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Search Results: 1 - 10 of 160043 matches for " Stephen B. Williams "
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Endourologic Procedures for Benign ProstaticHyperplasia: Review of Indications and Outcomes
Ravi Kacker,Stephen B. Williams
Urology Journal , 2011,
Abstract: PURPOSE: To discern the positive and negative attributes of the varioustreatment modalities for benign prostatic hyperplasia.MATERIALS AND METHODS: A comprehensive literature review is presentedfor endoscopic treatment of the bladder outlet obstruction with an emphasison current randomized controlled trials available comparing these treatmentmodalities.RESULTS: Transurethral resection of the prostate remains the gold standardwhen assessing alternative treatment options available for benign prostatichyperplasia. Holmium laser enucleation of the prostate demonstratesequivalent efficacy with a more favorable risk profile. Photo selective vaporization, transurethral needle ablation, and transurethral microwavetherapy have demonstrated safety and short-term efficacy; however, data onlong-term efficacy are currently lacking.CONCLUSION: The current endoscopic methods may offer favorable safetyand efficacy for the treatment of the bladder outlet obstruction. However,further research is needed to establish long-term efficacy for many of thecurrently available treatment options.
Unclamped Hand-Assisted Laparoscopic Partial Nephrectomy for Predominantly Endophytic Renal Tumors
Jason D. Engel,Stephen B. Williams
Urology Journal , 2013,
Abstract: PURPOSE: To describe our initial experience with unclamped laparoscopic hand-assisted partial nephrectomy for predominantly endophytic renal masses in the setting of relative contraindication to warm ischemia. MATERIALS AND METHODS:Unclamped laparoscopic hand-assisted partial nephrectomy was performed on eight consecutive patients from June 2009 to March 2010. All patients had predominantly endophytic renal masses with a preferential enhancing rim noted on the pre-operative computed tomography. The unclamped hand-assisted approach was utilized for no warm ischemia, minimal blood loss, and enhanced visualization of the tumor bed with improved operative exposure.RESULTS: Mean age of the participants was 55.8 years. All patients underwent unclamped hand-assisted partial nephrectomy (ie, zero ischemia). Mean estimated blood loss was 368.8 cc (range, 100 to 800 cc) and mean operation time was 236.9 minutes (range, 175 to 272 minutes). There were no intra-operative complications and no open conversions. There was one grade II (ileus with small pneumothorax) and one grade IV (pulmonary embolism) in the 90-day peri-operative period. There was one positive surgical margin, which was recognized intra-operatively. CONCLUSION: While our results are preliminary, we feel this technique provides superior visualization and adequate hemostasis while preserving oncologic efficacy and renal function in this patient population.
Will restored tidal marshes be sustainable?
Michelle Orr,Stephen Crooks,Philip B. Williams
San Francisco Estuary and Watershed Science , 2003,
Abstract: We assess whether or not restored marshes in the San Francisco Estuary are expected to be sustainable in light of future landscape scale geomorphic processes given typical restored marsh conditions. Our assessment is based on a review of the literature, appraisal of monitoring data for restored marshes, and application of vertical accretion modeling of organic and inorganic sedimentation. Vertical accretion modeling suggests that salt marshes in San Pablo Bay will be sustainable for moderate relative sea level rise (3 to 5 mm yr-1) and average sediment supply (c. 100 mg L-1). Accelerated relative sea level rise (above 6 mm yr-1) and/or reduced sediment supply (50 mg L-1) will cause lowering of the marsh surface relative to the tide range and may cause shifts from high to low marsh vegetation by the year 2100. Widespread conversion of marsh to mudflat-"ecological drowning"-is not expected within this time frame. Marshes restored at lower elevations necessary to aid the natural development of channel systems (c. 0.5 m below mean higher high water) are predicted to accrete to high marsh elevations by the year 2100 for moderate relative sea level rise and sediment supply conditions. Existing rates of sediment accretion in restored fresh water tidal marshes of the Delta of greater than 9 mm yr-1 and slightly lower drowning elevations suggest that these marshes will be resilient against relatively high rates of sea level rise. Because of higher rates of organic production, fresh water marshes are expected to be less sensitive to reduced sediment availability than salt marshes. The ultimate long-term threat to the sustainability of tidal marshes is the interruption of coastal rollover-the process by which landward marsh expansion in response to sea level rise compensates for shoreline erosion. Bay front development now prevents most landward marsh expansion, while shoreline erosion is expected to accelerate as sea level rises.
Chaotic Identities, Love and Fathering
Stephen Williams
Folklore : Electronic Journal of Folklore , 2011,
Abstract: Fathers today are confronted with constantly changing ideas on theirrole as a parent. The old traditional forms of fathering i.e. the breadwinner and protector roles are being gradually replaced by a more reflexive role that places unconditional love from their children as a central theme in a new type of reflexive parenting. This article examines the role of fatherhood through the theoreticallens of reflexive modernity. It recognises that men are increasingly becoming dependant on their children for unconditional love and this is forcing men to become more involved in the lives of their own children. The theory of reflexive modernisation is applied to a group of 40 fathers from a post-industrial area of Britain to unravel the processes and practices being used in this “new” type of parenting. This research discovers that fathers in the 21st century have numerouspressures from changing ideas about what is a good or bad father, but in the final instance it is their individualised responses to these societal and personal circumstances which create a new reflexive type of fathering. This type of fathering is therefore created by general social changes within a reflexive modern society and also by personal choice.
Using Serology to Assist with Complicated Post-Exposure Prophylaxis for Rabies and Australian Bat Lyssavirus
Niall Conroy,Susan Vlack,Julian M. Williams,John J. Patten,Robert L. Horvath,Stephen B. Lambert
PLOS Neglected Tropical Diseases , 2013, DOI: 10.1371/journal.pntd.0002066
Abstract: Background Australia uses a protocol combining human rabies immunoglobulin (HRIG) and rabies vaccine for post-exposure prophylaxis (PEP) of rabies and Australian bat lyssavirus (ABLV), with the aim of achieving an antibody titre of ≥0.5 IU/ml, as per World Health Organization (WHO) guidelines, as soon as possible. Methodology/Principal Findings We present the course of PEP administration and serological testing for four men with complex requirements. Following dog bites in Thailand, two men (62 years old, 25 years old) received no HRIG and had delayed vaccine courses: 23 days between dose two and three, and 18 days between dose one and two, respectively. Both seroconverted following dose four. Another 62-year-old male, who was HIV-positive (normal CD4 count), also suffered a dog bite and had delayed care receiving IM rabies vaccine on days six and nine in Thailand. Back in Australia, he received three single and one double dose IM vaccines followed by another double dose of vaccine, delivered intradermally and subcutaneously, before seroconverting. A 23-year-old male with a history of allergies received simultaneous HRIG and vaccine following potential ABLV exposure, and developed rash, facial oedema and throat tingling, which was treated with a parenteral antihistamine and tapering dose of steroids. Serology showed he seroconverted following dose four. Conclusions/Significance These cases show that PEP can be complicated by exposures in tourist settings where reliable prophylaxis may not be available, where treatment is delayed or deviates from World Health Organization recommendations. Due to the potentially short incubation time of rabies/ABLV, timely prophylaxis after a potential exposure is needed to ensure a prompt and adequate immune response, particularly in patients who are immune-suppressed or who have not received HRIG. Serology should be used to confirm an adequate response to PEP when treatment is delayed or where a concurrent immunosuppressing medical condition or therapy exists.
Naturally-Acquired Influenza-Specific CD4+ T-Cell Proliferative Responses Are Impaired in HIV-Infected African Adults
Kondwani C. Jambo, Enoch Sepako, Sarah J. Glennie, David Mzinza, Neil A. Williams, Stephen B. Gordon, Robert S. Heyderman
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0038628
Abstract: Background Seasonal influenza has been associated with greater morbidity and mortality in AIDS patients. Highly-active antiretroviral therapy (HAART) has led to some reduction in influenza-related complications but the nature of naturally-acquired T-cell immunity to influenza virus in an African setting, and how this changes with immune reconstitution following HAART is unknown. We measured influenza-specific CD4+ T-cell immunity in unimmunized HIV-infected Malawian adults and then investigated immune reconstitution following HAART. Methods Peripheral blood mononuclear cells were isolated from HIV-infected and HIV-uninfected Malawian adults. CFSE proliferation and CD154 expression flow cytometry-based assays were used to measure influenza-specific CD4+ T-cell immunity. Results We found lower naturally-acquired proliferative influenza-specific CD4+ T-cell responses in AIDS patients that was also present in asymptomatic HIV-infected adults with relatively high CD4 counts (>350 cells/μl). Influenza-specific CD4+ T-cell immune reconstitution in HIV-infected patients on HAART for 12 months was poor despite a marked reduction in viral load and an increase in CD4 count. This poor immune reconstitution was characterised by a low influenza-specific proliferative CD4+ T-cell response and reduced proportions of CD154-expressing influenza-specific CD4+ T-cells in peripheral blood. Conclusion Our data suggest that asymptomatic HIV-infected adults may also be at risk of influenza-related complications and that HAART alone may not circumvent this risk in AIDS patients. This study highlights the need to identify possible interventions early in HIV infection to reduce the risk of influenza and to intensify influenza surveillance in these susceptible African populations.
International Study to Predict Optimized Treatment for Depression (iSPOT-D), a randomized clinical trial: rationale and protocol
Leanne M Williams, A Rush, Stephen H Koslow, Stephen R Wisniewski, Nicholas J Cooper, Charles B Nemeroff, Alan F Schatzberg, Evian Gordon
Trials , 2011, DOI: 10.1186/1745-6215-12-4
Abstract: The International Study to Predict Optimized Treatment - in Depression (iSPOT-D) is a multi-centre, international, randomized, prospective, open-label trial. It is enrolling 2016 MDD outpatients (ages 18-65) from primary or specialty care practices (672 per treatment arm; 672 age-, sex- and education-matched healthy controls). Study-eligible patients are antidepressant medication (ADM) na?ve or willing to undergo a one-week wash-out of any non-protocol ADM, and cannot have had an inadequate response to protocol ADM. Baseline assessments include symptoms; distress; daily function; cognitive performance; electroencephalogram and event-related potentials; heart rate and genetic measures. A subset of these baseline assessments are repeated after eight weeks of treatment. Outcomes include the 17-item Hamilton Rating Scale for Depression (primary) and self-reported depressive symptoms, social functioning, quality of life, emotional regulation, and side-effect burden (secondary). Participants may then enter a naturalistic telephone follow-up at weeks 12, 16, 24 and 52. The first half of the sample will be used to identify potential predictors and moderators, and the second half to replicate and confirm.First enrolment was in December 2008, and is ongoing. iSPOT-D evaluates clinical and biological predictors of treatment response in the largest known sample of MDD collected worldwide.International Study to Predict Optimised Treatment - in Depression (iSPOT-D) ClinicalTrials.gov Identifier: NCT00693849URL: http:/ / clinicaltrials.gov/ ct2/ show/ NCT00693849?term=International+Stud y+to+Predict+Optimized+Treatment+fo r+Depression&rank=1 webciteMajor depressive disorder (MDD) is the fourth most disabling medical condition worldwide (based on disability-adjusted lifeyears) and is expected to be ranked second by year 2020 [1,2]. MDD is typically recurrent, often chronic and disabling, with a lifetime prevalence rate of over 15% [3]. Women are approximately twice as likely to dev
Topological Classification of Clusters in Condensed Phases
Stephen R. Williams
Physics , 2007,
Abstract: A methodology is developed to identify clusters in a bulk phase which are topologically equivalent to certain reference clusters. The selected reference clusters are the Morse clusters with 13 or less atoms and the 13 atom clusters found in an FCC and an HCP crystal phase, consisting of an atom and its 12 nearest neighbours. The first step in using the method requires the bond network of the bulk phase to be identified. The bonds may be identified in terms of the distance between the atom pairs or by using a modified Voronoi decomposition, introduced here. We then search for all the 3, 4 and 5 membered shortest path rings and use these to identify some basic clusters. These basic clusters are then combined to identify the above mentioned Morse and crystal clusters. The larger Morse clusters (N>13) may be identified in terms of the basic clusters and the smaller Morse clusters. This work has important applications in studying the energy landscape of a bulk phase. As an example, results from a limited preliminary study on the hard sphere fluid phase are presented.
Non-Cooperative Collusion in Static and Dynamic Oligopolies  [PDF]
Stephen B. Wolf
Theoretical Economics Letters (TEL) , 2013, DOI: 10.4236/tel.2013.36053

This paper provides an analysis of collusion in oligopolies from a game-theoretic perspective. It first provides a basic survey of oligopoly models and then uses game theory to analyze non-cooperative or tacit collusion in these models, in a way that should be accessible to undergraduate economics students. In this way, the author characterizes the conditions under which collusive behavior might occur. Importantly, this paper draws its conclusions by using relatively basic methods with which those foreign to the subject should be able to understand.

Helicopter EMS beyond Trauma: Utilization of Air Transport for Non-Trauma Conditions  [PDF]
Stephen H. Thomas, Lori J. Whelan, Emily Williams, Loren Brown
International Journal of Clinical Medicine (IJCM) , 2013, DOI: 10.4236/ijcm.2013.412090

Helicopter Emergency Medical Services (HEMS) use in civilian medical transport has its roots in the use of rotor-wing trauma transport in the military setting. Much of the literature and evidence based on the use of HEMS is therefore related to scene and interfacility transport of injured patients. Regionalization of care and increased understanding of time-criticality of various non-trauma conditions has contributed to growing utilization of HEMS for non-trauma conditions over recent decades. It is common for HEMS to be utilized for a variety of non-trauma situations ranging from neonatal and obstetrics transports to cardiac and stroke transports. The purpose of this review is to overview the use of HEMS for non-trauma, focusing on situations in which there is evidence addressing possible HEMS utility.

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