Total Gastrectomy for locally advanced Cancer: The total Laparoscopic Approach

Total gastrectomy is the treatment of choice for adenocarcinoma of the upper and middle third of the stomach resected with curative intent. The laparoscopic approach allows satisfactory exploration of the peritoneal cavity and optimizes staging in borderline T3 or T4 tumours in patients affected by locally advanced tumours or intraperitoneal carcinomatosis. Laparoscopy can eliminate unnecessary laparotomies in 10 % of patients affected by these conditions with formal contraindications for resection [1] . Complete resection of the stomach associated with D2 lymph node dissection is also performed using a currently well-established technique [2, 3] . The specificity of laparoscopic gastric resection for cancer is that the stomach and the greatomentum are withdrawn separately.Reconstruction of the digestive tract is more complex, and requires a variety of techniques (supra-umbilical mini-laparotomy, Orvil® technique, enlarging a port-site for passage of a circular stapler, mechanical side to side anastomosis, etc), but none ofthese has become the gold standard [4-7] . This explains the difficulties encountered in promoting the widespread use of minimally invasive resection in western countries. Scientific societies insist on the need for prospective studies to establish the place of laparoscopy for gastric cancer (prophylactic gastrectomy for CDH-1 related gastric cancer, < T3 Tumours, palliative gastrectomy) [4] . Here, we present our technique for total resection of the stomach and D2 lymph node dissection, which allows the manualcreation of a feasible, safe, tension-free and effective esojejunal anastomosis. It can be performed by any surgeon familiar with laparoscopic surgery and the principles of oncologic resection. The cost is also relatively low because neither a circular staplernor other special equipment is required. Finally, the incision for extraction of the specimen can be placed in any area of the abdomen (usually through a supra-pubic incision in our practice).Keywords: Gastric cancer, laparoscopy, total gastrectomy, lymphadenectomy, Intracorporeal anastomosis.Total gastrectomy is the treatment of choice for adenocarcinoma of the upper and middle third of the stomach resected with curative intent. The laparoscopic approach allows satisfactory exploration of the peritoneal cavity and optimizes staging in borderline T3 or T4 tumours in patients affected by locally advanced tumours or intraperitoneal carcinomatosis. Laparoscopy can eliminate unnecessary laparotomies in 10 % of patients affected by these conditions with formal contraindications for resection [1] . Complete resection of the stomach associated with D2 lymph node dissection is also performed using a currently well-established technique [2, 3] . The specificity of laparoscopic gastric resection for cancer is that the stomach and the great omentum are withdrawn separately.Reconstruction of the digestive tract is more complex, and requires a variety of techniques (supra-umbilical mini-laparotomy, Orvil® technique, enlarging a port-site for passage of a circular stapler, mechanical side to side anastomosis, etc), but none of these has become the gold standard [4-7] . This explains the difficulties encountered in promoting the widespread use of minimally invasive resection in western countries. Scientific societies insist on the need for prospective studies to establish the place of laparoscopy for gastric cancer (prophylactic gastrectomy for CDH-1 related gastric cancer, < T3 Tumours, palliative gastrectomy) [4] . Here, we present our technique for total resection of the stomach and D2 lymph node dissection, which allows the manual creation of a feasible, safe, tension-free and effective esojejunal anastomosis. It can be performed by any surgeon familiar with laparoscopic surgery and the principles of oncologic resection. The cost is also relatively low because neither a circular stapler nor other special equipment is required. Finally, the incision for extraction of the specimen can be placed in any area of the abdomen (usually through a supra-pubic incision in our practice).Keywords: Gastric cancer, laparoscopy, total gastrectomy, lymphadenectomy, Intracorporeal anastomosis

A benchmark for orientation control of a multirotor in a three degrees-of-freedom rotation structure

[EN] A fully equipped quadrotor is attached to a structure that allows free rotation without translation. Additionally, a set of MATLAB-Simulink® tools execute the flight controller programming and manage the real-time transmission of commands and flight states for the remote pilot. For this test bench a simulator is offered. It faithfully reproduces the behaviour of the real system in order to propose a benchmark on Control Engineering. This aims to control the quadrotor orientation described using the Euler angles. Thus the three control actions that attack the propulsion system must be generated taking into account the rotation speeds and angles that are estimated by the navigation system and the angle set points. During the performance tests, a modifiable supply voltage replaces the battery charge level and a control action emulates the height control, resulting in dierent operating points of the system as in a real flight. The simulator allows free setup of closed and open loop experiments for model identification tasks or analysing the control performance for dierent inputs and operating points. The final objective is to incorporate a control law that improves the behaviour given as a reference for a certain experiment. After a simulation, an evaluation function quantifies the dierences in tracking error and control action between the current control and the reference control for each degree of freedom. The main challenge is a narrow control bandwidth to govern a complex three-variable system.[ES] Un cuatrirrotor con todo el equipamiento de vuelo se encuentra fijado a una estructura que permite la rotación en el espacio sin desplazamiento. Además, un conjunto de herramientas software desarrolladas con MATLAB-Simulink® ejecutan la programación de su controladora y gestionan la transmisión en tiempo real de consignas y estados del vuelo pilotado remotamente. Para este banco de pruebas se ofrece un simulador que reproduce fielmente el comportamiento del sistema real con el fin de plantear un benchmark de Ingeniería de Control. El problema propuesto es controlar la orientación del mutirrotor definida por los ángulos de Euler. Para ello, deben generarse las tres acciones de control que atacan al sistema de propulsión, considerando las velocidades y ángulos que estima el sistema de navegacion y las consignas angulares. Para lograr un mayor realismo, en las pruebas de comportamiento se pueden modificar la tensión de alimentación, que simula el nivel de carga de la batería, y una acción de control que emula el control de la altura, lo que da lugar a diferentes puntos de operación. El simulador permite configurar experimentos en lazo abierto o cerrado, para tareas de identificación o para analizar el comportamiento de los controladores en diferentes puntos de operación y ante diferentes entradas. El objetivo final es incorporar una ley de control que mejore el comportamiento dado como referencia para cierto experimento. Tras una simulación, una función de evaluación cuantifica las diferencias en el error de seguimiento y en la acción de control entre el control actual y el de referencia para cada grado de libertad. El principal desafío es optimizar el reducido ancho de banda disponible para controlar un sistema dinámico complejo.Los autores agradecen la ayuda prestada por el Gobierno de La Rioja a través del proyecto de I+D ADER 2017-I-IDD00035, y por la Universidad de La Rioja a través de la Ayuda para la realización de Proyectos de Innovación Docente 2020 PID Nº 36 y la Ayuda a Grupos de Investigación REGI2020 /23.Rico-Azagra, J.; Gil-Martínez, M.; Rico, R.; Nájera, S.; Elvira, C. (2021). Benchmark de control de la orientación de un multirrotor en una estructura de rotación con tres grados de libertad. Revista Iberoamericana de Automática e Informática industrial. 18(3):265-276. https://doi.org/10.4995/riai.2021.14356OJS265276183Bejarano, G., Alfaya, J., Rodriguez, D., Ortega, M., Morilla, F., 2019. Control de un sistema de refrigeración. Visitado 27.03.2021. URL: http://www.dia.uned.es/∼fmorilla/CIC2019/Bigazzi, L., Gherardini, S., Innocenti, G., Basso, M., 2021. Development of non expensive technologies for precise maneuvering of completely autonomous unmanned aerial vehicles. Sensors (Switzerland) 21 (2), 1-24. https://doi.org/10.3390/s21020391Blasco, X., García-Nieto, S., Reynoso-Meza, G., 2012. Control autónomo del seguimiento de trayectorias de un vehículo cuatrirrotor. Simulación y evaluación de propuestas. Revista Iberoamericana de Automática e Informática Industrial 9 (2), 194-199. https://doi.org/10.1016/j.riai.2012.01.001Bo, G., Xin, L., Hui, Z., Ling, W., 2016. Quadrotor helicopter attitude control using cascade PID. 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In: 2015 23rd Mediterranean Conference on Control and Automation, MED 2015 - Conference Proceedings. pp. 865-870. https://doi.org/10.1109/MED.2015.7158854González-Vargas, A., Serna-Ramírez, J., Fory-Aguirre, C., Ojeda-Misses, A., Cardona-Ordoñez, J., Tombé-Andrade, J., Soria-López, A., 2019. A low-cost, free-software platform with hard real-time performance for control engineering education. Computer Applications in Engineering Education 27 (2), 406-418. https://doi.org/10.1002/cae.22084Hancer, M., Bitirgen, R., Bayezit, I., 2018. Designing 3-DOF hardware-inthe-loop test platform controlling multirotor vehicles. IFAC-PapersOnLine 51 (4), 119-124. https://doi.org/10.1016/j.ifacol.2018.06.058Kangunde, V., Jamisola, R.S., J., Theophilus, E., 2021. A review on drones controlled in real-time. International Journal of Dynamics and Control.https://doi.org/10.1007/s40435-020-00737-5Khan, S., Jaffery, M. H., Hanif, A., Asif, M. R., 2017. Teaching tool for a control systems laboratory using a quadrotor as a plant in MATLAB. IEEE Transactions on Education 60 (4), 249-256. https://doi.org/10.1109/TE.2017.2653762Lim, H., Park, J., Lee, D., Kim, H., 2012. Build your own quadrotor: Opensource projects on unmanned aerial vehicles. IEEE Robotics and Automation Magazine 19 (3), 33-45. https://doi.org/10.1109/MRA.2012.2205629Lotufo, M., Colangelo, L., Perez-Montenegro, C., Canuto, E., Novara, C., 2019. UAV quadrotor attitude control: An ADRC-EMC combined approach. Control Engineering Practice 84, 13-22. https://doi.org/10.1016/j.conengprac.2018.11.002Madridano, A., Campos, S., Al-Kaff, A., García, F., Martín, D., Escalera, A., 2020. Vehículo aéreo no tripulado para vigilancia y monitorización de incendios. Revista Iberoamericana de Automática e Informática industrial 17 (3), 254-263. https://doi.org/10.4995/riai.2020.11806Mercader, P., Cánovas, C. D., Baños, A., 2019. Control PID multivariable de una caldera de vapor. Revista Iberoamericana de Automática e Informática Industrial 16 (1), 15-25. https://doi.org/10.4995/riai.2018.9034Morilla, F., Rodríguez, C., 2017. Control de una caldera de vapor. Visitado 27.03.2021. URL: http://www.dia.uned.es/∼fmorilla/CIC2017/Nájera, S., Rico-Azagra, J., Elvira, C., Gil-Martínez, M., 2019. Plataforma giroscópica realizada mediante impresión 3D para el control de actitud y orientación de UAVs multi-rotor. In: Actas de las XL Jornadas de Automática, Comité Español de Automática de la IFAC. pp. 317-323. https://doi.org/10.17979/spudc.9788497497169.317Nascimento, T. P., Saska, M., 2019. Position and attitude control of multi-rotor aerial vehicles: A survey. Annual Reviews in Control 48, 129-146. https://doi.org/10.1016/j.arcontrol.2019.08.004Rico, R., Maisterra, P., Gil-Martínez, M., Rico-Azagra, J., S., N., 2015. Identificación experimental de los parámetros de un cuatrirrotor. In: Actas de las XXXVI Jornadas de Automática, Comité Español de Automática de la 'IFAC. pp. 973-982.Rico-Azagra, J., Gil-Martínez, M., Rico, R., Maisterra, P., 2016a. Plataforma didáctica de bajo coste para el control de actitud y orientación de UAVs multi-rotor. In: Actas de las XXXVII Jornadas de Automática, Comité Español de Automática de la IFAC. pp. 989-997.Rico-Azagra, J., Gil-Martínez, M., Rico-Azagra, R., Maisterra, P., 2016b. Low-cost attitude estimation for a ground vehicle. Advances in Intelligent Systems and Computing 417, 121-132. https://doi.org/10.1007/978-3-319-27146-0Rico-Azagra, J., Rico, R., Maisterra, P., Gil-Martínez, M., 2015. Comparación de algoritmos de estimación de actitud. In: Actas de las XXXVI Jornadas de Automática, Comité Español de Automática de la IFAC. pp. 911-920.Romero, J. A., Sanchis, R., 2011. Benchmark para la evaluación de algoritmos de auto-ajuste de controladores PID. Revista Iberoamericana de Automática e Informática Industrial 8 (1), 112-117. https://doi.org/10.4995/RIAI.2011.01.13Rubí, B., Perez, R., Morcego, B., 2020. A survey of path following control strategies for UAVs focused on quadrotors. Journal of Intelligent and Robotic Systems: Theory and Applications 98 (2), 241-265. https://doi.org/10.1007/s10846-019-01085-zShakhatreh, H., Sawalmeh, A. H., Al-Fuqaha, A., Dou, Z., Almaita, E., Khalil, I., Othman, N. S., Khreishah, A., Guizani, M., 2019. Unmanned aerial vehicles (UAVs): A survey on civil applications and key research challenges. IEEE Access 7, 48572-48634. https://doi.org/10.1109/ACCESS.2019.2909530Shraim, H., Awada, A., Youness, R., 2018. A survey on quadrotors: Configurations, modeling and identification, control, collision avoidance, fault diagnosis and tolerant control. IEEE Aerospace and Electronic Systems Magazine 33 (7), 14-33. https://doi.org/10.1109/MAES.2018.160246Shuster, M. D., 1993. Survey of attitude representations. Journal of the Astronautical Sciences 41 (4), 439-517.Sanchez-Fontes, E., Vilchis, J. A., Vilchis-González, A., Saldivar, B., Jacinto- 'Villegas, J., Martínez-Mendez, R., 2020. Nuevo vehículo aéreo autónomo estable por construcción: configuración y modelo dinámico. Revista Ibero-americana de Automática e Informática industrial 17 (3), 264-275. https://doi.org/10.4995/riai.2020.11603SolidWorks, 2018. Versión 2018. Dassault Systèmes S.A., Vélizy-Villacoublay, Francia.Wang, P., Man, Z., Cao, Z., Zheng, J., Zhao, Y., 2016. Dynamics modelling and linear control of quadcopter. In: International Conference on Advanced Mechatronic Systems, ICAMechS. Vol. 0. pp. 498-503. https://doi.org/10.1109/ICAMechS.2016.7813499Zhang, X., Li, X., Wang, K., Lu, Y., 2014. A survey of modelling and identification of quadrotor robot. Abstract and Applied Analysis 2014, Article ID 320526, 16 pages. https://doi.org/10.1155/2014/32052

Oligosaccharides Modulate Rotavirus-Associated Dysbiosis and TLR Gene Expression in Neonatal Rats

Colonization of the gut in early life can be altered through multiple environmental factors. The present study aimed to investigate the effects of 2'-fucosyllactose (2'-FL), a mixture of short-chain galactooligosaccharides/long-chain fructooligosaccharides (scGOS/lcFOS) 9:1 and their combination (scGOS/lcFOS/2'-FL) on dysbiosis induced during rotavirus (RV) diarrhea in neonatal rats, elucidating crosstalk between bacteria and the immune system. The dietary interventions were administered daily by oral gavage at days 2-8 of life in neonatal Lewis rats. On day 5, RV SA11 was intragastrically delivered to induce infection and diarrhea assessment, microbiota composition, and gene expression of Toll-like receptors (TLRs) in the small intestine were studied. All dietary interventions showed reduction in clinical variables of RV-induced diarrhea. RV infection increased TLR2 expression, whereas 2'-FL boosted TLR5 and TLR7 expressions and scGOS/lcFOS increased that of TLR9. RV-infected rats displayed an intestinal dysbiosis that was effectively prevented by the dietary interventions, and consequently, their microbiota was more similar to microbiota of the noninfected groups. The preventive effect of 2'-FL, scGOS/lcFOS, and their combination on dysbiosis associated to RV diarrhea in rats could be due to changes in the crosstalk between gut microbiota and the innate immune system

Immunomodulatory and Prebiotic Effects of 2'-Fucosyllactose in Suckling Rats

Human milk oligosaccharides are unconjugated complex glycans present in high concentration in human milk that serve as pre-biotics and immunomodulators. They are not primarily absorbed or metabolized by the infant and reach the lower part of the intestinal tract unaltered. One of the main oligosaccharides found in human milk is 2'-fucosyllactose (2'-FL). This study aimed to investigate the effects of daily oral administration of 2'-FL in healthy suckling rats. From days 2 to 16 of life, rats were daily given the oligosaccharide (2'-FL) or vehicle (REF), weighed and their stool characteristics were assessed. On days 8 and 16 of life the morphometry, intestinal architecture, and cytokine release, mesenteric lymph nodes cell composition, plasma immunoglobulin concentrations, fecal microbiota composition, cecal short-chain fatty acids content, and the urinary metabolic profile were assessed. Animals given 2'-FL showed higher plasma IgG and IgA and more T cell subsets in the mesenteric lymph nodes on day 16. Moreover, at intestinal level, villus heights, and areas were increased on day 8. Cecal samples displayed a higher Lactobacillus proportion and a different urinary metabolic profile was observed on day 8, and a higher proportion of butyrate on day 16. In conclusion, supplementation of 2'-FL in early life has a pre-biotic and intestinal trophic effect and promotes maturation of the immune system

Orion-KL Observations with the Extended Tuning Range of the New SEPIA660 APEX Facility Instrument

During Science Verification of the new SEPIA660 facility receiver at APEX, we carried out a shallow line survey of the archetypal Kleinmann- Low Nebula in the Orion star forming region (Orion-KL). These observations cover the tuning range towards the band edges, which has recently been extended beyond ALMA Band 9 specifications. At these frequencies, atmospheric transmission is very low but still sufficient to detect bright lines in Orion-KL. We present the collected spectra and compare with surveys from the literature, demonstrating the capabilities of the instrument

Early Life Prebiotic effect on the intestinal microbiota composition and functionality

Podeu consultar el III Workshop anual INSA-UB complet a: http://hdl.handle.net/2445/118993Sessió 2. Comunicació oral núm.

The SEDIGISM survey: First Data Release and overview of the Galactic structure

The SEDIGISM (Structure, Excitation and Dynamics of the Inner Galactic Interstellar Medium) survey used the APEX telescope to map 84 deg$^2$ of the Galactic plane between ℓ = −60° and +31° in several molecular transitions, including $^{13}$CO (2 – 1) and C$^{18}$O (2 – 1), thus probing the moderately dense (∼10$^3$ cm$^{-3}$) component of the interstellar medium. With an angular resolution of 30 arcsec and a typical 1σ sensitivity of 0.8–1.0 K at 0.25 km s$^{-1}$ velocity resolution, it gives access to a wide range of structures, from individual star-forming clumps to giant molecular clouds and complexes. The coverage includes a good fraction of the first and fourth Galactic quadrants, allowing us to constrain the large-scale distribution of cold molecular gas in the inner Galaxy. In this paper, we provide an updated overview of the full survey and the data reduction procedures used. We also assess the quality of these data and describe the data products that are being made publicly available as part of this First Data Release (DR1). We present integrated maps and position–velocity maps of the molecular gas and use these to investigate the correlation between the molecular gas and the large-scale structural features of the Milky Way such as the spiral arms, Galactic bar and Galactic Centre. We find that approximately 60 per cent of the molecular gas is associated with the spiral arms and these appear as strong intensity peaks in the derived Galactocentric distribution. We also find strong peaks in intensity at specific longitudes that correspond to the Galactic Centre and well-known star-forming complexes, revealing that the $^{13}$CO emission is concentrated in a small number of complexes rather than evenly distributed along spiral arms

Perioperative outcome of laparoscopic left lateral liver resection is improved by using a bioabsorbable staple line reinforcement material in a porcine model

Hypothesis Laparoscopic liver surgery is significantly limited by the technical difficulty encountered during transection of substantial liver parenchyma, with intraoperative bleeding and bile leaks. This study tested whether the use of a bioabsorble staple line reinforcement material would improve outcome during stapled laparoscopic left lateral liver resection in a porcine model. Study design A total of 20 female pigs underwent stapled laparoscopic left lateral liver resection. In group A (n = 10), the stapling devices were buttressed with a bioabsorbable staple line reinforcement material. In group B (n = 10), standard laparoscopic staplers were used. Operative data and perioperative complications were recorded. Necropsy studies and histopathological analysis were performed at 6 weeks. Data were compared between groups with the Student's t-test or the chi-square test. Results Operating time was similar in the two groups (64 +/- 11 min in group A versus 68 +/- 9 min in group B, p = ns). Intraoperative blood loss was significantly higher in group B (185 +/- 9 mL versus 25 +/- 5 mL, p <0.05). There was no mortality. There was no morbidity in the 6-week follow-up period; however, two animals in group B had subphrenic bilomas (20%) at necropsy. At necropsy, methylene blue injection via the main bile duct revealed leakage from the biliary tree in four animals in group B and none in group A (p <0.05). Histopathological examination of the resection site revealed minor abnormalities in group A while animals in group B demonstrated marked fibrotic changes and damaged vascular and biliary endothelium. Conclusion Use of a bioabsorbable staple line reinforcement material reduces intraoperative bleeding and perioperative bile leaks during stapled laparoscopic left lateral liver resection in a porcine model