Chirurgie endoscopique endonasale des tumeurs de la base du crane : historique, état de l'art et perspectives d'avenir [Shifting paradigm in skull base surgery: Roots, current state of the art and future trends of endonasal endoscopic approaches].

During the last two decades, endoscopic endonasal approach has completed the minimally invasive skull base surgery armamentarium. Endoscopic endonasal skull base surgery (EESBS) was initially developed in the field of pituitary adenomas, and gained an increasing place for the treatment of a wide variety of skull base pathologies, extending on the midline from crista galli process to the occipitocervical junction and laterally to the parasellar areas and petroclival apex. Until now, most studies are retrospective and lack sufficient methodological quality to confirm whether the endoscopic endonasal pituitary surgery has better results than the microsurgical trans-sphenoidal classical approach. The impressions of the expert teams show a trend toward better results for some pituitary adenomas with the endoscopic endonasal route, in terms of gross total resection rate and probably more comfortable postoperative course for the patient. Excepting intra- and suprasellar pituitary adenomas, EESBS seems useful for selected lesions extending onto the cavernous sinus and Meckel's cave but also for clival pathologies. Nevertheless, this infatuation toward endoscopic endonasal approaches has to be balanced with the critical issue of cerebrospinal fluid leaks, which constitutes actually the main limit of this approach. Through their experience and a review of the literature, the authors aim to present the state of the art of this approach as well as its limits.

Transvaginal specimen extraction in colorectal surgery: current state of the art.

Aim  Background The expected benefit of transvaginal specimen extraction is reduced incision-related morbidity. Objectives A systematic review of transvaginal specimen extraction in colorectal surgery was carried out to assess this expectation. Method  Search strategy The following keywords, in various combinations, were searched: NOSE (natural orifices specimen extraction), colorectal, colon surgery, transvaginal, right hemicolectomy, left hemicolectomy, low anterior resection, sigmoidectomy, ileocaecal resection, proctocolectomy, colon cancer, sigmoid diverticulitis and inflammatory bowel diseases. Selection criteria Selection criteria included large bowel resection with transvaginal specimen extraction, laparoscopic approach, human studies and English language. Exclusion criteria were experimental studies and laparotomic approach or local excision. All articles published up to February 2011 were included. Results  Twenty-three articles (including a total of 130 patients) fulfilled the search criteria. The primary diagnosis was colorectal cancer in 51% (67) of patients, endometriosis in 46% (60) of patients and other conditions in the remaining patients. A concurrent gynaecological procedure was performed in 17% (22) of patients. One case of conversion to laparotomy was reported. In two patients, transvaginal extraction failed. In left- and right-sided resections, the rate of severe complications was 3.7% and 2%, respectively. Two significant complications, one of pelvic seroma and one of rectovaginal fistula, were likely to have been related to transvaginal extraction. The degree of follow up was specified in only one study. Harvested nodes and negative margins were adequate and reported in 70% of oncological cases. Conclusion  Vaginal extraction of a colorectal surgery specimen shows potential benefit, particularly when associated with a gynaecological procedure. Data from prospective randomized trials are needed to support the routine use of this technique.

Current state of vaccine therapies in non-small-cell lung cancer.

A large variety of cancer vaccines have undergone extensive testing in early-phase clinical trials. A limited number have also been tested in randomized phase II clinical trials. Encouraging trends toward increased survival in the vaccine arms have been recently observed for 2 vaccine candidates in patients with non-small-cell lung cancer. These have provided the impetus for the initiation of phase III trials in large groups of patients with lung cancer. These vaccines target 2 antigens widely expressed in lung carcinomas: melanoma-associated antigen 3, a cancer testis antigen; and mucin 1, an antigen overexpressed in a largely deglycosylated form in advanced tumors. Therapeutic cancer vaccines aim at inducing strong CD8 and CD4 T-cell responses. The majority of vaccines recently tested in phase I clinical trials show efficacy in terms of induction of specific tumor antigen immunity. However, clinical efficacy remains to be determined but appears limited. Efforts are thus aimed at understanding the basis for this apparent lack of effect on tumors. Two major factors are involved. On one hand, current vaccines are suboptimal. Strong adjuvant agents and appropriate tumor antigens are needed. Moreover, dose, route, and schedule also need optimization. On the other hand, it is now clear that large tumors often present a tolerogenic microenvironment that hampers effective antitumor immunity. The partial understanding of the molecular pathways leading to functional inactivation of T cells at tumor sites has provided new targets for intervention. In this regard, blockade of cytotoxic T-lymphocyte antigen-4 and programmed death-1 with humanized monoclonal antibodies has reached the clinical testing stage. In the future, more potent cancer vaccines will benefit from intense research in antigen discovery and adjuvant agents. Furthermore, it is likely that vaccines need to be combined with compounds that reverse major tolerogenic pathways that are constitutively active at the tumor site. Developing these combined approaches to vaccination in cancer promises new, exciting findings and, at the same time, poses important challenges to academic research institutions and the pharmaceutical industry.

Laparoscopy in uterine cervical cancer. Current state and literature review

Cervical cancer remains the most frequent gynecological tumor in Brazil and other developing countries. Minimally invasive techniques, especially laparoscopy, have been increasingly employed in such tumors. This article aims to describe the main applications of laparoscopy in the treatment and staging of cervical cancer. In the early stages, it is possible to provide a fertility-preserving surgery in the form of radical trachelectomy and, in a study protocol, the function-preserving surgery, avoiding parametrectomy and the associated morbidity. A fully laparoscopic radical hysterectomy is fairly standard in the literature and has the tendency to become the standard of care in early cases, for patients who want to bear no more children. In advanced stages, minimally invasive surgery can offer ovarian transposition, with intent to prevent actinic castration, without upsetting the time for the start of radiotherapy and chemotherapy. Staging laparoscopic surgery, including pelvic and para-aortic lymphadenectomy, has been the subject of studies, since it has the potential to modify the extension of radiotherapy depending on the extent of lymph node spread.

Current State of Repository Interoperability: Work by the Confederation of Open Access Repositories (COAR)

Panel at Open Repositories 2014, Helsinki, Finland, June 9-13, 2014

Current State of Ontology Matching. A Survey of Ontology and Schema Matching

Ontology matching is an important task when data from multiple data sources is integrated. Problems of ontology matching have been studied widely in the researchliterature and many different solutions and approaches have been proposed alsoin commercial software tools. In this survey, well-known approaches of ontologymatching, and its subtype schema matching, are reviewed and compared. The aimof this report is to summarize the knowledge about the state-of-the-art solutionsfrom the research literature, discuss how the methods work on different application domains, and analyze pros and cons of different open source and academic tools inthe commercial world.

Power Electronic Converters in Low-Voltage Direct Current Distribution – Analysis and Implementation

Over the recent years, smart grids have received great public attention. Many proposed functionalities rely on power electronics, which play a key role in the smart grid, together with the communication network. However, “smartness” is not the driver that alone motivates the research towards distribution networks based on power electronics; the network vulnerability to natural hazards has resulted in tightening requirements for the supply security, set both by electricity end-users and authorities. Because of the favorable price development and advancements in the field, direct current (DC) distribution has become an attractive alternative for distribution networks. In this doctoral dissertation, power electronic converters for a low-voltage DC (LVDC) distribution system are investigated. These include the rectifier located at the beginning of the LVDC network and the customer-end inverter (CEI) on the customer premises. Rectifier topologies are introduced, and according to the LVDC system requirements, topologies are chosen for the analysis. Similarly, suitable CEI topologies are addressed and selected for study. Application of power electronics into electricity distribution poses some new challenges. Because the electricity end-user is supplied with the CEI, it is responsible for the end-user voltage quality, but it also has to be able to supply adequate current in all operating conditions, including a short-circuit, to ensure the electrical safety. Supplying short-circuit current with power electronics requires additional measures, and therefore, the short-circuit behavior is described and methods to overcome the high-current supply to the fault are proposed. Power electronic converters also produce common-mode (CM) and radio-frequency (RF) electromagnetic interferences (EMI), which are not present in AC distribution. Hence, their magnitudes are investigated. To enable comprehensive research on the LVDC distribution field, a research site was built into a public low-voltage distribution network. The implementation was a joint task by the LVDC research team of Lappeenranta University of Technology and a power company Suur-Savon S¨ahk¨o Oy. Now, the measurements could be conducted in an actual environment. This is important especially for the EMI studies. The main results of the work concern the short-circuit operation of the CEI and the EMI issues. The applicability of the power electronic converters to electricity distribution is demonstrated, and suggestions for future research are proposed.

Exploring the Current State of Grades 4 to 8 Science Education in Ontario

This study sought to explore the current state of Grades 4 to 8 science education in Ontario from the perspective of Junior/Intermediate (J/I) teachers. The study’s methodology was a sequential 2-phased mixed methods explanatory design denoted as QUAN (qual)  qual. Data were collected from an online survey and follow-up interviews. J/I teachers (N = 219) from 48 school boards in Ontario completed a survey that collected both quantitative and qualitative data. Interviewees were selected from the survey participant population (n = 6) to represent a range of teaching strategies, attitudes toward teaching science, and years of experience. Survey and interview questions inquired about teacher attitudes toward teaching science, academic and professional experiences, teaching strategies, support resources, and instructional time allotments. Quantitative data analyses involved the descriptive statistics and chi-square tests. Qualitative data was coded inductively and deductively. Academic background in science was found to significantly influence teachers’ reported level of capability to teach science. The undergraduate degrees held by J/I science teachers were found to significantly influence their reported levels of capability to teach science. Participants identified a lack of time allocated for science instruction and inadequate equipment and facilities as major limitations on science instruction. Science in schools was reported to be of a “second-tiered” value to language and mathematics. Implications of this study include improving undergraduate and preservice experiences of elementary teachers by supporting their science content knowledge and pedagogical content knowledge.

Animal health and welfare in organic livestock production in Europe: Current state and future challenges

Existing data on animal health and welfare in organic livestock production systems in the European Community countries are reviewed in the light of the demands and challenges of the recently implemented EU regulation on organic livestock production. The main conclusions and recommendations of a three-year networking project on organic livestock production are summarised and the future challenges to organic livestock production in terms of welfare and health management are discussed. The authors conclude that, whilst the available data are limited and the implementation of the EC regulation is relatively recent, there is little evidence to suggest that organic livestock management causes major threats to animal health and welfare in comparison with conventional systems. There are, however, some well-identified areas, like parasite control and balanced ration formulation, where efforts are needed to find solutions that meet with organic standard requirements and guarantee high levels of health and welfare. It is suggested that, whilst organic standards offer an implicit framework for animal health and welfare management, there is a need to solve apparent conflicts between the organic farming objectives in regard to environment, public health, farmer income and animal health and welfare. The key challenges for the future of organic livestock production in Europe are related to the feasibility of implementing improved husbandry inputs and the development of evidence-based decision support systems for health and feeding management.

Carbon balance of UK peatlands: current state of knowledge and future research challenges

The retention of peatland carbon (C) and the ability to continue to draw down and store C from the atmosphere is not only important for the UK terrestrial carbon inventory, but also for a range of ecosystem services, the landscape value and the ecology and hydrology of ~15% of the land area of the UK. Here we review the current state of knowledge on the C balance of UK peatlands using several studies which highlight not only the importance of making good flux measurements, but also the spatial and temporal variability of different flux terms that characterise a landscape affected by a range of natural and anthropogenic processes and threats. Our data emphasise the importance of measuring (or accurately estimating) all components of the peatland C budget. We highlight the role of the aquatic pathway and suggest that fluxes are higher than previously thought. We also compare the contemporary C balance of several UK peatlands with historical rates of C accumulation measured using peat cores, thus providing a long-term context for present-day measurements and their natural year-on-year variability. Contemporary measurements from 2 sites suggest that current accumulation rates (–56 to –72 g C m–2 yr–1) are at the lower end of those seen over the last 150 yr in peat cores (–35 to –209 g C m–2 yr–1). Finally, we highlight significant current gaps in knowledge and identify where levels of uncertainty are high, as well as emphasise the research challenges that need to be addressed if we are to improve the measurement and prediction of change in the peatland C balance over future decades.

Relaxing the Tropics to an ‘observed’ state: analysis using a simple baroclinic model

The technique of relaxation of the tropical atmosphere towards an analysis in a month-season forecast model has previously been successfully exploited in a number of contexts. Here it is shown that when tropical relaxation is used to investigate the possible origin of the observed anomalies in June–July 2007, a simple dynamical model is able to reproduce the observed component of the pattern of anomalies given by an ensemble of ECMWF forecast runs. Following this result, the simple model is used for a range of experiments on time-scales of relaxation, variables and regions relaxed based on a control model run with equatorial heating in a zonal flow. A theory based on scale analysis for the large-scale tropics is used to interpret the results. Typical relationships between scales are determined from the basic equations, and for a specified diabatic heating a chain of deductions for determining the dependent variables is derived. Different critical time-scales are found for tropical relaxation of different dependent variables to be effective. Vorticity has the longest critical time-scale, typically 1.2 days. For temperature and divergence, the time-scales are 10 hours and 3 hours, respectively. However not all the tropical fields, in particular the vertical motion, are reproduced correctly by the model unless divergence is heavily damped. To obtain the correct extra-tropical fields, it is crucial to have the correct rotational flow in the subtropics to initiate the Rossby wave propagation from there. It is sufficient to relax vorticity or temperature on a time-scale comparable or less than their critical time-scales to obtain this. However if the divergent advection of vorticity is important in the Rossby Wave Source then strong relaxation of divergence is required to accurately represent the tropical forcing of Rossby waves.

Dynamic whole system testing of combined renewable heating systems : the current state of the art

Objective: For the evaluation of the energetic performance of combined renewable heating systems that supply space heat and domestic hot water for single family houses, dynamic behaviour, component interactions, and control of the system play a crucial role and should be included in test methods. Methods: New dynamic whole system test methods were developed based on “hardware in the loop” concepts. Three similar approaches are described and their differences are discussed. The methods were applied for testing solar thermal systems in combination with fossil fuel boilers (heating oil and natural gas), biomass boilers, and/or heat pumps. Results: All three methods were able to show the performance of combined heating systems under transient operating conditions. The methods often detected unexpected behaviour of the tested system that cannot be detected based on steady state performance tests that are usually applied to single components. Conclusion: Further work will be needed to harmonize the different test methods in order to reach comparable results between the different laboratories. Practice implications: A harmonized approach for whole system tests may lead to new test standards and improve the accuracy of performance prediction as well as reduce the need for field tests.

Ferroelectric state analysis in grain boundary of Na0.85Li0.15NbO3 ceramic

The electric and dielectric properties of the grain boundary of Na0.85Li0.15NbO3 lead-free ferroelectric-semiconductor perovskite were investigated. The impedance spectroscopy was carried out as a function of a thermal cycle. The sodium lithium niobate was synthesized by a chemical route based on the evaporation method. Dense ceramic, relative density of 97%, was prepared at 1423 K for 2 h in air atmosphere. ac measurements were carried out in the frequency range of 5 Hz-13 MHz and from 673 to 1023 K. Theoretical adjust of the impedance data was performed to deriving the electric parameters of the grain boundary. The electric conductivity follows the Arrhenius law, with activation energy values equal to 1.55 and 1.54 eV for heating and cooling cycle, respectively. The nonferroelectric state of the grain boundary and its correlation with symmetry are discussed in the temperature domain. (C) 2003 American Institute of Physics.