Perforación colónica por endoprótesis biliar impactada / Colonic perforation due to impacted biliary stent

Introducción. La colocación de endoprótesis biliares es cada día más frecuente por ser actualmente una de las mejores opciones para el tratamiento de patologías de la vía biliar. La migración de las endoprótesis es una de las complicaciones que puede ocurrir en hasta un 10,8 % de los pacientes, pero en muy raras ocasiones llegan a causar una perforación intestinal. Caso clínico. Se trata de una paciente de 61 años, a quien cinco años atrás se le realizó una colangiopancreatografía retrógrada endoscópica por coledocolitiasis. Consultó por presentar dolor abdominal, y al examen físico se encontraron abdomen agudo y plastrón en fosa ilíaca izquierda a la palpación. La tomografía computarizada informó un cuerpo extraño a nivel del colon descendente, con perforación del mismo. Se realizó laparotomía exploratoria y colostomía por perforación del colon sigmoides secundaria a prótesis biliar migrada. Resultados. La paciente evolucionó favorablemente y a los seis meses se realizó el cierre de la colostomía, sin complicaciones. Conclusión. Los pacientes a quienes se les colocan prótesis biliares requieren un seguimiento adecuado para evitar complicaciones que, aunque raras, pueden ocurrir, como la migración intestinal con perforación. El tratamiento de dichas complicaciones se hace por vía endoscópica, laparoscópica o laparotomía en caso de complicación severa.

Introduction. Endoscopic placement of biliary stents is becoming more common every day, as it is currently one of the best options for the treatment of bile duct pathologies. One of the complications that can occur is the migration of the endoprostheses in up to 10.8% of patients, which in very rare cases can cause intestinal perforation. Clinical case. This is a 61-year-old female patient, who underwent endoscopic retrograde cholangiopancreatography five years ago for choledocholithiasis. She consulted due to abdominal pain, with a physical examination that upon palpation documented an acute abdomen and a palpable plastron in the left iliac fossa. The computed tomography revealed a foreign body at the level of the descending colon, with perforation. Exploratory laparotomy and colostomy were performed due to perforation of the sigmoid colon secondary to migrated biliary prosthesis. Results. The patient progressed favorably and six months later the colostomy was closed without complications. Conclusions. Patients who receive biliary stents require adequate follow-up to avoid complications that, although rare, may occur, such as intestinal migration with intestinal perforation. The treatment of these complications can be endoscopic, laparoscopic or laparotomy in case of severe complication.

Ratchet universality in coupled dissipative oscillators without external bias.

Directed ratchet transport is generally observed in nonautonomous systems as a result of the interplay of nonlinearity, symmetry breaking, and nonequilibrium fluctuations. Here we demonstrate that ratchet dynamics can appear in significant transporting degrees of freedom of dissipative coupled systems without external bias due to unidirectional coupling of oscillatory degrees of freedom (which are also nonbiasing in any direction), while optimal enhancement of directed ratchet transport occurs when the initial conditions and parameters of such ratcheting degrees of freedom are suitably chosen as predicted by the theory of ratchet universality. The simple case of linear oscillatory degrees of freedom is discussed in detail, and numerical experiments are described which confirm all the theoretical predictions, including the dependence of current (velocity) reversals on the initial conditions and the ratcheting degrees-of-freedom parameters. This autonomous ratchet scenario could be exploited technologically, for instance, in the context of noncontact, rack-and-pinion type, nanoscale setups with coupling from the lateral Casimir force, and is relevant for studies of molecular motors in the biological realm.

Directed ratchet transport of cold atoms and fluxons driven by biharmonic fields: A unified view.

This paper discusses two retrodictions of the theory of ratchet universality which explain previous experimental results concerning directed ratchet transport of cold atoms in dissipative optical lattices in one case and of fluxons in uniform annular Josephson junctions in the other, both driven by biharmonic fields. It has to be emphasized that these retrodictions are in sharp contrast with the current standard explanation of such experimental results, and they offer optimal control of the ratchetlike motion of such entities. New experimental proposals with cold atoms and fluxons are discussed, providing additional tests for novel predictions from ratchet universality.

Comportamiento de capacidades y mermas en la producción del Instituto Finlay de Vacunas en el año 2017 / Behavior of capacities and losses in the production of the Finlay Institute of Vaccines in the year 2017

El análisis de las mermas y las capacidades son fundamentales para la gestión empresarial, en cuanto permite conocer el grado de uso que se hace de cada uno de los recursos en la organización y optimizarlos. Ambos estudios constituyen una herramienta útil para incidir en los costos y mejorar la eficiencia de la empresa. En el presente trabajo se analizó el comportamiento de las capacidades y las mermas del año 2017 en el Instituto Finlay de Vacunas, teniendo en cuenta el plan de capacidades y de mermas certificados para ese año por BioCubaFarma (Organización Superior de Desarrollo Empresarial, a la que se subordinan los centros de la biotecnología en Cuba). Se realizó una evaluación del comportamiento de la utilización de las capacidades productivas por meses al cierre del 2017, teniendo como base la comparación entre el plan de producción por meses, lo real producido y la capacidad productiva mensual. Paralelamente se realizó un estudio comparativo entre la merma total de la empresa y la mensual real por vacunas con respecto al estándar de mermas establecido. Los resultados mostraron que al cierre del 2017 la utilización de las capacidades productivas fue de 78,9 por ciento; incidiendo negativamente en este aspecto roturas de la línea de llenado. Se obtuvo un 80 por ciento de cumplimiento del plan de producción, las mayores afectaciones ocurrieron en los meses de mayo, agosto y septiembre debido a roturas de los sistemas críticos, roturas de equipamiento y las afectaciones provocadas por el huracán Irma. Al cierre del año que se analiza, las mermas estuvieron por debajo de las mermas certificadas. Sin embargo, los meses de junio, julio agosto y diciembre mostraron un incremento de las mismas por encima de lo planificado. Las vacunas que mayores mermas aportaron fueron: vax-TET® con 13,7 por ciento, VA-DIFTET® con 13,0 por ciento y diTe-vax® con 11,3 por ciento, siendo la etapa de llenado la de mayor contribución de mermas. La vacuna vax-TET® fue la que sistemáticamente aportó mermas en la presentación unidosis(AU)

The analysis losses and capacities are fundamental for the managerial administration because allow to know the degree of use that is made of each resources in the organization and to optimize them. Both studies constitute an useful tool to impact in the cost and to improve the efficiency of the company. Presently work was analyzed the behavior of the capacities and losses at the Finlay Vaccine Institute in the year 2017, taking into account the plan of capacities and losses certified by BioCubaFarma for this year. An evaluation of the behavior of the use of productive capacities per months at the end of 2017 was carried out, having like base the comparison among the production plan per months, the real produced and the monthly productive capacity. Also a comparative study among the company total losses and the monthly real one for each vaccine with regard to the standard established was carried out. The results showed that in 2017 the use of productive capacities were 78.9 percent, impacting negatively in this aspect the constants breaks of the filled line. 80 percent was obtained for execution of production plan, with the biggest affectations in May, August and September due to breaks of critical systems; breaks of equipment and the affectations caused by the hurricane Irma. At the end of the analyzed year, the losses were below the certified one. However, the months of June, July August and December showed an increment above that planned. The vaccines that contribute with bigger losses were: vax-TET® with 13.7 percent, VA-DIFTET® with 13.0 percent and diTe-vax® with 11.3 percent, being the stage of filled of bigger losses contribution. The vaccine that systematically contributed with losses was vax-TET® vaccine, in the unidoses presentation(AU)

Reemplazo de cadera en pacientes jóvenes: Experiencia con vástago corto preservador de cuello femoral / Hip replacement in young patients: Experience with a femoral neck preserving short stem

Introduccion La tendencia creciente de uso de implantes no cementados y el desarrollo de tecnologías que buscan restablecer la anatomía y función articular con una mayor preservación ósea, ha incrementado el uso de vástagos cortos en el remplazo total de cadera (RTC). El objetivo de este estudio es describir resultados funcionales, restauración radiológica de la anatomía, tasa de complicaciones y reintervención de pacientes sometidos a RTC usando vástagos femorales cortos de fijación cervico metafisiaria con apoyo en cortical lateral. Materiales y Métodos Estudio descriptivo prospectivo, donde se incluyeron 45 caderas en pacientes con artrosis de cadera de cualquier etiología. El seguimiento fue de 18 meses. Las variables de desenlace evaluadas fueron: 1. Integración del implante, 2. Complicaciones dependientes del implante femoral, 3. Subsidencia y 4. Reintervención. Se evaluó adicionalmente el resultado funcional con escala WOMAC. Resultados Durante el periodo comprendido entre diciembre de 2011 a julio 2017, encontramos una mejoría en estado funcional en el 97% (n:44) de los pacientes, no hubo reintervenciones. Discusión En el 100% de los casos se encontró osteointegración del implante y los resultados son comparables con los reportes de la literatura. Consideramos que el uso de vástagos cortos en el Reemplazo total de Cadera es un procedimiento seguro, con buenos resultados, teniendo la ventaja de una adecuada integración ósea del implante y garantizar un mejor stock óseo en una próxima cirugía.

Background The growing trend in the use of non-cemented implants and the development of technologies that attempt to restore the anatomy and joint function with greater bone preservation has increased the use of short stems in the total hip replacement (THR). The objective of this study is to describe functional results, radiological restoration of the anatomy, complication and revision rate of patients undergoing THR using short femoral stems with metaphyseal cervical fixation with lateral cortical support. Materials and Methods A prospective descriptive study was performed that included 45 hips of patients with hip osteoarthritis of any origin. The follow-up was 18 months. The outcome variables evaluated were: 1. Integration of the implant, 2. Complications dependent on the femoral implant, 3. Subsidence, and 4. Re-intervention. The functional result was additionally evaluated using the Western Ontario and McMaster Universities Arthritis Index (WOMAC). Results During the period from December 2011 to July 2017, an improvement was observed in functional status in 97% (n: 44) of patients, with no reoperations. Discussion Bone integration of the implant was observed in 100% of the cases, making the results comparable with the reports in the literature. It is believed that the use of short stems in total hip replacement is a safe procedure, with good outcomes. It also has the advantage of an adequate bone integration of the implant, and guaranteeing a better bone stock in the next surgery.

Evaluación preliminar y actualización de las mermas productivas para mejorar la rentabilidad del Instituto Finlay de Vacunas / Preliminary evaluation and updating of the productive losses to improve the profitability of Finlay

Se realizó una evaluación preliminar de las mermas productivas en varios escenarios de la Planta de Procesamiento Aséptico y de Envase del Instituto Finlay de Vacunas de La Habana, Cuba. La evaluación abarco las áreas de formulación, llenado, etiquetado y envase, durante el período 2011-2015, con el propósito de constituir una herramienta útil que incidiera sobre los costos de producción y mejorar la eficiencia de la empresa. Los resultados muestran que la etapa de formulación presenta mayor promedio de pérdidas por mermas (6,99 por ciento), principalmente aportadas por las vacunas DTP-vax® y VA-MENGOC-BC®; seguido de la etapa de llenado con un promedio de mermas de 4 por ciento. Las mermas para el resto de las etapas oscilaron entre 0,2 por ciento y 1,57 por ciento. El costo general de las mermas de este período fue de 8.949.871,79 pesos cubanos, aportado por las vacunas vax-SPIRAL®, vax-TyVi®, vax-TET® y VA-MENGOC-BC®. Se observó que, excepto para vax-TET-5® (presentación de 20 dosis), debido a problemas confrontados con el volumen de los bulbos, las mermas del año 2016 estuvieron por debajo del porcentaje establecido. Por último, se realizó un análisis de tendencia de las mermas totales y por presentación, en el período 2011 al 2016, mostrando que en el año 2015 se obtuvo la mayor cantidad de mermas de vacunas, con mayor incidencia en la presentación de 20 dosis(AU)

A preliminary evaluation of production losses was carried out in several scenarios of the Aseptic Processing and Packaging Plant of Finlay Vaccine Institute, Havana, Cuba. The evaluation covered the areas of formulation, filling, labeling and packaging, during the period 2011-2015, with the purpose of constituting a useful tool that would influence the production costs and improve the efficiency of the company. The results show that the formulation stage presents a higher average loss due to wastage (6.99 percent), mainly contributed by the vaccines DTP-vax® and VA-MENGOC-BC®; followed by the filling stage with an average loss of 4 percent. The losses for the rest of the stages ranged between 0.2 percent and 1.57 percent. The general cost of the losses of this period was 8,949,871.79 Cuban pesos, contributed by vax-SPIRAL®, vax-TyVi®, vax-TET® and VA-MENGOC-BC® vaccines. It was observed that, except for vax-TET-5)® (presentation of 20 doses), due to problems faced with the volume of the bulbs, the losses of the year 2016 were below the established percentage. Finally, a trend analysis was made of the total losses and by presentation, in the period 2011 to 2016, showing that in 2015 the highest quantity of vaccine losses was obtained, with a higher incidence in the presentation of 20 doses(AU)

Evaluación preliminar y actualización de las mermas productivas para mejorar la rentabilidad del Instituto Finlay de Vacunas / Preliminary evaluation and updating of the productive losses to improve the profitability of Finlay

Se realizó una evaluación preliminar de las mermas productivas en varios escenarios de la Planta de Procesamiento Aséptico y de Envase del Instituto Finlay de Vacunas de La Habana, Cuba. La evaluación abarcó las áreas de formulación, llenado, etiquetado y envase, durante el período 2011-2015, con el propósito de constituir una herramienta útil que incidiera sobre los costos de producción y mejorar la eficiencia de la empresa. Los resultados muestran que la etapa de formulación presenta mayor promedio de pérdidas por mermas (6,99 por ciento), principalmente aportadas por las vacunas DTP-vax® y VA-MENGOC-BC®; seguido de la etapa de llenado con un promedio de mermas de 4 por ciento. Las mermas para el resto de las etapas oscilaron entre 0,2 por ciento y 1,57 por ciento. El costo general de las mermas de este período fue de 8.949.871,79 pesos cubanos, aportado por las vacunas vax-SPIRAL®, vax-TyVi®, vax-TET® y VA-MENGOC-BC®. Se observó que, excepto para vax-TET-5® (presentación de 20 dosis), debido a problemas confrontados con el volumen de los bulbos, las mermas del año 2016 estuvieron por debajo del porcentaje establecido. Por último, se realizó un análisis de tendencia de las mermas totales y por presentación, en el período 2011 al 2016, mostrando que en el año 2015 se obtuvo la mayor cantidad de mermas de vacunas, con mayor incidencia en la presentación de 20 dosis(AU)

A preliminary evaluation of production losses was carried out in several scenarios of the Aseptic Processing and Packaging Plant of Finlay Vaccine Institute, Havana, Cuba. The evaluation covered the areas of formulation, filling, labeling and packaging, during the period 2011-2015, with the purpose of constituting a useful tool that would influence the production costs and improve the efficiency of the company. The results show that the formulation stage presents a higher average loss due to wastage (6.99 percent), mainly contributed by the vaccines DTP-vax® and VA-MENGOC-BC®; followed by the filling stage with an average loss of 4 percent. The losses for the rest of the stages ranged between 0.2 percent and 1.57 percent. The general cost of the losses of this period was 8,949,871.79 Cuban pesos, contributed by vax-SPIRAL®, vax-TyVi®, vax-TET® and VA-MENGOC-BC® vaccines. It was observed that, except for vax-TET-5)® (presentation of 20 doses), due to problems faced with the volume of the bulbs, the losses of the year 2016 were below the established percentage. Finally, a trend analysis was made of the total losses and by presentation, in the period 2011 to 2016, showing that in 2015 the highest quantity of vaccine losses was obtained, with a higher incidence in the presentation of 20 doses(AU)

Identification of minimal parameters for optimal suppression of chaos in dissipative driven systems.

Taming chaos arising from dissipative non-autonomous nonlinear systems by applying additional harmonic excitations is a reliable and widely used procedure nowadays. But the suppressory effectiveness of generic non-harmonic periodic excitations continues to be a significant challenge both to our theoretical understanding and in practical applications. Here we show how the effectiveness of generic suppressory excitations is optimally enhanced when the impulse transmitted by them (time integral over two consecutive zeros) is judiciously controlled in a not obvious way. Specifically, the effective amplitude of the suppressory excitation is minimal when the impulse transmitted is maximum. Also, by lowering the impulse transmitted one obtains larger regularization areas in the initial phase difference-amplitude control plane, the price to be paid being the requirement of larger amplitudes. These two remarkable features, which constitute our definition of optimum control, are demonstrated experimentally by means of an analog version of a paradigmatic model, and confirmed numerically by simulations of such a damped driven system including the presence of noise. Our theoretical analysis shows that the controlling effect of varying the impulse is due to a subsequent variation of the energy transmitted by the suppressory excitation.

Impulse-induced localized control of chaos in starlike networks.

Locally decreasing the impulse transmitted by periodic pulses is shown to be a reliable method of taming chaos in starlike networks of dissipative nonlinear oscillators, leading to both synchronous periodic states and equilibria (oscillation death). Specifically, the paradigmatic model of damped kicked rotators is studied in which it is assumed that when the rotators are driven synchronously, i.e., all driving pulses transmit the same impulse, the networks display chaotic dynamics. It is found that the taming effect of decreasing the impulse transmitted by the pulses acting on particular nodes strongly depends on their number and degree of connectivity. A theoretical analysis is given explaining the basic physical mechanism as well as the main features of the chaos-control scenario.

Impulse-induced optimum signal amplification in scale-free networks.

Optimizing information transmission across a network is an essential task for controlling and manipulating generic information-processing systems. Here, we show how topological amplification effects in scale-free networks of signaling devices are optimally enhanced when the impulse transmitted by periodic external signals (time integral over two consecutive zeros) is maximum. This is demonstrated theoretically by means of a star-like network of overdamped bistable systems subjected to generic zero-mean periodic signals and confirmed numerically by simulations of scale-free networks of such systems. Our results show that the enhancer effect of increasing values of the signal's impulse is due to a correlative increase of the energy transmitted by the periodic signals, while it is found to be resonant-like with respect to the topology-induced amplification mechanism.

Drastic disorder-induced reduction of signal amplification in scale-free networks.

Understanding information transmission across a network is a fundamental task for controlling and manipulating both biological and manmade information-processing systems. Here we show how topological resonant-like amplification effects in scale-free networks of signaling devices are drastically reduced when phase disorder in the external signals is considered. This is demonstrated theoretically by means of a starlike network of overdamped bistable systems, and confirmed numerically by simulations of scale-free networks of such systems. The taming effect of the phase disorder is found to be sensitive to the amplification's strength, while the topology-induced amplification mechanism is robust against this kind of quenched disorder in the sense that it does not significantly change the values of the coupling strength where amplification is maximum in its absence.

Chaotic dynamics of a microswimmer in Poiseuille flow.

The chaotic dynamics of pointlike, spherical particles in cylindrical Poiseuille flow is theoretically characterized and numerically confirmed when their own intrinsic swimming velocity undergoes temporal fluctuations around an average value. Two dimensionless ratios associated with the three significant temporal scales of the problem are identified that fully determine the chaos scenario. In particular, small but finite periodic fluctuations of swimming speed result in chaotic or regular motion depending on the position and orientation of the microswimmer with respect to the flow center line. Remarkably, the spatial extension of chaotic microswimmers is found to depend crucially on the fluctuations' period and amplitude and to be highly sensitive to the Fourier spectrum of the fluctuations. This has implications for the design of artificial microswimmers.

Ratchet universality in the presence of thermal noise.

We show that directed ratchet transport of a driven overdamped Brownian particle subjected to a spatially periodic and symmetric potential can be reliably controlled by tailoring a biharmonic temporal force, in coherence with the degree-of-symmetry-breaking mechanism. We demonstrate that the effect of finite temperature on the purely deterministic ratchet scenario can be understood as an effective noise-induced change of the potential barrier which is in turn controlled by the degree-of-symmetry-breaking mechanism. Remarkably, we find that the same universal scenario holds for any symmetric periodic potential, while optimal directed ratchet transport occurs when the impulse transmitted (spatial integral over a half period) by the symmetric spatial force is maximum.

Reply to "Comment on 'Ratchet universality in the presence of thermal noise' ".

The Comment by Quintero et al. [preceding Comment, Phys. Rev. E 88, 066101 (2013)] does not dispute the central result of our paper [Martínez and Chacón, Phys. Rev. E 87, 062114 (2013)], which is a theory explaining the interplay between thermal noise and symmetry breaking in the ratchet transport of a Brownian particle moving on a periodic substrate subjected to a temporal biharmonic excitation γ[ηsin(ωt)+α(1-η)sin(2ωt+φ)]. In the Comment, the authors claim, on the sole basis of their numerical simulations for the particular case α=2, that "there is no such universal force waveform and that the evidence obtained by the authors otherwise is due to their particular choice of parameters." Here we demonstrate by means of theoretical arguments and additional numerical simulations that all the conclusions of our original article are preserved.

Geometric and colour data fusion for outdoor 3D models.

This paper deals with the generation of accurate, dense and coloured 3D models of outdoor scenarios from scanners. This is a challenging research field in which several problems still remain unsolved. In particular, the process of 3D model creation in outdoor scenes may be inefficient if the scene is digitalized under unsuitable technical (specific scanner on-board camera) and environmental (rain, dampness, changing illumination) conditions. We address our research towards the integration of images and range data to produce photorealistic models. Our proposal is based on decoupling the colour integration and geometry reconstruction stages, making them independent and controlled processes. This issue is approached from two different viewpoints. On the one hand, given a complete model (geometry plus texture), we propose a method to modify the original texture provided by the scanner on-board camera with the colour information extracted from external images taken at given moments and under specific environmental conditions. On the other hand, we propose an algorithm to directly assign external images onto the complete geometric model, thus avoiding tedious on-line calibration processes. We present the work conducted on two large Roman archaeological sites dating from the first century A.D., namely, the Theatre of Segobriga and the Fori Porticus of Emerita Augusta, both in Spain. The results obtained demonstrate that our approach could be useful in the digitalization and 3D modelling fields.

Disorder induced control of discrete soliton ratchets.

We demonstrate that directed transport of topological solitons in damped, biharmonically driven Frenkel-Kontorova chains can be strongly enhanced by introducing suitable phase disorder into the asymmetric periodic driving. From a collective coordinate formalism, we theoretically deduce an effective deterministic equation of motion governing the dynamics of the soliton center-of-mass for which we predict the dependence of maximal soliton drift on disorder strength according to recently proposed general scaling laws concerning directed transport induced by symmetry breaking of temporal forces. We find that these results are in excellent agreement with those of computer simulations of the original Frenkel-Kontorova chains.

Breakdown of autoresonance due to separatrix crossing in dissipative systems: From Josephson junctions to the three-wave problem.

Optimal energy amplification via autoresonance in dissipative systems subjected to separatrix crossings is discussed through the universal model of a damped driven pendulum. Analytical expressions of the autoresonance responses and forces as well as the associated adiabatic invariants for the phase space regions separated by the underlying separatrix are derived from the energy-based theory of autoresonance. Additionally, applications to a single Josephson junction, topological solitons in Frenkel-Kontorova chains, as well as to the three-wave problem in dissipative media are discussed in detail from the autoresonance analysis.

Controlling chaotic solitons in Frenkel-Kontorova chains by disordered driving forces.

We discuss a general mechanism explaining the taming effect of phase disorder in external forces on chaotic solitons in damped, driven, Frenkel-Kontorova chains. We deduce analytically an effective random equation of motion governing the dynamics of the soliton center of mass for which we obtain numerically the regions in the control parameter space where chaotic solitons are suppressed. We find that such predictions are in excellent agreement with results of computer simulations of the original Frenkel-Kontorova chains. We show theoretically how such a fundamental mechanism explains recent numerical results concerning extended chaos in arrays of coupled pendula [S. F. Brandt, Phys. Rev. Lett. 96, 034104 (2006)10.1103/PhysRevLett.96.034104].

Controlling the ratchet effect through the symmetries of the systems: application to molecular motors.

We discuss a novel generic mechanism for controlling the ratchet effect through the breaking of relevant symmetries. We review previous works on ratchets where directed transport is induced by the breaking of standard temporal symmetries f(t)=-f(t+T/2) and f(t)=f(-t) (or f(t)=-f(-t)). We find that in seemingly unrelated systems the average velocity (or the current) of particles (or solitons) exhibits common features. We show that, as a consequence of Curie's symmetry principle, the average velocity (or the current) is related to the breaking of the symmetries of the system. This relationship allows us to control the transport in a systematic way. The qualitative agreement between the present analytical predictions and previous experimental, numerical, and theoretical results leads us to suggest that for the given breaking of the temporal symmetries there is an optimal wave form for a given time-periodic force. Also, we comment on how this mechanism can be applied to the case where a ratchet effect is induced by breaking of spatial symmetries. Finally, we conjecture that the ratchet potential underlying biological motor proteins might be optimized according to the breaking of the relevant symmetries.