Management of Patients with Hernia or Incisional Hernia Undergoing Surgery for Morbid Obesity

Morbidly obese patients (MOPs) are predisposed to developing abdominal wall hernias with the potential complication of small bowel obstruction and other morbidity. We report our experience in treating morbidly obese patients. Hernia prophylaxis has been attempted as a means of decreasing the incisional hernia risk associated with weight loss surgery. The controversy regarding the optimal time and method of repair of abdominal wall hernias in patients undergoing open or laparoscopic gastric bypass is discussed with emphasis placed on either a simultaneous repair or splits of the omentum, and of leaving a plug in the hernia defect, to allow time to perform a delayed repair

Experimental Studies of Arc Motion Between Two Parallel Runners with Splitter Plates

In this paper, we present an experimental study in a simplified arc chamber geometry of Low-Voltage Circuit Breaker (LVCB). The influence of vent aperture on arc motion and the influence of splitter plates on arc voltage drop and arc motion are studied. The arc chamber is composed by two parallel arc runners and following the configuration chosen by one or two splitter plates. The experimental setup is completed by a generator (capacitor bench with triggered switch), a high-speed camera and electrical measurements. The arc ignition, arc displacement, arc splitting and arc re-strike have been observed. The results will be described and discussed for different experimental configurations

Influence of COVID-19 confinement in students’ performance in higher education

Documento procedente de EdArXiv Preprints , se deposita en Biblos-e Archivo versión 2 de 7 Mayo de 2020This study explores the effects of COVID-19 confinement in the students’ performance in higher education. Using a field experiment of 458 students from three different subjects in Universidad Autónoma de Madrid (Spain), we study the differences in assessments by dividing students into two groups. The first group (control) corresponds to academic years 2017/2018 and 2018/2019. The second group (experimental) corresponds to students from 2019/2020, which is the group of students that interrupted their face-to-face activities because of the confinement. The results show that there is a significant positive effect of the COVID-19 confinement on students’ performance. This effect is also significative in activities that did not change their format when performed after the confinement. We find that this effect is significative both in subjects that increased the number of assessment activities and subjects that did not change the workload of students. Additionally, an analysis of students’ learning strategies before confinement shows that students did not study on a continuous basis. Based on these results, we conclude that COVID-19 confinement changed students’ learning strategies to a more continuous habit, improving their efficiency. For these reasons, better scores in students’ assessment are expected due to COVID-19 confinement that can be explained by an improvement in their learning performanceThis work has been financed by the project Erasmus+ 2017-1-ES01-KA203-038266 Project of the European Union: “Advanced Design of e-Learning Applications Personalizing Teaching to Improve Virtual Education

Intracluster supernovae in the Multi-epoch Nearby Cluster Survey

The Multi-Epoch Nearby Cluster Survey (MENeaCS) has discovered twenty-three cluster Type Ia supernovae (SNe) in the 58 X-ray selected galaxy clusters (0.05 < z < 0.15) surveyed. Four of our SN Ia events have no host galaxy on close inspection, and are likely intracluster SNe. Deep image stacks at the location of the candidate intracluster SNe put upper limits on the luminosities of faint hosts, with M_{r} > -13.0 mag and M_{g} > -12.5 mag in all cases. For such limits, the fraction of the cluster luminosity in faint dwarfs below our detection limit is <0.1%, assuming a standard cluster luminosity function. All four events occurred within ~600 kpc of the cluster center (projected), as defined by the position of the brightest cluster galaxy, and are more centrally concentrated than the cluster SN Ia population as a whole. After accounting for several observational biases that make intracluster SNe easier to discover and spectroscopically confirm, we calculate an intracluster stellar mass fraction of 0.16^{+0.13}_{-0.09} (68% CL) for all objects within R_{200}. If we assume that the intracluster stellar population is exclusively old, and the cluster galaxies themselves have a mix of stellar ages, we derive an upper limit on the intracluster stellar mass fraction of <0.47 (84% one-sided CL). When combined with the intragroup SNe results of McGee & Balogh, we confirm the declining intracluster stellar mass fraction as a function of halo mass reported by Gonzalez and collaborators. (Abridged)Comment: 24 pages, 8 figures, ApJ publishe

Influence of COVID-19 confinement on students' performance in higher education

This study analyzes the effects of COVID-19 confinement on the autonomous learning performance of students in higher education. Using a field experiment with 458 students from three different subjects at Universidad Autónoma de Madrid (Spain), we study the differences in assessments by dividing students into two groups. The first group (control) corresponds to academic years 2017/2018 and 2018/2019. The second group (experimental) corresponds to students from 2019/2020, which is the group of students that had their face-to-face activities interrupted because of the confinement. The results show that there is a significant positive effect of the COVID-19 confinement on students' performance. This effect is also significant in activities that did not change their format when performed after the confinement. We find that this effect is significant both in subjects that increased the number of assessment activities and subjects that did not change the student workload. Additionally, an analysis of students' learning strategies before confinement shows that students did not study on a continuous basis. Based on these results, we conclude that COVID-19 confinement changed students' learning strategies to a more continuous habit, improving their efficiency. For these reasons, better scores in students' assessment are expected due to COVID-19 confinement that can be explained by an improvement in their learning performanceThis research was funded by ADeAPTIVE (Advanced Design of e-Learning Applications Personalizing Teaching to Improve Virtual Education) project with the support of the Erasmus + programme of the European Union (grant number 2017-1-ES01-KA203-038266). This study was also funded by ACCIO´, Spain (Pla d’Actuacio´ de Centres Tecnològics 2019) under the project Augmented Workplace. This study was also funded by the Fondo Supera COVID-19 (Project: Development of tools for the assessment in higher education in the COVID-19 confinemen

Isolated Langerhans Cell Histiocytosis of the Thyroid in an Adult Female: One-Year Followup

Thyroid gland involvement as the unique presentation of Langerhans cell histiocytosis is a rare phenomenon that can result in misdiagnosis. We report a case of Langerhans cell histiocytosis (LCH) presenting as a thyroid mass. It is a 52-year-old woman who presented an enlarged, diffusely firm, nontender, nonmobile, and not particularly nodular thyroid gland with mild compressive symptoms. Ultrasound and fine-needle aspiration showed a unique right node with benign signs. Patient was referred to our Ambulatory Surgery Department, where a hemithyroidectomy was performed. Histologic evaluation of the right thyroid gland revealed an involvement by LCH, confirmed by immunohistochemical analysis showing Langerhans cells that were positive for CD1a. LCH was a completely incidental occult finding apparent only after surgical resection and examination of the gland. Patient was evaluated, and no evidence of systemic affectation was found. LCH can rarely involve the thyroid gland in adults. Few cases have been reported in the literature. Most patients had evidence of LCH involving other anatomic sites

Endoscopic Management of Drain Inclusion in the Gastric Pouch after Gastrojejunal Leakage after Laparoscopic Roux-en-Y Gastric Bypass for the Treatment of Morbid Obesity (LRYGBP)

Background. Drain inclusion inside the gastric pouch is rare and can represent an important source of morbidity and mortality associated with laparocopic Roux-en-Y gastric bypass (LRYGBP). These leaks can become chronic and challenging. Surgical options are often unsuccessful. We present the endoscopic management of four patients with drain inclusion. Patients. All four obese morbidly patients underwent LRYGBP and presented a gastro-jejunal fistula after acute anastomotic leakage. During follow-up endoscopy the drain was found inside the gastric pouch. It was moved into the abdominal cavity. Fistula debit reduced significantly and closed. Results. Gastric leak closure in less than 24 hours was achieved in all, with complete resolution of symptoms. These patients benefited exclusively from endoscopic treatment. Conclusions. Endoscopy is useful and technically feasible in chronic fistulas. This procedure is a less invasive alternative to traditional surgical revision. Other therapeutic strategies can be used such as clips and fibrin glue. Drains should not be placed in contact with the anastomosis or stapled lines. Drain inclusion must be suspected when fistula debit suddenly arises. If so, endoscopy is indicated for diagnostic accuracy. Under endoscopy vision, the drain is gently removed from the gastric reservoir leading to sudden and complete resolution of the fistula

The Scientific Performance of the Microchannel X-ray Telescope on board the SVOM Mission

The Microchannel X-ray Telescope (MXT) will be the first focusing X-ray telescope based on a "Lobster-Eye" optical design to be flown on Sino-French mission SVOM. SVOM will be dedicated to the study of Gamma-Ray Bursts and more generally time-domain astrophysics. The MXT telescope is a compact (focal length ~ 1.15 m) and light (< 42 kg) instrument, sensitive in the 0.2--10 keV energy range. It is composed of an optical system, based on micro-pore optics (MPOs) of 40 micron pore size, coupled to a low-noise pnCDD X-ray detector. In this paper we describe the expected scientific performance of the MXT telescope, based on the End-to-End calibration campaign performed in fall 2021, before the integration of the SVOM payload on the satellite.Comment: 22 pages, 12 figures, accepted for publication in Experimental Astronom

Large Scale QSO-galaxy correlations for radio loud and optically selected QSO samples

We have studied the distribution of $B_J<20.5$ galaxies from the ROE/NRL COSMOS/UKST catalogue around two samples of $z>0.3$ QSOs with similar redshift distributions. The first sample is formed by 144 radio-loud QSOs from the Parkes Catalogue, and the other contains 167 optically selected QSOs extracted from the Large Bright Quasar Survey. It is found that there is a $\approx 99.0$ significance level excess of COSMOS/UKST galaxies around the PKS QSOs, whereas there is a marginal defect of galaxies around the LBQS QSOs. When the distribution of galaxies around both samples is compared, we found that there is an overdensity of galaxies around the PKS sample with respect to the LBQS sample anticorrelated with the distance from the QSOs at a $99.7$ significance level. Although this result apparently agrees with the predictions of the double magnification bias, it is difficult to explain by gravitational lensing effects alone; dust in the foreground galaxies and selection effects in the detection of LBQS QSOs should be taken into account. It has been established that the lines of sight to PKS flat-spectrum QSOs go through significatively higher foreground galaxy densities than the directions to LBQS quasars, what may be partially related with the reported reddening of PKS QSOs.Comment: 18 pages, 8 figures, AASTeX, accepted for publication in Ap

Ageing, functioning patterns and their environmental determinants in the spinal cord injury (SCI) population:A comparative analysis across eleven European countries implementing the International Spinal Cord Injury Community Survey

Background As the European population with Spinal Cord Injury (SCI) is expected to become older, a better understanding of ageing with SCI using functioning, the health indicator used to model healthy ageing trajectories, is needed. We aimed to describe patterns of functioning in SCI by chronological age, age at injury and time since injury across eleven European countries using a common functioning metric, and to identify country-specific environmental determinants of functioning. Methods Data from 6’635 participants of the International Spinal Cord Injury Community Survey was used. The hierarchical version of Generalized Partial Credit Model, casted in a Bayesian framework, was used to create a common functioning metric and overall scores. For each country, linear regression was used to investigate associations between functioning, chronological age, age at SCI or time since injury for persons with para- and tetraplegia. Multiple linear regression and the proportional marginal variance decomposition technique were used to identify environmental determinants. Results In countries with representative samples older chronological age was consistently associated with a decline in functioning for paraplegia but not for tetraplegia. Age at injury and functioning level were associated, but patterns differed across countries. An association between time since injury and functioning was not observed in most countries, neither for paraplegia nor for tetraplegia. Problems with the accessibility of homes of friends and relatives, access to public places and long-distance transportation were consistently key determinants of functioning. Conclusions Functioning is a key health indicator and the fundament of ageing research. Enhancing methods traditionally used to develop metrics with Bayesian approach, we were able to create a common metric of functioning with cardinal properties and to estimate overall scores comparable across countries. Focusing on functioning, our study complements epidemiological evidence on SCI-specific mortality and morbidity in Europe and identify initial targets for evidence-informed policy-making.</p