Treatment of tibial fractures with plates using minimally invasive percutaneous osteosynthesis in dogs and cats

OBJECTIVES: The aim of the here described case series was to develop and evaluate the minimally invasive percutaneous osteosynthesis for the plate fixation of tibial fractures in dogs and cats. METHODS: Six dogs and four cats with shaft fractures of the tibia were treated using minimally invasive percutaneous osteosynthesis. Follow-up radiographs four to six weeks after fracture fixation were evaluated for fracture healing. For the long-term follow-up (minimum 2.4 years), owners were contacted by phone to complete a questionnaire. RESULTS: All fractures healed without the need for a second procedure. Follow-up radiographs obtained after four to six weeks in seven cases showed advanced bony healing with callus formation and filling of the fracture gaps with calcified tissue in all seven. All the patients had a good to excellent long-term result with full limb function. The time needed for regaining full limb use was two to three months. CLINICAL SIGNIFICANCE: Minimally invasive percutaneous osteosynthesis seems to be a useful technique for the treatment of tibial shaft fractures in dogs and cats.

Exposure modeling of high-frequency electromagnetic fields

We developed a geospatial model that calculates ambient high-frequency electromagnetic field (HF-EMF) strengths of stationary transmission installations such as mobile phone base stations and broadcast transmitters with high spatial resolution in the order of 1 m. The model considers the location and transmission patterns of the transmitters, the three-dimensional topography, and shielding effects by buildings. The aim of the present study was to assess the suitability of the model for exposure monitoring and for epidemiological research. We modeled time-averaged HF-EMF strengths for an urban area in the city of Basel as well as for a rural area (Bubendorf). To compare modeling with measurements, we selected 20 outdoor measurement sites in Basel and 18 sites in Bubendorf. We calculated Pearson's correlation coefficients between modeling and measurements. Chance-corrected agreement was evaluated by weighted Cohen's kappa statistics for three exposure categories. Correlation between measurements and modeling of the total HF-EMF strength was 0.67 (95% confidence interval (CI): 0.33-0.86) in the city of Basel and 0.77 (95% CI: 0.46-0.91) in the rural area. In both regions, kappa coefficients between measurements and modeling were 0.63 and 0.77 for the total HF-EMF strengths and for all mobile phone frequency bands. First evaluation of our geospatial model yielded substantial agreement between modeling and measurements. However, before the model can be applied for future epidemiologic research, additional validation studies focusing on indoor values are needed to improve model validity.Journal of Exposure Science and Environmental Epidemiology (2008) 18, 183-191; doi:10.1038/sj.jes.7500575; published online 4 April 2007.

Radiofrequency electromagnetic field exposure and non-specific symptoms of ill health: A systematic review

This article is a systematic review of whether everyday exposure to radiofrequency electromagnetic field (RF-EMF) causes symptoms, and whether some individuals are able to detect low-level RF-EMF (below the ICNIRP [International Commission on Non-Ionizing Radiation Protection] guidelines). Peer-reviewed articles published before August 2007 were identified by means of a systematic literature search. Meta-analytic techniques were used to pool the results from studies investigating the ability to discriminate active from sham RF-EMF exposure. RF-EMF discrimination was investigated in seven studies including a total of 182 self-declared electromagnetic hypersensitive (EHS) individuals and 332 non-EHS individuals. The pooled correct field detection rate was 4.2% better than expected by chance (95% CI: -2.1 to 10.5). There was no evidence that EHS individuals could detect presence or absence of RF-EMF better than other persons. There was little evidence that short-term exposure to a mobile phone or base station causes symptoms based on the results of eight randomized trials investigating 194 EHS and 346 non-EHS individuals in a laboratory. Some of the trials provided evidence for the occurrence of nocebo effects. In population based studies an association between symptoms and exposure to RF-EMF in the everyday environment was repeatedly observed. This review showed that the large majority of individuals who claims to be able to detect low level RF-EMF are not able to do so under double-blind conditions. If such individuals exist, they represent a small minority and have not been identified yet. The available observational studies do not allow differentiating between biophysical from EMF and nocebo effects.

Safety of inferior vena cava filter retrieval in anticoagulated patients

PURPOSES: To evaluate the safety of inferior vena cava (IVC) filter retrieval in therapeutically anticoagulated patients in comparison to prophylactically or not therapeutically anticoagulated patients with respect to retrieval-related hemorrhagic complications. MATERIALS AND METHODS: This was a retrospective study of 115 consecutive attempted IVC filter retrievals in 110 patients. Filter retrievals were stratified as performed in patients who were therapeutically anticoagulated (group 1), prophylactically anticoagulated (group 2), or not therapeutically anticoagulated (group 3). The collected data included anticoagulant and antiplatelet medications (type, form and duration of administration, dosage) at the time of retrieval. Phone interviews and chart review was performed for the international normalized ratio (INR), activated partial thromboplastin time, platelet count, infusion of blood products, and retrieval-related hemorrhagic complications. RESULTS: Group 1 included 65 attempted filter retrievals in 61 therapeutically anticoagulated patients by measured INR or dosing when receiving low-molecular-weight heparin (LMWH). Four retrievals were not successful. In patients receiving oral anticoagulation, the median INR was 2.35 (range, 2 to 8). Group 2 comprised 23 successful filter retrievals in 22 patients receiving a prophylactic dose of LMWH. Group 3 included 27 attempted filter retrievals in 27 patients not receiving therapeutic anticoagulation. Six retrievals were not successful. Five patients were receiving oral anticoagulation with a subtherapeutic INR (median, 1.49; range, 1.16 to 1.69). No anticoagulation medication was administered in 22 patients. In none of the groups were hemorrhagic complications related to the retrieval procedures identified. CONCLUSIONS: These results suggest that retrieval of vena cava filters in anticoagulated patients is safe. Interruption or reversal of anticoagulation for the retrieval of vena cava filters is not indicated.

Managerial perseptions on corporate social responsbility: A Transatlantic comparison between forest products companies in Europe and North America

Corporate Social Responsibility (CSR) addresses the responsibility of companies for their impacts on society. The concept of strategic CSR is becoming increasingly mainstreamed in the forest industry, but there is, however, little consensus on the definition and implementation of CSR. The objective of this research is to build knowledge on the characteristics of CSR and to provide insights on the emerging trend to increase the credibility and legitimacy of CSR through standardization. The study explores how the sustainability managers of European and North American forest companies perceive CSR and the recently released ISO 26000 guidance standard on social responsibility. The conclusions were drawn from an analysis of two data sets; multivariate survey data based on one subset of 30 European and 13 North American responses, and data obtained through in-depth interviewing of 10 sustainability managers that volunteered for an hour long phone discussion about social responsibility practices at their company. The analysis concluded that there are no major differences in the characteristics of cross-Atlantic CSR. Hence, the results were consistent with previous research that suggests that CSR is a case- and company-specific concept. Regarding the components of CSR, environmental issues and organizational governance were key priorities in both regions. Consumer issues, human rights, and financial issues were among the least addressed categories. The study reveals that there are varying perceptions on the ISO 26000 guidance standard, both positive and negative. Moreover, sustainability managers of European and North American forest companies are still uncertain regarding the applicability of the ISO 26000 guidance standard to the forest industry. This study is among the first to provide a preliminary review of the practical implications of the ISO 26000 standard in the forest sector. The results may be utilized by sustainability managers interested in the best practices on CSR, and also by a variety of forest industrial stakeholders interested in the practical outcomes of the long-lasting CSR debate.

Understanding Michigan nonindustrial private forest landowners attitudes and knowledge about forest management

Approximately one-fourth of the non-industrial private forestland (NIPF) owners in the state of Michigan, who collectively own approximately 50% of the private forested land, have conducted commercial timber harvest in recent years. Previous studies indicated that NIPFs preferred to manage their forest for a sustained yield of high-quality timber, but were limited to even-aged regeneration treatments or conversion for uneven-aged silviculture due to previous cuttings. Improved knowledge about NIPF’s intentions and forest management behavior could be useful for successful implementation of sustained yield management. This study’s objective was to identify more active NIPF’s attitudes towards timber management, their forest management practices and whether their forest management behavior leads or leads not to q management for sustained yield. Active NIPF’s intentions to harvest timber for biofuels and its suitability with NIPF’s forest management behavior will be discussed. Phone interviews of 30 NIPFs who have experience with commercial timber harvests were conducted between August and October 2011. All interviews were recorded, transcribed, and analyzed for identifying NIPF’s motivations, attitudes, forest management behavior and forestry related knowledge. Interviewees, whether consciously or not, tended to manage their land for a sustained yield and they would be willing to harvest timber for biofuels facility as long as it benefits landowners management goals.

Teaching and aligning upper level mathematics classes to Michigan high school content expectations in an alternative education setting : approaches and issues

After teaching regular education secondary mathematics for seven years, I accepted a position in an alternative education high school. Over the next four years, the State of Michigan adopted new graduation requirements phasing in a mandate for all students to complete Geometry and Algebra 2 courses. Since many of my students were already struggling in Algebra 1, getting them through Geometry and Algebra 2 seemed like a daunting task. To better instruct my students, I wanted to know how other teachers in similar situations were addressing the new High School Content Expectations (HSCEs) in upper level mathematics. This study examines how thoroughly alternative education teachers in Michigan are addressing the HSCEs in their courses, what approaches they have found most effective, and what issues are preventing teachers and schools from successfully implementing the HSCEs. Twenty-six alternative high school educators completed an online survey that included a variety of questions regarding school characteristics, curriculum alignment, implementation approaches and issues. Follow-up phone interviews were conducted with four of these participants. The survey responses were used to categorize schools as successful, unsuccessful, and neutral schools in terms of meeting the HSCEs. Responses from schools in each category were compared to identify common approaches and issues among them and to identify significant differences between school groups. Data analysis showed that successful schools taught more of the HSCEs through a variety of instructional approaches, with an emphasis on varying the ways students learned the material. Individualized instruction was frequently mentioned by successful schools and was strikingly absent from unsuccessful school responses. The main obstacle to successful implementation of the HSCEs identified in the study was gaps in student knowledge. This caused pace of instruction to also be a significant issue. School representatives were fairly united against the belief that the Algebra 2 graduation requirement was appropriate for all alternative education students. Possible implications of these findings are discussed.

Smoking cessation advice: Swiss physicians lack training

OBJECTIVES: To assess the use and appropriateness of medical advice for smoking cessation provided by registrars in a General Medicine Outpatient Department to an unselected patient population in Switzerland. METHODS: A prospective observational study in which 314 consecutive outpatients were contacted by phone within 24h after their consultation. Questions and information concerning smoking asked and/or provided by the registrar to patients were collected. RESULTS: Eleven registrars (mean age 34 years (range 29-40), 54% females, mean of 5 years (range 3.5-6 years) postgraduate medical training) worked in the Basel University Hospital Medical Outpatient Department during the study period from 01.01.2006 to 31.03.2006. In total 314 participants (mean 48 years, age range 16-71 years, 50% females) completed the study. Registrars queried 81% of the patients about smoking, but inquired about smoking duration only in 44% of the patients. Twenty-eight percent of the patients received information about the risks related to smoking, whereas cessation was discussed only with 10% and offered to 9% of the patients. CONCLUSION: Though most junior physicians in the survey asked about smoking, they failed to appropriately address tobacco-related health issues and offer cessation advice in the majority of cases. Extended regular training for physicians on smoking-related issues will be necessary in order to improve counselling of smokers and meet the global tobacco challenge.

Automatic Food Intake Assessment Using Camera Phones

Obesity is becoming an epidemic phenomenon in most developed countries. The fundamental cause of obesity and overweight is an energy imbalance between calories consumed and calories expended. It is essential to monitor everyday food intake for obesity prevention and management. Existing dietary assessment methods usually require manually recording and recall of food types and portions. Accuracy of the results largely relies on many uncertain factors such as user's memory, food knowledge, and portion estimations. As a result, the accuracy is often compromised. Accurate and convenient dietary assessment methods are still blank and needed in both population and research societies. In this thesis, an automatic food intake assessment method using cameras, inertial measurement units (IMUs) on smart phones was developed to help people foster a healthy life style. With this method, users use their smart phones before and after a meal to capture images or videos around the meal. The smart phone will recognize food items and calculate the volume of the food consumed and provide the results to users. The technical objective is to explore the feasibility of image based food recognition and image based volume estimation. This thesis comprises five publications that address four specific goals of this work: (1) to develop a prototype system with existing methods to review the literature methods, find their drawbacks and explore the feasibility to develop novel methods; (2) based on the prototype system, to investigate new food classification methods to improve the recognition accuracy to a field application level; (3) to design indexing methods for large-scale image database to facilitate the development of new food image recognition and retrieval algorithms; (4) to develop novel convenient and accurate food volume estimation methods using only smart phones with cameras and IMUs. A prototype system was implemented to review existing methods. Image feature detector and descriptor were developed and a nearest neighbor classifier were implemented to classify food items. A reedit card marker method was introduced for metric scale 3D reconstruction and volume calculation. To increase recognition accuracy, novel multi-view food recognition algorithms were developed to recognize regular shape food items. To further increase the accuracy and make the algorithm applicable to arbitrary food items, new food features, new classifiers were designed. The efficiency of the algorithm was increased by means of developing novel image indexing method in large-scale image database. Finally, the volume calculation was enhanced through reducing the marker and introducing IMUs. Sensor fusion technique to combine measurements from cameras and IMUs were explored to infer the metric scale of the 3D model as well as reduce noises from these sensors.

The Technocrat - v. 35, no. 5

In this issue...Martin Karplus, Noble Prize, Dodgeball Duel, President Obama, community college, Pintler mountains, cell phone evolution, Facebook, social media

Temporal and spatial variability of personal exposure to radio frequency electromagnetic fields

BACKGROUND: Little is known about the population's exposure to radio frequency electromagnetic fields (RF-EMF) in industrialized countries. OBJECTIVES: To examine levels of exposure and the importance of different RF-EMF sources and settings in a sample of volunteers living in a Swiss city. METHODS: RF-EMF exposure of 166 volunteers from Basel, Switzerland, was measured with personal exposure meters (exposimeters). Participants carried an exposimeter for 1 week (two separate weeks in 32 participants) and completed an activity diary. Mean values were calculated using the robust regression on order statistics (ROS) method. RESULTS: Mean weekly exposure to all RF-EMF sources was 0.13 mW/m(2) (0.22 V/m) (range of individual means 0.014-0.881 mW/m(2)). Exposure was mainly due to mobile phone base stations (32.0%), mobile phone handsets (29.1%) and digital enhanced cordless telecommunications (DECT) phones (22.7%). Persons owning a DECT phone (total mean 0.15 mW/m(2)) or mobile phone (0.14 mW/m(2)) were exposed more than those not owning a DECT or mobile phone (0.10 mW/m(2)). Mean values were highest in trains (1.16 mW/m(2)), airports (0.74 mW/m(2)) and tramways or buses (0.36 mW/m(2)), and higher during daytime (0.16 mW/m(2)) than nighttime (0.08 mW/m(2)). The Spearman correlation coefficient between mean exposure in the first and second week was 0.61. CONCLUSIONS: Exposure to RF-EMF varied considerably between persons and locations but was fairly consistent within persons. Mobile phone handsets, mobile phone base stations and cordless phones were important sources of exposure in urban Switzerland.

A prediction model for personal radio frequency electromagnetic field exposure

Radio frequency electromagnetic fields (RF-EMF) in our daily life are caused by numerous sources such as fixed site transmitters (e.g. mobile phone base stations) or indoor devices (e.g. cordless phones). The objective of this study was to develop a prediction model which can be used to predict mean RF-EMF exposure from different sources for a large study population in epidemiological research. We collected personal RF-EMF exposure measurements of 166 volunteers from Basel, Switzerland, by means of portable exposure meters, which were carried during one week. For a validation study we repeated exposure measurements of 31 study participants 21 weeks after the measurements of the first week on average. These second measurements were not used for the model development. We used two data sources as exposure predictors: 1) a questionnaire on potentially exposure relevant characteristics and behaviors and 2) modeled RF-EMF from fixed site transmitters (mobile phone base stations, broadcast transmitters) at the participants' place of residence using a geospatial propagation model. Relevant exposure predictors, which were identified by means of multiple regression analysis, were the modeled RF-EMF at the participants' home from the propagation model, housing characteristics, ownership of communication devices (wireless LAN, mobile and cordless phones) and behavioral aspects such as amount of time spent in public transports. The proportion of variance explained (R2) by the final model was 0.52. The analysis of the agreement between calculated and measured RF-EMF showed a sensitivity of 0.56 and a specificity of 0.95 (cut-off: 90th percentile). In the validation study, the sensitivity and specificity of the model were 0.67 and 0.96, respectively. We could demonstrate that it is feasible to model personal RF-EMF exposure. Most importantly, our validation study suggests that the model can be used to assess average exposure over several months.

A communication and information technology infrastructure for real time monitoring and management of type 1 diabetes patients

This paper is focused on the integration of state-of-the-art technologies in the fields of telecommunications, simulation algorithms, and data mining in order to develop a Type 1 diabetes patient's semi to fully-automated monitoring and management system. The main components of the system are a glucose measurement device, an insulin delivery system (insulin injection or insulin pumps), a mobile phone for the GPRS network, and a PDA or laptop for the Internet. In the medical environment, appropriate infrastructure for storage, analysis and visualizing of patients' data has been implemented to facilitate treatment design by health care experts.

Constructing a user experience user experience-based mobile learning environment

Mobile learning, in the past defined as learning with mobile devices, now refers to any type of learning-on-the-go or learning that takes advantage of mobile technologies. This new definition shifted its focus from the mobility of technology to the mobility of the learner (O'Malley and Stanton 2002; Sharples, Arnedillo-Sanchez et al. 2009). Placing emphasis on the mobile learner’s perspective requires studying “how the mobility of learners augmented by personal and public technology can contribute to the process of gaining new knowledge, skills, and experience” (Sharples, Arnedillo-Sanchez et al. 2009). The demands of an increasingly knowledge based society and the advances in mobile phone technology are combining to spur the growth of mobile learning. Around the world, mobile learning is predicted to be the future of online learning, and is slowly entering the mainstream education. However, for mobile learning to attain its full potential, it is essential to develop more advanced technologies that are tailored to the needs of this new learning environment. A research field that allows putting the development of such technologies onto a solid basis is user experience design, which addresses how to improve usability and therefore user acceptance of a system. Although there is no consensus definition of user experience, simply stated it focuses on how a person feels about using a product, system or service. It is generally agreed that user experience adds subjective attributes and social aspects to a space that has previously concerned itself mainly with ease-of-use. In addition, it can include users’ perceptions of usability and system efficiency. Recent advances in mobile and ubiquitous computing technologies further underline the importance of human-computer interaction and user experience (feelings, motivations, and values) with a system. Today, there are plenty of reports on the limitations of mobile technologies for learning (e.g., small screen size, slow connection), but there is a lack of research on user experience with mobile technologies. This dissertation will fill in this gap by a new approach in building a user experience-based mobile learning environment. The optimized user experience we suggest integrates three priorities, namely a) content, by improving the quality of delivered learning materials, b) the teaching and learning process, by enabling live and synchronous learning, and c) the learners themselves, by enabling a timely detection of their emotional state during mobile learning. In detail, the contributions of this thesis are as follows: • A video codec optimized for screencast videos which achieves an unprecedented compression rate while maintaining a very high video quality, and a novel UI layout for video lectures, which together enable truly mobile access to live lectures. • A new approach in HTTP-based multimedia delivery that exploits the characteristics of live lectures in a mobile context and enables a significantly improved user experience for mobile live lectures. • A non-invasive affective learning model based on multi-modal emotion detection with very high recognition rates, which enables real-time emotion detection and subsequent adaption of the learning environment on mobile devices. The technology resulting from the research presented in this thesis is in daily use at the School of Continuing Education of Shanghai Jiaotong University (SOCE), a blended-learning institution with 35.000 students.

Are They Really Lost? "True" Status and Reasons for Treatment Discontinuation among HIV Infected Patients on Antiretroviral Therapy Considered Lost to Follow Up in Urban Malawi

INTRODUCTION Patients who are lost to follow-up (LTFU) while on antiretroviral therapy (ART) pose challenges to the long-term success of ART programs. We describe the extent to which patients considered LTFU are misclassified as true disengagement from care when they are still alive on ART and explain reasons for ART discontinuation using our active tracing program to further improve ART retention programs and policies. METHODS We identified adult ART patients who missed clinic appointment by more than 3 weeks between January 2006 and December 2010, assuming that such patients would miss their doses of antiretroviral drugs. Patients considered LTFU who consented during ART registration were traced by phone or home visits; true ART status after tracing was documented. Reasons for ART discontinuation were also recorded for those who stopped ART. RESULTS Of the 4,560 suspected LTFU cases, 1,384 (30%) could not be traced. Of the 3,176 successfully traced patients, 952 (30%) were dead and 2,224 (70%) were alive, of which 2,183 (99.5%) started ART according to phone-based self-reports or physical verification during in-person interviews. Of those who started ART, 957 (44%) stopped ART and 1,226 (56%) reported still taking ART at the time of interview by sourcing drugs from another clinic, using alternative ART sources or making brief ART interruptions. Among 940 cases with reasons for ART discontinuations, failure to remember (17%), too weak/sick (12%), travel (46%), and lack of transport to the clinic (16%) were frequently cited; reasons differed by gender. CONCLUSION The LTFU category comprises sizeable proportions of patients still taking ART that may potentially bias retention estimates and misdirect resources at the clinic and national levels if not properly accounted for. Clinics should consider further decentralization efforts, increasing drug allocations for frequent travels, and improving communication on patient transfers between clinics to increase retention and adherence.