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Robotic Resection of Intraductal Neoplasm of the Pancreas
Get PDFAbstract Background: Minimally invasive techniques have been revolutionary and provide clinical evidence of decreased morbidity and comparable efficacy to traditional open surgery. Computer-assisted surgical devices have recently been approved for general surgical use. Aim: The aim of this study was to report the first known case of pancreatic resection with the use of a computerassisted, or robotic, surgical device in Latin America. Patient and Methods: A 37-year-old female with a previous history of radical mastectomy for bilateral breast cancer due to a BRCA2 mutation presented with an acute pancreatitis episode. Radiologic investigation disclosed an intraductal pancreatic neoplasm located in the neck of the pancreas with atrophy of the body and tail. The main pancreatic duct was enlarged. The surgical decision was to perform a laparoscopic subtotal pancreatectomy, using the da Vinci Ò robotic system (Intuitive Surgical, Sunnyvale, CA). Five trocars were used. Pancreatic transection was achieved with vascular endoscopic stapler. The surgical specimen was removed without an additional incision. Results: Operative time was 240 minutes. Blood loss was minimal, and the patient did not receive a transfusion. The recovery was uneventful, and the patient was discharged on postoperative day 4. Conclusions: The subtotal laparoscopic pancreatic resection can safely be performed. The da Vinci robotic system allowed for technical refinements of laparoscopic pancreatic resection. Robotic assistance improved the dissection and control of major blood vessels due to three-dimensional visualization of the operative field and instruments with wrist-type end-effectors
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No full textThis paper discusses the impact of this relationship, looking in particular at how Government manipulation has muddied the 'idea' of the university. The interventionist policies devised to increas
Third Party Evaluation Model in Government Purchase of Home-Based Care Services and Its Improvement
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Improving Capacity and Energy Efficiency of Femtocell Based Cellular Network Through Cell Biasing
Get PDFAbstract-Future of cellular networks lies in heterogeneity. Heterogeneous cellular networks are characterized by overlay of low power nodes such as microcells, picocells, and femtocells along with traditional macrocell base stations. These nodes help operators to improve system capacity in cost effective manner while making the environment greener by reducing the carbon footprint. Research has shown that femtocells can be an effective solution to handle the increasing demands for indoor mobile traffic. However, low utilization of femtocell resources limits the gain obtained from their large scale deployment. Also, random placement of femtocells accumulate additional interference to macrocell users. In this paper, we introduce the concept of cell biasing for femtocells to improve user association and resource utilization. Our work analyses the effects of cell biasing on femtocell based cellular network and provides improvement in capacity and energy efficiency of the network through frequency reuse and subchannel power control. The obtained analytical results are verified through simulation
A Service of zbw Leibniz-Informationszentrum Wirtschaft Leibniz Information Centre for Economics A Flexible Global Warming Index for Use in an Integrated Approach to Climate Change Assessment A Flexible Global Warming Index for Use in an Integrated Approa
No full textStandard-Nutzungsbedingungen: Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden. Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen. Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Abstract. Global Warming Potential (GWP) is an index used to measure the relative accumulated radiative effect of a tonne of greenhouse gas (GHG) compared to that of a 'reference' gas (CO 2 ). Due to the different lifetimes of the GHGs, the GWPs are often measured over a fixed and long period of time (usually 20, 100, or 500 years). The disadvantage of this time-approach is that the index may give a good indication of the relative average effect of each GHG or total radiative forcing over the chosen time horizon, but it may not describe accurately the marginal contribution of each GHG to the overall climate change at a particular point in time, and conditional on a particular climate change policy scenario which is being considered. In this paper, we propose an alternative approach which measures the relative contribution of each GHG to total radiative forcing more accurately and in accordance with the current policy context being considered. We suggest the use of a marginal global warming potential (MGWP) rather than the existing (total or cumulative) GWP index. The MGWP can be calculated accurately and endogenously within a climate model. This is then linked to the marginal abatement cost (MAC) of the gas, estimated within an economic model linked to the climate model. In this way the balancing of the benefits and costs associated with the reduction of a unit of emission of the GHG can be achieved more accurately. We illustrate the use of the new approach in an illustrative experiment, using a multi-sector multi-gas and multi-regional computable general equilibrium economic model (GTAP-E) coupled with a reduced form climate change model (ICLIPS Climate Model, or ICM). The results show that the new approach can significantly improve on the existing method of measuring the trade-offs between different GHGs in their contribution to a climate change objective. Terms of use: Documents in
STUDY ON EMITTANCE DILUTION IN THE JAERI-FEL ENERGY-RECOVERY TRANSPORT
Get PDFAbstract An isochronous recirculating beam transport is under construction at the JAERI-FEL facility for energy-recovery experiments, where FEL output power over 2kW will be available. Since the FEL performance depends largely on the beam emittance, it is important to estimate emittance dilution along the recirculation. In the present paper, we study the emittance dilution in our recirculating transport, which is caused by higher-order aberrations, space charge force and coherent synchrotron radiation force
PRODUCTION OF NEUTRON-RICH LAMBDA HYPERNUCLEI AT J-PARC
Get PDFWe discuss the usefulness of the double charge-exchange reactions (DCX) for the production of the neutron-rich Λ-hypernuclei. We believe the (π − , K + ) reaction is one of the most promising DCX reactions, and propose to produce the neutron-rich Λ-hypernuclei, Keywords: Neutron-Rich Lambda Hypernuclei; Double Charge-Exchange Reaction. Physics Motivation We are preparing the J-PARC E10 experiment for the study of the neutronrich Λ-hypernuclei at the J-PARC 50 GeV PS facility. In this paper, we discuss the issues and the design of the experiment