Rehabilitation strategies for low anterior resection syndrome. A systematic review

OBJECTIVE: To summarize the evidence in the literature about rehabilitative treatments that reduce low anterior resection syndrome (LARS) symptoms in patients who underwent surgery for colorectal cancer. METHODS: We have search in PubMed, Cochrane Central Register of Controlled Trials, Cumulative Index of Nursing and Allied Health and Scopus databases. Studies selected were limited to those including only patient undergone low rectal resection with sphincter preservation and with pre-post assessment with a LARS score. Five articles fit the criteria. RESULTS: The percutaneous tibial nerve stimulation demonstrated moderate results and sacral nerve stimulation was found to be the best treatment with greater symptom improvement. Only one study considered sexual and urinary problems in the outcomes assessment. CONCLUSIONS: In clinical practice patients should evaluate with the LARS and other score for evaluation of urinary and sexual problems. Future research must be implemented with higher quality studies to identify the least invasive and most effective treatment/s

Numerical simulation of lava flow using a GPU SPH model

A smoothed particle hydrodynamics (SPH) method for lava-flow modeling was implemented on a graphical processing unit (GPU) using the compute unified device architecture (CUDA) developed by NVIDIA. This resulted in speed-ups of up to two orders of magnitude. The three-dimensional model can simulate lava flow on a real topography with free-surface, non- Newtonian fluids, and with phase change. The entire SPH code has three main components, neighbor list construction, force computation, and integration of the equation of motion, and it is computed on the GPU, fully exploiting the computational power. The simulation speed achieved is one to two orders of magnitude faster than the equivalent central processing unit (CPU) code. This GPU implementation of SPH allows high resolution SPH modeling in hours and days, rather than in weeks and months, on inexpensive and readily available hardware

Discrete derivatives and symmetries of difference equations

We show on the example of the discrete heat equation that for any given discrete derivative we can construct a nontrivial Leibniz rule suitable to find the symmetries of discrete equations. In this way we obtain a symmetry Lie algebra, defined in terms of shift operators, isomorphic to that of the continuous heat equation.Comment: submitted to J.Phys. A 10 Latex page

Modeling of ALOS and COSMO-SkyMed satellite data at Mt Etna: implications on relation between seismic activation of the Pernicana fault system and volcanic unrest

We investigate the displacement induced by the 2–3 April 2010 seismic swarm (the largest event being of Ml 4.3 magnitude) by means of DInSAR data acquired over the volcano by the Cosmo-SkyMed and ALOS radar systems. Satellite observations, combined with leveling data, allowed us to perform a high-resolution modeling inversion capable of fully capturing the deformation pattern and identifying the mechanism responsible for the PFS seismic activation. The inversion results well explain high gradients in the radar line of sight displacements observed along the fault rupture. The slip distribution model indicates that the fault was characterized by a prevailing left-lateral and normal dip–slip motion with no fault dilation and, hence, excludes that the April 2010 seismic swarm is a response to accommodate the stress change induced by magma intrusions, but it is due to the tectonic loading possibly associated with sliding of the eastern flank of the volcano edifice. These results provide a completely different scenario from that derived for the 22 September 2002 M3.7 earthquake along the PFS, where the co-seismic shear-rupture was accompanied by a tensile mechanism associated with a first attempt of magma intrusion that preceded the lateral eruption occurred here a month later. These two opposite cases provide hints into the behavior of the PFS between quiescence and unrest periods at Etna and pose different implications for eruptive activity prediction and volcano hazard assessment. The dense pattern of ground deformation provided by integration of data from short revisiting time satellite missions, together with refined modeling for fault slip distribution, can be exploited at different volcanic sites, where the activity is controlled by volcano-tectonic interaction processes, for a timely evaluation of the impending hazards

Detecção radiométrica da atividade metabólica do Paracoccidioides brasiliensis e da sua sensibilidade à Anfotericina B e ao Dietilestilbestrol

Paracoccidioidomycosis (South American blastomycosis) is a systemic disease, strikingly more frequent in males, caused by the dimorphic fungus Paracoccidioides brasiliensis. A radiometric assay system has been applied to study the metabolic activity and the effect of drugs on this fungus "in vitro". The Y form of the yeast, grown in liquid Sabouraud medium was inoculated into sterile reaction vials containing the 6B aerobic medium along with 2.0 μCi of 14C-substrates. Control vials, prepared in the same way, contained autoclaved fungi. To study the effects of amphotericin B (AB) (0.1 and 10 μg/ml) and diethylstilbestrol (DSB) (1.0, 5.0 and 10 μg/ml) extra controls with live fungi and no drug were used. All vials were incubated at 35°C and metabolism measured daily with a Bactec instrument. 14CO2 production by P. brasiliensis was slow and could be followed for as long as 50 days. AB at 10mg/ml and DSB at 5 μg/ml inhibited the metabolism and had a cidal effect on this fungus. The results with DSB might explain the low incidence of the disease in females. This technique shows promise for studying metabolic pathways, investi gating more convenient 14C-substrates to expedite radiometric detection and for monitoring the effects of other drugs and factors on the metabolism of P. brasiliensis "in vitro".A paracoccidiodomicose (blastomicose sul-americana) é uma doença sistêmica muito mais freqüente no sexo masculino, causada pelo fungo dimórfico Paracoccidioides brasiliensis. Um sistema radiométrico foi utilizado para estudar a atividade metabólica e o efeito deftrogas sobre este fungo "in vitro". A forma Y do fungo, cultivada em Sabouraud líquido, foi inoculada em frascos estéreis contendo o meio aeróbio 6B, juntamente com 2,0 uCi de substâncias marcadas com carbono-14. Frascos-controle, preparados da mesma forma, foram inoculados com fungos autoclavados. Para estudar os efeitos da anfotericina B (AB) (0,1 e 10 μg/ml) e do dietilestilbestrol (DEB) (1, 5 e 10 μg/ml), controles adicionais foram preparados, contendo fungos viáveis mas não a droga. Todos os frascos foram incubados a 35°C e o metabolismo medido diariamente com uma máquina Bactec. A produção de 14CO2 pelo P. brasiliensis foi lenta e pôde ser acompanhada por 50 dias. Concentrações de 10 μg/ml de AB e 5 μg/ml de DEB inibiram o metabolismo e tiveram efeito fungicida. Os resultados com DEB poderiam explicar a baixa incidência da doença em mulheres. Esta técnica é promissora para estudar as vias metabólicas, investigar substâncias marcadas mais adequadas para tornar mais rápida a detecção radiométrica do fungo e para acompanhar os efeitos de outras drogas e fatores sobre o metabolismo do P. brasiliensis "in vitro"

Magnetic features of the magmatic intrusion occurred in 2007 eruption at Stromboli Island (Italy.)

Significant changes in the local magnetic field marked the resumption of the eruptive activity at Stromboli volcano on February 27, 2007. After differential magnetic fields were filtered from the external noise by adaptive filters and from the seasonal thermic noise using temperature data, we highlighted step-like changes of 1-4 nT coincident with the eruptive fissures opening in the upper part of the Sciara del Fuoco. The magnetic variations detected at 2 stations are closely related to the propagation of a shallow NE-SW magmatic intrusion outside the summit craters area . These observations are consistent with those calculated from piezomagnetic models, where stress-induced changes in rock magnetization are produced by the magmatic intrusion. No significant magnetic changes were observed when the first fractures opened along the NE crater rim. Indeed, the stress-induced magnetization caused by this magmatic activity is expected to be too low because of the structural weakness and/or thermal state of the summit area. The continuous long-term decay characterizing the post-eruptive magnetic pattern was related to a time-dependent relaxation process. A Maxwell rheology was assumed and the temporal evolution of the piezomagnetic field was evaluated. This allowed for the estimate of the rheological properties of the medium, in particular an average viscosity ranging between 1016 and 1017 Pas was achieved involving a relaxation time τ of about 38 days

Spectral analysis of lava flows: Temporal and physicochemical effects

In a volcanic context, the spectral response of lava flows depends on several endogenous and exogenous factors, like chemical composition, passing of years and weathering. A deeper knowledge about lava properties can be inferred by investigating their spectral response in satellite images. Here, we compare the spectral response of lava in time, physical, and chemical characteristics, inspecting visible to infrared high spatial resolution ESA Sentinel-2 satellite images of different volcanoes. Our results show increasing and decreasing patterns of the lava spectral response as a function of time and physicochemical composition

Ultrasonographic diagnosis of placenta accreta spectrum (PAS) disorder: Ideation of an ultrasonographic score and correlation with surgical and neonatal outcomes

The objective of this study was to evaluate a novel ultrasonographic scoring system for the diagnosis of PAS and the prediction of maternal and neonatal outcomes. In this retrospective study, 138 patients with at least one previous caesarean section (CS) and placenta previa were included. They were divided into four groups ranging from Group 0 (Non PAS) to Group 3 (Placenta Percreta) according to the histological or surgical confirmation. Their ultrasound examinations during pregnancy were reviewed according to the nine different ultrasound signs reported by the European Working Group on Abnormally Invasive Placenta. For each parameter, 0 to 2 points were assigned. The sum of the points reflects the severity of PAS with a maximum score of 20. The scoring system revealed good performances in evaluation metrics, with an overall accuracy of 94%. In addition to this, patients’ characteristics and surgical and neonatal outcomes were analyzed with an evidence of higher incidence of complications in severe forms. Our study suggests that antenatal ultrasonographic diagnosis of PAS is feasible with sufficient level of accuracy. This will be important in identifying high-risk patients and implementing preventive strategy