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Open repair is the standard of care for patients with descending thoracic and thoracoabdominal aortic aneurysms. Although effective, surgery carries a high risk of morbidity and mortality. Endovascular stent-grafts were introduced to treat these aneurysms in patients considered too high risk for open repair. Early results are promising, but later results are incompletely known. Therefore, we sought to compare short- and intermediate-term outcomes of open versus endovascular repair for these aneurysms.

From 2000-2010, 1,053 patients underwent open (n=457) or endovascular (n=596) repair of descending thoracic and thoracoabdominal aortic aneurysms at Cleveland Clinic. To balance patient characteristics between these groups, propensity-score matching was performed, yielding 278 well-matched pairs (61% of possible pairs). Endpoints included short- and long-term outcomes.

In matched patients, compared with endovascular stenting, open repair achieved similar in-hospital mortality (n=23/8.3% vs n=21/7.6%, P=.8) and occurrence of paralysis and stroke (n=10/3.6% vs n=6/2.2%, P=.3), despite longer postoperative stay (median 11 vs 6 days), more dialysis-dependent acute renal failure (n=24/8.6% vs n=9/3.3%, P=.008), and prolonged ventilation (n=106/46% vs n=17/6.3%, P<.0001). Open repair resulted in better 10-year survival than endovascular repair (52% vs 33%, P<.0001), and aortic reintervention was less frequent (4% vs 21%, P<.0001). Despite a decrease in the first postoperative year, average aneurysm size did not recover to normal range after endovascular stenting.

Open repair of descending thoracic and thoracoabdominal aneurysms can achieve acceptable short-term outcomes with better intermediate-term outcomes than endovascular repair.
Open repair of descending thoracic and thoracoabdominal aneurysms can achieve acceptable short-term outcomes with better intermediate-term outcomes than endovascular repair.
To assess an alternative method for estimating demand for postpartum tubal ligation and evaluate reproductive trajectories of low-income women who did not obtain a desired procedure.

In a 2-year cohort study of 1700 publicly insured women who delivered at 8 hospitals in Texas, we identified those who had an unmet demand for tubal ligation prior to discharge from the hospital. We classified unmet demand as explicit or prompted based on survey questions that included a prompt regarding whether the respondent would like to have had a tubal ligation at the time of delivery. We assessed persistence of demand for permanent contraception, contraceptive use, and repeat pregnancies among all study participants who wanted but did not get a postpartum procedure.

Some 426 women desired a postpartum tubal ligation; 219 (51%) obtained one prior to discharge. Alectinib purchase Among the 207 participants with unmet demand, 62 (30%) expressed an explicit preference for the procedure, while 145 (70%) were identified from the prompt. Most e for permanent contraception. Among low-income women in Texas, those with unmet demand for postpartum tubal ligation require improved access to effective contraception.Formaldehyde (FA) is a naturally-occurring compound, produced endogenously in diverse living organisms. It also occurs widely in the environment due to anthropogenic (e.g. used as a chemical intermediate) and natural sources (e.g. a component of the volatile organic compounds blends emitted by plants). While FA is considered a potential carcinogen, living organisms have the ability to cope with FA, and some minimum endogenous levels of FA may be required for health. Recently, genetic engineering approaches transferring biological information from one organism to another led to increased assimilation of and conferred genetic-based tolerance to FA in plants-microorganisms systems. Here, we propose that FA commonly induces hormesis, a hypothesis that we confirm by collating evidence from various published studies with animals, plants, and microorganisms. The stimulation by low doses below the no-observed-adverse-effect-level (NOAEL) was modest in magnitude, in agreement with the general hormesis literature. In plants, among the endpoints showing hormesis were growth, lipid peroxidation, and photosynthetic pigments. In various animal cells, hormesis was observed in cell proliferation and viability, responses that were related to mechanisms, such as activation of phosphorylated ERK (extra-cellular signaling-regulated kinase) expression, acceleration of the process of cell division, and enhancement of the Warburg effect (i.e. use of glycolysis by tumor cells to produce energy for rapid growth). Hormetic in vitro responses were reported in several cancerous/tumorous cell lines, suggesting that FA has the potential to influence tumor promotion within a specific concentration range and biological context. These observations suggest that FA commonly acts in an hormetic manner with implications for study designs across a broad range of biological models and in the assessment of environmental and human risks associated with FA exposures.The coronavirus has come to the world and spread with great wide among the countries of the world and has resulted in numerous infections that exceeded 167,181,023 million patients and are close to 3.5 deaths by September 2021. It also brought with it panic and fear, halted many activities, and led to the decline of the global economy. It changed human behavior and forced people to change their lifestyles to avoid infection. One of the most sectors that must be taken into consideration through pandemic coronavirus (COVID-19) around the globe is the air conditioning systems. The HVAC systems depend on the air as a heat transfer medium. The air contains a group of pollutants, viruses, and bacteria, and it affects and destroys human life. The air filter plays a major role as an important component in the air conditioning systems. Thus, it requires more effort by researchers to improve its design to prevent the ultra-size of particles loaded with coronavirus (COVID-19). This paper provides insight into the design of existing combined air-conditioners on their suitability and their impact on the spread of the hybrid coronavirus epidemic and review efforts to obtain a highly efficient air filter to get rid of super-sized particles for protection against epidemic infection. In addition, important guideline recommendations have been made to limit the spread of the COVID-19 virus and to obtain indoor air quality in air-conditioned places.
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