Satisfactory Alternative Research Articles

On the Interplay among Entropy, Variable Metrics andPotential Functions in Interior-Point Algorithms

We are motivated by the problem of constructing a primal-dual barrier function whose Hessian induces the (theoretically and practically) popular symmetric primal and dual scalings for linear programming problems. Although this goal is impossible to attain, we show that the primal-dual entropy function may provide a satisfactory alternative. We study primal-dual interior-point algorithms whose search directions are obtained from a potential function based on this primal-dual entropy barrier. We provide polynomial iteration bounds for these interior-point algorithms. Then we illustrate the connections between the barrier function and a reparametrization of the central path equations. Finally, we consider the possible effects of more general reparametrizations on infeasible-interior-point algorithms.

Fixation for comminuted phalangeal fractures: A biomechanical study of five methods

The rigidities of five fixation methods have been studied with a comminuted phalangeal fracture model. Mechanical testing of compression, bending and torsion were performed for each fixation. Lateral plating with six screws seems to provide the most rigid fixation. If such lateral plating is not practicable, the four-Kirschner wire method would be a satisfactory alternative.

Technics for the preoperative marking of nonpalpable breast lesions in MRT

We describe a method of localizing suspicious breast lesions only visible by MRI that does not require additional hardware and can be carried out on any MRI-scanner suited for MR-mammography. We have performed a total of 48 localizations with different techniques: 28 charcoal/Gd-DTPA, 18 with wires and two skin markings. All localizations have been successful; wire localizations provided the best results, since the position of the wire could be corrected under MR-guidance. Until suitable localization- and biopsy coils become available the methods employed by us provide a satisfactory alternative which allows radiologists who perform diagnostic MR-mammography with techniques to carry out precise pre-operative localisations of breast lesions.

Empowerment: emancipation or enervation?

For some time now it has been possible to argue that the notion of empowerment has reached a critical stage in its semantic development; simultaneously bedecked in the sequins of market glitterspeak or the vibrant patchwork of postmodern socialisms its semantic fabric is inclined to fall apart at the touch. Whilst it is true that its burgeoning use has gone hand in hand with its increasingly elusive meaning, paradoxically the significance of empowerment has become more rather than less compelling. This paper offers a preliminary attempt to come to grips with empowerment so that we are in a better position to decide whether it is a helpful notion or whether we would be better off ditching it and focusing our energies on a more satisfactory alternative. Having set the contemporary scene I go on to look at the ‘neutral’, process account of empowerment which claims to be context and value‐free. In the third section I build on some of the emerging issues and sketch out an emancipatory account The fourth sectio...

Fundamentalism and Folk Science between the Wars

Reports of the demise of the “warfare” school of writing the history of religion and science may yet be premature, but it seems safe to say that it has had a near-death experience. Much recent historiography has underscored the shallowness, futility, and wrongheadedness of treating controversies involving religion and science simply as skirmishes in an ongoing, inevitable conflict between contradictory ways of viewing the world. We have been urged, as historians, to probe beneath the surface of apparent conflicts in search of the underlying reasons why people with different beliefs have come to disagree so deeply about matters involving science and to accept the realities of an historically complex situation. After showing the inadequacy of the warfare thesis, David C. Lindberg and Ronald L. Numbers note sadly that “we will never find a satisfactory alternative of equal simplicity.” John Hedley Brooke, the author of a recent comprehensive study, concludes that “Serious scholarship in the history of science has revealed so extraordinarily rich and complex a relationship between science and religion in the past that general theses are difficult to sustain. The real lesson turns out to be the complexity.”

Fundamentalism and Folk Science between the Wars

Reports of the demise of the “warfare” school of writing the history of religion and science may yet be premature, but it seems safe to say that it has had a near-death experience. Much recent historiography has underscored the shallowness, futility, and wrongheadedness of treating controversies involving religion and science simply as skirmishes in an ongoing, inevitable conflict between contradictory ways of viewing the world. We have been urged, as historians, to probe beneath the surface of apparent conflicts in search of the underlying reasons why people with different beliefs have come to disagree so deeply about matters involving science and to accept the realities of an historically complex situation. After showing the inadequacy of the warfare thesis, David C. Lindberg and Ronald L. Numbers note sadly that “we will never find a satisfactory alternative of equal simplicity.” John Hedley Brooke, the author of a recent comprehensive study, concludes that “Serious scholarship in the history of science has revealed so extraordinarily rich and complex a relationship between science and religion in the past that general theses are difficult to sustain. The real lesson turns out to be the complexity.”

Monte Carlo likelihood in the genetic mapping of complex traits.

Many of the likelihoods arising in the analysis of complex genetic traits, particularly in linkage analysis, are computationally infeasible. Where exact likelihoods cannot be computed, Monte Carlo estimates of likelihoods may provide a satisfactory alternative. Although simulation on pedigrees is straightforward, simulation conditional upon observed phenotypic data is not. However, recent advances in Markov chain Monte Carlo methods have provided a method well suited to this problem. From realizations of underlying genes, simulated under a genetic model, conditional upon observed data, a Monte Carlo estimate of this likelihood surface can be formed. Various sampler and model modifications are needed to enhance the statistical efficiency of the Monte Carlo estimator; as these methods become increasingly developed, this approach becomes a useful tool in resolving the genes contributing to the phenotypes associated with genetically complex diseases.

The Superficial-Plane Rhytidectomy Revisited

Complex procedures for aesthetic facial rejuvenation, such as the deep-plane, extended SMAS, subperiosteal, and composite rhytidectomies, have received significant attention in the literature and at recent symposia. Young plastic surgeons striving to achieve excellent results may be intimidated by these procedures and find them difficult to perform. We suggest a renewed interest in the superficial plane approach for facial rejuvenation. On the basis of our experience with a synthesis of result-oriented technical modifications in 750 patients, we present a procedure to offer not only the beginning but also the more experienced surgeon a safe and satisfactory surgical alternative that will provide both predictable and lasting results while limiting risks and avoiding complications.

Prospects for an artificial liver

The normal liver provides many complex and important activities. These include: (1) carbohydrate, amino acid, and fatty acid metabolism; (2) serum protein synthesis; (3) vitamin storage; (4) biliary excretion; and (5) detoxification. Fortunately many of these hepatic activities can be partially provided parenterally such as with total parenteral nutrition and clotting factor replacement. Of the activities of the liver required for survival that do not have a satisfactory alternative, detoxification is unique and for this reason, it should be one of the primaly objectives in the replacement of hepatic activities. Artificial liver support (ALS) can be defined as an artificial replacement of liver function using either an extracorporeal or an implantable device. Our efforts have been directed primarily in the development of an extracorporeal device that could be used in liver failure analogous to the use of renal dialysis systems in renal failure. ALS systems could be used in acute fulminant hepatic failure to support liver function while the liver regenerates or is replaced. ALS could also provide support in chronic liver failure, particularly when combined with orthotopic liver transplantation. While awaiting liver transplantation, ALS could improve the overall condition of the patient until a compatible liver could be obtained and ALS could assist hepatic function perioperatively for liver transplantation or during temporary hepatic graft dysfunction or rejection.

Objective clinical evaluation of physical impairment in chronic low back pain.

The aim of this study was to investigate physical impairment in patients with chronic low back pain, to develop a method of clinical evaluation suitable for routine use, and to consider the relationship between pain, disability, and physical impairment. Twenty-seven physical tests were investigated. Permanent anatomic and structural impairments of spinal deformities, spinal fractures, surgical scarring, and neurologic deficits were excluded as not relevant to the patient with low back pain in the absence of nerve root involvement or previous surgery. Three consecutive 20-patient reproducibility studies were used to develop reliable methods of examination for 23 of the tests. Only four tests were excluded as unreliable: sacral angle, pelvic tilt, and separate lumbar and pelvic extension, none of which are part of routine clinical examination or have any proven relationship to disability. The remaining 23 physical tests were evaluated in 70 asymptomatic subjects and 120 patients with chronic low back pain. Passive knee flexion, passive hip flexion, hip flexion strength, hip abduction strength, pain reproduction on each of these tests, and the prone extension strength test were excluded because they were too closely related to nonorganic and behavioral responses to examination. Eight tests successfully discriminated patients with low back pain from normal subjects and were significantly related to self-report disability in activities of daily living: pelvic flexion, total flexion, total extension, lateral flexion, straight leg raising, spinal tenderness, bilateral active straight leg raising, and sit-up. Factor analysis failed to demonstrate an underlying statistical dimension of physical impairment. However, an empirical combination of total flexion, total extension, average lateral flexion, average straight leg raising, spinal tenderness, bilateral active straight leg raising, and sit-up provided an equally satisfactory alternative. Simple cut-offs from normal subjects made the scale simple and quick to use. This final scale successfully discriminated 78% of patients and normal subjects and explained 25% of the variance of disability, with a specificity of 86% and sensitivity of 76%. This scale provides an objective clinical evaluation that meets the criteria for evaluating physical impairment, yet is simple, reliable, and suitable for routine clinical use. It should, however, be emphasized that all the tests included in the final scale are measures of current functional limitation rather than of permanent anatomic or structural impairment. This raises questions about the physical basis of permanent disability due to chronic low back pain.

Inferring feasible assemblies from spatial constraints

The authors treat two different problems in the analysis of assemblies, and algorithms are described for each. The first problem is the selection of consistent sets of part feature relationships, and it corresponds to a search over possible configurations of parts that are consistent with feature set mappings. The second problem is the evaluation of the kinematic consistency of an assembly that has been defined by consistent feature sets. These two problems are linked together as two of the steps required in a search for all correct assembly configurations of a given set of parts. Several of the other necessary steps related to part interference, path feasibility, and workcell device kinematics are referred to but not analyzed. The proposed search algorithm is based on a constraint posting strategy, i.e. rather than generating and testing all specific alternatives, chunks of the search space are progressively removed from consideration by constraints that rule them out until one satisfactory alternative is found.< <ETX xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">&gt;</ETX>

Failed Bladder Neck Reconstruction: Options for Management

During the last 10 years 17 patients have been seen at this institution for persistent urinary incontinence after Young-Dees-Leadbetter bladder neck reconstruction. Of these patients 16 were born with classical bladder exstrophy and 1 with complete epispadias. Six patients underwent 1, 10 underwent 2 and 1 underwent 3 prior bladder neck procedures. As salvage procedures 8 patients underwent another Young-Dees-Leadbetter procedure, 1 repeat bladder neck reconstruction and augmentation cystoplasty, 3 augmentation alone, 4 bladder augmentation with creation of a continent abdominal stoma and 1 augmentation with implantation of an artificial urinary sphincter. Of the 8 patients who underwent a repeat Young-Dees-Leadbetter procedure 7 are dry for 3 hours or more and 1 is dry for greater than 3 hours on intermittent self-catheterization. All of those who are dry for greater than 3 hours are dry at night and 1 wears pads when engaging in strenuous physical activity. Of the 9 patients who underwent augmentation cystoplasty along with other adjunctive procedures 8 are continent for greater than 3 hours on intermittent catheterization, 6 are dry at night if they perform catheterization at bedtime and 1 remains totally incontinent after removal of the artificial urinary sphincter. Thus, with persistence and creativity a child with a previously failed bladder neck reconstruction or even multiple failed repairs can be made socially continent, providing a satisfactory alternative without resorting to urinary diversion.

Zinc sulphate therapy for Wilson's disease after acute deterioration during treatment with low‐dose D‐penicillamine

A 30-year-old woman with Wilson's disease was treated with low-dose D-penicillamine. After 12 days, treatment was changed to zinc sulphate because of severe neurological deterioration. The patient subsequently improved within a few days. During a follow-up period of 20 months, the effectiveness of therapy was evaluated by measuring copper and zinc levels in plasma and urine, and by 64Cu-loading tests. We conclude that sulphate therapy may be a satisfactory alternative, even when rapid deterioration occurs in the early stages of D-penicillamine treatment.

Practical management of diabetic ketoacidosis and hyperosmolar coma

In diabetic ketoacidosis (DKA) and particularly in hyperosmolar coma, rapid normalisation of the measured extracellular fluid abnormalities cannot be equated with optimal management. In both disorders there are complex imbalances between extra- and intracellular compartments that are best corrected in a series of rational steps, based on an understanding of pathophysiology. Fluid administration in DKA can generally be divided into three successive phases: (i) a short period of rapid isotonic saline infusion, (ii) slower infusion of isotonic saline with potassium chloride, and (iii) glucose-potassium infusion until oral food intake is well established. In severe cases, there is a definite place for judicious use of isotonic sodium bicarbonate in small amounts. While insulin infusion is desirable, intramuscular insulin remains a satisfactory alternative. Biochemical monitoring is mandatory and management must be reviewed and modified every three to four hours on the basis of the clinical and biochemical response. In the management of hyperosmolar coma, insulin and fluid therapy are more conservative, with the aim of achieving complete rehydration and normoglycaemia only after 36 to 72 hours. Pulmonary complications and the effects of tissue ischaemia, as well as thromboembolic events, remain important causes of death in both disorders. The frequent recurrences of DKA that occur in a group of psychiatrically-unstable young patients remain an unsolved problem.

No load method of estimating stray load loss in small cage induction motors

The paper refers to the principal methods that have been used for measuring losses in cage induction motors and their assessment by Schwarz [1] and later investigators. Some claims have been contradictory and almost the only consensus is that the existing BS 4999 [2] method is inadequate for small motors; no satisfactory alternative has been suggested. The paper describes a no load test method which is simpler to perform and has fewer theoretical objections than other methods that have been used previously. Typical test results for three motors in the size range 0.25 to 5 kW are shown.

Bonding and debonding brackets to porcelain and gold

Today's orthodontic practice includes a larger proportion of adults. Because many of these adults have crown and bridge restorations fabricated from porcelain or gold, the orthodontist must use methods that permit the attachment of orthodontic brackets to porcelain and nonprecious metal or gold. A bracket may be placed on single-unit crowns of porcelain or gold, but banding becomes difficult. Thus bonding the orthodontic bracket to the restoration provides a satisfactory alternative. This clinical report describes several techniques for bonding orthodontic brackets to porcelain or gold surfaces, and some suggestions for removal of bonded brackets.

Comparison of cultural methods for primary isolation of infectious laryngotracheitis virus from field material

Primary isolation of infectious laryngotracheitis virus (ILT) from tracheal samples from 11 suspected field outbreaks was attempted using a variety of avian cell cultures, Vero cells and embryonated chicken eggs. Tracheal smears of each field sample were also examined by electron microscopy (EM) for the presence of herpesvirus particles. Chick embryo liver cells (CELi) appeared to be the most rapid and sensitive isolation system of those examined with chick kidney (CK) a satisfactory alternative, both demonstrating virus in all 11 samples on first passage. Chick embryo kidney, chick embryo lung and the dropped chorioallantoic membrane of eggs were all less sensitive. Chick embryo fibroblasts and Vero cells were of no particular value for the primary isolation of ILT virus. EM was a useful method of rapid virus identification and confirmation but at least 3.51og10/0.1ml of infectious virus was required to be detected by this method.

Minimal surgery in the prune belly syndrome

In the past 20 years 14 patients with the prune belly syndrome have been seen. A treatment regimen consisting of minimal operative intervention, prophylactic antibiotics, and regular surveillance has been followed. Four patients died in the first 4 weeks of life from grossly inadequate renal function and other anomalies. Another patient died in early adult life after a late presentation. The remaining 9 patients have recently been plan using minimal surgical intervention is a satisfactory alternative.

A comparison of carcinoembryonic antigen (CEA) and epithelial membrane antigen (EMA) in human colorectal cancer

The development of monoclonal antibodies (MAbs) to tumour-associated antigens has allowed the successful radioimmunolocalization of a variety of tumours and has provided a basis for targeted therapy. In patients with colorectal cancer, antibodies to CEA have been the most widely used for imaging, but their role in targeted therapy may be inhibited by their reaction with normal tissues and with circulating CEA. Epithelial-membrane antigen (EMA) is expressed by most epithelial tumours, including colorectal cancers, and antibodies to EMA may provide a satisfactory alternative. We therefore compared two high-affinity MAbs, one to CEA (C46) and one to EMA (ICR2), in tissues obtained from 31 patients with cancer (18 primary colonic, 6 nodal metastases and 7 liver metastases), 14 patients with adenomatous polyps and 17 with normal colon. The indirect immunoperoxidase staining reaction was used and the results classified as either positive or negative. A heterogeneous pattern of staining was found for both antibodies. ICR2, the anti-EMA, reacted with slightly fewer colonic cancers than C46, the anti-CEA antibody (83% vs. 100%) and a similar number of metastases. Most noticeable was the minimal reaction of anti-EMA with normal colon (12% vs. 71%) and benign polyps (7% vs. 79%) in comparison to anti-CEA. This would suggest a possible role for ICR2 in the radioimmunolocalization and targeting of colorectal cancer.

Hypercholesterolaemia treated by soybean protein diet.

After a period of stabilisation on a controlled low lipid low cholesterol diet with animal proteins a group of 16 children with familial hypercholesterolaemia were given a textured soybean protein based diet, with a similar fat composition. All the children had a highly significant reduction in total cholesterol, averaging -21.8% against the baseline after eight weeks. Compliance became less strict afterwards, but more than half of the patients have regularly continued the diet and results have been maintained for one year. Minimal changes were noted in triglyceridaemia and in high density lipoprotein cholesterol concentrations, which showed a slight rise only at the end of treatment. The children's growth during the trial was normal. In view of the psychological difficulties of prescribing treatment with drugs to children with severe hypercholesterolaemia before puberty and of the relative ineffectiveness of standard low lipid diets in this condition the soybean protein diet may offer a satisfactory alternative.