Wilkie's syndrome causing persistent vomiting post-colectomy

AbstractINTRODUCTIONWilkie's syndrome occurs when the superior mesenteric artery (SMA) compresses the third part of the duodenum causing proximal dilatation of small bowel. It is due to loss of the fat pad that sits between the duodenum and SMA and therefore is most commonly seen in people who have had significant weight loss.PRESENTATION OF CASEA 79 year old man presented with anaemia and weight loss and an ascending colon malignancy was found. He was built up nutritionally and subsequently underwent a right hemicolectomy. Post operatively he had persistent nausea and vomiting and duodenal compression by the SMA was identified on CT imaging. He was managed initially with parenteral nutrition then gradually enteral feeding was introduced via a nasojejunal tube. Symptoms resolved with weight gain and he was discharged well.DISCUSSIONThis condition often presents insidiously with intermittent nausea and vomiting. It infrequently occurs with a more acute onset in surgical patients. It has a classic appearance on CT imaging and is usually managed with conservative treatment although surgical options are feasible if this fails.CONCLUSIONWilkie's syndrome is an interesting and infrequent cause of small bowel obstruction following colorectal surgery. A high index of suspicion is required

Rapid destruction of protoplanetary discs due to external photoevaporation in star-forming regions

We analyse N-body simulations of star-forming regions to investigate the effects of external far- and extreme-ultraviolet photoevaporation from massive stars on protoplanetary discs. By varying the initial conditions of simulated star-forming regions, such as the spatial distribution, net bulk motion (virial ratio), and density, we investigate which parameters most affect the rate at which discs are dispersed due to external photoevaporation. We find that disc dispersal due to external photoevaporation is faster in highly substructured star-forming regions than in smooth and centrally concentrated regions. Subvirial star-forming regions undergoing collapse also show higher rates of disc dispersal than regions that are in virial equilibrium or are expanding. In moderately dense (∼100 M⊙ pc−3) regions, half of all protoplanetary discs with radii ≥100 au are photoevaporated within 1 Myr, three times faster than is currently suggested by observational studies. Discs in lower density star-forming regions (∼10 M⊙ pc−3) survive for longer, but half are still dispersed on short time-scales (∼2 Myr). This demonstrates that the initial conditions of the star-forming regions will greatly impact the evolution and lifetime of protoplanetary discs. These results also imply that either gas giant planet formation is extremely rapid and occurs before the gas component of discs is  evaporated, or gas giants only form in low-density star-forming regions where no massive stars are present to photoevaporate gas from protoplanetary discs

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

The design, implementation, and performance of the LZ calibration systems

LUX-ZEPLIN (LZ) is a tonne-scale experiment searching for direct dark matter interactions and other rare events. It is located at the Sanford Underground Research Facility (SURF) in Lead, South Dakota, USA. The core of the LZ detector is a dual-phase xenon time projection chamber (TPC), designed with the primary goal of detecting Weakly Interacting Massive Particles (WIMPs) via their induced low energy nuclear recoils. Surrounding the TPC, two veto detectors immersed in an ultra-pure water tank enable reducing background events to enhance the discovery potential. Intricate calibration systems are purposely designed to precisely understand the responses of these three detector volumes to various types of particle interactions and to demonstrate LZ's ability to discriminate between signals and backgrounds. In this paper, we present a comprehensive discussion of the key features, requirements, and performance of the LZ calibration systems, which play a crucial role in enabling LZ's WIMP-search and its broad science program. The thorough description of these calibration systems, with an emphasis on their novel aspects, is valuable for future calibration efforts in direct dark matter and other rare-event search experiments

New constraints on ultraheavy dark matter from the LZ experiment

Searches for dark matter with liquid xenon time projection chamber experiments have traditionally focused on the region of the parameter space that is characteristic of weakly interacting massive particles, ranging from a few GeV/c2 to a few TeV/c2. Models of dark matter with a mass much heavier than this are well motivated by early production mechanisms different from the standard thermal freeze-out, but they have generally been less explored experimentally. In this work, we present a reanalysis of the first science run of the LZ experiment, with an exposure of 0.9  tonne×yr, to search for ultraheavy particle dark matter. The signal topology consists of multiple energy deposits in the active region of the detector forming a straight line, from which the velocity of the incoming particle can be reconstructed on an event-by-event basis. Zero events with this topology were observed after applying the data selection calibrated on a simulated sample of signal-like events. New experimental constraints are derived, which rule out previously unexplored regions of the dark matter parameter space of spin-independent interactions beyond a mass of 1017  GeV/c2. Published by the American Physical Society 2024 </jats:sec

Interferon-? polymorphisms correlate with duration of survival in pancreatic cancer

Despite progress in diagnosis and staging, pancreatic cancer still has a poor prognosis and it remains difficult to predict duration of survival in advanced pancreatic cancer. Nutritional decline, or cachexia, is a contributory factor to decreased survival in advanced pancreatic carcinoma, and it has been demonstrated that proinflammatory cytokines give rise to cachexia. Interferon (IFN)-? is a proinflammatory cytokine whose administration increases survival outcomes in a variety of cancers. The human IFN-? gene has a variable length CA-repeat sequence, the length that has been shown to influence IFN-? production. The current study was performed to ascertain whether polymorphisms of the IFN-? gene would influence survival of individuals with advanced pancreatic cancer. The study demonstrated that the presence of allele 2 (12 {CA} repeats) was consistently associated with increased duration of survival after confirmation of nonresectable pancreatic carcinoma. We therefore propose that the presence of allele 2 may be a useful marker for patient outcome

Cosmogenic production of Ar 37 in the context of the LUX-ZEPLIN experiment

© 2022 authors. Published by the American Physical Society.We estimate the amount of Ar37 produced in natural xenon via cosmic-ray-induced spallation, an inevitable consequence of the transportation and storage of xenon on the Earth&apos;s surface. We then calculate the resulting Ar37 concentration in a 10-tonne payload (similar to that of the LUX-ZEPLIN experiment) assuming a representative schedule of xenon purification, storage, and delivery to the underground facility. Using the spallation model by Silberberg and Tsao, the sea-level production rate of Ar37 in natural xenon is estimated to be 0.024 atoms/kg/day. Assuming the xenon is successively purified to remove radioactive contaminants in 1-tonne batches at a rate of 1 tonne/month, the average Ar37 activity after 10 tons are purified and transported underground is 0.058-0.090 μBq/kg, depending on the degree of argon removal during above-ground purification. Such cosmogenic Ar37 will appear as a noticeable background in the early science data, while decaying with a 35-day half-life. This newly noticed production mechanism of Ar37 should be considered when planning for future liquid-xenon-based experiments.11Nsciescopu