Best Practices in Robot-assisted Radical Cystectomy and Urinary Reconstruction: Recommendations of the Pasadena Consensus Panel

CONTEXT Robot-assisted surgery is increasingly used for radical cystectomy (RC) and urinary reconstruction. Sufficient data have accumulated to allow evidence-based consensus on key issues such as perioperative management, comparative effectiveness on surgical complications, and oncologic short- to midterm outcomes. OBJECTIVE A 2-d conference of experts on RC and urinary reconstruction was organized in Pasadena, California, and the City of Hope Cancer Center in Duarte, California, to systematically review existing peer-reviewed literature on robot-assisted RC (RARC), extended lymphadenectomy, and urinary reconstruction. No commercial support was obtained for the conference. EVIDENCE ACQUISITION A systematic review of the literature was performed in agreement with the PRISMA statement. EVIDENCE SYNTHESIS Systematic literature reviews and individual presentations were discussed, and consensus on all key issues was obtained. Most operative, intermediate-term oncologic, functional, and complication outcomes are similar between open RC (ORC) and RARC. RARC consistently results in less blood loss and a reduced need for transfusion during surgery. RARC generally requires longer operative time than ORC, particularly with intracorporeal reconstruction. Robotic assistance provides ergonomic value for surgeons. Surgeon experience and institutional volume strongly predict favorable outcomes for either open or robotic techniques. CONCLUSIONS RARC appears to be similar to ORC in terms of operative, pathologic, intermediate-term oncologic, complication, and most functional outcomes. RARC consistently results in less blood loss and a reduced need for transfusion during surgery. RARC can be more expensive than ORC, although high procedural volume may attenuate this difference. PATIENT SUMMARY Robot-assisted radical cystectomy (RARC) is an alternative to open surgery for patients with bladder cancer who require removal of their bladder and reconstruction of their urinary tract. RARC appears to be similar to open surgery for most important outcomes such as the rate of complications and intermediate-term cancer-specific survival. Although RARC has some ergonomic advantages for surgeons and may result in less blood loss during surgery, it is more time consuming and may be more expensive than open surgery.

Time relevance, citation of reporting guidelines, and breadth of literature search in systematic reviews in orthodontics

INTRODUCTION As the importance of systematic review (SR) conclusions relies upon the scientific rigor of methods and the currency of evidence, we aimed to investigate the currency of orthodontic SRs using as proxy the time from the initial search to publication. Additionally, SR information regarding reporting guidelines, registration, and literature searches were recorded when available. MATERIALS AND METHODS A systematic PubMed search was carried out using the Clinical Queries page to identify orthodontic SRs cited between 1 January 2008 and 7 November 2013. Data related to reporting guidelines, review registration, dates of review processing, literature search, and abstract reporting were retrieved and classified by journal type. Survival analysis was used to assess the time to reach predefined manuscript stages for orthodontic and non-orthodontic journals. RESULTS One hundred twenty seven of the originally identified 585 SRs were considered eligible. The median interval from search until publication was 13.2 months (interquartile range: IQR = 9.7 months) irrespective of the journal type. There was evidence (P = 0.05) that SRs published by non-orthodontic journals appeared in PubMed faster than in orthodontic journals (non-orthodontic: median = 6.5 months; IQR = 5.7 months; orthodontic: median = 10.2 months; IQR = 5.6 months) from submission to publication and from acceptance to publication (non-orthodontic: median = 1.5 months; IQR = 2.4 months; orthodontic: median = 6.0 months; IQR = 6.2 months; P < 0.001). More than half of these SRs did not cite adherence to any reporting guidelines, whereas all but five studies were not prospectively registered. Search of unpublished research was undertaken in approximately 21 per cent and 29 per cent of the SRs published in non-orthodontic and orthodontic periodicals, respectively. CONCLUSIONS This study indicates that SR users should be aware that median time for orthodontic SRs from search to publication is 13.2 months. SRs published in non-orthodontic journals are likely to be more current in terms of submission until time to publication and acceptance until time to publication compared with those published in orthodontic journals.

Coherence and Historical understanding in children's Biography and Historical Nonfiction Literature: A Content Analysis of Selected Orbis Pictus Books

The purpose of this study was to investigate a selection of children's historical nonfiction literature for evidence of coherence. Although research has been conducted on coherence of textbook material and its influences on comprehension there has been limited study on coherence in children's nonfiction literature. Generally, textual coherence has been seen as critical in the comprehensibility of content area textbooks because it concerns the unity of connections among ideas and information. Disciplinary coherence concerns the extent to which authors of historical text show readers how historians think and write. Since young readers are apprentices in learning historical content and conventions of historical thinking, evidence of disciplinary coherence is significant in nonfiction literature for young readers. The sample of the study contained 32 books published between 1989 and 2000 ranging in length from less than 90 pages to more than 150 pages. Content analysis was the quantitative research technique used to measure 84 variables of textual and disciplinary coherence in three passages of each book, as proportions of the total number of words for each book. Reliability analyses and an examination of 750 correlations showed the extent to which variables were related in the books. Three important findings emerged from the study that should be considered in the selection and use of children's historical nonfiction literature in classrooms. First, characteristics of coherence are significantly related together in high quality nonfiction literature. Second, shorter books have a higher proportion of textual coherence than longer books as measured in three passages. Third, presence of the author is related to characteristics of coherence throughout the books. The findings show that nonfiction literature offers students content that researchers have found textbooks lack. Both younger and older students have the opportunity to learn the conventions of historical thinking as they learn content through nonfiction literature. Further, the children's literature, represented in the Orbis Pictus list, shows students that authors select, interpret, and question information, and give other interpretations. The implications of the study for teaching history, teacher preparation in content and literacy, school practices, children's librarians, and publishers of children's nonfiction are discussed.

Comparative studies of Hox genes in mammalian limb and vertebral pattern formation

Divergence of anterior-posterior (AP) limb pattern and differences in vertebral column morphology are the two main examples of mammalian evolution. The Hox genes (homeobox containing gene) have been implicated in driving evolution of these structures. However, regarding Hox genes, how they contribute to the generation of mammalian morphological diversities, is still unclear. Implementing comparative gene expression and phenotypic rescue studies for different mammalian Hox genes could aid in unraveling this mystery. In the first part of this thesis, the expression pattern of Hoxd13 gene, a key Hox gene in the establishment of the limb AP pattern, was examined in developing limbs of bats and mice. Bat forelimbs exhibit a pronounced asymmetric AP pattern and offer a good model to study the molecular mechanisms that contribute to the variety of mammalian limbs. The data showed that the expression domain of bat Hoxd13 was shifted prior to the asymmetric limb plate expansion, whereas its domain in mice was much more symmetric. This finding reveals a correlation between the divergence of Hoxd13 expression and the AP patterning difference in limb development. The second part of this thesis details a phenotypic rescue approach by human HOXB1-9 transgenes in mice with Hoxb1-9 deletion, The mouse mutants displayed homeosis in cervical and anterior thoracic vertebrae. The human transgenes entirely rescued the mouse mutants, suggesting that these human HOX genes have similar functions to their mouse orthologues in anterior axial skeletal patterning. The anterior expressing human HOXB transgenes such as HOXB1-3 were expressed in the mouse embryonic trunk in a similar manner as their murine orthologues. However, the anterior boundary of human HOXB9 expression domain was more posterior than that of the mouse Hoxb9 by 2-3 somites. These data provide the molecular support for the hypothesis that Hox genes are responsible for maintaining similar anterior axial skeletal architectures cervical and anterior thoracic regions, but different architectures in lumbar and posterior thoracic regions between humans and mice. ^

A New Method to Retrieve, Cluster And Annotate Clinical Literature Related To Electronic Health Records

The access to medical literature collections such as PubMed, MedScape or Cochrane has been increased notably in the last years by the web-based tools that provide instant access to the information. However, more sophisticated methodologies are needed to exploit efficiently all that information. The lack of advanced search methods in clinical domain produce that even using well-defined questions for a particular disease, clinicians receive too many results. Since no information analysis is applied afterwards, some relevant results which are not presented in the top of the resultant collection could be ignored by the expert causing an important loose of information. In this work we present a new method to improve scientific article search using patient information for query generation. Using federated search strategy, it is able to simultaneously search in different resources and present a unique relevant literature collection. And applying NLP techniques it presents semantically similar publications together, facilitating the identification of relevant information to clinicians. This method aims to be the foundation of a collaborative environment for sharing clinical knowledge related to patients and scientific publications.

O DISCURSO AMBIENTAL JORNALÍSTICO, POLÍTICO E EMPRESARIAL EM ÂMBITO LOCAL: uma proposta de análise

Esta tese tem como tema principal o discurso ambiental local. Trata-se de uma proposta de análise, que pode ser aplicada a este tipo de discurso em qualquer localidade, e um estudo de caso, que aplicou a análise proposta na tese. O objetivo geral desta pesquisa foi analisar a informação local sobre meio ambiente veiculada por meio dos discursos jornalístico, político e empresarial, estabelecendo relações históricas, sociais e ideológicas do discurso ambiental que permeiam as três áreas em questão. A metodologia incluiu três fases: pesquisa bibliográfica e revisão de literatura sobre os principais conceitos levantados no trabalho; levantamento de discursos locais disponíveis na mídia para análise no estudo de caso; análise dos discursos a partir de protocolo elaborado com base na Análise do Discurso de linha francesa. O estudo de caso traz a análise do discurso ambiental no município de Frutal-MG, onde hoje estão em andamento várias pesquisas e projetos na área ambiental. A principal conclusão do trabalho confirma a hipótese da pesquisa de que a informação ambiental fruto dos discursos político, jornalístico e empresarial em âmbito local tem caráter predominantemente situacional, mercadológico e propagandístico, pouco focada em conscientizar e educar e com ênfase em interesses comerciais e eleitorais e na resolução de problemas emergenciais.

Discursive constructions of social and environmental accounting in Brazil: the case of Petrobras.

In the 29 years following \"Our Common Future\" by the United Nations, there is considerable debate among governments, civil society, interest groups and business organisations about what constitutes sustainable development, which constitutes evidence for a contested discourse concerning sustainability. The purpose of this study is to understand this debate in the developing economic context of Brazil, and in particular, to understand and critique the social and environmental accounting [SEA] discursive constructions relating to the State-owned, Petrobras as well as to understand the Brazilian literature on SEA. The discourse theory [DT]-based analysis employs rhetorical redescription to analyse twenty-two reports from Petrobras from 2004-2013. I investigate the political notions by employing the methodological framework of the Logics of Critical Explanation [LCE]. LCE engenders five methodological steps: problematisation, retroduction, logics (social, political and fantasmatic), articulation and critique. The empirical discussion suggests that the hegemony of economic development operates to obfuscate, rhetorically, the development of sustainability, so as to maintain the core business of Petrobras conceived as capital accumulation. Equally, these articulations also illustrate how the constructions of SEA operate to serve the company\'s purpose with few (none) profound changes in integration of sustainability. The Brazilian literature on SEA sustains the status quo of neo-liberal market policies that operate to protect the dominant business case approach to maintain an agenda of wealth-creation in relation to social and environmental needs. The articulations of the case manifested in policies regarding, for example, corruption, which involved over-payments for contracts and unsustainable practices relating to the use of fossil fuels and demonstrated that there was antagonism between action and disclosure. The corruption scandal that emerged after SEA disclosures highlighted the rhetorical nature of disclosure when financial resources were subtracted from the company for political parties and engineering contractors hid facts through incomplete disclosures. The articulations of SEA misrepresent a broader context of the meanings associated with sustainability, which restricted the constructions of SEA to principally serve and represent the intention of the most powerful groups. The significance of SEA, then is narrowed to represent particular interests. The study argues for more critical studies as limited Brazilian literature concerning SEA kept a \'safe distance\' from substantively critiquing the constructions of SEA and its articulations in the Brazilian context. The literature review and the Petrobras\' case illustrate a variety of naming, instituting and articulatory practices that endeavour to maintain the current hegemony of development in an emerging economy, which allows Petrobras to continue to exercise significant profit at the expense of the social and environmental. The constructed idea of development in Petrobras\' discourses emphasises a rhetoric of wider development, but, in reality, these discourses were the antithesis of political, social and ethical developmental issues. These constructions aim to hide struggles between social inequalities and exploitation of natural resources and constitute excuses about a fanciful notion of rhetorical and hegemonic neo-liberal development. In summary, this thesis contributes to the prior literature in five ways: (i) the addition of DT to the analysis of SEA enhances the discussion of political elements such as hegemony, antagonism, logic of equivalence/difference, ideology and articulation; (ii) the analysis of an emerging economy such as Brazil incorporates a new perspective of the discussion of the discourses of SEA and development; (iii) this thesis includes a focus on rhetoric to discuss the maintenance of the status quo; (iv) the holistic structure of the LCE approach enlarges the understanding of the social, political and fantasmatic logics of SEA studies and; (v) this thesis combines an analysis of the literature and the case of Petrobras to characterise and critique the state of the Brazilian academy and its impacts and reflections on the significance of SEA. This thesis, therefore, argues for more critical studies in the Brazilian academy due to the persistence of idea of SEA and development that takes-for-granted deep exclusions and contradictions and provide little space for critiques.

Genetic diversity and susceptibility to Vip3Aa20 protein in Brazilian populations of Helicoverpa armigera and Helicoverpa zea (Lepidoptera: Noctuidae)

Helicoverpa armigera (Hübner) was officially reported in Brazil in 2013. This species is closely related to Helicoverpa zea (Boddie) and has caused significant crop damage in Brazil. The use of genetically modified crops expressing insecticidal protein from Bacillus thuringiensis (Berliner) has been one of the control tactics for managing these pests. Genetically modified maize expressing Vip3Aa20 was approved to commercial use in Brazil in 2009. Understanding the genetic diversity and the susceptibility to B. thuringiensis proteins in H. armigera and H. zea populations in Brazil are crucial for establishing Insect Resistance Management (IRM) programs in Brazil. Therefore, the objectives of this study were: (a) to infer demographic parameters and genetic structure of H. armigera and H. zea Brazil; (b) to assess the intra and interspecific gene flow and genetic diversity of H. armigera and H. zea; and (c) to evaluate the susceptibility to Vip3Aa20 protein in H. armigera and H. zea populations of Brazil. A phylogeographic analysis of field H. armigera and H. zea populations was performed using a partial sequence data from the cytochrome c oxidase I (COI) gene. H. armigera individuals were most prevalent on dicotyledonous hosts and H. zea individuals were most prevalent on maize crops. Both species showed signs of demographic expansion and no genetic structure. High genetic diversity and wide distribution were observed for H. armigera. A joint analysis indicated the presence of Chinese, Indian, and European lineages within the Brazilian populations of H. armigera. In the cross-species amplification study, seven microsatellite loci were amplified; and showed a potential hybrid offspring in natural conditions. Interespecific analyses using the same microsatellite loci with Brazilian H. armigera and H. zea in compare to the USA H. zea were also conducted. When analyses were performed within each species, 10 microsatellites were used for H. armigera, and eight for H. zea. We detected high intraspecific gene flow in populations of H. armigera and H. zea from Brazil and H. zea from the USA. Genetic diversity was similar for both species. However, H. armigera was more similar to H. zea from Brazil than H. zea from the USA and some putative hybrid individuals were found in Brazilian populations.Tthere was low gene flow between Brazilian and USA H. zea. The baseline susceptibility to Vip3Aa20 resulted in low interpopulation variation for H. zea (3-fold) and for H. armigera (5-fold), based on LC50. H. armigera was more tolerant to Vip3Aa20 than H. zea (≈ 40 to 75-fold, based on CL50). The diagnostic concentration for susceptibility monitoring, based on CL99, was fairly high (6,400 ng Vip3Aa20/cm2) for H. zea and not validated for H. armigera due to the high amount of protein needed for bioassays. Implementing IRM strategies to Vip3Aa20 in H. armigera and H. zea will be of a great challenge in Brazil, mainly due to the low susceptibility to Vip3Aa20 and high genetic diversity and gene flow in both species, besides a potential of hybrid individuals between H. armigera and H. zea under field conditions.

Análisis traductológico de la obra paremiográfica de Charles Cahier, (francés-español)

This thesis contains a translatological analysis of the Spanish proverbs collected by Charles Cahier in Quelque six mille proverbes et aphorismes usuels empruntés à notre âge et aux siècles derniers. Proverbs and other sententious sayings are part of our day-to-day life, and are more or less intensely used according to cultures and their types of speech. They have always existed in every single civilisation. There is, indeed, no denying that the purpose of proverbs is to convey an old experience. They are quoted by major philosophers and writers of all times. As a result of the interest they have raised, books of proverbs have been published for many centuries in a high number of countries. Proverbs can be found everywhere, both in professional and personal settings, or in a conversation between friends. In France, these sayings are more commonly used in literature than in spoken language, whereas in Spain proverbs can be found at all levels of communication. In this regard, it is interesting to compare the translations of international works to detect a number of misunderstandings regarding the interpretation of paremiological elements. This is why translating proverbs is a genuine, complex issue. This thesis, which is aimed at Spanish and French speakers (including native and foreign speakers), has a double application (translatological and linguistic) and falls within the context of translatological and comparative paremiology...

Benefits of the ISO 9001 and ISO 14001 standards: a literature review

Purpose: The purpose of this paper is to determine the similarities and differences between the benefits derived from implementing the ISO 9001 and the ISO 14001 standards. Methodology/Approach: The paper reviews the literature using an electronic search in the ScienceDirect, ABI/Inform, Emerald databases to identify papers focusing on the adoption of the ISO 9001 and 14001 standards and the benefits derived from implementing them. Findings: The paper identifies 82 articles about ISO 9001 and 29 about ISO 14001. Although some differences can be observed between the benefits considered by ISO 9001 and 14001, there is a great degree of coincidence in the benefits studied. The review suggests 13 benefits as the most usually analyzed (including environmental performance for the case of the ISO 14001 standard) by scholars. It is suggested that both standards have clear benefits on operational, people and customer results and that the effects on financial performance are inconclusive. Limitations/implications: One limitation of this paper is that the works identified are conditioned by the search strategy used. In addition, other key words could be included in future studies such as operational, market, quality, financial performance, and customer satisfaction in order to expand this search. Originality/Value: The main contribution is that the paper identifies the literature gap and future research proposals with regard to the benefits of the ISO 9001 and ISO 14001 standards.

Towards Effective Regulatory Cooperation under TTIP: A Comparative Overview of the EU and US Legislative and Regulatory Systems. CEPS Special Report No. 88, 15 May 2014

The aim of this report is to inform the EU-US Transatlantic Trade and Investment negotiations on enhanced regulatory coherence and cooperation, by providing negotiators, stakeholders and the public with a comparative overview of the US and EU legislative and regulatory processes in their current form, highlighting differences and similarities.

Texts and studies in Jewish history and literature,

Errata slip inserted between p. [vii] and viii of v. 1 and p. [iv] and v of v. 2.

Philology and literature series.

Each no. has also a distinctive title.

Books & characters, French & English /

Edmons A4b.

Matthew Arnold and American culture.

Originally published 1957.