Background
Several non‐randomized and retrospective studies have suggested that intracorporeal anastomosis (IA) has advantages over extracorporeal anastomosis (EA) in laparoscopic right colectomy, ...but scientific evidence is lacking. The aim was to compare short‐term outcomes and to define the possible benefits of IA compared with EA in elective laparoscopic right colectomy.
Methods
An RCT was conducted from May 2015 to June 2018. The primary endpoint was duration of hospital stay. Secondary endpoints were intraoperative technical events and postoperative clinical outcomes.
Results
A total of 140 patients were randomized. Duration of surgery was longer for procedures with an IA than in those with an EA (median 149 (range 95–215) versus 123 (60–240) min; P < 0·001). Wound length was shorter in the IA group (median 6·7 (4–9·5) versus 8·7 (5–13) cm; P < 0·001). Digestive function recovered earlier in patients with an IA (median 2·3 versus 3·3 days; P = 0·003) and the incidence of paralytic ileus was lower (13 versus 30 per cent; P = 0·022). Less postoperative analgesia was needed in the IA group (mean(s.d.) weighted analgesia requirement 39(24) versus 53(26); P = 0·001) and the pain score was also lower (P = 0·035). The postoperative decrease in haemoglobin level was smaller (mean(s.d.) 8·8(1·7) versus 17·1(1·7) mg/dl; P = 0·001) and there was less lower gastrointestinal bleeding (3 versus 14 per cent; P = 0·031) in the IA group. IA was associated with a significantly better rate of grade I and II complications (P = 0·016 and P = 0·037 respectively). The duration of hospital stay was slightly shorter in the IA group (median 5·7 (range 2–19) versus 6·6 (2–23) days; P = 0·194).
Conclusion
Duration of hospital stay was similar, but IA was associated with less pain and fewer complications. Registration number: NCT02667860 (
http://www.clinicaltrials.gov).
Antecedentes
Varios estudios no aleatorizados y retrospectivos sugieren que la anastomosis intracorpórea (intracorporeal anastomosis, IA) tiene ventajas sobre la anastomosis extracorpórea (extracorporeal anastomosis, EA) en la colectomía laparoscópica derecha, pero no hay suficientes evidencias científicas. El objetivo del estudio fue comparar los resultados a corto plazo y definir los posibles beneficios de la anastomosis intracorpórea versus extracorpórea en la colectomía derecha laparoscópica electiva.
Métodos
Se realizó un ensayo clínico prospectivo y aleatorizado de mayo de 2015 a junio de 2018. El criterio de valoración principal fue la duración de la estancia hospitalaria. Los criterios de valoración secundarios fueron los eventos técnicos intraoperatorios y los resultados clínicos postoperatorios.
Resultados
Se aleatorizaron 140 pacientes. El tiempo quirúrgico fue más largo para la IA que para la EA (149,49 ± 27,24 versus 123,35 ± 36,56 min; P = 0,001). La longitud de la herida fue más corta en la IA (6,65 ± 1,21 versus 8,72 ± 1,44 cm; P < 0,001). La función digestiva se recuperó antes en la IA que en la EA (2,3 versus 3,3 días, P = 0,003) y la incidencia de íleo paralítico fue menor (13% versus 30%, P = 0,022). Los requisitos de analgesia postoperatoria fueron menores con la IA (39 ± 24,3 versus 53 ± 26; P < 0,001) y la puntuación de dolor (EVA) también fue menor (P < 0,035). El descenso de la hemoglobina en el postoperatorio y la hemorragia gastrointestinal baja fueron menores en la IA que en la EA (‐8,83 ± 1,7 versus ‐17,07 ± 1,7 mg/dl; P = 0,001) y (2,8% versus 14%; P = 0,031), respectivamente. La clasificación de Clavien‐Dindo mostró que la IA se asoció con resultados significativamente mejores que la EA: grado I (10% versus 27% P = 0,016); grado II (18% versus 35%, P = 0,0369). La puntuación del índice de complicación integral (comprehensive complication index, CCI) fue menor en el grupo IA (5,33 ± 9,2 versus 11,15 ± 14,34; P = 0,006). La estancia hospitalaria fue más corta en el grupo de IA pero sin diferencia significativa (5,65 ± 3,75 versus 6,58 ± 4,63 días; P = 0,194).
Conclusión
La IA presenta ventajas clínicas sobre la EA en la colectomía derecha laparoscópica.
The objective of this RCT was to compare short‐term outcomes and to define the possible benefits of intracorporeal compared with extracorporeal anastomosis in elective laparoscopic right colectomy. An intracorporeal anastomosis was shown to have clinical advantages over an extracorporeal anastomosis for laparoscopic right colectomy.
Better inside
A
bstract
We study the complexity of Gaussian mixed states in a free scalar field theory using the ‘purification complexity’. The latter is defined as the lowest value of the circuit complexity, ...optimized over all possible purifications of a given mixed state. We argue that the optimal purifications only contain the essential number of ancillary degrees of freedom necessary in order to purify the mixed state. We also introduce the concept of ‘mode-by- mode purifications’ where each mode in the mixed state is purified separately and examine the extent to which such purifications are optimal. We explore the purification complexity for thermal states of a free scalar QFT in any number of dimensions, and for subregions of the vacuum state in two dimensions. We compare our results to those found using the various holographic proposals for the complexity of subregions. We find a number of qualitative similarities between the two in terms of the structure of divergences and the presence of a volume law. We also examine the ‘mutual complexity’ in the various cases studied in this paper.
Testable baryogenesis in seesaw models Hernández, P.; Kekic, M.; López-Pavón, J. ...
The journal of high energy physics,
08/2016, Letnik:
2016, Številka:
8
Journal Article
Recenzirano
Odprti dostop
A
bstract
We revisit the production of baryon asymmetries in the minimal type I seesaw model with heavy Majorana singlets in the GeV range. In particular we include “washout” effects from scattering ...processes with gauge bosons, Higgs decays and inverse decays, besides the dominant top scatterings. We show that in the minimal model with two singlets, and for an inverted light neutrino ordering, future measurements from SHiP and neutrinoless double beta decay could in principle provide sufficient information to predict the matter-antimatter asymmetry in the universe. We also show that SHiP measurements could provide very valuable information on the PMNS CP phases.
Mastitis in cows is a major cause of economic losses and it is commonly associated with Staphylococcus aureus. Little is known about the S. aureus lineages causing mastitis in Mexican cattle. The aim ...of this study was to type S. aureus isolates causing mastitis in cows from the Comarca Lagunera region in Mexico in 2015-2016. Multi-locus variable number tandem repeat fingerprinting (MLVF) of 33 S. aureus isolates obtained from 210 milk samples revealed the MLVF clusters A (n = 1), B (n = 26), C (n = 5) and D (n = 1). Spa-typing showed that clusters A and B represent the spa-type t224, cluster C includes spa-types t3196 and t416, and cluster D represents spa-type t114. The different spa-types were mirrored by the masses of protein A bands as detected by Western blotting. Antimicrobial susceptibility testing showed that one isolate was susceptible to all antimicrobials tested, whereas all other strains were resistant only to benzylpenicillin. These findings show that only four S. aureus lineages, susceptible to most antimicrobials, were responsible for causing mastitis at the time of sampling. Lastly, many isolates carried the same small plasmid, designated pSAM1. The high prevalence of pSAM1 amongst the antimicrobial-susceptible isolates suggests an association with bovine colonization or mastitis rather than antimicrobial resistance.
Leptogenesis in GeV-scale seesaw models Hernández, P.; Kekic, M.; López-Pavón, J. ...
The journal of high energy physics,
10/2015, Letnik:
2015, Številka:
10
Journal Article
Recenzirano
Odprti dostop
A
bstract
We revisit the production of leptonic asymmetries in minimal extensions of the Standard Model that can explain neutrino masses, involving extra singlets with Majorana masses in the GeV ...scale. We study the quantum kinetic equations both analytically, via a perturbative expansion up to third order in the mixing angles, and numerically. The analytical solution allows us to identify the relevant CP invariants, and simplifies the exploration of the parameter space. We find that sizeable lepton asymmetries are compatible with non-degenerate neutrino masses and measurable active-sterile mixings.
Nanoparticles with a compact spherical structure and a narrow size distribution were prepared from a zein protein polymer by electrohydrodynamic atomization. The effects of key parameters of the ...process (polymer concentration, flow rate and applied voltage) on the size and morphology of the particles was studied. Zein nanoparticles could be obtained from zein concentrations ranging from 2.5% to 15% (w/w). The sizes of these particles, ranging from 175 to 900 nm, increased with increasing polymer concentration. Compact nanostructures were obtained for 2.5% and 5% zein solutions whereas 10% and 15% solutions yielded collapsed and shrunken particles. Flow rate also exerted an effect, the lower the flow rate the smaller the nanoparticles. The morphology of the nanoparticles did not change after incorporating curcumin in proportions ranging from 1:500 to 1:10 (curcumin:zein), and the encapsulation efficiency was around 85–90%. Fluorescence microscopy images showed that the nanostuctures obtained took the form of matrix systems with the curcumin homogeneously distributed in the zein matrix. The curcumin remained in the amorphous state in the nanoparticle, as revealed by X-Ray diffractometry, evidencing intimate contact with the polymer. After three months of storage at 23 °C and 43% relative humidity in the dark, neither the size or the morphology of the nanoparticles had undergone significant changes, nor had the curcumin content altered. Thanks to encapsulation, the curcumin presented good dispersion in an aqueous food matrix: semi-skimmed milk.
Display omitted
•The use of lighting controls is recommendable in European office buildings.•Office buildings located in warmer climates can increase their cooling demand if the insulation of the envelop is not ...appropriate.•Orientation of the building plays a significant role in its energy demand during the use stage.
This article presents key energy use figures and explores the energy saving potentials in office buildings across Europe by simulating several currently available scenarios. The information provided in this research work is based on a review of relevant literature and the results of EnergyPlus simulations of a reference office building that can be considered as a representative office building across Europe. Three locations were selected to represent the three climate zones in which Europe was divided.
Lighting has been pointed out as an area with significant improvement potentials. These improvements have been investigated by using two scenarios with different lighting control systems. In both cases and regardless of the location of the office building, the energy savings were achieved with already existing technology and will bring important reductions in the overall energy bill.
Two further aspects were investigated in this work: the first one is an improvement of the insulation of the windows and the external walls (U-value) and the second one the orientation of the building.
Unlikely to the lighting improvements, the location of the buildings highly influences the amount of energy required by HVAC systems. It is observed that higher insulation factors are recommended in cold and medium climate zones while they should be carefully chosen in the warmer climate zones. Office buildings constructed in warm climate zones are subjected to higher heat gains that cannot be easily released from buildings within a well-insulated envelope. Consequently, the energy demand for cooling purposes is increased, affecting the overall energy consumption and the economic performance of the building.
FLAG Review 2021 Aoki, Y.; Blum, T.; Colangelo, G. ...
European physical journal. C, Particles and fields,
10/2022, Letnik:
82, Številka:
10
Journal Article
Recenzirano
Odprti dostop
We review lattice results related to pion, kaon,
D
-meson,
B
-meson, and nucleon physics with the aim of making them easily accessible to the nuclear and particle physics communities. More ...specifically, we report on the determination of the light-quark masses, the form factor
f
+
(
0
)
arising in the semileptonic
K
→
π
transition at zero momentum transfer, as well as the decay constant ratio
f
K
/
f
π
and its consequences for the CKM matrix elements
V
us
and
V
ud
. Furthermore, we describe the results obtained on the lattice for some of the low-energy constants of
S
U
(
2
)
L
×
S
U
(
2
)
R
and
S
U
(
3
)
L
×
S
U
(
3
)
R
Chiral Perturbation Theory. We review the determination of the
B
K
parameter of neutral kaon mixing as well as the additional four
B
parameters that arise in theories of physics beyond the Standard Model. For the heavy-quark sector, we provide results for
m
c
and
m
b
as well as those for the decay constants, form factors, and mixing parameters of charmed and bottom mesons and baryons. These are the heavy-quark quantities most relevant for the determination of CKM matrix elements and the global CKM unitarity-triangle fit. We review the status of lattice determinations of the strong coupling constant
α
s
. We consider nucleon matrix elements, and review the determinations of the axial, scalar and tensor bilinears, both isovector and flavor diagonal. Finally, in this review we have added a new section reviewing determinations of scale-setting quantities.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
We evaluate the contribution to N sub(eff) of the extra sterile states in low-scale type I seesaw models (with three extra sterile states). We explore the full parameter space and find that at least ...two of the heavy states always reach thermalization in the early Universe, while the third one might not thermalize provided the lightest neutrino mass is below scriptO(10 super(-3) eV). Constraints from cosmology therefore severely restrict the spectra of heavy states in the range 1 eV-100 MeV. The implications for neutrinoless double beta decay are also discussed.
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