Static fluid magnetic resonance urography in evaluation of ureteral ectopia: Experience in 10 pediatric cases

Introduction: Ectopic ureters are often very difficult to diagnose with conventional imaging modalities especially in children. Magnetic resonance urography (MRU) has been recently investigated as a problem-solving tool for the evaluation of various congenital urogenital anomalies with favorable results.Aim of the work: To assess the value of static fluid MRU in diagnosing ectopic ureters in childhood.Patientsand methods: Ten out of 14 pediatric patients with suspected ureteral ectopia (as suggested by clinical or conventional imaging techniques) were included in this study and prospectively studied by MRUaiming to confirmthe suspected diagnosis. The examinations were done on 1.5T machines using static fluid T2W-MRU sequences. Ultrasound examinations were done for all patients. Voiding cystourethrogram (VCUG) was done for 8 patients to exclude vesico-ureteric reflux or urethral anomalies.Results: All studied patients had dilated collecting systems. Static fluid MRU was able to detect the site of ectopic ureteric insertion in all 10 patients. It was superior to ultrasound in evaluation of 8 cases with complex duplex systems. In one patient with multiple congenital anomalies, MRU clearly demonstrated the urinary and extra-urinary anomalies. The final diagnosis was confirmed by surgical or endoscopic data in all patients.Conclusions: In dilated collecting systems, static fluid MRU can provide detailed assessment of the collecting systems and ureters as well as adequately detect ureteral ectopia. MRU should be recommended whenever a ureteric insertion anomaly is suspected.Keywords: Magnetic resonance urography; MRU; Ectopic ureter; Ureteral ectopia; Ureteric insertion anomalie

Performance evaluation framework of Wyoming connected vehicle pilot deployment program: summary of Phase 2 pre-deployment efforts and lessons learned

Purpose – This paper aims to present a summary of the performance measurement and evaluation plan of the Wyoming connected vehicle (CV) Pilot Deployment Program (WYDOT Pilot). Design/methodology/approach – This paper identified 21 specific performance measures as well as approaches to measure the benefits of the WYDOT Pilot. An overview of the expected challenges that might introduce confounding factors to the evaluation effort was outlined in the performance management plan to guide the collection of system performance data. Findings – This paper presented the data collection approaches and analytical methods that have been established for the real-life deployment of the WYDOT CV applications. Five methodologies for assessing 21 specific performance measures contained within eight performance categories for the operational and safety-related aspects. Analyses were conducted on data collected during the baseline period, and pre-deployment conditions were established for 1 performance measures. Additionally, microsimulation modeling was recommended to aid in evaluating the mobility and safety benefits of the WYDOT CV system, particularly when evaluating system performance under various CV penetration rates and/or CV strategies. Practical implications – The proposed performance evaluation framework can guide other researchers and practitioners identifying the best performance measures and evaluation methodologies when conducting similar research activities. Originality/value – To the best of the authors’ knowledge, this is the first research that develops performance measures and evaluation plan for low-volume rural freeway CV system under adverse weather conditions. This paper raised some early insights into how CV technology might achieve the goal of improving safety and mobility and has the potential to guide similar research activities conducted by other agencies

The Pediatric Allergy and Immunology Unit of Ain Shams University in times of SARS-CoV-2 pandemic: approach and challenges

The Pediatric Allergy and Immunology (PAI) Unit of Ain Shams University, founded in 1988 by Professor Yehia El-Gamal and currently headed by Professor Shereen Reda, is a tertiary referral center for pediatric allergy, primary immunodeficiency, and rheumatology patients in Egypt. It serves more than 1300 patients with different immunological disorders, with an outpatient and inpatient sections and investigational laboratory. With the widespread of the SARS-CoV-2 and its declaration as a "pandemic", and owing to the heterogeneity of the different disorders managed and followed up in the unit, several measures have been taken in order to provide the necessary services for the patients. This service should maintain a rational balance between the need to mitigate the virus spread and to provide the optimum care for those who get infected, when in the meantime keep their original disease morbidity and mortality to the minimum. These measures were taken by the members of the PAI unit with the help of the head management team of Children’s Hospital, Ain Shams University and were subjected to continuous modification based on the evolving situation, emerging information, problems faced and the availability of human and medical resources

Folic acid supplementation in postmenopausal women with hot flushes: phase III randomised double-blind placebo-controlled trial

Objective To assess whether folic acid supplementation ameliorates hot flushes. Design Double-blind, placebo-controlled randomised trial. Setting Nine hospitals in England. Population Postmenopausal women experiencing ≥50 hot flushes weekly. Methods Women (n = 164) were randomly assigned in a 1:1 ratio to receive folic acid 5 mg tablet or placebo daily for 12 weeks. Participants recorded frequency and severity of hot flushes in a Sloan Diary daily and completed Greene Climacteric and Utian Quality of Life (UQoL) Scales at 4-week intervals. Main outcome measures The change in daily Hot Flush Score at week 12 from randomisation based on Sloan Diary Composite Score B calculation. Results Data of 143 (87%) women were available for the primary outcome. The mean change (SD) in Hot Flush Score at week 12 was −6.98 (10.30) and −4.57 (9.46) for folic acid and placebo group, respectively. The difference between groups in the mean change was −2.41 (95% CI −5.68 to 0.87) (P = 0.149) and in the adjusted mean change −2.61 (95% CI −5.72 to 0.49) (P = 0.098). Analysis of secondary outcomes indicated an increased benefit in the folic acid group regarding changes in total and emotional UQoL scores at week 8 when compared with placebo. The difference in the mean change from baseline was 5.22 (95% CI 1.16–9.28) and 1.88 (95% CI 0.23–3.52) for total and emotional score, respectively. Conclusions The study was not able to demonstrate that folic acid had a statistically significant greater benefit in reducing Hot Flush Score over 12 weeks in postmenopausal women when compared with placebo. Tweetable abstract Folic acid may ameliorate hot flushes in postmenopausal women but confirmation is required from a larger study

A Rouse-based method to integrate the chemical composition of river sediments : application to the Ganga basin

Author Posting. © American Geophysical Union, 2011. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Journal of Geophysical Research 116 (2011): F04012, doi:10.1029/2010JF001947.The Ganga River is one of the main conveyors of sediments produced by Himalayan erosion. Determining the flux of elements transported through the system is essential to understand the dynamics of the basin. This is hampered by the chemical heterogeneity of sediments observed both in the water column and under variable hydrodynamic conditions. Using Acoustic Doppler Current Profiler (ADCP) acquisitions with sediment depth profile sampling of the Ganga in Bangladesh we build a simple model to derive the annual flux and grain size distributions of the sediments. The model shows that ca. 390 (±30) Mt of sediments are transported on average each year through the Ganga at Haring Bridge (Bangladesh). Modeled average sediment grain size parameters D50 and D84 are 27 (±4) and 123 (±9) μm, respectively. Grain size parameters are used to infer average chemical compositions of the sediments owing to a strong grain size chemical composition relation. The integrated sediment flux is characterized by low Al/Si and Fe/Si ratios that are close to those inferred for the Himalayan crust. This implies that only limited sequestration occurs in the Gangetic floodplain. The stored sediment flux is estimated to c.a. 10% of the initial Himalayan sediment flux by geochemical mass balance. The associated, globally averaged sedimentation rates in the floodplain are found to be ca. 0.08 mm/yr and yield average Himalayan erosion rate of ca. 0.9 mm/yr. This study stresses the need to carefully address the average composition of river sediments before solving large-scale geochemical budgets.This work was supported by INSU program “Relief de la Terre” and ANR Calimero. Valier Galy was supported by the U.S. National Science Foundation (grant OCE‐0851015)

Investigation of sediment behaviour in a channel with flood plains

SIGLEAvailable from British Library Document Supply Centre- DSC:D81739 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Sediment Dynamics in Alluvial Rivers Used as a Resource for Land-Building

There is a dire need to use sediment from alluvial rivers to sustain and create new marsh land and sustain barrier islands and ridges. Coastal Louisiana is a prime example where wetland loss rates are one of the highest nationwide. This study focuses on investigating the sediment dynamics of the Lower Mississippi River, specifically the temporal and spatial variability of the sediment concentration as well as the sediment size characteristics. The objectives of this study are: to analyze and quantify the impact of diversion design parameters on the efficiency of sediment capture, to analyze the hydrodynamic and morphological patterns at sand bar borrow areas and to quantify the infill spatial and temporal patterns of these dredged pits. The investigation was performed using a morphodynamic numerical tool (Delft3D). The Louisiana 2012 State Master Plan identified two viable mechanisms to build land: sediment diversions and dedicated dredging. The morphodynamic model was parameterized and validated using historical and recent field observations. The model was used to examine three different parameters hypothesized as key design parameters that govern the sediment capture efficiency of sediment diversions: the alignment angle, invert elevation and diversion size. Diverted sediment loads and the sediment concentration ratio were used to assess the efficiency achieved to the corresponding change in design. Implications of choosing the designs on construction and efficiency was discussed. The model was also used to investigate the riverside morphological response to a number of parameters for dredging lateral sand bars. Detailed analyses were carried out for the hydrodynamics at the dredge pit and its implications on the morphological development. Sensitivity analysis of hydrodynamic and sediment transport parameters examined the morphological response within the dredge pit. Findings put emphasis on data collection requirements and helped form future recommendations for predictive modeling of dredged sandbar infill. The study is concluded with an economic assessment for the impact of land-building mechanisms on the riverside in correlation to waterborne economy

The new era of vascular interventions: The venous side

In spite of the huge advances in endovascular management of arterial diseases, surgery remained for a long time the only available option for treating veins. The situation has changed dramatically since the introduction of minimally invasive interventions for treating superficial as well as deep venous diseases. Objectives: To review the recent advances in venous imaging and interventions for treatment of varicose veins, venous outflow obstruction and deep vein thrombosis. Methods: Reviewing available literature providing evidence for the new technologies available for treating: 1- Chronic Venous Disease (including superficial varicose veins and deep venous obstructions). 2- Deep Vein thrombosis (DVT). Results: RCTs showed that ultrasound-guided endovenous thermal or chemical ablation of superficial varicose veins are as effective as surgical ligation and stripping with the additional advantages of being minimally invasive, with less complications and more patient satisfaction, potential treatment in out-patient setup and early return to work. Stenting of chronic deep venous obstruction is safe, effective in improving symptoms and treating venous leg ulcers. Catheter-directed thrombolysis and pharmaco-mechanical thrombolysis are both effective in treating acute DVT and reducing post-thrombotic manifestations. Conclusion: Current evidence shows that management of venous diseases is now shifting towards minimally invasive interventions with very promising results. Given the lots of research work done in the field nowadays and evolving technologies provided by manufacturers, it will soon be the standard of practice offered for patients with chronic venous disease

Investigation of sediment behaviour in a channel with flood plains

The objective of this research was to investigate the sediment behaviour in a compound channel and, in particular, the transfer of sediment between a main channel and its flood plain.A review of the literature on compound channels showed that, whilst research on fixed boundaries had been carried out or was in hand, there was no evidence that the loose boundary situation had previously been studied.Experiments were conducted in a loose boundary, outdoor sand channel of symmetrical compound section. The channel was of straight alignment, 50 m long, with an overall width of 3 m. Pumping equipment was available for recirculation of the water and the sediment.Samples of suspended sediment were collected from the shallow and deep sections and analysed by Coulter Counter to obtain the particle size distributions. The distribution curves were found to be very similar for the main channel and the flood plains.Sand from the channel was labelled by fluorescent dye and inserted in the bed of the main channel so as to simulate a point release. Bed samples were collected at sections 5 m and 10 m downstream of the injection point and examined under UV light for their tracer proportions. It was found that the cross-sectional distribution of tracer concentration was approximately Gaussian indicating that there had been some sediment transfer to the flood plains.A two-dimensional diffusion model, which accounts for the movement in the longitudinal and lateral directions, has been applied to describe the transport and dispersion of the tracer particles. A best-fit overlay with the experimental results enabled the longitudinal and lateral dispersion coefficients to be established. The model results, for the distribution of tracer, are depicted in 2 and 3-dimensional form at a sequence of time intervals for up to 2 hours after tracer release.It was concluded that under steady state conditions there would be a constant transfer of sediment from the main channel to the flood plains; in fact, analysis showed that approximately 40% of a continuous tracer injection in the main channel would be transferred to the flood plains.</p