Long-term Outcome After Monosegmental L4/5 Stabilization for Degenerative Spondylolisthesis With the Dynesys Device.

STUDY DESIGN Retrospective analysis of prospectively collected clinical data. OBJECTIVE To assess the long-term outcome of patients with monosegmental L4/5 degenerative spondylolisthesis treated with the dynamic Dynesys device. SUMMARY OF BACKGROUND DATA The Dynesys system has been used as a semirigid, lumbar dorsal pedicular stabilization device since 1994. Good short-term results have been reported, but little is known about the long-term outcome after treatment for degenerative spondylolisthesis at the L4/5 level. METHODS A total of 39 consecutive patients with symptomatic degenerative lumbar spondylolisthesis at the L4/5 level were treated with bilateral decompression and Dynesys instrumentation. At a mean follow-up of 7.2 years (range, 5.0-11.2 y), they underwent clinical and radiographic evaluation and quality of life assessment. RESULTS At final follow-up, back pain improved in 89% and leg pain improved in 86% of patients compared with preoperative status. Eighty-three percent of patients reported global subjective improvement. Ninety-two percent would undergo the surgery again. Eight patients (21%) required further surgery because of symptomatic adjacent segment disease (6 cases), late-onset infection (1 case), and screw breakage (1 case). In 9 cases, radiologic progression of spondylolisthesis at the operated segment was found. Seventy-four percent of operated segments showed limited flexion-extension range of <4 degrees. Adjacent segment pathology, although without clinical correlation, was diagnosed at the L5/S1 (17.9%) and L3/4 (28.2%) segments. In 4 cases, asymptomatic screw loosening was observed. CONCLUSIONS Monosegmental Dynesys instrumentation of degenerative spondylolisthesis at L4/5 shows good long-term results. The rate of secondary surgeries is comparable to other dorsal instrumentation devices. Residual range of motion in the stabilized segment is reduced, and the rate of radiologic and symptomatic adjacent segment degeneration is low. Patient satisfaction is high. Dynesys stabilization of symptomatic L4/5 degenerative spondylolisthesis is a possible alternative to other stabilization devices.

Grief, Physical Symptoms, and Decision-Making in Mothers of Newborns Who Die

The purpose of this study was to describe predictors of level of grief and physical symptoms in mothers during the year after a newborn death. This was undertaken to fmd better ways to help these mothers during this crisis. Following appropriate approvals, volunteer subjects were contacted through hospitals, the Internet, and a health department. Of the 75 who responded, 77% were White and married, 64% were Christian. 51 % had other living children, 72% had had no prior pregnancy losses, 87% had support with decision-making about newborn care, and their mean age was 30 yrs. Once subjects had agreed to take Par4 the survey and consent form were sent to them. Study outcome variables were: Total scores on the Perinatal Grief Scale, Short Version (level of grief; T oedter, Lasker, & Alhadeff. 1988) and Sickness Impact Profile 68 (level of physical symptoms; de Bruin, Buys, de Witte, & Diederiks, 1994). Predictor variables were total scores on the Personal Resources Questionnaire 85, Part U (perceived support; Brandt & Weinert, 1981); Relationship Satisfaction Questionnaire (relationship satisfaction; Olson & McCubbin, 1983); Emotion-Focused. Problem-Focused, and Mixed Coping Subscales (emotion-focused, problem-focused, and mixed coping; Lazarus & Folkman, 1988); interval since death, ethnicity, religion, socioeconomic status, gestational age, and presence of living children. Coefficient alphas for scales were all over .75. In two stepwise-hierarchical multiple regressions, perceived support and emotion- focused coping combined to predict 43% of the variance in level of grief, and level of grief alone predicted 50% of the variance in level of physical symptoms. In written comments, mothers said they valued their role in decision-making about newborn care even with death as the result. and felt supported in that process. Findings may be used to design intervention programs to help bereaved mothers following a newborn death. Specifically, programs can help increase perceived support for bereaved mothers, and teach new ways of coping. Both strategies may result in lower levels of grief and physical symptoms in this group of bereaved mothers.

(Table 1) Age of Cretaceous seamounts in the Western Pacific

Dynamics of the Pacific Plate is recorded in the systematic variation of location and the 40Ar-39Ar age of seamounts in the Western Pacific from 120 to 65 Ma ago. The seamounts are grouped into three linear zones as long as 5000 km. The seamounts become younger in the southeastern direction along the strike of these zones. Correlation between age and location of seamounts allows to divide the history of their formation into three stages. Rate of seamount growth was relatively low (2-4 cm/yr) during the first and the third stages within intervals of 120-90 and 85-65 Ma, whereas during the second stage (90-85 Ma), the seamounts were growing very fast (80-100 cm/yr). In the midst of this stage, at ~87 Ma ago, magmatic activity increased abruptly. Dynamics of seamount building is in good agreement with (1) pulses in development of the Ontong Java, Manihiki, and Caribbean-Colombian oceanic plateaus; (2) age of spreading acceleration in the mid-Cretaceous; and (3) a short period when the Izanagi Plate ceased to exist and the Kula Plate was formed. Variation in seamounts' age and location are in consistence with the hypothesis of diffuse extension of the Pacific Plate in course of its motion with formation of impaired zones of decompression melting. Direction of extension (325°-340° NW) calculated from the strike of seamount zones is consistent with the path of the Pacific Plate (330° NW) in the Late Cretaceous. Immense perioceanic volcanic belts were formed at that time along the margin of the Asian continent. The Okhotsk-Chukchi Peninsula Belt extends at a right angle to the compression vector. Three stages of this belt's evolution are synchronous with the stages of seamount formation in the Pacific Plate. Delay in origination of the East Sikhote-Alin Volcanic Belt and its different orientation were caused by counterclockwise rotation of the vector of convergence of oceanic and continental plates in the mid-Cretaceous. At the same time, i.e. 95-85 Ma ago, volcanic activity embraced the entire continental margin and tin granites were emplaced everywhere in the Eastern Asia. This short episode (90+/-5 Ma) corresponds to the mid-Cretaceous maximum of compression of the continental margin, and its age fits well a culmination in extension of the Pacific Plate.

Isotopic geochemistry of granitoids in the Jinshajiang suture zone, SW China

The Jinshajiang suture zone, located in the eastern part of the Tethyan tectonic domain, is noticeable for a large-scale distribution of Late Jurassic to Triassic granitoids. These granitoids were genetically related to the evolution of the Paleo-Tethys Ocean. The Beiwu, Linong and Lunong granitoids occur in the middle zone of the Jinshajiang Suture Zone, and possess similar geochemical features, indicating they share a common magma source. SIMS zircon U-Pb dating reveals the Beiwu, Linong and Lunong granitic intrusions were emplaced at 233.9±1.4 Ma (2 sigma), 233.1 ±1.4 Ma (2 sigma) and 231.0±1.6 Ma (2 sigma), respectively. All of these granitoids are enriched in abundances of Si (SiO2 =65.2-73.5 wt.%), and large-ion-lithophile-elements (LILEs), but depleted in high-field-strength-elements contents (HFSEs, e.g., Nb, Ta, Ti). In addition, they have low P2O5 contents (0.06-0.11 wt.%), A/CNK values ([molecular Al2O3/(CaO+Na2O+K2O)], mostly<1.1) and 10000Ga/Al ratios (1.7-2.2), consistent with the characteristics of I-type granites. In terms of isotopic compositions, these granitoids have high initial 87Sr/86Sr ratios (0.7078-0.7148), Pb isotopic compositions [(206Pb/204Pb)t=18.213-18.598, (207Pb/204Pb)t=15.637-15.730 and (208Pb/204Pb)t=38.323-38.791], zircon d18O values (7. per mil-9.3 per mil) and negative eNd(t) values (-5.1 to -6.7), suggesting they were predominantly derived from the continental crust. Their Nb/Ta ratios (average value=8.6) are consistent with those of the lower continental crust (LCC). However, variable ?Hf(t) values (-8.6 to +2.8) and the occurrences of mafic microgranular enclaves (MMEs) suggest that mantle-derived melts and lower crustal magmas were involved in the generation of these granitoids. Moreover, the high Pb isotopic ratios and elevated zircon d18O values of these rocks indicate a significant contribution of the upper crustal composition. We propose a model in which the Beiwu, Linong and Lunong granitoids were generated under a late collisional or post-collisional setting. It is possible that this collision was completed before Late Triassic. Decompression induced mantle-derived magmas underplated and provided the heat for the anatexis of the crust. Hybrid melts including mantle-derived and the lower crustal magmas were then generated. The hybrid melts thereafter ascended to a shallow depth and resulted in some degree of sedimentary rocks assimilation. Such three-component mixing magmas source and subsequent fractional crystallization could be responsible for the formation of the Beiwu, Linong and Lunong granitoids.

"La recuperación es para obedientes" : Algunas articulaciones y ajustes metodológicos para el análisis de un tratamiento de adicción a las drogas

El escrito reflexiona sobre la adecuación teórica y metodológica del recurso a las categorías institución total, dispositivo y disciplina, para investigar problemáticas recientes en el campo de la salud-enfermedad-atención, particularmente las denominadas adicciones a las drogas. De la mano de numerosas investigaciones empíricas, ciertos conceptos se anudan en los análisis, asociándose disciplina-encierro, e institución total-espacio cerrado. El escrito propone el desacople de estas nociones y la recuperación de su productividad analítica, desde la investigación en un dispositivo terapéutico ambulatorio para la adicción a drogas del Area Metropolitana de Buenos Aires. Se aborda esta problemática desde una perspectiva etnográfica, con análisis documental, observación participante y entrevistas realizadas a profesionales de la salud de la institución, personal de apoyo y usuarios. Se concluye que las formulaciones de Goffman y Foucault ayudan a comprender la existencia de modalidades de tratamiento para las adicciones a las drogas que, sin fundarse en el encierro como técnica primordial de control de los cuerpos, sostienen un proceso de clausura y despojo significativos; y que la renuncia a homologar la clausura, y el espacio cerrado a una materialidad, permitió dar realce a una vivencia de despojo subjetivo de parte de quienes se encuentran en tratamiento en la institución

"La recuperación es para obedientes" : Algunas articulaciones y ajustes metodológicos para el análisis de un tratamiento de adicción a las drogas

El escrito reflexiona sobre la adecuación teórica y metodológica del recurso a las categorías institución total, dispositivo y disciplina, para investigar problemáticas recientes en el campo de la salud-enfermedad-atención, particularmente las denominadas adicciones a las drogas. De la mano de numerosas investigaciones empíricas, ciertos conceptos se anudan en los análisis, asociándose disciplina-encierro, e institución total-espacio cerrado. El escrito propone el desacople de estas nociones y la recuperación de su productividad analítica, desde la investigación en un dispositivo terapéutico ambulatorio para la adicción a drogas del Area Metropolitana de Buenos Aires. Se aborda esta problemática desde una perspectiva etnográfica, con análisis documental, observación participante y entrevistas realizadas a profesionales de la salud de la institución, personal de apoyo y usuarios. Se concluye que las formulaciones de Goffman y Foucault ayudan a comprender la existencia de modalidades de tratamiento para las adicciones a las drogas que, sin fundarse en el encierro como técnica primordial de control de los cuerpos, sostienen un proceso de clausura y despojo significativos; y que la renuncia a homologar la clausura, y el espacio cerrado a una materialidad, permitió dar realce a una vivencia de despojo subjetivo de parte de quienes se encuentran en tratamiento en la institución

Geochemistry of picrite basalts from the Liohi Volcano

Research of the ocean floor using the Mir submersibles carried out south of the Hawaiian Archipelago allowed to recover flows of recent picrite basalts. Lava vents are confined to a field of development of open fractures of a gjar type. Basalts represent initial lava flows in the structure of the Hawaiian volcanic archipelago. Considering contents of alkali and rare-earth elements in them, the picrite basalts of the bottom could be assigned to a series of island tholeiites. They are products of high level melting of asthenospheric matter at depth about 75-80 km as a result of decompression near a deep fracture that occurred in the lithosphere and asthenosphere. Similar picrite basalts were found in the base of the youngest volcano of the Hawaiian chain the Loihi Volcano. With respect to contents of alkali metals, these rocks are assigned to the subalkaline series of rocks formed during melting of garnet lherzolites. This could probably be explained by supply of melts from deeper levels of the asthenosphere after partial packing of an initial magma effluent fracture.

"La recuperación es para obedientes" : Algunas articulaciones y ajustes metodológicos para el análisis de un tratamiento de adicción a las drogas

El escrito reflexiona sobre la adecuación teórica y metodológica del recurso a las categorías institución total, dispositivo y disciplina, para investigar problemáticas recientes en el campo de la salud-enfermedad-atención, particularmente las denominadas adicciones a las drogas. De la mano de numerosas investigaciones empíricas, ciertos conceptos se anudan en los análisis, asociándose disciplina-encierro, e institución total-espacio cerrado. El escrito propone el desacople de estas nociones y la recuperación de su productividad analítica, desde la investigación en un dispositivo terapéutico ambulatorio para la adicción a drogas del Area Metropolitana de Buenos Aires. Se aborda esta problemática desde una perspectiva etnográfica, con análisis documental, observación participante y entrevistas realizadas a profesionales de la salud de la institución, personal de apoyo y usuarios. Se concluye que las formulaciones de Goffman y Foucault ayudan a comprender la existencia de modalidades de tratamiento para las adicciones a las drogas que, sin fundarse en el encierro como técnica primordial de control de los cuerpos, sostienen un proceso de clausura y despojo significativos; y que la renuncia a homologar la clausura, y el espacio cerrado a una materialidad, permitió dar realce a una vivencia de despojo subjetivo de parte de quienes se encuentran en tratamiento en la institución

Representative analyses of pre-tectonic metabasic rocks and metapelitic gneiss from Sverdrupfjella, East Antarctica

Extensive high-grade polydeformed metamorphic provinces surrounding Archaean cratonic nuclei in the East Antarctic Shield record two tectono-thermal episodes in late Mesoproterozoic and late Neoproterozoic-Cambrian times. In Western Dronning Maud Land, the high-grade Mesoproterozoic Maud Belt is juxtaposed against the Archaean Grunehogna Province and has traditionally been interpreted as a Grenvillian mobile belt that was thermally overprinted during the Early Palaeozoic. Integration of new U-Pb sensitive high-resolution ion microprobe and conventional single zircon and monazite age data, and Ar-Ar data on hornblende and biotite, with thermobarometric calculations on rocks from the H.U. Sverdrupfjella, northern Maud Belt, resulted in a more complex P-T-t evolution than previously assumed. A c. 540?Ma monazite, hosted by an upper ampibolite-facies mineral assemblage defining a regionally dominant top-to-NW shear fabric, provides strong evidence for the penetrative deformation in the area being of Pan-African age and not of Grenvillian age as previously reported. Relics of an eclogite-facies garnet-omphacite assemblage within strain-protected mafic boudins indicate that the peak metamorphic conditions recorded by most rocks in the area (T = 687-758°C, P = 9·4-11·3?kbar) were attained subsequent to decompression from P > 12·9?kbar. By analogy with limited U-Pb single zircon age data and on circumstantial textural grounds, this earlier eclogite-facies metamorphism is ascribed to subduction and accretion around 565?Ma. Post-peak metamorphic K-metasomatism under amphibolite-facies conditions is ascribed to the intrusion of post-orogenic granite at c. 480?Ma. The recognition of extensive Pan-African tectonism in the Maud Belt casts doubts on previous Rodinia reconstructions, in which this belt takes a pivotal position between East Antarctica, the Kalahari Craton and Laurentia. Evidence of late Mesoproterozoic high-grade metamorphism during the formation of the Maud Belt exists in the form of c. 1035?Ma zircon overgrowths that are probably related to relics of granulite-facies metamorphism recorded from other parts of the Maud Belt. The polymetamorphic rocks are largely derived from a c. 1140?Ma volcanic arc and 1072 ± 10?Ma granite.

(Table 1) Characteristics of South Pole personnel according to forced expiratory flow (FEF25-75) response to altitude

The impact of acute altitude exposure on pulmonary function is variable. A large inter-individual variability in the changes in forced expiratory flows (FEFs) is reported with acute exposure to altitude, which is suggested to represent an interaction between several factors influencing bronchial tone such as changes in gas density, catecholamine stimulation, and mild interstitial edema. This study examined the association between FEF variability, acute mountain sickness (AMS) and various blood markers affecting bronchial tone (endothelin-1, vascular endothelial growth factor (VEGF), catecholamines, angiotensin II) in 102 individuals rapidly transported to the South Pole (2835 m). The mean FEF between 25 and 75% (FEF25-75) and blood markers were recorded at sea level and after the second night at altitude. AMS was assessed using Lake Louise questionnaires. FEF25-75 increased by an average of 12% with changes ranging from -26 to +59% from sea level to altitude. On the second day, AMS incidence was 36% and was higher in individuals with increases in FEF25-75 (41 vs. 22%, P = 0.05). Ascent to altitude induced an increase in endothelin-1 levels, with greater levels observed in individuals with decreased FEF25-75. Epinephrine levels increased with ascent to altitude and the response was six times larger in individuals with decreased FEF25-75. Greater levels of endothelin-1 in individuals with decreased FEF25-75 suggest a response consistent with pulmonary hypertension and/or mild interstitial edema, while epinephrine may be upregulated in these individuals to clear lung fluid through stimulation of beta2-adrenergic receptors.

Geochemistry of boninite and harzburgite of ODP Leg 125 basement samples

Holes drilled into the volcanic and ultrabasic basement of the Izu-Ogasawara and Mariana forearc terranes during Leg 125 provide data on some of the earliest lithosphere created after the start of Eocene subduction in the Western Pacific. The volcanic basement contains three boninite series and one tholeiite series. (1) Eocene low-Ca boninite and low-Ca bronzite andesite pillow lavas and dikes dominate the lowermost part of the deep crustal section through the outer-arc high at Site 786. (2) Eocene intermediate-Ca boninite and its fractionation products (bronzite andesite, andesite, dacite, and rhyolite) make up the main part of the boninitic edifice at Site 786. (3) Early Oligocene intermediate-Ca to high-Ca boninite sills or dikes intrude the edifice and perhaps feed an uppermost breccia unit at Site 786. (4) Eocene or Early Oligocene tholeiitic andesite, dacite, and rhyolite form the uppermost part of the outer-arc high at Site 782. All four groups can be explained by remelting above a subduction zone of oceanic mantle lithosphere that has been depleted by its previous episode of partial melting at an ocean ridge. We estimate that the average boninite source had lost 10-15 wt% of melt at the ridge before undergoing further melting (5-10%) shortly after subduction started. The composition of the harzburgite (<2% clinopyroxene, Fo content of about 92%) indicates that it underwent a total of about 25% melting with respect to a fertile MORB mantle. The low concentration of Nb in the boninite indicates that the oceanic lithosphere prior to subduction was not enriched by any asthenospheric (OIB) component. The subduction component is characterized by (1) high Zr and Hf contents relative to Sm, Ti, Y, and middle-heavy REE, (2) light REE-enrichment, (3) low contents of Nb and Ta relative to Th, Rb, or La, (4) high contents of Na and Al, and (5) Pb isotopes on the Northern Hemisphere Reference Line. This component is unlike any subduction component from active arc volcanoes in the Izu-Mariana region or elsewhere. Modeling suggests that these characteristics fit a trondhjemitic melt from slab fusion in amphibolite facies. The resulting metasomatized mantle may have contained about 0.15 wt% water. The overall melting regime is constrained by experimental data to shallow depths and high temperatures (1250? C and 1.5 kb for an average boninite) of boninite segregation. We thus envisage that boninites were generated by decompression melting of a diapir of metasomatized residual MORB mantle leaving the harzburgites as the uppermost, most depleted residue from this second stage of melting. Thermal constraints require that both subducted lithosphere and overlying oceanic lithosphere of the mantle wedge be very young at the time of boninite genesis. This conclusion is consistent with models in which an active transform fault offsetting two ridge axes is placed under compression or transpression following the Eocene plate reorganization in the Pacific. Comparison between Leg 125 boninites and boninites and related rocks elsewhere in the Western Pacific highlights large regional differences in petrogenesis in terms of mantle mineralogy, degree of partial melting, composition of subduction components, and the nature of pre-subduction lithosphere. It is likely that, on a regional scale, the initiation of subduction involved subducted crust and lithospheric mantle wedge of a range of ages and compositions, as might be expected in this type of tectonic setting.

SHRIMP U-Pb zircon data from Gjelsvikfjella, Dronning Maud Land, East Antarctica

The Maud Belt in Dronning Maud Land (western East Antarctic Craton) preserves a high-grade polyphase tectono-thermal history with two orogenic episodes of Mesoproterozoic (1.2-1.0 Ga) and Neoproterozoic (0.6-0.5 Ga) age. New SHRIMP U-Pb zircon data from southern Gjelsvikfjella in the northeastern part of the belt make it possible to differentiate between a series of magmatic and metamorphic events. The oldest event recorded is the formation of an extensive 1140-1130 Ma volcanic arc. This was followed by 1104 ± 8 Ma granitoids that might represent, together with so far undated mafic dykes, part of a decompression melting-related bimodal suite that reflects the sub-continental Umkondo igneous event. The first high-grade metamorphism is constrained at 1070 Ma. The metamorphic age data are similar to those obtained from other parts of the Maud Belt, but also from the Namaqua-Natal Belt in South Africa, but the preceding arc formation was diachronous in the two belts. This indicates that the two belts did not form a continuous volcanic arc unit as suggested in previous models, but became connected only at the end of the Mesoproterozoic. Intense reworking during the Neoproterozoic, probably as a result of continent-continent collision between components of Gondwana, is indicated by ductile refliation, further high-grade metamorphic recrystallisation and metamorphic zircon overgrowths at approximately 530 Ma. This was followed by late- to post-tectonic magmatism, reflected by 500 Ma granite bodies and 490 Ma aplite dykes as well as a 480 Ma gabbro body.

Ar and U-Th-Pb age determinations for minerals from ODP Holes of ODP Legs 173 and 210

We report U-Pb and 39Ar-40Ar measurements on plutonic rocks recovered from the Ocean Drilling Program (ODP) Legs 173 and 210. Drilling revealed continental crust (Sites 1067 and 1069) and exhumed mantle (Sites 1070 and 1068) along the Iberia margin and exhumed mantle (Site 1277) on the conjugate Newfoundland margin. Our data record a complex igneous and thermal history related to the transition from rifting to seafloor spreading. The results show that the rift-to-drift transition is marked by a stuttering start of MORB-type magmatic activity. Subsequent to initial alkaline magmatism, localized mid-oceanic ridge basalts (MORB) magmatism was again replaced by basin-wide alkaline events, caused by a low degree of decompression melting due to tectonic delocalization of deformation. Such "off-axis" magmatism might be a common process in (ultra-) slow oceanic spreading systems, where "magmatic" and "tectonic" spreading varies in both space and time.

Area-delay Trade-offs of Texture Decompressors for a Graphics Processing Unit

Graphics Processing Units have become a booster for the microelectronics industry. However, due to intellectual property issues, there is a serious lack of information on implementation details of the hardware architecture that is behind GPUs. For instance, the way texture is handled and decompressed in a GPU to reduce bandwidth usage has never been dealt with in depth from a hardware point of view. This work addresses a comparative study on the hardware implementation of different texture decompression algorithms for both conventional (PCs and video game consoles) and mobile platforms. Circuit synthesis is performed targeting both a reconfigurable hardware platform and a 90nm standard cell library. Area-delay trade-offs have been extensively analyzed, which allows us to compare the complexity of decompressors and thus determine suitability of algorithms for systems with limited hardware resources.