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Hypocalcaemia following thyroid surgery can occur in up to 38% of patients. With over 7100 thyroid surgeries performed in 2018 in the UK, this is a common postoperative complication. Undertreated hypocalcaemia can result in cardiac arrhythmias and death. Preventing adverse events from hypocalcaemia requires preoperative identification and treatment of at-risk patients with vitamin D deficiency, timely recognition of postoperative hypocalcaemia and prompt appropriate treatment with calcium supplementation. This project aimed to design and implement a perioperative protocol for prevention, detection and management of post-thyroidectomy hypocalcaemia. A retrospective audit of thyroid surgeries (n=67; October 2017 to June 2018) was undertaken to establish baseline practice of (1) preoperative vitamin D levels assessment, (2) postoperative calcium checks and incidence of postoperative hypocalcaemia and (3) management of postoperative hypocalcaemia. A multidisciplinary team approach following quality improvement principles was then used to design a perioperative management protocol with all relevant stakeholders involved. After dissemination and implementation, the above measures were reassessed prospectively (n=23; April–July 2019). The percentage of patients having their preoperative vitamin D measured increased from 40.3% to 65.2%. Postoperative day-of-surgery calcium checks increased from 76.1% to 87.0%. Hypocalcaemia was detected in 26.8% of patients before and 30.43% of patients after protocol implementation. The postoperative component of the protocol was followed in 78.3% of patients. Limitations include low number of patients which precluded from analysis of the impact of the protocol on length of stay. Our protocol provides a foundation for preoperative risk stratification and prevention, early detection and subsequent management of hypocalcaemia in thyroidectomy patients. This aligns with enhanced recovery protocols. Moreover, we offer suggestions for others to build on this quality improvement project with the aim to further advance the perioperative care of thyroidectomy patients.

El objetivo de este proyecto esrealizar la investigación delanálisis de vibraciones en unrodamiento rígidode bolas(NSK 6302). El análisis de vibraciones, la termografía, el análisis de lubricantes, entre otras son parámetrosde mantenimiento predictivoque permiten detectarlas causas de posibles fallos, anticipándose a la avería de un elemento, conjunto o maquina en general. Además, se pretende generar una gráfica real deuna máquina herramienta –Fresadora Universal CUE-03338, generada desde una parteque presenta mayor importancia al momento de realizar un mantenimiento preventivo como lo es el husillo. La detección consiste en encontrar un problema en la maquinaria, para ello es imprescindible un seguimiento constante del nivel de vibraciones de la misma, los intervalos de mediciones pueden variar entre varios meses del año a una medición continua, según la importancia del proceso. La medición de vibraciones se realiza enpuntos estratégicos y son aquelloslugares donde se alojan rodamientos, ventiladores, piñones, etc.,en los puntos de medición se recabarán valores de velocidad, aceleración, desplazamiento en función de las características del banco de pruebas.

Introduction: olfactory neuroblastoma (ONB) is a rare cancer of the sinonasal region. We provide a comprehensive analysis of this malignancy with molecular and clinical trial data on a subset of our cohort to report on the potential efficacy of somatostatin receptor 2 (SSTR2)-targeting imaging and therapy.Methods: we conducted a retrospective analysis of 404 primary, locally recurrent, and metastatic olfactory neuroblastoma (ONB) patients from 12 institutions in the United States of America, United Kingdom and Europe. Clinicopathological characteristics and treatment approach were evaluated. SSTR2 expression, SSTR2-targeted imaging and the efficacy of peptide receptor radionuclide therapy [PRRT](177Lu-DOTATATE) were reported in a subset of our cohort (LUTHREE trial; NCT03454763).Results: dural infiltration at presentation was a significant predictor of overall survival (OS) and disease-free survival (DFS) in primary cases (n = 278). Kadish-Morita staging and Dulguerov T-stage both had limitations regarding their prognostic value. Multivariable survival analysis demonstrated improved outcomes with lower stage and receipt of adjuvant radiotherapy. Prophylactic neck irradiation significantly reduces the rate of nodal recurrence. 82.4% of the cohort were positive for SSTR2; treatment of three metastatic cases with SSTR2-targeted peptide-radionuclide receptor therapy (PRRT) in the LUTHREE trial was well-tolerated and resulted in stable disease (SD).Conclusions: this study presents pertinent clinical data from the largest dataset, to date, on ONB. We identify key prognostic markers and integrate these into an updated staging system, highlight the importance of adjuvant radiotherapy across all disease stages, the utility of prophylactic neck irradiation and the potential efficacy of targeting SSTR2 to manage disease.

Simple Summary Nasopharyngeal cancer (NPC) is a malignant epithelial tumor endemic to parts of Asia and associated with infection by the Epstein–Barr virus (EBV) in these regions. The cancer is often detected at a late stage which is associated with poor outcomes (63% 5-year survival). Advances for the management of this disease have remained largely stagnant and treatment relies primarily on radiotherapy and chemotherapy, as well as surgery when indicated. Nevertheless, our understanding of its underlying biology has grown rapidly in the past two decades, laying the foundation for the development of improved therapeutics which have the potential to improve outcomes. This review offers a comprehensive, up-to-date summary of this disease, with a focus on the role of somatostatin receptor 2 (SSTR2) in NPC and how this increased knowledge may lead to improved diagnosis and management of this disease. Abstract Nasopharyngeal carcinoma (NPC) is a malignant epithelial tumor, most commonly located in the pharyngeal recess and endemic to parts of Asia. It is often detected at a late stage which is associated with poor prognosis (5-year survival rate of 63%). Treatment for this malignancy relies predominantly on radiotherapy and/or systemic chemotherapy, which can be associated with significant morbidity and impaired quality of life. In endemic regions NPC is associated with infection by Epstein–Barr virus (EBV) which was shown to upregulate the somatostatin receptor 2 (SSTR2) cell surface receptor. With recent advances in molecular techniques allowing for an improved understanding of the molecular aetiology of this disease and its relation to SSTR2 expression, we provide a comprehensive and up-to-date overview of this disease and highlight the emergence of SSTR2 as a key tumor biomarker and promising target for imaging and therapy.

Oscar Emanuel urges engineers not to be put off by the challenges of timber, and to seek early specialist input where necessary to make the most of this natural material.

El documento consiste en analizar la influencia del estilo de conducción en la generación de emisiones contaminantes en la ciudad de Cuenca mediante el estudio de señales PID's, en la investigación realizada se toma dos estilos de conducción que son eficiente y agresiva, en las pruebas realizadas para cada estilo de conducción se tiene en cuenta tres condiciones como aceleración, velocidad crucero y desaceleración del vehículo para determinar así el porcentaje de emisiones contaminantes emitidas por el vehículo. The document consists of analyzing the influence of driving style on the generation of polluting emissions in the city of Cuenca through the study of PID's signals, in the research carried out, two driving styles are taken that are efficient and aggressive, in the tests carried out to Each driving style takes into account three conditions such as acceleration, cruising speed and deceleration of the vehicle to determine the percentage of pollutant emissions emitted by the vehicle.

Laminated bamboo is growing in potential as a novel construction material due to the need to lower the carbon impact of the built environment. The material utilises raw bamboo in an engineered composite to create a standardised prismatic section. The present study investigated the mechanical properties, as well as the performance under sustained load, of laminated bamboo sections which had undergone a secondary glue laminating process to facilitate the forming of curved profiles. Small and structural scale testing methods were used to evaluate the properties under varying service conditions representative of both internal and external environments. The results indicated that the material properties of the test pieces were generally consistent with previous studies. The long-term behaviour in bending was generally found to be consistent with or better than expectation based on the Eurocode 5 duration of load and creep factors applicable to solid or glued laminated timber, however, appear to be conservative when applied to laminated bamboo. In contrast, the Eurocode 5 torsional shear deformation factors appear to be unconservative for laminated bamboo. Further study is required to determine long-term performance in both bending and shear, in particular with respect to varying service class.

Treballs Finals de Grau d'Enginyeria Informàtica, Facultat de Matemàtiques, Universitat de Barcelona, Any: 2019, Director: Sergio Escalera Guerrero, [en] In medium to large projects, monitoring and organizing services begins to be important, since it increases the scalability and contributes to the detection of issues and the taking of measures quickly. My work has consisted, overall, in developing a monitoring project. This implies, on the one hand, monitoring different aspects of the logs that are generated and sent in the calls to services that my company offers to the client, such as the total volume, the volume of errors, the average time, or the timeouts. We also had to create alerts based on this monitoring, whose purpose is to send a webhook to a website every time an anomaly is detected or a desired condition is met. On the other hand, I have also contributed to the development of this website, which aims to allow users to quickly view key aspects of the health of the services and notify them by SMS or email when the anomalies are generated. The monitoring part has been done using an ELK cluster (acronym for Elasticsearch, Logstash and Kibana), technologies that allow us to search and analyze our logs easily (Elasticsearch), ingest data from different sources simultaneously, transform it and send it to a warehouse (Logstash), visualize and manage the cluster from a GUI (Kibana). Once we have the data in indexs, we can create machine learning jobs, which will be fed of selected and transformed data from these indexs, and will learn to detect and generate anomalies using, among oth- ers, unsupervised learning. In addition, ELK allows the creation of watches, which are scheduled querys which verify if their result meets a condition, and if so, perform an action (in our case send a webhook).On the other hand, the website is being developed using Spring for the backend and Angular for the frontend, as well as an Oracle database. This web renovates and unifies the two websites that were used in this project before we began to use ML jobs of ELK: one web of monitoring, which created graphs of the data of ELK (obtained using its API) and associate them with a service; the other one was an administration website, which allowed grouping users, grouping services, linking groups of users with a service, creating rules that a service must meet, notify users associated to the service in case that a rule is not meeting, etc.

Susceptibility to develop hypertension may be established during early stages of life that include the intrauterine period, infancy and childhood. We recently showed that blood pressure increased when rats reached adulthood when sucrose was ingested for a short-term critical window from postnatal day 12 to 28 in the rat, which corresponds to days around weaning. Here, we studied several factors that might participate in the increased susceptibility to hypertension when adulthood is reached by analyzing the changes produced at the end of the sucrose ingestion during this critical period. Body weight of the rats at the end of the sucrose period was decreased even if there was an increased ingestion in Kcal. We found an increase in blood pressure accompanied by a decrease in endothelial nitric oxide synthase (eNOS) expression in the aorta. When insulin was administered to rats receiving sucrose, glucose in plasma diminished later than in controls and this slight insulin resistance may reduce nitric oxide synthase action. Oleic acid that modulates eNOS expression was increased, lipoperoxidation was elevated and total non-enzymatic anti-oxidant capacity was decreased. There was also a decrease in SOD2 expression. We also studied the expression of Sirt1, which regulates eNOS expression and Sirt3, which regulates SOD2 expression as possible epigenetic targets of enzyme expression involved in the long- term programming of hypertension. Sirt3 was decreased but we did not find an alteration in Sirt1 expression. We conclude that these changes may underpin the epigenetic programming of increased susceptibility to develop hypertension in the adults when there was exposure to high sucrose levels near weaning in rats.

Análisis y propuestas de soluciones para la optimización de tiempos de viaje y seguridad vial en 10 intersecciones que presentan congestión vehicular en la ciudad de Azogues, estudiando de los impactos económicos, sociales y ambientales que ocasiona una propuesta. Analysis and proposed solutions for optimizing travel times and road safety in 10 intersections have traffic congestion in the city of Azogues, studying the economic, social and environmental impacts that causes a proposal.

The integration of data coming from different imaging modalities is something to take into account, due to the importance it can have in the development of a fast and reliable diagnosis by the health staff. In the medical imaging field, computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), and single photon emission computed tomography (SPECT) are examples of devices that generate 3-D data. Digital subtraction angiography (DSA) or ultrasound (US) output 2-D data, from which its possible to reconstruct 3-D data. An important fact is that 3-D space is common to all these devices and they are all capable of producing large amounts of data. Prior to display or even data integration, matching the various 3-D spaces has to be achieved with some specific technique, according to the anatomical region under examination. The augmented octree, an extension of the linear octree, is used for data integration; its properties can help to overcome some of the constraints that occur in medical imaging. To be fully accepted by the specialist, the display and manipulation of multimodality data must be interactive and done in real-time, or at least in `nearly' real-time. Parallel architectures seem to be a solution for some computation intensive applications, and so an implementation of the linear octree encoding process was developed on a 16 Transputer machine.© (1992) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.