Obstructing mucocele of the cystic duct after transplantation of the liver

A tension mucocele was created in three hepatic homografts by ligating a low-lying cystic duct during transplant cholecystectomy and by incorporating its outflow end into the anastomosis of the common hepatic duct to the recipient common duct or Roux limb of jejunum. The consequent complication of obstruction of the biliary tract that necessitated reoperation and excision of the mucocele in all three patients can be avoided by the simple expedient of completely removing the cystic duct when feasible or providing egress to the secretion of the cystic duct as described

A category of wide subcategories

An algebra is said to be τ-tilting finite provided it has only a finite number of τ-rigid objects up to isomorphism. To each such algebra, we associate a category whose objects are the wide subcategories of its category of finite dimensional modules, and whose morphisms are indexed by support τ-tilting pairs

Torsion pairs and rigid objects in tubes

We classify the torsion pairs in a tube category and show that they are in bijection with maximal rigid objects in the extension of the tube category containing the Pruefer and adic modules. We show that the annulus geometric model for the tube category can be extended to the larger category and interpret torsion pairs, maximal rigid objects and the bijection between them geometrically. We also give a similar geometric description in the case of the linear orientation of a Dynkin quiver of type A.Comment: 25 pages, 13 figures. Paper shortened. Minor errors correcte

Rigid and Schurian modules over cluster-tilted algebras of tame type

We give an example of a cluster-tilted algebra Λ with quiver Q, such that the associated cluster algebra A(Q) has a denominator vector which is not the dimension vector of any indecomposable Λ-module. This answers a question posed by T. Nakanishi. The relevant example is a cluster-tilted algebra associated with a tame hereditary algebra. We show that for such a cluster-tilted algebra Λ, we can write any denominator vector as a sum of the dimension vectors of at most three indecomposable rigid Λ-modules. In order to do this it is necessary, and of independent interest, to first classify the indecomposable rigid Λ-modules in this case

Cancer pharmacogenetics

The large number of active combination chemotherapy regimens for most cancers has led to the need for better information to guide the \u27standard\u27 treatment for each patient. In an attempt to individualise therapy, pharmacogenetics and pharmacogenomics (a polygenic approach to pharmacogenetic studies) encompass the search for answers to the hereditary basis for interindividual differences in drug response. This review will focus on the results of studies assessing the effects of polymorphisms in drug-metabolising enzymes and drug targets on the toxicity and response to commonly used chemotherapy drugs. In addition, the need for polygenic pharmacogenomic strategies to identify patients at risk for adverse drug reactions will be highlighted

Minimum intervention dentistry principles and objectives

Minimum intervention dentistry (MID) is the modern medical approach to the management of caries, utilizing caries risk assessment, and focusing on the early prevention and interception of disease. Moving the focus away from the restoration of teeth allows the dentist to achieve maximum intervention, with minimal invasive treatments. The four core principles of MID can be considered to be: (1) Recognition – early identification and assessment of potential caries risk factors through lifestyle analysis, saliva testing and using plaque diagnostic tests; (2) Reduction – to eliminate or minimize caries risk factors by altering diet and lifestyle habits and increasing the pH of the oral environment; (3) Regeneration – to arrest and reverse incipient lesions, using appropriate topical agents including fluorides and casein phosphopeptides-amorphous calcium phosphates (CPP-ACP); (4) Repair – when cavitation is present and surgical intervention is required, conservative caries removal is carried out to maximize the repair potential of the tooth and retain tooth structure. Bioactive materials are used to restore the tooth and promote internal healing of the dentine. Effective implementation of MID involves integrating each of these four elements into patient assessment and treatment planning. This review paper discusses the key principles of MID as a philosophy of patient care, and the practical objectives which flow into individual patient care

Long term time variability of cosmic rays and possible relevance to the development of life on Earth

An analysis is made of the manner in which the cosmic ray intensity at Earth has varied over its existence and its possible relevance to both the origin and the evolution of life. Much of the analysis relates to the 'high energy' cosmic rays ($E>10^{14}eV;=0.1PeV$) and their variability due to the changing proximity of the solar system to supernova remnants which are generally believed to be responsible for most cosmic rays up to PeV energies. It is pointed out that, on a statistical basis, there will have been considerable variations in the likely 100 My between the Earth's biosphere reaching reasonable stability and the onset of very elementary life. Interestingly, there is the increasingly strong possibility that PeV cosmic rays are responsible for the initiation of terrestrial lightning strokes and the possibility arises of considerable increases in the frequency of lightnings and thereby the formation of some of the complex molecules which are the 'building blocks of life'. Attention is also given to the well known generation of the oxides of nitrogen by lightning strokes which are poisonous to animal life but helpful to plant growth; here, too, the violent swings of cosmic ray intensities may have had relevance to evolutionary changes. A particular variant of the cosmic ray acceleration model, put forward by us, predicts an increase in lightning rate in the past and this has been sought in Korean historical records. Finally, the time dependence of the overall cosmic ray intensity, which manifests itself mainly at sub-10 GeV energies, has been examined. The relevance of cosmic rays to the 'global electrical circuit' points to the importance of this concept.Comment: 18 pages, 5 figures, accepted by 'Surveys in Geophysics

Improving the psychological evaluation of exercise referral: psychometric properties of the Exercise Referral Quality of Life Scale

There is a growing need to assess the psychological outcomes of exercise referral and the National Institute of Health and Care Excellence has called for the routine assessment of life-quality. However, a quality of life scale specific to the requirements of exercise referral is currently unavailable. Therefore, the aim of this study was to produce a quality of life measure for this purpose. The Exercise Referral Quality of Life Scale is a 22-item measure comprising three domains: mental and physical health, injury pain and illness and physical activity facilitators. Exploratory factor analysis determined the initial factor structure and was subsequently confirmed by confirmatory factor analysis. Additional scale properties were also assessed. The scale contributes to the global need for improved consistent psychological outcome assessment of exercise referral

Astronomical Spectroscopy

Spectroscopy is one of the most important tools that an astronomer has for studying the universe. This chapter begins by discussing the basics, including the different types of optical spectrographs, with extension to the ultraviolet and the near-infrared. Emphasis is given to the fundamentals of how spectrographs are used, and the trade-offs involved in designing an observational experiment. It then covers observing and reduction techniques, noting that some of the standard practices of flat-fielding often actually degrade the quality of the data rather than improve it. Although the focus is on point sources, spatially resolved spectroscopy of extended sources is also briefly discussed. Discussion of differential extinction, the impact of crowding, multi-object techniques, optimal extractions, flat-fielding considerations, and determining radial velocities and velocity dispersions provide the spectroscopist with the fundamentals needed to obtain the best data. Finally the chapter combines the previous material by providing some examples of real-life observing experiences with several typical instruments.Comment: An abridged version of a chapter to appear in Planets, Stars and Stellar Systems, to be published in 2011 by Springer. Slightly revise

Three clinically distinct chronic pediatric airway infections share a common core microbiota

Copyright © 2014 by the American Thoracic Society. Rationale: DNA-based microbiological studies are moving beyond studying healthy human microbiota to investigate diverse infectious diseases, including chronic respiratory infections, such as those in the airways of peoplewith cystic fibrosis (CF) and non-CF bronchiectasis. The species identified in the respiratory secretionmicrobiota fromsuch patients can be classified into those that are common and abundant among similar subjects (core) versus those that are infrequent and rare (satellite). This categorization provides a vital foundation for investigating disease pathogenesis and improving therapy. However, whether the core microbiota of people with different respiratory diseases, which are traditionally associated with specific culturable pathogens, are unique or shared with other chronic infections of the lower airways isnotwell studied. Little is also known about how these chronic infection microbiota change from childhood to adulthood. Objectives: We sought to compare the core microbiota in respiratory specimens from children and adults with different chronic lung infections. Methods: We used bacterial 16S rRNA gene pyrosequencing, phylogenetic analysis, and ecological statistical tools to compare the core microbiota in respiratory samples from three cohorts of symptomatic children with clinically distinct airway diseases (protracted bacterial bronchitis, bronchiectasis,CF), and from four healthy children.Wethen compared the core pediatric respiratory microbiota with those in samples from adults with bronchiectasis and CF. Measurements and Main Results: All three pediatric disease cohorts shared strikingly similar core respiratory microbiota that differed from adult CF and bronchiectasis microbiota. The most common species in pediatric disease cohort sampleswere also detected in those from healthy children. The adult CF and bronchiectasis microbiota also differed from each other, suggesting common early infection airwaymicrobiota that diverge by adulthood.The shared core pediatric microbiota included both traditional pathogens and many species not routinely identified by standard culture. Conclusions: Our results indicate that these clinically distinct chronic airway infections share common early core microbiota, which are likely shaped by natural aspiration and impaired clearance of the same airway microbes, but that disease-specific characteristics select for divergent microbiota by adulthood. Longitudinal and interventional studies will be required to define the relationships between microbiota, treatments, and disease progression