Autoimmune pancreatitis/IgG4-associated cholangitis and primary sclerosing cholangitis – Overlapping or separate diseases?

Autoimmune pancreatitis is a recently described fibroinflammatory disease which is characterised by raised serum levels of IgG4 (in >70% of cases), and an IgG4-positive lymphoplasmacytic tissue infiltrate. A favourable and rapid clinical response to oral steroid therapy is often seen. Biliary involvement is common, and the term IgG4-associated cholangitis has recently been coined. The cholangiographic appearances of IgG4-associated cholangitis and primary sclerosing cholangitis can be difficult to differentiate. Moreover, raised levels of serum IgG4 have been recently found in 9% of patients with primary sclerosing cholangitis (a much higher frequency than for other gastrointestinal diseases), and those with raised levels appear to progress more rapidly to liver failure. Here we review the similarities and differences between the biliary disease in autoimmune pancreatitis and primary sclerosing cholangitis, and address the issue of disease overlap. Improvements in understanding the relationship between these conditions might lead to an enhanced understanding of the aetiopathogenesis, and improved treatment of both conditions

A synchrotron jet from a post-asymptotic giant branch star

The evolution of low- and intermediate-initial-mass stars beyond the asymptotic giant branch (AGB) remains poorly understood. High-velocity outflows launched shortly after the AGB phase are thought to be the primary shaping mechanism of bipolar and multipolar planetary nebulae. However, little is known about the launching and driving mechanism for these jets, whose momentum and energy often far exceed the energy that can be provided by radiation pressure alone. Here, we report on the direct evidence of a magnetically collimated jet shaping the bipolar morphology of the circumstellar envelope of a post-AGB star. We present radio continuum observations of the post-AGB star IRAS 15445-5449 (OH 326.5-0.4) which has water masers tracing a fast bipolar outflow. Our observations confirm the earlier observed steep negative spectral index of the spectral energy distribution (SED) above similar to 3 GHz, and resolve, for the first time, the emission to originate from a radio jet, proving the existence of such jets around a post-AGB star. The SED is consistent with a synchrotron jet embedded in a sheath of thermal electrons. We find a close correspondence between the extent and direction of the synchrotron jet and the bipolar shape of the object observed at other wavelengths, suggesting that the jet is responsible for the source morphology. The jet is collimated by a magnetic field of the order of mG at almost 7000 au from the central star. We recover observations from the Australia Telescope Compact Array archive that indicate that the emission measure of the thermal component has increased by a factor of 3 between 1998 and 2005 after which it has remained constant. The short time-scale evolution of the radio emission suggests a short lifetime for the jet. The observations of a synchrotron jet from a post-AGB star with characteristics similar to those from protostars and young stellar objects, for instance, suggest that magnetic launching and collimation is a common feature of astrophysical jets

Illusory Decoherence

If a quantum experiment includes random processes, then the results of repeated measurements can appear consistent with irreversible decoherence even if the system's evolution prior to measurement was reversible and unitary. Two thought experiments are constructed as examples.Comment: 10 pages, 3 figure

Controls on the 87Sr/86Sr ratios of carbonates in the Garhwal Himalaya, Headwaters of the Ganges

The episodic variation of the seawater 87Sr/86Sr ratio has been attributed to either variations in the Sr flux or the Sr-isotopic composition of the riverine-dissolved load derived from weathering of the continental crust. The discovery that Himalayan rivers are characterized by high concentrations of dissolved Sr concentrations with high 87Sr/86Sr ratios has raised the possibility that collisional orogens play a critical role in moderating the variations in seawater 87Sr/86Sr ratios. Here we describe Himalayan carbonates and calc-silicates from Garhwal, the headwaters of the Ganges, with extreme 87Sr/86Sr ratios (>1.0). Elevated Sr-isotope ratios result from exchange with Rb-rich silicate material during both Himalayan and pre-Himalayan metamorphic episodes, and the carbonates contribute a significant fraction to the Ganges 87Sr flux. Particularly elevated 87Sr/86Sr ratios are found in calc-silicates from the Deoban Formation of the Lesser Himalaya. A detailed traverse of shales and calc-silicates from this unit confirms that carbonate horizons have increased 87Sr/86Sr ratios as a result of isotopic exchange over length scales of 1030 cm. We conclude that metamorphism of carbonates may cause elevation of their 87Sr/86Sr ratios and that uplift of metamorphosed carbonates may be a consequence of collisional orogens, which contributes to the elevation of seawater 87Sr/86Sr ratios

Stabilization of Hydrodynamic Flows by Small Viscosity Variations

Motivated by the large effect of turbulent drag reduction by minute concentrations of polymers we study the effects of a weakly space-dependent viscosity on the stability of hydrodynamic flows. In a recent Letter [Phys. Rev. Lett. {\bf 87}, 174501, (2001)] we exposed the crucial role played by a localized region where the energy of fluctuations is produced by interactions with the mean flow (the "critical layer"). We showed that a layer of weakly space-dependent viscosity placed near the critical layer can have a very large stabilizing effect on hydrodynamic fluctuations, retarding significantly the onset of turbulence. In this paper we extend these observation in two directions: first we show that the strong stabilization of the primary instability is also obtained when the viscosity profile is realistic (inferred from simulations of turbulent flows with a small concentration of polymers). Second, we analyze the secondary instability (around the time-dependent primary instability) and find similar strong stabilization. Since the secondary instability develops around a time-dependent solution and is three-dimensional, this brings us closer to the turbulent case. We reiterate that the large effect is {\em not} due to a modified dissipation (as is assumed in some theories of drag reduction), but due to reduced energy intake from the mean flow to the fluctuations. We propose that similar physics act in turbulent drag reduction.Comment: 10 pages, 17 figs., REVTeX4, PRE, submitte

An assessment of the resolution limitation due to radiation-damage in x-ray diffraction microscopy

X-ray diffraction microscopy (XDM) is a new form of x-ray imaging that is being practiced at several third-generation synchrotron-radiation x-ray facilities. Although only five years have elapsed since the technique was first introduced, it has made rapid progress in demonstrating high-resolution threedimensional imaging and promises few-nm resolution with much larger samples than can be imaged in the transmission electron microscope. Both life- and materials-science applications of XDM are intended, and it is expected that the principal limitation to resolution will be radiation damage for life science and the coherent power of available x-ray sources for material science. In this paper we address the question of the role of radiation damage. We use a statistical analysis based on the so-called "dose fractionation theorem" of Hegerl and Hoppe to calculate the dose needed to make an image of a lifescience sample by XDM with a given resolution. We conclude that the needed dose scales with the inverse fourth power of the resolution and present experimental evidence to support this finding. To determine the maximum tolerable dose we have assembled a number of data taken from the literature plus some measurements of our own which cover ranges of resolution that are not well covered by reports in the literature. The tentative conclusion of this study is that XDM should be able to image frozen-hydrated protein samples at a resolution of about 10 nm with "Rose-criterion" image quality.Comment: 9 pages, 4 figure

Pan-European early switch/early discharge opportunities exist for hospitalised patients with methicillin-resistant <em>Staphylococcus</em> <em>aureus</em> complicated skin and soft-tissue infections

AbstractThe objective of this study was to document pan-European real-world treatment patterns and healthcare resource use and estimate opportunities for early switch (ES) from intravenous (IV) to oral antibiotics and early discharge (ED) in hospitalized patients with methicillin-resistant Staphylococcus aureus (MRSA) complicated skin and soft tissue infections (cSSTIs). This retrospective observational medical chart review study enrolled 342 physicians across 12 European countries who collected data from 1542 patients with documented MRSA cSSTI who were hospitalized (July 2010 to June 2011) and discharged alive (by July 2011). Data included clinical characteristics and outcomes, hospital length of stay (LOS), MRSA-targeted IV and oral antibiotic use, and ES and ED eligibility according to literature-based and expert-validated criteria. The most frequent initial MRSA-active antibiotics were vancomycin (50.2%), linezolid (15.1%), clindamycin (10.8%), and teicoplanin (10.4%). Patients discharged with MRSA-active antibiotics (n = 480) were most frequently prescribed linezolid (42.1%) and clindamycin (19.8%). IV treatment duration (9.3 ± 6.5 vs. 14.6 ± 9.9 days; p <0.001) and hospital LOS (19.1 ± 12.9 vs. 21.0 ± 18.2 days; p 0.162) tended to be shorter for patients switched from IV to oral treatment than for patients who received IV treatment only. Of the patients, 33.6% met ES criteria and could have discontinued IV treatment 6.0 ± 5.5 days earlier, and 37.9% met ED criteria and could have been discharged 6.2 ± 8.2 days earlier. More than one-third of European patients hospitalized for MRSA cSSTI could be eligible for ES and ED, resulting in substantial reductions in IV days and bed-days, with potential savings of €2000 per ED-eligible patient

Navier-Stokes transport coefficients of dd-dimensional granular binary mixtures at low density

The Navier-Stokes transport coefficients for binary mixtures of smooth inelastic hard disks or spheres under gravity are determined from the Boltzmann kinetic theory by application of the Chapman-Enskog method for states near the local homogeneous cooling state. It is shown that the Navier-Stokes transport coefficients are not affected by the presence of gravity. As in the elastic case, the transport coefficients of the mixture verify a set of coupled linear integral equations that are approximately solved by using the leading terms in a Sonine polynomial expansion. The results reported here extend previous calculations [V. Garz\'o and J. W. Dufty, Phys. Fluids {\bf 14}, 1476 (2002)] to an arbitrary number of dimensions. To check the accuracy of the Chapman-Enskog results, the inelastic Boltzmann equation is also numerically solved by means of the direct simulation Monte Carlo method to evaluate the diffusion and shear viscosity coefficients for hard disks. The comparison shows a good agreement over a wide range of values of the coefficients of restitution and the parameters of the mixture (masses and sizes).Comment: 6 figures, to be published in J. Stat. Phy

The ATCA/VLA OH 1612 MHz survey. II. Observations of the galactic Disk region

Wetensch. publicatieFaculteit der Wiskunde en Natuurwetenschappe