![]() Intrahepatic exophytic nodular (peripheral) tumors are most commonly of the mass-forming type 3. Intraductal: proliferates in the lumen of the bile duct-like a papilla or tumor thrombus Periductal-infiltrating: extends longitudinally along the bile duct, often causing peripheral bile duct dilation Mass-forming: definite mass in the liver parenchyma The macroscopic appearance is further described according to the Liver Cancer Study Group of Japan classification 15,16: Macroscopic appearanceĬholangiocarcinomas are typically sclerotic masses without hemorrhage or macroscopic necrosis 2. In general, the active tumor is at the periphery, with the central portions replaced by fibrosis, accounting for the capsular retraction that may be seen in intrahepatic tumors. The previously mentioned Bismuth-Corlette anatomic classification is used for operative planning but is limited in predicting prognosis 16. Intrahepatic cholangiocarcinoma (staging) Prognostic staging uses the TNM system, depending on location: Perihilar cholangiocarcinomas are commonly subclassified by their anatomic extent according to the Bismuth-Corlette classification (described separately). Indeed, the International Liver Cancer Association guidelines on "Diagnosis and management of intrahepatic cholangiocarcinoma" published in 2014 discourage using the term Klatskin tumor altogether 22. Some institutions are discouraging the use of the terms Klatskin tumor and extrahepatic cholangiocarcinoma in favor of perihilar and distal cholangiocarcinoma in an attempt to standardize the classification and provide useful clinical information. For example, intrahepatic cholangiocarcinomas are sometimes subclassified into peripheral and hilar types 16. ![]() NB: There is variability in nomenclature in the literature, as perihilar cancers often span the vague and variable boundary between intrahepatic and extrahepatic bile ducts. Tumors involving the confluence of the right and left hepatic ducts are frequently referred to as Klatskin tumors, although use of the eponym is going out of favor in both the radiology and the clinical literature 22ĭistal (20%): distal to the cystic duct insertion Perihilar (70%): occur between the secondary biliary radicles and proximal to the cystic duct insertion Pathology LocationĬholangiocarcinomas may be classified anatomically as follows 16: Typically, the presentation is with painless jaundice. ![]() Individuals with ulcerative colitis are at higher risk of having cholangiocarcinoma in comparison to those with Crohn disease 17. Regarding inflammatory bowel disease, cholangiocarcinoma develops in one in every 100 to 200 patients, which means they have a 4 times greater risk than IBD-free patients. Liver fluke infestation: Opisthorchis spp. thorotrast, dioxin, polyvinylchloride, heavy alcohol use Recurrent pyogenic cholangitis: especially in Southeast Asia Primary sclerosing cholangitis (PSC): especially in Western countries ![]() Risk factorsĪ number of risk factors for cholangiocarcinoma have been identified, and bile stasis and chronic inflammation of the biliary epithelium are identified as common features among many of them 1,2,9,14:Ĭaroli disease / choledochal cysts: lifetime risk of 10-15% 2Ĭholedocholithiasis: more than cholelithiasis 10,11 There may be a slight male predilection.Ĭholangiocarcinomas correspond to ~15% of all primary liver tumors and to ~3% of all gastrointestinal malignancies 14. They usually present in the elderly, with a mean age of 65 years 7. The incidence ranges from 0.3 to 6 per 100,000 inhabitants per year 14. doi:10.Although overall cholangiocarcinoma is rare, there are significant regional variations in incidence with much higher rates seen in Southeast Asia and the Middle East 2. Matern Health Neonatol Perinatol. 2017 3:28. A review of clinical signs related to ecchymosis. An unusual presentation of ruptured abdominal aorta aneurysm. Ectopic pregnancy.ĭurdu T, Yilmaz F, Sönmez BM, et al. ![]() doi:10.4174/astr.2017.93.2.115Īmerican College of Obstetricians and Gynecologists. Grey Turner's and Cullen's signs induced by spontaneous hemorrhage of the abdominal wall after coughing. Return to play after liver and spleen trauma. National Institute for Diabetes and Digestive and Kidney Diseases. Acute pancreatitis: current perspectives on diagnosis and management. Abdominal physical signs of inspection and medical eponyms. Rastogi V, Singh D, Tekiner H, Ye F, Mazza JJ, Yale SH. Cullen sign and Grey Turner sign revisited. ![]()
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![]() ![]() Customize the template to fit your needs.Many different types of printable templates are available online, so make sure you choose one that fits your needs. Choose the suitable template for your needs. ![]() Here are some tips for using printable templates: All you need is a printer and some paper. You don’t need any special software or skills to use them. For example, if you download a budget planner template, you can add or remove categories to fit your budgeting needs.Īnother great thing about printable templates is that they are easy to use. You can edit them to fit your specific needs and preferences. One of the best things about printable templates is that they are customizable. Many different types of printable templates are available online, including calendars, to-do lists, budget planners, and more. They are pre-designed templates that you can download and print out for free. Printable templates are a great way to save time and money when creating documents. These templates save time, effort, and resources while ensuring a polished and professional finish. The options are virtually limitless, from organizational planners and to-do lists to artistic designs and business cards. They come in digital formats, often downloadable for free or at a minimal cost. Printable templates are pre-designed documents or patterns easily customized for various purposes. Web Cornell Notes Templates Browse the selection of the professionally designed Cornell Web 2 Questions As soon after the reading as possible formulate questions based on the Web Summarize information and take notes smarter with the Cornell Notes template Web Cornell Notes Notebook This is a 9 Page Cornell Notes notebook Make additional copies of each page according to the number of copies you need 9 Pages Color Code and 8 Templates with 8 Colors Word PDF FREE Cornell Notes Template Word PDF amp Google Docs ![]() ![]() ![]() Rule #6 The following will be removed at moderator discretion:.Rule #5 No affiliate/referral links or codes.Celebrities are the exception, as long as you respect rule #1. Rule #4 Screenshots of Reddit, Facebook, Youtube, and other site's comments should have the usernames blacked out (including yours).Do not attempt to circumvent this rule by any means. This includes NP links and archived links. Rule #3 Don't link to threads in other subreddits.brigading, witch-hunting, asking for upvotes or downvotes, enabling piracy, flamebaiting, clickbaiting, intentional rudeness, text spamming, using all caps or emojis/smileys/emoticons in titles or overusing them in comments, meta-reddit or meta-subreddit drama or complaints. Rule #2 We will not allow behavior contrary to PCMR Etiquette, e.g.We will not tolerate any kind of incitement to action against anyone, nor will we allow the posting of information that can be used to harm others (celebrities or not). Rule #1 Harassment of others is strictly forbidden.If needed, you can message the team behind PCMR.įor an in-depth explanation of our rules don't forget to check our rules wiki page.Owning a console does not necessarily make you a 'peasant'.You can be banned if you conduct yourself like that here. We are not a community where members feign stupidity when posting and commenting because they find it funny. We are a community where many of its members share similar opinions about the main topics, and sometimes end up having private jokes amongst ourselves. This is a normal subreddit with occasional tongue-in-cheek humor elements. This is not a satirical or 'circlejerk subreddit'. ![]() It's not about the hardware in your rig, but the software in your heart! You don't necessarily need a PC to be a member of the PCMR.This includes build help, tech support, and any kind of doubt one might have about PC ownership. Every kind of PC related content is welcome here.Everybody is welcome here, even those that have yet to ascend.Begin your ascension today! General Information Official Subreddit of the PC Master Race We're the largest community of PC enthusiasts on the Internet. ![]() ![]() It’s not really something most players will probably care about, but it’s there and it’s long. ![]() Game also has a story mode that goes into the 3 main maids becoming idols. I had to for content, but the game lets you turn off that content even showing up at the start. There is NTR, but only for the main 3 you start out with, and then only if you let it happen. In fact a lot of content is behind keeping them to yourself, with a lot of events about you becoming their lovers. For whatever reason, you don’t actually have to sell out your maids. Basically train the maids in sex and entertainment so that they can earn you enough money to survive. To help out and not yourself get into massive debt, you have three maids to train for this escort club. In a bid to fix this they sold almost everything, let almost everyone go, and now your uncle just had you sign the remaining debt and building to you. So in this super customizable building, your uncle ran so many projects that the place went near bankrupt. The secretary comes in and reveals what just really happened. There he explains his club and has you sign to become the owner. ![]() So like the other Custom Maids, your uncle has called you to his escort maid club. It even has full text sex events that use it’s animations in a VN like way. Unlike Illusion’s stuff that is fairly light on text beyond some plot stuff, Custom Maid 3D 2 and it’s spinoffs have a lot of text for it’s excuse plot. Besides Illusions games(Sexy beach, Honey Select, etc.) this is basically the most famous of the games in that genre.Īs for this, think Honey Select but with way more dating sim/RPG like elements. So for those who are not aware, Custom Maid 3D by Kiss is one of the biggest 3D sex animator/character creator games. ![]() ![]() Some in the tax profession wonder if AI can prepare tax returns and draft legal briefings, therefore replacing certified public accountants (CPAs) and tax attorneys. Although this prediction is dismal, the report states that there is a silver lining: The combination of significant labor cost savings, new job creation, and higher productivity for non-displaced workers will enhance overall labor productivity, which in turn will propel economic growth. A frequently cited Goldman Sachs study estimates that if the current trend continues, AI may substitute up to 25% of current jobs in the U.S. With the advancement of AI, a common concern is whether ChatGPT and other similar technologies will replace human jobs. Besides ChatGPT, Google’s Bard, Meta’s Blenderbot, Microsoft’s Bing AI, and Writesonic’s ChatSonic are a few well-known alternatives. These amounts show a five-fold increase between 20. Some researchers estimate that in 2021, private investment in AI was $53 billion in the U.S. The massive investment in AI reflects the popularity of this technology. Once trained, an algorithm can generate new content by mimicking the patterns it has learned, and developers can continue to input new data to fine tune a model. ) Well-established AI models, such as ChatGPT, are trained on hundreds of billions of words of text. (See an interactive illustration from The New York Times. The training datasets let the model learn the underlying structure and context of language and recognize patterns from these datasets. It is important to bear in mind that developing a powerful generative AI algorithm requires massive amounts of training data. This feature greatly facilitates its popularity and makes it highly approachable. The outputs of these algorithms are presented in the form of natural language chatbots, which have the ability to generate human-like, conversational outputs. This technology is not new, but technical advances have enabled its proliferation and sophistication. In non-technical terms, generative AI is a type of AI technology that can receive inputs and produce several kinds of outputs, including text, image, video, or synthetic data in response to various prompts. Together the briefs will highlight the most disruptive perspectives of AI in these areas and what issues to pay attention to when adopting AI. This first brief reviews the impact of current AI developments on tax research and compliance, and the second brief discusses recent efforts to use AI tools to inform tax policymaking and congressional attempts to regulate AI while still encouraging innovation in the U.S. There is no doubt that AI will have profound impacts on many aspects of daily life, and tax is no exception, as outlined in this two-part issue brief series. Some believe these AI tools will boost labor productivity, whereas others caution that AI development is out of control and government regulation is necessary. If that is not impressive enough, it can exhibit a sense of humor and, when asked, can turn a tax question into a rhyming poem. GPT-4 can even handle some tax-related tasks. In addition, it scores higher in many standardized tests (including bar exams, the SAT, and graduate record exams) than its predecessor, GPT-3.5. The latest version - GPT-4, released in March 2023 - can understand scratchy handwriting, arrange meetings, and read and describe images. In comparison, it took Instagram 2 1/2 years to reach the hundred million-user mark. ![]() Since its public debut in November 2022, ChatGPT has shown phenomenal growth: The chatbot reached a million users in five days and recorded over 100 million users within two months. Part 2 can be found here.Īrtificial intelligence (AI) has been getting a lot of attention, especially generative AI and its most well-known application, OpenAI’s ChatGPT. This is the first of two issue briefs by Joyce Beebe on the use of AI in the tax field. ![]() ![]() ![]() ![]() ![]() On the off chance that you’re searching for a spot to get the very best Android APK applications, then you’ve arrived perfectly located. Welcome To APKEXERA – Your New Source For APK Android If you are a Tourist looking for a best travel plans and information about Morocco, so you are in the right place. By the atlantic Ocean Morocco Has hundred of beaches which deserve to be visit especially during the summer such as small cities of Asilah, El Oualidya, Essaouira and Agadir which has a summer weather for more than 6 months per year. One of the most things which makes Morocco a best touristic destinations is its diversity and hospitality, If you head to North you will find such a great cities of Tangier, Saadia and Nador which are located in the edge of Medeteranean Sea, those cities are reach by its great weather and spanish aspects due to the spanish colonizer in the past. Morocco also has a diversity of cultures and traditions which allow you to full in such a great love with the country and its landscapes. Morocco also has a great desert and mountain landscapes which allows its visitors to make mellion pictures and live such great moments by exploring and discovering the magic of the desert. Today, Morocco offers everyone: from delicious Food, gorgeous historic land sites, Beaches to have an amazing summer holiday. Morocco or Al Maghrib which is the Arabic name is a country that is rich by its cultures, Hospitality, religious diversity, intellectual and its ancient history of (indigenous Berbers and Arabs) dynasties and empires that reached Northern Africa and Spain and Also middle Africa by the Great Sahara. ![]() 3 days Marrakech tours Septemat 10:39 am.We would like to remember this for a lifetime, and look forward to similar experience in future.Thanks Omar for a fantastic tour! OMAR SHARIEF was spectacular! He is such a nice, polite,professional Driver and guide.We had a blast during our 8 days at Morocco and were able to see almost all the essential highlights this country has to offer: an awesome desert camp night singing and dancing under the stars, a relaxing walk around in the blue city Chefchaouen, a glimpse of the Marrakesh palace and Jardin Majorelle ecte.Highlights: camel riding and camping in the dessert touring Fes touring the sahara area: the blue town of Chefchaouen getting to know the lovely people our wonderful tour guide!This was a memorable experience for my entire family. Our customized trip spanned 8 days, which was the perfect amount of time to get a good feel of the country. The best 8 days Tour in Morocco !!!!!!!!! Review of: Full-Day Private Tour of Ouzoud Waterfalls from Marrakesh Thank you so much for your helpful idea !!!!!!!!! I am going continue using the player for about another month and try to update it again and if the installer tries to install something other than potplayer I will uninstall it and on all of the other computers that I manage and will find another video player. I’ve been using PotPlayer for a very long time. There appears to be no way to install PotPlayer without McAfee WebAdvisor. But if I click ‘decline’ on installing McAfee WebAdvisor it just keeps taking me back to the previous step. I do not want McAfee WebAdvisor on my PC. I am not going to install your potplayer by clicking agree on installing Mcafee and not checking that I don’t understand. When I hit decline it won’t let me install. That means I don’t understand what that is. I know there is a way to install it but I will not because I have to click agree and that I don’t understand what I am installing. I know what you are saying but you are not reading what I am saying. Subject: RE: RE: RE: RE: PotPlayer Install. I hope you don’t mind but I am going to use this email with your replies to let everyone on the forums, twitter and anyone else I can communicate with of what PotPlayer thinks we as customers should do. But by your answer I can tell that this obviously was not a mistake so I will find another software to use. Like I said before I was going to wait and let PotPlayer get this fixed if indeed it was a mistake. Here is an email thread I had with Potplayer employee when I wrote to let them know that the 3rd party software they were trying to install when updating to new version of PotPlayer ![]() ![]() "In running, it doesn't matter if you come in first, in the middle of the pack, or last. Quitting lasts forever.” ~ Lance Armstrong The miracle is that I had the courage to start.” ~ John Bingham Happy Running! Do you use running as your therapy? Anything else to add? Pick a new place or your favorite place where you can zone out on the flowers, trees, lake, river, etc. You can use this time to either seek out the advice of a running buddy or maybe just chat about something totally unrelated to what is causing you anxiety. Run This World is one of my current favorites. You may be entertained or even learn something new. I now prefer to listen to them when I drive or run instead of music. I bet the lyrics and the beat will temporarily make you forget your stressors. So download your favorite tunes and sing along as you run. You’ll either be breathing too hard to care or checking your watch to see what your pace is.ĭo we have the time to sit at home and just listen to music? If you do play music, it is probably in the background while you are dong something else or often while you are driving. ![]() Running 400m repeats at a particular pace will certainly take your mind off your problems. ![]() So here are my tips on how to use running as “therapy.” I may have mentioned a few weeks ago that I almost risked a serious injury because I felt that if I stopped running, I’d go crazy. It’s Friday so I’m linking up with Running on Happy & Fairytales and Fitness for the Friday Five 2.0 linkup! Join in! Don’t forget to link back to your hostesses and visit some other bloggers. ![]() ![]() ![]() It was advertised as a "Dreamhouse Adventures special".Ī sneak peek of the show was uploaded to YouTube on March 26, 2018. On September 18, 2017, Barbie Dolphin Magic was released exclusively to Netflix. From their Dreamhouse in Malibu to escapades around the globe, they navigate life's ups and downs with plenty of laughs, musical numbers, and just enough sparkle and fantasy that will have every girl believing that anything is possible."Ĭhristopher Keenan, Senior Vice President Global Content & Executive Producer at Mattel Creations, said, "Barbie: Dreamhouse Adventures is a playful, CG-animated 'sitcom' aimed at the six to 11-year-old audience where comedy is the order of the day." The article also said, "Barbie and her fun-loving sisters, Chelsea, Stacie and Skipper take you on their wild adventures in a new animated comedy series. The new episodic show will chronicle the adventures of Barbie and her sisters, Chelsea, Stacie and Skipper, as they take the viewer along for their wild adventures that will have every girl believing that anything is possible." Animation World Network wrote that, "Barbie: Dreamhouse Adventures (26 x 22') is another brand new Barbie series developed for an older audience of 5 to 11 year olds, with a realistic and modern CGI look and answering requests from fans to learn more about Barbie and her family. Barbie Dreamtopia: The Series, and Barbie Dreamhouse Adventures. Īnimation World Network posted news about the series on Octoafter Mattel Creations announced Barbie Dolphin Magic. The Dreamhouse was designed by Renata Marchand. Colorforms Barbie Dreamhouse Adventures Play Set. ![]() Barbie Dream House Toy Box and Playmat (A1465XX?).Barbie Dreamhouse Adventures Swim 'n Dive Doll (GHK23).Spark storytelling and sports-play with Barbie dolls inspired by Barbie Dreamhouse Adventures! Barbie Dreamhouse Adventures Stacie Doll (GHR63)īarbie Travel Dolls and Toys Inspired by Barbie Dreamhouse Adventures!.Barbie Dreamhouse Adventures Skipper Doll (GHR62).Barbie Dreamhouse Adventures Ken Doll (GHR61).Barbie Dreamhouse Adventures Nikki Doll (GHR60).Barbie Dreamhouse Adventures Daisy Doll (GHR59).Barbie Dreamhouse Adventures Barbie Doll (GHR58).With dolls inspired by Barbie Dreamhouse Adventures, imaginations can peek into the everyday life of Barbie as she embarks on exciting adventures with her family and friends. Barbie's neighbors, the Reardon family: Whittaker, Poppy and Trey.Barbie's best friends: Nikki Watkins, Teresa Rivera, Renee Chao, Daisy Kostopoulos and Ken Carson.The puppies: Taffy, DJ, Rookie and Honey.Barbie's parents: Margaret and George Roberts.Barbie's sisters: Skipper, Stacie and Chelsea Roberts.Her favorite pop singers are Taylor Swift and Selena Gomez.She is 17 years old in Dreamhouse Adventures and 18 years old in Barbie & Chelsea: The Lost Birthday.She has 3 sisters, Skipper, Stacie and Chelsea.Her favorite game is "What If?" that she plays with her sisters.She has saved each of her Halloween costumes up to date.She learnt to play the guitar by herself.She loves freckles and wishes she had them.She has arachnophobia (fear of spiders) since she was 8.She wears a silver necklace with her name on it. She typically wears pink or blues, but her favourite dress is her denim shirt dress that she wears with white and pink sneakers. She has fair skin, big blue eyes and blonde long, straight hair that have been partly tied up in a braid. She wrote "Lead You Home" with Daisy and "Your Place To Shine" with Teresa. In the movie, Barbie Princess Adventure, she writes a song called "Try It On" with Daisy that had the chorus inspired by her sisters. ![]() She likes writing songs with Daisy, and also sometimes with Teresa. ![]() She tells people the stories of her everyday life on it. To inspire people, she runs a vlog: Barbie She never gives up, she always tries again when she fails to do things. She likes routines and getting things done without bad excuses, she even programmed her room to not accept bad excuses, when she has to do something. She is also very organized, neat and tidy. She has a saying ‘P.A.C.E.’ that means a Positive Attitude Changes Everything. She also always strive to make everything an adventure, for example, when her and her friends wanted coconut milk, she climbed a tree and made fresh drinks. She almost always has what you need at hand, bringing measurement tools to the beach. She is intelligent, sweet, kind, brave, caring and helpful. She is voiced by America Young and her singing voice is provided by Elli Moore. Barbara Millicent Roberts, is the lead character and the protagonist of the show Barbie: Dreamhouse Adventures. ![]() |
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