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Jim Z Li,1 Joanna Asia Lem,2 Muhammad Younus,2 Shaantanu S Donde,3 Janine Collins,4 Kelly H Zou1 1Global Medical Analytics, Real-World Evidence, and Health Economics & Outcomes Research Viatris Inc., Canonsburg, PA, USA; 2Safety Surveillance Research, Worldwide Medical and Safety, Pfizer Inc, New York, NY, USA; 3Medical Affairs - Developed Markets, Viatris Inc., Dorking, UK; 4Safety, Epidemiology, Registries and Risk Management Department, UBC, Geneve, SwitzerlandCorrespondence: Kelly H Zou, Global Medical Analytics, Real-World Evidence, and Health Economics & Outcomes Research, Viatris Inc., Canonsburg, PA, USA, Tel +1.212-722-0087, Email Kelly.Zou@viatris.comPurpose: A national additional risk minimization measures (aRMMs) program was implemented to train pharmacists for safe supply of non-prescription Viagra Connect® (VC) to erectile dysfunction (ED) patients in United Kingdom (UK). A survey aimed to evaluate the effectiveness of aRMMs.Methods: A cross-sectional, web-based survey enrolled ED patients who purchased at least 1 supply of VC in UK, using a structured self-administered questionnaire. Patients were assessed for the suitability of VC and received appropriate advice from pharmacists. Descriptive statistics were used.Results: The final sample had 297 patients, who reported that pharmacists inquired about blood pressure and heart comorbidities (91.9%), relevant illnesses (87.9%), medications (86.5%), ED diagnosis (82.2%), and were advised to consult their doctor regarding ED (51.2%). Furthermore, 85.5% of patients were advised on how to take VC correctly, 82.2% on possible side effects for which they might have to discontinue taking VC and consult their doctor, 80.1% on being informed that ED could be caused by underlying conditions. About 65.0% reported that they had visited (19.2%) or planned to visit (45.8%) their doctor. A majority (68.7%) also indicated that they had received advice on lifestyle modifications to manage their ED-related health risks.Conclusion: This survey provided a reasonable confirmation of the effectiveness of the VC aRMMs program and assurance that ED patients, when requesting and purchasing VC in UK pharmacies, are assessed appropriately for suitability of VC and receive the appropriate advice from pharmacists.Plain Language Summary: A national additional risk minimization measures (aRMMs) program was implemented to train pharmacists for safe supply of non-prescription VC to erectile dysfunction (ED) patients in United Kingdom (UK).A cross-sectional, web-based survey enrolled ED patients who purchased at least 1 supply of VC in UK, using a structured self-administered questionnaire. Patients were assessed for the suitability of VC and received appropriate advice from pharmacists.The final sample had 297 patients, who reported that pharmacists inquired about blood pressure and heart comorbidities, relevant illnesses, medications, ED diagnosis, and were advised to consult their doctor regarding ED. Additionally, most of the patients had consulted or planned to consult their doctors, on how to take VC correctly, on possible side effects for which they might have to discontinue taking VC and consult their doctor, on being informed that ED could be caused by underlying conditions, and on lifestyle modifications. A majority also indicated that they had received advice on lifestyle modifications to manage their ED-related health risks.This survey provided a reasonable confirmation of the effectiveness of the VC aRMMs program and assurance that ED patients, when requesting and purchasing VC in UK pharmacies, are assessed appropriately for suitability of VC and receive the appropriate advice from pharmacists.Keywords: aRMM, erectile dysfunction, pharmacist, sildenafil citrate

Introduction: The posterior auricular artery (PAA) is the preterminal branch of the external carotid artery (ECA), arising superiorly to the occipital artery (OA). The PAA has quite a few anatomical variations and established neurosurgical applications. We conducted this study as an overview to illustrate all neurosurgical aspects regarding this artery, its reconstructive uses, and anatomical variation. Method: We performed a literature review in Google Scholar and PubMed medical databases for studies discussing the PAA, its anatomical variations, and neurosurgical applications. Results: We identified 30 articles that discuss the anatomical variations and neurosurgical applications of the PAA. While reviewing the available articles and original works regarding PAA. Conclusion: The PAA has considerable anatomical variations regarding its origin, course, branches, and length. The related neurosurgical applications of PAA include bypass, embolization, aneurysm, AVM, and reconstruction flaps.

Air-Cooled Heat Exchangers (ACHE) have gained importance through their extensive use in the oil and gas industry. Many researchers studied ACHE extensively and proposed analysis methods. Most of them investigate part of the ACHE in their modeling. Others consider only pressure drop in their calculations in simulating the porous media (fins and surrounding air). These assumptions lead to unprecise modeling results. In contrast to existing literature, by incorporating computational fluid dynamics (CFD) with real geometry design, this paper includes a study of a full-size ACHE with precise geometric measurements, commencing at the hot water's input and going all the way to the ACHE's exit through a U-path tube. By incorporating the complete geometry dimensions of the U-path tube length from the hot water inlet to the outlet, this methodology has the potential to produce more accurate predictions of temperature distribution, heat flow rate, logarithmic mean temperature difference (LMTD), and fin efficiency for each tube along the entire length of the ACHE. Further, unlike other works of literature, the porous media in this research includes calculations for pressure drops and heat transmission in place of real geometry design which gives more sensible and accurate modeling results. Moreover, a novel verification method is proposed by presenting an iterative process for verification of entire geometry design calculations by comparison with the Real Geometric Design. The incorporation of Real Geometry Design and Computational Fluid Dynamics (CFD) Code programs can lead to more precise and efficient methodologies for modeling air-cooled exchangers, offering valuable insights that can ultimately enhance their design and performance. In this work, the convergence with the actual geometrical design is less than 1%, demonstrating the superiority of the suggested strategy.

Background: Neurosurgery's challenging area involves addressing intracranial aneurysms, given the high morbidity and mortality rates associated with them. Safe clipping, a technique that involves the intraoperative temporary occlusion of the arterial supply, is generally used. However, a focused review on the evolution of temporary clipping in intracranial aneurysms hasn't been previously carried out. Methods: We performed a comprehensive literature search on PubMed Medline and Google Scholar, using the combination of terms: [Temporary clip* AND (Cerebral OR Intracranial) Aneurysm]. Results: From an initial pool of 579 results, we excluded unrelated papers, narrowing it down to 25 relevant studies. These ranged from retrospective and prospective studies on the outcome favorability or radiological evidence, to analyses on potential independent prognostic factors, and articles related to the history and evolution of temporary clipping. Conclusion: Temporary arterial occlusion in aneurysm surgery has evolved significantly since its inception in the early 20th century, marked by innovations in instruments and temporary clips. Despite these advancements, the utility and safety of temporary clips continue to be topics of discussion, particularly due to concerns regarding possible complications and their influence on long-term results.

The present study reports the prevalence of Paramphistomum spp. in small and large ruminants and their association with the histopathology of the infected rumens. A total of 384 animals were screened for Paramphistomum spp. The animals found positive for Paramphistomum spp. were divided into three groups according to the worm load/5 cm2 (G1: 10 – 20 worms/5 cm2 = Low, G2: 20 – 40 worms/5 cm2 = Medium, and G3: >41 worms/5 cm2 = High). Tissue slides were prepared from samples of the rumen (1 cm2) taken from animals positive for ruminal fluke to determine the histological parameters, including epithelial length or thickness, length and width of the ruminal papilla, and thickness of tunica submucosa and mucularis externae. The overall prevalence of Paramphistomum spp. in the ruminant population of district Narowal was 56.25 % with a significant (P < 0.05) variation among different species of ruminants. The highest prevalence was in cattle, followed in order by buffalo, goat, and sheep. Epithelium thickness was significantly correlated with parasite load in large ruminants and the most significant (P < 0.05) decrease in epithelium thickness was in Group B (31.12 ± 1.82 μm) and Group C (31.07 ± 1.68 μm) and a same trend was recorded in small ruminants. Histopathological changes due to Paramphistomum spp. are reported for the first time, which explained the histomorphological and physiological changes in Paramphistomum-infected rumens which might be associated with lowered feed efficiency and productivity in ruminants.

The current study is an assessment of the Al-Tawsseea Cement Plant, located in the northwest of Iraq, Nineveh. This plant produces Ordinary Portland Cement grade 42.5R according to the I.Q.S No(5)/2019. Ordinary Portland Cement was chosen to determine the mineralogy using X-Ray Diffraction and Scanning Electron Microscope before and after hydration. Physical tests were carried out such as the Fineness Test (Blain) ( 331.4) M2/Kg, Soundness Test (Autoclave) 0.1% Compressive Strength Test (2 Days 22.35 N/mm2 and after 28 Days 47.81 N/mm2) and Setting Time Test (Initial 150 Min and Final 3:10 Hours) and all the physical tests are within the requirements of limits according to I.Q.S No(5)/2019. XRD analyses revealed that the studied cement is composed of alite, belite, ferrite, and aluminate which indicate good burning and cooling processes, while after hydration the paste is composed of CSH, CH, and Ettringite. The Scaning Electron Microscope showed that the studied Ordinary Portland Cement microstructure, characterized by an intensive intergrowth of hypidiomorphic crystals and belite (spherical to oval shape) is less but bigger than alite. After hydration, the microstructure became dense and calcium-silicate hydrate (C-S-H ) formed a lathe-like shape fill the pores of the cement paste and gave the paste hardness and good compressive strength. The pore diameters in studied Ordinary Portland Cement are ranging from 9.9 to more than 15.9 µm. They look like circular or irregular shape and are randomly distributed which decrease the density, and compressive strength of the paste. According to the results of the physical test and mineralogy microstructure, we can say that it is possible to raise the grade of Ordinary Portland Cement of the Al-Tawseea Cement Plant ( 42.5R) by increasing the proportion of calcium in the raw materials mixture within the specification. This will lead to an increase in the value of LSF and the C3S which is responsible for increasing hardness or compressive strength.

In this work, the gas sensing properties of ZnS/Porous silicon heterostructures have been investigated. . Zinc sulfide(ZnS) with high gas sensing performance is successfully synthesized over the Porous silicon substrate by the spray pyrolysis method. The properties of the as-prepared samples were characterized X-ray diffraction (XRD), scanning electron microscope (SEM), Fourier transform spectrum (FTIR) and optical properties. The results reveal that the properties of the ZnS/Porous silicon heterostructures enhanced when the when the ZnS concentration is increased. The performance ZnS/Porous silicon as a gas-sensing show that the maximum sensitivity is found to be 5.11 at ZnS concentration of 0.5 M and etching time of 15 min compared to the other sensitivities. The ZnS-PSi heterojunction based gas sensor may be used for UV-light photo-detectors due to a valuable properties such as high sensitivity and fast response. [ABSTRACT FROM AUTHOR]

Introduction: The posterior auricular artery (PAA) is the preterminal branch of the external carotid artery (ECA), arising superiorly to the occipital artery (OA). The PAA has quite a few anatomical variations and established neurosurgical applications. We conducted this study as an overview to illustrate all neurosurgical aspects regarding this artery, its reconstructive uses, and anatomical variation. Method: We performed a literature review in Google Scholar and PubMed medical databases for studies discussing the PAA, its anatomical variations, and neurosurgical applications. Results: We identified 30 articles that discuss the anatomical variations and neurosurgical applications of the PAA. While reviewing the available articles and original works regarding PAA. Conclusion: The PAA has considerable anatomical variations regarding its origin, course, branches, and length. The related neurosurgical applications of PAA include bypass, embolization, aneurysm, AVM, and reconstruction flaps. [ABSTRACT FROM AUTHOR]

Background: Gross total resection (GTR) of intracranial meningiomas is curative in most cases. However, perioperative blood transfusions may be necessary for complex skull bases and/or high-grade meningiomas. Guidelines for blood transfusions during intracranial meningioma surgery remain unclear. This scoping review aims to delineate the main characteristics of patients who underwent intracranial meningioma surgery, the prevalence of the selected patients who required blood transfusions, and common causes for transfusion. Methods: A scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Extension for Scoping Reviews guidelines to include studies reporting eligibility, protocols, and potential complications related to blood transfusion within the perioperative management of intracranial meningiomas. Results: A total of 33 articles encompassing 3009 meningioma patients were included in the study. The most common symptom was headache (18%), and the most frequent type of meningioma was World Health Organization grade-1 meningothelial (50.4%). The lateral supraorbital approach was the most common surgical corridor (59.1%) in skull base meningiomas, and most patients underwent GTR (69%). Blood transfusion was required for 20% of patients, with a mean estimated intraoperative blood loss of 703 mL (ranging from 200 mL to 2000 mL). The main indications for blood transfusion in meningioma surgery were intraoperative blood loss (86%) and preoperative anemia (7.3%). Conclusion: This scoping found that 20% of the included patients required blood transfusion. It also points out that several factors could influence the necessity for a transfusion, encompassing surgical blood loss, pre-existing anemia, and the surgery's length. This scoping review may provide surgeons with a potential guide to inform their decision-making process regarding blood transfusions during meningioma surgeries. [ABSTRACT FROM AUTHOR]

Background: Neurosurgery's challenging area involves addressing intracranial aneurysms, given the high morbidity and mortality rates associated with them. Safe clipping, a technique that involves the intraoperative temporary occlusion of the arterial supply, is generally used. However, a focused review on the evolution of temporary clipping in intracranial aneurysms hasn't been previously carried out. Methods: We performed a comprehensive literature search on PubMed Medline and Google Scholar, using the combination of terms: [Temporary clip* AND (Cerebral OR Intracranial) Aneurysm]. Results: From an initial pool of 579 results, we excluded unrelated papers, narrowing it down to 25 relevant studies. These ranged from retrospective and prospective studies on the outcome favorability or radiological evidence, to analyses on potential independent prognostic factors, and articles related to the history and evolution of temporary clipping. Conclusion: Temporary arterial occlusion in aneurysm surgery has evolved significantly since its inception in the early 20th century, marked by innovations in instruments and temporary clips. Despite these advancements, the utility and safety of temporary clips continue to be topics of discussion, particularly due to concerns regarding possible complications and their influence on long-term results. [ABSTRACT FROM AUTHOR]

It is imperative to design and operate sustainable solid waste management (SWM) systems in cities based on the results of waste amount and characterization study (WACS). In this work, WACS was conducted and results were used to design an SWM system for an intermediate city of Pakistan. The study revealed that about 110 tons of solid waste per day is generated with a per capita rate of 0.337 kg/day. Around 51.2% of mixed municipal solid waste (MSW) is organic in nature and its non-scientific disposal is resulting in higher greenhouse gas (GHG) emissions. It was also found that more than 80% of valuables are taken away by the informal sector during the transfer of MSW from the generation source to the dumping site. Ultimate analyses showed that the moisture content (MC) and carbon to nitrogen (C:N) ratio were 64.23% and 51.14%, respectively. Proximate analysis revealed that moisture and calorific values were 57 % and 3505 BTU/lb., respectively. Based on these results, a material sorting facility (MSF) was proposed, with an estimated investment cost of US $3.64 million. However, the efficiency of the existing collection system is limited to 32 % only. In order to improve the collection efficiency (>90 %), an additional investment of US $1.638 million was estimated with an operations and maintenance (O&M) cost of US $19.25 per ton. Existing non-scientific MSW disposal practices contribute 32,079.61 CO2e tons/year of GHG emissions. The proposed MSF followed by composting is estimated to reduce GHG emissions by 38% to 19,722.38 CO2e tons/year. [ABSTRACT FROM AUTHOR]