Subtotal pancreatectomy for cancer: closure of the pancreatic remnant with staplers

This paper presents a 2-year series of 26 consecutive pancreatectomies for periampullary cancer where the pancreatic tail was closed with a stapler in order to avoid complications related to a pancreatico-digestive anastomosis. The follow-up period was 14 months or more. Seven patients developed operative complications. Pancreatic fistulas developed in 3 patients. The fistulas closed spontaneously in 2 of the patients after 2-4 months. Intraabdominal abscesses developed in 4 patients and required surgical drainage. In 1 of these patients, the abscess eroded a large vessel with a fatal outcome resulting in an operative mortality rate of 3.8%. A transient postoperative gastric stasis was observed in seven patients. Postoperative hospital median stay was 27 days (range 10-83 days). Eighteen patients have died after 4-30 months in recurrent disease and seven patients are alive after a follow-up period of 15-29 months. Pancreatic endocrine function seemed well preserved; diabetes mellitus has developed in only one patient. In conclusion, it appears that subtotal pancreatectomy with closure of the pancreatic remnant with staples gives a low morbidity and mortality. Although the conclusion should be tempered by the small number of patients, the results justify continued evaluation of this technique with long-term follow-up

Quantitative APT analysis of Ti(C,N)

A specially produced Ti(C,N) standard material, with a known nominal composition, was investigated with laser assisted atom probe tomography. The occurrence of molecular ions and single/multiple events was found to be influenced by the laser pulse energy, and especially C related events were affected. Primarily two issues were considered when the composition of Ti(C,N) was determined. The first one is connected to detector efficiency, due to the detector dead-time. The second one is connected to peak overlap in the mass spectrum. A method is proposed for quantification of the C content in order to establish the C/N ratio. A correction was made to the major C peaks, C at 6 and 12 Da, with the 13C isotopes, at 6.5 and 13 Da, according to the known natural abundance. In addition, a correction of the peak at 24 Da, where C and Ti overlap, is proposed based on the occurrence of single/multiple events for respective element. The results were compared to the results from other techniques such as electron energy loss spectroscopy, chemical analysis and X-ray diffraction. After applying the corrections, atom probe tomography results were satisfactory. Furthermore, the content of dissolved O in Ti(C,N) was successfully quantified. \ua9 2011 Elsevier B.V

Visions of a more precise soil biology

Includes bibliographical references (pages 389-390).Soils have often been viewed as a black box. Soil biology is difficult to study with the precision we would wish, due to the presence of considerable soil heterogeneity, a huge diversity of organisms, and a plethora of interacting processes taking place in a complex physical-chemical environment. We have isolated a tiny fraction of the known organisms, and the possible interactions of soil parent materials, landscape, land use, depth and time with the biota mean that we are to some extent still fumbling in the dark. There have been great advances, but we argue that the pace of advance could be faster. To progress, science needs new theory and concepts but also acceptable methodologies. Coherent and generally accepted theoretical knowledge exists in many areas, but there is a shortage of valid and exact methods to test new and sometimes even old hypotheses. New methods add knowledge, but they also can add to the confusion if they are not tied to the existing knowledge base. We speculate on how to improve soil biology through improving the way we perform and interpret research. Can we deal with soil variability? Can we measure the critical variables with adequate precision to test our hypotheses? Can we avoid reinventing the wheel? Can we find a balance between the freedom to test new and maybe even controversial ideas and the control and direction of research required by society?

A review of architectures and concepts for intelligence in future electric energy system

Renewable energy sources are one key enabler to decrease greenhouse gas emissions and to cope with the anthropogenic climate change. Their intermittent behavior and limited storage capabilities present a new challenge to power system operators to maintain power quality and reliability. Additional technical complexity arises from the large number of small distributed generation units and their allocation within the power system. Market liberalization and changing regulatory framework lead to additional organizational complexity. As a result, the design and operation of the future electric energy system have to be redefined. Sophisticated information and communication architectures, automation concepts, and control approaches are necessary in order to manage the higher complexity of so-called smart grids. This paper provides an overview of the state of the art and recent developments enabling higher intelligence in future smart grids. The integration of renewable sources and storage systems into the power grids is analyzed. Energy management and demand response methods and important automation paradigms and domain standards are also reviewed.info:eu-repo/semantics/publishedVersio

Anthropogenic and climatic impacts on a coastal environment in the Baltic Sea over the last 1000 years

Coastal environments have experienced large ecological changes as a result of human activities over the last 100-200 years. To understand the severity and potential consequences of such changes, paleoenvironmental records provide important contextual information. The Baltic Sea coastal zone is naturally a vulnerable system and subject to significant human-induced impacts. To put the recent environmental degradation in the Baltic coastal zone into a long-term perspective, and to assess the natural and anthropogenic drivers of environmental change, we present sedimentary records covering the last 1000 years obtained from a coastal inlet (Gasfjarden) and a nearby lake (Lake Storsjon) in Sweden. We investigate the links between a pollen-based land cover reconstruction from Lake Storsjon and paleoenvironmental variables from Gasfjarden itself, including diatom assemblages, organic carbon (C) and nitrogen (N) contents, stable C and N isotopic ratios, and biogenic silica contents. The Lake Storsjon record shows that regional land use was characterized by small-scale agricultural activity between 900 and 1400 CE, which slightly intensified between 1400 and 1800 CE. Substantial expansion of cropland was observed between 1800 and 1950 CE, before afforestation between 1950 and 2010 CE. From the Gasfjarden record, prior to 1800 CE, relatively minor changes in the diatom and geochemical proxies were found. The onset of cultural eutrophication in Gasfjarden can be traced to the 1800s and intensified land use is identified as the main driver. Anthropogenic activities in the 20th century have caused unprecedented ecosystem changes in the coastal inlet, as reflected in the diatom composition and geochemical proxies. (c) 2018 Elsevier Ltd. All rights reserved.Peer reviewe

Holocene environmental changes in southern Kamchatka, Far Eastern Russia, inferred from a pollen and testate amoebae peat succession record

© 2015. High resolution palaeoenvironmental records in Far-Eastern Russia are rare, and the Kamchatka Peninsula is among the least studied areas of the region. This paper describes a record spanning the last ca. 11,000. yr, obtained from a bog in the southern part of Kamchatka. The radiocarbon dated core was analysed for pollen, testate amoebae, charcoal and loss-on-ignition (LOI).The vegetation during the early Holocene was dominated by grasses (Poaceae), birch (Betula) and heath (Ericaceae p. p.). Around 10,300. cal. yr BP there was a substantial change in the vegetation cover to shrub alder (Alnus viridis s.l.) stands with sedges and ferns (Polypodiophyta) as well as herbs such as meadow rue (Thalictrum) in the understory. In the surroundings of Utka peatlands started to form. The variations in the vegetation cover were most probably caused by climatic changes. At the beginning of sediment accumulation, before 10,300. cal. yr BP, the composition of the vegetation points to cooler summers and/or decreased annual precipitation. Around 10,300. cal. yr BP, changes in vegetation occurred due to rising temperatures and/or changed water regimes. Increased abundancies of dry indicating testate amoebae after 9100 cal. yr BP point to intermediate to dry soil conditions. Between 8600 and 7700 cal. yr BP tree alder (Alnus incana) was widely spread at the site which probably indicates optimal environmental conditions. The tephra layer at 381-384.5. cm (ca. 8500 cal. yr BP) produces a strong impact on the testate amoebae assemblages. At 7700 cal. yr BP there was a sudden drop of A. incana in the local vegetation. From this time on, A. incana and also A. viridis decrease continuously whereas Betula gradually increases. The upper part of the sequence (after 6300 cal. yr BP) shows higher abundancies of meadowsweet (Filipendula) and sweet gale (Myrica) pollen. After 6300 cal. yr BP, changes in testate amoebae demonstrate variable soil moisture conditions at the site. Between 3700 and 1800 cal. yr BP, wet conditions dominate as dry indicating testate amoebae decrease. After 1800 cal. yr BP soil conditions become more variable again but this time with dry dominating testate amoebae. In contrast to surrounding regions, there is no evidence of trees such as spruce or larch growing in the surroundings of the site even though those trees are characteristic of many eastern Siberian sites. This difference might be because of the maritime influence of the Okhotsk Sea. Even dwarf pine (Pinus pumila), which is currently widely dispersed in northern Kamchatka, became part of the local vegetation only during the last 700 yr

Mediterranean Diet Score and prostate cancer risk in a Swedish population-based case–control study

Several individual components of the Mediterranean diet have been shown to offer protection against prostate cancer. The present study is the first to investigate the association between adherence to the Mediterranean diet and the relative risk of prostate cancer. We also explored the usefulness of the Mediterranean Diet Score (MDS) in a non-Mediterranean population. FFQ data were obtained from 1482 incident prostate cancer patients and 1108 population-based controls in the Cancer of the Prostate in Sweden (CAPS) study. We defined five MDS variants with different components or using either study-specific intakes or intakes in a Greek reference population as cut-off values between low and high intake of each component. Unconditional logistic regression was used to estimate the relative risk of prostate cancer for high and medium v. low MDS, as well as potential associations with the individual score components. No statistically significant association was found between adherence to the Mediterranean diet based on any of the MDS variants and prostate cancer risk (OR range: 0·96–1·19 for total prostate cancer, comparing high with low adherence). Overall, we found little support for an association between the Mediterranean diet and prostate cancer in this Northern European study population. Despite potential limitations inherent in the study or in the build-up of a dietary score, we suggest that the original MDS with study-specific median intakes as cut-off values between low and high intake is useful in assessing the adherence to the Mediterranean diet in non-Mediterranean populations