Cost-effectiveness of diagnostic laparoscopy for assessing resectability in pancreatic and periampullary cancer.

Surgical resection is the only curative treatment for pancreatic and periampullary cancer, but many patients undergo unnecessary laparotomy because tumours can be understaged by computerised tomography (CT). A recent Cochrane review found diagnostic laparoscopy can decrease unnecessary laparotomy. We compared the cost-effectiveness of diagnostic laparoscopy prior to laparotomy versus direct laparotomy in patients with pancreatic and periampullary cancer with resectable disease based on CT scanning

Cost-Effectiveness Analysis of Endoscopic Ultrasound versus Magnetic Resonance Cholangiopancreatography in Patients with Suspected Common Bile Duct Stones.

Patients with suspected common bile duct (CBD) stones are often diagnosed using endoscopic retrograde cholangiopancreatography (ERCP), an invasive procedure with risk of significant complications. Using endoscopic ultrasound (EUS) or Magnetic Resonance CholangioPancreatography (MRCP) first to detect CBD stones can reduce the risk of unnecessary procedures, cut complications and may save costs

GEOMETRY AND CHARGE-DISTRIBUTION OF H-CENTERS IN THE FLUORITE STRUCTURE

The analysis of experimental optical and spin-resonance data for the H centre gives a consistent picture of the local geometry and one-electron wavefunctions. One of the two ions in the F2- molecular ion remains very close to the perfect lattice site the other is at a distance close to that found in other F2- centres. This analysis is confirmed by atomistic calculations using the HADES code. The results are used to give a preliminary analysis of the self-trapped exciton data

Symmetries of degenerate center singularities of plane vector fields

Let $D$ be a closed unit $2$-disk on the plane centered at the origin $O$, and $F$ be a smooth vector field such that $O$ is a unique singular point of $F$ and all other orbits of $F$ are simple closed curves wrapping once around $O$. Thus topologically $O$ is a "center" singularity. Let also $\mathrm{Diff}(F)$ be the group of all diffeomorphisms of $D$ which preserve orientation and orbits of $F$. In arXiv:0907.0359 the author described the homotopy type of $\mathrm{Diff}(F)$ under assumption that the $1$-jet of $F$ at $O$ is non-degenerate. In this paper degenerate case is considered. Under additional "non-degeneracy assumptions" on $F$ the path components of $\mathrm{Diff}(F)$ with respect to distinct weak topologies are described.Comment: 21 page, 3 figure

The impact of Mean Time Between Disasters on inventory pre-positioning strategy

Purpose - This paper addresses the impact of Mean Time Between Disasters (MTBD) to inventory pre-positioning strategy of medical supplies prior to a sudden-onset disaster

Stretch‐Induced Increase in Cardiac Contractility Is Independent of Myocyte Ca\u3csup\u3e2+\u3c/sup\u3e While Block of Stretch Channels by Streptomycin Improves Contractility After Ischemic Stunning

Stretching the cardiac left ventricle (LV) enhances contractility but its effect on myoplasmic [Ca2+] is controversial. We measured LV pressure (LVP) and [Ca2+] as a function of intra-LV stretch in guinea pig intact hearts before and after 15 min global stunning ± perfusion with streptomycin (STM), a stretch activated channel blocker. LV wall [Ca2+] was measured by indo-1 fluorescence and LVP by a saline-filled latex balloon inflated in 50 μL steps to stretch the LV. We implemented a mathematical model to interpret crossbridge dynamics and myofilament Ca2+ responsiveness from the instantaneous relationship between [Ca2+] and LVP ± stretching. We found that: (1) stretch enhanced LVP but not [Ca2+] before and after stunning in either control (CON) and STM groups, (2) after stunning [Ca2+] increased in both groups although higher in STM versus CON (56% vs. 39%), (3) STM-enhanced LVP after stunning compared to CON (98% vs. 76% of prestunning values), and (4) stretch-induced effects on LVP were independent of [Ca2+] before or after stunning in both groups. Mathematical modeling suggested: (1) cooperativity in cross-bridge kinetics and myofilament Ca2+ handling is reduced after stunning in the unstretched heart, (2) stunning results in depressed myofilament Ca2+ sensitivity in the presence of attached cross-bridges regardless of stretch, and (3) the initial mechanism responsible for increased contractility during stretch may be enhanced formation of cross-bridges. Thus stretch-induced enhancement of contractility is not due to increased [Ca2+], whereas enhanced contractility after stunning in STM versus CON hearts results from improved Ca2+ handling and/or enhanced actinomyosin cross-bridge cycling

Pengembangan Alat Ukur Keterampilan Dasar Bermain Softball

Developing Instruments to Measure Basic Softball Skills. This studyaims to develop instruments to measure basic softball skills and to test their validityand reliability. This study shows that (1) the result of overhand throwingmeasurement test is (rxx'= 0.704), (2) the sidearm throwing is rxx = 0.604, and (3) thestriking skill is rxx = 0.050. It can be concluded that the instrument to measure thethrowing-striking basic skill has satisfied the validity and reliability criteria, and theone to measure the striking basic skill is valid although its reliability is low. It issuggested that (1) a variety of instruments should be developed to measure avariety of skills, and (2) all practitioners are expected to develop othermeasurement instruments not covered in this study

Renal Cell Carcinoma Presenting as Metastasis to Scrotum and Spermatic Cord

Unusual site metastasis as presenting complaint of renal cell carcinoma (RCC) has been reported previously in literature. RCC is a notorious tumor with unpredictable behavior. We present a case of RCC who presented with scrotal mass and on subsequent investigation was found to have metastasis to scrotum and spermatic cord. Both testes were normal with no evidence of metastasis

Constraining Proton Lifetime in SO(10) with Stabilized Doublet-Triplet Splitting

We present a class of realistic unified models based on supersymmetric SO(10) wherein issues related to natural doublet-triplet (DT) splitting are fully resolved. Using a minimal set of low dimensional Higgs fields which includes a single adjoint, we show that the Dimopoulos--Wilzcek mechanism for DT splitting can be made stable in the presence of all higher order operators without having pseudo-Goldstone bosons and flat directions. The \mu term of order TeV is found to be naturally induced. A Z_2-assisted anomalous U(1)_A gauge symmetry plays a crucial role in achieving these results. The threshold corrections to alpha_3(M_Z), somewhat surprisingly, are found to be controlled by only a few effective parameters. This leads to a very predictive scenario for proton decay. As a novel feature, we find an interesting correlation between the d=6 (p\to e^+\pi^0) and d=5 (p\to \nu-bar K+) decay amplitudes which allows us to derive a constrained upper limit on the inverse rate of the e^+\pi^0 mode. Our results show that both modes should be observed with an improvement in the current sensitivity by about a factor of five to ten.Comment: 21 pages LaTeX, 2 figures, Few explanatory sentences and three new references added, minor typos corrected

Compensation of atmospheric CO2 buildup through engineered chemical shrinkage

Retrieval of background carbon dioxide into regional chemical extractors would counter anthropogenic inputs in a manner friendly to established industries. We demonstrate via atmospheric transport/scaling calculations that for idealized flat removal units, global coverage could be less than two hundred thousand square kilometers. The disrupted area drops to a small fraction of this with engineering into the vertical to bypass laminarity. Fence structures and artificial roughness elements can both be conceived. Sink thermodynamics are analyzed by taking calcium hydroxide as a sample reactant. Energy costs could be minimized at near the endothermicity of binding reversal. In the calcium case the value is 25 kcal mole-1, as against a fuel carbon content of 150 in the same units. Aqueous kinetics are less than favorable for the hydroxide, but misting could counteract slow liquid phase transfer. Properties of superior scrubbers are outlined