Perioperative tumor cell dissemination in patients with primary or metastatic colorectal cancer

INTRODUCTION: Although there is general correlation between the TNM stage of colorectal cancer (CRC) and its prognosis, there is often significant variability of tumor behaviour and individual patient outcome, which is unaccounted for by pathologic factors alone. Our aim was to estimate perioperative tumor cell dissemination in patients with primary or CRC liver metastases as a possible factor influencing the outcome. METHODS: Forty patients were prospectively enrolled in the study from the year 2007 to 2008. Eighteen patients had histologically proven CRC (50% rectal, 44% colonic, 6% colonic and rectal). Sixteen patients (47%) had CRC liver metastases only. The remaining six patients who underwent colon or liver resection for benign conditions, acted as the control group. All patients with malignant pathologies had R0 resections. Blood samples were taken before the surgical incision (T0), immediately after tumor resection (T1) and at the end of the surgical intervention (T2). Data acquisition was performed using a dual-laser FACSCalibur flow cytometer. Circulating malignant cells were identified as being CD45-/cytokeratin+. RESULTS: The analysis of patients overall (CRC resection subgroup and hepatectomy subgroup) revealed that there was no statistically significant difference of the tumoral cell count in the blood per million of hematopoietic cells at T0, T1 and T2. CONCLUSIONS: This study demonstrates no differences in the detected circulating numbers of tumor cells at different stages of surgical intervention

Testing the robustness of controllers for self-adaptive systems

Self-Adaptive systems are software-intensive systems endowed with the ability to respond to a variety of changes that may occur in their environment, goals, or the system itself, by adapting their structure and behavior at run-time in an autonomous way. Controllers are complex components incorporated in self-adaptive systems, which are crucial to their function since they are in charge of adapting the target system by executing actions through effectors, based on information monitored by probes. However, although controllers are becoming critical in many application domains, so far very little has been done to assess their robustness. In this paper, we propose an approach for evaluating the robustness of controllers for self-adaptive software systems, aiming to identify faults in their design. Our proposal considers the stateful nature of the controller, and identifies a set of robustness tests, which includes the provision of mutated inputs to the interfaces between the controller and the target system (i.e., probes). The feasibility of the approach is evaluated on Rainbow, a framework for architecture-based self-adaptation, and in the context of the Znn.com case study

Tablets in kindergarten for learning and parental involvement

Children in pre-school education may benefit from using tablet devices due to their portability, multitouch interaction and variety of age-appropriate educational apps. This paper describes a workshop in one kindergarten where children have used tablets and educational apps to carry out an educational activity - drawings and videos of their self-portrait. The results were shared with parents on a communication platform, as a strategy for parental involvement in kindergarten. The data presented was collected through direct observation of the children, observation of the contents posted on the platform, interview with the educator and focus group with the parents. Content analysis was used to treat data. The use of tablets and apps has encouraged children's interest and dedication in educational activities. Sharing children's work on the platform has led parents to participate, comment online and talk with children about their work, facilitating parental involvement. This study contributes to the research about the motivation, willingness and ease of young children to use tablets and apps in learning activities. It also supports that the main interest of parents in a communication platform with the kindergarten is to have access to their children's work and to know what they do during the day.publishe

Clinical and Laboratory Basis for the Diagnosis and Understanding of Neonatal Metabolic Diseases

The authors divide neonatal metabolic diseases into two major groups: intoxication and energy deficiency. The main signs which allow for the suspicion of the diagnosis are indicated for each group. The complementary examinations to be carried out by the Clinical Pathology Service of the Central Hospital and those which must be carried out by the metabolic diseases Reference Centre are reviewed. Based on the clinical framework and on the examination results, the authors establish five syndromatic groups to orientate diagnosis. The authors conclude by presenting differential diagnosis tables based on the original systematic classification by Jean-Marie Saudubray, with up-dated modifications from their own experience

Wind disturbances shape old Norway spruce-dominated forest in Bulgaria

Correct knowledge of disturbance ecology is essential for understanding the characteristic behavior of forest ecosystems and for guiding appropriate management strategies. However, the role of natural disturbances in shaping European mountain forest ecosystems has not been adequately studied, possibly because of the perception that the development of most European forests is primarily shaped by human influences and/or fine-scale gap-phase dynamics.In the present study, we investigate the long-term disturbance history of old protected forest dominated by Norway spruce in the Parangalitsa Reserve, Bulgaria. We used aerial photo interpretation and dendroecological methods to reconstruct the history of wind, insect, and fire disturbances across a topographically complex landscape. Over the past 150. years wind has been the most important disturbance agent in this ecosystem and at least 18% of the forested area shows evidence of high-severity blowdowns. Windthrow patches ranged in size from 10. ha (minimum 0.11. ha, mean 0.16. ha, maximum 10. ha). Although small disturbances were much more frequent, few larger blowdowns accounted for most of the disturbed area. Pure coniferous and single-cohort coniferous forest patches were more affected by blowdowns than mixed coniferous-deciduous and multi-cohort coniferous forest patches. Although bark beetle (Ips typhographus) populations were large enough to cause mortality of some live trees, the populations did not grow to epidemic proportions during recent decades. Fire disturbance was of limited importance in the last 200. years and only two patches (4% of the study area) showed evidence of fire.The present research indicates that wind disturbances have been characteristic of these ecosystems at least over the past decades to centuries. Thus, blowdowns appear integral to the normal function and structure of the Picea-dominated mountain forests in the region and such events, in and of themselves, do not represent unhealthy forest conditions or environmental emergencies. Management strategies that aim to maintain these ecosystems within a natural range of variation should incorporate wind disturbances into the management strategy. The frequency and magnitude of future wind disturbances may be considered within the historical framework described in the current study to assess potential effects of climate change on altered disturbance regimes. © 2011 Elsevier B.V