Grupo español de cirugía torácica asistida por videoimagen: método, auditoría y resultados iniciales de una cohorte nacional prospectiva de pacientes tratados con resecciones anatómicas del pulmón

Introduction: our study sought to know the current implementation of video-assisted thoracoscopic surgery (VATS) for anatomical lung resections in Spain. We present our initial results and describe the auditing systems developed by the Spanish VATS Group (GEVATS). Methods: we conducted a prospective multicentre cohort study that included patients receiving anatomical lung resections between 12/20/2016 and 03/20/2018. The main quality controls consisted of determining the recruitment rate of each centre and the accuracy of the perioperative data collected based on six key variables. The implications of a low recruitment rate were analysed for '90-day mortality' and 'Grade IIIb-V complications'. Results: the series was composed of 3533 cases (1917 VATS; 54.3%) across 33 departments. The centres' median recruitment rate was 99% (25-75th:76-100%), with an overall recruitment rate of 83% and a data accuracy of 98%. We were unable to demonstrate a significant association between the recruitment rate and the risk of morbidity/mortality, but a trend was found in the unadjusted analysis for those centres with recruitment rates lower than 80% (centres with 95-100% rates as reference): grade IIIb-V OR=0.61 (p=0.081), 90-day mortality OR=0.46 (p=0.051). Conclusions: more than half of the anatomical lung resections in Spain are performed via VATS. According to our results, the centre's recruitment rate and its potential implications due to selection bias, should deserve further attention by the main voluntary multicentre studies of our speciality. The high representativeness as well as the reliability of the GEVATS data constitute a fundamental point of departure for this nationwide cohort

Riesgo quirúrgico tras resección pulmonar anatómica en cirugía torácica. Modelo predictivo a partir de una base de datos nacional multicéntrica

Introduction: the aim of this study was to develop a surgical risk prediction model in patients undergoing anatomic lung resections from the registry of the Spanish Video-Assisted Thoracic Surgery Group (GEVATS). Methods: data were collected from 3,533 patients undergoing anatomic lung resection for any diagnosis between December 20, 2016 and March 20, 2018. We defined a combined outcome variable: death or Clavien Dindo grade IV complication at 90 days after surgery. Univariate and multivariate analyses were performed by logistic regression. Internal validation of the model was performed using resampling techniques. Results: the incidence of the outcome variable was 4.29% (95% CI 3.6-4.9). The variables remaining in the final logistic model were: age, sex, previous lung cancer resection, dyspnea (mMRC), right pneumonectomy, and ppo DLCO. The performance parameters of the model adjusted by resampling were: C-statistic 0.712 (95% CI 0.648-0.750), Brier score 0.042 and bootstrap shrinkage 0.854. Conclusions: the risk prediction model obtained from the GEVATS database is a simple, valid, and reliable model that is a useful tool for establishing the risk of a patient undergoing anatomic lung resection

Hybrid Models and Digital Twins for Condition Monitoring: HVAC System for Railway

Safety passenger transportation is more important than efficiency or reliability. Therefore, it is vital to maintain the proper condition of the equipment related to the passengers’ comfort and safety. This manuscript presents the methodology of complete development and implementation of both hybrid model and digital twin 3.0 for an HVAC in railways. The objective of this is to monitor the condition of the HVAC where it matters to the comfort and safety of the passengers in the trains. The level 3.0 of digital twin will be developed for the diagnosis and prognosis of HVAC by using hybrid modeling. The description illustrated in this paper is focused on the methodology used to implement a hybrid model-based approach, and both the need and advantages of using hybrid model approaches instead of data-based approaches. The development considers the importance of safety and environmental risks, which are included in the risk quantification of failure modes. Railway’s maintainers replace critical components in early stages of degradation; thus, the use of a data-driven model loses essential information related to advanced stages of degradation which might decrease the accuracy of the maintenance instructions provided. Physics-based model can be used to generate synthetic data to overcome the lack of data in advanced stages of degradation, and then, the synthetic data can be combined with the real data, which is collected by sensor located in the real system, to build the data-driven model. The combination leads to form hybrid-model based approach with a large number of failure modes that were unpredictable. Finally, the outcome is beneficial for the proper functioning of systems; hence, safety of the passengers. Godkänd;2022;Nivå 0;2022-10-14 (hanlid);Konferensartikel i tidskrift</p

Facile generation of giant unilamellar vesicles using polyacrylamide gels

Giant unilamellar vesicles (GUVs) are model cell-sized systems that have broad applications including drug delivery, analysis of membrane biophysics, and synthetic reconstitution of cellular machineries. Although numerous methods for the generation of free-floating GUVs have been established over the past few decades, only a fraction have successfully produced uniform vesicle populations both from charged lipids and in buffers of physiological ionic strength. In the method described here, we generate large numbers of free-floating GUVs through the rehydration of lipid films deposited on soft polyacrylamide (PAA) gels. We show that this technique produces high GUV concentrations for a range of lipid types, including charged ones, independently of the ionic strength of the buffer used. We demonstrate that the gentle hydration of PAA gels results in predominantly unilamellar vesicles, which is in contrast to comparable methods analyzed in this work. Unilamellarity is a defining feature of GUVs and the generation of uniform populations is key for many downstream applications. The PAA method is widely applicable and can be easily implemented with commonly utilized laboratory reagents, making it an appealing platform for the study of membrane biophysics.ISSN:2045-232

Hybrid models and digital twins for condition monitoring:HVAC system for railway

Abstract Safety passenger transportation is more important than efficiency or reliability. Therefore, it is vital to maintain the proper condition of the equipment related to the passengers’ comfort and safety. This manuscript presents the methodology of complete development and implementation of both hybrid model and digital twin 3.0 for an HVAC in railways. The objective of this is to monitor the condition of the HVAC where it matters to the comfort and safety of the passengers in the trains. The level 3.0 of digital twin will be developed for the diagnosis and prognosis of HVAC by using hybrid modeling. The description illustrated in this paper is focused on the methodology used to implement a hybrid model-based approach, and both the need and advantages of using hybrid model approaches instead of data-based approaches. The development considers the importance of safety and environmental risks, which are included in the risk quantification of failure modes. Railway’s maintainers replace critical components in early stages of degradation; thus, the use of a data-driven model loses essential information related to advanced stages of degradation which might decrease the accuracy of the maintenance instructions provided. Physics-based model can be used to generate synthetic data to overcome the lack of data in advanced stages of degradation, and then, the synthetic data can be combined with the real data, which is collected by sensor located in the real system, to build the data-driven model. The combination leads to form hybrid-model based approach with a large number of failure modes that were unpredictable. Finally, the outcome is beneficial for the proper functioning of systems; hence, safety of the passengers

Metal-polymer heterojunction in colloidal-phase plasmonic catalysis

[Image: see text] Plasmonic catalysis in the colloidal phase requires robust surface ligands that prevent particles from aggregation in adverse chemical environments and allow carrier flow from reagents to nanoparticles. This work describes the use of a water-soluble conjugated polymer comprising a thiophene moiety as a surface ligand for gold nanoparticles to create a hybrid system that, under the action of visible light, drives the conversion of the biorelevant NAD(+) to its highly energetic reduced form NADH. A combination of advanced microscopy techniques and numerical simulations revealed that the robust metal–polymer heterojunction, rich in sulfonate functional groups, directs the interaction of electron-donor molecules with the plasmonic photocatalyst. The tight binding of polymer to the gold surface precludes the need for conventional transition-metal surface cocatalysts, which were previously shown to be essential for photocatalytic NAD(+) reduction but are known to hinder the optical properties of plasmonic nanocrystals. Moreover, computational studies indicated that the coating polymer fosters a closer interaction between the sacrificial electron-donor triethanolamine and the nanoparticles, thus enhancing the reactivity

Transformation for inclusive conservation: evidence on values, decisions, and impacts in protected areas

As countries consider new area-based conservation targets under the Convention on Biological Diversity, protected areas (PAs) and their impacts on people and nature are coming under increasing scrutiny. We review the evidence base on PA impacts, combining the findings from existing rigorous impact evaluations with local case studies developed for this study. We identify characteristics of PA establishment and management that improve the sustainability of biodiversity conservation and justice for local communities. We find that recognizing and respecting local values and knowledge about natural resource stewardship, colearning, and comanagement are key to achieving positive impacts for nature and people. Transforming PA governance toward more inclusive conservation depends upon the ability of PAs to be designed and implemented around the values and needs of local people