Pancreatogastrostomy Versus Pancreatojejunostomy for RECOnstruction After PANCreatoduodenectomy (RECOPANC, DRKS 00000767): Perioperative and Long-term Results of a Multicenter Randomized Controlled Trial.

OBJECTIVES: To assess pancreatic fistula rate and secondary endpoints after pancreatogastrostomy (PG) versus pancreatojejunostomy (PJ) for reconstruction in pancreatoduodenectomy in the setting of a multicenter randomized controlled trial. BACKGROUND: PJ and PG are established methods for reconstruction in pancreatoduodenectomy. Recent prospective trials suggest superiority of the PG regarding perioperative complications. METHODS: A multicenter prospective randomized controlled trial comparing PG with PJ was conducted involving 14 German high-volume academic centers for pancreatic surgery. The primary endpoint was clinically relevant postoperative pancreatic fistula. Secondary endpoints comprised perioperative outcome and pancreatic function and quality of life measured at 6 and 12 months of follow-up. RESULTS: From May 2011 to December 2012, 440 patients were randomized, and 320 were included in the intention-to-treat analysis. There was no significant difference in the rate of grade B/C fistula after PG versus PJ (20% vs 22%, P = 0.617). The overall incidence of grade B/C fistula was 21%, and the in-hospital mortality was 6%. Multivariate analysis of the primary endpoint disclosed soft pancreatic texture (odds ratio: 2.1, P = 0.016) as the only independent risk factor. Compared with PJ, PG was associated with an increased rate of grade A/B bleeding events, perioperative stroke, less enzyme supplementation at 6 months, and improved results in some quality of life parameters. CONCLUSIONS: The rate of grade B/C fistula after PG versus PJ was not different. There were more postoperative bleeding events with PG. Perioperative morbidity and mortality of pancreatoduodenectomy seem to be underestimated, even in the high-volume center setting.

Self-rating of satisfaction with dental appearance in an elderly German population.

OBJECTIVE: To assess data on satisfaction with dental appearance in old age. DESIGN: Cross-sectional study of an elderly non-patient group born from 1930 to 1932. SETTING: Two urban regions of Germany. PARTICIPANTS: 225 subjects (73-75 years, 49.3% male). METHODS: A questionnaire was completed. Descriptive analysis and bivariate analysis of gender differences, and a regression model for multivariate analysis were performed. MAIN OUTCOMES: Satisfaction with overall dental appearance, tooth/denture colour, shape, and position, and importance of dental appearance to overall appearance. RESULTS: Importance of dental appearance to overall appearance was rated high (7.5 +/- 2.0, where 10 denotes most important), as was overall satisfaction with dental appearance (7.2 +/- 1.8, where 10 denotes best possible). Up to 12% were not at all satisfied with tooth/denture colour, shape, or position, however. Women were more critical when judging overall satisfaction with dental appearance (p = 0.02). A significant positive association was obtained between overall dental appearance and position of teeth (p < 0.001). CONCLUSIONS: Satisfaction with dental appearance was high, as was the importance of dental appearance to elderly patients. Both aesthetic and functional aspects should therefore receive special attention in dental treatment. In this context the position of teeth should be regarded as of special importance.

Somatostatin-28 is an hormonally active peptide secreted into hypophysial portal vessel blood.

Somatostatin 14 and 28 (SS-14 and SS-28) have been measured in hypophysial portal blood of male Wistar rats. The concentration and total amount of SS released into portal blood were increased 6- to 7-fold by electrical stimulation of the median eminence. On HPLC, only two peaks of immunoreactivity were detected in extracts of portal plasma and these peaks corresponded with SS-14 and SS-28, respectively. The amount of SS-28 in portal plasma was, on a molar basis, similar or greater than that of SS-14 and this together with other evidence suggests that SS-28 is an hormonally active peptide.

Unraveling social categorization in the "who said what?" paradigm.

A multinomial model of the "Who said what?" paradigm (S. E. Taylor, S. T. Fiske, N. J. Etcoff, & A. J. Ruderman, 1978) explains the pattern of participants' assignment errors by means of the joint operation of several processes. Specifically, memory for discussion statements, person memory, category memory, and 3 different guessing processes can be accommodated by the model. The model's ability to disentangle these processes is validated in a series of 5 experiments. The model thereby enables a more refined use of the "Who said what?" paradigm in testing theories of social categorization. This is demonstrated in a 6th experiment in which the validated model is applied to the study of the effects of cognitive load on categorization.

A rigorous complexity analysis of the (1 + 1) evolutionary algorithm for separable functions with Boolean inputs.

Evolutionary algorithms (EAs) are heuristic randomized algorithms which, by many impressive experiments, have been proven to behave quite well for optimization problems of various kinds. In this paper a rigorous theoretical complexity analysis of the (1 + 1) evolutionary algorithm for separable functions with Boolean inputs is given. Different mutation rates are compared, and the use of the crossover operator is investigated. The main contribution is not the result that the expected run time of the (1 + 1) evolutionary algorithm is theta (n ln n) for separable functions with n variables but the methods by which this result can be proven rigorously.