An experimental in vitro study involving ten hand-sutured, ten biofragmentable anastomotic ring (BAR) and ten stapled anastomoses was conducted to compare current anastomotic techniques on the basis of early bursting pressure. The 30 fresh human colon segments used in the study were harvested from patients who had undergone elective oncologic resection. Following the construction of in vitro anastomoses, the pressure required to burst these specimens was measured. The results showed no significant differences among the three techniques. Since hand-sutured anastomoses proved to be as effective and reliable as the other methods and can offer the advantage of cost savings, they should remain standard procedure in colorectal surgery.

Age itself cannot be considered a contraindication.

Purpose Considering a high prevalence of congenital and especially acquired bleeding disorders, their heterogeneity and the multitude of possible treatments strategies, a review of the scientific data on this topic is needed to implement a treatment guide for healthcare professionals. Methods A selective literature review was performed via PubMed for articles describing oral surgery / dental implant procedures in patients with congenital and acquired bleeding disorders. Out of the existing literature, potential treatment algorithms were extrapolated. Results In order to assess the susceptibility to bleeding, risk stratification can be used for both congenital and acquired coagulation disorders. This risk stratification, together with an appropriate therapeutic pathway, allows for an adequate and individualized therapy for each patient. A central point is the close interdisciplinary cooperation with specialists. In addition to the discontinuation or replacement of existing treatment modalities, local hemostyptic measures are of primary importance. If local measures are not sufficient, systemically administered substances such as desmopressin and blood products have to be used. Conclusions Despite the limited evidence, a treatment guide could be developed by means of this narrative review to improve safety for patients and practitioners. Prospective randomized controlled trials are needed to allow the implementation of official evidence-based guidelines.

Clinical outcome after X-Stop implantation might be considerably less favorable than when it was being published previously. Patient selection might be a reason for early revision surgery. More criteria for better X-Stop indications might be needed.

In case of revision or minimal invasive spinal surgery, the amount of autograft possibly harvested from the lamina and the spinous processes is limited. Ekanayake and Shad (Acta Neurochir 152:651-653, 2010) suggest the application of bone shavings harvested via high speed burr additionally or instead, but so far no data regarding their osteogenic potential exist. Aim of the study was to compare the osteogenic potential of bone chips and high speed burr shavings, and to evaluate the applicability of bone shavings as an autograft for spinal fusion. Bone chips and shavings from 14 patients undergoing spinal decompression surgery were analyzed using in vitro tissue culture methods. Osteoblast emigration and proliferation, viability and mineralization were investigated and histological evaluation was performed. Bone chips from all patients showed successful osteoblast emigration after average 5.5 days. In contrast, only 57% of the corresponding bone shavings successfully demonstrated osteoblast emigration within an average time span of 14.8 days. Average osteoblast mobilisation was 1.25 9 10 6 cells per gram from bone chips and 1.73 9 10 5 cells per gram from the corresponding bone shavings. No difference was observed regarding cell viability, but population doubling times of bone chip cultures were significantly lower (50.5 vs. 121 h) and mineralization was observed in osteoblasts derived from bone chips only. Although some authors suggest the general applicability of laminectomy bone shavings as autografts for spinal fusion, autologous bone grafts obtained from laminectomy bone chips are superior in terms of cell delivery, cell proliferation and mineralization.

In order to integrate uncertainty estimates into deep time-series modelling, Kalman Filters (KFs) (Kalman et al., 1960) have been integrated with deep learning models, however, such approaches typically rely on approximate inference techniques such as variational inference which makes learning more complex and often less scalable due to approximation errors. We propose a new deep approach to Kalman filtering which can be learned directly in an end-to-end manner using backpropagation without additional approximations. Our approach uses a high-dimensional factorized latent state representation for which the Kalman updates simplify to scalar operations and thus avoids hard to backpropagate, computationally heavy and potentially unstable matrix inversions. Moreover, we use locally linear dynamic models to efficiently propagate the latent state to the next time step. The resulting network architecture, which we call Recurrent Kalman Network (RKN), can be used for any time-series data, similar to a LSTM (Hochreiter & Schmidhuber, 1997) but uses an explicit representation of uncertainty. As shown by our experiments, the RKN obtains much more accurate uncertainty estimates than an LSTM or Gated Recurrent Units (GRUs) (Cho et al., 2014) while also showing a slightly improved prediction performance and outperforms various recent generative models on an image imputation task.

Estimating accurate forward and inverse dynamics models is a crucial component of model-based control for sophisticated robots such as robots driven by hydraulics, artificial muscles, or robots dealing with different contact situations. Analytic models to such processes are often unavailable or inaccurate due to complex hysteresis effects, unmodelled friction and stiction phenomena, and unknown effects during contact situations. A promising approach is to obtain spatio-temporal models in a data-driven way using recurrent neural networks, as they can overcome those issues. However, such models often do not meet accuracy demands sufficiently, degenerate in performance for the required high sampling frequencies and cannot provide uncertainty estimates. We adopt a recent probabilistic recurrent neural network architecture, called Recurrent Kalman Networks (RKNs), to model learning by conditioning its transition dynamics on the control actions. RKNs outperform standard recurrent networks such as LSTMs on many state estimation tasks. Inspired by Kalman filters, the RKN provides an elegant way to achieve action conditioning within its recurrent cell by leveraging additive interactions between the current latent state and the action variables. We present two architectures, one for forward model learning and one for inverse model learning. Both architectures significantly outperform existing model learning frameworks as well as analytical models in terms of prediction performance on a variety of real robot dynamics models.

IntroductionAlveolar ridge augmentation is often required before dental implant placement. In this context, autologous bone grafts are considered the biological gold standard. Still, bone block harvesting is accompanied by some serious potential disadvantages and possible complications, such as pain, bleeding, and nerve irritation. Several studies aimed to compare autologous to allogeneic bone grafts concerning bone quality and implant survival rates; this is the first prospective study analyzing and comparing morbidity‐related parameters after alveolar ridge augmentation using autogenous and allogeneic bone blocks from patients' perspective.MethodsUsing a questionnaire, 36 patients were asked to evaluate the surgery as well as the post‐operative period concerning pain, stress, sensibility deficits, satisfaction with, and consequences from the surgery as well as the preferred procedure for future alveolar ridge augmentations.ResultsNo significant differences were shown regarding stress and pain during and after surgery, whereas the rate of nerve irritations was twice as high in the autologous group. The swelling was significantly higher in patients with autologous bone blocks (p = 0.001). Nevertheless, the overall satisfaction of patients of both groups was very high, with over 8/10 points.ConclusionsThe swelling was the main reason for patients' discomfort in both groups and was significantly higher after autologous bone augmentation. Since this side effect seems to be a highly relevant factor for patients' comfort and satisfaction, it needs to be discussed during preoperative consultation to allow shared decision‐making considering the anticipated morbidity.