Robotic thymectomy: A surgical point of view

Robotic thymectomy is the most innovative surgical approach for treating disease of the anterior mediastinum. Robotic surgery offers low postoperative morbidity, faster recovery, shorter hospital stay, and better cosmetic results, without compromising surgical radicality. During the operation, the patient is placed in a supine position at the left edge of the operating table with the left hemithorax upward; the position is maintained with sandbags. The target area for the autodocking should be toward the jugulum. The first surgical step is to isolate the inferior thymic horns via the dissection that starts from the inferior portion of the mediastinal tissue and proceeds toward the right side, following the contralateral pleural reflection. Afterward, it is necessary to move toward the superior horns, following the phrenic nerve, the first landmark, to the innominate vein, our second landmark. Finally, we dissect the superior horns while searching for the thymic veins, which could appear atrophic, and clip the vessels to safely isolate the innominate vein. During this step, it is useful to use a retraction movement to progressively dissect the horns from the jugulum. The thymus gland is removed en bloc with the perithymus fat using an endoscopic bag inserted through the right port incision.

RESEARCH ON THE IMPROVED IMAGE TRACKING ALGORITHM OF ATHLETES’ CERVICAL HEALTH

ABSTRACT Objective: With the increasing number and youth of patients with cervical spondylosis, people pay more and more attention to the cervical spine. Early diagnosis, intervention and treatment play an important role in the recovery of cervical spondylosis. With the continuous development of computer technology, the improvement of various modeling theories, and the application of image processing methods in orthopedics, new ideas are opened to observe cervical vertebra motion health. Methods: In this paper, the measurement of cervical motion is achieved by machine vision. A method of parameter measurement based on the constraint relationship of lower cervical motion is proposed. Based on image preprocessing, the left edge of the cervical vertebra was extracted and analyzed. Results: With the horizontal coordinate of registration point as the reference line, the changing trend of the angle between the left edge curve and the reference line of C4 and C5 vertebrae in the process of spontaneous flexion and extension of the cervical vertebrae was observed, and the movement rate of the cervical vertebrae was analyzed. Conclusions: It was found that the speed of the cervical vertebrae in the process of movement of the patients with cervical spondylosis showed jumping changes. Level of evidence II; Therapeutic studies - investigation of treatment results.

Diagnostic evaluation of the presence of residues of glyphosate-AMPA and 2.4D pesticides in urine samples from people living in a rural Brazilian community

ABSTRACTPesticide contamination in rural communities is a known problem worldwide. In this study, we investigated the levels of pesticide residues in urine samples from residents of a rural community located in the municipality of Francisco Beltrão-Paraná, Brazil. According to the residents’ report obtained through a structured interview, the main form of exposure has been due to the drift of pesticides resulting from the spraying carried out on crops neighboring the community, with one crop existing on the left edge and another on the right edge of the site. The investigation was based on a demand from residents concerned about the frequent occurrence of symptoms after spraying on neighboring crops, such as nausea, headaches, and dizziness. Thus, samples were collected immediately after the occurrence of spraying in the crop surrounding the site. In the collected samples (n=35, 1 sample per family) laboratory analyzes were performed to identify possible pesticide residues. To identify possible contaminating pesticides in the samples, multi-residue analysis was performed by gas chromatography coupled with mass spectrometry (GC-MS/MS). To identify 2.4D residues, an active widely used in the region and not detectable by the technique used for other pesticides, the analyzes were performed using the enzyme immunoassay technique. The results indicate that all urine samples collected showed the presence of 2.4D residues and that 90% of them presented the presence of glyphosate-AMPA residues, without the detection of the other investigated residues. The analysis of data obtained from interviews with residents shows an association between living in the place for longer and having cases of abortion (p<0.05, R=0.43) or feeling unwell after the application of the poison by the neighboring crop (p<0.05, R=0.47). In addition, residents who reported being poisoned with poison also reported having cancer (p<0.05, R=0.42). Assuming that it is unacceptable that urine samples have pesticide residues, it is concluded that the residents of this community are widely contaminated by pesticides potentially coming from the spraying of the neighboring crop, especially by pesticides that have the active ingredients in their formulas. 2,4D and glyphosate-AMPA and that may be impacting the health of these people in the long term.

Paradoxical stabilization of relative position in moving frames

To capture where things are and what they are doing, the visual system may extract the position and motion of each object relative to its surrounding frame of reference [K. Duncker, Routledge and Kegan Paul, London 161–172 (1929) and G. Johansson, Acta Psychol (Amst.) 7, 25–79 (1950)]. Here we report a particularly powerful example where a paradoxical stabilization is produced by a moving frame. We first take a frame that moves left and right and we flash its right edge before, and its left edge after, the frame’s motion. For all frame displacements tested, the two edges are perceived as stabilized, with the left edge on the left and right edge on the right, separated by the frame’s width as if the frame were not moving. This stabilization is paradoxical because the motion of the frame itself remains visible, albeit much reduced. A second experiment demonstrated that unlike other motion-induced position shifts (e.g., flash lag, flash grab, flash drag, or Fröhlich), the illusory shift here is independent of speed and is set instead by the distance of the frame’s travel. In this experiment, two probes are flashed inside the frame at the same physical location before and after the frame moves. Despite being physically superimposed, the probes are perceived widely separated, again as if they were seen in the frame’s coordinates and the frame were stationary. This paradoxical stabilization suggests a link to visual stability across eye movements where the displacement of the entire visual scene may act as a frame to stabilize the perception of relative locations.

Overtly Headed XPs and Irish Syntax-Prosody Mapping

Analyses of Irish phonological phrasing (Elfner 2012 et seq.) have been influential in shaping Match Theory (Selkirk 2011), an OT approach to mapping syntactic to prosodic structure. We solve two constraint ranking paradoxes concerning the relative ranking of Match and StrongStart. Irish data indicate that while XPs with silent heads can fail to map to phonological phrases in certain circumstances, overtly headed XPs cannot. They also indicate that rebracketing due to the constraint StrongStart occurs only sentence-initially, contrary to predictions. We account for these puzzles by invoking Van Handel's (2019) Match constraint which sees only XPs with overt heads, and by positing a new version of StrongStart which only applies to material at the left edge of the intonational phrase. Our analysis is developed using the Syntax-Prosody in Optimality Theory application (SPOT) and OTWorkplace.

Pyosalpinx due to Cronobacter sakazakii in an elderly woman

Background Cronobacter sakazakii (C. sakazakii) is a bacterium known to cause severe neonatal infections in premature infants with the consumption of contaminated powdered milk formula. Adult infections are rare, and there have been no reports of pyosalpinx due to C. sakazakii to date. Case presentation We report a case of left pyosalpinx due to C. sakazakii in a sexually inactive postmenopausal woman. A 70-year-old woman presented to our hospital with left lower abdominal pain and fever. Abdominal computed tomography disclosed a cystic mass continuous with the left edge of the uterus. Urgent laparotomy revealed a ruptured left pyosalpinx with pus-like content. Left salpingo-oophorectomy, resection of the right tube, and washing of the abdominal cavity with saline were performed. Pathological examination of the left adnexa showed tubal tissue with acute inflammation and inflammatory exudate, which were compatible with pyosalpinx, and pus culture yielded C. sakazakii. Conclusions This is the first case report of pyosalpinx due to C. sakazakii. Cronobacter sakazakii infections in adult women might occur in the elderly, whose immunity has weakened. Further accumulation of cases of C. sakazakii infection is needed to clarify the etiology and behavior of C. sakazakii in adults.

Paradoxical stabilization of relative position in moving frames

ABSTRACTTo capture where things are and what they are doing, the visual system may extract the position and motion of each object relative to its surrounding frame of referencee.g., 1,2. Here we report a particularly powerful example where a paradoxical stabilization is produced by a moving frame. We first take a frame that moves left and right and we flash its right edge before, and its left edge after, the frame’s motion. For all frame displacements tested, the two edges are perceived as stabilized, with the left edge on the left and right edge on the right, separated by the frame’s width as if the frame were not moving. This illusory stabilization holds even when the frame travels farther than its width, reversing the actual spatial order of the two flashes. Despite this stabilization, the motion of the frame is still seen, albeit much reduced, and this hides the paradoxical standstill of relative positions. In a second experiment, two probes are flashed inside the frame at the same physical location before and after the frame moves. Despite being physically superimposed, the probes are perceived widely separated, again as if they were seen in the frame’s coordinates and the frame were stationary. This illusory separation is set by the distance of the frame’s travel, independently of its speed. This paradoxical stabilization suggests a link to visual constancy across eye movements where the displacement of the entire visual scene may act as a frame to stabilize the perception of relative locations.

Headless Relative Clauses in Pesh

The aim of this study is to describe the two main kinds of headless relative clauses that are attested in Pesh, a Chibchan language spoken in Honduras: free relative clauses, which use a wh-word that functions as a relative pronoun at their left edge and a subordinator at their right edge, and headless relative clauses, which lack a wh- word but show a case marker or the topic marker at the right edge of the clause. The first type is less frequently attested in the natural corpus this study relies on, although the corpus does contain various instances of maximal, existential, and free-choice free relative clauses. Each of the constructions is distinguished by features of the wh-word and/or by certain restrictions regarding the tense of the verb in headless relative clauses or the type of verb in matrix clauses. The second type of headless relative clause, the ones that do not use a wh-expression, are much more frequent in the corpus and behave like headed relative clauses that lack a wh-expression. They are like noun phrases marked by a phrase-final case marker or the topic maker. The case or topic markers are used for light-headed relative clauses and for almost all types of maximal headless relative clause that have neither a light head nor a wh-expression, in contrast to maximal free relatives, in which only locative wh-words occur.

Heat enhancement analysis of a differentially heated inclined square enclosure filled with Al2O3 nanofluids under three base fluids: Water, water-ethylene glycol mixture & ethylene glycol

This paper investigates the analysis of natural convection heat enhancement in an inclined square enclosure when filled with water-based nanofluids with left edge wall undergoing heating with consistent heat flux while the the right edge wall being cold and other remaining walls are kept adiabatic. The parameters used in this analysis include: solid fraction volume (range from 0% to 20%), length of the heaters (0.25cm, 0.50cm, and 1.0cm from the left edge), and Rayleigh number (range from 104 to 106). The nanolayer thickness ratio was kept at a constant value of 1.0 throughout the analysis. The heat source is found at the center of the left wall. Polynomial Differential Quadrature (PDQ) equations have been adopted for this analysis for various angles range from 0? to 90?. As the Rayleigh numbers and particle volume fraction got the much-needed raise, the average count of the heat transfer rate improved too. The length of the heat flux heater has become more prominent parameter that has been affecting the calculated temperature and the flow fields. When the heat flux heater length is pushed to an increasing limit, the heat enhancement rate essentially starts to decline. This happens at the smaller inclination angle, though.

N.I. Kuskov. - The case of the absence of the left kidney in combination with a bifid uterus. - (Collected Works. Doctors of St. Petersburg. Maryinsky Hospital. Issue II, St. Petersburg., P. 80).

In the corpse of a consumptive woman, 46 years old, in place of the left kidney was only the adrenal gland of normal structure. The right kidney is enlarged, parenchymal inflamed. Heart is small, 230 grm. vѣsom. Two uterus, as if spliced ​​by their necks over a length of 2.3 cm. Does the stigma have only one hole? for the canal of the right uterus, and resembles the stigma of the giving birth uterus. The size of the right uterus is normal, its left corner is rounded. This uterus has one round ligament, one wide and solitary appendages. The fallopian tube comes from the left corner. A thin fold of the peritoneum goes from the back surface of this uterus to the rectum, the same fold goes from the left edge to the left uterus. The left uterus is smaller in size, with a narrow cavity. She has two round ligaments and one wide ligament. There are no appendages. Densely augmented with old connective tissue to the rectum.