Most of the contaminant conceptual models in weathered crystalline bedrock aquifers in Brazil rely on data collected using conventional site investigation methods, at insufficient spatial resolution ...for associating contaminant distributions with observed heterogeneity. The DFN methodology was adapted for the characterization of a chlorinated solvent contaminated weathered crystalline bedrock aquifer, located in the region of the Jurubatuba district, Sao Paulo city, Brazil. The objective of this research is to establish a detailed 1-D conceptual model to show variable contaminant distribution within the bedrock matrix under different fracture and weathering conditions. The numerous depth-discrete rock sample analyses, assigned to specific geologic features, indicate the presence of PCE-Dense Non-Aqueous Phase Liquid (DNAPL) at discrete-depth intervals along the profile. These zones are mainly related to the lithological contacts and interfaces among the weathered bedrock. The soft and hard weathered-bedrock transition zone does not indicate a sharp decrease in the contaminant mass retention within the bedrock matrix for the studied area. This indicates that contaminant mass storage in the bedrock remains beyond this drilling method-defined interface, which can potentially sustain dissolved VOC concentrations over time and maintain the continuous vertical mass flux into deeper parts of the aquifer. There is a demonstrated need for an appropriate characterization methodology including high-resolution soil coring and sampling to delineate contaminant distribution over crystalline weathered bedrock aquifers. This is a key assumption for the definition of appropriate remedial and groundwater management strategies.
To explore the role of preoperative MRI prostate shape in urinary incontinence after robot-assisted radical prostatectomy (RARP).
Patients were stratified into four groups based on the mpMRI ...prostatic apex shape: Group A (prostatic apex overlapping the membranous urethra anteriorly and posteriorly), Group B and C (overlap of the prostatic apex of the anterior or posterior membranous urethra, respectively) and Group D (no overlap). Preoperative variables and intraoperative data were compared. Continence recovery was defined as no pad/day or 1 safety pad/day by an outpatient evaluation performed at 1, 3, 6, and 12 months after RARP.
One hundred patients underwent RARP were classified as belonging to Group A (n = 30), Group B (n = 16), Group C (n = 14), and Group D (n = 40). Group D showed a significantly more favorable urinary continence recovery after RARP respect to all the other shapes presenting any forms of overlapping (HR = 1.9, 95% CI 1.2-3.1, p = 0.007). The estimated HR remained substantially unchanged after adjusting by age, body mass index, CCI, prostate volume, and bladder neck sparing (HR = 1.9, 95% CI 1.1-3.2, p = 0.016). The continence recovery median time was 9 months for Group A + B + C (95% CI 5-11) and 4 months for Group D (95% CI 2-6) (p = 0.023).
Shape D showed a better continence recovery when compared to other shapes presenting any kind of overlapping of the prostatic apex over the membranous urethra.
Abstract Introduction and objectives To analyze postoperative complications and to assess for significant predictive factors during partial nephrectomy (PN) using a large multicenter dataset. Methods ...Patients who underwent PN for clinical T1 renal tumors at 19 urological Italian centers (Registry of Conservative Renal Surgery RECORd project) were evaluated between 2009 and 2012. Anthropometric data, comorbidities and perioperative outcomes were analyzed. Complications were divided as intra- and postoperative, medical and surgical, as appropriate. The severity of postoperative complications was graded according to the modified Clavien classification system. Patients who experienced intraoperative complications were excluded from the analyses for the potential confounding effect in the evaluation of predicting factors for postoperative complications. Results Overall, 979 patients were analyzed: open, laparoscopic and robot-assisted (available since 2011) surgical approaches were used in 522 (56.4%), 286 (30.9%) and 117 (12.6%) cases, respectively. Surgical postoperative complications were reported in 121 (13.1%) cases (32 (3.5%) were Clavien 3), medical were reported in 52 (5.6%) cases (3 (0.3%) were Clavien 3). No Clavien 4 complications were reported. At multivariable analysis, ECOG score ≥1 (OR 1.98; p = 0.002), lower preoperative hemoglobin (OR 0.71; p < 0.0001) and open surgical approach (2.91; p = 0.02) were significant predictive factors of overall surgical postoperative complications, ECOG score ≥1 (OR 1.93; p = 0.04) and surgical approach (p = 0.05) were significant predictive factors of Clavien 3 either surgical or medical postoperative complications. Conclusions Comorbidities and surgical approach should be considered in preoperative evaluation of patients undergoing PN, as they resulted to play a significant role in the occurrence of postoperative complications.
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•Chitosan/gelatin-based materials were functionalized with pomegranate peel extract.•Extract was capable to improve the functional characteristics of the materials.•High phenolic ...extract content improved antioxidant activity of the materials.•Extract incorporation enhanced the stability against the applied strain.•Rheological properties were influenced by extract incorporation and concentration.
Biopolymer-based materials are potential candidates for food coatings application. In this study, pomegranate (Punica granatum L.) peel extract (PPE) at different concentrations was incorporated to chitosan/gelatin gels and the rheological, antioxidant and structural properties were evaluated. Due to its high phenolic content, PPE enhanced the antioxidant capacity of chitosan/gelatin mixtures. PPE addition extended linear viscoelastic range and enabled the samples to easily flow under the applied shear rate. Rheological properties indicated that both viscosity and activation energy of materials containing natural compounds are highly dependent on temperature. Scanning electron microscopy (SEM) images revealed the influence of PPE concentration in the scaffolds pores size. Findings of this study proved that PPE was capable to improve the functional characteristics of chitosan/gelatin-based materials enhancing the desired properties for their potential application as food coatings.
Abstract Introduction and Objectives To objectively assess the impact of renal tumors characteristics and other measurable factors on baseline renal function in patient undergoing partial nephrectomy ...(PN). Methods Patients who underwent laparoscopic PN for a T1 renal mass between 2012 and 2016 and who also had a mercapto-acetyltriglycine renal scan prior to surgery were retrieved from a single institution prospectively-collected database. Split renal function (SRF) and Effective Renal Plasma Flow (ERPF) for both the operated kidney and the unaffected contralateral were calculated. Patient demographics and tumor characteristics (e.g. size, location and; nephrometry score) were assessed. Renal function of both the operated and the unaffected; contralateral kidney were compared. Statistical analysis was performed by using Statistica 8.0 (StatSoft). Results 227 patients were deemed eligible and included in the analysis. Univariable analysis showed a significant impact of age-adjusted CCI (p=0.027), hypertension (p=0.031) and age (p<0.001) on operated kidney ERPF. Gender (p=0.011), hypertension (p=0.042), CCI (both standard and age-adjusted, p=0.021 and =0.003, respectively) and age (p<0.001) were significantly; associated with contralateral unaffected kidney ERPF. Multivariable analysis confirmed age (p<0.001) and hypertension (p<0.021) as independent factors in both the operated and the unaffected kidney. Conclusions Characteristics of the renal mass (including nephrometry score and size) seem to have no clinically relevant impact on baseline renal function in patients undergoing partial nephrectomy for cT1 renal tumors. Age, hypertension and co-morbidities confirm to represent un-modifiable significant factors influencing baseline renal function.
Off-clamp laparoscopic partial nephrectomy in a hybrid operating room after superselective arterial embolization (hLPN) is a promising minimally invasive approach. In this study, we compared the ...perioperative surgical outcomes of this innovative technique with the conventional standard of care laparoscopic partial nephrectomy (cLPN) technique.
Overall, 86 and 127 patients treated with hLPN and cLPN, respectively, were included. These two techniques were compared in terms of surgical complications, estimated blood loss (EBL), operative time, length of stay (LOS), surgical margins, and Trifecta achievement rate (defined as warm ischemia duration <25 min, negative surgical margins and absence of complications). A propensity score based on age, gender, BMI, preoperative eGFR and tumor size was used for a 1:1 matching of patients of each group. After matching, 2 groups of 67 patients with similar characteristics were obtained.
Conversion rate to open surgery, complications and EBL were similar in both groups. Conversely, operative time, LOS and Trifecta rates favored hLPN. The multivariate analysis showed that hLPN had a 70% higher chance of Trifecta achievement than cLPN in all age groups and for all tumor size across the study population.
Compared to a conventional approach, off-clamp laparoscopic partial nephrectomy in a hybrid room after superselective arterial embolization showed satisfying immediate surgical outcomes and reached a higher rate of Trifecta achievement. Mid and long-term functional and oncological results are needed to establish this minimally invasive surgical alternative.
La nefrectomía parcial laparoscópica off-clamp tras la embolización arterial superselectiva (NPLh) en un quirófano híbrido es un abordaje mínimamente invasivo prometedor. En este estudio, comparamos los resultados quirúrgicos perioperatorios de esta técnica innovadora con los de la técnica estándar de nefrectomía parcial laparoscópica convencional (NPLc).
En total, se incluyeron 86 y 127 pacientes tratados con NPLh y NPLc, respectivamente. Las dos técnicas se compararon en términos de complicaciones quirúrgicas, pérdida de sangre estimada (PSE), tiempo quirúrgico, duración de la estancia hospitalaria (DEH), márgenes quirúrgicos y tasa de consecución de la Trifecta (definida como duración de isquemia caliente <25 min, márgenes quirúrgicos negativos y ausencia de complicaciones). Se utilizó una puntuación de propensión basada en la edad, el sexo, el IMC, la TFGe preoperatoria y el tamaño tumoral para un emparejamiento 1:1 de los pacientes de cada grupo. Tras el emparejamiento, se obtuvieron 2 grupos de 67 pacientes con características similares.
La tasa de conversión a cirugía abierta, las complicaciones y la PSE fueron similares entre ambos grupos. Por el contrario, el tiempo quirúrgico, la DEH y las tasas de Trifecta favorecieron la NPLh. El análisis multivariante demostró que la NPLh tenía un 70% más de probabilidades de lograr la Trifecta que la NPLc en todos los grupos de edad y para cualquier tamaño tumoral en toda la población del estudio.
En comparación con el abordaje convencional, la nefrectomía parcial laparoscópica sin clampado después de la embolización arterial superselectiva en una sala híbrida mostró resultados quirúrgicos satisfactorios inmediatos y alcanzó una mayor tasa de consecución de la Trifecta. Se necesitan resultados funcionales y oncológicos a medio y largo plazo para establecer esta alternativa quirúrgica mínimamente invasiva.
To evaluate if thulium laser vapoenucleation of the prostate (ThuVEP) is equally safe and effective in a selected cohort of elderly patients when compared to "younger" patients.
We performed a ...retrospective analysis of consecutive patients who underwent ThuVEP between September 2018 and February 2020. After application of the inclusion/exclusion criteria, patients were stratified according to the 75 years-old cut-off point suggested by the WHO. Group A included patients ≤75 years-old; Group B included patients >75 years-old. Preoperative assessment included urological consultation, prostate specific antigen (PSA), International Prostate Symptom Score (IPSS) and quality of life index, transrectal ultrasound to estimate prostate volume (PVol), and uroflowmetry to assess preoperative Qmax, Qave and post-void residual volume (PVR). Perioperative and postoperative data were analyzed during 3-month follow-up.
After propensity-score analysis, 51 versus 51 patients were 1:1 matched according to PVol, PSA, Qmax, IPSS and QoL. Patients were comparable at baseline excluding age (65 (IQR 59-70) versus 79 (IQR 77-82) years, Group A versus B, respectively, P-value <.001). No differences were found in terms of hemoglobin drop, complications rate, catheterization time and length of hospital stay. Group A (younger) patients had more significant improvement in 30-days absolute Qmax, Qave and ΔQmax. At 90-days follow-up, the differences between the groups disappeared. Within the 90-days follow-up, no significant differences were found in the readmission rate, with no need of reinterventions.
In our hands, even in elderly patients affected by BPH, ThuVEP appears to be a safe and effective treatment option.
Most feedstuffs contain antinutritive factors (ANF) such as insoluble fibers, lignins, tannins, and lectins. Intake of these ANF has the ability to reduce nutrient digestibility and to increase ...endogenous protein losses, such as through increased intestinal mucus secretion. The objective of this experiment was to determine the apparent ileal digestibilities (AID) of AA of 6 ANF-enriched diets to estimate endogenous protein loss associated with these ingredients in diets for young pigs. Forty-two 10-kg BW pigs fitted with a simple T-cannula at the distal ileum were randomly assigned to 1 of 7 casein-based diets with: no supplement (control), 100 g/kg of canola meal (CM), 100 g/kg of wheat bran (WB), 150 g/kg of barley (BR), 22.5 g/kg of lignin (LG), 15 g/kg of kidney beans as a lectin (LE) source, and 15 g/kg of tannins (TN). All diets were formulated to be similar in N, indispensable AA, and caloric contents. After a 7-d adaptation to the test diets, N balance was conducted for 5 d, followed by 24 h of collection of digesta for analyses of AA. Pigs fed BR had 17% lower ADG and 15% lower feed conversion ratio (P < 0.05) compared with control and CM pigs. Pigs fed diets containing WB and BR had lower N retention as a percentage of absorbed N compared with all other groups (P = 0.03). The AID for CP was lower in BR, WB, and LE pigs compared with control. Of the AA, AID of Thr was notably lowest in BR, WB, and TN pigs (P < 0.05). The standardized ileal digestibility was lower in WB and BR pigs for most indispensable AA. Altogether, these data suggest that hemicellulose fiber, at concentrations typical in commercial swine diets, reduces AID of AA by increasing endogenous losses. Understanding the differential effects of ANF on endogenous losses of individual dietary AA will improve the accuracy of diet formulation.
Ohmic heating may improve bioactive compounds and processing, ensuring food safety of beverages, liquid and pasty food, or liquid with solid pieces. Due to those traits, this study conducted a ...comparison between ohmic heating technology and conventional heating (CH), with a focus on assessing the impact of both methods on functional compounds (such as angiotensin-converting enzyme inhibition, α-amylase and α-glucosidase inhibition, and antioxidant activity) in both fresh and thawed raw sheep milk, which had been frozen for up to 3 mo. Different ohmic heating conditions were applied and compared to CH (3.33–8.33 V/cm vs. CH 73°C/15 s). A total of 18 peptides with some functional activities were identified by MALDI-TOF mass spectrometry analysis. Ohmic heating samples presented the highest activities related to health, followed by CH and raw milk samples; antioxidant activity range was from 0.11% to 0.71%, antihypertensive activity ranged from 0.20% to 0.72%, and antidiabetic activity ranged from 0.21% to 0.79%. Of 51 volatile compounds detected, some were degraded by freezing, storing, and heating the sheep milk. This study showed for the first time that ohmic heating processing improved sheep milk bioactive peptides and preserved volatile compounds.
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