Neurological disorders and violence: a systematic review and meta-analysis with a focus on epilepsy and traumatic brain injury

The objectives of this study were to systematically review and meta-analyze the research literature on the association of common neurological disorders and violence. Keywords relating to neurological disorders and violence were searched between 1966 and August 2008. Case–control and cohort studies were selected. Odds ratios of violence risk in particular disorders compared with controls were combined using fixed-effects meta-analysis with the data presented in forest plots. Sensitivity analyses were conducted to identify possible differences in risk estimates across surveys. Information on risk factors for violence was extracted if replicated in more than one study. Nine studies were identified that compared the risk of violence in epilepsy or traumatic brain injury compared with unaffected controls. For the epilepsy studies, the overall pooled odds ratio for violent outcomes was 0.67 [95% confidence interval (CI) 0.46–0.96]. For traumatic brain injury, the odds ratio was 1.66 (95% CI 1.12–2.31). An additional 11 case–control studies investigated factors associated with violence in epilepsy and traumatic brain injury. It was not possible to meta-analyze these data. Comorbid psychopathology was associated with violence. Data on other neurological conditions was limited and unreplicated. In conclusion, although the evidence was limited and methodological quality varied, epilepsy and traumatic brain injury appeared to differ in their risk of violence compared with control populations. Longitudinal studies are required to replicate this review’s provisional findings that epilepsy is inversely associated with violence and that brain injury modestly increases the risk, and further research is needed to provide information on a broader range of risk factors.     

The treatment of donor sites with cultured epithelial grafts

In a significant number of elderly patients, the healing of split skin donor sites can be delayed. The cultured allogenic epithelial graft (CAG) has been reported to heal leg ulcers. The mechanism of action may be to improve the healing environment and thus stimulate the host skin cells. A clinical trial was undertaken to compare the healing rate of the donor sites of elderly patients using CAGs and two commercially available dressings. Compared to Jelonet, CAGs (p = 0.008) and OpSite (p = 0.013) significantly reduced the number of patients with delayed healing. There was no significant difference between CAGs and the occlusive dressing, OpSite.     

A survey of general surgeons' attitudes towards breast reconstruction after mastectomy.

Within the last 15-20 years there have been many changes in the management of breast cancer. Along with changes in treatment, possibilities for breast reconstruction have become increasingly sophisticated and commonplace. Despite the availability of breast reconstruction, we have noted large variations in referral patterns. Because the surgical treatment of breast cancer is largely undertaken by general surgeons, we investigated general surgeons' attitudes towards reconstruction using a postal questionnaire. In 1995, a questionnaire involving hypothetical criticisms was sent to general surgical members of the Association of Surgeons of Great Britain and Ireland. A total of 136 surgeons responded, 79 (58%) of whom had a specialist interest in breast cancer. Each surgeon saw an average of 68 new cases of breast cancer per year (range 0-400). The general surgeons were concerned about three areas: (1) 32.3% felt that breast reconstruction might adversely delay the detection of local recurrence; (2) 16.6% were worried that breast reconstruction has high morbidity; and (3) 17.4% said that patients did not want breast reconstruction despite being advised of its availability. To investigate these concern's further, an extensive literature search was undertaken. There is no evidence that breast reconstruction delays the detection of local recurrence. With appropriate patient selection, the morbidity of reconstructive options appears very acceptable. Finally, immediate breast reconstruction has psychological benefits when compared with delayed reconstruction.     

Hydrogen Production by Steam Reforming of Ethanol over Nickel Catalysts Supported on Sol Gel Made Alumina: Influence of Calcination Temperature on Supports

Selecting a proper support in the catalyst system plays an important role in hydrogen production via ethanol steam reforming. In this study, sol gel made alumina supports prepared for nickel (Ni) catalysts were calcined at different temperatures. A series of (Ni/Al_S.G.) catalysts were synthesized by an impregnation procedure. The influence of varying the calcination temperature of the sol gel made supports on catalyst activity was tested in ethanol reforming reaction. The characteristics of the sol gel alumina supports and Ni catalysts were affected by the calcination temperature of the supports. The structure of the sol gel made alumina supports was transformed in the order of γ → (γ + θ) → θ-alumina as the calcination temperature of the supports increased from 600 °C to 1000 °C. Both hydrogen yield and ethanol conversion presented a volcano-shaped behavior with maximum values of 4.3 mol/mol ethanol fed and 99.5%, respectively. The optimum values were exhibited over Ni/Al_S.G800 (Ni catalyst supported on sol gel made alumina calcined at 800 °C). The high performance of the Ni/Al_S.G800 catalyst may be attributed to the strong interaction of Ni species and sol gel made alumina which lead to high nickel dispersion and small particle size.     

Levels Propagation Approach to Image Segmentation: Application to Breast MR Images

Journal of Digital Imaging - Accurate segmentation of a breast tumor region is fundamental for treatment. Magnetic resonance imaging (MRI) is a widely used diagnostic tool. In this paper, a new...