Set in Alaska in the 1980s, the novel Skinless reinterprets traditional Scottish legends of the seal maiden, or selkie, a seal who can remove her sealskin, revealing a human-looking woman. When ...Carol, a selkie villager from Prince William Sound goes to college, her sealskin is stolen, prompting her to move to Seattle to live as a normal human woman. When a piece of her sealskin is returned to her, her quest to find the rest of it leads her back to reconnect with village and her birth family while threatening her marriage. The critical essay, “It’s Fiction: Who Needs Facts?” looks at the commonly-offered advice to “write what you know” and an alternative approach, “know what you write.” Drawing from published materials in which novelists discuss their research, the essay examines how research can deepen and inform fiction, using examples from authors including Isabel Allende, Jean Auel, Tony Hillerman, Jodi Picoult, Kazuo Ishiguro, Ann Patchett, Phillip Meyer, Orhan Pamuk, and Carlos Ruiz Zafón.
Abstract
Background
Endoscopic retrograde cholangiopancreatography (ERCP) is used to diagnose and treat pancreatic and biliary disease. The current standard is to conduct ERCP under conscious ...sedation (CS). Patient movement and agitation during ERCP under CS can result in procedure failure and complications. Aiming to reduce procedure failure rates and complications, Kelowna General Hospital (KGH) in British Columbia, Canada transitioned to performing ERCP under general anesthesia (GA) as the practice standard.
Objective
To determine if conducting ERCP under GA compared to CS decreases procedure complications, particularly post-ERCP pancreatitis (PEP).
Methods
The charts of 2,198 patients who underwent ERCP at KGH between 2015 and 2020 were reviewed. Before September 17, 2017, ERCP was performed under CS (n = 1,316). Afterwards, ERCP was conducted under GA (n = 882). Demographic, clinical, and procedural data were extracted. The data were analyzed using univariate and multivariate statistical analysis.
Results
Procedure failure rates (CS = 9 percent, GA = 3 percent, P < 0.001) decreased in the GA cohort after adjusting for age, sex, and co-morbidities. Thirty-day mortality, intensive care unit (ICU) transfer, returns post-discharge, PEP, and cholangitis rates were similar between cohorts.
Conclusion
Performing ERCP under GA compared to CS resulted in an increase in procedural success rates. Other complication rates were similar between groups.
We have investigated isotope‐selective resonance ionization (mass) spectrometry of strontium (Sr) for applications in trace‐element analysis and isotope enrichment, making use of pulsed dye lasers of ...broad bandwidth and continuous‐wave semiconductor diode lasers of narrow bandwidth. In this first part, theoretical calculations are carried out to address the problems of isotope selectivity, saturation and line broadening effects, and maximum (quantifiable) ionization. The modelling approach is based on a density matrix formalism incorporating both quantum mechanical and experimental parameters.
In this method of trace analysis, including the capacity of single atom detection, the sample is atomized in the target to form an atom plume. This is irradiated by 2 lasers and preselected atoms are ...resonantly ionized by the absorption of 2 or more laser photons. The ions are extracted from the electron- ion cloud and enter the time of flight mass spectrometer for detection and display.
The importance of molecular complexes in gas discharge lasers has long been recognised, and indeed they are the essence in excimer lasers. For other discharge lasers operating with gas mixtures, for ...example metal vapour lasers, the role of molecular complexes in the laser discharge has hardly been addressed. In this work the emission from a cw multi‐colour hollow‐cathode HeCd + laser has been investigated spectroscopically, and emphasis was placed on the detection of molecular bands. Specifically the presence of in the laser discharge was confirmed which is thought to play a major role in the generation of the green laser lines. Emission bands attributed to the metal dimer were identified; however, this dimer does not seem to be of importance in the laser process. In addition to the and emission strong molecular continuum bands, exhibiting gain, were observed which accompany all laser lines; these can only be interpreted as originating from transitions in the ionic complex (HeCd + ) * .