Cholecysto-colonic fistula; a rare case

A 72 year old female was referred by her general practitioner (GP) on the urgent two- week waiting list with a history of weight loss, diarrhoea and a mass on the right upper quadrant with a possible underlying malignancy. She had a recent history of jaundice of one month’s duration. She was otherwise fit and well. On examination, she was afebrile, icteric, abdomen was soft, non-tender with fullness and possible mass in the right upper quadrant

The entropy of bulk quantum fields and the entanglement wedge of an evaporating black hole

Abstract Bulk quantum fields are often said to contribute to the generalized entropy $$\frac{A}{4{G}_N}+{S}_{\mathrm{bulk}}$$ A 4 G N + S bulk only at O(1). Nonetheless, in the context of evaporating black holes, O(1/GN ) gradients in S bulk can arise due to large boosts, introducing a quantum extremal surface far from any classical extremal surface. We examine the effect of such bulk quantum effects on quantum extremal surfaces (QESs) and the resulting entanglement wedge in a simple two-boundary 2d bulk system defined by Jackiw-Teitelboim gravity coupled to a 1+1 CFT. Turning on a coupling between one boundary and a further external auxiliary system which functions as a heat sink allows a two-sided otherwise-eternal black hole to evaporate on one side. We find the generalized entropy of the QES to behave as expected from general considerations of unitarity, and in particular that ingoing information disappears from the entanglement wedge after a scambling time $$\frac{\beta }{2\pi}\log \varDelta S+O(1)$$ β 2 π log ΔS + O 1 in accord with expectations for holographic implementations of the Hayden-Preskill protocol. We also find an interesting QES phase transition at what one might call the Page time for our process

Design of Microcontroller-Based Automatic School Bell

The world over the decades has made considerable advancement in automation; automation is employed in homes, industries, commercial and educational sectors. In this work, a microcontroller-based automatic school bell is designed. This circuit uses a programmed microcontroller chip to schedule the school teaching and break periods so that for every start or end of a period a bell is automatically rang. This design finds a tremendous use at primary and secondary school levels where the teaching sections can span over eight periods including breaks. The advantage here is that the bell rings at the start of each period without any human intervention to a great degree of accuracy. The time schedule results are compared with that obtained with a clock, however, some drift is noticed, which is negligible

Concurrent Acquisition of a Single Nucleotide Polymorphism in Diverse Influenza H5N1 Clade 2.2 Sub-clades

Highly pathogenic Influenza A H5N1 was first identified in Guangdong Province in 1996, followed by human cases in Hong Kong in 1997 1,2. The number of confirmed human cases now exceeds 300 and the associated Case Fatality Rate exceeds 60% 3. The genetic diversity of the serotype continues to increase. Four distinct clades or sub-clades have been linked to human cases 4-7. The gradual genetic changes identified in the sub-clades have been attributed to copy errors by viral encoded polymerases that lack an editing function, thereby resulting in antigenic drift 8. We report here the concurrent acquisition of the same polymorphism by multiple, genetically distinct, clade 2.2 sub-clades in Egypt, Russia, Kuwait, and Ghana. These changes are not easily explained by the current theory of “random mutation” through copy error, and are more easily explained by recombination with a common source. The recombination role is further supported by the high fidelity replication in swine influenza 9 and aggregation of single nucleotide polymorphisms in H5N1 clade 2.2 hemagglutinin 10

NUMASK: High Performance Scalable Skip List for NUMA

This paper presents NUMASK, a skip list data structure specifically designed to exploit the characteristics of Non-Uniform Memory Access (NUMA) architectures to improve performance. NUMASK deploys an architecture around a concurrent skip list so that all metadata accesses (e.g., traversals of the skip list index levels) read and write memory blocks allocated in the NUMA zone where the thread is executing. To the best of our knowledge, NUMASK is the first NUMA-aware skip list design that goes beyond merely limiting the performance penalties introduced by NUMA, and leverages the NUMA architecture to outperform state-of-the-art concurrent high-performance implementations. We tested NUMASK on a four-socket server. Its performance scales for both read-intensive and write-intensive workloads (tested up to 160 threads). In write-intensive workload, NUMASK shows speedups over competitors in the range of 2x to 16x

Factors Influencing Consumer’s Behavioural Intention towards the Adoption of Mobile Payment in Kuala Lumpur

Purpose: The purpose of the research is to investigate the connection between the adoption of digital payments in Kuala Lumpur and the system's credibility in Kuala Lumpur, Malaysia. The another goal of this study is to investigate the connection between social impact and mobile payment adoption in Kuala Lumpur. In Kuala Lumpur, study the relationship between effort expectation and mobile payment adoption. To determine the association between performance expectation and mobile payment adoption in KL.   Theoretical framework: One of the most well-known study models on customer adoption of new technological systems highlights how particular characteristics effect customer adoption. The idea takes into account things like social influences, credibility requirements, effort expectations, and performance requirements.   Design/methodology/approach: This is descriptive based study. In this research paper to accurately predict consumer behavioral intention to accept mobile payment in Kuala Lumpur, the study selects 100 students representative of the target population using probability-based random sampling.   Findings: Inability to collect information from all Malaysians is the primary justification for using a random sample. Mobile payment acceptance has a high link with expected effort, trustworthiness, and performance, demonstrating that these factors impact adoption. Because the majority of people consider a rapid and dependable mobile payment system to be essential.   Conclusion: Mobile payments are rapid. Their relocation is regular practice. Customers can complete the majority of transactions by just pressing their card to the screen