ADAPTING PORTAL DECOMPRESSION FOR ELEVATION OF EFFICACY OF PORTOSYSTEMIC SHUNTING OPERATIONS IN PORTAL HYPERTENSION

Purpose: to improve the results of portosystemic shunting surgical interventions using of procedures of adapting portal decompression during preoperation period. Materials and Methods: the results of transjugular intrahepatic portosystemic shunt (TIPS procedure) in 113 patients were analyzed. In 60 cases the procedure of adapting portal decompression during a period 3-5 weeks using selective vasoconstrictor octreotide in complex with non-selective beta-blockers.Results: during the follow-up postoperative period in group of patients who were undergone for adapting portal decompression the restitution of clinical and laboratory data was noticed and does not increase occurrence of hepatic insufficiency in comparison with control group.Summary: using of adapting portal decompression in preoperative period before TIPS procedure in patients with complicated portal hypertension is effective for prophylaxis of making worse of hepatic insufficiency

Assessment of ion kinetic effects in shock-driven inertial confinement fusion implosions using fusion burn imaging

The significance and nature of ion kinetic effects in D3He-filled, shock-driven inertial confinement fusion implosions are assessed through measurements of fusion burn profiles. Over this series of experiments, the ratio of ion-ion mean free path to minimum shell radius (the Knudsen number, NK) was varied from 0.3 to 9 in order to probe hydrodynamic-like to strongly kinetic plasma conditions; as the Knudsen number increased, hydrodynamic models increasingly failed to match measured yields, while an empirically-tuned, first-step model of ion kinetic effects better captured the observed yield trends [Rosenberg et al., Phys. Rev. Lett. 112, 185001 (2014)]. Here, spatially resolved measurements of the fusion burn are used to examine kinetic ion transport effects in greater detail, adding an additional dimension of understanding that goes beyond zero-dimensional integrated quantities to one-dimensional profiles. In agreement with the previous findings, a comparison of measured and simulated burn profiles shows that models including ion transport effects are able to better match the experimental results. In implosions characterized by large Knudsen numbers (NK3), the fusion burn profiles predicted by hydrodynamics simulations that exclude ion mean free path effects are peaked far from the origin, in stark disagreement with the experimentally observed profiles, which are centrally peaked. In contrast, a hydrodynamics simulation that includes a model of ion diffusion is able to qualitatively match the measured profile shapes. Therefore, ion diffusion or diffusion-like processes are identified as a plausible explanation of the observed trends, though further refinement of the models is needed for a more complete and quantitative understanding of ion kinetic effects

Two-Stage Rotational Disordering of a Molecular Crystal Surface: C60

We propose a two-stage mechanism for the rotational surface disordering phase transition of a molecular crystal, as realized in C$_{60}$ fullerite. Our study, based on Monte Carlo simulations, uncovers the existence of a new intermediate regime, between a low temperature ordered $(2 \times 2)$ state, and a high temperature $(1 \times 1)$ disordered phase. In the intermediate regime there is partial disorder, strongest for a subset of particularly frustrated surface molecules. These concepts and calculations provide a coherent understanding of experimental observations, with possible extension to other molecular crystal surfaces.Comment: 4 pages, 2 figure

Morphology of supported polymer electrolyte ultra-thin films: a numerical study

Morphology of polymer electrolytes membranes (PEM), e.g., Nafion, inside PEM fuel cell catalyst layers has significant impact on the electrochemical activity and transport phenomena that determine cell performance. In those regions, Nafion can be found as an ultra-thin film, coating the catalyst and the catalyst support surfaces. The impact of the hydrophilic/hydrophobic character of these surfaces on the structural formation of the films has not been sufficiently explored yet. Here, we report about Molecular Dynamics simulation investigation of the substrate effects on the ionomer ultra-thin film morphology at different hydration levels. We use a mean-field-like model we introduced in previous publications for the interaction of the hydrated Nafion ionomer with a substrate, characterized by a tunable degree of hydrophilicity. We show that the affinity of the substrate with water plays a crucial role in the molecular rearrangement of the ionomer film, resulting in completely different morphologies. Detailed structural description in different regions of the film shows evidences of strongly heterogeneous behavior. A qualitative discussion of the implications of our observations on the PEMFC catalyst layer performance is finally proposed

Statins in unconventional secretion of insulin-degrading enzyme and degradation of the amyloid-β peptide.

Population-based studies demonstrated that statins might decrease the risk of developing Alzheimer's disease (AD). Statins inhibit the 3-hydroxy-3-methyl-glutaryl-coenzyme-A reductase and thereby de novo synthesis of cholesterol. Cell culture and animal studies indicated that cholesterol affects the proteolytic processing of the amyloid precursor protein and the generation of amyloid-β (Aβ). Recently, we have demonstrated that statins can also stimulate the degradation of Aβ. The statin-induced clearance of Aβ could be attributed to increased release of the insulin-degrading enzyme (IDE) via an exosome-related unconventional secretory pathway. Interestingly, this statin-induced secretion of exosome-associated IDE was independent of cellular cholesterol concentrations, but rather caused by impairment of isoprenoid biosynthesis and protein prenylation. We further identified a new hexapeptide sequence in the C-terminal region of IDE, named the SlyX motif that is critically involved in IDE secretion. Taken these findings together, the increased clearance of Aβ by stimulated secretion of IDE might contribute to the protective effects of statins against AD

Performance and Mix Measurements of Indirect Drive Cu-Doped Be Implosions

The ablator couples energy between the driver and fusion fuel in inertial confinement fusion (ICF). Because of its low opacity, high solid density, and material properties, beryllium has long been considered an ideal ablator for ICF ignition experiments at the National Ignition Facility. We report here the first indirect drive Be implosions driven with shaped laser pulses and diagnosed with fusion yield at the OMEGA laser. The results show good performance with an average DD neutron yield of ~2 × 10[superscript 9] at a convergence ratio of R[subscript 0]/R ~ 10 and little impact due to the growth of hydrodynamic instabilities and mix. In addition, the effect of adding an inner liner of W between the Be and DD is demonstrated.United States. Dept. of Energy (Lawrence Livermore National Laboratory Contract DE-AC52-07NA27344

Quality of colonoscopy in an emerging country: A prospective, multicentre study in Russia

Background: The quality of colonoscopy has been related to a higher risk of interval cancer, and this issue has been addressed extensively in developed countries. The aim of our study was to explore the main quality indicators of colonoscopy in a large emerging country. Methods: Consecutive patients referred for colonoscopy in 14 centres were prospectively included between July and October 2014. Before colonoscopy, several clinical and demographic variables were collected. Main quality indicators (i.e. caecal intubation rate, (advanced) adenoma detection rate, rate of adequate cleansing and sedation) were collected. Data were analysed at per patient and per centre level (only for those with at least 100 cases). Factors associated with caecal intubation rate and adenoma detection rate were explored at multivariate analysis. Results: A total of 8829 (males: 35%; mean age: 57 + 14 years) patients were included, with 11 centres enrolling at least 100 patients. Screening (including non-alarm symptoms) accounted for 59% (5188/8829) of the indications. Sedation and split preparation were used in 26% (2294/8829) and 25% (2187/8829) of the patients. Caecal intubation was achieved in 7616 patients (86%), and it was ≥85% in 8/11 (73%) centres. Adenoma detection rate was 18% (1550/8829), and it was higher than 20% in five (45%) centres, whilst it was lower than 10% in four (33%) centres. At multivariate analysis, age (OR: 1.020, 95% CI: 1.015–1.024), male sex (OR: 1.2, 95% CI: 1.1–1.3), alarm symptoms (OR: 1.8, 95% CI: 1.7–2), split preparation (OR: 1.4, 95% CI: 1.2–1.6), caecal intubation rate (OR: 1.6, 95% CI: 1.3–1.9) and withdrawal time measurement (OR: 1.2, 95% CI: 1.6–2.1) were predictors of a higher adenoma detection rate, while adequate preparation (OR: 3.4: 95% CI: 2.9–3.9) and sedation (OR: 1.3; 95% CI: 1.1–1.6) were the strongest predictors of caecal intubation rate. Conclusions: According to our study, there is a substantial intercentre variability in the main quality indicators. Overall, the caecal intubation rate appears to be acceptable in most centres, whilst the overall level of adenoma detection appears low, with less than half of the centres being higher than 20%. Educational and quality assurance programs, including higher rates of sedation and split regimen of preparation, may be necessary to increase the key quality indicators

Core conditions for alpha heating attained in direct-drive inertial confinement fusion

It is shown that direct-drive implosions on the OMEGA laser have achieved core conditions that would lead to significant alpha heating at incident energies available on the National Ignition Facility (NIF) scale. The extrapolation of the experimental results from OMEGA to NIF energy assumes only that the implosion hydrodynamic efficiency is unchanged at higher energies. This approach is independent of the uncertainties in the physical mechanism that degrade implosions on OMEGA, and relies solely on a volumetric scaling of the experimentally observed core conditions. It is estimated that the current best-performing OMEGA implosion [Regan et al., Phys. Rev. Lett. 117, 025001 (2016)10.1103/PhysRevLett.117.025001] extrapolated to a 1.9 MJ laser driver with the same illumination configuration and laser-target coupling would produce 125 kJ of fusion energy with similar levels of alpha heating observed in current highest performing indirect-drive NIF implosions.United States. Department of Energy (DE-FC02-04ER54789)United States. National Nuclear Security Administration (DE-NA0001944

Scintillation Counters for the D0 Muon Upgrade

We present the results of an upgrade to the D0 muon system. Scintillating counters have been added to the existing central D0 muon system to provide rejection for cosmic ray muons and out-of-time background, and to provide additional fast timing information for muons in an upgraded Tevatron. Performance and results from the 1994-1996 Tevatron run are presented.Comment: 30 pages, 25 postscript figure