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We previously published a novel strategy for management of postcraniotomy bone flap infection consisting of single stage debridement, bone flap removal, and immediate titanium mesh cranioplasty.Postcraniotomy patients with surgical site infections treated with surgical debridement, bone flap removal, and immediate titanium mesh cranioplasty were retrospectively reviewed. The primary outcome measure was reoperation due to persistent infection or wound healing complications from the titanium mesh.We included 48 patients, of which 15 (31.3%) were female. The most common primary diagnoses were glioblastoma (31.3%), meningioma (18.8%), and vascular/trauma (16.7%). Most patients had a history of same-site craniotomy prior to the surgery complicated by surgical site infection and 47.9% had prior cranial radiation. Thirty-six (75.0%) patients achieved resolution of their infection and did not require a second operation. Twelve (25.0%) patients required reoperation: 6 (12.5%) patients were found to have frank intraoperative purulence on reoperation, whereas 6 (12.5%) had reoperation for poor wound healing without any evidence of persistent infection. Cochran Armitage trend test revealed that patients with increasing number of wound healing risk factors had significantly higher risk of reoperation (P = 0.001). Prior intensity modulated radiotherapy alone was a significant risk factor for reoperation (6.5 [1.40-30.31], P = 0.002). Median follow-up time was 20.5 weeks.Immediate titanium mesh cranioplasty at the time of debridement and bone flap removal is an acceptable option in the management of post-craniotomy bone flap infection. Patients with multiple wound healing risk factors are at higher risk for reoperation.

Intracranial solitary fibrous tumor (SFT) is characterized by aggressive local behavior and high post-resection recurrence rates. It is difficult to distinguish between SFT and meningiomas, which are typically benign. The goal of this study was to systematically review radiological features that differentiate meningioma and SFT.We performed a systematic review in accordance with PRISMA guidelines to identify studies that used imaging techniques to identify radiological differentiators of SFT and meningioma.Eighteen studies with 1565 patients (SFT: 662; meningiomas: 903) were included. The most commonly used imaging modality was diffusion weighted imaging, which was reported in 11 studies. Eight studies used a combination of diffusion weighted imaging and T1- and T2-weighted sequences to distinguish between SFT and meningioma. Compared to all grades/subtypes of meningioma, SFT is associated with higher apparent diffusion coefficient, presence of narrow-based dural attachments, lack of dural tail, less peritumoral brain edema, extensive serpentine flow voids, and younger age at initial diagnosis. Tumor volume was a poor differentiator of SFT and meningioma, and overall, there were less consensus findings in studies exclusively comparing angiomatous meningiomas and SFT.Clinicians can differentiate SFT from meningiomas on preoperative imaging by looking for higher apparent diffusion coefficient, lack of dural tail/narrow-based dural attachment, less peritumoral brain edema, and vascular flow voids on neuroimaging, in addition to younger age at diagnosis. Distinguishing between angiomatous meningioma and SFT is much more challenging, as both are highly vascular pathologies. Tumor volume has limited utility in differentiating between SFT and various grades/subtypes of meningioma.

Primary malignant non-osseous spinal tumors are relatively rare and this has led to a paucity of studies specifically examining the epidemiology of malignant spinal tumors.To provide an updated and more comprehensive study examining the epidemiology and relative survival of these rare tumors.Data was retrospectively acquired from the Central Brain Tumor Registry of the United States (CBTRUS).Primary malignant non-osseous spinal tumor cases diagnosed between 2000 and 2017 in the United States.Incidence rates (IRs), relative survival rates, and hazard ratios (HR) were measured.IRs were calculated only for histologically-confirmed cases between 2000 and 2017. Relative survival estimates were calculated from survival information on malignant spinal tumors between 2001 and 2016 for death from any cause. Multivariable Cox proportional hazards regression models were constructed to control for age, sex, race, and ethnicity.From 2000 to 2017, approximately 587 new cases of malignant non-osseous spinal tumors were diagnosed every year in the United States. The overall IR was 0.178 per 100,000 persons. Ependymomas were the most commonly diagnosed tumor in all age groups. The 10-year relative survival rates were 94.1%, 62.1%, 62.0%, and 13.3% for ependymomas, lymphomas, diffuse astrocytomas, and high-grade astrocytomas, respectively. Females have a significantly lower risk of death as compared with males for ependymomas (HR: 0.74, p.001) and diffuse astrocytomas (HR: 0.70, p=.005). African-Americans have a significantly higher risk of death compared with Caucasians when diagnosed with ependymomas (HR: 1.52, p=.009) or lymphomas (HR: 1.55, p=.009).Primary malignant non-osseous spinal tumors are primarily diagnosed in adulthood or late adulthood. Ependymal tumors are the most commonly diagnosed primary malignant non-osseous spinal tumors and have the highest 10-year relative survival rates. High-grade astrocytomas are rare and portend the worst prognosis.

This research was supported by the project MAT2017-82182-R funded by the State Research Agency (SRA) of Spain and European Regional Development Fund (ERDF). Funding for open access charge: Universidad de Granada / CBUA, Hypothesis: Ice adhesion to rigid materials is reduced with low energy surfaces of high receding contact angles. However, their adhesion strength values are above the threshold value to be considered as icephobic materials. Surface deformability is a promising route to further reduce ice adhesion. Experiments: In this work, we prepared elastomer surfaces with a wide range of elastic moduli and hydrophobicity degree and we measured their ice adhesion strength. Moreover, we also explored the deicing performance of oil-infused elastomeric surfaces. The ice adhesion was characterized by two detachment modes: tensile and shear. Findings: The variety of elastomeric surfaces allowed us to simultaneously analyze the ice adhesion dependence with deformability and contact angle hysteresis. We found that the impact of these properties depends on the detachment mode, being deformability more important in shear mode and hydrophobicity more relevant in tensile mode. In addition, oil infusion further reduces ice adhesion due to the interfacial slippage. From an optimal balance between deformability and hydrophobicity, we were able to identify surfaces with super-low ice adhesion., MAT2017-82182-R State Research Agency (SRA), European Regional Development Fund (ERDF), Universidad de Granada / CBUA

The common γ chain family of cytokines and their receptors play fundamental roles in the immune system. Evolutionary studies of γ chain cytokines have elegantly illustrated how the immune system adapts to ever-changing environmental conditions. Indeed, these studies have revealed the uniqueness of cytokine evolution, which exhibits strong positive selection pressure needed to adapt to rapidly evolving threats whilst still conserving their receptor binding capabilities. In this review, we summarise the evolutionary mechanisms that gave rise to the characteristically diverse family of γ chain cytokines. We also speculate on the benefits of studying cytokine evolution, which may provide alternative ways to design novel cytokine therapeutic strategies. Additionally, we discuss current evolutionary models that elucidate the emergence of distinct cytokines (IL-4 and IL-13) and cytokine receptors (IL-2Rα and IL-15Rα). Finally, we address and reflect on the difficulties associated with evolutionary studies of rapidly evolving genes and describe a variety of computational methods that have revealed numerous aspects of cytokine evolution.

Hypothesis Characterization of contact angle hysteresis on soft surfaces is sensitive to the measurement protocol and might present adventitious time-dependencies. Contact line dynamics on solid surfaces is altered by the surface chemistry, surface roughness and/or surface elasticity. We observed a “slow” spontaneous relaxation of static water sessile drops placed on elastic surfaces. This unexpected drop motion reveals unresolved equilibrium configurations that may affect the observed values of contact angle hysteresis. Drop relaxation on deformable surfaces is partially governed by a viscoelastic dissipation located at the contact line. Experiments In this work, we studied the natural relaxation of water drops formed on several smooth PDMS surfaces with different elastic moduli. We monitored in time the contact angle and contact radius of each drop. For varying the initial contact angle, we used the growing-shrinking drop method. Findings We postulate that the so-called “braking effect”, produced by the surface deformability, affects the contact line velocity and in consequence, the contact angle measurements. We conclude that the wetting properties of elastic surfaces should be properly examined with reliable values of contact angle measured after drop relaxation.

Background The magnetic resonance imaging sequence used to assess optic canal invasion by tuberculum sella meningiomas (TSMs) has not been standardized. Both constructive interference in steady state (CISS) and contrast-enhanced T1-weighted volume-interpolated breath-hold examination (VIBE) sequences are frequently used. The aim of the present study was to compare the accuracy and interrater reliability of these sequences in predicting optic canal invasion by TSMs. Methods In the present retrospective study of 27 patients (54 optic canals) who had undergone endoscopic transtuberculum transplanum resection of TSMs, images from preoperative CISS and contrast-enhanced T1-weighted VIBE sequences were assessed by 5 neuroradiologists who were unaware of the operative findings. The readers evaluated the optic canal in 4 quadrants at 2 locations (the posterior tip of the anterior clinoid process and the optic strut). A quadrant was considered positive for tumor invasion if invasion was present at either of these 2 locations. The reference standard was intraoperative observation of gross optic canal invasion. Results The interrater agreement was good for the presence or absence of tumor involvement in a particular quadrant (CISS, 0.635; VIBE, 0.643; 95% confidence interval for the difference, −0.086 to 0.010). The mean sensitivity and specificity for optic nerve invasion were 0.643 and 0.438 with CISS and 0.643 and 0.454 with VIBE, respectively. No significant differences were seen between the sequences in terms of reader accuracy when the intraoperative findings were used as the reference standard. Conclusion CISS and VIBE sequences both have good accuracy in predicting for optic canal tumor invasion by TMEs.

Resumen: En el año 2018 se conmemoraron 40 años desde el primer resultado exitoso producto de una fertilización in vitro (FIV), el nacimiento de Louise Brown en Inglaterra. Se estima que a la fecha han nacido más de 8 millones de seres humanos gracias a las tecnologías de reproducción asistida (TRA), técnicas que están en constante avance y desarrollo. Sin embargo, a pesar de ser cada vez más relevantes como tratamiento de la infertilidad, su acceso todavía es muy limitado y poco equitativo, alcanzando menos del 15% de la población a nivel global.En esta revisión analizamos los aspectos epidemiológicos de la infertilidad y exponemos el contraste entre la necesidad teórica de TRA y los ciclos realizados a nivel mundial, reflejando el bajo acceso a los tratamientos. Se enfatiza la realidad latinoamericana y con especial detalle la chilena, explorando tanto su dimensión histórica como actual, perfilando los desafíos que como país deberemos enfrentar en los próximos años. Summary: The 40-year anniversary of the first in vitro fertilization (IVF) newborn, Louise Brown in England, was celebrated in 2018. To date, over 8 million children have been born with assisted reproductive technologies (ART), a group of techniques in continuous development. Despite the increasing relevance of such technologies as treatments for infertility, the access to ART has been limited to less than 15% of the world population.In this review, we analyze the epidemiological aspects of infertility and present the contrast between the theoretical demand and the actual number of ART cycles performed worldwide, reflecting the low access to infertility treatments. We put emphasis on the Latin American historic and current context, then provide more details on the Chilean reality, and finally outline the challenges Chile will face in the future regarding access to ART.

Secretory meningioma (SM) is a rare subtype of benign meningioma reported to cause significant peritumoral brain edema (PTBE). Therefore, patients with SM may have more severe presenting symptoms and possibly increased postoperative complications. Our aim was to perform a statistically rigorous comparison of patients with SM with other nonsecretory World Health Organization grade I meningiomas and examine PTBE, postsurgical outcomes, and recurrence in a large series of cases.A retrospective review of all patients at our institution with pathologically confirmed SM between 2000 and 2017 was performed. A control group of nonsecretory grade I meningiomas was matched 1:1 according to tumor location and size. Study groups were compared on clinical characteristics and outcomes using logistic, cumulative logit, and normal linear generalized estimating equations regression models.Fifty-five patients with SM met inclusion criteria and were matched with 55 control patients. After adjusting for size and location, the odds of a patient with SM having a more severe T2 edema grade were 8.9 (95% confidence interval, 3.8-21.1; P 0.001) times higher, and the odds of any T2 edema were 6.2 (95% confidence interval, 2.2-17.6; P 0.001) times higher. Significance remained even when adjusting for age. Postoperative complications, Simpson grade resection, neurologic outcome, and recurrence were not significantly different.Patients with SM have significantly greater odds of having PTBE compared with patients with nonsecretory World Health Organization grade I meningiomas of a similar size and location. Despite this situation, surgical outcome and recurrence rates are similar.