bluuebunny/crossref_metadata_2025_split huggingface dataset:
Laser machining fundamentals: micro, nano, atomic and close-to-atomic scales
Authors: Wang Jinshi , Fang Fengzhou , An Haojie , Wu Shan , Qi Huimin , Cai Yuexuan , Guo Guanyu 
Published: January 2023

Abstract
With the rapid development in advanced industries, such as microelectronics and optics sectors, the functional feature size of devises/components has been decreasing from micro to nanometric, and even ACS for higher performance, smaller volume and lower energy consumption. By this time, a great many quantum structures are proposed, with not only an extreme scale of several or even single atom, but also a nearly ideal lattice structure with no material defect. It is almost no doubt that such structures play critical role in the next generation products, which shows an urgent demand for the ACSM. Laser machining is one of the most important approaches widely used in engineering and scientific research. It is high-efficient and applicable for most kinds of materials. Moreover, the processing scale covers a huge range from millimeters to nanometers, and has already touched the atomic level. Laser–material interaction mechanism, as the foundation of laser machining, determines the machining accuracy and surface quality. It becomes much more sophisticated and dominant with a decrease in processing scale, which is systematically reviewed in this article. In general, the mechanisms of laser-induced material removal are classified into ablation, CE and atomic desorption, with a decrease in the scale from above microns to angstroms. The effects of processing parameters on both fundamental material response and machined surface quality are discussed, as well as theoretical methods to simulate and understand the underlying mechanisms. Examples at nanometric to atomic scale are provided, which demonstrate the capability of laser machining in achieving the ultimate precision and becoming a promising approach to ACSM.
Trying to adjunct without knowing how: adjunction and the adoption problem
Authors: Susanszky Peter 
Published: January 2023

Abstract
The adoption question asks whether there are logical rules that cannot be adopted if one does not already infer in accordance with them. Several philosophers, most famously Saul Kripke and Romina Padró, agree that there are such rules. Accordingly, they agree that there is an adoption problem. However, there is disagreement over which rules are unadoptable. In particular, while most agree that if there is an adoption problem, modus ponens and universal instantiation are in its scope, many would exclude adjunction from the list. In this paper, I argue that adjunction is in the scope of the adoption problem. Then I show that the most straightforward counterargument against adjunction being in the scope of the problem, which tries to reformulate the adjunction rule into a more palatable one, does not work.
RANDOMIZED STUDY ON THE EFFICACY OF NEGATIVE PRESSURE WOUND THERAPY (NPWT) IN THE PREVENTION OF SURGICAL SITE COMPLICATIONS
Authors: Suárez Sánchez A , de Santiago Álvarez I , García Munar M , García González L A , Cifrian Canales I , Díaz Vico T , Moreno Gijón M , Sanz Álvarez L 
Published: January 2023

Abstract

Introduction
The secondary consequences of SSC worsen patient's quality of life, while increasing healthcare costs considerably. Applying preventive measures to reduce this complication rate should be one of the priorities of improving healthcare.

Methods
We conducted a prospective randomized study between March 2019 and March 2021 in a General Surgery Department of a tertiary hospital. Operated patients with risk factors for developing (SSC) were included according to the established protocol, and were randomized to the use of NPWT or conventional dressing (CD). The aim of our study was to compare SSC (skin dehiscence, seroma, hematoma, edge necrosis, and wound infection) in both groups, and to assess the benefit of NPWT.

Results
We studied 267 patients, 124 (46.4%) in the NPWT group and 143 (53.6%) in the CD group, with a mean age of 68 (±12.9) years. 96.2% of the patients corresponded to the ASA II or III classification.
A total of 72 (27%) SSC were observed, being significantly lower in the NPWT group (odds ratio [OR] 0.49; confidence interval [CI] 0.28–0.85; p &lt;0.05). The median hospital stay was 10 (7–20) days.
Relative risk reduction (RRR) was 41.5% and absolute risk reduction (ARR) was 14%, with a number needed to treat (NNT) of 6.9.

Conclusion
NPWT decreases the risk of SSC, so its use should be considered in patients with risk factors.
MANAGEMENT OF BILE DUCT INJURY IN A REFERRAL CENTER, 10 YEARS OF EXPERIENCE
Authors: Hinojosa Ugarte D , Montiel Hinojosa L , Lozada Hernandez E E , Crocco Quiros B , Nieves Condoy J , Cethorth Fonseca R 
Published: January 2023

Abstract

Introduction
Bile duct injury represents major morbidity and mortality, and in the last two decades in which laparoscopy cholecystectomy has been universally available several factors associated with bile duct injury have been described: one of them being the surgeon's training and experience in laparoscopic cholecystectomy. Some authors have reported that the training curve stabilizes the risk of bile duct injury from 1.7 to 0.17% by procedure number 50. Given that most surgical residency programs don't have enough experience in laparoscopy, this likely contributes to the development of bile duct injury. Therefore, it is important to elucidate the risk factors for bile duct injury in our country.

Methods
In a referral center we collected the data from 10 years of experience in bile duct repair for bile duct injury. The clinical records for 83 patients were obtained and analyzed.

Results
High-quality hepaticojejunostomy was performed in all 117 cases, 89.8% open, 8.5% laparoscopic and 1.7% was converted from laparoscopic to open. In 41% of patients, partial resection of the IV segment was necessary. the main post-operatory complication was surgical site infection in 19.6%, overall mortality was 3.4%. according to McDonald Classification for Group A 56.4%, Group B 28.2%, Group C 10.2%, Group D 5.2%, in long-term follow-up.

Conclusions
Surprisingly, the open cholecystectomy was the most common procedure associated with bile duct injury in our population. Postoperative injury detection was the most frequent, and the most common injury location was near the confluence. We obtained good long-term results even the type of injuries. The disproportion between training centers and hospitals all around the country may impact these results due to the lack of experience of the young surgeons that have only had training in laparoscopic surgery and the lack of universal laparoscopic availability for emergencies. The patients that suffer from this complication are of middle age, and there is a significant disproportion between males and females, with females being the most affected group. It has an impact on their quality of life. High-quality hepaticojejunostomy with Hepp-couinaud technique provides good long-term results, with no difference between the 1–5 year and the 6–10 year groups. The segment IV hepatectomy represents a good option to access the hilar plate. It is important to continue to expose surgeons during their residencies to open cholecystectomy. Prevention is the cheapest and safest way to decrease the incidence of bile duct injury.
The implementation of high-volume centers such as ours is important to bring early and high-quality solutions to problems like these.
ASSESSMENT OF THE RISK OF UROTHELIAL CANCER IN THE BLADDER AND UPPER URINARY TRACT WITH THE IDENTIFY STUDY CALCULATOR: MONOCENTRIC PROSPECTIVE STUDY
Authors: Abad López P , Gómez Rivas J , Alonso Bartolomé S , Gutiérrez Hidalgo B , Martín Monterrubio J , de la Parra Sánchez I , Galante Romo I , Moreno Sierra J 
Published: January 2023

Abstract

Introduction
The British Urology Researchers in Surgical Training (BURST) collaborative group developed a urothelial cancer risk calculator based on the IDENTIFY study, in patients with gross or microscopic hematuria. Our objective is the validation of this calculator in our environment.

Methods
Descriptive and ambispective study of 88 patients with hematuria, from June 2020 to November 2021. Demographic aspects, positivity of imaging tests, classification of the IDENTIFY risk calculator and the need for treatment were compared.

Results
53 presented with macrohematuria (60.2%) and 35 with microhematuria (39.8%). 58 were men (65.9%) and 30 women (34.1%). The mean age was 64.66 years (SD: 15) and the median follow-up was 7 months.
Of the 26 patients with high risk in the calculator, 17 had bladder tumors (65.4%), being 57.1% cTa and 35% cT2. Of the 38 patients with intermediate risk, 3 patients had tumors (7.9%). Of the 24 with low risk, none had tumors.
Among the high-risk patients, 48.1% presented an ultrasound with lesions, of the intermediate-risk patients, 3% presented an ultrasound with lesions, and of the low-risk patients, none (p&lt;0.05). With regard to high-risk patients, 58.8% presented cystoscopy with lesions, with 4% of intermediate-risk patients and only 2% of low-risk patients (p&lt;0.05).

Conclusions
In our series, there are statistically significant differences according to the risk group of the IDENTIFY calculator and the finding of tumors in conventional diagnostic tests.
ENDOSCOPIC AND PERCUTANEOUS MANAGEMENT OF AN IATROGENIC DISTAL PANCREATIC FISTULA DURING VASCULAR SURGERY
Authors: Solar García L , Miyar de León A , Cadenas F , García Bernardo C , Contreras Saiz E , Merayo Álvarez M , González Pinto I 
Published: January 2023

Abstract

Introduction
Traumatic pancreatic fistulas are, normally, secondary to a partial or complete rupture of the pancreatic duct. Pancreatic surgery is associated with high morbidity and mortality, thus a step-up approach, with priorization of a conservative or endoscopic management, is useful in selected cases.

Clinical case
A 74-year-old man underwent resection of a thoraco-abdominal aneurysm with placement of a vascular graft and reimplantation of visceral arteries. In the immediate postoperative period, he presented with febrile syndrome and abdominal pain. Abdominal CT was performed, observing a retroperitoneal collection of 7cm. Ultrasound-guided percutaneous drainage of the collection was performed. Amylase levels in the drainage were analyzed, which were compatible with a pancreatic fistula. Pancreatomagnetic resonance imaging confirmed partial disruption of the pancreatic duct. In successive radiological studies, the persistence of the collection was observed, and the removal of the drain was prevented. ERCP was performed with insertion of a pancreatic stent (photo 1) and papillotomy with good clinical evolution. In subsequent ambulatory CT, the progressive decrease of the retroperitoneal collection was evident. The percutaneous drainage was removed. After 3 months, the pancreatic stent was removed.

Discussion
Diagnosis of iatrogenic traumatic pancreatic injury is difficult and requires a high degree of caution. Pancreatoresonance is the gold-standard for imaging. The transpapillary placement of pancreatic stents, in selected patients, has a high success rate.
LAPAROSCOPIC LIVER RESECTION FOR METASTASIS OF RETROPERITONEAL LEIOMYOSARCOMA
Authors: Solar García L , Silva Cano D W , Miyar de León A , García Bernardo C , Contreras Saiz E , Michi Campos J L , González Pinto I 
Published: January 2023

Abstract

Introduction
Soft tissue leiomyosarcomas represents 0.7% of all malignant tumors. The most common location is the retroperitoneum, and the appearance of local or distant recurrences after resection is not uncommon. Pathological study is important to establish the confirmatory diagnosis and the prognosis of this type of lesion.

Clinical case
We present the clinical case of a patient with retroperitoneal leiomyosarcoma that was resected associated with ipsilateral nephrectomy. An 11-month follow-up revealed a hepatic lesion in segment 5, suggestive of metastasis. We decided on surgical resection of this lesion.
Liver segmentectomy was performed by laparoscopic approach. The pathological study of the liver lesion showed a tumor of about 5 centimeters, compatible with leiomyosarcoma metastasis, presenting abundant mitoses (8/10), 15% necrosis in the central area and a Ki67 of 20%.

Discussion
Leiomyosarcoma is a very aggressive tumor. Its treatment is fundamentally based on the surgical resection of the primary and its possible metastases. The pathological study of the piece, with special emphasis on the number of mitoses, as well as the Ki- 67%, are indicators of the aggressiveness of the tumor and the prognosis. Given the low incidence of these tumors, it is recommended that the approach of these tumors be done in multidisciplinary teams and in specialized centers.
EMPHYSEMATOUS PANCREATITIS: A RARE COMPLICATION OF ACUTE PANCREATITIS
Authors: Solar García L , García Munar M , Ibero Casadiego D P , Contreras Saiz E , Navarro Sanz S , Miyar de León A , García Bernardo C , González Pinto I 
Published: January 2023

Abstract

Introduction
Emphysematous pancreatitis (EP) is a serious and rare complication within the spectrum of acute pancreatitis (AP). The diagnosis is based on clinical and radiological data, that presents intraparenchymal pancreatic air in the setting of necrotizing infection.
This clinical and radiological manifestation of infected pancreatic necrosis has mortality rates of over 40%.

Clinical case
A 71-year-old male came to the emergency department due to epigastric pain of 48h duration associated with hypotension, bradycardia with elevated pancreatic enzymes, requiring admission to the Intensive Care Unit. Initial resuscitation treatment was established, and a CT scan was performed which showed abundant air in the retroperitoneum, associated with signs of inflammation of the pancreatic gland as well as obstructive choledocholithiasis and without being able to radiologically rule out an intestinal perforation.
After fluid resuscitation and stabilization of the patient, urgent surgery was performed, which showed necrosis of the entire pancreatic gland with abscessed peripancreatic collections. Wide open necrosectomy, exploration of the bile duct with extraction of lithiasis, and cholecystectomy were performed. The patient had a slow and prolonged postoperative period, progressively improving until he was discharged home.

Discussion
Therapeutic options for EP range from conservative management to surgery. Surgery, in these patients, is the last therapeutic step, after endoscopic or percutaneous drainage. The video-assisted retroperitoneal approach is the better procedure to be considered, since it entails less morbidity and mortality than open necrosectomy.
MANAGEMENT OF OBSTRUCTIVE JAUNDICE IN PATIENTS WITH PERIAMPULLARY TUMORS IN A COVID-19 PANDEMIC SITUATION
Authors: Carrasco Aguilera B , Solar García L , Miyar de León A , García Alonso L , del Val Ruiz P , García Bernardo C , Contreras Saiz E , González Pinto I 
Published: January 2023

Abstract

Introduction
The redistribution of hospital resources secondary to SARS-CoV-2(COVID19) produced a reduction and delay in surgical activity.
Analysis of the management of obstructive jaundice (OI) in a reference centre during COVID19 in patients with potentially resectable periampullary tumours.

Methods
Observational study, limited to the year 2021, on the management of OI in periampullary pathology.
Analysis of the different biliary drainage (BD) techniques (endoscopic/transhepatic) and the associated complications.
The indication criteria for BD were: bilirubin levels &gt;10 mg/dl, cholangitis or expectation of surgery &gt;2 weeks from inclusion on the waiting list. Patients with criteria of unresectability or those with neoadjuvant indication were excluded from the study.

Results
Thirty-five patients were analyzed, with an age range between 45–80 years, who were indicated to undergo a pancreaticoduodenectomy.
51% of these patients required preoperative DB. DB was performed endoscopically (ERCP) in 10 patients and by transparietohepatic approach (TPHD) in 8 patients. In endoscopic approach the majority of stents used were expandable coated metallic (eight patients).
The most frequent complications associated with ERCP were cholangitis and acute cholecystitis. The most frequent complication associated with TPHD was cholangitis.

Conclusions
Preoperative BD associates a greater number of perioperative complications. At present, there is consensus in avoiding preoperative DB, except in cases with cholangitis or hyperbilirubinemia. If DB is necessary, the endoscopic approach (ERCP) would be indicated. Coated Metal stents should be considered for patients with resectable pancreatic cancer, especially if surgery is not immediate.
ROBOTIC APPROACH TO THE MAIN BILE DUCT IN THE TREATMENT OF CHOLEDOCOLITIASIS. EXPERIENCE OF A BILIO-PANCREATIC UNIT
Authors: Sánchez-Bueno F , Gil Vázquez P J , Ferreras Martínez D , Gómez Pérez B , Gómez Boch F , Alcaraz Solano Á 
Published: January 2023

Abstract

Introduction
The aim of this paper is to analyze the validity and safety of a new program for the implementation of a robotic approach in the treatment of choledocholithiasis (CD) in a Bilio-Pancreatic Unit, evaluating morbi-mortality and hospital stay.

Methods
Given the controversy of which is the best therapeutic option in CD: preoperative ERCP followed by laparoscopic cholecystectomy (LC) or laparoscopic approach to the bile duct, we designed this prospective, non-randomized and single-center study with a robotic approach to the bile duct. 25 patients were included (14 women /11 males), with a mean age of 71.4 years. Preoperative abdominal ultrasound and cholangioresonance were performed in all patients.

Results
The robotic approach was effective in all cases: cholecystectomy and cleaning the bile duct. In the first three cases a radiological exploration was performed through the cystic duct during intervention. In all cases an exploration of the bile duct with a flexible choledoscope after choledochotomy was performed too. The mean operative time was 128.8 +/-16.9 minutes. Choledocholithiasis was confirmed in all patients. Furthermore, a patient had a papillary tumor of the distal common bile duct associated. One patient who had advanced cholecystitis had a biliary fistula. It was resolved conservatively by placing an endoscopic plastic biliary prosthesis. If we exclude the patient with the biliary fistula, the hospital stay postoperative period was 2 days.

Conclusions
Robotic approach in the treatment of choledocholithiasis is an effective and safe technique. In addition, postoperative morbidity and hospital stay decreases.
ANTIOXIDANT TREATMENTS IN THE PROPHYLAXIS OF INTESTINAL REPERFUSION DAMAGE
Authors: Velasco Oraa X , García-Alonso Montoya I , Cearra Guezuraga I , Ruiz Montesinos I , Herrero de la Parte B 
Published: January 2023

Abstract

Introduction
Intestinal ischemia-reperfusion is still a relevant clinical problem, especially in newborns and in the elderly. In this piece of work, we check the utility of curcumin and dexmedetomidine to overcome the damage induced by reperfusion, both locally and in distant organs, using α-tocopherol as a comparison.

Methods
In female Wag/RijHsd rats, the superior mesenteric artery was clamped for 1 h; then, animals were allowed 4 h of reperfusion. Curcumin (200 mg/kg, oral) was given 24 h and 2 h before clamping; α-tocopherol (20 mg/kg, i.p.) was administered 2 h before ischemia, and dexmedetomidine (10 or 40 mg/kg, s.c.; dex-10 and dex-40, respectively) was given 15 minutes before ischemia. Blood samples and terminal ileum were collected. Additionally, a D-xylose absorption test was performed to evaluate intestinal absorption; 1h after D-xylose administration, D-xylose plasma levels were quantified (mg/ml).

Results
All of the treatments reduced histological damage assessed with Chiu's scale (non-treated, 2.6 ± 0.75; curcumin, 1.54 ± 0.8; dex-10, 1.47 ± 0.7; dex-40 1.43 ± 0.9; α-tocopherol, 1.01 ± 0.8) and improved absorption of D-xylose (healthy rats 2.06 ± 0.07; non-treated, 1.18 ± 0.07; curcumin 1.76 ± 0.30; dex-10, 2.29 ± 0.20; dex-40, 2.25 ± 0.26; α-tocopherol 1.66 ± 0.21). Dexmedetomidine improved renal function (it reduced both creatinine and urea in serum). The elevation of liver enzymes in serum was not improved by any of the drugs.

Conclusions
The three drugs proved to be useful, though α-tocopherol was more efficient regarding histological damage, and only dexmedetomidine restored D-xylose absorption to normal values.
CHALLENGING THE DOGMAS: LAPAROSCOPIC COMMON BILE DUCT EXPLORATION THROUGH DIATHERMY, CHOLEDOCHOTOMY AND PRIMARY CLOSURE. LONG TERM OUTCOMES IN A REFERRAL CENTER
Authors: Gómez D , Mendoza A , Pedraza M , Salcedo Miranda D F , Mantilla-Sylvain F , Lozada-Martínez I D , Domínguez-Alvarado G , Cabrera Vargas L F 
Published: January 2023

Abstract

Introduction
Choledocholithiasis is a frequent pathology, unfortunately when its endoscopic management fails there is no consensus on how it should be addressed. The aim of this study was to evaluate the safety, feasibility and long-term outcomes of laparoscopic common bile duct exploration (LCDBE) using electrosurgery (coagulation) for choledochotomy followed by primary closure after endoscopic treatment failure.

Methods
A retrospective cohort of 168 patients who underwent LCDBE from 2013 to 2018 which was conducted all by choledochotomy. Clinical demographics, operative outcomes, recurrence rate of CBD stones, and long-term bile duct complications were analyzed.

Results
The male/female ratio was 90/78 and mean age was 73 years. Stone clearance was successful in 167 patients (99.4%). Nonlethal complications were noted in 3 patients during the surgery or in the immediate postoperative (1.79%) and managed with T-tube or endoscopically. No cases of surgery-related mortality were observed. There were no signs of any type of biliary injury or stricture observed in any of the patients during the 24-month follow-up period.

Conclusions
LCBDE through choledochotomy with diathermy and primary closure can be performed without increased risk of operative complications such as important and visual-impairment bleeding as well as long-term complications such as bile duct stricture or recurrent CBD stones. LCBDE with diathermy and primary closure is a safe and effective treatment option for choledocholithiasis for failed ERCP in terms of long-term outcome as well as short-term outcome.
RHEOLOGICAL CHARACTERISATION OF DIFFERENT ALGINATE-BASED HYDROGELS FOR A BIOMIMETIC REPRESENTATION OF A TOOTH
Authors: Mendoza Cerezo L , Rodríguez Rego J M , Macías García A , Carrasco Amador J P , Marcos Romero A C , Díaz Parralejo A 
Published: January 2023

Abstract

Introduction
In bioprinting, it is essential to correctly characterise the materials to be used in order to ensure the highest cell viability while maintaining the best structural properties of the hydrogels.

Methods
Alginate-based hydrogels with different concentrations have been characterised because they are currently the ones with the best printing properties according to the literature.
The concentrations chosen were 3.5%, 4% and 5% alginate, and then a scaffold was bioprinted with the one with the best mechanical properties.
Finally, a 3D model of a tooth was bioprinted to check the integrity of the hydrogel characterised as a somewhat more complex structure than a simple scaffold.

Results
It could be observed that, despite suffering a similar viscosity loss to the rest, the sample with the best viscosity properties when subjected to shear stresses was the one containing 5% alginate concentration.
When a simple scaffold was bioprinted, it was observed that the result was positive, as the visual analysis corresponded to the parameters programmed in 3D design software. Likewise, the subsequent bioprinting of the dental model showed good results.

Conclusions
The hydrogels characterised by rheometry showed similar behaviour with respect to viscosity. Furthermore, it was found that the hydrogel with higher viscosity allowed for higher quality bioprints.