Climate change has been predicted to adversely impact regional air quality with resulting health effects. Here a regional air quality model and a technology analysis tool are used to assess the ...additional emission reductions required and associated costs to offset impacts of climate change on air quality. Analysis is done for six regions and five major cities in the continental United States. Future climate is taken from a global climate model simulation for 2049-2051 using the Intergovernmental Panel on Climate Change (IPCC) A1B emission scenario, and emission inventories are the same as current ones to assess impacts of climate change alone on air quality and control expenses. On the basis of the IPCC A1B emission scenario and current control technologies, least-cost sets of emission reductions for simultaneously offsetting impacts of climate change on regionally averaged 4th highest daily maximum 8-hr average ozone and yearly averaged PM
2.5
(particulate matter PM with an aerodynamic diameter less than 2.5 μm) for the six regions examined are predicted to range from $36 million (1999$) yr
-1
in the Southeast to $5.5 billion yr
-1
in the Northeast. However, control costs to offset climate-related pollutant increases in urban areas can be greater than the regional costs because of the locally exacerbated ozone levels. An annual cost of $4.1 billion is required for offsetting climate-induced air quality impairment in 2049-2051 in the five cities alone. Overall, an annual cost of $9.3 billion is estimated for offsetting climate change impacts on air quality for the six regions and five cities examined. Much of the additional expense is to reduce increased levels of ozone. Additional control costs for offsetting the impacts everywhere in the United States could be larger than the estimates in this study. This study shows that additional emission controls and associated costs for offsetting climate impacts could significantly increase currently estimated control requirements and should be considered in developing control strategies for achieving air quality targets in the future.
To study the effects of octreotide, a somatostatin analogue, in patients with Idiopathic Intracranial Hypertension (IIH).
We performed a prospective, open-label study of the effect of Octreotide on ...26 patients with symptoms and signs of IIH, investigated by brain MRI and lumbar puncture. Octreotide was administered subcutaneously, at an initial dose of 0.3 mg/day; and was gradually increased until headache was relieved (upper-dose limit: 1 mg/day). Treatment with octreotide at 1 mg/day was administered for a maximum of six to eight months and afterwards the dose was gradually tapered. Patients were followed prospectively every month for three years. CSF opening pressure was measured before the treatment was started and again in the first follow-up examination, on month one. In all follow-up visits the presence of papilledema was evaluated by fundoscopy; visual fields and visual acuity were also examined.
Overall 24/26 patients improved significantly (92%). Headache was relieved within days (1-10, median 7 days). Papilledema subsided in all 24 patients, in up to two months (35 to 68, median 45 days). Visual disturbances, initially presenting in 20 of our patients, improved in 18 (90%). The mean reduction in CSF pressure after treatment was 20.72A+/-10.7 cmH2O (range 2 to 48). Patients were followed for three years after cessation of treatment. No recurrence of papilledema, or any other symptoms, has been observed.
Octreotide resulted in a significant and sustained improvement of IIH in our patients. These results suggest that it may be an effective alternative to existing treatments for IIH.
The present study demonstrates a new experimental model to compare the efficacy of end-to-end and end-to-end neurorrhaphy in free muscle flap neurotization. Forty animals were used, divided into four ...equal groups named A, B, C and D. The peripheral stump of the thoracodorsal nerve was stitched end-to-end in groups A and C and end-to-side in groups B and D to the long thoracic nerve. Free functional muscle transfer was simulated by putting vascular clamps to the thoracodorsal artery (FD SS8R, F: 15 to 20 g) and vein (FD SS6R, F: 10 to 15 g) for 60 minutes and transecting and then restitching the origin and insertion of the latissimus dorsi muscle. Electromyographic and histological studies were performed 150 days following completion of the experiment. The results could indicate the possibility that end-to-side neurorrhaphy might be used in free functional muscle transfer as an alternative to end-to-end neurorrhaphy. We believe that the proposed experimental model is useful for the comparative study between end-to-end and end-to-side neurorrhaphy in free muscle flap neurotization, as these are pure motor nerves and innervate synergistic muscles, are in close approximation, and have similar diameters.
The independence and the maintenance of the autonomy of the elderly promotes the self-care and the quality of living of the long-lived population. With the aid of Information and Communication ...Technologies (ICT), KINOPTIM project develops a tele-monitoring solution to be used by the elderly in their home environment in order to reduce the risk of falls by remotely monitoring the mobility of the persons through a series of interactive virtual reality games defined by clinicians. Data acquired by optical and motion sensors are fused to evaluate the mobility status of the senior and are processed by the Medical Business Intelligence (MBI) module of KINOPTIM platform, to assist the identification of symptomatic functional features, that decrease person's mobility status over time, and help to decide for proactive or active interventions. This paper focuses on the progress of the development of MBI module and the integration with the KINOPTIM platform.
Deep brain stimulation (DBS) represents one of the more recent advancements in Neurosurgery. Even though its most successful applications evolved in movement disorders (MDs), indications now include ...pain, psychiatric disorders, epilepsy, cluster headaches and Tourette syndrome. As this type of surgery gains popularity and the indications for DBS surgery increase, so it will certainly increase the number of neurosurgeons who will use this neuromodulatory technique. A detailed description of the technical aspects of the DBS procedure, as it is performed in our department, is presented. In our opinion, our method is a good combination of all the well-established necessary techniques in a cost-effective way. This technical article may be helpful to neurosurgeons considering to start performing this type of surgery. It could also prompt others who perform DBS regularly to express their views, and hence, lead to further refinement of this demanding procedure.
Falls are prominent among the causes of unintentional injury, particularly for the elderly, bringing serious socioeconomic impact to ageing societies. To address these challenges, ICT have recently ...demonstrated their potential in providing fall prevention solutions to the elderly. KINOPTIM project contributes towards this direction by developing a homecare solution that addresses falls in a preventive manner through training of seniors with the support of an interactive gaming platform. On top of the home care solution, KINOPTIM will implement a telemonitoring system that will follow the person's mobility status over time, and a Medical Business Intelligence (MBI) system will assist medical experts to diagnose impairments and related fall risks, to decide for proactive or active interventions. This paper presents the high level architecture of the KINOPTIM platform, comprising the game technologies as well as the sensing and decision support functionalities provided by the platform.
We present a novel closed-loop subthalamic nucleus (STN) deep brain stimulation (DBS) scheme for Parkinson's disease (PD) and obsessive-compulsive disorder (OCD). The algorithm is designed to ...effectuate real-time, adaptive stimulation employing the outcome of the 0-1 test for chaos as a state-specific biomarker. In case of a null outcome, the system identifies optimal patterns of stimulation desynchronizing pathologic neuronal activity with minimal energy consumption, on grounds of a stochastic dynamical model and an appropriately formulated cost function. Simulations are performed utilizing microelectrode recordings (MERs) acquired during 8 and 2 DBS surgical interventions for PD and OCD, respectively.
Breast cancer diagnosis requires specific expertise from the Medical Doctors. Furthermore, prognosis, monitoring and early detection of malignant findings can be successfully realized through ...synergies between physicians, researchers and general population in concert with the health policy program of each country. Information technology and computational intelligence play a crucial role in the production of digital repositories and cancer registries as well as in the development of systems to support diagnosis. In this paper we present the concept and the architecture of an approved grant under the National Strategic Reference Framework 2007-2013 (NSRF), called e-Prolipsis. Through this project, we will design and implement a web based risk estimation platform and a Central Breast Cancer Registry (CBCR) that will co-operate to provide medical doctors and patients with services such as multiplicity in diagnostic opinions, synergy, computational risk estimation, access to statistical/epidemiological data for trend estimation. Such a system, will serve as a reference tool and will help the clinician, the radiologist, the rural doctor or trainee doctor in the final assessment on the existence or likelihood of breast cancer. The system will assist in the successful diagnosis of breast cancer, giving each patient access to a large pool of doctors and at the same time, the data stored in the CBCR will be used for statistical analysis, providing useful results for improving both the cancer detection application and for making a national policy for combating breast cancer. This system will be accessible through a Web Portal, with different access levels for patients, doctors and general public and different web services available to each user group, eliminating the geographical distances that would be imposed otherwise.
