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Cholecystoenteric fistula with and without gallstone ileus: A case series

2009年

作者： edited by gerardo R. Vasta Hafiz Ahmed.

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Hepatobiliary & Pancreatic Diseases International 2020年第1期19卷 36-40页

作者： Mauricio Gonzalez-Urquijo Mario Rodarte-Shade gerardo Lozano-Balderas gerardo Gil-Galind Tecnologico de Monterrey Escuela de MedicinaCiencias de la SaludDr.Ignacio Morones Prieto O 3000Monterrey 64710México Department of Surgery Hospital Metropolitano“Dr.Bernardo Sepúlveda”Secretaria de Salud de Nuevo LeónAdolfo López Mateos No.4600San Nicolás de los Garza 66400México

Background: A cholecystoenteric stula (CEF) is an uncommon complication of gallstone disease. The aim of this study was to present our experience of a series of patients with CEF, presenting with or without gallstone ileus, along with their surgical outcomes. Methods: From 2015 to 2018, 3245 consecutive patients underwent cholecystectomy for gallbladder disease at our institution, of which 15 were diagnosed with a CEF. All electronic medical records were retrospectively reviewed. Results: Fifteen patients presented with CEF. Ten patients presented cholecystoduodenal stula, four pa- tients cholecystocolonic, and one patient cholecystogastric counterparts. Twelve patients were female. The median patient age was 61 years (range 33 86 years). Five patients presented with gallstone ileus treated by laparotomy and enterolithotomy. In ten patients, a laparoscopic approach was attempted, but conversion to open surgery was necessary for eight of them. The median operative time was 140 min (range 60 240 min), and the median operative blood loss was 50 mL (range 10600mL). The procedure-related morbidity and mortality rates were 13.3% and 6.7%, respectively. Conclusions: There is no consensus on the best treatment modality for a CEF, as the treatment outcome is mostly dependent on the surgeon’s expertise and the patient’s condition. Not all CEFs are accompanied by gallstone ileus. For such case, the main purpose is to resolve the intestinal obstruction and, unless necessary, avoidance of the gallbladder area.

关键词： Cholecystoenteric stula Gallbladder disease Biliary-enteric stula Gallstone ileus Intestinal obstruction

Fitting dynamic models to epidemic outbreaks with quantified uncertainty:A primer for parameter uncertainty,identifiability,and forecasts

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Infectious Disease Modelling 2017年第3期2卷 379-398页

作者： gerardo Chowell Division of Epidemiology&Biostatistics School of Public HealthGeorgia State UniversityAtlantaGAUSA Division of International Epidemiology and Population Studies Fogarty International CenterNational Institutes of HealthBethesdaMDUSA

Mathematical models provide a quantitative framework with which scientists can assess hypotheses on the potential underlying mechanisms that explain patterns in observed data at different spatial and temporal scales,generate estimates of key kinetic parameters,assess the impact of interventions,optimize the impact of control strategies,and generate *** review and illustrate a simple data assimilation framework for calibrating mathematical models based on ordinary differential equation models using time series data describing the temporal progression of case counts relating,for instance,to population growth or infectious disease transmission *** contrast to Bayesian estimation approaches that always raise the question of how to set priors for the parameters,this frequentist approach relies on modeling the error structure in the *** discuss issues related to parameter identifiability,uncertainty quantification and propagation as well as model performance and forecasts along examples based on phenomenological and mechanistic models parameterized using simulated and real datasets.

关键词： Parameter estimation Uncertainty quantification Bootstrap Parameter identifiability Model performance Forecasts Uncertainty propagation

Analysis and Validation for an Inverter-side Current Controller in LCL Grid-connected Power Systems

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Journal of Modern Power Systems and Clean Energy 2020年第2期8卷 387-398页

作者： Jose MSosa Panfilo R.Martinez-Rodriguez gerardo Escobar gerardo Vazquez Andres A.Valdez-Fernandez Juan F.Martinez-Garcia the Tecnologico Nacional de Mexico/ITS de Irapuato(TecNM/ITESI) IrapuatoGTO 36821Mexico the School of Sciences Autonomous University of San Luis Potosi(UASLP)San Luis PotosiSLP 78290Mexico Tecnologico de Monterrey N.L.64849Mexico

Transformerless grid-connected inverters offer greater efficiencies when transferring power from renewable energy sources to the electrical *** the grid-inverter connection is done with an LCL filter,high attenuation of switching harmonics is achieved while preserving a small-size output ***,damping must be included in the controller to assure closed-loop *** paper proposes a reference computation methodology for the inverter-side current feedback in a photovoltaic(PV)generation system connected to the grid through an LCL *** analysis of the closed-loop system stability and of the steady-state performance are presented as well as experimental validation of the closed-loop *** feedback controller includes active damping and relies on a resonant control structure which improves the ability of dealing with grid harmonic *** controller uses a reduced set of measurements,which requires the inverter-side current and grid voltage only,and assures a power factor close to unity.

关键词： LCL filter transformerless inverter grid connection inverter-side current feedback

Corrosion Behavior of Ψ and β Quasicrystalline Al–Cu–Fe Alloy

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Acta Metallurgica Sinica(English Letters) 2015年第9期28卷 1117-1122页

作者： Alvaro Torres Sergio Serna Cristobal Patio gerardo Rosas Facultad de Ciencias Químicas e Ingeniería P.A. Ing.Mecnica UAEM Av. Universidad 1001 Col. Chamilpa62210 Cuernavaca Mor. Mexico Centro de Investigación en Ingeniería y Ciencias Aplicadas UAEM Av. Universidad 1001 Col. Chamilpa62210 Cuernavaca Mor. Mexico Facultad de Ingeniería Universidad Autónoma del CarmenCampus Ⅲ Avenida Central S/N Esq. con Fracc. MundoMaya C.P. 24115 Ciudad del Carmen Campeche Mexico Instituto de Investigaciones Metalurgicas UMSNH Edificio U. Ciudad Universitaria Morelia Mich. 58000 Mexico

Two nanostructured A1-Cu-Fe alloys, A164Cu24Fe12 and A162.5Cu25.2Fe12.3, have been studied. Icosahedral quasicrystalline （ψ） A164CH24FeI2 and crystalline cubic （ β） ***25.2Fe12.3 cylindrical ingots were first produced using normal casting techniques. High-energy mechanical milling was then conducted to obtain β icosahedral and β intermetallic nanostructured powders. Electrochemical impedance spectroscopy, linear polarization resistance, and potentiodynamic polarization were used to investigate the electrochemical corrosion characteristics of the powders in solutions with different pH values. Current density （icorr）, polarization resistance （Rp）, and impedance modulus （121） were determined. The results showed that regardless of pH value, increasing the solution temperature enhanced the corrosion resistance of the both phases. However, the electrochemical behavior of the phase indicated that its stability depends on the submerged exposure time in neutral and alkaline environments. This behavior was related to the type of corrosion products present on the surfaces of the particles along with the diffusion and charge-transfer mechanisms of the corrosion process.

关键词： Nano-quasicrystalline AI-Cu-Fe alloy Mechanical alloying Corrosion

Between city and home： Spaces of transition in London Postwar Housing

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Frontiers of Architectural Research 2018年第3期7卷 257-291页

作者： gerardo Semprebon wenjun Ma Department of Civil Engineering Shanghai Jiao Tong University Shanghai China Department of Architecture and Urban Studies Politecnico di Milano Milan Italy Department of Architecture School of Design Shanghai Jiao Tong University Shanghai China

In the period between the idealistic vision of the ＇Reshaping society＇ and Thatcherism, in the so-called ＇Swinging London’,the second wave of modernism is facing the demands and the quantities of bombed cities. The architects of that season, moved by political ideals and interpreting the cultural ferment, have been responsible for shaping the city on the collective dreams and aspirations of the society and for forging the identity of London as unique experience in the international panorama. This paper focuses on the spatial relations between city and home, how they raised in that specific historical context, in which form they realized, and what are the architectural implications for current design culture. The methodology, based both on the literature review and on the graphic comparison of six case-studies, is articulated in four steps. First, the six case-studies are selected according to specific criteria. Second, the sociohistorical background is reported. Third, the cases are shortly introduced using text descriptions and graphic tools. Fourth, the cases are compared. This process leads to the definition of four transversal architectural items： the density, the settlement pattern, the basement, and the threshold, intended as elements able to raise connections between past and contemporary design culture.

关键词： London Housing Space of retation Transition

Screening for and surveillance of gastric cancer

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World Journal of Gastroenterology 2014年第38期20卷 13681-13691页

作者： Debora Compare Alba Rocco gerardo Nardone Department of Clinical Medicine and Surgery Gastroenterology UnitUniversity Federico Ⅱ of Naples

Although the prevalence of gastric cancer(GC) progressively decreased during the last decades,due to improved dietary habit,introduction of food refrigeration and recovered socio-economic level,it still accounts for 10% of the total cancer-related deaths. The best strategy to reduce the mortality for GC is to schedule appropriate screening and surveillance programs,that rises many relevant concerns taking into account its worldwide variability,natural history,diagnostic tools,therapeutic strategies,and cost-effectiveness. Intestinal-type,the most frequent GC histotype,develops through a multistep process triggered by Helicobacter pylori(H. pylori) and progressing from gastritis to atrophy,intestinal metaplasia(IM),and dysplasia. However,the majority of patients infected with H. pylori and carrying premalignant lesions do not develop GC. Therefore,it remains unclear who should be screened,when the screening should be started and how the screening should be performed. It seems reasonable that screening programs should target the general population in eastern countries,at high prevalence of GC and the high-risk subjects in western countries,at low prevalence of *** far as concern surveillance,currently,we are lacking of standardized international recommendations and many features have to be defined regarding the optimal diagnostic approach,the patients at higher risk,the best timing and the ***,patients with corpus atrophic gastritis,extensive incomplete IM and dysplasia should enter a surveillance *** present,screening and surveillance programs need further studies to draw worldwide reliable recommendations and evaluate the impact on mortality for GC.

关键词： Screening Surveillance Helicobacter pylori Gastric cancer Preneoplastic lesions Gastric atrophy Intestinal metaplasia Gastric dysplasia

Fabrication and testing of polymer-based capacitive micromachined ultrasound transducers for medical imaging

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Microsystems & Nanoengineering 2018年第1期4卷 178-189页

作者： Carlos D.gerardo Edmond Cretu Robert Rohling Department of Electrical and Computer Engineering University of British Columbia2332 Main MallVancouverBCCanada Department of Mechanical Engineering University of British Columbia6250 Applied Science LnVancouverBCCanada

The ultrasonic transducer industry is dominated by piezoelectric *** an emerging alternative,capacitive micromachined ultrasound transducers(CMUTs)offer wider bandwidth,better integration with electronics,and ease of fabricating large *** have a sealed cavity between a fixed electrode and a suspended metalized *** cost and sensitivity are limiting factors in current CMUTs that depend on the fabrication equipment and,especially,on the materials *** widespread use of CMUTs,a much lower fabrication cost that uses inexpensive materials,which maintain or improve upon existing sensitivity,is ***,a new fabrication process is described for polymer-based CMUTs(polyCMUTs)using the photopolymer SU-8 and *** first ultrasound B-mode image of a wire phantom created with a 64-element linear array using synthetic aperture beamforming techniques is presented.A 12 VAC signal superimposed on a 10 VDC signal was used on the transmission side,and only a bias-tee,with no amplifiers,was used on the receiving *** low operational voltage and high sensitivity of this device can be partially attributed to a pre-biasing condition on the *** using a novel sacrificial layer combined with a top electrode embedded inside the membrane,we demonstrated that SU-8 can be used to manufacture CMUTs ***,the fabrication used relatively simple equipment,and the number of fabrication steps was reduced compared to traditional CMUT *** new fabrication process has the potential to increase the use of CMUTs in the ultrasound market,including the market for wearable transducers.

关键词： polymer electrode testing

Can house sparrows recognize familiar or kin-related individuals by scent?

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Current Zoology 2019年第1期65卷 53-59页

作者： gerardo Fracasso Beniamino Tuliozi Herbert Hoi Matteo Griggio Evolutionary Ecology Group Biology Department University of An twerp Campus Drie Eiken Universiteitsplein 1 Wilrijk 2610 Belgium Department of Biology University of Padova Via U. Bassi 58/B Padova 1-35131 Italy Konrad Lorenz Institute of Ethology Department of Integrative Biology and Evolution University of Veterinary Medicine of Vienna Savoyenstrasse 1/A Vienna A-1160 Austria

In the last decades, higher attention has been paid to olfactory perception in birds. As a consequence, a handful of avian species have been discovered to use olfaction in different contexts. Nevertheless, we still have a very limited knowledge about the use of odor cues in avian social life, particularly, in the case of songbirds. Here, we investigate if female house sparrows Passer domesticus show any preference for the odor of kin and nonkin conspecifics and we also test a possible role of familiarity based on male see nt in female choice. We performed the experiment with captive birds twice, duri ng the non breeding and breedi ng seas ons. Our results show that female house sparrows strongly avoided the odor of unrelated familiar (UF) males, both in the breeding and nonbreeding seasons. Our results suggest recognition for olfactory stimuli related to familiarity and kin ship. We suggest that avoidance for UF males is associated with previous experie nee in this species. Also, we provided further evidenee to the use of olfaction in passerine species by using a new experimental setup.

关键词： familiarity house sparrow kinship recognition odor olfaction Passer domesticus

Case study for investigating groundwater and the future of mountain spring discharges in Southern Italy

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Journal of Mountain Science 2017年第9期14卷 1791-1800页

作者： Nazzareno DIODATO Gianni BELLOCCHI Francesco FIORILLO gerardo VENTAFRIDDA Science and Technology Department University of Sannio 82100 Benevento Italy Met European Research Observatory 82100 Beneuento Italy UMR Ecosysteme Frairial INRA VetAgro Sup 63000 Clermont-Ferrand France Acquedotto Pugliese S.p.A. 70121 Bari Italy

Groundwater extraction is used to alleviate drought in many habitats. However, widespread drought decreases spring discharge and there is a need to integrate climate change research into resource management and action. Accurate estimates of groundwater discharge may be valuable in improving decision support systems of hydrogeological resource exploitation. The present study performs a forecast for groundwater discharge in Aquifer?s Cervialto Mountains(southern Italy). A time series starting in 1883 was the basis for longterm predictions. An Ensemble Discharge Prediction(EDis P) was applied, and the progress of the discharge ensemble forecast was inferred with the aid of an Exponential Smoothing(ES) model initialized at different annual times. EDisP-ES hindcast model experiments were tested, and discharge plume-patterns forecast was assessed with horizon placed in the year 2044. A 46-year cycle pattern was identified by comparing simulations and observations, which is essential for the forecasting purpose. ED is P-ES performed an ensemble mean path for the coming decades that indicates a discharge regime within ± 1 standard deviation around the mean value of 4.1 m^3 s^(-1). These fluctuations are comparable with those observed in the period 1961-1980 and further back, with changepoints detectable around the years 2025 and 2035. Temporary drought conditions are expected after the year 2030.

关键词： Caposele(Italy) Ground water Drought Ensemble forecast Exponential smoothing Spring discharge