Diagnostic underestimation of atypical ductal hyperplasia and ductal carcinoma in situ at percutaneous core needle and vacuum-assisted biopsies of the breast in a Brazilian reference institution

Abstract Objective: To determine the rates of diagnostic underestimation at stereotactic percutaneous core needle biopsies (CNB) and vacuum-assisted biopsies (VABB) of nonpalpable breast lesions, with histopathological results of atypical ductal hyperplasia (ADH) or ductal carcinoma in situ (DCIS) subsequently submitted to surgical excision. As a secondary objective, the frequency of ADH and DCIS was determined for the cases submitted to biopsy. Materials and Methods: Retrospective review of 40 cases with diagnosis of ADH or DCIS on the basis of biopsies performed between February 2011 and July 2013, subsequently submitted to surgery, whose histopathological reports were available in the internal information system. Biopsy results were compared with those observed at surgery and the underestimation rate was calculated by means of specific mathematical equations. Results: The underestimation rate at CNB was 50% for ADH and 28.57% for DCIS, and at VABB it was 25% for ADH and 14.28% for DCIS. ADH represented 10.25% of all cases undergoing biopsy, whereas DCIS accounted for 23.91%. Conclusion: The diagnostic underestimation rate at CNB is two times the rate at VABB. Certainty that the target has been achieved is not the sole determining factor for a reliable diagnosis. Removal of more than 50% of the target lesion should further reduce the risk of underestimation.

Ager Tarraconensis 5. Paisatge, poblament, cultura material i història = Landscape, Settlement, Material Culture and History Proceedings of the International Symposium

Aquesta obra recull 28 comunicacions presentades al Simposi internacional «L’ager Tarraconensis. Paisatge, poblament, cultura material i història», celebrat a Tarragona el 27 i 28 d’octubre del 2010, organitzat per l’Institut Català d’Arqueologia Clàssica a la seu de l’Institut i a la Diputació de Tarragona. Les aportacions al simposi se centren en l'evolució del paisatge al Camp de Tarragona i en altres regions del món romà, en la varietat de les primeres estratègies de control romà del territori, en les tipologies i evolució dels establiments, en aspectes econòmics i en la dinàmica del poblament, sense faltar-hi alguna aportació de l'epigrafia. Tot plegat fa referència molt especialment al territori de Tarraco, tot i que el simposi també va comptar amb comunicacions sobre altres territoris de l'àrea catalana i saguntina i d'altres províncies romanes, com la Lusitània, les Gàl·lies i la Transpadana; les comparacions entre diferents regions han donat una riquesa notable al debat. Entre els resultats més suggerents comptem amb la constatació de la similitud en els models de romanització del territori en les diferents àrees d'àmbit català i valencià, que contrasten significativament amb els models de territoris d'Andalusia, França i Portugal.

Methods for assessing the sustainability of integrated municipal waste management and

The general striving to bring down the number of municipal landfills and to increase the reuse and recycling of waste-derived materials across the EU supports the debates concerning the feasibility and rationality of waste management systems. Substantial decrease in the volume and mass of landfill-disposed waste flows can be achieved by directing suitable waste fractions to energy recovery. Global fossil energy supplies are becoming more and more valuable and expensive energy sources for the mankind, and efforts to save fossil fuels have been made. Waste-derived fuels offer one potential partial solution to two different problems. First, waste that cannot be feasibly re-used or recycled is utilized in the energy conversion process according to EU’s Waste Hierarchy. Second, fossil fuels can be saved for other purposes than energy, mainly as transport fuels. This thesis presents the principles of assessing the most sustainable system solution for an integrated municipal waste management and energy system. The assessment process includes: · formation of a SISMan (Simple Integrated System Management) model of an integrated system including mass, energy and financial flows, and · formation of a MEFLO (Mass, Energy, Financial, Legislational, Other decisionsupport data) decision matrix according to the selected decision criteria, including essential and optional decision criteria. The methods are described and theoretical examples of the utilization of the methods are presented in the thesis. The assessment process involves the selection of different system alternatives (process alternatives for treatment of different waste fractions) and comparison between the alternatives. The first of the two novelty values of the utilization of the presented methods is the perspective selected for the formation of the SISMan model. Normally waste management and energy systems are operated separately according to the targets and principles set for each system. In the thesis the waste management and energy supply systems are considered as one larger integrated system with one primary target of serving the customers, i.e. citizens, as efficiently as possible in the spirit of sustainable development, including the following requirements: · reasonable overall costs, including waste management costs and energy costs; · minimum environmental burdens caused by the integrated waste management and energy system, taking into account the requirement above; and · social acceptance of the selected waste treatment and energy production methods. The integrated waste management and energy system is described by forming a SISMan model including three different flows of the system: energy, mass and financial flows. By defining the three types of flows for an integrated system, the selected factor results needed in the decision-making process of the selection of waste management treatment processes for different waste fractions can be calculated. The model and its results form a transparent description of the integrated system under discussion. The MEFLO decision matrix has been formed from the results of the SISMan model, combined with additional data, including e.g. environmental restrictions and regional aspects. System alternatives which do not meet the requirements set by legislation can be deleted from the comparisons before any closer numerical considerations. The second novelty value of this thesis is the three-level ranking method for combining the factor results of the MEFLO decision matrix. As a result of the MEFLO decision matrix, a transparent ranking of different system alternatives, including selection of treatment processes for different waste fractions, is achieved. SISMan and MEFLO are methods meant to be utilized in municipal decision-making processes concerning waste management and energy supply as simple, transparent and easyto- understand tools. The methods can be utilized in the assessment of existing systems, and particularly in the planning processes of future regional integrated systems. The principles of SISMan and MEFLO can be utilized also in other environments, where synergies of integrating two (or more) systems can be obtained. The SISMan flow model and the MEFLO decision matrix can be formed with or without any applicable commercial or free-of-charge tool/software. SISMan and MEFLO are not bound to any libraries or data-bases including process information, such as different emission data libraries utilized in life cycle assessments.

Application of fourier transform infrared spectroscopy, chemical and chemometrics analyses to the characterization of agro-industrial waste

Agroindustrial waste in general presents significant levels of nutrients and organic matter and has therefore been frequently put to agricultural use. In this context, the objective of this study was to determine the chemical composition, nitrogen, phosphorus, potassium, calcium, magnesium and carbon content, as well as the qualitative characteristics through Fourier transform infrared spectroscopy of four samples of poultry litter and one sample of cattle manure, from the southwestern region of Paraná, Brazil. Results revealed that, in general, the poultry litter presented higher amount of nutrients and carbon than the cattle manure. The infrared spectra allowed identification of the functional groups present and the differences in degree of sample humification. The statistical treatment confirmed the quantitative and qualitative differences revealed.

On the institution of the moral subject: on the commander and the commanded in Nietzsche's discussion of law

The article discusses how Nietzsche understands the institution of law and morals in distinction to Kant and the Christian tradition. It argues that Nietzsche to a large extent is inspired by the paradigm-shift toward a evolutionary biological thinking introduced by several of his peers in the late 19th century, among else F. A. Lange, who sees this shift as a sobering scientific-materialistic alternative to Kant. In Nietzsche, the Kantian moral imperative is replaced with a notion of a morality emerging thanks to historical, or pre-historical, civilizational processes, imposed on a feebleminded human without any inherent rational dispositions to obey Law. It is also a process, which rather than universalizing the human, splits it in a duality where one part obeys old immediate self-interests and another part obeys new 'commands,' having been shouted 'into the ear' by a so-called 'commander.' The compliance with law takes two radically different forms in Nietzsche: servile and mediocre individuals need to be exposed to discipline and punishment in order to adopt Law; while so-called 'sovereign' individuals are able to impose law upon themselves. The figure of the 'sovereign' has consequently been an issue for vigorous debate in especially the Anglo-Saxon tradition of Nietzsche research, since his apparent 'respect for law' and 'sense of duty' reiterate typical Kantian qualities. Relating to these discussions, I suggest that Nietzsche's 'sovereign' (in one context) is identical his 'commander' (in other contexts). When the 'sovereign' as such imposes law upon himself and others, his act is conventional and arbitrary (like language in Saussure), and is rather irrational than rational as in Kant. His will is not a good will, nor a rational will with a vision of human autonomy. His command of himself and others is a performative, thus without truth-value (like illocutionary speech-acts in Austin and Searle).

Proceedings from the conference Visibility and Collaboration of Researchers in Intercultural Communication in Finland - Visibilité et collaboration de la recherche en interculturel en Finlande

This document contains papers that were presented at the conference “Enhancing the Visibility and Collaboration of Researchers in Intercultural Communication in Finland” which took place at the University of Turku (Finland), on October 1st & 2nd 2004. A paper version of some of the following papers as well as articles by specialists in intercultural communication will be published by Peter Lang.

Importance of considering food waste in the development of sustainable food packaging systems

Meeting the needs of both present and future generations forms the foundation of sustainable development. Concern about food demand is increasing alongside the continuously growing population. In the pursuit of food security preventing food waste is one solution avoiding the negative environmental impacts that result from producing food unnecessarily. Packages offer one answer to preventing food waste, as they 1) preserve and protect food, 2) introduce the user to the correct way to handle and use the food and package and 3) allow the user to consume the food in its entirety. This thesis aims to enhance the sustainability of food packages by giving special emphasis to preventing food waste. The focus of this thesis is to assist the packaging designer in being able to take into account the requirements for the sustainability of food packages and to be able to integrate these requirements into the product development process. In addition, life cycle methods that can be used as a tool in the packaging design process or in assessing the sustainability of finished food-packaging combinations are evaluated. The methods of life cycle costing (LCC) and life cycle working environment (LCWE) are briefly discussed. The method of life cycle assessment (LCA) is examined more thoroughly through the lens of the literature review of food-package LCA case studies published in the 21st century in three relevant journals. Based on this review and on experiences learned from conducting LCAs, recommendations are given as to how the LCA practitioner should conduct a food packaging study to make most of the results. Two case studies are presented in this thesis. The first case study relates the results of a life cycle assessment conducted for three food items (cold cut (ham), sliced dark bread (rye) and Soygurt drink) and the alternative packaging options of each. Results of this study show that the packaging constitutes only 1–12 % of the total environmental impacts of the food-packaging combination. The greatest effect is derived from the food itself and the wasted food. Even just a small percentage of wasted food causes more environmental impacts than does the packaging. The second case study presents the results of LCC and LCWE analysis done for fruit and vegetable transport packages. In this thesis, the specific results of the study itself are not the focus, but rather the study methods and scope are analysed based on how these complement the sustainability assessment of food packages. This thesis presents reasons why prevention of food waste should be more thoroughly taken into account in food packaging design. In addition, the task of the packaging designer is facilitated by the requirements of sustainable food packaging, by the methods and step-by-step guidance on how to integrate sustainability issues into the design process, and by the recommendations on how to assess the sustainability of food packages. The intention of this thesis is to express the issues that are important in the field of the food packaging industry. Having recognised and implemented these issues, businesses can better manage the risks that could follow from neglecting these sustainability aspects.