Short- and long-term efficacy and mechanism of action of tumescent suction curettage for axillary hyperhidrosis

BACKGROUND Axillary hyperhidrosis is a common and distressing problem interfering with the life of affected individuals. Currently, local surgery is the treatment of choice once conservative treatment has failed. OBJECTIVES To evaluate the clinical efficacy and safety of tumescent suction curettage (TSC) in treating axillary hyperhidrosis and to correlate it with histological markers. METHODS Thirty patients (17 females and 13 males, average age 29.9 years) underwent TSC. After tumescent anaesthesia, a suction cannula was inserted in the axilla on each side through two tiny incisions and subcutaneous tissue was removed by suction. We evaluated the clinical efficacy and complications, and in a subset of patients performed biopsies before surgery, as well as 1 month and 1 year after the operation. RESULTS In comparison with preoperative values, the sweat rate was diminished by 85% after 1 month, 71% after 6 months, 77% after 12 months and 61% after 24 months. The reduced efficacy with time was histologically correlated with an increase in the innervation, whereas the number of sweat glands continued to diminish. The majority of patients were satisfied with the operation but the satisfaction diminished with time. Patients with the highest preoperative sweat rates were the most satisfied after the intervention. CONCLUSION TSC is an effective and safe treatment for axillary hyperhidrosis. The long-term recurrence may be due to reinnervation.

Long-term outcomes following “presumed” total parathyroidectomy for secondary hyperparathyroidism of chronic kidney disease

Aim. The most efficacious surgical treatment for renal hyperparathyroidism is still subject of research. Considering its low incidence rate of long-term relapse, “presumed” total parathyroidectomy without autotrasplantation (TP) may be indicated for secondary hyperparathyroidism (2HPT) in patients with chronic kidney disease (CKD), not eligible for kidney transplantation. The aim of this study was to analyse the TP long-term results in 2HPT haemodialysis (HD) patients. Method. Between January 2004 and October 2009, 25 2HPT HD patients, not eligible for kidney transplantation, underwent TP of at least four parathyroid glands. Clinical status and intact parathyroid hormone (iPTH) serum levels were assessed intraoperatively and during a 36-month follow-up. Results. TP improved the typical clinical symptoms and a significant reduction of iPTH serum levels was achieved in each patient. Aparathyroidism was never observed; in case of severe postoperative hypocalcemia, hypocalcemic seizures were never reported and the long-term recurrence rate was 8%. Only one patient received a kidney transplantation. Postoperative cardiovascular events (hypertension, peripheral artery disease, arrhythmia, coronary or cerebrovascular disease) were observed in 32% of cases and mortality rate was 16%. Conclusions. Considering its low long-term relapse rate and the absence of postoperative aparathyroidism, TP may still be considered the treatment of choice in patients with aggressive forms of 2HPT or of advanced dialytic vintage, with no access to renal transplantation. In case of postoperative hypoparathyroidism, hypocalcaemia can be effectively managed by medical treatment.

Ethics in project management : some Aristotelian insights

Purpose My aim is to introduce, in the project management field, an Aristotelian ethics lens moving beyond the classical deontological and consequentialism approaches underlying the current ethical practices and codes of ethics and professional conducts. In doing so, I wish to pose the premises of a debate on the implications of a conscious ethical perspective for the structure and agency relationship within the project management field Design/methodology/approach Project management is a knowledge field on its own right. However the current perspectives applied to make sense and develop the field (modernism vs. postmodernism) leads to dichotomous thinking rather than recognizing the merits and contextual validity of both sides. I call for Aristotelian Ethics as a way of moving beyond this dichotomous thinking. I introduce briefly Aristotelian Ethics and its consequences in term of relation theory – practice, means and ends, facts and values, and finally politics (i.e. being part of a community of practitioners). Then I illustrate some consequences for the field taking PMI Code of Ethics and Professional Conduct and APM Code of Professional Conduct as supports for discussion Findings I suggest a need for revisiting and/or redesigning the codes of ethics and professional conducts for project management according to an Aristotelian perspective, in order to move beyond the normative limitations of classical deontological (conflict between competing duties, exemplified by PMI Code) or consequentialism (focusing on the "right" outcome to the detriment of duties, exemplified by APM Code) approaches (both, in fact, leading to a disconnection means and ends, and facts and values). This implicates shifting our view from the question "what is my duty?" to the questions "why should I undertake my duty?" and "how ought I act in this situation?" Practical implications Raising Professional Bodies, Industry and Education institutions awareness and consciousness and leading them to rethink about codes of ethics and the implications for the way they conceive practice and research, bodies of knowledge, credentialing, education... Originality/value To the best of my knowledge, this kind of discussion has not yet been conducted within the project management field, and considering the implication of project management in our life and for the well being of the society, an ethical debate may present some value(s)

Efficient minimax strategies for square loss games

We consider online prediction problems where the loss between the prediction and the outcome is measured by the squared Euclidean distance and its generalization, the squared Mahalanobis distance. We derive the minimax solutions for the case where the prediction and action spaces are the simplex (this setup is sometimes called the Brier game) and the \ell_2 ball (this setup is related to Gaussian density estimation). We show that in both cases the value of each sub-game is a quadratic function of a simple statistic of the state, with coefficients that can be efficiently computed using an explicit recurrence relation. The resulting deterministic minimax strategy and randomized maximin strategy are linear functions of the statistic.

ESR studies of phase transitions in double propionates

Detailed ESR investigations of Mn2+ substituting for Ca2+ in Ca2Sr(C2H5COO)6 (DSP), Ca2Pb(C2H5COO)6 (DLP) and Ca2Ba(C2H5COO)6 (DBP), in single crystals and powders, over the temperature range from 200°C to -180°C have been carried out to study the successive phase transitions in these compounds. (DSP: [Tetragonal] ← 8.5°C → [tetragonal, ferroelectric] [tetragonal] ← -169°C → [monoclinic, ferroelectric]; DLP : [tetragonal] ← 60°C → [tetragonal, ferroelectric] ← -71.5°C → [monoclinic, ferroelectric]; [Cubic] ← -6°C → [orthorhombic] ← -75°C → [?]). Spectra have been analysed in terms of axial spin Hamiltonians and the temperature dependences of the parameters studied. In DSP and DLP across the I ↔ II transition, new physically and chemically inequivalent sites appear indicating the disappearance of the diad axes on which the propionate groups are located, bringing out the connection between the motional states of the propionate groups and the occurence of ferroelectricity. The II ↔ III transition also causes chemically inequivalent sites to develop, indicating that the transitions may not be isomorphous as believed previously. In DBP, the -6°C transition leads to (i) a doubling of both physically and chemically inequivalent sites (ii) a small (150 G at -6°C to 170 G at -8°C), but abrupt change in the magnitude of the zero-field splitting tensor D, and (iii) displacements of the orientations of the D tensors. Results are interpreted in terms of alternate rotations of the oxygen octahedra, showing participation of the carboxyl oxygens in the transition. No drastic changes in the parameters occur across the -75°C transition consistent with its second order nature. Similarities and dissimilarities of the ESR spectra of the three compounds in relation to the phase transitions, are discussed.

Isoperimetric Problem and Meta-fibonacci Sequences

Let G = (V,E) be a simple, finite, undirected graph. For S ⊆ V, let $\delta(S,G) = \{ (u,v) \in E : u \in S \mbox { and } v \in V-S \}$ and $\phi(S,G) = \{ v \in V -S: \exists u \in S$ , such that (u,v) ∈ E} be the edge and vertex boundary of S, respectively. Given an integer i, 1 ≤ i ≤ ∣ V ∣, the edge and vertex isoperimetric value at i is defined as b e (i,G) =  min S ⊆ V; |S| = i |δ(S,G)| and b v (i,G) =  min S ⊆ V; |S| = i |φ(S,G)|, respectively. The edge (vertex) isoperimetric problem is to determine the value of b e (i, G) (b v (i, G)) for each i, 1 ≤ i ≤ |V|. If we have the further restriction that the set S should induce a connected subgraph of G, then the corresponding variation of the isoperimetric problem is known as the connected isoperimetric problem. The connected edge (vertex) isoperimetric values are defined in a corresponding way. It turns out that the connected edge isoperimetric and the connected vertex isoperimetric values are equal at each i, 1 ≤ i ≤ |V|, if G is a tree. Therefore we use the notation b c (i, T) to denote the connected edge (vertex) isoperimetric value of T at i. Hofstadter had introduced the interesting concept of meta-fibonacci sequences in his famous book “Gödel, Escher, Bach. An Eternal Golden Braid”. The sequence he introduced is known as the Hofstadter sequences and most of the problems he raised regarding this sequence is still open. Since then mathematicians studied many other closely related meta-fibonacci sequences such as Tanny sequences, Conway sequences, Conolly sequences etc. Let T 2 be an infinite complete binary tree. In this paper we related the connected isoperimetric problem on T 2 with the Tanny sequences which is defined by the recurrence relation a(i) = a(i − 1 − a(i − 1)) + a(i − 2 − a(i − 2)), a(0) = a(1) = a(2) = 1. In particular, we show that b c (i, T 2) = i + 2 − 2a(i), for each i ≥ 1. We also propose efficient polynomial time algorithms to find vertex isoperimetric values at i of bounded pathwidth and bounded treewidth graphs.

Seismic Microzonation: Principles,Practices and Experiments

This paper presents an overview of the seismic microzonation and the grade/level based study along with methods used for estimating hazard. The principles of seismic microzonation along with some current practices are discussed. Summary of seismic microzonation experiments carried out in India is presented. A detailed work of seismic microzonation of Bangalore has been presented as a case study. In this case study, a seismotectonic map for microzonation area has been developed covering 350 km radius around Bangalore, India using seismicity and seismotectonic parameters of the region. For seismic microzonation Bangalore Mahanagar Palike (BMP) area of 220 km2 has been selected as the study area. Seismic hazard analysis has been carried out using deterministic as well as probabilistic approaches. Synthetic ground motion at 653 locations, recurrence relation and peak ground acceleration maps at rock level have been generated. A detailed site characterization has been carried out using borehole with standard penetration test (SPT) ―N‖ values and geophysical data. The base map and 3-dimensional sub surface borehole model has been generated for study area using geographical information system (GIS). Multichannel analysis of surface wave (MASW)method has been used to generate one-dimensional shear wave velocity profile at 58 locations and two- dimensional profile at 20 locations. These shear wave velocities are used to estimate equivalent shear wave velocity in the study area at every 5m intervals up to a depth of 30m. Because of wider variation in the rock depth, equivalent shear for the soil overburden thickness alone has been estimated and mapped using ArcGIS 9.2. Based on equivalent shear wave velocity of soil overburden thickness, the study area is classified as ―site class D‖. Site response study has been carried out using geotechnical properties and synthetic ground motions with program SHAKE2000.The soil in the study area is classified as soil with moderate amplification potential. Site response results obtained using standard penetration test (SPT) ―N‖ values and shear wave velocity are compared, it is found that the results based on shear wave velocity is lower than the results based on SPT ―N‖ values. Further, predominant frequency of soil column has been estimated based on ambient noise survey measurements using instruments of L4-3D short period sensors equipped with Reftek 24 bit digital acquisition systems. Predominant frequency obtained from site response study is compared with ambient noise survey. In general, predominant frequencies in the study area vary from 3Hz to 12Hz. Due to flat terrain in the study area, the induced effect of land slide possibility is considered to be remote. However, induced effect of liquefaction hazard has been estimated and mapped. Finally, by integrating the above hazard parameters two hazard index maps have been developed using Analytic Hierarchy Process (AHP) on GIS platform. One map is based on deterministic hazard analysis and other map is based on probabilistic hazard analysis. Finally, a general guideline is proposed by bringing out the advantages and disadvantages of different approaches.

Seismic Microzonation of Bangalore - Preliminary Maps

This paper presents an overview of the seismic microzonation and the grade/level based study along with methods used for estimating hazard. The principles of seismic microzonation along with some current practices are discussed. Summary of seismic microzonation experiments carried out in India is presented. A detailed work of seismic microzonation of Bangalore has been presented as a case study. In this case study, a seismotectonic map for microzonation area has been developed covering 350 km radius around Bangalore, India using seismicity and seismotectonic parameters of the region. For seismic microzonation Bangalore Mahanagar Palike (BMP) area of 220 km2 has been selected as the study area. Seismic hazard analysis has been carried out using deterministic as well as probabilistic approaches. Synthetic ground motion at 653 locations, recurrence relation and peak ground acceleration maps at rock level have been generated. A detailed site characterization has been carried out using borehole with standard penetration test (SPT) ―N‖ values and geophysical data. The base map and 3-dimensional sub surface borehole model has been generated for study area using geographical information system (GIS). Multichannel analysis of surface wave (MASW)method has been used to generate one-dimensional shear wave velocity profile at 58 locations and two- dimensional profile at 20 locations. These shear wave velocities are used to estimate equivalent shear wave velocity in the study area at every 5m intervals up to a depth of 30m. Because of wider variation in the rock depth, equivalent shear for the soil overburden thickness alone has been estimated and mapped using ArcGIS 9.2. Based on equivalent shear wave velocity of soil overburden thickness, the study area is classified as ―site class D‖. Site response study has been carried out using geotechnical properties and synthetic ground motions with program SHAKE2000.The soil in the study area is classified as soil with moderate amplification potential. Site response results obtained using standard penetration test (SPT) ―N‖ values and shear wave velocity are compared, it is found that the results based on shear wave velocity is lower than the results based on SPT ―N‖ values. Further, predominant frequency of soil column has been estimated based on ambient noise survey measurements using instruments of L4-3D short period sensors equipped with Reftek 24 bit digital acquisition systems. Predominant frequency obtained from site response study is compared with ambient noise survey. In general, predominant frequencies in the study area vary from 3Hz to 12Hz. Due to flat terrain in the study area, the induced effect of land slide possibility is considered to be remote. However, induced effect of liquefaction hazard has been estimated and mapped. Finally, by integrating the above hazard parameters two hazard index maps have been developed using Analytic Hierarchy Process (AHP) on GIS platform. One map is based on deterministic hazard analysis and other map is based on probabilistic hazard analysis. Finally, a general guideline is proposed by bringing out the advantages and disadvantages of different approaches.

Interações iniciais mãe-bebê: uma comparação entre díades de bebês prematuros e nascidos a termo

O estudo das interações iniciais entre mãe e bebê é fundamental para a compreensão da ontogênese humana (Seidl-de-Moura, et al., 2008) e para ajudar a promover a saúde relacional da díade. Nos estudos sobre as interações inicias entre mãe e bebê prematuro, ainda há um questionamento sobre se o nascimento prematuro e a internação em uma UTI-Neonatal fortalecem ou enfraquecem as trocas entre os membros da díade. Assim, neste estudo observou-se e analisou-se as interações iniciais entre mãe e bebê prematuro na UTI-Neonatal, observou o desenvolvimento das interações ao longo de dois meses, e comparou com interações de um grupo de mães-bebês nascidos a termo, de acordo com categorias predefinidas para a análise de vídeos. Também analisou, através de entrevistas, as características que as mães de cada tipo de díade relataram sobre seus filhos, bem como as metas de desenvolvimento apontadas e as emoções que expressaram em relação ao bebê. Participaram da pesquisa 20 díades mãe-bebê de nascidos a termo, e 20 díades de mãebebê de prematuros, nascidos entre 28 e 36 semanas de idade gestacional. Entre outras evidências, enquanto os bebês estavam na UTI-Neonatal, foram encontradas associações significativas entre as características maternas e as do bebê. Após a alta hospitalar, houve associações significativas entre a sincronia da díade e os comportamentos dos bebês. Não houve diferenças significativas entre as características de interações quando a díade estava na UTI-Neonatal e após dois meses. Não foram observadas diferenças significativas entre as díades de mães-bebês prematuros e mães-bebês a termo em relação à sincronia da díade, nem tampouco entre os comportamentos maternos nos dois momentos de observação, mas uma diferença significativa foi encontrada entre os comportamentos autorregulatórios dos bebês nascidos a termo e os dos prematuros. Verificou-se que para os dois grupos de mães, as emoções mais frequentemente relatadas foram as de amor e apego. As metas de desenvolvimento mais apontadas enquanto as mães estavam com seu bebê na UTI-Neonatal foram voltadas para o desenvolvimento físico do bebê, e quando os bebês estavam com dois meses, as metas eram mais voltadas para o desenvolvimento emocional, da mesma forma como ocorreu com as mães de bebês a termo. As características mais apontadas pelas mães ao pensarem em seus bebês enquanto eles estavam na UTI-Neonatal foram as físicas, enquanto após a alta, foram as pessoais e emocionais, assim como ocorreu com as mães de bebês nascidos a termo. Os resultados se contrapõem a afirmações de que em episódios de interação as mães de prematuros são menos sensitivas, mais intrusivas, e seus bebês, menos atentos e responsivos. Apontaram, ao contrário, para uma certa continuidade entre o que se observou na UTI-Neonatal e aos dois meses. Também não foram identificadas diferenças significativas na maioria das características de interações entre mães e bebês prematuros e mães e bebês nascidos a termo. Assim, tais resultados suavizam possíveis estigmatizações sobre estas mães e apontam a importância de se fortalecer essa relação na UTI-Neonatal através de estratégias de promoção de saúde.

On continued culture trials of Lates calcarifer (Bloch) and Oreochromis mossambicus in the ponds of Kharland Research Station, Panvel, Maharashtra

Pond culture trials of Lates calcarifer (Bloch) were initiated in the ponds of Kharland Research Station, Panvel, from 1985 up to 1989 by adopting varying methods of inputs of commonly available organic substances comprising de-oiled cake of groundnut, rice bran and raw cattle dung. Although provision of zooplankton generated under phased fertilisation technique resulted in considerable yield level, subsequent trials in combination with direct feed methods gave higher yield. Trials during 1990-91 adopting similar feed input techniques were continued but by stocking the seed of both Lates and Oreochromis mossambicus with yield percentage around 72.23 for Lates and 27.73 for Oreochromis. Trials were further continued during next three years. In relation to the organic input levels the yields rate for seven months period was in the range of 119.4 kg/ha to 250.4 kg/ha for Lates. In case of Oreochromis the yield rate varied between 28.5 to 153.32 kg/ha indicating the influence of differential stocking rates and size of the seed of two species.

Eigenmodes of lined flow ducts with rigid splices

This paper presents an analytic expression for the acoustic eigenmodes of a cylindrical lined duct with rigid axially running splices in the presence of flow. The cylindrical duct is considered to be uniformly lined except for two symmetrically positioned axially running rigid liner splices. An exact analytic expression for the acoustic pressure eigenmodes is given in terms of an azimuthal Fourier sum, with the Fourier coefficients given by a recurrence relation. Since this expression is derived using a Greens function method, the completeness of the expansion is guaranteed. A numerical procedure is described for solving this recurrence relation, which is found to converge exponentially with respect to number of Fourier terms used and is in practice quick to compute; this is then used to give several numerical examples for both uniform and sheared mean flow. An asymptotic expression is derived to directly calculate the pressure eigenmodes for thin splices. This asymptotic expression is shown to be quantitatively accurate for ducts with very thin splices of less than 1 % unlined area and qualitatively helpful for thicker splices of the order of 6 % unlined area. A thin splice is in some cases shown to increase the damping of certain acoustic modes. The influences of thin splices and thin boundary layers are compared and found to be of comparable magnitude for the parameters considered. Trapped modes at the splices are also identified and investigated. © 2011 Cambridge University Press.

Improved energy efficiency in paper making through reducing dryer steam consumption using advanced process control

Over the last two or three years, the increasing costs of energy and worsening market conditions have focussed even greater attention within paper mills than before, on considering ways to improve efficiency and reduce the energy used in paper making. Arising from a multivariable understanding of paper machine operation, Advanced Process Control (APC) technology enables paper machine behaviour to be controlled in a more coherent way, using all the variables available for control. Furthermore, with the machine under better regulation and with more variables used in control, there is the opportunity to optimise machine operation, usually providing very striking multi-objective performance improvement benefits of a number of kinds. Traditional three term control technology does not offer this capability. The paper presents results from several different paper machine projects we have undertaken around the world. These projects have been aimed at improving machine stability, optimising chemicals usage and reducing energy use. On a brown paperboard machine in Australasia, APC has reduced specific steam usage by 10%, averaged across the grades; the controller has also provided a significant capacity to increase production. On a North American newsprint machine, the APC system has reduced steam usage by more than 10%, and it provides better control of colour and much improved wet end stability. The paper also outlines early results from two other performance improvement projects, each incorporating a different approach to reducing the energy used in paper making. The first of these two projects is focussed on optimising sheet drainage, aiming to present the dryer with a sheet having higher solids content than before. The second project aims to reduce specific steam usage by optimising the operation of the dryer hood.

Prawda - istina w horyzoncie anthropos w myśli rosyjskiego renesansu religijno-filozoficznego

Wydział Nauk Społecznych: Instytut Filozofii

Using stimulus equivalence to teach monetary skills to school-age children with autism

The present study evaluated the use of stimulus equivalence in teaching monetary skills to school aged children with autism. An AB within-subject design with periodic probes was used. At pretest, three participants demonstrated relation DA, an auditory-visual relation (matching dictated coin values to printed coin prices). Using a three-choice match-to-sample procedure, with a multi-component intervention package, these participants were taught two trained relations, BA (matching coins to printed prices) and CA (matching coin combinations to printed prices). Two participants achieved positive tests of equivalence, and the third participant demonstrated emergent performances with a symmetric and transitive relation. In addition, two participants were able to show generalization of learned skills with a parent, in a second naturalistic setting. The present research replicates and extends the results of previous studies by demonstrating that stimulus equivalence can be used to teach an adaptive skill to children with autism.

Developing a numerical inverse-theory-based extraction of orientation-dependent relaxation rates from partially- relaxed spectra

Second-rank tensor interactions, such as quadrupolar interactions between the spin- 1 deuterium nuclei and the electric field gradients created by chemical bonds, are affected by rapid random molecular motions that modulate the orientation of the molecule with respect to the external magnetic field. In biological and model membrane systems, where a distribution of dynamically averaged anisotropies (quadrupolar splittings, chemical shift anisotropies, etc.) is present and where, in addition, various parts of the sample may undergo a partial magnetic alignment, the numerical analysis of the resulting Nuclear Magnetic Resonance (NMR) spectra is a mathematically ill-posed problem. However, numerical methods (de-Pakeing, Tikhonov regularization) exist that allow for a simultaneous determination of both the anisotropy and orientational distributions. An additional complication arises when relaxation is taken into account. This work presents a method of obtaining the orientation dependence of the relaxation rates that can be used for the analysis of the molecular motions on a broad range of time scales. An arbitrary set of exponential decay rates is described by a three-term truncated Legendre polynomial expansion in the orientation dependence, as appropriate for a second-rank tensor interaction, and a linear approximation to the individual decay rates is made. Thus a severe numerical instability caused by the presence of noise in the experimental data is avoided. At the same time, enough flexibility in the inversion algorithm is retained to achieve a meaningful mapping from raw experimental data to a set of intermediate, model-free