Adjuvant Radiofrequency Ablation Along With Stenting Versus Stenting Alone for Biliary Tree Drainage in Patients With Malignant Biliary Strictures: A Systemic Review and Meta-analysis.

OBJECTIVE: This metanalysis aims to assess the efficacy and safety of biliary stenting along with radiofrequency ablation compared with stents alone to treat malignant biliary obstruction (MBO) due to extrahepatic biliary strictures secondary to cholangiocarcinoma, pancreatic cancer, and metastatic cancer. METHODS: A systemic search of major databases through April 2022 was done. All original studies were included comparing radiofrequency ablation with stenting versus stenting alone for treating malignant biliary strictures. The primary outcomes of interest were the difference in the mean stent patency and overall survival (OS) days between the 2 groups. The secondary outcome was to compare the adverse events of the 2 groups. The mean difference in the stent patency and OS days was pooled by using a random-effect model. We calculated the odds ratio to compare the adverse events between the 2 groups. RESULTS: A total of 13 studies with 1339 patients were identified. The pooled weighted mean difference in stent patency was 43.50 days (95% CI, 25.60-61.41), favoring the RFA plus stenting. Moreover, the pooled weighted mean difference in OS was 90.53 days (95% CI, 49.00-132.07), showing improved survival in the RFA group. Our analysis showed no statistically significant difference in adverse events between the 2 groups OR 1.13 (95% CI, 0.90-1.42). CONCLUSION: Our analysis showed that RFA, along with stent, is safe and is associated with improved stent patency and overall patient survival in malignant biliary strictures. More robust prospective studies should assess this association further.

Vibrationally resolved two-photon electronic spectra including vibrational pre-excitation: Theory and application to VIPER spectroscopy with two-photon excitation.

Following up on our previous work on vibrationally resolved electronic absorption spectra including the effect of vibrational pre-excitation [von Cosel et al., J. Chem. Phys. 147, 164116 (2017)], we present a combined theoretical and experimental study of two-photon-induced vibronic transitions in polyatomic molecules that are probed in the VIbrationally Promoted Electronic Resonance experiment using two-photon excitation (2P-VIPER). In order to compute vibronic spectra, we employ time-independent and time-dependent methods based on the evaluation of Franck-Condon overlap integrals and Fourier transformations of time-domain correlation functions, respectively. The time-independent approach uses a generalized version of the FCclasses method, while the time-dependent approach relies on the analytical evaluation of Gaussian moments within the harmonic approximation, including Duschinsky rotation effects. For the Coumarin 6 dye, two-dimensional 2P-VIPER experiments involving excitation to the lowest-lying singlet excited state (S1) are presented and compared with corresponding one-photon VIPER spectra. In both cases, coumarin ring modes and a CO stretch mode show VIPER activity, albeit with different relative intensities. Selective pre-excitation of these modes leads to a pronounced redshift of the low-frequency edge of the electronic absorption spectrum, which is a prerequisite for the VIPER experiment. Theoretical analysis underscores the role of interference between Franck-Condon and Herzberg-Teller effects in the two-photon experiment, which is at the root of the observed intensity distribution.

A Triplet Label Extends Two-Dimensional Infrared Spectroscopy from Pico- to Microseconds.

In conventional two-dimensional infrared (2D-IR) spectroscopy, the inherently short vibrational lifetimes limit the time window to observe molecular dynamics typically to tens of picoseconds. The rather complex dynamics of organized molecular systems (e.g., glass formers, polymers, membranes, proteins), however, span a wide range of timescales from femto- to microseconds and beyond. Vibrationally Promoted Electronic Resonance (VIPER) 2D-IR negates the limitations of 2D-IR spectroscopy, for its signal decays with the electronic lifetime. Here, we present 2-Isopropylthioxanthone as the first VIPER 2D-IR probe to exploit intersystem crossing, thereby covering even the microsecond timescale. We achieved the required signal-to-noise ratio and resolution by introducing the Fourier-transform approach to the VIPER 2D-IR pulse sequence. Now, we are in a position to monitor dynamics via spectral diffusion several orders of magnitude beyond the vibrational lifetime of 2D-IR labels.

Endoscopic Retrograde Cholangiopancreatography (ERCP) in Patients With Liver Cirrhosis: Analysis of Trends and Outcomes From the National Inpatient Sample Database.

GOALS: We aimed to assess outcomes of patients with liver cirrhosis who underwent therapeutic or diagnostic endoscopic retrograde cholangiopancreatography (ERCP) to determine whether these patients had different outcomes relative to patients without cirrhosis. BACKGROUND: ERCP is an important procedure for treatment of biliary and pancreatic disease. However, ERCP is relatively technically difficult to perform when compared with procedures such as esophagogastroduodenoscopy or colonoscopy. Little is known about how ERCP use affects patients with liver cirrhosis. STUDY: Using patient records from the National Inpatient Sample (NIS) database, we identified adult patients who underwent ERCP between 2009 and 2014 using International Classification of Disease, Ninth Revision coding and stratified data into 2 groups: patients with liver cirrhosis and those without liver cirrhosis. We compared baseline characteristics and multiple outcomes between groups and compared outcomes of diagnostic versus therapeutic ERCP in patients with cirrhosis. A multivariate regression model was used to estimate the association of cirrhosis with ERCP outcomes. RESULTS: A total of 1,038,258 hospitalizations of patients who underwent ERCP between 2009 and 2014 were identified, of which 31,294 had cirrhosis and 994,681 did not have cirrhosis. Of the patients with cirrhosis, 21,835 (69.8%) received therapeutic ERCP and 9459 (30.2%) received diagnostic ERCP. Patients with cirrhosis had more ERCP-associated hemorrhages (2.5% vs. 1.2%; P <0.0001) compared with noncirrhosis patients but had lower incidence of perforations (0.1% vs. 0.2%; P <0.0001) and post-ERCP pancreatitis (8.6% vs. 7%; P <0.0001). Cholecystitis was the same between groups (2.3% vs. 2.3%; P <0.0001). In patients with cirrhosis, those who received therapeutic ERCP had higher post-ERCP pancreatitis (7.9% vs. 5.1%; P <0.0001) and ERCP-associated hemorrhage (2.7% vs. 2.1%; P <0.0001) but lower incidences of perforation and cholecystitis (0.1% vs. 0.3%; P <0.0001) and cholecystitis (1.9 vs. 3.1%; P <0.0001) compared with those who received diagnostic ERCP. CONCLUSIONS: Use of therapeutic ERCP in patients with liver cirrhosis may lead to higher risk of complications such as pancreatitis and postprocedure hemorrhage, whereas diagnostic ERCP may increase the risk of pancreatitis and cholecystitis in patients with cirrhosis. Comorbidities in cirrhosis patients may increase the risk of post-ERCP complications and mortality; therefore, use of ERCP in cirrhosis patients should be carefully considered, and further studies on this patient population are needed.

Tensile response of Ultra High Performance PE Fiber Reinforced Concretes (PE-UHPFRC) under imposed shrinkage deformations.

PE-UHPFRC is a new Ultra High-Performance Fiber Reinforced Concrete (UHPFRC), which is developed to reduce the environmental impact of conventional UHPFRC by replacing the steel fibers with synthetic ones and reducing the clinker content in the mix. The development of the dynamic elastic modulus, the evolution of free autogenous deformations and the eigenstresses development with age, under full and partial restraint conditions, were investigated for PE-UHPFRC and the results were put into perspective with that for conventional UHPFRC with steel fibers. Furthermore, the tensile responses of different mixes under imposed shrinkage were compared and discussed. The results showed a shorter setting time and consequently an earlier initiation of elastic modulus development for PE-UHPFRC compared with that of conventional UHPFRC. Furthermore, the developed eigenstresses under full restraint conditions in a PE-UHPFRC layer compared with that for conventional UHPFRC were reduced by more than 70%, which is highly beneficial especially for cast-in-place rehabilitation applications.

Efficient Excitation of Micro/Nano Resonators and Their Higher Order Modes.

We demonstrate a simple and flexible technique to efficiently activate micro/nano-electromechanical systems (MEMS/NEMS) resonators at their fundamental and higher order vibration modes. The method is based on the utilization of the amplified voltage across an inductor, L, of an LC tank resonant circuit to actuate the MEMS/NEMS resonator. By matching the electrical and mechanical resonances, significant amplitude amplification is reported across the resonators terminals. We show experimentally amplitude amplification up to twelve times, which is demonstrated to efficiently excite several vibration modes of a microplate MEMS resonator and the fundamental mode of a NEMS resonator.

Prevalence and characterization of Trypanosoma species from livestock of Cholistan desert of Pakistan.

Trypanosomiasis is one of the most pathogenic infection of livestock caused by several Trypanosoma species. The current study aims to determine the current prevalence of trypanosomiasis in livestock of Cholistan desert, Pakistan by molecular characterization. A total 272 animals, 61 camels, 59 cattle, 50 goats, 50 sheep and 52 donkeys that were bled and processed for thin smear microscopy, packed cell volume (PCV), DNA extraction, PCR, formol gel test and for cryo preservation. For diagnosis and molecular characterization, three sets of primers including TBR, RoTat 1.2, TRYP4 were used which detect their targets including repeated satellite DNA region, variant surface glycoprotein (VSG) gene and the ITS ribosomal DNA sequence of microbe. According to results, 6.2% animals were positive by microscopy, 51.1% by formol gel, 54.7% by PCV and 36.7% by PCR. The results of this study support the idea that PCR is a sensitive, robustic and reliable technique to diagnose trypanosomiasis and it should be added in conventional setup along with microscopy to avoid false negative and positive results. The PCR based order of prevalence of trypanosomiasis in Cholistani livestock was sheeps>camels>donkeys>goats>cattle. Similary, on the basis of thin smear microscopy the prevalence of trypanosomiasis was donkeys>camels>sheep>goats>cattle. It was observed that Trypanosoma evansi is the most prevalent specie involved in trypanosomiasis in Cholistani livestock.

Microelectromechanical reprogrammable logic device.

In modern computing, the Boolean logic operations are set by interconnect schemes between the transistors. As the miniaturization in the component level to enhance the computational power is rapidly approaching physical limits, alternative computing methods are vigorously pursued. One of the desired aspects in the future computing approaches is the provision for hardware reconfigurability at run time to allow enhanced functionality. Here we demonstrate a reprogrammable logic device based on the electrothermal frequency modulation scheme of a single microelectromechanical resonator, capable of performing all the fundamental 2-bit logic functions as well as n-bit logic operations. Logic functions are performed by actively tuning the linear resonance frequency of the resonator operated at room temperature and under modest vacuum conditions, reprogrammable by the a.c.-driving frequency. The device is fabricated using complementary metal oxide semiconductor compatible mass fabrication process, suitable for on-chip integration, and promises an alternative electromechanical computing scheme.

Hydrophilic and hydrophobic hydration of sodium propanoate and sodium butanoate in aqueous solution.

Aqueous solutions of sodium propanoate (NaOPr) and n-butanoate (NaOBu) have been studied at concentrations of c ~/< 3 M by broadband dielectric relaxation spectroscopy over the frequency range 0.2 ≤ ν/GHz ≤ 89 at 25 °C. Three relaxation modes were resolved, centered at (approximately) 1, 8, and 18 GHz, for both sets of solutions. The two faster modes were assigned to the cooperative relaxation of "slow" and bulk water molecules. Detailed analysis of the spectra indicated that both OPr(-) and OBu(-) were strongly hydrated, with ~23 and ~33 slow water molecules per anion, respectively, at infinite dilution. These effective hydration numbers include ~6 water molecules hydrophilically bound to the carboxylate moiety, with the remainder arising from the hydrophobic hydration of the nonpolar alkyl chains. The latter shows a characteristic rapid decrease with increasing solute concentration, which facilitated the separation of the hydrophobic and hydrophilic contributions. The lowest frequency mode was a composite with contributions from ion-cloud, ion-pair, and anion relaxations. Although this low intensity mode provided specific evidence of weak ion pairing between Na(+)(aq) and the carboxylate anions, reliable estimates of the association constant could not be made because of its composite nature.

Hydration of formate and acetate ions by dielectric relaxation spectroscopy.

Dielectric relaxation (DR) spectra have been measured for aqueous solutions of sodium formate (NaOFm) and sodium acetate (NaOAc) over a wide range of frequencies (0.2 ≤ ν/GHz ≤ 89) up to solute concentrations c is less or approximately equal to 3.2 M and is less or approximately equal to 3.7 M, respectively, at 25 °C. Measurements were also made on NaOAc(aq) at 15 ≤ T/°C ≤ 35. In addition to the usual dominant bulk-water relaxation process at ~20 GHz, one or two further relaxation modes were detected. One process, centered at ~8 GHz and observed for both NaOFm(aq) and NaOAc(aq), was attributed to the presence of slow water in the hydration shells of the anions. A lower-frequency process at ~0.6 GHz, observed only for NaOAc(aq) at c is less or approximately equal to 1 M, was thought to be due to the presence of very small concentrations of ion pairs. Detailed analysis of the spectra indicated that very few (<2 per anion) water molecules were irrotationally bound (frozen) on the DR time scale. Nevertheless, both anions are strongly hydrated, as evidenced by the significant amounts of slow water detected. Such H(2)O molecules with reduced dynamics result from two distinct effects. The first is the relatively strong hydrophilic interaction of water with the -COO(-) moiety, which is similar for the two anions and little affected by increasing solute concentration. The second (for OAc(-) only) is the hydrophobic hydration of the -CH(3) group, which is fragile, decreasing markedly with increasing solute concentration and temperature. The activation parameters for bulk-water relaxation in NaOAc(aq) indicated a breakdown of the bulk water structure at high solute concentrations.

Minor criteria for atopic dermatitis in children.

Atopic dermatitis (AD) is a common pruritic, eczematous skin disorder that runs a chronic and relapsing course. Major and minor criteria exist as guideline for arriving at a diagnosis of AD. Minor features vary with ethnicity and genetic background and can be used to aid diagnosis. A descriptive study was conducted including 210 patients of 1-12 years age who had concurrent or past history of AD according to criteria of Hanifin and Rajka. This study was conducted in the department of Dermatology of three different Hospitals of Bangladesh. Out of 33 sub-criteria of Hanifin and Rajka, 20 of which were examined encompassed tendency towards cutaneous infection, environmental factor, high IgE level, intolerance of wool, xerosis, infra-orbital fold, ichthyosis, early age of onset, itch on sweating, palmer hyperlinearity, food hypersensitivity, keratosis pilaris, pityriasis alba, facial erythema, cheilitis, hand eczema, foot eczema, intolerance of lipid solvent, scalp scaling and infra-auricular fissure. Out of 20 examined minor criteria, most common was cutaneous infection in 168(80.0%) patients followed by coursed influenced by environmental factor in 140(66.7%), high IgE level in 126(60.0%), intolerance of wool in 105(50.0%), xerosis in 92(43.8%), infra-orbital fold in 83(39.5%), ichthyosis in 72(34.3%), early age of onset in 65(31.0%), itch on sweating in 56(26.7%), palmary hyperlinearity in 52(24.8%), food hypersensitivity in 40(19.0%), keratosis pilaris in 31(14.8%), pityriasis alba in 30(14.3%), facial erythema in 25(1.9%), cheilitis in 22(10.5%), hand eczema in 19(9.0%), foot eczema in 16(7.6%), intolerance of lipid solvent in 14(6.7% ), scalp scaling in 11(5.2%) and infra-auricular fissure in 10(4.8%). These features were present singly or in combination. The result evidenced that minor criteria are many a times important for the diagnosis where major criteria are uncertain.

Dielectric relaxation study of the ion solvation and association of NaCF3SO3, Mg(CF3SO3)2, and Ba(ClO4)2 in N,N-dimethylformamide.

Solutions of sodium trifluoromethanesulfonate, magnesium trifluoromethanesulfonate, and barium perchlorate in N,N-dimethylformamide (DMF) have been investigated using broadband dielectric relaxation spectroscopy at 25 °C. All spectra were dominated by a solvent relaxation process centered at ∼15 GHz but also exhibited one (for NaCF(3)SO(3)) or two (for the 2:1 salts) low-amplitude processes, centered at frequencies below 2 GHz, that could be attributed to the presence of ion pairs. Effective solvation numbers calculated from the solvent relaxation amplitudes indicated strong solvation of all three cations, with evidence for the formation of a second solvation sheath for Mg(2+) and possibly Ba(2+). Detailed analysis of the solute-related processes showed that solvent-shared ion pairs (SIPs) were formed in NaCF(3)SO(3) solutions in DMF. The data for Mg(CF(3)SO(3))(2) and Ba(ClO(4))(2) solutions were not definitive but, consistent with the solvation evidence, favored the presence of double solvent-separated ion pairs and SIPs. Overall association constants, K(A), were small for all three salts in DMF and increased in the order: NaCF(3)SO(3)

Neutron capture cross-section measurement for the 186W(n,gamma)187W reaction at 0.0536eV energy.

The thermal neutron-induced activation cross section for the (186)W(n,gamma)(187)W reaction was measured at 0.0536eV neutron energy using TRIGA Mark-II research reactor, Atomic Energy Research Establishment, Savar, Dhaka, Bangladesh. The (197)Au(n,gamma)(198)Au monitor reaction induced in a high-purity gold foil was used to determine the effective neutron beam intensity. The activities induced in sample and monitor foils were measured nondestructively by a high-resolution HPGe gamma-ray detector. The present experimental cross-section value is the first one at 0.0536eV. The obtained new cross section that amounts to 26.6+/-1.6b is 2% higher than the recently reported data in ENDF/B-VII and 5% lower than that of JENDL-3.3.

Anti-HIV activity of a glycoprotein from first trimester placental tissue.

Human Immunodeficiency Virus-1 (HIV-1) transmission from a mother to the offspring during pregnancy is highly complex and a variable process in part due to the presence of several anti-HIV factors. In this study, we report an early pregnancy-associated protein (early pregnancy associated protein-1, Epap-1) with an apparent molecular weight of 90 kDa in placental tissue of pregnant women during the first trimester. Epap-1 was isolated and purified using Sambucus nigra agarose lectin affinity chromatography. Epap-1 strongly inhibits HIV-1(MN), HIV-1(91US056), HIV-1(VB-7) replication in vitro while it exhibits low activity with HIV-1(VB-66) strain. The molecular analysis of action of Epap-1 shows that it affects HIV-CD4 binding through inhibition of CD4-gp120 interaction.

Fine needle aspiration diagnosis of benign metastasizing leiomyoma of the lung. A case report.

Percutaneous fine needle aspiration biopsy was performed on a woman with multiple bilateral lung nodules. The cytology and histology showed a benign spindle cell tumor compatible with benign metastasizing leiomyoma. The patient had a history of hysterectomy 14 years earlier for a cellular leiomyoma with atypia. No significant mitosis was present in either the uterine tumor or lung metastasis.

Cytotoxic activity of Amaryllidaceae alkaloids from Crinum augustum and Crinum bulbispermum.

The cytotoxic activity of five minor Amaryllidaceae alkaloids and one flavan isolated from Crinum augustum Rox and Crinum bulbispermum Milne were tested on human leukemic Molt 4 cells. Whereas the crinine-type alkaloids (6 alpha-hydroxycrinine, powelline) and the new type augustamine did not even inhibit the growth of Molt 4 cells, the lycorine-type alkaloid (pratorinine) and the crinine-type alkaloid (6 alpha-hydroxybuphanisine) showed a moderate cytotoxic activity and the flavan (4'-hydroxy-7-methoxyflavan) showed an important cytotoxic effect.

Fine-needle aspiration diagnosis of extragonadal choriocarcinoma with immunoperoxidase studies.

A case of extragonadal choriocarcinoma in a 30-yr-old man was diagnosed by fine-needle aspiration (FNA) biopsy with immunoperoxidase studies. FNA diagnosis in this case resulted in prompt treatment of rapidly growing metastases without the need for an invasive diagnostic procedure.

Fine needle aspiration biopsy in the evaluation of lymphoma presenting as an ovarian and uterine mass.

Fine needle aspiration (FNA) was performed in conjunction with frozen section on a patient with primary uterine and ovarian lymphoma. While the frozen section showed evidence of tumor, a diagnosis of lymphoma was not possible on the frozen section alone. The fine needle aspirate showed the tumor to be a lymphoma. In cases of suspected lymphoma, FNA in conjunction with frozen section may be helpful for making the definitive diagnosis.

Cytophotometric determination of DNA in mesotheliomas and reactive mesothelial cells.

Cytophotometry was used to study the nuclear DNA content of cells in Feulgen-stained effusion specimens from 18 patients with mesothelioma and 14 patients with reactive mesothelial proliferations. The mean DNA content (MDNA) of mesothelioma cells was significantly higher than that of reactive mesothelial cells (P less than .001). Other parameters reflecting the DNA content also differed significantly between the two kinds of cells, including (1) the ratio of mean mesothelial DNA to mean lymphocyte DNA, (2) the percentage of mesothelial cells with DNA content exceeding three times the lymphocyte MDNA and (3) the coefficient of variation of the DNA content. Since these parameters were highly correlated, only one was accepted in a stepwise linear discriminant model for distinguishing reactive from mesotheliomatous effusions. The model correctly classified all of the reactive effusions studied and 89% of the mesotheliomatous effusions. These results indicate that DNA analysis, using the Feulgen stain and cytophotometry, yields criteria that may be useful in distinguishing benign reactive mesothelial cells from malignant mesothelioma in effusions when used in conjunction with other traditional parameters.