthopedic infection still presents a significant problem. Local antibiotic delivery systems enable to achieve effective concentrations of drugs in the focus of bone infection without the development of toxicity. It is the important accompaniment to systemic antibiotics in the treatment of periprosthetic infection and osteomyelitis. The data collected through the PubMed and eLIBRARY databases (http://www.ncbi.nlm., 1995-2015;, 2005-2015 years present the information about bone substitutes used for local antibiotic therapy in scientific investigations and in clinical practice. The information is submitted in accordance with the groups of materials: cements based on polymethylmethacrylate, bone grafts, demineralized bone matrix, bioceramics, natural and synthetic polymers, combined antibiotic delivery systems. The majority of these materials have only been studied experimentally and only a limited range of them is registered for use in clinical practice. Informing orthopedic surgeons about current methods of local antibiotic use is the key to the development of a modern integrated approach to the therapy of infectious complications after orthopedic surgery.

  12. Current status of cardiovascular surgery in Japan 2013 and 2014: A report based on the Japan Cardiovascular Surgery Database. 2: Congenital heart surgery. (United States)

    Hirata, Yasutaka; Hirahara, Norimichi; Murakami, Arata; Motomura, Noboru; Miyata, Hiroaki; Takamoto, Shinichi


    We analyzed the mortality and morbidity of congenital heart surgery in Japan using the Japan Cardiovascular Surgery Database (JCVSD). Data regarding congenital heart surgery performed between January 2013 and December 2014 were obtained from JCVSD. The 20 most frequent procedures were selected and the mortality rates and major morbidities were analyzed. The mortality rates of atrial septal defect repair and ventricular septal defect repair were less than 1%, and the mortality rates of tetralogy of Fallot repair, complete atrioventricular septal defect repair, bidirectional Glenn, and total cavopulmonary connection were less than 2%. The mortality rates of the Norwood procedure and total anomalous pulmonary venous connection repair were more than 10%. The rates of unplanned reoperation, pacemaker implantation, chylothorax, deep sternal infection, phrenic nerve injury, and neurological deficit were shown for each procedure. Using JCVSD, the national data for congenital heart surgery, including postoperative complications, were analyzed. Further improvements of the database and feedback for clinical practice are required.

  13. Trends in utilization and outcomes of bariatric surgery in obese people with and without type 2 diabetes in Spain (2001-2010). (United States)

    Lopez-de-Andres, Ana; Jiménez-García, Rodrigo; Hernández-Barrera, Valentin; Gil-de-Miguel, Angel; Jiménez-Trujillo, M Isabel; Carrasco-Garrido, Pilar


    Bariatric surgery is associated with a significant improvement in glucose control and even diabetes remission. There are no studies investigating national trends in the use of bariatric surgery in people with type 2 diabetes. We examine trends in the use of bariatric surgery in patients with and without type 2 diabetes between 2001 and 2010 in Spain. We identified patients who underwent bariatric surgery using national hospital discharge data. Discharges were grouped by diabetes status. Incidence of discharges due to bariatric surgery were calculated and stratified by diabetes status, procedure and year. We calculated length of stay (LOS) and in-hospital mortality (IHM). From 2001 to 2010 13,038 bariatric surgery procedures were performed. Over the study period 23.6% (n=3080) of all patients undergoing bariatric procedure had DM as a co-diagnosis. This prevalence increased from 17.3% in 2001 to 25.5% in 2010. LOS and IHM were similar among patients with and without type 2 diabetes. The proportion of subjects with type 2 diabetes among bariatric surgery patient has increased over time, in part due to an increase in the use of laparoscopic techniques. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  14. Current State of Laparoscopic Colonic Surgery in Austria: A National Survey. (United States)

    Klugsberger, Bettina; Haas, Dietmar; Oppelt, Peter; Neuner, Ludwig; Shamiyeh, Andreas


    Several studies have demonstrated that laparoscopic colonic resection has significant benefits in comparison with open approaches in patients with benign and malignant disease. The proportion of colonic and rectal resections conducted laparoscopically in Austria is not currently known; the aim of this study was to evaluate the current status of laparoscopic colonic surgery in Austria. A questionnaire was distributed to all general surgical departments in Austria. In collaboration with IMAS, an Austrian market research institute, an online survey was used to identify laparoscopic and open colorectal resections performed in 2013. The results were compared with data from the National Hospital Morbidity Database (NHMD), in which administrative in-patient data were also collected from all general surgical departments in Austria in 2013. Fifty-three of 99 surgical departments in Austria responded (53.5%); 4335 colonic and rectal resections were carried out in the participating departments, representing 50.5% of all NHMD-recorded colorectal resections (n = 8576) in Austria in 2013. Of these 4335 colonic and rectal resections, 2597 (59.9%) were carried out using an open approach, 1674 (38.6%) were laparoscopic, and an exact classification was not available for 64 (1.5%). Among the NHMD-recorded colonic and rectal resections, 6342 (73.9%) were carried out with an open approach, and 2234 (26.1%) were laparoscopic. The proportion of colorectal resections that are carried out laparoscopically is low (26.1%). Technical challenges and a learning curve with a significant number of cases may be reasons for the slow adoption of laparoscopic colonic surgery.

  15. Trends

    International Nuclear Information System (INIS)

    Lawyer, L.C.


    This paper reports that the oil industry has been through major changes in the past 10 years. We have seen an activity high in the early 1980s, which was stimulated by oil price predictions that went as high as $70/bbl. By 1985 we saw oil prices plunge to $8/bbl, causing numerous reorganizations and mergers. Today we find ourselves in a business environment in which large oil companies are reducing their explorative budgets in the mature basins of the U.S. and Canada in favor of more-attractive opportunities in frontier plays, usually overseas. These same companies are taking a hard look at their existing fields with the objective of increasing operating efficiency by sales, trades, and purchases. Nonperforming properties are sold or exchanged for properties that are within the supported infrastructure. Before a property can be considered for divestment, it must be evaluated on the basis of current reserves and potential for additional reserves. This process of restructuring producing properties is often referred to as property enhancement. The result of property enhancement is the identification of core producing properties. Resources and efforts are then focused on the core properties to maximize production and reserves. This is today's business environment. Our challenge is to provide value-added technology that will support exploration and production business objectives. Expenditures for technology should be treated like any other expenditures, with calculations of expected payouts and anticipated rates of return. An evaluation of risk should also be made. In other words, solid economic justification is required. This justification is particularly true in production, where expenditures and results are more closely coupled

  16. Trends in isolated lumbar spinal stenosis surgery among working US adults aged 40-64 years, 2010-2014. (United States)

    Raad, Micheal; Donaldson, Callum J; El Dafrawy, Mostafa H; Sciubba, Daniel M; Riley, Lee H; Neuman, Brian J; Kebaish, Khaled M; Skolasky, Richard L


    OBJECTIVE Recommendations for the surgical treatment of isolated lumbar spinal stenosis (LSS) (i.e., in the absence of concomitant scoliosis or spondylolisthesis) are unclear. The aims of this study were to investigate trends in the surgical treatment of isolated LSS in US adults and determine implications for outcomes. METHODS The authors analyzed inpatient and outpatient claims from the Truven Health Analytics MarketScan Commercial Claims and Encounters Database for 20,279 patients aged 40-64 years who underwent surgery for LSS between 2010 and 2014. Only patients with continuous 12-month insurance coverage after surgery were included. The rates of decompression with arthrodesis versus decompression only and of simple (1- or 2-level, single-approach) versus complex (> 2-level or combined-approach) arthrodesis were analyzed by year and geographic region. These trends were further analyzed with respect to complications, length of hospital stay, payments made to the hospital, and patient discharge status. Statistical significance was set at p < 0.05. RESULTS The proportion of patients who underwent decompression with arthrodesis compared with decompression only increased significantly and linearly from 2010 to 2014 (OR 1.08; 95% CI 1.06-1.10). Arthrodesis was more likely to be complex rather than simple with each subsequent year (OR 1.4; 95% CI 1.33-1.49). This trend was accompanied by an increased likelihood of postoperative complications (OR 1.11; 95% CI 1.02-1.21), higher costs (payments increased by a mean of US$1633 per year; 95% CI 1327-1939), and greater likelihood of being discharged to a skilled nursing facility as opposed to home (OR 1.11; 95% CI 1.03-1.20). The South and Midwest regions of the US had the highest proportions of patients undergoing arthrodesis (48% and 42%, respectively). The mean length of hospital stay did not change significantly (p = 0.324). CONCLUSIONS From 2010 to 2014, the proportion of adults undergoing decompression with


    Directory of Open Access Journals (Sweden)

    Z. A. Mamedyarov


    Full Text Available Purpose: the purpose of this article is to study the current state of the pharmaceutical industry in Russia, to identify trends in Russian pharmaceutical market, and to provide preliminary analysis of the state support policy for pharmaceuticals in Russia, focusing on the federal target program "Pharma-2020".Methods: the study is based on a quantitative study of the characteristics and trends of the Russian pharmaceutical market. The emphasis was put on the period 2008–2017. The volume of the market, the structure of imports and exports are considered, and expenditures under the federal program "Pharma-2020" are studied. A qualitative comparative comparison with the tendencies of the global development of the industry is conducted and recommendations are made on further stimulating the growth of the pharma industry in Russia.Results: in the past 5 years, the pharmaceutical industry in Russia did receive special attention from the government, significant funds have been allocated for to support domestic producers, and import substitution policies have been launched. Financial results of the industry show slight improvement in a number of indicators: the market share of domestic medicines is growing, the generics production increased, production standards became tighter controlled. Nevertheless, Russia remains on the periphery of the world pharmaceutical science, import retains two thirds of the market share by value, while innovative novel drugs are now launched primarily by MNEs from the US and the EU.Conclusions and relevance: the challenges and development factors of Russia's pharmaceutical industry identified in this research require effective regulatory tools. First of all, it is necessary to reduce the gap between Russia and the developed countries in the R&D standards and their market implementation. Statistical data has showed the progress in the production of drugs from the VED list (Vital and Essential Drugs, but it is necessary to

  18. Analysis of current trends on the Czech food market with a focus on a healthy lifestyle.


    Bartůňková, Eva


    The thesis of this work is to map current trends on the Czech food market with focus on a healthy lifestyle. In particular, it focuses on foodstuff labelling and GDA labels. The paper begins by surveying the development of the healthy lifestyle trend, as well as the activities of the Federation of the Food and Drink Industries of the Czech Republic involved in a healthy lifestyle; furthermore, the work elaborates on segmentation of the consumer and evaluation of a healthy lifestyle, obesity a...

  19. Impact of the Economic Downturn on Elective Lumbar Spine Surgery in the United States: A National Trend Analysis, 2003 to 2013. (United States)

    Bernstein, David N; Brodell, David; Li, Yue; Rubery, Paul T; Mesfin, Addisu


    Retrospective database analysis. The impact of the 2008-2009 economic downtown on elective lumbar spine surgery is unknown. Our objective was to investigate the effect of the economic downturn on the overall trends of elective lumbar spine surgery in the United States. The Nationwide Inpatient Sample (NIS) was used in conjunction with US Census and macroeconomic data to determine historical trends. The economic downturn was defined as 2008 to 2009. Codes from the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), were used in order to identify appropriate procedures. Confidence intervals were determined using subgroup analysis techniques. From 2003 to 2012, there was a 19.8% and 26.1% decrease in the number of lumbar discectomies and laminectomies, respectively. Over the same time period, there was a 56.4% increase in the number of lumbar spinal fusions. The trend of elective lumbar spine surgeries per 100 000 persons in the US population remained consistent from 2008 to 2009. The number of procedures decreased by 4.5% from 2010 to 2011, 7.6% from 2011 to 2012, and 3.1% from 2012 to 2013. The R 2 value between the number of surgeries and the S&P 500 Index was statistically significant ( P ≤ .05). The economic downturn did not affect elective lumbar fusions, which increased in total from 2003 to 2013. The relationship between the S&P 500 Index and surgical trends suggests that during recessions, individuals may utilize other means, such as insurance, to cover procedural costs and reduce out-of-pocket expenditures, accounting for no impact of the economic downturn on surgical trends. These findings can assist multiple stakeholders in better understanding the interconnectedness of macroeconomics, policy, and elective lumbar spine surgery trends.

  20. Anesthesia and Intensive care implications for pituitary surgery: Recent trends and advancements

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa


    Full Text Available The advancements in neuro-endocrine surgical interventions have been well supported by similar advancements in anesthesiology and intensive care. Surgery of the pituitary tumor poses unique challenges to the anesthesiologists and the intensivists as it involves the principles and practices of both endocrine and neurosurgical management. A multidisciplinary approach involving the endocrine surgeon, neurosurgeon, anesthesiologist, endocrinologist and intensivist is mandatory for a successful surgical outcome. The focus of pre-anesthetic checkup is mainly directed at the endocrinological manifestations of pituitary hypo or hyper-secretion as it secretes a variety of essential hormones, and also any pathological state that can cause imbalance of pituitary secretions. The pathophysiological aspects associated with pituitary tumors mandate a thorough airway, cardiovascular, neurologic and endocrinological assessment. A meticulous preoperative preparation and definite plans for the intra-operative period are the important clinical components of the anesthetic strategy. Various anesthetic modalities and drugs can be useful to provide a smooth intra-operative period by countering any complication and thus providing an uneventful recovery period.

  1. Online Teaching Tool for Sinus Surgery: Trends toward Mobile and Global Education

    Directory of Open Access Journals (Sweden)

    George K. Koch DMD


    Full Text Available Objective Online resources may provide an ideal forum for expert presentation of surgical techniques. The purpose of this study was to investigate utilization patterns of a sinus surgery website, , to gain insight into the needs of viewers. Study Design Retrospective analysis. Setting Surgical teaching website. Subjects and Methods The website’s anonymized analytic database was queried from 2009 to 2014. Quantified data included user demographics, geographic location, viewing device, page visits, and time spent on the website. Results A total of 428,691 website pages were viewed during the study period. Growth in viewership was observed each successive year since the site was launched. The mean time spent viewing webpages was 96.1 seconds for desktop computer users, 98.0 for tablet users, and 103.8 for mobile users. The percentage of mobile devices used to view the site increased significantly between 2009 and 2014 (2.1% vs 25.4%, respectively; P < .0001. The website’s viewership expanded globally, with a significant increase in site views from outside North America over this same period (18.4% vs 51.7%, P < .0001. Conclusion The observed increase in global participation and mobile device usage may reflect new areas of growth for surgical education.

  2. Trends in Percutaneous Coronary Intervention and Coronary Artery Bypass Surgery in Korea

    Directory of Open Access Journals (Sweden)

    Heeyoung Lee


    Full Text Available Background: Coronary angioplasty has been replacing coronary artery bypass grafting (CABG because of the relative advantage in terms of recovery time and noninvasiveness of the procedure. Compared to other Organization for Economic Cooperation and Development (OECD countries, Korea has experienced a rapid increase in coronary angioplasty volumes. Methods: We analyzed changes in procedure volumes of CABG and of percutaneous coronary intervention (PCI from three sources: the OECD Health Data, the National Health Insurance Service (NHIS surgery statistics, and the National Health Insurance claims data. Results: We found the ratio of procedure volume of PCI to that of CABG per 100,000 population was 19.12 in 2014, which was more than triple the OECD average of 5.92 for the same year. According to data from NHIS statistics, this ratio was an increase from 11.4 to 19.3 between 2006 and 2013. Conclusion: We found that Korea has a higher ratio of total procedure volumes of PCI with respect to CABG and also a more rapid increase of volumes of PCI than other countries. Prospective studies are required to determine whether this increase in absolute volumes of PCI is a natural response to a real medical need or representative of medical overuse.

  3. Current Status and Trend of Internet and E-Commerce Market in Korea

    Institute of Scientific and Technical Information of China (English)

    LEE Hongjoo; KIM Jongwoo; PARK Sungjoo


    After the remarkable increase of Internet users and broadband Internet subscribers at the end of the 20th century, the size of Korean Internet and e-commerce market steadily increased but the growth rate has been either stagnant or decreased. Trends of Korean Internet and e-commerce market are summarized in this paper the trends on Internet usage are introduced. Trends of online games, blogs and wireless Internet are introduced. The trends of Korean Internet market may have implications for China and Japan.

  4. Current status and new trends in the methodology of safety assessment for near surface disposal facilities

    International Nuclear Information System (INIS)

    Ilie, Petre; Didita, Liana; Danchiv, Alexandru


    The main goal of this paper is to present the status of the safety assessment methodology at the end of IAEA CRP 'Application of Safety Assessment Methodology for Near-Surface Radioactive Waste Disposal Facilities (ASAM)', and the new trends outlined at the launch of the follow-up project 'Practical Implementation of Safety Assessment Methodologies in a Context of Safety Case of Near-Surface Facilities (PRISM)'. Over the duration of the ASAM project, the ISAM methodology was confirmed as providing a good framework for conducting safety assessment calculations. In contrast, ASAM project identified the limitations of the ISAM methodology as currently formulated. The major limitations are situated in the area of the use of safety assessment for informing practical decisions about alternative waste and risk management strategies for real disposal sites. As a result of the limitation of the ISAM methodology, the PRISM project is established as an extension of the ISAM and ASAM projects. Based on the outcomes of the ASAM project, the main objective of the PRISM project are: 1 - to develop an overview of what constitutes an adequate safety case and safety assessment with a view to supporting decision making processes; 2 - to provide practical illustrations of how the safety assessment methodology could be used for addressing some specific issues arising from the ASAM project and national cases; 3 - to support harmonization with the IAEA's international safety standards. (authors)

  5. Evaluation of current trends and recent development in insulin therapy for management of diabetes mellitus. (United States)

    Nawaz, Muhammad Sarfraz; Shah, Kifayat Ullah; Khan, Tahir Mehmood; Rehman, Asim Ur; Rashid, Haroon Ur; Mahmood, Sajid; Khan, Shahzeb; Farrukh, Muhammad Junaid


    Diabetes mellitus is a major health problem in developing countries. There are various insulin therapies to manage diabetes mellitus. This systematic review evaluates various insulin therapies for management of diabetes mellitus worldwide. This review also focuses on recent developments being explored for better management of diabetes mellitus. We reviewed a number of published articles from 2002 to 2016 to find out the appropriate management of diabetes mellitus. The paramount parameters of the selected studies include the insulin type & its dose, type of diabetes, duration and comparison of different insulin protocols. In addition, various newly developed approaches for insulin delivery with potential output have also been evaluated. A great variability was observed in managing diabetes mellitus through insulin therapy and the important controlling factors found for this therapy include; dose titration, duration of insulin use, type of insulin used and combination therapy of different insulin. A range of research articles on current trends and recent advances in insulin has been summarized, which led us to the conclusion that multiple daily insulin injections or continuous subcutaneous insulin infusion (insulin pump) is the best method to manage diabetes mellitus. In future perspectives, development of the oral and inhalant insulin would be a tremendous breakthrough in Insulin therapy. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  6. Metal-enhanced luminescence: Current trend and future perspectives- A review

    International Nuclear Information System (INIS)

    Ranjan, Rajeev; Esimbekova, Elena N.; Kirillova, Maria A.; Kratasyuk, Valentina A.


    Optically enhanced biosensing strategies are prerequisites for developing miniature and highly sensitive multiplexed analytical platforms. Such smart biosensing systems are highly promising for use in the fields of biomedicine and environmental monitoring. Optical signal enhancement during bioassays is attributed to the complex opto-electronic interactions of incoming photonic signals at the nanomaterial interface. Research on the use of metals other than gold and silver for such purposes tends to extend the spectral window to observe luminescence enhancement effects. Such manifold increase in luminescence may be explained by the principles of plasmon coupling, directional emission led high collection efficiency, Rayleigh scattering and related opto-electronic events. The present review begins with a mechanistic description of important phenomena associated with metal-induced luminescence enhancement, particularly focusing on the origin of metal-enhanced luminescence. This review further analyses the hybrid nanostructure capabilities responsible for maintaining unique opto-electronic properties during bio-functionalisation. Current research trends in this area, future scope of this field for designing useful bioassays and concluding remarks are then discussed. - Highlights: • Nanomaterials significantly differ from their bulk counterparts. • Strong and pronounced photophysical effects at the metal surface provide opportunities for designing novel biosensors. • Metal-enhanced luminescence increases the quantum yield of luminescent reactions. • Under optimal conditions, plasmon coupling enhances the optical effects at the nanometal surface.

  7. Metal-enhanced luminescence: Current trend and future perspectives- A review

    Energy Technology Data Exchange (ETDEWEB)

    Ranjan, Rajeev [Laboratory of Bioluminescent Biotechnologies, Department of Biophysics, Institute of Fundamental Biology and Biotechnology, Siberian Federal University, 79 Svobodny Prospect, Krasnoyarsk 660041 (Russian Federation); Esimbekova, Elena N., E-mail: [Laboratory of Bioluminescent Biotechnologies, Department of Biophysics, Institute of Fundamental Biology and Biotechnology, Siberian Federal University, 79 Svobodny Prospect, Krasnoyarsk 660041 (Russian Federation); Institute of Biophysics SB RAS, Federal Research Center “Krasnoyarsk Science Center SB RAS”, Akademgorodok 50/50, Krasnoyarsk 660036 (Russian Federation); Kirillova, Maria A. [Laboratory of Bioluminescent Biotechnologies, Department of Biophysics, Institute of Fundamental Biology and Biotechnology, Siberian Federal University, 79 Svobodny Prospect, Krasnoyarsk 660041 (Russian Federation); Kratasyuk, Valentina A. [Laboratory of Bioluminescent Biotechnologies, Department of Biophysics, Institute of Fundamental Biology and Biotechnology, Siberian Federal University, 79 Svobodny Prospect, Krasnoyarsk 660041 (Russian Federation); Institute of Biophysics SB RAS, Federal Research Center “Krasnoyarsk Science Center SB RAS”, Akademgorodok 50/50, Krasnoyarsk 660036 (Russian Federation)


    Optically enhanced biosensing strategies are prerequisites for developing miniature and highly sensitive multiplexed analytical platforms. Such smart biosensing systems are highly promising for use in the fields of biomedicine and environmental monitoring. Optical signal enhancement during bioassays is attributed to the complex opto-electronic interactions of incoming photonic signals at the nanomaterial interface. Research on the use of metals other than gold and silver for such purposes tends to extend the spectral window to observe luminescence enhancement effects. Such manifold increase in luminescence may be explained by the principles of plasmon coupling, directional emission led high collection efficiency, Rayleigh scattering and related opto-electronic events. The present review begins with a mechanistic description of important phenomena associated with metal-induced luminescence enhancement, particularly focusing on the origin of metal-enhanced luminescence. This review further analyses the hybrid nanostructure capabilities responsible for maintaining unique opto-electronic properties during bio-functionalisation. Current research trends in this area, future scope of this field for designing useful bioassays and concluding remarks are then discussed. - Highlights: • Nanomaterials significantly differ from their bulk counterparts. • Strong and pronounced photophysical effects at the metal surface provide opportunities for designing novel biosensors. • Metal-enhanced luminescence increases the quantum yield of luminescent reactions. • Under optimal conditions, plasmon coupling enhances the optical effects at the nanometal surface.

  8. Current trends of antimicrobial susceptibility of typhoidal salmonellae isolated at tertiary care hospital

    International Nuclear Information System (INIS)

    Zehra, N.M.; Irfan, F.


    To determine the current trend of antimicrobial susceptibility of typhoidal Salmonellae. Study Design: Descriptive cross-sectional study. Place and Duration of Study: The study was carried out in the Department of Microbiology, PNS Shifa Hospital, Karachi, from January 2014 to December 2015. Methodology: Blood culture samples received from the wards and outpatient departments were included. Isolates of Salmonella were dealt with standard microbiological procedures. The antimicrobial sensitivity against the typhoidal Salmonellae was determined using Kirby-Bauer disc diffusion method as per the guidelines of Clinical and Laboratory Standards Institute (2013). Results: A total of 460 typhoidal Salmonellae were isolated; out of which 270 were Salmonella typhi and 190 were Salmonella paratyphiA. The percentage of MDR isolates of S. typhi was 57% and that of S. paratyphiA was 42%. None of the isolates were resistant to ceftriaxone, while sensitivity to ciprofloxacin (07% and 0% for S. typhiand S. paratyphiA, respectively) was very low. Conclusion: There is high percentage of MDR isolates of typhoidal Salmonellae in our region. The antimicrobial sensitivity of typhoidal Salmonellae to conventional agent has not improved enough to recommend their empirical use. There is almost complete resistance to fluoroquinolones as well, leaving very limited available treatment options. (author)

  9. Quality management in European screening laboratories in blood establishments: A view of current approaches and trends. (United States)

    Pereira, Paulo; Westgard, James O; Encarnação, Pedro; Seghatchian, Jerard; de Sousa, Gracinda


    The screening laboratory has a critical role in the post-transfusion safety. The success of its targets and efficiency depends on the management system used. Even though the European Union directive 2002/98/EC requires a quality management system in blood establishments, its requirements for screening laboratories are generic. Complementary approaches are needed to implement a quality management system focused on screening laboratories. This article briefly discusses the current good manufacturing practices and good laboratory practices, as well as the trends in quality management system standards. ISO 9001 is widely accepted in some European Union blood establishments as the quality management standard, however this is not synonymous of its successful application. The ISO "risk-based thinking" is interrelated with the quality risk-management process of the EuBIS "Standards and criteria for the inspection of blood establishments". ISO 15189 should be the next step on the quality assurance of a screening laboratory, since it is focused on medical laboratory. To standardize the quality management systems in blood establishments' screening laboratories, new national and European claims focused on technical requirements following ISO 15189 is needed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Lifelong education for older adults in Malta: Current trends and future visions (United States)

    Formosa, Marvin


    With European demographic developments causing a decline of the available workforce in the foreseeable future and the unsustainability of dominant pay-as-you-go pension systems (where contributions from the current workforce sustain pensioners), governments need to come up with strategies to deal with this upcoming challenge and to adjust their policies. Based on a study carried out between September 2009 and May 2010, this article evaluates the policies guiding late-life education in Malta, as well as the local plethora of learning opportunities for older adult education, and participation rates. The Maltese government is committed to supporting the inclusion of older persons (aged 60+) in lifelong education policies and programmes, to the extent that local studies have uncovered a recent rise in the overall participation of older adults in formal, non-formal and informal areas of learning. While the present and future prospects for late-life education in Malta seem promising, a critical scrutiny of present ideologies and trends finds the field to be no more than seductive rhetoric. Though the coordination of late-life education in Malta does result in various social benefits to older learners and Maltese society in general, it also occurs within five intersecting lines of inequality - namely an economic rationale, elitism, gender bias, the urban-rural divide and third ageism. This article ends by proposing policy recommendations for the future of late-life education.

  11. Gender trends in dental practice patterns. A review of current U.S. literature. (United States)

    Dolan, T A


    This paper reviews three recent reports of national gender trends in dental practice patterns. Although the three independent cross-sectional studies were conducted at different points in time, used different sampling strategies, and used similar but independent survey instruments, findings were consistent across studies. In summary: Women dentists are less likely to be married and have fewer children. Women are more likely to assume child rearing and household responsibilities. Women are less likely to be practice owners. Women worked slightly fewer hours per week and weeks per year, and were more likely to take a leave of absence for illness or child rearing. However, women dentists demonstrate a far greater professional work commitment than was previously reported in the literature. Women earn significantly less income from the practice of dentistry, even after controlling for age, practice ownership, hours worked per week, and other personal characteristics. The most current "Gender Wage Gap" estimates range from 57.7% for specialists to 75.4% for general practitioners (8). delta.

  12. Current status of food irradiation in the world. Trend in Asia

    International Nuclear Information System (INIS)

    Kume, Tamikazu


    This review describes the current status of food irradiation in the world and particularly, its trends in Asia, based on the report of the economic scale investigation on the irradiation in United States and Japan (2001) and on the information of 12th International Meeting on Radiation Processing in France in 2001 and on personal communications. International Consultative Group on Food Irradiation promotes its activities of irradiation globally and 46 countries are affiliated. Food irradiation is allowed in 52 countries. In 1999, 257,000 t of food is irradiated in the world, of which 1/3 is due to spice. The facilities for the irradiation have such sources as 60 Co and 137 Cs γ-rays, electron beam of <10 MeV and X-ray with <5 MeV. Detection methods of irradiated foods are summarized by the project of Analytical Detection Methods for Irradiation Treatment of Foods. The US is the most advanced country in the irradiation and, in Japan, only irradiation of potato is permitted. The detailed present status is also described of Bangladesh, China (the irradiation is most widely conducted in the world), India, Indonesia, Korea, Malaysia, Thailand and Vietnam. Recently Australia and New Zealand have started the irradiation. (K.H.)


    Directory of Open Access Journals (Sweden)



    Full Text Available In the economy of any country, the auto parts manufacturing sector holds an important percentage in the national automotive industry. The dynamics of sales within it can vary significantly on short term, depending on the automotive market trend. This is also the case of the current situation in Romania, where the effect of the regressive automotive sales evolution will propagate, most probably, with a significant delay for the companies involved in production and trade of auto parts (for both first-assembly manufacture and car maintenance and repair. The statistical data indicate that even though the total volume of vehicles delivered decreased with 7.4% in 2011 as compared to 2010, the total turnover of the companies in the automotive industry increased with 7.8%. The apparent paradox is explained in the present article through the particularities of the demand for spare parts intended for the rolling stock in operation and through the effective organization of the distribution system.

  14. Prevalence of current patterns and predictive trends of multidrug-resistant Salmonella Typhi in Sudan. (United States)

    Elshayeb, Ayman A; Ahmed, Abdelazim A; El Siddig, Marmar A; El Hussien, Adil A


    Enteric fever has persistence of great impact in Sudanese public health especially during rainy season when the causative agent Salmonella enterica serovar Typhi possesses pan endemic patterns in most regions of Sudan - Khartoum. The present study aims to assess the recent state of antibiotics susceptibility of Salmonella Typhi with special concern to multidrug resistance strains and predict the emergence of new resistant patterns and outbreaks. Salmonella Typhi strains were isolated and identified according to the guidelines of the International Standardization Organization and the World Health Organization. The antibiotics susceptibilities were tested using the recommendations of the Clinical Laboratories Standards Institute. Predictions of emerging resistant bacteria patterns and outbreaks in Sudan were done using logistic regression, forecasting linear equations and in silico simulations models. A total of 124 antibiotics resistant Salmonella Typhi strains categorized in 12 average groups were isolated, different patterns of resistance statistically calculated by (y = ax - b). Minimum bactericidal concentration's predication of resistance was given the exponential trend (y = n e x ) and the predictive coefficient R 2  > 0 current antimicrobial drug resistance patterns of community-acquired agents causing outbreaks.

  15. Current trend of annotating single nucleotide variation in humans--A case study on SNVrap. (United States)

    Li, Mulin Jun; Wang, Junwen


    As high throughput methods, such as whole genome genotyping arrays, whole exome sequencing (WES) and whole genome sequencing (WGS), have detected huge amounts of genetic variants associated with human diseases, function annotation of these variants is an indispensable step in understanding disease etiology. Large-scale functional genomics projects, such as The ENCODE Project and Roadmap Epigenomics Project, provide genome-wide profiling of functional elements across different human cell types and tissues. With the urgent demands for identification of disease-causal variants, comprehensive and easy-to-use annotation tool is highly in demand. Here we review and discuss current progress and trend of the variant annotation field. Furthermore, we introduce a comprehensive web portal for annotating human genetic variants. We use gene-based features and the latest functional genomics datasets to annotate single nucleotide variation (SNVs) in human, at whole genome scale. We further apply several function prediction algorithms to annotate SNVs that might affect different biological processes, including transcriptional gene regulation, alternative splicing, post-transcriptional regulation, translation and post-translational modifications. The SNVrap web portal is freely available at Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Mobile Device Trends in Orthopedic Surgery: Rapid Change and Future Implications. (United States)

    Andrawis, John P; Muzykewicz, David A; Franko, Orrin I


    Mobile devices are increasingly becoming integral communication and clinical tools. Monitoring the prevalence and utilization characteristics of surgeons and trainees is critical to understanding how these new technologies can be best used in practice. The authors conducted a prospective Internet-based survey over 7 time points from August 2010 to August 2014 at all nationwide American Council for Graduate Medical Education-accredited orthopedic programs. The survey questionnaire was designed to evaluate the use of devices and mobile applications (apps) among trainees and physicians in the clinical setting. Results were analyzed and summarized for orthopedic surgeons and trainees. During the 48-month period, there were 7 time points with 467, 622, 329, 223, 237, 111, and 134 responses. Mobile device use in the clinical setting increased across all fields and levels of training during the study period. Orthopedic trainees increased their use of Smartphone apps in the clinical setting from 60% to 84%, whereas attending use increased from 41% to 61%. During this time frame, use of Apple/Android platforms increased from 45%/13% to 85%/15%, respectively. At all time points, 70% of orthopedic surgeons believed their institution/hospital should support mobile device use. As measured over a 48-month period, mobile devices have become an ubiquitous tool in the clinical setting among orthopedic surgeons and trainees. The authors expect these trends to continue and encourage providers and trainees to be aware of the limitations and risks inherent with new technology. Copyright 2016, SLACK Incorporated.

  17. A Review of Player Monitoring Approaches in Basketball: Current Trends and Future Directions. (United States)

    Fox, Jordan L; Scanlan, Aaron T; Stanton, Robert


    Fox, JL, Scanlan, AT, and Stanton, R. A review of player monitoring approaches in basketball: current trends and future directions. J Strength Cond Res 31(7): 2021-2029, 2017-Effective monitoring of players in team sports such as basketball requires an understanding of the external demands and internal responses, as they relate to training phases and competition. Monitoring of external demands and internal responses allows coaching staff to determine the dose-response associated with the imposed training load (TL), and subsequently, if players are adequately prepared for competition. This review discusses measures reported in the literature for monitoring the external demands and internal responses of basketball players during training and competition. The external demands of training and competition were primarily monitored using time-motion analysis, with limited use of microtechnology being reported. Internal responses during training were typically measured using hematological markers, heart rate, various TL models, and perceptual responses such as rating of perceived exertion (RPE). Heart rate was the most commonly reported indicator of internal responses during competition with limited reporting of hematological markers or RPE. These findings show a large discrepancy between the reporting of external and internal measures and training and competition demands. Microsensors, however, may be a practical and convenient method of player monitoring in basketball to overcome the limitations associated with current approaches while allowing for external demands and internal responses to be recorded simultaneously. The triaxial accelerometers of microsensors seem well suited for basketball and warrant validation to definitively determine their place in the monitoring of basketball players. Coaching staff should make use of this technology by tracking individual player responses across the annual plan and using real-time monitoring to minimize factors such as fatigue

  18. Current Trends in Retirement: Implications for Career Counseling and Vocational Psychology (United States)

    Lytle, Megan C.; Clancy, Megan E.; Foley, Pamela F.; Cotter, Elizabeth W.


    This article provides an overview of emerging trends in retirement, examines demographic trends in the labor force, and provides practical recommendations for working with older workers across cultures (e.g., women and racial/ethnic minorities, and among others). Increasingly, older workers in the United States remain in the workforce for reasons…

  19. Historical Overview, Current Status, and Future Trends in Human-Computer Interfaces for Process Control

    International Nuclear Information System (INIS)

    Owre, Fridtjov


    Approximately 25 yr ago, the first computer-based process control systems, including computer-generated displays, appeared. It is remarkable how slowly the human-computer interfaces (HCI's) of such systems have developed over the years. The display design approach in those early days had its roots in the topology of the process. Usually, the information came from the piping and instrumentation diagrams. Later, some important additional functions were added to the basic system, such as alarm and trend displays. Today, these functions are still the basic ones, and the end-user displays have not changed much except for improved display quality in terms of colors, font types and sizes, resolution, and object shapes, resulting from improved display hardware.Today, there are two schools of display design competing for supremacy in the process control segment of the HCI community. One can be characterized by extension and integration of current practice, while the other is more revolutionary.The extension of the current practice approach can be described in terms of added system functionality and integration. This means that important functions for the plant operator - such as signal validation, plant overview information, safety parameter displays, procedures, prediction of future states, and plant performance optimization - are added to the basic functions and integrated in a total unified HCI for the plant operator.The revolutionary approach, however, takes as its starting point the design process itself. The functioning of the plant is described in terms of the plant goals and subgoals, as well as the means available to reach these goals. Then, displays are designed representing this functional structure - in clear contrast to the earlier plant topology representation. Depending on the design approach used, the corresponding displays have various designations, e.g., function-oriented, task-oriented, or ecological displays.This paper gives a historical overview of past

  20. Current Trends in the Detection of Sociocultural Signatures: Data-Driven Models

    Energy Technology Data Exchange (ETDEWEB)

    Sanfilippo, Antonio P.; Bell, Eric B.; Corley, Courtney D.


    available that are shaping social computing as a strongly data-driven experimental discipline with an increasingly stronger impact on the decision-making process of groups and individuals alike. In this chapter, we review current advances and trends in the detection of sociocultural signatures. Specific embodiments of the issues discussed are provided with respect to the assessment of violent intent and sociopolitical contention. We begin by reviewing current approaches to the detection of sociocultural signatures in these domains. Next, we turn to the review of novel data harvesting methods for social media content. Finally, we discuss the application of sociocultural models to social media content, and conclude by commenting on current challenges and future developments.


    Seffah, J D; Adu-Bonsaffoh, K


    The optimal mode of subsequent delivery of women with prior caesarean birth remains a subject of intense research and debate in contemporary obstetric practice especially in low resource settings like West Africa where there are obvious systemic and management-related challenges associated with trial of scar. However, there is evidence that vaginal birth after caesarean section (VBAC) is safe in appropriately selected women in addition to adequate intrapartum monitoring and ready access to theatre when emergency CS is indicated. The primary objective of the study was to determine the current trends and performance of VBAC in Ghana after decades of practice of trial of labour after caesarean section (TOLAC) in the mist of inherent challenges in deciding the optimal mode of childbirth for women with a previous caesarean birth. The secondary objective was to relate evidence based practice of TOLAC to obstetric practice in low resource settings like Ghana and provide recommendations for improving maternal and newborn health among women with prior caesarean birth. This was a retrospective study of the records of patients who had had a prior caesarean delivery and who then proceeded to deliver the next babies at the Korle Bu Teaching Hospital (KBTH) between Jan 2010 and Dec 2014. The data on demography, antenatal care, labour and delivery and outcomes were collected from the Labour and Recovery wards and the Biostatistics unit of the Maternity unit of the Hospital. Excluded were women with a previous CS who had multiple pregnancies and those with incomplete notes as well as those whose delivery plans were not predetermined antenatally.. The data were analyzed using SPSS version 20. There were 53,581 deliveries during the study period. Vaginal delivery was obtained in 31,870 (59.5%) pregnancies and 21,711(40.5%) had CS. Also, 6261 (11.7%) had had a prior CS and 2472 (39.5%) of these were selected for TOLAC while 2119 (33.8) were scheduled for planned repeat CS. There was

  2. Impact of the Economic Downturn on Elective Cervical Spine Surgery in the United States: A National Trend Analysis, 2003-2013. (United States)

    Bernstein, David N; Jain, Amit; Brodell, David; Li, Yue; Rubery, Paul T; Mesfin, Addisu


    To analyze overall trends of elective cervical spine surgery in the United States from 2003 to 2013 with the goal of determining whether the economic downturn had an impact. Codes from the International Classification of Diseases, Ninth Revision, Clinical Modification were used to identify elective cervical spine surgery procedures in the Nationwide Inpatient Sample from 2003 to 2013. National Health Expenditure, gross domestic product, and S&P 500 Index were used as measures of economic performance. The economic downturn was defined as 2008-2009. Confidence intervals were determined using subgroup analysis techniques. Linear regressions were completed to determine the association between surgery trends and economic conditions. From 2003 to 2013, posterior cervical fusions saw a 102.7% increase. During the same time frame, there was a 7.4% and 14.7% decrease in the number of anterior cervical diskectomy and fusions (ACDFs) and posterior decompressions, respectively. The trend of elective cervical spine surgeries per 100,000 persons in the U.S. population may have been affected by the economic downturn from 2008 to 2009 (-0.03% growth). The percentage of procedures paid for by private insurance decreased from 2003 to 2013 for all ACDFs, posterior cervical fusions, and posterior decompressions. The linear regression coefficients (β) and R 2 values between the number of surgeries and each of the macroeconomic factors analyzed were not statistically significant. The overall elective cervical spine surgery trend was not likely impacted by the economic downturn. Posterior cervical fusions grew significantly from 2003 to 2013, whereas ACDFs and posterior decompressions decreased. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Laparoscopic colorectal surgery: Current status and implementation of the latest technological innovations. (United States)

    Pascual, Marta; Salvans, Silvia; Pera, Miguel


    The introduction of laparoscopy is an example of surgical innovation with a rapid implementation in many areas of surgery. A large number of controlled studies and meta-analyses have shown that laparoscopic colorectal surgery is associated with the same benefits than other minimally invasive procedures, including lesser pain, earlier recovery of bowel transit and shorter hospital stay. On the other hand, despite initial concerns about oncological safety, well-designed prospective randomized multicentre trials have demonstrated that oncological outcomes of laparoscopy and open surgery are similar. Although the use of laparoscopy in colorectal surgery has increased in recent years, the percentages of patients treated with surgery using minimally invasive techniques are still reduced and there are also substantial differences among centres. It has been argued that the limiting factor for the use of laparoscopic procedures is the number of surgeons with adequate skills to perform a laparoscopic colectomy rather than the tumour of patients' characteristics. In this regard, future efforts to increase the use of laparoscopic techniques in colorectal surgery will necessarily require more efforts in teaching surgeons. We here present a review of recent controversies of the use of laparoscopy in colorectal surgery, such as in rectal cancer operations, the possibility of reproducing complete mesocolon excision, and the benefits of intra-corporeal anastomosis after right hemicolectomy. We also describe the results of latest innovations such as single incision laparoscopic surgery, robotic surgery and natural orifice transluminal endoscopic surgery for colon and rectal diseases.

  4. Ischaemic heart disease deaths in Brazil: current trends, regional disparities and future projections. (United States)

    Baena, Cristina P; Chowdhury, Rajiv; Schio, Nicolle Amboni; Sabbag, Ary Elias; Guarita-Souza, Luiz Cesar; Olandoski, Marcia; Franco, Oscar H; Faria-Neto, José Rocha


    To quantify the trend of ischaemic heart disease (IHD) deaths in Brazil during the last decade (2000-2010) for various population characteristics and to forecast the upcoming mortality trends across regions in Brazil until the year 2015. Nationwide comparative observational study. The population studied encompassed all adult residents (≥ 20 years) living in five Brazilian regions between 2000 and 2010. Demographic, economic and mortality data were obtained from Brazilian National Mortality Data System and National Applied Economics Research Institute. Subnotified deaths were redistributed proportionally to IHD deaths. Age-standardised mortality rates (ASMRs) per 100 000 inhabitants, by sex and region, were calculated employing a standard Brazilian population and constructing multivariate regression models to quantify and to project temporal trends. Absolute numbers of death due to IHD and region-specific death rates in Brazil by age and sex. During the study period, 627 786 men and 452 690 women died due to IHD in Brazil. ASMR trends across all regions for men and women converged, driven by a declining trend in the South and Southeast and an opposite incline in the North and Northeast (p < 0.05). Future projections demonstrated potential widening of the observed North-South gap in coming years. The IHD death trend in Brazil has changed from a decline to a stagnant state. However, a significant discrepancy in mortality trends exists between the northern and southern regions, which is likely to widen further. Reappraisal of the public health policies tailored to populations with diverse socioeconomic structures is urgently required.

  5. The Future of e-Learning in Medical Education: Current Trend and Future Opportunity

    Directory of Open Access Journals (Sweden)

    Sara Kim


    Full Text Available A wide range of e-learning modalities are widely integrated in medical education. However, some of the key questions related to the role of e-learning remain unanswered, such as (1 what is an effective approach to integrating technology into pre-clinical vs. clinical training?; (2 what evidence exists regarding the type and format of e-learning technology suitable for medical specialties and clinical settings?; (3 which design features are known to be effective in designing on-line patient simulation cases, tutorials, or clinical exams?; and (4 what guidelines exist for determining an appropriate blend of instructional strategies, including online learning, face-to-face instruction, and performance-based skill practices? Based on the existing literature and a variety of e-learning examples of synchronous learning tools and simulation technology, this paper addresses the following three questions: (1 what is the current trend of e-learning in medical education?; (2 what do we know about the effective use of e-learning?; and (3 what is the role of e-learning in facilitating newly emerging competency-based training? As e-learning continues to be widely integrated in training future physicians, it is critical that our efforts in conducting evaluative studies should target specific e-learning features that can best mediate intended learning goals and objectives. Without an evolving knowledge base on how best to design e-learning applications, the gap between what we know about technology use and how we deploy e-learning in training settings will continue to widen.

  6. Current trends in satellite based emergency mapping - the need for harmonisation (United States)

    Voigt, Stefan


    During the past years, the availability and use of satellite image data to support disaster management and humanitarian relief organisations has largely increased. The automation and data processing techniques are greatly improving as well as the capacity in accessing and processing satellite imagery in getting better globally. More and more global activities via the internet and through global organisations like the United Nations or the International Charter Space and Major Disaster engage in the topic, while at the same time, more and more national or local centres engage rapid mapping operations and activities. In order to make even more effective use of this very positive increase of capacity, for the sake of operational provision of analysis results, for fast validation of satellite derived damage assessments, for better cooperation in the joint inter agency generation of rapid mapping products and for general scientific use, rapid mapping results in general need to be better harmonized, if not even standardized. In this presentation, experiences from various years of rapid mapping gained by the DLR Center for satellite based Crisis Information (ZKI) within the context of the national activities, the International Charter Space and Major Disasters, GMES/Copernicus etc. are reported. Furthermore, an overview on how automation, quality assurance and optimization can be achieved through standard operation procedures within a rapid mapping workflow is given. Building on this long term rapid mapping experience, and building on the DLR initiative to set in pace an "International Working Group on Satellite Based Emergency Mapping" current trends in rapid mapping are discussed and thoughts on how the sharing of rapid mapping information can be optimized by harmonizing analysis results and data structures are presented. Such an harmonization of analysis procedures, nomenclatures and representations of data as well as meta data are the basis to better cooperate within

  7. Prevalence of current patterns and predictive trends of multidrug-resistant Salmonella Typhi in Sudan

    Directory of Open Access Journals (Sweden)

    Ayman A. Elshayeb


    Full Text Available Abstract Background Enteric fever has persistence of great impact in Sudanese public health especially during rainy season when the causative agent Salmonella enterica serovar Typhi possesses pan endemic patterns in most regions of Sudan - Khartoum. Objectives The present study aims to assess the recent state of antibiotics susceptibility of Salmonella Typhi with special concern to multidrug resistance strains and predict the emergence of new resistant patterns and outbreaks. Methods Salmonella Typhi strains were isolated and identified according to the guidelines of the International Standardization Organization and the World Health Organization. The antibiotics susceptibilities were tested using the recommendations of the Clinical Laboratories Standards Institute. Predictions of emerging resistant bacteria patterns and outbreaks in Sudan were done using logistic regression, forecasting linear equations and in silico simulations models. Results A total of 124 antibiotics resistant Salmonella Typhi strains categorized in 12 average groups were isolated, different patterns of resistance statistically calculated by (y = ax − b. Minimum bactericidal concentration’s predication of resistance was given the exponential trend (y = n ex and the predictive coefficient R2 > 0 < 1 are approximately alike. It was assumed that resistant bacteria occurred with a constant rate of antibiotic doses during the whole experimental period. Thus, the number of sensitive bacteria decreases at the same rate as resistant occur following term to the modified predictive model which solved computationally. Conclusion This study assesses the prediction of multi-drug resistance among S. Typhi isolates by applying low cost materials and simple statistical methods suitable for the most frequently used antibiotics as typhoid empirical therapy. Therefore, bacterial surveillance systems should be implemented to present data on the aetiology and current

  8. Robotic-Assisted Procedures in Pediatric Surgery: A Critical Appraisal of the Current Best Evidence in Comparison to Conventional Minimally Invasive Surgery. (United States)

    Friedmacher, Florian; Till, Holger


    In recent years, the use of robotic-assisted surgery (RAS) has expanded within pediatric surgery. Although increasing numbers of pediatric RAS case-series have been published, the level of evidence remains unclear, with authors mainly focusing on the comparison with open surgery rather than the corresponding laparoscopic approach. The aim of this study was to critically appraise the published literature comparing pediatric RAS with conventional minimally invasive surgery (MIS) in order to evaluate the current best level of evidence. A systematic literature-based search for studies comparing pediatric RAS with corresponding MIS procedures was performed using multiple electronic databases and sources. The level of evidence was determined using the Oxford Centre for Evidence-based Medicine (OCEBM) criteria. A total of 20 studies met defined inclusion criteria, reporting on five different procedures: fundoplication (n=8), pyeloplasty (n=8), nephrectomy (n=2), gastric banding (n=1), and sleeve gastrectomy (n=1). Included publications comprised 5 systematic reviews and 15 cohort/case-control studies (OCEBM Level 3 and 4, respectively). No studies of OCEBM Level 1 or 2 were identified. Limited evidence indicated reduced operative time (pyeloplasty) and shorter hospital stay (fundoplication) for pediatric RAS, whereas disadvantages were longer operative time (fundoplication, nephrectomy, gastric banding, and sleeve gastrectomy) and higher total costs (fundoplication and sleeve gastrectomy). There were no differences reported for complications, success rates, or short-term outcomes between pediatric RAS and conventional MIS in these procedures. Inconsistency was found in study design and follow-up with large clinical heterogeneity. The best available evidence for pediatric RAS is currently OCEBM Level 3, relating only to fundoplication and pyeloplasty. Therefore, higher-quality studies and comparative data for other RAS procedures in pediatric surgery are required.

  9. [Nutritional screening before surgery for esophageal cancer - current status and evaluation results]. (United States)

    Shimakawa, Takeshi; Asaka, Shinich; Sagawa, Masano; Shimazaki, Asako; Yamaguchi, Kentaro; Usui, Takebumi; Yokomizo, Hajime; Shiozawa, Shunichi; Yoshimatsu, Kazuhiko; Katsube, Takao; Naritaka, Yoshihiko


    The incidence of postoperative complications and mortality are usually higher in patients with preoperative malnutrition. Malnutrition often preexists, particularly in patients undergoing surgery for esophageal cancer, which is substantially invasive. It is therefore important to understand the nutritional condition of patients and actively control perioperative nutrition.Our hospital has been providing nutritional status screening for patients before resection of esophageal cancer, and we report the current status and evaluation results in this article.This screening included 158 patients requiring radical resection of esophageal cancer.Age, comorbidity with diabetes, body mass index(BMI), serum albumin(Alb), Onodera's prognostic nutritional index(PNI), and Glasgow prognostic score(GPS)were used as nutritional indicators to stratify patients for analysis.Evaluation parameters included the incidence of postoperative complications(any complication, pulmonary complications, psychiatric disorder, and anastomotic leakage)and rates of long-term postoperative hospitalization.The analysis indicated that age, BMI, serum Alb, PNI, and GPS are useful for predicting the onset of postoperative complications and prolonged postoperative hospitalization.For such patients, more active nutritional control should be provided.

  10. Innovations in surgery simulation: a review of past, current and future techniques. (United States)

    Badash, Ido; Burtt, Karen; Solorzano, Carlos A; Carey, Joseph N


    As a result of recent work-hours limitations and concerns for patient safety, innovations in extraclinical surgical simulation have become a desired part of residency education. Current simulation models, including cadaveric, animal, bench-top, virtual reality (VR) and robotic simulators are increasingly used in surgical training programs. Advances in telesurgery, three-dimensional (3D) printing, and the incorporation of patient-specific anatomy are paving the way for simulators to become integral components of medical training in the future. Evidence from the literature highlights the benefits of including simulations in surgical training; skills acquired through simulations translate into improvements in operating room performance. Moreover, simulations are rapidly incorporating new medical technologies and offer increasingly high-fidelity recreations of procedures. As a result, both novice and expert surgeons are able to benefit from their use. As dedicated, structured curricula are developed that incorporate simulations into daily resident training, simulated surgeries will strengthen the surgeon's skill set, decrease hospital costs, and improve patient outcomes.

  11. Proceedings of the BRNS-AEACI first symposium on current trends in analytical chemistry: book of abstracts

    International Nuclear Information System (INIS)

    Reddy, A.V.R.


    The symposium was very useful for the scientists on various aspects of current trends in analytical chemistry like separation science, speciation, nuclear analytical techniques, thermo analytical techniques, electro analytical techniques, spectrochemical and microscopic techniques, environmental studies, geochemical studies, chemical metrology, analytical instrumentation. Papers relevant to INIS are indexed separately

  12. Current Status of Surgical Planning for Orthognathic Surgery: Traditional Methods versus 3D Surgical Planning

    Directory of Open Access Journals (Sweden)

    Jeffrey A. Hammoudeh, MD, DDS


    Conclusions: It is our opinion that virtual model surgery will displace and replace traditional model surgery as it will become cost and time effective in both the private and academic setting for practitioners providing orthognathic surgical care in cleft and noncleft patients.

  13. Current Rates of Publication for Podium and Poster Presentations at the American Society for Surgery of the Hand Annual Meetings

    Directory of Open Access Journals (Sweden)

    Joshua M. Abzug


     Currently, fewer than half of the studies presented at Annual Meetings of the ASSH achieve publication in peer-eviewed journals. Presentations are most likely to be published within 3 years, and almost half are published in Journal of Hand Surgery

  14. Currents trends in the application of IBA techniques to air pollution source fingerprinting and source apportionment

    International Nuclear Information System (INIS)

    Cohen, David; Stelcer, Ed.; Atanacio, Armand; Crawford, Jagoda


    Full text: IBA techniques have been used for many years to characterise fine particle air pollution. This is not new the techniques are well established. Typically 2-3 MeV protons are used to bombard thin filter papers and up to four simultaneous techniques like PIXE, PIGE, RBS and ERDA will be applied to obtain (μg/g) concentrations for elements from hydrogen to lead. Generally low volume samplers are used to sample between 20-30 m 3 of air over a 24 hour period, this together with IBA's sensitivity means that concentrations down to 1 ng/m 3 of air sampled can be readily achieved with only a few minutes of proton irradiation. With these short irradiation times and low sensitivities for a broad range of elements in the periodic table, large numbers of samples can be obtained and analysed very quickly and easily. At ANSTO we have used IBA methods to acquire a database of over 50,000 filters from 85 different sites through Australia and Asia, each filter has been analysed for more than 21 different chemical species. Large databases extending over many years means that modern statistical techniques like positive matrix factorisation (PMF) can be used to define well characterised source fingerprints and source contributions for a range of different fine particle air pollutants. In this paper we will discuss these PMF techniques and show how they identify both natural sources like sea spray and windblown soils as well as anthropogenic sources like automobiles, biomass burning, coal-fired power stations and industrial emissions. These data are particularly useful for Governments, EPA's and managers of pollution to better understanding pollution sources and their relative contributions and hence to better manage air pollution. Current trends are to take these IBA and PMF techniques a step further and to combine them with wind speed and back trajectory data to better pin point and identify emission sources. We show how this is now being applied on both a local

  15. Currents trends in the application of IBA techniques to air pollution source fingerprinting and source apportionment

    Energy Technology Data Exchange (ETDEWEB)

    Cohen, David; Stelcer, Ed.; Atanacio, Armand; Crawford, Jagoda [Australian Nuclear Science and Technology Organisation, Kirrawee DC (Australia)


    Full text: IBA techniques have been used for many years to characterise fine particle air pollution. This is not new the techniques are well established. Typically 2-3 MeV protons are used to bombard thin filter papers and up to four simultaneous techniques like PIXE, PIGE, RBS and ERDA will be applied to obtain (μg/g) concentrations for elements from hydrogen to lead. Generally low volume samplers are used to sample between 20-30 m{sup 3} of air over a 24 hour period, this together with IBA's sensitivity means that concentrations down to 1 ng/m{sup 3} of air sampled can be readily achieved with only a few minutes of proton irradiation. With these short irradiation times and low sensitivities for a broad range of elements in the periodic table, large numbers of samples can be obtained and analysed very quickly and easily. At ANSTO we have used IBA methods to acquire a database of over 50,000 filters from 85 different sites through Australia and Asia, each filter has been analysed for more than 21 different chemical species. Large databases extending over many years means that modern statistical techniques like positive matrix factorisation (PMF) can be used to define well characterised source fingerprints and source contributions for a range of different fine particle air pollutants. In this paper we will discuss these PMF techniques and show how they identify both natural sources like sea spray and windblown soils as well as anthropogenic sources like automobiles, biomass burning, coal-fired power stations and industrial emissions. These data are particularly useful for Governments, EPA's and managers of pollution to better understanding pollution sources and their relative contributions and hence to better manage air pollution. Current trends are to take these IBA and PMF techniques a step further and to combine them with wind speed and back trajectory data to better pin point and identify emission sources. We show how this is now being applied on both


    Zorron, Ricardo; Galvão-Neto, Manoel Passos; Campos, Josemberg; Branco, Alcides José; Sampaio, José; Junghans, Tido; Bothe, Claudia; Benzing, Christian; Krenzien, Felix

    Roux-en-Y gastric bypass (RYGB) is a standard therapy in bariatric surgery. Sleeve gastrectomy and gastric banding, although with good results in the literature, are showing higher rates of treatment failure to reduce obesity-associated morbidity and body weight. Other problems after bariatric may occur, as band erosion, gastroesophageal reflux disease and might be refractory to medication. Therefore, a laparoscopic conversion to a RYGB can be an effective alternative, as long as specific indications for revision are fulfilled. The objective of this study was to analyse own and literature data on revisional bariatric procedures to evaluate best alternatives to current practice. Institutional experience and systematic review from the literature on revisional bariatric surgery. Endoscopic procedures are recently applied to ameliorate failure and complications of bariatric procedures. Therapy failure following RYGB occurs in up to 20%. Transoral outlet reduction is currently an alternative method to reduce the gastrojejunal anastomosis. The diameter and volume of sleeve gastrectomy can enlarge as well, which can be reduced by endoscopic full-thickness sutures longitudinally. Dumping syndrome and severe hypoglycemic episodes (neuroglycopenia) can be present in patients following RYGB. The hypoglycemic episodes have to be evaluated and usually can be treated conventionally. To avoid partial pancreatectomy or conversion to normal anatomy, a new laparoscopic approach with remnant gastric resection and jejunal interposition can be applied in non-responders alternatively. Hypoglycemic episodes are ameliorated while weight loss is sustained. Revisional and endoscopic procedures following bariatric surgery in patients with collateral symptomatic or treatment failure can be applied. Conventional non-surgical approaches should have been applied intensively before a revisional surgery will be indicated. Former complex surgical revisional procedures are evolving to less

  17. PREFACE: National Seminar on Current Trends in Materials Science (CTMS-2011) (United States)

    Jayakrishnan, R.; Vijayakumar, K. P.; Unnikrishnan, N. V.


    India is going through an era of many changes in its higher education system. Emphasis is being given to research and development initiatives at Universities and colleges. The teaching community is faced with the challenge of coping with both regular academic activities and research initiatives. The teaching faculties need to keep in step with the momentous research output being generated globally. To mold young talent that will be sought after, teachers need to undertake challenging initiatives. Research in emerging areas like nanotechnology, meta materials, functional materials and structures is being pursued vigorously in Universities and colleges in the state of Kerala. Awareness of the impact of integrating teaching and research in basic science has inspired the teaching faculty. The number of seminars and conferences is not commensurate with the amount of research being conducted in this state. The state lags behind in the number of institutes with state of the art facilities and human resource with cutting edge knowledge. The national seminar on Current Trends in Materials Science (CTMS-2011) is organized by the Department of Physics, Christian College, Chengannur. It is a continuation of the initiatives of the Department to bridge the haitus between teaching and research. Current Trends in Materials Science (CTMS-2007) was successfully conducted with over 80 research paper presentations and participation of delegates from the states of Karnataka, Andhrapradesh, Tamilnadu and Kerala. CTMS-2011 is a sequel envisaged to serve as an effective platform for teachers to interact with eminent scientists and share their knowledge and experience. Papers were invited from the subject area comprising glasses and ceramics, crystal growth, nanotechnology, semiconductors thin films and polymers. We are delighted that after a peer review process of the papers we have selected ten of the best papers presented at the seminar for publication in IOP Conference Series

  18. Cost Estimating in DoD: Current Status, Trends, and What the Future Holds

    National Research Council Canada - National Science Library

    Nussbaum, Daniel A


    (1) Current Status: Baseline analysis of current cost estimating community, including which organizations are responsible for developing and reviewing cost estimates, how many personnel there are, what...

  19. Current standards of neuropsychological assessment in epilepsy surgery centers across Europe. (United States)

    Vogt, Viola Lara; Äikiä, Marja; Del Barrio, Antonio; Boon, Paul; Borbély, Csaba; Bran, Ema; Braun, Kees; Carette, Evelien; Clark, Maria; Cross, Judith Helen; Dimova, Petia; Fabo, Daniel; Foroglou, Nikolaos; Francione, Stefano; Gersamia, Anna; Gil-Nagel, Antonio; Guekht, Alla; Harrison, Sue; Hecimovic, Hrvoje; Heminghyt, Einar; Hirsch, Edouard; Javurkova, Alena; Kälviäinen, Reetta; Kavan, Nicole; Kelemen, Anna; Kimiskidis, Vasilios K; Kirschner, Margarita; Kleitz, Catherine; Kobulashvili, Teia; Kosmidis, Mary H; Kurtish, Selin Yagci; Lesourd, Mathieu; Ljunggren, Sofia; Lossius, Morten Ingvar; Malmgren, Kristina; Mameniskiené, Ruta; Martin-Sanfilippo, Patricia; Marusic, Petr; Miatton, Marijke; Özkara, Çiğdem; Pelle, Federica; Rubboli, Guido; Rudebeck, Sarah; Ryvlin, Philippe; van Schooneveld, Monique; Schmid, Elisabeth; Schmidt, Pia-Magdalena; Seeck, Margitta; Steinhoff, Bernhard J; Shavel-Jessop, Sara; Tarta-Arsene, Oana; Trinka, Eugen; Viggedal, Gerd; Wendling, Anne-Sophie; Witt, Juri-Alexander; Helmstaedter, Christoph


    We explored the current practice with respect to the neuropsychological assessment of surgical epilepsy patients in European epilepsy centers, with the aim of harmonizing and establishing common standards. Twenty-six epilepsy centers and members of "E-PILEPSY" (a European pilot network of reference centers in refractory epilepsy and epilepsy surgery), were asked to report the status of neuropsychological assessment in adults and children via two different surveys. There was a consensus among these centers regarding the role of neuropsychology in the presurgical workup. Strong agreement was found on indications (localization, epileptic dysfunctions, adverse drugs effects, and postoperative monitoring) and the domains to be evaluated (memory, attention, executive functions, language, visuospatial skills, intelligence, depression, anxiety, and quality of life). Although 186 different tests are in use throughout these European centers, a core group of tests reflecting a moderate level of agreement could be discerned. Variability exists with regard to indications, protocols, and paradigms for the assessment of hemispheric language dominance. For the tests in use, little published evidence of clinical validity in epilepsy was provided. Participants in the survey reported a need for improvement concerning the validity of the tests, tools for the assessment of everyday functioning and accelerated forgetting, national norms, and test co-normalization. Based on the present survey, we documented a consensus regarding the indications and principles of neuropsychological testing. Despite the variety of tests in use, the survey indicated that there may be a core set of tests chosen based on experience, as well as on published evidence. By combining these findings with the results of an ongoing systematic literature review, we aim for a battery that can be recommended for the use across epilepsy surgical centers in Europe. Wiley Periodicals, Inc. © 2017 International League

  20. Perioperative antithrombotic therapy in patients undergoing endoscopic urologic surgery: where do we stand with current literature? (United States)

    Naspro, Richard; Lerner, Lori B; Rossini, Roberta; Manica, Michele; Woo, Henry H; Calopedos, Ross J; Cracco, Cecilia M; Scoffone, Cesare M; Herrmann, Thomas R; de la Rosette, Jean J; Cornu, Jean-Nicolas; DA Pozzo, Luigi F


    The number of patients on chronic anticoagulant or antiplatelet therapy requiring endoscopic urological surgery is increasing worldwide. Therefore, there is a strong demand to standardize the perioperative treatment of this cohort of patients, both from a surgical and cardiological point of view, balancing the risks of bleeding versus thrombosis, and the important possible clinical and medical legal repercussions therein. Although literature is scarce and the quality of evidence quite low, in line with other surgical specialties, guidelines and recommendations for the management of urological patients have begun to emerge. The aim of this review is to analyze current available literature and evidence on the most common endoscopic procedures performed in this high-risk group of patients, focusing on the perioperative management. In particular, to analyze the most frequently performed endoscopic procedures for the treatment of benign prostate enlargement (transurethral resection of the prostate, Thulium, Holmium and greenlight laser prostatectomy), bladder cancer (transurethral resection of the bladder), upper urinary tract urothelial cancer, and nephrolithiasis. Despite the lack of randomized studies, regardless of individual patient considerations, studies would support continuation of acetylsalicylic acid, which is recommended by cardiologists, in patients with intermediate/high risk of coronary thrombosis. In contrast, multiple studies found that bridging with light weight molecular weight heparin can potentially lead to more bleeding than continuation of the anticoagulant(s) and antiplatelet therapy, and caution with bridging is advised. All urologists should familiarize themselves with emerging guidelines and recommendations, and always be prepared to discuss specific cases or scenarios in a dedicated multidisciplinary team.

  1. [Strategies to ensure careers of young academics in plastic surgery - analysis of the current situation and future perspectives]. (United States)

    Horch, R E; Vogt, P M; Schaller, H E; Stark, G B; Lehnhardt, M; Kneser, U; Giunta, R E


    Recruitment problems in surgical disciplines have become an increasingly debated topic. On the one hand current career prospects appear to be less attractive than those were seen for the previous generation. On the other hand the demands for a so-called "work-life balance" have changed and the proportion of female students and colleagues in medicine has risen and will continue to increase. Although Plastic Surgery currently seems to be less affected by these problems than other surgical disciplines, securing a qualified supply of young academics in Plastic Surgery is a prerequisite for the further development of this discipline. The traditional model of mentoring is discussed and the role of coaching in a sense of helping the mentorees examine what they are doing in the light of their intentions and goals is reflected. The present article tries to analyze the current status of academic Plastic Surgery from the viewpoint of German university senior surgeons in academic plastic surgery, and aims to highlight the specific prospects for young academics against the backdrop of an often one-sided and superficial perception of this profession. © Georg Thieme Verlag KG Stuttgart · New York.

  2. Current Practices and Barriers to the Integration of Oncoplastic Breast Surgery: A Canadian Perspective. (United States)

    Maxwell, Jessica; Roberts, Amanda; Cil, Tulin; Somogyi, Ron; Osman, Fahima


    Despite the safety and popularity of oncoplastic surgery, there is limited data examining utilization and barriers associated with its incorporation into practice. This study examines the use of oncoplastic techniques in breast conserving surgery and determines the barriers associated with their implementation. A 13-item survey was mailed to all registered general surgeons in Ontario, Canada. The survey assessed surgeon demographics, utilization of specific oncoplastic techniques, and perceived barriers. A total of 234 survey responses were received, representing a response rate of 32.2 % (234 of 725). Of the respondents, 166 surgeons (70.9 %) reported a practice volume of at least 25 % breast surgery. Comparison was made between general surgeons performing oncoplastic breast surgery (N = 79) and those who did not use these techniques (N = 87). Surgeon gender, years in practice, fellowship training, and access to plastic surgery were similar across groups. Both groups rated the importance of breast cosmesis similarly. General surgeons with a practice volume involving >50 % breast surgery were more likely to use oncoplastic techniques (OR 8.82, p < .001) and involve plastic surgeons in breast conserving surgery (OR 2.21, p = .02). For surgeons not performing oncoplastic surgery, a lack of training and access to plastic surgeons were identified as significant barriers. For those using oncoplastic techniques, the absence of specific billing codes was identified as a limiting factor. Lack of training, access to plastic surgeons, and absence of appropriate reimbursement for these cases are significant barriers to the adoption of oncoplastic techniques.

  3. The private health sector in South Africa - current trends and future ...

    African Journals Online (AJOL)

    The private health sector is experiencing a crisis of spiralling costs, with average annual cost increases of between 13% and 32% over the decade 1978 - 1988. This trend is partly explained by the high utilisation rates that result from the combination of the 'fee-for-service' system and the 'third-party' payment structure of the ...

  4. Teaching Creativity: Current Findings, Trends, and Controversies in the Psychology of Creativity (United States)

    Simonton, Dean Keith


    In the past decade, the psychological study of creativity has accelerated greatly. To facilitate the teaching of creativity, I provide an overview of the recent literature. The overview begins by discussing recent empirical results and research trends. This discussion specifically treats creativity's cognitive, differential, developmental, and…

  5. Faculty Development for Advancing Community Engagement in Higher Education: Current Trends and Future Directions (United States)

    Welch, Marshall; Plaxton-Moore, Star


    This research involved the conduct of a conceptual review of 28 refereed journal articles and a survey of campus centers for community engagement staff to identify salient features and trends of existing faculty development programming designed to advance service-learning and community engagement in higher education. Results of this investigation…

  6. Teaching the Evolution of the Mind: Current Findings, Trends, and Controversies in Evolutionary Psychology (United States)

    Liddle, James R.; Shackelford, Todd K.


    As the burgeoning field of evolutionary psychology continues to gain exposure and acceptance throughout the psychological community, it is important to explain this field clearly and accurately to students. This article discusses some recent findings and trends in evolutionary psychological research to aid instructors in their efforts to provide…

  7. Intraoperative Image Guidance in Neurosurgery: Development, Current Indications, and Future Trends

    International Nuclear Information System (INIS)

    Schulz, Ch.; Mauer, U.M.; Waldeck, S.


    Introduction. As minimally invasive surgery becomes the standard of care in neurosurgery, it is imperative that surgeons become skilled in the use of image-guided techniques. The development of image-guided neurosurgery represents a substantial improvement in the microsurgical treatment of tumors, vascular malformations, and other intracranial lesions. Objective. There have been numerous advances in neurosurgery which have aided the neurosurgeon to achieve accurate removal of pathological tissue with minimal disruption of surrounding healthy neuronal matter including the development of microsurgical, endoscopic, and endovascular techniques. Neuro navigation systems and intraoperative imaging should improve success in cranial neurosurgery. Additional functional imaging modalities such as PET, SPECT, DTI (for fiber tracking), and fMRI can now be used in order to reduce neurological deficits resulting from surgery; however the positive long-term effect remains questionable for many indications. Method. Pub Med database search using the search term “image guided neurosurgery.” More than 1400 articles were published during the last 25 years. The abstracts were scanned for prospective comparative trials. Results and Conclusion. 14 comparative trials are published. To date significant data amount show advantages in intraoperative accuracy influencing the perioperative morbidity and long-term outcome only for cerebral glioma surgery.

  8. Current status and future perspectives in laparoendoscopic single-site and natural orifice transluminal endoscopic urological surgery. (United States)

    Autorino, Riccardo; Stein, Robert J; Lima, Estevão; Damiano, Rocco; Khanna, Rakesh; Haber, Georges-Pascal; White, Michael A; Kaouk, Jihad H


    Objective of this study is to provide an evidence-based analysis of the current status and future perspectives of scarless urological surgery. A PubMed search has been performed for all relevant urological literature regarding natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS). In addition, experience with LESS and NOTES at our own institution has been considered. All clinical and investigative reports for LESS and NOTES procedures in the urological literature have been considered. A wide variety of clinical procedures in urology have been successfully completed by using LESS techniques. Thus far, experience with NOTES has largely been investigational, although early clinical reports are emerging. Further development of instrumentation and platforms is necessary for both techniques to become more widely adopted throughout the urological community.

  9. Electronic commerce in China:current status, development strategies, and new trends

    Institute of Scientific and Technical Information of China (English)

    Xiang Junyong; Jing Linbo


    After years of development in China's electronic commerce sector,there has been a drastic increase not only in the number of electronic commerce enterprises and online shoppers,but also in electronic commerce market turnover in China.During this process,the Chinese government has played a key role in establishing legislation and market disciplines for the electronic commerce market.This paper explores policy regarding electronic commerce development in China and analyzes new trends in China's electronic commerce,including the rise of mobile commerce,social commerce,and cross-border electronic commerce,and the booming industries of internet financing and Big Data.This paper aims to provide a better understanding of the development,uniqueness,and trends of electronic commerce in China.In addition,this paper also provides policymakers in China and other developing countries with policy suggestions regarding electronic commerce.

  10. A study on the current situation and trend of college students’ love in China

    Directory of Open Access Journals (Sweden)

    Xiaohui Wang


    Full Text Available With regard to the incorrect love mentality of contemporary college students in China, the author not only elaborates measures of guiding students to form a healthy view of love in different aspects, such as strengthening college students’ sexual health education, carrying out campus cultural activities, enriching campus life, reinforcing the construction of school rules and disciplines, restraining and managing students’ behaviors, etc., but also analyzes the development trend of college students’ view of love in China.

  11. Current Trends in Cloud Computing A Survey of Cloud Computing Systems


    Harjit Singh


    Cloud computing that has become an increasingly important trend, is a virtualization technology that uses the internet and central remote servers to offer the sharing of resources that include infrastructures, software, applications and business processes to the market environment to fulfill the elastic demand. In today’s competitive environment, the service vitality, elasticity, choices and flexibility offered by this scalable technology are too attractive that makes the cloud computing to i...

  12. Current role of endovascular therapy in Marfan patients with previous aortic surgery

    Directory of Open Access Journals (Sweden)

    Ibrahim Akin


    Full Text Available Ibrahim Akin, Stephan Kische, Tim C Rehders, Tushar Chatterjee, Henrik Schneider, Thomas Körber, Christoph A Nienaber, Hüseyin InceDepartment of Medicine, Division of Cardiology at the University Hospital Rostock, Rostock School of Medicine, Ernst-Heydemann-Str. 6, 18057 Rostock, GermanyAbstract: The Marfan syndrome is a heritable disorder of the connective tissue which affects the cardiovascular, ocular, and skeletal system. The cardiovascular manifestation with aortic root dilatation, aortic valve regurgitation, and aortic dissection has a prevalence of 60% to 90% and determines the premature death of these patients. Thirty-four percent of the patients with Marfan syndrome will have serious cardiovascular complications requiring surgery in the first 10 years after diagnosis. Before aortic surgery became available, the majority of the patients died by the age of 32 years. Introduction in the aortic surgery techniques caused an increase of the 10 year survival rate up to 97%. The purpose of this article is to give an overview about the feasibility and outcome of stent-graft placement in the descending thoracic aorta in Marfan patients with previous aortic surgery.Keywords: Marfan syndrome, aortic dissection, root replacement, stent-graft, previous aortic surgery

  13. Current and Future Decadal Trends in the Oceanic Carbon Uptake Are Dominated by Internal Variability (United States)

    Li, Hongmei; Ilyina, Tatiana


    We investigate the internal decadal variability of the ocean carbon uptake using 100 ensemble simulations based on the Max Planck Institute Earth system model (MPI-ESM). We find that on decadal time scales, internal variability (ensemble spread) is as large as the forced temporal variability (ensemble mean), and the largest internal variability is found in major carbon sink regions, that is, the 50-65°S band of the Southern Ocean, the North Pacific, and the North Atlantic. The MPI-ESM ensemble produces both positive and negative 10 year trends in the ocean carbon uptake in agreement with observational estimates. Negative decadal trends are projected to occur in the future under RCP4.5 scenario. Due to the large internal variability, the Southern Ocean and the North Pacific require the most ensemble members (more than 53 and 46, respectively) to reproduce the forced decadal trends. This number increases up to 79 in future decades as CO2 emission trajectory changes.

  14. Current trends in Canadian health care: myths and misconceptions in health economics. (United States)

    Coyte, P C


    This paper is concerned with the economic aspects of the trends in Canadian health care. Various myths and misconceptions abound regarding the applicability of economics to behaviour in the health care industry as well as to the interpretation of recent trends. Both issues are examined in this paper. While most discussions regarding health care trends begin with the share of health expenditures in Gross National Product, I propose an alternative share that adjusts for cyclical variations in both unemployment and labour force participation. Using this measure, I show that the "real" growth of resources devoted to the health care industry is much larger than that obtained with conventional measures, and that the difference in growth rates between Canada and the U.S. is narrowed considerably. The paper outlines and disputes the validity of three public health policy propositions. First, it is not empirically valid to say that the introduction of universal medical insurance in Canada successfully contained the growth in the share of society's resources devoted to the health care industry. Second, it is not correct to argue that the change in the federal funding for hospital and medical care in 1977 was a "fiscal non-event". And finally, the proposed "equity" funding formula for Ontario hospitals is unlikely to contain costs and will potentially skew hospitals towards the provision of complex forms of care instead of cost-effective community-based alternatives.

  15. Current use of navigation system in ACL surgery: a historical review. (United States)

    Zaffagnini, S; Urrizola, F; Signorelli, C; Grassi, A; Di Sarsina, T Roberti; Lucidi, G A; Marcheggiani Muccioli, G M; Bonanzinga, T; Marcacci, M


    The present review aims to analyse the available literature regarding the use of navigation systems in ACL reconstructive surgery underling the evolution during the years. A research of indexed scientific papers was performed on PubMed and Cochrane Library database. The research was performed in December 2015 with no publication year restriction. Only English-written papers and related to the terms ACL, NAVIGATION, CAOS and CAS were considered. Two reviewers independently selected only those manuscripts that presented at least the application of navigation system for ACL reconstructive surgery. One hundred and forty-six of 394 articles were finally selected. In this analysis, it was possible to review the main uses of navigation system in ACL surgery including tunnel positioning for primary and revision surgery and kinematic assessment of knee laxity before and after different surgical procedures. In the early years, until 2006, navigation system was mainly used to improve tunnel positioning, but since the last decade, this tool has been principally used for kinematics evaluation. Increased accuracy of tunnel placement was observed using navigation surgery, especially, regarding femoral, 42 of 146 articles used navigation to guide tunnel positioning. During the following years, 82 of 146 articles have used navigation system to evaluate intraoperative knee kinematic. In particular, the importance of controlling rotatory laxity to achieve better surgical outcomes has been underlined. Several applications have been described and despite the contribution of navigation systems, its potential uses and theoretical advantages, there are still controversies about its clinical benefit. The present papers summarize the most relevant studies that have used navigation system in ACL reconstruction. In particular, the analysis identified four main applications of the navigation systems during ACL reconstructive surgery have been identified: (1) technical assistance for tunnel

  16. Pacemaker Dependency after Cardiac Surgery: A Systematic Review of Current Evidence. (United States)

    Steyers, Curtis M; Khera, Rohan; Bhave, Prashant


    Severe postoperative conduction disturbances requiring permanent pacemaker implantation frequently occur following cardiac surgery. Little is known about the long-term pacing requirements and risk factors for pacemaker dependency in this population. We performed a systematic review of the literature addressing rates and predictors of pacemaker dependency in patients requiring permanent pacemaker implantation after cardiac surgery. Using a comprehensive search of the Medline, Web of Science and EMBASE databases, studies were selected for review based on predetermined inclusion and exclusion criteria. A total of 8 studies addressing the endpoint of pacemaker-dependency were identified, while 3 studies were found that addressed the recovery of atrioventricular (AV) conduction endpoint. There were 10 unique studies with a total of 780 patients. Mean follow-up ranged from 6-72 months. Pacemaker dependency rates ranged from 32%-91% and recovery of AV conduction ranged from 16%-42%. There was significant heterogeneity with respect to the definition of pacemaker dependency. Several patient and procedure-specific variables were found to be independently associated with pacemaker dependency, but these were not consistent between studies. Pacemaker dependency following cardiac surgery occurs with variable frequency. While individual studies have identified various perioperative risk factors for pacemaker dependency and non-resolution of AV conduction disease, results have been inconsistent. Well-conducted studies using a uniform definition of pacemaker dependency might identify patients who will benefit most from early permanent pacemaker implantation after cardiac surgery.

  17. The potential benefits and disadvantages of laparoscopic surgery for ulcerative colitis: A review of current evidence

    NARCIS (Netherlands)

    Buskens, Christianne J.; Sahami, Saloomeh; Tanis, Pieter J.; Bemelman, Willem A.


    Up to 35% of patients with ulcerative colitis will require surgery during the course of their disease. Nowadays, a total colectomy with ileal pouch-anal anastomosis is the preferred procedure, which can be performed open or via laparoscopic approach. Since the early '90s, minimally invasive

  18. Language Play and Linguistic Hybridity as Current Trends in Hungarian Word-Formation

    Directory of Open Access Journals (Sweden)

    Réka Benczes


    Full Text Available Hungarian literature on word-formation typically focuses on rule-governed descriptions of regular and typologically relevant patterns. However, there are plenty of other word-formation trends that usually go unnoticed in mainstream morphological research. The present paper will focus on two such trends: 1 rhyming and alliterating compounds such as pannon puma ‘Pannonian puma’ (a euphemism for Hungary’s economic performance, on the analogy of Asian tiger; and 2 creative prefixations such as meggugliz (‘to google’ and felhájpol (‘to hype’. Although these are seemingly two quite different patterns, in fact they share two significant traits. On the one hand, they are demonstrations of the fact that language users make full use of the creative possibilities in language and routinely play with sounds and meanings. On the other hand, they are also indications of the influential role of English in present-day Hungarian word-formation. It seems that language users are not only aware of the possibilities that this interference can result in but are also able to exploit these consciously. This crossing of language boundaries is becoming increasingly inevitable with the global spread of English.

  19. Current trends in the health of children and young people in learning environments

    Directory of Open Access Journals (Sweden)

    S.V. Garkusha


    Full Text Available Determined by the dynamics in the health of students and medical teams consisting of physical training in secondary schools. Analyzed the records in-depth inspection of magazines and leaflets health of 32484 schoolchildren of Chernigov for the period 2008-2012. Established a steady trend to a significant deterioration in the health of schoolchildren. A decline in the number of healthy children with the increase in the period of study from 1 to 11. Revealed negative trend decline in the health of children in the main medical group. Shows a tendency to increase the number of children belonging to the preparatory and special medical groups. It is recommended to use a recreational form of physical education and health educational use of technology. It is recommended to include in the training sessions: gymnastics, gymnastic minutes during lessons, exercise, and outdoor games on the elongated recess and daily physical education classes in the extended day, independent study after school, sports and mass work in the community.

  20. Public Debts Trends in the Current Economic Context, from Both National and International Perspective

    Directory of Open Access Journals (Sweden)

    Doina Dascalu


    Full Text Available . The article presents an analysis of the way public debt operates in Romania, in the context of states economies trends, of complex and topical financial environments. In the context of a functional market economy, the issues faced by certain states involving high public debt levels or potential budgetary pressure risks converge towards the idea that public finances sustainability needs to be a major challenge at the level of public policies. Considering this situation, the adequate policies to tackle public finances sustainability need to have, as a launching base, the overall strategy of the European Union, focused on the three component parts, namely abatement of public debt, increasing productivity and employment and last but not least, reforming the pension and healthcare systems. To ensure reasonably sustainable public debt levels, EU member states need to attain medium term strategic budgetary objectives, that would ensure a downward trend of public debt, a condition which can be fulfilled by compliance with budget policies rules, which ground development in the macroeconomic framework.

  1. Diagnosis and Management of Merkel Cell Carcinoma of the Head and Neck: Current Trends and Controversies

    International Nuclear Information System (INIS)

    Swanson, Mark S.; Sinha, Uttam K.


    Merkel cell carcinoma is an aggressive neuroendocrine cutaneous malignancy with a predilection for regional and distant metastasis. This malignancy presents most commonly on the head and neck of elderly Caucasian males, with a higher prevalence in the immunosuppressed. A high index of suspicion must be maintained due to the often asymptomatic presentation. Lip tumors, scalp tumors, local invasion, nodal metastasis, distant metastasis, and lymphovascular invasion are poor prognostic factors. Up to 8.7% of patients present with distant metastasis, and PET-CT is an accurate staging tool with a 90% sensitivity. Combined aggressive surgical resection with adjuvant radiotherapy affords the best regional control rates. The regional lymphatics must be addressed with either sentinel lymph node biopsy, surgery, or elective radiation due to the risk of occult metastasis. Addition of chemotherapy has no proven benefit in locoregional control

  2. Diagnosis and Management of Merkel Cell Carcinoma of the Head and Neck: Current Trends and Controversies

    Energy Technology Data Exchange (ETDEWEB)

    Swanson, Mark S.; Sinha, Uttam K., E-mail: [Department of Otolaryngology-Head and Neck Surgery, University of Southern California, 1520 San Pablo St, Suite 4600, Los Angeles, CA 90033 (United States)


    Merkel cell carcinoma is an aggressive neuroendocrine cutaneous malignancy with a predilection for regional and distant metastasis. This malignancy presents most commonly on the head and neck of elderly Caucasian males, with a higher prevalence in the immunosuppressed. A high index of suspicion must be maintained due to the often asymptomatic presentation. Lip tumors, scalp tumors, local invasion, nodal metastasis, distant metastasis, and lymphovascular invasion are poor prognostic factors. Up to 8.7% of patients present with distant metastasis, and PET-CT is an accurate staging tool with a 90% sensitivity. Combined aggressive surgical resection with adjuvant radiotherapy affords the best regional control rates. The regional lymphatics must be addressed with either sentinel lymph node biopsy, surgery, or elective radiation due to the risk of occult metastasis. Addition of chemotherapy has no proven benefit in locoregional control.

  3. Staffing Patterns in Public School Systems: Current Status and Trends, Update 2001. Research Snapshot. (United States)

    Williams, Alicia D.; Protheroe, Nancy; Parks, Michael C.

    Staffing patterns in American public-school systems are presented in this report of the 2000-01 school year. The report addresses the following: why information about staffing ratios is important; how many people currently work in public schools; what proportion of these are teachers, administrators, and support staff; current staffing patterns in…

  4. Current nondestructive evaluation research and development trends in the United States

    International Nuclear Information System (INIS)

    Jackson, Jerry


    An underlying theme present in much of the nondestructive evaluation (NDE) research and development occurring in the United States as well as worldwide is the application of physics and engineering principles toward understanding and optimizing NDE processes. Expanding this trend of using mathematical models for NDE processes is critical to the entire spectrum of NDE technology. In NDE research, modeling anchors the investigation in scientific, proven principles and establishes a firm technical basis to guide the design and development of inspection equipment and approaches. It also provides for understanding the capabilities and the limitations of whatever designs are selected and ultimately applied in the field. This paper reviews the status of these efforts, presents several examples where mathematical modeling is being profitably used for practical inspection work, and shows the path being taken in ongoing research.

  5. Energy sector assistance in developing countries: Current trends and policy recommendations

    International Nuclear Information System (INIS)

    Tharakan, Pradeep J.; Castro, Julio de; Kroeger, Timm


    An estimated 2.5 billion people remain without access to modern energy supplies. This shortfall is expected to grow as the population in developing countries continues to grow rapidly and the existing infrastructure ages. The United Nations' goal of lowering poverty by half by 2015 will not be attained unless the poor in developing countries gain greater access to basic infrastructure and services, including energy services. The key objective of this paper is to analyze trends in overseas development assistance (ODA) to the energy sector in developing countries during the period 1990-2003, relative to realized private sector investments. This analysis then forms the basis for policy recommendations for consideration by decision makers within countries that are major contributors to ODA

  6. Current state and development trends of the agroindustrial complex and rural territories of Perm Region

    Directory of Open Access Journals (Sweden)

    Gennadiy Vladimirovich Klimenkov


    Full Text Available Analysis of regional agricultural sector status and rural areas of Perm in 1990-2011 years indicates a systemic crisis of agriculture in Perm region, which is largely determined by the fact that Perm region has no strategy or strategic plan and program for sustainable agricultural sector and rural areas of Perm region development, there is no scheme of territorial development and master plans of territorial development with the development of agro-industrial complex of Perm region. In these circumstances, there is a steady downward trend in production, weakening and bankruptcy of enterprises, social impoverishment of rural areas, appearance of many of irreversible processes (sale and neglect of agricultural land, demographic problems associated with low living standards, population migration, policy optimization in the areas of education and health, union of territories, policy of depopulation of territories etc.. This paper presents main recommendations for improving the situation in agriculture of Perm region.

  7. Return of the "intimate outsider": current trends and issues in family nursing research revisited. (United States)

    Ganong, Lawrence


    This article reviews family nursing research published from 1996 to 2011. This is a follow-up to a review published in the Journal of Family Nursing in 1995. Findings from the first review are compared with this one, trends in family nursing scholarship are identified, and predictions and suggestions for future directions are offered. The latest generation of family nursing scholarship is conceptually and methodologically sound, and there is evidence of more multidisciplinary and interdisciplinary research conducted by family nursing researchers. Scholars are paying more attention to issues of diversity and family context at present than in the past, although there are still aspects of diversity that need more attention. Strong research programs in family nursing exist worldwide; an international synergism has helped promote rapid expansion of family nursing research and theory development. A vigorous movement to promote research to practice initiatives and greater attention to family interventions are exciting developments.

  8. Psychologists conducting Psychotherapy in 2012: current practices and historical trends among Division 29 members. (United States)

    Norcross, John C; Rogan, Jessica D


    This study updates three similar investigations conducted in 1981, 1991, and 2001 on APA Division of Psychotherapy members in order to paint a contemporary portrait of psychologists conducting psychotherapy and to chronicle historical trends among Division 29 members. Four hundred twenty-eight psychologists (43% response) completed a questionnaire in 2012 regarding their demographic characteristics, professional activities, theoretical orientations, employment settings, and career experiences. The results point to an increasingly female and aging membership, which continues to be employed primarily in private practices and universities. Psychodynamic (27%), integrative (25%), and cognitive (17%) orientations continue to prevail. Professional activities have remained quite similar across the past 30 years with the exception of declines in projective testing and growth in neuropsychological and health testing. Training and career satisfactions remain high as well.

  9. TianShuiShi space breeding current situation and developing trend

    International Nuclear Information System (INIS)

    Wang Fuquan; Song Jianrong; Zhang Zhongping; Guo Zhenfang


    TianShuiShi is located in xian to lanzhou among two big cities, the five space launch, has vegetables, food, grasses, flowers, rape, melon and fruit, Chinese traditional medicine, amount of 8 categories of crops, such as the 22 new material after carrying the ground breeding work. Only vegetables on identified 23 aerospace new varieties. After ten years of space breeding, summarizes the present situation of TianShuiShi space breeding, development experience, characteristic, trends, and puts forward the development space breeding TianShuiShi organization and breeding of talent from the matching policy and grow up incentive mechanism, strengthen the cooperation and all over the country, establishing fiscal policy support from the aspects such as advice. (authors)

  10. Historical trends and current state of heating and cooling degree days in Italy

    International Nuclear Information System (INIS)

    De Rosa, Mattia; Bianco, Vincenzo; Scarpa, Federico; Tagliafico, Luca A.


    Highlights: • A comparison among methods for calculating heating degree-days (HDD) is provided. • ASHRAE method is used for analyze the historical trends of HDD and CDD in Italy. • The HDD historical profile for Rome is decomposed in its characterizing components. - Abstract: Degree days (DD) represent a versatile climatic indicator which is commonly used in the analysis of building energy performance, as e.g. (i) to perform energetic assessment of existent and new buildings, (ii) to analyze the territory energy consumption, (iii) to develop scenario analyses in terms of energy consumption forecasting, and so on. Different methods can be used for determining the DD values, depending on the available climatic data of each location. In the present paper, the simplified methods based on reduced climatic data set have been compared assuming the mean daily degree-hours method (MDDH) as reference. Hourly temperature profiles recorded by the meteorological station located at the University of Genoa have been used for these analyses. In the second part of the present work, the ASHRAE method has been selected to calculate heating (HDD) and cooling (CDD) degree days for several Italian cities. In particular, daily meteorological data of several Italian cities (covering the whole climatic conditions which occur in Italy) have been used to calculate heating and cooling degree days in the period 1978–2013, in order to analyze their trends in the last years. Finally, the historical profiles of Rome and Milan have been treated as time-series and analyzed in the frequency domain, performing a decomposition of the original data set into different characterizing components. This simplified approach permits to deeply analyze the historical profile of DD and represents a simple starting point method for future analyses with forecasting perspectives

  11. Infective endocarditis prophylaxis: current practice trend among paediatric cardiologists: are we following the 2007 guidelines? (United States)

    Naik, Ronak J; Patel, Neil R; Wang, Ming; Shah, Nishant C


    In 2007, the American Heart Association modified the infective endocarditis prophylaxis guidelines by limiting the use of antibiotics in patients with cardiac conditions associated with the highest risk of adverse outcomes after infective endocarditis. Our objective was to evaluate current practice for infective endocarditis prophylaxis among paediatric cardiologists. A web-based survey focussing on current practice, describing the use of antibiotics for infective endocarditis prophylaxis in various congenital and acquired heart diseases, was distributed via e-mail to paediatric cardiologists. The survey was kept anonymous and was distributed twice. Data from 253 participants were analysed. Most paediatric cardiologists discontinued infective endocarditis prophylaxis in patients with simple lesions such as small ventricular septal defect, patent ductus arteriosus, and bicuspid aortic valve without stenosis or regurgitation; however, significant disagreement persists in prescribing infective endocarditis prophylaxis in certain conditions such as rheumatic heart disease, Fontan palliation without fenestration, and the Ross procedure. Use of antibiotic prophylaxis in certain selected conditions for which infective endocarditis prophylaxis has been indicated as per the current guidelines varies from 44 to 83%. Only 44% follow the current guidelines exclusively, and 34% regularly discuss the importance of oral hygiene with their patients at risk for infective endocarditis. Significant heterogeneity still persists in recommending infective endocarditis prophylaxis for several cardiac lesions among paediatric cardiologists. More than half of the participants (56%) do not follow the current guidelines exclusively in their practice. Counselling for optimal oral health in patients at risk for infective endocarditis needs to be optimised in the current practice.

  12. Polymers as Carriers of Gentamicin in Traumatology and Orthopedic Surgery - Current State Of Knowledge. (United States)

    Witkowski, Jarosław; Wnukiewicz, Witold; Reichert, Paweł


    Osteomyelitis in patients undergoing surgery because of injuries and diseases of the musculoskeletal system is a serious clinical, economic and social problem. It is one of the greatest therapeutic challenges in traumatology and orthopedic surgery. To achieve the best results in the treatment of osteomyelitis, surgical debridement and intravenous antibiotic therapy is supported by local antibiotic delivery. Many different substances can be used as drug carriers. In this study we present and compare some polymers used as carriers of gentamicin. Some of them, such as poly(methyl methacrylate), are well known and have been used for 30 years, and others, such as polycaprolactone, polyacrylic acid, polyanhydrides, poly-trimethylene carbonate, polylactide, polyglycolide and poly(trimethylene carbonate), are perspectives for the future. In this study, we have tried to briefly present all of these polymers and compare some of their features. We have concentrated on the pharmacokinetics and bioactivity of such implants, which are important aspects for their potential practical use.

  13. Current aspects in reconstructive surgery for nasal cavity and paranasal sinus cancer (United States)

    Shtin, V. I.; Novikov, V. A.; Gjunter, V. E.; Choinzonov, E. L.; Ryabova, A. I.; Sirkashev, V. A.; Surkova, P. V.; Vasilev, R. V.; Menkova, E. N.


    Tumors of the nasal cavity and paranasal sinuses present a challenge to treat them. A combination of surgery and radiation therapy can improve treatment outcomes in 49-56% [1, 2] of the patients with locally advanced nasal cavity and paranasal sinus cancer. The midface reconstruction poses a formidable challenge to the reconstructive surgeon due to the region's complex skeletal and soft-tissue anatomy. The rehabilitation program including the reconstruction of the resected orbital walls using the porous and mesh implants from titanium nickelid (TiNi) was developed at the Cancer Research institute jointly with the Research Institute of Medical Materials. The technique was proven effective, allowing the natural position of the eye and visual function to be preserved in 90% [1-3] of the patients. A long period of reparative processes and risk of developing inflammation in the implant area, as well as the need to decrease length of surgery, contributed to the development of a novel approach to repairing the midface bone structures using the implant based on the microporous wire and TiNi mesh. Eighteen patients with nasal cavity and paranasal sinus cancer were treated using the combined thin implants. The novel technique allowed the time of the implant installation to be reduced to 5-10 min. The structure of the implant contributed to prevention of inflammatory processes in 97% [1, 2] of cases. Thus, the natural position of the eyeball and visual function were preserved in 100% [1, 3, 4] of patients. The use of the TiNi implants in reconstructive surgery for patients with nasal cavity and paranasal sinus cancer led to reduced time of surgery and rehabilitation, increased level of social adaptation of patients and improved cosmetic and functional results.

  14. Unused Opioid Pills After Outpatient Shoulder Surgeries Given Current Perioperative Prescribing Habits. (United States)

    Kumar, Kanupriya; Gulotta, Lawrence V; Dines, Joshua S; Allen, Answorth A; Cheng, Jennifer; Fields, Kara G; YaDeau, Jacques T; Wu, Christopher L


    In the past 16 years, the number of prescription opioids sold in the United States, as well as deaths from prescription opioids, has nearly quadrupled. However, the overall amount of pain reported by patients has not changed significantly. Specific information about opioid prescriptions in the perioperative period is lacking. Of the studies that have been published, investigators have shown that the majority of patients have unused postoperative opioid pills. Moreover, patients appear to lack information about disposal of unused opioid pills. To compare the number of pills prescribed versus the numbers left unused after outpatient shoulder surgeries at an orthopaedic surgery institution. Case series; Level of evidence, 4. In this prospective, observational study, 100 patients (age >18 years) undergoing outpatient shoulder surgery (rotator cuff repair, labral repair, stabilization/Bankart repair, debridement) were enrolled. Follow-ups were conducted via surveys on postoperative days (PODs) 7, 14, 28, and 90. The primary outcome was the number of unused pills from the originally prescribed medication. For all procedure types, the median (Q1, Q3) number of prescribed pills was 60 (40, 80). On POD 90, patients reported a median (Q1, Q3) of 13 (0, 32) unused pills; patients who underwent rotator cuff repairs had the lowest number of pills remaining (median [Q1, Q3], 0 [0, 16]), whereas patients who had stabilization/Bankart repairs had the highest number of unused pills (median [Q1, Q3], 37 [29, 50]). Patient satisfaction with pain management ranged from an average of 70% to 90%. Only 25 patients received instructions or education about opioid disposal. Most outpatient shoulder surgery patients who underwent certain operations were prescribed more opioid analgesics than they consumed. Patient education regarding the disposal of opioids was lacking.

  15. Current Evidence regarding Prophylactic Antibiotics in Head and Neck and Maxillofacial Surgery (United States)


    Antibiotic prophylaxis is commonly used to decrease the rate of infections in head and neck surgery. The aim of this paper is to present the available evidence regarding the application of antibiotic prophylaxis in surgical procedures of the head and neck region in healthy patients. A systemic literature review based on Medline and Embase databases was performed. All reviews and meta-analyses based on RCTs in English from 2000 to 2013 were included. Eight out of 532 studies fulfilled all requirements. Within those, only seven different operative procedures were analyzed. Evidence exists for the beneficial use of prophylactic antibiotics for tympanostomy, orthognathic surgery, and operative tooth extractions. Unfortunately, little high-level evidence exists regarding the use of prophylactic antibiotics in head and neck surgery. In numerous cases, no clear benefit of antibiotic prophylaxis has been shown, particularly considering their potential adverse side effects. Antibiotics are often given unnecessarily and are administered too late and for too long. Furthermore, little research has been performed on the large number of routine cases in the above-mentioned areas of specialization within the last few years, although questions arising with respect to the treatment of high-risk patients or of specific infections are discussed on a broad base. PMID:25110703

  16. Current Trends in the Monitoring and Treatment of Diabetic Retinopathy in Young Adults

    Directory of Open Access Journals (Sweden)

    Dorota Raczyńska


    Full Text Available The diagnosis and treatment of diabetic retinopathy (DR in young adults have significantly improved in recent years. Research methods have widened significantly, for example, by introducing spectral optical tomography of the eye. Invasive diagnostics, for example, fluorescein angiography, are done less frequently. The early introduction of an insulin pump to improve the administration of insulin is likely to delay the development of diabetic retinopathy, which is particularly important for young patients with type 1 diabetes mellitus (T1DM. The first years of diabetes occurring during childhood and youth are the most appropriate to introduce proper therapeutic intervention before any irreversible changes in the eyes appear. The treatment of DR includes increased metabolic control, laserotherapy, pharmacological treatment (antiangiogenic and anti-inflammatory treatment, enzymatic vitreolysis, and intravitreal injections, and surgery. This paper summarizes the up-to-date developments in the diagnostics and treatment of DR. In the literature search, authors used online databases, PubMed, and and browsed through individual ophthalmology journals, books, and leading pharmaceutical company websites.

  17. Rotator cuff injuries: current perspectives and trends for treatment and rehabilitation

    Directory of Open Access Journals (Sweden)

    Fabio Antonio Vieira


    Full Text Available ABSTRACT OBJECTIVE: To map out the approaches used by Brazilian orthopedists in treating complete tears of the rotator cuff. METHODS: A multiple-choice questionnaire was handed out to 232 orthopedists at the 45th Brazilian Congress of Orthopedics and Traumatology. Of these, 207 were returned but five were incomplete and were excluded. Thus, 202 questionnaires were used. RESULTS: Among the orthopedists who answered the questionnaires, around 60% were from the southeastern region and 46% were shoulder and elbow surgeons. There was a significant association ( p < 0.05 between length of experience and number of rotator cuff repairs performed per year. There was also a significant association ( p < 0.05 between shoulder specialty and the following variables: arthroscopic technique, use of anchors in a single-row configuration, mean time taken for an indication for surgery to be made in cases of traumatic and degenerative lesions, use of a specific protocol for postsurgical rehabilitation, return to sport and indication of irreparable injuries. CONCLUSIONS: Brazilian shoulder surgeons have well-established approaches toward treating rotator cuff injuries. Most of these approaches differ significantly from those of other specialties. This shows the importance of placing value on training in preparing shoulder specialists in this country.

  18. Current trends in the treatment of polycystic ovary syndrome with desire for children

    Directory of Open Access Journals (Sweden)

    Margalida E Sastre


    Full Text Available Margalida E Sastre1, Maria O Prat1, Miguel Angel Checa1,2, Ramon C Carreras11Department of Obstetrics and Gynaecology; 2Unit of Endocrinological Gynaecology and Human Reproduction, Hospital del Mar, Autonomous University of Barcelona, Barcelona, SpainAbstract: Polycystic ovary syndrome (PCOS, one of the most frequent endocrine diseases, affects approximately 5%–10% of women of childbearing age and constitutes the most common cause of female sterility regardless of the need or not for treatment, a change in lifestyle is essential for the treatment to work and ovulation to be restored. Obesity is the principal reason for modifying lifestyle since its reduction improves ovulation and the capacity for pregnancy and lowers the risk of miscarriage and later complications that may occur during pregnancy (gestational diabetes, pre-eclampsia, etc. When lifestyle modification is not sufficient, the first step in ovulation induction is clomiphene citrate. The second-step recommendation is either exogenous gonadotrophins or laparoscopic ovarian surgery. Recommended third-line treatment is in vitro fertilization. Metformin use in PCOS should be restricted to women with glucose intolerance.Keywords: polycystic ovarian syndrome, clomiphene citrate, letrozole, lifestyle, pregnancy, obesity 

  19. What the Current System Development Trends tell us about Systems Development Methodologies: Toward explaining SSDAM, Agile and IDEF0 Methodologies

    Directory of Open Access Journals (Sweden)

    Abdulla F. Ally


    Full Text Available Systems integration, customization and component based development approach are of increasing attention. This trend facilitates the research attention to also focus on systems development methodologies. The availability of systems development tools, rapid change in technologies, evolution of mobile computing and the growth of cloud computing have necessitated a move toward systems integration and customization rather than developing systems from scratch. This tendency encourages component based development and discourages traditional systems development approach. The paper presents and evaluates SSADM, IDEF0 and Agile systems development methodologies. More specifically, it examines how they fit or not fit into the current competitive market of systems development. In the view of this perspective, it is anticipated that despite of its popularity, SSADM methodology is becoming obsolete while Agile and IDEF0 methodologies are still gaining acceptance in the current competitive market of systems development. The present study more likely enrich our understanding of the systems development methodologies concepts and draw attention regarding where the current trends in system development are heading.

  20. Purification of natural gas using membrane - the current status and research trends

    International Nuclear Information System (INIS)

    Farooq Ahmad; Mukhtar, H.; Man, Z.; Dutta, B. K.


    Separation of acid gases and lower hydrocarbon from raw natural gas has been a challenging problem in a gas processing unit. Despite the availability of chemical and cryogenic routes, search for a better alternative has been on for the last several decades. Considerable success has been achieved in the recent years by use of polymeric membrane and many units are operating using hollow fiber and spirally wound modules. The initial success notwithstanding the quest for better membrane and strategically designed modules has gained more momentum in the recent years. While research inputs to modify rubbery membranes or to develop new glassy membranes are continuing, inorganic membrane have attracted a lot of attention because of a number of reasons such as thermal and chemical stability, mechanical strength and the advantage of engineered pores. In the above perspective it appears necessary to make a review of the present status of research as well as applications in relation to both polymeric and inorganic membranes for raw natural gas processing. The present paper is an attempt in this direction. Experimental findings reported in the literature together with novel theories that will eventually help in tailoring membranes both chemically and physically have been critically analyzed and the trends in the future direction of research have been identified. A survey of application of membrane technology for acid gas separation in industries world wide has been made

  1. Ten years after "Worrying trends in econophysics": developments and current challenges (United States)

    Ormerod, Paul


    Econophysics has made a number of important additions to scientific knowledge. Yet it continues to lack influence with both economists and policy makers. Ten years ago, I and three other economists sympathetic to econophysics wrote a paper on worrying trends within the discipline. For example, its lack of awareness of the economics literature, and shortfalls in the use of statistical analysis. These continue to be obstacles to wider acceptance by economists. Like all agents, policy makers respond to incentives, and economists understand this very well. Much of the econophysics community appears to think that simply doing good science is sufficient to have the work recognised, rather than relating to the motivations and incentives of policy makers. Nevertheless, econophysics now has three major opportunities to advance knowledge in areas where policy makers perceive weaknesses in what they are presented with by economists. All can benefit from the analysis of Big Data. The first is a core model of agent behaviour which is more relevant to cyber society than the rational agent model of economics. Second, extending our understanding of the business cycle, primarily by incorporating the importance of networks into models. Third, devising proper measures of output in cyber society.

  2. Otolaryngology in the medical school curriculum: Current trends in the United States. (United States)

    Boscoe, Elizabeth F; Cabrera-Muffly, Cristina


    To identify trends in medical school otolaryngology curriculum requirements. Survey of United States allopathic medical schools. A survey was sent to deans of curriculum at allopathic medical schools. We identified opportunities for medical students to learn basic concepts in otolaryngology during their undergraduate medical training. The opportunities were classified into preclinical and clinical as well as elective and mandatory rotations. Of the schools surveyed, 60% responded. Mean class size was 149 students. Sixty-eight percent of surveyed schools noted that 75% to 100% of their students participated in preclinical otolaryngology experiences, with 59% reporting a mandatory preclinical otolaryngology module for all students. Eighty-nine percent of schools offered otolaryngology as a clinical elective rotation, with a mean of 12 students participating yearly. Only 7% of schools required a mandatory otolaryngology clinical rotation. Our data suggest that medical students do not receive sufficient exposure to otolaryngology during medical school. Increased requirements for otolaryngology curriculum may be beneficial to all medical students, regardless of their specialty choice. NA. Laryngoscope, 00:000-000, 2016 127:346-348, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  3. Current Technology Trends and Issues among Health and Physical Education Professionals (United States)

    Krause, Jennifer M.; Franks, Hillary; Lynch, Brandy


    Health and physical education professionals who implement technology appropriately can contribute to helping students become physically educated individuals (NASPE, 2009). It is imperative that professionals be knowledgeable and resourceful in how to integrate technology effectively, but it is unclear what current challenges professionals face in…

  4. The Development of Professional Counseling in Uganda: Current Status and Future Trends (United States)

    Senyonyi, Ruth M.; Ochieng, Lois A.; Sells, James


    Professional counseling in Uganda has foundations in traditional cultures of its peoples, guidance offered in schools, and counseling to curb the HIV/AIDS epidemic. Currently, a definitive professional counselor profile in Uganda is being established. The Uganda Counselling Association continues the process of seeking legal authority to regulate…

  5. Increasing Inter-Parliamentary Cooperation in the European Union : Current Trends and Challenges

    NARCIS (Netherlands)

    Fromage, D.B.|info:eu-repo/dai/nl/370195086


    This article analyses the blossoming of the initiatives for inter-parliamentary cooperation currently observable in the European Union from a democratic legitimacy perspective. It shows that there exists numerous forms and settings for the cooperation among national parliaments (NPs) and with the

  6. Proceedings of the DAE-BRNS life sciences symposium on current trends in biology and medicine

    International Nuclear Information System (INIS)


    This year's Life Sciences Symposium is focused on Health Sciences. It will provide an interactive platform for deliberations on current developments in basic research on cancer, diabetes, infectious diseases, reproduction, stem cells and degenerative diseases. Several aspects like metabolism, use of biophysical techniques, detection methods, micro RNA based regulation, assisted reproductive technologies etc. are covered. Papers relevant to INIS are indexed separately

  7. Atrial Fibrillation in Singapore and Malaysia: Current Trends and Future Prospects

    Directory of Open Access Journals (Sweden)

    Razali Omar, MD FHRS FACC


    There is an unmet need for better anti-arrhythmic drugs that are well tolerated, efficacious, cost-effective and have a more favourable safety profile than current options. Although the perfect agent remains to be discovered, some promising new anti-arrhythmic drugs have the potential to overcome certain limitations of established approaches to AF management.

  8. Current trends in the management of ocular symptoms in Adamantiades-Behçet’s disease

    Directory of Open Access Journals (Sweden)

    Fouad R Zakka


    Full Text Available Fouad R Zakka,1 Peter Y Chang,1 Gian P Giuliari,1 C Stephen Foster1,21Massachusetts Eye Research and Surgery institution (MERSI, Cambridge, Massachusetts, USA; 2Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USAAbstract: Adamantiades-Behçet’s disease (ABD is a multisystemic vasculitic disease. It is most prevalent in the Eastern Mediterranean countries and the Eastern region of Asia. Its effect on the eye can range from mild to debilitating, resulting in total blindness. A necrotizing and obliterative vasculitis affects both arteries and veins of organs. Recurrent attacks of uveitis, oral aphthous ulcers, skin lesions, and genital ulcers are common. Topical and systemic corticosteroids have been the mainstay in the treatment of ocular inflammation for many years; however, due to the several known side effects of corticosteroids and thanks to scientific advances, more novel approaches to ABD treatment have been emerging. Antimetabolites such as methotrexate and azathioprine have been utilized with the latter showing positive results. Chlorambucil has been utilized effectively for ocular manifestations of ABD. Interferon alpha has shown encouraging results in the management of refractory ocular inflammation associated with ABD, either alone or in combination with other immunosuppressive agents. Surgical interventions to deal with complications from ABD can be safely done if adequate control of inflammation is achieved peri-operatively. Early detection and aggressive treatment, when needed, have proven to be essential in the management of this relentlessly explosive disease.Keywords: Adamantiades-Behçet’s disease, Behçet’s disease, ocular inflammation, uveitis, immunomodulatory therapy, immunosuppressive therapy

  9. Current controversies in reconstructive surgery of the anterior urethra: a clinical overview

    Directory of Open Access Journals (Sweden)

    Guido Barbagli


    Full Text Available We performed an overview of the surgical techniques suggested for the treatment of anterior urethral strictures using MEDLINE. In applying the MEDLINE search, we used the "MeSH" (Medical Subject Heading and "free text" protocols. The MeSH search was conducted by combining the following terms: "urethral stricture", "flap", "graft", "oral mucosa", "urethroplasty", "urethrotomy" and "failed hypospadias". Multiple "free text" searches were performed individually applying the following terms through all fields of the records: "reconstructive urethral surgery", "end-to-end anastomosis", "one-stage", "two stage". Descriptive statistics of the articles were provided. Meta-analyses were not employed. Seventy-eight articles were determined to be germane in this review. Six main topics were identified as controversial in anterior urethra surgery: the use of oral mucosa vs penile skin; the use of free grafts vs pedicled flaps in penile urethroplasty; the use of grafts vs anastomotic repair in bulbar urethral strictures; the use of dorsal vs ventral placement of the graft in bulbar urethroplasty; the use of definitive perineal urethrostomy vs one-stage repair in complex urethral strictures; the surgical options for patients with failed hypospadias repair. Different points of view are documented and presented in the literature by various authors from different countries. The aim of this clinical overview is to survey the main controversial issues in surgical reconstruction of the anterior urethra focusing on the use of flap or graft, substitute material, type of surgery and challenging situations, such as failed hypospadias or complex urethral stricture repair.

  10. Current applications of robotics in spine surgery: a systematic review of the literature. (United States)

    Joseph, Jacob R; Smith, Brandon W; Liu, Xilin; Park, Paul


    OBJECTIVE Surgical robotics has demonstrated utility across the spectrum of surgery. Robotics in spine surgery, however, remains in its infancy. Here, the authors systematically review the evidence behind robotic applications in spinal instrumentation. METHODS This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Relevant studies (through October 2016) that reported the use of robotics in spinal instrumentation were identified from a search of the PubMed database. Data regarding the accuracy of screw placement, surgeon learning curve, radiation exposure, and reasons for robotic failure were extracted. RESULTS Twenty-five studies describing 2 unique robots met inclusion criteria. Of these, 22 studies evaluated accuracy of spinal instrumentation. Although grading of pedicle screw accuracy was variable, the most commonly used method was the Gertzbein and Robbins system of classification. In the studies using the Gertzbein and Robbins system, accuracy (Grades A and B) ranged from 85% to 100%. Ten studies evaluated radiation exposure during the procedure. In studies that detailed fluoroscopy usage, overall fluoroscopy times ranged from 1.3 to 34 seconds per screw. Nine studies examined the learning curve for the surgeon, and 12 studies described causes of robotic failure, which included registration failure, soft-tissue hindrance, and lateral skiving of the drill guide. CONCLUSIONS Robotics in spine surgery is an emerging technology that holds promise for future applications. Surgical accuracy in instrumentation implanted using robotics appears to be high. However, the impact of robotics on radiation exposure is not clear and seems to be dependent on technique and robot type.

  11. History and Current Status of Cardiovascular Surgery at the University of Pennsylvania. (United States)

    Acker, Michael A; Bavaria, Joseph E; Barker, Clyde F


    The cardiothoracic surgery program at the University of Pennsylvania has enjoyed a decades long tradition of leadership and contributions to the field. Consistent with its place as a robust contributor in a major academic medical center, its focus is on the tripartite mission of clinical care, research and education, including the provision of cutting edge care delivered to patients in a multidisciplinary fashion. Faculty members' pursuit of translational research facilitates the delivery of such exceptional treatment and provision of excellent care. This foundation is ideal for the training of the outstanding surgeons of tomorrow, as evidenced by a history of such contributions. Copyright © 2015. Published by Elsevier Inc.

  12. Glaucoma treatment trends: a review. (United States)

    Conlon, Ronan; Saheb, Hady; Ahmed, Iqbal Ike K


    Glaucoma is one of the most common causes of blindness worldwide, and its prevalence is increasing. The aim of the present review is to describe the current medical and surgical treatment trends in the management of open-angle glaucoma. There has been an increase in the availability of glaucoma medications and the use of laser trabeculoplasty over the past decade, with a subsequent decrease in invasive incisional surgery. In addition, a new class of glaucoma procedures, termed microinvasive glaucoma surgery, has emerged, which aims to fill the gap between conservative medical management and more invasive surgery. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  13. Regulatory assessment of safety culture in nuclear organisations - current trends and challenges

    International Nuclear Information System (INIS)

    Tronea, M.


    The paper gives an overview of the current practices in the area of regulatory assessment of safety culture in nuclear organisations and of the associated challenges. While the assessment and inspection procedures currently in use by regulatory authorities worldwide are directed primarily at verifying compliance with the licensing basis, there is a recognised need for a more systematic approach to the identification, collection and review of data relevant to the safety culture in licensees' organisations. The paper presents a proposal for using the existing regulatory inspection practices for gathering information relevant to safety culture and for assessing it in an integrated manner. The proposal is based on the latest requirements and guidance issued by the International Atomic Energy Agency (IAEA) on management systems for nuclear facilities and activities, particularly as regards the attributes needed for a strong nuclear safety culture. (author)

  14. Current trends in research and clinical issues in the study of personality and its disorders

    DEFF Research Database (Denmark)

    Simonsen, Erik; Sørensen, Per; Pedersen, Liselotte


    lecture (Simonsen), a young researchers' symposium (Hopwood, Sharp, and Kaess), and special lectures on the Danish philosopher Soeren Kierkegaard and the poet Hans Christian Andersen. In this article we will survey the presentations and highlight the important issues in order to underline the current......The International Society for the Study of Personality Disorders (ISSPD) celebrated its 25th anniversary in September 2013 in Copenhagen and commemorated the First International Congress at the same site. The overall theme of the congress was "Bridging Personality and Psychopathology: The Person...... Behind the Illness." More than 400 abstracts were submitted, and the program included 8 keynote presentations, 18 invited symposia, a debate on current controversial issues in the classification of personality disorders (Fossati, Tyrer, Livesley, and Krueger), an ISSPD award lecture (Silk), a jubilee...

  15. Chemical warfare agent detection: a review of current trends and future perspective. (United States)

    Pacsial-Ong, Eden Joy; Aguilar, Zoraida P


    The World Health Organization recommends countries to create a public health system that can respond to the deliberate release of chemical warfare agents (CWAs). Procedures for preparedness, response, decontamination protocols and medical countermeasures against CWA attacks are described. Known CWAs, including their properties and pharmacological consequences upon exposure, are tabulated and discussed. Requirements imposed on detection systems by various applications and environmental needs are presented in order to assess the devices for detection and identification of specific CWAs. The review surveys current and near-term detection technologies and equipments, as well as devices that are currently available to the military and civilian first responders. Brief technical discussions of several detection technologies are presented, with emphasis placed in the principles of detection. Finally, enabling technologies that form the basis for advanced sensing systems and devices are described.

  16. Mercury Content of Sediments in East Fork Poplar Creek: Current Assessment and Past Trends

    Energy Technology Data Exchange (ETDEWEB)

    Brooks, Scott C. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Eller, Virginia A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Dickson, Johnbull O. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Earles, Jennifer E. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Lowe, Kenneth Alan [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Mehlhorn, Tonia L. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Olsen, Todd A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); DeRolph, Christopher R. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Watson, David J. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Phillips, Debra H. [Queen' s Univ., Belfast (United Kingdom); Peterson, Mark J. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)


    This study provided new information on sediment mercury (Hg) and monomethylmercury (MMHg) content and chemistry. The current inventory of Hg in East Fork Poplar Creek (EFPC) bed sediments was estimated to be 334 kg, which represents a ~67% decrease relative to the initial investigations in 1984. MMHg sediment inventory was estimated to be 44.1 g, lower but roughly similar to past estimates. The results support the relevance and potential impacts of other active and planned investigations within the Mercury Remediation Technology Development for Lower East Fork Poplar Creek project (e.g., assessment and control of bank soil inputs, sorbents for Hg and MMHg removal, re-introduction of freshwater clams to EFPC), and identify gaps in current understanding that represent opportunities to understand controlling variables that may inform future technology development studies.

  17. Recent trends for practical rehabilitation robotics, current challenges and the future. (United States)

    Yakub, Fitri; Md Khudzari, Ahmad Zahran; Mori, Yasuchika


    This paper presents and studies various selected literature primarily from conference proceedings, journals and clinical tests of the robotic, mechatronics, neurology and biomedical engineering of rehabilitation robotic systems. The present paper focuses of three main categories: types of rehabilitation robots, key technologies with current issues and future challenges. Literature on fundamental research with some examples from commercialized robots and new robot development projects related to rehabilitation are introduced. Most of the commercialized robots presented in this paper are well known especially to robotics engineers and scholars in the robotic field, but are less known to humanities scholars. The field of rehabilitation robot research is expanding; in light of this, some of the current issues and future challenges in rehabilitation robot engineering are recalled, examined and clarified with future directions. This paper is concluded with some recommendations with respect to rehabilitation robots.

  18. 3-D bioprinting technologies in tissue engineering and regenerative medicine: Current and future trends

    Directory of Open Access Journals (Sweden)

    Elliot S. Bishop


    Full Text Available Advances in three-dimensional (3D printing have increased feasibility towards the synthesis of living tissues. Known as 3D bioprinting, this technology involves the precise layering of cells, biologic scaffolds, and growth factors with the goal of creating bioidentical tissue for a variety of uses. Early successes have demonstrated distinct advantages over conventional tissue engineering strategies. Not surprisingly, there are current challenges to address before 3D bioprinting becomes clinically relevant. Here we provide an overview of 3D bioprinting technology and discuss key advances, clinical applications, and current limitations. While 3D bioprinting is a relatively novel tissue engineering strategy, it holds great potential to play a key role in personalized medicine.

  19. Current Trends in the Management of Lateral Ankle Sprain in the United States. (United States)

    Feger, Mark A; Glaviano, Neal R; Donovan, Luke; Hart, Joseph M; Saliba, Susan A; Park, Joseph S; Hertel, Jay


    To characterize trends in the acute management (within 30 days) after lateral ankle sprain (LAS) in the United States. Descriptive epidemiology study. Of note, 825 718 ankle sprain patients were identified; 96.2% were patients with LAS. Seven percent had an associated fracture and were excluded from the remaining analysis. Primary and tertiary care settings. We queried a database of national health insurance records for 2007 to 2011 by ICD-9 codes for patients with LAS while excluding medial and syndesmotic sprains and any LAS with an associated foot or ankle fracture. The percentage of patients to receive specific diagnostic imaging, orthopedic devices, or physical therapy treatments within 30 days of the LAS diagnosis and the associated costs. Over two-thirds of patients with LAS without an associated fracture received radiographs, 9% received an ankle brace, 8.1% received a walking boot, 6.5% were splinted, and 4.8% were prescribed crutches. Only 6.8% received physical therapy within 30 days of their LAS diagnosis, 94.1% of which performed therapeutic exercise, 52.3% received manual therapy, and 50.2% received modalities. The annual cost associated with physician visits, diagnostic imaging, orthopedic devices, and physical therapy was 152 million USD, 81.5% was from physician evaluations, 7.9% from physical therapy, 7.2% from diagnostic imaging, and 3.4% from orthopedic devices. Most patients with LAS do not receive supervised rehabilitation. The small proportion of patients with LAS to receive physical therapy get rehabilitation prescribed in accordance with clinical practice guidelines. The majority (>80%) of the LAS financial burden is associated with physician evaluations.

  20. Improving Control System Security through the Evaluation of Current Trends in Computer Security Research

    Energy Technology Data Exchange (ETDEWEB)



    At present, control system security efforts are primarily technical and reactive in nature. What has been overlooked is the need for proactive efforts, focused on the IT security research community from which new threats might emerge. Evaluating cutting edge IT security research and how it is evolving can provide defenders with valuable information regarding what new threats and tools they can anticipate in the future. Only known attack methodologies can be blocked, and there is a gap between what is known to the general security community and what is being done by cutting edge researchers --both those trying to protect systems and those trying to compromise them. The best security researchers communicate with others in their field; they know what cutting edge research is being done; what software can be penetrated via this research; and what new attack techniques and methodologies are being circulated in the black hat community. Standardization of control system applications, operating systems, and networking protocols is occurring at a rapid rate, following a path similar to the standardization of modern IT networks. Many attack methodologies used on IT systems can be ported over to the control system environment with little difficulty. It is extremely important to take advantage of the lag time between new research, its use on traditional IT networks, and the time it takes to port the research over for use on a control system network. Analyzing nascent trends in IT security and determining their applicability to control system networks provides significant information regarding defense mechanisms needed to secure critical infrastructure more effectively. This work provides the critical infrastructure community with a better understanding of how new attacks might be launched, what layers of defense will be needed to deter them, how the attacks could be detected, and how their impact could be limited.

  1. Current trends for improving the design of membrane devices for photoautotrophic biosynthesis is light dependent microorganisms

    Directory of Open Access Journals (Sweden)

    A. A. Shevtsov


    Full Text Available Modern trends in improving the design of membrane devices for photoautotrophic biosynthesis dependent lighting microorganisms aimed at a significant increase in the productivity of valuable products from biomass of microalgae and obtaining on the basis of their individual useful substances (drugs used in various industries and medicine. In film devices effectively the processes of heat - and mass-exchange with the gas comes into contact with the culture fluid flowing as a film on a transparent film-forming surface is STI in its light intensity and autotrophic biosynthesis occurs only in the presence of a mixture of air with carbon dioxide. Thus, completely eliminated the accumulation of metabolic products due to their continuous removal from film culture liquid with the process gas, which is not typical for devices of other types. Small size membrane bioreactors may increase the degree of saturation of the liquid carbon dioxide with the possibility of changing the concentration of gas in the culture fluid and to ensure the cultivation of microorganisms with a specified biomass yield. At present up to date-developed a significant number of ways to ensure contact of the gas with the liquid (bubbling, gas-lift, mechanical stirring, jet, membrane, etc. on the basis of which an industrial bioreactor, with various "stress" effect. It is believed that for the cultivation of the most optimal are bioreactors with mechanical stirring of the liquid, which allow the greatest productivity of biomass. However, the applied model of a mechanical mixing device to create a work whose cavity of the bioreactor chaotic, disorganized mixing, which contributes to the emergence, insufficient for the sustenance of the cell cultures and microorganisms. Analysis of the interactions of the gas with the liquid film devices showed the need to create a new generation of bioreactor with intensive mass transfer without the possibility of limiting the productivity of

  2. Public perception of hazardousness caused by current trends of municipal solid waste management. (United States)

    Al-Khatib, Issam A; Kontogianni, Stamatia; Abu Nabaa, Hendya; Alshami, Ni'meh; Al-Sari', Majed I


    Municipal solid waste (MSW) piling up is becoming a serious problem in all developing countries (DC) as a result of inequitable waste collection and treatment. Citizens' collaboration is partly based on understanding their views and their active involvement in MSW planning; on the other hand the assessment of the perception of hazardousness related with MSW is considered rather important as well since the identification of the weak points of the applied MWM strategy is eased and the level of required training is determined. Researchers implemented a case study in the West Bank (WB) and Gaza Strip (GS) regions of Palestine, taking into consideration previous researches in other developing countries. They reached to safe and useful conclusions regarding the parameters which mean the greatest in the waste management field as far as DC are concerned. Lack of skilled manpower, irregular collection services, inadequate equipment used for waste collection, inadequate legal provisions, and resource constraints are additional factors that are confirmed to be challenging the waste management scenarios in all DCs today. The research takes those factors under consideration but focuses on the educational gap and the results revealed interesting trends a significant relationship between respondent's educational attainment and their awareness of hazardous waste (hazard perception); the results will indicate the measure taking required to avoid accidents occurred in those regions (burns from toxics, cuts from sharps, etc). National policy and legislation development based on the research outcomes will ensure equitable and accessible services are in place in order to move towards a healthier environment. Specialized health education and training programs on national scale are also needed to enhance awareness on hazardous waste. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Organizational charts in a selection of LIBER libraries : analysis of current trends

    Directory of Open Access Journals (Sweden)

    Suzanne Jouguelet


    Full Text Available The survey of organization structures analyzed in this paper was launched at the end of 2005 by the LIBER Division Library Management and Administration (LMA. It was conducted electronically in a representative group of LIBER libraries located across Europe: 78 libraries from 33 countries. It has been analyzed by the LMA Division’s committee and a member of the staff of the Bibliothèque nationale de France (BnF, allocating groups of countries between them, with the very important help of the French school of librarianship. I want to give warm thanks to all the colleagues who have responded and to those who have helped in the analysis of this very rich material. The selection of libraries was made by the members of the committee, according to their geographical contacts. The answers give an uneven geographic representation (see Appendix 2 and the libraries are of different types and sizes, but all are research libraries affiliated to LIBER. The main purpose of the survey was to gain an insight into what organization charts can tell us about the evolution of research libraries in different European countries. The key goals were to compare organization and service arrangements in a range of libraries, to gain an understanding of changes in recent years, as evidenced by the organization charts, and to analyse trends in the evolution of organizations, rather than arriving at firm quantifiable findings concerning change. Our intention was not to investigate change in general, but merely to look at the way it has been expressed through organization charts (and their evolution over time. The work is indicative rather than scientifically significant.

  4. Surface soil moisture retrievals from remote sensing: Current status, products & future trends (United States)

    Petropoulos, George P.; Ireland, Gareth; Barrett, Brian

    Advances in Earth Observation (EO) technology, particularly over the last two decades, have shown that soil moisture content (SMC) can be measured to some degree or other by all regions of the electromagnetic spectrum, and a variety of techniques have been proposed to facilitate this purpose. In this review we provide a synthesis of the efforts made during the last 20 years or so towards the estimation of surface SMC exploiting EO imagery, with a particular emphasis on retrievals from microwave sensors. Rather than replicating previous overview works, we provide a comprehensive and critical exploration of all the major approaches employed for retrieving SMC in a range of different global ecosystems. In this framework, we consider the newest techniques developed within optical and thermal infrared remote sensing, active and passive microwave domains, as well as assimilation or synergistic approaches. Future trends and prospects of EO for the accurate determination of SMC from space are subject to key challenges, some of which are identified and discussed within. It is evident from this review that there is potential for more accurate estimation of SMC exploiting EO technology, particularly so, by exploring the use of synergistic approaches between a variety of EO instruments. Given the importance of SMC in Earth's land surface interactions and to a large range of applications, one can appreciate that its accurate estimation is critical in addressing key scientific and practical challenges in today's world such as food security, sustainable planning and management of water resources. The launch of new, more sophisticated satellites strengthens the development of innovative research approaches and scientific inventions that will result in a range of pioneering and ground-breaking advancements in the retrievals of soil moisture from space.

  5. Current trends in dextranomer hyaluronic acid copolymer (Deflux) injection technique for endoscopic treatment of vesicoureteral reflux. (United States)

    Kirsch, Andrew J; Arlen, Angela M; Lackgren, Goran


    To determine the current preferred injection technique(s) for endoscopic management of pediatric vesicoureteral reflux (VUR). Since the approval of dextranomer hyaluronic acid copolymer (Dx/HA) in 2001, injection methods have evolved and now include the hydrodistention implantation technique (HIT) and double HIT as well as subureteral transurethral injection (STING) method. In July 2012, 278 pediatric urologists in the United States were contacted to complete a 15-question survey regarding Dx/HA injection technique(s) currently used in their practice. Fifty board-certified pediatric urologists completed the survey for a response rate of 18%. Most respondents (60%) were in a single-specialty group practice, and 12% were affiliated with an academic- or university-based practice. Respondents reported seeing a mean of 159 pediatric patients (range, 40-400 patients) with VUR annually, and 94% used Dx/HA ≥4 times in the past year. Forty-seven respondents (94%) reported using double HIT over the course of their career compared with 36 (72%) for STING and 30 (60%) for HIT (P injection techniques. A significantly higher percentage currently perform double HIT (92%) compared with either STING (24%) or HIT (34%; P <.001). Respondents reported the use of double HIT 15 times more often than STING technique and 5 times more often than HIT during the past 12 months (P <.001). The double HIT method is currently the most commonly performed technique for endoscopic correction of VUR by pediatric urologists in the United States. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Plastics, the environment and human health: current consensus and future trends (United States)

    Thompson, Richard C.; Moore, Charles J.; vom Saal, Frederick S.; Swan, Shanna H.


    Plastics have transformed everyday life; usage is increasing and annual production is likely to exceed 300 million tonnes by 2010. In this concluding paper to the Theme Issue on Plastics, the Environment and Human Health, we synthesize current understanding of the benefits and concerns surrounding the use of plastics and look to future priorities, challenges and opportunities. It is evident that plastics bring many societal benefits and offer future technological and medical advances. However, concerns about usage and disposal are diverse and include accumulation of waste in landfills and in natural habitats, physical problems for wildlife resulting from ingestion or entanglement in plastic, the leaching of chemicals from plastic products and the potential for plastics to transfer chemicals to wildlife and humans. However, perhaps the most important overriding concern, which is implicit throughout this volume, is that our current usage is not sustainable. Around 4 per cent of world oil production is used as a feedstock to make plastics and a similar amount is used as energy in the process. Yet over a third of current production is used to make items of packaging, which are then rapidly discarded. Given our declining reserves of fossil fuels, and finite capacity for disposal of waste to landfill, this linear use of hydrocarbons, via packaging and other short-lived applications of plastic, is simply not sustainable. There are solutions, including material reduction, design for end-of-life recyclability, increased recycling capacity, development of bio-based feedstocks, strategies to reduce littering, the application of green chemistry life-cycle analyses and revised risk assessment approaches. Such measures will be most effective through the combined actions of the public, industry, scientists and policymakers. There is some urgency, as the quantity of plastics produced in the first 10 years of the current century is likely to approach the quantity produced in the

  7. Plastics, the environment and human health: current consensus and future trends. (United States)

    Thompson, Richard C; Moore, Charles J; vom Saal, Frederick S; Swan, Shanna H


    Plastics have transformed everyday life; usage is increasing and annual production is likely to exceed 300 million tonnes by 2010. In this concluding paper to the Theme Issue on Plastics, the Environment and Human Health, we synthesize current understanding of the benefits and concerns surrounding the use of plastics and look to future priorities, challenges and opportunities. It is evident that plastics bring many societal benefits and offer future technological and medical advances. However, concerns about usage and disposal are diverse and include accumulation of waste in landfills and in natural habitats, physical problems for wildlife resulting from ingestion or entanglement in plastic, the leaching of chemicals from plastic products and the potential for plastics to transfer chemicals to wildlife and humans. However, perhaps the most important overriding concern, which is implicit throughout this volume, is that our current usage is not sustainable. Around 4 per cent of world oil production is used as a feedstock to make plastics and a similar amount is used as energy in the process. Yet over a third of current production is used to make items of packaging, which are then rapidly discarded. Given our declining reserves of fossil fuels, and finite capacity for disposal of waste to landfill, this linear use of hydrocarbons, via packaging and other short-lived applications of plastic, is simply not sustainable. There are solutions, including material reduction, design for end-of-life recyclability, increased recycling capacity, development of bio-based feedstocks, strategies to reduce littering, the application of green chemistry life-cycle analyses and revised risk assessment approaches. Such measures will be most effective through the combined actions of the public, industry, scientists and policymakers. There is some urgency, as the quantity of plastics produced in the first 10 years of the current century is likely to approach the quantity produced in the

  8. Plastics, the environment and human health: current consensus and future trends


    Thompson, Richard C.; Moore, Charles J.; vom Saal, Frederick S.; Swan, Shanna H.


    Plastics have transformed everyday life; usage is increasing and annual production is likely to exceed 300 million tonnes by 2010. In this concluding paper to the Theme Issue on Plastics, the Environment and Human Health, we synthesize current understanding of the benefits and concerns surrounding the use of plastics and look to future priorities, challenges and opportunities. It is evident that plastics bring many societal benefits and offer future technological and medical advances. However...

  9. Field of Psychiatry: Current Trends and Future Directions: An Indian Perspective


    Dave, Kishore P.


    Attempting to predict future is dangerous. This is particularly true in medical science where change is a result of chance discoveries. Currently, practicing psychiatrists are aware of deficiencies in psychiatric practice. However, we have a number of genuine reasons for optimism and excitement. Genetics, novel treatment approaches, new investigative techniques, large-scale treatment trials, and research in general medicine and neurology will give better insights in psychiatric disorders and ...

  10. Orthopedic Surgery among Patients with Rheumatoid Arthritis: A Population-based study to Identify Risk factors, Sex differences, and Time trends. (United States)

    Richter, Michael; Crowson, Cynthia S; Matteson, Eric L; Makol, Ashima


    To identify risk factors for large joint (LJS) versus small joint surgery (SJS) in rheumatoid arthritis (RA) and evaluate trends in surgery rates over time. A retrospective medical record review was performed of all orthopedic surgeries following first fulfillment of 1987 ACR criteria for adult-onset RA among residents of Olmsted County, Minnesota, USA in 1980-2013. Risk factors were examined using Cox models adjusted for age, sex and calendar year of RA incidence. Trends in incidence of joint surgeries were examined using Poisson regression models. A total of 1077 patients with RA (mean age 56 years, 69% female, 66% seropositive) were followed for a median of 10.7 years during which 112 (90 women) underwent at least one SJS and 204 (141 women) underwent at least one LJS. Risk factors included advanced age, rheumatoid factor and anti-CCP antibody positivity for both SJS and LJS, and BMI≥30 kg/m 2 for LJS. Risk factors for SJS and LJS at any time during follow-up included the presence of radiographic erosions, large joint swelling, and methotrexate use. SJS rates decreased by calendar year of incidence (hazard ratio 0.53; p=0.001), with significant decline in SJS after 1995. The cumulative incidence of SJS was higher in women than men (p=0.008). In recent years, there has been a significant decline in rates of SJS but not LJS in patients with RA. The incidence of SJS is higher among women. Traditional RA risk factors are strong predictors for SJS and LJS. Increasing age and obesity are predictive of LJS. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  11. Current trends and future requirements for the mass spectrometric investigation of microbial, mammalian and plant metabolomes

    International Nuclear Information System (INIS)

    Dunn, Warwick B


    The functional levels of biological cells or organisms can be separated into the genome, transcriptome, proteome and metabolome. Of these the metabolome offers specific advantages to the investigation of the phenotype of biological systems. The investigation of the metabolome (metabolomics) has only recently appeared as a mainstream scientific discipline and is currently developing rapidly for the study of microbial, plant and mammalian metabolomes. The metabolome pipeline or workflow encompasses the processes of sample collection and preparation, collection of analytical data, raw data pre-processing, data analysis and data storage. Of these processes the collection of analytical data will be discussed in this review with specific interest shown in the application of mass spectrometry in the metabolomics pipeline. The current developments in mass spectrometry platforms (GC–MS, LC–MS, DIMS and imaging MS) and applications of specific interest will be highlighted. The current limitations of these platforms and applications will be discussed with areas requiring further development also highlighted. These include the detectable coverage of the metabolome, the identification of metabolites and the process of converting raw data to biological knowledge. (review article)

  12. Current computational modelling trends in craniomandibular biomechanics and their clinical implications. (United States)

    Hannam, A G


    Computational models of interactions in the craniomandibular apparatus are used with increasing frequency to study biomechanics in normal and abnormal masticatory systems. Methods and assumptions in these models can be difficult to assess by those unfamiliar with current practices in this field; health professionals are often faced with evaluating the appropriateness, validity and significance of models which are perhaps more familiar to the engineering community. This selective review offers a foundation for assessing the strength and implications of a craniomandibular modelling study. It explores different models used in general science and engineering and focuses on current best practices in biomechanics. The problem of validation is considered at some length, because this is not always fully realisable in living subjects. Rigid-body, finite element and combined approaches are discussed, with examples of their application to basic and clinically relevant problems. Some advanced software platforms currently available for modelling craniomandibular systems are mentioned. Recent studies of the face, masticatory muscles, tongue, craniomandibular skeleton, temporomandibular joint, dentition and dental implants are reviewed, and the significance of non-linear and non-isotropic material properties is emphasised. The unique challenges in clinical application are discussed, and the review concludes by posing some questions which one might reasonably expect to find answered in plausible modelling studies of the masticatory apparatus. © 2010 Blackwell Publishing Ltd.

  13. Foot Surgery (United States)

    ... coding trends along with compliance guidelines and practice marketing materials, APMA has you covered whether you are ... crutches after the surgery or in a cast. Fusions: Fusions are usually performed to treat arthritic or ...

  14. International attitudes of early adopters to current and future robotic technologies in pediatric surgery. (United States)

    Cundy, Thomas P; Marcus, Hani J; Hughes-Hallett, Archie; Najmaldin, Azad S; Yang, Guang-Zhong; Darzi, Ara


    Perceptions toward surgical innovations are critical to the social processes that drive technology adoption. This study aims to capture attitudes of early adopter pediatric surgeons toward robotic technologies in order to clarify 1) specific features that are driving appeal, 2) limiting factors that are acting as diffusion barriers, and 3) future needs. Electronic surveys were distributed to pediatric surgeons with personal experience or exposure in robotic surgery. Participants were classified as experts or nonexperts for subgroup analysis. Coded Likert scale responses were analyzed using the Friedman or Mann-Whitney test. A total of 48 responses were received (22 experts, 26 nonexperts), with 14 countries represented. The most highly rated benefits of robot assistance were wristed instruments, stereoscopic vision, and magnified view. The most highly rated limitations were capital outlay expense, instrument size, and consumables/maintenance expenses. Future technologies of greatest interest were microbots, image guidance, and flexible snake robots. Putative benefits and limitations of robotic surgery are perceived with widely varied weightings. Insight provided by these responses will inform relevant clinical, engineering, and industry groups such that unambiguous goals and priorities may be assigned for the future. Pediatric surgeons seem most receptive toward technology that is smaller, less expensive, more intelligent and flexible. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Open Access Publishing: A Study of Current Practice in Oral and Maxillofacial Surgery Research. (United States)

    Tahim, Arpan; Bansal, Hitesh; Goodson, Alexander M C; Payne, Karl F B; Sabharwal, Sanjeeve


    Open access (OA) publication has become an increasingly common route for dissemination of scientific research findings. However, it remains a contentious issue with continued debate as to its impact on the peer-review process and a potential change in the quality of subsequent evidence published. There is little research that looks into OA in oral and maxillofacial surgery. We investigated the OA policy in the 30 relevant journals listed in the Institute for Scientific Information Web of Knowledge journal citation report, comparing bibliometric data and quality of evidence produced in journals offering OA and those with subscription-only policies. 3474 articles were graded for evidence level and the results correlated to journal OA status. 76.7 % of journals offered authors OA services. There was no difference between impact factor, self-citation rate, total citations or quality of evidence between OA and subscription journals. These findings should send clear messages to both clinicians and researchers and should re- assure readers that scientific findings that are disseminated in open access form do not differ in quality to those in subscription-only format. It should reinforce that open access formats are a credible way to display research findings in oral and maxillofacial surgery.

  16. Current Trends in Numerical Simulation for Parallel Engineering Environments New Directions and Work-in-Progress

    International Nuclear Information System (INIS)

    Trinitis, C; Schulz, M


    In today's world, the use of parallel programming and architectures is essential for simulating practical problems in engineering and related disciplines. Remarkable progress in CPU architecture, system scalability, and interconnect technology continues to provide new opportunities, as well as new challenges for both system architects and software developers. These trends are paralleled by progress in parallel algorithms, simulation techniques, and software integration from multiple disciplines. ParSim brings together researchers from both application disciplines and computer science and aims at fostering closer cooperation between these fields. Since its successful introduction in 2002, ParSim has established itself as an integral part of the EuroPVM/MPI conference series. In contrast to traditional conferences, emphasis is put on the presentation of up-to-date results with a short turn-around time. This offers a unique opportunity to present new aspects in this dynamic field and discuss them with a wide, interdisciplinary audience. The EuroPVM/MPI conference series, as one of the prime events in parallel computation, serves as an ideal surrounding for ParSim. This combination enables the participants to present and discuss their work within the scope of both the session and the host conference. This year, eleven papers from authors in nine countries were submitted to ParSim, and we selected five of them. They cover a wide range of different application fields including gas flow simulations, thermo-mechanical processes in nuclear waste storage, and cosmological simulations. At the same time, the selected contributions also address the computer science side of their codes and discuss different parallelization strategies, programming models and languages, as well as the use nonblocking collective operations in MPI. We are confident that this provides an attractive program and that ParSim will be an informal setting for lively discussions and for fostering new

  17. Public perception of hazardousness caused by current trends of municipal solid waste management

    Energy Technology Data Exchange (ETDEWEB)

    Al-Khatib, Issam A., E-mail: [Institute of Environmental and Water Studies, Birzeit University, Birzeit, Palestine (Country Unknown); Kontogianni, Stamatia [Laboratory of Heat Transfer and Environmental Engineering, Dpt. of Mechanical Engineering, Aristotle University of Thessaloniki, Box 483, 54006 Thessaloniki (Greece); Abu Nabaa, Hendya; Alshami, Ni’meh [Faculty of Graduate Studies, Birzeit University, Birzeit, Palestine (Country Unknown); Al-Sari’, Majed I. [The Joint Services Council for Solid Waste Management for Hebron and Bethlehem Governorates JSC-H& B, West Bank (Palestinian Territory, Occupied)


    Highlights: • Contribution to the scientific literature by examining the relationship between concern for the environment and waste disposal in the frame of household waste treatment mechanism specifically in developing countries. • The awareness of the citizens satisfaction level and the local existing capacities in developing countries significantly contribute to decision making on MSW management sustainability in Palestine and other developing countries when applied. • Identification of the differences and similarities among DC resulting to failures or success in WM field. - Abstract: Municipal solid waste (MSW) piling up is becoming a serious problem in all developing countries (DC) as a result of inequitable waste collection and treatment. Citizens’ collaboration is partly based on understanding their views and their active involvement in MSW planning; on the other hand the assessment of the perception of hazardousness related with MSW is considered rather important as well since the identification of the weak points of the applied MWM strategy is eased and the level of required training is determined. Researchers implemented a case study in the West Bank (WB) and Gaza Strip (GS) regions of Palestine, taking into consideration previous researches in other developing countries. They reached to safe and useful conclusions regarding the parameters which mean the greatest in the waste management field as far as DC are concerned. Lack of skilled manpower, irregular collection services, inadequate equipment used for waste collection, inadequate legal provisions, and resource constraints are additional factors that are confirmed to be challenging the waste management scenarios in all DCs today. The research takes those factors under consideration but focuses on the educational gap and the results revealed interesting trends a significant relationship between respondent’s educational attainment and their awareness of hazardous waste (hazard perception); the

  18. The European mountain cryosphere: a review of its current state, trends, and future challenges (United States)

    Beniston, Martin; Farinotti, Daniel; Stoffel, Markus; Andreassen, Liss M.; Coppola, Erika; Eckert, Nicolas; Fantini, Adriano; Giacona, Florie; Hauck, Christian; Huss, Matthias; Huwald, Hendrik; Lehning, Michael; López-Moreno, Juan-Ignacio; Magnusson, Jan; Marty, Christoph; Morán-Tejéda, Enrique; Morin, Samuel; Naaim, Mohamed; Provenzale, Antonello; Rabatel, Antoine; Six, Delphine; Stötter, Johann; Strasser, Ulrich; Terzago, Silvia; Vincent, Christian


    The mountain cryosphere of mainland Europe is recognized to have important impacts on a range of environmental processes. In this paper, we provide an overview on the current knowledge on snow, glacier, and permafrost processes, as well as their past, current, and future evolution. We additionally provide an assessment of current cryosphere research in Europe and point to the different domains requiring further research. Emphasis is given to our understanding of climate-cryosphere interactions, cryosphere controls on physical and biological mountain systems, and related impacts. By the end of the century, Europe's mountain cryosphere will have changed to an extent that will impact the landscape, the hydrological regimes, the water resources, and the infrastructure. The impacts will not remain confined to the mountain area but also affect the downstream lowlands, entailing a wide range of socioeconomical consequences. European mountains will have a completely different visual appearance, in which low- and mid-range-altitude glaciers will have disappeared and even large valley glaciers will have experienced significant retreat and mass loss. Due to increased air temperatures and related shifts from solid to liquid precipitation, seasonal snow lines will be found at much higher altitudes, and the snow season will be much shorter than today. These changes in snow and ice melt will cause a shift in the timing of discharge maxima, as well as a transition of runoff regimes from glacial to nival and from nival to pluvial. This will entail significant impacts on the seasonality of high-altitude water availability, with consequences for water storage and management in reservoirs for drinking water, irrigation, and hydropower production. Whereas an upward shift of the tree line and expansion of vegetation can be expected into current periglacial areas, the disappearance of permafrost at lower altitudes and its warming at higher elevations will likely result in mass movements

  19. Trends in glaucoma surgery incidence and reimbursement for physician services in the Medicare population from 1995 to 1998. (United States)

    Paikal, David; Yu, Fei; Coleman, Anne L


    To better understand the relationship between glaucoma management and economic incentives, we examined the volume and the reimbursement of argon laser trabeculoplasty (ALT) and trabeculectomy in a 5% random sample of the Medicare population from 1995 to 1998. Retrospective cohort study. Subjects in a 5% random sample of the Medicare population who had ALT and trabeculectomy from 1995 to 1998. Using the Health Care Financing Administration (HCFA) Physician/Supplier Part-B files for a 5% random sample of the Medicare population, we identified all subjects who had ALT and trabeculectomy from 1995 to 1998. Descriptive summaries (the number of surgeries and the mean and the standard deviation of reimbursement per surgery) were calculated for each year. Analysis of variance was used to test for differences in reimbursement per surgery across years. Chi-square tests were used to assess any associations between the changing numbers of ALTs and trabeculectomies over the study period and both age and race. We assessed the number of ALTs and trabeculectomies and the allowed charges for each surgery in the 5% random sample of the Medicare population from 1995 to 1998. The volume of both ALTs and trabeculectomies declined during the study period. Reimbursement per surgery for both ALT and trabeculectomy varied significantly across years (P management of glaucoma, among other factors.

  20. Learning analytics fundaments, applications, and trends : a view of the current state of the art to enhance e-learning

    CERN Document Server


    This book provides a conceptual and empirical perspective on learning analytics, its goal being to disseminate the core concepts, research, and outcomes of this emergent field. Divided into nine chapters, it offers reviews oriented on selected topics, recent advances, and innovative applications. It presents the broad learning analytics landscape and in-depth studies on higher education, adaptive assessment, teaching and learning. In addition, it discusses valuable approaches to coping with personalization and huge data, as well as conceptual topics and specialized applications that have shaped the current state of the art. By identifying fundamentals, highlighting applications, and pointing out current trends, the book offers an essential overview of learning analytics to enhance learning achievement in diverse educational settings. As such, it represents a valuable resource for researchers, practitioners, and students interested in updating their knowledge and finding inspirations for their future work.

  1. More green infrastructure is required to maintain ecosystem services under current trends in land-use change in Europe. (United States)

    Maes, Joachim; Barbosa, Ana; Baranzelli, Claudia; Zulian, Grazia; Batista E Silva, Filipe; Vandecasteele, Ine; Hiederer, Roland; Liquete, Camino; Paracchini, Maria Luisa; Mubareka, Sarah; Jacobs-Crisioni, Chris; Castillo, Carolina Perpiña; Lavalle, Carlo

    Green infrastructure (GI), a network of nature, semi-natural areas and green space, delivers essential ecosystem services which underpin human well-being and quality of life. Maintaining ecosystem services through the development of GI is therefore increasingly recognized by policies as a strategy to cope with potentially changing conditions in the future. This paper assessed how current trends of land-use change have an impact on the aggregated provision of eight ecosystem services at the regional scale of the European Union, measured by the Total Ecosystem Services Index (TESI8). Moreover, the paper reports how further implementation of GI across Europe can help maintain ecosystem services at baseline levels. Current demographic, economic and agricultural trends, which affect land use, were derived from the so called Reference Scenario. This scenario is established by the European Commission to assess the impact of energy and climate policy up to 2050. Under the Reference Scenario, economic growth, coupled with the total population, stimulates increasing urban and industrial expansion. TESI8 is expected to decrease across Europe between 0 and 5 % by 2020 and between 10 and 15 % by 2050 relative to the base year 2010. Based on regression analysis, we estimated that every additional percent increase of the proportion of artificial land needs to be compensated with an increase of 2.2 % of land that qualifies as green infrastructure in order to maintain ecosystem services at 2010 levels.

  2. Current trends in the design of metallic coatings for harsh turbine environments

    Energy Technology Data Exchange (ETDEWEB)

    Gleeson, Brian [Pittsburgh Univ., PA (United States). Dept. of Mechanical Engineering and Materials Science


    The reliable and long-term operation of gas turbine engines at varying high temperatures and under the highly corrosive conditions found in technical applications requires further developments in materials science and technology. Quite often, the current engineering design solution to this problem is to coat the high-temperature turbine component materials, typically {gamma}-Ni+{gamma}'-Ni{sub 3}Al nickel-base superalloys, with a metallic alloy composition that is highly resistant to oxidation or corrosion. Ideally, such resistance is provided by the formation of a thermally grown oxide (TGO) scale of Al{sub 2}O{sub 3}. Indeed, the commonly used {beta}-NiAl-based coatings are excellent Al{sub 2}O{sub 3}-scale formers; however, their resistance to accelerated attack by molten-salt induced hot corrosion can rather poor. The hot-corrosion resistance of {beta}-based coatings can be improved by chromium or silicon addition, but potentially at the expense of oxidation resistance. This presentation will primarily focus on hot corrosion attack and the current approaches that are used to try to mitigate this form of attack. It will be shown that many factors affect hot corrosion resistance, particularly the composition and structure of the coating. The results from recent work on the effects of relative phase fractions, morphologies and chemistries will be drawn upon to provide guidance for optimized coating design. (orig.)

  3. Current trends in stroke rehabilitation. A review with focus on brain plasticity. (United States)

    Johansson, B B


    Current understanding of brain plasticity has lead to new approaches in ischemic stroke rehabilitation. Stroke units that combine good medical and nursing care with task-oriented intense training in an environment that provides confidence, stimulation and motivation significantly improve outcome. Repetitive trans-cranial magnetic stimulation (rTMS), and trans-cranial direct current stimulation (tDCS) are applied in rehabilitation of motor function. The long-term effect, optimal way of stimulation and possibly efficacy in cognitive rehabilitation need evaluation. Methods based on multisensory integration of motor, cognitive, and perceptual processes including action observation, mental training, and virtual reality are being tested. Different approaches of intensive aphasia training are described. Recent data on intensive melodic intonation therapy indicate that even patients with very severe non-fluent aphasia can regain speech through homotopic white matter tract plasticity. Music therapy is applied in motor and cognitive rehabilitation. To avoid the confounding effect of spontaneous improvement, most trials are preformed ≥3 months post stroke. Randomized controlled trials starting earlier after strokes are needed. More attention should be given to stroke heterogeneity, cognitive rehabilitation, and social adjustment and to genetic differences, including the role of BDNF polymorphism in brain plasticity. © 2010 John Wiley & Sons A/S.

  4. Current and future trends in global landfill gas generation and emissions

    International Nuclear Information System (INIS)

    Meadows, M.; Franklin, C.; Campbell, D.


    This paper assesses the magnitude and distribution of current and future methane generation and emissions from landfill on a world-wide basis. It also estimates the current and future global potential for energy recovery from landfill methane. The mass of methane emitted from land disposal of wastes in any country depends on the waste management strategy of that country. In turn, the waste management strategy of a country depends on its population size, relative proportion living in rural or urban regions and the economic development of the country. We estimate by 2010 there will be a large increase in global methane emissions from solid wastes disposed on land. This increase will be largely from developing regions of the world. The main factor driving this increase is a population shift from rural to urban areas, particularly in regions of highest population, i.e. China and India. This will lead to a greater concentration of waste generation, in turn leading to increased disposal of wastes in deeper sites. In addition increased industrialisation and improved standard of living in regions of high population, will increase the mass of waste disposed of per person and the degradable carbon content of the waste, i.e. the waste will become more like waste from developed countries. In contrast, methane emissions from waste disposed on land in developed countries is likely to decrease by 2010, mainly as result of increased collection and combustion of landfill methane. (Author)


    International Nuclear Information System (INIS)

    Tripathy, S. C.; Jain, K.; Hill, F.; Leibacher, J. W.


    We investigate the behavior of the intermediate-degree mode frequencies of the Sun during the current extended minimum phase to explore the time-varying conditions in the solar interior. Using contemporaneous helioseismic data from the Global Oscillation Network Group (GONG) and the Michelson Doppler Imager (MDI), we find that the changes in resonant mode frequencies during the activity minimum period are significantly greater than the changes in solar activity as measured by different proxies. We detect a seismic minimum in MDI p-mode frequency shifts during 2008 July-August but no such signature is seen in mean shifts computed from GONG frequencies. We also analyze the frequencies of individual oscillation modes from GONG data as a function of latitude and observe a signature of the onset of the solar cycle 24 in early 2009. Thus, the intermediate-degree modes do not confirm the onset of the cycle 24 during late 2007 as reported from the analysis of the low-degree Global Oscillations at Low Frequency frequencies. Further, both the GONG and MDI frequencies show a surprising anti-correlation between frequencies and activity proxies during the current minimum, in contrast to the behavior during the minimum between cycles 22 and 23.

  6. Support vector machine based estimation of remaining useful life: current research status and future trends

    International Nuclear Information System (INIS)

    Huang, Hong Zhong; Wang, Hai Kun; Li, Yan Feng; Zhang, Longlong; Liu, Zhiliang


    Estimation of remaining useful life (RUL) is helpful to manage life cycles of machines and to reduce maintenance cost. Support vector machine (SVM) is a promising algorithm for estimation of RUL because it can easily process small training sets and multi-dimensional data. Many SVM based methods have been proposed to predict RUL of some key components. We did a literature review related to SVM based RUL estimation within a decade. The references reviewed are classified into two categories: improved SVM algorithms and their applications to RUL estimation. The latter category can be further divided into two types: one, to predict the condition state in the future and then build a relationship between state and RUL; two, to establish a direct relationship between current state and RUL. However, SVM is seldom used to track the degradation process and build an accurate relationship between the current health condition state and RUL. Based on the above review and summary, this paper points out that the ability to continually improve SVM, and obtain a novel idea for RUL prediction using SVM will be future works.

  7. Current trends and challenges in the postoperative medical management of Crohn's disease: A systematic review. (United States)

    Schlussel, Andrew T; Cherng, Nicole B; Alavi, Karim


    Crohn's disease is an aggressive chronic inflammatory disorder, and despite medical advances no cure exists. There is a great risk of requiring an operative intervention, with evidence of recurrence developing in up to 80-90% of cases. Therefore, we sought to systematically review the current status in the postoperative medical management of Crohn's disease. A systematic literature review of medications administered following respective therapy for Crohn's disease was performed from 1979 through 2016. Twenty-six prospective articles provided directed guidelines for recommendations and these were graded based on the level of evidence. The postoperative management of Crohn's disease faces multiple challenges. Current indicated medications in this setting include: antibiotics, aminosalicylates, immunomodulators, and biologics. Each drug has inherent risks and benefits, and the optimal regimen is still unknown. Initiating therapy in a prophylactic fashion compared to endoscopic findings, or escalating therapy versus treating with the most potent drug first is debated. Although a definitive consensus on postoperative treatment is necessary, aggressive and early endoluminal surveillance is paramount in the treatment of these complicated patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. The Remote Employment: Current Trends in the Organization and Remuneration of Labor

    Directory of Open Access Journals (Sweden)

    Herasymenko Oksana O.


    Full Text Available The article is aimed at distinguishing between the concepts of «freelance», «remote employment», «work from home» with highlighting of differences affecting the organizational-legal format and the economic aspects of social and labor relations between the parties to the agreements on work in remote mode. The prerequisites for the emergence of the non-standard forms of employment in the conditions of establishing the post economy and the electronic-network society have been determined. The data of sociological researches on the current condition and prospects of prevalence of remote employment in Ukraine have been provided. The types and forms of remote employment have been generalized according to different classifications. Using a number of criteria, the article discloses characteristic features of such atypical forms of employment as freelance, distance employment, and work from home. The disadvantages of the atypical forms of employment have been allocated and their advantages have been generalized. An analysis of the current normative-legal regulation has been carried out and the substantiation of organizational and economic foundations of freelancing, remote employment, work from home in Ukraine has been provided.

  9. Current knowledge and trends in age-related macular degeneration: today's and future treatments. (United States)

    Velez-Montoya, Raul; Oliver, Scott C N; Olson, Jeffrey L; Fine, Stuart L; Mandava, Naresh; Quiroz-Mercado, Hugo


    To address the most dynamic and current issues concerning today's treatment options and promising research efforts regarding treatment for age-related macular degeneration. This review is aimed to serve as a practical reference for more in-depth reviews on the subject. An online review of the database PubMed and Ovid were performed, searching for the key words age-related macular degeneration, AMD, VEGF, treatment, PDT, steroids, bevacizumab, ranibizumab, VEGF-trap, radiation, combined therapy, as well as their compound phrases. The search was limited to articles published since 1985. All returned articles were carefully screened, and their references were manually reviewed for additional relevant data. The web page was also accessed in search of relevant research trials. A total of 363 articles were reviewed, including 64 additional articles extracted from the references. At the end, only 160 references were included in this review. Treatment for age-related macular degeneration is a very dynamic research field. While current treatments are mainly aimed at blocking vascular endothelial growth factor, future treatments seek to prevent vision loss because of scarring. Promising efforts have been made to address the dry form of the disease, which has lacked effective treatment.

  10. Laparoscopic surgery in colorectal cancer

    International Nuclear Information System (INIS)

    Bressler Hernandez, Norlan; Martinez Perez, Elliot; Fernandez Rodriguez, Leopoldo; Torres Core, Ramiro


    In the current age of minimally invasive surgery, laparoscopic surgery for colon cancer has been established as oncologically equivalent to conventional open surgery. The advantages of laparoscopic surgery have translated into smaller incisions and shorter recovery. Since the advent of laparoscopy, surgeons have been fueled to develop less invasive operative methods as feasible alternatives to traditional procedures. As techniques evolved and technology advanced, laparoscopy became more widely accepted and is now more commonly used in many institutions. Recently, a trend toward less invasive surgery, driven by patient and surgeon alike, has been a major objective for many institutions because of the ability of laparoscopic surgery to reduce postoperative pain, achieve a quicker recovery time, and improve cosmetic outcomes. Although still evolving, traditional laparoscopy has served as a foundation for even further refinements in the minimally invasive approach and as a result, more advanced equipment and newer techniques have arisen

  11. Landscape of current and emerging cell therapy clinical trials in the UK: current status, comparison to global trends and future perspectives. (United States)

    Bisson, Isabelle; Green, Emma; Sharpe, Michaela; Herbert, Chris; Hyllner, Johan; Mount, Natalie


    Cell Therapy Clinical Trial and Preclinical Research databases have been established by the Cell Therapy Catapult to document current and future cell therapy clinical trials in the UK. We identified 41 ongoing trials in April 2014, an increase of seven trials from April 2013. In addition, we identified 45 late-stage preclinical research projects. The majority of the clinical trials are early phase, primarily led by academic groups. The leading therapeutic areas are cancer, cardiology and neurology. The trends in the UK are also seen globally. As the field matures, more later phase and commercial studies will emerge and the challenges will likely evolve into how to manufacture sufficient cell quantities, manage complex logistics for multi-center trials and control cost.

  12. Introduction to the Issue on Current Trends in Terahertz Photonics and Applications

    DEFF Research Database (Denmark)


    Since the last special issue on terahertz science and technology, nearly three years have been passed. During this period, while there have been further developments in terahertz (THz) sources, detectors, materials, and applications, there have been new discoveries. The purpose of this issue of t...... reviews on recent THz research, the contributed papers cover a wide range of the cutting-edge research in the topics described earlier....... of the IEEE Journal of Selected Topics in Quantum Electronics (JSTQE) is to highlight the advances in materials, devices, and applications and new directions in the THz domain within the last three years. Broad technical areas include: 1) materials; 2) matamaterials, plasmonics, and plasmons; 3) techniques...... and effects; 4) generation and power scaling; 5) detectors; 6) devices; 7) applications. These key THz topics are discussed in both invited and contributed papers published in this issue, providing comprehensive overviews of the current status and future directions as well as publishing original results...

  13. Field of Psychiatry: Current Trends and Future Directions: An Indian Perspective. (United States)

    Dave, Kishore P


    Attempting to predict future is dangerous. This is particularly true in medical science where change is a result of chance discoveries. Currently, practicing psychiatrists are aware of deficiencies in psychiatric practice. However, we have a number of genuine reasons for optimism and excitement. Genetics, novel treatment approaches, new investigative techniques, large-scale treatment trials, and research in general medicine and neurology will give better insights in psychiatric disorders and its management. Psychiatric services in rural India can be reached by telemedicine. There are some threat perceptions which require solving and remedying. Subspecialties in psychiatry are the need of the hour. There is also a requirement for common practice guidelines. Mental Health Care Bill, 2013, requires suitable amendments before it is passed in the Indian Parliament. Research in psychiatry is yet to be developed as adequate resources are not available.

  14. Resident Involvement in Professional Otolaryngology Organizations: Current Trends in the United States. (United States)

    Wong, Kevin; Jang, Minyoung; Gilad, Amir; Levi, Jessica R


    Involvement by residents in professional medical organizations can enrich their training, but little data exist regarding the number and types of involvement opportunities available to otolaryngology residents. We sought to fill this gap in knowledge by quantifying the extent to which major otolaryngology-related organizations in the United States provide involvement opportunities to otolaryngology residents. Our analysis included 23 organizations and subspecialty societies. Results showed that many opportunities exist for residents to attend conferences and present research; however, fewer involvement and funding opportunities existed in any other leadership, health policy, or service-learning experiences. These findings were consistent across general and subspecialty societies. Given the many purported benefits of resident involvement in otolaryngology outside of the standard training environment, future efforts may be warranted to increase the number and type of involvement opportunities currently available in professional societies.

  15. A Commentary on Telerehabilitation Services in Pakistan: Current Trends and Future Possibilities

    Directory of Open Access Journals (Sweden)

    Zeshan Zahid


    Full Text Available A 2014 World Health Organization (WHO study reported that almost 27 million people with disability live in Pakistan with fewer than one allied rehabilitation professional per 10,000 people. The current study sought to determine the attitudes toward telerehabilitation via a survey administered to 329 Pakistani rehabilitation professionals. Study results indicate that rehabilitation professionals in Pakistan are knowledgeable about telerehabilitation and Information and Communication Technology (ICT, and are receptive to employing telerehabilitation programs and applications. Therefore, we can infer that the future of telerehabilitation can be bright in Pakistan but requires the attention of policy makers and non-government organizations to launch an appropriate program nationwide. The authors suggest that a range of telerehabilitation services (e.g., consultation, assessment, and therapy could alleviate the shortage of rehabilitation personnel in Pakistan.

  16. Trends in Dental Practice Sales and Associateships in the Current Economy

    Directory of Open Access Journals (Sweden)

    C. Steven Wolff


    Full Text Available Recent experiences would suggest that there is a significant discrepancy in the number of doctors retiring and transitioning their practices and the number of younger practitioners wishing to assume ownership and build a career. Peaks and valleys in dental school enrollment over the last forty years should have produced an abundance of retirement aged doctors wishing to place their practices on the market to a smaller pool of buyers. Such is currently not the case. Doctors in their sixties have experienced recent stock market downturns in 2000 and 2008, the “9-11” tragedy and a drop in both the value and liquidity of the housing market. The ready access to refinance or second mortgage funds may even find some doctors upside down on personal, vacation and investment real estate. All of this combined has had considerable negative impact on their net worth. Health care costs continue to increase and most dentists are personally responsible for their premiums. Combine all of this with the current low level of secure returns on invested capital along with a significant increase in life expectancy over the last two generations and many decide they are simply unable to retire as planned. The fear of running out of money is stronger than their will to pursue retirement. This article examines in some detail the reasons for this imbalance and the effects they are having on practice transitions, practice values and the market for associate employment. We will also explore what the future may hold for both retiring and new career doctors.

  17. Medicare Part D-a roundtable discussion of current issues and trends. (United States)

    Balfour, Donald C; Evans, Steven; Januska, Jeff; Lee, Helen Y; Lewis, Sonya J; Nolan, Steve R; Noga, Mark; Stemple, Charles; Thapar, Kishan


    Medicare Part D was introduced with a goal of providing access to prescription drug coverage for all Medicare beneficiaries. Regulatory mandates and the changing landscape of health care require continued evaluation of the state of the Part D benefit. To review the current state of plan offerings and highlight key issues regarding the administration of the Part D benefit. The Part D drug benefit continues to evolve. The benefit value appears to be diluted compared to the benefit value of large employer plans. Regulatory restrictions mandated by the Centers for Medicare and Medicaid Services (CMS) are reported to inhibit the ability of plans to create an effective, competitive drug benefit for Medicare beneficiaries. Management in this restrictive environment impedes competitive price negotiations and formulary coverage issues continue to create confusion especially for patients with chronic diseases. The doughnut hole coverage gap represents a significant cost-shifting issue for beneficiaries that may impact medication adherence and persistence. To address these and other challenges, CMS is working to improve the quality of care for Part D beneficiaries by designing and supporting demonstration projects. Although these projects are in different stages, all stakeholders are hopeful that they will lead to the development of best practices by plans to help manage their beneficiaries more efficiently. A significant number of Medicare beneficiaries are currently receiving prescription drug benefits through Part D. The true value of this benefit has been called into question as a result of plan design parameters that lead to cost-shifting, an increasing burden for enrollees. Concerns regarding the ability to provide a competitive plan given the stringent rules and regulations have been voiced by plan administrators. In an effort to drive toward evidence-based solutions, CMS is working to improve the overall quality of care through numerous demonstration projects.

  18. Current usage and future trends in gross digital photography in Canada. (United States)

    Horn, Christopher L; DeKoning, Lawrence; Klonowski, Paul; Naugler, Christopher


    The purpose of this study was to assess the current usage, utilization and future direction of digital photography of gross surgical specimens in pathology laboratories across Canada. An online survey consisting of 23 multiple choice and free-text questions regarding gross digital photography was sent out to via email to laboratory staff across Canada involved in gross dissection of surgical specimens. Sixty surveys were returned with representation from most of the provinces. Results showed that gross digital photography is utilized at most institutions (90.0%) and the primary users of the technology are Pathologists (88.0%), Pathologists' Assistants (54.0%) and Pathology residents (50.0%). Most respondents felt that there is a definite need for routine digital imaging of gross surgical specimens in their practice (80.0%). The top two applications for gross digital photography are for documentation of interesting/ complex cases (98.0%) and for teaching purposes (84.0%). The main limitations identified by the survey group are storage space (42.5%) and security issues (40.0%). Respondents indicated that future applications of gross digital photography mostly include teaching (96.6%), presentation at tumour boards/ clinical rounds (89.8%), medico-legal documentation (72.9%) and usage for consultation purposes (69.5%). The results of this survey indicate that pathology staff across Canada currently utilizes gross digital images for regular documentation and educational reasons. They also show that the technology will be needed for future applications in teaching, consultation and medico-legal purposes.

  19. Augmented reality technology for preoperative planning and intraoperative navigation during hepatobiliary surgery: A review of current methods. (United States)

    Tang, Rui; Ma, Long-Fei; Rong, Zhi-Xia; Li, Mo-Dan; Zeng, Jian-Ping; Wang, Xue-Dong; Liao, Hong-En; Dong, Jia-Hong


    Augmented reality (AR) technology is used to reconstruct three-dimensional (3D) images of hepatic and biliary structures from computed tomography and magnetic resonance imaging data, and to superimpose the virtual images onto a view of the surgical field. In liver surgery, these superimposed virtual images help the surgeon to visualize intrahepatic structures and therefore, to operate precisely and to improve clinical outcomes. The keywords "augmented reality", "liver", "laparoscopic" and "hepatectomy" were used for searching publications in the PubMed database. The primary source of literatures was from peer-reviewed journals up to December 2016. Additional articles were identified by manual search of references found in the key articles. In general, AR technology mainly includes 3D reconstruction, display, registration as well as tracking techniques and has recently been adopted gradually for liver surgeries including laparoscopy and laparotomy with video-based AR assisted laparoscopic resection as the main technical application. By applying AR technology, blood vessels and tumor structures in the liver can be displayed during surgery, which permits precise navigation during complex surgical procedures. Liver transformation and registration errors during surgery were the main factors that limit the application of AR technology. With recent advances, AR technologies have the potential to improve hepatobiliary surgical procedures. However, additional clinical studies will be required to evaluate AR as a tool for reducing postoperative morbidity and mortality and for the improvement of long-term clinical outcomes. Future research is needed in the fusion of multiple imaging modalities, improving biomechanical liver modeling, and enhancing image data processing and tracking technologies to increase the accuracy of current AR methods. Copyright © 2018 First Affiliated Hospital, Zhejiang University School of Medicine in China. Published by Elsevier B.V. All rights

  20. The current status and future prospects of computer-assisted hip surgery. (United States)

    Inaba, Yutaka; Kobayashi, Naomi; Ike, Hiroyuki; Kubota, So; Saito, Tomoyuki


    The advances in computer assistance technology have allowed detailed three-dimensional preoperative planning and simulation of preoperative plans. The use of a navigation system as an intraoperative assistance tool allows more accurate execution of the preoperative plan, compared to manual operation without assistance of the navigation system. In total hip arthroplasty using CT-based navigation, three-dimensional preoperative planning with computer software allows the surgeon to determine the optimal angle of implant placement at which implant impingement is unlikely to occur in the range of hip joint motion necessary for daily activities of living, and to determine the amount of three-dimensional correction for leg length and offset. With the use of computer navigation for intraoperative assistance, the preoperative plan can be precisely executed. In hip osteotomy using CT-based navigation, the navigation allows three-dimensional preoperative planning, intraoperative confirmation of osteotomy sites, safe performance of osteotomy even under poor visual conditions, and a reduction in exposure doses from intraoperative fluoroscopy. Positions of the tips of chisels can be displayed on the computer monitor during surgery in real time, and staff other than the operator can also be aware of the progress of surgery. Thus, computer navigation also has an educational value. On the other hand, its limitations include the need for placement of trackers, increased radiation exposure from preoperative CT scans, and prolonged operative time. Moreover, because the position of a bone fragment cannot be traced after osteotomy, methods to find its precise position after its movement need to be developed. Despite the need to develop methods for the postoperative evaluation of accuracy for osteotomy, further application and development of these systems are expected in the future. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.