A Glasgow tipple-transjugular intrahepatic portosystemic shunt insertion prior to Whipple resection

Abdominal surgery performed in patients with significant liver disease and portal hypertension is associated with high mortality rates, with even poorer outcomes associated with complex pancreaticobiliary operations. We report on a patient requiring portal decompression via transjugular intrahepatic portosystemic shunt (TIPS) prior to a pancreaticoduodenectomy. The 49-year-old patient presented with pain, jaundice and weight loss. At ERCP an edematous ampulla was biopsied, revealing high-grade dysplasia within a distal bile duct adenoma. Liver biopsy was performed to investigate portal hypertension, confirming congenital hepatic fibrosis (CHF). A TIPS was performed to enable a pancreaticoduodenectomy. Prophylactic TIPS can be performed for preoperative portal decompression for patients requiring pancreatic resection. A potentially curative resection was performed when abdominal surgery was initially thought impossible. Notably, CHF has been associated with the development of cholangiocarcinoma in only four previous instances, with this case being only the second reported distal bile duct cholangiocarcinoma

Kochen-Specker Sets and Generalized Orthoarguesian Equations

Every set (finite or infinite) of quantum vectors (states) satisfies generalized orthoarguesian equations ($n$OA). We consider two 3-dim Kochen-Specker (KS) sets of vectors and show how each of them should be represented by means of a Hasse diagram---a lattice, an algebra of subspaces of a Hilbert space--that contains rays and planes determined by the vectors so as to satisfy $n$OA. That also shows why they cannot be represented by a special kind of Hasse diagram called a Greechie diagram, as has been erroneously done in the literature. One of the KS sets (Peres') is an example of a lattice in which 6OA pass and 7OA fails, and that closes an open question of whether the 7oa class of lattices properly contains the 6oa class. This result is important because it provides additional evidence that our previously given proof of noa =< (n+1)oa can be extended to proper inclusion noa < (n+1)oa and that nOA form an infinite sequence of successively stronger equations.Comment: 16 pages and 5 figure

Defining the molecular pathology of pancreatic body and tail adenocarcinom

Background: Pancreatic ductal adenocarcinoma (PDAC) remains a dismal disease, with very little improvement in survival over the past 50 years. Recent large-scale genomic studies have improved understanding of the genomic and transcriptomic landscape of the disease, yet very little is known about molecular heterogeneity according to tumour location in the pancreas; body and tail PDACs especially tend to have a significantly worse prognosis. The aim was to investigate the molecular differences between PDAC of the head and those of the body and tail of the pancreas. Methods: Detailed correlative analysis of clinicopathological variables, including tumour location, genomic and transcriptomic data, was performed using the Australian Pancreatic Cancer Genome Initiative (APGI) cohort, part of the International Cancer Genome Consortium study. Results: Clinicopathological data were available for 518 patients recruited to the APGI, of whom 421 underwent genomic analyses; 179 of these patients underwent whole-genome and 96 RNA sequencing. Patients with tumours of the body and tail had significantly worse survival than those with pancreatic head tumours (12·1 versus 22·0 months; P = 0·001). Location in the body and tail was associated with the squamous subtype of PDAC. Body and tail PDACs enriched for gene programmes involved in tumour invasion and epithelial-to-mesenchymal transition, as well as features of poor antitumour immune response. Whether this is due to a molecular predisposition from the outset, or reflects a later time point on the tumour molecular clock, requires further investigation using well designed prospective studies in pancreatic cancer. Conclusion: PDACs of the body and tail demonstrate aggressive tumour biology that may explain worse clinical outcomes

Western oceanus procellarum as seen by c1xs on chandrayaan-1

We present the analysis of an X-ray fluorescence (XRF) observation of the western part of Oceanus Procellarum on the Moon’s nearside made by the Chandrayaan-1 X-ray Spectrometer on 10th February 2009. Through forward modelling of the X-ray spectra, we provide estimates of the MgO/SiO2 and Al2O3/SiO2 ratios for seven regions along the flare’s ground track. These results are combined with FeO and TiO2 contents derived from Clementine multispectral reflectance data in order to investigate the compositional diversity of this region of the Moon. The ground track observed consists mainly of low-Ti basaltic units, and the XRF data are largely consistent with this expectation. However, we obtain higher Al2O3/SiO2 ratios for these units than for most basalts in the Apollo sample collection. The widest compositional variation between the different lava flows is in wt% FeO content. A footprint that occurs in a predominantly highland region, immediately to the north of Oceanus Procellarum, has a composition that is consistent with mixing between low-Ti mare basaltic and more feldspathic regoliths. In contrast to some previous studies, we find no evidence for systematic differences in surface composition, as determined through X-ray and gamma-ray spectroscopy techniques

PRECISION-Panc: the next generation therapeutic development platform for pancreatic cancer

No abstract available

Repeatability and reproducibility of multiparametric magnetic resonance imaging of the liver

As the burden of liver disease reaches epidemic levels, there is a high unmet medical need to develop robust, accurate and reproducible non-invasive methods to quantify liver tissue characteristics for use in clinical development and ultimately in clinical practice. This prospective cross-sectional study systematically examines the repeatability and reproducibility of iron-corrected T1 (cT1), T2*, and hepatic proton density fat fraction (PDFF) quantification with multiparametric MRI across different field strengths, scanner manufacturers and models. 61 adult participants with mixed liver disease aetiology and those without any history of liver disease underwent multiparametric MRI on combinations of 5 scanner models from two manufacturers (Siemens and Philips) at different field strengths (1.5T and 3T). We report high repeatability and reproducibility across different field strengths, manufacturers, and scanner models in standardized cT1 (repeatability CoV: 1.7%, bias -7.5ms, 95% LoA of -53.6 ms to 38.5 ms; reproducibility CoV 3.3%, bias 6.5 ms, 95% LoA of -76.3 to 89.2 ms) and T2* (repeatability CoV: 5.5%, bias -0.18 ms, 95% LoA -5.41 to 5.05 ms; reproducibility CoV 6.6%, bias -1.7 ms, 95% LoA -6.61 to 3.15 ms) in human measurements. PDFF repeatability (0.8%) and reproducibility (0.75%) coefficients showed high precision of this metric. Similar precision was observed in phantom measurements. Inspection of the ICC model indicated that most of the variance in cT1 could be accounted for by study participants (ICC = 0.91), with minimal contribution from technical differences. We demonstrate that multiparametric MRI is a non-invasive, repeatable and reproducible method for quantifying liver tissue characteristics across manufacturers (Philips and Siemens) and field strengths (1.5T and 3T)

Solution of coupled vertex and propagator Dyson-Schwinger equations in the scalar Munczek-Nemirovsky model

In a scalar $\phi^2\chi$ model, we exactly solve the vertex and $\phi$ propagator Dyson-Schwinger equations under the assumption of a spatially constant (Munczek-Nemirovsky) propagator for the $\chi$ field. Various truncation schemes are also considered.Comment: 7 pages,4 figures, minor changes, reference added for published versio

Anthropogenic Space Weather

Anthropogenic effects on the space environment started in the late 19th century and reached their peak in the 1960s when high-altitude nuclear explosions were carried out by the USA and the Soviet Union. These explosions created artificial radiation belts near Earth that resulted in major damages to several satellites. Another, unexpected impact of the high-altitude nuclear tests was the electromagnetic pulse (EMP) that can have devastating effects over a large geographic area (as large as the continental United States). Other anthropogenic impacts on the space environment include chemical release ex- periments, high-frequency wave heating of the ionosphere and the interaction of VLF waves with the radiation belts. This paper reviews the fundamental physical process behind these phenomena and discusses the observations of their impacts.Comment: 71 pages, 35 figure