Performing percutaneous transphepatic cholangiography using simple x-ray equipment

Percutaneous transhepatic cholangiography (PTC) is a valuable procedure used for diagnosing diseases of bile duct. It is simple to perform, safe, and inexpensive. The only equipment needed to perform PTC is a simple x-ray machine and puncture needle 14cm long and of 0.1cm core diameter. As long as the puncture point is selected accurately and operation is performed correctly, an excellent image can be achieved. This procedure can therefore be used in developing countries where expensive, modern technology is not available. We report a ca.e of a 50 year old female patient in whom the procedure was successfully used.East African Medical Journal, May 1999, 287-28

Absorption Cross Sections of NH_3, NH_2D, NHD_2, and ND_3 in the Spectral Range 140-220 nm and Implications for Planetary Isotopic Fractionation

Cross sections for photoabsorption of NH_3, NH_2D, NHD_2, and ND_3 in the spectral region 140-220 nm were determined at ~298 K using synchrotron radiation. Absorption spectra of NH_2D and NHD_2 were deduced from spectra of mixtures of NH_3 and ND_3, of which the equilibrium concentrations for all four isotopologues obey statistical distributions. Cross sections of NH_2D, NHD_2, and ND_3 are new. Oscillator strengths, an integration of absorption cross sections over the spectral lines, for both A ← X and B ← X systems of NH_3 agree satisfactorily with previous reports; values for NH_2D, NHD_2, and ND_3 agree with quantum chemical predictions. The photolysis of NH_3 provides a major source of reactive hydrogen in the lower stratosphere and upper troposphere of giant planets such as Jupiter. Incorporating the measured photoabsorption cross sections of NH_3 and NH_2D into the Caltech/JPL photochemical diffusive model for the atmosphere of Jupiter, we find that the photolysis efficiency of NH_2D is lower than that of NH_3 by as much as 30%. The D/H ratio in NH_2D/NH_3 for tracing the microphysics in the troposphere of Jupiter is also discussed

An Approximation to Miscible Fluid Flows in Porous Media With Point Sources and Sinks by an Eulerian-Lagrangian Localized Adjoint Method and Mixed Finite Element Methods

We develop an Eulerian–Lagrangian localized adjoint method (ELLAM)-mixed finite element method (MFEM) solution technique for accurate numerical simulation of coupled systems of partial differential equations (PDEs), which describe complex fluid flow processes in porous media. An ELLAM, which was shown previously to outperform many widely used methods in the context of linear convection-diffusion PDEs, is presented to solve the transport equation for concentration. Since accurate fluid velocities are crucial in numerical simulations, an MFEM is used to solve the pressure equation for the pressure and Darcy velocity. This minimizes the numerical difficulties occurring in standard methods for approximating velocities caused by differentiation of the pressure and then multiplication by rough coefficients. The ELLAM-MFEM solution technique significantly reduces temporal errors, symmetrizes the governing transport equation, eliminates nonphysical oscillation and/or excessive numerical dispersion in many simulators, conserves mass, and treats boundary conditions accurately. Numerical experiments show that the ELLAM-MFEM solution technique simulates miscible displacements of incompressible fluid flows in porous media accurately with fairly coarse spatial grids and very large time steps, which are one or two orders of magnitude larger than the time steps used in many methods. Moreover, the ELLAM-MFEM solution technique can treat large mobility ratios, discontinuous permeabilities and porosities, anisotropic dispersion in tensor form, and point sources and sinks

Co-benefits and trade-offs of environmental pressures: A case study of Zhejiang’s socio-economic evolution

Our societies are continuously grappling with how to achieve rapid economic growth while minimizing the challenges of environmental sustainability. In this avenue, numerous studies have contributed towards investigating socio-economic factors and developing policies targeting environmental pressures (EPs). While previous studies have tended to focus on the individual driving forces of EPs, the consideration of the co-benefits and trade-offs among different EPs and policies have been considerably overlooked. In China, previous studies have mostly engaged these issues at the national level and have overlooked the regional socio-economic characteristics – this presents a mismatch between regional policy applications and average national level research findings. Towards this end, this study examines the co-benefits and trade-offs of eight EPs in Zhejiang during the 2007–2015 period. Our findings revealed strict co-benefits in reductions of all eight EPs due to intensity changes as well as trade-offs due to changes in final demand structure and final demand composition. Sectoral results show that only the Non-Ferrous Metal Ores sector has strict co-benefits among all EPs from the production perspective, while eight sectors have strict co-benefits from the consumption perspective mainly including the Mining and Washing of Coal, Ferrous Metal Ores, Electric Power and Heat Power sectors. Our findings suggest important policy implications associated with utilizing co-benefits and avoiding trade-offs for EP mitigation: making full use of all driving forces, strengthening intersectoral coordination, and establishing a joint evaluation mechanism among different sectors

Tissue signals imprint ILC2 identity with anticipatory function.

Group 2 innate lymphoid cells (ILC2s) are distributed systemically and produce type 2 cytokines in response to a variety of stimuli, including the epithelial cytokines interleukin (IL)-25, IL-33, and thymic stromal lymphopoietin (TSLP). Transcriptional profiling of ILC2s from different tissues, however, grouped ILC2s according to their tissue of origin, even in the setting of combined IL-25-, IL-33-receptor-, and TSLP-receptor-deficiency. Single-cell profiling confirmed a tissue-organizing transcriptome and identified ILC2 subsets expressing distinct activating receptors, including the major subset of skin ILC2s, which were activated preferentially by IL-18. Tissue ILC2 subsets were unaltered in number and expression in germ-free mice, suggesting that endogenous, tissue-derived signals drive the maturation of ILC2 subsets by controlling expression of distinct patterns of activating receptors, thus anticipating tissue-specific perturbations occurring later in life

Efficacy and safety of first-line treatment strategies for anaplastic lymphoma kinase-positive non-small cell lung cancer: a Bayesian network meta-analysis.

Background: Targeted therapies have led to significant improvement in the management and prognosis of anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC). We performed a network meta-analysis of frontline treatment options of ALK-positive NSCLC to provide clinical guidance. Methods: PubMed, Embase, ClinicalTrials.gov, and international conference databases were searched to identify relevant trials from inception to June 30, 2021. Phase III randomized controlled trials (RCTs) comparing treatments for patients with ALK-positive advanced NSCLC in the first-line setting were included in a Bayesian network meta-analysis. Eligible studies reported at least one of the following clinical outcomes: progression-free survival (PFS), overall survival (OS), risk of the central nervous system (CNS) progression, adverse events (AEs) of grade (G) 3 or higher (G3 AEs), or serious AEs (SAEs). Hazard ratios (HRs) and CI for primary outcome of PFS and secondary outcome of OS and risk of CNS progression were obtained. A multivariate, consistency model, fixed-effects analysis was used in the network meta-analysis. Data on G3 AEs and SAEs were abstracted and meta-analyzed. Risk of bias (RoB) was assessed using the Cochrane Collaboration's tool. Results: Nine RCTs comprising 2,484 patients were included with seven treatments: alectinib, brigatinib, ceritinib, crizotinib, ensartinib, lorlatinib, and chemotherapy. Compared with chemotherapy, ALK-tyrosine kinase inhibitors (TKIs) significantly prolong PFS and reduced risk of CNS progression except for ceritinib. Lorlatinib appears superior at reducing risk of CNS progression. None of the ALK-TKIs have a significantly prolonged OS as compared with chemotherapy. Lorlatinib increases the risk of G3 AEs as compared with alectinib (odds ratio 4.26 [95% CrI 1.22 to 15.53]), while alectinib caused the fewest G3 AEs. Conclusions: Lorlatinib is associated with the highest PFS benefit and lowest risk of CNS progression benefits for patients with advanced ALK-positive NSCLC, compared with other first-line treatments, but with higher toxicity. The implementation of a newer generation of ALK-TKIs in the first-line treatment of ALK-positive NSCLC into current clinical practice is evolving rapidly

Macroscopic Quantum Phase Interference in Antiferromagnetic Particles

The tunnel splitting in biaxial antiferromagnetic particles is studied with a magnetic field applied along the hard anisotropy axis. We observe the oscillation of tunnel splitting as a function of the magnetic field due to the quantum phase interference of two tunneling paths of opposite windings. The oscillation is similar to the recent experimental result with Fe}$_8$\textrm{\ molecular clusters.}Comment: 8 pages, 2 postscript figures, to appear in J. Phys.: Condes. Matte