Transabdominal pre-peritoneal repair procedure (TAPP) versus open hernia repair (OHR) in the treatment of inguinal hernia

Inguinal hernia is a common condition, with about 30% of men and 6% of women developing this condition throughout their lifetime. Laparoscopic hernia repair procedures have become more and more important lately, due to the advantages of a fast recovery and reduced postoperative pain. The paper presents our clinical experience involving the TAPP repair procedure, compared to open hernia repair (OHR). We retrospectively compared our first 50 cases comprising patients who underwent the TAPP hernia repair procedure between January 2018 and June 2020, with 50 cases who underwent the OHR procedure in the same period. The total operation duration was 102.5 minutes in the TAPP group and 78.4 minutes in the OHR group. The average hospital stay in the TAPP group was 1.5 days with six patients requiring reinterventions for postoperative bleeding and who were discharged seven to nine days later. There is still no consensus regarding the use of tacks and/or the surgical glue, the surgeon\u27s experience and the intraoperative findings representing a cornerstone in choosing the best repair method for each case. Laparoscopic hernia repair has some advantages over the open technique, but it can be followed by complications that can further raise parameters

Gridovi fine prostorne rezolucije dnevnih visina snijega za Rumunjsku (2005.–2015.)

This study presents the spatial interpolation procedure from snow depth measurements at weather stations implying the following stages: (1) Spatial interpolation at 1 km × 1 km resolution of the mean multiannual values (2005-2015) corresponding to each month, computed from the data extracted from the climatological database; (2) Computation of the daily deviations against the multiannual monthly mean for every day and year over 2005–2015 and their spatial interpolation; (3) Spatio-temporal datasets were obtained through merging the two surfaces obtained in stages 1 and 2. The anomalies were considered to be the ratio between the daily snow depth values and the climatology. The spatial variability of the data used in the first stage was accounted for through the use of a series of predictors derived from the digital elevation model (DEM). To plot the maps with the climatological normals (multiannual means), the Regression-Kriging (RK) spatial interpolation method was used. In order to choose the optimum method applied in spatializing deviations, four interpolation methods were tested using a cross-validation procedure: Multiquadratic, Ordinary Kriging (separated and pooled variograms) and 3d Kriging.Ova studija prikazuje proceduru prostorne interpolacije mjerenja dubine snijega na meteorološkim postajama koja podrazumijeva sljedeće faze: (1) prostorna interpolacija pri rezoluciji od 1 km x 1 km srednjih višegodišnjih vrijednosti (2005.–2015.), koja se provodi s podacima iz klimatološke baze; (2) izračunavanje dnevnih odstupanja od višegodišnjeg mjesečnog srednjaka za svaki dan i godinu tijekom razdoblja od 2005. do 2015. i njihova prostorna interpolacija; (3) prostorno-vremenski skup podataka dobiven je združivanjem procjena dobivenih u fazi 1 i 2. Odstupanja su definirana kao omjeri dnevnih vrijednosti dubine snijeg i klimatološkog srednjaka. Prostorna varijabilnost podataka korištenih u prvoj fazi objašnjena je korištenjem niza prediktora izvedenih iz digitalnog modela visina (DEM). Karte klimatoloških normala (višegodišnji srednjaci) izrađene su metodom prostorne interpolacije zvanom regresijski kriging (RK). Za odabir optimalne metode za prostornu interpolaciju odstupanja, testirane su četiri metode interpolacije i ocijenjene pomoću postupka poprečne validacije: multikvadratična, obični kriging (razdvojeni i skupni variogrami) i 3D kriging

Meta-F*: Proof Automation with SMT, Tactics, and Metaprograms

We introduce Meta-F*, a tactics and metaprogramming framework for the F* program verifier. The main novelty of Meta-F* is allowing the use of tactics and metaprogramming to discharge assertions not solvable by SMT, or to just simplify them into well-behaved SMT fragments. Plus, Meta-F* can be used to generate verified code automatically. Meta-F* is implemented as an F* effect, which, given the powerful effect system of F*, heavily increases code reuse and even enables the lightweight verification of metaprograms. Metaprograms can be either interpreted, or compiled to efficient native code that can be dynamically loaded into the F* type-checker and can interoperate with interpreted code. Evaluation on realistic case studies shows that Meta-F* provides substantial gains in proof development, efficiency, and robustness.Comment: Full version of ESOP'19 pape

Laparoscopic versus open surgical treatment of umbilical hernia

Umbilical hernia is one of the types of ventral hernias of the abdominal wall and it represents the externalization of a part of the abdominal contents through a defect of the anterior abdominal wall located in the umbilical region. It is estimated that more than 20 million abdominal wall hernia surgeries are performed worldwide each year. The paper presents a retrospective study on the patients diagnosed with umbilical hernia and admitted to the First and Second Surgery Departments of the Sibiu County Emergency Clinical Hospital. The study includes 82 cases diagnosed with umbilical hernias over a period of 4 years, between 01.01.2017 and 31.12.2020. Open and laparoscopic surgical techniques are compared in terms of outcomes and postoperative complications. Most cases of umbilical hernia were within the age group 51-70 years, with a slightly higher incidence in males. Arterial hypertension and obesity were the most frequent comorbidities. The alloplastic, classic or laparoscopic procedure became the most widely used due to benefits such as: rapid socio-professional reintegration, short-term hospitalization and low incidence of relapses and postoperative complications. The current trend is for the IPOM laparoscopic procedure to become the gold standard in the treatment of umbilical hernias

A rare complication of acute appendicitis – case presentation

Introduction. Considered by many authors a vestigial structure, the appendix is a small dimensions organ with mostly unknown functions. Acute appendicitis is the most common condition of the ileocecal appendix, having multifaceted clinical manifestations, often masquerading as various unrelated syndromes, but causing increased morbidity, especially when diagnosed late. Although the disease could manifest at any age, there is a progressive increase of its incidence from birth, with a maximum between 10 to 40 years. Case presentation. We report the case of an 84 years-old female patient, who presented with significant abdominal pain in the lower quadrants, mainly in the right iliac fossa and in whom the CT examination was suggestive of a utero-appendicular fistula, a very rare complication in daily practice and even more seldomly encountered in the elderly. Conclusions. Acute appendicitis remains a condition for which surgery is still the optimum treatment, especially in the case of an elderly patient having a radiologically suspected fistula with the uterus that could easily lead to septic gynecological complications and possibly progression to multiple organ failure

Multi-Phonon γ\gamma-Vibrational Bands and the Triaxial Projected Shell Model

We present a fully quantum-mechanical, microscopic, unified treatment of ground-state band and multi-phonon $\gamma$-vibrational bands using shell model diagonalization with the triaxial projected shell model. The results agree very well with data on the g- and $\gamma$-band spectra in $^{156-170}$Er, as well as with recently measured $4^+$ 2-phonon $\gamma$-bandhead energies in $^{166}$Er and $^{168}$Er. Multi-phonon $\gamma$-excitation energies are predicted.Comment: 4 pages, 4 figures, submitted to Phys. Lett.

Variability and Change in Water Cycle at the Catchment Level

This study proposes a simple methodology for assessing future-projected evolution of water cycle components (precipitation, potential evapotranspiration, and potential runoff) based on the two-level Palmer model of the soil and their impact on drought conditions at basin level. The Palmer Drought Severity Index (PDSI) is used as drought metric. The catchments of rivers Arges, Mures, Prut, Siret and Somes (mid- and lower Danube basin) have been chosen as case studies. The present climate data consist of Romanian gridded dataset, monthly precipitation and values of streamflow from Romania and Republic of Moldova and potential evapotranspiration-related data from the Climate Research Unit (University of East Anglia). We used as future projections five numerical experiments with regional models obtained through the EURO-CORDEX initiative, under two Representative Concentration Pathway scenarios. The correlations between observed streamflow at the river basin outlets and PDSI-related components of the water cycle show that PDSI represents reasonably well processes taking place in the selected catchments. Depending on the specific scenario and catchment, droughts that in the Palmer classification were deemed as incipient, mild or severe under present climate will become a normal summer feature toward the end of this century, especially over catchments situated in the lower Danube basin

Adaptive genetic potential of European silver fir in Romania in the context of climate change

Five provenance tests with twenty-six European silver fir autochthonous populations were used in order to assess the response of populations to climate change. Height growth and diameter at breast height of trees at age 31 years were considered as response variables and eight climate variables as predictors. Climatic variables for the trial sites and for origin location of provenances were calculated from 1961 to 2010. The experiments revealed a large genetic variability within species level and a plastic response to climate change, which certainly has a genetic basis. The transfer to warmer climate has resulted in an increase of the provenances growth, in the trial sites situated on the lower vegetation layer. But growth is significantly influenced by mean annual temperature and annual precipitation of planting site and also by the differences in mean annual temperature, annual precipitation, monthly mean temperature in July and July precipitation between provenance site and test site. These are the climatic factors which should be associated with risk in case of the transfer of forest reproductive materials. The provenance origin should be especially considered if the species will be planted outside of its current climate optimum. The best provenances in terms of total height and diameter at 1.30 m came from origin climate close to site climate, small transfer distances. Based on growth response functions and RCP4.5 scenario, we could project the shifts in species distribution for 2050s and 2100s and identify vulnerable populations.</p

Distinct expressions of contrast gain control in parallel synaptic pathways converging on a retinal ganglion cell

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65990/1/jphysiol.2008.156224.pd