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Feasibility of reduced port surgery applying Higuchi's transverse incision
No full textAbstractObjectiveHiguchi's transverse incision is made at a lower position than the Pfannenstiel transverse incision and is superior in terms of cosmetic outcomes. The purpose of this study was to examine the safety and efficacy of novel forms of reduced port surgery for ovarian cysts and uterine fibroids applying Higuchi's transverse incision.MethodsIn 33 patients with ovarian cysts who underwent low-position single-incision laparoscopic surgery (L-SILS)-modified single-port laparoscopy placed in the 2–3-cm Higuchi's incision above the pubis, patient's characteristics and perioperative outcomes were compared with those of patients who underwent multiport laparoscopy (n=53). In addition, 18 patients with uterine fibroids who underwent dual-port laparoscopically assisted myomectomy without using power morcellators and conventional four-port laparoscopically assisted myomectomy were investigated.ResultsThere were no significant differences between L-SILS and multiport laparoscopy in tumor diameter, bleeding, hospital stay, or postoperative pain. However, the L-SILS group demonstrated significantly shorter operative and pneumoperitoneum times (p<0.01 and p<0.01). In comparison with cases of uterine fibroids, no significant differences were found in maximum fibroid diameter, operative time, pneumoperitoneum time, or bleeding. However, the dual-port laparoscopically assisted myomectomy group demonstrated a significantly shorter length of hospital stay than the conventional laparoscopically assisted myomectomy group (p<0.05).ConclusionWe reported novel forms of reduced port surgery applying Higuchi's transverse incision. It was suggested that these procedures are relatively simple, but ensure the same safety and efficacy as conventional methods. We intend to increase the number of cases and examine safety, efficacy, and patient satisfaction for these procedures
Efeitos de diferentes níveis de pressão expiratória final sobre a hemodinâmica, mecânica respiratória e resposta sistêmica ao estresse durante colecistectomia laparoscópica
No full textResumoObjetivoA anestesia geral causa a redução da capacidade residual funcional e essa diminuição pode levar à atelectasia pulmonar e ao shunt intrapulmonar. Neste estudo pretendemos avaliar os efeitos de níveis de 5 e 10cmH2O de pressão expiratória final positiva (PEEP) sobre as trocas gasosas, a hemodinâmica, a mecânica respiratória e a resposta ao estresse sistêmico em colecistectomia laparoscópica.MétodoForam selecionados aleatoriamente 43 pacientes, estado físico ASA I‐II, agendados para colecistectomia laparoscópica, para receber PEEP a 5cmH2O (grupo PEEP‐5) ou PEEP de 10cmH2O (grupo PEEP‐10) durante o pneumoperitônio. Os parâmetros hemodinâmicos foram registrados, gasometria arterial e coleta de sangue foram feitas para estimativa dos níveis de cortisol, insulina e glicose para avaliar a resposta ao estresse sistêmico antes da indução anestésica. Trinta minutos após o pneumoperitônio, os parâmetros hemodinâmicos e respiratórios foram registrados novamente e gasometria e amostragem para os níveis de cortisol, insulina e glicose foram repetidos. E os últimos parâmetros hemodinâmicos foram registrados, análise e amostragem de gasometria para os níveis de resposta ao estresse foram feitas após 60 minutos da extubação.ResultadosNão houve diferença estatística entre dois grupos quanto aos parâmetros hemodinâmicos e respiratórios, exceto pressão média das vias aéreas (Pmédia). Os valores de Pmédia, complacência, PaO2 e do pH foram maiores no grupo PEEP‐10. Também os valores de PaCO2 foram menores no grupo PEEP‐10. Não foram observadas quaisquer diferenças entre os níveis de insulina e de ácido láctico nos dois grupos. Porém, o nível de cortisol no pós‐operatório foi significativamente menor no grupo PEEP‐10.ConclusãoVentilação com PEEP de 10cmH2O aumenta a complacência e a oxigenação, não causa hemodinâmica e complicações respiratórias e reduz a resposta ao estresse no pós‐operatório.AbstractObjectiveGeneral anesthesia causes reduction of functional residual capacity. And this decrease can lead to atelectasis and intrapulmonary shunting in the lung. In this study we want to evaluate the effects of 5 and 10cmH2O PEEP levels on gas exchange, hemodynamic, respiratory mechanics and systemic stress response in laparoscopic cholecystectomy.MethodsAmerican Society of Anesthesiologist I–II physical status 43 patients scheduled for laparoscopic cholecystectomy were randomly selected to receive external PEEP of 5cmH2O (PEEP 5 group) or 10cmH2O PEEP (PEEP 10 group) during pneumoperitoneum. Basal hemodynamic parameters were recorded, and arterial blood gases (ABG) and blood sampling were done for cortisol, insulin and glucose level estimations to assess the systemic stress response before induction of anesthesia. Thirty minutes after the pneumoperitoneum, the respiratory and hemodynamic parameters were recorded again and ABG and sampling for cortisol, insulin, and glucose levels were repeated. Lastly hemodynamic parameters were recorded; ABG analysis and sampling for stress response levels were taken after 60minutes from extubation.ResultsThere were no statistical differences between the two groups about hemodynamic and respiratory parameters except mean airway pressure (Pmean). Pmean, compliance and PaO2; pH values were higher in ‘PEEP 10 group’. Also, PaCO2 values were lower in ‘PEEP 10 group’. No differences were observed between insulin and lactic acid levels in the two groups. But postoperative cortisol level was significantly lower in ‘PEEP 10 group’.ConclusionVentilation with 10cmH2O PEEP increases compliance and oxygenation, does not cause hemodynamic and respiratory complications and reduces the postoperative stress response
Using the particle swarm optimization algorithm to calibrate the parameters relating to the turbulent flux in the surface layer in the source region of the Yellow River
No full textAbstractAccurately determining the fluxes of mass and energy between land and the atmosphere is important for understanding regional climates and hydrological cycles. In numerical modeling, the parameterization of a turbulent flux is usually based on Monin-Obukhov similarity theory (MOST). According to this theory, it is necessary to simultaneously calculate the empirical similarity parameters βm, βh, γm, and γh, the aerodynamic roughness (z0m) and the thermal roughness (zT). However, it is difficult to solve a simultaneous set of nonlinear equations for these six parameters. In this study, a new method was introduced to solving this problem. Using measurements from Maqu Station in the source region of the Yellow River, this study employed the artificial intelligence particle swarm optimization (PSO) algorithm to calibrate the parameters relating to the turbulent flux in the surface layer. We concluded that the differences in the sensible heat and momentum fluxes between the calculations that used the calibrated parameters and the measurements were rather small and that their correlation coefficients were relatively high. The results suggested that PSO algorithm is a feasible approach which can be applied in MOST parameter estimation
Measuring social capital: further insights
No full textAbstractSocial capital is defined as the resources available to individuals and groups through membership in social networks. However, multiple definitions, distinct dimensions and subtypes of social capital have been used to investigate and theorise about its relationship to health on different scales, creating a confusing picture. This heterogeneity makes it necessary to systematise social capital measures in order to build a stronger foundation in terms of how these associations between the different aspects of social capital and each specific health indicator develop. We aim to provide an overview of the measurement approaches used to measure social capital in its different dimensions and scales, as well as the mechanisms through which it is presumed to influence health. Understanding the mechanisms through which these relationships develop may help to refine the existing measures or to identify new, more appropriate ones
Can social media be a tool for reducing consumers’ food waste? A behaviour change experiment by a UK retailer
No full textAbstractThis paper reports on a landmark study to field-test the influence of a large retailer to change the behaviour of its millions of customers. Previous studies have suggested that social media interaction can influence behaviour. This study implemented three interventions with messages to encourage reductions in food waste. The first was a social influence intervention that used the retailer’s Facebook pages to encourage its customers to interact. Two additional information interventions were used as a comparison through the retailer’s print/digital magazine and e-newsletter. Three national surveys tracked customers’ self-reported food waste one month before as well as two weeks after and five months after the interventions. The control group included those who said they had not seen any of the interventions. The results were surprising and significant in that the social media and e-newsletter interventions as well as the control group all showed significant reductions in self-reported food waste by customers over the study period. Hence in this field study, social media does not seem to replicate enough of the effect of ‘face-to-face’ interaction shown in previous studies to change behaviour above other factors in the shopping setting. This may indicate that results from laboratory-based studies may over-emphasise the effect of social media interventions
The Heisenberg algebra as near horizon symmetry of the black flower solutions of Chern–Simons-like theories of gravity
No full textAbstractIn this paper we study the near horizon symmetry algebra of the non-extremal black hole solutions of the Chern–Simons-like theories of gravity, which are stationary but are not necessarily spherically symmetric. We define the extended off-shell ADT current which is an extension of the generalized ADT current. We use the extended off-shell ADT current to define quasi-local conserved charges such that they are conserved for Killing vectors and asymptotically Killing vectors which depend on dynamical fields of the considered theory. We apply this formalism to the Generalized Minimal Massive Gravity (GMMG) and obtain conserved charges of a spacetime which describes near horizon geometry of non-extremal black holes. Eventually, we find the algebra of conserved charges in Fourier modes. It is interesting that, similar to the Einstein gravity in the presence of negative cosmological constant, for the GMMG model also we obtain the Heisenberg algebra as the near horizon symmetry algebra of the black flower solutions. Also the vacuum state and all descendants of the vacuum have the same energy. Thus these zero energy excitations on the horizon appear as soft hairs on the black hole
Trophic overlap between wolves and free-ranging wolf × dog hybrids in the Apennine Mountains, Italy
No full textAbstractHybridization between wolves (Canis lupus) and domestic dogs (Canis familiaris) can represent a threat to wild populations via genetic introgression and ecological competition. Therefore understanding the ecological role of hybrids may be crucial for developing appropriate conservation strategies.The Italian wolf population has a peculiar genetic composition due to a long-lasting geographic isolation. Nowadays, however, its genetic integrity is threatened by the spread of canine genes as a result of the hybridization with stray dogs in the wild.The aim of the present study was to gain insights into the ecological role of free-ranging wolf–dog hybrids by investigating their winter food habits in comparison with wolves in a mountain area of Central Italy. Levels of genetic introgression from the dogs were assessed in two adjacent areas occupied by up to five different packs by analyzing non-invasive samples and carcasses collected therein with a set of uniparental and bi-parental molecular markers.The obtained results enabled us to classify the two areas as ‘hybrid’ and ‘wolf’ areas based on their level of genetic introgression.Trophic niche and similarity/dissimilarity analyses did not detect significant difference in the diet between the two areas: in both of them, wild boar was the main prey, followed by roe deer. Furthermore, the same age/body mass classes of the two ungulates were selected by wolves and hybrids. Our findings confirmed wolf–dog hybrids as potential competitors for wolves. Further studies on other aspects of their biology and ecology are recommended in order to better estimate the impact of hybridization on natural wolf populations
Iliopsoas abscess as a complication of glycogen storage disease 1b
No full textAbstractWe present a case of iliopsoas abscess secondary to inflammatory bowel disease associated to glycogen storage disease 1b in a 12-year-old boy. To the best of our knowledge, a similar case has not been reported in medical literature
Nitrogen-fixing bacteria and arbuscular mycorrhizal fungi in Piptadenia gonoacantha (Mart.) Macbr.
No full textAbstractThe family Leguminosae comprises approximately 20,000 species that mostly form symbioses with arbuscular mycorrhizal fungi (AMF) and nitrogen-fixing bacteria (NFB). This study is aimed at investigating and confirming the dependence on nodulation and biological nitrogen fixation in the specie Piptadenia gonoacantha (Mart.) Macbr., which belongs to the Piptadenia group. Two consecutive experiments were performed in a greenhouse. The experiments were fully randomized with six replicates and a factorial scheme. For the treatments, the two AMF species and three NFB strains were combined to nodulate P. gonoacantha in addition to the control treatments. The results indicate this species’ capacity for nodulation without the AMF; however, the AMF+NFB combinations yielded a considerable gain in P. gonoacantha shoot weight compared with the treatments that only included inoculating with bacteria or AMF. The results also confirm that the treatment effects among the AMF+NFB combinations produced different shoot dry weight/root dry weight ratios. We conclude that AMF is not necessary for nodulation and that this dependence improves species development because plant growth increases upon co-inoculation
Does medial temporal lobe thickness mediate the association between risk factor burden and memory performance in middle-aged or older adults with metabolic syndrome?
No full textAbstractMetabolic syndrome (MetS) is a cluster of cardiovascular and metabolic abnormalities that together may increase the risk of developing cognitive decline and dementia; however, the neural substrate is incompletely understood. We investigated cortical thickness in the medial temporal lobe (MTL), hippocampal volume, as well as relationships among metabolic risk factor burden, structure and memory performance. Path-analytic models were tested to explore the relations between MetS risk factor, structure and memory performance. Participants were 65 non-demented, middle-aged and older adults, 34 with and 31 without metabolic syndrome. We analyzed archival T1-weighted magnetic resonance imaging (MRI) acquired at 3T and Total Recall and Delayed Recall scores from the Brief Visuospatial Memory Test Revised (BVMT-R). Middle-aged adults with MetS showed less MTL thickness, particularly in entorhinal cortex; while older adults showed a trend for left hippocampal volume loss. Lower MTL thickness, particularly in entorhinal cortex, was associated with greater metabolic risk factor burden in middle-aged adults. In older adults, hippocampal volume was associated with Total Recall and Delayed Recall, while in middle-age entorhinal cortical thickness mediated the association between metabolic disease burden and episodic memory function. The differential findings in middle-aged and older adults with MetS contribute to an understanding of the relationships between metabolic syndrome, structural changes in the brain and increased risk for cognitive decline