Different Modalities for Management of Pediatric Epiphora.

Objective: This study assessed the efficacy and safety of different modalities for managing nasolacrimal duct obstruction and epiphora in children over one year. Methods: We performed a non-randomized prospective study on 98 children (149 eyes) with epiphora and no history of lacrimal operation. The selected candidates attended the ENT and ophthalmology outpatient clinics of Minia University Hospital, seeking to treat epiphora that may or may not be associated with sinonasal pathology. Nasolacrimal operations involved a joint approach involving an otorhinolaryngologist and an ophthalmologist. Results: Ninety-eight children (149 eyes) were identified. Ages varied from 1 to 12 years old. Conservative measures were successful in 32.6% of children. Silicone stents were used in 27.5% of the interventions with a mean time to removal of 3-6 months. The success rate for dacryocystorhinostomy (DCR) was 85.7%. Revision surgery was performed in 10% of probing cases, 8% of intubation cases, and 14.3% of DCR patients. The concomitant chronic sinonasal problems were evident in 62.2% of patients. Conclusion: Conservative measures, probing, endonasal nasolacrimal intubation, endoscopic DCR, and external DCR are safe and effective procedures for epiphora in children. Also, correcting concomitant nasopharyngeal or sinonasal diseases in epiphora patients is crucial for successful management, overcoming recurrence, and minimizing morbidity.

Paths to research-driven decision making in the realms of environment and water.

Now more than ever it is critical for researchers and decision makers to work together to improve how we manage and preserve the planet's natural resources. Water managers in the western U.S., as in many regions of the world, are facing unprecedented challenges including increasing water demands and diminishing or unpredictable supplies. The transfer of knowledge (KT) and technology (TT) between researchers and entities that manage natural resources can help address these issues. However, numerous barriers impede the advancement of such transfer, particularly between organizations that do not operate in a profit-oriented context and for which best practices for university-industry collaborative engagement may not be sufficient. Frameworks designed around environmental KT - such as the recently-developed Research-Integration-Utilization (RIU) model - can be leveraged to address these barriers. Here, we examine two examples in which NASA Earth science satellite data and remote-sensing technology are used to improve the management of water availability and quality. Despite differences in scope and outcomes, both of these case studies adopt KT and TT best practices and can be further understood through the lens of the RIU model. We show how these insights could be adopted by NASA through a conceptual framework that charts individual- and organizational-level integration milestones alongside technical milestones. Environmental organizations can learn from this approach and adapt it to fit their own institutional needs, integrating KT/TT models and best practices while recognizing and leveraging existing institutional logics that suit their organization's unique history, technical capability and priorities.

Clinical manifestations of Pacak-Zhuang syndrome in a male pediatric patient.

We report an index case of a male patient who presented with all clinical manifestations of Pacak-Zhuang syndrome, including early-age polycythemia, multiple pheochromocytomas/paragangliomas, duodenal somatostatinoma, and ocular findings. Sequencing analysis detected an EPAS1 mutation in all tumors tested, but not in the germline.

Author Correction: Assessing data availability and research reproducibility in hydrology and water resources.

In the original version of this Article the author of reference #38 was incorrectly stated as Quinn, J. et al. This has been corrected to Xu, W. et al. in both the HTML and PDF versions.

Assessing data availability and research reproducibility in hydrology and water resources.

There is broad interest to improve the reproducibility of published research. We developed a survey tool to assess the availability of digital research artifacts published alongside peer-reviewed journal articles (e.g. data, models, code, directions for use) and reproducibility of article results. We used the tool to assess 360 of the 1,989 articles published by six hydrology and water resources journals in 2017. Like studies from other fields, we reproduced results for only a small fraction of articles (1.6% of tested articles) using their available artifacts. We estimated, with 95% confidence, that results might be reproduced for only 0.6% to 6.8% of all 1,989 articles. Unlike prior studies, the survey tool identified key bottlenecks to making work more reproducible. Bottlenecks include: only some digital artifacts available (44% of articles), no directions (89%), or all artifacts available but results not reproducible (5%). The tool (or extensions) can help authors, journals, funders, and institutions to self-assess manuscripts, provide feedback to improve reproducibility, and recognize and reward reproducible articles as examples for others.

Laparoscopic ureterolithotomy: our experience with 74 cases.

OBJECTIVES: We retrospectively evaluated our experience with a relatively uncommon procedure, the laparoscopic ureterolithotomy, for the treatment of ureteral stones. METHODS: Between April 2002 and October 2006, a total of 74 patients (56 males, 18 females) with upper (54 cases), middle (18 cases) and lower (two cases) ureteral stones underwent laparoscopic ureterolithomy. The mean age was 39.4 years (range, 19-74). The stones were in the right side in 44 cases (59.5%) and in the left side in 30 (40.5%) cases. The mean stone size was 1.8 cm (range 1.5-2.8). The procedure was retroperitoneal in 66 cases (89.2%) and transperitoneal in eight (10.8%) cases. Laparoscopic guided flexible ureterorenoscopic extraction of kidney stone was carried out in one case as an adjuvant procedure. The ureter was stented and not sutured in 64 cases (86.5%). RESULTS: The procedure was successfully completed in 94.6% of cases and an open conversion was carried out in four (5.4%) patients. The mean operative time was 58.7 min, and the mean blood loss was 90.6 mL. No major complications were encountered. Prolonged urinary leakage occurred in one patient. The mean hospital stay was 6.4 days. One patient developed ureteral stricture during follow up and was treated by endoscopic dilatation and stenting. CONCLUSION: In our experience laparoscopic ureterolithotomy represents a safe and effective treatment option for ureteral stones either as primary for large impacted stones or as a salvage procedure after failed shock wave lithotripsy or ureteroscopy. This procedure fulfills the advantages of minimal blood loss and analgesia requirements, good cosmetic appearance, short hospital stay and convalescence period.