Breast segmentation in infrared thermography from characteristical inframammary shape.

Infrared thermography is gaining relevance in breast cancer assessment. For this purpose, breast segmentation in thermograms is an important task for performing automatic image analysis and detecting possible temperature changes that indicate the presence of malignancy. However, it is not a simple task since the breast limit borders, especially the top borders, often have low contrast, making it difficult to isolate the breast area. Several algorithms have been proposed for breast segmentation, but these highly depend on the contrast at the lower breast borders and on filtering algorithms to remove false edges. This work focuses on taking advantage of the distinctive inframammary shape to simplify the definition of the lower breast border, regardless of the contrast level, which indeed also provides a strong anatomical reference to support the definition of the poorly marked upper boundary of the breasts, which has been one of the major challenges in the literature. In order to demonstrate viability of the proposed technique for an automatic breast segmentation, we applied it to a database with 180 thermograms and compared their results with those reported by others in the literature. We found that our approach achieved a high performance, in terms of Intersection over Union of 0.934, even higher than that reported by artificial intelligence algorithms. The performance is invariant to breast sizes and thermal contrast of the images.

Assessing the impact of distal femoral morphology using Citak's ratio: an independent risk factor for aseptic loosening in rotating hinge knee prosthesis.

BACKGROUND: Aseptic loosening (AL) is a frequent complication after rotating hinge knee (RHK) prosthesis. Citak's ratio has recently been developed to describe and classify distal femoral morphology into 3 groups (A, B, C). It consists in a ratio between the diameters of the femoral canal at 20 cm from the knee joint line and at 2 cm from the adductor tubercle. The objective of the study was to identify whether the femoral distal anatomical shape described with this ratio represents a risk factor for AL in RHK prosthesis. METHODS: Retrospective study of patients who had undergone primary or revision RHK prosthesis, with a follow-up of minimum 4 years. Citak's ratio was calculated, and patients were classified depending on its value. Univariate and bivariate statistical analysis was performed to identify AL risk factors. Receiver Operating Characteristics (ROC) analyses were conducted to examine diagnostic quality of the parameters of interest. RESULTS: Thirty-three patients were included. Most of them females (ratio 26:7), with a mean age of 78.2 (SD 6.9). Three patients presented AL (rate of 9%), all of them classified into group C (100%). Citak's ratio was significantly related to the AL rate (p < 0.001), and so was the femoral canal diameter at 20 cm from the knee joint (p 0.010). The ROC curve analysis yielded an Area Under the Curve (AUC) of 0.922 (CI 95% 0.819-1.000) for the Citak´s ratio. CONCLUSION: The inner femoral diameter at 20 cm proximal to the knee joint line and Citak's ratio help indentify patients at risk of AL after RHK prosthesis, and thus a better planning of the surgery.

Surgeon's Experience and Accuracy of Preoperative Digital Templating in Primary Total Hip Arthroplasty.

Purpose: Preoperative planning has become essential in performance of total hip arthroplasty (THA). However, data regarding the effect of the planner's experience on the accuracy of digital preoperative planning is limited. The objective of this study was to assess the accuracy of digital templating in THA based on the surgeon's experience. Materials and Methods: A retrospective study was conducted. An analysis of 98 anteroposterior pelvic radiographs, which were individually templated by four surgeons (two hip surgeons and two orthopaedic residents) using TraumaCad® digital planning, was performed. A comparison of preoperatively planned sizes with implanted sizes was performed to evaluate the accuracy of predicting component size. The results of preoperative planning performed by hip surgeons and orthopaedic residents were compared for testing of the planner's experience. Results: Femoral stem was precisely predicted in 32.4% of cases, acetabular component in 40.3%, and femoral offset in 76.7%. Prediction of cup size showed greater accuracy than femoral size among all observers. No differences in any variable were observed among the four groups (acetabular cup P=0.07, femoral stem P=0.82, femoral offset P=0.06). All measurements showed good reliability (intraclass correlation coefficient [ICC] acetabular cup: 0.76, ICC femoral stem: 0.79). Conclusion: The results of this study might suggest that even though a surgeon's experience supports improved precision during the planning stage, it should not be restricted only to surgeons with a high level of experience. We consider preoperative planning an essential part of the surgery, which should be included in training for orthopaedics residents.

Advancements in polyol synthesis: expanding chemical horizons and Néel temperature tuning of CoO nanoparticles.

The polyol synthesis of CoO nanoparticles (NPs) is typically conducted by dissolving and heating cobalt acetate tetrahydrate and water in diethylene glycol (DEG). This process yields aggregates of approximately 100 nm made of partially aligned primary crystals. However, the synthesis demands careful temperature control to allow the nucleation of CoO while simultaneously preventing reduction, caused by the activity of DEG. This restriction hinders the flexibility to freely adjust synthesis conditions, impeding the ability to obtain particles with varied morpho-structural properties, which, in turn, directly impact chemical and physical attributes. In this context, the growth of CoO NPs in polyol was studied focusing on the effect of the polyol chain length and the synthesis temperature at two different water/cations ratios. During this investigation, we found that longer polyol chains remove the previous limits of the method, allowing the tuning of aggregate size (20-150 nm), shape (spherical-octahedral), and crystalline length (8-35 nm). Regarding the characterization, our focus revolved around investigating the magnetic properties inherent in the synthesized products. From this point of view, two pivotal findings emerged. Firstly, we identified small quantities of a layered hydroxide ferromagnetic intermediate, which acted as interference in our measurements. This intermediate exhibited magnetic properties consistent with features observed in other publications on CoO produced in systems compatible with the intermediate formation. Optimal synthetic conditions that prevent the impurity from forming were found. This resolution clarifies several ambiguities existing in literature about CoO low-temperature magnetic behavior. Secondly, a regular relationship of the NPs' TN with their crystallite size was found, allowing us to regulate TN over ~ 80 K. For the first time, a branching was found in this structure-dependent magnetic feature, with samples of spheroidal morphology consistently having lower magnetic temperatures, when compared to samples with faceted/octahedral shape, providing compelling evidence for a novel physical parameter influencing the TN of a material. These two findings contribute to the understanding of the fundamental properties of CoO and antiferromagnetic materials.

Long-Term Monitoring of the Traditional Knowledge of Plant Species Used for Culinary Purposes in the Valencia Region, South-Eastern Spain.

The aim of this study is to inventory and study ethnobotanical knowledge of edible plants in the Valencian Community (Spain). In respect to culinary uses, 92 species of plant were reported to be edible, finding the following uses: 58 raw, 52 cooked, 16 fried, 7 dried, 21 in liquors and beverages, 25 in dessert and sweets, 11 as seasoning, 17 in pickles, and 10 to curdle milk. We prepared a database that includes genus, family, scientific, and vernacular names in Spanish and Catalan for each plant. We also created a classification of nine edible uses and plant parts used, being Asteraceae (n = 18), Brassicaceae (n = 7), Chenopodiaceae (n = 6), and Rosaceae (n = 6) the families most characterized for gastronomic purposes. The species with the most elevated cultural importance (CI) values were Foeniculum vulgare (CI = 1.389), Cynara scolymus (CI = 1.374), Papaver rhoeas (CI = 1.211), Beta vulgaris (CI = 1.167), and Juglans regia (CI = 1.155). The most used parts were the leaves (71), flowers (25), and branches (19), while the least used were roots (9) and seeds (8). Traditional knowledge of these plants helps to preserve traditional cuisine, promote the local economy and, in several species, encourage their cultivation.

Interneuron FGF13 regulates seizure susceptibility via a sodium channel-independent mechanism.

Developmental and Epileptic Encephalopathies (DEEs), a class of devastating neurological disorders characterized by recurrent seizures and exacerbated by disruptions to excitatory/inhibitory balance in the brain, are commonly caused by mutations in ion channels. Disruption of, or variants in, FGF13 were implicated as causal for a set of DEEs, but the underlying mechanisms were clouded because FGF13 is expressed in both excitatory and inhibitory neurons, FGF13 undergoes extensive alternative splicing producing multiple isoforms with distinct functions, and the overall roles of FGF13 in neurons are incompletely cataloged. To overcome these challenges, we generated a set of novel cell type-specific conditional knockout mice. Interneuron-targeted deletion of Fgf13 led to perinatal mortality associated with extensive seizures and impaired the hippocampal inhibitory/excitatory balance while excitatory neuron-targeted deletion of Fgf13 caused no detectable seizures and no survival deficits. While best studied as a voltage-gated sodium channel (Nav) regulator, we observed no effect of Fgf13 ablation in interneurons on Navs but rather a marked reduction in K+ channel currents. Re-expressing different Fgf13 splice isoforms could partially rescue deficits in interneuron excitability and restore K+ channel current amplitude. These results enhance our understanding of the molecular mechanisms that drive the pathogenesis of Fgf13-related seizures and expand our understanding of FGF13 functions in different neuron subsets.

Genotoxicity and heating Performance of VxFe3-xO4 nanoparticles in Health applications.

The applications of magnetic nanoparticles (MNPs) as biocatalysts in different biomedical areas have been evolved very recently. One of the main challenges in this field is to design affective MNPs surfaces with catalytically active atomic centres, while producing minimal toxicological side effects on the hosting cell or tissues. MNPs of vanadium spinel ferrite (VFe2O4) are a promising material for mimicking the action of natural enzymes in degrading harmful substrates due to the presence of active V5+ centres. However, the toxicity of this material has not been yet studied in detail enough to grant biomedical safety. In this work, we have extensively measured the structural, compositional, and magnetic properties of a series of VxFe3-xO4 spinel ferrite MNPs to assess the surface composition and oxidation state of V atoms, and also performed systematic and extensive in vitro cytotoxicity and genotoxicity testing required to assess their safety in potential clinical applications. We could establish the presence of V5+ at the particle surface even in water-based colloidal samples at pH 7, as well as different amounts of V2+ and V3+ substitution at the A and B sites of the spinel structure. All samples showed large heating efficiency with Specific Loss Power values up to 400 W/g (H0 = 30 kA/m; f = 700 kHz). Samples analysed for safety in human hepatocellular carcinoma (HepG2) cell line with up to 24h of exposure showed that these MNPs did not induce major genomic abnormalities such as micronuclei, nuclear buds, or nucleoplasmic bridges (MNIs, NBUDs, and NPBs), nor did they cause DNA double-strand breaks (DSBs) or aneugenic effects-types of damage considered most harmful to cellular genetic material. The present study is an essential step towards the use of these type of nanomaterials in any biomedical or clinical application.

Routine pretransfusion testing before primary total hip or knee arthroplasty are an expensive and wasteful routine. Systematic review and meta-analysis.

BACKGROUND: The excessive routine ordering of pretransfusion tests (blood typing, screening, and cross-matching) for surgical cases incurs significant unnecessary costs and places an undue burden on transfusion services. This study aims to systematically review the literature regarding the necessity of routine pretransfusion tests before total hip arthroplasty (THA) or total knee arthroplasty (TKA) and summarize their outcomes. STUDY METHODS: A systematic review and meta-analysis were performed. The study's characteristics, the prevalence of over-ordering pretransfusion tests, transfusion rates, and potential cost savings to the healthcare system were analyzed. RESULTS: The study included 17,667 patients. Pooled results revealed a 96.3% over-ordering pretransfusion test rate (95% CI: 0.92-1.00; p < 0.001) among patients undergoing primary THA or TKA. The pooled prevalence of hospital transfusion rate was 3.6%. Notably, there were statistically significant differences in preoperative hemoglobin (Hb) levels between patients not requiring transfusion (Hb = 13.9 g/dl; 95% CI 12.59-15.20; p < 0.001) and those needing transfusion (Hb = 11.9 g/dl; 95% CI 10.69-13.01; p < 0.001) (p = 0.03). The per-patient total cost savings ranged from 28.63 to 191.27 dollars. DISCUSSION: Our study suggests that routine pre-transfusion testing for all patients undergoing primary THA or TKA may be unnecessary. We propose limiting pretransfusion test orders to patients with preoperative hemoglobin levels below 12 g/dl in unilateral primary TKA or THA. This targeted approach can result in significant cost savings for healthcare systems and transfusion services by reducing the over-ordering of pretransfusion tests in these surgical procedures.

Risk of venous thromboembolism in thromboprophylaxis between aspirin and low molecular weight heparins after total hip arthroplasty or total knee arthroplasty: Systematic review and meta-analysis. / Riesgo de tromboembolismo venoso en la tromboprofilaxis entre aspirina y heparinas de bajo peso molecular tras una artroplastia total de cadera o artroplastia total de rodilla. Revisión sistemática y metaanálisis.

INTRODUCTION: The aim of this study was to evaluate the efficacy of aspirin versus low molecular weight heparins (LMWH) for the prophylaxis of venous thromboembolism (VTE), deep vein thrombosis (DVT) and pulmonary embolism (PE) in patients undergoing total knee arthroplasty (TKA) and/or total hip arthroplasty (THA). MATERIALS AND METHODS: Systematic review and meta-analysis. Sixteen studies were selected. The risk of VTE, DVT and PE were analyzed. Mortality, risk of bleeding and surgical wound complications was also analyzed. RESULTS: 248,461 patients were included. 176,406 patients with thromboprophylaxis with LMWH and 72,055 patients with aspirin thromboprophylaxis. There were no significant differences in the risk of VTE (OR = 0.93; 95% CI: 0.69-1.26; P = .64), DVT (OR = 0.72; 95% CI: 0.43-1.20; P = .21) or PE (OR = 1.13; 95% CI: 0.86-1.49; P = .38) between both groups. No significant differences were found in mortality (P = .30), bleeding (P = .22), or complications in the surgical wound (P = .85) between both groups. These same findings were found in the sub-analysis of only randomized clinical trials (P>.05). CONCLUSIONS: No increased risk of PE, DVT, or VTE was found among patients with aspirin thromboprophylaxis versus patients with LMWH thromboprophylaxis. There was also no greater mortality, greater bleeding, or greater complications in the surgical wound found among patients with aspirin thromboprophylaxis versus patients with LMWH thromboprophylaxis.

Annealing effects on the magnetic and magnetotransport properties of iron oxide nanoparticles self-assemblies.

In magnetic tunnel junctions based on iron oxide nanoparticles the disorder and the oxidation state of the surface spin as well as the nanoparticles functionalization play a crucial role in the magnetotransport properties. In this work, we report a systematic study of the effects of vacuum annealing on the structural, magnetic and transport properties of self-assembled ∼10 nm Fe3O4nanoparticles. The high temperature treatment (from 573 to 873 K) decomposes the organic coating into amorphous carbon, reducing the electrical resistivity of the assemblies by 4 orders of magnitude. At the same time, the 3.Fe2+/(Fe3++Fe2+) ratio is reduced from 1.11 to 0.13 when the annealing temperature of the sample increases from 573 to 873 K, indicating an important surface oxidation. Although the 2 nm physical gap remains unchanged with the thermal treatment, a monotonous decrease of tunnel barrier width was obtained from the electron transport measurements when the annealing temperature increases, indicating an increment in the number of defects and hot-spots in the gap between the nanoparticles. This is reflected in the reduction of the spin dependent tunneling, which reduces the interparticle magnetoresistance. This work shows new insights about influence of the nanoparticle interfacial composition, as well their the spatial arrangement, on the tunnel transport of self-assemblies, and evidence the importance of optimizing the nanostructure fabrication for increasing the tunneling current without degrading the spin polarized current.

Autonomy with responsibility ¿Is informed consent just a signature on a paper? Evaluation in patients who underwent spine's surgery.

PURPOSE: To evaluate the information that patients undergoing spine surgery truly receive and assimilate when they sign their informed consent documents. METHODS: This was a retrospective study on patients who underwent spine arthrodesis or spine discectomy. Patients were given a full explanation of the surgical technique to be employed and its potential risks before they were included on the surgical waiting list. Before surgery, they were asked to sign an informed consent form. The studied variables included whether patients read the informed consent form, whether they recalled the surgical technique used or the spinal segment operated, whether they were aware of the surgical risks involved, and if they had looked for information about their procedure elsewhere. Answers were analyzed by age and educational level. RESULTS: Of a total of 458 total patients, only 51.9% answered all the questions. Sixty-three percent of patients said they had read the informed consent document before surgery. Although 91.6% of patients were aware of the spine segment operated, only 73.5% remembered the surgical technique employed. A total of 63.9% of patients could recall the vertebral levels operated. 39.1% were not aware of the surgical risks involved, and only 16.0% of patients admitted having looked for additional information. A statistically significant correlation was found between the search for additional information and young age (p < 0.001) on the one hand, and high educational level on the other (p = 0.023). CONCLUSION: Even though obtaining informed consent is an important procedure before spinal surgery, almost 40% of the patients in this study underwent surgery without reading the informed consent document or being aware of the risks posed by the procedure.

Complete Desorption of Hybrid Nanoclays Composed of Hydrotalcite and Disperse Dye.

Clays are considered great nanoadsorbents for many materials, including textile dyes. The use of these materials for cleaning textile wastewater is well known; however, it is not at all common to find applications for the hybrid materials formed from the clay and dye. In this work, a dye-loaded clay material was used to make new dye baths and colour a polyester textile substrate. The same hybrid could be used several times as it did not use all the adsorbed dye in a single dyeing. The hybrid obtained from hydrotalcite (nanoclay) and the dispersed red 1 dye was analysed by measuring the colour obtained, carrying out an X-ray diffraction analysis that provided information after each desorption-dyeing process, and using infrared spectroscopy to analyse the specific bands of each characteristic group. Both analyses showed that the amount of dye present in the hybrid decreases. Thermogravimetry (TGA), surface area and porosity measurements (BET), and X-ray photoelectron spectroscopy (XPS) tests were conducted. Chemical stability was assessed by subjecting the hybrid to the actions of different reagents. In addition, colour fastness tests were carried out after dyeing and washing the polyester test tubes to check for the correct fixing of the dye to the fibre. These fastness results showed that the dyeing was carried out correctly and as if it was a conventional dyeing process.

Two new species and records of the genus Questa (Annelida: Orbiniidae) from Azores and Canary Islands, Central Atlantic Ocean.

We here report two new species of meiofaunal orbiniids belonging to the genus Questa Hartman, 1966, which have been discovered during benthic surveys conducted around the Azores and the Canary Islands. The new species, Q. manuelgerardi n. sp. and Questa ericnunezi n. sp., are described, figured and discussed in detail. Questa manuelgerardi n. sp., endemic from the Azores, is characterized by the lack of furcate chaetae and branchiae, and by the presence of two pairs of anal cirri. Questa ericnunezi endemic from the Canary Island, is defined by the presence of furcate chaetae, 12-18 pairs of branchiae, and two pairs of anal cirri. In addition, new records of the species Q. caudicirra Hartman, 1966 are provided. An identification key to the 12 known species of Questa is also included.

Hypoalbuminemia increases the risk of failure following one-stage septic revision for periprosthetic joint infection.

PURPOSE: Malnutrition is a potentially modifiable risk factor of periprosthetic joint infection (PJI). The purpose of this study was to analyze the role of nutritional status as a risk factor for failure after one- stage revision hip or knee arthroplasty for PJI. METHODS: Retrospective, single-center, case-control study. Patients with PJI according to the 2018 International Consensus Meeting criteria were evaluated. Minimum follow-up was 4 years. Total lymphocyte count (TLC), albumin values, hemoglobin, C-reactive protein, white blood cell (WBC) count and glucose levels were analyzed. An analysis was also made of the index of malnutrition. Malnutrition was defined as serum albumin < 3.5 g/dL and TLC < 1500/mm3. Septic failure was defined as the presence of local or systemic symptoms of infection and the need of further surgery as a result of persistent PJI. RESULTS: No significant differences were found between increased failure rates after a one-stage revision hip or knee arthroplasty for PJI and TLC, hemoglobin level, WBC count, glucose levels, or malnutrition. Albumin and C-reactive protein values were found to have a positive and significant relationship with failure (p < 0.05). Multivariate logistic regression identified only hypoalbuminemia (serum albumin < 3.5 g/dL) (OR 5.64, 95% CI 1.26-25.18, p = 0.023) as a significant independent risk factor for failure. The receiver operating characteristic (ROC) curve for the model yielded an area under the curve of 0.67. CONCLUSION: TLC, hemoglobin; WBC count; glucose levels; and malnutrition, understood as the combination of albumin and TLC, were not found to be statically significant risk factors for failure after single-stage revision for PJI. However, albumin < 3.5 g/dL, alone was a statically significant risk factor for failure after single-stage revision for PJI. As hypoalbuminemia seems to influence the failure rate, it is advisable to measure albumin levels in preoperative workups.

Percepción comunitaria sobre arrecifes coralinos en Golfo Dulce: bases para integración social en programas de restauración

Introducción: Enfrentar la acelerada degradación de arrecifes coralinos requiere una acción integrada en múltiples niveles sociales y ecológicos. A escala local se debe incluir la participación activa de los usuarios de los recursos. Objetivo: evaluar el conocimiento y percepción local sobre los arrecifes coralinos en Golfo Dulce, y así generar bases para la integración social en la restauración coralina. Métodos: se realizaron 183 entrevistas en siete comunidades costeras del Golfo Dulce entre septiembre del 2016 y marzo del 2017. Los entrevistados se clasificaron en: (1) Pesca artesanal (PA) = 57 entrevistados, (2) Turismo (T) = 62, y (3) Otros (O) = 64. La primera parte de la entrevista fue de conocimiento y se asignó una nota basada en respuestas correctas. Según la nota se clasificó como informado, información media o desinformado. La segunda parte se basó en escalas de percepción sobre: (I) visitación, (II) factores que dañan los arrecifes coralinos, (III) medidas de manejo y (IV) salud de recursos marinos en Golfo Dulce. Resultados: El grupo T tuvo el mayor porcentaje de entrevistados informados = 42 % y el grupo O de desinformados = 37 %. La segunda parte fue percepción, más del 50 % de PA y T consideran que la visita es frecuente. La sedimentación y contaminación por agroquímicos fueron identificados por más del 60 % de PA y T como la principal amenaza. El 35 % de PA y el 40 % de T perciben las boyas fijas como la mejor medida para el Golfo Dulce. La restricción de visitas fue la medida con menor aceptación. El 60 % de los entrevistados de PA y T consideran que los recursos marinos del golfo estarán peor que en la actualidad. Conclusiones: Estos resultados confirman la importancia de comprender el conocimiento y la percepción de los usuarios de los arrecifes de coral en los procesos participativos y educativos en la restauración y conservación de los arrecifes de coral.

Introduction: Addressing the accelerated coral reefs degradation requires integrated action at multiple social and ecological scales. At local level, active participation of the main users must be included. Objective: To evaluate local knowledge and perception about coral reefs in Golfo Dulce to generate bases for social integration in coral restoration. Methods: 183 interviews were conducted in coastal communities in Golfo Dulce, between September 2016 and March 2017. The interviewees were classified as: (1) Artisanal fishing (PA) = 57 interviewees, (2) Tourism (T) = 62, and (3) Others (O) = 64. The first part of the interview was about knowledge and a grade was assigned based on correct answers. According to the grade, they were classified as informed, medium information or uninformed. The second part was based on perception scales on: (I) visitation, (II) factors that damage coral reefs, (III) management measures, and (IV) health of marine resources in Golfo Dulce. Results: Group T had the highest percentage of informed interviewees = 42 % and group O uninformed = 37 %. The second part was perception, more than 50 % of PA and T consider that the visit is frequent. Sedimentation and contamination by agrochemicals were identified by more than 60 % of PA and T as the main threat. 35 % of PA and 40 % of T perceive permanent buoys as the best measure for the Golfo Dulce. The visitation restriction was the measure with the least acceptance. 60 % of the interviewees of PA and T consider that the marine resources of the gulf will be worse than today. Conclusions: These results confirm the importance of understading coral reefs users knowledge and perception in participatory and educational processes in coral reef restoration and conservation.