Endoscopic Management of Post-Polypectomy Bleeding

Post-polypectomy bleeding (PPB) is one of the most common complications of endoscopic polypectomy. There are multiple risk factors related to patient and polyp characteristics that should be considered. In most cases, immediate PPB can be effectively managed endoscopically when recognized and managed promptly. Delayed PPB can manifest in a myriad of ways. In severe delayed PPB, resuscitation for hemodynamic stabilization should be prioritized, followed by endoscopic evaluation and therapy once the patient is stabilized. Future areas of research in PPB include the risks of direct oral anticoagulants and of specific electrosurgical settings for hot-snare polypectomy vs. cold-snare polypectomy, benefits of closure of post-polypectomy mucosal defects using through-the-scope clips, and prospective comparative evaluation of newer hemostasis agents such as hemostatic spray powder and over-the-scope clips

Vascular Malformation Involving the Maxillofacial Region: A Case Report

Vascular anomalies constitute some of the most difficult diagnostic and therapeutic enigmas in the head and neck region and most of the congenital vascular malformations were often misdiagnosed and left untreated. These lesions are the result of an embryonic abnormality of the vascular system. Vascular lesions in the maxillofacial region are rare. These lesions can cause facial asymmetry, loose teeth, tinnitus, headache, and bruits and can be complicated by life threatening conditions such as haemorrhage and heart failure. This article presents a case of 25-year old female patient reported to the Department of Oral Medicine and Radiology with a chief complaint of swelling on the left side of the face. Based on the clinical findings and radiological investigations such as USG with Color Doppler, MR Angiography and CBCT the case was diagnosed as slow flow venous malformation involving the left maxillofacial region. So, the present case report depicts that apart from the clinical findings advanced radiological techniques like contrast enhanced Magnetic Resonance Imaging and CBCT will acts as a useful tool for the accurate diagnosis of Vascular Anamolies (VA)

Implants in the severely resorbed mandibles: whether or not to augment? What is the clinician’s preference?

Contains fulltext : 96000.pdf (publisher's version ) (Open Access)INTRODUCTION: The aim of this study is to inventory in the Netherlands which therapy is the clinician's first choice when restoring the edentulous mandible. MATERIAL AND METHODS: A questionnaire was sent to all Dutch Oral and Maxillofacial surgeons. As part of this, the surgeons were invited to treat five virtual edentulous patients, differing only in mandibular residual height. RESULTS: In cases of a sufficient residual height of 15 mm, all surgeons were in favour to insert solely two implants to anchor an overdenture. In case of a residual height of 12 mm, 10% of the surgeons choose for an augmentation procedure. If a patient was presented with a mandibular height of 10 mm, already 40% of the OMF surgeons executed an augmentation procedure. Most (80%) surgeons prefer the (anterior) iliac crest as donor site. The choice of 'whether or not to augment' was not influenced by the surgeon's age; however, the hospital, where he was trained, did. Surgeons trained in Groningen were more in favour of installing short implants in mandibles with reduced vertical height. DISCUSSION: As the option overdenture supported on two interforaminal implants is reimbursed by the Dutch health assurance, this treatment modality is very popular in the Netherlands. From a point of costs and to minimize bypass comorbidity, surgeons should be more reluctant in executing augmentation procedures to restore the resorbed edentulous mandible as it is dated in literature that also in mandibles with a residual height of 10 mm or less, solely placing implants, thus without an augmentation procedure in advance, is a reliable treatment option

Pathways to breaking the poverty trap in Ethiopia: Investments in agricultural water, education, and markets

Investments in agricultural water management should complement or strengthen the livelihood and coping systems of the rural poor, and should thus be instrumental for breaking the poverty trap in Ethiopia. Underdeveloped water resources constrain progress towards poverty reduction. We examine linkages and complementarities between agricultural water, education, markets and rural poverty through an empirical study using household level data from selected villages in southern Ethiopia. We show that investments in irrigation can contribute to poverty reduction, but the poverty reducing impacts of irrigation water are greater when human capital and rural markets are well developed. The size of landholding, access to irrigation water, on-farm land and water conservation practices, literacy of the household head, and years of education of adults are all significant determinants of household welfare, and thus potential pathways for reducing poverty. Expansion of cultivated land, particularly irrigated land, universal literacy, and an extra school year for adults all reduce poverty, but reductions in poverty are greater when irrigation is combined with universal literacy. These findings call for simultaneous investments in agricultural water, education, markets and related policy support measures for reducing poverty in smallholder agriculture in Ethiopia.Irrigation Poverty reduction Consumption Income Inequality Rural infrastructure

Reducing poverty in sub-Saharan Africa through investments in water and other priorities

Water resources are essential to human development processes and to achieve the Millennium Development Goals that seek, inter alia, to eradicate extreme poverty and hunger, achieve universal literacy, and ensure environmental sustainability. Expanding irrigation is essential to increase agricultural production, which is needed to achieve economic development and attain food security in much of sub-Saharan Africa. Water resources and irrigated agriculture are not developed to their full potential. Currently less than 4% of renewable water resources in Africa are withdrawn for agriculture. Barriers include the lack of financial and human resources to build irrigation and related rural infrastructure and acquire agricultural technology, and inadequate access to markets. This constrains progress towards poverty reduction. We examine the linkages between agricultural water, education, markets and rural poverty through a review of published studies. We argue that, linking agricultural water, education, and market interventions, which are so often implemented separately, would generate more effective poverty reduction and hunger eradication programs. Investments in agricultural water management and complementary rural infrastructure and related policies are the pathways to break the poverty trap in smallholder African agriculture.Irrigation Agricultural productivity Poverty reduction Farmer education Rural infrastructure

Role of Brønsted and Lewis acid sites on Ni/TiO2 catalyst for vapour phase hydrogenation of levulinic acid: Kinetic and mechanistic study

The TiO2 supported Ni catalysts were investigated for vapour phase hydrogenation of aqueous levulinic acid at ambient pressure. Ni/TiO2 demonstrated high selectivity of -valerolactone (GVL) compared to noble metal (Pt, Pd, Ru) catalysts. The surface acid sites played an important role on the product distribution. Pyridine adsorbed DRIFT spectra revealed that the Lewis acid sites on Ni/TiO2 were responsible for high selectivity of -valerolactone. In contrast, the Brønsted acid sites are prone to ring opening of - valerolactone to produce valeric acid and hydrocarbons. The physicochemical characteristics of Ni/TiO2 were correlated with -valerolactone rates. Based on the kinetic study a mechanism has been proposed

Influence of Rare Earth (La, Pr, Nd, Gd, and Sm) Metals on the Methane Decomposition Activity of Ni-Al Catalysts

Rare earth (RE = La, Pr, Nd, Gd and Sm) metal-doped Ni-Al (Ni-RE-Al) hydrotalcite precursors were obtained by coprecipitation and calcined to form mixed oxide catalysts. The physicochemical characteristics of calcined and reduced Ni-RE-Al samples were determined by X-ray powder diffraction, Brunauer-Emmett-Teller surface area, H-2 temperature-programmed reduction, O-2 pulse chemisorption, UV-diffuse reflectance spectroscopy, electron spin resonance spectrometry, and Fourier transform infrared spectroscopy. The catalysts were evaluated for CH4 decomposition at 550 degrees C until their complete deactivation. The deactivated catalysts were examined by transmission electron, scanning electron, and Raman spectroscopy and elemental analysis. The Raman spectra indicated the presence of both ordered and disordered carbon in deactivated catalysts. A correlation is drawn between H-2 production rates and the Ni metal surface area of catalysts. The addition of La to Ni-Al dramatically changed the Ni behavior, leading to higher H-2 yields

Influence of La on reduction behaviour and Ni metal surface area of Ni-Al2O3 catalysts for Cox free H2 by catalytic decomposition of methane

A series of Ni:Al:La mixed oxides derived from hydrotalcite precursors with varying La/Al mole ratio were examined for COx free H2 production by catalytic decomposition of CH4. The physico-chemical characteristics of Ni:Al:La were determined by XRD, UV-DRS, SEM, TEM, Raman spectroscopy, BET-surface area, TPR and O2 pulse chemisorption measurements. Addition of La to NieAl improved the Ni metal surface area and the reduction behaviour of NiO particles is dramatically changed. Particle size of Ni was similar to the size of carbon nano fibre in the deactivated catalyst. A direct correlation between Ni metal surface area and the CH4 decomposition activity was observed