Uniportal pure robotic-assisted thoracic surgery—technical aspects, tips and tricks

The uniportal access for robotic thoracic surgery presents itself as a natural evolution of minimally invasive thoracic surgery (MITS). It was developed by surgeons who pioneered the uniportal video-assisted thoracic surgery (U-VATS) in all its aspects following the same principles of a single incision by using robotic technology. The robotic surgery was initially started as a hybrid procedure with the use of thoracoscopic staplers by the assistant. However, due to the evolution of robotic modern platforms, the staplers can be nowadays controlled by the main surgeon from the console. The pure uniportal robotic-assisted thoracic surgery (U-RATS) is defined as the robotic thoracic surgery performed through a single intercostal (ic) incision, without rib spreading, using the robotic camera, robotic dissecting instruments and robotic staplers. There are presented the advantages, difficulties, the general aspects and specific considerations for U-RATS. For safety reasons, the authors recommend the transition from multiportal-RATS through biportal-RATS to U-RATS. The use of robotic dissection and staplers through a single incision and the rapid undocking with easy emergent conversion when needed (either to U-VATS or to thoracotomy) are safety advantages over multi-port RATS that cannot be overlooked, offering great comfort to the surgeon and quick and smooth recovery to the patient.info:eu-repo/semantics/publishedVersio

Who benefits from HEIs engagement? An analysis of priority stakeholders and activity profiles of HEIs in the United Kingdom

It has been suggested that higher education institutions (HEIs) may develop different activity profiles (including research, teaching and socio-economic engagement) in their attempt to maximise the fit between institutional resources and strategic opportunities; the latter include strategies of engagement with different groups of external stakeholders. Understanding the extent to which HEIs’ resources and activity profiles are aligned with their strategic prioritisation of stakeholder groups, allows us to better understand the different ways in which HEIs drive socioeconomic development. Using non-parametric techniques – qualitative and quantitative ordinal multidimensional scaling – applied to data on the universe of HEIs in the United Kingdom, we show that HEIs with different institutional resources and undertaking different sets of activities prioritise their engagement with different stakeholder groups. We also confirm the complex associations between HEIs’ institutional resources, activity profiles and stakeholder prioritisation strategies, which lock HEIs into configurations that are difficult to change

Comparison of uniportal robotic-assisted thoracic surgery pulmonary anatomic resections with multiport robotic-assisted thoracic surgery: a multicenter study of the European experience

Background: Robotic-assisted thoracic surgery (RATS) has seen increasing interest in the last few years, with most procedures primarily being performed in the conventional multiport manner. Our team has developed a new approach that has the potential to convert surgeons from uniportal video-assisted thoracic surgery (VATS) or open surgery to robotic-assisted surgery, uniportal-RATS (U-RATS). We aimed to evaluate the outcomes of one single incision, uniportal robotic-assisted thoracic surgery (U-RATS) against standard multiport RATS (M-RATS) with regards to safety, feasibility, surgical technique, immediate oncological result, postoperative recovery, and 30-day follow-up morbidity and mortality. Methods: We performed a large retrospective multi-institutional review of our prospectively curated database, including 101 consecutive U-RATS procedures performed from September 2021 to October 2022, in the European centers that our main surgeon operates in. We compared these cases to 101 consecutive M-RATS cases done by our colleagues in Barcelona between 2019 to 2022. Results: Both patient groups were similar with respect to demographics, smoking status and tumor size, but were significantly younger in the U-RATS group [M-RATS =69 (range, 39-81) years; U-RATS =63 years (range, 19-82) years; P<0.0001]. Most patients in both operative groups underwent resection of a primary non-small cell lung cancer (NSCLC) [M-RATS 96/101 (95%); U-RATS =60/101 (59%); P<0.0001]. The main type of anatomic resection was lobectomy for the multiport group, and segmentectomy for the U-RATS group. In the M-RATS group, only one anatomical segmentectomy was performed, while the U-RATS group had twenty-four (24%) segmentectomies (P=0.0006). All M-RATS and U-RATS surgical specimens had negative resection margins (R0) and contained an equivalent median number of lymph nodes available for pathologic analysis [M-RATS =11 (range, 5-54); U-RATS =15 (range, 0-41); P=0.87]. Conversion rate to thoracotomy was zero in the U-RATS group and low in M-RATS [M-RATS =2/101 (2%); U-RATS =0/101; P=0.19]. Median operative time was also statistically different [M-RATS =150 (range, 60-300) minutes; U-RATS =136 (range, 30-308) minutes; P=0.0001]. Median length of stay was significantly lower in U-RATS group at four days [M-RATS =5 (range, 2-31) days; U-RATS =4 (range, 1-18) days; P<0.0001]. Rate of complications and 30-day mortality was low in both groups. Conclusions: U-RATS is feasible and safe for anatomic lung resections and comparable to the multiport conventional approach regarding surgical outcomes. Given the similarity of the technique to uniportal VATS, it presents the potential to convert minimally invasive thoracic surgeons to a robotic-assisted approach.info:eu-repo/semantics/publishedVersio

zCOSMOS 20k: Satellite galaxies are the main drivers of environmental effects in the galaxy population at least to z~0.7

We explore the role of environment in the evolution of galaxies over 0.1<z<0.7 using the final zCOSMOS-bright data set. Using the red fraction of galaxies as a proxy for the quenched population, we find that the fraction of red galaxies increases with the environmental overdensity and with the stellar mass, consistent with previous works. As at lower redshift, the red fraction appears to be separable in mass and environment, suggesting the action of two processes: mass and environmental quenching. The parameters describing these appear to be essentially the same at z~0.7 as locally. We explore the relation between red fraction, mass and environment also for the central and satellite galaxies separately, paying close attention to the effects of impurities in the central-satellite classification and using carefully constructed samples matched in stellar mass. There is little evidence for a dependence of the red fraction of centrals on overdensity. Satellites are consistently redder at all overdensities, and the satellite quenching efficiency increases with overdensity at 0.1<z<0.4. This is less marked at higher redshift, but both are nevertheless consistent with the equivalent local measurements. At a given stellar mass, the fraction of galaxies that are satellites also increases with the overdensity. At a given overdensity and mass, the obtained relation between the environmental quenching and the satellite fraction agrees well with the satellite quenching efficiency, demonstrating that the environmental quenching in the overall population is consistent with being entirely produced through the satellite quenching process at least up to z=0.7. However, despite the unprecedented size of our high redshift samples, the associated statistical uncertainties are still significant and our statements should be understood as approximations to physical reality, rather than physically exact formulae.Comment: 22 pages, 19 figures, submitted to MNRA

Fuzzy intelligence approach for modeling the migration of contaminants ina reservoir affected by AMD pollution

The Sancho Reservoir, located in the Huelva province (SW Spain), is supplied by the Meca River, which receives water contaminated by mining activities in Tharsis. This study focused on determining the relationship that temperature, pH, and electrical conductivity (EC) had with rainfall. The temperature, pH, and EC were simultaneously measured every 30 min by two probes suspended in the Sancho Reservoir. It was anticipated that the use of fuzzy logic and data mining would lead to a model that would show how the contaminant load evolved over space and time. Similar results were obtained for the two locations, except that the parameters had more outliers near the dam due to the greater distance from the contamination source. As expected, higher pH corresponded with lower EC, since, in the absence of chloride, sulphate was the principal anion. The dependency relationship of the variables as well as the cause–effect relationship with the rate of rainfall was more evident in the up-gradient sampling location than near the dam due to the different residence time and the transit time between the two points

The dependence of Galactic outflows on the properties and orientation of zCOSMOS galaxies at z ~ 1

We present an analysis of cool outflowing gas around galaxies, traced by MgII absorption lines in the co-added spectra of a sample of 486 zCOSMOS galaxies at 1 < z < 1.5. These galaxies span a range of stellar masses (9.45< log[M*/Msun]<10.7) and star formation rates (0.14 < log [SFR/Msun/yr] < 2.35). We identify the cool outflowing component in the MgII absorption and find that the equivalent width of the outflowing component increases with stellar mass. The outflow equivalent width also increases steadily with the increasing star formation rate of the galaxies. At similar stellar masses the blue galaxies exhibit a significantly higher outflow equivalent width as compared to red galaxies. The outflow equivalent width shows strong effect with star formation surface density ({\Sigma}SFR) of the sample. For the disk galaxies, the outflow equivalent width is higher for the face-on systems as compared to the edge-on ones, indicating that for the disk galaxies, the outflowing gas is primarily bipolar in geometry. Galaxies typically exhibit outflow velocities ranging from -200 km/s to -300 km/s and on average the face-on galaxies exhibit higher outflow velocity as compared to the edge-on ones. Galaxies with irregular morphologies exhibit outflow equivalent width as well as outflow velocities comparable to face on disk galaxies. These galaxies exhibit minimum mass outflow rates > 5-7 Msun/yr and a mass loading factor ({\eta} = dMout/dt /SFR) comparable to the star formation rates of the galaxies.Comment: 12 pages, 14 figures, ApJ submitte

Obscured AGN at z~1 from the zCOSMOS-Bright Survey I. Selection and Optical Properties of a [Ne v]-selected sample

A sample of 94 narrow line AGN with 0.65<z<1.20 has been selected from the 20k-Bright zCOSMOS galaxy sample by detection of the high-ionization [NeV]3426 line. Taking advantage of the large amount of data available in the COSMOS field, the properties of the [NeV]-selected Type-2 AGN have been investigated, focusing on their host galaxies, X-ray emission, and optical line flux ratios. Finally, the diagnostic developed by Gilli et al. (2010), based on the X-ray to [NeV] luminosity ratio, has been exploited to search for the more heavily obscured AGN. We found that [Ne v]-selected narrow line AGN have Seyfert 2-like optical spectra, although with emission line ratios diluted by a star-forming component. The ACS morphologies and stellar component in the optical spectra indicate a preference for our Type-2 AGN to be hosted in early-spirals with stellar masses greater than 10^(9.5-10)Msun, on average higher than those of the galaxy parent sample. The fraction of galaxies hosting [NeV]-selected obscured AGN increases with the stellar mass, reaching a maximum of about 3% at 2x10^11 Msun. A comparison with other selection techniques at z~1 shows that the detection of the [Ne v] line is an effective method to select AGN in the optical band, in particular the most heavily obscured ones, but can not provide by itself a complete census of AGN2. Finally, the high fraction of [NeV]-selected Type-2 AGN not detected in medium-deep Chandra observations (67%) is suggestive of the inclusion of Compton-thick sources in our sample. The presence of a population of heavily obscured AGN is corroborated by the X-ray to [NeV] ratio; we estimated, by mean of X-ray stacking technique and simulations, that the Compton-thick fraction in our sample of Type-2 AGN is 43+-4%, in good agreement with standard assumptions by the XRB synthesis models.Comment: 14 pages, 12 figures, accepted for publication in A&