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Thursday, December 18, 2008

A team of eight transplant surgeons in Cleveland Clinic in Ohio, USA, led by reconstructive surgeon Dr. Maria Siemionow, age 58, have successfully performed the first almost total face transplant in the US, and the fourth globally, on a woman so horribly disfigured due to trauma, that cost her an eye. Two weeks ago Dr. Siemionow, in a 23-hour marathon surgery, replaced 80 percent of her face, by transplanting or grafting bone, nerve, blood vessels, muscles and skin harvested from a female donor’s cadaver.

The Clinic surgeons, in Wednesday’s news conference, described the details of the transplant but upon request, the team did not publish her name, age and cause of injury nor the donor’s identity. The patient’s family desired the reason for her transplant to remain confidential. The Los Angeles Times reported that the patient “had no upper jaw, nose, cheeks or lower eyelids and was unable to eat, talk, smile, smell or breathe on her own.” The clinic’s dermatology and plastic surgery chair, Francis Papay, described the nine hours phase of the procedure: “We transferred the skin, all the facial muscles in the upper face and mid-face, the upper lip, all of the nose, most of the sinuses around the nose, the upper jaw including the teeth, the facial nerve.” Thereafter, another team spent three hours sewing the woman’s blood vessels to that of the donor’s face to restore blood circulation, making the graft a success.

The New York Times reported that “three partial face transplants have been performed since 2005, two in France and one in China, all using facial tissue from a dead donor with permission from their families.” “Only the forehead, upper eyelids, lower lip, lower teeth and jaw are hers, the rest of her face comes from a cadaver; she could not eat on her own or breathe without a hole in her windpipe. About 77 square inches of tissue were transplanted from the donor,” it further described the details of the medical marvel. The patient, however, must take lifetime immunosuppressive drugs, also called antirejection drugs, which do not guarantee success. The transplant team said that in case of failure, it would replace the part with a skin graft taken from her own body.

Dr. Bohdan Pomahac, a Brigham and Women’s Hospital surgeon praised the recent medical development. “There are patients who can benefit tremendously from this. It’s great that it happened,” he said.

Leading bioethicist Arthur Caplan of the University of Pennsylvania withheld judgment on the Cleveland transplant amid grave concerns on the post-operation results. “The biggest ethical problem is dealing with failure — if your face rejects. It would be a living hell. If your face is falling off and you can’t eat and you can’t breathe and you’re suffering in a terrible manner that can’t be reversed, you need to put on the table assistance in dying. There are patients who can benefit tremendously from this. It’s great that it happened,” he said.

Dr Alex Clarke, of the Royal Free Hospital had praised the Clinic for its contribution to medicine. “It is a real step forward for people who have severe disfigurement and this operation has been done by a team who have really prepared and worked towards this for a number of years. These transplants have proven that the technical difficulties can be overcome and psychologically the patients are doing well. They have all have reacted positively and have begun to do things they were not able to before. All the things people thought were barriers to this kind of operations have been overcome,” she said.

The first partial face transplant surgery on a living human was performed on Isabelle Dinoire on November 27 2005, when she was 38, by Professor Bernard Devauchelle, assisted by Professor Jean-Michel Dubernard in Amiens, France. Her Labrador dog mauled her in May 2005. A triangle of face tissue including the nose and mouth was taken from a brain-dead female donor and grafted onto the patient. Scientists elsewhere have performed scalp and ear transplants. However, the claim is the first for a mouth and nose transplant. Experts say the mouth and nose are the most difficult parts of the face to transplant.

In 2004, the same Cleveland Clinic, became the first institution to approve this surgery and test it on cadavers. In October 2006, surgeon Peter Butler at London‘s Royal Free Hospital in the UK was given permission by the NHS ethics board to carry out a full face transplant. His team will select four adult patients (children cannot be selected due to concerns over consent), with operations being carried out at six month intervals. In March 2008, the treatment of 30-year-old neurofibromatosis victim Pascal Coler of France ended after having received what his doctors call the worlds first successful full face transplant.

Ethical concerns, psychological impact, problems relating to immunosuppression and consequences of technical failure have prevented teams from performing face transplant operations in the past, even though it has been technically possible to carry out such procedures for years.

Mr Iain Hutchison, of Barts and the London Hospital, warned of several problems with face transplants, such as blood vessels in the donated tissue clotting and immunosuppressants failing or increasing the patient’s risk of cancer. He also pointed out ethical issues with the fact that the procedure requires a “beating heart donor”. The transplant is carried out while the donor is brain dead, but still alive by use of a ventilator.

According to Stephen Wigmore, chair of British Transplantation Society’s ethics committee, it is unknown to what extent facial expressions will function in the long term. He said that it is not certain whether a patient could be left worse off in the case of a face transplant failing.

Mr Michael Earley, a member of the Royal College of Surgeon‘s facial transplantation working party, commented that if successful, the transplant would be “a major breakthrough in facial reconstruction” and “a major step forward for the facially disfigured.”

In Wednesday’s conference, Siemionow said “we know that there are so many patients there in their homes where they are hiding from society because they are afraid to walk to the grocery stores, they are afraid to go the the street.” “Our patient was called names and was humiliated. We very much hope that for this very special group of patients there is a hope that someday they will be able to go comfortably from their houses and enjoy the things we take for granted,” she added.

In response to the medical breakthrough, a British medical group led by Royal Free Hospital’s lead surgeon Dr Peter Butler, said they will finish the world’s first full face transplant within a year. “We hope to make an announcement about a full-face operation in the next 12 months. This latest operation shows how facial transplantation can help a particular group of the most severely facially injured people. These are people who would otherwise live a terrible twilight life, shut away from public gaze,” he said.

Wednesday, September 4, 2019

A deadly boat fire earlier this week near Santa Cruz Island off the coast of California, United States, resulted in the death of all 33 passengers. The boat, Conception, which caught fire overnight in open seas, carried 33 passengers and six crew members. Five people, who were all crew, were rescued while the rest are presumed dead.

The Conception was a 75 ft (~23 m) long commercial boat on a three-day voyage for underwater diving with Monday being the Labor Day holiday. The fire started some time after 3 a.m. local time {1000 UTC) Monday. “This is probably the worst-case scenario you can possibly have,” said Santa Barbara County Sheriff Bill Brown. “You have a vessel that’s on the open sea, that is in the middle of the night. I mean, it’s 3:30 in the morning.” As of late Tuesday, 20 bodies had been recovered, eleven women and nine men, according to Brown.

The United States Coast Guard (USCG) called off its search late on Tuesday. USCG Captain Monica Rochester told the press a nearly 24-hour search mission involving three helicopters covering 160 square miles (~415 km²) had discovered no further signs in the water. “It is never an easy decision to suspend search efforts,” she said. “We know that this is a very difficult time for families and friends of the victims.”

Authorities have not named a cause for the fire, though it was intimated there were no signs of an explosion and the Conception was known to have the requisite fire suppression equipment. CNN, however, reported on a distress call from someone on the Conception, who may or may not have been the captain. The excerpts, which are only the dispatcher’s words were reported by CNN as such:

And there’s 33 people on board the vessel that’s on fire, they can’t get off? […] Roger, are they locked inside the boat? […] Roger, can you get back on board and unlock the boat, unlock the door so they can get off? […] Roger, you don’t have any firefighting gear at all? No fire extinguishers or anything?” […] Was that all the crew that jumped off? […] Roger, is the vessel fully engulfed right now […] Roger, and there’s no escape hatch for any of the people on board?

Commenting on the radio communications, Captain Rochester said the situation had “a lot of adrenaline, a lot of confusion. […] [The dispatcher] was trying to ask for information.” However, she added, “there are no locked doors in accommodation spaces” where the passengers would have been.

The Conception was owned by Truth Aquatics and chartered by Worldwide Diving Adventures. Both companies have been in operation since the 1970s according to USA Today.

Monday, June 23, 2008

2008 COMPUTEX Taipei, the largest trade fair since its inception in 1982, featured several seminars and forums, expansions on show spaces to TWTC Nangang, great transformations for theme pavilions, and WiMAX Taipei Expo, mainly promoted by Taipei Computer Association (TCA). Besides of ICT industry, “design” progressively became the critical factor for the future of the other industries. To promote innovative “Made In Taiwan” products, pavilions from “Best Choice of COMPUTEX”, “Taiwan Excellence Awards”, and newly-set “Design and Innovation (d & i) Award of COMPUTEX”, demonstrated the power of Taiwan’s designs in 2008 COMPUTEX Taipei.

Wednesday, November 1, 2006

The first comprehensive global study of sexual behaviour, published today as part of The Lancet’s Sexual and Reproductive Health Online Series, found that people aren’t losing their virginity at ever younger ages, married people have the most sex, and there is no firm link between promiscuity and sexually transmitted diseases.

Experts say data gleaned from the study will be useful not only in dispelling popular myths about sexual behaviour, but in shaping policies that will help improve sexual health across the world. Researchers looked at previously published studies on sexual behaviour in the last decade.

Professor Kaye Wellings, of the London School of Hygiene and Tropical Medicines, and her colleagues analysed data on sexual behaviour in the last decade from 59 countries.

The report also shows no support for the common notion that there is a culture of multiple sexual partners in countries with poor sexual health. Multiple sexual partners, it turns out, are more common in industrialised than in developing nations.

The study also found that contrary to popular belief, sexual activity is not starting earlier. Nearly everywhere, men and women have their first sexual experiences in their late teens; from 15 to 19 years old — with generally younger ages for women than for men, especially in developing countries.

“A single woman is more able to negotiate safe sex in certain circumstances than a married woman,” said Paul van Look, director of Reproductive Health and Research at the World Health Organisation, who was unconnected to the study and points out that “married women in Africa and Asia are often threatened by unfaithful husbands who frequent prostitutes”.

There is much greater equality between women and men with regard to the number of sexual partners in rich countries than in poor countries, the study found. This imbalance has significant public health implications. Because of the diversity of sexual habits worldwide, Wellings warns that no single approach to sexual health will work everywhere. “There are very different economic, religious and social rules governing sexual conduct across the world,” Wellings said.

For example, men and women in Australia, Britain, France and the United States tend to have an almost equal number of sexual partners. In contrast, in Cameroon, Haiti, and Kenya, men tend to have multiple partners while women tend only to have one.

Along with other industrialised countries, Australia was one in which having two or more sexual partners in the past year was comparatively common.

Single men and women in Africa were fairly sexually inactive: only two-thirds of them reported recent sexual activity, compared with three-quarters of their counterparts in developed countries.

In what researchers said was proof the sexual double standard was still strong, more men than women reported having more than one partner.

“These findings beg the question of who the men are having sex with,” they wrote.

Italy had one of the lowest percentages of men who had sex before age 15 (4 per cent), compared to 18 per cent in the United States and 30 per cent in Brazil and the Dominican Republic. The researchers said early initiation was more likely to be non-consensual, unsafe and generally to be regretted later.

The study suggests that unequal treatment of girls and women as the major sexual-health issue.

The researchers call for providing sexual health services to unmarried young women, supplying condoms, decriminalizing commercial sex and homosexual sex, and prosecuting the perpetrators of sexual violence.

Experts say data gleaned from the study will be useful not only in dispelling popular myths about sexual behaviour, but in shaping policies that will help improve sexual health across the world.

“There’s a misperception that there’s a great deal of promiscuity in Africa, which is one of the potential reasons for HIV/AIDS spreading so rapidly,” said van Look

Fewer than half of unmarried non-virgins reported having sex in the past month.

Some of the major findings the survey found were:

• School-based sexual education delays and does not hasten onset of sexual activity.
• First sexual experience is often forced or sold.
• Marriage is no safeguard of sexual health. It is more difficult for married women to negotiate safe sex and condom use than it is for single women.
• Condom use is increasing, but condom-use rates remain low in many developing countries.
• Among girls who marry at a very young age, “very early sexual experience within marriage can be coercive and traumatic.”
• While there is no major trend toward earlier sexual experience, a trend toward later marriage has led to an increase in premarital sex.
• Public health measures to improve sexual health should focus not only on individual behaviours but also on broader issues such as gender, poverty, and mobility.
• Public-health messages intended to reduce sexual risk-taking “should respect diversity and preserve choice.”
• Monogamy is the dominant pattern in most parts of the world. Men report more multiple partnerships than do women. Such men are more likely to live in developed nations.

Sunday, March 13, 2011

The new version of Apple Inc.’s tablet computing device, the iPad 2, has gone on sale in the United States at Apple Stores and a number of other retailers (including Wal-Mart, Target, Sam’s Club, Best Buy, Verizon, and AT&T), a shift from last year’s launch which was only available through Apple’s stores. The product will go on sale internationally on March 25.

The device was announced on March 2 at an event at the Yerba Buena Center for the Arts in San Francisco, California. CEO Steve Jobs emerged from sick leave to make the announcement.

The iPad 2 has an all-new design and has several improvements over the original iPad. The device runs on a dual-core Apple A5 CPU. According to Jobs, the CPU’s new dual-core capability enhances multitasking and doubles the processing speed. Apple additionally introduced a magnetic ‘Smart Cover’ accessory that snaps to the front screen of the device along with several new apps ported from the Mac OS X operating system and the iPhone. These include iMovie, GarageBand, and Photo Booth. The new iPad introduces front and rear cameras which enable FaceTime and video. The new tablet is fifteen percent lighter and 33 percent thinner than the previous version—thinner than an iPhone 4—and has beveled edges. It is available in black and white and continues to be capable of ten hours of battery life on a single charge.

The announcement came after months of rumors about the successor to the original iPad. Competitors have designed tablets to compete with the iPad, such as Motorola’s Xoom powered by the Android operating system. Apple, who normally follows a yearly product cycle, has pressed its iPad successor into the marketplace almost a full month earlier than usual.

Tablet computers have existed for years but, until recently, have not been popular amongst consumers. Tablet sales totaled 90,000 in 2009. Apple sold nearly fifteen million iPads worldwide in 2010, generating US$2 billion in revenue within three months. In 2010, Apple held a 75% share of the tablet computer market. According to one analyst, even with competition, iPads will still make up at least 20 million of the more than 24 million tablet computers sold in the United States in 2011. An analyst predicted ‘conservatively’ that 35 million iPad 2s will be sold in 2011. One analyst credits Apple’s enormous App Store for the iPad’s continued domination. Apple also holds an advantage in price over other tablets, many of which are still first generation devices. An analyst at J.P. Morgan predicts an overabundance of tablets caused by faltering demand. This could have drastic effects on competitors.

The iPad connects to the Internet over Wi-Fi and 3G models of the new device can connect to the wireless networks of AT&T or Verizon Wireless. The iPad 2 will start at US$499—the same starting price of the original iPad. The equivalent model of the original iPad has been reduced to US$399.

Timeline of Apple touchscreen devices

Tuesday, May 4, 2010

The United States National Transportation Safety Board (NTSB) has completed its investigation into the ditching of US Airways Flight 1549 into New York’s Hudson River. The fifteen-month probe began after the Airbus A320 performed a water landing when bird strikes damaged both engines in a move dubbed the “Miracle on the Hudson” by the media. Nobody was killed.

The NTSB’s final report, adopted after a board meeting today, concluded that a combination of safety equipment better than the mandatory minimums and good reactions by the crew were the main reasons the 150 passengers and five crew survived. The board stated that the aircraft’s equipment met the standards required for “extended overwater operations”, equipment that was not needed for the January 2009 flight.

The aircraft was equiped with escape slides that doubled as water rafts at the front and aft emergency exits, but the aft ones were rendered unavailable. Airbus assumed when designing the aircraft that only one engine would be inoperative during an emergency ditching, and current emergency checklists assume plenty of prior warning for dual-engine failure since the aircraft would be at a high altitude. The A320 was at just 2,700 feet when the incident occurred, having just taken off when it collided with a flock of Canada geese, almost completely removing the engines’ ability to generate thrust.

The final report has blamed a number of factors for extensive fuselage damage caused in the impact, which cracked a rear bulkhead and caused the aircraft to flood, as well as taking the rear slides out of action. The board said standards aircraft should meet in ditchings — set by the Federal Aviation Authority (FAA) — were inadequate, training in industry was not sufficient for ditchings and the high level of tasks the crew had to focus on made it difficult for the pilot to maintain his airspeed. The pilot’s decision to ditch was credited as being the best possible solution to the emergency.

The NTSB noted that while the rear rafts failed, 64 people climbed into the forward rafts, and said many of these people would have been immersed in the frigid river. The board claimed that this could induce “cold shock”, which can lead to drowning within minutes.

The report found that the good visibility, calm water, nearby ferries which provided rescues within twenty minutes and good cockpit resource management, allowing the crew to maintain control, were further factors that contributed to the survival of those on board. However, it also found that “more creative and effective methods of conveying safety information to passengers” are required after learning that most passengers had not paid attention to the in-flight safety announcement. It also noted that many passengers had difficulty putting on the life vests supplied under the seats.

The report further stated that the accident was hard to predict due to the fact that bird strikes tend to occur much lower, usually below 500 feet. It considered the possibilities of fitting engine screens or redesigning engines to mitigate bird strike risk, but these proposals were rejected after consideration since they were deemed unfeasable.

NTSB Chairman Deborah A.P. Hersman described the circumstances as “a great example of the professionalism of the crewmembers, air traffic controllers and emergency responders who all played a role in preserving the safety of everyone aboard.” She further discussed the safety recommendations the report will contain when it is released. “I believe the safety recommendations that have come out of this investigation have an extraordinary origin – a very serious accident in which everyone survived. Even in an accident where everyone survives, there are lessons learned and areas that could use improvement. Our report today takes these lessons learned so that, if our recommendations are implemented, every passenger and crewmember may have the opportunity to benefit from the advances in safety.” A total of 35 recommendations have been made seeking improved checklists for emergencies, better certification standards for aircraft and their engines, advances in crew training, better safety equipment and improved safety briefings to passengers.

One result of these findings is that the board will likely ask the FAA to require emergency equipment for water landings on all commercial aircraft. The FAA has until now held that such a move would place a disproportionately high cost on airlines.