A new large-caliber trocar for percutaneous endoscopic gastrostomy by the introducer technique in head and neck cancer patients

Background and study aims In many patients, percutaneous endoscopic gastrostomy (PEG) can be limited by digestive tract stenosis. PEG placement using an introducer is the safest alternative for this group of patients, but the available devices are difficult to implement and require smaller-caliber tubes. The aim of this study was to evaluate the modification of an introducer technique device for PEG placement with regard to the following: procedure feasibility, possibility of using a 20-Fr balloon gastrostomy tube, tube-related function and problems, complications, procedure safety, and mortality. Patients and methods Between March 2007 and February 2008, 30 consecutive patients with head and neck malignancies underwent introducer PEG placement with the modified device and gastropexy. Each patient was evaluated for 60 days after the procedure for the success of the procedure, infection, pain, complications, mortality, and problems with the procedure. Results The procedure was successful in all cases with no perioperative complications. No signs of stomal infection were observed using the combined infection score. The majority of patients experienced mild-to-moderate pain both in the immediate postoperative period and at 72 hours. One major early complication (3.3%) and two minor complications (6.7%) were observed. No procedure-related deaths occurred during the first 60 days after the procedure. Conclusion The device modification for PEG using the introducer technique is feasible, safe, and efficient in outpatients with obstructive head and neck cancer. In this series, it allowed the use of a larger-caliber tube with low complication rates and no procedure-related mortality.

Isolated osseous ovarian metaplasia: Case report

Background: Some ovarian metaplasias may contain bone or osteoid tissue. The most common tumors presenting these alterations are teratomas and mixed mesodermal tumors with heterologous elements. Case report: We report the case of a woman who, during gynecologic follow-up for chronic anovulation at the age of 31 years, presented a solid ovarian ultrasonographic image with calcifications. After laparoscopy and histological examination it was found to be an isolated ovarian osseous metaplasia. Conclusion: A rarely occurring condition, ovarian osseous metaplasia continues to be of uncertain clinical significance.

Renormalizing the kinetic energy operator in elementary quantum mechanics

In this paper, we consider solutions to the three-dimensional Schrodinger equation of the form psi(r) = u(r)/r, where u(0) not equal 0. The expectation value of the kinetic energy operator for such wavefunctions diverges. We show that it is possible to introduce a potential energy with an expectation value that also diverges, exactly cancelling the kinetic energy divergence. This renormalization procedure produces a self-adjoint Hamiltonian. We solve some problems with this new Hamiltonian to illustrate its usefulness.

Influence of endodontic sealers on the bond strength of carbon fiber posts

Objective: The aim of this study was to verify the influence of endodontic sealers on the bond strength of an adhesive system and a resin cement used for carbon posts cementation. Methods: Thirty extracted human premolars were instrumented and randomly divided into three groups according to the tested sealer: EndoFill, Sealapex, or EndoREZ. Specimens were stored at 37 degrees C. After 48 h, half of specimens were prepared to receive the post and the others after 7 days. The posts were cemented with Adper Single Bond/Rely X ARC and stored in distilled water at 37 degrees C for 7 days. After this period, the specimens were sectioned in three slices (coronal, middle, and apical). The push-out test was performed in a universal machine and the debonded area was examined in a stereomicroscope. Results: Data were submitted ANOVA and Tukey test (alpha = 0.05). The EndoFill showed lower bond strength than other sealers (p < 0.01). The EndoREZ sealer was statistically greater than other groups for coronal and middle portions and similar for apical portion (P > 0.05). Coronal and middle portions showed the best results for all groups, mainly when the canal preparation was performed after 48 h (p < 0.01). Mixed failure occurs with more frequency (55.6%) followed by failure in adhesive-dentin interface (34.4%) and adhesive-post interface (10.0%). Conclusion: The use of EndoREZ sealer promoted higher bond strength in root coronal and middle portions when carbon post was fixed with a resin cement. (C) 2007 Wiley Periodicals, Inc.

Prevalence of Adverse Life Events, Depression and Suicidal Thoughts and Behaviour among a Community Sample of Young People aged 15-24 Years

Objective: To provide prevalence data on several key mental health indicators for young people aged 15 to 24 years. Methods: A cross-sectional household survey, using telephone recruitment followed by a postal pencil-and-paper questionnaire. The overall response rate was 67.3%. Results: Difficulties with interpersonal relationships are common causes of distress for young people, in particular problems with parents, problems with friends and relationship break-ups. Depressive symptomatology is common among young people with approximately one in eight males and one in four females reporting current depressive symptomatology. One in three young people reported that they had had suicidal thoughts at some time in the past, 1.2% of young people reported that they had made a plan on how to kill themselves in the four-week period prior to completing the survey and 6.9% of young people reported that they had tried to kill themselves at some time during their life time (4.2% of males and 9.0% of females). Conclusions and implications: The prevalence figures for the various mental health indicators presented in this paper represent good baseline information upon which to examine the progress over time of interventions designed to improve the mental health of young people.

Assessing self- and peer-assessment: The students' views

Self- and peer-assessment are being used increasingly in higher education, to help assign grades to students' work and to help students to learn more effectively. However, in spite of this trend there is little in the published literature on how students view these methods. In this paper we present an analysis of the views of a large number of students (N = 233) who had just experienced self- and peer-feedback as part of one of their subjects. It is a rarely questioned commonplace in the literature that in order to gain benefit from peer and self-assessment schemes students first need training in the specific scheme being used; ideally they will play a role in devising the scheme. The intervention reported here, which involved a large (N = 233) group of students, included no such measures. The results show that students felt, nonetheless, that they benefited from the intervention. The results also present prima facie evidence that training or other measures to further involve the students in the peer and self-assessment scheme might be beneficial. Our analysis of students' views revealed eight general dimensions under which are grouped twenty higher order themes. The results both support and extend previous research and give a more detailed picture than previously available. The general dimensions found were: Difficult; Gained Better Understanding of Marking; Discomfort; Productive (including learning benefits and improved work); Problems with Implementation; Read Others' Work; Develop Empathy (with assessing staff); and, Motivation (especially motivation to impress peers). The practical implications of these findings are discussed.

The future of cognitive and behavioral therapies in the prevention and early management of psychosis: Opportunities and risks

Behavioral and cognitive interventions for people with psychosis have a long and distinguished history, although the evidence for their application to young people remains limited. We anticipate that the next decades will show substantial research into psychological intervention for this population. Important targets will include the management of environmental stressors, reduction of substance misuse, and promotion of early treatment. Psychological management of positive symptoms, depression, and suicidal behavior will continue to be critical objectives. Important secondary prevention goals will be the retention of cognitive functioning, vocational options, social skills, and social network support, including appropriate family support. We expect primary prevention to include both universal programs and interventions for adolescents at particularly high risk. Technical innovations will include increasing use of Internet-based intervention and behavior cueing devices. Pressures for intervention brevity will continue, as will problems with the systematic delivery of effective procedures.

Pediculus humanus capitis infestations in the community: A pilot study into transmission, treatment and factors affecting control

Head lice (Pediculus humanus capitis) infestations affect schoolchildren worldwide, creating social, economic and health consequences for families. Problems with self-detection, chronic infestations and classroom transmission are compounded by increasing resistance of the lice to pediculicides. Public health strategies are based on limited research and little is known about transmission dynamics. Mismanagement and transmission in the general community are blamed for control failure. The purpose of this study was to explore community head-lice experience in Brisbane, Australia, and to identify critical factors underlying control failure. A home-based pilot survey used physical examination to verify transmission and treatment patterns which were self-reported by a group of trace-contact families in addition to other unconnected participants. The survey was enlarged to further compare therapy outcomes and suspected risk factors. The findings reinforce those of previous studies - that children attending school and early childhood centres, and subsequently their families, are most at risk of contracting pediculosis capitis, and some may carry lice for years. First-line (pediculicidal) treatment and even additional physical methods of hand-picking and fine-toothed combing usually fail to eradicate lice quickly and completely (overall cure-rate 39 per cent, n = 84 cases). Failures were linked to hair characteristics. Public education alone may not control pediculosis. Accurate diagnosis requires considerable experience; a strong case exists for returning to institutional surveillance.

Combined hydraulic and biological modelling and full-scale validation of SBR process

The biological reactions during the settling and decant periods of Sequencing Batch Reactors (SBRs) are generally ignored as they are not easily measured or described by modelling approaches. However, important processes are taking place, and in particular when the influent is fed into the bottom of the reactor at the same time (one of the main features of the UniFed process), the inclusion of these stages is crucial for accurate process predictions. Due to the vertical stratification of both liquid and solid components, a one-dimensional hydraulic model is combined with a modified ASM2d biological model to allow the prediction of settling velocity, sludge concentration, soluble components and biological processes during the non-mixed periods of the SBR. The model is calibrated on a full-scale UniFed SBR system with tracer breakthrough tests, depth profiles of particulate and soluble compounds and measurements of the key components during the mixed aerobic period. This model is then validated against results from an independent experimental period with considerably different operating parameters. In both cases, the model is able to accurately predict the stratification and most of the biological reactions occurring in the sludge blanket and the supernatant during the non-mixed periods. Together with a correct description of the mixed aerobic period, a good prediction of the overall SBR performance can be achieved.

Patterns of resistance to angular leaf spot, anthracnose and common bacterial blight in common bean germplasm

Diseases and insect pests are major causes of low yields of common bean (Phaseolus vulgaris L.) in Latin America and Africa. Anthracnose, angular leaf spot and common bacterial blight are widespread foliar diseases of common bean that also infect pods and seeds. One thousand and eighty-two accessions from a common bean core collection from the primary centres of origin were investigated for reaction to these three diseases. Angular leaf spot and common bacterial blight were evaluated in the field at Santander de Quilichao, Colombia, and anthracnose was evaluated in a screenhouse in Popayan, Colombia. By using the 15-group level from a hierarchical clustering procedure, it was found that 7 groups were formed with mainly Andean common bean accessions (Andean gene pool), 7 groups with mainly Middle American accessions (Middle American gene pool), while 1 group contained mixed accessions. Consistent with the theory of co-evolution, it was generally observed that accessions from the Andean gene pool were resistant to Middle American pathogen isolates causing anthracnoxe, while the Middle American accessions were resistant to pathogen isolates from the Andes. Different combinations of resistance patterns were found, and breeders can use this information to select a specific group of accessions on the basis of their need.

Risk and protective factors for depressive symptomatology among a community sample of adolescents and young adults

Objectives: The study explores the risk and protective factors for current depressive symptomatology in a large community sample of 15-to-24-year-olds. Methods: The study was designed as a cross-sectional household survey, which used telephone recruitment followed by an anonymous self-report postal questionnaire. The final sample included 3,082 adolescents and young adults from Queensland, Australia. Results: The vast majority of measured risk and protective factors were associated with current depressive symptomatology. Key risk factors included high levels of neuroticism, perceived problems with parents, sexual abuse, relationship breakups, educational failure and sexual identity conflict. A different profile of protective factors was evident for each of these high-risk groups. Of particular note was the importance of well-developed intrapersonal skills as protective for both males and females. The significance of social connectedness as a protective factor for the males overall and across a range of high-risk groups was a central finding. Conclusions and implications: The implications of these findings in relation to a range of mental health promotion and mental illness prevention and early intervention initiatives are discussed. Supported initiatives include parenting programs that consider the realities of modern families, increasing community awareness of the impact on young people of the breakdown of their intimate relationships, initiatives in educational settings and workplaces to increase tolerance of gay/lesbian and bisexual lifestyles and the enhancement of social connectedness.

Water table waves in an unconfined aquifer: Experiments and modeling

[1] Comprehensive measurements are presented of the piezometric head in an unconfined aquifer during steady, simple harmonic oscillations driven by a hydrostatic clear water reservoir through a vertical interface. The results are analyzed and used to test existing hydrostatic and nonhydrostatic, small-amplitude theories along with capillary fringe effects. As expected, the amplitude of the water table wave decays exponentially. However, the decay rates and phase lags indicate the influence of both vertical flow and capillary effects. The capillary effects are reconciled with observations of water table oscillations in a sand column with the same sand. The effects of vertical flows and the corresponding nonhydrostatic pressure are reasonably well described by small-amplitude theory for water table waves in finite depth aquifers. That includes the oscillation amplitudes being greater at the bottom than at the top and the phase lead of the bottom compared with the top. The main problems with respect to interpreting the measurements through existing theory relate to the complicated boundary condition at the interface between the driving head reservoir and the aquifer. That is, the small-amplitude, finite depth expansion solution, which matches a hydrostatic boundary condition between the bottom and the mean driving head level, is unrealistic with respect to the pressure variation above this level. Hence it cannot describe the finer details of the multiple mode behavior close to the driving head boundary. The mean water table height initially increases with distance from the forcing boundary but then decreases again, and its asymptotic value is considerably smaller than that previously predicted for finite depth aquifers without capillary effects. Just as the mean water table over-height is smaller than predicted by capillarity-free shallow aquifer models, so is the amplitude of the second harmonic. In fact, there is no indication of extra second harmonics ( in addition to that contained in the driving head) being generated at the interface or in the interior.

Ensino primário e matemática dos imigrantes e descendentes germânicos em Santa Leopoldina (1857-1907)

O objetivo da pesquisa é descrever o cenário da imigração germânica no século XIX, tratando também, de trilhar o caminho da educação por meio de educadores e das comunidades na Colônia de Santa Leopoldina, criada em 1857, na Província do Espírito Santo, considerando 50 anos a partir do início da imigração (1857-1907). A pesquisa histórica ancorou-se em consultas a documentos oficiais do Império, documentos e relatórios oficiais dos Presidentes da Província do Espírito Santo, jornais de circulação da época, fotografias, mapas geográficos, mapas estatísticos, livros didáticos antigos e livros de autores que abordaram o processo imigratório do Espírito Santo. O diálogo com Marc Bloch ajudou a entender essa multiplicidade de documentos, na complexa relação entre o passado e o presente da educação do Espírito Santo. O trabalho apresenta uma trajetória do imigrante germânico vindo da Europa até a ex-colônia e como a administração da província tratou a imigração e a educação. O ensino primário iniciou-se a partir de iniciativas públicas e particulares. Foram identificados as primeiras escolas e os nomes de muitos professores que atuaram no período estudado. Os livros utilizados nas escolas das comunidades teuto-brasileiras eram oriundos da Alemanha e posteriormente foram produzidos no sul do Brasil. Entre os livros escritos em alemão encontrados destacam-se o livro texto de alfabetização „Lese – Schule I für Deutsche Kinder in Brasilien‟, editado na Alemanha no final do século XIX, de autoria do diretor de uma escola particular em Santa Leopoldina, Albert Richard Dietze, e o primeiro volume do livro de matemática „Rechenbuch für Deutsch-Brasilianische Volksschulen‟, de Ferdinand Hackbart, Konrad Glaus e Hermann Lange. Foi feita uma análise sob os aspectos físicos e formais, o processo de ensino e os conteúdos do livro de matemática. A análise evidenciou que a proposta de ensino apoia-se no “cálculo mental” e o escrito, com a repetição dos conteúdos, envolvendo o treino intensivo. Os conceitos de matemática são apresentados partindo de problemas com situações concretas do aluno para a aquisição de competências necessárias para inserir o aluno em sua comunidade. Levando-se em conta que o livro foi editado em 1906, conclui-se que se trata de uma obra relevante com uma proposta de ensino que se manteve presente nos livros didáticos de matemática até os dias atuais.

Initial growth of maize in response to application of rock phosphate, vermicompost and endophytic bacteria

Due to the high energy requirement and demand for non-renewable resources for the production of chemical fertilizers, added also to the environmental impact caused by the use of such products, it is important to intensify research on bio-based agricultural inputs. The use of nitrogen-fixing endophytic and phosphate solubilizing bacteria can provide these nutrients to the plants from the air and poorly soluble phosphorus sources, such as phosphate rock. The objective of this study was to evaluate the nutrition and initial growth of maize (Zea mays L.) in response to the inoculation of nitrogen-fixing and rock phosphate solubilizing endophytic bacteria, in single or mixed formulation, applied with vermicompost. The treatments containing bacteria, both diazotrophic and phosphate solubilizing, when compared to controls, showed higher levels of leaf nitrogen and phosphorus in maize, as well as higher growth characteristics. The application of vermicompost showed synergistic effect when combined with endophytic bacteria. Thus, the innovation of the combination of the studied factors may contribute to the early development of maize.

Self-optimization for dynamic scheduling in manufacturing systems

Scheduling is a critical function that is present throughout many industries and applications. A great need exists for developing scheduling approaches that can be applied to a number of different scheduling problems with significant impact on performance of business organizations. A challenge is emerging in the design of scheduling support systems for manufacturing environments where dynamic adaptation and optimization become increasingly important. In this paper, we describe a Self-Optimizing Mechanism for Scheduling System through Nature Inspired Optimization Techniques (NIT).