Sublobar resection for non-small cell lung cancer in Iceland

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn Skoða/Opna(view/open)Introduction: A sublobar resection is performed on patients with non-small cell lung cancer (NSCLC) who are not candidates for a lobectomy due to reduced pulmonary function or comorbid disease. The aim of this study was to investigate the outcomes of these operations in Iceland. Material and methods: A retrospective study of all patients with NSCLC who underwent wedge resection or segmentectomy with curative intent during 1994-2008. Data on indication, pathological TNM-stage, complications and overall survival was analyzed. All histological samples were re-evaluated. Results: Forty four patients underwent 42 wedge and 5 segmental resections (age 69.1 yrs, 55.3% female), with 38.3% of cases detected incidentally. The majority of patients (55.3%) had a history of coronary artery disease and 40.4% had chronic obstructive pulmonary disease. Mean operative time was 83 minutes (range 30-131), mean intraoperative bleeding was 260 ml (range 100-650) and median hospital stay was 9 days (range 4-24). Pneumonia (14.9%) and prolonged air leakage (12.8%) were the most common complications. Two patients had major complications and 36.2% stayed in the intensive care unit overnight. No deaths occurred within 30 days of surgery. Adenocarcinoma was the most common histological type (66.7%). Most cases were stage IA/IB (78.7%), 17.0% were stage IIA/IIB and 4.3% were stage IIIA. One and 5 year survival was 85.1% and 40.9% respectively. Conclusion: In Iceland, both survival and complication rate after sublobar resection for NSCLC are comparable to results published for lobectomies, even though a higher percentage of patients have underlying cardiopulmonary disease.Inngangur: Hefðbundin aðgerð við lungnakrabbameini öðru en smáfrumukrabbameini er blaðnám. Í völdum tilvikum, einkum þegar lungnastarfsemi er mikið skert, er gripið til fleyg- eða geiraskurðar. Markmið þessarar rannsóknar var að kanna árangur þessara aðgerða hér á landi. Efniviður og aðferðir: Afturskyggn rannsókn á sjúklingum sem gengust undir fleyg- eða geiraskurð vegna lungnakrabbameins af öðrum toga en smáfrumukrabbameini á Íslandi 1994-2008. Kannaðar voru ábendingar aðgerðar, stigun eftir aðgerð, fylgikvillar og heildarlífshorfur. Öll vefjasýni voru endurskoðuð. Niðurstöður: Alls gengust 44 sjúklingar (52,3% konur) undir samtals 47 fleyg- eða geiraskurði. Meðalaldur var 69,1 ár og greindust 38,3% tilfella fyrir tilviljun. Saga um kransæðasjúkdóm (55,3%) og langvinn lungnateppa (40,4%) voru algengustu áhættuþættirnir og meðal ASA-skor var 2,6. Aðgerðirnar tóku að meðaltali 83 mínútur (bil 30-131) og miðgildi legutíma var 9 dagar (bil 4-24). Helstu fylgikvillar voru lungnabólga (14,9%) og langvarandi loftleki (12,8%). Tveir sjúklingar fengu alvarlegan fylgikvilla en enginn lést innan 30 daga frá aðgerð. Meðalstærð æxlanna var 2,3 cm (bil 0,8-5,0) og var kirtilmyndandi krabbamein (66,7%) algengasta vefjagerðin. Stigun eftir aðgerð sýndi að 78,7% tilfella voru á stigi IA/IB, 17,0% á stigi IIA/IIB og tveir á stigi IIIA. Eins árs og 5 ára lífshorfur voru 85,1% og 40,9%. Ályktun: Lífshorfur eftir fleyg- og geiraskurði á Íslandi eru góðar og tíðni fylgikvilla lág. Þessar niðurstöður eru svipaðar og sést hafa eftir blaðnám hér á landi þótt hátt hlutfall þessara sjúklinga hafi þekkta hjarta- og æðasjúkdóma og skerta lungnastarfsem

Observing, Coaching and Reflecting: A Multi-modal Natural Language-based Dialogue System in a Learning Context

The Metalogue project aims to develop a multi-modal, multi-party dialogue system with metacognitive abilities that will advance our understanding of natural conversational human-machine interaction and dialogue interfaces. This paper introduces the vision for the system and discusses its application in the context of debate skills training where it has the potential to provide learners with a rich, immersive experience. In particular, it considers a potentially powerful learning analytics tool in the form of a performance reflection dashboard

Technology experience café - enabling technology - driven social innovation for an ageing society

Effective technology innovation process management in the context of active healthy ageing has the potential to improve older adults’ quality of life, allowing them to maintain their independence and age in their own homes for longer. But as older adults significantly differ from the general population in technology use and its impact on their quality of life, tools are needed that (1) involve this target group into the innovation process, as well as (2) capture the diverse needs of technology for various stakeholders involved in this process. This paper presents the framework called Technology Experience Café (TEC), developed within the European project SIforAGE, answering exactly this need. Detailed information on the methodology and its implementation in five sites, in four different countries across Europe, focusing on participating stakeholders, general design of the TEC, and used evaluation tools, is provided. Preliminary results show, that (1) the target group’s perception of the TEC as a framework was thoroughly positive and TECs had a positive impact on older adults’ technology related attitudes and (2) that stakeholders’ benefits affiliated with their involvement in the TECs are manifold. Implications and limitations are discussed

Air temperature changes in Toruń (central Poland) from 1871 to 2010

The article presents a detailed analysis of changes in air temperature in Toruń in the period 1871–2010 on the basis of homogenised monthly, seasonal and annual air temperature series which have been newly constructed (i.e. extended by the 50 years of 1871–1920). Over the 140-year study period, a sizeable and statistically significant increase of 0.1 °C per decade was found in the air temperature in Toruń. The greatest increases occurred for spring and winter, at 0.12 and 0.11 °C, respectively. A lesser warming, meanwhile, was recorded for autumn (0.10 °C/10 years), and particularly for summer (0.07 °C/10 years). The air temperature trends are statistically significant for all seasons. Air temperature differences between the monthly averages of three analysed subperiods (1871–1900, 1901–1950 and 1951–2010) and averages for the entire period under review rarely exceeded ± 0.5 °C. In all of these periods, the highest average air temperatures occurred in July and the lowest in January. The period of 1981–2010 had the highest frequency of occurrence of very and extremely warm seasons and years. Meanwhile, the highest frequency of very and extremely cool seasons and years was recorded in the 1940s and in the nineteenth century. In the period of 1871–2010, winters shortened markedly (by 7%) and summers lengthened by 3.8%. All of the presented aspects of air temperature in Toruń, which is representative of the climate of central Poland, are in close agreement with the findings of analogous studies of the same for other areas of Poland and Central Europe

How large are projected 21st century storm track changes?

Projected changes in the extra-tropical wintertime storm tracks are investigated using the multi-model ensembles from both the third and fifth phases of the World Climate Research Programme's Coupled Model Intercomparison Project (CMIP3 and CMIP5). The aim is to characterize the magnitude of the storm track responses relative to their present-day year-to-year variability. For the experiments considered, the ‘middle-of-the-road’ scenarios in each CMIP, there are regions of the Northern Hemisphere where the responses of up to 40% of the models exceed half of the inter-annual variability, and for the Southern Hemisphere there are regions where up to 60% of the model responses exceed half of the inter-annual variability

Creativity out of chaos

Creativity is said to be highly desired in post-modern and post-industrial organizations Creativity and anarchy on the one hand, and managerialism, on the other, can be seen as different forms of knowledge, two opposed ideals. In many organizational as well as societal reforms we currently observe it is the managerialist ideal that wins over the anarchic. In this paper, we wonder if people fear anarchy? We reflect on the possible reasons for the fear, and we also try to explain why we believe that anarchic organizing should not be avoided or feared

Aquaporin gene expression and apoplastic water flow in bur oak (Quercus macrocarpa) leaves in relation to the light response of leaf hydraulic conductance

It has previously been shown that hydraulic conductance in bur oak leaves (Quercus macrocarpa Michx.), measured with the high pressure flow meter technique (HPFM), can significantly increase within 30 min following exposure to high irradiance. The present study investigated whether this increase could be explained by an increase in the cell-to-cell pathway and whether the response is linked to changes in the transcript level corresponding to aquaporin genes. Four cDNA sequences showing high similarity to members of the aquaporin gene family from other plant species were characterized from bur oak leaves and the expression levels of these cDNA sequences were examined in leaves by quantitative real-time PCR (QRT-PCR). No change was found in the relative transcript abundance corresponding to these four putative aquaporin genes in leaves with light-induced high hydraulic conductance (exposed to high irradiance) compared to leaves with low hydraulic conductance (exposed to low irradiance). However, in sun leaves that were exposed to different light levels prior to leaf collection (full sunlight, shade, and covered with aluminium foil for 16 h), the relative transcript levels of two of the putative aquaporin genes increased several-fold in shaded leaves compared to the sun-exposed or covered leaves. When the leaves were pressure-infiltrated with the apoplastic tracer dye trisodium 3-hydroxy-5,8,10-pyrenetrisulphonate (PTS3, 0.02%), there was no change in the PTS3 concentration of leaf exudates collected in ambient light or in high irradiance, but there was a small apoplastic acidification. There was also no change in PTS3 concentration between the leaves infiltrated under high irradiance with 0.02% PTS3 or with 0.1 mM HgCl2 in 0.02% PTS3. The results suggest that the putative aquaporin genes that were identified in the present study probably do not play a role in the light responses of hydraulic conductance at the transcript level, but they may function in regulating water homeostasis in leaves adapted to different light conditions. In addition, it is shown that high irradiance induced changes in the pH of the apoplast and that there does not appear to be a significant shift to the cell-to-cell mediated water transport in bur oak leaves exposed to high irradiance as measured by the apoplastic tracer dye

Variability in fluvial suspended and streambed sediment phosphorus fractions among small agricultural streams

Agriculture is a major source of sediment and particulate phosphorus (P) inputs to freshwaters. Distinguishing between P fractions in sediment can aid in understanding its eutrophication risk. Although streams and rivers are important parts of the P cycle in agricultural catchments, streambed sediment and especially fluvial suspended sediment (FSS) and its P fractions are less studied. To address this knowledge gap, seasonal variations in FSS P fractions and their relation to water quality and streambed sediment were examined in three Swedish agricultural headwater catchments over 2 yr. Sequential fractionation was used to characterize P fractions in both streambed sediment and FSS. All catchments had similar annual P losses (0.4-0.8 kg ha(-1)), suspended solids (124-183 mg L-1), and FSS total P concentrations (1.15-1.19 mg g(-1)). However, distribution of P fractions and the dominant P fractions in FSS differed among catchments (p < .05), which was most likely dependent on differences in catchment geology, clay content, external P sources, and flow conditions. The most prominent seasonal pattern in all catchments was found for iron-bound P, with high concentrations during low summer flows and low concentrations during winter high flows. Streambed sediment P fractions were in the same concentration ranges as in FSS, and the distribution of the fractions differed between catchments. This study highlights the need to quantify P fractions, not just total P in FSS, to obtain a more complete understanding of the eutrophication risk posed by agricultural sediment losses