Monsplasty for Women After Massive Weight Loss

Ptosis with excess skin in the pubic area is a very common deformity in patients after massive weight loss. This deformity requires adequate surgical treatment whether combined with abdominoplasty or not. The enlarged pubogenital area may lead to psychosocial distress and impaired quality of life. A series of 23 women with a mean age of 39.5 years who previously underwent bariatric surgeries and later presented with pubogenital ptosis underwent monsplasty. The preoperative surgical markings and the surgical technique presented are easily reproducible. In this prospective study, the surgical outcomes were assessed by questionnaires applied to the patients, who scored the following parameters: movement dynamics, aesthetic appearance, sexual performance, improved hygiene, and use of clothing items. Four of the parameters assessed (movement dynamics, aesthetic appearance, hygiene, and use of clothing items) showed clear improvement, with scores ranging from good to very good. A small percentage of the patients (13%) reported fair improvement in sexual performance. The findings showed monsplasty to be a simple and reproducible technique with favorable outcomes and low morbidity rates.

Canonical Quantization of a Massive Weyl Field

We construct a consistent theory of a quantum massive Weyl field. We start with the formulation of the classical field theory approach for the description of massive Weyl fields. It is demonstrated that the standard Lagrange formalism cannot be applied for the studies of massive first-quantized Weyl spinors. Nevertheless we show that the classical field theory description of massive Weyl fields can be implemented in frames of the Hamilton formalism or using the extended Lagrange formalism. Then we carry out a canonical quantization of the system. The independent ways for the quantization of a massive Weyl field are discussed. We also compare our results with the previous approaches for the treatment of massive Weyl spinors. Finally the new interpretation of the Majorana condition is proposed.

Modularity and evolutionary constraints in a baculovirus gene regulatory network

Abstract Background The structure of regulatory networks remains an open question in our understanding of complex biological systems. Interactions during complete viral life cycles present unique opportunities to understand how host-parasite network take shape and behave. The Anticarsia gemmatalis multiple nucleopolyhedrovirus (AgMNPV) is a large double-stranded DNA virus, whose genome may encode for 152 open reading frames (ORFs). Here we present the analysis of the ordered cascade of the AgMNPV gene expression. Results We observed an earlier onset of the expression than previously reported for other baculoviruses, especially for genes involved in DNA replication. Most ORFs were expressed at higher levels in a more permissive host cell line. Genes with more than one copy in the genome had distinct expression profiles, which could indicate the acquisition of new functionalities. The transcription gene regulatory network (GRN) for 149 ORFs had a modular topology comprising five communities of highly interconnected nodes that separated key genes that are functionally related on different communities, possibly maximizing redundancy and GRN robustness by compartmentalization of important functions. Core conserved functions showed expression synchronicity, distinct GRN features and significantly less genetic diversity, consistent with evolutionary constraints imposed in key elements of biological systems. This reduced genetic diversity also had a positive correlation with the importance of the gene in our estimated GRN, supporting a relationship between phylogenetic data of baculovirus genes and network features inferred from expression data. We also observed that gene arrangement in overlapping transcripts was conserved among related baculoviruses, suggesting a principle of genome organization. Conclusions Albeit with a reduced number of nodes (149), the AgMNPV GRN had a topology and key characteristics similar to those observed in complex cellular organisms, which indicates that modularity may be a general feature of biological gene regulatory networks.

X-Ray studies of the physics of matter around super-massive black-holes in nearby Seyfert galaxies

Seyfert galaxies are the closest active galactic nuclei. As such, we can use them to test the physical properties of the entire class of objects. To investigate their general properties, I took advantage of different methods of data analysis. In particular I used three different samples of objects, that, despite frequent overlaps, have been chosen to best tackle different topics: the heterogeneous BeppoS AX sample was thought to be optimized to test the average hard X-ray (E above 10 keV) properties of nearby Seyfert galaxies; the X-CfA was thought the be optimized to compare the properties of low-luminosity sources to the ones of higher luminosity and, thus, it was also used to test the emission mechanism models; finally, the XMM–Newton sample was extracted from the X-CfA sample so as to ensure a truly unbiased and well defined sample of objects to define the average properties of Seyfert galaxies. Taking advantage of the broad-band coverage of the BeppoS AX MECS and PDS instruments (between ~2-100 keV), I infer the average X-ray spectral propertiesof nearby Seyfert galaxies and in particular the photon index (~1.8), the high-energy cut-off (~290 keV), and the relative amount of cold reflection (~1.0). Moreover the unified scheme for active galactic nuclei was positively tested. The distribution of isotropic indicators used here (photon index, relative amount of reflection, high-energy cut-off and narrow FeK energy centroid) are similar in type I and type II objects while the absorbing column and the iron line equivalent width significantly differ between the two classes of sources with type II objects displaying larger absorbing columns. Taking advantage of the XMM–Newton and X–CfA samples I also deduced from measurements that 30 to 50% of type II Seyfert galaxies are Compton thick. Confirming previous results, the narrow FeK line is consistent, in Seyfert 2 galaxies, with being produced in the same matter responsible for the observed obscuration. These results support the basic picture of the unified model. Moreover, the presence of a X-ray Baldwin effect in type I sources has been measured using for the first time the 20-100 keV luminosity (EW proportional to L(20-100)^(−0.22±0.05)). This finding suggests that the torus covering factor may be a function of source luminosity, thereby suggesting a refinement of the baseline version of the unifed model itself. Using the BeppoSAX sample, it has been also recorded a possible correlation between the photon index and the amount of cold reflection in both type I and II sources. At a first glance this confirms the thermal Comptonization as the most likely origin of the high energy emission for the active galactic nuclei. This relation, in fact, naturally emerges supposing that the accretion disk penetrates, depending to the accretion rate, the central corona at different depths (Merloni et al. 2006): the higher accreting systems hosting disks down to the last stable orbit while the lower accreting systems hosting truncated disks. On the contrary, the study of the well defined X–C f A sample of Seyfert galaxies has proved that the intrinsic X-ray luminosity of nearby Seyfert galaxies can span values between 10^(38−43) erg s^−1, i.e. covering a huge range of accretion rates. The less efficient systems have been supposed to host ADAF systems without accretion disk. However, the study of the X–CfA sample has also proved the existence of correlations between optical emission lines and X-ray luminosity in the entire range of L_(X) covered by the sample. These relations are similar to the ones obtained if high-L objects are considered. Thus the emission mechanism must be similar in luminous and weak systems. A possible scenario to reconcile these somehow opposite indications is assuming that the ADAF and the two phase mechanism co-exist with different relative importance moving from low-to-high accretion systems (as suggested by the Gamma vs. R relation). The present data require that no abrupt transition between the two regimes is present. As mentioned above, the possible presence of an accretion disk has been tested using samples of nearby Seyfert galaxies. Here, to deeply investigate the flow patterns close to super-massive black-holes, three case study objects for which enough counts statistics is available have been analysed using deep X-ray observations taken with XMM–Newton. The obtained results have shown that the accretion flow can significantly differ between the objects when it is analyzed with the appropriate detail. For instance the accretion disk is well established down to the last stable orbit in a Kerr system for IRAS 13197-1627 where strong light bending effect have been measured. The accretion disk seems to be formed spiraling in the inner ~10-30 gravitational radii in NGC 3783 where time dependent and recursive modulation have been measured both in the continuum emission and in the broad emission line component. Finally, the accretion disk seems to be only weakly detectable in rk 509, with its weak broad emission line component. Finally, blueshifted resonant absorption lines have been detected in all three objects. This seems to demonstrate that, around super-massive black-holes, there is matter which is not confined in the accretion disk and moves along the line of sight with velocities as large as v~0.01-0.4c (whre c is the speed of light). Wether this matter forms winds or blobs is still matter of debate together with the assessment of the real statistical significance of the measured absorption lines. Nonetheless, if confirmed, these phenomena are of outstanding interest because they offer new potential probes for the dynamics of the innermost regions of accretion flows, to tackle the formation of ejecta/jets and to place constraints on the rate of kinetic energy injected by AGNs into the ISM and IGM. Future high energy missions (such as the planned Simbol-X and IXO) will likely allow an exciting step forward in our understanding of the flow dynamics around black holes and the formation of the highest velocity outflows.

Inverse Static Analysis of Massive Parallel Arrays of Three-State Actuators via Artificial Intelligence

Massive parallel robots (MPRs) driven by discrete actuators are force regulated robots that undergo continuous motions despite being commanded through a finite number of states only. Designing a real-time control of such systems requires fast and efficient methods for solving their inverse static analysis (ISA), which is a challenging problem and the subject of this thesis. In particular, five Artificial intelligence methods are proposed to investigate the on-line computation and the generalization error of ISA problem of a class of MPRs featuring three-state force actuators and one degree of revolute motion.

The evolution of massive clumps in star forming regions

In this thesis two related arguments are investigated: - The first stages of the process of massive star formation, investigating the physical conditions and -properties of massive clumps in different evolutionary stages, and their CO depletion; - The influence that high-mass stars have on the nearby material and on the activity of star formation. I characterise the gas and dust temperature, mass and density of a sample of massive clumps, and analyse the variation of these properties from quiescent clumps, without any sign of active star formation, to clumps likely hosting a zero-age main sequence star. I briefly discuss CO depletion and recent observations of several molecular species, tracers of Hot Cores and/or shocked gas, of a subsample of these clumps. The issue of CO depletion is addressed in more detail in a larger sample consisting of the brightest sources in the ATLASGAL survey: using a radiative tranfer code I investigate how the depletion changes from dark clouds to more evolved objects, and compare its evolution to what happens in the low-mass regime. Finally, I derive the physical properties of the molecular gas in the photon-dominated region adjacent to the HII region G353.2+0.9 in the vicinity of Pismis 24, a young, massive cluster, containing some of the most massive and hottest stars known in our Galaxy. I derive the IMF of the cluster and study the star formation activity in its surroundings. Much of the data analysis is done with a Bayesian approach. Therefore, a separate chapter is dedicated to the concepts of Bayesian statistics.

Origin of cold gas and dust in massive elliptical galaxies

The recent availability of multi-wavelength data revealed the presence of large reservoirs of warm and cold gas and dust in the innermost regions of the majority of massive elliptical galaxies. To prove an internal origin of cold and warm gas, the investigation of the spatially distributed cooling process which occurs because of non-linear density perturbations and subsequent thermal instabilities is of crucial importance. The first goal of this work of thesis is to investigate the internal origin of warm and cold phases. Numerical simulations are the powerful tool of analysis. The way in which a spatially distributed cooling process originates has been examined and the off-centre amount of gas mass which cools when different and differently characterized AGN feedback mechanisms operate has been quantified. This thesis demonstrates that the aforementioned non-linear density perturbations originate and develop from AGN feedback mechanisms in a natural fashion. An internal origin of the warm phase from the once hot gas is shown to be possible. Computed velocity dispersions of ionized and hot gas are similar. The cold gas as well can originate from the cooling process: indeed, it has been estimated that the surrounding stellar radiation, which is one of the most feasible sources of ionization of the warm gas, does not manage to keep ionized all the gas at 10^4 K. Therefore, cooled gas does undergo a further cooling which can lead the warm phase to lower temperatures. However, the gas which has cooled from the hot phase is expected to be dustless; nonetheless, a large fraction of early type galaxies has detectable dust in their cores, both concentrated in filamentary and disky structures and spread over larger regions. Therefore a regularly rotating disk of cold and dusty gas has been included in the simulations. A new quantitative investigation of the spatially distributed cooling process has therefore been essential: the contribution of the included amount of dust which is embedded in the cold gas does have a role in promoting and enhancing the cooling. The fate of dust which was at first embedded in cold gas has been investigated. The role of AGN feedback mechanisms in dragging (if able) cold and dusty gas from the core of massive ellipticals up to large radii has been studied.

Bispectrum of cosmological models with massive neutrinos

Uno dei più importanti campi di ricerca che coinvolge gli astrofisici è la comprensione della Struttura a Grande Scala dell'universo. I principi della Formazione delle Strutture sono ormai ben saldi, e costituiscono la base del cosiddetto "Modello Cosmologico Standard". Fino agli inizi degli anni 2000, la teoria che spiegava con successo le proprietà statistiche dell'universo era la cosiddetta "Teoria Perturbativa Standard". Attraverso simulazioni numeriche e osservazioni di qualità migliore, si è evidenziato il limite di quest'ultima teoria nel descrivere il comportamento dello spettro di potenza su scale oltre il regime lineare. Ciò spinse i teorici a trovare un nuovo approccio perturbativo, in grado di estendere la validità dei risultati analitici. In questa Tesi si discutono le teorie "Renormalized Perturbation Theory"e"Multipoint Propagator". Queste nuove teorie perturbative sono la base teorica del codice BisTeCca, un codice numerico originale che permette il calcolo dello spettro di potenza a 2 loop e del bispettro a 1 loop in ordine perturbativo. Come esempio applicativo, abbiamo utilizzato BisTeCca per l'analisi dei bispettri in modelli di universo oltre la cosmologia standard LambdaCDM, introducendo una componente di neutrini massicci. Si mostrano infine gli effetti su spettro di potenza e bispettro, ottenuti col nostro codice BisTeCca, e si confrontano modelli di universo con diverse masse di neutrini.

Analisi e modellizzazione tramite mappe cognitive di processi decisionali in videogiochi moba - massive on-line battle arena

Tesi su un esperimento per la realizzazione di una mappa cognitiva sul processo decisionale e gli aspetti cognitivi di una persona durante lo svolgimento di una partita a un videogioco di genere Moba. La tesi presente anche cenni di teoria sulle mappe cognitive, sulle misure di rete e sugli aspetti cognitivi dei videogiochi in generale.

Sciatic neuropathy after body contouring surgery in massive weight loss patients

To date, obesity affects a substantial population in industrialised countries. Due to the increased awareness of obesity-related morbidity, efficient dietary regimens and the recent successes with bariatric surgery, there is now a high demand for body contouring surgery to correct skin abundancies after massive weight loss. The known risks for this type of surgery are mainly wound-healing complications, and, more rarely, thromboembolic or respiratory complications. We present two female patients (23 and 39 years of age) who, in spite of standard positioning and precautions, developed sciatic neuropathy after combined body contouring procedures, including abdominoplasty and inner thigh lift. Complete functional loss of the sciatic nerve was found by clinical and electroneurographic examination on the left side in patient one and bilaterally in patient two. Full nerve conductance recovery was obtained after 6 months in both patients. Although the occurrence of spontaneous neuropathies after heavy weight loss is well documented, this is the first report describing the appearance of such a phenomenon following body contouring surgery. One theoretical explanation may be the compression of the nerve during the semirecumbent positioning combined with hip flexion and abduction, which was required for abdominal closure and simultaneous access to the inner thighs. We advise to avoid this positioning and to include the risk of sciatic neuropathy in the routine preoperative information of patients scheduled for body contouring surgery after heavy weight loss.

The role of rotation thromboelastometry in early prediction of massive transfusion

Early prediction of massive transfusion (MT) is critical in the management of severely injured trauma patients. Variables available early after injury including physiologic, laboratory, and rotation thromboelastometric (ROTEM) parameters were evaluated as predictors for the need of MT.

Low-dose recombinant factor VIIa for massive bleeding: A single centre observational cohort study with 73 patients

recombinant activated factor VII (rFVIIa) is used off-label for massive bleeding. There is no convincing evidence of the benefits of this practice and the minimal effective dose is unknown. The aim of the study was to evaluate our in-house guideline recommending a low dose of 60 μg/kg for off-label use of rFVIIa.