How 3D patient-specific instruments improve accuracy of pelvic bone tumour resection in a cadaveric study

To assess the accuracy of patient-specific instruments (PSIs) versus standard manual technique and the precision of computer-assisted planning and PSI-guided osteotomies in pelvic tumour resection. CT scans were obtained from five female cadaveric pelvises. Five osteotomies were designed using Mimics software: sacroiliac, biplanar supra-acetabular, two parallel iliopubic and ischial. For cases of the left hemipelvis, PSIs were designed to guide standard oscillating saw osteotomies and later manufactured using 3D printing. Osteotomies were performed using the standard manual technique in cases of the right hemipelvis. Post-resection CT scans were quantitatively analysed. Student's t -test and Mann-Whitney U test were used. Compared with the manual technique, PSI-guided osteotomies improved accuracy by a mean 9.6 mm (p 5 mm and 27% (n = 8) were > 10 mm. In the PSI cases, deviations were 10% (n = 3) and 0 % (n = 0), respectively. For angular deviation from pre-operative plans, we observed a mean improvement of 7.06° (p < 0.001) in pitch and 2.94° (p < 0.001) in roll, comparing PSI and the standard manual technique. In an experimental study, computer-assisted planning and PSIs improved accuracy in pelvic tumour resections, bringing osteotomy results closer to the parameters set in pre-operative planning, as compared with standard manual techniques. Cite this article : A. Sallent, M. Vicente, M. M. Reverté, A. Lopez, A. Rodríguez-Baeza, M. Pérez-Domínguez, R. Velez. How 3D patient-specific instruments improve accuracy of pelvic bone tumour resection in a cadaveric study. Bone Joint Res 2017;6:577-583. DOI: 10.1302/2046-3758.610.BJR-2017-0094.R1

Les ocupacions prehistòriques a les Coves de l'Aumediella (Benifallet) : una visió sintètica

Les coves de l'Aumediella, situades en un dels meandres del riu Ebre a l'alçada de Benifallet (Baix Ebre), han estat fruit de diverses troballes d'interès arqueològic, ben documentades des d'inicis del segle XX. El treballs centrats en el reestudi dels materials arqueològics recuperats, principalment ceràmica, lític i macrolític, ha aportat noves dades relacionades amb les activitats de freqüentació i ús d'aquest conjunt de 6 cavitats. En aquest sentit, el present article es centra en sintetitzar i contextualitzar les principals aportacions dels materials arqueològics recuperats amb l'objectiu contribuir al coneixement de les comunitats del VI-II mil·lenni al tram baix del riu Ebre.The Aumediella's caves, located in a meander of the Ebro River in its passage by Benifallet (Baix Ebre), have generated several findings of archaeological interest, well documented from the early twentieth century. This work is centered on the revision and restudying of this recovered archaeological remains, being them mainly pottery, lithic implements and grinding stones, and has provided new data related to the activities of frequentation and use of this set of six cavities. In this sense, this article is focused on synthetizing and contextualizing the main contributions of this archaeological remains in order to contribute to the knowledge of the 6th to 2n Millennium communities in the lower stretch of the Ebro River

Bricks in the eclectic modernist architecture of the City of Zamora (Spain): an analysis of the types, building tools used and the construction of the walls

El presente trabajo lleva a cabo una investigación sobre los tipos de ladrillos empleados en las fachadas de los inmuebles de la época decimonónica de la capital zamorana. Este estudio engloba no sólo los ladrillos sino la relación de los mismos con los usos de los inmuebles. El análisis desarrollado es fundamentalmente técnico, centrándose tanto en los aspectos materiales y morfológicos de las piezas como en la relación existente entre los mismos y los diferentes sistemas constructivos empleados en la ejecución de sus muros. La existencia de múltiple y variada documentación original, combinada con la información recabada in situ sobre los inmuebles que se conservan en la ciudad, ha permitido realizar un estudio exhaustivo y detallado, que se destaca como el objetivo primordial, pues permitirá desarrollar de cara a las futuras actuaciones de conservación, intervenciones para preservar y actuar sobre los elementos de interés.The present work studies the types of bricks used on the façades of the 19th century buildings of the City of Zamora. The study covers not only the bricks themselves but also their relationship with the use the buildings were put to. The analysis is essentially technical, focusing on both the material and morphological aspects of the bricks and the relationship between them and the different construction systems used to build the walls. The existence of abundant and varied original literature, together with information collected “in situ” about the buildings preserved in the City, has allowed an exhaustive study that stands out as an initial aim since it will offer a way to guide future actions of conservation and interventions aimed at preserving the elements of interest

Blood Biomarker Panels for the Early Prediction of Stroke‐Associated Complications

Background Acute decompensated heart failure (ADHF) and respiratory tract infections (RTIs) are potentially life-threatening complications in patients experiencing stroke during hospitalization. We aimed to test whether blood biomarker panels might predict these complications early after admission. Methods and Results Nine hundred thirty-eight patients experiencing ischemic stroke were prospectively recruited in the Stroke-Chip study. Post-stroke complications during hospitalization were retrospectively evaluated. Blood samples were drawn within 6 hours after stroke onset, and 14 biomarkers were analyzed by immunoassays. Biomarker values were normalized using log-transformation and Z score. PanelomiX algorithm was used to select panels with the best accuracy for predicting ADHF and RTI. Logistic regression models were constructed with the clinical variables and the biomarker panels. The additional predictive value of the panels compared with the clinical model alone was evaluated by receiver operating characteristic curves. An internal validation through a 10-fold cross-validation with 3 repeats was performed. ADHF and RTI occurred in 19 (2%) and 86 (9.1%) cases, respectively. Three-biomarker panels were developed as predictors: vascular adhesion protein-1 >5.67, NT-proBNP (N-terminal pro-B-type natriuretic peptide) >4.98 and d-dimer >5.38 (sensitivity, 89.5%; specificity, 71.7%) for ADHF; and interleukin-6 >3.97, von Willebrand factor >3.67, and d-dimer >4.58 (sensitivity, 82.6%; specificity, 59.8%) for RTI. Both panels independently predicted stroke complications (panel for ADHF: odds ratio [OR] [95% CI], 10.1 [3-52.2]; panel for RTI: OR, 3.73 [1.95-7.14]) after adjustment by clinical confounders. The addition of the panel to clinical predictors significantly improved areas under the curve of the receiver operating characteristic curves in both cases. Conclusions Blood biomarkers could be useful for the early prediction of ADHF and RTI. Future studies should assess the usefulness of these panels in front of patients experiencing stroke with respiratory symptoms such as dyspnea

Bioaccessibility of contaminants of emerging concern in raw and cooked commercial seafood species: insights for food safety risk assessment.

Autoria na publicação: FABIOLA FOGAÇA

Ecological network complexity scales with area

Larger geographical areas contain more species—an observation raised to a law in ecology. Less explored is whether biodiversity changes are accompanied by a modification of interaction networks. We use data from 32 spatial interaction networks from different ecosystems to analyse how network structure changes with area. We find that basic community structure descriptors (number of species, links and links per species) increase with area following a power law. Yet, the distribution of links per species varies little with area, indicating that the fundamental organization of interactions within networks is conserved. Our null model analyses suggest that the spatial scaling of network structure is determined by factors beyond species richness and the number of links. We demonstrate that biodiversity–area relationships can be extended from species counts to higher levels of network complexity. Therefore, the consequences of anthropogenic habitat destruction may extend from species loss to wider simplification of natural communities.This work was supported by the TULIP Laboratory of Excellence (ANR-10-LABX-41 and 394 ANR-11-IDEX-002-02) to J.M.M., by a Region Midi-Pyrenees project (CNRS 121090) to J.M.M., and by the FRAGCLIM Consolidator Grant (726176) to J.M.M. from the European Research Council under the European Union’s Horizon 2020 Research and Innovation Program. The study was also supported by Spanish MICINN projects CGL2009-12646, CSD2008-0040 and CGL2013-41856 to J.B. and A.R. C.E. was funded through the São Paulo Research Foundation (FAPESP 2015/15172-7). V.A.G.B. was funded by National Funds through FCT—Foundation for Science and Technology under the Project UIDB/05183/2020. W.T. received funding from the ERA-Net BiodivERsA—Belmont Forum, with the national funder Agence National pour la Recherche (FutureWeb: ANR-18-EBI4–0009 and BearConnect: ANR-16-EBI3-0003).Peer reviewe

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

How 3D patient-specific instruments improve accuracy of pelvic bone tumour resection in a cadaveric study

To assess the accuracy of patient-specific instruments (PSIs) versus standard manual technique and the precision of computer-assisted planning and PSI-guided osteotomies in pelvic tumour resection. CT scans were obtained from five female cadaveric pelvises. Five osteotomies were designed using Mimics software: sacroiliac, biplanar supra-acetabular, two parallel iliopubic and ischial. For cases of the left hemipelvis, PSIs were designed to guide standard oscillating saw osteotomies and later manufactured using 3D printing. Osteotomies were performed using the standard manual technique in cases of the right hemipelvis. Post-resection CT scans were quantitatively analysed. Student's t -test and Mann-Whitney U test were used. Compared with the manual technique, PSI-guided osteotomies improved accuracy by a mean 9.6 mm (p 5 mm and 27% (n = 8) were > 10 mm. In the PSI cases, deviations were 10% (n = 3) and 0 % (n = 0), respectively. For angular deviation from pre-operative plans, we observed a mean improvement of 7.06° (p < 0.001) in pitch and 2.94° (p < 0.001) in roll, comparing PSI and the standard manual technique. In an experimental study, computer-assisted planning and PSIs improved accuracy in pelvic tumour resections, bringing osteotomy results closer to the parameters set in pre-operative planning, as compared with standard manual techniques. Cite this article : A. Sallent, M. Vicente, M. M. Reverté, A. Lopez, A. Rodríguez-Baeza, M. Pérez-Domínguez, R. Velez. How 3D patient-specific instruments improve accuracy of pelvic bone tumour resection in a cadaveric study. Bone Joint Res 2017;6:577-583. DOI: 10.1302/2046-3758.610.BJR-2017-0094.R1