Background
The body mass index (BMI) in the general population has increased over the past decades. A high BMI is a known risk factor for the development of esophageal adenocarcinoma. Several studies ...on the influence of a high BMI on the postoperative course and survival after esophagectomy have shown contradictory results. The aim of the present study was to determine the influence of a high BMI on postoperative complications and survival among a large cohort of esophageal cancer patients.
Methods
Patients who underwent an esophagectomy between 1993 and 2010 were divided into three groups according to their BMI: normal weight (<25 kg/m
2
), overweight (25–30 kg/m
2
) or obese (≥30 kg/m
2
). Severity of complications was scored according to the Dindo classification, which was divided into three categories: no complications, minor to moderate complications, and severe complications. Long-term survival was determined according to the Kaplan–Meier method.
Results
A total of 736 esophagectomy patients were divided into three groups: normal weight (
n
= 352), overweight (
n
= 308), and obese (
n
= 72). Complications rates were similar for all groups (65–72%,
P
= 0.241). The incidence of anastomotic leakage was higher among obese patients compared to the other groups (20% vs. 10–12% respectively,
P
= 0.019), but there was no significant difference between the three groups regarding the severity of complications according to the Dindo classification (
P
= 0.660) or in 5-year survival rates (
P
= 0.517).
Conclusions
A high BMI is not associated with an increased incidence or severity of complications after esophagectomy; however, anastomotic leakage occurred more frequently in obese patients. Five-year survival rates were not influenced by the preoperative BMI. A high BMI is therefore ought not be an exclusion criterion for esophagectomy.
•Posterior malleolar fracture morphology evaluated with computed tomography and not with - unreliable - plain radiographs.•Posterior malleolar fracture morphology determines outcome in rotational ...type ankle fractures.•Posterior malleolar ankle fractures with medial extension are associated with significantly poorer functional outcome scores at two years postoperative.•Undertake computed tomography imaging when a posterior malleolar ankle fracture is expected.•Base treatment decision not on the fracture-fragment-size threshold, but merely on fracture morphology and fragment pathoanatomy.
Rotational type ankle fractures with a concomitant fracture of the posterior malleolus are associated with a poorer clinical outcome as compared to ankle fractures without. However, clinical implications of posterior malleolar (PM) fracture morphology and pattern have yet to be established. Many studies on this subject report on fragment size, rather than fracture morphology based on computed tomography (CT). The overall purpose of the current study was to elucidate the correlation of PM fracture morphology and functional outcome, assessed with CT imaging and not with –unreliable- plain radiographs.
Between January 2010 and May 2014, 194 patients with an operatively (ORIF) treated ankle fracture, were prospectively included in the randomized clinical EF3X-trial at our Level-I trauma center. The current study retrospectively included 73 patients with rotational type ankle fractures and concomitant fractures of the posterior malleolus. According to the CT-based Haraguchi fracture morphology, all patients were divided into three groups: 20 Type I (large posterolateral-oblique), 21 Type II (transverse medial-extension) and 32 Type III (small-shell fragment). At 12 weeks, 1 year and 2 years postoperatively the Foot and Ankle Outcome Scores (FAOS) and SF-36 scores were obtained, with the FAOS domain scores at two years postoperative as primary study outcome. Statistical analysis included a multivariate regression and secondary a mixed model analysis.
Haraguchi Type II PM ankle fractures demonstrated significantly poorer outcome scores at two years follow-up compared to Haraguchi Types I and III. Mean FAOS domain scores at two years follow-up showed to be significantly worse in Haraguchi Type II as compared to Type III, respectively: Symptoms 48.2 versus 61.7 (p = 0.03), Pain 58.5 versus 84.4 (p < 0.01), Activities of Daily Living (ADL) 64.1 versus 90.5 (p < 0.01).
Posterior malleolar ankle fractures with medial extension of the fracture line (i.e. Haraguchi Type II) are associated with significantly poorer functional outcomes. The current dogma to fix PM fractures that involve at least 25–33% of the tibial plafond may be challenged, as posterior malleolar fracture pattern and morphology - rather than fragment size - seem to determine outcome.
Adsorption and diffusion of CO2 in CPO-27–Ni beads Krishnamurthy, S.; Blom, R.; Ferrari, M. C. ...
Adsorption : journal of the International Adsorption Society,
2020/7, Letnik:
26, Številka:
5
Journal Article
Recenzirano
Odprti dostop
The present work involves the scale-up and characterization of CPO-27–Ni metal organic framework using a range of experimental techniques aimed at determining equilibrium and kinetic parameters to ...assess its potential for post-combustion carbon capture. CPO-27–Ni was prepared from its precursors by molecular gastronomy methods in kilogram scale. Adsorption of isotherms of pure CO
2
and N
2
were obtained for different temperatures on these beads, using a volumetric apparatus and the isotherms were fitted to a dual-site Langmuir model. A series of experiments were then carried out in the volumetric apparatus by dosing a known volume of CO
2
and the pressure was monitored with time. The diffusional time constants were then extracted by fitting the series of curves to an isothermal diffusion model. From the time constants, the values of the diffusivities were obtained and compared with the values obtained from first principles correlations, which employed the pore size, and the porosity values from independent mercury porosimetry experiments. The results from the analysis showed that the transport of CO
2
in the beads was well described by a combination of Knudsen and viscous diffusion mechanisms. Experiments were also carried out using a zero-length column (ZLC) apparatus by preparing a 10% CO
2
–He and 10% CO
2
–N
2
mixture. The analysis of the ZLC curves showed that the two different carrier gases had an effect of the long-time slope, indicating the presence of a macropore-controlled diffusion mechanism.
This paper examines an approach to model the vibrations of a deformed rolling tyre at low frequencies (below 500
Hz). The starting point for this approach is a finite element (FE) model of the tyre ...and the aim is to calculate the dynamic response of a rolling tyre including the details of its complex build up. This allows to relate the tyre design parameters to its vibro-acoustic properties. In this context, a modal approximation based on the eigenvalues and eigenvectors extracted from the detailed FE model of the tyre seems a computationally efficient possibility. In the proposed approach the natural frequencies and modeshapes of a deformed tyre are calculated in a standard FE package using the full (nonlinear) FE model. Subsequently, this modal base is transformed to determine the response of the rotating tyre in a fixed (Eulerian) reference frame. Furthermore, this approach makes it possible to define a receptance matrix for the rotating tyre. Results from relatively simple tyre models show that the effects of rotation are modelled correctly and are in accordance with results from literature.
For a long time, public and semipublic organizations have borrowed Human Resource Management (HRM) practices from the private sector to enhance employee performance. Numerous scholars argue, however, ...that business-like practices are less effective outside the private sector context because of sector-specific conditions. Based on the ability–motivation–opportunity model, we performed a three-level meta-analysis to investigate differences in effects of HRM practices on individual performance across sectors. Our study shows that significant differences exist between sectors, but the expectation that the effects of HRM practices are largest in the private sector and smallest in the public sector is not supported. More specifically, the differences between the public, semipublic, and private sector are not straightforward. In this respect, we encourage future scholars to further examine these differences.
Abstract Background PET-CT scanning is increasingly applied in the primary work-up of esophageal cancer patients. The additional value of a second PET-CT after completion of neoadjuvant therapy (NT) ...prior to surgery is presently unclear. Therefore, a consecutive series of esophageal cancer patients underwent PET-CT scanning after completion of NT for evaluation of metastatic disease that became manifest under NT. Methods A consecutive series of patients planned for curative esophagectomy who underwent a PET-CT prior to and after NT were included in this study. Neoadjuvant therapy consisted of 5FU and cisplatinum combined with 50.4Gy radiotherapy. The first PET-CT was performed as part of the diagnostic work-up, the second PET-CT was performed after completion of NT and prior to surgery. Median interval between NT and second PETCT was 6 weeks. In case of metastatic disease on the post-neoadjuvant therapy PET-CT confirmed by a biopsy, patients were excluded from surgical resection. Results Between November 2008 and July 2010 a total of 50 patients underwent first and second PET-CT scanning. 80% of patients was diagnosed with adenocarcinoma, 18% with squamous cell carcinoma. Confirmed metastatic disease on the second PET-CT was present in 4/50 patients (8%). These patients were excluded from resection. A false-positive diagnosis concerning a pulmonary lesion was present in 1 patient (2%); this infiltrate had disappeared on follow up imaging. Discussion This study showed development of metastatic disease during NT detected by PET-CT in 8% of esophageal cancer patients, suggesting an additional value of a second PET-CT in order to prevent unnecessary surgical resections.
Summary
The implementation of neoadjuvant chemoradiotherapy (CRT) in esophageal cancer (EC) patients has led to improved survival rates. Worldwide, different CRT regimens are applied. It is unknown ...how these regimens relate to each other regarding efficacy. Therefore, the aim of this study was to determine the preferred regimen regarding toxicity of, response to CRT, and long‐term survival after esophagectomy in EC patients. EC patients in two centers who underwent CRT with different regimens prior to surgery were included in this study. CRT consisted of 50.4Gy combined with two cycles of cisplatin and 5‐FU(center A), or 41.4Gy combined with five cycles of carboplatin and paclitaxel (center B). Toxicity, response to therapy and long‐term survival were compared between groups. One hundred sisty‐five patients were included. Forty‐one percent of patients in center A developed ≥1 toxicity ≥ grade 3 versus 25% in center B (P = 0.025). CRT with a cisplatin‐based regimen was an independent predictor for development of toxicity ≥ grade 3 (P = 0.043). There were no differences in response between both regimens (P = 0.904). Three‐year survival was 61% (A) versus 57% (B) (P = 0.725). The carboplatin/paclitaxel/41.4Gy regimen causes less toxicity compared to the cisplatin/5‐FU/50.4Gy regimen with nonsignificant differences in response rates and long‐term survival; therefore our results support this regimen to be the preferred regimen for EC patients.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Satellite remote sensing is providing a systematic, synoptic framework for advancing scientific knowledge of the Earth as a complex system of geophysical phenomena that, directly and through ...interacting processes, often lead to natural hazards. Improved and integrated measurements along with numerical modeling are enabling a greater understanding of where and when a particular hazard event is most likely to occur and result in significant socioeconomic impact. Geospatial information products derived from this research increasingly are addressing the operational requirements of decision support systems used by policy makers, emergency managers and responders from international and federal to regional, state and local jurisdictions. This forms the basis for comprehensive risk assessments and better-informed mitigation planning, disaster assessment and response prioritization. Space-based geodetic measurements of the solid Earth with the Global Positioning System, for example, combined with ground-based seismological measurements, are yielding the principal data for modeling lithospheric processes and for accurately estimating the distribution of potentially damaging strong ground motions which is critical for earthquake engineering applications. Moreover, integrated with interferometric synthetic aperture radar, these measurements provide spatially continuous observations of deformation with sub-centimeter accuracy. Seismic and in situ monitoring, geodetic measurements, high-resolution digital elevation models (e.g. from InSAR, Lidar and digital photogrammetry) and imaging spectroscopy (e.g. using ASTER, MODIS and Hyperion) are contributing significantly to volcanic hazard risk assessment, with the potential to aid land use planning in developing countries where the impact of volcanic hazards to populations and lifelines is continually increasing. Remotely sensed data play an integral role in reconstructing the recent history of the land surface and in predicting hazards due to flood and landslide events. Satellite data are addressing diverse observational requirements that are imposed by the need for surface, subsurface and hydrologic characterization, including the delineation of flood and landslide zones for risk assessments. Short- and long-term sea-level change and the impact of ocean-atmosphere processes on the coastal land environment, through flooding, erosion and storm surge for example, define further requirements for hazard monitoring and mitigation planning. The continued development and application of a broad spectrum of satellite remote sensing systems and attendant data management infrastructure will contribute needed baseline and time series data, as part of an integrated global observation strategy that includes airborne and in situ measurements of the solid Earth. Multi-hazard modeling capabilities, in turn, will result in more accurate forecasting and visualizations for improving the decision support tools and systems used by the international disaster management community.
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