Borderline Situation Research Articles

A General Darling–Erdős Theorem in Euclidean Space

We provide an improved version of the Darling-Erd\"os theorem for sums of i.i.d. random variables with mean zero and finite variance. We extend this result to multidimensional random vectors. Our proof is based on a new strong invariance principle in this setting which has other applications as well such as an integral test refinement of the multidimensional Hartman-Wintner LIL. We also identify a borderline situation where one has weak convergence to a shifted version of the standard limiting distribution in the classic Darling-Erd\"os theorem.

Minor foot amputations in diabetic foot syndrome

The treatment strategy for diabetic foot syndrome must take into account protective sensibility of the foot, open wounds, infection status, and the rules of septic bone surgery. Interventions are classified as elective, prophylactic, curative, or emergency. Amputations in the forefoot and midfoot region are performed as ray amputations (including metatarsal), which can often be carried out as "inner" amputations. Gentle tissue treatment mandatory because of greater risk of revision with re-amputation compared to classical amputation. Good demarcation of infection, acute osteomyelitis, osteolytic lesions, neurotropic ulcer, arterial and venous blood flow to the other toes, gangrene of other toes with metatarsal affection. Arterial occlusive disease, infection of neighboring areas, avoidable amputations, poorly healing ulcers on the lower leg. Primary dorsal approach; minimal incisional distance (5cm) to minimize skin necrosis risk. Atraumatic preparation, minimize hemostasis to not compromise the borderline perfusion situation. In amputations, plantar skin preparation and longer seams placed as dorsal as possible, either disarticulated and maintain cartilage, or round the cortical metatarsal bone after resection. Diabetes control. Braun splint, mobilization in a shoe with forefoot decompression and hindfoot support, physiotherapy. Antibiotics based on resistance testing. If no complications, dressing change on postoperative day1. Optimal wound drainage by lowering foot several times a day; drainage removal after 12-24h. Insoles and footwear optimization. Amputations require continued attention and if necessary treatment to avoid sequelae. Insufficient treatment associated with recurrent ulceration and altered anatomy.

A Ficção de Respeito a Autonomia Individual como forma de Exploração do Sujeito nas Pesquisas Clínicas com Humanos

O presente artigo promove uma discussão em torno da concepção jurídica ocidental que concebe os indivíduos como sujeitos de direito, polemizando a conveniência de tal formulação no âmbito das pesquisas clínicas em seres humanos, posto a situação comumente limítrofe de vulnerabilidade em que se encontram os voluntários que se submetem aos referidos procedimentos. Para tanto, utilizou-se como marco teórico a obra Introdução crítica ao Direito de Michel Mialle, na qual o autor afirma de maneira contundente que a construção do instituto jurídico do sujeito de direito e a imposição do reconhecimento irrestrito da autonomia individual constituem uma construção do Estado burguês para facilitar a dominação do vulnerável, de maneira que este, mesmo não sendo juridicamente obrigado à praticar determinadas condutas, veja-se obrigado pelas circunstâncias a atuar em consonância com os interesses de tal instituição. Defende-se, desse modo, que a autonomia para consentir com a participação nos ensaios científicos deva ser aferida em cada caso concreto, com atenção especial às circunstâncias capazes de vulnerabilizar o voluntário de pesquisa e mitigar sua autonomia individual em face dos experimentos, sob pena de se estar submetendo o indivíduo à procedimentos nocivos a sua vida e saúde em prol dos interesses da sociedade de capital.

Intellectuals at Auschwitz: Jean Améry and Primo Levi on the Mind and Its Limits

For Jean Améry, the uselessness of intellectual culture in the “borderline situation” of Auschwitz proved the essential incompetence of the intellect as such. For Primo Levi, the intellect served as a precious resource in dealing with the realities of the camp. Levi's debate with Améry, the author of this article argues, is of fundamental value for our understanding of the nature and function of the intellect. A comparison of Améry's spirited defiance of the conditions of existence at Auschwitz with Levi's reflective openness to these same conditions yields convincing evidence of the intellect's essentially social character. Unlike Levi, Améry lacked intellectual companionship at Auschwitz; his testimony therefore reflects the essential deformation the mind suffers when dialogical communion with others becomes impossible.

When Ricardo Meets Chamberlin: A Simple Dynamic Model of Monopolistic Competition

We develop a dynamic model of monopolistic competition which sheds light on how the interplay between the degree of product differentiation and intertemporal elasticity of substitution affects the steady-state equilibrium. Consumers love variety and split their labor endowment between wage labor, which brings immediate income, and producing capital, which yields a rent in the future. The impact of the elasticity of substitution across varieties on the market outcome depends crucially on whether consumption today and consumption tomorrow are gross substitutes or gross complements. The case of Cobb-Douglas intertemporal utility is a borderline situation, when the market outcome is invariant to the degree of product differentiation. We also fully characterize the unique steady-state equilibrium path and show that the key dynamic properties of the model, such as local stability and determinacy of equilibrium, also hinge mainly on the interplay between the intra- and intertemporal elasticities of substitution.

Spaces of generalized smoothness in the critical case: Optimal embeddings, continuity envelopes and approximation numbers

We study necessary and sufficient conditions for embeddings of Besov spaces of generalized smoothness Bp,qσ,N(Rn) into generalized Hölder spaces Λ∞,rμ(⋅)(Rn) when s¯(Nτ−1)>0 and τ−1∈ℓq′, where τ=σN−n/p. A borderline situation, corresponding to the limiting situation in the classical case, is included and give new results. In particular, we characterize optimal embeddings for B-spaces.As immediate applications of our results we obtain continuity envelopes and give upper and lower estimates for approximation numbers for the related embeddings.We also consider the analogous results for the Triebel–Lizorkin spaces of generalized smoothness Fp,qσ,N(Rn).

Who Shall Live When Not All Can Live?

shall live when not all can live? Although this question has been urgently forced upon us by the dramatic use of artificial internal organs and organ transplantations, it is hardly new. George Bernard Shaw dealt with it in "The Doctor's Dilemma": Sir Patrick. Well, Mr. Savior of Lives: which is it to be? that honest decent man Blenkinsop, or that rotten blackguard of an artist, eh? Ridgeon. It's not an easy case to judge, is it? Blenkinsop's an honest decent man; but is he any use? Dubedaťs a rotten blackguard; but he's a genuine source of pretty and pleasant and good things. Sir Patrick. What will he be a source of for that poor innocent wife of his, when she finds him out? Ridgeon. That's true. Her life will be a hell. Sir Patrick. And tell me this. Suppose you had this choice put before you: either to go through life and find all the pictures bad but all the men and women good, or go through life and find all the pictures good and all the men and women rotten. Which would you choose?1

Escapar de los géneros entrando en ellos. Una tendencia del cine latinoamericano actual

The article approaches an actual Latin-American cinema tendency that has put in the center of the debate the discussion about the way Latin-American reality is been represented and, a supposed return to the realistic ways of representation. One of the most featured components, and the core of the debate, is the relation between documentary recording and staging. We propose that this antagonism is articulated in a large number of these films, as a borderline situation that allows a game of ruptures and dialogues that builds a new contact with what’s “real”, allowing us to read it as another way of relating with the social aspects. Thus, through a series of strategies that privileges a location in the genre frontiers, braking with the naturalized conventions.

Diagnosis and management of melanoma with regional lymph node metastases: a population-based study in France

Stage III melanoma represents a borderline situation regarding the potential curability of this potentially aggressive cancer and consequently, regional lymph node metastases (RLNM) are a major challenge for melanoma management. To describe the management of melanoma with RLNM as practised in France in 2008 and compare results with previous data from 2004, considering that new French recommendations were published in 2005. Retrospective population-based study in five regions of France totalling 8.3 million inhabitants, targeting all incident cases of RLNM diagnosed in 2008. Questionnaires were mailed to physicians to identify cases and collect data, with verification by cancer registries for cases diagnosed concomitantly with the primary tumour using sentinel lymph node biopsies (SLNB). Data were collected for 101 patients in 2008, and compared to 89 cases treated in 2004. Palpation by a dermatologist was the most common circumstance of diagnosis of RLNM in 2008 (36%), followed by SLNB (29%), self-palpation by the patient (16%) and lymph node ultrasonography (6%), without significant modification from 2004. After lymphadenectomy an adjuvant therapy was proposed in 62% of cases, mainly consisting in high-dose interferon (HD-IFN) (80%). Overall, HD-IFN was proposed in 49% of cases, but effectively started in only 40% of cases after being proposed, and prematurely withdrawn in 28%, showing major changes as compared with 2004 (33%, 77% and 67%, respectively, P < 0.05). Adjuvant chemotherapy was not proposed to any patients in 2008, compared to 29% in 2004. Surveillance procedures included medical imaging less often in 2008 (76%) than in 2004 (92%) (P = 0.004), but more often included FDG-PET (23% vs. 12%, P = 0.09). Overall, actual practice was in accordance with French recommendations. The main developments from 2004 to 2008 were the disappearance of adjuvant chemotherapies and a more accurate selection of patients for adjuvant interferon.

Financial and economic determinants of collective action: The case of wastewater management

Where public environmental funds support development of wastewater infrastructure, funding institutions ensure the economic use of funds, while the beneficiaries minimize their own costs. In rural areas, there is often a choice between decentralized or centralized (multi-village) systems: if the centralized system is most economic, then only this system is eligible for public funding. However, its implementation requires a voluntary cooperation of the concerned communities, who need to organize themselves to develop and run the infrastructure. The paper analyzes the social determinants of collaboration in a generic case study, using the following variables: method of (economic) assessment, modeled by the social discount rate, funding policy, modeled by the funding rate, and users' self-organization, modeled by cost sharing. In a borderline situation, where the centralized system turns out to be most economic, but this assessment is contingent on the assessment method, collective action may fail: the advantages of collective action from funding are too small to outweigh organizational deficiencies. Considering in this situation sanitation as a human right, authors recommend using innovative forms of organization and, if these fail, reassessing either the amount of funding or the eligibility for funding of more acceptable alternatives.

Meine Sprache und Ich. Ilse Aichingers Zwiesprache im Vergleich mit Derridas Le monolinguisme de l'autre

Meine Sprache und ich (1968), characterized by its author, Ilse Aichinger, as “narration,” can be read as a reflection on language and existence in an extreme borderline situation. Aichinger undoubtedly refers to the persecution and extermination of the Other in the Holocaust, but instead of discussing this as a historically unique occurrence, she treats its impact on the language and existence of the individual. While the ”I” still attempts to communicate by means of a speech that the text records, its unique personal language begins to detach itself as an Other, refusing all further communication. The epochal achievement of Aichinger's analysis, formulated when the Linguistic Turn was at its peak, is confirmed by a comparison with Jacques Derrida's much later ideas in Monolingualism of the Other (1996).

Erythromycin- and tetracycline-resistant lactobacilli in Italian fermented dry sausages

To assess the frequency of erythromycin- and tetracycline-resistant lactobacilli in Italian fermented dry sausages. We isolated lactobacilli colonies from 20 salami from the north of Italy (Piacenza province) using selective medium supplemented with erythromycin or tetracycline; we determined the minimum inhibitory concentration and searched for selected erythromycin and tetracycline resistance genes. A total of 312 lactobacilli colonies were genetically ascribed to 60 different strains belonging to seven Lactobacillus species. Lactobacillus sakei, Lactobacillus curvatus and Lactobacillus plantarum were the most frequently found species. Thirty strains (50%) were phenotypically resistant to erythromycin, 45 (75%) to tetracycline and 27 (45%) were resistant to both. The most frequently detected resistance genes were tet(M) and erm(B). This study provides evidence of the presence of tetracycline- and, to a lesser extent, erythromycin-resistant lactobacilli in fermented dry sausages produced in northern Italy. Although these antibiotic-resistant lactobacilli could serve as reservoir organisms, in our study, 16 of 20 salami could be considered safe in regard to possible antibiotic resistance gene transfer to pathogens, whereas 4 of 20 could represent a borderline situation.

Grenzsituationen bei hausärztlicher Betreuung

The end of life represents a borderline situation for all participants in a general practice setting. The patient finds himself trapped in the border zone of life and death and is faced with a multitude of existential and spiritual problems. The family doctor has to realize that the common decision-making pathways employed in everyday practice are hardly effective in palliative care. At this point it may be to the patient's benefit to decide against certain possible treatment options. Family and friends come into touch with the limits of their personal (com-) passion. Having to deal with feelings like powerlessness, helplessness and grief and being faced with one's own finiteness poses an enormous challenge.

Discrete and Embedded Eigenvalues for One-Dimensional Schrödinger Operators

I present an example of a discrete Schr"odinger operator that shows that it is possible to have embedded singular spectrum and, at the same time, discrete eigenvalues that approach the edges of the essential spectrum (much) faster than exponentially. This settles a conjecture of Simon (in the negative). The potential is of von Neumann-Wigner type, with careful navigation around a previously identified borderline situation.

Surgical Techniques: Distal Cavernosum–Glans Shunts for Ischemic Priapism

Priapism is a pathological condition of a penile erection that persists beyond or is unrelated to sexual stimulation. It is an important medical condition that requires evaluation and may require emergency management. Ischemic priapism is the most common form of priapism; it is usually a painful, rigid erection characterized clinically by absent cavernous blood flow. Ischemic priapism beyond 4 hours is a compartment syndrome requiring emergent medical intervention. Potential consequences are irreversible corporal fibrosis and permanent erectile dysfunction. Initial assessment of priapism involves history and physical (penile) examination, assessment of corporal blood flow status by visual inspection (color, consistency) of corporal aspirate, corporal blood gas (pH, PO2, PCO2), or color duplex ultrasound. After adequate penile anesthesia via penile block, aspiration with or without injection of an adrenergic agonist is used initially to induce detumescence. Monitoring of vital signs is recommended in patients with a history of cardiovascular diseases. As in all ischemic compartment conditions, rapid intervention is a necessity. Aspiration + administration of an adrenergic agonist are highly recommended before any surgical treatment. Treatments initiated beyond 72 hours may have benefits in relieving unwanted erection and associated pain, but have little documented benefit in potency preservation. Three possible outcomes can result from the aspiration + adrenergic agonist combination after a reasonable dosage and duration (e.g., 20 mg of diluted phenylephrine over 1 hour): complete resolution, partial resolution, and no resolution. Complete resolution (completely flaccid penis) often occurs in priapisms of less than 24-hour duration, although occasionally it may occur in those of longer duration. In cases of complete resolution, instructions are provided to the patient for management of possible recurrence and follow-up visits. Partial resolution (of less than 75% rigidity with a compressible penis) should be regarded as a borderline situation. When in doubt, color duplex ultrasound can be used to confirm the flow in the cavernous arteries. In such cases, inpatient observation is recommended and interval physical examination of penis and/or interval assessment of cavernosal arterial blood flow status by color duplex ultrasound. Adrenergic agonists may be administered, by intracavernous injection or orally, on an interval basis to maintain detumescence. No resolution (more than 75% rigidity) or recurrent priapism after a transient detumescence is a common outcome in priapisms of more than 24-hour duration, despite repeated adrenergic agonist administration. Absence of cavernous arterial flow can be confirmed with color duplex ultrasound if necessary. This condition is due to interstitial edema as well as smooth muscle and endothelial cell dysfunction. In such cases, the patient should be managed by a percutaneous cavernosum–glans surgical shunt procedure. Adrenergic agonist irrigation Baseline

Integration of night-vision and head-up display in vehicles

Night vision enhancement based on electronics is a very recent development within the field of driver assistance solutions. Night vision systems, as they are usually called, support the driver in a borderline situation of human perception in order to lower the risk of accidents. The ergonomics of displaying the vision enhanced image are one of the key issues of night vision solutions. Siemens VDO Automotive has developed two night vision technologies to functional maturity and has tested various image display locations in the cockpits of a passenger car and a commercial vehicle. This paper gives a current status of the findings so far and focuses on explaining the potential that lies in integrating night vision solution and head-up display.

A New Coordination Mode of the Photometric Reagent Glyoxalbis(2-hydroxyanil) (H2gbha): Bis-Bidentate Bridging by gbha2-in the Redox Series {(μ-gbha)[Ru(acac)2]2}n(n= −2, −1, 0, +1, +2), Including a Radical-Bridged Diruthenium(III) and a RuIII/RuIVIntermediate

The bis-bidentate bridging function of gbha2- with N,O-/N,O- coordination was observed for the first time in the complex (mu-gbha)[Ru(III)(acac)2]2 (1). Density functional theory calculations of 1 yield a triplet ground state with a large (deltaE > 6000 cm(-1)) singlet-triplet gap. Intermolecular antiferromagnetic coupling was observed (J approximately -5.3 cm(-1)) for the solid. Complex 1 undergoes two one-electron reduction and two one-electron oxidation steps; the five redox forms [(mu-gbha)[Ru(acac)2]2]n (n = -2, -1, 0, +1, +2) were characterized by UV-vis-NIR spectroelectrochemistry (NIR = near infrared). The paramagnetic intermediates were also investigated by electron paramagnetic resonance (EPR) spectroscopy. The monoanion with a comproportionation constant K(c) of 2.7 x 10(8) does not exhibit an NIR band for a Ru(III)/Ru(II) mixed-valent situation; it is best described as a 1,4-diazabutadiene radical anion containing ligand gbha*3-, which binds two ruthenium(III) centers. A Ru(III)-type EPR spectrum with g1 = 2.27, g2 = 2.21, and g3 = 1.73 is observed as a result of antiferromagnetic coupling between one Ru(III) and the ligand radical. The EPR-active monocation (K(c) = 1.7 x 10(6)) exhibits a broad (deltanu(1/2) = 2600 cm(-1)) intervalence charge-transfer band at 1800 nm, indicating a valence-averaged (Ru3.5)2 formulation (class III) with a tendency toward class II (borderline situation).

Hypersaline Microbial Systems of Sabkhas: Examples of Life's Survival in "Extreme" Conditions

Life and living systems need several important factors to establish themselves and to have a continued tradition. In this article the nature of the borderline situation for microbial life under heavy salt stress is analyzed and discussed using the example of biofilms and microbial mats of sabkha systems of the Red Sea. Important factors ruling such environments are described, and include the following: (1) Microbial life is better suited for survival in extremely changing and only sporadically water-supplied environments than are larger organisms (including humans). (2) Microbial life shows extremely poikilophilic adaptation patterns to conditions that deviate significantly from conditions normal for life processes on Earth today. (3) Microbial life adapts itself to such extremely changing and only ephemerally supportive conditions by the capacity of extreme changes (a) in morphology (pleomorphy), (b) in metabolic patterns (poikilotrophy), (c) in survival strategies (poikilophily), and (d) by trapping and enclosing all necessary sources of energy matter in an inwardly oriented diffusive cycle. All this is achieved without any serious attempt at escaping from the extreme and extremely changing conditions. Furthermore, these salt swamp systems are geophysiological generators of energy and material reservoirs recycled over a geological time scale. Neither energy nor material is wasted for propagation by spore formation. This capacity is summarized as poikilophilic and poikilotroph behavior of biofilm or microbial mat communities in salt and irradiationstressed environmental conditions of the sabkha or salt desert type. We use mainly cyanobacteria as an example, although other bacteria and even eukaryotic fungi may exhibit the same potential of living and surviving under conditions usually not suitable for life on Earth. It may, however, be postulated that such poikilophilic organisms are the true candidates for life support and survival under conditions never recorded on Planet Earth. Mars and some planets of other suns may be good candidates to search for life under conditions normally not thought to be favorable for the maintenance of life.

'n Kritiese evaluering van die kompromie as etiese figuur in die teologiese etiek van J. Douma, J.A. Heyns, S.J. Ridderbos en W.H. Velema

A critical evaluation of the compromise as ethical figure in the theological ethics of J. Douma, J.A. Heyns, S.J. Ridderbos and W.H. Velema Although the concept of a compromise is known in ethics, very little attention has been paid to the meaning of this concept in Reformed Ethics. In this article the author looks into the meaning of the compromise in the theological-ethical frameworks of J. Douma, J.A. Heyns, S.J. Ridderbos and W.H. Velema. In analysing this concept, it is pointed out that a compromise has to do with the choice between two conflicting norms in a borderline situation. In a borderline situation these norms are in conflict with each other and a conflict of interest is created. It then necessitates a choice between one of the norms in a borderline situation. To this choice is then referred to as a choice between the lesser of two evils. This is where the compromise comes into play. (Acta Theologica: 2002 22(1): 57-76)

Filósofos ante la muerte. Una reflexión acerca de la vida y de la muerte

El hecho de la muerte nos coloca ante una situación límite. Es, indudablemente, el acontecimiento más importante en nuestra vida. Y, aun cuando ha escrito La Rochefoucauid que "ni el sol ni la muerte pueden mirarse con fijeza", esto no es tan cierto. No es imposible mirar de frente a la muerte, compañera inseparable de la vida.