Robotic-Assisted Surgery Improves the Quality of Total Mesorectal Excision for Rectal Cancer Compared to Laparoscopy: Results of a Case-Controlled Analysis.

BACKGROUND: The use of a robotic surgical system is claimed to allow precise traction and counter-traction, especially in a narrow pelvis. Whether this translates to improvement of the quality of the resected specimen is not yet clear. The aim of the study was to compare the quality of the TME and the short-term oncological outcome between robotic and laparoscopic rectal cancer resections. METHODS: 20 consecutive robotic TME performed in a single institution for rectal cancer (Rob group) were matched 1:2 to 40 laparoscopic resections (Lap group) for gender, body mass index (BMI), and distance from anal verge on rigid proctoscopy. The quality of TME was assessed by 2 blinded and independent pathologists and reported according to international standardized guidelines. RESULTS: Both samples were well matched for gender, BMI (median 25.9 vs. 24.2 kg/m(2), p = 0.24), and level of the tumor (4.1 vs. 4.8 cm, p = 0.20). The quality of the TME was better in the Robotic group (complete TME: 95 vs. 55 %; p = 0.0003, nearly complete TME 5 vs. 37 %; p = 0.04, incomplete TME 0 vs. 8 %, p = 0.09). A trend for lower positive circumferential margin was observed in the Robotic group (10 vs. 25 %, p = 0.1). CONCLUSIONS: These results suggest that robotic-assisted surgery improves the quality of TME for rectal cancer. Whether this translates to better oncological outcome needs to be further investigated.

Toimintamalli asuinkiinteistö öljyvahingon hoitamiseksi

Pienkiinteistöjen öljyvahingot ovat viime vuosina lisääntyneet. Tämän työn tarkoituksena on luoda öljyvahingon torjuntaan ja jälkihoitoon osallistuvalle urakoitsijalle toimintamalli asuinkiinteistön öljyvahingon hoitamiseksi. Mallin halutaan erityisesti kuvaavan öljyvahingon hoitoon osallistuvien viranomaisten ja muiden tahojen vastuita ja velvollisuuksia. Työn tavoitteena on myös tunnistaa pienkiinteistöissä tapahtuvat öljyvahinkotyypit sekä niille altistavat riskitekijät. Öljyn päästäminen ympäristöön sekä öljyn käsittely ja varastointi niin, että siitä aiheutuu öljyvahingon vaara, kielletään laissa. Vahinkojen torjumiseksi on annettu määräyksiä muun muassa öljylämmityslaitteistojen turvallisuutta koskien. Asuinkiinteistöjen öljyvahingot liittyvät yleensä öljysäiliön täyttötilanteisiin. Vahinkojen syynä on usein säiliön ja sen varusteiden puutteellisuus tai huono kunto. Asuinrakennusten lämmitykseen käytetään kevyttä polttoöljyä. Maahan joutuessaan polttoöljy imeytyy sora- ja hiekkamaahan nopeasti, jolloin vaarana on öljyn kulkeutuminen pohjaveteen ja vesistöihin. Asuinkiinteistön öljyvahingossa öljyä joutuu usein myös rakenteisiin. Öljyvahingosta tulee ilmoittaa aina hätäkeskukseen. Vastuu öljyvahinkojen torjunnasta kuuluu alueelliselle pelastustoimelle. Torjuntatoimiin osallistuu usein myös urakoitsija. Jos vahinkokohdetta ei torjuntatoimin saada kunnostettua, alueellinen ympäristökeskus voi määrätä puhdistamisesta vastuussa olevan selvittämään pilaantuneen alueen laajuuden ja puhdistamistarpeen sekä toteuttamaan mahdollisen kunnostuksen. Pilaantuneen maaperän kunnostus voidaan toteuttaa massan vaihtona tai paikan päällä maata kaivamatta. Likaantuneiden rakenteiden saneerausta tarvitaan sisäilman hajuhaittojen poistamiseksi. Öljyvahingon kustannukset voivat nousta hyvinkin suuriksi. Ensisijainen vastuu niistä kuuluu vahingonaiheuttajalle.

The effects of real time control of welding parameters on weld quality in plasma arc keyhole welding

Joints intended for welding frequently show variations in geometry and position, for which it is unfortunately not possible to apply a single set of operating parameters to ensure constant quality. The cause of this difficulty lies in a number of factors, including inaccurate joint preparation and joint fit up, tack welds, as well as thermal distortion of the workpiece. In plasma arc keyhole welding of butt joints, deviations in the gap width may cause weld defects such as an incomplete weld bead, excessive penetration and burn through. Manual adjustment of welding parameters to compensate for variations in the gap width is very difficult, and unsatisfactory weld quality is often obtained. In this study a control system for plasma arc keyhole welding has been developed and used to study the effects of the real time control of welding parameters on gap tolerance during welding of austenitic stainless steel AISI 304L. The welding tests demonstrated the beneficial effect of real time control on weld quality. Compared with welding using constant parameters, the maximum tolerable gap width with an acceptable weld quality was 47% higher when using the real time controlled parameters for a plate thickness of 5 mm. In addition, burn through occurred with significantly larger gap widths when parameters were controlled in real time. Increased gap tolerance enables joints to be prepared and fit up less accurately, saving time and preparation costs for welding. In addition to the control system, a novel technique for back face monitoring is described in this study. The test results showed that the technique could be successfully applied for penetration monitoring when welding non magnetic materials. The results also imply that it is possible to measure the dimensions of the plasma efflux or weld root, and use this information in a feedback control system and, thus, maintain the required weld quality.

Alquilbenzeno sulfonato linear: uma abordagem ambiental e analítica

The environmental impact of detergents and other consumer products is behind the continued interest in the chemistry of the surfactants used. Of these, linear alkylbenzene sulfonates (LASs) are most widely employed in detergent formulations. The precursors to LASs are linear alkylbenzenes (LABs). There is also interest in the chemistry of these hydrocarbons, because they are usually present in commercial LASs (due to incomplete sulfonation), or form as one of their degradation products. Additionally, they may be employed as molecular tracers of domestic waste in the aquatic environment. The following aspects are covered in the present review: The chemistry of surfactants, in particular LAS; environmental impact of the production of LAS; environmental and toxicological effects of LAS; mechanisms of removal of LAS in the environment, and methods for monitoring LAS and LAB, the latter in domestic wastes. Classical and novel analytical methods employed for the determination of LAS and LAB are discussed in detail, and a brief comment on detergents in Brazil is given.

¿Qué entienden los jóvenes universitarios por monogamia y sexo sin penetración, como estrategias preventivas de la transmisión sexual del virus del SIDA? = What university students understand by monogamy and sex without penetration as preventive strategies of sexual transmission of AIDS virus?

Monogamy and sex without penetration are behaviors recommended by the WHO to avoid AIDS virus sexual transmission. Seven hundred and fifty university students from 18 to 25 years (67.7% women) were surveyed and they were asked to give a maximum of three free definitions of the words monogamy and sex without penetration to prevent AIDS virus sexual transmission. Their participation was voluntary and anonymous. Although the majority of the answers was correct, there was a considerable percentage of wrong answers, either for monogamy (3.7% masturbation; 2.1% to have many partners; 0.9% homosexual relations), or for sex without penetration (20.5% oral sex; 1.1% anal coitus; 0.8% coitus without orgasm; 0.4% coitus interruptus). Some definitions or examples differ by gender. The amount of wrongs or incomplete answers put researchers on the alert about insufficient preventive knowledge in a population with a high educational level

Avaliação do risco ambiental em sedimento dos lagos do Riacho Cambé, em Londrina, pela distribuição de metais

The proposal of this study was to obtain the profile of these metals distribution Al, Co, Cu, Pb, Cr, Ni, Co and Zn in sediments from lakes in the city of Londrina-PR and evaluate the environmental risk resulting from such distribution. The parameters of comparison were the values of geological occurrence of these metals in soil from this region, the concentrations of metals in soil samples in the surroundings of the sediments collection points, the guiding values from CETESB and resulting rate risk from RAC criterion application. The result shows that the numerical scale RAC alone is incomplete to this evaluation.

Diesel/biodiesel soot oxidation with ceo2 and ceo2-zro2-modified cordierites: a facile way of accounting for their catalytic ability in fuel combustion processes

CeO2 and mixed CeO2-ZrO2 nanopowders were synthesized and efficiently deposited onto cordierite substrates, with the evaluation of their morphologic and structural properties through XRD, SEM, and FTIR. The modified substrates were employed as outer heterogeneous catalysts for reducing the soot originated from the diesel and diesel/biodiesel blends incomplete combustion. Their activity was evaluated in a diesel stationary motor, and a comparative analysis of the soot emission was carried out through diffuse reflectance spectroscopy. The analyses have shown that the catalyst-impregnated cordierite samples are very efficient for soot oxidation, being capable of reducing the soot emission in more than 60%.

NOVO SORVENTE DE HIDROFOBICIDADE REDUZIDA PARA EXTRAÇÃO EM FASE SÓLIDA: PREPARAÇÃO E CARACTERIZAÇÃO

C18 chemically bonded sorbents have been the main materials used in solid phase extraction (SPE). However, due their high hydrophobicity some hydrophobic solutes are strongly retained leading to the consumption of larger quantities of organic solvent for efficient recoveries. This work presents a sorbent with lower hydrophobicity but similar selectivity to the C18 sorbent, prepared by thermal immobilization of poly(dimethylsiloxane-co-alkylmethylsiloxane) (PDAS) on silica. PDAS has organic chains with methyl groups alternating with octadecyl or hexadecyl groups in its monomeric unities. For the Si(PDAS) sorbent presented, the polymeric layer was physically adsorbed on the silica surface with 12% carbon load. Although the coating of silica with the polymeric layer was incomplete, the PDAS provided better protection for the silica surface groups, promoting mostly hydrophobic interactions between analytes and the sorbent. Sorption isotherm studies revealed that the retention of hydrophobic solutes on Si(PDAS) was less intense than on conventional sorbents, confirming the lower hydrophobicity of the lab-made sorbent. Additional advantages of Si(PDAS) include simplicity and low cost of preparation, making this material a potential sorbent for the analysis of highly hydrophobic solutes.

Cytopathological characterization of Mal de Río Cuarto virus in corn, wheat and barley

The Mal de Río Cuarto disease is caused by Mal de Río Cuarto virus (MRCV) transmitted by Delphacodes kuscheli. Comparative studies were carried out on the cytopathological alterations produced by MRCV in corn (Zea mays), wheat (Triticum aestivum) and barley (Hordeum vulgare), as seen with a transmission electron microscope. Corn plants were infected with viruliferous D. kuscheli collected from the endemic disease area (i.e. Río Cuarto County, Córdoba, Argentina). For the viral transmission to small grain cereal plants, laboratory rared insects were used. In this case, the inoculum source was wheat and barley plants infected with MRCV isolate grown in a greenhouse. Leaf samples with conspicuous symptoms were collected: enations and size reduction in corn; crenatures, swelling veins and dark green color in small grain cereals. Viral infection was corroborated by DAS-ELISA. Viroplasms containing complete and incomplete virus particles and fibrillar material were found in the cytoplasm of infected cells in all species. Mature virions were between 60 and 70 nm diameter. In wheat and barley, viroplasms and dispersed particles were observed only in phloem, while in corn virions were also found in cells of the bundle sheath. Crystalline arrays of particles were detected in corn enation constitutive cells. Tubular inclusions were found only in wheat samples. The three species showed abnormalities in the chloroplasts of affected cells. The results showed that MRCV cytopathology has similarities with other viruses from the genus Fijivirus, family family Reoviridae, but slight differences depending upon the host plant.

Liikkuvan kenttätyön hallinta etätunnistusta ja paikannusta hyödyntävällä mobiilijärjestelmällä

Liikkuvan kenttätyön työntekijät suorittavat työpäivän aikana työtä useassa eri työkohteessa. Työkohteilla suoritettujen työtehtävien kirjaus tapahtuu usein jälkikäteen ja muistinvaraisesti. Diplomityön tavoitteena on esittää ratkaisu liikkuvan kenttätyön työkirjausten automatisointiin. Tavoitteen mukaisen etätunnistusta ja paikannusta hyödyntävän mobiilijärjestelmän avulla työntekijöiden käsinkirjoitetut ja mahdollisesti puutteelliset työkirjaukset korvataan automaattisilla ja täsmällisillä kirjauksilla. Järjestelmän tavoitteena on vähentää työntekijöiden työkuormaa. Työssä arvioidaan etätunnistuksen hyödyntämistä mobiilisovelluksen käyttöä helpottavana tekniikkana. Parhaimmillaan etätunnistus poistaa kokonaan mobiililaitteen näppäilytarpeen, mutta aiheuttaa osaltaan lisää työtä järjestelmän ylläpitoon. Työn tuloksissa esitetään myös satelliittipaikannuksen todettu tarkkuus ja soveltuvuus liikkuvan kenttätyön tarpeisiin taajama- ja kaupunkialueella. Varsinkin kaupunkialueella satelliittiperustaisen paikkatiedon tehokas hyödyntäminen edellyttää suodatusta ja älykkyyttä paikkatiedon prosessointiin.

Survival and Quality of Life among Patients with Severe Lower Extremity Peripheral Arterial Disease

Lower extremity peripheral arterial disease (PAD) is associated with decreased functional status, diminished quality of life (QoL), amputation, myocardial infarction, stroke, and death. Nevertheless, public awareness of PAD as a morbid and mortal disease is low. The aim of this study was to assess the incidence of major lower extremity amputation due to PAD, the extent of reamputations, and survival after major lower extremity amputation (LEA) in a population based PAD patient cohort. Furthermore, the aim was to assess the functional capacity in patients with LEA, and the QoL after lower extremity revascularization and major amputation. All 210 amputees due to PAD in 1998–2002 and all 519 revascularized patients in 1998–2003 were explored. 59 amputees alive in 2004 were interviewed using a structured questionnaire of QoL. Two of each amputee age-, gender- and domicile-matched controls filled in and returned postal self-administered QoL questionnaire as well as 231 revascularized PAD patients (the amount of these patients who engaged themselves to the study), and one control person for each patient completed postal self-administered QoL questionnaire. The incidence rate of major LEA was 24.1/100 000 person-years and it was considerably high during the years studied. The one-month mortality rate was 21%, 52% at one-year, and the overall mortality rate was 80%. When comparing the one-year mortality risk of amputees, LEAs were associated with a 7.4-fold annual mortality risk compared with the reference population in Turku. Twenty-two patients (10%) had ipsilateral transversions from BK to AK amputation. Fifty patients (24%) ended up with a contralateral major LEA within two to four amputation operations. Three bilateral amputations were performed at the first major LEA operation. Of the 51 survivors returning home after their first major LEA, 36 (71%) received a prosthesis; (16/36, 44%) and were able to walk both in- and outdoors. Of the 68 patients who were discharged to institutional care, three (4%) had a prosthesis one year after LEA. Both amputees and revascularized patients had poor physical functioning and significantly more depressive symptoms than their controls. Depressive symptoms were more common in the institutionalized amputees than the home-dwelling amputees. The surviving amputees and their controls had similar life satisfaction. The amputees felt themselves satisfied and contented, whether or not they lived in long-term care or at home. PAD patients who had undergone revascularizations had poorer QoL than their controls. The revascularized patients’ responses on their perceived physical functioning gave an impression that these patients are in a declining life cycle and that revascularizations, even when successful, may not be sufficient to improve the overall function. It is possible that addressing rehabilitation issues earlier in the care may produce a more positive functional outcome. Depressive symptoms should be recognized and thoroughly considered at the same time the patients are recovering from their revascularization operation. Also primary care should develop proper follow-up, and community organizations should have exercise groups for those who are able to return home, since they very often live alone. In rehabilitation programs we should consider not only physical disability assessment but also QoL.

MENTAL FILES AND METAFICTIVE UTTERANCES

ABSTRACT Metafictive utterances raise a kind of intuitions (intuitions of truthfulness) that pose a problem for a view that combines a referentialist approach to proper names with an antirealist stance on fictional characters. In this article I attempt to provide a solution to this problem within the framework of mental files. According to my position, metafictive utterances literally express an incomplete proposition while pragmatically conveying a complete one, which accounts for the intuitions of truthfulness. The proposition pragmatically conveyed is ‘metarepresentational', I'll argue, in the sense that it is about a mental representation or mental file.

Soldiering and the making of Finnish manhood : conscription and masculinity in interwar Finland, 1918–1939

Military conscription and peacetime military service were the subjects of heated political, social and cultural controversies during the early years of national independence in Finland. Both the critics and the supporters of the existing military system described it as strongly formative of young men’s physical and moral development into adult men and male citizens. The conflicts over conscription prompted the contemporaries to express their notions about what Finnish men were like, at their best and at their worst, and what should and could be done about it. This thesis studies military conscription as an arena for the “making of manhood” in peacetime Finnish society, 1918–1939. It examines a range of public images of conscripted soldiering, asking how soldiering was depicted and given gendered meanings in parliamentary debates, war hero myths, texts concerned with the military and civic education of conscripts, as well as in works of fiction and reminiscences about military training as a personal experience. Studying conscription with a focus on masculinity, the thesis explores the different cultural images of manliness, soldiering and male citizenship on offer in Finnish society. It investigates how political parties, officers, educators, journalists, writers and “ordinary” conscripts used and developed, embraced or rejected these notions, according to their political purposes or personal needs. The period between the two world wars can be described as a fast-forward into military modernity in Finland. In the process, European middle class gender ideologies clashed with Finnish agrarian masculinities. Nationalistic agendas for the militarisation of Finnish manhood stumbled against intense class conflicts and ideological resistance. Military propaganda used images of military heroism, civic virtue and individual success to persuade the conscripts into ways of thinking and acting that were shaped by bourgeois mentality, nationalistic ideology and religious morality. These images are further analysed as expressive of the personal experiences and emotions of their middle-aged, male authors. The efforts of these military educators were, however, actively resisted on many fronts, ranging from rural working class masculinities among the conscripted young men to ideological critiques of the standing army system in parliament. In narratives about military training, masculinity was depicted as both strengthened and contradicted by the harsh and even brutal practices of interwar Finnish military training. The study represents a combination of new military history and the historical study of men and masculinities. It approaches masculinity as a contested and highly political form of social and cultural knowledge that is actively and selectively used by historic actors. Instead of trying to identify a dominant or “hegemonic” form of masculinity within a pre-determined theoretical structure, this study examines how the meanings ascribed to manhood varied according to class, age, political ideology and social situation. The interwar period in Finland can be understood as a period of contest between different notions of militarised masculinity, yet to judge by the materials studied, there was no clear winning party in that contest. A gradual movement from an atmosphere of conflict surrounding conscription towards political and cultural compromises can be discerned, yet this convergence was incomplete and many division lines remained.

Vascular Function in Chronic Kidney Disease and in Renovascular Disease

Cardiovascular mortality is 15 to 30 times higher in patients with chronic kidney disease than in the age-adjusted general population. Even minor renal dysfunction predicts cardiovascular events and death in the general population. In patients with atherosclerotic renovascular disease the annual cardiovascular event and death rate is even higher. The abnormalities in coronary and peripheral artery function in the different stages of chronic kidney disease and in renovascular disease are still poorly understood, nor have the cardiac effects of renal artery revascularization been well characterized, although considered to be beneficial. This study was conducted to characterize myocardial perfusion and peripheral endothelial function in patients with chronic kidney disease and in patients with atherosclerotic renovascular disease. Myocardial perfusion was measured with positron emission tomography (PET) and peripheral endothelial function with brachial artery flow-mediated dilatation. It has been suggested that the poor renal outcomes after the renal artery revascularization could be due to damage in the stenotic kidney parenchyma; especially the reduction in the microvascular density, changes mainly evident at the cortical level which controls almost 80% of the total renal blood flow. This study was also performed to measure the effect of renal artery stenosis revascularization on renal perfusion in patients with renovascular disease. In order to do that a PET-based method for quantification of renal perfusion was developed. The coronary flow reserve of patients with chronic kidney disease was similar to the coronary flow reserve of healthy controls. In renovascular disease the coronary flow reserve was, however, markedly reduced. Flow-mediated dilatation of brachial artery was decreased in patients with chronic kidney disease compared to healthy controls, and even more so in patients with renovascular disease. After renal artery stenosis revascularization, coronary vascular function and renal perfusion did not improve in patients with atherosclerotic renovascular disease, but in patients with bilateral renal artery stenosis, flow-mediated dilatation improved. Chronic kidney disease does not significantly affect coronary vascular function. On the contrary, coronary vascular function was severely deteriorated in patients with atherosclerotic renovascular disease, possibly because of diffuse coronary artery disease and/or diffuse microvascular disease. The peripheral endothelial function was disturbed in patients with chronic kidney disease and even more so in patient with atherosclerotic renovascular disease. Renal artery stenosis dilatation does not seem to offer any benefits over medical treatment in patients with renovascular disease, since revascularization does not improve coronary vascular function or renal perfusion.

Some advances in mathematical models for preference relations

Preference relations, and their modeling, have played a crucial role in both social sciences and applied mathematics. A special category of preference relations is represented by cardinal preference relations, which are nothing other than relations which can also take into account the degree of relation. Preference relations play a pivotal role in most of multi criteria decision making methods and in the operational research. This thesis aims at showing some recent advances in their methodology. Actually, there are a number of open issues in this field and the contributions presented in this thesis can be grouped accordingly. The first issue regards the estimation of a weight vector given a preference relation. A new and efficient algorithm for estimating the priority vector of a reciprocal relation, i.e. a special type of preference relation, is going to be presented. The same section contains the proof that twenty methods already proposed in literature lead to unsatisfactory results as they employ a conflicting constraint in their optimization model. The second area of interest concerns consistency evaluation and it is possibly the kernel of the thesis. This thesis contains the proofs that some indices are equivalent and that therefore, some seemingly different formulae, end up leading to the very same result. Moreover, some numerical simulations are presented. The section ends with some consideration of a new method for fairly evaluating consistency. The third matter regards incomplete relations and how to estimate missing comparisons. This section reports a numerical study of the methods already proposed in literature and analyzes their behavior in different situations. The fourth, and last, topic, proposes a way to deal with group decision making by means of connecting preference relations with social network analysis.