Does endovascular treatment with curative intention have benefits for treating High-grade AVM versus radiosurgery? Efficacy, safety, and cost-effectiveness analysis

BACKGROUND: The treatment of high-grade arteriovenous malformations (AVMs) remains challenging. Microsurgery provides a rapid and complete occlusion compared to other options, but is associated with undesirable morbidity and mortality. The aim of this study was to compare the occlusion rates, incidence of unfavorable outcomes, and cost-effectiveness of embolization and stereotactic radiosurgery (SRS) as a curative treatment for high-grade AVMs.METHODS: A retrospective series of 57 consecutive patients with high-grade AVM treated with embolization or SRS, with the aim of achieving complete occlusion, was analyzed. Demographic, clinical, and angio-architectonic variables were collected. Both treatments were compared for the occlusion rate and procedure-related complications. In addition, a cost-effectiveness analysis was performed.RESULTS: Thirty (52.6%) patients were men and 27 (47.4%) were women (mean age 39 years). AVMs were unruptured in 43 (75.4%) patients, and ruptured in 14 (24.6%) patients. The presence of deep venous drainage, nidus volume, perforated arterial supply, and eloquent localization were more frequent in the SRS group. Complications such as hemorrhage or worsening of previous seizures were more frequent in the embolization group. No significant differences were observed in the occlusion rates or in the time necessary to achieve occlusion between the groups. The incremental cost-effectiveness ratio for endovascular treatment vs. SRS was $ 53.279.CONCLUSION: Both techniques achieved similar occlusion rates, but SRS carried a lower risk of complications. Staged embolization may be associated with a greater risk of hemorrhage, while SRS was demonstrated to have a better cost-effectiveness ratio. These results support SRS as a better treatment option for high-grade AVMs

Evaluation of Fattening Efficiency of Grazing Bulls through Panel Data Envelop Analysis

The purpose of this paper was to assess fattening efficiency changes in grazing bulls, using panel data envelop analysis in two periods of time. The panel data were compiled by DEAP 2.1, which included the results of a 3-year period from 38 private farms (beef farms) in cooperatives of credits and services. The farms were on prairie savannahs, located on 21.4831 latitude, and -77.3174 longitude, less than 300 meters above sea level, province of Camagüey, mideastern Cuba. The output variable was total sold kg (TSKG), and the input variables were cost of Norgold (CN), fuel kg per ha (FKGXHA), fuel kg per livestock unit (FKGXLU), and unit of human labor force (UHL), which were highly correlated to the output variable. Table 2 shows that technical efficiency (TE), pure efficiency (PEC), and scale sufficiency (SEC), underwent 0.2%, 0.4, and 0.5%, respectively, by the third year of fattening. Technological change (TC) between the second and third years rose to almost 14%, and the total productivity factor (TPF) spiked as farmers became more skilled and experienced, with a 4.9% increase in comparison to the first year, and 13.7% in the second year

Evaluación de la eficiencia en la ceba de toros en pastoreo mediante análisis envolvente de datos de panel

El objetivo del presente trabajo fue valorar los cambios de eficiencia en la ceba de toros en pastoreo mediante el método de análisis envolvente de datos de panel en dos periodos de tiempo. Los datos de panel fueron elaborados en el programa DEAP 2.1 con la inclusión de 3 años de resultados de 38 granjas (unidades de producción de carne bovina) pertenecientes a cooperativas de crédito y servicio integradas por campesinos privados, de la provincia de Camagüey, Cuba. Se utilizó como variable de salida: kilogramos totales vendidos, (KGTV) y como variables de entrada: costo del Northgold, (CN), kg de combustible por ha, (KGCXHA), kg de combustible por unidades de ganado mayor, (KGCXUGM) y unidades de trabajo humano (UTH), las mismas que denotaron altas correlaciones con la variable de salida. Se observó que la eficiencia técnica, EC, la eficiencia pura, PEC, y la eficiencia de escala, SEC, disminuyeron para el tercer año de experiencia de ceba en un 0,2 %, 0,4 % y 0,5 %. El cambio tecnológico, TC, del segundo al tercer año, incrementó a casi el 14 % y el factor de productividad total, TFPC, incrementó marcadamente, en la medida que los productores adquirieron mayores habilidades y experiencias, el aumento fue del 4,9 % respecto al primer año, cuando se inició la operación y del 13,7 % en relación al segundo año.AbstractThe purpose of this paper was to assess efficiency changes in grazing bulls through the method of  data envelopment analysis, using panel data in two periods of time. The panel data were compiled by DEAP 2.1, with the inclusion of the results of a 3-year period, from 38 private farms (beef production units), at the cooperatives of credits and services, in province of Camaguey, Cuba. The output variable was total sold kg (TSKG); the input variable were cost of Northgold (CN), fuel kg per ha (FKGXHA), fuel kg per livestock unit (FKGXLU), and human labor force (HLF), which were highly correlated to the output variable. Technical efficiency (TE), pure efficiency (PEC), and scale efficiency (SEC), decreased by the third year of fattening, in 0.2, 0.4, and 0.5 %, respectively. Technology change (TC) between the second and third years rose to almost 14 %, and the total productivity factor (TPF) spiked as farmers became more skilled and experienced, with a 4.9 % increase in comparison to the first year, and 13.7 % in the second year

Bronchoscopist's perception of the quality of the single-use bronchoscope (Ambu aScope4™) in selected bronchoscopies: a multicenter study in 21 Spanish pulmonology services

Background: The disposable bronchoscope is an excellent alternative to face the problem of SARS-CoV-2 and other cross infections, but the bronchoscopist’s perception of its quality has not been evaluated. Methods: To evaluate the quality of the Ambu-aScope4 disposable bronchoscope, we carried out a cross-sectional study in 21 Spanish pulmonology services. We use a standardized questionnaire completed by the bronchoscopists at the end of each bronchoscopy. The variables were described with absolute and relative frequencies, measures of cen‑ tral tendency and dispersion depending on their nature. The existence of learning curves was evaluated by CUSUM analysis. Results: The most frequent indications in 300 included bronchoscopies was bronchial aspiration in 69.3% and the median duration of these was 9.1 min. The route of entry was nasal in 47.2% and oral in 34.1%. The average score for ease of use, image, and aspiration quality was 80/100. All the planned techniques were performed in 94.9% and the bronchoscopist was satisfed in 96.6% of the bronchoscopies. They highlighted the portability and immediacy of the aScope4TM to start the procedure in 99.3%, the possibility of taking and storing images in 99.3%. The CUSUM analysis showed average scores>70/100 from the frst procedure and from the 9th procedure more than 80% of the scores exceeded the 80/100 score

Bronchoscopist's perception of the quality of the single-use bronchoscope (Ambu aScope4™) in selected bronchoscopies : a multicenter study in 21 Spanish pulmonology services

Background: The disposable bronchoscope is an excellent alternative to face the problem of SARS-CoV-2 and other cross infections, but the bronchoscopist's perception of its quality has not been evaluated. Methods: To evaluate the quality of the Ambu-aScope4 disposable bronchoscope, we carried out a cross-sectional study in 21 Spanish pulmonology services. We use a standardized questionnaire completed by the bronchoscopists at the end of each bronchoscopy. The variables were described with absolute and relative frequencies, measures of central tendency and dispersion depending on their nature. The existence of learning curves was evaluated by CUSUM analysis. Results: The most frequent indications in 300 included bronchoscopies was bronchial aspiration in 69.3% and the median duration of these was 9.1 min. The route of entry was nasal in 47.2% and oral in 34.1%. The average score for ease of use, image, and aspiration quality was 80/100. All the planned techniques were performed in 94.9% and the bronchoscopist was satisfied in 96.6% of the bronchoscopies. They highlighted the portability and immediacy of the aScope4TM to start the procedure in 99.3%, the possibility of taking and storing images in 99.3%. The CUSUM analysis showed average scores > 70/100 from the first procedure and from the 9th procedure more than 80% of the scores exceeded the 80/100 score. Conclusions: The aScope4™ scored well for ease of use, imaging, and aspiration. We found a learning curve with excellent scores from the 9th procedure. Bronchoscopists highlighted its portability, immediacy of use and the possibility of taking and storing images

Impact of the first wave of the SARS-CoV-2 pandemic on the outcome of neurosurgical patients: A nationwide study in Spain

Objective To assess the effect of the first wave of the SARS-CoV-2 pandemic on the outcome of neurosurgical patients in Spain. Settings The initial flood of COVID-19 patients overwhelmed an unprepared healthcare system. Different measures were taken to deal with this overburden. The effect of these measures on neurosurgical patients, as well as the effect of COVID-19 itself, has not been thoroughly studied. Participants This was a multicentre, nationwide, observational retrospective study of patients who underwent any neurosurgical operation from March to July 2020. Interventions An exploratory factorial analysis was performed to select the most relevant variables of the sample. Primary and secondary outcome measures Univariate and multivariate analyses were performed to identify independent predictors of mortality and postoperative SARS-CoV-2 infection. Results Sixteen hospitals registered 1677 operated patients. The overall mortality was 6.4%, and 2.9% (44 patients) suffered a perioperative SARS-CoV-2 infection. Of those infections, 24 were diagnosed postoperatively. Age (OR 1.05), perioperative SARS-CoV-2 infection (OR 4.7), community COVID-19 incidence (cases/10 5 people/week) (OR 1.006), postoperative neurological worsening (OR 5.9), postoperative need for airway support (OR 5.38), ASA grade =3 (OR 2.5) and preoperative GCS 3-8 (OR 2.82) were independently associated with mortality. For SARS-CoV-2 postoperative infection, screening swab test <72 hours preoperatively (OR 0.76), community COVID-19 incidence (cases/10 5 people/week) (OR 1.011), preoperative cognitive impairment (OR 2.784), postoperative sepsis (OR 3.807) and an absence of postoperative complications (OR 0.188) were independently associated. Conclusions Perioperative SARS-CoV-2 infection in neurosurgical patients was associated with an increase in mortality by almost fivefold. Community COVID-19 incidence (cases/10 5 people/week) was a statistically independent predictor of mortality. Trial registration number CEIM 20/217

Química medioambiental

Elaborado por cinco profesores del Departamento de Química de la Escuela Politécnica Superior de la Universidad de Burgos. Objetivos: elaborar material docente adaptado a la impartición de asignaturas que tengan como objetivo: conocer los aspectos teóricos y prácticos de los problemas de contaminación del agua y aire ocasionado por residuos. Se ha subdividido el conjunto en dos partes: teórica y práctica. En la parte teórica se recogen los conocimientos básicos para comprender los fenómenos de contaminación: por qué se producen, cómo se miden, qué parámetros se utilizan para valorarlos, qué efectos ocasionan y cuáles son las prácticas adecuadas para minimizarlos o evitarlos. En la parte práctica se presentan una serie de problemas de química ambiental, con enunciados que se ciñen a cuestiones reales y para cuya resolución es necesario aplicar conocimientos tanto de aspectos medioambientales como químicos. Gran parte de los problemas están resueltos con detalle y otros van acompañados del resultado. También se han elaborado cuestiones generales y de test de respuesta múltiple. En cuanto a prácticas de laboratorio se han elaborado guiones de prácticas que pueden llevarse a cabo en los laboratorios de que se dispone habitualmente en este tipo de centros. El trabajo no está publicado.Castilla y LeónES

Spatial analysis of “Zanja de Alsina”, Province of La Pampa, Argentina (1876-1879): An interdisciplinary approach between Archeology and Geography

La Zanja de Alsina (1876-1879) fue un hito en la dinámica de frontera conlas parcialidades indígenas autónomas de Pampa y Patagonia. Su establecimientoconstituyó el puntapié inicial que dio lugar a la transformacióndel mundo fronterizo hacia uno rural plenamente integrado a la dinámicacapitalista global. Dicha zanja -de 3 m de boca por 2 de profundidad-fueconcebida y proyectada desde el Ministerio de Guerra y Marina (cito enBuenos Aires, Argentina), contando con una extensión ideal de 600 kmy real de 400 km. En este trabajo, desde un enfoque interdisciplinario,presentaremos los primeros resultados de los análisis espaciales llevadosa cabo sobre imágenes satelitales, cartografía histórica y otras fuentesdocumentales e información provista por la labor arqueológica con el objetivode poder localizar la mencionada zanja así como también los asentamientosmilitares adyacentes (Machado, Alsina y Alvear) - ubicados en elactual noreste del territorio pampeano.Fil: Landa, Carlos Gilberto. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Filosofía y Letras. Instituto de Arqueología; ArgentinaFil: Pineau, Virginia Giselle. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Filosofía y Letras. Instituto de Arqueología; ArgentinaFil: Coll, Luis Vicente Javier. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Filosofía y Letras. Instituto de Arqueología; ArgentinaFil: Alfayate, Emmanuel. Universidad Nacional de La Pampa; ArgentinaFil: Caretti, Maria Florencia. Universidad de Buenos Aires. Facultad de Filosofía y Letras. Instituto de Arqueología; ArgentinaFil: Doval, Jimena. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Filosofía y Letras. Instituto de Arqueología; ArgentinaFil: Rearte, Astrid. Universidad de Buenos Aires. Facultad de Filosofía y Letras. Instituto de Arqueología; ArgentinaFil: Andrade, Ariana. Universidad de Buenos Aires. Facultad de Filosofía y Letras. Instituto de Arqueología; ArgentinaFil: Montanari, Emanuel Guillermo. Universidad de Buenos Aires. Facultad de Filosofía y Letras. Instituto de Arqueología; Argentin