ENFOQUE TERAPEÚTICO ACTUAL EN EL TRAUMATISMO ABDOMINAL

En la actualidad, los traumatismos son la principal causa de muerte en las primeras cuatro décadas de la vida. En los Estados Unidos, las lesiones traumáticas son la primera causa de pérdida de vidas humanas en menores de 65 años y la segunda de incremento de los costos médicos. Los mecanismos más frecuentes que producen las lesiones traumáticas son los accidentes de tránsito y, en menor medida, las caídas de altura, heridas por arma de fuego, heridas por arma blanca y aplastamientos.  El trauma abdominal es aquel que tiene lugar cuando el abdomen sufre la acción violenta de agentes externos y se producen lesiones de diferente magnitud y gravedad. Puede afectar los elementos orgánicos que lo constituyen, sean estos de pared abdominal, del contenido (vísceras) o de ambos. Los traumas abdominales se clasifican en abiertos y cerrados. Ellos ocupan gran parte del quehacer médico–quirúrgico en los servicios de urgencia.  El manejo en el trauma abdominal ha evolucionado notablemente. Es de vital importancia diagnosticar y tratar estas lesiones con filosofía de urgencia, en el menor tiempo posible, pues puden poner en peligro la vida del paciente.  La atención al trauma abdominal en la actualidad provoca grandes dilemas diagnósticos y terapéuticos. Este artículo de revisión pretende presentar las características del trauma de abdomen, así como el enfoque terapéutico actual

Npj Materials Degradation

Catastrophic failure in brittle materials is often due to the rapid growth and coalescence of cracks aided by high internal stresses. Hence, accurate prediction of maximum internal stress is critical to predicting time to failure and improving the fracture resistance and reliability of materials. Existing high-fidelity methods, such as the Finite-Discrete Element Model (FDEM), are limited by their high computational cost. Therefore, to reduce computational cost while preserving accuracy, a deep learning model, StressNet, is proposed to predict the entire sequence of maximum internal stress based on fracture propagation and the initial stress data. More specifically, the Temporal Independent Convolutional Neural Network (TI-CNN) is designed to capture the spatial features of fractures like fracture path and spall regions, and the Bidirectional Long Short-term Memory (Bi-LSTM) Network is adapted to capture the temporal features. By fusing these features, the evolution in time of the maximum internal stress can be accurately predicted. Moreover, an adaptive loss function is designed by dynamically integrating the Mean Squared Error (MSE) and the Mean Absolute Percentage Error (MAPE), to reflect the fluctuations in maximum internal stress. After training, the proposed model is able to compute accurate multi-step predictions of maximum internal stress in approximately 20seconds, as compared to the FDEM run time of 4h, with an average MAPE of 2% relative to test data.Laboratory Directed Research and Development program of Los Alamos National Laboratory [20170103DR]; LANL Applied Machine Learning Summer Research Fellowship; National Science FoundationNational Science Foundation (NSF) [1855651]D.O., N.P., and G.S. were supported by the Laboratory Directed Research and Development program of Los Alamos National Laboratory under project number 20170103DR; Y.W. was supported by the LANL Applied Machine Learning Summer Research Fellowship; X.Y. were partially supported by the National Science Foundation under project number 1855651

The Political Economy of Longevity: Developing New Forms of Solidarity for Later Life

Aging populations now exert influence on all aspects of social life. This article examines changes to major social and economic institutions linked with old age, taking the period from the mid-20th century to the opening decades of the 21st century. These developments are set within the context of the influence of globalization as well as the impact of the 2008 financial crisis, these restructuring debates around the longevity revolution. The article examines how the basis for a new framework for accommodating longevity can be built, outlining ways of securing new forms of solidarity in later life