The modeling of flood-induced bend scour near embankment toes can provide important information for river engineering, embankment safety warnings, and emergency action management. During the rainy seasons, short-term general scour and bend scour are the most common causes for the failure of reinforced concrete embankments in Taiwan. To gain a deeper understanding of the scouring process near levee foundations, this study proposed a straightforward and practical method for bend scour simulation. The proposed simulation method is subdivided into three stages: two-dimensional flow simulation, general scour estimation, and bend scour estimation. A new bend-scour computation equation is proposed and incorporated into a two-dimensional hydraulic finite-volume model for simulating the evolution of bend scour depth around embankment toes. The proposed method is applied to simulate the temporal evolution of bend scouring near the Shuideliaw Embankment on the Cho-Shui River in Taiwan, where serious failure occurred during the June 2012 monsoon. Field data were gathered using the numbered-brick technique at the Shuideliaw Embankment to demonstrate the accuracy of the proposed method. The results of the bend scour simulations compared reasonably well with field measurements, indicating close agreement in terms of water levels and bend scour depths near the Shuideliaw Embankment. The proposed method was found to quickly estimate the maximum short-term general scour and bend scour depths for further enhancement of the safety of the embankment toe.

SpyGlass peroral cholangioscopy (POCS) has greatly improved the diagnosis of biliary strictures by allowing direct visualization and tissue sampling in the bile ducts. Supported by strong registry data and careful analysis, POCS is highly accurate in diagnosis and carries minimal risks. It plays a pivotal role in diagnosis of indeterminate biliary stricture like primary sclerosing cholangitis (PSC), which increases the risk of cancer. POCS facilitates early disease detection through distinctive endoscopic observations and provides essential information with directed biopsies that assess inflammation and potential malignancy. This case study showcased POCS's diagnostic ability when it accurately identified benign findings in a 59-year-old patient with jaundice. Treatment with ursodeoxycholic acid resulted in significant improvements, highlighting the diagnostic performance of POCS. In summary, POCS simplifies complex biliary stricture cases, expedites diagnosis and intervention, and significantly contributes to improving patient outcomes in challenging hepatobiliary conditions.

Introduction: Liver cirrhosis develops in about 10% of alcohol abusers. To date, a number of cells and cytokines have been identified, which are involved in induction of liver fibrotic processes. Nevertheless, the pathogenesis of liver cirrhosis has not been fully elucidated. The aim of the present study was to determine serum concentrations of afamin and adropin in patients with alcoholic liver cirrhosis and to define their correlation with the stage of disease. Materials and methods: The study included 99 patients with alcoholic cirrhosis from the region of Lublin, (Eastern Poland). Liver cirrhosis was diagnosed based on clinical features, history of heavy alcohol consumption, laboratory tests and abdominal ultrasonography. The control group consisted of 20 healthy individuals without liver disease who did not abuse alcohol. The serum afamin and adropin concentrations were determined using ELISA kits. Results: The concentration of afamin was found to be significantly lower in patients with compensated alcoholic liver cirrhosis, i.e. P-Ch B (85.1±40.6 μg/ml) and P-Ch C (56.4±32.3 μg/ml) individuals, as compared to the control group (135.9±43.6 μg/ml); p-value was <0.01 and <0.001, respectively. As far as adropin is concerned, a reverse relationship was demonstrated: the highest concentration was found in patients with P-Ch C (11.7±5.7 ng/ml) cirrhosis. Furthermore, the above concentration was significantly higher compared to patients with P-Ch A cirrhosis (7.2±2.8 ng/ml; p<0.05) and controls (7.5±2.6 ng/ml; p<0.05). Conclusions: The concentration of afamin decreases with the severity of alcoholic liver cirrhosis, which most likely results from impaired hepatic synthesis. Otherwise, the higher the stage of disease according to the Child-Pugh score, the higher the concentration of adropin.