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Despite the many historical events during the year 2020, this period of time will forever be remembered as the year of COVID-19. Since its onset in November 2019, The Sars-CoV-2 has made an enormous impact across all aspects of society across the entire world. Globally as of July 5th, 2021, there have been 184000000 confirmed cases of COVID-19, which tragically include 3980000 deaths. Sars-CoV-2 is spread through the respiratory system with the primary modes of transmission being aerosol, respiratory droplets, and direct contact. It is of great importance to understand that one of the primary modes of transmission, the aerosol (bioaerosol) mode is a mode that is omnipresent in most dental settings. To prevent dissemination of disease in American dental offices, the CDC and the ADA have developed strict protocols for dental care providers to follow. Protocols include case selection, protective equipment (PPE), Covid testing, procedure risk stratification, and reduction of aerosols. Laser-assisted dentistry has been identified as a potential key modality in the reduction of bio aerosols.

Vital pulp therapies (VPTs) aim to preserve the vitality of the pulp. The European Society of Endodontology have begun a campaign to raise awareness on the efficacy of VPTs following on from the publication of their 2019 position statement, aimed at both specialists and general dental practitioners. This review examines the current evidence surrounding VPTs and provides a rational approach to the management of the exposed pulp with the aid of case studies. Success lies in accurate diagnosis and case selection, along with well-executed treatment and appropriate follow-up protocols. The introduction of calcium silicate cements has made these treatments more predictable.

Endodontic intervention in necrotic immature permanent teeth is usually a clinical challenge. With appropriate case selection and optimal disinfection, regenerative endodontic procedure (REP) can be effective and a desirable result can be obtained. In this report, an immature necrotic mandibular second molar had been treated by REP in two visits. In the first visit, a nonsetting calcium hydroxide was used as intracanal medication after irrigation with 1.5% (NaOCl). In the second visit, blood clots were created in the root canals. MTA was placed over the blood clots and the tooth was restored with a composite filling and stainless-steel crown. A clinical and radiographic follow up was performed for three years where the tooth was deemed a symptomatic with a complete root formation.

Basilar artery occlusion is a relatively uncommon but neurologically devastating condition. If revascularization is not achieved, the potential for death and disability is substantial. During the last several years, there have been positive endovascular stroke trials for the treatment of large vessel occlusion; however, all of them excluded patients with basilar artery occlusion. The current treatment of basilar artery occlusion is still founded on small observational studies or meta-analyses. As case selection for revascularization and treatment protocols often vary widely across institutions, sample sizes remain limited. In this article, we aim to review some of the larger observational studies in stroke due to basilar artery occlusion, considering potential treatment strategies and resultant outcomes.

Hemisection is sectioning of multi-rooted teeth followed by removal of compromised root along with its associated crown portion and leaving the healthy root (with crown) intact. This treatment option can be considered when caries, resorption, perforation, or periodontal damage is restricted to one root while the other root is relatively healthy. The most critical factor determiningthe long term success in such cases is the appropriate case selection. This case report describes a case of hemisectionof a mandibular molar followed by adequate restoration in a young patient.

Objective The paradigm shift from replacement to repair of defective resin composite restorations to implement minimal intervention approaches has been popular. Therefore, the teaching of composite repair strategies is included in contemporary dental curricula across the globe. Methods A validated 18-item questionnaire pertaining to existing educational practices related to the teaching of defective composite restorations repair was acquired form dental colleges in Pakistan. Results The response rate was 63% and the majority of dental colleges (67%) reported that they have included the teaching of composite restorations repair in the curricula, where four colleges (33%) implemented only didactic teaching and eight colleges (66%) reported a combination of didactic teaching and clinical training. The composite repair indications taught included tooth substance conservation 100% (12), reduced cost to patient 84.3% (10) and dentist 100% (12), reduced iatrogenic pulpal damage 100% (12), and reduced chair side treatment time 91.3% (11), restoration-related defects (66% preferred repair), anterior tooth fracture from incisal/proximal margin (80% teach repair), and in case of posterior tooth cusp fracture (20% teach repair). Our results revealed that the choice of mechanical and adhesive substrate surface conditioning depended on case selection. Conclusion The teaching of defective composite restorations repair was less widespread and certain variations in teaching were identified. Nearly all dental colleges reported to incorporate current evidence of minimum invasive strategies of composite repair in curricula in future.

The North American Hybrid Algorithm has become the standard method for percutaneous intervention for coronary chronic total occlusions. In this article, the authors discuss antegrade wire escalation as it applies to the North American Hybrid Algorithm for chronic total occlusion percutaneous coronary intervention. There is a multitude of guidewires available to operators on the market, which can quickly prove overwhelming in terms of selection, cost, and practicality. The authors simplify wires into four overall groups or families. Operators should be able to pare their toolbox down to four wires only to achieve success at antegrade wire escalation.

The concept of the ischemic penumbra was defined over 40 years ago by Lindsay Symon and his group and is now an established principle of all acute ischemic stroke therapies. These reperfusion treatments rescue threatened, critically hypoperfused brain tissue and have been proven to improve clinical outcomes. We have been fortunate to have observed and played a small part in the penumbral story from its beginnings in the 1970s to its pivotal position today. Over this period, we have witnessed penumbral imaging evolve from positron emission tomography through to magnetic resonance imaging and now predominantly computed tomography perfusion, with the advent of automated imaging facilitating case selection for reperfusion therapies. We and others have conducted clinical trials using penumbral imaging to extend the time window for intravenous thrombolysis and select patients for thrombectomy. Together with the concept of fast- and slow-growing ischemic infarct patterns, this embeds the penumbral principle in everyday clinical management. The opportunity now exists to make penumbral imaging even more portable, affordable, and more widely available using mobile platforms, novel imaging techniques, digital linkage, and artificial intelligence.

Background: Critical care retrieval is a nascent field in South Africa. An increasing number of private and provincial emergency medical services are starting to invest in developing and setting up dedicated critical care retrieval services (CCRS). To date, there are no minimum standards or definitions on what constitutes a CCRS in the South African context. The aim of this paper is to describe the development of and propose a consensus definition of CCRS within the South African context. Methods: A literature search was performed to determine the key aspects of CCRS definitions elsewhere. An initial draft definition was circulated to the CCRS working group of the Emergency Care Society of South Africa (ECSSA) for commentary. Comments were collated, and a second round of commentary was undertaken. Finally, a consensus meeting was held through video-conferencing to finalise the definition presented herein. Thereafter, the definition was circulated to key role-players in emergency and critical care, both locally and internationally, for endorsement. The definition, as it is presented, has been endorsed by the ECSSA, the Southern African Society of Critical Care (SASCC), and the International Board for Specialty Certification (IBSC). Results: The proposed definition outlines five equally important aspects that should be demonstrable and interlinked to be denoted a CCRS. These five aspects are: specific patient populations, case selection, dedicated crew with additional training, dedicated equipment, and continuous quality management and training. Conclusion: Numerous questions remain unanswered regarding the best approach for CCRS development in South Africa and internationally. Defining what CCRS is in a South African context is a necessary departure point for further research endeavours to develop a core curriculum and practice standards.

As implant placement increases within all dental specialties, it is expected that the number of suboptimal results will increase, as well. The goal of this article is to provide clinicians with an outline of the management of periimplantitis cases, ranging from simple to complex. It will review signs and symptoms, diagnosis, case selection, and armamentarium. In addition, this chapter will discuss basic techniques which can be utilized at various stages to salvage the compromised implant.

Lower incisor extraction is a treatment regime since decades with its own advocates and opponents. Even though many pioneers and legends support lower incisor extraction therapy, there is still a dilemma in the orthodontic community which might be due to the fear of certain disadvantages such as formation of black triangles, midline discrepancy, loss of canine guidance, decrease in intercanine width and bite deepening. But proper case selection, treatment planning and treatment mechanics will produce stable and good results with lower incisor extraction therapy. In this article we are illustrating the specific indications of lower incisor extraction with the help of treated cases. Keywords: Mandibular incisor, Extraction, Bolton discrepancy, Adult orthodontics, Black triangle.

Cesarean myomectomy (CM) has been a controversial surgical procedure. It is fraught with increased blood loss and its associated postoperative morbidities of anemia, blood transfusion and sepsis or even an unintended obstetric hysterectomy. This case reports a life-threatening hemorrhagic shock in a patient for whom 2 large myomas were extracted during cesarean section. Safety of CM depends on proper case selection with small sized, subserous, pedunculated fibroids and the speed and skill of surgeon. Keywords: Cesarean, Myomectomy, Blood transfusion, Hysterectomy.

What wider lessons can be drawn from a single impact evaluation study? This article examines how case study and source selection contribute to useful generalisation. Practical suggestions for makin...

Background: Our study aim is to assess the functional outcome of arthroscopy assisted anatomical reconstruction of ACL with autologous hamstring graft using IKDC score. Methodology: Our study is a prospective observational study conducted in 40 patients, all patients between age group of 20-40yrs, both male and females with ACL injury, admitted to Yashoda Superspeciality hospital, between April 2016 and May 2017 (14 months) and fulfilling inclusion and exclusion criteria, treated surgically with Arthroscopic anatomic ACL reconstruction using autologous hamstring graft were included as the subjects for study. Case selection was done according to. Results: A total of 40 patients, 32 male and 8 female with 26 right knee and 14 left knee involvement with ACL tear were operated. The IKDC score reflected highly significant improvement in the stability, mainly rotational and anterior stability when preoperative score were compared with the score of most recent follow up i.e. 6 months. Pre-operative mean of 44.43+3.630 SD and Post-operative mean was 88.53+3.994 SD. The average Pre-operative mean was 44.525 and average Post-operative mean was 88.525, with an average mean increase in score was 44, with significant P value < 0.01 using IKDC score. Interpretation and conclusion: Anatomical ACL reconstruction is excellent technique for treating patients with ACL tear who are especially involved in the activities which involve pivoting most of the times in their life time for e.g. Athletes.

Recently, place branding has received increasing attention from both academic and policy circles. As place branding is an interdisciplinary field, scholars from different backgrounds have contribut...

To analyze correlations between the realistic surgical difficulty of LaLIF and anatomic characteristics in radiographic images, in order to develop a simple classification to provide guiding information for case selection and evaluate the potential risks of the technique. Ninety-six consecutive cases who underwent LaLIF surgeries at the L4-5 level with MR T2-weighted images were analyzed. A novel classification based on the anatomic relationships among the disk, great vessels, and psoas muscle was used for grouping. Clinical outcomes and realistic surgical difficulty parameters were recorded, and comparisons were made among different types of classifications. Of the 96 analyzed cases, the time of surgical exposure was significantly longer for type C than for type B, and both of these were longer than that of type A. The VAS and ODI were significantly improved at a 1-year follow-up. There was no statistically significant difference among the three types. Type C had the highest incidence of complications, while Type A had the lowest. Analyses of another 304 MRI cases obtained in outpatient clinics showed that the distribution of the three types among these cases was consistent with that of the surgical cohort. Our novel and simple classification provides useful information for case selection. Type A provided the best indication and is most appropriate for a beginner in this technique. Type C includes the most challenging situations, which may have a high incidence of complications and require sophisticated surgical skills to achieve satisfactory outcomes and avoid approach-related complications.

To prevent a software from going obsolete, it is mandatory to update it in order to meet the current ever changing requirements. Each update is accompanied by a regression testing cost. Attempts to...

Fixed Sized Candidate Set (FSCS) is the first of a series of methods proposed to enhance the effectiveness of random testing (RT) referred to as Adaptive Random Testing methods or ARTs. Since its inception, test case generation overheads have been a major drawback to the success of ART. In FSCS, the bulk of this cost is embedded in distance computations between a set of randomly generated candidate test cases and previously executed but unsuccessful test cases. Consequently, FSCS is caught in a logical trap of probing the distances between every candidate and all executed test cases before the best candidate is determined. Using data mining, however, we discovered that about 50% of all valid test cases are encountered much earlier in the distance computations process but without any benefit of a hindsight, FSCS is unable to validate them; a wild goose chase. This paper then uses this information to propose a new strategy that predictively and proactively selects valid candidates anywhere during the distance computation process without vetting every candidate. Theoretical analysis, simulations and experimental studies conducted led to a similar conclusion: 25% of the distance computations are wasteful and can be discarded without any repercussion on effectiveness.

In this article, we present the benefits of blending the methodological characteristics of the focused ethnographic method (FEM) and case study research (CSR) for a study on auxiliary work processes in a hospital in Barcelona, Spain. We argue that incorporating CSR logic and principles in the FEM produces a better form of inquiry, as this combination improves the quality of data and the ability to make comparisons in addition to enhancing the transferability of findings. These better outcomes are achieved because the characteristics of the case study methodological design reinforce many of the strengths of the FEM, such as its thematic concreteness and its targeted data collection. The role played by the theoretical framework of the study thus makes it easier to focus on the key variables of the initial theoretical model and to introduce a logic of multiple case comparison.

Every international and hybrid war crimes court has attracted a measure of controversy, but none more than the Extraordinary Chambers in the Courts of Cambodia (ECCC). While myriad aspects of the ECCC’s record are crucial to its legacy, this article explores one question of overarching importance: whether its performance has justified a key risk the UN assumed when it agreed to support the court — that case selection would be improperly influenced by the Cambodian government. More particularly, it assesses the ECCC’s performance in light of two questions: How well have safeguards against political interference worked? Are survivors of Khmer Rouge atrocities and other Cambodian citizens satisfied with ECCC justice? Along with their intrinsic importance, these benchmarks for assessment derive from the primacy of both considerations in deliberations leading to the Court’s creation.

Las villas de la ciudad autónoma de Buenos Aires (CABA), conformadas hacia la década de 1930 en el contexto de implantación del modelo de sustitución de importaciones, constituyen el prototipo clásico de hábitat informal y precario en Argentina. La Villa 20 se encuentra en la zona sur y cuenta con una población migrante proveniente de los países limítrofes. Según el Censo del Instituto de la Vivienda de la CABA (2016), los principales sostenes del hogar nacidos en Bolivia superan a los nativos y a los oriundos de otros países fronterizos (Paraguay y Perú). El objetivo de este trabajo es analizar los lazos con sus lugares de origen y sus vinculaciones con la dimensión socioeconómica y sociodemográfica de los hogares de migrantes bolivianos en el marco de la política local de reurbanización actual (2015-2019). De este modo, se propone analizar de manera incipiente la posibilidad de prácticas plurilocales desde una perspectiva transnacional que problematiza la definición demográfica y clásica de la migración. Para llevar a cabo este trabajo, que forma parte de un proyecto de investigación mayor, se utilizó una estrategia metodológica fundamentalmente cuantitativa, incorporando datos de fuentes primarias y secundarias. Se aplicó una encuesta con un muestreo estratégico (no probabilístico) a 60 hogares de migrantes bolivianos, donde la selección de los casos es de índole teórica. Este documento constituye una primera aproximación y se considera el primer eslabón para el desarrollo de un posterior abordaje cualitativo. The slums in the Autonomous City of Buenos Aires (CABA, in Spanish), set up in the 1930’s within the context of the import substitution model’s implementation, follow the classic prototype of informal precarious living in Argentina. Villa 20, or Slum 20, is in the south of the city and has a migrant population from neighboring countries. According to the CABA Housing Institute Census (2016), the main heads of household born in Bolivia outnumber locals or those from other neighboring countries (Paraguay and Peru). The goal is this work is to analyze the links with their places of origin and with the socioeconomic and sociodemographic aspect of Bolivian migrant homes in the context of the current local re-urbanization policy (2015-2019). In this way, the proposal is to make an initial analysis of the possibility of plurilocal practices from a transnational perspective, questioning the classic and demographic definition of migration. An essentially quantitative methodological strategy, which forms part of a larger research project, was used to carry out this work, incorporating both primary and secondary data sources. A survey was applied with a strategic (non-probabilistic) sampling to 60 homes of Bolivian migrants, where the case selection is theoretical in nature. This work constitutes a first approach and is considered as the first step for the development of a later qualitative approach. Fil: Diaz, Mariela Paula. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Instituto Multidisciplinario de Historia y Ciencias Humanas; Argentina. Universidad de Buenos Aires. Facultad de Arquitectura, Diseño y Urbanismo; Argentina

Focused clinical question What are the key considerations for the interdisciplinary dentofacial therapy (IDT) team in the diagnostic process to evaluate a patient for surgically facilitated orthodontic therapy (SFOT)? Summary SFOT creates a demineralized bone matrix and augments dentoalveolar deficiencies in the management of dentofacial disharmony malocclusion. Numerous indications and contraindications exist which are essential to the periodontal surgeon for proper case selection. A collaboratively focused workup by an IDT team is equally essential. Cone beam computed tomography (CBCT) and orthodontic simulation software which identifies changes in the dentoalveolar complex influenced by tooth movement are critical in providing transparency to the patient and IDT team during the treatment planning process. Such transparency can aid the team in assessing goals and outcomes that consider and respect foundational dentoalveolar parameters while contributing to sustainable outcomes. Conclusions The SFOT IDT decision making process is complex, yet full of opportunities. Embracing SFOT IDT with innovative and novel 3D technology can optimize conditions leading to long-term outcomes that align with periodontal stability as well as patient goals and preferences which permeate beyond the achievement of "straightening teeth". Transparency of complex IDT through 3D CBCT and orthodontic simulation software engenders "collaborative accountability" and can improve patient communication which is critical to developing meaningful and essential treatment plans.

Tooth autotransplantation is the technique of transplanting embedded, impacted or erupted teeth from one site into another in the same individual. Autotransplantation can provide a long-term, cost-effective and biological solution for adolescent patients with congenitally missing teeth or significantly compromised teeth when a suitable donor tooth is available. Successful autotransplantation of immature teeth can offer many advantages for a growing patient, including a normally functioning periodontium, proprioception and preservation of alveolar bone volume. Even in the event that an autotransplanted tooth does eventually fail, the bone and soft tissue conditions are likely to be conducive for subsequent implant treatment. Despite the significant physiological and cost-benefit advantages, tooth autotransplantation remains relatively underutilized, as the procedure is considered to be technique-sensitive. Although carefully considered individual case selection and surgical skill are the critical determinants for success, advances in three-dimensional computed tomography and rapid prototyping have the potential to simultaneously reduce the technique sensitivity and increase the predictability of the autotransplantation procedure. It is hoped that this case series will provide greater awareness and an appreciation of the tremendous value of autotransplantation for the management of patients with congenitally missing or significantly compromised posterior teeth.

Introduction:In the past decade, laparoscopic route of surgery has been on an increase especially for non-neoplastic uterine diseases. The present study aims to study and compare between Total Laparoscopic Hysterectomy (TLH) and conventional TAH (Total Abdominal Hysterectomy) in terms of characteristics like blood loss, operative time, intraoperative complications, postoperative pain & mobilisation, analgesic requirements, duration of hospital stay and finally patient satisfaction. Materials and methods: In this randomized prospective comparative study, 100 consecutive patients of hysterectomy (50 each of total TAH and TLH) at a tertiary care center in western India, were recruited. The present study aims to study and compare between TLH and conventional TAH (Total Abdominal Hysterectomy), in non-neoplastic uterine diseases, in terms of characteristics like blood loss, operative time, intraoperative complications, postoperative pain & mobilisation, analgesic requirements, duration of hospital stay and finally patient satisfaction. Results: We observed that average blood loss, postoperative pain and analgesic requirement and mean length of hospital stay in TLH was lesser than TAH group (p< 0.001). An average time taken for TLH as well as patient satisfaction level was more (p< 0.001) than that in TAH group. Intraoperative complications were comparable and not significantly different among the two procedures. Mobilization after the procedure was quicker in laparoscopic hysterectomy. Mobilization of patients during postoperative period was significantly earlier (p< 0.0001) in TLH group (12.2 hours) while in TAH (22.3 hours. Patient satisfaction level was 90% in patients in TLH group while only 60% for patients in TAH group. Conclusion: TLH is a safe and effective method of doing hysterectomy and it is a good alternative of conventional abdominal hysterectomy, especially after good training to standardized the procedure, proper case selection, day to day practice of the technique and application of sound surgical principles.

BACKGROUND: To investigate the anatomical and functional results of silicone oil (SO) removal after an extended period of SO tamponade in eyes having received vitrectomy for proliferative diabetic retinopathy (PDR). METHODS: From May 2009 to August 2017, clinical records of patients who had vitrectomy for PDR and underwent SO removal were retrospectively reviewed. SO was in principle left in the eye for an extended period of time and would be removed promptly when complications relevant to SO rose, or at the same setting when other intraocular surgeries were performed. Main outcome measures include anatomical outcome, functional outcome, and postoperative complications. RESULTS: Seventy-four eyes of 64 patients (31 males and 33 females) were analysed. The mean follow-up duration was 35.6 months (ranging from 6 to 99 months, median 32 months). The duration of SO tamponade ranged from 3 to 116 months (mean 26.89 months, median 16 months). Anatomical success was achieved in 95.9% at the last follow-up with best-corrected visual acuity (BCVA) becoming better or unchanged in 81.1%. Postoperative complications included ocular hypertension (>25 mmHg; > 4 weeks) in three eyes (4.1%), macular hole in two eyes (2.7%), transient choroidal detachment in one eye (1.4%), vitreous haemorrhage in four eyes (5.4%) and hyphaema in two eyes (2.7%). CONCLUSIONS: The rate of retinal redetachment after an extended period of SO tamponade and removal was low and the majority of eyes obtained final visual acuity improvement. SO removal after an extended period of tamponade in PDR seems to be safe under proper indications and case selection.

Most social scientists agree that case studies are useful for “theory building,” but ethnographic methods papers often look to survey research for case selection strategies. This is due to a common but untenable distinction between theoretical and empirical generalization, which obscures how theoretically inclined ethnographers make implicit external validity claims. I analyze several exemplary ethnographies to show that (a) the distinction between theoretically and empirically oriented ethnography revolves around competing conventions for making claims that others accept as provisionally externally valid, (b) comparative-historical sociology provides a framework for evaluating how theoretically oriented ethnographies make such claims, and (c) each approach to making validity claims is optimized by different kinds of cases. Empirically oriented ethnographies make inductive claims via “pointy” cases wherein a phenomenon is pronounced or bifurcated. Theoretically oriented ethnographers are like post–Millian historical sociologist who triangulate past studies with resolutive or negative cases to make constitutive arguments.

Chondrosarcomas in children and adolescents are uncommon and constitute < 5% of all chondrosarcomas. There are very few studies discussing extremity chondrosarcomas in young patients. The pelvis is the most common site, followed by the proximal femur. As cartilaginous tumours can be quite challenging to diagnose, it is best for these lesions to be discussed in a multidisciplinary meeting which includes a radiologist and a pathologist specializing in bone tumours. Treatment principles are similar to those in adults, with adequate surgical excision respecting oncologic principles being the mainstay of treatment. Select extremity Grade I chondrosarcomas may be managed with extended intralesional curettage without increasing the risk for local recurrence or metastatic disease, but case selection is critical and should be based on clinical, imaging and histological characteristics. Chondrosarcomas are resistant to chemotherapy and relatively radioresistant. For mesenchymal chondrosarcomas, there may be a role for chemotherapy, though data on this is limited. Prognosis and rate of recurrence correlate directly to the adequacy of the surgical resection. Chondrosarcomas in younger patients behave in a similar fashion to those in adults, and outcomes in the young are no different from those in adults.Cite this article: EFORT Open Rev 2020;5:90-95. DOI: 10.1302/2058-5241.5.190052

Introduction: The aim of this study was to analyze the influence of residents’ participation in flexible ureteroscopy (fURS) on intra- and postoperative outcomes. Materials and Methods: Intra- and postoperative parameters were compared in a retrospective monocentric setting between 3 groups: “resident group” (47 cases) for surgeries performed by experienced residents alone, “consultant group” (245 cases) for surgeries performed by consultants alone, “resident plus consultant group” (124 cases) for training surgeries between September 2013 and June 2017. Results: Patients operated by residents alone had a significantly smaller median kidney stone diameter (5.0 vs. 7.0 mm for “consultant group” and 6.0 mm for “resident plus consultant group,” p = 0.011), shorter operating time (median 47.0 vs. 63.0 and 77.0 min, p < 0.001) and fluoroscopy time (median 39.0 vs. 69.5 and 89.0 s, p < 0.001), as well as shorter postoperative hospital stay (p = 0.013). The laser application rate was the smallest in the “resident group” (10.64 vs. 31.43 and 29.84%, p = 0.009). Univariate analysis revealed no relevant differences regarding flexible ureteroscope defect rate, postoperative stone-free rate, or ≥2 Clavien-Dindo classification complications between the groups (p > 0.05). Conclusion: A proper case selection of less complicated cases, especially without laser application, could balance the experience deficit of the residents. fURS can be incorporated as a part of residents’ training without an impact on fURS device defect rate or clinical outcomes.

How does a political party become ‘mainstream’? And what makes some parties receive arguably the opposite designation – ‘pariah party’? This conceptual article examines the processes by which parties’ mainstream or pariah status must be constructed, negotiated and policed, not only by political scientists in the pursuit of case selection, but by several actors actively involved in the political process, including media actors and political parties themselves. It explains how these actors contribute to these processes of ‘mainstreaming’ and ‘pariahing’, considers their motivations and provides illustrative examples of how such processes take place. As such, the article moves beyond the literature on the ways in which mainstream parties seek to deal with or respond to threats from a variety of pariah parties, instead paying attention to how those parties have been constructed as pariahs in the first place, and how these processes simultaneously contribute to the maintenance of mainstream party identities.

OBJECTIVE: To determine the diagnostic yield of exome or genome sequencing (ES/GS) over chromosomal microarray analysis (CMA) in fetuses with increased nuchal translucency (NT) and no concomitant anomalies. METHODS: This systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. PubMed, Scopus and Web of Science were searched for studies describing ES/GS in fetuses with isolated increased NT. Inclusion criteria were: (1) study written in English; (2) more than two fetuses with increased NT > 99(th) percentile and no concomitant anomalies; and (3) a negative CMA result considered as the reference standard. Only positive variants identified on ES/GS that were classified as likely pathogenic or pathogenic and determined to be causative of the fetal phenotype were considered. Risk was assessed as the pooled effect size by single-proportion analysis using random-effects modeling (weighted by inverse of variance). RESULTS: Eleven studies reporting on the diagnostic yield of ES/GS in fetuses with isolated increased NT > 99(th) percentile were identified and included 309 cases. All studies were high quality according to Standards for Reporting of Diagnostic Accuracy. Overall, a pathogenic or likely pathogenic variant was identified on ES/GS in 15 fetuses, resulting in a pooled incremental yield of 4% (95% CI, 2-6%). Six (40%) of these fetuses had NT of 5 mm or more. The observed inheritance pattern was autosomal dominant in 12 cases, including four fetuses with Noonan syndrome, autosomal recessive in two cases and X-linked in one case. CONCLUSIONS: There is a 4% incremental diagnostic yield of ES/GS over CMA in fetuses with increased NT > 99(th) percentile without a concomitant anomaly. It is unclear whether a NT cut-off higher than 3.5 mm may be more useful in case selection for ES/GS. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

The treatment of intracranial aneurysms has undergone a few very significant paradigm shifts in its history. Needless to say, microsurgery and surgical clipping served as the initial basis for successful treatment of these lesions. The pursuit of endovascular therapy subsequently arose from the desire to reduce the invasiveness of therapy. While the first breakthrough arose with Guido Guglielmi's invention of the detachable platinum coil, commercialized flow diverter therapy represents a disruptive therapy with a completely different paradigm for aneurysmal obliteration. This has not only altered the distribution of aneurysmal management strategies, but also opened the gateway to the treatment of previously inoperable lesions. With the basic flow diverter stent technology now considered an integral part of the neurointerventional armamentarium, we now consider what may lay in the future – including potential directions for research with regards to case selection; the location and type of aneurysms which may become routinely treatable; and modifications to the flow diverter, which may increase its utility and safety in terms of size, structural design, and surface modifications.

RESUMEN El presente artículo analiza el alcance de la obligación de investigar, juzgar y sancionar en escenarios de transición de conflicto armado a una paz negociada, a la luz de la jurisprudencia del Sistema Interamericano de Derechos Humanos (SIDH) y del marco jurídico que rige a la Corte Penal Internacional (CPI). A través de un análisis doctrinal y jurisprudencial, las autoras identifican que existen debates, vacíos y cuestiones problemáticas en la determinación de la obligación de investigar, juzgar y sancionar, y que para darle mayor claridad deben analizarse conjuntamente el SIDH y el marco normativo de la CPI, ya que pueden resultar complementarios teniendo en cuenta el alto contenido penal de la obligación. Así mismo, las autoras evidencian que la existencia de vacíos en la determinación de la obligación, especialmente en relación con las conductas objeto de la obligación y la posibilidad de seleccionar casos y concentrarse en los máximos responsables, tiene graves consecuencias para la seguridad jurídica de los Estados y de los ciudadanos. ABSTRACT This article analyzes the scope of the obligation to investigate, prosecute and punish in a scenario of transition from armed conflict to a negotiated peace, in light of the jurisprudence of the Inter-American Human Rights System and the legal framework that governs the International Criminal Court. Through a doctrinal and jurisprudential analysis, the authors identify that there are debates, gaps and problematic issues in the determination of the duty to investigate, prosecute and punish. In order to give greater clarity, the IAHRS and the normative framework of the ICC must be analyzed together, since they can be complementary considering the high criminal content of the obligation. Likewise, the authors find that the existence of gaps in the determination of the obligation, especially in relation to the conducts subject to the obligation and the possibility of selecting cases and concentrating on those most responsible, has serious consequences for the legal security of the States and citizens.

OBJECTIVES: This study aims to present the outcomes of our decade-long experience of robotic pancreatoduodenectomy and provide insights into successful program implementation. BACKGROUND: Despite significant improvement inmortality over the past 30 years, morbidity following open pancreatoduodenectomy remains high. Weimplemented a minimally invasive pancreatic surgery program based on the robotic platform as one potential method of improving outcomes for this operation. METHODS: A retrospective review of a prospectively maintained institutional database was performed to identify patients who underwent robotic pancreatoduodenectomy (RPD) between 2008 and 2017 at the University of Pittsburgh. RESULTS: In total, 500 consecutive RPDs were included. Operative time, conversion to open, blood loss, and clinically relevant postoperative pancreatic fistula improved early in the experience and have remained low despite increasing complexity of case selection as reflected by increasing number of patients with pancreatic cancer, vascular resections, and higher Charlson Comorbidity scores (all P2) occurred in less than 24%, clinically relevant postoperative pancreatic fistula in 7.8%, 30- and 90-day mortality were 1.4% and 3.1% respectively, and median length of stay was 8 days. Outcomes were not impacted by integration of trainees or expansion of selection criteria. CONCLUSIONS: Structure dimple mentation of robotic pancreatoduodenectomy can be associated with excellent outcomes. In the largest series of RPD, we establish benchmarks for the surgical community to consider when adopting this approach.

Objective To determine the value of Bohler's angle (BA) in a group of Chinese people, analyze possible factors that influence it, and compare BA with that in previous literature. Methods A total of 143 cases, aged from 4 to 79 years, were enrolled in the study, including 64 males and 79 females (79 left feet and 64 right feet). Radiographs were independently measured by six observers. Age, sex, body side, subtalar joint congruity (STJC), and X-beam obliquity (TT) were recorded. The database was assessed based on intraobserver agreement, data distribution, the randomness of case selection, and the ratio equality of binomial variables. Then, the normal value of BA was established, as well as the correlation between BA and other parameters. Results In the present study, the interobserver reliability of BA, STJC, and TT was excellent. The BA data revealed a normal distribution, and the randomness of case selection was verified for age, sex, and body side. The ratio of sex and body side was equal. Homogeneity of variance was observed when comparing the value of BA between different groups. The value of BA was 31.6° ± 5.19° (range, 20.08°-47.19°), which was not related to age, sex, body side, and minor X-ray beam obliquity. BA application was not suitable for individuals younger than 10 years. The mean value of BA in this study was not identical with those in previous reports. This demonstrated that BA varies for different races. Conclusion For Chinese people, 30° to 33° is recommended as the target value of BA for calcaneal fracture reduction, except in children under 10 years of age.

Tunneling technique (TUN) has been introduced as a minimally invasive and highly esthetic treatment option for the treatment of gingival recession, one of the most frequent mucogingival deformities and conditions. The purpose of the present article is to review how specific technique modifications, different grafting materials, and different defect characteristics may affect the outcome of TUN for root coverage. TUN has been shown to be an efficacious root coverage technique that, in combination with various grafting materials, can achieve satisfactory root coverage outcomes in Miller class I and II recession defects that are more predictable in the maxilla and when multiple adjacent defects are treated. Recent evidence suggests that specific technique modifications may be promising for the treatment of challenging multiple Miller class III recession defects. In order to achieve successful root coverage outcomes with TUN, the etiology of the defect should be identified and risk factors controlled, case selection is critical, specific technique modifications may be beneficial, and a variety of graft materials may be utilized.

DOI: 10.1590/2179-8966/2021/57260.Resumo Quando define a pauta de julgamento, o presidente do STF também seleciona qual caso julgar. Este artigo argumenta que a escolha entre selecionar uma controvérsia concreta ou um julgamento de uma lei em tese, quando questões constitucionais idênticas estão em jogo, poderia gerar problemas de inconsistência e incoerência nos julgamentos. Nessas situações, o resultado do julgamento poderia não ser fruto de uma empreitada colegiada, mas sim da regra de seleção de casos. A solução seria uma deliberação sobre qual caso julgar.Palavras-chave: Pauta de julgamento; Seleção de casos; Paradoxo doutrinário.Abstract In Brazilian Supreme Court, the chief justice has the power of agenda-setting. By doing that, he also has the power of case selection. Through case selection, the chief justice is able to prioritize a concrete case instead of an abstract judicial review regarding the same constitutional issue. In situations like that, this paper argues that case selection could entail problems of inconsistency and incoherence. The result of the judgement turns out to be a mere consequence of the case selection rules, instead of a truly collegiate decision. In those cases, the court should deliberate on the case selection through the so-called meta-vote.Keywords: Agenda-setting; Case selection; Doctrinal paradox.

Resumo: Este artigo, direcionado aos pesquisadores que considerem adequada a utilização de estudos de caso em suas pesquisas, visa apresentar, de maneira sistematizada, os sete principais elementos relacionados ao procedimento de seleção de casos - isto é, o processo que se inicia com a pergunta de pesquisa e que se encerra com a escolha dos casos propriamente dita, sendo perpassada por uma necessidade latente de garantia de transparência. Para tal finalidade, é empreendida uma revisão bibliográfica narrativa com a finalidade de organizar, de maneira intuitiva, alguns elementos que se encontram dispersos pela literatura que trata do assunto. Com isso, busca-se contribuir tanto com o fortalecimento do uso rigoroso dos estudos de caso quanto com o desenvolvimento de um debate mais amplo sobre a necessidade de maior transparência e sistematização no que tange ao emprego de diferentes métodos nas ciências sociais brasileiras. Abstract: This article, directed at researchers who consider it appropriate to use case studies in their investigations, aims to present, in a systematic way, the seven key elements related to the case selection procedure - that is, the process that begins with the research question and that ends with the case selection itself, while dealing with the latent need to guarantee transparency along the way. To this end, a narrative literature review is conducted in order to organize and to present in an intuitive manner elements scattered throughout the literature on case studies. The purpose is to contribute to a more rigorous use of case studies and to the development of a broader debate on the need for more transparency and systematization in the use of different methods in Brazilian Social Sciences. Resumen: Este artículo, dirigido a investigadores que consideren oportuno utilizar estudios de casos en sus investigaciones, tiene como objetivo presentar de manera sistemática los siete principales elementos relacionados con el procedimiento de selección de casos - o, en otras palabras, el proceso que comienza con la pregunta de investigación y que finaliza con la elección de los casos propiamente dichos, atravesado por una necesidad latente de garantizar la transparencia. Para ese propósito, se realiza una revisión bibliográfica narrativa con el objetivo de organizar de una manera intuitiva algunos elementos que se encuentran dispersos en la literatura de lo asunto. Con ello, lo que se busca es contribuir tanto con el fortalecimiento del uso riguroso de los estudios de caso como con el desarrollo de un debate más amplio sobre la necesidad de que exista una mayor transparencia y sistematización en el uso de diferentes métodos en las ciencias sociales brasileñas.

Aims Evaluating the effect of Covid-19 on case selection and perioperative outcomes of emergency laparotomies across South West London (SWL). Methods A retrospective cohort study including all emergency laparotomies performed at three SWL-based NHS hospitals from 01/04/2020-31/12/2020 (i.e., “pandemic” cohort; from the first national lockdown), versus a “pre-pandemic” cohort (01/04/2019-31/12/2019). Data was extracted from the NELA database and hospital records, and analysed by two independent clinicians. Results 414 patients met the inclusion criteria. 17.6% fewer (227 vs. 187) laparotomies were performed during the pandemic period. There were no significant sociodemographic differences between cohorts (mean age 64.5 vs. 62.7 years, p = 0.284; M:F ratio 1:1.154 vs. 1:0.928, p = 0.221). Pre-operative NELA risk scores were higher before the pandemic (mean 13.05% vs. 9.55%, p = 0.020). The commonest indication for laparotomy in both cohorts was small bowel obstruction (32.6% vs. 37.4%), treated most commonly with adhesiolysis. Postoperatively, fewer patients received HDU/ITU care during the pandemic than before (ward-based recovery 4.7% vs. 13.8%, HDU/ITU recovery 93.4% vs. 79.4%, χ2=15.4, p Conclusions The overall reduction in emergency laparotomies observed during the pandemic period was potentially secondary to tighter case selection guided by objective risk stratification. Fewer patients were recovered postoperatively on HDU/ITU, and patients were generally discharged from hospital earlier. Such trends in perioperative care served to support organizational prioritization in response to Covid-19 service provision.

The LiverTox database compiles cases of idiosyncratic drug-induced liver injury (iDILI) with the promised aims to help identify hepatotoxicants and provide evidence-based information on iDILI. Weaknesses of this approach include case selection merely based on published case number and not on a strong causality assessment method such as the Roussel Uclaf Causality Assessment Method (RUCAM). The aim of this analysis was to find out whether the promised aims have been achieved by comparison of current iDILI case data with those promised in 2012 in LiverTox. First, the LiverTox criteria of likelihood categories applied to iDILI cases were analyzed regarding robustness. Second, the quality was analyzed in LiverTox cases caused by 46 selected drugs implicated in iDILI. LiverTox included iDILI cases of insufficient quality because most promised details were not fulfilled: (1) Standard liver injury definition, (2) incomplete narratives or inaccurate for alternative causes, and (3) not a single case was assessed for causality with RUCAM, as promised. Instead, causality was arbitrarily judged on the iDILI case number presented in published reports with the same drug. All of these issues characterize the paradox of LiverTox, requiring changes in the method to improve data quality and database reliability. In conclusion, establishing LiverTox is recognized as a valuable effort, but the paradox due to weaknesses between promised data quality and actual data must be settled by substantial improvements, including, for instance, clear definition and identification of iDILI cases after evaluation with RUCAM to establish a robust causality grading.