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Risk of massive intraoperative hemorrhage and the difficulty to control it makes the laparoscopic treatment of giant hepatic hemangiomas (GH) a challenge for minimally invasive hepatobiliary surgeons. Symptomatic GHs of more than 20 cm (extremely giant hepatic hemangiomas) are typically treated with an open resection. There is a paucity of literature on laparoscopic resection of extremely giant hepatic hemangiomas. We describe (with video), here, the technical nuances of pure laparoscopic resection of an extremely giant hepatic hemangioma using modified port positions and the anterior approach.

Hollow sphere polymeric pigments prepared from styrene-acrylate copolymer referred to as organic opacifiers (OP) are the primary substitutes of TiO.sub.2 in water-based architectural paints. This study describes the method for the quantification of OP in water-based paints using dynamic mechanical thermal analysis (DMTA). The significance of DMTA in visualizing the glass transitions over differential scanning calorimetry (DSC) is showcased. The glass transition temperature (T.sub.g) of OP was found to be ~109°C by DSC method and ~125°C by DMTA method. The peak intensity of tan [delta] at T.sub.g of OP in paints (tan [delta].sub.2) is not affected by the curing time and linearly increases as a function of OP concentration in water-based paints, irrespective of the difference in volume solids. DMTA can efficiently quantify OP in paint film if it is [greater than or equal to]3.3% (w/w). Increasing concentration of a coalescing solvent in water-based paints has a detrimental effect on the peak intensity of tan [delta].sub.2. Two commercially available grades of OP having difference in the core-shell morphology have been studied. Internal morphology of the OP studied by scanning electron microscopy has a significant effect on the peak intensity of tan [delta].sub.2 thereby affecting its opacity performance in paints. Owing to the limited effect of curing time, volume solids and coalescing solvent on the peak intensity of tan [delta].sub.2 of paints, this method can be used for the quantification of OP in paints, as it has been validated with seven commercially available paints with known OP contents., Author(s): Ritesh A. Bhavsar [sup.1] , Venugopal B. Raghavendra [sup.1] Author Affiliations: (1) grid.464770.6, 0000 0004 1776 8649, Asian Paints Limited, R&T center, Plot No. C-3B/1, TTC Industrial Area, MIDC [...]

Identifies five types of museum accessibility: (1) physical; (2) socio-cultural; (3) economic; (4) sensory; and (5) intelligence/learning accessibility. Considers ways to coordinate museum services to ensure accessibility for potential museum patrons who are disabled. Describes various programs launched by the National Museum of Natural History in New Delhi to accomplish this goal. (WRM)

Currently, there are no guidelines or consensus recommendations on the antithrombotic management of peripheral artery disease (PAD) from an Indian perspective. In this article, we have summarized clinical practice recommendations on antithrombotic management of (i) asymptomatic chronic PAD (cPAD), (ii) symptomatic cPAD (intermittent claudication [IC] and chronic limb-threatening ischemia [CLTI]), and (iii) after revascularization (endovascular and surgical). An electronic search of the PubMed database was undertaken to identify relevant articles. Various combinations of keywords such as PAD, chronic peripheral arterial disease, asymptomatic chronic peripheral arterial disease, symptomatic chronic peripheral arterial disease, dual antiplatelet therapy, single antiplatelet therapy, dual pathway inhibition, antithrombotic, revascularization, endovascular, and surgical were used. Randomized controlled trials, case reports, practice guidelines, systematic literature reviews, and meta-analyses were screened and assessed. A roundtable meeting of experts (n = 13) was conducted to arrive at clinical practice recommendations. Experts made their decisions based on the evidence and guideline recommendations. In patients with asymptomatic cPAD and significant peripheral artery stenosis (PAS), long-term single antiplatelet therapy may be considered at the discretion of the clinician. There is no clear evidence in favor of long-term dual antiplatelet therapy in symptomatic cPAD. Experts agreed that low-dose rivaroxaban plus aspirin should be considered in patients with asymptomatic cPAD with >50% PAS and conditions such as diabetes and polyvascular disease. This combination was also suggested in patients with IC, CLTI, postendovascular (stent based/nonstent), and surgical revascularization to reduce cardiovascular and limb ischemic risk, including major amputation in the absence of high bleeding risk or other contraindications.