EUS-Guided Biliary Drainage

The echoendoscopic biliary drainage is an option to treat obstructive jaundices when ERCP drainage fails. These procedures compose alternative methods to the side of surgery and percutaneous transhepatic biliary drainage, and it was only possible by the continuous development and improvement of echoendoscopes and accessories. The development of linear setorial array echoendoscopes in early 1990 brought a new approach to diagnostic and therapeutic dimenion on echoendoscopy capabilities, opening the possibility to perform punction over direct ultrasonographic view. Despite of the high success rate and low morbidity of biliary drainage obtained by ERCP, difficulty could be found at the presence of stent tumor ingrown, tumor gut compression, periampulary diverticula, and anatomic variation. The echoendoscopic technique starts performing punction and contrast of the left biliary tree. When performed from gastric wall, the access is made through hepatic segment III. From duodenum, direct common bile duct punction. Dilatation is required before stent introduction, and a plastic or metallic stent is introduced. This phrase should be replaced by: diathermic dilatation of the puncturing tract is required using a 6F cystostome. The technical success of hepaticogastrostomy is near 98%, and complications are present in 36%: pneumoperitoneum, choleperitoneum, infection, and stent disfunction. To prevent bile leakage, we have used the 2 stent techniques, the first stent introduced was a long uncovered metallic stent (8 or 10 cm), and inside this first stent a second fully covered stent of 6 cm was delivered to bridge the bile duct and the stomach. Choledochoduodenostomy overall success rate is 92% and described complications include, in frequency order, pneumoperitoneum and focal bile peritonitis, present in 19%. By the last 10 years, the technique was especially performed in reference centers, by ERCP experienced groups, and this seems to be a general guideline to safer procedure execution

Assessment of adoption and utilisation of superior rice germplasm by smallholder farmers in four rice producing zones of Nigeria

Conservation and sustainable use of plant genetic resources is essential to the sustainable development of agricultural production and rural in production zones in Nigeria. This study, therefore investigated the utilisation of recently released superior rice germplasm among smallholder farmers in Nigeria. A post- crop varietal release impact assessment was conducted in Oyo, Ekiti, Kwara and Ebonyi states of Nigeria in 2019. Structured questionnaires were administered to 120 farmers using a simple random sampling technique. Result from the study revealed that ricefarmers are mainly males, middle aged, married, with some form of education. They have medium (3-6 household member) household size with longer years of farming experiences. Inadequate capital and limited credit facilities, plant disease, birds and insect infestation are the major constraints encountered by the farmers. Result of the correlation analysis shows that there was no significant relationship between sources of planting materials and frequently planted varieties (r = 0.100 and p = 0.786). However, there was significant relationship between production  constraints and frequently planted varieties (r = 0.010 and p = 0.648). It is recommended that more channels of credit facilities should be provided to rice farmers by governments at various levels to improve their level productivity. Keywords: Rice, adoption, genetic resources, utilisation, smallholder farmer

Existence of Monetary Steady States in a Matching Model: Indivisible Money

Existence of a monetary steady state is established for a random matching model with divisible goods, indivisible money, and take-it-or-leave-it offers by consumers. There is no restriction on individual money holdings. The background environment is that in papers by Shi and by Trejos and Wright. The monetary steady state shown to exist has nice properties: the value function, defined on money holdings, is increasing and strictly concave, and the measure over money holdings has full support.

Spin-3/2 Nucleon and Delta Baryons in Lattice QCD

We present first results for masses of spin-3/2 N and Delta baryons in lattice QCD using Fat-Link Irrelevant Clover (FLIC) fermions. Spin-3/2 interpolating fields providing overlap with both spin-3/2 and spin-1/2 states are considered. In the isospin-1/2 sector, we observe, after appropriate spin and parity projection, a strong signal for the J^P=3/2^- state together with a weak but discernible signal for the 3/2^+ state with a mass splitting near that observed experimentally. We also find good agreement between the 1/2^+/- masses and earlier nucleon mass simulations with the standard spin-1/2 interpolating field. For the isospin-3/2 Delta states, clear mass splittings are observed between the various 1/2^+/- and 3/2^+/- channels, with the calculated level orderings in good agreement with those observed empirically.Comment: 17 pages, 8 figures, 2 table

MicroRNA15a modulates expression of the cell-cycle regulator Cdc25A and affects hepatic cystogenesis in a rat model of polycystic kidney disease

Hyperproliferation of bile duct epithelial cells due to cell-cycle dysregulation is a key feature of cystogenesis in polycystic liver diseases (PCLDs). Recent evidence suggests a regulatory role for microRNAs (miRNAs) in a variety of biological processes, including cell proliferation. We therefore hypothesized that miRNAs may be involved in the regulation of selected components of the cell cycle and might contribute to hepatic cystogenesis. We found that the cholangiocyte cell line PCK-CCL, which is derived from the PCK rat, a model of autosomal recessive polycystic kidney disease (ARPKD), displayed global changes in miRNA expression compared with normal rat cholangiocytes (NRCs). More specific analysis revealed decreased levels of 1 miRNA, miR15a, both in PCK-CCL cells and in liver tissue from PCK rats and patients with a PCLD. The decrease in miR15a expression was associated with upregulation of its target, the cell-cycle regulator cell division cycle 25A (Cdc25A). Overexpression of miR15a in PCK-CCL cells decreased Cdc25A levels, inhibited cell proliferation, and reduced cyst growth. In contrast, suppression of miR15a in NRCs accelerated cell proliferation, increased Cdc25A expression, and promoted cyst growth. Taken together, these results suggest that suppression of miR15a contributes to hepatic cystogenesis through dysregulation of Cdc25A

Discrimination of gamma rays due to inelastic neutron scattering in AGATA

Possibilities of discriminating neutrons and gamma rays in the AGATA gamma-ray tracking spectrometer have been investigated with the aim of reducing the background due to inelastic scattering of neutrons in the high-purity germanium crystals. This background may become a serious problem especially in experiments with neutron-rich radioactive ion beams. Simulations using the Geant4 toolkit and a tracking program based on the forward tracking algorithm were carried out by emitting neutrons and gamma rays from the center of AGATA. Three different methods were developed and tested in order to find 'fingerprints' of the neutron interaction points in the detectors. In a simulation with simultaneous emission of six neutrons with energies in the range 1-5 MeV and ten gamma rays with energies between 150 and 1450 keV, the peak-to-background ratio at a gamma-ray energy of 1.0 MeV was improved by a factor of 2.4 after neutron rejection with a reduction of the photopeak efficiency at 1.0 MeV of only a factor of 1.25.Comment: Accepted for publication in Nuclear Instruments and Methods in Physics Research, A, 26 May 2009; 13 pages, 5 tables, 12 figure

Excited Baryons in Lattice QCD

We present first results for the masses of positive and negative parity excited baryons calculated in lattice QCD using an O(a^2)-improved gluon action and a fat-link irrelevant clover (FLIC) fermion action in which only the irrelevant operators are constructed with APE-smeared links. The results are in agreement with earlier calculations of N^* resonances using improved actions and exhibit a clear mass splitting between the nucleon and its chiral partner. An correlation matrix analysis reveals two low-lying J^P=(1/2)^- states with a small mass splitting. The study of different Lambda interpolating fields suggests a similar splitting between the lowest two Lambda1/2^- octet states. However, the empirical mass suppression of the Lambda^*(1405) is not evident in these quenched QCD simulations, suggesting a potentially important role for the meson cloud of the Lambda^*(1405) and/or a need for more exotic interpolating fields.Comment: Correlation matrix analysis performed. Increased to 400 configurations. 22 pages, 13 figures, 15 table

Developing a core outcome set for fistulising perianal Crohn's disease

OBJECTIVE: Lack of standardised outcomes hampers effective analysis and comparison of data when comparing treatments in fistulising perianal Crohn's disease (pCD). Development of a standardised set of outcomes would resolve these issues. This study provides the definitive core outcome set (COS) for fistulising pCD. DESIGN: Candidate outcomes were generated through a systematic review and patient interviews. Consensus was established via a three-round Delphi process using a 9-point Likert scale based on how important they felt it was in determining treatment success culminating in a final consensus meeting. Stakeholders were recruited nationally and grouped into three panels (surgeons and radiologists, gastroenterologists and IBD specialist nurses, and patients). Participants received feedback fromtheir panel(in the second round) andall participants(in the third round) to allow refinement of their scores. RESULTS: A total of 295 outcomes were identified from systematic reviews and interviews that were categorised into 92 domains. 187 stakeholders (response rate 78.5%) prioritised 49 outcomes through a three-round Delphi study.The final consensus meeting of 41 experts and patients generated agreement on an eight domain COS. The COS comprised three patient-reported outcome domains (quality of life, incontinence and a combined score of patient priorities) and five clinician-reported outcome domains (perianal disease activity, development of new perianal abscess/sepsis, new/recurrent fistula, unplanned surgery and faecal diversion). CONCLUSION: A fistulising pCD COS has been produced by all key stakeholders. Application of the COS will reduce heterogeneity in outcome reporting, thereby facilitating more meaningful comparisons between treatments, data synthesis and ultimately benefit patient care