Chemotherapy for upper gastrointestinal tumours

The aim of this review is to identify current chemotherapy treatment for tumours of the oesophagus, stomach, pancreas, and liver. The role of both neoadjuvant, adjuvant, and palliative chemotherapy regimens will be discussed. This review will be of interest to oncologists in clarifying current issues regarding chemotherapy, and to physicians in other medical specialties, to increase their general understanding of benefits and drawbacks of chemotherapy in this patient group.

Upper Murrumbidgee : Talking fish - making connections with the rivers of the Murray-Darling Basin

The Upper Murrumbidgee cuts its way through the Snowy Mountains in south‐eastern New South Wales, snaking its way south, then turning north before dropping into the lowland and heading west to join the Murray downstream of Swan Hill. The Upper ‘Bidgee floodplain is only a couple of hundred metres wide, a stark contrast to the kilometres‐wide floodplains in other parts of the Murray‐ Darling Basin. When the floods come, they come up quickly and roar through the narrow valleys. These are the traditional lands of the Ngunnawal and Ngarigo peoples. They fished the river and surrounding waterways and hunted the wetlands. The seasonal rise and fall of the water guided their travels and featured in their stories. The Ngunnawal and Ngarigo people have seen their land and the river change...

Upper Darling: Brewarrina to Bourke : Talking fish - making connections with the rivers of the Murray-Darling Basin

To say ‘Back o’ Bourke’ means ‘miles from anywhere’ to most Australians, however the Barwon and Darling Rivers that pass by the townships of Brewarrina and Bourke, respectively, are at the heart of the Murray‐Darling Basin. These are the traditional lands of the Ngiyampaa, Murawari and Yuwalaraay peoples (refer Aboriginal language groups in the Bringing back the fish section at the back of this booklet). They fished the river and surrounding waterways and hunted the wetlands. The Ngiyampaa, Murawari and Yuwalaraay people have seen their land and the rivers change...

The development of an effective and efficient dispute resolution processes for strata scheme disputes in peninsular Malaysia

Dispute resolution in strata schemes in Peninsular Malaysia should focus on more than just "settlement." The quality of the outcome, its sustainability and its relevance in supporting the basic principles of a good neighbourhood and self-governance in a strata scheme are also fundamental. Based on the comprehensive law movement, this thesis develops a theoretical framework for strata scheme disputes within the parameters of therapeutic jurisprudence, preventive law, alternative dispute resolution (ADR) and problem-solving courts. The therapeutic orientation of this model offers approaches that promote positive communication between disputing parties, preserve neighbour relations and optimise people's psychological and emotional well-being.

Studying upper-limb kinematic using inertial sensors embedded in smartphones

Background: In recent years, there have been investigations concerning upper-limbs kinematics by various devices. The latest generation of smartphones often includes inertial sensors with subunits which can detect inertial kinematics. The use of smartphones is presented as a convenient and portable analysis method for studying kinematics in terms of angular mobility and linear acceleration Objective: The aim of this study was to study humerus kinematics through six physical properties that correspond to angular mobility and acceleration in the three axes of space, obtained by a smartphone. Methods: This cross-sectional study recruited healthy young adult subjects. Descriptive and anthropometric independent variables related to age, gender, weight, size, and BMI were included. Six physical properties were included corresponding to two dependent variables for each of three special axes: mobility angle (degrees) and lineal acceleration (meters/seconds2), which were obtained thought the inertial measurement sensor embedded in the iPhone4 smartphone equipped with three two elements for the detection of kinematic variables: a gyroscope and an accelerometer. Apple uses an LIS302DL accelerometer in the iPhone4. The application used to obtain kinematic data was xSensor Pro, Crossbow Technology, Inc., available at the Apple AppStore. The iPhone4 has storage capacity of 20MB. The data-sampling rate was set to 32 Hz, and the data for each analytical task was transmitted as email for analysis and postprocessing The iPhone4 was placed in the right half of the body of each subject located in the middle third of the humerus slightly posterior snugly secured by a neoprene fixation belt. Tasks were explained concisely and clearly. The beginning and the end were decided by a verbal order by the researcher. Participants were placed standing, starting from neutral position, performing the following analytical tasks: 180º right shoulder abduction (eight repetitions) and, after a break of about 3 minutes, 180º right shoulder flexion (eight repetitions). Both tasks were performed with the elbow extended, wrist in neutral position and the palmar area of the hand toward the midline at the beginning and end of the movement. Results: A total of 11 subjects (8 men, 3 woman) were measured, whose mean of age was 24.7 years (SD = 4.22 years) and their average BMI was 22.64 Kg/m2 (SD = 2.29 Kg/m2). The mean of angular mobility collected by the smartphone was bigger in pitch axis for flexion (= 157.28°, SD= 12.35°) and abduction (= 151.71°, SD= 9.70°). With regard to acceleration, the highest peak mean value was shown in the Y motion axis during flexion (= 19.5°/s2, SD = 0.8°/s2) and abduction (= 19.4°/s2, SD = 0.8°/s2). Also, descriptive graphics of analytical tasks performed were obtained. Conclusions: This study shows how humerus contributes to upper-limb motion and it identified movement patterns. Therefore, it supports smartphone as a useful device to analyze upper-limb kinematics. Thanks to this study it´s possible to develop a simple application that facilitates the evaluation of the patient.

New sale and leasing requirements for owners of swimming pools and their application to strata schemes

This article considers the changes to the Swimming Pools Act 1992 (NSW)(Act) which established a State-wide online register of all private swimming pools in NSW requiring pool owners to register their pools by 19 November 2013. Amendments to the Act introduced changes to the conveyancing and residential tenancy regulations to require vendors and landlords to have a valid Compliance Certificate issued for their swimming pool before offering the property for sale or lease. This article provides a brief overview of the new sale and leasing requirements effective from 29 April 2014, focusing on its application to lot owners within strata and community title schemes and other owners of water front properties with pools on Crown Land Reserves.

Cross-cultural adaptation, reliability and validity of the Spanish version of the upper limb functional index

Background The Upper Limb Functional Index (ULFI) is an internationally widely used outcome measure with robust, valid psychometric properties. The purpose of study is to develop and validate a ULFI Spanish-version (ULFI-Sp). Methods A two stage observational study was conducted. The ULFI was cross-culturally adapted to Spanish through double forward and backward translations, the psychometric properties were then validated. Participants (n = 126) with various upper limb conditions of >12 weeks duration completed the ULFI-Sp, QuickDASH and the Euroqol Health Questionnaire 5 Dimensions (EQ-5D-3 L). The full sample determined internal consistency, concurrent criterion validity, construct validity and factor structure; a subgroup (n = 35) determined reliability at seven days. Results The ULFI-Sp demonstrated high internal consistency (α = 0.94) and reliability (r = 0.93). Factor structure was one-dimensional and supported construct validity. Criterion validity with the EQ-5D-3 L was fair and inversely correlated (r = −0.59). The QuickDASH data was unavailable for analysis due to excessive missing responses. Conclusions The ULFI-Sp is a valid upper limb outcome measure with similar psychometric properties to the English language version.

Using upper bounds on attainable discrimination to select discrete valued features

Selection of features that will permit accurate pattern classification is a difficult task. However, if a particular data set is represented by discrete valued features, it becomes possible to determine empirically the contribution that each feature makes to the discrimination between classes. This paper extends the discrimination bound method so that both the maximum and average discrimination expected on unseen test data can be estimated. These estimation techniques are the basis of a backwards elimination algorithm that can be use to rank features in order of their discriminative power. Two problems are used to demonstrate this feature selection process: classification of the Mushroom Database, and a real-world, pregnancy related medical risk prediction task - assessment of risk of perinatal death.

Mississippi Delta subsidence primarily caused by compaction of Holocene strata

Coastal subsidence causes sea-level rise, shoreline erosion and wetland loss, which poses a threat to coastal populations. This is especially evident in the Mississippi Delta in the southern United States, which was devastated by Hurricane Katrina in 2005. The loss of protective wetlands is considered a critical factor in the extensive flood damage. The causes of subsidence in coastal Louisiana, attributed to factors as diverse as shallow compaction and deep crustal processes, remain controversial. Current estimates of subsidence rates vary by several orders of magnitude. Here, we use a series of radiocarbon-dated sediment cores from the Mississippi Delta to analyse late Holocene deposits and assess compaction rates. We find that millennial-scale compaction rates primarily associated with peat can reach 5mm per year, values that exceed recent model predictions. Locally and on timescales of decades to centuries, rates are likely to be 10 mm or more per year. We conclude that compaction of Holocene strata contributes significantly to the exceptionally high rates of relative sea-level rise and coastal wetland loss in the Mississippi Delta, and is likely to cause subsidence in other organic-rich and often densely populated coastal plains.

Safety of OPRA procedure for individuals with upper limb amputation

Surgical implantations of osseointegrated fixations for bone-anchored prosthesis are developing at an unprecedented pace worldwide while initial skepticism in the orthopedic community is slowly fading away. Clearly, this option is becoming accessible to a wide range of individuals with limb loss. [1-18] The team led by Dr Rickard Branemark has previously published a number of landmark articles focusing on the benefits and safety of the OPRA fixation mainly for individual with lower limb loss, particularly those with transfemoral amputation. [1-3, 19-32] However, similar information is lacking for those with upper limb amputation. This team is once again taking a leading role by sharing a retrospective study focusing on the implant survival, adverse events, implant stability, and bone remodelling for 18 individuals with transhumeral amputation over a 5-year post-operative period. Therefore, a comprehensive analysis of the safety of the procedure is accessible for the first time. In essence, the results showed an implant survival rate of 83% and 80% at 2 and 5 year follow ups, respectively. The most frequent adverse events were superficial skin infections that occurred for 28% (5) participants while the least frequent was deep bone infection that happened only once. More importantly, 38% of complications due to infections were effectively managed with nonoperative treatments (e.g., revision of skin penetration site, local cleaning, antibiotics, restriction of soft tissue mobility). Implant stability and bone remodelling were satisfactory. Clearly, this study provided better understanding of the safety of the OPRA surgical and rehabilitation procedure for individuals with upper limb amputation while establishing standards and benchmark data for future studies. However, strong evidences of the benefits are yet to be demonstrated. However, increase in health related quality of life and functional outcomes (e.g., range of movement) are likely. Altogether, the team of authors are providing further evidence that bone-anchored attachment is definitely a promising alternative to socket prostheses.

Therapeutic upper gastrointestinal endoscopy in children : An audit of 443 procedures and literature review

The safety, effectiveness and capabilities of therapeutic upper fibreoptic endoscopy in children undergoing therapeutic endoscopic procedures (n = 443) was studied. Therapy for gastrointestinal bleeding formed the major group (injection sclerotherapy for varices, n = 197 procedures; thermocoagulation for haemorrhagic gastritis, n = 1; and photocoaulation for Dieulafoy's disease, n = 1). Sclerotherapy was 97% effective in controlling acute bleeding and 84% effective in obliterating varices with no serious complications or deaths. Oesophageal dilatations for surgical, caustic, congenital and peptic strictures and achalasia (n = 193) were performed with no oesophageal perforations or deaths. Foreign bodies were retrieved (n = 34) with no failures or complications. Percutaneous endoscopic gastrostomy was performed (n = 11) with one failure, proceeding to an unsuccessful surgical gastrostomy. Miscellaneous procedures included endoscopic transpyloric tube placement (n = 5) and endoscopic diathermy of pyloric web (n = 1). Therapeutic fibreoptic endoscopy is therefore concluded to be safe and effective in children, replacing rigid oesophagoscopy and some traditional surgical approaches.

An upper bound for Cubicity in terms of Boxicity

An axis-parallel b-dimensional box is a Cartesian product R-1 x R-2 x ... x R-b where each R-i (for 1 <= i <= b) is a closed interval of the form [a(i), b(i)] on the real line. The boxicity of any graph G, box(G) is the minimum positive integer b such that G can be represented as the intersection graph of axis-parallel b-dimensional boxes. A b-dimensional cube is a Cartesian product R-1 x R-2 x ... x R-b, where each R-i (for 1 <= i <= b) is a closed interval of the form [a(i), a(i) + 1] on the real line. When the boxes are restricted to be axis-parallel cubes in b-dimension, the minimum dimension b required to represent the graph is called the cubicity of the graph (denoted by cub(G)). In this paper we prove that cub(G) <= inverted right perpendicularlog(2) ninverted left perpendicular box(G), where n is the number of vertices in the graph. We also show that this upper bound is tight.Some immediate consequences of the above result are listed below: 1. Planar graphs have cubicity at most 3inverted right perpendicularlog(2) ninvereted left perpendicular.2. Outer planar graphs have cubicity at most 2inverted right perpendicularlog(2) ninverted left perpendicular.3. Any graph of treewidth tw has cubicity at most (tw + 2) inverted right perpendicularlog(2) ninverted left perpendicular. Thus, chordal graphs have cubicity at most (omega + 1) inverted right erpendicularlog(2) ninverted left perpendicular and circular arc graphs have cubicity at most (2 omega + 1)inverted right perpendicularlog(2) ninverted left perpendicular, where omega is the clique number.

Modality as portrayed in upper secondary school textbooks : A corpus-based approach

Tämän pro gradu -lopputyön aiheena on englannin kielen modaalisten apuverbien ns. ydinjoukko: will, would, can, could, shall, should, may, might ja must. Semantiikan kannalta nämä apuverbit ovat erityisen kompleksisia: niiden tulkinnassa on usein huomattavaa monivivahteisuutta, vaikka perinteiset kieliopit antavat ymmärtää niillä olevan kaksi tai kolme toisistaan selkeästi erillään olevaa merkitystä. Ne asettavatkin vieraan kielen oppimisympäristössä erityisiä haasteita. Viimeaikainen kehitys korpuslingvistiikan metodeissa on tuottanut entistä tarkempia kuvauksia siitä, miten modaalisia apuverbejä nykyenglannissa käytetään ja mihin suuntaan niiden kehitys on lyhyenkin ajan sisällä kulkenut. Tämän tutkielman tavoitteena on ollut verrata näiden uusien tutkimusten tuloksia siihen todellisuuteen, jonka englannin kielen lukiotasoinen oppimateriaali Suomessa opiskelijalle tarjoaa. Lähdin siitä, että opetussuunnitelman vaatima autenttisuus ja kommunikaativisuus kieltenopetuksessa tulisi näkyä tasapuolisena modaalisten apuverbien kohteluna. Alkuperäinen hypoteesini kuitenkin oli, että siinä miten modaalisuus ilmenee autenttisessa ympäristössä ja siinä miten se esitetään oppikirjoissa, on poikkeavuuksia. Lähestymistapani tähän tutkielmaan oli korpuslähtöinen. Valitsin kahdesta lukion kirjasarjasta ne kirjat, joissa modaaliset apuverbit mainittiin eksplisiittisesti. Skannasin jokaisen neljästä eri kirjasta löytyvän (kokonaisen) tekstin ja rakensin näistä aineksista pienen korpuksen. Tästä korpuksesta hain korpusanalyyseihin tarkoitetulla ohjelmalla kaikki lauseet, joissa esiintyi modaalisia apuverbejä. Tämän jälkeen analysoin jokaisen modaalisen apuverbin semanttisesti lauseyhteydessään. Tämän analyysin tuloksena pystyin rakentamaan taulukoita ja vertailemaan tuloksia uusimpien tutkimusten tuloksiin. Tämän tutkielman perusteella poikkeavuuksia on olemassa. Yleisesti ottaen modaalisten apuverbien keskinäinen frekvenssi oli oikean suuntainen: mitään apuverbiä ei ollut käytetty merkittävästi enemmän tai vähemmän kuin mitä viimeaikaisen tutkimuksen valossa olisi suotavaa. Sen sijaan apuverbien semanttisessa jakaumassa oli paikoin suuriakin eroja siinä, mitkä merkitykset oppikirjoissa painottuivat ja mitkä taas nykyenglannissa vaikuttaisivat olevan frekvensseiltään suurempia. Erityisesti can ja must erottuivat joukosta siinä, että oppikirjojen tarjoama kuva niiden käytöstä on päinvastainen kuin mitä voisi odottaa: can-verbin käyttö painottui selvästi tarkoittamaan ’kykyä’ eikä ’mahdollisuutta’, joka nykytutkimuksen valossa on sen pääasiallinen käyttötapa. Toisaalta must tarkoitti aineistossa ylikorostuneesti ’pakkoa’, kun se useimmiten nykyään tarkoittaa yhtä usein ’johtopäätöstä’ kuin ’pakkoa’. Lisäksi ’lupaa’ pyydettiin aineistossa merkillisen harvoin. Tulosten perusteella esitän, että oppikirjojen tekijät yleisellä tasolla luopuisivat kielioppikirjojen luutuneista käsityksistä ja uskaltaisivat altistaa opiskelijat koko modaalisten apuverbien merkityskirjolle.

The SCOTS corpus and TEFL: Discovering and Using Strategies of Spoken English in Finnish Upper Secondary Schools

Suomen koulutuspolitiikasta vastaavat viranomaiset ovat reagoineet kansainvälisten kommunikaatiotarpeiden asettamiin haasteisiin ja muuttaneet yhden lukion A-tasoisen vieraan kielen kurssin sisällön vastaamaan suullisen viestinnän tarpeita. Tutkimuksessa selvitetään, miten englannin puhestrategioita voi opettaa suomalaisille lukiolaisille ja mitä metodeja on käytettävissä puhestrategioiden oppimisen arvioimiseksi. Vastaan asettamiini kysymyksiin aikaisemman tutkimuskirjallisuuden ja englannin kielen lukio-opetuksesta keräämäni aineiston avulla. Keskeisiä elementtejä tutkielmassa ovat erityisesti pragmaattinen kompetenssi ja kolme yleisen tason puhestrategiaa (keskustelun aloittaminen, oman puheenvuoron säilyttäminen sekä keskustelun ylläpitäminen). Aineistossa on mukana 65 ensimmäisen vuosiluokan lukiolaista (luokka A ja B) Helsingistä ja Espoosta. Opetusmateriaalina on käytetty SCOTS korpusta; tarkemmin määriteltynä puhetiedosto nimeltä Conversation 20: Four secondary school girls in the North East. Tiedostossa esille tulleet, kolmeen puhestrategiaan liittyvät fraasit, sanat ja rakenteet havainnollistettiin opiskelijoille mm. AntConc - konkordanssiohjelman avulla. Opiskelijat tekivät myös kirjallisia ja suullisia harjoituksia, jotka liittyivät puhestrategioihin. Neljälle vapaaehtoiselle opiskelijalle suunnattu toinen suullinen tehtävätyyppi vapaamuotoisine keskusteluineen äänitettiin, transkriboitiin ja tuloksia arvioitiin mm. eurooppalaisen viitekehyksen avulla. Lisäksi B - luokka vastasi kyselylomakkeeseen, jossa kysyttiin heidän mielipiteitään esim. hyödyllisimmästä testioppitunnista sekä heidän osallistumishalukkuudestaan uudelle pitkän englannin kahdeksannelle syventävälle kurssille. Tutkimustulokset ovat kannustavia ja osoittavat, että puhestrategioita on mahdollista opettaa jo lukiotasolla. Vaikka tutkimuksessa käytetty lähestymistapa oli opiskelijoille osittain uusi, valtaosa heistä myönsi oppineensa uutta englannin kielen keskustelurakenteista. Lisäksi vapaaehtoisten opiskelijoiden äänitetyt ja transkriboidut keskustelut tarjoavat hyvän lähtökohdan mahdolliselle jatkotutkimukselle.