Extraction of underwater fragile artifacts: research status and prospect

There are still many difficulties in the recovery and long-term preservation of underwater archaeological artifacts, in situ preservation should be the first choice before further procedures are considered. However, the materials, preservation status, and preservation environment of underwater artifacts are diverse, resulting in many fragile artifacts facing difficult situations. In order to prevent serious damage, it is a safe protective strategy to preserve them in a controlled environment for a long time after excavation. Extraction and transfer of fragile cultural relics are vital parts of this strategy. Due to the complexity of the underwater environment and the vulnerability of fragile artifacts, safety in extraction and transfer still faces enormous challenges. Researchers have developed new materials and technologies to tackle this problem. This paper focuses on introducing and developing prospects to different preservation techniques for fragile artifacts from underwater sites.

Perioperative Management of Pheochromocytomas and Sympathetic Paragangliomas

Pheochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumors arising from chromaffin cells of the adrenal medulla or extra-adrenal paraganglia, respectively. PPGLs have the highest degree of heritability among endocrine tumors. Currently, ~40% of PPGL individuals have a genetic germline and there exist at least 12 different genetic syndromes related to these tumors. Metastatic PPGLs are defined by the presence of distant metastases at sites where chromaffin cells are physiologically absent. Approximately 10% of pheochromocytomas and ~40% of sympathetic paragangliomas are linked to metastases explaining why complete surgical resection is the first-choice treatment for all PPGL patients. The surgical approach is a high-risk procedure requiring perioperative management by a specialized multidisciplinary team in centers with broad expertise. In this review, we summarize and discuss the most relevant aspects of perioperative management in patients with pheochromocytomas and sympathetic paragangliomas.

Comparative assessment of quality of life in chronic spontaneous urticaria receiving second generation anti histamines: A real world study

Objectives: Chronic spontaneous urticaria (CSU) is correlated with a high detrimental effect on the quality of life (QoL). Antihistamines are the first choice drugs in the management of CSU. QoL is important in the evaluation of the efficacy of antihistamines, as these are the most commonly used in CSU. Materials and Methods: In this comparative, three-arm study, patients with CSU were randomized to standard dose of either bilastine, fexofenadine, or levocetirizine for a period of 4 weeks. Patients were assessed for improvement in their QoL based on chronic urticaria QoL questionnaire (CU-Q2oL) questionnaire and urticaria activity score (UAS). Results: Fifty-eight CSU patients were randomized to bilastine (n = 23), fexofenadine (n = 18) and levocetrizine (n = 17) groups. There was significant improvement in CU-Q2oL and UAS score in all the groups during study period. 83%, 72%, and 65% patients reported improvement in CU-Q2oL score in bilastine, fexofenadine, and levocetrizine group, respectively. Bilastine was associated with significant improvement in CU-Q2oL compared to fexofenadine and levocetrizine (P < 0.05). Mean reduction in UAS score was 86%, 77%, and 68% in bilastine, fexofenadine and levocetrizine group respectively. The difference was statistically insignificant between the groups. The CU-Q2oL total score correlated more strongly (r = 0.62; P = 0.001) with the UAS7 in bilastine group than fexofenadine (r = 0.57; P = 0.01) and levocetrizine groups (r = 0.53; P = 0.02). Conclusion: The results of the study proved that, in CSU patients, QoL was improved significantly with bilastine as compared to fexofenadine and levocetirizine.

Bacterial Sensitivity To Chlorhexidine and Povidone-Iodine Antiseptics Over Time: A Systematic Review and Meta-Analysis of Human-Derived Data

Background Surgical site infection (SSI) is the most common complication of surgery, increasing healthcare costs and hospital stay. Chlorhexidine (CHX) and povidone-iodine (PVI) are used for skin antisepsis, minimising SSIs. There is increasing concern of developing resistance to topical biocides, though clinical implications remain unclear. Outcomes: Determining whether the Minimum Bactericidal Concentration (MBC) for topical preparations of CHX or PVI have changed over time, in microbes relevant to SSI. Methods We included studies reporting the mean bactericidal concentration (MBC) of laboratory and clinical isolates of common microbes to CHX and PVI. Excluding non-human samples and studies using antimicrobial solvents or mixtures with other active substances. MBC was pooled in random effects meta-analyses. Change in MBC over time was explored using meta-regression. Results 79 studies were including, analysing 6218 microbes over 45 years. Most used CHX (93%), with insufficient data for meta-analysis of PVI. There was no change in MBC of CHX to Staphylococci (β 0.12 [-1.13, 1.37]; I2 99%) or Streptococci (β 0.13 [-0.35, 0.62]; I2 97%). Conclusions There is no evidence of reduced susceptibility of common SSI-causing microbes to CHX over time. Providing reassurance that the worldwide guidance that CHX should remain the first-choice agent for surgical skin antisepsis.

Management of Appendicitis

Appendicitis is one of the most common causes of acute abdomen with life time risk between 6 and 8% and it’s a most common non obstetric surgical emergency during pregnancy. Appendicitis is claimed to be unknown in the villages of India and China in paper by A. M. Spencer. The reason is simply due to the fact that diagnostic facilities do not exist and cases are not recognized. So diagnosing acute appendicitis accurately and efficiently can reduce morbidity and mortality from perforation and other complications. Surgical intervention is the first choice for appendicitis with medical management being reserved for special situations.

Arterial Embolization of Polycystic Kidneys for Heterotopic Transplantation

Introduction: The purpose of this study was to evaluate the efficacy of polycystic kidney embolization, performed to reduce kidney volume before heterotopic kidney transplantation, as this technique could be an alternative to pretransplant nephrectomy. Materials and Methods: All patients who underwent pretransplant embolization of polycystic kidneys were included in a prospective register from June 2014 to February 2020. All patients underwent computed tomography (CT) scan with volumetric reconstruction (OsiriX, Bernex, Switzerland) before embolization and were then followed up at 3 and 6 months after embolization. Primary outcome was percentage of kidney volume reduction. Secondary outcomes were 30 day mortality and morbidity. Results: Thirty-one embolizations performed on 29 patients (medium age = 55.6; 62.1% male) were included between June 2014 and February 2020. All patients were under dialysis before embolization (9 peritoneal dialysis and 20 hemodialysis). Technical success was observed in 96.8% of cases. Mean procedural time was 65 minutes (range = 35–106 minutes) and mean length of in-hospital stay was 3.8 days (range = 3–6 days). A volume reduction allowing a kidney transplant was obtained for 28 patients (96.5%). The mean volume reduction was 39.9% (range = 6.01–68.2). The main observed complication was postembolization pain in 10 cases (32.2%). One patient needed complementary nephrectomy due to insufficient volume reduction. Twenty-three patients (79.3%) received renal transplant during follow-up with a mean delay of 19.5 month (range = 4–54). Conclusion: Polycystic kidney embolization is an effective and safe minimally invasive technique. It can be proposed as the first-choice technique for kidney transplant recipients as an alternative to pretransplantation nephrectomy.

Neurapraxia in patients with trigeminal neuralgia but no identifiable neurovascular conflict during microvascular decompression: a retrospective analysis of 26 cases

Background Microvascular decompression (MVD) is the first choice in patients with classic trigeminal neuralgia (TGN) that could not be sufficiently controlled by pharmacological treatment. However, neurovascular conflict (NVC) could not be identified during MVD in all patients. To describe the efficacy and safety of treatment with aneurysm clips in these situations. Methods A total of 205 patients underwent MVD for classic TGN at our center from January 1, 2015 to December 31, 2019. In patients without identifiable NVC upon dissection of the entire trigeminal nerve root, neurapraxia was performed using a Yasargil temporary titanium aneurysm clip (force: 90 g) for 40 s (or a total of 60 s if the process must be suspended temporarily due to bradycardia or hypertension). Results A total of 26 patients (median age: 64 years; 15 women) underwent neurapraxia. Five out of the 26 patients received prior MVD but relapsed. Immediate complete pain relief was achieved in all 26 cases. Within a median follow-up of 3 years (range: 1.0–6.0), recurrence was noted in 3 cases (11.5%). Postoperative complications included hemifacial numbness, herpes labialis, masseter weakness; most were transient and dissipated within 3–6 months. Conclusions Neurapraxia using aneurysm clip is safe and effective in patients with classic TGN but no identifiable NVC during MVD. Whether this method could be developed into a standardizable method needs further investigation.

Treatment of Human Sporotrichosis Caused by Sporothrix brasiliensis

We describe the successful treatment of a series of 30 zoonotic sporotrichosis cases from southern Brazil. Sporothrix brasiliensis was the species genotypically identified in all 25 confirmed cases. Five other cases were classified as probable, without laboratory confirmation, but with clinical and epidemiological data of cat-transmitted sporotrichosis. Two isolates were sequenced by translation elongation factor-1 alpha (EF1α) loci in order to compare their sequences, and both of them showed distinct genotypes from S. brasiliensis strains from other Brazilian states. Itraconazole (ITZ) or potassium iodide (KI) were the first choice treatment in 28 and 2 cases, respectively. Microdilution assay showed a wild-type profile of S. brasiliensis isolates to ITZ. However, a lack of clinical response occurred in 42% of cases, especially those treated with ITZ 100 mg/day, and treatment needed modifications, by either increased doses or antifungal combinations. Clinical cure required a mean of 187 days of treatment, which was dependent on the clinical form of the disease and age of patients. Therapy, including dosages and durations, for cutaneous forms of sporotrichosis requires re-evaluation, since cases caused by S. brasiliensis may influence treatment efficacy.

Polarimetric Persistent Scatterer Interferometry for Ground Deformation Monitoring with VV-VH Sentinel-1 Data

With the launch of the Sentinel-1 satellites, it becomes easy to obtain long time-series dual-pol (i.e., VV and VH channels) SAR images over most areas of the world. By combining the information from both VV and VH channels, the polarimetric persistent scatterer interferometry (PolPSI) techniques is supposed to achieve better ground deformation monitoring results than conventional PSI techniques (using only VV channel) with Sentinel-1 data. According to the quality metric used for polarimetric optimizations, the most commonly used PolPSI techniques can be categorized into three main categories. They are PolPSI-ADI (amplitude dispersion index as the phase quality metric), PolPSI-COH (coherence as the phase quality metric), and PolPSI-AOS (taking adaptive optimization strategies). Different categories of PolPSI techniques are suitable for different study areas and with different performances. However, the study that simultaneously applies all the three types of PolPSI techniques on Sentinel-1 PolSAR images is rare. Moreover, there has been little discussion about different characteristics of the three types of PolPSI techniques and how to use them with Sentinel-1 data. To this end, in this study, three data sets in China have been used to evaluate the three types of PolPSI techniques’ performances. Based on results obtained, the different characteristics of PolPSI techniques have been discussed. The results show that all three PolPSI techniques can improve the phase quality of interferograms. Thus, more qualified pixels can be used for ground deformation estimation by PolPSI methods with respect to the PSI technique. Specifically, this pixel density improvement is 50%, 12%, and 348% for the PolPSI-ADI, PolPSI-COH, and POlPSI-AOS, respectively. PolPSI-ADI is the most efficient method, and it is the first choice for the area with abundant deterministic scatterers (e.g., urban areas). Benefitting from its adaptive optimization strategy, PolPSI-AOS has the best performances at the price of highest computation cost, which is suitable for rural area applications. On the other hand, limited by the medium resolution of Sentinel-1 PolSAR images, PolPSI-COH’s improvement with respect to conventional PSI is relatively insignificant.

The Impact of International Labor Migration on Business Activities

Labor migration has gained momentum and has become an intensive and difficult process to manage. The problem of emigration is evidenced by the particularly high flows of people leaving to work and live abroad (Akerman, 2007). As migration processes intensify, there are risks of an economic, socio-cultural and political-managerial nature. Population migration takes place in all countries of the world, but the extent of population migration and the impact on the country&#39;s economy and business vary. The work summarizes the theories and concepts of international labor migration, explains the causes of international labor migration and the positive and negative consequences for business. Two countries were selected to assess international labor migration impact on businesses activities. Lithuania was the first choice because its economic and political and institutional and technological was growing from time to time. Egypt was the second choice because it was suffereing after the two revolutions and its indicators had negatively affected except technological sector .The business environment of selected countries were examined. The business environment of selected countries was also examined, and the impact of international labor migration on the activities of companies was determined (B&ouml;cker, 2019).