Impacto de dos técnicas quirúrgicas sobre la recaída local de carcinoma de mama en pacientes de una clínica de Bogotá D.C.

Introducción: El carcinoma de mama es el tumor maligno más frecuente entre las mujeres y representa una significativa mortalidad en los países en vías de desarrollo. Según datos del Instituto Nacional de Cancerología en el 2010 se reportaron 672 nuevos casos de cáncer de mama, lo que representó el 18% de todos los tumores malignos en mujeres. Durante las últimas 3 décadas las técnicas quirúrgicas para el tratamiento del cáncer de mama han presentado un cambio significativo y proponen disminución de procedimientos agresivos y radicales, intervenciones como: mastectomía radical modificada, cirugía conservadora y la disección de ganglio centinela son ejemplos claros de esta evolución asociado al incremento de la reconstrucción mamaria inmediata. Metodología: Estudio observacional tipo cohorte retrospectivo en el cual se revisó una base de datos de pacientes con cáncer de mama de las cuales 632 fueron sometidas a mastectomía radical con preservación de piel y complejo areola-pezón y mastectomía radical con preservación de piel sin preservación del complejo areola-pezón, los dos procedimientos asociados a reconstrucción mamaria inmediata y se comparó la frecuencia de recaída local entre los dos grupos. Resultados: De las 632 pacientes estudiadas al 30.5% se les realizo preservación del complejo areola pezón. Las mujeres a quienes se les realizó preservación del complejo areola pezón presentaron menor sobrevida a la recaída local a 10 años (80.51%) comparado con las mujeres a quienes no se les preservó el complejo areola pezón (87.40%), sin embargo no se encontró diferencia estadísticamente significativa para determinar que las probabilidades de sobrevida sean diferentes. Discusión: No se evidenció diferencia estadísticamente significativa entre los 2 procedimientos quirúrgicos (con y sin preservación del complejo areola pezón) en relación a la recaída local, estudios retrospectivos no han evidenciado una mayor tasa de recaídas locales en pacientes a quienes se les preserva el complejo areola-pezón, sin embargo hacen falta estudios prospectivos y aleatorizados que puedan otorgar un mayor sustento científico que garantice la seguridad de la preservación del complejo areola-pezón.

Aplicació d'algoritmes genètics en l'optimització dels processos de fabricació del paper

La creciente preocupación y concienciación de la sociedad respecto el medio ambiente, y en consecuencia la legislación y regulaciones generadas inducen a la modificación de los procesos productivos existentes en la industria química. Las configuraciones iniciales deben modificarse para conseguir una mayor integración de procesos. Para este fin se han creado y desarrollado diferentes metodologías que deben facilitar la tarea a los responsables del rediseño. El desarrollo de una metodología y herramientas complementarias es el principal objetivo de la investigación aquí presentada, especialmente centrada en el desarrollo y la aplicación de una metodología de optimización de procesos. Esta metodología de optimización se aplica sobre configuraciones de proceso existentes y pretende encontrar nuevas configuraciones viables según los objetivos de optimización fijados. La metodología tiene dos partes diferenciadas: la primera se basa en un simulador de procesos comercial y la segunda es la técnica de optimización propiamente dicha. La metodología se inicia con la elaboración de una simulación convenientemente validada que reproduzca el proceso existente, en este caso una papelera no integrada que produce papel estucado de calidad, para impresión. A continuación la técnica de optimización realiza una búsqueda dentro del dominio de los posibles resultados, en busca de los mejores resultados que satisfazcan plenamente los objetivos planteados. Dicha técnica de optimización está basada en los algoritmos genéticos como herramienta de búsqueda, junto a un subprograma basado en técnicas de programación matemática para el cálculo de resultados. Un número reducido de resultados son finalmente escogidos y utilizados para modificar la simulación existente fijando la redistribución de los flujos del proceso. Los resultados de la simulación del proceso determinan en último caso la viabilidad técnica de cada reconfiguración planteada. En el proceso de optimización, los objetivos están definidos en una función objetivo dentro de la técnica de optimización. Dicha función rige la búsqueda de resultados. La función objetivo puede ser individual o una combinación de objetivos. En el presente caso, la función persigue una minimización del consumo de agua y una minimización de la pérdida de materia prima. La optimización se realiza bajo restricciones para alcanzar este objetivo combinado en forma de una solución de compromiso. Producto de la aplicación de esta metodología se han obtenido resultados interesantes que significan una mejora del cierre de circuitos y un ahorro de materia prima, sin comprometer al mismo tiempo la operabilidad del proceso producto ni la calidad del papel.

Invasive neural prosthesis for neural signal detection and nerve stimulation

This paper specifically examines the implantation of a microelectrode array into the median nerve of the left arm of a healthy male volunteer. The objective was to establish a bi-directional link between the human nervous system and a computer, via a unique interface module. This is the first time that such a device has been used with a healthy human. The aim of the study was to assess the efficacy, compatibility, and long term operability of the neural implant in allowing the subject to perceive feedback stimulation and for neural activity to be detected and processed such that the subject could interact with remote technologies. A case study demonstrating real-time control of an instrumented prosthetic hand by means of the bi-directional link is given. The implantation did not result in infection, and scanning electron microscope images of the implant post extraction have not indicated significant rejection of the implant by the body. No perceivable loss of hand sensation or motion control was experienced by the subject while the implant was in place, and further testing of the subject following the removal of the implant has not indicated any measurable long term defects. The implant was extracted after 96 days. Copyright © 2004 John Wiley & Sons, Ltd.

The application of implant technology for cybernetic systems

Objective: To assess the usefulness, compatibility, and long-term operability of a microelectrode array into the median nerve of the left arm of a healthy volunteer, including perception of feedback stimulation and operation of an instrumented prosthetic hand. Setting: The study was carried out from March 14 through June 18, 2002, in England and the United States. Results: The blindfolded subject received feedback information, obtained from force and slip sensors on the prosthetic hand, and subsequently used the implanted device to control the hand by applying an appropriate force to g rip an unseen object. Operability was also demonstrated remotely via the Internet, with the subject in New York, NY, and the prosthetic hand in Reading, England. Finally, the subject was able to control an electric wheelchair, via decoded signals from the implant device, to select the direction of travel by opening and closing his hand. The implantation did not result in infection or any perceivable loss of hand sensation or motion control. The implant was finally extracted because of mechanical fatigue of the percutaneous connection. Further testing after extraction has not indicated any measurable long-term defects in the subject. Conclusions: This implant may allow recipients to have abilities they would otherwise not possess. The response to stimulation improved considerably during the trial, suggesting that the subject learned to process the incoming information more effectively.

Terrestrial ecosystems from space: a review of earth observation products for macroecology applications

Aim Earth observation (EO) products are a valuable alternative to spectral vegetation indices. We discuss the availability of EO products for analysing patterns in macroecology, particularly related to vegetation, on a range of spatial and temporal scales. Location Global. Methods We discuss four groups of EO products: land cover/cover change, vegetation structure and ecosystem productivity, fire detection, and digital elevation models. We address important practical issues arising from their use, such as assumptions underlying product generation, product accuracy and product transferability between spatial scales. We investigate the potential of EO products for analysing terrestrial ecosystems. Results Land cover, productivity and fire products are generated from long-term data using standardized algorithms to improve reliability in detecting change of land surfaces. Their global coverage renders them useful for macroecology. Their spatial resolution (e.g. GLOBCOVER vegetation, 300 m; MODIS vegetation and fire, ≥ 500 m; ASTER digital elevation, 30 m) can be a limiting factor. Canopy structure and productivity products are based on physical approaches and thus are independent of biome-specific calibrations. Active fire locations are provided in near-real time, while burnt area products show actual area burnt by fire. EO products can be assimilated into ecosystem models, and their validation information can be employed to calculate uncertainties during subsequent modelling. Main conclusions Owing to their global coverage and long-term continuity, EO end products can significantly advance the field of macroecology. EO products allow analyses of spatial biodiversity, seasonal dynamics of biomass and productivity, and consequences of disturbances on regional to global scales. Remaining drawbacks include inter-operability between products from different sensors and accuracy issues due to differences between assumptions and models underlying the generation of different EO products. Our review explains the nature of EO products and how they relate to particular ecological variables across scales to encourage their wider use in ecological applications.

The Open Provenance Model Core Specification (v1.1)

The Open Provenance Model is a model of provenance that is designed to meet the following requirements: (1) To allow provenance information to be exchanged between systems, by means of a compatibility layer based on a shared provenance model. (2) To allow developers to build and share tools that operate on such a provenance model. (3) To define provenance in a precise, technology-agnostic manner. (4) To support a digital representation of provenance for any 'thing', whether produced by computer systems or not. (5) To allow multiple levels of description to coexist. (6) To define a core set of rules that identify the valid inferences that can be made on provenance representation. This document contains the specification of the Open Provenance Model (v1.1) resulting from a community-effort to achieve inter-operability in the Provenance Challenge series.

Planejamento balanceado - PB elaboração e implementação de um sistema de gestão estratégica que integra as técnicas do planejamento estratégico com o Balanced Scorecard

Este trabalho propõe um critério estruturado de elaboração, implementação e operacionalização de um Sistema de Gestão Estratégica definido como Planejamento Balanceado, o qual é resultado do uso de conceitos do Planejamento Estratégico, adaptados a partir das obras de autores como Pagnoncelli e Vasconcellos (1992), Lobato (1997), entre outros e, aliando na seqüência deste, o uso do Balanced Scorecard de Kaplan e Norton (1997) para estabelecer as “Relações de Causa-e-efeito” entre as Estratégias e definir um processo sistemático para implementar e obter feedback sobre as mesmas, contribuindo assim para que a organização fique alinhada e focalizada na implementação e operacionalização das estratégias elaboradas.

Valorização dos gases da carbonização da madeira via rota de combustão

A produção de carvão vegetal a partir de florestas plantadas mudou de forma determinante a logística desta atividade dotando-a de escala e fixando a estrutura de produção composta por fornos e periféricos. A lógica de se ter os fornos construídos ao lado das frentes de exploração florestal, e se deslocando junto com ela à medida em que a colheita é realizada foi abandonada. A partir de então, tem-se buscado uma forma de aproveitar a disponibilidade energética contida nos gases da carbonização, que segue sem uso, tendo quando muito um aproveitamento incipiente e marginal. Esta dissertação apresenta uma proposta de lay out para a Unidade de Produção de Carvão (UPC) de fornos retangulares tradicionais em alvenaria projetados e posicionados de forma a possibilitar seu acoplamento a um sistema de coleta e queima dos gases da carbonização. Após exaustiva pesquisa bibliográfica e visitas técnicas para conhecimento de diferentes tecnologias de carbonização, elaborou-se o projeto, com objetivo de eliminar as limitações identificadas nas tecnologias tradicionais em uso atualmente pelas empresas com produção em escala industrial, reduzindo as perdas e dificuldades operacionais para aproveitamento dos gases. É caracterizado pela saída dos gases somente por uma chaminé instalada no fundo do forno, possui entradas de ar do processo em minicâmaras, que atuam evitando excesso de ar, queima excessiva de madeira e consequente geração excessiva de CO2 e metano – dois gases causadores de efeito estufa. Preconiza-se a queima dos gases da carbonização para uso posterior em geração de energia elétrica e/ou secagem da madeira antes da carbonização. Os resultados dos indicadores técnicos (ciclos dos fornos e produtividade, etc.) e de produção obtidos até o momento na planta em operação vêm confirmando a operacionalidade do conjunto de fornos na nova disposição concebida. Não houve perda de produtividade dos fornos causada pela nova disposição, e as modificações no projeto do forno não impactaram negativamente em seu desempenho operacional. A capacidade produtiva da Unidade vem se confirmando até o momento. Tivemos frustradas nossas expectativas de já apresentar nesta dissertação os resultados operacionais dos fornos juntamente com os do sistema de queima dos gases dado que houve considerável atraso na construção do mesmo impedindo-nos de tê-los antes da data limite de entrega da dissertação. Apresentamos os conceitos que nos levaram à tomada de decisão para o novo lay out e propomos a continuidade dos estudos comprobatórios da viabilidade econômica operacional do sistema, tão logo ele entre em operação.

A política pública de segurança em Mossoró-RN: uma avaliação de processo da implantação da guarda civil (2009-2013)

The subject of public safety is part of the academic and popular discussions, due to several factors that act in society culminating in an increasing criminality. The importance of the evaluation of public policies in this context consists in a possible control tool, monitoring and necessary adjustments to the government to make the necessary changes. Given this reality, it is thought the research problem: how Mossoró (RN) city has implemented his public security policy? In general guideline of the research, we work with the following hypothesis: the own formulation of the National Policy of Public Safety there are elements that hinder the implementation of a public policy of municipal security in Mossoró. The objective of this research is to evaluate the existing security public policy in the city of Mossoró, by the elements that facilitate and/or hamper its implementation, through the actions of municipal government in the activities of the Mossoro Civil Guard (GCM). For this, a review of the implementation process was conducted, specifically its subprocesses of selection, training, and logistical or operational. Was used bibliographical research, documental primary and secondary, and field research, with conducting of interviews. It was found that with a staff of 197 guards, and with five years of creation, the actions developed by this institution refer to an early implementation of the municipal security policy. The guard has the basic pattern selection, part of function relocation and part of public tender. The formation occurs in an introductory way, however, not complete and specific, for the function performance. Its operability is limited by the number of existing effective and by the physical structure that has not matching the demand yet, which touches on the municipal budgetary reality of direct resource intended to safety. It was found the absence of a municipal plan of public security with principles, guidelines and goals that could direct the actions of the guard. It is concluded that despite of the implementation of the GCM Mossoró have not achieved, within the parameters of efficiency, efficacy and effectiveness have played their actions, projects and programs, it could trigger a process of opening for construction of a municipal security policy. As well as break with the paradigm of municipal actions just meant for surveillance of public property, interaction affirmative for the prevention of violence and crime

A envergadura constitucional da posse qualificada na desapropriação privada

The constitutionalisation of private relations is the central theme of this work. Approached him overcome the dichotomy between public and private, through functionalization to the constitutionalization of civil law. Research on the effectiveness of horizontal rights. Constitutional under the lens, we analyzed the tense relationship between possession and ownership desfuncionalizada functionalized. We realize that having qualified and gained autonomy, and mechanism of access to goods, in view of the status sheet minimum, and of accomplishment, materializing human dignity. Then, we investigated the expropriation of private ownership qualified as legislative intervention that ensures the enforcement of fundamental rights through the state-court. We face the legal, the constitutionality and the burden of this institute. Also operability that it gives the judge, the process of exercise, the object, issues related to the burden and assessment of damages, as well as the nature, timing and costs of transferring property. At the end, we point to the scarcity palace, as well as the need to repair lege ferenda. The methodological approach has been championed by legal dogmatics in its analytical aspect, as we explore concepts and correlate with our planning. In empirical connotation, we evaluated the normativity and applicability of our law courts. For the ultimate in normative vision, answers to the problems faced and perform the necessary propositions, based on the results from the conceptual and empirical analysis

Formatividade e interpretação: a filosofia estética de Luigi Pareyson

The concept of formativity, coined by Luigi Pareyson, is a key to the development of countless contemporary aesthetic studies. The aim of this dissertation is to present a deep understanding of the notion of Formativity and Interpretation, as evidenciated by the title Formativity and Interpretation: the aesthetical philosophy of Luigi Pareyson. The work Aesthetics - Theory of Formativity, first published in 1954, is considered a mark in the rebirth of aesthetics. In this dissertation, the concept of Formativity is examined as a component applicable to every human action, and not limited to pre-determined practices, nor referred to the application of preexisting. I ve performed an investigation of the triple concept of doing-inventing-interpreting, which simultaneously grounds Formativity. In the first section, Pareyson s Aesthetical Propaedeutic is presented; in the second, the Theory of Formativity: the aesthetical character of the whole human experience is analysed; and in the third chapter, The Aesthetical of Form and the Metaphysics of Figuration is related to the formativity character of the knowledge. Through this analysis, I ve intended to evidence how human operability can be understood as search and trial, figuration and invention, in the search for success. In this sense, this thesis seeks to present an interpretation of the idea of work-form, speculating the inexorability of invention and interpretation in an attempt to establish a new bottom line for the studies Pareyson s Aesthetics in Brazil

Quality of performance of the operation of sugarcane mechanized planting in day and night shifts

The sugarcane mechanized planting is becoming increasingly widespread in Brazil due to a higher operability and better working conditions offered to workers compared to other types of planting. Studies related to this topic are insufficient or scarce in Brazil. In this context, the aim of this study was to evaluate the operation quality of sugarcane mechanized planting in two operation shifts, by means of statistical process control. The mechanized planting was held on March 2012 and statistical design was completely randomized with two treatments, totaling 40 replications for the day shift and 40 replications for the night shift. The variables evaluated were: speed, engine rotation, engine oil pressure, water temperature of the engine, effective field capacity and the time consumption hourly and effective fuel. The use of statistical control charts showed that random intrinsic do not cause this process. The tractor alignment error showed outliers in the day and night shifts operations, indicating a possible delay in receiving the signal. The water temperature of the engine and the effective fuel consumption showed lower variability in nighttime operation with average values of 81°C and 22.66 L ha-1, respectively. The hourly fuel consumption had greater variability and consequently lower quality during the night of the operation, with an average consumption of 25.46 L h-1 while the day shift showed 26.86 L h-1.

Programa Escola da Família: gestão democrática nas escolas públicas paulistas?

Pós-graduação em Educação - IBRC

Dimensões de cavacos industriais de eucalipto e relações com polpação, resistência e morfologia de fibras na polpa

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A educação e o cuidado da criança: o que advogam os documentos políticos do Ministério da Educação para a educação infantil?

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)