High-risk patients and high-risk grafts in infrainguinal bypass for critical limb ischaemia

The main purpose of revascularization procedures for critical limb ischaemia (CLI) is to preserve the leg and sustain the patient s ambulatory status. Other goals are ischaemic pain relief and healing of ischaemic ulcers. Patients with CLI are usually old and have several comorbidities affecting the outcome. Revascularization for CLI is meaningless unless both life and limb are preserved. Therefore, the knowledge of both patient- and bypass-related risk factors is of paramount importance in clinical decision-making, patient selection and resource allocation. The aim of this study was to identify patient- and graft-related predictors of impaired outcome after infrainguinal bypass for CLI. The purpose was to assess the outcome of high-risk patients undergoing infrainguinal bypass and to evaluate the usefulness of specific risk scoring methods. The results of bypasses in the absence of optimal vein graft material were also evaluated, and the feasibility of the new method of scaffolding suboptimal vein grafts was assessed. The results of this study showed that renal insufficiency - not only renal failure but also moderate impairment in renal function - seems to be a significant risk factor for both limb loss and death after infrainguinal bypass in patients with CLI. Low estimated GFR (PIENEMPI KUIN 30 ml/min/1.73 m2) is a strong independent marker of poor prognosis. Furthermore, estimated GFR is a more accurate predictor of survival and leg salvage after infrainguinal bypass in CLI patients than serum creatinine level alone. We also found out that the life expectancy of octogenarians with CLI is short. In this patient group endovascular revascularization is associated with a better outcome than bypass in terms of survival, leg salvage and amputation-free survival especially in presence of coronary artery disease. This study was the first one to demonstrate that Finnvasc and modified Prevent III risk scoring methods both predict the long-term outcome of patients undergoing both surgical and endovascular infrainguinal revascularization for CLI. Both risk scoring methods are easy to use and might be helpful in clinical practice as an aid in preoperative patient selection and decision-making. Similarly than in previous studies, we found out that a single-segment great saphenous vein graft is superior to any other autologous vein graft in terms of mid-term patency and leg salvage. However, if optimal vein graft is lacking, arm vein conduits are superior to prosthetic grafts especially in infrapopliteal bypasses for CLI. We studied also the new method of scaffolding suboptimal quality vein grafts and found out that this method may enable the use of vein grafts of compromised quality otherwise unsuitable for bypass grafting. The remarkable finding was that patients with the combination of high operative risk due to severe comorbidities and risk graft have extremely poor survival, suggesting that only relatively fit patients should undergo complex bypasses with risk grafts. The results of this study can be used in clinical practice as an aid in preoperative patient selection and decision-making. In the future, the need of vascular surgery will increase significantly as the elderly and diabetic population increases, which emphasises the importance of focusing on those patients that will gain benefit from infrainguinal bypass. Therefore, the individual risk of the patient, ambulatory status, outcome expectations, the risk of bypass procedure as well as technical factors such as the suitability of outflow anatomy and the available vein material should all be assessed and taken into consideration when deciding on the best revascularization strategy.

Constructing and negotiating entrepreneurial agency : A social psychological approach to entrepreneurship discourse in the farm context

Entrepreneurship, understood as the autonomous, effective pursuit of opportunities regardless of resources, is currently subject to a multitude of interests, expectations, and facilitation efforts. On the one hand, such entrepreneurial agency has broad appeal to individuals in Western market democracies and resonates with their longing for an autonomous, personally tailored, meaningful, and materially rewarding way of life. On the other hand, entrepreneurship represents a tempting and increasingly popular means of governance and policy making, and thus a model for the re-organization of a variety of societal sectors. This study focuses on the diffusion and reception of entrepreneurship discourse in the context of farming and agriculture, where pressures to adopt entrepreneurial orientations have been increasingly pronounced while, on the other hand, the context of farming has historically enjoyed state protection and adhered to principles that seem at odds with aspects of individualistic entrepreneurship discourse . The study presents an interpretation of the psychologically and politically appealing uses of the notion of entrepreneurial agency , reviews the historical and political background of the current situation of farming and agriculture with regard to entrepreneurship, and examines their relationships in four empirical studies. The study follows and develops a social psychological, situated relational approach that guides the qualitative analyses and interpretations of the empirical studies. Interviews with agents from the farm sector aim to stimulate evaluative responses and comments on the idea of entrepreneurship on farms. Analysis of the interview talk, in turn, detects the variety of evaluative responses and argumentative contexts with which the interviewees relate themselves to the entrepreneurship discourse and adopt, use, resist, or reject it. The study shows that despite the pressures towards entrepreneurialism, the diffusion of entrepreneurship discourse and the construction of entrepreneurial agency in farm context encounter many obstacles. These obstacles can be variably related to aspects dealing with the individual agent, the action situation, the characteristics of the action itself, or to the broader social, institutional and cultural context. Many aspects of entrepreneurial agency, such as autonomy, personal initiative and achievement orientation, are nevertheless familiar to farmers and are eagerly related to one s own farming activities. The idea of entrepreneurship is thus rarely rejected outright. The findings highlight the relational and situational preconditions for the construction of entrepreneurial agency in the farm context: When agents demonstrate entrepreneurial agency, they do so by drawing on available and accessed relational resources characteristic of their action context. Likewise, when agents fail or are reluctant to demonstrate entrepreneurial agency, they nevertheless actively account for their situation and demonstrate personal agency by drawing on the relational resources available to them.

On the basin-scale detection and attribution of human-induced climate change in monsoon precipitation and streamflow

Detecting and quantifying the presence of human-induced climate change in regional hydrology is important for studying the impacts of such changes on the water resources systems as well as for reliable future projections and policy making for adaptation. In this article a formal fingerprint-based detection and attribution analysis has been attempted to study the changes in the observed monsoon precipitation and streamflow in the rain-fed Mahanadi River Basin in India, considering the variability across different climate models. This is achieved through the use of observations, several climate model runs, a principal component analysis and regression based statistical downscaling technique, and a Genetic Programming based rainfall-runoff model. It is found that the decreases in observed hydrological variables across the second half of the 20th century lie outside the range that is expected from natural internal variability of climate alone at 95% statistical confidence level, for most of the climate models considered. For several climate models, such changes are consistent with those expected from anthropogenic emissions of greenhouse gases. However, unequivocal attribution to human-induced climate change cannot be claimed across all the climate models and uncertainties in our detection procedure, arising out of various sources including the use of models, cannot be ruled out. Changes in solar irradiance and volcanic activities are considered as other plausible natural external causes of climate change. Time evolution of the anthropogenic climate change ``signal'' in the hydrological observations, above the natural internal climate variability ``noise'' shows that the detection of the signal is achieved earlier in streamflow as compared to precipitation for most of the climate models, suggesting larger impacts of human-induced climate change on streamflow than precipitation at the river basin scale.

Fabrication of a novel biomaterial with enhanced mechanical and conducting properties

Conducting polymers have the combined advantages of metal conductivity with ease in processing and biocompatibility; making them extremely versatile for biosensor and tissue engineering applications. However, the inherent brittle property of conducting polymers limits their direct use in such applications which generally warrant soft and flexible material responses. Addition of fillers increases the material compliance, but is achieved at the cost of reduced electrical conductivity. To retain suitable conductivity without compromising the mechanical properties, we fabricate an electroactive blend (dPEDOT) using low grade PEDOT: PSS as the base conducting polymer with polyvinyl alcohol as filler and glycerol as a dopant. Bulk dPEDOT films show a thermally stable response till 110 degrees C with over seven fold increase in room temperature conductivity as compared to 0.002 S cm(-1) for pristine PEDOT: PSS. We characterize the nonlinear stress-strain response of dPEDOT, well described using a Mooney-Rivlin hyperelastic model, and report elastomer-like moduli with ductility similar to fives times its original length. Dynamic mechanical analysis shows constant storage moduli over a large range of frequencies with corresponding linear increase in tan(delta). We relate the enhanced performance of dPEDOT with the underlying structural constituents using FTIR and AFM microscopy. These data demonstrate specific interactions between individual components of dPEDOT, and their effect on surface topography and material properties. Finally, we show biocompatibility of dPEDOT using fibroblasts that have comparable cell morphologies and viability as the control, which make dPEDOT attractive as a biomaterial.

Classified one-step modified signed-digit arithmetic and its optical implementation

Based on the two-step modified signed-digit (MSD) algorithm, we present a one-step algorithm for the parallel addition and subtraction of two MSD numbers. This algorithm is reached by classifying the three neighboring digit pairs into 10 groups and then making a decision on the groups. It has only a look-up truth table, and can be further formulated by eight computation rules. A joint spatial encoding technique is developed to represent both the input data and the computation rules. Furthermore, an optical correlation architecture is suggested to implement the MSD adder in parallel. An experimental demonstration is also given. (C) 1996 Society of Photo-Optical instrumentation Engineers.

Indicators for management of coral reefs and their applications to marine protected areas

Informed planning and decision-making in the management of natural resources requires an ability to integrate complex interactions in ecosystems and communicate these effectively to stakeholders. This involves coping with three fundamental dilemmas. The first comes from the irregular pulse of nature. The second is the recognition that there are no strictly objective criteria for judging the well-being of an ecosystem. The third is posed by the quest for indicators with some integrative properties that may be used to analyze an ecosystem and impart the information to the relevant resource users. This paper presents some examples of indicators used to: 1) assess the status of a coral reef and, in particular, the state of its fisheries resources; 2) identify reefs that are most threatened by human activities; and 3) evaluate the likelihood of success of management interventions. These indicators are not exhaustive, but illustrate the range of options available for the management of coral reef ecosystems.

Indicators for management of coral reefs and their applications to marine protected areas

Informed planning and decision-making in the management of natural resources requires an ability to integrate complex interactions in ecosystems and communicate these effectively to stakeholders. This involves coping with three fundamental dilemmas. The first comes from the irregular pulse of nature. The second is the recognition that there are no strictly objective criteria for judging the “well-being” of an ecosystem. The third is posed by the quest for indicators with some integrative properties that may be used to analyze an ecosystem and impart the information to the relevant resource users. This paper presents some examples of indicators used to: 1) assess the status of a coral reef and, in particular, the state of its fisheries resources; 2) identify reefs that are most threatened by human activities; and 3) evaluate the likelihood of success of management interventions. These indicators are not exhaustive, but illustrate the range of options available for the management of coral reef ecosystems.

Building social and ecological resilience to climate change in Roviana, Solomon Islands: PASAP country activity for Solomon Islands: Brief review: climate change trends and projections for Solomon Islands

As part of the Australian Government’s International Climate Change Adaptation Initiative (ICCAI), the Pacific Adaptation Strategy Assistance Program (PASAP) aims to enhance the capacity of partner countries to assess key vulnerabilities and risks, formulate adaptation strategies and plans, mainstream adaptation into decision-making, and inform robust longterm national planning and decision-making in partner countries. The Department of Climate Change and Energy Efficiency contracted University of Queensland (UQ) and University of California, Santa Barbara (UCSB) to lead the project: “Building social and ecological resilience to climate change in Roviana, Solomon Islands” (2010-2012). Under this project The WorldFish Center was subcontracted to undertake outputs 5 and 6 of Objective three: (5) Review of climate change evidence and projections for the study area and (6) Vulnerability and adaptation assessment for the study area. This report addresses the first of these and comprises a desktop review of climate change evidence and projections for the study area.

Integration of fisheries acoustics surveys and bathymetric mapping to characterize midwater-seafloor habitats of US Virgin Islands and Puerto Rico (2008-2010)

NOAA’s Coral Reef Conservation program (CRCP) develops coral reef management priorities by bringing together various partners to better understand threats to coral reef ecosystems with the goal of conserving, protecting and restoring these resources. Place-based and ecosystem-based management approaches employed by CRCP require that spatially explicit information about benthic habitats and fish utilization are available to characterize coral reef ecosystems and set conservation priorities. To accomplish this, seafloor habitat mapping of coral reefs around the U.S. Virgin Islands (USVI) and Puerto Rico has been ongoing since 2004. In 2008, fishery acoustics surveys were added to NOAA survey missions in the USVI and Puerto Rico to assess fish distribution and abundance in relation to benthic habitats in high priority conservation areas. NOAA’s National Centers for Coastal Ocean Science (NCCOS) have developed fisheries acoustics survey capabilities onboard the NOAA ship Nancy Foster to complement the CRCP seafloor habitat mapping effort spearheaded by the Center for Coastal Monitoring and Assessment Biogeography Branch (CCMA-BB). The integration of these activities has evolved on the Nancy Foster over the three years summarized in this report. A strategy for improved operations and products has emerged over that time. Not only has the concurrent operation of multibeam and fisheries acoustics surveys been beneficial in terms of optimizing ship time and resources, this joint effort has advanced an integrated approach to characterizing bottom and mid-water habitats and the fishes associated with them. CCMA conducts multibeam surveys to systematically map and characterize coral reef ecosystems, resulting in products such as high resolution bathymetric maps, backscatter information, and benthic habitat classification maps. These products focus on benthic features and live bottom habitats associated with them. NCCOS Centers (the Center for Coastal Fisheries and Habitat Research and the Center for Coastal Environmental Health and Biomolecular Research) characterize coral reef ecosystems by using fisheries acoustics methods to capture biological information through the entire water column. Spatially-explicit information on marine resources derived from fisheries acoustics surveys, such as maps of fish density, supports marine spatial planning strategies and decision making by providing a biological metric for evaluating coral reef ecosystems and assessing impacts from pollution, fishing pressure, and climate change. Data from fisheries acoustics surveys address management needs by providing a measure of biomass in management areas, detecting spatial and temporal responses in distribution relative to natural and anthropogenic impacts, and identifying hotspots that support high fish abundance or fish aggregations. Fisheries acoustics surveys conducted alongside multibeam mapping efforts inherently couple water column data with information on benthic habitats and provide information on the heterogeneity of both benthic habitats and biota in the water column. Building on this information serves to inform resource managers regarding how fishes are organized around habitat structure and the scale at which these relationships are important. Where resource managers require place-based assessments regarding the location of critical habitats along with high abundances of fish, concurrent multibeam and fisheries acoustics surveys serve as an important tool for characterizing and prioritizing coral reef ecosystems. This report summarizes the evolution of fisheries acoustics surveys onboard the NOAA ship Nancy Foster from 2008 to 2010, in conjunction with multibeam data collection, aimed at characterizing benthic and mid-water habitats in high priority conservation areas around the USVI and Puerto Rico. It also serves as a resource for the continued development of consistent data products derived from acoustic surveys. By focusing on the activities of 2010, this report highlights the progress made to date and illustrates the potential application of fisheries data derived from acoustic surveys to the management of coral reef ecosystems.

CLADP - THE CAMBRIDGE LINEAR ANALYSIS AND DESIGN PROGRAMS USER REFERENCE MANUAL (4TH ISSUE: APRIL 1983).

CLADP is an engineering software program developed at Cambridge University for the interactive computer aided design of feedback control systems. CLADP contains a wide range of tools for the analysis of complex systems, and the assessment of their performance when feedback control is applied, thus enabling control systems to be designed to meet difficult performance objectives. The range of tools within CLADP include the latest techniques in the field whose central theme is the extension of classical frequency domain concepts (well known and well proven for single loop systems) to multivariable or multiloop systems, and by making extensive use of graphical presentation information is provided in a readily understood form.

A framework for clarifying the meaning of Triple Bottom-Line, Integrated, and Sustainability Assessment

Terms such as Integrated Assessment and Sustainability Assessment are used to label 'new' approaches to impact assessment that are designed to direct planning and decision-making towards sustainable development (SD). Established assessment techniques, such as EIA and SEA, are also widely promoted as SD 'tools'. This paper presents the findings of a literature review undertaken to identify the features that are typically promoted for improving the SD-directedness of assessments. A framework is developed which reconciles the broad range of emerging approaches and tackles the inconsistent use of terminology. The framework comprises a three-dimensional space defined by the following axes: the comprehensiveness of the SD coverage; the degree of 'integration' of the techniques and themes; and the extent to which a strategic perspective is adopted. By applying the framework, assessment approaches can be positioned relative to one another, enabling comparison on the basis of substance rather than semantics. © 2007 Elsevier Inc. All rights reserved.

Differential encoding of losses and gains in the human striatum.

Studies on human monetary prediction and decision making emphasize the role of the striatum in encoding prediction errors for financial reward. However, less is known about how the brain encodes financial loss. Using Pavlovian conditioning of visual cues to outcomes that simultaneously incorporate the chance of financial reward and loss, we show that striatal activation reflects positively signed prediction errors for both. Furthermore, we show functional segregation within the striatum, with more anterior regions showing relative selectivity for rewards and more posterior regions for losses. These findings mirror the anteroposterior valence-specific gradient reported in rodents and endorse the role of the striatum in aversive motivational learning about financial losses, illustrating functional and anatomical consistencies with primary aversive outcomes such as pain.

Achievements and challenges in machine vision-based inspection of large concrete structures

Large concrete structures need to be inspected in order to assess their current physical and functional state, to predict future conditions, to support investment planning and decision making, and to allocate limited maintenance and rehabilitation resources. Current procedures in condition and safety assessment of large concrete structures are performed manually leading to subjective and unreliable results, costly and time-consuming data collection, and safety issues. To address these limitations, automated machine vision-based inspection procedures have increasingly been proposed by the research community. This paper presents current achievements and open challenges in vision-based inspection of large concrete structures. First, the general concept of Building Information Modeling is introduced. Then, vision-based 3D reconstruction and as-built spatial modeling of concrete civil infrastructure are presented. Following that, the focus is set on structural member recognition as well as on concrete damage detection and assessment exemplified for concrete columns. Although some challenges are still under investigation, it can be concluded that vision-based inspection methods have significantly improved over the last 10 years, and now, as-built spatial modeling as well as damage detection and assessment of large concrete structures have the potential to be fully automated.

Integrated MMI Optical Couplers and Optical Switches in Silicon-on-Insulator Technology

Integrated multimode interference (MMI) coupler based on silicon-on-insulator(SOI) has been becoming a kind of more and more attractive device in optical systems. SiO2thin cladding layers (＜1.0 μm) can be usedin SOI waveguide due to the large index step be-tween Si and SiO2, making them compatible with VLSI technology. The design and fabrica-tion of MMI optical couplers and optical switches in SOI technology are presented in thepa-per. We demonstrated the switching time of 2 × 2 MMI-MZI thermo-optical switch is less than 20 μs:

MMI optical couplers and switches with SOI technology

MMI (multimode interference) coupler, modulator and switch based on SOI (silicon- on-insulator) have been become more and more attractive in optical systems since they show important performances. SiO2 thin cladding layers (<1.0mum) can be used in SOI waveguide due to the large index step between Si and SiO2, making them compatible with the VLSI technology. The design and fabrication of multimode interference (MMI) optical coupler, modulator and switche in SOI technology are presented in the paper. The results demonstrated that the modulator has an extinction ratio of -11.0dB and excess loss of -2.5dB, while the optical switch has a crosstalk of -12.5dB and responding time of less than 20 mus.