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Objective To assess MRI appearance of the dermal allograft and its correlation with clinical outcome following superior capsular reconstruction (SCR). Materials and methods This is a retrospective study of patients who underwent SCR between 2015 and 2018. Patients with postoperative MRI and clinical follow-up were included. Exclusion criteria were preoperative shoulder instability, advanced glenohumeral arthritis, and lack of postoperative MRI or clinical follow-up. Radiographs and MRIs were evaluated for graft integrity and position, acromiohumeral interval, superior subluxation distance (SSD), and glenohumeral cartilage loss. Correlation between imaging and clinical outcome measures were assessed. Results 24 shoulders (23 patients) met the inclusion criteria at a mean clinical and MRI follow-up of 9.1 months. There were 12 intact grafts (50%) and 12 torn grafts (50%), most commonly at the glenoid attachment (8/12). Patients with graft tear had greater SSD (mean 10.5 ± 6.1 mm) than those without tear (mean 6.1 ± 3.8 mm) (p = 0.028). SSD > 7.9 mm had a 79% sensitivity and 91% specificity for graft tear. The intact grafts were more commonly covering the superior humeral head (91.7%) compared with the torn grafts (41.7%) (p = 0.027). There was improvement of clinical outcome measures including American Shoulder and Elbow Surgeons score (p = 0.005) and forward elevation (p = 0.021) although there was no correlation between clinical outcome and integrity of the graft. Conclusion SCR results in significant short-term clinical improvement even in the presence of graft tear on postoperative MRIs on current study. Gap between graft and the anchors, non-superior position of the graft, and humeral head superior subluxation can be associated with tear.

Background Reducing intraoperative wound contamination is a critical preventive strategy for reducing the risk of prosthetic joint infection in shoulder arthroplasty. The aim of this study was to investigate the potential microbial colonization of subscapularis tagging sutures during shoulder arthroplasty. Methods In this prospective study, 50 consecutive patients undergoing primary shoulder arthroplasty (anatomic or reverse) were enrolled. Patients with revision shoulder arthroplasty and proximal humeral fractures were excluded. Nonabsorbable, braided tagging sutures were placed through the subscapularis tendon prior to tenotomy. A similar nonabsorbable, braided suture (control) was placed in a sterile container on the back table, open to the operating room environment. Subscapularis tagging sutures (experimental specimens) and control sutures were collected prior to subscapularis tenotomy repair and submitted for aerobic and anaerobic cultures. Cultures were held for 21 days to account for extended growth of slow-growing bacteria. Results A total of 12 of 50 experimental and 16 of 50 control sutures had positive cultures. Staphylococcus epidermidis and Cutibacterium acnes were the 2 most commonly isolated organisms. Active tobacco use (P = .038) and procedure length (P = .03) were significantly associated with positive cultures. No significant association between positive subscapularis tagging suture cultures and positive control cultures was found (P = .551). Patient age, sex, body mass index, and significant medical comorbidities were not significantly associated with positive cultures. Discussion Subscapularis tagging sutures are a potential source of microbial contaminant in shoulder arthroplasty, and we recommend exchanging the tagging suture with a suture opened immediately prior to subscapularis repair.

Urban parks offer many benefits for youth, including providing a place to express and build their social identity. Yet we know very little about how this group accesses and uses parks in Vietnam, and in non-western urban contexts in general. This paper begins to fill this gap by using the case of Hanoi where youth (18–24 years old) make up almost 20% of the population and their socio-cultural characteristics are changing rapidly. An intercept survey, using convenience sampling with quotas, was deployed in four parks in dense central areas and newer suburban zones (n = 382). Heat, crowded sidewalks, street crossings and traffic near parks are the most problematic obstacles to park access. Security was mentioned as an obstacle, with no significant difference between men and women. Participants reported on average 6.6 visits over two weeks and 77.5 min per visit. Perceived obstacles to access, duration of stay and frequency of visits were then fitted in a series of models against gender, timing of visits, travel modes, previous location, travel time, and performed activities (only in the last two models). Travel modes proved the most important features explaining obstacles to access. Practicing sports and exercises were predominant in explaining higher frequency and duration of visits. Gender differences were significant after controlling for other variables: women go to the park less frequently and stay for shorter periods than men. Our findings suggest avenues for park design and planning, such as providing equipment to support physical activities and addressing travelling obstacles near parks.

Purpose To correlate the histopathologic appearances of resected long head of the biceps tendon (LHBT) specimens following biceps tenodesis, with pre-operative MRI and arthroscopic findings, with attention to the radiologically normal biceps. Material and methods Retrospective analysis of patients who had undergone preoperative MRI, subsequent arthroscopic subpectoral tenodesis for SLAP tears and histopathologic inspection of the excised sample between 2013 and 16. Those with a normal MRI appearance or mildly increased intrasubstance signal were independently analyzed by 2 blinded radiologists. A blinded orthopedic surgeon and pathologist reviewed all operative imaging and pathologic slides, respectively. Results Twenty-three LHBT resected samples were identified on MRI as either normal (Reader 1 n = 15; Reader 2 n = 14) or demonstrating low-grade increased signal (Reader 1 n = 8; Reader 2 n = 9). Of these, 86.9% demonstrated a histopathological abnormality. 50% of samples with histopathological abnormality demonstrated normal appearance on MRI. The most common reported histopathology finding was myxoid degeneration (73.9%) and fibrosis (52.2%). The most common arthroscopic abnormality was fraying (18.2%) and erythema (13.6%). Utilizing histopathology as the gold standard, the two radiologists demonstrated a sensitivity of 35.0% v 42.9%, specificity of 66.7% v 100%, PPV of 87.5% v 100%, and NPV of 13.3% v 14.3%. Corresponding arthroscopic inspection demonstrated a sensitivity of 31.6%, specificity of 66.6%, PPV 85.7% and NPV of 13.3%. There was moderate agreement between the two radiologists, κ = 0.534 (95% CI, 0.177 to 0.891), p = 0.01. Conclusion Histopathological features of low grade tendinosis including mainly myxoid degeneration and fibrosis are frequently occult on MR imaging.

Coronavirus disease 2019 (COVID-19) is a global pandemic, and it is increasingly important that physicians recognize and understand its atypical presentations. Neurological symptoms such as anosmia, altered mental status, headache, and myalgias may arise due to direct injury to the nervous system or by indirectly precipitating coagulopathies. We present the first COVID-19 related cases of carotid artery thrombosis and acute PRES-like leukoencephalopathy with multifocal hemorrhage., Highlights • COVID-19 may manifest with neurological symptoms • SARS-CoV-2 may have direct neurologic effects due to endothelial invasion, such as our case of PRES-like leukoencephalopathy. • Indirect effects may include coagulation cascade disruption, resulting in unusual thrombosis and large vessel occlusions.

Dengue fever is one of the most common diseases in tropical and sub-tropical regions of the world, and has a variety of unpleasant and painful symptoms, including fever, bleeding, and even death. Thus, effective methods for its early-stage detection and diagnosis are urgently required. Accordingly, the present study proposes a method for detecting dengue virus through an inspection of the anisotropic polarization properties of blood serum samples, as measured using a backscattering polarimetry technique and Mueller matrix imaging method. The feasibility of the proposed approach is demonstrated using 31 real-world blood samples comprising 17 dengue-infected samples and 14 healthy non-dengue samples. It is shown that the values of the diagonal elements of the Mueller matrix for the non-dengue samples are significantly higher than those for the dengue samples. By contrast, the depolarization index of the dengue samples is higher than that of the non-dengue samples. Moreover, among the four Mueller matrix transformation (MMT) parameters considered in the present study (A, B, T and G), three of them (A, B and T) exhibit significant differences between the non-dengue and dengue samples, respectively. Thus, overall, the results indicate that the proposed method has significant potential as a rapid, low-cost, and effective technique for dengue fever diagnosis applications.

A hybrid framework consisting of the Stokes- decomposition method and various artificial intelligence (AI) models is proposed for classifying human melanoma and nonmelanoma skin cancer samples. In the proposed approach, the Stokes-Mueller matrix decomposition method is first used to extract the effective optical parameters of normal, squamous cell carcinoma, basal cell carcinoma, and melanoma skin cancer samples. The parameters are pre-processing using feature scaling and dimensional reduction techniques, and are then used to train nine different AI models, namely ExtraTree, Random Forest, Decision Tree, XGBoost, Support Vector Machine, k-Nearest Neighbors (k-NN), Radius Neighbors, Multilayer Perceptron (MLP), and Ridge. Finally, the trained models are used to classify a small number of normal and cancerous skin tissue samples. It is shown that all of the models have a classification accuracy (F1 score) of more than 90% given an appropriate pre-processing of the input parameters. Furthermore, the ExtraTree, k-NN, and MLP models achieve an accuracy of 100%. Overall, the results confirm that the proposed framework provides a promising approach for the efficient and accurate classification of human skin cancer tissue samples.

In the present study, a novel terpolymeric hydrogel was developed using sodium hyaluronate (HA), 2-hydroxyethyl acrylate (2-HEA), and poly(ethylene glycol) diacrylate (PEGDA) via free radical polymerization for biomedical applications. To achieve elasticity, swelling ability, porous architecture and sufficient gel strength, hyaluronate was chemically modified by grafting and crosslinking methods using 2-HEA and PEGDA, respectively. The structure and compositions of the fabricated terpolymer (HA-g-p(2-HEA)-x-PEGDA) were verified by FTIR, 1H HR-MAS-NMR, and TGA analyses. The surface morphology and cross-section of the hydrogel was detected by SEM analysis. The gel nature of terpolymer in aqueous medium at 37 °C was confirmed from swelling study, and rheological experiment. Non-cytotoxicity and biocompatibility of the HA-g-p(2-HEA)-x-PEGDA hydrogel were ascertained by in vitro mouse osteoblastic cells (MC3T3) proliferation, and viability studies. Hematoxylin and eosin Y, and Masson’s trichrome stainings were performed to show tissue regeneration ability on the prepared hydrogel. In vitro release results of proangiogenic drug-dimethyloxalylglycine (DMOG), and antibiotics-tetracycline (TCN) showed sustained release behaviour from the prepared hydrogel under different pHs at 37 °C. The mathematical models fitted data imply that both DMOG and TCN release follow first order kinetics, while, the release mechanism is primarily controlled by diffusion as well as erosion process. Finally, the novel biocompatible HA-g-p(2-HEA)-x-PEGDA gel, which showed sustained drugs release, and regeneration ability of extracellular matrix and collagen, could be employed in biomedical applications, especially, for the delivery of DMOG/TCN, and in tissue engineering.

Tree planting has been favoured in many North American cities, including Montreal which aims to increase its canopy from 20% to 25% in 2025. However, the mortality rate of street trees is especially high in the first few years after planting. Studies have shown that variables that are intrinsic to the tree and those related to its location, the urban form and the socio-demographic characteristics of the surrounding environment are significantly associated either with trees’ survival rate or with vegetation cover. In this research we examine variables that have statistical associations with tree growth, which is the diameter at breast height divided by the number of years on the ground, for approximately 28,000 street trees in Montreal. Independent variables were nested into three spatial scales: the tree (species and physical variables), the street section (urban form variables), and the census tract (socio-demographic variables). Multilevel models reveal that 65.51% of the growth variance is potentially explained by the species and planting physical conditions such as the east and north sides (positive associations with the growth), signage as an obstruction (negative association). 28.54% of the grow variance is potentially explained by the urban form, in our case building age (convex relationship with the growth), mixed zoning (negatively) and residential zoning (positively). At the neighbourhood level, although none of our variables is significant, 6.95% of the growth variance is be potentially explained by other missing variables. New planting programs should hence consider the urban form in order to improve tree growth.

Chronic exertional compartment syndrome (CECS) is a significant source of lower extremity pain and morbidity in the athletic population. Although endoscopic techniques have been introduced, open fasciotomy remains the mainstay of surgical treatment because of the paucity of evidence in support of an endoscopic approach. The literature on surgical management of CECS is mixed, and overall success rates are modest at best. Optimizing surgical technique, including prevention of neurovascular injury and wound complications, can make a significant impact on the clinical outcome. Here we present our surgical technique, including pearls and pitfalls, for open 4-compartment fasciotomy for treatment of chronic exertional compartment syndrome.

This paper examines the strengths and complexities of utilising narrative mapping to better understand and represent street vendors' everyday experiences as they attempt to access public spaces for their livelihoods. We draw on three case studies from urban Vietnam to compare and contrast both vendor experiences and narrative mapping potential. Focusing on stationary and itinerant vendors in the country's capital city, Hanoi, and in a rapidly growing upland tourist town, Sapa, we want to better understand the lived experiences and strategies of vendors who are often targeted by state officials for fines or bribes, as well as being demeaned for being ‘non-modern’ and ‘out of place’. We find that narrative mapping allows us to identify spatial and temporal patterns emerging from our data more easily than traditional text-based analyses, helping us to illustrate public space competition, frictions, and negotiations. Such an approach could make related research more accessible to a broad audience and support non-governmental organisations wanting to inform government officials with regards to how public spaces can be more equitably shared and utilised. More broadly, we suggest that narrative mapping can add nuance to analytical interpretations regarding marginalised populations in the Global South.

We examine the Croatian Kuna, the Czech Koruna, the Hungarian Forint, the Polish Złoty, the Romanian Leu, and the Swedish Krona whether their Euro exchange rates volatility exhibits true or spurious long memory. Recent research reveals long memory in foreign exchange rate volatility and we confirm this finding for these currency pairs by examining the long memory behavior of squared residuals by means of the V/S test. However, by using the ICSS approach we also find structural breaks in the unconditional variance. Literature suggests that structural breaks might lead to spurious long memory behavior. In a refined test strategy, we distinguish true from spurious long memory for the six exchange rates. Our findings suggest that Czech Koruna and Hungarian Forint only feature spurious long memory, while the rest of the series have both structural breaks and true long memory. Lastly, we demonstrate how to extend existing models to jointly model both properties yielding superior fit and better Value-at-Risk forecasts. The results of our work help to avoid misspecification and provide a better understanding of the properties of the foreign exchange rate volatility.

Street trees provide a wide range of benefits for cities. Street tree cover (STC) is explained by urban form, social stratification and lifestyle theories that operate at multiple scales. In this paper we examine how the urban form (street characteristics), social stratification and lifestyle (socio-demographics) account for variations of STC in Montreal. Tree cover was identified from Quickbird images and then overlaid on street segments to compute the STC. Each street segment was nested in a census tract. We used 2-level models with mixed effects and interactions (between street attributes and socio-demographic variables) while introducing a spatial term. Political, socio-economic or other explanatory factors operating at the tract level can potentially explain 17.6% of the variation of STC. Overall, the street characteristics explained more variation in STC than the socio-demographic context. Lifestyle is less important than social stratification. Street length is positively associated with STC; street width and the percentage of duplexes and triplexes are negatively associated with STC, while construction age has a u-shaped effect on STC. Interactions show that STC is higher in expensive and highly-educated areas that have residential streets or streets with large setback (sidewalk). Areas predominantly comprised of low-income households could have higher or lower STC depending on the number of buildings and the percentage of duplexes and triplexes. Streetscape and socio-demographic contexts intertwine to create complex patterns of STC. Greening programs should be designed carefully according to local contexts since certain types of greening can lead to gentrification and displacement of low-income households.

Recent studies have shown that urban vegetation is unevenly distributed across numerous North American cities: neighbourhoods predominantly inhabited by low-income populations and/or by certain ethnic groups have less vegetation cover. The goal of this paper is to examine the existence of environmental inequities related to access to urban vegetation on the Island of Montreal for four population groups (low-income people, visible minorities, individuals 0–14 years old and persons 65 years old and over). Six indicators of vegetation in and around residential city blocks (within 250 m and 500 m) are computed by using QuickBird satellite images. These indicators are then related to socioeconomic data by using different statistical analyses (T-test, seemingly unrelated regression and multinomial logistic regression). The results show that low-income people and, to a lesser degree, visible minorities reside in areas where vegetation is less abundant. On the other hand, the opposite situation is found for children and the elderly. The use of indicators computed in and around city blocks leads to the finding of a double inequity in certain neighbourhoods. This points to the need to target vegetation-deprived areas for urgent greening in order to improve vegetation cover within city blocks (in residential yards or through alternatives such as green walls and green roofs) and around these blocks (along streets and in parks).

Characterizing polarization of skin pathologies is still an interested issue for the dermatology community. In a previous study, the present group proposed a Stokes–Muellermatrix polarimetry for differentiating between squamous cell carcinoma tissue and normal healthy tissue in mice. The present study extends our method to the detection of squamous cell carcinoma, basal cell carcinoma and melanoma skin cancer in humans. Using the proposed method, the orientation angle of linear birefringence ( α ), phase retardance ( β ), optical rotation angle of circular birefringence ( γ ), orientation angle of linear dichroism ( θ d ), linear dichroism (D), circular dichroism (R), degrees of linear depolarization ( e 1 and e 2 ), degree of circular depolarization ( e 3 ), and depolarization index ( Δ ) are extracted for 72 slices of 12 squamous cell carcinoma samples, 72 slices of 12 basal cell carcinoma samples, 18 slices of 3 melanoma skin cancer samples, and 36 slices of 6 healthy samples. The experimental results show that the cancerous tissue exhibits lower phase retardance ( β ) and linear dichroism (D) than healthy skin tissue. Overall, the proposed method provides a useful insight into the characterization optical properties of human skin cancer by Stokes–Mueller matrix polarimetry.

Urban agriculture literature regarding the Global South reveals important knowledge gaps concerning spatial variations of food gardens across cityscapes, gardener motivations, and tensions with urban planning regulations, especially in locales beyond sub-Saharan Africa. In Vietnam, urban agriculture is growing in popularity and gaining media attention but there is little research as to why urban agriculture is practiced in smaller Vietnamese cities, especially those close to rural hinterlands. In this paper we investigate small-scale urban agriculture – or food gardens – in Lao Cai, a small upland city located on the Sino-Vietnamese border. We find a complex diversity of garden sizes and land management arrangements where gardens are built, including on state institutional land, thanks to informal arrangements. Gardener motivations focus predominantly on food safety concerns, contrasting with key motivations found elsewhere in the Global South. Throughout the city, albeit more so in newly urbanising sectors, this urban practice remains precarious due to irregular land access and confusing city authority regulations. We thus examine how urban residents are working to access safe food and contribute to their city’s urban food system while state officials tend to focus their priorities elsewhere.

In the complex agro-ecological conditions of Vietnam's northern borderlands, attempts by ethnic minority farmers to create sustainable livelihoods, along with the impacts of state development policies, have direct consequences for land use and land cover (LULC) change. In this paper we analyse the degree to which LULC has changed and diversified from 1999 to 2009 in Lao Cai Province and the underlying relationships with ethnic minority livelihood diversification strategies. We examine the correlation between LULC diversity and various socioeconomic and biophysical proxies using a spatial autoregressive model. Our findings indicate two major changes in LULC: an increase in closed canopy forest and substantial urban growth. LULC diversity increased between 1999 and 2009, suggesting a transition between land uses and/or a diversification of livelihood strategies. Socioeconomic proxies are significant predictors of LULC diversity in both years, while biophysical proxies are only effective predictors in 2009. In-depth interviews regarding state-led policies and ethnic minority livelihoods reveal some of the underlying mechanisms of such LULC transitions and associations.

It was not known if a relationship exists between job satisfaction and organizational commitment within a telecommuting environment. With the advancements in the area of technology and the positive outcomes associated with telecommuting, more organizations could incorporate telecommuting as a work environment option, making it beneficial to understand the organizational commitment necessary to improve employee’s job satisfaction within the telecommuting environment. The purpose of this quantitative correlational study was to determine if a relationship exists between job satisfaction and organizational commitment within the telecommuting environment. The findings from this study provide the insight into the role of predictor which impact on job satisfaction and affective commitment. In addition, the findings also figure out the direction for further studies on affective commitment and its possible predictor to reveal the comprehensive results for the offshore employees in the context of telecommuting working environment in Vietnam.

At the beginning of the new millennium, after a severe drought and destructive floods along the Yangtze River, the Chinese government implemented two large ecological rehabilitation and reforestation projects: the Natural Forest Protection Programme and the Sloping Land Conversion Programme. Using Landsat data from a decade before, during and after the inception of these programmes, we analyze their impacts along with other policies on land use, land cover change (LULCC) in southwest China. Our goal is to quantify the predominant land cover changes in four borderland counties, home to tens of thousands of ethnic minority individuals. We do this in three time stages (1990, 2000 and 2010). We use support vector machines as well as a transition matrix to monitor the land cover changes. The land cover classifications resulted in an overall accuracy and Kappa coefficient for forested area and cropland of respectively 91% (2% confidence interval) and 0.87. Our results suggest that the total forested area observed increased 3% over this 20-year period, while cropland decreased slightly (0.1%). However, these changes varied over specific time periods: forested area decreased between 1990 and 2000 and then increased between 2000 and 2010. In contrast, cropland increased and then decreased. These results suggest the important impacts of reforestation programmes that have accelerated a land cover transition in this region. We also found large changes in LULC occurring around fast growing urban areas, with changes in these peri-urban zones occurring faster to the east than west. This suggests that differences in socioeconomic conditions and specific local and regional policies have influenced the rates of forest, cropland and urban net changes, disturbances and net transitions. While it appears that a combination of economic growth and forest protection in this region over the past 20 years has been fairly successful, threats like drought, other extreme weather events and land degradation remain.

Urban vegetation is shown to be unevenly distributed across cities and there is evidence of disparities in benefits provided by vegetation and of public health problems induced by urban heat islands. In order to improve vegetation cover, it remains crucial to understand the underpinning of such unevenness. In this paper, we investigate in Montreal (Canada) how the built environment, sociodemographic factors and administrative boroughs influence tree and lawn cover in public and residential land. The analysis was conducted at the dissemination area (DA) level, a Canadian census unit containing about 400–700 people. Six vegetation indicators were used as dependent variables: the proportion of a DA covered by trees/shrubs, lawn and total vegetation; the proportion of streets covered by trees/shrubs and the proportion of residential yards covered by trees/shrubs and total vegetation. Three sets of independent variables were studied: the built environment, sociodemographics and borough names. We used spatial autoregressive models to control for dependence and the spatial autoregressive term explained a large amount of variability in vegetation cover. The built-environment variables tend to have higher effects than the socio-demographic variables when predicting the three DA vegetation indicators, backyard vegetation, and to a lesser degree, street tree/shrub cover. In particular, population density is associated negatively to all indicators but positively to street tree cover. Socio-demographics are substantial in the explanation of the distribution of street trees, especially the presence of recent immigrants (negative effect) and of university degree holders (positive effect). These findings call for appropriate greening programs adapted to the local socio-demographic profile. The significance of boroughs also suggests the need for further research on the impact of within-city administrative hierarchies on the unevenness of urban vegetation.

Associate with the development of information technology and the challenge from economic crisis, many employees, who are currently working in technology field, want to choose virtual working jobs as the best alternative to traditional jobs. The purpose of this article aims to find out the way how to improve employee engagement within virtual working environment in technology industry. To conduct the study, researcher based on self-determination theory as the theoretical foundation and used survey instruments from permissions of Leader Behavior Description Questionnaire and Development Dimensions International’s E3® Engagement Instrument. The results of the study point out a strong and positive correlation existed between both consideration and initiating structure leadership behavior and employee engagement among virtual working employees.

Growing evidence is showing that across North American cities, underprivileged populations and racial and/or visible groups have disproportionally less access to vegetation than affluent groups, raising concerns of environmental inequity. This study aims to verify whether in Montreal (Canada) there is environmental inequity resulting from variations in urban vegetation for low-income people and visible minorities. More specifically, various vegetation indicators were extracted from very-high-resolution satellite images, including the proportion of city blocks, streets, alleys and backyards covered by total vegetation and trees/shrubs. Socio-demographic variables were obtained from 2006 Canada Census and rescaled to the city block level, by using a population-based weighing method. Statistical analysis indicates that there are disparities in the distribution of vegetation in Montreal which disfavour low-income people and, to a lesser extent, visible minorities. Disparities are also more pronounced on public land (streets, alleys) than on private land (backyards). Income is a major factor but cannot fully explain inequities among visible minorities. Notwithstanding the weak extent of such disparities, those vulnerable communities might need a better access to ecological services provided by vegetation, notably such as heat island mitigation. Compensatory equity needs to be addressed and our findings call for authorities to reconsider greening budgetary allocation and practices, especially in the most deprived neighbourhoods of the city.

Thoracic duct ligation for chylothorax is considered a safe and efficient procedure. However, we observed two cases that were complicated by intractable chylous ascites. Refractory chylous ascites are usually cured by surgical peritoneovenous shunting, but in both patients successful treatment required peritoneoatrial shunting. Actually, a peritoneovenous shunt was impossible because of extensive venous thrombosis in jugular and superior vena cava in one patient and failed because of constrictive pericarditis requiring pericardectomy in the other, both underlying diseases also accounting for the thoracic duct ligation complications.