PURPOSE:Robotic-assisted laparoscopic surgery is an emerging modality in the field of minimally invasive colorectal surgery. However, there is a dearth of data comparing outcomes with other minimally ...invasive techniques. We present a 3-arm (conventional, hand-assisted, and robotic) matched-case analysis of intraoperative and short-term outcomes in patients undergoing minimally invasive colorectal procedures.
METHODS:Between August 2008 and October 2009, 70 robotic cases of the rectum and rectosigmoid were performed. Thirty of these were organized into triplets with conventional and hand-assisted cases based on the following 6 matching criteria1) surgeon; 2) sex; 3) body mass index; 4) operative procedure; 5) pathology; and 6) history of neoadjuvant therapy in malignant cases. Demographics, intraoperative parameters, and postoperative outcomes were assessed. Pathological outcomes were analyzed in malignant cases. Data were stratified by postoperative diagnosis and operative procedure.
RESULTS:There was no significant difference in intraoperative complications, estimated blood loss (126.1 ± 98.5 mL overall), or postoperative morbidity and mortality among the groups. Robotic technique required longer operative time compared with conventional laparoscopic (P < .01) and hand-assisted (P < .001) techniques; however, this difference was not maintained in cases with low pelvic anastomoses. The overall mean length of stay was 3.3 ± 1.8 days with no significant difference between the groups. Pathological analysis of malignant cases revealed a median lymph node extraction of 17 with no significant difference among the 3 modalities.
CONCLUSION:In this 3-arm case-matched series, the robotic approach results in short-term outcomes comparable to conventional and hand-assisted laparoscopic approaches for benign and malignant diseases of the rectum and rectosigmoid. With 3-dimensional visualization, additional freedom of motion, and improved ergonomics, this enabling technology may play an important role when performing colorectal procedures involving the pelvic anatomy.
Abstract
A management strategy to improve growth performance at weaning is segregation of pigs in the nursery period by body weight (BW; Light, Medium, and Heavy) in an attempt to increase productive ...performance and decrease within pen variation in BW. However, the result of current studies indicated that this practice may not be as effective as not sorting pigs. The objective was to determine the effect on productive performance and coefficient of variation (CV) within four categories of BW: Normal (without segregation), Light, Medium, and Heavy. A total of 24 Experimental Units, (EU; 50% barrows and 50% gilts) in an Incomplete Randomized Block Design with four treatments (Trt) and six replicates per Trt. Pen was the EU and block was the weaning group. Treatments were four; Normal (without segregation; 6.35 kg BW); Light (4.45 kg BW); Medium (5.89 kg BW); and Heavy (7.15 kg BW). Pigs were weighed individually on d 21 (at the beginning of the experiment), 70, 119, 135 and 146 of life. Growth data were analyzed using PROC MEANS and GLM of SAS. Results indicated that at the beginning of the experiment (for design) BW and the CV were different (P < 0.05). From weaning to d 70 Medium and Normal categories had similar BW (29.79 vs. 30.57 kg; P > 0.05), respectively. Light and Heavy pigs remained unchanged in their weight categories. Interestingly, the CV at d 70 was 3.46 percentage points greater in all the groups of pigs that were regrouped by weight, in fact, the only group that reduced the CV at d 70 was the Normal (it was decreased by 3.26 percentage points). Average daily gain at day 70 was less (P < 0.05) for Light (0.62 kg/d) compared with any of the other treatments (0.69 kg/d, average of the rest of the treatments). Average daily feed intake was less for Light (0.940 kg/d) followed by Medium and Normal (1.00 and 1.04 kg per day, respectively) and the Heavy which had the greatest intake (1.08 kg/d). No differences were found in removed animals and mortality (P > 0.05). However, the total number of animals treated parenterally was greater in the Light and Medium (16.75 vs. 12.80, respectively; P < 0.05) than the Heavy and Normal (7.83 and 7.00, respectively, P < 0.05). At the end of the experiment the BW of the pigs was different between treatments (P < 0.05) being the Light group pigs the least heavy (120.62 kg), followed by the Medium (128.02 kg) and Normal (131.31 kg) the treatment Heavy was the heaviest with 133.04 kg. These results suggest that segregation in nursery by BW has a negative effect on the CV.
In seasonal dry tropical forests, plants are subjected to severe water deficit, and the arbuscular mycorrhizal fungi (AMF) or inorganic phosphorus supply (Pi) can mitigate the effects of water ...deficit. This study aimed to assess the physiological performance of Poincianella pyramidalis subjected to water deficit in combination with arbuscular mycorrhizal fungi (AMF) and leaf inorganic phosphorus (Pi) supply. The experiment was conducted in a factorial arrangement of 2 water levels (+H2O and −H2O), 2 AMF levels (+AMF and −AMF) and 2Pi levels (+Pi and −Pi). Leaf primary metabolism, dry shoot biomass and leaf mineral nutrients were evaluated. Inoculated AMF plants under well-watered and drought conditions had higher photosynthesis and higher shoot biomass. Under drought, AMF, Pi or AMF+Pi plants showed metabolic improvements in photosynthesis, leaf biochemistry and higher biomass compared to the plants under water deficit without AMF or Pi. After rehydration, those plants submitted to drought with AMF, Pi or AMF+Pi showed a faster recovery of photosynthesis compared to treatment under water deficit without AMF or Pi. However, plants under the drought condition with AMF showed a higher net photosynthesis rate. These findings suggest that AMF, Pi or AMF+Pi increase the drought tolerance in P. pyramidalis, and AMF associations under well-watered conditions increase shoot biomass and, under drought, promoted faster recovery of photosynthesis.
Californian-style black olives can undergo different chemical changes during the sterilization process that can affect their sensory and phenol characteristics. Thus, these olives were stuffed with ...flavoured hydrocolloids and submitted to different thermal sterilization treatments to assess sensory categories. The triangular test indicated that the panellists were able to discriminate between samples from different categories according to their aromas with more than 85% success. The results indicated that the negative aroma detected by tasters was related to burn defects. The highest level of defects was found in standard olives, while the lowest was identified in the extra category. Furthermore, olives submitted to the lowest thermal sterilization treatment (extra) presented significantly higher phenol profile content, such as for hydroxytyrosol, tyrosol, oleuropein and procyanidin B1. The electronic nose (E-nose) discriminated between samples from different categories according to the specific aroma (PC1 = 82.1% and PC2 = 15.1%). The PLS-DA classified the samples with 90.9% accuracy. Furthermore, the volatile organic compounds responsible for this discrimination were creosol, copaene, benzaldehyde and diallyl disulphide. Finally, the models established by the PLS analysis indicated that the E-nose could predict olives according to their aroma and total phenol profile (RCV2 values were 0.89 and 0.92, respectively). Thus, this device could be used at the industrial level to discriminate between olives with different sensory aromas to determine those with the highest quality.
Yearly, the rates of Internet penetration are on the rise, surpassing 80% in developed nations. Despite this progress, over two billion individuals in rural and low-income regions face a complete ...absence of Internet access. This lack of connectivity hinders the implementation of vital services like remote healthcare, emergency assistance, distance learning, and personal communications. To bridge this gap and bring essential services to rural populations, this paper leverages Unmanned Aerial Vehicles (UAVs). The proposal introduces a UAV-based network architecture and an energy-efficient algorithm to deploy Internet of Things (IoT) applications. These applications are broken down into microservices, strategically distributed among a subset of UAVs. This approach addresses the limitations associated with running an entire IoT application on a single UAV, which could lead to suboptimal outcomes due to battery and computational constraints. Simulation results conducted in a realistic scenario underscore the effectiveness of the proposed solution. The evaluation includes assessing the percentage of IoT requests successfully served to users in the designated area and reducing the energy consumption required by UAVs during the handling of such requests.
Apert syndrome without craniosynostosis de Ângelis Ramos, Diego; Matushita, Hamilton; Cardeal, Daniel Dante ...
Child's nervous system,
03/2019, Letnik:
35, Številka:
3
Journal Article
Recenzirano
Background
Apert syndrome is a rare form of syndromic craniosynostosis, also known as acrocephalosyndactyly, which is a disorder characterized by a unique set of craniofacial, hand, and foot ...abnormalities. Diagnosis is made through a genetic analysis, where the mutation of FGFR2, Ser252Trp, and Pro253Arg confirms the diagnosis.
Case presentation
Although craniosynostosis is the most common characteristic in clinical presentation, we present an atypical case of a one-and-a-half-year-old girl with Apert syndrome confirmed by genetic testing but without craniosynostosis.
Actualmente la población estudiantil se enfrenta a eventos académicos que agotan su energía física y su estabilidad psicológica, originándole estrés académico que influye en sus sentimientos, ...emociones, comportamientos y actuaciones. De allí que se presenta este articulo de investigación enmarcado en describir el comportamiento del estrés académico en los estudiantes de bachillerato general unificado (BGU) de la Unidad Educativa Pensionado Americano International School de Riobamba, Ecuador. Dicho estudio se amparó en el paradigma positivista, y refiere a una investigación descriptiva caracteriza por un diseño no experimental, de campo y transeccional. Los resultados indican la experimentación de situaciones estresantes como: el proceso de evaluación, el tipo de trabajo docente, la sobrecarga de tareas escolares, la limitación del tiempo para las tareas, que, aunque se vivencian de manera episódica o puntual, advierten la posibilidad de afectar la productividad, el rendimiento académico y, en general, la calidad de vida del estudiante.
This work aims to develop a method to quantify the particles distribution in Pickering emulsions. Particle stabilized oil-in-water emulsions of different formulations were produced with different ...emulsification processes. These emulsions were then centrifugated to separate the oily from the aqueous phase. Successive rheological and gravimetric tests on the same aqueous phases provide information about the silica fraction adsorbed at the emulsion's interfaces and the particle interfacial concentration. The emulsification process changes the average droplet size of the emulsion, and results also show that the silica fraction in the dispersed phase and the silica interfacial concentration are modified. Moreover, the silica behaviour may be dictated by the nature of the stirrer, the time and the shear speed of the emulsification process.
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