Metastatic tumors to the stomach: clinical and endoscopic features.

AIM: To evaluate the clinical and endoscopic patterns in a large series of patients with metastatic tumors in the stomach. METHODS: A total of 64 patients with gastric metastases from solid malignant tumors were retrospectively examined between 1990 and 2005. The clinicopathological findings were reviewed along with tumor characteristics such as endoscopic pattern, location, size and origin of the primary sites. RESULTS: Common indications for endoscopy were anemia, bleeding and epigastric pain. Metastases presented as solitary (62.5%) or multiple (37.5%) tumors were mainly located in the middle or upper third of stomach. The main primary metastatic tumors were from breast and lung cancer and malignant melanoma. CONCLUSION: As the prognosis of cancer patients has been improving gradually, gastrointestinal (GI) metastases will be encountered more often. Endoscopic examinations should be conducted carefully in patients with malignancies, and endoscopic biopsies and information on the patient's clinical history are useful for correct diagnosis of gastric metastases

Conformation of Circular DNA in 2 Dimensions

The conformation of circular DNA molecules of various lengths adsorbed in a 2D conformation on a mica surface is studied. The results confirm the conjecture that the critical exponent $\nu$ is topologically invariant and equal to the SAW value (in the present case $\nu=3/4$), and that the topology and dimensionality of the system strongly influences the cross-over between the rigid regime and the self-avoiding regime at a scale $L\approx 8 \ell_p$. Additionally, the bond correlation function scales with the molecular length $L$ as predicted. For molecular lengths $L\leq5 \ell_p$, circular DNA behaves like a stiff molecule with approximately elliptic shape.Comment: 4 pages, 5 figure

Coordination in closed-loop supply chain with price-dependent returns

This paper proposes two Closed-loop Supply Chain (CLSC) games in which a manufacturer sets some green activity programs efforts and a retailer sets the selling price. Both strategies influence the return rate, which is a state variable. The pricing strategy plays a key role in the identification of the best contract to achieve coordination as well as in achieving environmental objectives. The pricing strategy influences the return rate negatively, as consumers delay the return of their goods when the purchasing (and repurchasing) price is high. We then compare a wholesale price contract (WPC) and a revenue sharing contract (RSC) mechanism as both have interesting pricing policy implications. Our result shows that firms coordinate the CLSC through a (WPC) when the sharing parameter is too low while the negative effect of pricing on returns is too severe. In that case, the low sharing parameter deters the manufacturer to accept any sharing agreements. Further, firms coordinate the CLSC when the sharing parameter is medium independent of the negative impact of pricing on returns. When the sharing parameter is too high the retailer never opts for an RSC. We find that the magnitude of pricing effect on returns determines the contract to be adopted: For certain sharing parameter, firms prefer an RSC when the price effect on return is low and a WPC when this effect is high. In all other cases, firms do not have a consensus on the contract to be adopted and coordination is then not achieved

Relationship between blood remifentanil concentration and stress hormone levels during pneumoperitoneum in patients undergoing laparoscopic cholecystectomy

The effect of remifentanil on stress response to surgery is unclear. However, there are not clinical studies investigating the relationship between blood remifentanil concentrations and stress hormones. Therefore, the aim of the present study was to assess the association between blood remifentanil concentrations measured after pneumoperitoneum and cortisol (CORT) or prolactin (PRL) ratio (intraoperative/preoperative value), in patients undergoing laparoscopic cholecystectom

A rank-and-compare algorithm to detect abnormally low bids in procurement auctions

3noDetecting abnormally low bids in procurement auctions is a recognized problem, since their acceptance could result in the winner not being able to provide the service or work awarded by the auction, which is a significant risk for the auctioneer. A rank-and-compare algorithm is considered to detect such anomalous bids and help auctioneers in achieving an effective rejection decision. Analytical expressions and simulation results are provided for the detection probability, as well as for the false alarm probability. The suggested range of application of the detection algorithm leaves out the cases of many tenderers (more than 20) and quite dispersed bids (coefficient of variation larger than 0.15). An increase in the number of tenderers leads to contrasting effects, since both the false alarm probability and the detection probability are reduced. If the bids are spread over a large range, we have instead a double negative effect, with more false alarms and less detections. The presence of multiple anomalous bids worsens the performance of the algorithm as well. On the other hand, the method is quite robust to the presence of courtesy bids.reservedmixedL. De Giovanni; P. L. Conti; M. NaldiDE GIOVANNI, Livia; P. L., Conti; M., Nald

Polypoid vascular malformation of the small intestine.

A 56-year-old man underwent capsule endoscopy because of obscure GI bleeding. Capsule endoscopy showed a pink and somewhat nodular polypoid lesion of the small bowel partially obstructing the intestinal lumen (A). The patient underwent an ileal resection and the operative specimen showed loss of mucosal folds and the presence of an erythematous area with a polypoid formation of 3.5 × 3 cm (B). Histologic examination revealed the presence of numerous ectatic thin-walled blood vessels and a small number of thick-walled vessels in the submucosa (C and D, arrows; H&E, orig. mag. ×4), surrounded by hypertrophic muscularis mucosae and a chronic inflammatory infiltrate that infiltrated the muscularis propria; the diagnosis of polypoid angiodysplasia was suggested. There has been no recurrence of GI bleeding 14 months after the ileal resection

Fuzzy clustering of spatial interval-valued data

In this paper, two fuzzy clustering methods for spatial interval-valued data are proposed, i.e. the fuzzy C-Medoids clustering of spatial interval-valued data with and without entropy regularization. Both methods are based on the Partitioning Around Medoids (PAM) algorithm, inheriting the great advantage of obtaining non-fictitious representative units for each cluster. In both methods, the units are endowed with a relation of contiguity, represented by a symmetric binary matrix. This can be intended both as contiguity in a physical space and as a more abstract notion of contiguity. The performances of the methods are proved by simulation, testing the methods with different contiguity matrices associated to natural clusters of units. In order to show the effectiveness of the methods in empirical studies, three applications are presented: the clustering of municipalities based on interval-valued pollutants levels, the clustering of European fact-checkers based on interval-valued data on the average number of impressions received by their tweets and the clustering of the residential zones of the city of Rome based on the interval of price values

Fossichnus solus and Oichnus simplex, two peculiar ichnospecies in modern benthic foraminifera from a polluted area in SW coast of Sardinia, Italy

The modern benthic foraminiferal tests collected from a coastal area of south-western Sardinia (Portoscuso-Portovesme) that is heavily polluted by industrial activity reveal intense and widespread bioerosional structures induced by diversifi ed microborers. A large number of the foraminifera reveals microscopic round holes (1-60 μm in diameter) and roundish concavities (25x40 μm in external diameter) on their surface that belong, respectively, to the ichnospecies Oichnus simplex Bromley, 1981, and Fossichnus solus Nielsen et al., 2003. These traces just occur in the tests of the foraminifera which are heavily infested by microendolithic cyanobacteria, algae and fungi suggests comparable ethological behaviour between the ichnospecies Fossichnus and Oichnus and the microbial euendoliths that are ascribed to individual biological taxa. The greater occurrence of F. solus and O. simplex in the high-Mg foraminiferal porcelanaceous tests than in the low-Mg foraminiferal hyaline tests reveals that the bioerosional processes seem to be related to the Mg/Ca ratio, as well as to morphological structures of the taxa

The Impact of Digital Technologies and Sustainable Practices on Circular Supply Chain Management

Background: This study investigates how firms can enhance the functionality of their circular supply chains (CSCs) by adopting a portfolio of sustainable practices as well as digital technologies to increase performance. It analyzes the benefits that firms can obtain when investing in specific technologies to boost the impact of technologies and sustainable practices on CSCs, and further increase performance. Methods: We test several hypotheses by using structural equation modeling as well as multi-group analysis to verify whether CSCs can be achieved through sustainable practices and technologies and improve the firms' performance. Results: The empirical results partially support the research hypotheses. While the main research hypotheses are fully supported, the analysis of single digital technologies reveals that only a few solutions can contribute to both the management and the improvement of the CSC. Conclusions: Our findings demonstrate that the identification of green suppliers and ad hoc environmental regulations, combined with attention to the origin and provenance of raw materials, can promote a CSC. Moreover, transportation management systems (TMS) and the internet of things (IoT) are efficient technologies for managing transportation and product flow in the CSC. Furthermore, machine learning (ML) is effective in making positive green decisions, and 3D printing can extend product life