Adequate Seal and No Endoleak on the First Postoperative Computed Tomography Angiography as Criteria for No Additional Imaging Up to 5 Years after Endovascular Aneurysm Repair

OBJECTIVE: Intensive image surveillance after endovascular aneurysm repair is generally recommended due to continued risk of complications. However, patients at lower risk may not benefit from this strategy. We evaluated the predictive value of the first postoperative computed tomography angiography (CTA) characteristics for aneurysm-related adverse events as a means of patient selection for risk-adapted surveillance. METHODS: All patients treated with the Low-Permeability Excluder Endoprosthesis (W. L. Gore & Assoc, Flagstaff, Ariz) at a tertiary institution from 2004 to 2011 were included. First postoperative CTAs were analyzed for the presence of endoleaks, endograft kinking, distance from the lowermost renal artery to the start of the endograft, and for proximal and distal sealing length using center lumen line reconstructions. The primary end point was freedom from aneurysm-related adverse events. Multivariable Cox regression was used to test postoperative CTA characteristics as independent risk factors, which were subsequently used as selection criteria for low-risk and high-risk groups. Estimates for freedom from adverse events were obtained using Kaplan-Meier survival curves. RESULTS: Included were 131 patients. The median follow-up was 4.1 years (interquartile range, 2.1-6.1). During this period, 30 patients (23%) sustained aneurysm-related adverse events. Seal length <10 mm and presence of endoleak were significant risk factors for this end point. Patients were subsequently categorized as low-risk (proximal and distal seal length ≥10 mm and no endoleak, n = 62) or high-risk (seal length <10 mm or presence of endoleak, or both; n = 69). During follow-up, four low-risk patients (3%) and 26 high-risk patients (19%) sustained events (P < .001). Four secondary interventions were required in three low-risk patients, and 31 secondary interventions in 23 high-risk patients. Sac growth was observed in two low-risk patients and in 15 high-risk patients. The 5-year estimates for freedom from aneurysm-related adverse events were 98% for the low-risk group and 52% for the high-risk group. For each diagnosis, 81.7 image examinations were necessary in the low-risk group and 8.2 in the high-risk group. CONCLUSIONS: Our results suggest that the first postoperative CTA provides important information for risk stratification after endovascular aneurysm repair when the Excluder endoprosthesis is used. In patients with adequate seal and no endoleaks, the risk of aneurysm-related adverse events was significantly reduced, resulting in a large number of unnecessary image examinations. Adjusting the imaging protocol beyond 30 days and up to 5 years, based on individual patients' risk, may result in a more efficient and rational postoperative surveillance.

Additional data on the epidemiology of chagas disease in the municipality of Caxias, Rio de Janeiro state, Brazil

An area believed to be an autochthonous focus for Chagas' disease was investigated in the municipality of Caxias, Rio de Janeiro State. The study included search for domestic triatomine bugs, serological test (IFT and CFT) in persons in whose house infested bugs were discovered, detailed clinicai examination and xenodiagnosis test of ali serologicall/ yy positive persons, and xenodiagnosis test on dogs from households in which infected triatomine bugs have been found. Only in one of the locatities (Piranema) domestic Triatoma infestans have been discovered. some of which were infected with T. cruzi. A small number of persons (mostly children) had a positive serologicál test for Chagas’ disease, but in all of them the infection was clinically asymptomatic. From two dogs, belonging to a household in which serologically positive children and infected T. infestans were discovered, T. cruzi was isolated by xenodiagnosis. The importunt epidemiological information obtained from this investigation was the discovery of domestic adaptation of T. infestans in an area with dense population .and with very low social and sanitary conditions, in a locality considered as non-endemic for the infection.

Study and characterization of the ZnPc:C60/MoOx interface in organic solar cells by means of photoelectron spectroscopy

Dissertation to obtain the academic degree of Master in materials engineering submitted to the Faculty of science and engineering of Universidade Nova de Lisboa

Absorption in human capital and r&d effects in an endogenous growth model

Until now, in models of endogenous growth with physical capital, human capital and R&D such as in Arnold [Journal of Macroeconomics 20 (1998)] and followers, steady-state growth is independent of innovation activities. We introduce absorption in human capital accumulation and describe the steady-state and transition of the model. We show that this new feature provides an effect of R&D in growth, consumption and welfare. We compare the quantitative effects of R&D productivity with the quantitative effects of Human Capital productivity in wealth and welfare.

The use of protein hydrolysate improves the protein intestinal absorption in undernourished mice infected with Schistosoma mansoni

Patients residing in endemic areas for schistosomiasis in Brazil are usually undernourished and when they develop the hepatosplenic clinical form of the disease should usually receive hospital care, many of them being in need of nutritional rehabilitation before specific treatment can be undertaken. In the mouse model, investigations carried out in our laboratory detected a reduced aminoacid uptake in undernourished animals which is aggravated by a superimposed infection with Schistosoma mansoni. However, in well-nourished infected mice no dysfunction occurs. In this study, we tried to improve the absorptive intestinal performance of undernourished mice infected with S. mansoni by feeding them with hydrolysed casein instead of whole casein. The values obtained for the coefficient of protein intestinal absorption (cpia) among well-nourished mice were above 90% (either hydrolysed or whole protein). In undernourished infected mice, however, the cpia improved significantly after feeding them with hydrolysed casein, animals reaching values close to those obtained in well-nourished infected mice.

NHL 3.5 mortars with scrap tire rubber

The use of wastes and industrial by-products as building materials is an important issue in order to decrease costs with waste management and the embodied energy of building products. Scrap tire rubber has been studied as aggregate for cementitious materials. Natural hydraulic limes are natural binders with particular characteristics of both air and hydraulic binders. Their specifications became stricter with the last version of EN 459-1:2010. In this study scrap tire rubber was used as additional aggregate of mortars, based on NHL3.5 and natural sand. Different particle size fractions and proportions of scrap tire rubber were used: a mix obtained almost directly from industry (only after sieving for preparation of particle sizes similar to mortar aggregate) and separated fine, medium and coarse fractions; 0%, 18%, 36% and 54% weight of binder, corresponding to 2.5%, 5% and 7.5% weight of sand. The influence of the rubbers´ additions on the mortars´ fresh state, mechanical and physical performance is presented, namely by flow table consistency, water retention, fresh bulk density, dynamic elasticity modulus, flexural and compressive strength, open porosity and bulk density, capillary absorption, drying and thermal conductivity. The use of the rubber mix coming from the waste tire industry seems advantageous and may open possibilities for use as raw material by the mortars industry.

Natural hydraulic lime (nhl3.5) mortars with scrap tire rubber

The use of wastes and industrial by-products as building materials is an important issue in order to decrease costs with waste management and the embodied energy of building products. In this study scrap tire rubber was used as additional aggregate of mortars based on natural hydraulic lime NHL 3.5 and natural sand. Different particle size fractions and proportions of scrap tire rubber were used: a mix obtained directly from industry and separated fine, medium and coarse fractions; 0 %, 18 %, 36 % and 54 % of the weight of binder, corresponding to 2.5 %, 5 % and 7.5 % of the weight of sand. As mortars based on NHL specifications became stricter with the current version of EN 459–1:2015, the influence of the rubber’s additions on the mortars’ fresh state, mechanical and physical performance is presented in this work: flow table consistency, water retention, dynamic elasticity modulus, flexural and compressive strength, open porosity and bulk density, capillary absorption, drying and thermal conductivity are studied. The use of the rubber mix coming from the waste tire industry seems advantageous and may open possibilities for use as raw material by the mortars industry.

On the temperature dependence of the absorption cross section for black holes in string theory

We study the low frequency absorption cross section of spherically symmetric nonextremal d-dimensional black holes. In the presence of α′ corrections, this quantity must have an explicit dependence on the Hawking temperature of the form 1/TH. This property of the low frequency absorption cross section is shared by the D1-D5 system from type IIB superstring theory already at the classical level, without α′ corrections. We apply our formula to the simplest example, the classical d-dimensional Reissner-Nordstr¨om solution, checking that the obtained formula for the cross section has a smooth extremal limit. We also apply it for a d-dimensional Tangherlini-like solution with α′3 corrections.

Absorption of scalars by nonextremal charged black holes in string theory

We analyze the low frequency absorption cross section of minimally coupled massless scalar fields by different kinds of charged static black holes in string theory, namely the D1–D5 system in d=5 and a four dimensional dyonic four-charged black hole. In each case we show that this cross section always has the form of some parameter of the solution divided by the black hole Hawking temperature. We also verify in each case that, despite its explicit temperature dependence, such quotient is finite in the extremal limit, giving a well defined cross section. We show that this precise explicit temperature dependence also arises in the same cross section for black holes with string \alpha' corrections: it is actually induced by them.

Fresh-water Algae of the United States; (exclusive of the Diatomaceae) complemental to Desmids of the United States ... One hundred and fifty-one plates ... including nine additional plates of desmids. By the Rev. Francis Wolle ...

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Fresh-water Algae of the United States; (exclusive of the Diatomaceae) complemental to Desmids of the United States ... One hundred and fifty-one plates ... including nine additional plates of desmids. By the Rev. Francis Wolle ...

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Beitrag zur Absorption in flüssigkeitsbedüsten Wirbelschichten

Magdeburg, Univ., Fak. für Verfahrens- und Systemtechnik, Diss., 2003

Absorption and nutrient concentration in apple (Pyrus mains L.)

In order to obtain the following informations: a) dry matter production and extraction of nutrients by the fruits at different ages; b) dry matter production and extraction of nutrient by the leaves and "trunk + branches" collected at the flowering stage; c) dry matter production and export of nutrients by pruning (leaves and branches) at the begining dormant stage; A trial was conducted on Latossolo Vermelho Escuro Orto group (Orthox) at Buri, São Paulo State, Brazil. The material was collected from 'Ohio Beauty' and 'Brazil' apples grafted on 'Doucin' 1-2; 3-4; 4-5 and 6-7 years old. The main conclusions were as follows: a) differences were observed on dry matter production by two varieties at the different stages of growth; b) differences were also observed between the two varieties on the matter production in the leaves and "trunk + branches" at the flowering stage, as well as by the leaves and branches pruned at the begining of dormant stages; c) differences were observed betwen the two varieties concerning to nutrient concentration (on dry matter basis) on the fruits collected at different stages of growth. Same results were observed on leaves and "trunk + branches" collected at flowering period; d) differences were observed on the exportation of the nutrients referring to growth period of fruit; e) at the flowering and dormant period, differences were observed on the contents of nutrients in the leaves, 'trunk + branches', on the two varieties; f) the nutrient exportation by the fruits obyed the following order: K>N>P>S>Ca>Mg>Fe>B > Cu > Mn > Zn > Mo; g) the nutrient extration by the aerial part the apple trees obyed the following order: N > K > Ca > Mg > P > S > Fe > B > Cu = Mn = Zn.