Head & neck optical diagnostics: vision of the future of surgery

Review paper and Proceedings of the Inaugural Meeting of the Head and Neck Optical Diagnostics Society (HNODS) on March 14th 2009 at University College London.

At the frontiers of surgery: review

The complete surgical removal of disease is a desirable outcome particularly in oncology. Unfortunately much disease is microscopic and difficult to detect causing a liability to recurrence and worsened overall prognosis with attendant costs in terms of morbidity and mortality. It is hoped that by advances in optical diagnostic technology we could better define our surgical margin and so increase the rate of truly negative margins on the one hand and on the other hand to take out only the necessary amount of tissue and leave more unaffected non-diseased areas so preserving function of vital structures. The task has not been easy but progress is being made as exemplified by the presentations at the 2nd Scientific Meeting of the Head and Neck Optical Diagnostics Society (HNODS) in San Francisco in January 2010. We review the salient advances in the field and propose further directions of investigation.

Development of an integrative cessation program for co-smokers of cigarettes and cannabis: demand analysis, program description, and acceptability

Abstract Background Tobacco and cannabis use are strongly interrelated, but current national and international cessation programs typically focus on one substance, and address the other substance either only marginally or not at all. This study aimed to identify the demand for, and describe the development and content of, the first integrative group cessation program for co-smokers of cigarettes and cannabis. Methods First, a preliminary study using expert interviews, user focus groups with (ex-)smokers, and an online survey was conducted to investigate the demand for, and potential content of, an integrative smoking cessation program (ISCP) for tobacco and cannabis co-smokers. This study revealed that both experts and co-smokers considered an ISCP to be useful but expected only modest levels of readiness for participation.Based on the findings of the preliminary study, an interdisciplinary expert team developed a course concept and a recruitment strategy. The developed group cessation program is based on current treatment techniques (such as motivational interviewing, cognitive behavioural therapy, and self-control training) and structured into six course sessions.The program was evaluated regarding its acceptability among participants and course instructors. Results Both the participants and course instructors evaluated the course positively. Participants and instructors especially appreciated the group discussions and the modules that were aimed at developing personal strategies that could be applied during simultaneous cessation of tobacco and cannabis, such as dealing with craving, withdrawal, and high-risk situations. Conclusions There is a clear demand for a double cessation program for co-users of cigarettes and cannabis, and the first group cessation program tailored for these users has been developed and evaluated for acceptability. In the near future, the feasibility of the program will be evaluated. Trial registration Current Controlled Trials ISRCTN15248397

The future of medical diagnostics: review paper

While histopathology of excised tissue remains the gold standard for diagnosis, several new, non-invasive diagnostic techniques are being developed. They rely on physical and biochemical changes that precede and mirror malignant change within tissue. The basic principle involves simple optical techniques of tissue interrogation. Their accuracy, expressed as sensitivity and specificity, are reported in a number of studies suggests that they have a potential for cost effective, real-time, in situ diagnosis.

Equilíbrio estático e dinâmico no indivíduo com espondilite anquilosante: revisão da literatura

Com o objetivo de analisar as alterações musculoesqueléticas dos indivíduos com espondilite anquilosante (EA) e suas repercussões sobre o controle postural, realizou-se uma revisão bibliográfica nas bases de dados da BIREME e EBSCO HOTS e no site Pubmed com as palavras-chave: "ankylosing spondylitis", "postural balance" e "posture". Foram selecionados artigos envolvendo seres humanos e que analisavam o controle postural e a biomecânica dos indivíduos com EA, nos idiomas inglês e português, publicados no período entre 1999 e 2010. Do total de artigos encontrados, apenas quatro preencheram os requisitos. Desses, três compararam os resultados de pacientes com EA com os dados obtidos de indivíduos saudáveis, e um analisou apenas indivíduos com EA. Nenhum artigo continha o mesmo método de análise postural. Para avaliação do equilíbrio foram utilizadas a Escala de Equilíbrio de Berg, a Plataforma de Força e a Magnometria. Os principais desvios posturais encontrados foram aumento da cifose torácica e flexão do quadril, que levam a uma anteriorização do centro de gravidade corporal, apresentando flexão do joelho e plantiflexão do tornozelo como compensação para manter o equilíbrio. Apenas um autor encontrou piora do equilíbrio funcional nos sujeitos com EA. Todos os métodos de avaliação utilizados foram considerados capazes de mensurar o equilíbrio, não havendo uma escala específica para pacientes com EA.

Equilíbrio, controle postural e força muscular em idosas osteoporóticas com e sem quedas

Um dos maiores problemas de saúde pública na população idosa são as quedas, agravando-se quando relacionadas à presença de osteoporose. Dentre os vários fatores de risco, destacam-se a diminuição do equilíbrio, controle postural e força muscular. O objetivo deste trabalho foi comparar o equilíbrio, o controle postural e a força muscular em idosas osteoporóticas com e sem quedas referidas no último ano. Foram avaliadas 45 mulheres entre 65 e 85 anos, divididas em dois grupos com base no relato de quedas nos 12 meses anteriores à avaliação: grupo com quedas (GCQ; n=21) e grupo sem quedas (GSQ; n=24). O equilíbrio foi avaliado por meio da escala de equilíbrio de Berg; o controle postural pelo teste clínico modificado de interação sensorial no equilíbrio (mCTSIB), realizado no equipamento Balance Master®; e a força muscular dos flexores e extensores de joelho e dorsiflexores de tornozelo, com dinamômetro EMG System do Brasil®. Foi considerado nível de significância α=0,05. Houve diferença significativa no equilíbrio (p<0,01) e na velocidade de oscilação do Centro de Pressão (CP) durante o teste mCTSIB nas condições olhos fechados superfície estável (p=0,05) e olhos abertos superfície instável (p<0,01), com valores maiores para o GCQ. Os grupos foram semelhantes entre si em relação à força muscular (p>0,05). Nossos resultados indicam que idosas osteoporóticas com histórico de quedas nos últimos 12 meses possuem pior equilíbrio e controle postural em relação às osteoporóticas sem quedas referidas.

Molecular phylogeny, morphology and their implications for the taxonomy of Eriocaulaceae

The pantropical family Eriocaulaceae includes ten genera and c. 1,400 species, with diversity concentrated in the New World. The last complete revision of the family was published more than 100 years ago, and until recently the generic and infrageneric relationships were poorly resolved. However, a multi-disciplinary approach over the last 30 years, using morphological and anatomical characters, has been supplemented with additional data from palynology, chemistry, embryology, population genetics, cytology and, more recently, molecular phylogenetic studies. This led to a reassessment of phylogenetic relationships within the family. In this paper we present new data for the ITS and trnL-F regions, analysed separately and in combination, using maximum parsimony and Bayesian inference. The data confirm previous results, and show that many characters traditionally used for differentiating and circumscribing the genera within the family are homoplasious. A new generic key with characters from various sources and reflecting the current taxonomic changes is presented.

Tjejer som slåss - en studie om tjejer som varit aktiva våldsutövare

Ungdomsvåldet, framförallt bland unga tjejer, har under de senaste åren ökat. Tjejer är idag i högre grad involverade i våldshandlingar än tidigare och våldet blir allt hårdare. Det övergripande syftet med denna studie var att belysa och undersöka fenomenet "tjejer som slåss". Avsikten var att återspegla hur tjejerna i denna studie beskriver sina personliga erfarenheter av att börja använda våld och av att aktivt ha utövat det. Vidare var avsikten att förstå vad som ligger bakom deras uppbrott och hur livet ser ut efteråt. För att uppnå syftet genomfördes en personlig kvalitativ intervju och fem kvalitativa intervjuer via e-mail. Resultatet var att tjejerna har gemensamma erfarenheter av att börja använda våld och ett antal återkommande riskfaktorer identifierades, exempelvis uppväxtmiljö präglad av våld och någon form av utanförskap bland jämnåriga. Tjejerna har också likartade erfarenheter av att aktivt ha utövat våld. Under tiden som våldsutövare kom många att hamna i brottsliga gäng. Eftersom tjejerna under sin uppväxt upplevt utanförskap uppfattades den gemenskap som de fann i dessa gäng som väldigt positiv. Vägen ut ur våldsbrottsligheten skedde på olika sätt, dock kunde likartade uppbrottsprocesser tydas. Uppbrottet från våldsutövandet karaktäriserades av en process som skedde under en lång tid. Tjejerna angav att de idag lever ett bra liv och att de till största delen har positiva erfarenheter av att ha varit en tjej som slåss. Dock ansåg de också att det är en erfarenhet som är svår att bära på. Studiens främsta fynd var att ensamhet och utanförskap tenderar att spela stor roll både vid vägen in i, under tiden, vägen ut ur våldsbrottslighet och livet efter.

Omvårdnadsåtgärder vid övervikt hos patienter som lider av schizofreni

Övervikt och fetma har utvecklats till ett stort problem i dagens samhälle. Patienter som lider av schizofreni är speciellt drabbade. Dessa patienters medicinska behandling mot sjukdomens symtom har en negativ inverkan på vikten samtidigt som den har en inverkan på deras livskvalité. Syftet med denna litteraturstudie var att belysa omvårdnadsåtgärder samt livskvalité hos patienter som lider av schizofreni samt viktproblem och som undergår behandling med antipsykotiska läkemedel. Metoden bestod av en systematisk litteraturstudie där 13 artiklar av kvantitativ ansats som värderades och analyserades. Resultatet av litteraturstudien visade att det fanns viktminskningsinterventioner att tillgå vid viktökning hos patienter som lider av schizofreni. Livskvalitén påverkades negativt på grund utav viktökning men även positivt i den meningen att den mentala hälsan förbättrades av den antipsykotiska medicineringen. Diskussionen grundade sig på att dessa patienter kunde uppleva två olika effekter av viktökning. Deras mentala hälsa förbättrades när de tog sin medicin på ett adekvat sätt och då ökade i vikt, samtidigt som de upplevde en försämrad livskvalité. Viktminskningsinterventioner var möjliga att genomföra vid övervikt hos patienter som lider av schizofreni och var av vikt för dessa patienters allmänna hälsostatus. Sjuksköterskans roll är att belysa detta problem samt initiera till dessa interventioner eftersom omvårdnaden är sjuksköterskans ansvarsområde.

Variance Reduction in Analytical Chemistry : New Numerical Methods in Chemometrics and Molecular Simulation

This thesis is based on five papers addressing variance reduction in different ways. The papers have in common that they all present new numerical methods. Paper I investigates quantitative structure-retention relationships from an image processing perspective, using an artificial neural network to preprocess three-dimensional structural descriptions of the studied steroid molecules. Paper II presents a new method for computing free energies. Free energy is the quantity that determines chemical equilibria and partition coefficients. The proposed method may be used for estimating, e.g., chromatographic retention without performing experiments. Two papers (III and IV) deal with correcting deviations from bilinearity by so-called peak alignment. Bilinearity is a theoretical assumption about the distribution of instrumental data that is often violated by measured data. Deviations from bilinearity lead to increased variance, both in the data and in inferences from the data, unless invariance to the deviations is built into the model, e.g., by the use of the method proposed in paper III and extended in paper IV. Paper V addresses a generic problem in classification; namely, how to measure the goodness of different data representations, so that the best classifier may be constructed. Variance reduction is one of the pillars on which analytical chemistry rests. This thesis considers two aspects on variance reduction: before and after experiments are performed. Before experimenting, theoretical predictions of experimental outcomes may be used to direct which experiments to perform, and how to perform them (papers I and II). After experiments are performed, the variance of inferences from the measured data are affected by the method of data analysis (papers III-V).

Research and theory driven insights: ten suggestions for L2 reading instruction

[EN]Research and theory on second language reading has reached heightened dimensions in recent years. It is through reading that learners access much information concerning the target language and culture, and consequently reading is an important part of almost all language programs across stages of acquisition. The purpose of this article is to offer informed suggestions for the foreign language instructor of reading. The ideas given in this paper constitute a collaborative project that developed as part of a graduate seminar on L2 Reading and Writing taught at Washington University in St. Louis.

Plant food supplement (PFS) market structure in EC Member States, methods and techniques for the assessment of individual PFS intake

The popularity of herbal products, especially plant food supplements (PFS) and herbal medicine is on the rise in Europe and other parts of the world, with increased use in the general population as well as among specific subgroups encompassing children, women or those suffering from diseases such as cancer. The aim of this paper is to examine the PFS market structures in European Community (EC) Member States as well as to examine issues addressing methodologies and consumption data relating to PFS use in Europe. A revision of recent reports on market data, trends and main distribution channels, in addition an example of the consumption of PFS in Spain, is presented. An overview of the methods and administration techniques used...

Safety assessment of plant food supplements (PFS)

Botanicals and botanical preparations, including plant food supplements (PFS), are widely used in Western diets. The growing use of PFS is accompanied by an increasing concern because the safety of these PFS is not generally assessed before they enter the market. Regulatory bodies have become more aware of this and are increasing their efforts to ensure the safety of PFS. The present review describes an overview of the general framework for the safety assessment of PFS, focusing on the different approaches currently in use to assess the safety of botanicals and/or botanical compounds, including their history of safe use, the tiered approach proposed by the European Food Safety Authority (EFSA), the Threshold of Toxicological Concern (TTC) and the...

Entwicklung eines Spektralradiometers zur Bestimmung von aktinischer Strahlung und Photolysefrequenzen in bewölkter Atmosphäre

In dieser Arbeit wird ein neu entwickeltes Spektralradiometer zur Messung des solaren aktinischen Strahlungsflusses, speziell bei bewölkter Atmosphäre, vorgestellt. Das Meßsystem benutzt ein spezielles neu entwickeltes optisches Empfangssystem mit winkelunabhängiger Empfindlichkeit über den gesamten Raum (4pisr). Das Spektrometer besteht aus einem Gitterspektrographen und einer CCD-Kamera als Detektor, wodurch die schnelle simultane Messung eines Wellenlängenbereiches von 300nm bis 660nm ermöglicht wird. Zudem können Spektren von drei Empfangssystemen gleichzeitig aufgenommen werden, was zur höhenaufgelösten Messung des aktinischen Flusses verwendet wird. Photolysefrequenzen von Ozon, Stickstoffdioxid, und anderen für die troposphärische Chemie interessanten Molekülen werden mit Literaturdaten des molekularen Absorptionsquerschnitts und der Quantenausbeute und dem gemessenen aktinischen Strahlungsfluß berechnet. Zudem werden anhand von Spektren des aktinischen Flusses, die bei der Feldmeßkampagne BERLIOZ (BERLIn OZonexperiment) und bei Feldmessungen an einem 107m hohen Turm auf einem Berg (753m NN, Hunsrück) aufgenommen wurden, die Effekte unterschiedlicher Bewölkungssituationen untersucht. Als Ergebnis dieser Arbeit wurden verschiedene wellenlängenabhängige Effekte deutlich: bei partieller Bewölkung ist der aktinische Fluß am Erdboden gegenüber dem wolkenfreien Fall teilweise reduziert, aber auch erhöht, wobei diese Effekte mit zunehmender Wellenlänge größer werden. Oberhalb von Wolken ist der aktinische Fluß gegenüber dem wolkenfreien Fall erhöht. Dieser Effekt nimmt mit abnehmender Wellenlänge zu.

Kontaktmechanik mit Quarzresonatoren

Die Arbeit befasst sich mit den Änderungen der Resonanzparameter von Schwingquarzen, die durch Kontakte mit festen Körpern an der Oberfläche hervorgerufen werden (Quarz als kontaktmechanische Sonde). Bei Kontakt zwischen (weichen) Gold-Oberflächen tritt ein Peak bei der Dämpfung auf, der mit Reibung in Verbindung gebracht wird.Zur Bestimmung der Resonanzparameter wurde das „ring-down“ Verfahren angewendet, bei dem der Quarzresonator zunächst auf seiner Resonanzfrequenz angeregt wird und dann die frei abklingende Quarzschwingung mit einer exponentiell abfallenden Sinusschwingung angefittet wird. Eine Unterteilung der Abklingkurve in einzelne Segmente liefert bei Kontakt eine amplitudenabhängige Resonanzfrequenz und Abkling-Konstante. Mittels Störungsrechnung wurden daraus explizit nichtlineare Federkraft-Auslenkung und Reibungskraft-Geschwindigkeit Relationen berechnet.Bei Gold-Gold Kontakten zeigt sich ein sublinearer Anstieg der elastischen Kraft mit der Auslenkung, und ein linearer Anstieg der Reibungskraft mit der Geschwindigkeit, der im Gegensatz zu Kontakten zwischen harten und spröden Oberflächen oft erst ab einer kritischen Geschwindigkeit einsetzt. Ist eine Thiol-Monolage in der Kontaktfläche vorhanden, so verringert sich die kritische Geschwindigkeit stark.Das Analyseverfahren wurde weiterhin auf die Untersuchung granularer Medien angewendet, die sich von Festkörpern und Flüssigkeiten durch das Auftreten von Spannungspfaden und Scherinstabilitäten unterscheiden. Dieses Verhalten ist bei kubischen Körnern stärker ausgeprägt als bei Kugeln.