Notes

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s technique may, therefore, be considered particularly critical in potentially infectious patients. Alternative methods may be given preference and personal protective equipment should be used consequently.
Despite the evolution of the endoscopic techniques for the treatment of symptomatic Zenker diverticulum, comparative studies are lacking. Aim of this observational study was to compare safety, efficacy, and outcomes of endoscopic stapling (ES) versus Laser (EL).

A prospectively collected database of patients who underwent treatment for Zenker diverticulum at a single institution was reviewed. Consecutive patients treated by ES or EL were included in the study. Demographic data, presenting symptoms, diverticulum characteristics, and intra- and postoperative data were analyzed. The Functional Outcome Swallowing Scale (FOSS) and MD Anderson Dysphagia Inventory (MDADI) questionnaires were administered to assess severity of dysphagia and quality of life before and after treatment.

Between March 2017 and September 2018, 36 patients underwent ES or EL. In the TL group (n = 19), the diverticulum size was smaller compared to the EL group (n = 17) (p = 0.002). Two perforations occurred in the EL group, one treated conservatively and the other requiring drainage of a mediastinal abscess. At a median follow-up of 16months, symptoms improved in both groups but the number of patients with a postoperative FOSS score ≥ 2 significantly decreased only after EL (p < 0.001). The scores of all items of the MDADI questionnaire significantly increased in both groups, but the average delta values were greater in the EL patients (p < 0.001).

Both TL and ES are effective treatment options for Zenker diverticulum. Postoperative quality of life was significantly higher in patients undergoing EL compared to ES.
Both TL and ES are effective treatment options for Zenker diverticulum. Postoperative quality of life was significantly higher in patients undergoing EL compared to ES.Urbanization in China has dramatically increased from 39.10 in 2002 to 58.52% in 2017. read more Studies have discussed the impacts of urbanization and its corresponding changes in consumption patterns on carbon dioxide emissions; however, little is known about their impacts on black carbon (BC). Therefore, we collected data on the BC emissions of various sectors to calculate the consumption-based BC emissions in China, and we used an input-output analysis (IOA) and structural decomposition analysis (SDA) to explore the impacts of urbanization and changes in consumption patterns on BC emissions from 2002 to 2017, focusing on sectoral BC emissions. The total BC emissions of various sectors first increased and then decreased. BC emissions increased from 1083.47 in 2002 to 2550.83 Gg in 2012. They were then reduced to 2478.63 Gg in 2017. Additionally, with the rise in the urbanization rate, household consumption BC emissions increased from 446.18 in 2002 to 1080.12 Gg in 2017. Urban consumption, rural consumption, and BC emission intensity were the three main contributing factors to household consumption BC emission changes. Transport, storage, postal, and telecommunications services (TSP); farming, forestry, animal husbandry, and fishery (FFA); and residential and other industries (RES) contributed the most to the urbanization-related BC emission increase. In particular, the TSP sector contributed the most to the BC emission increase because of the increasing TSP needs related to urbanization. Therefore, it is necessary to formulate mitigation policies for the TSP sector.South Asia is comprised of several countries, including Bangladesh, Pakistan, India, and Sri Lanka, all ranked highly at risk of climatic variability. The region's susceptibility to climate change can be attributed to both its spatial and inherent characteristics. Considering the countries' high dependence on agricultural products, to support their economies and growing populations, it is vital to measure the factors impacting crop productivity. This study quantifies the change in temperature and precipitation, coupled with their respective effects on the productivity of three major crops, wheat, rice and cotton, within two of Pakistan's largest provinces Punjab and Sindh. Based on the collated data, multivariate regression analysis is conducted. Moreover, highly vulnerable areas to climate change have been identified under RCP scenarios 4.5 and 8.5, until the end of this century. Results reveal that there is a substantial increasing trend in temperature, whereas precipitation has high inter-annual variability. Regression outcomes, based on fixed/random effects models, indicate that temperature above threshold values of 24.3 °C, 33.0 °C and 32.0 °C for wheat, rice and cotton, respectively, negatively impacts productivity (statistically significant). Precipitation is statistically insignificant in explaining its role in crop productivity. Overall, the region is heading towards temperature and threshold exceedances at an alarming rate, which will impact the overall availability of suitable crop-growing areas.The current study was conducted to determine the combined performance of soil micro- and macro-organisms to stimulate the growth and lead (Pb) uptake of Bermuda grass (Cynodon dactylon (L.) Persi.) in a soil polluted with Pb-mining activities. Plants were inoculated with a mixture of arbuscular mycorrhizal (AM) fungal species, plant growth-promoting rhizobacteria (PGPR) species, and epigeic earthworms (Eisenia fetida) either alone or in combination. Results demonstrated antagonistic interactions between AM fungi and PGPR or between AM fungi and earthworms on the growth of mycorrhizal plants by increasing the availability of both phosphorus (P) and Pb in the soil solution and the subsequent reduction of mycorrhizal root colonization following inoculation of PGPR or earthworms. Plant biomass was negatively correlated with soil-available Pb, but positively with the percentage of root colonization by AM fungi. Additionally, mycorrhizal root colonization was negatively correlated with soil-available P and Pb concentrations.
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