Laparoscopic versus open splenectomy in the management of hematologic diseases

Splenectomy is the best available treatment for severe forms of hereditary spherocytosis, idiopathic thrombocytopenic purpura, and other hematologic conditions when these prove refractory to conservative management. It has been employed for many decades with low mortality and favorable remission rates. The use of laparoscopic splenectomy in recent years has been rapidly and even enthusiastically adopted in this field. However, the exact role of laparoscopic versus open surgery for hematologic diseases is still debated. In this study of 58 adult patients, laparoscopic procedures were compared with conventional splenectomies for similar indications. METHODS: All patients were operated on within an 8-year period. Subjects underwent similar procedures under the supervision of the same surgical school and were compared regarding age, gender, body mass index, and diagnosis. Laparoscopically managed cases (Group I, n = 30) were prospectively followed according to a written protocol, whereas the same investigation was retrospectively done with regard to traditional laparotomy (Group II, n = 28). Methods included general and demographic findings, duration and technical steps of operation, blood loss, weight of spleen, need for conversion (in minimally invasive subjects), intraoperative and postoperative complications, time until realimentation, postoperative hospitalization, mortality, and late follow-up including recurrence rate. RESULTS: Idiopathic thrombocytopenic purpura was the surgical indication in over 50% of the patients in both groups, but familial spherocytosis, thalassemia, myelodysplasia, and lymphomas were also represented in this series. Laparoscopic procedures took more time to perform (P = 0.004), and postoperative hospitalization was 2 days shorter, but this difference was not statistically significant. Postoperative hematocrit and volume of blood transfusions was equivalent, although the laparoscopic cases had a somewhat lower preoperative hematocrit (NS) and displayed better recovery for this measurement (P = 0.03). More patients in Group I were able to accept oral food on the first day than subjects undergoing conventional operations (P < 0.05). Relatively few conversions were necessary during the minimally invasive surgeries (13.3%), and postoperative early and late complications as well as recurrences occurred in similar proportions. Also, the mean weight of the spleen was not statistically different between the groups, although there was a marked numerical tendency toward larger masses in conventional procedures. No spleen in Group I exceeded 2.0 kg, whereas in Group II values up to 4.0 kg occurred, and the mean weight was 50% higher in the latter group. CONCLUSIONS: 1) Minimally invasive splenectomy was essentially comparable to open surgery with regard to safety, efficacy, and late results; 2) Advantages concerning shorter postoperative hospitalization could not be shown, despite earlier food intake and a non-significant tendency toward earlier discharge; 3) This new modality should be considered an option in cases of hematologic conditions whenever the spleen is not hugely enlarged.

Bond of NSM FRP strengthened concrete: round robin test initiative

Despite the extensive research that has been conducted on the debonding behaviour of FRP strengthening systems, no standard methodology has been yet established on its experimental characterization. In this context, to assess the performance and reliability of small scale testing on NSM (near surface mounted) FRP strengthening systems, an experimental program was carried out on a series of nine NSM FRP strengthening systems, in the framework of an international Round Robin Testing (RRT). Eleven laboratories and seven manufacturers and suppliers participated in this extensive international exercise, which regarded both NSM and EBR FRP strengthening systems. Test results obtained for the NSM systems by the participating laboratories are discussed and compared in this paper to investigate the feasibility of the adopted single/double pulling shear test method, to investigate the mechanism of bond between NSM FRP reinforcement and concrete, and to investigate the level of variability obtained between the participating laboratories testing the same material batches. It is concluded that the tested variants in the adopted single/double shear pulling test have a significant influence, stressing the importance of the level of detail of standardized test protocols for bond verification. On overall, given the variants included in this study, the obtained variation in bond stress-slip behaviour between the laboratories remained fairly limited.

Plastic waste use as aggregate and binder modifier in open-graded asphalts

Road pavements are very important infrastructures for the Society, but they can cause serious environmental impacts during construction, operation and rehabilitation phases. Thus, it is essential to develop surface paving solutions that promote not only the durability but also a comfortable and safe use. In fact, this work aims to study the properties of new opengraded mixtures for surface layers produced with plastic wastes. First, HDPE and EVA wastes were used as bitumen modifiers, and then another plastic waste (PEX) replaced part of the aggregates. After studying the modified binders, the open-graded mixtures were designed, and then they were tested concerning their particle loss, rutting resistance, surface texture and damping effect. It was concluded that both ways of using the plastic wastes can improve the mechanical and functional properties of the open-graded mixtures related to the pavement performance.

State of the art and open questions on cathode preparation based on carbon coated lithium iron phosphate

One important component with particular relevance in battery performance is the cathode, being one of the main responsible elements for cell capacity and cycle life. Carbon coated lithium iron phosphate, C-LiFePO4, active material is one of the most promising cathode materials for the next generation of large scale lithium ion battery applications and strong research efforts are being devoted to it, due to its excellent characteristics, including high capacity, ~170 mAh/g, and safety. This review summarizes the main developments on C-LiFePO4 based cathode film preparation and performance. The effect of the binder, conductive additive, relationship between active material-binder-conductive additive and drying step, in the electrode film fabrication and performance is presented and discussed. Finally, after the presentation of the cell types fabricated with C-LiFePO4 active material and their performance, some conclusions and guidelines for further investigations are outlined.

User expectations for media sharing practices in open display networks

Open Display Networks have the potential to allow many content creators to publish their media to an open-ended set of screen displays. However, this raises the issue of how to match that content to the right displays. In this study, we aim to understand how the perceived utility of particular media sharing scenarios is affected by three independent variables, more specifically: (a) the locativeness of the content being shared; (b) how personal that content is and (c) the scope in which it is being shared. To assess these effects, we composed a set of 24 media sharing scenarios embedded with different treatments of our three independent variables. We then asked 100 participants to express their perception of the relevance of those scenarios. The results suggest a clear preference for scenarios where content is both local and directly related to the person that is publishing it. This is in stark contrast to the types of content that are commonly found in public displays, and confirms the opportunity that open displays networks may represent a new media for self-expression. This novel understanding may inform the design of new publication paradigms that will enable people to share media across the display networks.

Energy and carbon prices: a comparison of interactions in the European Union Emissions Trading Scheme and the Western Climate Initiative market

We provide a comparative analysis of how short-run variations in carbon and energy prices relate to each other in the emerging greenhouse gas market in California (Western Climate Initiative [WCI], and the European Union Emission Trading Scheme [EU ETS]). We characterize the relationship between carbon, gas, coal, electricity and gasoline prices and an indicator for economic activity, and present a first analysis of carbon prices in the WCI. We also provide a comparative analysis of the structures of the two markets. We estimate a vector autoregressive model and the impulse--response functions. Our main findings show a positive impact from a carbon shock toward electricity, in both markets, but larger in the WCI electricity price, indicating more efficiency. We propose that the widening of carbon market sectors, namely fuels transport and electricity imports, may contribute to this result. To conclude, the research shows significant and coherent relations between variables in WCI, which demonstrate some degree of success for a first year in operation. Reversely, the EU ETS should complete its intended market reform, to allow for more impact of the carbon price. Finally, in both markets, there is no evidence of carbon pricing depleting economic activity.

Repository power: how repositories can support Open Access mandates

Many funding agencies have Open Access mandates in place, but how often are scientific publications as outputs linked to funding details? The benefits of linking funding information to publications as part of the deposit workflow can assist in adhering to Open Access mandates. This paper examines how OpenAIRE – Open Access Infrastructure for Research in Europe – can ease monitoring Open Access and reporting processes for funders, and presents some results and opportunities. It also outlines how it relies on cleaned and curated repository content, a vital cog in the ever turning wheel of the global scholarly landscape, and the benefits it brings.

FOSTER: facilitate open science training for european research

FOSTER aims to support different stakeholders, especially young researchers, in adopting open access in the context of the European Research Area (ERA) and in complying with the open access policies and rules of participation set out for Horizon 2020 (H2020). FOSTER establish a European-wide training programme on open access and open data, consolidating training activities at downstream level and reaching diverse disciplinary communities and countries in the ERA. The training programme includes different approaches and delivery options: elearning, blearning, self-learning, dissemination of training materials/contents, helpdesk, face-to-face training, especially training-the-trainers, summer schools, seminars, etc.

Racionalização e redução de custos das TIC na Administração Pública: o caso da PSP

Dissertação de mestrado integrado em Engenharia e Gestão de Sistemas de Informação

Enquadramento para a compreensão dos impactos do Open Government Data

Dissertação de mestrado integrado em Engenharia e Gestão de Sistemas de Informação

Gender, sex and sexuality in two open access communication journals published in Portugal: a critical overview of current discursive practices

The links between gender, sex and sexuality and their relevance are theoretically and politically problematic (Richardson, 2007). One of the difficulties in understanding their interconnections is that these terms are often used differently and ambiguously by different authors (and even by the same authors). This article reports the results of an analysis of the articles published in open access communication journals with known impact factor, edited in Portugal and published between 2005 and 2012. The diverse conceptualisations of those three basic concepts and of their (inter)relationships within communication research are identified. The complexity and the intricate (and often implicit) nature of both the meanings of these categories and their relationships underlie and justify our attention and further research. What the findings suggest about the current communication research into gender issues published in the two journals surveyed is that the ‘Gender differences discourse’ (Sunderland, 2004) is the most pervasive discourse (also) in academic practice. Additionally, they show that gender and sex are mainly taken for a fact, not a question that is worth being studied. The editors of these journals, as well as the scholars submitting manuscripts, need to be more aware of the traditional nature of the theoretical and methodological choices that they make regarding gender- and sex-related issues, as well as of the relative lack of attention to sexuality as a research subject.

A multicenter, open-label study of the efficacy and safety of telmisartan in mild to moderate hypertensive patients

OBJECTIVE: To evaluate the efficacy and tolerability of telmisartan, given once a day to patients with mild to moderate hypertension, as well as to assess the 24-hour blood pressure profile with ABPM. METHODS: Initially, 163 patients over 18 were selected, regardless of sex, with blood pressure levels >140/90mmHg at visit 1, which was confirmed at visit 2. One hundred thirty-four patients completed the study. After a 4-week placebo run-in phase, telmisartan 40mg/daily was given for 6 weeks. In those patients whose blood pressure (BP) levels were lower than 140/90mmHg, the same dosage was kept for an additional period of 6 weeks. For those who had BP higher than 140/90mmHg, the dosage was increased to 80mg/daily. Sixty-two patients were included in a subgroup that underwent ABPM 3 different times during the study. RESULTS: In the overall group, blood pressure reduction ranged from 162.3±14.5/101.3±5.75 mmHg (baseline) to 147.3±20.1/90.8±10.9 mmHg (week 12) (p<0.05). Mean blood pressure decreases were 14.4mmHg for systolic BP and 10.3mmHg for diastolic BP, after 12 weeks of active treatment. A subanalysis showed that 47 (35%) patients took telmisartan 40mg throughout the study and 81 (65%) had the dosage increased to 80mg daily. Using ABPM, an 8-mmHg reduction in systolic BP as well as a 5-mmHg reduction in diastolic BP were observed, when compared with baseline values in the final 6 hours (18-24 hours after the last dose of study medication). CONCLUSION: Our results confirm that telmisartan given once a day is effective in reducing blood pressure levels in mild to moderate hypertensive patients. This reduction occurs in a sustained and gradual manner during a 24-hour period confirmed by ABPM.

Ciclos económicos en economías abiertas y menos desarrolladas: el papel de los "shocks" en los términos de intercambio.The business cycle in open and less developed economies: the rol of terms-of-trade shocks.

Nuestra preocupación reside en estudiar empíricamente el mecanismo de transmisión internacional de ciclos económicos a economías pequeñas y menos desarrolladas (LDC), evaluando el impacto de los shocks en los términos de intercambio en países dónde existen imperfecciones en el mercado crediticio que imponen severas restricciones en el financiamiento de la inversión doméstica y al crecimiento económico. Primero, analizamos si la cuenta corriente responde de manera asimétrica a movimientos de largo plazo en los términos de intercambio. La hipótesis es que “en los buenos tiempos” cuando se produce una mejora permanente en términos de intercambio (y con ello el nivel de ingreso) los individuos no elevan su consumo en un monto acorde con la mejora de su ingreso (permanente) sino que ahorran una fracción del aumento en su dotación para hacer frente a una reversión en la mejora en los términos de intercambios (aunque ésta sea transitoria) en el futuro. En consecuencia, la cuenta corriente (diferencia entre ingreso y absorción) responde de manera positiva a un shock permanente en los términos de intercambio, ya que el individuo ahorra de manera cautelosa –debido a que sabe que no le prestarán para suavizar consumo - aún suponiendo que en el futuro tendrá una reversión transitoria de su ingreso. Segundo, estudiamos la relación dinámica entre los términos de intercambio y la tasa de interés en la economía pequeña abierta y con imperfecciones en el mercado crediticio (información asimétrica). La hipótesis es que la economía doméstica tiene que soportar una prima de riesgo que eleva el costo de la inversión y retarda el crecimiento (Gertler y Rogoff; 1990). Esta prima de riesgo depende, además, en forma negativa del nivel del colateral que tenga la economía. El colateral es la dotación de recursos naturales, por ejemplo, que la economía posee a los fines garantizar el cumplimiento de las obligaciones contraídas (en el modelo presentado las actividades dónde se invierten son independientes del colateral). La hipótesis establecida indica que los cambios en los términos de intercambio generan un aumento del colateral de la economía y una reducción del riesgo país: aumentos en los términos de intercambio reducen la prima de riesgo de la economía que opera en mercados de capitales con asimetrías de información, y como consecuencia aumentarían los ingresos de capitales. De esta forma, se estaría encontrando una explicación a la denominada “Paradoja de Lucas”. Finalmente, el proyecto estudia la conexión entre dos variables “clave” en la economía de los países emergentes: la relación entre los términos de intercambio y el tipo de cambio real. Argumentamos que los efectos de las mejoras de los términos de intercambio sobre los flujos de capitales externos tienden a ser sobreestimadas si no se consideran los efectos “secundarios” de éstas sobre el tipo de cambio real de la economía pequeña menos desarrollada. En este proyecto se controlan estadísticamente esta relación. La estrategia empírica elegida resulta en aplicar a un panel (constituido por dieciocho países de Latinoamérica) el método generalizado de momentos (GMM) a dos modelos de regresión estadística a los fines de abordar de manera eficiente el problema de la endogeneidad de la variable dependiente que actúa como regresor rezagado. La estrategia de estimación elegida enfatiza el análisis de la relación dinámica de las variables económicas incluidas en el análisis. The paper analyzes the general problem related to the transmission of economic cycles to Small Open Economies. The analysis focuses on terms-of-trade shocks, which are considered one of the major sources of income volatility in developing economies. Specifically, we tackle the problem related to the impact of terms-of-trade shocks in Less Developed SOEs. ‘Less Developed SOEs’ are understood as those countries who have borrowing constraints. First, we put to a test the hypothesis of asymmetric response of current account to terms-of-trade shocks (the impact of the shock on current account differs depending whether it is positive or negative), which originates from considering binding restrictions in international capital markets (Agénor and Aizenman; 2004). Second, we investigate about the main determinants of External Capital Flows (ECF) directed to Developing Countries. We put to a test the Gertler and Rogoff (1990) hypothesis that a “risky rate” arises in that markets because the economy has not sufficient amount of wealth to “collateralize” the capital she needs to borrow to take advantage of the investment opportunities she has and additionally because the lender does not have the chance of observing what the borrowed does with the funds (that is information asymmetry arises because the lender can check the realized output of investment but he can not observe if he really invest in the project or secretly lend abroad). Finally, Following Prasad, E. S., Rajan and R. Subramanian, A (2007) we measure the relationship between external capital flows and domestic currency overvaluation. We run a panel GMM estimation for a set of 18 Latin American Countries during the period 1973-2008.

Spatio-temporal dynamics of glycolysis in an open spatial reactor

Magdeburg, Univ., Fak. für Verfahrens- und Systemtechnik, Diss., 2008