Evidence based medical use of aloe vera extracts, short review of literature

The use of aloe vera is being promoted for a large variety of conditions. The aim of this review was to summarize all available research papers on aloe vera preparations with a view to providing evidence for or against its clinical effectiveness. Independent literature searches were conducted in PubMed. All studies of controlled clinical trials, observational studies and case series were included. There were no restrictions on the language of publication. All studies were read by all authors and data were extracted in a standardized, pre-defined manner. Even though there are some promising results, clinical effectiveness of oral or topical aloe vera is not sufficiently defined at present

59. Early and late results of routine leaflet augmentation for complete atrio-ventricular septal defect repair

Complete AVSD (CAVSD) is characterized by the presence of a common atrio-ventricular (AV) orifice, an inter-atrial communication, and a ventricular septal defect (VSD). Results of surgical correction of atrio-ventricular septal defects (AVSDs) have improved over the last decades; however, the need for reoperation for left atrio-ventricular valve regurgitation, after primary AVSD repair remains a major concern. The aim of our study is to assess the outcome of the routine leaflet augmentation technique in CAVSD repair. A retrospective database and chart review analysis of all patients who underwent AV canal repair at king Abdul-Aziz Cardiac Center during period from 1999 to September 2014 was conducted. Demographic data, associated anomalies, operative data, ICU and hospital course were reviewed. Early outcomes were reviewed for postoperative complications (Chylothorax, complete AV block, Arrhythmias, early mortality) and late outcomes were reviewed for Left AV valve regurgitation requiring for re-intervention and late mortality. Two hundred and sixty patients underwent leaflet augmentation technique to repair complete AVSD, between January 1999 and September 2014. The mean age was (131.5months), and mean weight (6.06kg). A variety of concomitant procedures were performed at the time of repair of the CAVSD, including a total of 49 patients (18.8%) who underwent PDA ligation. Repair of TV (Right AV valve) was performed in 11 patients (4.2%), 9 patients (3.46%) required RVOTO resection, in 5 patients (1.92%), PA plasty was done and 2 patients (0.76%) required ECMO after CAVSD repair. Regarding reoperations, a total of 17 patients (of 260) required reoperation after initial CAVSD repair. The most common indication for reoperation was left AV valve regurgitation in 16 patients (6%) in the follow up period up to 15years. One patient (0.38%) required diaphragmatic plication. The overall mortality was 3 patients (1.1%). Leaflet augmentation for the repair of the complete AVSD, represent a good surgical alternative technique, allows for good exposure, good LAVV reconstruction and close to anatomical repair and results in reduced incidence of late Left atrio-ventricular valve regurgitation

Interactions between nation branding and corporate branding

The aim of this article is studying interactions between nation branding and corporate branding through reviewing the literature. Results show that both branding of a country and its corporates have influence to each other, either positive or negative effect that is called virtuous cycle or a vicious cycle. In fact, these two types of branding, act as a synergistic reinforcement tool to protect, improve or enhance the other one and therefore should be observed and maintained simustainasly.Keywords: National Reputation, CorporateBranding, Brand Positive Cycle, National Identit

Static Safety for an Actor Dedicated Process Calculus by Abstract Interpretation

The actor model eases the definition of concurrent programs with non uniform behaviors. Static analysis of such a model was previously done in a data-flow oriented way, with type systems. This approach was based on constraint set resolution and was not able to deal with precise properties for communications of behaviors. We present here a new approach, control-flow oriented, based on the abstract interpretation framework, able to deal with communication of behaviors. Within our new analyses, we are able to verify most of the previous properties we observed as well as new ones, principally based on occurrence counting

Mixing and chemical reaction in an idealized swirl chamber

A vorticity-based, low-Mach-number model for simulating combustion in closed chambers is constructed. Numerical scheme is based on a mixed finite-difference pseudo-spectral discretization of the governing equations. Discrete evolution equations are integrated in time using a predictor-corrector scheme, while discrete elliptic systems are inverted with the help of fast-Poisson solver. Scheme is applied to analyze mixing and combustion in an idealized swirl cavity, which consists of the annular space between a spinning inner cylinder and a stationary reaction. To this end, we assume that the oxidizer and fuel are initially separated by a thin mixed region, and carefully control mixing levels by varying the duration of the swirl-driven mixing period. The mixture is then ignited along the boundary of the inner cylinder. When pre-mixing is complete, an axisymmetric flame front is established, and the reactants are consumed as the front propagates radially outwards. When the charge is partially mixed, combustion in the early stages predominantly occurs within a non-uniform premixed front. As this non-uniform front approaches the outer cylinder, a transition to a distributed combustion regime occurs. Following the transition, the remaining fuel burns at a slow rate within non-premixed flames which wrap around the inner cylinder. Results show that the mixing time has substantial effects on the pressure rise within the cavity and on the evolution of the burnt fraction, and that these effects become more pronounced as the Damkoehler number increases

AMR, stability and higher accuracy

Efforts to achieve better accuracy in numerical relativity have so far focused either on implementing second order accurate adaptive mesh refinement or on defining higher order accurate differences and update schemes. Here, we argue for the combination, that is a higher order accurate adaptive scheme. This combines the power that adaptive gridding techniques provide to resolve fine scales (in addition to a more efficient use of resources) together with the higher accuracy furnished by higher order schemes when the solution is adequately resolved. To define a convenient higher order adaptive mesh refinement scheme, we discuss a few different modifications of the standard, second order accurate approach of Berger and Oliger. Applying each of these methods to a simple model problem, we find these options have unstable modes. However, a novel approach to dealing with the grid boundaries introduced by the adaptivity appears stable and quite promising for the use of high order operators within an adaptive framework

The EFSUMB Guidelines and Recommendations for Musculoskeletal Ultrasound - Part I: Extraarticular Pathologies

The first part of the guidelines and recommendations for musculoskeletal ultrasound, produced under the auspices of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB), provides information about the use of musculoskeletal ultrasound for assessing extraarticular structures (muscles, tendons, entheses, ligaments, bones, bursae, fasciae, nerves, skin, subcutaneous tissues, and nails) and their pathologies. Clinical applications, practical points, limitations, and artifacts are described and discussed for every structure. After an extensive literature review, the recommendations have been developed according to the Oxford Centre for Evidence-based Medicine and GRADE criteria and the consensus level was established through a Delphi process. The document is intended to guide clinical users in their daily practice

Comparative Effectiveness of Stereo-EEG versus Subdural Grids in Epilepsy Surgery

OBJECTIVE: To compare the outcomes of subdural electrode (SDE) implantations versus stereo-electroencephalography (SEEG), the two predominant methods of intracranial EEG (iEEG) performed in difficult to localize drug-resistant focal epilepsy. METHODS: The Surgical Therapies Commission of the International League Against Epilepsy created an international registry of iEEG patients implanted between 2005-2019 with ≥ 1 year follow-up. We used propensity score matching to control exposure selection bias and generate comparable cohorts. Study endpoints: 1) likelihood of resection after iEEG; 2) seizure-freedom at last follow-up; and 3) complications (composite of either post-operative infection, symptomatic intracranial hemorrhage, or permanent neurologic deficit). RESULTS: Ten study sites from seven countries and three continents contributed 2,012 patients, including 1,468 (73%) eligible for analysis (526 SDE, 942 SEEG) of whom 988 (67%) underwent subsequent resection. Propensity score matching improved covariate balance between exposure groups for all analyses. Propensity-matched patients who underwent SDE had higher odds of subsequent resective surgery (odds ratio OR = 1.4, 95% CI 1.05 - 1.84), and higher odds of complications (OR=2.24, 95% CI 1.34-3.74; unadjusted: 9.6% after SDE vs. 3.3% after SEEG). Odds of seizure-freedom in propensity-matched resected patients were 1.66 times higher (95% CI 1.21, 2.26) for SEEG compared to SDE (unadjusted: 55% seizure-free after SEEG-guided resections vs. 41% after SDE) INTERPRETATION: Compared to SEEG, SDE evaluations are more likely to lead to brain surgery in patients with drug-resistant epilepsy, but have more surgical complications and lower probability of seizure-freedom. This comparative-effectiveness study provides the highest feasible evidence level to guide decisions on iEEG. This article is protected by copyright. All rights reserved