Critical Points for Elliptic Equations with Prescribed Boundary Conditions

This paper concerns the existence of critical points for solutions to second order elliptic equations of the form $\nabla\cdot \sigma(x)\nabla u=0$ posed on a bounded domain $X$ with prescribed boundary conditions. In spatial dimension $n=2$, it is known that the number of critical points (where $\nabla u=0$) is related to the number of oscillations of the boundary condition independently of the (positive) coefficient $\sigma$. We show that the situation is different in dimension $n\geq3$. More precisely, we obtain that for any fixed (Dirichlet or Neumann) boundary condition for $u$ on $\partial X$, there exists an open set of smooth coefficients $\sigma(x)$ such that $\nabla u$ vanishes at least at one point in $X$. By using estimates related to the Laplacian with mixed boundary conditions, the result is first obtained for a piecewise constant conductivity with infinite contrast, a problem of independent interest. A second step shows that the topology of the vector field $\nabla u$ on a subdomain is not modified for appropriate bounded, sufficiently high-contrast, smooth coefficients $\sigma(x)$. These results find applications in the class of hybrid inverse problems, where optimal stability estimates for parameter reconstruction are obtained in the absence of critical points. Our results show that for any (finite number of) prescribed boundary conditions, there are coefficients $\sigma(x)$ for which the stability of the reconstructions will inevitably degrade.Comment: 26 pages, 4 figure

Oral platelet gel supernatant plus supportive medical treatment versus supportive medical treatment in the management of radiation-induced oral mucositis: a matched explorative active control trial by propensity analysis

OBJECTIVES:: In this active control trial, the rate of radio-induced WHO grade 3/4 oral mucositis and the change in quality of life, assessed by OMWQ-HN, were measured in subjects with head and neck cancer treated by platelet gel supernatant (PGS) and supportive medical treatment versus subjects treated by supportive medical treatment alone. MATERIALS AND METHODS:: Eighty patients with nonmetastatic head and neck cancer underwent curative or adjuvant radiotherapy. All patients underwent supportive medical treatment and/or PGS at the beginning and during radiotherapy. Sixteen patients received PGS in association with supportive medical treatment. To obtain 2 groups virtually randomized for important clinical characteristics subjects were matched, by propensity analysis, with a group of subjects (64 patients) treated with supportive medical treatment alone. RESULTS:: Subjects treated with standard supportive treatment experienced significant higher WHO grade 3/4 toxicity (55%; 35/64) than subjects treated by PGS (13%; 3/16). The reduced toxicity found in PGS group paralleled with the evidence that they developed later symptoms with respect to controls. The Cox proportional hazard model indicated that patients treated with standard supportive medical treatment experienced 2.7-fold increase (hazard ratio=2.7; 95% confidence interval, 1.3-5.7) in the occurrence of WHO grade 3/4 toxicity. PGS group significantly experienced higher quality of life than control groups as measured by OMWQ-HN. A significant decrease in the opioid analgesics usage was found in the PGS group. CONCLUSIONS:: These preliminary data should be interpreted with caution and could serve as a framework around which to design future trials

Laparoscopy in liver transplantation: The future has arrived

In the last two decades, laparoscopy has revolutionized the field of surgery. Many procedures previously performed with an open access are now routinely carried out with the laparoscopic approach. Several advantages are associated with laparoscopic surgery compared to open procedures: reduced pain due to smaller incisions and hemorrhaging, shorter hospital length of stay, and a lower incidence of wound infections. Liver transplantation (LT) brought a radical change in life expectancy of patients with hepatic endstage disease. Today, LT represents the standard of care for more than fifty hepatic pathologies, with excellent results in terms of survival. Surely, with laparoscopy and LT being one of the most continuously evolving challenges in medicine, their recent combination has represented an astonishing scientific progress. The intent of the present paper is to underline the current role of diagnostic and therapeutic laparoscopy in patients waiting for LT, in the living donor LT and in LT recipients

Finding Your Literature Match -- A Recommender System

The universe of potentially interesting, searchable literature is expanding continuously. Besides the normal expansion, there is an additional influx of literature because of interdisciplinary boundaries becoming more and more diffuse. Hence, the need for accurate, efficient and intelligent search tools is bigger than ever. Even with a sophisticated search engine, looking for information can still result in overwhelming results. An overload of information has the intrinsic danger of scaring visitors away, and any organization, for-profit or not-for-profit, in the business of providing scholarly information wants to capture and keep the attention of its target audience. Publishers and search engine engineers alike will benefit from a service that is able to provide visitors with recommendations that closely meet their interests. Providing visitors with special deals, new options and highlights may be interesting to a certain degree, but what makes more sense (especially from a commercial point of view) than to let visitors do most of the work by the mere action of making choices? Hiring psychics is not an option, so a technological solution is needed to recommend items that a visitor is likely to be looking for. In this presentation we will introduce such a solution and argue that it is practically feasible to incorporate this approach into a useful addition to any information retrieval system with enough usage.Comment: Contribution to the proceedings of the colloquium Future Professional Communication in Astronomy II, 13-14 April 2010, Cambridge, Massachusetts. 11 pages, 4 figures

Intestinal tuberculosis in a child living in a country with a low incidence of tuberculosis: a case report

Background: Relatively common in adults, intestinal tuberculosis is considered rare in children and adolescents. The protean manifestations of intestinal tuberculosis mean that the diagnosis is often delayed (sometimes even for years), thus leading to increased mortality and unnecessary surgery. The main diagnostic dilemma is to differentiate intestinal tuberculosis and Crohn’s disease because a misdiagnosis can have dramatic consequences. Case presentation: A 13-year-old Caucasian, Italian female adolescent attended the Emergency Department complaining of abdominal pain, a fever of up to 38°C, night sweats, diarrhea with blood in stool, and a weight loss of about three kilograms over the previous two months. Physical examination revealed a marked skin pallor and considerable abdominal distension with relevant discomfort in all the abdominal quadrant. Laboratory tests revealed a decreased white blood cell count with anemia and increased C-reactive protein levels. The Mantoux tuberculin skin test was negative. A chest X-ray and an abdominal ultrasonography did not reveal any significant findings. The patient underwent colonoscopy that showed diffuse mucosal congestion and significant blood loss, and laparatomy showed small bowel and colon loops with a whitish appearance. A biopsy of the ileal mucosa revealed inflammation with noncaseating granulomas possibly due to bacterial infection. Given the suspicion of an opportunistic bacterial infection in a child with chronic inflammatory bowel disease (possibly Crohn’s disease), treatment with a third-generation cephalosporin was started. However, the abdominal pain, fever and poor general condition persisted and so, after 11 days, the patient underwent total body computed tomography and magnetic resonance imaging of the brain. On the basis of the radiological findings, miliary tuberculosis was suspected and bronchoscopy was performed and resulted positive for Mycobacterium tuberculosis. Miliary tuberculosis was confirmed and an effective treatment with four drugs was started. Conclusion: This case shows that the manifestations of intestinal tuberculosis can be very difficult to diagnose and mimic those of Chron’s disease. Total body computed tomography and laparotomy with an intestinal biopsy for the detection of Mycobacterium tuberculosis are the means of avoid the risks of a misdiagnosis in children with unexplained chronic abdominal problems

The Drosophila Citrate Lyase Is Required for Cell Division during Spermatogenesis

The Drosophila melanogaster DmATPCL gene encodes for the human ATP Citrate Lyase (ACL) ortholog, a metabolic enzyme that from citrate generates glucose-derived Acetyl-CoA, which fuels central biochemical reactions such as the synthesis of fatty acids, cholesterol and acetylcholine, and the acetylation of proteins and histones. We had previously reported that, although loss of Drosophila ATPCL reduced levels of Acetyl-CoA, unlike its human counterpart, it does not affect global histone acetylation and gene expression, suggesting that its role in histone acetylation is either partially redundant in Drosophila or compensated by alternative pathways. Here, we describe that depletion of DmATPCL affects spindle organization, cytokinesis, and fusome assembly during male meiosis, revealing an unanticipated role for DmATPCL during spermatogenesis. We also show that DmATPCL mutant meiotic phenotype is in part caused by a reduction of fatty acids, but not of triglycerides or cholesterol, indicating that DmATPCL-derived Acetyl-CoA is predominantly devoted to the biosynthesis of fatty acids during spermatogenesis. Collectively, our results unveil for the first time an involvement for DmATPCL in the regulation of meiotic cell division, which is likely conserved in human cells

Esophageal atresia in newborns: a wide spectrum from the isolated forms to a full VACTERL phenotype?

Background: VATER association was first described in 1972 by Quan and Smith as an acronym which identifies a non-random co-occurrence of Vertebral anomalies, Anal atresia, Tracheoesophageal fistula and/or Esophageal atresia, Radial dysplasia. It is even possible to find out Cardiovascular, Renal and Limb anomalies and the acronym VACTERL was adopted, also, embodying Vascular, as single umbilical artery, and external genitalia anomalies. Methods: Data on patients with esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) admitted in the Neonatal Intensive Care Unit (NICU) between January 2003 and January 2013 were evaluated for the contingent occurrence of typical VACTERL anomalies (VACTERL-type) and non tipical VACTERL anomalies (non-VACTERL-type). The inclusion criterion was the presence of EA with or without TEF plus two or more of the following additional malformations: vertebral defects, anal atresia, cardiovascular defects, renal anomalies and lower limb deformities, like radial dysplasia. Results: Among 52 patients with EA/TEF, 20 (38,4%) had isolated EA and 7 (21,8%) had a recognized etiology such a syndrome and therefore were excluded. Among 32 infants with EA and associated malformations, 15 (46,8%) had VACTERL association. The most common anomalies were congenital heart defects (73,3%), followed by vertebral anomalies (66,6%). Many patients also had additional non-VACTERL-type defects. Single umbilical artery was the most common one followed by nervous system abnormalities and anomalies of toes. Between the groups of infants with VACTERL type and non-VACTERL-type anomalies, there are several overlapping data regarding both the tipically described spectrum and the most frequently reported non-VACTERL-type malformations. Thus, it is possible to differentiate infants with a full phenotype (VACTERL full phenotype) and patients that do not meet all the criteria mentioned above, but with some homologies with the first group (VACTERL partial phenotype). Conclusion: The high frequency of non-VACTERL-type anomalies encountered in full and partial phenotype patients would suggest the need for an extension of the clinical criteria for the diagnosis of VACTERL association and also for pre- and post-operative management and follow-up in the short and long term

Counter-propagating entangled photons from a waveguide with periodic nonlinearity

The conditions required for spontaneous parametric down-conversion in a waveguide with periodic nonlinearity in the presence of an unguided pump field are established. Control of the periodic nonlinearity and the physical properties of the waveguide permits the quasi-phase matching equations that describe counter-propagating guided signal and idler beams to be satisfied. We compare the tuning curves and spectral properties of such counter-propagating beams to those for co-propagating beams under typical experimental conditions. We find that the counter-propagating beams exhibit narrow bandwidth permitting the generation of quantum states that possess discrete-frequency entanglement. Such states may be useful for experiments in quantum optics and technologies that benefit from frequency entanglement.Comment: submitted to Phys. Rev.