Implications of laser beam metrology on laser damage temporal scaling law for dielectric materials in the picosecond regime.

We report on the implications that the temporal and spatial beam metrologies have on the accuracy of temporal scaling laws of Laser Induced Damage Threshold (LIDT) for dielectric materials in the picosecond regime. Thanks to a specific diagnostic able to measure the temporal pulse shape of subpicosecond and picosecond pulses, we highlight through simulations and experiments how the temporal shape has to be taken into account first in order to correctly understand the temporal dependency of dielectrics LIDT. This directly eases the interpretation of experimental temporal scaling laws of LIDT and improves their accuracy as a prediction means. We also give numerically determined benchmark temporal scaling laws of intrinsic LIDT for SiO2 (thin film) based on the model developed for this work. Finally, we show as well what kind of spatial metrology is needed during any temporal scaling law determination to take into account potential variations of the spatial profile.

Development and viability of biofilms grown on experimental abutments mimicking dental implants: An in vivo model.

BACKGROUND: To determine whether an experimental abutment mimicking the macro- and microstructure of a dental implant is a suitable method for recovering biofilm, and to describe the features of biofilms formed around such abutments on healthy implants. MATERIAL AND METHODS: Experimental abutments were used in 15 patients without peri-implant diseases. After 14 days' absence of dental hygiene in this area, the abutments were retrieved and analyzed through confocal laser scanning microscopy and scanning electron microscopy. The biofilm formation on the surface of the first 5 abutments was determined by a fluorescence-staining method using SYTO9 nucleic acid stain. In order to study the biofilm's coverage and vitality, 10 additional abutments were assessed using live & dead bacterial viability. Descriptive and bivariate analyses of the data were performed. RESULTS: A global plaque coverage of the abutments was observed in all cases. The submucosal area of the abutment was mostly covered with biofilm (over 21%). Moreover, significant differences between supra- and subgingival locations were detected. CONCLUSIONS: This in vivo experimental model allows detailed observation of the extensive plaque growth found on exposed experimental abutments mimicking dental implants when hygiene measures are absent. The biofilm coverage is significantly higher in the supragingival zone than in the subgingival portion.

Papel de enfermería de consultas en la implantación de un protocolo ERAS en cistectomía radical / No disponible

La cistectomía radical (CR) es un procedimiento con una elevada tasa de complicaciones. Los protocolos de rehabilitación multimodal (ERAS) optimizan al paciente para acelerar la recuperación posquirúrgica combinando estrategias pre, intra y posoperatorias. El objetivo principal de este estudio es dar a conocer el papel de la enfermera y remarcar su importancia dentro del equipo multidisciplinar. Para ello hemos elaborado una vía clínica siguiendo los protocolos ERAS, donde se estandarizan los cuidados, marcando todas las actividades donde interviene enfermería, tanto los enfocados al paciente como a la recogida de datos para la investigación y mejora de nuestra función. Entre junio de 2015 y julio de 2016 se han realizado 14 CR incluidas en vía clínica. Como conclusión, contar con el papel de la enfermería es básico para el buen desarrollo e implantación de un protocolo ERAS

Radical Cystectomy (RC) is a highly complex procedure with multiple risks for complication. Enhanced Recovery Surgery (ERAS) protocols are designed to achieve early recovery after surgical procedures by combining pre, intra and post-operative protocols. The main aim of this research is to get a better knowledge of the urology nurse and emphasize their role in multi-disciplinary teams. To do this, we elaborated a nursing care plan at following ERAS protocol, including standardized care protocols, focusing on the everyday actions of nursing practice, not only activities addressed to the patient but also data collection for medical research and capacity for improvement work. Between June 2016 and July 2016 14 RC have been performed and are included in the clinical guideline. In conclusion, it is recommended to consider the value of staff nurse involvement in decision making since it is necessary for the proper implementation of ERAS protocol in order to get a good outcome

Modern contaminants affecting microscopic residue analysis on stone tools: A word of caution.

Residue analysis is a method frequently used to infer the function of stone tools and it is very often applied in combination with use-wear analysis. Beyond its undeniable potential, the method itself has several intrinsic constraints. Apart from the exceptional circumstances necessary for residues to survive, the correct identification of the residue type is a very debatable topic. Before attempting to recognise ancient residues, a proper method should allow analysts to identify possible modern contaminants and exclude them from the final interpretation. Therefore, analysts should not underestimate the presence of modern contaminants and might learn how to discriminate the background noise due to handling. The main aim of this research is to provide some methodological improvements to residue analysis through the characterisation of some modern residues often present on the surface of stone tools (e.g. skin flakes, modelling clay). This characterisation was done by using both optical light microscopy (OLM) and scanning electron microscopy (SEM). Finally, a special care in the post-excavation treatment of stone tools is claimed in order to avoid major contamination of the samples.

Unilateral vertical scar breast reduction with glandular transposition of the nipple-areola in breast asymmetry.

BACKGROUND: A unilateral breast reduction procedure to mimic the contralateral breast poses a challenge to the plastic surgeon. All aspects of breast aesthetics are essential surgical considerations. The authors have used a vertical scar technique with glandular transposition of the nipple-areola complex. METHODS: In this series of patients, the larger of the asymmetrical breasts was reduced using a modified vertical scar breast reduction technique to simulate the shape and size of the smaller breast. Thirty-four patients are presented. Preoperative marking of the patient was modified to simulate the smaller breast, including measurements from the sternal notch to the nipple, to the midline of the submammary fold, the base of the breast, and the diameter of the nipple-areola complex. The mean resection weight was 282 g (range, 76 to 860 g) and the mean follow-up period was 15 months. A glanduloplasty was performed to simulate the shape of the contralateral breast. RESULTS: Thirty-one of the 34 patients reported that, overall, they were satisfied (91 percent) with the final shape of the breasts, symmetry, and the nature of the scars. Three patients were not entirely satisfied. Two of these requested further resection and one requested a minor scar revision because of persistent wrinkles in the submammary fold. CONCLUSIONS: Adequate long-term breast symmetry was achieved as confirmed by a high patient satisfaction rate. Unilateral vertical scar breast reduction with glandular transposition of the nipple-areola has been a valuable method in selected cases of breast asymmetry.

An Early Pleistocene hominin mandible from Atapuerca-TD6, Spain.

We present a mandible recovered in 2003 from the Aurora Stratum of the TD6 level of the Gran Dolina site (Sierra de Atapuerca, northern Spain). The specimen, catalogued as ATD6-96, adds to the hominin sample recovered from this site in 1994-1996, and assigned to Homo antecessor. ATD6-96 is the left half of a gracile mandible belonging to a probably female adult individual with premolars and molars in place. This mandible shows a primitive structural pattern shared with all African and Asian Homo species. However, it is small and exhibits a remarkable gracility, a trait shared only with the Early and Middle Pleistocene Chinese hominins. Furthermore, none of the mandibular features considered apomorphic in the European Middle and Early Upper Pleistocene hominin lineage are present in ATD6-96. This evidence reinforces the taxonomic identity of H. antecessor and is consistent with the hypothesis of a close relationship between this species and Homo sapiens.

Outcomes in peritoneal dialysis and haemodialysis--a comparative assessment of survival and quality of life.

Ever since the introduction of peritoneal dialysis (PD) as a therapy for managing patients with end-stage renal disease, there has been considerable debate about how it compares with outcomes on haemodialysis (HD) especially in terms of survival and quality of life. Whilst earlier results in the 1980s were certainly not comparable, data now emerging show that survival on PD is equivalent to that on HD. Recent registry data from the Canadian Organ Replacement Register show that survival of patients on PD is equivalent to that on HD and may well be better in the first few years of therapy. There have been numerous quality of life studies in patients on PD and HD. Health-related quality of life has been assessed using health profile measurements (both generic and disease-specific instruments) or preference-based measurements. The former approach has been used to analyse 14 different comparative studies. These studies suggest that patients on home HD and CAPD show better quality of life than patients on centre HD. Only a few studies found statistical differences between groups, and only in seven studies were results adjusted for patient differences. There is a need for longitudinal studies with more accurate information on health. Similar data are available for preference-based measurements and studies. Overall, the analysis suggests that PD and HD are equivalent therapies. On this basis, it is hard to explain the wide variation seen in the use of the two therapies.

The Pleistocene site of Gran Dolina, Sierra de Atapuerca, Spain: a history of the archaeological investigations.

Gran Dolina is part of an archaeological and paleontological complex located in the Sierra de Atapuerca karstic system (Burgos, Spain). The Trinchera del Ferrocarril sites were discovered as a consequence of the construction of a railway for the transport of minerals at the end of the nineteenth century. The systematic excavation of the upper Gran Dolina levels was initiated in 1981. In 1993, a 6 m(2)biostratigraphic survey pit was started, reaching level TD6 in 1994. This level was excavated during four consecutive years, yielding human fossils, identified as Homo antecessor, in association with lithic and faunal remains, dating to more than 0.78 m.y.a.

The TD6 level lithic industry from Gran Dolina, Atapuerca (Burgos, Spain): production and use.

Technological analysis of lithic artefacts recovered at the Aurora stratum of Atapuerca-TD6 shows that this Lower Pleistocene assemblage is similar to Mode I Technology (=Oldowan tradition) documented at many African sites. Diachronic comparison of the different levels of Gran Dolina allows us to conclude that this particular form of early European technology lacks the production of big flakes to manufacture large tools such as bifaces and cleavers. Rather, it is characterized by the presence of small artefacts, including flakes, denticulates, notches, and side-scrapers, many of which bear use-wear traces of butchery and woodworking. The dominant production technique is orthogonal, which is also reflected in the core recovered at the slightly older level of TD4. The raw materials also found in the Middle Pleistocene occupations at Atapuerca, though with significant proportion differences, have a local origin and include varieties of flint, quartzite and sandstone as well as limestone and quartz. TD6 small artefacts were made from most of these, although the retouched pieces seem to have been preferentially made of the best quality flint, i.e., Cretaceous flint, pointing to the existence of differential use of lithic material, and therefore, some degree of planned knapping behaviour. Most of the "chaînes opératoires" or reduction sequences took place inside the cave, although some artefacts, elaborated on Cretaceous flint, seem to have been retouched off site, possibly near the supply sources.

The TD6 (Aurora Stratum) hominid site. Final remarks and new questions.

The study of the faunal and lithic assemblage (including almost a hundred human fossil remains) recovered from the Aurora stratum-TD6 level of the Lower Pleistocene cave site of Gran Dolina (Sierra de Atapuerca, Spain) has allowed us to answer some important questions concerning the debate about the earliest evidence for human occupation of Europe. However, it has also started new discussions about some geographical, ecological, and economic aspects of this earliest occupation. The nature (definitive or ephemeral) of the first occupation, as well as the model for the arrival of the Acheulean (Mode 2) in Europe are also issues for discussion.

Cost-effectiveness analysis of different strategies for treating duodenal ulcer. Helicobacter pylori eradication versus antisecretory treatment.

Helicobacter pylori has recently been recognised as a causative agent for duodenal ulcer, and the efficacy of various combinations of antibacterials and antisecretory agents in eradicating this pathogen has been assessed. The objective of this study was to determine the efficiency of 2 treatment strategies for patients with H. pylori-positive duodenal ulcer. Cost effectiveness was analysed for antisecretory therapy (omeprazole 20 mg/day for 4 weeks), and eradication therapy (triple therapy: omeprazole 40 mg/day plus clarithromycin 1 g/day plus amoxicillin 2 g/day for 1 week). In a Markov model, a hypothetical cohort of 5000 patients was followed for 10 years through 6 disease states. Cyclic eradication therapy (i.e. in the first duodenal ulcer episode and in relapses) was the most cost effective [21 Spanish pesetas (Pta) per day free of symptoms (DFS); Pta128 = $US1 (October 1995)] of the eradication options evaluated [antisecretory in the first episode, then eradication for relapses (Pta22.3/DFS), and eradication therapy first, then antisecretory therapy (Pta27.3/DFS)]. Antisecretory therapy alone was less cost-effective (Pta39/DFS) than each of the 3 eradication options. Eradication treatment in the first episode of duodenal ulcer and relapses has savings in direct costs per patient of up to 56% compared with antisecretory therapy alone. Sensitivity analyses showed the model to be very robust. It is, therefore, advisable to treat initial episodes of H. pylori-positive duodenal ulcer and relapses with triple therapy. The improved cost-effectiveness ratio was largely explained by the long term reduction in relapses obtained with the eradication strategies.

Adverse reaction to streptokinase with multiple systemic manifestations.

We report the case of a 47-year-old woman with a history of mitral valve replacement with a mechanical prosthesis who was admitted to the hospital with a 3-month history of progressive exertional dyspnoea and was diagnosed as suffering from prosthetic valve thrombosis. Two consecutive courses of streptokinase were given as an intravenous infusion over 90 min at a dose of 1,500,000 IU each. Twenty minutes after the start of the second infusion (3 h and 20 min after the first one) she developed chills, fever, tachycardia and hypotension: symptomatic treatment was given and the infusion was completed. Two days later jaundice and choluria appeared with laboratory findings of hepatic cytolysis and cholestasis and renal insufficiency. The results of extensive microbiological and immunological investigations were not revealing. All the laboratory values spontaneously returned to baseline levels over the next 4 weeks. These abnormalities were attributed to an allergic reaction to streptokinase, although the exact pathogenic mechanisms involved are not known. We believe that further studies to elucidate the mechanism involved in the production of these effects are warranted in view of their potential clinical severity.