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Copyright of West China Journal of Stomatology is the property of Sichuan University, West China College of Stomatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Petroleum Geology & Oilfield Development in Daqing is the property of Editorial Department of Petroleum Geology & Oilfield Development in Daqing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Mengya Dong,1 Chenyuan Liang,1 Gong Cheng2 1Department of Cardiovascular Medicine, Shaanxi Provincial People’s Hospital, Xi’an, People’s Republic of China; 2Department of Cardiovascular Medicine, Honghui Hospital, Xi’an Jiaotong University, Xi’an, People’s Republic of ChinaCorrespondence: Gong Cheng, Department of Cardiovascular Medicine, Honghui Hospital, Xi’an Jiaotong University, 555 East Youyi Road, Xi’an, Shaanxi, 710054, People’s Republic of China, Tel +86– 18629529996, Email Xianchenggong@163.comObjective: A new approach called the loop technique has been proven safe and effective for repeated intraoperative transvenous left ventricular (LV) lead dislocations during cardiac resynchronization therapy (CRT) in a 3-year follow-up. This study aimed to report on the 5-year safety and effectiveness of the loop technique.Methods: This study was a prospective cohort study. Forty-four patients who underwent CRT device implantation at the Cardiology Department of Shaanxi Provincial People’s Hospital between January 2013 and June 2019 were included. Data on patient demographics, medical history, laboratory test results, and echocardiography images at admission were collected. The loop technique was performed with repeated intraoperative dislocations of the LV lead. The intraoperative CRT parameters were also recorded. All patients were followed for 5 years. Several auxiliary examinations were performed during follow-up.Results: The 44 patients were divided into the traditional operation group (n=36, 81.8%) and loop technique group (n=8, 18.2%). The baseline patient characteristics were almost balanced. During the 5-year follow-up, 8 (22.2%) patients in the traditional operation group and 2 (25.0%) patients in the loop technique group died. No lead dislocation or other complications related to CRT were observed. There were no significant differences in mortality rate (P=0.87), cardiac function (P=0.56), echocardiographic indices, threshold (P=0.58), or impedance (P=0.22) of the LV lead. There were no significant differences in the threshold and impedance between postoperative, 3-year, and 5-year follow-ups in the loop technique group (P=0.53).Conclusion: The loop technique is an ideal solution for repeated intraoperative LV lead dislocation during CRT implantation.Keywords: loop technique, new technique, cardiac resynchronization therapy, left ventricular lead, repeated intraoperative dislocations

Objective: This study was performed with the aim to evaluate the results of the treatment of vaginal fistulas caused by pelvic malignancy and to present a new surgical technique. In this retrospective study, patients with vaginal fistula who have been treated in Ghaem and Omid Hospitals of Mashhad University of Medical Sciences from 2004 to 2020 were studied. The inclusion criteria were the patients whose fistulas were caused by malignant neoplasia with pelvic organ origin. The patients with fistulas caused by other causes were excluded from the study. Patients' information was collected from the electronic records and the hospital archives and also the information recorded by the surgeon. Results: Out of 26 patients with vaginal fistula caused by pelvic malignancies, 18 cases had enterovaginal fistula. Cancer of cervix (11 cases) was the most prevalent cancer. Time interval between the incidence of fistula and the onset of the disease was 43.5 months. About 16 patients had a history of radiotherapy before the onset of the fistula, and 23 cases had undergone surgery before the onset of fistula. About 11 patients were treated with resection, 8 patients with ostomy, and 5 with fistulized loop bypass. Discussion and conclusion: In cases of extensive pelvic involvement with a tumor, it is recommended to use intestinal bypass in fistula site with the technique provided in this article, since it controls the symptoms of the patient and has limited complications. [ABSTRACT FROM AUTHOR]

We have developed a biopsy technique aimed at preoperative evaluating the extent of Paget’s vulvar disease in order to plan subsequent radical vulvar surgery. The aim is to find all possible lesion sites that are not visible macroscopically, to obtain a clear evaluation of the disease spread and to tailor the radical surgical procedure to remove even microscopic lesions, avoiding recurrences and excessively destructive surgery, adopting as conservative an approach as possible. We used this procedure for the first time to establish the radicality of the surgical intervention in a 68-year-old patient initially suffering from a single invasive vulvar Paget’s lesion.

Anticipatory behavior describes the actions taken to prepare for an upcoming event. It is considered a promising tool for welfare assessment, but it is not fully applied in zoos and other facilities. This is probably due to the need to train animals, which can take a long time and make its use impractical. In this work, we tested, on a group of six dolphins (Tursiops truncatus), the effectiveness of a new technique to induce and measure anticipatory behavior without training animals. Our results show how this new methodology, which we called The Fast Technique (TFT), has been able to induce and measure anticipatory behavior toward the event studied, i.e., the play sessions with objects (PSO). Furthermore, it has produced the same result obtained with The Classical Technique (TCT), which requires a training phase. Therefore, our finding demonstrates the efficacy of a new technique that could facilitate the use of anticipatory behavior for both research and animal welfare assessment protocols. [ABSTRACT FROM AUTHOR]

In this paper, a new technique for solving a class of Nonlinear Initial-Boundary Value Problems (NIBVPs) is introduced. The main advantage of this technique is that it utilizes both initial and boundary conditions in the Adomian series solution and consequently, an accurate approximate solution is obtained in both temporal and spatial directions. The sufficient condition that guarantees a unique solution is obtained. Convergence of the series solution is proved and the truncated error is estimated. Some numerical examples are discussed to illustrate the effectiveness of the proposed technique. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the oncological adequacy of lymphadenectomy (LND) for biliary tumors and surgical outcomes of resections performed using robotic, laparoscopic, and open approaches and to compare the techniques within a weighted propensity score analysis. Background: The need to perform formal LND is considered a limit for the applicability of minimally invasive liver surgery. Methods: Overall, 25 robotic resections with LND (2021-2022) from a single-center constituted the study group (Rob group), matched by inverse probability treatment weighting with 97 laparoscopic (Lap group) and 113 open (Open group) procedures to address the primary endpoint. A "per-period" analysis was performed comparing the characteristics and outcomes of the Rob group with the first 25 consecutive laparoscopic liver resections with associated LND (LapInit group). Results: Minimally invasive techniques performed equally well regarding the number of harvested nodes, blood transfusions, functional recovery, length of stay, and major morbidity and provided a short-term benefit to patients when compared with the open technique. A better performance of the robotic approach over laparoscopic approach (and both approaches over the open technique) was recorded for patients achieving LND with retrieval of >6 nodes. The open approach reduced both the operative time and time for LND, and robotic surgery performed better than laparoscopic surgery. Conclusions: Minimally invasive techniques are excellent tools for the management of LND in patients with biliary tumors, showing feasibility, and oncological adequacy. Robotics could contribute to the large-scale diffusion of these procedures with a high profile of complexity. [ABSTRACT FROM AUTHOR]

ObjectivesCardiac resynchronization therapy (CRT) is a well-established method that improves the clinical symptoms and long-term prognosis of specific heart failure (HF) patients by restoring systolic synchronicity and enhancing myocardial function. However, the high rate of intraoperative and postoperative left ventricular (LV) lead dislocation limits its application to a great extent. The aim of this study was to demonstrate the long-term safety and effectiveness of a new approach named the loop technique for patients who experience repeated intraoperative transvenous LV lead dislocations during CRT.MethodsThe current study was a single-centre, prospective, nonrandomized controlled trial. Forty-four HF patients who underwent CRT were included. All patients were followed to death or 3 years.ResultsAmong 44 HF patients, 36 underwent the traditional operation, and 8 underwent the loop technique due to repeated intraoperative LV lead dislocations. Intergroup comparison revealed no significant differences between the two groups with respect to most preoperative indices, intraoperative pacing and sensing parameters. At the end of the 3-year follow-up, 4 (11.1%) patients in the traditional operation group and 2 (25.0%) patients in the loop technique group had died. There was no significant difference in the mortality rate (P = 0.30). No complications related to this new technique were observed, such as intracoronary thrombosis, infection or dislocation. Intergroup comparison showed no significant difference in the New York Heart Association (NYHA) class, echocardiography indices, N-terminal pro brain natriuretic peptide (NT-proBNP) level or pacemaker programming parameters.ConclusionsThe loop technique is a safe and effective alternative method for patients who experience repeated intraoperative transvenous LV lead dislocations during CRT.

Monitoring the dynamics of the spore bank of arbuscular mycorrhizal fungi (AMF) is essential for the sustainable management and protection of agroecosystems. The most common method for extracting AMF spores from soil is the wet-sieving technique (WST). However, this method has many disadvantages. In this study, we modified the WST using new approaches: the ultrasound wet-sieving technique (UWST) and the ultrasound centrifuge technique (UCT). We enumerated and compared the numbers and quality of spores obtained from WST, UWST, and UCT to validate the new modified techniques. We extracted AMF spores from the rhizospheres of different plants, including wheat (Triticum aestivum L.), bean (Phaseolus vulgaris L.), tomato (Solanum lycopersicum L.), pepper (Piper nigrum L.), parsley (Petroselinum crispum Mill.), and turfgrass (Lolium perenne L.) collected from the Van Lake basin, Turkey. The highest and lowest AMF spore numbers were observed in wheat and turfgrass rhizospheres. The UCT allowed for the extraction of the highest number of spores from all rhizospheres, followed by the UWST and WST. The UWST and WST allowed for the extraction of similar spore numbers from wheat, pepper, parsley, and turfgrass rhizospheres. Beyond the high extracted spore number, UCT was shown to be a fast and low-material-consuming approach. These findings demonstrate that the UCT can be used to efficiently extract AMF spores in future research. [ABSTRACT FROM AUTHOR]

Multiple sclerosis is a slowly progressive disease, immunosuppressants and other drugs can delay the progression and progression of the disease, but the most patients will be left with varying degrees of neurological deficit symptoms, such as muscle weakness, muscle spasm, ataxia, sensory impairment, dysphagia, cognitive dysfunction, psychological disorders, etc. From the early stage of the disease to the stage of disease progression, professional rehabilitation treatment can reduce the functional dysfunction of multiple sclerosis patients, improve neurological function, and reduce family and social burdens. With the development of various new rehabilitation technologies such as transcranial magnetic stimulation, virtual reality technology, robot-assisted gait, telerehabilitation and transcranial direct current stimulation, the advantages of rehabilitation therapy in multiple sclerosis treatment have been further established, and more treatment means have also been provided for patients. [ABSTRACT FROM AUTHOR]

Introduction: Posterior capsule opacification (PCO) is the most frequent late sequelae after successful cataract surgery. Neodymium:yttrium aluminum garnet (Nd:YAG) laser capsulotomy is considered the gold standard and a well-accepted, safe, and effective measure in treating PCO. However, iatrogenic damage of the intraocular lens (IOL) due to inappropriate focusing is a quite common side effect. These permanent defects (YAG pits) can critically affect overall optical quality. Methods: In this laboratory study, we used the micro-computed tomography (µCT) technique to obtain high-resolution 3D images of the lens and the YAG pits. Results: To the best of our knowledge, this is the first description of a detailed analysis of IOLs with µCT technology. This non-destructive technique seems to be ideal for comparative studies, measuring dimensions of the damage, and visualizing shooting channels within the material. Conclusion: µCT is excellently suited to examine an IOL in detail, analyze optics and haptics in three dimensions, and to describe all kinds of changes within the IOL without damaging it. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Architecture & Civil Engineering is the property of Chang'an Daxue Zazhishe and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Fracture of the hallucial sesamoids is a pathology that causes difficulty for surgeons and patients. Because of the low incidence and the fact that up to 64–90 % heal with non-operative management, there is a lack of clear guidance in the literature for the surgical treatment of sesamoid fracture in cases of failure of non-operative management. Here long term follow up of an alternative method of surgical treatment of sesamoid fracture recalcitrant to nonoperative management is presented. 32 individuals were treated with temporary surgical immobilisation of the 1st metatarsophalangeal joint using either crossed wires or two orthogonally placed two hole plates. The patients then underwent removal of the construct at 8 weeks post op after confirmation of healing on a CT scan. There was a 94 % union rate. Return to work was 61 days (15–90) return to sport 80 days (64–112) with no immediate complications and no recurrence. At last follow up mean 10 years (4–16) only 2 patients had gone on to asymptomatic non-union and one patient developed arthritis between the sesamoid and the metatarsal head. No patient has required further surgical intervention. This retrospective cohort of patients demonstrate that this method of treatment is a valuable option in the management of sesamoid fracture which does not alter the biomechanics of the foot and has none of the long term complications of sesamoidectomy or partial sesamoidectomy. • Alternative technique to sesamoidectomy for sesamoid stress fracture. • Rigid temporary internal fixation of the 1st MTPJ eliminates sesamoid shear stresses. • Single surgeon's sample of 32 patients found a 94 % union rate. • Long term follow up of sesamoid fracture management. [ABSTRACT FROM AUTHOR]

BackgroundPeripheral pulmonary lesions are uncommon in children. Bronchoscopy is a minimal invasive method to obtain a diagnostic lung biopsy. However, due to the lack of effective guidance methods, the diagnostic efficacy of transbronchial lung biopsy for peripheral solitary pulmonary diseases is still limited.Research questionIs the Archimedes virtual bronchoscopic navigation system safe and effective for the diagnosis of peripheral pulmonary lesions in children?Study design and methodsThis pilot study retrospectively analyzed the clinical features, radiological characteristics, operation processes, intra-and postoperative complications, and pathological results of five children who underwent Archimedes-guided biopsy of peripheral pulmonary lesions in Beijing Children's Hospital from May 2021 to May 2022.ResultsThe cohort comprised five children (all males) with age of 7.1–15.8 years. A guide sheath was inserted through the bronchoscope under the guidance of Archimedes combined with radial endobronchial ultrasound to complete the biopsy under general anesthesia. The fused fluoroscopy technique was used to reconfirm the location of the forceps prior to biopsy in all children. The forceps reached the lesion under the guidance of the navigation and the samples were collected successfully in all children. Pathological examination of the biopsy specimens showed Epstein-Barr virus infection-related lymphoproliferative disease in one child, pulmonary metastasis of rhabdomyosarcoma in one child, and pulmonary vasculitis in one child; high-throughput sequencing of the biopsy tissue sample identified Mycobacterium tuberculosis (sequence no. 80) in one child and Aspergillus (sequence no. 40) in another child. All five children tolerated the biopsy procedure without developing postoperative complications, such as pneumothorax and hemoptysis.InterpretationArchimedes-guided bronchoscopic lung biopsy is a feasible and efficient way to diagnose peripheral pulmonary lesions in children with manageable complications.

Objective: To report a new patient friendly and convenient technique for phrenic nerve conduction with alternative sites of stimulation and recording.Methods: Phrenic nerve conduction was performed in forty volunteers and ten patients of peripheral neuropathy. Active recording electrode was placed in tenth intercostal space 2.5 cm away from para-spinal muscles (mid-scapular line), reference electrode in eighth intercostal space just medial to subcostal margin with ground between stimulating and recording electrode. Stimulation was done at the level of crico-thyroid space near or under the posterior margin of sternocleidomastoid muscle. This new method was compared with existing ones.Analysis: Data was analysed using SPSS 23 version. Correlation between height, weight, body mass index, age, and chest expansion was done using bi-variate correlation. Mean latency and amplitude of the study method were compared with other methods using MANNOVA test.Results: Total of forty subjects were studied. Thirty-seven were male subjects. Mean age was 28.03 ± 9.63 years, height 168.0 ± 9.60 cm and chest expansion 3.53 ± 0.64 cm. Right sided phrenic nerve mean latency was 5.99 ± 0.629 ms and amplitude 1.088 ± 0.178 mV. Left sided phrenic nerve conductions showed mean latency of 6.02 ± 1.82 ms, amplitude of 1.092 ± 0.2912 mV. These standard deviations were smaller than what were observed with other methods suggesting increased consistency of our results. There was no correlation between phrenic nerve conduction with age, height, gender or chest expansion.Conclusion: This study method gave a better as well as consistent morphology, higher amplitude and required lower amount of current strength. It was superior to previously reported methods in consistency of normative data. [ABSTRACT FROM AUTHOR]

Transcrestal maxillary sinus floor elevation is an effective method to solve the problem of insufficient bone height in the posterior maxillary region. However, current methods, such as osteotome sinus floor elevation, cushioned grind-out technique, Smart Drill technique, etc., require specialized surgical tool boxes. In this article, we introduce a new method of transcrestal maxillary sinus elevation that uses built-in reamers of various implant systems to scrap residual bone at the sinus floor and uses the implant to push the sinus membrane during implant placement. This technique is easy to operate and time saving and has a low rate of sinus membrane perforation. After a one-year follow-up observation of 146 people and 175 implants, the endo-sinus bone gains were 5.00 (4.70, 5.30) mm and 2.10 (1.40, 2.70) mm in the group of 3 mm≤residual bone height (RBH)<5 mm and the group of 5 mm≤RBH<8 mm, respectively, which can meet the clinical requirements of implant stability. This technique is suitable in generalizing dental implantation.

Monitoring the dynamics of the spore bank of arbuscular mycorrhizal fungi (AMF) is essential for the sustainable management and protection of agroecosystems. The most common method for extracting AMF spores from soil is the wet-sieving technique (WST). However, this method has many disadvantages. In this study, we modified the WST using new approaches: the ultrasound wet-sieving technique (UWST) and the ultrasound centrifuge technique (UCT). We enumerated and compared the numbers and quality of spores obtained from WST, UWST, and UCT to validate the new modified techniques. We extracted AMF spores from the rhizospheres of different plants, including wheat (Triticum aestivum L.), bean (Phaseolus vulgaris L.), tomato (Solanum lycopersicum L.), pepper (Piper nigrum L.), parsley (Petroselinum crispum Mill.), and turfgrass (Lolium perenne L.) collected from the Van Lake basin, Turkey. The highest and lowest AMF spore numbers were observed in wheat and turfgrass rhizospheres. The UCT allowed for the extraction of the highest number of spores from all rhizospheres, followed by the UWST and WST. The UWST and WST allowed for the extraction of similar spore numbers from wheat, pepper, parsley, and turfgrass rhizospheres. Beyond the high extracted spore number, UCT was shown to be a fast and low-material-consuming approach. These findings demonstrate that the UCT can be used to efficiently extract AMF spores in future research.

Objectives: This study concerns a new technique that aims to achieve precise interstitial brachytherapy of pelvic recurrent tumors under transvaginal ultrasound (US) guidance, enhance the conformity index of the brachytherapy (BT), and improve the curative effect of radiotherapy for gynecological oncology patients with pelvic relapse. Methods: A real-time transvaginal US-guided interstitial implant device was developed to assist in implant BT. Prior to implant brachytherapy, the size and location of the tumor in the pelvis and the interrelationship with adjacent organs were first assessed with intracavitary ultrasound. The transvaginal USguided interstitial implant device was then placed on the endoluminal ultrasound probe, the probe was oriented intravaginally to determine a safe needle path, the implant needle was placed into the needle passage of the device, and the implant needle was inserted into the tumor tissue in the direction guided by the ultrasound puncture guide line. After the implant needle was placed in place, the cover of the transvaginal US-guided interstitial implant device was opened perpendicular to the ultrasound probe, and the needle was separated from the ultrasound probe smoothly, and then the cover was re-covered for subsequent implantation. Results: In this study, 56 patients who underwent real-time transvaginal ultrasound-guided implantation for gynecologic oncology were enrolled, and insertion of 736 implant needles was completed. Among them, 13 patients had recurrent pelvic tumors after cervical cancer surgery and 6 patients had recurrent pelvic tumors after endometrial cancer surgery. Thirty-two patients who underwent radical radiation therapy for cervical cancer did not have adequate regression of parametrial invaded tissue after completion of standard EBRT treatment; and 5 patients had recurrent tumors in the radiation field after previous standard course of pelvic radiotherapy. The accuracy of the implant therapy was improved. The radiotherapy dose for recurrent pelvic masses was successfully increased, and the cumulative dose of external irradiation combined with BT was augmented to 80-100 Gy. The use of a new device for transvaginal implant for recurrent masses located in the lateral wall of the pelvic cavity was successful. Conclusion: This intravascular US-guided interstitial implant device can realize interstitial implant with the shortest path under transvaginal US guidance. With convenient operation, high precision, and good security, the device not only improves the accuracy of implant therapy, but it also reduces the risks of anesthesia and organ injury, so it is suitable for widespread promotion and use. [ABSTRACT FROM AUTHOR]

Aims: To describe the efficacy of a new pinhole amniotic membrane placement technique in cases of peripheral epithelial defects in patients with a single eye or low vision in the contrye. Methods: This technique is based on a small central hole done with a dermatological 3 to 4 mm punch (according to pupillary diameter in mesoscopic conditions) and a continuous suture in the perilimbal cornea to fix the amniotic membrane. We performed this technique in 6 patients. Patients were followed clinical and photographically. Results: No changes in the visual acuity before and after the surgery were observed. During follow-up, a complete re-epithelialization was observed with no need for reinterventions. Conclusions: Amniotic membrane transplantation is a very useful option in patients with persistent epithelial defects; however, its use is limited by the subsequent visual acuity. The use of the pinhole amniotic membrane technique allows us to treat peripheral persistent corneal lesions without modifying patients' visual acuity. This new technique may become especially useful in patients with functional single eye of low vision in the contralateral eye. [ABSTRACT FROM AUTHOR]

Ding Xu,* Weigang Lou,* Ming Li, Jianming Chen Department of Orthopedic Trauma Surgery, Ningbo No.6 Hospital, Ningbo, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ding Xu Email xuding831129@126.comAbstract: Due to the traction of the Achilles tendon and osteoporosis, a large number of reports have shown that a series of complications such as skin flap necrosis and failure of internal fixation after surgery often cause nonunion or malunion of calcaneal tuberosity fractures. At the same time, there is no uniform standard for the operative procedure in the treatment of the avulsion fractures of the calcaneal tuberosity. We presented a new technique for the treatment of avulsion fractures of the calcaneal tuberosity, which is fixed with a 180-degree microplate. We aim to provide a simple, safe, and strong internal fixation technique for avulsion fractures of the calcaneal tuberosity as one of the treatment options.Keywords: 180-degree annular internal fixation, avulsion fractures of the calcaneal tuberosity, new technique

Introduction: Scars and dimpled skin appearance is a common complaint in patients undergoing surgery using external fixators. Former studies described different methods to manage these scars. In current study, we demonstrate in details a new surgical technique to release the scars. Patients and Methods: Twenty-five females (mean age of 28 years) underwent cosmetic lower limb (16 Femurs and 34 tibias) lengthening or deformity correction using circular hybrid Ilizarov frame. Results: Time interval between frame removal and surgical release using the technique was 30 days. Average number of scars released using the technique was 382 (144 femur scars and 238 tibia scars). Two and half minutes is the average time for the whole procedure. Immediate scar release and disappearance of dimples was the result in all patients. This maintained for the whole time of follow-up after the procedure. Conclusion: This surgical technique is a quick, easy, efficient, and cost-effective while managing scar dimpling after using external fixator elements. [ABSTRACT FROM AUTHOR]

By presenting the composition of the crustal deformation observation system and the development of the observation techniques, we show the space-time characteristics of the different observation techniques, the advantage of the application of the optical fiber and long-baseline strainmeter and the integrated technique. It was found that the strain recorded by the 1500 m laser strainmeter constructed at Gifu Prefecture, Japan are nearly consistent with the calculated values based on the continuous GNSS stations of the GEONET (GPS Earth Observation Network). Some earthquakes can cause abnormal strains. The strainmeter is more sensitive to the environments. In practical work, we should develop the advanced techniques, use various observation techniques and research method and increase the monitoring density. It will improve the spatial and temporal resolution and promote the identification ability of the earthquake precursory characteristics and better serve scientific mitigating the disasters.

Although covered stents have been available for percutaneous treatment of coronary aneurysms, patients with longer aneurysmal segments have been difficult to treat with covered stents. We describe a case of a right coronary artery aneurysm with an angiographically estimated length exceeding 30 mm treated percutaneously using covered stents and conventionally available hardware. (Level of Difficulty: Advanced.)

Back ground: Many different splinting techniques have been described in dental trauma articles. Wire-composite splint, Orthodontic splint, TTS splint, Resin splint, Kevlar/fiberglass splint (fiberglass), Self-etching and bonding material, Suture splint. We describe here a new technique for splinting traumatized teeth and alveolar bone. To evaluate the simplicity and reliability of cold-cured acrylic resin immediate splinting in the management of traumatized anterior teeth. Results: A total number of (46) patients with traumatized dental or dento-alveolar segment due to accident or operation were managed with immediate cold-cured acrylic resin splint without the need for anesthesia for fixation, the study carried out from January (2008–2014). Forty four dento-alveolar trauma patients, 2 patients following upper dento-alveolar osteotomy, 2 splints dropped down (2) days post-splinting, the splints removed (14-21) days. Conclusion: this new technique in the management of dento-alveolar trauma is a reliable, simple, easy, less technical, painless and less time consuming procedure.

We have developed a biopsy technique aimed at preoperative evaluating the extent of Paget's vulvar disease in order to plan subsequent radical vulvar surgery. The aim is to find all possible lesion sites that are not visible macroscopically, to obtain a clear evaluation of the disease spread and to tailor the radical surgical procedure to remove even microscopic lesions, avoiding recurrences and excessively destructive surgery, adopting as conservative an approach as possible. We used this procedure for the first time to establish the radicality of the surgical intervention in a 68-year-old patient initially suffering from a single invasive vulvar Paget's lesion., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Della Corte, Ascione and Bifulco.)

A central question for firms releasing successive generations of a product is whether they should pursue a market-driven approach and align own product releases to existing industry-level patterns. While an alignment with industry patterns enables firms to capitalize on general market receptivity, it may also entail dilution and competitive interference effects. Using data on the consumer electronics and automotive industries, we show that the effectiveness of such alignment depends on two additional timing-related decisions: the firm's release regularity for successive product generations and its preannouncement timing. Firms benefit from alignment to the industry only if they release successive generations in a regular manner (to create anticipation) and refrain from early preannouncements (to avoid competitive counteraction). For all other combinations of release regularity and preannouncement timing, not aligning to the industry rhythm leads to higher levels of firm performance. Taken together, our findings enable a nuanced view of the interplay of timing-related launch decisions that provides actionable guidance for managers., Author(s): Torsten Bornemann [sup.1] , Cornelia Hattula [sup.2] , Stefan Hattula [sup.3] Author Affiliations: (1) grid.7839.5, 0000 0004 1936 9721, Department of Marketing, Goethe University Frankfurt, , Theodor-W.-Adorno-Platz 4, 60323, [...]

Facing growth pressures, firms attempt to target the large low-income consumer segment present in emerging markets. This multi-method study develops research insights regarding consumer-, retailer-, firm-, category- and country-level factors that enhance the acceptability, awareness, availability, and affordability of products that facilitate the low-income consumer adoption of and firms' introduction of new products for low-income consumers. Study 1 uses a qualitative grounded-theory approach by interviewing company managers and low-income consumers in India and Chile. Study 2, empirically tests an integrated multi-level model of several category factors identified in Study 1, combined with country-level factors drawn from the literature, using a unique 12-year longitudinal panel dataset of new product introductions in 27 emerging market countries from Africa, Asia, Eastern Europe, and South America. The research identifies consumer aspirations, region-based versioning, visible packaging and the product demonstrations as critical motivating factors for adoption of products by low income consumers. Consumers' knowledge of the product category, the concentration of branded products, availability of global brands, and the presence of traditional retail stores motivate firms to launch products for low income consumers in emerging markets., Author(s): S. Arunachalam [sup.1] , S. Cem Bahadir [sup.2] , Sundar G. Bharadwaj [sup.1] [sup.3] , Rodrigo Guesalaga [sup.4] Author Affiliations: (1) grid.462395.f, 0000 0004 0496 9265, Indian School of [...]

Introduction: Automated processing of electronic health data to classify complications of ischemic stroke serves numerous purposes, including improved electronic phenotyping for clinical research. Here, we present a natural language processing (NLP) approach to identify critical findings in acute ischemic stroke from unstructured radiology reports of computed tomography (CT) and magnetic resonance imaging (MRI). Methods: Text reports of CT and MRI scans taken from 2292 patients admitted for large (>1/2 middle cerebral artery territory), acute anterior circulation ischemic stroke were gathered from a single‐institution retrospective cohort. Reports were reviewed and labelled for the presence of hemorrhagic conversion, intracerebral edema, midline shift, intraventricular hemorrhage and parenchymal hematoma as defined by European Cooperative Acute Stroke Study PH1 and PH2 categories. For binary classifications, we quantified co‐occurrence of individual words within reports using two separate NLP methods: Bag‐of‐Words (BOW) and Term Frequency‐Inverse Document Frequency (TF‐IDF). We then trained Lasso regression, random forest, and neural network classifiers to predict all complications based on word co‐occurrence. Classifier performance was measured by area under receiver operating characteristic curves (AUC) using five separate folds of an internal test dataset. To predict midline shift as a continuous outcome, we developed a semantic rule‐based system (RBS) based on regular radiographic report expressions. This system was tested using an external validation dataset of 1472 acute large anterior circulation stroke reports from a separate hospital. Results: 2292 reports were fully labelled for the presence of all stroke complications. Lasso regression consistently displayed the best discrimination among all models. For BOW and TF‐IDF, Lasso yielded respective AUCs of 0.894 and 0.919 (hemorrhagic conversion), 0.935 and 0.950 (intracerebral edema), 0.968 and 0.963 (midline shift), 0.933 and 0.904 (intraventricular hemorrhage), and 0.873 and 0.879 (parenchymal hematoma). All models were well‐calibrated to underlying complication rates. The RBS also achieved strong performance in quantifying midline shift, achieving a mean absolute error (MAE) of 0.103 mm, sensitivity of 99.1% and specificity of 97.5% in the original cohort. In the external validation set of 1472 additional stroke reports, this same system achieved a MAE of 0.126 mm, sensitivity of 99.5% and specificity of 97.5% for midline shift. Wilcoxon rank sum testing on bootstrapped samples confirmed no statistically‐significant differences in RBS performance between institutions when comparing MAE (p = 0.918), sensitivity (p = 0.152), and specificity (p = 0.929). Conclusions: A machine learning pipeline based on Lasso regression successfully identified critical complications of large anterior circulation ischemic stroke from unstructured radiology reports, while our RBS quantified midline shift with a high degree of generalized accuracy between different institutions. We propose that these systems may warrant prospective validation in care settings and data mining for stroke research.

Introduction: C‐Guard carotid stent is a self‐expandable open cell stent covered with a double‐layer mesh which was developed for the treatment of internal carotid artery disease. Lower procedural and complications rates, as well as lower post‐operative infarctions are some advantages of this device. Nevertheless, the use of C‐Guard in the treatment of cervical internal carotid artery (ICA) aneurysms is scarce. Therefore, we present two cases in which the C‐Guard stent achieved complete angiographic occlusion at follow‐up. Methods: We identified two cases in which the C‐Guard carotid stent was used to treat symptomatic cervical ICA aneurysms. Angiographic follow‐up was performed. Results: Case 1: 47‐yo female presented left‐sided motor deficit. CT showed ischemic areas in the right hemisphere and CTA demonstrated an unruptured aneurysm in the C1 segment of the right ICA. The patient started dual antiplatelet therapy (DAPT) with aspirin and clopidogrel. A 6mm x 40 mm C‐Guard carotid stent was deployed without complications. One‐year follow‐up CTA showed complete obliteration of the aneurysm with reconstruction of the ICA. Case 2: 38‐yo male presented decreased left visual acuity. CTA and DSA showed an unruptured aneurysm in the C1 segment of the ICA. The patient started DAPT with aspirin and clopidogrel. A 7mm x 30 mm C‐Guard carotid stent was deployed without complications. Three‐month follow‐up DSA showed complete obliteration of the aneurysm with adequate filling of distal vessels. Conclusions: C‐Guard stent is a potential alternative to conventional carotid stents in the treatment of cervical ICA aneurysms with high obliteration rates at follow‐up.

Introduction: The transradial approach (TRA) has gained acceptance among interventionists due to the lower operative complication rates, less operative time and better patient comfort. Our study aimed to analyze our experience in the implementation of the TRA for diagnostic cerebral angiographies. Methods: Between March 2020 and July 2021, consecutive patients who underwent TRA in two institutions were selected and data was retrospectively collected. Demographics, technical details of the procedure, duration of the procedure, fluoroscopy time and radiation exposure were analyzed. Results: A total of 76 angiographies using the TRA were done. The mean age was 47.5 ± 16.8 years (8 – 82 years). Women represented 57% of cases. Successful radial artery (RA) catheterization was done in 94% (85 patients/80 successful). A preoperative cocktail was used in all the cases. Subcutaneous lidocaine and a 5F sheath were used in 46% and 57% of cases, respectively. The Simmons 2 catheter was used in all the cases. Glidecath, followed by Merit were used in 40% and 32% of the cases, respectively. Right internal carotid artery (ICA), left ICA, right vertebral artery (VA), left VA, right external carotid artery (ECA) and left ECA were studied in 95%, 91%, 76%, 20%, 20% and 15% of the cases, respectively. Post‐operative vasospasm occurred in 29% of the cases, which resolved with intra‐arterial verapamil. Vasospasm was not associated with sheath diameter (p = 0.129) or local anesthesia (p = 0.065). The mean fluoroscopy time was 16 minutes. Conversion to TFA was done in 9 patients (10.6%), of which the RA was successfully catheterized in 4 patients: 1 patient had an atheroma in the brachial artery, 1 patient had a thrombus in the subclavian artery and 2 patients presented severe pain in the forearm. In the remaining 5 patients, there were 2 radial dissections and in 3 the RA could not be approached. Conclusions: The TRA is a safe and effective alternative to perform diagnostic cerebral angiographies with conversion rates according to the literature. The use of appropriate catheters is necessary in order to lower fluoroscopy times when this technique is chosen.

Introduction: Cavernous sinus (CS) via inferior petrosal sinus (IPS) access can present a challenge in the treatment of carotid‐cavernous fistulas (CCF) due to anatomical variations, tortuosity, and/or difficult visualization of IPS given high retrograde flow through the fistulous connection. Methods: A 58‐year‐old male was referred to our academic medical center for three weeks of right eye pain, now complicated by redness, diplopia and blurry vision. Magnetic Resonance Imaging (MRI) brain at the outside hospital revealed hemorrhagic lesion in right parietotemporal region. Computerized tomography‐angiogram (CTA) of the head revealed filling of cavernous sinus during an arterial phase suspicious for CCF. Under general anesthesia, after accessing right common femoral artery, 4 French (F) cook catheter (Cook Medical LLC, Bloomington, IN) was advanced over 0.035 angled glide wire to the proximal right internal carotid artery. Contrast injected through the ICA showed the CS but not the IPS (Fig. 1A). Through the left common femoral vein, access was obtained using an Infinity guide catheter (Stryker Neurovascular, Fremont, CA) and Catalyst 5 (Stryker Neurovascular, Fremont, CA) distal access catheter. A Synchro 2 soft microwire (Stryker Neurovascular, Fremont, CA) was advanced through Echelon 10 (Medtronic, Minneapolis, MN) microcatheter. The venous guide catheter was advanced into right internal jugular vein (IJV) and the distal access catheter was placed into sigmoid jugular junction. Injection of contrast revealed the IPS, but not the CS (Fig. 1B). A subsequent simultaneous hand injection with the microcatheter within the IPS and the diagnostic catheter in the left ICA elucidated the venous‐venous connection (Fig. 1C,) allowing for subsequent navigation and complete treatment of the fistula through IPS using target coils (Fig. 1D). Results: Given the arterial system is a high‐pressure system and the usual direction of flow of contrast would be from the high‐pressure ICA to the low‐pressure CS, injecting a simultaneous contrast bolus from the venous end would oppose the arterial contrast flow. As a result, the fistulous connection that was previously obscured became visible allowing roadmap imaging guiding navigation into the CS. Conclusions: Use of simultaneous trans‐arterial/trans‐venous contrast injection is relatively simple compared to other reported techniques to reveal an obscure connection point. It also shortens the duration of endovascular tools in the bloodstream and thus, reduces the potential complication rate. Further use of this technique on larger study samples is important to validate its general use.

Introduction: Patients presenting with intracerebral hemorrhage (ICH) face higher rates of morbidity and mortality than other stroke patients. Currently, these patients are managed by surgical intervention and decompression or medical management, depending on categorization of the hemorrhage. Simultaneous, multifocal hemorrhages are a rare presentation of ICH that portend a worse prognosis. Here we report the treatment of bilateral simultaneous ICHs in a young patient with diagnostic cerebral angiography, biopsy, and bilateral minimally invasive surgiscopic ICH evacuation in a single procedure. Methods: The patient was a young female who presented to an outside hospital after two days of progressively worsening headaches and vomiting. Her medical history was significant for systemic lupus erythematosus (SLE), hypertension, chronic migraines, and opioid use disorder. In the emergency department, her mental status deteriorated, and she was intubated. Computed tomography (CT) scan was performed and showed a right parietal 43.3 cc ICH and a left parietal 38.7 cc ICH. MR angiogram and venogram showed no evidence of vascular malformations but were suggestive of potential cerebral venous sinus thrombosis. Upon arrival, the patient remained intubated but was able to open her eyes, follow commands, and respond to stimulation. The patient was brought to the angiosuite for diagnostic cerebral angiography which revealed diffuse intermittent arterial narrowing suggestive of vasculitis and patent venous sinuses. The patient was then positioned in the prone position and bilateral parietal 1.5 cm craniectomies were performed. Surgiscopic evacuation was performed sequentially using stereotactic navigation to access and evacuate each clot. A right parietal brain biopsy was performed at the minimally invasive cortical access point. Results: Active bleeding was encountered in both hematoma sites and was treated with a combination of irrigation and monopolar cautery transmitted through the Aurora Evacuator. After complete evacuation of the hematomas on both sides, an intraoperative conebeam CT was performed, demonstrating good right‐sided evacuation and resident left‐sided hematoma. Additional evacuation was performed on the left side and repeat conebeam CT demonstrated good bilateral evacuation. CT head on post operative day 1 showed 97.7% right‐sided evacuation and 81.5% left‐sided evacuation. The patient was treated with steroids for presumed vasculitis given the angiographic findings, which was later supported by the results of the brain biopsy. The patient made a good recovery and was discharged from the hospital alert and oriented, with CN II‐XII grossly intact, no focal deficits, and 5/5 strength in all extremities. Conclusions: Minimally invasive ICH evacuation can be performed in the angiosuite for ICH‐associated with vasculitis and even multifocal ICH when appropriate. Performing the procedure in the angiosuite permits completion of the diagnostic cerebral angiogram, brain biopsy, and hematoma evacuation at the same time, accelerating time to treatment for a patient with severe, symptomatic vasculitis.

Introduction: Stroke is one of the major leading causes of death and disability in India. One reason is the lack of stroke awareness in India. With the adoption of an unhealthy lifestyle like a lack of physical exercise, smoking, and excessive alcohol consumption, newer stroke cases are more prevalent in young adults. I surveyed about 100 high school students from urban cities in India to assess their stroke knowledge and decide how to take measures to bring more awareness about its symptoms, risk factors, and new effective treatments. Methods: I randomly selected high school students(9th‐12th graders) from Uttarakhand, Uttar Pradesh, Madhya Pradesh, Maharashtra, and Karnataka states to participate in the survey I created. I distributed multiple‐choice anonymous questionnaires to hundreds of high school students. The participants completed survey questions to the best of their ability. The survey assessed candidates' demographic characteristics, knowledge of stroke symptoms, stroke risk factors, ability to identify stroke symptoms, and knowledge about stroke‐related surgeries. It is important to note that these surveys were primarily sent to high school students in urban areas, where the knowledge and resources are relatively better than the rural areas. Results: I received a total of 91 survey responses from high schoolers across different states in India (30% were from Madhya Pradesh, 40% were from Maharashtra and 30% were from Karnataka and Uttar Pradesh). Even though 53.8% of the respondents reported some level of prior knowledge about the stroke, the rest of the respondents simply did not know or had misconceptions about stroke. Nearly ¾ did not know any stroke risk factors, warning signs, or recognize that the brain gets affected during the stroke. Only 27.5% of the students have heard of the popular acronym BE FAST(Balance Eyes Face Arms Speech Time) which is used to detect stroke in a patient. It is shocking that only 12.1% of the respondents have received an education on stroke at least once in their lifetime. Conclusions: The high schoolers have a good recognition of some basic facts of stroke. However, they have a poor understanding of stroke risk factors, the severity of the disease, and the treatment availability. However, there is hope. More than 57% of the high schoolers in my survey mentioned that they were willing to learn about stroke and ways to prevent and detect it. So it is our duty to educate the younger generation about the dangers of stroke and how to prevent, as well as to detect it. We should strive to provide access to these children in the hope of helping spread awareness all around India one step at a time.

The tuck-and-pull technique was developed for practical and safe explantations of posterior chamber phakic intraocular lenses (PCPIOLs). In this technique, after the creation of a side port, viscoelastic (or OVD [ophthalmic viscosurgical device]) is initially injected behind the PCPIOL to widen the space between PCPIOL and the crystalline lens. The old incisions can be used after recent implantations rendering the enlargement of the main incision unnecessary. After additional OVD over and under the PCPIOL, the haptic is tucked by a chopper and pulled through the main incision with a single maneuver. The haptic is grasped by two suture forceps and explanted with a “hand-to-hand” maneuver. The tuck-and-pull technique provided high protection of the corneal endothelium, crystalline lens, anterior chamber structures, and the PCPIOL itself. This technique is a practical, easy, and safe approach for explantations of all PCPIOL types, whatever the reason for its explantation may be.

Introduction: Successful cannulation of an arteriovenous fistula (AVF) is important in patients starting hemodialysis (HD). Metal needles have been used for decades, but the usefulness of plastic cannulae has recently been demonstrated as a new technique. Methods: This was a prospective, randomized, open-label study of incident HD patients. Eligible patients were randomized into 2 groups in a 1:1 ratio (n = 45/group). Maturation of the AVF was confirmed using Doppler ultrasound prior to first needling, and 2 well-trained nurses implemented the AVF cannulation. The primary endpoint was the initial cannulation failure rate, defined as the failure of successful completion of 3 consecutive dialysis sessions. The secondary endpoints were time for hemostasis at the end of HD, degree of patients' pain, degree of cannulation difficulty felt by the nursing staffs, and achieving optimal HD adequacy. Results: The mean elapsed time from AVF creation to the first cannulation was 48.1 ± 16.7 days. A total of 17 cases of cannulation failure occurred, and the failure risk tended to be higher in the metal needle group than the plastic cannula group (hazard ratio 2.6, 95% confidence interval 0.95–7.41) after adjusting for age, gender, comorbidities, and AVF location. The overall incidence of vessel injury was higher and time for hemostasis was significantly longer in the metal group than the plastic group. The use of plastic cannula was associated with a better HD adequacy compared to a metal needle. However, the patients' pain score (p = 0.004) and nursing staff's cannulation difficulty score (p = 0.084) were higher in the plastic group, emphasizing the great importance of practice using plastic cannulae. Conclusion: The vascular outcomes of plastic cannulae were much favorable compared to metal needles in incident HD patients. The use of plastic cannulae could be a new and innovative way to improve the quality of dialysis. [ABSTRACT FROM AUTHOR]

Maher Abdessater,1 Sandra Elias,2 Johnny Boustany,3 Raghid El Khoury31Urology Department, Centre Hospitalier Régional René DUBOS, Pontoise, 95300, France; 2Anesthesia Department, Institut Gustave Roussy, Villejuif, 94550, France; 3Urology Department, Notre Dame Des Secours University Medical Center, Byblos, LebanonObjective: To describe our new laparoscopic approach in ureterolysis using the ERBEJET® 2 device to hydrodissect the ureters in idiopathic retroperitoneal fibrosis.Methods: Bilateral laparoscopic ureterolysis was done after medical therapy failure (steroids) in a 47 year old patient with retroperitoneal fibrosis. Ureteral stents were placed before surgery. Only five trocars were used for both sides, Toldt’s fascia was opened and the dissection was performed till the psoas muscle. The ureters were completely freed from the fibrotic tissue using the ERBEJET 2 device (pure hydrodissection). An omental wrap was passed behind the colonic flexure at the right and placed around the ureter. At the left, we closed Toldt’s fascia by running sutures back to the freed ureter.Results: The operating time was 198 mins. The blood loss was 50 cc. The hospital stay was 3 days. The double J stents were removed at 4 weeks postoperatively. After 2 years, the patient is free of symptoms with normal creatinine level and no urinary tract obstructions.Conclusions: Hydrodissection of the ureter in retroperitoneal fibrosis is a new application in the upper urinary tract laparoscopic approach that has not been described in literature before. It seems to offer excellent midterm outcomes. The use of ERBEJET 2 device seems to simplify the procedure and make it feasible and safe (less trauma to the ureter and more conservation of its blood supply). We believe that comparative studies are needed to assess the role of hydrodissection in ureterolysis for retroperitoneal fibrosis.Keywords: hydrodissection, laparoscopic ureterolysis, retroperitoneal fibrosis, new technique

Background: The aim of the present study is to analyze the outcomes of laparoscopic and open liver resections for (Intrahepatic CholangioCarcinoma) ICC in the modern era of laparoscopic liver surgery. Methods: Patients undergoing laparoscopic and open liver resections for ICC in two European referral centers were included. Finally, 104 patients from the open group and 104 patients from the laparoscopic group were compared after propensity scores matching according to seven covariates representative of patients and disease characteristics. Indications to surgery and short- and long-term outcomes were compared. Results: Operative time, number of retrieved nodes, rate, and depth of negative resection margins were comparable between the two groups. Blood loss was lower in the MILS (150 ± 100 mL, mean ± SD) compared with the Open group (350 ± 250 mL, p = 0.030). Postoperative complications occurred in 14.4% of patients in the MILS and in the 24% of patients in the Open group (p = 0.02). There were no significant differences in long-term outcomes between groups. Conclusions: Our results confirm feasibility, safety, and oncological efficiency of the laparoscopic approach in the management of ICC. However, this surgery is often complex and should be only considered in centers with large experience in laparoscopic liver surgery. [ABSTRACT FROM AUTHOR]

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