Is professional recognition in plastic surgery related to activity in research

OBJECTIVE: To evaluate the relation of medical research, with the participation of prominent plastic surgeon in Congress.METHODS: We reviewed the scientific programs of the last 3 Brazilian Congress of Surgery, were selected 21 Brazilian plástic surgeons invited to serve as panelists or speakers in roundtable sessions in the last 3 congresses (Group 1). We randomly selected and paired by other members (associates) of the Brazilian Society of Plastic Surgery, with no participation in congress as speaker (Group 2). We conducted a search for articles published in journals indexed in Medline, Lilacs and SciELO for all doctors selected during the entire academic career and the last 5 years from March 2007 until March 2012. We assessed the research activity through the simple counting of the number of publications in indexed journals for each professional. The number of publications groups was compared.RESULTS: articles produced throughout career: Group 1- 639 articles (average of 30.42 items each). Group 2- 79 articles (mean 3.95 articles each). Difference between medias: p <0.001.CONCLUSION: The results demonstrate that the Brazilian Society of Plastic Surgery seeking professionals with a greater number of publications and journals of higher impact. This approach encourages new members to pursue a higher qualification, and give security to congressmen, they can rely on the existence of a technical criterion in the choice of speakers.

Plastic surgery in chest wall reconstruction: relevant aspects - case series

Objective: to discuss the participation of Plastic Surgery in the reconstruction of the chest wall, highlighting relevant aspects of interdisciplinaryness. Methods: we analyzed charts from 20 patients who underwent extensive resection of the thoracic integument, between 2000 and 2014, recording the indication of resection, the extent and depth of the raw areas, types of reconstructions performed and complications. Results: among the 20 patients, averaging 55 years old, five were males and 15 females. They resections were: one squamous cell carcinoma, two basal cell carcinomas, five chondrosarcomas and 12 breast tumors. The extent of the bloody areas ranged from 4x9 cm to 25x40 cm. In 12 patients the resection included the muscular plane. In the remaining eight, the tumor removal achieved a total wall thickness. For reconstruction we used: one muscular flap associated with skin grafting, nine flaps and ten regional fasciocutaneous flaps. Two patients undergoing reconstruction with fasciocutaneous flaps had partially suffering of the flap, solved with employment of a myocutaneous flap. The other patients displayed no complications with the techniques used, requiring only one surgery. Conclusion: the proper assessment of local tissues and flaps available for reconstruction, in addition to the successful integration of Plastic Surgery with the specialties involved in the treatment, enable extensive resections of the chest wall and reconstructions that provide patient recovery.

Porcine follicular fluid concentration of free insulin-like growth factor-I collected from different diameter ovarian follicles

The study aimed to quantify the concentrations of free IGF-I in serum and fluid of ovarian follicles in pre-pubertal gilts and describe the ovarian morphology by measuring the size of the ovaries and counting the number of surface follicles. Ovaries (n=1,000) from pre-pubertal gilts were obtained immediately after slaughter. A total of 10 samplings were performed, with ovaries obtained from 50 females for each collection. The follicles situated on the surface of each ovary were classified as small (SFs, 2 to 5mm in diameter) or large (LFs 6 to 10mm in diameter) and the follicular fluid was obtained by follicle aspiration. The collection of serum samples was performed after the gilts exsanguination using sterile tubes. From the pool of serum and follicular fluid obtained from 50 females, the concentration of free IGF-I was determined in each sample using an enzyme immunoassay kit (ELISA). The description of ovarian morphometry was performed in 100 ovaries from randomly selected gilts. The larger and smaller lengths of ovaries were measured, and the total number of SFs and LFs present on the surface of each ovary were also counted. The IGF-I concentration was greater (P<0.05) in LFs (170.92±88.29 ng/mL) compared with SFs (67.39±49.90ng/mL) and serum (73.48±34.63ng/mL). The largest and smallest length of the ovaries was 26.0±3.0 and 19.0mm ±2.0mm, respectively. The number of SFs (70.86±25.76) was greater (P<0.01) than LFs (6.54±5.26). The study concluded that LFs present greater levels of IGF-I when compared with SFs and blood, which is related to increased activity of the LFs and its differentiation to ovulation. In addition, ovaries of pre-pubertal gilts have a higher number of SFs compared to LFs. Therefore, our study demonstrated unique data regarding the physiological concentration of free IGF-I in ovarian follicles, that can be used in future research to evaluate the addition of this hormone in the in vitro production media of porcine embryos with the goal to improve the technique efficiency.

Laser-TIG–hybridihitsauksen soveltuvuustutkimus

Tässä tutkimuksessa selvitetään ilman hitsauslisäainetta tapahtuvan laser–TIG–hybridihitsausprosessin soveltuvuus 6 mm ja 8 mm paksujen päittäisliitettyjen S355 K2 ja Laser 355 MC rakenneterästen hitsaukseen. Hitsien tarkastelussa huomio kiinnitetään hitsausnopeuteen, hitsien tunkeumaan, liittämistehokkuuteen, hitsien kovuuteen ja hitsausliitoksen ulkonäköön. Muita tutkittavia asioita ovat laser-TIG-hybridihitsattujen levyjen muodonmuutokset ja suuresta hitsausnopeudesta sekä pienestä t8/5 jäähtymisajasta johtuvat mahdolliset kylmähalkeamat. Laser-TIG-hybridihitsejä verrataan robotti-MAG- ja käsin MAG-hitseihin sekä kaarihitsausstandardin SFS-EN ISO 5817 hitsiluokkien mukaisiin raja-arvoihin. Laser-TIG-hybridihitsausprosessissa TIG-valokaari mahdollistaa tasaisen ja lähes roiskeettoman hitsin ja lasersäde aikaansaa syvän tunkeuman sekä tasalaatuisen juurihitsin. Laser-TIG-hybridihitsausprosessilla 6 mm paksut S355 K2 rakenneteräslevyt on mahdollista hitsata levyn yhdeltä puolelta kerralla valmiiksi. Paksummat 8 mm levyt voidaan hitsata levyn yhdeltä tai molemmilta puolilta suoritettavalla laser-TIG-hybridihitsauksella. Laser-TIG-hybridihitsausprosessilla hitsatut hitsit ovat hyvin siistejä ja lähes roiskeettomia. Verrattaessa laser-TIG-hybridihitsausprosessia muihin hitsausprosesseihin sen voidaan todeta olevan erittäin kilpailukykyinen 6 mm paksujen päittäisliitettyjen rakenneterästen hitsaamisessa, mutta se soveltuu myös 8 mm paksujen rakenneterästen hitsaamiseen. Tutkitut hitsit täyttävät kaarihitsausstandardin SFS-EN ISO 5817 B- ja D-hitsiluokkien mukaiset raja-arvot. Vertailukokeet 6 mm paksulla S355 rakenneteräksellä osoittavat, että yhdeltä puolelta suoritettavan laser-TIG-hybridihitsauksen hitsausnopeus on robotti-MAG-hitsaukseen verrattuna yli nelinkertainen ja MAG-käsinhitsaukseen verrattuna yli viisinkertainen. Laser-TIG-hybridihitsauksessa liittämistehokkuus on noin viisinkertainen robotti-MAGhitsaukseen verrattuna. Molemmilta puolilta suoritettavalla laser-TIG-hybridihitsauksella voidaan 8 mm paksulla S355 rakenneteräksellä saavuttaa noin kolminkertainen hitsausnopeus ja liittämistehokkuus robotti-MAG-hitsaukseen verrattuna. Laser-TIG-hybridihitsauksessa TIG-kaaren tuoman lisälämmön ansiosta suurillakin hitsausnopeuksilla (1 m/min) voidaan saavuttaa edulliset kovuusarvot. Kovuusmittausten tulosten perusteella 6 mm ja 8 mm paksujen S355 K2 ja Laser 355 MC rakenneterästen hitsit eivät ylittäneet kaarihitsausstandardin määrittelemää 350 HV kovuuden enimmäisrajaa. Laser-TIG-hybridihitsauksen edullisesta lämmöntuonnista johtuen levyjen pituus- ja poikittaissuuntaiset muodonmuutokset ovat noin 80 prosenttia pienemmät kuin käsin suoritettavassa MAG-hitsauksessa. Laser-TIG-hybridihitsausprosessilla käytetään I-railoa, mutta robotti-MAG- ja käsin MAG-hitsausprosesseilla joudutaan käyttämään V-railoa, jolloin lämmöntuonti ja siitä johtuvat muodonmuutokset ovat suuremmat. Korkea liittämistehokkuus ja edullinen lämmöntuonti merkitsevät vähäisempiä muodonmuutoksia ja siten merkittäviä säästöjä työ-, materiaali- ja energiakustannuksissa. 8 mm ja sitä paksummilla S355 rakenneteräksillä levyn yhdeltä puolelta suoritettava päittäisliitoksen hitsaaminen on laser-TIG hybridihitsauksella haastavaa, koska yli 200 A:n TIG-kaarivirralla suuri metallisula aiheuttaa avaimenreiän sulkeutumisen ja avaimenreiän alaosaan muodostuu kaasukuplia. Tästä voidaan tehdä sellainen johtopäätös, että päittäisliitettävien levyjen ilmarakoa pitäisi kasvattaa niin suureksi, että avaimenreiän sulavirtaus ei pääse estymään. Yli 0,25 mm:n ilmarako edellyttää lasersäteen vaaputusta tai säteen halkaisijan kasvattamista. Ilmaraon kasvattaminen edellyttää myös lisäaineen käyttöä. Tutkimustulosten perusteella laser-TIG-hybridihitsausprosessilla voidaan saavuttaa merkittäviä etuja ja kustannussäästöjä, joten sen hyödyntämistä kannattaa harkita 8 mm ja sitä ohuempien päittäisliitettävien tuotteiden konepaja- ja tehdastuotannossa. Laser-TIGhybridihitsausprosessi soveltuu esimerkiksi seuraavien tuotteiden hitsaamiseen: päittäisliitettävät levyt, palkit, koneenosat, putket, säiliöt ja erilaiset pyörähdyskappaleet.

Chaos and Unpredictability in the Vibration of an Elasto-Plastic Beam

This contribution discusses the nonlinear dynamics of a pin-ended elasto-plastic beam with both kinematic and isotropic hardening. An iterative numerical procedure based on the operator split technique is developed in order to deal with the nonlinearities in the equations of motion. Free and forced responses for harmonic sinusoidal and square wave excitations are investigated. Numerical simulations present many interesting behaviors such as jump phenomena, sensitivity to initial conditions, chaos and transient chaos. These results indicate that there are practical problems in predicting the response of the beam even when periodic steady state response is expected.

Two-Phase (Solid-Liquid) Flow in Inclined Pipes

This paper presents an experimental research about the behavior of two-phase flows in inclined pipes. The inclination angle varied from 5° to 45° and the slurry solid concentration varied up to 15%. It was concluded that the head losses of the downward sloping pipe flow are always lower than the head losses of the horizontal flow and these are always lower than the head losses of the upward sloping pipe flow, regardless the concentration and inclination angle. It was possible to develop empirical equations to calculate the head losses of the horizontal flow and the upward and downward sloping pipe flows.

Leaching of Picloram in ultisol under different rainfall volumes

The present study aimed to evaluate the leaching potential of Picloram in Ultisol columns under different rainfall amounts. For such, 30 treatments were evaluated (one soil associated with three levels of rainfall and ten depths).The experiments were arranged in a split-plot design, in a completely randomized design, with four replications. PVC columns of 10 cm in diameter and 50 cm in length were filled with these soils, moistened, and placed upright for 48 hours to drain the excess water. The herbicide was applied and rainfall simulations were carried out at specified intensities, according to the treatments, to force Picloram leaching. After 72 hours, all the columns were arranged in a horizontal position and opened lengthwise. Then, soil sampling was carried out every 5 cm of depth for subsequent herbicide extraction and quantification and analysis by high performance liquid chromatography. The remaining soil samples were placed in plastic pots, and, at the respective depths, the indicator species Cucumis sativus was sown. Twenty-one days after the emergence (DAE) of the indicator plants, evaluations were conducted to verify the symptoms of toxicity caused by Picloram in the plants. It was concluded that Picloram leaching is directly dependent on the volume of rain applied. The herbicide reached the deepest regions in the soil with the highest intensity of rain. The results obtained by bioassay were in agreement with those found by liquid chromatography.

Diameter and height distributions in a gallery forest tree community and some of its main species in central Brazil over a six-year period (1985-1991)

(Diameter and height distributions in a gallery forest tree community and some of its main species in central Brazil over a six-year period (1985-1991)). The diameter and height structure were studied over six years in approximately 64 ha of the Gama gallery forest in Brasília, DF. Trees from 10 cm dbh were measured every three years from 1985 in 151 (10 x 20 m) permanent plots. Natural regeneration (individuals under 10 cm dbh) was measured in subplots within the 200 m² plots. Most individuals and species were under 45 cm diameter and 20 m high while the maximum diameter for individual species ranged from 30 to 95 cm. The diameter structure was typical of a mixed tropical forest with the number of individuals decreasing with increasing size classes and showing little change over the six years. The most abundant species occupy different positions in the canopy and have different size structures.

The requirements of a feasible plastic packaging material for cultured dairy products

The objective of this Master´s Thesis was to conduct a wide scale preliminary survey regarding the package requirements of a cultured dairy package, and to compare the currently used material polystyrene to other suitable packaging materials. Polystyrene has a long history of use in dairy cups, but in recent years its price has increased significantly compared to other common packaging materials. The overall environmental effects of a package and a package material are today a part of designing a sustainable product life cycle. In addition, in certain contexts there has been discussion of the risks posed by styrene polymer for the environment and for humans. These risks are also discussed in this thesis. Polystyrene (PS) is still the most widely used material in dairy cups. In recent years, polypropylene (PP) cups have appeared in increasing numbers on market shelves. This study focuses on the differences of the suitable polymers and examines the suitability of alternative “suitable” polymers with regards to dairy packaging. Aside from focusing on the cup manufacturer, this thesis also examines its subject matter from the viewpoint of the dairy customer, as well as observing the concrete implications of material changes in the overall value chain. It was known in advance that material permeability would be one of the determining factors and that gas transmission testing would be a significant part of the thesis. Mechanical tests were the second part of the testing process, providing information regarding package strength and protectiveness during the package’s life cycle. Production efficiency, along with uninterrupted stable production, was another important factor that was taken into consideration. These two issues are sometimes neglected in similar contexts due to their self-evident nature. In addition, materials used in production may have a surprising significance to the production and efficiency. Consistent high quality is also partly based on material selection. All of the aforementioned factors have been documented and the results have been analyzed by the development team at Coveris Rigid Finland. Coveris is now calculating the total finance effects and capacities should the material changes be implemented in practice. There are many factors in favor of switching to polypropylene at the moment. The overall production costs, as well as the environmental effects of resin production are the primary influences for said switch from the converters’ perspective.

Improving the usability of extruded wood-plastic composites by using modification technology

Using cellulosic reinforcement to produce plastic composites is a globally growing trend. One of such materials are wood-plastic composites, which are an extensively studied group of materials for which the global industry is looking for new applications. Issues such as bondability, durability and fire resistance still require development to improve the usability of the wood-plastic composite material. Improvement of the usability of wood-plastic composites is studied in this thesis through the effects of using selected modification technology in wood and plastic industry. The applied modification methods are surface by mechanical abrasion and plasma, chemical impregnation of wood flour, and structural modification by the co-extrusion process. The study shows that the properties of WPC can be influenced by the selected modification methods. The selected methods are also found to be able to result as improvement in the properties of the material. The may also affect other than just the targeted properties of the end-product, either in a positive or a negative manner. Therefore modification as performance improvement should be considered as a caseby- case study. Introducing WPC materials for new applications can be done by using modification technology. Structuralmodification can possibly be used to reduce material costs of the modified WPC material.

Bariatric and Post-Bariatric Surgery: from Metabolic Surgery to Plastic Surgery Indications

Background: Controversy exists concerning indications and outcomes of major bariatric surgery procedures. Massive weight loss after bariatric surgery leads to excess skin with functional and aesthetic impairments. The aim of this study was to investigate the major bariatric surgery procedures and their outcomes in two specific subgroups of morbidly obese patients, ≥55-year-olds and the superobese. Further aims were to evaluate whether the preoperative weight loss correlates with laparoscopic gastric bypass complications. The prevalence and impact of excess skin and the desire for body contouring after bariatric surgery were also studied. Patients and Methods: Data from patients who underwent Laparoscopic Adjustable Gastric Banding (LAGB) and Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) at Vaasa Central Hospital were collected and postoperative outcomes were evaluated according to the BMI, age and preoperative weight loss. Patients who had undergone bariatric surgery procedures were asked to complete a questionnaire to estimate any impairment due to redundant skin and to analyse each patient’s desire for body contouring by area. Results: No significant difference was found in operative time, hospital stay, or overall early postoperative morbidity between LAGB and LRYGB. Mean excess weight loss percents (EWL%) at 6 and 12 months after LRYGB were significantly higher. A significant difference was found in operative time favouring patients <55 years. Intraoperative complications were significantly more frequent in the group aged >55 years. No significant difference was detected in overall postoperative morbidity rates. A significant difference was found in operative time and hospital stay favouring all patients who lost weight preoperatively. Most patients reported problems with redundant skin, especially on the abdomen, upper arms and rear/buttocks, which impaired daily physical activity in half of them. Excess skin was significantly associated with female gender, weight loss and ΔBMI. Patients with a WL >20 kg, ΔBMI ≥10 kg/m2 and an EWL % > 50 showed a significantly surplus skin discomfort (p < 0.001). Most patients desired body contouring surgery, with high or very high desire for waist/abdomen (62.2%), upper arm (37.6%), chest/breast (28.3%), and rear/buttock (35.6%) contouring. Conclusions: LRYGB is effective and safe in superobese (BMI >50) and elderly (>55 years) patients. A preoperative weight loss >5% is recommended to improve the outcomes and reduce complications. A WL >20 kg, ΔBMI ≥10 kg/m2 and an EWL % > 50 are associated with a higher functional discomfort due to redundant skin and to a stronger desire for body contouring plastic surgery.

Hygro-elasto-plastic behavior of planar orthotropic material

The mechanical and hygroscopic properties of paper and board are factors affecting the whole lifecycle of a product, including paper/board quality, production, converting, and material and energy savings. The progress of shrinkage profiles, loose edges of web, baggy web causing wrinkling and misregistration in printing are examples of factors affecting runnability and end product quality in the drying section and converting processes, where paper or board is treated as a moving web. The structural properties and internal stresses or plastic strain differences built up during production also cause the end-product defects related to distortion of the shape of the product such as sheet or box. The objective of this work was to construct a model capable of capturing the characteristic behavior of hygroscopic orthotropic material under moisture change, during different external in-plane stretch or stress conditions. Two independent experimental models were constructed: the elasto-plastic material model and the hygroexpansivity-shrinkage model. Both describe the structural properties of the sheet with a fiber orientation probability distribution, and both are functions of the dry solids content and fiber orientation anisotropy index. The anisotropy index, introduced in this work, simplifies the procedure of determining the constitutive parameters of the material model and the hygroexpansion coefficients in different in-plane directions of the orthotropic sheet. The mathematically consistent elasto-plastic material model and the dry solids content dependent hygroexpansivity have been constructed over the entire range from wet to dry. The presented elastoplastic and hygroexpansivity-shrinkage models can be used in an analytical approach to estimate the plastic strain and shrinkage in simple one-dimensional cases. For studies of the combined and more complicated effects of hygro-elasto-plastic behavior, both models were implemented in a finite element program for a numerical solution. The finite element approach also offered possibilities for studying different structural variations of orthotropic planar material, as well as local buckling behavior and internal stress situations of the sheet or web generated by local strain differences. A comparison of the simulation examples presented in this work to results published earlier confirms that the hygro-elasto-plastic model provides at least qualitatively reasonable estimates. The application potential of the hygro-elasto-plastic model is versatile, including several phenomena and defects appearing in the drying, converting and end-use conditions of the paper or board webs and products, or in other corresponding complex planar materials.

Improving the fire retardancy of extruded/coextruded wood-plastic composites

The main objective of this thesis is to study the impact of different mineral fillers and fire retardants on the reaction-to-fire properties of extruded/coextruded wood-plastic composites (WPCs). The impact of additives on the flammability properties of WPCs is studied by cone calorimetry. The studied properties are ignition time, peak heat release rate, total heat release, total smoke production, and mass loss rate. The effects of mineral fillers and fire retardants were found to vary with the type of additive, the type of additive combinations, the amount of additives, as well as the production method of the WPCs. The study shows that talc can be used to improve the properties of extruded WPCs. Especially ignition time, peak heat release rate and mass loss rate were found to be improved significantly by talc. The most significant improvement in the fire retardancy of coextruded WPCs was achieved in combinations of natural graphite and melamine. Ignition time, peak heat release rate and total smoke production were improved essentially. High increase in smoke production was found in samples where the amount of ammonium polyphosphate was 10% or higher. Coextrusion as a structural modification was found as a promising way to improve the flammability properties of composite materials in a cost-effective way.

Diurnal variation of vascular diameter and reactivity in healthy young men

The higher incidence of cardiovascular events in the morning is accompanied by an increased vascular tone. However, there are few published studies designed to evaluate the diurnal variation of vascular and endothelial parameters in healthy subjects. In the present investigation, we evaluated the diurnal variation in brachial artery diameter (BAD), flow-mediated dilation (FMD) and endothelium-independent dilation (NFMD) in a homogeneous sample of healthy non-smoker young men. Fifty subjects aged 20.8 ± 0.3 years (range: 18 to 25 years) were investigated by brachial artery ultrasound. Exclusion criteria were female gender and evidence of clinically significant health problems, including obesity. Volunteers were asked to rest and avoid fat meals as well as alcoholic beverages 48 h before and until completion of the evaluations. BAD, FMD and NFMD were measured at 7 am, 5 pm, and 10 pm and tested by repeated measures ANOVA. BAD was smaller at 7 am (mean ± SEM, 3.8 ± 0.1 mm) in comparison with 5 pm (3.9 ± 0.1) and 10 pm (4.0 ± 0.1 mm; P < 0.001). FMD values did not change significantly during the day, while NFMD increased more at 7 am (18.5 ± 1.1%), when compared to 15.5 ± 0.9% at 10 pm and 15.5 ± 0.9% at 5 pm (P = 0.04). The physiological state of vasoconstriction after awakening, with preserved capability to dilate in the morning, should be considered to be part of the healthy cardiovascular adaptation before considering later life risk factors and endothelial dysfunction.