Laparoscopic cholecystectomy for left-sided gallbladder (sinistroposition).

Transposition of the gallbladder to the left side without situs inversus viscerum is rare. These gallbladders are situated under the left lobe of the liver between Segment III and IV or on Segment III to the left of the falciform ligament. Because routine preoperative studies may not detect the anomaly, it may provide the surgeons with an unusual surprise during laparoscopy. Awareness of the unpredictable confluence of the cystic duct into the common bile duct and selective use of intraoperative cholangiography aid in the safe laparoscopic management of this unusual problem.     

Modeling of gene regulatory networks with hybrid differential evolution and particle swarm optimization.

In the last decade, recurrent neural networks (RNNs) have attracted more efforts in inferring genetic regulatory networks (GRNs), using time series gene expression data from microarray experiments. This is critically important for revealing fundamental cellular processes, investigating gene functions, and understanding their relations. However, RNNs are well known for training difficulty. Traditional gradient descent-based methods are easily stuck in local minima and the computation of the derivatives is also not always possible. Here, the performance of three evolutionary-swarm computation technology-based methods, known as differential evolution (DE), particle swarm optimization (PSO), and the hybrid of DE and PSO (DEPSO), in training RNNs is investigated. Furthermore, the gene networks are reconstructed via the identification of the gene interactions, which are explained through corresponding connection weight matrices. The experimental results on two data sets studied in this paper demonstrate that the DEPSO algorithm performs better in RNN training. Also, the RNN-based model can provide meaningful insight in capturing the nonlinear dynamics of genetic networks and revealing genetic regulatory interactions.     

Psychiatric considerations in pulmonary disease.

Lung disease is a prominent cause of morbidity and mortality worldwide. When a patient has a common lung disease, such as asthma, or a less prevalent one, such as idiopathic pulmonary fibrosis, psychiatric issues should be considered as an integral part of the care plan for each patient. There have been many studies of psychologic factors and psychiatric syndromes in various lung diseases and their treatment. In this article, the authors focus on an evidence-based approach to reviewing this clinical literature.