Laparoscopic versus open total mesorectal excision for stage I-III mid and low rectal cancer: a retrospective 5 years analysis

Introduction. Total mesorectal excision (TME) is the cornerstone of a correct surgical therapy for extraperitoneal rectal cancer. Aim of the study is to evaluate our 5 years experience confronting retrospectively laparoscopic (lap) TME in respect to its laparotomic (open) counterpart. Patients and Methods. 30 patients were treated laparoscopically for stage I-III extraperitoneal rectal cancer and retrospectively compared to a homogeneous group, stratified for sex, age, comorbidities and stage of disease. Results. 30 days mortality was zero for both groups, while morbidity was 20% for the lap group and 36.6% for the open group. Mean lymph nodes harvested was 24 ± 12 for the lap group, 26 ± 14 for the open group (p > 0.05). Five years overall and disease free survival was respectively 82.2% and 81.4% in the lap group, 79.9% and 79.6% in the open group, without statistical significance (p>0.05). Discussion. Minimally invasive TME resulted a safe, effective and oncologically adequate procedure when retrospectively compared to its laparotomic counterpart, with 5 years overall survival and disease free survival reaching no statistical significance compared to the open approach, but with all the advantages of the laparoscopy such as less pain and blood loss, faster recovery, less morbidity and better cosmetics. Conclusions. Our study has retrospectively demonstrated that laparoscopic TME is feasible and oncologically effective, even if it remains a complex minimally invasive procedure, requiring adequate skill. More prospective, randomized studies are necessary to define such a procedure as the new gold standard in treatment of stage I-III extraperitoneal rectal cancer.

Meta-cinematic cultism: between high and low culture

ABSTRACT - Meta-cinema can depict film viewers’ attitudes towards cinema and their type of devotion for films. One subcategory of viewers - which I call meta-spectators - is highly specialized in its type of consumption, bordering on obsession. I contend that there are two main varieties of meta-cinematic reception, not altogether incompatible with one another, despite their apparent differences. As both of them are depicted on meta-cinematic products, the films themselves are the best evidence of my typology. My categories of film viewers are the ‘cinephile’, an elite prone to artistic militancy and the adoration of filmic masters; and the ‘fan’, a low culture consumer keen on certain filmic universes and their respective figures and motifs. I will base my rationale on four films that portray such reception practices: Travelling Avant (Jean-Charles Tacchella, 1987, FRA), The Dreamers (Bernardo Bertolucci, 2003, UK/FRA/ITA); Free Enterprise (Robert Mayer Burnett, 1998, USA); Fanboys (2009, Kyle Newman, USA).

Modeling the distribution of crossovers and interference with mice DNA data

Chiasma and crossover are two related biological processes of great importance in the understanding genetic variation. The study of these processes is straightforward in organisms where all products of meiosis are recovered and can be observed. This is not the case in mammals. Our understanding of these processes depends on our ability to model them. In this study I describe the biological processes that underline chiasma and crossover as well as the two main inference problems associated with these processes: i) in mammals we only recover one of the four products of meiosis and, ii) in general, we do not observe where the crossovers actually happen, but we find an interval containing type-2 censored information. NPML estimate was proposed and used in this work and used to compare chromosome length and chromosome expansion through the crosses.

All-regime Lagrangian-Remap numerical schemes for the gas dynamics equations. Applications to the large friction and low Mach coefficients

In this talk, we propose an all regime Lagrange-Projection like numerical scheme for the gas dynamics equations. By all regime, we mean that the numerical scheme is able to compute accurate approximate solutions with an under-resolved discretization with respect to the Mach number M, i.e. such that the ratio between the Mach number M and the mesh size or the time step is small with respect to 1. The key idea is to decouple acoustic and transport phenomenon and then alter the numerical flux in the acoustic approximation to obtain a uniform truncation error in term of M. This modified scheme is conservative and endowed with good stability properties with respect to the positivity of the density and the internal energy. A discrete entropy inequality under a condition on the modification is obtained thanks to a reinterpretation of the modified scheme in the Harten Lax and van Leer formalism. A natural extension to multi-dimensional problems discretized over unstructured mesh is proposed. Then a simple and efficient semi implicit scheme is also proposed. The resulting scheme is stable under a CFL condition driven by the (slow) material waves and not by the (fast) acoustic waves and so verifies the all regime property. Numerical evidences are proposed and show the ability of the scheme to deal with tests where the flow regime may vary from low to high Mach values.

An investigation into the folding and assembly of engineered antibodies and novel antibody formats

Monoclonal antibodies and novel antibody formats are currently one of the principal therapeutic in the biopharmaceutical industry worldwide and are widely used in the treatment of autoimmune diseases and cancer. It is for this reason that the productivity and quality of antibody production requires improvement; specifically investigations into the engineering of antibodies and any issues that may arise from the production of these therapeutics. The work presented in this thesis describes an investigation into the folding and assembly of seven antibodies plus the novel antibody format FabFv. IgG is comprised of two identical HCs and two identical LCs. The folding process of immunoglobulin is controlled by the CH1 domain within the HC. The CH1 domain remains in a disordered state and is sequestered by BiP in the endoplasmic reticulum. Upon the addition of a folded CL domain, BiP is displaced, the CH1 domain is able to fold and the complete IgG protein can then be secreted from the cell. The results presented in this thesis however, have outlined an additional mechanism for the folding of the CH1 domain. We have shown that the CH1 domain is able to fold in the absence of LC resulting in the secretion of HC dimers in a VH dependent manner. The proposed mechanism for the secretion of HC dimers suggests that some VH domains can interact with each other in order to bring the CH1 domains in close proximity to enable folding to occur. As HC dimer secretion is a hindrance in antibody production, this result has highlighted an engineering target to improve antibody yield. Examination of the folding of IgG4 with the variable region A33 has revealed the inability to secrete LC dimers, cleavage of the HC during expression and secretion of HC dimers in the Fab, FabFv and full length forms. The attributes described have also been shown to be variable region dependent. This has introduced a new concept that the variable domain is important in determining the expression and secretion of antibodies and their individual chains. Pulse chase and 2D gel electrophoresis analysis of the novel antibody format FabFv has revealed that the folding and expression of the LC and HC causes multimeric species of FabFv to be secreted, as opposed to the monomeric form which is the desired therapeutic. Our hypothesis is that this process occurs via a LC dependent mechanism. The proposed hypothesis suggests that further engineering to the LC could diminish the formation and secretion of FabFv multimers. The results from these investigations can be applied to increase the productivity of therapeutics and increase the biological understanding of the domain interactions of IgG during folding, assembly and secretion.

Voice acoustic profi le of males exposed to occupational infrasound and low-frequency noise

Background: Vibroacoustic disease (VAD) is a systematic pathology characterized by the abnormal growth of extra-cellular matrices in the absence of infl ammatory processes, namely collagen and elastin, both of which are abundant in the basement membrane zone of the vocal folds. VAD can develop due to long-term exposure to infrasound and low-frequency noise (ILFN, <500 Hz). Mendes et al. (2006, 2008 and 2012) revealed that ILFN-exposed males and females presented an increased fundamental frequency (F0), decreased jitter %, and reduced maximum phonation frequency range, when compared with normative data. Temporal measures of maximum phonation time and S/Z ratio were generally reduced. Study Aims: Herein, the same voice acoustic parameters of 48 males, 36 airline pilots and 12 cabin crewmembers (age range 25-60 years) were studied, and the effects and interaction of age and years of ILFN exposure were investigated within those parameters. ILFN-exposure time (i.e. years of professional activity) ranged from 3.5 to 36 years. Materials and Methods: Spoken and sung phonatory tasks were recorded with a DA-P1 Tascam DAT and a C420III PP AKG head-worn microphone, positioned at 3 cm from the mouth. Acoustic analyses were performed using KayPENTAX Computer Speech Lab and Multi-Dimensional Voice Program. Results: Results revealed that even though pilots and cabin crewmembers were exposed to occupational environments with distinct (ILFN-rich) acoustical frequency distributions and sound pressure levels, differences in the vocal acoustic parameters were not evident. Analyzing data from both professional groups (N = 48) revealed that F0 increased signifi cantly with the number of years of professional activity. Conclusion: These results strongly suggest that the number of years of professional activity (i.e. total ILFN exposure time) had a signifi cant effect on F0. Furthermore, they may refl ect the histological changes specifi cally observed on the vocal folds of ILFN-exposed professionals.

Effects of Tityus serrulatus scorpion venom on lung mechanics and inflammation in mice

The present study evaluated the effects of an intramuscular injection of Tityus serrulatus venom (TsV) (0.67 mu g/g) on lung mechanics and lung inflammation at 15, 30, 60 and 180 min after inoculation. TsV inoculation resulted in increased lung elastance when compared with the control group (p < 0.001): these values were significantly higher at 60 min than at 15 and 180 min (p < 0.05). Resistive pressure (Delta P(1)) values decreased significantly at 30, 60 and 180 min after TsV injection (p < 0.001). TsV inoculation resulted in increased lung inflammation, characterised by an increased density of mononuclear cells at 15, 30, 60 and 180 min after TsV injection when compared with the control group (p < 0.001). TsV inoculation also resulted in an increased pulmonary density of polymorphonuclear cells at 15, 30 and 60 min following injection when compared to the control group (p < 0.001). In conclusion, T serrulatus venom leads to acute lung injury, characterised by altered lung mechanics and increased pulmonary inflammation. (C) 2009 Elsevier Ltd. All rights reserved.

Body image dissatisfaction and low self-esteem due to physical appeareance in students of the faculty of medicine at the university of los andes (mérida, venezuela)

The purpose of this investigation was to evaluate body image dissatisfaction in relation to low self-esteem due to physical appearance in students of the Faculty of Medicine at the University of Los Andes in Mérida, Venezuela.  It was a non-experimental and correlational study.  The sample included 189 students (27% male and 73% female) with an average age of 19.58 ± 1.57 (men: 19.81 years of age ± 1.74 and women: 20.24 years of age ± 1.76).  Participants were intentionally selected from first-year courses of the Medicine, Nursing and Nutrition programs.  The Body Shape Questionnaire (BSQ) (Cooper and Taylor, 1987) was the instrument used to measure body image dissatisfaction and Graffar’s modified method (Méndez and De Méndez, 1994) was applied to determine the participants’ socioeconomic status.  A descriptive analysis (frequency, percentages, mean) and an inferential analysis (one-way ANOVA) were applied to the data using SPSS (Statistical Package for Social Sciences) version 9.0.  One of the most important findings in this study was the determination of a statistically significant relationship between dissatisfaction and body image and between low self-esteem and gender χ2 (2, N= 189) = 9.686, p=0.008.  Using ANOVA also helped determine that differences in the mean for dissatisfaction and low self-esteem levels with body image and gender are statistically significant, F= 11.236; p=0.008, F=10.23; p=0.002, respectively.  Conclusions: results obtained suggest a relationship between dissatisfaction and low self-esteem due to physical appearance. Consequently, subjects reject their body image because of a distorted or undistorted perception of their physical appearance, which can possibly affect self-esteem.  Moreover, it is observed that the students’ psychological health is more related to their satisfaction with their body-image than to the way their body image is perceived. Consequently, this group of participants must be analyzed regarding their self-esteem due to body image, as an expression in the institutional environment.  It is also important to emphasize that gender may be a risk factor concerning eating disorders.  We believe the foregoing because women showed higher dissatisfaction levels because of their physical appearance being conditioned by a higher dissatisfaction with their perceived body image, which is characterized by an overestimation of the physical dimension of their body image.

Flow around a hemisphere-cylinder at high angle of attack and low Reynolds number. Part II: POD and DMD applied to reduced domains

Three-dimensional direct numerical simulations (DNS) have been performed on a finite-size hemispherecylinder model at angle of attack AoA = 20◦ and Reynolds numbers Re = 350 and 1000. Under these conditions, massive separation exists on the nose and lee-side of the cylinder, and at both Reynolds numbers the flow is found to be unsteady. Proper orthogonal decomposition (POD) and dynamic mode decomposition (DMD) are employed in order to study the primary instability that triggers unsteadiness at Re = 350. The dominant coherent flow structures identified at the lower Reynolds number are also found to exist at Re = 1000; the question is then posed whether the flow oscillations and structures found at the two Reynolds numbers are related. POD and DMD computations are performed using different subdomains of the DNS computational domain. Besides reducing the computational cost of the analyses, this also permits to isolate spatially localized oscillatory structures from other, more energetic structures present in the flow. It is found that POD and DMD are in general sensitive to domain truncation and noneducated choices of the subdomain may lead to inconsistent results. Analyses at Re = 350 show that the primary instability is related to the counter rotating vortex pair conforming the three-dimensional afterbody wake, and characterized by the frequency St ≈ 0.11, in line with results in the literature. At Re = 1000, vortex-shedding is present in the wake with an associated broadband spectrum centered around the same frequency. The horn/leeward vortices at the cylinder lee-side, upstream of the cylinder base, also present finite amplitude oscillations at the higher Reynolds number. The spatial structure of these oscillations, described by the POD modes, is easily differentiated from that of the wake oscillations. Additionally, the frequency spectra associated with the lee-side vortices presents well defined peaks, corresponding to St ≈ 0.11 and its few harmonics, as opposed to the broadband spectrum found at the wake.

Flow around a hemisphere-cylinder at high angle of attack and low Reynolds number. Part I: Experimental and numerical investigation

Three-dimensional Direct Numerical Simulations combined with Particle Image Velocimetry experiments have been performed on a hemisphere-cylinder at Reynolds number 1000 and angle of attack 20◦. At these flow conditions, a pair of vortices, so-called “horn” vortices, are found to be associated with flow separation. In order to understand the highly complex phenomena associated with this fully threedimensional massively separated flow, different structural analysis techniques have been employed: Proper Orthogonal and Dynamic Mode Decompositions, POD and DMD, respectively, as well as criticalpoint theory. A single dominant frequency associated with the von Karman vortex shedding has been identified in both the experimental and the numerical results. POD and DMD modes associated with this frequency were recovered in the analysis. Flow separation was also found to be intrinsically linked to the observed modes. On the other hand, critical-point theory has been applied in order to highlight possible links of the topology patterns over the surface of the body with the computed modes. Critical points and separation lines on the body surface show in detail the presence of different flow patterns in the base flow: a three-dimensional separation bubble and two pairs of unsteady vortices systems, the horn vortices, mentioned before, and the so-called “leeward” vortices. The horn vortices emerge perpendicularly from the body surface at the separation region. On the other hand, the leeward vortices are originated downstream of the separation bubble, as a result of the boundary layer separation. The frequencies associated with these vortical structures have been quantified.

High Pressure and Low Temperature Study of Ammonia Borane and Lithium Amidoborane

Hydrogen has been considered as a potentially efficient and environmentally friendly alternative energy solution. However, one of the most important scientific and technical challenges that the “hydrogen economy” faces is the development of safe and economically viable on-board hydrogen storage for fuel cell applications, especially to the transportation sector. Ammonia borane (BH3NH3), a solid state hydrogen storage material, possesses exceptionally high hydrogen content (19.6 wt%).However, a fairly high temperature is required to release all the hydrogen atoms, along with the emission of toxic borazine. Recently research interests are focusing on the improvement of H2 discharge from ammonia borane (AB) including lowering the dehydrogenation temperature and enhancing hydrogen release rate using different techniques. Till now the detailed information about the bonding characteristics of AB is not sufficient to understand details about its phases and structures. Elemental substitution of ammonia borane produces metal amidoboranes. Introduction of metal atoms to the ammonia borane structure may alter the bonding characteristics. Lithium amidoborane is synthesized by ball milling of ammonia borane and lithium hydride. High pressure study of molecular crystal provides unique insight into the intermolecular bonding forces and phase stability. During this dissertation, Raman spectroscopic study of lithium amidoborane has been carried out at high pressure in a diamond anvil cell. It has been identified that there is no dihydrogen bond in the lithium amidoborane structure, whereas dihydrogen bond is the characteristic bond of the parent compound ammonia borane. It has also been identified that the B-H bond becomes weaker, whereas B-N and N-H bonds become stronger than those in the parent compound ammonia borane. At high pressure up to 15 GPa, Raman spectroscopic study indicates two phase transformations of lithium amidoborane, whereas synchrotron X-ray diffraction data indicates only one phase transformation of this material. Pressure and temperature has a significant effect on the structural stability of ammonia borane. This dissertation explored the phase transformation behavior of ammonia borane at high pressure and low temperature using in situ Raman spectroscopy. The P-T phase boundary between the tetragonal (I4mm) and orthorhombic (Pmn21) phases of ammonia borane has been determined. The transition has a positive Clapeyron slope which indicates the transition is of exothermic in nature. Influence of nanoconfinemment on the I4mm to Pmn21 phase transition of ammonia borane was also investigated. Mesoporus silica scaffolds SBA-15 with pore size of ~8 nm and MCM-41 with pore size of 2.1-2.7 nm, were used to nanoconfine ammonia borane. During cooling down, the I4mm to Pmn21 phase transition was not observed in MCM-41 nanoconfined ammonia borane, whereas the SBA-15 nanocondfined ammonia borane shows the phase transition at ~195 K. Four new phases of ammonia borane were also identified at high pressure up to 15 GPa and low temperature down to 90 K.

The impact of recent educational reforms on minority and low achieving students and on minority and all high achieving students

One of the criticisms of the recent educational reforms sweeping the nation is that low achieving and minority students will not be helped by the reforms. The reforms, some contend, will be harmful to low achieving and minority students because the higher standards and testing programs, which are typically included in the reforms, may actually create new barriers blocking at-risk student progress. This investigation studied this contention in South Carolina, which has been rich in educational reforms. Early evidence from this state indicates that the achievement of Black students and low achieving students of all races was not blocked by the reforms in South Carolina. In fact, low achieving students, Black and all students, made substantial progress in South Carolina since a combination of educational reforms have been in process.

Towards cheaper, safer and low environmental impact materials for energy storage devices: natural resources-derived carbon based electrodes and aqueous electrolytes for supercapacitors

The growing market of electrical cars, portable electronics, photovoltaic systems..etc. requires the development of efficient, low-cost, and low environmental impact energy storage devices (ESDs) including batteries and supercapacitors.. Due to their extended charge-discharge cycle, high specific capacitance, and power capabilities supercapacitors are considered among the most attractive ESDs. Over the last decade, research and development in supercapacitor technology have accelerated: thousands of articles have been published in the literature describing the electrochemical properties of the electrode materials and electrolyte in addition to separators and current collectors. Carbon-based supercapacitor electrodes materials have gained increasing attention due to their high specific surface area, good electrical conductivity, and excellent stability in harsh environments, as well as other characteristics. Recently, there has been a surge of interest in activated carbon derived from low-cost abundant sources such as biomass for supercapacitor electrode materials. Also, particular attention was given to a major challenging issue concerning the substitution of organic solutions currently used as electrolytes due to their highest electrochemical stability window even though their high cost, toxicity, and flammability. In this regard, the main objective of this thesis is to investigate the performances of supercapacitors using low cost abundant safe, and low environmental impact materials for electrodes and electrolytes. Several prototypes were constructed and tested using natural resources through optimization of the preparation of appropriate carbon electrodes using agriculture by-products waste or coal (i.e. Argan shell or Anthracite from Jerrada). Such electrodes were tested using several electrolyte formulations (aqueous and water in salt electrolytes) beneficing their non-flammability, lower cost, and environmental impact; the characteristics that provide a promising opportunity to design safer, inexpensive, and environmentally friendly devices compared to organic electrolytes.

Efficient and low-computational predictive models for spectral sensors

Spectral sensors are a wide class of devices that are extremely useful for detecting essential information of the environment and materials with high degree of selectivity. Recently, they have achieved high degrees of integration and low implementation cost to be suited for fast, small, and non-invasive monitoring systems. However, the useful information is hidden in spectra and it is difficult to decode. So, mathematical algorithms are needed to infer the value of the variables of interest from the acquired data. Between the different families of predictive modeling, Principal Component Analysis and the techniques stemmed from it can provide very good performances, as well as small computational and memory requirements. For these reasons, they allow the implementation of the prediction even in embedded and autonomous devices. In this thesis, I will present 4 practical applications of these algorithms to the prediction of different variables: moisture of soil, moisture of concrete, freshness of anchovies/sardines, and concentration of gasses. In all of these cases, the workflow will be the same. Initially, an acquisition campaign was performed to acquire both spectra and the variables of interest from samples. Then these data are used as input for the creation of the prediction models, to solve both classification and regression problems. From these models, an array of calibration coefficients is derived and used for the implementation of the prediction in an embedded system. The presented results will show that this workflow was successfully applied to very different scientific fields, obtaining autonomous and non-invasive devices able to predict the value of physical parameters of choice from new spectral acquisitions.