Long-term Use of Ultrasound for Locating Optimal LVA Sites: A Descriptive Data Analysis

2021 ◽  
Author(s):  
Balazs Mohos ◽  
Manon Czedik-Eysenberg ◽  
Johannes Steinbacher ◽  
Ines Tinhofer ◽  
Stefan Meng ◽  
...  
Keyword(s):  
Lymphatic Vessels ◽  
Preoperative Assessment ◽  
Skin Incision ◽  
Assessment Protocol ◽  
Preoperative Mapping ◽  
The Us ◽  
Integral Role ◽  
Caucasian Patients ◽  
Lymphovenous Anastomosis

Abstract Background Preoperative mapping of lymphatic vessels for lymphovenous anastomosis (LVA) surgery is frequently performed by indocyanine green (ICG) lymphography solely; however, other imaging modalities, such as ultrasound (US), might be more efficient, particularly for Caucasian patients. We present our preoperative assessment protocol, experience, and approach of using US for locating optimal LVA sites. Material and Methods Fifty-six (16 males) lymphedema patients who underwent LVA surgery were included in this study, 5 of whom received two LVA operations. In total, 61 LVA procedures with 233 dissected lymphatic vessels were evaluated. Preoperative US was performed by the author S.M. 2 days before intraoperative ICG lymphography. Fluid-predominant lymphedema regions were scanned more profoundly. Skin incisions followed preoperative US and ICG lymphography markings. Detection of lymphatic vessels was compared between ICG lymphography and the US by using the intraoperative verification under the microscope with 20 to 50x magnification as the reference standard. Results Among the dissected lymphatic vessels, 83.3% could be localized by US, and 70% were detectable exclusively by it. In all, 7.2% of US-detected lymphatic vessels could not be found and verified intraoperatively. Among the lymphatic vessels found by US, only 16% were apparent with ICG before skin incision. In total, 23.2% of the dissected lymphatic vessels could be visualized with ICG lymphography preoperatively. Only 9.9% of the lymphatic vessels could be found by ICG alone. Conclusion High-frequency US mapping accurately finds functional lymphatic vessels and matching veins. It locates fluid-predominant regions for targeted LVA surgeries. It reveals 3.6 times as many lymphatic vessels as ICG lymphography. In our practice, it has an integral role in planning LVA procedures.

An Assessment of Coastal Zone Hazard Mitigation Plans in Texas

2010 ◽  
Vol 5 (5) ◽  
pp. 526-534 ◽  
Author(s):  
Jung Eun Kang ◽  
◽  
Walter Gillis Peacock ◽  
Rahmawati Husein ◽  
Keyword(s):  
Hazard Mitigation ◽  
Disaster Mitigation ◽  
Disaster Resilience ◽  
Point Scale ◽  
Assessment Protocol ◽  
Management Zone ◽  
The Us ◽  
The Status

The U.S. Federal EmergencyManagement Agency requires jurisdictions to develop hazardmitigation plans (HMPs) to be eligible for hazard mitigation grants based on the 2000 Disaster Mitigation Act. As of May 2007, over 14,000 local jurisdictions in the US have developed single or multi-jurisdiction local hazard mitigation plans. However, little empirical research has examined the quality of local HMPs. This study develops a comprehensive HMP assessment protocol and then assesses the status of twelve HMPs within the Texas coastal management zone. The components of these plans are systematically examined in order to highlight their strengths and weaknesses. The average plan quality score (PǪS) was only 41.6 on a 100-point scale, with a high of 53.3 and a low of 28.7. Regional and county plans displayed higher PSQs than city plans. Most disconcerting was the finding of very low component quality scores forfact basisat 33.6 and mitigationpolicies & actionsat only 28.2. These two components are at the heart of HMPs. The relatively lowPǪSandCǪSresults suggest that there are significant improvements that should be undertaken in future iterations of HMPs to better insure long-term disaster resilience of local jurisdictions along the Texas coast.

Moving past the vaccine/autism controversy - to examine potential vaccine neurological harms

2020 ◽  
pp. 1-15
Author(s):  
Peter R. Breggin
Keyword(s):  
Neurological Disorders ◽  
Developmental Disorder ◽  
Physical Symptoms ◽  
Psychosocial Disorders ◽  
The Us ◽  
Potential Vaccine ◽  
Research And Education ◽  
The Brain ◽  
New Vaccines

BACKGROUND: The vaccine/autism controversy has caused vast scientific and public confusion, and it has set back research and education into genuine vaccine-induced neurological disorders. The great strawman of autism has been so emphasized by the vaccine industry that it, and it alone, often appears in authoritative discussions of adverse effects of the MMR and other vaccines. By dismissing the chimerical vaccine/autism controversy, vaccine defenders often dismiss all genuinely neurological aftereffects of the MMR (measles, mumps, and rubella) and other vaccines, including well-documented events, such as relatively rare cases of encephalopathy and encephalitis. OBJECTIVE: This report explains that autism is not a physical or neurological disorder. It is not caused by injury or disease of the brain. It is a developmental disorder that has no physical origins and no physical symptoms. It is extremely unlikely that vaccines are causing autism; but it is extremely likely that they are causing more neurological damage than currently appreciated, some of it resulting in psychosocial disabilities that can be confused with autism and other psychosocial disorders. This confusion between a developmental, psychosocial disorder and a physical neurological disease has played into the hands of interest groups who want to deny that vaccines have any neurological and associated neuropsychiatric effects. METHODS: A review of the scientific literature, textbooks, and related media commentary is integrated with basic clinical knowledge. RESULTS: This report shows how scientific sources have used the vaccine/autism controversy to avoid dealing with genuine neurological risks associated with vaccines and summarizes evidence that vaccines, including the MMR, can cause serious neurological disorders. Manufacturers have been allowed by the US Food and Drug Administration (FDA) to gain vaccine approval without placebo-controlled clinical trials. CONCLUSIONS: The misleading vaccine autism controversy must be set aside in favor of examining actual neurological harms associated with vaccines, including building on existing research that has been ignored. Manufacturers of vaccines must be required to conduct placebo-controlled clinical studies for existing vaccines and for government approval of new vaccines. Many probable or confirmed neurological adverse events occur within a few days or weeks after immunization and could be detected if the trials were sufficiently large. Contrary to current opinion, large, long-term placebo-controlled trials of existing and new vaccines would be relatively easy and safe to conduct.

Sanctions of the USA and the Policy of Bank of Russia:double Blow to the National Economy

2014 ◽  
pp. 13-29 ◽  
Author(s):  
S. Glazyev
Keyword(s):  
National Security ◽  
Economic Sanctions ◽  
Capital Flight ◽  
Practical Advice ◽  
The Us ◽  
Monetary Authorities ◽  
The Usa ◽  
Simultaneous Adoption ◽  
The Eu

This article examines fundamental questions of monetary policy in the context of challenges to the national security of Russia in connection with the imposition of economic sanctions by the US and the EU. It is proved that the policy of the Russian monetary authorities, particularly the Central Bank, artificially limiting the money supply in the domestic market and pandering to the export of capital, compounds the effects of economic sanctions and plunges the economy into depression. The article presents practical advice on the transition from external to domestic sources of long-term credit with the simultaneous adoption of measures to prevent capital flight.

Endurance of Transnationalism in Bolivia’s Valle Alto

2006 ◽  
Vol 3 (1) ◽  
pp. 63-74 ◽  
Author(s):  
Richard C. Jones ◽  
Leonardo De la Torre
Keyword(s):  
Random Sample ◽  
Work Experience ◽  
Household Income ◽  
Return Migration ◽  
Ethnographic Interviews ◽  
The Us ◽  
Foreign Work ◽  
Intentions To Return ◽  
Economic Ties

The increasing difficulty of return migration and the demands for assimilation into host societies suggest a long-term cutting of ties to origin areas—likely accentuated in the Bolivian case by the recent shift in destinations from Argentina to the US and Spain. Making use of a stratified random sample of 417 families as well as ethnographic interviews in the provinces of Punata, Esteban Arze, and Jordán in the Valle Alto region the authors investigate these issues. Results suggest that for families with greater than ten years cumulated foreign work experience, there are significantly more absentees and lower levels of remittances as a percentage of household income. Although cultural ties remain strong after ten years, intentions to return to Bolivia decline markedly. The question of whether the dimunition of economic ties results in long-term village decline in the Valle Alto remains an unanswered.   

Study of Natural Minerals of U-Ryrochlore-Type Structure as Analogues of Plutonium Ceramic Waste-form

2002 ◽  
Vol 713 ◽  
Author(s):  
Roman V. Bogdanov ◽  
Yuri F. Batrakov ◽  
Elena V. Puchkova ◽  
Andrey S. Sergeev ◽  
Boris E. Burakov
Keyword(s):  
Chemical Shifts ◽  
Pyrochlore Structure ◽  
Type Structure ◽  
Waste Form ◽  
X Ray ◽  
Ceramic Waste ◽  
Natural Minerals ◽  
The Us ◽  
Pyrochlore Type

ABSTRACTAt present, crystalline ceramic based on titanate pyrochlore, (Ca,Gd,Hf,Pu,U)2Ti2O7, is considered as the US candidate waste form for the immobilization of weapons grade plutonium. Naturally occuring U-bearing minerals with pyrochlore-type structure: hatchettolite, betafite, and ellsworthite, were studied in orders to understand long-term radiation damage effects in Pu ceramic waste forms. Chemical shifts (δ) of U(Lδ1)– and U(Lβ1) – X-ray emission lines were measured by X-ray spectrometry. Calculations were performed on the basis of a two-dimensional δLá1- and δLδ1- correlation diagram. It was shown that 100% of uranium in hatchettolite and, probably, 95-100% of uranium in betafite are in the form of (UO2)2+. formal calculation shows that in ellsworthite only 20% of uranium is in the form of U4+ and 80% of the rest is in the forms of U5+ and U6+. The conversion of the initial U4+ ion originally occurring in the pyrochlore structure of natural minerals to (UO2)2+ due to metamict decay causes a significant increase in uranium mobility.

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