Resultados de la cirugía laparoscópica comparada con la cirugía abierta en el cáncer colorrectal. Revisión sistemática

Determinar el efecto de la cirugía laparoscópica versus cirugía abierta sobre la supervivencia en el manejo de pacientes del cáncer colorectal.

Vertical structure of anthropogenic zonal-mean atmospheric circulation change

The atmospheric circulation changes predicted by climate models are often described using sea level pressure, which generally shows a strengthening of the mid-latitude westerlies. Recent observed variability is dominated by the Northern Annular Mode (NAM) which is equivalent barotropic, so that wind variations of the same sign are seen at all levels. However, in model predictions of the response to anthropogenic forcing, there is a well-known enhanced warming at low levels over the northern polar cap in winter. This means that there is a strong baroclinic component to the response. The projection of the response onto a NAM-like zonal index varies with height. While at the surface most models project positively onto the zonal index, throughout most of the depth of the troposphere many of the models give negative projections. The response to anthropogenic forcing therefore has a distinctive baroclinic signature which is very different to the NAM

On the Meridional Structure of Annular Modes

Using a simple stochastic model, the authors illustrate that the occurrence of a meridional dipole in the first empirical orthogonal function (EOF) of a time-dependent zonal jet is a simple consequence of the north–south excursion of the jet center, and this geometrical fact can be understood without appealing to fluid dynamical principles. From this it follows that one ought not, perhaps, be surprised at the fact that such dipoles, commonly referred to as the Arctic Oscillation (AO) or the Northern Annular Mode (NAM), have robustly been identified in many observational studies and appear to be ubiquitous in atmospheric models across a wide range of complexity.

Observed and simulated precursors of stratospheric polar vortex anomalies in the Northern Hemisphere

The Northern Hemisphere stratospheric polar vortex is linked to surface weather. After Stratospheric Sudden Warmings in winter, the tropospheric circulation is often nudged towards the negative phase of the Northern Annular Mode (NAM) and the North Atlantic Oscillation (NAO). A strong stratospheric vortex is often associated with subsequent positive NAM/NAO conditions. For stratosphere–troposphere associations to be useful for forecasting purposes it is crucial that changes to the stratospheric vortex can be understood and predicted. Recent studies have proposed that there exist tropospheric precursors to anomalous vortex events in the stratosphere and that these precursors may be understood by considering the relationship between stationary wave patterns and regional variability. Another important factor is the extent to which the inherent variability of the stratosphere in an atmospheric model influences its ability to simulate stratosphere–troposphere links. Here we examine the lower stratosphere variability in 300-year pre-industrial control integrations from 13 coupled climate models. We show that robust precursors to stratospheric polar vortex anomalies are evident across the multi-model ensemble. The most significant tropospheric component of these precursors consists of a height anomaly dipole across northern Eurasia and large anomalies in upward stationary wave fluxes in the lower stratosphere over the continent. The strength of the stratospheric variability in the models was found to depend on the variability of the upward stationary wave fluxes and the amplitude of the stationary waves.

Evidence for the chaotic origin of Northern Annular Mode variability

Exponential spectra are found to characterize variability of the Northern Annular Mode (NAM) for periods less than 36 days. This corresponds to the observed rounding of the autocorrelation function at lags of a few days. The characteristic persistence timescales during winter and summer is found to be ∼5 days for these high frequencies. Beyond periods of 36 days the characteristic decorrelation timescale is ∼20 days during winter and ∼6 days in summer. We conclude that the NAM cannot be described by autoregressive models for high frequencies; the spectra are more consistent with low-order chaos. We also propose that the NAM exhibits regime behaviour, however the nature of this has yet to be identified.

The distribution of the ring current: Cluster observations

Extending previous studies, a full-circle investigation of the ring current has been made using Cluster 4-spacecraft observations near perigee, at times when the Cluster array had relatively small separations and nearly regular tetrahedral configurations, and when the Dst index was greater than −30 nT (non-storm conditions). These observations result in direct estimations of the near equatorial current density at all magnetic local times (MLT) for the first time and with sufficient accuracy, for the following observations. The results confirm that the ring current flows westward and show that the in situ average measured current density (sampled in the radial range accessed by Cluster 4–4.5RE) is asymmetric in MLT, ranging from 9 to 27 nAm−2. The direction of current is shown to be very well ordered for the whole range of MLT. Both of these results are in line with previous studies on partial ring extent. The magnitude of the current density, however, reveals a distinct asymmetry: growing from 10 to 27 nAm−2 as azimuth reduces from about 12:00MLT to 03:00 and falling from 20 to 10 nAm−2 less steadily as azimuth reduces from 24:00 to 12:00MLT. This result has not been reported before and we suggest it could reflect a number of effects. Firstly, we argue it is consistent with the operation of region-2 field aligned-currents (FACs), which are expected to flow upward into the ring current around 09:00MLT and downward out of the ring current around 14:00MLT. Secondly, we note that it is also consistent with a possible asymmetry in the radial distribution profile of current density (resulting in higher peak at 4– 4.5RE). We note that part of the enhanced current could reflect an increase in the mean AE activity (during the periods in which Cluster samples those MLT).

Applications of behavioural economics to tax evasion

The paper reviews recent models that have applied the techniques of behavioural economics to the analysis of the tax compliance choice of an individual taxpayer. The construction of these models is motivated by the failure of the Yitzhaki version of the Allingham–Sandmo model to predict correctly the proportion of taxpayers who will evade and the effect of an increase in the tax rate upon the chosen level of evasion. Recent approaches have applied non-expected utility theory to the compliance decision and have addressed social interaction. The models we describe are able to match the observed extent of evasion and correctly predict the tax effect but do not have the parsimony or precision of the Yitzhaki model.

Ontology modeling for generation of clinical pathways

Purpose: Increasing costs of health care, fuelled by demand for high quality, cost-effective healthcare has drove hospitals to streamline their patient care delivery systems. One such systematic approach is the adaptation of Clinical Pathways (CP) as a tool to increase the quality of healthcare delivery. However, most organizations still rely on are paper-based pathway guidelines or specifications, which have limitations in process management and as a result can influence patient safety outcomes. In this paper, we present a method for generating clinical pathways based on organizational semiotics by capturing knowledge from syntactic, semantic and pragmatic to social level. Design/methodology/approach: The proposed modeling approach to generation of CPs adopts organizational semiotics and enables the generation of semantically rich representation of CP knowledge. Semantic Analysis Method (SAM) is applied to explicitly represent the semantics of the concepts, their relationships and patterns of behavior in terms of an ontology chart. Norm Analysis Method (NAM) is adopted to identify and formally specify patterns of behavior and rules that govern the actions identified on the ontology chart. Information collected during semantic and norm analysis is integrated to guide the generation of CPs using best practice represented in BPMN thus enabling the automation of CP. Findings: This research confirms the necessity of taking into consideration social aspects in designing information systems and automating CP. The complexity of healthcare processes can be best tackled by analyzing stakeholders, which we treat as social agents, their goals and patterns of action within the agent network. Originality/value: The current modeling methods describe CPs from a structural aspect comprising activities, properties and interrelationships. However, these methods lack a mechanism to describe possible patterns of human behavior and the conditions under which the behavior will occur. To overcome this weakness, a semiotic approach to generation of clinical pathway is introduced. The CP generated from SAM together with norms will enrich the knowledge representation of the domain through ontology modeling, which allows the recognition of human responsibilities and obligations and more importantly, the ultimate power of decision making in exceptional circumstances.

Brand equity, brand loyalty and consumer satisfaction

This study aims to investigate the mediating effects of consumer satisfaction on the relationship between consumer-based brand equity and brand loyalty in the hotel and restaurant industry. Based on a sample of 378 customers and using structural equation modelling approach, the five dimensions of brand equity—physical quality, staff behaviour, ideal self-congruence, brand identification and lifestyle-congruence—are found to have positive effects on consumer satisfaction. The findings of the study suggest that consumer satisfaction partially mediates the effects of staff behaviour, ideal self-congruence and brand identification on brand loyalty. The effects of physical quality and lifestyle-congruence on brand loyalty are fully mediated by consumer satisfaction.

PHYSICAL AND CHEMICAL CHARACTERISTICS OF FROZEN GROUND BEEF AND AGED BEEF MEAT FROM BOS INDICUS STEERS SUPPLEMENTED WITH alpha-TOCOPHEROL ACETATE

The objective of this study was to evaluate the effects of diet supplementation with vitamin E on the physical and chemical characteristics of ground, frozen and stored or aged Quadriceps femoris (QF) and Longissimus dorsi (LD) muscles from Nellore steers fed high concentrate diets. Muscles were obtained from 24 animals that were 30 months old with a mean live weight of 279 kg. Half of the animals received daily doses of 1,000 mg of alpha-tocopherol acetate (VIT E) per head per day that was added to 100 g of corn meal. The other half received 100 g of corn meal without the antioxidant. Twenty-four hours after slaughtering, QF samples from each animal were ground, frozen and stored for up to 6 months. In addition, 4 samples from the LD of each animal were vacuum packed individually and kept for 21 days. All samples were analyzed to determine the pH, color and water-holding-capacity. The VIT E supplementation improved only the water loss characteristics of frozen ground QF and did not have any positive effect on the physical-chemical characteristics of the aged LD.

Lek och empowerment : de alternativa rummens roll i sociala rörelser

Play and empowerment: the role of alternative spaces in social movements The article examines the role played by alternative space in social movements and argues that it plays a crucial role in counter-acting feelings of powerlessness and facilitating the empowerment of subaltern groups. Alternative space is defined – using Benjamin’s notions ofshock, nature and history – as constituted by forms of interaction in which society is made to appear as history. To facilitate empowerment, alternative space must, firstly, provide a place for subaltern groups in which they are no longer subordinated; secondly, instill hope that social change is possible and encourage such change; and, thirdly, expand or consolidate alternative space itself. These tasks can easily enter into conflict with each other, since they sometimes appear to require alternative space to adopt more ”abstract” forms of interaction in which aspects of the social situation are bracketed and sometimes more ”concrete”ones in which such aspects are again given attention. In order to study how movements may relate to this difficulty, the article looks at three contemporary Japanese social movements with NAM, New Start / New Start Kansai and the General Freeter Union as central organizations. Only the third successfully combines the three tasks, in large measure through its skillful use of the play-element.

Hydropower Energy Simulation Using Mike 11 Model; A Case Study In South Germany's Small Run-Of-River Hydropower Plants

Renewable energy production is a basic supplement to stabilize rapidly increasing global energy demand and skyrocketing energy price as well as to balance the fluctuation of supply from non-renewable energy sources at electrical grid hubs. The European energy traders, government and private company energy providers and other stakeholders have been, since recently, a major beneficiary, customer and clients of Hydropower simulation solutions. The relationship between rainfall-runoff model outputs and energy productions of hydropower plants has not been clearly studied. In this research, association of rainfall, catchment characteristics, river network and runoff with energy production of a particular hydropower station is examined. The essence of this study is to justify the correspondence between runoff extracted from calibrated catchment and energy production of hydropower plant located at a catchment outlet; to employ a unique technique to convert runoff to energy based on statistical and graphical trend analysis of the two, and to provide environment for energy forecast. For rainfall-runoff model setup and calibration, MIKE 11 NAM model is applied, meanwhile MIKE 11 SO model is used to track, adopt and set a control strategy at hydropower location for runoff-energy correlation. The model is tested at two selected micro run-of-river hydropower plants located in South Germany. Two consecutive calibration is compromised to test the model; one for rainfall-runoff model and other for energy simulation. Calibration results and supporting verification plots of two case studies indicated that simulated discharge and energy production is comparable with the measured discharge and energy production respectively.

"O milagre dos manauaras": Zona Franca de Manaus: (uma análise do processo de industrialização implantado em Manaus e da universidade como formadora da mão-de-obra especializada)

O que se pretende neste trabalho ,.. e examinar o processo de industrialização implantado em Manaus com a re formulação da Zona Franca e o papel desempenhado pela universidade como formadora de mão-de-obra qualificada para este processo. Tentou-se desenvolver uma análise que fosse capaz de situar o profissional de nível superior nas ig dústrias da Zona Franca levando-se em consideração a per - cepção de uma contradição bastante evidente. Se por um la do, Zonas Francas são· espaços industriais enclavados, onde empresas multinacionais podem importar livremente matérias primas ou produtos semi-acabados para processá-los e reexportar; por outro lado, como este processo consiste,em sua grande parte, em algumas operações de rotina, sobretudo de solda ou de montagens microscópicas por mão-de-obra barata e semi-qualificada, profissionais de nível superior se tor nam desnecessários.

Suco de laranja e vitamina C : efeito sobre a estabilidade genômica

Existem evidências crescentes indicando a associação entre dietas ricas em frutas e vegetais e a diminuição da incidência de câncer. O suco de laranja (OJ) pode ser incluído entre os alimentos com potencial quimioprotetor e seu estudo é muito relevante pelo amplo consumo desta bebida. O OJ possui vários nutrientes e compostos bioativos com atividades antioxidante, antimutagênica, anticarcinogênica e antiaterogênica, entre outras. A vitamina C (Vit C) é um dos nutrientes mais abundantes no OJ, e o único nutriente que pode ser provido em quantidade superior à recomendação diária por uma única porção de 200 mL de OJ. A Vit C, a exemplo de outros componentes do OJ, pode ser tanto benéfica quanto maléfica para os sistemas biológicos, dependendo do contexto metabólico. Neste sentido, vários nutrientes presentes no OJ têm sido identificados como mutagênicos ou carcinogênicos, especialmente quando administrados de forma isolada. Este estudo utilizou o ensaio Cometa alcalino em sangue de camundongos (in vivo) para avaliar: 1) a genotoxicidade do OJ e da Vit C; 2) a genotoxicidade do FeSO4 e do CuSO4: 3) o efeito modulador do OJ e da Vit C sobre a genotoxicidade do FeSO4 e CuSO4, bem como do metilmetanosulfonato (MMS) e da ciclofosfamida (CP). A versão alcalina do ensaio Cometa foi utilizada para avaliar o dano no DNA em células brancas do sangue periférico de camundongos. Adicionalmente, os níveis de cobre e ferro no sangue e no fígado dos camundongos tratados com metais e OJ foram avaliados pela metodologia de PIXE (Particle-Induced X-ray Emission). Grupos com pelo menos 6 camundongos (metade de cada sexo) foram tratados por gavage com uma ou duas doses de água (controle), CP, MMS, FeSO4 ou CuSO4. OJ (0.1 mL/Kg) foi administrado tanto antes (pré-tratamento) quanto após a administração das substâncias-teste (pós-tratamento). A Vit C (1 e 30 mg/Kg) foi administrada apenas no pós-tratamento. O dano no DNA foi avaliado 24 e 48 h após o início do tratamento. Após 24 h, o OJ induziu um suave aumento no dano no DNA, enquanto a Vit C foi genotóxica (30 mg/Kg > 1 mg/Kg). O tratamento duplo com Vit C (a 0 e a 24 h) induziu uma resposta genotóxica cumulativa a 48 h, que foi mais intensa para a dose maior. O FeSO4 e o CuSO4 foram genotóxicos após 24 h, mas tiveram seu dano efetivamente reparado após 48 h do tratamento. O pré-tratamento com OJ reduziu a genotoxicidade do FeSO4 e do CuSO4 (efeito preventivo). O pós-tratamento com OJ também reduziu a genotoxicidade do CuSO4 (efeito reparador). O OJ mostrou tanto efeito preventivo quanto reparador sobre a genotoxicidade do MMS. O OJ teve apenas efeito reparador sobre a CP. Ambas doses de Vit C aumentaram os danos no DNA causados pelo FeSO4 e pelo CuSO4. Adicionalmente, os níveis de cobre e ferro no sangue e no fígado dos camundongos tratados com metais e OJ foram avaliados pela metodologia de PIXE (Particle-Induced X-ray Emission). Grupos com pelo menos 6 camundongos (metade de cada sexo) foram tratados por gavage com uma ou duas doses de água (controle), CP, MMS, FeSO4 ou CuSO4. OJ (0.1 mL/Kg) foi administrado tanto antes (pré-tratamento) quanto após a administração das substâncias-teste (pós-tratamento). A Vit C (1 e 30 mg/Kg) foi administrada apenas no pós-tratamento. O dano no DNA foi avaliado 24 e 48 h após o início do tratamento. Após 24 h, o OJ induziu um suave aumento no dano no DNA, enquanto a Vit C foi genotóxica (30 mg/Kg > 1 mg/Kg). O tratamento duplo com Vit C (a 0 e a 24 h) induziu uma resposta genotóxica cumulativa a 48 h, que foi mais intensa para a dose maior. O FeSO4 e o CuSO4 foram genotóxicos após 24 h, mas tiveram seu dano efetivamente reparado após 48 h do tratamento. O pré-tratamento com OJ reduziu a genotoxicidade do FeSO4 e do CuSO4 (efeito preventivo). O pós-tratamento com OJ também reduziu a genotoxicidade do CuSO4 (efeito reparador). O OJ mostrou tanto efeito preventivo quanto reparador sobre a genotoxicidade do MMS. O OJ teve apenas efeito reparador sobre a CP. Ambas doses de Vit C aumentaram os danos no DNA causados pelo FeSO4 e pelo CuSO4. processado e armazenado de forma a preservar o seu potencial biológico é um alimento sugerido como uma das porções de uma dieta equilibrada (contendo pelo menos 5 porções de frutas e vegetais), recomendada para uma vida saudável e longeva.

Caracterização parcial e atividades farmacológicas do extrato rico em polissacarídeos sulfatatos da angiosperma marinha Halodule wrightii

Sulfated polysaccharides (PS) are biomolecules with a great biotechnological potential. There are few data about PS from high plants. In addition, pharmacological activities of PS from plants have not been carrying out. The aim of this work was extract PS from the angiosperm Halodule wrightii and study their anticoagulant and antioxidant activities. Histological analysis showed the presence of the PS manly in the roots. A polysaccharide-rich extract was obtained from H. wrightii by proteolysis followed by methanol and TCA precipitation. Chemical, infra-red analysis and agarose gel electrophoresis in 1.3 diaminopropane acetate buffer confirmed the presence of sulfated polysaccharides made by glucose, galactose, xylose and sulfate residues in the proportion 1: 0,9: 1: 1. In addition polyacrilamide electrophoresis have shown that extract is mainly compose by 11kDa sulfated polysaccharides. Pharmacological analysis have shown total antioxidant capacity (CAT) that resulted in 15,21 μg for equivalent of ascorbic acid, scavenging activity of the DPPH radical with 41,36 % of scavenging, activity of reducing power with the maximum of 0,290 nm (50 % of vitamin C activity) and scavenging activity superoxide radical (O2-) with a maximum of 32,23 %. Chelating activity of metal less than 4% and scavenging activity of the radical hydroxyl (OH-) less than 2%. Time of activated partial tromboplastin (aPTT) doubling the time of coagulation from 20μg of and protrombin time (PT) was not present. The data indicate that PS from Halodule wrightii could be considered for future applications in medicine, food production or cosmetic industry