Management and outcomes of obturator hernias: a systematic review and meta-analysis.

PURPOSE: Obturator Hernia (OH) is a rare type of abdominal wall hernia. It usually occurs in elderly women with late symptomatic presentation, increasing mortality rates. Surgery is the standard of care for OH, and laparotomy with simple suture closure of the defect is commonly used. Given the rarity of this disease, large studies are lacking, and data to drive management are still limited. This systematic review and meta-analysis aimed to describe current surgical options for OHs, with a focus on comparing the effectiveness and safety of mesh use with primary repair. METHODS: PubMed, EMBASE, and Cochrane were searched for studies comparing mesh and non-mesh repair for OH. Postoperative outcomes were assessed by pooled analysis and meta-analysis. Statistical analysis was performed using RevMan 5.4. RESULTS: One thousand seven hundred and sixty studies were screened and sixty-seven were thoroughly reviewed. We included 13 observational studies with 351 patients surgically treated for OH with mesh or non-mesh repair. One hundred and twenty (34.2%) patients underwent mesh repair and two hundred and thirty-one (65.81%) underwent non-mesh repair. A total of 145 (41.3%) underwent bowel resection, with the majority having a non-mesh repair performed. Hernia recurrence was significantly higher in patients who underwent hernia repair without mesh (RR 0.31; 95% CI 0.11-0.94; p = 0.04). There were no differences in mortality (RR 0.64; 95% CI 0.25-1.62; p = 0.34; I2 = 0%) or complication rates (RR 0.59; 95% CI 0.28-1.25; p = 0.17; I2 = 50%) between both groups. CONCLUSION: Mesh repair in OH was associated with lower recurrence rates without an increase in postoperative complications. While mesh in clean cases is more likely to offer benefits, an overall recommendation regarding its use in OH repair cannot be made due to potential bias across studies. Given that many OH patients are frail and present emergently, the decision to use mesh is complex and should consider the patient's clinical status, comorbidities, and degree of intraoperative contamination.

Microwave plasmonic mixer in a transparent fibre-wireless link.

To cope with the high bandwidth requirements of wireless applications1, carrier frequencies are shifting towards the millimetre-wave and terahertz bands2-5. Conversely, data is normally transported to remote wireless antennas by optical fibres. Therefore, full transparency and flexibility to switch between optical and wireless domains would be desirable6,7. Here, we demonstrate for the first time a direct wireless-to-optical receiver in a transparent optical link. We successfully transmit 20 and 10 Gbit/s over wireless distances of 1 and 5 m at a carrier frequency of 60 GHz, respectively. Key to the breakthrough was a plasmonic mixer directly mapping the wireless information onto optical signals. The plasmonic scheme with its subwavelength feature and pronounced field confinement provides a built-in field enhancement of up to 90'000 over the incident field in an ultra-compact and CMOS compatible structure. The plasmonic mixer is not limited by electronic speed and thus compatible with future terahertz technologies.

Plasmonic phased array feeder enabling ultra-fast beam steering at millimeter waves.

In this paper, we demonstrate an integrated microwave phoneeded for beamtonics phased array antenna feeder at 60 GHz with a record-low footprint. Our design is based on ultra-compact plasmonic phase modulators (active area <2.5µm2) that not only provide small size but also ultra-fast tuning speed. In our design, the integrated circuit footprint is in fact only limited by the contact pads of the electrodes and by the optical feeding waveguides. Using the high speed of the plasmonic modulators, we demonstrate beam steering with less than 1 ns reconfiguration time, i.e. the beam direction is reconfigured in-between 1 GBd transmitted symbols.

Pre-equalization technique enabling 70 Gbit/s photonic-wireless link at 60 GHz.

In this paper, we demonstrate a 70 Gbit/s photonic-based wireless link at 60 GHz using a single RF carrier and a single polarization. This high capacity is achieved by using 32QAM modulation with a symbol rate of 14 GBd. We show a novel pre-equalization technique that enables usage of such very high bandwidths at 60 GHz. Our work indicates that the consumer oriented 60 GHz band could be a viable alternative to more expensive E-band or sub-THz links for high capacity photonic wireless transmission, mobile backhauling and last-mile high-capacity connections.

[4 + 2] cycloadditions of nitroalkenes in water. Highly asymmetric synthesis of functionalized nitronates.

The [4 + 2] cycloadditions of (E)-2-aryl-1-cyano-1-nitroalkenes 1 with achiral and enantiopure vinyl ethers 2 and 3 carried out in sole water are reported. These reactions occur in a heterogeneous phase under mild conditions and are fast and highly stereoselective. By using (-)-N,N-dicyclohexyl-(1S)-isoborneol-10-sulfonamide as a chiral auxiliary, the cycloadditions are totally asymmetric. The face selectivity is discussed in terms of the shape of the chiral auxiliary and the reactive conformation of vinyl ether.

SIR2000, a program for the automatic ab initio crystal structure solution of proteins.

A new phasing procedure is described working both in direct and in reciprocal space. The procedure has been implemented into the program SIR2000, the heir to SIR99, and it is able routinely to solve ab initio crystal structures of proteins without any use of prior information and any user intervention. The moduli and the flow diagram of SIR2000 are also described and its efficiency tested on several protein diffraction data sets. Success has been attained for crystal structures with up to almost 2000 non-hydrogen atoms in the asymmetric unit and resolution higher than 1.2 A. The phasing process is analysed to provide a better insight into the role of the various steps of the procedure.

[Malignant lymphoma: a study of an outpatient cohort]. / Das maligne Lymphom: eine Studie an einem poliklinischen Krankengut.

Data from 168 patients with malignant lymphoma were collected. 57 had Hodgkin's disease, 76 suffered from non Hodgkin's lymphoma and 35 presented with chronic lymphocytic leukemia. All patients were treated between January 1980 and December 1986 at the medical policlinic of the university of Zurich either as in- or outpatients. Presentation at the time of diagnosis, therapeutic regimen and treatment success as well as prognostic features of disease were evaluated. Overall the therapeutic results in this patient cohort were good and comparable with the results of large prospective studies. Complete remission rate (CRR) was 91% and overall survival rate (OSR) after 5 years was 72% for Hodgkin's disease. In Non Hodgkin's lymphoma of low malignancy OSR was 60% after 5 years and 39% in NHL of intermediate or high malignancy. In NHL CRR varied according to histologic subtype. In Hodgkin's disease staging according to the Ann Arbor classification and extranodal involvement including the spleen proved meaningful for prognosis. In NHL the international working formulation (IWF) was a useful prognostic tool. Anemias, higher age and relapses carried a poorer prognosis whereas induction of remission was a favorable prognostic sign. For chronic lymphocytic leukemia staging according to Binet was found a useful prognostic criterion.

Interaction of adenosine 5'-triphosphate with metal ions X-ray structure of ternary complexes containing Mg(II), Ca(II), Mn(II), Co(II), ATP and 2,2'-dipyridylamine.

The X-ray structures of the isomorphous Mg2+, Ca2+, Mn2+ and Co2+ complexes of ATP have been determined. The metal ions are wrapped in hexa-coordination by the alpha, beta and gamma phosphate groups of two ATP molecules thus blocking the interaction of the metal ions with the adenine base. A second metal ion which is fully hydrated, M(H2O)2+(6), is engaged in a strong hydrogen bond with the gamma phosphate group of ATP and suggests a possible step in facilitating the cleavage between the beta and gamma phosphates in phosphoryl transfer reactions.

Diagnostic value of the paracoagulation protamine sulphate test (PSt) in the pulmonary diseases more frequently encountered in the clinical practice.

A single diluted protamine sulphate test has been employed by the Authors in several respiratory diseases in order to define its diagnostic usefulness. Such a test, easily performed in all clinical chemistry laboratories and very cheap, has resulted to be positive mostly in the pleuropulmonary pathology following microembolic spread to the lung (pulmonary infarction), with a higher significance the earlier the test has been made. The test has appeared to be also able to differentiate infarctual active pleurites (positive) from tubercular eudates and transudates (negative).