Correction to: Prognostic significance of serum inflammatory markers in esophageal cancer

Esophagus - In the original publication of the article, under the section “Clinicopathological characteristics”, the thresholds     

Meta-analysis and trial sequential analysis of randomized evidence comparing general anesthesia vs regional anesthesia for laparoscopic cholecystectomy

BACKGROUND In an effort to further reduce the morbidity and mortality profile of laparoscopic cholecystectomy, the outcomes of such procedure under regional anesthesia(RA) have been evaluated. In the context of cholecystectomy, combining a minimally invasive surgical procedure with a minimally invasive anesthetic technique can potentially be associated with less postoperative pain and earlier ambulation.AIM To evaluate comparative outcomes of RA and general anesthesia(GA) in patients undergoing laparoscopic cholecystectomy.METHODS A comprehensive systematic review of randomized controlled trials with subsequent meta-analysis and trial sequential analysis of outcomes were conducted in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement standards.RESULTS Thirteen randomized controlled trials enrolling 1111 patients were included. The study populations in the RA and GA groups were of comparable age(P = 0.41),gender(P = 0.98) and body mass index(P = 0.24). The conversion rate from RA to GA was 2.3%. RA was associated with significantly less postoperative pain at 4 h [mean difference(MD):-2.22, P 0.00001], 8 h(MD:-1.53, P = 0.0006), 12 h(MD:-2.08, P 0.00001), and 24 h(MD:-0.90, P 0.00001) compared to GA. Moreover, it was associated with significantly lower rate of nausea and vomiting [risk ratio(RR): 0.40, P 0.0001]. However, RA significantly increased postoperative headaches(RR: 4.69, P = 0.03), and urinary retention(RR: 2.73, P = 0.03). The trial sequential analysis demonstrated that the meta-analysis was conclusive for most outcomes, with the exception of a risk of type 1 error for headache and urinary retention and a risk of type 2 error for total procedure time.CONCLUSION Our findings indicate that RA may be an attractive anesthetic modality for daycase laparoscopic cholecystectomy considering its associated lower postoperative pain and nausea and vomiting compared to GA. However, its associated risk of urinary retention and headache and lack of knowledge on its impact on procedure-related outcomes do not justify using RA as the first line anesthetic choice for laparoscopic cholecystectomy.     

Design of a Unique Device for Residual Stresses Quantification by the Drilling Method Combining the PhotoStress and Digital Image Correlation

This paper presents a uniquely designed device combining the hole-drilling technique with two optical systems based on the PhotoStress and digital image correlation (DIC) method, where the digital image correlation system moves with the cutting tool. The authors aimed to verify whether the accuracy of the drilled hole according to ASTM E837-13a standard and the positioning accuracy of the device were sufficient to achieve accurate results. The experimental testing was performed on a thin specimen made from strain sensitive coating PS-1D, which allowed comparison of the results obtained by both methods. Although application of the PhotoStress method allows analysis of the strains at the edge of the cut hole, it requires a lot of experimenter’s practical skills to assess the results correctly. On the other hand, the DIC method allows digital processing of the measured data. However, the problem is not only to determine the data at the edge of the hole, the results also significantly depend on the smoothing levels used. The quantitative comparison of the results obtained was performed using finite element analysis.     

High Martensitic Steel after Welding with Micro-Jet Cooling in Microstructural and Mechanical Investigations

Modern means of transport will play a significant role in the smart city. In the automotive industry, high-strength steels such as Docol are employed more often. This kind of material is relatively not very well weldable. The main reason is related to the Heat Affect Zone, the region in which cracks occur. Another disadvantage is connected with differences in values of ultimate strength of parent and weld material. The differences can be diminished using the correct welding process, which employs nickel and molybdenum electrode wires at much lower sulfur content. The weld metal deposit contains mainly martensite and bainite with coarse ferrite, while the parent material contains mainly martensite and rather fine ferrite. New technology, micro-jet cooling after the joining process enables to obtain the microstructure of weld metal deposit at acceptable parameters. Welding with micro-jet cooling could be treated as a very promising welding Docol steels process with high industrial application. Results of non-destructive inspections on macro samples corresponded with further destructive test results (tensile strength, hardness, fatigue, metallographic structure analyses). This article aims to verify fatigue behavior of Docol 1200 M steel after welding supported by the cooling using the micro-jet technique. For the first time, micro-jet cooling was used to weld this kind of steel to check the mechanical properties of the joint, especially to determine the fatigue limit. This study is formulated as follows: investigating fatigue resistance of the Docol 1200 M weld manufactured at the cooling process with micro-jets. The joints were produced in the MAG (Metal Active Gas) technology modified by micro-jet cooling. The results collected in the fatigue test were processed in the form of the Wöhler’s S–N diagram following the fatigue limit of the weld examined. All data have indicated the possibility of obtaining a new method of welded joints with high fatigue limit minimum of 480 MPa. It could be important to achieve a tensile strength of 700 MPa while maintaining the best relative elongation at the level of the base material.     

Bone Density Micro-CT Assessment during Embedding of the Innovative Multi-Spiked Connecting Scaffold in Periarticular Bone to Elaborate a Validated Numerical Model for Designing Biomimetic Fixation of Resurfacing Endoprostheses

Our team has been working for some time on designing a new kind of biomimetic fixation of resurfacing endoprostheses, in which the innovative multi-spiked connecting scaffold (MSC-Scaffold) that mimics the natural interface between articular cartilage and periarticular trabecular bone in human joints is the crucial element. This work aimed to develop a numerical model enabling the design of the considered joint replacement implant that would reflect the mechanics of interacting biomaterials. Thus, quantitative micro-CT analysis of density distribution in bone material during the embedding of MSC-Scaffold in periarticular bone was applied. The performed numerical studies and corresponding mechanical tests revealed, under the embedded MSC-Scaffold, the bone material densification affecting its mechanical properties. On the basis of these findings, the built numerical model was modified by applying a simulated insert of densified bone material. This modification led to a strong correlation between the re-simulation and experimental results (FVU = 0.02). The biomimetism of the MSC-Scaffold prototype that provided physiological load transfer from implant to bone was confirmed based on the Huber–von Mises–Hencky (HMH) stress maps obtained with the validated finite element (FE) model of the problem. The micro-CT bone density assessment performed during the embedding of the MSC-Scaffold prototype in periarticular bone provides insight into the mechanical behaviour of the investigated implant-bone system and validates the numerical model that can be used for the design of material and geometric features of a new kind of resurfacing endoprostheses fixation.     

MOC Doped with Graphene Nanoplatelets: The Influence of the Mixture Preparation Technology on Its Properties

The ongoing tendency to create environmentally friendly building materials is nowadays connected with the use of reactive magnesia-based composites. The aim of the presented research was to develop an ecologically sustainable composite material based on MOC (magnesium oxychloride cement) with excellent mechanical, chemical, and physical properties. The effect of the preparation procedure of MOC pastes doped with graphene nanoplatelets on their fresh and hardened properties was researched. One-step and two-step homogenization techniques were proposed as prospective tools for the production of MOC-based composites of advanced parameters. The conducted experiments and analyses covered X-ray fluorescence, scanning electron microscopy, energy-dispersive spectroscopy, high-resolution transmission electron microscopy, sorption analysis, X-ray diffraction, and optical microscopy. The viscosity of the fresh mixtures was monitored using a rotational viscometer. For the hardened composites, macro- and micro-structural parameters were measured together with the mechanical parameters. These tests were performed after 7 days and 14 days. The use of a carbon-based nanoadditive led to a significant drop in porosity, thus densifying the MOC matrix. Accordingly, the mechanical resistance was greatly improved by graphene nanoplatelets. The two-step homogenization procedure positively affected all researched functional parameters of the developed composites (e.g., the compressive strength increase of approximately 54% after 7 days, and 37% after 14 days, respectively) and can be recommended for the preparation of advanced functional materials reinforced with graphene.     

Incidence of major hemorrhage after aggressive image-guided liver mass biopsy in the era of individualized medicine

Purpose

To analyze a large volume of image-guided liver mass biopsies to assess for an increased incidence of major hemorrhage after aggressive liver mass sampling, and to determine if coaxial technique reduces major hemorrhage rate.

Methods

Patients who underwent image-guided liver mass biopsy over a 15-year period (December 7, 2001–September 22, 2016) were retrospectively identified. An aggressive biopsy was defined as a biopsy event in which ≥ 4 core needle passes were performed. Association of major hemorrhage after aggressive liver mass biopsy and other potential risk factors of interest were assessed using logistic regression analysis. For the subset of aggressive biopsies, Fisher’s exact test was used to compare the incidence of major hemorrhage using coaxial versus noncoaxial techniques.

Results

Aggressive biopsies constituted 11.6% of biopsy events (N =579/5011). The incidence of major hemorrhage with <4 passes was 0.4% (N =18/4432) and with ≥4 passes 1.2% (N =6/579). In univariable models, aggressive biopsy was significantly associated with major hemorrhage (OR 3.0, 95% CI 1.16–6.92, p =0.025). After adjusting for gender and platelet count, the association was not significant at the p =0.05 level (OR 2.58, 95% CI 0.927–6.24, p =0.067). The rate of major hemorrhage in the coaxial biopsy technique group was 1.4% (N =3/209) compared to 1.1% (N =4/370) in the noncoaxial biopsy technique group, which was not a significant difference (p =0.707).

Conclusions

Although aggressive image-guided liver mass biopsies had an increased incidence of major hemorrhage, the overall risk of bleeding remained low. The benefit of such biopsies will almost certainly outweigh the risk in most patients.