The making of fetal surgery

Fetal diagnosis prompts the question for fetal therapy in highly selected cases. Some conditions are suitable for in utero surgical intervention. This paper reviews historically important steps in the development of fetal surgery. The first invasive fetal intervention in 1963 was an intra-uterine blood transfusion. It took another 20 years to understand the pathophysiology of other candidate fetal conditions and to develop safe anaesthetic and surgical techniques before the team at the University of California at San Francisco performed its first urinary diversion through hysterotomy. This procedure would be abandoned as renal and pulmonary function could be just as effectively salvaged by ultrasound-guided insertion of a bladder shunt. Fetoscopy is another method for direct access to the feto-placental unit. It was historically used for fetal visualisation to guide biopsies or for vascular access but was also abandoned following the introduction of high-resolution ultrasound. Miniaturisation revived fetoscopy in the 1990s, since when it has been successfully used to operate on the placenta and umbilical cord. Today, it is also used in fetuses with congenital diaphragmatic hernia (CDH), in whom lung growth is triggered by percutaneous tracheal occlusion. It can also be used to diagnose and treat urinary obstruction. Many fetal interventions remain investigational but for a number of conditions randomised trials have established the role of in utero surgery, making fetal surgery a clinical reality in a number of fetal therapy programmes. The safety of fetal surgery is such that even non-lethal conditions, such as myelomeningocoele repair, are at this moment considered a potential indication. This, as well as fetal intervention for CDH, is currently being investigated in randomised trials. Copyright © 2010 John Wiley & Sons, Ltd.     

Improved methodology to assess modification and completion of landfill gas management in the aftercare period

Municipal solid waste landfills represent the dominant option for waste disposal in many parts of the world. While some countries have greatly reduced their reliance on landfills, there remain thousands of landfills that require aftercare. The development of cost-effective strategies for landfill aftercare is in society’s interest to protect human health and the environment and to prevent the emergence of landfills with exhausted aftercare funding. The Evaluation of Post-Closure Care (EPCC) methodology is a performance-based approach in which landfill performance is assessed in four modules including leachate, gas, groundwater, and final cover. In the methodology, the objective is to evaluate landfill performance to determine when aftercare monitoring and maintenance can be reduced or possibly eliminated. This study presents an improved gas module for the methodology. While the original version of the module focused narrowly on regulatory requirements for control of methane migration, the improved gas module also considers best available control technology for landfill gas in terms of greenhouse gas emissions, air quality, and emissions of odoriferous compounds. The improved module emphasizes the reduction or elimination of fugitive methane by considering the methane oxidation capacity of the cover system. The module also allows for the installation of biologically active covers or other features designed to enhance methane oxidation. A methane emissions model, CALMIM, was used to assist with an assessment of the methane oxidation capacity of landfill covers.     

Conceptual Frameworks and Methods for Advancing Invasion Ecology

Invasion ecology has much advanced since its early beginnings. Nevertheless, explanation, prediction, and management of biological invasions remain difficult. We argue that progress in invasion research can be accelerated by, first, pointing out difficulties this field is currently facing and, second, looking for measures to overcome them. We see basic and applied research in invasion ecology confronted with difficulties arising from (A) societal issues, e.g., disparate perceptions of invasive species; (B) the peculiarity of the invasion process, e.g., its complexity and context dependency; and (C) the scientific methodology, e.g., imprecise hypotheses. To overcome these difficulties, we propose three key measures: (1) a checklist for definitions to encourage explicit definitions; (2) implementation of a hierarchy of hypotheses (HoH), where general hypotheses branch into specific and precisely testable hypotheses; and (3) platforms for improved communication. These measures may significantly increase conceptual clarity and enhance communication, thus advancing invasion ecology.     

Understanding global sea levels: past, present and future

The coastal zone has changed profoundly during the 20th century and, as a result, society is becoming increasingly vulnerable to the impact of sea-level rise and variability. This demands improved understanding to facilitate appropriate planning to minimise potential losses. With this in mind, the World Climate Research Programme organised a workshop (held in June 2006) to document current understanding and to identify research and observations required to reduce current uncertainties associated with sea-level rise and variability. While sea levels have varied by over 120 m during glacial/interglacial cycles, there has been little net rise over the past several millennia until the 19th century and early 20th century, when geological and tide-gauge data indicate an increase in the rate of sea-level rise. Recent satellite-altimeter data and tide-gauge data have indicated that sea levels are now rising at over 3 mm year⁻¹. The major contributions to 20th and 21st century sea-level rise are thought to be a result of ocean thermal expansion and the melting of glaciers and ice caps. Ice sheets are thought to have been a minor contributor to 20th century sea-level rise, but are potentially the largest contributor in the longer term. Sea levels are currently rising at the upper limit of the projections of the Third Assessment Report of the Intergovernmental Panel on Climate Change (TAR IPCC), and there is increasing concern of potentially large ice-sheet contributions during the 21st century and beyond, particularly if greenhouse gas emissions continue unabated. A suite of ongoing satellite and in situ observational activities need to be sustained and new activities supported. To the extent that we are able to sustain these observations, research programmes utilising the resulting data should be able to significantly improve our understanding and narrow projections of future sea-level rise and variability.     

Psychosocial and Ergonomic Factors,and Their Relation to Musculoskeletal Complaints in the Swedish Workforce

A random sample of 1 000 subjects (20–65 years old) from the national population of Sweden received a questionnaire; 70% (n = 695) replied, of whom 532 were occupationally active. Female gender, working with neck and/or body bent forward, arms above shoulders, and precision work tasks were predictors of musculoskeletal symptoms. Neck, shoulder, and upper back symptoms were more common in a strained situation at work (high demands, low control) (adjusted odds ratios [adjOR] 2.76, 2.80, and 2.26, respectively). Among females, neck and shoulder symptoms were more common in an iso-strain situation (high demands, low control and low social support) (adjOR 4.43 and 3.69, respectively), and low back symptoms were more common at low social support combined with a passive work situation (adjOR 3.35). No associations were found between iso-strain model and symptoms among males. In conclusion, iso-strain work situation was associated with neck symptoms among females, even when controlling for ergonomic factors.     

Urban community gardening,social capital,and "integration" – a mixed method exploration of urban "integration-gardening" in Copenhagen,Denmark

ABSTRACT

This study examines a community garden in Copenhagen, Denmark, "The Urban Integration Gardens" that endeavours to strengthen social integration in the local multicultural neighbourhood. The "community" in the gardens is explored, with a focus on how they foster social capital, particularly opportunities for "bridging" social capital. A mixed-methods approach is used, by employing a qualitative analysis of gardeners’ perceptions of "community", diversity and inclusivity, through the lens of "cognitive" social capital, and the meanings the gardeners assign to their experiences, and how they understand their involvement in the gardens. We also examine "structural" dimensions of social capital, involving quantitative data from a questionnaire and data from Statistics Denmark, comparing data concerning socio-demographic backgrounds from gardeners and residents in the local neighbourhood and Copenhagen. Major findings include that the garden generates both bonding and bridging "cognitive" social capital, and the gardeners consistently agreed that the garden has a strong community, and is permeated by diversity and inclusivity. Nonetheless, data from Denmark’s Statistics Office reveal that the garden does not "represent" the diversity in the neighbourhood regarding the distribution of members with a Western/non-Western background, as well as social class. This suggests that endeavours to involve co-citizens with non-Western backgrounds and gardeners with lower social status are restrained by potential structural barriers, which limits the "width" of bridging social capital in the garden.     

Wood Flour-Reinforced Green Composites: Parameter Optimization via Multi-criteria Decision-Making Methods

Journal of Polymers and the Environment - The aim of this study was to investigate the physical, mechanical, morphological, structural, and thermal properties of polylactic acid (PLA) and...