Preoperative localization of lung nodules: a comparative analysis of hookwire and radio-guided procedures

BackgroundHistological diagnosis of pulmonary nodules requires surgical resection on many occasions. There are multiple localization strategies each with their own benefits and complications. The objective of this study is to compare preoperative lung nodule localization with hookwire and radiotracer injection (radioguided occult lesion localization, ROLL). To compare results, complications, and volume of the sample resected with both techniques.MethodsPatients undergoing resection of pulmonary nodules with video-assisted thoracoscopy and pre-surgical localization with hookwire or ROLL were studied. Eighty-eight pulmonary nodules were resected in 76 patients: 52 with a hook wire and 36 with a radiotracer. The localization rate, the shortest distance between the nodule and the pleura, the intrapulmonary distance of the locator, the complications, the volume of the resection piece, and the histological result were all assessed. In addition, the factors that influence the volume of the surgical piece were analyzed.ResultsAll the nodules were resected with both techniques. The intrapulmonary path of the locator is longer for the ROLL group (23.91 vs. 16.28 mm; P=0.04), with no differences in the distance from the nodule to the pleura. The rate of pneumothorax was significantly higher after the placement of a hook wire (69.2% vs. 24.2%; P<0.0001), while there were no differences in the presence of hemorrhage. The volume of the pieces resected using ROLL was more minor than with hookwire, although not statistically significant (20.19 vs. 34.26 cc; P=0.07).ConclusionsPreoperative localization with the ROLL technique is safer than the placement of hookwire. In addition, the ROLL technique shows a tendency to obtain a smaller volume of resected tissue since the marking is not affected by the intrapulmonary route used during marker placement. ROLL technique allows to locate lung nodules with fewer complications than hookwire and probably gets smaller resection samples.     

Influence of the Stainless-Steel Microstructure on Tribological Behavior and Surface Integrity after Ball Burnishing

Burnishing is a plastic deformation process that reduces roughness while increasing hardness by introducing compressive residual stresses near the surface zone. These improvements will depend mainly on two fundamental variables: the applied load and the friction derived from the tool–surface interaction. Nevertheless, microstructural differences in the materials have not yet been considered within this interaction. This leads to a generalization of the process that can result in the failure of industrial components. Therefore, the aim of this work is to study the microstructural influence of the ball-burnishing process from a tribological perspective. Thus, martensitic and austenitic stainless steels were evaluated in terms of friction and surface integrity. The results show that parameterizing the process according to the tool–surface interaction is critical since improvements depend on friction as a function of the availability of plastic deformation of the crystallographic structures.     

Cerebral cortex layer segmentation using diffusion magnetic resonance imaging in vivo with applications to laminar connections and working memory analysis

Understanding the laminar brain structure is of great help in further developing our knowledge of the functions of the brain. However, since most layer segmentation methods are invasive, it is difficult to apply them to the human brain in vivo. To systematically explore the human brain''s laminar structure noninvasively, the K‐means clustering algorithm was used to automatically segment the left hemisphere into two layers, the superficial and deep layers, using a 7 Tesla (T) diffusion magnetic resonance imaging (dMRI)open dataset. The obtained layer thickness was then compared with the layer thickness of the BigBrain reference dataset, which segmented the neocortex into six layers based on the von Economo atlas. The results show a significant correlation not only between our automatically segmented superficial layer thickness and the thickness of layers 1–3 from the reference histological data, but also between our automatically segmented deep layer thickness and the thickness of layers 4–6 from the reference histological data. Second, we constructed the laminar connections between two pairs of unidirectional connected regions, which is consistent with prior research. Finally, we conducted the laminar analysis of the working memory, which was challenging to do in the past, and explained the conclusions of the functional analysis. Our work successfully demonstrates that it is possible to segment the human cortex noninvasively into layers using dMRI data and further explores the mechanisms of the human brain.     

The impact of cytogenetic risk on the outcomes of allogeneic hematopoietic cell transplantation in patients with relapsed/refractory acute myeloid leukemia: On behalf of the acute leukemia working party (ALWP) of the European group for blood and marrow transplantation (EBMT)

Karyotypic analysis at time of diagnosis has an important value in determining initial response to treatment, remission duration and overall survival (OS) in acute myeloid leukemia (AML). Less is known about its value before allogeneic hematopoietic cell transplantation (allo‐HCT) in patients transplanted with active disease, either relapsed or primary refractory (Rel‐Ref) AML. We explored the impact of cytogenetic risk (stratification according to MRC‐UK) in 2089 patients with either Ref (n = 972) or Rel AML (n = 1117) transplanted during the period 2000‐2017. Overall, 154 patients had a favorable risk, 1283 had an intermediate risk and 652 had an adverse cytogenetic risk. Median follow‐up was 49 months. Compared to the favorable risk group, intermediate and adverse risk patients were associated with worse leukemia‐free survival and OS and also with a higher incidence of relapse. In a subgroup analysis of patients in the intermediate risk group harboring Fms‐like tyrosine kinase 3‐internal tandem duplication (FLT3‐ITD), this remained an important prognostic factor, being associated with worse outcomes. When analyzing patients according to the intensity of the conditioning regimen, no differences were observed for the main transplant outcomes. In conclusion, in patients diagnosed with AML and transplanted with active disease, karyotype remains an important prognostic factor, allowing splitting patients into different risk groups according to their cytogenetics. Similarly, FLT3‐ITD mutation also remains a negative prognostic factor in this population.     

Health-related physical fitness and weight status in 13- to 15-year-old Latino adolescents. A pooled analysis

ObjectiveThe aim of this study was to investigate the relation between health-related physical fitness and weight status in 13- to 15-year-old Latino adolescents.MethodThe final sample consisted of 73,561 adolescents aged 13–15 years (35,175 girls) from Chile (n = 48,771) and Colombia (n = 24,790). Cardiorespiratory and musculoskeletal fitness were measured using 20-m shuttle run (relative peak oxygen uptake – VO_2peak) and standing broad jump test (lower body explosive strength), respectively. The International Obesity Task Force definition was used to define weight status (i.e., underweight, normal weight, overweight, and obese).ResultsThe present study found an inverted J-shape relationship between body mass index, cardiorespiratory fitness, and musculoskeletal fitness in both genders and all age groups (p < 0.01). Results also suggest that underweight adolescents, and not just overweight and obese adolescents, have lower odds of having a healthy cardiorespiratory fitness (based on new international criterion-referenced standards) profile when compared with their normal weight peers, except in girls aged 14 (p = 0.268) and 15 years (p = 0.280).ConclusionsThe present results indicate low cardiorespiratory fitness and musculoskeletal fitness levels in underweight, overweight, and obese adolescents when compared with their normal weight peers. The findings appear to suggest that exercise programs should to decrease fat mass in overweight/obese adolescents and increase muscle mass in underweight adolescents.     

Filarial worm circulation by mosquitoes along an urbanization gradient in southern Spain

Mosquitoes are the main vectors of pathogens affecting wild animals, livestock and humans. Here, we used molecular tools to assess the local circulation of filarial parasites in mosquitoes collected during 2013 from natural, rural and urban habitats from southern Spain. We screened parasites in 22,791 female mosquitoes of the genera Aedes, Culex and Culiseta. Filarial worms were only detected in two mosquito pools. An Ae. caspius pool was positive for Setaria equina and an unidentified worm related to Onchocerca was detected in a Cx. pipiens pool. None of the mosquito pools were positive for Dirofilaria. These results underlay the role of Ae. caspius in the transmission of Setaria parasites among livestock and/or wildlife to humans in southern Spain.     

Changes in perceived social support predict changes in depressive symptoms in adults with physical disability

Background

Perceived social support has been found to be associated with depression, subjective well-being and psychological health in cross-sectional studies in people with physical disabilities. No longitudinal studies have been conducted to examine these associations over time using a comprehensive measure of social support.