Hiatoplasty with crura buttressing versus hiatoplasty alone during laparoscopic sleeve gastrectomy

Introduction. In obese patients with hiatal hernia (HH), laparoscopic sleeve gastrectomy (LSG) with cruroplasty is an option but use of prosthetic mesh crura reinforcement is debated. The aim was to compare the results of hiatal closure with or without mesh buttressing during LSG. Methods. Gastroesophageal reflux disease (GERD) was assessed by the Health-Related Quality of Life (GERD-HRQL) questionnaire before and after surgery in two consecutive series of patients with esophageal hiatus ≤ 4 cm2. After LSG, patients in group A (12) underwent simple cruroplasty, whereas in group B patients (17), absorbable mesh crura buttressing was added. Results. At mean follow-up of 33.2 and 18.1 months for groups A and B, respectively (p = 0 006), the mean preoperative GERD-HRQL scores of 16.5 and 17.7 (p = 0 837) postoperatively became 9.5 and 2.4 (p = 0 071). In group A, there was no difference between pre- and postoperative scores (p = 0 279), whereas in group B, a highly significant difference was observed (p = 0 002). The difference (Δ) comparing pre- and postoperative mean scores between the two groups was significantly in favor of mesh placement (p = 0 0058). Conclusions. In obese patients with HH and mild-moderate GERD, reflux symptoms are significantly improved at medium term follow-up after cruroplasty with versus without crura buttressing during LSG.Introduction. In obese patients with hiatal hernia (HH), laparoscopic sleeve gastrectomy (LSG) with cruroplasty is an option but use of prosthetic mesh crura reinforcement is debated. The aim was to compare the results of hiatal closure with or without mesh buttressing during LSG. Methods. Gastroesophageal reflux disease (GERD) was assessed by the Health-Related Quality of Life (GERD-HRQL) questionnaire before and after surgery in two consecutive series of patients with esophageal hiatus ≤ 4 cm2. After LSG, patients in group A (12) underwent simple cruroplasty, whereas in group B patients (17), absorbable mesh crura buttressing was added. Results. At mean follow-up of 33.2 and 18.1 months for groups A and B, respectively (p = 0 006), the mean preoperative GERD-HRQL scores of 16.5 and 17.7 (p = 0 837) postoperatively became 9.5 and 2.4 (p = 0 071). In group A, there was no difference between pre- and postoperative scores (p = 0 279), whereas in group B, a highly significant difference was observed (p = 0 002). The difference (Δ) comparing pre- and postoperative mean scores between the two groups was significantly in favor of mesh placement (p = 0 0058). Conclusions. In obese patients with HH and mild-moderate GERD, reflux symptoms are significantly improved at medium term follow-up after cruroplasty with versus without crura buttressing during LSG

The formation heritage of Jupiter Family Comet 10P/Tempel 2 as revealed by infrared spectroscopy

We present spectral and spatial information for major volatile species in Comet 10P/Tempel 2, based on high-dispersion infrared spectra acquired on UT 2010 July 26 (heliocentric distance Rh = 1.44 AU) and September 18 (Rh = 1.62 AU), following the comet's perihelion passage on UT 2010 July 04. The total production rate for water on July 26 was (1.90 +/- 0.12) x 10^28 molecules s-1, and abundances of six trace gases (relative to water) were: CH3OH (1.58% +/- 0.23), C2H6 (0.39% +/- 0.04), NH3 (0.83% +/- 0.20), and HCN (0.13% +/- 0.02). A detailed analysis of intensities for water emission lines provided a rotational temperature of 35 +/- 3 K. The mean OPR is consistent with nuclear spin populations in statistical equilibrium (OPR = 3.01 +/- 0.18), and the (1-sigma) lower bound corresponds to a spin temperature > 38 K. Our measurements were contemporaneous with a jet-like feature observed at optical wavelengths. The spatial profiles of four primary volatiles display strong enhancements in the jet direction, which favors release from a localized vent on the nucleus. The measured IR continuum is much more sharply peaked and is consistent with a dominant contribution from the nucleus itself. The peak intensities for H2O, CH3OH, and C2H6 are offset by ~200 km in the jet direction, suggesting the possible existence of a distributed source, such as the release of icy grains that subsequently sublimed in the coma. On UT September 18, no obvious emission lines were present in our spectra, nevertheless we obtained a 3-sigma upper limit Q(H2O) < 2.86 x 10^27 molecules s-1

Virial series for inhomogeneous fluids applied to the Lennard-Jones wall-fluid surface tension at planar and curved walls

We formulate a straightforward scheme of statistical mechanics for inhomogeneous systems that includes the virial series in powers of the activity for the grand free energy and density distributions. There, cluster integrals formulated for inhomogeneous systems play a main role. We center on second order terms that were analyzed in the case of hard-wall confinement, focusing in planar, spherical and cylindrical walls. Further analysis was devoted to the Lennard-Jones system and its generalization the 2k-k potential. For this interaction potentials the second cluster integral was evaluated analytically. We obtained the fluid-substrate surface tension at second order for the planar, spherical and cylindrical confinement. Spherical and cylindrical cases were analyzed using a series expansion in the radius including higher order terms. We detected a $\ln R^{-1}/R^{2}$ dependence of the surface tension for the standard Lennard-Jones system confined by spherical and cylindrical walls, no matter if particles are inside or outside of the hard-walls. The analysis was extended to bending and Gaussian curvatures, where exact expressions were also obtained.Comment: 15 pages, 6 figure

Temporal and Spatial Aspects of Gas Release During the 2010 Apparition of Comet 103P/Hartley-2

We report measurements of eight primary volatiles (H2O, HCN, CH4, C2H6, CH3OH, C2H2, H2CO, and NH3) and two product species (OH and NH2) in comet 103P/Hartley-2 using high dispersion infrared spectroscopy. We quantified the long- and short-term behavior of volatile release over a three-month interval that encompassed the comet's close approach to Earth, its perihelion passage, and flyby of the comet by the Deep Impact spacecraft during the EPOXI mission. We present production rates for individual species, their mixing ratios relative to water, and their spatial distributions in the coma on multiple dates. The production rates for water, ethane, HCN, and methanol vary in a manner consistent with independent measures of nucleus rotation, but mixing ratios for HCN, C2H6, & CH3OH are independent of rotational phase. Our results demonstrate that the ensemble average composition of gas released from the nucleus is well defined, and relatively constant over the three-month interval (September 18 through December 17). If individual vents vary in composition, enough diverse vents must be active simultaneously to approximate (in sum) the bulk composition of the nucleus. The released primary volatiles exhibit diverse spatial properties which favor the presence of separate polar and apolar ice phases in the nucleus, establish dust and gas release from icy clumps (and also, directly from the nucleus), and provide insights into the driver for the cyanogen (CN) polar jet. The spatial distributions of C2H6 & HCN along the near-polar jet (UT 19.5 October) and nearly orthogonal to it (UT 22.5 October) are discussed relative to the origin of CN. The ortho-para ratio (OPR) of water was 2.85 \pm 0.20; the lower bound (2.65) defines Tspin > 32 K. These values are consistent with results returned from ISO in 1997.Comment: 18 pages, 3 figures, to be published in: Astrophysical Journal Letter

Disease severity adversely affects delivery of dialysis in acute renal failure

Background/Aims: Methods of intermittent hemodialysis (IHD) dose quantification in acute renal failure (ARF) are not well defined. This observational study was designed to evaluate the impact of disease activity on delivered single pool Kt/V-urea in ARF patients. Methods: 100 patients with severe ARF (acute intrinsic renal disease in 18 patients, nephrotoxic acute tubular necrosis in 38 patients, and septic ARF in 44 patients) were analyzed during four consecutive sessions of IHD, performed for 3.5-5 h every other day or daily. Target IHD dose was a single pool Kt/V-urea of 1.2 or more per dialysis session for all patients. Prescribed Kt/V-urea was calculated from desired dialyzer clearance (K), desired treatment time (t) and anthropometric estimates for urea distribution volume (V). The desired clearance (K) was estimated from prescribed blood flow rate and manufacturer's charts of in vivo data obtained in maintenance dialysis patients. Delivered single pool Kt/V-urea was calculated using the Daugirdas equation. Results: None of the patients had prescription failure of the target dose. The delivered IHD doses were substantially lower than the prescribed Kt/V values, particularly in ARF patients with sepsis/septic shock. Stratification according to disease severity revealed that all patients with isolated ARF, but none with 3 or more organ failures and none who needed vasopressive support received the target dose. Conclusion: Prescription of target IHD dose by single pool Kt/V-urea resulted in suboptimal dialysis dose delivery in critically ill patients. Numerous patient-related and treatment-immanent factors acting in concert reduced the delivered dose. Copyright (C) 2007 S. Karger AG, Basel

Análise de custo e benefício de duas tecnologias na cafeicultura, Ouro Preto d'Oeste, RO, 2007.

O presente trabalho avalia o retorno econômico da adoção das tecnologias da poda e da adubação em unidades de produção do município de Ouro Preto do Oeste, RO.bitstream/CPAF-RO-2010/13274/1/cot331-cafeicultura.pd

A Measurement of Water Vapour amid a Largely Quiescent Environment on Europa

Previous investigations proved the existence of local density enhancements in Europas atmosphere, advancing the idea of a possible origination from water plumes. These measurement strategies, however, were sensitive either to total absorption or atomic emissions, which limited the ability to assess the water content. Here we present direct searches for water vapour on Europa spanning dates from February 2016 to May 2017 with the Keck Observatory. Our global survey at infrared wavelengths resulted in non-detections on 16 out of 17 dates, with upper limits below the water abundances inferred from previous estimates. On one date (26 April 2016) we measured 2,095 658 tonnes of water vapour at Europas leading hemisphere. We suggest that the outgassing ls than previously estimated, with only rare localized events of stronger activity

Adaptive forest governance to face land use change impacts in Italy: a review

Il cambiamento dell’uso del suolo è uno dei driver principali della riduzione della resilienza ecosistemica, così come della perdita di biodiversità e approvvigionamento di servizi. Rappresenta una sfida peculiare, specialmente negli ambienti mediterranei, dove i fenomeni di abbandono e ricolonizzazione naturale stanno minacciando in modo sempre più crescente la capacità delle foreste di fornire benefici alle comunità locali. In queste condizioni, il sistema di governance forestale è chiamato a bilanciare gli impatti del cambiamento dell’uso del suolo con l’assicurazione della salute e della stabilità degli ecosistemi forestali, al fine di garantire la sostenibilità a lungo termine degli ambienti, soprattutto di quelli marginali. Questo lavoro si propone di analizzare in modo più approfondito gli impatti del cambiamento dell’uso del suolo sugli ecosistemi forestali negli ambienti montani italiani. In primo luogo, esegue un’analisi bibliografica dei concetti legati al cambiamento dell’uso del suolo e all’approvvigionamento dei servizi ecosistemici, dalla scala globale a quella locale. In seguito, indaga le relazioni fra le potenzialità adattive di gestione e pianificazione forestali e il cambiamento dell’uso del suolo. Infine, vengono proposte alcune strategie future di possibili strumenti di governance adattiva per affrontare i cambiamenti dell’uso del suolo. Questa infatti può migliorare la resilienza degli ecosistemi forestali riducendo il gap nel campo della ricerca tra il contesto nazionale e quello globale, utilizzando strumenti di valutazione e monitoraggio per simulare cambiamenti e disturbi esterni, e adottando strategie e misure politiche coerenti a scala locale.Land use change is one of the most important drivers for the reduction of ecosystem resilience, and the loss ofbiodiversity and services provision. This is a peculiar challenge, especially in Mediterranean mountain environments,where abandonment and forest transition phenomena increasingly threaten the forest capacity to provide benefits for local communities. Under these conditions, forest governance is called to balance the landuse change impacts and the health and stability of forest ecosystems, in order to ensure the long-term sustainabilityof such marginal environments. This paper aims at deeper understanding the impacts of land use change on forest ecosystem on mountain environments in Italy. At first, a downscaled review on the conceptsof land use change and ecosystem services provision is carried out. Then, according to the review results, therelationships between adaptive capacity of forest management and planning, and land use change is deeply described. Finally, future-oriented strategies of adaptive governance to face land use change are proposed. Inthe context of land use change, adaptive governance can improve forest resilience through filling the researchgaps between the national and the global contexts, adopting monitoring and assessment tools to simulate external changes and disturbances, and effectively implement consistent policy measures and strategies at localscale

Status of the CKM matrix

An updated determination of the parameters of the Cabibbo-Kobayashi-Maskawa matrix is presented.Comment: 8 pages, 9 figures, uses espcrc2.sty. Talk given at the "7th Topical Seminar on the Legacy of LEP and SLC", 8-11 October 2001, Siena (Italy