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Los linfangiomas abdominales son tumores quísticos poco frecuentes en pediatría, representan el 1% de todos los casos de linfangiomas; los síntomas clínicos no son específicos, se descubren de forma incidental; actualmente el manejo quirúrgico es de primera elección, pero se deben valorar otras posibilidades terapéuticas como los agentes esclerosantes que, dependiendo del tamaño, la ausencia o no de sintomatología y las comorbilidades del paciente se convierte en otra opción terapéutica menos invasivo con el cual se logran buenos resultados; se describe los casos clínicos de dos neonatos con diagnóstico de linfangioma retroperitoneal, manejados con agentes esclerosantes (caso 1) y cirugía (caso 2), mostrando las diferentes opciones terapéuticas. Recibido: 31/12/2020 Aceptado:17/02/2021 Conflicto de interés: Los autores declaran no poseer conflicto de interés

The concept of extended slash distribution is introduced. For the extended slash distribution of the sum of two independent logistic random variables, the characteristic function, moments, absolute...

(1) Background: A decrease in operative time can not only improve patient outcomes through a reduction in the risk of developing complications but can also result in cost savings. The aim of this study is to determine whether there an intraoperative time gain can be achieved by using the preoperative virtual planning of mandibular reconstruction using a free fibula flap compared with freehand plate bending and osteotomies. (2) Methods: A retrospective comparative study was carried out in the Oral and Maxillofacial Department of La Paz University Hospital, Madrid, Spain. The study compared 18 patients in the CAD/CAM group with 19 patients in the conventional freehand group. A comparison was made between the total surgical time, the comorbidities, and the hospital stay. The resource consumption was estimated using a cost analysis. (3) Results: Although CAD/CAM was a statistically more expensive procedure in the perioperative phase, no significant differences were observed in total health care costs between the two groups. There was a non-significant trend towards an increase in complications with conventional reconstruction plates compared to patient-specific plates (PSI). (4) Conclusions: CAD/CAM technology and a 3D printed cutting guide offer a significantly shorter surgical time, which is associated with a reduction in hospital days, PACU days, and complications. The cost of CAD/CAM technology is comparable to that of the conventional freehand technique.

Introduction: The management of subcondylar fractures has been very controversial in the maxillofacial literature. The open reduction and internal fixation (ORIF) technique has been considered by many authors the gold standard in selected cases. However, with the rise in endoscopic techniques in the craniomaxillofacial area, new boundaries and less invasive techniques are being explored. The endoscopic approach of subcondylar fractures has proved overall good and similar results to open approaches whilst reducing complications such as facial nerve injury. In this article we purpose to describe our experience with the endoscopic approach to subcondylar fractures. Patients and methods: We retrospectively analyzed 11 patients with subcondylar fractures treated at our department via an endoscopic approach. The number and type of plates used in each patient is recorded. Results and complications observed for all patients are described as well as functional outcomes in terms of mouth opening at 1 week, 3 months and 6 months postoperatively. Results: One patient presented with transient damage to the marginal and frontal branches of the facial nerve. 18.2 % of patients had their hardware removed due to pain or infection at the fracture site. No cases of salivary fistula or sialocele were found in this study. Mean mouth opening at one week postoperatively was 31.8 mm which increased to 37.8 mm at 6 months after surgery, meaning an increase of 18.86 % through the follow-up. Also, 18.2 % of patients presented with persistent deviation with mouth opening and one patient presented with postoperative persistent malocclusion that was treated with intermaxillary fixation and elastics. Conclusion: The endoscopic management of subcondylar fractures is a safe alternative to the open approach, specially in favorable cases, which reduces the risk of complications associa­ted to open approaches, such as unfavorable scarring, salivary gland complications and facial nerve damage. In our series only one patient presented with transient damage to the facial nerve. 18.2 % of the plates were removed, which is a high percentage and should be evaluated, although the small size of the series should be taken into account. Maxillofacial surgeons should be encouraged to learn and trained in endoscopic techniques and include the endoscopic assisted approach in their surgical armamentarium.

Learning to program is the new literacy of the 21st century. Computational thinking, closely related to programming, requires thinking and solving problems with different levels of abstraction and is independent of hardware devices. The early childhood education stage provides teachers with the opportunity to lay the foundations for a comprehensive quality education using innovative tools and technologies. Educational robotics in early childhood education becomes a tool that facilitates the acquisition of knowledge to children, playfully, based on the principles of interactivity, social interrelationships, collaborative work, creativity, constructivist and constructionist learning, and a student-centered didactic approach, allowing in turn that student can acquire digital competencies and develop logical and computational thinking in an underlying way. This project explores the current state of teaching and learning computational thinking and programming in early childhood education in an inclusive manner. Moreover, the lack of diversity and inequality is particularly latent in science, Technology, Engineering, and Mathematics (STEM) fields. Therefore, this work considers this problem and presents an inclusive coeducation approach to this new literacy, eliminating gender stereotypes and extending them to people with Down syndrome and hospitalized minors.

We consider the random variables Zi=βi2Yi/∑k=1mβk2Yk where Yi,i=1…,m are independent inverted chi-square r.v. with νi degrees of freedom. The probability density function of Z=(Z1,Z2,…Zm) is obtain...

The objective of this work was to design and build a fully mechanical knee orthosis. A knee orthosis should both allow control of the angle of flexion of the knee during the stance phase of the gait cycle and leave the joint free during the swing phase. Knee orthoses are normally used to assist the walking of people suffering from muscle weaknesses or gait pathologies in order to avoid excessive knee flexion during the stance phase. The design of the orthosis proposed in the present work is characterized by allowing the knee to be locked at any angle of flexion during the stance phase, and because the orthosis can be unlocked to allow the joint to be released in the swing phase without the action of any external agent, i.e., without requiring external electrical or electronic systems for the control and performance of the orthosis. These characteristics mean that the design can be adapted to the gait of any user. The proposed design consists of a set of three rods, one attached to the user's thigh, another to the calf, and the other to the foot, connected to each other by a self-locking planetary gear train (PGT).

This study will explore the use of a nonlinear relationship between dew point temperature (DPT) and precipitation to apply a method to downscale global circulation models (GCMs) information. Recently, there have been attempts to characterize dew point temperature (DPT) and precipitation intensity. The DPT has shown to be an easier variable to predict, and therefore forecast or prediction on GCM could provide a more reliable estimation. DPT using Clausius-Clapeyron (CC) relationship is one of the methods. This relationship has approximated a non-linear relation into a simple slope coefficient. In a recent study in the Netherlands, DPT was processed by the Advanced Delta Change Method (ADCM) and then converted to precipitation using CC or super CC relation observing better results. In this research work this approach is compared with a non-linear (neural network) model of the relationship. The main contribution of the overall project is to explore the improvement of a better relationship description and how much this could impact in our engineering intensity duration frequency curves. The problem posed is the analysis of the implications of climate change information for civil engineering design in the Metropolitan Area of Monterrey (Santa Catarina River Basin in Mexico).

International audience; Intercontinental introductions are widespread in the genus Spartina, with important ecological and evolutionary consequences. The native or introduced status of Spartina species is then critical with regard to biodiversity assessment, especially for vulnerable Mediterranean coastline ecosystems. Spartina versicolor was first recorded in southern France in 1849, then successively in various places on the European and North-African Mediterranean and Atlantic coasts. This species is considered to be either a European native or an invasive species introduced from North America which has a high morphological similarity to the Atlantic American species Spartina patens. We performed extensive sampling of S. versicolor in Europe and North Africa (from natural populations and herbarium collections) and compared these samples to other European and American Spartina species (including S. patens). Chromosome counts were reported for the first time and revealed that S. versicolor is tetraploid (2n = 4x = 40). Phylogenetic analyses based on chloroplast and nuclear ribosomal DNA sequences did not reveal any molecular variation within S. versicolor. In this species, a single haplotype, that is identical to one haplotype of S. patens, was found in the four chloroplast and the nuclear ribosomal ITS regions investigated. In addition, simple sequence repeat markers were used and revealed a low level of genetic diversity within S. versicolor, suggesting that the introduction of S. versicolor occurred from a narrow genetic pool of S. patens from North Americ

Apesar dos avanços no entendimento da fisiopatologia e dos recursos terapêuticos atualmente disponíveis, a cardiomiopatia dilatada (CMD) permanece como uma condição com alta mortalidade, sendo que a disfunção microvascular é um dos mecanismos relacionados à piora da função cardíaca. Nos últimos anos, novas técnicas de ecocardiografia vêm sendo utilizadas para avaliação da disfunção microvascular, incluindo a medida de velocidade de fluxo coronário pelo Doppler da artéria coronária descendente anterior (ADA), e a análise quantitativa do fluxo miocárdico pela ecocardiografia com perfusão miocárdica em tempo-real (EPMTR). No presente estudo, avaliamos o valor prognóstico da reserva de velocidade de fluxo coronário (RVFC), obtida pelo Doppler da ADA, e da reserva de fluxo miocárdico (RFM), obtida pela EPMTR, para predizer morte e transplante cardíaco em pacientes com CMD de origem não isquêmica. Adicionalmente, avaliamos se as medidas de reserva de fluxo acrescentam valor prognóstico sobre variáveis clínicas e ecocardiográficas que já são conhecidas como preditores de eventos nesta população. Estudamos 195 pacientes com CMD (130 homens, média etária 54 ± 12 anos) que apresentavam fração de ejeção do ventrículo esquerdo inferior a 35% pelo ecocardiograma e ausência de sinais de doença arterial coronária obstrutiva por angiografia coronária invasiva ou por método não invasivo (cintilografia de perfusão miocárdica ou angiotomografia de coronárias). Foram analisados parâmetros ecocardiográficos convencionais de função sistólica e diastólica do ventrículo esquerdo em repouso. A velocidade de fluxo coronário foi determinada pelo Doppler pulsado na ADA e a dinâmica das microbolhas no miocárdio foi quantificada pela EPMTR utilizando programas computacionais específicos, tanto em repouso como durante o estresse pelo dipiridamol (0,84 mg/Kg). As RVFC, RFM e reserva de velocidade de repreenchimento de microbolhas no miocárdio (reserva ) foram obtidas pela relação entre os parâmetros de fluxo durante a hiperemia e em repouso, sendo consideradas diminuídas quando os valores estavam abaixo de 2,0. O tempo médio de acompanhamento foi de 29 meses (variando de 6 a 69 meses). Neste período, 45 pacientes (24%) apresentaram eventos, sendo 43 mortes de causa cardíaca e 2 transplantes cardíacos. Na análise univariada foram preditores de eventos: etiologia chagásica, classe funcional de insuficiência cardíaca, uso de inibidores da enzima conversora de angiotensina e/ou bloqueadores dos receptores de angiotensina II (fator protetor), diâmetros ventriculares e do átrio esquerdo, volumes ventriculares, fração de ejeção, disfunção diastólica, grau de insuficiência mitral, RVFC, RFM e reserva . Na análise multivariada, foram preditores independentes de eventos o diâmetro do átrio esquerdo (razão de chances = 1,16 por unidade de aumento; intervalo de confiança 95% = 1,078 1,264; p