Current role of surgery for high risk prostate cancer

In this review, the role of surgery in patients with adverse tumor characteristics and a high risk of tumor progression are discussed. In the current PSA era the proportion of patients presenting with high risk prostate cancer (PCa) is estimated to be between 15% and 25% with a 10-year cancer specific survival in the range of 80-90% for those receiving active local treatment. The treatment of high risk prostate cancer is a contemporary challenge. Surgery in this group is gaining popularity since 10-year cancer specific survival data of over 90% has been described. Radical prostatectomy should be combined with extended lymphadenectomy. Adjuvant or salvage therapies may be needed in more than half of patients , guided by pathologic findings and postoperative PSA. Unfortunately there are no randomized controlled trials comparing radical prostatectomy to radiotherapy and no single treatment can be universally recommended. This group of high risk prostate cancer patients should be considered a multi-disciplinary challenge; however, for the properly selected patient, radical prostatectomy either as initial or as the only therapy can be considered an excellent treatment.

Poverty, Educational Attainment and Health Among America’s Children: Current and Future Effects of Population Diversification and Associated Socioeconomic Change

A complex of interrelated factors including minority status, poverty, education, health status, and other factors determine the general welfare of children in America, particularly in heavily diverse states such as Texas. Although racial/ethnic status is clearly only a concomitant factor in that determination it is a factor for which future projections are available and for which the relationships with the other factors in the complex can be assessed. After examining the nature of the interrelationships between these factors we utilize direct standardization techniques to examine how the future diversification of the United States and Texas will affect the number of children in poverty, the educational status of the householders in households in which children in poverty live and the health status of children in 2040 assuming that the current relationships between minority status and these socioeconomic factors continue into the future. In the results of the analyses, data are compared with the total population of the United States and Texas in 2040 assumed in the first simulation scenario, to have the race/ethnicity characteristics of 2008 and in the second those projected for 2040 by the U.S. Census Bureau for the nation and by the Texas State Data Center for Texas in 2040. The results show that the diversification of the population could increase the number of children in poverty in the United States by nearly 1.8 million more than would occur with the lower levels of diversification evident in 2008. In addition, poverty would become increasingly concentrated among minority children with minority children accounting for 76.2 percent of all children in poverty by 2040 and with Hispanic children accounting for nearly half of the children in poverty by 2040. Results for educational attainment show an increasing concentration of minority children in households with householders with very low levels of education such that by 2040, 85.2 percent of the increase in the number of children in poverty would be in households with a householder with less than a high school level of education. Finally, the results related to several health status factors show that children in poverty will have a higher prevalence of nearly all health conditions. For example, the number of children with untreated dental conditions could increase to more than 4 million in the United States and to nearly 500,000 in Texas. The results clearly show that improving the welfare of children in America will require concerted efforts to change the poverty, educational, and health status characteristics associated with minority status and particularly Hispanic status. Failing to do so will lead to a future in which America’s children are increasingly impoverished, more poorly educated, and less healthy and which, as a result, is an America with a more tentative future.

An Inexpensive Alternative to CS Photoshop & Bridge: Archival Master Image Capture and Batch Derivative Creation in Canon Scan Gear & Adobe Photoshop Elements 7

This presentation was made at the Connecticut State Library Service Center, Willimantic, CT, April 14, 2009. It focused on digital capture workflows for both archival and derivative image creation using accepted current standards. Tools used were inexpensive by choice and focused towards the needs of small to mid-sized cultural heritage institutions who wish to begin digital capture in their own facilities.

Estimated current patterns of food consumption and perceived changes among patients with lymphoma

Usual food choices during the past year, self-reported changes in consumption of three important food groups, and weight changes or stability were the questions addressed in this cross-sectional survey and retrospective review. The subjects were 141 patients with Hodgkin's disease or other B-cell types of lymphoma within their first three years following completion of initial treatments for lymphoma at the University of Texas M. D. Anderson Cancer Center in Houston, Texas. ^ The previously validated Block-98 Food Frequency Questionnaire was used to estimate usual food choices during the past year. Supplementary questions asked about changes breads and cereals (white or whole grain) and relative amounts of fruits and vegetables compared with before diagnosis and treatment. Over half of the subjects reported consuming more whole grains, fruits, and/or vegetables and almost three quarters of those not reporting such changes had been consuming whole grains before diagnosis and treatment. ^ Various dietary patterns were defined in order to learn whether proportionately more patients who changed in healthy directions fulfilled recognized nutritional guidelines such as 5-A-day fruits and vegetables and Dietary Reference Intakes (DRIB) for selected nutrients. ^ Small sizes of dietary pattern sub-groups limited the power of this study to detect differences in meeting recommended dietary guidelines. Nevertheless, insufficient and excessive intakes were detected among individuals with respect to fruits and vegetables, fats, calcium, selenium, iron, folate, and Vitamin A. The prevalence of inadequate or excess intakes of foods or nutrients even among those who perceived that they had increased or continued to eat whole grains and/or fruits and vegetables is of concern because of recognized effects upon general health and potential cancer related effects. ^ Over half of the subjects were overweight or obese (by BMI category) on their first visit to this cancer center and that proportion increased to almost three-quarters by their last follow-up visits. Men were significantly heavier than women, but no other significant differences in BMI measures were found even after accounting for prescribed steroids and dietary patterns. ^

Some advances in extensive bridge monitoring using low cost dynamic characterization

Dynamic measurements will become a standard for bridge monitoring in the near future. This fact will produce an important cost reduction for maintenance. US Administration has a long term intensive research program in order to diminish the estimated current maintenance cost of US$7 billion per year over 20 years. An optimal intervention maintenance program demands a historical dynamical record, as well as an updated mathematical model of the structure to be monitored. In case that a model of the structure is not actually available it is possible to produce it, however this possibility does not exist for missing measurement records from the past. Current acquisition systems to monitor structures can be made more efficient by introducing the following improvements, under development in the Spanish research Project “Low cost bridge health monitoring by ambient vibration tests using wireless sensors”: (a) a complete wireless system to acquire sensor data, (b) a wireless system that permits the localization and the hardware identification of the whole sensor system. The applied localization system has been object of a recent patent, and (c) automatization of the modal identification process, aimed to diminish human intervention. This system is assembled with cheap components and allows the simultaneous use of a large number of sensors at a low placement cost. The engineer’s intervention is limited to the selection of sensor positions, probably based on a preliminary FE analysis. In case of multiple setups, also the position of a number of fixed reference sensors has to be decided. The wireless localization system will obtain the exact coordinates of all these sensors positions. When the selection of optimal positions is difficult, for example because of the lack of a proper FE model, this can be compensated by using a higher number of measuring (also reference) points. The described low cost acquisition system allows the responsible bridge administration to obtain historical dynamic identification records at reasonable costs that will be used in future maintenance programs. Therefore, due to the importance of the baseline monitoring record of a new bridge, a monitoring test just after its construction should be highly recommended, if not compulsory.

Parametric analysis on bridge reinforced concrete elevated pile-cap foundations

Current design practices recommend to comply with the capacity protection principle, which pays special attention to ensuring an elastic response of the foundations under ground motion events. However, in cases such as elevated reinforced concrete (RC) pile-cap foundation typologies, this design criterion may lead to conservative designs, with excessively high construction costs. Reinforced concrete elevated pile-cap foundations is a system formed by a group of partially embedded piles connected through an aboveground stayed cap and embedded in soil. In the cases when they are subjected to ground motions, the piles suffer large bending moments that make it difficult to maintain their behavior within the elastic range of deformations. Aiming to make an in-depth analysis of the nonlinear behavior of elevated pile-cap foundations, a cyclic loading test was performed on a concrete 2x3 pile configuration specimen of elevated pile-cap foundation. Two results of this test, the failure mechanism and the ductile behavior, were used for the calibration of a numerical model built in OpenSees framework, by using a pushover analysis. The calibration of the numerical model enabled an in-depth study of the seismic nonlinear response of this kind of foundations. A parametric analysis was carried for this purpose, aiming to study how sensitive RC elevated pile-cap foundations are, when subjected to variations in the diameter of piles, reinforcement ratios, external loads, soil density or multilayer configurations. This analysis provided a set of ductility factors that can be used as a reference for design practices and which correspond to each of the cases analyzed.

A transient outward-rectifying K+ channel current down-regulated by cytosolic Ca2+ in Arabidopsis thaliana guard cells

Sustained (noninactivating) outward-rectifying K+ channel currents have been identified in a variety of plant cell types and species. Here, in Arabidopsis thaliana guard cells, in addition to these sustained K+ currents, an inactivating outward-rectifying K+ current was characterized (plant A-type current: IAP). IAP activated rapidly with a time constant of 165 ms and inactivated slowly with a time constant of 7.2 sec at +40 mV. IAP was enhanced by increasing the duration (from 0 to 20 sec) and degree (from +20 to −100 mV) of prepulse hyperpolarization. Ionic substitution and relaxation (tail) current recordings showed that outward IAP was mainly carried by K+ ions. In contrast to the sustained outward-rectifying K+ currents, cytosolic alkaline pH was found to inhibit IAP and extracellular K+ was required for IAP activity. Furthermore, increasing cytosolic free Ca2+ in the physiological range strongly inhibited IAP activity with a half inhibitory concentration of ≈ 94 nM. We present a detailed characterization of an inactivating K+ current in a higher plant cell. Regulation of IAP by diverse factors including membrane potential, cytosolic Ca2+ and pH, and extracellular K+ and Ca2+ implies that the inactivating IAP described here may have important functions during transient depolarizations found in guard cells, and in integrated signal transduction processes during stomatal movements.

Direct measurement of salt-bridge solvation energies using a peptide model system: implications for protein stability.

The solvation energies of salt bridges formed between the terminal carboxyl of the host pentapeptide AcWL- X-LL and the side chains of Arg or Lys in the guest (X) position have been measured. The energies were derived from octanol-to-buffer transfer free energies determined between pH 1 and pH 9. 13C NMR measurements show that the salt bridges form in the octanol phase, but not in the buffer phase, when the side chains and the terminal carboxyl group are charged. The free energy of salt-bridge formation in octanol is approximately -4 kcal/mol (1 cal = 4.184 J), which is equal to or slightly larger than the sum of the solvation energies of noninteracting pairs of charged side chains. This is about one-half the free energy that would result from replacing a charge pair in octanol with a pair of hydrophobic residues of moderate size. Therefore, salt bridging in octanol can change the favorable aqueous solvation energy of a pair of oppositely charged residues to neutral or slightly unfavorable but cannot provide the same free energy decrease as hydrophobic residues. This is consistent with recent computational and experimental studies of protein stability.

Disclosure of Leniency Materials: A Bridge between Public and Private Enforcement of Antitrust Law. Research Paper in Law 08/2013, December

The disclosure of leniency materials held by competition authorities has recently been under the spot. On the one hand, these documents could greatly help cartel victims to prove the damage and the causation link when filing damage actions against cartelists. On the other hand, future cartelists could be deterred from applying for leniency since damage actions could be brought as a result of the information submitted by themselves. Neither the current legislation nor the case law have attained yet to sufficiently clarify how to deal with this clash of interests. Our approach obviously attempts to strike a balance between both interests. But not only that. We see the current debate as a great opportunity to boost the private enforcement of antitrust law through the positive spillovers of leniency programmes. We hence propose to build a bridge between the public and the private enforcement by enabling a partial disclosure of the documents.

Progetto di un convertitore full-bridge phase-shifted isolato a commutazione risonante

L'evoluzione della tecnologia allo stato solido e il fiorire di nuove applicazioni determinano una forte spinta verso la miniaturizzazione dei convertitori elettronici di potenza. Questa riduzione di pesi ed ingombri è particolarmente sentita anche in quei convertitori di media potenza che necessitano di un trasformatore d'isolamento. In quest'ambito assume importante rilievo l'utilizzo di una architettura circuitale a ponte intero e di tecniche in grado di spingere la frequenza di commutazione il più in alto possibile. Questa tesi si propone quindi di studiare a fondo il funzionamento dei convertitori DC/DC isolati di tipo Full-Bridge e pilotati con la tecnica di modulazione Phase-Shifted che ben si presta all'impiego di commutazioni risonanti del tipo Zero-Voltage-Switching. L'analisi teorica sarà corroborata da simulazioni condotte su LTspice e sarà orientata all'individuazione di una metodologia di progetto generale per questo tipo di convertitori. Al fine di formalizzare meglio il progetto si è individuata una possibile applicazione nell'alimentazione di un DC-bus per telecomunicazioni (48 Volt DC sostenuti da batterie) a partire da una fonte di energia fotovoltaica quale una stringa di pannelli operanti con tensioni variabili da 120 a 180 Volt DC. Per questo particolare tipo di applicazione in discesa può avere senso l'impiego di un rettificatore del tipo a duplicazione di corrente, che quindi si provvederà a studiare e ad implementare a secondario del trasformatore d'isolamento. Infine particolare cura sarà dedicata alla parte di controllo che si ha intenzione di integrare all'interno di LTspice così da riuscire a simulare il comportamento dinamico del convertitore e verificare quanto predetto in via teorica mediante l'impiego della procedura che utilizza il K-Factor per la realizzazione della rete compensatrice.

Multimodal Imaging and Choroidal Volumetric Changes After Half-fluence PDT in Central Serous Chorioretinopathy.

PURPOSE The purpose of this study was to identify SD-OCT changes that correspond to leakage on fluorescein (FA) and indocyanine angiography (ICGA) and evaluate effect of half-fluence photodynamic therapy (PDT) on choroidal volume in chronic central serous choroidoretinopathy (CSC). METHODS Retrospective analysis of patients with chronic CSC who had undergone PDT. Baseline FA and ICGA images were overlaid on SD-OCT to identify OCT correlates of FA or ICGA hyperfluorescence. Choroidal volume was evaluated in a subgroup of eyes before and after PDT. RESULTS Twenty eyes were evaluated at baseline, of which seven eyes had choroidal volume evaluations at baseline and 3 months following PDT. SD-OCT changes corresponding to FA hyperfluorescence were subretinal fluid (73%), RPE microrip (50%), RPE double-layer sign (31%), RPE detachment (15%), and RPE thickening (8%). ICGA hyperfluoresence was correlated in 93% with hyperreflective spots in the superficial choroid. Choroidal volume decreased from 9.35 ± 1.99 to 8.52 ± 1.92 and 8.04 ± 1.7 mm(3) (at 1 and 3 months post PDT, respectively, p ≤ 0.001). CONCLUSIONS We identified specific OCT findings that correlate with FA and ICGA leakage sites. SD-OCT is a valuable tool to localize CSC lesions and may be useful to guide PDT treatment. Generalized choroidal volume decrease occurs following PDT and extends beyond PDT treatment site.

Report on proposed bridge crossing of Puget Sound from Seattle to the Olympic Peninsula made to the Washington Toll Bridge Authority.

Half title.

The history of Crowland Abbey, digested from the materials collected by Mr. Gough, and published ... 1783 and 1797; including an abstract of the observations of Mr. Essex, respecting the ancient and present state of the abbey, and the origin and use of the triangular bridge ...

"Appendix: Concerning the history of the building of our more ancient abbey churches, and the rise and progress of the pointed or English architecture; digested from the essays published by J. Taylor, on the architecture of the middle ages, by ... T. Warton, J. Bentham, and J. Milner, and Captain Grose ..." (p. [143]-182) has special half-title.

Direct and general support maintenance manual : boat, bridge erection, twin jet, aluminum hull, model USCSBMK 1 (1940-01-105-5728).

Includes index.

5-ton, 6x6, M809 series trucks (diesel) : truck, chassis, M809, M809A1, M810 ... truck, stake, bridge transporting, M821.

"January 1981."