Hemobilia due to cystic artery pseudoaneurysm: A rare late complication of laparoscopic cholecystectomy

We discuss a patient with late presentation of hemobilia following cholecystectomy, which is unusual because pseudoaneurysm caused by vascular injury during surgery typically presents soon after surgery. Endoscopic retrograde cholangiopancreatography revealed a large blood clot arising from the biliary orifice with subsequent computed tomography angiography diagnosing a large pseudoaneurysm in the region of the cystic artery adjacent to the cholecystectomy clips. Embolization was performed via direct percutaneous puncture of the pseudoaneurysm

Design and Performance Analysis of a Non-Standard EPICS Fast Controller

The large scientific projects present new technological challenges, such as the distributed control over a communication network. In particular, the middleware EPICS is the most extended communication standard in particle accelerators. The integration of modern control architectures in these EPICS networks is becoming common, as for example for the PXI/PXIe and xTCA hardware alternatives. In this work, a different integration procedure for PXIe real time controllers from National Instruments is proposed, using LabVIEW as the design tool. This methodology is considered and its performance is analyzed by means of a set of laboratory experiments. This control architecture is proposed for achieving the implementation requirements of the fast controllers, which need an important amount of computational power and signal processing capability, with a tight real-time demand. The present work studies the advantages and drawbacks of this methodology and presents its comprehensive evaluation by means of a laboratory test bench, designed for the application of systematic tests. These tests compare the proposed fast controller performance with a similar system implemented using an standard EPICS IOC provided by the CODAC system.Comment: This is the extended version of the Conference Record presented in the IEEE Real-Time Conference 2014, Nara, Japan. This paper has been submitted to the IEEE Transactions on Nuclear Scienc

Growth of equiaxed dendritic crystals settling in an undercooled melt, Part 1: Tip kinetics

Abstract Experiments are conducted to measure the dendrite tip growth velocities of equiaxed crystals of the transparent model alloy succinonitrile-acetone that are settling in an undercooled melt. The tip velocities are measured as a function of the crystal settling speed and the Eulerian angle between the dendrite arms and the flow direction relative to the crystal. The ratio of the settling speed (or flow velocity) to the tip growth velocity ranges from 62 to 572. The ratio of the measured tip velocity to that predicted from a standard diffusion theory for free dendritic growth ranges from almost zero for dendrite tips growing in the wake of the crystal, about unity for dendrite tips with an orientation close to normal to the flow direction, and up to two for dendrite tips growing into the flow. Despite the relatively strong flow relative to the crystal, the average tip growth velocity of the six primary dendrite arms of an equiaxed crystal is found to be in excellent agreement with the standard diffusion theory result. The individual tip velocities are correlated using a boundary layer model of free dendritic growth in the presence of melt flow that is modified to account for the flow angle dependence. Using the same dendrite tip selection parameter, s à , as established previously under purely diffusive conditions (0.02), good agreement is achieved between the measured and predicted tip velocities. The model is also found to predict well the variations in the tip velocity that occur during settling due to crystal rotation and settling speed changes.

RATE FORCE DEVELOPMENT DURING BENCH PRESS IS ONLY RELATED TO THROWING VELOCITY WHEN USING LIGHT LOADS

The bench press is a widely used movement to develop strength and power in the upper-body in team handball players. Although bench press has been extensively used, data about kinematics factors in light free weights is limited (Marques & González-Badillo, 2006). Few studies have examined the relationship between ball throwing performance in elite team handball players with power or rate of force development, and bar velocity during muscle contractions of the upper-extremity in concentric only bench press exercise. The aim of this study was to examine the relationship between ball throwing velocity during a 3-step running throw and strength parameters in each force-time curve against three different light free weights

Dissipative Dynamics of Polymer Phononic Materials

Phononic materials are artificial composites with unprecedented abilities to control acoustic waves in solids. Their performance is mainly governed by their architecture, determining frequency ranges in which wave propagation is inhibited. However, the dynamics of phononic materials also depends on the mechanical and material properties of their constituents. In the case of viscoelastic constituents, such as most polymers, it is challenging to correctly predict the actual dynamic behavior of real phononic structures. Existing studies on this topic either lack experimental evidence or are limited to specific materials and architectures in restricted frequency ranges. A general framework is developed and employed to characterize the dynamics of polymer phononic materials with different architectures made of both thermoset and thermoplastic polymers, presenting qualitatively different viscoelastic behaviors. Through a comparison of experimental results with numerical predictions, the reliability of commonly used elastic and viscoelastic material models is evaluated in broad frequency ranges. Correlations between viscous effects and the two main band-gap formation mechanisms in phononic materials are revealed, and experimentally verified guidelines on how to correctly predict their dissipative response are proposed in a computationally efficient way. Overall, this work provides comprehensive guidelines for the extension of phononics modeling to applications involving dissipative viscoelastic materials.</p

Architectural Features of Streetscapes and Aging in Cameron County, Texas: Preliminary Results

The impact of architectural features in urban settings reveals priorities for its residents and the integration of social and natural environments. It has been estimated that 23% of global deaths to the environments in which people live. We aim to characterize the most prevalent architectural features of Cameron County, Texas streetscapes and analyze their role in health promotion and healthy aging

¿Cuál es su diagnóstico?

ResumenSe trata de un paciente masculino de 58 años de edad, procedente de área rural, que refiere dolor torácico y disfagia, asociado a disnea leve, de inicio hace varios meses. Tiene como antecedente haber presentado cáncer de esófago hace tres años, por lo cual fue operado y sometido a radioterapia; no aporta más información relacionada ni trae estudios previos. Niega otros antecedentes. El examen fisico no muestra hallazgos de importancia

Features of dengue and chikungunya infections of colombian children under 24 months of age admitted to the emergency department

We aimed to assess clinical and laboratory differences between dengue and chikungunya in children <24 months of age in a comparative study. We collected retrospective clinical and laboratory data confirmed by NS1/IgM for dengue for 19 months (1 January 2013 to 17 August 2014). Prospective data for chikungunya confirmed by real-time polymerase chain reaction were collected for 4 months (22 September 2014-14 December 2014). Sensitivity and specificity [with 95% confidence interval (CI)] were reported for each disease diagnosis. A platelet count <150 000 cells/ml at emergency admission best characterized dengue, with a sensitivity of 67% (95% CI, 53-79) and specificity of 95% (95% CI, 82-99). The algorithm developed with classification and regression tree analysis showed a sensitivity of 93% (95% CI, 68-100) and specificity of 38% (95% CI, 9-76) to diagnose dengue. Our study provides potential differential characteristics between chikungunya and dengue in young children, especially low platelet counts. © The Author [2017].Universidad Nacional de Colombia, UN Johns Hopkins University1Departamento de Epidemiologia, Hospital Infantil Napoleón Franco Pareja—La Casa del Niño, Cartagena, Colombia 2Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia 3Departamento de Epidemiologia, Faculdade de Saúde Publica, Universidade de São Paulo, São Paulo, Brazil 4Facultad de Ingenería, Universidad Tecnológica de Bolívar, Cartagena, Colombia 5Facultad Ciencias Básicas y Biomédicas, Universidad Simón Bolívar, Barranquilla, Colombia 6Facultad de Medicina, Universidad de Cartagena, Cartagena, Colombia 7Instituto de Investigaciones Biologicas del Tropico, Universidad de Córdoba, Montería, Colombia 8Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA Correspondence: Angel Paternina-Caicedo, Hospital Infantil Napoleón Franco Pareja—La Casa del Niño, Bruselas Transversal 36 N. 36-33, Cartagena, Bolívar, Colombia. Tel: +1-412-3267809. E-mail or

Association of HIV-1 Infection and Antiretroviral Therapy With Type 2 Diabetes in the Hispanic Population of the Rio Grande Valley, Texas, USA

The Rio Grande Valley (RGV) in South Texas has one of the highest prevalence of obesity and type 2 diabetes (T2D) in the United States (US). We report for the first time the T2D prevalence in persons with HIV (PWH) in the RGV and the interrelationship between T2D, cardiometabolic risk factors, HIV-related indices, and antiretroviral therapies (ART). The PWH in this study received medical care at Valley AIDS Council (VAC) clinic sites located in Harlingen and McAllen, Texas. Henceforth, this cohort will be referred to as Valley AIDS Council Cohort (VACC). Cross-sectional analyses were conducted using retrospective data obtained from 1,827 registries. It included demographic and anthropometric variables, cardiometabolic traits, and HIV-related virological and immunological indices. For descriptive statistics, we used mean values of the quantitative variables from unbalanced visits across 20 months. Robust regression methods were used to determine the associations. For comparisons, we used cardiometabolic trait data obtained from HIV-uninfected San Antonio Mexican American Family Studies (SAMAFS; N = 2,498), and the Mexican American population in the National Health and Nutrition Examination Survey (HHANES; N = 5,989). The prevalence of T2D in VACC was 51% compared to 27% in SAMAFS and 19% in HHANES, respectively. The PWH with T2D in VACC were younger (4.7 years) and had lower BMI (BMI 2.43 units less) when compared to SAMAFS individuals. In contrast, VACC individuals had increased blood pressure and dyslipidemia. The increased T2D prevalence in VACC was independent of BMI. Within the VACC, ART was associated with viral load and CD4+ T cell counts but not with metabolic dysfunction. Notably, we found that individuals with any INSTI combination had higher T2D risk: OR 2.08 (95%CI 1.67, 2.6; p \u3c 0.001). In summary, our results suggest that VACC individuals may develop T2D at younger ages independent of obesity. The high burden of T2D in these individuals necessitates rigorously designed longitudinal studies to draw potential causal inferences and develop better treatment regimens

Relationship Between Throwing Velocity, Muscle Power, and Bar Velocity During Bench Press in Elite Handball Players

Purpose: The purpose of this study was to examine the relationship between ballthrowing velocity during a 3-step running throw and dynamic strength, power, and bar velocity during a concentric-only bench-press exercise in team-handball players. Methods: Fourteen elite senior male team-handball players volunteered to participate. Each volunteer had power and bar velocity measured during a concentric-only bench-press test with 26, 36, and 46 kg, as well as having 1-repetition-maximum (1-RMBP) strength determined. Ball-throwing velocity was evaluated with a standard 3-step running throw using a radar gun. Results: Ball-throwing velocity was related to the absolute load lifted during the 1-RMBP (r = .637, P = .014), peak power using 36 kg (r = .586, P = .028) and 46 kg (r = .582, P = .029), and peak bar velocity using 26 kg (r = .563, P = .036) and 36 kg (r = .625, P = .017). Conclusions: The results indicate that throwing velocity of elite team-handball players is related to maximal dynamic strength, peak power, and peak bar velocity. Thus, a training regimen designed to improve ball-throwing velocity in elite male team-handball players should include exercises that are aimed at increasing both strength and power in the upper body