Comparison of laparoscopic steerable instruments performed by expert surgeons and novices

As an alternative to the surgical robot, some medical companies have engineered new steerable devices that mimic the robot's capacities. This study aimed to assess how steerable instruments ameliorate the efficacy of suturing in comparison with the traditional instrument, and a combination instruments, performed by experienced and novice surgeons. The study was performed by three experienced surgeons and three novice surgeons. The instruments employed were divided into three surgical sets: two steerable dissectors; one steerable dissector and one straight needle ; two straight needle holders. The study supervisor recorded the total time for the procedure, the number of bites completed, the time for each bite, and the quality of the procedure. In our study, we found consistent data demonstrating that experienced laparoscopists completed the prescribed suture pattern with more bites in less time than novices. The use of two steerable instruments was more time consuming than standard straight instruments, but a combination of instruments was significantly less time consuming, as was the use of two straight needle holders. This result was even observed in novice surgeons. Combining a steerable instrument with a traditional straight needle holder provided more advantages in this study

Thermally driven circulation in a region of complex topography: comparison of wind-profiling radar measurements and MM5 numerical predictions

The diurnal variation of regional wind patterns in the complex terrain of Central Italy was investigated for summer fair-weather conditions and winter time periods using a radar wind profiler. The profiler is located on a site where interaction between the complex topography and land-surface produces a variety of thermally and dynamically driven wind systems. The observational data set, collected for a period of one year, was used first to describe the diurnal evolution of thermal driven winds, second to validate the Mesoscale Model 5 (MM5) that is a three-dimensional numerical model. This type of analysis was focused on the near-surface wind observation, since thermally driven winds occur in the lower atmosphere. According to the valley wind theory expectations, the site – located on the left sidewall of the valley (looking up valley) – experiences a clockwise turning with time. Same characteristics in the behavior were established in both the experimental and numerical results. <P style="line-height: 20px;"> Because the thermally driven flows can have some depth and may be influenced mainly by model errors, as a third step the analysis focuses on a subset of cases to explore four different MM5 Planetary Boundary Layer (PBL) parameterizations. The reason is to test how the results are sensitive to the selected PBL parameterization, and to identify the better parameterization if it is possible. For this purpose we analysed the MM5 output for the whole PBL levels. The chosen PBL parameterizations are: 1) Gayno-Seaman; 2) Medium-Range Forecast; 3) Mellor-Yamada scheme as used in the ETA model; and 4) Blackadar

Rationale, experimental data, and emerging clinical evidence on early and preventive use of levosimendan in patients with ventricular dysfunction

Acute ventricular dysfunction (AVD) is a complex condition with substantial morbidity and mortality, still featuring unique therapeutic challenges. Levosimendan is a calcium sensitizer and ATP-dependent potassium channel opener that was developed as an inodilating drug for the treatment of acute heart failure and cardiogenic shock. Differently from other more widely used inotropic agents, levosimendan has some exclusive characteristics, in terms of mechanisms of action, pharmacodynamic profile, and haemodynamic effects. This may have important clinical implications. In particular, in patients with AVD or in patients with pre-existing severe ventricular impairment undergoing planned myocardial stress, the administration of levosimendan before the onset of overt symptoms or before cardiovascular therapeutic procedures may have the potential to bridge the patient through the critical phase. In this review, we will focus on the rationale, the existing experimental data, and the emerging clinical experience supporting an early, even preventive use of levosimendan in severe ventricular dysfunction, beyond its recognized indications

Seismotectonics of the Southern Apennines and Adriatic foreland: insights on active regional E-W shear zones from analogue modeling

The active tectonics at the front of the Southern Apennines and in the Adriatic foreland is characterized by E-W striking, right-lateral seismogenic faults, interpreted as reactivated inherited discontinuities. The best studied among these is the Molise-Gondola shear zone (MGsz). The interaction of these shear zones with the Apennines chain is not yet clear. To address this open question we developed a set of scaled analogue experiments, aimed at analyzing: 1) how dextral strike-slip motion along a pre-existing zone of weakness within the foreland propagates toward the surface and affects the orogenic wedge; 2) the propagation of deformation as a function of displacement; 3) any insights on the active tectonics of Southern Italy. Our results stress the primary role played by these inherited structures when reactivated, and confirm that regional E-W dextral shear zones are a plausible way of explaining the seismotectonic setting of the external areas of the Southern Apennines

Modes of fault reactivation from analogue modeling experiments: implications for the seismotectonics of the southern Adriatic foreland (Italy)

The active tectonics at the front of the Southern Apennines and in the Adriatic foreland is characterized by E-W striking, right-lateral seismogenic faults, interpreted as reactivated inherited discontinuities. The best studied among these is the Molise-Gondola shear zone (MGsz). The interaction of these shear zones with the Apennines chain is not yet clear. To address this open question we developed a set of scaled analogue experiments, aimed at analyzing: 1) how dextral strike-slip motion along a pre-existing zone of weakness within the foreland propagates toward the surface and affects the orogenic wedge; 2) the propagation of deformation as a function of increasing displacement; 3) any insights on the active tectonics of Southern Italy. Our results stress the primary role played by these inherited structures when reactivated, and confirm that regional EW dextral shear zones are a plausible way of explaining the seismotectonic setting of the external areas of the Southern Apennines

Approaching the seismogenic source of the Calabria 8 September 1905 earthquake: New geophysical, geological and biochemical data from the S. Eufemia Gulf (S Italy)

Recognizing the seismogenic source of major historical earthquakes, particularly when these have occurred offshore, is a long-standing issue across the Mediterranean Sea and elsewhere. The destructive earthquake (M ~7) that struck western Calabria (southern Italy) on the night of 8 September 1905 is one such case. having various authors proposed a seismogenic source, with apparently diverse hypotheses and without achieving a unique solution. To gain novel insight into the crustal volume where the 1905 earthquake took place and to seek a more robust solution for the seismogenic source associated with this destructive event, we carried out a well-targeted multidisciplinary survey within the Gulf of S. Eufemia (SE Tyrrhenian Sea), collecting geophysical data, oceanographic measurements, and biological, chemical and sedimentary samples. We identified three main tectonic features affecting the sedimentary basin in the Gulf of S. Eufemia: 1) a NE-SW striking, ca. 13-km-long, normal fault, here named S. Eufemia Fault; 2) a WNW-striking polyphased fault system; and 3) a likely E-W trending lineament. Among these, the normal fault shows evidence of activity witnessed by the deformed recent sediments and by its seabed rupture along which, locally, fluid leakage occurs. Features in agreement with the anomalous distribution of prokaryotic abundance and biopolymeric C content, resulted from the shallow sediments analyses. The numerous seismogenic sources proposed in the literature during the past 15 years make up a composite framework of this sector of western Calabria, that we tested against a) the geological evidence from the newly acquired dataset, and b) the regional seismotectonic models. Such assessment allows us to propose the NE-SW striking normal fault as the most probable candidate for the seismogenic source of the 1905 earthquake. Re-appraising a major historical earthquake as the 1905 one enhances the seismotectonic picture of western Calabria. Further understanding of the region and better constraining the location of the seismogenic source may be attained through integrated interpretation of our data together with a) on-land field evidence, and b) seismological modeling

Evaluation of Weight Gain, Clinicopathological and Radiographic Changes after Early Diagnosis and Treatment of Congenital Hypothyroidism in Cats

Congenital hypothyroidism is uncommon in cats. This case report describes weight gain, clinicopathological and radiographic changes after early diagnosis and treatment of congenital hypothyroidism in three British shorthair cats’ siblings. Data were assessed at 53 (diagnosis), 83, 185 and 365 days of age. Correlations between serum insulin-like growth factor-1 (IGF-1) and body weight, levothyroxine dose, total thyroxine, and thyroid-stimulating hormone concentrations were evaluated. The body weights of the congenital hypothyroid kittens were compared with those of their two healthy siblings and British shorthair kittens of the same age. At diagnosis, the congenital hypothyroid kittens showed a significantly lower body weight compared to the healthy siblings (p = 0.03). After diagnosis, oral levothyroxine supplementation was started. The difference in body weight was no longer observed after one month of treatment. The clinical signs, clinicopathological and radiographic abnormalities ameliorated after one month of treatment. IGF-1 concentration was significantly positively correlated with body weight (rs = 0.80, p < 0.002). In conclusion, resolution of the clinical signs, achieving a consistent within-breed weight, and improvement of the clinico-pathological and radiographic parameters demonstrated the importance of the early diagnosis and treatment of feline congenital hypothyroidism

Evaluation of clinicopathological features in cats with chronic gastrointestinal signs

Food-responsive enteropathy (FRE), idiopathic inflammatory bowel disease (IBD), and alimentary tract lymphoma (AL) are often the remaining differentials for cats presenting with chronic gastrointestinal (GI) signs. Differential diagnosis is further complicated by overlapping clinicopathological features and histopathological changes, however. In this study we describe the clinical presentation of cats with chronic GI signs secondary to FRE, IBD, and AL, and evaluate possible associations between clinical, clinicopathological, ultrasonographic findings and diagnosis. The medical records of client-owned cats with chronic GI signs secondary to FRE, IBD, and AL were reviewed. Univariate and multivariate logistic regression models and receiver-operating characteristic curve (ROC) analysis were used for testing the data. Of the 56 cats included in the study, 22 were diagnosed with FRE (mean age, 70 months ± 49), 17 with IBD (mean age, 101 months ± 40), and 17 with AL (mean age, 122 months ± 45). Cats with FRE were younger and presented more often with diarrhea and less frequently with muscle wasting than cats with IBD or AL. In cats with AL, serum cobalamin levels were lower than in those with FRE or IBD (239 ± 190 ng/L vs. 762 ± 408 ng/L and 625 ± 443 ng/L, respectively) and folate levels were higher than in cats with IBD (18.2 ± 4.2 μg/L vs. 9.1 ± 4.7 μg/L, respectively). Multivariate/ROC curve analysis showed increased values of BUN (sensitivity 100, specificity 29.4, criterion >37 mg/dl) and serum folate (sensitivity 80, specificity 100, criterion >15.6 μg/L) and reduced values of cobalamin (sensitivity 100, specificity 62.5, criterion â¤540 ng/L), which suggested a diagnosis of AL versus IBD. Some clinicopathological features evaluated at diagnosis might suggest AL; however, because differentiating AL from IBD is often difficult, definitive diagnosis should be based on invasive diagnostic workup

Plasma technology increases the efficacy of prothioconazole against fusarium graminearum and fusarium proliferatum contamination of maize (Zea mays) seedlings

The contamination of maize by Fusarium species able to produce mycotoxins raises great concern worldwide since they can accumulate these toxic metabolites in field crop products. Further-more, little information exists today on the ability of Fusarium proliferatum and Fusarium graminearum, two well know mycotoxigenic species, to translocate from the seeds to the plants up to the kernels. Marketing seeds coated with fungicide molecules is a common practice; however, since there is a growing need for reducing chemicals in agriculture, new eco-friendly strategies are increasingly tested. Technologies based on ionized gases, known as plasmas, have been used for decades, with newer material surfaces, products, and approaches developed continuously. In this research, we tested a plasma-generated bilayer coating for encapsulating prothioconazole at the surface of maize seeds, to protect them from F. graminearum and F. proliferatum infection. A minimum amount of chemical was used, in direct contact with the seeds, with no dispersion in the soil. The ability of F. graminearum and F. proliferatum species to translocate from seeds to seedlings of maize has been clearly proven in our in vitro experiments. As for the use of plasma technology, the combined use of the plasma-generated coating with embedded prothioconazole was the most efficient approach, with a higher reduction of the infection of the maize seminal root system and stems. The debated capability of the two Fusarium species to translocate from seeds to seedlings has been demonstrated. The plasma-generated coating with embedded prothioconazole resulted in a promising sustainable approach for the protection of maize seedlings

Calcium and phosphate homeostasis in dogs with newly diagnosed naturally occurring hypercortisolism

Background: Hypercortisolism affects calcium and phosphate metabolism in dogs; however, the exact mechanisms are not completely understood. Objectives: To evaluate circulating concentrations of whole parathormone (wPTH), 25-hydroxyvitamin D (25-(OH)D), calcitriol, and fibroblast growth factor-23 (FGF-23) in dogs with naturally occurring hypercortisolism (NOHC) and healthy dogs, and their association with calcium and phosphate homeostasis. Animals: Twenty-three client-owned dogs with NOHC, and 12 client or staff-owned healthy dogs. Methods: Prospective cross-sectional study. The circulating concentrations of total calcium, ionized calcium (iCa), phosphate, wPTH, 25-(OH)D, calcitriol and FGF-23, and the urinary fractional excretion of phosphate (FEP) and calcium (FECa) were compared between dogs with NOHC before treatment and healthy dogs. Results: Dogs with NOHC had higher mean serum phosphate concentrations (4.81 mg/dL, SD ± 0.71 vs 3.86 mg/dL, SD ± 0.60; P <.001), median FECa (0.43%, range, 0.03-2.44 vs 0.15%, range, 0.06-0.35; P =.005), and median serum wPTH concentrations (54.6 pg/mL, range, 23.7-490 vs 24.6 pg/mL, range, 5.5-56.4; P =.003) as compared to the controls. Circulating concentrations of total calcium, iCa, and calcitriol and the FEP did not differ between groups, whereas the serum 25-(OH)D concentrations were lower in dogs with NOHC as compared to the controls (70.2 pg/mL, SD ± 42.3 vs 106.3 pg/mL, SD ± 35.3; P =.02). The dogs with NOHC had lower plasma FGF-23 concentrations than controls (316.6 pg/mL, range, 120.8-575.6 vs 448.7 pg/mL, range, 244.8-753; P =.03). Conclusions and Clinical Importance: Urine loss of calcium and hyperphosphatemia could contribute to the adrenal secondary hyperparathyroidism