Unclassified autoimmune pancreatitis mimicking pancreatic cancer

A 24-year-old black male presented with a 1-week obstructive jaundice and intermittent abdominal pain, with no significant weight loss and an unsuspicious abdominal exam. Blood chemistry showed a cholestatic pattern but a complete immunological and tumoral panel (anti-smooth muscle antibody, anti-mitochondrial antibody, anti-nuclear antibody, anti-neutrophil cytoplasmic antibody, anti-Smith, anti-double-stranded-DNA antibody (anti-dsDNA), complement C3/C4, carcinoembryonic antigen, CA 19-9 and IgG4) were all within normal limits. Abdominal ultrasound revealed dilatation of the intra and extra-hepatic bile ducts. CT scan showed an abnormal dilatation of the distal bile duct but no focal enlargement of the head of the pancreas. Endoscopic ultrasound suggested an inflammatory process but the magnetic resonance cholangio-pancreatography favored a neoplastic obstruction of the distal common bile duct. Fine-needle aspiration cytology was insufficient for definitive diagnosis and the patient underwent major surgery. Follow-up with mild exocrine pancreatic insufficiency treated with enzyme replacement.info:eu-repo/semantics/publishedVersio

Outsourcing: guidelines for a structured approach

Outsourcing is a management approach by which an organization delegates some noncore functions to specialized and ef®cient service providers. In the era of ªglobal marketº and ªe-economyº, outsourcing is one of the main pillars of the new way to conceive the relationships among companies. Despite outsourcing large diffusion, huge business cases and big deals of documentation available on network or press, there is no structured procedure able to support the govern of the evolution of a generic outsourcing process. In accordance with the principles of total quality management, this paper describes a proposal of a new approach for managing outsourcing processes. The model, which can be easily adapted to different application ®elds, has been conceived with the main aim of managing strategic decisions, economic factors and human resources. The approach is supported by different decision and analysis tools, such as benchmarking techniques, multiple criteria decision aiding (MCDA) methods, cost analysis, and other process-planning methodologies. An application of the method to a real case is also provide

Editorial: Anticoagulation in cardiovascular diseases: evolving role, unmet needs, and grey areas

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Automatic inspection and analysis of digital waveform images by means of convolutional neural networks

AbstractAnalyzing seismic data to get information about earthquakes has always been a major task for seismologists and, more in general, for geophysicists. Recently, thanks to the technological development of observation systems, more and more data are available to perform such tasks. However, this data "grow up" makes "human possibility" of data processing more complex in terms of required efforts and time demanding. That is why new technological approaches such as artificial intelligence are becoming very popular and more and more exploited. In this paper, we explore the possibility of interpreting seismic waveform segments by means of pre-trained deep learning. More specifically, we apply convolutional networks to seismological waveforms recorded at local or regional distances without any pre-elaboration or filtering. We show that such an approach can be very successful in determining if an earthquake is "included" in the seismic wave image and in estimating the distance between the earthquake epicenter and the recording station

Cooperative synaptic and intrinsic plasticity in a disynaptic limbic circuit drive stress-induced anhedonia and passive coping in mice

Stress promotes negative affective states, which include anhedonia and passive coping. While these features are in part mediated by neuroadaptations in brain reward circuitry, a comprehensive framework of how stress-induced negative affect may be encoded within key nodes of this circuit is lacking. Here, we show in a mouse model for stress-induced anhedonia and passive coping that these phenomena are associated with increased synaptic strength of ventral hippocampus (VH) excitatory synapses onto D1 medium spiny neurons (D1-MSNs) in the nucleus accumbens medial shell (NAcmSh), and with lateral hypothalamus (LH)-projecting D1-MSN hyperexcitability mediated by decreased inwardly rectifying potassium channel (IRK) function. Stress-induced negative affective states are prevented by depotentiation of VH to NAcmSh synapses, restoring Kir2.1 function in D1R-MSNs, or disrupting co-participation of these synaptic and intrinsic adaptations in D1-MSNs. In conclusion, our data provide strong evidence for a disynaptic pathway controlling maladaptive emotional behavior

An alternative 3D inversion method for magnetic anomalies with depth resolution

This paper presents a new method to invert magnetic anomaly data in a variety of non-complex contexts when a priori information about the sources is not available. The region containing magnetic sources is discretized into a set of homogeneously magnetized rectangular prisms, polarized along a common direction. The magnetization distribution is calculated by solving an underdetermined linear system, and is accomplished through the simultaneous minimization of the norm of the solution and the misfit between the observed and the calculated field. Our algorithm makes use of a dipolar approximation to compute the magnetic field of the rectangular blocks. We show how this approximation, in conjunction with other correction factors, presents numerous advantages in terms of computing speed and depth resolution, and does not affect significantly the success of the inversion. The algorithm is tested on both synthetic and real magnetic datasets

BodiesGenerator - A new GaMField integrated tool to improve potential field data generation

GaMField is a freely available integrated system tool, released in 2011 and upgraded in 2018, able to construct and visualize subsurface 3-D sources and to compute their gravimetric and magnetic effects. Since its first release, scientists and users worldwide have provided feedback and requested to implement new features. In this paper I describe a new tool named "BodiesGenerator". This tool is an add-on to GaMField package which provides the possibility to quickly generate more articulate geometry bodies

The future of translational biomedical research at Nazarbayev University

The ultimate goal of fundamental biomedical research is to decipher mechanisms underlying the impairment of molecules, cells, tissues, and organs and subsequent dysfunction of the whole human body. Knowledge of these mechanisms helps discover and develop new approaches in the diagnosis, prevention and treatment of various diseases. Translational biomedical research enables the application of basic scientific discoveries to diagnostics, patient care and clinical practice. Thus, translational biomedical research is a link between fundamental research, clinical research and clinical practice. Transfer of discoveries from the bench to the bedside is a very complex and time consuming process that includes pre-clinical studies and several phases of clinical trials, along with the development of clinical guidelines and protocols, and the eventual implementation of best clinical practices