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The impact of patient sex on the presentation of inflammatory bowel disease (IBD) has been poorly evaluated. Our aims were to assess potential disparities in IBD phenotype and progression between sexes. We performed an observational multicenter study that included patients with Crohn's disease (CD) or ulcerative colitis from the Spanish Estudio Nacional en Enfermedad Inflamatoria intestinal sobre Determinantes genéticos y Ambientales registry. Data extraction was conducted in July 2021. A total of 51,595 patients with IBD were included, 52% were males and 25,947 had CD. The median follow-up period after diagnosis was 9 years in males and 10 years in females. In CD, female sex was an independent risk factor for medium disease onset (age, 17–40 y) (relative risk ratio, 1.45; 95% CI, 1.31–1.62), later disease onset (age, >40 y) (relative risk ratio, 1.55; 95% CI, 1.38–1.73), exclusive colonic involvement (odds ratio, 1.24; 95% CI, 1.14–1.34), inflammatory behavior (odds ratio, 1.14; 95% CI, 1.07–1.21), and extraintestinal manifestations (odds ratio, 1.48; 95% CI, 1.38–1.59). However, female sex was a protective factor for upper gastrointestinal involvement (odds ratio, 0.84; 95% CI, 0.79–0.90), penetrating behavior (odds ratio, 0.76; 95% CI, 0.70–0.82), perianal disease (odds ratio, 0.77; 95% CI, 0.71–0.82), and complications (odds ratio, 0.73; 95% CI, 0.66–0.80). In ulcerative colitis, female sex was an independent risk factor for extraintestinal manifestations (odds ratio, 1.48; 95% CI, 1.26–1.61). However, female sex was an independent protective factor for disease onset from age 40 onward (relative risk ratio, 0.76; 95% CI, 0.66–0.87), left-sided colonic involvement (relative risk ratio, 0.72; 95% CI, 0.67–0.78), extensive colonic involvement (relative risk ratio, 0.59; 95% CI, 0.55–0.64), and abdominal surgery (odds ratio, 0.78; 95% CI, 0.69–0.88). There is sexual dimorphism in IBD. The patient's sex should be taken into account in the clinical management of the disease. [Display omitted] [ABSTRACT FROM AUTHOR]

myofascial pain syndrome (MPS) is associated with reductions in range of movement (ROM), decrease in physical function and performance and increase in pain in different populations. Elucidating the best prevention and treatment strategies for MPS has been one of the main goals in the last decade. The objective of the present study was to compare the acute effects of self-myofascial foam rolling release (SFR) and dry-needling (DN) techniques on ankle dorsiflexion ROM, soreness post-needling and performance through countermovement jump (CMJ) height. a prospective crossover design composed by 12 active adults, aged 23.41 ± 1.68 years (weight: 78.33 ± 9.02 Kg; height: 1.79 ± 0.088 m) with active ankle dorsiflexion restriction was performed. Participants were randomized into the SFR and DN techniques to analyze its effects on ankle dorsiflexion ROM, muscle soreness and jump height at pre, post and 24 h post-intervention. significant improvements were found by DN on ankle dorsiflexion at 24 h post intervention and muscle soreness by SFR at the same time point. No significant differences were found between conditions. Both SFR and DN are effective in improving ankle dorsiflexion and performance in young adults without producing an acute effect in muscle soreness. [ABSTRACT FROM AUTHOR]

The influence of age and region of the mouth was assessed in regard to mouth opening in fully guided implant placement. Ninety patients were included in this study, 30 in each of three age groups (20–34, 35–55, and >55 years). Maximum passive mouth opening was recorded in three locations: incisal, canine, and molar. The minimum distance required to allow the bone drilling sequence through a static fully guided approach was analysed for four implant systems: Straumann, MIS Dentsply, Astra Tech Dentsply, and Dentium. The mean ± standard deviation maximum mouth opening (all 90 patients) was 46.34 ± 7.70 mm, 36.82 ± 5.92 mm, and 30.99 ± 5.40 mm in the incisal, premolar, and molar region, respectively. No significant difference in mouth opening at any of the three locations was found between the age groups (all P > 0.05). However, a correlation was found between increasing age and decreasing average mouth opening in all three mouth regions; each additional 1 year resulted in a mean reduction of 0.13 mm, 0.09 mm, and 0.08 mm in the incisal, premolar, and molar region, respectively. The minimum required mouth opening was most likely to be met for implant placement in the incisal region (98.9% of all patients) and least likely to be met for placement in the molar region, particularly for older patients (as low as 30% of patients). Mouth opening remains a major limitation in fully guided implant surgery, especially in posterior areas and in older patients. The use of some implant systems in the posterior area may be limited to only one in three patients. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the effects of static (SBT), quasi-dynamic (QDBT), and dynamic (DBT) balance training on balance and muscle power performance in prepubertal children. Randomized, controlled trial design. Fifty-six children (10 and 11 years) were randomly assigned to static (n = 14), quasi-dynamic (n = 14) and dynamic balance training (n = 15), or a control group (n = 13). One-legged static (i.e., unipedal stance on stable surface), quasi-dynamic (i.e., unipedal stance on unstable surface), and dynamic balance (i.e., jumping and stabilizing in unipedal stance on unstable surface) were assessed using two dependent variables, i.e., center of pressure surface area (CoP SA) and velocity (CoP V) with opened (OE) and closed (CE) eyes; as well as lower limbs muscle power (i.e., standing long jump test [SLJ] and countermovement jump [CMJ height]). A significant group × test interactions were observed for static (CoP SA OE; p < 0.05, d = 1.18), quasi-dynamic (CoP SA CE; p < 0.05, d = 0.80), dynamic (CoP V CE; p < 0.05, d = 0.87) balance and power (SLJ [p < 0.05, d = 0.87] and CMJ height [p < 0.01, d = 2.66]) tests. Post hoc analysis showed that DBT demonstrated greater improvement in the measure of balance (p < 0.05, d = 0.80 to 5.17) and power (p < 0.05, d = 2.66 to 3.65) performance. To enhance balance and muscle power performance in prepubertal children, it appears that the level of difficulty in balance training may influence the observed effects. [ABSTRACT FROM AUTHOR]

The rural exodus in Europe has triggered population loss and ageing in many regions, exacerbating demographic and socio-economic imbalances. This study employs a comprehensive methodology to address these challenges, introducing a Territorial Exclusion indicator that covers deficiencies in services, economic stagnation, and limited accessibility of municipalities. Using structural equation modeling, we demonstrate how territorial exclusion acts as a fundamental factor driving depopulation. Furthermore, the study identifies homogeneous groups of municipalities based on their level of territorial exclusion, emphasizing the need for differentiated approaches in developing targeted and effective territorial development policies. To illustrate these findings, we focus on the region of Aragon (Spain) as an extreme example, providing valuable insights into the broader implications of territorial exclusion and informing strategies for addressing depopulation challenges in the region and beyond. • Structural Equation Modelling for addressing depopulation and territorial exclusion. • Territorial exclusion covers service, economic and accessibility deficiencies. • Territorial exclusion is a driver of depopulation (population loss and ageing). • Cluster Analysis for addressing geographical heterogeneity of territorial exclusion. • Strategies to address the challenges of depopulation and territorial exclusion. [ABSTRACT FROM AUTHOR]

Lung ultrasound (LUS), a non-invasive non-ionizing radiation tool, has become essential at the bedside in both adults and children, particularly in the critically ill. This manuscript reviews normal LUS patterns and the most important pathologies that LUS allows to diagnose. Normal LUS is represented by the pleural line, the lung-sliding and the A-lines and B-lines. These two last findings are artifacts derived from the pleural line. Pleural effusion appears as an anechoic collection. Pneumothorax is suspected when only A-lines are present, without lung-sliding and B-lines. Alveolo-interstitial syndrome is characterized by different degrees of confluent B-lines and can be present in different pathologies such as pulmonary edema and acute respiratory distress syndrome. The distribution of B-lines helps to differentiate between them. LUS is useful to evaluate the response to lung recruitment in pathologies such as acute respiratory distress syndrome or acute chest syndrome. The distribution of B-lines also appears to be useful to monitor the response to antibiotics in pneumonia. However, further studies are needed to further ascertain this evidence. LUS is also useful to guide thoracocentesis. [ABSTRACT FROM AUTHOR]

This study explores the ability of clean energy and European Union Allowance (EUA) assets to diminish portfolio risk when mixed with unclean energy assets. We use a family of Asymmetric Dynamic Conditional Correlation-Generalized AutoRegressive Conditional Heteroskedastic (ADCC-GARCH) models and provide a flexible and adaptive estimation and model selection framework based on a sequential strategy with differently sized estimation and validation windows, as well as different model update frequencies. Through this procedure, we obtain accurate estimations of the conditional covariance matrices of day-to-day asset returns and build adequate optimal minimum variance portfolios. The analyzed period (Jan. 2010–May. 2022) includes the latest crisis episodes (Sovereign debt crisis, Brexit, COVID-19, and the Russian–Ukrainian war). Our findings show that since the 2015 Paris Agreement (the only exception being the pandemic period), investing in clean energy companies and EUAs is an attractive investment in terms of return-risk. These results should provide investors with more incentives to decarbonize their portfolios. [Display omitted] • Sequential methodology to dynamically manage the risk of an investment portfolio. • Possibility that the model used to estimate the covariance matrices might change. • Different estimation and validation window sizes and model updating frequencies. • Quarterly updating is the best strategy and investing in renewables is worthwhile. • Despite Russo-Ukrainian war, low-carbon portfolios remain less risky.. [ABSTRACT FROM AUTHOR]

This review elucidates the advantages and disadvantages of the different implant navigation methods to assist the precise surgical placement of dental implants. Implant navigation surgery can be classified into: dynamic and static navigation, and static navigation can further be divided into full (FG)- and half-guided (HG) implant surgery. The HG implant placement includes the drilling-guided, pilot-drill guided, and the non-computed guided approaches. In dynamic navigation, the bone drilling and the implant placement are completely tracked with a specific software; while the static navigation refers to the use of static surgical templates. The FG associated with flapless surgery and teeth/crown supported guides has demonstrated the highest accuracy, followed by the drilling and pilot HG surgery that may provide comparable results, while the non-computer HG and FH implant placement provide the least accuracy in transmitting the implant positioning from the pre-surgical planning to the patient. Additionally, flapless implant surgery is related to reduced pain, less analgesic consumption, less swelling, shorter chair-time, and reduced risk of hemorrhage while achieving greater patient satisfaction. Nevertheless, other methods such as non-computer HG and FH implant surgery procedures require more surgical experience to overcome their limitations. There is still limited evidence to support dynamic surgery, and further investigations are needed. [ABSTRACT FROM AUTHOR]

Abstract The objective of this paper is to discover through a survey, the Spanish wine sector's attitude towards incorporating renewables. To that end, the multivariate statistical technique of factor analysis is applied to the information provided by a sample of 87 wineries stratified by Spanish regions. This resulted in a set of four indicators describing the determinant factors (Cost, Conviction, Motivation and Investment) influencing a winery's decision to implement renewable energies. Furthermore, a cluster analysis resulted in three groups of completely different wineries. The first contains a 25.3% of the wineries, which are not concerned about environmental issues. The second comprises a 26.7% of the wineries, which are dissuaded from adopting renewables as they perceive a high investment is necessary. The third group involves a 48% of wineries, which are committed to renewables because they are absolutely convinced of their benefits. [ABSTRACT FROM AUTHOR]

This paper focuses on the relationship between rural depopulation and territorial financial exclusion. We provide a replicable statistical methodology to identify the existing patterns at municipal level based on the degree of financial exclusion caused by the absence (named as Type I financial exclusion) or paucity (named as Type II financial exclusion) of bank branches. Firstly, the extent to which the sociodemographic characteristics of a municipality influence its degree and type of financial exclusion is analyzed by using panel data regression models. Secondly, by means of cluster analysis techniques, a typology of municipalities is provided that takes into account their sociodemographic characteristics as well as their availability of bank branches. Within this context, this paper explores the case of Aragón (Spain), a European region with significant depopulation and over-ageing problems. Our results show a lack of homogeneity across Aragonese municipalities, both in the processes of depopulation and financial exclusion. This heterogeneity has led us to propose financial inclusion measures tailored to the population size as well as the degree of ageing, the employment possibilities, and labor dynamism of each group of municipalities. In other words, this paper reveals the need to propose measures that accommodate each territory's peculiarities, which could contribute to the achievement of sustainable territorial development in Aragón. • Financial exclusion must be approached from a sociodemographic approach. • Panel data models are applied to municipality sociodemographic data. • Cluster analysis techniques are used to determine a municipal classification. • Maps support the visualization of territorial imbalances. [ABSTRACT FROM AUTHOR]

The objective of this paper is to design a map of the positive effects caused by the implementation, in a winery, of a series of prototypes for substituting non-renewable energies for clean energies. For this aim, we propose the use of a multi-level approach including three analyses: a multi-stakeholder analysis to determine all the interest groups affected by this intervention; a multi-dimensional analysis in order to identify the effects from the triple bottom line of sustainability; and a multi-term analysis to classify the effects depending on when they take place: immediate, intermediate and long-term. [ABSTRACT FROM AUTHOR]

We formulate a mesh morphing technique as mesh distortion minimization problem constrained to weakly satisfy the imposed displacement of the boundary nodes. The method is devised to penalize the appearance of inverted elements during the optimization process. Accordingly, we have not equipped the method with untangling capabilities. To solve the constrained minimization problem, we apply the augmented Lagrangian technique to incorporate the boundary condition in the objective function using the Lagrangian multipliers and a penalty parameter. We have applied the proposed formulation to mesh moving and mesh curving problems. The results show that the method has the ability to deal with large displacements for 2D and 3D meshes with non-uniform sizing, and mesh curving of highly stretched 2D high-order meshes. [ABSTRACT FROM AUTHOR]

A parallel distributed approach to refine a mesh while preserving the curvature of a target geometry is presented. Our approach starts by generating a coarse linear mesh of the computational domain. Second, the former coarse mesh is curved to match the curvature of the target geometry. Then, the curved mesh is partitioned and the subdomain meshes are sent to the slaves. Finally, the curved elements are uniformly subdivided in parallel targeting the geometry approximated by the curved mesh. The result is a distributed finer linear mesh featuring improved geometric accuracy. The key ingredient of our implementation is to approximate the target geometry as a linear mesh equipped with an elemental field corresponding to an element-wise polynomial geometry representation. Thus, the distribution of the curved geometry is equivalent to partitioning the linear mesh and sending the subdomain meshes and the elemental fields to the slaves. The main application of the obtained finer linear mesh is to compute in parallel steady state flow solutions on real topographies. The qualitative results show that for 2D and 3D steady state flow solutions, on real and synthetic topographies, our parallel subdivision approach mitigates the artificial artifacts that might appear with standard straight-sided subdivision methods. We also check the parallel performance of the implementation by performing a weak scalability test in 2D. [ABSTRACT FROM AUTHOR]

Objective The aim of the present study was to evaluate the principal anatomical characteristics of the maxillary sinus using Cone Beam Computed Tomography (CBCT) in order to facilitate prevention of intra- and post-operative complications. Materials and methods Three hundred CBCT scans from patients undergoing implant surgery were analysed. The following anatomical structures were evaluated: (1) Residual ridge height (RRH) and width (RRW); (2) Ridge bone density (BD); (3) Maxillary sinus angle (MSA); (4) Maxillary sinus lateral wall thickness (LWT); (5) Schneiderian membrane thickness (MT); (6) Maxillary sinus septa (SS); (7) Posterior superior alveolar artery (PSAA).‘ Results Mean patient age was 59.5 ± 13.6. Mean RRH at upper second premolar (2PM) was 8.66 ± 3.95 mm, 4.90 ± 2.28 mm at first molar (1 M), and 5.26 ± 2.13 mm at second molar (2 M). Mean RRW was 6.72 ± 2.69 mm at 2PM, 6.87 ± 2.65 mm at 1 M and 7.09 ± 2.80 mm at 2 M. Bone density was 330.93 ± 211.02 Hounsfield Units (HU) at first molar position and MSA was 73.39 ± 15.23°. LWT was 1.95 ± 0.98 mm. Mean Schneider Membrane thickness (MT) was 1.82 ± 1.59 mm; MT was ≤3 mm in 72.9% of patients and >3 mm in 27.10%. 20.56% of patients presented bucco-palatal oriented septa with a mean height of 13.11 ± 3.82 mm. PSAA was observed in 48.60% and mean distance to the top of the ridge was 13.15 ± 3.71 mm, and was mostly observed inside the sinus (53.85%). Conclusions CBCT scanning has been shown to be a useful tool for evaluating maxillary sinus anatomical variations. CBCT should be considered the gold standard when evaluating the maxillary sinus area. [ABSTRACT FROM AUTHOR]

Customarily, for housing markets, interest focuses on selling prices of properties at locations and times. Hedonic models are employed using property-level, neighborhood-level, and economic regressors. However, in hedonic modeling the fact that the locations and times of property transactions are random is ignored. Here, we focus on explanation of the locations of transactions in space and time, viewing them as a point pattern over space and time. Our contribution is to explain such a point pattern using suitable regressors. We examine two explanatory models, the nonhomogeneous Poisson process and the log Gaussian Cox process. We study a point pattern in the city of Zaragoza, Spain, over the years, 2006–2014. We argue for point level modeling since the process of property sales operates at that scale. We elaborate efficient computation for fitting the foregoing models to the Zaragoza data. We show how the modeling enables rich inference and extraction of novel stories for this market over this time period. In addition, we clarify the potential benefits of this modeling for brokers, buyers, and administrators. To our knowledge, this is the first application of formal space–time point pattern analysis to locations of urban real estate transactions. [ABSTRACT FROM AUTHOR]

The aim of the present study was to evaluate the feasibility of SEM and EDX microanalysis on evaluating the effect of porcine xenografts (MP3 ® ) supplemented with pamidronate during socket healing. Mandibular second premolars (P2) and first molars (M1) were extracted from six Beagle dogs. P2 were categorized as small defects (SD) and M1 as large defects (LD). Four random groups were created: SC (small control defects with MP3 ® ), ST (small test defects MP3 ® + pamidronate), LC (large control defects with MP3 ® ), and LT (large test defects MP3 ® + pamidronate). At four and eight weeks of healing the samples were evaluated fisically through scanning electron microscopy (SEM), and chemical element mapping was carried out by Energy dispersive X-ray spectroscopy (EDX). After four weeks of healing, SEM and EDX analysis revealed more mineralized bone in ST and LT groups compared with control groups (p < 0.05). After eight weeks, Ca/P ratios were slightly higher for small defects (groups SC and ST); in SEM description, in both control and test groups, trabecular bone density was similar to the adjacent mineralized cortical bone. Within the limitations of this experimental study, SEM description and EDX elemental microanalysis have demonstrated to be useful techniques to assess bone remodelling of small and large defects. Both techniques show increased bone formation in test groups (MP3 ® modified with pamidronate) after four and eight weeks of healing. [ABSTRACT FROM AUTHOR]

We present a robust and automatic method to generate an idealized surface geometry of a city landscape ready to be meshed for computer simulations. The city geometry is idealized for non viscous flow simulations and targets two main geometrical features: the topography and the city blocks. The procedure is fully automatic and demands no human interaction given the following source data: the city cadastre, a Digital Elevation Model (DEM) of all the target domain, and Light Detection And Ranging (LiDAR) data of the domain region covered by the cadastre. The geometry representation takes three main steps. First, a 2D mesh of the cadastre is generated, where the elements are marked according to street and block regions. Second, using a DEM of the city landscape the topography surface mesh is generated by finding the best surface mesh in the least-squares sense obtained by deforming the previous 2D mesh. Third, we extrude the block facades and we compute a planar ceiling taking into account all the buildings belonging to that city block. We describe the applicability of the geometry representation by presenting the work-flow required to generate an unstructured mesh valid for non-viscous flow or transport simulations. Finally, we illustrate the main application by obtaining a surface and tetrahedral mesh for the city of Barcelona in Spain. [ABSTRACT FROM AUTHOR]

Background & Aims After endoscopic mucosal resection (EMR) of colorectal lesions, delayed bleeding is the most common serious complication, but there are no guidelines for its prevention. We aimed to identify risk factors associated with delayed bleeding that required medical attention after discharge until day 15 and develop a scoring system to identify patients at risk. Methods We performed a prospective study of 1214 consecutive patients with nonpedunculated colorectal lesions 20 mm or larger treated by EMR (n = 1255) at 23 hospitals in Spain, from February 2013 through February 2015. Patients were examined 15 days after the procedure, and medical data were collected. We used the data to create a delayed bleeding scoring system, and assigned a weight to each risk factor based on the β parameter from multivariate logistic regression analysis. Patients were classified as being at low, average, or high risk for delayed bleeding. Results Delayed bleeding occurred in 46 cases (3.7%, 95% confidence interval, 2.7%–4.9%). In multivariate analysis, factors associated with delayed bleeding included age ≥75 years (odds ratio [OR], 2.36; P < .01), American Society of Anesthesiologist classification scores of III or IV (OR, 1.90; P ≤ .05), aspirin use during EMR (OR, 3.16; P < .05), right-sided lesions (OR, 4.86; P < .01), lesion size ≥40 mm (OR, 1.91; P ≤ .05), and a mucosal gap not closed by hemoclips (OR, 3.63; P ≤ .01). We developed a risk scoring system based on these 6 variables that assigned patients to the low-risk (score, 0–3), average-risk (score, 4–7), or high-risk (score, 8–10) categories with a receiver operating characteristic curve of 0.77 (95% confidence interval, 0.70–0.83). In these groups, the probabilities of delayed bleeding were 0.6%, 5.5%, and 40%, respectively. Conclusions The risk of delayed bleeding after EMR of large colorectal lesions is 3.7%. We developed a risk scoring system based on 6 factors that determined the risk for delayed bleeding (receiver operating characteristic curve, 0.77). The factors most strongly associated with delayed bleeding were right-sided lesions, aspirin use, and mucosal defects not closed by hemoclips. Patients considered to be high risk (score, 8–10) had a 40% probability of delayed bleeding. [ABSTRACT FROM AUTHOR]

The use of titanium implants is well documented and they have high survival and success rates. However, when used as reduced-diameter implants, the risk of fracture is increased. Narrow diameter implants (NDIs) of titanium–zirconium (Ti–Zr) alloy have recently been developed (Roxolid; Institut Straumann AG). Ti–Zr alloys (two highly biocompatible materials) demonstrate higher tensile strength than commercially pure titanium. The aim of this systematic review was to summarize the existing clinical evidence on dental NDIs made from Ti–Zr. A systematic literature search was performed using the Medline database to find relevant articles on clinical studies published in the English language up to December 2014. Nine clinical studies using Ti–Zr implants were identified. Overall, 607 patients received 922 implants. The mean marginal bone loss was 0.36 ± 0.06 mm after 1 year and 0.41 ± 0.09 mm after 2 years. The follow-up period ranged from 3 to 36 months. Mean survival and success rates were 98.4% and 97.8% at 1 year after implant placement and 97.7% and 97.3% at 2 years. Narrow diameter Ti–Zr dental implants show survival and success rates comparable to regular diameter titanium implants (>95%) in the short term. Long-term follow-up clinical data are needed to confirm the excellent clinical performance of these implants. [ABSTRACT FROM AUTHOR]

The aim of this study was to define the three-dimensional angulation of the pterygomaxillary corridor in which pterygoid implants should ideally be placed. A secondary objective was to study the bone density in the tuberosity area and pterygoid plate. Two hundred and two cone beam computed tomography files of atrophic posterior maxillae were evaluated. Implant placement was guided by the individual anatomy of each patient. The mean implant angulation was 74.19 ± 3.13° in the anteroposterior axis and 81.09 ± 2.65° in the buccopalatal axis, relative to the Frankfort plane. Density in the tuberosity area ranged from 285.8 to 329.1 DV units and density in the pterygoid plate area from 602.9 to 661.2 DV units, with a 95% confidence interval. The density in the pterygoid area was 139.2% greater than in the tuberosity zone. Implant placement should be guided by the individual anatomy of each patient. Statistically significant differences were found between the tuberosity and pterygoid plate in terms of bone density. Based on the results of this study, an implant of at least 15 mm long should be used in order to take advantage of the quantity and quality of the bone in this region. [ABSTRACT FROM AUTHOR]

We propose a new automatic procedure to generate hybrid meshes to simulate turbulent flows for wind farm design and management. In particular, numerical modeling of wind farms involves a RANS simulation of the Atmospheric Boundary Layer (ABL) flow and modeling the turbines using the actuator disc theory. Therefore, the generated meshes have to fulfill several geometrical requirements to answer to the different modeling features. They must: capture the topography features that can influence the wind flow; have a boundary layer close to the terrain to resolve the ABL; be conformally adapted to the disc (turbine) to simulate the turbine effects on the wind flow; be adapted around the disc to capture the wake effect; and present a smooth mesh size transition around the disc to conform the mesh size of the ABL mesh, in which the turbines are immersed. We highlight that the mesh generation procedure is fully automatic once given the mesh size, a topography description, the wind inflow direction, a list of turbine insertion points, and the turbine models. To illustrate the applicability of the proposed procedure, we present two wind farm cases: an offshore wind farm mesh where we illustrate the computed wind deficit, and an onshore farm assimilating real topography data. [ABSTRACT FROM AUTHOR]

Objective: The aim of this systematic review and meta-analysis was to assess the influence of platelet-rich plasma (PRP) on the regeneration of periodontal intrabony defects by means of evaluating clinical and radiographic outcomes in prospective human clinical trials.Background: PRP is a high concentration of platelets suspended in a small volume of plasma and has been used for periodontal tissue regeneration. However, although it has been broadly studied, there is much controversy on its efficacy when used to treat infrabony periodontal defects.Methods: An electronic literature search was conducted by two reviewers (AR and AM) in several databases up to February 2014. The PICO question was: Does PRP have a higher or similar efficacy of regenerating periodontal intrabony defects compared with other conventional periodontal regeneration treatments (e.g., bone grafts, barrier membranes)? Articles were included in this systematic review if they were prospective clinical trials with 10 or more human patients, reporting the radiographic and/or clinical outcomes PRP for regeneration intrabony periodontal defects. Random effects meta-analyses of the selected studies were applied to avoid any bias being caused by methodologic differences among studies.Results: Twenty-two papers were obtained and reviewed. Of these, 21 articles fulfilled the inclusion criteria and subsequently were qualitatively analyzed. Eighteen of these could be meta-analyzed. Fourteen articles were included for evaluating of probing pocket depth (PPD). The weighted mean difference (WMD) was 0.55 mm, with a 95% CI=-0.09 to 1.20 mm (P=.09). For bone level (BL), 2 articles measured BL in millimeters, and the other two articles measured BL in percentage. The WMD was 0.76 mm (95% CI=0.21-1.31 mm; P=.007) and 47.41% (95% CI=32.48%-62.33%; P<.0001), respectively. For attachment level (AL) changes, 12 articles were included. The WMD was 0.58 mm, with a 95% CI=0.24 to 0.91 mm (P=.0008). Sixteen articles were included for evaluation of marginal gingival level (MGL). The WMD -0.10 mm, with a 95% CI=-0.19 to -0.01 (P=.03).Conclusions: High heterogeneity among studies made it difficult to draw clear conclusions. Nonetheless, within the limitations of this review, PRP might offer some beneficial effects on clinical and radiographic outcomes for regeneration of periodontal intrabony defects. [ABSTRACT FROM AUTHOR]

Objective: it is known that very few women who continue to smoke at the time of delivery stop smoking during the postpartum period. Discovering strategies that can be incorporated during pregnancy to help improve women's participation in postpartum interventions could increase the number of women nonsmokers. The aim of this study is to identify the predictors of participation by pregnant women smokers in a postpartum smoking cessation intervention. Design: a cross-sectional study was carried out amongst women smokers who had attended to give birth. Setting: women attended the University Clinical Hospital 'Lozano Blesa' of Zaragoza (Spain) who were smokers before pregnancy and reported at delivery to have continued smoking during pregnancy were eligible and were invited to participate in the study. Findings: 2044 women completed the questionnaire 24 hours after giving birth. The smoking prevalence during pregnancy was 18.2% (n=372) and 62.9% of them (n=234) participated. The logistic regression model provided five significant predictors for women who participated: intention to breast feed, having less of an urge to smoke the first cigarette of the day before pregnancy, having reduced consumption during pregnancy by 50% or more, having received advice and being willing to get help. Conclusions and implications for the practice: the factors associated with participation show aspects that can be modified by maternal and child health professionals. Advice to stop smoking, received during pregnancy, encourages participation in a postpartum intervention. From the point of view of public health, the huge increase in the prevalence of smoking women poses the need to take advantage of the pregnancy as an opportunity for giving up smoking definitely. It would be necessary to identify what programmes of smoking cessation have better results in pregnant women and to know how to motivate health professionals to implement them. [ABSTRACT FROM AUTHOR]

• Sequential rolling selection of ADCC-GARCH models. • Dynamic strategy to compare risk of minimum-variance portfolios. • Since 2020, optimal risk-minimum portfolios take long positions in renewable energies and short positions in dirty energies. • From 2020 on investing in clean energy does not significantly raise risk levels. • Sustainable energy transition is also attractive from a financial viewpoint. This paper analyses whether investing in clean energy significantly worsens the risk level of investors. To that aim, we propose a dynamic strategy to carry out a comparative risk analysis of three minimum-variance portfolios: a portfolio made up exclusively of dirty energies, a portfolio made up only of clean energy assets, and a portfolio combined with the two types of energies. To that aim, we use multivariate GARCH models, concretely Asymmetric Dynamic Conditional Correlations models (ADCC-GARCH) to predict the variance and covariance matrices of the daily asset returns and we compare the portfolio volatilities using the methodology proposed by Engle and Colacito (2006). The analysed period was from January 2010 to September 2021, so that the data include half of phase II, full phase III and the onset of phase IV of the EU ETS, as well as the Brexit and COVID-19 outbreaks in the European context. Our results show that, unlike what happened in other economic crises (subprime, Brexit), from the pandemic crisis, the investment in clean energies is preferable to fossil energies, not only in terms of profitability, as other studies have shown, but also in terms of risk. Therefore, investing in clean energy companies, which are aligned with their role towards socially responsible initiatives, is valuable not only for its contribution to a sustainable energy transition to renewable sources but also for the attractiveness from a financial point of view. [ABSTRACT FROM AUTHOR]

Abstract: Objective: to analyse the efficacy of a proactive intervention during the postpartum period to prevent a relapse in recent quitters and to promote progress in the behavioural process of change in smokers. Design: randomised controlled trial designed for women at the end of the pregnancy using a proactive intervention. Motivational Interviewing (MI) and relapse prevention served as principles for the programme. In the intervention group, four telephone supporting sessions were performed in weeks 3, 6, 9 and 12. For the control group only two check calls in weeks 3 and 12. Setting: women who attended the University Clinical Hospital ‘Lozano Blesa’ of Zaragoza (Spain) to give birth between January 2009 and March 2010. The intervention began after delivery, lasted for 3 months, and finished with a visit to validate abstinence biochemically. Findings: a total of 2,044 women were studied, 30.6% (n=626) smoked before pregnancy; 65.8% (n=412) of them agreed to participate. The results for recent quitters by self-report showed that the probability of remaining abstinent after 12 weeks was 74% for the intervention group and 37% for the control group. Only the half of the sample attended the visit at 3 months to confirm the abstinence biochemically. For smokers, 90.7% of the intervention group said that they would be ready to try to quit in the following 6 months, vs. 18.3% for the control group. Conclusions and implications for the practice: a proactive intervention in the postpartum period may reduce the probability of relapse in recent quitters and helps female smokers to make progress in the behavioural process of change. Such interventions should be included systematically in mother–child health services. [Copyright &y& Elsevier]

Abstract: Background/purpose: Our aim was to perform a macroscopic and imaging (ultrasonographic and angiographic) evaluation of vascular closure stapler (VCS) metallic clips for renal transplantation in growing piglets to assess their role for transplantation surgery in young children. If these techniques are to be useful, it is necessary to prove that their use avoids one of the main pitfalls of conventional sutures in this setting, namely lack of growth in the suture line. Methods: Twenty-four piglets were used for this study. Animals were subjected to a heterotopic renal autotransplantation when they were 45 days old. The right kidney was moved from its normal location to the cranial area of the iliac fossa. The end-to-side anastomoses between the renal artery and vein and the aorta and vena cava, respectively, were performed using VCS metallic clips in 6 animals. Continuous polypropylene suturing was used in another 6 piglets, and continuous polyglycolic acid suture was used in 6 additional piglets. A control group of 6 animals without renal autotransplantation was also included in the study. All animals were allowed to grow for 6 months, during which time serial angiographic and ultrasonographic studies were carried out to assess the existence of vascular flow disturbances or stenosis. Similarly, angiographic measurements were obtained to document growth at the anastomotic site. Longitudinal growth was evaluated postmortem after the 6-month growing period. Results: Angiography showed significant (P < .001) transverse growth in both arteries and veins belonging to the VCS clips, running absorbable suture, or control groups. No significant difference was observed among the 3 groups. Vascular growth in the running nonabsorbable suture (polypropylene) group, however, was significantly less than in the other 3 groups and did not significantly differ from baseline. Baseline luminal diameters at the anastomotic site as measured by angiography in the VCS group were 3.64 ± 0.40 mm in the artery and 5.30 ± 1.43 mm in the vein. After growth, these values increased to 6.87 ± 0.90 mm and 11.27 ± 2.53 mm, respectively. Significant longitudinal growth was evidenced macroscopically after 6 months in both aorta and vena cava in all groups. On the other hand, significant longitudinal growth in the renal artery and vein were only observed in the control, VCS, and absorbable suture groups. Conclusions: In this experimental setting, satisfactory macroscopic and angiographic vascular growth results were obtained using the VCS clips, suggesting that this suture could be the technique of choice in pediatric transplantation surgery. [Copyright &y& Elsevier]

Antiplatelet agents are widely used in primary and secondary prevention of cardiovascular events. The scientific evidence has provided strong support for the benefits of aspirin in decreasing the risk of cardiovascular events in a wide range of pathologies. The relatively rare occurrence of major bleeding complications should not be underestimated, mainly due to its high morbi-mortality. The assessment of both gastrointestinal risk and cardiovascular benefits of low-dose aspirin for any individual patient may be difficult in clinical practice. In this review, we summarize the evidence supporting the efficacy of aspirin and the risks of side effects due to hemorrhagic complications. This article proposes a unifying framework for application to help the clinician in the decision making process of individuals who have different risk of cardiovascular and bleeding events with different examples. Finally, new developments in the field directed towards individualized risk assessment strategies are described. [Copyright &y& Elsevier]

Low dose aspirin (ASA) use has been associated with a wide range of adverse side effects in the upper gastrointestinal (GI) tract, which range from troublesome symptoms without mucosal lesions to more serious toxicity, including ulcers, GI bleeding, perforation and even death. Upper GI symptoms in low dose ASA users are common but often careless or misinterpreted and they are not always related to the presence of mucosal injury. Usually, low dose ASA related ulcers are reasonably small and asymptomatic, and probably heal over a period of weeks to a few months. But, the real clinical problem occurs when the ulcer results in a GI complication (mostly bleeding). The estimated average excess risk of symptomatic or complicated ulcer related to low dose ASA is five cases per 1000 ASA users per year. Death is the worst outcome of GI complications in low dose ASA users, but data about this aspect are scarce. Current evidence indicates that low dose ASA can damage the lower GI tract also, but the real size of the problem is still unknown. [Copyright &y& Elsevier]

Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the most widely prescribed medication in the world. Their main benefit derives from their anti-inflammatory and analgesic effect, but the use of these agents is not innocuous since they mainly increase the risk of gastrointestinal (GI) and cardiovascular complications compared with non-NSAID users. NSAIDs injures the upper and lower gut by depleting COX-1 derived prostaglandins and causing topical injury to the mucosa. The risk of upper GI complications varies, depending on the presence of one or more risk factors. Among them, the three main risk factors are prior history of peptic ulcer, the single most important risk factor, age, the most common, and concomitant aspirin use, due to their GI and cardiovascular implications. Those individuals at-risk should be considered for alternatives to NSAID therapy and modifications of risk factors. If NSAID therapy is required, patients at risk will need prevention strategies including co-therapy of NSAID with gastroprotectants (PPI or misoprostol) or the prescription of COX-2 selective inhibitors. The probable introduction of NO-NSAIDs in the market in the near future may open a new therapeutic option for patients with hypertension who need NSAIDs. [Copyright &y& Elsevier]

Drug use increases with age and the elderly is at increased risk of adverse drug reactions. Gastrointestinal adverse effects are one of the most often reported. Serious event are mostly caused by NSAIDs and/or aspirin which are the most widely prescribed medications in the world. NSAIDs and/or aspirin use are associated with complications from both the upper and the lower gastrointestinal tract. The risk of these complications depends on presence of risk factors, and age is the most frequent and relevant one. At-risk patients should be on prevention strategies including the use of the lowest effective dose, co-therapy with a gastroprotective agents or use of a COX-2 selective agent. Treatment of Helicobacter pylori infection is beneficial in patients starting therapy with these agents, especially in the presence of ulcer history. The best strategy to prevent lower GI complications has yet to be defined. [Copyright &y& Elsevier]

Abstract: Panoramic radiographs are the most widely used radiological diagnostic technique in dental practice, offering full vision of the maxillas and adjacent regions, but there are shortcomings regarding detailed dentoalveolar exploration. This study compared the precision of digital versus conventional panoramic radiographs in the presurgical evaluation of impacted lower third molars. 390 mandibular third molars were studied in 287 patients; their position, morphology and surgical technique used were recorded. 84 molars were evaluated with digital panoramic radiographs, and 306 with conventional panoramic radiographs. Four observers compared the presurgical data with the surgical findings and the diagnostic precision was established. There were statistically significant differences between the techniques; digital panoramic radiographs were more precise than conventional radiographs in providing the correct presurgical evaluation of the impacted third molars. Surgeon experience had a statistically significant influence on planning the presurgical study. Panoramic radiographs distort the position and morphology of the lower third molar, which may affect the presurgical strategy used. In this context, and because of their lesser experience, first year residents consider the operation to be more complicated, and tend to act less conservatively and cause increased trauma. In conclusion, digital panoramic radiographs offer significantly greater diagnostic precision than conventional panoramic radiographs. [Copyright &y& Elsevier]

Abstract: The aim of this study was to demonstrate the efficacy of methylprednisolone, as a single 40-mg dose, injected into the masseter muscle upon completion of extraction of impacted lower third molars. A prospective, randomized cross-over study was made of 35 healthy patients. The difficulty of extraction was similar in all cases. The study group received 40mg of methylprednisolone injected into the masseter muscle via the intrabuccal approach, immediately after suturing of the surgical wound. The control group received no intramuscular corticoid. Evaluations were made of postoperative pain, trismus and swelling. Oral aperture was measured, along with the following distances for the assessment of swelling: tragus–lip commissure, gonion–lip commissure and gonion–external canthus of the eye, before and 2 and 7 days after surgery. The patients administered methylprednisolone showed superior results after surgery in terms of oral aperture, pain and all the facial swelling parameters, with statistically significant differences versus the controls (p <0.05). The results obtained show that 40mg of methylprednisolone injected into the masseter muscle in the immediate postoperative period reduces swelling, trismus and pain. [Copyright &y& Elsevier]

Abstract: Background/Purpose: Lack of growth after surgery is still an unsolved issue in growing vessels. Aortic surgery is an integral part of vascular pediatric surgery. As an alternative to address this lack of growth in this scenario, we propose the use of titanium clips for vascular anastomosis. Methods: Thirty-two domestic swine were used in this study. Animals entered the study when they were 55 days old and were subjected to an end-to-end aortic anastomosis using vasular closure stapler (VCS) clips, interrupted polypropylene, or running polyglycolic acid suture. Control group animals were sham-operated. Pigs were allowed to grow for 6 months, during which time they were subjected to serial ultrasonographic and angiographic studies to assess vascular growth. Results: VCS clip anastomosis outcome was comparable with polypropylene or polyglycolic acid suture anastomosis. No significant differences in either longitudinal or transversal vascular growth were seen between the 3 studied suturing techniques and the control group. Conclusions: Our vascular growth and patency results suggest that VCS clips may provide a suitable alternative to conventional suture in pediatric aortic vascular surgery. [Copyright &y& Elsevier]

The latest generation in titanium clip application systems, the vascular closure staples (VCS) system avoids intimal lesions and therefore minimizes the subsequent hyperplastic reaction, while at the same time enhancing distensibility and vascular growth. Moreover, VCS clips allow the surgeon to perform vascular anastomosis easily and faster than conventional suture. This system may become the option of choice for vascular reconstruction in pediatric surgery where, as in the case of aortic and transplant surgery, decreasing vascular occlusion times may influence the outcomes. The aim of this study was to determine whether VCS metallic clips would allow shorter anastomosis times than conventional interrupted polypropylene or running Dexon suturing in end-to-end anastomosis performed in the abdominal aorta of young pigs. Twenty-four domestic swine, 45 days old, were used for this study. All animals were subjected to an end-to-end anastomosis in the abdominal aorta using VCS clips, interrupted polypropylene, or running Dexon suture. Aortic cross-clamping time was significantly shorter in the VCS clips group (4.02 ± 0.72 min), compared to interrupted polypropylene (21.89 ± 1.93 min) or running Dexon (9.82 ± 3.97 min) suture. VCS clips are easy to use, and therefore may aid surgeons to significantly decrease the time needed for performing an end-to-end anastomosis in the abdominal aorta, thus decreasing cross-clamping time when compared to interrupted polypropylene or running Dexon sutures. [ABSTRACT FROM AUTHOR]

Alternatives are still being sought in vascular surgery to avoid the complications caused in growing vessels by the various suture techniques and materials currently in use. A major complication is arrested growth following anastomosis. Opinions differ widely regarding the best approach to this problem, and research is currently underway at our center on the latest generation of clip appliers (vascular closure stapler, or VCS) and their potential application as an alternative to the conventional suture technique in pediatric vascular surgery. This study compared vascular growth and reendothelialization following anastomosis of growing arteries and veins using VCS clips versus the conventional interrupted polypropylene suture technique. Thirty 55-day-old lambs underwent end-to-end anastomosis of the carotid artery and jugular vein. Serial ultrasonography and angiography were carried out over the ensuing 6-month growth period, after which the lambs were euthanized. Gross examination of the anastomosis site was followed by histologic examination involving light microscopy, immunohistochemical techniques, and transmission electron microscopy. Although both VCS clips and polypropylene sutures allowed transverse vessel growth, the clips did not penetrate the intima and thus provided enhanced reendothelialization. The satisfactory results obtained here, as in earlier studies, increasingly point to VCS clips as the method of choice in pediatric vascular surgery. [ABSTRACT FROM AUTHOR]

The Endoscopic Resection Group of the Spanish Society of Endoscopy (GSEED-RE) model and the Australian Colonic Endoscopic Resection (ACER) model were proposed to predict delayed bleeding (DB) after EMR of large superficial colorectal lesions, but neither has been validated. We validated and updated these models. A multicenter cohort study was performed in patients with nonpedunculated lesions ≥20 mm removed by EMR. We assessed the discrimination and calibration of the GSEED-RE and ACER models. Difficulty performing EMR was subjectively categorized as low, medium, or high. We created a new model, including factors associated with DB in 3 cohort studies. DB occurred in 45 of 1034 EMRs (4.5%); it was associated with proximal location (odds ratio [OR], 2.84; 95% confidence interval [CI], 1.31-6.16), antiplatelet agents (OR, 2.51; 95% CI,.99-6.34) or anticoagulants (OR, 4.54; 95% CI, 2.14-9.63), difficulty of EMR (OR, 3.23; 95% CI, 1.41-7.40), and comorbidity (OR, 2.11; 95% CI,.99-4.47). The GSEED-RE and ACER models did not accurately predict DB. Re-estimation and recalibration yielded acceptable results (GSEED-RE area under the curve [AUC],.64 [95% CI,.54-.74]; ACER AUC,.65 [95% CI,.57-.73]). We used lesion size, proximal location, comorbidity, and antiplatelet or anticoagulant therapy to generate a new model, the GSEED-RE2, which achieved higher AUC values (.69-.73; 95% CI,.59-.80) and exhibited lower susceptibility to changes among datasets. The updated GSEED-RE and ACER models achieved acceptable prediction levels of DB. The GSEED-RE2 model may achieve better prediction results and could be used to guide the management of patients after validation by other external groups. (Clinical trial registration number: NCT 03050333.) [ABSTRACT FROM AUTHOR]