Do we follow the money? The drivers of migration across regions in the EU

Most immigration theories tend to highlight that migration follows wealth and economic dynamism, but is this also the case across regions in Europe? The aim of the paper is to investigate whether migrants in Europe indeed follow the money and to contrast this with a variety of potential alternative explanations, including the presence of migrants from a similar origin. The analysis is based on panel data estimations including 133 European regions over a time period of 17 years. Different lag structures have been employed in order to distinguish between short- and long-run effects. The results cast some doubt about the prominence of pecuniary factors as a determinant of cross regional migration in Europe, with little evidence to support the idea that migration follows economic dynamism. Network effects, human capital related-, and ‘territorially embedded’ innovation enhancing regional characteristics, by contrast, seem to play a much stronger role than hitherto considered

Real-time integration between Microsoft HoloLens 2 and 3D Slicer with demonstration in pedicle screw placement planning

We established a direct communication channel between Microsoft HoloLens 2 and 3D Slicer to exchange transform and image messages between the platforms in real time. This allows us to seamlessly display a CT reslice of a patient in the AR world.Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. Research supported by projects PI122/00601 and AC20/00102 (Ministerio de Ciencia, Innovación y Universidades, Instituto de Salud Carlos III, Asociación Española Contra el Cáncer and European Regional Development Fund “Una manera de hacer Europa”), project PerPlanRT (ERA Permed), TED2021-129392B-I00 and TED2021-132200B-I00 (MCIN/AEI/10.13039/501100011033 and European Union “NextGenerationEU”/PRTR) and EU Horizon 2020 research and innovation programme Conex plus UC3M (grant agreement 801538). APC funded by Universidad Carlos III de Madrid (Read & Publish Agreement CRUE-CSIC 2023)

Real-time tool detection for workflow identification in open cranial vault remodeling

Deep learning is a recent technology that has shown excellent capabilities for recognition and identification tasks. This study applies these techniques in open cranial vault remodeling surgeries performed to correct craniosynostosis. The objective was to automatically recognize surgical tools in real-time and estimate the surgical phase based on those predictions. For this purpose, we implemented, trained, and tested three algorithms based on previously proposed Convolutional Neural Network architectures (VGG16, MobileNetV2, and InceptionV3) and one new architecture with fewer parameters (CranioNet). A novel 3D Slicer module was specifically developed to implement these networks and recognize surgical tools in real time via video streaming. The training and test data were acquired during a surgical simulation using a 3D printed patientbased realistic phantom of an infant’s head. The results showed that CranioNet presents the lowest accuracy for tool recognition (93.4%), while the highest accuracy is achieved by the MobileNetV2 model (99.6%), followed by VGG16 and InceptionV3 (98.8% and 97.2%, respectively). Regarding phase detection, InceptionV3 and VGG16 obtained the best results (94.5% and 94.4%), whereas MobileNetV2 and CranioNet presented worse values (91.1% and 89.8%). Our results prove the feasibility of applying deep learning architectures for real-time tool detection and phase estimation in craniosynostosis surgeries.This work was supported by projects PI18/01625 (Ministerio de Ciencia, Innovación y Universidades, Instituto de Salud Carlos III and European Regional Development Fund “Una manera de hacer Europa”). Luis Hernández Álvarez was supported by CSIC Project 202050E304 (CASDiM)

Augmented reality as a tool to guide psi placement in pelvic tumor resections

Patient-specific instruments (PSIs) have become a valuable tool for osteotomy guidance in complex surgical scenarios such as pelvic tumor resection. They provide similar accuracy to surgical navigation systems but are generally more convenient and faster. However, their correct placement can become challenging in some anatomical regions, and it cannot be verified objectively during the intervention. Incorrect installations can result in high deviations from the planned osteotomy, increasing the risk of positive resection margins. In this work, we propose to use augmented reality (AR) to guide and verify PSIs placement. We designed an experiment to assess the accuracy provided by the system using a smartphone and the HoloLens 2 and compared the results with the conventional freehand method. The results showed significant differences, where AR guidance prevented high osteotomy deviations, reducing maximal deviation of 54.03 mm for freehand placements to less than 5 mm with AR guidance. The experiment was performed in two versions of a plastic threedimensional (3D) printed phantom, one including a silicone layer to simulate tissue, providing more realism. We also studied how differences in shape and location of PSIs affect their accuracy, concluding that those with smaller sizes and a homogeneous target surface are more prone to errors. Our study presents promising results that prove AR’s potential to overcome the present limitations of PSIs conveniently and effectively.This research was funded by project PI18/01625 (Ministerio de Ciencia e Innovación, Instituto de Salud Carlos III and European Regional Development Fund “Una manera de hacer Europa”)

HoloLens 1 vs. HoloLens 2: Improvements in the New Model for Orthopedic Oncological Interventions

This work analyzed the use of Microsoft HoloLens 2 in orthopedic oncological surgeries and compares it to its predecessor (Microsoft HoloLens 1). Specifically, we developed two equivalent applications, one for each device, and evaluated the augmented reality (AR) projection accuracy in an experimental scenario using phantoms based on two patients. We achieved automatic registration between virtual and real worlds using patient-specific surgical guides on each phantom. They contained a small adaptor for a 3D-printed AR marker, the characteristic patterns of which were easily recognized using both Microsoft HoloLens devices. The newest model improved the AR projection accuracy by almost 25%, and both of them yielded an RMSE below 3 mm. After ascertaining the enhancement of the second model in this aspect, we went a step further with Microsoft HoloLens 2 and tested it during the surgical intervention of one of the patients. During this experience, we collected the surgeons’ feedback in terms of comfortability, usability, and ergonomics. Our goal was to estimate whether the improved technical features of the newest model facilitate its implementation in actual surgical scenarios. All of the results point to Microsoft HoloLens 2 being better in all the aspects affecting surgical interventions and support its use in future experiences.This work was supported by projects PI18/01625, AC20/00102-3 and Era Permed PerPlanRT (Ministerio de Ciencia, Innovación y Universidades, Instituto de Salud Carlos III, Asociación Española Contra el Cáncer and European Regional Development Fund "Una manera de hacer Europa") and IND2018/TIC-9753 (Comunidad de Madrid)

Institutions vs. ‘first-nature’ geography: what drives economic growth in Europe's regions?

The debate on whether institutions or geography prevail in driving economic growth has been rife (e.g., Sachs 2003 vs. Rodrik et al. 2004). Most of the empirical analyses delving into this debate have focused on world countries, whose geographical and institutional conditions differ widely. Subnational analyses considering groups of countries with, in principle, more similar institutional and geographical conditions have been limited and tended to highlight that geography is more important than institutions at subnational level. This paper aims to address whether this is the case by investigating how differences in institutional and ‘first-nature’ geographical conditions have affected economic growth in Europe's regions in the period 1995–2009. In the analysis we use a newly developed dataset including regional quality of government indicators and geographical charactersitics and employ two-stage least squares (2SLS) and instrumental variables-generalized method of moments (IV-GMM) estimation techniques with a number of regional historical variables as instruments. Our results indicate that at a regional level in Europe institutions rule. Regional institutional conditions – and, particularly, government effectiveness and the fight against corruption – play an important role in shaping regional economic growth prospects. This does not imply, however, that geography is irrelevant. There is evidence of geographical factors affecting regional growth, although their impact is dwarfed by the overriding influence of institutions

Atrial fibrillation as a new prognosis factor in chronic patients after hospitalization: the CHRONIBERIA index

A collaborative project in different areas of Spain and Portugal was designed to find out the variables that influence the mortality after discharge and develop a prognostic model adapted to the current healthcare needs of chronic patients in an internal medicine ward. Inclusion criteria were being admitted to an Internal Medicine department and at least one chronic disease. Patients’ physical dependence was measured through Barthel index (BI). Pfeiffer test (PT) was used to establish cognitive status. We conducted logistic regression and Cox proportional hazard models to analyze the influence of those variables on one-year mortality. We also developed an external validation once decided the variables included in the index. We enrolled 1406 patients. Mean age was 79.5 (SD = 11.5) and females were 56.5%. After the follow-up period, 514 patients (36.6%) died. Five variables were identified as significantly associated with 1 year mortality: age, being male, lower BI punctuation, neoplasia and atrial fibrillation. A model with such variables was created to estimate one-year mortality risk, leading to the CHRONIBERIA. A ROC curve was made to determine the reliability of this index when applied to the global sample. An AUC of 0.72 (0.7–0.75) was obtained. The external validation of the index was successful and showed an AUC of 0.73 (0.67–0.79). Atrial fibrillation along with an advanced age, being male, low BI score, or an active neoplasia in chronic patients could be critical to identify high risk multiple chronic conditions patients. Together, these variables constitute the new CHRONIBERIA index

Alterations in Gut Microbiome in Cirrhosis as Assessed by Quantitative Metagenomics: Relationship With Acute-on-Chronic Liver Failure and Prognosis

Background and Aims: Cirrhosis is associated with changes in gut microbiome composition. Although acute-on-chronic liver failure (ACLF) is the most severe clinical stage of cirrhosis, there is lack of information about gut microbiome alterations in ACLF using quantitative metagenomics. We investigated the gut microbiome in patients with cirrhosis encompassing the whole spectrum of disease (compensated, acutely decompensated without ACLF, and ACLF). A group of healthy subjects was used as control subjects. Methods: Stool samples were collected prospectively in 182 patients with cirrhosis. DNA library construction and sequencing were performed using the Ion Proton Sequencer (ThermoFisher Scientific, Waltham, MA). Microbial genes were grouped into clusters, denoted as metagenomic species. Results: Cirrhosis was associated with a remarkable reduction in gene and metagenomic species richness compared with healthy subjects. This loss of richness correlated with disease stages and was particularly marked in patients with ACLF and persisted after adjustment for antibiotic therapy. ACLF was associated with a significant increase of Enterococcus and Peptostreptococcus sp and a reduction of some autochthonous bacteria. Gut microbiome alterations correlated with model for end-stage liver disease and Child-Pugh scores and organ failure and was associated with some complications, particularly hepatic encephalopathy and infections. Interestingly, gut microbiome predicted 3-month survival with good stable predictors. Functional analysis showed that patients with cirrhosis had enriched pathways related to ethanol production, γ-aminobutyric acid metabolism, and endotoxin biosynthesis, among others. Conclusions: Cirrhosis is characterized by marked alterations in gut microbiome that parallel disease stages with maximal changes in ACLF. Altered gut microbiome was associated with complications of cirrhosis and survival. Gut microbiome may contribute to disease progression and poor prognosis. These results should be confirmed in future studies

Allelic Variation of MYB10 Is the Major Force Controlling Natural Variation in Skin and Flesh Color in Strawberry (Fragaria spp.) Fruit

Independent mutations in the transcription factor MYB10 cause most of the anthocyanin variation observed in diploid woodland strawberry (Fragaria vesca) and octoploid cultivated strawberry (Fragaria x ananassa). The fruits of diploid and octoploid strawberry (Fragaria spp) show substantial natural variation in color due to distinct anthocyanin accumulation and distribution patterns. Anthocyanin biosynthesis is controlled by a clade of R2R3 MYB transcription factors, among which MYB10 is the main activator in strawberry fruit. Here, we show that mutations in MYB10 cause most of the variation in anthocyanin accumulation and distribution observed in diploid woodland strawberry (F. vesca) and octoploid cultivated strawberry (F. xananassa). Using a mapping-by-sequencing approach, we identified a gypsy-transposon in MYB10 that truncates the protein and knocks out anthocyanin biosynthesis in a white-fruited F. vesca ecotype. Two additional loss-of-function mutations in MYB10 were identified among geographically diverse white-fruited F. vesca ecotypes. Genetic and transcriptomic analyses of octoploid Fragaria spp revealed that FaMYB10-2, one of three MYB10 homoeologs identified, regulates anthocyanin biosynthesis in developing fruit. Furthermore, independent mutations in MYB10-2 are the underlying cause of natural variation in fruit skin and flesh color in octoploid strawberry. We identified a CACTA-like transposon (FaEnSpm-2) insertion in the MYB10-2 promoter of red-fleshed accessions that was associated with enhanced expression. Our findings suggest that cis-regulatory elements in FaEnSpm-2 are responsible for enhanced MYB10-2 expression and anthocyanin biosynthesis in strawberry fruit flesh.Peer reviewe