Quality improvement for portal vein embolization.

Fibrin sealant is used in many areas of surgery. We present a novel aspect of flap insetting in the ischial region using fibrin spray to seal the transferred tissue. We analyzed 10 patients suffering from decubital ulcers and assessed drainage output, time of drain removal, as well as complications following fasciocutaneous flap surgery. Patients were randomized to receive sprayed fibrin glue (study group) or not (control group) before wound closure. The mean drainage time was 4 +/- 1 days in the study group and 6 +/- 1 days in the control group ( P = 0.06). The mean drainage volume was 100 +/- 20 mL in the study group and 168 +/- 30 mL in the control group ( P < 0.01). Fibrin sealant led to reduced drainage volumes and duration of drainage, indicating a beneficial effect of the application of fibrin glue in fasciocutaneous flap surgery for pressure sore coverage.

Determinação do volume de madeira em povoamento de eucalipto por escâner a laser aerotransportado

O objetivo deste trabalho foi avaliar a possibilidade de se estimar o diâmetro à altura do peito (DAP) com os dados de altura e de número de árvores derivados do escâner a laser aerotransportado (LiDAR, "light detection and ranging"), e determinar o volume de madeira de talhão de Eucalyptus sp. a partir dessas variáveis. O número total de árvores detectadas foi obtido com uso da filtragem de máxima local. A altura de plantas estimada pelo LiDAR apresentou tendência não significativa à subestimativa. A estimativa do DAP foi coerente com os valores encontrados no inventário florestal; porém, também mostrou tendência à subestimativa, em razão do comportamento observado quanto à altura. A variável número de fustes apresentou valores próximos aos observados nas parcelas do inventário. O LiDAR subestimou o volume total de madeira do talhão em 11,4%, em comparação ao volume posto na fábrica. A tendência de subestimação da altura das árvores (em média, cerca de 5%) impactou a estimativa do volume individual de árvores e, consequentemente, a do volume do talhão. No entanto, é possível gerar equações de regressão que estimam o DAP com boa precisão, a partir de dados de altura de plantas obtidos pelo LiDAR. O modelo parabólico é o que possibilita as melhores estimativas da produção volumétrica dos talhões de eucalipto.

Computer-aided volume measurement of posttraumatic orbits reconstructed with AO titanium mesh plates: accuracy and reliability

PURPOSE: To prospectively evaluate the accuracy and reliability of "freehand" posttraumatic orbital wall reconstruction with AO (Arbeitsgemeinschaft Osteosynthese) titanium mesh plates by using computer-aided volumetric measurement of the bony orbits. METHODS: Bony orbital volume was measured in 12 patients from coronal CT scan slices using OsiriX Medical Image software. After defining the volumetric limits of the orbit, the segmentation of the bony orbital region of interest of each single slice was performed. At the end of the segmentation process, all regions of interest were grouped and the volume was computed. The same procedure was performed on both orbits, and thereafter the volume of the contralateral uninjured orbit was used as a control for comparison. RESULTS: In all patients, the volume data of the reconstructed orbit fitted that of the contralateral uninjured orbit with accuracy to within 1.85 cm3 (7%). CONCLUSIONS: This preliminary study has demonstrated that posttraumatic orbital wall reconstruction using "freehand" bending and placement of AO titanium mesh plates results in a high success rate in re-establishing preoperative bony volume, which closely approximates that of the contralateral uninjured orbit.

Redes neurais artificiais para a modelagem do volume de madeira e biomassa do cerradão com dados de satélite

Resumo:O objetivo deste trabalho foi avaliar a eficácia da aplicação de modelos de análise de regressão e redes neurais artificiais (RNAs) na predição do volume de madeira e da biomassa acima do solo, da vegetação arbórea em área de cerradão. Volume de madeira e biomassa foram estimados com equações alométricas desenvolvidas para a área de estudo. Os índices de vegetação, como variáveis preditoras, foram estimados a partir de imagens do sensor LISS-III, e a área basal foi determinada por medições na floresta. A precisão das equações foi verificada pela correlação entre os valores estimados e observados (r), erro-padrão da estimativa (Syx) e gráfico residual. As equações de regressão para o volume de madeira total e do fuste (0,96 e 0,97 para r, e 11,92 e 9,72% para Syx, respectivamente) e para a biomassa (0,91 e 0,92 para r, e 22,73 e 16,80% para Syx, respectivamente) apresentaram bons ajustes. As redes neurais também apresentaram bom ajuste com o volume de madeira (0,99 e 0,99 para r, e 4,93 e 4,83% para Syx) e a biomassa (0,97 e 0,98 r, e 8,92 e 7,96% para Syx, respectivamente). A área basal e os índices de vegetação foram eficazes na estimativa do volume de madeira e biomassa para o cerradão. Os valores reais de volume de madeira e biomassa não diferiram estatisticamente dos valores estimados pelos modelos de regressão e redes neurais (χ2ns); contudo, as RNAs são mais acuradas.

Analysis of a finite volume method for a cross-diffusion model in population dynamics

The main goal of this paper is to propose a convergent finite volume method for a reactionâeuro"diffusion system with cross-diffusion. First, we sketch an existence proof for a class of cross-diffusion systems. Then the standard two-point finite volume fluxes are used in combination with a nonlinear positivity-preserving approximation of the cross-diffusion coefficients. Existence and uniqueness of the approximate solution are addressed, and it is also shown that the scheme converges to the corresponding weak solution for the studied model. Furthermore, we provide a stability analysis to study pattern-formation phenomena, and we perform two-dimensional numerical examples which exhibit formation of nonuniform spatial patterns. From the simulations it is also found that experimental rates of convergence are slightly below second order. The convergence proof uses two ingredients of interest for various applications, namely the discrete Sobolev embedding inequalities with general boundary conditions and a space-time $L^1$ compactness argument that mimics the compactness lemma due to Kruzhkov. The proofs of these results are given in the Appendix.

Connexin 43 expression in human hypertrophied heart due to pressure and volume overload.

Left ventricular hypertrophy (LVH) is due to pressure overload or mechanical stretch and is thought to be associated with remodeling of gap-junctions. We investigated whether the expression of connexin 43 (Cx43) is altered in humans in response to different degrees of LVH. The expression of Cx43 was analyzed by quantitative polymerase chain reaction, Western blot analysis and immunohistochemistry on left ventricular biopsies from patients undergoing aortic or mitral valve replacement. Three groups were analyzed: patients with aortic stenosis with severe LVH (n=9) versus only mild LVH (n=7), and patients with LVH caused by mitral regurgitation (n=5). Cx43 mRNA expression and protein expression were similar in the three groups studied. Furthermore, immunohistochemistry revealed no change in Cx43 distribution. We can conclude that when compared with mild LVH or with LVH due to volume overload, severe LVH due to chronic pressure overload is not accompanied by detectable changes of Cx43 expression or spatial distribution.

Variation in performance in low-volume mammography screening programmes: experience from Switzerland.

BACKGROUND: Reading volume and mammography screening performance appear positively correlated. Quality and effectiveness were compared across low-volume screening programmes targeting relatively small populations and operating under the same decentralised healthcare system. Except for accreditation of 2nd readers (restrictive vs non-restrictive strategy), these organised programmes had similar screening regimen/procedures and duration, which maximises comparability. Variation in performance and its determinants were explored in order to improve mammography practice and optimise screening performance. METHODS: Circa 200,000 screens performed between 1999 and 2006 (4 rounds) in 3 longest standing Swiss cantonal programmes (of Vaud, Geneva and Valais) were assessed. Indicators of quality and effectiveness were assessed according to European standards. Interval cancers were identified through linkage with cancer registries records. RESULTS: Swiss programmes met most European standards of performance with a substantial, favourable cancer stage shift. Up to a two-fold variation occurred for several performance indicators. In subsequent rounds, compared with programmes (Vaud and Geneva) that applied a restrictive selection strategy for 2nd readers, proportions of in situ lesions and of small cancers (≤1cm) were one third lower and halved, respectively, and the proportion of advanced lesions (stage II+) nearly 50% higher in the programme without a restrictive selection strategy. Discrepancy in second-year proportional incidence of interval cancers appears to be multicausal. CONCLUSION: Differences in performance could partly be explained by a selective strategy for second readers and a prior experience in service screening, but not by the levels of opportunistic screening and programme attendance. This study provides clues for enhancing mammography screening performance in low-volume programmes.

Chirurgie de réduction de volume pulmonaire: Suivi des 26 premiers patients à Lausanne

Ce travail concerne les 26 premiers patients opérés à Lausanne de juillet 1995 à avril 1998 d?une gie de réduction de volume pulmonaire pour un emphysème sévère. Il présente leurs actéristiques préopératoires générales, leur évaluation radiologique et cardiologique, ainsi que mesures fonctionnelles pulmonaires. Il examine ensuite la technique opératoire, la période ériopératoire, ainsi que les résultats fonctionnels postopératoires des patients. De plus il présente les entretiens ayant eu lieu avec chaque patient pour connaître son évaluation de l?opération et de ges résultats. Ces informations sont ensuite comparées avec les résultats présents dans la littérature. Le profil préopératoire, la technique opératoire, la période péripopératoire, et les résultats fonctionnels postopératoires sont comparés. Un groupe de patients qui n?a pas répondu au point de vue fonctionnel A la chirurgie est ensuite examiné afin de tenter de définir des critères préopératoires de bonne ou mauvaise réponse, et ceux-ci sont mis en relation avec les données de la littérature. On compare ensuite le groupe de mauvais répondeurs fonctionnels avec le groupe des patients ne s?estimant pas améliorés par l?opération. En faisant une étude statistiques des valeurs fonctionnelles pré et postopératoire, on observe une amélioration significative du VEMS, du volume résiduel, de la PaC02, de la distance parcounie au test de marche de six minutes et de la dyspnée engendrée par le test sur une échelle de Borg. L?amélioration de la Pa02 postopératoire et de la saturation en oxygène pendant le test de marche n?était pas significative statistiquement. On peut voir que ce collectif de patients lausannois est comparable aux autres séries au niveau du profil préopératoire et de la gravité de l?atteinte fonctionnelle, au niveau de la technique opératoire, de la mortalité et morbidité, et des résultats fonctionnels postopératoires. On observe comme différence un volume résiduel moyen préopératoire plus élevé et davantage amélioré en postopératoire que dans la littérature. Cette étude ne met pas en évidence - et c?est également le cas dans la littérature - de critères clairs préopératoires prédictifs d?une bonne réponse à la chirurgie. De même elle n?a pas mis en évidence de concordance entre l?amélioration de la symptomatologie des patients et les résultats fonctionnels postopératoires. 11 serait donc intéressant de poursuivre ce travail par une évaluation prospective plus systématique des patients opérés et de pouvoir la comparer avec les résultats des patients récusés ou refusant la chirurgie de réduction de volume pulmonaire, afin de pouvoir mieux en évaluer les bénéfices à long terme.

Spray coating technique asa surface treatment for woodcontaining paper grades

The objective of this work was to introduce the emerging non-contacting spray coating process and compare it to the existing coating techniques. Particular emphasis was given to the details of the spraying process of paper coating colour and the base paper requirements set by the new coating method. Spraying technology itself is nothing new, but the atomisation process of paper coating colour is quite unknown to the paper industry. The differences between the rheology of painting and coating colours make it very difficult to utilise the existing information from spray painting research. Based on the trials, some basic conclusion can be made:The results of this study suggest that the Brookfield viscosity of spray coating colour should be as low as possible, presently a 50 mPas level is regarded as an optimum. For the paper quality and coater runnability, the solids level should be as high as possible. However, the graininess of coated paper surface and the nozzle wear limits the maximum solids level to 60 % at the moment. Most likelydue to the low solids and low viscosity of the coating colour the low shear Brookfield viscosity correlates very well with the paper and spray fan qualities. High shear viscosity is also important, but yet less significant than the low shear viscosity. Droplet size should be minimized and besides keeping the brrokfield viscosity low that can be helped by using a surfactant or dispersing agent in the coating colour formula. Increasing the spraying pressure in the nozzle can also reduce the droplet size. The small droplet size also improves the coating coverage, since there is hardly any levelling taking place after the impact with the base paper. Because of the lack of shear forces after the application, the pigment particles do not orientate along the paper surface. Therefore the study indicates that based on the present know-how, no quality improvements can be obtained by the use of platy type of pigments. The other disadvantage of them is the rapid deterioration of the nozzle lifetime. Further research in both coating colour rheology and nozzle design may change this in the future, but so far only round shape pigments, like typically calcium carbonate is, can be used with spray coating. The low water retention characteristics of spray coating, enhanced by the low solids and low viscosity, challenge the base paper absorption properties.Filler level has to be low not to increase the number of small pores, which have a great influence on the absorption properties of the base paper. Hydrophobic sizing reduces this absorption and prevents binder migration efficiently. High surface roughness and especially poor formation of the base paper deteriorate thespray coated paper properties. However, pre-calendering of the base paper does not contribute anything to the finished paper quality, at least at the coating colour solids level below 60 %. When targeting a standard offset LWC grade, spraycoating produces similar quality to film coating, but yet blade coating being on a slightly better level. However, because of the savings in both investment and production costs, spray coating may have an excellent future ahead. The porousnature of the spray coated surface offers an optimum substrate for the coldset printing industry to utilise the potential of high quality papers in their business.

Catalogue des manuscrits chinois de Touen-Houang. Volume IV, Nos 3501-4000 : fonds Pelliot chinois de la Bibliothèque nationale / [réd. sous la dir. de Michel Soymié ; publ. de l'Équipe de recherche sur les manuscrits de Dunhouang, École pratique des hautes études]

Collection : Publications hors série de l'École française d'Extrême-Orient