The Use of a Compression Device as an Alternative to Hand-Sewn and Stapled Colorectal Anastomoses: Is Three a Crowd?

BackgroundThe NiTi CAR™ 27 is a newer device that uses compression to create an anastomosis. An analysis of this device in the creation of colorectal anastomoses in humans has yet to be reported in the USA.MethodsA non-randomized, prospective pilot study of the NiTi CAR™ 27 device in patients undergoing a left-sided colectomy between March 2008 and August 2009 was performed.ResultsTwenty-three patients (9 men and 14 women) underwent a left-sided colectomy and compression anastomosis with the CAR™ 27 device. Minor morbidities, 3 of 23 (13%) patients, included one small postoperative abscess requiring antibiotics alone and two postoperative anastomotic strictures requiring balloon dilation. Major morbidities, 1 of 23 (4%) patients, included a partial anastomotic dehiscence/leak requiring surgical dismantling of the anastomosis and diversion.ConclusionThe CAR™ 27 device shows promise as a safe and effective alternative for the creation of colorectal anastomoses. However, studies in a larger patient population are warranted to demonstrate equivalence of this device

Improving the multiobjective evolutionary algorithm based on decomposition with new penalty schemes

It has been increasingly reported that the multiobjective optimization evolutionary algorithm based on decomposition (MOEA/D) is promising for handling multiobjective optimization problems (MOPs). MOEA/D employs scalarizing functions to convert an MOP into a number of single-objective subproblems. Among them, penalty boundary intersection (PBI) is one of the most popular decomposition approaches and has been widely adopted for dealing with MOPs. However, the original PBI uses a constant penalty value for all subproblems and has difficulties in achieving a good distribution and coverage of the Pareto front for some problems. In this paper, we investigate the influence of the penalty factor on PBI, and suggest two new penalty schemes, i.e., adaptive penalty scheme and subproblem-based penalty scheme (SPS), to enhance the spread of Pareto-optimal solutions. The new penalty schemes are examined on several complex MOPs, showing that PBI with the use of them is able to provide a better approximation of the Pareto front than the original one. The SPS is further integrated into two recently developed MOEA/D variants to help balance the population diversity and convergence. Experimental results show that it can significantly enhance the algorithm�s performance. © 2016, Springer-Verlag Berlin Heidelberg

WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis

Acute appendicitis (AA) is among the most common cause of acute abdominal pain. Diagnosis of AA is challenging; a variable combination of clinical signs and symptoms has been used together with laboratory findings in several scoring systems proposed for suggesting the probability of AA and the possible subsequent management pathway. The role of imaging in the diagnosis of AA is still debated, with variable use of US, CT and MRI in different settings worldwide. Up to date, comprehensive clinical guidelines for diagnosis and management of AA have never been issued. In July 2015, during the 3rd World Congress of the WSES, held in Jerusalem (Israel), a panel of experts including an Organizational Committee and Scientific Committee and Scientific Secretariat, participated to a Consensus Conference where eight panelists presented a number of statements developed for each of the eight main questions about diagnosis and management of AA. The statements were then voted, eventually modified and finally approved by the participants to The Consensus Conference and lately by the board of co-authors. The current paper is reporting the definitive Guidelines Statements on each of the following topics: 1) Diagnostic efficiency of clinical scoring systems, 2) Role of Imaging, 3) Non-operative treatment for uncomplicated appendicitis, 4) Timing of appendectomy and in-hospital delay, 5) Surgical treatment 6) Scoring systems for intra-operative grading of appendicitis and their clinical usefulness 7) Non-surgical treatment for complicated appendicitis: abscess or phlegmon 8) Pre-operative and post-operative antibiotics.Peer reviewe

Current trend in synthesis, Post-Synthetic modifications and biological applications of Nanometal-Organic frameworks (NMOFs)

Since the early reports of MOFs and their interesting properties, research involving these materials has grown wide in scope and applications. Various synthetic approaches have ensued in view of obtaining materials with optimised properties, the extensive scope of application spanning from energy, gas sorption, catalysis biological applications has meant exponentially evolved over the years. The far‐reaching synthetic and PSM approaches and porosity control possibilities have continued to serve as a motivation for research on these materials. With respect to the biological applications, MOFs have shown promise as good candidates in applications involving drug delivery, BioMOFs, sensing, imaging amongst others. Despite being a while away from successful entry into the market, observed results in sensing, drug delivery, and imaging put these materials on the spot light as candidates poised to usher in a revolution in biology. In this regard, this review article focuses current approaches in synthesis, post functionalization and biological applications of these materials with particular attention on drug delivery, imaging, sensing and BioMOFs

2013 WSES guidelines for management of intra-abdominal infections

Peer reviewe

Simulation of low dose positron emission mammography scanner for global breast health applications

Positron emission mammography ( PEM ) is a breast imaging modality that typically involves the administration of relatively high doses of radiotracer. In order to reduce tracer costs and consider PEM for global screening applications, it would be helpful to reduce the required amount of administered radiotracer so that patient dose would be comparable to conventional x-ray mammograms. We performed GATE Monte Carlo investigations of several possible camera configurations. Increasing the detector thickness from 10 to 30 mm, increasing the camera surface area from 5 x 20cm2 to 20 x 20cm2, and applying depth-ofinteraction information to increase the acceptance angle, increased the overall efficiency to radiation emitted from a breast cancer by a factor of 24 as compared to existing commercial system