bluuebunny/crossref_metadata_2025 huggingface dataset:
A real-time dynamic path planning method combining artificial potential field method and biased target RRT algorithm
Authors: Yingqi Xi , Wei Shen , Wen Zhang , Jingqiao Liu , Qinhui Liu , Han Shi
Published: May 2021

In order to improve the efficiency and effectiveness of path planning for mobile robots in dynamic environment, based on the comprehensive analysis of multiple path planning algorithms, an improved algorithm based on fast-spreading random tree algorithm is proposed. The proposed algorithm effectively combines the artificial potential field(APF) method with the biased target RRT algorithm, and judges the local minimum point in the process of solving the APF method to complete the switching with the biased target RRT algorithm. The motion environment simulation model is established in the Python environment, and the path planning simulation case of the mobile robot in the dynamic environment is completed. The simulation results show that the combined algorithm can avoid the phenomenon that the APF method falls into the local minimum point while taking the global and real-time performance into account, reduce the planning time of the biased target RRT algorithm, and improve the quality of path generation.
Research on the development status of AGV parking robot based on patent analysis
Authors: Shen Kai , Qiu Qiufei , Wu Qiaoling , Lin Zhijian , Wu Yeqing
Published: May 2021

With the increasing severity of parking problems, intelligent parking garages are gaining popularity. By the application in intelligent parking garages, AGV robot has opened a new application scenario after industrial and logistics fields. Dozens of enterprises have developed related products. Based on patent analysis method, the development trend, key technologies, regional distribution, advanced agencies and technology roadmap of AGV parking robot are clarified, to provide intelligence support for further development of related technologies and products. Research results indicate that AGV parking robot related technologies are booming. China exhibits great R&D enthusiasm towards this field in recent years, and has applied a large number of patents. In terms of vehicle exchange technologies, mechanical arm-based exchange and board based-exchange are key R&D types. In terms of vehicle guidance schemes, laser navigation, magnetic navigation, electromagnetic navigation and visual navigation are mainstream. Moreover, the improvement of driving mechanism, actuating mechanism and positioning mechanism of AGV parking robot, and the integration of AGV parking robot with stereo garage are the development trends of this field. Thus, countermeasures and suggestions are presented for the enterprises to further develop AGV parking robot related technologies.
Local path planning of mobile robot based on self-adaptive dynamic window approach
Authors: Zhang Jian hua , Feng Qi , Zhao Ai di , He Wei , Hao Xun
Published: May 2021

Dynamic Window Approach (DWA) is widely used in the local path planning of mobile robot. DWA algorithm has the advantages of simple planning algorithm and good realtime performance. However, the DWA exists unreachable target point, unreasonable path planning in the dense obstacles and it cannot ensure both speed and security. Therefore, an online parameter self-adaptive DWA algorithm is proposed to automatically adjust the weight of the objective function on the basis of the size of alternative velocity space and the distance between the mobile robot to the target point. By adapting to the dynamic changes of the environment, the optimal running speed and reasonable path of mobile robot can be obtained. The simulation verified that the mobile robot can pass through the dense obstacles area and reach the target point safely and reliably. And the problems that the robot might move around the dense obstacles and result in an unsmooth path are avoided. and the operational efficiency of the mobile robot is ensured simultaneously.
Electrical characterization of glass fiber reinforced polymer (GFRP) composites for future metasurface antenna applications
Authors: Ali A K M Shafaat , Ahmed Irfan
Published: May 2021

In this paper, the Glass Fiber Reinforced Polymer (GFRP) composite samples are explored in order to evaluate their feasibility and adaptability for use in future metasurface antenna application. Multi-layer GFRP composite samples are fabricated with a proportionate ratio of resins and fiber using Vacuum Assisted Resin Transfer Molding (VARTM) technique. N type to waveguide (WR-187) adapter specially designed for electrical characterization of these GFRP composite samples is used. Thru-Reflect-Line (TRL) calibration technique is used for the test setup, and scattering parameters of these GFRP samples is measured by using the manufactured adapter along with the sample holder on a two port Vector Network Analyzer (VNA). Relative permittivity and dielectric loss tangent of GFRP composite samples are computed using Nicholson-Ross-Weir (NRW) and New Non-Iterative conversion methods. The comparative analyses of both methods showed a very good agreement between them. The GFRP sample with the lowest relative permittivity is short listed for its possible application in future metasurface antenna.
Importance of trade dependencies for agricultural inputs: a case study of Finland
Authors: Lehikoinen Elina , Kinnunen Pekka , Piipponen Johannes , Heslin Alison , Puma Michael J , Kummu Matti
Published: May 2021

Approximately 80% of the world’s population lives in countries that are dependent on food imports to sustain an adequate food supply. Besides these food imports, further dependencies also arise due to the requirements for agricultural inputs, including energy, fertilisers, feed and agricultural machinery. While the trade of agricultural inputs is relatively well represented in economic analysis, the quantification is often in terms of monetary values, and thus the assessments of the actual input quantities are very limited. In this paper, we develop a framework for analysis of the traded input quantities at the country-level and demonstrate its utility through an in-depth analysis of Finland’s dependency on agricultural inputs. Further, we assess the importance of these inputs for domestic food production from a resilience perspective. We find that Finland, a country with relatively high food self-sufficiency but also a great dependency on imported agricultural inputs, experienced an increase in its dependency over the period 1996–2016. In case of trading partners, the story is more mixed: while trading partners for soybeans increased, those decreased in case of electricity while no significant change was observed in other commodities. In Finland, the rapeseed dependency on imports (ratio of net imports and consumption) grew from around 0% to almost 50% between the years 1987–2013. Changes for electricity remained substantially smaller, with dependency only slightly growing during the study period. Crude oil and soybean supplies are totally dependent on imports as neither is produced in Finland. Interestingly, the highest dependencies for agricultural inputs were on different countries than that for foodstuff imports. Thus, when identifying and assessing approaches to increase resilience to trade-related shocks, it is essential to understand both foodstuff and agricultural input dependencies within the global food system.
Septins and a formin have distinct functions in anaphase chiral cortical rotation in theCaenorhabditis eleganszygote
Authors: Zaatri Adhham , Perry Jenna A. , Maddox Amy Shaub
Published: May 2021

In early anaphase, the cortex of the Caenorhabditis elegans zygote rotates with a certain handedness. Rotation fails following loss of function of the septins, which scaffold the actomyosin cytoskeleton to the plasma membrane. Partial depletion of the formin CYK-1 does not eliminate rotation but makes its chirality reversed and unstable.
Potent germline-like monoclonal antibodies: rapid identification of promising candidates for antibody-based antiviral therapy
Authors: Zhu Xiaoyi , Yu Fei , Wu Yanling , Ying Tianlei
Published: May 2021

In recent years, fully human monoclonal antibodies (mAbs) are making up an increasing share of the pharmaceutical market. However, to improve affinity and efficacy of antibodies, many somatic hypermutations could be introduced during affinity maturation, which cause several issues including safety and efficacy and limit their application in clinic. Here, we propose a special class of human mAbs with limited level of somatic mutations, referred to as germline-like mAbs. Remarkably, germline-like mAbs could have high affinity and potent neutralizing activity in vitro and in various animal models, despite lacking of extensive affinity maturation. Furthermore, the germline nature of these mAbs implies that they exhibit lower immunogenicity and can be elicited relatively fast in vivo compared with highly somatically mutated antibodies. In this review, we summarize germline-like mAbs with strong therapeutic and protection activity against various viruses that caused large-scale outbreaks in the last decade, including influenza virus H7N9, Zika virus, Dengue virus, Middle East respiratory syndrome coronavirus and severe acute respiratory syndrome coronavirus 2. We also illustrate underlying molecular mechanisms of these germline-like antibodies against viral infections from the structural and genetic perspective, thus providing insight into further development as therapeutic agents for the treatment of infectious diseases and implication for rational design of effective vaccines.
Modeling the Cost-Effectiveness of Latent Tuberculosis Screening and Treatment Strategies in Recent Migrants to a Low-Incidence Setting
Authors: Dale Katie D , Abayawardana Milinda J , McBryde Emma S , Trauer James M , Carvalho Natalie
Published: May 2021

Many tuberculosis (TB) cases in low-incidence settings are attributed to reactivation of latent TB infection (LTBI) acquired overseas. We assessed the cost-effectiveness of community-based LTBI screening and treatment strategies in recent migrants to a low-incidence setting (Australia). A decision-analytical Markov model was developed that cycled 1 migrant cohort (≥11-year-olds) annually over a lifetime from 2020. Postmigration/onshore and offshore (screening during visa application) strategies were compared with existing policy (chest x-ray during visa application). Outcomes included TB cases averted and discounted cost per quality-adjusted life-year (QALY) gained from a health-sector perspective. Most recent migrants are young adults and cost-effectiveness is limited by their relatively low LTBI prevalence, low TB mortality risks, and high emigration probability. Onshore strategies cost at least $203,188 (Australian) per QALY gained, preventing approximately 2.3%–7.0% of TB cases in the cohort. Offshore strategies (screening costs incurred by migrants) cost at least $13,907 per QALY gained, preventing 5.5%–16.9% of cases. Findings were most sensitive to the LTBI treatment quality-of-life decrement (further to severe adverse events); with a minimal decrement, all strategies caused more ill health than they prevented. Additional LTBI strategies in recent migrants could only marginally contribute to TB elimination and are unlikely to be cost-effective unless screening costs are borne by migrants and potential LTBI treatment quality-of-life decrements are ignored.
Inconsistent Reporting of Discrimination Over Time Using the Experiences of Discrimination Scale: Potential Underestimation of Lifetime Burden
Authors: Van Dyke Miriam E , Kramer Michael R , Kershaw Kiarri N , Vaccarino Viola , Crawford Natalie D , Lewis Tené T
Published: May 2021

Studies documenting self-reported experiences of discrimination over the life course have been limited. Such information could be important for informing longitudinal epidemiologic studies of discrimination and health. We characterized trends in self-reports of racial, socioeconomic status, and gender discrimination over time measured using the Experiences of Discrimination Scale, with a focus on whether individuals’ reports of lifetime discrimination were consistent over time. Overall experiences of discrimination and the number of settings in which discrimination was reported in 1992, 2000, and 2010 were examined among 2,774 African-American and White adults in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Reports of “ever” experiencing discrimination decreased for all forms of discrimination across the 3 study visits. Approximately one-third (30%–41%) of the sample inconsistently reported ever experiencing any discrimination over time, which contributed to the observed decreases. Depending on the form of discrimination, inconsistent reporting patterns over time were more common among African-American, younger, less educated, and lower-income individuals and women—groups who are often most exposed to and severely impacted by the health effects of discrimination. Our findings highlight the possible underestimation of the lifetime burden of discrimination when utilizing the Experiences of Discrimination Scale to capture self-reports of discrimination over time.
The means and the good
Authors: Oliver Matthew
Published: May 2021

Are there moral constraints on the pursuit of the good? Our intuitions suggest that we may not use another person as a means to achieve a good outcome, even if that good outcome reduces the amount of using-as-a-means that occurs overall. These intuitions are assumed to be incompatible with consequentialism and to show the need for a deontological constraint on using others as a means. This assumption is a mistake. In this paper, I show that consequentialists can justify the same case-based intuitions that are thought to support a moral constraint on using others as a means.
Mental Health Problems as a Risk Factor for Workplace Bullying: The Protective Effect of a Well-Functioning Organization
Authors: Rosander Michael
Published: May 2021

This study examined a strain–stressor association, when mental health problems may lead to subsequent workplace bullying, and a mechanism of how this can happen. I hypothesized that the association between mental health problems and bullying depends on the perceived role clarity and order in the organization, and that sickness presenteeism (SP) mediates this association. The study is based on a longitudinal probability sample drawn from the total number of employees in Sweden. Workplace bullying, mental health, SP, and role clarity and order in the organization were assessed using a questionnaire. The results showed that mental health problems are associated with an increased risk for subsequent bullying, consistent with previous findings. However, this risk depends on the level of role clarity and order in the organization. The results also show a partial indirect effect via SP. This means that if one has mental health problems and persists in coming to work although one should have stayed at home, the risk of bullying increases. The indirect effect depends also on the level of order in the organization. The findings suggest that individual deficits, such as mental health problems, are associated with subsequent bullying only if organizational deficits are also present.
Safety Considerations of Fat Grafting in Buttock Augmentation
Authors: O’Neill Rebecca C , Hanson Summer E , Reece Edward , Winocour Sebastian
Published: May 2021

Autologous fat grafting for buttock augmentation is one of the fastest growing plastic surgery procedures, but has also received significant publicity for the relatively high mortality rate secondary to fat emboli. The literature has grown exponentially in the past 5 years on this subject, helping to clarify our knowledge and providing recommendations to minimize risks, including avoiding intramuscular injections, placing the patient in the jackknife position, and utilizing larger-bore cannulas. Since the application of these recommendations, the rate of pulmonary fat embolism has decreased from 0.097% to 0.04%, with a current mortality of 1 in 14,921, making it statistically safer than abdominoplasty. Despite the evolution in our knowledge, techniques, and outcomes, it remains of utmost importance to properly select and educate patients about the safety of fat grafting for buttock augmentation.

Level of Evidence: 4
PCLasso: a protein complex-based, group lasso-Cox model for accurate prognosis and risk protein complex discovery
Authors: Wang Wei , Liu Wei
Published: May 2021

For high-dimensional expression data, most prognostic models perform feature selection based on individual genes, which usually lead to unstable prognosis, and the identified risk genes are inherently insufficient in revealing complex molecular mechanisms. Since most genes carry out cellular functions by forming protein complexes—basic representatives of functional modules, identifying risk protein complexes may greatly improve our understanding of disease biology. Coupled with the fact that protein complexes have been shown to have innate resistance to batch effects and are effective predictors of disease phenotypes, constructing prognostic models and selecting features with protein complexes as the basic unit should improve the robustness and biological interpretability of the model. Here, we propose a protein complex-based, group lasso-Cox model (PCLasso) to predict patient prognosis and identify risk protein complexes. Experiments on three cancer types have proved that PCLasso has better prognostic performance than prognostic models based on individual genes. The resulting risk protein complexes not only contain individual risk genes but also incorporate close partners that synergize with them, which may promote the revealing of molecular mechanisms related to cancer progression from a comprehensive perspective. Furthermore, a pan-cancer prognostic analysis was performed to identify risk protein complexes of 19 cancer types, which may provide novel potential targets for cancer research.
ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION NUMERIC AND EXPERIMENTAL ANALYSES: INFLUENCE OF TRABECULAR BONE CONSTITUTIVE MODEL
Authors: Quintana Barcia C , Rodríguez González C , Betegón Biempica C , Álvarez Díaz G , Maestro A
Published: May 2021

INTRODUCTION

The number of variables that influence the success of an ACL reconstruction is such that, the use of numerical tools becomes increasingly necessary. In this work, a finite element model is developed to simulate the ACL reconstruction in its tibial insertion.

MATERIAL AND METHODS

Tibiae and ligaments porcine samples were used in this work. As the tibial fixation, an interference screw with a nominal diameter of 7mm and a length of 25mm is used.

The plasty which replace the injured ligament was characterize using tensile tests. Uniaxial and confined compression tests, as well as indentation tests, were used for characterizing trabecular bone. Finite element methods were used for the implementation of the ACL reconstruction simulation, which studies the effect in the knee joint of all the elements involved (plasty, bone and interference screw).

RESULTS

None of the models available for the description of the trabecular bone behavior (von Mises, Hill and Crushable Foam), is capable of doing it in a completely proper manner. The use of one or the other constitutive model does not greatly influence the numerical simulation results.

CONCLUSIONS

As trabecular bone has a strongly anisotropic and non-symmetric mechanical behavior, none of the constitutive models available in the finite element code used is capable of fully describing it. Thus, the use of von Mises criterion is recommended, as it is the easiest to define and the one that requires the least numerical resources (lower computational cost).
MALIGNANT SMALL BOWEL OBSTRUCTION: OUTCOMES OF PALLIATIVE SURGERY
Authors: Turrado-Rodríguez V , Termes Serra R , Besa A , Chullo Llerena G , Viladot M , Morales Sevillano X
Published: May 2021

INTRODUCTION

Surgical management of malignant bowel obstruction (MBO) represents a surgical challenge associated with high morbidity and mortality, readmission and re-obstruction rates. The aim of this study is to describe the postoperative outcomes of palliative surgery for MBO in order to provide a guide for oncologists, surgeons and patients.

MATERIAL AND METHODS

Retrospective descriptive study in a tertiary referral centre of all the patients operated of an acute bowel obstruction or bowel perforation due to peritoneal carcinomatosis between January 2015 and December 2019.

RESULTS

Fifty-one patients were included in the study. Time from index surgery to clinical recurrence as MBO was 21±27 months. The indication for surgery was acute obstruction in 92.2% and bowel perforation in 7.8% of the patients. Intraoperative complications were found in 24% of the patients. Postoperative complications were found in 71% of the patients. Postoperative mortality was 16%. Length of stay was 31±26 days with a median postoperative stay of 20±16 days. Time to reobstruction in the whole series was 216±240 days.

90-day mortality was 31%. The median overall survival of patients that survived the first 90 postoperative days was 286.45±281.14 days (9.5 months). Most of the patients who survived the 90-postoperative days received systemic treatment (66%).

CONCLUSIONS

Palliative surgery for MBO is associated with high rates of postoperative complications and mortality. Well-selected patients that survive the first 90 postoperative days may have a long symptom-free period and longer survival.
IMPACT OF LAPAROSCOPIC COLORECTAL SURGERY ON BODY IMAGE
Authors: Fernández Candela A , Sánchez-Guillén L , García Catalá L , Curtis Martínez C , Bosch Ramírez M , Lario Pérez S , Lillo García C , Arroyo Sebastián A
Published: May 2021

INTRODUCTION

The aim of this study is to evaluate the impact of laparoscopic colorectal surgery (LCS) on body image using the validated Body Image Scale (BIS) as a parameter of surgical quality.

MATERIAL AND METHODS

We conducted an observational descriptive study. Patients who underwent scheduled LCS between June 2015 and December 2019 by a General Hospital Coloproctology Unit were included.

RESULTS

The sample included 180 patients, 115 men (63.9%) and 65 women (36.1%) with a median age of 67 years. Right hemicolectomies (31.7%) and sigmoidectomies (28.3%) were the main procedures performed. In most patients, a suprapubic (69.4%) or transverse (19.4%) incision was made. 21.9% suffered some type of postoperative complication (13.9% wound complication, 10.6% incisional hernia).

The general result of the BIS questionnaire was satisfactory, with a median of 0 in the responses (no alteration of body image). We found that 46.2% of the women had some alteration in body image, compared to 28.7% of the men (p = 0.018) and low and ultra-low anterior resection were the surgeries that obtained worst scores, with 13,5% and 12,5% respectively of patients with a BIS score above 5 (p = 0.044). Patients with a stoma also obtained worst punctuation (25% above 5 vs 6,1%, p = 0.001). No statistically significant differences were found regarding type of incision, presence of complications and anxiety or depression.

CONCLUSION

Study results show, in general, good post-surgical body image after LCS. However, patients with stoma and women were more dissatisfied. Interestingly, there is no worse body image due to type of incision, so we recommend the least iatrogenic one.
WALL STRESS IN ASCENDING AORTA ANEURYSMS AS A PREDICTIVE FACTOR OF BREAKAGE
Authors: Burgos Lázaro R J , Burgos Frías N , Serrano-Fiz García S , Ospina Mosquera V , Rojo Pérez F , Atienza Riera J M , Forteza Gil A , Guinea Tortuero G
Published: May 2021

INTRODUCTION

The surgical indication for ascending aortic aneurysms (AAA) is established when the maximum diameter > 50 mm; It responds to Laplace's Law (T wall = P × r / 2e). The aim of the study is to define wall stress in AAA.

MATERIAL AND METHODS

218 ascending aortic walls have been studied: 96 from organ donors, and 122 from AAA: Marfán 58 (47.5%), bicuspid aortic valve 26 (21.4%), and atherosclerosis 38 (31.1%). The samples were studied "in vitro", according to the model Young's (relationship between stress and deformed area), by means of the mechanical traction test (Tension = Force / Area). The analysis was performed with the stress-elongation curve (d Tension / d Elongation).

RESULTS

The stress of the aortic wall, classified from highest to lowest according to pathology and age was: cystic necrosis of the middle layer, arteriosclerosis, age > 60 years, between 35 and 59, and < 34 years. The stress of “control aortas” wall increased directly in relation to the age of the donors.

CONCLUSIONS

The maximum diameter of the ascending aorta, the patient's type of pathology and age are factors that affect the maximum tension of the aortic wall and resistance, factors that allow differentiation and prediction of the risk of rupture of the AAA. The validation of the results obtained through numerical simulation was significant and the uniaxial analysis has modeled the response of the vessels to their internal pressure.
INFLUENCE OF NUTRITIONAL STATUS ON THE SURVIVAL OF PATIENTS UNDERGOING GASTRIC CANCER SURGERY
Authors: Garrosa Muñoz S , López Sánchez J , Abdel-Lah Fernández O , Hernández Cosido I , Jiménez Vaquero I , Carrero García S , Muñoz-Bellvís l , Parreño Manchado F C
Published: May 2021

INTRODUCTION

Preoperative nutritional status is a predictive modifiable factor of survival in gastrointestinal oncology surgery. The aim of the study was to analyze the influence of nutritional risk (NR) on survival in patients undergoing gastric cancer (GC) surgery.

MATERIAL AND METHODS

Retrospective study of 50 patients with gastric adenocarcinoma who underwent surgery over a 2-year period. To identify patients with malnutrition, the malnutrition criteria of the European Society for Clinical Nutrition and Metabolism (ESPEN) were followed, and the nutritional risk was calculated with The nutritional Risk Screening (NRS2002). Patients were divided into two groups: NR (NRS≥3) and non-NR (NRS≤2), and survival was compared between the two.

RESULTS

The 5-year survival of GC patients was 22%, with a median survival of 15.8 months [SEM: 4.760, 95% CI = (6.473-25.132)]. NR patients had lower 5-year survivals (14% vs 57%, p = 0.004). Additionally, they had 4.4 times [95% CI = (1.714-11.495)] higher risk of mortality during oncological follow-up than patients without NR.

CONCLUSIONS

NR patients undergoing GC surgery have lower long-term survival. The preoperative NR can be considered a prognostic factor for survival and it should be evaluated preoperatively in gastrointestinal cancer surgery.
RETROSPECTIVE COHORT STUDY: DIFFERENCES AND SIMILARITIES BETWEEN SPORADIC AND FAMILIAL PAPILLARY THYROID CARCINOMA
Authors: López de Lerma Martínez de Carneros C , López Morales P , Martínez Sanz N , Giménez Francés C , Medina Manuel E , Albarracín Marin-Blázquez A , Candel Arenas M F
Published: May 2021

INTRODUCTION

There is a lot of controversy around the study of the familial papillary thyroid carcinoma (CPFT), which has a different behaviour than sporadic. The aim of this investigation is to establish the differences and similarities between sporadic papillary thyroid carcinoma and the familial one in order to determine if the familial type is a more aggressive clinical entity than sporadic.

MATERIAL AND METHODS

A retrospective cohort study in 231 patients with papillary thyroid carcinoma (CPT) from 2006 to 2018. One group was established according to the presence of two or more relatives as CPFT (n = 46) and the other group were the sporadic cases (n = 185). Throughout this study the clinical-pathological characteristics of both groups were compared based on the analysis of twenty-one variables.

RESULTS

After having carried out this investigation, statistically significant differences have only been found in the vascular invasion (p < 0.001), presenting 3.8% in the sporadic group compared to the 21.7% found in the CPFT with an Odds Ratio of 7.6.

CONCLUSIONS

Based on our experience, patients with CPFT present a higher frequency of multifocal neoplasia, capsular invasion, vascular invasion, lymph node invasion and recurrence than sporadic CPT. However, these differences were only significant while analyzing the vascular invasion variable. Although the results of our study have been unable to prove that the CPFT is more aggressive than sporadic CPT, we recommend performing periodic ultrasounds such as the screening of the members of the families with CPFT. Finally, we conclude that more studies are needed.
GASTRODUODENAL PERFORATION, A FREQUENT SURGICAL EMERGENCY. REVIEW AND DESCRIPTIVE STUDY
Authors: Nuño Iglesias C , Fresnedo Pérez M R , Alonso Blanco R A , Soto Dopazo M , Pérez Prudencio E , Arango Bravo A , Mateos Palacios C , Fernández Fernández J C
Published: May 2021

INTRODUCTION

Perforated gastroduodenal ulcer represents a common surgical emergency and is associated with a morbimortality close to 40-50%. HP infection, tobacco and alcohol and some socioeconomic aspects represent the most commonly described risk factors.

MATERIAL AND METHODS

A descriptive and retrospective study was performed between 2018-2020. A total of 40 patients with a history of gastroduodenal perforation were selected. Data corresponding to: sex, age, ulcer location, treatment, tobacco and alcohol consumption, HP infection (presence or not of eradicating treatment) and other potential risk factors were collected and analysed. The aim of the study is to assess how new lifestyle changes, the evolution and improvement in the management of PH infection and the general decrease in smoking have modified the classic profile of patients with gastroduodenal perforations.

RESULTS

Gastroduodenal perforations predominated in the fifth/sixth decade of life (mean age 59 years). Although a predominance in men is described in the literature, in our sample no significant sex differences were found (1:1 ratio). The most frequent location was duodenal and the reference surgical treatment was primary suture + epipoplasty. Only one third of the patients had a known history of peptic ulcer.

CONCLUSIONS

Gastroduodenal perforations are a major problem for the on-call surgeon. It is essential to know the current risk factors and their potential relationship with morbimortality and postoperative evolution in order to guarantee the optimal management of these patients.
MALNUTRITION IN SURGICAL EMERGENCY PATIENTS: UN UNKOWN ISSUE
Authors: Diego Alonso E A , Abdel-Lah Fernández O , Hernández Cosido Lo , Jiménez Vaquero I , Carrero García S , Garrosa Muñoz S , Parreño Manchado F , Muñoz Bellvis L
Published: May 2021

INTRODUCTION

Malnutrition in hospitals is increasingly becoming more problematic, although its severity in surgical emergency patients has yet to be researched in depth. It entails higher rates of morbimortality as well as an increase in both days hospitalized and re-admissions which inflates health care-related costs.

MATERIAL AND METHODS

Using GLIM (Global Leadership Initiative on Malnutrition) criteria, we evaluated the nutritional state of 84 patients admitted through the emergency department in the Oesophago-Gastric and Bariatric Surgery Unit in our centre.

RESULTS

Of the total patients sampled, 57 (67,85%) were at risk of malnutrition. The percentage of patients suffering malnutrition was 44.04%, of which 15.8% were diagnosed with moderate malnutrition and 48.1% severe malnutrition.

Patients suffering malnutrition stay at hospital for 24 days on average, which implies a longer stay that those without malnutrition (13 days hospitalized on average), but no relation was found regarding any increase in overall complications.

After performing an analysis, malnutrition was significantly higher in oncological patients than in those who were admitted for other causes (58,3% vs 36.6%). However, the age analysis (over-70 vs under-70) showed no significant difference.

CONCLUSION

50% patients admitted through emergency services were diagnosed from malnutrition.

Oncological patients suffer greater risk and severity of malnutrition.

Malnutrition does imply longer stays at hospital; however there is no correlation with further complications.
PROGNOSTIC FACTORS OF RENAL TUMOR RECURRENCE AFTER RADICAL NEPHRECTOMY
Authors: Martínez Izquierdo G , Arnaiz Pérez A R , Escolano Fernández E , Merayo Álvarez M , Carrasco Aguilera B , Ibero Casadiego P , Rodicio Miravalles J L , Molina Escudero R
Published: May 2021

INTRODUCTION

Renal cell carcinoma (RCC) represents 3% of overall malignant neoplasms in adults. However, its aetiology has not been clearly established. Although surgery represents the cornerstone in treatment, recurrence postoperative rates are around 20-30%, what implies prognostic factors search must be mandatory in order to help to plan de follow-up and the different adjuvant therapy possibilities available in case they were necessary.

MATERIAL AND METHODS

A retrospective observational study was carried out in 110 patients who underwent radical nephrectomy between 2004 and 2018, with the aim of identifying possible prognostic factors of recurrence of RCC after these surgeries. Preoperative data (epidemiological, comorbidities and laboratory tests), surgical, pathological and variables related to follow-up were taken into account. A univariate and multivariate analysis were performed, using chi-square test and logistic regression, respectively.

RESULTS

The median follow-up time was 53.5 months (SD = 35.8), time in which 19 patients had a recurrence of RCC after radical nephrectomy (17.2%). Histopathological items such as the surgical piece size, the nodal and microvascular invasion, the renal sinus invasion and the presence of necrosis in the surgical piece were associated with RCC recurrence in the univariate analysis, while only the presence of necrosis in the surgical piece showed a significant result in the multivariate analysis (p = 0.004).

CONCLUSIONS

Histopathological analysis, highlighting the presence of necrosis in the histological sample, was proved to be the main risk factor of RCC recurrence.
3D PLANNING IN ORTHOPAEDICS: AN ESSENTIAL TOOL FOR COMPLEX SURGERY
Authors: García Arias A , Piñera Parrilla Á R , Suárez-Anta Rodríguez P J , Camblor Valladares A , Meneses Gutiérrez A , Cabria Fernández J , Lanuza Lagunilla L , Mateo Negreira J
Published: May 2021

INTRODUCTION

In orthopedic surgery, the appearance of three-dimensional digital reconstructions represented a clear before and after in the planning of highly complex surgeries. However, these reconstructions only allow to improve the visualization of the lesion. In recent years, new techniques have been incorporated, such as 3D printing of bone reconstructions, improving the understanding of the anatomy of each patient, allowing the simulation of possible treatments, and even their intraoperative manipulation.

MATERIAL AND METHODS

A 3D impression was made in surgical resin of a reconstruction of a CT of the cervico-thoracic spine, with a metastatic lesion in T2, in order to study the possible viability of an en-bloc vertebrectomy and the simulation of pedicle paths.

RESULTS

The feasibility of vertebrectomy was verified thanks to a better estimation of the available window size. Simulations were performed in the cervical pedicle paths, obtaining the best possible orientation according to the anatomy. Manipulation of the model in the surgical field allowed an in situ comparison with the exposed area, and optimized the result.

CONCLUSIONS

Planning and 3D printing in Orthopaedics is an indispensable tool when performing complex surgery. It allows to improve the understanding of the particular anatomy of each patient and simulate different treatments to obtain the best possible result.
EPIDEMIOLOGY AND MANAGEMENT OF PEDIATRIC FRACTURES DURING THE COVID-19 PANDEMIC
Authors: Meneses Gutiérrez A , Lanuza Lagunilla L , Suárez-Anta Rodríguez P J , Camblor Valladares Á , García Arias A , Cabria Fernández J , García Cuello L , Mateo Negreira J
Published: May 2021

INTRODUCTION

In Spain, the state of alarm, decreed by the COVID-19 pandemic, forced a home confinement that included the suspension of school activity. Our purpose is to examine how it affected the epidemiology of pediatric fractures in a tertiary hospital.

MATERIAL AND METHODS

Retrospective cohort study comparing the epidemiology and management of pediatric fractures in our centre during the COVID-19 pandemic in relation to the previous year. The "pandemic" cohort includes patients seen during this state of alarm (03/14/2020 to 06/21/20); and the "pre-pandemic" cohort the same period of 2019.

RESULTS

Between both periods, 233 pediatric patients were treated for 258 fractures. There were no significant changes in their age or sex. The incidence of fractures was decreased by 66%. Despite this decrease, the percentage of fractures that required surgical intervention doubled. The time until the evaluation in the emergency room was also modified, with a higher proportion of patients seen more than 24 hours after the trauma. Regarding the anatomical locations, a reduction in bicortical fractures stands out, in contrast to greenstick fractures and epiphysiolysis.

CONCLUSIONS

The COVID-19 pandemic has changed the epidemiology of pediatric fractures. There was a reduction in the incidence of fractures and a delay in hospital care, probably due to fear of going to the hospital due to the risk of contagion. Home confinement may justify the lower proportion of high-energy distal radius fractures, such as bicortical fractures.
INITIAL STUDY OF THE SELECTION OF THE TYPE OF INCISION FOR THE SPECIMEN EXTRACTION AFTER A LAPAROSCOPIC NEPHRECTOMY: PFANNENSTIEL INCISION
Authors: Suárez Sal P J , Fernández-Pello Montes S , Rúger Jiménez L , Salgado Plonski J J , Alonso Calvar L , Rodríguez Villamil L
Published: May 2021

INTRODUCTION

The transverse hypogastric Pfannenstiel incision is one of the possibilities for specimen extraction after a laparoscopic nephrectomy. Its advantages include low morbidity and a favorable cosmetic result.

MATERIAL AND METHODS

Retrospective and comparative observational study of 105 patients who underwent nephrectomy in our center. Group 1: renal extraction through Pfannenstiel incision. Group 2: renal extraction using other techniques. The presence of infection, incisional hernia and pain (visual analogue scale-VAS) was evaluated in each patient. Additionally, a telephone survey was conducted on the cosmetic results.

RESULTS

105 patients: 68 group 1 (Pfannenstiel incision) and 37 group 2 (other incisions).

The median size of the nephrectomy specimen was 14 cm (group 1 15cm, group 2 13cm).

27 patients (26%) had pain in the area of the hypogastric incision in the early postoperative period with a median on the VAS scale of 4 (16 group 1 vs 11 group 2).

3 patients (2.8%) presented incisional hernia (0 group 1 vs 3 group 2).

3 patients presented wound infection (0 group 1 vs 3 group 2).

70% of the patients in group 1 (48/68) answered the survey on cosmetic satisfaction: 93% were satisfied with the scar and its location. 49% of the patients in group 2 (18/37) answered the survey on cosmetic satisfaction: 83% were satisfied with the scar and its location.

CONCLUSIONS

The Pfannenstiel incision is a valid and safe alternative for laparoscopic nephrectomy specimen extraction with a favorable complication and cosmetic profile compared to other common techniques for nephrectomy specimen extraction.
POTENTIAL OF EXTRACELLULAR MICROVESICLES AS NEW COLORECTAL CANCER BIOMARKER
Authors: García-Santos G , Serrano Pertierra E , Fernández Hevia M , Duque Alcorta J M , Sánchez Domínguez L , Blanco López M C , García Flórez L J
Published: May 2021

INTRODUCTION

Colorectal cancer (CRC) is the third leading cause of cancer death and the fourth cancer with the highest incidence in the world; early detection is a key factor for patient´s prognosis. Microvesicles (MVs) are subcellular structures delimited by lipid bilayer intimately involved in physiopathological processes such as cancer. Our objective is to study the potential of microvesicles as new biomarkers in CRC.

MATERIAL AND METHODS

Blood was prospectively collected from 300 patients recruited during diagnostic colonoscopy. They were classified into control (no pathological findings), adenoma, high-grade adenoma or carcinoma groups. Microvesicles were isolated from patients serum and a selected cohort of samples was used for MVs characterization and the CD174 surface antigen detection by lateral flow immunoassay (LFI).

RESULTS

Mean age of the patients was 62.79 (SD 7.662), being 90% asymptomatic at the time of recruitment. The mean size of isolated microparticles was similar in all groups, although larger variability was observed in carcinoma group. MVs concentration is considerably lower in high-grade adenoma and CRC compared to control group. CRC associated surface antigen CD147 can be consistently detected on the surface of microvesicles by lateral flow immunoassay technique

CONCLUSION

The preliminary results of this project show that it is possible use MVs as diagnostic / prognostic markers. Likewise, is feasible the develop of rapid tests using IFL technology that could be used to complement and/or replace current detection techniques.
Classification differentiates clinical and neuroanatomic features of cerebral small vessel disease
Authors: Chou Kun-Hsien , Lee Pei-Lin , Peng Li-Ning , Lee Wei-Ju , Wang Pei-Ning , Chen Liang-Kung , Lin Ching-Po , Chung Chih-Ping
Published: May 2021

Age-related cerebral small vessel disease involves heterogeneous pathogenesis, such as arteriosclerosis/lipohyalinosis and cerebral amyloid angiopathy. MRI can visualize the brain lesions attributable to small vessel disease pathologies, including white-matter hyperintensities, lacune and cerebral microbleeds. However, these MRI markers usually coexist in small vessel disease of different aetiologies. Currently, there is no available classification integrating these neuroimaging markers for differentiating clinical and neuroanatomic features of small vessel disease yet. In this study, we tested whether our proposed stratification scheme could characterize specific clinical, neuroanatomic and potentially pathogenesis/aetiologies in classified small vessel disease subtypes. Cross-sectional analyses from a community-based non-demented non-stroke cohort consisting of ≥50 years old individuals were conducted. All participants were scanned 3T brain MRI for small vessel disease detection and neuroanatomic measurements and underwent physical and cognitive assessments. Study population were classified into robust and four small vessel disease groups based on imaging markers indicating (i) bleeding or non-bleeding; (ii) specific location of cerebral microbleeds; and (iii) the severity and combination of white-matter hyperintensities and lacune. We used whole-brain voxel-based morphometry analyses and tract-based spatial statistics to evaluate the regional grey-matter volume and white-matter microstructure integrity for comparisons among groups. Among the 735 participants with eligible brain MRI images, quality screening qualified 670 for grey-matter volume analyses and 617 for white-matter microstructural analyses. Common and distinct patterns of the clinical and neuroimaging manifestations were found in the stratified four small vessel disease subgroups. Hierarchical clustering analysis revealed that small vessel disease type 4 had features distinct from the small vessel disease types 1, 2 and 3. Abnormal white-matter microstructures and cognitive function but preserved physical function and grey-matter volume were found in small vessel disease type 4. Among small vessel disease types 1, 2 and 3, there were similar characteristics but different severity; the clinical features showed both physical frail and cognitive impairment and the neuroanatomic features revealed frontal–subcortical white-matter microstructures and remote, diffuse cortical abnormalities. This novel stratification scheme highlights the distinct clinical and neuroanatomic features of small vessel disease and the possible underlying pathogenesis. It could have potential application in research and clinical settings.
Vedolizumab Is Safe in Elderly Veteran Patients With Inflammatory Bowel Disease
Authors: Leung Kenneth , Jackson Christian S , Hammami Muhammad Bader
Published: May 2021

Lay Summary

Many medications used to treat inflammatory bowel disease (IBD) can increase the risk of infection and cancer, particularly in elderly patients. This study found that vedolizumab, a targeted therapy, was effective and safe in elderly patients with IBD.
False Belief Understanding in Deaf Children With Cochlear Implants
Authors: Pluta Agnieszka , Krysztofiak Magdalena , Zgoda Małgorzata , Wysocka Joanna , Golec Karolina , Wójcik Joanna , Włodarczyk Elżbieta , Haman Maciej
Published: May 2021

Theory of mind (ToM) is crucial for social interactions. Previous research has indicated that deaf and hard-of-hearing children born into hearing families (DoH) are at risk of delayed ToM development. However, it is unclear whether this is the case for DoH children who receive cochlear implants (CIs) before and around the second year of life. The present study aimed to investigate false belief understanding (FBU) in DoH children with CIs. The relationships between false belief task (FBT) performance, sentence comprehension, age at implantation, duration of CI use, and Speech Recognition Threshold were explored. A total of 94 children with typical levels of hearing (TH) and 45 DoH children (age range: 3–8), who received their first CI between 6 and 27 months of age, were tested on the FBT and a sentence comprehension test. Results showed that 4- and 5-year-old children with CIs performed significantly worse than their peers with TH on the FBT; 6- to 8-year-old children with CIs performed similarly to age-matched children with TH. Age at implantation and duration of CI use were correlated with sentence comprehension but not with the FBT. The results indicated that FBU was delayed until the age of 6 years in most of children with CIs.
Differential DNA methylation in somatic and sperm cells of hatchery vs wild (natural-origin) steelhead trout populations
Authors: Nilsson Eric , Sadler-Riggleman Ingrid , Beck Daniel , Skinner Michael K
Published: May 2021

Environmental factors such as nutrition, stress, and toxicants can influence epigenetic programming and phenotypes of a wide variety of species from plants to humans. The current study was designed to investigate the impacts of hatchery spawning and rearing on steelhead trout (Oncorhynchus mykiss) vs the wild fish on a molecular level. Additionally, epigenetic differences between feeding practices that allow slow growth (2 years) and fast growth (1 year) hatchery trout were investigated. The sperm and red blood cells (RBC) from adult male slow growth/maturation hatchery steelhead, fast growth/maturation hatchery steelhead, and wild (natural-origin) steelhead were collected for DNA preparation to investigate potential alterations in differential DNA methylation regions (DMRs) and genetic mutations, involving copy number variations (CNVs). The sperm and RBC DNA both had a large number of DMRs when comparing the hatchery vs wild steelhead trout populations. The DMRs were cell type specific with negligible overlap. Slow growth/maturation compared to fast growth/maturation steelhead also had a larger number of DMRs in the RBC samples. A number of the DMRs had associated genes that were correlated to various biological processes and pathologies. Observations demonstrate a major epigenetic programming difference between the hatchery and wild natural-origin fish populations, but negligible genetic differences. Therefore, hatchery conditions and growth/maturation rate can alter the epigenetic developmental programming of the steelhead trout. Interestingly, epigenetic alterations in the sperm allow for potential epigenetic transgenerational inheritance of phenotypic variation to future generations. The impacts of hatchery exposures are not only important to consider on the fish exposed, but also on future generations and evolutionary trajectory of fish in the river populations.