Pterional variable topography and morphology. An anatomical study and its clinical significance

Background: Pterion is the junction of the frontal, parietal, greater wing of the sphenoid and the squamous part of the temporal bone. The sphenoparietal, frontotemporal, stellate and epipteric pteria were described. The current study determines pterion topography, morphology (variant types’ frequency) and morphometry, as well as epipteric bones presence in dried skulls. Gender impact is underlined as well. Material and methods: Ninety Greek adult dried skulls were observed. The distances in between pterion and the zygomatic arch midpoint and in between pterion and the frontozygomatic suture were measured. Results: The sphenoparietal pterion was the commonest (58.3%), following by the stellate (25%), epipteric (15.5%) and by the frontotemporal pterion (1.1%). Twenty-eight skulls (15.5%) had epipteric bones, further categorized as quadrisutural (35.7%), trisutural (57.1%), bisutural and multiple (3.57%). The mean distances between pterion and the midpoint of zygomatic arch were 4.13+0.45cm on the right and 4.09 + 0.47cm on the left side and between pterion and the frontozygomatic suture were 3.47 + 0.61 cm on the right and 3.52 + 0.65 cm on the left. Both distances were symmetrical. Male skulls showed slightly higher values on the left side for the distance pterion and midpoint of zygomatic arch. Conclusions: Pterion is a commonly used neurosurgical landmark and thus in depth knowledge of the pteric area and its variants could be valuable. Recognition of the possible variability in pterion location, morphology and morphometry, as well as possible occurrence of epipteric bones may render pterional craniotomy safer among different population groups

Is prolonged infusion of piperacillin/tazobactam and meropenem in critically ill patients associated with improved pharmacokinetic/pharmacodynamic and patient outcomes? An observation from the Defining Antibiotic Levels in Intensive care unit patients (DALI) cohort

Objectives:We utilized the database of the Defining Antibiotic Levels in Intensive care unit patients (DALI) study to statistically compare the pharmacokinetic/pharmacodynamic and clinical outcomes between prolonged-infusion and intermittent-bolus dosing of piperacillin/tazobactam and meropenem in critically ill patients using inclusion criteria similar to those used in previous prospective studies.Methods: This was a post hoc analysis of a prospective, multicentre pharmacokinetic point-prevalence study (DALI), which recruited a large cohort of critically ill patients from 68 ICUs across 10 countries.Results: Of the 211 patients receiving piperacillin/tazobactam and meropenem in the DALI study, 182 met inclusion criteria. Overall, 89.0% (162/182) of patients achieved the most conservative target of 50% fT(> MIC) (time over which unbound or free drug concentration remains above the MIC). Decreasing creatinine clearance and the use of prolonged infusion significantly increased the PTA for most pharmacokinetic/pharmacodynamic targets. In the subgroup of patients who had respiratory infection, patients receiving beta-lactams via prolonged infusion demonstrated significantly better 30 day survival when compared with intermittent-bolus patients [86.2% (25/29) versus 56.7% (17/30); P=0.012]. Additionally, in patients with a SOFA score of >= 9, administration by prolonged infusion compared with intermittent-bolus dosing demonstrated significantly better clinical cure [73.3% (11/15) versus 35.0% (7/20); P=0.035] and survival rates [73.3% (11/15) versus 25.0% (5/20); P=0.025].Conclusions: Analysis of this large dataset has provided additional data on the niche benefits of administration of piperacillin/tazobactam and meropenem by prolonged infusion in critically ill patients, particularly for patients with respiratory infections

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Youth’s Perspectives of Computational Design in Making-based Coding Activities

There are increasing calls to introduce coding in K-12 in creative ways that provide opportunities for personal expression. Computational design projects include computational concepts fundamental to computer science to generate 2D and 3D models that can potentially be personally meaningful. We developed and implemented making-based coding activities for youth that combine computational design and 3D printing tools and allow the participants to design and fabricate free-choice projects. To investigate how young persons engaged in computational design and which aspects demotivated them, we used a mixed-methods approach that included semi-structured interviews and questionnaires. We took field notes and collected students’ artifacts to triangulate the data wherever possible. The results show that 3D printing, creating unique aesthetics, enhanced personalization, and ownership of design models are crucial elements for engaging youth in computational design. We discuss the implications of our exploratory study and suggest directions for future work in developing computationally rich making-based activities

Apollonius of Citium (first century BC) and his work on the treatment of joint dislocations

The purpose of this study was to summarise the life and work of the Cypriot physician Apollonius of Citium (first century BC). His overall work on medicine is presented, and special emphasis is given to his work on the treatment of joint dislocations. The most famous work of Apollonius is Treatise On Joints, which was preserved on the whole in a manuscript of the tenth century AD. In that manuscript, Apollonius is obviously influenced by the Hippocratic Corpus of Medicine. His description, diagnostic methods and reduction techniques are all based on those described by Hippocrates in his work “On Joints”. Apollonius’ contribution to this subject concerns accurate depiction in images of the reduction techniques he proposes. His simplifications describe the techniques of Hippocrates in a way they can be understood and used by athletes and nonphysicians in the Greek gymnasia. Perhaps his treatise is one of the earliest works of popularised medicine and surgery in the history of human civilisation. © 2018, SICOT aisbl

Pterional variable topography and morphology. An anatomical study and its clinical significance

Background: Pterion is the junction of the frontal, parietal, greater wing of the sphenoid and the squamous part of the temporal bone. The sphenoparietal, frontotemporal, stellate and epipteric pteria were described. The current study determines pterion topography, morphology (variant types' frequency) and morphometry, as well as epipteric bones presence in dried skulls. Gender impact is underlined as well. Materials and methods: Ninety Greek adult dried skulls were observed. The distances in between pterion and the zygomatic arch midpoint and in between pterion and the frontozygomatic suture were measured. Results: The sphenoparietal pterion was the commonest (58.3%), following by the stellate (25%), epipteric (15.5%) and by the frontotemporal pterion (1.1%). Twenty-eight (15.5%) skulls had epipteric bones, further categorised as quadrisutural (35.7%), trisutural (57.1%), bisutural and multiple (3.57%). The mean distances between pterion and the midpoint of zygomatic arch were 4.13 ± 0.45 cm on the right and 4.09 ± 0.47 cm on the left side and between pterion and the frontozygomatic suture were 3.47 ± 0.61 cm on the right and 3.52 ± 0.65 cm on the left side. Both distances were symmetrical. Male skulls showed slightly higher values on the left side for the distance (pterion-midpoint of zygomatic arch). Conclusions: Pterion is a commonly used neurosurgical landmark and thus in depth knowledge of the pteric area and its variants could be valuable. Recognition of the possible variability in pterion location, morphology and morphometry, as well as possible occurrence of epipteric bones may render pterional craniotomy safer among different population groups. Copyright © 2021 Via Medica

Vessel's trim optimization using IoT data and machine learning models

The shipping industry is an important source of greenhouse gas emissions, such as carbon dioxide, methane and nitrogen oxides. In the past few years, environmental and policy reasons dictate the immense reduction of greenhouse gas emissions in industries worldwide. Towards this direction, the shipping industry has focused on ship trim optimization in the last few years as an operational measure for better energy efficiency and thus a way to reduce consumption and energy-related emissions. In this paper, we present a machine learning solution to the problem of trim optimization. Specifically, we use Internet of Things (IoT) data for speed, draft, and trim in order to accurately predict shaft power. After our machine learning model is trained, we use its predicting capabilities to create the shaft power surface as part of the trim monitoring user interface of the maritime company infrastructure. © 2022 IEEE

Prognostic significance of 24-h blood pressure and variability indices in the outcome of acute ischaemic stroke

Background: The association between blood pressure (BP) levels and BP variability (BPV) following acute ischaemic stroke (AIS) and outcome remains controversial. Aims: To investigate the predictive value of systolic BP (SBP) and diastolic BP (DBP) and BPV measured using 24-h ambulatory blood pressure monitoring (ABPM) methods during AIS regarding outcome. Methods: A total of 228 AIS patients (175 without prior disability) underwent ABPM every 20 min within 48 h from onset using an automated oscillometric device (TM 2430, A&D Company Ltd) during day time (7:00–22:59) and night time (23:00–6:59). Risk factors, stroke subtypes, clinical and laboratory findings were recorded. Mean BP parameters and several BPV indices were calculated. End-points were death and unfavourable functional outcome (disability/death) at 3 months. Results: A total of 61 (26.7%) patients eventually died. Multivariate logistic regression analysis revealed that only mean night-time DBP (hazard ratio (HR): 1.04; 95% confidence interval (CI): 1.00–1.07) was an independent prognostic factor of death. Of the 175 patients without prior disability, 79 (45.1%) finally met the end-point of unfavourable functional outcome. Mean 24-h SBP (HR: 1.03; 95% CI: 1.00–1.05), day-time SBP (HR: 1.02; 95% CI: 1.00–1.05) and night-time SBP (HR: 1.03; 95% CI: 1.01–1.05), SBP nocturnal decline (HR: 0.93; 95% CI: 0.88–0.99), mean 24-h DBP (HR: 1.08; 95% CI: 1.03–1.13), day-time DBP (HR: 1.07; 95% CI: 1.03–1.12) and night-time DBP (HR: 1.06; 95% CI: 1.02–1.10) were independent prognostic factors of an unfavourable functional outcome. Conclusions: In contrast with BPV indices, ABPM-derived BP levels and lower or absence of BP nocturnal decline in the acute phase are prognostic factors of outcome in AIS patients. © 2022 Royal Australasian College of Physicians