Sivers and Boer-Mulders observables from lattice QCD.

DOE Office of Scientific and Technical Information (OSTI.GOV)

B.U. Musch, Ph. Hagler, M. Engelhardt, J.W. Negele, A. Schafer

We present a first calculation of transverse momentum dependent nucleon observables in dynamical lattice QCD employing non-local operators with staple-shaped, 'process-dependent' Wilson lines. The use of staple-shaped Wilson lines allows us to link lattice simulations to TMD effects determined from experiment, and in particular to access non-universal, naively time-reversal odd TMD observables. We present and discuss results for the generalized Sivers and Boer-Mulders transverse momentum shifts for the SIDIS and DY cases. The effect of staple-shaped Wilson lines on T-even observables is studied for the generalized tensor charge and a generalized transverse shift related to the worm gear function g{submore » 1}T. We emphasize the dependence of these observables on the staple extent and the Collins-Soper evolution parameter. Our numerical calculations use an n{sub f} = 2+1 mixed action scheme with domain wall valence fermions on an Asqtad sea and pion masses 369 MeV as well as 518 MeV.« less

C-reactive protein, fibrinogen, and procalcitonin levels as early markers of staple line leak after laparoscopic sleeve gastrectomy in morbidly obese patients within an Enhanced Recovery After Surgery (ERAS) program.

PubMed

Ruiz-Tovar, Jaime; Muñoz, Jose Luis; Gonzalez, Juan; Garcia, Alejandro; Ferrigni, Carlos; Jimenez, Montiel; Duran, Manuel

2017-12-01

The performance of most bariatric procedures within an Enhanced Recovery After Surgery program has resulted in significant advantages, including a reduction in the length of hospital stay to 2-3 days. However, some postoperative complications may appear after the patient has been discharged. The aim of this study was to investigate the efficacy of various acute-phase parameters determined 24 h after a laparoscopic sleeve gastrectomy for predicting staple line leak in the postoperative course. A prospective study of 208 morbidly obese patients undergoing laparoscopic sleeve gastrectomy as bariatric procedure between 2012 and 2015 was performed. Blood analysis was performed 24 h after surgery. Acute-phase parameters (C-reactive protein, procalcitonin, fibrinogen, and White Blood Cell count) were investigated. Staple line leak appeared in eight patients (3.8%). Using receiver operating characteristic analysis at 24 h postoperatively, a cutoff level of CRP at 9 mg/dL achieved 85% sensitivity and 90% specificity for predicting staple line leak, a cutoff level of procalcitonin at 0.85 ng/mL achieved 70% sensitivity and 90% specificity, and a cutoff level of fibrinogen at 600 mg/dL achieved 80% sensitivity and 87.5% specificity. An elevation of CRP > 9 mg/dL, procalcitonin > 0.85 ng/mL and fibrinogen > 600 mg/dL should alert the surgeon the possibility of occurrence of postoperative staple line leak.

Thoracoscopic Lobectomy in Infants and Children Utilizing a 5 mm Stapling Device.

PubMed

Rothenberg, Steven

2016-12-01

Thoracoscopic lobectomy for congenital cystic lung disease has become an accepted and in many institutions the preferred technique. However, the technical challenges are many. Previous endoscopic staplers (12 mm) used commonly in adults are too large for use in infants This study evaluates the safety and efficacy of using a 5 mm stapling device to seal and divide major pulmonary structures. From July 2014 to March 2016, 26 patients of age 6 weeks to 13 months underwent thoracoscopic lobectomy for CPAM or sequestration. Weights ranged from 3.2 to 11.4 kg. There were 7 upper lobectomies, 2 middle, and 17 lower lobectomies. In each case, the 5 mm stapler (Justright Surgical; Louisville, Colorado) was the primary device for vessel and bronchial sealing and division. It is 4.8 mm in diameter with an anvil length of 25 mm and lays down four rows of staples and divides between them. A 3 mm sealing device was used for dissection and to take smaller segmental vessels as necessary. Stump lines were evaluated for bleeding or air leak in all cases. All procedures were accomplished successfully thoracoscopically. The stapler was used on the main lobar artery cases and vein in 24 cases, a large systemic sequestration vessel in 5 cases, and the bronchus in all 26. The stapler was also used to complete the minor fissure in 1 case and the major fissure in 1 case. A total of 96 staple loads were fired. Operative times ranged from 35 to 135 minutes. There was no significant bleeding of any vascular stump. In 1 case, the edge of the bronchial stump had to be reinforced, this was thought to be secondary to too much tissue being enclosed in the jaws. There were no postoperative complications. The use of a 5 mm stapling device appears to be safe and effective in thoracoscopic lobectomy in infants. It allows for safe management of major pulmonary vessels and bronchi in the confined chest of an infant through a single 5 mm port.

Autologous fibrin sealant reduces the incidence of prolonged air leak and duration of chest tube drainage after lung volume reduction surgery: a prospective randomized blinded study.

PubMed

Moser, C; Opitz, I; Zhai, W; Rousson, V; Russi, E W; Weder, W; Lardinois, D

2008-10-01

Prolonged air leak is reported in up to 50% of patients after lung volume reduction surgery. The effect of an autologous fibrin sealant on the intensity and duration of air leak and on the time to chest drain removal after lung volume reduction surgery was investigated in a randomized prospective clinical trial. Twenty-five patients underwent bilateral thoracoscopic lung volume reduction surgery. In each patient, an autologous fibrin sealant was applied along the staple lines on one side, whereas no additional measure was taken on the other side. Randomization of treatment was performed at the end of the resection on the first side. Air leak was assessed semiquantitatively by use of a severity score (0 = no leak; 4 = continuous severe leak) by two investigators blinded to the treatment. Mean value of the total severity scores for the first 48 hours postoperative was significantly lower in the treated group (4.7 +/- 7.7) than in the control group (16.0 +/- 10.1) (P < .001), independently of the length of the resection. Prolonged air leak and mean duration of drainage were also significantly reduced after application of the sealant (4.5% and 2.8 +/- 1.9 days versus 31.8% and 5.9 +/- 2.9 days) (P = .03 and P < .001). Autologous fibrin sealant for reinforcement of the staple lines after lung volume reduction surgery significantly reduces prolonged air leak and duration of chest tube drainage.

Totally intracorporeal delta-shaped B-I anastomosis following laparoscopic distal gastrectomy using the Tri-Staple™ reloads on the manual Ultra handle: a prospective cohort study with historical controls.

PubMed

Man-I, Mariko; Suda, Koichi; Kikuchi, Kenji; Tanaka, Tsuyoshi; Furuta, Shimpei; Nakauchi, Masaya; Ishikawa, Ken; Ishida, Yoshinori; Uyama, Ichiro

2015-11-01

A delta-shaped anastomosis in totally laparoscopic Billroth I gastrectomy could be performed easily and sufficiently using only laparoscopic linear staplers. However, the restricted maneuverability and severe blurring of these staplers along with their limited hemostability induced strain. In this study, we determined the feasibility and safety of performing delta-shaped anastomosis using the Endo GIA™ Reloads with Tri-Staple™ Technology combined with Endo GIA™ Ultra Universal stapler (Tri-Staple) with a particular focus on short-term surgical outcomes. We performed a single-institutional prospective interventional study (UMIN 000008014). The Tri-Staple was prospectively used on 23 consecutive patients who underwent a curative totally laparoscopic Billroth I gastrectomy with delta-shaped anastomosis. These patients were matched with the 19 patients previously treated using the ENDOPATH(®) ETS Articulating Linear Cutters (ETS) on clinical and demographic characteristics. There were no differences between the groups in anastomosis-related local complications, morbidity, non-anastomosis-related local complications, total systemic complications, and short-term outcomes with the exception of significantly reduced blood loss in the Tri-Staple group (ETS vs. Tri-Staple: 37 [10-306] vs. 15 [5-210] mL, p = 0.02). Intraoperative bleeding from the staple line was significantly reduced in the Tri-Staple group. The postoperative drain indwelling period (ETS vs. Tri-Staple, 6 [4-10] vs. 4 [2-43] days, p = 0.032), fasting period (5 [3-7] vs. 3 [3-24] days, p = 0.022), and hospital stay (14 [10-47] vs. 11 [6-58] days, p = 0.025) were significantly shorter in the Tri-Staple group. There was no mortality in this series. Acceleration assessed as indices of blurring of stapler tip might have a significant adverse influence on staple-line bleeding at stapling sites. Totally laparoscopic Billroth I distal gastrectomy using Tri-Staple was feasible and safe with favorable short-term surgical outcomes. Reduced blurring while stapling may be a novel endpoint which newly developed stapling devices should target.

[Errors and dangers in use of the surgical stapler in lung surgery].

PubMed

Junginger, T; Walgenbach, S

1989-01-01

The staple closure of the bronchus, like the manual technique, depends on some essential prerequisites: vascular supply, the length and thickness of the bronchial stump, the resection line, the type of stapler and the size of staples used. GIA 55 or 90 instruments allow safe and simple closure of lung parenchyma. Familiarity with the stapling technique is essential for success.

Surgical stapling device–tissue interactions: what surgeons need to know to improve patient outcomes

PubMed Central

Chekan, Edward; Whelan, Richard L

2014-01-01

The introduction of both new surgical devices and reengineered existing devices leads to modifications in the way traditional tasks are carried out and allows for the development of new surgical techniques. Each new device has benefits and limitations in regards to tissue interactions that, if known, allow for optimal use. However, most surgeons are unaware of these attributes and, therefore, new device introduction creates a “knowledge gap” that is potentially dangerous. The goal of this review is to present a framework for the study of device– tissue interactions and to initiate the process of “filling in” the knowledge gap via the available literature. Surgical staplers, which are continually being developed, are the focus of this piece. The integrity of the staple line, which depends on adequate tissue compression, is the primary factor in creating a stable anastomosis. This review focuses on published studies that evaluated the creation of stable anastomoses in bariatric, thoracic, and colorectal procedures. Understanding how staplers interact with target tissues is key to improving patient outcomes. It is clear from this review that each tissue type presents unique challenges. The thickness of each tissue varies as do the intrinsic biomechanical properties that determine the ideal compressive force and prefiring compression time for each tissue type. The correct staple height will vary depending on these tissue-specific properties and the tissue pathology. These studies reinforce the universal theme that compression, staple height, tissue thickness, tissue compressibility, and tissue type must all be considered by the surgeon prior to choosing a stapler and cartridge. The surgeon’s experience, therefore, is a critical factor. Educational programs need to be established to inform and update surgeons on the characteristics of each stapler. It is hoped that the framework presented in this review will facilitate this process. PMID:25246812

Serosal Laceration During Firing of Powered Linear Stapler Is a Predictor of Staple Malformation.

PubMed

Matsuzawa, Fumihiko; Homma, Shigenori; Yoshida, Tadashi; Konishi, Yuji; Shibasaki, Susumu; Ishikawa, Takahisa; Kawamura, Hideki; Takahashi, Norihiko; Iijima, Hiroaki; Taketomi, Akinobu

2017-12-01

Although several types of staplers have been developed, staple-line leaks have been a great problem in gastrointestinal surgery. Powered linear staplers were recently developed to further reduce the risk of tissue trauma during laparoscopic surgery. The aim of this study was to identify the factors that predict staple malformation and determine the effect of precompression and slow firing on the staple formation of this novel powered stapling method. Porcine stomachs were divided using an endoscopic powered linear stapler with gold reloads. We divided the specimens into 9 groups according to the precompression time (0/60/180 seconds) and firing time (0/60/180 seconds). The occurrence and length of laceration and the shape of the staples were evaluated. We examined the factors influencing successful stapling and investigated the key factors for staple malformation. Precompression significantly decreased the occurrence and length of serosal laceration. Precompression and slow firing significantly improved the optimal stapling formation rate. Univariate analysis showed that the precompression time (0 seconds), firing time (0 seconds), and presence of serosal laceration were significantly associated with a low optimal formation rate. Multivariate analysis showed that these three factors were associated independently with low optimal formation rate and that the presence of serosal laceration was the only factor that could be detected during the stapling procedure. We have shown that serosal laceration is a predictor of staple malformation and demonstrated the importance of precompression and slow stapling when using the powered stapling method.

Multicenter prospective evaluation of a new articulating 5-mm endoscopic linear stapler.

PubMed

Kuthe, Andreas; Haemmerle, Alexander; Ludwig, Kaja; Falck, Stephan; Hiller, Wolfgang; Mainik, Frederick; Freys, Stephan; Dubovoy, Lev; Jaehne, Joachim; Oldhafer, Karl

2016-05-01

The objective of this study was to evaluate the safety and efficacy of a novel 5-mm laparoscopic linear stapler in clinical gastrointestinal surgical applications. A prospective, single-arm study with an open enrollment of subjects requiring stapling of the gastrointestinal (GI) tract was performed. The study endpoints were the number of complications and technical failures associated with the use of a novel stapler when compared to similar events with conventional staplers as described in the medical literature. Seven centers enrolled 160 subjects, 150 of which were followed up to at least 30 days postoperatively. Intraoperative success: In 423 deployments, there were two staple line leaks and five staple line bleeds, all of which were intraoperatively resolved. In addition, incomplete staple lines were noted as a result of user error (n = 15) or device-related issues (n = 22), all of which were immediately resolved and none of which resulted in a complication or a change of the surgical procedure. Late outcomes: A total of 13 surgical complications in 160 patients were related to a GI transection or anastomosis, 12 of which related to a hand-sewn anastomosis or use of other commercially available staplers. One event (1/153, 0.065 %) on POD 1, involving bleeding of the staple line, was felt to be related to the use of the new stapler. The study confirmed that the new device was user-friendly (9 % incidence of problems firing the device), reliable (3 % device failures) and safe (<1 % complication rate related to the stapler). Based on these results, it would seem that this new 5-mm stapler is a safe and effective alternative to standard 12-mm staplers.

Extra long staple upland cotton for the production of superior yarn

USDA-ARS?s Scientific Manuscript database

Cotton, Gossypium spp., fibers are produced primarily by two species, G. hirsutum L., upland, and G. barbadense L., pima, which also is referred to as Extra Long Staple (ELS). The Cotton Improvement Laboratory, Texas AgriLife Research, has developed ELS upland lines through intraspecific crosses and...

Comparison between orogastric tube/bougie and a suction calibration system for effects on operative duration, staple-line corkscrewing, and esophageal perforation during laparoscopic sleeve gastrectomy.

PubMed

Gagner, Michel; Huang, Rose Y

2016-04-01

Placement of a bougie for sleeve sizing during laparoscopic sleeve gastrectomy (LSG) is recommended. We compared this standard with a suction calibration system (SCS) that performs all functions with one insertion, and measured each step's duration. Primary LSG was performed using a bougie and SCS in alternating order. Number of tube movements to achieve optimal placement, durations of decompression, leak testing, and overall operative time, and remnant linear measurements were obtained. LSG was performed in 26 patients (15 women, 11 men; mean age 36.8 years; mean BMI 45.3 kg/m(2)). The mean number of tube movements was significantly greater for the bougie than for the SCS (8.13 vs. 3.58; p < 0.0001). Percent reductions achieved using the SCS were: time to full decompression of the stomach, 62% (21 vs. 8 s; p < 0.138); tube placement, 51% (101 vs. 49 s; p < 0.0001); leak testing, 78% (119 vs. 26 s; p < 0.0003); and mean operative duration (from tube insertion to end of stapling), 21% (875 vs. 697 s; p < 0.019). Variance of the staple-line distance, measured from the greater curvature to the staple line, was 1.64 and 0.92 for the bougie and SCS, respectively, indicating a reduction in corkscrewing, for a 43.9% straighter sleeve. SCS maintained the gastric wall in place, thereby preventing corkscrewing, and reducing total operating time. Reducing the number of tube insertions may prevent esophageal damage and accidental tube stapling.

Results of More Than 11,800 Sleeve Gastrectomies: Data Analysis of the German Bariatric Surgery Registry.

PubMed

Stroh, Christine; Köckerling, Ferdinand; Volker, Lange; Frank, Benedix; Stefanie, Wolff; Christian, Knoll; Christiane, Bruns; Thomas, Manger

2016-05-01

Laparoscopic sleeve gastrectomy (SG) is an upcoming procedure in bariatric surgery and is currently performed worldwide. Staple line leakage, as the most frequent and most feared complication, is still a major concern. Since 2005 data from patients undergoing bariatric procedures in Germany have been prospectively registered in an online database and analyzed. All patients who had undergone primary SG within a 7-year period were considered for analysis. Using the German Bariatric Surgery Registry, data from more than 11,800 SGs were collected between January 1, 2005, and December 31, 2013. Staple line leak rate decreased from 6.5% to 1.4%. Male sex, higher body mass index, concomitant sleep apnea, conversion to laparotomy, longer operation time, a combination of buttresses and oversewing, and the occurrence of intraoperative complications were associated with a significantly higher leakage rate compared with when using either buttresses or oversewing alone. On multivariable analysis, operation time and year of procedure only had a significant impact on staple line leakage rate. Owing to the growing experience a constant decrease in the leakage rate after SG has been observed. Staple line disruption may still lead to sepsis, multiorgan dysfunction, and increased mortality. The results of the current study demonstrated that there are factors that increase the risk of leakage and which would enable surgeons to define risk groups, select patients more carefully, and offer closer follow-up during the postoperative course with early recognition and adequate treatment.

A revolutionary design change to improve stapler safety.

PubMed

Arteaga-González, Iván J

2013-01-01

Postoperative staple line leaks and bleeding are the most common reasons for complications in surgical procedures that involve organ resection, such as sleeve gastrectomy. Increasing the safety of these operations requires improving the instruments (endostaplers or endocutters) used for stapling and sectioning the tissues. We present a new prototype stapler for marketing in resection surgery, especially designed for the sleeve gastrectomy. We suggest that the medical instrument industry creates devices in which the channel along which the knife blade runs is located asymmetrically. This would allow more staples to be placed on the side of the gastric remnant, thus improving the sealing and hemostasis of the suture line and reducing the number of complications for patients as a result. The application of new concepts in medical surgical devices can improve the safety of the procedures in our patients.

Are there risk factors that increase the rate of staple line leakage in patients undergoing primary sleeve gastrectomy for morbid obesity?

PubMed

Benedix, Frank; Benedix, Diana D; Knoll, Christian; Weiner, Rudolf; Bruns, Christiane; Manger, Thomas; Stroh, Christine

2014-10-01

Laparoscopic sleeve gastrectomy (LSG) is currently being performed with increasing frequency worldwide. It offers an excellent weight loss and resolution of comorbidities in the short term with a very low incidence of complications. However, the ever present risk of a staple line leak is still a major concern. Since 2005, data from obese patients that undergo bariatric procedures in Germany are prospectively registered in an online database and analyzed at the Institute of Quality Assurance in Surgical Medicine. For the current analysis, all patients that had undergone primary sleeve gastrectomy for morbid obesity within a 7-year period were considered. Using the GBSR, data from 5.400 LSGs were considered for analysis. Staple line leak rate decreased during the study period from 6.5 to 1.4 %. Male gender, higher BMI, concomitant sleep apnea, conversion to laparotomy, longer operation time, use of both buttresses and oversewing, and the occurrence of intraoperative complications were associated with a significantly higher leakage rate. On multivariate analysis, operation time and year of procedure only had a significant impact on staple line leak rate. The results of the current study demonstrated that there are factors that increase the risk of a leakage which would enable surgeons to define risk groups, to more carefully select patients, and to offer a closer follow-up during the postoperative course with early recognition and adequate treatment. All future efforts should be focused on a further reduction of serious complications to make the LSG a widely accepted and safer procedure.

Endoscopic hemostasis using endoclip in early gastrointestinal hemorrhage after gastric bypass surgery.

PubMed

Tang, Shou-Jiang; Rivas, Homero; Tang, Linda; Lara, Luis F; Sreenarasimhaiah, Jayaprakash; Rockey, Don C

2007-09-01

Roux-en-Y gastric bypass (RYGBP) is the most commonly performed bariatric operation in the USA. In the early postoperative stage, gastrointestinal (GI) bleeding is an infrequent but potentially serious complication that usually results from bleeding at the gastrojejunostomy staple-line. Observant management with transfusion for stable patients and surgical exploration for unstable patients is typically recommended for early GI bleeding. We hypothesized that use of endoclips, which do not cause thermal injury to the surrounding tissues (or anastomosis), may be preferable to thermal approaches which could cause tissue injury. We report 2 cases of early GI bleeding after RYGBP that were successfully managed with endoclip application to bleeding lesions. Emergent endoscopy was performed, and major stigmata such as active spurting vessel and adherent clot were noted at the gastrojejunostomy staple-lines. Endoscopic hemostasis using endoclips was readily applied to bleeding lesions at staple-lines. Primary hemostasis was achieved, and there was no recurrent bleeding or complication. We conclude that therapeutic endoscopy can be performed safely for early bleeding after RYGBP. In patients with early bleeding after RYGBP, use of endoclips is mechanistically preferable to other options.

75 FR 44224 - Initiation of Antidumping and Countervailing Duty Administrative Reviews and Requests for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-28

... orders on Certain Polyester Staple Fiber from the People's Republic of China (``PRC'') with respect to... Diameter Carbon and Alloy Seamless, 6/1/09-5/31/10 Standard, Line, and Pressure Pipe, A-588-850.... JFE... Republic of China: Certain Polyester Staple Fiber, \\3\\ A-570-905.... 6/1/09-5/31/10 Far Eastern Industries...

Evaluation of the ViSiGiTM Calibration System

ClinicalTrials.gov

2013-12-10

Enhance Delineation of the Stomach Anatomy and the Surgeon's Appreciation of the Extent of Gastric Volume to be Removed;; Increase the Safety Profile of the Patient (i.e., Reduce the Likelihood of Accidental Stapling of the Orogastric Tube or Bougie);; Reduce the Incidence of OR Contamination/Infection Transmission;; Streamline OR Workflow, Resulting in Reduced OR Time; Ensure Consistent and Reproducible Staple Lines.

Study of the internal confinement of concrete reinforced (in civil engineering) with woven reinforcement

NASA Astrophysics Data System (ADS)

Dalal, M.; Goumairi, O.; El Malik, A.

2017-10-01

Concrete is generally the most used material in the field of construction. Despite its extensive use in structures, it represents some drawbacks related to its properties including its low tensile strength and low ductility. To solve this problem, the use of steel reinforcement in concrete structures is possible. Another possibility is the introduction of different types of continuous fibre / staple in the concrete, such as steel fibres or synthetic fibres, to obtain ″Concretes bundles″. Many types of fibre concrete, which have been developed and for many of them, the gain provided by the fibre was rather low and no significant improvement in tensile strength was really reaching. By cons, the ductility was higher than that of ordinary concrete. The objective of this study is to examine concrete reinforcement by inserting reinforcements woven polyester. These are either woven bidirectional (2D) or three-dimensional woven (3D). So we will report the properties of each type of reinforcement and the influence of the method of weaving on the strength reinforcements and on the strength of concrete in which they are incorporated. Such influence should contribute to improving the sustainability and enhancement of reinforcement

Gastropexy with an automatic stapling instrument for the treatment of gastric dilatation and volvulus in 20 dogs

PubMed Central

Belandria, Gerardo A.; Pavletic, Michael M.; Boulay, James P.; Penninck, Dominique G.; Schwarz, Leslie A.

2009-01-01

Surgical stapling equipment was used to create a gastropexy in 20 dogs undergoing emergency surgery for gastric dilatation and volvulus (GDV). The technique involved creation of a tunnel between the seromuscular layer and the submucosa of the pyloric antrum, and a matching tunnel beneath the right m. transversus abdominis. The arms of a gastrointestinal anastomosis stapling device were introduced into the tunnels, and the device was fired to create the gastropexy. One dog died of systemic sequelae of GDV during the early postoperative period. None of the remaining 19 dogs developed a recurrence of GDV during follow-up periods ranging from 5 to 43 months. In 11 dogs, the integrity of the gastropexy was evaluated by abdominal ultrasonography and either negative contrast gastrography or double contrast gastrography; in these dogs, the radiographic and/or the ultrasonographic findings were suggestive of an intact gastropexy. There were no complications involving the gastropexy staple line. The results of this study indicate that an effective and consistent permanent gastropexy can be created, using surgical stapling equipment. PMID:19794869

Gastropexy with an automatic stapling instrument for the treatment of gastric dilatation and volvulus in 20 dogs.

PubMed

Belandria, Gerardo A; Pavletic, Michael M; Boulay, James P; Penninck, Dominique G; Schwarz, Leslie A

2009-07-01

Surgical stapling equipment was used to create a gastropexy in 20 dogs undergoing emergency surgery for gastric dilatation and volvulus (GDV). The technique involved creation of a tunnel between the seromuscular layer and the submucosa of the pyloric antrum, and a matching tunnel beneath the right m. transversus abdominis. The arms of a gastrointestinal anastomosis stapling device were introduced into the tunnels, and the device was fired to create the gastropexy. One dog died of systemic sequelae of GDV during the early postoperative period. None of the remaining 19 dogs developed a recurrence of GDV during follow-up periods ranging from 5 to 43 months. In 11 dogs, the integrity of the gastropexy was evaluated by abdominal ultrasonography and either negative contrast gastrography or double contrast gastrography; in these dogs, the radiographic and/or the ultrasonographic findings were suggestive of an intact gastropexy. There were no complications involving the gastropexy staple line. The results of this study indicate that an effective and consistent permanent gastropexy can be created, using surgical stapling equipment.

The Effects of Bougie Diameters on Tissue Oxygen Levels After Sleeve Gastrectomy: A Randomized Experimental Trial

PubMed

Konca, Can; Yılmaz, Ali Abbas; Çelik, Süleyman Utku; Kayılıoğlu, Selami Ilgaz; Paşaoğlu, Özge Tuğçe; Ceylan, Halil Arda; Genç, Volkan

2018-05-29

Staple-line leak is the most frightening complication of laparoscopic sleeve gastrectomy and several predisposing factors such as using improper staple sizes regardless of gastric wall thickness, narrower bougie diameter and ischemia of the staple line are asserted. To evaluate the effects of different bougie diameters on tissue oxygen partial pressure at the esophagogastric junction after sleeve gastrectomy. A randomized and controlled animal experiment with 1:1:1:1 allocation ratio. Thirty-two male Wistar Albino rats were randomly divided into 4 groups of 8 each. While 12-Fr bougies were used in groups 1 and 3, 8-Fr bougies were used in groups 2 and 4. Fibrin sealant application was also carried out around the gastrectomy line after sleeve gastrectomy in groups 3 and 4. Burst pressure of gastrectomy line, tissue oxygen partial pressure and hydroxyproline levels at the esophagogastric junction were measured and compared among groups. Mortality was detected in 2 out of 32 rats (6.25%) and one of them was in group 2 and the cause of this mortality was gastric leak. Gastric leak was detected in 2 out of 32 rats (6.25%). There was no significant difference in terms of burst pressures, tissue oxygen partial pressure and tissue hydroxyproline levels among the 4 groups. The use of narrower bougie along with fibrin sealant has not had a negative effect on tissue perfusion and wound healing.

Impact of the Surgical Experience on Leak Rate After Laparoscopic Sleeve Gastrectomy.

PubMed

Noel, Patrick; Nedelcu, Marius; Gagner, Michel

2016-08-01

Laparoscopic sleeve gastrectomy (LSG) has become one of the most commonly performed bariatric procedures, largely due to several advantages it carries over more complex bariatric procedures. LSG is generally considered a straightforward procedure, but one of the major concerns is a staple line leak. The objectives of this study are to evaluate the correlation between surgeon's experience and leak rate and to assess the different risk factors for developing a gastric leak after LSG. Private hospital, France. The analysis of a single surgeon's yearly leak rate since the introduction of LSG for possible risk factors was done. A total of 2012 LSGs were performed in between September, 2005 and December, 2014. Twenty cases (1 %) of gastric leak were recorded. Of these, 17 patients were women (94.4 %) with a mean age of 39.4 years (range 22-61) and mean body mass index (BMI) 41.2 kg/m(2) (range 34.8-57.1). On a yearly basis, the leak rate was 4.8 % (2006), 5.7 % (2007), 0 (2008), 2.6 % (2009), 2 % (2010), 0.8 % (2011), 0.6 % (2012), 0.2 % (2013), and 0 (2014). In the first 1000 cases (group A), there were 18 cases of gastric leak and in the last 1000 cases, there were 800 with GORE® SEAMGUARD® Bioabsorbable Staple Line Reinforcement (group B) 2 cases of gastric leak (p = 0.009). A revisional LSG, 395 patients after gastric banding and 61 patients re-sleeve gastrectomy, was performed in 456 cases (22.7 %). There were 3 cases of leak (0.65 %). There were two deaths. LSG can be performed with a low complication rate. This large series of a single surgeon's experience demonstrated that the leak rate after LSG could be significantly decreased over time with changes in techniques.

The double stapling technique for low anterior resection. Results, modifications, and observations.

PubMed Central

Griffen, F D; Knight, C D; Whitaker, J M; Knight, C D

1990-01-01

Since the introduction of the end-to-end anastomosis (EEA) stapler for rectal reconstruction, we have used a modification of the conventional technique in which the lower rectal segment is closed with the linear stapler (TA-55) and the anastomosis is performed using the EEA instrument across the linear staple line (double stapling technique). Our experience with this procedure includes stapled colorectal anastomoses in 75 patients and is the basis for the report. This review presents the details and advantages of the technique and the results. Complications include two patients with anastomotic leak (2.7%), and two with stenosis that required treatment (2.7%). Protective colostomy was not done in this series. There were no deaths. Our experience and that of others suggests that this modification of the EEA technique can allow a lower anastomosis in some patients, and that it can be done with greater safety and facility. Images Fig. 1. Fig. 2. Fig. 3. Fig. 4. Fig. 5. Fig. 6. PMID:2357137

[Application of inner figure-of-eight suture to laparoscopic colorectal surgery].

PubMed

Chen, Jianjun; Zhong, Ming

2018-03-25

Regardless of laparoscopic or open colorectal surgeries, intestinal anastomosis is usually an important operative procedure. Even if stapler is widely used in different intestinal surgery nowadays, hand sewn suture is an indispensable procedure in clinical practice, meanwhile after stapled anastomosis, additional hand sewn suture is usually performed to ensure the safety of anastomosis. The inner figure-of-eight suture is a single layer suture technique which has been widely used in skin, tendon, rectus and uterus for quick and secure approximation. We describe our innovative application of inner figure-of-eight suture technique for intestinal anastomosis and/or reinforcement after stapled anastomosis in laparoscopic colorectal surgery. Main steps of inner figure-of-eight suture for intestinal anastomosis on posterior wall are as follows: (1) At 4 mm from cut edge of bowel, needle enters vertically from one side and courses mucosa-serosa-opposite serosa-mucosa in parallel to the entry point. (2) The needle is brought back to first entry side of bowel at 45 degree to enter the mucosa 5 mm below the first entry point and out on opposite side mucosa horizontally. (3) Both lose ends of the suture are pulled to approximate bowel edges and knots are tied on mucosal surface, in which suture line presents figure-of-eight on mucosal surface and two parallel suture lines are seen on serosal surface. When inner figure-of-eight suture is performed on anterior wall, the procedure is similar, but needle passes from serosa-mucosa-opposite mucosa-serosa and repeated to complete the inner figure-8 suture and knots are tied on serosa. The final look is two parallel sutures at 0.5 mm in between and the figure-of-eight remains inside the lumen. We did not deliberately try to invert the bowel edges, and if anastomosis is not satisfactory at final examination, simple interrupted seromuscular suture can be carried out. From 2015 till now, we have successfully completed inner figure-of-eight sutures in 38 cases receiving intestinal anastomosis reinforcement procedure and in 24 cases receiving hand sewn anastomosis. Comparison study revealed inner figure-of-eight suture presented shorter anastomotic time and less medical cost without anastomotic leakage, stump leakage or bleeding. No anastomotic stenosis was found at enteroscopy examination during follow up. We think that inner figure-of-eight suture possesses safe and simple advantages and is a manual suture technique worthy of promotion.

Needlescopic sleeve gastrectomy: pushing the boundaries of the standard technique.

PubMed

Loureiro, Marcelo; Sultan, Abdulah; Alhaddad, Mohannad; Mostafa, Hatem; Nocca, David; Nedelcu, Marius; Buhaimed, Walled

2017-10-01

Laparoscopic sleeve gastrectomy (LSG) is the most common bariatric surgery performed worldwide. Improvements in LSG have been suggested to achieve better weight loss or to lessen the complications rates. We propose a change in the standard technique to privilege the use of thinner instruments, the needlescopic sleeve gastrectomy (NSG). A 40-year-old female, BMI 40, with no previous abdominal surgery was selected for a NSG. She was placed in a semi-sitting position with the surgeon standing between the legs. Pneumoperitoneum was created through open laparoscopy; 5 trocars were inserted in standard position for laparoscopic gastric surgery. We have used one 12 mm trocar in the navel for a 5 mm scope and for stapling the stomach; one 5 mm trocar for impedance coagulator and also for the scope during the stapling process, and three 3 mm trocars for liver retraction, left hand manipulation, and greater curve exposition. Surgical techniques are basically the same as for a standard LSG until the moment of stapling the stomach, when the 5 mm scope is changed to the right hand trocar. Stapling can be done trough the umbilical port, parallel to the lesser curvature, in contact with the calibration tube. After stapling, hemostasis was achieved by bipolar coagulation, application of titanium clips, and absorbable suture. The 12 mm umbilical orifice is closed after extraction of the resected stomach. Operative time was 76 min. There was no per-operative complication. Recovery was uneventful and patient was discharged at post operative day 2. Pain was considered minor by the patient. One month after surgery, cosmetic results were very convincing. There are several proposed technical modifications in LSG. They can influence complication rates or weight loss like the length of antrum resection, the size of Fouchet tube, or the reinforcement of staple line [1-4]. Besides that other concepts regarding reduction of size or number of trocars have also been applied. LSG has been performed with fewer trocars, using for example special designed internal retractors or even the posterior part of the dissected stomach to replace the liver retractor and its trocar [5, 6]. Single port is another well-known possibility [7, 8], but mini-laparoscopy or needlescopic SG is still not well explored in our opinion. We believe that this technical alternative proposed in this video keeps the standards of care and safety of conventional LSG. There is no change in the position of the surgeon, not even the trocars. Specially designed needlescopic instruments show enough strength to be used in bariatrics and allow the surgeon to perform all the routine maneuvers from dissection to suturing. LSG can be done by mini-laparoscopy with a short adaptation period, previewing a short learning curve with no increase in the complications rate. NSG is feasible in selected patients and with few modifications in the standard technique. There might be a benefit in terms of pain. Further studies with large series are necessary to observe these potential benefits.

Subcutaneous hemangiosarcoma induced by a foreign body (steel staple) in a cat.

PubMed

Tan, Rommel Max; Singh, Kuldeep; Sandman, Kristi

2013-04-01

An 8-year-old, female domestic shorthair cat was presented with a ventral abdominal subcutaneous mass. A radiograph showed that the center of the mass contained what appeared to be steel sutures, presumed to be from an ovariohysterectomy performed 7 years earlier. The excised mass was irregular and contained numerous pockets filled with friable necrotic material and hemorrhages that were dissected by fibrous connective tissue bands. Multiple tangled and fragmented pieces of steel staples were deeply embedded within the mass. Histologically, the mass was non-encapsulated, densely cellular, and infiltrative. Neoplastic cells lined caverns and channels and were factor VIII-positive by immunohistochemistry. The neoplastic cells were oval to round with granular cytoplasm and vesicular nucleus and exhibited moderate cellular and nuclear pleomorphism. A diagnosis of subcutaneous hemangiosarcoma was made. To our knowledge, this is the first report of foreign body associated hemangiosarcoma and the first case of steel staple associated neoplasm in domestic animals.

Accidental entrapment of an endo-bronchial blocker tip by a surgical stapler during selective ventilation for lung lobectomy in a dog.

PubMed

Levionnois, Olivier L; Bergadano, Alessandra; Schatzmann, Urs

2006-01-01

To describe the use of an endobronchial blocker (EBB) and to perform selective ventilation during pulmonary lobe resection via thoracotomy in a dog and report its accidental stapling in the resection site. Clinical case report. One female dog with a suspected abscess or neoplasia of the right caudal pulmonary lobe. One-lung ventilation was performed using a wire-guided EBB to seal the contaminated parenchyma and facilitate surgical access. The affected lung parenchyma was resected and the resection site was closed with staples. Lobar resection was performed successfully, but the loop of the EBB guide wire was inadvertently entrapped in the staple line of the lobectomy. Staples were removed to release the wire loop, and the resulting air leak caused loss of ventilation control until the parenchyma was re-sealed. We recommend removing the wire guide associate with the EBB after successful lung separation to avoid accidents that could have life-threatening consequences if not recognized. One-lung ventilation is useful to isolate healthy parenchyma from diseased parenchyma during lobectomy. Anesthesiologists and surgeons need to be aware of the potential complications associated with use of EBB.

Use of the stapler in anterior resection for cancer of the rectosigmoid.

PubMed

Resnick, S D; Burstein, A E; Viner, Y L

1983-02-01

The circular stapling device was used for anterior resection in 61 of 88 patients who underwent curative surgery for rectosigmoid cancer. Use of the autosuture increased the success rate to 68.5% for this radical sphincter-saving procedure. In three-quarters of the patients the stapling end-to-end inverting colorectal anastomosis was created within 3 to 8 cm from the dentate line, where it is difficult or even impossible to perform anastamoses by the conventional manual technique. Anastomotic leakage (3.3%) and hemorrhage (4.9%), mild anastomotic stenosis (1.6%) and transitory anal incontinence (4.9%) were the main complications. There were no deaths in our series. The great safety of the stapling anastomosis and the low rate of anal incontinence may be explained by the preservation of an adequate blood supply and innervation of the rectal stump and its sphincter apparatus, as the stapling device needs only minimal mobilization of the bowel involved in the anastomosis. Restoring colorectal continuity after Hartmann's resection is a speedy, safe and simple procedure with the EEA (enteroenterostomy) stapler. Hartmann's operation may thus be considered the procedure of choice in emergency surgery for obstructed rectosigmoid cancer.

Colovaginal anastomosis: an unusual complication of stapler use in restorative procedure after Hartmann operation

PubMed Central

Yan, Zhongshu; Liao, Guoqing

2005-01-01

Background Rectovaginal fistula is uncommon after lower anterior resection for rectal cancer. The most leading cause of this complication is involvement of the posterior wall of the vagina into the staple line when firing the circular stapler. Case presentation A 50-year-old women underwent resection for obstructed carcinoma of the sigmoid colon with Hartmann procedure. Four months later she underwent restorative surgery with circular stapler. Following which she developed rectovaginal fistula. A transvaginal repair was performed but stool passing from vagina not per rectum. Laporotomy revealed colovaginal anastomosis, which was corrected accordingly. Patient had an uneventful recovery. Conclusion Inadvertent formation of colovaginal anastomosis associated with a rectovaginal fistula is a rare complication caused by the operator's error. The present case again highlights the importance of ensuring that the posterior wall of vagina is away from the staple line. PMID:16285887

Stapled α−helical peptide drug development: A potent dual inhibitor of MDM2 and MDMX for p53-dependent cancer therapy

PubMed Central

Chang, Yong S.; Graves, Bradford; Guerlavais, Vincent; Tovar, Christian; Packman, Kathryn; To, Kwong-Him; Olson, Karen A.; Kesavan, Kamala; Gangurde, Pranoti; Mukherjee, Aditi; Baker, Theresa; Darlak, Krzysztof; Elkin, Carl; Filipovic, Zoran; Qureshi, Farooq Z.; Cai, Hongliang; Berry, Pamela; Feyfant, Eric; Shi, Xiangguo E.; Horstick, James; Annis, D. Allen; Manning, Anthony M.; Fotouhi, Nader; Nash, Huw; Vassilev, Lyubomir T.; Sawyer, Tomi K.

2013-01-01

Stapled α−helical peptides have emerged as a promising new modality for a wide range of therapeutic targets. Here, we report a potent and selective dual inhibitor of MDM2 and MDMX, ATSP-7041, which effectively activates the p53 pathway in tumors in vitro and in vivo. Specifically, ATSP-7041 binds both MDM2 and MDMX with nanomolar affinities, shows submicromolar cellular activities in cancer cell lines in the presence of serum, and demonstrates highly specific, on-target mechanism of action. A high resolution (1.7-Å) X-ray crystal structure reveals its molecular interactions with the target protein MDMX, including multiple contacts with key amino acids as well as a role for the hydrocarbon staple itself in target engagement. Most importantly, ATSP-7041 demonstrates robust p53-dependent tumor growth suppression in MDM2/MDMX-overexpressing xenograft cancer models, with a high correlation to on-target pharmacodynamic activity, and possesses favorable pharmacokinetic and tissue distribution properties. Overall, ATSP-7041 demonstrates in vitro and in vivo proof-of-concept that stapled peptides can be developed as therapeutically relevant inhibitors of protein–protein interaction and may offer a viable modality for cancer therapy. PMID:23946421

Investigation of the best suture pattern to close a stuffed Christmas turkey.

PubMed

Verwilghen, D; Busoni, V; van Galen, G; Wilke, M

Instructions on how to debone and stuff a turkey are available, but what is the best way to close it up? A randomised trial involving 15 turkeys was performed in order to evaluate skin disruption scores and cosmetic outcomes following the use of different suture patterns. Turkeys were deboned, stuffed and cooked according to guidelines of the US Department of Agriculture Food Safety and Inspection Services. After stuffing, they were randomly assigned to one of five closure groups: simple continuous Lembert; simple continuous Cushing; simple continuous Utrecht; simple continuous; or staples. Turkeys were cooked at 180 °C for two hours ensuring core temperature reached 75 °C. Suture line integrity was evaluated after removal of the sutures and the cosmetic aspect was graded. Before cooking, the Utrecht pattern and skin staples offered the best cosmetic result. After removal of the sutures, the skin remained intact only in the stapled group. All other suture patterns disrupted the skin after removal of the sutures, rendering the turkey less cosmetically appealing for serving. Closure of a stuffed turkey was best performed using skin staples to achieve the best cosmetic results. Using this technique you will be able to impress family and friends at a Christmas dinner, and finally show them your surgical skills.

Fabrication of biopolymer-based staple electrospun fibres for nanocomposite applications by particle-assisted low temperature ultrasonication.

PubMed

Mulky, Elias; Yazgan, Gökçe; Maniura-Weber, Katharina; Luginbuehl, Reto; Fortunato, Giuseppino; Bühlmann-Popa, Ana-Maria

2014-12-01

We demonstrate the fabrication of staple polymer-based fibres by the ultrasound-assisted processing of electrospun meshes. Bioabsorbable Poly-L-Lactic Acid (PLLA) was electrospun from organic solvent mixtures, yielding continuous fibres with diameters in the range of 244±78 nm. Subsequently, the obtained fibres were sonicated at low temperatures in the presence of nanoparticles in order to obtain fibres with small aspect ratios. The influence of the dispersion medium, the sonication process parameters (temperature and time) and the dimensions of the particles used on the respective length distribution of the obtained nanofibres was investigated. Hexane was identified as an optimal dispersion medium for the system studied in this work. When a cooling bath temperature of 0°C was used, a slight increase in the obtained fibres' average length and distribution was observed as compared to cooling at -80°C (54±43 μm vs 44±31 μm). Moreover, in the presence of hydroxyapatite and hydrophilic and hydrophobic TiO2 nanoparticles in the dispersion medium longer fibres were obtained (44±31 μm, 63±47 μm, and 51±52 μm). Finally, the application of the obtained PLLA-fibre-hydroxyapatite (HA) nanoparticle precursors for the fabrication of a fibre-reinforced Brushite-based cement with high compressive strength is shown. This method of obtaining nanoscaled fibre-reinforced materials opens up a wide range of perspectives for the fabrication of composites for tissue engineering applications. Copyright © 2014 Elsevier B.V. All rights reserved.

Preoperative Detection of Sarcopenic Obesity Helps to Predict the Occurrence of Gastric Leak After Sleeve Gastrectomy.

PubMed

Gaillard, Martin; Tranchart, Hadrien; Maitre, Sophie; Perlemuter, Gabriel; Lainas, Panagiotis; Dagher, Ibrahim

2018-03-02

Sleeve gastrectomy (SG) has become the primary procedure for many bariatric teams and staple-line leak represents its most feared complication. Sarcopenic obesity combines the risks of obesity and depleted lean mass leading possibly to an inferior surgical outcome after abdominal surgery. The aim of this study was to evaluate the existence of a potential link between radiologically determined sarcopenic obesity and staple-line leak risk after SG. A retrospective analysis of a prospective database was performed in consecutive patients undergoing SG as primary procedure. Total psoas muscles (TPA) and total visible muscles (TMA) areas were measured on a preoperative computed tomography (CT). Sarcopenia was defined as lowest tertile of skeletal muscular mass indexes (muscular areas over square of height) in each gender (using TPA or TMA). Multivariate analysis was performed to determine preoperative risk factors for staple-line leak. During the study period, 205 patients were included in the analysis. Median BMI was 40.8 kg/m 2 (34.2-49.6), and 9 patients (4.4%) presented a gastric leak. The sex-specific cut-offs for skeletal muscular mass index according to TPA were 8.2 cm 2 /m 2 for men and 6.08 cm 2 /m 2 for women. After multivariate analysis, preoperative weight (OR = 1043) and sarcopenia (TPA) (OR = 5204) were independent predictive factors for gastric leak. The present series suggests that CT scan-determined sarcopenic obesity is associated with increased risk of gastric leak after SG. This preoperatively radiological examination would be a useful clinical tool to tailor patient management according to gastric leak risk.

Laparoscopic Transhiatal Treatment of Large Epiphrenic Esophageal Diverticulum

PubMed Central

Casella, Giovanni; Recchia, Carlo Luigi; Bianchi, Ermanno; Lomartire, Nazzareno

2008-01-01

Background: Epiphrenic diverticulum is an uncommon disorder of the distal third of the esophagus. We report the case of a 73-year-old woman with a large symptomatic esophageal epiphrenic diverticulum, diffuse nonspecific esophageal dysmotility, and a hiatal hernia. Methods: Surgery was indicated by the patient's symptoms, the size of the diverticulum (maximum diameter 10 cm), and the associated esophageal motor disorder. Preoperative study included barium swallow, upper gastrointestinal endoscopy, and esophageal manometry. A laparoscopic transhiatal diverticulectomy associated with a Heller myotomy, hiatoplasty, and a Dor's fundoplication was carried out. The overall operative time was 230 minutes. Results: No intraoperative complications occurred. Gastrografin swallow performed on postoperative day 4 did not show any signs of leakage from the staple line. The postoperative hospital stay was 5 days. The patient was readmitted 10 days after discharge complaining of fever and chest pain. A new Gastrografin swallow demonstrated a small leak from the staple line successfully treated with 3 weeks of total enteral nutrition. Conclusion: The laparoscopic approach to epiphrenic diverticulum is feasible. Postoperative Gastrografin swallow is not 100% sensitive in detecting small suture-line leaks if a preexisting esophageal motility disorder is present. In case of late postoperative fever and pleural effusion, a suture-line leak should be suspected. Conservative management of the small suture-line leak should be considered as an effective therapeutic option. PMID:18402751

[Does the third staple line of a new endostapler offer an advantage?].

PubMed

Czymek, R; Keller, R; Hildebrand, P; Bouchard, R; Bader, F G; Jungbluth, T; Mirow, L; Roblick, U J; Bruch, H-P

2009-06-01

In laparoscopic colon surgery, endostaplers generate 2 parallel rows of staples. The aim of this paper is to analyse whether the introduction of a new endostapler generating a third row of staples influences the rate of anastomotic leakage and bleedings. 362 patients of the Department of Surgery, University Clinic of Schleswig-Holstein, Campus Lübeck, were included in this study. All patients underwent colon resection with performance of double-stapling anastomosis. In Group I (n = 148; 7 / 2004 to 12 / 2005), the Endopath TSB 45 endostapler (2 rows of staples) was used, whereas in Group II (n = 214; 7 / 2006 to 12 / 2007), the Echelon60 EC60 stapler (3 rows of staples) was used. All further operational steps were identical for both groups. Target parameters were the postoperative anastomotic leakage and anastomotic bleeding rates. Between July 2004 and December 2005, the number of anastomotic leaks (Stapler Endopath, TSB 45) was n = 4 (2.7 %), for the second period (Stapler Echelon60 EC60), it was n = 9 (3.7 %) (not significant). Using the Endopath TSB 45 stapler, the number of anastomotic bleedings was n = 12 (8.1 %), and for the Echelon60 EC60 stapler, it was n = 8 (3.7 %) (p = 0.074; not significant). Within the 18-month period between July 2006 and December 2007, the number of endoscopic colon operations (n = 214) rose by 44.6 % compared to the 18-month period between July 2004 and December 2005 (n = 148). The application of the advanced Echelon endostapler has no impact on the number of anastomotic leaks, and reduces the number of anastomotic bleedings slightly but not significantly. The increased number of endoscopic procedures in the second period results both from the growing number of indications for the application of endoscopic techniques and the positive findings of recent studies carried out by our own and other working groups.

Heterosis and correlation in interspecific and intraspecific hybrids of cotton.

PubMed

Munir, S; Hussain, S B; Manzoor, H; Quereshi, M K; Zubair, M; Nouman, W; Shehzad, A N; Rasul, S; Manzoor, S A

2016-06-24

Interspecific and intraspecific hybrids show varying degrees of heterosis for yield and yield components. Yield-component traits have complex genetic relationships with each other. To determine the relationship of yield-component traits and fiber traits with seed cotton yield, six lines (Bt. CIM-599, CIM-573, MNH-786, CIM-554, BH-167, and GIZA-7) and three test lines (MNH-886, V4, and CIM-557) were crossed in a line x tester mating design. Heterosis was observed for seed cotton yield, fiber traits, and for other yield-component traits. Heterosis in interspecific hybrids for seed cotton yield was more prominent than in intraspecific hybrids. The interspecific hybrid Giza-7 x MNH-886 had the highest heterosis (114.77), while among intraspecific hybrids, CIM-554 x CIM-557 had the highest heterosis (61.29) for seed cotton yield. A major trait contributing to seed cotton yield was bolls/plant followed by boll weight. Correlation studies revealed that bolls/plant, boll weight, lint weight/boll, lint index, seed index, lint/seed, staple length, and staple strength were significantly and positively associated with seed cotton yield. Selection based on boll weight, boll number, lint weight/boll, and lint index will be helpful for improving cotton seed yield.

[Results of Longo's stapled hemorrhoidectomy in ambulatory surgery for grade III-IV hemorrhoids].

PubMed

Zaragozá, Cristóbal; García Fadrique, Alfonso; Castaño, Sergio; Villalba, Raúl; Bruna Esteban, Marcos; Redondo Cano, Carlos

2007-03-01

We prospectively evaluated the results of stapled hemorrhoidectomy for grade III-IV hemorrhoids in the ambulatory setting. Eighty-five consecutive patients with grade III-IV hemorrhoids, treated with the stapled technique with PPH01 in the Ambulatory Surgery Service of the General Hospital of Valencia were studied. Symptomatic, ASA I-II patients who agreed to undergo ambulatory surgery (vehicle, an accompanying adult, address with telephone, elevator, and basic hygiene conditions) were included. Thirty-nine percent were women and 61% were men, with a mean age of 47.6 years. A total of 85.9% had grade IV hemorrhoids and 14.1% had grade III. The average surgical time was 29.81+/- 12 minutes with a mean length of hospital stay of 168.88 +/- 88 minutes. Surgical complications consisted of 16 hemorrhages of the staple line (18.8%) and five hemorrhages due to mucous tear (5.9%). During the first 8 days the most frequent complication was pain (45.9%); only 7.1% of the patients required analgesia with opiates, and one patient required admission for 24 hours for analgesic purposes. Bleeding occurred in 10 patients, five of whom reported slight bleeding on defecation that stopped spontaneously; the remaining five required admission for 24 hours after surgical revision. Nine patients (10.6%) were admitted to the hospital for 24 hours, three due to intraoperative hemorrhage, five due to postoperative hemorrhage and one due to pain. A second intervention was required in 8.2%. Stapled hemorrhoidectomy can be applied in an ambulatory regime. Although technically simple with a short learning curve, this technique is not free of complications. Suitable patient selection and adequate perioperative information are indispensable for the ambulatory management of this disorder.

Common side closure type, but not stapler brand or oversewing, influences side-to-side anastomotic leak rates.

PubMed

Fleetwood, V A; Gross, K N; Alex, G C; Cortina, C S; Smolevitz, J B; Sarvepalli, S; Bakhsh, S R; Poirier, J; Myers, J A; Singer, M A; Orkin, B A

2017-03-01

Anastomotic leak (AL) increases costs and cancer recurrence. Studies show decreased AL with side-to-side stapled anastomosis (SSA), but none identify risk factors within SSAs. We hypothesized that stapler characteristics and closure technique of the common enterotomy affect AL rates. Retrospective review of bowel SSAs was performed. Data included stapler brand, staple line oversewing, and closure method (handsewn, HC; linear stapler [Barcelona technique], BT; transverse stapler, TX). Primary endpoint was AL. Statistical analysis included Fisher's test and logistic regression. 463 patients were identified, 58.5% BT, 21.2% HC, and 20.3% TX. Covidien staplers comprised 74.9%, Ethicon 18.1%. There were no differences between stapler types (Covidien 5.8%, Ethicon 6.0%). However, AL rates varied by common side closure (BT 3.7% vs. TX 10.6%, p = 0.017), remaining significant on multivariate analysis. Closure method of the common side impacts AL rates. Barcelona technique has fewer leaks than transverse stapled closure. Further prospective evaluation is recommended. Copyright © 2017. Published by Elsevier Inc.

[Prevention of post-operative pain and haemorrhage in PPH (Procedure for Prolapse and Hemorrhoids) and STARR (Stapled Trans-Anal Rectal Resection). Preliminary results in 261 cases].

PubMed

Mongardini, M; Custureri, F; Schillaci, F; Cola, A; Maturo, A; Fanello, G; Corelli, S; Pappalardo, G

2005-04-01

Intra- and early (first week) post-operative haemorrhages are the most common complications in stapled hemorrhoidectomy PPH (Procedure for Prolapse and Hemorrhoids) and in circumferential resection of the rectal prolapse STARR (Stapled Trans Anal Rectal Resection). Performing PPH and STARR we employed a gelatin based haemostatic sealant with thrombin component (FloSeal) to control intra-operative bleeding and to reduce post-operative bleeding avoiding haemostatic stitches on suture line. We report the preliminary results on 197 PPH and 64 STARR; 44 PPH (22.4%) and 27 STARR (42.2%) were treated by FloSeal. No major post-operative bleeding was observed in all patients treated by FloSeal, compared to 1.3% and 2.7% of hemorrhage respectively in PPH and STARR patients treated without sealant. Post-operative pain was less severe in patients treated by FloSeal, without a difference statistically significant. The data are preliminary and must be confirmed in prospective randomized trials in larger series.

76 FR 40329 - Certain Polyester Staple Fiber From the People's Republic of China: Notice of Preliminary Results...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-08

...., Ltd.; Cixi Waysun Chemical Fiber Co., Ltd.; Hangzhou Sanxin Paper Co., Ltd.; Nantong Loulai Chemical... Fair Value, and Affirmative Critical Circumstances, In Part: Certain Lined Paper Products from the...., Final Results of Antidumping Duty Administrative Review: Petroleum Wax Candles from the People's...

Test cross evaluation of upland cotton accessions for selected fiber properties

USDA-ARS?s Scientific Manuscript database

Texas A&M AgriLife Research released several upland cotton (Gossypium hirsutum L.) germplasm lines that exhibit near extra-long and extra-long staple (ELS) upper half mean length (UHML) fibers, similar to those produced by pima cotton (Gossypium barbadense L.) and significantly longer than those of ...

An Endoscopic Nasomediastinal Approach to a Mediastinal Abscess Developing after Zenker's Diverticulectomy

PubMed Central

Gundogdu, Kemal; Eminler, Ahmet Tarik; Parlak, Erkan; Cakmak, Guner

2017-01-01

Zenker's diverticulum is the most frequent symptomatic diverticulum of the esophagus, but the prevalence is <0.1%. The optimal treatment is surgery. Here, we present a nasomediastinal drainage approach to treatment of a mediastinal abscess, developing in the late postoperative period and attributable to leakage from the staple line. PMID:28831318

Early Experience With a Partial Stapled Hemorrhoidopexy for Treating Patients With Grades III–IV Prolapsing Hemorrhoids

PubMed Central

Jeong, Hyeonseok; Ryu, Kil O; Lim, Jiyong; Kim, Hyun Tae; Yu, Hye Mi; Yoon, Jihoon; Lee, Ju-Young; Kim, Hyoung Rae; Choi, Young Gil

2017-01-01

Purpose Circular stapled hemorrhoidopexy (CSH) is widely used to treat patients with grades III–IV hemorrhoids because of less pain and short hospital stay. However, this procedure is associated with some complications, such as urge to defecate, anal stenosis, staple line dehiscence, abscess and sepsis. To avoid these complications, surgeons perform a partial stapled hemorrhoidopexy (PSH). The aim of this study is to present our early experience with the PSH. Methods We retrospectively reviewed the medical records of 58 patients with hemorrhoids who were treated with a PSH at Busan Hang-Un Hospital from January 2016 to June 2016. A specially designed tri-window anoscope was used, and a purse string suture was made at the mucosae of the protruding hemorrhoids through the window of the anoscope. The hemorrhoidopexy was done by using a circular stapler. Results Of the 58 patients included in this study, 34 were male and 24 were female patients (mean age, 50.4 years). The mean operation time was 12.4 minutes, and the mean postoperative hospital stay was 3.8 days. Three patients experienced bleeding (5.1%) 5 urinary retention (8.6%) and 5 skin tags (8.6%). Urge to defecate, tenesmus, abscess, rectovaginal fistula, anal stricture, incontinence, and recurrence did not occur. Conclusion PSH is a minimally invasive, feasible, and safe technique for treating patients with grades III–IV hemorrhoids. A PSH, instead of a CSH, can be used to treat certain patients with hemorrhoids. PMID:28289661

Technical characteristics can make the difference in a surgical linear stapler. Or not?

PubMed

Giaccaglia, Valentina; Antonelli, Maria Serena; Addario Chieco, Paola; Cocorullo, Gianfranco; Cavallini, Marco; Gulotta, Gaspare

2015-07-01

Anastomotic leak (AL) after gastrointestinal surgery is a severe complication associated with relevant short- and long-term sequelae. Most of the anastomosis are currently performed with a surgical stapler that is required to have appropriate characteristics to guarantee good performances. The aim of our study was to evaluate, in the laboratory, pressure resistance and tensile strength of anastomosis performed with different surgical linear staplers, available in the market. We have been studying three linear staplers, with diverse cartridges and staple heights, of three different companies, used for gastrointestinal anastomosis and gastric or intestinal closure. We performed 50 anastomosis for each device, with the pertinent different cartridges, on fresh pig intestine, for a total of 350 anastomosis, then injected saline solution and recorded the pressure that provokes a leak on the staple line. There were no statistically significant differences between the mean pressure necessary to induce an AL in the various instruments (P > 0.05). For studying the tensile strength, we performed a total of 350 anastomosis with the different linear staplers on a special strong paper (Tyvek), then recorded the maximal tensile force that could open the anastomosis. There were no statistically significant differences between the different staplers about the strength necessary to open the staple line (P > 0.05). we demonstrated that different linear staplers of three companies available in the market give comparable anastomotic pressure resistance and tensile strength. This might suggest that small dissimilarities between different devices are not involved, at least as major parameters, in AL etiology. Copyright © 2015 Elsevier Inc. All rights reserved.

Ethanol-reinforced responding by AA and ANA rats following the sucrose-substitution initiation procedure.

PubMed

Files, F J; Denning, C E; Hyytia, P; Kiianmaa, K; Samson, H H

1997-06-01

Ethanol-reinforced responding was initiated in male AA and ANA rats using the sucrose-substitution procedure. Before the initiation procedure, a homecage, two-bottle preference test was conducted. The rats were then trained to respond on an Fixed-Ratio 1 schedule with sucrose reinforcement. Over sessions, ethanol was added gradually to the sucrose solution as the concentration of sucrose was reduced until 10% ethanol (v/v) alone functioned as the reinforcer for lever pressing. The schedule of reinforcement was then increased to Fixed-Ratio 4. Next, the ethanol concentration presented as the reinforcer was increased over weeks to 15%, 20%, 30%, and then returned to 10%. A second homecage test was then performed. The results showed that the AA and ANA lines differed significantly on preference and intake (g/kg) during the homecage preference tests. There was a significant increase in preference during the second homecage test. During sucrose substitution, initial large differences in responding were observed between the lines. When the ethanol concentration was increased, intake (grams per kilogram) increased for the AA line but not for the ANA line. These effects were a function of no change in responding by the AA rats as concentration was increased and a decrease in responding by the ANA rats at the higher concentrations (20% and 30%). Taken together, data indicate that ethanol can function as a positive reinforcer for the behavior of AA and ANA rats. Even though 10% ethanol functioned as a reinforcer similarly for the two lines, ethanol intake in the AA line was significantly greater at the higher concentrations of ethanol, suggesting that ethanol functioned as a qualitatively different reinforcer for the AA rats, compared with the ANA rats.

Intraoperative leak testing has no correlation with leak after laparoscopic sleeve gastrectomy.

PubMed

Sethi, Monica; Zagzag, Jonathan; Patel, Karan; Magrath, Melissa; Somoza, Eduardo; Parikh, Manish S; Saunders, John K; Ude-Welcome, Aku; Schwack, Bradley F; Kurian, Marina S; Fielding, George A; Ren-Fielding, Christine J

2016-03-01

Staple line leak is a serious complication of sleeve gastrectomy. Intraoperative methylene blue and air leak tests are routinely used to evaluate for leak; however, the utility of these tests is controversial. We hypothesize that the practice of routine intraoperative leak testing is unnecessary during sleeve gastrectomy. A retrospective cohort study was designed using a prospectively collected database of seven bariatric surgeons from two institutions. All patients who underwent sleeve gastrectomy from March 2012 to November 2014 were included. The performance of intraoperative leak testing and the type of test (air or methylene blue) were based on surgeon preference. Data obtained included BMI, demographics, comorbidity, presence of intraoperative leak test, result of test, and type of test. The primary outcome was leak rate between the leak test (LT) and no leak test (NLT) groups. SAS version 9.4 was used for univariate and multivariate analyses. A total of 1550 sleeve gastrectomies were included; most were laparoscopic (99.8%), except for one converted and two open cases. Routine intraoperative leak tests were performed in 1329 (85.7%) cases, while 221 (14.3%) did not have LTs. Of the 1329 cases with LTs, there were no positive intraoperative results. Fifteen (1%) patients developed leaks, with no difference in leak rate between the LT and NLT groups (1 vs. 1%, p = 0.999). After adjusting for baseline differences between the groups with a propensity analysis, the observed lack of association between leak and intraoperative leak test remained. In this cohort, leaks presented at a mean of 17.3 days postoperatively (range 1-67 days). Two patients with staple line leaks underwent repeat intraoperative leak testing at leak presentation, and the tests remained negative. Intraoperative leak testing has no correlation with leak due to laparoscopic sleeve gastrectomy and is not predictive of the later development of staple line leak.

Properties of CF/PA6 friction spun hybrid yarns for textile reinforced thermoplastic composites

NASA Astrophysics Data System (ADS)

Hasan, MMB; Nitsche, S.; Abdkader, A.; Cherif, Ch

2017-10-01

Due to their excellent strength, rigidity and damping properties as well as low weight, carbon fibre reinforced composites (CFRC) are widely being used for load bearing structures. On the other hand, with an increased demand und usage of CFRCs, effective methods to re-use waste carbon fibre (CF) materials, which are recoverable either from the process scraps or from the end-of-life components are attracting increased attention. In this paper, hybrid yarns consisting of staple CF and polyamide 6 (PA 6) are manufactured on a DREF-3000 friction spinning machine with various machine parameters such as spinning drum speed and suction air pressure. The relationship between different textile physical properties of the hybrid yarns, such as tensile strength and elongation with different spinning parameters and CF content of hybrid yarn is investigated. Furthermore, the tensile properties of uni-directional (UD) composites manufactured from the developed hybrid yarn shows 80% of the UD composite strength made from CF filament yarn.

75 FR 40777 - Certain Polyester Staple Fiber From the People's Republic of China: Notice of Preliminary Results...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-14

....; Hangzhou Sanxin Paper Co., Ltd.; Hangzhou Taifu Textile Fiber Co., Ltd.; Jiaxang Fuda Chemical Fibre...: Certain Lined Paper Products from the People's Republic of China, 71 FR 53079, 53082 (September 8, 2006...: Petroleum Wax Candles from the People's Republic of China, 72 FR 52355, 52356 (September 13, 2007). In...

NOD promoter-controlled AtIRT1 expression functions synergistically with NAS and FERRITIN genes to increase iron in rice grains.

PubMed

Boonyaves, Kulaporn; Gruissem, Wilhelm; Bhullar, Navreet K

2016-02-01

Rice is a staple food for over half of the world's population, but it contains only low amounts of bioavailable micronutrients for human nutrition. Consequently, micronutrient deficiency is a widespread health problem among people who depend primarily on rice as their staple food. Iron deficiency anemia is one of the most serious forms of malnutrition. Biofortification of rice grains for increased iron content is an effective strategy to reduce iron deficiency. Unlike other grass species, rice takes up iron as Fe(II) via the IRON REGULATED TRANSPORTER (IRT) in addition to Fe(III)-phytosiderophore chelates. We expressed Arabidopsis IRT1 (AtIRT1) under control of the Medicago sativa EARLY NODULIN 12B promoter in our previously developed high-iron NFP rice lines expressing NICOTIANAMINE SYNTHASE (AtNAS1) and FERRITIN. Transgenic rice lines expressing AtIRT1 alone had significant increases in iron and combined with NAS and FERRITIN increased iron to 9.6 µg/g DW in the polished grains that is 2.2-fold higher as compared to NFP lines. The grains of AtIRT1 lines also accumulated more copper and zinc but not manganese. Our results demonstrate that the concerted expression of AtIRT1, AtNAS1 and PvFERRITIN synergistically increases iron in both polished and unpolished rice grains. AtIRT1 is therefore a valuable transporter for iron biofortification programs when used in combination with other genes encoding iron transporters and/or storage proteins.

21 CFR 878.4760 - Removable skin staple.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Removable skin staple. 878.4760 Section 878.4760...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4760 Removable skin staple. (a) Identification. A removable skin staple is a staple-like device intended to connect external tissues temporarily...

TRREMS procedure (transanal repair of rectocele and rectal mucosectomy with one circular stapler): a prospective multicenter trial.

PubMed

Cruz, José Vinicius; Regadas, Francisco Sergio P; Murad-Regadas, Sthela Maria; Rodrigues, Lusmar Veras; Benicio, Fernando; Leal, Rogério; Carvalho, César G; Fernandes, Margarete; Roche, Lucimar M C; Miranda, Antônio Carlos; Câmara, Lucia; Pereira, Joaquim Costa; Parra, Antonio Mallén; Leal, Vilmar Moura

2011-01-01

Since anorectocele is usually associated with mucosa prolapse and/or rectal intussusceptions, it was developed a stapled surgical technique using one circular stapler. To report the results of Transanal Repair of Rectocele and Rectal Mucosectomy with one Circular Stapler (TRREMS procedure) in the treatment of anorectocele with mucosa prolapse in a prospective multicenter trial. It was conducted by 14 surgeons and included 75 female patients, mean aged 49.6 years, with symptoms of obstructed defecation due to grade 2 (26.7%) and grade 3 (73.3%) anorectocele associated with mucosa prolapse and/or rectal intussusception (52.0%) and an average validated Wexner constipation score of 16. All patients were evaluated by a proctological examination, cinedefecography, anal manometry and colonic transit time. The TRREMS procedure consists of the manual removal of the rectocele wall with circumferential rectal mucosectomy performed with a circular stapler. The mean follow-up time was 21 months. All patients presented obstructed defecation and they persisted with symptoms despite conservative treatment. The mean operative time was 42 minutes. In 13 (17.3%) patients, bleeding from the stapled line required hemostatic suture. Stapling was incomplete in 2 (2.6%). Forty-nine patients (65.3%) required 1 hospitalization day, the remainder (34.7%) 2 days. Postoperatively, 3 (4.0%) patients complained of persistent rectal pain and 7 (9.3%) developed stricture on the stapled suture subsequently treated by stricturectomy under anesthesia (n = 1), endoscopic stricturectomy with hot biopsy forceps (n = 3) and digital dilatation (n = 3). Postoperative cinedefecography showed residual grade I anorectoceles in 8 (10.6%). The mean Wexner constipation score decreased significantly from 16 to 4 (0-4: n = 68) (6: n = 6) (7: n = 1) (P<0.0001). Current trial results suggest that TRREMS procedure is a safe and effective technique for the treatment of anorectocele associated with mucosa prolapse. The stapling technique is low-cost as requires the use of a single circular stapler.

Diagnosing Internal Herniation After Roux-en-Y Gastric Bypass Surgery: Literature Overview, Cadaver Study and the Added Value of 3D CT Angiography.

PubMed

Klop, Cornelis; Deden, Laura N; Aarts, Edo O; Janssen, Ignace M C; Pijl, Milan E J; van den Ende, Anneline; Witteman, Bart P L; de Jong, Gabie M; Aufenacker, Theo J; Slump, Cornelis H; Berends, Frits J

2018-02-05

The purposes of the study are to outline the complexity of diagnosing internal herniation after Roux-en-Y gastric bypass (RYGB) surgery and to investigate the added value of computed tomography angiography (CTA) for diagnosing internal herniation. A cadaver study was performed to investigate the manifestations of internal hernias and mesenteric vascularization. Furthermore, a prospective, ethics approved study with retrospective interpretation was conducted. Ten patients, clinically suspected for internal herniation, were prospectively included. After informed consent was obtained, these subjects underwent abdominal CT examination, including additional arterial phase CTA. All subjects underwent diagnostic laparoscopy for suspected internal herniation. The CTA was used to create a 3D reconstruction of the mesenteric arteries and surgical staples (3D CTA). The 3D CTA was interpreted, taking into account the presence and type of internal hernia that was found upon laparoscopy. Cadaveric analysis demonstrated the complexity of internal herniation. It also confirmed the expected changes in vascular structure and surgical staple arrangement in the presence of internal herniation. 3D CTA studies of the subjects with active internal hernias demonstrated remarkable differences when compared to control 3D CTA studies. The blood supply of herniated intestinal limbs in particular showed abnormal trajectories. Additionally, enteroenterostomy staple lines had migrated or altered orientation. 3D CTA is a promising technique for diagnosing active internal hernias. Our findings suggest that for diagnosing internal hernias, focus should probably shift from routine abdominal CT examination towards the 3D assessment of the mesenteric vasculature and surgical staples.

75 FR 43921 - Certain Polyester Staple Fiber From Taiwan: Final Results of Antidumping Duty Administrative Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-27

... DEPARTMENT OF COMMERCE International Trade Administration [A-583-833] Certain Polyester Staple... certain polyester staple fiber from Taiwan. The period of review is May 1, 2008, through April 30, 2009... polyester staple fiber (PSF) from Taiwan. See Certain Polyester Staple Fiber From Taiwan: Preliminary...

Finite element modelling of stapled colorectal end-to-end anastomosis: advantages of variable height stapler design.

PubMed

Nováček, V; Tran, T N; Klinge, U; Tolba, R H; Staat, M; Bronson, D G; Miesse, A M; Whiffen, J; Turquier, F

2012-10-11

The impact of surgical staplers on tissues has been studied mostly in an empirical manner. In this paper, finite element method was used to clarify the mechanics of tissue stapling and associated phenomena. Various stapling modalities and several designs of circular staplers were investigated to evaluate the impact of the device on tissues and mechanical performance of the end-to-end colorectal anastomosis. Numerical simulations demonstrated that a single row of staples is not adequate to resist leakage due to non-linear buckling and opening of the tissue layers between two adjacent staples. Compared to the single staple row configuration, significant increase in stress experienced by the tissue at the inner staple rows was observed in two and three rows designs. On the other hand, adding second and/or third staple row had no effect on strain in the tissue inside the staples. Variable height design with higher staples in outer rows significantly reduced the stresses and strains in outer rows when compared to the same configuration with flat cartridge. Copyright © 2012 Elsevier Ltd. All rights reserved.

A fibrin adhesive sealing method for the prevention of pancreatic fistula following distal pancreatectomy.

PubMed

Mita, Kazuhito; Ito, Hideto; Fukumoto, Masato; Murabayashi, Ryo; Koizumi, Kazuya; Hayashi, Takashi; Kikuchi, Hiroyuki; Kagaya, Tadashi

2011-01-01

Pancreatic fistula is the most common complication following distal pancreatectomy. We have developed a fibrin adhesive sealing method which covers the cut surface and parenchyma of the pancreas, to prevent pancreatic fistula. We performed 25 distal pancreatectomies. Fibrin adhesive (TachoComb) was applied to the staple line of the pancreas before stapling. Pancreatic fistula was defined and graded according to the International Study Group of Postoperative Pancreatic Fistula (ISGPF) definition. The overall incidence of pancreatic fistula was five cases (20%). Four cases (16%) were classified as Grade A. Only one case (4%) was classified as Grade B. In patients with or without pancreatic fistula, the mean length of postoperative hospital stay was not significant. The fibrin adhesive sealing method is a simple and effective method of preventing postoperative pancreatic fistula formation after distal pancreatectomy.

Differential reinforcement and resistance to change of divided-attention performance.

PubMed

Podlesnik, Christopher A; Thrailkill, Eric; Shahan, Timothy A

2012-06-01

Behavioral momentum theory provides a framework for understanding how conditions of reinforcement influence instrumental response strength under conditions of disruption (i.e., resistance to change). The present experiment examined resistance to change of divided-attention performance when different overall probabilities of reinforcement were arranged across two components of a multiple schedule. Pigeons responded in a delayed-matching-to-sample procedure with compound samples (color + line orientation) and element comparisons (two colors or two line orientations). Reinforcement ratios of 1:9, 1:1, and 9:1 for accurate matches on the two types of comparison trials were examined across conditions using reinforcement probabilities (color/lines) of .9/.1, .5/.5, and .1/.9 in the rich component and .18/.02, .1/.1, and .02/.18 in the lean component. Relative accuracy with color and line comparisons was an orderly function of relative reinforcement, but this relation did not depend on the overall rate of reinforcement between components. The resistance to change of divided-attention performance was greater for both trial types in the rich component with presession feeding and extinction, but not with decreases in sample duration. These findings suggest promise for the applicability of quantitative models of operant behavior to divided-attention performance, but they highlight the need to further explore conditions impacting the resistance to change of attending.

Differential reinforcement and resistance to change of divided-attention performance

PubMed Central

Thrailkill, Eric

2016-01-01

Behavioral momentum theory provides a framework for understanding how conditions of reinforcement influence instrumental response strength under conditions of disruption (i.e., resistance to change). The present experiment examined resistance to change of divided-attention performance when different overall probabilities of reinforcement were arranged across two components of a multiple schedule. Pigeons responded in a delayed-matching-to-sample procedure with compound samples (color + line orientation) and element comparisons (two colors or two line orientations). Reinforcement ratios of 1:9, 1:1, and 9:1 for accurate matches on the two types of comparison trials were examined across conditions using reinforcement probabilities (color/lines) of .9/.1, .5/.5, and .1/.9 in the rich component and .18/.02, .1/.1, and .02/.18 in the lean component. Relative accuracy with color and line comparisons was an orderly function of relative reinforcement, but this relation did not depend on the overall rate of reinforcement between components. The resistance to change of divided-attention performance was greater for both trial types in the rich component with presession feeding and extinction, but not with decreases in sample duration. These findings suggest promise for the applicability of quantitative models of operant behavior to divided-attention performance, but they highlight the need to further explore conditions impacting the resistance to change of attending. PMID:22038737

Techniques of stapler-based navigational thoracoscopic segmentectomy using virtual assisted lung mapping (VAL-MAP)

PubMed Central

Murayama, Tomonori; Nakajima, Jun

2016-01-01

Anatomical segmentectomies play an important role in oncological lung resection, particularly for ground-glass types of primary lung cancers. This operation can also be applied to metastatic lung tumors deep in the lung. Virtual assisted lung mapping (VAL-MAP) is a novel technique that allows for bronchoscopic multi-spot dye markings to provide “geometric information” to the lung surface, using three-dimensional virtual images. In addition to wedge resections, VAL-MAP has been found to be useful in thoracoscopic segmentectomies, particularly complex segmentectomies, such as combined subsegmentectomies or extended segmentectomies. There are five steps in VAL-MAP-assisted segmentectomies: (I) “standing” stitches along the resection lines; (II) cleaning hilar anatomy; (III) confirming hilar anatomy; (IV) going 1 cm deeper; (V) step-by-step stapling technique. Depending on the anatomy, segmentectomies can be classified into linear (lingular, S6, S2), V- or U-shaped (right S1, left S3, S2b + S3a), and three dimensional (S7, S8, S9, S10) segmentectomies. Particularly three dimensional segmentectomies are challenging in the complexity of stapling techniques. This review focuses on how VAL-MAP can be utilized in segmentectomy, and how this technique can assist the stapling process in even the most challenging ones. PMID:28066675

Comparison of endostapler performance in challenging tissue applications.

PubMed

Contini, Elizabeth; Whiffen, Jennifer; Bronson, Dwight

2013-01-01

Surgical staplers are frequently used in a variety of applications, demanding exacting instrument performance over a huge range of tissue compositions and disease states. The shape of a staple that is formed by a stapling device is one industry-accepted indicator of device performance; typically a B-shaped staple is considered the gold standard for staple formation. This B shape allows blood flow through the tissue, which is one important factor in the healing events that take place clinically after stapling. With the use of an animal model, this ex vivo study investigated staple formation when thick tissue endoscopic staplers were used on challenging and variable tissue. The setting was a corporate institution in the United States. Two 60-mm linear endoscopic thick tissue reloads, a varied-height stapler (VHS), and a single-height stapler (SHS) were fired on 7 different regions of porcine stomach. Resultant staple formation was assessed per region of the stomach and evaluated for proper B-shaped staple formation and staple malformation. The VHS reload had significantly better B-shaped formation (P<.001) for all regions of the stomach and reduced occurrence of malformed staples in 5 of the 7 regions compared with the SHS reload, wherein the remaining 2 regions exhibited comparable malform occurrence. This study compared 2 thick tissue reloads and found that the VHS reload had superior outcomes, with respect to staple formation, compared with the SHS reload. Copyright © 2012 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Radical cystectomy with W-shaped orthotopic ileal neobladder constructed with non-absorbable titanium staples-long term follow-up.

PubMed

Kravchick, Sergey; Lobik, Leonid; Paz, Adrian; Stepnov, Eugeny; Ben-Dor, David; Cytron, Shmuel

2013-01-01

We retrospectively assessed our experience with the W-shaped orthotopic ileal pouch, which was constructed with non-absorbable titanium staples. For these purpose, we discuss the results of bladder capacity, urinary continence and early and long-term postoperative complications. We included in the study 17 patients who underwent radical cystoprostatectomy followed by construction of an orthotopic W-shaped ileal pouch between October 2000 and November 2009. A 65-70 cm segment of ileum was isolated and prearranged into a W-configuration, leaving two 10 cm intact segments on both sides of the ileal fragment. In our technique we entirely anatomized all adjacent limbs in order to create a sphere-shaped pouch. The ureters were directly anastomized to both intact segments of the ileal division. All our patients underwent pouchscopy 6 months after operation and annually. Mean operative time for neobladder reconstruction and ureteral anastomoses was 87 ± 7.67 minutes. In one patient a leak from the ileo-ileal anastomosis was confirmed on the 3rd day after operation. In 2 cases unilateral stricture of the ureteral-neobladder anastomosis was documented. Staple lines were mostly covered with ileal mucosa after 6 months. The mean functional bladder capacity was 340 ± 27.6 mL and 375 ± 43.4 mL at 6 and 12 months, respectively. First-year daytime and nighttime continence was good and acceptable in 90% and 78% of patients, while it increased to 95% during the 2nd year. The long term follow-up shows that non-absorbable titanium staples can be safely used for creation of an orthotopic ileal neobladder. However, these data should be further validated in a larger series of patients.

LONG TERM RESULTS AFTER STAPLED HEMORRHOIDOPEXY ALONE AND COMPLEMENTED BY EXCISIONAL HEMORRHOIDECTOMY: A RETROSPECTIVE COHORT STUDY

PubMed Central

ARAUJO, Sergio Eduardo Alonso; HORCEL, Lucas de Araujo; SEID, Victor Edmond; BERTONCINI, Alexandre Bruno; KLAJNER, Sidney

2016-01-01

ABSTRACT Background: Stapled hemorrhoidopexy is associated with less postoperative pain and faster recovery. However, it may be associated with a greater risk of symptomatic recurrence. We hypothesized that undertaking a limited surgical excision of hemorrhoid disease after stapling may be a valid approach for selected patients. Aim: To compare long-term results after stapled hemorrhoidopexy with and without complementation with closed excisional technique. Method: In a retrospective uni-institutional cohort study, sixty-five (29 men) patients underwent stapled hemorrhoidopexy and 21 (13 men) underwent stapled hemorrhoidopexy with excision. The same surgeons operated on all cases. Patients underwent stapled hemorrhoidectomy associated with excisional surgery if symptoms attributable to external hemorrhoid piles were observed preoperatively, or if residual prolapse or bulky external disease was observed after the firing of the stapler. A closed excisional diathermy hemorrhoidectomy without vascular ligation was utilized in all complemented cases. All clinical variables were obtained from a questionnaire evaluation obtained through e-mail, telephone interview, or office follow-up. Results: The median duration of postoperative follow-up was 48.5 (6-40) months. Patients with grades 3 and 4 hemorrhoid disease were operated on more frequently using stapled hemorrhoidopexy complemented with excisional technique (95.2% vs. 55.4%, p=0.001). Regarding respectively stapled hemorrhoidopexy and stapled hemorrhoidopexy complemented with excision, there was no difference between the techniques in relation to symptom recurrence (43% and 33%, p=0.45) and median interval between surgery and symptom recurrence (30 (8-84) and 38.8 (8-65) months, p=0.80). Eight (12.3%) patients were re-operated after stapled hemorrhoidopexy and 2 (9.6%), after hemorrhoidopexy with excision (p=0.78). Patient distribution in both groups according to the degree of postoperative satisfaction was similar (p=0.97). Conclusion: Stapled hemorrhoidopexy combined with an excisional technique was effective for more advanced hemorrhoid disease. The combination may have prevented symptomatic recurrence associated to stapled hemorrhoidopexy alone. PMID:27759778

Agronomic and physiological performance of Teqing x Lemont introgression rice (Oryza sativa L.) lines under limited irrigation system

USDA-ARS?s Scientific Manuscript database

Rice is a staple food for almost half of the world. Most rice in the world, including the USA, is produced under a flooded paddy system that makes rice one of the most irrigated grain crops on earth. With many water resources being depleted due to high irrigation demands, it has become essential to ...

7 CFR 457.105 - Extra long staple cotton crop insurance provisions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 6 2014-01-01 2014-01-01 false Extra long staple cotton crop insurance provisions... long staple cotton crop insurance provisions. The extra long staple cotton crop insurance provisions... Crop Insurance Corporation ELS Cotton Crop Provisions 1. Definitions Cotton. Varieties identified as...

7 CFR 457.105 - Extra long staple cotton crop insurance provisions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 6 2012-01-01 2012-01-01 false Extra long staple cotton crop insurance provisions... long staple cotton crop insurance provisions. The extra long staple cotton crop insurance provisions... Crop Insurance Corporation ELS Cotton Crop Provisions 1. Definitions Cotton. Varieties identified as...

7 CFR 457.105 - Extra long staple cotton crop insurance provisions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 6 2013-01-01 2013-01-01 false Extra long staple cotton crop insurance provisions... long staple cotton crop insurance provisions. The extra long staple cotton crop insurance provisions... Crop Insurance Corporation ELS Cotton Crop Provisions 1. Definitions Cotton. Varieties identified as...

76 FR 2886 - Certain Polyester Staple Fiber From the People's Republic of China: Final Results and Partial...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-18

... DEPARTMENT OF COMMERCE International Trade Administration [A-570-905] Certain Polyester Staple... duty order on certain polyester staple fiber (``PSF'') from the People's Republic of China (``PRC''). See Certain Polyester Staple Fiber From the People's Republic of China: Notice of Preliminary Results...

78 FR 51707 - Certain Polyester Staple Fiber From the Republic of Korea: Rescission of Antidumping Duty...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-21

... DEPARTMENT OF COMMERCE International Trade Administration [A-580-839] Certain Polyester Staple... certain polyester staple fiber (polyester staple fiber) from the Republic of Korea (Korea) for the period..., 2013, the Department initiated an administrative review of the antidumping duty order on polyester...

75 FR 34097 - Certain Polyester Staple Fiber From Taiwan: Extension of the Final Results of Antidumping Duty...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-16

... DEPARTMENT OF COMMERCE International Trade Administration [A-583-833] Certain Polyester Staple... administrative review of the antidumping duty order on certain polyester staple fiber from Taiwan. See Certain Polyester Staple Fiber from Taiwan: Preliminary Results of Antidumping Duty Administrative Review, 75 FR...

77 FR 6783 - Certain Polyester Staple Fiber From the People's Republic of China: Extension of Preliminary...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-09

... DEPARTMENT OF COMMERCE International Trade Administration [A-570-905] Certain Polyester Staple... results of the administrative review of certain polyester staple fiber from the People's Republic of China... polyester staple fiber from the PRC. See Initiation of Antidumping and Countervailing Duty Administrative...

Exploratory Development of New and Improved Self-Sealing Materials for Fuel Lines

DTIC Science & Technology

1974-10-01

identify hy block number) New and improved self-sealing fuel line composites were developed under this program. Fabric reinforced plastic and nonflowering...integrated aluminum foil, fabric reinforced laminated fuel line composites employing compressed natural rubber foam as the sealant were fabricated which...successfully sealed wounds inflicted by .30 and .50 caliber projectiles. The weight of these new self-sealing fuel line composites ranged from 0.83

26 CFR 301.269B-1 - Stapled foreign corporations.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 18 2012-04-01 2012-04-01 false Stapled foreign corporations. 301.269B-1....269B-1 Stapled foreign corporations. In accordance with section 269B(a)(1), a stapled foreign corporation is subject to the same taxes that apply to a domestic corporation under Title 26 of the Internal...

26 CFR 301.269B-1 - Stapled foreign corporations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Stapled foreign corporations. 301.269B-1....269B-1 Stapled foreign corporations. In accordance with section 269B(a)(1), a stapled foreign corporation is subject to the same taxes that apply to a domestic corporation under Title 26 of the Internal...

26 CFR 301.269B-1 - Stapled foreign corporations.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 18 2013-04-01 2013-04-01 false Stapled foreign corporations. 301.269B-1....269B-1 Stapled foreign corporations. In accordance with section 269B(a)(1), a stapled foreign corporation is subject to the same taxes that apply to a domestic corporation under title 26 of the Internal...

26 CFR 301.269B-1 - Stapled foreign corporations.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 18 2014-04-01 2014-04-01 false Stapled foreign corporations. 301.269B-1....269B-1 Stapled foreign corporations. In accordance with section 269B(a)(1), a stapled foreign corporation is subject to the same taxes that apply to a domestic corporation under title 26 of the Internal...

26 CFR 1.269B-1 - Stapled foreign corporations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 3 2010-04-01 2010-04-01 false Stapled foreign corporations. 1.269B-1 Section 1... (CONTINUED) INCOME TAXES Items Not Deductible § 1.269B-1 Stapled foreign corporations. (a) Treatment as a domestic corporation—(1) General rule. Except as otherwise provided, if a foreign corporation is a stapled...

26 CFR 301.269B-1 - Stapled foreign corporations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 18 2011-04-01 2011-04-01 false Stapled foreign corporations. 301.269B-1....269B-1 Stapled foreign corporations. In accordance with section 269B(a)(1), a stapled foreign corporation is subject to the same taxes that apply to a domestic corporation under Title 26 of the Internal...

75 FR 30373 - Certain Polyester Staple Fiber From the People's Republic of China: Extension of Preliminary...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-01

... DEPARTMENT OF COMMERCE International Trade Administration [A-570-905] Certain Polyester Staple... results of the administrative review of certain polyester staple fiber from the People's Republic of China... administrative review of the antidumping duty order on certain polyester staple fiber from the PRC. See...

75 FR 47795 - Certain Polyester Staple Fiber from Korea: Rescission of Antidumping Duty Administrative Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-09

... DEPARTMENT OF COMMERCE International Trade Administration [A-580-839] Certain Polyester Staple... Polyester staple fiber (``PSF'') covered by the scope of the order is defined as synthetic staple fibers, not carded, combed or otherwise processed for spinning, of polyesters measuring 3.3 decitex (3 denier...

77 FR 21733 - Certain Polyester Staple Fiber From Taiwan: Extension of Time Limit for Preliminary Results of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-11

... DEPARTMENT OF COMMERCE International Trade Administration [A-583-833] Certain Polyester Staple... Department) initiated an administrative review of the antidumping duty order on certain polyester staple fiber from Taiwan for the period May 1, 2010, through April 30, 2011.\\1\\ In Certain Polyester Staple...

75 FR 39208 - Polyester Staple Fiber from Taiwan: Final Results of Changed-Circumstances Antidumping Duty...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-08

... DEPARTMENT OF COMMERCE International Trade Administration [A-583-833] Polyester Staple Fiber from... Eastern Textile Limited with regard to the antidumping duty order on polyester staple fiber from Taiwan... on polyester staple fiber from Taiwan to determine whether FENC was the successor-in-interest to FET...

75 FR 51442 - Polyester Staple Fiber from Taiwan: Rescission of Antidumping Duty Administrative Review in Part

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-20

... DEPARTMENT OF COMMERCE International Trade Administration [A-583-833] Polyester Staple Fiber from... antidumping duty order on polyester staple fiber from Taiwan. The period of review is May 1, 2009, through... duty order on polyester staple fiber from Taiwan with respect to respondents Nan Ya Plastics...

78 FR 38938 - Polyester Staple Fiber From Taiwan: Final Results of Antidumping Duty Administrative Review; 2011...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-28

... DEPARTMENT OF COMMERCE International Trade Administration [A-583-833] Polyester Staple Fiber From... duty order on polyester staple fiber (PSF) from Taiwan. The period of review is May 1, 2011, through... Results. None were received. \\1\\ See Polyester Staple Fiber From Taiwan: Preliminary Results of...

76 FR 58040 - Certain Polyester Staple Fiber From Korea and Taiwan

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-19

... Polyester Staple Fiber From Korea and Taiwan Determination On the basis of the record \\1\\ developed in the... antidumping duty orders on certain polyester staple fiber from Korea and Taiwan would be likely to lead to...), entitled Certain Polyester Staple Fiber From Korea and Taiwan: Investigation Nos. 731-TA-825 and 826...

75 FR 6352 - Certain Polyester Staple Fiber from the People's Republic of China: Extension of Preliminary...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-09

... DEPARTMENT OF COMMERCE International Trade Administration [A-570-905] Certain Polyester Staple... results of the administrative review of certain polyester staple fiber from the People's Republic of China... administrative review of the antidumping duty order on certain polyester staple fiber from the PRC. See...

76 FR 7532 - Certain Polyester Staple Fiber From the People's Republic of China: Extension of Preliminary...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-10

... DEPARTMENT OF COMMERCE International Trade Administration [A-570-905] Certain Polyester Staple... results of the administrative review of certain polyester staple fiber from the People's Republic of China... initiation of the administrative review of the antidumping duty order on certain polyester staple fiber from...

77 FR 19619 - Certain Polyester Staple Fiber from the People's Republic of China: Extension of Preliminary...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-02

... DEPARTMENT OF COMMERCE International Trade Administration [A-570-905] Certain Polyester Staple... results of the administrative review of certain polyester staple fiber from the People's Republic of China... polyester staple fiber from the PRC.\\1\\ On February 9, 2012 the Department partially extended the deadline...

76 FR 28420 - Certain Polyester Staple Fiber From the People's Republic of China: Full Extension of Preliminary...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-17

... DEPARTMENT OF COMMERCE International Trade Administration [A-570-905] Certain Polyester Staple... results of the administrative review of certain polyester staple fiber from the People's Republic of China... administrative review of the antidumping duty order on certain polyester staple fiber from the PRC. See...

75 FR 76954 - Certain Polyester Staple Fiber From the People's Republic of China: Extension of Time Limit for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-10

... DEPARTMENT OF COMMERCE International Trade Administration [A-570-905] Certain Polyester Staple... administrative review of certain polyester staple fiber (``PSF'') from the People's Republic of China (``PRC''), covering the period June 1, 2008--May 31, 2009. See Certain Polyester Staple Fiber From the People's...

76 FR 52935 - Certain Polyester Staple Fiber From Korea: Rescission of Antidumping Duty Administrative Review

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-24

... DEPARTMENT OF COMMERCE International Trade Administration [A-580-839] Certain Polyester Staple... on polyester staple fiber from Korea. See Antidumping or Countervailing Duty Order, Finding, or..., 76 FR 37781 (June 28, 2011). Scope of the Order Polyester staple fiber covered by the scope of the...

Recent Honey Bee Colony Declines

DTIC Science & Technology

2007-06-20

climate and temperature changes,38 the effects of feed supplements that are produced from transgenic or genetically modified crops, such as high - fructose ... corn syrup ,39 and also the effects of cell phone transmissions and radiation from power lines that may be interfering with a bee’s navigational...podcasts.psu.edu/taxonomy/term/62]. Staple crops such as wheat, corn , and rice do not rely on insect pollination and are mostly wind pollinated

Design and structure of stapled peptides binding to estrogen receptors.

PubMed

Phillips, Chris; Roberts, Lee R; Schade, Markus; Bazin, Richard; Bent, Andrew; Davies, Nichola L; Moore, Rob; Pannifer, Andrew D; Pickford, Andrew R; Prior, Stephen H; Read, Christopher M; Scott, Andrew; Brown, David G; Xu, Bin; Irving, Stephen L

2011-06-29

Synthetic peptides that specifically bind nuclear hormone receptors offer an alternative approach to small molecules for the modulation of receptor signaling and subsequent gene expression. Here we describe the design of a series of novel stapled peptides that bind the coactivator peptide site of estrogen receptors. Using a number of biophysical techniques, including crystal structure analysis of receptor-stapled peptide complexes, we describe in detail the molecular interactions and demonstrate that all-hydrocarbon staples modulate molecular recognition events. The findings have implications for the design of stapled peptides in general.

Numerical modelling of the reinforced concrete influence on a combined system of tunnel support

NASA Astrophysics Data System (ADS)

Grujić, Bojana; Jokanović, Igor; Grujić, Žarko; Zeljić, Dragana

2017-12-01

The paper presents the experimental, laboratory determined rheological-dynamic analysis of the properties of fiber reinforced concrete, which was then utilized to show nonlinear analysis of combined system of tunnel support structure. According to the performed experiments and calculations, different processes of destructive behavior of tunnel lining were simulated in combination with elastic and elastic-plastic behavior of materials taking into account the tunnel loading, the interaction between the fiber reinforced concrete and soil, as well as the interaction between the fiber reinforced concrete and the inner lining of the tunnel.

[First experience in surgical treatment of hemorrhoidal disease using the PPH stapler].

PubMed

Morales-Olivera, José Martín; Velasco, Liliana; Bada-Yllán, Orlando; Vergara-Fernández, Omar; Takahashi-Monroy, Takeshi

2007-01-01

Haemorrhoidal disease is a frequent entity worldwide. The surgical management is indicated in third or fourth degree internal hemorrhoidal disease. The conventional hemorrhoidectomy has showed good results but the severe postoperative pain is an important complain. Currently diverse surgical alternatives have been described, mainly to avoid the postoperative pain that follows surgical hemorrhoidectomy. One of these new options is the stapled hemorrhoidectomy using the PPH stapler. This procedure may produce less postoperative pain, with a shorter inpatient stay and faster return to work. The aim of this paper is to analyze the results of using the Procedure for Prolapsed Hemorrhoids (PPH) as treatment in Hemorrhoidal Disease. This is an observational and descriptive study, where 17 patients underwent stapled hemorrhoidectomy with PPH procedure, between March 2000 and August 2003. 52.8% of this patients presented grade three internal hemorrhoids and 47.2% grade four; 52.9% presented mild postoperative pain; 41.2% moderate and 5.9% severe pain. In a short and median follow up, due to the persistence of hemorrhoidal disease symptoms two patients required surgical re-intervention. Two more patients presented incontinency. One patient presented stenosis in the line of staples treated satisfactory with an anal dilatation session. The use of PPH is a feasible and safe procedure and it could be a surgical alternative in the treatment of hemorrhoidal disease, even before than conventional hemorrhoidectomy.

Stapled ileoanal anastomosis for ulcerative colitis and familial polyposis without a temporary diverting ileostomy.

PubMed Central

Sugerman, H J; Newsome, H H; Decosta, G; Zfass, A M

1991-01-01

Between March 1989 and August 1990, we performed 21 stapled J pouch ileonal procedures (20 ulcerative colitis [UC], 1 familial polyposis [FP]) without an ileostomy in 19, of whom 13 were taking prednisone and eight underwent semi-emergent surgery for uncontrollable bleeding. During the same time, an additional four patients required a standard ileonal procedure. The results of anal manometry and clinical function were compared to 25 patients who had previously undergone mucosal stripping and a sutured J pouch ileoanal anastomoses with a temporary diverting ileostomy between October 1982 and August 1990. During this same time period, an additional 19 patients underwent an anti-peristaltic reversed J pouch and 18 an S pouch, for a total of 83 ileoanal procedures. The reversed J pouch had a lower stool frequency than a standard J pouch but had an unacceptable incidence of complications and problems with pouch emptying. The S pouch had a stool frequency similar to the standard J pouch but provided greater length in patients with a short mesentery. Stapled J pouch ileoanal patients had a better (p less than 0.02) maximum and sphincter resting pressure (46 +/- 11 versus 34 +/- 12 mmHg), fewer (p less than 0.05) night-time accidents (22% versus 68%), daytime (17% versus 55%) or night-time (28 versus 61%) spotting, or use of a protective pad at night (11% versus 42%) than nonstapled J pouch ileoanal patients. Stool frequency was similar in the two groups. All but one UC patient had residual disease at the anastomosis. Anal mucosa between the dentate line and stapled anastomosis was 1.8 +/- 1.3 cm (range, 0 to 3.5 cm). Complications in the nonstapled J pouch group included 4 pouches excised (2 for complications, 2 for excessive stool frequency), 1 pelvic abscess, 2 stenosis requiring dilation under anesthesia, 1 enterocutaneous fistula after ileostomy closure, 1 ileostomy site hernia, and 2 small bowel obstructions. Of the 65 patients who underwent ileostomy closure in the entire series, 8 (12%) developed a complication requiring surgical intervention. Complications in the stapled group included 1 anastomotic leak, 1 pouch leak, and 1 pelvic abscess. Patients were managed successfully with drainage (all 3) and diverting ileostomy (1). One patient developed stenosis requiring dilation under anesthesia. The stapled J pouch ileoanal anastomosis is a simpler, safer procedure with less tension than a standard handsewn J pouch but leaves a very small cuff of residual disease. It provides significantly better stool control and may obviate the need for an ileostomy with its complications. PMID:2039292

Estimating A Reference Standard Segmentation With Spatially Varying Performance Parameters: Local MAP STAPLE

PubMed Central

Commowick, Olivier; Akhondi-Asl, Alireza; Warfield, Simon K.

2012-01-01

We present a new algorithm, called local MAP STAPLE, to estimate from a set of multi-label segmentations both a reference standard segmentation and spatially varying performance parameters. It is based on a sliding window technique to estimate the segmentation and the segmentation performance parameters for each input segmentation. In order to allow for optimal fusion from the small amount of data in each local region, and to account for the possibility of labels not being observed in a local region of some (or all) input segmentations, we introduce prior probabilities for the local performance parameters through a new Maximum A Posteriori formulation of STAPLE. Further, we propose an expression to compute confidence intervals in the estimated local performance parameters. We carried out several experiments with local MAP STAPLE to characterize its performance and value for local segmentation evaluation. First, with simulated segmentations with known reference standard segmentation and spatially varying performance, we show that local MAP STAPLE performs better than both STAPLE and majority voting. Then we present evaluations with data sets from clinical applications. These experiments demonstrate that spatial adaptivity in segmentation performance is an important property to capture. We compared the local MAP STAPLE segmentations to STAPLE, and to previously published fusion techniques and demonstrate the superiority of local MAP STAPLE over other state-of-the- art algorithms. PMID:22562727

Reinforcement Learning Strategies for Clinical Trials in Non-small Cell Lung Cancer

PubMed Central

Zhao, Yufan; Zeng, Donglin; Socinski, Mark A.; Kosorok, Michael R.

2010-01-01

Summary Typical regimens for advanced metastatic stage IIIB/IV non-small cell lung cancer (NSCLC) consist of multiple lines of treatment. We present an adaptive reinforcement learning approach to discover optimal individualized treatment regimens from a specially designed clinical trial (a “clinical reinforcement trial”) of an experimental treatment for patients with advanced NSCLC who have not been treated previously with systemic therapy. In addition to the complexity of the problem of selecting optimal compounds for first and second-line treatments based on prognostic factors, another primary goal is to determine the optimal time to initiate second-line therapy, either immediately or delayed after induction therapy, yielding the longest overall survival time. A reinforcement learning method called Q-learning is utilized which involves learning an optimal regimen from patient data generated from the clinical reinforcement trial. Approximating the Q-function with time-indexed parameters can be achieved by using a modification of support vector regression which can utilize censored data. Within this framework, a simulation study shows that the procedure can extract optimal regimens for two lines of treatment directly from clinical data without prior knowledge of the treatment effect mechanism. In addition, we demonstrate that the design reliably selects the best initial time for second-line therapy while taking into account the heterogeneity of NSCLC across patients. PMID:21385164

NASA's S'COOL Project: Bridging the Divide Between the 'Real' World and the Classroom

NASA Technical Reports Server (NTRS)

Sepulveda, Roberto; Chambers, Lin H.

2004-01-01

In an effort to bridge the gap between scientific research, teacher instruction and student learning, the CERES Students Cloud Observations On-Line (S'COOL) Project offers a unique perspective on how to narrow the divide between the real world and the classroom. Reality-based learning has become a staple in the education of our youth and the S'COOL Project has taken this concept one step further.

Committing Canadian sociology: developing a Canadian sociology and a sociology of Canada.

PubMed

Matthews, Ralph

2014-05-01

This paper is a slightly revised version of the author's "Outstanding Career Award Lecture" presented at the Annual Meeting of the Canadian Sociological Association in Victoria, British Columbia on June 6, 2013. The paper distinguishes between Canadian Sociology and the Sociology of Canada. The former involves the explanatory stance that one takes to understanding Canada. The latter addresses the significant social dimensions that underlie Canadian social organization, culture, and behavior. I make a case for a Canadian Sociology that focuses on the unique features of Canadian society rather than adopting a comparative perspective. I also argue that there is a continuing need within the Sociology of Canada to address the issues of staples development. However, I argue that "new" staples analysis must have a directional change from that of the past, in that social processes now largely determine the pattern of staples development. Moreover, new staples analysis must include issues that were never part of earlier staples analysis, such as issues of environmental impacts and of staples depletion under conditions, such as climate change. The paper concludes by analyzing four factors that provide the dominant social contexts for analyzing modern staples development: (1) the rise of neoliberal government, (2) the implementation of globalization and its social consequences, (3) the assumption of aboriginal rights and entitlement, and (4) the rise of environmentalism. These factors were generally not considered in earlier staples approaches. They are critical to understanding the role of staples development and its impact on Canada in the present time.

Supraperitoneal colorectal anastomosis: hand-sewn versus circular staples--a controlled clinical trial. French Associations for Surgical Research.

PubMed

Fingerhut, A; Hay, J M; Elhadad, A; Lacaine, F; Flamant, Y

1995-09-01

Although used widely for supraperitoneal anastomoses, circular stapled anastomoses have never been proved better than hand-sewn anastomoses. In the one prospective controlled trial that studied these anastomoses specifically, the only significant difference found was that there were more clinically obvious leakages with the circular stapled variety, but not in the overall clinical and roentgenologic leakage rates. One hundred fifty-nine consecutive patients (88 men and 71 women, mean age 65.8 +/- 12.1 years) were randomized to undergo hand-sewn (n = 74) or circular stapled (n = 85) supraperitoneal colorectal anastomosis after left colectomy. Patient demographics were similar in both groups. Overall mortality was 1.3% (2 of 159; one in each group). No statistically significant difference (NS) was found in the rate of early complications, including anastomotic leakage (4 of 74 versus 6 of 85) in the hand-sewn and stapled anastomoses, respectively). Mishaps (n = 10) and hemorrhage (n = 5) occurred in the stapled group only. Stapled anastomoses took an average of 8 minutes less to perform (p < 0.001), but this time gain did not significantly influence the overall duration of operation (identical median times). The median duration of hospitalization was 13 and 14 days, respectively (NS). At 8 months there were 2 of 74 strictures in the hand-sewn group and 4 of 85 strictures in the stapled group (NS). According to these results, there seems to be no advantage of routine or regular use of stapling instruments for supraperitoneal colorectal anastomosis.

Bowel anastomoses: The theory, the practice and the evidence base

PubMed Central

Goulder, Frances

2012-01-01

Since the introduction of stapling instruments in the 1970s various studies have compared the results of sutured and stapled bowel anastomoses. A literature search was performed from 1960 to 2010 and articles relating to small bowel, colonic and colorectal anastomotic techniques were reviewed. References from these articles were also reviewed, and relevant articles obtained. Either a stapled or sutured gastrointestinal tract anastomosis is acceptable in most situations. The available evidence suggests that in the following situations, however, particular anastomotic techniques may result in fewer complications: A stapled side-to-side ileocolic anastomosis is preferable following a right hemicolectomy for cancer. A stapled side-to-side anastomosis is likely also preferable after an ileocolic resection for Crohn’s disease. Colorectal anastomoses can be sutured or stapled with similar results, although the incidence of strictures is higher following stapled anastomoses. Following reversal of loop ileostomy there is some evidence to suggest that a stapled side-to-side anastomosis or sutured enterotomy closure (rather than spout resection and sutured anastomosis) results in fewer complications. Non-randomised data has indicated that small bowel anastomoses are best sutured in the trauma patient. This article reviews the theory, practice and evidence base behind the various gastrointestinal anastomoses to help the practising general surgeon make evidence based operative decisions. PMID:23293735

Field resistance of transgenic plantain to nematodes has potential for future African food security

PubMed Central

Tripathi, Leena; Babirye, Annet; Roderick, Hugh; Tripathi, Jaindra N.; Changa, Charles; Urwin, Peter E.; Tushemereirwe, Wilberforce K.; Coyne, Danny; Atkinson, Howard J.

2015-01-01

Plant parasitic nematodes impose losses of up to 70% on plantains and cooking bananas in Africa. Application of nematicides is inappropriate and resistant cultivars are unavailable. Where grown, demand for plantain is more than for other staple crops. Confined field testing demonstrated that transgenic expression of a biosafe, anti-feedant cysteine proteinase inhibitor and an anti-root invasion, non-lethal synthetic peptide confers resistance to plantain against the key nematode pests Radopholus similis and Helicotylenchus multicinctus. The best peptide transgenic line showed improved agronomic performance relative to non-transgenic controls and provided about 99% nematode resistance at harvest of the mother crop. Its yield was about 186% in comparison with the nematode challenged control non-transgenic plants based on larger bunches and diminished plant toppling in storms, due to less root damage. This is strong evidence for utilizing this resistance to support the future food security of 70 million, mainly poor Africans that depend upon plantain as a staple food. PMID:25634654

[Resistance to pressure of bronchial closures. Comparison of pressure resistance of manual and stapler bronchial closures depending on the angle to the cartilaginous rings].

PubMed

Ludwig, C; Behrend, M; Hoffarth, U; Schüttler, W; Stoelben, E

2004-09-01

This study was aimed to determine the resistance to pressure of manual and stapled bronchial closures under ideal conditions (90 degrees to the bronchial tree) and parallel to the trachea (45 degrees). An experimental study was done on 60 explanted pig tracheae which were alternatively closed with either double-layer, running sutures angled 90 degrees to the cartilaginous rings or an automatic stapling device. The closure line was placed exactly 90 degrees to the bronchial tree in 30 cases and parallel to the trachea (45 degrees) in 30. The sutures were placed under pressure until air leakage was observed. The leakage pressure was digitally recorded. A statistically significant difference existed between the two groups. Mechanical sutures proved more resistant to pressure (P=0.011). Under ideal conditions, the resistance to pressure of mechanical sutures is equal to if not better than that of manual sutures.

Pulmonary suture abscess with false-positive 18F-fluorodeoxyglucose positron emission scan mimicking lung cancer recurrence.

PubMed

Iwasaki, Teruo; Nakagawa, Katsuhiro; Katsura, Hiroshi; Nakane, Shigeru; Kawahara, Kunimitsu; Fukuda, Haruyuki

2006-08-01

We present the case of a 57-year-old woman with pulmonary suture abscess. She had undergone right S3 segmentectomy for early lung adenocarcinoma 7 years before and right breast-conserving surgery for invasive ductal carcinoma 5 months previously, followed by irradiation plus endocrine therapy. Chest radiography and computed tomography revealed an irregular mass (3.5 cm in diameter) between the residual S1 segment and the middle lobe, neighboring the staple line of the segmentectomy. 18F-fluorodeoxyglucose uptake into the mass increased, seen by positron emission scans. Therefore, we could not rule out the possibility of local recurrence of lung cancer and resected it. Pathologically and microbiologically, the mass was a suture abscess arising around the nylon suture of the previous segmentectomy. This lesion was the result of a foreign-body reaction, as confirmed by polarized microscopy. Moreover, titanium staples at the segmentectomy and breast-conserving surgery may also have contributed to this condition.

Clinical impact and cost-effectiveness of making third-line antiretroviral therapy available in sub-Saharan Africa: a model-based analysis in Côte d'Ivoire.

PubMed

Ouattara, Eric N; Ross, Eric L; Yazdanpanah, Yazdan; Wong, Angela Y; Robine, Marion; Losina, Elena; Moh, Raoul; Walensky, Rochelle P; Danel, Christine; Paltiel, A David; Eholié, Serge P; Freedberg, Kenneth A; Anglaret, Xavier

2014-07-01

In sub-Saharan Africa, HIV-infected adults who fail second-line antiretroviral therapy (ART) often do not have access to third-line ART. We examined the clinical impact and cost-effectiveness of making third-line ART available in Côte d'Ivoire. We used a simulation model to compare 4 strategies after second-line ART failure: continue second-line ART (C-ART2), continue second-line ART with an adherence reinforcement intervention (AR-ART2), immediate switch to third-line ART (IS-ART3), and continue second-line ART with adherence reinforcement, switching patients with persistent failure to third-line ART (AR-ART3). Third-line ART consisted of a boosted-darunavir plus raltegravir-based regimen. Primary outcomes were 10-year survival and lifetime incremental cost-effectiveness ratios (ICERs), in $/year of life saved (YLS). ICERs below $3585 (3 times the country per capita gross domestic product) were considered cost-effective. Ten-year survival was 6.0% with C-ART2, 17.0% with AR-ART2, 35.4% with IS-ART3, and 37.2% with AR-ART3. AR-ART2 was cost-effective ($1100/YLS). AR-ART3 had an ICER of $3600/YLS and became cost-effective if the cost of third-line ART decreased by <1%. IS-ART3 was less effective and more costly than AR-ART3. Results were robust to wide variations in the efficacy of third-line ART and of the adherence reinforcement, as well as in the cost of second-line ART. Access to third-line ART combined with an intense adherence reinforcement phase, used as a tool to distinguish between patients who can still benefit from their current second-line regimen and those who truly need third-line ART would provide substantial survival benefits. With minor decreases in drug costs, this strategy would be cost-effective.

Non-Destructive and rapid evaluation of staple foods quality by using spectroscopic techniques: A review.

PubMed

Su, Wen-Hao; He, Hong-Ju; Sun, Da-Wen

2017-03-24

Staple foods, including cereals, legumes, and root/tuber crops, dominate the daily diet of humans by providing valuable proteins, starch, oils, minerals, and vitamins. Quality evaluation of staple foods is primarily carried out on sensory (e.g. external defect, color), adulteration (e.g. species, origin), chemical (e.g. starch, proteins), mycotoxin (e.g. Fusarium toxin, aflatoxin), parasitic infection (e.g. weevil, beetle), and internal physiological (e.g. hollow heart, black heart) aspects. Conventional methods for the quality assessment of staple foods are always laborious, destructive, and time-consuming. Requirements for online monitoring of staple foods have been proposed to encourage the development of rapid, reagentless, and noninvasive techniques. Spectroscopic techniques, such as visible-infrared spectroscopy, Raman spectroscopy, nuclear magnetic resonance spectroscopy, and spectral imaging, have been introduced as promising analytical tools and applied for the quality evaluation of staple foods. This review summarizes the recent applications and progress of such spectroscopic techniques in determining various qualities of staple foods. Besides, challenges and future trends of these spectroscopic techniques are also presented.

A Discussion with Suzanne Fisher Staples: The Author as Writer and Cultural Observer.

ERIC Educational Resources Information Center

Sawyer, Walter E.; Sawyer, Jean C.

1993-01-01

Presents an interview with Suzanne Fisher Staples, author of the children's novel, "Shabanu, Daughter of the Wind." Discusses Staples' creative writing process, background, and the writer's role as cultural observer. (HB)

Effect of Stapling Architecture on Physiochemical Properties and Cell Permeability of Stapled α-Helical Peptides: A Comparative Study.

PubMed

Tian, Yuan; Jiang, Yanhong; Li, Jingxu; Wang, Dongyuan; Zhao, Hui; Li, Zigang

2017-11-02

Stapled peptides have emerged as a new class of targeting molecules with high binding affinity and specificity for intracellular undruggable targets. Their ability to penetrate cell membranes is exceptionally intriguing but remains elusively and controversially discussed. To understand the effect of stapling architectures on their physiochemical properties and to aid in promoting their cell permeability, we report herein a comparative study on the physiochemical properties and cell permeability of stapled α-helical peptides with different types of crosslinks. We highlight the decisive impact of the intrinsic properties of the crosslinks on cell permeability rather than the helical contents of the peptides in model amphipathic sequences targeting estrogen receptor-coactivator interaction. We envision this finding to shed further light on the chemical optimization of stapled α-helical peptides or macrocyclic cell-penetrating peptides for enhanced cell penetration. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Will Transition of Staple Food Strategy in China Really Mitigate Global Climate Change?

NASA Astrophysics Data System (ADS)

Liu, B.; Zhao, D.

2017-12-01

With the increase in agricultural demand, reducing greenhouse gas (GHG) emissions is a vital challenge in mitigating climate change. Potato staple food strategy in China introduced by Ministry of Agriculture in 2015 is to gradually adjust staple food structure, which provides an opportunity to meet with the challenge. Apart from staple food structure, difference on energy, material input, geography, and crop management are essential to determine agriculture's contribution to climate change. In this study, we conduct a life cycle analysis of four staple foods in China, namely rice, wheat, maize, and potato, to develop crop-specific estimates of GHG emissions and GHG intensity by using `Production intensity' (carbon dioxide equivalent emissions per kilocalorie produced), to help us understand potential synergies and frictions between food producing and climate mitigation. Data used in this study is on city / province levels if city level is unavailable in 2015. First, we evaluate GHG reductions due to transition of staple food structure in China. Staple food GHG emissions in China are 546.90 Tg CO2e yr-1 in 2015, with 47.6%, 21.9%, 27.3% and 3.2% from rice, wheat, maize and potato. Mean production intensity of staple food is 0.45 Mg CO2e M kcal-1 in 2015. Maize leads the intensity with 0.77 Mg CO2e M kcal-1, followed by rice (0.49 Mg CO2e M kcal-1), wheat (0.28 Mg CO2e M kcal-1) and potato (0.24 Mg CO2e M kcal-1). After staple food structure adjustment, 25 Tg CO2e yr-1 (4.2%) reduction will be accomplished in 2020 without any crop management improvement. Further reduction (33.3% - 40.4%) could be achieved with crop management improvement. In addition, because of staple food structure switching, native rice production will decline, which might lead to more export from countries with higher production intensity. Estimated emission leakage from rice import is 30.10 Tg CO2e yr-1, exceeds emission reduction in native China. Therefore, potato staple food strategy could meet the demand for food in China, but it increases risk of global climate change.

Thoracoscopic stapler-based "bidirectional" segmentectomy for posterior basal segment (S10) and its variants.

PubMed

Sato, Masaaki; Murayama, Tomonori; Nakajima, Jun

2018-04-01

Thoracoscopic segmentectomy for the posterior basal segment (S10) and its variant (e.g., S9+10 and S10b+c combined subsegmentectomy) is one of the most challenging anatomical segmentectomies. Stapler-based segmentectomy is attractive to simplify the operation and to prevent post-operative air leakage. However, this approach makes thoracoscopic S10 segmentectomy even more tricky. The challenges are caused mostly from the following three reasons: first, similar to other basal segments, "three-dimensional" stapling is needed to fold a cuboidal segment; second, the belonging pulmonary artery is not directly facing the interlobar fissure or the hilum, making identification of target artery difficult; third, the anatomy of S10 and adjacent segments such as superior (S6) and medial basal (S7) is variable. To overcome these challenges, this article summarizes the "bidirectional approach" that allows for solid confirmation of anatomy while avoiding separation of S6 and the basal segment. To assist this approach under limited thoracoscopic view, we also show stapling techniques to fold the cuboidal segment with the aid of "standing stiches". Attention should also be paid to the anatomy of adjacent segments particularly that of S7, which tends to be congested after stapling. The use of virtual-assisted lung mapping (VAL-MAP) is also recommended to demark resection lines because it flexibly allows for complex procedures such as combined subsegmentectomy such as S10b+c, extended segmentectomy such as S10+S9b, and non-anatomically extended segmentectomy.

The Surgical Management of Complex Fistulas After Sleeve Gastrectomy.

PubMed

Nguyen, David; Dip, Fernando; Hendricks, LéShon; Lo Menzo, Emanuele; Szomstein, Samuel; Rosenthal, Raul

2016-02-01

Laparoscopic sleeve gastrectomy (LSG) is gaining acceptance as the preferred option for treating obesity. Risks of leak and subsequent fistula after sleeve gastrectomy still present significant concerns in clinical practice. This current series presents unusual fistulas post-LSG and their surgical management. The series presents chronic leaks that have progressed into fistulas. Three patients with fistulas are presented: gastrocolic, gastropleural, and gastrosplenic. Surgical intervention was warranted in all cases with en-bloc resection of the fistula with subtotal gastrectomy and Roux-en-Y esophagojejunostomy reconstruction. A subtotal colectomy with ileo-descending colon anastomosis was additionally necessary in the gastrocolic patient. The patients with the gastropleural and gastrosplenic fistulas were discharged home on postoperative Day 6 and Day 7, respectively. The patient with the gastrocolic fistula had an extended postoperative hospital course and was discharged home on postoperative Day 35. All cases were negative for staple line leaks. To date, the fistulas healed with no recurrence. En-bloc resection of the fistula with proximal gastrectomy and Roux-en-Y esophagojejunostomy (PGRYEJ) is a surgical option to treat chronic staple line leakage when non-operative therapy is rendered ineffective. Adequate preoperative planning with optimization of nutritional status and control of local and systemic sepsis is paramount for ultimate success. A symptomatic leak requires immediate operation regardless of the time interval between the primary sleeve operation and appearance of the leak.

A standardized safe hepatectomy; selective Glissonean transection using endolinear stapling devices.

PubMed

Fujii, Masahiko; Shimada, Mitsuo; Satoru, Imura; Morine, Yuji; Ikemoto, Tetsuya; Soejima, Yuji

2007-01-01

Selective clamping of Glisson's pedicle at the hilum is effective for systematized hepatectomy. Because of the development of stapling devices, a Glissonean transection using a surgical stapler has been used widely. However, the risk of accidental stapling of the biliary confluence still remains. In this paper we report about a case that underwent selective Glissonean transection using an endolinear stapling device. We used this standardized technique in five patients without any major complications. The particular case to which we refer was a 71-year-old woman with hepatocellular carcinoma in the right lobe. The anterior and posterior branches of Glisson's pedicle were independently divided using an endolinear stapling device. The right hepatic lobectomy was achieved with little bleeding and in addition there was a shortened operation time and the postoperative course was uneventful. In the patient with liver cirrhosis, postoperative complications often related to liver failure. We herein advocate a standardized safe hepatectomy using endolinear stapling devices. We believe that the shortened operative time and decreased risk of complications by selective Glissonean transection as well as hepatic vein transection using stapling devices contribute to the improved short-term outcome.

[Is the stapled suture in visceral surgery still justified? A prospective controlled, randomized study of cost effectiveness of manual and stapler suture].

PubMed

Izbicki, J R; Gawad, K A; Quirrenbach, S; Hosch, S B; Breid, V; Knoefel, W T; Küpper, H U; Broelsch, C E

1998-07-01

Hospitals are facing increasing economic pressure. It therefore seems necessary to evaluate the efficiency and effectiveness of medical or surgical interventions. In this study 324 anastomoses (167 stapled and 157 hand-sewn) were performed after randomization during 200 elective operations [20.5% gastrectomies, 14% gastric resections (Billroth II), 15% Whipple's procedures, 4% segmental colonic resections, 18% right-sided hemicolectomies, 4% left-sided hemicolectomies, 22% sigmoid- or anterior rectal resections, 2.5% total colectomies with pouch-anal anastomoses] in 200 patients. Postoperative motility (time to full oral diet, time with naso-gastric tube) and hospitalization were comparable in both groups. Anastomotic insufficiency was observed in 2.1% of all patients, five after stapled and two after hand-sewn anastomoses. Hospital mortality was 1.5%. All stapled anastomoses were performed significantly (P < 0.001) faster. However, the cost of material for these anastomoses was significantly (P < 0.001) higher, resulting in significantly higher total costs for reconstruction. The time saving for the reconstruction did not influence the total operative time (except for stapled gastrectomy). Therefore, all operations with stapled reconstruction were more expensive than those with sutured reconstruction. The difference was significant for the gastrectomy (P < 0.01), colonic resection (P < 0.01) and sigmoid and rectal resection (P < 0.001) groups. Stapled and sutured anastomoses are equally effective. Stapled anastomoses are not efficient, however, and should be reserved for individual indications.

Conformationally constrained peptides target the allosteric kinase dimer interface and inhibit EGFR activation.

PubMed

Fulton, Melody D; Hanold, Laura E; Ruan, Zheng; Patel, Sneha; Beedle, Aaron M; Kannan, Natarajan; Kennedy, Eileen J

2018-03-15

Although EGFR is a highly sought-after drug target, inhibitor resistance remains a challenge. As an alternative strategy for kinase inhibition, we sought to explore whether allosteric activation mechanisms could effectively be disrupted. The kinase domain of EGFR forms an atypical asymmetric dimer via head-to-tail interactions and serves as a requisite for kinase activation. The kinase dimer interface is primarily formed by the H-helix derived from one kinase monomer and the small lobe of the second monomer. We hypothesized that a peptide designed to resemble the binding surface of the H-helix may serve as an effective disruptor of EGFR dimerization and activation. A library of constrained peptides was designed to mimic the H-helix of the kinase domain and interface side chains were optimized using molecular modeling. Peptides were constrained using peptide "stapling" to structurally reinforce an alpha-helical conformation. Peptide stapling was demonstrated to notably enhance cell permeation of an H-helix derived peptide termed EHBI2. Using cell-based assays, EHBI2 was further shown to significantly reduce EGFR activity as measured by EGFR phosphorylation and phosphorylation of the downstream signaling substrate Akt. To our knowledge, this is the first H-helix-based compound targeting the asymmetric interface of the kinase domain that can successfully inhibit EGFR activation and signaling. This study presents a novel, alternative targeting site for allosteric inhibition of EGFR. Copyright © 2017 Elsevier Ltd. All rights reserved.

Influence of sensory and cultural perceptions of white rice, brown rice and beans by Costa Rican adults in their dietary choices.

PubMed

Monge-Rojas, Rafael; Mattei, Josiemer; Fuster, Tamara; Willett, Walter; Campos, Hannia

2014-10-01

Little is known about the distinct perceptions towards rice and beans that may shape the consumption of these main staple foods among Costa Ricans. We aimed to identify barriers and motivators that could change the current staple into a healthier one, and assess the sensory perceptions of these foods in this population. Focus group discussions and sensory tastings of 8 traditional white or brown rice and beans preparations were conducted in 98 Costa Ricans, aged 40-65 years. Traditional habits and family support emerged as the two main drivers for current consumption. Consuming similar amounts of rice and beans, as well as unfamiliarity with brown rice, are habits engrained in the Costa Rican culture, and are reinforced in the family and community environment. Suggested strategies for consuming more brown rice and more beans included introducing them during childhood, disseminating information of their health benefits that take into account the importance of tradition, lowering the cost, increasing availability, engaging women as agents of change and for brown rice masking the perceived unpleasant sensory characteristics by incorporating them into mixed dishes. Plain brown rice received the lowest mean hedonic liking scores. The preparations rated highest for pleasant were the beans: rice 1:1 ratio regardless of the type of rice. This study identified novel strategies to motivate Costa Rican adults to adapt their food choices into healthier ones within their cultural and sensory acceptability. Copyright © 2014 Elsevier Ltd. All rights reserved.

21 CFR 878.4750 - Implantable staple.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Implantable staple. 878.4750 Section 878.4750 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4750 Implantable staple. (a...

21 CFR 878.4750 - Implantable staple.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Implantable staple. 878.4750 Section 878.4750 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4750 Implantable staple. (a...

21 CFR 878.4750 - Implantable staple.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Implantable staple. 878.4750 Section 878.4750 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4750 Implantable staple. (a...

21 CFR 878.4750 - Implantable staple.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Implantable staple. 878.4750 Section 878.4750 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4750 Implantable staple. (a...

21 CFR 878.4750 - Implantable staple.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Implantable staple. 878.4750 Section 878.4750 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4750 Implantable staple. (a...

Comparison of stapled haemorrhoidopexy with traditional excisional surgery for haemorrhoidal disease (eTHoS): a pragmatic, multicentre, randomised controlled trial.

PubMed

Watson, Angus J M; Hudson, Jemma; Wood, Jessica; Kilonzo, Mary; Brown, Steven R; McDonald, Alison; Norrie, John; Bruhn, Hanne; Cook, Jonathan A

2016-11-12

Two commonly performed surgical interventions are available for severe (grade II-IV) haemorrhoids; traditional excisional surgery and stapled haemorrhoidopexy. Uncertainty exists as to which is most effective. The eTHoS trial was designed to establish the clinical effectiveness and cost-effectiveness of stapled haemorrhoidopexy compared with traditional excisional surgery. The eTHoS trial was a large, open-label, multicentre, parallel-group, pragmatic randomised controlled trial done in adult participants (aged 18 years or older) referred to hospital for surgical treatment for grade II-IV haemorrhoids. Participants were randomly assigned (1:1) to receive either traditional excisional surgery or stapled haemorrhoidopexy. Randomisation was minimised according to baseline EuroQol 5 dimensions 3 level score (EQ-5D-3L), haemorrhoid grade, sex, and centre with an automated system to stapled haemorrhoidopexy or traditional excisional surgery. The primary outcome was area under the quality of life curve (AUC) measured with the EQ-5D-3L descriptive system over 24 months, assessed according to the randomised groups. The primary outcome measure was analysed using linear regression with adjustment for the minimisation variables. This trial is registered with the ISRCTN registry, number ISRCTN80061723. Between Jan 13, 2011, and Aug 1, 2014, 777 patients were randomised (389 to receive stapled haemorrhoidopexy and 388 to receive traditional excisional surgery). Stapled haemorrhoidopexy was less painful than traditional excisional surgery in the short term and surgical complication rates were similar between groups. The EQ-5D-3L AUC score was higher in the traditional excisional surgery group than the stapled haemorrhoidopexy group over 24 months; mean difference -0·073 (95% CI -0·140 to -0·006; p=0·0342). EQ-5D-3L was higher for stapled haemorrhoidopexy in the first 6 weeks after surgery, the traditional excisional surgery group had significantly better quality of life scores than the stapled haemorrhoidopexy group. 24 (7%) of 338 participants who received stapled haemorrhoidopexy and 33 (9%) of 352 participants who received traditional excisional surgery had serious adverse events. As part of a tailored management plan for haemorrhoids, traditional excisional surgery should be considered over stapled haemorrhoidopexy as the surgical treatment of choice. National Institute for Health Research Health Technology Assessment programme. Copyright © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved.

75 FR 70906 - Certain Polyester Staple Fiber From the People's Republic of China: Partial Rescission of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-19

... DEPARTMENT OF COMMERCE International Trade Administration [A-570-905] Certain Polyester Staple Fiber From the People's Republic of China: Partial Rescission of the Third Antidumping Duty... Request Administrative Review'' of the antidumping duty order on certain polyester staple fiber (``PSF...

76 FR 5331 - Certain Polyester Staple Fiber From Taiwan: Extension of Time Limit for Preliminary Results of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-31

... DEPARTMENT OF COMMERCE International Trade Administration [A-583-833] Certain Polyester Staple Fiber From Taiwan: Extension of Time Limit for Preliminary Results of Antidumping Duty Administrative...) initiated an administrative review of the antidumping duty order on certain polyester staple fiber from...

77 FR 54562 - Certain Polyester Staple Fiber From the Republic of Korea: Rescission of Antidumping Duty...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-05

... DEPARTMENT OF COMMERCE International Trade Administration [A-580-839] Certain Polyester Staple Fiber From the Republic of Korea: Rescission of Antidumping Duty Administrative Review AGENCY: Import... antidumping duty order on certain polyester staple fiber from the Republic of Korea (``the Order''). The...

75 FR 4044 - Polyester Staple Fiber From Taiwan: Initiation and Preliminary Results of Changed-Circumstances...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-26

... DEPARTMENT OF COMMERCE International Trade Administration [A-583-833] Polyester Staple Fiber From... Commerce is initiating a changed- circumstances review of the antidumping duty order on polyester staple... previously accorded to Far Eastern Textile Limited with regard to the antidumping duty order on polyester...

77 FR 4543 - Certain Polyester Staple Fiber From Taiwan: Extension of Time Limit for Preliminary Results of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-30

... DEPARTMENT OF COMMERCE International Trade Administration [A-583-833] Certain Polyester Staple Fiber From Taiwan: Extension of Time Limit for Preliminary Results of Antidumping Duty Administrative...) initiated an administrative review of the antidumping duty order on certain polyester staple fiber from...

77 FR 50530 - Polyester Staple Fiber From China; Scheduling of an Expedited Five-Year Review Concerning the...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-21

... INTERNATIONAL TRADE COMMISSION [Investigation No. 731-TA-1104 (Review)] Polyester Staple Fiber... Polyester Staple Fiber From China AGENCY: United States International Trade Commission. ACTION: Notice... CONTACT: Joanna Lo (202-205-1888), Office of Investigations, U.S. International Trade Commission, 500 E...

77 FR 60720 - Certain Polyester Staple Fiber From China

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-04

... Fiber From China Determination On the basis of the record \\1\\ developed in the subject five-year review... certain polyester staple fiber from China would be likely to lead to continuation or recurrence of... (September 2012), entitled Certain Polyester Staple Fiber from China: Investigation No. 731-TA-1104 (Review...

7 CFR 28.303 - Standards for length of staple for American upland cotton.

Code of Federal Regulations, 2013 CFR

2013-01-01

... cotton. 28.303 Section 28.303 Agriculture Regulations of the Department of Agriculture AGRICULTURAL... STANDARDS AND STANDARD CONTAINER REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for Length of Staple § 28.303 Standards for length of staple for...

7 CFR 28.304 - Original representation of American Pima cotton staple lengths.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 2 2013-01-01 2013-01-01 false Original representation of American Pima cotton staple... STANDARDS AND STANDARD CONTAINER REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for Length of Staple § 28.304 Original representation of American...

7 CFR 28.304 - Original representation of American Pima cotton staple lengths.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 2 2012-01-01 2012-01-01 false Original representation of American Pima cotton staple... STANDARDS AND STANDARD CONTAINER REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for Length of Staple § 28.304 Original representation of American...

75 FR 70850 - Common Crop Insurance Regulations; Extra Long Staple Cotton Crop Provisions

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-19

... Crop Insurance Regulations; Extra Long Staple Cotton Crop Provisions AGENCY: Federal Crop Insurance... Corporation (FCIC) proposes to amend the Common Crop Insurance Regulations, Extra Long Staple Cotton Crop Insurance Provisions to remove all references to the Daily Spot Cotton Quotation and replace the reference...

76 FR 32067 - Common Crop Insurance Regulations; Extra Long Staple Cotton Crop Provisions

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-03

... 0563-AC27 Common Crop Insurance Regulations; Extra Long Staple Cotton Crop Provisions AGENCY: Federal... (FCIC) finalizes amendments made to the Common Crop Insurance Regulations, Extra Long Staple Cotton Crop Insurance Provisions to remove all references to the Daily Spot Cotton Quotation and replace the references...

7 CFR 28.303 - Standards for length of staple for American upland cotton.

Code of Federal Regulations, 2011 CFR

2011-01-01

... cotton. 28.303 Section 28.303 Agriculture Regulations of the Department of Agriculture AGRICULTURAL... STANDARDS AND STANDARD CONTAINER REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for Length of Staple § 28.303 Standards for length of staple for...

78 FR 47214 - Common Crop Insurance Regulations; Extra Long Staple Cotton Crop Provisions

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-05

... Long Staple Cotton Crop Provisions AGENCY: Federal Crop Insurance Corporation, USDA. ACTION: Proposed... Insurance Regulations, Extra Long Staple (ELS) Cotton Crop Insurance Provisions to make the ELS Cotton Crop Insurance Provisions consistent with the Upland Cotton Crop Insurance Provisions and to allow a late...

7 CFR 28.304 - Original representation of American Pima cotton staple lengths.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 2 2014-01-01 2014-01-01 false Original representation of American Pima cotton staple... STANDARDS AND STANDARD CONTAINER REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for Length of Staple § 28.304 Original representation of American...

7 CFR 28.303 - Standards for length of staple for American upland cotton.

Code of Federal Regulations, 2014 CFR

2014-01-01

... cotton. 28.303 Section 28.303 Agriculture Regulations of the Department of Agriculture AGRICULTURAL... STANDARDS AND STANDARD CONTAINER REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for Length of Staple § 28.303 Standards for length of staple for...

7 CFR 28.304 - Original representation of American Pima cotton staple lengths.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 2 2011-01-01 2011-01-01 false Original representation of American Pima cotton staple... STANDARDS AND STANDARD CONTAINER REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for Length of Staple § 28.304 Original representation of American...

7 CFR 28.304 - Original representation of American Pima cotton staple lengths.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Original representation of American Pima cotton staple... STANDARDS AND STANDARD CONTAINER REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for Length of Staple § 28.304 Original representation of American...

7 CFR 28.303 - Standards for length of staple for American upland cotton.

Code of Federal Regulations, 2012 CFR

2012-01-01

... cotton. 28.303 Section 28.303 Agriculture Regulations of the Department of Agriculture AGRICULTURAL... STANDARDS AND STANDARD CONTAINER REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for Length of Staple § 28.303 Standards for length of staple for...

7 CFR 28.303 - Standards for length of staple for American upland cotton.

Code of Federal Regulations, 2010 CFR

2010-01-01

... cotton. 28.303 Section 28.303 Agriculture Regulations of the Department of Agriculture AGRICULTURAL... STANDARDS AND STANDARD CONTAINER REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for Length of Staple § 28.303 Standards for length of staple for...

21 CFR 878.4760 - Removable skin staple.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Removable skin staple. 878.4760 Section 878.4760 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4760 Removable skin staple. (a...

21 CFR 878.4760 - Removable skin staple.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Removable skin staple. 878.4760 Section 878.4760 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4760 Removable skin staple. (a...

21 CFR 878.4760 - Removable skin staple.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Removable skin staple. 878.4760 Section 878.4760 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4760 Removable skin staple. (a...

21 CFR 878.4760 - Removable skin staple.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Removable skin staple. 878.4760 Section 878.4760 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4760 Removable skin staple. (a...

Circular stapled anopexy for haemorrhoidal disease: results.

PubMed

Lehur, P A; Gravié, J F; Meurette, G

2001-11-01

Stapled anopexy is a new approach for haemorrhoids requiring surgical treatment. This study reviews the available information concerning the present results of this procedure. Medline and hand search of the literature was conducted to identify available information on the procedure, with a special interest for the on-going or published randomized clinical trials. The advantages of the stapled approach of haemorrhoids were analyzed in the different areas of concern, including postoperative pain reduction, length of hospital stay and sick-leave, postoperative wound care and type and rate of complications. Continence status, symptom cure and patient satisfaction following stapled anopexy are also reported. Stapled anopexy is probably less painful than conventional haemorrhoidectomy. Other advantages in the short term result from this new approach. Long term efficacy of the procedure is still unknown.

Characterization of materials eliciting foreign body reaction in stapled human gastrointestinal anastomoses.

PubMed

Lim, C B B; Goldin, R D; Darzi, A; Hanna, G B

2008-08-01

Staples are made of titanium, which elicits minimal tissue reaction. The authors have encountered foreign body reaction associated with stapled human gastrointestinal anastomoses, although the literature has no reports of this. The aim of this study was to identify the refractile foreign materials causing this reaction. Histological sections were taken from 14 gastrointestinal specimens from patients with a history of a stapled anastomosis within the specimen excised. These were reviewed by light and polarization microscopy. Scanning electron microscopy and energy dispersive X-ray analysis were carried out on these sections, staples and stapler cartridges used for gastrointestinal surgery. Foreign bodies rich in fluorine were found in three patients, and those rich in carbon in 12. Other elements identified included oxygen, calcium, sodium, potassium, magnesium, aluminium and silicon. One specimen was found to contain titanium with no surrounding foreign body reaction. Stapler cartridges contained carbon, oxygen, fluorine, calcium, sodium, potassium, magnesium, aluminium, silicon and traces of titanium. Staples were composed of pure titanium with some fibrous material on the surface containing elements found in stapler cartridges. The presence of foreign body reaction was confirmed in stapled human gastrointestinal anastomoses. The source of refractile materials eliciting this reaction was the stapler cartridges. (c) 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Rectal distensibility and symptoms after stapled and Milligan-Morgan operation for hemorrhoids.

PubMed

Corsetti, Maura; De Nardi, Paola; Di Pietro, Salvatore; Passaretti, Sandro; Testoni, Pier Alberto; Staudacher, Carlo

2009-12-01

In a previous uncontrolled study, a reduction of rectal distensibility and volume thresholds for sensations have been related to the occurrence of fecal urgency and/or increased stool frequency after stapled hemorrhoidopexy. The aim of this study was to compare rectal symptoms and sensory-motor function after stapled hemorrhoidopexy and Milligan-Morgan hemorrhoidectomy. The clinical records of 12 (four women) and ten patients (four women) with third- and fourth-degree hemorrhoids, respectively, who underwent stapled hemorrhoidopexy or Milligan-Morgan's hemorrhoidectomy, were evaluated. One week before and 6 months after surgery, rectal motor and sensory response to distension was assessed by an electronic barostat, and bowel and rectal symptoms were recorded by means of a 7-day diary and Bristol Index scale and psychological symptoms with SCL-90 questionnaire. Rectal distensibility and volume thresholds for sensations were significantly lower after surgery (P < 0.02) in the stapled group. Increased stool frequency and/or fecal urgency arose in 41% of patients in the stapled group and associated with altered rectal distensibility. No difference within and between groups could be demonstrated in SCL-90 score. Rectal distensibility and volume thresholds for sensations decrease after stapled hemorrhoidopexy. Altered rectal distensibility was associated with rectal urgency and/or increased stool frequency.

Frequency of Dehiscence in Hand-Sutured and Stapled Intestinal Anastomoses in Dogs.

PubMed

Duell, Jason R; Thieman Mankin, Kelley M; Rochat, Mark C; Regier, Penny J; Singh, Ameet; Luther, Jill K; Mison, Michael B; Leeman, Jessica J; Budke, Christine M

2016-01-01

To determine the frequency of dehiscence of hand-sutured and stapled intestinal anastomoses in the dog and compare the surgery duration for the methods of anastomosis. Historical cohort study. Two hundred fourteen client-owned dogs undergoing hand-sutured (n = 142) or stapled (n = 72) intestinal anastomoses. Medical records from 5 referral institutions were searched for dogs undergoing intestinal resection and anastomosis between March 2006 and February 2014. Demographic data, presence of septic peritonitis before surgery, surgical technique (hand-sutured or stapled), surgery duration, surgeon (resident versus faculty member), indication for surgical intervention, anatomic location of resection and anastomosis, and if dehiscence was noted postoperatively were retrieved. Estimated frequencies were summarized and presented as proportions and 95% confidence intervals (CI) and continuous outcomes as mean (95% CI). Comparisons were made across methods of anastomosis. Overall, 29/205 dogs (0.14, 95% CI 0.10-00.19) had dehiscence, including 21/134 dogs (0.16, 0.11-0.23) undergoing hand-sutured anastomosis and 8/71 dogs (0.11, 0.06-0.21) undergoing stapled anastomosis. There was no significant difference in the frequency of dehiscence across anastomosis methods (χ(2), P = .389). The mean (95% CI) surgery duration of 140 minutes (132-147) for hand- sutured anastomoses and 108 minutes (99-119) for stapled anastomoses was significantly different (t-test, P < .001). No significant difference in frequency of dehiscence was noted between hand- sutured and stapled anastomoses in dogs but surgery duration is significantly reduced by the use of staples for intestinal closure. © Copyright 2015 by The American College of Veterinary Surgeons.

26 CFR 1.269B-1 - Stapled foreign corporations.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 3 2013-04-01 2013-04-01 false Stapled foreign corporations. 1.269B-1 Section 1... (CONTINUED) INCOME TAXES (CONTINUED) Items Not Deductible § 1.269B-1 Stapled foreign corporations. (a) Treatment as a domestic corporation—(1) General rule. Except as otherwise provided, if a foreign corporation...

26 CFR 1.269B-1 - Stapled foreign corporations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 3 2011-04-01 2011-04-01 false Stapled foreign corporations. 1.269B-1 Section 1... (CONTINUED) INCOME TAXES (CONTINUED) Items Not Deductible § 1.269B-1 Stapled foreign corporations. (a) Treatment as a domestic corporation—(1) General rule. Except as otherwise provided, if a foreign corporation...

26 CFR 1.269B-1 - Stapled foreign corporations.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 3 2014-04-01 2014-04-01 false Stapled foreign corporations. 1.269B-1 Section 1... (CONTINUED) INCOME TAXES (CONTINUED) Items Not Deductible § 1.269B-1 Stapled foreign corporations. (a) Treatment as a domestic corporation—(1) General rule. Except as otherwise provided, if a foreign corporation...

26 CFR 1.269B-1 - Stapled foreign corporations.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 3 2012-04-01 2012-04-01 false Stapled foreign corporations. 1.269B-1 Section 1... (CONTINUED) INCOME TAXES (CONTINUED) Items Not Deductible § 1.269B-1 Stapled foreign corporations. (a) Treatment as a domestic corporation—(1) General rule. Except as otherwise provided, if a foreign corporation...

76 FR 60802 - Certain Polyester Staple Fiber From the Republic of Korea and Taiwan: Continuation of Antidumping...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-30

... DEPARTMENT OF COMMERCE International Trade Administration [A-580-839, A-583-833] Certain Polyester... Commission (ITC) that revocation of the antidumping duty orders on certain polyester staple fiber from the... and the ITC instituted sunset reviews of the antidumping duty orders on polyester staple fiber from...

77 FR 62217 - Certain Polyester Staple Fiber From the People's Republic of China: Continuation of Antidumping...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-12

... DEPARTMENT OF COMMERCE International Trade Administration [A-570-905] Certain Polyester Staple... International Trade Commission (``ITC'') that revocation of the antidumping duty order on certain polyester... antidumping duty order on certain polyester staple fiber from the PRC pursuant to section 751(c)(2) of the...

76 FR 37830 - Polyester Staple Fiber From Korea and Taiwan; Scheduling of Expedited Five-Year Reviews...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-28

... INTERNATIONAL TRADE COMMISSION [Investigation Nos. 731-TA-825 and 826 (Second Review)] Polyester... Duty Orders on Polyester Staple Fiber From Korea and Taiwan AGENCY: United States International Trade... determine whether revocation of the antidumping duty orders on polyester staple fiber from Korea and Taiwan...

75 FR 5763 - Notice of Correction to the First Administrative Review of Certain Polyester Staple Fiber From...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-04

... First Administrative Review of Certain Polyester Staple Fiber From the People's Republic of China: Final... the People's Republic of China (``PRC''). See First Administrative Review of Certain Polyester Staple Fiber From the People's Republic of China: Final Results of Antidumping Duty Administrative Review, 75...

78 FR 70485 - Common Crop Insurance Regulations; Extra Long Staple Cotton Crop Provisions

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-26

...-0002] RIN 0563-AC41 Common Crop Insurance Regulations; Extra Long Staple Cotton Crop Provisions AGENCY... Cotton Crop Insurance Provisions to make the Extra Long Staple (ELS) Cotton Crop Insurance Provisions consistent with the Upland Cotton Crop Insurance Provisions and to allow a late planting period. The intended...

75 FR 1336 - First Administrative Review of Certain Polyester Staple Fiber From the People's Republic of China...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-11

... System. Jianxin Fuda Chemical Fibre Factory. Comment 6: Correction of Name in Federal Register Notice... of Certain Polyester Staple Fiber From the People's Republic of China: Final Results of Antidumping... duty order on certain polyester staple fiber (``PSF'') from the People's Republic of China (``PRC...

77 FR 39990 - Certain Polyester Staple Fiber From the People's Republic of China: Preliminary Results of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-06

... calls into question the reliability of this information. \\27\\ See Polyester Staple Fiber Final... Fiber From the People's Republic of China: Preliminary Results of the Antidumping Duty Administrative... duty order on certain polyester staple fiber from the People's Republic of China (``PRC'') for the...

78 FR 17637 - Polyester Staple Fiber From Taiwan: Preliminary Results of Antidumping Duty Administrative Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-22

... DEPARTMENT OF COMMERCE International Trade Administration [A-583-833] Polyester Staple Fiber From... staple fiber (PSF) from Taiwan. The period of review (POR) is May 1, 2011, through April 30, 2012. The.... DATES: Effective Date: March 22, 2013. FOR FURTHER INFORMATION CONTACT: Bryan Hansen or Minoo Hatten, AD...

Novel Structures of Self-Associating Stapled Peptides

PubMed Central

Bhattacharya, Shibani; Zhang, Hongtao; Cowburn, David; Debnath, Asim K.

2012-01-01

Hydrocarbon stapling of peptides is a powerful technique to transform linear peptides into cell-permeable helical structures that can bind to specific biological targets. In this study, we have used high resolution solution NMR techniques complemented by Dynamic Light Scattering to characterize extensively a family of hydrocarbon stapled peptides with known inhibitory activity against HIV-1 capsid assembly to evaluate the various factors that modulate activity. The helical peptides share a common binding motif but differ in charge, the length and position of the staple. An important outcome of the study was to show the peptides share a propensity to self-associate into organized polymeric structures mediated predominantly by hydrophobic interactions between the olefinic chain and the aromatic side-chains from the peptide. We have also investigated in detail the structural significance of the length and position of the staple, and of olefinic bond isomerization in stabilizing the helical conformation of the peptides as potential factors driving polymerization. This study presents the numerous challenges of designing biologically active stapled peptides and the conclusions have broad implications for optimizing a promising new class of compounds in drug discovery. PMID:22170623

A randomized, controlled trial of diathermy hemorrhoidectomy vs. stapled hemorrhoidectomy in an intended day-care setting with longer-term follow-up.

PubMed

Cheetham, M J; Cohen, C R G; Kamm, M A; Phillips, R K S

2003-04-01

Hemorrhoidectomy is the most effective long-term treatment for hemorrhoids. Although it is possible to perform hemorrhoidectomy as a day case with a high degree of patient satisfaction, patients take an average of 14 days off work after surgery. Stapled hemorrhoidectomy is believed to be less painful than conventional hemorrhoidectomy and should allow an earlier return to work. The aim of this study was to compare both the immediate and the long-term results of stapled hemorrhoidectomy with diathermy hemorrhoidectomy in patients with prolapsing internal hemorrhoids in an intended day-care setting. Thirty-one patients were randomly assigned to undergo diathermy hemorrhoidectomy (n = 16) or stapled hemorrhoidectomy performed with a purpose-designed endoluminal stapling device, PPH01T (n = 15). All operations were planned as day or short-stay cases. All patients received lactulose, commenced preoperatively, together with postoperative topical glyceryl trinitrate and oral metronidazole. Patients were assessed by structured interview to assess their symptoms before and after surgery, with an intended follow-up of six months. All patients completed a 10-cm visual analog pain scale daily for the first ten days after surgery. The total pain score (sum of all pain scores) was significantly higher in the diathermy group (50 (range, 9.8-79.9) vs. 19.6 (range, 1.3-89.5), P = 0.03). Patients took a median of 14 (range, 3-21) days off work after diathermy hemorrhoidectomy compared with 10 (range, 3-38) days for the patients undergoing stapled hemorrhoidectomy (P = 0.15). At long-term follow-up, three patients (all in the stapled group) developed new symptoms of fecal urgency and anal pain, and three patients required further surgery to remove symptomatic external hemorrhoids after stapled hemorrhoidectomy. Although stapled hemorrhoidectomy is less painful in the short term, this does not lead to a significantly earlier return to work, and some patients develop new symptoms at long-term follow-up.

Gastroesophageal reflux disease and Barrett's esophagus after laparoscopic sleeve gastrectomy: a possible, underestimated long-term complication.

PubMed

Genco, Alfredo; Soricelli, Emanuele; Casella, Giovanni; Maselli, Roberta; Castagneto-Gissey, Lidia; Di Lorenzo, Nicola; Basso, Nicola

2017-04-01

Morbidly obese patients are affected by gastroesophageal reflux disease (GERD) and hiatal hernia (HH) more frequently than lean patients. Because of conflicting results, the indication to sleeve gastrectomy (SG) in patients with GERD is still debated. To evaluate the incidence of GERD on the basis of clinical, endoscopic, and histologic data in patients undergoing SG. University hospital, Rome, Italy. From July 2007 to January 2010, 162 patients underwent primary SG. Preoperatively all patients underwent visual analogue scale (VAS) evaluation of GERD symptoms, proton pump inhibitors (PPIs) consumption recording, and esophagogastroduodenoscopy (EGD). Stomach resection started 6 cm from pylorus on a 48Fr bougie. Staple line was reinforced by an oversewing suture. A postoperative clinical control with VAS evaluation, PPI consumption, and EGD was proposed to all patients. Three patients were excluded because of the occurrence of major postoperative complications. A total of 110 patients accepted to take part in the study (follow-up rate: 69.1%). At a mean 58 months of follow-up, incidence of GERD symptoms, VAS mean score, and PPI intake significantly increased compared with preoperative values (68.1% versus 33.6%: P<.0001; 3 versus 1.8: P = .018; 57.2% versus 19.1%: P<.0001) At EGD, an upward migration of the "Z" line and a biliary-like esophageal reflux was found in 73.6% and 74.5% of cases, respectively. A significant increase in the incidence and in the severity of erosive esophagitis (EE) was evidenced, whereas nondysplastic Barrett's esophagus (BE) was newly diagnosed in 19 patients (17.2%). No significant correlations were found between GERD symptoms and endoscopic findings. In the present series the incidence of EE and of BE in SG patients was considerably higher than that reported in the current literature, and it was not related to GERD symptoms. Endoscopic surveillance after SG should be advocated irrespective of the presence of GERD symptoms. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Comparison of the fracture resistances of glass fiber mesh- and metal mesh-reinforced maxillary complete denture under dynamic fatigue loading.

PubMed

Im, So-Min; Huh, Yoon-Hyuk; Cho, Lee-Ra; Park, Chan-Jin

2017-02-01

The aim of this study was to investigate the effect of reinforcing materials on the fracture resistances of glass fiber mesh- and Cr-Co metal mesh-reinforced maxillary complete dentures under fatigue loading. Glass fiber mesh- and Cr-Co mesh-reinforced maxillary complete dentures were fabricated using silicone molds and acrylic resin. A control group was prepared with no reinforcement (n = 15 per group). After fatigue loading was applied using a chewing simulator, fracture resistance was measured by a universal testing machine. The fracture patterns were analyzed and the fractured surfaces were observed by scanning electron microscopy. After cyclic loading, none of the dentures showed cracks or fractures. During fracture resistance testing, all unreinforced dentures experienced complete fracture. The mesh-reinforced dentures primarily showed posterior framework fracture. Deformation of the all-metal framework caused the metal mesh-reinforced denture to exhibit the highest fracture resistance, followed by the glass fiber mesh-reinforced denture ( P <.05) and the control group ( P <.05). The glass fiber mesh-reinforced denture primarily maintained its original shape with unbroken fibers. River line pattern of the control group, dimples and interdendritic fractures of the metal mesh group, and radial fracture lines of the glass fiber group were observed on the fractured surfaces. The glass fiber mesh-reinforced denture exhibits a fracture resistance higher than that of the unreinforced denture, but lower than that of the metal mesh-reinforced denture because of the deformation of the metal mesh. The glass fiber mesh-reinforced denture maintains its shape even after fracture, indicating the possibility of easier repair.

Transanal repair of rectocele and full rectal mucosectomy with one circular stapler: a novel surgical technique.

PubMed

Regadas, F S P; Regadas, S M M; Rodrigues, L V; Misici, R; Silva, F R; Regadas Filho, F S P

2005-04-01

We present a new surgical stapling technique for treatment of rectocele when associated with internal mucosal prolapse or haemorrhoids using only one circular mechanical stapler. Eight female patients, mean age 53 years (range, 42-70), complaining of obstructed defecation with vaginal digitation because of rectocele associated with internal mucosal prolapse underwent transanal repair of rectocele and rectal mucosectomy using one circular stapler between April and July 2004. A running horizontal mattress suture was placed through the base of the rectocele including mucosa, submucosa and the muscle layer of the whole anterior anorectal junction wall. The prolapsed mucosa and the muscular layer were then excised with an electrical scapel. A continuous pursestring rectal mucosa suture was placed 0.5 cm before the previous anterior mucosa and muscle layers resected wound, including the anorectal junction wall which was kept separate from the posterior vaginal wall by a Babcock forceps. Posteriorly, the pursestring suture included only mucosal and submucosal layers. The stapled suture was positioned between normal anterior rectal wall and the anal canal, 0.5 cm above the pectinate line. The stapler was then closed, fired and withdrawn. One patient complained of a perianal hematoma on the seventh postoperative day, requiring surgical excision. Postoperative defecography showed correction of the rectocele and outlet obstruction disappeared in all patients. This novel combined manual-stapled technique for rectocele and rectal internal mucosal prolapse seems to be a safe procedure and the preliminary results are encouraging. Further investigations have to be performed to assess long-term outcome in a larger number of patients.

[An alternative continence mechanism for continent catheterisable micturation].

PubMed

Honeck, P; Alken, P

2010-01-01

The creation of a stable, reliable, continent and easily catheterisable continence mechanism is an essential prerequisite for the construction of a continent cutaneous urinary reservoir. Although a substantial number of surgical methods has been described, construction is still a complex surgical procedure. The aim of this study was the evaluation of a new method for a continence mechanism using stapled small or large intestine. Small and large pig intestine was used for construction. For stapling the tube a 3 cm or 6 cm double row stapling system was used. Two variations using small and large intestine segments were constructed (IL 1, COL 1, COL 2). A 3 or 6 cm long stapler line was placed alongside a 12 Fr catheter positioned at the antimesenterial side creating a partially two-luminal segment. The open end of the non-catheterised lumen and the opposite intestinal end were closed by continuous sutures. The created tube was then embedded into the pouch. Pressure evaluation was performed for each variation. Intermittent external manual compression was used to simulate sudden pressure exposure. Construction times for the IL 1 and COL 1 variations were 10 +/- 1.5 min and 6.2 +/- 1.3 min for COL 2. All variations showed no leakage during filling or external compression. The maximum capacity was lower for the IL 1 compared to the COL variation. The maximum pressure levels reached did not differ significantly. The described technique is an easy and fast method to construct a continent and easy to catheterize continence mechanism using small or large intestine.

Thoracoscopic stapler-based “bidirectional” segmentectomy for posterior basal segment (S10) and its variants

PubMed Central

Murayama, Tomonori; Nakajima, Jun

2018-01-01

Thoracoscopic segmentectomy for the posterior basal segment (S10) and its variant (e.g., S9+10 and S10b+c combined subsegmentectomy) is one of the most challenging anatomical segmentectomies. Stapler-based segmentectomy is attractive to simplify the operation and to prevent post-operative air leakage. However, this approach makes thoracoscopic S10 segmentectomy even more tricky. The challenges are caused mostly from the following three reasons: first, similar to other basal segments, “three-dimensional” stapling is needed to fold a cuboidal segment; second, the belonging pulmonary artery is not directly facing the interlobar fissure or the hilum, making identification of target artery difficult; third, the anatomy of S10 and adjacent segments such as superior (S6) and medial basal (S7) is variable. To overcome these challenges, this article summarizes the “bidirectional approach” that allows for solid confirmation of anatomy while avoiding separation of S6 and the basal segment. To assist this approach under limited thoracoscopic view, we also show stapling techniques to fold the cuboidal segment with the aid of “standing stiches”. Attention should also be paid to the anatomy of adjacent segments particularly that of S7, which tends to be congested after stapling. The use of virtual-assisted lung mapping (VAL-MAP) is also recommended to demark resection lines because it flexibly allows for complex procedures such as combined subsegmentectomy such as S10b+c, extended segmentectomy such as S10+S9b, and non-anatomically extended segmentectomy. PMID:29785292

Circumferentially oversewn inverted stapled anastomosis.

PubMed

Karam, Charbel; Lord, Sally; Gett, Rohan; Meagher, Alan P

2018-04-01

Leak rates of over 5% following anastomoses between the ileum and colon continue to be reported in large series and are associated with substantial morbidity and with mortality rates of 10-20%. In 1994, we began performing circumferentially oversewn inverted stapled anastomoses in patients undergoing ileo-colic anastomoses or ileostomy closure. It has become increasingly apparent that this method is associated with a low risk of leakage, which we should report. The anastomotic technique described was used in all patients undergoing ileo-colic anastomosis or closure of ileostomy by surgeon 1 (1994-2015) and in all ileo-colic anastomoses by surgeon 2 (2007-2015). All patients had a widely patent anastomosis constructed by two firings of a linear cutting stapler, as previously described. Additionally, the entire staple line was carefully oversewn with interrupted, inverting 4/0 polydioxanone sutures. Anastomotic leak was defined as a patient requiring re-operation or radiological drainage. One thousand and twelve patients underwent ileo-colic anastomosis and 685 patients underwent closure of ileostomy by surgeon 1, and 165 patients underwent ileo-colic anastomosis by surgeon 2. None of the 1862 patients required re-operation or radiological drainage for a leak (event rate 0%, 95% confidence interval 0-0.2%). However, there were three possible contained leaks treated successfully conservatively. The time taken to perform the actual anastomosis was measured in the last 30 ileo-colic resections. The median time was 42 min. While this method may well be too slow to gain widespread adoption, we hope this report encourages increased research into finding techniques with similar low leak rates. © 2016 Royal Australasian College of Surgeons.

The Effect of Pleural Abrasion on the Treatment of Primary Spontaneous Pneumothorax: A Systematic Review of Randomized Controlled Trials

PubMed Central

Ming, Mo-yu; Cai, Shuang-qi; Chen, Yi-Qiang

2015-01-01

Background Pleural abrasion has been widely used to control the recurrence of primary spontaneous pneumothorax (PSP). However, controversy still exists regarding the advantages and disadvantages of pleural abrasion compared with other interventions in preventing the recurrence of PSP. Methods The PubMed, Embase, and Cochrane Central Register of Controlled Trials databases were searched up to December 15, 2014 to identify randomized controlled trials (RCTs) that compared the effects of pleural abrasion with those of other interventions in the treatment of PSP. The study outcomes included the PSP recurrence rate and the occurrence rate of adverse effects. Results Mechanical pleural abrasion and apical pleurectomy after thoracoscopic stapled bullectomy exhibited similarly persistent postoperative air leak occurrence rates (p = 0.978) and 1-year PSP recurrence rates (p = 0.821), whereas pleural abrasion led to reduced residual chest pain and discomfort (p = 0.001) and a smaller rate of hemothorax (p = 0.036) than did apical pleurectomy. However, the addition of minocycline pleurodesis to pleural abrasion did not reduce the pneumothorax recurrence rate compared with apical pleurectomy (3.8% for both procedures) but was associated with fewer complications. There was no statistical difference in the pneumothorax recurrence rate between mechanical pleural abrasion and chemical pleurodesis with minocycline on either an intention-to-treat basis (4 of 42 versus 0 of 42, p = 0.12; Fisher exact test) or after exclusions (2 of 40 versus 0 of 42, p = 0.24; Fisher exact test). Pleural abrasion plus minocycline pleurodesis also did not reduce the pneumothorax recurrence rate compared with pleural abrasion alone (p = 0.055). Moreover, pleural abrasion plus minocycline pleurodesis was associated with more intense acute chest pain. The postoperative overall recurrence rate in patients who underwent staple line coverage with absorbable cellulose mesh and fibrin glue was similar to that with mechanical abrasion after thoracoscopic bullectomy (13.8% vs. 14.2%, respectively; p = 0.555), but staple line coverage resulted in less postoperative residual pain than mechanical abrasion (0.4% vs.3.2%; p<0.0001). Pleural abrasion after thoracoscopic wedge resection did not decrease the recurrence of pneumothorax compared with wedge resection alone (p = 0.791), but the intraoperative bleeding and postoperative pleural drainage rates were higher when pleural abrasion was performed. Conclusions In addition to resulting in the same pneumothorax recurrence rate, thoracoscopic pleural abrasion with or without minocycline pleurodesis is safer than apical pleurectomy in the treatment of PSP. However, minocycline pleurodesis with or without pleural abrasion is not any more effective than pleural abrasion alone. Moreover, additional mechanical abrasion is not safer than additional staple line coverage with absorbable cellulose mesh and fibrin glue after thoracoscopic bullectomy because of increased postoperative pain. Additionally, pleural abrasion after thoracoscopic wedge resection should not be recommended for routine application due to the greater incidence of adverse effects than wedge resection alone. However, further large-scale, well-designed RCTs are needed to confirm the best procedure. PMID:26042737

77 FR 54898 - Certain Polyester Staple Fiber From the People's Republic of China: Final Results of Expedited...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-06

... Fiber From the People's Republic of China: Final Results of Expedited Sunset Review of the Antidumping... (``sunset'') review of the antidumping duty order on certain polyester staple fiber from the People's... Department finds that revocation of the antidumping duty order on certain polyester staple fiber from the PRC...

76 FR 53899 - Notice to All Interested Parties of the Termination of the Receivership of 10006-First Integrity...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-30

... Receivership of 10006--First Integrity Bank, Staples, MN Notice Is Hereby Given that the Federal Deposit Insurance Corporation (``FDIC'') as Receiver for First Integrity Bank, Staples, MN (``the Receiver... Integrity Bank, Staples, MN on May 30, 2008. The liquidation of the receivership assets has been completed...

Polymorphic design of DNA origami structures through mechanical control of modular components.

PubMed

Lee, Chanseok; Lee, Jae Young; Kim, Do-Nyun

2017-12-12

Scaffolded DNA origami enables the bottom-up fabrication of diverse DNA nanostructures by designing hundreds of staple strands, comprised of complementary sequences to the specific binding locations of a scaffold strand. Despite its exceptionally high design flexibility, poor reusability of staples has been one of the major hurdles to fabricate assorted DNA constructs in an effective way. Here we provide a rational module-based design approach to create distinct bent shapes with controllable geometries and flexibilities from a single, reference set of staples. By revising the staple connectivity within the desired module, we can control the location, stiffness, and included angle of hinges precisely, enabling the construction of dozens of single- or multiple-hinge structures with the replacement of staple strands up to 12.8% only. Our design approach, combined with computational shape prediction and analysis, can provide a versatile and cost-effective procedure in the design of DNA origami shapes with stiffness-tunable units.

Exploitation of the Ornithine Effect Enhances Characterization of Stapled and Cyclic Peptides

NASA Astrophysics Data System (ADS)

Crittenden, Christopher M.; Parker, W. Ryan; Jenner, Zachary B.; Bruns, Kerry A.; Akin, Lucas D.; McGee, William M.; Ciccimaro, Eugene; Brodbelt, Jennifer S.

2016-05-01

A method to facilitate the characterization of stapled or cyclic peptides is reported via an arginine-selective derivatization strategy coupled with MS/MS analysis. Arginine residues are converted to ornithine residues through a deguanidination reaction that installs a highly selectively cleavable site in peptides. Upon activation by CID or UVPD, the ornithine residue cyclizes to promote cleavage of the adjacent amide bond. This Arg-specific process offers a unique strategy for site-selective ring opening of stapled and cyclic peptides. Upon activation of each derivatized peptide, site-specific backbone cleavage at the ornithine residue results in two complementary products: the lactam ring-containing portion of the peptide and the amine-containing portion. The deguanidination process not only provides a specific marker site that initiates fragmentation of the peptide but also offers a means to unlock the staple and differentiate isobaric stapled peptides.

Skin closure using staples and nylon sutures: a comparison of results.

PubMed

Stockley, I; Elson, R A

1987-03-01

A disposable skin stapler (Elite: Auto Suture UK Ltd) and Nylon vertical mattress sutures have been used for skin closure. The complications related to each method were evaluated in 129 wounds. There was a higher incidence of inflammation, discomfort on removal and spreading of the healing scar associated with staples. The only advantage of staples was speed of wound closure.

75 FR 33783 - Certain Polyester Staple Fiber from the Republic of Korea: Preliminary Results of the 2008 - 2009...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-15

... Fiber from the Republic of Korea: Preliminary Results of the 2008 - 2009 Antidumping Duty Administrative... antidumping duty order on certain polyester staple fiber from the Republic of Korea. The period of review is May 1, 2008, through April 30, 2009. This review covers imports of certain polyester staple fiber from...

Is STAPLE algorithm confident to assess segmentation methods in PET imaging?

NASA Astrophysics Data System (ADS)

Dewalle-Vignion, Anne-Sophie; Betrouni, Nacim; Baillet, Clio; Vermandel, Maximilien

2015-12-01

Accurate tumor segmentation in [18F]-fluorodeoxyglucose positron emission tomography is crucial for tumor response assessment and target volume definition in radiation therapy. Evaluation of segmentation methods from clinical data without ground truth is usually based on physicians’ manual delineations. In this context, the simultaneous truth and performance level estimation (STAPLE) algorithm could be useful to manage the multi-observers variability. In this paper, we evaluated how this algorithm could accurately estimate the ground truth in PET imaging. Complete evaluation study using different criteria was performed on simulated data. The STAPLE algorithm was applied to manual and automatic segmentation results. A specific configuration of the implementation provided by the Computational Radiology Laboratory was used. Consensus obtained by the STAPLE algorithm from manual delineations appeared to be more accurate than manual delineations themselves (80% of overlap). An improvement of the accuracy was also observed when applying the STAPLE algorithm to automatic segmentations results. The STAPLE algorithm, with the configuration used in this paper, is more appropriate than manual delineations alone or automatic segmentations results alone to estimate the ground truth in PET imaging. Therefore, it might be preferred to assess the accuracy of tumor segmentation methods in PET imaging.

Is STAPLE algorithm confident to assess segmentation methods in PET imaging?

PubMed

Dewalle-Vignion, Anne-Sophie; Betrouni, Nacim; Baillet, Clio; Vermandel, Maximilien

2015-12-21

Accurate tumor segmentation in [18F]-fluorodeoxyglucose positron emission tomography is crucial for tumor response assessment and target volume definition in radiation therapy. Evaluation of segmentation methods from clinical data without ground truth is usually based on physicians' manual delineations. In this context, the simultaneous truth and performance level estimation (STAPLE) algorithm could be useful to manage the multi-observers variability. In this paper, we evaluated how this algorithm could accurately estimate the ground truth in PET imaging. Complete evaluation study using different criteria was performed on simulated data. The STAPLE algorithm was applied to manual and automatic segmentation results. A specific configuration of the implementation provided by the Computational Radiology Laboratory was used. Consensus obtained by the STAPLE algorithm from manual delineations appeared to be more accurate than manual delineations themselves (80% of overlap). An improvement of the accuracy was also observed when applying the STAPLE algorithm to automatic segmentations results. The STAPLE algorithm, with the configuration used in this paper, is more appropriate than manual delineations alone or automatic segmentations results alone to estimate the ground truth in PET imaging. Therefore, it might be preferred to assess the accuracy of tumor segmentation methods in PET imaging.

Modelling DNA origami self-assembly at the domain level.

PubMed

Dannenberg, Frits; Dunn, Katherine E; Bath, Jonathan; Kwiatkowska, Marta; Turberfield, Andrew J; Ouldridge, Thomas E

2015-10-28

We present a modelling framework, and basic model parameterization, for the study of DNA origami folding at the level of DNA domains. Our approach is explicitly kinetic and does not assume a specific folding pathway. The binding of each staple is associated with a free-energy change that depends on staple sequence, the possibility of coaxial stacking with neighbouring domains, and the entropic cost of constraining the scaffold by inserting staple crossovers. A rigorous thermodynamic model is difficult to implement as a result of the complex, multiply connected geometry of the scaffold: we present a solution to this problem for planar origami. Coaxial stacking of helices and entropic terms, particularly when loop closure exponents are taken to be larger than those for ideal chains, introduce interactions between staples. These cooperative interactions lead to the prediction of sharp assembly transitions with notable hysteresis that are consistent with experimental observations. We show that the model reproduces the experimentally observed consequences of reducing staple concentration, accelerated cooling, and absent staples. We also present a simpler methodology that gives consistent results and can be used to study a wider range of systems including non-planar origami.

Modelling DNA origami self-assembly at the domain level

NASA Astrophysics Data System (ADS)

Dannenberg, Frits; Dunn, Katherine E.; Bath, Jonathan; Kwiatkowska, Marta; Turberfield, Andrew J.; Ouldridge, Thomas E.

2015-10-01

We present a modelling framework, and basic model parameterization, for the study of DNA origami folding at the level of DNA domains. Our approach is explicitly kinetic and does not assume a specific folding pathway. The binding of each staple is associated with a free-energy change that depends on staple sequence, the possibility of coaxial stacking with neighbouring domains, and the entropic cost of constraining the scaffold by inserting staple crossovers. A rigorous thermodynamic model is difficult to implement as a result of the complex, multiply connected geometry of the scaffold: we present a solution to this problem for planar origami. Coaxial stacking of helices and entropic terms, particularly when loop closure exponents are taken to be larger than those for ideal chains, introduce interactions between staples. These cooperative interactions lead to the prediction of sharp assembly transitions with notable hysteresis that are consistent with experimental observations. We show that the model reproduces the experimentally observed consequences of reducing staple concentration, accelerated cooling, and absent staples. We also present a simpler methodology that gives consistent results and can be used to study a wider range of systems including non-planar origami.

A low glycemic index staple diet reduces postprandial glucose values in Asian women with gestational diabetes mellitus.

PubMed

Hu, Zhi-Geng; Tan, Rong-Shao; Jin, Di; Li, Wei; Zhou, Xiao-Yan

2014-12-01

A low glycemic index (GI) diet is beneficial for glucose control in patients with diabetes mellitus. This study aimed to investigate the influence of a low-GI diet on postprandial glucose levels in women with gestational diabetes mellitus (GDM). Pregnant women with GDM were randomized to receive a normal diabetic control diet or a low-GI staple diet for 5 days. A low-GI staple food was used to replace rice in lunch and dinner for the low-GI staple diet group, whereas the total energy and carbohydrate levels remained equal in both groups. Fasting and postprandial glucose levels were determined daily. A total of 140 pregnant women with GDM were included in the study, including 66 in the low-GI staple diet group and 74 in the normal diabetic diet control group. No differences existed in baseline characteristics between the 2 groups (all P > 0.05). After dietary intervention, glucose levels were significantly reduced in the low-GI staple diet group (all P < 0.01) and the control group (all P < 0.008). Postintervention glucose values after breakfast, lunch, and dinner were significantly reduced in the treatment group compared with those in the control group (all P < 0.05). The percentage changes from baseline of all glucose values were significantly greater in the treatment group than in the control group (all P < 0.05). A low-GI staple diet significantly reduces postprandial glucose levels in women with GDM.

Implementation of a New High-Volume Circular Stapler in Stapled Anopexy for Hemorrhoidal Disease: Is Patient's Short-Term Outcome Affected by a Higher Volume of Resected Tissue?

PubMed

Grotenhuis, Brechtje A; Nonner, Joost; de Graaf, Eelco J R; Doornebosch, Pascal G

2017-11-02

Stapled anopexy is a safe technique for the treatment of hemorrhoids but carries a higher risk of recurrence, which might be caused due to the limited volume of resected tissue. In this study, we investigated the introduction of a high-volume circular stapling device; in particular whether an increased amount of resected tissue could affect patients' short-term postoperative outcome. Between 2011 and 2015, stapled anopexy was performed for hemorrhoids and/or anal prolapse in 141 patients (n = 25 conventional PPH-3©-stapler versus n = 116 high-volume CHEX©-stapler). In this prospectively collected dataset, operation details and short-term postoperative outcome were compared. With the high-volume stapler, a significantly higher amount of tissue was resected: 9.8 g (range 6.2-11.4) vs. 6.4 g (range 4.9-8.8) with the conventional stapler, p < 0.01. Postoperative short-term outcome did not differ in terms of readmission and complication rates. In all 5 patients who underwent a redo operation for residual hemorrhoids or prolapse, the high-volume stapler was used in the primary operation. A high-volume stapling device for stapled anopexy was introduced safely with a significantly higher amount of resected tissue without a worse short-term outcome. However, it remains unclear whether higher stapling volumes may lead to improved long-term outcome with less reinterventions. © 2017 S. Karger AG, Basel.

Comparison of the fracture resistances of glass fiber mesh- and metal mesh-reinforced maxillary complete denture under dynamic fatigue loading

PubMed Central

2017-01-01

PURPOSE The aim of this study was to investigate the effect of reinforcing materials on the fracture resistances of glass fiber mesh- and Cr–Co metal mesh-reinforced maxillary complete dentures under fatigue loading. MATERIALS AND METHODS Glass fiber mesh- and Cr–Co mesh-reinforced maxillary complete dentures were fabricated using silicone molds and acrylic resin. A control group was prepared with no reinforcement (n = 15 per group). After fatigue loading was applied using a chewing simulator, fracture resistance was measured by a universal testing machine. The fracture patterns were analyzed and the fractured surfaces were observed by scanning electron microscopy. RESULTS After cyclic loading, none of the dentures showed cracks or fractures. During fracture resistance testing, all unreinforced dentures experienced complete fracture. The mesh-reinforced dentures primarily showed posterior framework fracture. Deformation of the all-metal framework caused the metal mesh-reinforced denture to exhibit the highest fracture resistance, followed by the glass fiber mesh-reinforced denture (P<.05) and the control group (P<.05). The glass fiber mesh-reinforced denture primarily maintained its original shape with unbroken fibers. River line pattern of the control group, dimples and interdendritic fractures of the metal mesh group, and radial fracture lines of the glass fiber group were observed on the fractured surfaces. CONCLUSION The glass fiber mesh-reinforced denture exhibits a fracture resistance higher than that of the unreinforced denture, but lower than that of the metal mesh-reinforced denture because of the deformation of the metal mesh. The glass fiber mesh-reinforced denture maintains its shape even after fracture, indicating the possibility of easier repair. PMID:28243388

Yellow fever risk assessment in the Central African Republic.

PubMed

Ramos Junior, Alberto Novaes; Heukelbach, Jorg

2015-04-01

Yellow fever still causes high burden in several areas of sub-Saharan Africa and Latin America. There are few well-designed epidemiological studies and limited data about yellow fever in Africa. Staples et al., in a recently published paper in Transactions of the Royal Society of Tropical Medicine & Hygiene, performed a nationwide study in the Central African Republic (CAR) assessing infection risk and the operational impact of preventive measures. The rapid assessment of human, non-human and mosquito data call attention to the potential risk of future yellow fever outbreaks in the CAR and elsewhere. The study reinforces the need for intensified applied and operational research to address problems and human capacity needs in the realm of neglected tropical diseases in the post-2015 agenda. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Hemorrhoids.

PubMed

Hulme-Moir, M; Bartolo, D C

2001-03-01

Understanding of hemorrhoidal pathology and treatment has come a long way. The theory of a sliding anal canal lining and the knowledge that hemorrhoidal cushions are a normal part of the anal anatomy should encourage symptom control rather than radical removal of tissue. Techniques that fix the cushions back in position can be performed in outpatients with reasonable success rates. When required, surgery should be aimed at symptomatic hemorrhoids. It is hoped that new developments such as circular stapling and better pain management will promote increased day surgery, better pain control, and less time off work for patients.

Management of a failed mandibular staple implant: a clinical report.

PubMed

Ettinger, Ronald L; Fakhry, Ali

2010-12-01

A 48-year-old woman sought treatment because her staple implant-retained overdenture was no longer retentive, and the denture was worn over the abutments. After unsuccessfully attempting to move the retentive nuts along the transosseous posts of the staple implant, the posts were cut off at the level of the bone. Two endosseous implants were placed around the staple implant, and a new implant-retained overdenture was fabricated and inserted using ball attachments for retention. This article describes the treatment for this patient, who has been wearing the new dentures successfully for the past 4 years. Copyright © 2010 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

Comparison of the effect of the GABAB receptor agonist, baclofen, and the positive allosteric modulator of the GABAB receptor, GS39783, on alcohol self-administration in three different lines of alcohol-preferring rats

PubMed Central

Maccioni, Paola; Zaru, Alessandro; Loi, Barbara; Lobina, Carla; Carai, Mauro A.M.; Gessa, Gian Luigi; Capra, Alessandro; Mugnaini, Claudia; Pasquini, Serena; Corelli, Federico; Hyytiä, Petri; Lumeng, Lawrence; Colombo, Giancarlo

2012-01-01

Background Administration of the GABAB receptor agonist, baclofen, and positive allosteric modulator (PAM), GS39783, has been repeatedly reported to suppress multiple alcohol-related behaviors, including operant oral alcohol self-administration, in rats. The present study was designed to compare the effect of baclofen and GS39783 on alcohol self-administration in three lines of selectively bred, alcohol-preferring rats: Indiana alcohol-preferring (P), Sardinian alcohol-preferring (sP), and Alko Alcohol (AA). Methods Rats of each line were initially trained to respond on a lever, on a fixed ratio (FR) 4 (FR4) schedule of reinforcement, to orally self-administer alcohol (15%, v/v) in daily 30-min sessions. Once responding reached stable levels, rats were exposed to a sequence of experiments testing baclofen (0, 1, 1.7, and 3 mg/kg; i.p.) and GS39783 (0, 25, 50, and 100 mg/kg; i.g.) on FR4 and progressive ratio (PR) schedules of reinforcement. Finally, to assess the specificity of baclofen and GS39783 action, rats were slightly food-deprived and trained to lever-respond for food pellets. Results The rank of order of the reinforcing and motivational properties of alcohol was: P>sP>AA rats. Under both FR and PR schedules of reinforcement, the rank of order of potency and efficacy of baclofen and GS39783 in suppressing alcohol self-administration was: P>sP>AA rats. Only the highest dose of baclofen reduced lever-responding for food pellets; this effect was common to all three rat lines. Conversely, no dose of GS39783 altered lever-responding for food in any rat line. Conclusions These results suggest that: (a) the strength of the reinforcing and motivational properties of alcohol differ among P, sP, and AA rats; (b) the reinforcing and motivational properties of alcohol in P, sP, and AA rats are differentially sensitive to treatment with baclofen and GS39783; (c) the heterogeneity in sensitivity to baclofen and GS39783 of alcohol self-administration in P, sP, and AA rats may resemble the differential effectiveness of pharmacotherapies among the different typologies of human alcoholics; (d) the GABAB receptor is part of the neural substrate mediating the reinforcing and motivational properties of alcohol. PMID:22486245

Preparation and Characterization of Nitinol Bone Staples for Cranio-Maxillofacial Surgery

NASA Astrophysics Data System (ADS)

Lekston, Z.; Stróż, D.; Jędrusik-Pawłowska, M.

2012-12-01

The aim of this work was to form NiTi and TiNiCo body temperature activated and superelastic staples for clinical joining of mandible and face bone fractures. The alloys were obtained by VIM technique. Hot and cold processing was applied to obtain wires of required diameters. The martensitic transformation was studied by DSC, XRD, and TEM. The shape memory effects were measured by a bend and free recovery ASTM F2082-06 test. The superelasticity was recorded in the tension stress-strain and by the three-point bending cycles in an instrument equipped with a Hottinger force transducer and LVDT. Excellent superelastic behavior of TiNiCo wires was obtained after cold working and annealing at 400-500 °C. The body temperature activated shape memory staples were applied for fixation of mandibular condyle fractures. In experiments on the skull models, fixation of the facial fractures by using shape memory and superelastic staples were compared. The superelastic staples were used in osteosynthesis of zygomatico-maxillo-orbital fractures.

Stapled Golgi cisternae remain in place as cargo passes through the stack

PubMed Central

Lavieu, Gregory; Zheng, Hong; Rothman, James E

2013-01-01

We have designed a membrane ‘staple’, which consists of membrane-anchored repeats of the trans-aggregating FM domain that face the lumen of the secretory pathway. In the presence of the disaggregating drug these proteins transit the secretory pathway. When the drug is removed these proteins form electron-dense plaques which we term staples. Unexpectedly, when initially positioned within the cis-Golgi, staples remained at the cis face of the Golgi even after many hours. By contrast, soluble FM-aggregates transited the Golgi. Staples and soluble aggregates placed in cis-Golgi cisternae therefore have different fates. Whereas the membrane staples are located in the flattened, stacked central regions of the cisternae, the soluble aggregates are in the dilated rims. This suggests that while the cisternae are static on the time scale of protein traffic, the dilated rims are mobile and progress in the cis → trans direction via a mechanism that we term ‘Rim Progression’. DOI: http://dx.doi.org/10.7554/eLife.00558.001 PMID:23755362

A randomized study comparing skin closure in cesarean sections: staples vs subcuticular sutures.

PubMed

Rousseau, Julie-Anne; Girard, Karine; Turcot-Lemay, Lucile; Thomas, Nancy

2009-03-01

We sought to compare postoperative pain according to the skin closure method (subcuticular sutures vs staples) after an elective term cesarean section. A randomized controlled trial of 101 women was performed. Women were randomly assigned to subcuticular sutures or staples. Operative technique and postoperative analgesia were standardized. Stratification was used for primary vs repeat cesareans. Analog pain and satisfaction scales ranging from 0-10 were completed at postoperative days 1 and 3, and at 6 weeks postoperatively. A digital photograph of the incision was taken at 6 weeks postoperatively and evaluated by 3 independent blinded observers. Pain at 6 weeks postoperatively was significantly less in the staple group (0.17 vs 0.51; P = .04). Operative time was shorter in that group (24.6 vs 32.9 minutes; P < .0001). No difference was noted for incision appearance and women's satisfaction. Staples are the method of choice for skin closure for elective term cesareans in our population.

A randomized study comparing outcomes of stapled and hand-sutured anastomoses in patients undergoing open gastrointestinal surgery.

PubMed

Chandramohan, S M; Gajbhiye, Raj Narenda; Agwarwal, Anil; Creedon, Erin; Schwiers, Michael L; Waggoner, Jason R; Tatla, Daljit

2013-08-01

Although stapling is an alternative to hand-suturing in gastrointestinal surgery, recent trials specifically designed to evaluate differences between the two in surgery time, anastomosis time, and return to bowel activity are lacking. This trial compared the outcomes of the two in subjects undergoing open gastrointestinal surgery. Adult subjects undergoing emergency or elective surgery requiring a single gastric, small, or large bowel anastomosis were enrolled into this open-label, prospective, randomized, interventional, parallel, multicenter, controlled trial. Randomization was assigned in a 1:1 ratio between the hand-sutured group (n = 138) and the stapled group (n = 142). Anastomosis time, surgery time, and time to bowel activity were collected and compared as primary endpoints. A total of 280 subjects were enrolled from April 2009 to September 2010. Only the time of anastomosis was significantly different between the two arms: 17.6 ± 1.90 min (stapled) and 20.6 ± 1.90 min (hand-sutured). This difference was deemed not clinically or economically meaningful. Safety outcomes and other secondary endpoints were similar between the two arms. Mechanical stapling is faster than hand-suturing for the construction of gastrointestinal anastomoses. Apart from this, stapling and hand-suturing are similar with respect to the outcomes measured in this trial.

Long-term Evaluation of a Modified Double Staple Technique for Low Anterior Resection.

PubMed

Illuminati, G; Carboni, F; Ceccanei, G; Pacilè, M A; Pizzardi, G; Palumbo, P; Vietri, F

2014-01-01

When performing low anterior resection for rectal cancer with the double staple technique, -closing the rectum with a linear stapler in the abdomen can be challenging, especially when dealing with a narrow pelvis. For such instances we proposed to modify this technique by pulling the rectal stump through the anus, doing an extra-anal resection of the tumor and linear suture of the rectal stump, before performing a standard, stapled colorectal anastomosis. The purpose of this study was to assess the adequacy of this modification of the double staple technique. Retrospective review of 108 patients undergoing a stapled, low colorectal or coloanal anastomosis, after -eversion, extra-anal resection of the tumor and linear closure of the rectal stump for colorectal cancer, from January 1990 to December 2012. Operative mortality was 0.9%. Fourteen patients (13%) presented early, surgery-related complications -consisting of 7 anastomotic leaks, 5 wound infections, 1 ureteral lesion, and 1 peristomal abscess. Late complications related to surgery included 5 incisional hernias (4.6%), 4 anastomotic strictures (3.7%), 4 neurogenic bladders (3.7%) and 2 fecal incontinences (1.8%). The incidence of local disease recurrence was 10%. Surgical and oncological results validate the proposed modification of the double staple technique, when facing difficulties in suturing the rectum from the abdomen. Copyright© Acta Chirurgica Belgica.

Skin closure using staples and nylon sutures: a comparison of results.

PubMed Central

Stockley, I.; Elson, R. A.

1987-01-01

A disposable skin stapler (Elite: Auto Suture UK Ltd) and Nylon vertical mattress sutures have been used for skin closure. The complications related to each method were evaluated in 129 wounds. There was a higher incidence of inflammation, discomfort on removal and spreading of the healing scar associated with staples. The only advantage of staples was speed of wound closure. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 PMID:3566131

Polypropylene fiber reinforced concrete detention ponds : final report.

DOT National Transportation Integrated Search

1995-09-01

In 1991, two Durafiber polypropylene fiber reinforced concrete lined detention ponds were constructed. The detention ponds are located on the north side of the 181st Avenue Interchange, on the Columbia River Highway (I-84), approximately ten miles ea...

A multicenter study of routine versus selective intraoperative leak testing for sleeve gastrectomy.

PubMed

Bingham, Jason; Kaufman, Jedediah; Hata, Kai; Dickerson, James; Beekley, Alec; Wisbach, Gordon; Swann, Jacob; Ahnfeldt, Eric; Hawkins, Devon; Choi, Yong; Lim, Robert; Martin, Matthew

2017-09-01

Staple line leaks after sleeve gastrectomy are dreaded complications. Many surgeons routinely perform an intraoperative leak test (IOLT) despite little evidence to validate the reliability, clinical benefit, and safety of this procedure. To determine the efficacy of IOLT and if routine use has any benefit over selective use. Eight teaching hospitals, including private, university, and military facilities. A multicenter, retrospective analysis over a 5-year period. The efficacy of the IOLT for identifying unsuspected staple line defects and for predicting postoperative leaks was evaluated. An anonymous survey was also collected reflecting surgeons' practices and beliefs regarding IOLT. From January 2010 through December 2014, 4284 patients underwent sleeve gastrectomy. Of these, 37 patients (.9%) developed a postoperative leak, and 2376 patients (55%) received an IOLT. Only 2 patients (0.08%) had a positive finding. Subsequently, 21 patients with a negative IOLT developed a leak. IOLT demonstrated a sensitivity of only 8.7%. There was a nonsignificant trend toward increased leak rates when an IOLT was performed versus when IOLT was not performed. Leak rates were not statistically different between centers that routinely perform IOLT versus those that selectively perform IOLT. Routine IOLT had very poor sensitivity and was negative in 91% of patients who later developed postoperative leaks. The use of IOLT was not associated with a decrease in the incidence of postoperative leaks, and routine IOLT had no benefit over selective leak testing. IOLT should not be used as a quality indicator or "best practice" for bariatric surgery. Published by Elsevier Inc.

Sleeve gastrectomy severe complications: is it always a reasonable surgical option?

PubMed

Moszkowicz, David; Arienzo, Roberto; Khettab, Idir; Rahmi, Gabriel; Zinzindohoué, Franck; Berger, Anne; Chevallier, Jean-Marc

2013-05-01

Laparoscopic sleeve gastrectomy (LSG) is widely adopted but exposes serious complications. A retrospective database analysis was done to study LSG staple line complications in a tertiary referral university center with surgical ICU experienced in treatment of morbid obesity and complications. Twenty-two consecutive patients were referred between January 2004 and February 2012 with postoperative gastric leak or stenosis after LSG. Interventions consisted in the control of intra-abdominal and general sepsis; restoration of staple line continuity or revision of LSG; nutritional support; treatment of associated complications. Main outcome measures concerned success rates of therapeutic strategies, morbidity and mortality rates, LOS, and time to cure. Thirteen patients (59 %) were referred after failure of reoperation (seven fistula repairs were attempted). Three patients received emergency surgery in our center with transorificial intubation and jejunostomy formation. An endoscopic stent was tried in nine patients but failed in 84.6 % of cases within 20 days (1-161). Seven patients (32 %) necessitated total gastrectomy within 217 days (0-1,915 days) for conservative treatment failure. Procedures under general anesthesia were required in 41 % of cases, organ failure was found in 55 % of cases, and central venous device infection in 40 %. Mortality rate was 4.5 % (n = 1). Patients with unfavorable evolution of LSG complications (death or additional gastrectomy) had more previous bariatric procedure (82 % vs. 18 %, p = 0.003). Median time to cure was 310 days (9-546 days). LSG exposes severe complications occurring in patients with benign condition. Endoscopic stents entail high failure rate. Total gastrectomy is required in one third of the cases.

Systematic review and network meta-analysis comparing clinical outcomes and effectiveness of surgical treatments for haemorrhoids.

PubMed

Simillis, C; Thoukididou, S N; Slesser, A A P; Rasheed, S; Tan, E; Tekkis, P P

2015-12-01

The aim was to compare the clinical outcomes and effectiveness of surgical treatments for haemorrhoids. Randomized clinical trials were identified by means of a systematic review. A Bayesian network meta-analysis was performed using the Markov chain Monte Carlo method in WinBUGS. Ninety-eight trials were included with 7827 participants and 11 surgical treatments for grade III and IV haemorrhoids. Open, closed and radiofrequency haemorrhoidectomies resulted in significantly more postoperative complications than transanal haemorrhoidal dearterialization (THD), LigaSure™ and Harmonic® haemorrhoidectomies. THD had significantly less postoperative bleeding than open and stapled procedures, and resulted in significantly fewer emergency reoperations than open, closed, stapled and LigaSure™ haemorrhoidectomies. Open and closed haemorrhoidectomies resulted in more pain on postoperative day 1 than stapled, THD, LigaSure™ and Harmonic® procedures. After stapled, LigaSure™ and Harmonic® haemorrhoidectomies patients resumed normal daily activities earlier than after open and closed procedures. THD provided the earliest time to first bowel movement. The stapled and THD groups had significantly higher haemorrhoid recurrence rates than the open, closed and LigaSure™ groups. Recurrence of haemorrhoidal symptoms was more common after stapled haemorrhoidectomy than after open and LigaSure™ operations. No significant difference was identified between treatments for anal stenosis, incontinence and perianal skin tags. Open and closed haemorrhoidectomies resulted in more postoperative complications and slower recovery, but fewer haemorrhoid recurrences. THD and stapled haemorrhoidectomies were associated with decreased postoperative pain and faster recovery, but higher recurrence rates. The advantages and disadvantages of each surgical treatment should be discussed with the patient before surgery to allow an informed decision to be made. © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd.

A Circular Surgical Stapler Designed to Anastomose Aorta and Dacron Tube Graft

PubMed Central

2013-01-01

Background: A circular aortic stapler has been developed to anastomose the open end of the aorta to a size-matched Dacron tube graft in one quick motion and without having to pull sutures through the aortic wall. Methods: A prototype was developed, and its design and function were tested in bench experiments and compared with hand-sewn anastomosis. The basic design of the stapler is a central rod (anvil) surrounded by 10 stapling limbs, which can be closed over the anvil in a full circle, with staples extruded by turning a knob at the back. To test its function, a Dacron tube graft was inserted in the middle of a length of bovine aorta. One side was anastomosed with the stapler and the other hand-sewn in each of 10 experiments. Bovine blood was infused under increasing pressure. Results: It took considerably less time to complete the stapled anastomosis than the hand-sewn side (3 minutes, 46 seconds versus 15 minutes, 42 seconds). Initial leak occurred at low pressures on the hand-sewn side (mean pressure 40 mm Hg) compared with the stapled side (mean pressure 70 mm Hg). In 7 of 10 experiments, the leak became too brisk on the hand-sewn side to sustain pressure, compared with 3 of 10 with stapled anastomoses. The stapling device performed well in all cases except when the bovine aorta was too thick for the staples (two cases) or when there was a missed branch at the anastomotic site (one case). Conclusions: These experiments validate the concept and the design of this aortic stapler. There are some limitations in the current design, which will need to be modified before its use in live animals or clinically. PMID:26798678

Glycaemic responses of staple South Asian foods alone and combined with curried chicken as a mixed meal.

PubMed

George, R; Garcia, A L; Edwards, C A

2015-06-01

The glycaemic responses of staples differ when eaten as mixed meals. We determined the glycaemic responses and glycaemic index (GI) values for common South Asian carbohydrate rich foods and the effect of adding curried chicken to them as mixed meals. The GI and glycaemic response to staples (basmati rice, pilau rice and chapatti) and mixed meals (pilau rice with chicken curry and chapatti with chicken curry) were measured in healthy volunteers. Paired comparisons in each subject were carried out for staples and their equivalent mixed meals (n = 9). GI values for the mixed meals were significantly lower than the staples alone (41 and 60 for pilau rice with chicken curry and pilau rice alone, P = 0.001; 45 and 68 for chapatti with chicken curry and chapatti alone, P = 0.004). Both, pilau rice and chapatti with chicken curry had a significantly lower glycaemic response than their equivalent staples alone: incremental area under the blood glucose response curves (IAUC) 111.9 mmol min(-1 ) L(-1) for pilau rice with curry versus 162.4 mmol min(-1 ) L(-1) for pilau rice alone (P = 0.001) and IAUC 110.1 mmol min(-1 ) L(-1) for chapatti with chicken curry versus 183.6 mmol min(-1 ) L(-1) for chapatti alone (P = 0.002). Adding fat and protein-containing curries as part of a mixed meal to carbohydrate rich staple foods reduced glycaemic responses, and also changed the GI category. © 2014 The British Dietetic Association Ltd.

A Circular Surgical Stapler Designed to Anastomose Aorta and Dacron Tube Graft: Validation of the Concept and Comparison to Hand-Sewn Anastomosis in Bench Experiments.

PubMed

Raza, Syed T

2013-06-01

A circular aortic stapler has been developed to anastomose the open end of the aorta to a size-matched Dacron tube graft in one quick motion and without having to pull sutures through the aortic wall. A prototype was developed, and its design and function were tested in bench experiments and compared with hand-sewn anastomosis. The basic design of the stapler is a central rod (anvil) surrounded by 10 stapling limbs, which can be closed over the anvil in a full circle, with staples extruded by turning a knob at the back. To test its function, a Dacron tube graft was inserted in the middle of a length of bovine aorta. One side was anastomosed with the stapler and the other hand-sewn in each of 10 experiments. Bovine blood was infused under increasing pressure. It took considerably less time to complete the stapled anastomosis than the hand-sewn side (3 minutes, 46 seconds versus 15 minutes, 42 seconds). Initial leak occurred at low pressures on the hand-sewn side (mean pressure 40 mm Hg) compared with the stapled side (mean pressure 70 mm Hg). In 7 of 10 experiments, the leak became too brisk on the hand-sewn side to sustain pressure, compared with 3 of 10 with stapled anastomoses. The stapling device performed well in all cases except when the bovine aorta was too thick for the staples (two cases) or when there was a missed branch at the anastomotic site (one case). These experiments validate the concept and the design of this aortic stapler. There are some limitations in the current design, which will need to be modified before its use in live animals or clinically.

Nonwoven glass fiber mat reinforces polyurethane adhesive

NASA Technical Reports Server (NTRS)

Roseland, L. M.

1967-01-01

Nonwoven glass fiber mat reinforces the adhesive properties of a polyurethane adhesive that fastens hardware to exterior surfaces of aluminum tanks. The mat is embedded in the uncured adhesive. It ensures good control of the bond line and increases the peel strength.

Rigid spine reinforced polymer microelectrode array probe and method of fabrication

DOEpatents

Tabada, Phillipe; Pannu, Satinderpall S

2014-05-27

A rigid spine-reinforced microelectrode array probe and fabrication method. The probe includes a flexible elongated probe body with conductive lines enclosed within a polymeric material. The conductive lines connect microelectrodes found near an insertion end of the probe to respective leads at a connector end of the probe. The probe also includes a rigid spine, such as made from titanium, fixedly attached to the probe body to structurally reinforce the probe body and enable the typically flexible probe body to penetrate and be inserted into tissue, such as neural tissue. By attaching or otherwise fabricating the rigid spine to connect to only an insertion section of the probe body, an integrally connected cable section of the probe body may remain flexible.

Autonomous reinforcement learning with experience replay.

PubMed

Wawrzyński, Paweł; Tanwani, Ajay Kumar

2013-05-01

This paper considers the issues of efficiency and autonomy that are required to make reinforcement learning suitable for real-life control tasks. A real-time reinforcement learning algorithm is presented that repeatedly adjusts the control policy with the use of previously collected samples, and autonomously estimates the appropriate step-sizes for the learning updates. The algorithm is based on the actor-critic with experience replay whose step-sizes are determined on-line by an enhanced fixed point algorithm for on-line neural network training. An experimental study with simulated octopus arm and half-cheetah demonstrates the feasibility of the proposed algorithm to solve difficult learning control problems in an autonomous way within reasonably short time. Copyright © 2012 Elsevier Ltd. All rights reserved.

Development of Flame Resistant Combat Uniform Fabrics Made from Long Staple Wool and Aramid Blend Yarn

DTIC Science & Technology

2013-04-15

Kentwool recombed the wool top ( wool is first combed during the production of wool top); a second combing process is an optional step sometimes used in...RESISTANT COMBAT UNIFORM FABRICS MADE FROM LONG STAPLE WOOL AND ARAMID BLEND YARN by Parvez Mehta* Mitchell Driggers* and Carole...SUBTITLE DEVELOPMENT OF FLAME RESISTANT COMBAT UNIFORM FABRICS MADE FROM LONG STAPLE WOOL AND ARAMID BLEND YARN 5a. CONTRACT NUMBER W911QY-11

Intelligence moderates reinforcement learning: a mini-review of the neural evidence

PubMed Central

2014-01-01

Our understanding of the neural basis of reinforcement learning and intelligence, two key factors contributing to human strivings, has progressed significantly recently. However, the overlap of these two lines of research, namely, how intelligence affects neural responses during reinforcement learning, remains uninvestigated. A mini-review of three existing studies suggests that higher IQ (especially fluid IQ) may enhance the neural signal of positive prediction error in dorsolateral prefrontal cortex, dorsal anterior cingulate cortex, and striatum, several brain substrates of reinforcement learning or intelligence. PMID:25185818

Intelligence moderates reinforcement learning: a mini-review of the neural evidence.

PubMed

Chen, Chong

2015-06-01

Our understanding of the neural basis of reinforcement learning and intelligence, two key factors contributing to human strivings, has progressed significantly recently. However, the overlap of these two lines of research, namely, how intelligence affects neural responses during reinforcement learning, remains uninvestigated. A mini-review of three existing studies suggests that higher IQ (especially fluid IQ) may enhance the neural signal of positive prediction error in dorsolateral prefrontal cortex, dorsal anterior cingulate cortex, and striatum, several brain substrates of reinforcement learning or intelligence. Copyright © 2015 the American Physiological Society.

Stapler-assisted closure in total laryngectomy.

PubMed

Anand, Akash G

2013-01-01

The total laryngectomy is a surgical procedure that requires technically sound reconstruction in order to preserve a patient's swallowing function. Traditionally, a handsewn technique has been utilized to accomplish this endeavor. Recent applications of surgical stapling devices have been noted in an attempt to circumvent the need for handsewn reconstruction. This paper documents the application of a surgical stapling device in reconstructing a total laryngectomy defect. A brief review of the literature is provided to compare the differences between handsewn techniques and stapling techniques.

Scraping and stapling of end-grafted DNA chains by a bioadhesive spreading vesicle to reveal chain internal friction and topological complexity.

PubMed

Nam, Gimoon; Hisette, Marie Laure; Sun, Yuting Liang; Gisler, Thomas; Johner, Albert; Thalmann, Fabrice; Schröder, André Pierre; Marques, Carlos Manuel; Lee, Nam-Kyung

2010-08-20

Stained end-grafted DNA molecules about 20 μm long are scraped away and stretched out by the spreading front of a bioadhesive vesicle. Tethered biotin ligands bind the vesicle bilayer to a streptavidin substrate, stapling the DNAs into frozen confinement paths. Image analysis of the stapled DNA gives access, within optical resolution, to the local stretching values of individual DNA molecules swept by the spreading front, and provides evidence of self-entanglements.

Wound Complication Rates After Staples or Suture for Midline Vertical Skin Closure in Obese Women: A Randomized Controlled Trial.

PubMed

Kuroki, Lindsay M; Mullen, Mary M; Massad, L Stewart; Wu, Ningying; Liu, Jingxia; Mutch, David G; Powell, Matthew A; Hagemann, Andrea R; Thaker, Premal H; McCourt, Carolyn K; Novetsky, Akiva P

2017-07-01

To compare wound complication rates after skin closure with staples and subcuticular suture in obese gynecology patients undergoing laparotomy through a midline vertical incision. In this randomized controlled trial, women with body mass indexes (BMIs) of 30 or greater undergoing surgery by a gynecologic oncologist through a midline vertical incision were randomized to skin closure with staples or subcuticular 4-0 monofilament suture. The primary outcome was the rate of wound complication, defined as the presence of a wound breakdown, or infection, within 8 weeks postoperatively. Secondary outcomes included operative time, Stony Brook scar cosmetic score, and patient satisfaction. A sample size of 162 was planned to detect a 50% reduction in wound complications. At planned interim review (n=82), there was no significant difference in primary outcome. Between 2013 and 2016, 163 women were analyzed, including 84 who received staples and 79 suture. Women who received staples were older (mean age 59 compared with 57 years), had lower mean BMI (37.3 compared with 38.9), and fewer benign indications for surgery (22 compared with 27). There were no differences in wound complication rates between staple compared with suture skin closure (28 [33%] compared with 25 [32%], relative risk 1.05, 95% confidence interval [CI] 0.68-1.64). Women with staples reported worse median cosmetic scores (four of five compared with five of five, P<.001), darker scar color (37 [49%] compared with 13 [18%], relative risk 2.69, 95% CI 1.57-4.63), and more skin marks (30 [40%] compared with three [4%], relative risk 9.47, 95% CI 3.02-29.65) compared with women with suture closure. There was no group difference regarding satisfaction with their scar. Stepwise multivariate analysis revealed BMI (odds ratio [OR] 1.13, 95% CI 1.07-1.20), maximum postoperative glucose (OR 1.01, 95% CI 1.00-1.01), and cigarette smoking (OR 4.96, 95% CI 1.32-18.71) were correlates of wound complication. Closure of midline vertical skin incisions with subcuticular suture does not reduce surgical site wound complications compared with staples in obese gynecology patients. ClinicalTrials.gov, NCT01977612.

Cullin3 - BTB Interface: A Novel Target for Stapled Peptides

PubMed Central

Palmieri, Maddalena; Balasco, Nicole; Esposito, Luciana; Russo, Luigi; Mazzà, Daniela; Di Marcotullio, Lucia; Di Gaetano, Sonia; Malgieri, Gaetano; Vitagliano, Luigi; Pedone, Emilia; Zaccaro, Laura

2015-01-01

Cullin3 (Cul3), a key factor of protein ubiquitination, is able to interact with dozens of different proteins containing a BTB (Bric-a-brac, Tramtrack and Broad Complex) domain. We here targeted the Cul3–BTB interface by using the intriguing approach of stabilizing the α-helical conformation of Cul3-based peptides through the “stapling” with a hydrocarbon cross-linker. In particular, by combining theoretical and experimental techniques, we designed and characterized stapled Cul3-based peptides embedding the helix 2 of the protein (residues 49–68). Intriguingly, CD and NMR experiments demonstrate that these stapled peptides were able to adopt the helical structure that the fragment assumes in the parent protein. We also show that some of these peptides were able to bind to the BTB of the tetrameric KCTD11, a substrate adaptor involved in HDAC1 degradation, with high affinity (~ 300–600 nM). Cul3-derived staple peptides are also able to bind the BTB of the pentameric KCTD5. Interestingly, the affinity of these peptides is of the same order of magnitude of that reported for the interaction of full-length Cul3 with some BTB containing proteins. Moreover, present data indicate that stapling endows these peptides with an increased serum stability. Altogether, these findings indicate that the designed stapled peptides can efficiently mimic protein-protein interactions and are potentially able to modulate fundamental biological processes involving Cul3. PMID:25848797

Strength of fixation constructs for basilar osteotomies of the first metatarsal.

PubMed

Lian, G J; Markolf, K; Cracchiolo, A

1992-01-01

Twenty-four pairs of fresh-frozen human feet had a proximal osteotomy of the first metatarsal that was fixed using either screws, staples, or K wires. Each metatarsal was excised and the specimen was loaded to failure in a cantilever beam configuration by applying a superiorly directed force to the metatarsal head using an MTS servohydraulic test machine. Specimens with a crescentic osteotomy that were fixed using a single screw demonstrated higher mean failure moments than pairs that were fixed with four staples or two K wires; staples were the weakest construct. All specimens fixed with staples failed by bending of the staples without bony fracture; all K wire constructs but one failed by wire bending. Chevron and crescentic osteotomies fixed with a single screw demonstrated equal bending strengths; the bending strength of an oblique osteotomy fixed with two screws was 82% greater than for a crescentic osteotomy fixed with a single screw. Basilar osteotomies of the first metatarsal are useful in correcting metatarsus primus varus often associated with hallux valgus pathology. Fixation strength is an important consideration since weightbearing forces on the head of the first metatarsal acting at a distance from the osteotomy site subject the construct to a dorsiflexion bending moment, as simulated in our tests. Our results show that screw fixation is the strongest method for stabilizing a basilar osteotomy. Based upon the relatively low bending strengths of the staple and K wire constructs, we would not recommend these forms of fixation.(ABSTRACT TRUNCATED AT 250 WORDS)

Transgenic Cavendish bananas with resistance to Fusarium wilt tropical race 4.

PubMed

Dale, James; James, Anthony; Paul, Jean-Yves; Khanna, Harjeet; Smith, Mark; Peraza-Echeverria, Santy; Garcia-Bastidas, Fernando; Kema, Gert; Waterhouse, Peter; Mengersen, Kerrie; Harding, Robert

2017-11-14

Banana (Musa spp.) is a staple food for more than 400 million people. Over 40% of world production and virtually all the export trade is based on Cavendish banana. However, Cavendish banana is under threat from a virulent fungus, Fusarium oxysporum f. sp. cubense tropical race 4 (TR4) for which no acceptable resistant replacement has been identified. Here we report the identification of transgenic Cavendish with resistance to TR4. In our 3-year field trial, two lines of transgenic Cavendish, one transformed with RGA2, a gene isolated from a TR4-resistant diploid banana, and the other with a nematode-derived gene, Ced9, remain disease free. Transgene expression in the RGA2 lines is strongly correlated with resistance. Endogenous RGA2 homologs are also present in Cavendish but are expressed tenfold lower than that in our most resistant transgenic line. The expression of these homologs can potentially be elevated through gene editing, to provide non-transgenic resistance.

DNA origami metallized site specifically to form electrically conductive nanowires.

PubMed

Pearson, Anthony C; Liu, Jianfei; Pound, Elisabeth; Uprety, Bibek; Woolley, Adam T; Davis, Robert C; Harb, John N

2012-09-06

DNA origami is a promising tool for use as a template in the design and fabrication of nanoscale structures. The ability to engineer selected staple strands on a DNA origami structure provides a high density of addressable locations across the structure. Here we report a method using site-specific attachment of gold nanoparticles to modified staple strands and subsequent metallization to fabricate conductive wires from DNA origami templates. We have modified DNA origami structures by lengthening each staple strand in select regions with a 10-base nucleotide sequence and have attached DNA-modified gold nanoparticles to the lengthened staple strands via complementary base-pairing. The high density of extended staple strands allowed the gold nanoparticles to pack tightly in the modified regions of the DNA origami, where the measured median gap size between neighboring particles was 4.1 nm. Gold metallization processes were optimized so that the attached gold nanoparticles grew until gaps between particles were filled and uniform continuous nanowires were formed. Finally, electron beam lithography was used to pattern electrodes in order to measure the electrical conductivity of metallized DNA origami, which showed an average resistance of 2.4 kΩ per metallized structure.

Neural mechanisms of negative reinforcement in children and adolescents with autism spectrum disorders.

PubMed

Damiano, Cara R; Cockrell, Dillon C; Dunlap, Kaitlyn; Hanna, Eleanor K; Miller, Stephanie; Bizzell, Joshua; Kovac, Megan; Turner-Brown, Lauren; Sideris, John; Kinard, Jessica; Dichter, Gabriel S

2015-01-01

Previous research has found accumulating evidence for atypical reward processing in autism spectrum disorders (ASD), particularly in the context of social rewards. Yet, this line of research has focused largely on positive social reinforcement, while little is known about the processing of negative reinforcement in individuals with ASD. The present study examined neural responses to social negative reinforcement (a face displaying negative affect) and non-social negative reinforcement (monetary loss) in children with ASD relative to typically developing children, using functional magnetic resonance imaging (fMRI). We found that children with ASD demonstrated hypoactivation of the right caudate nucleus while anticipating non-social negative reinforcement and hypoactivation of a network of frontostriatal regions (including the nucleus accumbens, caudate nucleus, and putamen) while anticipating social negative reinforcement. In addition, activation of the right caudate nucleus during non-social negative reinforcement was associated with individual differences in social motivation. These results suggest that atypical responding to negative reinforcement in children with ASD may contribute to social motivational deficits in this population.

A powered vascular staple for the application of segmental bronchial closure in thoracoscopic anatomic segmentectomy.

PubMed

Kuroda, Hiroaki; Yoshida, Tatsuya; Sakao, Yukinori

2017-12-01

We used the powered vascular staple (PVS) instead of the conventional staple technique [the utilization of the powered linier cutter (PLC)] or ligation for total 23 segmental or subsegmental bronchi with less than 10 mm in the bronchial luminal size on computed tomography (CT) in thoracoscopic segmentectomy. Our results suggested that the availability of the PVS represents a novel advance in the armamentarium and may have a possibility of being pervasive widely however, more observative periods and further sample accumulation are needed.

M1.3 - a small scaffold for DNA origami

NASA Astrophysics Data System (ADS)

Said, Hassan; Schüller, Verena J.; Eber, Fabian J.; Wege, Christina; Liedl, Tim; Richert, Clemens

2012-12-01

The DNA origami method produces programmable nanoscale objects that form when one long scaffold strand hybridizes to numerous oligonucleotide staple strands. One scaffold strand is dominating the field: M13mp18, a bacteriophage-derived vector 7249 nucleotides in length. The full-length M13 is typically folded by using over 200 staple oligonucleotides. Here we report the convenient preparation of a 704 nt fragment dubbed ``M1.3'' as a linear or cyclic scaffold and the assembly of small origami structures with just 15-24 staple strands. A typical M1.3 origami is large enough to be visualized by TEM, but small enough to show a cooperativity in its assembly and thermal denaturation that is reminiscent of oligonucleotide duplexes. Due to its medium size, M1.3 origami with globally modified staples is affordable. As a proof of principle, two origami structures with globally 5'-capped staples were prepared and were shown to give higher UV-melting points than the corresponding assembly with unmodified DNA. M1.3 has the size of a gene, not a genome, and may function as a model for gene-based nanostructures. Small origami with M1.3 as a scaffold may serve as a workbench for chemical, physical, and biological experiments.The DNA origami method produces programmable nanoscale objects that form when one long scaffold strand hybridizes to numerous oligonucleotide staple strands. One scaffold strand is dominating the field: M13mp18, a bacteriophage-derived vector 7249 nucleotides in length. The full-length M13 is typically folded by using over 200 staple oligonucleotides. Here we report the convenient preparation of a 704 nt fragment dubbed ``M1.3'' as a linear or cyclic scaffold and the assembly of small origami structures with just 15-24 staple strands. A typical M1.3 origami is large enough to be visualized by TEM, but small enough to show a cooperativity in its assembly and thermal denaturation that is reminiscent of oligonucleotide duplexes. Due to its medium size, M1.3 origami with globally modified staples is affordable. As a proof of principle, two origami structures with globally 5'-capped staples were prepared and were shown to give higher UV-melting points than the corresponding assembly with unmodified DNA. M1.3 has the size of a gene, not a genome, and may function as a model for gene-based nanostructures. Small origami with M1.3 as a scaffold may serve as a workbench for chemical, physical, and biological experiments. Electronic supplementary information (ESI) available: Materials, full sequence of M1.3, alternative restriction reactions, sequences and origami designs, ALEX data, estimated cost of producing M13, additional melting data for origami, and MALDI spectra of individual capped oligonucleotides. See DOI: 10.1039/c2nr32393a

Initial experience with the use of fibrin sealant for the fixation of the prosthetic mesh in laparoscopic transabdominal preperitoneal hernia repair.

PubMed

Langrehr, J M; Schmidt, S C; Neuhaus, P

2005-08-01

Laparoscopic inguinal hernia repair offers more rapid recovery and less pain than with the traditional open approach. However, injury to the nerves of the lumbar plexus with subsequent chronic pain or neuralgia has a reported incidence of 2% during laparoscopic hernia repair, particularly when the transabdominal preperitoneal technique (TAPP) is used. These complications are inherent to the use of staples for fixation of the mesh. To avoid nerve irritation, we considered the use of fibrin sealant for the fixation of the mesh instead of staples. The aim of this study was to evaluate this technique and to compare the short-term follow-up of these patients with patients who underwent the staple repair technique. This is the first reported use of fibrin sealant in laparoscopic TAPP hernia repair. Between September and November 2004, we performed 17 consecutive laparoscopic hernia repairs (TAPP) in 14 patients (3 bilateral hernias) with primary hernias. The prosthetic mesh was fixed (10 x 15 cm) with 1 ml fibrin. The fibrin was applied using a special laparoscopic applicator. The peritoneum was closed with absorbable sutures. The postoperative course of these patients was compared with a cohort of matched patients who received the traditional staple fixation of the prosthetic mesh. Patients were evaluated at a median follow-up of 10.4 months (3.8-16.0 months). All patients underwent postoperative physical examinations. No recurrent hernia was found. There were 2 seromas and one hematoma in the stapled group. In the stapled group, one patient had pain in the area of the lateral femoral cutaneous nerve. There was no postoperative complication in the non-stapled group. Fibrin fixation of the mesh during laparoscopic transabdominal preperitoneal inguinal hernia repair is feasible without higher risk of recurrences. In addition the fibrin fixation method may decrease postoperative neuralgia and reduce the incidence of postoperative seromas and hematomas.

The efficacy and integrity of shape memory alloy staples and bone anchors with ligament tethers in the fusionless treatment of experimental scoliosis.

PubMed

Braun, John T; Akyuz, Ephraim; Ogilvie, James W; Bachus, Kent N

2005-09-01

Scoliosis is a complex three-dimensional deformity with limited treatment options. Current treatments present potential problems that may be addressed with use of fusionless techniques for the correction of scoliosis. However, there are few data comparing the efficacy of different fusionless implant strategies in controlling scoliosis or on the integrity of rigid compared with flexible devices in an in vivo setting over time. The objective of this study was to compare the efficacy and integrity of rigid and flexible anterior thoracic tethers used to treat experimental scoliosis. Experimental scoliosis was created in twenty-four Spanish Cross-X female goats and was subsequently treated with either anterior shape memory alloy staples or anterior ligament tethers attached to bone anchors. Serial radiographs were analyzed to determine the efficacy of the implants in controlling scoliosis progression as well as the integrity of the implants at study completion. After the goats were killed, the implants were analyzed with use of three quantitative indices of implant integrity and implant pullout testing. Over the treatment period, scoliosis progressed from 77.3 degrees to 94.3 degrees in the goats treated with staples and was corrected from 73.4 degrees to 69.9 degrees in the goats treated with bone anchors, with loosening of eighteen of forty-two staples (two of the eighteen dislodged) and evidence of drift in two of forty-nine anchors. Histologic sections revealed a consistent halo of fibrous tissue around the staple tines but well-fixed bone anchors at all sites. Pullout testing demonstrated that bone anchors had greater strength than staples initially and at the study completion, with an increase in bone anchor fixation over the course of the study. In this scoliosis model, the flexible ligament tethers attached to bone anchors demonstrated greater efficacy and integrity than the more rigid shape memory alloy staples.

Ultrastructural analysis of different-made staplers' staples.

PubMed

Gentilli, S; Portigliotti, L; Aronici, M; Ferrante, D; Surico, D; Milanesio, M; Gianotti, V; Gatti, G; Addante, A; Garavoglia, M

2012-10-01

Recently, Chinese-made mechanical staplers with lower price respect to American-made ones have been introduced in clinical practice. In literature, small case series compare the clinical outcomes of different staplers concluding that the new stapler devices perform as well as the American ones. The aim of this study is to compare with an ultrastructural analysis the staples of different staplers in order to verify the existence of differences that might explain significant price disparity and condition clinical outcomes. Each stapler was subjected to morphological analysis, energy dispersive X-Ray spectroscopy, metal release assessment followed by inductively coupled plasma mass spectroscopy. P-values were considered statistically significant when <0.05. Autosuture staples have square section whereas the other American one and Chinese made staples have round sections. Roughness index and chips presence before and after ageing tests were comparable for all samples except for Ethicon Endo-Surgery stapler. Energy dispersive X-Ray spectroscopy showed that all staplers are made of pure Titanium but Ethicon Endo-Surgery staples are made with an alloy. Metal release analysis release statistically significant differences between samples in simulated body fluid 20 days solution (P=0.002) and in Aquaregia at 14 days solution. Discussion. Stapling devices have became routinely used in gastrointestinal surgery mainly because of operative time reduction. Recently, new Chinese-made mechanical staplers, with significantly lower prices, have been introduced in clinical practice. In literature, there are some studies that compare clinical outcomes of American-made and Chinese-made staplers on small groups of patients but doesn't exist any work which consider structural differences between traditional and new devices. In our study, for the first time, we propose a comparison between two American-made staplers and three Chinese-made staplers which evaluate morphology, metal composition and chemical staples release. Our study suggest that there are some ultrastructural differences between commercially available staplers with no correlation to price disparity. More studies are needed to confirm our results and to verify if our findings could condition clinical outcomes.

Reducing the global burden of type 2 diabetes by improving the quality of staple foods: The Global Nutrition and Epidemiologic Transition Initiative.

PubMed

Mattei, Josiemer; Malik, Vasanti; Wedick, Nicole M; Hu, Frank B; Spiegelman, Donna; Willett, Walter C; Campos, Hannia

2015-06-04

The prevalence of type 2 diabetes has been reaching epidemic proportions across the globe, affecting low/middle-income and developed countries. Two main contributors to this burden are the reduction in mortality from infectious conditions and concomitant negative changes in lifestyles, including diet. We aimed to depict the current state of type 2 diabetes worldwide in light of the undergoing epidemiologic and nutrition transition, and to posit that a key factor in the nutrition transition has been the shift in the type and processing of staple foods, from less processed traditional foods to highly refined and processed carbohydrate sources. We showed data from 11 countries participating in the Global Nutrition and Epidemiologic Transition Initiative, a collaborative effort across countries at various stages of the nutrition-epidemiologic transition whose mission is to reduce diabetes by improving the quality of staple foods through culturally-appropriate interventions. We depicted the epidemiologic transition using demographic and mortality data from the World Health Organization, and the nutrition transition using data from the Food and Agriculture Organization food balance sheets. Main staple foods (maize, rice, wheat, pulses, and roots) differed by country, with most countries undergoing a shift in principal contributors to energy consumption from grains in the past 50 years. Notably, rice and wheat products accounted for over half of the contribution to energy consumption from staple grains, while the trends for contribution from roots and pulses generally decreased in most countries. Global Nutrition and Epidemiologic Transition Initiative countries with pilot data have documented key barriers and motivators to increase intake of high-quality staple foods. Global research efforts to identify and promote intake of culturally-acceptable high-quality staple foods could be crucial in preventing diabetes. These efforts may be valuable in shaping future research, community interventions, and public health and nutritional policies.

Small intestinal volvulus caused by loose surgical staples.

PubMed

Page, Matthew P; Kim, Heung Bae; Fishman, Steven J

2009-09-01

Small intestinal volvulus beyond infancy is rare and usually has an iatrogenic cause. The authors describe an adolescent boy with small bowel volvulus secondary to the presence of free intraperitoneal surgical staples after a laparoscopic appendectomy.

78 FR 26791 - Government-Owned Inventions; Availability for Licensing

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-08

... 301-435-0103. Stapled Peptides for Treatment of Cardiovascular Diseases and Inflammation Description... inflammation and cardiovascular diseases, including hyperlipidemia, atherosclerosis, restenosis, and acute...-stapled Apolipoprotein Peptide Mimetics for the Treatment of Cardiovascular Diseases and Inflammation. For...

[Technical considerations on 222 cases of esophageal anastomosis using a stapler].

PubMed

Liboni, A; Zamboni, P; Mari, C; Uzzau, A; Salomoni, C; Brunelli, G; Buccoliero, F; Donini, I

1989-05-01

The Authors report their experience with 222 esophagoenteric anastomoses, performed in 211 cases for malignant neoplasms (middle and lower third) of the esophagus or stomach. Particularly, they have performed 4 Sujura operations, 31 esophagogastric, 4 esophagocolic, 183 esophagojejunal anastomoses utilizing SPTU, ILS and EEA circular stapler. GIA was used in the preparation of the stomach before esophagogastroplasty. Mortality rate of the manual period (1970-1980: 114 cases operated) was 14.5% versus 2.2% of the stapling period (1981-1987: 222 cases operated). From the technical point of view reasons of the superiority of stapled technique are discussed and summarized as follows: 1) space not favourable for handsewn anastomoses; 2) stapled technique allows the surgeon to save anastomoses vascularization; 3) the stapler performs the suture simultaneously so to reduce tensile strength on the anastomoses and the fragile esophageal wall especially; 4) stapled agraphes are fixed in three points vs. the two points of the handsewn stitches.

Complications and results after stapled haemorrhoidopexy as a day surgical procedure.

PubMed

Mlakar, B; Kosorok, P

2003-10-01

The aim of this report is to describe our experience with stapled haemorrhoidopexy as a day surgery procedure. From January 2000 to January 2003, a total of 214 patients with third- and fourth-degree haemorrhoids underwent stapled haemorrhoidopexy under spinal anaesthesia. We analysed early postoperative complications and long-term results. Patients were followed for 4-36 months (mean, 22 months). Only 3 patients (1%) were hospitalised. The long-term complications were analysed by means of a mailed questionnaire. Minor bleeding at wiping after defecation was observed by 9% of patients and minor haemorrhoidal prolapse by 8% of patients. Pain after defecation was reported by 6% of patients and anal stenosis occurred in 2% of them. Faecal urgency was reported by 3% of patients with previously unknown incontinence problems. According to our experience, stapled haemorrhoidopexy can be safely performed as a day surgery procedure.

Extracellular matrix scaffold as a tubular graft for ascending aorta aneurysm repair.

PubMed

Abu Saleh, Walid K; Al Jabbari, Odeaa; Grande-Allen, Jane; Ramchandani, Mahesh

2015-08-01

Although extracellular xenograft repair has produced encouraging results when applied to cardiac, valvular, and specific aortic defects, its employment as a tube graft to replace the ascending aorta has not been reported. We describe a patient who underwent resection and replacement of an infected ascending aortic graft with an extracellular matrix conduit. The patient did well, but 14 months later developed a pseudoaneurysm from the staple line used to construct the extracellular matrix conduit. The patient underwent a repeat sternotomy and removal of the graft. Because of the increased risk of graft failure, a homograft was felt to be more appropriate in this setting. Ultimately, we were unable to implant the homograft because it was too small for the aortic root; therefore we decided to construct a tubular graft from Cormatrix extracellular matrix (CorMatrix, Roswell, GA, USA). Fourteen months later, he presented with shortness of breath. Computed tomography scan revealed a 3.5 cm pseudoaneurysm of the ascending aorta. It appeared as if there was a disruption of the staple line in the extra cellular matrix graft. The plan was to replace it with a Dacron graft. The Cormatrix graft material was removed and sent for culture and histological analysis. A 28-mm Gel weave graft (Terumo Cardiovascular Systems, Ann Arbor, MI, USA) was implanted. The patient tolerated the procedure well with good hemodynamics. Our experience suggests that the superior strength, handling characteristics, and resistance to infection make extra cellular matrix scaffold a possible alternative conduit to cryopreserved homografts. Applicability as an aortic conduit merits further investigation to better understand behavior of extra cellular matrix in this situation. © 2015 Wiley Periodicals, Inc.

Outcomes of mechanical stapling for postlaryngectomy open pharyngotomy closure.

PubMed

Paddle, Paul; Husain, Inna; McHugh, Lauren; Franco, Ramon

2017-03-01

A total laryngectomy (TL) is performed as a primary or salvage therapy for laryngeal carcinoma. Pharyngotomy closure after TL is typically performed using manual sutures. Automatic stapling devices are routinely used in thoracoabdominal surgery, but have not been widely accepted for use in pharyngotomy closure. Previously described closed stapling techniques of pharyngeal closure do not allow direct evaluation of surgical margins and are limited to endolaryngeal disease. We describe an open technique for pharyngotomy closure using a mechanical stapling device. Retrospective review. A review was conducted of 16 total laryngectomies performed from May 2008 to August 2015 utilizing an Ethicon Endopath ETS Compact-Flex 45 stapler. Sixteen patients (15 male, one female), mean age 69 years, received open TL (14 salvage, two primary) with endostapler pharyngeal closure and primary tracheoesophageal puncture (TEP). Surgical time averaged 218 minutes. Median time to swallowing was 4 days (range, 2-240 days) and mean hospital stay 6 days (range, 3-10 days). Fistula incidence was 31% (5/16) overall and 36% (5/14) in the postradiation patients. Mechanical stapling is a simple method for postlaryngectomy open pharyngotomy closure. This technique allows evaluation of margins, easy primary TEP, and the opportunity for early swallowing and shorter hospital stays. In addition, it can be performed for closure of salvage laryngectomies with rates of fistula formation similar to that found in the literature using suture closure techniques. Future studies are necessary to compare oncological results and surgical complications between the open and closed stapling techniques and to traditional suture closure. 4 Laryngoscope, 127:605-610, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Delayed temporal discrimination in pigeons: A comparison of two procedures

PubMed Central

Chatlosh, Diane L.; Wasserman, Edward A.

1987-01-01

A within-subjects comparison was made of pigeons' performance on two temporal discrimination procedures that were signaled by differently colored keylight samples. During stimulus trials, a peck on the key displaying a slanted line was reinforced following short keylight samples, and a peck on the key displaying a horizontal line was reinforced following long keylight samples, regardless of the location of the stimuli on those two choice keys. During position trials, a peck on the left key was reinforced following short keylight samples and a peck on the right key was reinforced following long keylight samples, regardless of which line stimulus appeared on the correct key. Thus, on stimulus trials, the correct choice key could not be discriminated prior to the presentation of the test stimuli, whereas on position trials, the correct choice key could be discriminated during the presentation of the sample stimulus. During Phase 1, with a 0-s delay between sample and choice stimuli, discrimination learning was faster on position trials than on stimulus trials for all 4 birds. During Phase 2, 0-, 0.5-, and 1.0-s delays produced differential loss of stimulus control under the two tasks for 2 birds. Response patterns during the delay intervals provided some evidence for differential mediation of the two delayed discriminations. These between-task differences suggest that the same processes may not mediate performance in each. PMID:16812483

Hydrocarbon-stapled lipopeptides exhibit selective antimicrobial activity.

PubMed

Jenner, Zachary B; Crittenden, Christopher M; Gonzalez, Martín; Brodbelt, Jennifer S; Bruns, Kerry A

2017-05-01

Antimicrobial peptides (AMPs) occur widely in nature and have been studied for their therapeutic potential. AMPs are of interest due to the large number of possible chemical structural combinations using natural and unnatural amino acids, with varying effects on their biological activities. Using physicochemical properties from known naturally occurring amphipathic cationic AMPs, several hydrocarbon-stapled lipopeptides (HSLPs) were designed, synthesized, and tested for antimicrobial properties. Peptides were chemically modified by N-terminal acylation, C-terminal amidation, and some were hydrocarbon stapled by intramolecular olefin metathesis. The effects of peptide length, amphipathic character, and stapling on antimicrobial activity were tested against Escherichia coli, three species of Gram-positive bacteria (Staphylococcus aureus, Bacillus megaterium, and Enterococcus faecalis), and two strains of Candida albicans. Peptides were shown to disrupt liposomes of different phospholipid composition, as measured by leakage of a fluorescent compound from vesicles. Peptides with (S)-2-(4'-pentenyl)-alanine substituted for l-alanine in a reference peptide showed a marked increase in antimicrobial activity, hemolysis, and membrane disruption. Stapled peptides exhibited slightly higher antimicrobial potency; those with greatest hydrophobic character showed the greatest hemolysis and liposome leakage, but lower antimicrobial activity. The results support a model of HSLPs as membrane-disruptive AMPs with potent antimicrobial activity and relatively low hemolytic potential at biologically active peptide concentrations. © 2017 Wiley Periodicals, Inc.

Friction Stir Welding of SiC/Aluminum Metal Matrix Composites

NASA Technical Reports Server (NTRS)

Lee, Jonathan A.

1999-01-01

Friction Stir Welding (FSW) is a new solid state process for joining metals by plasticizing and consolidating materials around the bond line using thermal energy producing from frictional forces. A feasibility study for FSW of Metal Matrix Composites (MMC) was investigated using aluminum 6092 alloy reinforced with 17% SiC particulates. FSW process consists of a special rotating pin tool that is positioned to plunge into the MMC surface at the bond line. As the tool rotates and move forward along the bond line, the material at the bond line is heated up and forced to flow around the rotating tip to consolidate on the tip's backside to form a solid state joint. FSW has the potential for producing sound welds with MMC because the processing temperature occurs well below the melting point of the metal matrix; thereby eliminating the reinforcement-to-matrix solidification defects, reducing the undesirable chemical reactions and porosity problems.

Tailored prolapse surgery for the treatment of hemorrhoids with a new dedicated device: TST Starr plus.

PubMed

Naldini, G; Fabiani, B; Menconi, C; Giani, I; Toniolo, G; Martellucci, J

2015-12-01

The aim of the study was to assess the results of the stapled transanal procedure in the treatment of hemorrhoidal prolapse in terms of postoperative complications and recurrence rate using a new dedicated device, TST Starr plus. Patients affected by III-IV degree hemorrhoidal prolapsed that underwent stapled transanal resection with the TST Starr plus were included in the present study. Results of the procedure with perioperative complications, postoperative complications, and recurrence rate were reported. From November 2012 to October 2014, 52 patients (19 females) were enrolled in the study. The main symptoms were prolapse (100 %) and bleeding (28.8 %). Transanal rectal resection was performed with parachute technique in 24 patients (46.2 %) and purse string technique in 23 patients (53.8 %). A mild hematoma at the suture line occurred in one patient (1.9 %). Postoperative bleeding was reported in three patients (5.7 %), in one of which, reoperation was necessary (1.9 %). Tenesmus occurred in one patient (1.9 %), and it was resolved with medical therapy. Urgency was reported in nine patients (17.1 %) at 7 days after surgery. Of these, three patients (5.7 %) complained urgency at the median follow-up of 14.5 months. Reoperation was performed in one patient (1.9 %) for chronic anal pain for rigid suture fixed on the deep plans. Occasional bleeding was reported in four patients (7.7 %). No recurrence of prolapse was reported at a median of 14.5 months after surgery, even if one patient (1.9 %) had a partial recurrent prolapse of a downstaged single pile. TST Starr plus seems to be safe and effective for a tailored transanal stapled surgery for the treatment of III-IV degree hemorrhoidal prolapse. The new conformation and innovative technology of the stapler seems to reduce some postoperative complications and recurrence rate.

A Single Institution Review of Initial Application of a 5-mm Stapler.

PubMed

Rogers, Andrew P; Zens, Tiffany J; Kohler, Jonathan E; Le, Hau D; Nichol, Peter F; Leys, Charles M

2016-08-01

Operating in small spaces presents physical constraints that can be even more challenging in minimally invasive operations. Recently, a 5-mm stapler was approved for use in general surgery and pediatric surgery. Here, we present our initial experience using the 5-mm stapler in pediatric general surgery. A retrospective chart review was conducted to identify cases using the 5-mm stapler at our institution. Demographic data included age (in months) and weight (in kilograms). Operative data included indication for use, number of loads used, complications related to 5-mm stapler use, and interventions to address complications. A second review focused on patients undergoing the same operations, but using a 10-mm stapler. A total of 60 staple loads were deployed in 32 procedures. There were four adverse outcomes, all recognized intraoperatively. One bleed resulted from application on irradiated tissue and another bleed from application to a small noninflamed mesoappendix. A bronchial staple line leak resulted from improper stapler loading, and a bowel anastomosis leak was oversewn with a single stitch. When compared with 32 matched cases using a 10-mm stapler, there was no difference in age (5-mm = 39.11 months, 10-mm = 50.21 months, P = .49) or weight (5-mm = 16.34 kg, 10-mm = 19.93 kg, P = .51). A total of 60 staple applications were used, with one bleed noted. There was no significant difference in overall complication rate (5-mm rate = 4/60, 10-mm rate = 1/60; P = .36). Our initial experience suggests that although there were more complications with the 5-mm stapler, there is no statistically significant difference in complication rates when compared with the 10-mm stapler. Furthermore, the 5-mm stapler complications can be corrected with device training and proper patient selection. In appropriately selected pediatric surgery cases with size limitations, the 5-mm stapler can be used to minimize the invasiveness of the operation.

Stapled technique for acute thrombosed hemorrhoids: a randomized, controlled trial with long-term results.

PubMed

Wong, J C H; Chung, C C; Yau, K K; Cheung, H Y S; Wong, D C T; Chan, O C Y; Li, M K W

2008-04-01

This study was designed to compare stapled vs. conventional hemorrhoidectomy for patients with acute thrombosed hemorrhoids. Forty-one patients with acute thrombosed hemorrhoids were randomized into: 1) stapled hemorrhoidectomy (PPH group; n = 21), and 2) open hemorrhoidectomy (open group; n = 20). Emergency surgery was performed with perioperative data and complications were recorded. Patients were followed up by independent assessors to evaluate pain, recurrence, continence function, and satisfaction at regular intervals. The median follow-up for the PPH group and open group were 59 and 56 weeks, respectively. There was no significant difference in terms of the hospital stay, complication rate, and continence function; however, the mean pain intensity in the first postoperative week was significantly less in the PPH group (4.1 vs. 5.7, P = 0.02). Patients in the PPH group recovered significantly faster in terms of the time to become analgesic-free (4 vs. 8.5 days, P < 0.01), time to become pain-free (9 vs. 20.5 days, P = 0.01), resumption of work (7 vs. 12.5 days, P = 0.01), and time for complete wound healing (2 vs. 4 weeks, P < 0.01). On long-term follow-up, significantly fewer patients in the PPH group complained of recurrent symptoms (0 vs. 5, P = 0.02). The overall symptom improvement and patients' satisfaction were significantly better in the PPH group (90 vs. 80 percent, P = 0.03 and +3 vs. +2, P < 0.01 respectively). Stapled hemorrhoidectomy is safe and effective for acute thrombosed hemorrhoids. Similar to elective stapled procedure, emergency stapled excision has greater short-term benefits compared with conventional excision: diminished pain, faster recovery, and earlier return to work. Long-term results and satisfaction were excellent.

Superiority of stapled side-to-side gastrojejunostomy over conventional hand-sewn end-to-side gastrojejunostomy for reducing the risk of primary delayed gastric emptying after subtotal stomach-preserving pancreaticoduodenectomy.

PubMed

Murata, Yasuhiro; Tanemura, Akihiro; Kato, Hiroyuki; Kuriyama, Naohisa; Azumi, Yoshinori; Kishiwada, Masashi; Mizuno, Shugo; Usui, Masanobu; Sakurai, Hiroyuki; Isaji, Shuji

2017-08-01

Delayed gastric emptying (DGE) is the most common complication following pancreaticoduodenectomy (PD). The clinical efficacy of stapled side-to-side anastomosis using a laparoscopic stapling device during alimentary reconstruction in PD is not well understood and its superiority over conventional hand-sewn end-to-side anastomosis remains controversial. The objective of this study was to evaluate the effectiveness of the stapled side-to-side anastomosis in preventing the development of DGE after PD. The subjects of this retrospective study were 137 patients who underwent pancreaticoduodenectomy, as subtotal stomach-preserving pancreaticoduodenectomy (SSPPD; n = 130), or conventional whipple procedure (n = 7) with Child reconstruction, between January 2010 and May 2014. The patients were divided into two groups according to whether they had had a stapled side-to-side anastomosis (SA group; n = 57) or a conventional hand-sewn end-to-side anastomosis (HA group; n = 80). SA reduced the operative time (SA vs. HA: 508 vs. 557 min, p = 0.028) and the incidence of delayed gastric emptying (SA vs. HA: 21.1 vs. 46.3%, p = 0.003) and was associated with shorter hospitalization (SA vs. HA: 33 vs. 39.5 days, p = 0.007). In this cohort, SA was the only significant factor contributing to a reduction in the incidence of DGE (p = 0.002). Stapled side-to-side gastrojejunostomy reduced the operative time and the incidence of DGE following PD with Child reconstruction, thereby also reducing the length of hospitalization.

The Impact of Nitinol Staples on the Compressive Forces, Contact Area, and Mechanical Properties in Comparison to a Claw Plate and Crossed Screws for the First Tarsometatarsal Arthrodesis.

PubMed

Aiyer, Amiethab; Russell, Nicholas A; Pelletier, Matthew H; Myerson, Mark; Walsh, William R

2016-06-01

Background The optimal fixation method for the first tarsometatarsal arthrodesis remains controversial. This study aimed to develop a reproducible first tarsometatarsal testing model to evaluate the biomechanical performance of different reconstruction techniques. Methods Crossed screws or a claw plate were compared with a single or double shape memory alloy staple configuration in 20 Sawbones models. Constructs were mechanically tested in 4-point bending to 1, 2, and 3 mm of plantar displacement. The joint contact force and area were measured at time zero, and following 1 and 2 mm of bending. Peak load, stiffness, and plantar gapping were determined. Results Both staple configurations induced a significantly greater contact force and area across the arthrodesis than the crossed screw and claw plate constructs at all measurements. The staple constructs completely recovered their plantar gapping following each test. The claw plate generated the least contact force and area at the joint interface and had significantly greater plantar gapping than all other constructs. The crossed screw constructs were significantly stiffer and had significantly less plantar gapping than the other constructs, but this gapping was not recoverable. Conclusions Crossed screw fixation provides a rigid arthrodesis with limited compression and contact footprint across the joint. Shape memory alloy staples afford dynamic fixation with sustained compression across the arthrodesis. A rigid polyurethane foam model provides an anatomically relevant comparison for evaluating the interface between different fixation techniques. Clinical Relevance The dynamic nature of shape memory alloy staples offers the potential to permit early weight bearing and could be a useful adjunctive device to impart compression across an arthrodesis of the first tarsometatarsal joint. Therapeutic, Level V: Bench testing. © 2015 The Author(s).

A brief opportunity to run does not function as a reinforcer for mice selected for high daily wheel-running rates.

PubMed

Belke, Terry W; Garland, Theodore

2007-09-01

Mice from replicate lines, selectively bred based on high daily wheel-running rates, run more total revolutions and at higher average speeds than do mice from nonselected control lines. Based on this difference it was assumed that selected mice would find the opportunity to run in a wheel a more efficacious consequence. To assess this assumption within an operant paradigm, mice must be trained to make a response to produce the opportunity to run as a consequence. In the present study an autoshaping procedure was used to compare the acquisition of lever pressing reinforced by the opportunity to run for a brief opportunity (i.e., 90 s) between selected and control mice and then, using an operant procedure, the effect of the duration of the opportunity to run on lever pressing was assessed by varying reinforcer duration over values of 90 s, 30 min, and 90 s. The reinforcement schedule was a ratio schedule (FR 1 or VR 3). Results from the autoshaping phase showed that more control mice met a criterion of responses on 50% of trials. During the operant phase, when reinforcer duration was 90 s, almost all control, but few selected mice completed a session of 20 reinforcers; however, when reinforcer duration was increased to 30 min almost all selected and control mice completed a session of 20 reinforcers. Taken together, these results suggest that selective breeding based on wheel-running rates over 24 hr may have altered the motivational system in a way that reduces the reinforcing value of shorter running durations. The implications of this finding for these mice as a model for attention deficit hyperactivity disorder (ADHD) are discussed. It also is proposed that there may be an inherent trade-off in the motivational system for activities of short versus long duration.

A Brief Opportunity to Run Does Not Function as a Reinforcer for Mice Selected for High Daily Wheel-running Rates

PubMed Central

Belke, Terry W; GarlandJr, Theodore

2007-01-01

Mice from replicate lines, selectively bred based on high daily wheel-running rates, run more total revolutions and at higher average speeds than do mice from nonselected control lines. Based on this difference it was assumed that selected mice would find the opportunity to run in a wheel a more efficacious consequence. To assess this assumption within an operant paradigm, mice must be trained to make a response to produce the opportunity to run as a consequence. In the present study an autoshaping procedure was used to compare the acquisition of lever pressing reinforced by the opportunity to run for a brief opportunity (i.e., 90 s) between selected and control mice and then, using an operant procedure, the effect of the duration of the opportunity to run on lever pressing was assessed by varying reinforcer duration over values of 90 s, 30 min, and 90 s. The reinforcement schedule was a ratio schedule (FR 1 or VR 3). Results from the autoshaping phase showed that more control mice met a criterion of responses on 50% of trials. During the operant phase, when reinforcer duration was 90 s, almost all control, but few selected mice completed a session of 20 reinforcers; however, when reinforcer duration was increased to 30 min almost all selected and control mice completed a session of 20 reinforcers. Taken together, these results suggest that selective breeding based on wheel-running rates over 24 hr may have altered the motivational system in a way that reduces the reinforcing value of shorter running durations. The implications of this finding for these mice as a model for attention deficit hyperactivity disorder (ADHD) are discussed. It also is proposed that there may be an inherent trade-off in the motivational system for activities of short versus long duration. PMID:17970415

Channel lining with fiber reinforced shotcrete

DOT National Transportation Integrated Search

1992-07-01

The Arizona Department of Transportation (ADOT) has used four brands of discrete synthetic fibers in a drainage outfall channel lining as part of construction project ACI-10-3(270). The use of the fibers was intended to test the constructibility and ...

Staples.com: Focus on Usability.

ERIC Educational Resources Information Center

McCann, Tom; Hynes, Colin

2002-01-01

Describes the Staples.com electronic commerce Web site; discusses its steady growth rate; and details two case studies in which data from a variety of sources were used to identify and resolve site usability issues and which are supported by compelling ROI (return on investment) figures. (Author/LRW)

Hemorrhoids.

PubMed

Mounsey, Anne L; Halladay, Jacqueline; Sadiq, Timothy S

2011-07-15

Most patients with hemorrhoids experience only mild symptoms that can be treated with nonprescription topical preparations. Patients usually seek treatment when symptoms increase. Internal hemorrhoids typically present with prolapse or painless rectal bleeding. External hemorrhoids also bleed and can cause acute pain if thrombosed. Medical therapy should be initiated with stool softeners plus local therapy to relieve swelling and symptoms. If medical therapy is inadequate, surgical intervention is warranted. Rubber band ligation is the treatment of choice for grades 1 and 2 hemorrhoids. Rubber band ligation, excisional hemorrhoidectomy, or stapled hemorrhoidopexy can be performed in patients with grade 3 hemorrhoids. Rubber band ligation causes less postoperative pain and fewer complications than excisional hemorrhoidectomy and stapled hemorrhoidopexy, but has a higher recurrence rate. Excisional hemorrhoidectomy or stapled hemorrhoidopexy is recommended for treatment of grade 4 hemorrhoids. Stapled hemorrhoidopexy has a faster postoperative recovery, but a higher recurrence rate. Postoperative pain from excisional hemorrhoidectomy can be treated with nonsteroidal anti-inflammatory drugs, narcotics, fiber supplements, and topical antispasmodics. Thrombosed external hemorrhoids can be treated conservatively or excised.

The stapled hemorrhoidopexy syndrome: a new clinical entity?

PubMed

Efthimiadis, Chr; Kosmidis, Chr; Grigoriou, M; Anthimidis, G; Vasiliadou, K; Baka, S; Gerasimidou, D; Basdanis, G

2011-10-01

Haemorrhoidal disease is a rather common disease of unknown cause. A new technique for treating prolapsing haemorrhoids known as the stapled hemorrhoidopexy (SH) or the "Longo procedure" is widely used. Serious adverse events were reported in 2000 and some discussion over the syndrome but nothing since. Two hundred and five patients underwent SH by our surgical team at the Interbalkan European Medical Center. Modified SH was performed. Despite the low incidence of postoperative complications (11/205), 36.58% of patients developed syndrome comprised of urgency to defecate, sensation of anal foreign body and incomplete defecation and mild cramp like anal discomfort, immediately after surgery or in the following 48 h. There is not statistically significant relationship between the presence of the syndrome and the gender, the presence of muscle fibres in the resected "ring" the degree of haemorrhoidal disease, age and ring length. Observations led us to conclude that the stapled hemorrhoidopexy syndrome (SHS) is probably caused by the irritating presence of the titanium staples in the rectal mucosa and by the resection itself.

Long-term prospective evaluation of intestinal anastomosis using stainless steel staples in 14 dogs

PubMed Central

Benlloch-Gonzalez, Manuel; Gomes, Eymeric; Bouvy, Bernard; Poncet, Cyrill

2015-01-01

This prospective clinical study evaluated the use, complications, and clinical and ultrasonographic follow-ups of end-to-end intestinal anastomoses with skin staples in naturally occurring diseases in canine small and large intestines. Intestinal anastomoses were performed in 14 dogs and pre-, peri-, and postoperative data were recorded. Postoperative clinical and ultrasound evaluations were performed at regular intervals for 1 year. The mean time taken to construct the anastomosis was 5 min. There were no intraoperative complications. Hemorrhage and colonic stricture were the main postoperative complications. Staple loss occurred in 2 cases. Absence of wall layering and focal wall thickening were observed in all cases at each ultrasonographic follow-up. Hyperechoic fat was observed in all but 1 of the cases at month 1. Nine dogs were alive with normal digestive function at the end of the study. The skin stapler technique enabled rapid construction of consistent anastomoses with inexpensive stapling material. PMID:26130833

Stapled or manual suturing in esophagojejunostomy after total gastrectomy: a comparison of outcome in 379 patients.

PubMed

Fujimoto, S; Takahashi, M; Endoh, F; Takai, M; Kobayashi, K; Kiuchi, S; Konno, C; Obata, G; Okui, K

1991-09-01

From January 1983 to December 1989, we performed esophagojejunostomy on 379 patients who underwent total gastrectomy for gastric cancer. A mechanical EEA stapler or conventional manual suturing was used. The clinical outcomes of 199 patients in whom stapling was used (stapler group) and 180 patients in whom manual suturing was done (manual group) were compared. Two of the 199 patients in the stapler group and 3 of the 180 patients in the manual group died of causes directly related to the anastomosis. In the stapler group, 16 stapled anastomoses were formed supradiaphragmatically, and manual suturing was done for 6 patients. The highly placed anastomosis was formed without left thoracotomy or with median sternotomy in 8 of the 16 patients in whom the stapling device was used and in 1 of the 6 patients in whom manual suturing was used. The incidence of anastomotic leakage and stenosis did not differ between the groups. Thus, the mechanical stapler facilitated the construction of a rapid, reliable esophagojejunostomic anastomosis.

Inflatable wing

DOEpatents

Priddy, Tommy G.

1988-01-01

An inflatable wing is formed from a pair of tapered, conical inflatable tubes in bonded tangential contact with each other. The tubes are further connected together by means of top and bottom reinforcement boards having corresponding longitudinal edges lying in the same central diametral plane passing through the associated tube. The reinforcement boards are made of a stiff reinforcement material, such as Kevlar, collapsible in a direction parallel to the spanwise wing axis upon deflation of the tubes. The stiff reinforcement material cooperates with the inflated tubes to impart structural I-beam characteristics to the composite structure for transferring inflation pressure-induced tensile stress from the tubes to the reinforcement boards. A plurality of rigid hoops shaped to provide airfoil definition are spaced from each other along the spanwise axis and are connected to the top and bottom reinforcement boards. Tension lines are employed for stabilizing the hoops along the trailing and leading edges thereof.

Synthesis of all-hydrocarbon stapled α-helical peptides by ring-closing olefin metathesis.

PubMed

Kim, Young-Woo; Grossmann, Tom N; Verdine, Gregory L

2011-06-01

This protocol provides a detailed procedure for the preparation of stapled α-helical peptides, which have proven their potential as useful molecular probes and as next-generation therapeutics. Two crucial features of this protocol are (i) the construction of peptide substrates containing hindered α-methyl, α-alkenyl amino acids and (ii) the ring-closing olefin metathesis (RCM) of the resulting resin-bound peptide substrates. The stapling systems described in this protocol, namely bridging one or two turns of an α-helix, are highly adaptable to most peptide sequences, resulting in favorable RCM kinetics, helix stabilization and promotion of cellular uptake.

Design of stapled DNA-minor-groove-binding molecules with a mutable atom simulated annealing method

NASA Astrophysics Data System (ADS)

Walker, Wynn L.; Kopka, Mary L.; Dickerson, Richard E.; Goodsell, David S.

1997-11-01

We report the design of optimal linker geometries for the synthesis of stapledDNA-minor-groove-binding molecules. Netropsin, distamycin, and lexitropsinsbind side-by-side to mixed-sequence DNA and offer an opportunity for thedesign of sequence-reading molecules. Stapled molecules, with two moleculescovalently linked side-by-side, provide entropic gains and restrain theposition of one molecule relative to its neighbor. Using a free-atom simulatedannealing technique combined with a discrete mutable atom definition, optimallengths and atomic composition for covalent linkages are determined, and anovel hydrogen bond `zipper' is proposed to phase two molecules accuratelyside-by-side.

Pricing of Staple Foods at Supermarkets versus Small Food Stores

PubMed Central

Caspi, Caitlin E.; Pelletier, Jennifer E.; Harnack, Lisa J.; Erickson, Darin J.; Laska, Melissa N.

2017-01-01

Prices affect food purchase decisions, particularly in lower-income communities, where access to a range of food retailers (including supermarkets) is limited. The aim of this study was to examine differences in staple food pricing between small urban food stores and the closest supermarkets, as well as whether pricing differentials varied based on proximity between small stores and larger retailers. In 2014, prices were measured for 15 staple foods during store visits in 140 smaller stores (corner stores, gas-marts, dollar stores, and pharmacies) in Minneapolis/St. Paul, MN and their closest supermarket. Mixed models controlling for store type were used to estimate the average price differential between: (a) smaller stores and supermarkets; (b) isolated smaller stores (>1 mile to closest supermarket) and non-isolated smaller stores; and (c) isolated smaller stores inside versus outside USDA-identified food deserts. On average, all items except white bread were 10–54% more expensive in smaller stores than in supermarkets (p < 0.001). Prices were generally not significantly different in isolated stores compared with non-isolated stores for most items. Among isolated stores, there were no price differences inside versus outside food deserts. We conclude that smaller food stores have higher prices for most staple foods compared to their closest supermarket, regardless of proximity. More research is needed to examine staple food prices in different retail spaces. PMID:28809795

Pricing of Staple Foods at Supermarkets versus Small Food Stores.

PubMed

Caspi, Caitlin E; Pelletier, Jennifer E; Harnack, Lisa J; Erickson, Darin J; Lenk, Kathleen; Laska, Melissa N

2017-08-15

Prices affect food purchase decisions, particularly in lower-income communities, where access to a range of food retailers (including supermarkets) is limited. The aim of this study was to examine differences in staple food pricing between small urban food stores and the closest supermarkets, as well as whether pricing differentials varied based on proximity between small stores and larger retailers. In 2014, prices were measured for 15 staple foods during store visits in 140 smaller stores (corner stores, gas-marts, dollar stores, and pharmacies) in Minneapolis/St. Paul, MN and their closest supermarket. Mixed models controlling for store type were used to estimate the average price differential between: (a) smaller stores and supermarkets; (b) isolated smaller stores (>1 mile to closest supermarket) and non-isolated smaller stores; and (c) isolated smaller stores inside versus outside USDA-identified food deserts. On average, all items except white bread were 10-54% more expensive in smaller stores than in supermarkets ( p < 0.001). Prices were generally not significantly different in isolated stores compared with non-isolated stores for most items. Among isolated stores, there were no price differences inside versus outside food deserts. We conclude that smaller food stores have higher prices for most staple foods compared to their closest supermarket, regardless of proximity. More research is needed to examine staple food prices in different retail spaces.

Bronchial closure methods and risks for bronchopleural fistula in pulmonary resections: how a surgeon may choose the optimum method?

PubMed

Uçvet, Ahmet; Gursoy, Soner; Sirzai, Serdar; Erbaycu, Ahmet E; Ozturk, Ali A; Ceylan, Kenan C; Kaya, Seyda O

2011-04-01

There is debate about which bronchial closure technique is the best to prevent bronchopleural fistulas (BPFs). We aim to assess the effect of bronchial closure procedures and patients' characteristics on BPF occurrence in pulmonary resections. Bronchial closures in 625 consecutive patients were assessed. Stumps were closed by manual suturing in 204 and by mechanical stapling in 421 cases. In the mechanical stapling group, stapling supported by manual suture was performed in 170 cases. BPFs occurred in 3.8%. Of these, stapling was used in 5.0%, whereas manual suturing was used in 1.5% (P=0.04). BPFs were more prevalent among patients who had undergone pneumonectomy (P<0.01), right pneumonectomy (P<0.01), stapler closure (P<0.01), patients with co-factors (P<0.01), and patients who had undergone preoperative neo-adjuvant (P=0.01) or postoperative adjuvant therapy (P=0.03). There was no difference in the frequency of BPF between patients with and without adjuvant support in the stapling group. The optimum bronchial closure method has to be chosen by considering the patient and bronchus based characteristics. This has to be assessed carefully, especially in pneumonectomy and co-factors. The manual closure seems to be the more preferable method in risky patients. An additive support suture on the bronchial stump does not decrease the risk of BPF.

Suzanne Fisher Staples: From Journalist to Novelist.

ERIC Educational Resources Information Center

Greever, Ellen A.; Austin, Patricia

1997-01-01

Presents the story of Suzanne Fisher Staples, author of the Newbery Honor Book, "Shabanu: Daughter of the Wind." States that she was first a journalist who experienced different foreign cultures firsthand, which provided the background for the novel. Discusses the difference between writing for newspapers and writing fiction. (PA)

Rural Inservice Education: Staples Teacher Center Style.

ERIC Educational Resources Information Center

Krueger, Rick

In its two-year existence, the federally funded Staples Teacher Center (STC) in Minnesota has had a significant impact on improving classroom instruction and staff development activities in a rural setting, proving that teacher centers are a most effective delivery system for inservice education in sparsely populated areas. Services are rendered…

Genome-wide association mapping of provitamin A carotenoid content in cassava

USDA-ARS?s Scientific Manuscript database

Global efforts are underway to develop staple crops with improved levels of provitamin A carotenoids to help combat dietary vitamin A deficiency, which is widespread among resource-poor farmers in the developing world. As a staple crop for more than 500 million people in sub-Saharan Africa, cassava ...

Irrigation Comes to Staples

ERIC Educational Resources Information Center

Lund, Duane R.

1977-01-01

Describes the case of Staples, Minnesota, where the vocational-technical school bought a 300-acre farm and with the help of a strong advisory committee was instrumental in changing the farming practices in an eight-county area. Emphasis is on the role and activities of the advisory committee; eleven specific contributions are listed. (HD)

7 CFR 1427.160 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-01-01

.... (a) This subpart is applicable to the 2008 through 2012 crops of upland and extra long staple seed... for upland cotton and the national average loan rate for extra long staple cotton. (c) A producer must...) Loans shall not be available for seed cotton produced on land owned or otherwise in the possession of...

Development and characterization of self-healing carbon fabric/ionomer composite through stitched polymeric artificial muscle

NASA Astrophysics Data System (ADS)

Gabriel, Mark Joseph

Typical cracks in composite materials are hard to detect, because they may be very small or occur inside the material. This study investigates the development and characterization of carbon fiber and an ionomer, self-healing, laminate composite, enhanced with stitched artificial muscle elements. Although the carbon fiber is used as a structural reinforcement, the carbon fiber can also act as a resistive heating element in order to activate the healing elements in a Close-Then-Heal (CTH) approach. However in this study, hot air in an oven was used to activate the, SurlynRTM 8940, self-healing matrix. Artificial muscle was prepared from commercial fishing line to stitch reinforce the carbon laminate composite in the Z plane. Holes were drilled into the final composite and the muscle was stitched into the composite for active reinforcement. Differential scanning calorimetry was used to characterize the matrix and fishing line properties. The resulting smart composite was subjected to low velocity impact tests and consequential damage before healing in an oven, followed by three point bending flexure tests. Cracks in the carbon fiber reinforcement formed more easily than expected after impact because the holes were drilled to facilitate the muscle stitching. The matrix material could heal, but the reinforcement carbon could not. Several equipment issues and failures limited the amount of samples that could be created to continue testing with new parameters.

The Effects of Multiple Exemplar Training on a Working Memory Task Involving Sequential Responding in Children with Autism

ERIC Educational Resources Information Center

Baltruschat, Lisa; Hasselhorn, Marcus; Tarbox, Jonathan; Dixon, Dennis R.; Najdowski, Adel; Mullins, Ryan David; Gould, Evelyn

2012-01-01

This study is part of a programmatic line of research into the use of basic positive reinforcement procedures for improving working memory in children with autism spectrum disorders. The authors evaluated the effects of multiple exemplar training, utilizing positive reinforcement, on performance of a "digit span backwards" task--a test of working…

Use of disposable stapler in operative cystogastrostomy for pancreatic pseudocyst.

PubMed

Yunoki, Y; Takeuchi, H; Yasui, Y; Tanakaya, K; Konaga, E; Hamazaki, K

1999-01-01

Surgical stapling techniques are widely used in gastrointestinal surgery. These procedures are excellent in convenience and safety. We describe here a new practical application of the surgical disposable stapler, Auto Suture Premium Plus CEEA 34 circular stapler, for the operative drainage of a large symptomatic pancreatic pseudocyst. A 68 year-old man underwent an operative cystogastrostomy using this instrument. His post-operative recovery was uneventful. He is free from symptoms, and abdominal tomography shows complete disappearance of the cystic cavity. We believe that this is the first clinical paper that reports on the stapled cystogastrostomy. This instrument is very useful for creating a stapled cystogastrostomy, similar to one created in the standard open approach.

Combining high performance simulation, data acquisition, and graphics display computers

NASA Technical Reports Server (NTRS)

Hickman, Robert J.

1989-01-01

Issues involved in the continuing development of an advanced simulation complex are discussed. This approach provides the capability to perform the majority of tests on advanced systems, non-destructively. The controlled test environments can be replicated to examine the response of the systems under test to alternative treatments of the system control design, or test the function and qualification of specific hardware. Field tests verify that the elements simulated in the laboratories are sufficient. The digital computer is hosted by a Digital Equipment Corp. MicroVAX computer with an Aptec Computer Systems Model 24 I/O computer performing the communication function. An Applied Dynamics International AD100 performs the high speed simulation computing and an Evans and Sutherland PS350 performs on-line graphics display. A Scientific Computer Systems SCS40 acts as a high performance FORTRAN program processor to support the complex, by generating numerous large files from programs coded in FORTRAN that are required for the real time processing. Four programming languages are involved in the process, FORTRAN, ADSIM, ADRIO, and STAPLE. FORTRAN is employed on the MicroVAX host to initialize and terminate the simulation runs on the system. The generation of the data files on the SCS40 also is performed with FORTRAN programs. ADSIM and ADIRO are used to program the processing elements of the AD100 and its IOCP processor. STAPLE is used to program the Aptec DIP and DIA processors.

78 FR 38939 - Certain Polyester Staple Fiber From the People's Republic of China: Final Results of Antidumping...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-28

... DEPARTMENT OF COMMERCE International Trade Administration [A-570-905] Certain Polyester Staple... Preliminary Results of the 2011-2012 administrative review of the antidumping duty order on certain polyester... dumping margin is listed in the ``Final Results of Review'' section below. \\1\\ See Certain Polyester...

76 FR 45227 - Initiation of Antidumping and Countervailing Duty Administrative Reviews, Requests for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-28

... antidumping duty orders on Certain Polyester Staple Fiber from the People's Republic of China with respect to... Certain Polyester Staple Fiber from the People's Republic of China with respect to two exporters and on... exporter. Period to be reviewed Antidumping Duty Proceedings Japan: Certain Large Diameter Carbon and Alloy...

7 CFR 28.301 - Measurement: humidity; temperature.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 2 2014-01-01 2014-01-01 false Measurement: humidity; temperature. 28.301 Section 28... for Length of Staple § 28.301 Measurement: humidity; temperature. The length of staple of any cotton... its fibers under a relative humidity of the atmosphere of 65 percent and a temperature of 70 °F. ...

7 CFR 28.301 - Measurement: humidity; temperature.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 2 2011-01-01 2011-01-01 false Measurement: humidity; temperature. 28.301 Section 28... for Length of Staple § 28.301 Measurement: humidity; temperature. The length of staple of any cotton... its fibers under a relative humidity of the atmosphere of 65 percent and a temperature of 70 °F. ...

7 CFR 28.301 - Measurement: humidity; temperature.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Measurement: humidity; temperature. 28.301 Section 28... for Length of Staple § 28.301 Measurement: humidity; temperature. The length of staple of any cotton... its fibers under a relative humidity of the atmosphere of 65 percent and a temperature of 70° F. ...

7 CFR 28.301 - Measurement: humidity; temperature.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 2 2012-01-01 2012-01-01 false Measurement: humidity; temperature. 28.301 Section 28... for Length of Staple § 28.301 Measurement: humidity; temperature. The length of staple of any cotton... its fibers under a relative humidity of the atmosphere of 65 percent and a temperature of 70 °F. ...

7 CFR 28.301 - Measurement: humidity; temperature.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 2 2013-01-01 2013-01-01 false Measurement: humidity; temperature. 28.301 Section 28... for Length of Staple § 28.301 Measurement: humidity; temperature. The length of staple of any cotton... its fibers under a relative humidity of the atmosphere of 65 percent and a temperature of 70 °F. ...

Comparative Study of Hand-Sutured versus Circular Stapled Anastomosis for Gastrojejunostomy in Laparoscopy Assisted Distal Gastrectomy.

PubMed

Seo, Su Hyun; Kim, Ki Han; Kim, Min Chan; Choi, Hong Jo; Jung, Ghap Joong

2012-06-01

Mechanical stapler is regarded as a good alternative to the hand sewing technique, when used in gastric reconstruction. The circular stapling method has been widely applied to gastrectomy (open orlaparoscopic), for gastric cancer. We illustrated and compared the hand-sutured method to the circular stapling method, for Billroth-II, in patients who underwent laparoscopy assisted distal gastrectomy for gastric cancer. Between April 2009 and May 2011, 60 patients who underwent laparoscopy assisted distal gastrectomy, with Billroth-II, were enrolled. Hand-sutured Billroth-II was performed in 40 patients (manual group) and circular stapler Billroth-II was performed in 20 patients (stapler group). Clinicopathological features and post-operative outcomes were evaluated and compared between the two groups. Nosignificant differences were observed in clinicopathologic parameters and post-operative outcomes, except in the operation times. Operation times and anastomosis times were significantly shorter in the stapler group (P=0.004 and P<0.001). Compared to the hand-sutured method, the circular stapling method can be applied safely and more efficiently, when performing Billroth-II anastomosis, after laparoscopy assisted distal gastrectomy in patients with gastric cancer.

A simplified technique for a totally diverting transverse loop colostomy and distal irrigation.

PubMed

Rose, D; Koniges, F; Frazier, T G

1985-12-01

This technique of totally diverting loop colostomy may be performed as an independent procedure or with exploratory laparotomy and surgical treatment on the distal part of the colon. Either a transverse or sigmoid loop colostomy can be used for diversion without the risk of fecal contamination of the peritoneal cavity, particularly when working with unprepared intestine. When distal irrigation is desired to purge the intestine of fecal material, either intraoperatively or as part of a subsequent intestinal preparation, it can easily be accomplished by placing an irrigating catheter distal to the staple line. In addition, the use of a small rubber suspension bar facilitates application of standard colostomy appliances for the stoma.

[Staple fixation for the treatment of hamate metacarpal joint injury].

PubMed

Tang, Yang-Hua; Zeng, Lin-Ru; Huang, Zhong-Ming; Yue, Zhen-Shuang; Xin, Da-Wei; Xu, Can-Da

2014-03-01

To investigate the effcacy of the staple fixation for the treatment of hamate metacarpal joint injury. From May 2009 to November 2012,16 patients with hamate metacarpal joint injury were treated with staple fixation including 10 males and 6 females with an average age of 33.6 years old ranging from 21 to 57 years. Among them, 11 cases were on the fourth or fifth metacarpal base dislocation without fractures, 5 cases were the fourth or fifth metacarpal base dislocation with avulsion fractures of the back of hamatum. Regular X-ray review was used to observe the fracture healing, joint replacement and position of staple fixation. The function of carpometacarpal joint and metacarpophalangeal joint were evaluated according to ASIA (TAM) system evaluation method. All incision were healed well with no infection. All patients were followed up from 16 to 24 months with an average of (10.0 +/- 2.7) months. No dislocation recurred, the position of internal fixator was good,no broken nail and screw withdrawal were occurred. Five patients with avulsion fracture of the back of hamatum achieved bone healing. The function of carpometacarpal joint and metacarpophalangeal was excellent in 10 cases,good in 5 cases, moderate in 1 case. The application of the staple for the treatment of hamatometacarpal joint injury has the advantages of simple operation, small trauma, reliable fixation, early postoperative function exercise and other advantages, which is the ideal operation mode for hamatometacarpal joint injury.

The Importance of Animal Source Foods for Nutrient Sufficiency in the Developing World: The Zambia Scenario.

PubMed

Zhang, Zhiying; Goldsmith, Peter D; Winter-Nelson, Alex

2016-05-05

There have been successful interventions fortifying staple foods to mobilize micronutrients as well as agricultural efforts to raise yields of staple foods to increase food availability. Zambia serves as an interesting case study because since 1961 there has been a notable decline in the availability of animal source foods (ASFs) and pulses and a significant increase in the supply of cassava and vegetable oils. The shift in food availability was partly attributed to the agricultural success in high-yielding and drought-resistant varieties that made cassava and oil crops more affordable and readily available. In this research, we explore another policy strategy that involves ASF as a mechanism to help remedy micronutrient inadequacies in a population. A scenario modeling analysis compares the changes in the nutrient profile of the Zambian diet through adding either staple plant source foods (PSFs) or ASFs. The scenarios under study involve the addition of (1) 18 fl oz of whole cow's milk; (2) 60 g of beef, 30 g of chicken, and 5 g of beef liver; (3) milk plus meat; or (4) 83 g of maize flour, 123 g of cassava, and other staple PSF, that is, isocaloric to the "milk + meat" group. The findings alert program planners and policy makers to the value of increasing the availability, accessibility, and utilization of ASF to simultaneously address multiple nutrient deficiencies, as well as the nutrition challenges that remain when expanding the availability of plant-based staples. © The Author(s) 2016.

[The advantages in using cyanoacrylate glue over skin staples as a method of skin graft fixation in the pediatric burns population].

PubMed

Curings, P; Vincent, P-L; Viard, R; Gir, P; Comparin, J-P; Voulliaume, D

2017-11-23

Local postoperative care and burn wound management can present with a certain degree of difficulty in the pediatric population. While the use of skin staples as a method of skin graft fixation is a well-known, rapid and simple method, their removal can be painful and may necessitate some sedation or even general anesthesia. We studied in this article the advantages and economic value of using the cyanoacrylate glue as a fixation method for skin grafts. A comparative study was carried out from 2012 to 2016. Hundred and eighteen infants with burns up to 5% of total body surface area were included in the study. Seventy-two infants had split thickness skin grafts fixed with skin staples. Forty-six infants had split thickness skin grafts fixed with cyanoacrylate glue. We compared the quality of graft, the sedation used during the first postoperative dressing, the length of hospital stay, the amount of glue used and the presence of complications. There is a difference between the two groups studied in terms of age and total burn surface area. The rate of graft take was 100% in both groups. The first postoperative dressing was carried out without the use of powerful analgesia in the cyanoacrylate group, while it was necessary to use general anesthesia in 64% of the skin staples group. The average length of stay in hospital after skin grafting was 4.9 days for the cyanoacrylate glue versus 6.5 days in the skin staples group. No complications were noted in the 2 groups. The use of cyanoacrylate glue allows rapid fixation of skin grafts and avoid general anesthesia for postoperative cares. Subsequently the length of hospital stay is reduced within 25%. The medico-economic value of glue protocol is highly significant compared to skin staples, while having similar good results and without significant problems. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

SU-E-J-101: Improved CT to CBCT Deformable Registration Accuracy by Incorporating Multiple CBCTs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Godley, A; Stephans, K; Olsen, L Sheplan

2015-06-15

Purpose: Combining prior day CBCT contours with STAPLE was previously shown to improve automated prostate contouring. These accurate STAPLE contours are now used to guide the planning CT to pre-treatment CBCT deformable registration. Methods: Six IGRT prostate patients with daily kilovoltage CBCT had their original planning CT and 9 CBCTs contoured by the same physician. These physician contours for the planning CT and each prior CBCT are deformed to match the current CBCT anatomy, producing multiple contour sets. These sets are then combined using STAPLE into one optimal set (e.g. for day 3 CBCT, combine contours produced using the planmore » plus day 1 and 2 CBCTs). STAPLE computes a probabilistic estimate of the true contour from this collection of contours by maximizing sensitivity and specificity. The deformation field from planning CT to CBCT registration is then refined by matching its deformed contours to the STAPLE contours. ADMIRE (Elekta Inc.) was used for this. The refinement does not force perfect agreement of the contours, typically Dice’s Coefficient (DC) of > 0.9 is obtained, and the image difference metric remains in the optimization of the deformable registration. Results: The average DC between physician delineated CBCT contours and deformed planning CT contours for the bladder, rectum and prostate was 0.80, 0.79 and 0.75, respectively. The accuracy significantly improved to 0.89, 0.84 and 0.84 (P<0.001 for all) when using the refined deformation field. The average time to run STAPLE with five scans and refine the planning CT deformation was 66 seconds on a Telsa K20c GPU. Conclusion: Accurate contours generated from multiple CBCTs provided guidance for CT to CBCT deformable registration, significantly improving registration accuracy as measured by contour DC. A more accurate deformation field is now available for transferring dose or electron density to the CBCT for adaptive planning. Research grant from Elekta.« less

Economic and clinical comparison of 2-octyl cyanoacrylate/polymer mesh tape with skin staples in total knee replacement.

PubMed

Sutton, Nadia; Schmitz, Niels-Derrek; Johnston, Stephen S

2018-04-01

To compare economic and clinical outcomes between skin staples and 2-octyl cyanoacrylate plus polymer mesh tape, Dermabond Prineo skin closure system, (SCS) among patients undergoing total knee replacement (TKR). Retrospective, observational study using the Premier Healthcare Database, which comprises hospital administrative and billing data for over 700 hospitals in the US. Patients selected for study had an elective hospital admission, with discharge occurring between January 2012 and September 2015, carrying primary ICD-9-CM procedure and diagnosis codes for TKR and osteoarthritis. Patients were classified into two mutually-exclusive groups based on billing records during the index admission: those with billing record(s) for the skin closure system (SCS group); and those with billing record(s) for skin staples (staple group). Primary outcomes were index admission's length of stay (LOS), total hospital costs, and discharge status (skilled nursing facility (SNF)/other versus home/home health-care); exploratory outcomes included operating room time (ORT) during index admission and 30, 60, and 90-day readmissions. The SCS and staple groups were propensity score matched (1:1/nearest neighbour/caliper=0.10) on patient, hospital, and provider characteristics. Multivariable regressions accounting for hospital-level clustering after matching were used to compare outcomes between study groups. Each group comprised 971 patients (1942 total patients; mean age: 65.3 years; female: 63.5%). The groups were generally well-balanced on matching covariates: mean standardised difference calculated across 49 covariates=0.049. Compared with the staple group, the SCS group had statistically significant shorter LOS (2.8 days versus 3.2 days, p=0.002), lower rate of discharge to SNF/other versus home/home health-care (26.4% versus 38.5%, p=0.011), and lower rate of 30, 60, and 90-day readmissions (30-day, 1.8% versus 4.4%, p=0.006; 60-day, 3.0% versus 5.4%, p<0.001; 90-day, 5.4% versus 7.4%, p=0.016). Differences between the groups for other outcomes were not statistically significant. Among patients undergoing TKR, use of the SCS was associated with shorter LOS, less resource intensive discharge status, and lower rates of all-cause readmission as compared with skin staples.

Process of Making Boron-Fiber Reinforced Composite Tape

NASA Technical Reports Server (NTRS)

Belvin, Harry L. (Inventor); Cano, Roberto J. (Inventor); Johnston, Norman J. (Inventor); Marchello, Joseph M. (Inventor)

2002-01-01

The invention is an apparatus and method for producing a hybrid boron reinforced polymer matrix composition from powder pre-impregnated fiber tow bundles and a linear array of boron fibers. The boron fibers are applied onto the powder pre-impregnated fiber tow bundles and then are processed within a processing component having an impregnation bar assembly. After passing through variable-dimension forming nip-rollers, the powder pre-impregnated fiber tow bundles with the boron fibers become a hybrid boron reinforced polymer matrix composite tape. A driving mechanism pulls the powder pre-impregnated fiber tow bundles with boron fibers through the processing line of the apparatus and a take-up spool collects the formed hybrid boron-fiber reinforced polymer matrix composite tape.

Identification of line-specific strategies for improving carotenoid production in synthetic maize through data-driven mathematical modeling.

PubMed

Comas, Jorge; Benfeitas, Rui; Vilaprinyo, Ester; Sorribas, Albert; Solsona, Francesc; Farré, Gemma; Berman, Judit; Zorrilla, Uxue; Capell, Teresa; Sandmann, Gerhard; Zhu, Changfu; Christou, Paul; Alves, Rui

2016-09-01

Plant synthetic biology is still in its infancy. However, synthetic biology approaches have been used to manipulate and improve the nutritional and health value of staple food crops such as rice, potato and maize. With current technologies, production yields of the synthetic nutrients are a result of trial and error, and systematic rational strategies to optimize those yields are still lacking. Here, we present a workflow that combines gene expression and quantitative metabolomics with mathematical modeling to identify strategies for increasing production yields of nutritionally important carotenoids in the seed endosperm synthesized through alternative biosynthetic pathways in synthetic lines of white maize, which is normally devoid of carotenoids. Quantitative metabolomics and gene expression data are used to create and fit parameters of mathematical models that are specific to four independent maize lines. Sensitivity analysis and simulation of each model is used to predict which gene activities should be further engineered in order to increase production yields for carotenoid accumulation in each line. Some of these predictions (e.g. increasing Zmlycb/Gllycb will increase accumulated β-carotenes) are valid across the four maize lines and consistent with experimental observations in other systems. Other predictions are line specific. The workflow is adaptable to any other biological system for which appropriate quantitative information is available. Furthermore, we validate some of the predictions using experimental data from additional synthetic maize lines for which no models were developed. © 2016 The Authors The Plant Journal © 2016 John Wiley & Sons Ltd.

Framework for robot skill learning using reinforcement learning

NASA Astrophysics Data System (ADS)

Wei, Yingzi; Zhao, Mingyang

2003-09-01

Robot acquiring skill is a process similar to human skill learning. Reinforcement learning (RL) is an on-line actor critic method for a robot to develop its skill. The reinforcement function has become the critical component for its effect of evaluating the action and guiding the learning process. We present an augmented reward function that provides a new way for RL controller to incorporate prior knowledge and experience into the RL controller. Also, the difference form of augmented reward function is considered carefully. The additional reward beyond conventional reward will provide more heuristic information for RL. In this paper, we present a strategy for the task of complex skill learning. Automatic robot shaping policy is to dissolve the complex skill into a hierarchical learning process. The new form of value function is introduced to attain smooth motion switching swiftly. We present a formal, but practical, framework for robot skill learning and also illustrate with an example the utility of method for learning skilled robot control on line.

Strong and tough magnesium wire reinforced phosphate cement composites for load-bearing bone replacement.

PubMed

Krüger, Reinhard; Seitz, Jan-Marten; Ewald, Andrea; Bach, Friedrich-Wilhelm; Groll, Jürgen

2013-04-01

Calcium phosphate cements are brittle biomaterials of low bending strength. One promising approach to improve their mechanical properties is reinforcement with fibers. State of the art degradable reinforced composites contain fibers made of polymers, resorbable glass or whiskers of calcium minerals. We introduce a new class of composite that is reinforced with degradable magnesium alloy wires. Bending strength and ductility of the composites increased with aspect ratio and volume content of the reinforcements up to a maximal bending strength of 139±41MPa. Hybrid reinforcement with metal and polymer fibers (PLA) further improved the qualitative fracture behavior and gave indication of enhanced strength and ductility. Immersion tests of composites in SBF for seven weeks showed high corrosion stability of ZEK100 wires and slow degradation of the magnesium calcium phosphate cement by struvite dissolution. Finally, in vitro tests with the osteoblast-like cell line MG63 demonstrate cytocompatibility of the composite materials. Copyright © 2013 Elsevier Ltd. All rights reserved.

76 FR 38612 - Certain Polyester Staple Fiber From the Republic of Korea and Taiwan: Final Results of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-01

... DEPARTMENT OF COMMERCE International Trade Administration [A-580-839, A-583-833] Certain Polyester... sunset reviews of the antidumping duty orders on polyester staple fiber (PSF) from the Republic of Korea... polyesters measuring 3.3 decitex (3 denier, inclusive) or more in diameter. This merchandise is cut to...

78 FR 2366 - Certain Polyester Staple Fiber From the People's Republic of China: Final Results of Antidumping...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-11

... Fiber From the People's Republic of China: Final Results of Antidumping Duty Administrative Review; 2010... staple fiber (``PSF'') from the People's Republic of China (``PRC'').\\1\\ We gave interested parties an opportunity to comment on the Preliminary Results. Based upon our analysis of the comments and information...

78 FR 14512 - Certain Polyester Staple Fiber From the People's Republic of China: Preliminary Results and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-06

... Fiber From the People's Republic of China: Preliminary Results and Rescission in Part of the 2011-2012... administrative review of the antidumping duty order on certain polyester staple fiber from the People's Republic... Industries (``Far Eastern'') and Huvis Sichuan Chemical Fiber Corp. and Huvis Sichuan Polyester Fiber Ltd...

Maize genotype and food matrix affect the provitamin A carotenoid bioefficacy from staple and carrot-fortified feeds in Mongolian gerbils (Meriones unguiculatus)

USDA-ARS?s Scientific Manuscript database

Biofortification of staple crops to increase provitamin A carotenoids is a promising technique to alleviate vitamin A deficiency. ß-Carotene (ßC) and ß-cryptoxanthin (ßCX) are low in typical maize but higher in biofortified varieties. In vitro screening methods evaluate bioaccessibility of carotenoi...

Formulating Spatially Varying Performance in the Statistical Fusion Framework

PubMed Central

Landman, Bennett A.

2012-01-01

To date, label fusion methods have primarily relied either on global (e.g. STAPLE, globally weighted vote) or voxelwise (e.g. locally weighted vote) performance models. Optimality of the statistical fusion framework hinges upon the validity of the stochastic model of how a rater errs (i.e., the labeling process model). Hitherto, approaches have tended to focus on the extremes of potential models. Herein, we propose an extension to the STAPLE approach to seamlessly account for spatially varying performance by extending the performance level parameters to account for a smooth, voxelwise performance level field that is unique to each rater. This approach, Spatial STAPLE, provides significant improvements over state-of-the-art label fusion algorithms in both simulated and empirical data sets. PMID:22438513

[Local recurrence following anterior rectum resection--manual versus stapler suture].

PubMed

Metzger, U; Weber, W; Weber, E; Linggi, J; Buchmann, P; Largiadèr, F

1985-04-01

A retrospective study was carried out on 88 hand sewn and 34 stapled anastomoses following anterior resection to evaluate the impact of suture technique on local recurrence rate. The patient groups were comparable with one exception: there were significantly more Dukes C lesions resected and sutured using the stapling gun (35% versus 15%, X2 = 6.33, p less than 0.05). Stage-corrected recurrence rate was similar in both groups, Dukes A: 8%, Dukes B 21%, Dukes C 52%, all recurrences being detected within 24 months following operation. Significantly fewer protective colostomies were needed using the staple gun (15% versus 34%, X2 = 4.50, p less than 0.05). Otherwise, no significant difference or benefit was observed comparing the two suture techniques.

[Stapler and manual bronchial anastomosis--results of a consecutive trial series].

PubMed

Junginger, T; Walgenbach, S; Pichlmaier, H

1989-01-01

After lobectomy and pneumonectomy in experimental evaluations stapled bronchial closures showed the lowest incidence of inflammatory reaction and the highest strength determined by leakage pressure compared with other suture material. A total of 233 lung resections-performed at Surgical University Clinic Köln-Lindenthal and the Clinic for General and Abdominal Surgery of the Johannes-Gutenberg-Universität Mainz--were reviewed. Mechanical stapling reduced the rate of bronchopleural fistulas to 2.0% compared with 7.1% after manual suturing. In parallel, mortality related to bronchial stump leakage decreased to 0.7%. Main advantages of bronchial closure with staplers are the simplicity of their use, the speed and the uniformity of the closure. Thereby stapling devices are valuable completions in pulmonary surgery.

Pancreatic surgery.

PubMed

Donahue, Timothy R; Reber, Howard A

2013-09-01

To summarize published research on pancreatic surgery over the past year. A number of studies aiming to reduce the costs associated with pancreatic surgery were reported. Retrospective analyses confirmed previous findings that neither the routine use of pancreatic duct stents decreases the rate of fistula formation nor does placement of a drain at the time of surgery change the morbidity in patients who develop one. Minimally invasive approaches, both laparoscopic and robot-assisted, are being performed more frequently to remove pancreatic cancers. A randomized trial confirmed that reinforcement of stapled closure during distal pancreatectomy reduces the rate of fistula formation. Controversy remains over whether small pancreatic neuroendocrine tumors need to be surgically resected or can be treated nonoperatively. Patients with chronic pancreatitis should be screened thoroughly before being offered surgical treatment; two studies reported preoperative factors that can be used to identify those most likely to experience pain relief. Studies published on pancreatic surgery last year focused on a wide-range of topics. The morbidity and mortality of patients undergoing pancreatic surgery continues to improve, and we anticipate that incorporation of these new findings will lead to even better outcomes.

Vibration characteristics of functionally graded carbon nanotube reinforced composite rectangular plates on Pasternak foundation with arbitrary boundary conditions and internal line supports

NASA Astrophysics Data System (ADS)

Zhong, Rui; Wang, Qingshan; Tang, Jinyuan; Shuai, Cijun; Liang, Qian

2018-02-01

This paper presents the first known vibration characteristics of moderately thick functionally graded carbon nanotube reinforced composite rectangular plates on Pasternak foundation with arbitrary boundary conditions and internal line supports on the basis of the firstorder shear deformation theory. Different distributions of single walled carbon nanotubes (SWCNTs) along the thickness are considered. Uniform and other three kinds of functionally graded distributions of carbon nanotubes along the thickness direction of plates are studied. The solutions carried out using an enhanced Ritz method mainly include the following three points: Firstly, create the Lagrange energy function by the energy principle; Secondly, as the main innovation point, the modified Fourier series are chosen as the basic functions of the admissible functions of the plates to eliminate all the relevant discontinuities of the displacements and their derivatives at the edges; Lastly, solve the natural frequencies as well as the associated mode shapes by means of the Ritz-variational energy method. In this study, the influences of the volume fraction of CNTs, distribution type of CNTs, boundary restrain parameters, location of the internal line supports, foundation coefficients on the natural frequencies and mode shapes of the FG-CNT reinforced composite rectangular plates are presented.

Haploids: Constraints and opportunities in plant breeding.

PubMed

Dwivedi, Sangam L; Britt, Anne B; Tripathi, Leena; Sharma, Shivali; Upadhyaya, Hari D; Ortiz, Rodomiro

2015-11-01

The discovery of haploids in higher plants led to the use of doubled haploid (DH) technology in plant breeding. This article provides the state of the art on DH technology including the induction and identification of haploids, what factors influence haploid induction, molecular basis of microspore embryogenesis, the genetics underpinnings of haploid induction and its use in plant breeding, particularly to fix traits and unlock genetic variation. Both in vitro and in vivo methods have been used to induce haploids that are thereafter chromosome doubled to produce DH. Various heritable factors contribute to the successful induction of haploids, whose genetics is that of a quantitative trait. Genomic regions associated with in vitro and in vivo DH production were noted in various crops with the aid of DNA markers. It seems that F2 plants are the most suitable for the induction of DH lines than F1 plants. Identifying putative haploids is a key issue in haploid breeding. DH technology in Brassicas and cereals, such as barley, maize, rice, rye and wheat, has been improved and used routinely in cultivar development, while in other food staples such as pulses and root crops the technology has not reached to the stage leading to its application in plant breeding. The centromere-mediated haploid induction system has been used in Arabidopsis, but not yet in crops. Most food staples are derived from genomic resources-rich crops, including those with sequenced reference genomes. The integration of genomic resources with DH technology provides new opportunities for the improving selection methods, maximizing selection gains and accelerate cultivar development. Marker-aided breeding and DH technology have been used to improve host plant resistance in barley, rice, and wheat. Multinational seed companies are using DH technology in large-scale production of inbred lines for further development of hybrid cultivars, particularly in maize. The public sector provides support to national programs or small-medium private seed for the exploitation of DH technology in plant breeding. Copyright © 2015 Elsevier Inc. All rights reserved.

Dispersion fraction enhances cellular growth of carbon nanotube and aluminum oxide reinforced ultrahigh molecular weight polyethylene biocomposites.

PubMed

Patel, Anup Kumar; Balani, Kantesh

2015-01-01

Ultrahigh molecular weight polyethylene (UHMWPE) is widely used as bone-replacement material for articulating surfaces due to its excellent wear resistance and low coefficient of friction. But, the wear debris, generated during abrasion between mating surfaces, leads to aseptic loosening of implants. Thus, various reinforcing agents are generally utilized, which may alter the surface and biological properties of UHMWPE. In the current work, the cellular response of compression molded UHMWPE upon reinforcement of bioactive multiwalled carbon nanotubes (MWCNTs) and bioinert aluminum oxide (Al2O3) is investigated. The phase retention and stability were observed using X-ray diffraction, Raman spectroscopy and Fourier transform infrared (FTIR) spectroscopy. The reinforcement of MWCNTs and Al2O3 has shown to alter the wettability (from contact angle of ~88°±2° to ~118°±4°) and surface energy (from ~23.20 to ~17.75 mN/m) of composites with respect to UHMWPE, without eliciting any adverse effect on cytocompatibility for the L929 mouse fibroblast cell line. Interestingly, the cellular growth of the L929 mouse fibroblast cell line is observed to be dominated by the dispersion fraction of surface free energy (SFE). After 48 h of incubation period, a decrease in metabolic activity of MWCNT-Al2O3 reinforced composites is attributed to apatite formation that reduces the dispersion fraction of surface energy. The mineralized apatite during incubation was confirmed and quantified by energy dispersive spectroscopy and X-ray diffraction respectively. Thus, the dispersion fraction of surface free energy can be engineered to play an important role in achieving enhanced metabolic activity of the MWCNT-Al2O3 reinforced UHMWPE biopolymer composites. Copyright © 2014 Elsevier B.V. All rights reserved.

Incorporating priors on expert performance parameters for segmentation validation and label fusion: a maximum a posteriori STAPLE

PubMed Central

Commowick, Olivier; Warfield, Simon K

2010-01-01

In order to evaluate the quality of segmentations of an image and assess intra- and inter-expert variability in segmentation performance, an Expectation Maximization (EM) algorithm for Simultaneous Truth And Performance Level Estimation (STAPLE) was recently developed. This algorithm, originally presented for segmentation validation, has since been used for many applications, such as atlas construction and decision fusion. However, the manual delineation of structures of interest is a very time consuming and burdensome task. Further, as the time required and burden of manual delineation increase, the accuracy of the delineation is decreased. Therefore, it may be desirable to ask the experts to delineate only a reduced number of structures or the segmentation of all structures by all experts may simply not be achieved. Fusion from data with some structures not segmented by each expert should be carried out in a manner that accounts for the missing information. In other applications, locally inconsistent segmentations may drive the STAPLE algorithm into an undesirable local optimum, leading to misclassifications or misleading experts performance parameters. We present a new algorithm that allows fusion with partial delineation and which can avoid convergence to undesirable local optima in the presence of strongly inconsistent segmentations. The algorithm extends STAPLE by incorporating prior probabilities for the expert performance parameters. This is achieved through a Maximum A Posteriori formulation, where the prior probabilities for the performance parameters are modeled by a beta distribution. We demonstrate that this new algorithm enables dramatically improved fusion from data with partial delineation by each expert in comparison to fusion with STAPLE. PMID:20879379

Incorporating priors on expert performance parameters for segmentation validation and label fusion: a maximum a posteriori STAPLE.

PubMed

Commowick, Olivier; Warfield, Simon K

2010-01-01

In order to evaluate the quality of segmentations of an image and assess intra- and inter-expert variability in segmentation performance, an Expectation Maximization (EM) algorithm for Simultaneous Truth And Performance Level Estimation (STAPLE) was recently developed. This algorithm, originally presented for segmentation validation, has since been used for many applications, such as atlas construction and decision fusion. However, the manual delineation of structures of interest is a very time consuming and burdensome task. Further, as the time required and burden of manual delineation increase, the accuracy of the delineation is decreased. Therefore, it may be desirable to ask the experts to delineate only a reduced number of structures or the segmentation of all structures by all experts may simply not be achieved. Fusion from data with some structures not segmented by each expert should be carried out in a manner that accounts for the missing information. In other applications, locally inconsistent segmentations may drive the STAPLE algorithm into an undesirable local optimum, leading to misclassifications or misleading experts performance parameters. We present a new algorithm that allows fusion with partial delineation and which can avoid convergence to undesirable local optima in the presence of strongly inconsistent segmentations. The algorithm extends STAPLE by incorporating prior probabilities for the expert performance parameters. This is achieved through a Maximum A Posteriori formulation, where the prior probabilities for the performance parameters are modeled by a beta distribution. We demonstrate that this new algorithm enables dramatically improved fusion from data with partial delineation by each expert in comparison to fusion with STAPLE.

Development of Bt Rice and Bt Maize in China and Their Efficacy in Target Pest Control

PubMed Central

Liu, Qingsong; Hallerman, Eric; Peng, Yufa; Li, Yunhe

2016-01-01

Rice and maize are important cereal crops that serve as staple foods, feed, and industrial material in China. Multiple factors constrain the production of both crops, among which insect pests are an important one. Lepidopteran pests cause enormous yield losses for the crops annually. In order to control these pests, China plays an active role in development and application of genetic engineering (GE) to crops, and dozens of GE rice and GE maize lines expressing insecticidal proteins from the soil bacterium Bacillus thuringiensis (Bt) have been developed. Many lines have entered environmental release, field testing, and preproduction testing, and laboratory and field experiments have shown that most of the Bt rice and Bt maize lines developed in China exhibited effective control of major target lepidopteran pests on rice (Chilo suppressalis, Scirpophaga incertulas, and Cnaphalocrocis medinalis) and maize (Ostrinia furnacalis), demonstrating bright prospects for application. However, none of these Bt lines has yet been commercially planted through this writing in 2016. Challenges and perspectives for development and application of Bt rice and maize in China are discussed. This article provides a general context for colleagues to learn about research and development of Bt crops in China, and may shed light on future work in this field. PMID:27763554

Development of Bt Rice and Bt Maize in China and Their Efficacy in Target Pest Control.

PubMed

Liu, Qingsong; Hallerman, Eric; Peng, Yufa; Li, Yunhe

2016-10-18

Rice and maize are important cereal crops that serve as staple foods, feed, and industrial material in China. Multiple factors constrain the production of both crops, among which insect pests are an important one. Lepidopteran pests cause enormous yield losses for the crops annually. In order to control these pests, China plays an active role in development and application of genetic engineering (GE) to crops, and dozens of GE rice and GE maize lines expressing insecticidal proteins from the soil bacterium Bacillus thuringiensis ( Bt ) have been developed. Many lines have entered environmental release, field testing, and preproduction testing, and laboratory and field experiments have shown that most of the Bt rice and Bt maize lines developed in China exhibited effective control of major target lepidopteran pests on rice ( Chilo suppressalis , Scirpophaga incertulas , and Cnaphalocrocis medinalis ) and maize ( Ostrinia furnacalis ), demonstrating bright prospects for application. However, none of these Bt lines has yet been commercially planted through this writing in 2016. Challenges and perspectives for development and application of Bt rice and maize in China are discussed. This article provides a general context for colleagues to learn about research and development of Bt crops in China, and may shed light on future work in this field.

Maize, tropical (Zea mays L.).

PubMed

Assem, Shireen K

2015-01-01

Maize (Zea mays L.) is the third most important food crop globally after wheat and rice. In sub-Saharan Africa, tropical maize has traditionally been the main staple of the diet; 95 % of the maize grown is consumed directly as human food and as an important source of income for the resource-poor rural population. The biotechnological approach to engineer biotic and abiotic traits implies the availability of an efficient plant transformation method. The production of genetically transformed plants depends both on the ability to integrate foreign genes into target cells and the efficiency with which plants are regenerated. Maize transformation and regeneration through immature embryo culture is the most efficient system to regenerate normal transgenic plants. However, this system is highly genotype dependent. Genotypes adapted to tropic areas are difficult to regenerate. Therefore, transformation methods used with model genotypes adapted to temperate areas are not necessarily efficient with tropical lines. Agrobacterium-mediated transformation is the method of choice since it has been first achieved in 1996. In this report, we describe a transformation method used successfully with several tropical maize lines. All the steps of transformation and regeneration are described in details. This protocol can be used with a wide variety of tropical lines. However, some modifications may be needed with recalcitrant lines.

Workable male sterility systems for hybrid rice: Genetics, biochemistry, molecular biology, and utilization.

PubMed

Huang, Jian-Zhong; E, Zhi-Guo; Zhang, Hua-Li; Shu, Qing-Yao

2014-12-01

The exploitation of male sterility systems has enabled the commercialization of heterosis in rice, with greatly increased yield and total production of this major staple food crop. Hybrid rice, which was adopted in the 1970s, now covers nearly 13.6 million hectares each year in China alone. Various types of cytoplasmic male sterility (CMS) and environment-conditioned genic male sterility (EGMS) systems have been applied in hybrid rice production. In this paper, recent advances in genetics, biochemistry, and molecular biology are reviewed with an emphasis on major male sterility systems in rice: five CMS systems, i.e., BT-, HL-, WA-, LD- and CW- CMS, and two EGMS systems, i.e., photoperiod- and temperature-sensitive genic male sterility (P/TGMS). The interaction of chimeric mitochondrial genes with nuclear genes causes CMS, which may be restored by restorer of fertility (Rf) genes. The PGMS, on the other hand, is conditioned by a non-coding RNA gene. A survey of the various CMS and EGMS lines used in hybrid rice production over the past three decades shows that the two-line system utilizing EGMS lines is playing a steadily larger role and TGMS lines predominate the current two-line system for hybrid rice production. The findings and experience gained during development and application of, and research on male sterility in rice not only advanced our understanding but also shed light on applications to other crops.

The tissue-selecting technique: segmental stapled hemorrhoidopexy.

PubMed

Lin, Hong-Cheng; Lian, Lei; Xie, Shang-Kui; Peng, Hui; Tai, Jian-Dong; Ren, Dong-Lin

2013-11-01

We describe a technique for the management of prolapsing hemorrhoids, with the aim to minimize the risk of anal stricture and rectovaginal fistula and to reduce the impact of the stapling technique on rectal compliance. This modified procedure was successfully applied in China, and preliminary data showed promising outcomes (see Video, Supplemental Digital Content 1, http://links.lww.com/DCR/A117).

Statistical fusion of continuous labels: identification of cardiac landmarks

NASA Astrophysics Data System (ADS)

Xing, Fangxu; Soleimanifard, Sahar; Prince, Jerry L.; Landman, Bennett A.

2011-03-01

Image labeling is an essential task for evaluating and analyzing morphometric features in medical imaging data. Labels can be obtained by either human interaction or automated segmentation algorithms. However, both approaches for labeling suffer from inevitable error due to noise and artifact in the acquired data. The Simultaneous Truth And Performance Level Estimation (STAPLE) algorithm was developed to combine multiple rater decisions and simultaneously estimate unobserved true labels as well as each rater's level of performance (i.e., reliability). A generalization of STAPLE for the case of continuous-valued labels has also been proposed. In this paper, we first show that with the proposed Gaussian distribution assumption, this continuous STAPLE formulation yields equivalent likelihoods for the bias parameter, meaning that the bias parameter-one of the key performance indices-is actually indeterminate. We resolve this ambiguity by augmenting the STAPLE expectation maximization formulation to include a priori probabilities on the performance level parameters, which enables simultaneous, meaningful estimation of both the rater bias and variance performance measures. We evaluate and demonstrate the efficacy of this approach in simulations and also through a human rater experiment involving the identification the intersection points of the right ventricle to the left ventricle in CINE cardiac data.

Estimated Dietary Exposure to Mycotoxins after Taking into Account the Cooking of Staple Foods in Japan

PubMed Central

Sakuma, Hisako; Watanabe, Yasushi; Furusawa, Hiroko; Yoshinari, Tomoya; Akashi, Hajime; Kawakami, Hiroshi; Saito, Shiro; Sugita-Konishi, Yoshiko

2013-01-01

Mycotoxins are commonly present in cereal grains and are not completely destroyed during their cooking and processing. When mycotoxins contaminate staple foods, the risk for exposure becomes serious. In East Asia, including Japan, rice is consumed as a staple food, and with the increasingly Westernized lifestyle, the consumption of wheat has increased. The mycotoxins commonly associated with rice and wheat are total aflatoxin (AFL) and ochratoxin A (OTA), respectively. This study examined the retention of AFL and OTA during the cooking of rice and pasta. AFL was retained at 83%–89% the initial level after the cooking of steamed rice. In pasta noodles, more than 60% of the OTA was retained. These results show that AFL and OTA are relatively stable during the cooking process, suggesting that a major reduction in the exposure to these mycotoxins cannot be expected to occur by cooking rice and pasta. The estimated exposure assessment at the high consumer level (95th percentile) and the mycotoxin contamination level determined by taking into account these reductions in the present study should be useful for the establishment of practical regulations for mycotoxins in staple foods. PMID:23698358

Comparative Study of Hand-Sutured versus Circular Stapled Anastomosis for Gastrojejunostomy in Laparoscopy Assisted Distal Gastrectomy

PubMed Central

Seo, Su Hyun; Kim, Min Chan; Choi, Hong Jo; Jung, Ghap Joong

2012-01-01

Purpose Mechanical stapler is regarded as a good alternative to the hand sewing technique, when used in gastric reconstruction. The circular stapling method has been widely applied to gastrectomy (open orlaparoscopic), for gastric cancer. We illustrated and compared the hand-sutured method to the circular stapling method, for Billroth-II, in patients who underwent laparoscopy assisted distal gastrectomy for gastric cancer. Materials and Methods Between April 2009 and May 2011, 60 patients who underwent laparoscopy assisted distal gastrectomy, with Billroth-II, were enrolled. Hand-sutured Billroth-II was performed in 40 patients (manual group) and circular stapler Billroth-II was performed in 20 patients (stapler group). Clinicopathological features and post-operative outcomes were evaluated and compared between the two groups. Results Nosignificant differences were observed in clinicopathologic parameters and post-operative outcomes, except in the operation times. Operation times and anastomosis times were significantly shorter in the stapler group (P=0.004 and P<0.001). Conclusions Compared to the hand-sutured method, the circular stapling method can be applied safely and more efficiently, when performing Billroth-II anastomosis, after laparoscopy assisted distal gastrectomy in patients with gastric cancer. PMID:22792525

Statistical Fusion of Continuous Labels: Identification of Cardiac Landmarks.

PubMed

Xing, Fangxu; Soleimanifard, Sahar; Prince, Jerry L; Landman, Bennett A

2011-01-01

Image labeling is an essential task for evaluating and analyzing morphometric features in medical imaging data. Labels can be obtained by either human interaction or automated segmentation algorithms. However, both approaches for labeling suffer from inevitable error due to noise and artifact in the acquired data. The Simultaneous Truth And Performance Level Estimation (STAPLE) algorithm was developed to combine multiple rater decisions and simultaneously estimate unobserved true labels as well as each rater's level of performance (i.e., reliability). A generalization of STAPLE for the case of continuous-valued labels has also been proposed. In this paper, we first show that with the proposed Gaussian distribution assumption, this continuous STAPLE formulation yields equivalent likelihoods for the bias parameter, meaning that the bias parameter-one of the key performance indices-is actually indeterminate. We resolve this ambiguity by augmenting the STAPLE expectation maximization formulation to include a priori probabilities on the performance level parameters, which enables simultaneous, meaningful estimation of both the rater bias and variance performance measures. We evaluate and demonstrate the efficacy of this approach in simulations and also through a human rater experiment involving the identification the intersection points of the right ventricle to the left ventricle in CINE cardiac data.

Staple Food Self-Sufficiency of Farmers Household Level in The Great Solo

NASA Astrophysics Data System (ADS)

Darsono

2017-04-01

Analysis of food security level of household is a novelty of measurement standards which usually includes regional and national levels. With household approach is expected to provide the basis of sharp food policy formulation. The purpose of this study are to identify the condition of self-sufficiency in staple foods, and to find the main factors affecting the dynamics of self-sufficiency in staple foods on farm household level in Great Solo. Using primary data from 50 farmers in the sample and secondary data in Great Solo (Surakarta city, Boyolali, Sukoharjo, Karanganyar, Wonogiri, Sragen and Klaten). Compiled panel data were analyzed with linear probability regression models to produce a good model. The results showed that farm households in Great Solo has a surplus of staple food (rice) with an average consumption rate of 96.8 kg/capita/year. This number is lower than the national rate of 136.7 kg/capita/year. The main factors affecting the level of food self-sufficiency in the farmer household level are: rice production, rice consumption, land tenure, and number of family members. Key recommendations from this study are; improvement scale of the land cultivation for rice farming and non-rice diversification consumption.

A Single Institution Review of Initial Application of a 5-mm Stapler

PubMed Central

Zens, Tiffany J.; Kohler, Jonathan E.; Le, Hau D.; Nichol, Peter F.; Leys, Charles M.

2016-01-01

Abstract Background: Operating in small spaces presents physical constraints that can be even more challenging in minimally invasive operations. Recently, a 5-mm stapler was approved for use in general surgery and pediatric surgery. Here, we present our initial experience using the 5-mm stapler in pediatric general surgery. Materials and Methods: A retrospective chart review was conducted to identify cases using the 5-mm stapler at our institution. Demographic data included age (in months) and weight (in kilograms). Operative data included indication for use, number of loads used, complications related to 5-mm stapler use, and interventions to address complications. A second review focused on patients undergoing the same operations, but using a 10-mm stapler. Results: A total of 60 staple loads were deployed in 32 procedures. There were four adverse outcomes, all recognized intraoperatively. One bleed resulted from application on irradiated tissue and another bleed from application to a small noninflamed mesoappendix. A bronchial staple line leak resulted from improper stapler loading, and a bowel anastomosis leak was oversewn with a single stitch. When compared with 32 matched cases using a 10-mm stapler, there was no difference in age (5-mm = 39.11 months, 10-mm = 50.21 months, P = .49) or weight (5-mm = 16.34 kg, 10-mm = 19.93 kg, P = .51). A total of 60 staple applications were used, with one bleed noted. There was no significant difference in overall complication rate (5-mm rate = 4/60, 10-mm rate = 1/60; P = .36). Conclusion: Our initial experience suggests that although there were more complications with the 5-mm stapler, there is no statistically significant difference in complication rates when compared with the 10-mm stapler. Furthermore, the 5-mm stapler complications can be corrected with device training and proper patient selection. In appropriately selected pediatric surgery cases with size limitations, the 5-mm stapler can be used to minimize the invasiveness of the operation. PMID:27398952

The business case for transitioning to safer chemicals.

PubMed

McFadden, Roger D

2011-01-01

Emerging domestic and international chemical regulations and a heightened consumer awareness of chemicals of concern in products is challenging American businesses to reevaluate and reconsider their approaches to supply chain management and product design. Some of these companies recognize business opportunities and are responding proactively with innovative strategies and tactics. This article describes steps that Staples Inc., the world's largest office products provider, is taking to meet demand for products that are safer and more sustainable. In trying to meet the demand for safer products, Staples faces significant barriers, including the complexity of supply chains, data gaps, and confidential business information. New collaborations between companies, government, and advocates, and improved tools and criteria for defining safer products enhance the ability of businesses, like Staples, to meet new consumer demands.

Azelaic acid was sensitizing effect in the chemotherapeutic treatment of several melanoma cell lines.

PubMed

Rodriguez-Vicente, J; Vicente-Ortega, V; Canteras-Jordana

1996-12-01

Chemotherapy for melanoma results in low response and must be reinforced with sensitizer compounds. We believed that azelaic acid (AZA) could modulate melanomas' resistance to antineoplastics. Therefore we tried to compare in vitro treatment with antineoplastics alone versus AZA treatment followed by antineoplastics. We carried out MTT assays to evaluate the cytotoxicity of melphalan, lomustine (CCNU), fotemustine, and 4-Hydroxyanisole (4-HA) on three melanoma lines (B16F10, SK-MEL-28, and SK-MEL-1), and the modulating effect of pretreatment with AZA (1 mM). AZA showed a dose-dependent antineoplastic activity on the three lines. Melphalan was the most active drug followed by CCNU, fotemustine, and 4-HA. The most sensitive line was B16F10 and the least sensitive was SK-meL-1. Previous treatment with AZA of B16F10 reinforced the effect of melphalan (2.5 times), CCNU (10 times), and fotemustine (14 times); whereas for SK-MEL-28 and SK-MEL-1, only the cytotoxicity of CCNU and fotemustine increased. An antagonist effect was produced by 4-HA on all three lines. We concluded that AZA enhances in vitro cytotoxicity of CCNU and fotemustine.

A note on the cracked plates reinforced by a line stiffener

NASA Technical Reports Server (NTRS)

Yahsi, O. S.; Erdogan, F.

1983-01-01

The problem of a cracked plate reinforced by a line stiffener is reconsidered. The original solution of this problem was given in the literature. Also, a variation of the problem with debonding between the plate and the stiffener near the cracked region was reported in the literature. However, the special case of the problem in which the crack tip terminates at the stiffener does not appear to have been studied. In practice, the solution may be necessary in order to assess the crack arrest effectiveness of the stiffener. The problem of a stiffened plate with a crack is reformulated, the asymptotic stress state near the crack tip terminating at the stiffener is examined, and numerical results are given for various stiffness constants.

The growing importance of staple foods and condiments used as ingredients in the food industry and implications for large-scale food fortification programs in Southeast Asia.

PubMed

Spohrer, Rebecca; Larson, Melanie; Maurin, Clémence; Laillou, Arnaud; Capanzana, Mario; Garrett, Greg S

2013-06-01

Food fortification is a viable strategy to improve the nutritional status of populations. In Southeast Asia, recent growth and consolidation of the food industry provides an opportunity to explore whether certain widely consumed processed foods could contribute to micronutrient status if they are made with adequately fortified staples and condiments. To estimate the potential contribution certain processed foods can make to micronutrient intake in Southeast Asia if they are made with fortified staples and condiments; e.g., via the inclusion of iodized salt in various processed foods in the Philippines, fortified wheat flour in instant noodles in Indonesia, and fortified vegetable oil in biscuits in Vietnam. For Indonesia, the Philippines, and Vietnam, a review of consumption trends, relevant policies, and industry practices was conducted using publicly available sources,food industry market data and research reports, and oral communication. These informed the estimates of the proportion of the Recommended Nutrient Intake (RNI) that could be delivered via select processed foods. In the Philippines, Indonesia, and Vietnam, the processed food industry is not always required to use fortified staples and condiments. In the Philippines, dried salted fish with iodized salt would provide 64% to 85% of the iodine RNI for women of reproductive age and 107% to 141% of the iodine RNI for children 1 to 6 years of age. In Indonesia, a 75-g pack of instant noodles (a highly consumed product) with fortified wheat flour would provide 45% to 51% of the iron RNI for children 4 to 6 years of age and 10% to 11% of the iron RNI for women of reproductive age. In Vietnam, biscuits containing vegetable oil are increasingly popular. One 35-g biscuit serving with fortified vegetable oil would provide 13% to 18% of the vitamin A RNI for children 4 to 6 years of age and 12% to 17% of the vitamin A RNI for women of reproductive age. Ensuring that fortified staples and condiments such as flour, salt, and vegetable oil are used in widely consumed processed foods would ensure that these foods contribute to improvement in micronutrient intake among populations in Southeast Asia, particularly as the consumption of these foods is increasing. Policymakers and nutrition program managers should consider the contribution to nutritional intake that fortified staples and condiments can provide through processed foods, in addition to being used for cooking in the home, and ensure that the food industry is required to use these fortified staples and condiments rather than nonfortified foods.

Electron-processing technology: A promising application for the viscose industry

NASA Astrophysics Data System (ADS)

Stepanik, T. M.; Rajagopal, S.; Ewing, D.; Whitehouse, R.

1998-06-01

In marketing its IMPELA ® line of high power, high-throughput industrial accelerators, Atomic Energy of Canada Limited (AECL) is working with viscose (rayon) companies world-wide to integrate electron-processing technology as part of the viscose manufacturing process. The viscose industry converts cellulose wood pulp into products such as staple fiber, filament, cord, film, packaging, and non-edible sausage casings. This multibillion dollar industry is currently suffering from high production costs, and is facing increasingly stringent environmental regulations. The use of electron-treated pulp can significantly lower production costs and can provide equally significant environmental benefits. This paper describes our current understanding of the benefits of using electron-treated pulp in this process, and AECL's efforts in developing this technology.

[Manual suture versus/or mechanical suture from the Austrian viewpoint].

PubMed

Kronberger, L; Germann, R

1987-01-01

A general inquiry was made at surgical units and university clinics in Austria about the anastomosis techniques used between 1980 to 1985. The result was that in 90.3% the suture was made by hand and in 9.7% by machine. The first mentioned was performed as double row inverting suture by 66% of our surgeons, and only in 30% as an all-layer suture. The stapler-technique was mostly preferred for the oesophago-jejunostomy and the high and lower resection of the rectum. A leakage of the suture line was observed in 3.9% after sewing by hand and in 6.3% after stapling. The total lethality finally was 1.4% for hand made suture and 1.8% for apparative suture.

Legume carotenoids.

PubMed

Sri Kantha, S; Erdman, J W

1987-01-01

In recent years, the results of research studies have suggested a positive beneficial relationship between a vegetarian-based diet and low incidence of diseases, including coronary heart disease, cancer, obesity, dental caries, and osteoporosis. beta-Carotene has specifically been suggested as a nutrient with antitumorigenic properties. In this regard there is a need to evaluate the carotenoid content of foods. Legumes are one of the staple components of a vegetarian diet. This review specifically surveys the prevalence of carotenoids in food and forage legumes. In addition, the methods available for carotenoid analysis are discussed; factors affecting the determination of carotenoid content during maturation, germination, processing and storage are identified; research areas which have been inadequately explored are identified; and suggestions are made for future lines of investigation.

Performance of Pallet Nails and Staples in 22 Southern Hardwoods

Treesearch

E.G. Stern

1976-01-01

The effectiveness of pointless, helically threaded, hardened-steel, 3 by O.120-inch, pallet nails with umbrella heads and 21/2-inch, 15-gauge, 7/16-inch crown, plastic-coated, pallet staples in 22 hardwoods grown on southern pine sites was determined on the basis of tests on 522 joints. Specific average performance values were derived from the test data for the tested...

Long-term clinical results of double-pursestring stapled hemorrhoidopexy in a selected group of patients for the treatment of chronic hemorrhoids.

PubMed

Arroyo, Antonio; Pérez-Legaz, Juan; Miranda, Elena; Moya, Pedro; Ruiz-Tovar, Jaime; Lacueva, Francisco-Javier; Candela, Fernando; Calpena, Rafael

2011-05-01

The aim of this prospective controlled trial was to evaluate the long-term clinical and manometric results of stapled hemorrhoidopexy performed by expert surgeons in a selected group of patients for the treatment of chronic hemorrhoids. This study took place in the outpatient clinic and at the Day Surgery Unit attached to the University Hospital of Elche. From March 2003 to May 2005, 200 consecutive patients with third-degree hemorrhoids and treated with double-pursestring stapled hemorrhoidopexy with a PPH33-03 stapler were included in the study. Demographic, manometric, and clinical features were analyzed, as well as the variables related to surgery, postoperative course, and follow-up. Manometry was repeated at the 6-month, 1-year, and 5-year follow-up. Median follow-up was 110 months. Four patients (2%) reported daily rectal bleeding. One patient with active rectal bleeding was taken for reoperation within the first 12 postoperative hours. Seventy percent of patients reported pain ≤ 2 on the first postoperative day, 85% on the fourth postoperative day, and 95% on the seventh postoperative day. Pain was measured with a linear analog scale from 0 to 10 (0 = no pain; 10 = unbearable pain). Seventeen patients (8.5%) reported tenesmus during the first week. Eight patients (4%) reported persistent pain: in 5 patients, the pain resolved within the next 6 months; 2 patients presented with anal fissure; and 1 patient required the removal of the staples. Two patients (1%) reported residual soiling at the 5-year revision. Fourteen patients (7%) experienced recurrence with symptomatic prolapse. Six (3%) underwent further surgery: stapled hemorrhoidopexy was indicated again in 2 patients, and 4 patients underwent a Milligan-Morgan open hemorrhoidectomy, because they did not have a uniform prolapse. Six patients required treatment with rubber band ligation. There were no statistically significant differences between preoperative and postoperative manometric values. The new PPH33-03 stapler, the learning process of the modified surgical procedure, and the correct selection of patients will overcome the main objections to stapled hemorrhoidopexy.

Stapled haemorrhoidopexy transiently decreases rectal compliance and sensitivity.

PubMed

Filho, F L A; Macedo, G M; Dos Santos, A A; Rodrigues, L V; Oliveira, R B; Nobre E Souza, M A

2011-02-01

Stapled haemorrhoidopexy may damage the anorectal musculature and its sensorimotor function. Most studies have not used a barostat for the measurement of compliance. This study aimed to investigate the effect of stapled haemorrhoidopexy on rectal compliance and sensitivity. After Ethical Committee approval, we studied 10 male patients (mean age 33.8 years) with third- or fourth-degree haemorrhoids. Rectal compliance and sensitivity were measured with a 600-ml bag and an electronic barostat. Volunteers were submitted to two consecutive rectal distension protocols, including continuous distension at 2, 4 and 6 months after stapled haemorrhoidopexy. Intraluminal volume and pressure were recorded, including the first rectal sensation, desire to defecate and onset of rectal pain. Another group of 10 male control patients (mean age 24.9 years) with pilonidal sinus and no haemorrhoids was also included in the study. Two months after stapled haemorrhoidopexy, rectal compliance decreased (7.1 ± 0.2 vs 5.3 ± 0.1, 6.4 ± 0.1 vs 5.1 ± 0.1 and 5.6 ± 0.2 vs 4.7 ± 0.1 ml/mmHg for first rectal sensation, desire to defecate and rectal pain, respectively; P < 0.05). The sensitivity threshold volume did not change for the first sensation but decreased significantly for the desier to defecate and pain (p <0.05) (116.8 ± 13.8 vs 148.4 ± 14.61, 251.1 ± 8.9 vs 185.8 ± 8.6 and 293.3 ± 16.6 vs 221.2 ± 6.0 ml for first rectal sensation, desire to defecate and rectal pain, respectively). Four and 6 months after surgery, rectal compliance and sensitivity returned to levels similar to those in the basal period. Muscle tissue was found in only three of the 10 resected doughnuts. Controls remained without any change in rectal compliance and sensitivity. Stapled haemorrhoidopexy transiently decreases rectal compliance and sensitivity threshold in young male patients. © 2010 The Authors. Colorectal Disease © 2010 The Association of Coloproctology of Great Britain and Ireland.

A State-of-the-Art Review on Soil Reinforcement Technology Using Natural Plant Fiber Materials: Past Findings, Present Trends and Future Directions.

PubMed

Gowthaman, Sivakumar; Nakashima, Kazunori; Kawasaki, Satoru

2018-04-04

Incorporating sustainable materials into geotechnical applications increases day by day due to the consideration of impacts on healthy geo-environment and future generations. The environmental issues associated with conventional synthetic materials such as cement, plastic-composites, steel and ashes necessitate alternative approaches in geotechnical engineering. Recently, natural fiber materials in place of synthetic material have gained momentum as an emulating soil-reinforcement technique in sustainable geotechnics. However, the natural fibers are innately different from such synthetic material whereas behavior of fiber-reinforced soil is influenced not only by physical-mechanical properties but also by biochemical properties. In the present review, the applicability of natural plant fibers as oriented distributed fiber-reinforced soil (ODFS) and randomly distributed fiber-reinforced soil (RDFS) are extensively discussed and emphasized the inspiration of RDFS based on the emerging trend. Review also attempts to explore the importance of biochemical composition of natural-fibers on the performance in subsoil reinforced conditions. The treatment methods which enhances the behavior and lifetime of fibers, are also presented. While outlining the current potential of fiber reinforcement technology, some key research gaps have been highlighted at their importance. Finally, the review briefly documents the future direction of the fiber reinforcement technology by associating bio-mediated technological line.

A State-of-the-Art Review on Soil Reinforcement Technology Using Natural Plant Fiber Materials: Past Findings, Present Trends and Future Directions

PubMed Central

Gowthaman, Sivakumar; Nakashima, Kazunori; Kawasaki, Satoru

2018-01-01

Incorporating sustainable materials into geotechnical applications increases day by day due to the consideration of impacts on healthy geo-environment and future generations. The environmental issues associated with conventional synthetic materials such as cement, plastic-composites, steel and ashes necessitate alternative approaches in geotechnical engineering. Recently, natural fiber materials in place of synthetic material have gained momentum as an emulating soil-reinforcement technique in sustainable geotechnics. However, the natural fibers are innately different from such synthetic material whereas behavior of fiber-reinforced soil is influenced not only by physical-mechanical properties but also by biochemical properties. In the present review, the applicability of natural plant fibers as oriented distributed fiber-reinforced soil (ODFS) and randomly distributed fiber-reinforced soil (RDFS) are extensively discussed and emphasized the inspiration of RDFS based on the emerging trend. Review also attempts to explore the importance of biochemical composition of natural-fibers on the performance in subsoil reinforced conditions. The treatment methods which enhances the behavior and lifetime of fibers, are also presented. While outlining the current potential of fiber reinforcement technology, some key research gaps have been highlighted at their importance. Finally, the review briefly documents the future direction of the fiber reinforcement technology by associating bio-mediated technological line. PMID:29617285

Thermographic Analysis of Composite Cobonds on the X-33

NASA Technical Reports Server (NTRS)

Russell, S. S.; Walker, J. L.; Lansing, M. D.

2001-01-01

During the manufacture of the X-33 liquid hydrogen (LH2) Tank 2, a total of 36 reinforcing caps were inspected thermographically. The cured reinforcing sheets of graphite/epoxy were bonded to the tank using a wet cobond process with vacuum bagging and low temperature curing. A foam filler material wedge separated the reinforcing caps from the outer skin of the tank. Manufacturing difficulties caused by a combination of the size of the reinforcing caps and their complex geometry lead to a potential for trapping air in the bond line. An inspection process was desired to ensure that the bond line was free of voids before it had cured so that measures could be taken to rub out the entrapped air or remove the cap and perform additional surface matching. Infrared thermography was used to perform the procure 'wet bond' inspection as well a to document the final 'cured' condition of the caps. The thermal map of the bond line was acquired by heating the cap with either a flash lamp or a set of high intensity quartz lamps and then viewing it during cool down. The inspections were performed through the vacuum bag and voids were characterized by localized hot spots. In order to ensure that the cap had bonded to the tank properly, a post cure 'flash heating' thermographic investigation was performed with the vacuum bag removed. Any regions that had opened up after the preliminary inspection or that were hidden during the bagging operation were marked and filled by drilling small holes in the cap and injecting resin. This process was repeated until all critical sized voids were filled.

Thermographic Analysis of Composite Cobonds on the X-33

NASA Technical Reports Server (NTRS)

Russell, Samuel S.; Walker, James L.; Lansing, Matthew D.; Whitaker, Ann F. (Technical Monitor)

2000-01-01

During the manufacture of the X-33 liquid hydrogen (LH2) Tank 2, a total of thirty-six reinforcing caps were inspected thermographically. The cured reinforcing sheets of graphite/epoxy were bonded to the tank using a wet cobond process with vacuum bagging and low temperature curing. A foam filler material wedge separated the reinforcing caps from the outer skin of the tank. Manufacturing difficulties caused by a combination of the size of the reinforcing caps and their complex geometry lead to a potential for trapping air in the bond line. An inspection process was desired to ensure that the bond line was free of voids before it had cured so that measures could be taken to rub out the entrapped air or remove the cap and perform additional surface matching. Infrared thermography was used to perform the precure "wet bond" inspection as well as to document the final "cured" condition of the caps. The thermal map of the bond line was acquired by heating the cap with either a flash lamp or a set of high intensity quartz lamps and then viewing it during cool down. The inspections were performed through the vacuum bag and voids were characterized by localized hot spots. In order to ensure that the cap had bonded to the tank properly, a post cure "flash heating" thermographic investigation was performed with the vacuum bag removed. Any regions that had opened up after the preliminary inspection or that were hidden during the bagging operation were marked and filled by drilling small holes in the cap and injecting resin. This process was repeated until all critical sized voids were filled.

Exploratory Development of Improved Fatigue Strength Adhesives

DTIC Science & Technology

1974-11-01

fiber reinforced adhesives. A fifty-fold in-j crease in fatigue life at equivalent stress levels was achieved when a woven high modulus graphite...the stress level which could survive 10’ fatigue cycles was increased from approximately 30 percent of the ultimate shear strength with nylor knit...supports to as much as fifty percent with the high modulus fiber bond line reinforcement. The stress level which could withstand 10’ fatigue cycles

Nondestructive Evaluation of Fiber Reinforced Composites. A State-of-the-Art Survey. Volume 1. NDE of Graphite Fiber-Reinforced Plastic Composites. Part 1. Radiography and Ultrasonics

DTIC Science & Technology

1982-03-01

20 14. Particle Displacements in Elastic Waves...fibers, which in 1978 (Ref. 3). was about 159,000 kg, is expected to grow 300 to 40% annually, and along with the multimillion pound pro- 2...inherent radiation source is used. Neutrons are electrically neu- limitations. Since radiation traveling in straight lines tral particles that are

The synthesis and coupling of photoreactive collagen-based peptides to restore integrin reactivity to an inert substrate, chemically-crosslinked collagen

PubMed Central

Malcor, Jean-Daniel; Bax, Daniel; Hamaia, Samir W.; Davidenko, Natalia; Best, Serena M.; Cameron, Ruth E.; Farndale, Richard W.; Bihan, Dominique

2016-01-01

Collagen is frequently advocated as a scaffold for use in regenerative medicine. Increasing the mechanical stability of a collagen scaffold is widely achieved by cross-linking using 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide (EDC) and N-hydroxysuccinimide (NHS). However, this treatment consumes the carboxylate-containing amino acid sidechains that are crucial for recognition by the cell-surface integrins, abolishing cell adhesion. Here, we restore cell reactivity to a cross-linked type I collagen film by covalently linking synthetic triple-helical peptides (THPs), mimicking the structure of collagen. These THPs are ligands containing an active cell-recognition motif, GFOGER, a high-affinity binding site for the collagen-binding integrins. We end-stapled peptide strands containing GFOGER by coupling a short diglutamate-containing peptide to their N-terminus, improving the thermal stability of the resulting THP. A photoreactive Diazirine group was grafted onto the end-stapled THP to allow covalent linkage to the collagen film upon UV activation. Such GFOGER-derivatized collagen films showed restored affinity for the ligand-binding I domain of integrin α2β1, and increased integrin-dependent cell attachment and spreading of HT1080 and Rugli cell lines, expressing integrins α2β1 and α1β1, respectively. The method we describe has wide application, beyond collagen films or scaffolds, since the photoreactive diazirine will react with many organic carbon skeletons. PMID:26854392

[Closure of pancreas stump after distal and segmental resection : Suture, stapler, coverage or anastomosis?

PubMed

Michalski, C W; Tramelli, P; Büchler, M W; Hackert, T

2017-01-01

Postoperative pancreatic fistulas represent the most frequent complication after distal and segmental pancreatectomy and occur with a frequency of up to 50 %. There are many technical variations of pancreatic stump treatment for reduction of fistula rates after distal resection. Most of these techniques have only been analyzed in retrospective studies and the evidence for or against a specific technique is low. Several retrospective trials have been conducted with good results to compare suturing with stapled closure of the remnant and to assess the effect of a vascularized falciform ligament patch in reducing postoperative pancreatic fistula; however, in a recently published randomized trial, which analyzed closure of the remnant with a pancreaticojejunostomy compared to standard closure, these results could not be confirmed. Because stapler resection and closure is the most commonly used technique in laparoscopic distal pancreatectomy, there are a large number of studies which assessed various novel methods of improving stapling. Extended stapler compression time and mesh augmentation of the stapler line can be valid methods to reduce fistula rates. Central pancreatectomy is a relatively rarely used procedure where the right-sided pancreatic remnant is closed in the same fashion as during distal pancreatectomy and the left-sided remnant is connected to the intestines with a pancreaticojejunostomy or pancreaticogastrostomy. In conclusion, postoperative pancreatic fistula rates are still a relevant clinical problem after distal pancreatectomy and further studies on potentially improved novel techniques are required.

Influence of intraoperative hypotension on leaks after sleeve gastrectomy.

PubMed

Nienhuijs, Simon W; Kaymak, Uzay; Korsten, Erik; Buise, Marc P

2016-01-01

Leak after a sleeve gastrectomy (SG) is a severe complication. Risk factors, such as regional ischemia, increased intraluminal pressure, technical failure of the stapling device, and surgeon error, have been reported. It was hypothesized that intraoperative hypotension is another risk factor for leak, similar to that reported for colorectal surgery. Tertiary teaching hospital in The Netherlands. Results of a 7-year cohort of primary SGs were reviewed in relation to multiple intraoperative blood pressure measurements. The thresholds for the mean pressure were 40 to 70 mm Hg and for the systolic pressure 70 to 100 mm Hg. Only continuous episodes of 15 and 20 minutes were included. Twenty-four leaks were identified in a cohort of 1041 primary SGs. Episodes of systolic blood pressure<100 mm Hg for 15 min (P = .027) and 20 minutes (P = .008) were significantly related to a staple line leak. An episode of mean blood pressure<70 mm Hg for 20 min was significantly related to leak (P = .014). Episodes with lower thresholds of pressure occurred less frequently and revealed no significant differences. Other identified risk factors were smoking (P = .019), fast-track recovery program (P = .006), use of a tri-stapler (P = .004), and duration of surgery (P = .000). In a multivariate analysis, only intraoperative systolic pressure<100 mm Hg for 20 minutes remained significant (odds ratio, 2.45; P = .012). Intraoperative hypotension may contribute independently to a leak after SG. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Transverse momentum-dependent parton distribution functions from lattice QCD

DOE Office of Scientific and Technical Information (OSTI.GOV)

Michael Engelhardt, Philipp Haegler, Bernhard Musch, John Negele, Andreas Schaefer

Transverse momentum-dependent parton distributions (TMDs) relevant for semi-inclusive deep inelastic scattering (SIDIS) and the Drell-Yan process can be defined in terms of matrix elements of a quark bilocal operator containing a staple-shaped Wilson connection. Starting from such a definition, a scheme to determine TMDs in lattice QCD is developed and explored. Parametrizing the aforementioned matrix elements in terms of invariant amplitudes permits a simple transformation of the problem to a Lorentz frame suited for the lattice calculation. Results for the Sivers and Boer-Mulders transverse momentum shifts are obtained using ensembles at the pion masses 369MeV and 518MeV, focusing in particularmore » on the dependence of these shifts on the staple extent and a Collins-Soper-type evolution parameter quantifying proximity of the staples to the light cone.« less

VERNIER CHRONOTRON UTILIZING AT LEAST TWO SHORTED DELAY LINES

DOEpatents

Rufer, R.P.

1964-02-25

An improved vernier chronotron featuring pulse-forming circuits of a ringing'' or back and forth'' oscillatory type is described. A delay line shorted at both ends together with transistor circuitry to introduce a pulse into that line and also to provide reinforcement of the pulse as it oscillates between the pulse-reflective extremities is provided. A transistorized coincidence circuit is also provided. Enhanced measurement of time intervals in the nanosecond range is afforded. (AEC)

The Curse of Planning: Dissecting multiple reinforcement learning systems by taxing the central executive

PubMed Central

Otto, A. Ross; Gershman, Samuel J.; Markman, Arthur B.; Daw, Nathaniel D.

2013-01-01

A number of accounts of human and animal behavior posit the operation of parallel and competing valuation systems in the control of choice behavior. Along these lines, a flexible but computationally expensive model-based reinforcement learning system has been contrasted with a less flexible but more efficient model-free reinforcement learning system. The factors governing which system controls behavior—and under what circumstances—are still unclear. Based on the hypothesis that model-based reinforcement learning requires cognitive resources, we demonstrate that having human decision-makers perform a demanding secondary task engenders increased reliance on a model-free reinforcement learning strategy. Further, we show that across trials, people negotiate this tradeoff dynamically as a function of concurrent executive function demands and their choice latencies reflect the computational expenses of the strategy employed. These results demonstrate that competition between multiple learning systems can be controlled on a trial-by-trial basis by modulating the availability of cognitive resources. PMID:23558545

Optimization of Production Lines and Cross-sections of Fiberglass Rebar

NASA Astrophysics Data System (ADS)

Maksimov, S. P.; Dildin, A. N.; Maksimova, A. E.

2017-11-01

The article substantiates the need of the construction industry in new lightweight and durable materials that ensure reduction in the cost of work and increase in the operational characteristics of the constructed facilities. These materials include fiberglass reinforcement which is an auxiliary bar made of heavy-duty glass fibers impregnated with a polymer adhesive composition and additionally entwined to create a ribbed surface and tight fit with fiberglass threads. This fitting has undeniable advantages in comparison with steel fittings. The polymer composite is resistant to corroding medium, does not corrode, does not conduct electricity, has high elastic properties, low thermal conductivity, increased tensile strength, etc. It is shown that the issues related to the improvement of technology and the form of a fiberglass rebar section are relevant for the construction industry. So, in particular, the presented developments will significantly reduce the consumption of adhesive composition for impregnating roving threads, reduce production costs by eliminating the loss of adhesive composition in impregnating vessels and pull-guide rollers, increasing the environmental friendliness of production and increasing the line productivity. In addition, it is possible to improve the strength characteristics by optimizing the cross-section and longitudinal cross-sections of the resulting fiberglass reinforcement. The presented changes in the design and technology of fiberglass reinforcement production can be realized as a separate independent module. It is easy to integrate into existing lines during repair work or routine maintenance of equipment.

Stapled peptides as a new technology to investigate protein-protein interactions in human platelets.

PubMed

Iegre, Jessica; Ahmed, Niaz S; Gaynord, Josephine S; Wu, Yuteng; Herlihy, Kara M; Tan, Yaw Sing; Lopes-Pires, Maria E; Jha, Rupam; Lau, Yu Heng; Sore, Hannah F; Verma, Chandra; O' Donovan, Daniel H; Pugh, Nicholas; Spring, David R

2018-05-28

Platelets are blood cells with numerous crucial pathophysiological roles in hemostasis, cardiovascular thrombotic events and cancer metastasis. Platelet activation requires the engagement of intracellular signalling pathways that involve protein-protein interactions (PPIs). A better understanding of these pathways is therefore crucial for the development of selective anti-platelet drugs. New strategies for studying PPIs in human platelets are required to overcome limitations associated with conventional platelet research methods. For example, small molecule inhibitors can lack selectivity and are often difficult to design and synthesise. Additionally, development of transgenic animal models is costly and time-consuming and conventional recombinant techniques are ineffective due to the lack of a nucleus in platelets. Herein, we describe the generation of a library of novel, functionalised stapled peptides and their first application in the investigation of platelet PPIs. Moreover, the use of platelet-permeable stapled Bim BH3 peptides confirms the part of Bim in phosphatidyl-serine (PS) exposure and reveals a role for the Bim protein in platelet activatory processes. Our work demonstrates that functionalised stapled peptides are a complementary alternative to conventional platelet research methods, and could make a significant contribution to the understanding of platelet signalling pathways and hence to the development of anti-platelet drugs.

Finite element analysis and cadaveric cinematic analysis of fixation options for anteriorly implanted trabecular metal interbody cages.

PubMed

Berjano, Pedro; Blanco, Juan Francisco; Rendon, Diego; Villafañe, Jorge Hugo; Pescador, David; Atienza, Carlos Manuel

2015-11-01

To assess, with finite element analysis and an in vitro biomechanical study in cadaver, whether the implementation of an anterior interbody cage made of hedrocel with nitinol shape memory staples in compression increases the stiffness of the stand-alone interbody cage and to compare these constructs' stiffness to other constructs common in clinical practice. A biomechanical study with a finite element analysis and cadaveric testing assessed the stiffness of different fixation modes for the L4-L5 functional spinal unit: intact spine, destabilized spine with discectomy, posterior pedicle-screw fixation, anterior stand-alone interbody cage, anterior interbody cage with bilateral pedicle screws and anterior interbody cage with two shape memory staples in compression. These modalities of vertebral fixation were compared in four loading modes (flexion, extension, lateral bending, and axial rotation). The L4-L5 spinal unit with an anterior interbody cage and two staples was stiffer than the stand-alone cage. The construct stiffness was similar to that of a model of posterior pedicular stabilization. The stiffness was lower than that of the anterior cage plus bilateral pedicle-screw fixation. The use of an anterior interbody implant with shape memory staples in compression may be an alternative to isolated posterior fixation and to anterior isolated implants, with increased stiffness.

Comparison of single-stapling and hemi-double-stapling methods for intracorporeal esophagojejunostomy using a circular stapler after totally laparoscopic total gastrectomy.

PubMed

Amisaki, Masataka; Kihara, Kyoichi; Endo, Kanenori; Suzuki, Kazunori; Nakamura, Seiichi; Sawata, Takashi; Shimizu, Tetsu

2016-07-01

Laparoscopic total gastrectomy is not widely performed because of the difficulty of esophagojejunal reconstruction. This study analyzed complication rates of two different methods for reconstruction by a circular stapler after totally laparoscopic total gastrectomy (TLTG). Between 2010 and 2014, clinical data of 19 patients who underwent TLTG for gastric adenocarcinoma were collected retrospectively. There were two methods to fix the anvil of a circular stapler into the distal esophagus: In the single-stapling technique (SST) group, Endo-PSI(II) was used for purse-suturing on the distal esophagus for reconstruction, and in the hemi-double-stapling technique (hemi-DST) group, the esophagus was cut by linear stapler with the entry hole of the anvil shaft opened after inserting the anvil tail. In both groups, surgical procedures were the same, except for the reconstruction. All TLTGs were performed securely without mortality. Intracorporeal laparoscopic esophagojejunal anastomosis was performed successfully for all the patients. In the hemi-DST group, four patients experienced anastomotic stenosis, three of whom required endoscopic balloon dilation. In contrast, no stenosis was seen in the SST group (p = 0.033). Anastomosis with SST is preferred to that with hemi-DST to minimize postoperative complications.

Higher Education and the Color Line: College Access, Racial Equity, and Social Change

ERIC Educational Resources Information Center

Orfield, Gary, Ed.; Marin, Patricia, Ed.; Horn, Catherine L., Ed.

2005-01-01

"Higher Education and the Color Line" examines the role of higher education in opening up equal opportunity for mobility in American society--or in reinforcing the segregation between white and nonwhite America. In the wake of the U.S. Supreme Court's landmark decision upholding affirmative action, this comprehensive and timely book…

Joint Interdiction

DTIC Science & Technology

2016-09-09

law enforcement detachment (USCG) LEO law enforcement operations LOC line of communications MACCS Marine air command and control system MAS...enemy command and control [C2], intelligence, fires, reinforcing units, lines of communications [ LOCs ], logistics, and other operational- and tactical...enemy naval, engineering, and personnel resources to the tasks of repairing and recovering damaged equipment, facilities, and LOCs . It can draw the

Study of the mechanical properties of hybrid composite basalt / alumina / shells for brake lining pads

NASA Astrophysics Data System (ADS)

Adi Atmika, I. K.; Ary Subagia, IDG.; Surata, I. W.; Sutantra, I. N.

2017-05-01

Brake lining pad as one of the active safety components in motor vehicles has been studied thoroughly. Asbestos is the main material forming the brake in addition to other alloy materials that have a negative impact on health and the environment. This paper explain the behavior of hybrid composites phenolic resin with basalt/alumina/clamshell powder reinforced on brake lining pad. This materials has been manufactured use compaction and sintering process through any steps, that an emphasis of 2,000 kg for 30 minutes at a constant temperature of 150° C. The research aims to investigate hardness characteristic of hybrid composite that test using the vickers according to standard ASTM E-384. The reinforced materials and phenolic resin composition is 60%: 40%. The results show for the average hardness VHN to 24.18, 25.11, 26.34, 27.21 and 28.83. The average hardness hybrid composite shows the hardness harder than asbestos materials.

Understanding Optimal Decision-Making

DTIC Science & Technology

2015-06-01

Task (IGT) (Bechara, Damasio, Damasio, & Anderson,1994), a very common test of reinforcement learning that has been used in hundreds of psychology ... psychology task that elicits reinforcement learning (Bechara et al., 1994) and has been used in hundreds of studies (Krain et al., 2006). Subjects...34) 70 # LatByTrial<- LatByTrial+geom_line(data=player,aes(x=trial,y=ewma),linetype=1, colour ="grey8 8") # LatByTrial<- LatByTrial+geom_point

A note on the cracked plates reinforced by a line stiffener

NASA Technical Reports Server (NTRS)

Yahsi, O. S.; Erdogan, F.

1983-01-01

The problem of a cracked plate reinforced by a line stiffener is reconsidered. The original solution of this problem was given in the literature. Also, a variation of the problem with debonding between the plate and the stiffener near the cracked region was reported in the literature. However, the special case of the problem in which the crack tip terminates at the stiffener does not appear to have been studied. In practice, the solution may be necessary in order to assess the crack arrest effectiveness of the stiffener. The problem of a stiffened plate with a crack is reformulated, the asymptotic stress state near the crack tip terminating at the stiffener is examined, and numerical results are given for various stiffness constants. Previously announced in STAR as N83-21388

Thermo-oxidative stability studies of PMR-15 polymer matrix composites reinforced with various fibers

NASA Technical Reports Server (NTRS)

Bowles, Kenneth J.

1990-01-01

An experimental study was conducted to measure the thermo-oxidative stability of PMR-15 polymer matrix composites reinforced with various fibers and to observe differences in the way they degrade in air. The fibers that were studied included graphite and the thermally stable Nicalon and Nextel ceramic fibers. Weight loss rates for the different composites were assessed as a function of mechanical properties, specimen geometry, fiber sizing, and interfacial bond strength. Differences were observed in rates of weight loss, matrix cracking, geometry dependency, and fiber-sizing effects. It was shown that Celion 6000 fiber-reinforced composites do not exhibit a straight-line Arrhenius relationship at temperatures above 316 C.

Behaviors observed during S− in a simple discrimination learning task1

PubMed Central

Rand, Judith F.

1977-01-01

Key pecking of pigeons was reinforced with food in the presence of a horizontal line and never reinforced in the presence of a vertical line. Highly stereotyped behaviors, as well as key pecking, were observed and recorded in the presence of both stimuli. Results showed that a high proportion of time spent in the presence of the horizontal line was occupied by key pecking, a high proportion of time in the presence of the vertical line was occupied by stereotyped nonkey-pecking behaviors, and intermediate proportions of time spent in the presence of intermediate stimuli were occupied by each class of behavior during generalization tests. Similar running rates (number of key pecks divided by observed key-pecking time) were obtained in the presence of all stimuli, indicating that changes in time rather than tempo accounted for the changes in overall rates of key pecking. An exception occurred in responding to the horizontal line as differential performance was developing. In addition to an increase in time spent key pecking, increased running rates occurred in seven of eight birds, suggesting that both time allocation and tempo play a role in behavioral contrast of overall rates of key pecking. ImagesFig. 2a.Fig. 2b. PMID:16811968

Hydrocarbon-Stapled Peptides: Principles, Practice, and Progress

PubMed Central

2015-01-01

Protein structure underlies essential biological processes and provides a blueprint for molecular mimicry that drives drug discovery. Although small molecules represent the lion’s share of agents that target proteins for therapeutic benefit, there remains no substitute for the natural properties of proteins and their peptide subunits in the majority of biological contexts. The peptide α-helix represents a common structural motif that mediates communication between signaling proteins. Because peptides can lose their shape when taken out of context, developing chemical interventions to stabilize their bioactive structure remains an active area of research. The all-hydrocarbon staple has emerged as one such solution, conferring α-helical structure, protease resistance, cellular penetrance, and biological activity upon successful incorporation of a series of design and application principles. Here, we describe our more than decade-long experience in developing stapled peptides as biomedical research tools and prototype therapeutics, highlighting lessons learned, pitfalls to avoid, and keys to success. PMID:24601557

Lung abscess mimicking lung cancer developed around staples in a patient with permanent tracheostoma.

PubMed

Watanabe, Yui; Aoki, Masaya; Suzuki, Soichi; Umehara, Tadashi; Harada, Aya; Wakida, Kazuhiro; Nagata, Toshiyuki; Kariatsumari, Kota; Nakamura, Yoshihiro; Sato, Masami

2015-11-01

A 68-year-old male with a tracheostoma due to hypopharyngeal cancer was admitted because his chest computed tomography (CT) showed a small nodule in the right middle lobe. Following a partial resection of the right middle lobe, histopathological diagnosis of the resected sample was that of organizing pneumonia. Eleven months later, chest CT showed a mass with pleural indentation and spiculation in the right middle lobe. 18-Fluorodeoxyglucose-positron emission tomography showed significant accumulation in the middle lobe tumor mass shadow. The abnormal chest shadow that had developed around surgical staples suggested inadequate resection and tumor recurrence. As the abnormal radiological shadow was enlarging, middle lobectomy was carried out. Histological examination revealed that the tumor was a lung abscess without malignant features. This is a unique case of lung abscess mimicking lung cancer which developed around staples used during partial resection of the lung.

Biofortification of rice with the essential amino acid lysine: molecular characterization, nutritional evaluation, and field performance

PubMed Central

Yang, Qing-qing; Zhang, Chang-quan; Chan, Man-ling; Zhao, Dong-sheng; Chen, Jin-zhu; Wang, Qing; Li, Qian-feng; Yu, Heng-xiu; Gu, Ming-hong; Sun, Samuel Sai-ming; Liu, Qiao-quan

2016-01-01

Rice (Oryza sativa L.), a major staple crop worldwide, has limited levels of the essential amino acid lysine. We previously produced engineered rice with increased lysine content by expressing bacterial aspartate kinase and dihydrodipicolinate synthase and inhibiting rice lysine ketoglutarate reductase/saccharopine dehydrogenase activity. However, the grain quality, field performance, and integration patterns of the transgenes in these lysine-enriched lines remain unclear. In the present study, we selected several elite transgenic lines with endosperm-specific or constitutive regulation of the above key enzymes but lacking the selectable marker gene. All target transgenes were integrated into the intragenic region in the rice genome. Two pyramid transgenic lines (High Free Lysine; HFL1 and HFL2) with free lysine levels in seeds up to 25-fold that of wild type were obtained via a combination of the above two transgenic events. We observed a dramatic increase in total free amino acids and a slight increase in total protein content in both pyramid lines. Moreover, the general physicochemical properties were improved in pyramid transgenic rice, but the starch composition was not affected. Field trials indicated that the growth of HFL transgenic rice was normal, except for a slight difference in plant height and grain colour. Taken together, these findings will be useful for the potential commercialization of high-lysine transgenic rice. PMID:27252467

40 CFR 63.5880 - How do I determine how much neat resin plus is applied to the line and how much neat gel coat...

Code of Federal Regulations, 2010 CFR

2010-07-01

... SOURCE CATEGORIES National Emissions Standards for Hazardous Air Pollutants: Reinforced Plastic... gel coat plus is applied to the line each year. (a) Track formula usage by end product/thickness combinations. (b) Use in-house records to show usage. This may be either from automated systems or manual...

Puget Sound Area Electric Reliability Plan : Appendix E, Transmission Reinforcement Analysis.

DOE Office of Scientific and Technical Information (OSTI.GOV)

United States. Bonneville Power Administration.

1992-04-01

The purpose of this appendix to the draft environmental impact statement (EIS) report is to provide an update of the latest study work done on transmission system options for the Puget Sound Area Electric Reliability Plan. Also included in the attachments to the EIS are 2 reports analyzing the voltage stability of the Puget Sound transmission system and a review by Power Technologies, Inc. of the BPA voltage stability analysis and reactive options. Five transmission line options and several reactive options are presently being considered as possible solutions to the PSAFRP by the Transmission Team. The first two line optionsmore » would be built on new rights-of way adjacent (as much as possible) to existing corridors. The reactive options would optimize the existing transmission system capability by adding new stations for series capacitors and/or switchgear. The other three line options are rebuilds or upgrades of existing cross mountain transmission lines. These options are listed below and include a preliminary assessment of the additional transmission system reinforcement required to integrate the new facilities into the existing transmission system. Plans were designed to provide at least 500 MVAR reactive margin.« less

Lattice QCD calculations of nucleon transverse momentum-dependent parton distributions using clover and domain wall fermions

DOE PAGES

Yoon, Boram; Bhattacharya, Tanmoy; Gupta, Rajan; ...

2015-01-01

Here, we present a lattice QCD calculation of transverse momentum dependent parton distribution functions (TMDs) of protons using staple-shaped Wilson lines. For time-reversal odd observables, we calculate the generalized Sivers and Boer-Mulders transverse momentum shifts in SIDIS and DY cases, and for T-even observables we calculate the transversity related to the tensor charge and the generalized worm-gear shift. The calculation is done on two different n f = 2+1 ensembles: domain-wall fermion (DWF) with lattice spacing 0:084fm and pion mass of 297 MeV, and clover fermion with lattice spacing 0:114 fm and pion mass of 317 MeV. The results frommore » those two different discretizations are consistent with each other.« less

Radiographic findings of post-operative double stapled trans anal rectal resection (STARR) in patient with obstructed defecation syndrome (ODS).

PubMed

Grassi, Roberto; Romano, Stefania; Micera, Osvaldo; Fioroni, Claudio; Boller, Brigitta

2005-03-01

Longo's procedure of double stapled trans anal rectal resection (STARR) has been evocated as surgical treatment of the obstructed defecation syndrome (ODS) in patients with rectal mucosal prolapse. The aim of this study was to investigate the post-interventional findings of this technique, to help radiologist in knowledge of the changed morphology of the rectal lumen, also in attempt to recognize some potential related complications.

Stapled Voltage-Gated Calcium Channel (CaV) α-Interaction Domain (AID) Peptides Act As Selective Protein-Protein Interaction Inhibitors of CaV Function.

PubMed

Findeisen, Felix; Campiglio, Marta; Jo, Hyunil; Abderemane-Ali, Fayal; Rumpf, Christine H; Pope, Lianne; Rossen, Nathan D; Flucher, Bernhard E; DeGrado, William F; Minor, Daniel L

2017-06-21

For many voltage-gated ion channels (VGICs), creation of a properly functioning ion channel requires the formation of specific protein-protein interactions between the transmembrane pore-forming subunits and cystoplasmic accessory subunits. Despite the importance of such protein-protein interactions in VGIC function and assembly, their potential as sites for VGIC modulator development has been largely overlooked. Here, we develop meta-xylyl (m-xylyl) stapled peptides that target a prototypic VGIC high affinity protein-protein interaction, the interaction between the voltage-gated calcium channel (Ca V ) pore-forming subunit α-interaction domain (AID) and cytoplasmic β-subunit (Ca V β). We show using circular dichroism spectroscopy, X-ray crystallography, and isothermal titration calorimetry that the m-xylyl staples enhance AID helix formation are structurally compatible with native-like AID:Ca V β interactions and reduce the entropic penalty associated with AID binding to Ca V β. Importantly, electrophysiological studies reveal that stapled AID peptides act as effective inhibitors of the Ca V α 1 :Ca V β interaction that modulate Ca V function in an Ca V β isoform-selective manner. Together, our studies provide a proof-of-concept demonstration of the use of protein-protein interaction inhibitors to control VGIC function and point to strategies for improved AID-based Ca V modulator design.

Expected increase in staple crop imports in water-scarce countries in 2050

NASA Astrophysics Data System (ADS)

Chouchane, Hatem; Krol, Maarten; Hoekstra, Arjen

2017-04-01

Water scarcity is a major challenge in the coming decades. The increasing population and the changing pattern of water availability that results from global warming reduce the potential of sufficient food production in many countries over the world. Today, two thirds of the global population are already living under conditions of severe water scarcity at least one month of the year. This rises the importance of addressing the present and future relationship between water availability and food import in water-scarce countries. The net import of staple crops (barley, cassava, maize, millet and products, oats, potatoes, rice, rye, sorghum, soybeans, sweet potatoes, wheat and yams) is analysed in relation to water availability per capita for the period 1961-2010, considering five decadal averages. The relation found is used together with the low, medium and high population growth scenarios from the United Nations to project the staple crops import in water-scarce countries for the year 2050. Additionally, we investigate the uncertainties related to the three population scenarios. Results will help countries to better understand the impact of population growth and limited water resources on their future food trade. This study will provide a valuable supporting tool for policy makers towards more sustainable and water-efficient food production as targeted with the Sustainable Development Goals. Keywords: Water Availability, Food Import, Staple Crops, Water Scarcity, Water-Use Efficiency, Sustainable Development Goals.

α/β-Peptide Foldamers Targeting Intracellular Protein-Protein Interactions with Activity in Living Cells.

PubMed

Checco, James W; Lee, Erinna F; Evangelista, Marco; Sleebs, Nerida J; Rogers, Kelly; Pettikiriarachchi, Anne; Kershaw, Nadia J; Eddinger, Geoffrey A; Belair, David G; Wilson, Julia L; Eller, Chelcie H; Raines, Ronald T; Murphy, William L; Smith, Brian J; Gellman, Samuel H; Fairlie, W Douglas

2015-09-09

Peptides can be developed as effective antagonists of protein-protein interactions, but conventional peptides (i.e., oligomers of l-α-amino acids) suffer from significant limitations in vivo. Short half-lives due to rapid proteolytic degradation and an inability to cross cell membranes often preclude biological applications of peptides. Oligomers that contain both α- and β-amino acid residues ("α/β-peptides") manifest decreased susceptibility to proteolytic degradation, and when properly designed these unnatural oligomers can mimic the protein-recognition properties of analogous "α-peptides". This report documents an extension of the α/β-peptide approach to target intracellular protein-protein interactions. Specifically, we have generated α/β-peptides based on a "stapled" Bim BH3 α-peptide, which contains a hydrocarbon cross-link to enhance α-helix stability. We show that a stapled α/β-peptide can structurally and functionally mimic the parent stapled α-peptide in its ability to enter certain types of cells and block protein-protein interactions associated with apoptotic signaling. However, the α/β-peptide is nearly 100-fold more resistant to proteolysis than is the parent stapled α-peptide. These results show that backbone modification, a strategy that has received relatively little attention in terms of peptide engineering for biomedical applications, can be combined with more commonly deployed peripheral modifications such as side chain cross-linking to produce synergistic benefits.

Gender Difference on the Association between Dietary Patterns and Obesity in Chinese Middle-Aged and Elderly Populations.

PubMed

Yuan, Ya-Qun; Li, Fan; Meng, Pai; You, Jie; Wu, Min; Li, Shu-Guang; Chen, Bo

2016-07-23

Dietary patterns are linked to obesity, but the gender difference in the association between dietary patterns and obesity remains unclear. We explored this gender difference in a middle-aged and elderly populations in Shanghai. Residents (n = 2046; aged ≥45 years; 968 men and 1078 women) who participated in the Shanghai Food Consumption Survey were studied. Factor analysis of data from four periods of 24-h dietary recalls (across 2012-2014) identified dietary patterns. Height, body weight, and waist circumference were measured to calculate the body mass index. A log binominal model examined the association between dietary patterns and obesity, stratified by gender. Four dietary patterns were identified for both genders: rice staple, wheat staple, snacks, and prudent patterns. The rice staple pattern was associated positively with abdominal obesity in men (prevalence ratio (PR) = 1.358; 95% confidence interval (CI) 1.132-1.639; p = 0.001), but was associated negatively with general obesity in women (PR = 0.745; 95% CI: 0.673-0.807; p = 0.031). Men in the highest quartile of the wheat staple pattern had significantly greater risk of central obesity (PR = 1.331; 95% CI: 1.094-1.627; p = 0.005). There may be gender differences in the association between dietary patterns and obesity in middle-aged and elderly populations in Shanghai, China.

Stapled Voltage-Gated Calcium Channel (CaV) α-Interaction Domain (AID) Peptides Act As Selective Protein–Protein Interaction Inhibitors of CaV Function

PubMed Central

2017-01-01

For many voltage-gated ion channels (VGICs), creation of a properly functioning ion channel requires the formation of specific protein–protein interactions between the transmembrane pore-forming subunits and cystoplasmic accessory subunits. Despite the importance of such protein–protein interactions in VGIC function and assembly, their potential as sites for VGIC modulator development has been largely overlooked. Here, we develop meta-xylyl (m-xylyl) stapled peptides that target a prototypic VGIC high affinity protein–protein interaction, the interaction between the voltage-gated calcium channel (CaV) pore-forming subunit α-interaction domain (AID) and cytoplasmic β-subunit (CaVβ). We show using circular dichroism spectroscopy, X-ray crystallography, and isothermal titration calorimetry that the m-xylyl staples enhance AID helix formation are structurally compatible with native-like AID:CaVβ interactions and reduce the entropic penalty associated with AID binding to CaVβ. Importantly, electrophysiological studies reveal that stapled AID peptides act as effective inhibitors of the CaVα1:CaVβ interaction that modulate CaV function in an CaVβ isoform-selective manner. Together, our studies provide a proof-of-concept demonstration of the use of protein–protein interaction inhibitors to control VGIC function and point to strategies for improved AID-based CaV modulator design. PMID:28278376

Gender Difference on the Association between Dietary Patterns and Obesity in Chinese Middle-Aged and Elderly Populations

PubMed Central

Yuan, Ya-Qun; Li, Fan; Meng, Pai; You, Jie; Wu, Min; Li, Shu-Guang; Chen, Bo

2016-01-01

Dietary patterns are linked to obesity, but the gender difference in the association between dietary patterns and obesity remains unclear. We explored this gender difference in a middle-aged and elderly populations in Shanghai. Residents (n = 2046; aged ≥45 years; 968 men and 1078 women) who participated in the Shanghai Food Consumption Survey were studied. Factor analysis of data from four periods of 24-h dietary recalls (across 2012–2014) identified dietary patterns. Height, body weight, and waist circumference were measured to calculate the body mass index. A log binominal model examined the association between dietary patterns and obesity, stratified by gender. Four dietary patterns were identified for both genders: rice staple, wheat staple, snacks, and prudent patterns. The rice staple pattern was associated positively with abdominal obesity in men (prevalence ratio (PR) = 1.358; 95% confidence interval (CI) 1.132–1.639; p = 0.001), but was associated negatively with general obesity in women (PR = 0.745; 95% CI: 0.673–0.807; p = 0.031). Men in the highest quartile of the wheat staple pattern had significantly greater risk of central obesity (PR = 1.331; 95% CI: 1.094–1.627; p = 0.005). There may be gender differences in the association between dietary patterns and obesity in middle-aged and elderly populations in Shanghai, China. PMID:27455322

Disulfide-Mediated β-Strand Dimers: Hyperstable β-Sheets Lacking Tertiary Interactions and Turns.

PubMed

Kier, Brandon L; Anderson, Jordan M; Andersen, Niels H

2015-04-29

Disulfide bonds between cysteine residues are essential to the structure and folding of many proteins. Yet their role in the design of structured peptides and proteins has frequently been limited to use as intrachain covalent staples that reinforce existing structure or induce knot-like conformations. In β-hairpins, their placement at non-H-bonding positions across antiparallel strands has proven useful for achieving fully folded positive controls. Here we report a new class of designed β-sheet peptide dimers with strand-central disulfides as a key element. We have found that the mere presence of a disulfide bond near the middle of a short peptide chain is sufficient to nucleate some antiparallel β-sheet structure; addition of β-capping units and other favorable cross-strand interactions yield hyperstable sheets. Strand-central cystines were found to be superior to the best designed reversing turns in terms of nucleating β-sheet structure formation. We have explored the limitations and possibilities of this technique (the use of disulfides as sheet nucleators), and we provide a set of rules and rationales for the application and further design of disulfide-tethered "turnless" β-sheets.

Overcoming inter-subspecific hybrid sterility in rice by developing indica-compatible japonica lines

PubMed Central

Guo, Jie; Xu, Xiaomei; Li, Wentao; Zhu, Wenyin; Zhu, Haitao; Liu, Ziqiang; Luan, Xin; Dai, Ziju; Liu, Guifu; Zhang, Zemin; Zeng, Ruizhen; Tang, Guang; Fu, Xuelin; Wang, Shaokui; Zhang, Guiquan

2016-01-01

Rice (Oryza sativa L.) is an important staple crop. The exploitation of the great heterosis that exists in the inter-subspecific crosses between the indica and japonica rice has long been considered as a promising way to increase the yield potential. However, the male and female sterility frequently occurred in the inter-subspecific hybrids hampered the utilization of the heterosis. Here we report that the inter-subspecific hybrid sterility in rice is mainly affected by the genes at Sb, Sc, Sd and Se loci for F1 male sterility and the gene at S5 locus for F1 female sterility. The indica-compatible japonica lines (ICJLs) developed by pyramiding the indica allele (S-i) at Sb, Sc, Sd and Se loci and the neutral allele (S-n) at S5 locus in japonica genetic background through marker-assisted selection are compatible with indica rice in pollen fertility and in spikelet fertility. These results showed a great promise of overcoming the inter-subspecific hybrid sterility and exploiting the heterosis by developing ICJLs. PMID:27246799

Overcoming inter-subspecific hybrid sterility in rice by developing indica-compatible japonica lines.

PubMed

Guo, Jie; Xu, Xiaomei; Li, Wentao; Zhu, Wenyin; Zhu, Haitao; Liu, Ziqiang; Luan, Xin; Dai, Ziju; Liu, Guifu; Zhang, Zemin; Zeng, Ruizhen; Tang, Guang; Fu, Xuelin; Wang, Shaokui; Zhang, Guiquan

2016-06-01

Rice (Oryza sativa L.) is an important staple crop. The exploitation of the great heterosis that exists in the inter-subspecific crosses between the indica and japonica rice has long been considered as a promising way to increase the yield potential. However, the male and female sterility frequently occurred in the inter-subspecific hybrids hampered the utilization of the heterosis. Here we report that the inter-subspecific hybrid sterility in rice is mainly affected by the genes at Sb, Sc, Sd and Se loci for F1 male sterility and the gene at S5 locus for F1 female sterility. The indica-compatible japonica lines (ICJLs) developed by pyramiding the indica allele (S-i) at Sb, Sc, Sd and Se loci and the neutral allele (S-n) at S5 locus in japonica genetic background through marker-assisted selection are compatible with indica rice in pollen fertility and in spikelet fertility. These results showed a great promise of overcoming the inter-subspecific hybrid sterility and exploiting the heterosis by developing ICJLs.

Development of ductile hybrid fiber reinforced polymer (D-H-FRP) reinforcement for concrete structures

NASA Astrophysics Data System (ADS)

Somboonsong, Win

The corrosion of steel rebars has been the major cause of the reinforced concrete deterioration in transportation structures and port facilities. Currently, the Federal Highway Administration (FHWA) spends annually $31 billion for maintaining and repairing highways and highway bridges. The study reported herein represents the work done in developing a new type of reinforcement called Ductile Hybrid Fiber Reinforced Polymer or D-H-FRP using non-corrosive fiber materials. Unlike the previous FRP reinforcements that fail in a brittle manner, the D-H-FRP bars exhibit the stress-strain curves that are suitable for concrete reinforcement. The D-H-FRP stress-strain curves are linearly elastic with a definite yield point followed by plastic deformation and strain hardening resembling that of mild steel. In addition, the D-H-FRP reinforcement has integrated ribs required for concrete bond. The desirable mechanical properties of D-H-FRP reinforcement are obtained from the integrated design based on the material hybrid and geometric hybrid concepts. Using these concepts, the properties can be tailored to meet the specific design requirements. An analytical model was developed to predict the D-H-FRP stress-strain curves with different combination of fiber materials and geometric configuration. This model was used to optimize the design of D-H-FRP bars. An in-line braiding-pultrusion manufacturing process was developed at Drexel University to produce high quality D-H-FRP reinforcement in diameters that can be used in concrete structures. A series of experiments were carried out to test D-H-FRP reinforcement as well as their individual components in monotonic and cyclic tensile tests. Using the results from the tensile tests and fracture analysis, the stress-strain behavior of the D-H-FRP reinforcement was fully characterized and explained. Two series of concrete beams reinforced with D-H-FRP bars were studied. The D-H-FRP beam test results were then compared with companion steel reinforced concrete beams having the same ultimate strength. All D-H-FRP reinforced concrete beams show consistent performance with ultimate strengths and ductility similar to the steel reinforced control specimens and to theoretical predictions.

Stapled haemorrhoidopexy: extent of tissue excision and clinical implications in the early postoperative period.

PubMed

Behboo, R; Zanella, S; Ruffolo, C; Vafai, M; Marino, F; Scarpa, M

2011-06-01

This study quantified prospectively the amount of rectal wall removed during stapled haemorrhoidopexy and assessed its effect on ano-rectal function and health-related quality of life. Thirty-three consecutive patients who underwent stapled haemorrhoidopexy for second- or third- degree haemorrhoids, or for failed medical treatment, in the Department of Surgery and Gastroenterological Sciences at the University of Padova were included. All patients were assessed preoperatively and postoperatively using a structured questionnaire to determine the number of defecations per week, incomplete defecations, time taken to defecate any difficulty in defecating, soiling, the use of drugs and continence. All patients were reassessed at 1 and 2 weeks and at 30 days after the procedure using the Cleveland Global Quality of Life (CGQL) questionnaire. All patients underwent preoperative and postoperative ano-rectal manometry at least 30 days after stapled haemorrhoidopexy. The median surface area of the resected rectal wall was 10.5 (range, 9-15) mm(2) and the median thickness was 3 (range, 2-4) mm. Muscle tissue was included in all specimens. The median thickness of the resected rectal wall correlated inversely with the rectal volume when the recto-anal inhibitory reflex (RAIR) was initiated during postoperative manometry (ρ = -0.50, P = 0.07). A significant, direct correlation was found between the surface area of the resected rectal wall and the rectal volume during postoperative manometry (ρ = 0.53, P = 0.08) and the use of analgesic drugs after 2 weeks (ρ = 0.63, P = 0.04). Significant correlations were found between being female and postoperative resting pressure (ρ = -0.74, P < 0.01), squeeze pressure (ρ = -0.64, P = 0.01) and maximum tolerated volume (ρ = -0.78, P < 0.01). Stapled haemorrhoidopexy is safe and effective. The thicker the resected rectal wall, the lower the volume of initiation of the RAIR. © 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.

Doppler-Guided Transanal Hemorrhoidal Dearterialization (DG-THD) Versus Stapled Hemorrhoidopexy (SH) in the Treatment of Third-Degree Hemorrhoids: Clinical Results at Short and Long-Term Follow-Up.

PubMed

Leardi, S; Pessia, B; Mascio, M; Piccione, F; Schietroma, M; Pietroletti, R

2016-11-01

The stapled hemorrhoidopexy (SH) and the Doppler-guided transanal hemorrhoidal dearterialization (DG-THD) are minimally invasive procedures for the surgical treatment of hemorrhoids. This study aims to verify the efficacy of the DG-THD versus the SH in the treatment of third-degree hemorrhoids. One hundred consecutive patients were causally allocated to either procedure, obtaining two groups of 50 pts. A clinical examination was performed at 3, 7, 15, and 30 days after the operation. Quality of life, anal symptoms, recurrence of hemorrhoids, and reoperation were assessed by means of a questionnaire and of a clinical examination at long-term follow-up (7.0 year average). At short-term follow-up, the median postoperative pain score was significantly lower in DG-THD group compared to SH group, (V.A.S 2 vs 6; t = 2.65, p < 0.01). The morbidity rate and the return to normal life and work were similar after the two procedures. At long-term follow-up, the incidence of piles was not statistically different between the two groups (DG-THD 10.0 %; SH 14.0 %). No differences were reported by patients in terms of satisfaction for surgery. SH and DG-THD procedures do not show significantly different results with regard to the patients outcome. However, considering the lower p. o. pain, the DG-THD might be proposed as the first line treatment in third-degree hemorrhoids.

An alternative continence tube for continent urinary reservoirs: evaluation of surgical technique, pressure and continence study in an ex-vivo model.

PubMed

Honeck, Patrick; Michel, Maurice Stephan; Trojan, Lutz; Alken, Peter

2009-02-01

Despite the large number of surgical techniques for continent cutaneous diversion described in literature, the creation of a reliable, continent and easily catheterizable continence mechanism remains a complex surgical procedure. Aim of this study was the evaluation of a new method for a catheterizable continence mechanism using stapled pig intestine. Small and large pig intestines were used for construction. A 3 or 6 cm double row stapling system was used. Three variations using small and large intestine segments were constructed. A 3 or 6 cm long stapler line was placed alongside a 12 Fr catheter positioned at the antimesenterial side creating a partially two-luminal segment. Construction time for the tube was measured. The created tube was then embedded into the pouch. Pressure evaluation of the continence mechanism was performed for each variation. Intermittent external manual compression was used to simulate sudden pressure exposure. All variations were 100% continent under filling volumes of up to 700 ml and pressure levels of 58 +/- 6 cm H(2)O for large intestine and 266 ml and 87 +/- 18 cm H(2)O for small intestine, respectively. With further filling above the mentioned capacity suture insufficiency occurred but no tube insufficiency. Construction time for all variations was less than 12 min. The described technique is an easy and fast method to construct a continence mechanism using small or large intestine. Our ex vivo experiments have shown sufficient continence situation in an ex-vivo model. Further investigations in an in-vivo model are needed to confirm these results.

Technical Feasibility of Enterotomy Closure with Knotless Barbed Suture Material (V-Loc 180) in Esophagojejunostomy Using Linear Stapler during Totally Laparoscopic Total Gastrectomy for Gastric Cancer.

PubMed

Kim, Dong Jin; Kim, Wook; Lee, Jun Hyun

2017-08-01

Intra-corporeal esophagojejunostomy (EJ) using a linear stapler creates a stapler entry hole that requires secure closure during the totally laparoscopic total gastrectomy (TLTG) procedure for gastric cancer. Since a standard method has not been established yet, the feasibility of using V-loc 180 (Covidien, Mansfield, MA, USA) suture material was evaluated in this study. During January 2012 to March 2015, 25 patients who underwent linear stapling EJ and V-loc 180 closure of remaining enterotomy were included in this study. Basic clinico-pathological characteristics, surgical outcomes, and short-term complications were analyzed. The mean patient age was 60.4 ± 8.5 years. Nineteen males and six females were included in this study. The mean body mass index was 25.3 ± 2.3 kg/m 2 . There were 22 stage-I, 2 stage-II, and 1 stage-III gastric cancer patients. The mean operation time was 240.5 ± 44.6 min, and the time for anastomosis was 38.8 ± 11.2 min. The procedures were successfully performed in all cases without any intra-operative complications. There was one case of EJ leakage that occurred at the corner of EJ staple line and not at the enterotomy closure site. The closure of the remaining enterotomy site using V-loc 180 suture following linear stapler EJ is technically feasible and safe during the TLTG procedure. However, further experience and results from other surgeons are necessary to generalize this procedure.

Minimizing blood loss at cesarean-hysterectomy for placenta previa percreta.

PubMed

Belfort, Michael A; Shamshiraz, Alireza A; Fox, Karin

2017-01-01

Preventing blood loss at the time of a cesarean delivery during a scheduled, nonemergent cesarean hysterectomy for placenta percreta may reduce the need for crystalloid and blood product transfusion. Commonly a classical hysterotomy is created and this can result in as much as a 500-800 mL blood loss before the hysterotomy is closed. Our technique involves placement of 4 full-thickness interrupted sutures in a box pattern to create an unperfused area of upper uterine segment. Diathermy is used to open the uterus to the membranes in the center of the "box" without blood loss. A finger is then inserted between the membranes and uterus to create a space into which 1 side of an 80-mm linear cutting stapler is introduced. The other side of the stapler is then attached and clamped closed, and the stapler is activated. Forward motion of the lever lays down 2 rows of staples, and backward movement of the lever divides the uterine muscle between the 2 staple lines. The stapler is removed and reloaded and reintroduced 1 or 2 times as needed to create an avascular hysterotomy large enough to atraumatically deliver the baby. The membranes are then opened and the baby is delivered. Following this the umbilical cord is clamped and cut without any attempt to remove the placenta, replaced in the uterine cavity, and the hysterotomy is closed with a running locked suture that incorporates the membrane edges. The hysterectomy then proceeds. In most cases there is minimal blood loss (usually <20 mL) from the cesarean delivery. Copyright © 2016 Elsevier Inc. All rights reserved.

40 CFR Table 11 to Subpart Wwww of... - Data Requirements for New and Existing Continuous Lamination and Continuous Casting Lines...

Code of Federal Regulations, 2010 CFR

2010-07-01

... Continuous Lamination and Continuous Casting Lines Complying With a Percent Reduction Limit or a Lbs/Ton...: Reinforced Plastic Composites Production Pt. 63, Subpt. WWWW, Table 11 Table 11 to Subpart WWWW of Part 63... With a Percent Reduction Limit or a Lbs/Ton Limit on an Averaging Basis As required in § 63.5865, in...

Photoreactive Stapled BH3 Peptides to Dissect the BCL-2 Family Interactome

PubMed Central

Braun, Craig R.; Mintseris, Julian; Gavathiotis, Evripidis; Bird, Gregory H.; Gygi, Steven P.; Walensky, Loren D.

2010-01-01

SUMMARY Defining protein interactions forms the basis for discovery of biological pathways, disease mechanisms, and opportunities for therapeutic intervention. To harness the robust binding affinity and selectivity of structured peptides for interactome discovery, we engineered photoreactive stapled BH3 peptide helices that covalently capture their physiologic BCL-2 family targets. The crosslinking α-helices covalently trap both static and dynamic protein interactors, and enable rapid identification of interaction sites, providing a critical link between interactome discovery and targeted drug design. PMID:21168768

Stapled peptide inhibitors of RAB25 target context-specific phenotypes in cancer | Office of Cancer Genomics

Cancer.gov

Recent evidence has established a role for the small GTPase RAB25, as well as related effector proteins, in enacting both pro-oncogenic and anti-oncogenic phenotypes in specific cellular contexts. Here we report the development of all-hydrocarbon stabilized peptides derived from the RAB-binding FIP-family of proteins to target RAB25. Relative to unmodified peptides, optimized stapled peptides exhibit increased structural stability, binding affinity, cell permeability, and inhibition of RAB25:FIP complex formation.

Noise Hazard Evaluation Sound Level Data on Noise Sources

DTIC Science & Technology

1975-01-01

Saw, Root Woodworking 43-20-J 102 16. Construction Saw, DeWalt Industrial 2185A 96 17. Cross-Cut Sw, Automatic 1-H 94 18, Cross-Cut Saw, DeWalt 3561...Saw, GM Diehr 750 92 53. Rip Saw, Wabach Industrial 750 97 59. Rip Saw, Yates American B. 102 60. Router: Black & Decker 118 61. Ruuter, Rockwell 150B...13. Sander, Disk, National-Detroit Dual Action 100 14. Stapler , Senco Mll 94* 15. Stapling Gun, Bostich II 105* 16. Stapling Gun, Bostich III 104* 17

The Boer-Mulders Transverse Momentum Distribution in the Pion and its Evolution in Lattice QCD

NASA Astrophysics Data System (ADS)

Engelhardt, M.; Musch, B.; Hägler, P.; Schäfer, A.; Negele, J.

2015-02-01

Starting from a definition of transverse momentum-dependent parton distributions (TMDs) in terms of hadronic matrix elements of a quark bilocal operator containing a staple-shaped gauge link, selected TMD observables can be evaluated within Lattice QCD. A TMD ratio describing the Boer-Mulders effect in the pion is investigated, with a particular emphasis on its evolution as a function of a Collins-Soper-type parameter which quantifies the proximity of the staple-shaped gauge links to the light cone.

Apex technique in the treatment of obstructed defecation syndrome associated with rectal intussusception and full rectal mucosa prolapse.

PubMed

Regadas, F Sergio P; Abedrapo, Mario; Cruz, Jose Vinicius; Murad Regadas, Sthela M; Regadas Filho, F Sergio P

2014-11-01

The aim of the current study was to demonstrate the use of a modified stapling technique, called the apex technique, to treat rectal intussusception and full rectal mucosal prolapse. It was conducted as a retrospective study at 3 centers (2 in Brazil and 1 in Chile). The apex technique is performed by using a HEM/EEA-33 stapler. A pursestring suture is placed at the apex of the prolapse, on the 4 quadrants, independent of the distance to the dentate line. A second pursestring is then placed to define the band of rectal mucosa to be symmetrically resected. Outcome measures included width of the resected full-thickness rectal wall; the intensity of postoperative pain on a visual analog scale from 1 to 10; full mucosal prolapse and rectal intussusception assessed by physical examination, cinedefecography, or echodefecography; and change in the constipation scale. Forty-five patients (30 women/15 men; mean age, 59.5 years) with rectal intussusception and full mucosal prolapse were included. The median operative time was 17 (range, 15-30) minutes. Bleeding after stapler fire requiring manual suture occurred in 3 patients (6.7%); 25 (55.6%) patients reported having no postoperative pain. Hospital stay was 24 hours. The mean width of the resected rectal wall was 5.9 (range, 5.0-7.5) cm. Stricture at the staple line was seen in 4 patients, of whom 1 required dilation under anesthesia. The median follow-up time was 120 (range, 90-120) days. A small residual prolapse was identified in 6 (13.3%) patients. Imaging demonstrated complete disappearance of rectal intussusception in all patients, and the mean postoperative constipation score decreased from 13 (range, 8-15) to 5 (range, 3-7). The apex technique appears to be a safe, quickly performed, and low-cost method for the treatment of rectal intussusception. In this series, imaging examinations showed the disappearance of rectal intussusception, and a significant decrease in constipation score suggested improvement in functional outcomes.

46 CFR 28.335 - Fuel systems.

Code of Federal Regulations, 2011 CFR

2011-10-01

... paragraph (e)(1) and (e)(2) of this section, each fuel line must be seamless and must be of steel, annealed... reinforced with wire braid. (iv) Be fitted with suitable, corrosion resistant, compression fittings; and (v...

75 FR 43230 - Notice of Application for Special Permits

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-23

... and use of carbon Westminster, MD. and glass fiber reinforced, brass lined composite pressure vessels..., 49 CFR 172.101 To authorize the Inc. Column (9B), transportation in 172.204(c)(3), commerce of...

The Gut Microbiota, Food Science, and Human Nutrition: A Timely Marriage.

PubMed

Barratt, Michael J; Lebrilla, Carlito; Shapiro, Howard-Yana; Gordon, Jeffrey I

2017-08-09

Analytic advances are enabling more precise definitions of the molecular composition of key food staples incorporated into contemporary diets and how the nutrient landscapes of these staples vary as a function of cultivar and food processing methods. This knowledge, combined with insights about the interrelationship between consumer microbiota configurations and biotransformation of food ingredients, should have a number of effects on agriculture, food production, and strategies for improving the nutritional value of foods and health status. These effects include decision-making about which cultivars of current or future food staples to incorporate into existing and future food systems, and which components of waste streams from current or future food manufacturing processes have nutritional value that is worth capturing. They can also guide which technologies should be applied, or need to be developed, to produce foods that support efficient microbial biotransformation of their ingredients into metabolic products that sustain health. Copyright © 2017 Elsevier Inc. All rights reserved.

Anesthetic management of the SRS™ Endoscopic Stapling System for gastro-esophageal reflux disease.

PubMed

Topuz, Ufuk; Umutoglu, Tarik; Bakan, Mefkur; Ozturk, Erdogan

2013-01-14

The SRS(TM) Endoscopic Stapling System (Medigus, Tel Aviv, Israel) is a new tool capable of creating a totally endoscopic fundoplication, combined with an endoscope, endoscopic ultrasound and a surgical stapler. SRS(TM) endoscopic stapling for gastro-esophageal reflux disease is a minimally invasive, outpatient procedure, which requires general anesthesia with positive-pressure ventilation. Keeping the patient on positive end-expiratory pressure (PEEP) may minimize the pressure gradient between the esophagus and the mediastinum, as well as help to prevent air from leaking around the screws and causing pneumomediastinum. In addition, in patients with hiatal hernia, higher PEEP levels may be required to increase intra-thoracic pressure and to force the stomach to slide into the abdomen for ease of endoscopy. We advise smoother emergence from anesthesia, taking precautions for retching, postoperative nausea and vomiting (PONV), while coughing and gagging during extubation and PONV may affect the success of the procedure. Total intravenous anesthesia with propofol and remifentanil seems to be a good choice for these reasons.

Circular stapler introducer: a novel device to facilitate stapled colorectal anastomosis.

PubMed

Guweidhi, Ahmed; Steffen, Rudolf; Metzger, Alejandro; Teuscher, Jürg; Flückiger, Petra; Z'graggen, Kaspar

2009-04-01

A circular stapler introducer was developed to protect the head of the circular stapler and enable atraumatic introduction and advancement of the circular stapler without interfering with the application and safety of an anastomosis. In a Phase I prospective study, we tested the feasibility and safety of the novel circular stapler introducer device in 60 consecutive patients undergoing left-sided colorectal resections. The median distance of the anastomoses from the anal verge was 12 cm (7-20, n = 60). Total morbidity was 15 percent. No mortality was observed. Handling of the circular stapler introducer was considered nonproblematic by all surgeons who participated in the study. No interference of the circular stapler introducer with the circular stapling devices used was encountered. The advancement of the stapler into the end of the colorectal stump was always possible with the aid of the circular stapler introducer. Use of the circular stapler introducer facilitates the double-stapling technique of colorectal anastomosis. The circular stapler introducer has great potential and should be tested in larger studies.

Guidelines for the use of fiberglass reinforced plastic in utility FGD systems. [Flue gas desulfurization (FGD); contains glossary

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rapoza, R.J.; Vollmer, H.R.; Haberly, K.L.

1992-11-01

Fiberglass reinforced plastic (FRP) materials offer excellent corrosion-resistant properties and long-term cost advantages compared to exotic alloys or organic lining systems. This guideline document provides potential buyers of FRP FGD (flue gas desulfurization) equipment with enough knowledge of FRP materials and methods to make informed decisions when procuring FRP equipment or services. It is divided into the following chapters: application criteria, procurement strategies, FRP basics, guidelines for designing FRP equipment, quality management. A glossary and manufacturers information/recommendations are included.

An enhanced functional interrogation/manipulation of intracellular signaling pathways with the peptide 'stapling' technology.

PubMed

He, Y; Chen, D; Zheng, W

2015-11-12

Specific protein-protein interactions (PPIs) constitute a key underlying mechanism for the presence of a multitude of intracellular signaling pathways, which are essential for the survival of normal and cancer cells. Specific molecular blockers for a crucial PPI would therefore be invaluable tools for an enhanced functional interrogation of the signaling pathway harboring this particular PPI. On the other hand, if a particular PPI is essential for the survival of cancer cells but is absent in or dispensable for the survival of normal cells, its specific molecular blockers could potentially be developed into effective anticancer therapeutics. Due to the flat and extended PPI interface, it would be conceivably difficult for small molecules to achieve an effective blockade, a problem which could be potentially circumvented with peptides or proteins. However, the well-documented proteolytic instability and cellular impermeability of peptides and proteins in general would make their developing into effective intracellular PPI blockers quite a challenge. With the advent of the peptide 'stapling' technology which was demonstrated to be able to stabilize the α-helical conformation of a peptide via bridging two neighboring amino-acid side chains with a 'molecular staple', a linear parent peptide could be transformed into a stronger PPI blocker with enhanced proteolytic stability and cellular permeability. This review will furnish an account on the peptide 'stapling' technology and its exploitation in efforts to achieve an enhanced functional interrogation or manipulation of intracellular signaling pathways especially those that are cancer relevant.

Unexpected involvement of staple leads to redesign of selective bicyclic peptide inhibitor of Grb7

NASA Astrophysics Data System (ADS)

Gunzburg, Menachem J.; Kulkarni, Ketav; Watson, Gabrielle M.; Ambaye, Nigus D.; Del Borgo, Mark P.; Brandt, Rebecca; Pero, Stephanie C.; Perlmutter, Patrick; Wilce, Matthew C. J.; Wilce, Jacqueline A.

2016-06-01

The design of potent and specific peptide inhibitors to therapeutic targets is of enormous utility for both proof-of-concept studies and for the development of potential new therapeutics. Grb7 is a key signaling molecule in the progression of HER2 positive and triple negative breast cancers. Here we report the crystal structure of a stapled bicyclic peptide inhibitor G7-B1 in complex with the Grb7-SH2 domain. This revealed an unexpected binding mode of the peptide, in which the staple forms an alternative contact with the surface of the target protein. Based on this structural information, we designed a new series of bicyclic G7 peptides that progressively constrain the starting peptide, to arrive at the G7-B4 peptide that binds with an approximately 2-fold enhanced affinity to the Grb7-SH2 domain (KD = 0.83 μM) compared to G7-B1 and shows low affinity binding to Grb2-, Grb10- and Grb14-SH2 domains (KD > 100 μM). Furthermore, we determined the structure of the G7-B4 bicyclic peptide in complex with the Grb7-SH2 domain, both before and after ring closing metathesis to show that the closed staple is essential to the target interaction. The G7-B4 peptide represents an advance in the development of Grb7 inhibitors and is a classical example of structure aided inhibitor development.

Technique-associated outcomes in horses following large colon resection.

PubMed

Pezzanite, Lynn M; Hackett, Eileen S

2017-11-01

To compare survival and complications in horses undergoing large colon resection with either sutured end-to-end or stapled functional end-to-end anastomoses. Retrospective cohort study. Twenty-six client-owned horses with gastrointestinal disease. Retrospective data were retrieved from the medical records of 26 horses undergoing colectomy, including 14 horses with sutured end-to-end and 12 horses with stapled functional end-to-end anastomoses, between 2003 and 2016. Records were evaluated for signalment, medical and surgical treatments, and survival to hospital discharge. Long-term follow-up was obtained through owner contact. Continuous variables were compared with Mann-Whitney tests. Fisher's exact testing was used to compare survival to hospital discharge. Survival time was compared by constructing Kaplan-Meier survival curves and performing log-rank curve comparison testing. Mean age of horses undergoing colectomy was 13 years. Reason for colectomy was prophylaxis (12) or salvage (14). Mean surgical time was 169 minutes. Mean hospitalization time was 9 days, which did not differ with anastomosis type (P = .62). Nine of 12 horses undergoing stapled functional end-to-end anastomosis and 12 of 14 horses undergoing sutured end-to-end anastomosis survived to hospital discharge (P = .63). Survival time did not differ with anastomosis technique (P = .35). Short- and long-term survival outcomes are not different between sutured end-to-end or stapled functional end-to-end anastomoses in horses undergoing colectomy. © 2017 The American College of Veterinary Surgeons.

Effect of public symphysiodesis on pelvic development in the skeletally immature greyhound.

PubMed

Swainson, S W; Conzemius, M G; Riedesel, E A; Smith, G K; Riley, C B

2000-01-01

To evaluate the effect of pubic symphysiodesis (PS) on pelvic development in skeletally immature dogs. Prospective randomized clinical trial. Eight 4 month-old, sexually intact female Greyhounds. Initial PS was performed at 4 months of age using a powered stapling device. Because of failure of the initial surgery, a second PS was performed 1 month later by resecting the pubic symphysis with a rongeur followed by placement of handmade bone staples in four dogs. Sham PS was performed in four control dogs at 4 months of age. Pubic growth rate and pelvic development were evaluated using standard plane radiography and computed tomography. Specific measurements included acetabular ventroversion, Norberg angle, lateral center-edge angle, and pelvic inlet dimensions. Hip distraction indices were determined as well. PS at 4 months of age using a stapling device failed. Pubic symphysiodesis using hand made staples was successful at 5 months of age and did not result in any clinically significant intraoperative or postoperative complications. Pubic symphysiodesis markedly decreased pubic symphysis growth in the treatment group. Hip distraction indices and pelvic inlet circumference, area, and width significantly decreased in treated dogs compared to those in the control group. Acetabular ventroversion was significantly increased in treated dogs compared to those in the control group. PS decreases pelvic canal size, increases acetabular ventroversion, and does not appear to have any clinically significant complications. PS performed in skeletally immature dogs with hip dysplasia may provide an effect similar to a triple pelvic osteotomy and warrants further investigation.

Is hand sewing comparable with stapling for anastomotic leakage after esophagectomy? A meta-analysis

PubMed Central

Liu, Quan-Xing; Min, Jia-Xin; Deng, Xu-Feng; Dai, Ji-Gang

2014-01-01

AIM: To compare the outcome of hand sewing and stapling for anastomotic leakage after esophagectomy. METHODS: A rigorous study protocol was established according to the recommendations of the Cochrane Collaboration. An electronic database search, hand search, and reference search were used to retrieve all randomized controlled trials that compared hand-sewn and mechanical esophagogastric anastomoses. RESULTS: This study included 15 randomized controlled trials with a total of 2337 patients. The results revealed that there was no significant difference in the incidence of anastomotic leakage between the methods [relative risk (RR) = 0.77, 95% confidence interval (CI): 0.57-1.04; P = 0.09], but a subgroup analysis yielded a significant difference for the sutured layer and year of publication (Ps < 0.05). There was also no significant difference in the incidence of postoperative mortality (RR = 1.52, 95%CI: 0.97-2.40; P = 0.07). However, the anastomotic strictures rate was increased in the stapler group compared with the hand-sewn group (RR = 1.45, 95%CI: 1.11-1.91; P < 0.01) in the end-to-side subgroup, while the incidence of anastomotic strictures was decreased (RR = 0.34, 95%CI: 0.16-0.76; P < 0.01) in the side-to-side subgroup. CONCLUSION: The stapler reduces the anastomotic leakage rate compared with hand sewing. End-to-side stapling increases the risk of anastomotic strictures, but side-to-side stapling decreases the risk. PMID:25493038

A Brief Opportunity to Run Does Not Function as a Reinforcer for Mice Selected for High Daily Wheel-Running Rates

ERIC Educational Resources Information Center

Belke, Terry W.; Garland, Theodore, Jr.

2007-01-01

Mice from replicate lines, selectively bred based on high daily wheel-running rates, run more total revolutions and at higher average speeds than do mice from nonselected control lines. Based on this difference it was assumed that selected mice would find the opportunity to run in a wheel a more efficacious consequence. To assess this assumption…

Fabrication of porous chitosan/poly(vinyl alcohol) reinforced single-walled carbon nanotube nanocomposites for neural tissue engineering.

PubMed

Shokrgozar, Mohammad Ali; Mottaghitalab, Fatemeh; Mottaghitalab, Vahid; Farokhi, Mehdi

2011-04-01

With the ability to form a nano-sized fibrous structure with large pore sizes mimicking the extracellular matrix (ECM), electrospinning was used to fabricate chitosan/poly(vinyl alcohol) nanofibers reinforced by single-walled carbon nanotube (SWNT-CS/PVA) for potential use in neural tissue engineering. Moreover, ultrasonication was performed to fabricate highly dispersed SWNT/CS solution with 7%, 12%, and 17% SWNT content prior to electrospinning process. In the present study, a number of properties of CS/PVA reinforced SWNTs nanocomposites were evaluated. The in vitro biocompatibility of the electrospun fiber mats was also assessed using human brain-derived cells and U373 cell lines. The results have shown that SWNTs as reinforcing phase can augment the morphology, porosity, and structural properties of CS/PVA nanofiber composites and thus benefit the proliferation rate of both cell types. In addition, the cells exhibit their normal morphology while integrating with surrounding fibers. The results confirmed the potential of SWNT-CS/PVA nanocomposites as scaffold for neural tissue engineering.

A sequential learning analysis of decisions in organizations to escalate investments despite continuing costs or losses

PubMed Central

Goltz, Sonia M.

1992-01-01

Reinforcement process may underlie decisions frequently found in organizations to escalate investments of time, money and other resources in strategies (e.g., product development, capital investment, plant expansion) that do not result in immediate reinforces. Whereas cognitive biases have been proffered in previous explanations, the present analysis suggested that this persistence is a form of resistance to extinction arising from experiences with past investments that were variably reinforced. This explanation was examined in two experiments by varying the pattern of returns and losses subjects experienced for investment decisions prior to experiencing a series losses. Consistent with the proposed explanation, two conditions resulted in higher levels of recommitment during continuous losses: (a) training using a variable schedule of partial reinforcement, and (b) no training on the task. Results indicate that behavior analysis can be used to understand and control situations in organizations that are prone to escalation, such as investments in the research and development of new product lines and extensions of further loans to customers. PMID:16795785

Numerical Simulations for Distribution Characteristics of Internal Forces on Segments of Tunnel Linings

NASA Astrophysics Data System (ADS)

Li, Shouju; Shangguan, Zichang; Cao, Lijuan

A procedure based on FEM is proposed to simulate interaction between concrete segments of tunnel linings and soils. The beam element named as Beam 3 in ANSYS software was used to simulate segments. The ground loss induced from shield tunneling and segment installing processes is simulated in finite element analysis. The distributions of bending moment, axial force and shear force on segments were computed by FEM. The commutated internal forces on segments will be used to design reinforced bars on shield linings. Numerically simulated ground settlements agree with observed values.

CD-ROM-aided Databases

NASA Astrophysics Data System (ADS)

Kusama, Hideo; Matsumoto, Toshiaki

The CD-ROM system can be used independently or as a compliment to an on-line data system. It has many of the same features as an on-line system. Nippan developed the CD-NOCS system as a reinforcement or substitute for the on-line systems of the customers (bookstores). CD-NOCS is not necessarily designed just for bookstores, it is also applicable to libraries and companies. Authors would also like to emphasize that it is important to understand the development and background of the CD-NOCS system, as well as its operations.

Diagnosis and treatment of haemorrhoids.

PubMed

Buntzen, Steen; Christensen, Peter; Khalid, Ali; Ljungmann, Ken; Lindholt, Jan; Lundby, Lilli; Walker, Line Rossell; Raahave, Dennis; Qvist, Niels

2013-12-01

These guidelines provide a review of diagnosis, conservative and surgical treatment of haemorrhoids with primary focus on the surgical treatment. In symptomatic hemorrhoids it is recommended, that conservative treatment is used as basic treatment regardless of grading. The vast majority of grade II haemorrhoids are treated conservatively, but surgery may be considered in a few cases with pronounced symptoms. In these cases chirurgia minor, Doppler guided dearterilization procedures or stapled haemorrhoidopexy are recommended. In grade III and IV Doppler guided dearterilization procedures, stapled haemorrhoidopexy (Grade III) or conventional Milligan Morgan haemorrhoidectomy are recommended.

Culvert rehabilitation & invert lining using fiber reinforced polymer (FRP) composites.

DOT National Transportation Integrated Search

2010-06-01

As part of the state of Maine bridge funding initiative, MaineDOT has partnered with the University of : Maines AEWC Advanced Structures and Composite Center and the Maine composites industry to : incorporate composite technologies into bridge con...

Study on the measures of tunnels side-crossing bridge based on sheltering effects of isolation piles

NASA Astrophysics Data System (ADS)

Tang, Jian; Liu, Jun yan; Liu, Yan

2017-08-01

Based on the transit line 3, we studied the effect of the bridge piles crossed closely from the side by the shield tunnel. Using the three-dimensional finite element numerical analysis software Midas GTS/NX, we analyzed the effect of shield tunnel on pile deformation, statistics are obtained that under the condition of pile, subgrade reinforcement and ground changes. The calculation results show that in the condition of reinforcement, the new tunnel shield crossing through the pile caused longitudinal disturbance of the tunnel surrounding strata along the tunnel, where the soil over the area is within a certain range of pile and settlement deformation of surface subsidence occurs, changing the surface roughly to the shape of “V”. The maximum value appears above the shield tunnel and the value is high. In combination with engineering geology, hydrogeology and environment factors, this paper adopted isolation pile reinforcement to the pile, and the simulated results show that, pile settlement was significantly reduced under the condition of pile reinforcement. The calculation results show the rationality of the reinforcement scheme to a certain extent, which provides a theoretical basis for the similar tunnel.

Investigation on surface layer characteristics of shot peened graphene reinforced Al composite by X-ray diffraction method

NASA Astrophysics Data System (ADS)

Zhan, Ke; Wu, Yihao; Li, Jiongli; Zhao, Bin; Yan, Ya; Xie, Lechun; Wang, Lianbo; Ji, V.

2018-03-01

Graphene reinforced Al composite with high mechanical property was successfully reported. However, there are quite limited studies about shot peening effect on this new type material. Here, 1.0 wt% graphene reinforced Al composite was produced by powder metallurgy and treated by shot peening. The surface layer characteristics of shot peened composite was investigated by X-ray diffraction line profile analysis. The microstructure including domain size, micro-strain, dislocation density and crystalline texture were analyzed. The results showed that after surface shot-peening, the domain size were refined, the dislocation density of the composite was increased sharply to 9.0 × 1011/cm2 at the top surface. The original strong texture was diminished after shot peening. Based on the calculated results, the microstructure variation of composite was more severe than that of Al without graphene reinforcement after shot peening. Besides, the micro-hardness of composite at the top surface increased up to 75HV one time higher than that of matrix. It is concluded that shot peening can be considered as an essential process of improving the surface properties of graphene reinforced Al composite.

Laboratory simulation of high-frequency GPR responses of damaged tunnel liners

NASA Astrophysics Data System (ADS)

Siggins, A. F.; Whiteley, Robert J.

2000-04-01

Concrete lined tunnels and pipelines commonly suffer from damage due to subsidence or poor drainage in the surrounding soils, corrosion of reinforcement if present, and acid vapor leaching of the lining. There is a need to conduct tunnel condition monitoring using non-destructive testing methods (NDT) on a regular basis in many buried installations, for example sewers and storm water drains. A wide variety of NDT methods have been employed in the past to monitor these linings including closed circuit TV (CCTV) inspection, magnetic and various electromagnetic and seismic methods. Ground penetrating radar, GPR, is a promising technique for this application, however there are few systems currently available that can provide the high resolution imaging needed to test the lining. A recently developed Australian GPR system operating at 1400 MHz offers the potential to overcome many of these limitations while maintaining adequate resolution to the rear of the linings which are typically less than 0.5 meters thick. The new high frequency GPR has a nominal resolution of 0.03 m at the center of the pulse band-width. This is a significant improvement over existing radars with the possible exception of some horn based systems. This paper describes the results of a laboratory study on a model tunnel lining using the new 1.4 GHz radar. The model simulated a concrete lining with various degrees of damage including, heavily leached sections, voids and corroded reinforcing. The test results established that the new GPR was capable of imaging subtle variations in the concrete structure and that simulated damage could be detected throughout the liner depth. Furthermore, resolution was found to exceed 0.02 m which was significantly better than expected.

Gas distributor for fluidized bed coal gasifier

DOEpatents

Worley, Arthur C.; Zboray, James A.

1980-01-01

A gas distributor for distributing high temperature reaction gases to a fluidized bed of coal particles in a coal gasification process. The distributor includes a pipe with a refractory reinforced lining and a plurality of openings in the lining through which gas is fed into the bed. These feed openings have an expanding tapered shape in the downstream or exhaust direction which aids in reducing the velocity of the gas jets as they enter the bed.

Long-term outcome of stapled transanal rectal resection (STARR) versus stapled hemorrhoidopexys (STH) for grade III-IV hemorrhoids: preliminary results.

PubMed

Zanella, Simone; Spirch, Saverio; Scarpa, Marco; Ricci, Francesco; Lumachi, Franco

2014-01-01

Circular stapled transanal hemorrhoidopexy (STH) was first introduced by A. Longo for the correction of internal mucosal prolapse and obstructed defecation and in 1998, was proposed as alternative to conventional excisional hemorrhoidectomy. More recently, stapled transanal rectal resection (STARR) has gradually gained popularity, as the Longo procedure, in the treatment of hemorrhoids. The aim of our study was to evaluate the usefulness of STARR as alternative to STH in patients with grade III (n=218, 68.1%) and IV (n=102, 31.9%) hemorrhoids. A group of 320 consecutive patients (median age=51 years; range=16-85) underwent STH (n=281) or STARR (n=39) procedure. The rate of postoperative bleeding (53.8% vs. 74.4%, p<0.01) was significantly reduced in patients who underwent STARR procedure, which required a longer (45 ± 22 vs. 26 ± 11 min, p<0.01) operative time. There were no differences between groups with regard to use of painkillers, postoperative pain intensity, short- (three months) and long-term (one and three years) residual pain, soiling, incontinence and urgency. Patients treated with the STARR procedure had lower recurrence rate of hemorrhoids and a lower incidence of prolapse, both at one year (none vs. 1.4%, p=0.593 and 2.6% vs. 5.3%, p=0.396, respectively) and at two years (none vs. 6.8%, p=0.078 and none vs. 13.2%, p=0.012, respectively). The one-year (9.0 ± 1.8 vs. 9.4 ± 0.7, p=0.171) and two-year (9.6 ± 0.8 vs. 9.1 ± 1.7, p=0.072) general satisfaction was similar but higher in STARR patients than in the STH group. In conclusion, according to our preliminary results, the STARR procedure leads to a lower incidence of complications and recurrences and should be considered for patients with grade III or IV hemorrhoids previously selected for stapled hemorrhoidectomy, as a promising alternative to STH. Copyright © 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

An open, prospective, randomized pilot investigation evaluating pain with the use of a soft silicone wound contact layer vs bridal veil and staples on split thickness skin grafts as a primary dressing.

PubMed

Patton, Mary Lou; Mullins, Robert Fred; Smith, David; Korentager, Richard

2013-01-01

An open, prospective, randomized, pilot investigation was implemented to evaluate the pain, cost-effectiveness, ease of use, tolerance, efficacy, and safety of a soft silicone wound contact layer (Mepitel One) vs Bridal Veil and staples used on split thickness skin grafts in the treatment of deep partial or full-thickness thermal burns. Individuals aged between 18 and 70 years with deep partial or full-thickness thermal burns (1-25% TBSA) were randomized into two groups and treated for 14 days or until greater than 95% graft take was achieved, whichever occurred first. Data were obtained and analyzed on pain experienced before, during, and after dressing removal. Secondary considerations included the overall cost (direct), graft take and healing, the ease of product use, overall experience of the dressing, and adverse events. A total of 43 subjects were recruited. There were no significant differences in burn area profiles within the groups. The pain level during dressing removal was significant between the groups (P = .0118) with the removal of Mepitel One being less painful. The staff costs were lower in the group of patients treated with Mepitel One (P = .0064) as reflected in the shorter time required for dressing removal (P = .0005), with Mepitel One taking on average less than a quarter of the time to remove. There was no significant difference in healing between the two groups, with 99.0% of the Mepitel One group and 93.1% of the Bridal Veil and staples group showing greater than 95% graft take at post-op day 7 (+/-1) (P = .2373). Clinicians reported that the soft silicone dressing was easier to use, more conformable, and demonstrated better ability to stay in place, compared with the Bridal Veil and staples regime. Both treatments were well tolerated, with no serious adverse events in either treatment group. Mepitel One was at least as effective in the treatment of patients as the standard care (Bridal Veil and staples). In addition, the group of patients treated with the soft silicone dressing demonstrated decreased pain and lower costs associated with treatment.

Dynamic Analysis of Tunnel in Weathered Rock Subjected to Internal Blast Loading

NASA Astrophysics Data System (ADS)

Tiwari, Rohit; Chakraborty, Tanusree; Matsagar, Vasant

2016-11-01

The present study deals with three-dimensional nonlinear finite element (FE) analyses of a tunnel in rock with reinforced concrete (RC) lining subjected to internal blast loading. The analyses have been performed using the coupled Eulerian-Lagrangian analysis tool available in FE software Abaqus/Explicit. Rock and RC lining are modeled using three-dimensional Lagrangian elements. Beam elements have been used to model reinforcement in RC lining. Three different rock types with different weathering conditions have been used to understand the response of rock when subjected to blast load. The trinitrotoluene (TNT) explosive and surrounding air have been modeled using the Eulerian elements. The Drucker-Prager plasticity model with strain rate-dependent material properties has been used to simulate the stress-strain response of rock. The concrete damaged plasticity model and Johnson-Cook plasticity model have been used for the simulation of stress-strain response of concrete and steel, respectively. The explosive (TNT) has been modeled using Jones-Wilkins-Lee (JWL) equation of state. The analysis results have been studied for stresses, deformation and damage of RC lining and the surrounding rock. It is observed that damage in RC lining results in higher stress in rock. Rocks with low modulus and high weathering conditions show higher attenuation of shock wave. Higher amount of ground shock wave propagation is observed in case of less weathered rock. Ground heave is observed under blast loading for tunnel close to ground surface.

Evaluation of ultraliner PVC alloy pipeliner.

DOT National Transportation Integrated Search

2013-12-01

In an effort to evaluate promising pipe lining techniques, the Agency installed two Ultraliner : PVC Alloy Pipeliners in the town of Barton, Vermont in May of 2003; one in an 18 : - : inch (450 : mm nominal) reinforced concrete pipe (RCP) and one in ...

Patient and surgical factors influencing air leak after lung volume reduction surgery: lessons learned from the National Emphysema Treatment Trial.

PubMed

DeCamp, Malcolm M; Blackstone, Eugene H; Naunheim, Keith S; Krasna, Mark J; Wood, Douglas E; Meli, Yvonne M; McKenna, Robert J

2006-07-01

Although staple line buttressing is advocated to reduce air leak after lung volume reduction surgery (LVRS), its effectiveness is unknown. We sought to identify risk factors for air leak and its duration and to estimate its medical consequences for selecting optimal perioperative technique(s), such as buttressing technique, to preempt or treat post-LVRS air leak. Detailed air leak data were available for 552 of 580 patients receiving bilateral stapled LVRS in the National Emphysema Treatment Trial. Risk factors for prevalence and duration of air leak were identified by logistic and hazard function analyses. Medical consequences were estimated in propensity-matched pairs with and without air leak. Within 30 days of LVRS, 90% of patients developed air leak (median duration = 7 days). Its occurrence was more common and duration prolonged in patients with lower diffusing capacity (p = 0.06), upper lobe disease (p = 0.04), and important pleural adhesions (p = 0.007). Duration was also protracted in Caucasians (p < 0.0001), patients using inhaled steroids (p = 0.004), and those with lower 1-second forced expiratory volume (p = 0.0003). Surgical approach, buttressing, stapler brand, and intraoperative adjunctive procedures were not associated with fewer or less prolonged air leaks (p >/= 0.2). Postoperative complications occurred more often in matched patients experiencing air leak (57% vs 30%, p = 0.0004), and postoperative stay was longer (11.8 +/- 6.5 days vs 7.6 +/- 4.4 days, p = 0.0005). Air leak accompanies LVRS in 90% of patients, is often prolonged, and is associated with a more complicated and protracted hospital course. Its occurrence and duration are associated with characteristics of patients and their disease, not with a specific surgical technique.

Biofortification of essential nutritional compounds and trace elements in rice and cassava.

PubMed

Sautter, C; Poletti, S; Zhang, P; Gruissem, W

2006-05-01

Plant biotechnology can make important contributions to food security and nutritional improvement. For example, the development of 'Golden Rice' by Professor Ingo Potrykus was a milestone in the application of gene technology to deliver both increased nutritional qualities and health improvement to wide sections of the human population. Mineral nutrient and protein deficiency as well as food security remain the most important challenges for developing countries. Current projects are addressing these issues in two major staple crops, cassava (Manihot esculenta Crantz) and rice. The tropical root crop cassava is a major source of food for approximately 600 million of the population worldwide. In sub-Saharan Africa >200 million of the population rely on cassava as their major source of dietary energy. The nutritional quality of the cassava root is not sufficient to meet all dietary needs. Rice is the staple food for half the world population, providing approximately 20% of the per capita energy and 13% of the protein for human consumption worldwide. In many developing countries the dietary contributions of rice are substantially greater (29.3% dietary energy and 29.1% dietary protein). The current six most popular 'mega' rice varieties (in terms of popularity and acreage), including Chinese hybrid rice, have an incomplete amino acid profile and contain limited amounts of essential micronutrients. Rice lines with improved Fe contents have been developed using genes that have functions in Fe absorption, translocation and accumulation in the plant, as well as improved Fe bioavailability in the human intestine. Current developments in biotechnology-assisted plant improvement are reviewed and the potential of the technology in addressing human nutrition and health are discussed.

Landslide Caused Damages in a Gallery

NASA Astrophysics Data System (ADS)

Poisel, R.; Mair am Tinkhof, K.; Preh, A.

2016-06-01

On October 5th, 2010, cracks were found in a gallery 1.8 m high and 1.4 m wide. The gallery is 100 years old, runs parallel to a valley flank and was excavated in a tectonically strongly stressed, weathered and slightly dipping sandwich of clayey shales, sandstones and marls. The cracks in the roof as well as in the invert ran parallel to the axis of the gallery. Monitoring showed that crack widths were increasing 1.5 mm per year, sidewall distances were increasing 3.5 mm per year, whereas the height of the gallery was decreasing 2.5 mm per year. After eliminating several possible causes of cracking, a landslide producing the damages had to be taken into consideration. Monitoring of the valley flank surface as well as inclinometer readings revealed that a landslide was occurring, loading the gallery lining. Most probably the landslide had been reactivated by excessive rainfall in 2009 as well as by works for the renewal of a weir in the valley bottom. As stabilization of the slope was not an option for several reasons, it was decided to replace the gallery by a new one deeper inside the slope, which will be ready for operation in 2017. Thus the old gallery has to be kept in operation till then and it was decided to reinforce the old gallery by a heavily reinforced shotcrete lining 10 cm thick. As slope displacements went on, cracks in the shotcrete lining developed with a completely different pattern: in the section where the gallery lies completely in the landslide shear zone no cracks formed until now due to heavy reinforcement, whereas in the transition sections stable ground-landslide and landslide-stable ground diagonal tension cracks in the roof due to shear by the landslide developed. Numerical models showed that cracking and spalling of the shotcrete lining would occur only after some centimetres of additional displacements of the slope, which hopefully will not occur before 2017.

Modified Longo's stapled hemorrhoidopexy with additional traction sutures for the treatment of residual prolapsed piles.

PubMed

Chen, Chuang-Wei; Kang, Jung-Cheng; Wu, Chang-Chieh; Hsiao, Cheng-Wen; Jao, Shu-Wen

2008-03-01

Residual prolapsed piles is a problem after the stapled hemorrhoidopexy, especially in large third- or fourth-degree hemorrhoids. We have developed a method using additional traction sutures along with modified Longo's procedure to manage this problem. From January 2005 to October 2005, 30 consecutive patients with symptomatic third- or fourth-degree hemorrhoids who underwent the modified Longo's stapled hemorrhoidopexy with additional traction sutures in a single institution were collected. The demographics, postoperative pain score, surgical features, outcomes, and early and late complications were recorded. All patients were followed for a mean duration of 8.8 (range, 4-15) months. Thirty patients (17 males) with a mean age of 45 (range, 27-63) years were identified. The mean postoperative pain score on the morning of the first postoperative day was 2.8 (range, 1-4). The mean duration of operation was 30.7 (range, 25-37) min. The mean duration of hospital stay was 2 (range, 1-3) days. The mean days for patients to resume normal work was 6.7 (range, 4-9) days. No other procedure-related complications occurred in all patients. There was no early complication except for fecal urgency found in one patient during the first postoperative days. Regarding the late complications, no residual prolapsed piles, persistent anal pain, incontinence, anal stenosis, or recurrent symptoms were found. Our preliminary experiences indicated that this modified procedures truly contributed to reduce the residual internal hemorrhoids and maintained the benefits of stapled hemorrhoidopexy. Randomized trial and long-term follow-up warrant to determine possible surgical and functional outcome.

Dietary acculturation among the South-Asian Surinamese population in the Netherlands: the HELIUS study.

PubMed

Raza, Qaisar; Nicolaou, Mary; Snijder, Marieke B; Stronks, Karien; Seidell, Jacob C

2017-08-01

To test Koctürk's model of dietary change among South-Asian Surinamese in the Netherlands. The model categorizes foods into staple, complementary and accessory foods and postulates that dietary change after migration begins with accessory foods while foods associated with ethnic identity (staple foods) change at a slower rate. Cross-sectional data from the HELIUS study. Dietary intake was assessed with an FFQ. Acculturation was based on social contacts and sense of belonging and was translated into four strategies of acculturation: assimilation, integration, separation and marginalization. Other indicators of acculturation included residence duration, age at migration and migration generation status. Amsterdam, the Netherlands. Participants of Dutch (n 1456) and South-Asian Surinamese origin (n 968). Across all acculturation strategies, South-Asian Surinamese participants reported significantly higher intakes of rice (staple food) and chicken (complementary food) and significantly lower intakes of red meat and vegetables (complementary foods) and cookies and sweets (accessory food) than Dutch participants. Men, second-generation and assimilated South-Asian Surinamese were inclined towards Dutch foods such as potato, pasta and red meat. Accessory foods like fruits showed variation across acculturation strategies. Consistent with the Koctürk model, the intake of staple foods was stable among South-Asian Surinamese irrespective of acculturation strategy while the intake of accessory foods like fruit varied. Contrary to expectations, South-Asian Surinamese showed consistently high intakes of complementary foods like chicken and fish irrespective of acculturation strategy. Public health practitioners should take into consideration the complex and dynamic nature of dietary acculturation.

A modified efficient purse-string stapling technique (mEST) that uses a new metal rod for intracorporeal esophagojejunostomy in laparoscopic total gastrectomy

PubMed Central

Moon, Jeong-Ho; Yamamoto, Kazuyoshi; Yanagimoto, Yoshitomo; Sugimura, Keijirou; Miyata, Hiroshi; Yano, Masahiko; Sakon, Masato

2017-01-01

Intracorporeal esophagojejunostomy after laparoscopic total gastrectomy is technically difficult because this procedure should be performed in a narrow surgical field in the upper abdomen even when completely laparoscopic approaches are used. The placement of the anvil of a circular stapling device into the esophagus and connection the instrument to the anvil are extremely difficult steps in this surgery. Therefore, we developed a simple technique for intracorporeal esophagojejunostomy using hemi-double stapling technique; we named this technique the efficient purse-string stapling technique (EST). More recently, we have developed a modified EST (mEST) that utilizes a new stainless steel anvil rod instead of a plastic rod. Relative to the plastic rod, the steel rod is reusable and shorter; thus, it was easier to perform anvil placement into the esophagus with the steel rod. Anvil preparation for mEST: a stainless steel rod is attached to the shaft of the anvil, and the needle and thread are sutured to the tip of the rod. After complete insertion of the anvil into the esophageal cavity, the needle and thread are used to penetrate the anterior esophageal wall, and the esophagus is then clamped using a linear stapler just distal to the site penetrated by the thread. The linear stapler is fired, and anvil placement in the esophagus is simultaneously accomplished. After the rod is removed from the anvil, the instrument is intracorporeally connected to the anvil and then fired to complete the gastrojejunostomy. This technique is simple and facilitates intracorporeal reconstruction procedures in laparoscopic total gastrectomy. PMID:28815221

Retrograde stapling of a free cervical jejunal interposition graft: a technical innovation and case report

PubMed Central

2014-01-01

Background Free jejunal interposition is a useful technique for reconstruction of the cervical esophagus. However, the distal anastomosis between the graft and the remaining thoracic esophagus or a gastric conduit can be technically challenging when located very low in the thoracic aperture. We here describe a modified technique for retrograde stapling of a jejunal graft to a failed gastric conduit using a circular stapler on a delivery system. Case presentation A 56 year-old patient had been referred for esophageal squamous cell carcinoma at 20 cm from the incisors. On day 8 after thoracoabdominal esophagectomy with gastric pull-up, an anastomotic leakage was diagnosed. A proximal-release stent was successfully placed by gastroscopy and the patient was discharged. Two weeks later, an esophagotracheal fistula occurred proximal to the esophageal stent. Cervical esophagostomy was performed with cranial closure of the gastric conduit, which was left in situ within the right hemithorax. Three months later, reconstruction was performed using a free jejunal interposition. The anvil of a circular stapler (Orvil®, Covidien) was placed transabdominally through an endoscopic rendez-vous procedure into the gastric conduit. A free jejunal graft was retrogradely stapled to the proximal end of the conduit. Microvascular anastomoses were performed subsequently. The proximal anastomosis of the conduit was completed manually after reperfusion. Conclusions This modified technique allows stapling of a jejunal interposition graft located deep in the thoracic aperture and is therefore a useful method that may help to avoid reconstruction by colonic pull-up and thoracotomy. PMID:25319372

Breakfast staple types affect brain gray matter volume and cognitive function in healthy children.

PubMed

Taki, Yasuyuki; Hashizume, Hiroshi; Sassa, Yuko; Takeuchi, Hikaru; Asano, Michiko; Asano, Kohei; Kawashima, Ryuta

2010-12-08

Childhood diet is important for brain development. Furthermore, the quality of breakfast is thought to affect the cognitive functioning of well-nourished children. To analyze the relationship among breakfast staple type, gray matter volume, and intelligence quotient (IQ) in 290 healthy children, we used magnetic resonance images and applied voxel-based morphometry. We divided subjects into rice, bread, and both groups according to their breakfast staple. We showed that the rice group had a significantly larger gray matter ratio (gray matter volume percentage divided by intracranial volume) and significantly larger regional gray matter volumes of several regions, including the left superior temporal gyrus. The bread group had significantly larger regional gray and white matter volumes of several regions, including the right frontoparietal region. The perceptual organization index (POI; IQ subcomponent) of the rice group was significantly higher than that of the bread group. All analyses were adjusted for age, gender, intracranial volume, socioeconomic status, average weekly frequency of having breakfast, and number of side dishes eaten for breakfast. Although several factors may have affected the results, one possible mechanism underlying the difference between the bread and the rice groups may be the difference in the glycemic index (GI) of these two substances; foods with a low GI are associated with less blood-glucose fluctuation than are those with a high GI. Our study suggests that breakfast staple type affects brain gray and white matter volumes and cognitive function in healthy children; therefore, a diet of optimal nutrition is important for brain maturation during childhood and adolescence.

Reinforcement learning in professional basketball players

PubMed Central

Neiman, Tal; Loewenstein, Yonatan

2011-01-01

Reinforcement learning in complex natural environments is a challenging task because the agent should generalize from the outcomes of actions taken in one state of the world to future actions in different states of the world. The extent to which human experts find the proper level of generalization is unclear. Here we show, using the sequences of field goal attempts made by professional basketball players, that the outcome of even a single field goal attempt has a considerable effect on the rate of subsequent 3 point shot attempts, in line with standard models of reinforcement learning. However, this change in behaviour is associated with negative correlations between the outcomes of successive field goal attempts. These results indicate that despite years of experience and high motivation, professional players overgeneralize from the outcomes of their most recent actions, which leads to decreased performance. PMID:22146388

Thoracoscopic modified pleural tent for spontaneous pneumothorax.

PubMed

Kawachi, Riken; Matsuwaki, Rie; Tachibana, Keisei; Karita, Shin; Nakazato, Yoko; Tanaka, Ryota; Nagashima, Yasushi; Takei, Hidefumi; Kondo, Haruhiko

2016-08-01

We developed a modified pleural tent (m-tent) procedure and used it in our hospital in almost 30 consecutive patients with spontaneous pneumothorax. The objective of this study was to clarify the feasibility and effectiveness of a thoracoscopic m-tent for the treatment of spontaneous pneumothorax. From July 2013 to November 2014, 107 patients with spontaneous pneumothorax were treated in our institution. Eighty-nine of these patients were analysed retrospectively. The inclusion criteria for thoracoscopic m-tent for spontaneous pneumothorax were multiple and widespread bullae, postoperative relapse and secondary spontaneous pneumothorax. The surgical procedures were usually performed through three ports. After bullectomy, an m-tent is made to strip the parietal pleura off the chest wall from about the level of the fourth or fifth rib to the apex, and two or three ligations are then applied to fix the pleural tent and lung parenchyma. Patients in whom an m-tent was not indicated underwent bullectomy plus coverage using absorbable materials. Twenty-seven patients underwent bullectomy plus m-tent (m-tent group) and 62 underwent bullectomy plus coverage over a staple line using an absorbable material such as a polyglycolic acid sheet or nitrocellulose sheet (coverage group). No severe postoperative complications were observed in either group. The m-tent and coverage groups showed significant differences in operation time (129 vs 86 min, mean), haemorrhage (12.8 vs 7.2 ml), postoperative hospital stay (3.7 vs 2.9 days) and postoperative painkiller intake (8.6 vs 6.8 days). Recurrence was observed in 1 (3.7%) and 2 patients (3.2%), respectively. The thoracoscopic m-tent procedure requires a longer operation, a longer hospital stay and greater painkiller intake. However, these differences are acceptable, and an m-tent should be considered as an option for pleural reinforcement in spontaneous pneumothorax, especially in patients who are complicated with severe pulmonary emphysema, widespread bullae or recurrent pneumothorax. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Investigation of deformation of elements of three-dimensional reinforced concrete structures located in the soil, interacting with each other through rubber gaskets

NASA Astrophysics Data System (ADS)

Berezhnoi, D. V.; Balafendieva, I. S.; Sachenkov, A. A.; Sekaeva, L. R.

2017-06-01

In work the technique of calculation of elements of three-dimensional reinforced concrete substructures located in a soil, interacting with each other through rubber linings is realized. To describe the interaction of deformable structures with the ground, special “semi-infinite” finite elements are used. A technique has been implemented that allows one to describe the contact interaction of three-dimensional structures by means of a special contact finite element with specific properties. The obtained numerical results are compared with the experimental data, their good agreement is noted.

Fiber glass reinforcement wrap gets DOT nod for gas-line use

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1993-12-13

Panhandle Eastern Corp.'s Texas Eastern Transmission Corp. has become the first US natural-gas pipeline company to install, under federal waiver, a fiber glass reinforcement on an in-service gas pipeline. The Clock Spring repair system was installed in August on six segments of Texas Eastern's 20-in. gas pipeline in Fayette County, Ohio, after the company had received a US Department of Transportation (DOT) waiver to use the system in place of conventional DOT-mandated repair methods. The paper describes the conventional methods, as well as comparing costs of both methods.

Stapled haemorrhoidectomy in the operative treatment of grade III and IV haemorrhoids.

PubMed

Shrestha, S; Pradhan, G B N; Shrestha, R; Poudel, P; Bhattachan, C L

2014-09-01

Stapled haemorrhoidectomy (SH) is a minimally invasive intervention that uses a stapling device which avoids the need for wounds in the sensitive anal area and reduces the pain after surgery. This study was undertaken in Nepal Medical College Teaching Hospital from January 2010 to December 2012 to evaluate the efficacy of this modality of treatment among patients (32) who presented in the Surgery OPD with grade III and grade IV haemorrhoids. The results of SH were evaluated by the relief of symptoms, severity of post operative pain, and complications of SH. Twenty five (78.1%) patients had grade III and 7 (21.9%) presented with grade IV hemorrhoids. The most frequent presentation reported in our study was bleeding per rectum with perianal prolapse. Mean operating time was 40-60 minutes whereas mean hospital stay was 1.9 days. Urinary retention was the most common complication found in 12 (37.5%) patients in the immediate post operative period. SH is a safe, rapid, and convenient surgical remedy for grade III and grade IV hemorrhoids with low rate of complications, minimal postoperative pain, and shorter hospital stay.

Transgenic Biofortification of the Starchy Staple Cassava (Manihot esculenta) Generates a Novel Sink for Protein

PubMed Central

Abhary, Mohammad; Siritunga, Dimuth; Stevens, Gene; Taylor, Nigel J.; Fauquet, Claude M.

2011-01-01

Although calorie dense, the starchy, tuberous roots of cassava provide the lowest sources of dietary protein within the major staple food crops (Manihot esculenta Crantz). (Montagnac JA, Davis CR, Tanumihardjo SA. (2009) Compr Rev Food Sci Food Saf 8:181–194). Cassava was genetically modified to express zeolin, a nutritionally balanced storage protein under control of the patatin promoter. Transgenic plants accumulated zeolin within de novo protein bodies localized within the root storage tissues, resulting in total protein levels of 12.5% dry weight within this tissue, a fourfold increase compared to non-transgenic controls. No significant differences were seen for morphological or agronomic characteristics of transgenic and wild type plants in the greenhouse and field trials, but relative to controls, levels of cyanogenic compounds were reduced by up to 55% in both leaf and root tissues of transgenic plants. Data described here represent a proof of concept towards the potential transformation of cassava from a starchy staple, devoid of storage protein, to one capable of supplying inexpensive, plant-based proteins for food, feed and industrial applications. PMID:21283593

Transgenic biofortification of the starchy staple cassava (Manihot esculenta) generates a novel sink for protein.

PubMed

Abhary, Mohammad; Siritunga, Dimuth; Stevens, Gene; Taylor, Nigel J; Fauquet, Claude M

2011-01-25

Although calorie dense, the starchy, tuberous roots of cassava provide the lowest sources of dietary protein within the major staple food crops (Manihot esculenta Crantz). (Montagnac JA, Davis CR, Tanumihardjo SA. (2009) Compr Rev Food Sci Food Saf 8:181-194). Cassava was genetically modified to express zeolin, a nutritionally balanced storage protein under control of the patatin promoter. Transgenic plants accumulated zeolin within de novo protein bodies localized within the root storage tissues, resulting in total protein levels of 12.5% dry weight within this tissue, a fourfold increase compared to non-transgenic controls. No significant differences were seen for morphological or agronomic characteristics of transgenic and wild type plants in the greenhouse and field trials, but relative to controls, levels of cyanogenic compounds were reduced by up to 55% in both leaf and root tissues of transgenic plants. Data described here represent a proof of concept towards the potential transformation of cassava from a starchy staple, devoid of storage protein, to one capable of supplying inexpensive, plant-based proteins for food, feed and industrial applications.

Pelvic flexure enterotomy closure in the horse with a TA-90 stapling device: A retrospective clinical study of 84 cases (2001–2008)

PubMed Central

Rosser, Julie; Brounts, Sabrina; Slone, Don; Lynch, Tim; Livesey, Michael; Hughes, Faith; Clark, Carol

2012-01-01

Our objective was to compare survival and complication rates of horses undergoing pelvic flexure enterotomy closure with a TA-90 stapler to those with hand-sewn closure. Medical records of horses undergoing pelvic flexure enterotomy between 2001 and 2008 were reviewed. History, clinical signs, surgical findings, surgical techniques, and post-operative complications were recorded. Long-term outcome was established by telephone questionnaire. Of 84 pelvic flexure enterotomies performed, 70 were stapled and 14 were hand-sewn. Seventy-seven horses survived to discharge (91.7%). There were no significant associations between survival and closure technique (P = 0.69). Follow-up was available for 54 horses; 50 survived long-term (93.0%). No statistical significance was identified between long-term survival and closure method (P = 0.39). Forty horses went on to athletic performance (80.0%). TA-90 stapled closure of pelvic flexure enterotomies is a safe technique resulting in survival and complication rates equivalent to those of hand-sewn closure. PMID:23204584

Assessment of the use of disposable skin staplers in bowel anastomoses to reduce laparotomy time in penetrating ballistic injury to the abdomen.

PubMed Central

Howell, G. P.; Ryan, J. M.; Morgans, B. T.; Cooper, G. J.

1991-01-01

Laparotomy and anastomosis of the small bowel after penetrating injury to the abdomen is a lengthy procedure. This paper describes the use of skin staplers for bowel anastomosis and presents the results of a short series of experiments upon dead pigs to compare the staple technique with conventional handsewn anastomosis. The time taken to perform each small bowel anastomosis, the integrity of the anastomosis and the skill required were assessed. The staple technique was considerably faster (mean construction time: 5.4 min, range 4-6 min) than the handsewn technique (mean construction time: 12 min, range 10-14 min), at least halving the anastomosis time (Kolmogorov two-sample test P = 0.05). In addition, the stapled anastomosis had a higher intraluminal failure pressure (mean failure pressure: 65 cmH2O, 6.37 kPa, range 30-70 cmH2O) than the handsewn anastomosis (mean failure pressure: 38.6 cmH2O, 3.78 kPa, range 10-70 cmH2O). Images Figure 1 Figure 2 Figure 3 Figure 4 PMID:2018326

A simplified technique for continent urinary diversion: an all-stapled colonic reservoir.

PubMed

Parra, R O

1991-12-01

A simple continent colonic reservoir was constructed in its entirety with the aid of surgical stapling techniques in 17 men and 10 women. In 5 men an orthotopic pouch was created and in the rest a continent stoma was designed. Detubularization of the entire colonic segment assures a low pressure system with disruption of directional peristaltic activity. The ureters are implanted by simply burying them in a mucosal furrow. Operative time required for the creation of the reservoir (excluding time for cystectomy) has ranged between 70 and 140 minutes (mean 95.4 minutes). With a followup of 9 to 60 months (mean 22.8 months) continence has been achieved in all but 1 patient with no ureteral reflux or obstruction. Urodynamically the pouch has achieved a large capacity (mean 750 cc) with low filling pressures (8.1 cm. water) because of technical ease of construction together with a shortened operative time due to the stapling techniques. This form of bladder replacement offers an option for select patients in whom continent urinary diversion is contemplated.

Antioxidant capacity, total phenolics and nutritional content in selected ethiopian staple food ingredients.

PubMed

Forsido, Sirawdink Fikreyesus; Rupasinghe, H P Vasantha; Astatkie, Tess

2013-12-01

The total antioxidant capacity, total phenolics content (TPC) and nutritional content of five types of enset (Enset ventricosum) flour in comparison with four staples (teff [Eragrostis tef], wheat, corn and tapioca) were evaluated. Teff, corn and "amicho" (corm of enset) had the highest ferric reducing antioxidant power (FRAP). The FRAP and TPC of teff (1.8 mmol Trolox equivalence/100 g dry matter (DM) and 123.6 mg gallic acid equivalent/100 g DM, respectively) were over 4-fold larger than the lowest obtained from "bulla" (dehydrated juice of pseudostem of enset). Corn had the lowest IC(50) value of 1,1-diphenyl-2-picrylhydrazyl radical scavenging (10.27 mg DM mL(-1)). Teff had the highest crude fat content (3.71%) and some mineral profile (P, Mg, Mn and Cu). Enset products had higher fiber, Ca, K, Mg and Mn content as compared to wheat and corn. Ethiopian staple teff has a potential for developing value-added food products with nutritional and health benefits.

Field trial of GABA-fortified rice plants and oral administration of milled rice in spontaneously hypertensive rats.

PubMed

Kowaka, Emi; Shimajiri, Yasuka; Kawakami, Kouhei; Tongu, Miki; Akama, Kazuhito

2015-06-01

Hypertension is one of the most critical risk factors accompanying cardiovascular diseases. γ-Aminobutyric acid (GABA) is a non-protein amino acid that functions as a major neurotransmitter in mammals and also as a blood-pressure lowering agent. We previously produced GABA-fortified rice lines of a popular Japonica rice cultivar 'Koshihikari' by genetic manipulation of GABA shunt-related genes. In the study reported here, we grew these same novel rice lines in a field trial and administered the milled rice orally to rats. The yield parameters of the transgenic rice plants were almost unchanged compared to those of untransformed cv. 'Koshihikari' plants, while the rice grains of the transgenic plants contained a high GABA content (3.5 g GABA/kg brown rice; 0.75-0.85 GABA g/kg milled rice) in a greenhouse trial. Oral administration of a diet containing 2.5% GABA-fortified rice, with a daily intake for 8 weeks, had an approximately 20 mmHg anti-hypertensive effect in spontaneous hypertensive rats but not in normotensive Wistar-Kyoto rats. These results suggest that GABA-fortified rice may be applicable as a staple food to control or prevent hypertension.

Expression of Finger Millet EcDehydrin7 in Transgenic Tobacco Confers Tolerance to Drought Stress.

PubMed

Singh, Rajiv Kumar; Singh, Vivek Kumar; Raghavendrarao, Sanagala; Phanindra, Mullapudi Lakshmi Venkata; Venkat Raman, K; Solanke, Amolkumar U; Kumar, Polumetla Ananda; Sharma, Tilak Raj

2015-09-01

One of the critical alarming constraints for agriculture is water scarcity. In the current scenario, global warming due to climate change and unpredictable rainfall, drought is going to be a master player and possess a big threat to stagnating gene pool of staple food crops. So it is necessary to understand the mechanisms that enable the plants to cope with drought stress. In this study, effort was made to prospect the role of EcDehydrin7 protein from normalized cDNA library of drought tolerance finger millet in transgenic tobacco. Biochemical and molecular analyses of T0 transgenic plants were done for stress tolerance. Leaf disc assay, seed germination test, dehydration assay, and chlorophyll estimation showed EcDehydrin7 protein directly link to drought tolerance. Northern and qRT PCR analyses shows relatively high expression of EcDehydrin7 protein compare to wild type. T0 transgenic lines EcDehydrin7(11) and EcDehydrin7(15) shows superior expression among all lines under study. In summary, all results suggest that EcDehydrin7 protein has a remarkable role in drought tolerance and may be used for sustainable crop breeding program in other food crops.

Factors influencing food preparation behaviours: findings from focus groups with Mexican-American mothers in southern California.

PubMed

Smith, Teresa M; Dunton, Genevieve F; Pinard, Courtney A; Yaroch, Amy L

2016-04-01

The purpose of the present study was to explore food preparation behaviours, attitudes, meal planning and shopping among Mexican-American mothers. Data were collected through four focus groups with mothers of Mexican origin/ancestry who considered themselves to be the primary food preparer. Topics included food preparation behaviours and influencers (culture, family, attitudes, barriers, meal planning and shopping). Data were analysed using a qualitative grounded theory approach. All focus groups were audio recorded, transcribed verbatim and coded for themes. Data were collected in southern California, USA in 2013. Of the sample of twenty-one Mexican-American mothers, thirteen were born outside the USA and the mean household size was five members. Participants reported that food was often prepared using traditional staples and food preparation behaviours were learned from maternal family members. Participants also suggested that health was influenced by foods eaten and how they were prepared. Salient factors influencing food preparation behaviours included culture and tradition, maternal family members' food preparation behaviours, food preparation self-efficacy and attitudes towards healthy eating. Time and busy schedules were cited as barriers. Future interventions should consider utilizing family-based approaches and teaching culturally relevant food preparation skills, especially to youth, while reinforcing more healthful dietary practices.

Blind-Side, High-Temperature Fastener Lock

NASA Technical Reports Server (NTRS)

Matza, E. C.; While, D. M.

1985-01-01

Formed-in-place staple provides positive mechanical lock. Post-supported, advanced carbon/carbon standoff panels, currently under consideration as alternate thermal protection system for Shuttle orbiter, locking feature applicable to temperatures of 1,600 degrees F (870 degrees C) and higher and employable after panel installed, resulting in blind application. Blind-side locking technique employs wire staple inserted into grooves in post, formed in place by ramped portion of post grooves. This splays out wire ends that move into castellated end of grommet, mechanically locking post and grommet against relative rotation. Splayed ends provide mechanical lock to prevent wire from falling out.

Laser-assisted skin closure at 1.32 microns: the use of a software-driven medical laser system

NASA Astrophysics Data System (ADS)

Dew, Douglas K.; Hsu, Tung M.; Hsu, Long S.; Halpern, Steven J.; Michaels, Charles E.

1991-06-01

This study investigated the use of a computerized 1 .3 micron Nd:YAG laser to seal approximated wound edges in pig skin. The medical laser system used was the DLS Type 1 , 1 .32 micron Nd:YAG laser (Laser Surgery Software, Inc.). The purpose of this study was to evaluate the effectiveness of laser assisted skin closure using the DLS YAG laser in a large animal model. Effectiveness was judged on the basis of wound dehiscence, infection, unusual healing result and consistency of results. Comparative cosmetic result was also evaluated. In this study, the DLS YAG laser was used to close scalpel-induced, full-thickness wounds. The pig model was chosen for its many integumentary similarities to man. Controls included scalpel-induced wounds closed using suture, staple and some with norepair. After adequate anesthesia was achieved, the dorsum of Yucutan pigs (approximately 75- 100 pounds) each was clipped with animal hair clippers from the shoulder area to the hind legs. The area was then shaved with a razor blade, avoiding any inadvertent cuts or abrasions of the skin. The dorsum was divided into four rows of four parallel incisions made by a #15 scalpel blade. Full-thickness incisions, 9 cm long, were placed over the dorsum of the pigs and then closed either with one loosely approximating Prolene" suture (the "no repair' group), multiple interrupted 6-0 nylon sutures, staples or laser. The experimental tissue sealing group consisted of 1 69 laser assisted closures on 1 3 pigs. Sutured control wounds were closed with 6-0 nylon, full thickness, simple, interrupted sutures. Eight sutures were placed 1 cm apart along the 9 cm incision. Stapled control wounds were approximated using two evenly spaced 3-0 VicryP' sub-dermal sutures and the dermis closed using Proximate' skin staples. Eight staples were placed 1 cm apart along the 9 cm incision. The no-repair incisions were grossly approximated using a single 2-0 Prolene full thickness, simple, interrupted suture located at the center of the 9 cm incision. Experimental wounds were approximated using two evenly spaced subdermal 3.0 Vicryl' sutures and the dermis closed by laser sealing using the DLS YAG laser. Wounds were examined daily for the first seven days and followed for up to 20 months postoperatively. To facilitate wound edge approximation, surgical tape that is relatively transparent to 1.3 micron irradiation was used to hold the wound edges approximated while laser application occurred. Surgical tape was also applied to the "no-repair" suture and staple closures at the end of each procedure.

Next generation internet architecture and cyber-assisted energy efficiency in smart grids of buildings

NASA Astrophysics Data System (ADS)

Peterson, Robb Alex

Northern Minnesota's iron mines are the starting point for the majority of the steel that gets produced in the United States. Their taconite processing plants use heat in furnaces to oxidize and indurate iron in the final stage of making a taconite pellet. Facilities can increase efficiencies when refractory service life is maintained. Efficiencies gained include: less fuel used, better quality control, better furnace control, and less mechanical component maintenance. Furnace refractory linings fail when the cracks that develop in them are uncontrolled or too large. These failures allow heat and gases retained by the lining to reach structural or mechanical components. Furnace control and efficiencies are also compromised when heat and gases are allowed to short circuit or escape the system. These failures are primarily the result of thermal of shock and expansion. It is common place to add stainless steel needle reinforcement to a monolithic refractory in an effort to counteract these effects. This study used several standard ASTM testing procedures to test 65% alumina mullite based refractory samples with 304 and 406 grade stainless steel needles. Mechanical property data gathered was used to analyze performance. The study found that adding reinforcement does not increase initial Compression and Cold Modulus of Ruptures strengths, however, after prolonged heat and thermal shock exposure, needles help maintain integrity and mechanical properties of samples. The study also found that corrosion due to oxidation was a major contributing factor to the way needles performed; and concluded that a concentration of 3% 406 "Alfa 1" stainless steel reinforcing needles added to the working lining of a taconite furnace is recommended.

Flow monitoring of microwave pre-heated resin in LCM processes

NASA Astrophysics Data System (ADS)

Rubino, F.; Paradiso, V.; Carlone, P.

2017-10-01

Liquid composite molding is manufacturing techniques that involve the injection or infusion of catalyzed liquid resin into a mold to impregnate a dry fiber preform. The challenges of LCM processes are related to the obtaining of a complete wetting of the reinforcement as well as a reduction of the void to obtain a final product with high mechanical properties. The heating of the resin prior the injection into the mold cavity has proven to be useful to improve the LCM processes. The increasing of temperature results in a reduction of resin viscosity and allows the resin to flow more easily through the reinforcement; the cure stage is also improved resulting in a reduction of global process time required. Besides the conventional solutions to heat up the resin based on the thermal conduction, in-line microwave heating is a suitable method to heat dielectric materials providing an even temperature distribution through the resin, thereby avoiding a thermal gradient between the surface and the core of liquid resin, which could result in a premature and uncontrolled cure. In the present work, an in-line microwave system, manually controlled, have been coupled with a VARTM apparatus to heat the resin before the infusion. In addition, parallel-plate dielectric sensors and pressure sensors, embedded into the mold, were employed to track the flow front through the fiber reinforcement in two distinct cases: unheated resin and pre-heated resin. The aim of work was to assess the effectiveness of microwave pre-heating to improve the macro and micro-impregnation of dry preform. The obtained results showed capability of in-line microwave heating to shorten the impregnation of dry fabric and provide a homogeneous wetting of fibers.

Comparative morphology, biology and histology of reproductive development in three lines of Manihot esculenta Crantz (Euphorbiaceae: Crotonoideae).

PubMed

Perera, P I P; Quintero, M; Dedicova, B; Kularatne, J D J S; Ceballos, H

2013-01-01

Cassava (Manihot esculenta), a major food staple in the tropics and subtropics, thrives even in environments undergoing threatening climate change. To satisfy the increasing demand for crop improvement and overcome the limitations of conventional breeding, the introduction of inbreeding techniques such as the production of doubled haploid lines via androgenesis or gynogenesis offers advantages. However, comprehensive studies on cassava flower bud biology or structural development are lacking and precise structural and biological information is a prerequisite to enhance the efficiency of these techniques. The floral biology of three selected cassava lines was studied, focusing on morphology, phenology and pollen biology (quantity, viability and dimorphism). Histological studies were also conducted on microsporogenesis/microgametogenesis and megasporogenesis/megagameto-genesis to generate precise developmental data for these lines. Male and female cyathia have distinct developmental phases. Pollen viability was high during immature stages of plant development; however, pollen mortality was common at later stages. Pollen trimorphism in male gametophytes towards the larger or smaller pollen size, as compared with normal size, was observed. Ten characteristic events were identified in male gametogenesis and six in female gametogenesis that were correlated with flower bud diameter. Male gametophyte diameter at different developmental stages was also determined. Results indicate that the three lines did not differ significantly, except regarding a few morphological aspects such as plant height, flower colour and number of male cyathia. Pollen grains were initially viable, but viability decreased drastically at later stages of growth. Abnormal meiosis or mitosis triggered pollen trimorphism. The demonstrated sequential events of reproductive development generated valuable information at the cellular level, which will help close the current information gap for cassava improvement via breeding programmes and doubled haploid plant production.

Perioperative complications of sleeve gastrectomy: Review of the literature.

PubMed

Iannelli, Antonio; Treacy, Patrick; Sebastianelli, Lionel; Schiavo, Luigi; Martini, Francesco

2018-05-04

Sleeve gastrectomy (SG) has known a spectacular rise worldwide during the last decade. The absence of digestive anastomosis simplifies the surgical technique, reducing anastomosis-related complications such as fistula, stricture and marginal ulcer. Furthermore, the respect for digestive continuity preserves the functions of pylorus, that regulates gastric emptying, and duodenum, where calcium, B vitamins and iron are absorbed. Despite the multiple advantages, SG also has specific complications such as bleeding, stenosis, portal thrombosis and leak. The staple line leak at the oesophagogastric junction is the most feared complication and its prevention remains difficult, as the involved mechanisms have been only partially elucidated. Its management is long and requires a multidisciplinary technical platform including Intensive Care Unit, digestive endoscopy and interventional radiology as well as a specialised surgeon. The aim of this review is to explain in detail the perioperative complications of SG, their prevention and treatment, referring to the most recent available literature.

Hypopharyngeal reconstruction using a circular stapler.

PubMed

Schultz, P; Dupret-Bories, A; Ciftci, S; Fath, L

2018-02-01

Distal anastomosis by tubed free flap is one of the main technical difficulties encountered during hypopharyngeal reconstruction. Although high flap survival probability can be achieved by experienced surgical teams, two complications are commonly observed at the flap-oesophagus junction: fistula and stenosis. Use of a circular stapler reduced the frequency of these complications by ensuring a perfectly circular and resistant suture line. Salivary stent placement is therefore unnecessary, allowing earlier resumption of feeding. The stapling procedure is simple, but a few technical skills are required, as the stapler is not specifically designed for this purpose. We describe the indications, surgical procedure and global results based on our series. We consider the forearm flap to be the gold standard for this reconstruction, but thicker flaps, such as pectoralis major flap, can also be used, but with poorer results in terms of healing and swallowing performance. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Development and preliminary validation of a behavioral task of negative reinforcement underlying risk taking and its relation to problem alcohol use in college freshmen

PubMed Central

MacPherson, Laura; Calvin, Nicholas T.; Richards, Jessica M.; Guller, Leila; Mayes, Linda C.; Crowley, Michael J.; Daughters, Stacey B.; Lejuez, C.W.

2011-01-01

Background A long line of theoretical and empirical evidence implicates negative reinforcement as a process underlying the etiology and maintenance of risky alcohol use behaviors from adolescence through emerging adulthood. However, the bulk of this literature has relied on self-report measures and there is a notable absence of behavioral modes of assessments of negative reinforcement-based alcohol-related risk-taking. To address this clear gap in the literature, the current study presents the first published data on the reliability and validity of the Maryland Resource for the Behavioral Utilization of the Reinforcement of Negative Stimuli (MRBURNS), which is a modified version of the positive reinforcement-based Balloon Analogue Risk Task (BART). Methods Participants included a convenience sample of 116 college freshmen ever regular drinkers (aged 18–19) who completed both behavioral tasks; self-report measures of negative reinforcement/avoidance constructs and of positive reinforcement/appetitive constructs to examine convergent validity and discriminant validity, respectively; and self-report measures of alcohol use, problems, and motives to examine criterion validity. Results The MRBURNS evidenced sound experimental properties and reliability across task trials. In support of convergent validity, risk taking on the MRBURNS correlated significantly with negative urgency, difficulties in emotion regulation and depressive and anxiety-related symptoms. In support of discriminant validity, performance on the MRBURNS was unrelated to risk taking on the BART, sensation seeking, and trait impulsivity. Finally, pertaining to criterion validity, risk taking on the MRBURNS was related to alcohol-related problems but not heavy episodic alcohol use. Notably, risk taking on the MRBURNS was associated with negative reinforcement-based but not with positive reinforcement-based drinking motives. Conclusions Data from this initial investigation suggest the utility of the MRBURNS as a behavioral measure of negative-reinforcement based risk-taking that can provide a useful compliment to existing self-report measures to improve our understanding of the relationship between avoidant reinforcement processes and risky alcohol use. PMID:22309846

Analysis of Glass-Reinforced Epoxy Material for Radio Frequency Resonator

PubMed Central

Islam, M. T.; Misran, N.; Yatim, Baharudin

2014-01-01

A radio frequency (RF) resonator using glass-reinforced epoxy material for C and X band is proposed in this paper. Microstrip line technology for RF over glass-reinforced epoxy material is analyzed. Coupling mechanism over RF material and parasitic coupling performance is explained utilizing even and odd mode impedance with relevant equivalent circuit. Babinet's principle is deployed to explicate the circular slot ground plane of the proposed resonator. The resonator is designed over four materials from different backgrounds which are glass-reinforced epoxy, polyester, gallium arsenide (GaAs), and rogers RO 4350B. Parametric studies and optimization algorithm are applied over the geometry of the microstrip resonator to achieve dual band response for C and X band. Resonator behaviors for different materials are concluded and compared for the same structure. The final design is fabricated over glass-reinforced epoxy material. The fabricated resonator shows a maximum directivity of 5.65 dBi and 6.62 dBi at 5.84 GHz and 8.16 GHz, respectively. The lowest resonance response is less than −20 dB for C band and −34 dB for X band. The resonator is prototyped using LPKF (S63) drilling machine to study the material behavior. PMID:24977230

COMBINED SEWER OVERFLOW - BALANCING FLOW FOR CSO ABATEMENT

EPA Science Inventory

Instead of using conventional storage units, e.g., reinforced concrete tanks and lined earthen basins, which are relatively expensive and require a lot of urban land area, the in-receiving water flow balance method (FBM) facilities use the receiving water body itself for storage ...

Variability of chemical analysis of reinforcing bar produced in Saudi Arabia

NASA Astrophysics Data System (ADS)

Salman, A.; Djavanroodi, F.

2018-04-01

In view of the importance and demanding roles of steel rebar’s in the reinforced concrete structures, accurate information on the properties of the steels is important at the design stage. In the steelmaking process, production variations in chemical composition are unavoidable. The aim of this work is to study the variability of the chemical composition of reinforcing steel produced throughout the Saudi Arabia and asses the quality of steel rebar’s acoording to ASTM A615. 68 samples of ASTM A615 Grade 60 from different manufacturers were collected and tested using the Spectrometer test to obtain Chemical Compositions. EasyFit (5.6) software is utilized to conducted statistical analysis. Chemical compositions distributions and, control charts are generated for the compositions. Results showed that some compositions are above the upper line of the control chart. Finally, the analyses show that less than 3% of the steel failed to meet minimum ASTM standards for chemical composition.

Partial stapled hemorrhoidopexy versus circular stapled hemorrhoidopexy for grade III-IV prolapsing hemorrhoids: a two-year prospective controlled study.

PubMed

Lin, H-C; Ren, D-L; He, Q-L; Peng, H; Xie, S-K; Su, D; Wang, X-X

2012-10-01

Circular stapled hemorrhoidopexy (CSH) is an effective technique for treating prolapsing hemorrhoids; but urgency and anal stenosis are common postoperative complications. The aim of this study was to assess the efficacy and postoperative outcomes of partial stapled hemorrhoidopexy (PSH), compared with CSH. Seventy-two consecutive patients with grade III and IV hemorrhoids who met the inclusion/exclusion criteria were divided in a non-randomized manner to undergo either PSH (n = 34) or CSH (n = 38). Intraoperative and postoperative parameters in both groups were collected and compared. The postoperative visual analog score for pain at first defecation was significantly lower in the PSH group than that in the CSH group (P = 0.001). Fewer patients in the PSH group experienced postoperative urgency, compared with those in the CSH group at 12 h, 1 day, and 7 days after surgery (P = 0.025, P = 0.019, and P = 0.043, respectively). Gas incontinence occurred in 3 patients (7.9%) in the CSH group, but in none of patients in the PSH group (P = 0.242). Postoperative anal stenosis developed in one patient (2.6%) in the CSH group, but in none of the patients in the PSH group (P = 1.0). The 2-year recurrence rate was 2.9 and 5.3%, respectively, in the PSH and CSH groups (P = 1.0). The 2-year recurrence rate is similar in patients with grade III-IV hemorrhoids treated with PSH or CSH. However, PSH is associated with less postoperative pain, fewer episodes of urgency, and no anal incontinence or anal stenosis.

Assessment of MRI issues at 3-Tesla for metallic surgical implants: findings applied to 61 additional skin closure staples and vessel ligation clips.

PubMed

Gill, Amreeta; Shellock, Frank G

2012-01-09

Metallic skin closure staples and vessel ligation clips should be tested at 3-Tesla to characterize MRI issues in order to ensure patient safety. Therefore, metallic surgical implants were assessed at 3-Tesla for magnetic field interactions, MRI-related heating, and artifacts. A skin closure staple (Visistat Skin Stapler, staple, Polytetrafluoroethylene, PTFE, coated 316L/316LVM stainless steel; Teleflex Medical, Durham, NC) and a vessel ligation clip (Hemoclip Traditional, stainless steel; Teleflex Medical, Durham, NC) that represented the largest metallic sizes made from materials with the highest magnetic susceptibilities (i.e., based on material information) among 61 other surgical implants (52 metallic implants, 9 nonmetallic implants) underwent evaluation for magnetic field interactions, MRI-related heating, and artifacts using standardized techniques. MRI-related heating was assessed by placing each implant in a gelled-saline-filled phantom with MRI performed using a transmit/receive RF body coil at an MR system reported, whole body averaged SAR of 2.9-W/kg for 15-min. Artifacts were characterized using T1-weighted, SE and GRE pulse sequences. Each surgical implant showed minor magnetic field interactions (20- and 27-degrees, which is acceptable from a safety consideration). Heating was not substantial (highest temperature change, ≤ 1.6°C). Artifacts may create issues if the area of interest is in the same area or close to the respective surgical implant. The results demonstrated that it would be acceptable for patients with these metallic surgical implants to undergo MRI at 3-Tesla or less. Because of the materials and dimensions of the surgical implants that underwent testing, these findings pertain to 61 additional similar implants.

Comparison of intracorporeal single-stapled and double-stapled anastomosis in laparoscopic low anterior resection for rectal cancer: a case-control study.

PubMed

Kim, Hye Jin; Choi, Gyu-Seog; Park, Jun Seok; Park, Soo Yeun

2013-01-01

Recently, a single-stapled technique (SST) was performed instead of the conventional double-stapled technique (DST) in laparoscopic low anterior resection for anastomosis, by placement of intracorporeal purse-string sutures on the distal rectum with transanal specimen extraction. This study aimed to compare the short-term outcomes between the two anastomotic techniques. Between July 2007 and April 2010, 60 patients underwent SST by laparoscopic or robotic procedure. These patients were matched 1:2 by age, gender, date of surgery, and tumor stage with 120 patients who underwent conventional DST in laparoscopic low anterior resection. The robotic-assisted operative approach was used more frequently in the SST group than in the DST group (61.7 % vs. 3.3 %, p < 0.001). The mean operative time was 203.9 (range, 120-400) min for the SST group and 167.6 (range, 90-300) min for the DST group (p < 0.001). For specimen removal, the transanal approach was used in the SST group, while the transabdominal approach was used for the DST group. The pain score (visual analogue scale) of the SST group was lower (4.5 vs. 5.6, p < 0.001), although postoperative recovery was similar. Pathological examination revealed that the distal resection margin was significantly longer in the SST group (3.1 vs. 2.5 cm, p = 0.018). Postoperative morbidity including anastomotic leakage was similar in both groups. SST yielded equivalent short-term outcomes when compared to conventional DST and provided the advantages of minimal access and a longer distal resection margin. Therefore, SST in lower anterior resection may be a useful alternative to conventional DST.

Assessment of MRI issues at 3-Tesla for metallic surgical implants: findings applied to 61 additional skin closure staples and vessel ligation clips

PubMed Central

2012-01-01

Purpose Metallic skin closure staples and vessel ligation clips should be tested at 3-Tesla to characterize MRI issues in order to ensure patient safety. Therefore, metallic surgical implants were assessed at 3-Tesla for magnetic field interactions, MRI-related heating, and artifacts. Methods A skin closure staple (Visistat Skin Stapler, staple, Polytetrafluoroethylene, PTFE, coated 316L/316LVM stainless steel; Teleflex Medical, Durham, NC) and a vessel ligation clip (Hemoclip Traditional, stainless steel; Teleflex Medical, Durham, NC) that represented the largest metallic sizes made from materials with the highest magnetic susceptibilities (i.e., based on material information) among 61 other surgical implants (52 metallic implants, 9 nonmetallic implants) underwent evaluation for magnetic field interactions, MRI-related heating, and artifacts using standardized techniques. MRI-related heating was assessed by placing each implant in a gelled-saline-filled phantom with MRI performed using a transmit/receive RF body coil at an MR system reported, whole body averaged SAR of 2.9-W/kg for 15-min. Artifacts were characterized using T1-weighted, SE and GRE pulse sequences. Results Each surgical implant showed minor magnetic field interactions (20- and 27-degrees, which is acceptable from a safety consideration). Heating was not substantial (highest temperature change, ≤ 1.6°C). Artifacts may create issues if the area of interest is in the same area or close to the respective surgical implant. Conclusions The results demonstrated that it would be acceptable for patients with these metallic surgical implants to undergo MRI at 3-Tesla or less. Because of the materials and dimensions of the surgical implants that underwent testing, these findings pertain to 61 additional similar implants. PMID:22230200

Individual surgeon is an independent risk factor for leak after double-stapled colorectal anastomosis: An institutional analysis of 800 patients.

PubMed

García-Granero, Eduardo; Navarro, Francisco; Cerdán Santacruz, Carlos; Frasson, Matteo; García-Granero, Alvaro; Marinello, Franco; Flor-Lorente, Blas; Espí, Alejandro

2017-11-01

Our aim was to assess whether the individual surgeon is an independent risk factor for anastomotic leak in double-stapled colorectal anastomosis after left colon and rectal cancer resection. This retrospective analysis of a prospectively collected database consists of a consecutive series of 800 patients who underwent an elective left colon and rectal resection with a colorectal, double-stapled anastomosis between 1993 and 2009 in a specialized colorectal unit of a tertiary hospital with 7 participating surgeons. The main outcome variable was anastomotic leak, defined as leak of luminal contents from a colorectal anastomosis between 2 hollow viscera diagnosed radiologically, clinically, endoscopically, or intraoperatively. Pelvic abscesses were also considered to be an anastomotic leak. Radiologic examination was performed when there was clinical suspicion of leak. Anastomotic leak occurred in 6.1% of patients, of which 33 (67%) were treated operatively, 6 (12%) with radiologic drains, and 10 (21%) by medical treatment. Postoperative mortality rate was 2.9% for the whole group of 800 patients. In patients with anastomotic leak, mortality rate increased up to 16% vs 2.0% in patients without anastomotic leak (P < .0001). At multivariate analysis, rectal location of tumor, male sex, bowel obstruction preoperatively, tobacco use, diabetes, perioperative transfusion, and the individual surgeon were independent risk factors for anastomotic leak. The surgeon was the most important factor (mean odds ratio 4.9; range 1.0 to 13.5). The variance of anastomotic leak between the different surgeons was 0.56 in the logit scale. The individual surgeon is an independent risk factor for leakage in double-stapled, colorectal, end-to-end anastomosis after oncologic left-sided colorectal resection. Copyright © 2017 Elsevier Inc. All rights reserved.

A Randomized Trial Comparing Stapled Rectal Mucosectomy Versus Open and Semiclosed Hemorrhoidectomy.

PubMed

Ripetti, Valter; La Vaccara, Vincenzo; Greco, Santi; Arullani, Augusto

2015-11-01

Different results have been reported concerning the postoperative outcomes of different surgical approaches for hemorrhoids. We aimed to determine the postoperative outcome following 3 main surgical techniques. A prospective, randomized trial was designed with 180 patients in 3 arms of 60 patients each. The study was conducted from April 1999 to January 2007 at the University Hospital "Campus Bio-Medico di Roma." All of the patients who were referred for hemorrhoid surgery were enrolled according to inclusion and exclusion criteria (ISRCTN12040297). Treatments according to the open, semiclosed, and stapled techniques were compared. Sample size was calculated to determine a difference in terms of the intensity of postoperative pain at the first week and the days required for return to work activity. After 1 week, patients who underwent semiclosed hemorrhoidectomy reported significantly less pain (p < 0.01) and a significant decrease in analgesic intake from the third postoperative day (p < 0.01) than after the other 2 techniques. The patients resumed work ≈11 days after semiclosed and stapled techniques (11.8 and 11.6 days), which was earlier compared with 21.3 days in the open group (p < 0.05). The high number of patients excluded might be considered a limitation of the study, but our selection criteria including patients living within 50 km of the hospital allowed for a low rate (9.4%) of patients lost to follow-up. This study found an earlier resumption of work and less pain in patients who underwent the stapled and semiclosed procedures rather than open, which was associated with more complications, particularly because of a higher rate of stenosis (see Video, Supplemental Digital Content 1, http://links.lww.com/DCR/A196).

Targeting the Toll of Drug Abuse: The Translational Potential of Toll-Like Receptor 4

PubMed Central

Bachtell, Ryan; Hutchinson, Mark R.; Wang, Xiaohui; Rice, Kenner C.; Maier, Steven F; Watkins, Linda R.

2017-01-01

There is growing recognition that glial proinflammatory activation importantly contributes to the rewarding and reinforcing effects of a variety of drugs of abuse, including cocaine, methamphetamine, opioids, and alcohol. It has recently been proposed that glia are recognizing, and becoming activated by, such drugs as a CNS immunological response to these agents being xenobiotics; that is, substances foreign to the brain. Activation of glia, primarily microglia, by various drugs of abuse occurs via toll like receptor 4 (TLR4). The detection of such xenobiotics by TLR4 results in the release of glial neuroexcitatory and neurotoxic substances. These glial products of TLR4 activation enhance neuronal excitability within brain reward circuitry, thereby enhancing their rewarding and reinforcing effects. Indeed, selective pharmacological blockade of TLR4 activation, such as with the non-opioid TLR4 antagonist (+)-naltrexone, suppresses a number of indices of drug reward/reinforcement. These include: conditioned place preference, self-administration, drug-primed reinstatement, incubation of craving, and elevations of nucleus accumbens shell dopamine. Notably, TLR4 blockade fails to alter self-administration of food, indicative of a selective effect on drugs of abuse. Genetic disruption of TLR4 signaling recapitulates the effects of pharmacological TLR4 blockade, providing converging lines of evidence of a central importance of TLR4. Taken together, multiple lines of evidence converge to raise TLR4 as a promising therapeutic target for drug abuse. PMID:26022268

Advanced Metallic Air Vehicle Structure Program

DTIC Science & Technology

1974-06-01

soapstone line around the periphery of the lower plate from XFO.00 to the outboard edge using edge of MSLO X7224175 as guide. Remove MSLO X7224175. D...hole in the lug reinforcement plates). Make soapstone line to edge of MSLO to denote periphery of cutouts. E. Relocate MSLO X7224175 on opposite end of...of plate). G. Drill .50 diameter holes (10) using the Bux- Magnetic drill unit. See MAP-I-3 for approximate locations of these start and stop holes. A 1

Design of reinforced areas of concrete column using quadratic polynomials

NASA Astrophysics Data System (ADS)

Arif Gunadi, Tjiang; Parung, Herman; Rachman Djamaluddin, Abd; Arwin Amiruddin, A.

2017-11-01

Designing of reinforced concrete columns mostly carried out by a simple planning method which uses column interaction diagram. However, the application of this method is limited because it valids only for certain compressive strenght of the concrete and yield strength of the reinforcement. Thus, a more applicable method is still in need. Another method is the use of quadratic polynomials as a basis for the approach in designing reinforced concrete columns, where the ratio of neutral lines to the effective height of a cross section (ξ) if associated with ξ in the same cross-section with different reinforcement ratios is assumed to form a quadratic polynomial. This is identical to the basic principle used in the Simpson rule for numerical integral using quadratic polynomials and had a sufficiently accurate level of accuracy. The basis of this approach to be used both the normal force equilibrium and the moment equilibrium. The abscissa of the intersection of the two curves is the ratio that had been mentioned, since it fulfill both of the equilibrium. The application of this method is relatively more complicated than the existing method but provided with tables and graphs (N vs ξN ) and (M vs ξM ) so that its used could be simplified. The uniqueness of these tables are only distinguished based on the compresssive strength of the concrete, so in application it could be combined with various yield strenght of the reinforcement available in the market. This method could be solved by using programming languages such as Fortran.

Teaching Beginning Chess Skills to Students with Disabilities.

ERIC Educational Resources Information Center

Storey, Keith

2000-01-01

This article discusses teaching higher-level thinking skills and concentration to students with disabilities through chess instruction. Guidelines for chess instruction are provided, including: teaching ideas and strategy first rather than specific lines of play, using a variety of instructional modalities, and building in reinforcement for…

Utilizing Snap-Tite slip line pipe as a direct burial cross pipe, construction and first interim report, October, 2007.

DOT National Transportation Integrated Search

2007-10-01

The Maine Department of Transportation uses reinforced concrete, polymer coated corrugated metal, : corrugated aluminum or corrugated polyethylene for highway cross pipes. Design life for cross pipe is 50 : plus years. Repair of failed cross pipes in...

Can a curved stapler made for open surgery be useful in laparoscopic lower rectal resections? Technique and experience of a single centre.

PubMed

Mari, Francesco Saverio; Gasparrini, Marcello; Nigri, Giuseppe; Berardi, Giammauro; Laracca, Giovanni Guglielmo; Flora, Barbara; Pancaldi, Alessandra; Brescia, Antonio

2013-01-01

The use of laparoscopy to perform lower anterior rectal resection is increasing worldwide because it allows better visualisation and rectal mobilisation and also reduces postoperative pain and recovery. The Contour Curved Stapler (CCS) is a very helpful device because of its curved profile that enables better access into the pelvic cavity and allows rectal closure and section to be performed in one shot. In this paper, we present an original technique to use this device, made for open surgery, in laparoscopy and the results of our experience. We retrospectively evaluated the data of all patients who underwent lower laparoscopic anterior rectal resection and in which the CCS was used to perform section of the rectum between September 2005 and September 2011. To perform section of the rectum a Lapdisc(®) was inserted through a 6-7 cm supra-pubic midline incision to allow placement of the CCS into the pelvic cavity. Patients' biographical and surgical data such as sex, age, indication for surgery, infection, anastomotic leakage or stenosis and staple-line bleeding were prospectively collected in a computerised database and evaluated. Between September 2005 and September 2011, we performed 45 laparoscopic lower rectal resection using CCS, 27 male and 18 female with a mean age of 61 years (range 40-82 years) and a mean body mass index (BMI) of 26.5 kg/m(2) (range 16.5-35 kg/m(2)). In 29 cases a temporary ileostomy was performed. Mean operative time was 131 min (range 97-210 min). In all cases it was possible to perform a lower section of the rectum with CCS. No intraoperative or postoperative staple line bleeding occurred. In two patients we observed anastomotic leaks and in one of these a temporary ileostomy was performed. None of the patients showed an anastomotic stenosis at 1-year follow-up colonoscopy. This study shows that CCS enables section of the lower rectum to be easily performed, especially in adverse anatomical condition, and the technique proposed by us allows the use of this stapler without giving up the benefits of laparoscopic access. Copyright © 2012 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

NASA/UH signing of memorandum of understanding

NASA Image and Video Library

1996-10-02

NASA/University of Houston (UH) signing of memorandum of understanding. Johnson Space Center (JSC) Director George Abbey signs a memorandum of understanding with University of Houston's President Glenn Goerke and University of Houston Clear Lake President Williams Staples. UH will supply post-doctoral researchers to JSC for more than 15 projects of scientific interest to both JSC and the university. Seated from left are, Abbey, Goerke and Staples. Standing from left are David Criswell, director of the Institute of Space Systems Operations; Texas State Representatives Michael Jackson, Robert Talton and Talmadge Heflin. View appears in Space News Roundup v35 n41 p4, 10-18-96.

Lattice QCD Studies of Transverse Momentum-Dependent Parton Distribution Functions

NASA Astrophysics Data System (ADS)

Engelhardt, M.; Musch, B.; Hägler, P.; Negele, J.; Schäfer, A.

2015-09-01

Transverse momentum-dependent parton distributions (TMDs) relevant for semi-inclusive deep inelastic scattering and the Drell-Yan process can be defined in terms of matrix elements of a quark bilocal operator containing a staple-shaped gauge link. Such a definition opens the possibility of evaluating TMDs within lattice QCD. By parametrizing the aforementioned matrix elements in terms of invariant amplitudes, the problem can be cast in a Lorentz frame suited for the lattice calculation. Results for selected TMD observables are presented, including a particular focus on their dependence on a Collins-Soper-type evolution parameter, which quantifies proximity of the staple-shaped gauge links to the light cone.

Transverse Momentum-Dependent Parton Distributions from Lattice QCD

NASA Astrophysics Data System (ADS)

Engelhardt, M.; Musch, B.; Hägler, P.; Negele, J.; Schäfer, A.

Starting from a definition of transverse momentum-dependent parton distributions for semi-inclusive deep inelastic scattering and the Drell-Yan process, given in terms of matrix elements of a quark bilocal operator containing a staple-shaped Wilson connection, a scheme to determine such observables in lattice QCD is developed and explored. Parametrizing the aforementioned matrix elements in terms of invariant amplitudes permits a simple transformation of the problem to a Lorentz frame suited for the lattice calculation. Results for the Sivers and Boer-Mulders transverse momentum shifts are presented, focusing in particular on their dependence on the staple extent and the Collins-Soper evolution parameter.

Transverse Momentum-Dependent Parton Distributions From Lattice QCD

DOE Office of Scientific and Technical Information (OSTI.GOV)

Michael Engelhardt, Bernhard Musch, Philipp Haegler, Andreas Schaefer

Starting from a definition of transverse momentum-dependent parton distributions for semi-inclusive deep inelastic scattering and the Drell-Yan process, given in terms of matrix elements of a quark bilocal operator containing a staple-shaped Wilson connection, a scheme to determine such observables in lattice QCD is developed and explored. Parametrizing the aforementioned matrix elements in terms of invariant amplitudes permits a simple transformation of the problem to a Lorentz frame suited for the lattice calculation. Results for the Sivers and Boer-Mulders transverse momentum shifts are presented, focusing in particular on their dependence on the staple extent and the Collins-Soper evolution parameter.

Why Clothes Don't Fall Apart: Tension Transmission in Staple Yarns

NASA Astrophysics Data System (ADS)

Warren, Patrick B.; Ball, Robin C.; Goldstein, Raymond E.

2018-04-01

The problem of how staple yarns transmit tension is addressed within abstract models in which the Amontons-Coulomb friction laws yield a linear programing (LP) problem for the tensions in the fiber elements. We find there is a percolation transition such that above the percolation threshold the transmitted tension is in principle unbounded. We determine that the mean slack in the LP constraints is a suitable order parameter to characterize this supercritical state. We argue the mechanism is generic, and in practical terms, it corresponds to a switch from a ductile to a brittle failure mode accompanied by a significant increase in mechanical strength.

Suture Products and Techniques: What to Use, Where, and Why.

PubMed

Regula, Christie G; Yag-Howard, Cyndi

2015-10-01

There are an increasing number of wound closure materials and suturing techniques described in the dermatologic and surgery literature. A dermatologic surgeon's familiarity with these materials and techniques is important to supplement his or her already established practices and improve surgical outcomes. To perform a thorough literature review of wound closure materials (sutures, tissue adhesives, surgical tape, and staples) and suturing techniques and to outline how and when to use them. A literature review was conducted using PubMed and other online search engines. Keywords searched included suture, tissue adhesive, tissue glue, surgical tape, staples, dermatologic suturing, and suturing techniques. Numerous articles outline the utility of various sutures, surgical adhesives, surgical tape, and staples in dermatologic surgery. In addition, there are various articles describing classic and novel suturing techniques along with their specific uses in cutaneous surgery. Numerous factors must be considered when choosing a wound closure material and suturing technique. These include wound tension, desire for wound edge eversion/inversion, desired hemostasis, repair type, patient's ability to care for the wound and return for suture removal, skin integrity, and wound location. Careful consideration of these factors and proper execution of suturing techniques can lead to excellent cosmetic results.

Improved Estimation of Cardiac Function Parameters Using a Combination of Independent Automated Segmentation Results in Cardiovascular Magnetic Resonance Imaging.

PubMed

Lebenberg, Jessica; Lalande, Alain; Clarysse, Patrick; Buvat, Irene; Casta, Christopher; Cochet, Alexandre; Constantinidès, Constantin; Cousty, Jean; de Cesare, Alain; Jehan-Besson, Stephanie; Lefort, Muriel; Najman, Laurent; Roullot, Elodie; Sarry, Laurent; Tilmant, Christophe; Frouin, Frederique; Garreau, Mireille

2015-01-01

This work aimed at combining different segmentation approaches to produce a robust and accurate segmentation result. Three to five segmentation results of the left ventricle were combined using the STAPLE algorithm and the reliability of the resulting segmentation was evaluated in comparison with the result of each individual segmentation method. This comparison was performed using a supervised approach based on a reference method. Then, we used an unsupervised statistical evaluation, the extended Regression Without Truth (eRWT) that ranks different methods according to their accuracy in estimating a specific biomarker in a population. The segmentation accuracy was evaluated by estimating six cardiac function parameters resulting from the left ventricle contour delineation using a public cardiac cine MRI database. Eight different segmentation methods, including three expert delineations and five automated methods, were considered, and sixteen combinations of the automated methods using STAPLE were investigated. The supervised and unsupervised evaluations demonstrated that in most cases, STAPLE results provided better estimates than individual automated segmentation methods. Overall, combining different automated segmentation methods improved the reliability of the segmentation result compared to that obtained using an individual method and could achieve the accuracy of an expert.

Improved Estimation of Cardiac Function Parameters Using a Combination of Independent Automated Segmentation Results in Cardiovascular Magnetic Resonance Imaging

PubMed Central

Lebenberg, Jessica; Lalande, Alain; Clarysse, Patrick; Buvat, Irene; Casta, Christopher; Cochet, Alexandre; Constantinidès, Constantin; Cousty, Jean; de Cesare, Alain; Jehan-Besson, Stephanie; Lefort, Muriel; Najman, Laurent; Roullot, Elodie; Sarry, Laurent; Tilmant, Christophe

2015-01-01

This work aimed at combining different segmentation approaches to produce a robust and accurate segmentation result. Three to five segmentation results of the left ventricle were combined using the STAPLE algorithm and the reliability of the resulting segmentation was evaluated in comparison with the result of each individual segmentation method. This comparison was performed using a supervised approach based on a reference method. Then, we used an unsupervised statistical evaluation, the extended Regression Without Truth (eRWT) that ranks different methods according to their accuracy in estimating a specific biomarker in a population. The segmentation accuracy was evaluated by estimating six cardiac function parameters resulting from the left ventricle contour delineation using a public cardiac cine MRI database. Eight different segmentation methods, including three expert delineations and five automated methods, were considered, and sixteen combinations of the automated methods using STAPLE were investigated. The supervised and unsupervised evaluations demonstrated that in most cases, STAPLE results provided better estimates than individual automated segmentation methods. Overall, combining different automated segmentation methods improved the reliability of the segmentation result compared to that obtained using an individual method and could achieve the accuracy of an expert. PMID:26287691

Zenker’s diverticulum: flexible versus rigid repair

PubMed Central

Beard, Kristen

2017-01-01

Zenker’s diverticula (ZDs) are a relatively common cause of cervical dysphagia. Diagnosis is best by a good upper GI exam though upper endoscopy should be performed as well. Treatment is either by open, transcervical approaches or trans-oral. Over the past 20 years, transoral approach has mostly replace transcervical approaches due to less pain, no scarring and a rapid recovery. Transoral approaches are either using rigid access or flexible endoscopy. Today, the most common approach is transoral stapling using a 12 mm laparoscopic linear cutting stapler. This has the drawbacks of requiring extreme neck extension, the massive size of the stapler making visualization mostly impossible and the current staple design that does not cut/staple all the way to the end of the blades—resulting in a residual pouch. Flexible endoscopy allows a more tailored approach under direct vision, the myotomy can even be extended beyond the diverticulum and onto the esophageal wall to minimize the risk of incomplete myotomy. Experienced endoscopists report high technical success and low complication. Success rates are similar but maybe slightly higher than with ridged transoral approaches or open surgery. Today, flexible endoscopic Zenkers is our preferred initial approach—with open or ridged being reserved for special indications. PMID:28446979

A question of balance: achieving appropriate nutrient levels in biofortified staple crops.

PubMed

Sanahuja, Georgina; Farré, Gemma; Berman, Judit; Zorrilla-López, Uxue; Twyman, Richard M; Capell, Teresa; Christou, Paul; Zhu, Changfu

2013-12-01

The biofortification of staple crops with vitamins is an attractive strategy to increase the nutritional quality of human food, particularly in areas where the population subsists on a cereal-based diet. Unlike other approaches, biofortification is sustainable and does not require anything more than a standard food-distribution infrastructure. The health-promoting effects of vitamins depend on overall intake and bioavailability, the latter influenced by food processing, absorption efficiency and the utilisation or retention of the vitamin in the body. The bioavailability of vitamins in nutritionally enriched foods should ideally be adjusted to achieve the dietary reference intake in a reasonable portion. Current vitamin biofortification programmes focus on the fat-soluble vitamins A and E, and the water-soluble vitamins C and B9 (folate), but the control of dosage and bioavailability has been largely overlooked. In the present review, we discuss the vitamin content of nutritionally enhanced foods developed by conventional breeding and genetic engineering, focusing on dosage and bioavailability. Although the biofortification of staple crops could potentially address micronutrient deficiency on a global scale, further research is required to develop effective strategies that match the bioavailability of vitamins to the requirements of the human diet.

Vitamin Deficiencies in Humans: Can Plant Science Help?[W

PubMed Central

Fitzpatrick, Teresa B.; Basset, Gilles J.C.; Borel, Patrick; Carrari, Fernando; DellaPenna, Dean; Fraser, Paul D.; Hellmann, Hanjo; Osorio, Sonia; Rothan, Christophe; Valpuesta, Victoriano; Caris-Veyrat, Catherine; Fernie, Alisdair R.

2012-01-01

The term vitamin describes a small group of organic compounds that are absolutely required in the human diet. Although for the most part, dependency criteria are met in developed countries through balanced diets, this is not the case for the five billion people in developing countries who depend predominantly on a single staple crop for survival. Thus, providing a more balanced vitamin intake from high-quality food remains one of the grandest challenges for global human nutrition in the coming decade(s). Here, we describe the known importance of vitamins in human health and current knowledge on their metabolism in plants. Deficits in developing countries are a combined consequence of a paucity of specific vitamins in major food staple crops, losses during crop processing, and/or overreliance on a single species as a primary food source. We discuss the role that plant science can play in addressing this problem and review successful engineering of vitamin pathways. We conclude that while considerable advances have been made in understanding vitamin metabolic pathways in plants, more cross-disciplinary approaches must be adopted to provide adequate levels of all vitamins in the major staple crops to eradicate vitamin deficiencies from the global population. PMID:22374394

Isothermal folding of a light-up bio-orthogonal RNA origami nanoribbon.

PubMed

Torelli, Emanuela; Kozyra, Jerzy Wieslaw; Gu, Jing-Ying; Stimming, Ulrich; Piantanida, Luca; Voïtchovsky, Kislon; Krasnogor, Natalio

2018-05-03

RNA presents intringuing roles in many cellular processes and its versatility underpins many different applications in synthetic biology. Nonetheless, RNA origami as a method for nanofabrication is not yet fully explored and the majority of RNA nanostructures are based on natural pre-folded RNA. Here we describe a biologically inert and uniquely addressable RNA origami scaffold that self-assembles into a nanoribbon by seven staple strands. An algorithm is applied to generate a synthetic De Bruijn scaffold sequence that is characterized by the lack of biologically active sites and repetitions larger than a predetermined design parameter. This RNA scaffold and the complementary staples fold in a physiologically compatible isothermal condition. In order to monitor the folding, we designed a new split Broccoli aptamer system. The aptamer is divided into two nonfunctional sequences each of which is integrated into the 5' or 3' end of two staple strands complementary to the RNA scaffold. Using fluorescence measurements and in-gel imaging, we demonstrate that once RNA origami assembly occurs, the split aptamer sequences are brought into close proximity forming the aptamer and turning on the fluorescence. This light-up 'bio-orthogonal' RNA origami provides a prototype that can have potential for in vivo origami applications.

Gastrointestinal surgery in gynecologic oncology: evaluation of surgical techniques.

PubMed

Penalver, M; Averette, H; Sevin, B U; Lichtinger, M; Girtanner, R

1987-09-01

In recent years, the use of surgical staples has become popular in all subspecialties of surgery. The advantages proposed have been a decrease in operative time and morbidity. This paper reviews the University of Miami/Jackson Memorial Medical Center, Division of Gynecologic Oncology experience with the use of surgical staples in gastrointestinal surgery on patients with a diagnosis of a gynecologic malignancy. Between January 1, 1979 and July 1, 1985, a total of 152 procedures were done, 81 by stapler and 71 by suture anastomosis. Ninety-one patients had received previous radiation or chemotherapy. The average age of the patients was 52 years. The results show a decrease in operating time, blood loss, and postoperative hospital stay in those patients where the stapler anastomosis was used. The postoperative morbidity and mortality were not increased. Twenty-seven total pelvic exenterations were performed during the period of study and they were evaluated separately. The hospital stay and blood loss as well as the operative time were significantly less using staplers. This report includes a detailed evaluation of the results. From this study, we concluded that surgical staples are a safe alternative in gastrointestinal surgery in patients with a gynecologic malignancy.

Aggressive Attitudes and Prevalence of Bullying Bystander Behavior in Middle School

ERIC Educational Resources Information Center

Datta, Pooja; Cornell, Dewey; Huang, Francis

2016-01-01

Separate lines of research find that proaggressive attitudes promote peer aggression and that bystanders play a pivotal role in deterring or facilitating bullying behavior. The current study hypothesized that proaggressive attitudes in middle school would deter students from standing up to bullying and encourage them to reinforce bullying…

86. Round Meadow Creek Viaduct. This steel girder bridge, built ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

86. Round Meadow Creek Viaduct. This steel girder bridge, built in 1939, has a reinforced concrete deck and piers. It is an example of a major in-line, or straight, viaduct over a deep ravine. - Blue Ridge Parkway, Between Shenandoah National Park & Great Smoky Mountains, Asheville, Buncombe County, NC

Two Attentional Models of Classical Conditioning: Variations in CS Effectiveness Revisited.

DTIC Science & Technology

1987-04-03

probability is in closer agreement with empirical expectations, tending to lie on a line with slope equal to 1. Experiments in pigeon autoshaping have shown...Gibbon, J., Farrell, L., Locurto, C.M., Duncan, H., & Terrace, H.S. (1980). Partial reinforcement in autoshaping with pigeons. Animal Learning and

Applying genotyping (TILLING) and phenotyping analyses to elucidate gene function in a chemically induced sorghum mutant population

PubMed Central

Xin, Zhanguo; Li Wang, Ming; Barkley, Noelle A; Burow, Gloria; Franks, Cleve; Pederson, Gary; Burke, John

2008-01-01

Background Sorghum [Sorghum bicolor (L.) Moench] is ranked as the fifth most important grain crop and serves as a major food staple and fodder resource for much of the world, especially in arid and semi-arid regions. The recent surge in sorghum research is driven by its tolerance to drought/heat stresses and its strong potential as a bioenergy feedstock. Completion of the sorghum genome sequence has opened new avenues for sorghum functional genomics. However, the availability of genetic resources, specifically mutant lines, is limited. Chemical mutagenesis of sorghum germplasm, followed by screening for mutants altered in important agronomic traits, represents a rapid and effective means of addressing this limitation. Induced mutations in novel genes of interest can be efficiently assessed using the technique known as Targeting Induced Local Lesion IN Genomes (TILLING). Results A sorghum mutant population consisting of 1,600 lines was generated from the inbred line BTx623 by treatment with the chemical agent ethyl methanesulfonate (EMS). Numerous phenotypes with altered morphological and agronomic traits were observed from M2 and M3 lines in the field. A subset of 768 mutant lines was analyzed by TILLING using four target genes. A total of five mutations were identified resulting in a calculated mutation density of 1/526 kb. Two of the mutations identified by TILLING and verified by sequencing were detected in the gene encoding caffeic acid O-methyltransferase (COMT) in two independent mutant lines. The two mutant lines segregated for the expected brown midrib (bmr) phenotype, a trait associated with altered lignin content and increased digestibility. Conclusion TILLING as a reverse genetic approach has been successfully applied to sorghum. The diversity of the mutant phenotypes observed in the field, and the density of induced mutations calculated from TILLING indicate that this mutant population represents a useful resource for members of the sorghum research community. Moreover, TILLING has been demonstrated to be applicable for sorghum functional genomics by evaluating a small subset of the EMS-induced mutant lines. PMID:18854043

Local SIMPLE multi-atlas-based segmentation applied to lung lobe detection on chest CT

NASA Astrophysics Data System (ADS)

Agarwal, M.; Hendriks, E. A.; Stoel, B. C.; Bakker, M. E.; Reiber, J. H. C.; Staring, M.

2012-02-01

For multi atlas-based segmentation approaches, a segmentation fusion scheme which considers local performance measures may be more accurate than a method which uses a global performance measure. We improve upon an existing segmentation fusion method called SIMPLE and extend it to be localized and suitable for multi-labeled segmentations. We demonstrate the algorithm performance on 23 CT scans of COPD patients using a leave-one- out experiment. Our algorithm performs significantly better (p < 0.01) than majority voting, STAPLE, and SIMPLE, with a median overlap of the fissure of 0.45, 0.48, 0.55 and 0.6 for majority voting, STAPLE, SIMPLE, and the proposed algorithm, respectively.

Expediency of wet-mix shotcreting in mines of Vostoktsvetmet

NASA Astrophysics Data System (ADS)

Shaposhnik, YuN

2018-03-01

This paper offers a substantiation of the transition from heavy and difficult-to-install steel frame support to the cheaper and simpler reinforced shotcrete lining (at the same bearing-capacity of the support). The process line for the preparation of the shotcrete mix is designed. The author of the paper presents calculation of the material inputs and labor costs of installation of different support types in Kazakhstan Mines. The economic efficiency of the wet-mix shotcrete spraying technology is illustrated in terms of Orlov and Artemevsk Mines.

Performance of PTFE-lined composite journal bearings

NASA Technical Reports Server (NTRS)

Sliney, H. E.; Williams, F. J.

1982-01-01

Plain cylindrical journal bearings consisting of aramid fiber reinforced epoxy outer shells and glass fiber reinforced PTFE lubricating liners were evaluated. All materials in these bearings are electrically nonconductive; thus eliminating the problem of galvanic corrosion sometimes encountered with metal bearings installed in dissimilar metal mountings. Friction and wear characteristics were determined for loads, temperatures, and oscillating conditions that are typical of current airframe bearing applications. Friction and wear characteristics were found to be compatible with most airframe bearing requirements from -23 C to 121 C. Contamination with MIL H-5606 hydraulic fluid increased wear of the PTFE liners at 121 C, but did not affect the structural integrity of the aramid/epoxy composite.

Current-sheet formation in two-dimensional coronal fields

NASA Astrophysics Data System (ADS)

Billinghurst, M. N.; Craig, I. J. D.; Sneyd, A. D.

1993-11-01

The formation of current sheets by shearing motions in line-tied twin-lobed fields is examined. A general analytic argument shows that current sheets form along the fieldline bounding the two lobes in the case of both symmetric and asymmetric footpoint motions. In the case of strictly antisymmetric motions however no current sheets can form. These findings are reinforced by magnetic relaxation experiments involving sheared two-lobed fields represented by Clebsh variables. It is pointed out that, although current singularites cannot be expected to form when the line-tying assumption is relaxed, the two-lobed geometry is still consistent with the formation of highly localised currents - and strong resistive dissipation - along field lines close to the bounding fieldline.

Magic Termites: Exploring Scientific Inquiry

ERIC Educational Resources Information Center

Callis, Kristine; Henkel, Melissa; Lund, Rachael

2010-01-01

The objective of the termite experiment is to walk students through the process of designing and conducting an experiment while allowing them to use inquiry-based methods to infer why, in this lab, termites follow the line of blue Bic or Paper Mate brand ballpoint pens. This experiment also reinforces the concept of observation versus inference…

Stereotypes of Latin Americans Perpetuated in Secondary School History Textbooks.

ERIC Educational Resources Information Center

Cruz, Barbara C.

1994-01-01

This study reviewed six history textbooks widely used in grades 7-12 across the U.S. Using a story-line analysis, the findings of this study suggest: (1) textbooks reinforce negative stereotypes of Latin Americans as lazy, passive, irresponsible, and, somewhat paradoxically, lustful, animalistic and violent; (2) the method of description employed…

The acquisition of observing.

PubMed Central

Dinsmoor, J A; Mueller, K L; Martin, L T; Bowe, C A

1982-01-01

Pigeons were exposed to stimuli correlated with the presence or absence of a variable-interval 60-second schedule of reinforcement only while they depressed a crossbar or "perch." In the first experiment, the stimuli were different tilts of a line displayed on the key. When the difference in brightness between the line and the background (salience) was maximal, seven of eight birds acquired the discrimination, but when the difference was reduced by 50%, only one succeeded. In the second experiment, wavelength of chamber illumination served as the relevant dimension. Neither experiment showed a large effect attributable to the magnitude of the difference (disparity) between the positive and the negative stimulus. Individual differences in time spent observing were positively correlated with level of discrimination in the presence of the stimuli. All birds produced the positive stimulus for a greater proportion of the available time than they did the negative stimulus. This may be the mechanism that provides selective reinforcement of observing. Finally, the formation of a discrimination was analyzed in terms of changes in the proportion of time spent in contact with the discriminative stimuli. PMID:7175427

Fault-tolerant optimised tracking control for unknown discrete-time linear systems using a combined reinforcement learning and residual compensation methodology

NASA Astrophysics Data System (ADS)

Han, Ke-Zhen; Feng, Jian; Cui, Xiaohong

2017-10-01

This paper considers the fault-tolerant optimised tracking control (FTOTC) problem for unknown discrete-time linear system. A research scheme is proposed on the basis of data-based parity space identification, reinforcement learning and residual compensation techniques. The main characteristic of this research scheme lies in the parity-space-identification-based simultaneous tracking control and residual compensation. The specific technical line consists of four main contents: apply subspace aided method to design observer-based residual generator; use reinforcement Q-learning approach to solve optimised tracking control policy; rely on robust H∞ theory to achieve noise attenuation; adopt fault estimation triggered by residual generator to perform fault compensation. To clarify the design and implementation procedures, an integrated algorithm is further constructed to link up these four functional units. The detailed analysis and proof are subsequently given to explain the guaranteed FTOTC performance of the proposed conclusions. Finally, a case simulation is provided to verify its effectiveness.

Raman Study of Uncoated and P-bn/sic-coated Hi-nicalon Reinforced Celsian Matrix Composites. Part 2; Residual Stress in the Fibers

NASA Technical Reports Server (NTRS)

Gouadec, Gwenael; Colomban, Philippe; Bansal, Narottam P.

2000-01-01

Band shifts on Raman spectra were used to assess, at a microscopic scale, the residual strain existing in Hi-Nicalon fibers reinforcing celsian matrix composites. Uncoated as well as p-BN/SiC- and p-B(Si)N/SiC-coated Hi-Nicalon fibers were used as the reinforcements. We unambiguously conclude that the fibers are in a state of compressive residual stress. Quantitative determination of the residual stress was made possible by taking into account the heating induced by laser probing and by using a reference line, of fixed wavenumber. We found fiber compressive residual stress values between 110 and 960 MPa depending on the fiber/matrix coating in the composite. A stress relaxation-like phenomenon was observed at the surface of p-BN/SiC-coated Hi-Nicalon fibers whereas the uncoated or p-B(Si)N/SiC-coated Hi-Nicalon fibers did not show any stress relaxation in the Celsian matrix composites.

Isolation and characterisation of microcrystalline cellulose and cellulose nanocrystals from coffee husk and comparative study with rice husk.

PubMed

Collazo-Bigliardi, Sofía; Ortega-Toro, Rodrigo; Chiralt Boix, Amparo

2018-07-01

Cellulosic material from coffee husk has not been previously studied despite being a potential source of reinforcing agents for different applications. This material has been extracted and characterised from coffee husk, in parallel with previously studied rice husk. Samples have been analysed as to their ability to obtain cellulosic fibres and cellulose nanocrystals (CNC) by applying alkali and bleaching treatments and final sulphuric acid hydrolysis. Microstructural changes were analysed after treatments, and the size and aspect ratio of CNCs were determined. Crystallinity and thermal stability of both materials progressed in line with the enrichment in cellulosic compounds. The CNC aspect ratio was higher than 10, which confers good reinforcing properties. These were tested in thermoplastic starch films, whose elastic modulus increased by 186 and 121% when 1 wt% of CNCs from rice and coffee husks, respectively, was incorporated into the matrix. Coffee husk represents an interesting source of cellulosic reinforcing materials. Copyright © 2018 Elsevier Ltd. All rights reserved.

Glycaemic Index and Load Values Tested in Normoglycemic Adults for Five Staple Foodstuffs: Pounded Yam, Pounded Cassava-Plantain, Placali, Attieke and Maize Meal Stiff Porridge

PubMed Central

Kouamé, Adam C.; Kouassi, Kouakou N.; N’dri, Yao D.; Amani, N’guessan G.

2015-01-01

There is currently an increased global interest in the published glycaemic index (GI) and glycaemic load (GL) values of foods. However, data on the GI and GL values of different varieties of foods within Côte d’Ivoire are very limited. The study therefore aimed at finding the GI and GL of the main food staples in Côte d’Ivoire. Following the International Standard Organisation’s protocol (ISO/FDI 26642:2010), a selection of five staple foodstuffs were tested for their GI and GL. Fasted healthy subjects were given 50 g of available carbohydrate servings of a glucose reference, which was tested twice, and test foods which were tested once, on separate occasions. Excepted attieke (GI 63), the majority of foods tested have a high GI (GI > 70). Attieke (agbodjama) had a high GL (GL 29) while placali (GL 17) and maize meal stiff porridge (GL 16) had medium GLs. The GLs of pounded cassava-plantain and pounded yam are 26 and 22. Consumption of attieke could minimize postprandial blood glucose spikes, in spite of high GL and potentially have benefit in the management and prevention of some chronic diseases. PMID:25690417

A stapled BIM peptide overcomes apoptotic resistance in hematologic cancers

PubMed Central

LaBelle, James L.; Katz, Samuel G.; Bird, Gregory H.; Gavathiotis, Evripidis; Stewart, Michelle L.; Lawrence, Chelsea; Fisher, Jill K.; Godes, Marina; Pitter, Kenneth; Kung, Andrew L.; Walensky, Loren D.

2012-01-01

Cancer cells subvert the natural balance between cellular life and death, achieving immortality through pathologic enforcement of survival pathways and blockade of cell death mechanisms. Pro-apoptotic BCL-2 family proteins are frequently disarmed in relapsed and refractory cancer through genetic deletion or interaction-based neutralization by overexpressed antiapoptotic proteins, resulting in resistance to chemotherapy and radiation treatments. New pharmacologic strategies are urgently needed to overcome these formidable apoptotic blockades. We harnessed the natural killing activity of BCL-2–interacting mediator of cell death (BIM), which contains one of the most potent BH3 death domains of the BCL-2 protein family, to restore BH3-dependent cell death in resistant hematologic cancers. A hydrocarbon-stapled peptide modeled after the BIM BH3 helix broadly targeted BCL-2 family proteins with high affinity, blocked inhibitory antiapoptotic interactions, directly triggered proapoptotic activity, and induced dose-responsive and BH3 sequence–specific cell death of hematologic cancer cells. The therapeutic potential of stapled BIM BH3 was highlighted by the selective activation of cell death in the aberrant lymphoid infiltrates of mice reconstituted with BIM-deficient bone marrow and in a human AML xenograft model. Thus, we found that broad and multimodal targeting of the BCL-2 family pathway can overcome pathologic barriers to cell death. PMID:22622039

Competitive annealing of multiple DNA origami: formation of chimeric origami

NASA Astrophysics Data System (ADS)

Majikes, Jacob M.; Nash, Jessica A.; LaBean, Thomas H.

2016-11-01

Scaffolded DNA origami are a robust tool for building discrete nanoscale objects at high yield. This strategy ensures, in the design process, that the desired nanostructure is the minimum free energy state for the designed set of DNA sequences. Despite aiming for the minimum free energy structure, the folding process which leads to that conformation is difficult to characterize, although it has been the subject of much research. In order to shed light on the molecular folding pathways, this study intentionally frustrates the folding process of these systems by simultaneously annealing the staple pools for multiple target or parent origami structures, forcing competition. A surprising result of these competitive, simultaneous anneals is the formation of chimeric DNA origami which inherit structural regions from both parent origami. By comparing the regions inherited from the parent origami, relative stability of substructures were compared. This allowed examination of the folding process with typical characterization techniques and materials. Anneal curves were then used as a means to rapidly generate a phase diagram of anticipated behavior as a function of staple excess and parent staple ratio. This initial study shows that competitive anneals provide an exciting way to create diverse new nanostructures and may be used to examine the relative stability of various structural motifs.

"Life without line dancing and the other activities would be too dreadful to imagine": an increase in social activity for older women.

PubMed

Nadasen, Krishnavelli

2008-01-01

The literature on aging is replete with the positive effects of physical exercise on the well-being of older adults. Some suggest, however, that the potential impact of social activities has not received adequate attention, and others note the importance of distinguishing between the physical and nonphysical impact of these activities. This study investigated whether line dancing, a physical activity, led to an increase in social activity. Thirty women over the age of 60 were interviewed to discover how line dancing affected them. Content analysis of the interviews helped identify various themes indicating that line dancing enabled these women to expand their repertoire of social activity, leading to positive reinforcements such as further community involvement, charitable work, inclusion in national sports events, self-expression, and personal development. The impact of line dancing plainly goes beyond the perceived physical benefits.

Spicing up your advice for South Asian and Anglo-Australians with type 2 diabetes and CVD: Do cultural constructions of diet matter?

PubMed

Gupta, Sabrina S; Teede, Helena; Aroni, Rosalie

2018-01-01

South Asians are a growing migrant population, both globally and in Australia. This group are at higher risk for both cardiovascular disease and type 2 diabetes. The aim of this qualitative study was to compare dietary practices of South Asians, n = 41 (Indian, n = 25; Sri Lankan, n = 16) and Anglo-Australians, n = 16, with these conditions, using semi-structured in-depth interviews. Findings suggest that both groups had a high level of awareness of dietary practices necessary for optimum disease management, both prior to and post diagnosis. Bi-directional effects of migration were noted in the dietary practices of both groups suggesting hybrid diets are evident in Australia. A key barrier to implementing dietary changes highlighted by both groups of participants was a lack of specific, timely and detailed dietary advice from clinicians. Both groups expressed that advice should be repeated and reinforced throughout the course of their disease. In addition, South Asian participants wanted more culturally relevant advice. Clinicians providing dietary advice need to recognise that preferences for staple food items are resistant to change and may affect adherence. Acculturation was evident in the dietary practices of the South Asian participants. Nevertheless, many maintained traditional food practices which were tied to their cultural identity. It is recommended that clinicians consider these factors when offering advice. Copyright © 2017. Published by Elsevier Ltd.

Balancing the Role of Priors in Multi-Observer Segmentation Evaluation

PubMed Central

Huang, Xiaolei; Wang, Wei; Lopresti, Daniel; Long, Rodney; Antani, Sameer; Xue, Zhiyun; Thoma, George

2009-01-01

Comparison of a group of multiple observer segmentations is known to be a challenging problem. A good segmentation evaluation method would allow different segmentations not only to be compared, but to be combined to generate a “true” segmentation with higher consensus. Numerous multi-observer segmentation evaluation approaches have been proposed in the literature, and STAPLE in particular probabilistically estimates the true segmentation by optimal combination of observed segmentations and a prior model of the truth. An Expectation–Maximization (EM) algorithm, STAPLE’S convergence to the desired local minima depends on good initializations for the truth prior and the observer-performance prior. However, accurate modeling of the initial truth prior is nontrivial. Moreover, among the two priors, the truth prior always dominates so that in certain scenarios when meaningful observer-performance priors are available, STAPLE can not take advantage of that information. In this paper, we propose a Bayesian decision formulation of the problem that permits the two types of prior knowledge to be integrated in a complementary manner in four cases with differing application purposes: (1) with known truth prior; (2) with observer prior; (3) with neither truth prior nor observer prior; and (4) with both truth prior and observer prior. The third and fourth cases are not discussed (or effectively ignored) by STAPLE, and in our research we propose a new method to combine multiple-observer segmentations based on the maximum a posterior (MAP) principle, which respects the observer prior regardless of the availability of the truth prior. Based on the four scenarios, we have developed a web-based software application that implements the flexible segmentation evaluation framework for digitized uterine cervix images. Experiment results show that our framework has flexibility in effectively integrating different priors for multi-observer segmentation evaluation and it also generates results comparing favorably to those by the STAPLE algorithm and the Majority Vote Rule. PMID:20523759

Water and Land Limitations to Future Agricultural Production in the Middle East

NASA Astrophysics Data System (ADS)

Koch, J. A. M.; Wimmer, F.; Schaldach, R.

2015-12-01

Countries in the Middle East use a large fraction of their scarce water resources to produce cash crops, such as fruit and vegetables, for international markets. At the same time, these countries import large amounts of staple crops, such as cereals, required to meet the nutritional demand of their populations. This makes food security in the Middle East heavily dependent on world market prices for staple crops. Under these preconditions, increasing food demand due to population growth, urban expansion on fertile farmlands, and detrimental effects of a changing climate on the production of agricultural commodities present major challenges to countries in the Middle East that try to improve food security by increasing their self-sufficiency rate of staple crops.We applied the spatio-temporal land-use change model LandSHIFT.JR to simulate how an expansion of urban areas may affect the production of agricultural commodities in Jordan. We furthermore evaluated how climate change and changes in socio-economic conditions may influence crop production. The focus of our analysis was on potential future irrigated and rainfed production (crop yield and area demand) of fruit, vegetables, and cereals. Our simulation results show that the expansion of urban areas and the resulting displacement of agricultural areas does result in a slight decrease in crop yields. This leads to almost no additional irrigation water requirements due to the relocation of agricultural areas, i.e. there is the same amount of "crop per drop". However, taking into account projected changes in socio-economic conditions and climate conditions, a large volume of water would be required for cereal production in order to safeguard current self-sufficiency rates for staple crops. Irrigation water requirements are expected to double until 2025 and to triple until 2050. Irrigated crop yields are projected to decrease by about 25%, whereas there is no decrease in rainfed crop yields to be expected.

Procedure of brewing alcohol as a staple food: case study of the fermented cereal liquor "Parshot" as a staple food in Dirashe special woreda, southern Ethiopia.

PubMed

Sunano, Yui

2016-07-01

For most brews, alcohol fermentation and lactic fermentation take place simultaneously during the brewing process, and alcohol fermentation can progress smoothly because the propagation of various microorganisms is prevented by lactic fermentation. It is not necessary to cause lactic fermentation with a thing generated naturally and intentionally. The people living in the Dirashe area in southern Ethiopia drink three types of alcoholic beverages that are prepared from cereals. From these alcoholic beverages, parshot is prepared by the addition of plant leaves for lactic fermentation and nech chaka by adding cereal powder for lactic fermentation before alcohol fermentation. People living in the Dirashe area partake of parshot as part of their staple diet. The brewing process used for parshot and a food culture with alcoholic beverages as parts of the staple diet are rare worldwide. This article discusses the significance of using lactic fermentation before alcoholic fermentation and focuses on lactic fermentation in the brewing methods used for the three kinds of alcoholic beverages consumed in the Dirashe area. We initially observed the brewing process and obtained information about the process from the people in that area. Next, we determined the pH and analyzed the lactic acid (g/100 g) and ethanol (g/100 g) content during lactic fermentation of parshot and nech chaka; the ethyl acetate (mg/100 g) and volatile base nitrogen (mg/100 g) content during this period was also analyzed. In addition, we compared the ethanol (g/100 g) content of all three kinds of alcoholic beverages after completion of brewing. The results showed that it was possible to consume large quantities of these alcoholic beverages because of the use of lactic fermentation before alcoholic fermentation, which improved the safety and preservation characteristics of the beverages by preventing the propagation of various microorganisms, improving flavor, and controlling the alcohol level.

What is the benefit of a new stapler device in the surgical treatment of obstructed defecation? Three-year outcomes from a randomized controlled trial.

PubMed

Boccasanta, Paolo; Venturi, Marco; Roviaro, Giancarlo

2011-01-01

A randomized study was conducted to compare the clinical and functional outcomes of the stapled transanal rectal resection, using the traditional 2 circular staplers and a new, curved stapler device in patients with obstructed defecation caused by rectal intussusception and rectocele. Stapled transanal rectal resection gives good midterm results in patients with obstructed defecation syndrome, but the limited capacity of the casing of the circular stapler and the impossibility to control the positioning of the rectal wall and the firing of staples may result in incomplete removal of the prolapsed tissues, or serious complications. The new curved multifire stapler could avoid these drawbacks. From January to December 2006, 100 women were selected, with clinical examination, constipation score, colonoscopy, anorectal manometry, and perineography, and randomly assigned to 2 groups: 50 patients underwent stapled transanal rectal resection with 2 traditional circular staplers (STARR group) and 50 had the same operation with a new, curved multifire stapler (TRANSTAR group). Patients were followed up with clinical examination, constipation score, and colpocystodefecography, with the recurrence rate as the primary outcome measure. Recurrence rates at 3 years were 12.0% in STARR group and 0 in the TRANSTAR group (P = .035). Operating time was significantly shorter in the STARR group (P = .008). Complications were 2 bleeds (4%) in the STARR group and 1 tear of the vagina in the TRANSTAR group. The incidence of fecal urgency was 34.0% in the STARR group and 14.0% in the TRANSTAR group (P = .035). All symptoms and defecographic parameters significantly improved after the operation (P < .001) without differences between groups. The curved Contour Transtar stapler device did not appear to offer significant advantages over the traditional PPH-01 device during the operation or in the clinical and functional outcomes. However, the lower incidence of fecal urgency and recurrences might justify the higher cost of the new stapler.

A Safe and Reproducible Anastomotic Technique for Minimally Invasive Ivor Lewis Esophagectomy: The Circular Stapled Anastomosis with the Transoral Anvil

PubMed Central

Campos, Guilherme M; Jablons, David; Brown, Lisa M; Ramirez, René M; Rabl, Charlotte; Theodore, Pierre

2010-01-01

Objectives In expert hands, the intra-thoracic esophago-gastric anastamosis usually provides a low rate of strictures and leaks. However, anastomoses can be technically challenging and time consuming when minimally invasive techniques are used. We present our preliminary results of a standardized 25mm/4.8mm circular stapled anastomosis using a trans-orally placed anvil. Materials and Methods We evaluated a prospective cohort of 37 consecutive patients offered minimally invasive Ivor Lewis Esophagectomy at a tertiary referral center. The esophagogastric anastomosis was created using a 25mm anvil (Orvil, Autosuture, Norwalk, CT) passed trans-orally, in a tilted position, and connected to a 90cm long PVC delivery tube through an opening in the esophageal stump. The anastomosis was completed by joining the anvil to a circular stapler (EEA XL 25mm with 4.8mm Staples, Autosuture, Norwalk, CT) inserted into the gastric conduit. Primary outcomes were leak and stricture rates. Results Thirty-seven patients (mean age 65 yrs) with distal esophageal adenocarcinoma (n=29), squamous cell cancer (n=5), or high-grade dysplasia in Barrett's Esophagus (n=3) underwent an Ivor Lewis Esophagectomy between October 2007 and August 2009. The abdominal portion of the operation was completed laparoscopically in 30 patients (81.1%). The thoracic portion was done using a muscle sparing mini-thoracotomy in 23 patients (62.2%) and thoracoscopic techniques in 14 patients (37.8%). There were no intra-operative technical failures of the anastomosis or deaths. Five patients had strictures (13.5%) and all were successfully treated with endoscopic dilations. One patient had an anastomotic leak (2.7%) that was successfully treated by re-operation and endoscopic stenting of the anastomosis. Discussion The circular stapled anastomosis with the transoral anvil allows for an efficient, safe and reproducible anastomosis. This straightforward technique is particularly suited to the completely minimally invasive Ivor Lewis Esophagectomy. PMID:20153660

Stapled versus handsewn methods for colorectal anastomosis surgery.

PubMed

Lustosa, S A; Matos, D; Atallah, A N; Castro, A A

2001-01-01

Randomized controlled trials comparing stapled with handsewn colorectal anastomosis have not shown either technique to be superior, perhaps because individual studies lacked statistical power. A systematic review, with pooled analysis of results, might provide a more definitive answer. To compare the safety and effectiveness of stapled and handsewn colorectal anastomosis. The following primary hypothesis was tested: the stapled technique is more effective because it decreases the level of complications. The RCT register of the Cochrane Review Group was searched for any trial or reference to a relevant trial (published, in-press, or in progress). All publications were sought through computerised searches of EMBASE, LILACS, MEDLINE, the Cochrane Controlled Clinical Trials Database, and through letters to industrial companies and authors. There were no limits upon language, date, or other criteria. All randomized clinical trials (RCTs) in which stapled and handsewn colorectal anastomosis were compared. Adult patients submitted electively to colorectal anastomosis. Endoluminal circular stapler and handsewn colorectal anastomosis. a) Mortality b) Overall Anastomotic Dehiscence c) Clinical Anastomotic Dehiscence d) Radiological Anastomotic Dehiscence e) Stricture f) Anastomotic Haemorrhage g) Reoperation h) Wound Infection i) Anastomosis Duration j) Hospital Stay. Data were independently extracted by the two reviewers (SASL, DM) and cross-checked. The methodological quality of each trial was assessed by the same two reviewers. Details of the randomization (generation and concealment), blinding, whether an intention-to-treat analysis was done, and the number of patients lost to follow-up were recorded. The results of each RCT were summarised on an intention-to-treat basis in 2 x 2 tables for each outcome. External validity was defined by characteristics of the participants, the interventions and the outcomes. The RCTs were stratified according to the level of colorectal anastomosis. The Risk Difference method (random effects model) and NNT for dichotomous outcomes measures and weighted mean difference for continuous outcomes measures, with the corresponding 95% confidence interval, were presented in this review. Statistical heterogeneity was evaluated by using funnel plot and chi-square testing. Of the 1233 patients enrolled ( in 9 trials), 622 were treated with stapled, and 611 with manual, suture. The following main results were obtained: a) Mortality: result based on 901 patients; Risk Difference - 0.6% Confidence Interval -2.8% to +1.6%. b) Overall Dehiscence: result based on 1233 patients; Risk Difference 0.2%, 95% Confidence Interval -5.0% to +5.3%. c) Clinical Anastomotic Dehiscence : result based on 1233 patients; Risk Difference -1.4%, 95% Confidence Interval -5.2 to +2.3%. d) Radiological Anastomotic Dehiscence : result based on 825 patients; Risk Difference 1.2%, 95% Confidence Interval -4.8% to +7.3%. e) Stricture: result based on 1042 patients; Risk Difference 4.6%, 95% Confidence Interval 1.2% to 8.1%. Number needed to treat 17, 95% confidence interval 12 to 31. f) Anastomotic Hemorrhage: result based on 662 patients; Risk Difference 2.7%, 95% Confidence Interval - 0.1% to +5.5%. g) Reoperation: result based on 544 patients; Risk Difference 3.9%, 95% Confidence Interval 0.3% to 7.4%. h) Wound Infection: result based on 567 patients; Risk Difference 1.0%, 95% Confidence Interval -2.2% to +4.3%. i) Anastomosis duration: result based on one study (159 patients); Weighted Mean Difference -7.6 minutes, 95% Confidence Interval -12.9 to -2.2 minutes. j) Hospital Stay: result based on one study (159 patients), Weighted Mean Difference 2.0 days, 95% Confidence Interval -3.27 to +7.2 days. The evidence found was insufficient to demonstrate any superiority of stapled over handsewn techniques in colorectal anastomosis, regardless of the level of anastomosis.

Sleeve gastrectomy and the risk of leak: a systematic analysis of 4,888 patients.

PubMed

Aurora, Alexander R; Khaitan, Leena; Saber, Alan A

2012-06-01

Sleeve gastrectomy has become a popular stand-alone bariatric procedure with comparable weight loss and resolution of comorbidities to that of laparoscopic gastric bypass. The simplicity of the procedure and the decreased long-term risk profile make this surgery more appealing. Nonetheless, the ever present risk of a staple-line leak is still of great concern and needs further investigation. An electronic literature search of MEDLINE database plus manual reference checks of articles published on laparoscopic sleeve gastrectomy for morbid obesity and its complications was completed. Keywords used in the search were "sleeve gastrectomy" OR "gastric sleeve" AND "leak." We analyzed 29 publications, including 4,888 patients. We analyzed the frequency of leak after sleeve gastrectomy and its associated risks of causation. The risk of leak after sleeve gastrectomy in all comers was 2.4%. This risk was 2.9% in the super-obese [body mass index (BMI) > 50 kg/m(2)] and 2.2% for BMI < 50 kg/m(2). Staple height and use of buttressing material did not affect leak rate. The use of a size 40-Fr or greater bougie was associated with a leak rate of 0.6% compared with those who used smaller sizes whose leak rate was 2.8%. Leaks were found at the proximal third of the stomach in 89% of cases. Most leaks were diagnosed after discharge. Endoscopic management is a viable option for leaks and was documented in 11% of cases as successful. Sleeve gastrectomy has become an important surgical option for the treatment of the ever growing morbidly obese population. The risk of leak is low at 2.4%. Attention to detail specifically at the esophagogastric junction cannot be stressed enough. Careful patient selection (BMI < 50 kg/m(2)) and adopting the use of a 40-Fr or larger bougie may decrease the risk of leak. Vigilant follow-up during the first 30 days is critical to avoid catastrophe, because most leaks will happen after patient discharge.

An endoscopic mucosal grading system is predictive of leak in stapled rectal anastomoses.

PubMed

Sujatha-Bhaskar, Sarath; Jafari, Mehraneh D; Hanna, Mark; Koh, Christina Y; Inaba, Colette S; Mills, Steven D; Carmichael, Joseph C; Nguyen, Ninh T; Stamos, Michael J; Pigazzi, Alessio

2018-04-01

Anastomotic leak is a devastating postoperative complication following rectal anastomoses associated with significant clinical and oncological implications. As a result, there is a need for novel intraoperative methods that will help predict anastomotic leak. From 2011 to 2014, patient undergoing rectal anastomoses by colorectal surgeons at our institution underwent prospective application of intraoperative flexible endoscopy with mucosal grading. Retrospective review of patient medical records was performed. After creation of the colorectal anastomosis, application of a three-tier endoscopic mucosal grading system occurred. Grade 1 was defined as circumferentially normal appearing peri-anastomotic mucosa. Grade 2 was defined as ischemia or congestion involving <30% of either the colon or rectal mucosa. Grade 3 was defined as ischemia or congestion involving >30% of the colon or rectal mucosa or ischemia/congestion involving both sides of the staple line. From 2011 to 2014, a total of 106 patients were reviewed. Grade 1 anastomoses were created in 92 (86.7%) patients and Grade 2 anastomoses were created in 10 (9.4%) patients. All 4 (3.8%) Grade 3 patients underwent immediate intraoperative anastomosis takedown and re-creation, with subsequent re-classification as Grade 1. Demographic and comorbidity data were similar between Grade 1 and Grade 2 patients. Anastomotic leak rate for the entire cohort was 12.2%. Grade 1 patients demonstrated a leak rate of 9.4% (9/96) and Grade 2 patients demonstrated a leak rate of 40% (4/10). Multivariate logistic regression associated Grade 2 classification with an increased risk of anastomotic leak (OR 4.09, 95% CI 1.21-13.63, P = 0.023). Endoscopic mucosal grading is a feasible intraoperative technique that has a role following creation of a rectal anastomosis. Identification of a Grade 2 or Grade 3 anastomosis should provoke strong consideration for immediate intraoperative revision.

The opioid effects of gluten exorphins: asymptomatic celiac disease.

PubMed

Pruimboom, Leo; de Punder, Karin

2015-11-24

Gluten-containing cereals are a main food staple present in the daily human diet, including wheat, barley, and rye. Gluten intake is associated with the development of celiac disease (CD) and related disorders such as diabetes mellitus type I, depression, and schizophrenia. However, until now, there is no consent about the possible deleterious effects of gluten intake because of often failing symptoms even in persons with proven CD. Asymptomatic CD (ACD) is present in the majority of affected patients and is characterized by the absence of classical gluten-intolerance signs, such as diarrhea, bloating, and abdominal pain. Nevertheless, these individuals very often develop diseases that can be related with gluten intake. Gluten can be degraded into several morphine-like substances, named gluten exorphins. These compounds have proven opioid effects and could mask the deleterious effects of gluten protein on gastrointestinal lining and function. Here we describe a putative mechanism, explaining how gluten could "mask" its own toxicity by exorphins that are produced through gluten protein digestion.

Pro-apoptotic and anti-proliferative effects of corn silk extract on human colon cancer cell lines.

PubMed

Guo, Hao; Guan, Hong; Yang, Wenqin; Liu, Han; Hou, Huiling; Chen, Xue; Liu, Zhenyan; Zang, Chuangang; Liu, Yuchao; Liu, Jicheng

2017-02-01

Corn silk is an economically and nutritionally significant natural product as it represents a staple food for a large proportion of the world population. This study investigated the anticancer activity of corn silk extract in human colon cancer cells and human gastric cancer cells. Following treatment with corn silk extract, certain apoptosis-related events were observed, including inhibition of cell proliferation, loss of mitochondrial membrane potential (ΔΨm), release of Ca2+ and release of cytochrome c from the mitochondria into the cytosol. Our results revealed that corn silk extract inhibited the proliferation of cancer cells and increased the level of apoptosis in a concentration-dependent manner. Western blot analysis revealed that corn silk extract upregulated the levels of Bax, cytochrome c , caspase-3 and caspase-9, but downregulated the levels of B-cell lymphoma 2. These results suggest that corn silk extract may induce apoptosis through the mitochondria-mediated pathway.

Towards Establishment of a Rice Stress Response Interactome

PubMed Central

Seo, Young-Su; Chern, Mawsheng; Bartley, Laura E.; Han, Muho; Jung, Ki-Hong; Lee, Insuk; Walia, Harkamal; Richter, Todd; Xu, Xia; Cao, Peijian; Bai, Wei; Ramanan, Rajeshwari; Amonpant, Fawn; Arul, Loganathan; Canlas, Patrick E.; Ruan, Randy; Park, Chang-Jin; Chen, Xuewei; Hwang, Sohyun; Jeon, Jong-Seong; Ronald, Pamela C.

2011-01-01

Rice (Oryza sativa) is a staple food for more than half the world and a model for studies of monocotyledonous species, which include cereal crops and candidate bioenergy grasses. A major limitation of crop production is imposed by a suite of abiotic and biotic stresses resulting in 30%–60% yield losses globally each year. To elucidate stress response signaling networks, we constructed an interactome of 100 proteins by yeast two-hybrid (Y2H) assays around key regulators of the rice biotic and abiotic stress responses. We validated the interactome using protein–protein interaction (PPI) assays, co-expression of transcripts, and phenotypic analyses. Using this interactome-guided prediction and phenotype validation, we identified ten novel regulators of stress tolerance, including two from protein classes not previously known to function in stress responses. Several lines of evidence support cross-talk between biotic and abiotic stress responses. The combination of focused interactome and systems analyses described here represents significant progress toward elucidating the molecular basis of traits of agronomic importance. PMID:21533176

A rare cause of bleeding after laparoscopic sleeve gastrectomy : pseudo-aneurysm of the gastro-omental artery.

PubMed

Mege, D; Louis, G; Berthet, B

2013-01-01

A serious complication of laparoscopic sleeve gastrectomy (LSG) is bleeding that is primarily located along the staples lines. Bleeding may be due to several causes, including hematomas, trocar sites, or visceral pseudo-aneurysms. We reported here a case of bleeding related to a pseudo-aneurysm of the gastro-omental artery. An LSG was performed on a 43-year-old woman (BMI = 46 kg/m2) without apparent surgical complications. Fifteen days later, she was admitted to the emergency department for hematemesis and symptoms of hemorrhagic shock. Abdominal computed tomography angiography revealed blood in the stomach, without a digestive leak, and active bleeding from a pseudo-aneurysm of the gastro-omental artery. An arterial embolisation was performed with the sandwich technique and angiographic guide wires and the placement of several detachable coils. The patient was discharged two days later. We demonstrated for the first time that post-LSG bleeding may involve a pseudo-aneurysm of the gastro-omental artery.

Efficient CRISPR/Cas9 Genome Editing of Phytoene desaturase in Cassava.

PubMed

Odipio, John; Alicai, Titus; Ingelbrecht, Ivan; Nusinow, Dmitri A; Bart, Rebecca; Taylor, Nigel J

2017-01-01

CRISPR/Cas9 has become a powerful genome-editing tool for introducing genetic changes into crop species. In order to develop capacity for CRISPR/Cas9 technology in the tropical staple cassava ( Manihot esculenta ), the Phytoene desaturase ( MePDS ) gene was targeted in two cultivars using constructs carrying gRNAs targeting two sequences within MePDS exon 13. After Agrobacterium -mediated delivery of CRISPR/Cas9 reagents into cassava cells, both constructs induced visible albino phenotypes within cotyledon-stage somatic embryos regenerating on selection medium and the plants regenerated therefrom. A total of 58 (cv. 60444) and 25 (cv. TME 204) plant lines were recovered, of which 38 plant lines (19 from each cultivar) were analyzed for mutagenesis. The frequency of plant lines showing albino phenotype was high, ranging from 90 to 100% in cv. TME 204. Observed albino phenotypes were comprised of full albinos devoid of green tissue and chimeras containing a mixture of white and green tissues. Sequence analysis revealed that 38/38 (100%) of the plant lines examined carried mutations at the targeted MePDS site, with insertions, deletions, and substitutions recorded. One putatively mono-allelic homozygous line (1/19) was found from cv. 60444, while 1 (1/19) and 4 (4/19) putatively bi-allelic homozygous lines were found in 60444 and TME204, respectively. The remaining plant lines, comprised mostly of the chimeras, were found to be putatively heterozygous. We observed minor (1 bp) nucleotide substitutions and or deletions upstream of the 5' and or downstream of the 3' targeted MePDS region. The data reported demonstrates that CRISPR/Cas9-mediated genome editing of cassava is highly efficient and relatively simple, generating multi-allelic mutations in both cultivars studied. Modification of MePDS described here generates visually detectable mutated events in a relatively short time frame of 6-8 weeks, and does not require sequencing to confirm editing at the target. It therefore provides a valuable platform to facilitate rapid assessment and optimization of CRISPR/Cas9 and other genome-editing technologies in cassava.

Potential for the use of germinated wheat and soybeans to enhance human nutrition.

PubMed

Finney, P L

1978-01-01

Wheat and soybeans are the major agricultural exports of the United States. The U.S. sells more of each crop than any other nation. Soybeans are the main staple in China, but the U.S. sells more soybeans than China grows. For hundreds of millions of other people, wheat is the main staple. And yet, most Americans eat whole grains of neither wheat nor soybeans. In the United States, many nutrients of wheat and soybeans are lost in processing or are fed to animals. A highly significant share of the wheat nutrients are lost from the main foodstream when the germ and bran (with aleurone) portions are separated. Whole soybeans are carefully processed for food by only a handful of Americans.

Effects of family-togetherness on the food selection by primary and junior high school students: family-togetherness means better food.

PubMed

Kusano-Tsunoh, A; Nakatsuka, H; Satoh, H; Shimizu, H; Sato, S; Ito, I; Fukao, A; Hisamichi, S

2001-06-01

To see how different foods were selected depending on family-togetherness at breakfast and dinner, we investigated the meals of eight thousand primary and four thousand junior high school students by questionnaire. About 70% of primary school children but less than 50% of junior high school children ate breakfast with their family. The food, eaten by children who ate meals together with their family, took more time for cooking and was more traditional with rice as the staple. Food eaten by children who did not eat with their family lacked both preparation time and staple base. Family-togetherness affects the foods of primary school children more than those of junior high school students.

Completely staple-free hand-sewn laparoscopic anastomosis in colorectal surgery.

PubMed

Lipski, David; Dapri, Giovanni; Himpens, Jacques

2008-04-01

Colonic continuity following a laparoscopic left hemicolectomy is usually performed by using a circular stapler to achieve end-to-end colorectal anastomosis. However, not much consideration is given to the costs of this technique and the long-term risk of stenosis. In this paper, we report the first case of a completely staple-free hand-sewn laparoscopic colonic anastomosis (CSHLCA) following a laparoscopic left hemicolectomy for cancer. Total operative time was 170 minutes, and the time to perform the anastomosis was 38 minutes. The postoperative stay was uneventful, with a total hospital stay of 6 days. CSHLCA is feasible and can lower the cost of the laparoscopic procedure. It may be considered in countries with limited access to mechanical staplers.

Gender, Dialogue and Discursive Psychology: A Pilot Sexuality Intervention with South African High-School Learners

ERIC Educational Resources Information Center

Jearey-Graham, Nicola; Macleod, Catriona Ida

2017-01-01

Good-quality sexuality education can be effective in reducing sexual health risks, but may also be disconnected from the lived realities of learners' lives and reinforce gendered stereotypes. In line with the trend towards "empowerment" in and through sexuality education, we implemented a pilot sexuality intervention with Grade 10…

Report on Spending Trends Highlights Inequities in Model for Financing Colleges

ERIC Educational Resources Information Center

Blumenstyk, Goldie

2009-01-01

An analysis of spending trends that is designed to discourage policy makers' focus on finding new revenue rather than reining in spending suggests that the model for financing colleges has reinforced educational inequities and failed to increase the rate at which students graduate. According to the analysis, "serious fault lines" in the current…