Treatment of gastrointestinal hemorrhage

Background: We assessed the value of selective arteriography in the diagnosis and management of acute gastrointestinal hemorrhage. Methods: We reviewed the records of 107 consecutive patients who had gastrointestinal hemorrhage and underwent selective arteriography between January 1992 and October 2003: 10 had upper gastrointestinal bleeding, 79 had lower gastrointestinal bleeding, and 18 had varicose bleeding with portal hypertension. Selective embolization was attempted in 15 patients to obtain hemostasis. Angiographic findings were reviewed and prospective reports were compared with the final diagnosis and outcome. Results: Of 129 angiographic studies, 36 correctly revealed the bleeding site and 93 were negative. Extravasation was seen in 24 cases at the level of stomach (n = 2), duodenum (n = 1), small bowel (n = 5), or colon (n = 16). Indirect signs of bleeding sources were identified in 12 patients (stomach in one, small bowel in four, large bowel in four, liver in three). Transcatheter embolization induced definitive hemostasis in 11 of 15 patients (73%), namely in the stomach (n = 2), small bowel (n = 3), colon (n = 7), and liver (n = 3). Three patients required surgery after embolization. Conclusion: Abdominal arteriography may localize gastrointestinal bleeding sources in approximately one-third of cases. Selective embolization may provide definitive hemostasis in most instance

Vaccination recommendations for adult patients with autoimmune inflammatory rheumatic diseases

BACKGROUND: The number of individuals with autoimmune inflammatory rheumatic diseases (AIIRDs) treated with immunosuppressive drugs is increasing steadily. The variety of immunosuppressive drugs and, in particular, biological therapies is also rising. The immunosuppressants, as well as the AIIRD itself, increase the risk of infection in this population. Thus, preventing infections by means of vaccination is of utmost importance. New Swiss vaccination recommendations for AIIRD patients were initiated by the Swiss Federal Office of Public Health and prepared by a working group of the Federal Commission for Vaccination Issues as well as by consultation of international experts. METHODS: A literature search was performed in electronic databases (Cochrane, Medline, PubMed, Embase). In addition, unpublished literature was identified through a targeted website search of relevant organisations and international conferences dealing with vaccination, infectious diseases and rheumatology. RESULTS: Although data are scarce, the following main points were retrieved from the literature. Inactivated vaccines are safe, but their immunogenicity may be reduced in AIIRD patients, especially if they are under immunosuppressive therapy. Rituximab and abatacept appear to reduce significantly immune responses after vaccination. Live vaccines are generally contraindicated under immunosuppressive therapy owing to safety concerns. Specific exceptions, as well as time intervals for the administration of live vaccines after interruption of an immunosuppressive therapy, have been formulated in this article. CONCLUSION: More evidence regarding the immunogenicity and safety of vaccinations in AIIRD patients under various therapies is needed. Vaccination recommendations should be updated on a regular basis, as more scientific data will become available

Precision determination of the dpi -> NN transition strength at threshold

An unusual but effective way to determine at threshold the dpi -> NN transition strength is to exploit the hadronic ground-state broadening in pionic deuterium, accessible by x-ray spectroscopy. The broadening is dominated by the true absorption channel dpi- -> nn, which is related to s-wave pion production pp -> dpi+ by charge symmetry and detailed balance. Using the exotic atom circumvents the problem of Coulomb corrections to the cross section as necessary in the production experiments. Our dedicated measurement finds (1171+23/-49) meV for the broadening yielding (252+5/-11) \mub.Comment: 4 pages, 2 figures, 1 tabl

The imprint of the analogue Hawking effect in subcritical flows

We study the propagation of low-frequency shallow water waves on a one-dimensional flow of varying depth. When taking into account dispersive effects, the linear propagation of long-wavelength modes on uneven bottoms excites new solutions of the dispersion relation which possess a much shorter wavelength. The peculiarity is that one of these new solutions has a negative energy. When the flow becomes supercritical, this mode has been shown to be responsible for the (classical) analog of the Hawking effect. For subcritical flows, the production of this mode has been observed numerically and experimentally, but the precise physics governing the scattering remained unclear. In this work, we provide an analytic treatment of this effect in subcritical flows. We analyze the scattering of low-frequency waves using a new perturbative series, derived from a generalization of the Bremmer series. We show that the production of short-wavelength modes is governed by a complex value of the position: a complex turning point. Using this method, we investigate various flow profiles and derive the main characteristics of the induced spectrum

SrCu_2(BO_3)_2 - a Two Dimensional Spin Liquid

We study an extended Shastry-Sutherland model for SrCu_2(BO_3)_2 and analyze the low lying parts of the energy spectrum by means of a perturbative unitary transformation based on flow equations. The derivation of the 1-magnon dispersion (elementary triplets) is discussed. Additionally, we give a quantitative description (symmetries and energies) of bound states made from two elementary triplets. Our high order results allow to fix the model parameters for SrCu_2(BO_3)_2 precisely: J_1=6.16(10)meV, x:=J_2/J_1=0.603(3), J_\perp=1.3(2)meV. To our knowledge this is the first quantitative treatment of bound states in a true 2d model.Comment: 4 pages, 3 figures, Proceeding paper of the HFM2000 conference in Waterloo, Canada, Jun 200

An investigation into the perspectives of providers and learners on MOOC accessibility

An effective open eLearning environment should consider the target learner’s abilities, learning goals, where learning takes place, and which specific device(s) the learner uses. MOOC platforms struggle to take these factors into account and typically are not accessible, inhibiting access to environments that are intended to be open to all. A series of research initiatives are described that are intended to benefit MOOC providers in achieving greater accessibility and disabled learners to improve their lifelong learning and re-skilling. In this paper, we first outline the rationale, the research questions, and the methodology. The research approach includes interviews, online surveys and a MOOC accessibility audit; we also include factors such the risk management of the research programme and ethical considerations when conducting research with vulnerable learners. Preliminary results are presented from interviews with providers and experts and from analysis of surveys of learners. Finally, we outline the future research opportunities. This paper is framed within the context of the Doctoral Consortium organised at the TEEM'17 conference

Measurement and analysis of needle penetration forces in industrial high-speed sewing machine

The industrial manufacturing of sewn products has always been one of the critical processes of the textile chain concerning quality assurance. Assuring the appropriate set-up and operation of all the machines, and thus the final seam quality, is a very complex task. Traditionally, this task is accomplished through empirical methods, with the machine setting and quality control relying on the skills of operators and technicians. This work presents an approach to a more knowledge-based and integrated process planning and control. A system was developed to measure and analyze the most important mechanical effects occurring during high-speed sewing. The paper will focus mainly on the measurement and evaluation of needle penetration and withdrawal force. After an overview of the system, the most important experimental results obtained in a series of experiments will be described

Dispersion and Symmetry of Bound States in the Shastry-Sutherland Model

Bound states made from two triplet excitations on the Shastry-Sutherland (ShaSu) lattice are investigated. Based on the perturbative unitary transformation by flow equations quantitative properties like dispersions and qualitative properties like symmetries are determined. The high order results (up to (J_2/J_1)^{14}) permit to fix the parameters of SrCu_2(BO_3)_2 precisely: J_1=6.16(10)meV, x:=J_2/J_1=0.603(3), J_\perp=1.3(2)meV. At the border of the magnetic Brillouin zone (MBZ) a general double degeneracy is derived. An unexpected instability in the triplet channel at x=0.63 indicates a first order transition towards a triplet condensate, related to classical helical order.Comment: 4 pages, submitted to Phys. Rev. Let