131,488 research outputs found
A Counterexample to a Conjecture of D. B. Fuks
No full textIn [3] D. B. Fuks defined a duality of functors in the category
of weak homotopy types. In general this duality is
more difficult to work with than the duality of functors of the category
of pointed Kelley spaces [2]. It happens however
that all so-called strong functors [2] F of induce functors of
, and if we denote the duality operators of
and by
and D respectively, then there are many cases where
.</jats:p
Existence of geodesic spirals for the Kobayashi--Fuks metric on planar domains
No full textIn this note, we discuss the following problem: Given a smoothly bounded
strongly pseudoconvex domain in , can we guarantee the
existence of geodesics for the Kobayashi--Fuks metric which ``spiral around" in
the interior of ? We find an affirmative answer to the above question for
when is not simply connected.Comment: 12 pages, Introduction modifie
Path to effortlessness: Mauricio Fuks' pedagogical perspectives on the art of violin playing
No full textFor Mauricio Fuks, Rudy Professor of Violin at Indiana University Jacobs School of Music, effortlessness in violin playing has more implications than mere technical facility. It is the aesthetic ideal and the essence of the finest artisanship that may lead to true artistic freedom in playing. The concept of effortlessness in Professor Fuks’ teaching practice involves the paradoxical project of making an effort to play effortlessly, to obtain a degree of violin mastery in which playing is full of intensity and free of needless tension, and to achieve the technical virtuosity as nonchalance or Sprezzatura, an essential foundation in one’s endeavor to reach the highest level of artistry. His meticulous yet plainly elucidated instructions on the physiology of violin playing and its relationship to the mental process not only eradicate any hindrance to attaining technical effortlessness but also reveal the path to self-discovery and artistic identity. My project in this document is to describe how Professor Fuks’ teaching brings this technical and aesthetical ideal about
Timing of Perioperative Chemotherapy Does Not Influence Long-Term Outcome of Patients Undergoing Combined Laparoscopic Colorectal and Liver Resection in Selected Upfront Resectable Synchronous Liver Metastases
No full textBackground: The aim of this study was to compare patients undergoing combined colorectal and hepatic surgery with and without neoadjuvant chemotherapy to clarify the prognostic advantage of preoperative oncological treatment in a case-matched analysis using propensity scores and to identify factors predictive of good prognosis in a selected population of Synchronous ColoRectal Liver Metastases (SCRLM). Methods: A total of 73 patients who underwent upfront elective combined surgery without preoperative CT for SCRLM in two European tertiary referral centers were selected and constituted the study group (NoNACT group). The NoNACT group was matched (ratio 1:1) with patients who were operated after chemotherapy with neoadjuvant intent (NACT group, the control group). The matching was achieved based on six covariates representative of patients and disease characteristics. Results: While the characteristics of both colorectal and hepatic procedures were similar, the NoNACT group, as compared to the NACT group, had lower blood loss (200 mL vs. 550 mL). Postoperative stay (9 vs. 12 days) and morbidity rate (24.7% vs. 32.9%) were reduced in the NoNACT compared with the NACT group. Mid- and long-term outcomes were comparable. At multivariable analysis, predictors of long-term outcome were: right colonic neoplasms, RAS mutational status, CRS score ≥3 and the absence of perioperative chemotherapy. Conclusion: Preoperative neoadjuvant chemotherapy in patients with colorectal cancer and synchronous resectable liver metastases does not influence the risk of recurrence in patients with favorable tumor biology, while it was associated with increased intraoperative blood loss and morbidity. There is no strong evidence to recommend upfront chemotherapy in the absence of negative prognostic factors
MeSH term explosion and author rank improve expert recommendations
No full textInformation overload is an often-cited phenomenon that reduces the productivity, efficiency and efficacy of scientists. One challenge for scientists is to find appropriate collaborators in their research. The literature describes various solutions to the problem of expertise location, but most current approaches do not appear to be very suitable for expert recommendations in biomedical research. In this study, we present the development and initial evaluation of a vector space model-based algorithm to calculate researcher similarity using four inputs: 1) MeSH terms of publications; 2) MeSH terms and author rank; 3) exploded MeSH terms; and 4) exploded MeSH terms and author rank. We developed and evaluated the algorithm using a data set of 17,525 authors and their 22,542 papers. On average, our algorithms correctly predicted 2.5 of the top 5/10 coauthors of individual scientists. Exploded MeSH and author rank outperformed all other algorithms in accuracy, followed closely by MeSH and author rank. Our results show that the accuracy of MeSH term-based matching can be enhanced with other metadata such as author rank
Laparoscopic Management of Hepatocellular Carcinoma: A Critical Reappraisal
No full textFollowing the introduction of the first laparoscopic liver resection, after similar to 25 years, a critical reappraisal seems to be warranted. Liver resection represents the first choice for curing early hepatocellular carcinoma (HCC) allowing a curative chance also in selected patients with intermediate stage tumors. The criteria for liver resectability by laparoscopy remains the same for open surgery, which is oncological criteria (absence of extrahepatic tumor location; completely resectable R0 resection), anatomic (resectability of involved segment with its own blood surely and biliary drainage; absence of vascular invasion of portal or hepatic veins) and technical (possibility to leave in place a residual volume >= 40%). Anatomic resections being more challenging than wedged resections, were initially performed mainly for lesions located in the left liver (segments 2, 3, and 4) and segments 5 and 6 of the right liver (anterior and lateral hepatic segments). Left lateral segmentectomy seemed most suited for laparoscopic resection because of the thinness of the liver, the possibility of resection without hilar dissection, ease of stapling the left hepatic vein and portal pedicles of segment II and III by mechanical stapling. Conversely, right hepatectomy seemed most difficult and technically challenging to perform. The analysis of literature confirms that minor liver resections for HCC can be safely conducted also in cirrhotic patients and that laparoscopy, when feasible, should be the approach of first choice. As mentioned, there have been several studies that compared the long-term outcomes of laparoscopic hepatectomy (LH) versus open hepatectomy for HCC, even in cirrhotic patients, showing that laparoscopy does not seem to have any impact on the risk of postoperative HCC recurrence. However, further studies seem to be required, especially for long-term oncological results and for major hepatectomy, before LH become a common alternative to open liver surgery. The practice of performing LH (major) is challenging, due to the significant complexity of these interventions
Umbilical Single-Port Sleeve Gastrectomy as a Standardized Procedure: How to Do It? (Video)
No full textLaparoscopic sleeve gastrectomy is the most common bariatric procedure worldwide, commonly performed using laparoscopic multiport. Feasibility and safety of single-port sleeve gastrectomy (SPSG) have been proved. We reported a standardized procedure describing the different steps as a reference for bariatric surgeons.
MATERIALS:
Two news concepts are necessary: "surgical corridor," surgeon working in a small intraperitoneal area is less disturbed by excess abdominal fat and liver hypertrophy; "parietal space" is the area in the abdominal wall through the instruments are introduced, it's important to preserve this. The patient was placed in a seated position and we utilized 2.5-3 cm skin incision in the umbilicus. Single trocar was placed; a flexible camera and double curve grasper are needed to decrease grasper conflict. Dissection of the stomach was obtained by 47 cm Thunderbeat (Olympus-Japan), the sleeve of the stomach was created over a 36F calibrator. A 60-mm roticulating XL staplers were used and beginning 4 cm proximal to the pylorus next to the gastro-pancreatic ligament and heading toward the left side of the gastro-esophageal junction. We utilized a linear staple line using 4 to 7 staples; hemostasis is controlled by bipolar coagulation.
RESULTS:
Specimen was removed easily through the single-site trocar. Parietal defect is easily repaired. Operating time is 41 min. The patient was discharged at day 1 without naso-gastric tube or drainage. No complication.
CONCLUSION:
Umbilical SPSG is nowadays a standardized procedure based on the surgical corridor and the parietal space. This is a safe and reproductive procedure applicable in most patients with massive obesity but necessitate learning curve
Pokeweed Mitogen-induced differentiation of human peripheral blood B lymphocytes. I. Surface membrane phenomena and their correlation to intracellular immunoglobulin synthesis
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