Notes

Malfunction associated with OPHL type IIb due to undiagnosed Novelty helmet symptoms.
Splenic flexure mobilization (SFM) is one of the most difficult steps in laparoscopic colorectal surgery and its role is harshly debated. Some surgeons considered it routinely necessary to obtain a safe anastomosis and to respect oncologic criteria; for others SFM is frequently unnecessary, not ensuring the aspects mentioned above and increasing the risk of morbidity (splenic, bowel and vessels injury, lengthened procedure). We performed a systematic review and a comprehensive meta-analysis, without any language restriction, about the peri-operative and post-operative outcomes (anastomotic leakage, intra-operative complication, conversion rate, operative time, post-operative bleeding, intra-abdominal collection, prolonged ileus, wound infection, anastomotic stricture, overall complications, hospital stay, re-operation, post-operative mortality, R0 margin resection, local recurrence) in patients undergoing elective anterior rectal resection (ARR) with or without SFM, both in laparotomic (LT) and laparoscopic (LS) approach. Fourteen studies were meta-analyzed with a total amount of 42,221 patients. The comprehensive meta-analysis shows that the mobilization or the preservation (SFP) of the splenic flexure does not statistically influence the incidence of colorectal anastomotic leakage, conversion rate, post-operative bleeding, intra-abdominal collection, prolonged ileus, wound infection, anastomotic stricture, overall complications, hospital stay, re-operation, R0 margin resection, and local recurrence results. The operative time is significantly longer in every group of patients undergoing SFM. The incidence of intra-operative complication is statistically increased in overall patients and also in the LS subgroup of patients undergoing SFM, in which also higher incidence of wound infection and re-operation is shown. The meta-analysis shows that SFM may be considered not necessary to ensure better peri-operative and post-operative outcomes in both LT and LS ARR.
Telehealth delivery of pediatric weight management interventions may address time, travel, and cost barriers to in-person interventions, thus improving accessibility. This narrative review highlights findings from the past 5 years of pediatric lifestyle interventions for weight management that utilize telehealth for treatment delivery. We describe impressions and future directions.

We identified and included 20 studies that described unique interventions from the past 5 years. The majority of reviewed studies indicated statistically significant reductions in BMI z-scores, high retention and attendance, and high satisfaction. However, mean decreases in BMI z-scores were marginal (approximately 0.10) in all but two studies. Studies did not often report effect sizes. Pediatric telehealth weight management interventions demonstrate good feasibility and acceptability. Improvement in reporting results and more rigorous research, including use of randomized designs, recruitment of larger samples, and incorporation of extended follow-up is needed to determine clinical impact and magnitude of effects.
We identified and included 20 studies that described unique interventions from the past 5 years. The majority of reviewed studies indicated statistically significant reductions in BMI z-scores, high retention and attendance, and high satisfaction. However, mean decreases in BMI z-scores were marginal (approximately 0.10) in all but two studies. Studies did not often report effect sizes. Pediatric telehealth weight management interventions demonstrate good feasibility and acceptability. Improvement in reporting results and more rigorous research, including use of randomized designs, recruitment of larger samples, and incorporation of extended follow-up is needed to determine clinical impact and magnitude of effects.Black crusts (BCs) are one of the most critical alteration forms found on stones belonging to architectural heritage. Since they could be considered as passive samplers of atmospheric pollution, it would be plausible to establish relations between the air contamination and the BCs. With this aim, we have characterized BCs collected on historic buildings from two Spanish cities (Granada and Vigo) with different polluted atmospheres, as well as formed on stone substrates of varied mineralogy and texture. Likewise, in order to assess the impact of the atmospheric pollutants on the growth of BCs, quartz fiber filters were used as surrogate substrates and placed nearby the studied buildings to collect and analyze the aerosol particulate matter (PM). To this end, an array of complementary analytical techniques was used to evaluate the mineralogy, chemical composition, and texture of the BCs and to establish the correlation with the ions, OC (organic carbon), and EC (elemental carbon) detected in the PM on the quartz fiber filters. As result, BCs developed on carbonate substrates from Granada show more complex structure than those from Vigo, which are thinner because of frequent rain episodes. In both cities, NaCl, Pb-Cl, and Ca-Cl-rich particles, Ca-phosphate particles and clusters of Ba-sulfate-rich particles were detected. However, metal-rich rounded particles were more abundant in Granada's BCs, including soot particles. BCs from Granada were richer in carbonaceous components (OC and EC) than the Vigo's BCs. Although in the filters PM did not show EC-mainly due to traffic-, in the BCs from both locations OC and EC were detected. Therefore, this different composition was related to the mineralogy of the stones and the higher pollution of Granada in contrast to the industrial and sea-exposed city of Vigo.Chlorophenols are used in many industries for their importance in preservation and herbicide preparation even though they possess high-risk factors. The prolonged usage of these compounds makes it very complicated to remove them from water and soil by conventional treatment methods. Biosurfactant are the promising structures with the ability to remove contaminants effectively. In this work, an attempt has been made to eliminate 2,4-dichlorophenol from soil and water using amino acid-enhanced cationic biosurfactant obtained from Bacillus axarquiensis. The produced BS has the ability to reduce the surface tension to 30.0 mN m-1. From RSM, the optimum conditions for the maximum production of BS were obtained at time 95 h; pH 7; temperature 35 °C, and concentration of substrate 5%. The BS was immobilized using a solid support matrix for the stability. The environmental factors such as temperature and pH have no effect on the matrix used and found to be viable even under extreme conditions. The removal efficiency was achieved in the range of 93-96% from water and 80-85% from soil. Additionally, the recyclability and reusability of the matrix were also analyzed, and it withstands up to 8 cycles. As a result, the significance of biosurfactant by enhancing the amino acid content was explored in remediation technology.Ambio is a leading journal in environmental science and policy, sustainable development, and human-environment interactions. The paper at hand aims to run a bibliometric analysis to inspect the main publications features of Ambio in Science Citation Index Expanded SCI-EXPANDED. Selleckchem NX-5948 For this scope, a bibliometric survey has been carried out to investigate the journal's historic characteristics in the Web of Science (WoS) categories of environmental sciences and environmental engineering for Ambio from 1980 to 2019. These are the categories for which the journal has been indexed throughout the indexed time frame. The paper proposes technical and methodological innovations, including improvements in the methods and original characteristics analyzed. Documents published in Ambio were searched out from SCI-EXPANDED. Six publication indicators were applied to evaluate the publication performance of countries, institutes, and authors. Three citation indicators were used to compare publications. As a parameter, the journal impact factor contributor was applied to compare the most frequently cited publications. The journal impact factor contributing publications were also discussed. Results show that Sweden ranked top in six publication indicators and that the top three productive institutes were located in Sweden. A low percentage of productive authors emerged as a journal impact factor contributor. Similarly, a low relationship between the IF contributing publications and the highly cited publications was also found. Less than half of the top 100 highly cited publications in Ambio did not lie within the high impact in most the recent year of 2019. Three members of the advisory board in Ambio were the main productive authors. T.V. Callaghan contributed to most of the publications while papers published by J. Rockstrom as first and corresponding author contributed the most to the journal impact factor. An article authored by Steffen et al. (2007) scored the highest total citations in 2019.
To compare preoperative contrast-enhanced spectral mammography (CEM) versus digital mammography plus digital breast tomosynthesis (DM + DBT) in detecting breast cancer (BC) and assessing its size.

We retrospectively included 78 patients with histological diagnosis of BC who underwent preoperative DM, DBT, and CEM over one year. Four readers, blinded to pathology and clinical information, independently evaluated DM + DBT versus CEM to detect BC and measure its size. Readers' experience ranged 3-10years. We calculated the per-lesion cancer detection rate (CDR) and the complement of positive predictive value (1-PPV) of both methods, stratifying analysis on the total of lesions, index lesions, and additional lesions. The agreement in assessing cancer size versus pathology was assessed with Bland-Altman analysis.

100 invasive BCs (78 index lesions and 22 additional lesions) were analyzed. Compared to DM + DBT, CEM showed higher overall CDR in less experienced readers (range 0.85-0.90 vs. 0.95-0.96), and higher CDR for additional lesions, regardless of the reader (range 0.54-0.68 vs. 0.77-0.86). CEM increased the detection of additional disease in dense breasts in all readers and non-dense breasts in less experienced readers only. The 1-PPV of CEM (range 0.10-0.18) was comparable to that of DM + DBT (range 0.09-0.19). At Bland-Altman analysis, DM + DBT and CEM showed comparable mean differences and limits of agreement in respect of pathologic cancer size.

Preoperative CEM improved the detection of additional cancer lesions compared to DM + DBT, particularly in dense breasts. CEM and DM + DBT achieved comparable performance in cancer size assessment.
Preoperative CEM improved the detection of additional cancer lesions compared to DM + DBT, particularly in dense breasts. CEM and DM + DBT achieved comparable performance in cancer size assessment.Recurrent fever during/post-dialysis can occur due to infectious or non-infectious causes. We present the case of a 79-year-old patient who had persistent post-dialysis fever after long-term tunneled central venous catheterization with acetate-containing bicarbonate dialysate. Drug-induced lymphocyte stimulation test (DLST) was positive for acetate dialysate, and he was suspected of having acetate dialysate-induced hypersensitivity reaction. However, switching to acetate-free dialysate did not attenuate the fever. Since Serratia marcescens had been isolated twice from the blood, catheter-related bloodstream infection (CRBSI) was suspected. The culture of the catheter tip confirmed CRBSI caused by S. marcescens. Elevation of β-d-glucan levels and appearance of pulmonary nodular shadow on chest computed tomography images indicated complicated fungal infections. Administration of antibiotics and antifungals led to resolution of the pulmonary nodular shadow with attenuation of fever and C-reactive protein levels.
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