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

A statistical system management method to tackle data uncertainty when using key performance indicators of the balanced scorecard

[EN] This work is focused on the development of a graphical method using statistical non-parametric tests for randomness and parametric tests to detect significant trends and shifts in key performance indicators from balanced scorecards. It provides managers and executives with a tool to determine if processes are improving or decaying. The method tackles the hitherto unresolved problem of data uncertainty due to sample size for key performance indicators on scorecards. The method has been developed and applied in a multinational manufacturing company using scorecard data from two complete years as a case study approach to test validity and effectiveness.Sánchez-Márquez, R.; Albarracín Guillem, JM.; Vicens Salort, E.; Jabaloyes Vivas, JM. (2018). A statistical system management method to tackle data uncertainty when using key performance indicators of the balanced scorecard. Journal of Manufacturing Systems. 48:166-179. https://doi.org/10.1016/j.jmsy.2018.07.010S1661794

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

Arthroscopic versus open Latarjet: a step-by-step comprehensive and systematic review

Purpose: To investigate whether arthroscopic Latarjet procedure significantly differs from the open procedure as for the clinical, functional and radiographic outcomes. Methods: Two reviewers independently conducted a systematic search according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses using the MEDLINE/PubMed database and the Cochrane Database of Systematic Reviews. These databases were queried with the terms “shoulder” AND “anterior” AND “instability” AND “Latarjet”. Results: From the 259 initial papers, we finally assessed five clinical studies which were eligible to our inclusion–exclusion criteria. The mean modified Coleman score for methodological deficiencies of the studies was 65.4/100, whereas it ranged from 53/100 to 77/100. The arthroscopic technique illustrated comparable results to the open technique regarding the postoperative recurrence rate. No significant difference was found amongst groups in relation to the postoperative osteoarthritis, infection rates, soft tissue healing, postoperative mean American Shoulder and Elbow Surgeons score, mean Walch–Duplay score, fatty infiltration of the subscapularis muscle and posterior protrusion of the screw. The arthroscopic technique yielded significantly superior results as for the non-union rate of the graft, the total graft osteolysis and graft resorption, the mean Western Ontario Shoulder Instability Index score and the early postoperative pain. Conclusions: Both the open and the arthroscopic Latarjet procedures led to satisfactory radiographic and clinical outcomes for the treatment of patients with recurrent anterior shoulder instability and significant glenoid bone loss. However, the overall quality of the studies ranged from low to moderate. Level of evidence: Comprehensive and systematic review of level II–III therapeutic studies. © 2019, Springer-Verlag France SAS, part of Springer Nature

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