Management of a Case of Colovesical Fistula with Fecaluria as First Sign

Introduction. Fecaluria and pneumaturia are the patognomonic signs of an abnormal communication between the bladder and the intestinal tract. Therefore, when a history of digestive signs, symptoms or digestive diseases is missing, this borderline pathology leads the patients in the care of urologists. From diagnosis to treatment the management of these cases can be difficult and challenging. Materials and Methods. A 48 year old patient, without any significant medical history, presented to the emergency room for fecaluria, pneumaturia and an episode of haematuria. He had no prior digestive symptoms. The contrast enhanced abdominal and pelvic CT scan revealed a pelvic mass involving the sigmoid colon and the dome and the posterior wall of the bladder. The cystoscopy objectifies a tumor mass involving the right postero-lateral bladder wall, with extravasation of faeces. A biopsy was taken and the frozen section found mainly uncertain inflammatory type tissue. A colonoscopy couldn’t be done because of an impassable obstacle at 15 cm from the anus. Together with general surgeons we decided for en bloc resection of the tumor with partial cystectomy, right ureterocystoneostomy and rectosigmoid resection with mechanic end to end anastomosis. Results. The postoperative period was uneventful. The histopathological examination revealed an abscessed sigmoid diverticulum with vesico-sigmoid fistula and perilesional inflammatory tissue. Two years after the surgery the patient is asymptomatic with a normal function of the right kidney and restored bladder capacity. Conclusions. Being a borderline pathology, patients with fecaluria and pneumaturia and lack of digestive symptoms are referred and managed by the urologists. Despite extensive investigations, even when preoperative biopsies reveal inflammatory tissue the patients should be treated as oncologic cases. A close cooperation with general surgeons for en bloc multiorgan resection within oncologic safety margins is mandatory

L∞L_\infty-Algebras, the BV Formalism, and Classical Fields

We summarise some of our recent works on $L_\infty$-algebras and quasi-groups with regard to higher principal bundles and their applications in twistor theory and gauge theory. In particular, after a lightning review of $L_\infty$-algebras, we discuss their Maurer-Cartan theory and explain that any classical field theory admitting an action can be reformulated in this context with the help of the Batalin-Vilkovisky formalism. As examples, we explore higher Chern-Simons theory and Yang-Mills theory. We also explain how these ideas can be combined with those of twistor theory to formulate maximally superconformal gauge theories in four and six dimensions by means of $L_\infty$-quasi-isomorphisms, and we propose a twistor space action.Comment: 19 pages, Contribution to Proceedings of LMS/EPSRC Durham Symposium Higher Structures in M-Theory, August 201

Conformal Einstein equations and Cartan conformal connection

Necessary and sufficient conditions for a space-time to be conformal to an Einstein space-time are interpreted in terms of curvature restrictions for the corresponding Cartan conformal connection

Differential Calculi on Some Quantum Prehomogeneous Vector Spaces

This paper is devoted to study of differential calculi over quadratic algebras, which arise in the theory of quantum bounded symmetric domains. We prove that in the quantum case dimensions of the homogeneous components of the graded vector spaces of k-forms are the same as in the classical case. This result is well-known for quantum matrices. The quadratic algebras, which we consider in the present paper, are q-analogues of the polynomial algebras on prehomogeneous vector spaces of commutative parabolic type. This enables us to prove that the de Rham complex is isomorphic to the dual of a quantum analogue of the generalized Bernstein-Gelfand-Gelfand resolution.Comment: LaTeX2e, 51 pages; changed conten

Quantisation of twistor theory by cocycle twist

We present the main ingredients of twistor theory leading up to and including the Penrose-Ward transform in a coordinate algebra form which we can then `quantise' by means of a functorial cocycle twist. The quantum algebras for the conformal group, twistor space CP^3, compactified Minkowski space CMh and the twistor correspondence space are obtained along with their canonical quantum differential calculi, both in a local form and in a global *-algebra formulation which even in the classical commutative case provides a useful alternative to the formulation in terms of projective varieties. We outline how the Penrose-Ward transform then quantises. As an example, we show that the pull-back of the tautological bundle on CMh pulls back to the basic instanton on S^4\subset CMh and that this observation quantises to obtain the Connes-Landi instanton on \theta-deformed S^4 as the pull-back of the tautological bundle on our \theta-deformed CMh. We likewise quantise the fibration CP^3--> S^4 and use it to construct the bundle on \theta-deformed CP^3 that maps over under the transform to the \theta-deformed instanton.Comment: 68 pages 0 figures. Significant revision now has detailed formulae for classical and quantum CP^

Two dimensional Sen connections and quasi-local energy-momentum

The recently constructed two dimensional Sen connection is applied in the problem of quasi-local energy-momentum in general relativity. First it is shown that, because of one of the two 2 dimensional Sen--Witten identities, Penrose's quasi-local charge integral can be expressed as a Nester--Witten integral.Then, to find the appropriate spinor propagation laws to the Nester--Witten integral, all the possible first order linear differential operators that can be constructed only from the irreducible chiral parts of the Sen operator alone are determined and examined. It is only the holomorphy or anti-holomorphy operator that can define acceptable propagation laws. The 2 dimensional Sen connection thus naturally defines a quasi-local energy-momentum, which is precisely that of Dougan and Mason. Then provided the dominant energy condition holds and the 2-sphere S is convex we show that the next statements are equivalent: i. the quasi-local mass (energy-momentum) associated with S is zero; ii.the Cauchy development $D(\Sigma)$ is a pp-wave geometry with pure radiation ($D(\Sigma)$ is flat), where $\Sigma$ is a spacelike hypersurface whose boundary is S; iii. there exist a Sen--constant spinor field (two spinor fields) on S. Thus the pp-wave Cauchy developments can be characterized by the geometry of a two rather than a three dimensional submanifold.Comment: 20 pages, Plain Tex, I

3-dimensional Cauchy-Riemann structures and 2nd order ordinary differential equations

The equivalence problem for second order ODEs given modulo point transformations is solved in full analogy with the equivalence problem of nondegenerate 3-dimensional CR structures. This approach enables an analog of the Feffereman metrics to be defined. The conformal class of these (split signature) metrics is well defined by each point equivalence class of second order ODEs. Its conformal curvature is interpreted in terms of the basic point invariants of the corresponding class of ODEs

The kernel of the edth operators on higher-genus spacelike two-surfaces

The dimension of the kernels of the edth and edth-prime operators on closed, orientable spacelike 2-surfaces with arbitrary genus is calculated, and some of its mathematical and physical consequences are discussed.Comment: 12 page

Almost optimal asynchronous rendezvous in infinite multidimensional grids

Two anonymous mobile agents (robots) moving in an asynchronous manner have to meet in an infinite grid of dimension δ> 0, starting from two arbitrary positions at distance at most d. Since the problem is clearly infeasible in such general setting, we assume that the grid is embedded in a δ-dimensional Euclidean space and that each agent knows the Cartesian coordinates of its own initial position (but not the one of the other agent). We design an algorithm permitting the agents to meet after traversing a trajectory of length O(d δ polylog d). This bound for the case of 2d-grids subsumes the main result of [12]. The algorithm is almost optimal, since the Ω(d δ) lower bound is straightforward. Further, we apply our rendezvous method to the following network design problem. The ports of the δ-dimensional grid have to be set such that two anonymous agents starting at distance at most d from each other will always meet, moving in an asynchronous manner, after traversing a O(d δ polylog d) length trajectory. We can also apply our method to a version of the geometric rendezvous problem. Two anonymous agents move asynchronously in the δ-dimensional Euclidean space. The agents have the radii of visibility of r1 and r2, respectively. Each agent knows only its own initial position and its own radius of visibility. The agents meet when one agent is visible to the other one. We propose an algorithm designing the trajectory of each agent, so that they always meet after traveling a total distance of O( ( d)), where r = min(r1, r2) and for r ≥ 1. r)δpolylog ( d r

The Early Years

Policy concentration on the early years is of vital importance for the wellbeing of children now and for their future health outcomes and life chances. Evidence-based research points to the need for a focus that is properly holistic and to precipitate intervention to promote a healthy diet, regular patterns of activity and rest and give children the best start in life. In 2005, The United Nations Committee on the Rights of the Child (General Comment No. 7) acknowledged the need for a fresh strategy, pinpointing research findings indicating that a failure to prioritise early years’ welfare exposes children to the ills of ‘malnutrition, disease, poverty, neglect, social exclusion and a range of other adversities.’ Professor Dame Sally Davies, Chief Medical Officer of the United Kingdom, considers that robust early years’ policies make both social and economic sense: ‘Too many children and young people do not have the start in life they need, leading to high costs for society, and too many affected lives’ (Forward to ‘The 1001 Critical Days’, June 16th 2014). This observation is significant because there remains much to do. In 2012, the NSPCC reviewed the United Kingdom policy scenario for babies and very young children and concluded that identifiable advances in maternity and early years’ provision did not detract from the fact that: ‘babies are still particularly vulnerable’ and ‘their rights are not always recognised or realised’. (‘All Babies Count – But what about their rights?’ Sally Knock and Lorriann Robinson, January 2012). Knock and Robinson highlight glaring gaps of support and provision – especially in maternity services whereby the fostering of a strong parent-child bond is invariably sacrificed to a concentration upon purely medical practicalities such as labour, birth and the immunisation programme. The All Party Group on a Fit and Healthy Childhood aims, in this report, to offer the incoming Government recommendations for an early years’ strategy that are credible, feasible and evidence-based and will enable the United Kingdom to set the standard in a crucial policy field both at home and abroad. In defining ‘early childhood’, we follow the example of The United Nations (2005) Convention on the Right of the Child by examining the period of 0-8 including, as it does, the vital transition phase from pre-school to primary school. We consider the antenatal period and maternal physical and mental health, methods of feeding the newborn, parental support services both hospital and home-based and infant nutrition and socioeconomic factors that may impact upon the health and wellbeing of young children. The report examines the optimum balance between sleep, rest and activity, the need for freely-chosen play, safeguarding measures and the importance of respecting cultural diversity in all early years’ settings. Above all, we analyse the relationship between young families and the professionals whose role it is to ensure that babies have the very best start in life, supported by parents who have confidence in the choices that they make and the advice that they are given. Just as new families require mentoring so that they can act in the best interests of their children, so the early years’ workforce needs training and continuous professional development to ensure that the advice given is of the highest possible quality and specifically tailored to the individual family. Early Years’ students from The University of Northampton (interviewed) explain what a positive difference their newly acquired knowledge has made to their performance in the settings and Government recognition of The Early Years as a developmental stage in its own right and the creation of the new posts of Early Years Teacher and Early Years Educator have been positive. Yet as the Ilkeston ‘Mums Group’ (interviewed) makes clear, there is still no guarantee of uniform excellence in the delivery of services nationwide and no assurance of continuity between, for example, advice on feeding from the midwife and the health visitor, or the emphasis put on freely-chosen play in an early years’ setting and a primary school. If young children are to thrive, we believe it is essential that there is a national consensus and political will behind multi-disciplinary working in the early years. We see the early years as a window of opportunity and make no apology for the fact that each section of this report is accompanied by many policy recommendations. It has not been possible to produce a uniform handful of ‘asks’, just as the early years itself is a rich, complex and multifarious developmental phase. However, neither do we consider it to be feasible to achieve everything that we recommend in the lifespan of a single Government. This is a two, even three term journey. However, if the nation’s families and the early years workforce are to embark upon it, the Government must be prepared to provide the resources; the Cabinet Minister for Children and Families, the commitment to multi-disciplinary co-operation to achieve an early years workforce that is truly ‘joined up’ and, above all, the finance to make well–intentioned aspiration a reality. In an age of austerity, by spending early, the later savings to education, health, social or criminal justice services will be immense. Investing in the children of today is not a gambl