VARIABLE LEVEL OF DETAIL IN ARCHAEOLOGICAL 3D MODELS OBTAINED THROUGH A DIGITAL SURVEY

[EN] This paper focuses on the use of information technologies in the field of archaeological representation. It is part of a series of studies on the VillaAdriana in Tivoli which have led us to investigate the decoration of the Maritime Theatre (Emperor Hadrian¿s personal residence) and other famous archaeological structures located within this UNESCO World Heritage listed site. The richness of detail that characterise the curved entablature pieces of this landmark building stimulated our research team 1 to develop new methods of representation, allowing the interactive assembling of digital models of a high geometric detail obtained by means of laser scanning. This article explains a new methodology for optimising digital survey data in the archaeological field which has previously been developed in other research sectors but not yet implemented in digital survey programs.[ES] Esta contribución, centrada en el uso de tecnologías informáticas para la representación, forma parte de una serie de estudios sobre la Villa Adriana en Tívoli, que nos han llevado a investigar la decoración del Teatro Marítimo, residencia personal del Emperador Adriano, así como otras famosas arquitecturas de este conjunto arqueológico perteneciente a la Lista del Patrimonio Mundial. La riqueza de detalles que caracteriza a las piezas del entablamento curvo de este emblemático edificio ha estimulado a nuestro equipo de investigación 1 para desarrollar nuevos métodos de representación, que permitan el uso interactivo de modelos digitales de alto detalle geométrico obtenidos con escáner laser. En este artículo se explicará una nueva metodología de optimización de los datos de levantamiento digital en el campo arqueológico, desarrollado en otros sectores de investigación, y que todavía no se han incluido en los programas para el levantamiento con escáner.Fantini, F. (2012). MODELOS CON NIVEL DE DETALLE VARIABLE REALIZADOS MEDIANTE UN LEVANTAMIENTO DIGITAL APLICADOS A LA ARQUEOLOGÍA. EGA. Revista de Expresión Gráfica Arquitectónica. 17(19):306-317. doi:10.4995/ega.2012.1383SWORD3063171719Adembri, B., 2010. La decorazione architettonica del Teatro Marittimo. En: Marina Sapelli Ragni, ed. 2010.Villa Adriana. Una storia mai finita. Electa, Milano, 2010.Apollonio, I., Gaiani, M., Manfredini, A.M., 2010. Modellazione semantica metodi a multirisoluzione. En: Benedetti, B., Gaiani, M., Remondino, F., ed. 2010. Modelli digitali 3D in archeologia: il caso di Pompei. Pisa. Edizioni della Normale.Battini, C., Fantini, F., 2007. Clouds and clay. Superfici di suddivisione e ottimizzazione. En: L. De Carlo, ed. 2007. Informatica e fondamenti scientifici della rappresentazione. Roma. Gangemi.Di Tondo, S., 2010. Modelli digitali per la comprensione dell'aspetto originario del manufatto: architettura e apparato decorativo del Teatro Marittimo a Villa Adriana. En: Mandelli, E., Velo, U.,ed. 2010. Il modello in architettura, cultura scientifica e rappresentazione. Firenze. Alinea.Gaiani, M., ed. 2006, La rappresentazione riconfigurata. Milano, Edizioni POLI.design.Guidi, G., Russo, M., Beraldin, J.A., 2010. Acquisizione 3D e modellazione poligonale. Milano. McGraw-Hill.Juan Vidal, F., Merlo, A., 2008. Nuevas aplicaciones del levantamiento integrado (rilievo). Arché, 2008, 3, p. 307-318.Lee, A., Moreton, H., & Hoppe, H. (2000). Displaced subdivision surfaces. Proceedings of the 27th annual conference on Computer graphics and interactive techniques - SIGGRAPH ’00. doi:10.1145/344779.344829Lévy, B. (2001). Constrained texture mapping for polygonal meshes. Proceedings of the 28th annual conference on Computer graphics and interactive techniques - SIGGRAPH ’01. doi:10.1145/383259.383308Migliari, R., ed. 2008, Prospettiva dinamica interattiva, la tecnologia dei videogiochi per l'esplorazione di modelli 3D di architettura. Roma, Edizioni Kappa.Piponi, D., & Borshukov, G. (2000). Seamless texture mapping of subdivision surfaces by model pelting and texture blending. Proceedings of the 27th annual conference on Computer graphics and interactive techniques - SIGGRAPH ’00. doi:10.1145/344779.34499

Regional reference values for spirometric parameters in young people from La Plata, Buenos Aires, Argentina.

Introducción: En los estudios espirométricos se recomienda que cada población cuente con sus propios valores de referencia debido a condiciones regionales y a características de tipo étnico, etario, social, geográfico y climático. Estudios previos muestran elevados niveles de material particulado, hidrocarburos policíclicos y compuestos volátiles en el aire de La Plata y alrededores, con correlación entre exposición crónica a contaminantes y efectos adversos sobre desarrollo y función pulmonar. El objetivo fue establecer valores de referencia regionales para parámetros espirométricos en jóvenes de La Plata, siguiendo las recomendaciones de la American Thoracic Society (ATS) y la European Respiratory Society (ERS). Métodos: Estudio transversal, observacional y descriptivo. Se realizaron y analizaron 171 espirometrías a jóvenes sanos de 13-17 años. Se llevaron a cabo medidas de correlación, identificando las variables predictoras. Para las ecuaciones de predicción se ajustaron modelos de regresión en función del sexo. Resultados: La mayor correlación se encontró con talla y peso. Se desarrollaron ecuaciones para capacidad vital forzada (FVC) y volumen espiratorio forzado en el primer segundo (FEV1) según género. Discusión: El cálculo de nuevos parámetros con valores menores a los propuestos por un estudio en Barcelona y adaptados por la Sociedad Española de Neumología y Cirugía Torácica (SEPAR) confirmó la importancia de contar con valores de referencia regionales.Introduction: It is recommended that in spirometric studies each population have its own reference values due to regional conditions as well as ethnic, age, social, geographical and climatic characteristics. Previous studies show high levels of particulate matter, polycyclic hydrocarbons and volatile compounds in the air of La Plata city and surroundings, with correlation between chronic exposure to pollutants and adverse effects on lung development and function. The objective was to establish regional reference values for spirometric parameters in adolescents of La Plata, following the recommendations of the American Thoracic Society (ATS) and European Respiratory Society (ERS). Methods: A cross-sectional, observational and descriptive study was carried out, performing and analyzing 171 spirometries in healthy young people between 13 and 17 years of age. Correlation measures were carried out to identify the predictive variables of spirometry. For the prediction equations, regression models were adjusted according to gender. Results: The highest correlation was found with height and weight. Equations were developed for forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) for each gender. Discussion: The calculation of new parameters, with values lower than those proposed by a study in Barcelona and adapted by the Spanish Society of Pneumology and Thoracic Surgery (SEPAR), confirmed the importance of having regional reference values.Centro de Investigaciones del Medioambient

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p&lt;0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p&lt;0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

A new class of glycomimetic drugs to prevent free fatty acid-induced endothelial dysfunction

Background: Carbohydrates play a major role in cell signaling in many biological processes. We have developed a set of glycomimetic drugs that mimic the structure of carbohydrates and represent a novel source of therapeutics for endothelial dysfunction, a key initiating factor in cardiovascular complications. Purpose: Our objective was to determine the protective effects of small molecule glycomimetics against free fatty acid­induced endothelial dysfunction, focusing on nitric oxide (NO) and oxidative stress pathways. Methods: Four glycomimetics were synthesized by the stepwise transformation of 2,5­dihydroxybenzoic acid to a range of 2,5­substituted benzoic acid derivatives, incorporating the key sulfate groups to mimic the interactions of heparan sulfate. Endothelial function was assessed using acetylcholine­induced, endotheliumdependent relaxation in mouse thoracic aortic rings using wire myography. Human umbilical vein endothelial cell (HUVEC) behavior was evaluated in the presence or absence of the free fatty acid, palmitate, with or without glycomimetics (1µM). DAF­2 and H2DCF­DA assays were used to determine nitric oxide (NO) and reactive oxygen species (ROS) production, respectively. Lipid peroxidation colorimetric and antioxidant enzyme activity assays were also carried out. RT­PCR and western blotting were utilized to measure Akt, eNOS, Nrf­2, NQO­1 and HO­1 expression. Results: Ex vivo endothelium­dependent relaxation was significantly improved by the glycomimetics under palmitate­induced oxidative stress. In vitro studies showed that the glycomimetics protected HUVECs against the palmitate­induced oxidative stress and enhanced NO production. We demonstrate that the protective effects of pre­incubation with glycomimetics occurred via upregulation of Akt/eNOS signaling, activation of the Nrf2/ARE pathway, and suppression of ROS­induced lipid peroxidation. Conclusion: We have developed a novel set of small molecule glycomimetics that protect against free fatty acidinduced endothelial dysfunction and thus, represent a new category of therapeutic drugs to target endothelial damage, the first line of defense against cardiovascular disease

Impact of uncontrolled hypertension on atrial fibrillation ablation outcome

Objectives The goal of this study was to evaluate the impact of hypertension on the outcome of atrial fibrillation (AF) ablation. Background Hypertension is a well-known independent risk factor for incident AF. Methods A total of 531 consecutive patients undergoing AF ablation were enrolled in this study and divided into 3 groups: patients with uncontrolled hypertension despite medical treatment (group I, n = 160), patients with controlled hypertension (group II, n = 192), and patients without hypertension (group III, n = 179). Pulmonary vein (PV) antrum and posterior wall isolation was always performed, and non-PV triggers were identified during isoproterenol infusion. All patients underwent extensive follow-up. Results Three groups differed in terms of left atrial (LA) size, non-PV triggers, and moderate/severe LA scar. Non-PV triggers were present in 94 (58.8%), 64 (33.3%), and 50 (27.9%) patients in groups I, II, and III, respectively (p < 0.001). After 19 ± 7.7 months of follow-up, 65 (40.6%), 54 (28.1%), and 46 (25.7%) patients in groups I, II, and III had recurrences (log-rank test, p = 0.003). Among patients in group I who underwent additional non-PV trigger ablation, freedom from AF/atrial tachycardia was 69.8%, which was similar to groups II and III procedural success (log-rank p = 0.7). After adjusting for confounders, uncontrolled hypertension (group I) (hazard ratio [HR]: 1.52, p = 0.045), non-PV triggers (HR: 1.85, p < 0.001), and nonparoxysmal AF (HR: 1.64, p = 0.002) demonstrated significant association with arrhythmia recurrence. Conclusions Controlled hypertension does not affect the AF ablation outcome when compared with patients without hypertension. By contrast, uncontrolled hypertension confers higher AF recurrence risk and requires more extensive ablation

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

Background: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Outcomes in Newly Diagnosed Atrial Fibrillation and History of Acute Coronary Syndromes: Insights from GARFIELD-AF

BACKGROUND: Many patients with atrial fibrillation have concomitant coronary artery disease with or without acute coronary syndromes and are in need of additional antithrombotic therapy. There are few data on the long-term clinical outcome of atrial fibrillation patients with a history of acute coronary syndrome. This is a 2-year study of atrial fibrillation patients with or without a history of acute coronary syndromes