Hypertension and intra-operative incidents: a multicentre study of 125000 surgical procedures in Swiss hospitals

Background: It is debated whether chronic hypertension increases the risk of cardiovascular incidents during anaesthesia. Methods: We studied all elective surgical operations performed in adults under general or regional anaesthesia between 2000 and 2004, in 24 hospitals collecting computerised clinical data on all anaesthetia since 1996. The focus was on cardiovascular incidents, though other anaesthesia-related incidents were also evaluated. Results: Among 124 939 interventions, 27 881 (22%) were performed in hypertensive patients. At least one cardiovascular incident occurred in 7549 interventions (6% [95% CI 5.9-6.2%]). The average adjusted odds ratio of cardiovascular risk in patients with chronic hypertension was 1.38 (95% CI 1.27-1.49). However, across hospitals, adjusted odd ratios varied from 0.41 up to 2.25. Hypertension did not increase the risk of other incidents. Conclusions: Hypertensive patients are still at risk of intra-operative cardiovascular incidents. The heterogeneity of the risk to develop cardiovascular incidents varied across hospitals, despite taking into account casemix and hospital characteristics. These variations suggest that anaesthetic practices differ across anesthesia services

La noció d'Espanya a la Catalunya medieval

A partir de la necessitat de conèixer les bases del propi present i d'assolir puntals on arrelar els discursos de futur, ara i adés les diferents col·lectivitats es remeten als orígens, "l'obsessió pels orígens" deia Marc Bloch. I aquests, en una Europa que parla de l'Edat Mitjana com la infantesa de la pròpia identitat, s'aboquen a una època medieval on conflueixen -en el que des de la llunyania de la nostra quotidianitat pot semblar una amalgama poc destriada- tant les realitats gresoladores dels actuals signes d'identitat culrurals, socials i lingüístics, com les projeccions que delerosament hi cerquen les justificacions del present i els condicionants del furur. Així doncs, convé apamar bé l'espai físic i conceptual per definir adientment la realitat existent en aquells moments que han alimentat les arrels d'identitats que, travessant diferents estímuls al llarg de la història, han menat fins als nostres dies.

Direct to consumer advertising : the case for greater consumer control

A nyone traveling to the United States from countries other than New Zealand will be surprised by the prevalence of health-related advertisements on television, including ads for drugs. Typically, these TV ads follow a pattern: an ad for a burger at only 99 cents, followed by one for a proton-pump inhibitor, then an ad on healthy home-cooked food delivered directly to your home and an ad for a home-based abdominal workout DVD, followed by an ad for a lipid-lowering drug. There are, however, nuances. After 8 pm, the visitor might encounter an ad for the "little blue pill." This sequence sometimes includes an ad featuring antihistamines for allergic rhinitis in spring and one promoting antidepressants in the winter. Such direct-to-consumer advertising (DTCA) of prescription drugs is usual business in the United States and New Zealand but is prohibited in the rest of the world. Why? Because DTCA for prescribing drugs has pros and cons (discussed elsewhere,1-3 including in JGIM4) that are balanced differently in different countries. Constitutional factors-such as the First Amendment protections on speech, including commercial speech, in the United States5 -as well as patient and population safety considerations, which all differ across countries, modulate reactions to DTCA. Additionally, lack of robust data on the impact of DTCA on prescription drug use adds to the confusion. Evidence, though limited, suggests that DTCA increases drug sales. However, whether the increase in sales corrects existing underuse or encourages over/misuse is not clear.

Evolving characteristics and outcome of secondary acute promyelocytic leukemia (APL): A prospective analysis by the French-Belgian-Swiss APL group.

BACKGROUND: Reports of patients with secondary acute promyelocytic leukemia (APL) have increased in recent years, particularly for those who received treatment with mitoxantrone, and retrospective studies have suggested that their characteristics and outcomes were similar to those of patients with de novo APL. METHODS: The authors investigated patients with de novo and secondary APL who were included in the ongoing APL-2006 trial. Patients with secondary APL who were included in that trial also were compared with a previous retrospective cohort of patients with secondary APL. RESULTS: In the APL-2006 trial, 42 of 280 patients (15%) had secondary APL. Compared with the retrospective cohort, patients with secondary APL in the APL-2006 trial had a lower incidence of prior breast carcinoma (35.7% vs 57%; P = .03) and a higher incidence of prior prostate carcinoma (26.2% vs 4.7%; P < .001). Treatment of the primary tumor in the APL-2006 trial less frequently included combined radiochemotherapy (28.6% vs 47.2%; P = .044) and no mitoxantrone (0% vs 46.7%; P = .016) but more frequently included anthracyclines (53.3% vs 38.3%; P = .015). In the APL-2006 trial, patients who had secondary APL, compared with those who had de novo APL, were older (mean, 60.2 years vs 48.7 years, respectively; P < .0001) but had a similar complete response rate (97.6% vs 90.3%, respectively), cumulative incidence of relapse (0% vs 1.8%, respectively), and overall survival (92.3% vs 90.9%, respectively) at 18 months. CONCLUSIONS: Although the incidence of secondary APL appears to be stable over time, evolving strategies for the treatment of primary cancers have reduced its occurrence among breast cancer patients but have increased its incidence among patients with prostate cancer. The current results confirm prospectively that patients with secondary APL have characteristics and outcomes similar to those of patients with de novo APL. Cancer 2015;121:2393-2399. © 2015 American Cancer Society.

Molecular profiling of non-small cell lung cancer by histologic subtype

Background: A substantial proportion of NSCLC has been shown to harbour specific molecular alterations affecting tumour proliferation and resulting in sensitivity to inhibition of the corresponding activated oncogenic pathway by targeted therapies. Comprehensive tumor profiling can diagnose such alterations and may identify new alterations opening additional treatment options for all distinct NSCLC subtypes. Methods: Over 6,700 non-small cell lung cancer cases referred to Caris Life Sciences between 2009 and 2014 were evaluated; clinical diagnoses and detailed tumor pathology were collected from referring physicians. Specific profiling was performed per physician request and included a combination of sequencing (Sanger, NGS or pyrosequencing), protein expression (IHC), gene amplification/rearrangement (CISH or FISH), and/or RNA fragment analysis within potential cancer-related genes and pathways. Results: Patients were grouped into cohorts according to histological subtype - adenocarcinoma (AD) (n=4,286), squamous cell carcinoma (SCC) (n=1,280), large cell carcinoma (LCC) (n=153) and bronchioalveolar carcinoma (BAC) (n=94). Protein overexpression of cMET (>2+ in >50% cells) was higher in AD (35.9%) compared to other subgroups (12-20%) while RRM1 and TOP2A levels were lower in AD. ALK or ROS1 were rearranged in 5.3% of patients with AD compared to 3.7% of patients with LCC and 1.2% of patients with SCC. EGFR mutations were found at low prevalence in both the LCC (0%) and SCC cohorts (2.8%) compared to 21% in AD. Similar lower rates of BRAF mutations were observed in the LCC and SCC cohorts compared to AD (0%, 1.1% and 5.1%). Pathway analysis showed activating mutations in the ERK pathway in 40% of patients with AD. Only 10-12% of patients with LCC or SCC had activating mutations in the ERK pathway. Conclusions: Despite the limitations of this retrospective series, we report comprehensive profiling of the largest cohort of NSCLC. Tumor profiling reveals that ADs may be more addicted to the ERK pathway than other histological subtypes. Drugs which target cMET may also have most utility in AD. Full analysis by histological subtype and additional correlative data on protein expression, gene copy number and mutations will be presented.

Estudos da deposição em subtensão de cádmio sobre ouro policristalino na presença de diferentes ânions co-adsorvidos

Cadmium UPD on Au was studied by voltammetric and microgravimetric measurements. In the oxide formation/reduction potential region, a mass increasing/decreasing of 32 ng cm-2 was associated to incorporation/elimination of one oxygen per active site. The modifications promoted in the voltammetric and mass profiles by 10-5 M Cd(ClO4)2 are restricted to potentials more negative than 0.4 V. After a 120 s potential delay at 0.05 V, the positive sweep reveals an anodic peak with charge of 40 muC cm-2 and mass decrease of 22 ng cm-2, associated to Cd ads dissolution. Sulphate or chloride was added to the solution without significant influence, due to the low coverage with Cd or anions.

Estudi de viabilitat tecnològica de tags RFID sobre diferents substrats

En aquest projecte s’han dissenyat i simulat diferents models de tags RFID per a la banda UHF sobre diferents classes de substrats i tintes conductores amb l’objectiu d’estudiar la viabilitat de la tecnologia de Printed Electronics per a la seva d’implementació física. A partir de dues configuracions ja existents a la literatura, aquestes etiquetes RFID s’han modelat electromagnèticament mitjançant el software ADS i s’ha simulat la seva resposta freqüencial. En segon terme, a fi d’avaluar el seu rendiment, també s’ha representat el read range d’aquests tags RFID en funció d’aquestes tintes conductores i substrats. Posteriorment, s’han realitzat diferents proves de fabricació mitjançant un mètode basat en la serigrafia, així com d’obtenció experimental de la seva distància de lectura. Finalment, en base als resultats obtinguts s’ha pogut concloure que és viable realitzar tags RFID segons aquesta tècnica d’impressió, però a falta d’una verificació experimental únicament a nivell de simulació.

Control de 6 respiròmetres i anàlisi de les dades

L’aplicació de tècniques respiromètriques és de recent innovació dins l’estudi dels tractaments d’aigües residuals. Aquest conjunt de tècniques ens permeten analitzar dos processos importants dins una planta de tractament biològic: el creixement de la biomassa i el consum del substrat. Això fa que siguin una eina amb gran potencial en l’avaluació dels sistemes de tractament biològic d’aigües residuals. L’objectiu principal d’aquest treball es la realització d’una aplicació capaç de controlar el funcionament de 6 respiròmetres, gestionant el procés del mostreig de les respirometries i l’anàlisi de les dades obtingudes, per obtenir el substrat ràpidament biodegradable (Ss) per a mostres d’aigua residual, i la taxa màxima de creixement específic per a mostres de compost. L’aplicació s’ha desenvolupat sobre l’entorn Microsoft Access, on s’integren la base de dades amb les mostres i els resultats de les respirometries, i els formularis de control que ens permeten gestionar i controlar els processos de mostreig i anàlisi. L’aplicació es comunica amb els sensors i actuadors dels respiròmetres a través del control ActiveX, ADS-OCX, subministrat per TwinCAT, que ens permet capturar les lectures dels sensors i controlar el funcionament dels actuadors. Aquests elements estan connectats a mòduls descentralitzats d’entrades i sortides, comunicats mitjançant el bus Ethernet amb el PC-Industrial, on s’executa l’aplicació. Un cop finalitzada l’aplicació, aquesta controla correctament el mostreig de les respirometries, registrant les lectures de les sondes a la base de dades i controlant l’activació de les vàlvules del respiròmetre. Partint de les mostres obtingudes, o de respirometries externes, importades des de Microsoft Excel, s’ha comprovat el correcte funcionament en el càlcul del substrat ràpidament biodegradable (Ss) i la taxa màxima de creixement específic. Amb l’aplicació desenvolupada, s’ha comprovat el funcionament i les possibilitats que ens ofereix TwinCAT alhora de controlar mòduls d’entrades i sortides, així com la seva comunicació amb aplicacions com Microsoft Access. Això pot afavorir a la utilització d’aquest tipus de tecnologia, per aplicacions futures.

Vauhtikausi. Autoilun sukupuoli 1920-luvun Suomessa

The Age of Speed:Automobility’s Gender in the 1920s Finland The aim of this study is to analyze the connections between automobility and gender in Finland in the 1920s. In this study it is argued that the 1920s was the significant era in the Finnish history of automobility when many of the long-lasting gendered notions and cultural understandings were constructed. This study combines cultural history of technology with gender analysis. As the previous research on gender and technology has recognized, technology is a significant site of gender negotiations. Both from the cultural historical perspective and a gender perspective it is important to understand both technology and gender as cultural constructions. They were linked together and constructed each other. In other words: technology shapes gender and gender shapes technology. Historians of technology like Nina Lerman, Ruth Oldenziel and Arwen Mohun have argued that both gender and technology are about power: social, cultural, economic and political. In this study automobility means technology that can be analyzed in layers of identity, structures, institutions and representations. The source material consists of various types of historical sources, magazines and journals, advertisements, archival material together with films and literature. In the previous studies of the history of automobility gender has often been neglected. The term “gender” has also quite often been misunderstood. Some studies in the field have only focused on the early female drivers. However, far too little attention has been paid to the question, why automobility was considered as masculine sphere only. This study aims to give new insights to the previous interpretations of the history of automobility. As in various other countries also in Finland, the decade of the 1920s is characterized as a period of “modern times.” It was also the era of the automobiles. Although the number of cars in Finland was still low compared to the other European countries and the USA, in press, films and literature, images of automobiles and new women – and men – on the wheel became as an emblem of a new era. The thesis consists of three main chapters. The first main chapter focuses on the conflicts between drivers and non-drivers. The study shows how in the debate of the automobility “a driver” was constantly referred as a man and “a pedestrian” accordingly a woman, even though in the reality there were as much men and women walking on the streets and the roads. Thus, the public debate constructed and reconstructed the gendered traffic system where men were playing the key role. The second main chapter of the study analyses the automobile clubs and the cultural representations. The chapter answers the question how the concept of a driver was gendered. The Automobile clubs and the organizations of professional drivers were in a significant role in developing the early history of traffic in Finland. The Finnish Automobile Club (Suomen Automobiili Klubi, founded in 1919) was the oldest and the most powerful of all automobile organizations. The Finnish Automobile Club accepted women as members from the very beginning. The membership was strictly limited to the upper class and the very first female members were wives and daughters of the male members. However, Doctor of medicine and surgery 316 Karolina Eskelin (1867-1936) the founding member of the Club was an exception to that convention. The male members of the Finnish Automobile Club attended official international meetings and consulted Finnish authorities in traffic and road questions, whereas, female members joined car trips, picnics and social gatherings arranged by the club. Few young female members of the club drove in races and gross-country-tours. The cultural representations of drivers in the Finnish media in the 1920s both deconstructed and reconstructed the concept of gender. In Finnish press in general, motoring was seen as male dominated area. Men were represented as the experts of the automobility. The drivers’ uniforms and the automobile clubs underlined professionalism and expertise which, thus, got masculine meaning. Women were beautiful accessories in the car ads, but they were also becoming a new consumer group in the market. The representations of the female and the male drivers influenced and shaped actively the understandings of femininity and masculinity. In the third main chapter the analysis focuses on the automobile as an artifact.The automobile was considered as an artifact that primarily belonged to the masculine domain. However, the representations of the automobiles were ambivalent. The automobile was both masculine and feminine depending on the context. The representations of the automobile were also used to construct the discourse of heteronormativity.

Sorção e hidrólise do herbicida flazasulfuron

O herbicida flazasulfuron vem sendo utilizado no Brasil para o controle de plantas daninhas mono e dicotiledôneas nas culturas de cana-de-açúcar e tomate. Há carência de informações sobre o seu comportamento no ambiente. O objetivo deste trabalho foi estudar a retenção do flazasulfuron em amostras de solos, superficiais e subsuperficiais, e sua hidrólise em diferentes valores de pH e temperatura. Nos ensaios de sorção e dessorção utilizou-se metodologia de batelada em equilíbrio nas concentrações de 0,07 a 5,00 mg L-1 e quantificação por CLAE. A hidrólise do flazasulfuron mostrou-se dependente da temperatura e do pH, seguindo modelo de primeira ordem. A meia-vida do herbicida em solução aquosa variou de 0,76 hora a 35 ºC e pH 3 a 167,4 horas a 25 ºC e pH 5. O Kf,ads variou de 1,19 (1/n ads = 0,40) a 27,97 (1/n ads = 0,90), apresentando correlação positiva e significativa com os teores de CO, silte e CTC. A adsorção do flazasulfuron foi menor nas amostras com maiores valores de pH, indicando maior risco de lixiviação nessa condição.

Industrial-Scale hydrothermal carbonization of waste sludge materials for fuel production

Hydrothermal carbonization (HTC) is a thermochemical process used in the production of charred matter similar in composition to coal. It involves the use of wet, carbohydrate feedstock, a relatively low temperature environment (180 °C-350 °C) and high autogenous pressure (up to 2,4 MPa) in a closed system. Various applications of the solid char product exist, opening the way for a range of biomass feedstock materials to be exploited that have so far proven to be troublesome due to high water content or other factors. Sludge materials are investigated as candidates for industrial-scale HTC treatment in fuel production. In general, HTC treatment of pulp and paper industry sludge (PPS) and anaerobically digested municipal sewage sludge (ADS) using existing technology is competitive with traditional treatment options, which range in price from EUR 30-80 per ton of wet sludge. PPS and ADS can be treated by HTC for less than EUR 13 and 33, respectively. Opportunities and challenges related to HTC exist, as this relatively new technology moves from laboratory and pilot-scale production to an industrial scale. Feedstock materials, end-products, process conditions and local markets ultimately determine the feasibility of a given HTC operation. However, there is potential for sludge materials to be converted to sustainable bio-coal fuel in a Finnish context.

Effects of adrenalectomy and adrenal enucleation on liquid gastric emptying in rats

The effects of adrenalectomy and adrenal enucleation on liquid gastric emptying were studied in male Wistar rats that were adrenalectomized, adrenal enucleated (AE) or sham operated (SH). The animals in the first group had free access to a 1% NaCl solution (ADS), while the animals in the second and third groups were divided into two subgroups, which ingested either tap water (AEW, SHW) or 1% NaCl solution (AES, SHS). The gastric emptying study was performed on the 16th post-operative day. Three test meals labeled with phenol red (6 mg/dl) were used (0.9% NaCl, 1.8% NaCl and 5% glucose). Percent gastric retention was determined 10 min after orogastric infusion of the NaCl test meals and 15 min after the glucose meal. Gastric retention of the ADS subgroup was significantly lower (P<0.01) (median = 19.8% vs 25.5% for SHW, vs 31.9% for SHS, vs 25.7% for AEW, and vs 27.1% for AES) for the 0.9% NaCl test meal and for the 1.8% NaCl test meal (33.5% for ADS vs 47.5% for AEW and 50.6% for AES). When 5% glucose was used as a test meal, gastric retention was similar for all subgroups. These results suggest that ablation of the adrenal cortex results in increased gastric emptying of an isosmolar NaCl meal.

Aircraft tracking and classification with vhf passive bistatic radar

Since the times preceding the Second World War the subject of aircraft tracking has been a core interest to both military and non-military aviation. During subsequent years both technology and configuration of the radars allowed the users to deploy it in numerous fields, such as over-the-horizon radar, ballistic missile early warning systems or forward scatter fences. The latter one was arranged in a bistatic configuration. The bistatic radar has continuously re-emerged over the last eighty years for its intriguing capabilities and challenging configuration and formulation. The bistatic radar arrangement is used as the basis of all the analyzes presented in this work. The aircraft tracking method of VHF Doppler-only information, developed in the first part of this study, is solely based on Doppler frequency readings in relation to time instances of their appearance. The corresponding inverse problem is solved by utilising a multistatic radar scenario with two receivers and one transmitter and using their frequency readings as a base for aircraft trajectory estimation. The quality of the resulting trajectory is then compared with ground-truth information based on ADS-B data. The second part of the study deals with the developement of a method for instantaneous Doppler curve extraction from within a VHF time-frequency representation of the transmitted signal, with a three receivers and one transmitter configuration, based on a priori knowledge of the probability density function of the first order derivative of the Doppler shift, and on a system of blocks for identifying, classifying and predicting the Doppler signal. The extraction capabilities of this set-up are tested with a recorded TV signal and simulated synthetic spectrograms. Further analyzes are devoted to more comprehensive testing of the capabilities of the extraction method. Besides testing the method, the classification of aircraft is performed on the extracted Bistatic Radar Cross Section profiles and the correlation between them for different types of aircraft. In order to properly estimate the profiles, the ADS-B aircraft location information is adjusted based on extracted Doppler frequency and then used for Bistatic Radar Cross Section estimation. The classification is based on seven types of aircraft grouped by their size into three classes.

How a quarter pounder becomes a quarter pounder

Print ads featuring the "story" of the Quarter Pounder. The ad highlights the many features of a Quarter Pounder, including the beginning, the middle and the end.