Conventional approach x laparoscopic abdominoperineal resection for rectal cancer treatment after neoadjuvant chemoradiation: results of a prospective randomized trial

OBJECTIVE: The aims of this study were to evaluate the safety and efficacy of laparoscopic abdominoperineal resection compared to conventional approach for surgical treatment of patients with distal rectal cancer presenting with incomplete response after chemoradiation. METHOD: Twenty eight patients with distal rectal adenocarcinoma were randomized to undergo surgical treatment by laparoscopic abdominoperineal resection or conventional approach and evaluated prospectively. Thirteen underwent laparoscopic abdominoperineal resection and 15 conventional approach. RESULTS: There was no significant difference (p<0,05) between the two studied groups regarding: gender, age, body mass index, patients with previous abdominal surgeries, intra and post operative complications, need for blood transfusion, hospital stay after surgery, length of resected segment and pathological staging. Mean operation time was 228 minutes for the laparoscopic abdominoperineal resection versus 284 minutes for the conventional approach (p=0.04). Mean anesthesia duration was shorter (p=0.03) for laparoscopic abdominoperineal resection when compared to conventional approach : 304 and 362 minutes, respectively. There was no need for conversion to open approach in this series. After a mean follow-up of 47.2 months and with the exclusion of two patients in the conventional abdominoperineal resection who presented with unsuspected synchronic metastasis during surgery, local recurrence was observed in two patients in the conventional group and in none in the laparoscopic group. CONCLUSIONS: We conclude that laparoscopic abdominoperineal resection is feasible, similar to conventional approach concerning surgery duration, intra operative morbidity, blood requirements and post operative morbidity. Larger number of cases and an extended follow-up are required to adequate evaluation of oncological results for patients undergoing laparoscopic abdominoperineal resection after chemoradiation for radical treatment of distal rectal cancer.

A historical approach to the new secular stagnation hypothesis

In this paper, we analyze the behavior of real interest rates over the long-run using historical data for nine developed economies, to assess the extent to which the recent decline observed in most advanced countries is at odds with the past data, as suggested by the Secular Stagnation hypothesis. By using data from 1703 and performing stationarity and structural breaks tests, we find that the recent decline in interest rates is not explained by a structural break in the time series. Our results also show that considering long-run data leads to different conclusions than using short-run data.

Synthesis and characterization of C3-symmetric 1,3,5 - Benzenetricarboxamide derived supramolecular systems

The aim of this work was to study the self-assembly process of C3-symmetric molecules. To accomplish this objective 1,3,5 – benzentricarboxamides (BTA) derivatives were obtained. Five C3-symmetric molecules were synthesized in moderate to good yields (39-72%) using azo-benzene, aniline, benzylamine, tryptophan and tyrosine. The aggregation behavior of the BTA derivatives was probed with 1H-NMR spectroscopy, 1H-1H 2D Nuclear Overhauser Effect Spectroscopy (NOESY) and Diffusion Ordered Spectroscopy (DOSY). These experiments allowed to study the influence of H-bonding groups, aromatic rings, unsaturated bonds and the overall geometry in the molecular self-assembly associated with the different structural patterns present on these molecules. The stacking and large molecule behavior where observed in BTA 1, aniline derivative, BTA 4, tyrosine derivative or BTA 5, tryptophan derivative, with several of those discussed functional groups such as unsaturated bonds and H-bonding groups. BTA 5 was used in a few preliminary interaction studies with glucose and ammonium chloride showing interaction with the ammonium ion.

A qualitative approach to define the prototype of a Portuguese expatriate leader in Angola

This qualitative research analyzes the individual life experiences of Portuguese expatriate leaders who left their home country to work at organizations in Angola, a place that offers better job opportunities. Through interviews with those professionals and their followers, a prototype of a Portuguese expatriate leader in Angola has been developed. Even though Angola is a former Portuguese colony, it was at war for many years and so the economic situation and culture of the country are distant from what Portuguese workers are used too, which requires them to adapt and be open-minded to change.

A proactive approach o XY international expansion

This work project was conducted under a Direct Research internship (DRI) that consists on an individual dissertation established on a given organization. DRI has a problem solving format to an empirical question to be addressed, «Which country has the highest potential for the next step of XY internationalization process? ». In order to achieve the project’s purpose, it was conducted a scanning process using a top-down approach over an initial list of nine countries given by XY. To do so it was developed an international scanning framework based on different domains and weights that allowed to achieve the top two countries with highest potential. After an in depth analysis over the final set, it was recommended Switzerland as the best country to make the next step of XY internationalization in Europe.

An interactive learning approach to accounting classes

This working paper explores the use of interactive learning tools, such as business simulations, to facilitate the active learning process in accounting classes. Although business simulations were firstly introduced in the United States in the 1950s, the vast majority of accounting professors still use traditional teaching methods, based in end-of-chapter exercises and written cases. Moreover, the current students’ generation brings new challenges to the classroom related with their video, game, internet and mobile culture. Thus, a survey and an experimentation were conducted to understand, on one hand, if accounting professors are willing to adjust their teaching methods with the adoption of interactive learning tools and, on the other hand, if the adoption of interactive learning tools in accounting classes yield better academic results and levels of satisfaction among students. Students using more interactive learning approaches scored significantly higher means than others that did not. Accounting professors are clearly willing to try, at least once, the use of an accounting simulator in classes.

The reasons behind the progression in PISA scores: An education production function approach using semi-parametric techniques

Research Masters

A practical approach to execute and test a lean startup

This paper practically applies the “Lean Startup Approach” by identifying, analyzing and executing a newly developed web-based business idea. Hypotheses were designed and tested with the construction of a minimum viable product – i.e. a landing page. In-depth interviews allowed deciding either to pivot or persevere the initial launch strategy. Overall, the aim was to collect as much valuable response as possible from customers and ultimately decide for a superior strategy while devoting the smallest amount of time and money.

Tendon regeneration through a scaffold-free approach: development of tenogenic magnetic hASCs sheets

Tendon's regeneration is limited, demanding for cell-based strategies to fully restore their functionality upon injury. The concept of magnetic force-based TE(1), generally using magnetic nanoparticles may enable, for example, stem cell stimulation and/or remote control over TE constructs. Thus, we originally propose the development of magnetic cell sheets (magCSs) with tenogenic capability, aimed at promoting tendon's regeneration. A Tenomodulin (TNMD+) subpopulation was sorted from human adipose stem cells (hASCs), using TNMD-coated immunomagnetic beads(2) and used as cell source for the development of magCSs. Briefly, cells were labeled with iron oxide composite particles (Micromod) and cultured for 7 days in α-MEM medium with or without magnetic stimulation provided by a magnetic device (nanoTherics). CSs were retrieved from the plates using magnet attraction as contiguous sheets of cells within its own deposited ECM.

A data-driven analytics approach in the study of pneumonia’s fatalities

As huge amounts of data become available in organizations and society, specific data analytics skills and techniques are needed to explore this data and extract from it useful patterns, tendencies, models or other useful knowledge, which could be used to support the decision-making process, to define new strategies or to understand what is happening in a specific field. Only with a deep understanding of a phenomenon it is possible to fight it. In this paper, a data-driven analytics approach is used for the analysis of the increasing incidence of fatalities by pneumonia in the Portuguese population, characterizing the disease and its incidence in terms of fatalities, knowledge that can be used to define appropriate strategies that can aim to reduce this phenomenon, which has increased more than 65% in a decade.

Detection of road accident accumulation zones with a visual analytics approach

Nowadays, road accidents are a major public health problem, which increase is forecasted if road safety is not treated properly, dying about 1.2 million people every year around the globe. In 2012, Portugal recorded 573 fatalities in road accidents, on site, revealing the largest decreasing of the European Union for 2011, along with Denmark. Beyond the impact caused by fatalities, it was calculated that the economic and social costs of road accidents weighted about 1.17% of the Portuguese gross domestic product in 2010. Visual Analytics allows the combination of data analysis techniques with interactive visualizations, which facilitates the process of knowledge discovery in sets of large and complex data, while the Geovisual Analytics facilitates the exploration of space-time data through maps with different variables and parameters that are under analysis. In Portugal, the identification of road accident accumulation zones, in this work named black spots, has been restricted to annual fixed windows. In this work, it is presented a dynamic approach based on Visual Analytics techniques that is able to identify the displacement of black spots on sliding windows of 12 months. Moreover, with the use of different parameterizations in the formula usually used to detect black spots, it is possible to identify zones that are almost becoming black spots. Through the proposed visualizations, the study and identification of countermeasures to this social and economic problem can gain new grounds and thus the decision- making process is supported and improved.

A bayesian approach for NDT data fusion: The Saint Torcato Church case study

This paper presents a methodology based on the Bayesian data fusion techniques applied to non-destructive and destructive tests for the structural assessment of historical constructions. The aim of the methodology is to reduce the uncertainties of the parameter estimation. The Young's modulus of granite stones was chosen as an example for the present paper. The methodology considers several levels of uncertainty since the parameters of interest are considered random variables with random moments. A new concept of Trust Factor was introduced to affect the uncertainty related to each test results, translated by their standard deviation, depending on the higher or lower reliability of each test to predict a certain parameter.

The potential field method and the nonlinear attractor dynamics approach: what are the differences?

One of the most popular approaches to path planning and control is the potential field method. This method is particularly attractive because it is suitable for on-line feedback control. In this approach the gradient of a potential field is used to generate the robot's trajectory. Thus, the path is generated by the transient solutions of a dynamical system. On the other hand, in the nonlinear attractor dynamic approach the path is generated by a sequence of attractor solutions. This way the transient solutions of the potential field method are replaced by a sequence of attractor solutions (i.e., asymptotically stable states) of a dynamical system. We discuss at a theoretical level some of the main differences of these two approaches.

Analytical approach for the flexural analysis of RC beams strengthened with prestressed CFRP

The objective of this paper is to propose a simplified analytical approach to predict the flexural behavior of simply supported reinforced-concrete (RC) beams flexurally strengthened with prestressed carbon fiber reinforced polymer (CFRP) reinforcements using either externally bonded reinforcing (EBR) or near surface mounted (NSM) techniques. This design methodology also considers the ultimate flexural capacity of NSM CFRP strengthened beams when concrete cover delamination is the governing failure mode. A moment–curvature (M–χ) relationship formed by three linear branches corresponding to the precracking, postcracking, and postyielding stages is established by considering the four critical M–χ points that characterize the flexural behavior of CFRP strengthened beams. Two additional M–χ points, namely, concrete decompression and steel decompression, are also defined to assess the initial effects of the prestress force applied by the FRP reinforcement. The mid-span deflection of the beams is predicted based on the curvature approach, assuming a linear curvature variation between the critical points along the beam length. The good predictive performance of the analytical model is appraised by simulating the force–deflection response registered in experimental programs composed of RC beams strengthened with prestressed NSM CFRP reinforcements.

Assessment of the effectiveness of steel fibre reinforcement for the punching resistance of flat slabs by experimental research and design approach

The present paper deals with the experimental assessment of the effectiveness of steel fibre reinforcement in terms of punching resistance of centrically loaded flat slabs, and to the development of an analytical model capable of predicting the punching behaviour of this type of structures. For this purpose, eight slabs of 2550 x 2550 x 150 mm3 dimensions were tested up to failure, by investigating the influence of the content of steel fibres (0, 60, 75 and 90 kg/m3) and concrete strength class (50 and 70 MPa). Two reference slabs without fibre reinforcement, one for each concrete strength class, and one slab for each fibre content and each strength class compose the experimental program. All slabs were flexurally reinforced with a grid of ribbed steel bars in a percentage to assure punching failure mode for the reference slabs. Hooked ends steel fibres provided the unique shear reinforcement. The results have revealed that steel fibres are very effective in converting brittle punching failure into ductile flexural failure, by increasing both the ultimate load and deflection, as long as adequate fibre reinforcement is assured. An analytical model was developed based on the most recent concepts proposed by the fib Mode Code 2010 for predicting the punching resistance of flat slabs and for the characterization of the behaviour of fibre reinforced concrete. The most refined version of this model was capable of predicting the punching resistance of the tested slabs with excellent accuracy and coefficient of variation of about 5%.