A case of portal hypertension due to a superior mesenteric arteriovenous fistula

Introduction: Superior mesenteric arteriovenous fistula (SMAVF) is an infrequent vascular disorder characterized by abnormal communication between high-pressure superior mesenteric artery and low-pressure superior mesenteric vein. This allows blood to bypass the intestinal capillary bed and produces portal hypertension leading to ascites and gastro-esophageal variceal bleeding. Although SMAVF can be congenital, most reported cases have been due to abdominal trauma or iatrogenic causes. Here, we report a case of SMAVF presenting as severe ascites. Case presentation: A 61-year-old female presented to the emergency department with a 1-week history of abdominal distention and discomfort. Her past medical history was significant for abdominal hysterectomy complicated by bowel resection. Initial evaluation was remarkable for severe hyponatremia and severe abdominal and pelvic ascites evidenced on computed tomography. A paracentesis was performed, fluid analysis was negative for spontaneous bacterial peritonitis. The Serum Ascites Albumin Gradient was elevated (\u3e1.1 g/dL). The hospital course was complicated by gastrointestinal bleeding requiring blood transfusions. An upper endoscopy revealed bleeding esophageal varices that were banded. A magnetic resonance of the abdomen revealed a large SMAVF between causing increased portal vein blood flow and pressure; the patient subsequently underwent embolization of the SMAVF. The patient clinically improved and was discharged on stable condition. On follow-up after discharge, cross sectional imaging revealed improved appearance of the mesenteric vasculature and resolution of the ascites. Discussion: This case illustrates the for clinicians to be vigilant for rare but reversible causes of portal hypertension that can mimic cirrhosis in order to provide appropriate diagnosis and management.https://scholarlycommons.henryford.com/merf2020caserpt/1028/thumbnail.jp

Brendan meets Columbus: A more commodious islescape

This paper proposes that we can reimagine insular literatures and medieval islescapes as commodious seas of cultural and intellectual loci that span time, culture, and text alike. By moving beyond the rhetoric of insular separation or connectivity, we can see that islands connect even when medieval minds saw separation. The essay focuses on the Brendan legend and the commodious cultural ‘sea of islands’ that it inhabits, a space that connects the modern reader to a history of other connections, fact to fancy, and the real and the imaginary. When sailing in this sea, Brendan meets Columbus, and the late medieval idea of a lost island spreads though space and time

Exploring embodiment through martial arts and combat sports: a review of empirical research

Since the late 1970s, social scientists have turned considerable attention to investigating martial arts and combat sports (MACS). In particular, this broad range of fighting disciplines has been shown to offer numerous avenues for scholarly enquiry into social change and personal transformation via processes of embodiment. Adopting a thematic structure, we assess the empirical literature in this area via four interconnecting categories pertaining to MACS and embodiment: (1) body cultures; (2) body pedagogies; (3) the embodiment of gender; and (4) bodily harm. Following this review, we identify several gaps in the existing literature, suggesting potential new topics and strategies for research connecting to the social world of physical culture more generally

Nucleophilic Functionalization of the Calix[6]arene Para- and Meta-Position via p‑Bromodienone Route

It is here demonstrated that the p-bromodienone route, previously reported for calix[4]arenes, is also effective for the functionalization of the calix[6]arene macrocycle. Thus, alcoholic O-nucleophiles can be introduced at the calix[6]arene exo rim. In addition, the reaction of a calix[6]arene p-bromodienone derivative with an actived aromatic substrate, such as resorcinol, led to the first example of a meta-functionalized, inherently chiral calix[6]arene derivativ

Generating transgenic reporter lines for studying nervous system development in the cnidarian nematostella vectensis

Neurons often display complex morphologies with long and fine processes that can be difficult to visualize, in particular in living animals. Transgenic reporter lines in which fluorescent proteins are expressed in defined populations of neurons are important tools that can overcome these difficulties. By using membrane-attached fluorescent proteins, such reporter transgenes can identify the complete outline of subsets of neurons or they can highlight the subcellular localization of fusion proteins, for example at pre- or postsynaptic sites. The relative stability of fluorescent proteins furthermore allows the tracing of the progeny of cells over time and can therefore provide information about potential roles of the gene whose regulatory elements are controlling the expression of the fluorescent protein. Here we describe the generation of transgenic reporter lines in the sea anemone Nematostella vectensis, a cnidarian model organism for studying the evolution of developmental processes. We also provide an overview of existing transgenic Nematostella lines that have been used to study conserved and derived aspects of nervous system development.acceptedVersio

Site-directed spin labeling measurements of nanometer distances in nucleic acids using a sequence-independent nitroxide probe

In site-directed spin labeling (SDSL), local structural and dynamic information is obtained via electron paramagnetic resonance (EPR) spectroscopy of a stable nitroxide radical attached site-specifically to a macromolecule. Analysis of electron spin dipolar interactions between pairs of nitroxides yields the inter-nitroxide distance, which provides quantitative structural information. The development of pulse EPR methods has enabled such distance measurements up to 70 Å in bio-molecules, thus opening up the possibility of SDSL global structural mapping. This study evaluates SDSL distance measurement using a nitroxide (designated as R5) that can be attached, in an efficient and cost-effective manner, to a phosphorothioate backbone position at arbitrary DNA or RNA sequences. R5 pairs were attached to selected positions of a dodecamer DNA duplex with a known NMR structure, and eight distances, ranging from 20 to 40 Å, were measured using double electron-electron resonance (DEER). The measured distances correlated strongly (R(2) = 0.98) with the predicted values calculated based on a search of sterically allowable R5 conformations in the NMR structure, thus demonstrating accurate distance measurements using R5. Furthermore, distance measurement in a 42 kD DNA was demonstrated. The results establish R5 as a sequence-independent probe for global structural mapping of DNA and DNA–protein complexes

Additive manufacturing in SMEs: empirical evidences from Italy

Research on innovative technological methods in SMEs’ production processes is progressively receiving attention. However, little is known about the emerging phenomenon of Additive Manufacturing (AM), which may represent a significant strategic lever for fostering a company's competitiveness and performance, especially for SMEs. Our aim is to investigate the effects of AM on SMEs’ production process, in order to better understand the relative outcomes of such an innovative technique. We used latent content analysis for empirically analyzing SMEs present in one of the most important Italian gold jewelry districts. Our findings suggest that the AM introduction in a company’s production process effectively results in many positive outcomes, such as process innovation, customer satisfaction, costs, revenues, profits, and competitive advantage. Specifically, there is a positive linkage between AM and a company’s performance. Hence, such an innovative technique may be interpreted as a viable growth strategy for SMEs. Theoretical and managerial implications are discussed

The Presidency and the Executive Branch in Latin America: What We Know and What We Need to Know

The presidential politics literature depicts presidents either as all- powerful actors or figureheads and seeks to explain outcomes accordingly. Th e president and the executive branch are nonetheless usually treated as black boxes, particularly i n developing countries, even though the presidency has evolved into an extremely complex branch of government. While these developments have been studied in the U nited States, far less i s known in other countries, particularly in Latin America, where presi dential systems have been considered the source of all goods and evils. To help close the knowledge gap and explore differences in policymaking characteristics not only between Latin America and the US but also across Latin American countries, this paper s ummarizes the vast literature on the organization and resources of the Executive Branch in the Americas and sets a research agenda for the study of Latin American presidencies.Fil: Bonvecchi, Alejandro. Universidad Torcuato Di Tella. Departamento de Ciencia Política y Estudios Internacionales; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Scartascini, Juan Carlos. Banco Interamericano de Desarrollo; Estados Unido