There is a place for radical cystectomy and urinary diversion, including orthotopic bladder substitution, in patients aged 75 and older: Results of a retrospective observational analysis from a high-volume center

INTRODUCTION The incidence of cancer increases with age and owing to the changing demographics we are increasingly confronted with treating bladder cancer in old patients. We report our results in patients>75 years of age who underwent open radical cystectomy (RC) and urinary diversion. MATERIAL AND METHODS From January 2000 to March 2013, a consecutive series of 224 old patients with complete follow-up who underwent RC and urinary diversion (ileal orthotopic bladder substitute [OBS], ileal conduit [IC], and ureterocutaneostomy [UCST]) were included in this retrospective single-center study. End points were the 90-day complication rates (Clavien-Dindo classification), 90-day mortality rates, overall and cancer-specific survival rates, and continence rates (OBS). RESULTS Median age was 79.2 years (range: 75.1-91.6); 35 of the 224 patients (17%) received an OBS, 178 of the 224 patients (78%) an IC, and 11 of the 224 patients (5%) an UCST. The 90-day complication rate was 54.3% in the OBS (major: Clavien grade 3-5: 22.9%, minor: Clavien Grade 1-2: 31.4%), 56.7% in the IC (major: 27%, minor: 29.8%), and 63.6% in the UCST group (major: 36.4%, minor: 27.3%); P = 0.001. The 90-day mortality was 0% in the OBS group, 13% in the IC group, and 10% in the UCST group (P = 0.077). The Glasgow prognostic score was an independent predictor of all survival parameters assessed, including 90-day mortality. Median follow-up was 22 months. Overall and cancer-specific survivals were 90 and 98, 47 and 91, and 11 and 12 months for OBS, IC, and UCST, respectively. In OBS patients, daytime continence was considered as dry in 66% and humid in 20% of patients. Nighttime continence was dry in 46% and humid 26% of patients. CONCLUSION With careful patient selection, oncological and functional outcome after RC can be good in old patients. Old age as the sole criterion should not preclude the indication for RC or the option of OBS. In old patients undergoing OBS, satisfactory continence results can be achieved.

National performance audit program : 1980 proficiency surveys for sulfur dioxide, nitrogen dioxide, carbon monoxide, sulfate, nitrate, lead and high volume flow /

Mode of access: Internet.

Development of a motor vehicle materials historical, high volume industrial processing rates cost data bank (light truck). Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Development of a motor vehicle materials historical high-volume industrial processing rates cost data bank (3500-4000 pound) full size car. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Identification of sources causing TSP non-attainment in the Peoria area : analysis of historical high-volume filters /

"Project no. 10.064."

Development of a motor vehicle materials historical high-volume industrial processing rates cost data bank (3500-4000 pound) full size car /

Mode of access: Internet.

High volume fabrication of laser targets using MEMS techniques

The latest techniques for the fabrication of high power laser targets, using processes developed for the manufacture of Micro-Electro-Mechanical System (MEMS) devices are discussed. These laser targets are designed to meet the needs of the increased shot numbers that are available in the latest design of laser facilities. Traditionally laser targets have been fabricated using conventional machining or coarse etching processes and have been produced in quantities of 10s to low 100s. Such targets can be used for high complexity experiments such as Inertial Fusion Energy (IFE) studies and can have many complex components that need assembling and characterisation with high precision. Using the techniques that are common to MEMS devices and integrating these with an existing target fabrication capability we are able to manufacture and deliver targets to these systems. It also enables us to manufacture novel targets that have not been possible using other techniques. In addition, developments in the positioning systems that are required to deliver these targets to the laser focus are also required and a system to deliver the target to a focus of an F2 beam at 0.1Hz is discussed.

Radiological and material characterization of high volume fly ash concrete

The main goal of research presented in this paper was the material and radiological characterization of high volume fly ash concrete (HVFAC) in terms of determination of natural radionuclide content and radon emanation and exhalation coefficients. All concrete samples were made with a fly ash content between 50% and 70% of the total amount of cementitious materials from one coal burning power plant in Serbia. Physical (fresh and hardened concrete density) and mechanical properties (compressive strength, splitting tensile strength and modulus of elasticity) of concrete were tested. The radionuclide content (226Ra, 232Th and 40K) and radon massic exhalation of HVFAC samples were determined using gamma spectrometry. Determination of massic exhalation rates of HVFAC and its components using radon accumulation chamber techniques combined with a radon monitor was performed. The results show a beneficial effect of pozzolanic activity since the increase in fly ash content resulted in an increase in compressive strength of HVFAC by approximately 20% for the same mass of cement used in the mixtures. On the basis of the obtained radionuclide content of concrete components the I -indices of different HVFAC samples were calculated and compared with measured values (0.27e0.32), which were significantly below the recommended 1.0 index value. The prediction was relatively close to the measured values as the ratio between the calculated and measured I-index ranged between 0.89 and 1.14. Collected results of mechanical and radiological properties and performed calculations clearly prove that all 10 designed concretes with a certain type of fly ash are suitable for structural and non-structural applications both from a material and radiological point of view.

Use of Gypsum and CKD to enhance early age strength of High Volume Fly Ash (HVFA) pastes

Use of higher proportions of fly ash as a cement replacement in concrete has obvious environmental and performance benefits but high volumes of fly ash are not commonly used due to perceived lower early age strengths. In this investigation, addition of cement kiln dust (CKD) and gypsum to activate the fly ash was studied and the proportions used in the paste mixes were designed to optimize the mixture ingredients to achieve the highest early age compressive strength. Change of mineral phase composition and micro structure of the composites was analyzed. It was found that CKD was much more effective in activating the fly ash than gypsum. Appreciable early age compressive strengths were achieved for fly ash contents up to 60% of the binder and these observations were supported by analysis of the mineral phases.

THE HYDROSOCIAL COSTS OF HIGH-VOLUME HYDRAULIC FRACTURING: A TALE OF TWO COUNTIES IN MICHIGAN

Although natural gas has been praised as a clean and abundant energy source, the varying impacts and uncertainties surrounding the process of extracting natural gas from unconventional sources, known as horizontal high-volume hydraulic fracturing (HVHF) or “fracking,” have raised important concerns. The practice of HVHF is expanding so quickly that the full impacts are not yet known. This thesis project, using a grounded theory methodological approach, explores the risks and benefits associated with HVHF as recognized by the residents of two Michigan counties, one that currently produces natural gas by HVHF (Crawford County) and one that does not (Barry County). Through an analysis of media content related to HVHF in each case study site and interviews with stakeholders in both counties, this study examines perceptions of risks and benefits by comparing two communities that differ in their level of experience with HVHF operations, contributing to our understanding of how perceptions of risks and benefits are shaped by natural gas development. The comparative analysis of the case study counties revealed similarities and differences between the case study counties. Overall, Barry County residents identified fewer benefits and more risks, and had stronger negative perceptions than Crawford County residents. This study contributes to the social science literature by developing a richer theoretical frame for understanding perceptions of HVHF and also shares recommendations for industry, organizations, regulators, and government leaders interested in effectively communicating with community stakeholders about the benefits and risks of HVHF.

Effects of high and low volume of strength training on muscle strength, muscle volume and lipid profile in postmenopausal women

Changes in lipid profile are considered a risk factor for cardiovascular disease (CVD), especially in postmenopausal woman who have been associated with age-related loss of muscle mass. The beneficial role of aerobic exercise in the prevention of CVD has been well documented. However, the effect of strength training has not been established. The purpose of this study was to determine the changes of lipoprotein levels after 12 weeks of different volumes of strength training and its correlation with strength and muscle volume in postmenopausal women. The participants were randomized into three groups: low volume (LVST; n = 12, 1 set) and high volume of strength training (HVST; n = 11, 3 sets), or control group (n = 12). Training groups performed 12 weeks of supervised strength exercises, 15 maximum repetitions, five times a week, 20 minutes for LVST and 40 minutes for HVST for each training session. Measurements included body composition, strength and muscle volume, as well as blood analysis (glucose, total cholesterol, triglycerides, low-density lipoprotein, and high-density lipoprotein) pre- and post-training. The HVST and LVST improved the one-repetition maximum knee extension strength (p < 0.001), maximal dynamic strength (p < 0.001), and muscle volume (p = 0.048). Post-training triglyceride was lower in HVST when compared to LVST and the control group (p = 0.047). Even though they present the same neuromuscular and morphological adaptations in postmenopausal women, the HVST is more effective than LVST in improving the lipid profile of postmenopausal woman, and can be considered as an ideal program of intervention to reverse changes in lipid metabolism commonly found in this group. Copyright (C) 2014, The Society of Chinese Scholars on Exercise Physiology and Fitness. Published by Elsevier (Singapore) Pte Ltd. All rights reserved.