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Selected AbstractsOne-year survey of carcinoma of the oesophagus and stomach in WalesBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 2 2001J. K. Pye Background: The aim of the study was to identify all patients who presented with oesophagogastric malignancy within a single National Health Service region (Wales) over 1 year, and to follow the cohort for 5 years. Management and outcome were analysed to identify current practice and draft guidelines for Wales. Methods: Patients were identified from hospital records. Details were recorded in structured format for analysis. Results: Analysable data were obtained for 910 of 916 patients. The overall incidence was 31·4 per 100 000 population. Treatment was by resection 298 (33 per cent), palliation 397 (44 per cent) or no treatment 215 (24 per cent). The 30-day mortality rate was 12 per cent and the in-hospital mortality rate was 13 per cent. Some 226 patients (25 per cent) were alive at 2 years. Resection conferred a significant survival advantage over palliation (P < 0·001) and no treatment. Anastomotic leakage occurred in 16 patients (5 per cent), of whom eight died in hospital. ,Open and close' operations were common (23 per cent), laparoscopy was infrequent (16 per cent), and many surgeons undertook small caseloads. Operating on fewer than six patients per year increased the mortality rate after partial gastrectomy (P < 0·05) and was associated with a trend to a higher mortality rate after mediastinal and cardia surgery. Operating on more than 70 per cent of patients seen resulted in a significantly higher mortality rate (P < 0·01) irrespective of case volume. Conclusion: Tumour resection conferred a survival advantage. Wider use of laparoscopy is advocated. Improved selection for surgery should result in a lower mortality rate. © 2001 British Journal of Surgery Society Ltd [source] An Optimizing Compiler for Automatic Shader BoundingCOMPUTER GRAPHICS FORUM, Issue 4 2010Petrik Clarberg Abstract Programmable shading provides artistic control over materials and geometry, but the black box nature of shaders makes some rendering optimizations difficult to apply. In many cases, it is desirable to compute bounds of shaders in order to speed up rendering. A bounding shader can be automatically derived from the original shader by a compiler using interval analysis, but creating optimized interval arithmetic code is non-trivial. A key insight in this paper is that shaders contain metadata that can be automatically extracted by the compiler using data flow analysis. We present a number of domain-specific optimizations that make the generated code faster, while computing the same bounds as before. This enables a wider use and opens up possibilities for more efficient rendering. Our results show that on average 42,44% of the shader instructions can be eliminated for a common use case: single-sided bounding shaders used in lightcuts and importance sampling. [source] A multicentre review of the hairdressing allergens tested in the UKCONTACT DERMATITIS, Issue 3 2005Ruwani P. Katugampola Allergens used for patch testing in the hairdressing series vary between dermatology centres in the UK. The aim of our study is to ascertain the hairdressing allergens currently in use and their test results in several dermatology centres in the UK. Data were obtained from databases in 9 dermatology departments. The allergens with positive results and current/past relevance were included in a new hairdressing series based on collective experience, for wider use and further evaluation. [source] The case for long-acting antipsychotic agents in the post-CATIE eraACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2007H. A. Nasrallah Objective:, Long-acting antipsychotic agents were developed to promote treatment compliance in patients requiring maintenance treatment for schizophrenia. Method:, An analysis of the impact of non-compliance on treatment outcomes in schizophrenia and the advantages and disadvantages of long-acting antipsychotics. Results:, Partial or total non-compliance with oral antipsychotics remains widespread and is associated with significant increases in the risk of relapse, rehospitalization, progressive brain tissue loss and further functional deterioration. Long-acting agents have the potential to address issues of all-cause discontinuation and poor compliance. The development of the first long-acting atypical antipsychotic, which appears to be effective and well tolerated, should further improve the long-term management of schizophrenia. Conclusion:, Long-acting agents represent a valuable tool for the management of schizophrenia and merit wider use, especially in light of emerging literature regarding the neuroprotective advantages of atypical antipsychotics over conventional agents in terms of regenerating brain tissue during maintenance therapy. [source] Treatment of the myeloproliferative disorders with 32PEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 1 2000Nathaniel I. Berlin After World War II when 32P became widely available, it was used extensively to treat the chronic leukemias and polycythemia vera. Its use in the treatment of essential thrombocythemia began later in 1950. Today it is not widely used in the treatment of the chronic leukemia, if at all, its use in polycythemia vera appears to have decreased substantially and replaced by hydroxyurea, and its use in the management of essential thrombocythemia is not widespread. In each instance it has been replaced by a drug developed for use in cancer chemotherapy, and in some instances by interferon. It probably has wider use in polycythemia vera in the rest of Western Europe than in the UK, and there are cogent reasons to suggest that it may be the best tool for the treatment of polycythemia vera. Thus have we discarded a treatment modality that in polycythemia vera may be the best? [source] Linkage disequilibrium estimates of contemporary Ne using highly variable genetic markers: a largely untapped resource for applied conservation and evolutionEVOLUTIONARY APPLICATIONS (ELECTRONIC), Issue 3 2010Robin S. Waples Abstract Genetic methods are routinely used to estimate contemporary effective population size (Ne) in natural populations, but the vast majority of applications have used only the temporal (two-sample) method. We use simulated data to evaluate how highly polymorphic molecular markers affect precision and bias in the single-sample method based on linkage disequilibrium (LD). Results of this study are as follows: (1) Low-frequency alleles upwardly bias , but a simple rule can reduce bias to Women's working wardrobes: a study using card sortsEXPERT SYSTEMS, Issue 3 2005Sue Gerrard Abstract: Picture sorts were used to investigate perceptions of women's office clothes, with a sample of ten male and ten female subjects who normally worked in an office environment. The pictures on the cards were taken from catalogues, and showed women's outfits which might be worn in an office. The subjects sorted the cards repeatedly and generated criteria and categories of their own choice. Some of the criteria and categories had not been previously reported in the clothing research literature. Over half of the male subjects, but none of the female subjects, used ,married/unmarried woman' as a sorting criterion, although only one of the images sorted showed a wedding ring. A significantly higher proportion of male than of female subjects used dichotomous categorization (i.e. sorting the cards into two piles for one or more of the criteria). The reasons for this are obscure, but do not appear to be a simple outcome of males not knowing much about female clothing. Previous research into clothing has tended to involve researcher-centred approaches such as semiotics; the results from this study suggest that there would be advantages in wider use of subject-centred approaches such as card sorts, both in this domain and elsewhere. It was concluded that card sorts were a useful method and should be more widely used. [source] Reflective practice in nursing ethics education: international collaborationJOURNAL OF ADVANCED NURSING, Issue 2 2004Carol J. Leppa PhD RN Background., The Internet provides the opportunity for international comparative study and collaboration when learning about ethics in clinical nursing practice. Aim., This paper aims to discuss Internet links developed between US and UK postregistration nursing students who were reflecting on clinical practice in order to explore how political and organizational structures of the health care system affect ethical decision-making. Discussion., An analysis is presented of the stages in developing an exchange course for students from these countries, which involved various combinations of classroom-based teaching, on-line discussions and international visits by students and teachers during its evolution. The strengths and weaknesses of the different methods are considered, and future developments identified. Conclusion., The Internet collaboration resulted in postregistration nursing students using reflection on practice in the study of ethics in clinical practice and an understanding of how systems structures and procedures affect ethical decision making. Internet-assisted teaching offers opportunities for collaboration, and student participants demonstrate sophisticated critical thinking in ethical decision-making. Issues of access barriers and motivation remain challenges to wider use. [source] Mechanical Circulatory Support for AMI and Cardiogenic ShockJOURNAL OF CARDIAC SURGERY, Issue 4 2010Yasir Abu-Omar D.Phil. The dismal prognosis associated with post-MI cardiogenic shock, allied with surgical and technological advancements, has shifted the treatment paradigm toward wider use of mechanical circulatory support devices (MCSD). Current experience demonstrates that better outcomes may be achieved with early MCSD deployment (prior to the onset of end-organ dysfunction). However, perceived limitations with existing devices mean that they remain infrequently applied. There is an urgent need for increased awareness of MCSD options among clinicians treating post-MI shock patients. (J Card Surg 2010;25:434-441) [source] Increased Incidence of Gastrointestinal Bleeding Following Implantation of the HeartMate II LVADJOURNAL OF CARDIAC SURGERY, Issue 3 2010David R. Stern M.D. To avoid device-related thromboembolic complications, antiplatelet, and anticoagulation therapy are routinely administered. A worrisome frequency of gastrointestinal (GI) bleeding events has been observed. Methods: A retrospective review of all 33 patients undergoing long-term LVAD implantation between June 1, 2006 and July 31, 2008 at our institution for any indication was conducted. Anticoagulation consisted of heparin (intravenous or subcutaneous) followed by transition to Coumadin therapy to a target INR of two to three. Antiplatelet therapy consisted of low-dose aspirin and dipyridamole. Results: Twenty patients received the HMII and 13 patients received other devices. Eight (40%) HMII recipients suffered at least one episode of GI bleeding while no GI bleeding occurred in recipients of other devices (p = 0.012). Of 17 total bleeding episodes, no definitive source could be identified in 11 instances (65%). Conclusions: Although definitive source identification remains elusive, we believe that the majority of bleeding arises in the small bowel, possibly due to angiodysplasias, similar to the pathophysiology encountered in patients with aortic stenosis and GI bleeding. As we move toward wider use of the HMII and other axial continuous-flow devices in both bridge-to-transplant patients and for destination therapy, more studies will be necessary to understand the mechanisms of this obscure GI bleeding and develop treatment strategies to minimize its development.,(J Card Surg 2010;25:352-356) [source] Is there an easier way to autograft skin in chronic leg ulcers? ,Minced micrografts', a new techniqueJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 10 2008P Boggio Abstract Background Chronic venous leg ulcers represent an urgent and increasing problem for public health. The use of skin autografts results in a greater therapeutic success in healing chronic ulcers. Objective A simple method of skin autografting that could permit a wider use of skin grafts in outpatients is needed. A new technique allowing skin autografting in a simple one-step process, without complex surgical procedures or expensive technical supplies, is presented. Methods A small, full-thickness skin specimen taken from the patient is finely minced and spread on his leg ulcer bed allowing to cover a surface many times wider than the sample itself. Results This method induces faster re-epithelization of chronic leg ulcers that failed to heal despite good conservative local therapy and give the possibility to repair very large ulcers with small fragments of skin. A clinical case is shown as an example out of 20 ulcers we recently treated. Conclusion Our preliminary report shows that this technique results in a greater therapeutic success (18 of 20 cases) in healing chronic leg ulcers, a common pathology that often affects outpatients treated for very long periods at home or in the Dermatologist's office. In our experience, this new and successful reparative possibility makes ,mince grafting' a recommendable procedure. [source] Binding of extracellular matrix molecules by probiotic bacteriaLETTERS IN APPLIED MICROBIOLOGY, Issue 4 2003tyriak Abstract Aims: The aim of this study was to investigate extracellular matrix (ECM) and mucin binding of selected bacterial isolates with probiotic features in comparison with commercially used probiotic bacteria. Methods and Results: ECM molecules were immobilized in microtitre plates (mucin and fetuin) or on the surface of latex beads. Porcine mucin was bound by all 13 probiotic strains tested with important inter-strain differences; however, fetuin binding was similar (weak) for all 14 strains tested. Strongly positive (three) binding of bovine fibrinogen was expressed by strains from fermented food (Lactobacillus rhamnosus GG, L. casei Shirota and L. johnsonii La1) as well as by L. casei L.c., Lactobacillus sp. 2I3 and by L. plantarum LP. The other strains expressed moderate (2) or weakly positive (1) binding of bovine fibrinogen. Strongly positive (3) binding of porcine fibronectin was observed only with two strains; however, all other strains also bound this molecule. Bovine lactoferrin was bound to a higher extent than transferrins. Significance and Impact of the Study: Some animal strains (at least L. casei L.c. and Lactobacillus sp. 2I3) are comparable with the commercially used strains with respect to their ECM binding ability. As this feature is important for probiotic bacteria to be able to colonize intestine, these strains should be considered for their wider use in fermented feed (or probiotic preparations) for animals. [source] Thresholds for food allergens and their value to different stakeholdersALLERGY, Issue 5 2008R. W. R Crevel Thresholds constitute a critical piece of information in assessing the risk from allergenic foods at both the individual and population levels. Knowledge of the minimum dose that can elicit a reaction is of great interest to all food allergy stakeholders. For allergic individuals and health professionals, individual threshold data can inform allergy management. Population thresholds can help both the food industry and regulatory authorities assess the public health risk and design appropriate food safety objectives to guide risk management. Considerable experience has been gained with the double-blind placebo-controlled food challenge (DBPCFC), but only recently has the technique been adapted to provide data on thresholds. Available data thus vary greatly in quality, with relatively few studies providing the best quality individual data, using the low-dose DBPCFC. Such high quality individual data also form the foundation for population thresholds, but these also require, in addition to an adequate sample size, a good characterization of the tested population in relation to the whole allergic population. Determination of thresholds at both an individual level and at a population level is influenced by many factors. This review describes a low-dose challenge protocol developed as part of the European Community-funded Integrated Project Europrevall, and strongly recommends its wider use so that data are generated that can readily increase the power of existing studies. [source] Application of a computer model to evaluate the ability of plastics to act as functional barriersPACKAGING TECHNOLOGY AND SCIENCE, Issue 3 2003Jong-Koo Han Abstract A simulation model computer program, which accounts for not only the diffusion process inside the polymer but also partitioning of the contaminant between the polymer and the contacting phase, was developed based on a numerical treatment, the finite element method, to quantify migration through multilayer structures. The accuracy of the model in predicting migration was demonstrated successfully by comparing simulated results to experimental data. For this study, three-layer co-extruded high density polyethylene (HDPE) film samples, having a symmetrical structure with a contaminated core layer and virgin outer layers as the functional barriers, were fabricated with varying thickness of the outer layers and with a known amount of selected contaminant simulant, 3,5-di-t-butyl-4-hydroxytoluene (BHT), in the core layer. Migration of the contaminant simulant from the core layer to the liquid food simulants was determined experimentally as a function of the thickness of the outer layer at different temperatures. The computer program, developed as a total solution package for migration problems, can be applied not only to multilayer structures made with the same type of plastics but also to structures with different plastics, e.g. PP/PE/PP. This work might provide the potential for wider use of recycled plastic, especially polyolefins, which have lower barrier properties, in food packaging, and simplification of the task of convincing the FDA that adequate safety guarantees have been provided. Copyright © 2003 John Wiley & Sons, Ltd. [source] Poverty Intensity in AustraliaTHE AUSTRALIAN ECONOMIC REVIEW, Issue 3 2000J. R. Rodgers Even though poverty indices with axiomatically sound properties have been advocated for several decades, most empirical studies of poverty in Australia and elsewhere continue to use the crude, but easily understood, head-count ratio. The difficulty of interpreting the axiomatically more desirable indices is a major reason why their use has been resisted in applied poverty measurement. This paper demonstrates how the more sophisticated poverty indices can be converted into a form that is readily interpreted as a measure of poverty intensity of a group, relative to the population to which the group belongs. The resulting poverty-intensity index is easy to understand and it retains the axiomatic properties of the poverty index on which it is based. We apply the method to Australian data. Poverty measures reported previously in the literature are converted into measures of poverty intensity and interpreted accordingly. We also calculate and interpret some new measures of poverty and poverty intensity using the 1996,97 Income and Housing Costs Survey, Australia (Australian Bureau of Statistics 1997). It is hoped our procedure will lead to wider use of poverty indices that are theoretically superior to the head-count ratio. [source] Monitoring stress levels in postgraduate medical trainingTHE LARYNGOSCOPE, Issue 1 2009Justin D. Hill MD Abstract Objectives: The Accreditation Council for Graduate Medical Education (ACGME) mandates that residency Program Directors (PD) monitor resident well-being, including stress. Burnout, as a measure of work-related stress, is defined by a high degree of emotional exhaustion and depersonalization, and a low degree of personal accomplishment using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). The purpose of this study is to describe the use of the MBI-HSS as a method of monitoring stress levels in an academic otolaryngology residency training program and introduce this survey as a tool for wider use in meeting ACGME requirements. Methods: The MBI-HSS was administered to residents in an academic otolaryngology residency training program on three separate occasions: at the beginning, middle, and end of different academic years. In addition, at the time of the third administration, the MBI-HSS was completed by faculty and staff in the same department. Surveys were completed and collected anonymously. Responses were scored against normative data from the MBI-HSS overall sample and the medicine subscale. Low, average, and high levels of burnout were identified for the individual categories of emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA); average levels for each category were calculated. Results: Twenty-two residents completed the first survey, taken near the end of an academic year; 19 completed the second administration in the middle of the following academic year; and 24 completed the third survey at the beginning of the subsequent academic year. Thirteen faculty and 23 staff also completed the third survey. We found that three, one, and one residents reported high levels of burnout on the first, second, and third surveys, respectively. These figures compare to one faculty member and no staff members in the same department reporting high levels of burnout. Conclusions: The MBI-HSS is an established and validated tool for identifying burnout in resident physicians. Residency PDs may find the MBI-HSS useful as an aid in monitoring resident well-being and stress. In our own department, we found levels of burnout comparable to those previously reported for residents and faculty in this specialty. Laryngoscope, 119:75,78, 2009 [source] Protocol Biopsies in Renal Transplantation: Insights into Patient Management and PathogenesisAMERICAN JOURNAL OF TRANSPLANTATION, Issue 3 2007M. Mengel A 1-day symposium on the application of protocol biopsies in renal transplantation was held in Boston, 21 July 2006. Representatives from centers with extensive experience in the use of protocol biopsies for routine patient care and research reported results on the pathological findings and their value in patient management. The consensus was that protocol biopsies, in experienced hands, are a safe and valuable means of detecting subclinical disease that can benefit from modification of therapy. Furthermore, molecular studies reveal evidence of activity or progression not readily appreciated by histological techniques. Wider application is expected in multicenter clinical trials to predict and validate outcomes. The principal barrier to wider use of protocol biopsies is knowledge of the benefits of intervention. [source] Geographical information systems-based models for offshore floating marine fish cage aquaculture site selection in Tenerife, Canary IslandsAQUACULTURE RESEARCH, Issue 10 2005Oscar M Pérez Abstract The present study focuses on the development of a standard methodology for selection of suitable sites for offshore (exposed) marine fish-cage farming (floating cages) of seabream (Sparus aurata) and seabass (Dicentrarchus labrax) in an island environment, using Tenerife as an example. Site selection is a key factor in any aquaculture operation, affecting both success and sustainability and can solve conflicts between different activities, making a rational use of the coastal space. Site selection was achieved by using geographical information systems (GIS)-based models and related technology to support the decision-making process. The framework for spatial multicriteria decision analysis used in this study began with a recognition and definition of the decision problem. Subsequently, 31 production functions (factors and constraints) were identified, defined and subdivided into eight submodels. These were then integrated into a GIS database in the form of thematic layers and later scored for standardization. At this stage, the database was verified by field sampling to establish the quality of data used. The decision maker's preferences were incorporated into the decision model by assigning weights of relative importance to the evaluation under consideration. These, together with the thematic layers, were incorporated using multicriteria evaluation techniques and simple overlays to provide an overall assessment of possible alternatives. The integration, manipulation and presentation of the results by means of GIS-based models in this sequential and logical flow of steps proved to be very effective for helping the decision-making process of site selection. Tenerife has very favourable environmental conditions for culture of marine fish and there are no totally unsuitable sites for cage farming identified in this study. On the other hand, there are few very suitable sites (high scores) either, principally due to the heavy use of the coastline and the conflicts between different users. From the 228 km2 of available area for siting cages in the coastal regions with depth less than 50 m, the total area suitable for siting cages (scores 6,8) was 37 km2. There are only 0.51 km2 of very suitable areas (score 8) and approximately 5.37 km2 of suitable (score 7), most of these being located in the southeast of the island. These relatively small areas of suitability should be put into the context of the wider use of the coastal environment around Tenerife. [source] The potential of long-wavelength satellite-borne radar to support implementation of the Ramsar Wetlands ConventionAQUATIC CONSERVATION: MARINE AND FRESHWATER ECOSYSTEMS, Issue 3 2007Ake Rosenqvist Abstract 1.This paper provides an introduction to Synthetic Aperture Radar (SAR) remote sensing and, in particular, the significance of long-wavelength (L-band) SAR for wetland applications relevant to the Ramsar Wetlands Convention. 2.The Convention has long been a supporter of effective wetland inventory being used to support management initiatives and the wise use of all wetlands. 3.Three major application areas have been identified where SAR data may constitute an important additional information source for wetland inventory and management. These comprise mapping of below-canopy inundation, monitoring of environmental disturbances and wetland inventories based on SAR mosaics. These areas have all previously been supported in general terms by formal resolutions on wetland inventory and assessment through the Convention with recognition that further technique development was required. 4.The potential to make further use of remote sensing is increased through wider use of the special features of SAR in situations where other data are less suitable. 5.The Japanese Advanced Land Observing Satellite (ALOS) provides an opportunity to support the Convention and its goal of wise use of all wetlands. Copyright © 2007 John Wiley & Sons, Ltd. [source] A Sample Size Formula for the Supremum Log-Rank StatisticBIOMETRICS, Issue 1 2005Kevin Hasegawa Eng Summary An advantage of the supremum log-rank over the standard log-rank statistic is an increased sensitivity to a wider variety of stochastic ordering alternatives. In this article, we develop a formula for sample size computation for studies utilizing the supremum log-rank statistic. The idea is to base power on the proportional hazards alternative, so that the supremum log rank will have the same power as the standard log rank in the setting where the standard log rank is optimal. This results in a slight increase in sample size over that required for the standard log rank. For example, a 5.733% increase occurs for a two-sided test having type I error 0.05 and power 0.80. This slight increase in sample size is offset by the significant gains in power the supremum log-rank test achieves for a wide range of nonproportional hazards alternatives. A small simulation study is used for illustration. These results should facilitate the wider use of the supremum log-rank statistic in clinical trials. [source] Value of post-nasal space biopsy in patients with adult onset serous otitis mediaCLINICAL OTOLARYNGOLOGY, Issue 3 2006A.H. Sadr Background. Otitis media with effusion (OME) is common in children but this is not the case in adults. In adults it can be associated with nasopharyngeal neoplasms (NPN). It is accepted practice in the UK to biopsy the posterior nasal space (PNS) to rule out neoplasms. We believe this routine practice is no longer justified in view of modern methods of examination of PNS. Aims and objectives. To identify the incidence of NPN in adults with otitis media with effusion without any other signs and symptoms suggestive of NPN. We also identified the presenting symptoms and signs of all patients who were diagnosed with NPN during the study period. Methods. This is a retrospective study of 158 adult onset otitis media who had a posterior nasal space biopsy performed. The patients with positive and negative biopsy results were analysed for their presenting signs and symptoms. Results. Only 58 patients had OME as the sole presentation. The rest had other signs or symptoms in addition to OME. All patients with OME as the sole presentation had negative biopsy results and all patients with a positive biopsy result for NPN had other symptoms or signs in addition to OME. Conclusions. The role of PNS biopsy in adults with isolated OME seems to be questionable in view of the limited information it provides. This may be due to wider use of endoscopes which enable us to detect small abnormalities in PNS. [source]
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