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. Ambulatory Surgery: Current Status and Future Trends | Castoro ...

    African Journals Online (AJOL)

    According to international terminology, Day surgery or Ambulatory surgery is the admission of selected patients to hospital for a planned, non emergency, surgical procedure, returning home on the same day. Minor outpatient procedures and most day cases endoscopic procedures are not considered appropriate day ...

  3. Restrictive bariatric surgery techniques: evolution and current trends

    Directory of Open Access Journals (Sweden)

    Maher Musleh


    Full Text Available Bariatric surgery has proved to be more effective than medical therapy in the treatment for obesity. Multiple techniques have been described and can be divided into three main groups: Restrictive surgery, where the main objective is to decrease the volume of caloric intake; malabsortive surgery, where a portion of the absortive circuit is bypassed and thus limiting the caloric absortion; and a combination of both. Among the restrictive techniques, gastroplasty was one of the first procedures described. First horizontal gastroplasty and then vertical banded gastroplasty showed good short-term results but with poor long-term outcomes. These techniques have been gradually abandoned. Adjustable gastric banding is a minimally invasive technique and has the advantage of being reversible. Weight loss is adequate, but less effective than gastric bypass. Postoperative complications are low at short-term, but increase per year at long-term follow-up. Sleeve gastrectomy is an effective weight loss procedure that can be performed safely as a first stage or primary procedure. This results in excellent weight loss and co-morbidity reduction that exceeds, or is comparable to, that of other accepted bariatric procedures. Gastric plicature is a relatively new procedure and has reported good short-term outcomes in weight loss with few short-term complications. However, long-term outcomes are yet to be demonstrated.

  4. The current trends of mortality following congenital heart surgery: the Japan Congenital Cardiovascular Surgery Database. (United States)

    Hoashi, Takaya; Miyata, Hiroaki; Murakami, Arata; Hirata, Yasutaka; Hirose, Keiichi; Matsumura, Goki; Ichikawa, Hajime; Sawa, Yoshiki; Takamoto, Shinichi


    Whereas surgical outcomes of congenital heart surgery have improved during the past two decades, there are still measurable postoperative mortalities in this field. This study is aimed at evaluating the current situation of mortality following congenital heart surgery. Data on all registered 28 810 patients in The Japan Congenital Cardiovascular Surgery Database (JCCVSD) between 2008 and 2012 were analysed, except for patients with degenerative cardiomyopathy including dilated, restrictive and hypertrophic cardiomyopathy, and pathologically or histologically malignant cardiac tumours. The number of registered cases increased every year, and reached ∼9000 cases in 2012. The median age at surgery was 0.8 years (range, 0-82). More than half of the patients (54%) who underwent surgery were <1 year old, and 6.0% of all patients were over 18 years old (adults). In this study, all mortalities within 90 days after the operation and mortality at discharge beyond 90 days of hospitalization were defined as '90-day and in-hospital mortality'. The 30-, 90-day and in-hospital mortality rates were 2.3, 3.5 and 4.5%, respectively. The mean and median durations from surgery to death were 61 ± 89 and 28 days (range, 0-717), respectively. Whereas 658 mortalities (51%) occurred within 30 days of surgery, 265 (21%) occurred later than 90 days after surgery. A total of 3630 patients (13%) were hospitalized for more than 90 days after the operation; of those, 3365 patients survived at discharge (93%). Cardiac problems were the most frequent causes of death after the surgery at any point in time, and 7.1 per 1000 patients died at over 30 days after the operation due to solely cardiac. The investigation of JCCVSD revealed that about a half of mortalities occurred later than 30 days; hence 90-day and in-hospital mortality would be a good discriminator that accurately represented the current situation of mortality after congenital heart surgery. Mortalities long after the operation due to


    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.

  6. Current trends for medico-legal disputes related to functional nasal surgery in Italy. (United States)

    Motta, S; Nappi, S


    The problem of professional liability in case of adverse outcomes or failures secondary to surgery is very sensitive in many countries of the European Community. In Italy, a recent sentence of the Supreme Court concerning a patient who underwent septoplasty raised considerable doubts in relation to the guidance to be followed in disputes related to an alleged professional liability, further exacerbating the juridical orientation of recent years in this context. This ruling involves any surgery, as well as rhinologic surgery, and calls into question most regulatory and legal principles that have traditionally been adopted by the Italian Civil Law. The sentence states that the plaintiff is only required to document the failure of surgical treatment, but not the breach of the duty of care by the surgeon, thus shifting the burden of proof to the physician-debtor. It also considers that, in assessing the degree of negligence, reference should be made to the qualifications of the surgeon, according to principles that are not covered by current regulations, denying that in general surgery (i.e., not with aesthetic purposes) the surgeon must only to act with diligence and need not guarantee a favourable outcome. This series of statements, complementing one another and evolving more unfavourably towards physicians, facilitate legal disputes for speculative purposes through complainants, with obvious health and socio-economic implications.

  7. 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

  8. Current Trends in Upper and Lower Eyelid Blepharoplasty Among American Society of Ophthalmic Plastic and Reconstructive Surgery Members. (United States)

    Kossler, Andrea L; Peng, Grace L; Yoo, Donald B; Azizzadeh, Babak; Massry, Guy G

    To assess current practice patterns for management of upper and lower eyelid blepharoplasty by active American Society of Ophthalmic Plastic and Reconstructive Surgery members. An invitation to participate in a web-based anonymous survey was sent to the active American Society of Ophthalmic Plastic and Reconstructive Surgery membership via email. The survey consists of 34 questions, both multiple choice and free response, regarding upper and lower eyelid blepharoplasty surgery. Practice patterns for both aesthetic and functional blepharoplasty are assessed. Thirty-four percent (161/472) of American Society of Ophthalmic Plastic and Reconstructive Surgery members polled responded to the survey. Members perform an average of 196 upper eyelid, 46 lower eyelid, and 53 four-eyelid blepharoplasty procedures per year, with 70% of cases being functional and 30% purely aesthetic. Most members prefer monitored care (71%) to local (21%) or general (8%) anesthesia. Eighty-nine percent of surgeons use topical antibiotics after surgery, erythromycin being the most common (51%). Fourteen percent of members use postoperative oral antibiotics, with cephalexin (81%) being most common. In upper eyelid blepharoplasty, orbicularis muscle is excised by 86% of respondents. Orbital fat is excised, when deemed appropriate, in 97% of cases, with nasal fat excised most commonly (88%). Less commonly, fat repositioning (36%) and adjunctive fat grafting (33%) are performed. In lower eyelid blepharoplasty, surgeons report using one or more of the following approaches: transconjunctival (96%), transcutaneous (82%), and both transconjunctival and transcutaneous (51%). Common adjunctive procedures include orbital fat excision (99%), fat repositioning (80%), and lateral canthal suspension (96%). Less common adjunctive procedures include laser skin resurfacing (36%) and chemical peels (29%). This report outlines contemporary practice patterns among active American Society of Ophthalmic Plastic and

  9. New Trends in General Surgery


    Bautista Iturrizaga, Juan


    Currently, with the advance of science, more and more basic disciplines are associated with surgery exerting some influence and giving rise to the concept of Medical-Surgical Science. Besides that, surgery has evolved in paralel with immunology (in the field of transplants), interventional radiology and diagnostic-therapeutic endoscopy. Indeed, many of changes in surgery, such as the use of new diagnostic tools, approaches with shorter incisions, and the colaboration -still in an evaluative p...

  10. Changing trends in bariatric surgery. (United States)

    Lo Menzo, E; Szomstein, S; Rosenthal, R J


    Bariatric surgery is considered the only long-lasting treatment for morbid obesity. Techniques and procedures have changed dramatically. We report on some of the major changes in the field. We reviewed some of the major changes in trends in bariatric surgery based on some landmark paper published in the literature. We identified three major phases in the evolution of bariatric surgery. The pioneer phase was mostly characterized by discovery of weight loss procedures serendipitously from procedures done for other purposes. The second phase can be identified with the advent of laparoscopic techniques. This is considered the phase of greatest expansion of bariatric surgery. The metabolic phase derives from the improved understanding of the mechanisms of actions of the bariatric operations at the hormonal and molecular level. Bariatric surgery has changed significantly over the years. The safety of the laparoscopic approach, along with the better understanding of the metabolic changes obtained postoperatively, has led to a more individualized approach and also an attempt to expand the indications for these procedures. © The Finnish Surgical Society 2014.

  11. 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

  12. Current trends in local anesthesia in cosmetic plastic surgery of the head and neck: results of a German national survey and observations on the use of ropivacaine. (United States)

    Koeppe, Tobias; Constantinescu, Mihai A; Schneider, Jochen; Gubisch, Wolfgang


    The goal of this study was to evaluate at the national level the current practice in the use of local anesthetics in cosmetic head and neck surgery and to compare the results with the novel local anesthesia technique used in the authors' department over the past 2 years. A questionnaire was posted to all 211 board-certified members of the Association of German Plastic Surgeons. The questions related to the daily practice in rhinoplasty, blepharoplasty, otoplasty, face lift, and forehead lift. The focus was laid on anesthesia techniques, local anesthetics, vasoconstricting agents, dosages, activity onset, observed side effects, mean duration of each procedure type, and surgeon satisfaction with the anesthetic used. A total of 86 questionnaires (40.8 percent) were returned. The overall analysis revealed that local anesthetics were used in 88.9 percent of all cosmetic procedures of the head and neck. Prilocaine 1% (Xylonest; AstraZeneca, Wedel, Germany) was the most frequently used local anesthetic (32.0 percent), followed by lidocaine 1% (Xylocaine; AstraZeneca) and mepivacaine 1% (Scandicaine; AstraZeneca). Ropivacaine 0.2% (Naropin; AstraZeneca) was used only by 1.1 percent and ropivacaine 0.75% only by 0.9 percent (including two of the authors). Approximately half of the respondents (47.2 percent) used epinephrine 1:100,000 for vasoconstriction. In face lifts, the necessity of repeated "top-up" infiltration was reported in more than half (54.7 percent) of the procedures. Ten percent of surgeons surpassed the maximum recommended dosages when working without ropivacaine. Overall adverse cardiovascular effects were reported in 5.9 percent of rhinoplasties and 8.1 percent of face lifts performed mostly with prilocaine and lidocaine. No adverse cardiovascular reactions or overdoses were noticed with the use of ropivacaine. The survey showed a clear trend toward the increasing use of local anesthetics in cosmetic surgery of the head and neck. Although the use of

  13. Current trends of banking innovations


    A.M. Karminskiy; O.R. Zhdanova


    The current stage of the global banking system development takes place in an increasingly competitive environment and unstable financial markets. One of the key factors of bank's successful development is a policy of continuous innovative behavior. Nowadays innovation is a key factor of bankingnstability, competitiveness and sustainable growth.The aim of the article. The main goal of this article is to examine key trends of banking innovations and innovative in Russia. Experience in the devel...

  14. Current Trends and Future Directions

    DEFF Research Database (Denmark)

    Harboe, Peter G.; Madsen, Sabine; Svejvig, Per


    This book is an attempt to gather current state-of-the-art research on project management from multiple universities and university colleges in Denmark. This chapter first discuss a literature review of Danish and Scandinavian research on project management thereby complementing the short review ...... in chapter 1. Second the chapter undertake the risky adventure of pointing out future trends, using the chapters in this book as a stepping stone for doing that....

  15. 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)

  16. 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.

  17. Current trends in breast reduction. (United States)

    Roje, Zdravko; Roje, Zeljka; Milosević, Milan; Varvodić, Josip; Mance, Marko


    Results of our study describe the long term effects of reduction mammaplasty. Many women with excessively small or large breasts have an altered personal self-image and often suffer from low self-esteem and other psychological stresses. This procedure is designed to reduce and reshape large breasts, and since the size, shape, and symmetry of a woman's breasts can have a profound effect on her mental and physical well-being it is important to observe the patient's long-term outcome. Currently, breast reduction surgery is safe, effective and beneficial to the patient. In Croatia, reduction mammoplasty is often excluded from the general health care plan. The distinction between "reconstructive" versus "cosmetic" breast surgery is very well defined by the American Society of Plastic Surgeons Board of Directors. Unfortunately, the Croatian Health Society has yet to standardize such a distinction. There is an imperative need for evidence-based selection criteria. We retrospectively analyzed data of 59 female patients suffering from symptomatic macromastia who underwent reduction mammaplasty over a 16 year period (1995 until 2011). Our aim was to compare and contrast the various techniques available for reduction mammaplasty and to determine, based on patient outcome and satisfaction, which technique is most suited for each patient. The results of our study generally reinforce the observation that reduction mammaplasty significantly provides improvements in health status, long-term quality of life, postsurgical breast appearance and significantly decrease physical symptoms of pain. A number of 59 consecutive cases were initially treated with the four different breast reduction techniques: inverted-T scat or Wisa pattern breast reduction, vertical reduction mammaplasty, simplified vertical reduction mammaplasty, inferior pedicle and free nipple graft techniques. The average clinical follow-up period was 6-months, and included 48 patients. The statistical analysis of the


    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.

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

    Sharma, Ramesh Kumar


    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. PMID:25190909

  1. 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.

  2. Current trends of balloon laryngoplasty in Thailand. (United States)

    Moungthong, Greetha; Bunbanjerdsuk, Sacarin; Wright, Nida; Sathavornmanee, Thanakrit; Setabutr, Dhave


    To describe the current trend in balloon laryngoplasty usage and experience by practicing otolaryngologists in Thailand. Anonymous 11 question online and paper survey of otolaryngologists on their current balloon laryngoplasty practices. Current practices and experience in balloon laryngoplasty were queried with multiple choice and open-ended questions. Laser use is the most commonly utilized instrument to treat airway stenosis in Thailand. 86% of respondents do not have experience with balloon dilatation; yet, almost half (47.6%) report they perform a minimum of five airway surgeries per year. Most respondents had been in practice for less than 6 years (41%) and reported that they did not have exposure to balloon use during residency training. The largest barrier reported for the use of balloon instrumentation in the airway is inexperience (44.4%) followed by cost (38.3%), yet most feel that treatment in airway stenosis could benefit by usage of balloons (95.5%). Most otolaryngologists in Thailand do not have experience with the use of balloon dilatation and lack of exposure remains the largest barrier to its use. Otolaryngologists in Thailand feel that increased usage of balloons in the airway could improve airway stenosis treatment in the country.

  3. 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.

  4. 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 ...

  5. 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

  6. 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)

  7. Trends of risk factors in coronary surgery

    Directory of Open Access Journals (Sweden)

    Fabri Mikloš


    Full Text Available Introduction. In current era of widespread use of percutaneous coronary interventions (PCI, it is debatable whether coronary artery by-pass graft (CABG patients are at higher risk. Objective. The aim of the study was to evaluate trends in risk profile of isolated CABG patients. Methods. By analysing the EuroSCORE and its risk factors, we reviewed a consecutive group of 4675 isolated CABG patients, operated on during the last 8 years (2001-2008 at our Clinic. The number of PCI patients was compared to the number of CABG patients. For statistical analyses, Pearson’s chi-square and ANOVA tests were used. Results. The number of PCI increased from 159 to 1595 (p<0.001, and the number of CABG from 557 to 656 (p<0.001. The mean EuroSCORE increased from 2.74 to 2.92 (p=0.06. The frequency of the following risk factors did not change over years: female gender, previous cardiac surgery, serum creatinine >200μmol/l, left ventricular dysfunction and postinfarct ventricular septal rupture. Chronic pulmonary disease, neurological dysfunction, and unstable pectoral angina declined significantly (p<0.001. Critical preoperative care declined from 3.1% in 2001 to 0.5 % in 2005, than increased and during the last 3 years did not change (2.3%. The mean age increased from 56.8 to 60.7 (p<0.001 and extracardiac arteriopathy increased from 9.2% to 22.9% (p<0.001. Recent preoperative myocardial infarction increased from 11% to 15.1% (p=0.021, while emergency operations increased from 0.9% to 4.0% (p=0.001. Conclusion. The number of CABG increases despite the enlargement of PCI. The risk for isolated CABG given by EuroSCORE increases over years. The risk factors, significantly contributing to higher EuroSCORE are: older age, extracardiac arteriopathy, recent myocardial infarction and emergency operation.

  8. Current status of robot-assisted surgery. (United States)

    Ng, Ada T L; Tam, P C


    The introduction of robot-assisted surgery, and specifically the da Vinci Surgical System, is one of the biggest breakthroughs in surgery since the introduction of anaesthesia, and represents the most significant advancement in minimally invasive surgery of this decade. One of the first surgical uses of the robot was in orthopaedics, neurosurgery, and cardiac surgery. However, it was the use in urology, and particularly in prostate surgery, that led to its widespread popularity. Robotic surgery, is also widely used in other surgical specialties including general surgery, gynaecology, and head and neck surgery. In this article, we reviewed the current applications of robot-assisted surgery in different surgical specialties with an emphasis on urology. Clinical results as compared with traditional open and/or laparoscopic surgery and a glimpse into the future development of robotics were also discussed. A short introduction of the emerging areas of robotic surgery were also briefly reviewed. Despite the increasing popularity of robotic surgery, except in robot-assisted radical prostatectomy, there is no unequivocal evidence to show its superiority over traditional laparoscopic surgery in other surgical procedures. Further trials are eagerly awaited to ascertain the long-term results and potential benefits of robotic surgery.

  9. Oncoplastic breast surgery: current strategies. (United States)

    Piper, Merisa; Peled, Anne Warren; Sbitany, Hani


    The surgical management of breast cancer has dramatically evolved over the past 20 years, with oncoplastic surgery gaining increased popularity. This field of breast surgery allows for complete resection of tumor, preservation of normal parenchyma tissue, and the use of local or regional tissue for immediate breast reconstruction at the time of partial mastectomy. These techniques extend the options for breast conservation surgery, improve aesthetic outcomes, have high patient satisfaction and result in better control of tumor margins. This article will detail the approach to evaluating and treating patients undergoing oncoplastic reconstruction. Different oncoplastic approaches will be described and applied to an oncoplastic reconstructive algorithm. Surgical complications, oncologic outcomes and aesthetic outcomes are reviewed.

  10. Current trends in radiation protection

    Energy Technology Data Exchange (ETDEWEB)

    Metivier, H.; Arranz, L.; Gallego, E.; Sugier, A


    Organizers of the 11. IRPA International Congress have wished to take advantage of this occasion to launch a new series of books dedicated to review the current important problems of concerns in radioprotection. The four editors have combined their efforts to assemble within this book contributions from the worldwide and most famous specialists in their respective fields. Their signatures lead to the insurance of a first class information. all aspects of radioprotection are treated, through synthetic articles accessible to all. Very didactic, this book will be useful to radioprotection professionals willing to take the stake of all aspects within their profession, but also to engineers, physicists, physicians, researchers, and non-specialist people who will find here a thorough synthesis of all aspects of radiological protection. (author)

  11. Current trends in radiation protection

    International Nuclear Information System (INIS)

    Metivier, H.; Arranz, L.; Gallego, E.; Sugier, A.


    Organizers of the 11. IRPA International Congress have wished to take advantage of this occasion to launch a new series of books dedicated to review the current important problems of concerns in radioprotection. The four editors have combined their efforts to assemble within this book contributions from the worldwide and most famous specialists in their respective fields. Their signatures lead to the insurance of a first class information. all aspects of radioprotection are treated, through synthetic articles accessible to all. Very didactic, this book will be useful to radioprotection professionals willing to take the stake of all aspects within their profession, but also to engineers, physicists, physicians, researchers, and non-specialist people who will find here a thorough synthesis of all aspects of radiological protection. (author)

  12. Current trends in protein crystallization. (United States)

    Gavira, José A


    Proteins belong to the most complex colloidal system in terms of their physicochemical properties, size and conformational-flexibility. This complexity contributes to their great sensitivity to any external change and dictate the uncertainty of crystallization. The need of 3D models to understand their functionality and interaction mechanisms with other neighbouring (macro)molecules has driven the tremendous effort put into the field of crystallography that has also permeated other fields trying to shed some light into reluctant-to-crystallize proteins. This review is aimed at revising protein crystallization from a regular-laboratory point of view. It is also devoted to highlight the latest developments and achievements to produce, identify and deliver high-quality protein crystals for XFEL, Micro-ED or neutron diffraction. The low likelihood of protein crystallization is rationalized by considering the intrinsic polypeptide nature (folded state, surface charge, etc) followed by a description of the standard crystallization methods (batch, vapour diffusion and counter-diffusion), including high throughput advances. Other methodologies aimed at determining protein features in solution (NMR, SAS, DLS) or to gather structural information from single particles such as Cryo-EM are also discussed. Finally, current approaches showing the convergence of different structural biology techniques and the cross-methodologies adaptation to tackle the most difficult problems, are presented. Current advances in biomacromolecules crystallization, from nano crystals for XFEL and Micro-ED to large crystals for neutron diffraction, are covered with special emphasis in methodologies applicable at laboratory scale. Copyright © 2015 Elsevier Inc. All rights reserved.


    African Journals Online (AJOL)

    CURRENT TRENDS IN CATALOGUING AND THE CHALLENGES OF. A CATALOGUER IN THE DIGITAL ... Information Communication Technology (ICT) and the attendant innovations and trends that are required to cope in this new ... much tact and techniques including doggedness to keep pace with it. The tact one would.

  14. 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

  15. US trends in refractive surgery: 2002 ISRS survey. (United States)

    Duffey, Richard J; Leaming, David


    To determine the latest trends in refractive surgery in the United States. The full U.S. membership of the International Society of Refractive Surgery (ISRS) (approximately 900 members) was mailed the 2002 refractive surgery survey dealing with volumes, types, preferences of refractive surgery performed, and use of emerging technology. Questions regarding RK, AK, PRK, LASIK, LASEK, intracorneal ring segments (ICRS), laser thermal keratoplasty (LTK), conductive keratoplasty (CK), phakic intraocular lenses (PIOL), and clear lens extractions (CLE) were examined in the survey. Procedure preference for low, moderate, and high myopia, and hyperopia, were compared with the results from the surveys of the previous 5 years. Preference for unilateral versus bilateral same-day surgery, laser type, and microkeratome choice were also compared with the survey data from previous years. Incidence and frequency of co-management of refractive surgery patients were compared with 1999-2001 data. New questions regarding pupil measurement/documentation, wavefront aberrometry, and custom ablations were incorporated into the 2002 survey. As refractive surgery grows in the mainstream of ophthalmology, trends and changes in the United States continue to be elucidated by this professional organization survey. LASIK continues to dominate for refractive errors between -10.00 to +3.00 D. LASIK, LASEK, CLE, PIOL, and CK appear to have bright futures, whereas, RK, ICR, and LTK are on the decline. VISX continues to be utilized 2:1 over all other lasers combined, and instrumentation pupillometry is preferred 2:1 over pupil gauge cards. Currently, wavefront aberrometry and custom ablations are minimally employed but appear poised to be the wave of the future.

  16. Current advances in liver surgery

    Directory of Open Access Journals (Sweden)

    Shannon Melissa Chan


    Full Text Available Hepatobiliary surgery has taken a big step forward in recent decades especially in the minimally invasive approach for hepatectomy. From being sceptical at the beginning of the 1990s when laparoscopic surgery had become prevalent, to now, where laparoscopic hepatectomy has been well-established, especially in minor hepatectomies; this new technique has evolved rapidly over the past 20-years demonstrating better short-term outcomes and equivalent oncological outcomes in selected patients and in expert hands. Laparoscopic hepatectomy is indeed, more difficult to master than the open procedure with restrictions in working space, difficulty in haemostasis and the potential risk of gas embolism. However, with better visibility of the operative field around the liver, especially beneath the costal margin, the magnified view and theoretical advantage of pneumoperitoneum acting as haemostatic pressure have made laparoscopic hepatectomy increasingly popular. Another important advancement is the new surgical technique of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS. This procedure induces more rapid liver hypertrophy within a median period of 9-days, allowing resection to be performed in candidates with borderline functional liver remnant and at an earlier date. However, studies have shown that ALPPS is associated with a relatively higher rate of morbidity and mortality. Therefore, it remains a highly controversial treatment option and more studies have to be performed to establish its usefulness and define its role in liver surgery.

  17. Hearing preservation surgery: current opinions. (United States)

    Fitzgerald O'Connor, Edmund; O'Connor, Alec Fitzgerald


    Although the indications and surgical technique for cochlear implantation are well formalized, the introduction of hearing preservation surgery and electric acoustic stimulation have posed new questions for the cochlear implant clinician. This study was designed to crystallize the contemporary views of the implant community on how best to implement these new strategies. An anonymized questionnaire was made available to members of the Politzer Society and a selected group of implant surgeons via the Internet. Five questions required the respondent to choose a specific answer from the text on technique and 17 questions assessed the relative importance attached to the statements relating to the surgical process. A final question inquired on what basis the opinions were derived. The country of origin was also identified. The questionnaire was sent to 180 clinicians of whom 62 replied (34%). Tacit agreement was obtained in 2 of the specific questions and in 10 of the relative importance inquiries. There were varying degrees of opinions on the remaining questions. It is clear that there is still limited consensus between surgeons when considering ways of maximizing outcomes in hearing preservation surgery and electric acoustic stimulation. More protocol-driven studies are required before an accepted gold standard approach can be achieved. Copyright 2010 S. Karger AG, Basel.

  18. Current trends in research on gas sensors

    International Nuclear Information System (INIS)

    Mohd Mustamam A, Karim; John Ojur Dennis; Md Rahim Sahar; Mohd Khairi Saidin


    This paper reviews the current trends in researches on gas sensors by considering the techniques and methods for improvement of the performance of semiconductor gas sensors and reporting the newly emerging researches on the detection of gases at the part per million (ppb) levels and photoconduction (author)

  19. 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…

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

    Indian Academy of Sciences (India)

    Current Trends in Science. Platinum Jubilee special publication 2010. Edited by N. Mukunda © 2009 Indian Academy of Sciences. pp 1-1. A Jubilee Celebration. D. Balasubramanian and N. Mukunda. CHEMISTRY. pp 5-5. Foreword. Charusita Chakravarty, S. Chandrasekaran, T. K. Chandrashekar and S. Sivaram. pp 7-8.

  1. 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.

  2. 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

  3. 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)

  4. 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.

  5. 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.

  6. Surgery for spontaneous intracerebral hemorrhage: Emerging trends

    Directory of Open Access Journals (Sweden)

    Girish Menon


    Full Text Available In spite of advances in imaging and surgical techniques, spontaneous intracerebral hemorrhage (SICH has defied attempts to find a scientifically proven effective therapy. The pathophysiology of SICH suggests that early removal of the clot with minimal additional surgical trauma should prove beneficial. Trials in this direction have been few, and for some unknown reason, surgery has not proved to be superior to best medical management in most of these trials. This has led to substantial variability in the management of ICH throughout the world, and the treatment of SICH remains a controversy. SICH encompasses spectra of possible clot locations with varying volumes. Surgery so far has been reserved only for patients with large hematomas and impending brain herniation. Critical analysis of the earlier studies has now shown that surgery does help in clots in certain locations and of particular volume and when done at an optimal time. Poor grade patients with large hematomas, earlier considered poor surgical candidates are being taken up for aggressive decompressive craniectomies with fair results. In addition, minimally invasive surgical techniques complemented by thrombolytic techniques seem to providing surprisingly good results. Overall surgery seems to be going through a period of renaissance with respect to primary spontaneous ICHs.

  7. 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.

  8. 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.

  9. 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...

  10. Current Market Trends Maritime Transport Services

    Directory of Open Access Journals (Sweden)

    Florin Dan Puscaciu


    Full Text Available Maritime transport services is a fundamental component of international logistics, given that approximately 80% of world trade is carried by sea. Also, considering the spatial distribution of resources according to the processing sites and disposal of finished goods and the fact that nearly two thirds of the globe is covered by water, has led a Norwegian ship-owner, Erling Næss, to claim that "Divinity has been very generous with ship owners."In the 3rd millennium, when this study was done, there were a number of trends representing some sequels of a prior period and also a series of phenomenon of the current period. We aim to address key market segments of shipping. In order to carry out the graphs and determine the indicators we used Matlab software.

  11. 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

  12. 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.

  13. Current standards and recent progress in minimally invasive Phlebo surgery

    Directory of Open Access Journals (Sweden)

    Oliver Göckeritz


    Full Text Available Venous disorders are among the most frequent disease patterns in the Western world. Still at the turn to the 21st century there was no alternative available to the surgical treatment of varicosis. Meanwhile the endoluminal treatment methods have established and have demonstrated their efficiency while having lower side effects in comparison to the traditional treatment, even though conservatively oriented surgeons are still skeptically eyeing these methods. In the US, according to the latest MRG report of 2011, about 95% of all venous surgeries are already done endoluminally. This paper offers an overview of prevailing treatment standards of the most important endoluminal therapy techniques and shows current trends.

  14. 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.

  15. Common Stochastic Trends in the Current Account

    NARCIS (Netherlands)

    Kumah, F.Y.


    Solow residuals are used as proxies for productivity shocks in many empirical studies.Considering the shortcomings of this approach this paper proposes the common trends approach as an alternative.The common trends econometric technique is utilized here in an attempt to identify and analyze the long

  16. Current peripheral bypass surgery: various clinical studies

    NARCIS (Netherlands)

    Slaa, Alexander te


    Substantial post-operative edema occurs in the majority of patients who undergo peripheral bypass surgery due to severe peripheral arterial disease (PAD). The pathophysiological mechanisms that underlay edema formation following peripheral bypass surgery include hyperemia, an increased capillary

  17. 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...

  18. Current Educational Technology Research Trends in Japan (United States)

    Nakayama, Minoru; Ueno, Maomi


    To examine trends in educational practice research, this article conducted a survey and analysis of factors affecting the review of research papers in the field of the educational technology in Japan. Two factors, namely, practical orientation and theoretical orientation, were extracted from 63 survey responses, and scores from members of a…

  19. Daycase laparoscopic gynaecological procedures- current trends in ...

    African Journals Online (AJOL)

    The trend towards a multimodal approach to postoperative pain and prevention of postoperative nausea and vomiting (PONV) improves postoperative profile of day case gynaecological patients. Expertise in providing a pneumoperitoneum with carbon dioxide is desirable even as other options for lifting the abdominalwall ...

  20. US trends in refractive surgery: 2003 ISRS/AAO survey. (United States)

    Duffey, Richard J; Leaming, David


    To determine the latest trends in refractive surgery in the United States. All U.S. members of the International Society of Refractive Surgery of the American Academy of Ophthalmology were mailed the 2003 refractive surgery survey dealing with volumes, types, preferences of refractive surgery performed, and use of new emerging technology. Questions regarding radial keratotomy (RK), astigmatic keratotomy (AK), limbal relaxing incisions (LRI), photorefractive keratectomy (PRK), laser in situ keratomileusis (LASIK), laser subepithelial keratomileusis (LASEK), intracorneal ring segments (ICRS), laser thermokeratoplasty (LTK), conductive keratoplasty (CK), phakic intraocular lenses (PIOL), clear lens extractions (CLE), and scleral expansion (SE) procedures were examined in the survey. Use of lasers, microkeratomes, pupillometry instruments, postoperative medications, wavefront analyzers, topographers, etc were examined. In 2003, LASIK continued to dominate for refractive errors between -8.00 to +3 diopters. Surgeons are waiting on the PIOL for high myopes and are performing CLE for high hyperopes. Photorefractive keratectomy, LASIK, LASEK, CLE, PIOL, and CK appeared to have bright futures; whereas, RK, ICR, LTK and SE were on the decline. Bilateral LASIK at the same surgical session is offered by 98% of surgeons. VISX lasers are used 2:1 over all other lasers in the United States. Zeiss-Humphrey still dominates topographers at 37%. The Bausch & Lomb Hansatome (48%) leads microkeratomes. Surgeons are charging, on average, 300-500 dollars more per eye for custom ablations and these ablations have already been accepted and integrated into refractive practices. Comanaging of refractive surgery patients is significantly down from previous years. Fourth-generation fluoroquinolones overtook the postoperative antibiotic prescriptions, with prednisolone and fluoromethalone dominating as anti-inflammatories. Trends and changes as refractive surgery grows in the mainstream of

  1. Current trend of robotics application in medical (United States)

    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.

  2. 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.

  3. 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.

  4. Current standards in oncoplastic breast conserving surgery. (United States)

    Weber, Walter P; Soysal, Savas D; Zeindler, Jasmin; Kappos, Elisabeth A; Babst, Doris; Schwab, Fabienne; Kurzeder, Christian; Haug, Martin


    Oncoplastic breast conserving surgery is increasingly used to treat patients with breast cancer. In the absence of randomized data, a large body of observational evidence consistently indicates low rates of recurrence and high rates of survival, but points to a higher rate of complications compared to conventional breast conserving surgery. Established goals of oncoplastic breast conserving surgery are to broaden the indication for breast conservation towards larger tumors, and to improve esthetic outcomes. The benefit from the patient's perspective, however, remains largely to be confirmed. There is a growing demand to standardize various aspects of oncoplastic breast conserving surgery for implementation in clinical research and practice. Several classification systems and outcomes measurement tools have been proposed, but to the present day, none of them has achieved international acceptance. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. [Surgery of renoureteral lithiasis. Current indications]. (United States)

    González Enguita, C; Calahorra Fernández, F J; Cabrera Pérez, J; García Cardoso, J; Rodríguez-Miñón Cifuentes, J L; García de la Peña, E; Vela Navarrete, R


    Today, the issue about kidney and ureteral stone and their management is based on ESWL (Extracorporeal Shock Wave Lithotripsy) like singly or as a part of combination therapy. In some cases, endoscopic procedures (URS, PNL) with contact lithotripsy, is the first-line treatment. Retroperitoneoscopic is a therapeutical option in some hospitals. Open stone surgery is now drastically reducing and the endoscopic and extracorporeal methods are increasing, overcoat ESWL in those hospitals who has an own lithotripter. The optimal results of non-invasive procedures, and the ESWL advantages for the patients (outpatient and anesthesia-free treatment, decreased morbidity,...), has caused limited annual indications of open surgery for stone disease even a complete disappearance in many center. The Stone and Lithotripsy Unit of "Jiménez Díaz" Foundation (FJD) (Madrid), who has an own lithotipter (Modulith SL 20, STORZ) make an evaluation of 54 patients treated with open surgery (1990-2000) in order to reflect on the indications. Nephrectomy for serious paremquimal lithiasic lesions (complicated pyelonefhritis, xantogranulomatosis....) is not included. The open surgery techniques for stone diseases were the classic according to every case: pielolithotomy (simple or extended +/- infundibulolithotomy), anatrophic nephrotomy, ureterolithotomy,.... At the same time it should be resolved those anomalous structures or obstruction associated to the stone disease (congenital hydroneprosis, ureterocele,...). Now days are difficult cases of stone diseases to be managed for any methods included open surgery. It's the renal complex stone. Of course, surgery is the best option, the more effectively choice. When endoscopic procedures (URS, NPL) fall and the stone is synthomatic must be operated. When they are serious situation (septic shock, complications derived from the others methods,...). It's necessary an urgent and effectively treatment and it's the open surgery. Open surgery is

  6. 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

  7. 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.

  8. Current Trends in Neurolinguistic Studies of Bilingualism. (United States)

    Kraetschmer, Kurt


    A review of current research in bilingualism reveals much attention being given to the role of the brain's right hemisphere in linguistic production. It is proposed that application of findings in second-language learning research and applied linguistics would give experimental support to the existing neurolinguistic theories. (MSE)

  9. Current Trends in the World Economy

    Directory of Open Access Journals (Sweden)

    Leonid Markovich Grigoryev


    Full Text Available The paper presents the dynamics of the world economy that emerged by the autumn of 2015. The review is based on the following data for the world leading countries: GDP, industrial production, exports and imports, money market indicators, stock indices, exchange rate, retail turnover and oil prices. The study shows that the global market situation remains heterogeneous across countries and continents, and it is still in a depression; there is a new equilibrium which is characterized by slipping down long-term trends (concerning the level of 2008-2009. The main emphasis is on the economies of the Great Middle East - Arab countries, Iran and Turkey. The authors note that the region is characterized by great unevenness of economic development depending on three key parameters: availability of oil production; population and its growth rate; and sustainability of socio-political situation. There are two groups of regional countries: ones with a stable socio-political situation and countries affected by conflicts. The study reflects dynamics of the main socio-economic parameters and indices of democracy, corruption and freedom of speech for both groups. The authors conclude that the series of revolutions, wars and conflicts did not lead to the improvement of living and development acceleration

  10. 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.

  11. Current trends in translational research in leptospirosis. (United States)

    Ricaldi, Jessica N; Swancutt, Mark A; Matthias, Michael A


    In the past years, the importance of studying leptospirosis in a translational context has become more evident. This review addresses recent findings in the study of leptospirosis infection, focusing on those applicable to public health, or that will affect management and diagnosis of cases of leptospirosis. We review here recent findings regarding translational aspects of leptospirosis research. Briefly, PCR or a combination of serology and PCR seem to have a higher sensitivity than the current gold standard (microagglutination test). More clinical trials are needed to determine the best treatment for mild and severe leptospirosis. Dendritic cells and γδ T cells seem to have an important role in the immune response to leptospirosis. Environmental assessment is emerging as a very useful tool. In order to understand leptospirosis, multiple aspects need to be considered, including host, pathogen and environment. In this review, we will address newer diagnostics, current advances in immunology and treatment and the growing role of environmental assessment.

  12. Green Computing: From Current to Future Trends


    Tariq Rahim Soomro; Muhammad Sarwar


    During recent years, attention in 'Green Computing' has moved research into energy-saving techniques for home computers to enterprise systems' Client and Server machines. Saving energy or reduction of carbon footprints is one of the aspects of Green Computing. The research in the direction of Green Computing is more than just saving energy and reducing carbon foot prints. This study provides a brief account of Green Computing. The emphasis of this study is on current tren...

  13. 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.  

  14. Solar photovoltaics: current state and trends (United States)

    Milichko, V. A.; Shalin, A. S.; Mukhin, I. S.; Kovrov, A. E.; Krasilin, A. A.; Vinogradov, A. V.; Belov, P. A.; Simovski, C. R.


    Basic aspects of current solar photovoltaics (PVs) are reviewed, starting from the recently developed already-on-the-market first-generation solar cells and ending with promising but not yet commercialized third-generation cells and materials possibly leading to new cell designs. The emphasis is on the physical principles of operation of various solar cells, which are divided into several groups according to our classification scheme. To make the picture complete, some technological and economic aspects of the field are discussed. A separate chapter considers antireflection coatings and light-trapping textures — structures which, while not having appeared yet in the PV review literature, are an integral part of the solar cells.

  15. Emergent anthropogenic trends in California Current upwelling (United States)

    Brady, Riley X.; Alexander, Michael A.; Lovenduski, Nicole S.; Rykaczewski, Ryan R.


    Upwelling in the California Current System (CCS) sustains a productive ecosystem and is mediated by alongshore, equatorward wind stress. A decades-old hypothesis proposes that global warming will accelerate these upwelling favorable winds. Recent analyses provide empirical support for upwelling intensification in the poleward portion of the CCS. However, these studies rely on proxies for upwelling and are limited in their ability to distinguish anthropogenic forcing from internal climate variability. Here we estimate simulated changes in CCS upwelling from 1920 to 2100 using monthly output from a single climate model ensemble, where divergences among simulations can be attributed entirely to internal climate variability. Our projections suggest that CCS upwelling will become more intense in the spring and less intense in the summer as a result of anthropogenic climate change. Anthropogenic changes in upwelling will emerge primarily in the second half of the century.

  16. 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...... 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...... a diversity of individual, academic and labour-market needs. Within Europe, two types of higher education in chemical engineering can be found: more research-oriented or more application-oriented first cycle programmes. Both types of studies cover a period of 3-4 academic years and 60 credits per year. After...

  17. 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.

  18. 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.

  20. 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

  1. 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.

  2. National Trends and Outcomes in Isolated Tricuspid Valve Surgery. (United States)

    Zack, Chad J; Fender, Erin A; Chandrashekar, Pranav; Reddy, Yogesh N V; Bennett, Courtney E; Stulak, John M; Miller, Virginia M; Nishimura, Rick A


    Severe isolated disease of the tricuspid valve (TV) is increasing and results in intractable right heart failure. However, isolated TV surgery is rarely performed, and there are little data describing surgical outcomes. The purpose of this study was to evaluate contemporary utilization trends and in-hospital outcomes for isolated TV surgery in the United States. Patients age >18 years who underwent TV repair or replacement from 2004 to 2013 were identified using the National Inpatient Sample. Patients with congenital heart disease, with endocarditis, and undergoing concomitant cardiac operations except for coronary bypass surgery were excluded. Over a 10-year period, a total of 5,005 isolated TV operations were performed nationally. Operations per year increased from 290 in 2004 to 780 in 2013 (p valve replacement. Given the increasing prevalence of isolated TV disease in the population, research into optimal surgical timing and patient selection is critical. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  3. 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

  4. 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.

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

    African Journals Online (AJOL)

    Annals of Pediatric Surgery. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 9, No 4 (2013) >. Log in or Register to get access to full text downloads.

  6. Current Trends in Nursing Informatics: Results of an International Survey. (United States)

    Peltonen, Laura-Maria; Alhuwail, Dari; Ali, Samira; Badger, Martha K; Eler, Gabrielle Jacklin; Georgsson, Mattias; Islam, Tasneem; Jeon, Eunjoo; Jung, Hyunggu; Kuo, Chiu-Hsiang; Lewis, Adrienne; Pruinelli, Lisiane; Ronquillo, Charlene; Sarmiento, Raymond Francis; Sommer, Janine; Tayaben, Jude L; Topaz, Maxim


    Nursing informatics (NI) can help provide effective and safe healthcare. This study aimed to describe current research trends in NI. In the summer 2015, the IMIA-NI Students Working Group created and distributed an online international survey of the current NI trends. A total of 402 responses were submitted from 44 countries. We identified a top five NI research areas: standardized terminologies, mobile health, clinical decision support, patient safety and big data research. NI research funding was considered to be difficult to acquire by the respondents. Overall, current NI research on education, clinical practice, administration and theory is still scarce, with theory being the least common. Further research is needed to explain the impact of these trends and the needs from clinical practice.

  7. 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.

  8. Current status of robot-assisted gastric surgery (United States)

    Baek, Se-Jin; Lee, Dong-Woo; Park, Sung-Soo; Kim, Seon-Hahn


    In an effort to minimize the limitations of laparoscopy, a robotic surgery system was introduced, but its role for gastric cancer is still unclear. The objective of this article is to assess the current status of robotic surgery for gastric cancer and to predict future prospects. Although the current study was limited by its small number of patients and retrospective nature, robot-assisted gastrectomy with lymphadenectomy for the treatment of gastric cancer is a feasible and safe procedure for experienced laparoscopic surgeons. Most studies have reported satisfactory results for postoperative short-term coutcomes, such as: postoperative oral feeding, gas out, hospital stay and complications, compared with laparoscopic surgery; the difference is a longer operation time. However, robotic surgery showed a shallow learning curve compared with the familarity of conventional open surgery; after the accumulation of several cases, robotic surgery could be expected to result in a similar operation time. Robotic-assisted gastrectomy can expand the indications of minimally invasive surgery to include advanced gastric cancer by improving the ability to perform lymphadenectomy. Moreover, ”total” robotic gastrectomy can be facilitated using a robot-sewing technique and gastric submucosal tumors near the gastroesophageal junction or pylorus can be resected safely by this novel technique. In conclusion, robot-assisted gastrectomy may offer a good alternative to conventional open or laparoscopic surgery for gastric cancer, provided that long-term oncologic outcomes can be confirmed. PMID:22046490

  9. 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.

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

    African Journals Online (AJOL)

    Objective The objective of this study was to determine the current practices of pediatric minimal access surgery (MAS) in our institute over a period of 3 years. Background data Pediatric MAS has received recognition among pediatric surgeons and is currently being practiced in most centers worldwide. However, studies in ...

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

    African Journals Online (AJOL)

    Objective The objective of this study was to determine the current practices of pediatric minimal access surgery. (MAS) in our institute over a period of 3 years. Background data Pediatric MAS has received recognition among pediatric surgeons and is currently being practiced in most centers worldwide. However, studies in ...

  12. 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…

  13. Current trends in lamb production with particular reference to New ...

    African Journals Online (AJOL)

    Current trends in lamb production with particular reference to New Zealand. Information on the production, processing, and marketing of lamb in New Zealand is presented. Consideration is given to new practices such as genetics and animal breeding, nutrition, and flock management that have been introduced in sheep.


    African Journals Online (AJOL)


    failure, priapism, autosplenectomy, jaundice, acute chest syndrome, stroke, retinopathy, leg ulcers, and infections. CURRENT. TRENDS. IN. MANAGEMENT. Neonatal Screening .... appearance of radiographic changes may be delayed24, the diagnosis may ..... women in the same fashion as for women who are not ...

  15. 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…

  16. 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…

  17. 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.

  18. 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

  19. 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.

  20. 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.

  1. High-quality lossy compression: current and future trends (United States)

    McLaughlin, Steven W.


    This paper is concerned with current and future trends in the lossy compression of real sources such as imagery, video, speech and music. We put all lossy compression schemes into common framework where each can be characterized in terms of three well-defined advantages: cell shape, region shape and memory advantages. We concentrate on image compression and discuss how new entropy constrained trellis-based compressors achieve cell- shape, region-shape and memory gain resulting in high fidelity and high compression.

  2. 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)

  3. 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.

  4. 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...... The Electrochemical Society. [DOI: 10.1149/1.1856988] All rights reserved....

  5. 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.

  6. 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 ...

  7. 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 plastic surgery had fewer female authors than other medical specialties including pediatrics, obstetrics and gynecology, general surgery, internal medicine, and radiation oncology (p 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.

  8. Trends in pediatric strabismus surgery in the new millennium: influence of funding and perceived benefits of surgery. (United States)

    Szigiato, Andrei-Alexandru; Caldwell, Meggie; Buys, Yvonne M; Mireskandari, Kamiar


    The rate of strabismus surgery was previously reported to be decreasing in the United Kingdom and Ontario. Data on the influence of government funding on surgical trends and recent population trends for surgery in pediatric patients in Canada are limited. This study aims to analyze the trend in pediatric strabismus procedures in Ontario from 2000 to 2013. A population based, retrospective data analysis. An analysis of the yearly volume of strabismus procedures in the pediatric population of Ontario was performed, subdivided by number of muscles repaired and repeat procedures. The number of ophthalmologists performing strabismus surgery on the pediatric population was analyzed, subdivided by high- and low-volume surgeons and career stage. From 2000 to 2013, per 100,000 pediatric population, the number of total strabismus surgeries in Ontario increased 38.1%; rates of single-muscle surgery increased 12.8%, 2-muscle surgery increased 24.2%, and surgery of ≥3 muscles increased 135.4%. Repeat procedures increased 263.1% from 2000 to 2013 and represented 28.5% of all surgeries in 2013.The number of high-volume surgeons increased 33.3%, whereas low-volume surgeons decreased 61.4% during the same time span. The number of pediatric strabismus procedures in Ontario has increased since 2000, and the practice has become increasingly subspecialized. This is likely due to changes in health care funding and increased parental and physician awareness of the functional and psychosocial benefits of strabismus surgery. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  9. Current trends in the development of laser glasses

    Energy Technology Data Exchange (ETDEWEB)

    Lunter, S.G.; Mit' kin, V.M.; Tolstoi, M.N.; Fedorov, IU.K.


    The principal requirements for glasses suitable for use in solid state lasers are briefly discussed, and some current trends in the development of thermally stable laser-grade phosphate glasses based on I-III elements are reviewed. In particular, attention is given to the optimization of glass composition with respect to structural strength and low brittleness; development of new methods for machining and protecting the side surfaces of active elements; development of new glasses with low concentration quenching, such as a lithium-neodymium-lanthanum-phosphate glass; new neodymium glasses with high chemical stability and low crystallizability; and methods for the dehydration of erbium phosphate glasses. 24 references.

  10. 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...

  11. 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

  12. 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.

  13. 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 ex...... to be published to confirm its value. An ideal training route for surgeons who are adopting the technique was agreed upon, as was the need for a single, large clinical registry of data....

  14. 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.

  15. Robotic hepatobiliary surgery: update on the current status. (United States)

    Carr, A D; Ali, M R; Khatri, V P


    An update on the current status of robotic hepatobiliary surgery based on a review of the available literature. A literature search was performed using the PubMed database with search phrases "robotic hepatectomy", "robotic liver resection", "robotic liver surgery", "robotic hepatobiliary surgery", and "robotic biliary reconstruction". We selected articles with high volume case series or case controlled series. As a result of our literature search we will focus on the 9 major articles on robotic liver resection (RLR) with 235 patients undergoing RLR for a total of 244 liver resections. In addition a brief update on robotic biliary reconstruction will also be presented based on the above articles and recent review articles. Indications for robotic liver resection included both benign (N.=72, 29.5%) and malignant disease (N.=172, 70.5%). The most common indication was colorectal liver metastasis (N.=87, 50.6%) and hepatocellular carcinoma (N.=57, 33%). The most common type of resection was subsegmental (N.=55, 22.5%), with a significant number of major hepatectomies (N.=80, 32.8%). Overall conversion rate was 7.8%, with majority converted to open (N.=18) and one converted to hand assisted. The overall complication rate was 11.8% (N.=29). No perioperative mortality was reported. Preliminary results show that robotic assisted laparoscopic hepatobiliary surgery has materialized as a new technique that combines the advantages of laparoscopy with the dissection, suturing and articulation of robotics. This more closely approximates open surgery. The preliminary data demonstrates that RLR can be applied in major hepatobiliary centers safely. Future comparative studies are needed to determine if this is of significant benefit over current open techniques.

  16. 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)

  17. Trends in cognitive dysfunction following surgery for intracranial tumors. (United States)

    Dhandapani, Manju; Gupta, Sandhya; Mohanty, Manju; Gupta, Sunil Kumar; Dhandapani, Sivashanmugam


    This study was conducted to prospectively assess the cognitive function of patients with intracranial tumors. The cognitive status of patients with intracranial tumors were prospectively studied before surgery, and later at 1 and 6 months following surgery, on purposive sampling, using validated post graduate institute (PGI) battery for brain dysfunction (score 0-30) with a higher dysfunction rating score indicating poor cognitive status. Out of 23 patients enrolled, 20 could complete the study. They had substantial cognitive dysfunction before surgery (score 17.1 ± 9.4). Though there was no significant improvement (16.9 ± 9.0) at 1 month, the score improved significantly (10.3 ± 9.2) at 6 months following surgery (P = 0.008). The improvement was relatively subdued in intra-axial, malignant, and radiated tumors. Overall, there was a significant improvement in mental balance (P = 0.048), verbal retention of dissimilar pairs (P = 0.01), and recognition (P = 0.01), while dysfunction persisted in the domains of memory, verbal retention to similar pairs, and visual retention. Patients with intracranial tumors have substantial cognitive dysfunction, which tend to show significant improvement beyond 6 months following surgery, especially among tumors, which were extra-axial, benign, and nonirradiated.

  18. 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.

  19. 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.

  20. [Cancer of the anus. Current role of surgery]. (United States)

    Cola, B; Ismail, I; Montanari-Reggiani, F; Carnali, M; de Manzini, N


    70 cases of carcinoma of the anus are described in a retrospective study. All patients had been operated, since surgical treatment was regarded as the method of choice at that time. Our work therefore consists in assessing the role of surgery in the treatment of such carcinomas. In the initial forms, extended sphincter saving exeresis allowed excellent results (100% survival over a 1- to 10-year follow-up). In more advanced lesions, treated with abdominoperineal resection, the survival rate was 50% after 5 years. The same figure was obtained in case of extension to the female genital organs (the invasion of which is not a pejorative sign), while the prognosis was considerably worsened for the patients who had had lymph node resection due to invasion of inguinal nodes (20% survived after 5 years). Local surgical exeresis currently is as valuable as radiation therapy, but the latter is clearly indicated for advanced carcinomas, for which mutilating surgery has not demonstrated its superiority.

  1. Liberal transfusion strategies still the trend in burn surgery | Allorto ...

    African Journals Online (AJOL)

    Objective: Blood is a limited resource in middle-income countries such as South Africa. Transfusion is associated with complications and expense. We aimed to understand our transfusion practices in burn surgery as well as ascertain the opinion of a broader group of surgeons and anaesthetists regarding transfusion ...

  2. 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.

  3. 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

  4. 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.

  5. 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

  6. 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

  7. 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.

  8. 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

  9. 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.

  10. Time-trend and variations in the proportion of second-eye cataract surgery

    Directory of Open Access Journals (Sweden)

    Bernal-Delgado Enrique


    Full Text Available Abstract Background Despite recommendations for greater use of second-eye cataract surgery and the bilateral progression of the disease, there is a substantial proportion of unmet need for this treatment. Few studies have explored the factors associated with second-eye cataract surgery utilisation. The objective of our study was to estimate the proportion of second-eye cataract surgery, evaluate its time-trend, and explore differences in utilisation by patients' gender, age, and region of residence. Methods All senile cataract surgeries performed between 1999 and 2002 in the public health system of Catalonia (Spain were obtained from the Minimum Data Set. The proportion of second-eye surgery from November 2000 to December 2002 was calculated. The time-trend of this proportion was characterised through linear regression models with the logarithmic transformation of time. Results The proportion of second-eye surgery was 30.0% and showed an increasing trend from 24.8% (95% Confidence Interval [CI] 21.6; 26.1 in November 2000 to 31.8% (95% CI 31.4; 33.6 in December 2002. This proportion was 1.9% (95% CI 0.9; 2.9 higher in women (p Conclusion We predict greater utilization of second-eye surgery in patients aged 70 to 79 years and in women. A greater increase in the utilisation rates of second-eye surgery is expected in the regions with lower proportions and in older patients. The observed trend suggests that there will be a substantial proportion of unmet need for bilateral surgery.

  11. Current state of the art of computer-guided implant surgery. (United States)

    D'haese, Jan; Ackhurst, Johan; Wismeijer, Daniel; De Bruyn, Hugo; Tahmaseb, Ali


    The invention of computerized axial tomography (now known as computerized tomography) and developments of interactive software to allow virtual planning, with the aim to guide the surgery precisely toward a specific target, has dramatically improved general, as well as oral, surgery. Virtual dental implant planning allows for a prosthetically driven approach, resulting in the best possible design of the prosthesis, better esthetics, optimized occlusion and loading. This approach has also changed the surgical paradigm of using extensive flaps to obtain a proper view of the surgical area because flapless implant surgery, with or without immediate loading, has become more predictable. Two types of guided implant surgery protocols - static and dynamic - are described in the literature. The static approach, better known as computer-guided surgery, refers to the use of a tissue-supported surgical template. This reproduces the virtual implant position directly from computerized tomographic data and this information can be converted to guide templates to be used during surgery, with or without raising a mucoperiosteal flap. Dynamic guided surgery, also called navigation, reproduces the virtual implant position directly from computerized tomographic data and uses motion-tracking technology to guide the implant osteotomy preparation. As the technology developed further, different levels of evidence were presented that showed various degrees of accuracy. Several protocols for guided surgery are available in the literature and are distinguished by different guide production techniques, methods of support and drilling/placement protocols. Currently, implant planning software using cone-beam computerized tomography data has made it possible to plan the optical implant position virtually the optimal implant position, taking the surrounding vital anatomic structures and future prosthetic requirements into consideration. This paper summarizes the evolution and ongoing trends in

  12. Laparoscopic surgery for inguinal hernia: Current status and controversies

    Directory of Open Access Journals (Sweden)

    Bhandarkar Deepraj


    Full Text Available Repair of inguinal hernia is one of the commonest operations performed by surgeons around the world. The treatment of this common problem has seen an evolution from the pure tissue repairs to the prosthetic repairs and in the recent past to laparoscopic repair. The fact that so many hernia repairs are practiced is a testimony to the fact that probably none is distinctly superior to the other. This review assesses the current status of surgery for repair of inguinal hernia and examines the various controversial issues surrounding the subject.

  13. Current trends in nuclear energy (5). Trend of nuclear power development in India

    International Nuclear Information System (INIS)

    Sato, Koji; Yanagisawa, Tsutomu


    This article introduces the trend of nuclear power development of India, in which the current energy and electric power situation, the nuclear energy policy (historical background, nuclear development organization, three-stage nuclear power development program, introduction plan of electric power and nuclear power, and international cooperation), current status of nuclear development (first phase: thermal neutron reactors (pressurized heavy-water reactors (PHWR) and light water reactors (LWR)) and related fuel cycle, secondary stage-fast reactors and related fuel cycle, third stage: advanced reactors and related fuel cycle, development of human resources, influence of the TEPCO's Fukushima dai-ichi nuclear power station accident, and the expectation for nuclear cooperation are described. (author)


    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.

  15. Cold and hot extremozymes: industrial relevance and current trends

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    Felipe eSarmiento


    Full Text Available The development of enzymes for industrial applications relies heavily on the use of microorganisms. The intrinsic properties of microbial enzymes e.g. consistency, reproducibility and high yields along with many others, has pushed their introduction into a wide range of products and industrial processes. Extremophilic microorganisms represent an underutilized and innovative source of novel enzymes. These microorganisms have developed unique mechanisms and molecular means to cope with extreme temperatures, acidic and basic pH, high salinity, high radiation, low water activity, and high metal concentrations among other environmental conditions.Extremophile derived enzymes, or extremozymes, are able to catalyze chemical reactions under harsh conditions, like those found in industrial processes, which were previously not thought to be conducive for enzymatic activity. Due to their optimal activity and stability under extreme conditions, extremozymes offer new catalytic alternatives for current industrial applications. These extremozymes also represent the cornerstone for the development of environmentally-friendly, efficient and sustainable industrial technologies. Many advances in industrial biocatalysis have been achieved in recent years, however, the potential of biocatalysis through the use of extremozymes is far from being fully realized. In this article, the adaptations and significance of psychrophilic, thermophilic and hyperthermophilic enzymes, and their applications in selected industrial markets will be reviewed. Also the current challenges in the development and mass-production of extremozymes as well as future prospects and trends for their biotechnological application will be discussed.

  16. Cold and Hot Extremozymes: Industrial Relevance and Current Trends. (United States)

    Sarmiento, Felipe; Peralta, Rocío; Blamey, Jenny M


    The development of enzymes for industrial applications relies heavily on the use of microorganisms. The intrinsic properties of microbial enzymes, e.g., consistency, reproducibility, and high yields along with many others, have pushed their introduction into a wide range of products and industrial processes. Extremophilic microorganisms represent an underutilized and innovative source of novel enzymes. These microorganisms have developed unique mechanisms and molecular means to cope with extreme temperatures, acidic and basic pH, high salinity, high radiation, low water activity, and high metal concentrations among other environmental conditions. Extremophile-derived enzymes, or extremozymes, are able to catalyze chemical reactions under harsh conditions, like those found in industrial processes, which were previously not thought to be conducive for enzymatic activity. Due to their optimal activity and stability under extreme conditions, extremozymes offer new catalytic alternatives for current industrial applications. These extremozymes also represent the cornerstone for the development of environmentally friendly, efficient, and sustainable industrial technologies. Many advances in industrial biocatalysis have been achieved in recent years; however, the potential of biocatalysis through the use of extremozymes is far from being fully realized. In this article, the adaptations and significance of psychrophilic, thermophilic, and hyperthermophilic enzymes, and their applications in selected industrial markets will be reviewed. Also, the current challenges in the development and mass production of extremozymes as well as future prospects and trends for their biotechnological application will be discussed.

  17. Current trends and progress in clinical applications of oocyte cryopreservation (United States)

    Cil, Aylin P.; Seli, Emre


    Purpose of review To delineate the current trends in the clinical application of oocyte cryopreservation. Recent findings Although the first live birth from oocyte cryopreservation was reported approximately three decades ago, significant improvement in the clinical application of oocyte cryopreservation took place only over the past decade. On the basis of the available evidence suggesting that success rates with donor oocyte vitrification are similar to that of IVF with fresh donor oocytes, the American Society of Reproductive Medicine has recently stated that oocyte cryopreservation should no longer be considered experimental for medical indications, outlying elective oocyte cryopreservation. Meanwhile, a few surveys on the attitudes toward oocyte cryopreservation revealed that elective use for the postponement of fertility is currently the most common indication for oocyte cryopreservation. Most recently, a randomized controlled trial revealed important evidence on the safety of nondonor oocyte cryopreservation, and confirmed that the clinical success of vitrification is comparable to that of IVF with fresh oocytes. Summary The evidence suggesting similar IVF success rates with both donor and nondonor cryopreserved oocytes compared with fresh oocytes will increase the utilization of elective oocyte cryopreservation. Appropriate counseling of women for oocyte cryopreservation requires the establishment of age-based clinical success rates with cryopreserved oocytes for various indications. PMID:23562954

  18. Current Trends in Adolescent Substance Use in Jamaica

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    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.

  19. Trends and demographic characteristics of Saudi cosmetic surgery patients. (United States)

    Alharethy, Sami E


    To  present the demographic characteristics of Saudi patients undergoing cosmetic procedures.  Methods: This prospective study survey was conducted in 3 private cosmetic surgery centers in different regions of Saudi Arabia (Riyadh and Jeddah) between January and August 2016. Validated questionnaire with modification was used and the following patient's information were provided: age group, height and weight, marital status, number of children, age of the patient's spouse, educational level, monthly income, name of the cosmetic procedure, names of any previous cosmetic procedures and their reason for cosmetic procedure. Results: The present study revealed that a typical Saudi cosmetic surgery patients are university graduates, married (46.8%), employed (68.3%), and middle aged 20-40 years of age (70%), with a fairly high typical monthly income.  Conclusion: There is a possible positive correlation between gender and undergoing cosmetic procedure. Laser hair removal, botox, liposuction, filler, and scar revision are common among females, while rhinoplasty is a common procedure among males.

  20. Trends and demographic characteristics of Saudi cosmetic surgery patients

    Directory of Open Access Journals (Sweden)

    Sami E. Alharethy


    Full Text Available Objectives: To present the demographic characteristics of Saudi patients undergoing cosmetic procedures. Methods: This prospective study survey was conducted in 3 private cosmetic surgery centers in different regions of Saudi Arabia (Riyadh and Jeddah between January and August 2016. Validated questionnaire with modification was used and the following patient’s information were provided: age group, height and weight, marital status, number of children, age of the patient’s spouse, educational level, monthly income, name of the cosmetic procedure, names of any previous cosmetic procedures and their reason for cosmetic procedure. Results: The present study revealed that a typical Saudi cosmetic surgery patients are university graduates, married (46.8%, employed (68.3%, and middle aged 20-40 years of age (70%, with a fairly high typical monthly income. Conclusion: There is a possible positive correlation between gender and undergoing cosmetic procedure. Laser hair removal, botox, liposuction, filler, and scar revision are common among females, while rhinoplasty is a common procedure among males.

  1. Emerging trends in social media and plastic surgery. (United States)

    Gould, Daniel J; Leland, Hyuma A; Ho, Adelyn L; Patel, Ketan M


    Social media has increasingly changed the landscape of medicine and surgery and is rapidly expanding its influence in most peoples' lives. The average person spends nearly 2 hours per day using social media, consuming information about everything from family updates to entertainment news to presidential elections. The concentration of consumers on social media platforms has resulted in direct medicine and medical products marketing to consumers. Similarly, social media is increasingly becoming a platform for interaction between physicians and potential patients. Some physicians have taken this opportunity to better educate patients, while allowing patients to learn more about their surgeons online. These tools can increase internet traffic online to bonafide internet sites, as well as bolster marketing for many hospitals, hospital systems, and individual doctors. It can also serve to increase knowledge about procedures and conditions through direct outreach to patients. Social media is a powerful tool which needs to be utilized wisely to avoid pitfalls.

  2. Single-incision Laparoscopic Surgery (SILS) in general surgery: a review of current practice. (United States)

    Froghi, Farid; Sodergren, Mikael Hans; Darzi, Ara; Paraskeva, Paraskevas


    Single-incision laparoscopic surgery (SILS) aims to eliminate multiple port incisions. Although general operative principles of SILS are similar to conventional laparoscopic surgery, operative techniques are not standardized. This review aims to evaluate the current use of SILS published in the literature by examining the types of operations performed, techniques employed, and relevant complications and morbidity. This review considered a total of 94 studies reporting 1889 patients evaluating 17 different general surgical operations. There were 8 different access techniques reported using conventional laparoscopic instruments and specifically designed SILS ports. There is extensive heterogeneity associated with operating methods and in particular ways of overcoming problems with retraction and instrumentation. Published complications, morbidity, and hospital length of stay are comparable to conventional laparoscopy. Although SILS provides excellent cosmetic results and morbidity seems similar to conventional laparoscopy, larger randomized controlled trials are needed to assess the safety and efficacy of this novel technique.

  3. 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.

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

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    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.

  5. 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

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

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    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.

  7. Hypertension in Latin America: Current perspectives on trends and characteristics. (United States)

    Ruilope, L M; Chagas, A C P; Brandão, A A; Gómez-Berroterán, R; Alcalá, J J A; Paris, J V; Cerda, J J O

    The region of Latin America, which includes Central America, the Caribbean and South America, is one that is rapidly developing. Signified by socio-economic growth, transition and development over the last few decades, living standards in countries like Brazil and Mexico have improved dramatically, including improvements in education and health care. An important marker of socio-economic change has been the epidemiological shift in disease burden. Cardiovascular disease is now the leading cause of death in Latin America, and the drop in prevalence of infectious diseases has been accompanied by a rise in non-communicable diseases. Hypertension is the major risk factor driving the cardiovascular disease continuum. In this article we aim to discuss the epidemiological and management trends and patterns in hypertension that may be specific or more common to Latin-American populations - what we term 'Latin American characteristics' of hypertension - via a review of the recent literature. Recognizing that there may be a specific profile of hypertension for Latin-American patients may help to improve their treatment, with the ultimate goal to reduce their cardiovascular risk. We focus somewhat on the countries of Brazil, Mexico and Venezuela, the experience of which may reflect other Latin American countries that currently have less published data regarding epidemiology and management practices. Copyright © 2016 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. 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.

  9. Current Trends in the Nuclear Power Global Market

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    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

  10. 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.

  11. 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.

  12. 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.

  13. Current trends of liposuction in India: Survey and Analysis

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    Bijoy Methil


    Full Text Available Background: Liposuction is the commonest aesthetic procedure performed by Indian plastic surgeons. However, there exists substantial disparity amongst Indian surgeons about guidelines concerning liposuction.To address this disparity, a nationwide email survey (Association of Plastic Surgeons of India [APSI] database was started in December 2013 and continued for 5 months. Material and Methods: The survey was developed with software from The study was designed to cover most aspects of patient selection, perioperative management, technical considerations, postoperative management and complications. This is the first survey to be conducted in India for an extremely popular procedure. It is also one of the most exhaustive surveys that have been conducted in terms of the topics covered. Results and Conclusions: One hundred and eighteen surgeons (including a majority of the cosmetic surgery stalwarts in the country completed the survey. As expected, the results show a disparity in most parameters but also consolidation on some issues. Liposuction is considered extremely safe (86.1%. The majority of surgeons (70.3% aspirated >5 L at onetime.The majority (80.2% felt that the limits for liposuction should be relative and not absolute. The survey highlights lack of standardization with respect to infiltration solutions. The commonest complications observed were contour irregularities, followed by seroma and inadequate skin redrape. The amount of aspirate is the only factor, which achieves statistical significance with respect to major complications. A review of the current evidence and recommendations has been incorporated, along with an in depth analysis of the survey.

  14. Current trends in surgical approach and outcomes following pituitary tumor resection. (United States)

    Villwock, Jennifer A; Villwock, Mark R; Goyal, Parul; Deshaies, Eric M


    The goals of pituitary tumor resection include normalizing endocrine function, relieving mass effect, and minimizing risk of recurrence. This study investigated current trends in costs and complications for transfrontal and transsphenoidal pituitary surgery. Retrospective review of the 2008-2011 Nationwide Inpatient Sample for patients undergoing pituitary lesion resection. Demographics and outcomes were compared between transfrontal and transsphenoidal surgical approaches using χ(2) tests. Multivariate analysis was performed to investigate outcomes while controlling for confounders. There were 8,543 admissions for resection of pituitary lesions that met our inclusion criteria. Most (>90%) were treated transsphenoidally. The transfrontal approach was most frequent in the young (<35 years) and in the South. Rates of mortality and complications were higher in patients undergoing transfrontal surgery. Multivariate analysis found transsphenoidal resection was associated with a reduction in hospital costs and length of stay by over 50%; low-volume hospitals had increased cost and length of stay. There was an increased rate of transfrontal approaches at low-volume centers. Multiple factors influence outcomes of pituitary tumor resection. Transsphenoidal pituitary surgery is associated with a shorter length of stay, lower cost, and lower complication rates when compared to transfrontal surgery. Case specifics, including tumor location and size, influence approach and lead to a selection bias that cannot be controlled for in the present study. The prevalence of transfrontal resections at low-volume centers may indicate an area of further investigation. Additionally, when controlling for surgical approach, low-volume centers were found to adversely affect economic outcomes and also warrants investigation. 2c. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  15. Trends in the use of minimally invasive surgery in children. (United States)

    Tovaranonte, Preechapon Pleay; Beasley, Spencer W; Maoate, Kiki; Blakelock, Russell; Skinner, Adrian


    To determine trends in the scope of use of minimally invasive surgical (MIS) techniques in children as a predictor of future operative workload and operating theatre requirements. A retrospective review was conducted of all paediatric patients less than 16 years of age who underwent minimally invasive surgical procedures at Christchurch Hospital, New Zealand between 1996 and 2007. There were 1693 children who received 1826 MIS procedures during a period in which 11,893 operative procedures were performed. MI case-weights, an indirect measure of the financial burden and technical difficulty of the procedures, represented 29% of the workload of the unit overall. There was a rapid rise of the number of MIS procedures from 1996 to 2000, but since then the scope and volume has changed little. Use of MIS in children increased rapidly until 2000 since which time it has remained relatively constant. Recent additional applications have involved a small number of rare low-volume and more complex procedures. These observations may assist in the planning of theatre allocation requirements for MIS in children.

  16. Trends, Frequency, and Nature of Surgeon-Reported Conflicts of Interest in Plastic Surgery. (United States)

    Lopez, Joseph; Musavi, Leila; Quan, Amy; Calotta, Nicholas; Juan, Ilona; Park, Angela; Tufaro, Anthony P; May, James W; Dorafshar, Amir H


    The purpose of this study was to identify types and trends in industry sponsorship of plastic surgery research since the establishment of conflict-of-interest reporting policies in plastic surgery. The authors analyzed the frequency and types of self-reported conflicts of interest in the plastic surgery literature since the adoption of reporting policies in 2007. All original articles that met the authors' inclusion criteria and were published in the following three journals from 2008 to 2013 were included: Annals of Plastic Surgery, Plastic and Reconstructive Surgery, and Journal of Plastic, Reconstructive & Aesthetic Surgery. A multivariate regression analysis was performed to determine what study-specific variables were associated with conflict-of-interest disclosures. A total of 3722 articles were analyzed. The incidence of conflicts of interest increased from 14 percent in 2008 to 24 percent in 2009. However, thereafter, the incidence of conflicts of interest decreased steadily from 21 percent in 2010 to 9 percent in 2013. Furthermore, the authors' analysis revealed that from 2008 to 2013, industry decreased direct research support but steadily increased the rate of consultantships (p plastic surgery subspecialty (p plastic surgery declined overall. Although the absolute number of consultantships did not change, the rate of consultantships rather than direct research support increased over this period.

  17. 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)

  18. 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

  19. Current Trends in Physical Anthropology in Japan


    HANIHARA, Kazuro


    The trends in physical anthropology in Japan have largely changed through the introduction of new methodologies such as molecular genetics and multivariate statistics in the 1960s. The development of ecology and primatology brought another new wave into the field of physical anthropology. This paper reviews briefly general trends in research in physical anthropology now on-going in Japan. Microevolutionary studies of the Japanese and neighboring populations which have a long history in Jap...

  20. Trends in techniques to avoid bone augmentation surgery: Application of short implants, narrow-diameter implants and guided surgery. (United States)

    Pommer, Bernhard; Busenlechner, Dieter; Fürhauser, Rudolf; Watzek, Georg; Mailath-Pokorny, Georg; Haas, Robert


    Minimally invasive implantology using reduced implant dimensions as well as virtual treatment planning and CAD/CAM stereolithographic templates has gained popularity in recent years. The aim of the present investigation was to analyze prevailing trends in clinical utilization of these graftless therapeutic options. A total of 12.865 dental implants were placed in 5.365 patients at the Academy for Oral Implantology in Vienna, of which 5.5% were short (length short implants and guided surgery increased significantly in all subgroups. Narrow-diameter implants were most frequent in single-tooth gaps (24.1%), however, upward trends could only be observed in partially and completely edentulous patients. Short implants were predominantly used in the mandible (9.9% vs. 2.5%, P Short implants (most frequent in partial edentulism) and guided implant surgery (most frequent in complete edentulism) represent uprising and promising surgical approaches to avoid patient morbidity associated with bone graft surgery. Copyright © 2016. Published by Elsevier Ltd.

  1. Current trends and future directions in flower development research. (United States)

    Scutt, Charlie P; Vandenbussche, Michiel


    Flowers, the reproductive structures of the approximately 400 000 extant species of flowering plants, exist in a tremendous range of forms and sizes, mainly due to developmental differences involving the number, arrangement, size and form of the floral organs of which they consist. However, this tremendous diversity is underpinned by a surprisingly robust basic floral structure in which a central group of carpels forms on an axis of determinate growth, almost invariably surrounded by two successive zones containing stamens and perianth organs, respectively. Over the last 25 years, remarkable progress has been achieved in describing the molecular mechanisms that control almost all aspects of flower development, from the phase change that initiates flowering to the final production of fruits and seeds. However, this work has been performed almost exclusively in a small number of eudicot model species, chief among which is Arabidopsis thaliana. Studies of flower development must now be extended to a much wider phylogenetic range of flowering plants and, indeed, to their closest living relatives, the gymnosperms. Studies of further, more wide-ranging models should provide insights that, for various reasons, cannot be obtained by studying the major existing models alone. The use of further models should also help to explain how the first flowering plants evolved from an unknown, although presumably gymnosperm-like ancestor, and rapidly diversified to become the largest major plant group and to dominate the terrestrial flora. The benefits for society of a thorough understanding of flower development are self-evident, as human life depends to a large extent on flowering plants and on the fruits and seeds they produce. In this preface to the Special Issue, we introduce eleven articles on flower development, representing work in both established and further models, including gymnosperms. We also present some of our own views on current trends and future directions of the

  2. 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

  3. Current trends in the management of infected necrotizing pancreatitis. (United States)

    Sakorafas, George H; Lappas, Christos; Mastoraki, Aikaterini; Delis, Spiros G; Safioleas, Michael


    Severe acute pancreatitis is a potentially life-threatening disease. Pancreatic necrosis is associated with an aggravated prognosis, while superimposed infection is almost always lethal without surgery. Bacterial translocation mainly from the gut is the most widely accepted mechanism in the pathogenesis of infected pancreatic necrosis. Infected pancreatic necrosis should be suspected in the presence of the usual markers of systemic inflammation (i.e., fever and leukocytosis), organ failure, or a protracted severe clinical course. The diagnostic method of choice to confirm the diagnosis of pancreatic necrosis is contrast-enhanced computed tomography, where necrotic areas are evidenced as regions without enhancement. The presence of pancreatic necrotic infection should be based on a combination of clinical manifestations, results of laboratory investigation (mainly increased levels of CRP and / or procalcitonin), and can be confirmed by image-guided fine-needle aspiration and gram stain /culture of the aspirates. Surgery remains the treatment of choice for the management of infected pancreatic necrosis and involves open necrosectomy (debridement) and wide drainage of the peripancreatic areas, often in association with continuous irrigation. Planned reoperations may be required to achieve complete removal of the necrotic / infected material. The timing of surgery is of paramount importance; ideally, surgery should be performed after 2 or 3 weeks from the onset of pancreatitis. Recently, various minimally invasive approaches have been described, but they have not been compared in prospective trials with the classical open surgery. Antibiotic therapy is routinely used in patients with infected necrotizing pancreatitis, in conjunction with surgical debridement; its role, however, in the management of patients with sterile necrosis is recently questioned. Nutritional support should be taken into consideration in these patients; enteral nutrition should be preferred over

  4. 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 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.

  5. National Trends in Short-term Outcomes Following Non-emergent Surgery for Diverticular Disease. (United States)

    Papageorge, Christina M; Kennedy, Gregory D; Carchman, Evie H


    Elective surgery for diverticulitis has evolved over the last decade. We aimed to evaluate the impact of changing practice patterns on postoperative outcomes. We hypothesized that the increased use of laparoscopy, and other management changes, would correlate with a decrease in postoperative complications. Patients undergoing non-emergent surgery for diverticulitis from 2005 to 2013 were selected from the National Surgical Quality Improvement Program (NSQIP) database. We compared patient demographics, comorbidities, and operative approach by year of operation using chi-square tests and investigated temporal trends in postoperative outcomes using univariate, trend, and multivariate analyses. The analytic cohort, which included 29,893 patients, had increasing rates of obesity, advanced age, and higher American Society of Anesthesiologists (ASA) class over the study period. The use of laparoscopy increased significantly from 48 % in 2005/2006 to 70 % in 2013 (p trend towards increasing patient complexity, there has been a decline in postoperative morbidity following non-emergent surgery for diverticulitis. This trend coincides with the steadily increasing use of laparoscopy in this population.

  6. [The influence of current social, medical, and political trends on the future of otorhinolaryngology]. (United States)

    Heinrich, D; Löhler, J


    All medical specialties are changing permanently, including otorhinolaryngology. Analyzing trends in social changes, medical progress, and political decisions will allow the effects of these on ENT medicine to be at least partially anticipated. Demographic changes and medical progress lead to an increasing demand for medical treatments. In addition, increasing numbers of female physicians are observed, as are many changes in the lifestyles of young physicians. Medical treatment will develop toward more individualized therapies in the future. ENT surgery will become a more ambulatory medical specialty. Driven by political decisions, digital medicine will become more important. Particular services once provided by physicians will be delegated to non-physician professionals. The lack of physicians and the progress in medicine require better networking between in- and outpatient services in the future. The potential of such collaborations is currently not completely realized. However, these developments will also increase the cost of health care. These trends will develop otorhinolaryngology into a conservative and surgical ambulatory care driven medical specialty. Embedded in decentralized networks and cooperations, and supported by IT technologies and specialized non-physician professionals, ENT physicians will work in hospitals as well as in practices on a permanent basis. Nevertheless, the question of funding these changes has yet to be clarified.

  7. 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…

  8. Primary Postpartum Haemorrhage [PPH] In Ilorin: Current Trends ...

    African Journals Online (AJOL)

    This study was carried out to determine the incidence of Primary Postpartum Haemorrhage following vaginal delivery and evaluate the trend at the University of Ilorin Teaching Hospital [UITH], Ilorin, Nigeria. This study was a hospital based retrospective study of all cases of Primary Postpartum Haemorrhage [PPH] following ...

  9. 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…

  10. Hispanic Superintendents in Illinois: Current Trends and Challenges (United States)

    Espinoza, Ricardo


    The trends and challenges faced by Hispanic superintendents in Illinois are stated and analyzed throughout the study in both literature and practice. The examined items centered on the issues of hiring experiences and other barriers associated with the acquisition and longevity of the superintendency in Illinois. Data for the study were collected…

  11. Current Status of Bariatric and Metabolic Surgery in Korea

    Directory of Open Access Journals (Sweden)

    Youn-Baik Choi


    Full Text Available Bariatric surgery is considered to be the most effective treatment modality in maintaining long-term weight reduction and improving obesity-related conditions in morbidly obese patients. In Korea, surgery for morbid obesity was laparoscopic sleeve gastrectomy first performed in 2003. Since 2003, the annual number of bariatric surgeries has markedly increased, including adjustable gastric banding (AGB, Roux-en-Y gastric bypass, sleeve gastrectomy, mini-gastric bypass, and others. In Korea, AGB is much more common than in others countries. A large proportion of doctors, the public, and government misunderstand the necessity and effectiveness of bariatric surgery, believing that bariatric surgery has an unacceptably high morbidity, and that it is not superior to non-surgical treatments to improve obesity and obesity-related diseases. The effectiveness, safety, and cost-effectiveness of bariatric surgery have been well demonstrated. The Korean Society of Metabolic and Bariatric Surgery recommend bariatric surgery confining to morbidly obese patients (body mass index ≥40 or >35 in the presence of significant comorbidities.


    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

  13. 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.

  14. Sex imbalances at birth : current trends, consequences and policy implications


    Guilmoto, Christophe


    This report offers an updated review of the various facets and the latest trends and differentials in sex selection in Asia. It includes a set of recommendations to combat gender discrimination and prenatal sex selection at the national and regional level. Education, urbanization and economic development have significantly improved opportunities for Asian women and girls over the last two decades. Yet, this has coincided with a fall in the proportion of girls among children in many countri...

  15. 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...

  16. Current Trends in the Political Economy of Communication


    Vincent Mosco


    In this paper five major trends in the political economy of communication are addressed: the globalization of the field, the expansion of an enduring emphasis on historical research, the growth of research from alternative standpoints, especially feminism and labour, the shift from an emphasis on old to new media, and the growth of activism connected to the political economy tradition. None of these are brand new tendencies but rather build on existing ones, which were often submerged beneath...

  17. Current work and future trends. IAEA reports to ECOSOC

    International Nuclear Information System (INIS)


    The present and future role of the International Atomic Energy Agency is outlined in two recent reports submitted by the Agency to the United Nations Economic and Social Council. One of them is the Agency's annual report to the Council covering the period 16 April 1959 to 15 April 1960 while the other, containing an appraisal of likely trends in the future, is a document specially prepared for the Appraisals Committee of the Council

  18. 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

  19. 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...

  20. 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

  1. 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

  2. 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

  3. 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.

  4. Current trends in selection of conduits for coronary artery bypass grafting. (United States)

    Carrel, Thierry; Winkler, Bernhard


    The procedure of coronary artery bypass grafting continues to be the "gold standard" for patients with multivessel coronary artery disease and left main stenosis due to favourable long-term and consistent outcomes despite the advent of new generations of stents. But the targeted better long-term outcome of surgical revascularization over percutaneous interventions depends on several variables and aspects; one of them is the choice of conduits used to bypass the stenosed arteries. Coronary artery bypass surgery has been studied and debated for decades and the same applies to the selection of grafts. Current data provide significant benefits for patients who receive full arterial revascularization using both internal thoracic arteries and, if applicable, the radial artery. Unfortunately, the use of multiple arterial grafts is still not performed widely despite the evidence of superiority over multiple saphenous vein grafts that are still the most used grafts in cardiovascular procedures. In this review article, we present current trends and evidences for graft selection and give an overview of controversial data regarding the comparison of the radial artery and saphenous vein. Additionally, few words are spelt on alternative conduits.

  5. Current trends in the management of Mirizzi Syndrome (United States)

    Chen, Hang; Siwo, Ernest Amos; Khu, Megan; Tian, Yu


    Abstract Mirizzi Syndrome is a rare and challenging clinical entity to manage. However, recent advances in technology have provided surgeons with new options for more effective diagnosis and treatment of this condition. This paper reviews these new diagnostic modalities and treatment approaches for the management of Mirizzi Syndrome. An online search language was performed using PubMed and Web of Science for literature published in English between 2012 and 2017 using the search terms “Mirizzi Syndrome” and “Mirizzi.” In total, 16 case series and 11 case reports were identified and analyzed. The most frequently used diagnostic modalities were ultrasound, computed tomography (CT); magnetic resonance cholangiopancreaticography (MRCP); endoscopic retrograde cholangiopancreaticography (ERCP). A combination of ≥2 diagnostic modalities was frequently used to detect Mirizzi Syndrome. Literature shows that the specific type of Mirizzi Syndrome determined the type of treatment chosen. Open surgery was the preferred option, although there are documented cases of the use of minimally-invasive techniques, even in advanced cases. Laparoscopic, endoscopic or robot-assisted surgery, used individually or in combination with lithotripsy, were all associated with a favorable outcome. As yet, there are no internationally-accepted guidelines for the management of Mirizzi Syndrome. Laparotomy is the preferred surgical technique of choice, although an increasing number of surgeons are beginning to opt for minimally-invasive techniques. The number of papers in the existing literature describing diagnostic and treatment procedures is relatively small at present, thus making it difficult to reasonably propose an evidence-based standard of care for Mirizzi Syndrome. PMID:29369192

  6. 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)

  7. Current trends in nuclear medicine metabolic therapy - international experience

    International Nuclear Information System (INIS)

    Chavdarova, L.; Tsonevska, A.; Piperkova, E.


    Full text: Introduction: Modern nuclear medicine (NM) metabolic therapy involves treatment with radionuclides sources mainly β-, and lately more often and α- rays and aims target specificity to the disease process with minimal damage to healthy surrounding tissues. Materials and Methods: We present some of the most important clinically significant contemporary trends in metabolic therapy in the light of international experience, including low-known in Bulgaria peptide radioreceptor therapy, radioimmunotherapy and so called SIRT (Selective internal radiation therapy) for liver metastases. Results: The ability of NM therapy range from definitive treatment of benign thyroid disease and differentiated thyroid cancer by achieving partial response or complete remission to a temporary palliative analgesic and symptom reducing effect in different, mainly cancer, diseases. Conclusion: The principle of 'terradiagnostic' - the interdependence of diagnostic and therapeutic nuclear medicine approaches is crucial for individualizing treatment and achieving better results in extending survival and improving the quality of life of patients

  8. Current Trends in Nanoporous Anodized Alumina Platforms for Biosensing Applications

    Directory of Open Access Journals (Sweden)

    Ganesan Sriram


    Full Text Available Pristine aluminum (Al has received great deal of attention on fabrication of nanoporous anodized alumina (NAA with arrays of nanosized uniform pores with controllable pore sizes and lengths by the anodization process. There are many applications of NAA in the field of biosensors due to its numerous key factors such as ease of fabrication, high surface area, chemical stability and detection of biomolecules through bioconjugation of active molecules, its rapidness, and real-time monitoring. Herein, we reviewed the recent trends on the fabrication of NAA for high sensitive biosensor platforms like bare sensors, gold coated sensors, multilayer sensors, and microfluidic device supported sensors for the detection of various biomolecules. In addition, we have discussed the future prospectus about the improvement of NAA based biosensors for the detection of biomolecules.

  9. Mycosis fungoides: Current trends in diagnosis and management

    Directory of Open Access Journals (Sweden)

    Panda Saumya


    Full Text Available Mycosis fungoides (MF is the most common group of cutaneous T-cell lymphomas. It is a rare non-Hodgkin′s lymphoma of mature, skin-homing, clonal, malignant T lymphocytes, usually observed in mid to late adulthood, that initially presents in the skin as patches, plaques, tumors, or generalized erythema (erythroderma and can involve the lymph nodes and peripheral blood. Much progress has been made in recent years in understanding the origin of the malignant T cell in MF and the patho-physiology and immunology of the disease. This recent work has made a great impact on diagnosis, prognostication, and treatment. In this review, we survey the MF literature of the last decade and highlight the major trends.

  10. Integrated Plastic Surgery Residency Applicant Trends and Comparison With Other Surgical Specialties. (United States)

    Abraham, Jasson T; Nguyen, Anson V; Weber, Robert A


    There has been a relatively rapid increase in the number and size of "integrated" residency programs in plastic surgery (PS) over the past decade. The objective of this study is to evaluate trends of US senior applicants of PS compared with other surgical specialties from 2007 to 2016. Data were obtained from "NRMP: Main Residency Match" and from "NRMP: Charting Outcomes in the Match." Frequencies, percentages, and proportions were calculated for categorical variables. Odds ratios with 95% confidence interval were calculated to evaluate the relationship of Alpha Omega Alpha membership and match success. The overall National Resident Matching Program match rate ranged from 93.1% to 95.1%, but rates were lower for surgical specialties, ranging from 74.7% to 86.6% in 2016. From 2008 to 2016, PS had a relatively high growth rate in the number of positions (65.2%) from 2008 to 2016. Matched PS and Otolaryngology applicants routinely had the highest mean United States Medical Licensing Examination Step 1 and Step 2 Clinical Knowledge scores. Alpha Omega Alpha membership has a significant impact on successfully matching into a surgical specialty (P < 0.1). Matched applicants of surgical subspecialties (PS, Otolaryngology, orthopedics, and neurosurgery) had similar mean number of research, work, and volunteer experiences. However, PS and neurosurgery matched applicants had notably higher mean research productivity. The rapid increase in the number of positions in PS residency training has not resulted in a decrease in caliber of matched applicants, even though match rates have dramatically increased. Currently, PS continues to attract and successfully match highly qualified applicants, but other surgical specialties have increasingly similar board scores and mean number of extracurricular experiences.

  11. Current Trends in Targeted Therapies for Glioblastoma Multiforme

    Directory of Open Access Journals (Sweden)

    Fumiharu Ohka


    Full Text Available Glioblastoma multiforme (GBM is one of the most frequently occurring tumors in the central nervous system and the most malignant tumor among gliomas. Despite aggressive treatment including surgery, adjuvant TMZ-based chemotherapy, and radiotherapy, GBM still has a dismal prognosis: the median survival is 14.6 months from diagnosis. To date, many studies report several determinants of resistance to this aggressive therapy: (1 O6-methylguanine-DNA methyltransferase (MGMT, (2 the complexity of several altered signaling pathways in GBM, (3 the existence of glioma stem-like cells (GSCs, and (4 the blood-brain barrier. Many studies aim to overcome these determinants of resistance to conventional therapy by using various approaches to improve the dismal prognosis of GBM such as modifying TMZ administration and combining TMZ with other agents, developing novel molecular-targeting agents, and novel strategies targeting GSCs. In this paper, we review up-to-date clinical trials of GBM treatments in order to overcome these 4 hurdles and to aim at more therapeutical effect than conventional therapies that are ongoing or are about to launch in clinical settings and discuss future perspectives.

  12. Update on xerostomia: current treatment modalities and future trends. (United States)

    Givens, Edward


    This article discusses some of the current treatment modalities available to those who suffer from xerostomia and looks at some therapies currently being explored to ameliorate the condition. With the number of elderly patients in the U.S. population expected to increase--concomitant with the increase in incidence of xerostomia in this group as well as other special patient population groups (that is, postradiation, Sjogren's syndrome, and so forth)--it is increasingly important that dentists maintain an awareness of the clinical implications of xerostomia and a knowledge of appropriate treatment recommendations.

  13. History, current status, and trends of radiation protection standards. (United States)

    Hendee, W R


    Quantitative standards for protection against exposure to ionizing radiation were first formulated in the 1930s. Since that time, standards have been restated periodically in different radiation units and conceptual frameworks that reflect improved understanding of the biological effects of radiation interactions and their consequences for human health. In the 1970s the expression of protection standards shifted from a dose- to a risk-based approach, with dose limits established to yield risks to radiation workers comparable with those for workers in other "safe" industries. Over the years, radiation protection standards have exhibited a downward trend to more rigorous limits that require increased commitments of personnel and resources for their enforcement. There are several reasons for this trend, including increased recognition of the long-term health effects of radiation, improved protection measures that permit radiation use at lower levels of exposure, growing numbers of persons exposed occupationally to radiation, and probably a greater intolerance to involuntary risks in society, with radiation targeted as a highly visible source of involuntary risks in the form of nuclear power plants and radioactive waste sites. In the past few years, reports of the Radiation Effects Research Foundation, United Nations Scientific Committee on the Effects of Atomic Radiation, and the National Research Council of the U.S. National Academy of Sciences have presented increased risk estimates for radiation exposure as a consequence of ongoing epidemiological analyses of human populations exposed to ionizing radiation. These risk estimates have enhanced public concern about radiation exposure and set the stage for discussions about the desirability of further reductions in exposure standards for radiation workers and members of the public. Such reductions would directly affect the professional activities, educational responsibilities, and administrative burdens of most medical

  14. 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 .

  15. Current HRD trends in the Netherlands: Conceptualisation and practices

    NARCIS (Netherlands)

    Kwakman, C.H.E.; Streumer, Jan; van der Heijden, Beatrice; Wognum, Ida; van Zolingen, S.J.


    In this contribution, we first report on a literature study aimed at describing current HRD developments. The resulting literature report was presented to a group of experts in the field of HRD. The participants were asked to sketch their vision as to the relevance of the HRD developments for their

  16. 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.

  17. Continuing Education: Atrial fibrillation: Current trends in management

    African Journals Online (AJOL)

    There is however, a recent resurgence of interest following some important experimental and therapeutic advances. This article reviews the current understanding of the nature of atrial fibrillation (AF) and some recent developments in the pharmacological and alternative therapeutic approaches. Key Words: Atrial fibrillation, ...

  18. Colorectal Carcinoma: An Update of Current Trends in Accra ...

    African Journals Online (AJOL)

    BACKGROUND: Clinical experience and earlier studies indicate that the number of colorectal cancer cases seen annually in the Accra metropolis is increasing. OBJECTIVE: This study was aimed at providing a current update on colorectal cancer in Accra, Ghana. METHODS: A prospective study of confirmed cases of ...

  19. 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 ...

  20. 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...

  1. Language Policy in Ethiopia: History and Current Trends | Getachew ...

    African Journals Online (AJOL)

    The historical survey of language use policy was made based on the secondary data (i.e. written documents) from different sources. The study on the implementation of the current language policy of the country focuses mainly on four regional states, namely Amhara, Oromiya and SNNP regional states and the Addis Ababa ...

  2. 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…

  3. 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.

  4. 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.

  5. Current Trends in Preoperative Biliary Stenting in Pancreatic Cancer Patients (United States)

    Jinkins, Lindsay J.; Parmar, Abhishek D.; Han, Yimei; Duncan, Casey B.; Sheffield, Kristin M.; Brown, Kimberly M.; Riall, Taylor S.


    BACKGROUND Sufficient evidence suggests that preoperative biliary stenting is associated with increased complication rates after pancreaticoduodenectomy. METHODS Surveillance, Epidemiology, and End Results (SEER) and linked Medicare claims data (1992–2007) were used to identify patients with pancreatic cancer who underwent pancreaticoduodenectomy. We evaluated trends in the use of preoperative biliary stenting, timing of physician visits relative to stenting, and time to surgical resection and symptoms in stented and unstented patients. RESULTS Pancreaticoduodenectomy was performed in 2,573 patients. 52.6% of patients underwent preoperative biliary stenting (N=1,354). Of these, 75.3% underwent endoscopic stenting only, 18.9% received a percutaneous stent, and 5.8% underwent both procedures. The overall stenting rate increased from 29.6% of patients in 1992–95 to 59.1% in 2004–07 (pPreoperative stenting was more common in patients with jaundice, cholangitis, pruritus, or coagulopathy (ppreoperative biliary stenting doubled from 1992–2007 despite evidence that stenting is associated with increased perioperative infectious complications. The majority of stenting occurred prior to surgical consultation and is associated with significant delay in time to operation. Surgeons should be involved early in order to prevent unnecessary stenting and improve outcomes. PMID:23889947

  6. 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

  7. Harm reduction history, response, and current trends in Asia. (United States)

    Thomson, Nicholas


    HIV epidemics in Asia have been initially driven through injecting drug use and the use of shared needles and syringes. Molecular epidemiological work has shown that where there is heroin trafficking and use, so too is there HIV. Given the often strict enforcement of national anti-narcotic laws, harm reduction responses to HIV infections driven by injecting drug use have been historically slow. As it became clear that preventing HIV meant embracing harm reduction, many countries in the region have adopted harm reduction as part of their national AIDS strategy and increasingly as part of their national drug strategy. Initial successes have proven that harm reduction, as it pertains to HIV among IDUs, can and does work in Asia. These initial successes have led to more comprehensive scale-up of other essential components of HIV prevention among IDUs, including increased availability of opiate substitution programs. Still, multiple challenges remain as overall coverage of services in the region remains poor. Changes in the availability and patterns of use of drugs, including the exponential increase in the use of amphetamine-type stimulants, is providing ongoing challenges to both the law enforcement and public health sectors. This paper reflects on the history of harm reduction in Asia and the shifting trends forcing policy makers to adapt and expand harm reduction strategies to include an ever widening approach to criminal justice, policing, public health, and human rights.

  8. 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.

  9. 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

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


    Fontana,Luigi; Coassin,Marco; Iovieno,Alfonso; Moramarco,Antonio; Cimino,Luca


    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 ...

  11. 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

  12. Use of Google Trends to Examine Interest in Mohs Micrographic Surgery: 2004 to 2016. (United States)

    Callaghan, Daniel J


    Mohs micrographic surgery (MMS) is the gold standard for treatment of high-risk skin cancers. There has been an upward trend in the use of this procedure as demonstrated by data from Medicare and the National Ambulatory Medical Care Survey. To assess interest in MMS among members of the general public as measured by number of online searches, and how that interest has changed over time. Google Trends was used to plot interest in search terms including "Mohs surgery," "basal cell carcinoma," "squamous cell carcinoma," "melanoma," and "skin cancer" from January 1, 2004, to November 30, 2016. Search interest for the term "Mohs surgery" has steadily increased since 2004 and correlates closely with increased interest for "basal cell carcinoma" (r = 0.82) and "squamous cell carcinoma" (r = 0.85). Search interest in MMS did not correlate well with searches for melanoma (r = -0.15) or skin cancer (r = -0.29). Public interest in MMS has continued to steadily increase in the United States, which may be a reflection of the increasing volume of MMS that is performed.

  13. 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

  14. Current trends and future development in pharmacologic stress testing

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Jin Ho; Lee, Jae Tae [Kyungpook National University Medical School, Daegu (Korea, Republic of)


    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.



    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 ...

  16. 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...

  17. Current trends in the management of Graves' disease

    International Nuclear Information System (INIS)

    Solomon, B.; Glinoer, D.; Lagasse, R.; Wartofsky, L.


    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

  18. 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

  19. 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

  20. [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.

  1. Current trends and pitfalls in endoscopic treatment of urolithiasis. (United States)

    Inoue, Takaaki; Okada, Shinsuke; Hamamoto, Shuzo; Yoshida, Takashi; Matsuda, Tadashi


    Current development of endoscopic technology, lithotripters, and stone-retrieval devices has expanded the indications for retrograde and antegrade endoscopic therapy in the management of urolithiasis. This technology has also resulted in minimally invasive therapy. As surgeons' experience of endourological procedures with the newer instruments has become integrated, the surgical technique and indications for urolithiasis have also changed in the past few years. The present review provides an overview of endourological procedures for upper urinary tract stones and the key points related to surgical techniques. © 2017 The Japanese Urological Association.

  2. 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

  3. Current trends in the management of urinary stones

    International Nuclear Information System (INIS)

    Smith, T.P.; Castaneda-Zuniga, W.R.; Darcy, M.D.; Cragg, A.H.; Hunter, D.W.; Amplatz, K.


    The treatment of renal and ureteral stones has undergone rapid and major changes over the past ten years. Extracorporeal shockwave lithotripsy has become the most commonly used modality for the treatment of renal and upper ureteral stones. Lower ureteral stones are more commonly being approached by retrograde techniques. Percutaneous nephrolithotomy, medical therapy, and open surgical nephrolithotomy offer viable alternatives in given situations. Presented here is the current application of each of these techniques, both alone and in combination, for the treatment of urinary stones. (orig.)

  4. 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

  5. Antiviral Nanodelivery Systems: Current Trends in Acyclovir Administration

    Directory of Open Access Journals (Sweden)

    Haniza Hassan


    Full Text Available Poor bioavailability of acyclovir in the treatment of viral infections remains one of the major drug delivery concerns of pharmaceutical manufacturers and researchers. Nanoparticulate systems have been exploited with the aim of improving the current pharmacological limitations of acyclovir administration. In fact, nanoparticles do offer many advantages, especially in terms of their physicochemical stability and sustained-release properties. Besides, they are made of biocompatible materials, which are nontoxic to cells. Acyclovir has been a focus since the last decade as one of the low bioavailability drug models loaded in various types of newly synthesized drug delivery vehicles. In this review, compositions and formulations of nanosized acyclovir particles, as well as their stability and pharmacokinetic profile, are discussed in further detail.

  6. 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

  7. 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.)

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

    Energy Technology Data Exchange (ETDEWEB)

    Durran, Alexandra C., E-mail: [Peninsula Radiology Academy, Plymouth International Business Park (United Kingdom); Watts, Christopher, E-mail: [Salisbury District Hospital (United Kingdom)


    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 {approx}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.

  9. 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.

  10. Evaluating Trends in the Volume-Outcomes Relationship Following Liver Surgery: Does Regionalization Benefit All Patients the Same? (United States)

    Gani, Faiz; Azoulay, Daniel; Pawlik, Timothy M


    Data evaluating trends in hospital volume are lacking. The current study sought to examine trends in outcomes relative to hospital volume following liver surgery. A total of 14,296 patients >18 years undergoing an elective liver resection (LR) for cancer were identified using the National Inpatient Sample from 2001 to 2011. Multivariable logistic regression analysis was performed to compare postoperative morbidity and mortality relative to hospital volume over time. Over time, the proportion of patients undergoing a LR at a high-volume hospital (HVH) increased from 24.4 to 45.0 %, while the proportion of patients undergoing a LR at a low-volume hospital (LVH) decreased from 40.4 to 22.7 %. On multivariable analysis, patients undergoing a LR at high-volume hospitals demonstrated a 29 % lower odds of mortality (OR = 0.71, 95 % CI = 0.59-0.86, p Trends in regionalization were, however, associated with discrepancies in access to HVH among specific patient populations.

  11. Overview of Current Trends in Mental Health Problems for Australia's Youth and Adolescents (United States)

    Rickwood, Debra; White, Angela; Eckersley, Richard


    This paper provides an overview of current trends in the mental health problems of Australia's youth and adolescents. It presents information derived from the most recent and comprehensive Australian surveys of youth mental health, and provides international comparisons and views from professional practice where relevant. An update of trends for…

  12. 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)

  13. The private health sector in South Africa current trends and future ...

    African Journals Online (AJOL)


    Aug 4, 1990 ... current trends and future developments. '-10 . = \\. J. BROOMBERG, C. DE BEER, M. R. PRICE. Summary. 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 ...

  14. 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,…

  15. 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.

  16. 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.

  17. 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.

  18. Information and Communication Technology in Education - Current Trends

    Directory of Open Access Journals (Sweden)

    Milkova Eva


    Full Text Available The paper is aimed at current approaches toward using of information and communication technology in education. Firstly, nowadays usage of computers in education is introduced on the basis of an overview and survey of the researches presented on the recent conference Computers in Education organized by the Asia-Pacific Society for Computers in Education. Last research in the following areas is discussed here: computer-supported personalized and collaborative learning, seamless learning, level of attention and learning efficiency, learning analytics, application of innovative educational technologies in STEM education, and online game-based learning in school education. Despite the geographical orientation many issues may be inspirational for scholars from western countries. On the other hand, from research papers presented by researchers from Asia-Pacific region it is evident that they have been focusing on very similar topics in education as scientists in western countries do. Secondly, some observation concerning usage of information and communication technology in Egypt education as well as recent research works examined within the doctoral study program information and communication technology in Education provided by the University of Hradec Králové, Czech Republic, are presented in the paper in the light of the mentioned survey.

  19. 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.

  20. P300 brain computer interface: current challenges and emerging trends

    Directory of Open Access Journals (Sweden)

    Reza eFazel-Rezai


    Full Text Available 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 event-related potential (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.

  1. 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

  2. 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

  3. 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)

  4. Mental health care in Germany: current state and trends. (United States)

    Salize, Hans Joachim; Rössler, Wulf; Becker, Thomas


    Germany turned towards community-based mental health care in the mid seventies, during a general climate of social and political reform. The continuing deinstitutionalisation process and the implementation of community mental health services was considerably affected by the reunification of East and West Germany in 1990, which required dramatic changes in the structure and quality of the mental health care system of the former German Democratic Republic (GDR). Overall, German mental health care is organised as a subsidiary system, where planning and regulating mental health care is the responsibility of the 16 federal states. So German mental health care provision is spread among many sectors and characterised by considerable regional differences. A key characteristic is the particularly wide gap between inpatient and outpatient services, which are funded separately and staffed by different teams. In 2003 the total number of psychiatric beds was a mere two thirds of the overall bed capacity in 1991, the first year as a re-unified Germany, when psychiatric beds in East and West Germany totalled 80,275. From 1970 onwards the number of psychiatric beds was cut by roughly half. So the momentum of the reform has been strong enough to assimilate the completely different mental health care system of the former German Democratic Republic and, in the course of a decade, to re-structure mental health services for an additional 17-18 million new inhabitants. In an ongoing struggle to adapt to changing administrative set-ups, legal frameworks, and financial constraints, psychiatry in Germany in currently facing specific problems and is seriously challenged to defend to considerable achievements of the past. A major obstacle to achieving this aim lies in the fragmented system of mental health care provision and mental health care funding.

  5. 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.

  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. 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.

  9. The Origins and Current State of Plastic Surgery Residency in the United States. (United States)

    Mackay, Donald Roy; Johnson, Shane


    The history of plastic surgery residency training in the United States dates back to the establishment of plastic surgery as a specialty. The pivotal role played by the American Board of Plastic Surgery is outlined. The history of the early regulatory bodies leading to the formation of the Accreditation Council for Graduate Medical Education and the Residency Review Committees and the establishment of the American Council of Academic Plastic Surgeons gives context to our current training models.

  10. 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

  11. 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

  12. 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...

  13. Current limitations of trend curve analysis for the prediction of reactor PV embrittlement

    International Nuclear Information System (INIS)

    Gold, R.; McElroy, W.N.


    To define the effects of neutron radiation damage on LWR pressure-temperature operating limits and to assess fracture toughness of power reactor PV, trend curves for the prediction of PV embrittlement have been developed. These trend curves are very general PV embrittlement curves that are used to evaluate current PV status as well as to predict the future state of the PV. In such trend curves, the two main measures of radiation damage are the adjusted reference nil-ductility temperature ART/sub NDT/(RT/sub NDT/initial + ΔRT/sub NDT/) and the decrease in upper-shelf energy level determined from Charpy V notch impact tests. Current measures of neutron exposure most commonly used in trend curve analyses are fluence > 1 MeV and displacements per atom (dpa) in iron. Since trend curves play such a crucial role in the assessment of PV embrittlement of operating commercial LWR power plants, a critical appraisal of trend curve analysis is essential. To this end, current limitations in trend curve analysis for the prediction of reactor PV embrittlement are examined. It is concluded that a number of systematic effects can arise because environmental differences exist between test reactors, surveillance capsule locations, and the actual irradiation conditions that accrue within the PV of an operating LWR commercial power plant. An irradiation test program is advanced to investigate these systematic effects and to produce the requisite data needed to correct for such systematic biases in trend curve analysis

  14. Technical advancements and utilization of spine surgery. International disparities in trend-dynamics between Japan, Korea, and the USA

    International Nuclear Information System (INIS)

    Kim, Phyo; Kurokawa, Ryu; Itoki, Kazushige


    Spine surgery has made radical advancements in the last two decades and provision has expanded a great deal. The history of the technical development is briefly reviewed. To analyze trends in utilization and to assess the macroeconomic demand for spine surgery, the incidence of all spine surgery per capita is estimated referring to diverse statistical data from the USA, Korea and Japan. When compared internationally, there is a great disparity in the utilization of spine surgery, especially for fusion/instrumentation. Medico-socioeconomic conditions underlying the variations are discussed. Adequate surgeon training has to be supplied in a matched volume, and the number of surgeons to balance the need is estimated. (author)

  15. 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

  16. Alcohol withdrawal syndrome: current management strategies for the surgery patient. (United States)

    Morris, P R; Mosby, E L; Ferguson, B L


    As advances in the therapeutic management of alcohol withdrawal syndrome occur, oral and maxillofacial surgeons should be aware of the current treatment philosophies and modalities. This article provides a comprehensive review of alcohol withdrawal syndrome and presents some of the current management strategies that can be used for these patients, whether it be in the office or in the hospital.

  17. 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

  18. [Current Nomina Anatomica for oral and maxillofacial surgery]. (United States)

    Trost, O; Hardy, H; Péron, J-M; Trouilloud, P


    Using the international organonymy is mandatory as well for daily clinical practice as for research and teaching our students. The international organonymy, Nomina Anatomica, is in Latin. A rather unsuccessful attempt at using a French version of the international organonymy in clinical practice has been made in France. Eponyms have been systematically contraindicated; the definitions of general anatomy are applied, as well as a systematic Gallicization of the Latin terminology. Despite a stringent observance of these rules, some terms remain inappropriate because they are misleading or inaccurate. Furthermore, using this language used worldwide remains uneasy in daily clinical practice. We had for objective to focus on the main anatomical terms used routinely in oral and maxillofacial surgery, and to justify their use in clinical practice, research, and education. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  19. Current Rehabilitation Concepts for Anterior Cruciate Ligament Surgery in Athletes. (United States)

    Malempati, Chaitu; Jurjans, John; Noehren, Brian; Ireland, Mary L; Johnson, Darren L


    The anterior cruciate ligament is the most commonly disrupted ligament in the knee in high-performance athletes. Most recently, advancements in surgical technique and graft fixation have enabled athletes to participate in early postoperative rehabilitation, focusing on range of motion and progressing to patellar mobilization, strengthening, and neuromuscular control. Several rehabilitation protocols exist with variations in specific exercises, progression through phases, and key components. The ultimate goal of rehabilitation is to return the athlete to preinjury performance level, including motion and strength, without injuring or elongating the graft. Each athlete is unique; thus, safe return to play should be individualized rather than follow a particular postoperative month or time line. This article provides an overview of the application and the scientific basis for formulating a rehabilitation protocol prior to and following anterior cruciate ligament surgery. Copyright 2015, SLACK Incorporated.

  20. Assessing performance trends in laparoscopic nephrectomy and nephron sparing surgery for localized renal tumors (United States)

    Smaldone, Marc C.; Kutikov, Alexander; Egleston, Brian; Simhan, Jay; Canter, Daniel J.; Teper, Ervin; Viterbo, Rosalia; Chen, David Y.T.; Greenberg, Richard E.; Uzzo, Robert G.


    Objective To assess the impact of laparoscopy on utilization of partial nephrectomy (PN) by comparing national utilization trends in patients undergoing surgery for localized renal tumors. Methods Using linked Surveillance, Epidemiology, and End Results (SEER)-Medicare data, we retrospectively examined trends in procedure utilization from 1995–2007 for patients undergoing surgery for localized (stage I/II) renal masses. Procedures were classified as open radical nephrectomy (ORN), laparoscopic radical nephrectomy (LRN), open partial nephrectomy (OPN), and laparoscopic partial nephrectomy (LPN). Patients were further stratified by tumor size (≤4cm, >4 to ≤7cm, >7cm). Data were primarily analyzed using logistic regressions. Results 11,689 patients (mean age 74.4±5.7 years, 56% male) with a mean tumor size of 4.7±3.3cm met inclusion criteria. From 1995–2007, ORN rates decreased while for each year successive year, patients were more likely to be treated with OPN (OR 1.17, CI 1.14–1.19), LRN (OR 1.44, CI 1.41–1.47) and LPN (OR 1.75, CI 1.68–1.83). While the increased utilization of OPN (7.5% vs. 13.6%, p<0.001) and LPN (0% vs. 14.2%, p<0.001) reached statistical significance, this was offset by a marked increase in LRN over the same time period (3.0% vs. 43.0%, p<0.001). Conclusions Despite increasing emphasis on nephron preservation, PN utilization rates remain low. Compared to a 40% increase in LRN, utilization of PN increased by only 20% from 1995–2007. As a result, 72% of identified Medicare beneficiaries with localized tumors were managed with RN in 2007. The trade-off of minimally invasive surgery for nephron preservation may have adverse long term consequences. PMID:22704174

  1. Minimally invasive surgery: national trends in adoption and future directions for hospital strategy. (United States)

    Tsui, Charlotte; Klein, Rachel; Garabrant, Matthew


    Surgeons have rapidly adopted minimally invasive surgical (MIS) techniques for a wide range of applications since the first laparoscopic appendectomy was performed in 1983. At the helm of this MIS shift has been laparoscopy, with robotic surgery also gaining ground in a number of areas. Researchers estimated national volumes, growth forecasts, and MIS adoption rates for the following procedures: cholecystectomy, appendectomy, gastric bypass, ventral hernia repair, colectomy, prostatectomy, tubal ligation, hysterectomy, and myomectomy. MIS adoption rates are based on secondary research, interviews with clinicians and administrators involved in MIS, and a review of clinical literature, where available. Overall volume estimates and growth forecasts are sourced from The Advisory Board Company's national demand model which provides current and future utilization rate projections for inpatient and outpatient services. The model takes into account demographics (growth and aging of the population) as well as non demographic factors such as inpatient to outpatient shift, increase in disease prevalence, technological advancements, coverage expansion, and changing payment models. Surgeons perform cholecystectomy, a relatively simple procedure, laparoscopically in 96 % of the cases. Use of the robot as a tool in laparoscopy is gaining traction in general surgery and seeing particular growth within colorectal surgery. Surgeons use robotic surgery in 15 % of colectomy cases, far behind that of prostatectomy but similar to that of hysterectomy, which have robotic adoption rates of 90 and 20 %, respectively. Surgeons are using minimally invasive surgical techniques, primarily laparoscopy and robotic surgery, to perform procedures that were previously done as open surgery. As risk-based pressures mount, hospital executives will increasingly scrutinize the cost of new technology and the impact it has on patient outcomes. These changing market dynamics may thwart the expansion of new

  2. 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.

  3. Current spine surgery in North America: progress or violation? (United States)

    Kelly, D L


    We physicians are the drivers, the people who select the patients, the people who do the operations, and the people who encourage the instrument companies; it is our responsibility to oversee both the effectiveness of treatment and its cost. The resources available to neurosurgery for improving care, controlling cost, and promoting research include the following. 1. The outstanding spinal neurosurgeons actively participating in excellent clinical care and research, neurosurgeons in training, and neurosurgeons committed to excellence. 2. A commitment by neurosurgery to improve the plight of the patients with spinal disorders. 3. Support from instrument and drug companies and national funding. 4. A medical wave of support for outcome studies and clinical trials. 5. A proven track record in doing clinical trials and a clear indication that others are in process. 6. The knowledge, abilities, and energies of neurosurgeons. Our liabilities include the following. 1. Irresponsible behavior by a few professionals. 2. The negative effects of competition with non-neurosurgical spinal surgeons. We must obtain their support in many of these clinical trials. 3. Inertia. It is much easier to take the path of least resistance, much easier to choose the course of economic incentive. Perhaps, out of all of this, spinal neurosurgery will lead the way to developing a better understanding of the natural history of degenerative diseases of the spine and the way to selecting patients properly on the basis of studies of the efficacy of appropriate surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. National trends in minimally invasive and open operative experience of graduating general surgery residents: implications for surgical skills curricula development? (United States)

    Carson, Jeffrey S; Smith, Lynette; Are, Madhuri; Edney, James; Azarow, Kenneth; Mercer, David W; Thompson, Jon S; Are, Chandrakanth


    The aim of this study was to analyze national trends in minimally invasive and open cases of all graduating residents in general surgery. A retrospective analysis was performed on data obtained from Accreditation Council for Graduate Medical Education logs (1999-2008) of graduating residents from all US general surgery residency programs. Data were analyzed using Mantel-Haenszel χ(2) tests and the Bonferroni adjustment to detect trends in the number of minimally invasive and open cases. Minimally invasive procedures accounted for an increasing proportion of cases performed (3.7% to 11.1%, P surgery (P general surgery residents in the United States are performing a greater number of minimally invasive and fewer open procedures for common surgical conditions. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. AMS-11 in Rome, 2008: Past achievements, current and future trends (United States)

    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.

  6. 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

  7. National Trends and Factors Associated with Hospital Costs Following Thyroid Surgery. (United States)

    Biron, Vincent L; Bang, Heejung; Farwell, D Gregory; Bewley, Arnaud F


    Medical costs in the United States have been increasing disproportionally to gross domestic product, raising concerns about the sustainability of U.S. healthcare expenditures. Care of patients with thyroid disease has been identified as an area of medicine where cost increases have been pronounced. The goals of this study were to identify potential drivers of the cost of hospitalization following thyroid surgery, and to understand which of these factors may be contributing to observed increases in cost from 2003 to 2011. A retrospective cross-sectional analysis of discharge data from the Nationwide Inpatient Sample (NIS) database for all admissions following thyroid lobectomy or total thyroidectomy in the years 2003, 2007, and 2011 was performed. Multiple regression analysis via a weighted generalized linear model was used to identify factors that were independently associated with high cost of hospitalization. Trend as well as subgroup analyses were then performed to identify which of these factors could be contributing to increasing costs. There were 47,854 hospital admissions following total thyroidectomy or thyroid lobectomy identified in the years 2003, 2007, and 2011. The aggregate national cost of hospitalization increased from $198 million in 2003 to $373 million in 2011 in inflation-adjusted 2011 dollars. The weighted mean cost of hospitalization following thyroid surgery increased from $6154 to $8982 from 2003 to 2011 in inflation-adjusted 2011 dollars. Higher comorbidity score, total thyroidectomy, lymphadenectomy, western region, rural region, and certain postoperative complications were the factors most highly associated with increased hospital costs. Of these, an increasing proportion of patients with higher severity of illness score and an increasing proportion of patients undergoing total thyroidectomy and lymphadenectomy were implicated as the most likely contributors to the cost increases. The rate of total thyroidectomy and lymphadenectomy was

  8. Plastic Surgery and Acellular Dermal Matrix: Highlighting Trends from 1999 to 2013 (United States)

    Daar, David A; Gandy, Jessica R; Clark, Emily G; Mowlds, Donald S; Paydar, Keyianoosh Z; Wirth, Garrett A


    The last decade has ushered in a rapidly expanding global discussion regarding acellular dermal matrix (ADM) applications, economic analyses, technical considerations, benefits, and risks, with recent emphasis on ADM use in breast surgery. This study aims to evaluate global trends in ADM research using bibliometric analysis. The top nine Plastic Surgery journals were determined by impact factor (IF). Each issue of the nine journals between 1999 and 2013 was accessed to compile a database of articles discussing ADM. Publications were further classified by IF, authors’ geographic location, study design, and level of evidence (LOE, I-V). Productivity index and productivity share were calculated for each region. In total, 256 ADM articles were accessed. The annual global publication volume increased significantly by 4.2 (0.87) articles per year (p<0.001), with a mean productivity index of 36.3 (59.0). The mean impact factor of the nine journals increased significantly from 0.61 (0.11) to 2.47 (0.99) from 1993 to 2013 (p<0.001). Despite this increase in the global ADM literature, the majority of research was of weaker LOE (level I: 2.29% and level II: 9.17%). USA contributed the most research (87%), followed by Asia (4.76%) and Western Europe (4.71%). USA contributed the greatest volume of research. Regarding clinical application of ADM, the majority of publications focused on ADM use in breast surgery, specifically breast reconstruction (154 articles, 60.2%). The majority of research was of lower LOE; thus, efforts should be made to strengthen the body of literature, particularly with regard to cost analysis. PMID:27579264

  9. Trends in hospital volume and operative mortality for high-risk surgery. (United States)

    Finks, Jonathan F; Osborne, Nicholas H; Birkmeyer, John D


    There were numerous efforts in the United States during the previous decade to concentrate selected surgical procedures in high-volume hospitals. It remains unknown whether referral patterns for high-risk surgery have changed as a result and how operative mortality has been affected. We used national Medicare data to study patients undergoing one of eight different cancer and cardiovascular operations from 1999 through 2008. For each procedure, we examined trends in hospital volume and market concentration, defined as the proportion of Medicare patients undergoing surgery in the top decile of hospitals by volume per year. We used regression-based techniques to assess the effects of volume and market concentration on mortality over time, adjusting for case mix. Median hospital volumes of four cancer resections (lung, esophagus, pancreas, and bladder) and of repair of abdominal aortic aneurysm (AAA) rose substantially. Depending on the procedure, higher hospital volumes were attributable to an increasing number of cases nationwide, an increasing market concentration, or both. Hospital volumes rose slightly for aortic-valve replacement but fell for coronary-artery bypass grafting and carotid endarterectomy. Operative mortality declined for all eight procedures, ranging from a relative decline of 8% for carotid endarterectomy (1.3% mortality in 1999 and 1.2% in 2008) to 36% for AAA repair (4.4% in 1999 and 2.8% in 2008). Higher hospital volumes explained a large portion of the decline in mortality for pancreatectomy (67% of the decline), cystectomy (37%), and esophagectomy (32%), but not for the other procedures. Operative mortality with high-risk surgery fell substantially during the previous decade. Although increased market concentration and hospital volume have contributed to declining mortality with some high-risk cancer operations, declines in mortality with other procedures are largely attributable to other factors. (Funded by the National Institute on Aging.).

  10. Surgery for diverticulitis: a re-evaluation of the changing trends. (United States)

    Makarawo, Tafadzwa P; Eichenauer, Steffan; Shah, Uma; Jaeger, Amy; McKendrick, Alasdair; Mittal, Vijay K


    The surgical management of diverticulitis continues to evolve but recent literature has not qualified just how different current practice is compared with the previous era. This study aims to update the seminal paper by Rodkey and Welch regarding indications and operation types performed for diverticulitis by comparing their findings with present practice at a community based institution. The charts of 407 patients admitted with "diverticular disease" between 2005 and 2010 were identified. For each admission, patients' demographics, presentations and management were recorded. Direct comparisons were made with results from the study by Rodkey and Welch. Of the 407 admissions studied, the distribution was 335 emergency and 72 elective. Medical management alone treated 90% of emergency admissions, while 4% required additional radiologic intervention. Emergency surgery was necessary in only 6% of cases with Hartmann's procedure being the most common procedure. Recurrent diverticulitis was a prime indication for elective surgery with 96% of cases undergoing a 1-staged procedure. Compared with the previous era, the nonoperative approach to managing acute diverticulitis is now applied for the vast majority of admissions. Improved success in medically temporizing patients in the present era has allowed for a higher percentage of successful single-staged elective surgeries.

  11. National Trends in Vestibular Schwannoma Surgery: Influence of Patient Characteristics on Outcomes. (United States)

    Hatch, Jonathan L; Bauschard, Michael J; Nguyen, Shaun A; Lambert, Paul R; Meyer, Ted A; McRackan, Theodore R


    Objective To characterize current vestibular schwannoma (VS) surgery outcomes with a nationwide database and identify factors associated with increased complications and prolonged hospital course. Study Design Retrospective review utilizing the University HealthSystem Consortium national inpatient database. Setting US academic health centers. Subjects and Methods Data from patients undergoing VS surgery were analyzed over a 3-year time span (October 2012 to September 2015). Surgical outcomes, such as length of stay (LOS), complications, and mortality, were analyzed on the basis of race, sex, age, and comorbidities during the 30-day postoperative period. Results A total of 3697 VS surgical cases were identified. The overall mortality rate was 0.38%, and the overall complication rate was 5.3%. Advanced age significantly affected intensive care unit LOS, mortality, and complications ( P = .04). Comorbidities, including hypertension, obesity, and depression, also significantly increased complication rates ( P = .02). Sixty-eight patients (1.8%) had a history of irradiation, and they had a significantly increased LOS ( P = .03). Conclusion Modern VS surgery has a low mortality rate and a relatively low rate of complications. Several factors contribute to high complication rates, including age and comorbidities. These data will help providers in counseling patients on which treatment course might be best suited for them.

  12. A survey of current state of training of plastic surgery residents. (United States)

    Hashmi, Asra; Khan, Faraz A; Herman, Floyd; Narasimhan, Nathan; Khan, Shaher; Kubiak, Carrie; Gursel, Eti; Edelman, David A


    Plastic surgery training is undergoing major changes however there is paucity of data detailing the current state of training as perceived by plastic surgical trainees. Our aim was to determine the quality of training as perceived by the current trainee pool and their future plans. A 25-item anonymous survey with three discrete sections (demographics, quality of training, and post-graduate career plans) was developed and distributed to plastic surgery residents during the academic year 2013. With the confidence interval of 95% and margin of error of 10%, our target response rate was 87 responders. We received a total of 114 respondents with all levels of Post Graduate Year in training represented. Upon comparison of residents with debt of 250,000, those with higher debt were significantly less interested in fellowship training (p value 0.05) and were more likely to pursue private practice (p value plastic surgery least offered as a separate rotation were microsurgery (45%) followed by aesthetic surgery (33%). 53.7% of the residents felt that they were least trained in aesthetic surgery followed by burn surgery 45.4%. Of note 56.4% intended to seek additional training after residency. Moreover residents with an average of 6.4 months of experience in an individual subspecialty were more likely to feel comfortable with that specialty. This survey highlights the areas and subspecialties that deserve attention as perceived by the current trainee pool.

  13. 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,…

  14. 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

  15. 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...

  16. 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…

  17. Bowker, L. et al., eds. Unity in diversity? current trends in translation studies. Bowker, L. et al., eds. Unity in diversity? current trends in translation studies.

    Directory of Open Access Journals (Sweden)

    Maria Lúcia Vasconcellos


    Full Text Available Unity in Diversity? Current Trends in Translation Studies—a result of the diverse range of phenomena addressed in the Dublin City University Translation Studies (TS Conference (1996—proves to be a timely publication of St. Jerome Publishing at the end of the 20th century. This collection of papers exploring the central and uptodate issue of disciplinary identity in the young academic field of TS is in tune with the present concern in the area, as can be seen in the topic suggested for the international Translation Conference I IATIS Conference:“Disciplinary Identity—Redefining Translation in the 21st Century” (cf., to be held in 2005. Unity in Diversity? Current Trends in Translation Studies—a result of the diverse range of phenomena addressed in the Dublin City University Translation Studies (TS Conference (1996—proves to be a timely publication of St. Jerome Publishing at the end of the 20th century. This collection of papers exploring the central and uptodate issue of disciplinary identity in the young academic field of TS is in tune with the present concern in the area, as can be seen in the topic suggested for the international Translation Conference I IATIS Conference:“Disciplinary Identity—Redefining Translation in the 21st Century” (cf., to be held in 2005.

  18. Trends in the treatment of coronary disease today. Selective use of PTCA and bypass surgery. (United States)

    Jones, E L; Craver, J M; Guyton, R A; Bone, D K; Hatcher, C R


    Selection and treatment of patients with ischemic heart disease is presently undergoing an evolutionary trend. Percutaneous transluminal coronary angioplasty (PTCA) has been recommended as the initial procedure for many patients with coronary artery disease (CAD), thus possibly redefining candidates for coronary bypass surgery (CABS). Between October 1980 and June 1982, 777 patients having PTCA and 2068 patients having CABS were analyzed for differences in clinical presentation, complications, and early outcome. Patients having CABS were significantly older, had a higher incidence of hypertension (46% vs. 32%), more multivessel disease (80% vs. 12%), and poorer left ventricular function (nl. wall motion = 88% vs. 52%). The incidence of myocardial infarction in patients after PTCA was 1.0% (8/777). Emergency CAB was required in 5.3% of patients following PTCA. There were no deaths following the angioplasty procedure and 25 deaths in 2068 patients having CABS (hospital mortality rate = 1.2%). Since 1973, there has been a progressive decline in hospital mortality rate (now, less than 1%), postoperative infarction (now, 3%), requirement for inotropic drugs (now, 5%) and frequency of IABP (less than 1%). Increasing ability to achieve complete revascularization now means improved survival and freedom from angina with CAB surgery. PTCA and CAB are both procedures that may be used effectively for selected patients, depending on clinical presentation, extent of CAD, and left ventricular function (LVF). Careful patient selection affords the opportunity for use of PTCA in patients with single-vessel disease (SVD) and good LVF and CABS in patients with multivessel disease, regardless of LVF. Symptomatic patients with SVD and total vessel occlusion are not candidates for PTCA. Our data demonstrate that both PTCA and CABS may be accomplished with very low perioperative complications and hospital mortality. PMID:6222708

  19. 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

  20. Current and future applications of nanotechnology in plastic and reconstructive surgery

    Directory of Open Access Journals (Sweden)

    Dana K Petersen


    Full Text Available Although nanotechnology is a relatively young field, there are countless biomedical applications in use or under investigation. Many specialties have benefitted from nanoscale refinements of diagnostic and therapeutic techniques. Plastic and reconstructive surgery is an incredibly diverse specialty, encompassing craniofacial and hand surgery; trauma, oncologic and congenital reconstruction; burn care, and aesthetic surgery. Advances in nanotechnology have significantly impacted wound management, topical skin care, implant and prosthetic design, tissue engineering, and drug delivery systems. Currently, plastic surgeons are researching the utility of nanoscale tools for bone regeneration, bone prosthetics, and drug delivery. Nanotechnology will continue to build upon preceding discoveries, and its biomedical applications in the field of plastic and reconstructive surgery will expand significantly.

  1. 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.

  2. 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.

  3. 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.

  4. Current trends in BPD research as indicative of a broader sea-change in psychiatric nosology. (United States)

    Sharp, Carla


    The aim of the Special Section that this paper contributes to is to review current trends in borderline personality disorder (BPD) research. Three major trends were identified. First, there has been a marked increase in studies that attempt to locate BPD in the dimensional latent structure of psychopathology. Second, identifying the endophenotypic markers associated with BPD has become a focus of interest. Here, we focus on one endophenotype in the form of impaired self-other processing. Third, there has been an explosion of research into the developmental aspects of BPD specifically focused on uncovering complex Biology × Environment interactions in the development of BPD. This paper discusses how these trends (Dimensions, Biology, and Development) are challenging the nature and form of BPD as we know it, and may be indicative of a broader sea-change in psychiatric nosology. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  5. Recent trends in applicants and the matching process for the integrated plastic surgery match. (United States)

    Super, Nikki; Tieman, Joshua; Boucher, Kenneth; Rockwell, William Bradford; Agarwal, Jayant P


    Matching into a plastic surgery (PS) residency program is a highly competitive process. Selection criteria are very stringent and may influence an applicant's candidacy and application strategy. The purpose of this study was to evaluate recent trends of applicants matching into integrated PS programs using published National Resident Match Program data. Residency match data were gathered for application years 2002 to 2011 using the National Resident Match Program/Association of American Medical Colleges databases. Analyses were limited to the US senior group and excluded the non-US senior group because of the small numbers in the latter group. For all data sets, a logistic regression was performed to analyze the statistical significance of the data. The overall match rate continues to approximately 50%. United States senior applicants were more likely to rank PS only versus PS and others (PS + other) over time (P ranking PS only were more likely to match versus US senior applicants ranking PS + other (odds ratio, 1.71; P rank PS only. The proportion of applicants ranking PS only is steadily rising. The ranking strategy used by US senior applicants is self-selecting into a more competitive (PS only) and less competitive (PS + other) applicant pool. If this continues, nearly 50% of applicants will not match and could be left scrambling for an alternative residency position. These findings therefore suggest that all candidates, regardless of their perceived application strength, should consider having a "backup plan."

  6. 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.

  7. 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.

  8. Validated Assessment Tools and Maintenance of Certification in Plastic Surgery: Current Status, Challenges, and Future Possibilities. (United States)

    Janis, Jeffrey E; Vedder, Nicholas B; Reid, Christopher M; Gosman, Amanda; Mann, Karen


    The transition to the Next Accreditation System is well underway, and a shift toward competency-based assessment in the form of milestones is now the standard. A significant effort has been completed by the Plastic Surgery Milestones Working Group to develop specific milestones and assessment tools for plastic surgery training. The history of the development toward competency-based assessment was reviewed. Data regarding the trends and regulations associated with board certification and the role of maintenance of certification were reviewed. The work of the Plastic Surgery Milestones Working Group has sparked interest in assessment and created an opportunity for further development. The efforts toward validating assessment tools by our colleagues working in other surgical specialties serve as a suitable roadmap for further progress. Board certification is an integral part of successful practice and should be regarded as an expectation. Despite the burdens associated with maintenance of certification, it serves a valuable function in ensuring optimal patient care and is often retrospectively seen as an important component of practice. The competency-based milestones are the new standard, and work on this new methodology of assessing plastic surgery trainees is expected to continue. Accurate assessment is critical to the pathways for board certification and maintenance of certification, which serve important roles for all parties involved in the delivery of medical care.

  9. 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.

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

    DEFF Research Database (Denmark)

    Korhonen, Jari


    . In communications applications, transmission errors, including packet losses and bit errors, can be a significant source of quality degradation. Also the environmental factors, such as background noise, ambient light and display characteristics, pose an impact on perception. A third aspect that has not been widely...... 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...

  11. 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...

  12. 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

  13. 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

  14. 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

  15. Current Selection Criteria and Perioperative Therapy Used for Fetal Myelomeningocele Surgery. (United States)

    Moise, Kenneth J; Moldenhauer, Julie S; Bennett, Kelly A; Goodnight, William; Luks, Francois I; Emery, Stephen P; Tsao, Kuojen; Moon-Grady, Anita J; Moore, R Clifton; Treadwell, Marjorie C; Vlastos, Emanuel J; Wetjen, Nicholas M


    To determine the current maternal and fetal selection criteria and operative approaches used at centers performing fetal myelomeningocele surgery. The 17 principal investigators participating in the Fetal Myelomeningocele Consortium were asked to participate in an anonymous online survey regarding the current practice of maternal-fetal surgery for neural tube defect repair and results were tabulated. The 35-question survey related to diagnostic testing, inclusion and exclusion criteria, and clinical management. Sixty-five percent (11/17) of principal investigators responded to the survey and not all centers responded to all 35 questions. All centers continue to use magnetic resonance imaging in their preoperative evaluation. Diagnostic testing from amniocentesis is varied: 5 of 11 (45%) require amniotic fluid α-fetoprotein, 4 of 10 (40%) amniotic fluid acetylcholinesterase, and 8 of 11 (73%) DNA microarray. There is also variation from the Management of Myelomeningocele Study with regard to body mass index (BMI) (1/11; 9% would offer surgery with BMIs higher than 35), maternal medical risk factors (surgery would be offered for controlled pregestational diabetes [3/10 (30%)]), hepatitis C with negative viral load (4/11 [36%]), and human immunodeficiency virus with an undetectable viral load (1/10 [10%] or an obstetric history [3/11 (27%)] would offer surgery with a history of preterm delivery on progesterone). Ten of 11 (91%) centers did not consider ventriculomegaly of 18 mm and 9 of 11 (82%) centers did not consider lack of leg movement as an exclusion criteria. Nuances in the perioperative and intraoperative management were also reported, including 5 of 11 (45%) use intraoperative echocardiography and alterations in postoperative tocolytics. Variation in practice patterns for offering and performing maternal-fetal surgery for myelomeningocele repair exists among centers. Ongoing evaluation of inclusion and exclusion criteria as well as operative techniques is

  16. 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.

  17. 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.

  18. 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.

  19. [Current trends in the depopulation process in the northwestern economic region of Russia]. (United States)

    Semenov, S P; Dobroskok, V A


    Current demographic trends in the northwestern region of Russia, one of the regions most affected by depopulation, are analyzed. The author discusses the general decline in the standard of living and the decrease in the funding available for providing social services, as well as unemployment in the local military industry, as the main causes of the deterioration of the demographic situation. Data are presented by sex. Fertility seems to have reached its lowest level and mortality its highest in 1994, with a modest improvement in both indicators since then. The author compares trends among various ethnic groups and geographic regions. High levels of mortality among the young, and the contribution of alcoholism to mortality rates, continue to give cause for concern.

  20. Current trend of research on 131I therapy for thyroid diseases

    International Nuclear Information System (INIS)

    Lu Tizhang


    At present time, there are two current trends of research on 131 I therapy for thyroid diseases. The first is extension of the application on the field of thyroid diseases. Formerly, the authors use the 131 I only on the hyperthyroidism of Graves' disease, plummer's disease or toxic nodular goiter as well as thyroid cancer, but now, also for some thyroid diseases with normal thyroid function, such as nontoxic multi-nodular goiter, simple diffuse goiter even the thyroid cyst. It seems quite rational to use the 131 I more widely, because it is really safe, easy and cheaper than others. The second trend is using 131 I combined together with other drugs in order to reduce the occurrence of hypothyroidism and enhance the therapeutic effect. Authors call it as combined therapy. Drugs recommended for such therapy are antithyroid drugs, β-adrenergic receptor blocking agents, thyroid hormone, gtucocorticoid as well as Chinese herb drugs and so on

  1. 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.

  2. The Current State and Trends of Development of Stores in Kyiv Region

    Directory of Open Access Journals (Sweden)

    Beglarashvili Oksana P.


    Full Text Available The current state and trends of development of stores in Kyiv region for 2010-2016 are analyzed. The research reflects regional aspects of the basic indicators of development of the stores — there analyzed the dynamics of retail turnover, consumer price indices, retail turnover of retail trade enterprises, commodity stocks in the enterprises’ retail network, basic indicators of stores of enterprises-legal entities, namely the number of stores; sales area; provision of the population with sales area; sales area per store, etc. Carrying out the research of development trends of the retail trade network in Kiev region, the indicators characterizing the network of stores of enterprises-legal entities trading in food and non-food goods of are analyzed. There proposed measures to level the disproportions in the development of the retail trade network in urban and rural area of Kyiv region.

  3. 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.

  4. 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

  5. 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.

  6. Current challenges in providing bariatric surgery in France: A nationwide study. (United States)

    Czernichow, Sébastien; Paita, Michel; Nocca, David; Msika, Simon; Basdevant, Arnaud; Millat, Bertrand; Fagot-Campagna, Anne


    Bariatric surgery is a well-accepted procedure for severe and massive obesity management. We aimed to determine trends, geographical variations, and factors influencing bariatric surgery and the choice of procedure in France in a large observational study.The Health Insurance Fund for Salaried Workers (Caisse National Assurance Maladie Travailleurs Salariés) covers about 86% of the French population. The Système National d'Information Inter-régimes de l'Assurance Maladie database contains individualized and anonymized patient data on all reimbursements for healthcare expenditure. All types of primary bariatric procedures (Roux-en-Y gastric bypass [RYGB] or omega loop, adjustable gastric banding [AGB], or longitudinal sleeve gastrectomy [LSG]) performed during 2011 to 2013 were systematically recorded. Surgical techniques performed by region of residence and age-range relative risks with 95% confidence intervals of undergoing LSG or RYGB versus AGB were computed.In 2013, LSG was performed more frequently than RYGB and AGB (57% vs 31% and 13%, respectively). A total of 41,648 patients underwent a bariatric procedure; they were predominantly female (82%) with a mean (±standard deviation) age of 40 (±12) years and a body mass index ≥40 kg/m for 68% of them. A total of 114 procedures were performed in patients younger than 18 years and 2381 procedures were performed in patients aged 60 years and older. Beneficiaries of the French universal health insurance coverage for low-income patients were more likely to undergo surgery than the general population. Large nationwide variations were observed in the type choice of bariatric surgical procedures. Significant positive predictors for undergoing RYGB compared to those for undergoing AGB were as follows: referral to a center performing a large number of surgeries or to a public hospital, older age, female gender, body mass index ≥50 kg/m, and treatment for obstructive sleep apnea syndrome, diabetes, or

  7. 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

  8. 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


    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...... trends in research and clinical interests in personality disorders. The keynote video presentations, invited symposia, and slide presentations are freely available at

  9. 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.

  10. 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.

  11. Current state and research trend in light environment for plant factory (United States)

    Shimizu, Hiroshi; Nakashima, Hiroshi; Miyasaka, Juro; Ohdoi, Katsuaki


    Plant factory has been attracting attention as a new system of food production, and there are approximately 130 commercially operated facilities in March 2012 in Japan. Currently, leafy vegetables are mainly produced in plant factory. However, not only year-round and agricultural chemical free production but new researches focused on high value-added vegetable production and raw material production for pharmaceutical compounds have been studied. This report outlines the recent trends in research on high-value-added plants using light environments.

  12. A national resident survey about the current state of venous education in vascular surgery training programs. (United States)

    Hicks, Caitlin W; Kernodle, Amber; Abularrage, Christopher J; Heller, Jennifer A


    The objective of this study was to characterize U.S. vascular surgery trainees' perceptions, case numbers, and attitudes toward venous disease education, as well as their intent to incorporate it into future practice. These data will provide us with a current snapshot of postgraduate venous education from a resident's perspective. Institutional Review Board approval was obtained. A 13-question survey was created and distributed to all vascular surgery residents in the United States by SurveyMonkey. Formal electronic distribution remained deidentified as the surveys were e-mailed to residents from the Association of Program Directors in Vascular Surgery. Of 464 vascular surgery trainees queried, 104 (22%) responded to the survey. The majority of responders (80%) were between 25 and 34 years of age, 60% were male, and 72% were white; 91% reported that they were in an academic training program, and 57% were enrolled in an integrated vascular surgery residency program. Postgraduate years (PGYs) of training among respondents were well represented: PGY 1, 14%; PGY 2, 8%; PGY 3, 14%; PGY 4, 12%; PGY 5, 9%; PGY 6, 18%; and PGY 7, 25%. Vascular resident training experience with venous disease revealed the following: 63% performed training. Experience with endothermal ablations was slightly better, with 74% of responders reporting having performed up to 20 cases. Case volumes for endothermal ablation, vein stripping/ligation, inferior vena cava stenting, and iliac stenting increased progressively by clinical training year among integrated vascular residents (P ≤ .02) but were relatively stable for classic 5 + 2 vascular fellows (P ≥ .67). Integrated residents reported having received more didactic venous education than the 5 + 2 vascular surgery fellows (P = .01). There were no differences in overall reported venous procedure volumes between groups (P ≥ .28). The majority of trainees (82%) acknowledged that treating venous disease is part of a standard vascular

  13. 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.

  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. Current and Future Intraoperative Imaging Strategies to Increase Radical Resection Rates in Pancreatic Cancer Surgery

    Directory of Open Access Journals (Sweden)

    Henricus J. M. Handgraaf


    Full Text Available Prognosis of patients with pancreatic cancer is poor. Even the small minority that undergoes resection with curative intent has low 5-year survival rates. This may partly be explained by the high number of irradical resections, which results in local recurrence and impaired overall survival. Currently, ultrasonography is used during surgery for resectability assessment and frozen-section analysis is used for assessment of resection margins in order to decrease the number of irradical resections. The introduction of minimal invasive techniques in pancreatic surgery has deprived surgeons from direct tactile information. To improve intraoperative assessment of pancreatic tumor extension, enhanced or novel intraoperative imaging technologies accurately visualizing and delineating cancer cells are necessary. Emerging modalities are intraoperative near-infrared fluorescence imaging and freehand nuclear imaging using tumor-specific targeted contrast agents. In this review, we performed a meta-analysis of the literature on laparoscopic ultrasonography and we summarized and discussed current and future intraoperative imaging modalities and their potential for improved tumor demarcation during pancreatic surgery.


    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.

  17. 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.

  18. 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.

  19. 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

  20. 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.

  1. 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.

  2. 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

  3. [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.

  4. 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.

  5. 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:


    ZORRON, Ricardo; GALVÃO-NETO, Manoel Passos; CAMPOS, Josemberg; BRANCO, Alcides José; SAMPAIO, José; JUNGHANS, Tido; BOTHE, Claudia; BENZING, Christian; KRENZIEN, Felix


    ABSTRACT Background: 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. Objective: The objective of this study was to analyse own and literature data on revisional bariatric procedures to evaluate best alternatives to current practice. Methods: Institutional experience and systematic review from the literature on revisional bariatric surgery. Results: 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. Conclusion: 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

  7. 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.

  8. 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...

  9. 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

  10. 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.

  11. Safety consideration and current trend in design of shutdown system of NPP

    International Nuclear Information System (INIS)

    Chandra, K.K.


    While reaping the benefit of nuclear energy issues related to nuclear safety shall be adequately addressed. Reactor Shutdown System plays a major role in ensuring safety in NPP by terminating any postulated reactivity excursion in the reactor core which is beyond the capability of regulating system to control and maintaining the reactor core to sub critical state with adequate margin. Shutdown system ensures this under all operating conditions with high degree of certainty. To achieve this objective design of shutdown system includes appropriate safety features whose adequacy is established through analysis, design verification and testing. Design shall be passively safe. Self actuating passive Shutdown systems are becoming popular because of their reliability. Objective of the paper is to describe the safety consideration and current trend in design of Shutdown System. (author)

  12. 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...

  13. 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.

  14. Space Robotics: Current Status, Long-term Objectives, and Development Trends. Analytical Review

    Directory of Open Access Journals (Sweden)

    P. P. Belonozhko


    Full Text Available Prospects for space robotics concern both the development of used prototypes to extend the capabilities and the creation of new classes of systems, the operating analogues of which are, currently, unavailable. Thus, a uniqueness of the objects of space robotics, extreme operating conditions, difficulty in full-scale ground work and tests define a variety of design solutions and a wide scope of issues for further theoretical and experimental studies. The paper highlights the tasks successfully solved up to date, involving the space robotics equipment that was used in orbital environment, those of currently solved, involving the robotics equipment that is in use, and the long-term objectives, following from the logic of the space technology development to define the ways of its further development and require a development and creation of new equipment of space robotics. Thus, the development trends of space robotics are largely defined by its history of development, on the one hand, and by a growing demand for the robotic service as applied to the promising objects of space technology, on the other one. The paper considers the trends of space robotics development, which are a consequence of the natural logic of its development and are determined by a demand for advanced objects of space technology in robotic servicing. Highlights the most important elements of a design concept and the creating and operating features of the multipurpose extendable space systems, including those, which have no analogues and prototypes, are rolled into one demand for automation, and associated with their creation, operation, and problems of utilization. The concept of assembly and service autonomous robotic space modules has been under consideration. Within the orbital assembly procedure, the typical dynamic modes, relevant in terms of practical implementation of controlled movement are highlighted.

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

    Directory of Open Access Journals (Sweden)



    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

  16. 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 study...... a possible association between the changes and the raised iodine intake. Design: A nationwide register study. Methods: Information on operations and radioiodine treatments for benign thyroid disorders was extracted from nationwide registers in the years 1990 to 2007. Treatment rates are presented for surgery...

  17. Laser interstitial thermotherapy application for breast surgery: Current situation and new trends. (United States)

    Kerbage, Yohan; Betrouni, Nacim; Collinet, Pierre; Azaïs, Henri; Mordon, Serge; Dewalle-Vignion, Anne-Sophie; Merlot, Benjamin


    While breast specialists debate on therapeutic de-escalation in breast cancer, the treatment of benign lesions is also discussed in relation to new percutaneous ablation techniques. The purpose of these innovations is to minimize potential morbidity. Laser Interstitial ThermoTherapy (LITT) is an option for the ablation of targeted nodules. This review evaluated the scientific publications investigating the LITT approach in malignant and benign breast disease. Three preclinical studies and eight clinical studies (2 studies including fibroadenomas and 6 studies including breast cancers) were reviewed. Although the feasibility and safety of LITT have been confirmed in a phase I trial, heterogeneous inclusion criteria and methods seem to be the main reason for LITT not being yet an extensively used treatment option. In conclusion, further development is necessary before this technique can be used in daily practice. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Current trends in initial management of hypopharyngeal cancer : The declining use of open surgery

    NARCIS (Netherlands)

    Takes, Robert P.; Strojan, Primoz; Silver, Carl E.; Bradley, Patrick J.; Haigentz, Missak; Wolf, Gregory T.; Shaha, Ashok R.; Hartl, Dana M.; Olofsson, Jan; Langendijk, Johannes A.; Rinaldo, Alessandra; Ferlito, Alfio

    Squamous cell carcinoma of the hypopharynx represents a distinct clinical entity. Most patients present with significant comorbidities and advanced-stage disease. The overall survival is relatively poor because of high rates of regional and distant metastasis at presentation or early in the course

  19. Revisit of Functional Tricuspid Regurgitation; Current Trends in the Diagnosis and Management (United States)

    Muraru, Denisa; Surkova, Elena


    Current knowledge of functional tricuspid regurgitation (FTR) as a progressive entity, worsening the prognosis of patients irrespective of its aetiology, has led to renewed interest in the pathophysiology and assessment of FTR. For the proper management of FTR, not only its severity, but also the mechanisms, the mode of leaflet coaptation, the degree of tricuspid annulus enlargement and leaflet tenting, and the haemodynamic consequences for right atrial and right ventricular morphology and function have to be taken into account. A better assessment of the anatomy and function of tricuspid apparatus and tricuspid regurgitation severity should help with the appropriate selection of patients who will benefit from either surgical tricuspid valve repair/replacement or a percutaneous procedure, especially among patients who are to undergo or have undergone primary left-sided valvular surgery. In this article, we review the anatomy, pathophysiology and the use of imaging techniques to assess patients with FTR, as well as the various treatment options for FTR, including emerging transcatheter procedures. The limitations affecting the current approach to FTR patients and the unmet clinical needs for their management have also been discussed. PMID:27482252

  20. Challenges in pancreatic adenocarcinoma surgery - National survey and current practice guidelines.

    Directory of Open Access Journals (Sweden)

    Sameer A Dhayat

    Full Text Available Pancreatic ductal adenocarcinoma (PDAC remains one of the most deadly cancers in Europe and the USA. There is consensus that radical tumor surgery is the only viable option for any long-term survival in patients with PDAC. So far, limited data are available regarding the routine surgical management of patients with advanced PDAC in the light of surgical guidelines.A national survey on perioperative management of patients with PDAC and currently applied criteria on their tumor resectability in German university and community hospitals was carried out.With a response rate of 81.6% (231/283 a total of 95 (41.1% participating departments practicing pancreatic surgery in Germany are certified as competence and reference centers for surgical diseases of the pancreas in 2016. More than 95% of them indicate to carry out structured and interdisciplinary therapies along with an interdisciplinary pre- and postoperative tumor board. The majority of survey respondents prefer the pylorus-preserving partial pancreatoduodenectomy (93.1% with standard lymphadenectomy for cancer of the pancreatic head. Intraoperative histological evaluation of the resection margins is used regularly by 99% of the survey respondents. 98.7% of survey respondents carry out partial or complete vein resection, 126 respondents (54.5% would resect tumor adjacent arteries, and 102 respondents (44.2% would perform metastasectomy if complete PDAC resection (R0 is possible.Evidence-based and standardized pancreatic surgery is practiced by a large number of hospitals in Germany. However, a significant number of survey respondents support an extended radical tumor resection in patients with advanced PDAC even when not indicated by current clinical guidelines.

  1. 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.

  2. 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.

  3. 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.

  4. Changing trends in abdominal surgical complications following cardiac surgery in an era of advanced procedures. A retrospective cohort study. (United States)

    Ashfaq, Awais; Johnson, Daniel J; Chapital, Alyssa B; Lanza, Louis A; DeValeria, Patrick A; Arabia, Francisco A


    Abdominal complications following cardiopulmonary bypass (CPB) procedures may have mortality rates as high as 25%. Advanced procedures such as ventricular assist devices, artificial hearts and cardiac transplantation are being increasingly employed, changing the complexity of interventions. This study was undertaken to examine the changing trends in complications and the impact of cardiac surgery on emergency general surgery (EGS) coverage. A retrospective review was conducted of all CPB procedures admitted to our ICU between Jan. 2007 and Mar. 2010. The procedures included coronary bypass (CABG), valve, combination (including adult congenital) and advanced heart failure (AHF) procedures. The records were reviewed to obtain demographics, need for EGS consult/procedure and outcomes. Mean age of the patients was 66 ± 8.5 years, 71% were male. There were 945 CPB procedures performed on 914 patients during this study period. Over 39 months, 23 EGS consults were obtained, resulting in 10 operations and one hospital death (10% operative mortality). CABG and valve procedures had minimal impact on EGS workload while complex cardiac and AHF procedures accounted for significantly more EGS consultations (p surgery, advanced technology has increased the volume of complex CPB procedures increasing the EGS workload. Emergency general surgeons working in institutions that perform advanced procedures should be aware of the potential for general surgical complications perioperatively and the resultant nuances that are associated with operative management in this patient population. Copyright © 2015 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  5. Current Trends for Sodium Fast Reactor Design Options: An Industrial Perspective

    International Nuclear Information System (INIS)

    Serpantie, J.-P.; Lefevre, J.-C.; Hamy, J.-M.


    The fast reactor capabilities of fuel breeding and minor actinide burning give a strong incentive to pursue the development of such reactors in order to keep up with the evolution of the general regulatory environment of nuclear energy and technological progress. Further engineering and R&D efforts have to be invested in order to gain assurance that the benefits expected from the industrial operation of fast reactors will be actually obtained when the need arises. This paper gives an overview of the main current design trends under study in France, and particularly at AREVA, to achieve the high performance level requested by utilities and GENIII+ safety standards. In particular, the issues raised by using liquid sodium as the primary coolant and intermediate heat transfer fluid are presented with regard to safety analysis and response to operational constraints. Examples are given of the rationale for design options that are being assessed by AREVA, from past experience and projects, currently in the framework of R&D actions, to conceptual studies for the ASTRID NSSS and/or more generally for the study of future commercial SFR plants. (author)

  6. The distribution of pharmaceuticals in Europe--current and future trends in wholesaling. (United States)

    Andersson, F


    As of January 1, 1993 a huge market, encompassing more than 325 million people, has been established with the unification of the 12 member states in the European Community. During the last 10 years, the pharmaceutical wholesaling sector has therefore been involved in an intense restructuring process. But, there is a considerable scientific gap in the knowledge of pharmaceutical wholesaling. In view of the uncertain situation and the scarcity of structured information, the purpose of this article is to examine current and future trends in the European pharmaceutical wholesaling sector. We reviewed the literature and identified three major areas of interest; general threats to traditional full-line wholesaling, wholesalers' response to these threats, and the new Glaxo distribution scheme. The current and expected importance of these areas were assessed with the help of a survey, encompassing 20 experts in this field. Based on the review and the survey, we conclude that there are many serious threats to traditional wholesaling, the major ones being governmental pressures to lower the already relatively low gross margins, manufacturers contemplating taking over the drug distribution process themselves and increasing international competition. The major responses to these threats are to become a truly international player (via mergers, acquisitions and joint ventures), or being able to provide the customers with detailed management information through computerised networks. In order to survive the next 5-10 years, companies have to be very alert to the changing competitive situation.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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

  9. 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...

  10. Modern implant dentistry based on osseointegration: 50 years of progress, current trends and open questions. (United States)

    Buser, Daniel; Sennerby, Lars; De Bruyn, Hugo


    Periodontology 2000 also discusses the current trends and open questions of implant dentistry, such as the potential of digital implant dentistry in the surgical and prosthetic field, the trend for an increasing average age of implant patients and the related adaptations of treatment protocols, and the second attempt to establish ceramic implants using, this time, zirconia as the implant material. Finally, some of the hottest controversies are discussed, such as recent suggestions on bone integration being a potential foreign-body reaction and the evidence-based appraisal of the peri-implantitis debate. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. 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.

  12. ‘Guru’ devotion in India: Socio-cultural perspectives and current trends

    Directory of Open Access Journals (Sweden)

    Anusha Gavankar


    Full Text Available ‘Guru’ devotion in India: Socio-cultural perspectives and current trends Though the academic study of religion is considered nascent in India, eminent scholars speak of Hindu restoration and the evolution of a guru. In a highly dynamic and pluralistic India, various sociological perspectives stand valid even today, for a better understanding into the spurt of the new movements – religious, spiritual and charismatic. These offer several insights into the evolution of the ‘guru phenomenon’ in the country. We have come a long way from the traditional guru to the contemporary godman (godwoman. The ‘Guru’ in India has today entered the realm of religion. Despite having access to a wide pantheon of divine entities, what makes a people of a nation in current civilized and better literate times, cut across all barriers of caste and religion (also class and surrender one’s all to that one ultimate authority called a ‘guru’? What makes him ‘god’? This paper attempts to comprehend, appreciate and study the evolution and progression of the ‘guru’ tradition in India - with an understanding of some sociological perspectives, the need for a ‘Guru’, role in Indian society, related psychoanalysis, and finally current trends. As we do so, this would only be the beginning of a journey in discovering the numerous traditions and movements that come to be associated with this phenomenon, each enshrined with its own trends, plentiful stories and abundant miracles – taking it to a new level, altogether.   Zjawisko guru w Indiach. Perspektywy społeczno-kulturowe i aktualne kierunki Chociaż akademickie studia nad religią nadal postrzegane są w Indiach jako nowość, to wybitni uczeni mówią o hinduskim odnowieniu i ewolucji „guru”. W dynamicznych i pluralistycznych Indiach wciąż pojawiają się różnorodne koncepcje socjologiczne mające pomóc w lepszym zrozumieniu wzrostu liczby nowych ruchów religijnych, duchowych i

  13. Mortality risk prediction models for coronary artery bypass graft surgery: current scenario and future direction. (United States)

    Karim, Mohammed N; Reid, Christopher M; Cochrane, Andrew; Tran, Lavinia; Alramadan, Mohammed; Hossain, Mohammed N; Billah, Baki


    Many risk prediction models are currently in use for predicting short-term mortality following coronary artery bypass graft (CABG) surgery. This review critically appraised the methods that were used for developing these models to assess their applicability in current practice setting as well as for the necessity of up-gradation. Medline via Ovid was searched for articles published between 1946 and 2016 and EMBASE via Ovid between 1974 and 2016 to identify risk prediction models for CABG. Article selection and data extraction was conducted using the CHARMS checklist for review of prediction model studies. Association between model development methods and model's discrimination was assessed using Kruskal-Wallis one-way analysis of variance and Mann-Whitney U-test. A total of 53 risk prediction models for short-term mortality following CABG were identified. The review found a wide variation in development methodology of risk prediction models in the field. Ambiguous predictor and outcome definition, sub-optimum sample size, inappropriate handling of missing data and inefficient predictor selection technique are major issues identified in the review. Quantitative synthesis in the review showed "missing value imputation" and "adopting machine learning algorithms" may result in better discrimination power of the models. There are aspects in current risk modeling, where there is room for improvement to reflect current clinical practice. Future risk modelling needs to adopt a standardized approach to defining both outcome and predictor variables, rational treatment of missing data and robust statistical techniques to enhance performance of the mortality risk prediction.

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

    Directory of Open Access Journals (Sweden)

    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.

  15. 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...

  16. Current Surgical Outcomes of Congenital Heart Surgery for Patients With Down Syndrome in Japan. (United States)

    Hoashi, Takaya; Hirahara, Norimichi; Murakami, Arata; Hirata, Yasutaka; Ichikawa, Hajime; Kobayashi, Junjiro; Takamoto, Shinichi


    Current surgical outcomes of congenital heart surgery for patients with Down syndrome are unclear.Methods and Results:Of 29,087 operations between 2008 and 2012 registered in the Japan Congenital Cardiovascular Surgery Database (JCCVSD), 2,651 were carried out for patients with Down syndrome (9%). Of those, 5 major biventricular repair procedures [ventricular septal defect repair (n=752), atrioventricular septal defect repair (n=452), patent ductus arteriosus closure (n=184), atrial septal defect repair (n=167), tetralogy of Fallot (TOF) repair (n=108)], as well as 2 major single ventricular palliations [bidirectional Glenn (n=21) and Fontan operation (n=25)] were selected and their outcomes were compared. The 90-day and in-hospital mortality rates for all 5 major biventricular repair procedures and bidirectional Glenn were similarly low in patients with Down syndrome compared with patients without Down syndrome. On the other hand, mortality after Fontan operation in patients with Down syndrome was significantly higher than in patients without Down syndrome (42/1,558=2.7% vs. 3/25=12.0%, P=0.005). Although intensive management of pulmonary hypertension is essential, analysis of the JCCVSD revealed favorable early prognostic outcomes after 5 major biventricular procedures and bidirectional Glenn in patients with Down syndrome. Indication of the Fontan operation for patients with Down syndrome should be carefully decided.

  17. The current status of international partnerships for child surgery in sub-Saharan Africa. (United States)

    Ekenze, Sebastian O; Onumaegbu, Okechukwu O; Nwankwo, Okechukwu E


    Disparity still exists in the surgical care between sub-Saharan Africa and developed countries. Several international initiatives have been undertaken in the past decades to address the disparity. This study looks at the impact of these programs in child surgery in Sub-Saharan Africa. Review of electronic databases Medline and African Index Medicus on international partnerships for child surgery in Sub-Saharan Africa was undertaken. Four types of international initiatives were identified and consist of periodic medical missions; partnerships between foreign medical institutions or charities and local institutions; international health electives by surgical residents; and training of individual surgeons from developing countries in foreign institutions. The results of these efforts were variable, but sustainability and self-reliance of host nations were limited. Sociocultural factors, dearth of facilities, and lack of local governments' commitment were main impediments to effective local development or transfer of modern protocols of surgical management and improvement of pediatric surgical care at the host community level. Current initiatives may need improvements with better understanding of the sociocultural dynamics and local politics of the host nation, and improved host nation involvement and commitment. This may engender development of locally controlled viable services and sustainable high level of care.

  18. Tissue engineering in plastic surgery: an up-to-date review of the current literature. (United States)

    Sterodimas, Aris; De Faria, Jose; Correa, Wanda Elizabeth; Pitanguy, Ivo


    Tissue engineering is an interdisciplinary field that applies the principles of engineering and life sciences toward the development of biological substitutes that restore, maintain, or improve tissue function. This field has enjoyed tremendous growth in the past 10 years fuelled by its potential role in regenerating new tissues and naturally healing injured or diseased organs. Stem cells due to their pluripotentiality and unlimited capacity for self-renewal, may allow significant advances for distinct reconstructive and cosmetic procedures. This review aims at outlining the principles of tissue engineering, focusing on the use of adult-derived stem cells as applied to the research and practice of plastic surgery. Review categories have been divided into tissue engineering of the skin and connective tissue, bone marrow, cartilage, adipose tissue, and breast tissue. An analytical review of the current literature on stem cell technology on the above mentioned areas is presented. There have been reports of side effects and unsuccessful treatments. The key to the progress of tissue engineering is an understanding between basic scientists, biochemical engineers, clinicians, and industry. Although there has been an ongoing research pointing to the enormous potential of using stem cells in cosmetic and reconstructive surgery, at this stage, stem cell therapy is still a hope that has not been fully studied and approved. More long-term studies are needed and many questions remain to be answered.

  19. Dealing with robot-assisted surgery for rectal cancer: Current status and perspectives (United States)

    Biffi, Roberto; Luca, Fabrizio; Bianchi, Paolo Pietro; Cenciarelli, Sabina; Petz, Wanda; Monsellato, Igor; Valvo, Manuela; Cossu, Maria Laura; Ghezzi, Tiago Leal; Shmaissany, Kassem


    The laparoscopic approach for treatment of rectal cancer has been proven feasible and oncologically safe, and is able to offer better short-term outcomes than traditional open procedures, mainly in terms of reduced length of hospital stay and time to return to working activity. In spite of this, the laparoscopic technique is usually practised only in high-volume experienced centres, mainly because it requires a prolonged and demanding learning curve. It has been estimated that over 50 operations are required for an experienced colorectal surgeon to achieve proficiency with this technique. Robotic surgery enables the surgeon to perform minimally invasive operations with better vision and more intuitive and precise control of the operating instruments, thus promising to overcome some of the technical difficulties associated with standard laparoscopy. It has high-definition three-dimensional vision, it translates the surgeon’s hand movements into precise movements of the instruments inside the patient, the camera is held and moved by the first surgeon, and a fourth robotic arm is available as a fixed retractor. The aim of this review is to summarise the current data on clinical and oncologic outcomes of robot-assisted surgery in rectal cancer, focusing on short- and long-term results, and providing original data from the authors’ centre. PMID:26811606

  20. Urinary, sexual, and cosmetic results after puberty in hypospadias repair: current results and trends

    NARCIS (Netherlands)

    Rynja, Sybren P.; de Kort, Laetitia M. O.; de Jong, Tom P. V. M.


    To give an overview of the recently published long-term outcomes of hypospadias surgery performed at childhood, of patients who have had multiple previous repairs, and results of surgery done to treat late complications following hypospadias repair. Urethral function after hypospadias repair is

  1. Surgery (United States)

    ... and sterile gloves. Before the surgery begins, a time out is held during which the surgical team confirms ... the Consumer Version. DOCTORS: Click here for the Professional Version What Participants Need to Know About Clinical ...

  2. Anticoagulants and Statins As Pharmacological Agents in Free Flap Surgery: Current Rationale. (United States)

    Pršić, Adnan; Kiwanuka, Elizabeth; Caterson, Stephanie A; Caterson, Edward J


    Microvascular free flaps are key components of reconstructive surgery, but despite their common use and usual reliability, flap failures still occur. Many pharmacological agents have been utilized to minimize risk of flap failure caused by thrombosis. However, the challenge of most antithrombotic therapy lies in providing patients with optimal antithrombotic prophylaxis without adverse bleeding effects. There is a limited but growing body of evidence suggesting that the vasoprotective and anti-inflammatory actions of statins can be beneficial for free flap survival. By inhibiting mevalonic acid, the downstream effects of statins include reduction of inflammation, reduced thrombogenicity, and improved vasodilation. This review provides a summary of the pathophysiology of thrombus formation and the current evidence of anticoagulation practices with aspirin, heparin, and dextran. In addition, the potential benefits of statins in the perioperative management of free flaps are highlighted.

  3. Current status of retrograde intrarenal surgery for management of nephrolithiasis in children

    Directory of Open Access Journals (Sweden)

    Yaser El-Hout


    Full Text Available Purpose : To review the current status of retrograde intrarenal surgery (RIRS for renal stones in children focusing on its indications, outcomes and success in the management of nephrolithiasis. Materials and Methods : Between 1988 and 2009, a comprehensive PubMed/MEDLINE literature review on RIRS was conducted. Results : The available literature is limited and heterogeneous, skewed by favorable results on ureteral stone outcomes. However, recent case series report outcomes comparable to time-honored modalities: percutaneous nephrolithotomy and shock wave lithotripsy. Concerns about urinary tract damage are not substantiated by the yet available intermediate-term follow-up. Conclusions : RIRS seems to be an effective modality in pediatric nephrolithiasis management. However, long-term outcomes and comparative prospective randomized studies are awaited.

  4. 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

  5. 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.)

  6. 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.

  7. Current trends in the treatment of primary mediastinal large B-cell lymphoma – an overview (United States)


    Primary mediastinal large B-cell lymphoma has been recognised as a distinct entity with unique clinical, pathologic, and genetic features. According to WHO 2008 classification it is marked as a variant of diffuse large B-cell lymphoma but shares characteristics with classic Hodgkin lymphoma. Genetic analysis has shown that amplification of the 9p24.1 region is the disease's specific structural alteration. Aggressive behaviour and a tendency to invade surrounding tissues of the thoracic cavity, often causing superior vena cava syndrome, or pleural or pericardial effusions, are the clinical hallmarks of this disease. For a long period of time it has been considered as a disease with poor prognosis, which responds poorly to the conventional treatment created for diffuse large B-cell lymphoma. An elective treatment has not yet been established, but recently the situation has became much more favourable. After the introduction of rituximab the cure rates have risen to over 80%, and the most recent results have demonstrated a new insight with dose-adjusted intensified continuous treatments, in which the cure rates have exceeded 90%. Current trends have led to the introduction of dose-adjusted intensified protocols becoming a standard of care, whereas the use of radiotherapy remains controversial because of the questionable predictive value of post-treatment PET/CT validity. The relapse rate is very low after two years of sustained complete remission. If the disease relapses or is resistant the outcome is very poor regardless of the applied treatment modality. PMID:26843837

  8. 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.

  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.


    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.

  11. Current trends in treatment outcomes of orbital cellulitis in a tertiary hospital in Southern Nigeria

    Directory of Open Access Journals (Sweden)

    Odarosa M Uhumwangho


    Full Text Available Background: Orbital cellulitis refers to the inflammation or infection of the soft tissues of the orbit located behind the orbital septum. Aim: To determine the current trends in the outcomes following the management of orbital cellulitis in a tertiary hospital in Southern Nigeria. Patients and Methods: A retrospective review of medical records of patients with orbital cellulitis from January 2008 to December 2014 was conducted. The age, sex, duration of symptoms, predisposing factors, clinical findings, laboratory/radiological investigations, treatment provided, complications, and follow-up were recorded. Results were analyzed with SPSS Version 21 program. Results: Forty-two patients were seen made of 17 (40.5% males and 25 (59.5% females with a mean age of 18.2 ± 18.7 years of which children 6/18 at presentation, 38 (82.6% and at discharge, 39 (84.8%. The mean duration of presenting complaints was 15.5 ± 31.6 days. Patients who presented early were less likely to develop complications, P = 0.003. The most common complication was exposure keratopathy in 8 (44.4% eyes. The only surgical intervention performed was incision and drainage of abscess in 3 (7.1% eyes. No patient came for follow-up. Conclusion: Prompt institution of effective antibiotics and management of complications that may arise improves prognosis of orbital cellulitis.

  12. 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.

  13. 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)

  14. 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.

  15. 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.

  16. ICT-based health information services for elderly people: past experiences, current trends, and future strategies. (United States)

    Marschollek, Michael; Mix, Stefan; Wolf, Klaus-H; Effertz, Beate; Haux, Reinhold; Steinhagen-Thiessen, Elisabeth


    Although health information is readily available on the Internet and has changed the way people deal with their health in many ways, the retrieval of relevant information remains problematic, especially for elderly people. With a focus on elderly people, this paper summarizes current trends in consumer health informatics, discusses past and present initiatives providing health-information services, and proposes a future strategy for the design of sustainable services. A systematic literature review and a review of past German and EU projects concerned with health information services for elderly people are given. Many publications focus on health information services for specific diseases and on their quality and semantic accessibility, yet few deal with presenting and customizing health information for elderly and disabled people. Past experiences from Germany suggest that very often the specific needs of this target group are not met, and therefore accessibility remains largely hypothetical. We propose a strategy with five key points for the design of sustainable health-information services for elderly people. More research is needed to customize web-based health information services to the needs of the user group that needs them most urgently - elderly and disabled people.

  17. 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)

  18. Pediatric robotic rehabilitation: Current knowledge and future trends in treating children with sensorimotor impairments. (United States)

    Michmizos, Konstantinos P; Krebs, Hermano Igo


    Robot-aided sensorimotor therapy imposes highly repetitive tasks that can translate to substantial improvement when patients remain cognitively engaged into the clinical procedure, a goal that most children find hard to pursue. Knowing that the child's brain is much more plastic than an adult's, it is reasonable to expect that the clinical gains observed in the adult population during the last two decades would be followed up by even greater gains in children. Nonetheless, and despite the multitude of adult studies, in children we are just getting started: There is scarcity of pediatric robotic rehabilitation devices that are currently available and the number of clinical studies that employ them is also very limited. We have recently developed the MIT's pedi-Anklebot, an adaptive habilitation robotic device that continuously motivates physically impaired children to do their best by tracking the child's performance and modifying their therapy accordingly. The robot's design is based on a multitude of studies we conducted focusing on the ankle sensorimotor control. In this paper, we briefly describe the device and the adaptive environment we built around the impaired children, present the initial clinical results and discuss how they could steer future trends in pediatric robotic therapy. The results support the potential for future interventions to account for the differences in the sensorimotor control of the targeted limbs and their functional use (rhythmic vs. discrete movements and mechanical impedance training) and explore how the new technological advancements such as the augmented reality would employ new knowledge from neuroscience.

  19. 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.

  20. 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

  1. Manufacture and use of nanomaterials: current status in the UK and global trends. (United States)

    Aitken, R J; Chaudhry, M Q; Boxall, A B A; Hull, M


    This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.

  2. 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...

  3. 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.

  4. The role of bariatric surgery to treat diabetes: current challenges and perspectives


    Koliaki, Chrysi; Liatis, Stavros; le Roux, Carel W.; Kokkinos, Alexander


    Bariatric surgery is emerging as a powerful weapon against severe obesity and type 2 diabetes mellitus (T2DM). Given its role in metabolic regulation, the gastrointestinal tract constitutes a meaningful target to treat T2DM, especially in light of accumulating evidence that surgery with gastrointestinal manipulations may result in T2DM remission (metabolic surgery). The major mechanisms mediating the weight loss-independent effects of bariatric surgery comprise effects on tissue-specific insu...

  5. Do differences in early hemodynamic performance of current generation biologic aortic valves predict outcomes 1 year following surgery? (United States)

    Thalji, Nassir M; Suri, Rakesh M; Michelena, Hector I; Greason, Kevin L; Dearani, Joseph A; Daly, Richard C; Joyce, Lyle D; Stulak, John M; Burkhart, Harold M; Li, Zhuo; Schaff, Hartzell V


    Small early postoperative hemodynamic differences were noted in a randomized comparison of 3 current-generation bioprosthetic aortic valves. Whether these differences persist and influence clinical outcomes 1 year following implantation is unknown. Three hundred adults with severe aortic stenosis undergoing valve replacement were randomized to receive the Epic (St Jude, St Paul, Minn) (n = 99), Magna (Edwards LifeSciences Inc, Irvine, Calif) (n = 100), or Mitroflow (Sorin Biomedica Spa, Saluggio, Italy) (n = 101) bioprostheses. Hemodynamic valve performance was examined by echocardiography at 1 year, and clinical outcomes were assessed in 241 patients (79 Epic, 77 Magna, and 85 Mitroflow; P = .437). Mean age was 75 ± 8 years and 164 were men (68%). Between dismissal and 1 year there were 9 deaths (3.7%) (Epic: 3.7%, Magna: 5.0%, and Mitroflow: 2.3%; P = .654), 6 episodes of heart failure (2.5%) (Epic: 1.3%, Magna: 1.3%, and Mitroflow: 5.8%; P = .265), 27 instances of atrial fibrillation/flutter (11.2%) (Epic: 8.1%, Magna: 11.0%, and Mitroflow: 7.9%; P = .577) and no strokes/transient ischemic attacks. One-year echocardiography demonstrated small hemodynamic differences between Epic, Magna, and Mitroflow bioprostheses in mean gradient (15.2 ± 5.5, 12.3 ± 4.3, and 16.2 ± 5.7 mm Hg, respectively; P < .001) and indexed aortic valve area (0.93 ± 0.28, 1.04 ± 0.28, and 0.96 ± -0.26 cm(2)/m(2), respectively; P = .015). Several early trends persisted when stratifying data by echocardiographic annulus diameter, universal annulus size, and implant size, particularly with annular size ≥23 mm. Overall left ventricular mass index regression between dismissal and 1 year was -16.5 ± 28.1 g/m(2), and was similar among groups (P = .262). There were no aortic valve reoperations. Despite midterm persistence of small hemodynamic differences amongst current-generation porcine and pericardial aortic valves, our prospective randomized comparison reveals

  6. Review of Current Studies in Instructional Design Theory in Korea: Major Trends and Future Directions (United States)

    Lim, Cheolil; Yeon, Eunkyoung


    This article reviewed recent studies of instructional design theory in Korea to explore major trends and suggest future directions. Based on the analysis of 40 articles from the "Journal of Educational Technology" between 1994 and 2006, this study identified six trends: little emphasis on the conceptualization of instructional design…

  7. 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.

  8. 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


    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

  10. Matching Trends for the Fellowship in Minimally Invasive Gynecologic Surgery (FMIGS) Since Participation in the National Residency Match Program (NRMP). (United States)

    Vargas, Maria V; Milad, Magdy P


    To describe the level of interest in the fellowship in minimally invasive gynecologic surgery (FMIGS) using data from National Residency Match Program (NRMP) over the past 4 years. Retrospective report (Canadian Task Force Classification II-2) SETTING: Publically reported data from the NRMP PARTICIPANTS: Applicants using the NRMP to match into fellowship training. Reporting matching trends for the gynecologic surgical subspecialty programs starting in 2014, when the FMIGS programs started participating in the NRMP. From 2014 to 2017, the number of FMIGS positions increased from 28 to 37. Over the 4 application cycles, the FMIGS programs had the highest ratio of applicants to positions overall (range 1.7-2.0 for FMIGS) of the surgical gynecologic sub-specialty programs (gynecologic oncology, female pelvic medicine and reconstructive surgery, and reproductive endocrinology and infertility). Since the FMIGS programs began participating in the NRMP in 2014, the FMIGS match has been highly competitive as a gynecologic surgical subspecialty program, suggesting a high level of interest from residency graduates. This may reflect growing recognition that there is a body of knowledge that is unique to MIGS and that a well trained MIGS specialist can improve patient outcomes. Copyright © 2018. Published by Elsevier Inc.

  11. Population based trends in procedures following sling surgery for urinary incontinence. (United States)

    Suskind, Anne M; Kaufman, Samuel R; Dunn, Rodney L; Stoffel, John T; Clemens, J Quentin; Hollenbeck, Brent K


    To investigate practice patterns and variation associated with sling removal/revision and urethrolysis on a population level. We used CPT 4 codes and the State Ambulatory Surgery Database (SASD) to identify all ambulatory procedures for sling removal/revision and urethrolysis from 2004 to 2009 in Florida. Next, we calculated adjusted rates for these procedures and measured regional variation in rates at the level of the Hospital Service Area (HSA). During this time period, rates of secondary procedures following slings more than doubled from 3.2 per 100,000 to 6.5 per 100,000 population (pfollowing sling placement. The large amount of variability in rates of secondary procedures following slings signifies considerable uncertainty about the indications for these procedures. Further research is warranted to better explain potential sources for this variation in order to improve the quality of care surrounding midurethral sling placement and the recognition and treatment of its complications.

  12. Changing trends in corneal graft surgery: a ten-year review (United States)

    de Sanctis, Ugo; Alovisi, Camilla; Bauchiero, Luigi; Caramello, Guido; Girotto, Gianfranco; Panico, Claudio; Vinai, Luisa; Genzano, Federico; Amoroso, Antonio; Grignolo, Federico


    AIM To review indications and corneal tissue use for penetrating and lamellar surgery between 2002 and 2011. METHODS The surgical reports of corneal grafts performed during 2002-2011, using tissues supplied by the Eye Bank of Piedmont (Italy), were reviewed retrospectively. Patient demographic data, date of intervention, indication for surgery, and surgical technique used were recorded. Surgical techniques included penetrating keratoplasty (PK), deep anterior lamellar keratoplasty (DALK) and endothelial keratoplasty (EK). The χ2 test was used to compare the distribution of indications and types of surgical technique used, for corneal grafts done during 2002-2006 versus those done during 2007-2011. RESULTS The number of corneal grafts increased by 30.7% from 2002-2006 to 2007-2011 (from 1567 to 2048). Comparing the two periods, both main indications and surgical techniques changed significantly. In 2007-2011, the proportion of interventions for aphakic/pseudophakic bullous keratopathy (from 16.8% to 21.3%), graft failure (from 16.4% to 19.1%) and Fuchs endothelial dystrophy (from 12.8% to 16.7%) all increased significantly (P<0.05), while those for keratoconus decreased significantly (from 35.6% to 27.3%; P<0.001). In 2007-2011, the proportion of PK decreased significantly (from 92.4% to 57.2%; P<0.001) while that of EK and DALK went from 0.4% to 30.2% (P<0.001) and from 7.2% to 12.6% (P<0.001) respectively. CONCLUSION During 2002-2011 the number of interventions increased significantly for corneal endothelial diseases and graft failure. The growing demand for interventions for these diseases corresponded to the widespread adoption of EK techniques. The use of DALK also increased, but more moderately than EK procedures. PMID:26949609

  13. [Current Status and Future Prospect of Robot-assisted Thoracoscopic Surgery]. (United States)

    Nakamura, Hiroshige; Haruki, Tomohiro


    As surgical robots have widely spread, verification of their usefulness in the general thoracic surgery field is required. The most favorable advantage of robot-assisted surgery is the markedly free movement of joint-equipped robotic forceps under 3-dimensional high-vision. Accurate operation makes complex procedures straightforward and may overcome weak points of previous thoracoscopic surgery. Robot-assisted surgery for lung cancer and mediastinal disease have been safely introduced and initial results have shown favorable. It is still at the stage of clinical research, but recently a lot of merits of robot-assisted thoracic surgery are proved. Although safety management, education and significant cost are also important issues, the robotic-assisted thoracoscopic surgery will become one of the surgical options in minimally invasive surgery.

  14. Radiotherapy confined to the tumor bed following breast conserving surgery. Current status, controversies, and future prospects

    Energy Technology Data Exchange (ETDEWEB)

    Polgar, C.; Fodor, J.; Major, T.; Takacsi-Nagy, Z.; Nemeth, G. [National Institut of Oncology, Department of Radiotherapy, Budapest (Hungary); Kasler, M. [Semmelweis University Budapest, Chair of Oncology, Budapest (Hungary); Hammer, J. [Barmherzige Schwestern Hospital, Department of Radiation Oncology, Linz (Austria); Limbergen, E. van [University Ziekenhuizen, Department of Radiation Oncology, Leuven (Belgium)


    The aim of this study was to review the current status, controversies, and future prospects of tumor bed irradiation alone after breast conserving surgery. Material and Methods: Published prospective trials evaluating the feasibility and efficacy of radiotherapy confined to the tumor bed following breast conserving surgery were reviewed in order to analyze treatment results. Results: In three earlier studies, using tumor bed radiotherapy for unselected patients, the incidence of intra-breast relapse was reported in the range of 15.6-37%. However, in nine prospective phase I-II trials, sole brachytherapy (BT) with different dose rates, strict patients selection, and meticulous quality assurance, resulted in 95.6-100% local control rates. To date, only one phase III protocol has been initiated comparing the efficacy of tumor bed brachytherapy alone with conventional whole breast radiotherapy. The ideal extent of the planning target volume (PTV) for tumor bed radiotherapy alone has not been established yet. In most series, PTV was defined as the excision cavity with generous (1-3 cm) safety margins. Minimal requirement for PTV localization is the use of titanium clips to mark the walls of the excision cavity intraoperatively, but the combination of clip demarcation and three-dimensional (3-D) visual information obtained from cross-sectional images seems to be the best method to determine the target volume. 3-D virtual brachytherapy is also a promising method to minimize the chance of geographic miss. Recently developed techniques, such as intraoperative radiotherapy (IORT), as well as accelerated 3-D conformal external beam radiation therapy (3-D-CRT) were also found to be feasible for tumor bed radiotherapy alone. Conclusions: In spite of the existing arguments against limiting radiotherapy to the tumor bed after breast conserving surgery, results of phase I-II studies suggest that tumor bed radiotherapy alone might be an appropriate treatment option for selected

  15. 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.

  16. Inflammatory responses after laparoscopic uterine myomectomy compared to open surgery in current clinical practice

    International Nuclear Information System (INIS)

    Holub, Z.; Kliment, L.; Jabor, A.; Sprongl, L.


    Objective was to determine the differences in inflammatory response and clinical outcome of current clinical practice in women undergoing laparoscopic myomectomy (LM) and abdominal myomectomy (AM) for symptomatic fibroid. A total of 36 women entered the study between October 2004 to June 2005 at the Department of Gynecology and Obstetrics and the Endosopy Training Center at the Baby Friendly Hospital in Klando, Czech Republic, based upon an ultrasonographic assessment size of dominant fibroid (DM) before surgery. All women were allocated to one of 2 groups: group 1 (n=17), DM -6cm, treated with open myomectomy. Surgical characteristics, hospital stay and complications were analyzed. Blood samples for assay of the acute phase reactants and markers of tissue trauma [C-reactive protein (CRP), interleukin-6 (IL-6), serum amyloid kinase (CK)] were taken preoperatively and on the first and third postoperative day. The difference between the groups in mean size of DM was statistically significant (4.8 cm in group 1 versus 6.9 cm in group 2, p<0.05). Statistically, significant differences were found between the compared groups in intra-operative blood loss (p<0.05) and length of hospital stay (p<0.001). No complication was reported after LM. There were significantly higher levels of CRP, IL-6, SAA, WBC and CK in both groups after surgery. Increased levels of IL-6, WBC and CK were greatest on the first postoperative day in the open group. The serum CRP, IL-6, SAA, WBC, CK and the fall in the hemoglobin were statistically different between the 2 groups. Compared with open myomectomy, LM was associated with a less intensive inflammatory response and a more favorable clinical outcome. (author)

  17. The Development of Perioperative Practices for Liver Transplantation: Advances and Current Trends

    Directory of Open Access Journals (Sweden)

    Merceds Susan Mandell


    Full Text Available Transplantation is a young medical specialty that has grown rapidly over the past 50 years. Anesthesiologists, surgeons and hepatologists are all essential partners in the process of determining patient outcome. Each specialty has made landmark improvements in patient outcome. However, there is still variability in practice patterns in each of the 3 major specialties. This review will use a historic perspective to explore the unique forces that shaped specific transplant practices and those that gave rise to differences in perioperative practices. Anesthesiologists and surgeons have made significant improvements in the management of blood loss, and coagulation monitoring and intervention. This has improved operative survival and early patient outcome. Perioperative survival has improved despite a worldwide shortage of donor organs and a trend to transplant sicker patients. A smaller pool of donor organs is required to meet the needs of an expanding waiting list. The innovations to reduce deaths on the transplant wait list are reviewed along with their impact on overall patient outcome. The evolving organ shortage is the pinnacle point in shaping future transplant practices. Currently, institutional-specific practices may be reinforced by the informal “tutorship” that is used to train physicians and by the resources available at each site of practice. However, there is evidence that specific intraoperative practices such as the use of a low central venous pressure, selection of vasopressors and certain surgical techniques can modify patient outcome. Further investigation is needed to determine whether the good or the bad associated with each practice prevails and in what unique circumstance.

  18. Current Trends in Treatment Outcomes of Orbital Cellulitis in a Tertiary Hospital in Southern Nigeria. (United States)

    Uhumwangho, Odarosa M; Kayoma, Dumebi H


    Orbital cellulitis refers to the inflammation or infection of the soft tissues of the orbit located behind the orbital septum. To determine the current trends in the outcomes following the management of orbital cellulitis in a tertiary hospital in Southern Nigeria. A retrospective review of medical records of patients with orbital cellulitis from January 2008 to December 2014 was conducted. The age, sex, duration of symptoms, predisposing factors, clinical findings, laboratory/radiological investigations, treatment provided, complications, and follow-up were recorded. Results were analyzed with SPSS Version 21 program. Forty-two patients were seen made of 17 (40.5%) males and 25 (59.5%) females with a mean age of 18.2 ± 18.7 years of which children Orbital cellulitis was a unilateral occurrence in 38 (90.5%) patients. Trauma and sinusitis were the common predisposing causes in 20 (47.6%) and 6 (14.3%) patients, respectively. The most common complaint was eye swelling 36 (52.9%). Most patients had visual acuities of >6/18 at presentation, 38 (82.6%) and at discharge, 39 (84.8%). The mean duration of presenting complaints was 15.5 ± 31.6 days. Patients who presented early were less likely to develop complications, P = 0.003. The most common complication was exposure keratopathy in 8 (44.4%) eyes. The only surgical intervention performed was incision and drainage of abscess in 3 (7.1%) eyes. No patient came for follow-up. Prompt institution of effective antibiotics and management of complications that may arise improves prognosis of orbital cellulitis.

  19. Current Trends in Treatment Outcomes of Orbital Cellulitis in a Tertiary Hospital in Southern Nigeria (United States)

    Uhumwangho, Odarosa M; Kayoma, Dumebi H


    Background: Orbital cellulitis refers to the inflammation or infection of the soft tissues of the orbit located behind the orbital septum. Aim: To determine the current trends in the outcomes following the management of orbital cellulitis in a tertiary hospital in Southern Nigeria. Patients and Methods: A retrospective review of medical records of patients with orbital cellulitis from January 2008 to December 2014 was conducted. The age, sex, duration of symptoms, predisposing factors, clinical findings, laboratory/radiological investigations, treatment provided, complications, and follow-up were recorded. Results were analyzed with SPSS Version 21 program. Results: Forty-two patients were seen made of 17 (40.5%) males and 25 (59.5%) females with a mean age of 18.2 ± 18.7 years of which children Orbital cellulitis was a unilateral occurrence in 38 (90.5%) patients. Trauma and sinusitis were the common predisposing causes in 20 (47.6%) and 6 (14.3%) patients, respectively. The most common complaint was eye swelling 36 (52.9%). Most patients had visual acuities of >6/18 at presentation, 38 (82.6%) and at discharge, 39 (84.8%). The mean duration of presenting complaints was 15.5 ± 31.6 days. Patients who presented early were less likely to develop complications, P = 0.003. The most common complication was exposure keratopathy in 8 (44.4%) eyes. The only surgical intervention performed was incision and drainage of abscess in 3 (7.1%) eyes. No patient came for follow-up. Conclusion: Prompt institution of effective antibiotics and management of complications that may arise improves prognosis of orbital cellulitis. PMID:27843275

  20. 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

  1. Current Trends and Research Challenges Regarding “Preparation for Oxidative Stress”

    Directory of Open Access Journals (Sweden)

    Daniel C. Moreira


    Full Text Available Survival under stress, such as exposure to hypoxia, anoxia, freezing, dehydration, air exposure of water breathing organisms, and estivation, is commonly associated to enhanced endogenous antioxidants, a phenomenon coined “preparation for oxidative stress” (POS. The regulation of free radical metabolism seems to be crucial under these selective pressures, since this response is widespread among animals. A hypothesis of how POS works at the molecular level was recently proposed and relies on two main processes: increased reactive species production under hypoxia, and activation of redox-sensitive transcription factors and signaling pathways, increasing the expression of antioxidants. The present paper brings together the current knowledge on POS and considers its future directions. Data indicate the presence of POS in 83 animal species (71.6% among investigated species, distributed in eight animal phyla. Three main research challenges on POS are presented: (i to identify the molecular mechanism(s that mediate/induce POS, (ii to identify the evolutionary origins of POS in animals, and (iii to determine the presence of POS in natural environments. We firstly discuss the need of evidence for increased RS production in hypoxic conditions that underlie the POS response. Secondly, we discuss the phylogenetic origins of POS back 700 million years, by identifying POS-positive responses in cnidarians. Finally, we present the first reports of the POS adaptation strategy in the wild. The investigation of these research trends and challenges may prove useful to understand the evolution of animal redox adaptations and how they adapt to increasing stressful environments on Earth.

  2. Current trends and status of continuing professional development in implant dentistry in Europe. (United States)

    Ucer, T C; Botticelli, D; Stavropoulos, A; Mattheos, N


    Previous surveys have shown that newly graduated dentists, in most European countries, do not obtain adequate theoretical knowledge and, especially, clinical skills in implant dentistry (ID) through their undergraduate education and must therefore acquire knowledge and develop competencies through further postgraduate study. Moreover, clinicians, in general, need to continue to maintain the currency of their competence by undertaking ongoing continuing professional development (CPD). This seems particularly important in ID as techniques, and materials develop rapidly due to advances in biomedical technology. Despite recent developments, CPD in ID remains poorly organised with little standardisation or harmonisation across Europe. The objective of this survey was to explore the current status and trends within CPD education in ID in Europe. Stakeholders and opinion leaders associated with ID education were invited by email to fill an online questionnaire (closing date: 30th April 2013). Two hundred and forty-seven questionnaires were distributed, and two separate reminders were sent to participants in 38 European countries. The survey contained 14 multiple-choice questions, and the data were collected using SurveyMonkey© software, exported in SPSS (Inc, Chicago, IL, USA) format and analysed using descriptive statistics. Two hundred respondents working in 24 countries replied to the survey (response rate of 81% of invitees and 63% of countries surveyed). The results demonstrated a wide divergence in the content and structure of CPD in ID in Europe. Dentists need CPD to develop their skills and to maintain their competence in ID. There is an urgent need for structured and accredited CPD, which should be readily available to all dentists practising ID. It should have pre-determined learning objectives, delivered by accredited CPD providers and educators, and have assessable outcome measures to ensure the best possible impact on clinical practice and patient safety.

  3. 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.

  4. 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 their underlying epistemological views. The aim of this work was to investigate the respondents’ opinions and, if possible, to identify the areas where convergence or even consensus occurred. The results showed that some of the items on the research questionnaire produced a high degree of agreement with the respondents’ views, while a few others were exactly the opposite. These items are considered to be representative of more widespread views. In order to explore the diverging opinions, the items on the research questionnaire that showed great variance were analyzed to determine, whether or not there were significant inter-item correlations among subgroups of participants with different demographic characteristics. Postgraduate studies, professional occupation, age/experience, and career within or outside the wide educational sector were among the main factors that significantly influenced the research results. The study did not reveal any single belief framework underlying the opinions of the respondents. Nevertheless, three specific approach frameworks—ACADEMIC, CONSTRUCTIVIST and SCIENTIFIC REALISM—were analyzed to determine which had the highest degree of agreement. It was found that the SCIENTIFIC REALISM framework and the curriculum emphasis characteristic of the context-based CTSE (Chemistry, Technology, Society and Environment) prevailed, as they produced a significantly higher mean score. The ACADEMIC framework followed with a moderate mean score and the CONSTRUCTIVIST framework had a lower mean score.

  5. Present status of bariatric surgery in Poland


    Janik, Micha? R.; Stanowski, Edward; Pa?nik, Krzysztof


    Introduction : The first survey of bariatric surgery in Poland was published in 2007. New trends are observed worldwide, and there is a current need to investigate the status of bariatric surgery in Polish institutions. This survey was initiated to gain an overview of Polish bariatric surgery during 2007–2014. Aim : To analyze the number and types of bariatric procedures performed in Polish institutions in 2014 and to perform a trend analysis from 2007 to 2014. Material and methods ...

  6. Surgery (United States)

    ... surgery has several common causes, including the following: Infections at the operative site Lung problems such as pneumonia or collapsed lung ... the trauma of an operation. The risk of infections at the operative site, DVTs, and UTIs can be decreased by meticulous ...

  7. 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.

  8. 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

  9. 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.

  10. 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.

  11. 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.

  12. Breast Microsurgery in Plastic Surgery Literature: A 21-Year Analysis of Publication Trends (United States)

    Daly, Lauren Tracy; Mowlds, Donald; Brodsky, Merrick A.; Abrouk, Michael; Gandy, Jessica R.; Wirth, Garrett A.


    Introduction Microsurgical reconstruction of the breast represents an area of continual evolution, as new autologous flaps are introduced and principles are refined. This progression can be demonstrated by bibliometric analysis of the scientific literature. Methods The top 10 plastic surgery journals were determined by impact factor (IF). Each issue of every journal from 1993 to 2013 was accessed directly, and all articles discussing microsurgery on the female breast were classified by authors’ geographic location, study design, and level of evidence (LOE, I–V). The productivity index and productivity share of each geographic region was calculated based on number of articles published and IF. Results A total of 706 breast microsurgery articles were analyzed. There was a significant increase in microsurgical breast research (p < 0.01), with an average 33.6 ± 31.1 articles per year and a mean increase of 4.4 articles per year. Most research was of lower LOE, with level I constituting 0.14% and level II constituting 5.21% of all articles. United States contributed the most research with 336.4 articles, followed by Western Europe with 242.2. However, Western Europe experienced the greatest increase in productivity share, with + 0.50 ± 0.29 growth, while United States demonstrated the greatest decrease in productivity share with − 1.23 ± 0.31 growth. Among autologous flaps, transverse rectus abdominis muscle research had the greatest yearly publication volume until 2002, when overtaken by deep inferior epigastric perforator flap research. Conclusion Over the 21-year study period, the United States not only contributed the greatest volume of research on female breast microsurgery but also demonstrated the greatest decline in research productivity. Efforts should be made to increase the LOE in breast microsurgery research. PMID:26645157

  13. Current Trends and Problems of Development of the Arctic Marine Freight Traffic

    Directory of Open Access Journals (Sweden)

    Vladimir Stepanovich Selin


    Full Text Available The article analyzes the trends and evaluates the prospects of functioning of the Northern Sea Route. It shows that after the change of its management model its freight traffic has dropped 4-fold, and in the Eastern sector (outside the Vilkitsky Strait – 40-fold. In the recent years there has been a certain revival of transportation, including transit, which reached its maximum of 1.27 million tons in 2012. However, over the next two years they declined again; the drop was particularly significant in 2014 and amounted to a total of 240 thousand tons. The main problem is that this rather complex system is influenced by many factors, often contradictory and poorly predictable. Thus, the growing need for energy resources determines the overall need for developing the Arctic shelf. However, the possibility of climate cooling and the deterioration of ice situation can influence the possibility of transporting these resources. Besides, the Ukrainian crisis followed by the “war of sanctions” will cause a significant decline, especially in the medium term, the attractiveness of the European oil and gas market, which will cause the shift of strategic interests of Russian companies to the Asia-Pacific region. This necessitates the modernization of the Arctic transport and logistics system and introduction of new technical solutions. For instance, even nuclearpowered icebreakers series LA-60Ya that are currently under construction will not be able to escort linear tankers and gas carriers with a deadweight of more than 100 thousand tons along the eastern sector of the Northern Sea Route. It is necessary to create more powerful vessels of the classical type or to design new models. All these driving forces and constraints are not always predictable within the framework of standard economic and statistical approaches. In this regard, the study reflected in the article used expert approaches along with the methods of factor and economic analysis. The

  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. Innovations in surgery simulation: a review of past, current and future techniques (United States)

    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. PMID:28090509

  16. National Trends in Readmission Following Inpatient Surgery in the Hospital Readmissions Reduction Program Era. (United States)

    Mehtsun, Winta T; Papanicolas, Irene; Zheng, Jie; Orav, E John; Lillemoe, Keith D; Jha, Ashish K


    The aim of this study was to investigate whether the Hospital Readmissions Reduction Program, a national program that introduced financial penalties for high readmission rates for certain medical conditions, had a "spillover" effect on surgical conditions. During the past decade, there have been multiple national efforts to improve surgical care. Readmission rates are a key metric for assessing surgical quality. Whether surgical readmission rates have declined, and whether the Hospital Readmissions Reduction Program has had an influence is unclear. Using national Medicare data, we identified patients undergoing a range of procedures during the past decade. We examined whether certain procedures that would be targeted by the HRRP had a differential change in readmissions compared to other procedures. We used an interrupted time-series model to examine readmission trends in three time periods: pre-ACA, HRRP implementation, and HRRP penalty. Between 2005 and 2014, 17,423,106 patients underwent the procedures of interest; risk-adjusted rates of readmission across the 8 procedures declined from 12.2% to 8.6%. Pre-ACA rates of readmission were decreasing [-0.060% per quarter (-0.072%, -0.048%), P < 0.001]. During the HRRP implementation period, the rate of decline of readmissions increased [-0.129% (-0.142%, -0.116%), P < 0.001] and continued declining at a similar rate during the penalty period [-0.118% (-0.131%, -0.105%), P < 0.001]. Largest declines in surgical readmissions were seen among the nontargeted procedures. The hospitals with the greatest reductions in medical readmissions also had the greatest drop in surgical readmissions. Surgical readmission rates have fallen during the past decade and rates of decline have increased during the HRRP period.

  17. Revisional surgery following the superiorly based posterior pharyngeal wall flap. Historical perspectives and current considerations.

    NARCIS (Netherlands)

    Keuning, K.H.; Meijer, G.J.; Bilt, A. van der; Koole, R.A.


    The aim of this study was to describe the surgical and functional complications following superiorly based posterior pharyngeal wall (SBPP) flap surgery. Records of 130 patients with velopharyngeal insufficiency (VPI) who had undergone SBPP flap surgery as a secondary procedure to reduce nasal


    Directory of Open Access Journals (Sweden)

    Владимир Иванович Заварухин


    Full Text Available This article is a brief historical review of distraction osteogenesis development in hand surgery. It describes the key steps in the evolution of methods beginning with immobilization and external fixation up to the distraction method in orthopaedics and its introduction in hand surgery.



    Владимир Иванович Заварухин; Сергей Иванович Голяна; Антон Владимирович Говоров


    This article is a brief historical review of distraction osteogenesis development in hand surgery. It describes the key steps in the evolution of methods beginning with immobilization and external fixation up to the distraction method in orthopaedics and its introduction in hand surgery.

  20. 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

  1. 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

  2. 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 ...

  3. 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…

  4. 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…


    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

  6. 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.

  7. 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

  8. [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.

  9. Operative Treatments for Reflux After Bariatric Surgery: Current and Emerging Management Options. (United States)

    Treitl, Daniela; Nieber, Derek; Ben-David, Kfir


    Gastroesophageal reflux disease (GERD) is a common disorder that has a well-established connection with obesity. To ameliorate the morbidity associated with obesity, bariatric procedures have become an established pathway to accomplish sustained weight loss. In some procedures, such as with the Roux-en-Y gastric bypass surgery, weight loss is also accompanied by the resolution of GERD symptoms. However, other popular bariatric surgeries, such as the sleeve gastrectomy, have a controversial impact on their effect on reflux. Consequently, increased attention has been given to the development of strategies for the management of de novo or recurrent reflux after bariatric surgery. This article aims to discuss medical and surgical strategies for reflux after bariatric surgery, and their outcomes.


    Directory of Open Access Journals (Sweden)

    Nicolae PAVEL


    Full Text Available By this approach, the proposed study opens a complex and complete vision, but not exhaustive on: The current trends of constitutionalisation of the new Civil Code and of the new Civil Procedure Code. The subject of the scientific endeavor will be circumscribed to the scientific analysis of its parts, as follows: 1 Preamble. 2 The first judicial review of the constitutionality of the law established in the United States and in Romania – their consequences. 3 Reflection of the constitutional principles in the new Civil Code and the new Code of Civil Procedure. 4 Reflection of the dispositions of new Civil Code and of the new Code of Civil Procedure in the Constitutional Court decisions. 5 Compliance with Romanian Constitution of new Civil Code and of new Code of Civil Procedure - the current trends of constitutionalisation of the law. 6 Conclusions.

  11. 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 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.

  12. 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.

  13. Current trends in business negotiation research: An overview of articles published 1996-2005


    Agndal, Henrik


    This report presents an overview of 263 articles dealing with business negotiations. Firstly, some general trends in business negotiation research are identified. Secondly, a number of research topics are discussed in greater detail, based on a model of negotiation research. This model focuses on the negotiating parties, the context in which the negotiation takes place, the negotiation process, and outcomes of negotiations. Third, some suggestions for future research are presented.

  14. Four dimensions of journalistic convergence: a preliminary approach to current media trends at Spain


    Domingo, David; Salaverría, Ramón; Aguado Terrón, Juan Miguel; Cabrera, María Ángeles; Edo Bolós, Concha; Masip, Pere; Meso Ayerdi, Koldo; Palomo, María Bella; Sádaba, Charo; Orihuela Colliva, José Luis; Portilla, Idoia; Díaz Noci, Javier; Larrañaga, José; Larrondo Ureta, Ainara; López, Xosé


    Convergence is a very polysemous concept that has been used to describe various trends in journalism that have something in common: the blurring of the limits between different media, professional skills and roles. This paper proposes to analytically structure convergence into four dimensions: integrated production, multiskilled professionals, multiplatform delivery and active audience. This analytical grid can help in exploring convergence avoiding deterministic assumptions and allowing to m...

  15. Pregnancy after bariatric surgery: a current view of maternal, obstetrical and perinatal challenges. (United States)

    Magdaleno, Ronis; Pereira, Belmiro Gonçalves; Chaim, Elinton Adami; Turato, Egberto Ribeiro


    With the increase in the number of bariatric surgeries being performed in women of childbearing age, physicians must have concerns regarding the safety of pregnancy after bariatric surgery. The aim of this review is to summarize the literature reporting on maternal, obstetrical and perinatal implications of pregnancy following BS. English, Spanish and Portuguese-language articles were identified in a PUBMED search from 2005 to February 2011 using the keywords for pregnancy and bariatric surgery or gastric bypass or gastric banding. The studies show improved fertility and a reduced risk of gestational diabetes, pregnancy-induced hypertension and pre-eclampsia, macrosomia in pregnant women after bariatric surgery. The incidence of intrauterine growth restriction and small for gestational age are increased. No conclusions can be drawn concerning the risk for cesarean delivery and the best surgery-to-conception interval. Deficiencies in iron, vitamin A, vitamin B12, vitamin K, folate and calcium can result in maternal and fetal complications. Pregnancy outcome of women who delivered after BS, as compared to obese populations, is better and safer and comparable to the general population. Close supervision before, during and after pregnancy following bariatric surgery and nutrient supplementation adapted to the patient's individual requirements can prevent nutrition-related complications and improve maternal and fetal health.

  16. 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.

  17. Assessment of systemic inflammation by time-trends of blood granulocyte count and plasma myeloperoxidase and elastase concentrations following colic surgery in horses. (United States)

    Salciccia, Alexandra; Grulke, Sigrid; de la Rebière de Pouyade, Geoffroy; Franck, Thierry; Detilleux, Johann; Serteyn, Didier; Sandersen, Charlotte


    To determine changes in blood granulocyte counts and in plasma myeloperoxidase (MPO) and elastase (ELT) concentrations in surgical colic cases, and to determine the relationship between these changes and the surgical procedure performed, occurrence of postoperative ileus, and final outcome. Prospective clinical study conducted over a 12-month period. University teaching hospital. Fifty-three horses undergoing emergency laparotomy and surviving at least 12 hours postoperatively. Blood samples were taken before surgery, during surgery, at the recovery from anesthesia, and then serially until the 150th hour after the first blood sampling. Granulocyte counts were performed by an automated cell hematology analyzer. Specific ELISAs were performed for the MPO and ELT measurements. Mixed models were used to compare the time-trends of the 3 parameters. Taking all horses together, the time-trends of MPO and ELT were not significantly different from each other, but they were significantly different from the granulocyte time-trend. The type of surgical procedure did not influence the time-trends of the 3 parameters. Significant changes in the granulocyte time-trends were associated with postoperative ileus and outcome. Significant changes in the MPO time-trends were associated with outcome. The ELT time-trends were not influenced by ileus or outcome. Granulocyte counts and MPO change over time and are related to the severity of the inflammatory reaction in surgical colic cases. These time-trends may allow evaluation of treatment efficacy in an effort to modulate excessive granulocyte activation and degranulation. © Veterinary Emergency and Critical Care Society 2016.

  18. Certification Examination Cases of Candidates for Certification by the American Board of Plastic Surgery: Trends in Practice Profiles Spanning a Decade (2000–2009) (United States)

    Chung, Kevin C.; Song, Jae W.; Shauver, Melissa J.; Cullison, Terry M.; Noone, R. Barrett


    Background To evaluate the case mix of plastic surgeons in their early years of practice by examining candidate case-logs submitted for the Oral Examination. Methods De-identified data from 2000–2009 consisting of case-logs submitted by young plastic surgery candidates for the Oral Examination were analyzed. Data consisted of exam year, CPT (Current Procedural Terminology) Codes and the designation of each CPT code as cosmetic or reconstructive by the candidate, and patient age and gender. Subgroup analyses for comprehensive, cosmetic, craniomaxillofacial, and hand surgery modules were performed by using the CPT code list designated by the American Board of Plastic Surgery Maintenance of Certification in Plastic Surgery ( ) module framework. Results We examined case-logs from a yearly average of 261 candidates over 10 years. Wider variations in yearly percent change in median cosmetic surgery case volumes (−62.5% to 30%) were observed when compared to the reconstructive surgery case volumes (−18.0% to 25.7%). Compared to cosmetic surgery cases per candidate, which varied significantly from year-to-year (pplastic surgery training programs are committed to performing a broad spectrum of reconstructive and cosmetic surgical procedures in their first year of practice. However, hand surgery continues to have a small presence in the practice profiles of young plastic surgeons. PMID:21788850

  19. 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

  20. [Single and reduced port laparoscopic surgery for colorectal cancer: current status and future perspectives]. (United States)

    Li, G X; Li, J M; Wang, Y N; Deng, H J; Mou, T Y


    For further maximizing the minimally invasive benefits for colorectal cancer patients, laparoscopic surgeons have been dedicating to improve the surgery through single-port (SILES) or natural orifice transluminal endoscopic surgery (NOTES), which is supported by amount of single-port devices and flexible laparoscopic instruments.Many small sample studies of single institution have suggested that SILES for colorectal cancer has similar oncological outcomes with conventional laparoscopic surgery (CLS), could improve the cosmetic results, and is more minimally invasive than CLS. However, evidences of advantages for SILES are limited, because of there has been only 4 published studies of prospective randomized clinical trial so far. Due to the technical difficulties and long learning curves, SILES and NOTES are relatively hard to be widely promoted. Thus, a balance between minimally invasive pursuit and laparoscopic technical challenge should be sought. In this way, modified SILES and reduced-port laparoscopic surgery have emerged in recent years, which might be minimally invasive solutions with lower technical demanding for laparoscopic colorectal cancer surgeries. Adding a port as the surgeon's dominant operation channel improved the collisions or overlapping of instruments with movement to reduce the technical difficulties. SILS+ 1 is safe and feasible, would be supported by more and more evidences.

  1. Robot-assisted minimally invasive surgery for pediatric solid tumors: a systematic review of feasibility and current status. (United States)

    Cundy, Thomas P; Marcus, Hani J; Clark, James; Hughes-Hallett, Archie; Mayer, Erik K; Najmaldin, Azad S; Yang, Guang-Zhong; Darzi, Ara


    Open surgery remains the primary technique for resection of pediatric solid tumors despite the popularity of minimally invasive surgery (MIS) for oncological indications in adults and nononcological indications in children. Robot-assisted surgery offers technical and ergonomic advantages that might make MIS more achievable in this setting, permitting benefits for both the patient and surgeon. The aim of this study is to critically appraise the current status of robot-assisted MIS for pediatric solid tumors. A systematic search of multiple electronic literature databases was undertaken, supplemented by several relevant secondary sources. A total of 23 publications met eligibility criteria, reporting 40 cases overall. Indications for surgery were widely varied, with over 20 different pathologies described. One-third of tumors were classified as malignant. Most procedures involved abdominal or retroperitoneal located tumors in adolescent patients (age range, 1-18 years). The collective complication and conversion rates were 10% and 12.5%, respectively. Oncological adverse events involved two isolated events of tumor spillage and residual disease. The evidence is limited to case reports and small case series only. For the diverse and highly selective cases in this review, robot-assisted MIS seems safe and feasible. Current status is low volume, in a relatively static state of adoption, and without any apparent index pathology or procedure. The benefits of robot assistance seem well suited but remain unsubstantiated by evidence. Higher quality studies are needed to determine true safety and efficacy. Georg Thieme Verlag KG Stuttgart · New York.

  2. 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.

  3. 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.

  4. Periodontal management in orthognathic surgery: early screening of periodontal risk and its current management for the optimization of orthodontic and surgical treatments. (United States)

    Straub, B; Bouletreau, P; Breton, P


    Orthodontic preparation for orthognathic surgery requires correcting mal-occlusions and coordination of arcades. In addition to improving the aesthetics, these treatments can ensure the achievement and sustainability of prosthetics and/or implants. Nevertheless, periodontal structures are easily damaged. Orthodontic displacement can only be applied in the absence of inflammation or weakened periodontal structure. An early detection of periodontal risk should be achievable by prescribers of a surgical-orthodontic treatment. Simplified periodontal examination, with easily detectable warning signs, will help to identify the periodontal risk. Although periodontal treatment follows current "non invasive" trend, some procedures remain necessary to prevent and/or remedy periodontal defects or diseases, such as mineral periodontal reinforcement corticotomy. It is essential that the patient meets all the practitioners to plan and assess the extent of the constraints necessary to optimize results, before starting orthodontic treatment combined with orthognathic surgery. Any periodontal complication (even minor) will be considered as a failure, regardless of good aesthetic and functional results. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  5. 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.

  6. 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

  7. Trends in Bariatric Surgery in Spain in the Twenty-First Century: Baseline Results and 1-Month Follow Up of the RICIBA, a National Registry. (United States)

    Lecube, Albert; de Hollanda, Ana; Calañas, Alfonso; Vilarrasa, Núria; Rubio, Miguel Angel; Breton, Irene; Goday, Albert; Vidal, Josep; Iglesias, Paloma; Fernández-Soto, María Luisa; Pellitero, Silvia; de Cos, Ana Isabel; Morales, María José; Campos, Cristina; Masmiquel, Lluís; Tinahones, Francisco; Pujante, Pedro; García-Luna, Pedro P; Bueno, Marta; Cámara, Rosa; Bandrés, Orosia; Caixàs, Assumpta


    Specific data is needed to safely expand bariatric surgery and to preserve good surgical outcomes in response to the non-stop increase in obesity prevalence worldwide. The aims of this study are to provide an overview of the baseline characteristics, type of surgery, and 30-day postoperative morbidity and mortality in patients undergoing bariatric surgery in Spanish public hospitals, and evaluate changes throughout the 2000-2014 period. This is a descriptive study using data from the RICIBA, a computerized multicenter and multidisciplinary registry created by the Obesity Group of the Endocrinology and Nutrition Spanish Society. Three periods according to the date of surgery were created: January 2000 to December 2004 (G1), January 2005 to December 2009 (G2), and January 2010 to December 2014 (G3). Data from 3843 patients were available (44.8 ± 10.5 years, a 3:1 female-to-male ratio, 46.9 ± 8.2 kg/m(2)). Throughout the 15-year period assessed, candidate patients for bariatric surgery were progressively older and less obese, with an increase in associated comorbidities and in the prevalence of men. The global trend also showed a progressive decrease in Roux-en-Y gastric bypass, the most performed bariatric procedure (75.1 % in G1, 69.3 % in G2, and 42.6 % in G3; p bariatric surgery in response to increasing demand.

  8. An overview of RDF processing systems: Current status, design features, and future trends

    Energy Technology Data Exchange (ETDEWEB)

    Ohlsson, O.O. (Argonne National Lab., IL (United States)); Walter, D.K. (USDOE Assistant Secretary for Conservation and Renewable Energy, Washington, DC (United States). Waste Material Management Div.); Goodman, B.J. (Solar Energy Research Inst., Golden, CO (United States))


    This paper discusses the recent history of refuse-derived fuel (RDF) processing facilities in the United States. The current status of these facilities, including environmental, institutional, and economic considerations is discussed. The unit operations used to produce a desired RDF product are described, and the future potential of RDF processing systems is evaluated. Current research sponsored by the US Department of Energy is also presented. 6 refs., 3 figs., 8 tabs.

  9. 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.

  10. 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.

  11. 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

  12. 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.

  13. 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

  14. 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.

  15. 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.

  16. 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.

  17. 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 

  18. Mental Health Services for Homeless Mentally Ill Persons: Federal Initiatives and Current Service Trends. (United States)

    Levine, Irene S.; Rog, Debra J.


    Recent research suggests that approximately one-third of homeless single adults suffer from severe mental illnesses. Discusses federal initiatives undertaken by the National Institutes of Mental Health (NIMH) to encourage research and improve services for this subgroup. Describes the target population, NIMH research findings, and current mental…

  19. 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…

  20. Increasing Inter-Parliamentary Cooperation in the European Union : Current Trends and Challenges

    NARCIS (Netherlands)

    Fromage, D.B.


    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

  1. 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.

  2. 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…

  3. 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.

  4. 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

  5. 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.

  6. 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

  7. 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.

  8. Current Evidence regarding Prophylactic Antibiotics in Head and Neck and Maxillofacial Surgery

    Directory of Open Access Journals (Sweden)

    Kilian Kreutzer


    Full Text Available 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.

  9. Current status and prerequisites for natural orifice translumenal endoscopic surgery (NOTES). (United States)

    Tomikawa, Morimasa; Xu, Hao; Hashizume, Makoto


    Natural orifice translumenal endoscopic surgery (NOTES) is a sophisticated form of endoscopic surgery whose use has recently spread rapidly around the world. Although hundreds of reports of animal studies and clinical cases about NOTES have been published since 2004, NOTES is still in the experimental phase. The formation of an iatrogenic incision in the lumenal wall of intraperitoneal organs is a major disadvantage of NOTES. No reliable technique for complete closure has yet been established, and this problem must be resolved before NOTES can be adopted as a routine clinical practice. Several devices for the closure of lumenal incisions in the stomach or colorectum have been developed, and their safety and usefulness have been examined in animal studies and clinical cases. Kyushu University has been involved in furthering the adoption of NOTES as a routine clinical practice, and the Kyushu University Training Center for Minimally Invasive Surgery holds training sessions on endoscopic surgical techniques for surgeons from all over Japan. Studies to develop a navigation system and robotic technology for use with NOTES are also in progress at Kyushu University. The further development of endoscopy-related technologies and equipment, such as robotic technology, is therefore essential to allow the safe, widespread adoption of pure NOTES.

  10. Current indications of low-level laser therapy in plastic surgery: a review. (United States)

    Hersant, Barbara; SidAhmed-Mezi, Mounia; Bosc, Romain; Meningaud, Jean Paul


    The aim of this comprehensive review is assess the relevant indications of LLLT in plastic surgery. Low-level laser therapy (LLLT) is a safe adjunct treatment for a myriad indications such as pain, musculoskeletal disorders, or oral mucositis in cancer patients. A systematic literature review was performed using the automated computerized PubMed search, with the key words low-level laser therapy and plastic surgery. In vivo and in vitro comparative studies conducted in humans or animals were included. A total of 113 articles were retrieved for screening, and 40 articles were analyzed for data extraction: 28 on animals and 12 on humans. Thirteen studies on animals showed that LLLT had efficacy in the improvement of flap survival. LLLT on a single spot over the pedicle area of the flap or near the base of the flap seemed to be superior to multi-irradiation. Also, LLLT seemed to improve chronic burn scars in humans, and acute wound healing in animals. On the contrary, LLLT cannot be considered as a valid therapeutic option for venous ulcers. The published studies on alopecia did not show that LLLT had efficacy for this indication, and on skin aging only two studies are reported showing that LLLT globally improved aging of skin. No side effects have been reported. More comparative studies are needed to validate and widen the medical indications of LLLT in plastic surgery.

  11. 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.

  12. 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.

  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. Disease management of tomato through PGPB: current trends and future perspective. (United States)

    Singh, Vipin Kumar; Singh, Amit Kishore; Kumar, Ajay


    Tomato is the world's second most cultivated vegetable. During cultivation or post-harvest storage, it is susceptible to more than 200 diseases caused by an array of pathogenic fungi, nematodes, bacteria, and viruses. Although wide range of chemical pesticides are currently available to manage plant diseases, continuous application of pesticides not only affect the nutritional contents of tomato but also the texture or productivity of soil. In this context, plant growth promoting bacteria (PGPB) are one of the nature friendly, safe, and effective alternatives for the management of diseases and pathogens of tomato. Currently, numbers of microbes have been used as soil or plant inoculants in different plants including tomato as biocontrol. Besides disease inhibition, these inoculants also act as growth modulators. The present article describes the biocontrol potential of PGPB strains and mechanisms for the diseases management in tomato.

  15. 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.

  16. 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

  17. 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...

  18. 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

  19. 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.

  20. Polish Land Forces of the XXI Century - Reforms in Accordance with Current RMA Trends (United States)


    Hoffman Gen. Andrzej Cieniuch Gen. Mieczyslaw Stachowiak Gen. Piotr Czerwinski Maj. Mieczyslaw Malec I would also like to thank all of those other...this author, insist that getting rid of conscription would be a great, irreparable mistake. Former II Corps Commander, gen. Stachowiak underlined...19.10.2004. 243 „Direction – Professional Army”, Roman Polak, Jerzy Telep p. 128 244 Stachowiak , Mieczysław, General, former II Corps Cdr, current

  1. History and current trends in influenza virus infections with special reference to Sri Lanka. (United States)

    Rafeek, R A M; Divarathna, M V M; Noordeen, F


    The World Health Organization (WHO) estimates that approximately one billion people are infected and up to 500,000 people die from influenza each year in the world. Influenza is considered to be the greatest killer of the human populations, due to the 1918 Spanish flu, which killed millions around the world. Despite the effective treatment available against influenza, it still contributes to significant morbidity and mortality. Currently circulating influenza strains in humans include influenza A (H1N1)pdm09, influenza A (H3N2) and influenza B viruses, (B/Victoria and B/Yamagata). Influenza has been prevalent in Sri Lanka from 1969, since then it continued to cause morbidity and mortality in children and adults. The current global influenza surveillance network monitors the global influenza activity through WHO collaborating centres. The Medical Research Institute monitors and diagnoses influenza cases in the country as part of the WHO network laboratories. Vaccinations to high risk groups and antiviral therapy for the successful prevention of influenza have been practiced in Sri Lanka. This review highlights the impact of influenza on public health in Sri Lanka including the historical aspects, current diagnostic practices and prevention approaches in high risk individuals in the country.

  2. 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.

  3. 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.

  4. 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.

  5. Current trends and future projections of hip fracture in South Korea using nationwide claims data. (United States)

    Ha, Y-C; Kim, T-Y; Lee, A; Lee, Y-K; Kim, H-Y; Kim, J-H; Park, C-M; Jang, S


    Incidence of hip fracture increased in Korean populations over age 50 between 2008 and 2012, and the number of fractures was predicted to increase by 1.4 times by 2025. This is important information for public health planning. The purposes of this study were to evaluate the trends in the incidence and mortality of hip fracture between 2008 and 2012 and predict the number of hip fractures in Korea through 2025 using nationwide claims data. The data managed by the National Health Insurance Service were used to identify the hip fractures in patients aged >50 years between 2008 and 2012. Projections of hip fractures were conducted using the Poisson distribution from 2016 to 2025 in Korea. The incidence of hip fractures (per 100,000) increased by 14.1 % over the 5 years of the study, by 15.8 % in women and 10.9 % in men; the older age group showed a steep rise and shift in the incidence from 2008 to 2012. The cumulative mortality rates at 1 year after hip fractures were 17.2 % (3575/20,849) in 2008 and 16.0 % (4547/28,426) in 2012. Overall standardized mortality ratios (SMRs) for hip fracture were higher in men (11.93) than in women (11.22) and were higher than those in the general population in all age groups. In 2016, the total number of hip fractures was estimated to increase an overall of 1.4 times by 2025. The incidence of hip fracture continues to increase, and the related mortality is still high, although it has decreased over time. The socioeconomic burden of hip fracture is expected to increase in Korea along with the increased estimated number of fractures. Nationwide strategies should include attempts to reduce the future socioeconomic burdens of hip fractures.

  6. 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

  7. Socioeconomic impact of ethnic cosmetic surgery: trends and potential financial impact the african american, asian american, latin american, and middle eastern communities have on cosmetic surgery. (United States)

    Wimalawansa, Sunishka; McKnight, Aisha; Bullocks, Jamal M


    The popularity of cosmetic surgery has increased around the world, and whereas in the past, the patient base consisted of mainly Caucasian individuals, interest in this field has grown among persons of varying ethnic backgrounds. Growing interest enables ethnic populations to contribute to the economic growth of the cosmetic surgery industry and impact the direction of the field in the future. Minority populations accounted for 22% of the cosmetic procedures performed in 2007, with the most common being liposuction, Botox((R)) generic botulinum toxin type A (Allergan, Inc., Irvine, CA), and chemical peels. Ultimately, changes in the population characteristics of the plastic surgery patient will alter the techniques of plastic surgeons that treat ethnic patients to cater to their physical differences. Factors such as increased cultural acceptance of plastic surgery, growing ethnic populations, and media emphasis on personal appearance have contributed to the increase in minorities seeking out cosmetic surgery. Escalating economic power within these populations has created an additional potentially lucrative market for interested plastic surgeons.

  8. Segmentation and Image Analysis of Abnormal Lungs at CT: Current Approaches, Challenges, and Future Trends (United States)

    Mansoor, Awais; Foster, Brent; Xu, Ziyue; Papadakis, Georgios Z.; Folio, Les R.; Udupa, Jayaram K.; Mollura, Daniel J.


    The computer-based process of identifying the boundaries of lung from surrounding thoracic tissue on computed tomographic (CT) images, which is called segmentation, is a vital first step in radiologic pulmonary image analysis. Many algorithms and software platforms provide image segmentation routines for quantification of lung abnormalities; however, nearly all of the current image segmentation approaches apply well only if the lungs exhibit minimal or no pathologic conditions. When moderate to high amounts of disease or abnormalities with a challenging shape or appearance exist in the lungs, computer-aided detection systems may be highly likely to fail to depict those abnormal regions because of inaccurate segmentation methods. In particular, abnormalities such as pleural effusions, consolidations, and masses often cause inaccurate lung segmentation, which greatly limits the use of image processing methods in clinical and research contexts. In this review, a critical summary of the current methods for lung segmentation on CT images is provided, with special emphasis on the accuracy and performance of the methods in cases with abnormalities and cases with exemplary pathologic findings. The currently available segmentation methods can be divided into five major classes: (a) thresholding-based, (b) region-based, (c) shape-based, (d) neighboring anatomy–guided, and (e) machine learning–based methods. The feasibility of each class and its shortcomings are explained and illustrated with the most common lung abnormalities observed on CT images. In an overview, practical applications and evolving technologies combining the presented approaches for the practicing radiologist are detailed. ©RSNA, 2015 PMID:26172351

  9. Current trends in mesenchymal stem cell application in bone augmentation: a review of the literature. (United States)

    Khojasteh, Arash; Behnia, Hossein; Dashti, Seyedeh Ghazaleh; Stevens, Mark


    The literature regarding mesenchymal stem cell (MSC)-based bone reconstruction techniques are sparse and no comprehensive review of current methods has been performed. The aim of this article was to provide a discussion of clinical and experimental reports of MSC application in the reconstruction of bony defects in live models. This search was executed using the PubMed database with various combinations of related keywords. Currently published English-language studies that had applied MSCs as a part of their treatment protocol for reconstruction of bony defects in rat, rabbit, dog, and human models were reviewed. The included studies had reported substantiation that the applied cells were of MSC origin as a part of the study design. Publications inclusive to February 1, 2010 were evaluated. Of review of 187 found abstracts and full texts, 25 articles met the inclusion criteria. Based on this review, tremendous differences exist among investigators for the application of MSCs in bone augmentation procedures. These differences include not only species uniqueness but also a plethora of other variances, such as stem cell source, defect sites and sizes, carriers and constructs, use of additional growth factors, measured parameters, and methods of data collection. Because of the multitude of protocols, range of parameters, and data in the current English-language literature, this review did not reach any significant conclusion as to the "most predictable" model in stem cell reconstruction. However, it does "shed light" on the need for additional collaborated studies using similar homogenous designs and data analysis in advancing the science of bone reconstruction using MSCs. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Segmentation and Image Analysis of Abnormal Lungs at CT: Current Approaches, Challenges, and Future Trends. (United States)

    Mansoor, Awais; Bagci, Ulas; Foster, Brent; Xu, Ziyue; Papadakis, Georgios Z; Folio, Les R; Udupa, Jayaram K; Mollura, Daniel J


    The computer-based process of identifying the boundaries of lung from surrounding thoracic tissue on computed tomographic (CT) images, which is called segmentation, is a vital first step in radiologic pulmonary image analysis. Many algorithms and software platforms provide image segmentation routines for quantification of lung abnormalities; however, nearly all of the current image segmentation approaches apply well only if the lungs exhibit minimal or no pathologic conditions. When moderate to high amounts of disease or abnormalities with a challenging shape or appearance exist in the lungs, computer-aided detection systems may be highly likely to fail to depict those abnormal regions because of inaccurate segmentation methods. In particular, abnormalities such as pleural effusions, consolidations, and masses often cause inaccurate lung segmentation, which greatly limits the use of image processing methods in clinical and research contexts. In this review, a critical summary of the current methods for lung segmentation on CT images is provided, with special emphasis on the accuracy and performance of the methods in cases with abnormalities and cases with exemplary pathologic findings. The currently available segmentation methods can be divided into five major classes: (a) thresholding-based, (b) region-based, (c) shape-based, (d) neighboring anatomy-guided, and (e) machine learning-based methods. The feasibility of each class and its shortcomings are explained and illustrated with the most common lung abnormalities observed on CT images. In an overview, practical applications and evolving technologies combining the presented approaches for the practicing radiologist are detailed. ©RSNA, 2015.

  11. 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

  12. 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

  13. 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

  14. 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.

  15. The current practice trends in pediatric bone-anchored hearing aids in Canada: a national clinical and surgical practice survey (United States)


    Background Since the introduction of bone-anchored hearing aids (BAHAs) in the 1980s, the practices of surgeons who implant these hearing aids have become varied; different indications and surgical techniques are utilized depending on the surgeon and institution. The objective of the current study is to describe the clinical and surgical practices of otolaryngologists in Canada who perform pediatric BAHA operations. Methods A detailed practice questionnaire was devised and sent to all members of the Canadian Society of Otolaryngology-Head and Neck Surgery. Those who performed pediatric BAHA surgeries were asked to participate. Results Twelve responses were received (response rate of 80%). All of the respondents identified congenital aural atresia to be an indication for pediatric BAHAs. Other indications were chronic otitis externa or media with hearing loss (92%), allergic reactions to conventional hearing aids (75%), congenital fixation or anomaly of ossicular chain (67%), and unilateral deafness (25%). Minor complications, such as skin reactions, were reported in 25% of cases, while major complications were very rare. There was great variability with regards to surgical techinque and post-operative management. The extent of financial support for the BAHA hardware and device also varied between provinces, and even within the same province. Conclusion There is a lack of general consensus regarding pediatric BAHA surgeries in Canada. With such a small community of otolaryngologists performing this procedure, we are hopeful that this survey can serve as an impetus for a national collaboration to establish a set of general management principles and inspire multi-site research ventures. PMID:23815797

  16. Current trends, figures and challenges in out of home child care: An internationalcomparative analysis

    Directory of Open Access Journals (Sweden)

    Jorge F. del Valle


    Full Text Available This article closes the special issue of this journal about an international review of out-of-home child care, principally family foster care and residential care, tough several aspects related to adoption were included as well. Although a comparison on some data about residential and foster care, or kinship and non-kinship care, is carried out, the article tries above all to make a reflection on the implications of several themes that have emerged as more interesting or important. Matters such as the use of residential care and its role in the current child care system, the overrepresentation of ethnic minorities in foster care in several countries, the situation of unaccompanied young people asylum seeking, the use of adoption as a permanent solution, the challenges of the transition to the adulthood from care, the relevance of the professionalization and models based on social pedagogy, the evaluation and planning based on data, and the current financial crisis and its impact on child care systems are some of the remarkable topics that will be reviewed.

  17. 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.

  18. 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)

  19. 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.

  20. 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.