The VAT in the bank system

Directory of Open Access Journals (Sweden)

Krzysztof Biernacki

2013-07-01

Full Text Available The bank system in the European Union plays an important role as a significant sector of the economy. Implementing in the last century -VAT exemption also for services performed by banks generates extra tax inflows, but decreases international competitiveness of this sector. However, VAT is a perfect consumption tax, alternatives were created for banks’ services taxation. As the paper shows, many of them are used in other then EU countries and provide smaller distortions in taxation. The aim of this article is to shortly present the dominant model of VAT taxation in the EU with a particular reference to banks’ services and describe an alternative method of taxating them. The analysis will also refer to introducing a new Financial Transaction Tax since 2014.

21 CFR 73.3112 - C.I. Vat Orange 1.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 1 2010-04-01 2010-04-01 false C.I. Vat Orange 1. 73.3112 Section 73.3112 Food... COLOR ADDITIVES EXEMPT FROM CERTIFICATION Medical Devices § 73.3112 C.I. Vat Orange 1. (a) Identity. The color additive is C.I. Vat Orange 1, Colour Index No. 59105. (b) Uses and restrictions. (1) The...

Crossing the bridge to VATS lobectomy.

Science.gov (United States)

Tcherveniakov, P; Bogdan, C; Chaudhuri, N

2017-11-01

Introduction The impact of the introduction of video assisted thoracoscopic surgery (VATS) on the management of lung cancer 20 years ago has been well documented. However, the uptake of VATS lobectomy in surgical practice worldwide has been slower than expected. We believe that this is partly due to a lack of consensus on how this procedure should be integrated into training programmes. We present our initial experience with a newly developed training model, which could help bridge the divide between open and VATS lobectomy. Methods Two surgical registrars were initiated into this model, supervised by a single consultant. All cases were performed using a standardised three-port anterior approach with systematic lymph node dissection. Both registrars were scrubbed for each case, alternating as first surgeon and assistant, with the supervising consultant operating the camera. Results Over a 6-month period, 22 lung resections for non-small cell lung carcinoma were performed as VATS lobectomies. Thirteen of them were upper lobectomies. There were no emergency conversions to open surgery. The mean operative time for the registrars was 155 minutes compared with 140 minutes for consultant-led operations (p=0.22). There was no perioperative mortality. The most common postoperative complications were atrial fibrillation (4 cases) and prolonged air leak (3 cases). Conclusions VATS lobectomy involves a team approach. Especially in upper lobectomies, the assistant surgeon plays a significant role in the operation, often helping with the dissection as well as stapling of the bronchial and vascular structures. With a team consisting of two trainees and a supervising surgeon, the teaching process becomes more intuitive and is accelerated. This should reduce the learning curve considerably and improve safety during training.

Comparative Short-Term Clinical Outcomes of Mediastinum Tumor Excision Performed by Conventional VATS and Single-Port VATS

OpenAIRE

Wu, Ching-Feng; Gonzalez-Rivas, Diego; Wen, Chih-Tsung; Liu, Yun-Hen; Wu, Yi-Cheng; Chao, Yin-Kai; Hsieh, Ming-Ju; Wu, Ching-Yang; Chen, Wei-Hsun

2015-01-01

Abstract Single-port video-assisted thoracoscopic surgery (VATS) has been widely applied recently. However, there are still only few reports describing its use in mediastinum tumor resection. We present the technique of single-port video-assisted thoracoscopic mediastinum tumor resection and compare it with conventional VATS with regard to short-term outcome. We retrospectively enrolled 105 patients who received mediastinum surgery in Chang Gung Memorial Hospital. Sixteen patients received st...

VAT ON E-SERVICES: HOW NEW RULES AFFECT BUSINESSES

Directory of Open Access Journals (Sweden)

Adina TRANDAFIR

2014-06-01

Full Text Available From 1st January 2015, in the European Unionwill enter into force a new VAT regime for business-to-consumer suppliers of telecoms, broadcasting and electronic services. This regime will have an impact on businesses engaged in the supply of certain products and services over the Internet. This article is a literature review. It is aimed to provide an analysis of the European VAT regime applicable to electronic services and clarify some key issues like: what are e-services, what are the changes and how the businesses are affected by these new rules. The paper also approaches issues such as: the change of the rules regarding VAT place of supplying and the introduction of the VAT Mini One Stop Shop (MOSS. The main conclusion is that the change in the place of supplying rules will serve to negate the VAT advantages associated with Internet companies which locate their invoicing functions in a Member State that is different from where they locate their substantial activities.

Tutorial on Modeling VAT Rules Using OWL-DL

DEFF Research Database (Denmark)

Nielsen, Morten Ib; Simonsen, Jakob Grue; Larsen, Ken Friis

. In an ERP setting such a model could reduce the Total Cost of Ownership (TCO) and increase the quality of the system. We have selected OWL-DL because we believe that description logic is suited for modeling VAT rules due to the decidability of important inference problems that are key to the way we plan...... to use the model and because OWL-DL is relatively intuitive to use....

Institutional paradoxes of vat under developing economy of transition period

Directory of Open Access Journals (Sweden)

Dmitriy G. Bachurin

2016-01-01

Full Text Available Objective to determine the characteristics of the destructive impact of VAT taxation on the socioeconomic situation of the Russian Federation. Methods the research is based on the complex economic and legal methodology including the institutional approach with the account of the national socioeconomic and legal realities determining the conditions of functioning of branches and particular enterprises in the Russian economy. Results the conditions and characteristics of the introduction of VAT in the Russian Federation are viewed the reasons are revealed for the formation and development of the problemcausing VAT in the domestic tax system the socioeconomic implications of VAT are analyzed the viability of replacing VAT for a turnover tax is demonstrated. Scientific novelty for the first time the conceptual position is articulated that under the realities of the reformed Russian economy the normativelegal outline of the VAT complements the accumulated destructive potential blocking the way to the industrial growth in the national economy enhances the asymmetry of conditions of different forms of ownership while the actual conditions of the transition period in Russia do not correspond to the main idea and purpose of VAT as an institution aimed at the efficient relocation of a significant part of the newly created value added to the social sectors and at the modernizing effect on the productive forces for technological improvement in industry. Practical significance the provisions and conclusions of the article can be used when discussing issues on the need for the VAT reform in the Russian Federation including switching to the turnover tax. nbsp

Features of VAT Accounting and Fiscality – History, Practices and Prospects

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Violeta ISAI

2013-12-01

Full Text Available The value-added tax (VAT is an indirect tax, supported by the final consumer of the good/service that it is applied. During the productive and commercial cycle, the companies pay VAT according to the value added on the good/service. Quite recently appeared in the fiscal system of different states, VAT has a big spreading area. The taxation rates are different from a country to another, according to the economic conditions and the fiscal law (in EU, from 15% for Cyprus and Luxembourg to 27% for Hungary, and outside EU, from 3% for Iran, to 25% for Norway. In Romania, the rates are: the standard rate of 24% and the reduced rates of 9% and 5%, the payment term being monthly or quarterly, according to the company turnover. In the accounting and fiscality area, VAT presents special features, conditioned by the type of activity and the company size. In order to support the small companies, starting with 01.01.2013 the “VAT Encashment System” was introduced, that relates the VAT payability to the encashment moment of the invoice. The VAT impact on the profitability is an aspect that must be considered when we discuss about: costs, cash-flow, results, liquidity, solvency or efficiency rates.

The reduced VAT rate for small business in Croatia

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Mira Dimitrić

2009-06-01

Full Text Available This paper assesses the potential effects of introduction of the reduced VAT rate for small business, based on the EU VAT legislation development. The analysis includes effects on prices, sales, shadow economy and employment. It starts with the assumption of no substantial effect. Survey for Croatia is done by small business owners’ interviews and encompasses descriptive and inferential statistics based on parametric tests. The EU expected existence of a link between VAT reduction, price reduction, sales increase and positive effects on employment (as well as decline in the shadow economy is proved even in this research. However, the pass-through to prices is very moderate as well as other effects. The reduced VAT rate could have some positive results for the restaurants and bars only. There exists also some possibility for construction of housing and construction services related to housing as well as some other labour intensive services.

The value-added tax (VAT) rate of international natural gas trade

International Nuclear Information System (INIS)

Botter, E.

2008-01-01

Since January 1, 2005, international gas trades are controlled by common right derogatory VAT rules. Transfrontier exchanges do not obey to the classical territory rules of exchange of goods but to a particular VAT regime. Moreover, the access to networks and the transportation of natural gas are subjected to particular VAT regulations. This article explains these particularities. (J.S.)

Transfer pricing principles in VAT Law

DEFF Research Database (Denmark)

Jensen, Dennis Ramsdahl

2011-01-01

The main part of the article is devoted to a critical analysis of the optional transfer pricing provisions in the EC VAT Directive in the light of the principle of fiscal neutrality. As an integrated part of this analysis, the VAT transfer pricing regime is considered in the light of the well......-known principles for transfer pricing in the area of income tax law, as set out in Art. 9 of the OECD Model Tax Convention. The last part of the article contains a brief discussion of to which extent it is desirable to harmonize the two tax systems´ transfer pricing rules....

How early should VATS be performed for retained haemothorax in blunt chest trauma?

Science.gov (United States)

Lin, Hsing-Lin; Huang, Wen-Yen; Yang, Chyan; Chou, Shih-Min; Chiang, Hsin-I; Kuo, Liang-Chi; Lin, Tsung-Ying; Chou, Yi-Pin

2014-09-01

Blunt chest injury is not uncommon in trauma patients. Haemothorax and pneumothorax may occur in these patients, and some of them will develop retained pleural collections. Video-assisted thoracoscopic surgery (VATS) has become an appropriate method for treating these complications, but the optimal timing for performing the surgery and its effects on outcome are not clearly understood. In this study, a total of 136 patients who received VATS for the management of retained haemothorax from January 2003 to December 2011 were retrospectively enrolled. All patients had blunt chest injuries and 90% had associated injuries in more than two sites. The time from trauma to operation was recorded and the patients were divided into three groups: 2-3 days (Group 1), 4-6 days (Group 2), and 7 or more days (Group 3). Clinical outcomes such as the length of stay (LOS) at the hospital and intensive care unit (ICU), and duration of ventilator and chest tube use were all recorded and compared between groups. The mean duration from trauma to operation was 5.9 days. All demographic characteristics showed no statistical differences between groups. Compared with other groups, Group 3 had higher rates of positive microbial cultures in pleural collections and sputum, longer duration of chest tube insertion and ventilator use. Lengths of hospital and ICU stay in Groups 1 and 2 showed no statistical difference, but were longer in Group 3. The frequency of repeated VATS was lower in Group 1 but without statistically significant difference. This study indicated that an early VATS intervention would decrease chest infection. It also reduced the duration of ventilator dependency. The clinical outcomes were significantly better for patients receiving VATS within 3 days under intensive care. In this study, we suggested that VATS might be delayed by associated injuries, but should not exceed 6 days after trauma. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

VAT-teater vaatab 30 aastat tulevikku / Tiiu Laks

Index Scriptorium Estoniae

Laks, Tiiu, 1984-

2010-01-01

VAT Teater toob S. Becketti "Krappi viimase lindi" lavale ebatavalisel moel. Festivalil "Draama 2010" Tartus toimub 8. septembril esimene avalik lindistus "...viimane lint / Saare esimene lint". Kontseptsioon: Tanel Saar ja Co. Esitus: Tanel Saar ja Hanna Allsaar. Näitejuhid-konsultandid: Rait Avestik ja Aare Toikka. "Krappi viimane lint" esietendub VAT Teatri ja Tanel Saare esituses 2040. a. sügisel. Festivali "Draama 2010" kavast

Tax Reforms in Nigeria: Case for Value Added Tax (VAT)

African Journals Online (AJOL)

Nneka Umera-Okeke

amended based on destination principle to impose VAT on imported services rendered ... It was the view of Popoola (2009) that Nigeria tax administration and practice be structured ..... have low VAT rates, e.g. Nigeria, India and Malaysia.

The Problem of VAT Credit on Expired Goods: An Opinion

Directory of Open Access Journals (Sweden)

Fatma TAŞ

2017-12-01

Full Text Available VAT paid on certain goods acquired does not allow the deducting of the Turkish tax system. One of them is the loss of goods VAT. There is no clear definition in the law is wasted. Therefore, there are certain problems in practice. The problems, in particular, focused on the VAT on expired or valueless goods. Current opinion on the subject of the tax administration is inconvenient regarding tax justice. Both states of the solution to the problem should be developed as well as an objective approach to protecting taxpayers.

VAT COLLECTION TO COLLECTION: ADVANTAGES AND DISADVANTAGES

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ROXANA ISPAS

2012-10-01

Full Text Available This paper presents the major changes in the payment system of value added tax (VAT. Through the Government Ordinance no. 15/2012 amending and supplementing Law no. 571/2003 regarding the Fiscal Code, there was introduced, with effect from 01.01.2013, the payment of the value added tax (VAT on cashing the whole or partial counter value of the supply of goods or provision of services. There are detailed the most important data on the topic, but also information about the risks and benefits resulting from the new legal provisions.

Reimbursement of VAT on written-off Receivables

DEFF Research Database (Denmark)

Florentsen, Bjarne; Møller, Michael; Nielsen, Niels Chr.

2003-01-01

In many OECD countries, a seller has a right to reimbursement of VAT (RVAT) she has paid on goods sold, but for which she has not yet received payment. Such reimbursement of VAT on receivables is economically inefficient. It leads to:@* Distortion of credit markets, by subsidizing direct credit...... at the cost of financial intermediaries.@* Price discrimination, by subsidizing buyers with low creditworthiness.@* A less efficient collection of bad debts, as trade with bad debts is made extremely expensive.The finance literature presents several `good' arguments in favor of trade credits, e.g. transaction...

Stoppage - Vat Return and Accounting Practice in Re-Delivery of a Delivery Subject to Stoppage

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Ahmet Yanık

2016-12-01

Full Text Available Value Added Tax (VAT is calculated based on the goods and service delivery costs realized by the corporations. Unless this VAT is subject to stoppage, seller takes the VAT from the purchaser in delivery of goods or services and then the corporate pays this amount to the tax office or sets off through the VAT he paid for his service or goods procurement. However, in some cases, Ministry of Finance holds not those providing the delivery or service but those purchasing or procuring the goods or services responsible partly or fully for the tax calculated based on the delivery or service fee. The purpose of this paper is to reveal VAT stoppage, accounting entries with regards to the corporation accepting the delivery and re-delivering it, VAT set off and VAT return in the re-delivery of a delivery subject to stoppage pursuant to General Communiqué of VAT Serial No 117

Efficiency of a single-rate and broad-based VAT system: the case of Bosnia and Herzegovina

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Dinka Antić

2014-09-01

Full Text Available The aim of this paper is to analyze the performance and efficiency of the VAT system in B&H and explore the effects of internal and external factors influencing VAT collection. The VAT system in B&H is a consumption-type, single-rate and broad-based system. Ever since its implementation, VAT collection in B&H has been subject to strong oscillations, from an extremely high performance in the first two years after the introduction, to a sharp drop at the beginning of the crisis. After a temporary recovery, VAT collection declined in the last quarter of 2012 and has been negative ever since, although a weak recovery of the B&H economy was observed in 2013. The key hypothesis is that the high efficiency of the broadbased and single-rate structured VAT system may be neutralized by the country’s specific circumstances and VAT policy design. Applying a set of indicators for VAT efficiency analysis, developed by IMF, OECD and EU, we find a deterioration of the components of the policy gap caused by derogations of the VAT Law, and an increasing compliance gap, due to an increase of the VAT debt and tax evasion, in consequence of poor policy design in the field of excises. As a result of the influence of the country’s specific circumstances and its VAT policy design the identifiable current net losses on VAT in 2013 amount to 4% of net VAT collection or 0.4% of GDP. The analysis presented in the paper proves the main hypothesis that a VAT design, even when it is close to theoretically ideal concept, cannot on its own produce a high level of VAT efficiency and performance.

STUDY ON THE APPLICATION OF CASH ACCOUNTING SYSTEM FOR VAT IN ROMANIA

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ECOBICI NICOLAE

2014-02-01

Full Text Available The cash accounting system for VAT has been implemented in Romania as of 1 January 2013 and now turns one year of application in Romania. Since its implementation the system has sparked controversy, being harshly criticised by professional accountants in Romania and elsewhere. Criticisms mainly concerned the following issues: no possibility to choose to apply the system, breach of the VAT neutrality principles, maximum period of 90 days to postpone the chargeability of VAT for unpaid deliveries, while VAT deduction was subject to payment of the value of goods and services invoiced without specifying any term. In this article we would like to examine the extent to which the legislative changes that came into effect as of 1 January 2014 improve the cash accounting system for VAT in Romania. We will also analyse to what extent the system applied in 2013 has brought advantages/disadvantages to the economic entities in Romania based on a survey carried out on a heterogeneous sample of companies in the county of Gorj, regarded as nationally representative. Finally, we intend to compare the cash accounting system for VAT in Romania with its UK counterpart.

Biological features produced by additive manufacturing processes using vat photopolymerization method

DEFF Research Database (Denmark)

Davoudinejad, Ali; Mendez Ribo, Macarena; Pedersen, David Bue

2017-01-01

of micro biological features by Additive Manufacturing (AM) processes. The study characterizes the additive manufacturing processes for polymeric micro part productions using the vat photopolymerization method. A specifically designed vat photopolymerization AM machine suitable for precision printing...

Transfer Pricing Principles VAT/GST v. Direct Taxation

DEFF Research Database (Denmark)

Jensen, Dennis Ramsdahl

2009-01-01

Convention, [2] including an examination of whether it is appropriate to base transfer pricing rules on the same principles in the two different areas of tax law. [1] Council Directive 2006/112/EC of 28 November 2006 on the common system of value added tax, OJ L 347 of 11 December 2006, pp. 1-118 (EC VAT......In this paper the optional transfer pricing provisions in the EC VAT Directive [1] are subject to a more detailed analysis, with a view to considering them in the light of the well-known principles for transfer pricing in the area of income tax law, as set out in Art. 9 of the OECD Model Tax...... Directives are to be construed as references to the EC VAT Directive and should be read in accordance with the correlation table in Annex XII. [2] OECD Model Tax Convention on Income and on Capital (OECD Model Tax Convention)....

Estimated revenues of VAT and fuel tax on aviation

Energy Technology Data Exchange (ETDEWEB)

Korteland, M.; Faber, J.

2013-07-15

International aviation is exempt from VAT, both on their inputs (e.g. on fuel or aircraft) and on their revenues (e.g. on tickets). In the EU, aviation fuel is also exempt from the minimum fuel excise tariffs. This report calculates the potential revenues of VAT on tickets and fuel tax on jet fuel. If VAT were to be levied on tickets while other aviation taxes were simultaneously abolished, this would yield revenues in the order of EUR 7 billion. Excise duty on jet fuel would raise revenues in the order of EUR 20 billion. These figures do not take into account the impact of the cost increases on demand for aviation into account. Since higher costs will reduce demand, the estimates can be considered an upper bound.

[A Paired Case Controlled Study Comparing the Short-term Outcomes of Da Vinci RATS and VATS Approach for Non-small Cell Lung Cancer].

Science.gov (United States)

Dai, Feng; Xu, Shiguang; Xu, Wei; Ding, Renquan; Liu, Bo; Meng, Hao; Kang, Yunteng; Meng, Xiangrui; Lin, Jie; Wang, Shumin

2018-03-20

Da Vinci Surgical System is one of the greatest inventions of the 20th century, which represents the development direction of the precise minimally invasive surgical techniques, the aim of this study was to comparing the short-term outcomes between da Vinci robot-assisted lobectomy and video-assisted thoracic surgery (VATS) lobectomy for non-small cell lung cancer. 45 pairs of non-small cell lung cancer patients underwent pulmonary lobectomy with da Vinci Robotic assisted thoracoscopic (RATS) and VATS approach during the same period from January 2014 to January 2017. The operative time, estimated blood loss (EBL), total number and total groups of dissected lymph nodes, postoperative duration of drainage, the first day volume of drainage, total volume of drainage were compared. No perioperative death and convertion to thoracotomy occured in both groups. There were significant difference between RATS group and VATS group in EBL [(50.30±32.33) mL vs (208.60±132.63) mL], the first day volume of drainage [(275.00±145.42) mL vs (347.60±125.80) mL], the dissected total number [(22.67±9.67) vs (15.51±5.41)] and total team [(6.31±1.43) vs (4.91±1.04)] of lymph node. There were no significant difference in other outcomes. RATS is safe and effective and took better short-outcomes than VATS in non-small cell lung cancer.

Radiation dosimetry of [(18)F]VAT in nonhuman primates.

Science.gov (United States)

Karimi, Morvarid; Tu, Zhude; Yue, Xuyi; Zhang, Xiang; Jin, Hongjun; Perlmutter, Joel S; Laforest, Richard

2015-12-01

The objective of this study is to determine the radiation dosimetry of a novel radiotracer for vesicular acetylcholine transporter (-)-(1-((2R,3R)-8-(2-[(18)F]fluoro-ethoxy)-3-hydroxy-1,2,3,4-tetrahydronaphthalen-2-yl)piperidin-4-yl)(4-fluorophenyl)-methanone ([(18)F]VAT) based on PET imaging in nonhuman primates. [(18)F]VAT has potential for investigation of neurological disorders including Alzheimer's disease, Parkinson's disease, and dystonia. Three macaque fascicularis (two males, one female) received 185.4-198.3 MBq [(18)F]VAT prior to whole-body imaging in a MicroPET-F220 scanner. Time activity curves (TACs) were created from regions of interest (ROIs) that encompassed the entire small organs or samples with the highest activity within large organs. Organ residence times were calculated based on the TACs. We then used OLINDA/EXM 1.1 to calculate human radiation dose estimates based on scaled organ residence times. Measurements from directly sampled arterial blood yielded a residence time of 0.30 h in agreement with the residence time of 0.39 h calculated from a PET-generated time activity curve measured in the left ventricle. Organ dosimetry revealed the liver as the critical organ (51.1 and 65.4 μGy/MBq) and an effective dose of 16 and 19 μSv/MBq for male and female, respectively. The macaque biodistribution data showed high retention of [(18)F]VAT in the liver consistent with hepatobiliary clearance. These dosimetry data support that relatively safe doses of [(18)F]VAT can be administered to obtain imaging in humans.

Contracting out: Dutch municipalities reject the solution for the VAT-distortion

NARCIS (Netherlands)

Gradus, R.H.J.M.; Dijkgraaf, E.; Wassenaar, M.C.

2010-01-01

In 2003, the Dutch government introduced a VAT-compensation fund in order to create a level playing field for local governments with respect to Value Added Tax (VAT). This fund eliminates the effect of the tax difference between local governments that supply services themselves and local governments

The Impact of the Charter of Fundamental Rights of the European Union on VAT Law

DEFF Research Database (Denmark)

Elgaard, Karina Kim Egholm

2016-01-01

The Charter of Fundamental Rights of the European Union became legally binding following its entry into force with the Lisbon Treaty on 1 December 2009, and it has the same legal value as the EU Treaties. Since then, the EU fundamental rights aspect of VAT law has not been subject to much academic...... discussion or particular attention from VAT practitioners. This article contributes to further development of research in the area of EU fundamental rights and VAT law by examining; when the Charter is relevant in VAT law and if so how the Charter manifests itself in EU VAT case law, and what special...

The direct and immediate link test regarding deduction of input VAT

DEFF Research Database (Denmark)

Jensen, Dennis Ramsdahl; Stensgaard, Henrik

2014-01-01

It follows explicitly from the EC VAT Directive that the deduction of input VAT depends on a positive link between on the one hand the incurred expenses and on the other hand the planned or actually completed taxed output transactions. In theory and in practice the deeper nature of this link...

An Analysis on Combating Vat Fraud in The European Union Using New IT Technologies

Directory of Open Access Journals (Sweden)

Lixăndroiu R.

2009-12-01

Full Text Available European VAT fraud has been growing at an alarming rate [2]. The level of VAT losses for one year is between €60bn and €100bn for all member states. This level of fraud has created an urgent need for Europe to address the issue of the reform of the VAT system.

Kivirähk VAT Teatris / Meelis Kapstas

Index Scriptorium Estoniae

Kapstas, Meelis, 1963-

1999-01-01

VAT Teatri hooaja repertuaar. A. Kivirähki näidend "Sibulad ja šokolaad". Järgmise aasta jaanuaris saab teater oma statsionaarse lava - amfiteatri põhimõttel tehtud kammersaali Rahvusraamatukogus

A Self-Peeling Vat for Improved Release Capabilities During DLP Materials Processing

DEFF Research Database (Denmark)

Pedersen, David Bue; Zhang, Yang; Nielsen, Jakob Skov

2016-01-01

for an eased release of the manufactured part from the vat by means of a flexible membrane system. A membrane of fluorinated ethylene polymer will through elastic deformation automatically peel off the part as the part is lifted during layer changes. Peeling has been qualified by means of a truncated inverted...... cone as test geometry. As the cross-sectional diameter of the cone increase throughout the build-job, the geometry will release from the glass based build platform at the point where the peeling force exceed the adhesion force between platform and part. At failure point the lateral surface area...... of the top and bottom of the truncated cone is used as a measure of the performance of the vat with respect to release-capability. This has been tested at increasing manufacturing rates. The new self-peeling vat outperformed industrial state-of-the-art vats by 814% percent....

INTRODUCTION OF VAT SPLIT PAYMENT MECHANISM IN ROMANIA – COMPULSORY VERSUS OPTIONALLY

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ECOBICI NICOLAE

2017-11-01

Full Text Available The objective of this article is to analyze the implications of introducing the VAT split payment mechanism in Romania, as it is regulated, as a compulsory system, through GO 23/2017 respectively, as well as in the case of the modification of the regulation in the sense of replacing the compulsory by optionality. We will analyze the effects of Ordinance 23/2017 of the Romanian Government regarding the mandatory distinctly payment of VAT for Romanian legal persons, registered or not for VAT purposes, as well as the result which the Government hopes to obtain as a result of the application of this provision, on the one hand. On the other hand, we will discuss the effects of a change in regulation for the optionally application of the VAT split payment mechanism, as of January 1, 2018, as compared with the amendments already approved by the Romanian Senate on October 31st, 2017. The structure of the article includes the following main sections: a briefly presents of the VAT split payment mechanism, as it was originally regulated by GO 23/2017; the second part includes the analysis of the implications of introducing the VAT split payment mechanism on legal entities and the state, in the initial phase of the Ordinance; the third part is devoted to the presentation of the amendments approved at the end of October 2017, respectively to the recommendations on amendments needed to be taken into account by the Chamber of Deputies, and the last part will include the conclusions and recommendations.

V. Monitoring the stability of coumaphos acaricide in field cattle dipping vats by using HPLC

International Nuclear Information System (INIS)

Espinosa Gonzalez, J.; Rodriguez, F.; Barrera, R.

1997-01-01

The concentration of coumaphos in four field cattle dipping vats and its distribution at different depths in the suspension and in the sediment was monitored over 12 to 48 weeks. The residual concentration of coumaphos and degradation products was determined by HPLC. Coumaphos was extracted from the suspension by shaking with equal volume of methanol and 90% of coumaphos was extracted by this method. A reverse phase C-18 column (25 cm x 0.4 cm) was used in the HPLC and the eluent was a mixture of methanol+ water (80+20,v/v). The initial concentration of coumaphos was 200 mg/L. However, it steadily decreased in all four vats with time. The final concentration was reduced to 39% of the concentration at zero time in vat number 1 after 12 week 17% after 18 weeks in vat number 2, 29% after 19 weeks in vat number 3 and 23% after 48 weeks in vat number 4. The concentration in the sediment increased from 165 mg/kg at zero time to 1960 mg/kg after 18 weeks in vat number 1 and 152 mg/kg to 2020 mg/kg after 48 weeks in vat number 4. The concentration of coumaphos in the suspension ranged between 28 to 81 mg/L at the surface, 46 to 115 mg/L at 20 cm and 86 to 147 mg/L at 100 cm depth. (author)

COMPARATIVE ANALYSIS OF VAT EVOLUTION IN THE EUROPEAN ECONOMIC SYSTEM

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MIHAELA ANDREEA STROE

2011-04-01

Full Text Available In this paper we study a comparative analysis of VAT in different states of the world. I made some observation on this theme because I believe that VAT is very important in carrying out transactions and the increase or decrease of this tax has a major impact upon national economies and also on the quality of life in developing countries. The papers has to pourpose to make a comparison between the American and European system of taxation with its advantages and disadvantages and, in the end to render an economic model and its statistics components. VAT is a value added tax which appeared about 50 years, initially with two purposes: one to replace certain indirect taxes, and another to reduce the budget deficit according to the faith of that time. The first country that has adopted this model was France, calling it today as value-added tax.

VATS intraoperative tattooing to facilitate solitary pulmonary nodule resection

Directory of Open Access Journals (Sweden)

Boutros Cherif

2008-03-01

Full Text Available Abstract Introduction Video-assisted thoracic surgery (VATS has become routine and widely accepted for the removal of solitary pulmonary nodules of unknown etiology. Thoracosopic techniques continue to evolve with better instruments, robotic applications, and increased patient acceptance and awareness. Several techniques have been described to localize peripheral pulmonary nodules, including pre-operative CT-guided tattooing with methylene blue, CT scan guided spiral/hook wire placement, and transthoracic ultrasound. As pulmonary surgeons well know, the lung and visceral pleura may appear featureless on top of a pulmonary nodule. Case description This paper presents a rapid, direct and inexpensive approach to peripheral lung lesion resection by marking the lung parenchyma on top of the nodule using direct methylene blue injection. Methods In two patients with peripherally located lung nodules (n = 3 scheduled for VATS, we used direct methylene blue injection for intraoperative localization of the pulmonary nodule. Our technique was the following: After finger palpation of the lung, a spinal 25 gauge needle was inserted through an existing port and 0.1 ml of methylene blue was used to tattoo the pleura perpendicular to the localized nodule. The methylene blue tattoo immediately marks the lung surface over the nodule. The surgeon avoids repeated finger palpation, while lining up stapler, graspers and camera, because of the visible tattoo. Our technique eliminates regrasping and repalpating the lung once again to identify a non marked lesion. Results Three lung nodules were resected in two patients. Once each lesion was palpated it was marked, and the area was resected with security of accurate localization. All lung nodules were resected in totality with normal lung parenchymal margins. Our technique added about one minute to the operative time. The two patients were discharged home on the second postoperative day, with no morbidity. Conclusion

VAT: a computational framework to functionally annotate variants in personal genomes within a cloud-computing environment.

Science.gov (United States)

Habegger, Lukas; Balasubramanian, Suganthi; Chen, David Z; Khurana, Ekta; Sboner, Andrea; Harmanci, Arif; Rozowsky, Joel; Clarke, Declan; Snyder, Michael; Gerstein, Mark

2012-09-01

The functional annotation of variants obtained through sequencing projects is generally assumed to be a simple intersection of genomic coordinates with genomic features. However, complexities arise for several reasons, including the differential effects of a variant on alternatively spliced transcripts, as well as the difficulty in assessing the impact of small insertions/deletions and large structural variants. Taking these factors into consideration, we developed the Variant Annotation Tool (VAT) to functionally annotate variants from multiple personal genomes at the transcript level as well as obtain summary statistics across genes and individuals. VAT also allows visualization of the effects of different variants, integrates allele frequencies and genotype data from the underlying individuals and facilitates comparative analysis between different groups of individuals. VAT can either be run through a command-line interface or as a web application. Finally, in order to enable on-demand access and to minimize unnecessary transfers of large data files, VAT can be run as a virtual machine in a cloud-computing environment. VAT is implemented in C and PHP. The VAT web service, Amazon Machine Image, source code and detailed documentation are available at vat.gersteinlab.org.

Using virtual reality simulation to assess competence in video-assisted thoracoscopic surgery (VATS) lobectomy.

Science.gov (United States)

Jensen, Katrine; Bjerrum, Flemming; Hansen, Henrik Jessen; Petersen, René Horsleben; Pedersen, Jesper Holst; Konge, Lars

2017-06-01

The societies of thoracic surgery are working to incorporate simulation and competency-based assessment into specialty training. One challenge is the development of a simulation-based test, which can be used as an assessment tool. The study objective was to establish validity evidence for a virtual reality simulator test of a video-assisted thoracoscopic surgery (VATS) lobectomy of a right upper lobe. Participants with varying experience in VATS lobectomy were included. They were familiarized with a virtual reality simulator (LapSim ® ) and introduced to the steps of the procedure for a VATS right upper lobe lobectomy. The participants performed two VATS lobectomies on the simulator with a 5-min break between attempts. Nineteen pre-defined simulator metrics were recorded. Fifty-three participants from nine different countries were included. High internal consistency was found for the metrics with Cronbach's alpha coefficient for standardized items of 0.91. Significant test-retest reliability was found for 15 of the metrics (p-values 50 VATS lobectomies performed). A pass/fail level defined as approximately one standard deviation from the mean metric scores for experienced surgeons passed none of the novices (0 % false positives) and failed four of the experienced surgeons (29 % false negatives). This study is the first to establish validity evidence for a VATS right upper lobe lobectomy virtual reality simulator test. Several simulator metrics demonstrated significant differences between novices and experienced surgeons and pass/fail criteria for the test were set with acceptable consequences. This test can be used as a first step in assessing thoracic surgery trainees' VATS lobectomy competency.

Impact of VAT on the Profitability and the Cash Flow of Romanian Small and Medium Enterprises

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MARIA ZENOVIA GRIGORE

2014-05-01

Full Text Available The options available to taxpayers make tax systems attractive and give them an opportunity to choose one system or another after a careful analysis of the fiscal advantages and disadvantages of each choice. A small or medium company has to explore the options available, whether that is VAT registration or de-registration or choosing the best VAT special scheme. VAT optimisation is particularly interesting because of the high cash flow involved and because of the cash flow benefits that can be obtained. This paper presents an analysis of VAT costs and their impact on profitability and cash flow of small and medium enterprises. We also analysed specific mechanisms to improve profitability and cash flow through VAT optimisation.

IMPACT OF VAT ON THE PROFITABILITY AND THE CASH FLOW OF ROMANIAN SMALL AND MEDIUM ENTREPRISES

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Maria Zenovia GRIGORE

2014-05-01

Full Text Available The options available to taxpayers make tax systems attractive and give them an opportunity to choose one system or another after a careful analysis of the fiscal advantages and disadvantages of each choice. A small or medium company has to explore the options available, whether that is VAT registration or de-registration or choosing the best VAT special scheme. VAT optimisation is particularly interesting because of the high cash flow involved and because of the cash flow benefits that can be obtained. This paper presents an analysis of VAT costs and their impact on profitability and cash flow of small and medium enterprises. We also analysed specific mechanisms to improve profitability and cash flow through VAT optimisation.

Resignation from the VAT exemption of sales of residential premises by the developer

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Joanna Koziollek

2016-09-01

Full Text Available Tax institutions should be construed in a rational manner, in order so as to not restrict economic turnover excessively. The regulations concerning the possibility to resign from the VAT exemption of sales of residential premises by the developer characterizes by the high level of formalism which affects in a negative manner the sales process performed by the developer. This paper is devoted to the fragment of the polish Act on the goods and services tax governing the issue of resignation from the VAT exemption of sales of residential premises, which implies in a certain extent to appeal to the regulation of exemptions stipulated in this Act. The subject matter of this analysis is to examine the correctness of transposition of the Directive 112 into polish legal system in the field of real estate exemptions from VAT, the conditions for exercising the optional exemption, as well as the benefit of the resignation from the VAT exemption by the taxpayer.

Dissipation of coumaphos acaricide in model cattle dipping vats and soil columns under sub-tropical climate of Delhi

International Nuclear Information System (INIS)

Jindal, T.; Singh, D.K.; Agarwal, H.C.

1997-01-01

The stability of coumaphos was studied in model dipping vats under field conditions using 14 C-labelled and unlabelled coumaphos, with or without additives. Four vats were used each containing 50 litre of water treated with 3.7 MBq 14 C and 10 g (AI) unlabelled coumaphos in 25 mL acetone. Vat 1 was control. Vat 2 and 3 were maintained at pH 5 by addition of superphosphate initially and at regular intervals as required. Vat 3 and 4 were treated with bacteriostat copper sulphate at 0.01 g per litre. The pH of vat 1 and 4 gradually increased with time from initial value of 7 to 8.47 and 7.57 respectively. In vat 1 and 4 the concentration of coumaphos declined from about initial concentration of 200 μg/mL to about 9 μg/mL in 255 days after initial treatment, whereas the persistence of coumaphos was more in vats 2 and 3. The stability of coumaphos in model vats increased significantly by maintaining a pH of 5 by addition of superphosphate. The pesticide residues consisted of 80 % or more of unchanged coumaphos. In addition potasan, chlorferon and 4 - methylumbelliferone were detected in small proportions. In another experiment the effect of pH was studied. Coumaphos was most stable at pH 5 as also observed in model vats under field conditions. Coumaphos did not leach below 10 cm in all the four cases. Dissipation, degradation and bound residue formation was more in case of alkali treated coumaphos than normal coumaphos. Aged residues of vat 3 were reasonably stable as copper sulphate inhibited the degradation of coumaphos in soil by microorganisms. Coumaphos along with the the above three metabolises were detected in the extractable insecticide residues from the soil, though the proportion of metabolises was much more than found in model vats. Again treatment of coumaphos with alkali further increased its metabolism and the soil bound residues were double as compared to untreated coumaphos

Using virtual reality simulation to assess competence in video-assisted thoracoscopic surgery (VATS) lobectomy

DEFF Research Database (Denmark)

Jensen, Katrine; Bjerrum, Flemming; Hansen, Henrik Jessen

2017-01-01

for a virtual reality simulator test of a video-assisted thoracoscopic surgery (VATS) lobectomy of a right upper lobe. METHODS: Participants with varying experience in VATS lobectomy were included. They were familiarized with a virtual reality simulator (LapSim(®)) and introduced to the steps of the procedure...... % false positives) and failed four of the experienced surgeons (29 % false negatives). CONCLUSION: This study is the first to establish validity evidence for a VATS right upper lobe lobectomy virtual reality simulator test. Several simulator metrics demonstrated significant differences between novices...

VAT teatril kaks uut noortelavastust / Tiiu Talvist

Index Scriptorium Estoniae

Talvist, Tiiu

2010-01-01

VAT teater panustab sel hooajal uutesse laste- ja noortelavastustesse: lisaks itaallaste Nino d’Introna ja Giacomo Ravicchio teksti põhjal valminud seiklusloole „Robinson & Crusoe” (lavastaja Aare Toikka), esietendub aprillis Mare Sabolotny noorte probleemidest kõnelev lavalugu „Kirjaklambritest vöö”. Lavastaja Rein Agur

Changes in the Strength of the Polymer Concrete Used in the Electroplating Vats Under Operational Load

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Radna Lidia

2017-12-01

Full Text Available Due to the strong and aggressive electrolyte media and thermal load, design of the electroplating vats in the copper industry often relies on the resin concrete. The article presents the results of the strength tests of the polymer concrete based on the "Derakane" resin, used in the construction of electroplating vats. Samples were taken from the real vats - both new and 17-year old. Strength tests included compression and bending tensile strength test. To assess the effect of operational conditions the tests were performed on the same-age vats, some of which were never used while others were subjected to the operational load. During the operation, the vats sustained load of the anode and cathode weights, cyclic electrolyte loading with a temperatures up to 60°C. As a result, it was noted that the operational conditions led to the increased strength of the polymer concrete material.

Changes in the Strength of the Polymer Concrete Used in the Electroplating Vats Under Operational Load

Science.gov (United States)

Radna, Lidia; Sakharov, Volodymyr

2017-12-01

Due to the strong and aggressive electrolyte media and thermal load, design of the electroplating vats in the copper industry often relies on the resin concrete. The article presents the results of the strength tests of the polymer concrete based on the "Derakane" resin, used in the construction of electroplating vats. Samples were taken from the real vats - both new and 17-year old. Strength tests included compression and bending tensile strength test. To assess the effect of operational conditions the tests were performed on the same-age vats, some of which were never used while others were subjected to the operational load. During the operation, the vats sustained load of the anode and cathode weights, cyclic electrolyte loading with a temperatures up to 60°C. As a result, it was noted that the operational conditions led to the increased strength of the polymer concrete material.

Apex-to-Cupola Distance Following VATS Predicts Recurrence in Patients With Primary Spontaneous Pneumothorax

Science.gov (United States)

Chang, Jia-Ming; Lai, Wu-Wei; Yen, Yi-Ting; Tseng, Yau-Lin; Chen, Ying-Yuan; Wu, Ming-Ho; Chen, Wei; Light, Richard W.

2015-01-01

Abstract Our study sought to determine whether the size of the residual apical pleural space in young patients with primary spontaneous pneumothorax (PSP) following video-assisted thoracoscopic surgery is associated with the risk of recurrence. We retrospectively reviewed patients (≤30 years’ old) with primary spontaneous pneumothorax following thoracoscopic surgery (2002–2010) in a university-affiliated hospital. The size of residual apical pleural space was estimated by measuring the apex-to-cupola distance on a postoperative chest radiograph at 2 time windows: first between postoperative day (POD) 0 and 3, and second between POD 4 and 14. A total of 149 patients were enrolled with a median follow-up of 11.2 months (interquartile range, 0.95–29.5 months), of whom 141 (94.6%) were male with a mean age of 20 years. The postoperative recurrence rate was 11.4%. Comparing the characteristics between the patients with and without recurrent pneumothorax, the patients with recurrence were younger (18.2 + 2.4 vs 20.7 + 3.7 years, P = 0.008), with a lower rate of pleurodesis (35% vs1 69%, P = 0.037), longer apex-to-cupola distance at POD 0 to 3 (22.41 ± 19.56 vs 10.07 ± 10.83 mm, P pneumothorax, age 10 mm (P = 0.027, OR: 5.319), and no pleurodesis during VATS (P = 0.022, OR: 5.042) were independent risk factors for recurrent pneumothorax. The recurrence rate was not low (11.4%) in young patients with PSP following VATS. Residual apical pleural space with apex-to-cupola distance of 10 mm or greater at POD 0 to 3, younger age, and no pleurodesis would increase postoperative recurrence of primary spontaneous pneumothorax. PMID:26376396

The taxable events for the Value-Added Tax (VAT based on a Comparative Law approach

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Walker Villanueva Gutiérrez

2014-07-01

Full Text Available This article analyzes the definitions of the main taxable events for the Value-Added Tax (VAT based on a comparative approach to thelegislation of different countries (Spain, Mexico, Chile, Colombia, Argentina and Peru. In this regard, it analyzes which legislations offer definitions according to the principles of generality, fiscal neutrality and legal certainty for VAT. Moreover, it points out that the VAT systems of those countries do not require as a condition for the configuration of the taxable events that the transactions involve a «value added» or a final consumption. In the specificcase of «supplies of goods», the VAT systems have a similar definition of the taxable event, although there are a few differences. However, in the case of«supplies of services», which is the most important taxable event for VAT, there are important differences at the time each country defines it. This is not a desirable effect for the international trade of services, since the lack of harmonization produces double taxation or double non taxation.

In pursuit of tax equity: lessons from VAT rate structure adjustment in Poland

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Artur Świstak

2015-06-01

Full Text Available In 2011, in the aftermath of the economic crisis, Poland increased its value added tax rates. Despite an already large VAT policy gap, further rate differentiation was used to address distributional concerns and to protect the most vulnerable households. We find that the changes to the VAT rate structure hardly improved the overall progressivity of the VAT and the tax system as a whole. While providing only minimal relief to the poor, taxation of food products at a super reduced rate greatly subsidized the richer households. With a small change to the income tax structure, the government could have secured more progressivity at a lower cost in terms of revenue foregone.

Geometrical shape assessment of additively manufactured features by direct light processing vat polymerization method

DEFF Research Database (Denmark)

Péreza, Lucia C. Díaz; Davoudinejad, Ali; Quagliotti, Danilo

The importance of Additive Manufacturing (AM) in the field of micro manufacturing is increasing. Vat Polymerization Methods are one of the lead AM technologies to produce polymer micro parts. In the Technical University of Denmark (DTU), a vat photopolymerization AM machine able to print features...

Preparation of iron-deposited graphite surface for application as cathode material during electrochemical vat-dyeing process

International Nuclear Information System (INIS)

Anbu Kulandainathan, M.; Kiruthika, K.; Christopher, G.; Babu, K. Firoz; Muthukumaran, A.; Noel, M.

2008-01-01

Iron-deposited graphite surfaces were prepared, characterized and employed as cathode materials for electrochemical vat-dyeing process containing very low concentration of sodium dithionite. The electrodeposition, in presence of ammonium thiocyanate and gelatin or animal glue as binding additives, were found to give finer iron deposits for improved electrochemical dyeing application. The electrodeposits were characterized using scanning electron microscopy, electron-dispersive X-ray spectroscopy and X-ray diffraction methods, before and after electrochemical dyeing process. The electrochemical activity of the iron-deposited graphite electrodes always stored in water seems to depend on the surface-bound Fe 3+ /Fe 2+ redox species. Vat dyes like C.I. Vat Violet 1, C.I. Vat Green 1 and C.I. Vat Blue 4 could be efficiently dyed employing these above electrode materials. The colour intensity and washing fastness of the dyed fabrics were found to be equal with conventionally dyed fabrics. The electrodes could also be reused for the dyeing process

Changes in VAT rates during the economic crisis

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Jan Široký

2011-01-01

Full Text Available To solve the current economical crisis, there are used various tools of economic policy. Some of them are changes in taxes, particularly changes in the value added tax due to its importance.Value added tax is the most harmonized tax in the single internal market of the European Communities. Although community law defines the basic legal constraints of VAT rules in individual countries, the Council Directive 2006/112/EC on the common system of value added tax, as amended, leaves some areas open for the Member States. One of the main characteristics of VAT is its tax rates which are – while maintaining specified minimal borders – in competency of Member States.Paper illustrates and evaluates the changes in tax rates of individual Member States during the economic crisis and points to their context and consequences.

Material-Dependent Implant Artifact Reduction Using SEMAC-VAT and MAVRIC: A Prospective MRI Phantom Study.

Science.gov (United States)

Filli, Lukas; Jud, Lukas; Luechinger, Roger; Nanz, Daniel; Andreisek, Gustav; Runge, Val M; Kozerke, Sebastian; Farshad-Amacker, Nadja A

2017-06-01

The aim of this study was to compare the degree of artifact reduction in magnetic resonance imaging achieved with slice encoding for metal artifact correction (SEMAC) in combination with view angle tilting (VAT) and multiacquisition variable resonance image combination (MAVRIC) for standard contrast weightings and different metallic materials. Four identically shaped rods made of the most commonly used prosthetic materials (stainless steel, SS; titanium, Ti; cobalt-chromium-molybdenum, CoCr; and oxidized zirconium, oxZi) were scanned at 3 T. In addition to conventional fast spin-echo sequences, metal artifact reduction sequences (SEMAC-VAT and MAVRIC) with varying degrees of artifact suppression were applied at different contrast weightings (T1w, T2w, PDw). Two independent readers measured in-plane and through-plane artifacts in a standardized manner. In addition, theoretical frequency-offset and frequency-offset-gradient maps were calculated. Interobserver agreement was assessed using intraclass correlation coefficient. Interobserver agreement was almost perfect (intraclass correlation coefficient, 0.86-0.99). Stainless steel caused the greatest artifacts, followed by CoCr, Ti, and oxZi regardless of the imaging sequence. While for Ti and oxZi rods scanning with weak SEMAC-VAT showed some advantage, for SS and CoCr, higher modes of SEMAC-VAT or MAVRIC were necessary to achieve artifact reduction. MAVRIC achieved better artifact reduction than SEMAC-VAT at the cost of longer acquisition times. Simulations matched well with the apparent geometry of the frequency-offset maps. For Ti and oxZi implants, weak SEMAC-VAT may be preferred as it is faster and produces less artifact than conventional fast spin-echo. Medium or strong SEMAC-VAT or MAVRIC modes are necessary for significant artifact reduction for SS and CoCr implants.

Three-dimensional (3D)- computed tomography bronchography and angiography combined with 3D-video-assisted thoracic surgery (VATS) versus conventional 2D-VATS anatomic pulmonary segmentectomy for the treatment of non-small cell lung cancer.

Science.gov (United States)

She, Xiao-Wei; Gu, Yun-Bin; Xu, Chun; Li, Chang; Ding, Cheng; Chen, Jun; Zhao, Jun

2018-02-01

Compared to the pulmonary lobe, the anatomical structure of the pulmonary segment is relatively complex and prone to variation, thus the risk and difficulty of segmentectomy is increased. We compared three-dimensional computed tomography bronchography and angiography (3D-CTBA) combined with 3D video-assisted thoracic surgery (3D-VATS) to perform segmentectomy to conventional two-dimensional (2D)-VATS for the treatment of non-small cell lung cancer (NSCLC). We retrospectively reviewed the data of randomly selected patients who underwent 3D-CTBA combined with 3D-VATS (3D-CTBA-VATS) or 2D-VATS at the Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University Hospital, from January 2014 to May 2017. The operative duration of 3D group was significantly shorter than the 2D group (P 0.05). The extent of intraoperative bleeding and postoperative drainage in the 3D group was significantly lower than in the 2D group (P 3D group was shorter than in the 2D group (P 0.05). However, hemoptysis and pulmonary air leakage (>3d) occurred significantly less frequently in the 3D than in the 2D group (P 3D-CTBA-VATS is a more accurate and smooth technique and leads to reduced intraoperative and postoperative complications. © 2018 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

Allometric relationship between changes of visceral fat and total fat mass

DEFF Research Database (Denmark)

Hallgreen, C. E.; Hall, K. D.

2008-01-01

Objective: To elucidate the mathematical relationship between changes of visceral adipose tissue (VAT) and total body fat mass (FM) during weight loss. Design: We hypothesized that changes of VAT mass are allometrically related to changes of FM, regardless of the type of weight-loss intervention...

The Impact of Taxation of the Domestic Economic Transactions on the Vat Collection Through Electronic Fiscal Devices

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Ionel Bostan

2017-05-01

Full Text Available The issue of collecting tax resources to the consolidated budget has determined and still determines difficulties which cannot be neglected in all the former socialist countries of the Central and Eastern Europe. From the Members States of the European Union, Romania is the country with the highest VAT Gap between EU Member States: 41%, compared to a European average of 15.2%. One solution tried to solve this problem was the regulation of mandatory use of electronic cash registers with fiscal memory. In this way, it was considered that a better highlight and also a tighter control of economic transactions will be achieved, from a fiscal point of view. In our study, we analyze, for the Romanian context in the postEU accession, whether the mandatory introduction of these devices in recording commercial transactions has had a significant impact on VAT collection. The study includes two stages of the analysis: in the first stage we estimated the influence of VAT rate variation on the degree of the VAT collection. Then we used the residual component to test the influence of EFDs’ mandatory introduction on VAT collection or on fiscal efficiency. The results indicate an improvement in the collection of VAT but also a decrease in the efficiency of fiscal collection.

Persistence of wild Streptococcus thermophilus strains on wooden vat and during the manufacture of a traditional Caciocavallo type cheese.

Science.gov (United States)

Settanni, L; Di Grigoli, A; Tornambé, G; Bellina, V; Francesca, N; Moschetti, G; Bonanno, A

2012-04-02

The present work was undertaken to evaluate the influence of the wooden dairy plant equipment on the microbiological characteristics of curd to be transformed into Caciocavallo Palermitano cheese. Traditional raw milk productions were performed concomitantly with standard cheese making trials carried out in stainless steel vat inoculated with a commercial starter. Milk from two different farms (A and B) was separately processed. The wooden vat was found to be a reservoir of lactic acid bacteria (LAB), while unwanted (spoilage and/or pathogenic) microorganisms were not hosted or were present at very low levels. All microbial groups were numerically different in bulk milks, showing higher levels for the farm B. LAB, especially thermophilic cocci, dominated the whole cheese making process of all productions. Undesired microorganisms decreased in number or disappeared during transformation, particularly after curd stretching. LAB were isolated from the wooden vat surface and from all dairy samples, subjected to phenotypic and genetic characterization and identification. Streptococcus thermophilus was the species found at the highest concentration in all samples analyzed and it also dominated the microbial community of the wooden vat. Fourteen other LAB species belonging to six genera (Enterococcus, Lactobacillus, Lactococcus, Leuconostoc, Streptococcus and Weissella) were also detected. All S. thermophilus isolates were genetically differentiated and a consortium of four strains persisted during the whole traditional production process. As confirmed by pH and the total acidity after the acidification step, indigenous S. thermophilus strains acted as a mixed starter culture. Copyright © 2012 Elsevier B.V. All rights reserved.

VAT-teatris mõtiskletakse allasurutud pingete üle / Mari Rebane

Index Scriptorium Estoniae

Rebane, Mari

2006-01-01

13. apr. esietendus VAT Teatris Amélie Nothombi "Vaenlase kosmeetika", tõlkija, lavastaja ja muusikaline kujundaja Peeter Raudsepp, kunstnik Hardi Volmer. Tükki mängitakse rahvusraamatukogu teatrisaalis

The impact of VAT introduction on UK residential energy demand: an investigation using the cointegration approach

International Nuclear Information System (INIS)

Fouquet, Roger

1995-01-01

Over a two-year period, which started in April 1994, the real price of energy to UK households was expected to rise by 17.5% as a result of value-added tax (VAT) introduction. The regressive nature of the tax forced the government to limit VAT on residential fuel to 8%. Using a cointegration approach, to take account of the non-stationarity fuel consumption time series, this paper estimates real energy and fuel specific price and income elasticities for the period 1974:1-1994:1. They suggest that natural gas has a positive real energy price elasticity indicating that, as real price of energy rises, households scrap inefficient heaters and invest in more efficient ones, principally natural gas. These estimates enable projections to be made of the impact of the introduction of VAT and imply a rise in natural gas consumption as a result of the additional VAT, although at the expense of other less efficient fuels. (author)

Comparison study between bacteriological aetiology and outcome of VAT & VAP

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Nasr H. Kahlil

2017-01-01

Conclusion: From the study we concluded that VAT infection is as severe as VAP and it needs more attention to prevent its presence as, once present, it usually progress to VAP increasing mortality rate in ICU.

VATS Lobectomy: Surgical Evolution from Conventional VATS to Uniportal Approach

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Diego Gonzalez-Rivas

2012-01-01

Full Text Available There is no standardized technique for the VATS lobectomy, though most centres use 2 ports and add a utility incision. However, the procedure can be performed by eliminating the two small ports and using only the utility incision with similar outcomes. Since 2010, when the uniportal approach was introduced for major pulmonary resection, the technique has been spreading worldwide. The single-port technique provides a direct view to the target tissue. The conventional triple port triangulation creates a new optical plane with genesis of dihedral or torsional angle that is not favorable with standard two-dimension monitors. The parallel instrumentation achieved during single-port approach mimics inside the maneuvers performed during open surgery. Furthermore, it represents the less invasive approach possible, and avoiding the use of trocar, we minimize the compression of the intercostal nerve. Further development of new technologies like sealing devices for all vessels and fissure, robotic arms that open inside the thorax, and wireless cameras will facilitate the uniportal approach to become the standard surgical procedure for pulmonary resection in most thoracic departments.

The Vat Exemption for Health Care: Eu Law and its Impact on Swedish law

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Påhlsson Robert

2015-12-01

Full Text Available The general rule in EU law is that value-added tax (VAT is to be levied on all goods and services. There are a number of exceptions, however, one of which applies to certain medical services. This paper examines the legal basis for tax exemptions in EU VAT law and in Swedish law, with particular attention to the extent to which the rapidly growing private health-care sector is covered by these tax exemptions.

Flow Characteristics of a Thermoset Fiber Composite Photopolymer Resin in a Vat Polymerization Additive Manufacturing Process

DEFF Research Database (Denmark)

Hofstätter, Thomas; Spangenberg, Jon; Pedersen, David B.

Additive manufacturing vat polymerization has become a leading technology and gained a massive amount of attention in industrial applications such as injection molding inserts. By the use of the thermoset polymerization process inserts have increased their market share. For most industrial...... understood. Research indicates an orientation within the manufacturing layer and efforts have been made to achieve a more uniform orientation within the part. A vat polymerization machine consisting of a resin vat and a moving build plate has been simulated using the fluid flow module of Comsol Multiphysics...... photopolymer resin. The prediction can be used to identify potential clusters or misalignment of fibers and in the future allow for optimization of the machine design and manufacturing process....

The Intertemporal Substitution and Income Effects of a VAT Rate Increase: Evidence from Japan

OpenAIRE

David CASHIN; UNAYAMA Takashi

2011-01-01

One of the biggest political issues in Japan is an increase in the rate of value added tax (VAT). In this paper, we evaluate its impact on household expenditure, using Japan's April 1997 VAT rate increase from three to five percent as a case study. A rate increase induces price hikes, and provided this increase in price levels is anticipated, households should engage in intertemporal substitution of purchases. In addition, if households are not compensated for the rate increase, it has the po...

METHODOLOGICAL AND PRACTICAL ASPECTS CONCERNING THE VAT COLLECTION SYSTEM Case study made in a company operating in the construction sector

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BOGDAN OANA

2015-03-01

Full Text Available This paper presents the impact of the collected VAT on a company acting in the construction field in the current economic environmnet; the study is based on data provided by the company before and after applying the VAT collection system. The research reflects the VAT payable on State Budget three times: before its entry into the system, its activity during the application system and its situation in 2014 when the company can choose between staying in the system or getting out of it. The research method consisted in reviewing approaches made in the literature, articles and specialized studies in national and international journals. We followed a detailed approach of the effects generated by the VAT collection system among companies acting in the construction filed and we made a case study based on the activity of the construction companies before applying the system and their option to stay or exit the VAT collection system.

VAT Teater toob külakosti Hiiumaa lastele ja noortele / Tiiu Talvist

Index Scriptorium Estoniae

Talvist, Tiiu

2009-01-01

VAT Teater esineb Hiiumaal lastelavastusega "Varblase Priidu" (autor Rudolf Herfurtner, lavastaja Mart Kampus) ja noortelavastusega "Kas sulle meeldib porno?" (autor Klas Abrahamsson, lavastaja Margo Teder)

The role of diagnostic VATS in penetrating thoracic injuries

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Guasti Guido

2006-10-01

Full Text Available Abstract Background Penetrating chest injuries account for 1–13% of thoracic trauma hospital admissions and most of these are managed with a conservative approach. Nevertheless, 18–30% of cases managed only with tube thoracostomy have residual clotted blood, considered the major risk factor for the development of fibrothorax and empyema. In addition, 4–23% of chest injury patients present persistent pneumothorax and 15–59% present an injury to the diaphragm, which is missed in 30% of cases. In order to make a correct diagnosis, reduce the number of missed injuries, chronic sequelae and late mortality we propose performing surgical exploration of all patients with a penetrating injury of the pleural cavity. Methods 1270 patients who sustained thoracic trauma were admitted to our hospital between 1994 and 2004. Of these, 16 patients had penetrating injuries: thirteen were surgically explored by means of Video Assisted Thoracic Surgery (VATS, and 3 with thoracotomy due to hemodynamic instability or suspected lesion of the heart or great vessels. Results In the 13 patients who underwent VATS, 5 injuries to the diaphragm, 3 lesions to an intercostal artery, and 1 lesion to the diaphragmatic artery were detected. In 12 of these patients a laceration of the pulmonary parenchyma was also present. A conversion to thoracotomy was necessary due to a broad laceration of the diaphragm and due to hemostasis of an intercostal artery. In all but one case, which was later converted, diagnostic imaging missed the diagnosis of laceration of the diaphragm. There was no intra- or postoperative mortality, and average hospital stay was five days. Conclusion VATS is a safe and effective way to diagnose and manage penetrating thoracic injuries, and its extensive use leads to a reduction in the number of missed, potentially fatal lesions as well as in chronic sequelae.

[Flexible endoscope in thoracic surgery: CITES or cVATS?].

Science.gov (United States)

Assouad, J; Fénane, H; Masmoudi, H; Giol, M; Karsenti, A; Gounant, V; Grunenwald, D

2013-10-01

Early pain and persistent parietal disorders remains a major unresolved problem in thoracic surgery. Thoracotomy and the use of multiple ports in most Video Assisted Thoracic Surgery (VATS) procedures are the major cause of this persistent pain. For the last decade, a few publications describing the use of either single incision VATS and cervical thoracic approaches have been reported without significant results in comparison with current used techniques. Intercostals compression during surgery and early after by intercostals chest tube placement, are probably the major cause of postoperative pain. Flexible endoscope is currently used in several surgeries and will take more and more importance in our daily use in thoracic surgery. Instrument flexibility allows its use through minimally invasive approaches and offers a very interesting intra-thoracic navigation. We describe here the first use in France of a flexible endoscope in thoracic surgery through a single cervical incision to perform simultaneous exploration and biopsies of the mediastinum and right pleura using the original approach of Cervical Incision Thoracic Endoscopic Surgery (CITES). Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Vat leaching of gold ores and utilization of the tailings; Kinkoseki no vat leaching to koshi no yuko riyo

Energy Technology Data Exchange (ETDEWEB)

Hosooka, T. [Nippon Clay Mining Co. Ltd., Tokyo (Japan); Miyagawa, H. [Mitsui Mining and Smelting Co. Ltd., Tokyo (Japan)

1996-01-25

Mitsui Kushikino Mine previously processed two gold ores from Kushikino and Iwato ore deposits by the all slime cyanidation method, where the ores were ground to fine size smaller than 75 {mu}m and leached with sodium, cyanide. A large amount of slimes were produced as waste and discarded in tailings ponds. To save the costs of grinding and waste treatment it is desirable to process coarse sized ores. The Iwato ore is gold and silver bearing silicified porous rock. As most gold and silver in the Iwato ore are concentrated in the pores, leaching of coarse sized ore is expected to be possible. Laboratory tests and pilot plant tests of vat leaching for the Iwato ore were carried out using 0.15-8.0 mm feed. These results showed that the gold dissolution rate was similar to that by the all slime cyanidation and the decrease in gold recovery was a few %. The properties of these tailings can be used in fine aggregate of concrete. Based on the results vat leaching of the Iwato ore was adopted in the plant. The tailings are sold and used as fine aggregate. Utilization of slime tailings from the other ores was also developed and they are used as flux in copper smelters. Now, there is no tailings pond at Mitsui Kushikino Mine. 9 refs., 10 figs., 5 tabs.

Changes in the VAT Burden on Expenses of Selected Households in the Czech Republic (2007–2014

Directory of Open Access Journals (Sweden)

Střílková Regína

2015-09-01

Full Text Available The Czech Republic is a typical representative EU Member State which has several times changed VAT rates during the analyzed period 2007–2014 in an effort to consolidate the public budget. These changes are reflected in household spending, which were analyzed by means of the consumer basket, the composition of which is also undergoing changes. Another factor that has an impact on household expenditures is the transfer of commodities between the reduced and standard rate of VAT. The final factor used is the differentiation of households according to their income levels. The aim of this paper is to determine how these changes took effect in the Czech Republic in the share of consumption of commodities included in the standard and reduced VAT rates and in exempt transactions according to household income groups in the analyzed period 2007–2014 and to determine the impact of these changes on the tax burden on selected households by value added tax and confirmation of the assumption of VAT regressivity.

THE VALUE ADDED TAX AND THE EVASION CHAIN OF INTRA-COMMUNITARIAN VAT

Directory of Open Access Journals (Sweden)

Deliman Eugen

2011-12-01

Full Text Available The relationship IRS taxpayer runs the risk of turning into a psychological war in which, however, given the positions held, the IRS is by far on a favorable footing. Between the apparently excessively formal position held by the IRS, which seems to conceal behind the laws, and the sometimes forced interpretation of the laws, by the taxpayer, there are the courts of law, also disturbed by the legislative changes which appear to have entered a perpetual motion. The objective of the fiscal administration regarding the value added tax is to combat tax evasion and fraud. It is very important to combat evasion in the VAT field because it represents the indirect tax of the largest share in the consolidated general budget. VAT evasion represents the intention of not paying the tax, withholding or not declaring it, or requesting its refund which would not be fit, due to the exaggeration of the deductible amount of the VAT. The essential aim of the IRS inspector is to verify the correctness of the declared amount of the value added tax. It should also be observed whether the incorrectness is deliberate or whether it was due to misunderstanding, carelessness or the ignorance of the payer. In all cases judgment is necessary, as for the cases of negligence the amount to be paid must be corrected and accompanied by applying fines and / or penalties, and in the cases of intended fraud legal actions are to be applied in order to obtain a conviction. Deceitful deductions represent other methods for tax evasion and are undertaken based on fake invoices, invoices often used several times for deduction, or invoices related to purchases that have never been made. Thus there are examples of economic agents who have practiced the right to deduct the VAT due to the acquisition of goods which consisted in the property of other economic agents. In other cases noticed was the deduction of VAT on goods or services that were not included in the activities of the economic

Video-assisted thoracoscopic surgery (VATS) lobectomy using a standardized anterior approach

DEFF Research Database (Denmark)

Hansen, Henrik Jessen; Petersen, René Horsleben; Christensen, Merete

2011-01-01

Lobectomy using video-assisted thoracoscopic surgery (VATS) still is a controversial operation despite its many observed benefits. The controversy may be due to difficulties performing the procedure. This study addresses a standardized anterior approach facilitating the operation....

Enhanced recovery pathways in thoracic surgery from Italian VATS Group: perioperative analgesia protocols.

Science.gov (United States)

Piccioni, Federico; Segat, Matteo; Falini, Stefano; Umari, Marzia; Putina, Olga; Cavaliere, Lucio; Ragazzi, Riccardo; Massullo, Domenico; Taurchini, Marco; Del Naja, Carlo; Droghetti, Andrea

2018-03-01

Video-assisted thoracoscopic surgery (VATS) is a minimally invasive technique that allows a faster recovery after thoracic surgery. Although enhanced recovery after surgery (ERAS) principles seem reasonably applicable to thoracic surgery, there is little literature on the application of such a strategy in this context. In regard to pain management, ERAS pathways promote the adoption of a multimodal strategy, tailored to the patients. This approach is based on combining systemic and loco-regional analgesia to favour opioid-sparing strategies. Thoracic paravertebral block is considered the first-line loco-regional technique for VATS. Other techniques include intercostal nerve block and serratus anterior plane block. Nonsteroidal anti-inflammatory drugs and paracetamol are essential part of the multimodal treatment of pain. Also, adjuvant drugs can be useful as opioid-sparing agents. Nevertheless, the treatment of postoperative pain must take into account opioid agents too, if necessary. All above is useful for careful planning and execution of a multimodal analgesic treatment to enhance the recovery of patients. This article summarizes the most recent evidences from literature and authors' experiences on perioperative multimodal analgesia principles for implementing an ERAS program after VATS lobectomy.

The diagnosis efficacy and safety of video-assisted thoracoscopy surgery (VATS) in undefined interstitial lung diseases: a retrospective study.

Science.gov (United States)

Luo, Qun; Han, Qian; Chen, Xiaobo; Xie, Jiaxing; Wu, Lulu; Chen, Rongchang

2013-06-01

To evaluate the efficacy and safety of lung biopsies by video-assisted thoracoscopy surgery (VATS) in the diagnosis of undefined interstitial lung disease (ILD). The retrospective analysis was performed in 32 who patients underwent VATS for the diagnosed with ILD from Jan 2007 to Dec 2011. The main reason for VATS for all the patients was due to no specific diagnosis could be obtained after non-invasive methods, transbronchial lung biopsy (TBLB) examination and the consultation with pulmonologist, radiologist and pathologist. The clinical profiles, chest high resolution computerized tomography (HRCT), laboratory profile, TBLB as well as the diagnosis of before and after the VATS were analyzed. The surgery site, biopsy number, duration of the thoracic drain, post-operative complications were also recorded. The 30- and 90-day post-operative mortality rates were calculated. The risk factors associated with the incidence of post-operative complications were assessed. The specific diagnosis could be established in all patients after VATS lung biopsies, with change from previous ones in 27 (84.4%). Among 20 cases (62.5%) diagnosed as unclassified ILD before the surgery, 14 (70.0%) were diagnosed as nonspecific interstitial pneumonia (NSIP), 3 (15.0%) as idiopathic pulmonary fibrosis (IPF) and 3 (15.0%) as connective tissue disease-related ILD (CTD-ILD). Among the 7 cases with complete change of diagnosis after VATS, 4 (57.1%) were cryptogenic organizing pneumonia (COP). The number of site of biopsy had no significant impact on the diagnostic efficacy. There were no significant change of vital sign and lung function after the VATS. 21 (65.6%) patients had post-operative complications, including pulmonary infection (56.3%), pulmonary atelectasis (28.1%) and pneumothorax (25.0%). The 30- and 90-day mortality rates were 0 and 5.2% respectively. Patients were divided into 2 groups based on the incidence of post-operative complications, and no significant difference was found

VAP/VAT: video analytics platform and test bed for testing and deploying video analytics

Science.gov (United States)

Gorodnichy, Dmitry O.; Dubrofsky, Elan

2010-04-01

Deploying Video Analytics in operational environments is extremely challenging. This paper presents a methodological approach developed by the Video Surveillance and Biometrics Section (VSB) of the Science and Engineering Directorate (S&E) of the Canada Border Services Agency (CBSA) to resolve these problems. A three-phase approach to enable VA deployment within an operational agency is presented and the Video Analytics Platform and Testbed (VAP/VAT) developed by the VSB section is introduced. In addition to allowing the integration of third party and in-house built VA codes into an existing video surveillance infrastructure, VAP/VAT also allows the agency to conduct an unbiased performance evaluation of the cameras and VA software available on the market. VAP/VAT consists of two components: EventCapture, which serves to Automatically detect a "Visual Event", and EventBrowser, which serves to Display & Peruse of "Visual Details" captured at the "Visual Event". To deal with Open architecture as well as with Closed architecture cameras, two video-feed capture mechanisms have been developed within the EventCapture component: IPCamCapture and ScreenCapture.

Reflection of the Change in VAT Rates on Selected Household Expenditures in the Czech Republic and the Slovak Republic (2007–2013

Directory of Open Access Journals (Sweden)

Jan Široký

2014-01-01

Full Text Available Member States of the European Union in the period of years 2007–2013 increased the rate of value added tax several times in an attempt to consolidate public budgets. While the Czech Republic is a typical representative of country changing VAT rates several times, Slovakia made practically only one change in the VAT rate. On the other hand, the Slovak Republic is a country where the reduced rate is applied only to the minimum of commodities. Changes in VAT are naturally reflected in household expenditures which are analyzed by the consumer basket, whose composition is also a subject of changes. Another factor that has an impact on household spending is swapping commodities between the rates of VAT.The aim of this paper is, based on the analytic-synthetic methods, to determine how are these changes differently manifested in the Czech Republic and the Slovak Republic in reference to the share of commodity consumption included in the standard and reduced VAT rates and to the exempt transactions, and, in particular, to determine how they affected the VAT burden of the hypothetical household in both countries.

7 CFR 58.416 - Cheese vats, tanks and drain tables.

Science.gov (United States)

2010-01-01

... uniform heating. The inner liner shall be minimum 16 gauge stainless steel or other equally corrosion... jacket. The outer jacket shall be constructed of stainless steel or other metal which can be kept clean... 7 Agriculture 3 2010-01-01 2010-01-01 false Cheese vats, tanks and drain tables. 58.416 Section 58...

Flow Characteristics of a Thermoset Fiber Composite Photopolymer Resin in a Vat Polymerization Additive Manufacturing Process

DEFF Research Database (Denmark)

Hofstätter, Thomas; Spangenberg, Jon; Pedersen, David B.

Additive manufacturing vat polymerization has become a leading technology and gained a massive amount of attention in industrial applications such as injection molding inserts. By the use of the thermoset polymerization process inserts have increased their market share. For most industrial...... applications, strength and stiffness are crucial factors to a successful implementation of cured photopolymer thermosets. Hence, fiber-reinforced polymers have recently been introduced. The behavior and especially orientation of fibers during the vat photopolymerization process has yet not been fully...

GLOBALIZATION OF ECONOMY AND GREATER CYCLES OF THE TOTAL REGIONAL PRODUCT, INFLATION AND UNEMPLOYMENT

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V.A. Belkin

2009-06-01

Full Text Available The process of synchronization of greater and small waves of real gross national product of the USA and a total regional product of the Chelyabinsk area is shown on the materials of economic statistics. The conclusion about defining influence of dynamics of real gross national product of the USA on the basic macroeconomic parameters of the Chelyabinsk area owing to high dependence of its economy on export of metal products is done from here. It is evidently shown, that the modern world economic crisis quite keeps within the theory of greater cycles of an economic conjuncture of N.D. Kondratyev. To greater cycles of a total regional product of the Chelyabinsk area there correspond return greater cycles of inflation and unemployment.

Comparison of VATS and Robotic Approaches For Clinical Stage I and II NSCLC Using the STS Database

Science.gov (United States)

Louie, Brian E.; Wilson, Jennifer L.; Kim, Sunghee; Cerfolio, Robert J.; Park, Bernard J.; Farivar, Alexander S.; Vallières, Eric; Aye, Ralph W.; Burfeind, William R.; Block, Mark I.

2016-01-01

Background Data from selected centers show that robotic lobectomy (RL) is safe, effective and has comparable 30-day mortality to video assisted lobectomy (VATS). However, widespread adoption of RL is controversial. We used the STS-GTS-Database to evaluate quality metrics for these two minimally invasive lobectomy techniques. Methods A database query for primary clinical stage I or II NSCLC at high volume centers from 2009 to 2013 identified 1,220 RLs and 12,378 VATS. Quality metrics evaluated included operative morbidity, 30-day mortality and nodal upstaging (NU), defined as cN0 to pN1. Multivariable logistic regression was used to evaluate NU. Results RL patients were older, less active, less likely to be an ever smoker, and had higher BMI (all p<0.05). They were also more likely to have coronary heart disease or hypertension (all p<0.001) and to have had preoperative mediastinal staging (p<0.0001). RL operative times were longer (median 186 vs 173 min, p<0.001); all other operative parameters were similar. All postoperative outcomes were similar including complications and 30-day mortality (RL 0.6% vs VATS 0.8%, p=0.4). Median length of stay was 4 days for both, but a higher proportion of RLs stayed < 4 days: 48% vs 39%, p<0.001. NU overall was similar (p=0.6), but with trends favoring VATS in the cT1b group, and RL in the cT2a group. Conclusions RL patients had more co-morbidities and RL operative times were longer, but quality outcome measures including complications, hospital stay, 30-day mortality, and NU suggest RL and VATS are equivalent. PMID:27209613

Sexual dimorphism in circulating leptin concentrations is not accounted for by differences in adipose tissue distribution.

Science.gov (United States)

Rosenbaum, M; Pietrobelli, A; Vasselli, J R; Heymsfield, S B; Leibel, R L

2001-09-01

Circulating concentrations of leptin normalized to total adipose tissue mass are significantly greater in females than in males. Rates of leptin expression (per gram of adipose tissue) are significantly greater in subcutaneous (SAT) than visceral (VAT) adipose tissue and the relative amount of fat stored as SAT vs VAT is significantly greater in pre-menopausal females than in males. Gender-related differences in the relative amounts of SAT and VAT may account for the greater circulating leptin concentration relative to fat-mass in females than males. We examined body composition and anatomic fat distribution by dual energy X-ray-absorptiometry (DEXA) and magnetic resonance imaging (MRI), and post-absorptive circulating concentrations of leptin and insulin in 58 subjects (26 females, 32 males). Stepwise multiple linear regression analyses, treating gender as a dichotomous variable, were performed to determine inter-relationships among leptin concentrations and insulin concentrations, VAT and SAT. Body composition by DEXA and MRI were highly correlated (r(2)=0.97, P<0.0001). There were significant gender effects on leptin/total fat mass (males, 0.17+/-0.01 ng/ml/kg; females, 0.49+/-0.05 ng/ml/kg; P<0.0001) and relative amounts of fat in SAT and VAT depots (ratio of SAT/VAT; males, 12.3+/-1.5; females, 32.9+/-3.2; P<0.0001). Circulating leptin concentration was significantly correlated with insulin concentration (P=0.001), SAT (P<0.0001) and gender (P=0.033). Circulating concentrations of insulin were significantly correlated with VAT, but not SAT, in males and with SAT, but not VAT, in females. The sexual dimorphism in the relationship between leptin and adipose tissue mass cannot be explained by differences in the relative amounts of VAT and SAT. Thus, the sexual dimorphism in plasma leptin concentration appears to reflect, at least in part, effects of circulating concentrations of gonadal steroids (especially androgens) and/or primary genetic differences that are

Association of Habitual Patterns and Types of Physical Activity and Inactivity with MRI-Determined Total Volumes of Visceral and Subcutaneous Abdominal Adipose Tissue in a General White Population.

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Karina Fischer

Full Text Available Population-based evidence for the role of habitual physical activity (PA in the accumulation of visceral (VAT and subcutaneous (SAAT abdominal adipose tissue is limited. We investigated if usual patterns and types of self-reported PA and inactivity were associated with VAT and SAAT in a general white population. Total volumes of VAT and SAAT were quantified by magnetic resonance imaging in 583 men and women (61 ± 11.9 y; BMI 27.2 ± 4.4 kg/m2. Past-year PA and inactivity were self-reported by questionnaire. Exploratory activity patterns (APAT were derived by principal components analysis. Cross-sectional associations between individual activities, total PA in terms of metabolic equivalents (PA MET, or overall APAT and either VAT or SAAT were analyzed by multivariable-adjusted robust or generalized linear regression models. Whereas vigorous-intensity PA (VPA was negatively associated with both VAT and SAAT, associations between total PA MET, moderate-intensity PA (MPA, or inactivity and VAT and/or SAAT depended on sex. There was also evidence of a threshold effect in some of these relationships. Total PA MET was more strongly associated with VAT in men (B = -3.3 ± 1.4; P = 0.02 than women (B = -2.1 ± 1.1; P = 0.07, but was more strongly associated with SAAT in women (B = -5.7 ± 2.5; P = 0.05 than men (B = -1.7 ± 1.6; P = 0.3. Men (-1.52 dm3 or -1.89 dm3 and women (-1.15 dm3 or -2.61 dm3 in the highest (>6.8 h/wk VPA or second (4.0-6.8 h/wk VPA tertile of an APAT rich in VPA, had lower VAT and SAAT, respectively, than those in the lowest (<4.0 h/wk VPA tertile (P ≤ 0.016; P trend ≤ 0.0005. They also had lower VAT and SAAT than those with APAT rich in MPA and/or inactivity only. In conclusion, our results suggest that in white populations, habitual APAT rich in MPA might be insufficient to impact on accumulation of VAT or SAAT. APAT including ≥ 4.0-6.8 h/wk VPA, by contrast, are more strongly associated with lower VAT and SAAT.

Impact of Electronic Tax Registers on VAT Compliance: A Study of ...

African Journals Online (AJOL)

The purpose of this study was to assess the impact of use of Electronic Tax Registers (ETRs ) on Value Added Tax (VAT) compliance among private business firms in Kisumu city, Kenya. A sample of 233 private firms was selected from a population of 590 private firms using stratified sampling technique. The data was ...

A Comparison of Some Properties of Vat-Heated and Dry Skim Milk ...

African Journals Online (AJOL)

Some properties, namely; viscosity, flavour, acidity, texture, aroma and palatability of cultured yoghurt made from milk previously heated to 90OC for 30 minutes in a Vat were studied and the results compared to those of yoghurt fortified by addition of dry skim milk powder. The results showed no significant difference (P ...

The compliance costs of VAT in the hotel industry in Mauritius | Pillai ...

African Journals Online (AJOL)

The cost of complying with tax legislation has stimulated much controversy recently and the survey conducted by Sandford (1973) suggested that the essential characteristics of a successful VAT system are clarify and simplicity. This article lays down facts and figures that arise from a survey carried out in July 1999 in the ...

A Review on Fabricating Tissue Scaffolds using Vat Photopolymerization.

Science.gov (United States)

Chartrain, Nicholas A; Williams, Christopher B; Whittington, Abby R

2018-05-09

Vat Photopolymerization (stereolithography, SLA), an Additive Manufacturing (AM) or 3D printing technology, holds particular promise for the fabrication of tissue scaffolds for use in regenerative medicine. Unlike traditional tissue scaffold fabrication techniques, SLA is capable of fabricating designed scaffolds through the selective photopolymerization of a photopolymer resin on the micron scale. SLA offers unprecedented control over scaffold porosity and permeability, as well as pore size, shape, and interconnectivity. Perhaps even more significantly, SLA can be used to fabricate vascular networks that may encourage angio and vasculogenesis. Fulfilling this potential requires the development of new photopolymers, the incorporation of biochemical factors into printed scaffolds, and an understanding of the effects scaffold geometry have on cell viability, proliferation, and differentiation. This review compares SLA to other scaffold fabrication techniques, highlights significant advances in the field, and offers a perspective on the field's challenges and future directions. Engineering de novo tissues continues to be challenging due, in part, to our inability to fabricate complex tissue scaffolds that can support cell proliferation and encourage the formation of developed tissue. The goal of this review is to first introduce the reader to traditional and Additive Manufacturing scaffold fabrication techniques. The bulk of this review will then focus on apprising the reader of current research and provide a perspective on the promising use of vat photopolymerization (stereolithography, SLA) for the fabrication of complex tissue scaffolds. Copyright © 2018. Published by Elsevier Ltd.

Video-assisted Thoracoscopic surgery (VATS) lobectomy for lung cancer does not induce a procoagulant state

DEFF Research Database (Denmark)

Christensen, Thomas Decker; Vad, Henrik; Pedersen, Søren

2017-01-01

Background: Changes in the coagulation system in patients undergoing surgery for lung cancer have been sparsely investigated and the impact of the surgical trauma on the coagulation system is largely unknown in these patients. An increased knowledge could potentially improve the thromboprophylaxis...... regimes. The aim of this study was to assess the coagulation profile evoked in patients undergoing curative surgery by Video-Assisted Thoracoscopic Surgery (VATS) lobectomy for primary lung cancer. Methods: Thirty-one patients diagnosed with primary lung cancer undergoing VATS lobectomy were prospectively...... thrombography. Patients did not receive thromboprophylactic treatment. Data was analyzed using repeated measures one-way ANOVA. Results: The standard coagulation parameters displayed only subtle changes after surgery and the ROTEM® and thrombin generation results remained largely unchanged. Conclusions...

The Effect of VAT e-Service Quality on Taxpayers’ Satisfaction in Iran

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Maryam Alipour

2017-03-01

Full Text Available The design of e-government websites with improper service quality is one of the common problems in the contemporary era. Users’ perceptions of e-service quality are affected by their perceived service content and delivery quality. In this study, based on the model of e-government service quality, first we identify the factors of service content and delivery related to Value Added Tax (VAT system in Iran. Then, we develop a conceptual model that depicts the influence of these factors on service quality and users’ satisfaction.  Data gathering is performed through electronic questionnaire and the case study of taxpayers using VAT services. The results show that transactional performance and accessibility respectively, have the greatest impact on quality of service content and delivery. In addition, the users’ positive perceptions of service content and delivery quality influence their positive perceptions of overall service quality. This study offers the design of a user-centric governmental website with effective service quality to improve users’ satisfaction and also to encourage the adoption and continuance use of these services.

Evaluation of polymer micro parts produced by additive manufacturing processes using vat photopolymerization method

DEFF Research Database (Denmark)

Davoudinejad, Ali; Pedersen, David Bue; Tosello, Guido

2017-01-01

Micro manufacturing scale feature production by Additive Manufacturing (AM) processes for the direct production of miniaturized polymer components is analysed in this work. The study characterizes the AM processes for polymer micro parts productions using the vat photopolymerization method...

CONTROVERSIES ON THE APPLICATION OF THE VAT SPLIT PAYMENT MECHANISM

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PALIU – POPA LUCIA

2017-11-01

Full Text Available Taking into account the urgent need to attract additional amounts to the state budget to cover the increased budget expenditures involved in the implementation of the government program, by the end of August 2017, the Government of Romania adopted an ordinance obliging the entities to apply, starting on January 1st 2018, the VAT split payment mechanism, system which no longer allows them to use the value added tax cashed affently to the delivery of goods and provision of services, which is why these amounts are to be cashed in separate accounts opened by entities in the state treasury or credit institutions. Only that, later, through the draft of Law on the approval of that ordinance, the Senate made changes to the legislative act, so that the VAT split payment would only apply to companies in insolvency or that register delays in payment of the tax. Although this measure aims at combating the tax evasion and fraud by increasing the voluntary compliance and tax collection degree, the measure can prove to be unfounded, which violates the legislative technique and, in particular, the Community provisions by being inappropriate. In this context, the main objective of this scientific approach is to identify the special situations that arise at the level of entities as a result of the application of the breakdown mechanism of value added tax and to determine the possible advantages and disadvantages.

IMPLICAÇÕES DA ANÁLISE V-A-T DA TEORIA DAS RESTRIÇÕES NA GESTÃO DA CADEIA DE SUPRIMENTOS

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Diego Augusto de Jesus Pacheco

2016-03-01

Full Text Available O objetivo dessa pesquisa é identificar o impacto da análise V-A-T da Teoria das Restrições na gestão estratégica de materiais à luz da Matriz de Posicionamento Estratégico dos Materiais (MPEM. A partir de dois estudos de caso, buscou-se verificar: i em qual classificação cada empresa se enquadrava dentro da lógica V-A-T, e ii se a gestão estratégica de materiais a partir da abordagem da MPEM pode ser considerada semelhante ou não nos casos investigados. Os resultados da pesquisa apontaram que a classificação V-A-T no caso da empresa S é do tipo A e no caso da empresa K é do tipo V. Já a análise da gestão estratégica de materiais a partir da MPEM, evidenciou que no caso S pertence ao quadrante não crítico e no caso K pertence ao quadrante estratégico. Identificou-se que a classificação V-A-T tende a impactar na gestão de materiais e no controle de estoques.

‘Do You Want a Receipt?’ Combating VAT and RST Evasion with Lottery Tickets

NARCIS (Netherlands)

S.J.C. Hemels (Sigrid); M. Fabbri (Marco)

2013-01-01

textabstractGovernments both in developed and developing countries are facing the problem of value added tax (VAT) and retail sales tax (RST) evasion. This explains a growing interest in policies alternative to the traditional methods of deterrence. This paper describes the achievements resulting

Performance Simulation and Verification of Vat Photopolymerization Based, Additively Manufactured Injection Molding Inserts with Micro-Features

DEFF Research Database (Denmark)

Mischkot, Michael; Hofstätter, Thomas; Michailidou, Ifigeneia

2017-01-01

Injection molding soft tooling inserts manufactured additively with vat photopolymerization represent a valid technology for prototyping and pilot production of polymer parts. However, a significant drawback is the low heat conductivity of photopolymers influencing cycletime and part quality...

Implementation of a biotechnological process for vat dyeing with woad.

Science.gov (United States)

Osimani, Andrea; Aquilanti, Lucia; Baldini, Gessica; Silvestri, Gloria; Butta, Alessandro; Clementi, Francesca

2012-09-01

The traditional process for vat dyeing with woad (Isatis tinctoria L.) basically relies on microbial reduction of indigo to its soluble form, leucoindigo, through a complex fermentative process. In the 19th century, cultivation of woad went into decline and use of synthetic indigo dye and chemical reduction agents was established, with a consequent negative impact on the environment due to the release of polluting wastewaters by the synthetic dyeing industry. Recently, the ever-growing demand for environmentally friendly dyeing technologies has led to renewed interest in ecological textile traditions. In this context, this study aims at developing an environmentally friendly biotechnological process for vat dyeing with woad to replace use of polluting chemical reduction agents. Two simple broth media, containing yeast extract or corn steep liquor (CSL), were comparatively evaluated for their capacity to sustain the growth and reducing activity of the strain Clostridium isatidis DSM 15098(T). Subsequently, the dyeing capacity of the CSL medium added with 140 g L⁻¹ of woad powder, providing 2.4 g L⁻¹ of indigo dye, was evaluated after fermentation in laboratory bioreactors under anaerobic or microaerophilic conditions. In all fermentations, a sufficiently negative oxidation/reduction potential for reduction of indigo was reached as early as 24 h and maintained up to the end of the monitoring period. However, clearly faster indigo dye reduction was seen in the broth cultures fermented under strict anaerobiosis, thus suggesting the suitability of the N₂ flushing strategy for enhancement of bacterial-driven indigo reduction.

Coumaphos dissipation, degradation and binding to sediment in a model laboratory vat system using 14C-labelled acaricide

International Nuclear Information System (INIS)

Khan, S.U.; Behki, R.

1997-01-01

Dissipation and degradation of 14 C-labelled coumaphos in suspension and binding to sediment was studied in a model laboratory glass vat was studied. The water in the vat was treated with a mixture of 14 C-labelled and unlabelled coumaphos and initial concentration determined. Two weeks later 50 g soil was added to the suspension and 3 x 25 mL samples taken and analysis. The procedure was repeated every two weeks for 44 weeks. pH was also recorded at each sampling time. At the end of the experiment soil was extracted by using Soxhlet apparatus and by supercritical fluid extraction and concentrations of free and bound coumaphos and metabolites were determined. Very little dissipation of total 14 C occurred and 88% of the initial concentration was still present at the end of 44 weeks. The 14 C content in the filtrate declined to 20% but there was a corresponding increase in the 14 C content of the sediment mixed with emulsion. The pH of the suspension steadily decreased with time. HPLC analysis of the filtrate, soil wash and Soxhlet extract indicated the presence of coumaphos and three metabolites chlorferon, potasan and oxygen analogue of coumaphos. Analysis of supercritical fluid extract of the sediment-bound radioactivity showed the presence of coumaphos but no metabolites. In another study filtered and washed soil from the tank was incubated with an EPTC-degrading bacterial strain, Rhodococcus TE1 to study the effect on the metabolism of coumaphos. About 10.9% of 14 C was released in the incubation mixture and it contained mostly chlorferon with some oxygen analogue of coumaphos. Exposure of 14 C-labelled coumaphos to U.V. and sun lamp, to study photolysis, resulted in the formation of a brown precipitate. While the 14 C content in the filtrate decreased, its concentration in the precipitate increased. The filtrate contained primarily coumaphos, whereas, the precipitate contained coumaphos, chlorferon and potasan. These findings suggest that in the field vat the

Nonintubated uniportal VATS pulmonary anatomical resections.

Science.gov (United States)

Galvez, Carlos; Navarro-Martinez, Jose; Bolufer, Sergio; Lirio, Francisco; Sesma, Julio; Corcoles, Juan Manuel

2017-01-01

Nonintubated procedures have widely developed during the last years, thus nowadays major anatomical resections are performed in spontaneously breathing patients in some centers. In an attempt for combining less invasive surgical approaches with less aggressive anesthesia, nonintubated uniportal video-assisted thoracic surgery (VATS) lobectomies and segmentectomies have been proved feasible and safe, but there are no comparative trials and the evidence is still poor. A program in nonintubated uniportal major surgery should be started in highly experienced units, overcoming first a learning period performing minor procedures and a training program for the management of potential crisis situations when operating on these patients. A multidisciplinary approach including all the professionals in the operating room (OR), emergency protocols and a comprehensive knowledge of the special physiology of nonintubated surgery are mandatory. Some concerns about regional analgesia, vagal block for cough reflex control and oxygenation techniques, combined with some specific surgical tips can make safer these procedures. Specialists must remember an essential global concept: all the efforts are aimed at decreasing the invasiveness of the whole procedure in order to benefit patients' intraoperative status and postoperative recovery.

THE IMPACT OF VAT ON THE ECONOMY IN RELATION TO OTHER TAXES IN SOUTH EAST EUROPE

Directory of Open Access Journals (Sweden)

Petre BREZEANU

2018-06-01

Full Text Available Through this article, we aim to create a multifactorial model of linear regression by which we discover the impact of the most important taxes in an economy in the economies of the countries of Southeastern Europe. We have selected South East Europe to include and Romania in the empirical analysis. So for building the model, we considered it opportune to choose the following independent variables: VAT, Excise, Income Tax. The economy as a whole was considered to be well defined by the Gross Domestic Product it produces, which is why GDP has been selected as a variable. The chosen period spans a sample of 20 years. In conclusion, this study will try to highlight how fiscal pillars, such as VAT, ACIs and income taxes, affect the GDP. In the light of the results obtained, we will try to interpret the coefficients obtained through a fiscal policy that is dominant or not at this level.

Analysis of Potential Impacts of Inclusion of Locally Supplied Services into Reduced VAT Rate on the Suppliers of these Services

Directory of Open Access Journals (Sweden)

Kateřina Randová

2010-09-01

Full Text Available Member States of the European Union are in accordance with the Community law allowed to include locally supplied services into reduced value added tax rates (hereinafter referred to as “VAT rates” without time restriction. In the Czech Republic there has not yet been a sufficient political will to implement this possibility into the legislation. The purpose of this paper is to analyse the potential impact of the relevant Directive implementation into the Czech VAT Act on the tax liability of the suppliers of these services. The paper is based on the comparison of the national legislation and the Community law, and their analysis. Moreover, the deductive method is used in this paper.

VAT TAXATION OF INTRA-COMMUNITY SUPPLIES AND ACQUISITIONS OF SERVICES

Directory of Open Access Journals (Sweden)

Antonescu Ligia

2010-12-01

Full Text Available As of January 1st, 2010, as a result of the transposition in the national legislation of the Council Directive 2008/8/CE of 12.02.2008 for the amendment of the Directive 2006/112/CE regarding the place of the supply of services, new notions of tax law have arisen, namely intra-community acquisitions of services and intra-community supply of services. The transposition in the national legislation of the new CE directives in the field of the VAT aims not only at the way the place of the supply of services is determined, but also at the changes regarding the person subject to taxation, tax registration, declarative obligations, etc.

The Distinction between Direct and General Costs with Regard to the Deduction of Input VAT - The Case of Acquisition, Holding and Sale of Shares

DEFF Research Database (Denmark)

Jensen, Dennis Ramsdahl; Stensgaard, Henrik

2012-01-01

of distinguishing between direct and general costs. On the other hand the aim is to describe and analyse the law as it stands regarding the treatment of shares in the EU VAT system, with a special focus on the right to deduct input VAT on costs re-lating to transactions in shares. As a part of this analysis the aim......In revealing the conditions for the deduction of input VAT, the essential questions concern the nature of the so-called ‘direct and immediate link’ test and thus also the criteria for the important distinction between direct costs and general costs. The ‘direct and immediate link’ test...... is of general importance to all types of costs, but judged from the case law of the ECJ it has especially materialised itself when it comes to costs related to the acquisition, holding or sales of shares. The purpose of this article is therefore twofold. On the one hand it deals with the difficult question...

Development and validation of a theoretical test of proficiency for video-assisted thoracoscopic surgery (VATS) lobectomy

DEFF Research Database (Denmark)

Savran, Mona M; Hansen, Henrik Jessen; Horsleben Petersen, René

2015-01-01

BACKGROUND: Testing stimulates learning, improves long-term retention, and promotes technical performance. No purpose-orientated test of competence in the theoretical aspects of VATS lobectomy has previously been presented. The purpose of this study was, therefore, to develop and gather validity...... performed significantly better than the novices (p better than the novices (p

Fractures of the greater trochanter following total hip replacement.

Science.gov (United States)

Brun, Ole-Christian L; Maansson, Lukas

2013-01-01

We studied the incidence of greater trochanteric fractures at our department following THR. In all we examined 911 patients retrospectively and found the occurance of a greater trochanteric fracture to be 3%. Patients with fractures had significantly poorer outcome on Oxford Hip score, Pain VAS, Satisfaction VAS and EQ-5D compared to THR without fractures. Greater trochanteric fracture following THR is one of the most common complications following THR. It has previously been thought to have little impact on the overall outcome following THR, but our study suggests otherwise.

VAT regime affecting the acquisition of electronic information sources in Slovenia and in the European Union

Directory of Open Access Journals (Sweden)

Tilen Mandelj

2010-01-01

Full Text Available Tax legislation system in the Republic of Slovenia as well as that of the European Union does not keep pace with the rapid technological development. A lot of problems arise in the field of purchasing and providing access to electronic information sources, namely electronic journals which are very important to disseminate research results. Problems arising from the application of the EC Directive 2006/112 in the Slovenian legislation system are described. The goal that the Value Added Tax (VAT would not affect the international competitiveness of the EU Member states was not met. Different levels of general and reduced tax rates and even different levels of taxation of electronic information sources put Member States in unequal positions. Tax regimes in Member States and their responses to the problem of VAT are discussed. The article shows the complexity of electronic information sources which can partly be taxed as services and party as goods in electronic form. A simulation of expenditure on electronic information sources at different tax rates and possible changes of tax legislation are presented.

Less Waste on Waist Measurements: Determination of Optimal Waist Circumference Measurement Site to Predict Visceral Adipose Tissue in Postmenopausal Women with Obesity

Directory of Open Access Journals (Sweden)

Radhika V. Seimon

2018-02-01

Full Text Available With obesity being a leading cause of preventable death, it is vital to understand how best to identify individuals with greater risk of metabolic disease, especially those with high visceral adipose tissue (VAT. This study aimed to determine whether three commonly used waist circumference (WC measurement sites could provide accurate estimations of VAT, as determined by magnetic resonance imaging (MRI, which is a gold standard for measuring VAT, in postmenopausal women with obesity. VAT volume was measured by MRI of the total abdomen in 97 women aged 57.7 ± 0.4 years (mean ± SEM, mean body mass index 34.5 ± 0.2 kg/m2. WC was measured at the midpoint between the lowest rib and the iliac crest (WCmid, the narrowest point of the torso (WCnarrow, and at the level of the umbilicus (WCumbilicus. WC differed significantly according to measurement site, with WCnarrow (102.1 ± 0.7 cm < WCmid (108.3 ± 0.7 cm < WCumbilicus (115.7 ± 0.8 cm (p < 0.001. WCmid, WCnarrow and WCumbilicus were all significantly correlated with VAT, as measured by MRI (r = 0.581, 0.563 and 0.390, respectively; p < 0.001 for all, but the relationships between WCmid or WCnarrow and VAT determined by MRI were stronger than for WCumbilicus. Measurement of either WCmid or WCnarrow provides valid estimates of VAT in postmenopausal women with obesity, with WCnarrow being favoured in light of its greater ease and speed of measurement in this population.

Insight into the bacterial diversity of fermentation woad dye vats as revealed by PCR-DGGE and pyrosequencing.

Science.gov (United States)

Milanović, Vesna; Osimani, Andrea; Taccari, Manuela; Garofalo, Cristiana; Butta, Alessandro; Clementi, Francesca; Aquilanti, Lucia

2017-07-01

The bacterial diversity in fermenting dye vats with woad (Isatis tinctoria L.) prepared and maintained in a functional state for approximately 12 months was examined using a combination of culture-dependent and -independent PCR-DGGE analyses and next-generation sequencing of 16S rRNA amplicons. An extremely complex ecosystem including taxa potentially contributing to both indigo reduction and formation, as well as indigo degradation was found. PCR-DGGE analyses revealed the presence of Paenibacillus lactis, Sporosarcina koreensis, Bacillus licheniformis, and Bacillus thermoamylovorans, while Bacillus thermolactis, Bacillus pumilus and Bacillus megaterium were also identified but with sequence identities lower than 97%. Dominant operational taxonomic units (OTUs) identified by pyrosequencing included Clostridium ultunense, Tissierella spp., Alcaligenes faecalis, Erysipelothrix spp., Enterococcus spp., Virgibacillus spp. and Virgibacillus panthothenicus, while sub-dominant OTUs included clostridia, alkaliphiles, halophiles, bacilli, moderately thermophilic bacteria, lactic acid bacteria, Enterobacteriaceae, aerobes, and even photosynthetic bacteria. Based on the current knowledge of indigo-reducing bacteria, it is considered that indigo-reducing bacteria constituted only a small fraction in the unique microcosm detected in the natural indigo dye vats.

VAT application in travel services pursuant to the Czech and EU legislations and a proposal for amendments in the Czech value-added tax law

Directory of Open Access Journals (Sweden)

Milena Otavová

2010-01-01

Full Text Available The domain of value-added tax has been already fully harmonized. Its regulation dwells on the Council Directive 2006/112/EC on the common system of value-added tax, and all member countries of the European Union are obliged to provide for the implementation of this Directive into their national legislations similarly as the Czech Republic, which entered the European Union on 1 May 2004. The Act no. 235/2004 Coll. on the value-added tax as amended (hereinafter „value-added tax law“ should be therefore in line with the Directive. In reality however, some issues in the VAT law have not been fully harmonized yet. One of these issues is for example the application of a special routine for travel services according to §89 of the VAT law, which is in essential contradiction with the Directive in question, the controversial point being definition of the person of customer whom the Directive understands in a different way than the VAT law. Thus, the characterization of the problem based on the Czech and EU legislations with respect to jurisdiction of the Court of Justice of the European Community forms a framework of the paper. Based on a comparative analysis of the application of special and ordinary routines in providing travel services to the customer by the taxpayer, tax incidence in his assessment base is determined. At the same time, the paper also includes a proposal for the change of the definition of customer in the VAT law so that the application of the given routine is fully in line with the EU Directive.

Direct fabrication of bio-inspired gecko-like geometries with vat polymerization additive manufacturing method

DEFF Research Database (Denmark)

Davoudinejad, A.; M. Ribo, M.; Pedersen, D. B.

2018-01-01

on. The geometry and fabrication of these surfaces are still under research. In this study, the feasibility of using direct fabrication of microscale features by Additive Manufacturing (AM) processes was investigated. The investigation was carried out using a specifically designed vat...... photopolymerization AM machine-tool suitable for precision manufacturing at the micro dimensional scale which has previously been developed, built and validated at the Technical University of Denmark. It was shown that it was possible to replicate a simplified surface inspired by the Tokay gecko, the geometry...

The detection and settlement of VAT fraud in four countries : Addendum to the report value-added tax fraud in the European Union

NARCIS (Netherlands)

Aronowitz, A.A.; Laagland, D.C.G.; Paulides, G.

1996-01-01

This addendum to the report 'Value-added tax fraud in the European Union' gives additional information on the detection and settlement of VAT fraud in Belgium, Germany, the United Kingdom and the Netherlands. See link to the report at: More information.

Variability of Bacterial Biofilms of the “Tina” Wood Vats Used in the Ragusano Cheese-Making Process▿

OpenAIRE

Licitra, G.; Ogier, J. C.; Parayre, S.; Pediliggieri, C.; Carnemolla, T. M.; Falentin, H.; Madec, M. N.; Carpino, S.; Lortal, S.

2007-01-01

Ragusano cheese is a “protected denomination of origin” cheese made in the Hyblean region of Sicily from raw milk using traditional wooden tools, without starter. To explore the Ragusano bacterial ecosystem, molecular fingerprinting was conducted at different times during the ripening and biofilms from the wooden vats called “tinas” were investigated. Raw milks collected at two farm sites, one on the mountain and one at sea level, were processed to produce Ragusano cheese. Raw milk, curd befo...

Short-run Distributional Effects of VAT Rate Change: Evidence from a consumption tax rate increase in Japan

OpenAIRE

David CASHIN; UNAYAMA Takashi

2012-01-01

Households will purchase more items than usual prior to a value added tax (VAT) rate increase in order to avoid taxation. Since this type of arbitrage requires resources such as shopping time and storage space, the impacts of tax increases vary across households, which has brought distributional effects in the short-run. Using the case of a consumption tax rate increase in Japan in 1997, we show that households who are non-working, with non-working spouses and residing in larger houses, benef...

Decolorization of a textile vat dye by adsorption on waste ash

Directory of Open Access Journals (Sweden)

MIODRAG ŠMELCEROVIĆ

2010-06-01

Full Text Available An adsorption process using cheap adsorbents could be described as a simple, selective and low cost alternative for the treatment of colored waste water compared to conventional physical and chemical processes. In this study the use of a natural waste adsorbent–ash was investigated for the removal of a textile vat dye Ostanthren blue GCD remaining after the dyeing of cotton textile. The ash obtained as a waste material during the burning of brown coal in the heating station of Leskovac (Serbia was used for the treatment of waste waters from the textile industry, i.e., waste water after the dyeing process. The effect of ash quantity, initial dye concentration, pH and agitation time on adsorption was studied. The Langmuir model was used to describe the adsorption isotherm. Based on the analytical expression of the Langmuir model, the adsorption constants, such as adsorption capacity and adsorption energy, were found. Pseudo first and second order kinetic models were studied to evaluate the kinetic data.

Operation of Small Radio Telescope (SRT) recorded 21 cm spectral line of Hydrogen at VATLY Laboratory

International Nuclear Information System (INIS)

Pham Ngoc Dong; Pham Tuan Anh; Pham Ngoc Diep; Pham Thi Tuyet Nhung; Nguyen Van Hiep

2013-01-01

A small radio telescope (SRT) has been installed on the roof of the Hanoi astrophysics laboratory VATLY. It is equipped with a 2.6 m diameter mobile parabolic dish remotely controlled in elevation and azimuth and with super-heterodyne detection around the 21 cm hydrogen line. They demonstrate the high quality of the telescope performance and are used to evaluate lobe size, signal to noise ratios, anthropogenic interferences and measurement accuracies. Particular attention is given to the measurement of the pointing accuracy. First results of observations of the Sun and of the centre of the Milky Way are presented. (author)

Increased Visceral Adipose Tissue Is an Independent Predictor for Future Development of Atherogenic Dyslipidemia.

Science.gov (United States)

Hwang, You-Cheol; Fujimoto, Wilfred Y; Hayashi, Tomoshige; Kahn, Steven E; Leonetti, Donna L; Boyko, Edward J

2016-02-01

Atherogenic dyslipidemia is frequently observed in persons with a greater amount of visceral adipose tissue (VAT). However, it is still uncertain whether VAT is independently associated with the future development of atherogenic dyslipidemia. The aim of this study was to determine whether baseline and changes in VAT and subcutaneous adipose tissue (SAT) are associated with future development of atherogenic dyslipidemia independent of baseline lipid levels and standard anthropometric indices. Community-based prospective cohort study with 5 years of follow-up. A total of 452 Japanese Americans (240 men, 212 women), aged 34-75 years were assessed at baseline and after 5 years of follow-up. Abdominal fat areas were measured by computed tomography. Atherogenic dyslipidemia was defined as one or more abnormalities in high-density lipoprotein (HDL) cholesterol, triglycerides, or non-HDL cholesterol levels. Baseline VAT and change in VAT over 5 years were independently associated with log-transformed HDL cholesterol, log-transformed triglyceride, and non-HDL cholesterol after 5 years (standardized β = -0.126, 0.277, and 0.066 for baseline VAT, respectively, and -0.095, 0.223, and 0.090 for change in VAT, respectively). However, baseline and change in SAT were not associated with any future atherogenic lipid level. In multivariate logistic regression analysis, incremental change in VAT (odds ratio [95% confidence interval], 1.73 [1.20-2.48]; P = .003), triglycerides (4.01 [1.72-9.33]; P = .001), HDL cholesterol (0.32 [0.18-0.58]; P dyslipidemia independent of age, sex, diastolic blood pressure, homeostasis model assessment insulin resistance, body mass index (BMI), change in BMI, SAT, and baseline atherogenic lipid levels. Baseline and change in VAT were independent predictors for future development of atherogenic dyslipidemia. However, BMI, waist circumference, and SAT were not associated with future development of atherogenic dyslipidemia.

VAT-69, a software system for gamma spectroscopy

International Nuclear Information System (INIS)

Furr, A.K.; Roscoe, B.A.; Parkinson, T.F.

1979-01-01

The software system was originally developed solely for neutron activation analysis. Its usefulness has been enhanced by adding modules that allow processing of gamma spectra from natural radioisotopes and from fission products. It allows: (1) separation of overlapping peaks, allowing retrieval of a peak of interest in the presence of an interfering peak, (2) calibration of each gamma spectrum for energy and peak width, using criteria based on gamma peak data internal to the individual spectrum, (3) correction for errors due to rapidly changing dead times during the counting interval, permitting accurate count data for samples containing mixed short-, medium-, and long-lived isotopes. One disadvantage of the original software was that it produced more output information than desired. The modifications that have been implemented to produce final concentration values include: (1) computation of a weighted-average concentration of the ith element where two or more gamma peaks are available, (2) rejection of gamma peaks when the difference in energies of the located peak and library peak exceeds a preset value, (3) rejection of concentration values based on gamma peaks which do not satisfy preselected criteria for irradiation time and wait time, (4) computation of the error in concentration of the ith element, and (5) correction of sample concentration for trace elements in the irradiation vials. Overall performance of the software system is checked periodically by analyzing standards. Several thousand spectra are processed each year with VAT-69, with typically 25 to 40 elements quantitatively determined

Surgeons’ Volume-Outcome Relationship for Lobectomies and Wedge Resections for Cancer Using Video-Assisted Thoracoscopic Techniques

Directory of Open Access Journals (Sweden)

Guy David

2012-01-01

Full Text Available This study examined the effect of surgeons’ volume on outcomes in lung surgery: lobectomies and wedge resections. Additionally, the effect of video-assisted thoracoscopic surgery (VATS on cost, utilization, and adverse events was analyzed. The Premier Hospital Database was the data source for this analysis. Eligible patients were those of any age undergoing lobectomy or wedge resection using VATS for cancer treatment. Volume was represented by the aggregate experience level of the surgeon in a six-month window before each surgery. A positive volume-outcome relationship was found with some notable features. The relationship is stronger for cost and utilization outcomes than for adverse events; for thoracic surgeons as opposed to other surgeons; for VATS lobectomies rather than VATS wedge resections. While there was a reduction in cost and resource utilization with greater experience in VATS, these outcomes were not associated with greater experience in open procedures.

C-VAT – Clinical Video game Addiction Test: een diagnostisch instrument voor het herkennen van gameverslaving in de klinische praktijk.

OpenAIRE

Rooij, A.J. van; Duin, L. van; Frielink, N.; DeFuentes-Merillas, L.; Schoenmakers, T.M.

2012-01-01

In de Nederlandse verslavingszorg worden hulpverleners in toenemende mate geconfronteerd met een hulpvraag op het gebied van ‘gameverslaving’. Tot nu toe is er echter geen diagnostisch instrument dat gebruikt kan worden om het probleem goed in kaart te brengen. Dit artikel bespreekt de ontwikkeling van een dergelijk instrument, de Clinical Video game Addiction Test (C-VAT). De lijst bestaat uit drie introductievragen, negen kernvragen en aanbevelingen gericht op het ontdekken van comorbide pr...

Identification of acetates in elasmopalpulus lignosellus pheromone glands using a newly created mass spectral database and kóvats retention indices

OpenAIRE

Jham, Gulab N.; Silva, Alexsandro A. da; Lima, Eraldo R.; Viana, Paulo A.

2007-01-01

Based on a specially created mass spectral database utilizing 23 tetradecenyl and 22 hexadecenyl acetate standards along with Kóvats retention indices obtained on a very polar stationary phase [poly (biscyanopropyl siloxane)] (SP 2340), (Z)-9-hexadecenyl acetate, (Z)-11-hexadecenyl acetate and (E)-8-hexadecenyl acetate were identified in active pheromone extracts of Elasmopalpus lignosellus. This identification was more efficient than our previous study using gas chromatography/mass spectrome...

Dosimetric optimization of worksite involving the installation of VATS containing highly active effluent

International Nuclear Information System (INIS)

Legee, F.; Busani, J.; Madigand, Y.; Pailloux, J.

1996-01-01

Within the framework of safety improvements at the CEA, CEA-FAR, concerned to formalize the ALARA initiative, has carried out for information and training purpose and to create awareness a dosimetric assessment of the worksite where new storage vats for highly active effluents are to be installed. The approach used for this worksite is global. Techniques used were all complementary, ensuring constant elaboration, experiment follow-up and feedback of a worksite at a relatively low dosimetric cost (an estimated 36 men.mSv brought down to 30 men.mSv through implementation of the ALARA principle). This type of global conception of radioprotection involving all the employees (head of project, project managers, companies, radioprotection employees...) which today proves its worth on a modest worksite must now be extended to worksites of a broader scope (several hundreds of men.mSv) where fulfillment of the dosimetric objectives is a major stake. (author)

Clinical validation of the C-VAT 2.0 assessment tool for gaming disorder: A sensitivity analysis of the proposed DSM-5 criteria and the clinical characteristics of young patients with 'video game addiction'.

Science.gov (United States)

van Rooij, Antonius J; Schoenmakers, Tim M; van de Mheen, Dike

2017-01-01

Clinicians struggle with the identification of video gaming problems. To address this issue, a clinical assessment tool (C-VAT 2.0) was developed and tested in a clinical setting. The instrument allows exploration of the validity of the DSM-5 proposal for 'internet gaming disorder'. Using C-VAT 2.0, the current study provides a sensitivity analysis of the proposed DSM-5 criteria in a clinical youth sample (13-23years old) in treatment for video gaming disorder (N=32). The study also explores the clinical characteristics of these patients. The patients were all male and reported spending extensive amounts of time on video games. At least half of the patients reported playing online games (n=15). Comorbid problems were common (n=22) and included (social) anxiety disorders, PDD NOS, ADHD/ADD, Parent-Child relationship problem, and various types of depressive mood problems. The sensitivity of the test was good: results further show that the C-VAT correctly identified 91% of the sample at the proposed cut-off score of at least 5 out of 9 of the criteria. As our study did not include healthy, extreme gamers, we could not assess the specificity of the tool: future research should make this a priority. Using the proposed DSM-5 cut-off score, the C-VAT 2.0 shows preliminary validity in a sample of gamers in treatment for gaming disorder, but the discriminating value of the instrument should be studied further. In the meantime, it is crucial that therapists try to avoid false positives by using expert judgment of functional impairment in each case. Copyright © 2015 Elsevier Ltd. All rights reserved.

Reduce chest pain using modified silicone fluted drain tube for chest drainage after video-assisted thoracic surgery (VATS) lung resection.

Science.gov (United States)

Li, Xin; Hu, Bin; Miao, Jinbai; Li, Hui

2016-02-01

The aim of this study was to assess the feasibility, efficacy and safety of a modified silicone fluted drain tube after video-assisted thoracic surgery (VATS) lung resection. The prospective randomized study included 50 patients who underwent VATS lung resection between March 2015 and June 2015. Eligible patients were randomized into two groups: experimental group (using the silicone fluted drain tubes for chest drainage) and control group (using standard drain tubes for chest drainage). The volume and characteristics of drainage, postoperative (PO) pain scores and hospital stay were recorded. All patients received standard care during hospital admission. In accordance with the exit criteria, three patients were excluded from study. The remaining 47 patients included in the final analysis were divided into two groups: experiment group (N=24) and control group (N=23). There was no significant difference between the two groups in terms of age, sex, height, weight, clinical diagnosis and type of surgical procedure. There was a trend toward less PO pain in experimental group on postoperative day (POD) 1, with a statistically significant difference. Patients in experimental group had a reduced occurrence of fever [temperature (T) >37.4 °C] compared to the control group. The silicone fluted drain tube is feasible and safe and may relieve patient PO pain and reduce occurrence of fever without the added risk of PO complications.

Characterization of a Staphylococcal Plasmid Related to pUB110 and Carrying Two Novel Genes, vatC and vgbB, Encoding Resistance to Streptogramins A and B and Similar Antibiotics

Science.gov (United States)

Allignet, Jeanine; Liassine, Nadia; El Solh, Névine

1998-01-01

We isolated and sequenced a plasmid, named pIP1714 (4,978 bp), which specifies resistance to streptogramins A and B and the mixture of these compounds. pIP1714 was isolated from a Staphylococcus cohnii subsp. cohnii strain found in the environment of a hospital where pristinamycin was extensively used. Resistance to both compounds and related antibiotics is encoded by two novel, probably cotranscribed genes, (i) vatC, encoding a 212-amino-acid (aa) acetyltransferase that inactivates streptogramin A and that exhibits 58.2 to 69.8% aa identity with the Vat, VatB, and SatA proteins, and (ii) vgbB, encoding a 295-aa lactonase that inactivates streptogramin B and that shows 67% aa identity with the Vgb lactonase. pIP1714 includes a 2,985-bp fragment also found in two rolling-circle replication and mobilizable plasmids, pUB110 and pBC16, from gram-positive bacteria. In all three plasmids, the common fragment was delimited by two direct repeats of four nucleotides (GGGC) and included (i) putative genes closely related to repB, which encodes a replication protein, and to pre(mob), which encodes a protein required for conjugative mobilization and site-specific recombination, and (ii) sequences very similar to the double- and single-strand origins (dso, ssoU) and the recombination site, RSA. The antibiotic resistance genes repB and pre(mob) carried by each of these plasmids were found in the same transcriptional orientation. PMID:9661023

Characterization of a staphylococcal plasmid related to pUB110 and carrying two novel genes, vatC and vgbB, encoding resistance to streptogramins A and B and similar antibiotics.

Science.gov (United States)

Allignet, J; Liassine, N; el Solh, N

1998-07-01

We isolated and sequenced a plasmid, named pIP1714 (4,978 bp), which specifies resistance to streptogramins A and B and the mixture of these compounds. pIP1714 was isolated from a Staphylococcus cohnii subsp. cohnii strain found in the environment of a hospital where pristinamycin was extensively used. Resistance to both compounds and related antibiotics is encoded by two novel, probably cotranscribed genes, (i) vatC, encoding a 212-amino-acid (aa) acetyltransferase that inactivates streptogramin A and that exhibits 58.2 to 69.8% aa identity with the Vat, VatB, and SatA proteins, and (ii) vgbB, encoding a 295-aa lactonase that inactivates streptogramin B and that shows 67% aa identity with the Vgb lactonase. pIP1714 includes a 2,985-bp fragment also found in two rolling-circle replication and mobilizable plasmids, pUB110 and pBC16, from gram-positive bacteria. In all three plasmids, the common fragment was delimited by two direct repeats of four nucleotides (GGGC) and included (i) putative genes closely related to repB, which encodes a replication protein, and to pre(mob), which encodes a protein required for conjugative mobilization and site-specific recombination, and (ii) sequences very similar to the double- and single-strand origins (dso, ssoU) and the recombination site, RSA. The antibiotic resistance genes repB and pre(mob) carried by each of these plasmids were found in the same transcriptional orientation.

A systematic review and meta-analysis on the effects of exercise training versus hypocaloric diet: distinct effects on body weight and visceral adipose tissue.

Science.gov (United States)

Verheggen, R J H M; Maessen, M F H; Green, D J; Hermus, A R M M; Hopman, M T E; Thijssen, D H T

2016-08-01

Exercise training ('exercise') and hypocaloric diet ('diet') are frequently prescribed for weight loss in obesity. Whilst body weight changes are commonly used to evaluate lifestyle interventions, visceral adiposity (VAT) is a more relevant and stronger predictor for morbidity and mortality. A meta-analysis was performed to assess the effects of exercise or diet on VAT (quantified by radiographic imaging). Relevant databases were searched through May 2014. One hundred seventeen studies (n = 4,815) were included. We found that both exercise and diet cause VAT loss (P diet versus training, diet caused a larger weight loss (P = 0.04). In contrast, a trend was observed towards a larger VAT decrease in exercise (P = 0.08). Changes in weight and VAT showed a strong correlation after diet (R(2)  = 0.737, P diet showed virtually no change (1.1%). In conclusion, both exercise and diet reduce VAT. Despite a larger effect of diet on total body weight loss, exercise tends to have superior effects in reducing VAT. Finally, total body weight loss does not necessarily reflect changes in VAT and may represent a poor marker when evaluating benefits of lifestyle-interventions. © 2016 World Obesity.

Distribution of abdominal adipose tissue as a predictor of hepatic steatosis assessed by MRI

International Nuclear Information System (INIS)

Ducluzeau, P.-H.; Manchec-Poilblanc, P.; Roullier, V.; Cesbron, E.; Lebigot, J.; Bertrais, S.; Aube, C.

2010-01-01

Aim: To evaluate the relationship between the distribution of visceral and subcutaneous adipose tissue and hepatic steatosis assessed using magnetic resonance imaging (MRI). Materials and methods: One T1-weighted, in-/out-of-phase, single-section sequence at the L3/L4 level and one multi-echo gradient MRI (MGRE) sequence were performed on 65 patients [19 females and 46 males; age 57 ± 9.5 years; body mass index (BMI) 31 ± 5.1 kg/m 2 ]. Visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) surfaces, and hepatic steatosis were automatically calculated using in-house software. Weight, height, BMI, waist circumference, hip circumference, and waist:hip ratio were recorded. The probability of having a steatosis greater than 10% on MRI was evaluated by receiver operating characteristic (ROC) curves. Results: The anthropometric parameter best correlated to hepatic steatosis was the waist-to-hip ratio (r = 0.301). VAT and proportion of VAT were correlated to liver fat content (r = 0.307 and r = 0.249, respectively). No significant correlations were found for BMI, hip circumference, and SAT. The area under the receiver operating characteristics (AUROCs) for the relationship between liver steatosis and BMI, waist circumference, waist:hip ratio, VAT surface, and proportion of VAT, were respectively 0.52, 0.63, 0.71, 0.73 and 0.75. Conclusion: Adipose tissue distribution is more relevant than total fat mass when assessing the possibility of liver steatosis in overweight patients.

Distribution of abdominal adipose tissue as a predictor of hepatic steatosis assessed by MRI

Energy Technology Data Exchange (ETDEWEB)

Ducluzeau, P.-H. [Department of endocrinology-Diabetology-Nutrition, Universitary Hospital of Angers, Faculty of Medicine of Angers (France); Manchec-Poilblanc, P., E-mail: Manchecp@yahoo.f [Department of Radiology, Universitary Hospital of Angers, Faculty of Medicine of Angers (France); Roullier, V. [Department of Radiology, Universitary Hospital of Angers, Faculty of Medicine of Angers (France); LISA, Laboratoire d' Ingenierie des Systemes Automatises, Universitary Hospital of Angers, Faculty of Medicine of Angers (France); Cesbron, E. [Department of digestive and liver disease, Universitary hospital of Angers, Faculty of Medicine of Angers (France); Lebigot, J. [Department of Radiology, Universitary Hospital of Angers, Faculty of Medicine of Angers (France); Bertrais, S. [HIFIH Laboratory, UPRES EA 3859, IFR 132, Universitary Hospital of Angers, Faculty of Medicine of Angers (France); Aube, C. [Department of Radiology, Universitary Hospital of Angers, Faculty of Medicine of Angers (France); HIFIH Laboratory, UPRES EA 3859, IFR 132, Universitary Hospital of Angers, Faculty of Medicine of Angers (France)

2010-09-15

Aim: To evaluate the relationship between the distribution of visceral and subcutaneous adipose tissue and hepatic steatosis assessed using magnetic resonance imaging (MRI). Materials and methods: One T1-weighted, in-/out-of-phase, single-section sequence at the L3/L4 level and one multi-echo gradient MRI (MGRE) sequence were performed on 65 patients [19 females and 46 males; age 57 {+-} 9.5 years; body mass index (BMI) 31 {+-} 5.1 kg/m{sup 2}]. Visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) surfaces, and hepatic steatosis were automatically calculated using in-house software. Weight, height, BMI, waist circumference, hip circumference, and waist:hip ratio were recorded. The probability of having a steatosis greater than 10% on MRI was evaluated by receiver operating characteristic (ROC) curves. Results: The anthropometric parameter best correlated to hepatic steatosis was the waist-to-hip ratio (r = 0.301). VAT and proportion of VAT were correlated to liver fat content (r = 0.307 and r = 0.249, respectively). No significant correlations were found for BMI, hip circumference, and SAT. The area under the receiver operating characteristics (AUROCs) for the relationship between liver steatosis and BMI, waist circumference, waist:hip ratio, VAT surface, and proportion of VAT, were respectively 0.52, 0.63, 0.71, 0.73 and 0.75. Conclusion: Adipose tissue distribution is more relevant than total fat mass when assessing the possibility of liver steatosis in overweight patients.

Relationship between vaspin gene expression and abdominal fat distribution of Korean women

International Nuclear Information System (INIS)

Lee, Jin-A; Park, Hye-Soon; Song, Young-Sook; Jang, Yeon-Jin; Kim, Jong-Hyeok; Lee, Yeon-Ji; Heo, Yoon-Suk

2011-01-01

Visceral adipose tissue-derived serpin (vaspin) is a novel adipokine that is thought to have insulin-sensitizing effects. We investigated vaspin mRNA expression in abdominal adipose tissue and examined how gene expression related to abdominal fat distribution and metabolic parameters in Korean women. We measured anthropometric variables, metabolic parameters, serum vaspin concentration, and vaspin mRNA expression in abdominal adipose tissue obtained from women who underwent abdominal gynecological surgery and were aged 18-67 years (n=85). Visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) area were measured in 40 subjects using computed tomography (CT). Vaspin expression was analyzed by real-time quantitative radiotherapy-polymerase chain reaction (RT-PCR) according to abdominal fat distribution. Vaspin mRNA expression was greater in adipocytes than in stroma/vascular cells. In the total subjects, vaspin expression was significantly higher in SAT than in VAT. Vaspin expression in SAT in subcutaneous fat type (VSR ≤0.3) was significantly higher than in visceral fat type (VSR >0.3), although vaspin expression in VAT was similar between subcutaneous and visceral fat type. There was a significant negative correlation between vaspin expression in SAT and VAT area (r=-0.55, p=0.001). Serum vaspin concentration was significantly correlated with fasting insulin (r=0.30, p=0.02), homeostasis model assessment-insulin resistance (HOMA-IR) (r=0.29, p=0.02), and the ratio of vaspin expression in VAT to vaspin expression in SAT (r=0.41, p=0.04). Vaspin expression in abdominal adipose tissue was adipocyte-specific and vaspin expression in SAT decreased as VAT area increased. (author)

Visceral Adipose Tissue Is Associated With Bone Microarchitecture in the Framingham Osteoporosis Study.

Science.gov (United States)

Liu, Ching-Ti; Broe, Kerry E; Zhou, Yanhua; Boyd, Steven K; Cupples, L Adrienne; Hannan, Marian T; Lim, Elise; McLean, Robert R; Samelson, Elizabeth J; Bouxsein, Mary L; Kiel, Douglas P

2017-01-01

Obesity has been traditionally considered to protect the skeleton against osteoporosis and fracture. Recently, body fat, specifically visceral adipose tissue (VAT), has been associated with lower bone mineral density (BMD) and increased risk for some types of fractures. We studied VAT and bone microarchitecture in 710 participants (58% women, age 61.3 ± 7.7 years) from the Framingham Offspring cohort to determine whether cortical and trabecular BMD and microarchitecture differ according to the amount of VAT. VAT was measured from CT imaging of the abdomen. Cortical and trabecular BMD and microarchitecture were measured at the distal tibia and radius using high-resolution peripheral quantitative computed tomography (HR-pQCT). We focused on 10 bone parameters: cortical BMD (Ct.BMD), cortical tissue mineral density (Ct.TMD), cortical porosity (Ct.Po), cortical thickness (Ct.Th), cortical bone area fraction (Ct.A/Tt.A), trabecular density (Tb.BMD), trabecular number (Tb.N), trabecular thickness (Tb.Th), total area (Tt.Ar), and failure load (FL) from micro-finite element analysis. We assessed the association between sex-specific quartiles of VAT and BMD, microarchitecture, and strength in all participants and stratified by sex. All analyses were adjusted for age, sex, and in women, menopausal status, then repeated adjusting for body mass index (BMI) or weight. At the radius and tibia, Ct.Th, Ct.A/Tt.A, Tb.BMD, Tb.N, and FL were positively associated with VAT (all p-trend <0.05), but no other associations were statistically significant except for higher levels of cortical porosity with higher VAT in the radius. Most of these associations were only observed in women, and were no longer significant when adjusting for BMI or weight. Higher amounts of VAT are associated with greater BMD and better microstructure of the peripheral skeleton despite some suggestions of significant deleterious changes in cortical measures in the non-weight bearing radius. Associations were

The Impact of Value Added Tax on the North Cyprus Economy: A Short Term Assessment = Katma Değer Vergisinin Kuzey Kıbrıs Ekonomisi Üzerine Etkisi : Kısa Dönem Değerlendirmesi

Directory of Open Access Journals (Sweden)

Abdul GHAFOOR

2005-01-01

Full Text Available Value added tax was introduced in North Cyprus in 1996 to increase public revenue as well as to harmonize with Turkey and EU member countries. It is however evident that the budget deficit has rather increased after the introduction of VAT. The literature argues that VAT not only has potential to generate enough revenue to reduce the budget deficit but also encourages savings and investments. The question is why could North Cyprus not achieve these objectives? The present study was designed to answer this question. It evaluates the impact of VAT on the North Cyprus economy by using several macroeconomic variables such as total consumption, total domestic savings, public, private and total investments, government purchases, exports and imports. The impact of VAT has been studied through simple regression techniques with dummy variable for policy change.

A new possibility in thoracoscopic virtual reality simulation training

DEFF Research Database (Denmark)

Jensen, Katrine; Bjerrum, Flemming; Hansen, Henrik Jessen

2015-01-01

OBJECTIVES: The aims of this study were to develop virtual reality simulation software for video-assisted thoracic surgery (VATS) lobectomy, to explore the opinions of thoracic surgeons concerning the VATS lobectomy simulator and to test the validity of the simulator metrics. METHODS: Experienced...... VATS surgeons worked with computer specialists to develop a VATS lobectomy software for a virtual reality simulator. Thoracic surgeons with different degrees of experience in VATS were enrolled at the 22nd meeting of the European Society of Thoracic Surgeons (ESTS) held in Copenhagen in June 2014...... content validity. Metrics were compared between the three groups. RESULTS: We succeeded in developing the first version of a virtual reality VATS lobectomy simulator. A total of 103 thoracic surgeons completed the simulated lobectomy and were distributed as follows: novices n = 32, intermediates n = 45...

Predominance of Abdominal Visceral Adipose Tissue Reflects the Presence of Aortic Valve Calcification.

Science.gov (United States)

Oikawa, Masayoshi; Owada, Takashi; Yamauchi, Hiroyuki; Misaka, Tomofumi; Machii, Hirofumi; Yamaki, Takayoshi; Sugimoto, Koichi; Kunii, Hiroyuki; Nakazato, Kazuhiko; Suzuki, Hitoshi; Saitoh, Shu-Ichi; Takeishi, Yasuchika

2016-01-01

Background. Aortic valve calcification (AVC) is a common feature of aging and is related to coronary artery disease. Although abdominal visceral adipose tissue (VAT) plays fundamental roles in coronary artery disease, the relationship between abdominal VAT and AVC is not fully understood. Methods. We investigated 259 patients who underwent cardiac and abdominal computed tomography (CT). AVC was defined as calcified lesion on the aortic valve by CT. %abdominal VAT was calculated as abdominal VAT area/total adipose tissue area. Results. AVC was detected in 75 patients, and these patients showed higher %abdominal VAT (44% versus 38%, p AVC. When the cutoff value of %abdominal VAT was set at 40.9%, the area under the curve to diagnose AVC was 0.626. Multivariable logistic regression analysis showed that age (OR 1.120, 95% CI 1.078-1.168, p AVC. The net reclassification improvement value for detecting AVC was increased when %abdominal VAT was added to the model: 0.5093 (95% CI 0.2489-0.7697, p AVC.

Cyclic method for the fermentation of starch raw material in the Romadanovsk alcohol plant

Energy Technology Data Exchange (ETDEWEB)

Naumenko, I I; Basharin, I I; Pol' gin, I V

1958-01-01

Fermentation vats (volume 32 cu.m.) were connected in 2 series of 4 vats communicating by flow pipes supplied with cut-off valves. The main wort conduit was supplied with a 3-way valve connected with a bent pipe joint, by means of which the 3-way valve could be turned to any of the vats. Fermentation took place alternately, each vat series being filled for 24 hours with wort after yeast had been added. Fermentation in the main vat continued for 38 hours and in the others for 20 hours. Draining the finished brew and the preparation of the vats for the next fermentation began from the 4th vat, which in the following cycle, became the main vat. Fermentation took place with satisfactory acidity-increase indexes (less than or equal to 0.20 D.), with wastes no greater than expected, and with an alcohol yield of 100.2 to 100.3% of that expected from 1 ton of starch. The advantages of the cyclic method are a decrease in the fermentation time and a more complete fermentation of sugar; the method can thus be recommended for fermentation plants which have an insufficient productivity as a method which does not require many repairs or much expense. A flow sheet of the process and the design of the distributing pipes are given.

Comparison of posterolateral thoracotomy and video-assisted thoracoscopic clipping for the treatment of patent ductus arteriosus in neonates and infants.

Science.gov (United States)

Chen, Haiyu; Weng, Guoxing; Chen, Zhiqun; Wang, Huan; Xie, Qi; Bao, Jiayin; Xiao, Rongdong

2011-04-01

This study was designed to compare the long-term clinical outcomes and costs between video-assisted thoracic surgery (VATS) and posterolateral thoracotomy (PT) in neonates and infants. This study enrolled 302 patients with isolated patent ductus arteriosus (PDA) from January 2002 to 2007 and followed them up until April 2010. A total of 134 patients underwent total VATS (VATS group), and 168 underwent PDA closure through PT (PT group). The two groups were compared according to clinical outcomes and costs. The demographics and preoperative clinical characteristics of the patients were similar in the two groups. No cardiac deaths occurred, and the closure rate was 100% successful in both groups. The operating, recovery, and pleural fluid drainage times were significantly shorter in the VATS group than in the PT group. Statistically significant differences in length of incision, postoperative temperature, and acute procedure-related complications were observed between the two groups. The cost was $1,150.3 ± $221.2 for the VATS group and $2415.8 ± $345.2 for the PT group (P ventricular end-diastolic diameter and the pulmonary artery diameter could be restored to normal in the VATS group but not in the PT group. The study confirmed that VATS offers a minimally traumatic, safe, and effective technique for PDA interruption in neonates and infants.

Elektronik Ticaretin Vergilendirilmesine İlişkin Türk Vergi Sisteminde Katma Değer Vergisi Açısından Bir Değerlendirme(An Evaluation of Taxation of Electronic Commerce Under Turkish Tax System According to Value Added Tax (VAT

Directory of Open Access Journals (Sweden)

Yunus CERAN

2007-01-01

Full Text Available The development of internet has brought e-commerce to front as a new and contemporary instrument that enables to trade effectively and efficiently. However, because of extensive acceptance of internet in trade-life, the unusual ways of commerce and distribution channels have emerged and this has caused serious problems in taxation of e-commerce processes. Most of these problems are about the differences of taxation systems in different countries like how to evaluate the value added tax (VAT or how to tax the web-based incomes, etc. The solution of all these internet-related problems is about to be solved by OECD. In addition, EU mostly involves with taxation of VAT.

Robotic surgery, video-assisted thoracic surgery, and open surgery for early stage lung cancer: comparison of costs and outcomes at a single institute.

Science.gov (United States)

Novellis, Pierluigi; Bottoni, Edoardo; Voulaz, Emanuele; Cariboni, Umberto; Testori, Alberto; Bertolaccini, Luca; Giordano, Laura; Dieci, Elisa; Granato, Lorenzo; Vanni, Elena; Montorsi, Marco; Alloisio, Marco; Veronesi, Giulia

2018-02-01

Robotic surgery is increasingly used to resect lung cancer. However costs are high. We compared costs and outcomes for robotic surgery, video-assisted thoracic surgery (VATS), and open surgery, to treat non-small cell lung cancer (NSCLC). We retrospectively assessed 103 consecutive patients given lobectomy or segmentectomy for clinical stage I or II NSCLC. Three surgeons could choose VATS or open, the fourth could choose between all three techniques. Between-group differences were assessed by Fisher's exact, two-way analysis of variance (ANOVA), and Wilcoxon-Mann-Whitney test. P values open surgery. Age, physical status, pulmonary function, comorbidities, stage, and perioperative complications did not differ between the groups. Pathological tumor size was greater in the open than VATS and robotic groups (P=0.025). Duration of surgery was 150, 191 and 116 minutes, by robotic, VATS and open approaches, respectively (Popen groups. Estimated costs were 82%, 68% and 69%, respectively, of the regional health service reimbursement for robotic, VATS and open approaches. Robotic surgery for early lung cancer was associated with shorter stay and more extensive lymph node dissection than VATS and open surgery. Duration of surgery was shorter for robotic than VATS. Although the cost of robotic thoracic surgery is high, the hospital makes a profit.

Identification of acetates in elasmopalpulus lignosellus pheromone glands using a newly created mass spectral database and kóvats retention indices

Directory of Open Access Journals (Sweden)

Gulab N. Jham

2007-08-01

Full Text Available Based on a specially created mass spectral database utilizing 23 tetradecenyl and 22 hexadecenyl acetate standards along with Kóvats retention indices obtained on a very polar stationary phase [poly (biscyanopropyl siloxane] (SP 2340, (Z-9-hexadecenyl acetate, (Z-11-hexadecenyl acetate and (E-8-hexadecenyl acetate were identified in active pheromone extracts of Elasmopalpus lignosellus. This identification was more efficient than our previous study using gas chromatography/mass spectrometry with a dimethyl disulfide derivative where we could only identify the first two acetates. The acetate composition of the pheromone gland differed from region to region in Brazil and from that from the Tifton (GA, USA population, suggesting polymorphism or a different sub-species.

Validity of a new abdominal bioelectrical impedance device to measure abdominal and visceral fat: comparison with MRI

OpenAIRE

Browning, Lucy M; Mugridge, Owen; Chatfield, Mark; Dixon, Adrian; Aitken, Sri; Joubert, Ilse; Prentice, Andrew M.; Jebb, Susan A

2010-01-01

Abdominal fat, and in particular, visceral adipose tissue (VAT), is the critical fat depot associated with metabolic aberrations. At present VAT can only be accurately measured by computed tomography (CT) or magnetic resonance imaging (MRI). This study was designed to compare a new abdominal bioelectrical impedance device against total abdominal adipose tissue (TAAT) and VAT area measurements made from an abdominal MRI scan, and to assess it’s reliability and accuracy.

Clinical validation of the C-VAT 2.0 assessment tool for gaming disorder: a sensitivity analysis of the proposed DSM-5 criteria and the clinical characteristics of young patients with ‘video game addiction’.

NARCIS (Netherlands)

Rooij, A.J. van; Schoenmakers, T.M.; Mheen, D. van de

2017-01-01

Aims: Clinicians struggle with the identification of video gaming problems. To address this issue, a clinical assessment tool (C-VAT 2.0) was developed and tested in a clinical setting. The instrument allows exploration of the validity of the DSM-5 proposal for ‘internet gaming disorder’. Method:

Ergon-trial: ergonomic evaluation of single-port access versus three-port access video-assisted thoracic surgery.

Science.gov (United States)

Bertolaccini, Luca; Viti, Andrea; Terzi, Alberto

2015-10-01

Single-port access video-assisted thoracic surgery (VATS), a technique progressively developed from the standard three-port approach in minimally invasive surgery, offers ergonomic advantages but also new challenges for the surgeon. We compared the ergonomics of three-port versus single-port VATS. Posture analysis of surgeons was evaluated during 100 consecutive VATS wedge resections (50 triportal vs. 50 uniportal). Technically demanding procedures (major lung resection) were excluded. Operating table height, monitor height, distance and inclination were adjusted according to operator preference. Body posture was assessed by measuring head-trunk axial rotation and head flexion. Perceived physical strain was self-evaluated on the Borg Category Ratio (CR-10) scale. Mental workload was assessed with the National Aeronautics Space Administration-Task Load indeX (NASA-TLX), a multidimensional tool that rates workloads on six scales (mental, physical and temporal demand; effort; performance; frustration). All procedures were completed without complications. Head-trunk axial rotation was significantly reduced and neck flexion significantly improved in uniportal VATS. Viewing direction significantly declined (p = 0.01), body posture as measured on the Borg CR-10 scale was perceived as more stressful and the NASA-TLX score for overall workload was higher (p = 0.04) during triportal VATS. The NASA-TLX score for frustration was higher with uniportal VATS (p = 0.02), but the score for physical demand was higher in triportal VATS (p = 0.006). The surgeon can maintain a more neutral body posture during uniportal VATS by standing straight and facing the monitor with only minimal neck extension/rotation; however, frustration is greater than with triportal VATS.

Plerixafor mobilization leads to a lower ratio of CD34+ cells to total nucleated cells which results in greater storage costs.

Science.gov (United States)

Tanhehco, Yvette C; Adamski, Jill; Sell, Mary; Cunningham, Kathleen; Eisenmann, Christa; Magee, Deborah; Stadtmauer, Edward A; O'Doherty, Una

2010-01-01

Plerixafor (Mozobil, AMD3100) with granulocyte-colony stimulating factor (G-CSF) mobilizes more CD34+ cells/kg compared to G-CSF alone. Given that plerixafor enhances mobilization of multiple white blood cell lineages, we determined if more storage space is required for products collected from patients mobilized with plerixafor. A review of the medical records of 15 patients mobilized with chemotherapy and G-CSF (control) and 14 patients mobilized with plerixafor plus G-CSF (plerixafor) was performed. Data on demographics, baseline characteristics, CD34+ cells/kg, total nucleated cells, total mononuclear cells, total apheresis sessions, and total bags for storage were collected. Mean values were determined and compared using Student's t-test. We found that the proportion of CD34+ cells among total nucleated cells was less in the plerixafor group compared to the control group (P = 0.0427). More nucleated cells (10.7 x 10(10) vs. 7.1 x 10(10), P =0.0452) and mononuclear cells (9.7 x 10(10) vs. 5.9 x 10(10), P = 0.0059) were mobilized with plerixafor plus G-CSF. However, there was no significant difference in CD34+ cells/kg, total CD34+ cells or the proportion of mononuclear cells among total nucleated cells between the two groups. More storage bags were required for the plerixafor group compared to the control group (15 vs. 9, P = 0.0299). Mobilization with plerixafor plus G-CSF resulted in a smaller proportion of CD34+ cells collected and a greater number of storage bags. An increase in the number of bags required for stem cell storage may be logistically problematic and will also lead to increased costs for storage of stem cells.

The influence of prior multiport experience on the learning curve for single-port thoracoscopic lobectomy: a multicentre comparative study†.

Science.gov (United States)

Martin-Ucar, Antonio E; Aragon, Javier; Bolufer Nadal, Sergio; Galvez Munoz, Carlos; Luo, Qigang; Perez Mendez, Itzel; Sihoe, Alan D L; Socci, Laura

2017-06-01

Competency in video-assisted thoracoscopic (VATS) lobectomy is estimated to be reached after the surgeon completes 50 cases. We wanted to explore the impact of competency in performing multiport VATS lobectomies on completing the needed number of single-port VATS. In a retrospective multicentre study, 6 individual surgeons (3 with previous competency in multiport VATS lobectomy and 3 without) submitted their first 50 cases of single-port VATS lobectomies. Extended and sublobar resections were excluded. Pre-, peri- and postoperative data were compared between the groups of surgeons. Chi-square and Wilcoxon's rank tests were used. The less experienced surgeons had previously attended dedicated training courses and visited with experts. A total of 300 cases were included [150 in Group A (surgeons with previous experience performing multiport VATS) and 150 in Group B (surgeons without extensive experience performing multiport VATS)]. Surgeons in Group B performed significantly more elective open lobectomies during their learning curve period than surgeons of Group A (58 vs 1). Patients in Group B were older and had more risk factors. There were 3 in-hospital deaths (respiratory failure, sepsis and fatal stroke). There were no differences between the groups in operative time, intensive care unit admissions, hospital stay, total complications, tumour size or number of N2 stations explored. Only the duration of intercostal drainage (2 vs 3 days, 0.012), incidence of respiratory tract infections (1% vs 7%, P  = 0.002) and conversion rates (4% vs 12%, P  = 0.018) were better in Group A. Patients characteristics played a role in the development of respiratory infections and longer drainage times but not in the need for conversion. Overall, postoperative outcomes during the learning curve period for single-port VATS lobectomies are not noticeably affected by previous multiport VATS experience. Less experienced surgeons were more selective in order to achieve

Race differences in obesity and its relationship to the sex hormone milieu.

Science.gov (United States)

Perry, Arlette C; Martin, Lorena

2014-09-01

A sexual dimorphism exists in which increased abdominal and visceral adipose tissue (VAT) - found in women and marked by low sex hormone binding globulin (SHBG) and high bioavailable testosterone (BT) - is related to the metabolic risk profile. In men, increased BT is related to decreased abdominal obesity and a decrease in the metabolic risk profile. In women, race differences have been found in androgenic sex steroids including SHBG and BT as well as central fat distribution, creating inherently greater metabolic risk for certain populations. Estrogen and estrogen receptor isoforms play a role in fat deposition and distribution and may influence the changes that occur during the menopausal transition. Androgenic sex steroids serve a mediating role, influencing VAT accumulation and its associated metabolic risk factors while VAT also serves a mediating role influencing the androgenic sex steroid-metabolic risk relationship in women. Furthermore, androgenic sex steroids and VAT may independently contribute to the variance in several metabolic variables associated with cardiovascular disease, type 2 diabetes, and their antecedent conditions such as the metabolic syndrome. Race has been shown to modify the relationship between androgenic sex steroids and metabolic variables associated with risk for diabetes in Black and White women. Further research is warranted to examine the mechanisms involved in race differences. Total adiposity and central fat distribution in accordance with changes in the hormone and metabolic milieu influence breast cancer risk, which varies by race and menopausal status. These findings have broader implications for the study of health promotion/disease prevention in women.

Saccharin and aspartame, compared with sucrose, induce greater weight gain in adult Wistar rats, at similar total caloric intake levels.

Science.gov (United States)

Feijó, Fernanda de Matos; Ballard, Cíntia Reis; Foletto, Kelly Carraro; Batista, Bruna Aparecida Melo; Neves, Alice Magagnin; Ribeiro, Maria Flávia Marques; Bertoluci, Marcello Casaccia

2013-01-01

It has been suggested that the use of nonnutritive sweeteners (NNSs) can lead to weight gain, but evidence regarding their real effect in body weight and satiety is still inconclusive. Using a rat model, the present study compares the effect of saccharin and aspartame to sucrose in body weight gain and in caloric intake. Twenty-nine male Wistar rats received plain yogurt sweetened with 20% sucrose, 0.3% sodium saccharin or 0.4% aspartame, in addition to chow and water ad libitum, while physical activity was restrained. Measurements of cumulative body weight gain, total caloric intake, caloric intake of chow and caloric intake of sweetened yogurt were performed weekly for 12 weeks. Results showed that addition of either saccharin or aspartame to yogurt resulted in increased weight gain compared to addition of sucrose, however total caloric intake was similar among groups. In conclusion, greater weight gain was promoted by the use of saccharin or aspartame, compared with sucrose, and this weight gain was unrelated to caloric intake. We speculate that a decrease in energy expenditure or increase in fluid retention might be involved. Copyright © 2012 Elsevier Ltd. All rights reserved.

Inspection with non destructive assay techniques of the aluminium coating of the TRIGA Mark III reactor vat

International Nuclear Information System (INIS)

Reyes A, A.I.; Gonzalez M, A.; Castaneda J, G.; Rivera M, H.; Sandoval G, I.

2001-01-01

In June 2000, the Reactor Department assigned to the Scientific Research Direction of the National Institute of Nuclear Research requested to the Non-destructive Assays Laboratory (LEND), assigned to the Materials Science Management, the inspection and measurement of thickness of the aluminium coating (liner) of the TRIGA Mark III reactor vat with non-destructive assay techniques, due to that the aluminium coating is exposed mainly to undergo slimming on its back side due to corrosion phenomena. Activity that was able to be carried out from april until august 2001. It is worth pointing out that this type of inspection with these techniques was realized by first time. The non-destructive assays (NDA) are techniques which use indirect physical methods for inspecting the sanitation of components in process or in service, for detect lack of continuity or defects which affect their quality or usefulness. The application of those do not alter the physical, chemical, mechanical or dimensional properties of the part subject of inspection. The results of the application of the ultrasound inspection techniques, industrial radiography and penetrating liquids are presented. (Author)

Anesthesia and fast-track in video-assisted thoracic surgery (VATS): from evidence to practice.

Science.gov (United States)

Umari, Marzia; Falini, Stefano; Segat, Matteo; Zuliani, Michele; Crisman, Marco; Comuzzi, Lucia; Pagos, Francesco; Lovadina, Stefano; Lucangelo, Umberto

2018-03-01

In thoracic surgery, the introduction of video-assisted thoracoscopic techniques has allowed the development of fast-track protocols, with shorter hospital lengths of stay and improved outcomes. The perioperative management needs to be optimized accordingly, with the goal of reducing postoperative complications and speeding recovery times. Premedication performed in the operative room should be wisely administered because often linked to late discharge from the post-anesthesia care unit (PACU). Inhalatory anesthesia, when possible, should be preferred based on protective effects on postoperative lung inflammation. Deep neuromuscular blockade should be pursued and carefully monitored, and an appropriate reversal administered before extubation. Management of one-lung ventilation (OLV) needs to be optimized to prevent not only intraoperative hypoxemia but also postoperative acute lung injury (ALI): protective ventilation strategies are therefore to be implemented. Locoregional techniques should be favored over intravenous analgesia: the thoracic epidural, the paravertebral block (PVB), the intercostal nerve block (ICNB), and the serratus anterior plane block (SAPB) are thoroughly reviewed and the most common dosages are reported. Fluid therapy needs to be administered critically, to avoid both overload and cardiovascular compromisation. All these practices are analyzed singularly with the aid of the most recent evidences aimed at the best patient care. Finally, a few notes on some of the latest trends in research are presented, such as non-intubated video-assisted thoracoscopic surgery (VATS) and intravenous lidocaine.

Characterization of a Staphylococcal Plasmid Related to pUB110 and Carrying Two Novel Genes, vatC and vgbB, Encoding Resistance to Streptogramins A and B and Similar Antibiotics

OpenAIRE

Allignet, Jeanine; Liassine, Nadia; El Solh, Névine

1998-01-01

We isolated and sequenced a plasmid, named pIP1714 (4,978 bp), which specifies resistance to streptogramins A and B and the mixture of these compounds. pIP1714 was isolated from a Staphylococcus cohnii subsp. cohnii strain found in the environment of a hospital where pristinamycin was extensively used. Resistance to both compounds and related antibiotics is encoded by two novel, probably cotranscribed genes, (i) vatC, encoding a 212-amino-acid (aa) acetyltransferase that inactivates streptogr...

Association of ectopic fat with abdominal aorto-illiac and coronary artery calcification in african ancestry men.

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Kuipers, Allison L; Zmuda, Joseph M; Carr, J Jeffrey; Terry, James G; Nair, Sangeeta; Cvejkus, Ryan; Bunker, Clareann H; Patrick, Alan L; Wassel, Christina L; Miljkovic, Iva

2017-08-01

There is strong evidence that fat accumulating in non-adipose sites, "ectopic fat", is associated with cardiovascular disease (CVD), including vascular calcification. Most previous studies of this association have assessed only a single ectopic fat depot. Therefore, our aim was to assess the association of total, regional, and ectopic fat with abdominal aorto-illiac calcification (AAC) and coronary artery calcification (CAC) in 798 African ancestry men. Participants (mean age 62) were from the Tobago Bone Health Study cohort. Adiposity was assessed via clinical examination, dual x-ray absorptiometry, and computed tomography (CT). Ectopic fat depots included: abdominal visceral adipose tissue (VAT), liver attenuation, and calf intermuscular adipose tissue (IMAT). Vascular calcification was assessed by CT and quantified as present versus absent. Associations were tested using multiple logistic regression adjusted for traditional cardiovascular risk factors. Models of ectopic fat were additionally adjusted for total body fat and standing height. All adiposity measures, except VAT, were associated with AAC. Lower liver attenuation or greater calf IMAT was associated with 1.2-1.3-fold increased odds of AAC (p fat measure was associated with CAC. Greater adiposity in the skeletal muscle and liver, but not in the visceral compartment, was associated with increased odds of AAC in African ancestry men. These results highlight the potential importance of both quantity and location of adiposity accumulation throughout the body. Copyright © 2017 Elsevier B.V. All rights reserved.

Radioactivity levels in well water supplies within the greater Chicago area

International Nuclear Information System (INIS)

Kristoff, L.M.; Lordi, D.T.; Lue-Hing, C.

1976-01-01

The radiological analysis of well water supplies within the geographical boundaries of the Metropolitan Sanitary District of Greater Chicago was prompted by the relatively high total alpha levels encountered in wastewaters of a MSDGC water reclamation plant as compared to the wastewaters of the other waste treatment plants. Consequently, 87 wells constituting 42 water supplies were sampled and analyzed for total alpha and beta radioactivity. The wells were grouped according to depth. In general, both total alpha and total beta radioactivity concentrations were found to be a function of well depth. The relatively higher total alpha and beta activities in the wastewaters to one of the treatment plants was attributed to the higher levels found in the well water supply. Comparison with the USEPA's Drinking Water Regulations for Radionuclides (July 9, 1976) showed the maximum total alpha level of 15 pCi/liter was exceeded in 3 wells and 32 of the deep well waters had total alpha level greater than 5 pCi/liter. The total beta level of 50 pCi/liter was exceeded in 8 wells

Selected Aspects of the Copenhagen Economics Study on Reduced VAT Rates in the Current Conditions of the Moravian-Silesian Region

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Kateřina Randová

2012-01-01

Full Text Available This paper deals with a long-debated issue of the application of value added tax rates to labour-intensive services. The level of value added tax rates has a dominant influence on the tax liability of suppliers of these services and subsequently on the amount of available funds that they could use for development of their business. The aim of this paper is a presentation of results of the student grant Quantification of Impacts of Application of Reduced Value Added Tax Rate to Locally Supplied Services on the Suppliers of these Services”, which is focused on selected aspects of the “Study on reduced VAT applied to goods and services in the Member States of the European Union” in the conditions of the providers of these services from the Moravian-Silesian Region. For this paper the methods of regression analysis and analysis of variance – ANOVA were used. The deductive method and method of analysis have also been used.

Transitioning from video-assisted thoracic surgical lobectomy to robotics for lung cancer: are there outcomes advantages?

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Lee, Benjamin E; Korst, Robert J; Kletsman, Elaine; Rutledge, John R

2014-02-01

To determine if there are advantages to transitioning to robotics by a surgeon who is already proficient in performing video-assisted thoracic surgical (VATS) lobectomy. A single surgeon proficient in VATS lobectomy initiated a robotic lobectomy program, and a retrospective review was conducted of his patients undergoing minimally invasive lobectomy (robotics or VATS) for lung cancer between 2011 and 2012. Data collected included patient/tumor characteristics, morbidity, mortality, operative times, and length of hospital stay. Over a 24-month period, a total of 69 patients underwent minimally invasive lobectomy (35 robotic, 34 VATS). Patients in each group were similar in age and clinical stage. Robotic upper lobectomy operative times were longer than VATS (172 vs 134 minutes; P = .001), with no significant difference in lower lobectomies noted (140 vs 123 minutes; P = .1). Median length of stay was 3 days in both groups, and the median number of lymph nodes harvested was 18 (robotic) versus 16 (VATS; P = .42). Morbidity and mortality for robotic versus VATS were 11% versus 18% (P = .46) and 0% versus 3% (P = .49), respectively. There does not seem to be a significant advantage for an established VATS lobectomy surgeon to transition to robotics based on clinical outcomes. The learning curve for robotic upper lobectomies seems to be more significant than that for lower lobectomies. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Expectativas y satisfacción en el tratamiento del neumotórax espontáneo primario recurrente tratado por toracotomía o cirugía torácica video-asistida Expectations and patient satisfaction related to the use of thoracotomy and video-assisted thoracoscopic surgery for treating recurrence of spontaneous primary pneumothorax

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Jorge Ramón Lucena Olavarrieta

2009-02-01

Full Text Available OBJETIVO: Comparar los resultados de la toracotomía con la video-assisted thoracoscopic surgery (VATS, cirugía torácica video-asistida en el tratamiento de las recurrencias del neumotórax espontáneo primario. MÉTODOS: Se revisaron los expedientes clínicos de los pacientes con neumotórax primario recurrente dividiéndose en dos grupos: pacientes sometidos a toracotomía (n = 53, grupo toracotomía y pacientes sometidos a VATS (n = 47, grupo VATS. RESULTADOS: La morbilidad fue mayor en el grupo A. Sin mortalidad en ninguno de los dos grupos. La duración de la hospitalización fue similar. Los pacientes del grupo toracotomía necesitaron más dosis de narcóticos durante períodos más largos de tiempo que los del grupo VATS (p OBJECTIVE: To compare the outcomes of thoracotomy and video-assisted thoracoscopic surgery (VATS in the treatment of recurrence of primary spontaneous pneumothorax. METHODS: Medical records of patients presenting recurrence of primary spontaneous pneumothorax were retrospectively reviewed. Patients were divided into two groups: those who underwent conservative thoracotomy (n = 53, thoracotomy group; and those who underwent VATS (n = 47, VATS group. RESULTS: Although there were no deaths in either group and the length of hospital stays was similar between the two, there was greater morbidity in the thoracotomy group. Patients in the thoracotomy group required more pain medication for longer periods than did those in the VATS group (p < 0.05. In the thoracotomy group, the rate of recurrence was 3%. Pain was classified as insignificant at one month after the operation by 68% of patients in the VATS group and by only 21% of those in the thoracotomy group (p < 0.05. At three years after the surgical procedure, 97% of the VATS group patients considered themselves completely recovered from the operation, compared with only 79% in the thoracotomy group (p < 0.05. Chronic or intermittent pain, requiring the use of analgesics

Fast-track rehabilitation following video-assisted pulmonary sublobar wedge resection: A prospective randomized study

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Christos Asteriou

2016-01-01

Full Text Available Background: Postoperative morbidity and inhospital length of stay are considered major determinants of total health care expenditure associated with thoracic operations. The aim of this study was to prospectively evaluate the role of video-assisted thoracic surgery (VATS compared to mini-muscle-sparing thoracotomy in facilitating early recovery and hospital discharge after pulmonary sublobar wedge resections. Patients and Methods: A total number of 120 patients undergoing elective pulmonary sublobar wedge resection were randomly assigned to VATS (n = 60 or mini-muscle-sparing thoracotomy (n = 60. The primary endpoint was time to hospital discharge. Postoperative complications, cardiopulmonary morbidity and 30-day mortality served as secondary endpoints. Results: Patients' baseline demographic and clinical data did not differ among study arms as well as the number of pulmonary segments resected and the morphology of the nodular lesions. Total hospital stay was significantly shorter in patients assigned to the thoracoscopic technique as opposed to those who were operated using the mini-muscle-sparing thoracotomy approach (4 ± 0.6 versus 4.4 ± 0.6 days respectively, P = 0.006. Multivariate analysis revealed that VATS approach was inversely associated with longer inhospital stay whereas the number of resected segments was positively associated with an increased duration of hospitalization. Patients in the VATS group were less likely to develop atelectasis (≥1 lobe compared to those who underwent thoracotomy (0% versus 6.7% respectively, P = 0.042. Kaplan-Meier analysis revealed similar 30-day mortality rates in both study arms (Log-rank P = 0.560. Conclusion: VATS was associated with shorter duration of hospitalization positively affecting the patients' quality of life and satisfaction. Significant suppression of the total cost of recovery after thoracoscopic pulmonary resections is expected.

A risk-adjusted financial model to estimate the cost of a video-assisted thoracoscopic surgery lobectomy programme.

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Brunelli, Alessandro; Tentzeris, Vasileios; Sandri, Alberto; McKenna, Alexandra; Liew, Shan Liung; Milton, Richard; Chaudhuri, Nilanjan; Kefaloyannis, Emmanuel; Papagiannopoulos, Kostas

2016-05-01

To develop a clinically risk-adjusted financial model to estimate the cost associated with a video-assisted thoracoscopic surgery (VATS) lobectomy programme. Prospectively collected data of 236 VATS lobectomy patients (August 2012-December 2013) were analysed retrospectively. Fixed and variable intraoperative and postoperative costs were retrieved from the Hospital Accounting Department. Baseline and surgical variables were tested for a possible association with total cost using a multivariable linear regression and bootstrap analyses. Costs were calculated in GBP and expressed in Euros (EUR:GBP exchange rate 1.4). The average total cost of a VATS lobectomy was €11 368 (range €6992-€62 535). Average intraoperative (including surgical and anaesthetic time, overhead, disposable materials) and postoperative costs [including ward stay, high dependency unit (HDU) or intensive care unit (ICU) and variable costs associated with management of complications] were €8226 (range €5656-€13 296) and €3029 (range €529-€51 970), respectively. The following variables remained reliably associated with total costs after linear regression analysis and bootstrap: carbon monoxide lung diffusion capacity (DLCO) 0.05) in 86% of the samples. A hypothetical patient with COPD and DLCO less than 60% would cost €4270 more than a patient without COPD and with higher DLCO values (€14 793 vs €10 523). Risk-adjusting financial data can help estimate the total cost associated with VATS lobectomy based on clinical factors. This model can be used to audit the internal financial performance of a VATS lobectomy programme for budgeting, planning and for appropriate bundled payment reimbursements. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Differential Impact of Weight Loss on Nonalcoholic Fatty Liver Resolution in a North American Cohort with Obesity.

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Rachakonda, Vikrant; Wills, Rachel; DeLany, James P; Kershaw, Erin E; Behari, Jaideep

2017-08-01

Nonalcoholic fatty liver disease (NAFLD) is closely associated with obesity. In this study, a North American cohort with obesity enrolled in a lifestyle modification program was examined to determine the impact of weight loss on NAFLD resolution and sarcopenia. Nondiabetic individuals with World Health Organization Class II/III obesity enrolled in a 6-month weight loss intervention were included. Steatosis was measured using computed tomography (CT)-derived liver:spleen attenuation ratio. Body composition was assessed using dual X-ray absorptiometry, air-displacement plethysmography, and CT anthropometry. At baseline, participants with NAFLD had greater visceral adipose tissue (VAT) but similar skeletal muscle area compared to those without NAFLD. After intervention, weight loss was similar in the two groups, but participants with NAFLD lost more VAT than those without NAFLD (-38.81 [-55.98 to -21.63] cm 2 vs. -13.82 [-29.65 to -2.02] cm 2 ; P = 0.017). In the subset with NAFLD at baseline, participants with NAFLD resolution after intervention lost more VAT than those with persistent NAFLD (-57.23 [-88.63 to -25.84) cm 2 vs. -26.92 [-52.14 to -26.92] cm 2 , P = 0.039). In a Western cohort with obesity, NAFLD was not associated with sarcopenia. After lifestyle modification, there was a differential impact on NAFLD resolution, with twofold greater VAT loss in participants who resolved NAFLD compared with those with persistent NAFLD despite similar weight loss. © 2017 The Obesity Society.

Waist to hip ratio and trunk to extremity fat (DXA are better surrogates for IMCL and for visceral fat respectively than for subcutaneous fat in adolescent girls

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Russell Melissa

2010-12-01

Full Text Available Abstract Background Increased visceral adipose tissue (VAT and intramyocellular lipids (IMCL are associated with increased metabolic risk. Clinical and DXA body composition measures that are associated with VAT are generally even more strongly associated with subcutaneous adipose tissue (SAT reflecting general adiposity, and thus are not specific for VAT. Measures more strongly associated with VAT than SAT (thus more specific for VAT, and predictors of IMCL have not been reported. Subjects/Methods We studied 30 girls 12-18 years; 15 obese, 15 normal-weight. The following were assessed: (1 anthropometric measures: waist circumference at the umbilicus and iliac crest (WC-UC and WC-IC, waist-to-hip ratio (WHR, waist-to-height ratio (WHtR, (2 DXA measures: total fat, percent body fat (PBF, percent trunk fat (PTF, trunk-to-extremity fat ratio (TEFR, (3 MRI and 1H-MRS: VAT and SAT (L4-L5, soleus-IMCL. Results Group as a whole: WC, trunk fat and PBF were more strongly associated with SAT than VAT; none were specific for VAT. In contrast, PTF and TEFR were more significantly associated with VAT (r = 0.83 and 0.81 respectively, p Subgroup analysis: In obese girls, WHR and WHtR were more strongly correlated with VAT (r = 0.62 and 0.82, p = 0.04 and 0.001 than SAT (r = 0.41 and 0.73, p not significant and 0.007, and for DXA measures, PTF and TEFR were more significantly associated with VAT (r = 0.70 and 0.72, p = 0.007 and 0.006 than SAT (r = 0.52 and 0.53, p = 0.07 and 0.06. In controls, PTF and TEFR were more strongly correlated with VAT (r = 0.79, p = 0.0004 for both than SAT (r = 0.71 and 0.72, p = 0.003 for both. WHR was associated with IMCL in obese girls (r = 0.78, p = 0.008, but not controls. Conclusion Overall, WHR (anthropometry, and PTF and TEFR (DXA are good surrogates for IMCL and for visceral fat respectively in adolescent girls.

A new possibility in thoracoscopic virtual reality simulation training: development and testing of a novel virtual reality simulator for video-assisted thoracoscopic surgery lobectomy.

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Jensen, Katrine; Bjerrum, Flemming; Hansen, Henrik Jessen; Petersen, René Horsleben; Pedersen, Jesper Holst; Konge, Lars

2015-10-01

The aims of this study were to develop virtual reality simulation software for video-assisted thoracic surgery (VATS) lobectomy, to explore the opinions of thoracic surgeons concerning the VATS lobectomy simulator and to test the validity of the simulator metrics. Experienced VATS surgeons worked with computer specialists to develop a VATS lobectomy software for a virtual reality simulator. Thoracic surgeons with different degrees of experience in VATS were enrolled at the 22nd meeting of the European Society of Thoracic Surgeons (ESTS) held in Copenhagen in June 2014. The surgeons were divided according to the number of performed VATS lobectomies: novices (0 VATS lobectomies), intermediates (1-49 VATS lobectomies) and experienced (>50 VATS lobectomies). The participants all performed a lobectomy of a right upper lobe on the simulator and answered a questionnaire regarding content validity. Metrics were compared between the three groups. We succeeded in developing the first version of a virtual reality VATS lobectomy simulator. A total of 103 thoracic surgeons completed the simulated lobectomy and were distributed as follows: novices n = 32, intermediates n = 45 and experienced n = 26. All groups rated the overall user realism of the VATS lobectomy scenario to a median of 5 on a scale 1-7, with 7 being the best score. The experienced surgeons found the graphics and movements realistic and rated the scenario high in terms of usefulness as a training tool for novice and intermediate experienced thoracic surgeons, but not very useful as a training tool for experienced surgeons. The metric scores were not statistically significant between groups. This is the first study to describe a commercially available virtual reality simulator for a VATS lobectomy. More than 100 thoracic surgeons found the simulator realistic, and hence it showed good content validity. However, none of the built-in simulator metrics could significantly distinguish between novice, intermediate

High prevalence of vertebral artery tortuosity of Loeys-Dietz syndrome in comparison with Marfan syndrome

International Nuclear Information System (INIS)

Kono, Atsushi K.; Higashi, Masahiro; Tsutsumi, Yoshiaki; Akutsu, Koichi; Naito, Hiroaki; Morisaki, Hiroko; Morisaki, Takayuki; Sugimura, Kazuro

2010-01-01

Loeys-Dietz syndrome (LDS) is a connective tissue disease caused by mutations in the genes encoding the transforming growth factor-β receptor (TGFBR). LDS is associated with aneurysms or dissections of the aorta similar to Marfan syndrome (MFS) as well as arterial tortuosity and aneurysms in the peripheral arteries. The purpose of this study was to evaluate the arterial diseases of LDS to differentiate it from MFS. A total of 10 LDS patients with an identified mutation in TGFBR (6 male, 4 female; mean age 36.3 years) and 20 MFS patients with an identified mutation in fibrilin-1 who were age- and sex-matched to the LDS subjects (12 male, 8 female; mean age 37.1 years) were reviewed. The prevalence of vertebral arterial tortuosity (VAT) and peripheral aneurysm (PAN) was studied using computed tomography angiography. In all, 9 of the 10 LDS patients had VAT, and five PANs were observed in 3 patients. In contrast, 8 (40%) of the MFS patients had VAT, and 1 patient had a PAN. LDS had a higher prevalence of VAT (P=0.017) by Fisher's exact test. The VAT was highly prevalent among LDS patients. Thus, the presence of VAT has the potential to differentiate LDS from MFS. (author)

Uniportal versus three-port video-assisted thoracoscopic surgery for spontaneous pneumothorax: a meta-analysis

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Qin, Shi-Lei; Huang, Jin-Bo; Yang, Yan-Long

2015-01-01

Background Whether or not uniportal video-assisted thoracoscopic surgery (VATS) is beneficial for spontaneous pneumothorax remains inconclusive. This meta-analysis aimed to summarize the available evidence to assess the feasibility and advantages of uniportal VATS for the treatment of spontaneous pneumothorax compared with three-port VATS. Methods Eligible publications were identified by searching the Cochrane Library, PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data databases and CQVIP. Odds ratios (OR) and standardized mean differences (SMD) with 95% confidence intervals (CI) were calculated to compare dichotomous and continuous variables, respectively. Results This meta-analysis was based on 17 studies and included a total of 988 patients with spontaneous pneumothorax. No death was reported during the perioperative period. Compared with three-port VATS groups, there was a statistically significant difference in uniportal VATS groups regarding postoperative hospital stay (SMD= −0.58; 95% CI: −1.04 to −0.12; P=0.01), paresthesia (OR=0.13; 95% CI: 0.07 to 0.24; Pparesthesia as well as an improvement in patients’ satisfaction. This meta-analysis indicated that using uniportal VATS to treat spontaneous pneumothorax was safe and feasible, and it may be a better alternative procedure because of its advantage in reducing postoperative pain and paresthesia. PMID:26793349

Physical Activity and Abdominal Fat Distribution in Greenland.

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Dahl-Petersen, Inger Katrine; Brage, Søren; Bjerregaard, Peter; Tolstrup, Janne Schurmann; Jørgensen, Marit Eika

2017-10-01

We examined how total volume of physical activity and reallocation of time spent at various objectively measured intensities of physical activity (PA) were associated with overall and abdominal fat distribution in adult Inuit in Greenland. Data were collected as part of a countrywide cross-sectional health survey in Greenland. A combined accelerometer and HR monitor measured total physical activity energy expenditure (PAEE) and intensities of PA (N = 1536). Visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were assessed by ultrasonography. Isotemporal substitution modeling was used to analyze the association between substitution of 1 h of sedentary time to light- or moderate-intensity PA and 1 h light-intensity PA to moderate- or vigorous-intensity PA in relation to body mass index (BMI), waist circumference (WC), SAT, and VAT. A negative linear association was found for total PAEE and BMI, WC, VAT, and SAT. Exchanging 1 h of sedentary time with light-intensity PA was associated with lower WC (-0.6 cm, P = 0.01), SAT (-0.08 cm, P abdominal fat distribution. Physical activity energy expenditure is associated with lower BMI, WC, and abdominal fat among Greenland Inuit. The importance of promoting an upward shift of the whole PA intensity distribution and to spur even short bouts of MVPA to limit excessive accumulation of SAT and VAT is highlighted.

Reduced cortical thickness associated with visceral fat and BMI

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Ralf Veit

2014-01-01

Full Text Available Structural brain imaging studies have shown that obesity is associated with widespread reductions in gray matter (GM volume. Although the body mass index (BMI is an easily accessible anthropometric measure, substantial health problems are more related to specific body fat compartments, like visceral adipose tissue (VAT. We investigated cortical thickness measures in a group of 72 healthy subjects (BMI range 20–35 kg/m2, age range 19–50 years. Multiple regression analyses were performed using VAT and BMI as predictors and age, gender, total surface area and education as confounds. BMI and VAT were independently associated with reductions in cortical thickness in clusters comprising the left lateral occipital area, the left inferior temporal cortex, and the left precentral and inferior parietal area, while the right insula, the left fusiform gyrus and the right inferior temporal area showed a negative correlation with VAT only. In addition, we could show significant reductions in cortical thickness with increasing VAT adjusted for BMI in the left temporal cortex. We were able to detect widespread cortical thinning in a young to middle-aged population related to BMI and VAT; these findings show close resemblance to studies focusing on GM volume differences in diabetic patients. This may point to the influence of VAT related adverse effects, like low-grade inflammation, as a potentially harmful factor on brain integrity already in individuals at risk of developing diabetes, metabolic syndromes and arteriosclerosis.

Obesometric factors associated with increased skin-to-stone distances in renal stone patients.

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Allard, Christopher B; Shuster, Anatoly; Pinthus, Jehonathan H; Farrokhyar, Forough; Raees, A; Patlas, Michael; Matsumoto, Edward D; Whelan, J Paul

2012-12-01

Obese patients are at increased risk for renal stones as well as treatment failures due to increased skin-to-stone distances (SSD) and harder stone compositions. We investigated the relationships between obesometric parameters (body mass index [BMI], body fat distribution and obesity-related hormone levels) with SSD and stone hardness. We prospectively enrolled patients undergoing stone interventions at our institution. Computed tomography (CT) scans were analyzed; adipose tissue was identified according to Hounsfield units (HU) and separated into subcutaneous (SAT) and visceral (VAT) components. The pixels were averaged at three levels to calculate fat distribution: %VAT = (VAT)/(VAT + SAT). SSD was measured and HU were used as a surrogate for stone hardness. Obesity-related hormones leptin and adiponectin were measured by ELISA. Seventy-nine patients were prospectively enrolled. Mean BMI and %VAT were 30.02 kg/m2 and 40.13 kg/m2. Mean leptin and adiponectin levels were 17.5 ng/mL and 7.67 mcg/mL indicating high risk for metabolic consequences of obesity. Females had greater proportions of subcutaneous fat than males (%VAT 28.4 versus 46.94, p r = 0.454, p = 0.008). Obese patients with %VAT > 40 versus stone compositions as measured by HU than non-diabetics (982.86 versus 648.86, p = 0.001). Obesometric parameters such as BMI, body fat distribution, and the presence of diabetes mellitus are important considerations in the management of renal stone disease. A large proportion of subcutaneous fat, which can be estimated by physical examination, predicts SSD among obese patients and may aid treatment decisions in patients, particularly those without pre-treatment CT scans. Further studies are needed to refine the role of obesometrics in personalizing treatment decisions.

Remediation of uranium-contaminated soil using the Segmented Gate System and containerized vat leaching techniques: a cost effectiveness study

International Nuclear Information System (INIS)

Cummings, M.; Booth, S.R.

1996-01-01

Because it is difficult to characterize heterogeneously contaminated soils in detail and to excavate such soils precisely using heavy equipment, it is common for large quantities of uncontaminated soil to be removed during excavation of contaminated sites. Until now, volume reduction of radioactively contaminated soil depended upon manual screening and analysis of samples, a costly and impractical approach, particularly with large volumes of heterogeneously contaminated soil. The baseline approach for the remediation of soils containing radioactive waste is excavation, pretreatment, containerization, and disposal at a federally permitted landfill. However, disposal of low-level radioactive waste is expensive and storage capacity is limited. ThermoNuclean's Segmented Gate System (SGS) removes only the radioactively contaminated soil, in turn greatly reducing the volume of soils that requires disposal. After processing using the SGS, the fraction of contaminated soil is processed using the containerized vat leaching (CVL) system developed at LANL. Uranium is leached out of the soil in solution. The uranium is recovered with an ion exchange resin, leaving only a small volume of liquid low-level waste requiring disposal. The reclaimed soil can be returned to its original location after treatment with CVL

Thoracoscopic surgery for pulmonary metastases after chemotherapy using a tailor-made virtual lung

International Nuclear Information System (INIS)

Akiba, Tadashi; Marushima, Hideki; Kinoshita, Satoki; Kamiya, Noriteru; Odaka, Makoto; Takeyama, Hiroshi; Morikawa, Toshiaki

2011-01-01

Details with regard to the standard criteria for a therapeutic metastasectomy and the use of video-assisted thoracic surgery (VATS) remain elusive. To evaluate the feasibility of VATS using a tailor-made virtual lung for patients with pulmonary metastases after chemotherapy, we reviewed the following cases. Clinical data from October 2006 to April 2010 were obtained from patients who received chemotherapy before a pulmonary metastasectomy (lobectomy or segmentectomy). VATS was the primarily selected surgical approach except for treating hilar lesions. A lobectomy was performed when the metastasis was greater than 3.0 cm in diameter or located deeply in the lobe. Tailor-made virtual lungs were created using three-dimensional multidetector computed tomography before lobectomy on a routine basis. The virtual lung consisted of three-dimensional pulmonary vessels, a tracheobronchial tree, pulmonary parenchyma, and tumors. Twelve operations, consisting of 1 segmentectomy, 10 lobectomies, and 1 wedge bronchoplasty upper lobectomy, were performed on 11 patients during the study period. VATS was completed in 10 of these 12 operations. The mean operative time for the lobectomies was 257 min, and the mean operative bleeding volume was 215 ml. Two cases experienced postoperative transient atrial fibrillation, and no mortalities associated with these operations were reported. VATS was performed safely in instances of metastasectomy after chemotherapy, and the tailor-made virtual lung assisted in lung orientation during the operation. (author)

Visual associations cued recall A Paradigm for Measuring Episodic Memory Decline in Alzheimer's Disease.

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Meyer, Sascha R A; Spaan, Pauline E J; Boelaarts, Leo; Ponds, Rudolf W H M; Schmand, Ben; de Jonghe, Jos F M

2016-09-01

Repeated measurements of episodic memory are needed for monitoring amnestic mild cognitive impairment (aMCI) and mild Alzheimer's disease (AD). Most episodic memory tests may pose a challenge to patients, even when they are in the milder stages of the disease. This cross-sectional study compared floor effects of the Visual Association Test (VAT) and the Rey Auditory Verbal Learning Test (RAVLT) in healthy elderly controls and in patients with aMCI or AD (N = 125). A hierarchical multiple regression analysis was used to examine whether linear or quadratic trends best fitted the data of cognitive test performance across global cognitive impairment. Results showed that VAT total scores decreased linearly across the range of global cognitive impairment, whereas RAVLT total scores showed a quadratic trend, with total scores levelling off for 90% of aMCI patients and 94% of AD patients. We conclude that the VAT shows few if any floor effects in patients with aMCI and mild AD and is therefore a potentially promising cognitive test for monitoring episodic memory impairment.

Abdominal fat sub-depots and energy expenditure: Magnetic resonance imaging study.

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Serfaty, Dana; Rein, Michal; Schwarzfuchs, Dan; Shelef, Ilan; Gepner, Yftach; Bril, Nitzan; Cohen, Noa; Shemesh, Elad; Sarusi, Benjamin; Kovsan, Julia; Kenigsbuch, Shira; Chassidim, Yoash; Golan, Rachel; Witkow, Shula; Henkin, Yaakov; Stampfer, Meir J; Rudich, Assaf; Shai, Iris

2017-06-01

We aimed to assess the association between the distinct abdominal sub-depots and resting energy expenditure (REE). We performed magnetic resonance imaging (MRI) to quantify abdominal visceral-adipose-tissue (VAT), deep-subcutaneous-adipose-tissue (deep-SAT), and superficial-subcutaneous-adipose-tissue (superficial-SAT). We measured REE by indirect-calorimetry. Non-exercise activity thermogenesis (NEAT) [1-3 metabolic equivalents (METs)] and exercise thermogenesis (activities of 4+MET S ) were estimated based on 6-days of accelerometry to assess total physical activity energy expenditure (PAEE). We studied 282 participants: 249 men [mean age = 47.4 years, body-mass-index (BMI) = 31 kg/m 2 , mean VAT proportion from total abdominal fat = 34.5%, mean superficial-SAT proportion from total abdominal fat = 24.3%] and 33 women (mean age = 51.2 years, BMI = 30.1 kg/m 2 , mean VAT proportion from total abdominal fat = 22.8%, mean superficial-SAT proportion from total abdominal fat = 37.8%). As expected, women had lower REE [by 32.4% (1488 ± 234 kcal/day vs. 1971 ± 257 kcal/day; p abdominal VAT was the dominant proportional depot, had higher REE (1964 ± 297 kcal/day vs. 1654 ± 352 kcal/day; p Abdominal fat distribution patterns are associated with varying levels of resting energy expenditure, potentially reflecting different metabolic rates of adipose sub-depots and providing an anatomic/anthropometric link to physiological obese sub-phenotypes. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

La valutazione di efficacia della spesa pubblica destinata alle imprese vitivinicole: un’analisi delle politiche agricole e strutturali in rapporto al credito d’imposta sul valore aggiunto

Directory of Open Access Journals (Sweden)

Diego Begalli

2012-03-01

Full Text Available The paper analyses the total amount and the redistribution of public support in a sample survey of 1888 wine farms operating in the Verona region. The impact of public policies has been crossed with the accounting movements subject to Value Added Tax (VAT in the years 2006-2008. The paper discusses the possibility to modify the actual system in law proposing the use of the VAT clearing mechanism to co-finance wine business structural investments. The first results of the research show that the volume of funding recovered through VAT clearing mechanism are even higher than the amount of public support given to wine companies for promoting structural investments.

Image-guided total marrow and total lymphatic irradiation using helical tomotherapy

International Nuclear Information System (INIS)

Schultheiss, Timothy E.; Wong, Jeffrey; Liu, An; Olivera, Gustavo; Somlo, George

2007-01-01

Purpose: To develop a treatment technique to spare normal tissue and allow dose escalation in total body irradiation (TBI). We have developed intensity-modulated radiotherapy techniques for the total marrow irradiation (TMI), total lymphatic irradiation, or total bone marrow plus lymphatic irradiation using helical tomotherapy. Methods and Materials: For TBI, we typically use 12 Gy in 10 fractions delivered at an extended source-to-surface distance (SSD). Using helical tomotherapy, it is possible to deliver equally effective doses to the bone marrow and lymphatics while sparing normal organs to a significant degree. In the TMI patients, whole body skeletal bone, including the ribs and sternum, comprise the treatment target. In the total lymphatic irradiation, the target is expanded to include the spleen and major lymph node areas. Sanctuary sites for disease (brain and testes) are included when clinically indicated. Spared organs include the lungs, esophagus, parotid glands, eyes, oral cavity, liver, kidneys, stomach, small and large intestine, bladder, and ovaries. Results: With TBI, all normal organs received the TBI dose; with TMI, total lymphatic irradiation, and total bone marrow plus lymphatic irradiation, the visceral organs are spared. For the first 6 patients treated with TMI, the median dose to organs at risk averaged 51% lower than would be achieved with TBI. By putting greater weight on the avoidance of specific organs, greater sparing was possible. Conclusion: Sparing of normal tissues and dose escalation is possible using helical tomotherapy. Late effects such as radiation pneumonitis, veno-occlusive disease, cataracts, neurocognitive effects, and the development of second tumors should be diminished in severity and frequency according to the dose reduction realized for the organs at risk

Neck circumference as a measure of neck fat and abdominal visceral fat in Chinese adults.

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Li, Hong-Xing; Zhang, Fen; Zhao, Dong; Xin, Zhong; Guo, Shu-Qin; Wang, Shu-Mei; Zhang, Jian-Jun; Wang, Jun; Li, Yan; Yang, Guang-Ran; Yang, Jin-Kui

2014-04-04

Visceral adipose tissue (VAT) is a unique pathogenic fatty deposit, in that it is closely correlated with risk of cardiovascular diseases. The present study is to investigate the usefulness of neck circumference (NC) to indicate VAT. Participants aged 35 to 75 years who had taken abdomen and neck computer tomography (CT) examination were included in this study. Neck adipose tissue, abdominal VAT and subcutaneous adipose tissue (SAT) areas, as well as sagittal abdominal diameter (SAD) were measured by CT. Body anthropometrics and metabolic parameters including blood glucose, lipid profiles and blood pressure were also measured. A lower abdomen CT examination was carried out on a total of 177 patients (87 male and 90 female) with a mean age of 59 years. Of the 177 participants, 15 men and 15 women also took a neck CT examination. With a comparable age and BMI, neck adipose area was correlated with abdominal VAT area significantly in men (r = 0.57, p = 0.028) and women (r = 0.53, p = 0.041). NC is positively correlated with VAT both in men (r = 0.49, p fat both in men (r = 0.83, p fat area is significantly correlated with abdominal VAT. Meanwhile, SAD is the best predictor for visceral fat in the Chinese population.

Association between Blood Mercury Level and Visceral Adiposity in Adults

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Jong Suk Park

2017-01-01

Full Text Available BackgroundFew studies have examined the association between mercury exposure and obesity. The aim of this study is to investigate the association between blood mercury concentrations and indices of obesity in adults.MethodsA total of 200 healthy subjects, aged 30 to 64 years, who had no history of cardiovascular or malignant disease, were examined. Anthropometric and various biochemical profiles were measured. Visceral adipose tissue (VAT was measured using dual-energy X-ray absorptiometry (DXA.ResultsAll subjects were divided into three groups according to blood mercury concentrations. Compared with the subjects in the lowest tertile of mercury, those in the highest tertile were more likely to be male; were current alcohol drinkers and smokers; had a higher body mass index (BMI, waist circumference (WC, and VAT; had higher levels of blood pressure, fasting glucose, and insulin resistance; and consumed more fish. The blood mercury concentration was significantly associated with anthropometric parameters, showing relationships with BMI, WC, and VAT. After adjusting for multiple risk factors, the odds ratios (ORs for high mercury concentration was significantly higher in the highest VAT tertile than in the lowest VAT tertile (OR, 2.66; 95% confidence interval, 1.05 to 6.62; P<0.05.ConclusionThe blood mercury concentration was significantly associated with VAT in healthy adults. Further studies are warranted to confirm our findings.

Predicting volumes of metabolically important whole-body adipose tissue compartments in overweight and obese adolescents by different MRI approaches and anthropometry

International Nuclear Information System (INIS)

Springer, Fabian; Ehehalt, Stefan; Sommer, Julia; Ballweg, Verena; Machann, Jürgen; Binder, Gerhard; Claussen, Claus D.; Schick, Fritz

2012-01-01

Objectives: To evaluate 5-slice stack/single-slice MRI approaches and anthropometric measures as predictors for metabolically relevant whole-body adipose tissue (AT) compartments in overweight/obese adolescents. Methods: Forty adolescents (22 males, age 11.4–16.1 years) were included with a BMI above the 90th percentile. Volumes of whole-body AT compartments, i.e. total AT (TAT), subcutaneous AT (SCAT) and visceral AT (VAT), were determined using a breath-hold T1-weighted-FSE-MR-sequence and semi-automated segmentation serving as the gold standard. SCAT, VAT and TAT was estimated by either axially oriented single-slices or 5-slice-stacks centred at specific anatomic landmarks (umbilicus, head of femur and humerus). Furthermore, anthropometric measures were also evaluated as predictors of whole-body AT compartments. Results: Strong correlations were found for both genders between TAT/SCAT and single-slice evaluation (e.g. whole-body SCAT-SCAT at umbilicus level: r = 0.91 (m), r = 0.92 (f)) or anthropometry (SCAT-BMI: r = 0.93 (m, f)). VAT was correlated to VAT at umbilicus (r = 0.71 (m), r = 0.94 (f)) but only weakly to anthropometry. Conclusions: Anthropometric measures and single-slice MRI can accurately predict TAT/SCAT which cannot be improved by evaluation of 5-slice stacks. Prediction of VAT by 5-slice stack/single-slice MRI protocols seems only to be accurate in females. Anthropometry cannot be reliably used for prediction of VAT in both genders. Thus, MRI seems to be necessary for quantification of VAT in overweight/obese adolescents of both genders.

Definition of new cut-offs of BMI and waist circumference based on body composition and insulin resistance: differences between children, adolescents and adults.

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Hübers, M; Pourhassan, M; Braun, W; Geisler, C; Müller, M J

2017-09-01

This study aims to determine associations between anthropometric traits, regional fat depots and insulin resistance in children, adolescents and adults to define new cut-offs of body mass index (BMI) or waist circumference (WC). Cross-sectional data were assessed in 433 children, adolescents and adults (aged: 6-60 years, BMI: 23.6 [21.0-27.7] kg m -2 ). Total adipose tissue (TAT), regional subcutaneous adipose tissue (SAT total , SAT trunk ) and visceral adipose tissue (VAT) were determined by whole-body magnetic resonance imaging, fat mass by air-displacement plethysmography. Insulin resistance was evaluated by homeostasis model assessment of insulin resistance (HOMA-IR). Bivariate as well as partial correlations and regression analyses were used. Cut-off values of BMI and WC related to regional fat depots and HOMA-IR were analysed by receiver operating characteristics curve. In adults, TAT, SAT total and SAT trunk increased linearly with increasing BMI and WC, whereas they followed a cubic function in children and adolescents with a steep increase at BMI and WC ≥1 standard deviation score and VAT at WC ≥2 standard deviation score. Sex differences were apparent in adults with women having higher masses of TAT and SAT and men having higher VAT. Using established BMI or WC cut-offs, correspondent masses of TAT, SAT total , SAT trunk and VAT increased from childhood to adulthood. In all age groups, there were positive associations between BMI, WC, SAT trunk , VAT and HOMA-IR. When compared with normative cut-offs of BMI or WC, HOMA-IR-derived cut-offs of regional fat depots were lower in all age groups. Associations between BMI, WC and regional fat depots varied between children, adolescents, young and older adults. When compared with BMI-derived and WC-derived values, an insulin resistance-derived cut-off corresponded to lower masses of regional fat depots. Thus, established BMI and WC cut-offs are not appropriate to assess metabolic disturbances associated

A case-control study on the clinical impact of ventilator associated tracheobronchitis in adult patients who did not develop ventilator associated pneumonia.

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Cantón-Bulnes, María Luisa; González-García, María Ascensión; García-Sánchez, Manuela; Arenzana-Seisdedos, Ángel; Garnacho-Montero, José

2018-02-05

The main objective was to determine whether ventilator-associated tracheobronchitis (VAT) is related to increased length of ICU stay. Secondary endpoints included prolongation of hospital stay, as well as, ICU and hospital mortality. A retrospective matched case-control study. Each case was matched with a control for duration of ventilation (± 2 days until development of ventilator-associated tracheobronchitis), disease severity (Acute Physiology and Chronic Health Evaluation II) at admission ± 3, diagnostic category and age ±10 years. Critically ill adults admitted to a polyvalent 30-beds ICU with the diagnosis of VAT in the period 2013-2016. We identified 76 cases of VAT admitted to our ICU during the study period. No adequate controls were found for 3 patients with VAT. There were no significant differences in demographic characteristics, reasons for admission and comorbidities. Patients with VAT had a longer ICU length of stay, median 22 days (14-35), compared to controls, median 15 days (8-27), p=.02. Ventilator days were also significantly increased in VAT patients, median 18 (9-28) versus 9 days (5-16), p=.03. There was no significant difference in total hospital length of stay 40 (28-61) vs. 35days (23-54), p=.32; ICU mortality (20.5 vs. 31.5% p=.13) and hospital mortality (30.1 vs. 43.8% p=.09). We performed a subanalysis of patients with microbiologically proven VAT receiving adequate antimicrobial treatment and did not observe significant differences between cases and the corresponding controls. VAT is associated with increased length of intensive care unit stay and longer duration of mechanical ventilation. This effect disappears when patients receive appropriate empirical treatment. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Distinct Blood and Visceral Adipose Tissue Regulatory T Cell and Innate Lymphocyte Profiles Characterize Obesity and Colorectal Cancer

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Gloria Donninelli

2017-06-01

Full Text Available Visceral adipose tissue (VAT is a main site where metabolic and immunologic processes interplay to regulate, at local and systemic level, the inflammatory status and immune response. Obesity-associated inflammation and immune dysfunctions are inextricably linked to tumor but, in spite of intense efforts, the mechanisms underpinning this association remain elusive. In this report, we characterized the profile of VAT-associated and circulating innate lymphocyte and regulatory T (Treg cell subsets underlying inflammatory conditions, such as obesity and colorectal cancer (CRC. Analysis of NK, NKT-like, γδ T, and Treg cell populations in VAT and blood of healthy lean subjects revealed that CD56hi NK and OX40+ Treg cells are more abundant in VAT with respect to blood. Conversely, CD56dim NK and total Treg cells are most present in the circulation, while γδ T lymphocytes are uniformly distributed in the two compartments. Interestingly, a reduced frequency of circulating activated Treg cells, and a concomitant preferential enrichment of OX40-expressing Treg cells in VAT, were selectively observed in obese (Ob subjects, and directly correlated with body mass index. Likewise, CRC patients were characterized by a specific enrichment of VAT-associated NKT-like cells. In addition, Ob and CRC-affected individuals shared a significant reduction of the Vγ9Vδ2/γδ T cell ratio at systemic level. The alterations in the relative proportions of Treg and NKT-like cells in VAT were found to correlate with the content of pro- and anti-inflammatory polyunsaturated fatty acids (PUFA, respectively. Overall, these results provide evidence for distinct alterations of the immune cell repertoire in the periphery with respect to the VAT microenvironment that uniquely characterize or are shared by different inflammatory conditions, such as obesity and CRC, and suggest that VAT PUFA composition may represent one of the factors that contribute to shape the immune

Future of uniportal video-assisted thoracoscopic surgery-emerging technology.

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Li, Zheng; Ng, Calvin S H

2016-03-01

Uniportal VATS poses unique difficulties to the surgeon, mainly as a consequence of operating through a small single incision. The instruments in uniportal VATS have limited movement through the small incision. In addition, the approach to the surgical operating site is unidirectional, which may restrict vision and retraction, and unavoidably suffers from instrument fencing. Recent thoracoscopic technology in the form of a wide variable angled lens has to some extent improved these shortcomings. The development of an extendable flexible thoracoscope and wireless steerable endoscope (WSE) systems can further improve the visualization for surgery and reduce or even remove fencing between endoscope and instruments. New single incision access platforms both derived from Natural orifice transluminal endoscopic surgery (NOTES) and robotic surgery approaches are on the horizon. These may allow uniportal VATS to be performed through an even smaller ultra-minimally invasive incision, with improved vision, more freedom of movement of the instruments and greater precision. However, a number of problems remain to be resolved, including provision of a stable platform and payload, applied force limitations and equipment sterilization. Advances in uniportal VATS major lung resection techniques have not only challenged the surgeon to acquire new skills and knowledge, but at the same time have rekindled the collaborative spirit between industry and clinician in developing novel equipment and technology to push the boundaries of minimally invasive surgery. These technological improvements and innovations may improve operating efficiency and safety during uniportal VATS surgery.

Glyceroneogenesis is inhibited through HIV protease inhibitor-induced inflammation in human subcutaneous but not visceral adipose tissue

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Leroyer, Stéphanie; Vatier, Camille; Kadiri, Sarah; Quette, Joëlle; Chapron, Charles; Capeau, Jacqueline; Antoine, Bénédicte

2011-01-01

Glyceroneogenesis, a metabolic pathway that participates during lipolysis in the recycling of free fatty acids to triglycerides into adipocytes, contributes to the lipid-buffering function of adipose tissue. We investigated whether glyceroneogenesis could be affected by human immunodeficiency virus (HIV) protease inhibitors (PIs) responsible or not for dyslipidemia in HIV-infected patients. We treated explants obtained from subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) depots from lean individuals. We observed that the dyslipidemic PIs nelfinavir, lopinavir and ritonavir, but not the lipid-neutral PI atazanavir, increased lipolysis and decreased glyceroneogenesis, leading to an increased release of fatty acids from SAT but not from VAT. At the same time, dyslipidemic PIs decreased the amount of perilipin and increased interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) secretion in SAT but not in VAT. Parthenolide, an inhibitor of the NFκB pathway, counteracted PI-induced increased inflammation and decreased glyceroneogenesis. IL-6 (100 ng) inhibited the activity of phosphoenolpyruvate carboxykinase, the key enzyme of glyceroneogenesis, in SAT but not in VAT. Our data show that dyslipidemic but not lipid-neutral PIs decreased glyceroneogenesis as a consequence of PI-induced increased inflammation in SAT that could have an affect on adipocytes and/or macrophages. These results add a new link between fat inflammation and increased fatty acids release and suggest a greater sensitivity of SAT than VAT to PI-induced inflammation. PMID:21068005

No clinical difference between large metal-on-metal total hip arthroplasty and 28-mm-head total hip arthroplasty?

NARCIS (Netherlands)

Zijlstra, Wierd P; van den Akker-Scheek, Inge; Zee, Mark J M; van Raay, Jos J A M

2011-01-01

PURPOSE: We aimed to test the claim of greater range of motion (ROM) with large femoral head metal-on-metal total hip arthroplasty. METHODS: We compared 28-mm metal-on-polyethylene (MP) total hip arthroplasty with large femoral head metal-on-metal (MM) total hip arthroplasty in a randomised clinical

Longitudinal changes in visceral and subcutaneous adipose tissue and metabolic syndrome: Results from the Multicultural Community Health Assessment Trial (M-CHAT).

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Tu, Andrew W; Humphries, Karin H; Lear, Scott A

2017-12-01

Few studies have examined whether longitudinal changes in visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT), independent of each other, are associated with the risk of developing metabolic syndrome (MetS). The objective of this study was to examine the longitudinal effects of VAT and SAT on MetS and metabolic risk factors in a multi-ethnic sample of Canadians followed for 5-years. In total, 598 adults of the Multicultural Community Health Assessment Trial (M-CHAT) were included in this study. Assessments of body composition using computed tomography (CT) and metabolic risk factors were conducted at baseline, 3-, and 5-years. Mixed-effects logistic regression was used to model the longitudinal effects of VAT and SAT on MetS and metabolic risk factors. There were significant between-person (cross-sectional) effects such that for every 10cm 2 higher VAT, the odds of MetS, high-risk fasting glucose levels and high-risk HDL-C levels significantly increased by 16% (95% CI: 9-24%), 11% (3-20%), and 7% (0-14%) respectively. Significant within-person (longitudinal) effects were also found such that for every 10cm 2 increase in VAT the odds of MetS and high-risk triglyceride levels significantly increased by 23% (9-39%) and 30% (14-48%), respectively. Cross-sectional or longitudinal changes in SAT were not associated with MetS or metabolic risk factors. This study found a direct relationship between longitudinal change in VAT and MetS risk independent of changes in SAT. Clinical practice should focus on the reduction of VAT to improve cardiovascular health outcomes. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Estimated Visceral Adipose Tissue, but Not Body Mass Index, Is Associated with Reductions in Glomerular Filtration Rate Based on Cystatin C in the Early Stages of Chronic Kidney Disease

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Ana Karina Teixeira da Cunha França

2014-01-01

Full Text Available Information on the association between obesity and initial phases of chronic kidney disease (CKD is still limited, principally those regarding the influence of visceral adipose tissue. We investigated whether the visceral adipose tissue is more associated with reductions in glomerular filtration rate (GFR than total and abdominal obesity in hypertensive individuals with stage 1-2 CKD. A cross-sectional study was implemented which involved 241 hypertensive patients undergoing treatment at a primary health care facility. GFR was estimated using equations based on creatinine and cystatin C levels. Explanatory variables included body mass index (BMI, waist circumference (WC, and estimated visceral adipose tissue (eVAT. The mean age was 59.6±9.2 years old and 75.9% were female. According to BMI, 28.2% of subjects were obese. Prevalence of increased WC and eVAT was 63.9% and 58.5%, respectively. Results from the assessment of GFR by BMI, WC, and eVAT categories showed that only women with increased eVAT (≥150 cm2 had a lower mean GFR by Larsson (P=0.016, Levey 2 (P=0.005, and Levey 3 (P=0.008 equations. The same result was not observed when the MDRD equation was employed. No association was found between BMI, WC, eVAT, and GFR using only serum creatinine. In the early stages of CKD, increased eVAT in hypertensive women was associated with decreased GFR based on cystatin C.

[Treatment-refractory-dental-extraction-associated pyothorax involving infection by 2 species of oral originated bacteria requires surgical debridement by video assisted thoracoscopic surgery (VATS)].

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Rai, Kammei; Matsuo, Kiyoshi; Yonei, Toshiro; Sato, Toshio

2008-09-01

Cases of septic pulmonary embolism (SPE) diagnosed clinically by CT after dental extraction rarely include verification of bacteria from the local infection site. We report the case of a 70-year-old man without background disease suffering severe pyothrax after dental extraction. We detected two species of oral bacteria from his pleural effusion. Treatment was so difficult that it required surgical debridement by video assisted thoracoscopic surgery (VATS), even after the appropriate administration of antibiotics. According to the American Heart Association (AHA) prophylaxis guidelines for preventing infective endocarditis indicate that it is uncommon to prescribe antibiotics to patients without background disease after dental extraction. No appropriate Japanese guidelines exist considering the prevention of SPE causing severe pyothorax as in our case. The hematogenous spread of bacteria such as SPE caused by sepsis after tooth extraction thus requires more attended careful consideration in clinical practice if patients are to be properly protected against potentially serious complications.

Video-assisted thoracoscopic surgery or transsternal thymectomy in the treatment of myasthenia gravis?

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Zahid, Imran; Sharif, Sumera; Routledge, Tom; Scarci, Marco

2011-01-01

A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was how video-assisted thoracoscopic surgery (VATS) compares to median sternotomy in the surgical management of patients with myasthenia gravis (MG)? Overall 74 papers were found using the reported search, of which 15 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results are tabulated. We conclude that VATS produces equivalent postoperative mortality and complete stable remission (CSR) rates, with superior results in terms of hospital stay, operative blood loss and patient satisfaction at the expense of a doubling of operative time. Six studies comparing VATS and transsternal sternotomy in non-thymomatous myasthenia gravis (NTMG) patients found VATS to have lower operative blood loss (73.8±70.7 vs. 155.3±91.7 ml; P0.05). One study comparing video-assisted thoracoscopic extended thymectomy to transsternal thymectomy in only thymoma-associated myasthenia gravis (T-MG) patients found equivalent CSR (11.3 vs. 8.7%, P=0.1090) at six-year follow-up. Thymoma recurrence rate (9.64%) was not significantly different (P=0.1523) between the two groups. Eight studies comparing VATS and transsternal approach in mixed T-MG and NTMG patients found a lower hospital stay (1.9±2.6 vs. 4.6±4.2 days, P<0.001), reduced need for postoperative medication (76.5 vs. 35.7%, P=0.022), lower intensive care unit stay (1.5 vs. 3.2 days, P=0.018), greater symptom improvement (100 vs. 77.9%, P=0.019) and better cosmetic satisfaction (100 vs. 83, P=0.042) with VATS. In concordance with NTMG and T-MG alone patient groups, VATS and transsternal methods had equivalent complication rates (23 vs. 19%, P=0.765) with no mortalities in either group. Even though VATS has a longer operative time (268±51 vs. 177±92 min, P<0.05), its improved cosmesis, reduced need

Adsorption of a textile dye "Indanthrene Blue RS (C.I. Vat Blue 4)" from aqueous solutions onto smectite-rich clayey rock.

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Chaari, Islem; Feki, Mongi; Medhioub, Mounir; Bouzid, Jalel; Fakhfakh, Emna; Jamoussi, Fakher

2009-12-30

The adsorption of a textile dye, namely, Indanthrene Blue RS (C.I. Vat Blue 4) onto smectite-rich clayey rock (AYD) and its sulphuric acid-activated products (AYDS) in aqueous solution was studied in a batch system with respect to contact time, pH, and temperature. The adsorbents employed were characterized by X-ray diffraction, infrared spectroscopy and specific surface area, cation exchange capacity and point of zero charge were also estimated. The effect of contact time on dye adsorption showed that the equilibrium was reached after a contact time of 40 min for the both adsorbents. The optimum pH for dye retention was found 6.0 for AYDS and 7.3 for AYD. The equilibrium adsorption data were analysed using the Langmuir and Freundlich isotherms. The adsorption capacities (Q(m)) for AYD and AYDS were found 13.92 mg/g and 17.85 mg/g, respectively. The effect of temperature on the adsorption was also investigated; adsorption of Indanthrene Blue RS is an endothermic process. This study demonstrates that all the considered adsorbents can be used as an alternative emerging technology for water treatment.

Greater Total Antioxidant Capacity from Diet and Supplements Is Associated with a Less Atherogenic Blood Profile in U.S. Adults

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Kijoon Kim

2016-01-01

Full Text Available Evidence from epidemiologic studies has shown that total antioxidant capacity (TAC in the diet might be inversely associated with stroke, heart failure, and inflammatory biomarkers. However, studies on the association of TAC from both diet and supplements with cardiovascular disease (CVD risk factors in the U.S. population are lacking. This cross-sectional population-based study aimed to investigate the association of TAC with both diet and supplements with CVD risk factors among 4039 U.S. adults in National Health and Nutrition Examination Survey (NHANES 2007–2012. TAC from both food sources and dietary supplements was estimated from two 24-h dietary recalls using the NHANES supplement ingredient database, United States Department of Agriculture (USDA proanthocyanidin, flavonoid, and isoflavone databases. Top contributors to TAC were tea, antioxidant supplements, vegetable mixture, orange juice, berries, and wine. Antioxidant supplement users had 1.6 times higher TAC than non-users. Greater TAC was associated with reduced triglycerides (TG (−1.39% change; 95% CI = −2.56 to −0.21, TG to high-density lipoprotein cholesterol (HDL-C ratio (−2.03% change; 95% CI = −3.45 to −0.60, HDL-C (0.65% change; 95% CI = 0.07 to 1.23, insulin (−1.37% change; 95% CI = −2.64 to −0.09, homeostasis model assessment of insulin resistance (HOMA-IR (−1.57% change; 95% CI = −3.02 to −0.09 and C-reactive protein (CRP (−0.83% change; 95% CI = −1.29 to −0.38 after adjusting for potential confounders. There was no significant association between TAC and waist circumference, BMI, blood pressure, low-density lipoprotein cholesterol (LDL-C, total cholesterol (TC, and fasting glucose. The findings of this study support the hypothesis that an antioxidant-rich diet and intake of supplements are beneficial to reduce CVD risk.

Patient expectations predict greater pain relief with joint arthroplasty.

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Gandhi, Rajiv; Davey, John Roderick; Mahomed, Nizar

2009-08-01

We examined the relationship between patient expectations of total joint arthroplasty and functional outcomes. We surveyed 1799 patients undergoing primary hip or knee arthroplasty for demographic data and Western Ontario McMaster University Osteoarthritis Index scores at baseline, 3 months, and 1 year of follow-up. Patient expectations were determined with 3 survey questions. The patients with the greatest expectations of surgery were younger, male, and had a lower body mass index. Linear regression modeling showed that a greater expectation of pain relief with surgery independently predicted greater reported pain relief at 1 year of follow-up, adjusted for all relevant covariates (P relief after joint arthroplasty is an important predictor of outcomes at 1 year.

Stabilization of chlorfenvinphos in model dips using a buffer and a bacteriostat agent

International Nuclear Information System (INIS)

Kaposhi, C.K.M.; Mundia, M.P.; Nondo, J.C.; Mwangala, F.S.; Banda, R.

1997-01-01

The stability of chlorfenvinphos acaricide was studied in 50 L model dip tanks using a mixture of 14 C-labelled and unlabelled chlorfenvinphos with or without recharge. Calcium superphosphate fertilizer was used as buffer and to reduce the pH to below 5, while copper sulfate was used as a bacteriostat. In addition 50 g of sediment from around the dip tank was added to the vats and contents of vats were made up to 50 L using the water available at chalimbana NCSR farm. The buffer, by itself as well as in combination with copper sulfate stabilized chiorfenvinphos in the suspension. Binding with the sediment was a key factor in the reduction of chlorfenvinphos level, which was significantly reduced in all vats that contained sediments. Most of the acaricide bound to the sediment was not extractable. The pH in vats was maintained at 4.8 - 5.0 by the addition of superphosphate fertilizer, which reduced the degradation of chlorfenvinphos. Copper sulfate had no effect on the pH of the suspension and the vats treated with the bacteriostat had the lowest levels of chlorfenvinphos. TLC analysis also showed that acaricide breakdown was greater in non-buffered than in buffered vats. A metabolite, 2,4-dichloroacetophenone, was detected, although at a low level. A study of the leaching potential of chlorfenvinphos in soil columns showed that only 3% of the applied acaricide percolated through the 30 cm length of the column, while most of it remained soil-bound. A calorimetric method for measuring the concentration of chlorfenvinphos in dips was evaluated. The method is based on the reaction of the acaricide with 4-(4-nitrobenzyl) pyridine and subsequent measurement of the intensity of the colour formed with tetraethylene pentamine. The measurement was relatively accurate. (author)

The Influence of Green Infrastructure on Urban Resilience in Greater London

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Oh, Yukyung

2017-04-01

High population densities and diverse economic activities in urban areas create social issues as well as a range of environmental impacts including air pollution, soil contamination, loss of biodiversity and health problems (Alberti et al., 2003; Dobbs, Escobedo, & Zipperer, 2011; Grimm et al., 2008). The concept of urban resilience has been used for increasing the capacity of the entities and players to adapt to rapid changes, and urban green spaces play a crucial role in increasing urban resilience. Greater London has a good case for increasing urban green spaces and resilience under the London Plan. The relevance of urban open spaces and several socioeconomic indicators would provide researchers and policy makers with the information for managing green coverage. The correlation analysis of two quantitative data such as open space and socioeconomic data of Greater London was conducted with SPSS. The data for open spaces in Greater London was gained through Greenspace Information for Greater London. The data was converted from vector to raster in Geographic Information System (GIS), so as to calculate landscape metrics for open spaces in Greater London through a spatial pattern analysis program, FRAGSTATS 4.2. The socioeconomic data was obtained from "London Borough Profile", London Datastore. In addition, data on total carbon emissions from Industry and Commercial, Domestic, Transport, LULUCF Net Emissions, and per capita emissions were gained from UK local authority and regional carbon dioxide emissions national statistics: 2005-2014 released from Department of Energy and Climate Change. The indicators from open spaces are total area of open space and patch density or contagion of open spaces. The latter indicator allows to figure out the level of fragmentation of open spaces. The socioeconomic indicators cover number of jobs by workplace, jobs density, crime rates per thousand population, and several wellbeing indicators such as life satisfaction

Variability of bacterial biofilms of the "tina" wood vats used in the ragusano cheese-making process.

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Licitra, G; Ogier, J C; Parayre, S; Pediliggieri, C; Carnemolla, T M; Falentin, H; Madec, M N; Carpino, S; Lortal, S

2007-11-01

Ragusano cheese is a "protected denomination of origin" cheese made in the Hyblean region of Sicily from raw milk using traditional wooden tools, without starter. To explore the Ragusano bacterial ecosystem, molecular fingerprinting was conducted at different times during the ripening and biofilms from the wooden vats called "tinas" were investigated. Raw milks collected at two farm sites, one on the mountain and one at sea level, were processed to produce Ragusano cheese. Raw milk, curd before and after cooking, curd at stretching time (cheese 0 time), and cheese samples (4 and 7 months) were analyzed by PCR-temporal temperature gel electrophoresis (PCR-TTGE) and by classical enumeration microbiology. With the use of universal primers, PCR-TTGE revealed many differences between the raw milk profiles, but also notable common bands identified as Streptococcus thermophilus, Lactobacillus lactis, Lactobacillus delbrueckii, and Enterococcus faecium. After the stretching, TTGE profiles revealed three to five dominant species only through the entire process of ripening. In the biofilms of the two tinas used, one to five species were detected, S. thermophilus being predominant in both. Biofilms from five other tinas were also analyzed by PCR-TTGE, PCR-denaturating gradient gel electrophoresis, specific PCR tests, and sequencing, confirming the predominance of lactic acid bacteria (S. thermophilus, L. lactis, and L. delbrueckii subsp. lactis) and the presence of a few high-GC-content species, like coryneform bacteria. The spontaneous acidification of raw milks before and after contact with the five tinas was followed in two independent experiments. The lag period before acidification can be up to 5 h, depending on the raw milk and the specific tina, highlighting the complexity of this natural inoculation system.

Prevention and management of intraoperative crisis in VATS and open chest surgery: how to avoid emergency conversion.

Science.gov (United States)

Safdie, Fernando M; Sanchez, Manuel Villa; Sarkaria, Inderpal S

2017-01-01

Video assisted thoracic surgery (VATS) has become a routinely utilized approach to complex procedures of the chest, such as pulmonary resection. It has been associated with decreased postoperative pain, shorter length of stay and lower incidence of complications such as pneumonia. Limitations to this modality may include limited exposure, lack of tactile feedback, and a two-dimensional view of the surgical field. Furthermore, the lack of an open incision may incur technical challenges in preventing and controlling operative misadventures leading to major hemorrhage or other intraoperative emergencies. While these events may occur in the best of circumstances, prevention strategies are the primary means of avoiding these injuries. Unplanned conversions for major intraoperative bleeding or airway injury during general thoracic surgical procedures are relatively rare and often can be avoided with careful preoperative planning, review of relevant imaging, and meticulous surgical technique. When these events occur, a pre-planned, methodical response with initial control of bleeding, assessment of injury, and appropriate repair and/or salvage procedures are necessary to maximize outcomes. The surgeon should be well versed in injury-specific incisions and approaches to maximize adequate exposure and when feasible, allow completion of the index operation. Decisions to continue with a minimally invasive approach should consider the comfort and experience level of the surgeon with these techniques, and the relative benefit gained against the risk incurred to the patient. These algorithms may be expected to shift in the future with increasing sophistication and capabilities of minimally invasive technologies and approaches.

Clinical Features and Antimicrobial Resistance of Bacterial Agents of Ventilator-Associated Tracheobronchitis in Hamedan, Iran

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Seyyed Hamid Hashemi

2017-09-01

Full Text Available Objectives: Ventilator-associated tracheobronchitis (VAT is a common cause of mortality and morbidity in patients admitted to intensive care units (ICUs. This study was conducted to evaluate the clinical course, etiology, and antimicrobial resistance of bacterial agents of VAT in ICUs in Hamedan, Iran. Methods: During a 12-month period, all patients with VAT in a medical and a surgical ICU were included. The criteria for the diagnosis of VAT were fever, mucus production, a positive culture of tracheal secretions, and the absence of lung infiltration. Clinical course, including changes in temperature and tracheal secretions, and outcomes were followed. The endotracheal aspirates were cultured on blood agar and chocolate agar, and antimicrobial susceptibility testing of isolates were performed using the disk diffusion method. Results: Of the 1 070 ICU patients, 69 (6.4% were diagnosed with VAT. The mean interval between the patient’s intubation and the onset of symptoms was 4.7±8.5 days. The mean duration of response to treatment was 4.9±4.7 days. A total of 23 patients (33.3% progressed to ventilator-associated pneumonia (VAP, and 38 patients (55.0% died. The most prevalent bacterial isolates included Acinetobacter baumannii (24.6%, Pseudomonas aeruginosa (20.2%, and Enterobacter(13.0%. P. aeruginosa and Enterobacter were the most prevalent bacteria in surgical ICU, and A. baumannii and K. pneumoniae were the most common in the medical ICU. All A. baumannii and Citrobacter species were multidrug-resistant (MDR. MDR pathogens were more prevalent in medical ICU compared to surgical ICU (p < 0.001. Conclusions: VAT increases the rates of progression to VAP, the need for tracheostomy, and the incidence of mortality in ICUs. Most bacterial agents of VAT are MDR. Preventive policies for VAP, including the use of ventilator care bundle, and appropriate empirical antibiotic therapy for VAT may reduce the incidence of VAP.

Perioperative Outcomes and Long-term Survival in Clinically Early-stage Thymic 
Malignancies: Video-assisted Thoracoscopic Thymectomy versus Open Approaches

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Hao WANG

2016-07-01

Full Text Available Background and objective Video-assisted thoracoscopic surgery (VATS theoretically offers advantages over open thymectomy for clinically early-stage (Masaoka-Koga stage I and II thymic malignancies. However, longterm outcomes have not been well studied. We compared the postoperative outcomes and survival from a cohort study based on the database of the Chinese Alliance for Research in Thymomas (ChART. Methods Between 1994 and 2012, data of 1,117 patients having surgery for clinically early-stage (Masaoka-Koga stage I and II tumors were enrolled for the study. Among them, 241 cases underwent VATS thymectomy (VATS group, while 876 cases underwent open thymectomy (Open group. Univariate analyses were used to compare the clinical character and perioperative outcomes between the two groups. And multivariate analysis was performed to determine the independent predictive factors for long-term survival. Results Compared with the Open group, the VATS group had higher percentage of total thymectomy (80.5% vs 73.9%, P=0.028, resection rate (98.8% vs 88.7%, P<0.001 and less recurrence (2.9% vs 16.0%, P<0.001. Five-year overall survival was 92% after VATS and 92% after open thymectomy, with no significant difference between the two groups (P=0.15. However, 5-year disease free survival were 92% in VATS group and 83% in Open group (P=0.011. Cox proportional hazards model revealed that WHO classification, Masaoka-Koga stage and adjuvant therapy were independent predictive factors for overall survival, while surgical approach had no significant impact on long-term outcome. Conclusion This study suggests that VATS thymectomy is an effective approach for clinically early-stage thymic malignancies. And it may offer better perioperative outcomes, as well as equal oncological survival.

In growing pigs, the true ileal and total tract digestibility of acid hydrolyzed ether extract in extracted corn oil is greater than in intact sources of corn oil or soybean oil.

Science.gov (United States)

Kim, B G; Kil, D Y; Stein, H H

2013-02-01

An experiment was conducted to determine the true ileal digestibility (TID) and the true total tract digestibility (TTTD) of acid-hydrolyzed ether extract (AEE) in extracted corn oil, high-oil corn, distillers dried grains with solubles (DDGS), corn germ, and high protein distillers dried grains (HP DDG) and to compare these values to the TID and TTTD of AEE in full-fat soybeans. Nineteen barrows with an initial BW of 52.2 kg (SD = 3.8) were fitted with a T-cannula in the distal ileum and allotted to a 19 × 11 Youden square design with 19 diets and 11 periods. A basal diet based on cornstarch, casein, sucrose, and corn bran was formulated. Eighteen additional diets were formulated by adding 3 levels of extracted corn oil, high-oil corn, DDGS, corn germ, HP DDG, or full-fat soybeans to the basal diet. The apparent ileal and the apparent total tract digestibility of AEE were calculated for each diet. The endogenous flow of AEE associated with each ingredient and values for TID and TTTD were calculated using the regression procedure. Results indicated that digested AEE in ileal digesta and feces linearly increased as AEE intake increased regardless of ingredient (P 0.77). However, the ileal and fecal endogenous losses of AEE were different (P oil, HP DDG, and full-fat soybeans. The TID of AEE was greater (P oil (95.4%) than for all other ingredients. The TID of AEE in HP DDG (76.5%) was not different from the TID of AEE in full-fat soybeans (85.2%) but greater (P oil corn, DDGS, and corn germ (53.0, 62.1, and 50.1%, respectively). The TTTD of AEE was greater (P oil (94.3%) than for all other ingredients, and the TTTD in full-fat soybeans (79.7%) was greater (P oil corn, DDGS, corn germ, and HP DDG (41.4, 51.9, 43.9, and 70.2%, respectively). The TTTD of AEE in HP DDG was also greater (P oil corn, DDGS, and corn germ. In conclusion, the intact sources of oil originating from high-oil corn, DDGS, corn germ, or HP DDG are much less digestible than extracted corn oil

Adipose Tissue Redistribution and Ectopic Lipid Deposition in Active Acromegaly and Effects of Surgical Treatment

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Reyes-Vidal, Carlos M.; Mojahed, Hamed; Shen, Wei; Jin, Zhezhen; Arias-Mendoza, Fernando; Fernandez, Jean Carlos; Gallagher, Dympna; Bruce, Jeffrey N.; Post, Kalmon D.

2015-01-01

Context: GH and IGF-I have important roles in the maintenance of substrate metabolism and body composition. However, when in excess in acromegaly, the lipolytic and insulin antagonistic effects of GH may alter adipose tissue (AT) deposition. Objectives: The purpose of this study was to examine the effect of surgery for acromegaly on AT distribution and ectopic lipid deposition in liver and muscle. Design: This was a prospective study before and up to 2 years after pituitary surgery. Setting: The setting was an academic pituitary center. Patients: Participants were 23 patients with newly diagnosed, untreated acromegaly. Main Outcome Measures: We determined visceral (VAT), subcutaneous (SAT), and intermuscular adipose tissue (IMAT), and skeletal muscle compartments by total-body magnetic resonance imaging, intrahepatic and intramyocellular lipid by proton magnetic resonance spectroscopy, and serum endocrine, metabolic, and cardiovascular risk markers. Results: VAT and SAT masses were lower than predicted in active acromegaly, but increased after surgery in male and female subjects along with lowering of GH, IGF-I, and insulin resistance. VAT and SAT increased to a greater extent in men than in women. Skeletal muscle mass decreased in men. IMAT was higher in active acromegaly and decreased in women after surgery. Intrahepatic lipid increased, but intramyocellular lipid did not change after surgery. Conclusions: Acromegaly may present a unique type of lipodystrophy characterized by reduced storage of AT in central depots and a shift of excess lipid to IMAT. After surgery, this pattern partially reverses, but differentially in men and women. These findings have implications for understanding the role of GH in body composition and metabolic risk in acromegaly and other clinical settings of GH use. PMID:26037515

Video-assisted thoracoscopic surgery in the management of penetrating and blunt thoracic trauma.

Science.gov (United States)

Milanchi, S; Makey, I; McKenna, R; Margulies, D R

2009-01-01

The role of video-assisted Thoracoscopic Surgery (VATS) is still being defined in the management of thoracic trauma. We report our trauma cases managed by VATS and review the role of VATS in the management of thoracic trauma. All the trauma patients who underwent VATS from 2000 to 2007 at Cedars-Sinai Medical Center were retrospectively studied. Twenty-three trauma patients underwent 25 cases of VATS. The most common indication for VATS was retained haemothorax. Thoracotomy was avoided in 21 patients. VATS failed in two cases. On an average VATS was performed on trauma day seven (range 1-26) and the length of hospital stay was 20 days (range 3-58). There was no mortality. VATS was performed in an emergency (day 1-2), or in the early (day 2-7) or late (after day 7) phases of trauma. VATS can be performed safely for the management of thoracic traumas. VATS can be performed before or after thoracotomy and at any stage of trauma. The use of VATS in trauma has a trimodal distribution (emergent, early, late), each with different indications.

Exenatide with Metformin Ameliorated Visceral Adiposity and Insulin Resistance

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Xuan Du

2018-01-01

Full Text Available Background. To study the effectiveness of exenatide with metformin and sequential treatment with exenatide and glargine added to metformin and their influence on insulin sensitivity and adipose distribution. Methods. 20 newly diagnosed obese type 2 diabetic patients were enrolled, and 2-month washout treatment of metformin, 6-month exenatide treatment, and 6-month glargine treatment were administrated sequentially accompanied with previous metformin. Glucolipid metabolic parameters were compared among groups. Adipose distribution was quantified with computerized tomography according to anatomy, dividing into visceral adipose tissue (VAT and subcutaneous adipose tissue (SAT, adding up to total adipose tissue (TAT. Results. The 6-month exenatide treatment dramatically ameliorated the glucose and lipid profile, improved insulin sensitivity, and mainly decreased VAT and also the ratio of VAT/SAT (RVS. The following 6-month glargine treatment increased VAT. The whole 12-month sequential treatment with exenatide and glargine added to metformin basically improved the insulin sensitivity and glucolipid control though VAT rebounded at the end, however without deteriorating the other parameters. Conclusion. Exenatide is an ideal treatment for obese type 2 diabetic patients in the aspect of adipose tissue distribution. Sequential treatment of exenatide and glargine could be an alternative for low-income patients who cannot afford GLP-1 agonist for long time. This trial is registered with ChiCTR-OOC-17013679.

Greater happiness for a greater number: Is that possible in Austria?

NARCIS (Netherlands)

R. Veenhoven (Ruut)

2011-01-01

textabstractWhat is the final goal of public policy? Jeremy Bentham (1789) would say: greater happiness for a greater number. He thought of happiness as subjective enjoyment of life; in his words as “the sum of pleasures and pains”. In his time the happiness of the great number could not be measured

Greater happiness for a greater number: Is that possible in Germany?

NARCIS (Netherlands)

R. Veenhoven (Ruut)

2009-01-01

textabstractWhat is the final goal of public policy? Jeremy Bentham (1789) would say: greater happiness for a greater number. He thought of happiness as subjective enjoyment of life; in his words as “the sum of pleasures and pains”. In his time the Happiness of the great number could not be measured

Enhanced recovery after surgery and video-assisted thoracic surgery lobectomy: the Italian VATS Group**List of collaborators of the Italian ERAS Group: Jacopo Vannucci, MD (University of Perugia); Antonio D’Andrilli, MD (S. Andrea Hospital, Roma); Majed Refai, MD (Ospedali Riuniti, Ancona); Guendalina Graffigna, MD (Università Cattolica del Sacro Cuore, Milano); Stefano Lovadina, MD (Ospedali Riuniti, Trieste); Marzia Umari (Ospedali Riuniti, Trieste), Paolo Ferrari, MD (IRCCS ISMETT-UPMC, University of Pittsburgh, Palermo); Michele Zuliani, MD (Ospedali Riuniti, Trieste); Marco Taurchini, MD (Casa Sollievo della Sofferenza, San Giovanni Rotondo); Carlo Del Naja, MD (Casa Sollievo della Sofferenza, San Giovanni Rotondo); Domenico Massullo, MD (S. Andrea Hospital, Roma), Olha Putina, MD (ASST Mantova), Nicoletta Pia Ardò (University of Foggia). surgical protocol

Science.gov (United States)

Viggiano, Domenico; Voltolini, Luca; Bertani, Alessandro; Bertolaccini, Luca; Crisci, Roberto; Droghetti, Andrea

2018-01-01

Enhanced recovery after surgery (ERAS®) is a strategy that seeks to reduce patients’ perioperative stress response, thereby reducing potential complications, decreasing hospital length of stay and enabling patients to return more quickly to their baseline functional status. The concept was introduced in the late 1990s and was first adopted in patients undergoing open colorectal surgery. Since then, the concept of ERAS has been adopted by multiple surgical specialties. The diffusion of video-assisted thoracic surgery lobectomy (VATS-L) sets also the surgical treatment of lung cancer as a new area for ERAS development. In this paper, we present the Italian VATS Group (www.vatsgroup.org) surgical protocol as part of the ERAS clinical pathway belonging to the VATS-L national database. PMID:29629203

Coagulation profile in open and video-assisted thoracoscopic lobectomies

DEFF Research Database (Denmark)

Christensen, Thomas Decker; Vad, Henrik; Pedersen, Søren

2018-01-01

OBJECTIVES: Lung cancer patients are perceived to have a relatively high risk of venous thromboembolic events due to an activation of the coagulation system. In terms of activation of the coagulation system, the difference between video-assisted thoracoscopic surgery (VATS) and open lobectomies...... for primary lung cancer has not been investigated. The aim of this study was to compare the impact on the coagulation system in patients undergoing curative surgery for primary lung cancer by either VATS or open lobectomies. METHODS: In total, 62 patients diagnosed with primary lung cancer were allocated...... to either VATS (n = 32) or open lobectomies (n = 30). All patients received subcutaneous injections with dalteparin (Fragmin®) 5000 IE once daily. The coagulation was assessed pre- and intraoperatively, and the first 2 days postoperatively by standard coagulation blood tests, thromboelastometry (ROTEM...

Neurotensin Is a Lipid-Induced Gastrointestinal Peptide Associated with Visceral Adipose Tissue Inflammation in Obesity.

Science.gov (United States)

Barchetta, Ilaria; Cimini, Flavia Agata; Capoccia, Danila; Bertoccini, Laura; Ceccarelli, Valentina; Chiappetta, Caterina; Leonetti, Frida; Di Cristofano, Claudio; Silecchia, Gianfranco; Orho-Melander, Marju; Melander, Olle; Cavallo, Maria Gisella

2018-04-23

Neurotensin (NT) is a 13-amino acid peptide localized in the neuroendocrine cells of the small intestine, which promotes fat absorption and fatty acids translocation in response to lipid ingestion. NT-knock-out mice fed with a high-fat diet are protected from obesity, fatty liver, and the development of insulin-resistance. In humans, higher plasma levels of pro-NT, which is the stable circulating precursor of NT, predict obesity, type 2 diabetes (T2D), and cardiovascular disease. In obesity, the presence of visceral adipose tissue (VAT) inflammation leads to unfavorable metabolic outcomes and is associated with the development of T2D and non-alcoholic fatty liver disease (NAFLD). In this study, we investigated the relationship between plasma pro-NT levels and the presence of VAT inflammation in biopsies from 40 morbidly obese subjects undergoing bariatric surgery. We demonstrated that higher proNT levels are significantly associated with greater macrophages infiltration, HIF-1α, WISP-1, and UNC5B expression in VAT (all p < 0.01) due to the diagnosis of T2D and NAFLD. The overall results show that, in obesity, pro-NT is a biomarker of VAT inflammation and insulin-resistance. Additionally, NT may be involved in the development of dysmetabolic conditions likely mediated by increased gut fat absorption and the presence of a proinflammatory milieu in the adipose tissue.

Video-assisted thoracoscopic surgery in the management of penetrating and blunt thoracic trauma

Directory of Open Access Journals (Sweden)

Milanchi S

2009-01-01

Full Text Available Background: The role of video-assisted Thoracoscopic Surgery (VATS is still being defined in the management of thoracic trauma. We report our trauma cases managed by VATS and review the role of VATS in the management of thoracic trauma. Materials and Methods: All the trauma patients who underwent VATS from 2000 to 2007 at Cedars-Sinai Medical Center were retrospectively studied. Results: Twenty-three trauma patients underwent 25 cases of VATS. The most common indication for VATS was retained haemothorax. Thoracotomy was avoided in 21 patients. VATS failed in two cases. On an average VATS was performed on trauma day seven (range 1-26 and the length of hospital stay was 20 days (range 3-58. There was no mortality. VATS was performed in an emergency (day 1-2, or in the early (day 2-7 or late (after day 7 phases of trauma. Conclusion: VATS can be performed safely for the management of thoracic traumas. VATS can be performed before or after thoracotomy and at any stage of trauma. The use of VATS in trauma has a trimodal distribution (emergent, early, late, each with different indications.

Assay development status report for total cyanide

International Nuclear Information System (INIS)

Simpson, B.C.; Jones, T.E.; Pool, K.H.

1993-02-01

A validated cyanide assay that is applicable to a variety of tank waste matrices is necessary to resolve certain waste tank safety issues and for purposes of overall waste characterization. The target for this effort is an assay with an applicable range of greater than 1,000 ppM (0.10 wt%) total cyanide and a confidence level greater than 80%. Figure 1 illustrates the operating regime of the proposed cyanide assay method. The Assay Development Status Report for Total Cyanide will summarize the past experience with cyanide analyses on-tank waste matrices and will rate the status of the analytical methods used to assay total cyanide (CN - ion) in the tank waste matrices as acceptable or unacceptable. This paper will also briefly describe the current efforts for improving analytical resolution of the assays and the attempts at speciation

Avaliação por imagem da área de gordura visceral e suas correlações com alterações metabólicas Evaluación por imagen del área de grasa visceral y sus correlaciones con alteraciones metabólicas Imaging assessment of visceral adipose tissue area and its correlations with metabolic alterations

Directory of Open Access Journals (Sweden)

Anna Karla Carneiro Roriz

2010-12-01

(VAT area, measured by computed tomography (CT, on the metabolic alterations in adult and elderly individuals. METHODS: CT results and lipoprotein levels, total cholesterol and fractions, triglycerides, glycemia and uric acid levels, were obtained from 194 individuals stratified by sex, age group and body mass and analyzed using the tests of correlation and means. RESULTS: The elderly individuals presented higher VAT area, glycemia, uric acid and total cholesterol levels. The most important correlations were observed between VAT area, triglycerides (TG and VLDL-c (r > 0.5; p < 0.01, in both age groups. The mean VAT area was always higher when TG and glycemia levels were altered, in both age groups. CONCLUSION: Most tests showed a strong correlation with VAT area, which was considered as risk for metabolic alterations. In elderly individuals, the risk VAT area seems to be higher than that of adult individuals.

Hypothyroidism Reduces the Size of Ovarian Follicles and Promotes Hypertrophy of Periovarian Fat with Infiltration of Macrophages in Adult Rabbits

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J. Rodríguez-Castelán

2017-01-01

Full Text Available Ovarian failure is related to dyslipidemias and inflammation, as well as to hypertrophy and dysfunction of the visceral adipose tissue (VAT. Although hypothyroidism has been associated with obesity, dyslipidemias, and inflammation in humans and animals, its influence on the characteristics of ovarian follicles in adulthood is scarcely known. Control and hypothyroid rabbits were used to analyze the ovarian follicles, expression of aromatase in the ovary, serum concentration of lipids, leptin, and uric acid, size of adipocytes, and infiltration of macrophages in the periovarian VAT. Hypothyroidism did not affect the percentage of functional or atretic follicles. However, it reduced the size of primary, secondary, and tertiary follicles considered as large and the expression of aromatase in the ovary. This effect was associated with high serum concentrations of total cholesterol and low-density lipoprotein cholesterol (LDL-C. In addition, hypothyroidism induced hypertrophy of adipocytes and a major infiltration of CD68+ macrophages into the periovarian VAT. Our results suggest that the reduced size of ovarian follicles promoted by hypothyroidism could be associated with dyslipidemias, hypertrophy, and inflammation of the periovarian VAT. Present findings may be useful to understand the influence of hypothyroidism in the ovary function in adulthood.

Hypothyroidism Reduces the Size of Ovarian Follicles and Promotes Hypertrophy of Periovarian Fat with Infiltration of Macrophages in Adult Rabbits.

Science.gov (United States)

Rodríguez-Castelán, J; Méndez-Tepepa, M; Carrillo-Portillo, Y; Anaya-Hernández, A; Rodríguez-Antolín, J; Zambrano, E; Castelán, F; Cuevas-Romero, E

2017-01-01

Ovarian failure is related to dyslipidemias and inflammation, as well as to hypertrophy and dysfunction of the visceral adipose tissue (VAT). Although hypothyroidism has been associated with obesity, dyslipidemias, and inflammation in humans and animals, its influence on the characteristics of ovarian follicles in adulthood is scarcely known. Control and hypothyroid rabbits were used to analyze the ovarian follicles, expression of aromatase in the ovary, serum concentration of lipids, leptin, and uric acid, size of adipocytes, and infiltration of macrophages in the periovarian VAT. Hypothyroidism did not affect the percentage of functional or atretic follicles. However, it reduced the size of primary, secondary, and tertiary follicles considered as large and the expression of aromatase in the ovary. This effect was associated with high serum concentrations of total cholesterol and low-density lipoprotein cholesterol (LDL-C). In addition, hypothyroidism induced hypertrophy of adipocytes and a major infiltration of CD68+ macrophages into the periovarian VAT. Our results suggest that the reduced size of ovarian follicles promoted by hypothyroidism could be associated with dyslipidemias, hypertrophy, and inflammation of the periovarian VAT. Present findings may be useful to understand the influence of hypothyroidism in the ovary function in adulthood.

Insulin resistance, hepatic lipid and adipose tissue distribution in HIV infected men

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He, Qing; Engelson, Ellen S.; Ionescu, Gabriel; Glesby, Marshall J.; Albu, Jeanine B.; Kotler, Donald P.

2010-01-01

Background A large proportion of HIV-infected subjects on antiretroviral medication develop insulin resistance, especially in the context of fat redistribution. This study investigates the interrelationships among fat distribution, hepatic lipid content, and insulin resistance in HIV-infected men. Design and methods We performed a cross-sectional analysis of baseline data from twenty-three HIV-infected participants in 3 prospective clinical studies. Magnetic resonance spectroscopy was applied to quantify hepatic lipid concentrations. Magnetic resonance imaging was used to quantify whole body adipose tissue compartments, i.e., subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) volumes as well as inter-muscular adipose tissue (IMAT) subcompartment, and omental-mesenteric adipose tissue (OMAT) and retroperitoneal adipose tissue (RPAT) subcompartments of VAT. Homeostasis model for assessment of insulin resistance (HOMA-IR) was calculated from fasting glucose and insulin concentrations. Results Hepatic lipid content correlated significantly with total VAT (r=0.62, p=0.0014) but not with SAT (r=0.053, p=0.81). In univariate analysis, hepatic lipid content was associated with the OMAT (r=0.67, p=0.0004) and RPAT (r=0.53, p=0.009) subcompartments; HOMA-IR correlated with both VAT and hepatic lipid contents (r=0.61, p=0.057 and 0.68, p=0.0012, respectively). In stepwise linear regression models, hepatic lipid had the strongest associations with OMAT and with HOMA-IR. Conclusion Hepatic lipid content is associated with VAT volume, especially the omental-mesenteric subcompartment, in HIV-infected men. Hepatic lipid content is associated with insulin resistance in HIV-infected men. Hepatic lipid content might mediate the relationship between VAT and insulin resistance among treated, HIV-infected men. PMID:18572755

Insulin resistance, hepatic lipid and adipose tissue distribution in HIV-infected men.

Science.gov (United States)

He, Qing; Engelson, Ellen S; Ionescu, Gabriel; Glesby, Marshall J; Albu, Jeanine B; Kotler, Donald P

2008-01-01

A large proportion of HIV-infected patients on antiretroviral medication develop insulin resistance, especially in the context of fat redistribution. This study investigates the interrelationships among fat distribution, hepatic lipid content, and insulin resistance in HIV-infected men. We performed a cross-sectional analysis of baseline data from 23 HIV-infected participants in three prospective clinical studies. Magnetic resonance spectroscopy was used to quantify hepatic lipid concentrations. Magnetic resonance imaging was used to quantify whole-body adipose tissue compartments: that is, subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) volumes, as well as the intermuscular adipose tissue (IMAT) subcompartment and the omental-mesenteric adipose tissue (OMAT) and retroperitoneal adipose tissue (RPAT) subcompartments of VAT. The homeostasis model for assessment of insulin resistance (HOMA-IR) was calculated from fasting glucose and insulin concentrations. Hepatic lipid content correlated significantly with total VAT (r = 0.62, P = 0.0014), but not with SAT (r = 0.053, P = 0.81). In univariate analysis, hepatic lipid content was associated with the OMAT (r = 0.67, P = 0.0004) and RPAT (r = 0.53, P = 0.009) subcompartments; HOMA-IR correlated with both VAT and hepatic lipid contents (r = 0.61, P = 0.057 and r = 0.68, P = 0.0012, respectively). In stepwise linear regression models, hepatic lipid had the strongest associations with OMAT and with HOMA-IR. Hepatic lipid content is associated with VAT volume, especially the OMAT subcompartment, in HIV-infected men. Hepatic lipid content is associated with insulin resistance in HIV-infected men. Hepatic lipid content might mediate the relationship between VAT and insulin resistance among treated, HIV-infected men.

The relationship between epicardial fat and indices of obesity and the metabolic syndrome: a systematic review and meta-analysis.

Science.gov (United States)

Rabkin, Simon W

2014-02-01

Epicardial fat (epicardial adipose tissue, EAT) has been implicated in the pathogenesis of coronary artery disease (CAD). The objective of this study was to examine the relationship between EAT and generalized obesity, central or visceral adipose tissue (VAT), and the components of the metabolic syndrome--systolic blood pressure (SBP), triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), and fasting blood glucose (FBG)--that are linked to CAD. A systematic review of the literature, following meta-analysis guidelines, was conducted until May, 2013, using the search strategy "Obesity" OR "abdominal obesity" OR "metabolic syndrome" OR "metabolic syndrome X" AND "epicardial fat". Thirty-eight studies fulfilled the criteria. There was a highly significant (Pcorrelation between EAT and body mass index (BMI), waist circumference (WC), or VAT. The correlation between EAT and VAT was significantly (Pcorrelation between EAT and WC, which in turn was significantly greater than the correlation between EAT and BMI. Overall, EAT was 7.5 ± 0.1 mm in thickness in the metabolic syndrome (n=427) compared to 4.0 ± 0.1 mm in controls (n=301). EAT correlated significantly (PHDL, and FBG, but the strength of the association was less than one-half of the relationship of EAT to indices of obesity. The results of multivariate analysis were less consistent but show a relationship between EAT and metabolic syndrome independent of BMI. In summary, the very strong correlation between EAT and VAT suggests a relationship between these two adipose tissue depots. Measurement of EAT can be useful to indicate VAT. Whereas EAT correlates significantly with each of the components of the metabolic syndrome- SBP, TGs, HDL, or FBG-the magnitude of the relationship is considerably and significantly less than the relationship of EAT to BMI. These data show the strong relationship between EAT and BMI but especially with WC and VAT. They also demonstrate the smaller magnitude of the

Oxygen uptake and body composition after aquatic physical training in women with fibromyalgia: a randomized controlled trial.

Science.gov (United States)

Andrade, Carolina P; Zamunér, Antonio R; Forti, Meire; França, Thalita F; Tamburús, Nayara Y; Silva, Ester

2017-10-01

Aquatic physical training (APT) has been strongly recommended to improve symptoms in fibromyalgia syndrome (FMS). However, its effects on body composition and whether lean body mass (LBM) directly influences the aerobic functional capacity of this population are still not clear. To investigate whether APT can help improve body composition and increase the aerobic functional capacity in women with FMS, and whether oxygen uptake (VO2) related to LBM can better quantify the functional capacity of this population. Randomized controlled trial. The Federal University of São Carlos, São Paulo, Brazil. Fifty-four women with FMS were randomly assigned to trained group (TG, N.=27) or control group (CG, N.=27). All women underwent cardiopulmonary exercise test (CPET) to assess oxygen consumption at ventilatory anaerobic threshold (VAT) and at peak exercise, and also to assess body composition. The TG was submitted to APT program, held twice a week for 16 weeks. The exercise intensity was adapted throughout the sessions in order to keep heart rate and ratings of perceived exertion achieved at VAT. After APT, body composition was not significantly different between groups (TG and CG). In VAT only TG showed increased VO2 related to LBM, since in peak CPET, VO2 in absolute units, VO2 related to total body mass (TBM), VO2 related to LBM and power showed significant differences. Significant difference between VO2 related to TBM and VO2 related to baseline LBM and after 16 weeks of follow-up, both in VAT as in peak CPET in both groups. Significant difference between VO2 related to TBM and VO2 related to LBM at VAT and at peak CPET in both groups at baseline and after 16 weeks of follow-up was observed. APT with standardized intensities did not cause significant changes in body composition, but was effective in promoting increased VO2 at peak CPET in women with FMS. However, VO2 related to LBM more accurately reflected changes in aerobic functional capacity at VAT level after to

Outcomes of the Tower Crane Technique with a 15-mm Trocar in Primary Spontaneous Pneumothorax

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Yooyoung Chong

2016-04-01

Full Text Available Background: Video-assisted thoracoscopic surgery (VATS pulmonary wedge resection has emerged as the standard treatment for primary spontaneous pneumothorax. Recently, single-port VATS has been introduced and is now widely performed. This study aimed to evaluate the outcomes of the Tower crane technique as novel technique using a 15-mm trocar and anchoring suture in primary spontaneous pneumothorax. Methods: Patients who underwent single- port VATS wedge resection in Chungnam National University Hospital from April 2012 to March 2014 were enrolled. The medical records of the enrolled patients were reviewed retrospectively. Results: A total of 1,251 patients were diagnosed with pneumothorax during this period, 270 of whom underwent VATS wedge resection. Fifty-two of those operations were single-port VATS wedge resections for primary spontaneous pneumothorax performed by a single surgeon. The median age of the patients was 19.3±11.5 years old, and 43 of the patients were male. The median duration of chest tube drainage following the operation was 2.3±1.3 days, and mean postoperative hospital stay was 3.2±1.3 days. Prolonged air leakage for more than three days following the operation was observed in one patient. The mean duration of follow-up was 18.7±6.1 months, with a recurrence rate of 3.8%. Conclusion: The tower crane technique with a 15-mm trocar may be a promising treatment modality for patients presenting with primary spontaneous pneumothorax.

Frustrated Total Internal Reflection: A Simple Application and Demonstration.

Science.gov (United States)

Zanella, F. P.; Magalhaes, D. V.; Oliveira, M. M.; Bianchi, R. F.; Misoguti, L.; Mendonca, C. R.

2003-01-01

Describes the total internal reflection process that occurs when the internal angle of incidence is equal to or greater than the critical angle. Presents a demonstration of the effect of frustrated total internal reflection (FTIR). (YDS)

Composition and Variation of Macronutrients, Immune Proteins, and Human Milk Oligosaccharides in Human Milk From Nonprofit and Commercial Milk Banks.

Science.gov (United States)

Meredith-Dennis, Laura; Xu, Gege; Goonatilleke, Elisha; Lebrilla, Carlito B; Underwood, Mark A; Smilowitz, Jennifer T

2018-02-01

When human milk is unavailable, banked milk is recommended for feeding premature infants. Milk banks use processes to eliminate pathogens; however, variability among methods exists. Research aim: The aim of this study was to compare the macronutrient (protein, carbohydrate, fat, energy), immune-protective protein, and human milk oligosaccharide (HMO) content of human milk from three independent milk banks that use pasteurization (Holder vs. vat techniques) or retort sterilization. Randomly acquired human milk samples from three different milk banks ( n = 3 from each bank) were analyzed for macronutrient concentrations using a Fourier transform mid-infrared spectroscopy human milk analyzer. The concentrations of IgA, IgM, IgG, lactoferrin, lysozyme, α-lactalbumin, α antitrypsin, casein, and HMO were analyzed by mass spectrometry. The concentrations of protein and fat were significantly ( p < .05) less in the retort sterilized compared with the Holder and vat pasteurized samples, respectively. The concentrations of all immune-modulating proteins were significantly ( p < .05) less in the retort sterilized samples compared with vat and/or Holder pasteurized samples. The total HMO concentration and HMOs containing fucose, sialic acid, and nonfucosylated neutral sugars were significantly ( p < .05) less in retort sterilized compared with Holder pasteurized samples. Random milk samples that had undergone retort sterilization had significantly less immune-protective proteins and total and specific HMOs compared with samples that had undergone Holder and vat pasteurization. These data suggest that further analysis of the effect of retort sterilization on human milk components is needed prior to widespread adoption of this process.

Comparison of serum vaspin levels and vaspin expression in adipose tissue and smooth muscle tissue in pregnant women with and without gestational diabetes.

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Tang, Yuping; Qiao, Ping; Qu, Xiaoxian; Bao, Yirong; Li, Yuhong; Liao, Yini; Ying, Hao

2017-10-01

Vaspin is associated with metabolic parameters and insulin resistance. However, the expression of vaspin in visceral adipose tissue (VAT) in pregnant women with gestational diabetes mellitus (GDM) has not been fully explored, and the contribution of vaspin to the biological mechanisms underlying GDM remains unclear. This study aimed to compare circulating vaspin levels and its expression in different insulin target tissues including subcutaneous adipose tissue (SAT), VAT and smooth muscle tissue (SMT) in pregnant women with and without GDM. A total of 37 women with GDM (GDM group) and 37 normal pregnant women (control group) were selected. Fasting plasma glucose (FPG), fasting insulin (FINS) and serum vaspin levels were quantified at term, and homeostasis model of assessment2-insulin resistance (HOMA2-IR) values were calculated. RT-qPCR and Western blotting were used to measure mRNA and protein levels of vaspin in VAT, SAT and SMT of 15 GDM women and normal pregnant women. In the GDM group, serum vaspin concentrations were significantly higher than in the control group. Serum vaspin levels were positively correlated with HOMA2-IR in the GDM group but not in the control group. In the GDM group, vaspin mRNA and protein expression levels in SAT and VAT were both significantly higher than in controls, but no difference was found in SMT. Moreover, relative mRNA but not protein expression levels of vaspin in SAT were highest among the three tissues in both groups. Circulating vaspin levels and expression of vaspin in SAT and VAT were higher in GDM women than in normal pregnant women. However, the specific role of vaspin from SAT and VAT in the pathogenesis of GDM needs further study. © 2017 John Wiley & Sons Ltd.

Fat distribution and glucose intolerance among Greenland inuit

DEFF Research Database (Denmark)

Jørgensen, Marit Eika; Borch-Johnsen, Knut; Stolk, Ronald

2013-01-01

circumference [WC], and percentage of body fat) and the indices of glucose metabolism (fasting and 2-h glucose levels, insulin resistance per homeostasis model assessment [HOMA-IR], and the insulin sensitivity index [ISI0,120]) among Greenland Inuit. RESEARCH DESIGN AND METHODS A total of 3,108 adult Inuit...... associated with glucose intolerance, fasting and 2-h plasma glucose levels, HOMA-IR, and ISI0,120. VAT was more strongly associated with all outcomes than was SAT. After further adjustment for BMI or WC, VAT was associated with glucose intolerance and insulin resistance, whereas there was a trend toward...

Velocity Drives Greater Power Observed During Back Squat Using Cluster Sets.

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Oliver, Jonathan M; Kreutzer, Andreas; Jenke, Shane C; Phillips, Melody D; Mitchell, Joel B; Jones, Margaret T

2016-01-01

This investigation compared the kinetics and kinematics of cluster sets (CLU) and traditional sets (TRD) during back squat in trained (RT) and untrained (UT) men. Twenty-four participants (RT = 12, 25 ± 1 year, 179.1 ± 2.2 cm, 84.6 ± 2.1 kg; UT = 12, 25 ± 1 year, 180.1 ± 1.8 cm, 85.4 ± 3.8 kg) performed TRD (4 × 10, 120-second rest) and CLU (4 × (2 × 5) 30 seconds between clusters; 90 seconds between sets) with 70% one repetition maximum, randomly. Kinematics and kinetics were sampled through force plate and linear position transducers. Resistance-trained produced greater overall force, velocity, and power; however, similar patterns were observed in all variables when comparing conditions. Cluster sets produced significantly greater force in isolated repetitions in sets 1-3, while consistently producing greater force due to a required reduction in load during set 4 resulting in greater total volume load (CLU, 3302.4 ± 102.7 kg; TRD, 3274.8 ± 102.8 kg). Velocity loss was lessened in CLU resulting in significantly higher velocities in sets 2 through 4. Furthermore, higher velocities were produced by CLU during later repetitions of each set. Cluster sets produced greater power output for an increasing number of repetitions in each set (set 1, 5 repetitions; sets 2 and 3, 6 repetitions; set 4, 8 repetitions), and the difference between conditions increased over subsequent sets. Time under tension increased over each set and was greater in TRD. This study demonstrates greater power output is driven by greater velocity when back squatting during CLU; therefore, velocity may be a useful measure by which to assess power.

ANALISIS PERHITUNGAN DAN PELAPORAN PAJAK PERTAMBAHAN NILAI PADA PT FAJAR MAS KARYATAMA

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MARINDO PUTRA

2017-05-01

Full Text Available Value Added Tax (VAT is Tax that imposed on any apreciation in value of the goods or services in its circulation from producers to consumers. Through the calculation dan reporting is good, then the company may be said it has complied with the applicable rules in order to enhance the national development budget of the Government. PT Fajar Mas Karyatama as a company engaged intrade of goods subject to VAT, as in general make a purchase with Input Tax which may be credited. The purpose of this study to know whether the application of VAT and VAT underpayment or overpayment in accordance with law of VAT No. 42 of 2009. This study used a comparative method. The company will account for and report the delivery of Added Value Tax in the Notice Period of Added Value Tax (VAT Period SPT. VAT calculations made by company are the basis for the report required to implement Tax Laws for the companies. Conclusion is that application of VAT in the calculating and reporting of PT Fajar Mas Karyatama was almost accordance with the VAT Act applied and through the application of VAT, namely the purchase and sale of Taxable Goods so that the sum of the difference by the number of Input Tax or Output Tax generate VAT Less/More Pay at the end each mont, it is accordance with the Law of VAT No. 42 of 2009.

A multi-center retrospective study of single-port versus multi-port video-assisted thoracoscopic lobectomy and anatomic segmentectomy.

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Ji, Chunyu; Xiang, Yangwei; Pagliarulo, Vincenzo; Lee, Jangming; Sihoe, Alan D L; Kim, HyunKoo; Zhang, Xuefei; Wang, Zhexin; Zhao, Weigang; Feng, Jian; Fang, Wentao

2017-10-01

To assess the feasibility and perioperative outcomes of single-port (SP) and multi-port (MP) approaches for video-assisted thoracoscopic surgery (VATS) lobectomy and anatomical segmentectomy. Retrospective data from 458 patients who received VATS lobectomy or anatomical segmentectomy at Shanghai Chest Hospital, Korea University Guro Hospital, Affiliated Hospital of National Taiwan University, University of Hong Kong Queen Mary Hospital and Shenzhen Hospital were collected. Patients were divided into SP group and MP group according to the surgical approach. Perioperative factors such as operation time, blood loss during surgery, conversion rate, the number and stations of lymph nodes harvested, postoperative chest tube drainage time, postoperative hospitalization time, perioperative morbidity and mortality, and pain scores during the first 3 days after surgery were compared between the two groups. There were no differences in the number (P=0.278) and stations (P=0.564) of lymph nodes harvested, postoperative morbidity (P=0.414) or mortality(P=0.246), and pain score on the third day (P=0.630) after surgery between the two groups. The SP group had a longer operation time (P=0.042) and greater intraoperative blood loss (P<0.001), but the conversion rate was even higher in the MP group (P=0.018). Patients in the SP group had shorter chest tube removal time (P=0.012) and postoperative hospitalization time (P=0.005). Pain scores were lower on the first (P=0.014) and second (P=0.006) day after surgery in the SP group. SP VATS lobectomy and anatomical segmentectomy is technologically more demanding than MP VATS. It can be safe and feasible in the hands of experienced surgeons, with comparable preoperative outcomes to MP VATS, but less pain in the early postoperative period.

Women at greater risk of HIV infection.

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Mahathir, M

1997-04-01

Although many people believe that mainly men get infected with HIV/AIDS, women are actually getting infected at a faster rate than men, especially in developing countries, and suffer more from the adverse impact of AIDS. As of mid-1996, the Joint UN Program on AIDS estimated that more than 10 million of the 25 million adults infected with HIV since the beginning of the epidemic are women. The proportion of HIV-positive women is growing, with almost half of the 7500 new infections daily occurring among women. 90% of HIV-positive women live in a developing country. In Asia-Pacific, 1.4 million women have been infected with HIV out of an estimated total 3.08 million adults from the late 1970s until late 1994. Biologically, women are more vulnerable than men to infection because of the greater mucus area exposed to HIV during penile penetration. Women under age 17 years are at even greater risk because they have an underdeveloped cervix and low vaginal mucus production. Concurrent sexually transmitted diseases increase the risk of HIV transmission. Women's risk is also related to their exposure to gender inequalities in society. The social and economic pressures of poverty exacerbate women's risk. Prevention programs are discussed.

Greater happiness for a greater number: Is that possible? If so how? (Arabic)

NARCIS (Netherlands)

R. Veenhoven (Ruut); E. Samuel (Emad)

2012-01-01

textabstractWhat is the final goal of public policy? Jeremy Bentham (1789) would say: greater happiness for a greater number. He thought of happiness as subjective enjoyment of life; in his words as “the sum of pleasures and pains”. In his time, the happiness of the great number could not be

LINE-1 methylation in visceral adipose tissue of severely obese individuals is associated with metabolic syndrome status and related phenotypes

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Turcot Valérie

2012-07-01

Full Text Available Abstract Background Epigenetic mechanisms may be involved in the regulation of genes found to be differentially expressed in the visceral adipose tissue (VAT of severely obese subjects with (MetS+ versus without (MetS- metabolic syndrome (MetS. Long interspersed nuclear element 1 (LINE-1 elements DNA methylation levels (%meth in blood, a marker of global DNA methylation, have recently been associated with fasting glucose, blood lipids, heart diseases and stroke. Aim To test whether LINE-1%meth levels in VAT are associated with MetS phenotypes and whether they can predict MetS risk in severely obese individuals. Methods DNA was extracted from VAT of 34 men (MetS-: n = 14, MetS+: n = 20 and 152 premenopausal women (MetS-: n = 84; MetS+: n = 68 undergoing biliopancreatic diversion for the treatment of obesity. LINE-1%meth levels were assessed by pyrosequencing of sodium bisulfite-treated DNA. Results The mean LINE-1%meth in VAT was of 75.8% (SD = 3.0%. Multiple linear regression analyses revealed that LINE-1%meth was negatively associated with fasting glucose levels (β = -0.04; P = 0.03, diastolic blood pressure (β =  -0.65; P = 0.03 and MetS status (β = -0.04; P = 0.004 after adjustments for the effects of age, sex, waist circumference (except for MetS status and smoking. While dividing subjects into quartiles based on their LINE-1%meth (Q1 to Q4: lower %meth to higher %meth levels, greater risk were observed in the first (Q1: odds ratio (OR = 4.37, P = 0.004 and the second (Q2: OR = 4.76, P = 0.002 quartiles compared to Q4 (1.00 when adjusting for age, sex and smoking. Conclusions These results suggest that lower global DNA methylation, assessed by LINE-1 repetitive elements methylation analysis, would be associated with a greater risk for MetS in the presence of obesity.

Association of abdominal obesity, insulin resistance, and oxidative stress in adipose tissue in women with polycystic ovary syndrome.

Science.gov (United States)

Chen, Li; Xu, Wen Ming; Zhang, Dan

2014-10-01

To study the expression of insulin signaling-related genes and oxidative stress markers in the visceral adipose tissue obtained from polycystic ovary syndrome (PCOS) patients and healthy control subjects and to investigate the relationships among abdominal obesity, insulin resistance, and oxidative stress at the tissue level. Case-control study. University teaching hospital. In total, 30 PCOS patients and 30 healthy control subjects, who underwent laparoscopic surgery, were included in the study. Abdominal obesity was defined based on waist circumference (WC). The homeostasis model index was used to assess insulin resistance (HOMA-IR). Gene expression of glucose transporter 4 (GLUT4) and insulin receptor substrate 1 (IRS1) in visceral adipose tissue (VAT) and the parameters of oxidative stress, such as superoxide dismutase, enzyme glutathione reductase, and dimethylarginine, were measured, and the expression of protein oxidative damage product 3-nitro-tyrosine residues (nitrotyrosine) in VAT was identified with the use of immunohistochemistry. PCOS was associated with lower expression of GLUT4 and IRS1 and a higher level of oxidative stress in VAT, which was strongly correlated with WC and HOMA-IR. Presence of abdominal obesity further intensified the correlations observed in our measurements. The nitrotyrosine expression in VAT was stronger in PCOS patients. The strong correlation of insulin resistance with oxidative stress at the VAT level suggests that local oxidative stress and abnormalities of insulin signaling in adipose tissue play critical roles in the pathogenesis of PCOS. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

The Impact of the Ecological ICMS on Investments on Sanitation and Environmental Management: Analysis of Municipalities in the State of Rio de Janeiro

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Simone Assis Ferreira

2015-08-01

Full Text Available In a growing economic and industrial development scenario, public policy can be used to encourage environment-friendly behaviour. In this context, it is a part of the Ecological ICMS, which is the VAT percentage of transfer raised by the States in favour of their municipalities, according to criteria established by law. In this paper, we seek to assess the contribution of the Ecological VAT in the State of Rio de Janeiro for the environmental development in this State. Therefore, of the 92 municipalities, data of budget expenses were collected for 87 of them (5 were excluded from analysis due to lack of information for some periods in sanitation functions and environmental management from 2005 to 2012 and therefore the 4 years before and after the validity of the Ecological VAT (2009. From the collected data, the mean difference test was used (Wilcoxon. The hypothesis tested was that the institution of the Ecological VAT in the State of Rio de Janeiro generated an increase of municipal expenditures in sanitation functions and environmental management. The results indicated that the average spending on sanitation and environmental management of municipalities in the state of Rio de Janeiro before and after the ecological ICMS institution are, from a statistical point of view, different and that the this benefit has contributed to an increase of environmental investments there. Moreover, the average expense on environmental management showed the largest percentage increase in the periods before and after the start of the distribution of resources to the Ecological VAT, although spending on sanitation express a higher total sum.

Comparison between submucosal tunneling endoscopic resection and video-assisted thoracoscopic surgery for large esophageal leiomyoma originating from the muscularis propria layer.

Science.gov (United States)

Tan, Yuyong; Lv, Liang; Duan, Tianying; Zhou, Junfeng; Peng, Dongzi; Tang, Yao; Liu, Deliang

2016-07-01

Submucosal tunneling endoscopic resection (STER) has been proved to be safe and effective for removal of esophageal leiomyoma originating from the muscularis propria (MP) layer. However, there are still technical challenges for tumors ≥35 mm due to the limited space of the submucosal tunnel. The aim of the study was to estimate the safety and efficacy of STER for large esophageal leiomyoma originating from the MP layer as well as compare its efficacy with video-assisted thoracoscopic surgery (VATS), which is a standard procedure for treating esophageal leiomyoma. We retrospectively collected the clinical data of the patients with esophageal leiomyoma of 35-55 mm who underwent STER or VATS at our hospital between January 2010 and December 2014. Epidemiological data (gender, age), tumor location, tumor size, procedure-related parameters, complications, length of stay and cost were compared between STER and VATS. A total of 31 patients were enrolled, and 18 patients underwent STER and the other 13 received VATS. There was no significant difference between the two groups in gender, age, tumor location, tumor size, complications and rate of en bloc resection (P > 0.05). However, patients in the STER groups had a shorter operation time, a less decrease in hemoglobin level, a shorter length of hospital stay and a decreased cost (P leiomyoma of 35-55 mm. However, STER is superior to VATS in a shorter operation time, a less decrease in hemoglobin level, a shorter length of hospital stay and a decreased cost.

Protein-pacing caloric-restriction enhances body composition similarly in obese men and women during weight loss and sustains efficacy during long-term weight maintenance

DEFF Research Database (Denmark)

Arciero, Paul J; Edmonds, Rohan; He, Feng

2016-01-01

Short-Term protein-pacing (P; ~6 meals/day, >30% protein/day) and caloric restriction (CR, ~25% energy deficit) improves total (TBF), abdominal (ABF) and visceral (VAT) fat loss, energy expenditure, and biomarkers compared to heart healthy (HH) recommendations (3 meals/day, 15% protein/day) in ob......Short-Term protein-pacing (P; ~6 meals/day, >30% protein/day) and caloric restriction (CR, ~25% energy deficit) improves total (TBF), abdominal (ABF) and visceral (VAT) fat loss, energy expenditure, and biomarkers compared to heart healthy (HH) recommendations (3 meals/day, 15% protein....../day) in obese adults. Less is known whether obese men and women respond similarly to P-CR during weight loss (WL) and whether a modified P-CR (mP-CR) is more efficacious than a HH diet during long-term (52 week) weight maintenance (WM). The purposes of this study were to evaluate the efficacy of: (1) P......-CR on TBF, ABF, resting metabolic rate (RMR), and biomarkers between obese men and women during WL (weeks 0-12); and (2) mP-CR compared to a HH diet during WM (weeks 13-64). During WL, men (n = 21) and women (n = 19) were assessed for TBF, ABF, VAT, RMR, and biomarkers at weeks 0 (pre) and 12 (post). Men...

Value Added Tax and price stability in Nigeria: A partial equilibrium analysis

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Marius Ikpe

2013-12-01

Full Text Available The economic impact of Value Added Tax (VAT that was implemented in Nigeria in 1994 has generated much debate in recent times, especially with respect to its effect on the level of aggregate prices. This study empirically examines the influence of VAT on price stability in Nigeria using partial equilibrium analysis. We introduced the VAT variable in the framework of a combination of structuralist, monetarist and fiscalist approaches to inflation modelling. The analysis was carried out by applying multiple regression analysis in static form to data for the 1994-2010 period. The results reveal that VAT exerts a strong upward pressure on price levels, most likely due to the burden of VAT on intermediate outputs. The study rules out the option of VAT exemptions for intermediate outputs as a solution, due to the difficulty in distinguishing between intermediate and final outputs. Instead, it recommends a detailed post-VAT cost-benefit analysis to assess the social desirability of VAT policy in Nigeria.

The effect of exercise on obesity, body fat distribution and risk for type 2 diabetes.

Science.gov (United States)

Goedecke, Julia H; Micklesfield, Lisa K

2014-01-01

It is well known that obesity is a major risk factor for type 2 diabetes (T2D), while exercise is known to reduce body fatness and attenuate the risk of T2D. The aim of this chapter is to examine the interactions between exercise, obesity and body fat distribution, and the risk for T2D. Firstly, we show that body fatness, in particular visceral adipose tissue (VAT) accumulation, is associated with insulin resistance and incident T2D. We then show that aerobic exercise of sufficient intensity and volume results in a decrease in body fat and VAT. Conversely, sedentary behavior and physical inactivity are associated with increased body fat and VAT. Finally, the chapter examines the interaction between physical activity (PA), obesity and risk for T2D and shows that both obesity and PA are significant independent predictors of incident T2D, but the magnitude of risk imparted by high levels of body fat is much greater than that of low levels of PA. Further, we show that obese physically active individuals are at greater risk for incident T2D than normal-weight physically inactive individuals. The mechanisms underlying this complex interaction include the ability of exercise to increase free fatty acid oxidation to match high rates of lipolysis associated with obesity, as well as the effects of exercise on adipokine, cytokine and myokine secretion. Exercise, of sufficient volume and intensity, is therefore recommended to reduce obesity, centralization of body fat, and risk of T2D.

Postoperative recurrence after VATS for spontaneous pneumothorax

International Nuclear Information System (INIS)

Katsuno, Gotaro; Tsumura, Makoto; Kokudo, Yasutaka; Muraoka, Atsushi; Tsuruno, Masaki

2003-01-01

A total of 88 cases of 81 patients with spontaneous pneumothorax treated at the hospital from March 1992 to August 2001 were subjected to a study of examining preoperative chest CT and thoracographic findings from the standpoint of postoperative recurrence. Preoperative chest CT and thoracography were conducted in 82 cases and 41 cases (including 25 cases with continuous air leakage), respectively. Eight (9.1%) patients developed recurrence of pneumothorax, and three patients of them underwent reoperation. Considering the intraoperative findings, newly formed bullae appeared to be a cause of recurrence. Resulting from these examinations, we conclude that it is difficult to predict the risk factor for postoperative recurrence at this time, in addition, it is important that the area of air leakage can be confirmed by thoracoscopic findings. (author)

Prediction of whole-body fat percentage and visceral adipose tissue mass from five anthropometric variables.

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Michelle G Swainson

Full Text Available The conventional measurement of obesity utilises the body mass index (BMI criterion. Although there are benefits to this method, there is concern that not all individuals at risk of obesity-associated medical conditions are being identified. Whole-body fat percentage (%FM, and specifically visceral adipose tissue (VAT mass, are correlated with and potentially implicated in disease trajectories, but are not fully accounted for through BMI evaluation. The aims of this study were (a to compare five anthropometric predictors of %FM and VAT mass, and (b to explore new cut-points for the best of these predictors to improve the characterisation of obesity.BMI, waist circumference (WC, waist-to-hip ratio (WHR, waist-to-height ratio (WHtR and waist/height0.5 (WHT.5R were measured and calculated for 81 adults (40 women, 41 men; mean (SD age: 38.4 (17.5 years; 94% Caucasian. Total body dual energy X-ray absorptiometry with Corescan (GE Lunar iDXA, Encore version 15.0 was also performed to quantify %FM and VAT mass. Linear regression analysis, stratified by sex, was applied to predict both %FM and VAT mass for each anthropometric variable. Within each sex, we used information theoretic methods (Akaike Information Criterion; AIC to compare models. For the best anthropometric predictor, we derived tentative cut-points for classifying individuals as obese (>25% FM for men or >35% FM for women, or > highest tertile for VAT mass.The best predictor of both %FM and VAT mass in men and women was WHtR. Derived cut-points for predicting whole body obesity were 0.53 in men and 0.54 in women. The cut-point for predicting visceral obesity was 0.59 in both sexes.In the absence of more objective measures of central obesity and adiposity, WHtR is a suitable proxy measure in both women and men. The proposed DXA-%FM and VAT mass cut-offs require validation in larger studies, but offer potential for improvement of obesity characterisation and the identification of individuals

Video-assisted thoracoscopic surgery lobectomy via confronting upside-down monitor setting

OpenAIRE

Mun, Mingyon; Ichinose, Junji; Matsuura, Yosuke; Nakao, Masayuki; Okumura, Sakae

2017-01-01

Video-assisted thoracoscopic surgery (VATS) has been widely accepted as a minimally invasive surgery for treatment of early-stage lung cancer. However, various VATS approaches are available. In patients with lung cancer, VATS should achieve not only minimal invasiveness but also safety and oncological clearance. In this article, we introduce our method of VATS lobectomy.

Predicting Greater Prairie-Chicken Lek Site Suitability to Inform Conservation Actions.

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Torre J Hovick

Full Text Available The demands of a growing human population dictates that expansion of energy infrastructure, roads, and other development frequently takes place in native rangelands. Particularly, transmission lines and roads commonly divide rural landscapes and increase fragmentation. This has direct and indirect consequences on native wildlife that can be mitigated through thoughtful planning and proactive approaches to identifying areas of high conservation priority. We used nine years (2003-2011 of Greater Prairie-Chicken (Tympanuchus cupido lek locations totaling 870 unique leks sites in Kansas and seven geographic information system (GIS layers describing land cover, topography, and anthropogenic structures to model habitat suitability across the state. The models obtained had low omission rates (0.81, indicating high model performance and reliability of predicted habitat suitability for Greater Prairie-Chickens. We found that elevation was the most influential in predicting lek locations, contributing three times more predictive power than any other variable. However, models were improved by the addition of land cover and anthropogenic features (transmission lines, roads, and oil and gas structures. Overall, our analysis provides a hierarchal understanding of Greater Prairie-Chicken habitat suitability that is broadly based on geomorphological features followed by land cover suitability. We found that when land features and vegetation cover are suitable for Greater Prairie-Chickens, fragmentation by anthropogenic sources such as roadways and transmission lines are a concern. Therefore, it is our recommendation that future human development in Kansas avoid areas that our models identified as highly suitable for Greater Prairie-Chickens and focus development on land cover types that are of lower conservation concern.

Effect of protocatechuic acid on insulin responsiveness and inflammation in visceral adipose tissue from obese individuals: possible role for PTP1B.

Science.gov (United States)

Ormazabal, Paulina; Scazzocchio, Beatrice; Varì, Rosaria; Santangelo, Carmela; D'Archivio, Massimo; Silecchia, Gianfranco; Iacovelli, Annunziata; Giovannini, Claudio; Masella, Roberta

2018-05-16

The occurrence of chronic inflammation in visceral adipose tissue (VAT) in obese subjects precipitates the development of insulin resistance and type 2 diabetes (T2D). Anthocyanins and their main metabolite protocatechuic acid (PCA) have been demonstrated to stimulate insulin signaling in human adipocytes. The aim of this study was to investigate whether PCA is able to modulate insulin responsiveness and inflammation in VAT from obese (OB) and normal weight (NW) subjects. VATs obtained from NW and OB subjects were incubated or not (control) with 100 μM PCA for 24 h. After incubation, tissues untreated and treated with PCA were acutely stimulated with insulin (20 nM, 20 min). PTP1B, p65 NF-κB, phospho-p65 NF-κB, IRS-1, IRβ, Akt, GLUT4 as well as basal and insulin-stimulated Tyr-IRS-1 and Ser-Akt phosphorylations were assessed by Western blotting in NW- and OB-VAT. Samples were assessed for PTP1B activity and adipocytokine secretion. PCA restored insulin-induced phosphorylation in OB-VAT by increasing phospho-Tyr-IRS-1 and phospho-Ser-Akt after insulin stimulation as observed in NW-VAT (p < 0.05). PTP1B activity was lower in OB-VAT treated with PCA with respect to untreated (p < 0.05). Compared to non-treated tissues, PCA reduced phospho-p65 NF-κB and IL-6 in OB-VAT, and IL-1β in NW-VAT (p < 0.05); and increased adiponectin secretion in NW-VAT (p < 0.05). PCA restores the insulin responsiveness of OB-VAT by increasing IRS-1 and Akt phosphorylation which could be related with the lower PTP1B activity found in PCA-treated OB-VAT. Furthermore, PCA diminishes inflammation in VAT. These results support the beneficial role of an anthocyanin-rich diet against inflammation and insulin resistance in obesity.

Total carbon content and humic substances quality in selected subtypes of Cambisols

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Veronika Petrášová

2009-01-01

Full Text Available Cambisols cover an estimated 45% of agricultural soils in the Czech Republic. We aimed our work at stabile forms of organic carbon and humic substances quality in Cambisols under different types of soil management (grassland and arable soil. Object of our study were the following subtypes of Cambisols: Eutric Cambisol (locality Vatín – arable soil, Eutric Cambisol (locality Vatín – grassland, Haplic Cambisol (locality Náměšť n/Oslavou – arable soil, Leptic Cambisol (locality Ocmanice – grassland, Haplic Cambisol (locality Nové Město na Moravě – arable soil, Haplic Cambisol (locality Přemyslov – Tři Kameny – grassland, Arenic Cambisol (locality Pocoucov – arable soil, Dystric Cambisol (locality Sněžné – arable soil, Dystric Cambisol (locality Velká Skrovnice – arable soil, Dystric Cambisol (locality Vojnův Městec – arable soil. Non-destructive spectroscopic methods such as UV-VIS spectroscopy, synchronous fluorescence spectroscopy (SFS and 13C NMR spectroscopy for humic substances (HS quality assessment were used. Total organic carbon (TOC content was determined by oxidimetric titration. Fractionation of HS was made by short fractionation method. Isolation of pure humic ­acids (HA preparation was made according to the standard IHSS method.Results showed that TOC and humus content varied from 2.70 % (grassland to 1.3 % (arable soil. Ave­ra­ge HS sum was 8.4 mg / kg in grassland and 6.4 mg / kg in arable soil. Average HA sum was 3.6 mg / kg in grassland and 3 mg / kg in arable soil. Fulvic acids (FA content was 4.7 mg / kg in grassland and 3.7 mg / kg in arable soil. HS quality was low and very similar for all studied samples. HA/FA ratio low (< 1. HS absorbance in UV-VIS spectral range was low and similar in all studied samples. Higher absorption in this spectral range was closely connected with higher HS content. Also in 2D-synchronous fluorescence scan spectra

Global development and current evidence of uniportal thoracoscopic surgery

Science.gov (United States)

Tu, Cheng-Che

2016-01-01

In the era of video-assisted thoracoscopic surgery (VATS), uniportal and single incision thoracoscopic surgeries are gaining popularity. The spectrum of uniportal VATS indications is now almost equal to that of conventional VATS. For example, successful uniportal sleeve lobectomy, rib segmental resection, and management of intraoperative bleeding have all been reported. According to published data in the English-language literature, more than 9,545 uniportal VATS have been performed to date, including 1,293 lobectomies, 1,024 procedures for pneumothorax, and 6,845 sympathectomies. Of the 192 articles discussing this topic, 35 were conducted in Spain, and there were an increasing number of publications from China, Korea, and other Asian countries. There were 41 technical and review articles, all of which provided an excellent foundation of surgical concept and skill learning. The benefits of uniportal VATS include better surgical geometry and cosmetics. Regarding postoperative outcomes, thirteen out of the 15 articles reviewed showed that uniportal VATS has similar or superior outcomes to conventional VATS. Most studies demonstrated that uniportal VATS produced less postoperative pain and paresthesia. In conclusion, uniportal VATS can produce excellent operative outcome, which is becoming a mature surgical approach in thoracic disease, supported by fast-accumulating and abundant experience. PMID:27014479

The Effect of Diet or Exercise on Visceral Adipose Tissue in Overweight Youth.

Science.gov (United States)

Vissers, Dirk; Hens, Wendy; Hansen, Dominique; Taeymans, Jan

2016-07-01

Excess visceral adipose tissue (VAT) in children with obesity is associated with the development of cardiovascular and metabolic disease. This meta-analysis investigated if lifestyle interventions can reduce VAT in overweight and obese youth. Pubmed, Cochrane, and PEDro were searched for clinical trials that objectively assessed VAT and included study arms with supervised diet, exercise, or a combination of both. If there was a no-therapy control group, the data of the control group and the intervention groups were used to meta-analyze the data. In all other cases, the preintervention and the postintervention data were used to meta-analyze. Effect sizes were calculated as standardized mean differences or changes of VAT and expressed as Hedges' g. The overall weighted mean effect size on VAT of all included interventions was -0.69 (95% confidence interval [CI] = -0.90 to -0.48) (P diet-only interventions on VAT was 0.23 (95% CI = -0.22 to 0.68) (P = 0.311). Interventions that combined diet and exercise showed a pooled effect size on VAT of -0.55 (95% CI = -0.75 to -0.39) (P exercise-only interventions on VAT was -0.85 (95% CI = -1.20 to -0.57) (P exercise-only or combined diet and exercise interventions can reduce VAT in overweight and obese children and adolescents. The strongest effect was found in exercise-only groups. However, high-quality randomized controlled trials describing the effect of supervised dietary interventions on VAT in children are lacking.

Feasibility and safety of robot-assisted thoracic surgery for lung lobectomy in patients with non-small cell lung cancer: a systematic review and meta-analysis.

Science.gov (United States)

Wei, Shiyou; Chen, Minghao; Chen, Nan; Liu, Lunxu

2017-05-08

The aim of this study is to evaluate the feasibility and safety of robot-assisted thoracic surgery (RATS) lobectomy versus video-assisted thoracic surgery (VATS) for lobectomy in patients with non-small cell lung cancer (NSCLC). An electronic search of six electronic databases was performed to identify relevant comparative studies. Meta-analysis was performed by pooling the results of reported incidence of overall morbidity, mortality, prolonged air leak, arrhythmia, and pneumonia between RATS and VATS lobectomy. Subgroup analysis was also conducted based on matched and unmatched cohort studies, if possible. Relative risks (RR) with their 95% confidence intervals (CI) were calculated by means of Revman version 5.3. Twelve retrospective cohort studies were included, with a total of 60,959 patients. RATS lobectomy significantly reduced the mortality rate when compared with VATS lobectomy (RR = 0.54, 95% CI 0.38-0.77; P = 0.0006), but this was not consistent with the pooled result of six matched studies (RR = 0.12, 95% CI 0.01-1.07; P = 0.06). There was no significant difference in morbidity between the two approaches (RR = 0.97, 95% CI 0.85-1.12; P = 0.70). RATS lobectomy is a feasible and safe technique and can achieve an equivalent short-term surgical efficacy when compared with VATS, but its cost effectiveness also should be taken into consideration.

The Greater Caucasus Glacier Inventory (Russia, Georgia and Azerbaijan)

Science.gov (United States)

Tielidze, Levan G.; Wheate, Roger D.

2018-01-01

There have been numerous studies of glaciers in the Greater Caucasus, but none that have generated a modern glacier database across the whole mountain range. Here, we present an updated and expanded glacier inventory at three time periods (1960, 1986, 2014) covering the entire Greater Caucasus. Large-scale topographic maps and satellite imagery (Corona, Landsat 5, Landsat 8 and ASTER) were used to conduct a remote-sensing survey of glacier change, and the 30 m resolution Advanced Spaceborne Thermal Emission and Reflection Radiometer Global Digital Elevation Model (ASTER GDEM; 17 November 2011) was used to determine the aspect, slope and height distribution of glaciers. Glacier margins were mapped manually and reveal that in 1960 the mountains contained 2349 glaciers with a total glacier surface area of 1674.9 ± 70.4 km2. By 1986, glacier surface area had decreased to 1482.1 ± 64.4 km2 (2209 glaciers), and by 2014 to 1193.2 ± 54.0 km2 (2020 glaciers). This represents a 28.8 ± 4.4 % (481 ± 21.2 km2) or 0.53 % yr-1 reduction in total glacier surface area between 1960 and 2014 and an increase in the rate of area loss since 1986 (0.69 % yr-1) compared to 1960-1986 (0.44 % yr-1). Glacier mean size decreased from 0.70 km2 in 1960 to 0.66 km2 in 1986 and to 0.57 km2 in 2014. This new glacier inventory has been submitted to the Global Land Ice Measurements from Space (GLIMS) database and can be used as a basis data set for future studies.

REVERSE CHARGE AND THE CASH FLOW OF THE PUBLIC BUDGETS IN THE CZECH REPUBLIC

Directory of Open Access Journals (Sweden)

Kohoutková Růžena

2015-12-01

Full Text Available Reverse charge is currently used as a measure against VAT carousel fraud. Its extension to all goods and services is discussed among the tax policy makers at the national and EU level. Opponents of general reverse-charge argue that this method of VAT collection would completely change the nature of the VAT system. One of the practical drawbacks of reverse charge is the negative impact on the cash flow of the public budgets. This article quantifies the average monthly financing available to the State thanks to delayed repayments of input tax to VAT payers under the normal VAT system. This amount equals to almost 53 billion CZK and represents the negative impact of the general reverse charge on the cash flow of the public budgets. A change in the deadline for remitting VAT or introducing VAT advances to be paid prior to the final tax payment would reduce the negative influence on public finances.

Exercise training favors increased insulin-stimulated glucose uptake in skeletal muscle in contrast to adipose tissue: a randomized study using FDG PET imaging

DEFF Research Database (Denmark)

Reichkendler, M. H.; Auerbach, P.; Rosenkilde, M.

2013-01-01

abdominal SAT compared with CON but not in either intra- or retroperitoneal VAT. Total adipose tissue mass decreased in both exercise groups, and the decrease was distributed equally among subcutaneous and intra-abdominal depots. In conclusion, aerobic exercise training increases insulin-stimulated glucose...

Regional analgesia for video-assisted thoracic surgery – a systematic review

DEFF Research Database (Denmark)

Julia Steinthorsdottir, Kristin; Wildgaard, Lorna; Jessen Hansen, Henrik

2013-01-01

there is no gold standard for regional analgesia for VATS. This systematic review aimed to assess different regional techniques in regards to effect on acute post-operative pain following VATS, with emphasis on VATS lobectomy. The systematic review of the PubMed, Cochrane Library and Embase databases yielded...... be demonstrated, but a guide of factors to include in future studies on regional analgesia for VATS is presented....

Greater physiological and behavioral effects of interrupted stress pattern compared to daily restraint stress in rats.

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Wei Zhang

Full Text Available Repeated stress can trigger a range of psychiatric disorders, including anxiety. The propensity to develop abnormal behaviors after repeated stress is related to the severity, frequency and number of stressors. However, the pattern of stress exposure may contribute to the impact of stress. In addition, the anxiogenic nature of repeated stress exposure can be moderated by the degree of coping that occurs, and can be reflected in homotypic habituation to the repeated stress. However, expectations are not clear when a pattern of stress presentation is utilized that diminishes habituation. The purpose of these experiments is to test whether interrupted stress exposure decreases homotypic habituation and leads to greater effects on anxiety-like behavior in adult male rats. We found that repeated interrupted restraint stress resulted in less overall homotypic habituation compared to repeated daily restraint stress. This was demonstrated by greater production of fecal boli and greater corticosterone response to restraint. Furthermore, interrupted restraint stress resulted in a lower body weight and greater adrenal gland weight than daily restraint stress, and greater anxiety-like behavior in the elevated plus maze. Control experiments demonstrated that these effects of the interrupted pattern could not be explained by differences in the total number of stress exposures, differences in the total number of days that the stress periods encompased, nor could it be explained as a result of only the stress exposures after an interruption from stress. These experiments demonstrate that the pattern of stress exposure is a significant determinant of the effects of repeated stress, and that interrupted stress exposure that decreases habituation can have larger effects than a greater number of daily stress exposures. Differences in the pattern of stress exposure are therefore an important factor to consider when predicting the severity of the effects of repeated

Anthropometry, DXA and leptin reflect subcutaneous but not visceral abdominal adipose tissue by MRI in 197 healthy adolescents

DEFF Research Database (Denmark)

Tinggaard, Jeanette; Hagen, Casper P; Christensen, Anders Nymark

2017-01-01

Background Abdominal fat distribution is associated with the development of cardio-metabolic disease independently of body mass index (BMI). We assessed anthropometry, serum adipokines, and DXA as markers of abdominal subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) using...... to total abdominal volume. Results Girls had a higher SAT% than did boys in early and late puberty (16 vs. 13%, Pfat% (standard deviation score (SDS)), suprailiac skinfold...... magnetic resonance imaging (MRI). Methods We performed a cross-sectional study that included 197 healthy adolescents (114 boys) aged 10–15 years nested within a longitudinal population-based cohort. Clinical examination, blood sampling, DXA, and abdominal MRI were performed. SAT% and VAT% were adjusted...

Greater-confinement disposal

International Nuclear Information System (INIS)

Trevorrow, L.E.; Schubert, J.P.

1989-01-01

Greater-confinement disposal (GCD) is a general term for low-level waste (LLW) disposal technologies that employ natural and/or engineered barriers and provide a degree of confinement greater than that of shallow-land burial (SLB) but possibly less than that of a geologic repository. Thus GCD is associated with lower risk/hazard ratios than SLB. Although any number of disposal technologies might satisfy the definition of GCD, eight have been selected for consideration in this discussion. These technologies include: (1) earth-covered tumuli, (2) concrete structures, both above and below grade, (3) deep trenches, (4) augered shafts, (5) rock cavities, (6) abandoned mines, (7) high-integrity containers, and (8) hydrofracture. Each of these technologies employ several operations that are mature,however, some are at more advanced stages of development and demonstration than others. Each is defined and further described by information on design, advantages and disadvantages, special equipment requirements, and characteristic operations such as construction, waste emplacement, and closure

Simultaneous bilateral isolated greater trochanter fracture

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Maruti Kambali

2013-01-01

Full Text Available A 48-year-old woman sustained simultaneous isolated bilateral greater trochanteric fracture, following a road traffic accident. The patient presented to us 1 month after the injury. She presented with complaints of pain in the left hip and inability to walk. Roentgenograms revealed displaced comminuted bilateral greater trochanter fractures. The fracture of the left greater trochanter was reduced and fixed internally using the tension band wiring technique. The greater trochanter fracture on the right side was asymptomatic and was managed conservatively. The patient regained full range of motion and use of her hips after a postoperative follow-up of 6 months. Isolated fractures of the greater trochanter are unusual injuries. Because of their relative rarity and the unsettled controversy regarding their etiology and pathogenesis, several methods of treatment have been advocated. Furthermore, the reports of this particular type of injury are not plentiful and the average textbook coverage afforded to this entity is limited. In our study we discuss the mechanism of injury and the various treatment options available.

Alguns Impactos da Expansão da Produção de Soja no Município de Sorriso-MT

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Argemiro Luís Brum

2009-01-01

Full Text Available This article aims to highlight the importance of soybean Glyceni Max and to examine the issue of economic development provided by this culture in the city of Sorriso-MT, and their impact on the progress of deforestation of the cerrado in the period 2000 to 2006. The article also highlights the lines of development of the municipality and in particular health, education, sanitation and housing. It was noted, with the data collected that the soybean crop participated with percentage between 75% and 90% of total primary municipal sector in the period studied. Also gives a percentage of the total VAT on the total taxes collected from around 75%, while the percentage of total taxes for the items of municipal development it is 80.2% and soybean participates in the total amount collected from VAT in the period, with 65%. Furthermore, the participation of soybean in relation to the total value for the lines of social development was approximately 47.46%. The percentage figures for deforestation in the municipality is 12% during the study period. This value is an indication that despite the council having an indicator of human development considered for the high standards of the Brazilian cities, there is a negative impact caused by the degradation of environmental resources.

VAT refund according to the Eight VAT Directive / Tomas Davidonis

Index Scriptorium Estoniae

Davidonis, Tomas

2007-01-01

Nõukogu kaheksandast direktiivist (79/1072/EMÜ) kumuleeruvate käibemaksudega seotud liikmesriikide õigusaktide ühtlustamise kohta - välismaal asuvatele maksukohustuslastele käibemaksu tagastamise korrast

Chest Fat Quantification via CT Based on Standardized Anatomy Space in Adult Lung Transplant Candidates.

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Yubing Tong

whole chest volume separately for SAT and VAT components. The same parameters were also computed from the single abdominal and thigh slices. The ability of the slice at each anatomic location in the chest (and abdomen and thigh to act as a marker of the measures derived from the whole chest volume was assessed via Pearson correlation coefficient (PCC analysis.The SAS approach correctly identified slice locations in different subjects in terms of vertebral levels. PCC between chest fat volume and chest slice fat area was maximal at the T8 level for SAT (0.97 and at the T7 level for VAT (0.86, and was modest between chest fat volume and abdominal slice fat area for SAT and VAT (0.73 and 0.75, respectively. However, correlation was weak for chest fat volume and thigh slice fat area for SAT and VAT (0.52 and 0.37, respectively, and for chest fat volume for SAT and VAT and BMI (0.65 and 0.28, respectively. These same single slice locations with maximal PCC were found for SAT and VAT within both COPD and IPF groups. Most of the attenuation properties derived from the whole chest volume and single best chest slice for VAT (but not for SAT were significantly different between COPD and IPF groups.This study demonstrates a new way of optimally selecting slices whose measurements may be used as markers of similar measurements made on the whole chest volume. The results suggest that one or two slices imaged at T7 and T8 vertebral levels may be enough to estimate reliably the total SAT and VAT components of chest fat and the quality of chest fat as determined by attenuation distributions in the entire chest volume.

Visceral fat is associated with brain structure independent of human immunodeficiency virus infection status.

Science.gov (United States)

Lake, Jordan E; Popov, Mikhail; Post, Wendy S; Palella, Frank J; Sacktor, Ned; Miller, Eric N; Brown, Todd T; Becker, James T

2017-06-01

The combined effects of human immunodeficiency virus (HIV), obesity, and elevated visceral adipose tissue (VAT) on brain structure are unknown. In a cross-sectional analysis of Multicenter AIDS Cohort Study (MACS) participants, we determined associations between HIV serostatus, adiposity, and brain structure. Men (133 HIV+, 84 HIV-) in the MACS Cardiovascular 2 and magnetic resonance imaging (MRI) sub-studies with CT-quantified VAT and whole brain MRI measured within 1 year were assessed. Voxel-based morphometry analyzed brain volumes. Men were stratified by elevated (eVAT, ≥100cm 2 ) or "normal" (nVAT, 25 kg/m 2 , smaller gray and white matter volumes, and larger cerebrospinal fluid volume than nVAT men. In multivariate analysis, hypertension, higher adiponectin, higher interleukin-6, age, diabetes mellitus, higher body mass index, and eVAT were associated with brain atrophy (p central nervous system effects may be amplified in this population.

Can genetically based clines in plant defence explain greater herbivory at higher latitudes?

Science.gov (United States)

Anstett, Daniel N; Ahern, Jeffrey R; Glinos, Julia; Nawar, Nabanita; Salminen, Juha-Pekka; Johnson, Marc T J

2015-12-01

Greater plant defence is predicted to evolve at lower latitudes in response to increased herbivore pressure. However, recent studies question the generality of this pattern. In this study, we tested for genetically based latitudinal clines in resistance to herbivores and underlying defence traits of Oenothera biennis. We grew plants from 137 populations from across the entire native range of O. biennis. Populations from lower latitudes showed greater resistance to multiple specialist and generalist herbivores. These patterns were associated with an increase in total phenolics at lower latitudes. A significant proportion of the phenolics were driven by the concentrations of two major ellagitannins, which exhibited opposing latitudinal clines. Our analyses suggest that these findings are unlikely to be explained by local adaptation of herbivore populations or genetic variation in phenology. Rather greater herbivory at high latitudes can be explained by latitudinal clines in the evolution of plant defences. © 2015 John Wiley & Sons Ltd/CNRS.

Associations between accelerometer-derived physical activity and regional adiposity in young men and women.

Science.gov (United States)

Smith, H A; Storti, K L; Arena, V C; Kriska, A M; Gabriel, K K Pettee; Sutton-Tyrrell, K; Hames, K C; Conroy, M B

2013-06-01

Empirical evidence supports an inverse relationship between physical activity (PA) and adiposity, but studies using detailed measures of both are scarce. The relationship between regional adiposity and accelerometer-derived PA in men and women are described. Cross-sectional analysis included 253 participants from a weight loss study limited to ages 20-45 years and BMI 25-39.9 kg m(-2) . PA data were collected with accelerometers and expressed as total accelerometer counts and average amount of time per day accumulated in different intensity levels [sedentary, light-, and moderate-to-vigorous intensity PA (MVPA)]. Accumulation of time spent above 100 counts was expressed as total active time. Computed tomography (CT) was used to measure abdominal and adipose tissue (AT). Multivariate linear regression analyses were used to assess the relationship between regional adiposity (dependent variable) and the various PA levels (independent variable), and were executed separately for men and women, adjusting for wear time, age, race, education, and BMI. Among males, light activity was inversely associated with total AT (β = -0.19; P = 0.02) as well as visceral AT (VAT) (β = -0.30; P = 0.03). Among females sedentary time was positively associated with VAT (β = 0.11; P = 0.04) and total active time was inversely associated with VAT (β = -0.12; P = 0.04). Findings from this study suggest that PA intensity level may influence regional adiposity differently in men and women. Additional research is needed in larger samples to clarify the difference in these associations by sex, create recommendations for the frequency, duration and intensity of PA needed to target fat deposits, and determine if these recommendations should differ by sex. Copyright © 2013 The Obesity Society.

Role of the greater sciatic notch of the hip bone in sexual dimorphism: a morphometric study of the north Indian population.

Science.gov (United States)

G, Kalsey; R K, Singla; K, Sachdeva

2011-04-01

The distinctive morphology and sexual dimorphism of the human hip bone makes it of interest from the anatomical, anthropological and forensic points of view. The shape of the greater sciatic notch has attracted great attention in the past. In the current investigation, an attempt has been made to find the baseline data of various parameters pertaining to the greater sciatic notch of 100 hip bones of known sex (male:female = 80:20) and side (right:left = 50:50), obtained from the Department of Anatomy, Government Medical College, Amritsar, Punjab, India, during the period 2007-2009. Seven parameters of the notch, viz. width, depth, posterior segment width, total angle, posterior segment angle, index I and index II of the greater sciatic notch were studied. The results thus obtained were compiled, tabulated, statistically analysed and were compared with the accessible literature. Out of all the parameters studied, width of the notch, posterior segment width, total angle, posterior segment angle and index II of notch were found to be significantly greater in women as compared with men. Thus the greater sciatic notch can serve as a reliable sex indicator even when the complete hip bone has not been well preserved.

The variability of practice in minimally invasive thoracic surgery for pulmonary resections.

Science.gov (United States)

Rocco, Gaetano; Internullo, Eveline; Cassivi, Stephen D; Van Raemdonck, Dirk; Ferguson, Mark K

2008-08-01

Thoracic surgeons participating in this survey seemed to have clearly indicated their perception of VATS major lung resections, in particular VATS lobectomy. 1. The acronym VATS as a short form of "video-assisted thoracic surgery" was the preferred terminology. 2. According to the respondents, the need or use of rib spreading served as the defining characteristic of "open" thoracic surgery. 3. It was most commonly suggested that VATS lobectomy is performed by means of two or three port incisions with the addition of a minithoracotomy or access incision. 4. Rib spreading (shearing) was not deemed acceptable as part of a strictly defined VATS procedure. 5. Although there was no general consensus, respondents suggested that the preferred approach for visualization in a VATS procedure was only through the video monitor. 6. Although minimally invasive procedures for lung resection are still mainly being used for diagnostic and minor therapeutic purposes, young surgeons seemed to be more likely to recommend VATS lung surgery for major pulmonary resections than their more senior colleagues. 7. The survey confirmed that the use of the standard posterolateral thoracotomy is still widespread. Almost 40% of the surgeons claimed to use the standard posterolateral thoracotomy for more than 50% of their cases and less than 30% use it for less than 5% of cases. 8. The major reasons to perform VATS lobectomy were perceived to be reduced pain and decreased hospitalization. 9. Approximately 60% of the surgeons claimed to perform VATS lobectomy in less than 5% of their lobectomy cases. Younger consultants reported using VATS lobectomy in up to 50% of their lobectomy cases. There was the suggestion that lack of resources could justify the minor impact of VATS lobectomy in the thoracic surgical practice in middle- to low-income countries. 10. The currently available scientific evidence on safety and effectiveness, and technologic advancements were emphasized as the two factors having a

Daň z přidané hodnoty v účetnictví v České republice

OpenAIRE

Radinová, Eliška

2013-01-01

This master's thesis deals with recording VAT in accounting in the Czech Republic in accordance with the tax and accounting acts. The thesis is divided into four parts, in which is proceeded from the general definition of tax and accounting, their development into their current definition of the subject to VAT and accounting, recording VAT in the accounting into the special situation of VAT and their recording in accounting. The thesis is supplemented by graphs, tables and accounting charts f...

A longitudinal study of quality of life and functional status in total hip and total knee replacement patients.

Science.gov (United States)

Mandzuk, Lynda L; McMillan, Diana E; Bohm, Eric R

2015-05-01

Primary total hip and primary total knee surgeries are commonly performed to improve patients' quality of life and functional status. This longitudinal retrospective study (N = 851) examined self-reported quality of life and functional status over the preoperative and postoperative periods: 12 months prior to surgery, one month prior to surgery and 12 months following surgery. A linear mixed effects model was used to analyze the changes in quality of life and functional status over the sampling period. Patients in the convenience sample reported improvements in quality of life and functional status utilizing the SF-12 and Oxford Hip and Oxford Knee, although differences were noted by procedure and gender. Total hip patients tended to demonstrate greater improvement than total knee patients and males reported higher levels of physical and mental quality of life as well as functional status when compared to females. Of particular note was that mental health scores were consistently lower in both total hip and total knee replacement patients across the perioperative period and up to one year postoperative. This study identifies an opportunity for health care providers to proactively address the mental health of total hip and total knee replacement patients throughout their joint replacement trajectory. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Effect of Pioglitazone and Resistance Training on Body Composition in Older Men and Women Undergoing Hypocaloric Weight Loss

OpenAIRE

Shea, M. Kyla; Nicklas, Barbara J.; Marsh, Anthony P.; Houston, Denise K.; Miller, Gary D.; Isom, Scott; Miller, Michael E.; Carr, J. Jeffrey; Lyles, Mary F.; Harris, Tamara B.; Kritchevsky, Stephen B.

2011-01-01

Age-related increases in ectopic fat accumulation are associated with greater risk for metabolic and cardiovascular diseases, and physical disability. Reducing skeletal muscle fat and preserving lean tissue are associated with improved physical function in older adults. PPARγ-agonist treatment decreases abdominal visceral adipose tissue (VAT) and resistance training preserves lean tissue, but their effect on ectopic fat depots in nondiabetic overweight adults is unclear. We examined the influ...

VALUE-ADDED TAX AND ITS EFFICIENCY: EU–28 AND TURKEY

Directory of Open Access Journals (Sweden)

Sabina Hodzic

2017-06-01

Full Text Available This paper analyses value-added tax (VAT, with special emphasis on efficiency in the EU-28 Member States and Turkey, over the period from 2009 to 2013. From the results of the analysis, we concluded that, the highest efficiency ratio (50.8 was recorded in Croatia in 2013. This indicates that Croatia’s value-added tax revenues as percentage of gross domestic product in the state budget were very high (12.7 in comparison to Turkey’s (9.0 in 2013. As such, VAT is one of the most important taxes in the EU-28 Member States and many countries worldwide, like Turkey. The current VAT system in EU-28 Member States and Turkey is quite complex for the growing number of businesses operating cross-border. To increase investment, competitiveness and growth, an action plan on VAT is proposed for the creation of a single VAT area. The VAT system needs to be more efficient and simpler for businesses to use.

Greater Vancouver regional district air quality management plan : implementation status report

International Nuclear Information System (INIS)

2001-03-01

In December 1994, an Air Quality Management Plan (AQMP) was adopted by the Greater Vancouver Regional District. The AQMP included ways to improve air quality in the region, leading to reduced emissions from commercial and industrial operations. This Plan encourages cooperation with the various communities affected to achieve clean air lifestyles and manage emissions from human activity to enhance human health and the integrity of the environment. The reduction of total emissions of the common air contaminants sulphur and nitrogen oxides, particulate matter, carbon monoxide and volatile organic compounds by 38 per cent is the stated aim of the AQMP. Five years of planning resulted in the formulation of the AQMP. The issues addressed were assigned one of four priorities as follows: priority 1 deals with ground level ozone and fine particulate, priority 2 looks at visibility, hazardous air pollutants, and global climate change, priority 3 concerns odour, carbon monoxide, sulphur dioxide, acidic deposition, and nitrogen dioxide, and priority 4 contains total suspended particulate matter and volatile organic compounds. A total of 54 Emission Reduction Measures were established, and the document reviewed them. Progress is being made in all areas. 2 tabs., 3 figs

[Two compartment model of body composition and abdominal fat area in postmenopausal women - pilot study].

Science.gov (United States)

Milewska, Magdalena; Mioduszewska, Milena; Pańczyk, Mariusz; Kucharska, Alicja; Sińska, Beata; Dąbrowska-Bender, Marta; Michota-Katulska, Ewa; Zegan, Magdalena; Szabla, Anna

2016-01-01

Both menopausal period and aging have influence on body composition, increase of total body fat and visceral fat in particular. We should be aware that changes in body composition, mainly fat translocation to abdominal region, can occur without significant changes in body weight. Therefore quantitative abdominal fat assessment should be our aim. Body composition analysis based on two compartment model and abdominal fat area assessment in cross section. Subjects in postmenopausal period (41 women) were recruited for this study and divided into 2 groups: group 1 - women aged 45-56 years and group 2 - women aged 57-79 years. Body composition analysis and abdominal fat area assessment were conducted by using bioelectrical impedance method with BioScan 920 (Maltron int.) accordingly with standardized procedure. Women in early postmenopausal stage (Group 1) had statistically significant lower total body fat percentage in comparison with women in late postmenopausal period (Group 2) (41.09 ± 7.72% vs. 50.7 ± 9.88%, p=0.0021). Also women in group 1 were characterized by significant lower visceral fat area (VAT) as well as subcutaneous fat area (SAT) in comparison with group 2 (respectively VAT 119.25 ± 30.09 cm2 vs. 199.36 ± 87.38 cm2, p=0.0011; SAT 175.19 ±57.67 cm2 vs. 223.4±74.29 cm2, p=0.0336). According to VAT criteria (>120 cm2), 44% of women in group 1 and 80% in group 2 had excess of visceral fat. Both total body fat and intra-abdominal fat increased with age, independently of weight changes.

Robotic-Arm Assisted Total Knee Arthroplasty Demonstrated Greater Accuracy and Precision to Plan Compared with Manual Techniques.

Science.gov (United States)

Hampp, Emily L; Chughtai, Morad; Scholl, Laura Y; Sodhi, Nipun; Bhowmik-Stoker, Manoshi; Jacofsky, David J; Mont, Michael A

2018-05-01

This study determined if robotic-arm assisted total knee arthroplasty (RATKA) allows for more accurate and precise bone cuts and component position to plan compared with manual total knee arthroplasty (MTKA). Specifically, we assessed the following: (1) final bone cuts, (2) final component position, and (3) a potential learning curve for RATKA. On six cadaver specimens (12 knees), a MTKA and RATKA were performed on the left and right knees, respectively. Bone-cut and final-component positioning errors relative to preoperative plans were compared. Median errors and standard deviations (SDs) in the sagittal, coronal, and axial planes were compared. Median values of the absolute deviation from plan defined the accuracy to plan. SDs described the precision to plan. RATKA bone cuts were as or more accurate to plan based on nominal median values in 11 out of 12 measurements. RATKA bone cuts were more precise to plan in 8 out of 12 measurements ( p  ≤ 0.05). RATKA final component positions were as or more accurate to plan based on median values in five out of five measurements. RATKA final component positions were more precise to plan in four out of five measurements ( p  ≤ 0.05). Stacked error results from all cuts and implant positions for each specimen in procedural order showed that RATKA error was less than MTKA error. Although this study analyzed a small number of cadaver specimens, there were clear differences that separated these two groups. When compared with MTKA, RATKA demonstrated more accurate and precise bone cuts and implant positioning to plan. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Value Added Tax Implications of Illegal Transactions

Directory of Open Access Journals (Sweden)

SP van Zyl

2011-01-01

Full Text Available In the case of MP Finance Group CC (In Liquidation v CSARS the High Court of Appeal ruled that income "received by" a taxpayer from illegal gains will be taxable in the hands of the taxpayer. This article explores whether or not the decision in the MP Finance-case (and preceding cases on the taxation of illegal receipts can be applied to determine if illegal transactions are subject to VAT and moreover if a trader in illegal goods and services should register as a VAT vendor. Although strictly speaking no analogy can be drawn between the charging provisions for income tax and VAT, it is clear that in the determination of the taxability of illegal income, the courts applied the principle of tax neutrality. In terms of the principle of tax neutrality, taxes are not concerned with the legality or illegality of a transaction, but rather with whether the transaction complies with the requirements for it to be taxed or not. That said, the European Court of Justice has a different approach in applying this principle. According to the European Court of Justice where the intrinsic nature of the goods excludes it from the commercial arena (like narcotic drugs it should not be subject to VAT, but where the goods compete with a legal market it must be subject to VAT. Charging VAT on illegal transactions might give the impression that government benefits from criminal activities. However, if illegal transactions are not subject to VAT the trader in illegal goods will benefit as his products will be 14% cheaper than his rival’s. Is this necessarily a moral dilemma? In conclusion three arguments can be deduced on the question if illegal transactions should be subject to VAT:1. Illegal transactions should not be taxed at all. Illegal goods or services fall outside the sphere of the application of the charging provision in section 7(1 of the VAT Act. Moreover, taxing illegal transactions lends a quasi-validity to the contract and gives the impression that

Value-Addes Tax and Shadow Economy : the Role of Input-Output Linkages (revision of CentER Discussion Paper 2013-036)

NARCIS (Netherlands)

Hoseini, Mohammad

2015-01-01

Under the VAT, formal traders report their purchases to the administration for a deduction in their VAT bill. This paper models this third-party reporting feature of the VAT in an input-output economy and quantifies it among different activities using a forward linkages index. The administration can

Resource use and costs associated with opioid-induced constipation following total hip or total knee replacement surgery

Directory of Open Access Journals (Sweden)

Wittbrodt ET

2018-05-01

Full Text Available Eric T Wittbrodt,1 Tong J Gan,2 Catherine Datto,1 Charles McLeskey,1 Meenal Sinha3 1US Medical Affairs, AstraZeneca, Wilmington, DE, USA; 2Department of Anesthesiology, Stony Brook Medicine, Stony Brook, NY, USA; 3Premier Applied Sciences, Premier, Inc., Charlotte, NC, USA Purpose: Constipation is a well-known complication of surgery that can be exacerbated by opioid analgesics. This study evaluated resource utilization and costs associated with opioid-induced constipation (OIC. Patients and methods: This retrospective, observational, and propensity-matched cohort study utilized the Premier Healthcare Database. The study included adults ≥18 years of age undergoing total hip or total knee replacement as inpatients who received an opioid analgesic and were discharged between January 1, 2012, and June 30, 2015. Diagnosis codes identified patients with OIC who were then matched 1:1 to patients without OIC. Generalized linear and logistic regression models were used to compare inpatient resource utilization, total hospital costs, inpatient mortality, and 30-day all-cause readmissions and emergency department visits. Results: Of 788,448 eligible patients, 40,891 (5.2% had OIC. Covariates were well balanced between matched patients with and without OIC (n=40,890 each. In adjusted analyses, patients with OIC had longer hospital lengths of stay (3.6 versus 3.3 days; p<0.001, higher total hospital costs (US$17,479 versus US$16,265; p<0.001, greater risk of intensive care unit admission (odds ratio [OR]=1.12, 95% CI: 1.01–1.24, and increased likelihood of 30-day hospital readmissions (OR=1.16, 95% CI: 1.11–1.22 and emergency department visits (OR=1.38, 95% CI: 1.07–1.79 than patients without OIC. No statistically significant difference was found with inpatient mortality (OR=0.89, 95% CI: 0.59–1.35. Conclusion: OIC was associated with greater resource utilization and hospital costs for patients undergoing primarily elective total hip or total knee

Thoracoscopic or open surgery for pulmonary metastasectomy

DEFF Research Database (Denmark)

Eckardt, Jens; Licht, Peter B

2014-01-01

are now performed routinely worldwide. This prompted us to conduct a prospective observer-blinded study on pulmonary metastasectomy. METHODS: Eligible patients with oligometastatic pulmonary disease on computed tomography (CT) underwent high-definition VATS, with digital palpation by 1 surgical team...... number of additional nodules were detected during thoracotomy despite advancements in CT imaging and VATS technology. Many of these nodules were malignant and would have been missed if VATS was used exclusively. Consequently, we considered VATS inadequate if the intention is to resect all pulmonary...

How to Enforce Value-Added Tax? The Role of Inter-Sectoral Linkages

NARCIS (Netherlands)

Hoseini, M.

2013-01-01

Abstract: This paper models and empirically tests a self-enforcing feature of the value added tax (VAT) which is absent in the theory: An incentive that makes formal traders buy from suppliers who pay VAT too. In addition, it explores how the government can deploy this feature to enforce VAT more

Uniportal video-assisted thoracoscopic surgery: safety, efficacy and learning curve during the first 250 cases in Quebec, Canada.

Science.gov (United States)

Drevet, Gabrielle; Ugalde Figueroa, Paula

2016-03-01

Video-assisted thoracoscopic surgery (VATS) using a single incision (uniportal) may result in better pain control, earlier mobilization and shorter hospital stays. Here, we review the safety and efficiency of our initial experience with uniportal VATS and evaluate our learning curve. We conducted a retrospective review of uniportal VATS using a prospectively maintained departmental database and analyzed patients who had undergone a lung anatomic resection separately from patients who underwent other resections. To assess the learning curve, we compared the first 10 months of the study period with the second 10 months. From January 2014 to August 2015, 250 patients underwent intended uniportal VATS, including 180 lung anatomic resections (72%) and 70 other resections (28%). Lung anatomic resection was successfully completed using uniportal VATS in 153 patients (85%), which comprised all the anatomic segmentectomies (29 patients), 80% (4 of 5) of the pneumonectomies and 82% (120 of 146) of the lobectomies attempted. The majority of lung anatomic resections that required conversion to thoracotomy occurred in the first half of our study period. Seventy patients underwent other uniportal VATS resections. Wedge resections were the most common of these procedures (25 patients, 35.7%). Although 24 of the 70 patients (34%) required the placement of additional ports, none required conversion to thoracotomy. Uniportal VATS was safe and feasible for both standard and complex pulmonary resections. However, when used for pulmonary anatomic resections, uniportal VATS entails a steep learning curve.

Maternal obesity influences the relationship between location of neonate fat mass and total fat mass.

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Hull, H R; Thornton, J; Paley, C; Navder, K; Gallagher, D

2015-08-01

It is suggested that maternal obesity perpetuates offspring obesity to future generations. To determine whether location of neonate fat mass (FM: central vs. peripheral) is related to total neonate FM and whether maternal obesity influences this relationship. Neonate body composition and skin-fold thicknesses were assessed in healthy neonates (n = 371; 1-3 days old). Linear regression models examined the relationship between total FM and location of FM (central vs. peripheral). Location of FM was calculated by skin-folds: peripheral was the sum of (biceps and triceps)/2 and central was represented by the subscapular skin-fold. A significant interaction was found for location of FM and maternal obesity. Holding all predictors constant, in offspring born to non-obese mothers, a 0.5 mm increase in central FM predicted a 15 g greater total FM, whereas a 0.5 mm increase in peripheral FM predicted a 66 g greater total FM. However, in offspring born to obese mothers, a 0.5 mm increase in central FM predicted a 56 g total FM, whereas a 0.5 mm increase in peripheral FM predicted a 14 g greater total FM. The relationship between total FM and location of FM is influenced by maternal obesity. © 2014 The Authors. Pediatric Obesity © 2014 World Obesity.

View-Angle Tilting and Slice-Encoding Metal Artifact Correction for Artifact Reduction in MRI: Experimental Sequence Optimization for Orthopaedic Tumor Endoprostheses and Clinical Application.

Directory of Open Access Journals (Sweden)

Pia M Jungmann

Full Text Available MRI plays a major role in follow-up of patients with malignant bone tumors. However, after limb salvage surgery, orthopaedic tumor endoprostheses might cause significant metal-induced susceptibility artifacts.To evaluate the benefit of view-angle tilting (VAT and slice-encoding metal artifact correction (SEMAC for MRI of large-sized orthopaedic tumor endoprostheses in an experimental model and to demonstrate clinical benefits for assessment of periprosthetic soft tissue abnormalities.In an experimental setting, tumor endoprostheses (n=4 were scanned at 1.5T with three versions of optimized high-bandwidth turbo-spin-echo pulse sequences: (i standard, (ii VAT and (iii combined VAT and SEMAC (VAT&SEMAC. Pulse sequences included coronal short-tau-inversion-recovery (STIR, coronal T1-weighted (w, transverse T1-w and T2-w TSE sequences. For clinical evaluation, VAT&SEMAC was compared to conventional metal artifact-reducing MR sequences (conventional MR in n=25 patients with metal implants and clinical suspicion of tumor recurrence or infection. Diameters of artifacts were measured quantitatively. Qualitative parameters were assessed on a five-point scale (1=best, 5=worst: "image distortion", "artificial signal changes at the edges" and "diagnostic confidence". Imaging findings were correlated with pathology. T-tests and Wilcoxon-signed rank tests were used for statistical analyses.The true size of the prostheses was overestimated on MRI (P<0.05. A significant reduction of artifacts was achieved by VAT (P<0.001 and VAT&SEMAC (P=0.003 compared to the standard group. Quantitative scores improved in the VAT and VAT&SEMAC group (P<0.05. On clinical MR images, artifact diameters were significantly reduced in the VAT&SEMAC-group as compared with the conventional-group (P<0.001. Distortion and artificial signal changes were reduced and diagnostic confidence improved (P<0.05. In two cases, tumor-recurrence, in ten cases infection and in thirteen cases other

Leptin, IL-6, and suPAR reflect distinct inflammatory changes associated with adiposity, lipodystrophy and low muscle mass in HIV-infected patients and controls

DEFF Research Database (Denmark)

Langkilde, Anne; Petersen, Janne; Henriksen, Jens Henrik

2015-01-01

BACKGROUND: HIV-infected patients could exhibit accelerated ageing, since age-associated complications like sarcopenia; increased inflammation; lipodystrophy with loss of subcutaneous adipose tissue and/or gain of visceral adipose tissue (VAT); and cardiovascular disease occur at an earlier age...... was significantly positively associated with fat mass index (FMI) and abdominal VAT, but not with lean mass index (LMI). IL-6 was significantly associated with both FMI and VAT, and low LMI. High suPAR was associated with low LMI, and weakly with high FMI and VAT. CONCLUSIONS: Leptin reflected adiposity...

[Pulmonary resection using video-assisted thoracoscopic surgery--20 years experience].

Science.gov (United States)

Baste, J-M; Orsini, B; Rinieri, P; Melki, J; Peillon, C

2014-04-01

Major lung resection using minimally invasive techniques - video-assisted thoracoscopic surgery (VATS) - was first described 20 years ago. However, its development has been slow in many countries because the value of this approach has been questioned. Different techniques and definitions of VATS are used and this can be confusing for physicians and surgeons. The benefit of minimally invasive thoracic surgery was not always apparent, while many surgeons pointed to suboptimal operative outcomes. Recently, technological advances (radiology, full HD monitor and new stapler devices) have improved VATS outcomes. The objectives of this review are to emphasize the accepted definition of VATS resection, outline the different techniques developed and their results including morbidity and mortality compared to conventional approaches. Minimally invasive thoracic surgery has not been proven to give superior survival (level one evidence) compared to thoracotomy. A slight advantage has been demonstrated for short-term outcomes. VATS is not a surgical revolution but rather an evolution of surgery. It should be considered together with the new medical environment including stereotactic radiotherapy and radiofrequency. VATS seems to be more accurate in the treatment of small lung lesions diagnosed with screening CT scan. In the academic field, VATS allows easier teaching and diffusion of techniques. Copyright © 2014 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Departures From Neutrality in Canada’s Goods and Services Tax

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Michael Smart

2012-02-01

Full Text Available With recent accessions to the federal-provincial Harmonized Sales Tax, provinces with valueadded taxes (VATs now comprise over two-thirds of the national economy. While Canadian VATs are economically superior to the taxes they replaced, they are not as well designed as in other countries. An efficient VAT is a uniform tax on all consumer (but not business purchases. Although the OECD has reported that Canada’s VAT is one of the most efficient in the world, that assessment was based on data shown here to be misleading. In reality, Canada’s VATs have large exemptions, rebates and rate preferences that reduce revenues and hamper productivity. If all these tax preferences were eliminated, government VAT revenues would increase by as much as $39 billion, or more than 50 percent. Moreover, taxing consumer commodities at a single rate reduces opportunities for tax evasion, simplifies tax compliance, and in most cases increases economic productivity. Given the fiscal and productivity challenges currently facing Canadian governments, a new look at VAT design is clearly warranted. This paper offers a detailed assessment of the effects of the tax on the economy, and it proposes a number of specific, feasible reforms to the GST-HST system.

Metal artefact reduction in MRI at both 1.5 and 3.0 T using slice encoding for metal artefact correction and view angle tilting

Science.gov (United States)

Reichert, M; Morelli, J N; Nittka, M; Attenberger, U; Runge, V M

2015-01-01

Objective: To compare metal artefact reduction in MRI at both 3.0 T and 1.5 T using different sequence strategies. Methods: Metal implants of stainless steel screw and plate within agarose phantoms and tissue specimens as well as three patients with implants were imaged at both 1.5 T and 3.0 T, using view angle tilting (VAT), slice encoding for metal artefact correction with VAT (SEMAC-VAT) and conventional sequence. Artefact reduction in agarose phantoms was quantitatively assessed by artefact volume measurements. Blinded reads were conducted in tissue specimen and human imaging, with respect to artefact size, distortion, blurring and overall image quality. Wilcoxon and Friedman tests for multiple comparisons and intraclass correlation coefficient (ICC) for interobserver agreement were performed with a significant level of p 3.0 T (p 3.0 T. Advances in knowledge: The feasibility of metal artefact reduction with SEMAC-VAT was demonstrated at 3.0-T MR. SEMAC-VAT significantly reduced metal artefacts at both 1.5 and 3.0 T. SEMAC-VAT allowed for better visualization of the tissue structures adjacent to the metal implants. SEMAC-VAT produced consistently better image quality in both tissue specimen and human imaging. PMID:25613398

Association Between Markers of Inflammation and Total Stroke by Hypertensive Status Among Women

Science.gov (United States)

Rexrode, Kathryn M.; Kotler, Gregory; Everett, Brendan M.; Glynn, Robert J.; Lee, I-Min; Buring, Julie E.; Ridker, Paul M.; Sesso, Howard D.

2016-01-01

BACKGROUND Markers of systemic inflammation (high-sensitivity C-reactive protein [hsCRP], soluble intercellular adhesion molecule 1 [sICAM-1], and fibrinogen) have been associated with a greater risk of total and ischemic stroke, in addition to elevated blood pressure. However, the role of these inflammatory markers on stroke pathophysiology by hypertension status is uncertain. METHODS Blood samples were collected and assayed for hsCRP, sICAM-1, and fibrinogen among 27,330 initially healthy women from the Women’s Health Study, and women were followed up from 1992 to 2013. Prior to randomization, the baseline questionnaire collected self-reported hypertension status, cardiovascular risk factors, and lifestyle factors. New cases of total, ischemic, and hemorrhagic stroke were updated annually through questionnaires and confirmed by medical records according to the National Survey of Stroke criteria. Multivariable Cox models estimated overall associations between each inflammatory marker and stroke and separately stratified by hypertension status. RESULTS We observed 629 incident total strokes over 477,278 person-years. In adjusted analyses, extreme quartiles of hsCRP and sICAM-1 were each associated with a significantly greater risk of total stroke (hsCRP: hazard ratios [HR] = 1.77, 95% confidence interval [CI]: 1.39–2.26; sICAM-1: HR = 1.28, 95% CI: 1.00–1.63). Fibrinogen was not associated with a significantly greater stroke risk. In analyses stratified by hypertension status, elevated hsCRP was associated with a nonstatistically significant greater risk of total stroke among prehypertensive and hypertensive women. CONCLUSIONS These data indicate that hsCRP and sICAM-1 are associated with hypertension status and stroke risk among women. Further work should examine the role of inflammatory markers on ischemic stroke subtypes and clarify mechanisms. PMID:27235695

Unsupervised quantification of abdominal fat from CT images using Greedy Snakes

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Agarwal, Chirag; Dallal, Ahmed H.; Arbabshirani, Mohammad R.; Patel, Aalpen; Moore, Gregory

2017-02-01

Adipose tissue has been associated with adverse consequences of obesity. Total adipose tissue (TAT) is divided into subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT). Intra-abdominal fat (VAT), located inside the abdominal cavity, is a major factor for the classic obesity related pathologies. Since direct measurement of visceral and subcutaneous fat is not trivial, substitute metrics like waist circumference (WC) and body mass index (BMI) are used in clinical settings to quantify obesity. Abdominal fat can be assessed effectively using CT or MRI, but manual fat segmentation is rather subjective and time-consuming. Hence, an automatic and accurate quantification tool for abdominal fat is needed. The goal of this study is to extract TAT, VAT and SAT fat from abdominal CT in a fully automated unsupervised fashion using energy minimization techniques. We applied a four step framework consisting of 1) initial body contour estimation, 2) approximation of the body contour, 3) estimation of inner abdominal contour using Greedy Snakes algorithm, and 4) voting, to segment the subcutaneous and visceral fat. We validated our algorithm on 952 clinical abdominal CT images (from 476 patients with a very wide BMI range) collected from various radiology departments of Geisinger Health System. To our knowledge, this is the first study of its kind on such a large and diverse clinical dataset. Our algorithm obtained a 3.4% error for VAT segmentation compared to manual segmentation. These personalized and accurate measurements of fat can complement traditional population health driven obesity metrics such as BMI and WC.

Effect of different exercise intensities on the pancreas of animals with metabolic syndrome.

Science.gov (United States)

Amaral, Fernanda; Lima, Nathalia Ea; Ornelas, Elisabete; Simardi, Lucila; Fonseca, Fernando Luiz Affonso; Maifrino, Laura Beatriz Mesiano

2015-01-01

Metabolic syndrome (MS) comprises several metabolic disorders that are risk factors for cardiovascular disease and has its source connected to the accumulation of visceral adipose tissue (VAT) and development of insulin resistance. Despite studies showing beneficial results of exercise on several risk factors for cardiovascular disease, studies evaluating the effects of different intensities of exercise training on the pancreas with experimental models are scarce. In total, 20 Wistar rats were used, divided into four groups: control (C), metabolic syndrome (MS and without exercise), metabolic syndrome and practice of walking (MSWalk), and metabolic syndrome and practice of running (MSRun). The applied procedures were induction of MS by fructose in drinking water; experimental protocol of walking and running; weighing of body mass and VAT; sacrifice of animals with blood collection and removal of organs and processing of samples for light microscopy using the analysis of volume densities (Vv) of the studied structures. Running showed a reduction of VAT weight (-54%), triglyceride levels (-40%), Vv[islet] (-62%), Vv[islet.cells] (-22%), Vv[islet.insterstitial] (-44%), and Vv[acinar.insterstitial] (-24%) and an increase of Vv[acini] (+21%) and Vv[acinar.cells] (+22%). Regarding walking, we observed a decrease of VAT weight (-34%) and triglyceride levels (-27%), an increase of Vv[islet.cells] (+72%) and Vv[acinar.cells] (+7%), and a decrease of Vv[acini] (-4%) and Vv[acinar.insterstitial] (-16%) when compared with those in the MS group. Our results suggest that the experimental model with low-intensity exercise (walking) seems to be more particularly recommended for preventing morphological and metabolic disorders occurring in the MS.

Insulin sensitivity in relation to fat distribution and plasma adipocytokines among abusers of anabolic androgenic steroids.

Science.gov (United States)

Rasmussen, Jon Jarløv; Schou, Morten; Selmer, Christian; Johansen, Marie Louise; Gustafsson, Finn; Frystyk, Jan; Dela, Flemming; Faber, Jens; Kistorp, Caroline

2017-09-01

Abuse of anabolic androgenic steroids (AAS) is prevalent among young men, but information regarding effects on insulin sensitivity and fat distribution is limited. The objective was to investigate insulin sensitivity in relation to fat distribution and adipocytokines among current and former AAS abusers compared with controls. Cross-sectional study among men involved in recreational strength training. Current and former AAS abusers (n=37 and n=33) and controls (n=30) volunteered from the community. We assessed insulin sensitivity by Matsuda index (oral glucose tolerance test). Using overnight fasting blood samples, adiponectin and leptin were measured. Body composition and fat distribution, including visceral adipose tissue (VAT), were assessed by dual energy X-ray absorptiometry. Current and former AAS abusers displayed lower Matsuda index than controls (%-difference (95%CI) from controls, -26% (-45; -1) and -39% (-55; -18)). Testosterone was markedly higher among current AAS abusers and subnormal among former AAS abusers compared with controls. Current AAS abusers displayed higher mean VAT than controls (388 (17) vs 293 (12) cm 3 , P<.001) whereas body fat %, adiponectin and leptin concentrations were lower. In contrast, former AAS abusers showed highest leptin concentrations and body fat %. Multivariate linear regressions identified VAT as independent predictor of lower Matsuda index among current AAS abusers compared with controls; while body fat % independently predicted lower Matsuda index among former AAS abusers. Both current and former AAS abusers displayed lower insulin sensitivity which could be mediated by higher VAT and total body fat %, respectively. © 2017 John Wiley & Sons Ltd.

Total quality management in hotel industry

OpenAIRE

Mitreva, Elizabeta; Saneva, Dusica; Miteva, Natasa

2017-01-01

Total quality management (TQM) is a systematic management approach aiming at continuous increase of the value offered to consumers through improvement of service quality. In hotel industry, success is achieved through service quality, which stands as a key factor for sustainability in the twenty-first century. Nowadays, quality is the basic factor for survival on the market, better competition, and greater profitability. TQM is a process that starts and ends with the consumer. The aim of this...

Metabolomics and transcriptomics identify pathway differences between visceral and subcutaneous adipose tissue in colorectal cancer patients: the ColoCare study.

Science.gov (United States)

Liesenfeld, David B; Grapov, Dmitry; Fahrmann, Johannes F; Salou, Mariam; Scherer, Dominique; Toth, Reka; Habermann, Nina; Böhm, Jürgen; Schrotz-King, Petra; Gigic, Biljana; Schneider, Martin; Ulrich, Alexis; Herpel, Esther; Schirmacher, Peter; Fiehn, Oliver; Lampe, Johanna W; Ulrich, Cornelia M

2015-08-01

Metabolic and transcriptomic differences between visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) compartments, particularly in the context of obesity, may play a role in colorectal carcinogenesis. We investigated the differential functions of their metabolic compositions. Biochemical differences between adipose tissues (VAT compared with SAT) in patients with colorectal carcinoma (CRC) were investigated by using mass spectrometry metabolomics and gene expression profiling. Metabolite compositions were compared between VAT, SAT, and serum metabolites. The relation between patients' tumor stage and metabolic profiles was assessed. Presurgery blood and paired VAT and SAT samples during tumor surgery were obtained from 59 CRC patients (tumor stages I-IV) of the ColoCare cohort. Gas chromatography time-of-flight mass spectrometry and liquid chromatography quadrupole time-of-flight mass spectrometry were used to measure 1065 metabolites in adipose tissue (333 identified compounds) and 1810 metabolites in serum (467 identified compounds). Adipose tissue gene expression was measured by using Illumina's HumanHT-12 Expression BeadChips. Compared with SAT, VAT displayed elevated markers of inflammatory lipid metabolism, free arachidonic acid, phospholipases (PLA2G10), and prostaglandin synthesis-related enzymes (PTGD/PTGS2S). Plasmalogen concentrations were lower in VAT than in SAT, which was supported by lower gene expression of FAR1, the rate-limiting enzyme for ether-lipid synthesis in VAT. Serum sphingomyelin concentrations were inversely correlated (P = 0.0001) with SAT adipose triglycerides. Logistic regression identified lipids in patients' adipose tissues, which were associated with CRC tumor stage. As one of the first studies, we comprehensively assessed differences in metabolic, lipidomic, and transcriptomic profiles between paired human VAT and SAT and their association with CRC tumor stage. We identified markers of inflammation in VAT, which

The Association between State Value-added Taxes and Tobacco Use in India- Evidence from GATS and TCP India Survey.

Science.gov (United States)

Shang, Ce; Chaloupka, Frank J; Fong, Geoffrey T; Gupta, Prakash C; Pednekar, Mangesh S

2017-08-30

State value-added taxes (VAT) on tobacco products have been increased significantly in recent years in India. Evidence on how these VATs were associated with smoking is highly needed. State bidi and cigarette VAT rates were linked to Global Adult Tobacco Survey (GATS) India 2009-2010 and Tobacco Control Policy (TCP) India Survey waves 1 (2010-2011) and 2 (2012-2013), respectively. These linked data were used to analyze the associations between bidi VAT rates and bidi smoking, between cigarette VAT rates and cigarette smoking, and between the two VAT rates and dual use of bidis and cigarettes. Weighted logistic regressions were employed to examine GATS cross-sectional data, whereas Generalized Estimating Equations (GEE) were employed to examine longitudinal TCP data. We further stratified the analyses by gender. A 10% increase in cigarette VAT rates was associated with a 6.5% (p<0.001) decrease in dual use of cigarettes and bidis among adults and a 0.9% decrease (p<0.05) in cigarette smoking among males in TCP; and with a 21.6% decrease (p<0.05) in dual use among adults and a 17.2% decrease (p<0.001) in cigarette smoking among males in GATS. TCP analyses controlling for state fixed effects are less likely to be biased and indicate a cigarette price elasticity of - 0.44. As female smoking prevalence was extremely low, these associations were non-significant for females. Higher state cigarette VAT rates in India were significantly associated with lower cigarette smoking and lower dual use of cigarettes and bidis. Increasing state VAT rates may significantly reduce smoking in India. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Analisis PPN Membangun Sendiri untuk Pengusaha Kena Pajak di Indonesia

Directory of Open Access Journals (Sweden)

Fany Inasius

2012-05-01

Full Text Available Value-Added Tax (VAT imposition on self build activity will be distinguished if it is provided by using contractor service. As the result, different VAT treatment on both transactions above has implication to whole company‘s profit. In fact, the implementation of this regulation was ineffective because Taxable Firm will easily run away from such disadvantageous regulation. This paper focuses on comparison between VAT imposition to Taxable Firm in the form of limited liability company for self build activity and equal treatment to buildingconstruction provided by contractor. In fact, from comparative and descriptive researches, it is found that equal treatment on VAT imposition for self construction by Taxable Firm will not reduce income tax earnings compared with using contractor service. On the contrary, VAT imposition for self build activity by Taxable Firm in the form of Limited Liability Company becomes ineffective. In the other sides, because VAT in by means of selfbuild activity that can not be credited it has implication to inefficiency that in turn will not conducive to business climates.

[Microbiological studies in poultry meat production].

Science.gov (United States)

Monov, G

1981-01-01

Microbiologic studies were carried out in the production of poultry meat in a poultry dressing combine of the Stork system. Examined were a total of 125 washing samples taken at the 9th, 11th and 15th hour from the scalding vat, the cooling vat, the machine of eviscerating and the skin surface after plucking, eviscerating and shower washing and prior to packing the carcasses. It was found that the count of aerobic organisms continuously rose during the technologic processing of the slaughtered birds with regard to the surface of the carcasses, the peak values of the total counts and that of coliforms being reached during evisceration. It was further established that shower washing of the carcasses immediately following evisceration guaranteed a washing effect so far as the microflora on the surface was concerned, amounting to 77.60 per cent. So far as the coliform bacteria was concerned this effect was found to be equal to 89.78 per cent. The total count of aerobic microflora on the surface of carcasses prior to packing was found to vary within the range of 3000 to 72000, while the count of coliforms ranged from 100 to 1800/cm2.

(Microbiological studies in poultry meat production)

Energy Technology Data Exchange (ETDEWEB)

Monov, G.

1981-01-01

Microbiologic studies were carried out in the production of poultry meat in a poultry dressing combine of the Stork system. Examined were a total of 125 washing samples taken at the 9th, 11th and 15th hour from the scalding vat, the cooling vat, the machine of eviscerating and the skin surface after plucking, eviscerating and shower washing and prior to packing the carcasses. It was found that the count of aerobic organisms continuously rose during the technologic processing of the slaughtered birds with regard to the surface of the carcasses, the peak values of the total counts and that of coliforms being reached during evisceration. It was further established that shower washing of the carcasses immediately following evisceration guaranteed a washing effect so far as the microflora on the surface was concerned, amounting to 77.60 per cent. So far as the coliform bacteria was concerned this effect was found to be equal to 89.78 per cent. The total count of aerobic microflora on the surface of carcasses prior to packing was found to vary within the range of 3000 to 72000, while the count of coliforms ranged from 100 to 1800/cm2.

Greater autonomy at work

NARCIS (Netherlands)

Houtman, I.L.D.

2004-01-01

In the past 10 years, workers in the Netherlands increasingly report more decision-making power in their work. This is important for an economy in recession and where workers face greater work demands. It makes work more interesting, creates a healthier work environment, and provides opportunities

Total facing the new oil and gas situation

International Nuclear Information System (INIS)

Desmarest, Th.

2006-01-01

Total produces oil and gas in more than thirty countries, and contributes to warding off energy shortfalls through its exploration and investment programmes, through its expertise at the leading edge of hydrocarbon technology, and by its attention to the interests of host countries. However, the combination of unflagging demand and growing dependence vis-a-vis the principal producing regions is a source of tension and of risks which call for a much greater discipline in energy consumption and a diversification of energy sources. Thierry Desmarest, the Chairman and Managing Director of Total, gives his view of the new energy situation. (author)

Efficacy of prophylactic splenectomy for proximal advanced gastric cancer invading greater curvature.

Science.gov (United States)

Ohkura, Yu; Haruta, Shusuke; Shindoh, Junichi; Tanaka, Tsuyoshi; Ueno, Masaki; Udagawa, Harushi

2017-05-25

For proximal gastric cancer invading the greater curvature, concomitant splenectomy is frequently performed to secure the clearance of lymph node metastases. However, prognostic impact of prophylactic splenectomy remains unclear. The aim of this study was to clarify the oncological significance of prophylactic splenectomy for advanced proximal gastric cancer invading the greater curvature. Retrospective review of 108 patients who underwent total or subtotal gastrectomy for advanced proximal gastric cancer involving the greater curvature was performed. Short-term and long-term outcomes were compared between the patients who underwent splenectomy (n = 63) and those who did not (n = 45). Patients who underwent splenectomy showed higher amount of blood loss (538 vs. 450 mL, p = 0.016) and morbidity rate (30.2 vs. 13.3, p = 0.041) compared with those who did not undergo splenectomy. In particular, pancreas-related complications were frequently observed among patients who received splenectomy (17.4 vs. 0%, p = 0.003). However, no significant improvement of long-term outcomes were confirmed in the cases with splenectomy (5-year recurrence-free rate, 60.2 vs. 67.3%; p = 0.609 and 5-year overall survival rates, 63.7 vs. 73.6%; p = 0.769). On the other hand, splenectomy was correlated with marginally better survival in patients with Borrmann type 1 or 2 gastric cancer (p = 0.072). For advanced proximal gastric cancer involving the greater curvature, prophylactic splenectomy may have no significant prognostic impact despite the increased morbidity rate after surgery. Such surgical procedure should be avoided as long as lymph node involvement is not evident.

Suppression of Adaptive Immune Cell Activation Does Not Alter Innate Immune Adipose Inflammation or Insulin Resistance in Obesity.

Directory of Open Access Journals (Sweden)

Manikandan Subramanian

Full Text Available Obesity-induced inflammation in visceral adipose tissue (VAT is a major contributor to insulin resistance and type 2 diabetes. Whereas innate immune cells, notably macrophages, contribute to visceral adipose tissue (VAT inflammation and insulin resistance, the role of adaptive immunity is less well defined. To address this critical gap, we used a model in which endogenous activation of T cells was suppressed in obese mice by blocking MyD88-mediated maturation of CD11c+ antigen-presenting cells. VAT CD11c+ cells from Cd11cCre+Myd88fl/fl vs. control Myd88fl/fl mice were defective in activating T cells in vitro, and VAT T and B cell activation was markedly reduced in Cd11cCre+Myd88fl/fl obese mice. However, neither macrophage-mediated VAT inflammation nor systemic inflammation were altered in Cd11cCre+Myd88fl/fl mice, thereby enabling a focused analysis on adaptive immunity. Unexpectedly, fasting blood glucose, plasma insulin, and the glucose response to glucose and insulin were completely unaltered in Cd11cCre+Myd88fl/fl vs. control obese mice. Thus, CD11c+ cells activate VAT T and B cells in obese mice, but suppression of this process does not have a discernible effect on macrophage-mediated VAT inflammation or systemic glucose homeostasis.

Comparison of total phenolic content and composition of individual ...

African Journals Online (AJOL)

A successful peanut breeding to obtain genotypes with greater phenolic content requires information on type and content of phenolic compounds in parental peanut genotypes. The aim of this study was to investigate the total phenolic contents and phenolic acid profiles of 15 Valencia-type peanut genotypes both in peanut ...

Clinical outcomes of CO2-less single-port video-assisted thoracoscopic thymectomy versus open thymectomy: comparative study.

Science.gov (United States)

Aragón, Javier; Pérez Méndez, Itzell; Gutiérrez Pérez, Alexia

2016-01-01

Although video-assisted thoracoscopic surgery (VATS) for thymic disorders has been introduced, its oncological outcome and benefits over others open approaches remains unclear. Single-port VATS thymectomy using a flexible port and CO 2 has been described. However, VATS thymectomy is possible by a single incision of 3 cm without CO 2 insufflation or special port device avoiding objections related to CO 2 insufflation and allowing instruments to move more freely making procedure easier and cheaper. Our institutional experience in open and CO 2 -less VATS single-port thymectomy was retrospectively reviewed to evaluate compared to sternotomy, the clinical and oncological outcomes with this novel approach. A retrospective review consisting of 84 patients who underwent thymectomy because different thymic disorders especially thymoma was performed. Eighteen patients underwent CO 2 -less VATS single port thymectomy, while 66 underwent thymectomy through open sternotomy. Many clinical factors associated with the surgical and clinical outcomes, including tumor recurrence and clinical remission, were recorded. Non major postoperative complications were observed in any group. The median operative time and postoperative hospital stay of CO 2 -less VATS single port thymectomy were 95 min and 1 day, respectively and 120 min and 7 days for open sternotomy. The thymoma was the most common thymic disorder with 7 patients (38%) in VATS group and 28 patients (42.4%) for the open approach. The median lesion size was 2.6 cm in the VATS group and 3.2 cm in the open approach. No thymoma recurrence in patients undergoing VATS was observed during the follow-up time, while in the open surgery group 14.28% recurrence was observed, distributed as follows: loco-regional 75% and 25% at distance; free disease period of these patients was 8.3 months. Thymectomy associated with myasthenia gravis (MG) was observed in 6 (33%) patients in the VATS group and 32 (48%) patients for sternotomy; our

Independent associations of insulin resistance with high whole-body intermuscular and low leg subcutaneous adipose tissue distribution in obese HIV-infected women123

Science.gov (United States)

Albu, Jeanine B; Kenya, Sonjia; He, Qing; Wainwright, Marsha; Berk, Evan S; Heshka, Stanley; Kotler, Donald P; Engelson, Ellen S

2009-01-01

Background Obesity and insulin resistance are growing problems in HIV-positive (HIV+) women receiving highly active antiretroviral therapy (HAART). Objective The objective was to determine the contribution of adipose tissue (AT) enlargement and distribution to the presence of insulin resistance in obese HIV+ women. Design Whole-body intermuscular AT (IMAT), visceral AT (VAT), subcutaneous AT (SAT), and SAT distribution (leg versus upper body) were measured by whole-body magnetic resonance imaging. Insulin sensitivity (SI) was measured with an intravenous glucose tolerance test in obese HIV+ women recruited because of their desire to lose weight (n = 17) and in obese healthy controls (n = 32). Results The HIV+ women had relatively less whole-body SAT and more VAT and IMAT than did the controls (P < 0.05 for all). A significant interaction by HIV status was observed for the relation of total SAT with SI (P < 0.001 for the regression’s slope interactions after adjustment for age, height, and weight). However, relations of IMAT, VAT, and SAT distribution (leg SAT as a percentage of total SAT; leg SAT%) with SI did not differ significantly between groups. For both groups combined, the best model predicting a low SI included significant contributions by both high IMAT and low leg SAT%, independent of age, height, and weight, and no interaction between groups was observed (overall r2 = 0.44, P = 0.0003). Conclusion In obese HIV+ women, high whole-body IMAT and low leg SAT% distribution are independently associated with insulin resistance. PMID:17616768

Labour-Intensive Services and Changes in Value Added Tax Revenue

Directory of Open Access Journals (Sweden)

Krzikallova Katerina

2016-03-01

Full Text Available VAT rates have gradually become an important fiscal policy tool of of EU member states. This paper quantifies the influence on the VAT revenue of the potential transfer of selected labour intensive services from the standard to a reduced VAT rate in the Czech Republic. The data used for the analysis were obtained by a questionnaire, as well as through research performed at the General Financial Directorate and the Czech Statistical Office. To analyze the data, a comparison analysis and descriptive statistical methods were used. The change in VAT rate would cause a decrease in VAT revenue up to 1.6 billion CZK per year, but it would also bring positive effects, especially in the business development of the suppliers of labor intensive services. It could also prevent a price increase during the planned introduction of the e-sales system in restaurants.

VALUE ADDED TAX IN THE ECONOMIC CRISIS CONTEXT

Directory of Open Access Journals (Sweden)

Mara Cristian

2011-07-01

Full Text Available This article tries to present the major aspects concerning the value added tax in the context of economic crisis in European Union countries and Romania. The paper realizes an analysis of the impact of economic crises on VAT in the European space underlining the current situation when the revenues from VAT represent a valuable source of financing the public expenditures. In Romania the economic crises has led to increasing o f VAT rate from 19% to 24%. This measure is an important fiscal measure for the state budget and this study tries to reflect the impact of this VAT rate increase on the public revenues and consumption.

Trends in antimicrobial susceptibility and presence of resistance genes in Staphylococcus hyicus isolated from exudative epidermitis in pigs

DEFF Research Database (Denmark)

Aarestrup, Frank Møller; Jensen, L. B.

2002-01-01

(vat, vga, vga(B), vat(B), vat(D) and vat(E)), streptomycin (aadE) and tetracycline resistance (tet(K), tet(L), tet(M) and tet(O)) were determined in selected isolates. The occurrence of erythromycin resistance increased from 33% in 1996 to a maximum of 62% in 1997 and decreased to 26% in 2001....... Resistance to sulphametazole increased from 17% in 1996 to 30% in 1998 but has since decreased to 4% in 2001. Resistance to trimethoprim increased to 51% in 1997 and decreased to 21% in 2001. Resistance to tetracycline (21-31%) remained relatively constant during 1996-2000, but increased to 47% in 2001...

Trends in antimicrobial susceptibility in relation to antimicrobial usage and presence of resistance genes in Staphylococcus hyicus isolated from exudative epidermitis in pigs

DEFF Research Database (Denmark)

Aarestrup, Frank Møller; Jensen, Lars Bogø

2002-01-01

(vat, vga, vga(B), vat(B), vat(D) and vat(E)), streptomycin (aadE) and tetracycline resistance (tet(K), tet(L), tet(M) and tet(O)) were determined in selected isolates. The occurrence of erythromycin resistance increased from 33% in 1996 to a maximum of 62% in 1997 and decreased to 26% in 2001....... Resistance to sulphametazole increased from 17% in 1996 to 30% in 1998 but has since decreased to 4% in 2001. Resistance to trimethoprim increased to 51% in 1997 and decreased to 21% in 2001. Resistance to tetracycline (21-31%) remained relatively constant during 1996-2000, but increased to 47% in 2001...

Mortality in NHS Greater Glasgow and Clyde employees: 2007-2009.

Science.gov (United States)

Freer, K; Waclawski, E

2013-09-01

Just over a fifth of all deaths in Scotland occur in those under the age of 65. This study examined deaths in service in employees of the National Health Service Greater Glasgow and Clyde (NHS GG&C) Health Board over a 3-year period. To assess crude death rates by occupational group, the main causes of death and evidence of causes that could have been prevented or modified by lifestyle changes. Demographic details, occupational grouping and death certificate data were obtained for all NHS GG&C employees who died in service between 2007 and 2009. A total of 138 employees died in this period. The occupational groups in which most deaths occurred were support services (porters, domestic and catering staff; 35%) and nurses (34%). The commonest causes of death were lung cancer (15%), ischaemic heart disease (9%) and suicide (9%). The overall crude death rate was 1.2/1000 persons/year (females 1.0 and males 1.7) and was highest among support services employees (2.4) and lowest among medical staff (0.5). The relative risk of death in support services was significantly greater than the majority of occupational groups. These findings suggest health inequality within this workforce. The main causes of death identified in the support services group could potentially be modified through workplace risk factor screening and health promotion.

Experimental studies of applicability of the wet air oxidation for purification liquid radioactive waste

International Nuclear Information System (INIS)

Sergienko, V. I.; Dobrzansky, V. G.

2005-01-01

The scheme of handling with liquid radioactive waste (LRW) accepted to exploitation at atomic electric station (AWS) is often connected with evaporating technologies. In this case vat residues of evaporating systems with activity 10 5 -10 6 Bq/1 and containing to 200-300 g/1 of salts are delivered up to LRW storages for lasting keeping. This schema does not correlate to the modern safety standards of handling with LRW, therefore at present numerous works are being carried on including those using technology of accumulated vat residues processing. Some successful experiments on sorption purification of high-salt LRW from cesium radionuclides giving the principal contribution into the total activity of a certain LRW are known. Unfortunately, attempts of sorption purification of the vat residues from other long-lived radionuclides (mainly from 60 Co-radionuclide) were unsuccessful up to the present time. It is found with the fact that the vat residues contain a considerable amount of complexing agent producing stable complexes with transition metal radionuclides including those of 60 Co. Extreme oxidation of the vat residues for decomposition of radioactive organic complexes is one of the solutions of this problem. The works related to oxidation of LRW including the AES vat residues with ozone, hydrogen peroxide as well as photo catalytic and electrochemical oxidation are known, however, possibilities of wet air oxidation (WAO) for LRW processing are not studied till the present time. Condition for decomposition of cobalt complex compounds and necessary excess of oxidizing agent may be easily attained with WAO usage. The necessary experiments were carried out at the experimental plant with the great interface surface (oxygen-solutions) equal to 400m -1 and 3 mm probe bed thickness. The heating time of the reactor to the working temperature 250 .deg. C did not exceed 50 seconds. 20... 50-fold oxidizer excess was achieved by the initial oxygen pressure into the reactor

Comparison of T1-weighted 2D TSE, 3D SPGR, and two-point 3D Dixon MRI for automated segmentation of visceral adipose tissue at 3 Tesla.

Science.gov (United States)

Fallah, Faezeh; Machann, Jürgen; Martirosian, Petros; Bamberg, Fabian; Schick, Fritz; Yang, Bin

2017-04-01

To evaluate and compare conventional T1-weighted 2D turbo spin echo (TSE), T1-weighted 3D volumetric interpolated breath-hold examination (VIBE), and two-point 3D Dixon-VIBE sequences for automatic segmentation of visceral adipose tissue (VAT) volume at 3 Tesla by measuring and compensating for errors arising from intensity nonuniformity (INU) and partial volume effects (PVE). The body trunks of 28 volunteers with body mass index values ranging from 18 to 41.2 kg/m 2 (30.02 ± 6.63 kg/m 2 ) were scanned at 3 Tesla using three imaging techniques. Automatic methods were applied to reduce INU and PVE and to segment VAT. The automatically segmented VAT volumes obtained from all acquisitions were then statistically and objectively evaluated against the manually segmented (reference) VAT volumes. Comparing the reference volumes with the VAT volumes automatically segmented over the uncorrected images showed that INU led to an average relative volume difference of -59.22 ± 11.59, 2.21 ± 47.04, and -43.05 ± 5.01 % for the TSE, VIBE, and Dixon images, respectively, while PVE led to average differences of -34.85 ± 19.85, -15.13 ± 11.04, and -33.79 ± 20.38 %. After signal correction, differences of -2.72 ± 6.60, 34.02 ± 36.99, and -2.23 ± 7.58 % were obtained between the reference and the automatically segmented volumes. A paired-sample two-tailed t test revealed no significant difference between the reference and automatically segmented VAT volumes of the corrected TSE (p = 0.614) and Dixon (p = 0.969) images, but showed a significant VAT overestimation using the corrected VIBE images. Under similar imaging conditions and spatial resolution, automatically segmented VAT volumes obtained from the corrected TSE and Dixon images agreed with each other and with the reference volumes. These results demonstrate the efficacy of the signal correction methods and the similar accuracy of TSE and Dixon imaging for automatic volumetry of VAT at 3 Tesla.

Socio-economic considerations of cleaning Greater Vancouver's air

International Nuclear Information System (INIS)

2005-08-01

Socio-economic considerations of better air quality on the Greater Vancouver population and economy were discussed. The purpose of the study was to provide socio-economic information to staff and stakeholders of the Greater Vancouver Regional District (GVRD) who are participating in an Air Quality Management Plan (AQMP) development process and the Sustainable Region Initiative (SRI) process. The study incorporated the following methodologies: identification and review of Canadian, American, and European quantitative socio-economic, cost-benefit, cost effectiveness, competitiveness and health analyses of changes in air quality and measures to improve air quality; interviews with industry representatives in Greater Vancouver on competitiveness impacts of air quality changes and ways to improve air quality; and a qualitative analysis and discussion of secondary quantitative information that identifies and evaluates socio-economic impacts arising from changes in Greater Vancouver air quality. The study concluded that for the Greater Vancouver area, the qualitative analysis of an improvement in Greater Vancouver air quality shows positive socio-economic outcomes, as high positive economic efficiency impacts are expected along with good social quality of life impacts. 149 refs., 30 tabs., 6 appendices

{sup 18}F-FDG PET/CT imaging factors that predict ischaemic stroke in cancer patients

Energy Technology Data Exchange (ETDEWEB)

Kim, Jahae; Song, Ho-Chun [Chonnam National University Hospital, Department of Nuclear Medicine, Gwangju (Korea, Republic of); Choi, Kang-Ho [Chonnam National University Hospital, Cerebrovascular Center, Gwangju (Korea, Republic of); Chonnam National University Hwasun Hospital, Department of Neurology, Hwasun-gun, Jeollanam-do (Korea, Republic of); Kim, Joon-Tae; Park, Man-Seok; Cho, Ki-Hyun [Chonnam National University Hospital, Cerebrovascular Center, Gwangju (Korea, Republic of)

2016-11-15

{sup 18}F-FDG PET/CT can acquire both anatomical and functional images in a single session. We investigated which factors of {sup 18}F-FDG PET/CT imaging have potential as biomarkers for an increased risk of ischaemic stroke in cancer patients. From among cancer patients presenting with various neurological symptoms and hemiparesis, 134 were selected as eligible for this retrospective analysis. A new infarct lesion on brain MRI within 1 year of FDG PET/CT defined future ischaemic stroke. The target-to-background ratio (TBR) of each arterial segment was used to define arterial inflammation on PET imaging. Abdominal obesity was defined in terms of the area and proportion of visceral adipose tissue (VAT), subcutaneous adipose tissue and total adipose tissue (TAT) on a single CT slice at the umbilical level. Ischaemic stroke confirmed by MRI occurred in 30 patients. Patients with stroke had higher TBRs in the carotid arteries and abdominal aorta (P < 0.001) and a higher VAT proportion (P = 0.021) and TAT proportion (P = 0.041) than patients without stroke. Multiple logistic regression analysis showed that TBRs of the carotid arteries and abdominal aorta, VAT and TAT proportions, and the presence of a metabolically active tumour were significantly associated with future ischaemic stroke. Combining PET and CT variables improved the power for predicting future ischaemic stroke. Our findings suggest that arterial FDG uptake and hypermetabolic malignancy on PET and the VAT proportion on CT could be independent predictors of future ischaemic stroke in patients with cancer and could identify those patients who would benefit from medical treatment. (orig.)

Computed Tomography-Assisted Thoracoscopic Surgery: A Novel, Innovative Approach in Patients With Deep Intrapulmonary Lesions of Unknown Malignant Status.

Science.gov (United States)

Kostrzewa, Michael; Kara, Kerim; Rathmann, Nils; Tsagogiorgas, Charalambos; Henzler, Thomas; Schoenberg, Stefan O; Hohenberger, Peter; Diehl, Steffen J; Roessner, Eric D

2017-06-01

Minimally invasive resection of small, deep intrapulmonary lesions can be challenging due to the difficulty of localizing them during video-assisted thoracoscopic surgery (VATS). We report our preliminary results evaluating the feasibility of an image-guided, minimally invasive, 1-stop-shop approach for the resection of small, deep intrapulmonary lesions in a hybrid operating room (OR). Fifteen patients (5 men, 10 women; mean age, 63 years) with a total of 16 solitary, deep intrapulmonary nodules of unknown malignant status were identified for intraoperative wire marking. Patients were placed on the operating table for resection by VATS. A marking wire was placed within the lesion under 3D laser and fluoroscopic guidance using a cone beam computed tomography system. Then, wedge resection by VATS was performed in the same setting without repositioning the patient. Complete resection with adequate safety margins was confirmed for all lesions. Marking wire placement facilitated resection in 15 of 16 lesions. Eleven lesions proved to be malignant, either primary or secondary; 5 were benign. Mean lesion size was 7.7 mm; mean distance to the pleural surface was 15.1 mm (mean lesion depth-diameter ratio, 2.2). Mean procedural time for marking wire placement was 35 minutes; mean VATS duration was 36 minutes. Computed tomography-assisted thoracoscopic surgery is a new, safe, and effective procedure for minimally invasive resection of small, deeply localized intrapulmonary lesions. The benefits of computed tomography-assisted thoracoscopic surgery are 1. One-stop-shop procedure, 2. Lower risk for the patient (no patient relocation, no marking wire loss), and 3. No need to coordinate scheduling between the CT room and OR.

Dietary pattern associated with selenoprotein P and MRI-derived body fat volumes, liver signal intensity, and metabolic disorders.

Science.gov (United States)

di Giuseppe, Romina; Plachta-Danielzik, Sandra; Koch, Manja; Nöthlings, Ute; Schlesinger, Sabrina; Borggrefe, Jan; Both, Marcus; Müller, Hans-Peter; Kassubek, Jan; Jacobs, Gunnar; Lieb, Wolfgang

2018-02-14

The association of complex dietary patterns with circulating selenoprotein P (SELENOP) levels in humans is unknown. In a general population sample, we aimed to identify a dietary pattern explaining inter-individual variation in circulating SELENOP concentrations and to study this pattern in relation to prevalent diabetes, metabolic syndrome (MetS), MRI-determined total volumes of visceral (VAT) and subcutaneous (SAT) abdominal adipose tissue, and liver signal intensity/fatty liver disease. In this cross-sectional study, serum SELENOP levels were measured in 853 individuals. In a subsample of 553 participants, whole-body MRI was performed to assess body fat distribution and liver fat. Dietary intake was assessed by a self-administered food frequency questionnaire and the dietary pattern identified using reduced-rank regression (RRR). Multivariable linear and logistic regressions were used to investigate associations between dietary pattern score and metabolic traits. Characterized by high intake of fruit, vegetables and antioxidant beverages, the RRR-derived dietary pattern displayed inverse associations with VAT, SAT, MetS, and prevalent diabetes in multivariable-adjusted restricted cubic splines. Each unit increase in dietary pattern score was associated with 31% higher SELENOP levels, 12% lower VAT (95% CI: - 19%; - 5%), 13% (95% CI: - 20%; - 6%) lower SAT values and 46% (95% CI: 27%; 60%) and 53% (95% CI: 22%; 72%) lower odds of having MetS or diabetes, respectively. No meaningful relations were observed between the dietary pattern and liver traits. Our observations propose diet-related regulation in SELENOP levels and that the identified dietary pattern is inversely related to VAT, SAT, MetS, and prevalent diabetes.

Atomic resonances above the total ionization energy

International Nuclear Information System (INIS)

Doolen, G.

1975-01-01

A rigorous result obtained using the theory associated with dilatation analytic potentials is that by performing a complex coordinate rotation, r/subj/ → r/subj/e/subi//sup theta/, on a Hamiltonian whose potential involves only pairwise Coulombic interactions, one can show that when theta = π/2, no complex eigenvalues (resonances) appear whose energies have a real part greater than the total ionization energy of the atomic system. This appears to conflict with experimental results of Walton, Peart, and Dolder, who find resonance behavior above the total ionization energy of the H -- system and also the theoretical stabilization results of Taylor and Thomas for the same system. A possible resolution of this apparent conflict is discussed and a calculation to check its validity is proposed

Status on disposal of greater-than-Class C

Energy Technology Data Exchange (ETDEWEB)

Plummer, T.L.

1995-12-31

The Department of Energy (DOE) has developed a plan for the management and disposal of commercially generated greater-than-Class C (GTCC) low-level radioactive waste. The Low-Level Radioactive Waste Policy Amendments Act of 1985 made DOE responsible for disposal of GTCC waste. The act requires that GTCC waste be disposed in a Nuclear Regulatory Commission (NRC)-licensed facility. The NRC has amended 10 CFR 61 to express a preference for geologic disposal of GTCC waste. Based on reassessment studies, legislative guidance, and stakeholder involvement, a revised plan has been formulated to provide for total management of GTCC waste. The plan has four major thrusts: (1) plan for GTCC waste storage at the generator site until disposal is available, (2) establish storage for GTCC sealed sources posing health and safety risk to the public, (3) facilitate storage for other GTCC waste posing health and safety risk to the public, and (4) plan for co-disposal of GTCC waste in a geologic disposal site with similar waste types. The revised plan focuses on applying available resources to near- and long-term needs.

Interleukins 6 and 15 Levels Are Higher in Subcutaneous Adipose Tissue, but Obesity Is Associated with Their Increased Content in Visceral Fat Depots

Directory of Open Access Journals (Sweden)

Marta Izabela Jonas

2015-10-01

Full Text Available Excess adiposity is associated with chronic inflammation, which takes part in the development of obesity-related complications. The aim of this study was to establish whether subcutaneous (SAT or visceral (VAT adipose tissue plays a major role in synthesis of pro-inflammatory cytokines. Concentrations of interleukins (IL: 1β, 6, 8 and 15 were measured at the protein level by an ELISA-based method and on the mRNA level by real-time PCR in VAT and SAT samples obtained from 49 obese (BMI > 40 kg/m2 and 16 normal-weight (BMI 20–24.9 kg/m2 controls. IL-6 and IL-15 protein concentrations were higher in SAT than in VAT for both obese (p = 0.003 and p < 0.0001, respectively and control individuals (p = 0.004 and p = 0.001, respectively, while for IL-1β this was observed only in obese subjects (p = 0.047. What characterized obese individuals was the higher expression of IL-6 and IL-15 at the protein level in VAT compared to normal-weight controls (p = 0.047 and p = 0.016, respectively. Additionally, obese individuals with metabolic syndrome had higher IL-1β levels in VAT than did obese individuals without this syndrome (p = 0.003. In conclusion, concentrations of some pro-inflammatory cytokines were higher in SAT than in VAT, but it was the increased pro-inflammatory activity of VAT that was associated with obesity and metabolic syndrome.

Video-Assisted versus Open Lobectomy in Patients with Compromised Lung Function: A Literature Review and Meta-Analysis.

Directory of Open Access Journals (Sweden)

Ruoyu Zhang

Full Text Available It has been suggested that video-assisted (VATS lobectomy is safer than open lobectomy in patients with compromised lung function, but data regarding this are limited. We assessed acute outcomes of VATS compared to open lobectomy in these high-risk patients using a systematic literature review and meta-analysis of data.The databases PubMed and Scopus were searched for studies published between 2000 and 2013 that reported mortality and morbidity of VATS in high-risk lung cancer patients defined as having compromised pulmonary or cardiopulmonary function. Study selection, data collection and critical assessment of the included studies were performed according to the recommendations of the Cochrane Collaboration.Three case-control studies and three case series that included 330 VATS and 257 open patients were identified for inclusion. Operative mortality, overall morbidity and pulmonary morbidity were 2.5%, 39.3%, 26.2% in VATS patients and 7.8%, 57.5%, 45.5% in open lobectomy group, respectively. VATS lobectomy patients experienced significantly lower pulmonary morbidity (RR = 0.45; 95% CI, 0.30 to 0.67; p = 0.0001, somewhat reduced operative mortality (RR = 0.51; 95% CI, 0.24 to 1.06; p = 0.07, but no significant difference in overall morbidity (RR = 0.68; 95% CI, 0.41 to 1.14; p = 0.14.The existing data suggest that VATS lobectomy is associated with lower risk for pulmonary morbidity compared with open lobectomy in lung cancer patients with compromised lung function.

Cemented total hip replacement cable debris and acetabular construct durability.

Science.gov (United States)

Altenburg, Aaron J; Callaghan, John J; Yehyawi, Tameem M; Pedersen, Douglas R; Liu, Steve S; Leinen, Jessica A; Dahl, Kevin A; Goetz, Devon D; Brown, Thomas D; Johnston, Richard C

2009-07-01

Third-body wear can adversely affect the outcome of total hip arthroplasty by causing increased polyethylene wear, osteolysis, and component loosening. We hypothesized that there would be greater generation and migration of metal debris to the bearing surfaces in hips in which cobalt-chromium cables were used to reattach the osteotomized greater trochanter when compared with hips in which stainless steel wires were used. Between June 1981 and December 1983, 196 consecutive total hip arthroplasties were performed with use of an Iowa stem and a titanium-backed cemented acetabular component, with cobalt-chromium cable trochanteric reattachment. After nineteen to twenty years of follow-up, the patients were evaluated with regard to the depth of head penetration into the polyethylene (as a surrogate for wear), osteolysis, loosening, and the need for revision. The results were compared with those for a series of 304 total hip arthroplasties that were performed by the same surgeon from January 1984 to December 1985 with use of the same components and the same surgical technique, but with stainless steel wire trochanteric reattachment. The two groups had a comparable nineteen to twenty-year follow-up. All living patients (fifty-nine hips in the cable group and ninety-two hips in the wire group) had minimum ten-year follow-up radiographs. The polyethylene wear rate was 0.101 mm/yr for the cable group and 0.082 mm/yr for the wire group (p = 0.039). For the living patients, the rate of revision of the acetabular component because of aseptic loosening was 37.3% (twenty-two hips) for the cable group and 20.7% (nineteen hips) for the wire group (p = 0.025). The rate of acetabular osteolysis was 44% (twenty-six hips) for the cable group and 26% (twenty-four hips) for the wire group (p = 0.022). Kaplan-Meier analysis with revision of the acetabular component because of aseptic loosening as the end point demonstrated survival rates of 73.7% +/- 9% and 83% +/- 7% for the cable and

Whole-body adipose tissue and lean muscle volumes and their distribution across gender and age: MR-derived normative values in a normal-weight Swiss population.

Science.gov (United States)

Ulbrich, Erika J; Nanz, Daniel; Leinhard, Olof Dahlqvist; Marcon, Magda; Fischer, Michael A

2018-01-01

To determine age- and gender-dependent whole-body adipose tissue and muscle volumes in healthy Swiss volunteers in Dixon MRI in comparison with anthropometric and bioelectrical impedance (BIA) measurements. Fat-water-separated whole-body 3 Tesla MRI of 80 healthy volunteers (ages 20 to 62 years) with a body mass index (BMI) of 17.5 to 26.2 kg/m 2 (10 men, 10 women per decade). Age and gender-dependent volumes of total adipose tissue (TAT), visceral adipose tissue (VAT), total abdominal subcutaneous adipose tissue (ASAT) and total abdominal adipose tissue (TAAT), and the total lean muscle tissue (TLMT) normalized for body height were determined by semi-automatic segmentation, and correlated with anthropometric and BIA measurements as well as lifestyle parameters. The TAT, ASAT, VAT, and TLMT indexes (TATi, ASATi, VATi, and TLMTi, respectively) (L/m 2  ± standard deviation) for women/men were 6.4 ± 1.8/5.3 ± 1.7, 1.6 ± 0.7/1.2 ± 0.5, 0.4 ± 0.2/0.8 ± 0.5, and 5.6 ± 0.6/7.1 ± 0.7, respectively. The TATi correlated strongly with ASATi (r > 0.93), VATi, BMI and BIA (r > 0.70), and TAATi (r > 0.96), and weak with TLMTi for both genders (r > -0.34). The VAT was the only parameter showing an age dependency (r > 0.32). The BMI and BIA showed strong correlation with all MR-derived adipose tissue volumes. The TAT mass was estimated significantly lower from BIA than from MRI (both genders P muscle volumes might serve as normative values. The estimation of adipose tissue volumes was significantly lower from anthropometric and BIA measurements than from MRI. Magn Reson Med 79:449-458, 2018. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

Long-term high-physiological-dose growth hormone reduces intra-abdominal fat in HIV-infected patients with a neutral effect on glucose metabolism

DEFF Research Database (Denmark)

Hansen, B R; Haugaard, S B; Jensen, Frank Krieger

2010-01-01

, glucose tolerance, and total plasma cholesterol and triglycerides did not significantly change during intervention. CONCLUSIONS: Daily 0.7 mg rhGH treatment for 40 weeks reduced abdominal visceral fat and trunk fat mass in HIV-infected patients. This treatment appeared to be safe with respect to glucose......OBJECTIVES: The aim of the study was to investigate the effect of long-term high-physiological-dose recombinant human growth hormone (rhGH) therapy on fat distribution and glucose metabolism in HIV-infected patients. METHODS: Forty-six HIV-infected Caucasian men on highly active antiretroviral...... between 1 and 3 pm for 40 weeks. Endpoints included changes in visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), limb fat mass, percentage of limb fat, plasma lipids, insulin resistance and glucose tolerance. RESULTS: VAT and trunk fat mass decreased significantly in the GH group compared...

Reserves in western basins: Part 1, Greater Green River basin

Energy Technology Data Exchange (ETDEWEB)

1993-10-01

This study characterizes an extremely large gas resource located in low permeability, overpressured sandstone reservoirs located below 8,000 feet drill depth in the Greater Green River basin, Wyoming. Total in place resource is estimated at 1,968 Tcf. Via application of geologic, engineering and economic criteria, the portion of this resource potentially recoverable as reserves is estimated. Those volumes estimated include probable, possible and potential categories and total 33 Tcf as a mean estimate of recoverable gas for all plays considered in the basin. Five plays (formations) were included in this study and each was separately analyzed in terms of its overpressured, tight gas resource, established productive characteristics and future reserves potential based on a constant $2/Mcf wellhead gas price scenario. A scheme has been developed to break the overall resource estimate down into components that can be considered as differing technical and economic challenges that must be overcome in order to exploit such resources: in other words, to convert those resources to economically recoverable reserves. Total recoverable reserves estimates of 33 Tcf do not include the existing production from overpressured tight reservoirs in the basin. These have estimated ultimate recovery of approximately 1.6 Tcf, or a per well average recovery of 2.3 Bcf. Due to the fact that considerable pay thicknesses can be present, wells can be economic despite limited drainage areas. It is typical for significant bypassed gas to be present at inter-well locations because drainage areas are commonly less than regulatory well spacing requirements.

Waste management in Greater Vancouver

Energy Technology Data Exchange (ETDEWEB)

Carrusca, K. [Greater Vancouver Regional District, Burnaby, BC (Canada); Richter, R. [Montenay Inc., Vancouver, BC (Canada)]|[Veolia Environmental Services, Vancouver, BC (Canada)

2006-07-01

An outline of the Greater Vancouver Regional District (GVRD) waste-to-energy program was presented. The GVRD has an annual budget for solid waste management of $90 million. Energy recovery revenues from solid waste currently exceed $10 million. Over 1,660,00 tonnes of GVRD waste is recycled, and another 280,000 tonnes is converted from waste to energy. The GVRD waste-to-energy facility combines state-of-the-art combustion and air pollution control, and has processed over 5 million tonnes of municipal solid waste since it opened in 1988. Its central location minimizes haul distance, and it was originally sited to utilize steam through sales to a recycle paper mill. The facility has won several awards, including the Solid Waste Association of North America award for best facility in 1990. The facility focuses on continual improvement, and has installed a carbon injection system; an ammonia injection system; a flyash stabilization system; and heat capacity upgrades in addition to conducting continuous waste composition studies. Continuous air emissions monitoring is also conducted at the plant, which produces a very small percentage of the total air emissions in metropolitan Vancouver. The GVRD is now seeking options for the management of a further 500,000 tonnes per year of solid waste, and has received 23 submissions from a range of waste energy technologies which are now being evaluated. It was concluded that waste-to-energy plants can be located in densely populated metropolitan areas and provide a local disposal solution as well as a source of renewable energy. Other GVRD waste reduction policies were also reviewed. refs., tabs., figs.

Greater trochanteric pain syndrome diagnosis and treatment.

Science.gov (United States)

Mallow, Michael; Nazarian, Levon N

2014-05-01

Lateral hip pain, or greater trochanteric pain syndrome, is a commonly seen condition; in this article, the relevant anatomy, epidemiology, and evaluation strategies of greater trochanteric pain syndrome are reviewed. Specific attention is focused on imaging of this syndrome and treatment techniques, including ultrasound-guided interventions. Copyright © 2014 Elsevier Inc. All rights reserved.

Total and antigen-specific Ige levels in umbilical cord blood

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Sybilski AJ

2009-12-01

Full Text Available Abstract The present study was conducted to learn whether the perinatal and environmental factors could influence the total and antigen-specific IgE levels in umbilical cord blood. Retrospective data were obtained from 173 mother-infant pairs. Total and specific (for children's food, wheat/grass and house dust mite-HDM cord blood IgE levels were determined using the immunoassay test. The total cord blood IgE was between 0.0-23.08 IU/ml (mean 0.55 ± 2.07 IU/ml; median 0.16 IU/ml. Total IgE levels were significantly higher in boys compared with girls (OR = 2.2; P = 0.007, and in newborns with complicated pregnancy (OR = 2.7; P = 0.003. A greater number of siblings correlated with increases in the total cord blood IgE (P

Genome-wide association for abdominal subcutaneous and visceral adipose reveals a novel locus for visceral fat in women

DEFF Research Database (Denmark)

Fox, Caroline S; Liu, Yongmei; White, Charles C

2012-01-01

of European ancestry. Subcutaneous and visceral fat were quantified in 5,560 women and 4,997 men from 4 population-based studies. Genome-wide genotyping was performed using standard arrays and imputed to ~2.5 million Hapmap SNPs. Each study performed a genome-wide association analysis of subcutaneous adipose...... tissue (SAT), visceral adipose tissue (VAT), VAT adjusted for body mass index, and VAT/SAT ratio (a metric of the propensity to store fat viscerally as compared to subcutaneously) in the overall sample and in women and men separately. A weighted z-score meta-analysis was conducted. For the VAT/SAT ratio......-specific analyses. Our most significant finding was for VAT in women, rs1659258 near THNSL2 (p = 1.6 × 10-08), but not men (p = 0.75). Validation of this SNP in the GIANT consortium data demonstrated a similar sex-specific pattern, with observed significance in women (p = 0.006) but not men (p = 0.24) for BMI...

How to deal with benign hilar or interlobar lymphadenopathy during video-assisted thoracoscopic surgery lobectomy.

Science.gov (United States)

Yan, Shi; Lv, Chao; Wang, Xing; Wu, Nan

2016-01-01

Video-assisted thoracoscopic surgery (VATS) surgery has changed the way lobectomy procedure was performed over the past few decades. However, some difficulties impede the accomplishment of VATS lobectomy, which of them, benign lymphadenopathy may pose a threat to safety of surgery. We reported a case with enlarged hilar and interlobar lymph nodes. The video showed the instrumentation and techniques that we had adopted to deal with the complicated dilemma during the operation. Critical experience was also suggested in some hypothetical scenarios. AS techniques were further refined, successful VATS segmentectomy or lobectomy with challenging hilar or interlobar lymphadenopathy could be performed without uncontrolled bleeding or unexpected conversion. A VATS approach is acceptable in the management of benign hilar or interlobar lymphadenopathy. However, facile technique is necessary to deal with intraoperative dilemma. To those who are not sure about the practicability of the VATS procedure, planned conversion is still an effective method to ensure safety of the operation.

Ultrasound-Guided Intermediate Site Greater Occipital Nerve Infiltration: A Technical Feasibility Study.

Science.gov (United States)

Zipfel, Jonathan; Kastler, Adrian; Tatu, Laurent; Behr, Julien; Kechidi, Rachid; Kastler, Bruno

2016-01-01

Two studies recently reported that computed tomography (CT) guided infiltration of the greater occipital nerve at its intermediate site allows a high efficacy rate with long-lasting pain relief following procedure in occipital neuralgia and in various craniofacial pain syndromes. The purpose of our study was to evaluate the technical feasibility and safety of ultrasound-guided intermediate site greater occipital nerve infiltration. Retrospective study. This study was conducted at the imaging department of a 1,409 bed university hospital. Local institutional review board approval was obtained and written consent was waived. In this retrospective study, 12 patients suffering from refractory occipital neuralgia or craniofacial pain syndromes were included between April and October 2014. They underwent a total of 21 ultrasound-guided infiltrations. Infiltration of the greater occipital nerve was performed at the intermediate site of the greater occipital nerve, at its first bend between obliqus capitis inferior and semispinalis capitis muscles with local anestetics and cortivazol. Technical success was defined as satisfactory diffusion of added iodinated contrast media in the fatty space between these muscles depicted on control CT scan. We also reported first data of immediate block test efficacy and initial clinical efficacy at 7 days, one month, and 3 months, defined by a decrease of at least 50% of visual analog scale (VAS) scores. Technical success rate was 95.24%. Patients suffered from right unilateral occipital neuralgia in 3 cases, left unilateral occipital neuralgia in 2 cases, bilateral occipital neuralgia in 2 cases, migraine in one case, cervicogenic headache in one case, tension-type headache in 2 cases, and cluster headache in one case. Block test efficacy was found in 93.3% (14/15) cases. Clinical efficacy was found in 80% of cases at 7 days, in 66.7% of cases at one month and in 60% of cases at 3 months. No major complications were noted. Some of the

Bacterial clearance after total splenectomy and splenic autotransplantation in rats

Energy Technology Data Exchange (ETDEWEB)

Marques, R.G. E-mail: rmarques@uerj.br; Petroianu, Andy; Oliveira, M.B.N. de; Bernardo-Filho, M.; Boasquevisque, E.M.; Portela, M.C

2002-12-01

Wistar rats submitted to isolated total splenectomy or total splenectomy combined with splenic autotransplantation were inoculated with {sup 99m}technetium-labeled Escherichia coli. Measurement of isotope uptake in the organs of the mononuclear phagocytic system showed a greater bacterial bloodstream clearance in rats with splenic autotransplantation. Although uptake of bacteria in the spleen was higher in the control group, the number of bacteria remaining in the bloodstream did not differ between groups. These results indicate that splenic autotransplantation preserves the phagocytic function of the spleen.

Bacterial clearance after total splenectomy and splenic autotransplantation in rats

International Nuclear Information System (INIS)

Marques, R.G.; Petroianu, Andy; Oliveira, M.B.N. de; Bernardo-Filho, M.; Boasquevisque, E.M.; Portela, M.C.

2002-01-01

Wistar rats submitted to isolated total splenectomy or total splenectomy combined with splenic autotransplantation were inoculated with 99m technetium-labeled Escherichia coli. Measurement of isotope uptake in the organs of the mononuclear phagocytic system showed a greater bacterial bloodstream clearance in rats with splenic autotransplantation. Although uptake of bacteria in the spleen was higher in the control group, the number of bacteria remaining in the bloodstream did not differ between groups. These results indicate that splenic autotransplantation preserves the phagocytic function of the spleen

Post site metastasis of breast cancer after video-assisted thoracic surgery for pulmonary metastasis of breast cancer: A case report

Energy Technology Data Exchange (ETDEWEB)

Park, Mee Hyun; Hwang, Ji Young; Hyun, Su Jeong; Lee, Yul; Woo, Ji Young; Yang, Ik; Hong, Hye Sook; Kim, Han Myun [Dept. of Radiology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul (Korea, Republic of)

2016-05-15

We reported a case of port site metastasis in a 57-year-old patient who underwent video-assisted thoracic surgery (VATS) resection of pulmonary metastasis from breast cancer. Port site metastasis after VATS is very rare in patients with breast cancer. However, when suspicious lesions are detected near the port site in patients who have undergone VATS for pulmonary metastasis, port site metastasis should be considered in the differential diagnosis.

Obesity-induced vascular inflammation involves elevated arginase activity.

Science.gov (United States)

Yao, Lin; Bhatta, Anil; Xu, Zhimin; Chen, Jijun; Toque, Haroldo A; Chen, Yongjun; Xu, Yimin; Bagi, Zsolt; Lucas, Rudolf; Huo, Yuqing; Caldwell, Ruth B; Caldwell, R William

2017-11-01

Obesity-induced vascular dysfunction involves pathological remodeling of the visceral adipose tissue (VAT) and increased inflammation. Our previous studies showed that arginase 1 (A1) in endothelial cells (ECs) is critically involved in obesity-induced vascular dysfunction. We tested the hypothesis that EC-A1 activity also drives obesity-related VAT remodeling and inflammation. Our studies utilized wild-type and EC-A1 knockout (KO) mice made obese by high-fat/high-sucrose (HFHS) diet. HFHS diet induced increases in body weight, fasting blood glucose, and VAT expansion. This was accompanied by increased arginase activity and A1 expression in vascular ECs and increased expression of tumor necrosis factor-α (TNF-α), monocyte chemoattractant protein-1 (MCP-1), interleukin-10 (IL-10), vascular cell adhesion molecule-1 (VCAM-1), and intercellular adhesion molecule-1 (ICAM-1) mRNA and protein in both VAT and ECs. HFHS also markedly increased circulating inflammatory monocytes and VAT infiltration by inflammatory macrophages, while reducing reparative macrophages. Additionally, adipocyte size and fibrosis increased and capillary density decreased in VAT. These effects of HFHS, except for weight gain and hyperglycemia, were prevented or reduced in mice lacking EC-A1 or treated with the arginase inhibitor 2-( S )-amino-6-boronohexanoic acid (ABH). In mouse aortic ECs, exposure to high glucose (25 mM) and Na palmitate (200 μM) reduced nitric oxide production and increased A1, TNF-α, VCAM-1, ICAM-1, and MCP-1 mRNA, and monocyte adhesion. Knockout of EC-A1 or ABH prevented these effects. HFHS diet-induced VAT inflammation is mediated by EC-A1 expression/activity. Limiting arginase activity is a possible therapeutic means of controlling obesity-induced vascular and VAT inflammation.

Uniportal video assisted thoracoscopic lobectomy: primary experience from an Eastern center.

Science.gov (United States)

Feng, Mingxiang; Shen, Yaxing; Wang, Hao; Tan, Lijie; Mao, Xuping; Liu, Yi; Wang, Qun

2014-12-01

Uniportal video-assisted thoracoscopic surgery (VATS) lobectomy is an emerging technique for the surgical resection of non-small cell lung cancer (NSCLC). Besides its wide debates on safety and efficacy throughout the world, there were few report on uniportal VATS from the Eastern countries. In this article, we summarized our primary experience on uniportal VATS lobectomy in an Eastern center. From October 2013 till February 2014, 54 consecutive uniportal VATS lobectomy were performed in the Department of Thoracic Surgery, Zhongshan Hospital of Fudan University. Patients' clinical features and operative details were recorded. Post-operatively, the morbidity and mortality were recorded to analyze the safety and efficacy of uniportal VATS lobectomy for NSCLCs. Among the 54 planned uniportal VATS lobectomy, there was one conversion to mini-thoracotomy due to lymph node sticking. Extra ports were required in two patients. The uniportal VATS lobectomy was achieved in 51 out of 54 patients (94.4%). The average operation duration was 122.2±37.5 min (90-160 min). The average volume of estimated blood loss during the operation was 88.8±47.1 mL (50-200 mL). The mean chest tube duration and hospital stay were 3.2±1.9 days and 4.6±2.0 days, respectively. There was no postoperative mortality in this study. Two patients suffered from prolonged air leakage (5 and 7 days), and one atrial fibrillation was observed in this cohort. Based on our primary experience, uniportal VATS lobectomy is a safe and effective procedure for the surgical resection of NSCLCs. The surgical refinements and instrumental improvements would facilitate the technique. Further studies based on larger population are required to determine its benefits towards patients with NSCLCs.

To Explore Clinical Value of Single-port Video-assisted Thoracoscopic Surgery 
in Elderly Patients with Non-small Cell Lung Cancer: Lobectomy, Segmentectomy 
and Lobectomy vs Segmentectomy

Directory of Open Access Journals (Sweden)

Lin HUANG

2018-04-01

Full Text Available Background and objective The morbidity of lung cancer has long been the highest in cancer. Stage I, stage II and partly of stage III non-small cell lung cancer (NSCLC are mainly treated by surgery. Lobectomy and segmentectomy both are common lung resection methods. Video-assisted thoracoscopic surgery (VATS has been widely used in clinical, and the application of single-portvideo-assisted thoracoscopic surgery (SP VATS has gradually been recognized and accepted by professors. With increasing degree of eldly in society, eldly patients already have become inceasingly difficulties in the diagnosis and treatment of NSCLC. The aim of this study is to explore and analyze clinical value of SP VATS lobectomy and segmentectomy in elderly patients with NSCLC. Methods In this retrospective observational study, the outcomes of 417 consecutive patients who had undergone SP VATS anatomic segmentectomy or lobectomy for NSCLC from May 2014 to December 2016 on department of thoracic surgery in Fujian Medical University Affiliated Union Hospital were examined, including 139 elderly-case (lobectomy vs segmentectomy: 124 vs 15 and 278 nonelderly-case (lobectomy vs segmentectomy: 248 vs 30. The condition of perioperative period and postoperative short-time recovery could be compared with lobectomy and segmentectomy between elderly and nonelderly cases and lobectomy and segmentectomy in elderly cases. Results The morbidty of preoperative complications was significant difference (P0.05. Numbers of dissected lymph nodes and mediastinal nodal stations of SP VATS lobectomy in elderly patients with NSCLC were more than segmentectomy (P0.05. Postoperative drainage volume [(1,150.15±140.02 mL vs (853.53±177.04 mL] and duration [(7.00±1.31 d vs (5.00±0.74 d], duration of postoperative hospital stay [(3.18±1.32 d vs (5.04±1.30 d], costs [(70.06±5.23 thousands yuan vs (61.20±5.22 thousands yuan ] or postoperative complications (5.97% vs 20.00%(P>0.05. Notwithstanding

Operational technology for greater confinement disposal

International Nuclear Information System (INIS)

Dickman, P.T.; Vollmer, A.T.; Hunter, P.H.

1984-12-01

Procedures and methods for the design and operation of a greater confinement disposal facility using large-diameter boreholes are discussed. It is assumed that the facility would be located at an operating low-level waste disposal site and that only a small portion of the wastes received at the site would require greater confinement disposal. The document is organized into sections addressing: facility planning process; facility construction; waste loading and handling; radiological safety planning; operations procedures; and engineering cost studies. While primarily written for low-level waste management site operators and managers, a detailed economic assessment section is included that should assist planners in performing cost analyses. Economic assessments for both commercial and US government greater confinement disposal facilities are included. The estimated disposal costs range from $27 to $104 per cubic foot for a commercial facility and from $17 to $60 per cubic foot for a government facility. These costs are based on average site preparation, construction, and waste loading costs for both contact- and remote-handled wastes. 14 figures, 22 tables

Combined effects of energy development and disease on greater sage-grouse.

Directory of Open Access Journals (Sweden)

Rebecca L Taylor

Full Text Available Species of conservation concern are increasingly threatened by multiple, anthropogenic stressors which are outside their evolutionary experience. Greater sage-grouse are highly susceptible to the impacts of two such stressors: oil and gas (energy development and West Nile virus (WNv. However, the combined effects of these stressors and their potential interactions have not been quantified. We used lek (breeding ground counts across a landscape encompassing extensive local and regional variation in the intensity of energy development to quantify the effects of energy development on lek counts, in years with widespread WNv outbreaks and in years without widespread outbreaks. We then predicted the effects of well density and WNv outbreak years on sage-grouse in northeast Wyoming. Absent an outbreak year, drilling an undeveloped landscape to a high permitting level (3.1 wells/km² resulted in a 61% reduction in the total number of males counted in northeast Wyoming (total count. This was similar in magnitude to the 55% total count reduction that resulted from an outbreak year alone. However, energy-associated reductions in the total count resulted from a decrease in the mean count at active leks, whereas outbreak-associated reductions resulted from a near doubling of the lek inactivity rate (proportion of leks with a last count = 0. Lek inactivity quadrupled when 3.1 wells/km² was combined with an outbreak year, compared to no energy development and no outbreak. Conservation measures should maintain sagebrush landscapes large and intact enough so that leks are not chronically reduced in size due to energy development, and therefore vulnerable to becoming inactive due to additional stressors.

The specifics of applying value added tax for local authorities

Directory of Open Access Journals (Sweden)

Miloš Grásgruber

2010-01-01

Full Text Available If local authorities units carry out an economic activity, are considered to be taxable under Act No. 235/2004 Coll., On Value Added Tax as amended. Adjustment of VAT in all countries of the European Union is based on Council Directive 2006/112/EC of 28 November 2006 on the common system of value added tax as amended. The application of this directive is binding for all EU member states and national treatment of VAT may diverge from the Directive only in cases where the Directive permits. Decisions of the European Court of Justice are of considerable importance during the interpretation of the Czech VAT Act.For the municipalities and regions article defines the activities that are considered to be an economic activity and activities that are deemed to exercise of public administration and are not therefore subject to VAT. Further the paper defines the concept of turnover of local authorities. At paper there are evaluating the impact of the application of VAT on municipalities and regions in the provision of the individual fulfillment. Great attention must municipalities and region devote to the problem of correct application of claim to tax deduction if they carry out the exercise of public administration, taxable activities and fulfillments exempt from VAT.

Cost and effectiveness of lung lobectomy by video-assisted thoracic surgery for lung cancer.

Science.gov (United States)

Mafé, Juan J; Planelles, Beatriz; Asensio, Santos; Cerezal, Jorge; Inda, María-Del-Mar; Lacueva, Javier; Esteban, Maria-Dolores; Hernández, Luis; Martín, Concepción; Baschwitz, Benno; Peiró, Ana M

2017-08-01

Video-assisted thoracic surgery (VATS) emerged as a minimally invasive surgery for diseases in the field of thoracic surgery. We herein reviewed our experience on thoracoscopic lobectomy for early lung cancer and evaluated Health System use. A cost-effectiveness study was performed comparing VATS vs. open thoracic surgery (OPEN) for lung cancer patients. Demographic data, tumor localization, dynamic pulmonary function tests [forced vital capacity (FVC), forced expiratory volume in one second (FEV1), diffusion capacity (DLCO) and maximal oxygen uptake (VO2max)], surgical approach, postoperative details, and complications were recorded and analyzed. One hundred seventeen patients underwent lung resection by VATS (n=42, 36%; age: 63±9 years old, 57% males) or OPEN (n=75, 64%; age: 61±11 years old, 73% males). Pulmonary function tests decreased just after surgery with a parallel increasing tendency during first 12 months. VATS group tended to recover FEV1 and FVC quicker with significantly less clinical and post-surgical complications (31% vs. 53%, P=0.015). Costs including surgery and associated hospital stay, complications and costs in the 12 months after surgery were significantly lower for VATS (P<0.05). The VATS approach surgery allowed earlier recovery at a lower cost than OPEN with a better cost-effectiveness profile.

Technique for laparoscopic autonomic nerve preserving total mesorectal excision.

Science.gov (United States)

Breukink, S O; Pierie, J P E N; Hoff, C; Wiggers, T; Meijerink, W J H J

2006-05-01

With the introduction of total mesorectal excision (TME) for treatment of rectal cancer, the prognosis of patients with rectal cancer is improved. With this better prognosis, there is a growing awareness about the quality of life of patients after rectal carcinoma. Laparoscopic total mesorectal excision (LTME) for rectal cancer offers several advantages in comparison with open total mesorectal excision (OTME), including greater patient comfort and an earlier return to daily activities while preserving the oncologic radicality of the procedure. Moreover, laparoscopy allows good exposure of the pelvic cavity because of magnification and good illumination. The laparoscope seems to facilitate pelvic dissection including identification and preservation of critical structures such as the autonomic nervous system. The technique for laparoscopic autonomic nerve preserving total mesorectal excision is reported. A three- or four-port technique is used. Vascular ligation, sharp mesorectal dissection and identification and preservation of the autonomic pelvic nerves are described.

Protein Losses and Urea Nitrogen Underestimate Total Nitrogen Losses in Peritoneal Dialysis and Hemodialysis Patients.

Science.gov (United States)

Salame, Clara; Eaton, Simon; Grimble, George; Davenport, Andrew

2018-04-28

Muscle wasting is associated with increased mortality and is commonly reported in dialysis patients. Hemodialysis (HD) and peritoneal dialysis (PD) treatments lead to protein losses in effluent dialysate. We wished to determine whether changes in current dialysis practice had increased therapy-associated nitrogen losses. Cross-sectional cohort study. Measurement of total protein, urea and total nitrogen in effluent dialysate from 24-hour collections from PD patients, and during haemodiafiltration (HDF) and haemodialysis (HD) sessions. One hundred eight adult dialysis patients. Peritoneal dialysis, high-flux haemodialysis and haemodiafiltration. Total nitrogen and protein losses. Dialysate protein losses were measured in 68 PD and 40 HD patients. Sessional losses of urea (13.9 [9.2-21.1] vs. 4.8 [2.8-7.8] g); protein (8.6 [7.2-11.1] vs. 6.7 [3.9-11.1] g); and nitrogen (11.5 [8.7-17.7] vs. 4.9 [2.6-9.5] g) were all greater for HD than PD, P losses were lower with HD 25.9 (21.5-33.4) versus 46.6 (27-77.6) g/week, but nitrogen losses were similar. We found no difference between high-flux HD and HDF: urea (13.5 [8.8-20.6] vs. 15.3 [10.5-25.5] g); protein (8.8 [7.3-12.2] vs. 7.6 [5.8-9.0] g); and total nitrogen (11.6 [8.3-17.3] vs. 10.8 [8.9-22.5] g). Urea nitrogen (UN) only accounted for 45.1 (38.3-51.0)% PD and 63.0 (55.3-62.4)% HD of total nitrogen losses. Although sessional losses of protein and UN were greater with HD, weekly losses were similar between modalities. We found no differences between HD and HDF. However, total nitrogen losses were much greater than the combination of protein and UN, suggesting greater nutritional losses with dialysis than previously reported. Copyright © 2018 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Greater trochanteric fracture with occult intertrochanteric extension.

Science.gov (United States)

Reiter, Michael; O'Brien, Seth D; Bui-Mansfield, Liem T; Alderete, Joseph

2013-10-01

Proximal femoral fractures are frequently encountered in the emergency department (ED). Prompt diagnosis is paramount as delay will exacerbate the already poor outcomes associated with these injuries. In cases where radiography is negative but clinical suspicion remains high, magnetic resonance imaging (MRI) is the study of choice as it has the capability to depict fractures which are occult on other imaging modalities. Awareness of a particular subset of proximal femoral fractures, namely greater trochanteric fractures, is vital for both radiologists and clinicians since it has been well documented that they invariably have an intertrochanteric component which may require surgical management. The detection of intertrochanteric or cervical extension of greater trochanteric fractures has been described utilizing MRI but is underestimated with both computed tomography (CT) and bone scan. Therefore, if MRI is unavailable or contraindicated, the diagnosis of an isolated greater trochanteric fracture should be met with caution. The importance of avoiding this potential pitfall is demonstrated in the following case of an elderly woman with hip pain and CT demonstrating an isolated greater trochanteric fracture who subsequently returned to the ED with a displaced intertrochanteric fracture.

On efficiency of fire simulation realization: parallelization with greater number of computational meshes

Science.gov (United States)

Valasek, Lukas; Glasa, Jan

2017-12-01

Current fire simulation systems are capable to utilize advantages of high-performance computer (HPC) platforms available and to model fires efficiently in parallel. In this paper, efficiency of a corridor fire simulation on a HPC computer cluster is discussed. The parallel MPI version of Fire Dynamics Simulator is used for testing efficiency of selected strategies of allocation of computational resources of the cluster using a greater number of computational cores. Simulation results indicate that if the number of cores used is not equal to a multiple of the total number of cluster node cores there are allocation strategies which provide more efficient calculations.

Influence of the pro-ecological tax on the market prices of fuels and electricity

International Nuclear Information System (INIS)

Szargut, Jan; Stanek, Wojciech

2008-01-01

The proposed pro-ecological tax should be proportional to the cumulative consumption of non-renewable natural exergy burdening the considered product. It should replace the existing value-added tax (VAT). The income of the state after introducing the new tax, should remain without any change. That principle determines the coefficient of proportionality between the cumulative consumption of non-renewable exergy and the value of the tax. The total value of the tax should be paid to the state after extracting the minerals and fuels from nature and importing the fuels and semi-finished products, then transferred to the subsequent products in a form of their elevated price. Hence, the tax is eventually paid by the consumers in the form of an elevated price of goods and services. The total income of the society should remain without any changes. The largest price increase will appear in the case of fuels and electricity. The prices of electricity produced from renewable resources are calculated too, taking into account the accompanying unavoidable consumption of non-renewable exergy for the construction of the power plant. The new VAT should enhance the economy of the most energy-consuming products, stimulate the mitigation of the total consumption level of the society and increase the application of the renewable energy resources. (author)

Handling value added tax (VAT) in economic evaluations: should prices include VAT?

Science.gov (United States)

Bech, Mickael; Christiansen, Terkel; Gyrd-Hansen, Dorte

2006-01-01

In health economic evaluations, value added tax is commonly treated as a transfer payment. Following this argument, resources are valued equal to their net-of-tax prices in economic evaluations applying a societal perspective. In this article we argue that if there is the possibility that a new healthcare intervention may expand the healthcare budget, the social cost of input factors should be the gross-of-tax prices and not the net-of-tax prices. The rising interest in cost-benefit analysis and the use of absolute thresholds, net benefit estimates and acceptability curves in cost-effectiveness analysis makes this argument highly relevant for an appropriate use of these tools in prioritisation.

Efectos distributivos del impuesto al valor agregado sobre el consumo de los hogares en Colombia. Una estimación no paramétrica

Directory of Open Access Journals (Sweden)

Manuel Ramírez Gómez

2010-05-01

Full Text Available This paper estimates household consumption levels reached after analyzing the effect of eight VAT structures. The exercise used the Colombian Income and Consumption Survey of 1994. After analyzing the effects of the eight VAT structures over consumption, we find that the 2000 VAT structure is neutral. Food consumption trend is always regressive regardless of the tax rate, but this effect can be neutralized by the progressive consumption trend of other goods.

Defining the cost of care for lobectomy and segmentectomy: a comparison of open, video-assisted thoracoscopic, and robotic approaches.

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Deen, Shaun A; Wilson, Jennifer L; Wilshire, Candice L; Vallières, Eric; Farivar, Alexander S; Aye, Ralph W; Ely, Robson E; Louie, Brian E

2014-03-01

Knowledge about the cost of open, video-assisted thoracoscopic (VATS), or robotic lung resection and drivers of cost is crucial as the cost of care comes under scrutiny. This study aims to define the cost of anatomic lung resection and evaluate potential cost-saving measures. A retrospective review of patients who had anatomic resection for early stage lung cancer, carcinoid, or metastatic foci between 2008 and 2012 was performed. Direct hospital cost data were collected from 10 categories. Capital depreciation was separated for the robotic and VATS cases. Key costs were varied in a sensitivity analysis. In all, 184 consecutive patients were included: 69 open, 57 robotic, and 58 VATS. Comorbidities and complication rates were similar. Operative time was statistically different among the three modalities, but length of stay was not. There was no statistically significant difference in overall cost between VATS and open cases (Δ = $1,207) or open and robotic cases (Δ = $1,975). Robotic cases cost $3,182 more than VATS (p depreciation. The main opportunities to reduce cost in open cases were the intensive care unit, respiratory therapy, and laboratories. Lowering operating time and supply costs were targets for VATS and robotic cases. VATS is the least expensive surgical approach. Robotic cases must be shorter in operative time or reduce supply costs, or both, to be competitive. Lessening operating time, eradicating unnecessary laboratory work, and minimizing intensive care unit stays will help decrease direct hospital costs. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Adipose tissue macrophages impair preadipocyte differentiation in humans.

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Li Fen Liu

Full Text Available The physiologic mechanisms underlying the relationship between obesity and insulin resistance are not fully understood. Impaired adipocyte differentiation and localized inflammation characterize adipose tissue from obese, insulin-resistant humans. The directionality of this relationship is not known, however. The aim of the current study was to investigate whether adipose tissue inflammation is causally-related to impaired adipocyte differentiation.Abdominal subcutaneous(SAT and visceral(VAT adipose tissue was obtained from 20 human participants undergoing bariatric surgery. Preadipocytes were isolated, and cultured in the presence or absence of CD14+ macrophages obtained from the same adipose tissue sample. Adipocyte differentiation was quantified after 14 days via immunofluorescence, Oil-Red O, and adipogenic gene expression. Cytokine secretion by mature adipocytes cultured with or without CD14+macrophages was quantified.Adipocyte differentiation was significantly lower in VAT than SAT by all measures (p<0.001. With macrophage removal, SAT preadipocyte differentiation increased significantly as measured by immunofluorescence and gene expression, whereas VAT preadipocyte differentiation was unchanged. Adipocyte-secreted proinflammatory cytokines were higher and adiponectin lower in media from VAT vs SAT: macrophage removal reduced inflammatory cytokine and increased adiponectin secretion from both SAT and VAT adipocytes. Differentiation of preadipocytes from SAT but not VAT correlated inversely with systemic insulin resistance.The current results reveal that proinflammatory immune cells in human SAT are causally-related to impaired preadipocyte differentiation, which in turn is associated with systemic insulin resistance. In VAT, preadipocyte differentiation is poor even in the absence of tissue macrophages, pointing to inherent differences in fat storage potential between the two depots.

The Relative Concentrations of Nutrients and Toxins Dictate Feeding by a Vertebrate Browser, the Greater Glider Petauroides volans.

Directory of Open Access Journals (Sweden)

Lora M Jensen

Full Text Available Although ecologists believe that vertebrate herbivores must select a diet that allows them to meet their nutritional requirements, while avoiding intoxication by plant secondary metabolites, this is remarkably difficult to show. A long series of field and laboratory experiments means that we have a good understanding of the factors that affect feeding by leaf-eating marsupials. This knowledge and the natural intraspecific variation in Eucalyptus chemistry allowed us to test the hypothesis that the feeding decisions of greater gliders (Petauroides volans depend on the concentrations of available nitrogen (incorporating total nitrogen, dry matter digestibility and tannins and of formylated phloroglucinol compounds (FPCs, potent antifeedants unique to Eucalyptus. We offered captive greater gliders foliage from two species of Eucalyptus, E. viminalis and E. melliodora, which vary naturally in their concentrations of available nitrogen and FPCs. We then measured the amount of foliage eaten by each glider and compared this with our laboratory analyses of foliar total nitrogen, available nitrogen and FPCs for each tree offered. The concentration of FPCs was the main factor that determined how much gliders ate of E. viminalis and E. melliodora, but in gliders fed E. viminalis the concentration of available nitrogen was also a significant influence. In other words, greater gliders ate E. viminalis leaves with a particular combination of FPCs and available nitrogen that maximised the nutritional gain but minimised their ingestion of toxins. In contrast, the concentration of total nitrogen was not correlated with feeding. This study is among the first to empirically show that browsing herbivores select a diet that balances the potential gain (available nutrients and the potential costs (plant secondary chemicals of eating leaves. The major implication of the study is that it is essential to identify the limiting nutrients and relevant toxins in a system in

Optimization of abdominal fat quantification on CT imaging through use of standardized anatomic space: A novel approach

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Tong, Yubing; Udupa, Jayaram K., E-mail: jay@mail.med.upenn.edu [Department of Radiology, Medical Image Processing Group, University of Pennsylvania, Philadelphia, Pennsylvania 19104-6021 (United States); Torigian, Drew A. [Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104-6021 (United States)

2014-06-15

, but is more superiorly located at T12-L1 for SAT and at L3-L4 for VAT. Furthermore, the optimal anatomic locations for SAT and VAT estimation are not the same, contrary to common assumption. The proposed standardized space mapping achieves high consistency of anatomic localization by accurately managing nonlinearities in the relationships among landmarks. Multiple slices achieve greater improvement in correlation for VAT than for SAT. The optimal locations in the case of multiple slices are not contiguous.

Impact of body composition on outcome in patients with early breast cancer.

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Deluche, Elise; Leobon, Sophie; Desport, Jean Claude; Venat-Bouvet, Laurence; Usseglio, Julie; Tubiana-Mathieu, Nicole

2018-03-01

We investigated the impact of body composition on outcomes of patients with early breast cancer. Skeletal muscle mass, visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and muscle fat infiltration or inter-muscular adipose tissue areas (IMAT), obtained by computed tomography (CT), were assessed. A total of 119 female patients who had breast cancer were included in this retrospective study. The total skeletal muscle and fat tissue areas were evaluated in two adjacent axial slices obtained at the third lumbar vertebra by CT used for disease staging. The women were assigned to either a sarcopenia or non-sarcopenia group based on their skeletal muscle index (cut-off 41.0 cm 2 /m 2 ). They also were classified into high and low VAT/SAT ratio groups and assigned to either the high or low IMAT index group. The association of the body composition parameters and prognosis was statistically analyzed. Among the 119 evaluable patients, 58 were sarcopenic (48.8%), 55 (46.2%) had a high VAT/SAT ratio, and 62 (52.1%) had a high IMAT index. Median follow-up was 52.4 months. Multivariate analysis revealed sarcopenia and IMAT index as independent prognostic factors for disease-free survival (p = 0.02 and p = 0.04, respectively) and overall survival (p = 0.05 and p = 0.02, respectively). BMI was not significantly associated with disease-free survival, but a trend was observed (p = 0.09). Sarcopenia and IMAT index are independent prognostic factors in early breast cancer; therefore, assessing body composition could be a simple and useful approach to integrate into patient management.

Alcohol tax pass-through across the product and price range: do retailers treat cheap alcohol differently?

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Ally, Abdallah K; Meng, Yang; Chakraborty, Ratula; Dobson, Paul W; Seaton, Jonathan S; Holmes, John; Angus, Colin; Guo, Yelan; Hill-McManus, Daniel; Brennan, Alan; Meier, Petra S

2014-12-01

Effective use of alcohol duty to reduce consumption and harm depends partly on retailers passing duty increases on to consumers via price increases, also known as 'pass-through'. The aim of this analysis is to provide evidence of UK excise duty and sales tax (VAT) pass-through rates for alcohol products at different price points. March 2008 to August 2011, United Kingdom. Panel data quantile regression estimating the effects of three duty changes, two VAT changes and one combined duty and VAT change on UK alcohol prices, using product-level supermarket price data for 254 alcohol products available weekly. Products were analysed in four categories: beers, ciders/ready to drink (RTDs), spirits and wines. Within all four categories there exists considerable heterogeneity in the level of duty pass-through for cheaper versus expensive products. Price increases for the cheapest 15% of products fall below duty rises (undershifting), while products sold above the median price are overshifted (price increases are higher than duty increases). The level of undershifting is greatest for beer [0.85 (0.79, 0.92)] and spirits [0.86 (0.83, 0.89)]. Undershifting affects approximately 67% of total beer sales and 38% of total spirits sales. Alcohol retailers in the United Kingdom appear to respond to increases in alcohol tax by undershifting their cheaper products (raising prices below the level of the tax increase) and overshifting their more expensive products (raising prices beyond the level of the tax increase). This is likely to impact negatively on tax policy effectiveness, because high-risk groups favour cheaper alcohol and undershifting is likely to produce smaller consumption reductions. © 2014 Society for the Study of Addiction.

Inducible displacement of cemented tibial components ten years after total knee arthroplasty.

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Lam Tin Cheung, K; Lanting, B A; McCalden, R W; Yuan, X; MacDonald, S J; Naudie, D D; Teeter, M G

2018-02-01

The aim of this study was to evaluate the long-term inducible displacement of cemented tibial components ten years after total knee arthroplasty (TKA). A total of 15 patients from a previously reported prospective trial of fixation using radiostereometric analysis (RSA) were examined at a mean of 11 years (10 to 11) postoperatively. Longitudinal supine RSA examinations were acquired at one week, one year, and two years postoperatively and at final follow-up. Weight-bearing RSA examinations were also undertaken with the operated lower limb in neutral and in maximum internal rotation positions. Maximum total point motion (MTPM) was calculated for the longitudinal and inducible displacement examinations (supine versus standing, standing versus internal rotation, and supine versus standing with internal rotation). All patients showed some inducible displacement. Two patients with radiolucent lines had greater mean standing-supine MTPM displacement (1.35; sd 0.38) compared with the remaining patients (0.68; sd 0.36). These two patients also had a greater mean longitudinal MTPM at ten years (0.64; sd 0.50) compared with the remaining patients (0.39; sd 0.13 mm). Small inducible displacements in well-fixed cemented tibial components were seen ten years postoperatively, of a similar magnitude to that which has been reported for well-fixed components one to two years postoperatively. Greater displacements were found in components with radiolucent lines. Cite this article: Bone Joint J 2018;100-B:170-5. ©2018 The British Editorial Society of Bone & Joint Surgery.

The relationship between age, rotator cuff integrity, and osseous microarchitecture of greater tuberosity: Where should we put anchor?

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Kholinne, Erica; Lee, Hyun Joo; Kim, Sung Jung; Park, So Hyun; Jeon, In-Ho

2018-01-01

The aim of this study was to compare the microarchitecture of the greater tuberosity with or without rotator cuff tear and to obtain optimum location for anchor screw insertion for rotator cuff repair. Twenty-five humeral heads were harvested from 13 male cadavers of mean age 58.4 years, including 6 humeri with rotator cuff tear and 19 intact humeri. Six regions of interest (proximal, intermediate, and distal zones of the superficial and deep regions) were divided into the anterior (G1), middle (G2), and posterior (G3) areas of the greater tuberosity. Trabecular bone volume and cortical thickness were evaluated. Total trabecular bone volume was greater in subjects 50 years old but did not differ significantly in subjects with and without rotator cuff tear. Cortical thickness in both intact and torn rotator cuff groups was significantly greater in the proximal and intermediate zones than in the distal zone. Cortical thickness was related to anatomic location rather than age or cuff tear. The optimal location for anchor screw insertion during rotator cuff repair is either the proximal or intermediate region of the greater tuberosity. Age has more influence in terms of trabecular bone volume loss than rotator cuff integrity. Copyright © 2017. Production and hosting by Elsevier B.V.

[Clinical Results of Endoscopic Treatment of Greater Trochanteric Pain Syndrome].

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Zeman, P; Rafi, M; Skala, P; Zeman, J; Matějka, J; Pavelka, T

2017-01-01

PURPOSE OF THE STUDY This retrospective study aims to present short-term clinical outcomes of endoscopic treatment of patients with greater trochanteric pain syndrome (GTPS). MATERIAL AND METHODS The evaluated study population was composed of a total of 19 patients (16 women, 3 men) with the mean age of 47 years (19-63 years). In twelve cases the right hip joint was affected, in the remaining seven cases it was the left side. The retrospective evaluation was carried out only in patients with greater trochanteric pain syndrome caused by independent chronic trochanteric bursitis without the presence of m. gluteus medius tear not responding to at least 3 months of conservative treatment. In patients from the followed-up study population, endoscopic trochanteric bursectomy was performed alone or in combination with iliotibial band release. The clinical results were evaluated preoperatively and with a minimum follow-up period of 1 year after the surgery (mean 16 months). The Visual Analogue Scale (VAS) for assessment of pain and WOMAC (Western Ontario MacMaster) score were used. In both the evaluated criteria (VAS and WOMAC score) preoperative and postoperative results were compared. Moreover, duration of surgery and presence of postoperative complications were assessed. Statistical evaluation of clinical results was carried out by an independent statistician. In order to compare the parameter of WOMAC score and VAS pre- and post-operatively the Mann-Whitney Exact Test was used. The statistical significance was set at 0.05. RESULTS The preoperative VAS score ranged 5-9 (mean 7.6) and the postoperative VAS ranged 0-5 (mean 2.3). The WOMAC score ranged 56.3-69.7 (mean 64.2) preoperatively and 79.8-98.3 (mean 89.7) postoperatively. When both the evaluated parameters of VAS and WOMAC score were compared in time, a statistically significant improvement (ppain syndrome yields statistically significant improvement of clinical results with the concurrent minimum incidence of

The Greater Sekhukhune-CAPABILITY outreach project.

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Gregersen, Nerine; Lampret, Julie; Lane, Tony; Christianson, Arnold

2013-07-01

The Greater Sekhukhune-CAPABILITY Outreach Project was undertaken in a rural district in Limpopo, South Africa, as part of the European Union-funded CAPABILITY programme to investigate approaches for capacity building for the translation of genetic knowledge into care and prevention of congenital disorders. Based on previous experience of a clinical genetic outreach programme in Limpopo, it aimed to initiate a district clinical genetic service in Greater Sekhukhune to gain knowledge and experience to assist in the implementation and development of medical genetic services in South Africa. Implementing the service in Greater Sekhukhune was impeded by a developing staff shortage in the province and pressure on the health service from the existing HIV/AIDS and TB epidemics. This situation underscores the need for health needs assessment for developing services for the care and prevention of congenital disorders in middle- and low-income countries. However, these impediments stimulated the pioneering of innovate ways to offer medical genetic services in these circumstances, including tele-teaching of nurses and doctors, using cellular phones to enhance clinical care and adapting and assessing the clinical utility of a laboratory test, QF-PCR, for use in the local circumstances.

[The Visual Association Test to study episodic memory in clinical geriatric psychology].

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Diesfeldt, Han; Prins, Marleen; Lauret, Gijs

2018-04-01

The Visual Association Test (VAT) is a brief learning task that consists of six line drawings of pairs of interacting objects (association cards). Subjects are asked to name or identify each object and later are presented with one object from the pair (the cue) and asked to name the other (the target). The VAT was administered in a consecutive sample of 174 psychogeriatric day care participants with mild to major neurocognitive disorder. Comparison of test performance with normative data from non-demented subjects revealed that 69% scored within the range of a major deficit (0-8 over two recall trials), 14% a minor, and 17% no deficit (9-10, and ≥10 respectively).VAT-scores correlated with another test of memory function, the Cognitive Screening Test (CST), based on the Short Portable Mental Status Questionnaire (r = 0.53). Tests of executive functioning (Expanded Mental Control Test, Category Fluency, Clock Drawing) did not add significantly to the explanation of variance in VAT-scores.Fifty-five participants (31.6%) were faced with initial problems in naming or identifying one or more objects on the cue cards or association cards. If necessary, naming was aided by the investigator. Initial difficulties in identifying cue objects were associated with lower VAT-scores, but this did not hold for difficulties in identifying target objects.A hierarchical multiple regression analysis was used to examine whether linear or quadratic trends best fitted VAT performance across the range of CST scores. The regression model revealed a linear but not a quadratic trend. The best fitting linear model implied that VAT scores differentiated between CST scores in the lower, as well as in the upper range, indicating the absence of floor and ceiling effects, respectively. Moreover, the VAT compares favourably to word list-learning tasks being more attractive in its presentation of interacting visual objects and cued recall based on incidental learning of the association

Inspection with non destructive assay techniques of the aluminium coating of the TRIGA Mark III reactor vat; Inspeccion con tecnicas de ensayos no destructivos del recubrimiento de aluminio de la tina del reactor TRIGA Mark III

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Reyes A, A.I.; Gonzalez M, A.; Castaneda J, G.; Rivera M, H.; Sandoval G, I. [Instituto Nacional de Investigaciones Nucleares, A.P. 18-1027, 11801 Mexico D.F. (Mexico)

2001-07-01

In June 2000, the Reactor Department assigned to the Scientific Research Direction of the National Institute of Nuclear Research requested to the Non-destructive Assays Laboratory (LEND), assigned to the Materials Science Management, the inspection and measurement of thickness of the aluminium coating (liner) of the TRIGA Mark III reactor vat with non-destructive assay techniques, due to that the aluminium coating is exposed mainly to undergo slimming on its back side due to corrosion phenomena. Activity that was able to be carried out from april until august 2001. It is worth pointing out that this type of inspection with these techniques was realized by first time. The non-destructive assays (NDA) are techniques which use indirect physical methods for inspecting the sanitation of components in process or in service, for detect lack of continuity or defects which affect their quality or usefulness. The application of those do not alter the physical, chemical, mechanical or dimensional properties of the part subject of inspection. The results of the application of the ultrasound inspection techniques, industrial radiography and penetrating liquids are presented. (Author)

Resin Characterization

Science.gov (United States)

2015-06-01

approximately two-thirds filled with water. All samples must be fully submerged. The vat/beaker is placed in a calibrated oven at 30 °C. Alternatively, the...vat that is approximately filled with water. All samples must be fully submerged. The vat/beaker is placed in a calibrated oven at 80 °C...water samples and chemically analyzed after a period of time. If wildlife testing is undertaken, birds are often the desired target, and bobwhite

Self-mastery among Chinese Older Adults in the Greater Chicago Area

Directory of Open Access Journals (Sweden)

Xinqi Dong

2014-09-01

Full Text Available Background: Self-mastery is an important psychological resource to cope with stressful situations. However, we have limited understanding of self-mastery among minority aging populations. Objective: This study aims to examine the presence and levels of self-mastery among U.S. Chinese older adults. Methods: Data were drawn from the PINE study, a population-based survey of U.S. Chinese older adults in the Greater Chicago area. Guided by a community-based participatory research approach, a total of 3,159 Chinese older adults aged 60 and above were surveyed. A Chinese version of the Self-Mastery Scale was used to assess self-mastery. Results: Out of the 7-item Chinese Self-Mastery Scale, approximately 42.8% to 87.5% of Chinese older adults experienced some degree of self-mastery in their lives. Older adults with no formal education and the oldest-old aged 85 and over had the lowest level of self-mastery in our study. A higher mastery level was associated with being married, having fewer children, better self-reported health status, better quality of life, and positive health changes. Conclusion: Although self-mastery is commonly experienced among the Chinese aging population in the Greater Chicago area, specific subgroups are still vulnerable. Future longitudinal studies are needed to improve the understanding of risk factors and outcomes associated with self-mastery among Chinese older adults.

Lowering histamine formation in a red Ribera del Duero wine (Spain) by using an indigenous O. oeni strain as a malolactic starter.

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Berbegal, Carmen; Benavent-Gil, Yaiza; Navascués, Eva; Calvo, Almudena; Albors, Clara; Pardo, Isabel; Ferrer, Sergi

2017-03-06

This study demonstrates for the first time that a non-commercial selected autochthonous O. oeni strain has been used to conduct malolactic fermentation (MLF) while lowering histamine formation in the same winery. Lactic acid bacteria (LAB) were isolated from 13 vats before and after spontaneous MLF at the Pago de Carraovejas winery from the Ribera del Duero region (Spain). Only O. oeni were present, typed and characterized, and both histamine producer and non-producers existed. From the non-producers, one strain was selected to become a starter according to its genetic profile, prevalence in the different wines in the winery, resistance to alcoholic degree, resistance to high polyphenolic content, inability to synthesise histamine, growth kinetics and malolactic activity. This starter was produced at semi-industrial levels to inoculate 20,000L of Tempranillo red wine. The inoculated vat showed 5-fold less histamine than the non-inoculated control vat. After 1year, the barrel-ageing histamine concentrations were 3-fold lower in the inoculated vat than in the non-inoculated vat. Copyright © 2016 Elsevier B.V. All rights reserved.

Video game addiction test: validity and psychometric characteristics.

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van Rooij, Antonius J; Schoenmakers, Tim M; van den Eijnden, Regina J J M; Vermulst, Ad A; van de Mheen, Dike

2012-09-01

The study explores the reliability, validity, and measurement invariance of the Video game Addiction Test (VAT). Game-addiction problems are often linked to Internet enabled online games; the VAT has the unique benefit that it is theoretically and empirically linked to Internet addiction. The study used data (n=2,894) from a large-sample paper-and-pencil questionnaire study, conducted in 2009 on secondary schools in Netherlands. Thus, the main source of data was a large sample of schoolchildren (aged 13-16 years). Measurements included the proposed VAT, the Compulsive Internet Use Scale, weekly hours spent on various game types, and several psychosocial variables. The VAT demonstrated excellent reliability, excellent construct validity, a one-factor model fit, and a high degree of measurement invariance across gender, ethnicity, and learning year, indicating that the scale outcomes can be compared across different subgroups with little bias. In summary, the VAT can be helpful in the further study of video game addiction, and it contributes to the debate on possible inclusion of behavioral addictions in the upcoming DSM-V.

Cost-savings accruable to removing value added tax from ...

African Journals Online (AJOL)

Varsha Bangalee

added tax (VAT), regardless of their therapeutic value in the private healthcare sector of. South Africa. ..... addition, removing VAT on selective medicines, such as essential ... through increased taxes on unhealthy consumption patterns.

The post-orgasmic prolactin increase following intercourse is greater than following masturbation and suggests greater satiety.

Science.gov (United States)

Brody, Stuart; Krüger, Tillmann H C

2006-03-01

Research indicates that prolactin increases following orgasm are involved in a feedback loop that serves to decrease arousal through inhibitory central dopaminergic and probably peripheral processes. The magnitude of post-orgasmic prolactin increase is thus a neurohormonal index of sexual satiety. Using data from three studies of men and women engaging in masturbation or penile-vaginal intercourse to orgasm in the laboratory, we report that for both sexes (adjusted for prolactin changes in a non-sexual control condition), the magnitude of prolactin increase following intercourse is 400% greater than that following masturbation. The results are interpreted as an indication of intercourse being more physiologically satisfying than masturbation, and discussed in light of prior research reporting greater physiological and psychological benefits associated with coitus than with any other sexual activities.

A study of the stability of coumaphos, 14C-labelled lindane and 14C-labelled chlorpyrifos in model cattle dip

International Nuclear Information System (INIS)

Malek, M.A.; Rahman, M.M.; Amin, M.R.; Rahman, M.S.; Khatoon, J.

1997-01-01

The study was undertaken to evaluate the stability of coumaphos, 14 C-labelled lindane and chlorpyrifos insecticides/acaricides in a simulated cattle dipping vat. During the period of the study the pH of the suspension in vat increased due to addition of soil from the vacinity of cattle barn as well as due to standing in cement-concrete of the vat. The residual amounts of lindane and chiorpyrifos were estimated by counting the corresponding radioactivity in the suspension. Lindane dissipated rapidly and its half-life during the first phase was 4 d only. After standing for 3 weeks lindane residues were equivalent to 3.5% of the original amount in the suspension and 9.6% in the supernatent. Similarly, 97% of the original amount of lindane bad dissipated in the soil sediment at the end of 3 weeks, indicating that dissipation of lindane was primarily due to volatilization. Chlorpyrifos was more stable under the experimental conditions and its half life was calculated to be 22 d during the first phase of dissipation. After 3 weeks the concentration of chlorpyriphos in the suspension remained almost unchanged. However, in the supernatant its concentration increased to 115% of the initial amount. The concentration of soil-bound residues of chlopyrofos remained less than 5% of the total amount applied through out the period of study

Neuropeptide Y gene-by-psychosocial stress interaction effect is associated with obesity in a Korean population.

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Kim, Hyun-Jin; Min, Kyoung-Bok; Min, Jin-Young

2016-07-01

Chronic psychosocial stress is a crucial risk factor in the development of many diseases including obesity. Neuropeptide Y (NPY), distributed throughout the peripheral and central nervous system, is believed to pay a role in the pathophysiologic relationship between stress and obesity. Although several animal studies have investigated the impact on obesity of interactions between NPY single nucleotide polymorphisms (SNPs) and stress, the same remains to be analyzed in humans. To identify NPY gene-by-stress interaction effects on human obesity, we analyzed the interaction between four NPY SNPs and stress with obesity-related traits, including visceral adipose tissue (VAT). A total of 1468 adult subjects were included for this analysis. In a SNP-only model without interaction with stress, no significant SNPs were found (pSNP>0.05). However, NPY SNPs-by-stress interaction effects were significantly linked to body mass index (BMI), waist circumference, and VAT (pintobesity. Among the obesity traits, mean changes of VAT by increased stress levels in homozygous risk allele carriers were the greatest (range of mean increases for four SNPs (min-max)=12.57cm(2)-29.86cm(2)). This study suggests that common polymorphisms for NPY were associated with human obesity by interacting with psychosocial stress, emphasizing the need for stress management in obesity prevention. Copyright © 2016 Elsevier Ltd. All rights reserved.

Radiographic and scintigraphic evaluation of total knee arthroplasty

International Nuclear Information System (INIS)

Schneider, R.; Soudry, M.

1986-01-01

Various radiographic and scintigraphic methods are used to supplement clinical findings in the evaluation of total knee arthroplasty and its complications. Serial roentgenograms offer reliable information for diagnosing mechanical loosening. Wide and extensive radiolucency at the cement-bone interface and shift in position and alignment of prosthetic components can be seen in almost all cases by the time revision is necessary. Radiographic abnormalities are usually not present in acute infection, but are often present in chronic infection. Bone scanning has a high sensitivity for diagnosis of infection or loosening, but is nonspecific because increased uptake is often present around asymptomatic total knee arthroplasties with normal radiographs. Differential bone and Gallium scanning and scanning with Indium 111-labeled leukocytes have a greater specificity for diagnosis of infection than does bone or Gallium scanning alone. Routine radiographic and scintigraphic studies have shown a high incidence of deep vein thrombosis in the calf after total knee arthroplasty. Clinically significant pulmonary embolization is infrequent

Objectively Quantified Physical Activity and Sedentary Behavior in Predicting Visceral Adiposity and Liver Fat

Directory of Open Access Journals (Sweden)

Shelley E. Keating

2016-01-01

Full Text Available Objective. Epidemiologic studies suggest an inverse relationship between nonalcoholic fatty liver disease (NAFLD, visceral adipose tissue (VAT, and self-reported physical activity levels. However, subjective measurements can be inaccurate and prone to reporter bias. We investigated whether objectively quantified physical activity levels predicted liver fat and VAT in overweight/obese adults. Methods. Habitual physical activity was measured by triaxial accelerometry for four days (n=82. Time spent in sedentary behavior (MET < 1.6 and light (MET 1.6 < 3, moderate (MET 3 < 6, and vigorous (MET 6 < 9 physical activity was quantified. Magnetic resonance imaging and spectroscopy were used to quantify visceral and liver fat. Bivariate correlations and hierarchical multiple regression analyses were performed. Results. There were no associations between physical activity or sedentary behavior and liver lipid. Sedentary behavior and moderate and vigorous physical activity accounted for just 3% of variance for VAT (p=0.14 and 0.003% for liver fat (p=0.96. Higher levels of VAT were associated with time spent in moderate activity (r=0.294, p=0.007, but there was no association with sedentary behavior. Known risk factors for obesity-related NAFLD accounted for 62% and 40% of variance in VAT and liver fat, respectively (p<0.01. Conclusion. Objectively measured levels of habitual physical activity and sedentary behavior did not influence VAT or liver fat.

High-volume intensive training course: a new paradigm for video-assisted thoracoscopic surgery education.

Science.gov (United States)

Sihoe, Alan D L; Gonzalez-Rivas, Diego; Yang, Timothy Y; Zhu, Yuming; Jiang, Gening

2018-03-27

The emergence of ultra-high-volume centres promises new opportunities for thoracic surgical training. The goal of this study was to investigate the effectiveness of a novel observership course in teaching video-assisted thoracoscopic surgery (VATS) at an ultra-high-volume centre. Two-week courses in VATS at a specialist unit now performing >10 000 major lung resections annually (>50 daily on average) were attended by 230 surgeons from around the world from 2013 to 2016. An online survey preserving responder anonymity was completed by 156 attendees (67.8%). Attendees included 37% from Western Europe, 18% from Eastern Europe and 17% from Latin America. Experience with open thoracic surgery for more than 5 years was reported by 67%, but 79% had less than 5 years of VATS lobectomy experience. During the course, 70% observed over 30 uniportal VATS operations (including 38% observing over 50), and 69% attended an animal wet lab. Although 72% of the responders attended the course less than 12 months ago, the number of ports used (P < 0.001), operation times (P < 0.001) and conversion rates (P < 0.001) reported by the responders were reduced significantly after the course. Improvements in the problem areas of tissue retraction, instrumentation, stapler application and coordination with the assistant during VATS were reported by 56%, 57%, 58% and 53%, respectively. Of those who had attended other VATS courses previously, 87% preferred the training from this high-volume course. High-volume intensive observership training at an ultra-high-volume centre may improve VATS proficiency in a short period of time, and may provide a time-efficient modality for future thoracic surgical training.

Technical concept for a greater-confinement-disposal test facility

International Nuclear Information System (INIS)

Hunter, P.H.

1982-01-01

Greater confinement disposal (GCO) has been defined by the National Low-Level Waste Program as the disposal of low-level waste in such a manner as to provide greater containment of radiation, reduce potential for migration or dispersion or radionuclides, and provide greater protection from inadvertent human and biological intrusions in order to protect the public health and safety. This paper discusses: the need for GCD; definition of GCD; advantages and disadvantages of GCD; relative dose impacts of GCD versus shallow land disposal; types of waste compatible with GCD; objectives of GCD borehole demonstration test; engineering and technical issues; and factors affecting performance of the greater confinement disposal facility

Prolonged heart xenograft survival using combined total lymphoid irradiation and cyclosporine

International Nuclear Information System (INIS)

Knechtle, S.J.; Halperin, E.C.; Saad, T.; Bollinger, R.R.

1986-01-01

Total lymphoid irradiation and cyclosporine have profound immunosuppressive properties and permit successful heart allotransplantation. Cyclosporine used alone has not permitted consistently successful transplantation between species in all cases. Total lymphoid irradiation has not been applied to xenotransplantation. The efficacy of total lymphoid irradiation alone and in combination with cyclosporine was examined using an animal model of heart xenotransplantation. Heterotopic heart transplants were performed using inbred Syrian hamsters as donors and Lewis rats as recipients. Total lymphoid irradiation was administered preoperatively over 3 weeks for a total dose of 15 gray. Cyclosporine was started on the day of surgery and was given as a daily intramuscular injection of 2.5, 5, or 10 mg/kg/day until rejection was complete. Neither total lymphoid irradiation nor cyclosporine alone markedly prolonged graft survival. However, combined total lymphoid irradiation and cyclosporine, 5 or 10 mg/kg/day, dramatically prolonged graft survival to greater than 100 days in most recipients. There were no treatment-related deaths. In conclusion, combined total lymphoid irradiation and cyclosporine permit successful long-term survival of heart xenotransplants in this hamster-to-rat model

Value Added Tax Revisited: Toward a Reasonable Consumption Tax Reform in Japan

OpenAIRE

Yukinobu Kitamura

2013-01-01

This paper explores a reasonable consumption tax (VAT) reform in Japan, after passing the tax reform bill in the Diet in August 2012. First, the macro (SNA) data indicates that tax revenue increases by about 12 trillion yen if the VAT rate is raised from 5% to 10%. Secondly, the VAT revenue function reveals the revenue elasticity with respect to 1% consumption increase is 0.96. This is very efficient. Thirdly, remaining tax administration issues are discussed. Fourthly the empirical consumer ...

Multicentric evaluation of the impact of central tumour location when comparing rates of N1 upstaging in patients undergoing video-assisted and open surgery for clinical Stage I non-small-cell lung cancer.

Science.gov (United States)

Decaluwé, Herbert; Petersen, René Horsleben; Brunelli, Alex; Pompili, Cecilia; Seguin-Givelet, Agathe; Gust, Lucile; Aigner, Clemens; Falcoz, Pierre-Emmanuel; Rinieri, Philippe; Augustin, Florian; Sokolow, Youri; Verhagen, Ad; Depypere, Lieven; Papagiannopoulos, Kostas; Gossot, Dominique; D'Journo, Xavier Benoit; Guerrera, Francesco; Baste, Jean-Marc; Schmid, Thomas; Stanzi, Alessia; Van Raemdonck, Dirk; Bardet, Jeremy; Thomas, Pascal-Alexandre; Massard, Gilbert; Fieuws, Steffen; Moons, Johnny; Dooms, Christophe; De Leyn, Paul; Hansen, Henrik Jessen

2017-09-27

Large retrospective series have indicated lower rates of cN0 to pN1 nodal upstaging after video-assisted thoracic surgery (VATS) compared with open resections for Stage I non-small-cell lung cancer (NSCLC). The objective of our multicentre study was to investigate whether the presumed lower rate of N1 upstaging after VATS disappears after correction for central tumour location in a multivariable analysis. Consecutive patients operated for PET-CT based clinical Stage I NSCLC were selected from prospectively managed surgical databases in 11 European centres. Central tumour location was defined as contact with bronchovascular structures on computer tomography and/or visibility on standard bronchoscopy. Eight hundred and ninety-five patients underwent pulmonary resection by VATS (n = 699, 9% conversions) or an open technique (n = 196) in 2014. Incidence of nodal pN1 and pN2 upstaging was 8% and 7% after VATS and 15% and 6% after open surgery, respectively. pN1 was found in 27% of patients with central tumours. Less central tumours were operated on by VATS compared with the open technique (12% vs 28%, P < 0.001). Logistic regression analysis showed that only tumour location had a significant impact on N1 upstaging (OR 6.2, confidence interval 3.6-10.8; P < 0.001) and that the effect of surgical technique (VATS versus open surgery) was no longer significant when accounting for tumour location. A quarter of patients with central clinical Stage I NSCLC was upstaged to pN1 at resection. Central tumour location was the only independent factor associated with N1 upstaging, undermining the evidence for lower N1 upstaging after VATS resections. Studies investigating N1 upstaging after VATS compared with open surgery should be interpreted with caution due to possible selection bias, i.e. relatively more central tumours in the open group with a higher chance of N1 upstaging. © The Author 2017. Published by Oxford University Press on behalf of the European

Associations of objectively measured physical activity and abdominal fat distribution.

Science.gov (United States)

Philipsen, Annelotte; Hansen, Anne-Louise Smidt; Jørgensen, Marit Eika; Brage, Søren; Carstensen, Bendix; Sandbaek, Annelli; Almdal, Thomas Peter; Gram, Jeppe; Pedersen, Erling Bjerregaard; Lauritzen, Torsten; Witte, Daniel Rinse

2015-05-01

Visceral adipose tissue (VAT) and physical activity are both independent predictors of Type 2 diabetes. Physical activity and overall obesity are inversely associated with each other. Yet the nature of the association between objectively measured dimensions of physical activity and abdominal fat distribution has not been well characterized. We aimed to do so in a middle-age to elderly population at high risk of diabetes. A cross-sectional analysis of 1134 participants of the ADDITION-PRO study. VAT and subcutaneous adipose tissue (SAT) were assessed one-dimensionally by ultrasonography and physical activity with combined accelerometry and HR monitoring. Linear regression of physical activity energy expenditure (PAEE) and time spent in different physical activity intensity levels on VAT and SAT was performed. Median body mass index (BMI) was 26.6 kg·m and PAEE was 28.1 kJ·kg·d, with 18.9 h·d spent sedentary, 4.5 h·d in light-intensity physical activity, and 0.4 h·d in moderate-intensity physical activity. PAEE was significantly negatively associated with VAT, and in women, PAEE was also significantly negatively associated with SAT. The difference in VAT was -1.1 mm (95% confidence interval [CI] = -1.8 to -0.3) per 10-kJ·kg·d increment, and the corresponding difference in SAT for women was -0.6 mm (95% CI = -1.2 to -0.04) in models adjusted for age, sex, and waist circumference. Exchanging 1 h of light physical activity with moderate physical activity was significantly associated with VAT (-4.5 mm, 95% CI = -7.6 to -1.5). Exchanging one sedentary hour with light physical activity was significantly associated with both VAT (-0.9 mm, 95% CI = -0.1 to -1.8) and SAT (-0.4 mm, 95% CI = -0.0 to -0.7). In this population with low physical activity levels, cross-sectional findings indicate that increasing overall physical activity and decreasing time spent sedentary is important to avoid the accumulation of metabolically deleterious VAT.

Myiasis in Dogs in the Greater Accra Region of Ghana.

Science.gov (United States)

Johnson, Sherry A M; Gakuya, Daniel W; Mbuthia, Paul G; Mande, John D; Afakye, Kofi; Maingi, Ndichu

2016-01-01

Myiasis is the infestation of tissues of live vertebrate animals and humans with dipterous larvae. In sub-Saharan Africa, Cordylobia anthropohaga and Cordylobia rodhaini are known to be responsible for cutaneous myiasis in animals and humans. Human cases of myiasis, purportedly acquired in Ghana but diagnosed in other countries, have been reported; however, published data on its occurrence in animals in Ghana is unavailable. This study assessed the prevalence of canine myiasis among owned dogs in the Greater Accra region (GAR) of Ghana. A cross-sectional study was conducted in the Greater Accra region of Ghana, selected for being the region with the highest estimated population density of owned dogs. Physical examination and demographic characteristics of the study dogs were assessed. Management of the dogs was assessed through a questionnaire administered to the dog owners. A total of 392 owned dogs were sampled. Twenty-nine (7.4%) had cutaneous myiasis caused by C. rodhaini. In addition, one (0.2%) of the dogs had intestinal myiasis, with Dermatobia hominis as the offending larvae. Among the breeds of dogs with myiasis, the mongrel was most affected, with 24 (82.8%) out of the 29 cases. The mongrels, majority of which (24; 82.8%) were males, were left to roam freely in the community. Results from this study demonstrate that C. rodhaini and D. hominis are important causes of myiasis in owned dogs in the GAR of Ghana. Dogs could play a role in the spread of myiasis to humans, with its attendant public health implications.

Institutsionaalne ja marginaalne Kolumats / Madis Kolk

Index Scriptorium Estoniae

Kolk, Madis

2004-01-01

H. Hoffmanni-J. Crouchi-P. McDermotti muusikal "Kolumats" (lavastaja Ch. Römer) Kuressaare teatrilaval koostöös VAT Teatriga ja M. Zohneri "Kalevipoeg" (Fr. R. Kreutzwaldi ainetel) VAT Teatri esituses Tallinna Linnateatris

Total bone calcium in normal women: effect of age and menopause status

International Nuclear Information System (INIS)

Gallagher, J.C.; Goldgar, D.; Moy, A.

1987-01-01

Bone density in different regions of the skeleton was measured in 392 normal women aged 20-80 years by dual photon absorpiometry. In premenopausal women, aged 25-50 years, multiple regression analysis of regional bone density on age, height, and weight showed a small significant decrease in total bone density (less than 0.01) but no significant change in other regions of the skeleton. In postmenopausal women there were highly significant decreases in all regions of the skeleton (p less than 0.001), and bone density in these areas decreased as a logarithmic function of years since menopause. Based on multiple regression analyses, the decrease in spine density and total bone calcium was 2.5-3.0 times greater in the 25 years after menopause than the 25 years before menopause. The largest change, however, occurred in the first five years after menopause. During this time the estimated annual change in spine density and total bone calcium was about 10 times greater than that in the premenopausal period. These results demonstrate the important effect of the menopause in determining bone mass in later life

IS THE VALUE ADDED TAX A SUPERIOR SALES TAX IN ALL SALES TAXES?

Directory of Open Access Journals (Sweden)

MUSTAFA ALİ SARILI

2013-05-01

Full Text Available Value Added Tax (VAT is a tax imposed on the value added to a product at each stage of the production and distribution process. Value added is never taxed twice under VAT and thus cascading (tax on tax effects do not occur. It is a single tax on goods and services but the tax is collected multiple stages. At each of these stages, the amount of tax payable is computed by subtracting the tax previously paid on purchases from the tax charged on sales by the traders for each taxation period. In last three decades, VAT, a relatively new and better commodity taxation, has been introduced in many countries. It has replaced different types of sales taxes in such countries. This article attempts to evaluate VAT by comparing with other sales taxes.

Management of Medial Collateral Ligament Injury During Primary Total Knee Arthroplasty: A Systematic Review

Directory of Open Access Journals (Sweden)

Paul Della Torre, MD

2014-07-01

Full Text Available Medial collateral ligament injury during primary total knee arthroplasty is a recognised complication potentially resulting in valgus instability, suboptimal patient outcomes and a higher rate of revision or reoperation. Options for management include primary repair with or without augmentation, reconstruction or immediate conversion to prosthesis with greater constraint, in conjunction with various postoperative rehabilitation protocols. Inconsistent recommendations throughout the orthopaedic literature have made the approach to managing this complication problematic. The objective of this study was to review the available literature to date comparing intraoperative and postoperative management options for primary total knee arthroplasty complicated by recognised injury to the medial collateral ligament. This systematic literature review was prospectively registered with PROSPERO (#CRD42014008866 and performed in accordance with PRISMA guidelines including a PRISMA flow diagram. Five articles satisfied the inclusion criteria. Each was a retrospective, observational cohort or case series with small numbers reported, inconsistent methodology and incompletely reported outcomes. Four of the five studies managing medial collateral ligament injury during total knee arthroplasty (47/84 patients with direct repair with or without autograft augmentation reported good outcomes with no revision or reoperation required for symptomatic instability over a follow-up period of 16 months to almost 8 years. The fifth study with a follow-up to 10 years and a high rate of conversion to unlinked semi constrained total knee arthroplasty implant (30/37 patients reported a greater incidence of revision due to instability, in patients in whom the medial collateral ligament injury was directly repaired without added constraint. Overall balance of evidence is in favour of satisfactory outcomes without symptomatic instability following direct repair with or without

Qualità totale e mobilità totale Total Quality and Total Mobility

Directory of Open Access Journals (Sweden)

Giuseppe Trieste

2010-05-01

Full Text Available FIABA ONLUS (Italian Fund for Elimination of Architectural Barriers was founded in 2000 with the aim of promoting a culture of equal opportunities and, above all, it has as its main goal to involve public and private institutions to create a really accessible and usable environment for everyone. Total accessibility, Total usability and Total mobility are key indicators to define quality of life within cities. A supportive environment that is free of architectural, cultural and psychological barriers allows everyone to live with ease and universality. In fact, people who access to goods and services in the urban context can use to their advantage time and space, so they can do their activities and can maintain relationships that are deemed significant for their social life. The main aim of urban accessibility is to raise the comfort of space for citizens, eliminating all barriers that discriminate people, and prevent from an equality of opportunity. “FIABA FUND - City of ... for the removal of architectural barriers” is an idea of FIABA that has already affected many regions of Italy as Lazio, Lombardy, Campania, Abruzzi and Calabria. It is a National project which provides for opening a bank account in the cities of referring, in which for the first time, all together, individuals and private and public institutions can make a donation to fund initiatives for the removal of architectural barriers within its own territory for a real and effective total accessibility. Last February the fund was launched in Rome with the aim of achieving a Capital without barriers and a Town European model of accessibility and usability. Urban mobility is a prerequisite to access to goods and services, and to organize activities related to daily life. FIABA promotes the concept of sustainable mobility for all, supported by the European Commission’s White Paper. We need a cultural change in management and organization of public means, which might focus on

The Sum Total is Greater than the Sum of All Parts

Directory of Open Access Journals (Sweden)

Zuhal GERÇEK

2011-01-01

Full Text Available Institutional social responsibility is the responsibility of an institution to promote economic, environmental, cultural and social development to improve the quality of life, together with local people and the whole society, for a sustainable world. It also ensures companies to perform fairly and responsibly and treat all stakeholders and the community accordingly. How should universities practice corporate social responsibility? New world requires universities to redefine their missions and while continuing to serve as a space for innovation, creativity and learning they should provide tools necessary for sustainable development, social analysis and critical thinking. Universities with the basic tasks of education and research, is a prototype of the society as involving individuals of each sex, and culture ranging from the age range from 18 to 70, varying levels of education from primary school to doctoral studies. In this regard, universities should be a part of shaping the dynamics of present and future of the social and physical environment. Universities first carry out Institutional Social Responsibility within their own culture first. Universities then should provide students as the most important stakeholders with genuine education, self-knowledge and the learning process by promoting the personal development of people in the community in finding a way to show locations and social development, as well as mobilizing communities, strengthening the process. Education should encourage and motivate free and active participation in life to inspire individuals by helping them to acquire physical and social skills with new approaches essential to address problems around them. Education should also ensure the development of personal, social and environmental consciousness. Within a society social responsibility may become natural characteristic when individuals equipped with this awareness.

Total petroleum systems of the Paleozoic and Jurassic, Greater Ghawar Uplift and adjoining provinces of central Saudi Arabia and northern Arabian-Persian Gulf

Science.gov (United States)

Pollastro, Richard M.

2003-01-01

The greater Paleozoic and Jurassic petroleum systems of the Arabian Peninsula form two of the most prolific petroleum-producing systems in the world. Source rocks of these systems extend throughout the eastern Arabian Peninsula and Arabian-Persian Gulf. Primary elements of these Paleozoic and Jurassic petroleum systems - source, reservoir, and seal rocks - are of great areal extent and exceptional quality. The combination of these regionally extensive, exceptional petroleum-system elements, and the formation of large subtle structural closures prior to, or coincident with, peak oil generation and migration, have produced oil and gas fields with reserve volumes second to none.

Transition from thoracotomy to uniportal video-assisted thoracic surgery in non-small cell lung cancer-the Oslo experience.

Science.gov (United States)

Aamodt, Henrik

2016-01-01

Thoracoscopic surgery has been applied in medicine for more than 100 years. Still it is only within the last decade that it has gained momentum as a method in non-small cell lung cancer (NSCLC) surgery. Several approaches have been published, one of the more resent being uniportal video-assisted thoracic surgery (VATS). In this article we describe the transition from thoracotomy to uniportal VATS in our institution, the last step to uniportal VATS exemplified with two cases performed during our masterclass held in May 2016.

Analysis of scenarious for sewerage, wastewater treatment and prioritised load on environment from the Greater City of Copenhagen

DEFF Research Database (Denmark)

Harremoës, Poul; Andersen, H.S.; Dupont, R.

2002-01-01

plants. The effluent from the two treatment plants discharges during dry weather to Øresund, the sound between Denmark and Sweden. This large system has been analysed for selected scenarios with respect to handling runoff in an optimal way in order to minimise the loads on the most sensitive receiving......The sewer system for the Greater Copenhagen area covers an area of 4460 ha contributing to the runoff. The total area serves in total 8 municipalities, however it is dominated by the areas in the City of Copenhagen proper. The catchments merge into interceptors, which feed two large treatment...... waters and optimising treatment plant performance....

Analysis of scenarios for sewerage, wastewater treatment and prioritised load on environment from the Greater City of Copenhagen.

Science.gov (United States)

Harremoës, P; Andersen, H S; Dupont, R; Jacobsen, P; Rindel, K

2002-01-01

The sewer system for the Greater Copenhagen area covers an area of 4460 ha contributing to the runoff. The total area serves in total 8 municipalities, however it is dominated by the areas in the City of Copenhagen proper. The catchments merge into interceptors, which feed two large treatment plants. The effluent from the two treatment plants discharges during dry weather to Oresund, the sound between Denmark and Sweden. This large system has been analysed for selected scenarios with respect to handling runoff in an optimal way in order to minimise the loads on the most sensitive receiving waters and optimising treatment plant performance.

Collagen synthesis in CBA mouse heart after total thoracic irradiation

International Nuclear Information System (INIS)

Murray, J.C.; Parkins, C.S.; Institute of Cancer Research, Sutton

1988-01-01

CBA mice were irradiated to the whole thorax with single doses of 240 kVp X-rays in the dose range 8-16 Gy. Collagen and total protein synthesis rates in the heart were measured at 2-monthly intervals using a radio-isotope incorporation techniques. Doses of 10 Gy or greater caused a slight increase in collagen synthesis, followed by significantly reduced collagen synthesis by 16 weeks or longer after treatment. The depression in synthesis appeared correspondingly earlier with increasing dose. Total protein synthesis in heart followed similar patterns although changes were not statistically significant, indicating that the changes reflected alterations to collagen synthesis specifally, and not protein synthesis in geneal. Total hydroxyproline measurements showed no significant changes in heart collagen at any time as a result of X-irradiation. 18 refs.; 7 figs

Propensity Score Analysis Comparing Videothoracoscopic Lobectomy With Thoracotomy: A French Nationwide Study.

Science.gov (United States)

Pagès, Pierre-Benoit; Delpy, Jean-Philippe; Orsini, Bastien; Gossot, Dominique; Baste, Jean-Marc; Thomas, Pascal; Dahan, Marcel; Bernard, Alain

2016-04-01

Video-assisted thoracoscopic surgery (VATS) lobectomy has recently become the recommended approach for stage I non-small cell lung cancer. However, these guidelines are not based on any large randomized control trial. Our study used propensity scores and a sensitivity analysis to compare VATS lobectomy with open thoracotomy. From 2005 to 2012, 24,811 patients (95.1%) were operated on by open thoracotomy and 1,278 (4.9%) by VATS. The end points were 30-day postoperative death, postoperative complications, hospital stay, overall survival, and disease-free survival. Two propensity scores analyses were performed: matching and inverse probability of treatment weighting, and one sensitivity analysis to unmask potential hidden bias. A subgroup analysis was performed to compare "high-risk" with "low-risk" patients. Results are reported by odds ratios or hazard ratios and their 95% confidence intervals. Postoperative death was not significantly reduced by VATS whatever the analysis. Concerning postoperative complications, VATS significantly decreased the occurrence of atelectasis and pneumopathy with both analysis methods, but there were no differences in the occurrence of other postoperative complications. VATS did not provide a benefit for high-risk patients. The VATS approach decreased the hospital length of stay from 2.4 days (95% confidence interval, -1.7 to -3 days) to -4.68 days (95% confidence interval, -8.5 to 0.9 days). Overall survival and disease-free survival were not influenced by the surgical approach. The sensitivity analysis showed potential biases. The results must be interpreted carefully because of the differences observed according to the propensity scores method used. A multicenter randomized controlled trial is necessary to limit the biases. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Fat segmentation on chest CT images via fuzzy models

Science.gov (United States)

Tong, Yubing; Udupa, Jayaram K.; Wu, Caiyun; Pednekar, Gargi; Subramanian, Janani Rajan; Lederer, David J.; Christie, Jason; Torigian, Drew A.

2016-03-01

Quantification of fat throughout the body is vital for the study of many diseases. In the thorax, it is important for lung transplant candidates since obesity and being underweight are contraindications to lung transplantation given their associations with increased mortality. Common approaches for thoracic fat segmentation are all interactive in nature, requiring significant manual effort to draw the interfaces between fat and muscle with low efficiency and questionable repeatability. The goal of this paper is to explore a practical way for the segmentation of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) components of chest fat based on a recently developed body-wide automatic anatomy recognition (AAR) methodology. The AAR approach involves 3 main steps: building a fuzzy anatomy model of the body region involving all its major representative objects, recognizing objects in any given test image, and delineating the objects. We made several modifications to these steps to develop an effective solution to delineate SAT/VAT components of fat. Two new objects representing interfaces of SAT and VAT regions with other tissues, SatIn and VatIn are defined, rather than using directly the SAT and VAT components as objects for constructing the models. A hierarchical arrangement of these new and other reference objects is built to facilitate their recognition in the hierarchical order. Subsequently, accurate delineations of the SAT/VAT components are derived from these objects. Unenhanced CT images from 40 lung transplant candidates were utilized in experimentally evaluating this new strategy. Mean object location error achieved was about 2 voxels and delineation error in terms of false positive and false negative volume fractions were, respectively, 0.07 and 0.1 for SAT and 0.04 and 0.2 for VAT.

Aare Toikka näidend tuli lavale Budapestis

Index Scriptorium Estoniae

2011-01-01

Budapestis Kolibri teatris esietendus noortelavastus "Help", mille kirjutasid VAT teatri kunstiline juht Aare Toikka ja Ungari lavastja, proosa- ja näitekirjanik Peter Horvath. VAT teatri lavale jõuab "Help" 9. mail, lavastajaiks Margo Teder ja Aare Toikka

Selective conservatism in the management of thoracic trauma remains appropriate in the 21st century.

Science.gov (United States)

Kong, V Y; Oosthuizen, G V; Clarke, D L

2015-04-01

Selective conservatism for thoracic trauma is well established but the emergence of new technologies may cause management strategies to continue to evolve. A retrospective study was conducted on thoracic trauma patients managed in a single institution in South Africa over a 4-year period to determine the appropriateness of our current policy of selective conservatism. A total of 1,239 patients were included in the study; 112 required an emergency thoracotomy, 125 were admitted for observation and 1,002 required a tube thoracostomy (TT). Ninety-one per cent of the patients were male and the median age was 24 years. Seventy-five per cent of the cases were penetrating trauma and the remaining were blunt trauma. The indications for TT were pneumothorax (PTX) (n=382, 38%), haemothorax (HTX) (n=300, 30%) and haemopneumothorax (HPTX) (n=320, 32%). A total of 13% (127/1,002) of all chest x-rays (CXR) following tube removal demonstrated residual pathologies that precluded immediate discharge: 32 (8%) in Group A (PTX), 44 (15%) in Group B (HTX) and 51 (16%) in Group C (HPTX). All 32 patients in Group A were simply observed and did not require further intervention. In Group B, 17 patients required repeat TTs and 27 required video assisted thoracoscopic surgery (VATS) for clearance of residual HTX. Twenty-nine patients in Group C required repeat TTs and twenty-two required VATS. The vast majority of patients with thoracic trauma can be managed conservatively with TT alone. Residual pathology appeared to be lowest in patients with a PTX, which seldom requires treatment, while only a minority of patients required repeat TTs or VATS for a retained HTX. Selective conservatism is still appropriate in the current era in a developing world setting.

Selective conservatism in the management of thoracic trauma remains appropriate in the 21st century

Science.gov (United States)

Oosthuizen, GV; Clarke, DL

2015-01-01

Introduction Selective conservatism for thoracic trauma is well established but the emergence of new technologies may cause management strategies to continue to evolve. Methods A retrospective study was conducted on thoracic trauma patients managed in a single institution in South Africa over a 4-year period to determine the appropriateness of our current policy of selective conservatism. Results A total of 1,239 patients were included in the study; 112 required an emergency thoracotomy, 125 were admitted for observation and 1,002 required a tube thoracostomy (TT). Ninety-one per cent of the patients were male and the median age was 24 years. Seventy-five per cent of the cases were penetrating trauma and the remaining were blunt trauma. The indications for TT were pneumothorax (PTX) (n=382, 38%), haemothorax (HTX) (n=300, 30%) and haemopneumothorax (HPTX) (n=320, 32%). A total of 13% (127/1,002) of all chest x-rays (CXR) following tube removal demonstrated residual pathologies that precluded immediate discharge: 32 (8%) in Group A (PTX), 44 (15%) in Group B (HTX) and 51 (16%) in Group C (HPTX). All 32 patients in Group A were simply observed and did not require further intervention. In Group B, 17 patients required repeat TTs and 27 required video assisted thoracoscopic surgery (VATS) for clearance of residual HTX. Twenty-nine patients in Group C required repeat TTs and twenty-two required VATS. Conclusions The vast majority of patients with thoracic trauma can be managed conservatively with TT alone. Residual pathology appeared to be lowest in patients with a PTX, which seldom requires treatment, while only a minority of patients required repeat TTs or VATS for a retained HTX. Selective conservatism is still appropriate in the current era in a developing world setting. PMID:26263809

Lung abscess combined with chronic osteomyelitis of the mandible successfully treated with video-assisted thoracoscopic surgery.

Science.gov (United States)

Arai, Hiromasa; Inui, Kenji; Watanabe, Keisuke; Watanuki, Kei; Okudela, Koji; Tsuboi, Masahiro; Masuda, Munetaka

2015-04-01

With the progress of antibiotic therapy, the mortality of lung abscess has been improved, and surgical intervention has declined. However, surgery is still required in selected cases that are intractable to antibiotic treatment. Video-assisted thoracoscopic surgery (VATS) is beneficial for treatment and/or diagnosis of pulmonary disease as it provides a less invasive surgical technique and reduces prolongation of post-operative recovery. However, the indication of VATS lobectomy for lung abscess is controversial as a result of particular complications, i.e. wet lung, intrapleural adhesion and ease of bleeding. We herein report a rare combination of lung abscess and osteomyelitis of mandible resulting from the same pathogen successfully treated with VATS lobectomy. We propose VATS lobectomy for lung abscess. This procedure might be the best treatment candidate for selected cases of lung abscess. © 2014 John Wiley & Sons Ltd.

Uniportal video assisted thoracic surgery: summary of experience, mini-review and perspectives.

Science.gov (United States)

Migliore, Marcello; Calvo, Damiano; Criscione, Alessandra; Borrata, Francesco

2015-09-01

The uniportal-video assisted thoracic surgery (VATS) technique comprises operations which can be performed with skin incisions ranging from 2 to 8 cm and the manifest result of the introduction of the uniportal lobectomy had made possible to increase rapidly the number of published papers on this subject. Many of the large ensuing literature report incomplete historical information on uniportal VATS, and doubts exist about the indication of uniportal VATS for some thoracic oncologic pathologies. Known limitations have been overcome. On the other hand, the modern thoracic surgical team includes one surgeon, one assistant and a scrub nurse, and it is clear that the new generation of thoracic surgeons need to use the "less" used hand. The new technology which permitted the introduction of the uniportal VATS could influence the future need of thoracic surgeons worldwide.

Visceral obesity is associated with increased soluble CD163 concentration in men with type 2 diabetes mellitus

DEFF Research Database (Denmark)

Sørensen, Lars Peter; Parkner, Tina; Søndergaard, Esben

2015-01-01

individuals. The objective was to examine the effect of male overweight/obesity and type 2 diabetes mellitus (T2DM) on associations between adiposity parameters and sCD163. A total of 23 overweight/obese non-diabetic men, 16 overweight/obese men with T2DM, and a control group of 20 normal-weight healthy men...... multiple linear regression analysis. In the normal-weight healthy men, there was no significant association between adiposity parameters and sCD163, whereas in the overweight/obese non-diabetic men, measures of general and regional adiposity were positively associated with sCD163. In the overweight/obese......-body fat, adjusted for BMI and age, VAT remained a significant predictor of sCD163 in the overweight/obese T2DM men, but not in the overweight/obese non-diabetic men. Our results indicate that VAT inflammation is exaggerated in men with T2DM, and that propensity to store excess body fat viscerally...

Non-intubated uniportal left-lower lobe upper segmentectomy (S6).

Science.gov (United States)

Galvez, Carlos; Navarro-Martinez, Jose; Bolufer, Sergio; Sesma, Julio; Lirio, Francisco; Galiana, Maria; Rivera, Maria Jesus

2017-01-01

Worldwide accepted indications of anatomical segmentectomies are mainly early stage primary adenocarcinomas, pulmonary metastasis and benign conditions. Their performance through uniportal VATS has become more and more popular due to the less invasiveness of the whole procedure under this approach. Recently, many efforts have focused on non-intubated spontaneously breathing management of lobectomies and anatomical segmentectomies, although specific selection criteria and main advantages are not completely standardized. In a 62-year-old thin man with two pulmonary residual metastasis from sigma adenocarcinoma, after chemotherapy plus antiangiogenic treatment, we indicated a single-incision video-assisted left-lower lobe (LLL) upper segmentectomy (S6) under spontaneous breathing and intercostal blockade. Total operation time was 240 minutes. Chest tube was removed at 24 hours and the patient was discharge on postoperative day 2 without any complication. Non-intubated uniportal VATS is a safe and reasonable approach for lung-sparing resections in selected patients, although more evidence is required for selecting which patients can benefit more over standard intubated procedures.

Persistent postsurgical pain after video-assisted thoracic surgery – an observational study

DEFF Research Database (Denmark)

Wildgaard, Kim; Ringsted, T K; Jessen Hansen, Henrik

2016-01-01

on activities of daily living of PPP after VATS. METHODS: Using a prospective observational design, 47 patients undergoing VATS completed both preoperative, early postoperative and 3 months follow-up. Preoperative pain, pain characteristics, psychological factors, pain-related functional impairment...

Coronary artery disease is associated with an increased mortality rate following video-assisted thoracoscopic lobectomy

DEFF Research Database (Denmark)

Sandri, Alberto; Petersen, Rene Horsleben; Decaluwé, Herbert

2017-01-01

OBJECTIVE: To compare the incidence of major adverse cardiac events (MACE) and mortality following video-assisted thoracoscopic surgery (VATS) lobectomy in patients with and without coronary artery disease (CAD). METHODS: Multicentre retrospective analysis of 1699 patients undergoing VATS lobectomy...

Instability after total hip arthroplasty

Science.gov (United States)

Werner, Brian C; Brown, Thomas E

2012-01-01

Instability following total hip arthroplasty (THA) is an unfortunately frequent and serious problem that requires thorough evaluation and preoperative planning before surgical intervention. Prevention through optimal index surgery is of great importance, as the management of an unstable THA is challenging even for an experienced joints surgeon. However, even after well-planned surgery, a significant incidence of recurrent instability still exists. Non-operative management is often successful if the components are well-fixed and correctly positioned in the absence of neurocognitive disorders. If conservative management fails, surgical options include revision of malpositioned components; exchange of modular components such as the femoral head and acetabular liner; bipolar arthroplasty; tripolar arthroplasty; use of a larger femoral head; use of a constrained liner; soft tissue reinforcement and advancement of the greater trochanter. PMID:22919568

Total antioxidant capacity in children with acute appendicitis.

Science.gov (United States)

Kaya, M; Boleken, M E; Kanmaz, T; Erel, O; Yucesan, S

2006-02-01

This study aimed to investigate antioxidant capacity by using a novel automated method in children with acute appendicitis. Blood samples were obtained from consecutive patients with acute appendicitis (appendicitis group, n = 12) and acute abdominal pain due to non surgical disease (non-appendicitis group, n = 11), and from patients with inguinal hernia (healthy group, n = 12) as the control group. At admission, total antioxidant capacity (TAC) levels of plasma were evaluated in all patients by a method recently developed by Erel. Four other major individual plasma antioxidant components, the levels of total protein, albumin, uric acid and bilirubin, were also evaluated. Total antioxidant capacity in patients with acute appendicitis was statistically compared with the two other groups. While the TAC level in the appendicitis group was significantly greater than in the non-appendicitis group, no significant difference was found in healthy groups (p 0.05, 1.94 +/- 0.38, 1.40 +/- 0.36, and 1.99 +/- 0.35 respectively). Individual components of total antioxidant capacity, i.e. total protein, albumin, uric acid and bilirubin concentrations, were also higher in the patients with acute appendicitis than those of the other two control groups. Our data show that children with acute appendicitis do not have deficient blood plasma antioxidant capacity. These results provide evidence that acute appendicitis results in more induction of antioxidative response than non-surgical diseases.

Wet and dry hands after video-assisted thoracoscopic pleurectomy

NARCIS (Netherlands)

Brakel, T.J. van; Barendregt, W.B.

2013-01-01

Damage to the thoracic sympathic chain is a rare complication of video-assisted thoracic surgery (VATS) pleurectomy. We report our experience with a patient who underwent parietal pleurectomy and bullectomy by VATS and postoperatively suffered from palmar anhydrosis and compensatory controlateral

Tranexamic acid versus aminocaproic acid for blood management after total knee and total hip arthroplasty: A systematic review and meta-analysis.

Science.gov (United States)

Liu, Qiuliang; Geng, Peishuo; Shi, Longyan; Wang, Qi; Wang, Pengliang

2018-06-01

To compare the efficacy and safety of tranexamic acid and aminocaproic acid for reducing blood loss and transfusion requirements after total knee and total hip arthroplasty. We conduct electronic searches of Medline (1966-2017.11), PubMed (1966-2017.11), Embase (1980-2017.11), ScienceDirect (1985-2017.11) and the Cochrane Library (1900-2017.11). The primary outcomes, including total blood loss, hemoglobin decline and transfusion requirements. Secondary outcomes include length of hospital stay and postoperative complications such as the incidence of deep vein thrombosis and pulmonary embolism. Each outcome is combined and calculated using the statistical software STATA 12.0. Fixed/random effect model is adopted based on the heterogeneity tested by I 2 statistic. A total of 1714 patients are analyzed across three randomized controlled trials (RCTs) and one non-RCT. The present meta-analysis reveals that TXA is associated with a significantly reduction of total blood loss and postoperative hemoglobin drop compared with EACA. No significant differences are identified in terms of transfusion rates, length of hospital stay, and the incidence of postoperative complications. Although total blood loss and postoperative hemoglobin drop are significant greater in EACA groups, there is no significant difference between TXA and EACA groups in terms of transfusion rates. Based on the current evidence available, higher quality RCTs are still required for further research. Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Greater temperature sensitivity of plant phenology at colder sites

DEFF Research Database (Denmark)

Prevey, Janet; Vellend, Mark; Ruger, Nadja

2017-01-01

Warmer temperatures are accelerating the phenology of organisms around the world. Temperature sensitivity of phenology might be greater in colder, higher latitude sites than in warmer regions, in part because small changes in temperature constitute greater relative changes in thermal balance...

Greater Somalia, the never-ending dream?

DEFF Research Database (Denmark)

Zoppi, Marco

2015-01-01

This paper provides an historical analysis of the concept of Greater Somalia, the nationalist project that advocates the political union of all Somali-speaking people, including those inhabiting areas in current Djibouti, Ethiopia and Kenya. The Somali territorial unification project of “lost...

Assessing Human Impacts on the Greater Akaki River, Ethiopia ...

African Journals Online (AJOL)

We assessed the impacts of human activities on the Greater Akaki River using physicochemical parameters and macroinvertebrate metrics. Physicochemical samples and macroinvertebrates were collected bimonthly from eight sites established on the Greater Akaki River from February 2006 to April 2006. Eleven metrics ...

Molecular insights into the biology of Greater Sage-Grouse

Science.gov (United States)

Oyler-McCance, Sara J.; Quinn, Thomas W.

2011-01-01

Recent research on Greater Sage-Grouse (Centrocercus urophasianus) genetics has revealed some important findings. First, multiple paternity in broods is more prevalent than previously thought, and leks do not comprise kin groups. Second, the Greater Sage-Grouse is genetically distinct from the congeneric Gunnison sage-grouse (C. minimus). Third, the Lyon-Mono population in the Mono Basin, spanning the border between Nevada and California, has unique genetic characteristics. Fourth, the previous delineation of western (C. u. phaios) and eastern Greater Sage-Grouse (C. u. urophasianus) is not supported genetically. Fifth, two isolated populations in Washington show indications that genetic diversity has been lost due to population declines and isolation. This chapter examines the use of molecular genetics to understand the biology of Greater Sage-Grouse for the conservation and management of this species and put it into the context of avian ecology based on selected molecular studies.

Automatic segmentation of abdominal organs and adipose tissue compartments in water-fat MRI: Application to weight-loss in obesity.

Science.gov (United States)

Shen, Jun; Baum, Thomas; Cordes, Christian; Ott, Beate; Skurk, Thomas; Kooijman, Hendrik; Rummeny, Ernst J; Hauner, Hans; Menze, Bjoern H; Karampinos, Dimitrios C

2016-09-01

To develop a fully automatic algorithm for abdominal organs and adipose tissue compartments segmentation and to assess organ and adipose tissue volume changes in longitudinal water-fat magnetic resonance imaging (MRI) data. Axial two-point Dixon images were acquired in 20 obese women (age range 24-65, BMI 34.9±3.8kg/m(2)) before and after a four-week calorie restriction. Abdominal organs, subcutaneous adipose tissue (SAT) compartments (abdominal, anterior, posterior), SAT regions along the feet-head direction and regional visceral adipose tissue (VAT) were assessed by a fully automatic algorithm using morphological operations and a multi-atlas-based segmentation method. The accuracy of organ segmentation represented by Dice coefficients ranged from 0.672±0.155 for the pancreas to 0.943±0.023 for the liver. Abdominal SAT changes were significantly greater in the posterior than the anterior SAT compartment (-11.4%±5.1% versus -9.5%±6.3%, pabdominal adipose tissue and organ segmentation, and allowed the detection of SAT and VAT subcompartments changes during weight loss. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Foorumteater pakub võimalust teisiti mõelda / Mari Rebane

Index Scriptorium Estoniae

Rebane, Mari

2005-01-01

VAT Teatri foorumgrupp ja MTÜ Caritas loovuskooli teatriringi noored etendavad Sõle gümnaasiumis üht osa VAT Teatri foorumgrupi koolivägivalla ennetamise projektist "ValikuVabadus" (projektijuht M.-L. Velberg), mis hõlmab kuut Tallinna kooli. Ka lühidalt foorumteatri ajaloost

INDUSTRIAL LAND DEVELOPMENT AND MANUFACTURING DECONCENTRATION IN GREATER JAKARTA

NARCIS (Netherlands)

Hudalah, Delik; Viantari, Dimitra; Firman, Tommy; Woltjer, Johan

2013-01-01

Industrial land development has become a key feature of urbanization in Greater Jakarta, one of the largest metropolitan areas in Southeast Asia. Following Suharto's market-oriented policy measures in the late 1980s, private developers have dominated the land development projects in Greater Jakarta.

Relationship between MRI-measured bone marrow adipose tissue and hip and spine bone mineral density in African-American and Caucasian participants: the CARDIA study.

Science.gov (United States)

Shen, Wei; Scherzer, Rebecca; Gantz, Madeleine; Chen, Jun; Punyanitya, Mark; Lewis, Cora E; Grunfeld, Carl

2012-04-01

An increasing number of studies suggest that bone marrow adipose tissue (BMAT) might play a role in the pathogenesis of osteoporosis. Our previous study of Caucasian women demonstrated that there is an inverse relationship between BMAT and whole-body bone mineral density (BMD). It is unknown whether visceral adipose tissue (VAT), sc adipose tissue (SAT), and skeletal muscle had an effect on the relationship between BMAT and BMD. In the present study we investigated the relationship between pelvic, hip, and lumbar spine BMAT with hip and lumbar spine BMD in the population-based Coronary Artery Risk Development in Young Adults (CARDIA) sample with adjustment for whole-body magnetic resonance imaging (MRI)-measured VAT, SAT, and skeletal muscle. T1-weighted MRI was acquired for 210 healthy African-American and Caucasian men and women (age 38-52 yr). Hip and lumbar spine BMD were measured by dual-energy x-ray absorptiometry. Pelvic, hip, and lumbar spine BMAT had negative correlations with hip and lumbar spine BMD (r = -0.399 to -0.550, P BMAT and BMD remained strong after adjusting for demographics, weight, skeletal muscle, SAT, VAT, total adipose tissue (TAT), menopausal status, lifestyle factors, and inflammatory markers (standardized regression coefficients = -0. 296 to -0.549, P BMAT (standardized regression coefficients = 0.268-0.614, P BMAT and hip and lumbar spine BMD independent of demographics and body composition. These observations support the growing evidence linking BMAT with low bone density.

Birth weight and risk of adiposity among adult Inuit in Greenland.

Directory of Open Access Journals (Sweden)

Pernille Falberg Rønn

Full Text Available OBJECTIVE: The Inuit population in Greenland has undergone rapid socioeconomic and nutritional changes simultaneously with an increasing prevalence of obesity. Therefore, the objective was to examine fetal programming as part of the aetiology of obesity among Inuit in Greenland by investigating the association between birth weight and measures of body composition and fat distribution in adulthood. METHODS: The study was based on cross-sectional data from a total of 1,473 adults aged 18-61 years in two population-based surveys conducted in Greenland between 1999-2001 and 2005-2010. Information on birth weight was collected from birth records. Adiposity was assessed by anthropometry, fat mass index (FMI, fat-free mass index (FFMI, and visceral (VAT and subcutaneous adipose tissue (SAT estimated by ultrasound. The associations to birth weight were analyzed using linear regression models and quadratic splines. Analyses were stratified by sex, and adjusted for age, birthplace, ancestry and family history of obesity. RESULTS: Spline analyses showed linear relations between birth weight and adult adiposity. In multiple regression analyses, birth weight was positively associated with BMI, waist circumference, FMI, FFMI and SAT with generally weaker associations among women compared to men. Birth weight was only associated with VAT after additional adjustment for waist circumference and appeared to be specific and inverse for men only. CONCLUSIONS: Higher birth weight among Inuit was associated with adiposity in adulthood. More studies are needed to explore a potential inverse association between birth size and VAT.

Streptogramin resistance among Enterococcus faecium isolated from production animals in Denmark in 1997

DEFF Research Database (Denmark)

Jensen, Lars Bogø; Hammerum, Anette Marie; Bager, Flemming

2002-01-01

The genetic background for streptogramin resistance was examined in Enterococcus faecium isolated from pigs (n = 55) and broilers (n = 207) in 1997 in Denmark. Fifty-one percent and 67%, respectively, of the isolates were resistant to streptogramins. Among streptogramin-resistant E. faecium (SREF......), the genetic background for streptogramin A resistance could be determined in 96% of the isolates from broilers, compared with 14% among SREF from pigs. For broiler isolates 89% of SREF contained the vat(E) gene and 10% the vat(D) gene. Three of these isolates contained both resistance genes. Among SREF from...... pigs two isolates contained the vat(E) gene and two others the vat(D) gene. The genetic background for streptogramin B was most often identified as the erm(B) gene encoding macrolide, lincosamide, and streptogramin B (MLSB) resistance. Among SREF, 84% and 86% of isolates from broilers and pigs...

Thymectomy for Nonthymomatous Myasthenia Gravis: Comparison of Video-Assisted Thoracoscopic and Transsternal Thymectomy.

Science.gov (United States)

Bagheri, Reza; Boonstani, Reza; Sadrizadeh, Ali; Salehi, Maryam; Afghani, Reza; Rahnama, Ali; Azmounfar, Vahab; Hakimian, Saeed; Baradaran Firoozabadi, Mohammad

Thymectomy considered as a standard procedure in treatment of all the steps of myasthenia gravis. Video-assisted thoracoscopic surgery (VATS) thymectomy is one of the minimally invasive procedures that because of the short duration of hospitalization, less postoperative pain, and scar after surgery, nowadays it is replaced the traditional methods of surgery for patients with myasthenia gravis, but there are still differences and concerns. The aim of this study was to compare outcomes of two different techniques of surgery, VATS versus transsternal (TS) in the treatment of myasthenia gravis. In this pilot study, 42 patients with myasthenia gravis and without a thymus tumor were evaluated based on Myasthenia Gravis Foundation of America classification and drug consumption. Then, they randomly underwent two different techniques of surgery: VATS versus TS. Patients were evaluated based on preoperative and postoperative variables. Duration of intensive care unit stay and hospitalization has been reduced in patients who underwent VATS thymectomy operation technique. In addition, duration of surgical procedure has been reduced significantly in these patients. These patients have less blood loss during surgery compared with TS group. The Myasthenia Gravis Foundation of America postoperative status in VATS thymectomy revealed that the number of patients with complete stable remission was higher and number of persons remained unchanged was lower in this group. VATS thymectomy is a safe and appropriate approach comparing with traditional methods such as TS thymectomy for patients with myasthenia gravis. This method has better results after surgery and can be used as a minimally invasive alternative method instead of TS thymectomy.

Video game addiction test: validity and psychometric characteristics.

NARCIS (Netherlands)

Rooij, A.J. van; Schoenmakers, T.M.; Eijnden, R.J.J.M. van den; Vermulst, A.A.; Mheen, D. van de

2012-01-01

The study explores the reliability, validity, and measurement invariance of the Video game Addiction Test (VAT). Game-addiction problems are often linked to Internet enabled online games; the VAT has the unique benefit that it is theoretically and empirically linked to Internet addiction. The study

Video Game Addiction Test: Validity and Psychometric Characteristics

NARCIS (Netherlands)

Rooij, A.J. van; Schoenmakers, T.M.; Eijnden, R.J.J.M. van den; Vermulst, A.A.; Mheen, H. van de

2012-01-01

The study explores the reliability, validity, and measurement invariance of the Video game Addiction Test (VAT). Game-addiction problems are often linked to Internet enabled online games; the VAT has the unique benefit that it is theoretically and empirically linked to Internet addiction. The study

The usefulness of two-port video-assisted thoracosopic surgery in low-risk patients with secondary spontaneous pneumothorax compared with open thoracotomy.

Science.gov (United States)

Park, Kyoung Taek

2014-01-01

Secondary spontaneous pneumothorax is difficult to treat and has been thought to have high morbidity and mortality rate due to the underlying diseases and presence of comorbidities in the patients. However, early surgical intervention will be beneficial if it is tolerable by the patient. In the surgical approach for treating pneumothorax, video-assisted thoracoscopic surgery (VATS) may reduce the postoperative drainage period and hospital stay compared with open thoracotomy. A retrospective review of the clinical data of 40 patients with secondary spontaneous pneumothorax who underwent open thoracotomy (n = 20) or two-port VATS (n = 20) between January 2008 and December 2012 was performed. Postoperative drainage period of open thoracotomy group and two-port VATS group was 9.85 ± 5.28 and 6.75 ± 2.45, respectively, with a significant inter-group difference. Postoperative hospital stay was 11.8 ± 5.12 in the open thoracotomy group and 8.25 ± 2.88 in the two-port VATS group, with a significant inter-group difference. Recurrence rate and postoperative complication rate were not significant between the two groups. In selected patients with secondary spontaneous pneumothorax treated with surgical approach, two-port VATS resulted in shorter postoperative drainage period and hospital stay compared with open thoracotomy.

Effects of visceral adiposity on glycerol pathways in gluconeogenesis.

Science.gov (United States)

Neeland, Ian J; Hughes, Connor; Ayers, Colby R; Malloy, Craig R; Jin, Eunsook S

2017-02-01

To determine the feasibility of using oral 13 C labeled glycerol to assess effects of visceral adiposity on gluconeogenic pathways in obese humans. Obese (BMI ≥30kg/m 2 ) participants without type 2 diabetes underwent visceral adipose tissue (VAT) assessment and stratification by median VAT into high VAT-fasting (n=3), low VAT-fasting (n=4), and high VAT-refed (n=2) groups. Participants ingested [U- 13 C 3 ] glycerol and blood samples were subsequently analyzed at multiple time points over 3h by NMR spectroscopy. The fractions of plasma glucose (enrichment) derived from [U- 13 C 3 ] glycerol via hepatic gluconeogenesis, pentose phosphate pathway (PPP), and tricarboxylic acid (TCA) cycle were assessed using 13 C NMR analysis of glucose. Mixed linear models were used to compare 13 C enrichment in glucose between groups. Mean age, BMI, and baseline glucose were 49years, 40.1kg/m 2 , and 98mg/dl, respectively. Up to 20% of glycerol was metabolized in the TCA cycle prior to gluconeogenesis and PPP activity was minor (gluconeogenesis from glycerol in obese humans. Our findings provide preliminary evidence that excess visceral fat disrupts multiple pathways in hepatic gluconeogenesis from glycerol. Copyright © 2016 Elsevier Inc. All rights reserved.

Strategies for Talent Management: Greater Philadelphia Companies in Action

Science.gov (United States)

Council for Adult and Experiential Learning (NJ1), 2008

2008-01-01

Human capital is one of the critical issues that impacts the Greater Philadelphia region's ability to grow and prosper. The CEO Council for Growth (CEO Council) is committed to ensuring a steady and talented supply of quality workers for this region. "Strategies for Talent Management: Greater Philadelphia Companies in Action" provides…

Greater oil investment opportunities

International Nuclear Information System (INIS)

Arenas, Ismael Enrique

1997-01-01

Geologically speaking, Colombia is a very attractive country for the world oil community. According to this philosophy new and important steps are being taken to reinforce the oil sector: Expansion of the exploratory frontier by including a larger number of sedimentary areas, and the adoption of innovative contracting instruments. Colombia has to offer, Greater economic incentives for the exploration of new areas to expand the exploratory frontier, stimulation of exploration in areas with prospectivity for small fields. Companies may offer Ecopetrol a participation in production over and above royalties, without it's participating in the investments and costs of these fields, more favorable conditions for natural gas seeking projects, in comparison with those governing the terms for oil

Improving greater trochanteric reattachment with a novel cable plate system.

Science.gov (United States)

Baril, Yannick; Bourgeois, Yan; Brailovski, Vladimir; Duke, Kajsa; Laflamme, G Yves; Petit, Yvan

2013-03-01

Cable-grip systems are commonly used for greater trochanteric reattachment because they have provided the best fixation performance to date, even though they have a rather high complication rate. A novel reattachment system is proposed with the aim of improving fixation stability. It consists of a Y-shaped fixation plate combined with locking screws and superelastic cables to reduce cable loosening and limit greater trochanter movement. The novel system is compared with a commercially available reattachment system in terms of greater trochanter movement and cable tensions under different greater trochanteric abductor application angles. A factorial design of experiments was used including four independent variables: plate system, cable type, abductor application angle, and femur model. The test procedure included 50 cycles of simultaneous application of an abductor force on the greater trochanter and a hip force on the femoral head. The novel plate reduces the movements of a greater trochanter fragment within a single loading cycle up to 26%. Permanent degradation of the fixation (accumulated movement based on 50-cycle testing) is reduced up to 46%. The use of superelastic cables reduces tension loosening up to 24%. However this last improvement did not result in a significant reduction of the grater trochanter movement. The novel plate and cables present advantages over the commercially available greater trochanter reattachment system. The plate reduces movements generated by the hip abductor. The superelastic cables reduce cable loosening during cycling. Both of these positive effects could decrease the risks related to grater trochanter non-union. Copyright © 2012 IPEM. Published by Elsevier Ltd. All rights reserved.

Teater

Index Scriptorium Estoniae

2005-01-01

VAT Teatri "Kalevipoeg" annab etendusi 2.-15. aug. rahvusvahelisel liikuval teatrifestivalil "Vertical Tour of Japan", mis toimub Jaapani ja Euroopa Liidu koostööaasta raames. VAT Teatri lavastust mängitakse teatrilavadel Tokios, Tottoris ja Hokkaidos ; Setumaal esietenduvast "Taarkast", Soorinna külas etenduvast "Eesti ballaadidest"

Requirements for Logical Models for Value-Added Tax Legislation

DEFF Research Database (Denmark)

Nielsen, Morten Ib; Simonsen, Jakob Grue; Larsen, Ken Friis

Enterprise resource planning (ERP) systems are ubiquitous in commercial enterprises of all sizes and invariably need to account for the notion of value-added tax (VAT). The legal and technical difficulties in handling VAT are exacerbated by spanning a broad and chaotic spectrum of intricate country...

Postoperative pain and quality of life after lobectomy via video-assisted thoracoscopic surgery or anterolateral thoracotomy for early stage lung cancer

DEFF Research Database (Denmark)

Bendixen, Morten; Jørgensen, Ole Dan; Kronborg, Christian

2016-01-01

(1:1) to lobectomy via four-port VATS or anterolateral thoracotomy. After surgery, we applied identical surgical dressings to ensure masking of patients and staff. Postoperative pain was measured with a numeric rating scale (NRS) six times per day during hospital stay and once at 2, 4, 8, 12, 26......, and 52 weeks, and self-reported quality of life was assessed with the EuroQol 5 Dimensions (EQ5D) and the European Organisation for Research and Treatment of Cancer (EORTC) 30 item Quality of Life Questionnaire (QLQ-C30) during hospital stay and 2, 4, 8, 12, 26, and 52 weeks after discharge. The primary...... died during the follow-up period (three in the VATS group and six in the thoracotomy group). INTERPRETATION: VATS is associated with less postoperative pain and better quality of life than is anterolateral thoracotomy for the first year after surgery, suggesting that VATS should be the preferred...

Greater Trochanteric Fixation Using a Cable System for Partial Hip Arthroplasty: A Clinical and Finite Element Analysis

Science.gov (United States)

Ozan, Fırat; Koyuncu, Şemmi; Pekedis, Mahmut; Altay, Taşkın; Yıldız, Hasan; Toker, Gökhan

2014-01-01

The aim of the study was to investigate the efficacy of greater trochanteric fixation using a multifilament cable to ensure abductor lever arm continuity in patients with a proximal femoral fracture undergoing partial hip arthroplasty. Mean age of the patients (12 men, 20 women) was 84.12 years. Mean follow-up was 13.06 months. Fixation of the dislocated greater trochanter with or without a cable following load application was assessed by finite element analysis (FEA). Radiological evaluation was based on the distance between the fracture and the union site. Harris hip score was used to evaluate final results: outcomes were excellent in 7 patients (21.8%), good in 17 patients (53.1%), average in 5 patients (15.6%), and poor in 1 patient (9.3%). Mean abduction angle was 20.21°. Union was achieved in 14 patients (43.7%), fibrous union in 12 (37.5%), and no union in 6 (18.7%). FEA showed that the maximum total displacement of the greater trochanter decreased when the fractured bone was fixed with a cable. As the force applied to the cable increased, the displacement of the fractured trochanter decreased. This technique ensures continuity of the abductor lever arm in patients with a proximal femoral fracture who are undergoing partial hip arthroplasty surgery. PMID:25177703

Measurements of total OH reactivity during PROPHET-AMOS 2016

Science.gov (United States)

Rickly, P.; Sakowski, J.; Bottorff, B.; Lew, M.; Stevens, P. S.; Sklaveniti, S.; Locoge, N.; Dusanter, S.

2017-12-01

As one of the main oxidant in the atmosphere, the hydroxyl radical (OH) initiates the oxidation of volatile organic compounds that can lead to the formation of ozone and secondary organic aerosols. Understanding both the sources and sinks of OH is therefore important to address issues related to air quality and climate change. Measurements of total OH reactivity can provide an important test of our understanding of the OH radical budget. Recent measurements of total reactivity in many environments have been greater than calculated based on the measured concentration of VOCs, suggesting that important OH sinks in these environments are not well characterized. Measurements of total OH reactivity were performed in a forested environment during the PROPHET - AMOS field campaign (Program for Research on Oxidants: PHotochemisty, Emissions, and Transport - Atmospheric Measurements of Oxidants in Summer) using the Comparative Reactivity Method (CRM) and the Total OH Loss Rate Method (TOHLM). The site is characterized by large emissions of isoprene and monoterpenes and low anthropogenic influence. Measurements of total OH reactivity using these two techniques agree to within their respective uncertainties, giving confidence in the measured OH reactivity. In addition, measurements of trace gases (VOCs, NOx, O3) were used to perform a comprehensive apportionment of OH sinks. These measurements are used in a chemical model using the Master Chemical Mechanism to calculate the expected OH reactivity. The results will be compared to previous measurements of total OH reactivity at this site.

Polychlorinated biphenyls (PCB's) levels in transformer oils from selected transformers in sensitive areas in the Greater Accra Region

International Nuclear Information System (INIS)

Buah-Kwofie, A.

2009-02-01

Knowledge of PCBs and the adverse effects on humans and the environment have been assessed among Electricity Company of Ghana (ECG) staff members, Volta River Authority (VRA) staff members and the general public. Evidence obtained shows that, Staff members of the technical departments of ECG/VRA (71.4 %) as well as a few welders (16.7 %) have come in contact with the transformer oil that may possibly contain PCBs. About fifty six percent (55.6 %) of the ECG/VRA staff members do not wear any protective gears when working on these transformers thus exposing themselves to PCBs. About twenty seven percent (27.3 %) of the management staff members of ECG/VRA are not aware of the adverse health effects caused by PCBs. Using PCB test kits (CLOR-N-OIL) developed by Dexsil Company of USA, 17 out of the 80 transformers screened for PCB contaminated oils, tested positive as containing PCBs levels greater than 50 ppm. Neutron Activation Analysis and gamma ray spectroscopy using Canberra HPGe detector coupled to MAESTRO 32 software has been used to determine the total chlorine content in 22 of the transformer oil samples screened using the test kits, including the 17 samples that tested positive using the test kits. The total chlorine content measured in the transformer oils that tested positive by the test kit was in the range of 71.34 ± 8.63 with 6 - 7.5 % accuracy. This being deduced that using NAA, total chlorine greater than 71.34 ppm is an indication of PCB contamination. NAA thus provides a faster and efficient way of analyzing transformer oil samples for possible PCB contamination

Unilateral vs one stage bilateral total knee replacement in rheumatoid and osteoarthritis - A comparative study

Directory of Open Access Journals (Sweden)

Kiran E

2005-01-01

Full Text Available Background : A controversy exists regarding simultaneous or staged bilateral total knee replacement. Methods: Fifty patients undergoing simultaneous bilateral and 50 undergoing unilateral total knee arthroplasty were evaluated prospectively to compare the clinical, radiological results and complication rates. Eighty-four patients belonged to ASA category II or III preoperatively. The study included a high proportion of rheumatoid patients and osteoarthritis patients with severe deformities. Results: Bilateral group had greater blood loss and required more blood transfusion, but there was no difference in requirement of postoperative intensive care and the complication rates. Rheumatoid knees had lower pre and postoperative knee score and functional score as compared to osteoarthritic knees. Morbidity and mortality of one stage bilateral knee replacement was no greater than unilateral operation. Conclusion: Simultaneous bilateral knee replacement in younger patients with advanced rheumatoid arthritis is safe and effective

Total-ozone and nitrogen-dioxide measurements at the Molodezhnaya and Mirnyi Antarctic stations during spring 1987-autumn 1988

Energy Technology Data Exchange (ETDEWEB)

Elokhov, A.S.; Gruzdev, A.N. (AN SSSR, Institut Fiziki Atmosfery, Moscow, (USSR))

1991-09-01

Results of measurements of the total-ozone and NO2 content during November-December (Molodezhnaya) and February-April 1988 (Mirnyi) are reported. During the November-December period an irregular total ozone increase was observed, which characterized the filling up of the ozone hole. Stratospheric warming and the total NO2 increase occurred simultaneously. During the summer-autumn period the total NO2 content decreased gradually. The evening total NO2 content was systematically greater than the morning one, which reflects changes in the NO2 abundance from day to night. 12 refs.

The (co-)occurrence of problematic video gaming, substance use, and psychosocial problems in adolescents

OpenAIRE

Van Rooij, AJ; Kuss, DJ; Griffiths, MD; Shorter, GW; Schoenmakers, TM; Van de Mheen, D

2014-01-01

Aims: The current study explored the nature of problematic (addictive) video gaming (PVG) and the association with game type, psychosocial health, and substance use. Methods: Data were collected using a paper and pencil survey in the classroom setting. Three samples were aggregated to achieve a total sample of 8478 unique adolescents. Scales included measures of game use, game type, the Video game Addiction Test (VAT), depressive mood, negative self-esteem, loneliness, social anxiety, educati...

The Role of Value Added Tax on Economic Growth of Ethiopia ...

African Journals Online (AJOL)

The achievement of economic growth is crucial for countries sustainable development. Recently, Value Added Tax (VAT) becomes a major worldwide tax instrument which enhances economic growth. Being a tax levied on the final consumption of goods and services, VAT is collected at each stage of production and ...

2018-05-09T08:04:19Z https://www.ajol.info/index.php/all/oai oai:ojs ...

African Journals Online (AJOL)

article/24359 2018-05-09T08:04:19Z ajfm:ART Equity and VAT in Tanzania. Mugoya, Patrick KD It is normally argued that Value Added Tax (VAT) is essentially regressive in the sense that all consumers pay the same amount of the tax per unit of ...

Review of CD Rom: The Virtual Surgeon: ACL Reconstruction ...

African Journals Online (AJOL)

THE VIRTUAL SURGEON: ACL RECONSTRUCTION Professor George Bentley ChM FRCS, Russell E LVindsor MD, Mr Andrew Williams FRCS(0rth); 4150 + VAT(UK) The Virtual Surgeon - 3D Anatomy of the Knee 469 + VAT(UK). TVF Multimedia Ltd, 375 City Road, London, EClV lNB, UK ...

Total phosphorus recovery in flowback fluids after gelled hydrocarbon fracturing fluid treatments

Energy Technology Data Exchange (ETDEWEB)

Fyten, G.; Houle, P.; Taylor, R.S. [Halliburton Energy Services, Calgary, AB (Canada); Stemler, P.S. [Petro-Canada Oil and Gas Inc., Calgary, AB (Canada); Lemieux, A. [Omnicon Consultants Inc., Calgary, AB (Canada)

2006-07-01

Carbon dioxide miscible hydrocarbon fracturing fluids are used in unconventional gas reservoirs such as tight gas, shale gas, and coalbed methane. These fracturing fluids address phase trapping concerns by using oil-based fracturing fluid technology for use in reservoirs that are water sensitive. This paper addressed the problem of refinery tower fouling caused by volatile phosphorous components found in phosphate ester oil gellants. In order to address costly unplanned refinery shutdowns, a maximum 0.5 ppm volatile phosphorus in crude specification has been proposed. However, this specification is based on average concentrations of phosphorus added to the oil to gel it. The specification also falsely assumes that the oil is phosphorus free to begin with. The authors noted that refinery tower fouling is actually the result of total phosphorus throughput rather than peak concentrations at any one point. This paper focused on the total phosphorus recovery in addition to peak concentrations. It also examined what percentage of the total recovered phosphorus is in fact volatile, since this is the material that plugs the trays. The total per cent recovery of phosphorus originally added as phosphorus based gellant was examined along with the total percent recovery of volatile phosphorus as a function of total phosphorus. The phosphorus concentrations in both new and reused fracturing fluids before addition of gellants was also examined along with the potential explanations for phosphorus concentrations higher than those originally added. It was shown that the first 50 per cent of a hydraulic fracturing fluid flowback can result in recovery of greater than or less than the amount of phosphorus added to that portion of the fracturing fluid. The initial high concentrations of total and volatile phosphorus are greater than the phosphorus concentrations inherent in the system. Therefore, as flowback continues, there would be a rapid decline in the concentration of phosphorus

Greater healthcare utilization and costs among Black persons compared to White persons with aphasia in the North Carolina stroke belt.

Science.gov (United States)

Ellis, Charles; Hardy, Rose Y; Lindrooth, Richard C

2017-05-15

To examine racial differences in healthcare utilization and costs for persons with aphasia (PWA) being treated in acute care hospitals in North Carolina (NC). NC Healthcare Cost and Utilization Project State Inpatient Database (HCUP-SID) data from 2011-2012 were analyzed to examine healthcare utilization and costs of care for stroke patients with aphasia. Analyses emphasized length of stay, charges and cost of general hospital services. Generalized linear models (GLM) were constructed to determine the impact of demographic characteristics, stroke/illness severity, and observed hospital characteristics on utilization and costs. Hospital fixed effects were included to yield within-hospital estimates of disparities. GLM models demonstrated that Blacks with aphasia experienced 1.9days longer lengths of stay compared to Whites with aphasia after controlling for demographic characteristics, 1.4days controlling for stroke/illness severity, 1.2days controlling for observed hospital characteristics, and ~1 extra day controlling for unobserved hospital characteristics. Similarly, Blacks accrued ~$2047 greater total costs compared to Whites after controlling for demographic characteristics, $1659 controlling for stroke/illness severity, $1338 controlling for observed hospital characteristics, and ~$1311 greater total costs after controlling for unobserved hospital characteristics. In the acute hospital setting, Blacks with aphasia utilize greater hospital services during longer hospitalizations and at substantially higher costs in the state of NC. A substantial portion of the adjusted difference was related to the hospital treating the patient. However, even after controlling for the hospital, the differences remained clinically and statistically significant. Copyright © 2017 Elsevier B.V. All rights reserved.

An integrative transcriptomic approach to identify depot differences in genes and microRNAs in adipose tissues from high fat fed mice.

Science.gov (United States)

Wijayatunga, Nadeeja N; Pahlavani, Mandana; Kalupahana, Nishan S; Kottapalli, Kameswara Rao; Gunaratne, Preethi H; Coarfa, Cristian; Ramalingam, Latha; Moustaid-Moussa, Naima

2018-02-06

Obesity contributes to metabolic disorders such as diabetes and cardiovascular disease. Characterization of differences between the main adipose tissue depots, white (WAT) [including subcutaneous (SAT) and visceral adipose tissue (VAT)] and brown adipose tissue (BAT) helps to identify their roles in obesity. Thus, we studied depot-specific differences in whole transcriptome and miRNA profiles of SAT, VAT and BAT from high fat diet (HFD/45% of calories from fat) fed mice using RNA sequencing and small RNA-Seq. Using quantitative real-time polymerase chain reaction, we validated depot-specific differences in endoplasmic reticulum (ER) stress related genes and miRNAs using mice fed a HFD vs. low fat diet (LFD/10% of calories from fat). According to the transcriptomic analysis, lipogenesis, adipogenesis, inflammation, endoplasmic reticulum (ER) stress and unfolded protein response (UPR) were higher in VAT compared to BAT, whereas energy expenditure, fatty acid oxidation and oxidative phosphorylation were higher in BAT than in VAT of the HFD fed mice. In contrast to BAT, ER stress marker genes were significantly upregulated in VAT of HFD fed mice than the LFD fed mice. For the first time, we report depot specific differences in ER stress related miRNAs including; downregulation of miR-125b-5p, upregulation miR-143-3p, and miR-222-3p in VAT following HFD and upregulation of miR-30c-2-3p only in BAT following a HFD in mice than the LFD mice. In conclusion, HFD differentially regulates miRNAs and genes in different adipose depots with significant induction of genes related to lipogenesis, adipogenesis, inflammation, ER stress, and UPR in WAT compared to BAT.

The effect of recombinant human growth hormone with or without rosiglitazone on hepatic fat content in HIV-1-infected individuals: a randomized clinical trial.

Science.gov (United States)

Kotler, Donald P; He, Qing; Engelson, Ellen S; Albu, Jeanine B; Glesby, Marshall J

2016-01-01

Hepatic fat is related to insulin resistance (IR) and visceral adipose tissue (VAT) in HIV+ and uninfected individuals. Growth hormone (GH) reduces VAT but increases IR. We evaluated the effects of recombinant human GH (rhGH) and rosiglitazone (Rosi) on hepatic fat in a substudy of a randomized controlled trial. HIV+ subjects with abdominal obesity and IR (QUICKI≤0.33) were randomized to rhGH 3 mg daily, Rosi 4 mg twice daily, the combination or double placebo. Hepatic fat was measured by magnetic resonance spectroscopy, visceral fat by MRI and IR by frequently sampled intravenous glucose tolerance tests at baseline and week 12. 31 subjects were studied at both time points. Significant correlations between hepatic fat and VAT (r=0.41; P=0.02) and QUICKI (r=0.39; P<0.05) were seen at baseline. IR rose with rhGH but not Rosi. When rhGH treatment groups were combined, hepatic fat expressed as percentage change decreased significantly (P<0.05) but did not change in Rosi (P=0.71). There were no correlations between changes in hepatic fat and VAT (P=0.4) or QUICKI (P=0.6). In a substudy of 21 subjects, a trend was noticed between changes in hepatic fat and serum insulin-like growth factor-1 (IGF-1; P=0.09). Hepatic fat correlates significantly with both VAT and IR, but changes in hepatic fat do not correlate with changes in VAT and glucose metabolism. Hepatic fat content is reduced by rhGH but Rosi has no effect. These results suggest an independent effect of GH or IGF-1 on hepatic fat. The study was registered at Clinicaltrials.gov (NCT00130286).

Improved knee flexion following high-flexion total knee arthroplasty

Directory of Open Access Journals (Sweden)

Lionberger David R

2012-06-01

Full Text Available Abstract Background The application of new techniques and materials in total knee arthroplasty (TKA continue to be a primary focus in orthopedic surgery. The primary aim of the present study is to evaluate post TKA total range of motion (ROM among a group of patients who received a gender specific high-flexion design modification implant compared to a control group of patients who received non-gender specific implants. Methods and results The control group was comprised of 39 TKAs that were recruited pre-operatively and received the non-gender specific implant while the study group consisted of 39 TKAs who received gender specific implants. The study group yielded an improvement in mean post-operative ROM of 21° at 12 months, whereas the mean improvement in ROM among the control group was 11°. Thus, the study group had a 10° increased ROM improvement (91% over the control group (p = 0.00060. In addition, 100% of the subjects with gender specific high-flexion implants achieved greater or equal ROM post-operatively compared to 82% for the control cohort. Lastly, women who exhibited greater pre-operative ROM and lower body mass index (BMI were found to benefit the most with the gender specific prosthesis. Conclusion Our study demonstrates that among subjects with a normal BMI, the gender specific high-flexion knee implant is associated with increased ROM as compared to the non-gender specific non-high-flexion implant designs.

The boreal winter Madden-Julian Oscillation's influence on summertime precipitation in the greater Caribbean

Science.gov (United States)

Curtis, Scott; Gamble, Douglas W.

2016-07-01

Precipitation totals in the greater Caribbean are known to be affected by interannual variability. In particular, dry conditions in the spring-summer have been physically linked to the positive phase of North Atlantic Oscillation (NAO) in the literature. In this study, it was found through regression analysis that an active Madden-Julian Oscillation (MJO) in winter geographically focused over the Maritime Continent contributes to a positive NAO in March via the generation of Rossby waves in the Northern Hemisphere. Specifically, a negative Pacific-North American pattern develops in the winter and transitions to an Atlantic pattern in spring. The positive NAO is a transient feature of this evolving wave train, but a center of significant positive 200 hPa geopotential heights is entrenched over the southeast U.S. throughout the February to May time period and is manifested as high pressure at the surface. The southern flank of this system increases the speeds of the trade winds and leads to a cooling of the Caribbean sea surface temperatures and, thus, convection suppression and reduced precipitation. Thus, this study advances our understanding of the climate of the greater Caribbean by using climate teleconnections to relate the MJO to rainfall in the region.

Greater Occipital Nerve Block for Acute Treatment of Migraine Headache: A Large Retrospective Cohort Study.

Science.gov (United States)

Allen, Sorcha M; Mookadam, Farouk; Cha, Stephen S; Freeman, John A; Starling, Amaal J; Mookadam, Martina

2018-01-01

Greater occipital nerve (GON) blocks are frequently used to treat migraine headaches, although a paucity of supporting clinical evidence exists. The objective of this study was to assess the efficacy of GON block in acute treatment of migraine headache, with a focus on pain relief. This retrospective cohort study was undertaken between January 2009 and August 2014 and included patients who underwent at least 1 GON block and attended at least 1 follow-up appointment. Change in the 11-point numeric pain rating scale (NPRS) was used to assess the response to GON block. Response was defined as "minimal" (50% NPRS point reduction). A total of 562 patients met inclusion criteria; 423 were women (75%). Mean age was 58.6 ± 16.7 years. Of these 562, 459 patients (82%) rated their response to GON block as moderate or significant. No statistically significant relationship existed between previous treatment regimens and response to GON block. GON block was equally effective across the different age and sex groups. Greater occipital block seems to be an effective option for acute management of migraine headache, with promising reductions in pain scores. © Copyright 2018 by the American Board of Family Medicine.

GREATER OMENTUM: MORPHOFUNCTIONAL CHARACTERISTICS AND CLINICAL SIGNIFICANCE IN PEDIATRICS

Directory of Open Access Journals (Sweden)

A.V. Nekrutov

2007-01-01

Full Text Available The review analyzes the structure organization and pathophysiological age specificities of the greater omentum, which determine its uniqueness and functional diversity in a child's organism. the article discusses protective functions of the organ, its role in the development of post operative complications of children, and the usage in children's reconstructive plastic surgery.Key words: greater omentum, omentitis, of post operative complications, children.

Methane. [biosynthesis from manure or analogous substance

Energy Technology Data Exchange (ETDEWEB)

Ducellier, G L.R.; Isman, M A

1949-04-19

CH/sub 4/ is produced by the fermentation of manure or analogous substances in a vat having a dome covering the vat, the lower edge of the dome being immersed in a liquid seal, and the dome being arranged to rise vertically in order to hold the CH/sub 4/ produced.

Pink läks pikemaks... / Margit Tõnson

Index Scriptorium Estoniae

Tõnson, Margit, 1978-

2007-01-01

20. sept. VAT Teatris esietendunud Eesti Muusika ja Teatriakadeemia Lavakunstikooli lavastajate õppesuuna tudengite koolitööst "Pink", mis koosneb kahest iseseisvast loost - Jon Fosse "Talv", lavastaja Robert Annus ja Edward Albee "Loomaaialugu", lavastaja Uku Uusberg. Lisaks küsimus "Aare Toikka, kuidas noored lavastajatudengid VAT Teatri tiiva alla sattusid?"

More features, greater connectivity.

Science.gov (United States)

Hunt, Sarah

2015-09-01

Changes in our political infrastructure, the continuing frailties of our economy, and a stark growth in population, have greatly impacted upon the perceived stability of the NHS. Healthcare teams have had to adapt to these changes, and so too have the technologies upon which they rely to deliver first-class patient care. Here Sarah Hunt, marketing co-ordinator at Aid Call, assesses how the changing healthcare environment has affected one of its fundamental technologies - the nurse call system, argues the case for wireless such systems in terms of what the company claims is greater adaptability to changing needs, and considers the ever-wider range of features and functions available from today's nurse call equipment, particularly via connectivity with both mobile devices, and ancillaries ranging from enuresis sensors to staff attack alert 'badges'.

Greater-than-Class C low-level radioactive waste characterization: Estimated volumes, radionuclide activities, and other characteristics

International Nuclear Information System (INIS)

Hulse, R.A.

1991-08-01

Planning for storage or disposal of greater-than-Class C low-level radioactive waste (GTCC LLW) requires characterization of that waste to estimate volumes, radionuclide activities, and waste forms. Data from existing literature, disposal records, and original research were used to estimate the characteristics and project volumes and radionuclide activities to the year 2035. GTCC LLW is categorized as: nuclear utilities waste, sealed sources waste, DOE-held potential GTCC LLW; and, other generator waste. It has been determined that the largest volume of those wastes, approximately 57%, is generated by nuclear power plants. The Other Generator waste category contributes approximately 10% of the total GTCC LLW volume projected to the year 2035. Waste held by the Department of Energy, which is potential GTCC LLW, accounts for nearly 33% of all waste projected to the year 2035; however, no disposal determination has been made for that waste. Sealed sources are less than 0.2% of the total projected volume of GTCC LLW

A Computer-Based Sustained Visual Attention Test for Pre-School Children: Design, Development and Psychometric Properties

Directory of Open Access Journals (Sweden)

Roohollah Zahedian Nasb

2016-06-01

Full Text Available Background: Sustained visual attention is a prerequisite for learning and memory. The early evaluation of attention in childhood is essential for their school and career success in the future. The aim of this study was to design, development and investigation of psychometric properties (content, face and convergent validity and test-retest and internal consistency reliability of the computer - based sustained visual attention test (SuVAT for healthy preschool children aged 4-6 with their special needs. Methods: This study was carried out in two stages: in the first stage computerbased SuVAT in two versions original and parallel were developed. Then the test-retest and internal consistency reliability using intra-class correlation and Cronbach’s alpha coefficients respectively were examined; Face validity was calculated through ideas gathering from 10 preschool children and content validity evaluated using CVI and CVR method and convergent validity of SuVAT with CPT was assessed using Pearson correlation. Results: The developed test showed a good content and faces validity, and also had excellent test-retest reliability. In addition, the assessment of internal consistency indicated the high internal consistency of the test (Cronbach’s alpha=0.869. SuVAT and CPT test demonstrated a positive correlation upon the convergent validity testing. Conclusion: SuVAT with good reliability and validity could be used as an acceptable sustained attention assessment in preschool children.

Gender differences in the association of visceral and subcutaneous adiposity with adiponectin in African Americans: the Jackson Heart Study

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Bidulescu Aurelian

2013-02-01

Full Text Available Abstract Background Adiponectin, paradoxically reduced in obesity and with lower levels in African Americans (AA, modulates several cardiometabolic risk factors. Because abdominal visceral adipose tissue (VAT, known to be reduced in AA, and subcutaneous adipose tissue (SAT compartments may confer differential metabolic risk profiles, we investigated the associations of VAT and SAT with serum adiponectin, separately by gender, with the hypothesis that VAT is more strongly inversely associated with adiponectin than SAT. Methods Participants from the Jackson Heart Study, an ongoing cohort of AA (n = 2,799; 64% women; mean age, 55 ± 11 years underwent computer tomography assessment of SAT and VAT volumes, and had stored serum specimens analyzed for adiponectin levels. These levels were examined by gender in relation to increments of VAT and SAT. Results Compared to women, men had significantly lower mean levels of adiponectin (3.9 ± 3.0 μg/mL vs. 6.0 ± 4.4 μg/mL; p 3 vs. 2,668 ± 968 cm3; p 3 vs. 801 ± 363 cm3; p  Conclusion In African Americans, abdominal visceral adipose tissue had an inverse association with serum adiponectin concentrations only among women. Abdominal subcutaneous adipose tissue appeared as a protective fat depot in men.

Adolescent gambling in greater Athens area: a cross-sectional study.

Science.gov (United States)

Anagnostopoulos, Dimitris C; Lazaratou, Helen; Paleologou, Mina P; Peppou, Lily E; Economou, Marina; Malliori, Melpomeni; Papadimitriou, George N; Papageorgiou, Charalampos

2017-11-01

Problem gambling in adolescents has recently emerged as a pressing public health concern. In this context and in light of the pervasive financial crisis in Greece, the present study aimed to explore adolescents' gambling involvement in Athens region to estimate the prevalence of its problematic form and to identify its risk/protective factors. A total of 2141 students were recruited from a representative sample of 51 schools located in greater Athens area. The presence of problem gambling was assessed through the use of the DSM-IV-MR-J questionnaire. Data were collected in the form of a self-reported questionnaire during one school hour. Results indicate that 1-year prevalence of high severity problem gambling was found to be 5.6%. Regarding the risk factors for problem gambling; male gender, parental engagement with gambling activities, living without the parents, low grades at school, foreign nationality and the referent absence of availability of food in the household, increased the risk of suffering from the disorder. Gambling behavior among adolescents constitutes a problem in Greece and highlights the need for designing and implementing appropriate preventive interventions, especially amid the ongoing financial crisis.

Greater Sudbury fuel efficient driving handbook

Energy Technology Data Exchange (ETDEWEB)

NONE

2009-12-15

Reducing the amount of fuel that people use for personal driving saves money, improves local air quality, and reduces personal contributions to climate change. This handbook was developed to be used as a tool for a fuel efficient driving pilot program in Greater Sudbury in 2009-2010. Specifically, the purpose of the handbook was to provide greater Sudbury drivers with information on how to drive and maintain their personal vehicles in order to maximize fuel efficiency. The handbook also provides tips for purchasing fuel efficient vehicles. It outlines the benefits of fuel maximization, with particular reference to reducing contributions to climate change; reducing emissions of air pollutants; safe driving; and money savings. Some tips for efficient driving are to avoid aggressive driving; use cruise control; plan trips; and remove excess weight. Tips for efficient winter driving are to avoid idling to warm up the engine; use a block heater; remove snow and ice; use snow tires; and check tire pressure. The importance of car maintenance and tire pressure was emphasized. The handbook also explains how fuel consumption ratings are developed by vehicle manufacturers. refs., figs.

Characterization of suspended solids and total phosphorus loadings from small watersheds in Wisconsin

Science.gov (United States)

Danz, Mari E.; Corsi, Steven R.; Graczyk, David J.; Bannerman, Roger T.

2010-01-01

early summer (June through July), with fall (October through November) and early winter (December through January) contributing the smallest loadings. The Northern Lakes and Forests/North Central Hardwoods region had some substantial loading in September. There was a similar pattern for total phosphorus loading in all regions, with the pattern somewhat less pronounced in urban watersheds. As with the loading results, average monthly streamflow values were greatest in late winter, spring, and early summer, with the lowest values typically in fall and early winter. Loading contributions were greater from stormflow than from base flow in all instances, except total phosphorus in the Northern Lakes and Forests/North Central Hardwoods region, which had equal or greater base-flow contribution for several months. Base flow constituted a greater percentage of the total streamflow than stormflow in all rural watersheds for all regions. Only a few storms each year dominated the annual loading totals for solids and total phosphorus. When daily loading values were ranked for the year, all regions reached 50 percent of the annual solids loading in the 5 highest loading days and nearly 50 percent of the annual total phosphorus loading in the 14 highest loading days.

7 CFR 58.128 - Equipment and utensils.

Science.gov (United States)

2010-01-01

... cleaning and inspection. Any opening at the top of the tank or vat including the entrance of the shaft... equally noncorrosive metal it shall be properly tinned over the entire surface. Sanitary seal assemblies at the shaft ends of coil vats shall be of the removable type, except that existing equipment not...

Capture, transport and husbandry of Naucrates ductor

Directory of Open Access Journals (Sweden)

Francisco De Vaissier Ferro Mauricio

2014-06-01

Full Text Available This is a report on the capture, transport, and husbandry of Naucrates ductor, also known as pilot fish. Approximately 100 individuals were collected by Flying Sharks in the sequence of an order from multiple public aquaria. Because there is vely limited knowledge about the capture, husbandry and transport of this species, it became necessary to investigate how to achieve this while causing minimum mortality and ensuring animal welfare. Collection was done in the Azores Islands, approximately 20 nautical miles from Horta, using a standard fishing rod and hook, after attracting blue sharks with bait. The animals were transported to shore inside plastic vats and introduced to large 2,0 m wide holding tanks at the Porto Pim Aquarium, where they were held for 2 months. Multiple treatments for wounds, and parasite control, were used and are reported. Transport to mainland Portugal was done aboard a commercial vessel, inside 2,4 m wide polyethylene vats with mechanical and chemical filtration consisting of cartridge filters and protein skimmers, respectively. Once docked on shore the 40 ft. container was then moved to a truck, where it traveled to Spain and France over 6 days. The total transport time of those animals delivered last was therefore 11 days and no mortalities were sustained in transit. The remaining animals were kept in Peniche for 2 more months inside 2,4 m wide polyethylene vats, with filtration consisting of cartridge and protein skimmers, as well as daily water changes. Multiple challenges faced during the collection, holding and transport processes are presented in this presentation.

Effects of Dietary Fructose Restriction on Liver Fat, De Novo Lipogenesis, and Insulin Kinetics in Children With Obesity.

Science.gov (United States)

Schwarz, Jean-Marc; Noworolski, Susan M; Erkin-Cakmak, Ayca; Korn, Natalie J; Wen, Michael J; Tai, Viva W; Jones, Grace M; Palii, Sergiu P; Velasco-Alin, Moises; Pan, Karen; Patterson, Bruce W; Gugliucci, Alejandro; Lustig, Robert H; Mulligan, Kathleen

2017-09-01

Consumption of sugar is associated with obesity, type 2 diabetes mellitus, nonalcoholic fatty liver disease, and cardiovascular disease. The conversion of fructose to fat in liver (de novo lipogenesis [DNL]) may be a modifiable pathogenetic pathway. We determined the effect of 9 days of isocaloric fructose restriction on DNL, liver fat, visceral fat (VAT), subcutaneous fat, and insulin kinetics in obese Latino and African American children with habitual high sugar consumption (fructose intake >50 g/d). Children (9-18 years old; n = 41) had all meals provided for 9 days with the same energy and macronutrient composition as their standard diet, but with starch substituted for sugar, yielding a final fructose content of 4% of total kilocalories. Metabolic assessments were performed before and after fructose restriction. Liver fat, VAT, and subcutaneous fat were determined by magnetic resonance spectroscopy and imaging. The fractional DNL area under the curve value was measured using stable isotope tracers and gas chromatography/mass spectrometry. Insulin kinetics were calculated from oral glucose tolerance tests. Paired analyses compared change from day 0 to day 10 within each child. Compared with baseline, on day 10, liver fat decreased from a median of 7.2% (interquartile range [IQR], 2.5%-14.8%) to 3.8% (IQR, 1.7%-15.5%) (P fructose restriction decreased liver fat, VAT, and DNL, and improved insulin kinetics in children with obesity. These findings support efforts to reduce sugar consumption. ClinicalTrials.gov Number: NCT01200043. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

The Active Structure of the Greater Dead Sea Basin

Science.gov (United States)

Shamir, G.

2002-12-01

The Greater Dead Sea Basin (GDSB) is a 220km long depression situated along the southern section of the Dead Sea Transform (DST), between two structurally and gravitationally elevated points, Wadi Malih in the north and Paran fault zone in the south. In its center is the Dead Sea basin 'sensu strictu' (DSB), which has been described since the 1970s as a pull-apart basin at a left step-over along the DST. However, several observations, or their lack thereof, contradict this scheme, e.g. (i) It is not supported by recent seismological and geomorphic data; (ii) It does not explain the fault pattern and mixed sinistral and dextral offset along the DSB western boundary; (iii) It does not simply explain the presence of intense deformation outside the presumed fault step zone; (iv) It is inconsistent with the orientation of seismically active faults within the Dead Sea and Jericho Valley; (v) The length of the DSB exceeds the total offset along the Dead Sea Transform, while its subsidence is about the age of the DST. In this study, newly acquired and analyzed data (high resolution seismic reflection and earthquake relocation and fault plane solutions) has been integrated with previously published data (structural mapping, fracture orientation distribution, Bouguer anomaly maps, sinkhole distribution, geomorphic lineaments). The results show that the GDSB is dominated by two active fault systems, one trending NNE and showing normal-dextral motion, the other trending NW. These systems are identified by earthquake activity, seismic reflection observations, alignment of recent sinkholes, and distribution of Bouguer anomaly gradients. As a result, the intra-basin structure is of a series of rectangular blocks. The dextral slip component along NNE trending faults, the mixed sense of lateral offset along the western boundary of the DSB and temporal change in fracture orientation in the Jericho Valley suggest that the intra-basin blocks have rotated counterclockwise since the

Greater Trochanteric Fixation Using a Cable System for Partial Hip Arthroplasty: A Clinical and Finite Element Analysis

Directory of Open Access Journals (Sweden)

Fırat Ozan

2014-01-01

Full Text Available The aim of the study was to investigate the efficacy of greater trochanteric fixation using a multifilament cable to ensure abductor lever arm continuity in patients with a proximal femoral fracture undergoing partial hip arthroplasty. Mean age of the patients (12 men, 20 women was 84.12 years. Mean follow-up was 13.06 months. Fixation of the dislocated greater trochanter with or without a cable following load application was assessed by finite element analysis (FEA. Radiological evaluation was based on the distance between the fracture and the union site. Harris hip score was used to evaluate final results: outcomes were excellent in 7 patients (21.8%, good in 17 patients (53.1%, average in 5 patients (15.6%, and poor in 1 patient (9.3%. Mean abduction angle was 20.21°. Union was achieved in 14 patients (43.7%, fibrous union in 12 (37.5%, and no union in 6 (18.7%. FEA showed that the maximum total displacement of the greater trochanter decreased when the fractured bone was fixed with a cable. As the force applied to the cable increased, the displacement of the fractured trochanter decreased. This technique ensures continuity of the abductor lever arm in patients with a proximal femoral fracture who are undergoing partial hip arthroplasty surgery.

Ingestion of a natural mineral-rich water in an animal model of metabolic syndrome: effects in insulin signalling and endoplasmic reticulum stress.

Science.gov (United States)

Pereira, Cidália D; Passos, Emanuel; Severo, Milton; Vitó, Isabel; Wen, Xiaogang; Carneiro, Fátima; Gomes, Pedro; Monteiro, Rosário; Martins, Maria J

2016-05-01

High-fructose and/or low-mineral diets are relevant in metabolic syndrome (MS) development. Insulin resistance (IR) represents a central mechanism in MS development. Glucocorticoid signalling dysfunction and endoplasmic reticulum (ER) and oxidative stresses strongly contribute to IR and associate with MS. We have described that natural mineral-rich water ingestion delays fructose-induced MS development, modulates fructose effects on the redox state and glucocorticoid signalling and increases sirtuin 1 expression. Here, we investigated mineral-rich water ingestion effects on insulin signalling and ER homeostasis of fructose-fed rats. Adult male Sprague-Dawley rats had free access to standard-chow diet and different drinking solutions (8 weeks): tap water (CONT), 10%-fructose/tap water (FRUCT) or 10%-fructose/mineral-rich water (FRUCTMIN). Hepatic and adipose (visceral, VAT) insulin signalling and hepatic ER homeostasis (Western blot or PCR) as well as hepatic lipid accumulation were evaluated. Hepatic p-IRS1Ser307/IRS1 (tendency), p-IRS1Ser307, total JNK and (activated IRE1α)/(activated JNK) decreased with fructose ingestion, while p-JNK tended to increase; mineral-rich water ingestion, totally or partially, reverted all these effects. Total PERK, p-eIF2α (tendency) and total IRS1 (tendency) decreased in both fructose-fed groups. p-ERK/ERK and total IRE1α increasing tendencies in FRUCT became significant in FRUCTMIN (similar pattern for lipid area). Additionally, unspliced-XBP1 increased with mineral-rich water. In VAT, total ERK fructose-induced increase was partially prevented in FRUCTMIN. Mineral-rich water modulation of fructose-induced effects on insulin signalling and ER homeostasis matches the better metabolic profile previously reported. Increased p-ERK/ERK, adding to decreased IRE1α activation, and increased unspliced-XBP1 and lipid area may protect against oxidative stress and IR development in FRUCTMIN.

Outcomes of Total Knee Arthroplasty in Patients With Poliomyelitis.

Science.gov (United States)

Gan, Zhi-Wei Jonathan; Pang, Hee Nee

2016-11-01

We report our experience with outcomes of poliomyelitis in the Asian population. Sixteen total knee replacements in 14 patients with polio-affected knees were followed up for at least 18 months. Follow-up assessment included scoring with the American Knee Society Score (AKSS), Oxford knee score, and Short Form 36 Health Survey scores. The mean AKSS improved from 25.59 preoperatively to 82.94 at 24 months, with greater improvement in the knee score. The mean Oxford knee score improved from 40.82 preoperatively to 20.53 at 24 months. The mean AKSS pain score rose from 2.35 to 47.66 at 24 months. The Short Form 36 Health Survey physical functioning and bodily pain scores improved for all patients. Primary total knee arthroplasty of poliomyelitis-affected limbs shows good outcomes, improving quality of life, and decreasing pain. Copyright © 2016 Elsevier Inc. All rights reserved.

Greater general startle reflex is associated with greater anxiety levels: a correlational study on 111 young women

Directory of Open Access Journals (Sweden)

Eleonora ePoli

2015-02-01

Full Text Available Startle eyeblink reflex is a valid non-invasive tool for studying attention, emotion and psychiatric disorders. In the absence of any experimental manipulation, the general (or baseline startle reflex shows a high inter-individual variability, which is often considered task-irrelevant and therefore normalized across participants. Unlike the above view, we hypothesized that greater general startle magnitude is related to participants’ higher anxiety level. 111 healthy young women, after completing the State-Trait Anxiety Inventory, were randomly administered 10 acoustic white noise probes (50 ms, 100 dBA acoustic level while integrated EMG from left and right orbicularis oculi was recorded. Results showed that participants with greater state anxiety levels exhibited larger startle reflex magnitude from the left eye (r109=0.23, p<0.05. Furthermore, individuals who perceived the acoustic probe as more aversive reported the largest anxiety scores (r109=0.28, p<0.05 and had the largest eyeblinks, especially in the left eye (r109 = 0.34, p<0.001. Results suggest that general startle may represent a valid tool for studying the neural excitability underlying anxiety and emotional dysfunction in neurological and mental disorders.

Cognitively Engaging Activity is Associated with Greater Cortical and Subcortical Volumes

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Talia R. Seider

2016-05-01

Full Text Available As the population ages and dementia becomes a growing healthcare concern, it is increasingly important to identify targets for intervention to delay or attenuate cognitive decline. Research has shown that the most successful interventions aim at altering lifestyle factors. Thus, this study examined how involvement in physical, cognitive, and social activity is related to brain structure in older adults. Sixty-five adults (mean age = 71.4 years, standard deviation = 8.9 received the Community Healthy Activities Model Program for Seniors (CHAMPS, a questionnaire that polls everyday activities in which older adults may be involved, and also underwent structural magnetic resonance imaging. Stepwise regression with backwards selection was used to predict weekly time spent in either social, cognitive, light physical, or heavy physical activity from the volume of one of the cortical or subcortical regions of interest (corrected by intracranial volume as well as age, education, and gender as control variables. Regressions revealed that more time spent in cognitive activity was associated with greater volumes of all brain regions studied: total cortex (β = .289, p = .014, frontal (β = .276, p = .019, parietal (β = .305, p = .009, temporal (β = .275, p = .020, and occipital (β = .256, p = .030 lobes, and thalamus (β = .310, p = .010, caudate (β = .233, p = .049, hippocampus (β = .286, p = .017, and amygdala (β = .336, p = .004. These effects remained even after accounting for the positive association between cognitive activity and education. No other activity variable was associated with brain volumes. Results indicate that time spent in cognitively engaging activity is associated with greater cortical and subcortical brain volume. Findings suggest that interventions aimed at increasing levels of cognitive activity may delay cognitive consequences of aging and decrease the risk of developing dementia.

Epidemiological link of a major cholera outbreak in Greater Accra region of Ghana, 2014.

Science.gov (United States)

Ohene-Adjei, Kennedy; Kenu, Ernest; Bandoh, Delia Akosua; Addo, Prince Nii Ossah; Noora, Charles Lwanga; Nortey, Priscillia; Afari, Edwin Andrew

2017-10-11

Cholera remains an important public health challenge globally. Several pandemics have occurred in different parts of the world and have been epidemiologically linked by different researchers to illustrate how the cases were spread and how they were related to index cases. Even though the risk factors associated with the 2014 cholera outbreak were investigated extensively, the link between index cases and the source of infection was not investigated to help break the transmission process. This study sought to show how the index cases from various districts of the Greater Accra Region may have been linked. We carried out a descriptive cross sectional study to investigate the epidemiological link of the 2014 cholera outbreak in the Greater Accra region of Ghana. An extensive review of all district records on cholera cases in the Greater Accra region was carried out. Index cases were identified with the help of line lists. Univariate analyses were expressed as frequency distributions, percentages, mean ± Standard Deviation, and rates (attack rates, case-fatality rates etc.) as appropriate. Maps were drawn using Arc GIS and Epi info software to describe the pattern of transmission. Up to 20,199 cholera cases were recorded. Sixty percent of the cases were between 20 and 40 years and about 58% (11,694) of the total cases were males. Almost 50% of the cases occurred in the Accra Metro district. Two-thirds of the index cases ate food prepared outside their home and had visited the Accra Metropolis. The 2014 cholera outbreak can be described as a propagated source outbreak linked to the Accra Metropolis. The link between index cases and the source of infection, if investigated earlier could have helped break the transmission process. Such investigations also inform decision-making about the appropriate interventions to be instituted to prevent subsequent outbreaks.

Conversion total hip arthroplasty: Primary or revision total hip arthroplasty

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Schwarzkopf, Ran; Baghoolizadeh, Mahta

2015-01-01

Total hip arthroplasty (THA) is an increasingly common procedure among elderly individuals. Although conversion THA is currently bundled in a diagnosis related group (DRG) with primary THA, there is a lack of literature supporting this classification and it has yet to be identified whether conversion THA better resembles primary or revision THA. This editorial analyzed the intraoperative and postoperative factors and functional outcomes following conversion THA, primary THA, and revision THA to understand whether the characteristics of conversion THA resemble one procedure or the other, or are possibly somewhere in between. The analysis revealed that conversion THA requires more resources both intraoperatively and postoperatively than primary THA. Furthermore, patients undergoing conversion THA present with poorer functional outcomes in the long run. Patients undergoing conversion THA better resemble revision THA patients than primary THA patients. As such, patients undergoing conversion THA should not be likened to patients undergoing primary THA when determining risk stratification and reimbursement rates. Conversion THA procedures should be planned accordingly with proper anticipation of the greater needs both in the operating room, and for in-patient and follow-up care. We suggest that conversion THA be reclassified in the same DRG with revision THA as opposed to primary THA as a step towards better allocation of healthcare resources for conversion hip arthroplasties. PMID:26601055

Observations of territorial breeding common ravens caching eggs of greater sage-grouse

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Howe, Kristy B.; Coates, Peter S.

2015-01-01

Previous investigations using continuous video monitoring of greater sage-grouse Centrocercus urophasianus nests have unambiguously identified common ravens Corvus corax as an important egg predator within the western United States. The quantity of greater sage-grouse eggs an individual common raven consumes during the nesting period and the extent to which common ravens actively hunt greater sage-grouse nests are largely unknown. However, some evidence suggests that territorial breeding common ravens, rather than nonbreeding transients, are most likely responsible for nest depredations. We describe greater sage-grouse egg depredation observations obtained opportunistically from three common raven nests located in Idaho and Nevada where depredated greater sage-grouse eggs were found at or in the immediate vicinity of the nest site, including the caching of eggs in nearby rock crevices. We opportunistically monitored these nests by counting and removing depredated eggs and shell fragments from the nest sites during each visit to determine the extent to which the common raven pairs preyed on greater sage-grouse eggs. To our knowledge, our observations represent the first evidence that breeding, territorial pairs of common ravens cache greater sage-grouse eggs and are capable of depredating multiple greater sage-grouse nests.

Association of Changes in Abdominal Fat and Cardiovascular Risk Factors

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Lee, Jane J.; Pedley, Alison; Hoffmann, Udo; Massaro, Joseph M.; Fox, Caroline S.

2017-01-01

BACKGROUND Subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) are associated with adverse cardiometabolic risk profiles. OBJECTIVES This study explored the degree to which changes in abdominal fat quantity and quality are associated with changes in cardiovascular disease (CVD) risk factors. METHODS Study participants (n = 1,106; 44.1% women; mean baseline age 45.1 years) were drawn from the Framingham Heart Study Third Generation cohort who participated in the computed tomography (CT) substudy Exams 1 and 2. Participants were followed for 6.1 years on average. Abdominal adipose tissue volume in cm3 and attenuation in Hounsfield units (HU) were determined by CT-acquired abdominal scans. RESULTS The mean fat volume change was an increase of 602 cm3 for SAT and an increase of 703 cm3 for VAT; the mean fat attenuation change was a decrease of 5.5HU for SAT and an increase of 0.07 HU for VAT. An increase in fat volume and decrease in fat attenuation were associated with adverse changes in CVD risk factors. An additional 500 cm3 increase in fat volume was associated with incident hypertension (odds ratio [OR]: 1.21 for SAT; OR: 1.30 for VAT), hypertriglyceridemia (OR: 1.15 for SAT; OR: 1.56 for VAT), and metabolic syndrome (OR: 1.43 for SAT; OR: 1.82 for VAT; all p abdominal adipose tissue attenuation. Most associations remained significant even after further accounting for body mass index change, waist circumference change, or respective abdominal adipose tissue volumes. CONCLUSIONS Increasing accumulation of fat quantity and decreasing fat attenuation are associated with worsening of CVD risk factors beyond the associations with generalized adiposity, central adiposity, or respective adipose tissue volumes. PMID:27687192

Association of Changes in Abdominal Fat Quantity and Quality With Incident Cardiovascular Disease Risk Factors.

Science.gov (United States)

Lee, Jane J; Pedley, Alison; Hoffmann, Udo; Massaro, Joseph M; Fox, Caroline S

2016-10-04

Subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) are associated with adverse cardiometabolic risk profiles. This study explored the degree to which changes in abdominal fat quantity and quality are associated with changes in cardiovascular disease (CVD) risk factors. Study participants (n = 1,106; 44.1% women; mean baseline age 45.1 years) were drawn from the Framingham Heart Study Third Generation cohort who participated in the computed tomography (CT) substudy Exams 1 and 2. Participants were followed for 6.1 years on average. Abdominal adipose tissue volume in cm(3) and attenuation in Hounsfield units (HU) were determined by CT-acquired abdominal scans. The mean fat volume change was an increase of 602 cm(3) for SAT and an increase of 703 cm(3) for VAT; the mean fat attenuation change was a decrease of 5.5 HU for SAT and an increase of 0.07 HU for VAT. An increase in fat volume and decrease in fat attenuation were associated with adverse changes in CVD risk factors. An additional 500 cm(3) increase in fat volume was associated with incident hypertension (odds ratio [OR]: 1.21 for SAT; OR: 1.30 for VAT), hypertriglyceridemia (OR: 1.15 for SAT; OR: 1.56 for VAT), and metabolic syndrome (OR: 1.43 for SAT; OR: 1.82 for VAT; all p abdominal adipose tissue attenuation. Most associations remained significant even after further accounting for body mass index change, waist circumference change, or respective abdominal adipose tissue volumes. Increasing accumulation of fat quantity and decreasing fat attenuation are associated with worsening of CVD risk factors beyond the associations with generalized adiposity, central adiposity, or respective adipose tissue volumes. Published by Elsevier Inc.

Video-assisted thoracic surgery lobectomy does not offer any functional recovery advantage in comparison to the open approach 3 months after the operation: a case matched analysis†.

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Salati, Michele; Brunelli, Alessandro; Xiumè, Francesco; Monteverde, Marco; Sabbatini, Armando; Tiberi, Michela; Pompili, Cecilia; Palloni, Roberto; Refai, Majed

2017-06-01

The objective of the present study was to compare functional loss [forced expiratory volume in one second to forced vital capacity ratio (FEV1), DLCO and VO2max reduction] after VATS versus open lobectomies. We performed a prospective observational study on 195 patients who had a pulmonary lobectomy from June 2010 to November 2014 and who were able to complete a 3-months functional evaluation follow-up program. Since the VATS technique was our first choice for performing lobectomies from January 2012, we divided the patients into two groups: the OPEN group (112 patients) and the VATS group (83 patients). The open approach was intended as a muscle sparing/nerve sparing lateral thoracotomy. Fourteen baseline factors were used to construct a propensity score to match the VATS-group patients with their OPEN-group counterparts. These two matched groups were then compared in terms of reduction of FEV1, DLCO and VO2max (Mann-Whitney test). The propensity score analysis yielded 83 well-matched pairs of OPEN and VATS patients. In both groups, 3 months postoperatively, we found a reduction in FEV1, DLCO and VO2max values (OPEN patients: FEV1-10%, DLCO -11.9%, VO2max - 5.5%; VATS patients: FEV1-7.2%, DLCO-10.6%, VO2max-6.9%). The reductions in FEV1, DLCO and VO2max were similar to those in the two matched groups, with a Cohen effect size offer any advantages in terms of FEV1, DLCO and exercise capacity recovery in comparison to the muscle-sparing thoracotomy approach. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Effect of Electroacupuncture on Visceral and Hepatic Fat in Women with Abdominal Obesity: A Randomized Controlled Study Based on Magnetic Resonance Imaging.

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Lei, Hong; Chen, Xiao; Liu, Shuyun; Chen, Zhenyan

2017-04-01

Visceral adipose tissue (VAT) and hepatic fat deposition are the most important risk factors for women's health. Acupuncture, including electroacupuncture (EA), is used to treat obesity throughout the world. The effect of EA is evaluated mainly by body mass index (BMI) and waist circumference (WC). Few studies have assessed its effect in reducing VAT volume and hepatic fat fraction (HFF) based on an exact measurement method such as magnetic resonance imaging (MRI). This study aimed to resolve this issue. Thirty subjects were randomly divided into two groups. The control group (n = 15) did not receive any intervention and maintained a normal diet and their usual exercise habits. The treatment group (n = 15) received EA three times a week for 3 months. BMI and WC were measured using different devices. VAT and HFF were measured by MRI and calculated by related software before and after the intervention. A marked difference was evident in group that received EA treatment in the following tests. The differences in BMI (U = 21.00, p treatment group were distinct and significant compared with those of the control group. Three months later, the treatment group showed a lower BMI (W = 91.00, p = 0.001), WC (t = 4.755, p treatment group showed a lower VAT volume (t = 60.00, p = 0.029) after 3 months of treatment. After 3 months, the control group showed higher mean HFF (t = -2.900, p = 0.012) and VAT volume (W = 11.50, p = 0.006) compared with their initial levels. Based on MRI evaluation, this randomized controlled study proved that EA treatment reduces BMI and WC as well as VAT volume and HFF in women with abdominal obesity.

The effect of recombinant human growth hormone with or without rosiglitazone on hepatic fat content in HIV-1 infected individuals; a randomized clinical trial

Science.gov (United States)

Kotler, Donald P; He, Qing; Engelson, Ellen S; Albu, Jeanine B; Glesby, Marshall J

2016-01-01

Background Hepatic fat is related to insulin resistance (IR) and visceral adipose tissue (VAT) in HIV+ and uninfected individuals. Growth hormone (GH) reduces VAT but increases IR. We evaluated the effects of recombinant human GH (rhGH) and rosiglitazone (Rosi) on hepatic fat in a substudy of a randomized controlled trial. Methods HIV+ subjects with abdominal obesity and IR (QUICKI ≤ 0.33) were randomized to rhGH 3 mg daily, Rosi 4 mg twice daily, the combination, or double placebo. Hepatic fat was measured by magnetic resonance spectroscopy (MRS), visceral fat by MRI, and IR by frequently sampled IV glucose tolerance tests at baseline and week 12. Results 31 subjects were studied at both time points. Significant correlations between hepatic fat and VAT (r = 0.41, p=0.02) and QUICKI (r = 0.39, p<0.05) were seen at baseline. Insulin resistance rose with rhGH but not Rosi. When rhGH treatment groups were combined, hepatic fat expressed as percent change decreased significantly (p<0.05) but did not change in Rosi (p=0.71). There were no correlations between changes in hepatic fat and VAT (p=0.4) or QUICKI (p=0.6). In a substudy of 21 subjects, a trend was noticed between changes in hepatic fat and serum IGF-1 (p=0.09). Conclusions Hepatic fat correlates significantly with both VAT and IR, but changes in hepatic fat do not correlate with changes in VAT and glucose metabolism. Hepatic fat content is reduced by rhGH but Rosi has no effect. These results suggest an independent effect of growth hormone or IGF-1 on hepatic fat. The study was registered at Clinicaltrials.gov (NCT00130286). PMID:25536669

Comparative Education in Greater China: Contexts, Characteristics, Contrasts and Contributions.

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Bray, Mark; Qin, Gui

2001-01-01

The evolution of comparative education in Greater China (mainland China, Taiwan, Hong Kong, and Macau) has been influenced by size, culture, political ideologies, standard of living, and colonialism. Similarities and differences in conceptions of comparative education are identified among the four components and between Greater China and other…

Active convergence between the Lesser and Greater Caucasus in Georgia: Constraints on the tectonic evolution of the Lesser-Greater Caucasus continental collision

Science.gov (United States)

Sokhadze, G.; Floyd, M.; Godoladze, T.; King, R.; Cowgill, E. S.; Javakhishvili, Z.; Hahubia, G.; Reilinger, R.

2018-01-01

We present and interpret newly determined site motions derived from GPS observations made from 2008 through 2016 in the Republic of Georgia, which constrain the rate and locus of active shortening in the Lesser-Greater Caucasus continental collision zone. Observation sites are located along two ∼160 km-long profiles crossing the Lesser-Greater Caucasus boundary zone: one crossing the Rioni Basin in western Georgia and the other crossing further east near the longitude of Tbilisi. Convergence across the Rioni Basin Profile occurs along the southern margin of the Greater Caucasus, near the surface trace of the north-dipping Main Caucasus Thrust Fault (MCTF) system, and is consistent with strain accumulation on the fault that generated the 1991 MW6.9 Racha earthquake. In contrast, convergence along the Tbilisi Profile occurs near Tbilisi and the northern boundary of the Lesser Caucasus (near the south-dipping Lesser Caucasus Thrust Fault), approximately 50-70 km south of the MCTF, which is inactive within the resolution of geodetic observations (< ± 0.5 mm/yr) at the location of the Tbilisi Profile. We suggest that the southward offset of convergence along strike of the range is related to the incipient collision of the Lesser-Greater Caucasus, and closing of the intervening Kura Basin, which is most advanced along this segment of the collision zone. The identification of active shortening near Tbilisi requires a reevaluation of seismic hazards in this area.

Value Added Tax Gap in the Czech Republic

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Jana Stavjaňová

2014-01-01

Full Text Available The paper deals with an estimation of tax evasion of value added tax in the Czech Republic during 2006–2012. For the estimation I have used the concept of tax gap which is based on a comparison of the theoretical tax liability in the economy with the actual tax receipts. According to my results the VAT gap in the Czech Republic gradually increased during the observed period and it is more than CZK 100 billion in the last three years. The most significant growth of VAT gap occurred between the years 2007 and 2008 and between 2011 and 2012 when the reduced VAT rate was increased by 4 percentage points. The second part of the paper focuses on impact of my estimates on tax policy of the Czech Republic. I discuss two different possibilities how the additional revenue gained from VAT gap reduction could be used – either to decrease the government deficit and therefore to meet the Maastricht criteria or to decrease tax burden on labour which influences particularly low income workers.

Evaluation of the Function and Quality of Life after Total Hip Arthroplasty by Different Approaches

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Paulo Araújo

2017-09-01

Conclusion: After 24 months post total hip arthroplasty there are no differences between the two approaches with regard to function or quality of life. However, the patients operated by the anterolateral approach had greater muscle strength deficits and higher percentage of positive Trendelenburg test.

Why shorter half-times of repair lead to greater damage in pulsed brachytherapy

International Nuclear Information System (INIS)

Fowler, J.F.

1993-01-01

Pulsed brachytherapy consists of replacing continuous irradiation at low dose-rate with a series of medium dose-rate fractions in the same overall time and to the same total dose. For example, pulses of 1 Gy given every 2 hr or 2 Gy given every 4 hr would deliver the same 70 Gy in 140 hr as continuous irradiation at 0.5 Gy/hr. If higher dose-rates are used, even with gaps between the pulses, the biological effects are always greater. Provided that dose rates in the pulse do not exceed 3 Gy/hr, and provided that pulses are given as often as every 2 hr, the inevitable increases of biological effect are no larger than a few percent (of biologically effective dose or extrapolated response dose). However, these increases are more likely to exceed 10% (and thus become clinically significant) if the half-time of repair of sublethal damage is short (less than 1 hr) rather than long. This somewhat unexpected finding is explained in detail here. The rise and fall of Biologically Effective Dose (and hence of Relative Effectiveness, for a constant dose in each pulse) is calculated during and after single pulses, assuming a range of values of T 1/2 , the half-time of sublethal damage repair. The area under each curve is proportional to Biologically Effective Dose and therefore to log cell kill. Pulses at 3 Gy/hr do yield greater biological effect (dose x integrated Relative Effectiveness) than lower dose-rate pulses or continuous irradiation at 0.5 Gy/hr. The contrast is greater for the short T 1/2 of 0.5 hr than for the longer T 1/2 of 1.5 hr. More biological damage will be done (compared with traditional low dose rate brachytherapy) in tissues with short T 1/2 (0.1-1 hr) than in tissues with longer T 1/2 values. 8 refs., 3 figs

125I Monotherapy Using D90 Implant Doses of 180 Gy or Greater

International Nuclear Information System (INIS)

Kao, Johnny; Stone, Nelson N.; Lavaf, Amir; Dumane, Vishruta; Cesaretti, Jamie A.; Stock, Richard G.

2008-01-01

Purpose: The purpose of this study was to characterize the oncologic results and toxicity profile of patients treated with 125 I implants using the dose delivered to 90% of the gland from the dose-volume histogram (D90) of greater than 144 Gy. Methods and Materials: From June 1995 to Feb 2005, a total of 643 patients were treated with 125 I monotherapy for T1-T2 prostate cancer with a D90 of 180 Gy or greater (median, 197 Gy; range, 180-267 Gy). Implantations were performed using a real-time ultrasound-guided seed-placement method and intraoperative dosimetry to optimize target coverage and homogeneity by using modified peripheral loading. We analyzed biochemical disease-free survival (bDFS) of 435 patients who had a minimum 2-year prostate-specific antigen follow-up (median follow-up, 6.7 years; range, 2.0-11.1 years). Results: Five-year bDFS rates for the entire cohort using the American Society for Therapeutic Radiology and Oncology and Phoenix definitions were 96.9% and 96.5%, respectively. Using the Phoenix definition, 5-year bDFS rates were 97.3% for low-risk patients and 92.8% for intermediate/high-risk patients. The positive biopsy rate was 4.1%. The freedom rate from Grade 2 or higher rectal bleeding at 5 years was 88.5%. Acute urinary retention occurred in 10.7%, more commonly in patients with high pretreatment International Prostate Symptom Scores (p < 0.01). In patients who were potent before treatment, 73.4% remained potent at 5 years after implantation. Conclusions: Patients with a minimum D90 of 180 Gy had outstanding local control based on prostate-specific antigen control and biopsy data. Toxicity profiles, particularly for long-term urinary and sexual function, were excellent and showed that D90 doses of 180 Gy or greater performed using the technique described were feasible and tolerable

Srovnávat nesrovnatelné

Czech Academy of Sciences Publication Activity Database

Sobek, Tomáš

2017-01-01

Roč. 9, č. 1 (2017), s. 3-23 ISSN 1804-0969 R&D Projects: GA ČR GA13-30299S Institutional support: RVO:68378122 Keywords : law philosophy * theory of law * ethics Subject RIV: AG - Legal Sciences OBOR OECD: Law https://filosofiednes.ff.uhk.cz/index.php/hen/issue/view/20

uniportal vats for surgical repair

African Journals Online (AJOL)

2017-03-23

Mar 23, 2017 ... aDepartamet of Pediatric Surgery, Hospital Teresa Herrera, Complejo Hospitalario. Universitario de A ... Advances in anesthesia, neonatal intensive, surgical, and cardiac care have ... First, these patients are at risk of airway ...

Breeding of Greater and Lesser Flamingos at Sua Pan, Botswana ...

African Journals Online (AJOL)

to fledging was unknown owing to the rapid drying of the pan in late March 1999. No Greater Flamingo breeding was seen that season. Exceptional flooding during 1999–2000 produced highly favourable breeding conditions, with numbers of Greater and Lesser Flamingos breeding estimated to be 23 869 and 64 287 pairs, ...

Surgical anatomy of greater occipital nerve and its relation to ...

African Journals Online (AJOL)

Introduction: The knowledge of the anatomy of greater occipital nerve and its relation to occipital artery is important for the surgeon. Blockage or surgical release of greater occipital nerve is clinically effective in reducing or eliminating chronic migraine symptoms. Aim: The aim of this research was to study the anatomy of ...

Surgical anatomy of greater occipital nerve and its relation to ...

African Journals Online (AJOL)

Nancy Mohamed El Sekily

2014-08-19

Aug 19, 2014 ... Abstract Introduction: The knowledge of the anatomy of greater occipital nerve and its relation to occipital artery is important for the surgeon. Blockage or surgical release of greater occipital nerve is clinically effective in reducing or eliminating chronic migraine symptoms. Aim: The aim of this research was to ...

Measles outbreak in Greater Manchester, England, October 2012 to September 2013: epidemiology and control.

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Pegorie, M; Shankar, K; Welfare, W S; Wilson, R W; Khiroya, C; Munslow, G; Fiefield, D; Bothra, V; McCann, R

2014-12-11

This paper describes the epidemiology and management of a prolonged outbreak of measles across the 2.7 million conurbation of Greater Manchester in the United Kingdom. Over a period of one year (from October 2012 to September 2013), over a thousand suspected measles cases (n = 1,073) were notified across Greater Manchester; of these, 395 (37%) were laboratory-confirmed, 91 (8%) were classed as probable, 312 (29%) were classed as possible and 275 (26%) excluded. Most confirmed and probable cases occurred in children within two age groups—infants (too young to be eligible for measles-mumps-rubella (MMR) vaccination according to the national immunisation programme) and children aged 10-19 years (low vaccine uptake in this cohort because of unfounded alleged links between the MMR vaccine and autism). During this one year period, there were a series of local outbreaks and many of these occurred within the secondary school setting. A series of public health measures were taken to control this prolonged outbreak: setting up incident management teams to control local outbreaks, a concerted immunisation catch-up campaign (initially local then national) to reduce the pool of children partially or totally unprotected against measles, and the exclusion of close contacts from nurseries and school settings for a period of 10 days following the last exposure to a case of measles.

Projecting the spatiotemporal carbon dynamics of the Greater Yellowstone Ecosystem from 2006 to 2050.

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Huang, Shengli; Liu, Shuguang; Liu, Jinxun; Dahal, Devendra; Young, Claudia; Davis, Brian; Sohl, Terry L; Hawbaker, Todd J; Sleeter, Ben; Zhu, Zhiliang

2015-12-01

Climate change and the concurrent change in wildfire events and land use comprehensively affect carbon dynamics in both spatial and temporal dimensions. The purpose of this study was to project the spatial and temporal aspects of carbon storage in the Greater Yellowstone Ecosystem (GYE) under these changes from 2006 to 2050. We selected three emission scenarios and produced simulations with the CENTURY model using three General Circulation Models (GCMs) for each scenario. We also incorporated projected land use change and fire occurrence into the carbon accounting. The three GCMs showed increases in maximum and minimum temperature, but precipitation projections varied among GCMs. Total ecosystem carbon increased steadily from 7,942 gC/m 2 in 2006 to 10,234 gC/m 2 in 2050 with an annual rate increase of 53 gC/m 2 /year. About 56.6% and 27% of the increasing rate was attributed to total live carbon and total soil carbon, respectively. Net Primary Production (NPP) increased slightly from 260 gC/m 2 /year in 2006 to 310 gC/m 2 /year in 2050 with an annual rate increase of 1.22 gC/m 2 /year. Forest clear-cutting and fires resulted in direct carbon removal; however, the rate was low at 2.44 gC/m 2 /year during 2006-2050. The area of clear-cutting and wildfires in the GYE would account for 10.87% of total forested area during 2006-2050, but the predictive simulations demonstrated different spatial distributions in national forests and national parks. The GYE is a carbon sink during 2006-2050. The capability of vegetation is almost double that of soil in terms of sequestering extra carbon. Clear-cutting and wildfires in GYE will affect 10.87% of total forested area, but direct carbon removal from clear-cutting and fires is 109.6 gC/m 2 , which accounts for only 1.2% of the mean ecosystem carbon level of 9,056 gC/m 2 , and thus is not significant.

The Value Added Tax Implications of Illegal Transactions | van Zyl ...

African Journals Online (AJOL)

This article explores whether or not the decision in the MP Finance-case (and preceding cases on the taxation of illegal receipts) can be applied to determine if illegal transactions are subject to VAT and moreover if a trader in illegal goods and services should register as a VAT vendor. Although strictly speaking no analogy ...

Is thoracoscopic patent ductus arteriosus closure superior to conventional surgery?

Science.gov (United States)

Stankowski, Tomasz; Aboul-Hassan, Sleiman Sebastian; Marczak, Jakub; Cichon, Romuald

2015-10-01

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether thoracoscopic patent ductus arteriosus (PDA) closure is superior to conventional surgery. Altogether 821 papers were found using the reported search, 11 of which represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Eleven studies included in the analysis consisted of two prospective and three retrospective, non-randomized studies and six case series. Four included studies focused only on preterm infants, three studies enrolled neonates and the other four analysed all age groups from neonates to older children or young adults. There were no differences in mortality between video-assisted thoracoscopic surgery (VATS) and conventional surgery. Two studies suggested that VATS offers shorter operative times. Two papers observed shorter hospital stay, although the other two noted no significant difference. A large prospective trial found VATS to be associated with a lower number of postoperative complications in neonates and infants, whereas other studies suggested no significant differences in short-term postoperative complications. There is little evidence to suggest better musculoskeletal status and cosmesis in neonates following VATS. Conversion from thoracoscopy to thoracotomy described in six papers was seldom and it did not lead to any additional complications. All observational studies confirmed that both techniques are free from major adverse cardiovascular complications and these two techniques can be safely used in all patients qualified for surgical PDA closure. Two studies compared cost-effectiveness between the two techniques; one of them described VATS as significantly more cost-efficient, whereas the other study observed no difference. However, it should be noted that data

Technical concept for a Greater Confinement Disposal test facility

International Nuclear Information System (INIS)

Hunter, P.H.

1982-01-01

For the past two years, Ford, Bacon and Davis has been performing technical services for the Department of Energy at the Nevada Test Site in specific development of defense low-level waste management concepts for greater confinement disposal concept with particular application to arid sites. The investigations have included the development of Criteria for Greater Confinement Disposal, NVO-234, which was published in May of 1981 and the draft of the technical concept for Greater Confinement Disposal, with the latest draft published in November 1981. The final draft of the technical concept and design specifications are expected to be published imminently. The document is prerequisite to the actual construction and implementation of the demonstration facility this fiscal year. The GCD Criteria Document, NVO-234 is considered to contain information complimentary and compatible with that being developed for the reserved section 10 CFR 61.51b of the NRCs proposed licensing rule for low level waste disposal facilities

Physicochemical Assessment of Surface and Groundwater Quality of the Greater Chittagong Region of Bangladesh

Directory of Open Access Journals (Sweden)

M. J. Ahmed

2010-12-01

Full Text Available The study was carried out to assess surface and groundwater quality of the greater Chittagong (Chittagong and Cox’s Bazar districts and Chittagong Hill Tracts (Rangamati, Khagrachhari and Bandarban districts of Bangladesh. To study the various physicochemical and microbiological parameters, surface water samples from the Karnafuli, Halda, Sangu, Matamuhuri, Bakkhali, Naf, Kasalong, Chingri and Mayani Rivers, Kaptai Lake and groundwater samples from almost every Upazilas, smaller administrative unit of Bangladesh, were collected and analyzed. The statistical methods of sampling were used for collecting samples. Samples were preserved using suitable preservation methods. Water samples from the freshwater resources were collected from different points and tide conditions and at different seasons for continuous monitoring during the hydrological years 2008-2009. The collected samples were analyzed for the following parameters: pH, electrical conductivity (EC, total dissolved solids (TDS, total suspended solids (TSS, total solids (TS, dissolved oxygen (DO, transparency, acidity, dissolved carbon dioxide, total alkalinity, total hardness, chloride, ammonia-N, hydrogen sulfide, sulphate-S, o-phosphate-P, biochemical oxygen demand (BOD, chemical oxygen demand (COD, nitrate-N, nitrite-N, total nitrite and nitrate-N, arsenic, iron, manganese, copper, nickel, chromium, cadmium, lead, calcium, magnesium, sodium and potassium using the procedure outlined in the standard methods. Average values of maximum physicochemical and microbiological parameters studied for the Karnafuli River were found higher than the World Health Organization (WHO guideline. The maximum water quality parameters of Kaptai Lake and other Rivers of Chittagong region were existed within the permissible limits of WHO guideline. The data showed the water quality slightly differs in pre-monsoon and post-monsoon than monsoon season. The concentration of different constituents of most of

Wear particles and osteolysis in patients with total wrist arthroplasty

DEFF Research Database (Denmark)

Boeckstyns, Michel E H; Toxværd, Anders; Bansal, Manjula

2014-01-01

PURPOSE: To determine whether the amount of polyethylene debris in the interphase tissue between prosthesis and bone in patients with total wrist arthroplasty correlated with the degree of periprosthetic osteolysis (PPO); and to investigate the occurrence of metal particles in the periprosthetic...... tissue, the level of chrome and cobalt ions in the blood, and the possible role of infectious or rheumatoid activity in the development of PPO. METHODS: Biopsies were taken from the implant-bone interphase in 13 consecutive patients with total wrist arthroplasty and with at least 3 years' follow......-up. Serial annual radiographs were performed prospectively for the evaluation of PPO. We collected blood samples for white blood cell count, C-reactive protein, and metallic ion level. RESULTS: A radiolucent zone of greater than 2 mm was observed juxta-articular to the radial component in 4 patients...

Evaluation of abdominal fat index by ultrasonography and its relationship with psoriasis and metabolic syndrome.

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Gönül, Müzeyyen; Tatar, İdil; Canpolat, Filiz; Işıl Kurmus, Gökçe; Ergin, Can; Hekimoğlu, Baki

2017-10-01

Accumulating evidence indicates that psoriasis is associated with obesity and metabolic syndrome. Psoriasis and obesity share similar inflammatory mediators, and obesity may potentiate some inflammatory cytokines seen in psoriasis. Body fat distribution, particularly visceral adipose tissue (VAT), is an important factor in metabolic syndrome and atherosclerotic diseases. An association has been demonstrated between psoriasis and abdominal VAT measured by computed tomography (CT). To measure abdominal VAT noninvasively by ultrasonography (USG) in patients with psoriasis and investigated its relation to psoriasis and metabolic syndrome. The study population consisted of 41 psoriasis patients and 41 control subjects matched for age, sex, and body mass index. The maximal preperitoneal fat thickness (Pmax) at the anterior surface of the liver and the minimal subcutaneous fat thickness (Smin) of the abdomen were measured by USG. The abdominal fat index (AFI = Pmax/Smin ratio) was calculated and the results were compared between groups. The rate of metabolic syndrome was significantly higher in psoriasis patients ( p = 0.0018). The mean AFI was similar in both groups. AFI was not associated with psoriasis in subjects with metabolic syndrome ( p = 0.495) or with Psoriasis Area and Severity Index ( r = 0.123, p = 0.443). This is the first study to evaluate abdominal VAT by USG. Computed tomography may be more reliable than USG, but its high cost and radiation exposure are major disadvantages. Further studies are required to determine the relationships between psoriasis and VAT.

Interleukin-17A Gene Expression in Morbidly Obese Women

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Fernando Zapata-Gonzalez

2015-07-01

Full Text Available Data from recent studies conducted in rodent models and humans suggest that interleukin-17A (IL-17A plays a role in the induction of inflammation in adipose tissue during obesity. The aim of this study was to assess the gene expression of IL-17A in adipose tissue of morbidly obese patients. We used RT-PCR to evaluate the expression of IL-17A and several adipo/cytokines in the visceral adipose tissue (VAT and subcutaneous adipose tissue (SAT of 10 normal-weight control women (BMI < 25 kg/m2 and 30 morbidly obese women (MO, BMI > 40 kg/m2. We measured serum levels of IL-17A and adipo/cytokines in MO and normal weight women. IL-17A expression was significantly higher in VAT than in SAT in MO patients (p = 0.0127. It was very low in normal-weight controls in both VAT and SAT tissues. We found positive correlations between IL-17A and IL-6, lipocalin-2 and resistin in VAT of MO patients. The circulating level of IL-17A was higher in the normal-weight group than the MO patients (p = 0.032, and it was significantly related to adiponectin and TNFRII levels. In conclusion, IL-17A expression in VAT is increased in morbidly obese women, which suggests a link between obesity and innate immunity in low-grade chronic inflammation in morbidly obese women.

Fructose-enriched diet induces inflammation and reduces antioxidative defense in visceral adipose tissue of young female rats.

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Kovačević, Sanja; Nestorov, Jelena; Matić, Gordana; Elaković, Ivana

2017-02-01

The consumption of refined, fructose-enriched food continuously increases and has been linked to development of obesity, especially in young population. Low-grade inflammation and increased oxidative stress have been implicated in the pathogenesis of obesity-related disorders including type 2 diabetes. In this study, we examined alterations in inflammation and antioxidative defense system in the visceral adipose tissue (VAT) of fructose-fed young female rats, and related them to changes in adiposity and insulin sensitivity. We examined the effects of 9-week fructose-enriched diet applied immediately after weaning on nuclear factor κB (NF-κB) intracellular distribution, and on the expression of pro-inflammatory cytokines (IL-1β and TNFα) and key antioxidative enzymes in the VAT of female rats. Insulin signaling in the VAT was evaluated at the level of insulin receptor substrate-1 (IRS-1) protein and its inhibitory phosphorylation on Ser 307 . Fructose-fed rats had increased VAT mass along with increased NF-κB nuclear accumulation and elevated IL-1β, but not TNFα expression. The protein levels of antioxidative defense enzymes, mitochondrial manganese superoxide dismutase 2, and glutathione peroxidase, were reduced, while the protein content of IRS-1 and its inhibitory phosphorylation were not altered by fructose diet. The results suggest that fructose overconsumption-related alterations in pro-inflammatory markers and antioxidative capacity in the VAT of young female rats can be implicated in the development of adiposity, but do not affect inhibitory phosphorylation of IRS-1.

Identifying ventilatory anaerobic threshold in children and adolescents: A literature review. DOI: http://dx.doi.org/10.5007/1980-0037.2012v14n3p343

Directory of Open Access Journals (Sweden)

Luciana Carletti

2012-05-01

Full Text Available Ventilatory anaerobic threshold (VAT has been used in research to represent pulmonary function and submaximal performance capacity of children and adolescents. This study aimed to identify: a the group of children and adolescents that has been the main focus of research; b the criteria most commonly used to determine VAT; and c the main references that have been used to support the theoretical analysis. A literature search was conducted using LILACS, MEDLINE/PubMed, and SciELO. The search was limited to studies using VAT in their methodology, published between 2000 and 2010, in order to identify categories through content analysis. Descriptive statistics were used to analyze the data. Forty-five studies were found and distributed according to categories identified, as follows: severe exercise intolerance (23 [51%]; healthy subjects (6 [13%]; obese subjects and comparison of methodologies (4 [9%], each; O2 kinetics (3 [7%]; sports (2 [4%]; stunting, asthma, and effort perception (1 [2%], each. The main reference used is Beaver WL, Wasserman K, Whipp BJ (1986, cited in 24 (53% studies, and the main criterion for VAT determination is the V-slope method. In addition to this method, ventilatory equivalents for O2 and CO2 have been used, accounting for 37% (17 of cases. In conclusion, the dataindicate that VAT has been primarily used in rehabilitation studies including children and adolescents by the V-slope method.

Comparison of HOMA-IR, HOMA-β% and disposition index between US white men and Japanese men in Japan: the ERA JUMP study.

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Ahuja, Vasudha; Kadowaki, Takashi; Evans, Rhobert W; Kadota, Aya; Okamura, Tomonori; El Khoudary, Samar R; Fujiyoshi, Akira; Barinas-Mitchell, Emma J M; Hisamatsu, Takashi; Vishnu, Abhishek; Miura, Katsuyuki; Maegawa, Hiroshi; El-Saed, Aiman; Kashiwagi, Atsunori; Kuller, Lewis H; Ueshima, Hirotsugu; Sekikawa, Akira

2015-02-01

At the same level of BMI, white people have less visceral adipose tissue (VAT) and are less susceptible to developing type 2 diabetes than Japanese people. No previous population-based studies have compared insulin resistance and insulin secretion between these two races in a standardised manner that accounts for VAT. We compared HOMA-IR, HOMA of beta cell function (HOMA-β%) and disposition index (DI) in US white men and Japanese men in Japan. We conducted a population-based, cross-sectional study, comprising 298 white men and 294 Japanese men aged 40-49 years without diabetes. Insulin, glucose, VAT and other measurements were performed at the University of Pittsburgh. We used ANCOVA to compare geometric means of HOMA-IR, HOMA-β% and DI, adjusting for VAT and other covariates. White men had higher HOMA-IR, HOMA-β% and DI than Japanese men, and the difference remained significant (p HOMA-IR, HOMA-β% and DI were significantly higher in white men even after further adjustment for BMI, impaired fasting glucose and other risk factors. The higher VAT-adjusted DI in white men than Japanese men may partly explain lower susceptibility of white people than Japanese people to developing type 2 diabetes. The results, however, should be interpreted with caution because the assessment of insulin indices was made using fasting samples and adjustment was not made for baseline glucose tolerance. Further studies using formal methods to evaluate insulin indices are warranted.

Perioperative and long-term outcome of thymectomy for myasthenia gravis: comparison of surgical approaches and prognostic analysis.

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Liu, Cheng-wu; Luo, Meng; Mei, Jian-dong; Zhu, Yun-ke; Pu, Qiang; Ma, Lin; Che, Guo-wei; Lin, Yi-dan; Wu, Zhu; Wang, Yun; Kou, Ying-li; Liu, Lun-xu

2013-01-01

Thymectomy is an established treatment for myasthenia gravis (MG), and video-assisted thoracoscopic surgery (VATS) thymectomy has become an acceptable surgical procedure. This study aimed to compare the results of VATS thymectomy and open thymectomy and to identify the prognostic factors after thymectomy. The clinical data of 187 consecutive thymectomies performed between July 2000 and December 2009 were retrospectively reviewed; 75 open thymectomies and 112 VATS thymectomies. Clinical efficacy and variables influencing outcome were assessed by Kaplan-Meier survival curves and Cox proportional hazards regression analysis. The operative blood loss in the VATS group was significantly less than that in the open group ((62.14 ± 55.43) ml vs. (137.87 ± 165.25) ml, P CSR) was the end point for evaluation of the treatment results. The overall five-year CSR rate was 57.5%. Two good prognostic factors were identified; preoperative prescription of anticholinesterase alone (P = 0.035) and non-thymomatous MG (P = 0.003). The five-year CSR rate of the ocular type of MG reached a high level of 67.4%. Thymectomy can achieve good long-term CSR in MG, and VATS is an ideal alternative method. High-dose prescription of anticholinesterase and the advanced stage by Myasthenia Gravis Foundation of America (MGFA) classification have higher risks of postoperative crisis. Preoperative prescription of anticholinesterase alone and non-thymomatous MG are good prognostic factors. Thymectomy should also be considered for the ocular type of MG.

Genetic analysis of pathway regulation for enhancing branched-chain amino acid biosynthesis in plants

KAUST Repository

Chen, Hao

2010-08-01

The branched-chain amino acids (BCAAs) valine, leucine and isoleucine are essential amino acids that play critical roles in animal growth and development. Animals cannot synthesize these amino acids and must obtain them from their diet. Plants are the ultimate source of these essential nutrients, and they synthesize BCAAs through a conserved pathway that is inhibited by its end products. This feedback inhibition has prevented scientists from engineering plants that accumulate high levels of BCAAs by simply over-expressing the respective biosynthetic genes. To identify components critical for this feedback regulation, we performed a genetic screen for Arabidopsis mutants that exhibit enhanced resistance to BCAAs. Multiple dominant allelic mutations in the VALINE-TOLERANT 1 (VAT1) gene were identified that conferred plant resistance to valine inhibition. Map-based cloning revealed that VAT1 encodes a regulatory subunit of acetohydroxy acid synthase (AHAS), the first committed enzyme in the BCAA biosynthesis pathway. The VAT1 gene is highly expressed in young, rapidly growing tissues. When reconstituted with the catalytic subunit in vitro, the vat1 mutant-containing AHAS holoenzyme exhibits increased resistance to valine. Importantly, transgenic plants expressing the mutated vat1 gene exhibit valine tolerance and accumulate higher levels of BCAAs. Our studies not only uncovered regulatory characteristics of plant AHAS, but also identified a method to enhance BCAA accumulation in crop plants that will significantly enhance the nutritional value of food and feed. © 2010 Blackwell Publishing Ltd.

Machinery and labour force requirements for forest chip production in Finland in 2020

Energy Technology Data Exchange (ETDEWEB)

Kaerhae, K.; Strandsroem, M. (Metsaeteho Oy, Helsinki (Finland)), Email: kalle.karha@metsateho.fi, Email: markus.strandstrom@metsateho.fi; Lahtinen, P.; Elo, J. (Poeyry Energy Oy, Espoo (Finland)), Email: perttu.lahtinen@poyry.com, Email: juha.elo@poyry.com

2009-07-01

The research carried out by Metsaeteho Oy and Poeyry Energy Oy estimated how much machinery and labour would be needed for large-scale forest chip production if the use of forest chips increases extensively in Finland during the coming decade. If the production and consumption of forest chips are 25 to 30 TWh in Finland 2020, then 1,900 to 2,200 machinery units, i.e. machines and trucks, would be needed. This would mean total investments in production machinery of 530 to 630 million euro (VAT 0 %). The labour demand would be 3,400 to 4,000 machine operators and drivers, and 4,200 to 5,100 labour years including indirect labour. Respectively, if the production and consumption of forest chips is 15 to 20 TWh in Finland in 2020, then the production machinery requirement would be 1,100 to 1,500 machines and trucks. The total machinery investment cost would be 320 to 420 million euro (VAT 0 %) and the calculated labour demand 2,000 to 2,700 machine operators and drivers (2,500 to 3,400 labour years). The results of the study indicated that forest chip production resources will be a major bottleneck in reaching the consumption target of 12 million m3, i.e. around 24 TWh of forest chips in Finland by 2020. (orig.)

Repair of Medial Patellofemoral, Ligament Improves Patellar, Tracking in Total Knee Replacement.

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Meneghini, R Michael; Ziemba-Davis, Mary; Smits, Shelly; Bicos, James

2015-11-01

The medial patellofemoral ligament (MPFL) is essential to maintain patella stability; however, its role in total knee replacement (TKR) has not been studied. Forty-six consecutive TKRs in 40 patients were reviewed. Standard closure was performed in 29 TKRs. The MPFL was isolated and anatomically re-approximated in 17 subsequent TKRs. Blinded radiographic evaluation of patellar tilt and subluxation was performed preoperatively and 4 months postoperatively. Despite greater preoperative lateral tilt, the MPFL repair group demonstrated greater correction in patellar tilt compared with the standard closure group (p = 0.02). Patellar tracking also was optimized in the MPFL group, despite equivalent preoperative lateral patellar subluxation in the two groups. Simple repair of the MPFL at arthrotomy closure appears to optimize patellar stability radiographically and may improve long-term results by minimizing patellar complications and wear.