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Summary: Background: Venous thromboembolism appears to be associated with severe COVID-19 infection than in those without it. However, this varies considerably depending on the cohort studied. The aims of this single-centre, multi-site retrospective cross-sectional study were to assess the number of all venous scans performed in the first month of pandemic in a large university teaching hospital, to evaluate the incidence of deep venous thrombosis (DVT), and assess the predictive ability of the clinical information available on the electronic patient record in planning work-up for DVT and prioritising ultrasound scans. Patients and methods: All consecutive patients undergoing venous ultrasound for suspected acute DVT between 1st of March and 30th of April 2020 were considered. Primary outcome was the proportion of scans positive for DVT; the secondary outcomes included association of a positive SARS-CoV-2 PCR test, demographic, clinical factors, and Wells scores. Results: 819 ultrasound scans were performed on 762 patients across the Trust in March and April 2020. This number was comparable to the corresponding pre-pandemic cohort from 2019. The overall prevalence of DVT in the studied cohort was 16.1% and was higher than before the pandemic (11.5%, p=.047). Clinical symptoms consistent with COVID-19, irrespective of the SARS-CoV-2 PCR test result (positive_COVID_PCR OR 4.97, 95%CI 2.31–10.62, p

The present paper investigates the location pattern of co-working spaces in Delhi which is absent in the existing body of knowledge. Delhi is a political, administrative, educational, scientific and innovation capital that accommodates many co-working spaces in India. We developed Ordinary least squares (OLS) and geographically weighted regression (GWR) models to understand the associations of co-working spaces of digital labourers with other urban socio-economic, services and lifestyle variables in Delhi using secondary data for 117 coworking locations in 280 municipal wards of NCT-Delhi. Model diagnostic suggested that the GWR model provides additional information regarding geographical distribution of coworking spaces, and density of bars, median house rent, fitness centres, metro train stations, restaurants, cinemas, cafés, and creative enterprises are statistically significant parameters to estimate them. The importance of coworking spaces has increased in the post-disaster period, so this study informs public policies to benefit people and companies who choose coworking routes, and recommends urban planners, developers, and real-estate professionals to consider the proximity of creative industries in planning and developing coworking spaces in the future. Also, in the post COVID-19 period, to increase local jobs and long-term place sustainability, a localised policy intervention for coworking spaces in Delhi is highly recommended.

BACKGROUND: The infection caused by the SARS-CoV-2 (COVID-19) pandemic is a threat to human lives. An early and accurate diagnosis is necessary for treatment. OBJECTIVE: The study presents an efficient classification methodology for precise identification of infection caused by COVID-19 using CT and X-ray images. METHODS: The depthwise separable convolution-based model of MobileNet V2 was exploited for feature extraction. The features of infection were supplied to the SVM classifier for training which produced accurate classification results. RESULT: The accuracies for CT and X-ray images are 99.42% and 98.54% respectively. The MCC score was used to avoid any mislead caused by accuracy and F1 score as it is more mathematically balanced metric. The MCC scores obtained for CT and X-ray were 0.9852 and 0.9657, respectively. The Youden’s index showed a significant improvement of more than 2% for both imaging techniques. CONCLUSION: The proposed transfer learning-based approach obtained the best results for all evaluation metrics and produced reliable results for the accurate identification of COVID-19 symptoms. This study can help in reducing the time in diagnosis of the infection.

This paper summarizes the results of a comprehensive analysis to investigate the performance of both thermal comfort-based and temperature-based controls for schools in harsh hot climates of Saudi Arabia. The analysis considers the impact of building envelope characteristics including thermal insulation level of exterior walls and air leakage rate on the ability of both control options to maintain indoor thermal comfort while minimizing cooling energy consumption. The analysis utilizes a calibrated energy model for an existing Saudi school with monitored energy consumption data. The analysis results indicated that the thermal comfort-based control is able to maintain the predicted percentage of dissatisfied (PPD) value at 5% throughout the year for any combination of the exterior wall’s R-value and air infiltration rate unlike the case of the temperature-based controls that do not maintain acceptable indoor thermal comfort conditions. However, the thermal comfort-based controls consume more cooling energy than the temperature-based controls. The analysis also revealed that the difference between the annual cooling energy of the PMV-based control and the temperature-based controls increases almost linearly with the cooling degree days of the site where the school is located. The analysis results indicate that acceptable indoor thermal comfort levels can be achieved using temperature-based controls when optimal temperature set points are used.

Isolated extracranial internal carotid artery aneurysms (EICAAs) are rare, accounting for only about .4–4% of all peripheral artery aneurysms. We present a case of an EICAA in a young pregnant patient. To our knowledge, this is the first case being reported of a true EICAA during pregnancy in a multiparous woman. A 25-year-old pregnant patient presented with a pulsatile left neck swelling. Radiological investigations and subsequent surgery during the first trimester confirmed a true saccular left ICA with a maximum diameter of 3.5 cm. She was treated with aneurysm excision and primary anastomosis. She did not have any underlying diseases predisposing to an EICAA. She has been well for 3 years post procedure. It has been postulated that pregnancy could lead to aneurysm development through multiple mechanisms, including hemodynamic, hormonal, and other physiologic changes of pregnancy. Aggressive treatment with surgical intervention is advocated because of the risk of cerebral ischemic complications associated with non-operative treatment, and because satisfactory long-term outcomes can be achieved from surgery.

Background Current instruction for endovenous laser ablation (EVLA) recommends that the laser fibre tip should be at least 2 cm caudal to the saphenofemoral or saphenopopliteal junction. This is to reduce risk of deep vein thrombosis (DVT) whilst ensuring that the Great Saphenous Vein (GSV)/Short saphenous vein (SSV) occlusion (residual stump) is close to the SFJ/SPJ to reduce recurrence rates. Our aim was to primarily assess the effects of pre-operative junction distance of the laser fibre on stump length but also look at other factors affecting this. Patient and Methods This was a retrospective analysis of an electronic collected database performing EVLA of the GSV and SSV under local anaesthesia. Patients with previous venous thromboembolic events and incomplete data were excluded. Patients were reviewed at 6 weeks with venous Duplex scan to assess for the residual stump distance and DVT. Multivariable logistic regression was used to account for confounders. Results Between 2012 and 2018, 2341 patients underwent EVLA and complete data were available on 825 (35.2%) patients. All patients were scanned 6 weeks after procedure. Sixty-nine patients (8.4%) had flush occlusion, 3 patients (.4%) had extension into femoral or popliteal vein but not considered to be a DVT and 1 patient had a DVT. High BMI and increasing length of the pre-operative junction was associated with lower incidence of flush occlusion; higher rates of flush occlusions were noted in patients undergoing short saphenous vein (SSV) EVLT (OR 4.11, 95% CI 2.34-7.20; P < .001). Conclusions Consideration should be given to increase the intra-procedure laser tip junction to more than 2 cm particularly in patients undergoing SSV treatment to ensure that residual stump is sufficiently distal to SPJ and SFJ reducing risks of thrombus into the femoral or popliteal veins. Lower BMI may be associated with higher risk of this though the reasons for this are unclear.

Investigation of the parameters affecting the agglomeration process of nanoparticles and its morphology is a challenging research problem. In recent years, various computer simulation methods are d...

Introduction There has been an exponential rise in number of coronavirus disease 2019 (COVID-19)-positive infections since March 23, 2020. However, cancer management cannot take a backseat. Objective The aim of this study was to identify any difference in the complication and mortality rates for the cancer patients operated during the ongoing COVID-19 pandemic. Materials and Methods This was a retrospective study of a prospectively maintained database of five centers situated in different parts of India. Variables such as demographics, intraoperative, and postoperative complications were compared between COVID-19 (group A—March 23, 2020–May 22, 2020) and pre-COVID time period (group B—January 1 to January 31, 2020). Results One-hundred sixty-eight cancer surgeries were performed in group B as compared with 148 patients who underwent oncosurgeries in group A. Sixty-two percent lesser cancer surgeries were performed in the COVID-19 period as compared with the specific pre-COVID-19 period. There was no significant difference in age group, gender, comorbidities, and type of cancer surgeries. Except for the duration of surgery, all other intraoperative parameters like blood loss and intraoperative parameters were similar in both the groups. Minimally invasive procedures were significantly lesser in group A. Postoperative parameters including period of intensive care unit stay, rate of infection, need for the change of antibiotics, and culture growth were similar for both the groups. While minor complication like Clavien-Dindo classification type 2 was significantly higher for group A, all other complication rates were similar in the groups. Also, postoperatively no COVID-19-related symptoms were encountered in the study group. A subset analysis was done among the study groups between those tested preoperatively for COVID-19 versus those untested showed no difference in intraoperative and postoperative parameters. No health-care worker was infected from the patient during the time period of this study. Conclusion Our study shows that there is no significant difference in the incidence of postoperative morbidity and mortality rates in surgeries performed during COVID-19 pandemic as compared with non-COVID-19 time period.

Purpose By using exploratory mixed methods, this study aims to present the investigation of the existing situation of private off-campus student accommodation at the University of Allahabad (UoA) in Prayagraj city. Design/methodology/approach This study explored the geographical variability of student’s private rental housing in Prayagraj city of India through 721 responses from an online semi-structured questionnaire, together with 12 interviews. Moran’s I and LISA were used to determine spatial clustering of rents paid by male and female students. Findings Results of this study reveal prevalence of unregulated with poor quality of off-campus housing in general and expensive rents in the proximity of UoA. Research limitations/implications Obtaining less responses from the female students was one of the important limitations. Practical implications A win-win strategy might be formulated with a mix of innovative solutions inclusive of public private partnerships and social economy solutions woven with need-based rental housing, rekindled as the affordable rental housing complexes after COVID-19 pandemic. Social implications This study is highly beneficial to improve liveability in the student housing segment. Originality/value This paper develops extensive understanding on the potential student housing segment in the Indian cities. Additionally, this paper demonstrates weak coordination between the central government policies, educational administrators and municipal officials.

With more than 84% of the population residing in cities, the Kingdom of Saudi Arabia is among the highly urbanized countries in the world. New strategic policies support the development of smart cities across the kingdom. Though non-availability of data is a major hurdle in the way of planning smart cities. We used a mixed method approach for this study including a qualitative review of various urban planning applications in Jeddah and worldwide in combination with a pilot survey to understand what type and mode of data reporting people prefer. Based on the initial findings a data crowdsourcing application—‘SMART JEDDH’ was developed and tested. Around 177 crowdsourced reports detecting 15 hotspots of car parking dearth, while 47 PM2.5 measurements at King Abdulaziz University campus was recorded. Results were visualized by heat maps in an open-source GIS environment. Furthermore, we model developed ordinal logistic regression (OLR) models with the 1581 responses on 5-point Likert scale to answer 3 key questions including importance of smartphone-based participation in resolving location specific urban challenges, importance of public participation through smartphones in the improvement of the quality of smart city plans, and the importance of the role of the authorities in mobilising people for smartphone-based participation. OLR results revealed that there is a significant difference of public opinions based on their nationality, gender, education, profession, and income levels in the city of Jeddah. Finally, we recommend that crowdsourced smartphone applications should be promoted for data collection because of inherent benefits through increased public participation. Abundant data though public participation might be helpful in realizing success of smart cities under Vision 2030 of Saudi Arabia of which maximizing ‘quality of life’ is a key target.

Introduction: Endovenous cyanoacrylate glue (CAG) ablation for the treatment of chronic venous insufficiency (CVI) and varicose veins has shown non-inferior outcomes with an excellent safety profile, high patient satisfaction rate, and excellent efficacy when compared to the gold standard of endothermal ablation. A review of the current literature for CAG use in CVI showed that most studies and longer-term data are from Caucasian-based populations, which are subject to different anatomical venous variations and socio-economical contexts. This review aimed to gather the current evidence for CAG use in Asian CVI patients. Methods: Asian studies for the use of CAG in CVI were included in this review. Successful ablation rates, quality of life improvement and novel complications such as glue hypersensitivity reactions are described, along with anatomical descriptions of superficial venous anatomy in study patients. Use of CAG in Singapore and Asia was addressed. Results: CAG has been gaining traction as an option for CVI treatment in Asians. In Singapore, it has been adopted with comparable low complication rates and significant improvement of quality of life after treatment. As we increase our understanding of the variations in venous anatomy in the Asian population, new techniques such as retrograde deployment of the device and use of CAG ablation for venous leg ulcers have been developed. Conclusion: Further robust evidence in terms of large randomised control trials along with costeffectiveness studies are needed to determine the true value of CAG ablation in the Asian setting.

Objective While it is generally considered that patients with diabetes mellitus (DM) have more distal peripheral arterial disease (PAD), there is little information on how individual vessels are affected. The aim of this study was to adapt Bollinger's scoring system for lower limb angiograms (DSAs) to include the distal and planter vessels. The reliability of this extension was tested and was used to compare the distribution of disease in two cohorts of patients with and without DM. Methods Patients who had undergone DSA ± angioplasty for PAD at a single centre between September 2010 and April 2014 were identified. Twenty-five patients' images were reviewed by four clinicians and scored using an extended version of the Bollinger score. A total of 153 patients with DM were matched, for age, sex, ethnicity, smoking, and hypertension, with 153 patients without DM. The infrainguinal vessels were divided into 16 arterial segments, including plantar vessels, and scored using the Bollinger score. The score ranges from 0 to 15. Fifteen represents an arterial segment with more than 50% of its length occluded. Interobserver reliability was tested using interclass correlation (ICC) and Cohen's kappa coefficient. Results The ICC demonstrated good agreement between observers (0.76 [0.72–0.79]) with good internal consistency (Cronbach's alpha 0.93). When the Bollinger scores were categorised, the results were weaker, Cohen's kappa ranged from 0.39 (standard error 0.033) to 0.54 (0.030). Patients with DM had a higher burden of disease in the anterior tibial and posterior tibial arteries with relative sparing of the peroneal artery and no difference in the plantar vessels. Conclusion It has been demonstrated that the Bollinger score can be extended to include the distal vessels. This amended scoring system can be used to compare the burden of distal disease in patients with PAD. How the score relates to clinical presentation and outcomes needs further investigation.

Saudi cities were expanded toward the outer areas in the past; that has produced urban sprawl which is solely dependent on private cars, as an outcome of cheaper gasoline. However, decreasing energ...

Effect of INM approach on Sulphur farctions in rice grown on a Vertisol was studied under long-term fertilizer experiment during kharif 2019 at research farm of Indira Gandhi Krishi Vishwavidyalaya, Raipur (C.G.). The experiment comprised of different levels or doses of NPK fertilizers alone and in combination with zinc sulphate, farmyard manure (FYM), blue green algae (BGA) and green manuring (GM) was laid out in randomized block design with four replications and ten treatments viz. Control, 50% NPK,”“100% NPK,”“150% NPK,”“100% NPK”+“ZnSO4@ 10kg”ha-1,”100% NP, “100% N,”“100% NPK + FYM” @“5t ha-1”, “50% NPK+BGA”@ “10kg ha-1” and “50% NPK + GM” @“40kg ha-1. Different S fractions were estimated in surface and sub-surface soil samples before the rice transplanting (2019). Application of 150% NPK significantly increased the sulphate sulphur (36.4 kg ha-1), water soluble sulphur (35.0 kg ha-1), organic sulphur (86 kg ha-1) and heat soluble sulphur (80 kg ha-1) as compared to other treatments. A decrease in S fractions was observed with increase in the depth of soil from 0-15 to 15-30 cm. The results of surface and sub surface soil samples (0-15 cm and 15-30 cm) collected before of rice showed that zero fertilization led to decline in the levels of all the S forms, while application of sulphur containing fertilizer (SSP and ZnSO4) and organics increased it over omission of these nutrients and control. Organic sulphur was found to be the most dominant fraction (about 90%) followed by heat soluble sulphur. Integration of inorganic fertilizers with organics proved better as compared to application of inorganic fertilizers alone. Integrated use of inorganic fertilizers in conjunction with organics increased grain and straw yields over inorganically treated plots. Highest grain and straw yields of rice were recorded in 150% NPK 6970 and 8364 (kg ha-1), respectively. The yield of rice had highest correlation with sulphate sulphur (r=0.810**) followed by water soluble (r=0.793**). The values of coefficients of correlation for sulphate S, water soluble S, heat soluble S and organic S with yield of rice were 0.810**, 0.793**, 0.737** and 0.790**, respectively. All the sulphur fractions positively correlated with each other amongst continuous application of inorganic fertilizers and organic manure.

The experiment was conducted during the kharif season at research farm, Indira Gandhi Krishi Viswavidyalaya, Raipur to investigate the long term effect of Inorganic fertilizer and organic manures on soil fertility, microbial biomass carbon and yield or rice. The soil was sandy loan and locally known as matasi, neutral in pH, Low in nitrogen, medium in P and K. the experiment was laid in RBD and replicated three times with eleven treatment T1 -No Fertilizer, No Organic manure (Control),T2 -50% Recommended NPK (40:30:20), T3-75% Recommended NPK,T4-100% Recommended NPK (80:60:40),T5-50% Recommended NPK +50%N through Farm yard manure,T6 -75% Recommended NPK +25%N through Farm yard manure,T7-50% Recommended NPK +50%N through rice residue,T8-75% Recommended NPK +25%N through rice residue,T9-50% Recommended NPK +50%N through Green manure,T10-75% Recommended NPK +25%N through Green manure,T11- Conventional Farmer’ Practice (50:30:20). A medium duration high yielding rice variety Mahamaya was taken as test crop. The results revealed that combination application of inorganic fertilizer and organic manure i.e. integrated of fertilizer and manure improve chemical propertied of soil like organic carbon, available N, P, and K status in soil microbial biomass in soil as compare to absolute and alone inorganic fertilizer. Application of organic (FYM, Rice residue, Green manure) with inorganic fertilizer in rice along with 50 and 75 % RDF gave higher soil organic carbon available P and MBC content of soil as compared to control. The result revealed that MBC positively significant correlated with organic carbon, available N, P and K and yield of rice.

Background and aims: Atherosclerosis is widely accepted to be an inflammatory disease driven by lipid accumulation and leukocyte recruitment. More recently, galectins, a family of β-galactoside binding proteins, have been shown to play a role in leukocyte recruitment among other immunomodulatory functions. Galectin (Gal) −9, a tandem repeat type galectin expressed by the endothelium in inflammatory environments, has been proposed to promote leukocyte recruitment. However, the role of Gal-9 in the context of monocyte recruitment remains elusive. Methods and Results: Here, we characterise the immunomodulatory role of Gal-9 in context of atherosclerosis. We show that ApoE−/−Gal-9−/− mice have a significantly reduced aortic plaque burden compared to their ApoE−/− littermate controls after 12 weeks of high fat diet. RNA sequencing data from two independent studies reveal Lgals9 expression in leukocyte clusters isolated from murine atherosclerotic plaques. Additionally, soluble Gal-9 protein induces monocyte activation and a pro-inflammatory phenotype in macrophages. Furthermore, we show that immobilised recombinant Gal-9 acts as capture and adhesion molecule for CD14+ monocytes in a β2-integrin and glycan dependent manner, while adhesion of monocytes to stimulated endothelium is reduced when Gal-9 is knocked down. Gal-9 also facilitates enhanced recruitment of leukocytes from peripheral arterial disease (PAD) patients compared to healthy young and aged controls. We further characterise the endothelium as source of circulating Gal-9, which is increased in plasma of PAD patients compared to healthy controls. Conclusions: These results highlight a pathological role for Gal-9 as promoter of monocyte recruitment and atherosclerotic plaque progression, making it a novel target in the prevention of plaque formation and progression.

Introduction Access to the femoral artery for a femoral endarterectomy and patchplasty (CFE) can be undertaken either through transverse (TI) or longitudinal incision (LI). LIs have been shown in previous studies to have higher groin complications though these were undertaken in multiple types of vascular procedures. We looked at wound complications for patients undergoing elective CFE procedures only with or without angioplasty via TI or LI. Methods All patients who had undergone CFE were retrospectively analysed from a prospective database. Length of stay, wound complications and readmission rates were recorded. Factors for wound complication were looked at using logistic regression with backward elimination. Results 122 CFE procedures were performed (30 TI) over the study period. 92 (76.7%) of patients had a prosthetic patch used, whilst 57 (46.7%) patients underwent an adjunctive endovascular procedure, namely, iliac angioplasty and stenting. Median length of stay was 3 days for both groups. The wound complication rate was 6.7% in the TI group and 22.6% in the LI group. 85.6% of the wound complications were identified after discharge. 6/122 (4.9%) were readmitted for intravenous antibiotics, whilst others were managed in the outpatient setting. TI (aOR = 0.15; 95% 0.03–0.75) and combined open FE with endovascular revascularisation (aOR = 0.33; 95% 0.11–0.95) had protective effects on wound complications. Type of the patch used was not associated with any wound complications ( p = 0.07). Conclusion Compared to traditional LI, TI for CFE and OTA have lower risk of wound complications and reduced readmission rates in our series. We advocate adopting TI as the standard for femoral artery procedures rather than LI.

Neutrophil trafficking is a key component of the inflammatory response. Here, we have investigated the role of the immunomodulatory lectin Galectin-9 (Gal-9) on neutrophil recruitment. Our data indicate that Gal-9 is upregulated in the inflamed vasculature of RA synovial biopsies and report the release of Gal-9 into the extracellular environment following endothelial cell activation. siRNA knockdown of endothelial Gal-9 resulted in reduced neutrophil adhesion and neutrophil recruitment was significantly reduced in Gal-9 knockout mice in a model of zymosan-induced peritonitis. We also provide evidence for Gal-9 binding sites on human neutrophils; Gal-9 binding induced neutrophil activation (increased expression of β2 integrins and reduced expression of CD62L). Intra-vital microscopy confirmed a pro-recruitment role for Gal-9, with increased numbers of transmigrated neutrophils following Gal-9 administration. We studied the role of both soluble and immobilized Gal-9 on human neutrophil recruitment. Soluble Gal-9 significantly strengthened the interaction between neutrophils and the endothelium and inhibited neutrophil crawling on ICAM-1. When immobilized, Gal-9 functioned as an adhesion molecule and captured neutrophils from the flow. Neutrophils adherent to Gal-9 exhibited a spread/activated phenotype that was inhibited by CD18 and CD44 neutralizing antibodies, suggesting a role for these molecules in the pro-adhesive effects of Gal-9. Our data indicate that Gal-9 is expressed and released by the activated endothelium and functions both in soluble form and when immobilized as a neutrophil adhesion molecule. This study paves the way for further investigation of the role of Gal-9 in leukocyte recruitment in different inflammatory settings.

Considering spatial accessibility of health services is a critical part in the planning and management of health services. There is evidence that poor geographical locations can obstruct prompt basic health care services to some population sections. We developed a location-allocation P-median model for health centres after analysing their sites, demand location of health services and the road network in Jeddah, Saudi Arabia. This model attempts to optimize health care services network and to put forward location recommendations to maximise service coverage. Our model is shown to be useful as it provides a robust evidence base to urban planners and policymakers responsible for making spatial decisions for the development of the health sector. Besides, it follows the paradigm of new urbanism that encourages decentralisation of essential facilities including basic healthcare in cities, where emphasis is on offering all basic services within walkable distances of 15 min. or less.

Air pollution is fatal. Fine particles, such as PM2.5, in ambient air might be the cause of many physical and psychological disorders, including cognitive decline. This is why educational policymakers are adopting sustainable mobility, and other policy measures, to make their campuses carbon-neutral, however, car-dependent cities and their university campuses are still lagging behind in this area. This study attempts to model the spatial heterogeneity and determinants of PM2.5 at the King Abdulaziz University campus in Jeddah, which is ranked first among the Saudi Arabian universities, as well as in the MENA region. We developed four OLS and GWR models of different peak and off-peak periods during weekdays in order to estimate the determinants of the PM2.5 concentration. The number of cars, humidity, temperature, windspeed, distance from trees, and construction sites were the estimators in our analysis. Because of a lack of secondary data at a finer scale, we collected the samples of all dependent and independent variables at 51 locations on the KAU campus. Model selection was based on RSS, log-likelihood, adjusted R2, and AICc, and a modal comparison shows that the GWR variant of Model-2 outperformed the other models. The results of the GWR model demonstrate the geographical variability of the PM2.5 concentration on the KAU campus, to which the volume of car traffic is the key contributor. Hence, we recommend using the results of this study to support the development of a car-free and zero-carbon campus at KAU, furthermore, this study could be exploited by other campuses in Saudi Arabia and the Gulf region.

The creation of an arteriovenous fistula instead of a synthetic vascular graft is a smart decision in hemodialysis patients who do not have a suitable superficial vein. Basilic vein transposition (BVT) is a viable option in most cases, except in patients who do not have a proper basilic vein. In patients with inadequate superficial veins, another source of the autogenous vein is the brachial vein, a deep vein of the upper arm. Most surgeons choose a full medial arm incision to perform brachial vein exploration. We describe a patient in whom BVT was not possible and so brachial vein transposition using skip incisions was performed, with good results.

Background: Abdominal aortic aneurysm (AAA) repair in patients with organ transplant remains a challenge. We looked at AAA repair in patients with organ transplants at our tertiary liver and kidney transplant unit. Methods: A retrospective analysis of a prospectively maintained database was undertaken from January 2008 to July 2018. We looked at patient demographics, type of repair, and technical success including reinterventions, perioperative transplant organ function, and 30-day and 1-year survival rate. Eight of 662 patients who underwent AAA repair had a solid organ transplant. Of these, 5 were kidney transplants, 2 liver transplants, and 1 had kidney and liver transplant; 75% were male; and average age was 63.4 (range: 49-83). All patients had asymptomatic AAAs, and 6 were treated with standard endovascular repair, 1 standard repair with iliac branch device, and 1 open repair. Adjunctive techniques such as CO2 angiograms, deployment of main body through contralateral iliac, low-profile sheaths, custom-made stent grafts, and temporary axillo-femoral shunting were used to protect transplant organs. Thirty-day survival was 100% with 1 death at 5 months from liver failure, and 1 patient has a persistent type-2 endoleak 3 years after the procedure. Conclusion: Abdominal aortic aneurysm repair in patients with organ transplants can be undertaken using adjunctive endovascular and open surgical techniques.

The aim of this study is to appraise the current literature on the endovascular management options and their outcomes of cephalic arch stenosis in the setting of a failing brachiocephalic fistula for hemodialysis.A systematic search of the literature was performed using PubMed, Embase, and Google Scholar from January 2000 to December 2017 in accordance with the PRISMA guidelines to investigate the outcomes of endovascular management of cephalic arch stenosis. Data from randomized controlled trials and observational studies, published in the English language, were extracted to determine pooled proportion of primary and secondary patency, using a random-effects meta-analysis. Subgroup analyses of stent grafts, bare metal stents, and percutaneous transluminal angioplasty outcomes were performed.Of the 125 total studies, 11 were included for analysis by consensus. Overall, 457 patients were reviewed and analyzed for primary and secondary patency rates at 6 and 12 months post-treatment. There was significantly higher primary patency at both 6 and 12 months in the stent graft group compared to those who received bare metal stents or percutaneous transluminal angioplasty (relative risk = 0.30-0.31, relative risk = 0.34-0.59, respectively; p0.01). Higher secondary patency rates were noted in the bare metal stents cohort compared to the percutaneous transluminal angioplasty cohort at 12 months (relative risk = 0.17, 95% confidence interval = 0.07-0.26; p0.01).This study demonstrated a significant benefit in using stent grafts in cephalic arch stenosis compared to bare metal stents or percutaneous transluminal angioplasty with higher primary and secondary patency rates.

Endovenous cyanoacrylate glue (CAG) ablation for the treatment of chronic venous insufficiency (CVI) and varicose veins has shown non-inferior outcomes with an excellent safety profile, high patient satisfaction rate, and excellent efficacy when compared to the gold standard of endothermal ablation. A review of the current literature for CAG use in CVI showed that most studies and longer-term data are from Caucasian-based populations, which are subject to different anatomical venous variations and socio-economical contexts. This review aimed to gather the current evidence for CAG use in Asian CVI patients.Asian studies for the use of CAG in CVI were included in this review. Successful ablation rates, quality of life improvement and novel complications such as glue hypersensitivity reactions are described, along with anatomical descriptions of superficial venous anatomy in study patients. Use of CAG in Singapore and Asia was addressed.CAG has been gaining traction as an option for CVI treatment in Asians. In Singapore, it has been adopted with comparable low complication rates and significant improvement of quality of life after treatment. As we increase our understanding of the variations in venous anatomy in the Asian population, new techniques such as retrograde deployment of the device and use of CAG ablation for venous leg ulcers have been developed.Further robust evidence in terms of large randomised control trials along with cost effectiveness studies are needed to determine the true value of CAG ablation in the Asian setting.

Mobility of individuals and their physical social networks are the root causes for the spread of current coronavirus pandemic. We propose here a method of visualizing the spatial and chronological aspects of the spread of this virus based on geographical information systems (GIS) and Gephi graphs. For this approach we used qualitative data from newspaper reports and prepared layouts varying from macro to micro scales that show that this approach can enrich traditional GIS approaches, thereby assisting mobility planners and policymakers.

Investigating the connections between pedestrian crashes and various urban variables is critical to ameliorate the prediction of pedestrian fatalities, formulate advisories for the stakeholders, and provide an evidence base for policy change to mitigate the occurrence and intensity of pedestrian fatalities. In this paper, we aim to explore the geographically varying association between the pedestrian fatalities and other associated factors of an urban environment in Jeddah city, which is a car-dependent city in Saudi Arabia. At first, Global Moran’s I and Local Indicators of Spatial Association (LISA) were applied to visualize the clustering of pedestrian fatalities in the various districts of Jeddah. Subsequently, we developed Poisson regression models based on their geographically weighted indicators. Both the global and geographically weighted regression models attempt to assess the association between the pedestrian fatalities and the geographically relevant land use and transport infrastructure factors. The results indicate that geographically weighted Poisson regression (GWPR) performed better than the global Poisson counterparts. It is also revealed that the existing transportation infrastructure in Jeddah was significantly associated with the higher pedestrian fatalities. The results have shown that the proposed model in this study can inform transport policies in Jeddah in prioritizing more safety measures for the pedestrians, including expanding pedestrians’ infrastructure, and cautious monitoring of pedestrian footpaths. It can facilitate the analysis and improvement of road safety for pedestrians in car-dependent cities.