Synchronous Roundabouts with Rotating Priority Sectors (SYROPS): high capacity and safety for conventional and autonomous vehicles

Roundabouts are a highway engineering concept meant to reduce congestion and improve safety. However, experience shows that capacity of roundabouts is limited, and safety is not optimal. However, these improvements in capacity and safety should be compatible with both manually-driven and autonomous vehicles. Incorporating existing advanced technologies to the signaling and control of roundabouts will undoubtedly contribute to these improvements but should not restrict this compatibility. We approach roundabouts as synchronous switches of vehicles, and propose a roundabout system (synchronous roundabouts with rotating priorities) based on vehicle platoons arriving at the roundabout at a uniform speed and within the time slot assigned to their entry, avoiding conflicts and stops. The proposed signaling system is visual for human drivers and wireless for connected and autonomous vehicles. We evaluated analytically and with simulations roundabouts of different radii for several values of the average distance between vehicles. Results show that average delays are 28.7% lower, with negligible dispersion. The capacity improvements depend on design parameters, moderate for small roundabouts, but that goes up to 70&-100% for short inter vehicular distances and medium and large roundabouts. Simulations with unbalanced traffic maintained the capacity improvement over standard roundabouts.Comunidad de Madri

Sauvé-Kapandji and reverse Sauvé-Kapandji procedures for treating chronic longitudinal radioulnar dissociation with capitellum fracture

Almost all reported cases of longitudinal radioulnar dissociation have involved fracture of the radial head, rupture of the interosseous membrane, and disruption of the distal radioulnar joint, although unusual patterns of Essex-Lopresti injury have also been described. To our knowledge, this is the first report of a chronic Essex-Lopresti variant including fracture of the capitellum. A displaced capitellum fracture must alert to the possibility of longitudinal radioulnar dissociation, even without concomitant radial head fracture or symptoms at the forearm and ulnar wrist. Successful mid-term results can be achieved by treating malunion of humeral condyle and proximal migration of the radius with simultaneous Sauvé-Kapandji procedure at the wrist and reverse Sauvé-Kapandji at the elbow.Essex-Lopresti lezyonlarının nadir görülen bazı atipik formları tanımlanmış olsa da, literatürde bildirilen longitudinal radioulnar instabilite olgularında genellikle radius başı kırığı ve proksimal ve distal radioulnar eklemlerde yaralanma söz konusudur. Bu çalışmada kapitellum kırığı ile birlikte Essex- Lopresti lezyonu olan bir hastayı bildiriyoruz. Olgumuzda el bileğinde Sauvé-Kapandji ve dirsekte ters Sauvé-Kapandji tekniklerinin kombine olarak uygulanması ile orta vadede başarılı sonuçlar alınmıştır. El bileği ve önkol yakınması olmasa bile deplase kapitellum kırıklı hastalarda longitudinal radioulnar instabilite akla getirilmelidir

Machine Learning as an aid to management decisions on high somatic cell counts in dairy farms

High somatic cell counts (SCC) is associated with mastitis infection, in dairy herds, worldwide. This work describes Machine Learning (ML) techniques designed to improve the information offered to farmers on animals producing high SCCs according to particular herd profiles. The analysed population included 71 dairy farms in Asturias (Northern Spain) and a total of 2,407 lactating cows. Four sources of information were available: a) a questionnaire survey describing facilities, milking routines and management practices of the farms studied; b) dairy recording information; c) classification of the cows suspected of being healthy or subclinical mastitic according to farmers’ expertise; and d) positive or negative scores with respect to the California Mastitis Test (CMT). The decimal logarithm of the SCC (linear score), lactation number, herd size, lactating cows per milker, milk urea concentration, number of clusters per milker and actual SCC are shown to be the most informative attributes for mimicking both farmers’ expertise or CMT performance in order to identify animals producing persistently high SCCs in dairy herds. However, to improve the identification of cows suspected of being non-healthy, the system uses other information related to management and milking routines. Decision rules to predict CMT performance can provide useful, additional information to farmers to improve the management of dairy herds included in milk recording programs

ARP-P4: deep analysis of a hybrid SDN ARP-Path/P4-Runtime switch

The Software-Defined Networking (SDN) architecture decouples the control plane from the data plane, but it does not explicitly state where the control should be located. This article analyses the benefits of maintaining the control as close as possible to the data plane, instead of the more traditional centralised control plane approach. To this purpose, it delves into the study of ARP-P4, a hybrid software switch defined by using the P4 language to facilitate its future use and deployment in P4 targets. Its hybrid properties come from supporting two complementary different ways of establishing paths: a centralised SDN approach based on P4-Runtime and a traditional distributed approach based on the ARP-Path protocol that obtains a similar performance to centralised solutions based on Equal Cost Multi-Path (ECMP) and Dijkstra. The results show the feasibility of hybrid devices that combine different forwarding paradigms without losing performance with respect to well-known solutions such as ECMP, and how their combined use can lead to enhance and scale communication networks.Comunidad de MadridUniversidad de Alcal

Development of a novel splice array platform and its application in the identification of alternative splice variants in lung cancer

<p>Abstract</p> <p>Background</p> <p>Microarrays strategies, which allow for the characterization of thousands of alternative splice forms in a single test, can be applied to identify differential alternative splicing events. In this study, a novel splice array approach was developed, including the design of a high-density oligonucleotide array, a labeling procedure, and an algorithm to identify splice events.</p> <p>Results</p> <p>The array consisted of exon probes and thermodynamically balanced junction probes. Suboptimal probes were tagged and considered in the final analysis. An unbiased labeling protocol was developed using random primers. The algorithm used to distinguish changes in expression from changes in splicing was calibrated using internal non-spliced control sequences. The performance of this splice array was validated with artificial constructs for <it>CDC6</it>, <it>VEGF</it>, and <it>PCBP4 </it>isoforms. The platform was then applied to the analysis of differential splice forms in lung cancer samples compared to matched normal lung tissue. Overexpression of splice isoforms was identified for genes encoding <it>CEACAM1</it>, <it>FHL-1</it>, <it>MLPH</it>, and <it>SUSD2. </it>None of these splicing isoforms had been previously associated with lung cancer.</p> <p>Conclusions</p> <p>This methodology enables the detection of alternative splicing events in complex biological samples, providing a powerful tool to identify novel diagnostic and prognostic biomarkers for cancer and other pathologies.</p

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

Effectiveness and Safety of the Sequential Use of a Second and Third Anti-TNF Agent in Patients With Inflammatory Bowel Disease: Results From the Eneida Registry

Background: The effectiveness of the switch to another anti-tumor necrosis factor (anti-TNF) agent is not known. The aim of this study was to analyze the effectiveness and safety of treatment with a second and third anti-TNF drug after intolerance to or failure of a previous anti-TNF agent in inflammatory bowel disease (IBD) patients. Methods: We included patients diagnosed with IBD from the ENEIDA registry who received another anti-TNF after intolerance to or failure of a prior anti-TNF agent. Results: A total of 1122 patients were included. In the short term, remission was achieved in 55% of the patients with the second anti-TNF. The incidence of loss of response was 19% per patient-year with the second anti-TNF. Combination therapy (hazard ratio [HR], 2.4; 95% confidence interval [CI], 1.8-3; P < 0.0001) and ulcerative colitis vs Crohn's disease (HR, 1.6; 95% CI, 1.1-2.1; P = 0.005) were associated with a higher probability of loss of response. Fifteen percent of the patients had adverse events, and 10% had to discontinue the second anti-TNF. Of the 71 patients who received a third anti-TNF, 55% achieved remission. The incidence of loss of response was 22% per patient-year with a third anti-TNF. Adverse events occurred in 7 patients (11%), but only 1 stopped the drug. Conclusions: Approximately half of the patients who received a second anti-TNF achieved remission; nevertheless, a significant proportion of them subsequently lost response. Combination therapy and type of IBD were associated with loss of response. Remission was achieved in almost 50% of patients who received a third anti-TNF; nevertheless, a significant proportion of them subsequently lost response

Risk Factors for COVID-19 in Inflammatory Bowel Disease: A National, ENEIDA-Based Case–Control Study (COVID-19-EII)

(1) Scant information is available concerning the characteristics that may favour the acquisition of COVID-19 in patients with inflammatory bowel disease (IBD). Therefore, the aim of this study was to assess these differences between infected and noninfected patients with IBD. (2) This nationwide case-control study evaluated patients with inflammatory bowel disease with COVID-19 (cases) and without COVID-19 (controls) during the period March-July 2020 included in the ENEIDA of GETECCU. (3) A total of 496 cases and 964 controls from 73 Spanish centres were included. No differences were found in the basal characteristics between cases and controls. Cases had higher comorbidity Charlson scores (24% vs. 19%; p = 0.02) and occupational risk (28% vs. 10.5%; p < 0.0001) more frequently than did controls. Lockdown was the only protective measure against COVID-19 (50% vs. 70%; p < 0.0001). No differences were found in the use of systemic steroids, immunosuppressants or biologics between cases and controls. Cases were more often treated with 5-aminosalicylates (42% vs. 34%; p = 0.003). Having a moderate Charlson score (OR: 2.7; 95%CI: 1.3-5.9), occupational risk (OR: 2.9; 95%CI: 1.8-4.4) and the use of 5-aminosalicylates (OR: 1.7; 95%CI: 1.2-2.5) were factors for COVID-19. The strict lockdown was the only protective factor (OR: 0.1; 95%CI: 0.09-0.2). (4) Comorbidities and occupational exposure are the most relevant factors for COVID-19 in patients with IBD. The risk of COVID-19 seems not to be increased by immunosuppressants or biologics, with a potential effect of 5-aminosalicylates, which should be investigated further and interpreted with caution