Intraoperative adverse events during laparoscopic colorectal resection-better laparoscopic treatment but unchanged incidence. Lessons learnt from a Swiss multi-institutional analysis of 3,928 patients.

PURPOSE: Intraoperative adverse events significantly influence morbidity and mortality of laparoscopic colorectal resections. Over an 11-year period, the changes of occurrence of such intraoperative adverse events were assessed in this study. METHODS: Analysis of 3,928 patients undergoing elective laparoscopic colorectal resection based on the prospective database of the Swiss Association of Laparoscopic and Thoracoscopic Surgery was performed. RESULTS: Overall, 377 intraoperative adverse events occurred in 329 patients (overall incidence of 8.4 %). Of 377 events, 163 (43 %) were surgical complications and 214 (57 %) were nonsurgical adverse events. Surgical complications were iatrogenic injury to solid organs (n = 63; incidence of 1.6 %), bleeding (n = 62; 1.6 %), lesion by puncture (n = 25; 0.6 %), and intraoperative anastomotic leakage (n = 13; 0.3 %). Of note, 11 % of intraoperative organ/puncture lesions requiring re-intervention were missed intraoperatively. Nonsurgical adverse events were problems with equipment (n = 127; 3.2 %), anesthetic problems (n = 30; 0.8 %), and various (n = 57; 1.5 %). Over time, the rate of intraoperative adverse events decreased, but not significantly. Bleeding complications significantly decreased (p = 0.015), and equipment problems increased (p = 0.036). However, the rate of adverse events requiring conversion significantly decreased with time (p < 0.001). Patients with an intraoperative adverse event had a significantly higher rate of postoperative local and general morbidity (41.2 and 32.9 % vs. 18.0 and 17.2 %, p < 0.001 and p < 0.001, respectively). CONCLUSIONS: Intraoperative surgical complications and adverse events in laparoscopic colorectal resections did not change significantly over time and are associated with an increased postoperative morbidity.

The QUASAR reproducibility study, Part II: Results from a multi-center Arterial Spin Labeling test-retest study.

Arterial Spin Labeling (ASL) is a method to measure perfusion using magnetically labeled blood water as an endogenous tracer. Being fully non-invasive, this technique is attractive for longitudinal studies of cerebral blood flow in healthy and diseased individuals, or as a surrogate marker of metabolism. So far, ASL has been restricted mostly to specialist centers due to a generally low SNR of the method and potential issues with user-dependent analysis needed to obtain quantitative measurement of cerebral blood flow (CBF). Here, we evaluated a particular implementation of ASL (called Quantitative STAR labeling of Arterial Regions or QUASAR), a method providing user independent quantification of CBF in a large test-retest study across sites from around the world, dubbed "The QUASAR reproducibility study". Altogether, 28 sites located in Asia, Europe and North America participated and a total of 284 healthy volunteers were scanned. Minimal operator dependence was assured by using an automatic planning tool and its accuracy and potential usefulness in multi-center trials was evaluated as well. Accurate repositioning between sessions was achieved with the automatic planning tool showing mean displacements of 1.87+/-0.95 mm and rotations of 1.56+/-0.66 degrees . Mean gray matter CBF was 47.4+/-7.5 [ml/100 g/min] with a between-subject standard variation SD(b)=5.5 [ml/100 g/min] and a within-subject standard deviation SD(w)=4.7 [ml/100 g/min]. The corresponding repeatability was 13.0 [ml/100 g/min] and was found to be within the range of previous studies.

Atributos físicos de um Neossolo Quartzarênico e um Latossolo Vermelho sob diferentes sistemas de manejo

O objetivo deste estudo foi avaliar o efeito de diferentes sistemas de manejo, nos atributos físicos de um Neossolo Quartzarênico e de um Latossolo Vermelho. Foram avaliados a densidade do solo, o volume total de poros e a resistência mecânica à penetração. Todos os sistemas de manejo e uso do solo promoveram aumento na densidade, diminuição do volume total de poros e variação da resistência do solo à penetração. No Neossolo Quartzarênico houve diminuição da macroporosidade.

Application of Multi-SNP Approaches Bayesian LASSO and AUC-RF to Detect Main Effects of Inflammatory-Gene Variants Associated with Bladder Cancer Risk

The relationship between inflammation and cancer is well established in several tumor types, including bladder cancer. We performed an association study between 886 inflammatory-gene variants and bladder cancer risk in 1,047 cases and 988 controls from the Spanish Bladder Cancer (SBC)/EPICURO Study. A preliminary exploration with the widely used univariate logistic regression approach did not identify any significant SNP after correcting for multiple testing. We further applied two more comprehensive methods to capture the complexity of bladder cancer genetic susceptibility: Bayesian Threshold LASSO (BTL), a regularized regression method, and AUC-Random Forest, a machine-learning algorithm. Both approaches explore the joint effect of markers. BTL analysis identified a signature of 37 SNPs in 34 genes showing an association with bladder cancer. AUC-RF detected an optimal predictive subset of 56 SNPs. 13 SNPs were identified by both methods in the total population. Using resources from the Texas Bladder Cancer study we were able to replicate 30% of the SNPs assessed. The associations between inflammatory SNPs and bladder cancer were reexamined among non-smokers to eliminate the effect of tobacco, one of the strongest and most prevalent environmental risk factor for this tumor. A 9 SNP-signature was detected by BTL. Here we report, for the first time, a set of SNP in inflammatory genes jointly associated with bladder cancer risk. These results highlight the importance of the complex structure of genetic susceptibility associated with cancer risk.

Micromorfologia do solo e sua relação com atributos físicos e hídricos

O objetivo deste trabalho foi avaliar a relação entre atributos micromorfológicos e físicos de um Latossolo Vermelho eutroférrico, sob cultivo de cana-de-açúcar. As amostras de solo foram coletadas nos pontos de cruzamento de uma malha, com intervalos regulares de 10 m, perfazendo um total de 100 pontos, nos horizontes A1 e AB. Os altos valores da densidade do solo, microporosidade e resistência do solo à penetração, e os baixos valores da macroporosidade, porosidade total e condutividade hidráulica do solo saturado, principalmente no horizonte AB, indicaram compactação confirmada pela análise de imagens (micromorfologia).

Simulação estocástica de atributos do clima e da produtividade potencial de milho utilizando-se distribuição triangular

O objetivo deste trabalho foi simular a produtividade potencial da cultura de milho, pelo método de Monte Carlo, utilizando um modelo agrometeorológico estocástico. O experimento foi conduzido em Piracicaba, SP, a 22º42'30''S, 47º38'30''W, e altitude de 546 m, o clima da região é do tipo Cwa (tropical úmido). Foram utilizados os valores médios diários de temperatura (de 1917 a 2002) e radiação solar global (de 1978 a 2002). Para comparar os dados reais com os simulados, foram utilizados índices de desempenho estatístico. Observou-se que os modelos probabilísticos, desenvolvidos para a simulação de dados médios diários de temperatura e de radiação solar global, geraram valores semelhantes aos observados por meio da distribuição triangular, a qual pode ser utilizada em modelo estocástico, para previsão da produtividade potencial de milho, nas diferentes épocas de semeadura.

Remote collaborative multi-user informal learning experiences: design and evaluation

This paper presents a customizable system used to develop a collaborative multi-user problem solving game. It addresses the increasing demand for appealing informal learning experiences in museum-like settings. The system facilitates remote collaboration by allowing groups of learners tocommunicate through a videoconferencing system and by allowing them to simultaneously interact through a shared multi-touch interactive surface. A user study with 20 user groups indicates that the game facilitates collaboration between local and remote groups of learners. The videoconference and multitouch surface acted as communication channels, attracted students’ interest, facilitated engagement, and promoted inter- and intra-group collaboration—favoring intra-group collaboration. Our findings suggest that augmentingvideoconferencing systems with a shared multitouch space offers newpossibilities and scenarios for remote collaborative environments and collaborative learning.

Análise multivariada de atributos nutricionais associados ao "bitter pit" em maçãs 'Gala'

O objetivo deste trabalho foi identificar atributos nutricionais, quantificados na polpa e na casca dos frutos, que melhor discriminam quanto à severidade de "bitter pit" em maçãs 'Gala'. Depois de quatro meses de armazenamento em atmosfera normal (0-1°C; 90-95% UR), os frutos foram separados em quatro lotes, de acordo com a severidade de incidência de "bitter pit": nula (nenhuma lesão por fruto), baixa (1-2 lesões por fruto), moderada (3-4 lesões por fruto) e alta (5-13 lesões por fruto). Foram determinados os teores de Ca, Mg, K e N na casca e na polpa em frutos individuais (doze frutos de cada lote). A análise univariada mostrou que os frutos com sintomas de "bitter pit" apresentaram menor teor de Ca na casca e na polpa, maior teor de K na casca e maiores valores das relações K/Ca, Mg/Ca, N/Ca, (K+Mg)/Ca e (K+Mg+N)/Ca, tanto na casca como na polpa. Todavia, quando todos os atributos nutricionais avaliados na casca e na polpa foram submetidos à análise canônica discriminante (análise multivariada), a melhor discriminação entre frutos sem "bitter pit" e frutos com severidade de incidência de "bitter pit" de baixa a alta é obtida com a relação K/Ca na casca, seguido, em menor grau, pelas relações Mg/Ca e N/Ca na polpa.

Atributos de fertilidade e frações húmicas de um Latossolo Vermelho no Cerrado

O objetivo deste trabalho foi avaliar os atributos de fertilidade e as frações de matéria orgânica, ácido fúlvico, ácido húmico e humina, em um Latossolo Vermelho distroférrico, sob diferentes sistemas de cultivo no Cerrado. Os experimentos foram conduzidos no período de 1993 a 2003. Os tratamentos foram divididos em quatro grupos: lavoura (1 e 7), rotação lavoura/pastagem (3 e 5), rotação pastagem/lavoura (4 e 6) e pastagem contínua (2 e 8), todos em plantio direto. A avaliação do solo foi feita após dez anos de cultivo, com análises químicas de amostras da profundidade de 0-20 cm. Foi observado que os teores de Ca2+ variaram de 4,6 cmol c kg-1 (lavoura) a 6,20 cmol c kg-1 (pastagem contínua), e os de P disponível, de 1 a 6 mg kg-1. Os teores de Mg2+ variaram de 3 cmol c kg-1, sob lavoura/pastagem, a 3,8 cmol c kg-1 em pastagem contínua, e os de K+, de 0,28 cmol c kg-1 sob pastagem contínua, a 1,10 cmol c kg-1 em lavoura/pastagem. Os teores de C orgânico variaram de 16,6 g kg-1 na lavoura a 28,0 g kg-1 sob lavoura/pastagem. A fração humina apresenta os maiores valores entre as frações da matéria orgânica.

La part du national. Comparer des politiques infranationales dans un environnement multi-niveaux

Si des enjeux, des configurations d'acteurs, ou la définition de certains problems peuvent être propres au niveau local, ceux-ci sont fréquemment influencés par des paramètres définis à d'autres niveaux de gouvernement. En particulier, il est nécessaire que les dispositifs de recherche centrés sur la comparaison de politiques infranationales abordent directement la question de l'intégration et de l'impact du cadre national. Comment faire la part du national dans les comparaisons de politiques infranationales ? À partir d'un ensemble de travaux de sociologie de l'action publique, cet article montre que dominent deux manières d'articuler national et infranational. Certains travaux privilégient le niveau national, et prennent en compte ce qui se joue à d'autres niveaux pour observer des déclinaisons ou des réappropriations de politiques mises en place au niveau national. D'autres travaux, en particulier la littérature centrée sur la gouvernance territoriale ou urbaine, accordent un primat au local tout en prenant acte de la multiplication des niveaux de gouvernement. Enfin, l'accent est placé sur les tentatives visant à concilier ces perspectives. À l'appui de nos propres travaux, nous montrons comment des approches centrées sur les acteurs permettent d'ouvrir des pistes stimulantes pour articuler plusieurs niveaux d'analyse.

Análise multivariada de atributos do solo em sistemas convencional e orgânico de produção de maçãs

Este estudo foi conduzido em pomares de maçãs nos sistemas de manejo convencional e orgânico, com o objetivo de identificar diferenças entre os dois sistemas de produção, com base em atributos microbiológicos e químicos do solo, por meio de métodos multivariados, como a análise canônica discriminante (ACD) e a análise de correlação canônica (ACC). Em ambos os pomares, foram feitas amostragens em 24 plantas distribuídas em uma grade de 45x54 m, em duas épocas, para a quantificação de teores de carbono da biomassa microbiana (CBM), carbono orgânico total do solo (COT), nitrogênio da biomassa microbiana (NBM), nitrogênio total do solo (NT), relação CBM:COT, relação NBM:NT, respiração basal (C-CO2) e quociente metabólico (qCO2), além da determinação de atributos químicos destes solos. A ACD identificou o CBM como o atributo microbiológico mais importante pela análise multivariada, na separação entre os pomares, seguido do qCO2 e da relação NBM:NT. Atributos microbiológicos e químicos relacionados ao carbono foram mais sensíveis às variações entre os sistemas do que os relacionados ao nitrogênio. Houve alta correlação canônica entre os atributos microbiológicos e químicos do solo nos pomares, com destaque para o CBM, entre os atributos biológicos, e para o pH H2O e alumínio, entre os atributos químicos.

Fate of the herbicide glyphosate and its metabolite AMPA in soils and their transfer to surface waters: A multi-scale approach in the Lavaux vineyards, western Switzerland

The use of herbicides in agriculture may lead to environmental problems, such as surface water pollution, with a potential risk for aquatic organisms. The herbicide glyphosate is the most used active ingredient in the world and in Switzerland. In the Lavaux vineyards it is nearly the only molecule applied. This work aimed at studying its fate in soils and its transfer to surface waters, using a multi-scale approach: from molecular (10-9 m) and microscopic scales (10-6 m), to macroscopic (m) and landscape ones (103 m). First of all, an analytical method was developed for the trace level quantification of this widely used herbicide and its main by-product, aminomethylphosphonic acid (AMPA). Due to their polar nature, their derivatization with 9-fluorenylmethyl chloroformate (FMOC-Cl) was done prior to their concentration and purification by solid phase extraction. They were then analyzed by ultra performance liquid chromatography coupled with tandem mass spectrometry (UPLC-MS/MS). The method was tested in different aqueous matrices with spiking tests and validated for the matrix effect correction in relevant environmental samples. Calibration curves established between 10 and 1000ng/l showed r2 values above 0.989, mean recoveries varied between 86 and 133% and limits of detection and quantification of the method were as low as 5 and 10ng/l respectively. At the parcel scale, two parcels of the Lavaux vineyard area, located near the Lutrive River at 6km to the east of Lausanne, were monitored to assess to which extent glyphosate and AMPA were retained in the soil or exported to surface waters. They were equipped at their bottom with porous ceramic cups and runoff collectors, which allowed retrieving water samples for the growing seasons 2010 and 2011. Results revealed that the mobility of glyphosate and AMPA in the unsaturated zone was likely driven by the precipitation regime and the soil characteristics, such as slope, porosity structure and layer permeability discrepancy. Elevated glyphosate and AMPA concentrations were measured at 60 and 80 cm depth at parcel bottoms, suggesting their infiltration in the upper parts of the parcels and the presence of preferential flow in the studied parcels. Indeed, the succession of rainy days induced the gradual saturation of the soil porosity, leading to rapid infiltration through macropores, as well as surface runoff formation. Furthermore, the presence of more impervious weathered marls at 100 cm depth induced throughflows, the importance of which for the lateral transport of the herbicide molecules was determined by the slope steepness. Important rainfall events (>10 mm/day) were clearly exporting molecules from the soil top layer, as indicated by important concentrations in runoff samples. A mass balance showed that total loss (10-20%) mainly occurred through surface runoff (96%) and, to a minor extent, by throughflows in soils (4%), with subsequent exfiltration to surface waters. Observations made in the Lutrive River revealed interesting details of glyphosate and AMPA dynamics in urbanized landscapes, such as the Lavaux vineyards. Indeed, besides their physical and chemical properties, herbicide dynamics at the catchment level strongly depend on application rates, precipitation regime, land use and also on the presence of drains or constructed channels. Elevated concentrations, up to 4970 ng/l, observed just after the application, confirmed the diffuse export of these compounds from the vineyard area by surface runoff during main rain events. From April to September 2011, a total load of 7.1 kg was calculated, with 85% coming from vineyards and minor urban sources and 15% from arable crops. Small vineyard surfaces could generate high concentrations of herbicides and contribute considerably to the total load calculated at the outlet, due to their steep slopes (~10%). The extrapolated total amount transferred yearly from the Lavaux vineyards to the Lake of Geneva was of 190kg. At the molecular scale, the possible involvement of dissolved organic matter (DOM) in glyphosate and copper transport was studied using UV/Vis fluorescence spectroscopy. Combined with parallel factor (PARAFAC) analysis, this technique allowed characterizing DOM of soil and surface water samples from the studied vineyard area. Glyphosate concentrations were linked to the fulvic-like spectroscopic signature of DOM in soil water samples, as well as to copper, suggesting the formation of ternary complexes. In surface water samples, its concentrations were also correlated to copper ones, but not in a significant way to the fulvic-like signature. Quenching experiments with standards confirmed field tendencies in the laboratory, with a stronger decrease in fluorescence intensity for fulvic-like fluorophore than for more aromatic ones. Lastly, based on maximum concentrations measured in the river, an environmental risk for these compounds was assessed, using laboratory tests and ecotoxicity data from the literature. In our case and with the methodology applied, the risk towards aquatic species was found negligible (RF<1).

Statistical mechanics of multi-edge networks

Statistical properties of binary complex networks are well understood and recently many attempts have been made to extend this knowledge to weighted ones. There are, however, subtle yet important considerations to be made regarding the nature of the weights used in this generalization. Weights can be either continuous or discrete magnitudes, and in the latter case, they can additionally have undistinguishable or distinguishable nature. This fact has not been addressed in the literature insofar and has deep implications on the network statistics. In this work we face this problem introducing multiedge networks as graphs where multiple (distinguishable) connections between nodes are considered. We develop a statistical mechanics framework where it is possible to get information about the most relevant observables given a large spectrum of linear and nonlinear constraints including those depending both on the number of multiedges per link and their binary projection. The latter case is particularly interesting as we show that binary projections can be understood from multiedge processes. The implications of these results are important as many real-agent-based problems mapped onto graphs require this treatment for a proper characterization of their collective behavior.

The Job Board : Borsa de treball on-line, distribuïda i multi-dispositiu

Aquest treball final de carrera es basa en la creació d'una borsa de treball on-line, distribuïda i multi-dispositiu. Ha estat creada a partir de noves tecnologies com Play Framework i Twiter Bootstrap, utilitzant els llenguatges Java i Scala, usant marcatge HTML5 i desplegada en un servidor de cloud computing anomenat Heroku.