Use of artificial intelligence embryo selection based on static images to predict first-trimester pregnancy loss.

RESEARCH QUESTION: Can an artificial intelligence embryo selection assistant predict the incidence of first-trimester spontaneous abortion using static images of IVF embryos? DESIGN: In a blind, retrospective study, a cohort of 172 blastocysts from IVF cases with single embryo transfer and a positive biochemical pregnancy test was ranked retrospectively by the artificial intelligence morphometric algorithm ERICA. Making use of static embryo images from a light microscope, each blastocyst was assigned to one of four possible groups (optimal, good, fair or poor), and linear regression was used to correlate the results with the presence or absence of a normal fetal heart beat as an indicator of ongoing pregnancy or spontaneous abortion, respectively. Additional analyses included modelling for recipient age and chromosomal status established by preimplantation genetic testing for aneuploidy (PGT-A). RESULTS: Embryos classified as optimal/good had a lower incidence of spontaneous abortion (16.1%) compared with embryos classified as fair/poor (25%; OR = 0.46, P = 0.005). The incidence of spontaneous abortion in chromosomally normal embryos (determined by PGT-A) was 13.3% for optimal/good embryos and 20.0% for fair/poor embryos, although the difference was not significant (P = 0.531). There was a significant association between embryo rank and recipient age (P = 0.018), in that the incidence of spontaneous abortion was unexpectedly lower in older recipients (21.3% for age ≤35 years, 17.9% for age 36-38 years, 16.4% for age ≥39 years; OR = 0.354, P = 0.0181). Overall, these results support correlation between risk of spontaneous abortion and embryo rank as determined by artificial intelligence; classification accuracy was calculated to be 67.4%. CONCLUSIONS: This preliminary study suggests that artificial intelligence (ERICA), which was designed as a ranking system to assist with embryo transfer decisions and ploidy prediction, may also be useful to provide information for couples on the risk of spontaneous abortion. Future work will include a larger sample size and karyotyping of miscarried pregnancy tissue.

Preservación de extremidad torácica izquierda en osteosarcoma con endoprótesis y colgajo dorso-epigástrico. Caso clínico / Left thoracic extremity preservation in osteosarcoma with endoprosthesis and dorso-epigastric flap. Case report

El osteosarcoma es un tipo de neoplasia ósea que se desarrolla en las células osteoblásticas formadoras de hueso. Su incidencia es más frecuente en niños, adolescentes y adultos jóvenes, su presentación es agresiva y generalmente los pacientes son sometidos a tratamiento radical con amputación de la extremidad afectada. Presentamos el caso clínico de un paciente con secuelas de osteosarcoma sometido a tratamiento multidisciplinario con colocación de endoprótesis tumoral y colgajo dorso-epigástrico para preservación de la extremidad torácica izquierda.(AU)

Osteosarcoma is a type of bone neoplasm that deve-lops in the osteoblastic cells that make up bone. It occurs more frequently in children, adolescents and young adults, its presentation is aggressive and patients are usually subjected to radical treatment with amputation of the affected limb. We present the report of a patient with sequelae of osteosarcoma who underwent multidisciplinary treatment with application of tumor stent and epigastric-dorsal flap for preservation of the left thoracic extremity.(AU)

It Sounds Cool: Exploring Sonification of Mid-Air Haptic Textures Exploration on Texture Judgments, Body Perception, and Motor Behaviour.

Ultrasonic mid-air haptic technology allows for the perceptual rendering of textured surfaces onto the user's hand. Unlike real textured surfaces, however, mid-air haptic feedback lacks implicit multisensory cues needed to reliably infer a texture's attributes (e.g., its roughness). In this paper, we combined mid-air haptic textures with congruent sound feedback to investigate how sonification could influence people's (1) explicit judgment of the texture attributes, (2) explicit sensations of their own hand, and (3) implicit motor behavior during haptic exploration. Our results showed that audio cues (presented solely or combined with haptics) influenced participants' judgment of the texture attributes (roughness, hardness, moisture and viscosity), produced some hand sensations (the feeling of having a hand smoother, softer, looser, more flexible, colder, wetter and more natural), and changed participants' speed (moving faster or slower) while exploring the texture. We then conducted a principal component analysis to better understand and visualize the found results and conclude with a short discussion on how audio-haptic associations can be used to create embodied experiences in emerging application scenarios in the metaverse.

Automated identification of blastocyst regions at different development stages.

The selection of the best single blastocyst for transfer is typically based on the assessment of the morphological characteristics of the zona pellucida (ZP), trophectoderm (TE), blastocoel (BC), and inner cell-mass (ICM), using subjective and observer-dependent grading protocols. We propose the first automatic method for segmenting all morphological structures during the different developmental stages of the blastocyst (i.e., expansion, hatching, and hatched). Our database contains 592 original raw images that were augmented to 2132 for training and 55 for validation. The mean Dice similarity coefficient (DSC) was 0.87 for all pixels, and for the BC, BG (background), ICM, TE, and ZP was 0.85, 0.96, 0.54, 0.63, and 0.71, respectively. Additionally, we tested our method against a public repository of 249 images resulting in accuracies of 0.96 and 0.93 and DSC of 0.67 and 0.67 for ICM and TE, respectively. A sensitivity analysis demonstrated that our method is robust, especially for the BC, BG, TE, and ZP. It is concluded that our approach can automatically segment blastocysts from different laboratory settings and developmental phases of the blastocysts, all within a single pipeline. This approach could increase the knowledge base for embryo selection.

Characteristics of patients undergoing robotic-assisted prostatectomy. Observational study / Características de pacientes sometidos a prostatectomía robótica. Estudio observacional

Abstract Introduction Prostatectomy is the standard treatment for patients with clinically localized prostate cancer. Currently, robot-assisted radical prostatectomy (RARP) is widely used for its advantages, as it provides better visualization, precision, and reduced tissue manipulation. However, RARP requires a multidisciplinary approach in which anesthesia and analgesia management are especially important. Objective This study aims to describe our experience delivering anesthesia for the first cases of patients undergoing RARP in a teaching hospital in Bogotá, Colombia. Methodology An observational study was conducted. We included all patients undergoing RARP from September 2015 to December 2019 at Fundación Santa Fe de Bogotá. All patients with incomplete data were excluded. Patient demographics were recorded, and significant perioperative events were reviewed. Results A total of 301 patients were included. At our institution, the mean age for patients undergoing RARP was 61.4 ± 6.7 years. The mean operative time was 205 ± 43 min and mean blood loss was 300 [200400] mL. Only 6 (2%) patients required transfusion. Age and BMI were not associated with clinical outcomes. Conclusions An adequate perioperative approach in RARP is important to minimize complications, which in this study and in this institution were infrequent.

Resumen Introducción La prostatectomía es el tratamiento estándar para pacientes con cáncer de próstata localizado. Actualmente, la prostatectomía radical asistida por robot es ampliamente utilizada por sus ventajas en visualización, precisión y manipulación de los tejidos. Sin embargo, este abordaje requiere un manejo multidisciplinario, pues el enfoque analgésico y anestésico es fundamental para optimizar los desenlaces. Objetivo Describir los primeros casos de prostatectomía radical asistida por robot realizadas en un hospital universitario de cuarto nivel en Bogotá, Colombia. Metodología Estudio observacional en el cual se incluyeron todos los pacientes sometidos a prostatectomía radical asistida por robot (PRAR) en el hospital Fundación Santa Fe de Bogotá entre septiembre de 2015 y diciembre de 2019. Se excluyeron los pacientes con historia clínica incompleta. Se registraron los datos demográficos y se revisaron los eventos perioperatorios importantes. Resultados Se analizaron 301 pacientes. La edad media de pacientes sometidos a PRAR fue 61,4 ± 6,7 años. El tiempo quirúrgico promedio fue 205 ± 43 minutos y la pérdida sanguínea media fue 300 [200-400] mL. Solo 6 pacientes (2 %) requirieron transfusión. La edad y el IMC no mostraron una asociación relevante con los desenlaces clínicos. Conclusiones El adecuado abordaje perioperatorio en PRAR es importante para minimizar las complicaciones, las cuales en este estudio y en esta institución fueron infrecuentes.

An Interactive System for Fine Motor Rehabilitation.

PURPOSE: One of the most important aspects in neuromotor rehabilitation is the need of feedback for patients. The rehabilitation system's efficiency relies on the therapist's judgment; the therapist tells the patient whether he/she is performing the exercises correctly. This process may be quite subjective, because it depends on the therapist's personal opinion. On the other hand, recent studies have shown that vibrotactile biofeedback can improve the effectiveness of interaction as it is a very helpful tool in the physiological process of neuromotor rehabilitation. DESIGN: We designed an interactive system focused on rehabilitation of the upper limbs using active markers and image processing, which consists of drawing activities in both augment and virtual reality. METHODS: The system gives the user a correction through multimodal stimuli feedback (vibrotactile, visual, and sound stimulus) and force measurement to let the patients know if they are not achieving the tasks' goals. FINDINGS: The developed system could be used by nursing assistants to better help patients. The purpose of this system was assisting patients with injuries in shoulders, elbows, or wrists, providing an audio-vibrotactile feedback as a factor of correction in the movements of the patient. To examine our system, 11 participants were asked to participate in an experiment where they performed activities focused to strengthen their fine motor movements. CONCLUSIONS AND CLINICAL RELEVANCE: Results showed show that patients' fine motor skills improved 10% on average by comparing their error rates throughout the sessions.

Servicio financiero crediticio destinado al pequeño y microempresario

Esta enfocado a demostrar la factibilidad economica y la viabilidad tecnica de crear un nuevo producto crediticio destinado al Pequeño y Microempresario, a ser implantado en la Banca Privada, a traves de una unidad organizacional definida como area de negocios semi-independiente de la entidad. Cap.1 Introduccion Cap.2 Microfinanzas Cap.3 Analisis sectorial Cap.4 Estudio de mercado Cap.5Estudio tecnico Cap.6 Fase experimental Cap.7 Proyecciones financieras.

Síndrome de aplastamiento e insuficiencia renal aguda por rabdomiolisis / Smoothing Syndrome and acute renal insufficiency Rabdomyolisis

Se revisa en forma exhaustiva la rabdomiolisis traumática como consecuencia del síndrome de aplastamiento, y al mismo tiempo la profilaxis de la insuficiencia renal aguda. Se incluye la fisiopatología, cuadro clínico, laboratorio y tratamiento médico y quirúrgico de las patologías enumeradas anteriormente y que están íntimamente relacionadas.

El trasplante de médula osea / Bone Marrow Transplantation

Desde hace más de 35 años, con el Trasplante de Médula ósea se abre un campo muy importante en el tratamiento de enfermedades hematológicas, hereditarias o malignas. El avance que han obtenido especialidades como la infectología y la Inmunología ha permitido su uso expandido a nivel mundial, haciendo que cerca de 15.000 pacientes reciban por año dicho tipo de tratamiento. La base de Trasplante de Médula Osea (TMO) es la posibildad de utilizar altas dosis de quimioterapia resguardande el sistema hematopoiético de una lesión letal permanente. Los resultados actuales a mediano plazo son bastante buenos en la gran mayoría de enfermedades malignas (Leucemia, Linfomas). En los Tumores Sólidos los resultados son muy preliminares e insuficientes para ser analizados. En las enfermedades hematológicas hereditarias su potencial curativo es inigualable. Desafortunadamente las complicaciones de este tratamiento tales como: Infecciones oportunistas, Rechazo medular, Reacción de donante contra el huésped, Tumores secundarios, Esterilidad, Cataratas, Fibrosis pulmonar y otros, son de una alta incidencia y su índice de mortalidad es sumamente elevado. El futuro es prometedor y nuevas áreas de la Medicina como la Biología Molecular y celular han incursionado con aplicaciones prácticas como los Factores de Crecimiento Hematopoiético, la detección de la enfermedad mínima residual, la Terapia Génica y la Depuración celular. El TMO es pues un campo que progresa diariamente y que podrían ser en un futuro una excelente posibilidad de cura para algunos de estos pacientes que hoy en día tienen un pronóstico sombrio.

Perfil socio-economico cultural de la poblacion hemofilica en Costa Rica / Socioeconomic and cultural aspects of the hemophiliac population in Costa Rica

El presente trabajo es el resultado de una pesquiza efectuada en Marzo de 1985 en Costa Rica con datos obtenidos de expedientes sociales de pacientes portadores de Hemofilia A y B del Servicio Hematologia del Hospital México de la Coja Costarricense de Seguro Social; sede del Centro Internacional de entrenamiento de la Federación Mundial de la Hemofilia. Se selecionaron un 44,6% de la población en los quales se consideraron los aspectos socioeconómicos, culturales mas relevantes