Direct intrahepatic portocaval shunt (DIPS) or transjugular transcaval intrahepatic portosystemic shunt (TTIPS) to treat complications of portal hypertension: Indications, technique, and outcomes beyond Budd-Chiari syndrome.

Transjugular intrahepatic portosystemic shunt (TIPS) is nowadays the benchmark treatment of severe portal hypertension complications. However, besides usual contraindication to the procedure (namely recurrent hepatic encephalopathy, severe liver dysfunction, right heart failure and/or pulmonary hypertension), TIPS appears regularly unfeasible due to abnormal and/or distorted anatomy. In this situation, the only non-surgical approaches to treat severe portal hypertension consist in the creation of an intrahepatic portocaval shunt from percutaneous (direct intrahepatic portocaval shunt - DIPS) or transjugular route (transjugular transcaval intrahepatic portosystemic shunt - TTIPS). These procedures have been rapidly adopted in patients with Budd-Chiari syndrome but are only poorly reported in patients with cirrhosis and without BCS. Considering the broadening landscape of TIPS indication in patients with cirrhosis within the last ten years, we aimed to describe the techniques, safety and efficacy of DIPS and TTIPS procedures as an alternative to TIPS in case of unfavourable anatomy

Lipids in liver failure syndromes: a focus on eicosanoids, specialized pro-resolvinglipid mediators and lysophospholipids.

Lipids are organic compounds insoluble in water with a variety of metabolic and non-metabolic functions. They not only represent an efficient energy substrate but can also act as key inflammatory and anti-inflammatory molecules as part of a network of soluble mediators at the interface of metabolism and the immune system. The role of endogenous bioactive lipid mediators has been demonstrated in several inflammatory diseases (rheumatoid arthritis, inflammatory bowel disease, atherosclerosis, cancer). The liver is unique in providing balanced immunotolerance to the exposure of bacterial components from the gut transiting through the portal vein and the lymphatic system. This balance is abruptly deranged in liver failure syndromes such as acute liver failure and acute-on-chronic liver failure. In these syndromes, researchers have recently focused on bioactive lipid mediators by global metabonomic profiling and uncovered the pivotal role of these mediators in the immune dysfunction observed in liver failure syndromes explaining the high occurrence of sepsis and subsequent organ failure. Among endogenous bioactive lipids, the mechanistic actions of three classes (eicosanoids, pro-resolving lipid mediators and lysophospholipids) in the pathophysiological modulation of liver failure syndromes will be the topic of this narrative review. Furthermore, the therapeutic potential of lipid-immune pathways will be described

Effects of Quark Spin Flip on the Collins Fragmentation Function in a Toy Model

The recent extension of the NJL-jet model to hadronization of transversely polarized quarks allowed the study of the Collins fragmentation function. Both favored and unfavored Collins fragmentation functions were generated, the latter purely by multiple hadron emissions, with 1/2 moments of opposite sign in the region of the light-cone momentum fraction $z$ accessible in current experiments. Hints of such behavior has been seen in the measurements in several experiments. Also, in the transverse momentum dependent (TMD) hadron emission probabilities, modulations of up to fourth order in sine of the polar angle were observed, while the Collins effect describes just the linear modulations. A crucial part of the extended model was the calculation of the quark spin flip probability after each hadron emission in the jet. Here we study the effects of this probability on the resulting unfavored and favored Collins functions by setting it as a constant and use a toy model for the elementary single hadron emission probabilities. The results of the Monte Carlo simulations showed that preferential quark spin flip in the elementary hadron emission is needed to generate the favored and unfavored Collins functions with opposite sign 1/2 moments. For the TMD hadron emission modulations, we showed that the model quark spin flip probabilities are a partial source of the higher rode modulations, while the other source is the Collins modulation of the remnant quark from the hadron emission recoil.Comment: 7 pages, 6 figures. To appear in proceedings of HITES 2012, Conference in Honor of Jerry P. Draayer, Horizons of Innovative Theories, Experiments, and Supercomputing in Nuclear Physics, New Orleans, Louisiana, June 4-7, 201

Single spin asymmetry for p↑p→πXp^{\uparrow}p \to \pi X in perturbative QCD

Within the QCD-improved parton model and assuming the factorization theorem to hold in the helicity basis and for higher twist contributions, we show how non zero single spin asymmetries in hadron-hadron high energy and moderately large $p_T$ inclusive processes can be obtained, even in massless perturbative QCD, provided the quark intrinsic motion is taken into account. A simple model is constructed which reproduces the main features of the data on the single spin asymmetry observed in inclusive pion production in $p\,p$ collisions.Comment: 11 pages + 1 figure, plain LaTeX, figure appended as uuencoded, compressed postscript file. Revised version, to be published in Phys. Lett. B; extensive changes in Sections 1 and 2, new References added, results and conclusions essentially unchange

Second Stage String Fragmentation Model

A string model, advocated by Bowler, provides a physical and intuitive picture of heavy quark fragmentation. When supplemented by an ad hoc factor of (1-z), to suppress fragmentation near z=1, it supplies an excellent fit to the data. We extend Bowler's model by accounting for the further decay of the massive mesonic states produced by the initial string breaking. We find that each subsequent string break and cascade decay beyond the first, introduces a factor of (1-z). Furthermore we find that including a finite mass for the quarks, which pop out of the vacuum and split the string, forces the first string breaking to produce massive states requiring further decay. This sequence terminates at the second stage of fragmentation where only relatively "light" heavy meson systems are formed. Thus we naturally account for the phenomenologically required factor of (1-z). We also predict that the ratio of (primary) fragments-vector/(vector plus scalar) should be .61. Our second stage string fragmentation model provides an appealing picture of heavy quark fragmentation.Comment: 15 page

Shunt dysfunction patterns after transjugular intrahepatic portosystemic shunt creation using a combination of a generic stent-graft and bare-stents.

Even though transjugular intrahepatic portosystemic shunt (TIPS) using Fluency Stent-grafts provides good shunt patency rates, shunt dysfunction is a great concern after TIPS creation, occurring in up to 20% of cases within one year. The objective of this study was to describe shunt dysfunction patterns after TIPS creation using a combination of generic stent-grafts/bare-stents. Single-center retrospective study of all TIPS revisions between January 2005 and December 2020. TIPS revision angiograms were analyzed for stents' positions, stenoses' diameters, and stenoses' locations. Out of 99 TIPS, a total of 33 TIPS revisions were included. The median time to TIPS revision was 10.4 months. Angiograms showed four patterns of TIPS dysfunction-associated features (DAF), defined as follows: Type 1 was defined as stenosis located after the stent end in the hepatic vein (HV), type 2 as intra-stent stenosis located in the hepatic vein, type 3 as intra-stent stenosis or a kink in the parenchymal tract or the portal vein end of the TIPS, and type 4 as a complete TIPS occlusion. Types 1, 2, 3, and 4 were seen in 23 (69.7%), 5 (15.2%), 2 (6.1%), and 3 (9.1%) TIPS respectively. TIPS revision was successful in 30 (90.1%) patients with median pre- and post-TIPS revision PSG of 18.5 mmHg and 8 mmHg respectively (p < .001). Our results illustrate the four angiographic patterns of TIPS DAF after TIPS creation using a combination of generic stent-grafts/bare-stents and emphasize the need for appropriate stent length extending to the HV/inferior vena cava junction

Measuring transversity densities in singly polarized hadron-hadron and lepton-hadron collisions

We show how the transverse polarization of a quark initiating a jet can be probed by the azimuthal distribution of two hadrons (of large $z$) in the jet. This permits a twist 2 asymmetry in hard processes when only one of the initial particles is polarized transversely. Applications to hadron-hadron and lepton-hadron scattering are discussed.Comment: 16 pages, LaTeX + EPSF, 2 postscript figures. PSU/TH/10

Single spin asymmetries in DIS

We consider possible mechanisms for single spin asymmetries in inclusive Deep Inelastic Scattering (DIS) processes with unpolarized leptons and transversely polarized nucleons. Tests for the effects of non-zero \bfk_\perp, for the properties of spin dependent quark fragmentations and for quark helicity conservation are suggested.Comment: 5 pages, LaTeX, no figures. Revised version, to be published in Phys. Rev. D. Some equations and statements added to clarify text and notation

Tetraquarks and Pentaquarks in String Models

We consider the production and decay of multiquark systems in the framework of string models where the hadron structure is determined by valence quarks together with string junctions. We show that the low mass multiquark resonances can be very narrow.Comment: 7 pages, 2 figure