ICAR: endoscopic skull‐base surgery

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International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

A comprehensive review of quay crane scheduling, yard operations and integrations thereof in container terminals

Over the past decades, container transportation has achieved considerable growth, and maritime trade now constitutes 80% of the global trade. The vessel sizes increased in parallel, up to 21,400 TEU (Twenty-foot-equivalent unit container). Accordingly, global containerized trade reached up to 150 million TEU in 2017 (UNCTAD 2018). This growth brings the need to use scientific methods to manage and operate container terminals more economically throughout the globe. In order to manage container transshipment and to use large vessels efficiently, the docking time at the container port for each vessel should be minimized. The decrease in the docking time enables the vessel to move to its next destination faster, decreasing turnover time and facilitating more containers to be transported. Container terminals can be divided into five main areas as the berth, the quay, the storage yard, the transport area, and the gate. The vessels must be berthed in suitable positions, after which many containers have to be unloaded or loaded via quay cranes, transshipped by vehicles inside the terminal, and stacked by yard cranes to suitable positions, all by using expensive equipment. With the invention of new technologies, the bottleneck at the berth side is almost overcome; however, the yard and the quayside operations have to be further perfected to obtain efficient plans. In this comprehensive literature review study, we aim to combine the literature on both yard and quayside operations, carefully examining independently studied problems as well as integrated ones. General information about port operations and relevant literature is provided. For the quayside, the literature on quay crane assignment and scheduling problems is investigated, whereas, for the yard side, yard crane scheduling, transport vehicle dispatching and scheduling, vehicle routing and traffic control, and storage location and space planning problems are reviewed in depth. In addition to these individual problems, their integrations are also analyzed, relevant publications and their respective contributions are explained in detail. Besides the milestone papers that lead the literature on container terminals, recent publications and advances are also reviewed, and managerial insights and future research directions are identified.Project Evaluation Commission of Yasar University [BAP038]The authors would like to thank the anonymous referees for their invaluable suggestions. This study was supported within the scope of the scientific research project, which was accepted by the Project Evaluation Commission of Yasar University under project number BAP038 and title Solution Approaches for Integrated Liner Shipping Network Design and Container Terminal Operations

Differences in Comorbidity Burden Between those with Chronic Kidney Disease and Normal Renal Function

Introduction and Aims: Chronic kidney disease (CKD) and renal replacement therapy are both associated with significant mortality and morbidity. Co-existing comorbidity is common. The degree to which the increased morbidity and mortality is a result of the CKD, and how much a result of the co-existing comorbidity is less clear. We aimed to describe the range of comorbidity at baseline in a population cohort containing all identified within a healthcare region with CKD, those on RRT and a sample of 20,000 individuals from the same population with normal renal function. Methods: The GLOMMS-II cohort contained all individuals with a low eGFR (<60) ml/min/1.73m2 measured in our healthcare region in 2003 (in 2/3 of these with “CKD” the low eGFR was present for at least 90 days, in 1/3 with “impaired eGFR” it was not present for at least 90 days); all those with raised PCR and ACR; all those receiving RRT and a 20,000 sample of those with only normal eGFR measurements in 2003. Data-linkage to hospital episode statistics in the five years prior gave information on comorbidity in 2003. The prevalence of common comorbidities in the subgroups of the cohort is described. The odds of having each comorbidity at baseline with adjustment for age and sex are presented. Results: The prevalence of most comorbidities was higher in those with more advanced CKD (including RRT, as table). After correction for age and sex, vascular comorbidity, diabetes and haematological malignancy continued to be strongly associated with more advanced CKD. The association for other comorbidities was less marked, particularly for dementia. Impaired eGFR was also associated with many of these comorbidities Conclusions: More advanced CKD was strongly associated with vascular comorbidity and diabetes even after correction for age. This association may in part be due to the role of these comorbidities in the aetiology of CKD, as well as a consequence. In the assessment of outcomes in CKD, the effect of these comorbidities on outcome over and above that of CKD itself should be investigated further