Determinación de procesos de fractura sobre huesos frescos: un sistema de análisis de los ángulos de los planos de fracturación como discriminador de agentes bióticos

The breakage planes of bones have diversely been used to classify breakage patterns. However, no diagnosis seems to be currently valid to differentiate between humans and carnivores as the main breaking agents. This work presents the results of experimentation focused on the analysis of the angles of each plane between the cortical and medullary surfaces resulting from breakage. It is shown that this approach can be fairly resolutive since both types of agents break bones through different physical processes (percussion and pression) which produce different angles in each fracture episode, as a result of the use of dynamic and static loading processes.Los paños de fractura de los huesos siempre se han prestado a diversos análisis de clasificación, pero con menor éxito se ha podido averiguar el (los) agente(s) responsable( s) de su ruptura. De los diversos atributos utilizados, uno de ellos (los ángulos de los planos de fractura) se ha sometido a exhaustivo análisis, con los resultados que se ofrecen en el presente trabajo. Se concluye que dichos ángulos, en su consideración global en una muestra pueden ser resolutivos ya que los diversos agentes bióticos que rompen huesos (humanos y carnívoros) lo hacen por procesos físicos distintos (percusión y presión) que provocan diagnosis diferenciadas en el modo en que los huesos aparecen fracturados

Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago

Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results: 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P < 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions: After 100 years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception

The two-stage constrained equal awards and losses rules for multi-issue allocation situations

Bankruptcy problems, Multi-issue allocation situations, Constrained equal awards, Constrained equal losses, Two-stage solutions, 91A12, 91B14,

The Two-Stage Constrained Equal Awards and Losses Rules for Multi-Issue Allocation Situation

This paper considers two-stage solutions for multi-issue allocation situations.Characterisations are provided for the two-stage constrained equal awards and constrained equal losses rules, based on the properties of composition and path independence.