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Aim The eTEP approach for ventral hernia is becoming a promising treatment option for obese patients as a scheduled procedure, in specialized high volumen centers. Is it feasible also in emergency surgey? M&M We present a case of a 73 year old female patient with an incarcerated ventral hernia, presenting itself as a bowel obstruction on the early postoperative period after a prosthetic knee surgery. The patient had a previous midline laparotomy (Cesarian), two onlay ventral hernia repairs, and body mass index of 32. The CT imaging findings revealed a bowel obstruction close to incarcerated ventral hernia. We performed an endoscopic retromuscular sac exploration, reduced the incarcerated hernia, ruled out bowel damage, completed intraperitoneal adhesiolysis and followed through with an eTEP procedure, closing anterior and posterior rectus sheat running sutures. We began closing supraumbilical abdominal wall using inferior trocars and finished closing infraumbilical part using superior trocars. Then we introduced and deployed a polypropylene 26×15 cm mesh. No mesh fixation or drains were used. Results Bowel obstruction was solved after surgery. Oral liquids intake started on the second postoperative day. Despite of knee pain, sedentary lifestyle, depressive disorder and obesity, the patient started walking, assisted by physiotherapist also on second postoperative day. Intravenous naproxen and acetaminophen were used as painkillers. Discharged on postoperative day 10 because of knee wound celulitis. Conclusions eTEP approach seams feasible also in emergency surgeries in specialized centers.

This is a case presentation of a preperitoneal repair of a bilateral Spigelian hernia and a recurrent left inguinal hernia. A 71 year old male patient was admitted in the Emergency department after a 3 hour right quadrant acute pain. On his medical record he had an anterior left inguinal repair (Lichtenstein) 6 months before. The physical examination revealed a bulge on the right lower quadrant. The Spigelian hernia was incarcerated but easily reduced. The CT scan findings include a bilateral Spigelian hernia (bowel content), a small umbilical and a left inguinal omental hernia. The patient did not suffer any other incarceration episodes before the surgery, programmed 10 days later. We present the video of the surgical TEP repair, a preperitoneal access, triple hernia reduction, double 15×20cm polypropilene tailored mesh placement. The patient was discharged on the second postoperative day, and had an uneventful recovery with no recurrence after 3 months followup.

Aim Laparoscopic total extraperitoneal approach (TEP) is a widely recognised treatment for hernia repair. As a reference group in minimally invasive hernia repair, with more than 1200 TEP cases performed in the last 5 years, and with more than 25 years of experience, we want to share our TEP systematisation in 10 steps, as we teach in our international courses. Material and Methods We describe the technique in 10 simple steps, attaching small video-clips to illustrate each one. Results Demostration of the 10 TEP steps: Conclusions Together with proctoring, this systematic way of teaching TEP technique allows a safer and shorter learning curve, by providing a series of simple steps to follow and repeat.

Aim Laparoscopic totally extraperitoneal (TEP) repair of inguinal hernia can be technically challenging. The learning curve is long, unless you have supervision and systematisation of the procedure. After learning curve of TEP is achieved, it is time to broaden horizons, and repair ventral hernias using the extended totally extraperitoneal laparoscopic technique (ETEP). The purpose of this paper is to describe the key points and pitfalls in the ETEP learning curve, coming from the expertise of TEP hernia repair. Material and Methods After overcoming the learning curve of laparoscopic TEP inguinal hernia repair, with more than 110 consecutives procedures performed in an experienced centre, and having reduced operative times and maintaining a minimal complication rate, I start my learning curve of ETEP with supervision and systematisation of the technique. We will move from the key points already known from the TEP learning curve, identifying similarities to the more complex points of ETEP learning curve. Results and conclusions The extrapolable key points from TEP are: The critical points, which need enhanced surveillance, are: It is important to emphasise that this technique requires patience and proctoring.

Background Cardiac ageing is associated to heart failure with preserved ejection fraction (HF-pEF) and increased senescence, hypertrophy and diastolic dysfunction. No treatments have yet proved to reduce HF-pEF morbidity and mortality. Cardiosphere-derived cells (CDCs) and their secreted extracellular vesicles (CDC-EVs) have demonstrated efficacy in old animals with cardiac dysfunction, but variability of effect and lack of adequate potency tests remain as challenges. Purpose To explore in vitro predictors of cardiac protective potency of CDC-EVs, focusing on the chronological age of the CDC-donors, CDC-senescence, and their in vitro anti-senescent and pro-angiogenic effect. Methods CDCs derived from 34 patients (age range 0–81 years old, both sexes) were characterized in terms of senescence, proliferative and migration capacities, VEGF secretion, expression of specific surface markers and cardiosphere size. CDC-EVs were purified and their in vitro anti-senescent potential (at genetic, secretory and cellular level over cardiac stromal cells) and their pro-angiogenic potential (ability to induce tube formation over endothelial cells) quantified. According to the performance in each of these tests, potency was scored and CDC-EVs were classified as potent (P-EVs) and non-potent (NP-EVs). The effect of P-EVs and NP-EVs were then tested in vivo in rats with induced cardiac aging. SD-rats received 3-months of daily intraperitoneal injections (IP) of saline (healthy control) or D-galactose. Rats in the D-Gal group were randomly allocated to receive IP saline (sham control, n=12), P-EVs (n=7) or NP-EVs (n=6) and followed-up for one month. Results Chronological age of the donor or expression of surface markers did not relate to most CDC properties nor to their in vitro potency. CDC senescence did relate to other CDC bioactive properties, but this was insufficient to predict CDC-EV anti-senescence and pro-angiogenic in vitro potency. In vivo, EV classified as P-EVs, but not NP-EVs, prevented D-gal induced hypertrophy (2.4 vs. 2.9 mg/gr, p=0.05). This finding was in parallel to the levels of galactosidase-beta 1 expression in cardiac tissue, which were increased in sham vs. P-EVs (1.22 vs. 0.73, p=0.03) but levels in NP-EVs were not significantly different to the sham group (0.86, p=0.1). P-EVs tended to reduce TGFB1 expression, while NP-EVs significantly increased cardiac fibrosis and reduced cardiac perfusion. At systemic level, while P-EVs significantly improved glucose metabolism and tended to drive total antioxidant capacity and hair growth to a healthier profile, NP-EVs did not significantly improve any of the explored parameters and significantly increased total antioxidant capacity. Conclusions After further validation, the matrix potency assay proposed here, scoring the anti-senescent and pro-angiogenic in vitro effect of CDC-EVs could be used to predict EV suitability as an allogenic product in the treatment of cardiac ageing. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): Instituto de Salud Carlos III, Ministerio de Ciencia e Innovaciόn, Spain: PI16/01123; PI19/00161; Red de Terapia Celular, Tercel, (RD16.0011.0029) and CIBERCV (CB16.11.00292)

We present the clinical case of a 58 year old patient with a left subcostal incisional hernia, years after an emergent aortic thrombectomy and aortobifemoral bypass. The physical examination revealed a lateral subcostal bulge near the anterior axillary line. CT findings showed a left lateral 5 cm defect without significant muscular atrophy. An endoscopic ipsilateral transversus abdominal release (TAR) and preperitoneal mesh repair was successfully performed. 1: Port placement. We used one 10 mm port and two 5 mm ports in a left near-midline position. 2: Retrorectal and Bogros space dissection. Locating the arcuate line and opening the posterior rectus sheath we then proceeded with the left transversus abdominal release (in a down to up direction). 3: Hernia dissection. After the hernial sac is identified we opened it to explore the peritoneal cavity and release the possible adhesions if encountered. 4: Full space dissection. Once the defect dissection is finished, we fully completed the TAR in order to achieve a satisfactory space for the mesh placement. 5: Defect closure. We performed a two-plane resorbable continuous barbed suture. 6: Mesh placement. We measured the surgical space in order to insert a tailored mesh and lay it without fixation or drain. Clinical outcome: The patient is discharged on postoperative day 1 and took acetaminophen 3 times daily for 48 hours, due to good pain control. On the first postoperative followup (10 days) the patient had resumed usual activities, driving and was already back to work. He was advised to avoid heavy efforts.

Background Cardiac ageing is characterized by hypertrophy and diastolic dysfunction and related with heart failure with preserved ejection fraction, an unmet medical need for treatments development. Cardiosphere-derived cells (CDCs) have demonstrated glimpses of efficacy in old animals with cardiac dysfunction, however variability of effect among different CDC-donors is observed. Purpose To identify markers of in vitro potency of CDCs and to test it in an in vivo model of cardiac ageing. Methods CDCs were derived from cardiac biopsies of forty patients (age range 0 - 81 years old, 16 females) who underwent cardiac surgery for other reasons. CDC-secreted extracellular vesicles (CDC-EVs) were purified and used in in vitro and in vivo experiments. Since anti-ageing effect was targeted in vivo, in vitro potency of CDC-EVs was checked in terms of their anti-senescence bioactivity. A panel of six parameters (genetic, secretory and cellular) related with cellular senescence were analysed in vitro for all 40-donors CDC-EVs and those with most favourable and unfavourable profiles were classified as potent (P-EVs) and non-potent (NP-EVs), respectively. P-EVs and NP-EVs were then tested in vivo in 25 rats with D-galactose-induced cardiac ageing and 7-healthy controls in a randomized blinded study. Results In vitro, despite variations in the extent of the observed effect, all CDC-EVs significantly reduced cellular senescence and increased IL-6 secretion of human cardiac stromal cells. Most CDC-EVs decreased the expression of senescence-related genes (p21, p16, p53, TGF-b). Based on the observed profiles as P-EVs were selected CDC-EVs from 75- and 14-years old donors and as NP-EVs from 73-years old. In vivo, 3-months old SD-rats (30% female) after 3-months of daily intraperitoneal injections of saline (healthy control) or D-Gal, were randomly allocated (D-Gal group) to receive intraperitoneal injection of saline (sham control, n=12), P-EVs (n=7), NP-EVs (n=6) and followed-up for one month. While sham control group developed myocardial hypertrophy compared to healthy control animals (heart/body weight 2.7 vs. 2.2 mg/gr, p=0.03), this effect was prevented by P-EVs but not by NP-EVs (2.5 vs. 2.9 mg/gr, p=0.02). This finding was in parallel to the levels of serum antioxidants which were increased in sham vs healthy (p=0.02) and in sham vs. P-EVs (p=0.01) but levels in NP-EVs were similar to the sham group. Conclusions Anti-senescence in vitro effect of CDC-EVs is correlated to their therapeutic efficacy in vivo model of cardiac ageing. The relevance of this study is double: identification of senescence-related markers as determinant of therapeutic potency of the tested product and confirming the potential utility of CDC-EVs as therapy for cardiac ageing-related pathologies. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Instituto de Salud Carlos III, Ministerio de Ciencia e Innovaciόn,CIBERCV, Spain

The correlation length $\xi$, a key quantity in glassy dynamics, can now be precisely measured for spin glasses both in experiments and in simulations. However, known analysis methods lead to discrepancies either for large external fields or close to the glass temperature. We solve this problem by introducing a scaling law that takes into account both the magnetic field and the time-dependent spin-glass correlation length. The scaling law is successfully tested against experimental measurements in a CuMn single crystal and against large-scale simulations on the Janus II dedicated computer., Comment: Revised version, including supplemental material

The Airway Division of the Catalan Society of Anaesthesiology, Intensive Care and Pain Management (SCARTD) presents its latest guidelines for the evaluation and management of the difficult airway. This update includes the technical advances and changes observed in clinical practice since publication of the first edition of the guidelines in 2008. The recommendations were defined by a consensus of experts from the 19 participating hospitals, and were adapted from 5 recently published international guidelines following an in-depth analysis and systematic comparison of their recommendations. The final document was sent to the members of SCARTD for evaluation, and was reviewed by 11 independent experts. The recommendations, therefore, are supported by the latest scientific evidence and endorsed by professionals in the field. This edition develops the definition of the difficult airway, including all airway management techniques, and places emphasis on evaluating and classifying the airway into 3 categories according to the anticipated degree of difficulty and additional safety considerations in order to plan the management strategy. Pre-management planning, in terms of preparing patients and resources and optimising communication and interaction between all professionals involved, plays a pivotal role in all the scenarios addressed. The guidelines reflect the increased presence of video laryngoscopes and second-generation devices in our setting, and promotes their routine use in intubation and their prompt use in cases of unanticipated difficult airway. They also address the increased use of ultrasound imaging as an aid to evaluation and decision-making. New scenarios have also been included, such as the risk of bronchoaspiration and difficult extubation Finally, the document outlines the training and continuing professional development programmes required to guarantee effective and safe implementation of the guidelines.

BACKGROUND FGFR mutations and translocations occur in approximately 10% of glioblastomas (GBMs). FGFR3-TACC3 fusion has been reported as predictive of response to FGFR tyrosine kinase inhibitor therapy both pre-clinically and clinically. Infigratinib (BGJ398) is a selective small-molecule pan-FGFR kinase inhibitor that has demonstrated anti-tumor activity in several solid tumors with FGFR genetic alterations. Therefore, we conducted a phase II trial to test the efficacy of infigratinib in FGFR-altered recurrent GBM (NCT01975701). METHODS This open-label trial accrued adults with recurrent high-grade gliomas following failure of initial therapy that harbored FGFR1-TACC1 or FGFR3-TACC3 fusions; activating mutations in FGFR1, 2 or 3; or FGFR1, 2, 3, or 4 amplification. Oral infigratinib was administered 125 mg on days 1–21 every 28 days. Prophylaxis for hyperphosphatemia, a common toxicity, was recommended. The primary endpoint was the 6-month progression-free survival (6mPFS) rate by RANO (locally assessed, estimated by K-M method), with a goal of >40%. RESULTS As of the Sep 2017 data cut-off, 26 patients (16 men, 10 women; median age 55 years, range 20–76 years; 50% with ≥2 prior regimens) were treated, and 24 (92.3%) discontinued for disease progression (n=21) or other reasons (n=3). All patients had FGFR1 or FGFR3 gene alterations, and 4 had >1 gene alteration. The estimated 6mPFS rate was 16% (95% CI 5.0–32.5%); median PFS was 1.7 months (95% CI 1.1–2.8 months); median OS was 6.7 months (95% CI 4.2–11.7 months); ORR was 7.7% (95% CI 1.0–25.1%). The best overall response was: partial response 7.7% (FGFR1 mutation n=1; FGFR3 amplification n=1); stable disease 26.9%; progressive disease 50.0%; missing/unknown 15.3%. The most common (>15%) all-grade treatment-related adverse events (AEs) were hyperphosphatemia, fatigue, diarrhea, hyperlipasemia, and stomatitis. There were no grade 4 treatment-related AEs. Eleven patients (42.3%) had treatment-related AEs requiring dose interruptions or reductions (most commonly hyperphosphatemia). CONCLUSIONS Infigratinib induced partial response or stable disease in approximately one-third of patients with recurrent GBM and/or other glioma subtypes harboring FGFR alterations. Most AEs were reversible and manageable. Further potential combinations are being explored in patients with proven FGFR-TACC fusion genes and analysis of biomarker data is ongoing.

The Mpemba effect occurs when a hot system cools faster than an initially colder one, when both are refrigerated in the same thermal reservoir. Using the custom built supercomputer Janus II, we study the Mpemba effect in spin glasses and show that it is a non-equilibrium process, governed by the coherence length \xi of the system. The effect occurs when the bath temperature lies in the glassy phase, but it is not necessary for the thermal protocol to cross the critical temperature. In fact, the Mpemba effect follows from a strong relationship between the internal energy and \xi that turns out to be a sure-tell sign of being in the glassy phase. Thus, the Mpemba effect presents itself as an intriguing new avenue for the experimental study of the coherence length in supercooled liquids and other glass formers., Comment: Version accepted for publication in PNAS. 6 pages, 7 figures

Induction heating is an example of a power converter where high performance control is required to ensure efficient and safe operation under a wide range of operating conditions. One key challenge is the development of a flexible test-bench platform for software development that enables fast testing while ensuring system integrity. In this context, hardware in the loop arises as a useful tool to provide fast and safe simulations, while ensuring a high flexibility. This paper details the development of a hardware-in-the-loop test-bench for an induction heating appliance taking advantage of FPGA technology. In this paper, the power converter topology is reviewed, and the modeling and implementation processed detailed. Finally, some simulations of the complete system are shown.

Infectious diseases are disorders caused by many different microorganisms that produce clinical conditions with a wide variation in patient-rated symptoms and severity. Therefore, different diagnostic and prognostic tools are needed to help make the most accurate decisions at each moment of patient´s care with suspected infection. This mini review will analyse how some biomarkers reduce the level of uncertainty in the making decision process at some phases of sepsis, including prompt identification of septic patients, early initiation of empiric broad-spectrum antimicrobials, regimen and duration.

The formation and migration energies of interstitial hydrogen in rutile TiO

The challenge of automatically recommending job offers to appropriate job seekers is a topic that has attracted many research effort during the last times. However, it is generally assumed that there is a need of more user-friendly filtering methods so that the automated recommendation systems might be more widely used. We present here our research on two methods from the data analytics field being able to disseminate job offers to the right person at the right time, which are based on Random Forest and Support Vector Machines respectively. Both methods are used here to identify the actual attributes in which users are set when they are attracted to a job offer. Preliminary results in the context of automatic job recommendation suggest that these two methods seem to be promising.

Computing the semantic similarity between terms (or short text expressions) that have the same meaning but which are not lexicographically similar is a key challenge in many computer related fields. The problem is that traditional approaches to semantic similarity measurement are not suitable for all situations, for example, many of them often fail to deal with terms not covered by synonym dictionaries or are not able to cope with acronyms, abbreviations, buzzwords, brand names, proper nouns, and so on. In this paper, we present and evaluate a collection of emerging techniques developed to avoid this problem. These techniques use some kinds of web intelligence to determine the degree of similarity between text expressions. These techniques implement a variety of paradigms including the study of co-occurrence, text snippet comparison, frequent pattern finding, or search log analysis. The goal is to substitute the traditional techniques where necessary.

Finding the best matching job offers for a candidate profile or, the best candidates profiles for a particular job offer, respectively constitutes the most common and most relevant type of queries in the Human Resources (HR) sector. This technically requires to investigate top-k queries on top of knowledge bases and relational databases. We propose in this paper a top-k query algorithm on relational databases able to produce effective and efficient results. The approach is to consider the partial order of matching relations between jobs and candidates profiles together with an efficient design of the data involved. In particular, the focus on a single relation, the matching relation, is crucial to achieve the expectations.

Percutaneous treatment of patent ductus arteriosus (PDA) in extreme premature infants is technically difficult, and therefore, often not consider as an alternative to surgery. The main objective of our work was to compare respiratory status prior and post ductal closure and morbi-mortality, in our series of preterm infants with percutaneous PDA closure versus surgical ligation in the same time-period. Retrospective review of all premature infants submitted to percutaneous and surgical PDA closure from January 2011 to December 2016. All the antenatal, perinatal, and postnatal characteristics were collected. The main outcome was the assessment of the pulmonary status before and after ductal closure using a pulmonary score. Secondary outcomes included moderate-severe disability in neurodevelopment, death before discharge, moderate-severe chronic lung disease, and morbidity at discharge. 25 patients with a mean weight of 1330 g (± 280) underwent percutaneous closure of PDA with ADO-II-AS, and a total of 53 underwent surgical ligation. 28/53 with similar gestational age, birth weight, and procedure weight to those in the percutaneous group, were selected to perform the comparative study. Ductal closure (percutaneous and surgical) resulted in improved respiratory status. However, percutaneous group achieved a fastest respiratory improvement, than surgical group. The surgical closure group associated higher morbidity among survivors (HIV, number of sepsis, need, and duration of inotropics post-interventionism). The incidence of recurrent laryngeal nerve palsy among the surgical group was 17%. Percutaneous closure of PDA in carefully selected low-weight preterm infants is a safe and reliable alternative to surgical ligation.

Resume But de l’etude Le diagnostic de myocardite aigue est difficile surtout quand la presentation clinique mime un syndrome coronaire aigu. Cette affection pourrait favoriser l’evolution vers une cardiomyopathie dilatee et la survenue d’arythmies severes. Trois mois apres l’episode aigu, la reevaluation integrant l’IRM cardiaque pourrait permettre d’identifier les patients a risque d’evolution defavorable. Patients et resultats Les auteurs rapportent une serie prospective de 43 patients consecutifs hospitalises pour myocardite aigue : 36 hommes et 7 femmes, âges en moyenne de 32 ans, sans signe d’insuffisance cardiaque. Tous presentaient une elevation de la troponine I. L’echocardiographie montrait une dysfonction moderee du ventricule gauche dans 6 cas et des troubles de la cinetique segmentaire dans 22 cas. L’IRM cardiaque realisee precocement n’a jamais montre de defect de premier passage apres injection de gadolinium mais un rehaussement tardif sous-epicardique dans 39 cas, essentiellement localise au niveau des segments lateraux. Trois mois apres l’episode aigu, tous les patients etaient vivants et asymptomatiques. L’echocardiographie, le Holter ECG etaient normaux. L’IRM montrait la persistance du rehaussement tardif dans 23 cas, sans anomalie de la cinetique segmentaire en regard. La presence de ces anomalies tardives a conduit a effectuer un suivi annuel clinique et electrocardiographique. Un patient a ete perdu de vue. Parmi les 22 autres, un seul a developpe une insuffisance cardiaque revelant une cardiomyopathie dilatee compliquee de troubles du rythme ventriculaire au cours d’un suivi moyen de trois ans. Conclusion Lors de l’admission, l’absence de defect de perfusion apres injection de gadolinium et la localisation sous-epicardique du rehaussement tardif en IRM cardiaque constituent des criteres fiables en faveur du diagnostic de myocardite aigue, permettant d’ecarter un syndrome coronaire aigu. Dans cette serie apres un suivi moyen de trois ans, la persistance du rehaussement tardif n’a pas ete associee a des anomalies cliniques ou para-cliniques, sauf chez un patient, et ne parait pas avoir d’impact pronostic significatif.

Virtual screening is a key process used to identify the most suitable molecule combinations when developing a new drug. Molecule docking is a commonly used method to analyze molecule structures and requires computing large databases to identify possible affinities between molecules. The special-purpose, field-programmable gate array (FPGA)-based Janus supercomputer accelerates the virtual screening process.

In 2012, the prevalence of obesity and overweight statuses among children in Spain was 9% and 26%, respectively. Concerns about childhood obesity have increased over the past few years, as obesity developed during childhood can persist throughout an individual's lifetime (cohort effect). This study aims to develop a better understanding of the factors influencing the prevalence of obesity in Spain.Microdata from the 2012 National Health Survey are used, and the methodological framework is based on the estimation of a sample selection model.Results suggest that the prevalence of obesity increases among children who live in households of a lower socio-economic status and households in which parents are obese. Lower levels of childhood physical activity are positively related to the probability of being obese. Finally, there exists a positive relationship between children's body mass index and an inappropriate intake of fresh fruits, fish, pasta and rice, legumes, sweets and soft drinks.The methodological framework used in this study is flexible enough to be used in traditional longitudinal studies. Children's and households' lifestyles play a pivotal role in the prevalence of obesity. Policies should be oriented toward changing lifestyles, which would require more multidisciplinary research in the future to reduce childhood obesity.

Left bundle branch block (LBBB) during exercise can be associated with chest pain. Though this association is mostly correlated with an underlying coronary artery disease, painful LBBB has been described in patients with normal coronary arteries. We report a case of exercise-induced LBBB with typical angina pectoris related to antimalarial prophylaxis with chloroquine in a 66-year old woman with normal coronary arteries, which was reversed after treatment discontinuation. The effect of chloroquine on the electrophysiological properties of nodal cardiac tissue is responsible for this rate-dependent LBBB. Precautions for future antimalarial prophylaxis are also discussed.

Isolated hydrogen in p- and n-type CdTe was studied by muon spin polarization using muonium as light analogue. Transverse field spectra as a function of temperature were collected and analysed taking into account the muonium ionisation state. Evidence is presented showing that the dynamics of the hydrogen electronic spin depends on the conductivity type (p or n) of the semiconductor and that μSR is sensitive to the presence of shallow donors in CdTe. On the other hand, the probability of formation of deep states or the electronic structure of shallow donors is not influenced by the type of conductivity.

The diagnosis of acute myocarditis is complex, especially when the clinical presentation mimics an acute coronary syndrome. This condition may promote the progression to dilated cardiomyopathy and the occurrence of severe arrhythmias. A reassessment integrating a cardiac MRI at three months after the acute episode could help identify patients with a poor prognosis.This prospective series of 43 consecutive patients hospitalised for acute myocarditis included 36 men and seven women, with a mean age of 32 years, with no indication of heart failure. All patients presented elevated levels of troponin I. Echocardiography showed moderate left ventricular dysfunction in six cases and segmental wall motion abnormalities in 22 cases. After gadolinium injection, a subepicardial late enhancement was observed in 39 cases. Three months after the acute episode, all patients were asymptomatic. The echocardiography and laboratory tests were normal. In 23 cases, the MRI showed persistence of the late enhancement without segmental wall motion abnormality. After a mean follow-up of three years, one patient was lost to follow-up and only one suffered a heart failure revealing a dilated cardiomyopathy complicated by ventricular arrhythmias.On admission, the subepicardial localisation of late enhancement in the cardiac MRI is reliable criteria for the diagnosis of acute myocarditis, enabling to rule out an acute coronary syndrome. During follow-up, the persistence of late enhancement has no impact on prognosis. In this series, after a mean follow-up of three years, it was not associated with clinical or paraclinical abnormalities, except in one patient.

This paper describes the architecture, the development and the implementation of Janus II, a new generation application-driven number cruncher optimized for Monte Carlo simulations of spin systems (mainly spin glasses). This domain of computational physics is a recognized grand challenge of high-performance computing: the resources necessary to study in detail theoretical models that can make contact with experimental data are by far beyond those available using commodity computer systems. On the other hand, several specific features of the associated algorithms suggest that unconventional computer architectures, which can be implemented with available electronics technologies, may lead to order of magnitude increases in performance, reducing to acceptable values on human scales the time needed to carry out simulation campaigns that would take centuries on commercially available machines. Janus II is one such machine, recently developed and commissioned, that builds upon and improves on the successful JANUS machine, which has been used for physics since 2008 and is still in operation today. This paper describes in detail the motivations behind the project, the computational requirements, the architecture and the implementation of this new machine and compares its expected performances with those of currently available commercial systems., Comment: 28 pages, 6 figures

Lipomatous hypertrophy of the heart is a benign rare tumor characterized by fatty tissue deposits in the interatrial septum. Its diagnosis during life is mostly seen incidental. We report the case of a 74-year-old female patient, in which a cardiac mass protruding in the right atrium was diagnosed by transthoracic echocardiography. Transoesophageal echocardiography examination detected an echogenic infiltration and hypertrophy of the interatrial septum, sparing the foramen ovale. The diagnosis of lipomatous hypertrophy of the interatrial septum is confirmed by MRI, which shows a well limited and not encapsulated tumor, appearing in increased signal density on T1-weighted images, and that decreases with fat-saturated sequences. This tumor did not enhance with the administration of contrast material. The benign and lipomatous nature of the lesion is confirmed, thus making the use of histology unnecessary.

In this chapter we describe the Janus supercomputer, a massively parallel FPGA-based system optimized for the simulation of spin-glasses, theoretical models that describe the behavior of glassy materials. The custom architecture of Janus has been developed to meet the computational requirements of these models. Spin-glass simulations are performed using Monte Carlo methods that lead to algorithms characterized by (1) intrinsic parallelism allowing us to implement many Monte Carlo update engines within a single FPGA; (2) rather small data base (2 MByte) that can be stored on-chip, significantly boosting bandwidth and reducing latency. (3) need to generate a large number of good-quality long (≥ 32 bit) random numbers; (4) mostly integer arithmetic and bitwise logic operations. Careful tailoring of the architecture to the specific features of these algorithms has allowed us to embed up to 1024 special purpose cores within just one FPGA, so that simulations of systems that would take centuries on conventional architectures can be performed in just a few months.

We describe Janus, an application-driven architecture for Monte Carlo simulations of spin glasses. Janus is a massively parallel architecture, based on reconfigurable FPGA nodes; it offers two orders of magnitude better performance than commodity systems for spin glass applications. The first generation Janus machine has been operational since early 2008; we are currently developing a new generation, that will be on line in early 2013. In this paper we present the Janus architecture, describe both implementations and compare their performances with those of commodity systems.

Spin-glasses have become one of the most computing-demanding problems of the last 50 years in Statistical Physics. These extremely slow systems represent a clear example of an easy-to-describe but hard-to-simulate numerical problem. We have developed an FPGAs architecture, called Janus, able to exploit the simplicity of the problem by an extensive parallelization of the computing units. In this work we describe the architecture after motivating the problem. We give the performance figures compared with other more usual architectures. We have obtained a clear advantage in terms of computing power which produced several top results in the field. In addition, we describe the current development of the next generation of the infrastructure: Janus II.

We have characterized numerically, using the Janus computer, the Lee-Yang complex singularities related to the overlap in the 3D Ising spin glass with binary couplings in a wide range of temperatures (both in the critical and in the spin-glass phase). Studying the behavior of the zeros at the critical point, we have obtained an accurate measurement of the anomalous dimension in very good agreement with the values quoted in the literature. In addition, by studying the density of the zeros we have been able to characterize the phase transition and to investigate the Edwards-Anderson order parameter in the spin-glass phase, finding agreement with the values obtained using more conventional techniques., 20 pages, 11 figures. Some typos corrected and references added

Mid-line sternotomy is the routine approach for surgical repair of congenital heart diseases. However, its noticeable scar is a constant reminder of having undergone heart surgery. Several alternative approaches have been developed for simple cardiac conditions to hide the scar. Our series, consisting of 26 patients with axillary closure of atrial septal defect, is presented. The median age was 5.45 years (range 3-13), and median weight was 19.84 Kg. (range 13-37). The defect was closed directly in 13 cases, and with an autologous pericardial patch in the other 13. The number of surgical steps and time taken were the same as in median sternotomy. Functional recovery, intensive care unit stay, and hospital discharge were also standard. The cosmetic result, assessed both by patients and relatives, was excellent.

We describe the past and future of the Janus project. The collaboration started in 2006 and deployed in early 2008 the Janus supercomputer, a facility that allowed to speed-up Monte Carlo Simulations of a class of model glassy systems and provided unprecedented results for some paradigms in Statistical Mechanics. The Janus Supercomputer was based on state-of-the-art FPGA technology, and provided almost two order of magnitude improvement in terms of cost/performance and power/performance ratios. More than four years later, commercial facilities are closing-up in terms of performance, but FPGA technology has largely improved. A new generation supercomputer, Janus2, will be able to improve by more than one orders of magnitude with respect to the previous one, and will accordingly be again the best choice in Monte Carlo simulations of Spin Glasses for several years to come with respect to commercial solutions.

Knowledge about productivity and efficiency differences between conventional and organic farms has important implications for the evaluation of the economic viability of these two agricultural practices. The main purpose of this study was to compare the efficiency ratings of organic and conventional grape farms in Catalonia. To do so, we fit a stochastic production frontier to cross sectional, farm-level data collected from a sample of 141 Catalan farms that specialize in grape growing. Results show that organic farmers, on average, are more efficient than their conventional counterparts (efficiency ratings are on the order of 0.80 and 0.64, respectively). Apart from adoption of organic practices, experience is also found to improve technical efficiency. Conversely, technical efficiency tends to decrease with the relevance of unpaid family labor, farm location in less favored areas, and farmers’ strong environmental preservation preferences. Conocer las diferencias de productividad y eficiencia entre la agricultura convencional y la ecológica tiene implicaciones importantes para la evaluación de la viabilidad económica de estas dos prácticas agrícolas. El principal objetivo de este estudio fue comparar la eficiencia técnica de las explotaciones de uva ecológicas y convencionales en Cataluña. Para ello utilizamos el modelo de la frontera de producción estocástica. El análisis se basó en datos de corte transversal de una muestra de 141 explotaciones catalanas especializadas en la producción de uva. Los agricultores ecológicos fueron, de promedio, técnicamente más eficientes que los convencionales (los ratios de eficiencia fueron 0,80 y 0,64, respectivamente). Además de la adopción de técnicas ecológicas, la experiencia también incrementa la eficiencia técnica. En cambio, las explotaciones con una mayor proporción de trabajo no remunerado, que se encuentran en una zona desfavorecida y/o que tienden a tener fuertes preferencias por preservar el medio ambiente, son generalmente menos eficientes.

To analyze the chronobiological and time variations of out- hospital cardiac arrest (OHCA).A retrospective descriptive study was made.All cases of OHCA of cardiac origin registered over 18 months in the database of the emergency medical service (EMS) of the Autonomous Community of Castilla y León (Spain) were evaluated. VARIABLES ANALYZED: Age, sex, recovery of spontaneous circulation (ROSC), first monitored rhythm (amenable / not amenable to defibrillation), alert site [(home, public place, primary care (PC) center], alerting person (family, witness, law enforcement member, PC center staff), alert time (0-8; 8-16; 16-24), emergency team activation time, care time and day of the week. Univariate analysis (chi-squared), variance, and nonparametric tests comparing the variables in three periods of 8 hours. Chronobiological analysis by fast Fourier transform and Cosinor testing.We studied 1286 cases reported between January 2007 and June 2008. Statistically significant differences were observed in terms of younger age, higher incidence in the victim's home, and greater frequency of family-cohabiting persons as witnesses in the period between 0 and 8 hours. Chronobiological analysis found daily rhythm (circadian) with acrophase at 11.16 h (p0.001) and weekly rhythm (circaseptan) with acrophase on Wednesday (p0.05). The median alert time-care time interval and emergency team activation time-care time were 11.7 min and 8.0 min, respectively, without differences between periods.We have demonstrated the presence of a daily rhythm of emergence of OHCA with a morning peak and a weekly rhythm with a peak on Wednesdays. These results can guide the planning of resources and improvements in response in certain time periods.

In this study we show the results derived from the processing of the data of the Registry of the patients on peritoneal dialysis that initiated renal replacement therapy in Andalucía between January of 1999 and December of 2008. All the information comes from the base of the Registry of Renal Patients of the Andalucia s Health Service. The results show demographic data, distribution by provinces, etiology of the end stage renal disease, reason for election of the peritoneal dialysis, inclusion or not in list of renal transplant, catheter data, withdraws and their causes, and peritonitis data of 2008. We also analyze in the report, from 1999-2008: annual incidence, diabetes, automatic peritoneal dialysis and peritonitis incidence. Finally we have studied patient and technique survival and factors affecting mortality on peritoneal dialysis, the initial comorbid conditions and its impact in the patient s survival.

We study the 3D Disordered Potts Model with p=5 and p=6. Our numerical simulations (that severely slow down for increasing p) detect a very clear spin glass phase transition. We evaluate the critical exponents and the critical value of the temperature, and we use known results at lower $p$ values to discuss how they evolve for increasing p. We do not find any sign of the presence of a transition to a ferromagnetic regime., Comment: 9 pages and 9 Postscript figures. Final version published in J. Stat. Mech

Most cases of chylopericardium in childhood are secondary to thoracic surgery, especially after cardiac surgery. However, it can also be present in children without this history, as we show in this report. First, a nine year-old boy in whom chylopericardium was the first manifestation of a lymphangiomatosis, and the second one, a fifteen months old girl with a history of Down's syndrome and autoimmune enteropathy, which was classified as primary congenital chylopericardium. Also, a review of literature over the last 13 years is made, and management of this rare entity is discussed.

Lipomatous hypertrophy of the heart is a benign rare tumor characterized by fatty tissue deposits in the interatrial septum. Its diagnosis during life is mostly seen incidental. We report the case of a 74-year-old female patient, in which a cardiac mass protruding in the right atrium was diagnosed by transthoracic echocardiography. Transoesophageal echocardiography examination detected an echogenic infiltration and hypertrophy of the interatrial septum, sparing the foramen ovale. The diagnosis of lipomatous hypertrophy of the interatrial septum is confirmed by MRI, which shows a well limited and not encapsulated tumor, appearing in increased signal density on T1-weighted images, and that decreases with fat-saturated sequences. This tumor did not enhance with the administration of contrast material. The benign and lipomatous nature of the lesion is confirmed, thus making the use of histology unnecessary.