298 resultados para Kyminkartanon lääni
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Although lymphadenectomy (lymph node dissection [LND]) is currently accepted as the most accurate and reliable staging procedure for the detection of lymph node invasion (LNI), its therapeutic benefit in renal cell carcinoma (RCC) still remains controversial.
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CONTEXT: Pelvic lymph node dissection (PLND) is considered the most reliable procedure for the detection of lymph node metastases in prostate cancer (PCa); however, the therapeutic benefit of PLND in PCa management is currently under debate. OBJECTIVE: To systematically review the available literature concerning the role of PLND and its extent in PCa staging and outcome. All of the existing recommendations and staging tools determining the need for PLND were also assessed. Moreover, a systematic review was performed of the long-term outcome of node-positive patients stratified according to the extent of nodal invasion. EVIDENCE ACQUISITION: A Medline search was conducted to identify original and review articles as well as editorials addressing the significance of PLND in PCa. Keywords included prostate cancer, pelvic lymph node dissection, radical prostatectomy, imaging, and complications. Data from the selected studies focussing on the role of PLND in PCa staging and outcome were reviewed and discussed by all of the contributing authors. EVIDENCE SYNTHESIS: Despite recent advances in imaging techniques, PLND remains the most accurate staging procedure for the detection of lymph node invasion (LNI) in PCa. The rate of LNI increases with the extent of PLND. Extended PLND (ePLND; ie, removal of obturator, external iliac, hypogastric with or without presacral and common iliac nodes) significantly improves the detection of lymph node metastases compared with limited PLND (lPLND; ie, removal of obturator with or without external iliac nodes), which is associated with poor staging accuracy. Because not all patients with PCa are at the same risk of harbouring nodal metastases, several nomograms and tables have been developed and validated to identify candidates for PLND. These tools, however, are based mostly on findings derived from lPLND dissections performed in older patient series. According to these prediction models, a staging PLND might be omitted in low-risk PCa patients because of the low rate of lymph node metastases found, even after extended dissections (<8%). The outcome for patients with positive nodes is not necessarily poor. Indeed, patients with low-volume nodal metastases experience excellent survival rates, regardless of adjuvant treatment. But despite few retrospective studies reporting an association between PLND and PCa progression and survival, the exact impact of PLND on patient outcomes has not yet been clearly proven because of the lack of prospective randomised trials. CONCLUSIONS: On the basis of current data, we suggest that if a PLND is indicated, then it should be extended. Conversely, in view of the low rate of LNI among patients with low-risk PCa, a staging ePLND might be spared in this patient category. Whether this approach is also safe from oncologic perspectives is still unknown. Patients with low-volume nodal metastases have a good long-term prognosis; to what extent this prognosis is the result of a positive impact of PLND on PCa outcomes is still to be determined.
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This document provides a general description of the telematic voting scenario designed by the author?s research group. This scenario reinforces verification procedures as key elements to achieve full acceptance of the system on the part of voters. To frame this work, a general overview of electronic voting is given and the conditions entailed by these systems are specified.
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The use of semantic and Linked Data technologies for Enterprise Application Integration (EAI) is increasing in recent years. Linked Data and Semantic Web technologies such as the Resource Description Framework (RDF) data model provide several key advantages over the current de-facto Web Service and XML based integration approaches. The flexibility provided by representing the data in a more versatile RDF model using ontologies enables avoiding complex schema transformations and makes data more accessible using Web standards, preventing the formation of data silos. These three benefits represent an edge for Linked Data-based EAI. However, work still has to be performed so that these technologies can cope with the particularities of the EAI scenarios in different terms, such as data control, ownership, consistency, or accuracy. The first part of the paper provides an introduction to Enterprise Application Integration using Linked Data and the requirements imposed by EAI to Linked Data technologies focusing on one of the problems that arise in this scenario, the coreference problem, and presents a coreference service that supports the use of Linked Data in EAI systems. The proposed solution introduces the use of a context that aggregates a set of related identities and mappings from the identities to different resources that reside in distinct applications and provide different views or aspects of the same entity. A detailed architecture of the Coreference Service is presented explaining how it can be used to manage the contexts, identities, resources, and applications which they relate to. The paper shows how the proposed service can be utilized in an EAI scenario using an example involving a dashboard that integrates data from different systems and the proposed workflow for registering and resolving identities. As most enterprise applications are driven by business processes and involve legacy data, the proposed approach can be easily incorporated into enterprise applications.
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"Čili, staré písemné památky české i moravské, sebrané z archivů domácích i cizích."
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Czech, German, and Latin.
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Title from volume title page.
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In their article - Sales Promotion In Hotels: A British Perspective - by Francis Buttle, Lecturer, Department of Hotel, Restaurant, and Travel Administration, University of Massachusetts and Ini Akpabio, Property Manager, Trusthouse Forte, Britain, Buttle and Akpabio initially state: “Sales promotion in hotels is in its infancy. Other industries, particularly consumer goods manufacturing, have long recognized the contribution that sales promotion can make to the cost-effective achievement of marketing objectives. Sales promotion activities in hotels have remained largely uncharted. The authors define, identify and classify these hotel sales promotion activities to understand their function and form, and to highlight any scope for improvement.” The authors begin their discussion by attempting to define what the phrase sales promotion [SP] actually means. “The Institute of Sales Promotion regards sales promotions as “adding value, usually of a temporary nature, to a product or service in order to persuade the end user to purchase that particular brand as opposed to a competitive brand,” the authors offer. Williams, however, describes sales promotions more broadly as “short term tactical marketing tools which are used to achieve specific marketing objectives during a defined time period,” Buttle and Akpabio present with attribution. “The most significant difference between these two viewpoints is that Williams does not limit his definition to activities which are targeted at the consumer,” is their educated view. A lot of the discussion is centered on the differences in the collective marketing-promotional mix. “…it is not always easy to definitively categorize promotional activity,” Buttle and Akpabio say. “For example, in personal selling, a sales promotion such as a special bonus offer may be used to close the sale; an advertisement may be sales promotional in character in that it offers discounts.” Are promotion and marketing distinguishable as two separate entities? “…not only may there be conceptual confusion between components of the promotional mix, but there is sometimes a blurring of the boundaries between the elements of the marketing mix,” the authors suggest. “There are several reasons why SP is particularly suitable for use in hotels: seasonality, increasing competitiveness, asset characteristics, cost characteristics, increased use of channel intermediaries, new product launches, and deal proneness.” Buttle and Akpabio offer their insight on each of these segments. The authors also want you to know that SP customer applications are not the only game in town, SP trade applications are just as essential. Bonuses, enhanced commission rates, and vouchers are but a few examples of trade SP. The research for the article was compiled from several sources including, mail surveys, telephone surveys, personal interviews, trade magazines and newspapers; essentially in the U.K.
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Boldog és elégedett életet élni, miközben a Föld ökológiai korlátain belül maradunk: ez századunk egyik legfőbb kihívása. A spiritualitás életünket anyagi és nem-anyagi értelemben is befolyásolja, így hatást gyakorol a természeti környezettel kapcsolatos viselkedésünkre és fogyasztási szokásaink környezetterhelésére is. Cikkünk célja az értékvezérelt élet és az ökológiai lábnyom1 közötti kapcsolat feltárása.