479 research outputs found
Long-term restoration of bowel continuity after rectal cancer resection and the influence of surgical technique:A nationwide cross-sectional study
Aim: Literature on nationwide long-term permanent stoma rates after rectal cancer resection in the minimally invasive era is scarce. The aim of this population-based study was to provide more insight into the permanent stoma rate with interhospital variability (IHV) depending on surgical technique, with pelvic sepsis, unplanned reinterventions and readmissions as secondary outcomes. Method: Patients who underwent open or minimally invasive resection of rectal cancer (lower border below the sigmoid take-off) in 67 Dutch centres in 2016 were included in this cross-sectional cohort study. Results: Among 2530 patients, 1470 underwent a restorative resection (58%), 356 a Hartmann's procedure (14%, IHV 0%–42%) and 704 an abdominoperineal resection (28%, IHV 3%–60%). Median follow-up was 51 months. The overall permanent stoma rate at last follow-up was 50% (IHV 13%–79%) and the unintentional permanent stoma rate, permanent stoma after a restorative procedure or an unplanned Hartmann's procedure, was 11% (IHV 0%–29%). A total of 2165 patients (86%) underwent a minimally invasive resection: 1760 conventional (81%), 170 transanal (8%) and 235 robot-assisted (11%). An anastomosis was created in 59%, 80% and 66%, with corresponding unintentional permanent stoma rates of 12%, 24% and 14% (p = 0.001), respectively. When corrected for age, American Society of Anesthesiologists classification, cTNM, distance to the anorectal junction and neoadjuvant (chemo)radiotherapy, the minimally invasive technique was not associated with an unintended permanent stoma (p = 0.071) after a restorative procedure. Conclusion: A remarkable IHV in the permanent stoma rate after rectal cancer resection was found. No beneficial influence of transanal or robot-assisted laparoscopy on the unintentional permanent stoma rate was found, although this might be caused by the surgical learning curve. A reduction in IHV and improving preoperative counselling for decision-making for restorative procedures are required.</p
Comparison between Spanish young and elderly people evaluated using Rivermead Behavioural Memory Test
The first objective of this work was to compare scores obtained in the daily memory function between young and elderly people, and to check whether there are differences between the groups for each of the profile scores obtained in the memory test. A second aim of this paper is to study the relationship between everyday memory and age, while controlling for gender and educational level. The total and profile scores obtained in the Rivermead Behavioural Memory Test were compared in a sample of 60 young and 120 elderly people from Valencia (Spain). Results showed significant differences between the two groups: those between 18 and 30 years obtained a higher average than those over 65. Once the group comparison was controlled for gender and educational level, the statistical effect of age group disappeared. The non-significant effect of group can not be explained by the introduction of gender, because both its main effect and the interaction were not statistically significant. However, educational level had a statistically significant effect which may explain the non-significant effect of group in this new analysis. The main conclusion is the need to carefully control for educational level in all studies related with everyday memory and ageing, as the differences found could be due to generational differences more than to biological deterioratio
Rare Decays
The rare decays of the meson have had a long tradition as a laboratory
for testing the symmetry properties of the weak interactions, and the manner in
which these symmetries are broken by higher order effects. Present--day
interest is focussed on decays that are suppressed by --symmetry or GIM
symmetry. Such decays, in the standard theory, are sensitive to effects of the
virtual top quark, and could also reveal new interactions transcending the
standard model. In addition, the radiative decays of the meson have become
a useful testing--ground for effective Lagrangians describing the low energy
interactions of pions, kaons and photons.Comment: Invited Talk at the Third Workshop on High Energy Particle Physics
(WHEPP 3) Madras, 1994, LaTex, 14 pages, 3 figures available upon reques
Report of the Workshop on Growth-increment Chronologies in Marine Fish: climate-ecosystem interactions in the North Atlantic 2.
Summary statistics in auditory perception
Sensory signals are transduced at high resolution, but their structure must be stored in a more compact format. Here we provide evidence that the auditory system summarizes the temporal details of sounds using time-averaged statistics. We measured discrimination of 'sound textures' that were characterized by particular statistical properties, as normally result from the superposition of many acoustic features in auditory scenes. When listeners discriminated examples of different textures, performance improved with excerpt duration. In contrast, when listeners discriminated different examples of the same texture, performance declined with duration, a paradoxical result given that the information available for discrimination grows with duration. These results indicate that once these sounds are of moderate length, the brain's representation is limited to time-averaged statistics, which, for different examples of the same texture, converge to the same values with increasing duration. Such statistical representations produce good categorical discrimination, but limit the ability to discern temporal detail.Howard Hughes Medical Institut
Beyond the Libet clock: modality variants for agency measurements
The Sense of Agency (SoA) refers to our capability to control our own actions and influence the world around us. Recent research in HCI has been exploring SoA to provide users an instinctive sense of “I did that” as opposed to “the system did that”. However, current agency measurements are limited. The Intentional Binding (IB) paradigm provides an implicit measure of the SoA. However, it is constrained by requiring high visual attention to a “Libet clock” onscreen. In this paper, we extend the timing stimulus through auditory and tactile cues. Our results demonstrate that audio timing through voice commands and haptic timing through tactile cues on the hand are alternative techniques to measure the SoA using the IB paradigm. They both address limitations of the traditional method (e.g., lack of engagement and visual demand). We discuss how our results can be applied to measure SoA in tasks involving different interactive scenarios common in HCI
Variance in Centrality within Rock Hyrax Social Networks Predicts Adult Longevity
BACKGROUND: In communal mammals the levels of social interaction among group members vary considerably. In recent years, biologists have realized that within-group interactions may affect survival of the group members. Several recent studies have demonstrated that the social integration of adult females is positively associated with infant survival, and female longevity is affected by the strength and stability of the individual social bonds. Our aim was to determine the social factors that influence adult longevity in social mammals. METHODOLOGY/PRINCIPAL FINDINGS: As a model system, we studied the social rock hyrax (Procavia capensis), a plural breeder with low reproductive skew, whose groups are mainly composed of females. We applied network theory using 11 years of behavioral data to quantify the centrality of individuals within groups, and found adult longevity to be inversely correlated to the variance in centrality. In other words, animals in groups with more equal associations lived longer. Individual centrality was not correlated with longevity, implying that social tension may affect all group members and not only the weakest or less connected ones. CONCLUSIONS/SIGNIFICANCE: Our novel findings support previous studies emphasizing the adaptive value of social associations and the consequences of inequality among adults within social groups. However, contrary to previous studies, we suggest that it is not the number or strength of associations that an adult individual has (i.e. centrality) that is important, but the overall configuration of social relationships within the group (i.e. centrality SD) that is a key factor in influencing longevity
Do Fleas Affect Energy Expenditure of Their Free-Living Hosts?
Parasites can cause energetically costly behavioural and immunological responses which potentially can reduce host fitness. However, although most laboratory studies indicate that the metabolic rate of the host increases with parasite infestation, this has never been shown in free-living host populations. In fact, studies thus far have shown no effect of parasitism on field metabolic rate (FMR).We tested the effect of parasites on the energy expenditure of a host by measuring FMR using doubly-labelled water in free-living Baluchistan gerbils (Gerbillus nanus) infested by naturally occurring fleas during winter, spring and summer. We showed for the first time that FMR of free-living G. nanus was significantly and positively correlated with parasite load in spring when parasite load was highest; this relationship approached significance in summer when parasite load was lowest but was insignificant in winter. Among seasons, winter FMRs were highest and summer FMRs were lowest in G. nanus.The lack of parasite effect on FMR in winter could be related to the fact that FMR rates were highest among seasons. In this season, thermoregulatory costs are high which may indicate that less energy could be allocated to defend against parasites or to compensate for other costly activities. The question about the cost of parasitism in nature is now one of the major themes in ecological physiology. Our study supports the hypothesis that parasites can elevate FMR of their hosts, at least under certain conditions. However, the effect is complex and factors such as season and parasite load are involved
Long-term restoration of bowel continuity after rectal cancer resection and the influence of surgical technique: A nationwide cross-sectional study
Aim: Literature on nationwide long-term permanent stoma rates after rectal cancer resection in the minimally invasive era is scarce. The aim of this population-based study was to provide more insight into the permanent stoma rate with interhospital variability (IHV) depending on surgical technique, with pelvic sepsis, unplanned reinterventions and readmissions as secondary outcomes. Method: Patients who underwent open or minimally invasive resection of rectal cancer (lower border below the sigmoid take-off) in 67 Dutch centres in 2016 were included in this cross-sectional cohort study. Results: Among 2530 patients, 1470 underwent a restorative resection (58%), 356 a Hartmann's procedure (14%, IHV 0%–42%) and 704 an abdominoperineal resection (28%, IHV 3%–60%). Median follow-up was 51 months. The overall permanent stoma rate at last follow-up was 50% (IHV 13%–79%) and the unintentional permanent stoma rate, permanent stoma after a restorative procedure or an unplanned Hartmann's procedure, was 11% (IHV 0%–29%). A total of 2165 patients (86%) underwent a minimally invasive resection: 1760 conventional (81%), 170 transanal (8%) and 235 robot-assisted (11%). An anastomosis was created in 59%, 80% and 66%, with corresponding unintentional permanent stoma rates of 12%, 24% and 14% (p = 0.001), respectively. When corrected for age, American Society of Anesthesiologists classification, cTNM, distance to the anorectal junction and neoadjuvant (chemo)radiotherapy, the minimally invasive technique was not associated with an unintended permanent stoma (p = 0.071) after a restorative procedure. Conclusion: A remarkable IHV in the permanent stoma rate after rectal cancer resection was found. No beneficial influence of transanal or robot-assisted laparoscopy on the unintentional permanent stoma rate was found, although this might be caused by the surgical learning curve. A reduction in IHV and improving preoperative counselling for decision-making for restorative procedures are required
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