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Perspectives on bioenergy and biotechnology in Brazil.

Brazil is one of the world's largest producers of alcohol from biomass at low cost and is responsible for more than 1 million direct jobs. In 1973, the Brazilian Program of Alcohol (Proalcool) stimulated the creation of a bioethanol industry that has led to large economic, social, and scientific improvements. In the year 1984, 94.5% of Brazil's cars used bioethanol as fuel. In 2003/2004, 350.3 million of sugarcane produced 24.2 million t of sugar and 14.4 billion L of ethanol for an average 4.3 million cars using ethanol. Since its inception, cumulative investment in Proalcool totals US$11 billion, and Brazil has saved US$27 billion in oil imports. The ethanol production industry from sugarcane gene-rates 152 times more jobs than would have been the case if the same amount of fuel was produced from petroleum, and the use of ethanol as a fuel is advantageous for environmental reasons. In 2003, one of the biggest Brazilian ethanol industries started consuming 50% of the residual sugarcane bagasse to produce electrical energy (60 MW), a new alternative use of bioenergy for the Brazilian market. Other technologies for commercial uses of bagasse are in development, such as in the production of natural fibers, sweeteners (glucose and xylitol), single-cell proteins, lactic acid, microbial enzymes, and many other products based on fermentations (submerged and semisolid). Furthermore, studies aimed at the increase in the biosynthesis of sucrose and, consequently, ethanol productivity are being conducted to understand the genetics of sugarcane. Although, at present, there remain technical obstacles to the economic use of some ethanol industry residues, several research projects have been carried out and useful data generated. Efficient utilization of ethanol industry residues has created new opportunities for new value-added products, especially in Brazil, where they are produced in high quantities.

Biotechnology↗

[Thinking about care in the dialetic relationship among social subjects].

The objective of this essay is to offer theoretical data to the understanding of care, oriented by an ethic in which interaction among the constitutive dimensions of the social subjects is put into effect. A review of the historical construction of care and its medication appraising and its influence in the training and in professional practices is done. It emphazises current meaning of care and the need for building a healthcare political project that should not only respond to the available services increasing and to technical actions solution but also, sensitively listen to the needs by taking into account singularities and the formation of critical-reflexive subjects able to promote changes and modify the reality in which they live in.

Delivery of Health Care↗

Direct oblique sagittal CT of orbital wall fractures.

Direct oblique sagittal CT was used to evaluate trauma to 77 orbits. Sixty-seven orbital wall fractures with intact orbital rims (36 floor, 22 medial wall, nine roof) were identified in 47 orbits. Since persistent diplopia and/or enophthalmos may warrant surgical repair of orbital floor fractures, optimal imaging should include an evaluation of extraocular muscle status, the nature and amount of displaced orbital contents, and an accurate definition of fracture margins. For orbital floor fractures, a combination of the direct oblique sagittal and direct coronal projections optimally displayed all fracture margins, the fracture's relationship to the inferior orbital rim and medial orbital wall, and the amount of displacement into the maxillary sinus. Inferior rectus muscle status with 36 floor fractures was best seen on the direct oblique sagittal projection in 30 fractures (83.3%) and was equally well seen on sagittal and coronal projections in two fractures (5.5%). Floor fractures were missed on 100% of axial, 5.5% of sagittal, and 0% of coronal projections. Since the direct oblique sagittal projection complements the direct coronal projection in evaluating orbital floor fractures, it should not be performed alone. A technical approach to the CT evaluation or orbital wall fractures is presented.

Adolescent↗

Objective measurement of upper limb activity and mobility during everyday behavior using ambulatory accelerometry: the upper limb activity monitor.

Ambulatory accelerometry is a technique that allows objective measurement of aspects of everyday human behavior. The aim of our research has been to develop, validate, and apply this technique, which recently resulted in an upper limb activity monitor (ULAM). The ULAM consists of body-mounted acceleration sensors connected to a waist-worn data recorder and allows valid and objective assessment of activity of both upper limbs during performance of also automatically detected mobility-related activities: lying, sitting, standing, walking, cycling, and general movement. The ULAM can be used to determine (limitations of) upper limb activity and mobility in freely moving subjects with upper limb disorders. This article provides a detailed description of its characteristics, summarizes the results of a feasibility study and four application studies in subjects having upper limb complex regional pain syndrome, discusses the most important practical, technical, and methodological issues that were encountered, and describes current and future research projects related to measuring (limitations of) upper limb activity.

Acceleration↗

Web site blues.

So far, Rachel Soltanoff's instincts had been right. As CEO in this fictional case study, she had successfully navigated TradeRite Software's transition from a news service for stockbrokers to a $70 million provider of shrink-wrapped software geared toward both brokers and the growing day-trader market. Now a well-financed start-up, Stock-net.com, was testing a very competitive product that traders could download directly over the Web. And TradeRite's Web site was nothing more than a collection of elaborate marketing brochures. Rachel knew she needed to start selling over the Web. But the e-commerce consultants she had hired to set up her Web store were behind schedule, and their 21-year-old CEO had just resigned. Her product manager, Lisa Bandini, was working overtime to transform TradeRite's entire product line into Web-aware applications to match Stocknet's, and Rachel had $2.5 million to launch them. But the consultants said it would take $5 million just to rent e-commerce capabilities. Ace sales VP Brian Rockart thought the company had already wasted too much time and money--money from his budget--on its Web site. Marketing VP Rob Collins thought TradeRite should focus on its core stockbroker customers. Chief Technical Officer Joe Martinez doesn't want to go ahead without a pilot project. Should Rachel try to convince Brian, Rob, and the rest of the senior management team that e-commerce is the way to go? Four commentators offer advice.

Commerce↗

Prenatal diagnosis of epignathus in the first half of pregnancy: a case report and review of the literature.

Congenital teratomas of the oral cavity commonly present as tissue masses projecting from the mouth. The important prognostic determinants are: the age of presentation, technical problems during surgical removal of the mass, associated anomalies, and the nature of the composing tissues. This study reports one case of epignathus (an extremely rare oropharyngeal teratoma) that was diagnosed by ultrasonography at 19 weeks of gestation and reviews the relevant literature.

Adult↗

Screening for retinopathy of prematurity employing the retcam 120: sensitivity and specificity.

OBJECTIVES: To compare the method of photographic screening using the RetCam 120 to the standard method of screening for retinopathy of prematurity (ROP) by ophthalmologic examination. METHODS: A total of 100 RetCam 120 photoscreening examinations of the retina were performed on 32 premature infants. These were stored in a separate file from which all identifying information was removed. At this same examination, a detailed ophthalmological evaluation, employing the indirect ophthalmoscope with scleral depression, was performed by an experienced examiner. Masked examiners performed an evaluation of the fundus photographs to identify presence or absence of ROP, the location and extent of the disease, and the presence or absence of plus disease. These data were then compared with the results of the ophthalmological examination to determine the specificity, sensitivity, and the positive and negative predictive value (PPV and NPV) of the method. RESULTS: Retinopathy of prematurity was detected in 68 of 100 subjects by ophthalmologic examinations and in 58 of 100 subjects' photoscreening examinations. No ROP was detected in 32 of 100 subjects. The sensitivity of the method was 56 (82.4%) of 68 and the specificity was 30 (93.8%) of 32. The PPV was 96.6%; NPV, 76.9%. CONCLUSIONS: The sensitivity of the method was low. The ROP that was missed was peripheral stage 1 or stage 2 disease in peripheral zone 2 or zone 3. This was largely due to the technical limitations of the speculum-camera interface preventing a better view of the periphery. The ROP cases that were missed by the photographic examination regressed spontaneously on follow-up. No disease more posterior to peripheral zone 2 was overlooked. These results detail the accuracy of the method employing the technique of photoscreening as a potential substitute for detailed ophthalmological examination. At present there are clear technical limitations to such a substitution. The study is part of an ongoing project to determine the feasibility of employing neonatal nurses trained to take digitized images of the premature infant's retina and telemeter the results to be read by an experienced ophthalmologist remote from the site.

False Negative Reactions↗

Virtual colonography: techniques and current clinical applications.

The advent of volumetric helical computed tomography (CT), coupled with the almost universal use of oral and intravenous contrast agents, has resulted in CT becoming the diagnostic and therapeutic cornerstone for alimentary tract disease. Recent technical advances, further enhanced by innovative software developments, now permit multiplanar and endoluminal projections of the entire abdomen, and have resulted in the development of novel diagnostic applications in the abdomen.

Journal Article↗

[Analysis of malarial infection among technical personnel dispatched to Burkina Faso, West Africa].

Fifty-six technical personnel, who had been dispatched to carry out the Chinese-aid project in Burkina Faso, West Africa (a highly prevalent area of malaria and infected by asexual from of plasmodium), developed malaria within one year after the repatriation from that country. The number of paroxysm of this disease per individual varied from one to six, with an average of 2.8.

Burkina Faso↗

Case study: benefits of IT for older people and their carers.

The first article in this series (Vol 11(11): 759-63) described the development of the ACTION project, an information technology-based initiative designed to enhance the quality of life for family carers and older people, and the second article (Vol 11(12): 827-31) considered how the usability of the ACTION system as a whole was evaluated. This, the third article, presents a case study which describes in more detail the impact of the ACTION project on the lives of both a family carer (Rolf) and his wife (Kerstin), and on the technical worker (Thomas) who helped Rolf and Kerstin to learn to use the ACTION system. The impact of the intervention is assessed using two broad sets of criteria: (1) those relating to the PREP (Preparedness, Enrichment, Predictability) model of nursing interventions, and (2) those relating to the wider implications of participation in a research and development project of this nature.

Aged↗

Can laparoscopic cholecystectomy be a day surgery procedure?

BACKGROUND/AIMS: Gallbladder surgery by videolaparoscopy (VL) is now able to obtain the same goals as traditional surgery, and is associated with comparable or better results both in terms of positive surgical outcome and patient satisfaction. With public health spending under growing social and administrative pressure, and continuous efforts focusing on enhancing the efficiency of both surgical instruments and operating procedures, it is a most attractive, albeit initially challenging, prospect to regard video-laparoscopic surgery as day-case surgery. Herein, the authors assess the outpatient treatment option, due to recent technical developments and relevant major organizational and professional implications, and consider the feasibility of day-case surgery projects which should soon be implemented. METHODOLOGY: From January 1994 to December 1996, 1,334 patients underwent videolaparoscopic cholecystectomy. Of these, 898 were women and 436 men. In 1,034 of the laparoscopies gas was used and 300 were performed without gas. Out of the total 1,334 patients who were submitted to the videolaparoscopic cholecystectomy procedure with or without the use of gas, 72 (5.4%) were treated on an outpatient basis. RESULTS: In our series, 93.5% of patients reported normal post-operative functions within 24 hours; 90.2% of patients were able to take oral fluid on the same day of the operation and had normal bowel peristalsis within the first post-operative day. CONCLUSIONS: The authors assess the outpatient option treatment, due to recent technical developments and relevant major organizational and professional implications, and consider the feasibility of a day-case surgery project which should soon be implemented.

Adolescent↗

Dose reduction in computed tomography by attenuation-based on-line modulation of tube current: evaluation of six anatomical regions.

This study investigated the potential of attenuation-based on-line modulation of tube current to reduce the dose of computed tomography (in milliamperes) without loss in image quality. The dose can be reduced for non-circular patient cross-sections by reducing the tube current at the angular positions at which the diameter through the patient diameter is smallest. We investigated a new technical approach with attenuation-based on-line modulation of tube current. Computed tomographic projection data were analyzed to determine the optimal milliampere values for each projection angle in real time, instead of performing prior measurements with localizer radiographs. We compared image quality, noise pattern, and dose for standard scans and for scans with attenuation-based on-line modulation of tube current in a group of 30 radiation therapy patients. Six different anatomical regions were examined: head, shoulder, thorax, abdomen, pelvis, and extremities (knee). Image quality was evaluated by four radiologists in a blinded fashion. We found the dose to be reduced typically by 15-50 %. In general, no deterioration in image quality was observed. Thus the dose in computed tomography be reduced substantially by technical measures without sacrificing image quality. Attenuation-based on-line modulation of tube current is an efficient and practical means for this.

Humans↗

Conservative surgery in solitary and bilateral renal carcinoma: indications and technical considerations.

Seven patients presented with solitary or bilateral renal carcinoma. All 4 patients treated by partial nephrectomy are well and 3 are free of disease (followup of 24 to 32 months). A survey of similar series reveals a survival of 78 per cent in patients with solitary renal tumors undergoing partial nephrectomy (mean followup of 52 months). Since the projected survival in patients undergoing chronic hemodialysis for the same interval is only 65 per cent partial nephrectomy, when technically feasible, would appear to be the treatment of choice in solitary renal carcinoma. In cases involving bilateral lesions the survival rate after partial nephrectomy seems to be similar to that of cases on hemodialysis.

Aged↗

On the improvement of demographic forecasting in Poland.

"In the paper attempts at improving demographic projections, undertaken in Poland in the late 1980s, are discussed." The focus is on the use of the LIPRO (LIfe-style PROjections) model, developed by the Netherlands Interdisciplinary Demographic Institute. The model is used "to project changes in marital composition of Poland's population by place of residence (urban/rural areas) till 2050.... In the paper, the brief description of the marital status version of the LIPRO model is given and the selected results of projections for the period 1985-2050 are discussed to illustrate the usefulness of that approach."

Demography↗

[Future changes in the age structure and the problem of pensions in the Austrian case].

Projections of rapid demographic aging in Austria are reviewed up to the year 2050. "After the turn of the century the proportion of the population above age 60 will gradually increase from 20% to at least 30 if not as much as 40 or 50% by 2050. During the same period the population above age 80 will be multiplied by four." It is argued that drastic pension reform is needed to guarantee future pension payments and avoid a large increase in the pension contribution rate. (SUMMARY IN ENG AND FRE)

Adult↗

'Imi Hale -- the Native Hawaiian cancer awareness, research, and training network: second-year status report.

PURPOSE: The purpose of this paper is to describe 'Imi Hale, a program developed and managed by Native Hawaiians to increase cancer awareness and research capacity among Native Hawaiians. This US subgroup of indigenous people of the Hawaiian islands has disproportionately high rates of cancer mortality and low rates of participation in health and research careers. METHODS: As a community-based research project, 'Imi Hale spent its first year gathering data from Native Hawaiians about their cancer awareness and research priorities. These findings guide 'Imi Hale's community and scientific advisors, a community-based Institutional Review Board, Na Liko Noelo (budding researchers), and staff in developing and carrying out projects that address these priority areas. Emphasis is placed on transferring skills and resources to Native Hawaiians through training, technical assistance, and mentorship. A biennial survey assesses the extent to which community-based participatory research principles are being followed. PRINCIPAL FINDINGS: By the end of the school year, statewide and island-specific awareness plans were produced, and 9 funded awareness projects are supporting the development and dissemination of Hawaiian health education materials. Research accomplishments include the enrollment of 42 Native Hawaiian Na Liko Noelo (budding researchers), 22 of which are involved in 14 funded research projects. The biennial evaluation survey found that 92% of our advisors felt that 'Imi Hale was promoting scientifically rigorous research that was culturally appropriate and respectful of Native Hawaiian beliefs, and 96% felt that 'Imi Hale was following its own principles of community-based participatory research. CONCLUSION: 'Imi Hale's community-based approach to promoting cancer awareness will result in a sustainable infrastructure for reducing the cancer burden on Native Hawaiians.

Awareness↗