Visores 3D, servicios interoperables e información geográfica: aplicaciones en ciencias de la tierra

Esta comunicación muestra los resultados de incorporar la geovisualización 3D y el tiempo (4ª dimensión) a la información geográfica (mapas temáticos, MDE, etc) y, específicamente, a los servicios interoperables a través de Internet, aplicados al campo de las ciencias naturales. Para ello se utiliza el visor Condor (con versiones desktop y cliente-web) desarrollado informáticamente por la empresa Elimco Sistemas, con la que el Grupo de Investigación al que pertenecen los autores de la Universidad de Sevilla mantiene una estrecha colaboración para el diseño de sus funcionalidades y el tratamiento semiológico de los datos geográficos. Se han elegido dos áreas específicas del territorio de Andalucía: un sector litoral y marino (tramo Algeciras- Estepona) y un área de alta montaña (Sierra Nevada). Los resultados reflejan el interés de estos visores para la visualización multitemporal y 3D de dos medios extremos (el medio submarino y el alpino) que, al incorporar algunas sencillas herramientas interactivas de análisis de los datos (cálculo de perfiles topográficos, simulación de subidas del nivel del mar, calculo de pendientes, etc.), les proporcionan un claro valor añadido para la transmisión del conocimiento en el medio natural.The aim of this paper is to show the results of incorporating the 3D geovisualization and the time (as a 4th dimension) to the geographical information and, specifically, to the interoperable geoservices by means of the Internet, applied to the field of Natural Sciences. The Condor geoviewer (with desktop and web-client versions) is a software developed by Elimco Sistemas, a company which keeps a strong relationship with the authors focussed on the design of the functionalities and the usage of graphic semiology to the geographical data. In order to make a test of these geoviewer capabilities, two areas –a coastal and marine one and an alpine geomorphological area- were chosen. The results show the potentialities of this tool in the 3D and multitemporal geovisualization applied to two extreme environments (such as alpine and submerged areas). An obvious additional advantage in the transmission of knowledge of natural environments is given to the geoviewer by means of the addition of some user-friendly interactive analysis tools (real time calculations of slope and shades, topographic profiles, etc)

Utilidades y funcionalidades de un visor tridimensional interactivo en la gestión litoral (SIGLA: Sistema de Información Geográfica del Litoral de Andalucía)

Se presenta el diseño y funcionalidades de un visor desarrollado inicialmente para proporcionar un fácil acceso a la información contenida en el SIGLA (Sistema de Información Geográfica del Litoral Andaluz), mantenido por la Consejería de Obras Publicas de la Junta de Andalucía (Vuelo interactivo del litoral Andaluz). El visor presenta dos versiones según el usuario: (i) para un usuario no especialista permite la visualización 2D y 2,5D, así como vuelos virtuales, sobre información geográfica georreferenciada en varios formatos (tif, jpg, ecw, msid, shp, dxf, bip), teniendo acceso a la información alfanumérica asociada en el caso de los «shapes». Permite igualmente el acceso a información multimedia georreferenciada (fotos, videos, etc); (ii) Para usuarios técnicos, a las funcionalidades anteriores se le añaden la posibilidad de generar videos (.avi) e imágenes tridimensionales, así como digitalizar puntos, líneas y polígonos en formato shape, editando los atributos alfanúmericos. Igualmente el visor permite, en tiempo real, calcular parámetros derivados del Modelo Digital de Elevaciones utilizado (pendientes, sombras, zonas ocultas, etc.)

Forecasters priorities for improving probabilistic flood forecasts.

Hydrological ensemble prediction systems (HEPS) have in recent years been increasingly used for the operational forecasting of floods by European hydrometeorological agencies. The most obvious advantage of HEPS is that more of the uncertainty in the modelling system can be assessed. In addition, ensemble prediction systems generally have better skill than deterministic systems both in the terms of the mean forecast performance and the potential forecasting of extreme events. Research efforts have so far mostly been devoted to the improvement of the physical and technical aspects of the model systems, such as increased resolution in time and space and better description of physical processes. Developments like these are certainly needed; however, in this paper we argue that there are other areas of HEPS that need urgent attention. This was also the result from a group exercise and a survey conducted to operational forecasters within the European Flood Awareness System (EFAS) to identify the top priorities of improvement regarding their own system. They turned out to span a range of areas, the most popular being to include verification of an assessment of past forecast performance, a multi-model approach for hydrological modelling, to increase the forecast skill on the medium range (>3 days) and more focus on education and training on the interpretation of forecasts. In light of limited resources, we suggest a simple model to classify the identified priorities in terms of their cost and complexity to decide in which order to tackle them. This model is then used to create an action plan of short-, medium- and long-term research priorities with the ultimate goal of an optimal improvement of EFAS in particular and to spur the development of operational HEPS in general

Patients with Crohn's disease have longer post-operative in-hospital stay than patients with colon cancer but no difference in complications' rate

BACKGROUNDRight hemicolectomy or ileocecal resection are used to treat benign conditions like Crohn's disease (CD) and malignant ones like colon cancer (CC).AIMTo investigate differences in pre- and peri-operative factors and their impact on post-operative outcome in patients with CC and CD.METHODSThis is a sub-group analysis of the European Society of Coloproctology's prospective, multi-centre snapshot audit. Adult patients with CC and CD undergoing right hemicolectomy or ileocecal resection were included. Primary outcome measure was 30-d post-operative complications. Secondary outcome measures were post-operative length of stay (LOS) at and readmission.RESULTSThree hundred and seventy-five patients with CD and 2,515 patients with CC were included. Patients with CD were younger (median = 37 years for CD and 71 years for CC (P < 0.01), had lower American Society of Anesthesiology score (ASA) grade (P < 0.01) and less comorbidity (P < 0.01), but were more likely to be current smokers (P < 0.01). Patients with CD were more frequently operated on by colorectal surgeons (P < 0.01) and frequently underwent ileocecal resection (P < 0.01) with higher rate of de-functioning/primary stoma construction (P < 0.01). Thirty-day post-operative mortality occurred exclusively in the CC group (66/2515, 2.3%). In multivariate analyses, the risk of post-operative complications was similar in the two groups (OR 0.80, 95%CI: 0.54-1.17; P = 0.25). Patients with CD had a significantly longer LOS (Geometric mean 0.87, 95%CI: 0.79-0.95; P < 0.01). There was no difference in re-admission rates. The audit did not collect data on post-operative enhanced recovery protocols that are implemented in the different participating centers.CONCLUSIONPatients with CD were younger, with lower ASA grade, less comorbidity, operated on by experienced surgeons and underwent less radical resection but had a longer LOS than patients with CC although complication's rate was not different between the two groups

The impact of stapling technique and surgeon specialism on anastomotic failure after right?sided colorectal resection: an international multicentre, prospective audit

Aim There is little evidence to support choice of technique and configuration for stapled anastomoses after right hemicolectomy and ileocaecal resection. This study aimed to determine the relationship between stapling technique and anastomotic failure. Method Any unit performing gastrointestinal surgery was invited to contribute data on consecutive adult patients undergoing right hemicolectomy or ileocolic resection to this prospective, observational, international, multicentre study. Patients undergoing stapled, side?to?side ileocolic anastomoses were identified and multilevel, multivariable logistic regression analyses were performed to explore factors associated with anastomotic leak. Results One thousand three hundred and forty?seven patients were included from 200 centres in 32 countries. The overall anastomotic leak rate was 8.3%. Upon multivariate analysis there was no difference in leak rate with use of a cutting stapler for apical closure compared with a noncutting stapler (8.4% vs 8.0%, OR 0.91, 95% CI 0.54–1.53, P = 0.72). Oversewing of the apical staple line, whether in the cutting group (7.9% vs 9.7%, OR 0.87, 95% CI 0.52–1.46, P = 0.60) or noncutting group (8.9% vs 5.7%, OR 1.40, 95% CI 0.46–4.23, P = 0.55) also conferred no benefit in terms of reducing leak rates. Surgeons reporting to be general surgeons had a significantly higher leak rate than those reporting to be colorectal surgeons (12.1% vs 7.3%, OR 1.65, 95% CI 1.04–2.64, P = 0.04). Conclusion This study did not identify any difference in anastomotic leak rates according to the type of stapling device used to close the apical aspect. In addition, oversewing of the anastomotic staple lines appears to confer no benefit in terms of reducing leak rates. Although general surgeons operated on patients with more high?risk characteristics than colorectal surgeons, a higher leak rate for general surgeons which remained after risk adjustment needs further exploration

Predictors for anastomotic leak, postoperative complications, and mortality after right colectomy for cancer: Results from an international snapshot audit

Background: A right hemicolectomy is among the most commonly performed operations for colon cancer, but modern high-quality, multination data addressing the morbidity and mortality rates are lacking. Objective: This study reports the morbidity and mortality rates for right-sided colon cancer and identifies predictors for unfavorable short-term outcome after right hemicolectomy. Design: This was a snapshot observational prospective study. Setting: The study was conducted as a multicenter international study. Patients: The 2015 European Society of Coloproctology snapshot study was a prospective multicenter international series that included all patients undergoing elective or emergency right hemicolectomy or ileocecal resection over a 2-month period in early 2015. This is a subanalysis of the colon cancer cohort of patients. Main Outcome Measures: Predictors for anastomotic leak and 30-day postoperative morbidity and mortality were assessed using multivariable mixed-effect logistic regression models after variables selection with the Lasso method. Results: Of the 2515 included patients, an anastomosis was performed in 97.2% (n = 2444), handsewn in 38.5% (n = 940) and stapled in 61.5% (n = 1504) cases. The overall anastomotic leak rate was 7.4% (180/2444), 30-day morbidity was 38.0% (n = 956), and mortality was 2.6% (n = 66). Patients with anastomotic leak had a significantly increased mortality rate (10.6% vs 1.6% no-leak patients; p 65 0.001). At multivariable analysis the following variables were associated with anastomotic leak: longer duration of surgery (OR = 1.007 per min; p = 0.0037), open approach (OR = 1.9; p = 0.0037), and stapled anastomosis (OR = 1.5; p = 0.041). Limitations: This is an observational study, and therefore selection bias could be present. For this reason, a multivariable logistic regression model was performed, trying to correct possible confounding factors. Conclusions: Anastomotic leak after oncologic right hemicolectomy is a frequent complication, and it is associated with increased mortality. The key contributing surgical factors for anastomotic leak were anastomotic technique, surgical approach, and duration of surgery

The relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection: an international snapshot audit.

BACKGROUND: Anastomosis technique following right sided colonic resection is widely variable and may affect patient outcomes. This study aimed to assess the association between leak and anastomosis technique (stapled versus handsewn) METHODS: This was a prospective, multicentre, international audit including patients undergoing elective or emergency right hemicolectomy or ileo-caecal resection operations over a two-month period in early 2015. The primary outcome measure was the presence of anastomotic leak within 30 days of surgery, using a pre-specified definition. Mixed effects logistic regression models were used to assess the association between leak and anastomosis method, adjusting for patient, disease and operative cofactors, with centre included as a random effect variable. RESULTS: This study included 3208 patients, of whom 78.4% (n=2515) underwent surgery for malignancy and 11.7% (n=375) for Crohn's disease. An anastomosis was performed in 94.8% (n=3041) of patients, which was handsewn in 38.9% (n=1183) and stapled in 61.1% (n=1858) cases. Patients undergoing handsewn anastomosis were more likely to be emergency admissions (20.5% handsewn versus 12.9% stapled) and to undergo open surgery (54.7% versus 36.6%). The overall anastomotic leak rate was 8.1% (245/3041), which was similar following handsewn (7.4%) and stapled (8.5%) techniques (p=0.3). After adjustment for cofactors, the odds of a leak were higher for stapled anastomosis (adjusted odds ratio 1.43, 95% confidence interval 1.04-1.95, p=0.03). DISCUSSION: Despite being used in lower risk patients, stapled anastomosis was associated with an increased anastomotic leak rate in this observational study. Further research is needed to define patient groups in whom a stapled anastomosis is safe. This article is protected by copyright. All rights reserve