How to Reduce the Laparoscopic Colorectal Learning Curve

Producción CientíficaThe laparoscopic approach for colorectal pathologies is becoming more widely used, and surgeons have had to learn how to perform this new technique. The purpose of this work is to study the indicators of the learning curve for laparoscopic colectomy in a community hospital and to find when the group begins to improv

OPERATIONAL RESEARCH OF WEAR OF RAILWAY BUFFERS HEADS COVERED WITH ALUMINUM BRONZE

In recent years in Europe and in Poland is discernible trend to significant increase safety in rail transport. Safety improvement is realizing at many levels and in many aspects (organizational, systematic, technical etc.). Implementation of Safety and Maintenance Management Systems is an example of activities seeking to systematic increasing safety in rail in Europe. Similarly, on the part of technical solution there are discernible activities which are aimed to improve safety level. There are proposing new construction solutions, new control systems or new communication technologies which are designed to increase reliability and safety of this mode of transport. For innovations introduced in vehicles it is used to think about improvement safety almost only in the field of implementing enhancements in construction of running gear systems of vehicle. However, it is worth remembering that not only the bogie, wheelset or wheels are responsible for the proper cooperation of the vehicle with the track and its safe leading. Elements that have not been yet subjected to deeper analyzes are railway buffers whose proper maintenance and cooperation is a guarantee of correct vehicle dynamics, especially when passing through rail curves. This article presents the results of operational research of railway buffers whose heads were covered with an aluminum bronze layer. This solution has helped to increase the durability of their co-operating surfaces and has allowed the resignation of the now-proposed solution, which consists in periodically covering buffers heads with the grease which has a lot of defects

孤立状態にある蛋白質およびペプチドイオンの構造と反応

En el mundo real donde tendrán que desarrollar su actividad los futuros ingenieros casi todos los problemas se desarrollan en un ámbito multidimensional entre otras cosas porque el espacio en que vivimos tiene tres dimensiones porque todos los procesos se desarrollan en el tiempo y porque es difícil encontrar una magnitud que no dependa de una gran número de otras magnitudes. En esta asignatura se desarrollarán los siguientes temas: Superficies cuadráticas Sistemas de coordenadas cilíndricas y esféricas las funciones vectoriales y su aplicación en el movimiento las funciones reales de varias variables el diferencial valores extremos de funciones reales de varias variables campos vectoriales integral doble integral triple integral de línea integral de superficie y sus aplicaciones

Pengaruh Komisaris Independen, Komite Audit Independen, Pergantian Chief Executive Officer dan Struktur Kepemilikan Saham Publik Terhadap Return On Asset (Studi Empiris pada Perusahaan Properti dan Real Estate di Bursa Efek Indonesia)

           The purpose of this study to analyze empirically the extent of the influence of the four independent variables are independent directors, independent audit committees, CEO turnover and structure of public ownership of the dependent variable is the return on assets(ROA). The study used secondary data on the Indonesia Stock Exchange, with a population of 51 companies and is considered complete and met the study criteria were 38 sample companies. The sample selection is done by purposive sampling in the field of real estate property during the five year study period the year 2009-2013. Model data analysis used multiple regression analysis (multiple regression) either partially or simultaneously.The test results proved and concluded that the proportion of independent directors, independent audit committees, CEO turnover and structure of public ownership according f and t test and a positive significant effect on return on assets(ROA).

Assessment of a New ROS1 Immunohistochemistry Clone (SP384) for the Identification of ROS1 Rearrangements in Patients with Non–Small Cell Lung Carcinoma: the ROSING Study

Introduction: The ROS1 gene rearrangement has become an important biomarker in NSCLC. The College of American Pathologists/International Association for the Study of Lung Cancer/Association for Molecular Pathology testing guidelines support the use of ROS1 immunohistochemistry (IHC) as a screening test, followed by confirmation with fluorescence in situ hybridization (FISH) or a molecular test in all positive results. We have evaluated a novel anti-ROS1 IHC antibody (SP384) in a large multicenter series to obtain real-world data. Methods: A total of 43 ROS1 FISH-positive and 193 ROS1 FISH-negative NSCLC samples were studied. All specimens were screened by using two antibodies (clone D4D6 from Cell Signaling Technology and clone SP384 from Ventana Medical Systems), and the different interpretation criteria were compared with break-apart FISH (Vysis). FISH-positive samples were also analyzed with next-generation sequencing (Oncomine Dx Target Test Panel, Thermo Fisher Scientific). Results: An H-score of 150 or higher or the presence of at least 70% of tumor cells with an intensity of staining of 2+ or higher by the SP384 clone was the optimal cutoff value (both with 93% sensitivity and 100% specificity). The D4D6 clone showed similar results, with an H-score of at least 100 (91% sensitivity and 100% specificity). ROS1 expression in normal lung was more frequent with use of the SP384 clone (p < 0.0001). The ezrin gene (EZR)-ROS1 variant was associated with membranous staining and an isolated green signal FISH pattern (p = 0.001 and p = 0.017, respectively). Conclusions: The new SP384 ROS1 IHC clone showed excellent sensitivity without compromising specificity, so it is another excellent analytical option for the proposed testing algorithm

Spread of a SARS-CoV-2 variant through Europe in the summer of 2020

[EN] Following its emergence in late 2019, the spread of SARS-CoV-21,2 has been tracked by phylogenetic analysis of viral genome sequences in unprecedented detail3,4,5. Although the virus spread globally in early 2020 before borders closed, intercontinental travel has since been greatly reduced. However, travel within Europe resumed in the summer of 2020. Here we report on a SARS-CoV-2 variant, 20E (EU1), that was identified in Spain in early summer 2020 and subsequently spread across Europe. We find no evidence that this variant has increased transmissibility, but instead demonstrate how rising incidence in Spain, resumption of travel, and lack of effective screening and containment may explain the variant’s success. Despite travel restrictions, we estimate that 20E (EU1) was introduced hundreds of times to European countries by summertime travellers, which is likely to have undermined local efforts to minimize infection with SARS-CoV-2. Our results illustrate how a variant can rapidly become dominant even in the absence of a substantial transmission advantage in favourable epidemiological settings. Genomic surveillance is critical for understanding how travel can affect transmission of SARS-CoV-2, and thus for informing future containment strategies as travel resumes.S

Penilaian Kinerja Keuangan Koperasi di Kabupaten Pelalawan

This paper describe development and financial performance of cooperative in District Pelalawan among 2007 - 2008. Studies on primary and secondary cooperative in 12 sub-districts. Method in this stady use performance measuring of productivity, efficiency, growth, liquidity, and solvability of cooperative. Productivity of cooperative in Pelalawan was highly but efficiency still low. Profit and income were highly, even liquidity of cooperative very high, and solvability was good

Optimasi Portofolio Resiko Menggunakan Model Markowitz MVO Dikaitkan dengan Keterbatasan Manusia dalam Memprediksi Masa Depan dalam Perspektif Al-Qur`an

Risk portfolio on modern finance has become increasingly technical, requiring the use of sophisticated mathematical tools in both research and practice. Since companies cannot insure themselves completely against risk, as human incompetence in predicting the future precisely that written in Al-Quran surah Luqman verse 34, they have to manage it to yield an optimal portfolio. The objective here is to minimize the variance among all portfolios, or alternatively, to maximize expected return among all portfolios that has at least a certain expected return. Furthermore, this study focuses on optimizing risk portfolio so called Markowitz MVO (Mean-Variance Optimization). Some theoretical frameworks for analysis are arithmetic mean, geometric mean, variance, covariance, linear programming, and quadratic programming. Moreover, finding a minimum variance portfolio produces a convex quadratic programming, that is minimizing the objective function ðð¥with constraintsð ð 𥠥 ðandð´ð¥ = ð. The outcome of this research is the solution of optimal risk portofolio in some investments that could be finished smoothly using MATLAB R2007b software together with its graphic analysis

Juxtaposing BTE and ATE – on the role of the European insurance industry in funding civil litigation

One of the ways in which legal services are financed, and indeed shaped, is through private insurance arrangement. Two contrasting types of legal expenses insurance contracts (LEI) seem to dominate in Europe: before the event (BTE) and after the event (ATE) legal expenses insurance. Notwithstanding institutional differences between different legal systems, BTE and ATE insurance arrangements may be instrumental if government policy is geared towards strengthening a market-oriented system of financing access to justice for individuals and business. At the same time, emphasizing the role of a private industry as a keeper of the gates to justice raises issues of accountability and transparency, not readily reconcilable with demands of competition. Moreover, multiple actors (clients, lawyers, courts, insurers) are involved, causing behavioural dynamics which are not easily predicted or influenced. Against this background, this paper looks into BTE and ATE arrangements by analysing the particularities of BTE and ATE arrangements currently available in some European jurisdictions and by painting a picture of their respective markets and legal contexts. This allows for some reflection on the performance of BTE and ATE providers as both financiers and keepers. Two issues emerge from the analysis that are worthy of some further reflection. Firstly, there is the problematic long-term sustainability of some ATE products. Secondly, the challenges faced by policymakers that would like to nudge consumers into voluntarily taking out BTE LEI