Intestinal perforation after surgical treatment for incisional hernia. iatrogenic or idiopathic?

Intestinal perforation (IP) is a life-threatening gastroenterological condition requiring urgent surgical care, which may present itself as an uncommon complication following incisional hernia repair surgery, most often because of iatrogenic traumatism occurring during the procedure. However, we report a case where a spontaneous onset can be hypothesised. A 60-years-old patient underwent repair of an abdominal laparocele, through rectus abdominis muscle plasty, 5 years after development of an incisional hernia due to exploratory laparotomy for the treatment of acute appendicitis. Xipho-pubic scar was excised and umbilicus and supra-umbilical hernia sac dissected, a linear median incision was performed along the sub-umbilical linea alba, reaching preperitoneal plane to assess any intestinal loop adherence to the abdominal wall. After limited viscerolysis, abdominal wall defect was corrected by 'rectus abdominis muscle plasty' and umbilicus reconstruction by Santanelli technique. Postoperative course was uneventful until Day 29, with sudden onset of epigastric pain, fever and bulge. Sixty cubic centimeter pus was drained percutaneously and cavity was rinsed with a 50% H2O2 and H2O V-V solution until draining clear fluid. Symptoms recurred two days later, while during rinsing presented dyspnoea. X-Ray and CT scan diagnosed IP, and she underwent under emergency an exploratory laparotomy, leading to right hemicolectomy extended to last ileal loops and middle third of the transverse, right monolateral salpingo-ovariectomy and a temporary ileostomy by general surgeon. Twenty-three days later an ileostomy reversal surgery was performed and 8 days after she was discharged. At latest follow-up patient showed fair conditions, complaining abdominal pain and diarrhoea, attributable to the extensive intestinal resection. IP following incisional hernia repair, is reported as uncommon and early postoperative complication. In our case, the previous regular postoperative course with late onset lead us to hypothesise a possible idiopathic etiopathogenesis, because of a strangulation followed by gangrene and abscess formation, which might begin before the incisional hernia repair and unnoticed at the time surgery was performed

On local boundary CFT and non-local CFT on the boundary

The holographic relation between local boundary conformal quantum field theories (BCFT) and their non-local boundary restrictions is reviewed, and non-vacuum BCFT's, whose existence was conjectured previously, are constructed.Comment: 16 pages. Contribution to "Rigorous Quantum Field Theory", Symposium in honour of J. Bros, Paris, July 2004. Based on joint work math-ph/0405067 with R. Long

Causes of visual disability among Central Africans with diabetes mellitus

Background: Diabetic Retinopathy (DR) remains a common and one of the major causes of blindness in the developed and western societies. The same situation is shown in emerging economic areas (5,6). In sub-Saharan Africa (SSA) however, the issues of visual disability due to diabetes mellitus (DM) are overshadowed by the presence of the prevalent and common nutritional deficiency diseases and eye infectionsObjective: This clinic-based study was conducted to determine whether diabetic retinopathy is independently related to visual disability in black patients with diabetes mellitus (DM) from Kinshasa, Congo.Methods: A total of 299 urban patients with DM and low income including 108 cases of visual disability and matched for time admission and DM type to 191 controls, were assessed. Demographic, clinical, and ophthalmic data were assessed using univariate and multivariate analyses.Results: Age >60 years, female sex, presence of diabetic retinopathy (DR), proliferative DR, shorter DM duration, glaucoma, macular oedema, diabetic nephropathy were the univariate risk factors of visual disability. Using logistic regression model, visual disability was significantly associated with female sex and diabetic retinopathy.Conclusion: The risk of visual disability is 4 times higher in patients with diabetic retinopathy and 2 times higher in females with DM. Therefore, to prevent further increase of visual disability, the Congolese Ministry of Health should prioritize the eye care in patients with DM.Keywords: Visual disability, diabetic retinopathy, females, risk factors, Central Afric

The Metal-Insulator Transition of NbO2: an Embedded Peierls Instability

Results of first principles augmented spherical wave electronic structure calculations for niobium dioxide are presented. Both metallic rutile and insulating low-temperature NbO2, which crystallizes in a distorted rutile structure, are correctly described within density functional theory and the local density approximation. Metallic conductivity is carried to equal amounts by metal t_{2g} orbitals, which fall into the one-dimensional d_parallel band and the isotropically dispersing e_{g}^{pi} bands. Hybridization of both types of bands is almost negligible outside narrow rods along the line X--R. In the low-temperature phase splitting of the d_parallel band due to metal-metal dimerization as well as upshift of the e_{g}^{pi} bands due to increased p-d overlap remove the Fermi surface and open an optical band gap of about 0.1 eV. The metal-insulator transition arises as a Peierls instability of the d_parallel band in an embedding background of e_{g}^{pi} electrons. This basic mechanism should also apply to VO2, where, however, electronic correlations are expected to play a greater role due to stronger localization of the 3d electrons.Comment: 4 pages, revtex, 6 eps figures, additional material avalable at http://www.physik.uni-augsburg.de/~eyert

Representations of Conformal Nets, Universal C*-Algebras and K-Theory

We study the representation theory of a conformal net A on the circle from a K-theoretical point of view using its universal C*-algebra C*(A). We prove that if A satisfies the split property then, for every representation \pi of A with finite statistical dimension, \pi(C*(A)) is weakly closed and hence a finite direct sum of type I_\infty factors. We define the more manageable locally normal universal C*-algebra C*_ln(A) as the quotient of C*(A) by its largest ideal vanishing in all locally normal representations and we investigate its structure. In particular, if A is completely rational with n sectors, then C*_ln(A) is a direct sum of n type I_\infty factors. Its ideal K_A of compact operators has nontrivial K-theory, and we prove that the DHR endomorphisms of C*(A) with finite statistical dimension act on K_A, giving rise to an action of the fusion semiring of DHR sectors on K_0(K_A)$. Moreover, we show that this action corresponds to the regular representation of the associated fusion algebra.Comment: v2: we added some comments in the introduction and new references. v3: new authors' addresses, minor corrections. To appear in Commun. Math. Phys. v4: minor corrections, updated reference

Owning an overweight or underweight body: distinguishing the physical, experienced and virtual body

Our bodies are the most intimately familiar objects we encounter in our perceptual environment. Virtual reality provides a unique method to allow us to experience having a very different body from our own, thereby providing a valuable method to explore the plasticity of body representation. In this paper, we show that women can experience ownership over a whole virtual body that is considerably smaller or larger than their physical body. In order to gain a better understanding of the mechanisms underlying body ownership, we use an embodiment questionnaire, and introduce two new behavioral response measures: an affordance estimation task (indirect measure of body size) and a body size estimation task (direct measure of body size). Interestingly, after viewing the virtual body from first person perspective, both the affordance and the body size estimation tasks indicate a change in the perception of the size of the participant’s experienced body. The change is biased by the size of the virtual body (overweight or underweight). Another novel aspect of our study is that we distinguish between the physical, experienced and virtual bodies, by asking participants to provide affordance and body size estimations for each of the three bodies separately. This methodological point is important for virtual reality experiments investigating body ownership of a virtual body, because it offers a better understanding of which cues (e.g. visual, proprioceptive, memory, or a combination thereof) influence body perception, and whether the impact of these cues can vary between different setups

Thermal States in Conformal QFT. II

We continue the analysis of the set of locally normal KMS states w.r.t. the translation group for a local conformal net A of von Neumann algebras on the real line. In the first part we have proved the uniqueness of KMS state on every completely rational net. In this second part, we exhibit several (non-rational) conformal nets which admit continuously many primary KMS states. We give a complete classification of the KMS states on the U(1)-current net and on the Virasoro net Vir_1 with the central charge c=1, whilst for the Virasoro net Vir_c with c>1 we exhibit a (possibly incomplete) list of continuously many primary KMS states. To this end, we provide a variation of the Araki-Haag-Kastler-Takesaki theorem within the locally normal system framework: if there is an inclusion of split nets A in B and A is the fixed point of B w.r.t. a compact gauge group, then any locally normal, primary KMS state on A extends to a locally normal, primary state on B, KMS w.r.t. a perturbed translation. Concerning the non-local case, we show that the free Fermi model admits a unique KMS state.Comment: 36 pages, no figure. Dedicated to Rudolf Haag on the occasion of his 90th birthday. The final version is available under Open Access. This paper contains corrections to the Araki-Haag-Kaster-Takesaki theorem (and to a proof of the same theorem in the book by Bratteli-Robinson). v3: a reference correcte

Further spectroscopic observations of the CSL-1 object

CSL-1 is a peculiar object (R.A._{2000}= 12h 23m 30.5"; Dec_{2000}= -12deg 38' 57.0") which, for its photometric and spectroscopic properties, is possibly the first case of gravitational lensing by a cosmic string. In this paper we present additional evidences, based on medium-high resolution VLT + FORS1 observations, that the spectra of the two components of CSL-1 are identical within a confidence level higher than 99.9% and the velocity difference of the two components is consistent with zero. This result adds further confidence to the interpretation of the system as a true lens.Comment: In press on ApJ Letters. 10 pages, 3 figures - Accepted version with additional statistical evidenc

How Many Templates for GW Chirp Detection? The Minimal-Match Issue Revisited

In a recent paper dealing with maximum likelihood detection of gravitational wave chirps from coalescing binaries with unknown parameters we introduced an accurate representation of the no-signal cumulative distribution of the supremum of the whole correlator bank. This result can be used to derive a refined estimate of the number of templates yielding the best tradeoff between detector's performance (in terms of lost signals among those potentially detectable) and computational burden.Comment: submitted to Class. Quantum Grav. Typing error in eq. (4.8) fixed; figure replaced in version