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Thursday, June 23, 2011

NASA’s Cassini–Huygens spacecraft has discovered evidence for a large-scale saltwater reservoir beneath the icy crust of Saturn’s moon Enceladus. The data came from the spacecraft’s direct analysis of salt-rich ice grains close to the jets ejected from the moon. The study has been published in this week’s edition of the journal Nature.

Data from Cassini’s cosmic dust analyzer show the grains expelled from fissures, known as tiger stripes, are relatively small and usually low in salt far away from the moon. Closer to the moon’s surface, Cassini found that relatively large grains rich with sodium and potassium dominate the plumes. The salt-rich particles have an “ocean-like” composition and indicate that most, if not all, of the expelled ice and water vapor comes from the evaporation of liquid salt-water. When water freezes, the salt is squeezed out, leaving pure water ice behind.

Cassini’s ultraviolet imaging spectrograph also recently obtained complementary results that support the presence of a subsurface ocean. A team of Cassini researchers led by Candice Hansen of the Planetary Science Institute in Tucson, Arizona, measured gas shooting out of distinct jets originating in the moon’s south polar region at five to eight times the speed of sound, several times faster than previously measured. These observations of distinct jets, from a 2010 flyby, are consistent with results showing a difference in composition of ice grains close to the moon’s surface and those that made it out to the E ring, the outermost ring that gets its material primarily from Enceladean jets. If the plumes emanated from ice, they should have very little salt in them.

“There currently is no plausible way to produce a steady outflow of salt-rich grains from solid ice across all the tiger stripes other than salt water under Enceladus’s icy surface,” said Frank Postberg, a Cassini team scientist at the University of Heidelberg in Germany.

The data suggests a layer of water between the moon’s rocky core and its icy mantle, possibly as deep as about 50 miles (80 kilometers) beneath the surface. As this water washes against the rocks, it dissolves salt compounds and rises through fractures in the overlying ice to form reserves nearer the surface. If the outermost layer cracks open, the decrease in pressure from these reserves to space causes a plume to shoot out. Roughly 400 pounds (200 kilograms) of water vapor is lost every second in the plumes, with smaller amounts being lost as ice grains. The team calculates the water reserves must have large evaporating surfaces, or they would freeze easily and stop the plumes.

“We imagine that between the ice and the ice core there is an ocean of depth and this is somehow connected to the surface reservoir,” added Postberg.

The Cassini mission discovered Enceladus’ water-vapor and ice jets in 2005. In 2009, scientists working with the cosmic dust analyzer examined some sodium salts found in ice grains of Saturn’s E ring but the link to subsurface salt water was not definitive. The new paper analyzes three Enceladus flybys in 2008 and 2009 with the same instrument, focusing on the composition of freshly ejected plume grains. In 2008, Cassini discovered a high “density of volatile gases, water vapor, carbon dioxide and carbon monoxide, as well as organic materials, some 20 times denser than expected” in geysers erupting from the moon. The icy particles hit the detector target at speeds between 15,000 and 39,000 MPH (23,000 and 63,000 KPH), vaporizing instantly. Electrical fields inside the cosmic dust analyzer separated the various constituents of the impact cloud.

“Enceladus has got warmth, water and organic chemicals, some of the essential building blocks needed for life,” said Dennis Matson in 2008, Cassini project scientist at NASA’s Jet Propulsion Laboratory in Pasadena, California.

“This finding is a crucial new piece of evidence showing that environmental conditions favorable to the emergence of life can be sustained on icy bodies orbiting gas giant planets,” said Nicolas Altobelli, the European Space Agency’s project scientist for Cassini.

“If there is water in such an unexpected place, it leaves possibility for the rest of the universe,” said Postberg.

Friday, July 10, 2009

The Saskatchewan provincial government alongside the University of Saskatchewan (U of S) have come together to establish a CA$500 million, 10 megawatts research nuclear reactor to produce medical isotopes.

“In 1949 … cobalt-60 treatment was tried for the first time here in Saskatchewan, where it saved a woman battling cervical cancer. Maybe we can lead again in terms of nuclear medicine,” said Brad Wall, the Premier of Saskatchewan, “Governments should be involved in pure research. We’re dealing with some circumstances as they present themselves”

“We’ve had faculty that are interested in this. We have an issue of national importance, We see a reason why the U of S and the province could assist in this national issue. We see how it could help the country. We see how it could build on the university’s research strength,” said Richard Florizone, U of S vice-president of finance and resources.

The research conducted at the Canadian Light Source Synchrotron on campus would be enhanced by a research reactor.

“In the case of a power reactor, in Saskatchewan we have much better alternatives. In the case of a medical isotopes research reactor, this may be a circumstance where the benefits outweigh the risks,” said Peter Prebble, director of energy and water policy for the Saskatchewan Environmental Society.

The nuclear reactor at Chalk River, Ontario in Canada was shut down on Thursday, May 14 by the Atomic Energy of Canada Limited (AECL) due to a leak of heavy water and will not re-open until late 2009 or spring of 2010.

The repairs of the NRU are complex and challenging. “I’ve heard it described as . . . trying to change the oil in your car from your living room. We’re faced with conducting remote investigations in a radioactive environment with high radiation fields, conducting the examinations and inspections through small openings in the top of the reactor and accessing over great distances,” said David Cox, director of the NRU engineering task force.

“The unplanned shutdown of the NRU will result in a significant shortage of medical isotopes in Canada, and in the world, this summer,” said Leona Aglukkaq, Minister of Health and Lisa Raitt, Minister of Natural Resources.

The Petten reactor in the Netherlands is another of the six extant nuclear reactors globally. It must also be shut down between mid July and mid August.

Medical isotopes are used in diagnostic procedures for cancer, heart disease and other medical conditions. When radioactive isotopes are injected into the body, radiologists can view higher radiation via medical imaging, enabling them to make a more accurate diagnosis.

Tuesday, January 19, 2010

A Scottish woman who set out before Christmas to purchase a turkey finally made it home on Monday, after being cut off by snow for a month. Kay Ure left the Lighthouse Keeper’s cottage on Cape Wrath, at the very northwest tip of Great Britain, in December. She was heading to Inverness on a shopping trip.

However on her return journey heavy snow and ice prevented her husband, John, from travelling the last 11 miles to pick her up. She was forced to wait a month in a friend’s caravan, before the weather improved and the couple could finally be reunited.

They were separated not just for Christmas and New Year, but also for Mr Ure’s 58th birthday. With no fresh supplies, he was reduced to celebrating with a tin of baked beans. He also ran out of coal, and had to feed the couple’s six springer spaniels on emergency army rations.

“It’s the first time we’ve been separated”, said Mr Ure in December. “We’ve been snowed in here for three weeks before, so we are well used to it and it’s quite nice to get a bit of peace and quiet.”

Friday, April 7, 2006Legislators in the Massachusetts General Court, their name for the state legislature, approved legislation on Tuesday, April 4, that would make it the first state in the United States to require all residents to have health insurance and impose penalties for non-compliance. Massachusetts Governor Mitt Romney, a Republican who is expected to run for U.S. President in 2008, is expected to sign the bill.

The bill passed the lower house, the Massachusetts House of Representatives by a vote of 155-2, and unanimously by the state senate. The Democratic Party holds supermajorities in both houses of the legislature.

Among the bill’s provisions are these:

1. Businesses that employ more than 10 people are required to provide health insurance for all staff or face fines of $295 per year per uninsured worker.
2. Individuals will be required to enroll in a health plan by July 1, 2007, or face tax penalties.
3. Health insurers will provide partially to fully subsidized coverage for low-income residents.

At least one other state (Hawaii) requires employers to provide employee health insurance, but no other state holds individuals accountable for coverage.

Friday, September 28, 2012

Melbourne, Australia — Monday, following her return from London, Wikinews talked with Amanda Carter, the longest-serving member of Australia’s national wheelchair basketball team (the Gliders).

((Wikinews)) You’re Amanda Carter!

Amanda Carter: Yes!

((WN)) And, where were you born?

Amanda Carter: I was born in Melbourne.

((WN)) It says here that you spent your childhood living in Banyule?

Amanda Carter: City of Banyule, but I was West Heidelberg.

((WN)) Okay. And you used to play netball when you were young?

Amanda Carter: Yes.

((WN)) And you’re an occupational therapist, and you have a son called Alex?

Amanda Carter: Yes. It says “occupational therapist” on the door even. And I do have a son called Alex. Which is him there [pointing to his picture].

((WN)) Any more children?

Amanda Carter: No, just the one.

((WN)) You began playing basketball in 1991.

Amanda Carter: Yes.

((WN)) And that you’re a guard.

Amanda Carter: Yes.

((WN)) And that you are a one point player.

Amanda Carter: Yes.

((WN)) And you used to be a two point player?

Amanda Carter: I used to be a two point player.

((WN)) When were you first selected for the national team?

Amanda Carter: 1992.

((WN)) And that was for Barcelona?

Amanda Carter: It was for a tournament prior to then. Australia had to qualify at a pre-Paralympic tournament in England in about April of 1992 and I was selected for that. And that was my first trip overseas with the Gliders.

((WN)) How did we go?

Amanda Carter: We won that tournament, which qualified us for Barcelona.

((WN)) And what was Barcelona like?

Amanda Carter: Amazing. I guess because it was my first Paralympics. I hadn’t long been in a wheelchair, so all of it was pretty new to me. Barcelona was done very, very well. I guess Australia wasn’t expected to do very well and finished fourth, so it was a good tournament for us.

((WN)) Did you play with a club as well?

Amanda Carter: I did. I played in the men’s league at that point. Which was Dandenong Rangers. It had a different name back then. I can’t remember what they were called back then but eventually it became the Dandenong Rangers.

((WN)) The 1994 World Championships. Where was that at?

Amanda Carter: Good question. Very good question. I think it was in Stoke. ‘Cause 1998 was Sydney, so I’ve got a feeling that it was in Stoke Mandeville in England.

((WN)) Which brings us to 1996.

Amanda Carter: Atlanta!

((WN)) Your team finished fourth.

Amanda Carter: Yes.

((WN)) Lost to the Unites States in the bronze medal game in front of a crowd of 5,000.

Amanda Carter: That would have been about right. It was pretty packed.

((WN)) That must have been awesome.

Amanda Carter: It was. It was. I guess also because it was the USA. It was their home crowd and everything, so it was a very packed game.

((WN)) They also have a fondness for the sport.

Amanda Carter: They do. They love basketball. But Atlanta again was done very well. Would have been nice to get the medal, ‘cause I think we sort of had bigger expectations of ourselves at that point, ‘cause we weren’t the new kids on the block at that point but still finished fourth.

((WN)) They kept on saying in London that the Gliders have never won.

Amanda Carter: We’ve never won a gold, no. Not at World’s or Paralympics.

((WN)) So that was Atlanta. Then there was another tournament, the 1998 Gold Cup.

Amanda Carter: Yes. Which was the World Championships held in Sydney.

((WN)) How did we go in that?

Amanda Carter: Third.

((WN)) But that qualified… no, wait, we didn’t need to qualify…

Amanda Carter: We didn’t need to qualify.

((WN)) You were the second leading scorer in the event, with thirty points scored for the competition.

Amanda Carter: Yes. Which was unusual for a low pointer.

((WN)) In basketball, some of the low pointers do pretty well.

Amanda Carter: Yeah, but in those days I guess it was more unusual for a low pointer to be more a scorer.

((WN)) I notice the scores seem lower than the ones in London.

Amanda Carter: Yes. I think over time the women’s game has developed. Girls have got stronger and they’re competing against guys. Training has got better, and all sorts of things. So teams have just got better.

((WN)) How often do the Gliders get together? It seems that you are all scattered all over the country normally.

Amanda Carter: Yes. I mean we’ve got currently three in Perth, four in Melbourne, four in New South Wales, and one in Brisbane out of the twelve that were in London. But the squad is bigger again. We usually get together probably every six or eight weeks.

((WN)) That’s reasonably often.

Amanda Carter: Cost-wise it’s expensive to get us all together. What we sometimes do is tack a camp on to the Women’s League, when we’re mostly all together anyway, no matter where it is, and we might stay a couple of extra days in order to train together. But generally if we come into camp it would be at the AIS.

((WN)) I didn’t see you training in Sydney this time… then you went over to…

Amanda Carter: Perth. And then we stayed in Perth the extra few days.

((WN)) 2000. Sydney. Two Australia wins for the first time against Canada. In the team’s 52–50 win against Canada you scored a lay up with sixteen seconds left in the match.

Amanda Carter: I did! That was pretty memorable actually, ‘cause Canada had a press on, and what I did was, I went forward and then went back, and they didn’t notice me sitting behind. Except Leisl did in my team, who was inbounding the ball, and Leisl hurled a big pass to almost half way to me, which I ran on to and had an open lay up. And the Canadians, you could just see the look on their faces as Leisl hurled this big pass, thinking “but we thought we had them all trapped”, and then they’ve looked and seen that I’m already over half way waiting for this pass on an open lay up. Scariest lay up I’ve ever taken, mind you, because when you know there’s no one on you, and this is the lay up that could win the game, it’s like: “Don’t miss this! Don’t miss this!” And I just thought: “Just training” Ping!

((WN)) That brings us to the 2000 Paralympics. It says you missed the practice game beforehand because of illness, and half the team had some respiratory infection prior to the game.

Amanda Carter: Yeah.

((WN)) You scored twelve points against the Netherlands, the most that you’ve ever scored in an international match.

Amanda Carter: Quite likely, yeah.

((WN)) At one point you made four baskets in a row.

Amanda Carter: I did!

((WN)) The team beat Japan, and went into the gold medal game. You missed the previous days’ training session due to an elbow injury?

Amanda Carter: No, I got the elbow injury during the gold medal game.

((WN)) During the match, you were knocked onto your right side, and…

Amanda Carter: The arm got trapped underneath the wheelchair.

((WN)) Someone just bumped you?

Amanda Carter: Tracey Fergusson from Canada.

((WN)) You were knocked down and you tore the tendons in your elbow, which required an elbow reconstruction…

Amanda Carter: Yes. And multiple surgeries after that.

((WN)) You spent eleven weeks on a CPM machine – what’s a CPM machine?

Amanda Carter: It’s a continuous passive movement machine. You know what they use for the footballers after they’ve had a knee reconstruction? It’s a machine that moves their knee up and down so it doesn’t stiffen. And they start with just a little bit of movement following the surgery and they’re supposed to get up to about 90 degrees before they go home. There was only one or two elbow machines in the country, so they flew one in from Queensland for me to use, to try and get my arm moving.

((WN)) You’re right handed?

Amanda Carter: Yes.

((WN)) So, how’s the movement in the right arm today?

Amanda Carter: I still don’t have full movement in it. And I’ve had nine surgeries on it to date.

((WN)) You still can’t fully flex the right hand.

Amanda Carter: I also in 2006 was readmitted back to hospital with another episode of transverse myelitis, which is my original disability, which then left me a C5 incomplete quad, so it then affected my right arm, in addition to the elbow injury. So, I’ve now got weakness in my triceps, biceps, and weakness in my hand on my right side. And that was following the birth of my son.

((WN)) How old is he now?

Amanda Carter: He’s seven. I had him in July 2005, and then was readmitted to hospital in early 2006 with another episode of transverse myelitis.

((WN)) So that recurs, does it?

Amanda Carter: It can. And it has a higher incidence of recurring post pregnancy. And around the age of forty. And I was both, at the same time.

((WN)) So you gave up wheelchair basketball after the 2000 games?

Amanda Carter: I did. I was struggling from… In 2000 I had the first surgery so I literally arrived back in Melbourne and on to an operating table for the ruptured tendons. Spent the next nine months in hospital from that surgery. So I had the surgery and then went to rehab for nine months, inpatient, so it was a big admission, because I also had a complication where I grew heterotopic bone into the elbow, so that was also causing some of the sticking and things. And then went back to a camp probably around 2002, and was selected to go overseas. And at that point got a pressure sore, and decided not to travel, because I thought the risk of travelling with the pressure sore was an additional complication, and at that point APC were also saying that if I was to go overseas, because I had a “pre existing” elbow injury, that they wouldn’t cover me insurance-wise. So I though: “hmmm Do I go overseas? Don’t I go overseas?”

((WN)) Did they cover you from the 2000 injury?

Amanda Carter: Yes. They covered me for that one. But because that had occurred, they then said that they would not cover if my arm got hurt again. And given that the tournament was the Roosevelt Cup in the US, and that we don’t have reciprocal health care rights, the risk was that if I fell, or landed on my arm and got injured, I could end up with a huge medical bill from the US and lose my house. So I decided not to play, and at that point I guess then decided to back off from basketball a little bit at that point. But then, after I had my son, and I had the other episode of transverse myelitis, in 2008, I just happened to come across the coach for the women’s team…

((WN)) Who was that?

Amanda Carter: It was Brendan Stroud at the time, who was coaching the Dandenong Rangers women’s team. I just happened to cross him at Northland, the shopping centre. And he said: “Why don’t you come out and play for Dandenong?” I was looking fit and everything else, so I thought “Okay, I’ll come out to one training session and see how I go.” And from there played in the 2008 Women’s National League. And was voted MVP — most valuable one-pointer, and all-star five. So at that point, in 2009, after that, they went to Beijing, so I watched Beijing from home, because I wasn’t involved in the Gliders program. I just really came back to do women’s league. In 2009, I received some phone calls from the coaching staff, John Trescari, who was coaching the Gliders at that point, who invited me back in to the Glider’s training program, about February, and I said I would come to the one camp and see how I went. And went to the one camp and then got selected to go to Canada. So, since then I’ve been back in the team.

((WN)) Back in the Gliders again.

Amanda Carter: Yeah!

((WN)) And of course you got selected for 2012…

Amanda Carter: Yes.

((WN)) My recollection is that you weren’t on the court a great deal, but there was a game when you scored five points?

Amanda Carter: Yeah! Within a couple of minutes.

((WN)) That was against Mexico.

Amanda Carter: Yes. That was a good win, actually, that one.

((WN)) The strange thing was that afterwards the Mexicans were celebrating like they’d won…

Amanda Carter: Oh yeah! It was very strange. I guess one of the things that, like, I am in some ways the backup one pointer in some ways, but what gives me my one point classification, because I used to be a two, is my arm, the damage I received, and the quadriplegia from the transverse myelitis. So despite the fact I probably shoot more accurately that most people in the team, because I’ve just had to learn to shoot, it also slows me down; I’m not the quickest in the team for getting up and down the court, because of having trouble with grip and stuff on my right hand to push. I push reasonably quick! Most people would say I’m reasonably quick, but when you at me in comparison to, say, the other eleven girls in the team, I am not as quick.

((WN)) The speed at which things move is quite astonishing.

Amanda Carter: Yeah, and my ability is more in knowing where people want to get to, so I aim to get there first by taking the most direct route. [laughter]

((WN)) Because you are the more experienced player.

Amanda Carter: Yeah!

((WN)) And now you have another silver medal.

Amanda Carter: Yes. Which is great.

((WN)) We double-checked, and there was nobody else on the team who had been in Sydney, much less Barcelona or Atlanta.

Amanda Carter: I know.

((WN)) Most of the Gliders seem to have come together in 2004, the current roster.

Amanda Carter: Yes, most since 2004, and some since 2008. And of course there are three newbies for 2012.

((WN)) Are you still playing?

Amanda Carter: I’m having a rest at this particular point. Probably because it’s been a long campaign of the training over the four years. I guess more intense over the last eighteen months or so. At the moment I am having a short break just to spend some time with my son. Those sorts of things. ‘Cause he stayed at home rather than come to London.

((WN)) You would have been isolated from him anyway.

Amanda Carter: And that’s the thing. We just decided that if he had come, it would have been harder for him, knowing he’d have five minutes a day or twenty minutes or something like that where he could see me versus he spoke to me for an hour on Skype every day. So, I think it would have been harder to say to Alex: “Look, you can’t come back to the village. You need to go with my friend now” and stuff like that. So he made the decision that he wanted to stay, and have his normal routine of school activities, and just talk to mum on Skype every day.

((WN)) Fair enough.

Amanda Carter: Yeah! But I haven’t decided where to [go] from here.

((WN)) You will continue playing with the club?

Amanda Carter: I ‘ll still keep playing women’s league, but not sure about some of the international stuff. And who knows? I may well still, but at this point I’m just leaving my options open. It’s too early to say which way I’m going to go.

((WN)) Is there anything else you’d like to say about your record? Which is really impressive. I can count the number of Paralympians who were on Team Australia in London who were at the Sydney games on my fingers.

Amanda Carter: Yes!

((WN)) Greg Smith obviously, who was carrying the flag…

Amanda Carter: Libby Kosmala… Liesl Tesch… I’ve got half my hand already covered!

((WN)) What I basically wanted to ask was what sort of changes you’ve seen with the Paralympics over that time — 1992 to 2012.

Amanda Carter: I think the biggest change has been professionalism of Paralympic sports. I think way back in ’92, especially in basketball, I guess, was that there weren’t that many girls and as long as you trained a couple of times a week, and those sorts of things, you could pretty much make the team. It wasn’t as competitive. This campaign, certainly, we’ve had a lot more than the twelve girls who were vying for those twelve positions. The ones who certainly didn’t make the team still trained as hard and everything as the ones who did. And just the level of training has changed. Like, I remember for 2012 I’d still go and train, say, four, five times a week, and that’s mostly shooting and things like that, but now it’s not just about the shooting court skills, it’s very much all the gym sessions, the strength and conditioning. Chair skills, ball skills, shooting, those sorts of things to the point where leading in to London, I was doing twelve sessions a week. So it was a bigger time commitment. So the level of commitment and the skill level of the team has improved enormously over that twenty years. I think you see that in other sports where the records are so much, throwing records, the greater distances, people jump further in long jump. Speeds have improved, not just with technology, but dedication to training and other areas. So I think that’s the big thing. I think also the public’s view of the Paralympics has changed a lot, in that it was seen more as, “oh, isn’t it good that they’re participating” in 1992, where I think the general public understands the professionalism of athletes now in the Paralympics. And that’s probably the biggest change from a public perspective.

((WN)) To me… London… the coverage on TV in Britain, but also here, some countries are ahead of others, but basically it’s being treated like the Olympics.

Amanda Carter: Yeah! Yeah. There wasn’t a lot of difference between.

((WN)) Huge crowds…

Amanda Carter: Huge crowds! We played for our silver medal in a sell-out crowd… you couldn’t see a vacant seat around the place.

((WN)) I was looking around the North Greenwich Arena…And that arena! The seats went up and up and up! And as it was filling on the night, you could see that even that top deck had people sitting in it. I guess in 2000 even, to fill stadiums, which we did, we gave APC and school programs, a lot of school kids came to fill seats and things. We didn’t necessarily see that in London. They were paid seats! People had gone out and spent money on tickets to come and see that sport.

((WN)) I saw school groups at the football and the goalball, but not at the basketball.

Amanda Carter: No. Which is a big difference also, that people are willing to come and pay to watch that level of sport.

((WN)) I was very impressed with the standard of play.

Amanda Carter: The standard, over the years, has improved so much. But the good thing is, we’re looking at development. So we’ve got the next rung of girls, and guys, coming through the group. Like, we’ve got girls that weren’t necessarily up to selection for London but will probably be right up there for Rio… Our squad will open, come January, for the first training camp. That will be an invitational to most of the girls who are playing women’s league and those sorts of things, and from there they’ll do testing and stuff, cutting down and they’ll select a side for Osaka for February, but the program will remain open leading into the next world championship, which is in Canada.

((WN)) What’s in Osaka?

Amanda Carter: The Osaka Cup. It’s held every year in February, so that will be the Gliders’ first major tournament…

((WN)) After the Paralympics.

Amanda Carter: Yeah. So everyone’s taking an opportunity now to have a bit of a break.

((WN)) And then after that?

Amanda Carter: It’s the world championships in 2014 in Canada. So that will be what they’re next training to.

((WN)) How many tournaments do they normally play each year?

Amanda Carter: We’ve played a few. And you often play more in a Paralympic year, because you’re looking to see the competition, and the other teams, and those sorts of things, so… This year we did Osaka, which Canada went to, China went to… Japan, and us. We then went to — and we’d previously just been to Korea last November for qualification. We’ve been over to Germany. We’ve been to Manchester. So we’ve had a few tournaments where we’ve travelled. And then we’ve had of course a tournament in Sydney about three weeks before we went to London. And then of course we went to the Netherlands, before we went on to Cardiff in Wales.

((WN)) You played a tournament in the Netherlands?

Amanda Carter: Yes. Of four nations — five nations. We had Mexico at the tournament… GB… Netherlands… us… and there was one other… There were five of us at the tournament. It was a sort of warm up going in to… Canada! Canada it was. Canada was the fifth team. Because Canada stayed on and continued to train in the Netherlands. So they were good teams. Mexico we don’t often get a look at so it was a good chance to get a look at them at tournaments and things like that. And then flew back in to Heathrow and then in to Cardiff to train for the last six days leading in to London.

((WN)) Thank you very much for that.

Amanda Carter: That’s okay!

Sunday, August 21, 2005

A robotic system at Stanford Medical Center was used to perform a laparoscopic gastric bypass surgery successfully with a theoretically similar rate of complications to that seen in standard operations. However, as there were only 10 people in the experimental group (and another 10 in the control group), this is not a statistically significant sample.

If this surgical procedure is as successful in large-scale studies, it may lead the way for the use of robotic surgery in even more delicate procedures, such as heart surgery. Note that this is not a fully automated system, as a human doctor controls the operation via remote control. Laparoscopic gastric bypass surgery is a treatment for obesity.

There were concerns that doctors, in the future, might only be trained in the remote control procedure. Ronald G. Latimer, M.D., of Santa Barbara, CA, warned “The fact that surgeons may have to open the patient or might actually need to revert to standard laparoscopic techniques demands that this basic training be a requirement before a robot is purchased. Robots do malfunction, so a backup system is imperative. We should not be seduced to buy this instrument to train surgeons if they are not able to do the primary operations themselves.”

There are precedents for just such a problem occurring. A previous “new technology”, the electrocardiogram (ECG), has lead to a lack of basic education on the older technology, the stethoscope. As a result, many heart conditions now go undiagnosed, especially in children and others who rarely undergo an ECG procedure.

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.