Floating appendix: post-traumatic amputation of the appendix as sequela or complication?: a case report

Background Appendicitis following trauma is a well-documented sequela of blunt trauma to the abdomen, while appendiceal transection following trauma is extremely rare. Literature reports have documented appendicitis and appendiceal transection as the presenting pathology in a trauma setting. This is first report of auto-amputation of the appendix as a delayed presentation with peritonitis, which was detected during the second surgery in a child with blunt abdominal trauma. Case presentation A 11-year-old Asian boy presented to our center with a 2-day history of blunt abdominal trauma and chief complaint of severe abdominal pain. On evaluation, a computed tomography scan showed gross pneumoperitoneum. The child underwent emergency laparotomy, where a jejunal perforation was noted, which was repaired. The rest of the bowel and solid organs were healthy. The child was managed in the intensive care unit postoperatively, when he developed a burst abdomen. During the second surgery, pyoperitoneum and free-floating appendix were found in the left paracolic gutter. After peritoneal wash, the bowel was noted to be healthy and the previous jejunal repair was intact. The child was allowed oral intake of food and discharged on postoperative days 4 and 8, respectively. At the 1-year follow-up, he remained asymptomatic. Conclusions This case report is unique as it describes auto-amputation of the appendix as a delayed event in the course of treatment for blunt trauma of the abdomen. Although a remote event, the possibility of amputation of the appendix should be retained as a differential diagnosis and unusual complication in cases of delayed peritonitis.

ORGANIZING EFFECTIVE ONLIDE BUSINESS MEETING

Currently, the correct organization of internet communication is an important stage of effective work. A business meeting is the integral parts of the working process, a gathering of colleagues for exchanging information, making decisions and discussing internal organizational issues. Sometimes internet distance meetings can lose their effectiveness because of many reasons, and instead of being strictly stuck to the agenda, they become digressive and ineffective. The purpose of this article is to identify the factors influencing the effectiveness internet business meetings at dental clinical departments. The commonest drawback of online meetings is that people are actually little involved in the subject matter, often do not listen and do not response others speaker and try to chat in chat box. Different technical equipment and technical skills of the participants, as well as online platforms chosen can also have negative impact. The experience of internet communication has stressed the importance of careful planning and organization in order to conduct an effective business meeting. Knowing the type of the online meeting type, key issues to be discussed help to organize an effective remote event. Early planning of an online meeting structure declines possible drawback.

Composition of English News Stories: Strategies or Schemas?

The research deals with the composition of the English news story revealing that it rests on the interaction of strategies, tactics and schemas of perceptual origin. The material of the research is the BBC news stories. The paper applies cognitive and discursive methods to revealing the composition of English news stories. The results obtained show that strategies determine the choice of predicates structuring an event. Schemas of perceptual origin define the representation of event components in terms of human perception of environment: focusing, with the concentration of attention on one entity; identification, with the introduction of a single entity into the reader’s visual field; zooming-in by the use of the nouns indicating a transformation of a far distance into remote, close or immediate. In this case remote event models are comparatively few in number, because they offer a general picture of what is happening, without going into detail. In case of the subjective zooming-in model the desired effect is evoked by the interaction of collective nouns pointing to a group, i.e. distant perspective, and units in the plural, implying a distant position. The event-subjective perspective is implemented by a sequence of uncountables, denoting a general state of affairs, countables in the plural and in the singular, representing participants from the near or close distance. The tactics include verbalized contents into the composition of the text introducing the sections of context, commentaries, referring to witnesses or sources of information. The conclusions indicate the interaction of strategies, perceptual schemas and tactics in organizing English news stories.

Observations of remotely triggered seismicity in Salton Sea and Coso geothermal regions, Southern California, USA, after big (MW>7.8) teleseismic earthquakes

A relocated catalog was used to search for changes in seismicity rate in the Salton Sea and the Coso geothermal regions, southern California, USA, during and after large (MW>7.8) teleseismic earthquakes. Seismicity in these two regions was analyzed within 30- day windows before and after the occurrence of five major earthquakes: the 2002 Denali fault, Alaska (MW7.9); the 2004 Sumatra-Andaman (MW9.2); the 2010 Central Chile (MW8.8); the 2011 Tohoku-Oki, Japan (MW9.1); and the 2012 Offshore Northern Sumatra (Mw8.6) earthquakes. The Denali (MW7.9) earthquake coincided with an increase in seismicity in the Salton Sea region the day when this remote event occurred, indicating that instantaneous trigge-red seismicity was likely related with the passage of its surface waves. However, in the Coso region the seismicity rate remained approximately constant during the 30-day observation period. The seismicity after the 2004 Sumatra-Andaman (MW9.2) earthquake increased in both regions 9 days after the mega-earthquake. The seismicity after the 2010 Chile (MW8.8) earthquake increased in both regions approximately 14 days after the remote event. The seismicity in Salton Sea and Coso regions increased 17 and 14 days, respectively, after the 2011 Japan (MW9.1) earthquake, suggesting that delayed triggered seismicity was induced after the passage of the surface waves in both regions. Similarly, 6 and 16 days after the 2012 northern Sumatra (MW8.6) earthquake the seismicity also increased in Salton Sea and Coso regions, respectively. These observations can be interpreted as evidence of instantaneous and delayed dynamic triggering induced by large remote earthquakes. The maximum magnitude of the delayed triggered swarm increased with the strength (MW/?) of the mega-earthquake and, the stronger the remote earthquake, the longer the delay time.

Pebble Bed Reactor Dust Production Model

The operation of pebble bed reactors, including fuel circulation, can generate graphite dust, which in turn could be a concern for internal components; and to the near field in the remote event of a break in the coolant circuits. The design of the reactor system must, therefore, take the dust into account and the operation must include contingencies for dust removal and for mitigation of potential releases. Such planning requires a proper assessment of the dust inventory. This paper presents a predictive model of dust generation in an operating pebble bed with recirculating fuel. In this preliminary work the production model is based on the use of the assumption of proportionality between the dust production and the normal force and distance traveled. The model developed in this work uses the slip distances and the inter-pebble forces computed by the authors’ PEBBLES. The code, based on the discrete element method, simulates the relevant static and kinetic friction interactions between the pebbles as well as the recirculation of the pebbles through the reactor vessel. The interaction between pebbles and walls of the reactor vat is treated using the same approach. The amount of dust produced is proportional to the wear coefficient for adhesive wear (taken from literature) and to the slip volume, the product of the contact area and the slip distance. The paper will compare the predicted volume with the measured production rates. The simulation tallies the dust production based on the location of creation. Two peak production zones from intra pebble forces are predicted within the bed. The first zone is located near the pebble inlet chute due to the speed of the dropping pebbles. The second peak zone occurs lower in the reactor with increased pebble contact force due to the weight of supported pebbles. This paper presents the first use of a Discrete Element Method simulation of pebble bed dust production.