CFD simulation of pumping ventilation in a three-story isolated building with internal partitioning:Effects of partition widths,heights and locations

Pumping ventilation(PV),a special single-sided ventilation(SSV),has been certified as an effective strategy to improve the air exchange rate of SSV.However,most studies targeted on the single space,and few studies have been focused on the effect of internal partitioning on PV.This paper aims to evaluate the ventilation performance of PV influenced by different configurations of internal partitioning.Computational fluid dynamics(CFD)simulation was used to predict the flow fields and ventilation rates.The width(w/H),height(h/H)and location(d/H)are the three main internal partition parameters considered in this study.The simulation results showed that the total,mean and fluctuating ventilation rates all decrease with wider internal partitions.The normalized total ventilation rate decreases by 7.6%when w/H is increased from 50%to 75%.However,the reduction rate is only 0.23%between w/H=0 and 25%,and only 0.61%between w/H=25%and 50%.The ventilation rate is hardly reduced by increasing the partition width when w/H<50%,whereas greatly reduced by wider partition for w/H>50%.Increasing the partition height will reduce the mean ventilation rate but promote the fluctuating and total ventilation rate in some cases.An increase of total ventilation rate by 1.4%is observed from h/H=50%to 75%.The ventilation rate is larger when the internal partition is attached to the leeward or windward wall.The total,mean and fluctuating ventilation rates for d/H=50%are relatively higher than d/H=0 by 1.5%,3.1%and 0.8%,respectively.Hence the internal partition should be mounted attached to the windward wall so as to obtain the greatest pumping ventilation rate.The periodicity of pumping flow oscillation and pumping frequency are independent of the partition configurations.The peak power of pumping flow is the lowest for the widest internal partition and is negatively affected by the partition height,but it generally has a positive correlation with the distance between the partition and leeward wall.Present research will help to understand pumping ventilation mechanism in real buildings with internal partitioning and provide theoretical basis for developing unsteady natural ventilation technology in low-carbon buildings.

Endoscopic Internal Urethrotomy in the Treatment of Male Urethral Stenosis in the Urology-Andrology Department of KARA Teaching Hospital (Togo)

Introduction: Endoscopic internal urethrotomy (EIU) is a method for stricture opening using transurethral incision by direct visualisation of the urethral channel, resulting in a widening of the urinary canal with the aim of improving the quality of bladder emptying. The aim of the study was to evaluate the indication and results of EIU in the treatment of stenosis of the male urethra in the Urology-Andrology Department of Kara Teaching Hospital. Methodology: This was a cross-sectional descriptive study with retrospective data collection in the Urology-Andrology department of Kara Teaching Hospital. It involved 21 records of patients with urethral stenosis treated by endoscopic internal urethrotomy (EIU) in the said department during the period from January 2021 to September 2023. The following variables were evaluated: age, circumstance of discovery, site, length, number, etiology of the urethral stenosis and evolution of the patients. Results: The mean age of the patients was 59.2 ± 11.7 years. Infectious etiology of stenosis was predominant with 10 patients (47.6%) followed by trauma with 5 cases (23.8%). The bulbar urethra was the most frequently observed site, with 11 cases (52.4%). The length was mostly less than 2 cm in 12 patients (57.1%). Stenosis was unique in 14 patients (66.7%). The mean postoperative follow-up time was 3.2 months. The result was immediately better in 11 patients (52.4%) and it was poor in 8 patients (38.1%) who required maintenance dilation sessions.

Viral Hepatitis B and C: Epidemiological, Clinical and Paraclinical Aspects in the Internal Medicine Department of KARA University Hospital in Togo

Introduction: Viral hepatitis B and C constitute real public health problems worldwide. The objective of this work was to describe the epidemiological, clinical and paraclinical aspects of viral hepatitis B and c in the internal medicine department of Kara University Hospital. Method: this was a retrospective descriptive study carried out in the Internal Medicine department of Kara University Hospital, over a period of 3 years from March 2020 to April 2023. It included all patients seen in consultation or hospitalized for hepatitis viral B and/or C. Results: A total of 57 patients were included in our study. The average age was 44.30 years ± 16.75 and the M/F sex ratio was 1.38. Married people were in the majority 63.2%. The circumstances of the discovery of viral hepatitis B and C were dominated by abdominal pain in 35.1% of cases and hepatomegaly in 29.8% of cases and in 33.3% of cases, it was during screening voluntary. Patients with viral hepatitis B only accounted for 64.9% of cases;those with only viral hepatitis C represented 31.6% of cases and 3.5% of cases had HVB/HCV co-infection. We recorded 36.8% complications including 52.4% liver cirrhosis and 47.6% hepatocellular carcinomas. During the evolution, there were 03 deaths. Conclusion: the prevalence of hepatitis B and C virus carriage in patients followed in internal medicine at Kara University Hospital is high. It is therefore essential to put in place treatment and prevention strategies against these viruses.

Internal hernia as a rare cause of small bowel obstruction:An insight from 13 years of experience

BACKGROUND Internal hernia(IH)is a rare culprit of small bowel obstruction(SBO)with an incidence of<1%.It poses a considerable diagnostic challenge requiring a high index of suspicion to prevent misdiagnosis,improper treatment,and subsequent morbidity and mortality.AIM To determine the clinico-demographic profile,radiological and operative findings,and postoperative course of patients with IH and its association with SBO.METHODS Medical records of 586 patients with features of SBO presenting at a tertiary care centre at Lucknow,India between September 2010 and August 2023 were reviewed.RESULTS Out of 586 patients,7(1.2%)were diagnosed with IH.Among these,4 had congenital IH and 3 had acquired IH.The male-to-female ratio was 4:3.The median age at presentation was 32 years.Contrast-enhanced computed tomography(CECT)was the most reliable investigation for preoperative identification,demonstrating mesenteric whirling and clumped-up bowel loops.Left paraduodenal hernia and transmesenteric hernia occurred with an equal frequency(approximately 43%each).Intraoperatively,one patient was found to have bowel ischemia and one had associated malrotation of gut.During follow-up,no recurrences were reported.CONCLUSION IH,being a rare cause,must be considered as a differential diagnosis for SBO,especially in young patients in their 30s or with unexplained abdominal pain or discomfort post-surgery.A rapid imaging evaluation,preferably with CECT,is necessary to aid in an early diagnosis and prompt intervention,thereby reducing financial burden related to unnecessary investigations and preventing the morbidity and mortality associated with closed-loop obstruction and strangulation of the bowel.

Effect of external and internal cues on core muscle activation during the Sahrmann five-level core stability test

BACKGROUND Pain in the back or pelvis or fear of back pain may affect the timing or cocontraction of the core muscles.In both static and dynamic movements,the Sahrmann core stability test provides an assessment of core muscle activation and a person's ability to stabilize the lumbopelvic complex.Preparatory cues and images can be used to increase the activation of these muscles.To attain optimal movement patterns,it will be necessary to determine what cueing will give the most effective results for core stability.AIM To investigate the effects of external and internal cues on core muscle activation during the Sahrmann five-level core stability test.METHODS Total 68 participants(21.83±3.47 years)were randomly allocated to an external(n=35)or internal cue group(n=33).Participants performed the Sahrmann fivelevel core stability test without a cue as baseline and the five-level stability exercises with an internal or external cue.External cue group received a pressure biofeedback unit(PBU),and the internal cue group received an audio cue.A Delsys Trigno^(TM)surface electromyography unit was used for muscle activation from the rectus abdominis,external oblique,and transverse abdominis/internal oblique muscles.RESULTS Linear mixed effects model analysis showed that cueing had a significant effect on core muscle activation(P=0.001);however,there was no significant difference between cue types(internal or external)(P=0.130).CONCLUSION Both external and internal cueing have significant effects on core muscle activation during the Sahrmann five-level core stability test and the PBU does not create higher muscle activation than internal cueing.

Weak Internal Partition of Regular Graphs

An(s,t)-partition of a graph G=(V,E)is a partition of V=V 1∪V 2 suchthatδ(G[V_(1)])≥s andδ(G[V_(2)])≥t.Ithasbeenconjecturedthat,forsufficiently large n,every d-regular graph of order n has a(d/2,d/2)-partition(called an internal partition).Inthispaper,weprovethateveryd-regulargraphofordern hasa(d/2,d/2)partition(called a weak internal partition)for d≤9 and sufficiently large n.

Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection for circumferential mixed hemorrhoids

AIM:To identify a more effective treatment protocol for circumferential mixed hemorrhoids.METHODS:A total of 192 patients with circumferential mixed hemorrhoids were randomized into the treatment group,where they underwent Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection,or the control group,where traditional external dissection and internal ligation were performed.Postoperative recovery and complications were monitored.RESULTS:The time to wound healing was 12.96 ± 2.25 d in the treatment group shorter than 19.58 ± 2.71 d in the control group.Slight pain rate was 58.3% in the treatment group higher than 22.9% in the control group;moderate pain rate was 33.3% in the treatment group lower than 56.3% in the control group severe pain rate was 8.4% in the treatment group lower than 20.8% in the control group.No edema rate was 70.8% in the treatment group higher than 43.8% in the control group;mild local edema rate was 26% in the treatment group lower than 39.6% in the control group obvious local edema was 3.03% in the treatment group lower than 16.7% in the control group.No stenosis rate was 85.4% in the treatment group higher than 63.5% in the control group;moderate stenosis rate was 14.6% in the treatment group Lower than 27.1% in the control group severe anal stenosis rate was 0% in the treatment group lower than 9.4% in the control group.CONCLUSION:Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection is the optimal treatment for circumferential mixed hemorrhoids and can be widely applied in clinical settings.

Responses of wind-induced internal pressure in a two-compartment building with a dominant opening and background porosity Part 1:Theoretical formulation and experimental verification

The equations governing wind-induced internal pressure responses for a two-compartment building with a dominant opening and background porosity were derived.The unsteady form of the Bernoulli equation,the law of mass conservation,and adiabatic equation were used for the derivation.The precision of the governing equations was verified by a wind tunnel test on a rigid model of a low-rise building.The results show that the governing equations can effectively analyze the wind-induced internal pressure responses.The internal pressure responses in both compartments are suppressed due to the additional damping provided by background porosity.The responses of internal pressure in both compartments,especially in the compartment without an external opening,decrease with increased lumped leakage area.

An evaluation method for internal erosion potential of gravelly soil based on particle size distribution

Internal erosion occurs when fine particles escape from the soil driven by seepage flow,which is considered to be the crucial factor causing the failure of earth structures filled with gravelly soil.The objective of this paper is to suggest an appropriate method to assess internal erosion potential of gravelly soil.By analyzing the sensitivity of soil material to internal erosion,the variable(Dc15/df85)max and the content of coarse particles(Pc)are selected as the evaluation indexes(Dc15 and df85 are the diameters of 15%mass passing in the coarse component and 85%mass passing in the fine component,respectively).A series of gravelly soils with different particle size distributions are tested for internal erosion by the self-made permeameter.Based on the test results,an evaluation method for the internal erosion of gravelly soil is proposed.Gravelly soil is prone to internal erosion when 60%≤Pc<95%and(Dc15/df85)max≥9.5.The proposed method shows good accuracy in evaluating the internal erosion of 36 soil samples from other studies,which confirms the reliability of the method.The proposed method makes it possible to accurately assess internal erosion of gravelly soil,and an alternative method is provided for engineers to determine whether there is a risk of internal erosion in earth structures consisting of gravelly soil.

A good death from the perspective of healthcare providers from the internal medicine department in Shanghai:A qualitative study

Objective:This study aimed to explore the understanding of healthcare providers working in the internal medicine department in Shanghai regarding a good death.Methods:The data of the study was collected using face-to-face semi-structured interviews.Through purposive sampling,16 physicians and 13 nurses who had experiences of caring for adult patients with life-threatening illnesses at the end-of-life stage in Shanghai were interviewed.The interviews were analyzed using qualitative content analysis.Results:Six characteristics of a good death emerged:no suffering,companionship and care,no worries or concerns,dying with dignity,involvement and acceptance,and less impact on the family.Eighteen categories were identified:dying without experiencing suffering;being relieved of symptoms and suffering;being relieved of psychological suffering;avoiding the use of futile treatment and resuscita-tion;being cared for and accompanied by family;receiving good health care;having a meaningful life without regrets;making good arrangements for family issues;having a chance to say goodbye;having a quality life before death;dying in a decent environment;the personal will to be respected;maintaining the integrity of the body;death of the patient being accepted by the family and healthcare providers;the death occurred despite the best efforts to care for the patient;limited financial and care burden;shortly affected quality of life of the patient;and improved family cohesion.Conclusion:Family members’early involvement in caring for patients at the end-of-life stage helps achieve a good death.For patients with a terminal illness,avoiding unnecessary medical treatment and resuscitation could be the first step in achieving better patient death and promoting the development of advanced care planning in the mainland of China.

Glut-4 is translocated to both caveolae and non-caveolar lipid rafts, but is partially internalized through caveolae in insulin-stimulated adipocytes

Caveolae and non-caveolar lipid rafts are two types of membrane lipid microdomains that play important roles in insulin-stimulated glucose uptake in adipocytes. In order to ascertain their specific functions in this process, caveolae were ablated by caveolin-1 RNA interference. In Cav-1 RNAi adipocytes, neither insulin-stimulated glucose uptake nor Glut-4 （glucose transporter 4） translocation to membrane lipid microdomains was affected by the ablation of caveolae. With a modified sucrose density gradient, caveolae and non-caveolar lipid rafts could be separated. In the wild-type 3T3- L l adipocytes, Glut-4 was found to be translocated into both caveolae and non-caveolar lipid rafts. However, in Cav1 RNAi adipocytes, Glut-4 was localized predominantly in non-caveolar lipid rafts. After the removal of insulin, caveolaelocalized Glut-4 was internalized faster than non-caveolar lipid raft-associated Glut-4. The internalization of Glut-4 from plasma membrane was significantly decreased in Cav-1 RNAi adipocytes. These results suggest that insulin-stimulated Glut-4 translocation and glucose uptake are caveolae-independent events. Caveolae play a role in the internalization of Glut-4 from plasma membrane after the removal of insulin.

High‑Performance Silicon‑Rich Microparticle Anodes for Lithium‑Ion Batteries Enabled by Internal Stress Mitigation

Si is a promising anode material for Li ion batteries because of its high specific capacity,abundant reserve,and low cost.However,its rate performance and cycling stability are poor due to the severe particle pulverization during the lithiation/delithiation process.The high stress induced by the Li concentration gradient and anisotropic deformation is the main reason for the fracture of Si particles.Here we present a new stress mitigation strategy by uniformly distributing small amounts of Sn and Sb in Si micron-sized particles,which reduces the Li concentration gradient and realizes an isotropic lithiation/delithiation process.The Si8.5Sn0.5Sb microparticles(mean particle size:8.22μm)show over 6000-fold and tenfold improvements in electronic conductivity and Li diffusivity than Si particles,respectively.The discharge capacities of the Si_(8.5)Sn_(0.5)Sb microparticle anode after 100 cycles at 1.0 and 3.0 A g^(-1)are 1.62 and 1.19 Ah g^(-1),respectively,corresponding to a retention rate of 94.2%and 99.6%,respectively,relative to the capacity of the first cycle after activation.Multicomponent microparticle anodes containing Si,Sn,Sb,Ge and Ag prepared using the same method yields an ultra-low capacity decay rate of 0.02%per cycle for 1000 cycles at 1 A g^(-1),corroborating the proposed mechanism.The stress regulation mechanism enabled by the industry-compatible fabrication methods opens up enormous opportunities for low-cost and high-energy-density Li-ion batteries.

Partial and Full Arc Volumetric Modulated Arc Therapy in Lung Cancer Stereotactic Body Radiotherapy with Different Definitions of Internal Target Volume Based on 4D CT

Purpose: To investigate the feasibility of partial arc volumetric modulated arc therapy (VMAT) in lung cancer stereotactic body radiotherapy (SBRT), as well the volumetric and dosimetric effects of different internal target volume (ITV) definitions with 4D CT. Methods: Fourteen patients with primary and metastatic lung cancer underwent SBRT were enrolled. Full and partial arc VMAT plans were generated with four different ITVs: ITVall, ITVMIP, ITVAIP and ITV2phases, representing ITVs generated from all 10 respiratory phases, maximum intensity projection (MIP), average intensity projection (AIP), and 2 extreme respiratory phases. Volumetric and dosimetric differences, as well as MU and delivery time were investigated. Results: Partial arc VMAT irradiated more dose at 2 cm away from planning target volume (PTV) (P = 0.002), however, it achieved better protection on mean lung dose , lung V5, spinal cord, heart and esophagus compared with full arc VMAT. The average MU and delivery time of partial arc VMAT were 240 and 1.6 min less than those of full arc VMAT. There were no significant differences on target coverage and organ at risks (OARs) sparing among four ITVs. The average percent volume differences of ITVMIP, ITVAIP and ITV2phases to ITVall were 8.6%, 13.4%, and 25.2%, respectively. Conclusions: Although partial arc VMAT delivered more dose 2 cm out of PTV, it decreases the dose to lung, spinal cord, and esophagus, as well decreased the total MU and delivery time compared with full arc VMAT without sacrificing target coverage. Partial arc VMAT was feasible and more efficient for lung SBRT.

Modified virtual internal bond model based on deformable Voronoi particles

In last time,the series of virtual internal bond model was proposed for solving rock mechanics problems.In these models,the rock continuum is considered as a structure of discrete particles connected by normal and shear springs(bonds).It is well announced that the normal springs structure corresponds to a linear elastic solid with a fixed Poisson ratio,namely,0.25 for threedimensional cases.So the shear springs used to represent the diversity of the Poisson ratio.However,the shearing force calculation is not rotationally invariant and it produce difficulties in application of these models for rock mechanics problems with sufficient displacements.In this letter,we proposed the approach to support the diversity of the Poisson ratio that based on usage of deformable Voronoi cells as set of particles.The edges of dual Delaunay tetrahedralization are considered as structure of normal springs(bonds).The movements of particle’s centers lead to deformation of tetrahedrals and as result to deformation of Voronoi cells.For each bond,there are the corresponded dual face of some Voronoi cell.We can consider the normal bond as some beam and in this case,the appropriate face of Voronoi cell will be a cross section of this beam.If during deformation the Voronoi face was expand,then,according Poisson effect,the length of bond should be decrees.The above mechanism was numerically investigated and we shown that it is acceptable for simulation of elastic behavior in 0.1–0.3 interval of Poisson ratio.Unexpected surprise is that proposed approach give possibility to simulate auxetic materials with negative Poisson’s ratio in interval from–0.5 to–0.1.

Profile of Urinary Tract Infections in the Elderly in the Internal Medicine Department of the University Hospital Center of Point G, Bamako, Mali

Introduction: Urinary tract infections (UTI) are frequent and of polymorphous clinical symptomatology in elderly subjects both in and out of hospital. In Mali, to our knowledge, no study concerning UTIs in the elderly has been conducted, hence the interest in this innovative work. Objectives: To determine the prevalence and clinical and paraclinical aspects of urinary tract infections in the elderly. Materials and Methods: This was a prospective descriptive and cross-sectional study from September 1, 2013 to August 31, 2014, i.e. duration of 12 months. All patients aged 65 years and over, hospitalized or ambulatory in the internal medicine department with a documented urinary tract infection were included. Results: We collected and examined 194 patients. The cytobacteriological study of urine (CBSU) was positive in 28 patients, i.e. a prevalence of 14.43%. The male sex represented 59.8% of the cases, the sex ratio was equal to 1.46. The age groups between 65 - 69 and 70 - 74 years were the most affected, respectively 28.57% and 39.28%. The main clinical signs were: asthenia, anorexia, dependence, fever, urinary burning, dysuria. Hospitalization was associated with urinary tract infection with P = 0.01. The group of enterobacteria were incriminated in 75% of cases. Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa represented 39.28%, 14.28% and 10.71% of cases. Urinary tract infections were represented by pyelonephritis, acute prostatitis, orchi-epididymitis and simple cystitis. Conclusion: Urinary tract infection is frequent in the elderly, its clinical presentation is polymorphic and enterobacteria are the most incriminated group of bacteria.

Endoscopic polidocanol foam sclerobanding for the treatment of grade Ⅱ-Ⅲ internal hemorrhoids:A prospective,multi-center,randomized study

BACKGROUND Endoscopic rubber band ligation(ERBL)is a nonsurgical technique for the treatment of symptomatic internal hemorrhoids but is limited by recurrence and post-procedural pain.AIM To evaluate satisfaction,long-term recurrence,and post-procedural pain in managing internal hemorrhoids using a combination of polidocanol foam sclerotherapy and ERBL.METHODS This was a prospective,multicenter,randomized study.A total of 195 consecutive patients diagnosed with grade II-III internal hemorrhoids were enrolled from four tertiary hospitals and randomly divided into a cap-assisted endoscopic polidocanol foam sclerobanding(EFSB)or an ERBL group.All patients were followed-up for 12 months.Symptom-based severity and post-procedural pain were assessed using a hemorrhoid severity score(HSS)and a visual analog scale(VAS).Continuous variables were reported as medians and interquartile range.RESULTS One hundred and ninety-five patients were enrolled,with 98 in the EFSB group.HSS was lower in the EFSB group than in the ERBL group at 8 weeks[4.0(3.0-5.0)vs 5.0(4.0-6.0),P=0.003]and 12-month[2.0(1.0-3.0)vs 3.0(2.0-3.0),P<0.001]of follow-up.The prolapse recurrence rate was lower in the EFSB group at 12 months(11.2%vs 21.6%,P=0.038).Multiple linear regression analysis demonstrated that EFSB treatment[B=-0.915,95%confidence interval(CI):−1.301 to−0.530,P=0.001]and rubber band number(B=0.843,95%CI:0.595-1.092,P<0.001)were negatively and independently associated with the VAS score 24 hours post-procedure.The median VAS was lower in the EFSB group than in the ERBL[2.0(1.0-3.0)vs 3.0(2.0-4.0),P<0.001].CONCLUSION Cap-assisted EFSB provided long-term satisfaction and effective relief from the recurrence of prolapse and pain 24 hours post-procedure.

Mechanism of internal thermal runaway propagation in blade batteries

Blade batteries are extensively used in electric vehicles,but unavoidable thermal runaway is an inherent threat to their safe use.This study experimentally investigated the mechanism underlying thermal runaway propagation within a blade battery by using a nail to trigger thermal runaway and thermocouples to track its propagation inside a cell.The results showed that the internal thermal runaway could propagate for up to 272 s,which is comparable to that of a traditional battery module.The velocity of the thermal runaway propagation fluctuated between 1 and 8 mm s^(-1),depending on both the electrolyte content and high-temperature gas diffusion.In the early stages of thermal runaway,the electrolyte participated in the reaction,which intensified the thermal runaway and accelerated its propagation.As the battery temperature increased,the electrolyte evaporated,which attenuated the acceleration effect.Gas diffusion affected thermal runaway propagation through both heat transfer and mass transfer.The experimental results indicated that gas diffusion accelerated the velocity of thermal runaway propagation by 36.84%.We used a 1D mathematical model and confirmed that convective heat transfer induced by gas diffusion increased the velocity of thermal runaway propagation by 5.46%-17.06%.Finally,the temperature rate curve was analyzed,and a three-stage mechanism for internal thermal runaway propagation was proposed.In Stage I,convective heat transfer from electrolyte evaporation locally increased the temperature to 100℃.In Stage II,solid heat transfer locally increases the temperature to trigger thermal runaway.In StageⅢ,thermal runaway sharply increases the local temperature.The proposed mechanism sheds light on the internal thermal runaway propagation of blade batteries and offers valuable insights into safety considerations for future design.

Selective internal radiation therapy segmentectomy:A new minimally invasive curative option for primary liver malignancies?

Transarterial radioembolization or selective internal radiation therapy(SIRT)has emerged as a minimally invasive approach for the treatment of tumors.This percutaneous technique involves the local,intra-arterial delivery of radioactive microspheres directly into the tumor.Historically employed as a palliative measure for liver malignancies,SIRT has gained traction over the past decade as a potential curative option,mirroring the increasing role of radiation segmentectomy.The latest update of the BCLC hepatocellular carcinoma guidelines recognizes SIRT as an effective treatment modality comparable to other local ablative methods,particularly well-suited for patients where surgical resection or ablation is not feasible.Radiation segmentectomy is a more selective approach,aiming to deliver high-dose radiation to one to three specific hepatic segments,while minimizing damage to surrounding healthy tissue.Future research efforts in radiation segmentectomy should prioritize optimizing radiation dosimetry and refining the technique for super-selective administration of radiospheres within the designated hepatic segments.

Seeing beneath the surface:Harnessing point-of-care ultrasound for internal jugular vein evaluation

Point-of-care ultrasound(POCUS)of the internal jugular vein(IJV)offers a noninvasive means of estimating right atrial pressure(RAP),especially in cases where the inferior vena cava is inaccessible or unreliable due to conditions such as liver disease or abdominal surgery.While many clinicians are familiar with visually assessing jugular venous pressure through the internal jugular vein,this method lacks sensitivity.The utilization of POCUS significantly enhances the visualization of the vein,leading to a more accurate identification.It has been demonstrated that combining IJV POCUS with physical examination enhances the specificity of RAP estimation.This review aims to provide a comprehensive summary of the various sonographic techniques available for estimating RAP from the internal jugular vein,drawing upon existing data.

Relative Impacts of Sea Ice Loss and Atmospheric Internal Variability on the Winter Arctic to East Asian Surface Air Temperature Based on Large-Ensemble Simulations with NorESM2

To quantify the relative contributions of Arctic sea ice and unforced atmospheric internal variability to the “warm Arctic, cold East Asia”(WACE) teleconnection, this study analyses three sets of large-ensemble simulations carried out by the Norwegian Earth System Model with a coupled atmosphere–land surface model, forced by seasonal sea ice conditions from preindustrial, present-day, and future periods. Each ensemble member within the same set uses the same forcing but with small perturbations to the atmospheric initial state. Hence, the difference between the present-day(or future) ensemble mean and the preindustrial ensemble mean provides the ice-loss-induced response, while the difference of the individual members within the present-day(or future) set is the effect of atmospheric internal variability. Results indicate that both present-day and future sea ice loss can force a negative phase of the Arctic Oscillation with a WACE pattern in winter. The magnitude of ice-induced Arctic warming is over four(ten) times larger than the ice-induced East Asian cooling in the present-day(future) experiment;the latter having a magnitude that is about 30% of the observed cooling. Sea ice loss contributes about 60%(80%) to the Arctic winter warming in the present-day(future) experiment. Atmospheric internal variability can also induce a WACE pattern with comparable magnitudes between the Arctic and East Asia. Ice-lossinduced East Asian cooling can easily be masked by atmospheric internal variability effects because random atmospheric internal variability may induce a larger magnitude warming. The observed WACE pattern occurs as a result of both Arctic sea ice loss and atmospheric internal variability, with the former dominating Arctic warming and the latter dominating East Asian cooling.