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OBJECTIVE: To determine the results peranal excision for rectal carcinoma. DESIGN: Retrospective case series. SETTING: A university-affiliated hospital. PATIENTS: Of 178 patients who presented for curative resection of rectal carcinoma between 1975 and 1993, 19 (10.7%) were deemed suitable for local excision. There were 10 men and 9 women with a mean age of 71.2 years. The follow-up ranged from 13 to 184 months. INTERVENTION: Peranal excision. MAIN OUTCOME MEASURES: Histologic differentiation, gross morphology, depth of invasion and size of the carcinoma, adequacy of margins of excision, complications of operation, rates of recurrence, results of salvage therapy and 5-year survival. RESULTS: There were no intraoperative complications. Postoperative complications included urinary retention (one patient) and bleeding (one patient). There were five local recurrences (26%). Salvage operations were performed in three (60%) patients and were successful in two of them. The 5-year cancer-specific survival rate was 82%. The recurrence rate was higher in patients with inadequate margins of excision and ulcerative lesions. Neither size nor grade of the carcinoma correlated with recurrence. CONCLUSIONS: Local excision of rectal carcinoma can be performed successfully in selected patients. Diligent follow-up is required, because up to 60% of local recurrences can be treated successfully.  相似文献   
23.
Examined the use of an intervention for reducing unawareness of memory deficits in 3 male adults (aged 20–25 yrs) with brain injury. High predicted test scores on a brief multiparametric memory test, relative to actual test scores, were considered underestimations of symptom severity (unawareness). An estimation technique, feedback, and explicit positive reinforcement for decreases in discrepancies between predicted and actual scores were used to reduce unawareness. Differences between Ss' predicted and actual scores decreased over time following treatment for all Ss. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   
24.
The influence of extra-cellular polymeric substances in microbiologically influenced corrosion Unexpected pitting failures in copper potable water installations have occurred in some countries (Germany, Sweden, Scotland, South-West England, Saudi-Arabia) in the mid-eighties. These failures could not be expected in a single case based on the chemical composition of the potable water. Further typical manifestation characteristics of this microbiologically influenced corrosion have been i.) an uptake of dissolved and undissolved copper species in an obsolete, non regular fashion, ii.) black layers of copper(II)-oxide on the inner tube surface, accompanied by posniakite and malachite in the pitting areas, and, iii.) the detection of extracellular polymeric substances (EPS). These EPS consist partly of polysaccharides. They could either be produced by microorganisms within the potable water installation or be transported in a dissolved or undissolved state into the installation. Consequently, they sediment on the inner surfaces of the copper tubes. The physico-chemical properties of some kinds of EPS, especially their membrane properties and their cation selectivity, play a key role in this corrosion process. This is shown exemplarily performing diffusion potential measurements and contact corrosion experiments.  相似文献   
25.
Infrequent captures of invasive, non-native grass carp (Ctenopharyngodon idella) have occurred in Lake Erie over the last 30+ years, with recent evidence suggesting wild reproduction in the lake’s western basin (WB) is occurring. Information on grass carp movements in the Laurentian Great Lakes is lacking, but an improved understanding of large-scale movements and potential areas of aggregation will help inform control strategies and risk assessment if grass carp spread to other parts of Lake Erie and other Great Lakes. Twenty-three grass carp captured in Lake Erie’s WB were implanted with acoustic transmitters and released. Movements were monitored with acoustic receivers deployed throughout Lake Erie and elsewhere in the Great Lakes. Grass carp dispersed up to 236 km, with approximately 25% of fish dispersing greater than 100 km from their release location. Mean daily movements ranged from <0.01 to 2.49 km/day, with the highest daily averages occurring in the spring and summer. The Sandusky, Detroit, and Maumee Rivers, and Plum Creek were the most heavily used WB tributaries. Seventeen percent of grass carp moved into Lake Erie’s central or eastern basins, although all fish eventually returned to the WB. One fish emigrated from Lake Erie through the Huron-Erie Corridor and into Lake Huron. Based on our results, past assessments may have underestimated the potential for grass carp to spread in the Great Lakes. We recommend focusing grass carp control efforts on Sandusky River and Plum Creek given their high use by tagged fish, and secondarily on Maumee and Detroit Rivers.  相似文献   
26.
Recent years have seen a growing call for inquiry-based learning in science education, and mobile technologies are perceived as increasingly valuable tools to support this approach. However, there is a lack of understanding of mobile technology-supported inquiry-based learning (mIBL) in secondary science education. More evidence-based, nuanced insights are needed into how using mobile technologies might facilitate students' engagement with various levels of inquiry and enhance their science learning. We, therefore, conducted a robust systematic literature review (SLR) of the research articles on mIBL in secondary school science education that have been published from 2000 to 2019. We reviewed and analysed 31 empirical studies (34 articles) to explore the types of mIBL, and the benefits and constraints of mIBL in secondary school science education. The findings of this SLR suggest new research areas for further exploration and provide implications for science teachers' selection, use and design of mIBL approaches in their teaching.  相似文献   
27.
Journal of Logic, Language and Information - Despite the incremental nature of Dynamic Syntax (DS), the semantic grounding of it remains that of predicate logic, itself grounded in set theory, so...  相似文献   
28.
This paper proposes a new method for calculating a bound on the gain of a system comprising a linear time invariant part and a static nonlinear part, which is odd, bounded, zero at zero and has a restriction on its slope. The nonlinear part is also assumed to be sector bounded, with the sector bound being (possibly) different from that implied by the slope restriction. The computation of the gain bound is found by solving a set of linear matrix inequalities, which arise from an integral quadratic constraint formulation of a multiplier problem involving both Zames‐Falb and Popov multipliers. Examples illustrate the effectiveness of the results, and comparisons are made against the state‐of‐the‐art. Copyright © 2011 John Wiley & Sons, Ltd.  相似文献   
29.
Breakdowns in complex systems often occur as a result of system elements interacting in unanticipated ways. In systems with human operators, human–automation interaction associated with both normative and erroneous human behavior can contribute to such failures. Model-driven design and analysis techniques provide engineers with formal methods tools and techniques capable of evaluating how human behavior can contribute to system failures. This paper presents a novel method for automatically generating task analytic models encompassing both normative and erroneous human behavior from normative task models. The generated erroneous behavior is capable of replicating Hollnagel's zero-order phenotypes of erroneous action for omissions, jumps, repetitions, and intrusions. Multiple phenotypical acts can occur in sequence, thus allowing for the generation of higher order phenotypes. The task behavior model pattern capable of generating erroneous behavior can be integrated into a formal system model so that system safety properties can be formally verified with a model checker. This allows analysts to prove that a human–automation interactive system (as represented by the model) will or will not satisfy safety properties with both normative and generated erroneous human behavior. We present benchmarks related to the size of the statespace and verification time of models to show how the erroneous human behavior generation process scales. We demonstrate the method with a case study: the operation of a radiation therapy machine. A potential problem resulting from a generated erroneous human action is discovered. A design intervention is presented which prevents this problem from occurring. We discuss how our method could be used to evaluate larger applications and recommend future paths of development.  相似文献   
30.
For any angle α<2π, we show that any connected communication graph that is induced by a set P of n transceivers using omni-directional antennas of radius 1, can be replaced by a strongly connected communication graph, in which each transceiver in P is equipped with a directional antenna of angle α and radius r dir, for some constant r dir=r dir(α). Moreover, the new communication graph is a c-spanner of the original graph, for some constant c=c(α), with respect to number of hops.  相似文献   
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