How do patients' clinical phenotype and the physiological mechanisms of the operations impact the choice of bariatric procedure?

Bariatric surgery is currently the most effective option for the treatment of morbid obesity and its associated comorbidities. Recent clinical and experimental findings have challenged the role of mechanical restriction and caloric malabsorption as the main mechanisms for weight loss and health benefits. Instead, other mechanisms including increased levels of satiety gut hormones, altered gut microbiota, changes in bile acid metabolism, and/or energy expenditure have been proposed as explanations for benefits of bariatric surgery. Beside the standard proximal Roux-en-Y gastric bypass and the biliopancreatic diversion with or without duodenal switch, where parts of the small intestine are excluded from contact with nutrients, resectional techniques like the sleeve gastrectomy (SG) have recently been added to the armory of bariatric surgeons. The variation of weight loss and glycemic control is vast between but also within different bariatric operations. We surveyed members of the Swiss Society for the Study of Morbid Obesity and Metabolic Disorders to assess the extent to which the phenotype of patients influences the choice of bariatric procedure. Swiss bariatric surgeons preferred Roux-en-Y gastric bypass and SG for patients with type 2 diabetes mellitus and patients with a body mass index >50 kg/m(2), which is consistent with the literature. An SG was preferred in patients with a high anesthetic risk or previous laparotomy. The surgeons' own experience was a major determinant as there is little evidence in the literature for this approach. Although trends will come and go, evidence-based medicine requires a rigorous examination of the proof to inform clinical practice

Multikulturele onderwys vir Suid-Afrika: utopiese ideaal of logiese realiteit?

Multicultural education for South Africa: utopian ideal or logical reality?In a new South African dispensation the reconstruction of the global education system necessitates fundamental change to existing educational policies and practices. An educational approach which enjoys increasing attention and consideration today, is multicultural education. South Africa as a multicultural society needs an educational system that recognises and accommodates the value of ethnic and cultural diversity. Meaningful education takes sociocultural realities into consideration in preparing the youth for a multicultural society o f tomorrow. Multicultural education therefore seems to be a logical reality in empowering all children towards adequate and constructive adulthood

Steps Towards Averting Desertification in the Sefiane Rural Community, Algeria: The Role of Environmental Education

Desertification reflects and contributes towards societal problems such as poverty, underdevelopment and lack of food security. For mere survival purposes, many people feel they have no option but to engage in environmentally unsustainable activities that further contribute to desertification and perpetuate the cycle. Constraints in successfully dealing with desertification have been identified as being a lack of adequate and validated information on the different aspects of the phenomenon in individual areas, a lack of sustainable development plans for desertified areas, a lack of active awareness-raising campaigns, a lack of appropriate training on assessment and mitigation of desertification and the neglect of local stakeholder involvement in addressing land degradation and desertification. This paper provides a contextual profile of desertification and land degradation processes in the Sefiane rural community in Algeria, focusing on how the community’s survival is affected by their current farming activities. A qualitative study using a snowball sampling technique to identify respondents was conducted. Data collection tools included observation, interviews and questionnaires. The research findings, which highlighted activities that farmers engage in that compromise their ability to sustain their environment and their livelihood, were considered and used as a guideline to develop a framework for a contextually relevant environmental education programme that could empower the local community to address the land degradation and sustainable agricultural concerns in their community

No problem! Avoidance of cultural diversity in teacher training

Research all over the world indicates that initial teacher training, as far as multicultural education is concerned, is grossly inadequate or, in many instances, non-existent. In many cases it is still regarded as a luxury which cannot be afforded in a time of scarcity of resources, or as a contentious politically sensitive area best avoided. Avoidance or so-called ";no problem!"; strategies are often the outcome of teacher training that fails or falls short of addressing issues of diversity in schools. There is much talk worldwide of permeating a multicultural perspective in teacher training programmes. Most educational stakeholders agree on the feasibility of training prospective teachers to teach in a multicultural society. In practice, however, very little, if anything (in some cases), is being done to impregnate existing initial teacher training courses with a pluralistic vision or perspective. Teachers cannot be expected to be effective in teaching multicultural content and working effectively with ethnically diverse student groups without being professionally prepared for this task. (South African Journal of Education: 2003 22(3): 184-187

The Wide-field High-resolution Infrared TElescope (WHITE)

The Wide-field High-resolution Infrared TElescope (WHITE) will be dedicated in the first years of its life to carrying out a few (well focused in terms of science objectives and time) legacy surveys. WHITE would have an angular resolution of ~0.3'' homogeneous over ~0.7 sq. deg. in the wavelength range 1 - 5 um, which means that we will very efficiently use all the available observational time during night time and day time. Moreover, the deepest observations will be performed by summing up shorter individual frames. We will have a temporal information that can be used to study variable objects. The three key science objectives of WHITE are : 1) A complete survey of the Magellanic Clouds to make a complete census of young stellar objects in the clouds and in the bridge and to study their star formation history and the link with the Milky Way. The interaction of the two clouds with our Galaxy might the closest example of a minor merging event that could be the main driver of galaxy evolution in the last 5 Gyrs. 2) The building of the first sample of dusty supernovae at z<1.2 in the near infrared range (1-5 um) to constrain the equation of state from these obscured objects, study the formation of dust in galaxies and build the first high resolution sample of high redshift galaxies observed in their optical frame 3) A very wide weak lensing survey over that would allow to estimate the equation of state in a way that would favourably compete with space projects.Comment: Invited talk to the 2nd ARENA Conference : "The Astrophysical Science Cases at Dome C" Potsdam 17-21 September, 200

Emergent aneurysm clipping without angiography in the moribund patient with intracerebral hemorrhage: the use of infusion computed tomography scans

Journal ArticleTHE AUTHORS REPORT their experience with 25 patients (mean age, 44.3 ± 12.1 years) with an intracerebral hematoma (ICH) from a ruptured aneurysm who were emergently operated on without angiography. Instead, preoperative high-resolution infusion computed tomography (CT) scans were used to identify the aneurysm causing the hemorrhage. In all patients, the preoperative Glasgow Coma Scale score was 1 cm) midline shift (n = 18). Infusion CT scans correctly identified the aneurysm in all patients (middle cerebral artery, 18; posterior communicating artery, 2; carotid bifurcation, 3; anterior communicating artery, 2). Partial evacuation of the hematoma guided by infusion CT scan was usually required first to clip the aneurysm definitively using standard microvascular techniques. Intraoperative rupture occurred twice, and temporary clips were used on four occasions. Lobectomy (n = 8) , decompressive craniotomy (n=15), and ventriculostomy (n=8) were required to control cerebral swelling. All patients underwent postoperative angiography to confirm aneurysm obliteration. Eleven unruptured aneurysms were subsequently identified. Nine had been predicted by infusion scan. Twelve patients survived, eight of whom were only moderately disabled and were independent at 6-months' follow-up. Of the 13 patients who died, all except one died within 4 days of admission. The authors conclude that although angiographic verification before aneurysm surgery is preferable, in the moribund patient with intracerebral hemorrhage, infusion CT scanning provides sufficient information concerning vascular anatomy to allow rational emergency craniotomy and aneurysm clipping

A Bayesian approach for inferring the dynamics of partially observed endemic infectious diseases from space-time-genetic data

We describe a statistical framework for reconstructing the sequence of transmission events between observed cases of an endemic infectious disease using genetic, temporal and spatial information. Previous approaches to reconstructing transmission trees have assumed all infections in the study area originated from a single introduction and that a large fraction of cases were observed. There are as yet no approaches appropriate for endemic situations in which a disease is already well established in a host population and in which there may be multiple origins of infection, or that can enumerate unobserved infections missing from the sample. Our proposed framework addresses these shortcomings, enabling reconstruction of partially observed transmission trees and estimating the number of cases missing from the sample. Analyses of simulated datasets show the method to be accurate in identifying direct transmissions, while introductions and transmissions via one or more unsampled intermediate cases could be identified at high to moderate levels of case detection. When applied to partial genome sequences of rabies virus sampled from an endemic region of South Africa, our method reveals several distinct transmission cycles with little contact between them, and direct transmission over long distances suggesting significant anthropogenic influence in the movement of infected dogs

Decontamination on pork carcasses: qualification of thermic treatment by thermal imaging

Singeing improves the visual quality of rind in pig slaughterhouses. In addition, the thermic inactivation allows the bacterial contamination of carcass surfaces to be reduced. However, the thermal image of pig carcasses shows temperature differences along the carcasses. The objective of this study was to develop a method to analyze a thermal image. After defining an imaging protocol adapted to pig slaughterhouses, image analysis was carried out with the free software: ImageJ©. Three methods were developed in order to preserve the spatial arrangement and time information for each measurement: (1) Method by line profile, (2) Method by mouse over, (3) Method by mouse over and line profile. Moreover, the method had to be simple and accurate. After a statistical comparison (mean, variance, distribution) between the three methods on 20 carcasses, the method by line profile was validated to analyze the characteristics of heat treatment in four pig slaughterhouses during process. This validated method of image acquisition and analysis was a tool used to measure the temperature variability on carcasses. The reference temperature was the temperature of carcasses after 90 minutes of continuous process. This method confirmed temperature differences on carcass surfaces (the top part of the carcass is warmer than the bottom part within a range of 2-7°C) and within a production day; the lowest temperatures were observed when the process started or re-started (after breaks), on average 4°C. These temperature variations along the working day were observed in every slaughterhouse studied. Bacterial contamination was evaluated on carcasses prior and following singeing for two heating settings. Results were similar to the literature (reduction of 3 Log10 CFU/cm² of the Aerobic colony counts). With this pragmatic method, companies could have access to a measurement tool not only for characterizing, checking, optimizing and qualifying the efficiency of singeing, but also for investigating all thermic treatments on meat in slaughterhouses

Utilisation conjointe de trains d'ondes LiDAR vert et infrarouge pour la bathymétrie des eaux de très faible profondeurs

La bathymétrie et la topographie des surfaces immergées sont des connaissances essentielles pour la gestion durable des rivières et des espaces littoraux. Parmi les techniques permettant de les obtenir, le LiDAR bathymétrique apparaît prometteur par sa capacité à relever de grandes surfaces en un temps limité, avec une forte résolution spatiale et de manière continue entre zones émergées et immergées. Bien que certaines études aient porté sur la précision de cette technique dans les zones côtières de profondeur modérée, peu se sont intéressées aux eaux très peu profondes (<3m). Dans cette étude, une nouvelle méthode de traitement de formes d'ondes LiDAR pour les très faibles profondeurs est proposée. Cet algorithme s'appuie sur le traitement conjoint des trains d'ondes vert et proche-infrarouge (PIR). La densité et la précision des données résultantes sur les eaux côtières très peu profondes sont ensuite analysées. Les résultats de ces développements et analyses sont présentés sur des données acquises sur le Golfe du Morbihan (France) par le Service Hydrographique et Océanographique de la Marine (SHOM) en 2005 avec un système SHOALS qui fournit les formes d'ondes Raman, PIR et vert. Ce travail met l'accent sur la comparaison de la qualité entre les données bathymétriques livrées issues du traitement des signaux par l'opérateur et celles issues de l'algorithme de traitement proposé. Pour la validation des résultats, une méthode spécifique est utilisée ici afin de faciliter la comparaison de mesures altimétriques réalisées entre des points GPS de référence et des empreintes LiDAR (diamètre de l'ordre de 2m). Dans les très faibles profondeurs d'eau, l'algorithme proposé extrait 41% de mesures supplémentaires par rapport aux données livrées, avec un biais de mesure comparable (environ 5cm) et un écart-type des erreurs plus faible (26,1cm contre 41,1cm). 55% de ces mesures supplémentaires sont situés à une profondeur comprise entre 1,5m et 2m. De plus, l'algorithme proposé améliore la profondeur minimale détectable de 80cm par rapport aux données livrées (1m contre 1,8m)