Comparison of a modified Sugiura procedure with portal systemic shunt for prevention of recurrent variceal bleeding in cirrhosis

BACKGROUND: There is no agreement on the management of patients with cirrhosis and recurrent variceal bleeding after failure of medical or endoscopic treatments or both. Portal systemic shunts are highly effective in preventing rebleeding but are associated with a high incidence of chronic encephalopathy. This study compared the results of a slightly modified Sugiura procedure (esophageal transection plus esophagogastric devascularization plus splenectomy) with those of nonselective portal systemic shunts in patients with previous variceal bleeding. METHODS: Fifty-four patients were included in this randomized controlled study between January 1984 and April 1989. The major end point was chronic encephalopathy. Secondary end points were recurrent variceal bleeding, survival, ascites, and hepatocellular carcinoma. RESULTS: Twenty-seven patients were assigned to each group. The rate of chronic encephalopathy was significantly (p = 0.002) lower after modified Sugiura procedure than after portal systemic shunt. Recurrent variceal bleeding was more frequent after modified Sugiura procedure than after portal systemic shunt, but the difference is not significant. One-, two-, and three-year survival rates were 93%, 81%, and 67%, respectively, in the modified Sugiura group and 78%, 66%, and 39%, respectively, in the portal systemic shunt group (p = 0.044). CONCLUSIONS: These results suggest that the modified Sugiura procedure is better overall than the nonselective portal systemic shunt in the management of patients with cirrhosis and recurrent variceal bleeding. Although the rebleeding rate is higher after the modified Sugiura procedure, this does not seem to affect mortality in these patients.     

Effect of the pressure drop rate on cell nucleation in continuous processing of microcellular polymers

Microllular plastics are cellular polymers characterized by cell densities greater than 10⁹ cells/cm³ and cells smaller than 10 μm. One of the critical steps in the continuous production of microcellular plastics is the promotion of high cell nucleation rates in a flowing polymer matrix. These high nucleation rates can be achieved by first forming a polymer/gas solution followed by rapidly decreasing the solubility of gas in the polymer. Since, in the processing range of interest, the gas solubility in the polymer decreases as the pressure decreases, a rapid pressure drop element, consisting of a nozzle, has been employed as a continuous microcellular nucleation device. In this paper, the effects of the pressure drop rate on the nucleation of cells and the cell density are discussed. The experimental results indicate that both the magnitude and the cell density are discussed. The experimental results indicate that both the magnitude and the rate of pressure drop play a strong role in microcellular processing. The pressure phenomenon affects the thermodynamic instability induced in the polymer/gas solution and the competition between cell nucleation and growth.     

Transmission loss allocation through equivalent bilateral exchanges and economical analysis

A new loss allocation (LA) scheme based on the principle of equivalent bilateral exchanges (EBEs) is presented and compared with other available techniques. Formulation and results from extensive simulations including consistency tests show that the suggested methodology has several desirable properties: It is flow-based, requiring only a solved load flow for its implementation; it is not dependent on the choice of a slack bus; it is straightforward to apply; undesirable negative loss allocation is not produced; and low volatilities are shaped. An economic analysis with various LA methods is also carried out when these are integrated into a combined economic dispatch/load flow dispatch strategy, a likely scenario for LA in a real system. This combined dispatch strategy yields prices charged to the loads and rates received by the generators that account for loss allocation and loss supply. Results show that these economic indexes are very close to the marginal costs derived from an optimal power flow (OPF) approach with the advantage of reducing volatility.     

Remote sensing of species mixtures in conifer plantations using LiDAR height and intensity data

In even-aged, single species conifer plantations LiDAR height data can be modelled to provide accurate estimates of tree height and volume. However, it is apparent that growth models developed for single species stands are not directly transferable to a more general situation of mixed species plantations. This paper evaluates the ability of small footprint, dual-return, pulsed airborne LiDAR data to estimate the proportion of the productive species when mixed with a nurse crop in closed canopy plantations. A study area located in Galloway Forest District in Scotland is used as an example of Lodgepole pine and Sitka spruce mixed plantation; this area contains good examples of a wide range of pure and mixed species plantation types. Three species groups are studied: areas of pure Sitka spruce, areas of pure Lodgepole pine and areas where the two species have been planted together. Two approaches are assessed for detection of plantation mixtures: the first uses LiDAR intensity data to separate spruce and pine species and the second uses LiDAR-derived canopy density measures, coefficient of variation, skewness, percent of ground returns (which provides a measure of canopy openness) and the mean canopy height, which enables areas with height variations to be identified. From analysis of LiDAR data extracted from 54 study plots using logistic regression, the coefficient of variation and LiDAR intensity data provide the most useful predictors of the proportion of spruce in a pine/spruce mixture with coefficients of determination (R²) of 0.914 and 0.930 respectively. The method could be developed as a mapping tool, which in combination with existing inventory data should help to improve timber volume forecasting for mixed species even-aged plantations.     

Energy indicators for tracking sustainability in developing countries

Due to the fact that human activities and most sustainability issues are closely related to energy use, the energy system is a sound framework for providing lead indicators for sustainable development. Common energy-economic models enable the estimation of future states of the energy system. An energy system-based lead indicator set can be used to develop consistent and coherent future indicator estimates and to track sustainability, a clear advantage over existing sets.     

Putting it all together – Formal verification of the VAMP

In the verified architecture microprocessor (VAMP) project we have designed, functionally verified, and synthesized a processor with full DLX instruction set, delayed branch, Tomasulo scheduler, maskable nested precise interrupts, pipelined fully IEEE compatible dual precision floating point unit with variable latency, and separate instruction and data caches. The verification has been carried out in the theorem proving system PVS. The processor has been implemented on a Xilinx FPGA. A shorter version of this article with the title “Instantiating uninterpreted functional units and memory system: functional verification of the VAMP” appeared in [8]. The work reported here was done while all the authors were with Saarland University.     

Fast location of high-order modes for boxed microstrip with finite strip thickness

Many analyses of boxed microstrip discontinuities require the location of large numbers of high-order modes. Using Sturm-Liouville theory, this letter derives a relationship between microstrip modes and slab-loaded guide modes, leading to an efficient mode location algorithm for microstrip, including microstrip with finite strip thickness.<>