Early treatment of acute biliary pancreatitis by endoscopic papillotomy

Background. Most patients with acute biliary pancreatitis have stones in the biliary tract or ampulla of Vater. Because these stones may be passed spontaneously soon after a patient is admitted to the hospital, the importance of early operative removal is not known. We tested the hypothesis that endoscopic papillotomy within 24 hours of admission decreased the incidence of complications in patients with acute biliary pancreatitis. Methods. We studied 195 patients with acute pancreatitis who were randomly assigned to one of two groups: 97 patients underwent within 24 hours after admission emergency endoscopic retrograde cholangiopancreatography (ERCP) followed by endoscopic papillotomy for ampullary and common-bile-duct stones, and 98 patients received initial conservative treatment and selective ERCP with or without endoscopic papillotomy only if their condition deteriorated. Results. One hundred twenty-seven patients ultimately proved to have biliary stones. Emergency ERCP with or without endoscopic papillotomy resulted in a reduction in biliary sepsis as compared with conservative treatment (0 of 97 patients vs. 12 of 98 patients, P = 0.001). The decrease in biliary sepsis occurred both in patients predicted to have mild pancreatitis (0 of 56 patients in the group that received emergency ERCP vs. 4 of 58 patients in the conservative-treatment group, P = 0.14) and in patients predicted to have severe pancreatitis (0 of 41 patients vs. 8 of 40 patients, P = 0.008). In all patients who had unrelenting biliary sepsis, persistent ampullary or common-bile-duct stones were identified. There were no major differences in the incidence of local complications (10 patients in the group that received emergency ERCP vs. 12 patients in the conservative-treatment group) or systemic complications (10 patients vs. 14 patients) of acute pancreatitis between the two groups, but the hospital mortality rate was slightly lower in the group undergoing emergency ERCP with or without endoscopic papillotomy (5 patients vs. 9 patients, P = 0.4). Conclusions. Emergency ERCP with or without endoscopic papillotomy is indicated in the treatment of patients with acute pancreatitis.published_or_final_versio

Ab Initio Investigation of Charge Trapping Across the Crystalline- Si -Amorphous- Si O2 Interface

Accurate microscopic description of the charge-trapping process from semiconductor to defects in the dielectric-oxide layer is of paramount importance for understanding many microelectronic devices such as complementary metal-oxide-semiconductor (CMOS) transistors, as well as electrochemical reactions. Unfortunately, most current microscopic descriptions of such processes are based on empirical models with parameters fitted to experimental device performance results or simplified approximations like the Wentzel-Kramers-Brillouin (WKB) method. Some critical questions are still unanswered, including: What controls the charge-hopping rate, the coupling strength between the defect level to semiconductor level, or the energy difference? How does the hopping rate decay with defect-semiconductor distance? What is the fluctuation of the defect level, especially in amorphous dielectrics? Many of these questions can be answered by ab initio calculations. However, to date, there are few ab initio studies for this problem mainly due to technical challenges from atomic-structure construction to large-system calculations. Here, using the latest advances in calculation methods and codes, we study the carrier-trapping problem using density-functional theory (DFT) based on the Heyd-Scuseria-Ernzerhof (HSE) exchange correlation functional. The valence bond random-switching method is used to construct the crystalline-Si-amorphous-SiO2 (c-Si/a-SiO2) interfacial atomic structure, and the HSE yields a band offset that agrees well with experiments. The hopping rate is calculated with the Marcus theory, and the hopping-rate dependences on the gate potential and defect distances are revealed, as well as the range of fluctuation results from amorphous structural variation. We also analyze the result with the simple WKB model and find a major difference in the description of the coupling constant decay with the defect-semiconductor distance. Our results provide the ab initio simulation insights for this important carrier-trapping process for device operation

Identification of chromosomes responsible for crown rot resistance in durum wheat

Dissertação de mestrado em Saúde Ocupacional, apresentada á Faculdade de Medicina da Universidade de CoimbraA Segurança, Higiene e Saúde no Trabalho (SHST) tem como objetivo conservar o bem-estar físico, mental e social dos trabalhadores, para isso, é necessário adotar medidas que exigem a interação de várias áreas como a medicina do trabalho, a higiene do trabalho, a engenharia de segurança, a ergonomia, a psicologia, entre outras. Este assunto começou a ser tido em conta, em meados do Séc. XX. Até aí o único aspeto importante relacionado com o trabalho era a produtividade, não havendo preocupação com lesões, doenças nem mesmo se essas situações conduzissem à morte do trabalhador. Tem-se verificado que os riscos psicossociais são riscos emergentes de saúde ocupacional, ou seja, são riscos novos, que estão a aumentar e cujos efeitos sobre a saúde dos trabalhadores estão a agravar-se. As novas formas de contratos de trabalho e insegurança no emprego, a mão-de-obra em envelhecimento, a intensificação do trabalho, as exigências emocionais elevadas no trabalho e a difícil conciliação entre a vida profissional e pessoal são os principais geradores de consequências negativas para os trabalhadores, para as organizações e para a sociedade. Estes riscos requerem grande preocupação por parte das empresas, no entanto devido à delicadeza necessária para abordar esta temática, à escassez dos recursos e à falta de sensibilização, muitas vezes não lhe é dada a devida importância. Os objetivos deste estudo são analisar o nível de exposição da população ativa aos riscos psicossociais, avaliar a capacidade para o trabalho e analisar os efeitos dos riscos psicossociais no trabalho na capacidade para o trabalho. Para atingir os objetivos anteriormente referidos, a metodologia utilizada foram dois questionários, autoadministrados, numa amostra de 140 trabalhadores residentes na localidade de Outil. Com os dados obtidos, foi possível inferir que a população se encontra numa situação de risco intermédio relativamente à exposição aos riscos psicossociais. Este facto não se deve ao sexo do trabalhador nem ao setor em que exerce a sua atividade profissional. Concluiu-se também que a população em estudo apresenta, de um modo geral um bom Índice de Capacidade para o Trabalho (ICT). Este índice vai diminuindo com o avançar Riscos Psicossociais e Capacidade no Trabalho na população de Outil (Cantanhede) XV da idade do trabalhador. O ICT não está correlacionado linearmente com o sexo nem com o setor profissional. Com este estudo verifica-se também que o nível de exposição aos riscos psicossociais se relaciona com a capacidade para o trabalho na medida em que alguns aspetos psicossociais do trabalho potenciam ou inibem a capacidade para o trabalho. Os aspetos que inibem a capacidade para o trabalho são: as exigências quantitativas, os conflitos laborais, a confiança horizontal e vertical, o compromisso face ao local de trabalho, a saúde em geral e os problemas em dormir. Já pelo contrário, o significado do trabalho, a importância que o trabalhador atribui ao trabalho é um fator que potencia a capacidade para o trabalho. A crise económico-financeira atravessada pelo país, e um pouco por toda a Europa, neste momento origina muitas alterações organizacionais e estruturais nas empresas, o que potencia o aparecimento dos riscos psicossociais afetando a saúde física e mental do trabalhador e consequentemente a sua capacidade para o trabalho. O reconhecimento e a gestão dos riscos psicossociais a que estão sujeitos os trabalhadores e a avaliação da sua capacidade para o trabalho tornam mais fácil e eficaz a tomada de decisão e o desenrolar de programas de ação que ajudem as empresas a ultrapassar este momento conturbado a nível socioeconómico e financeiro, mantendo os trabalhadores saudáveis física e mentalmente.The Safety and Health at Work aims to conserve the physical well-being, mental and social workers, for that is necessary to adopt measures that require the interaction of several areas such as occupational medicine, hygiene at work safety engineering, ergonomics, psychology, among others. This issue began to be taken into account in the mid-century. XX, until then the only important aspect related to the work was productivity, with no concern for injury, illness or even if these situations would lead to the death of the workers. It has been found that psychosocial risks are emerging risks to occupational health, it means that they are new risks that are increasing and whose effects on the health of workers are getting worse. The new forms of contracts of work and job insecurity, the hand labor aging, work intensification, high emotional demands at work and the difficult balance between work and personal life are the main triggers of negative consequences for workers, to organizations and to society. These risks require major concern of companies, however because of the sensitivity needed to approach this issue, resources are scarce and the lack of awareness often not been given due importance. The objectives of this study are analyze the level of exposure of the workforce to psychosocial risks, assessing the ability to work and analyze the effects of psychosocial risks at work in the capacity for work. To achieve the above objectives, the methodology used were two questionnaires, self-administered on a sample of 140 workers living in Outil. With the data obtained, it was possible to infer that the population is at an intermediate risk for exposure to psychosocial risks. This is not due to the sex of the worker or the sector where he is pursuing his professional activity. It was also concluded that the study population has, in general a good Work Ability Index (WAI). This ratio decreases with advancing age of the worker. The WAI is not correlated linearly with sex or with the professional sector. The level of exposure to psychosocial risk relates to the ability to work in so far some psychosocial aspects of the work potentiate or inhibit the ability to work. The aspects that inhibit the ability to work are: quantitative requirements, labor disputes, the horizontal and vertical trust, commitment towards the workplace, health in general and trouble sleeping. Already the contrary, the meaning of work, the importance that the worker attaches to the work is a factor that enhances the ability to work. The economic and financial crisis experienced by the country, and almost everywhere in Europe at this time gives many organizational and structural changes in companies, which enhances the appearance of psychosocial risks affecting the physical and mental health of the worker and consequently their ability to the work. Riscos Psicossociais e Capacidade no Trabalho na população de Outil (Cantanhede) XVII The recognition and management of psychosocial risks to which they are subject workers and the evaluation of their ability to make work easier and more effective decision-making and the development of programs which help companies overcome this troubled time the level socio-economic and financial, keeping the physical and mentally healthy worker

Effects of hydrogen bond and solvent polarity on the C=O strectching of bis(2-thienyl)ketone in solution

The optimized structural parameters, the absorption and the resonance Raman spectra have been investigated for the bis(2-thienyl)ketone in gas phase, in cyclohexane, methanol, and acetonitrile solvents by means of time dependent density functional theory calculations, the solvent electronic polarization effect on the solvation shift is examined and in well accordance with the calculation. The effect of increasing the polarity of the solvent is well represented by the polarizable continuum model, both for the absorption spectra and resonance Raman intensities. The Raman spectra of the C=O stretching mode, which is sensitive to the intermolecular interaction for bis(2-thienyl)ketone dissolved in solvents, were systematically studied. It was found that the hydrogen bond effect plays an important role in reducing the carbonyl stretching wavenumbers. The results of Raman shifts were interpreted through the dilution effect, solvation effects, and hydrogen bond-forming effects. Furthermore, the excitation profiles of several important Raman bands of bis(2-thienyl)ketone molecule in different solvents have been critically analyzed. The solvent effects on structural and symmetry properties of the molecule in S2 electronic state as well as the short-time photo relaxation dynamics have been discussed.published_or_final_versio

A Swing-Contract Market Design for Flexible Service Provision in Electric Power Systems

The need for flexible service provision in electric power systems has dramatically increased due to the growing penetration of variable energy resources, as has the need to ensure fair access and compensation for this provision. A swing contract (SC) facilitates flexible service provision because it permits multiple service attributes to be offered together in bundled form with each attribute expressed as a range of possible values rather than as a single point value. This paper discusses a new SC Market Design for electric power systems that permits SCs to be offered by any dispatchable resource. An analytical optimization formulation is developed for the clearing of an SC day-ahead market that can be implemented using any standard mixed integer linear programming (MILP) solver. The practical feasibility of the optimization formulation is demonstrated by means of a numerical example

Microstructures and resistivity of cuprate/manganite bilayer deposited on SrTiO3 substrate

Thin Yba[SUB2]Cu[SUB3]O[SUB7-δ/La[SUB0.67]Ca[SUB0.33]MnO[SUB3] (YBCO/LCMO) films were grown on SrTiO[SUB3](STO)substrates by magnetron sputtering technique. The microstructures of the bilayers were characterized and a standard four-probe technique was applied to measure the resistivity of the samples. The interdiffusions at the YBCO/LCMO and LCMO/STO interfaces formed two transient layers with the thickness of about 3 and 2 nm, respectively. All the bilayers were well textured along the c axis. At low temperature, the superconductivity can only be observed when the thickness of YBCO is more than 25 nm. When the thickness of YBCO is less than 8 nm, the bilayers show only ferromagnetism. The superconductivity and ferromagnetism perhaps coexist in the bilayer with the YBCO thickness of 12.5 nm. These interesting properties are related to the interaction between spin polarized electrons in the manganites and the cooper pairs in the cuprates. © 2003 American Institute of Physics.published_or_final_versio

Survival of dental implants in patients with oral cancer treated by surgery and radiotherapy: a retrospective study

BACKGROUND: The aim of this retrospective study was to evaluate the survival of dental implants placed after ablative surgery, in patients affected by oral cancer treated with or without radiotherapy. METHODS: We collected data for 34 subjects (22 females, 12 males; mean age: 51 ± 19) with malignant oral tumors who had been treated with ablative surgery and received dental implant rehabilitation between 2007 and 2012. Postoperative radiation therapy (less than 50 Gy) was delivered before implant placement in 12 patients. A total of 144 titanium implants were placed, at a minimum interval of 12 months, in irradiated and non-irradiated residual bone. RESULTS: Implant loss was dependent on the position and location of the implants (P = 0.05-0.1). Moreover, implant survival was dependent on whether the patient had received radiotherapy. This result was highly statistically significant (P < 0.01). Whether the implant was loaded is another highly significant (P < 0.01) factor determinin

Components of the Hematopoietic Compartments in Tumor Stroma and Tumor-Bearing Mice

Solid tumors are composed of cancerous cells and non-cancerous stroma. A better understanding of the tumor stroma could lead to new therapeutic applications. However, the exact compositions and functions of the tumor stroma are still largely unknown. Here, using a Lewis lung carcinoma implantation mouse model, we examined the hematopoietic compartments in tumor stroma and tumor-bearing mice. Different lineages of differentiated hematopoietic cells existed in tumor stroma with the percentage of myeloid cells increasing and the percentage of lymphoid and erythroid cells decreasing over time. Using bone marrow reconstitution analysis, we showed that the tumor stroma also contained functional hematopoietic stem cells. All hematopoietic cells in the tumor stroma originated from bone marrow. In the bone marrow and peripheral blood of tumor-bearing mice, myeloid populations increased and lymphoid and erythroid populations decreased and numbers of hematopoietic stem cells markedly increased with time. To investigate the function of hematopoietic cells in tumor stroma, we co-implanted various types of hematopoietic cells with cancer cells. We found that total hematopoietic cells in the tumor stroma promoted tumor development. Furthermore, the growth of the primary implanted Lewis lung carcinomas and their metastasis were significantly decreased in mice reconstituted with IGF type I receptor-deficient hematopoietic stem cells, indicating that IGF signaling in the hematopoietic tumor stroma supports tumor outgrowth. These results reveal that hematopoietic cells in the tumor stroma regulate tumor development and that tumor progression significantly alters the host hematopoietic compartment