166 research outputs found

    Suppression of spin-state transition in epitaxially strained LaCoO_{3}

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    Epitaxial thin films of LaCoO_{3} (E-LCO) exhibit ferromagnetic order with a transition temperature T_c = 85 K, while polycrystalline thin LaCoO_{3} films (P-LCO) remain paramagnetic. The temperature-dependent spin-state structure for both E-LCO and P-LCO was studied by x-ray absorption spectroscopy at the Co L_{2,3} and O K edges. Considerable spectral redistributions over temperature are observed for P-LCO. The spectra for E-LCO, on the other hand, do not show any significant changes for temperatures between 30 K and 450 K at both edges, indicating that the spin state remains constant and that the epitaxial strain inhibits any population of the low-spin (S = 0) state with decreasing temperature. This observation identifies an important prerequisite for ferromagnetism in E-LCO thin films.Comment: 5 pages, 5 figures, submitted to Physical Review

    The Clinical Frailty Scale is a useful tool for predicting postoperative complications following elective colon cancer surgery at the age of 80 years and above: A prospective, multicentre observational study

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    Aim Identification of the risks of postoperative complications may be challenging in older patients with heterogeneous physical and cognitive status. The aim of this multicentre, observational study was to identify variables that affect the outcomes of colon cancer surgery and, especially, to find tools to quantify the risks related to surgery. Method Patients aged >= 80 years with electively operated Stage I-III colon cancer were recruited. The prospectively collected data included comorbidities, results of the onco-geriatric screening tool (G8), Clinical Frailty Scale (CFS), Charlson Comorbidity Index (CCI) and Mini Nutritional Assessment-Short Form (MNA-SF), and operative and postoperative outcomes. Results A total of 161 patients (mean 84.5 years, range 80-97, 60% female) were included. History of cerebral stroke (64% vs. 37%, p = 0.02), albumin level 31-34 g/l compared with >= 35 g/l (57% vs. 32%, p = 0.007), CFS 3-4 and 5-9 compared with CFS 1-2 (49% and 47% vs. 16%, respectively) and American Society of Anesthesiologists score >3 (77% vs. 28%, P = 0.006) were related to a higher risk of complications. In multivariate logistic regression analysis CFS >= 3 (OR 6.06, 95% CI 1.88-19.5, p = 0.003) and albumin level 31-34 g/l (OR 3.88, 1.61-9.38, p = 0.003) were significantly associated with postoperative complications. Severe complications were more common in patients with chronic obstructive pulmonary disease (43% vs. 13%, p = 0.047), renal failure (25% vs. 12%, p = 0.021), albumin level 31-34 g/l (26% vs. 8%, p = 0.014) and CCI >6 (23% vs. 10%, p = 0.034). Conclusion Surgery on physically and cognitively fit aged colon cancer patients with CFS 1-2 can lead to excellent operative outcomes similar to those of younger patients. The CFS could be a useful screening tool for predicting postoperative complications.Peer reviewe

    Staged gasification of wood chips: test and characterization of a 75 kWth pilot plant

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    Un pilote de gazéification étagée de 75 kWth a été installé au Cirad. Il comprend 2 réacteurs couplés, l'un de pyrolyse, l'autre de gazéification et est instrumenté pour mesurer en continu les températures et pressions du procédé ainsi que la composition des gaz produits. Par ailleurs, une ligne d'échantillonnage des goudrons a été développée et utilisée dans le cadre de cette étude. Nous avons montré dans un premier temps qu'un régime stabilisé pouvait être atteint et maintenu à partir du contrôle de la hauteur du lit de biomasse dans le réacteur de gazéification. Dans un deuxième temps, les campagnes d'essais ont confirmé le potentiel des technologies dite "étagés" pour la production d'un gaz propre compatible avec une valorisation en moteur. Le gaz obtenu a un pouvoir calorifique de 5,8 MJ/Nm3 et ne contient qu'une très faible concentration de goudrons (inférieure à 10 mg/Nm3

    Design of a precision compactor for use in guided bone regeneration in the area of oral surgery

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    During the processes of guided bone regeneration in the maxillary bones, which aim to recover or preserve support tissue for the placement of implants on which dental prostheses are retained, the use of various particulate graft biomaterials from different sources (animal or synthetic) is standardized. At present, the pressure of compaction of this material in the recipient bone is manual, dependent on the clinician, although there is some scientific evidence on the effects of different compressive forces on angiogenesis and prognosis of the regeneration of the grafted areas. The aim of the present study is to design, calibrate and verify in vitro a compaction instrument for clinical use, which allows a controlled and precise compaction pressure of the particulate graft biomaterial and standardize the procedure. The designed instrument is a precision compactor of adequate size for proper intra and extraoral clinical manageability and manufactured in a sterilizable material by autoclaving. The range of compression that allows (0 -1, 82 Newton), is within the forces that are commonly applied in surgery and that have been determined by a specific test on 8 oral surgeons. Instrument calibration has been performed by an independent accredited company. The testing of the instrument was carried out by an in vitro test where the biomaterial was compacted at different forces (0, 80 and 1, 82 Newton) and was observed by a computerized micro-tomography that when increasing the compression force, decreased the space between particles provided for the migration and proliferation of new blood vessels and cells. Durante los procedimientos de regeneración ósea guiada en los huesos maxilares, que tienen como objetivo recuperar o preservar tejido de soporte para la colocación de implantes sobre los que se retienen las prótesis dentales, está estandarizado el uso de diversos biomateriales de injerto particulado de diferente procedencia (animal o sintético). En la actualidad la presión de compactación de dicho material en el hueso receptor es manual, clínico dependiente, pese a que existe cierta evidencia científica sobre los efectos de las diferentes fuerzas de compresión en la angiogénesis y pronóstico de la regeneración de las zonas injertadas. El objetivo del presente estudio es el de diseñar, calibrar y comprobar in vitro un instrumento de compactación para uso clínico, que permita una presión de compactación controlada y precisa del biomaterial de injerto particulado y estandarizar el procedimiento. El instrumento diseñado es un compactador de precisión de tamaño adecuado para una correcta manejabilidad clínica intra y extraoral y fabricado en un material esterilizable por autoclavado. El rango de compresión que permite (0 – 1, 82 Newton), está dentro de las fuerzas que se aplican comúnmente en cirugía y que se han determinado mediante una prueba específica sobre 8 cirujanos orales. La calibración del instrumento se ha realizado por una empresa acreditada independiente. La comprobación del instrumento se ha realizado mediante un ensayo in vitro donde se compactó el biomaterial a diferentes fuerzas (0, 80 y 1, 82 Newton) y se observó mediante micro-tomografía computerizada que al aumentar la fuerza de compresión disminuía el espacio entre partículas provisto para la migración y proliferación de los nuevos vasos sanguíneos y células

    Laparoscopic versus hybrid approach for treatment of incisional ventral hernia : a 5–10-year follow-up of the randomized controlled multicenter study

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    Purpose: In this long-term follow-up of a prospective, randomized, and multicenter study, we compare the results of a group receiving laparoscopic incisional ventral hernia repair using intraperitoneal onlay mesh (LG) to a group receiving a hybrid hernia repair where open closure of fascial defect was added to intraperitoneal mesh placement (HG). Methods: Originally, 193 patients with 2–7 cm incisional hernias were randomly assigned to either the LG or HG during the 30-month recruitment period in 2012 to 2015. Long-term follow-up was conducted 5–10 years after surgery to evaluate hernia recurrence rate and quality of life (QoL). Results: In all, 65 patients in the LG and 60 in the HG completed the long-term follow-up with a median follow-up period of 87 months. Recurrent hernia was detected in 11 of 65 patients (16.9%) in the LG and 10 of 60 patients (16.7%) in the HG (p > 0.9). Kaplan–Meier analysis demonstrated a recurrence rate approaching 20% in both groups, with similar curves. Three patients in the LG (4.6% and five patients in the HG (8.1%) had undergone re-operation due to recurrence (p = 0.48). There was no difference in patient-reported QoL measured using the SF-36 questionnaire. Mean pain scores were similar between groups, mean numeric rating scale (NRS) 0 to 10 being 1.1 in the LG and 0.7 in the HG (p = 0.43). Conclusion: Fascial closure did not reduce hernia recurrence rate in this study population, even though it has been shown to be beneficial and recommended in surgery guidelines. In the long term, recurrence rate for both groups is similar.Peer reviewe

    Robotic Wireless Sensor Networks

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    In this chapter, we present a literature survey of an emerging, cutting-edge, and multi-disciplinary field of research at the intersection of Robotics and Wireless Sensor Networks (WSN) which we refer to as Robotic Wireless Sensor Networks (RWSN). We define a RWSN as an autonomous networked multi-robot system that aims to achieve certain sensing goals while meeting and maintaining certain communication performance requirements, through cooperative control, learning and adaptation. While both of the component areas, i.e., Robotics and WSN, are very well-known and well-explored, there exist a whole set of new opportunities and research directions at the intersection of these two fields which are relatively or even completely unexplored. One such example would be the use of a set of robotic routers to set up a temporary communication path between a sender and a receiver that uses the controlled mobility to the advantage of packet routing. We find that there exist only a limited number of articles to be directly categorized as RWSN related works whereas there exist a range of articles in the robotics and the WSN literature that are also relevant to this new field of research. To connect the dots, we first identify the core problems and research trends related to RWSN such as connectivity, localization, routing, and robust flow of information. Next, we classify the existing research on RWSN as well as the relevant state-of-the-arts from robotics and WSN community according to the problems and trends identified in the first step. Lastly, we analyze what is missing in the existing literature, and identify topics that require more research attention in the future

    One-year functional outcomes of patients aged 80 years or more undergoing colonic cancer surgery: prospective, multicentre observational study

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    Background: Older patients are at high risk of experiencing delayed functional recovery after surgical treatment. This study aimed to identify factors that predict changes in the level of support for activities of daily living and mobility 1 year after colonic cancer surgery.Methods: This was a multicentre, observational study conforming to STROBE guidelines. The prospective data included pre-and postoperative mobility and need for support in daily activities, co-morbidities, onco-geriatric screening tool (G8), clinical frailty scale (CFS), operative data, and postoperative surgical outcomes.Results: A total of 167 patients aged 80 years or more with colonic cancer were recruited. After surgery, 30 per cent and 22 per cent of all patients had increased need for support and decreased motility. Multivariableanalysis with all patients demonstrated that preoperative support in daily activities outside the home (OR 3.23, 95 per cent c.i. 1.06 to 9.80, P = 0.039) was associated with an increased support at follow-up. A history of cognitive impairment (3.15, 1.06 to 9.34, P = 0.038) haemoglobin less than 120 g/l (7.48, 1.97 to 28.4, P = 0.003) and discharge to other medical facilities (4.72, 1.39 to 16.0, P = 0.013) were independently associated with declined mobility. With functionally independent patients, haemoglobin less than 120 g/l (8.31, 1.76 to 39.2, P = 0.008) and discharge to other medical facilities (4.38, 1.20 to 16.0, P = 0.026) were associated with declined mobility.Conclusion: Increased need for support before surgery, cognitive impairment, preoperative anaemia, and discharge to other medical facilities predicts an increased need for support or declined mobility 1 year after colonic cancer surgery. Preoperative assessment and optimization should focus on anaemia correction, nutritional status, and mobility with detailed rehabilitation plan.Greater increased need for support before surgery, cognitive impairment, preoperative anaemia, and discharge to other medical facilities predicted an increased need for support or declined mobility 1 year after colonic cancer surgery. Preoperative assessment and optimization should especially focus on anaemia correction, nutritional status, and mobility with a detailed rehabilitation plan.</p

    Imaging standardisation in metastatic colorectal cancer: A joint EORTC-ESOI-ESGAR expert consensus recommendation

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    Background: Treatment monitoring in metastatic colorectal cancer (mCRC) relies on imaging to evaluate the tumour burden. Response Evaluation Criteria in Solid Tumors provide a framework on reporting and interpretation of imaging findings yet offer no guidance on a standardised imaging protocol tailored to patients with mCRC. Imaging protocol hetero-geneity remains a challenge for the reproducibility of conventional imaging end-points and is an obstacle for research on novel imaging end-points.Patients and methods: Acknowledging the recently highlighted potential of radiomics and arti-ficial intelligence tools as decision support for patient care in mCRC, a multidisciplinary, international and expert panel of imaging specialists was formed to find consensus on mCRC imaging protocols using the Delphi method.Results: Under the guidance of the European Organisation for Research and Treatment of Cancer (EORTC) Imaging and Gastrointestinal Tract Cancer Groups, the European Society of Oncologic Imaging (ESOI) and the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), the EORTC-ESOI-ESGAR core imaging protocol was identified.Conclusion: This consensus protocol attempts to promote standardisation and to diminish variations in patient preparation, scan acquisition and scan reconstruction. We anticipate that this standardisation will increase reproducibility of radiomics and artificial intelligence studies and serve as a catalyst for future research on imaging end-points. For ongoing and future mCRC trials, we encourage principal investigators to support the dissemination of these im-aging standards across recruiting centres. (c) 2022 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)

    Síndrome de quemarse por el trabajo (burnout) en los médicos de España.

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    El Síndrome de Quemarse por el Trabajo (SQT) o "Burnout" es un problema de salud que puede afectar a profesionales de todo tipo, pero muy especialmente a aquellos cuya actividad guarda relación con el cuidado de seres humanos. Los profesionales de la salud están particularmente expuestos a este cuadro y los médicos son el prototipo de trabajador expuesto al mismo. Se trata de un problema de salud tremendamente destructivo que afecta a la vida laboral y personal, que lesiona la calidad del trabajo prestado y que deteriora los planos cognitivo y emocional del individuo, su vida familiar y hasta su salud física
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