Fijación con tornillos iliosacros en las fracturas de la parte posterior del anillo pélvico

Los objetivos principales del presente trabajo es la actualización y revisión bibliográfica sobre el tratamiento de las fracturas inestables de la parte posterior del anillo pélvico. Revisión de la casuística mediante un estudio observacional, descriptivo, tipo serie de casos retrospectivo-prospectivo, en el Servicio de Cirugía Ortopédica y Traumatología-COT de nuestro centro; con una serie de 6 pacientes (3 hombres y 3 mujeres) tratados por fracturas inestables de pelvis que comprometieron la estabilidad de la articulación sacro-ilíaca. El promedio de edad era de 43 años con un rango de 37 a 55 años. Cuatro de los paciente (66,6%) presentaron fracturas tipo B2 de Tile (compresión lateral ipsilateral) y los dos restantes (33,3%) presentaron fracturas tipo C1 de Tile (disrupción completa posterior unilateral)

Relación entre la perimetría automatizada convencional y la topografía papilar realizada con el tomógrafo Heidelberg

espanolObjetivo: Determinar las correlaciones entre los parametros de la cabeza del nervio optico (CNO) obtenidos mediante el laser confocal de barrido (HRT), y los resultados de la perimetria automatizada convencional (PA) en sujetos normales, hipertensos oculares (HTO), sospechosos de glaucoma y glaucomatosos. Metodos: Cuatrocientos veintitres ojos fueron incluidos en el estudio y clasificados segun la presion intraocular basal, morfologia papilar y los resultados de la PA en 4 grupos: 87 normales, 192 hipertensos oculares, 70 sospechosos de glaucoma y 74 glaucomatosos. En los diferentes grupos diagnosticos, se calcularon los coeficientes de correlacion de Pearson entre los parametros de la CNO y la desviacion media (DM), la desviacion estandar de la media (DSM), el numero de puntos alterados en cada cuadrante del campo visual (superior-nasal, inferior-nasal, superior-temporal e inferior-temporal), el numero de puntos alterados segun los niveles de probabilidad y los valores umbral en cada punto de la PA. Resultados: En el grupo normal y de hipertensos oculares, se encontraron pocas correlaciones debiles entre los parametros del HRT y los resultados de la PA. La fuerza y el numero de correlaciones significativas aumentaron en el grupo de sospechosos de glaucoma. En el grupo de glaucomas, las correlaciones fueron mas fuertes, especialmente entre los cocientes excavacion/disco y anillo/disco con la DM (r=0,479) y entre el area de anillo con la DSM (r=0,444). Conclusiones: Se encontraron correlaciones debiles o moderadas entre algunos parametros de la CNO medidos con el HRT y los resultados de la PA, en el grupo de glaucomas. EnglishPurpose: To determine the correlations between optic nerve head (ONH) parameters measured with the Heidelberg Retina Tomograph (HRT), and the main outcomes of standard automated perimetry (SAP) in normal, ocular hypertensive, glaucoma suspects and glaucomatous subjects. Methods: Four hundred and twenty-three patients were enrolled in the study and classified into four groups depending on baseline intraocular pressure, optic nerve head morphology, and SAP results: 87 normal eyes, 192 ocular hypertensive eyes, 70 glaucoma suspects and 74 glaucomatous eyes. In the different diagnostic groups, Pearson's correlation coefficients were calculated between ONH parameters and mean deviation, pattern standard deviation (PSD), number of altered points in each quadrant of the visual field (superior-nasal, inferior-nasal, superior-temporal and inferior-temporal), number of points altered at different probability levels, and threshold values at each point of SAP. Results: In the normal and ocular hypertensive groups, only a few weak correlations were found between HRT and SAP parameters. The strength and number of significant correlations increased in the suspected glaucoma group. The glaucoma group had the strongest correlations, particularly between cup/disc ratio and rim/disc ratio with MD (r=0.479) and between rim area and PSD (r=0.444). Conclusions: Weak to moderate correlations were found between some ONH parameters obtained with the HRT and SAP results in the glaucoma grou

A weed monitoring system using UAV-imagery and the Hough transform

Usually, crops require the use of herbicides as a useful manner of controlling the quality and quantity of crop production. Although there are weed-free areas, the most common approach is to broadcast herbicides entirely over crop fields, resulting in a reduction of profits and increase in environmental risks. Recently, patch spraying has allowed the use of site-specific weed management, allowing precise and timely weed maps at very early phenological stage, either by ground sampling or remote analysis. Remote imagery from piloted planes and satellites are not suitable for this purpose given their low spatial and temporal resolutions, however, unmanned aerial vehicles (UAV) represent an excellent alternative. This paper presents a new classification framework for weed monitoring via UAV showing promising results and accurate generalisation in different scenariosLos cultivos precisan del uso de herbicidas para controlar la calidad y cantidad de producción. A pesar de que las malas hierbas se distribuyen en rodales, la práctica más extendida es la fumigación de herbicidas en todo el cultivo, resultando en un aumento del coste y de riesgos mediambientales. La pulvericación por parches ha dado lugar al auge de otras técnicas de manejo de malas hierbas, permitiendo su tratamiento en un estado fenológico temprano. Las imágenes remotas de aviones pilotados o satélites no son útiles en este caso debido a su baja resolución espacial y temporal. Sin embargo, este no es el caso de los vehículos aéreos no tripulados. Este artículo presenta un nuevo método para monitorización de malas hierbas usando este tipo de vehículos, mostrando resultados prometedore

Weed mapping in early-season sunflower fields using images from an unmanned aerial vehicle (UAV)

Revista oficial de la Asociación Española de Teledetección[EN] Weed mapping in early season requires of very high spatial resolution images (pixels <5 cm). Currently only Unmanned Aerial Vehicles (UAV) can take such images. The aim of this work was to evaluate the optimal flight altitude for mapping weeds in an early season sunflower field using a low-cost camera that took images in the visible spectrum at several flight altitudes (40, 60, 80 and 100 m). The object based image analysis procedure used for weed mapping was divided in two main phases: 1) crop-row identification, and 2) crop, weed and bare soil classification. The algorithm identified the crop rows with 100% accuracy at every flight altitude (phase 1) and it detected weed-free zones with 100% accuracy in the images captured at 40 and 60 m flight altitude. In weed-infested zones, the classification algorithm obtained the best results in the images captured at low altitude (40 m), reporting 71% of correctly classified sampling frames (phase 2). Most of errors committed (incorrectly classified frames) were produced by non-detection of weeds (negative false). Subsequent studies would consist in a multi-temporal study aiming to detect weeds are at a more advance growth stage. It could reduce the percentage of negative false in the classification.[ES] La discriminación de malas hierbas en fase temprana con técnicas de teledetección requiere imágenes re-motas de muy elevada resolución espacial (píxeles <5 cm). Actualmente, sólo los vehículos aéreos no tripulados (UAV) pueden generar este tipo de imágenes. El objetivo de este trabajo fue evaluar imágenes UAV tomadas con una cámara visible a diferentes alturas de vuelo (40, 60, 80 y 100 m) y cuantificar la influencia de la resolución espacial en la discrimi-nación de malas hierbas en fase temprana en un cultivo de girasol. Se aplicó un algoritmo de clasificación de imágenes basado en objetos, el cual se divide en dos fases principales: 1) detección de líneas de cultivo y 2) clasificación de cultivo, malas hierbas y suelo desnudo. El algoritmo resultó 100% eficaz en la detección de las líneas de cultivo en todos los ca-sos (fase 1), así como en la detección de zonas libres de mala hierba en las imágenes tomadas a 40 y 60 m de altura. En las zonas con presencia de malas hierbas, los mejores resultados se obtuvieron en las imágenes tomadas a baja altura (40 m), con un 71% de marcos de muestreo clasificados correctamente (fase 2). La mayoría de los fallos de clasificación cometidos en todas las imágenes fueron falsos negativos, es decir, malas hierbas no detectadas debido a su pequeño tamaño en el momento de la captura de las imágenes. Por tanto, el siguiente paso sería desarrollar un estudio multi-temporal para estudiar la detección de las malas hierbas en estados fenológicos más avanzados. Esto podría facilitar su discriminación en las imágenes y, por tanto, disminuir el porcentaje de falsos negativos en las clasificacionesEste trabajo fue financiado por el proyecto Recupera 2020 (Ministerio de Economía y Competitividad y Fondos FEDER de la Unión Europea). La investigación de Jorge Torres Sánchez fue financiada por el programa FPI (CSIC y fondos FEDER).Peña, J.; Torres-Sánchez, J.; Serrano-Pérez, A.; López-Granados, F. (2014). Detección de malas hierbas en girasol en fase temprana mediante imágenes tomadas con un vehículo aéreo no tripulado (UAV). Revista de Teledetección. (42):39-48. doi:10.4995/raet.2014.3148SWORD39484

Clasificación de cultivos y de sus medidas agroambientales mediante segmentación de imágenes QuickBird

En la últimas décadas han ido creciendo considerablemente los conocimientos y la sensibilización sobre la protección al medioambiente en muy diversas áreas, entre las que se encuentra la Agricultura. El uso intensivo del laboreo ocasiona graves daños medioambientales como la erosión del suelo, la contaminación de las aguas superficiales (escorrentía y colmatación de embalses), el descenso del contenido de la materia orgánica y de la biodiversidad de los suelos labrados, y el aumento de la emisión de CO2 del suelo a la atmósfera. Actualmente, la Unión Europea sólo subvenciona a los agricultores que cumplen lo que se conoce como “Medidas Agroambientales o de Condicionalidad” cuyo diseño ha estado dentro de las competencias de las Políticas Agrarias Autonómicas, Nacionales y Europeas. Estas medidas consisten en alterar el perfil y la estructura del suelo lo menos posible, dejando éste sin labrar y permanentemente protegido por cubiertas vegetales (rastrojo) en el caso de cultivos herbáceos (ej. trigo, maíz, girasol), o por cubiertas vegetales vivas o inertes (restos de poda) en el caso de cultivos leñosos (principalmente cítricos y olivar). El seguimiento del cumplimiento de estas medidas se realiza a través de visitas presenciales a un 1% de los campos susceptibles de recibir ayudas. Este método es ineficiente y provoca muchos errores con la consiguiente presentación de un ingente número de reclamaciones. Para subsanar esta problemática, en este artículo presentamos los resultados obtenidos en la clasificación de los cultivos y las medidas agroambientales asociadas a éstos en una imagen multiespectral QuickBird tomada a principios de Julio de una zona típica de cultivos en régimen de secano de Andalucía. Se aplicaron 5 métodos de clasificación (Paralelepípedos, P; Mínima Distancia, MD; Distancia de Mahalanobis, MC; Mapeo del Ángulo Espectral, SAM; y Máxima Probabilidad, ML) para la discriminación de rastrojo de trigo quemado y sin quemar, arbolado, carreteras, olivar, cultivos herbáceos de siembra primaveral y suelo desnudo. Además, la imagen es segmentada en objetos para comparar la fiabilidad obtenida aplicando los métodos anteriores partiendo tanto de píxeles como de objetos como Unidades Mínimas de Información (MIU). El análisis de los resultados permite concluir que las clasificaciones de todos los usos de suelo basadas en objetos claramente mejoraron las basadas en píxeles, obteniéndose precisiones (overall accuracy) mayores al 85%. La elección de un método de clasificación u otro influye en gran medida en la precisión de los mapas obtenidos. Debido a que la precisión del mapa temático que necesitamos obtener ha de ser muy elevada para tomar decisiones sobre Conceder / No conceder las ayudas, sería interesante estudiar si el incremento de la resolución espacial que se obtenga gracias a la fusión de imágenes multiespectral y pancromática de QuickBird para obtener una imagen fusionada con resolución espacial de la pancromática (0.7 m) y espectral de la multiespectral (4 bandas) mejora la precisión de cualquiera de los métodos de clasificación estudiadosSoil management in crops is mainly based on intensive tillage operations, which have a great relevancy in terms of increase of atmospheric CO2, desertification, erosion and land degradation. Due to these negative environmental impacts, the European Union only subsidizes cropping systems which require the implementation of certain no-tillage systems and agro-environmental measures, such as keeping the winter cereal residues and non-burning of stubble to reduce erosion, and to increase the organic matter, the fertility of soils and the crop production. Nowadays, the follow-up of these agrarian policy actions is achieved by ground visits to sample targeted farms; however, this procedure is time-consuming and very expensive. To improve this control procedure, a study of the accuracy performance of several classification methods has been examined to verify if remote sensing can offer the ability to efficiently identify crops and their agro-environmental measures in a typical agricultural Mediterranean area of dry conditions. Five supervised classification methods based on different decision rule routines, Parallelepiped (P), Minimum Distance (MD), Mahalanobis Classifier Distance (MC), Spectral Angle Mapper (SAM), and Maximum Likelihood (ML), were examined to determine the most suitable classification algorithm for the identification of agro-environmental measures such as winter cereal stubble and burnt stubble areas and other land uses such as river side trees, vineyard, olive orchards, spring sown crops, roads and bare soil. An object segmentation of the satellite information was also added to compare the accuracy of the classification results of pixel and object as Minimum Information Unit (MIU). A multispectral QuickBird image taken in early summer was used to test these MIU and classification methods. The resulting classified images indicated that object-based analyses clearly outperformed pixel ones, yielding overall accuracies higher than 85% in most of the classifications. The choice of a classification method can markedly influence the accuracy of classification maps

Landscape dynamics and fire activity since 6740 cal yr BP in the Cantabrian region (La Molina peat bog, Puente Viesgo, Spain)

A lack of paleobotanic studies with adequate resolution and multiproxy approaches has limited proper discussion of vegetation dynamics in Cantabria and of the role of fires in the configuration of the plant landscape during the Holocene in the northwest part of the Iberian peninsula. The pollen diagram of La Molina peat bog in Puente Viesgo (43 ‹15 Œ38 N.3 ‹58 Œ37 W; ETRS89), located at 484 m.a.s.l., and the study of its sedimentary charcoals allowed the acquisition of a continuous and thorough fire sequence for the last 6 700 cal yr BP and an understanding of its relationship to the forest. The results show the importance of human influence on the incidence and characteristics of fire activity during the different phases studied: the Neolithic, Bronze Age, Iron Age, Roman period, and Middle Ages. A synergy seems to exist between dry climate periods (especially during Bond events 3 and 4) and a greater presence of biomass. As the Holocene advances, vegetation coverage clearly tends to decrease. This study provides key elements for understanding the role of fire activity in the forest dynamics of deciduous and evergreen Quercus, Corylus, Pinus, Fagus, and Alnus and demonstrates the strongly artificialized character of the present landscape

Association between Use of Enhanced Recovery after Surgery Protocol and Postoperative Complications in Total Hip and Knee Arthroplasty in the Postoperative Outcomes Within Enhanced Recovery after Surgery Protocol in Elective Total Hip and Knee Arthroplasty Study (POWER2)

Importance: The Enhanced Recovery After Surgery (ERAS) care protocol has been shown to improve outcomes compared with traditional care in certain types of surgery. Objective: To assess the association of use of the ERAS protocols with complications in patients undergoing elective total hip arthroplasty (THA) and total knee arthroplasty (TKA). Design, Setting, and Participants: This multicenter, prospective cohort study included patients recruited from 131 centers in Spain from October 22 through December 22, 2018. All consecutive adults scheduled for elective THA or TKA were eligible for inclusion. Patients were stratified between those treated in a self-designated ERAS center (ERAS group) and those treated in a non-ERAS center (non-ERAS group). Data were analyzed from June 15 through September 15, 2019. Exposures: Total hip or knee arthroplasty and perioperative management. Sixteen individual ERAS items were assessed in all included patients, whether they were treated at a center that was part of an established ERAS protocol or not. Main Outcomes and Measures: The primary outcome was postoperative complications within 30 days after surgery. Secondary outcomes included length of stay and mortality. Results: During the 2-month recruitment period, 6146 patients were included (3580 women [58.2%]; median age, 71 [interquartile range (IQR), 63-76] years). Of these, 680 patients (11.1%) presented with postoperative complications. No differences were found in the number of patients with overall postoperative complications between ERAS and non-ERAS groups (163 [10.2%] vs 517 [11.4%]; odds ratio [OR], 0.89; 95% CI, 0.74-1.07; P =.22). Fewer patients in the ERAS group had moderate to severe complications (73 [4.6%] vs 279 [6.1%]; OR, 0.74; 95% CI, 0.56-0.96; P =.02). The median overall adherence rate with the ERAS protocol was 50.0% (IQR, 43.8%-62.5%), with the rate for ERAS facilities being 68.8% (IQR, 56.2%-81.2%) vs 50.0% (IQR, 37.5%-56.2%) at non-ERAS centers (P <.001). Among the patients with the highest and lowest quartiles of adherence to ERAS components, the patients with the highest adherence had fewer overall postoperative complications (144 [10.6%] vs 270 [13.0%]; OR, 0.80; 95% CI, 0.64-0.99; P <.001) and moderate to severe postoperative complications (59 [4.4%] vs 143 [6.9%]; OR, 0.62; 95% CI, 0.45-0.84; P <.001) and shorter median length of hospital stay (4 [IQR, 3-5] vs 5 [IQR, 4-6] days; OR, 0.97; 95% CI, 0.96-0.99; P <.001). Conclusions and Relevance: An increase in adherence to the ERAS program was associated with a decrease in postoperative complications, although only a few ERAS items were individually associated with improved outcomes

Evidence for a mixed mass composition at the `ankle' in the cosmic-ray spectrum

We report a first measurement for ultra-high energy cosmic rays of the correlation between the depth of shower maximum and the signal in the water Cherenkov stations of air-showers registered simultaneously by the fluorescence and the surface detectors of the Pierre Auger Observatory. Such a correlation measurement is a unique feature of a hybrid air-shower observatory with sensitivity to both the electromagnetic and muonic components. It allows an accurate determination of the spread of primary masses in the cosmic-ray flux. Up till now, constraints on the spread of primary masses have been dominated by systematic uncertainties. The present correlation measurement is not affected by systematics in the measurement of the depth of shower maximum or the signal in the water Cherenkov stations. The analysis relies on general characteristics of air showers and is thus robust also with respect to uncertainties in hadronic event generators. The observed correlation in the energy range around the `ankle' at $\lg(E/{\rm eV})=18.5-19.0$ differs significantly from expectations for pure primary cosmic-ray compositions. A light composition made up of proton and helium only is equally inconsistent with observations. The data are explained well by a mixed composition including nuclei with mass $A > 4$. Scenarios such as the proton dip model, with almost pure compositions, are thus disfavoured as the sole explanation of the ultrahigh-energy cosmic-ray flux at Earth.Comment: Published version. Added journal reference and DOI. Added Report Numbe

Exploring Health Science Students’ Notions on Organ Donation and Transplantation: A Multicenter Study

The knowledge acquired during university education about organ donation and transplantation (ODT) decisively influences the information future health professionals transmit. This is important in ODT where the participation of the general public is essential to obtain organs. Objective: To determine notions of Spanish medicine and nursing students on ODT and its relationship with attitude toward ODT. Methods and Design: and design. We conducted a sociologic, multicenter, and observational study. The population for our study consisted of medical and nursing students in Spanish universities. Our database was the Collaborative International Donor Project, stratified by geographic area and academic course. A validated questionnaire (PCID-DTO-RIOS) was self-administered and completed anonymously. Our sample consisted of 9598 medical and 10, 566 nursing students (99% confidence interval; precision of ±1%), stratified by geographic area and year of study. Results: The completion rate for our study was 90%. Only 20% (n=3640) of students thought their notions on ODT were good; 41% (n=7531) thought their notions were normal; 36% (n=6550) thought their notions were scarce. Comparing groups, there were differences between those who believed that their notions on ODT were good (44% nursing vs 56% medical students; P < .000), and those who believed it scarce (54% nursing vs 46% medical students; P < .000). Notions on ODT were related with attitude toward the donation of one''s own organs: those who considered their notions were good were more in favor then those who considered it scarce (88% vs 72%; P < .000). Conclusion: Only 20% of Spanish medical and nursing students thought their notions on ODT were good. Having good knowledge is related to a favorable attitude towards ODT. Receiving specific information on the subject could improve their knowledge about ODT during their training

Overview of recent TJ-II stellarator results

The main results obtained in the TJ-II stellarator in the last two years are reported. The most important topics investigated have been modelling and validation of impurity transport, validation of gyrokinetic simulations, turbulence characterisation, effect of magnetic configuration on transport, fuelling with pellet injection, fast particles and liquid metal plasma facing components. As regards impurity transport research, a number of working lines exploring several recently discovered effects have been developed: the effect of tangential drifts on stellarator neoclassical transport, the impurity flux driven by electric fields tangent to magnetic surfaces and attempts of experimental validation with Doppler reflectometry of the variation of the radial electric field on the flux surface. Concerning gyrokinetic simulations, two validation activities have been performed, the comparison with measurements of zonal flow relaxation in pellet-induced fast transients and the comparison with experimental poloidal variation of fluctuations amplitude. The impact of radial electric fields on turbulence spreading in the edge and scrape-off layer has been also experimentally characterized using a 2D Langmuir probe array. Another remarkable piece of work has been the investigation of the radial propagation of small temperature perturbations using transfer entropy. Research on the physics and modelling of plasma core fuelling with pellet and tracer-encapsulated solid-pellet injection has produced also relevant results. Neutral beam injection driven Alfvénic activity and its possible control by electron cyclotron current drive has been examined as well in TJ-II. Finally, recent results on alternative plasma facing components based on liquid metals are also presented. ISSN:0029-5515 ISSN:1741-432