Endoscopic sphincterotomy for delaying choLecystectomy in mild acute biliarY pancreatitis (EMILY study): Protocol of a multicentre randomised clinical trial

Introduction: According to the literature, early cholecystectomy is necessary to avoid complications related to gallstones after an initial episode of acute biliary pancreatitis (ABP). A randomised, controlled multicentre trial (the PONCHO trial) revealed that in the case of gallstone-induced pancreatitis, early cholecystectomy was safe in patients with mild gallstone pancreatitis and reduced the risk of recurrent gallstone-related complications, as compared with interval cholecystectomy. We hypothesise that carrying out a sphincterotomy (ES) allows us to delay cholecystectomy, thus making it logistically easier to perform and potentially increasing the efficacy and safety of the procedure. Methods/Design: EMILY is a prospective, randomised, controlled multicentre trial. All patients with mild ABP, who underwent ES during the index admission or in the medical history will be informed to take part in EMILY study. The patients will be randomised into two groups: (1) early cholecystectomy (within 6 days after discharge) and (2) patients with delayed (interval) cholecystectomy (between 45 and 60 days after discharge). During a 12-month period, 93 patients will be enrolled from participating clinics. The primary endpoint is a composite endpoint of mortality and recurrent acute biliary events (that is, recurrent ABP, acute cholecystitis, uncomplicated biliary colic and cholangitis). The secondary endpoints are organ failure, biliary leakage, technical difficulty of the cholecystectomy, surgical and other complications

ATR-FTIR study of the interaction of CO2 with bacterial cellulose-based membranes

Bacterial cellulose (BC) was used as an active material for fabrication of the membrane for CO2 capture. The BC-membrane is further modified with silk fibroin protein and ZnO nanoparticles in order to increase the number of sites that may bind CO2. The interaction of the CO2 with the membranes was investigated by means of ATR-FTIR spectroscopy. The argon purged membranes were used as the control samples. After pressurizing the membranes in CO2 at 3 bar, FTIR spectra were recorded and compared to the spectra of the controls. The interaction of the membrane materials with CO2 were studied by examining two regions of the spectra: 740-610 cm (1) (bending vibrations of CO2) and 2400- 2320 cm (1) (asymmetric stretching vibrations of CO2). The envelope of the bending mode peak in 740-610 cm (1) region is resolved into particular peaks and the appearance of the additional line at 654 cm (1) suggested that the absorption bands of CO2 alters because of the Lewis acid- base type of interaction with membranes. The changes in the region of asymmetric stretching vibrations of CO2 were even more pronounced after pressurization. The presence of the number of different sites (active groups) for the CO2 adsorption reflected in the appearance of several additional asymmetric stretching peaks. Also, due to the entrapment of the CO2 in the membrane, a typical C=O asymmetric stretching vibration line at similar to 2340 cm (1) is shifted towards lower frequencies. The analysis of the results suggested that there is a strong interaction of CO2 with BC membrane, which is additionally improved by its modification with silk fibroin and ZnO nanoparticles. From the results of CO2 permeation experiment, the basic BC membrane, silk fibroin- modified BC membrane and ZnO nanoparticles- modified BC membrane exhibited the CO2 permeability of 2.73, 2.69 and 2.66 Barrer, respectively. (C) 2017 Elsevier B.V. All rights reserved

Technical and safety aspects at the demolition by blasting works of a cooling tower with a high of 72.00 m

From the point of view of demolition, one of the most interesting construction categories is the hyperboloid shape cooling towers. These seemingly fragile structures support at the base on a reinforced concrete belt and pillars. An important element to be taken into account when choosing the demolition solution is the slope of the tower. As this ratio between tower height and base diameter is greater (4-5), the easier is the demolition of the tower by overturning, respectively by moving the centre of gravity of the construction away from its base. In the case of the cooling tower described in this article, its height was 72.00 m and the base diameter of 52.00 m - the slope ratio index being less than 2, which was why the chosen solution of demolition was that of partial lateral collapse followed by a total crash of the tower on its position. The article describes how to perform the demolition of the cooling tower, the technical and safety solutions adopted for its successful collapse in the intended direction, in very sensitive location conditions regarding the constructions and installations in its immediate vicinity

Technical and safety aspects at the demolition by blasting works of a cooling tower with a high of 72.00 m

From the point of view of demolition, one of the most interesting construction categories is the hyperboloid shape cooling towers. These seemingly fragile structures support at the base on a reinforced concrete belt and pillars. An important element to be taken into account when choosing the demolition solution is the slope of the tower. As this ratio between tower height and base diameter is greater (4-5), the easier is the demolition of the tower by overturning, respectively by moving the centre of gravity of the construction away from its base. In the case of the cooling tower described in this article, its height was 72.00 m and the base diameter of 52.00 m - the slope ratio index being less than 2, which was why the chosen solution of demolition was that of partial lateral collapse followed by a total crash of the tower on its position. The article describes how to perform the demolition of the cooling tower, the technical and safety solutions adopted for its successful collapse in the intended direction, in very sensitive location conditions regarding the constructions and installations in its immediate vicinity

Assessing the Digital Transformation in Two Banks: Case Study in Hungary

The influence of Industry 4.0 and the trend of economic globalization has led to growing competition among enterprises in all business sectors, then compelled them to seek new ways to create competitive advantages and sustainable development. Presently, digital transformation plays a critical role across many countries and in all sectors including the agriculture and the rural development. New players have been increasing in the banking sector in which incumbent banks are competing with other traditional banks, fintech, and big tech. Nevertheless, not all banks are successful in digital transformation. By analyzing the practices of two banks in Hungary, this study aims to highlight the digital transformation process which happens at the leading banks and compare and contrast in all dimensions at these transformations. The study results confirm that digitalization in incumbent banks is still at a low and medium level. Moreover, the study outcomes suggest that strategic planning and human resource play key roles in implementing Digital transformation. In addition, digital transformation at traditional banks is not only related to internal; external stakeholders can be drivers or barriers to this process. Government policy and support are important factors to improve the digitalization process in Hungary related to financial services for the agriculture. Based on the results obtained, the authors aim to supplement the lack of research on digital transformation in Hungary

High Resolution Digital Tissue Image Processing using Texture Image Databases

Part 8: Signal Processing in MedicineInternational audienceTexture based image databases integrated with effective searching algorithms are useful solutions for many scientific and industrial purposes. Medical image processing of high resolution tissue images is one of the areas, where the cell/tissue classification can rely on such solutions. In this paper we are describing the design, development and usage of a specialized medical texture image database. Our primary aim with this texture database is to provide Digital Imaging and Communication in Medicine (DICOM) compatible texture image dataset for cell, gland and epithelium classification in histology. Our solution includes a Picture Archiving and Communication System (PACS) subsystem, which is mainly provide a communication interface (texture image searching and retrieval) and enables image processing algorithms to work more effectively on high resolution tissue slide images. In this paper we describe how our Local Binary Pattern (LBP) based algorithm benefits texture database usage when solving image processing problems in histology and histopathology

Development of Population Tariffs for the ICECAP-A Instrument for Hungary and their Comparison With the UK Tariffs

Objectives: The ICEpop CAPability measure for Adults (ICECAP-A) was developed to assess the capability well-being of adults for use in economic evaluations. Currently, ICECAP-A tariffs are available only for the UK population. The objectives of this study were to develop a Hungarian tariff set for the ICECAP-A instrument and to explore intercountry differences between the Hungarian and the UK value sets. Methods: A survey was conducted by computer-assisted personal interviews on a sample representative of the Hungarian adult population (N = 1000) to elicit their preferences regarding ICECAP-A attributes with the use of a best-worst scaling choice task. A latent class multinomial logit model with continuous variance scale was used to estimate the weights for each of the 4 capability levels of all 5 ICECAP-A attributes, namely, attachment, stability, achievement, enjoyment, and autonomy. Results: The model identified 2 preference classes with approximately equal share. The first class had a stronger relative preference for autonomy and achievement, whereas the second class had a strong preference for attachment. Multivariate analysis of the classes revealed that women, pensioners, people who are married or living in a partnership, and people with poorer health status are characteristics associated with the latter class membership (preference for attachment). Population tariffs were estimated from the model. Overall, attachment was found to be the most important attribute, followed by stability, enjoyment, achievement, and autonomy. Conclusions: Hungarian tariffs are largely consistent with those found for the United Kingdom; nevertheless, autonomy seems to be less important in Hungary compared with the United Kingdom

Cardioprotective mechanisms of Prunus cerasus (sour cherry) seed extract against ischemia-reperfusion-induced damage in isolated rat hearts.

The effects of kernel extract obtained from sour cherry (Prunus cerasus) seed on the postischemic cardiac recovery were studied in isolated working rat hearts. Rats were treated with various daily doses of the extract for 14 days, and hearts were then isolated and subjected to 30 min of global ischemia followed by 120 min of reperfusion. The incidence of ventricular fibrillation (VF) and tachycardia (VT) fell from their control values of 92% and 100% to 50% (not significant) and 58% (not significant), 17% (P<0.05), and 25% (P<0.05) with the doses of 10 mg/kg and 30 mg/kg of the extract, respectively. Lower concentrations of the extract (1 and 5 mg/kg) failed to significantly reduce the incidence of VF and VT during reperfusion. Sour cherry seed kernel extract (10 and 30 mg/kg) significantly improved the postischemic recovery of cardiac function (coronary flow, aortic flow, and left ventricular developed pressure) during reperfusion. We have also demonstrated that the extract-induced protection in cardiac function significantly reflected in a reduction of infarct size. Immunohistochemistry indicates that a reduction in caspase-3 activity and apoptotic cells by the extract, beside other potential action mechanisms of proanthocyanidin, trans-resveratrol, and flavonoid components of the extract, could be responsible for the cardioprotection in ischemic-reperfused myocardium