El efecto de arroyos tributarios de menor orden sobre el perifiton de un río de llanura

Confluence zones are important places to analyze discontinuities that succeed in the river continuum, when two streams of different order link up with their collector. In this work we analyzed the periphyton composition and structure in the confluence of two mountain streams, where Chocancharava river (Cuarto river) foothill reach begins, in Córdoba province. Monthly periphyton samples were taken by scraping a known surface, in three sites located in Piedras Blancas and San Bartolomé stream confluence at 550 m a.s.l. TWINSPAN classification and sample and species ordinations by means of Canonic Correspondence Analysis (CCA) were carried out. Seventy one algae species were determined. Bacillarophyceae and Chlorophyceae presented higher species richness. Dominant species were Cocconeis placentula var. euplypta and Achnanthidium minutissimum, both exhibited an annual bimodal distribution pattern, with maximal densities in autumn and spring. CCA clusters demonstrated seasonal changes in periphyton structure. Summer species were associated to higher temperature and precipitations, and winter species (were associated) to higher conductivity and pH. The tributary of minor order, San Bartolomé stream, evidenced a wider distance in the sample grouping; its flora was different in winter months, during the phase of low water levels. From the obtained results it is concluded that at the confluence sectors the composition and structure of the higher order stream is continuous with the principal river during low water levels while, during high water levels, the periphyton of both tributaries colonize the receiving river.Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) - Instituto de Limnología "Dr. Raul A. Ringuelet" (ILPLA

El efecto de arroyos tributarios de menor orden sobre el perifiton de un río de llanura

Confluence zones are important places to analyze discontinuities that succeed in the river continuum, when two streams of different order link up with their collector. In this work we analyzed the periphyton composition and structure in the confluence of two mountain streams, where Chocancharava river (Cuarto river) foothill reach begins, in Córdoba province. Monthly periphyton samples were taken by scraping a known surface, in three sites located in Piedras Blancas and San Bartolomé stream confluence at 550 m a.s.l. TWINSPAN classification and sample and species ordinations by means of Canonic Correspondence Analysis (CCA) were carried out. Seventy one algae species were determined. Bacillarophyceae and Chlorophyceae presented higher species richness. Dominant species were Cocconeis placentula var. euplypta and Achnanthidium minutissimum, both exhibited an annual bimodal distribution pattern, with maximal densities in autumn and spring. CCA clusters demonstrated seasonal changes in periphyton structure. Summer species were associated to higher temperature and precipitations, and winter species (were associated) to higher conductivity and pH. The tributary of minor order, San Bartolomé stream, evidenced a wider distance in the sample grouping; its flora was different in winter months, during the phase of low water levels. From the obtained results it is concluded that at the confluence sectors the composition and structure of the higher order stream is continuous with the principal river during low water levels while, during high water levels, the periphyton of both tributaries colonize the receiving river.Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) - Instituto de Limnología "Dr. Raul A. Ringuelet" (ILPLA

Predictive factors for lymph node involvement in sporadic medullary thyroid microcarcinoma: A systematic review

Objective: The aim of the study was to determine the impact of laboratory and imaging tests in predicting central and lateral neck lymph node/LN involvement and in decision making for surgical extent. Materials and Methods: A PubMed, Web of Science and Scopus search was performed according to PRISMA criteria. The relationship between nodule size, diagnostic biomarkers and imaging with LN involvement were evaluated. Results: The available data analysis did not yield clear indications of the relationship between each of these topics and the presence, number, and location of LN involved. There was no conclusive data for the selective indication of central neck dissection in the preoperative diagnosis of microMTC. Conclusions: There is no justification for less invasive interventions than total thyroidectomy with lymph node dissection

Experimental and theoretical analyses of Iroko wood laminates

This paper reports the experimental tests, which have been carried out to assess the mechanical properties of Iroko wood laminates used for the construction of a large wooden sailing ship. Three-point bending tests have been carried out on different types of specimens: laminates with 3 layers @ 0\ub0 and without scarf joints, laminates with 3 layers @ 0\ub0 having the outer layers with scarf joints, and laminates with 4 layers @ 0\ub0/\ub145\ub0/0\ub0 and no scarf joints. The tests have been performed in compliance with the current EN Standards. The analyses of the experimental data allowed the assessment of the mechanical properties of the laminated Iroko wood as well as the influence of scarf joints. The experimental results demonstrated that the presence of scarf joints only affect the strength of the glued laminate, while the stiffness properties in terms of Young modulus in bending and shear modulus, obtained applying the \u201cmethod of variable support span\u201d, remain essentially the same. The investigated laminates have been also analysed using a 3D computed tomography and an ultrasonic phased array equipment in order to assess the dimensions of possible defects or voids in the adhesive and the dynamic modulus of elasticity. The tomographic measurements of the glue thickness explained the reason of the reduced strength of the scarf joints, due to the inhomogeneity of the glue bond-line. The value of the dynamic modulus of elasticity, obtained by the ultrasonic technique, is slightly higher than the value of the modulus of elasticity obtained by the bending tests. Finally, the experimental findings have been compared with those drawn from both Classical Lamination Theory and Dietz approach, obtaining a good agreement and confirming that the Dietz approach is a fast and easy way to assess the elastic properties of a laminated structure

Study on Chinese Tourism Web Sites' Distribution and Online Marketing Effects.

As a platform and carrier of tourism information, tourism websites (TWs) and online tourism marketing have deeply affected the tourism industry. The authors adopt a geographical perspective to analyze the distribution of Chinese tourism websites (CTWs), and statistical analysis with SPSS16.0 was conducted to explore the online marketing effects of CTWs, and some meaningful results has been produced: 1) The number of CTWs generally decreases from eastern China to central and western China, and are especially dominant in tourism developed provinces. 2) The number of tourists has strong statistical correlation with the number of CTWs. 3) The strongest correlation for inbound tourists is with hotel websites, and the highest correlation coefficient is 0.807 between the number of domestic tourist and resort websites. Both inbound and domestic tourists have a low correlation coefficient with travel agency websites (TA). 4) There exist some statistical models between tourist numbers and different kinds of CTWs. The results clearly unveil the marketing effects and correlation of CTWs and is helpful for further online marketing strategies

Latin American Thyroid Society Recommendations For The Management Of Thyroid Nodules [recomendações Da Sociedade Latino-americana De Tireoide No Manejo De Nódulos Tireoideos]

Several guidelines on diagnosis and treatment of thyroid nodules and cancer have recently been published. However, recommended practices are not always appropriate to different settings or countries. The aim of this consensus was to develop Clinical Guidelines for evaluation and management of patients with thyroid nodules applicable to Latin American countries. The panel was composed by 13 members of the Latin American Thyroid Society involved with research and management of thyroid nodules and cancer from different medical centers in Latin America. The consensus was produced based on the expert opinion of the panel with use of principles of evidence-based medicine. Following a group meeting, a first draft based on the expert opinion of the panel was elaborated and later circulated among panel members for further revision. After revision, this document was submitted to all LATS members for commentaries and considerations and finally revised and refined by the authors. 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Emergent Orthotopic Liver Transplantation for Hemorrhage from a Giant Cavernous Hepatic Hemangioma: Case Report and Review

IntroductionCavernous hemangiomas represent the most common benign primary hepatic neoplasm, often being incidentally detected. Although the majority of hepatic hemangiomas remain asymptomatic, symptomatic hepatic hemangiomas can present with abdominal pain, hemorrhage, biliary compression, or a consumptive coagulopathy. The optimal surgical management of symptomatic hepatic hemangiomas remains controversial, with resection, enucleation, and both deceased donor and living donor liver transplantation having been reported.Case reportWe report the case of a patient found to have a unique syndrome of multiorgan cavernous hemangiomatosis involving the liver, lung, omentum, and spleen without cutaneous involvement. Sixteen years following her initial diagnosis, the patient suffered from intra-abdominal hemorrhage due to her giant cavernous hepatic hemangioma. Evidence of continued bleeding, in the setting of Kasabach-Merritt Syndrome and worsening abdominal compartment syndrome, prompted MELD exemption listing. The patient subsequently underwent emergent liver transplantation without complication.ConclusionAlthough cavernous hemangiomas represent the most common benign primary hepatic neoplasm, hepatic hemangioma rupture remains a rare presentation in these patients. Management at a center with expertise in liver transplantation is warranted for those patients presenting with worsening DIC or hemorrhage, given the potential for rapid clinical decompensation

Social cognition in people with schizophrenia: A cluster-analytic approach

Background The study aimed to subtype patients with schizophrenia on the basis of social cognition (SC), and to identify cut-offs that best discriminate among subtypes in 809 out-patients recruited in the context of the Italian Network for Research on Psychoses. Method A two-step cluster analysis of The Awareness of Social Inference Test (TASIT), the Facial Emotion Identification Test and Mayer-Salovey-Caruso Emotional Intelligence Test scores was performed. Classification and regression tree analysis was used to identify the cut-offs of variables that best discriminated among clusters. Results We identified three clusters, characterized by unimpaired (42%), impaired (50.4%) and very impaired (7.5%) SC. Three theory-of-mind domains were more important for the cluster definition as compared with emotion perception and emotional intelligence. Patients more able to understand simple sarcasm (14 for TASIT-SS) were very likely to belong to the unimpaired SC cluster. Compared with patients in the impaired SC cluster, those in the very impaired SC cluster performed significantly worse in lie scenes (TASIT-LI <10), but not in simple sarcasm. Moreover, functioning, neurocognition, disorganization and SC had a linear relationship across the three clusters, while positive symptoms were significantly lower in patients with unimpaired SC as compared with patients with impaired and very impaired SC. On the other hand, negative symptoms were highest in patients with impaired levels of SC. Conclusions If replicated, the identification of such subtypes in clinical practice may help in tailoring rehabilitation efforts to the person's strengths to gain more benefit to the person

Efficacy and durability of multifactorial intervention on mortality and MACEs:a randomized clinical trial in type-2 diabetic kidney disease

Background: Multiple modifiable risk factors for late complications in patients with diabetic kidney disease (DKD), including hyperglycemia, hypertension and dyslipidemia, increase the risk of a poor outcome. DKD is associated with a very high cardiovascular risk, which requires simultaneous treatment of these risk factors by implementing an intensified multifactorial treatment approach. However, the efficacy of a multifactorial intervention on major fatal/non-fatal cardiovascular events (MACEs) in DKD patients has been poorly investigated. Methods: Nephropathy in Diabetes type 2 (NID-2) study is a multicentre, cluster-randomized, open-label clinical trial enrolling 395 DKD patients with albuminuria, diabetic retinopathy (DR) and negative history of CV events in 14 Italian diabetology clinics. Centres were randomly assigned to either Standard-of-Care (SoC) (n = 188) or multifactorial intensive therapy (MT, n = 207) of main cardiovascular risk factors (blood pressure 40/50 mg/dL for men/women and < 175 mg/dL, respectively). Primary endpoint was MACEs occurrence by end of follow-up phase. Secondary endpoints included single components of primary endpoint and all-cause death. Results: At the end of intervention period (median 3.84 and 3.40 years in MT and SoC group, respectively), targets achievement was significantly higher in MT. During 13.0 years (IQR 12.4–13.3) of follow-up, 262 MACEs were recorded (116 in MT vs. 146 in SoC). The adjusted Cox shared-frailty model demonstrated 53% lower risk of MACEs in MT arm (adjusted HR 0.47, 95%CI 0.30–0.74, P = 0.001). Similarly, all-cause death risk was 47% lower (adjusted HR 0.53, 95%CI 0.29–0.93, P = 0.027). Conclusion: MT induces a remarkable benefit on the risk of MACEs and mortality in high-risk DKD patients. Clinical Trial Registration ClinicalTrials.gov number, NCT00535925. https://clinicaltrials.gov/ct2/show/NCT0053592