Immediate reconstruction following breast-conserving surgery: Management of the positive surgical margins and influence on secondary reconstruction

The efficacy of breast-conserving Surgery for the local control of early breast cancer has been repeatedly evidenced. Although immediate reconstruction following breast-conserving Surgery has been described, little information is available regarding surgical management in reoperative settings due to positive margins. We studied the influence of intraoperatively assessed and postoperatively controlled Surgical margin status on the type of breast-conserving Surgery and report our results regarding complications in a reoperative breast reconstruction scenario. All patients were seen by a multidisciplinary team who recommended breast-conserving surgery. According to the breast volume, ptosis and tumor size/location, the patients were also evaluated by a plastic Surgeon, who recommended reconstruction with the appropriate technique. Intraoperative assessment Of Surgical margins was determined by histological examination of frozen sections. The mean follow-up time was 48 months. Two hundred and eighteen patients (88.5%) underwent breast-conserving Surgery and immediate reconstruction. Twelve (5.5%) patients had a positive tumor margin after review of the permanent section. All patients underwent re-exploration. In 1.3%, a second reconstructive technique was indicated and in 2.2% a skin-sparing mastectomy with total reconstruction was performed. Our findings support the important role of the intraoperative assessment of surgical margins and its interference in the selection of reconstruction techniques and negative margins: however, it will not guarantee complete excision of the tumor. Success depends on coordinated planning with the oncologic Surgeon and careful intraoperative management, (C) 2008 Elsevier Ltd. All rights reserved.

Effective measures to decrease air contaminants through risk and control visualization : a study of the effective use of QR codes to facilitate safety training

Woodworking industries still consists of wood dust problems. Young workers are especially vulnerable to safety risks. To reduce risks, it is important to change attitudes and increase knowledge about safety. Safety training have shown to establish positive attitudes towards safety among employees. The aim of current study is to analyze the effect of QR codes that link to Picture Mix EXposure (PIMEX) videos by analyzing attitudes to this safety training method and safety in student responses. Safety training videos were used in upper secondary school handicraft programs to demonstrate wood dust risks and methods to decrease exposure to wood dust. A preliminary study was conducted to investigate improvement of safety training in two schools in preparation for the main study that investigated a safety training method in three schools. In the preliminary study the PIMEX method was first used in which students were filmed while wood dust exposure was measured and subsequently displayed on a computer screen in real time. Before and after the filming, teachers, students, and researchers together analyzed wood dust risks and effective measures to reduce exposure to them. For the main study, QR codes linked to PIMEX videos were attached at wood processing machines. Subsequent interviews showed that this safety training method enables students in an early stage of their life to learn about risks and safety measures to control wood dust exposure. The new combination of methods can create awareness, change attitudes and motivation among students to work more frequently to reduce wood dust. 

Growth Regulation and Other Secondary Effects of Herbicides

As all herbicides act on pathways or processes crucial to plants, in an inhibitory or stimulatory way, low doses of any herbicide might be used to beneficially modulate plant growth, development, or composition. Glyphosate, the most used herbicide in the world, is widely applied at low rates to ripen sugarcane. Low rates of glyphosate also can stimulate plant growth (this effect is called hormesis). When applied at recommended rates for weed control, glyphosate can inhibit rust diseases in glyphosate-resistant wheat and soybean. Fluridone blocks carotenoid biosynthesis by inhibition of phytoene desaturase and is effective in reducing the production of abscisic acid in drought-stressed plants. Among the acetolactate synthase inhibitors, sulfometuron-methyl is widely used to ripen sugarcane and imidazolinones can be used to suppress turf species growth. The application of protoporphyrinogen oxidase inhibitors can trigger plant defenses against pathogens. Glufosinate, a glutamine syntherase inhibitor, is also known to improve the control of plant diseases. Auxin agonists (i.e., dicamba and 2,4-D) are effective, low-cost plant growth regulators. Currently, auxin agonists are still used in tissue cultures to induce somatic embryogenesis and to control fruit ripening, to reduce drop of fruits, to enlarge fruit size, or to extend the harvest period in citrus orchards. At low doses, triazine herbicides stimulate growth through beneficial effects on nitrogen metabolism and through auxin-like effects. Thus, sublethal doses of several herbicides have applications other than weed control.

The Crab-eating Fox (Cerdocyon thous) as a secondary seed disperser of Eugenia umbelliflora (Myrtaceae) in a Restinga forest of southeastern Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Microbiological or Chemical Models of Enamel Secondary Caries Compared by Polarized-Light Microscopy and Energy Dispersive X-ray Spectroscopy

Different secondary caries models may present different results. The purpose of this study was to compare different in vitro secondary caries models, evaluating the obtained results by polarized-light microscopy (PLM), scanning electron microscopy (SEM), and energy dispersive X-ray spectroscopy (EDS). Standardized human enamel specimens (n = 12) restored with different materials (Z250 conventional composite resin-CRZ, Freedom polyacid-modified composite resin-CRF, Vitremer resin-modified glass-ionomer-GIV, and Fuji IX conventional glass-ionomer cement-GIF) were submitted to microbiological (MM) or chemical caries models (CM). The control group was not submitted to any caries model. For MM, specimens were immersed firstly in sucrose broth inoculated with Streptococcus mutans ATCC 35688, incubated at 37 degrees C/5% CO(2) for 14 days and then in remineralizing solution for 14 days. For CM, specimens were submitted to chemical pH-cycling. Specimens were ground, submitted to PLM and then were dehydrated, gold-sputtered and submitted to SEM and EDS. Results were statistically analyzed by Kruskall-Wallis and Student-Newman-Keuls tests (alpha = 0.05). No differences between in vitro caries models were found. Morphological differences in enamel demineralization were found between composite resin and polyacid-modified composite resin (CRZ and CRF) and between the resin-modified glass-ionomer and the glass-ionomer cement (GIF and GIV). GIF showed higher calcium concentration and less demineralization, differing from the other materials. In conclusion, the glass-ionomer cement showed less caries formation under both in vitro caries models evaluated. (C) 2009 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 90B: 635-640, 2009

Ability of different restorative materials to prevent in situ secondary caries: analysis by polarized light-microscopy and energy-dispersive X-ray

Secondary caries is the main cause of direct restoration replacement. The purpose of this study was to analyze enamel adjacent to different restorative materials after in situ cariogenic challenge using polarized-light microscopy (PLM), scanning electron microscopy (SEM) and energy-dispersive X-ray analysis (EDS). Twelve volunteers, with a low level of dental plaque, a low level of mutans streptococci, and normal salivary flow, wore removable palatal acrylic appliances containing enamel specimens restored with Z250 composite, Freedom composite, Fuji IX glass-ionomer cement, or Vitremer resin-modified glass-ionomer for 14 days. Volunteers dripped one drop of 20% sucrose solution (n = 10) or distilled water (control group) onto each specimen 8 times per day. Specimens were removed from the appliances and submitted to PLM for examination of the lesion area (in mm(2)), followed by dehydration, gold-sputtering, and submission to SEM and EDS. The calcium (Ca) and phosphorus (P) contents were evaluated in weight per cent (%wt). Differences were found between Z250 and Vitremer, and between Z250 and FujiIX, when analyzed using PLM. Energy-dispersive X-ray analysis results showed differences between the studied materials regarding Ca %wt. In conclusion, enamel adjacent to glass-ionomer cement presented a higher Ca %wt, but this material did not completely prevent enamel secondary caries under in situ cariogenic challenge.

Analytical study of the nonlinear behavior of a shape memory oscillator: Part II-resonance secondary

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Developing an Anchor system to enhance postural control

This article uses an anchor metaphor to explain the dynamic interplay between the human body's active uses of nonrigid tools to mediate information about its adjacent environment to enhance postural control. The author used an anchor system (ropes attached to varying weights resting on the floor) to test blindfolded adults who performed a restricted-balance task (30 s one-foot standing). Participants were tested while holding the anchors under a variety of weight conditions (125 g, 250 g, 500 g, and I kg) and again during a baseline condition (no anchors). When compared with the baseline condition, there was a significant reduction in the amount of body sway across the anchor conditions. The author found that mechanical support provided by the anchor system was secondary to its haptic exploratory function and that an individual can use the anchoring strategy with a dual purpose: for resting and for reorientation after intrinsic disruptions.

A low-cost neurostimulator with accurate pulsed-current control

A constant-current stimulator for high-impedance loads using only low-cost standard high-voltage components Is presented. A voltage-regulator powers an oscillator built across the primary of a step-up transformer whose secondary supplies, after rectification, the high voltage to a switched current-mirror in the driving stage. Adjusting the regulated voltage controls the pulsed-current intensity. A prototype produces stimulus of amplitude and pulsewidth within 0 less than or equal to I-skin less than or equal to 20 mA and 50 mus less than or equal to T-pulse less than or equal to 1 ms, respectively. Pulse-repetition spans from 1 Hz to 10 Hz. Worst case ripple is 3.7% at I-skin = 1 mA. Overall consumption is 5.6 W at I-skin = 20 mA.

Organic complexation and translocation of ferric iron in podzols of the Negro River watershed. Separation of secondary Fe species from Al species

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Hypogaeic anti epigaeic ant (Hymenoptera: Formicidae) assemblages of atlantic costal rainforest and dry mature and secondary amazon forest in Brazil: Continuums or communities

Meat, flour and sugar baits were used on the soil surface and buried to examine species composition of the ant fauna in three separate tropical forests in Brazil, and to control for the effect of the regional faunal pool. Compositional mosaic diversities were comparable among areas, bait types and foraging strata. Mosaic diversity was independent of mean assemblage size. The number of unique species per sampling unit was correlated with mean assemblage size. Canonical correspondence analysis ordered species first by foraging substrate, second by geographic location, and third by diet. The first axis was significantly correlated with mean similarity and affinity. Mean Mahanalobis distances between centroids of groups based upon foraging strata were significantly larger than between localities, indicating local ecological pressures stronger than regional species pool constraints. As most. species foraged in only one stratum in one geographical position and were not omnivorous, the response of species to environmental gradients (continuums) showed a lower coherency with these patterns than did communities, structured around guilds based upon foraging strata and diet.

A simple constant-current neural stimulator with accurate pulse-amplitude control

A simple constant-current electrocutaneous stimulator for high-impedance loads using low-cost, standard high-voltage components is presented. A voltage-regulator powers an oscillator built across the primary of a transformer whose secondary delivers, after rectification, the high-voltage supply to switched current-mirrors in the driving stage. Since the compliance high-voltage is proportional to the stimulation current, overall power consumption is minimized. By adjusting the regulated voltage, control of the pulsed-current amplitude is achieved. A prototype with readily available components features stimulation currents of amplitude and pulsewidth in the range 0≤Iskin≤20mA and 50μs ≤Tpulse≤1ms, respectively. Pulse-repetition spans from 1 Hz to 10Hz. Worst-case ripple is 3.7% @Iskin=1mA. Measured pulse fall-time is shorter than 32μs. Overall consumption is 4.4W @Iskin=20mA. Subject isolation from line is 4KV.

Planning of secondary distribution circuits through evolutionary algorithms

In this work, the planning of secondary distribution circuits is approached as a mixed integer nonlinear programming problem (MINLP). In order to solve this problem, a dedicated evolutionary algorithm (EA) is proposed. This algorithm uses a codification scheme, genetic operators, and control parameters, projected and managed to consider the specific characteristics of the secondary network planning. The codification scheme maps the possible solutions that satisfy the requirements in order to obtain an effective and low-cost projected system-the conductors' adequate dimensioning, load balancing among phases, and the transformer placed at the center of the secondary system loads. An effective algorithm for three-phase power flow is used as an auxiliary methodology of the EA for the calculation of the fitness function proposed for solutions of each topology. Results for two secondary distribution circuits are presented, whereas one presents radial topology and the other a weakly meshed topology. © 2005 IEEE.

Optimal impulsive control in a powered Swing-By

This paper studies the problem of applying an impulsive control in a spacecraft that is performing a Swing-By maneuver. The objective is to study the changes in velocity, energy and angular momentum for this maneuver as a function of the three usual parameters of the standard Swing-By plus the three parameters (the magnitude of the impulse, the point of its application and the angle between the impulse and the velocity of the spacecraft) that specify the impulse applied. The dynamics used is the restricted three body problem under the regularization of Lemaitre, made to increase the accuracy of the numerical integration near the primaries. The present research develops an algorithm to calculate the variation of energy and angular momentum in a maneuver where the application of the impulsive control occurs before or after the passage of the spacecraft by the periapsis, but within the sphere of influence of the secondary body and in a non-tangential direction. Using this approach, it is possible to find the best position and direction to apply the impulse to maximize the energy change of the total maneuver. The results showed that the application of the impulse at the periapsis and in the direction of motion of the spacecraft is usually not the optimal solution.

Risk factors for perinatal death in two different levels of care: a case-control study

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)