Laparoscopic Roux-en-Y Gastric Bypass After Failed Vertical Banded Gastroplasty: a Multicenter Experience with 203 Patients

Background: Vertical banded gastroplasty (VBG) has long been the main restrictive procedure for morbid obesity but has many long-term complications for which conversion to Roux-en-Y gastric bypass (RYGBP) is often considered the best option. Methods: This series regroups patients operated on by three different surgeons in four different centers. All data were collected prospectively, then pooled and analyzed retrospectively. Results: Out of 2,522 RYGBP performed between 1998 and 2010, 538 were reoperations, including 203 laparoscopic RYGBP after VBG. There were 175 women and 28 men. The mean BMI before VBG was 43.2 ± 6.3, and the mean BMI before reoperation was 37.4 ± 8.3. Most patients had more than one indication for reoperation and/or had regained significant weight. There was no conversion to open surgery. A total of 24 patients (11.8%) developed complications, including nine (4.5%) who required reoperation and one death. With a follow-up of 88.9% after 8years, the mean BMI after 1, 3, 5, 7, and 9years was 29.1, 28.8, 28.7, 29.9, and 28.8, respectively. Conclusions: On the basis of this experience, the largest with laparoscopic reoperative RYGBP after failed VBG, we conclude that this procedure can safely be performed in experienced hands, with weight loss results similar to those observed after primary RYGBP. In patients with too difficult an anatomy below the cardia, dividing the esophagus just above the esophago-gastric junction and performing an esophagojejunostomy may be a safe alternative to converting to a Scopinaro-type BPD, obviating the additional long-term risks associated with malabsorptio

Transabdominal Laparoscopic Repair of Amyand's Hernia: A Case Report

The occurrence of appendicitis within an inguinal hernia, known as Amyand's hernia, is a rare condition. Laparoscopic approach to this type of hernia is not widely used, and there is little data comparing it to the open surgery approach. This article presents a case of Amyand's hernia treated successfully by laparoscopy via a transabdominal approach supported by a short review of literature on this rare condition

Taux d’intérêt et risque de crédit : analyse du comportement des banques en relation avec les petites et moyennes entreprises sénégalaises

Cet article évalue d'un point de vue microéconomique, les déterminants du risque et du taux d’intérêt appliqués par les banques aux petites et moyennes entreprises (PME) en 2016 au Sénégal. En utilisant le modèle de Heckman (1979), deux équations sont estimées. Le premier modèle empirique spécifie le risque crédit des PME et le second donne l’impact sur le taux d’intérêt du score de crédit et des caractéristiques des Petites et Moyennes Entreprises. Les résultats fournissent des informations précieuses sur les caractéristiques que les institutions financières bancaires et non bancaires considèrent comme importantes dans leur décision de prêter aux PME. La connaissance de ces informations peut fournir aux PME un large éventail de critères qui doivent être satisfaits pour obtenir un financement des institutions financières au Sénégal. Selon les conclusions de l'étude, le risque de crédit a eu une influence notable sur le taux d’intérêt et les prêts consentis aux PME par les banques au Sénégal.This article assesses, from a microeconomic point of view, the risk and interest rate determinants applied by banks to small and medium-sized enterprises (SMEs) in 2016 in Senegal. Using Heckman's (1979) model, two equations are estimated. The first empirical model specifies the credit risk of SMEs and the second gives the impact on the interest rate of the credit score and the characteristics of Small and Medium Enterprises. The results provide valuable information on the characteristics that banks and non-banks financial institutions consider important in their decision to lend to SMEs. Knowledge of this information can provide SMEs with a wide range of criteria that must be met to obtain financing from financial institutions in Senegal. According to the findings of the study, credit risk has had a significant influence on the interest rate and loans granted to SMEs by banks in Senegal

The three-loop beta function in SU(N) lattice gauge theories

We calculate the third coefficient of the lattice $\beta$ function in pure Yang-Mills theory. We make use of a computer code for solving perturbation theory analytically on the lattice. We compute the divergent integrals by using a method based on a Taylor expansion of the integrand in powers of the external momenta in $4 - \epsilon$ dimensions. Our results are in agreement with a previous calculation by M. L\"uscher and P. Weisz where the authors used a different technique. We also show how this new coefficient modifies the scaling function on the lattice in both the standard and energy schemes. In particular we show that asymptotic scaling is extremely well achieved in the energy scheme.Comment: 17 pages, 2 postcript files corresponding to a figur

Exploring Memory Interventions in Depression through Lifelogging Lens

Depression is a major affective disorder with significant socio-economic cost. Distinctive autobiographical memory impairments in depression include overgeneralization, negative-bias, and repetitive negative thinking. Some psychotherapeutic interventions are designed to address these impairments, with insufficient technological support. This paper reports on an analysis of four memory-based interventions proven effective in therapeutic practice for depression, while explores the memory impairments addressed by these interventions. We address these findings into three design implications for digital tools in this space. We suggest supports for enriched positive memory recall, strategically negative memory reappraisal and future episodic imagination

The politics of local finance : changes in central/local financial relationships in France (1970-2010)

Ces dernières années, en France, les finances publiques locales ont fait l’objet de deux réformes d’ampleur, particulièrement médiatisées tant l’histoire dans ce domaine est jalonnée d’échecs et de réformes à la marge. La suppression de la taxe professionnelle, remplacée par une contribution économique territoriale, ainsi que la baisse sans précédent de la dotation globale de fonctionnement, ont pour effet de limiter les recettes des collectivités et pèsent indirectement sur leurs dépenses. Autrement dit, ces réformes témoigneraient de la capacité de l’Etat à imposer aux gouvernements locaux davantage de contrainte budgétaire, conformément à la discipline qu’il applique aux administrations centrales ainsi qu’aux organismes de Sécurité sociale. Des transformations identiques, voire plus marquées, s’opèrent dans d’autres pays européens. Partant de ce constat, cette thèse cherche à montrer dans quelle mesure et comment l’Etat parvient à changer les règles en matière de finances locales de telle sorte qu’elles soient davantage compatibles avec un objectif de long terme de maîtrise des dépenses, de la dette et des déficits publics.This last years in France, two important reforms of local public finance were adopted, the reform of the business tax and the decrease of grants. It was widely advertised in the local and national press. Actually, the history of local public finance is caracterized by the failure of reforms. It could be analized as an illustration of the state capacity to impose budget consolidation and fiscal constrain to subnational governments. Identical change takes place in other european countries. This thesis shows in what extent and how the state succeed in changing the rules of local public finance to be more compatible with a long term goal of fiscal consolidation

First-Principles Investigation of Electronic and Related Properties of Cubic Magnesium Silicide (Mg2Si)

We present results from ab initio, self-consistent calculations of electronic, transport, and bulk properties of cubic magnesium silicide (Mg2Si). We employed a local density approximation (LDA) potential to perform the computation, following the Bagayoko, Zhao, and Williams (BZW) method, as improved by Ekuma and Franklin (BZW-EF). The BZW-EF method guarantees the attainment of the ground state as well as the avoidance of over-complete basis sets. The ground state electronic energies, total and partial densities of states, effective masses, and the bulk modulus are investigated. As per the calculated band structures, cubic Mg2Si has an indirect band gap of 0.896 eV, from Γ to X, for the room temperature experimental lattice constant of 6.338 Å. This is in reasonable agreement with the experimental value of 0.8 eV, unlike previous ab initio DFT results of 0.5 eV or less. The predicted zero temperature band gap of 0.965 eV, from Γ to X, is obtained for the computationally determined equilibrium lattice constant of 6.218 Å. The calculated value of the bulk modulus of Mg2Si is 58.58 GPa, in excellent agreement with the experimental value of 57.03 ± 2 GPa

La régulation de l’urbanisme commercial : élus locaux versus promoteurs ?

This article addresses local politicians’ capacity to negotiate and regulate commercial urban planning in the face of developers. It uses a qualitative analysis of urban projects and planning documents from the urban intermunicipality of Strasbourg and the municipality of Chambourcy (Ile-de-France). This article shows that developers’ interests are far from prevailing directly, systematically or uniformly in urban governance