Novel prototype sewing device, EndoSew ® , for minimally invasive surgery: an extracorporeal ileal conduit construction pilot study in 10 patients

What's known on the subject? and What does the study add? The EndoSew® prototype was first tested in a porcine model several years ago. The investigators found it both simple to master and reliable, its greatest advantage being a 2.4-fold time saving compared with straight laparoscopic suturing. In addition to that publication, there is a single case report describing the performance of an open EndoSew® suture to close parts (16 cm) of an ileal neobladder. The time for suturing the 16 cm ileum was 25 min, which is in line with our experience. The knowledge on this subject is limited to these two publications. We report on the first consecutive series of ileal conduits performed in humans using the novel prototype sewing device EndoSew®. The study shows that the beginning and the end of the suture process represent the critical procedural steps. It also shows that, overall, the prototype sewing machine has the potential to facilitate the intracorporeal suturing required in reconstructive urology for construction of urinary diversions. Objective To evaluate the feasibility and safety of the novel prototype sewing device EndoSew® in placing an extracorporeal resorbable running suture for ileal conduits. Patients and Methods We conducted a prospective single-centre pilot study of 10 consecutive patients undergoing ileal conduit, in whom the proximal end of the ileal conduit was closed extracorporeally using an EndoSew® running suture. The primary endpoint was the safety of the device and the feasibility of the sewing procedure which was defined as a complete watertight running suture line accomplished by EndoSew® only. Watertightness was assessed using methylene blue intraoperatively and by loopography on postoperative days 7 and 14. Secondary endpoints were the time requirements and complications ≤30 days after surgery. Results A complete EndoSew® running suture was feasible in nine patients; the suture had to be abandoned in one patient because of mechanical failure. In three patients, two additional single freehand stitches were needed to anchor the thread and to seal tiny leaks. Consequently, all suture lines in 6/10 patients were watertight with EndoSew® suturing alone and in 10/10 patients after additional freehand stitches. The median (range) sewing time was 5.5 (3–10) min and the median (range) suture length was 4.5 (2–5.5) cm. There were no suture-related complications. Conclusions The EndoSew® procedure is both feasible and safe. After additional freehand stitches in four patients all sutures were watertight. With further technical refinements, EndoSew® has the potential to facilitate the intracorporeal construction of urinary diversions.

Investigation of the Network Construction Behaviour on Social Networking Sites

By enabling connections between individuals, Social Networking Sites, such as Facebook, promise to create significant individual as well as social value. Encouraging connections between users is also crucial for service providers who increasingly rely on social advertising and viral marketing campaigns as important sources of their revenue. Consequently, understanding user’s network construction behavior becomes critical. However, previous studies offer only few scattered insights into this research question. In order to fill this gap, we employ Grounded Theory methodology to derive a comprehensive model of network construction behavior on social networking sites. In the following step we assess two Structural Equation Models to gain refined insights into the motivation to send and accept friendship requests – two network expansion strategies. Based on our findings, we offer recommendations for social network providers.

EFFECTS OF INFORMATION DISPLAY ON THE CONSTRUCTION OF CLINICIAN MENTAL MODELS

Objective: To determine how a clinician’s background knowledge, their tasks, and displays of information interact to affect the clinician’s mental model. Design: Repeated Measure Nested Experimental Design Population, Sample, Setting: Populations were gastrointestinal/internal medicine physicians and nurses within the greater Houston area. A purposeful sample of 24 physicians and 24 nurses were studied in 2003. Methods: Subjects were randomized to two different displays of two different mock medical records; one that contained highlighted patient information and one that contained non-highlighted patient information. They were asked to read and summarize their understanding of the patients aloud. Propositional analysis was used to understand their comprehension of the patients. Findings: Different mental models were found between physicians and nurses given the same display of information. The information they shared was very minor compared to the variance in their mental models. There was additionally more variance within the nursing mental models than the physician mental models given different displays of the same information. Statistically, there was no interaction effect between the display of information and clinician type. Only clinician type could account for the differences in the clinician comprehension and thus their mental models of the cases. Conclusion: The factors that may explain the variance within and between the clinician models are clinician type, and only in the nursing group, the use of highlighting.

Developmental self-construction and -configuration of functional neocortical neuronal networks.

The prenatal development of neural circuits must provide sufficient configuration to support at least a set of core postnatal behaviors. Although knowledge of various genetic and cellular aspects of development is accumulating rapidly, there is less systematic understanding of how these various processes play together in order to construct such functional networks. Here we make some steps toward such understanding by demonstrating through detailed simulations how a competitive co-operative ('winner-take-all', WTA) network architecture can arise by development from a single precursor cell. This precursor is granted a simplified gene regulatory network that directs cell mitosis, differentiation, migration, neurite outgrowth and synaptogenesis. Once initial axonal connection patterns are established, their synaptic weights undergo homeostatic unsupervised learning that is shaped by wave-like input patterns. We demonstrate how this autonomous genetically directed developmental sequence can give rise to self-calibrated WTA networks, and compare our simulation results with biological data.

A new model construction by making a detour via intuitionistic theories I: Operational set theory without choice is Π1-equivalent to KP

We introduce a version of operational set theory, OST−, without a choice operation, which has a machinery for Δ0Δ0 separation based on truth functions and the separation operator, and a new kind of applicative set theory, so-called weak explicit set theory WEST, based on Gödel operations. We show that both the theories and Kripke–Platek set theory KPKP with infinity are pairwise Π1Π1 equivalent. We also show analogous assertions for subtheories with ∈-induction restricted in various ways and for supertheories extended by powerset, beta, limit and Mahlo operations. Whereas the upper bound is given by a refinement of inductive definition in KPKP, the lower bound is by a combination, in a specific way, of realisability, (intuitionistic) forcing and negative interpretations. Thus, despite interpretability between classical theories, we make “a detour via intuitionistic theories”. The combined interpretation, seen as a model construction in the sense of Visser's miniature model theory, is a new way of construction for classical theories and could be said the third kind of model construction ever used which is non-trivial on the logical connective level, after generic extension à la Cohen and Krivine's classical realisability model.

A new model construction by making a detour via intuitionistic theories II: Interpretability lower bound of Feferman's explicit mathematics T0

We partially solve a long-standing problem in the proof theory of explicit mathematics or the proof theory in general. Namely, we give a lower bound of Feferman’s system T0 of explicit mathematics (but only when formulated on classical logic) with a concrete interpretat ion of the subsystem Σ12-AC+ (BI) of second order arithmetic inside T0. Whereas a lower bound proof in the sense of proof-theoretic reducibility or of ordinalanalysis was already given in 80s, the lower bound in the sense of interpretability we give here is new. We apply the new interpretation method developed by the author and Zumbrunnen (2015), which can be seen as the third kind of model construction method for classical theories, after Cohen’s forcing and Krivine’s classical realizability. It gives us an interpretation between classical theories, by composing interpretations between intuitionistic theories.

Enhancing Food Sovereignty and Food Security through the Revitalization of Indigenous Knowledge: Experiences from the Bolivian Andes

Endogenous development is defined as development that values primarily locally available resources and the way people organized themselves for that purpose. It is a dynamic and evolving concept that also embraces innovations and complementation from other than endogenous sources of knowledge; however, only as far as they are based on mutual respect and the recognition of cultural and socioeconomic self-determination of each of the parties involved. Experiences that have been systematized in the context of the BioAndes Program are demonstrating that enhancing food security and food sovereignty on the basis of endogenous development can be best achieved by applying a ‘biocultural’ perspective: This means to promote and support actions that are simultaneously valuing biological (fauna, flora, soils, or agrobiodiversity) and sociocultural resources (forms of social organization, local knowledge and skills, norms, and the related worldviews). In Bolivia, that is one of the Latin-American countries with the highest levels of poverty (79% of the rural population) and undernourishment (22% of the total population), the Program BioAndes promotes food sovereignty and food security by revitalizing the knowledge of Andean indigenous people and strengthening their livelihood strategies. This starts by recognizing that Andean people have developed complex strategies to constantly adapt to highly diverse and changing socioenvironmental conditions. These strategies are characterized by organizing the communities, land use and livelihoods along a vertical gradient of the available eco-climatic zones; the resulting agricultural systems are evolving around the own sociocultural values of reciprocity and mutual cooperation, giving thus access to an extensive variety of food, fiber and energy sources. As the influences of markets, competition or individualization are increasingly affecting the life in the communities, people became aware of the need to find a new balance between endogenous and exogenous forms of knowledge. In this context, BioAndes starts by recognizing the wealth and potentials of local practices and aims to integrate its actions into the ongoing endogenous processes of innovation and adaptation. In order to avoid external impositions and biases, the program intervenes on the basis of a dialogue between exogenous, mainly scientific, and indigenous forms of knowledge. The paper presents an analysis of the strengths and weaknesses of enhancing endogenous development through a dialogue between scientific and indigenous knowledge by specifically focusing on its effects on food sovereignty and food security in three ‘biocultural’ rural areas of the Bolivian highlands. The paper shows how the dialogue between different forms of knowledge evolved alongside the following project activities: 1) recuperation and renovation of local seeds and crop varieties (potato – Solanum spp., quinoa – Chenopodium quinoa, cañahua – Chenopodium pallidicaule); 2) support for the elaboration of community-based norms and regulations for governing access and distribution of non-timber forest products, such as medicinal, fodder, and construction plants; 3) revitalization of ethnoveterinary knowledge for sheep and llama breeding; 4) improvement of local knowledge about the transformation of food products (sheep-cheese, lacayote – Cucurbita sp. - jam, dried llama meat, fours of cañahua and other Andean crops). The implementation of these activities fostered the community-based livelihoods of indigenous people by complementing them with carefully and jointly designed innovations based on internal and external sources of knowledge and resources. Through this process, the epistemological and ontological basis that underlies local practices was made visible. On this basis, local and external actors started to jointly define a renewed concept of food security and food sovereignty that, while oriented in the notions of well being according to a collectively re-crafted world view, was incorporating external contributions as well. Enabling and hindering factors, actors and conditions of these processes are discussed in the paper.

The construction of aging and health in older African American women

Persistence of racial and ethnic health disparities and governmental policies based on outdated ideas of aging call for inclusive approaches to the study of elder African Americans. The lived experiences of aging among urban, poor African American women, who comprise a vulnerable population, are not well known, as most studies focus on mainstream populations. Gerontological studies have tended to employ methods that collapse contextual information for ease of analysis, thus failing to capture nuanced information critically relevant to health of marginalized groups. Few researchers have been successful highlighting the importance of local knowledge, resilience, and resources for health by using participatory methods with older Black women. This study utilizes participatory principles to gather discursive data from nine older African American women, engaged in three generational cohorts: those born around World War II, women born after the great depression, and those born before the great depression. Videotaped and transcribed conversations of cohorts were analyzed in search of contextual factors that influence their experience of aging and health. As women responded to general themes that provoked their talk about their lives, they helped answer the study's questions: How do older African American women make sense of their aging experience? What are some of the important social and cultural influences that shape the construction of aging and health by these women? Are generational discourse groups an effective tool for exploring changes in the experiences of aging? A key finding demonstrated rich heterogeneity of experiences with strong generational influences on the construction of aging and health. The participants' moral orders comprised of traditional values of family, reinforced by personal experiences and the church, have guided their lives through oppression and stress but appear to be failing younger women who have greater exposure to new environmental pressures. Limited time and the size of the study were weaknesses although the women's interest in the study and their participation were gratifying. The participants served to highlight the importance of recognizing generational and other contextual factors in formation of ideas of aging and likelihood of additional challenges to the experience of old age among older, poorer, African Americans. ^

The development of professor's professional knowledge in Psychology

This work belongs to the Project "Teaching and learning Psychology: a study of the educational practice in professors and beginners". It is part of an investigation program developed in the context of the subject "Didactic and Practical Planning of Psychology teaching" in which we have been working since 1998. This subject is also considered as the final stage of the formative itinerary for Psychology s professors. The reached results show the incidence that the beliefs and professors' representations have in the teaching processes. By getting into the studies centered in the educational knowledge we guide the inquiry around the development of the professor's professional knowledge and particularly the development of their formation. Our proposal contemplates a formation device which incorporates the observation, reflection, evaluation and self-evaluation of the practice in order to facilitate the reconstruction, significance and re-significance of the teaching and learning processes by giving relevance to the development of the teacher professional knowledge. The analysis of teaching practices process reveals that the mediations that cross the knowledge in the being taught instances are constituted in reflections axes. This involves the future professor's relationship with the knowledge and their projection in the construction of the professional identity.

The development of the psychologist's professional knowledge : A study of graduated in the U.N.L.P., their insert in the educational field

Los estudios sobre la formación de profesores en psicología nos fueron situando en el proceso de construcción del conocimiento profesional tanto en profesores como en psicólogos que ejercen la docencia, visualizando el papel que en él asumen los conocimientos construidos en los ámbitos académico y profesional y la relación entre ambos.

The development of professor's professional knowledge in Psychology

This work belongs to the Project "Teaching and learning Psychology: a study of the educational practice in professors and beginners". It is part of an investigation program developed in the context of the subject "Didactic and Practical Planning of Psychology teaching" in which we have been working since 1998. This subject is also considered as the final stage of the formative itinerary for Psychology s professors. The reached results show the incidence that the beliefs and professors' representations have in the teaching processes. By getting into the studies centered in the educational knowledge we guide the inquiry around the development of the professor's professional knowledge and particularly the development of their formation. Our proposal contemplates a formation device which incorporates the observation, reflection, evaluation and self-evaluation of the practice in order to facilitate the reconstruction, significance and re-significance of the teaching and learning processes by giving relevance to the development of the teacher professional knowledge. The analysis of teaching practices process reveals that the mediations that cross the knowledge in the being taught instances are constituted in reflections axes. This involves the future professor's relationship with the knowledge and their projection in the construction of the professional identity.

The development of the psychologist's professional knowledge : A study of graduated in the U.N.L.P., their insert in the educational field

Los estudios sobre la formación de profesores en psicología nos fueron situando en el proceso de construcción del conocimiento profesional tanto en profesores como en psicólogos que ejercen la docencia, visualizando el papel que en él asumen los conocimientos construidos en los ámbitos académico y profesional y la relación entre ambos.

The development of professor's professional knowledge in Psychology

This work belongs to the Project "Teaching and learning Psychology: a study of the educational practice in professors and beginners". It is part of an investigation program developed in the context of the subject "Didactic and Practical Planning of Psychology teaching" in which we have been working since 1998. This subject is also considered as the final stage of the formative itinerary for Psychology s professors. The reached results show the incidence that the beliefs and professors' representations have in the teaching processes. By getting into the studies centered in the educational knowledge we guide the inquiry around the development of the professor's professional knowledge and particularly the development of their formation. Our proposal contemplates a formation device which incorporates the observation, reflection, evaluation and self-evaluation of the practice in order to facilitate the reconstruction, significance and re-significance of the teaching and learning processes by giving relevance to the development of the teacher professional knowledge. The analysis of teaching practices process reveals that the mediations that cross the knowledge in the being taught instances are constituted in reflections axes. This involves the future professor's relationship with the knowledge and their projection in the construction of the professional identity.

The development of the psychologist's professional knowledge : A study of graduated in the U.N.L.P., their insert in the educational field

Los estudios sobre la formación de profesores en psicología nos fueron situando en el proceso de construcción del conocimiento profesional tanto en profesores como en psicólogos que ejercen la docencia, visualizando el papel que en él asumen los conocimientos construidos en los ámbitos académico y profesional y la relación entre ambos.

Professional Liability of the Construction Professional as an Expert Witness in the Spanish Legal Framework

Inside COBRA 2011 RICS International Research Conference, the present paper is linked to analyze the liability of the construction professional in his practice as a expert witness in the Spanish legal framework. In a large number of legal procedures related to the building it is necessary the intervention of the expert witness to report on the subject of litigation, and to give an opinion about possible causes and solutions. This field is increasingly importantly for the practice of construction professional that requires an important specialization. The expert provides his knowledge to the judge in the matter he is dealing with (construction, planning, assessment, legal, ...), providing arguments or reasons as the base for his case and acting as part of the evidence. Although the importance of expert intervention in the judicial process, the responsibilities arising from their activity is a slightly studied field. Therefore, the study has as purpose to think about the regulation of professional activities raising different aims. The first is to define the action of the construction professional-expert witness and the need for expert evidence, establishing the legal implications of this professional activity. The different types of responsibilities (the civil, criminal and administrative) have been established as well as the economic, penal or disciplinary damages that can be derived from the expert report