bluuebunny/crossref_metadata_2025 huggingface dataset:
Simultaneous Topography-Guided PRK/CXL Versus Topography-Assisted PTK/CXL: 1-Year Prospective Outcomes in Keratoconic Eyes
Authors: Shetty Rohit , Ahuja Prerna , D'Souza Sharon , Khamar Pooja , Paritekar Prajakta , Dadachanji Zelda , Sinha Roy Abhijit
Published: August 2021

PURPOSE:

To compare 1-year visual and tomographic outcomes of topography-guided photorefractive keratectomy (TGPRK) and topography-assisted phototherapeutic keratectomy (TPTK) with corneal cross-linking (CXL).

METHODS:

TGPRK and TPTK were performed in 72 eyes (68 patients) and 74 eyes (71 patients), respectively. Based on the TGPRK ablation plan, the eyes underwent TPTK where the theoretical minimum corneal thickness (MCT) after surgery was less than 400 µm. In the TGPRK group, the theoretical maximum ablation depth was 50 µm after epithelium removal. In TPTK, a decentered single-step PTK was performed only in the steepest anterior curvature zone and the stromal ablation depth was limited to 25 µm. After ablation, accelerated CXL was performed in the central 8-mm zone (9 mW/cm
2
for 10 minutes in “epithelium-off” mode) in both TGPRK and TPTK. The visual acuity and tomography were assessed.

RESULTS:

Improvement in uncorrected (
P
= .73) and corrected (
P
= .66) distance visual acuity was similar between the two groups. However, TGPRK eyes had a greater decrease in keratometry, anterior defocus, and spherical aberration (
P
< .001) at the cost of greater ablation of tissue (
P
< .001). The median MCT decreased by 27 and 52.5 µm in the TPTK and TGPRK eyes, respectively. Both groups had similar decreases in anterior root mean square of lower (
P
= .10) and higher (
P
= .12) order aberrations.

CONCLUSIONS:

Both TGPRK and TPTK improved visual acuity in the keratoconic eyes at 1 year of follow-up. However, TPTK removed less volume of tissue. Further, it could be an alternative to TGPRK if the theoretical stromal ablation exceeds 50 µm in thin keratoconic corneas.

[
J Refract Surg
. 2021;37(8):562–569.]
Effects of fear and anti-predator response in a discrete system with delay
Authors: Banerjee Ritwick , Das Pritha , Mukherjee Debasis
Published: August 2021

In this paper a discrete-time two prey one predator model is considered with delay and Holling Type-Ⅲ functional response. The cost of fear of predation and the effect of anti-predator behavior of the prey is incorporated in the model, coupled with inter-specific competition among the prey species and intra-specific competition within the predator. The conditions for existence of the equilibrium points are obtained. We further derive the sufficient conditions for permanence and global stability of the co-existence equilibrium point. It is observed that the effect of fear induces stability in the system by eliminating the periodic solutions. On the other hand the effect of anti-predator behavior plays a major role in de-stabilizing the system by giving rise to predator-prey oscillations. Finally, several numerical simulations are performed which support our analytical findings.
Exponential attractors for nonclassical diffusion equations with arbitrary polynomial growth nonlinearity
Authors: Yuan Jianbo ,   School of Traffic and Transportation Engineering, Changsha University of Science and Technology, Changsha, 410114, China, Zhang Shixuan , Xie Yongqin , Zhang Jiangwei ,   School of Mathematics and Statistics, Changsha University of Science and Technology, Changsha, 410114, China
Published: August 2021

In this paper, the dynamical behavior of the nonclassical diffusion equation is investigated. First, using the asymptotic regularity of the solution, we prove that the semigroup $ \{S(t)\}_{t\geq 0} $ corresponding to this equation satisfies the global exponentially $ \kappa- $dissipative. And then we estimate the upper bound of fractal dimension for the global attractors $ \mathscr{A} $ for this equation and $ \mathscr{A}\subset H^1_0(\Omega)\cap H^2(\Omega) $. Finally, we confirm the existence of exponential attractors $ \mathscr{M} $ by validated differentiability of the semigroup $ \{S(t)\}_{t\geq 0} $. It is worth mentioning that the nonlinearity $ f $ satisfies the polynomial growth of arbitrary order.
Solutions for systems of complex Fermat type partial differential-difference equations with two complex variables
Authors: Li Hong ,   Office of Academic Research, Gannan Normal University, Ganzhou, Jiangxi 341000, China, Zhang Keyu , Xu Hongyan ,   School of Psychology, Jiangxi Normal University, Nanchang 330022, China,   School of Mathematics, Qilu Normal university, Jinan, Shandong 250200, China,   School of Mathematics and Computer Science, Shangrao Normal University, Shangrao, Jiangxi 334001, China
Published: August 2021

By making use of the Nevanlinna theory and difference Nevanlinna theory of several complex variables, we investigate some properties of the transcendental entire solutions for several systems of partial differential difference equations of Fermat type, and obtain some results about the existence and the forms of transcendental entire solutions of the above systems, which improve and generalize the previous results given by Cao, Gao, Liu [5,24,39]. Some examples are given show that there exist some significant differences in the forms of transcendental entire solutions with finite order of the systems of equations with between several complex variables and a single complex variable.
Differential Regulation of ATP- and UTP-Evoked Prostaglandin E2 and IL-6 Production from Human Airway Epithelial Cells
Authors: Kountz Timothy S , Jairaman Amit , Kountz Candace D , Stauderman Kenneth A , Schleimer Robert P , Prakriya Murali
Published: August 2021

The airway epithelial cells (AECs) lining the conducting passageways of the lung secrete a variety of immunomodulatory factors. Among these, PGE2 limits lung inflammation and promotes bronchodilation. By contrast, IL-6 drives intense airway inflammation, remodeling, and fibrosis. The signaling that differentiates the production of these opposing mediators is not understood. In this study, we find that the production of PGE2 and IL-6 following stimulation of human AECs by the damage-associated molecular pattern extracellular ATP shares a common requirement for Ca2+ release-activated Ca2+ (CRAC) channels. ATP-mediated synthesis of PGE2 required activation of metabotropic P2Y2 receptors and CRAC channel-mediated cytosolic phospholipase A2 signaling. By contrast, ATP-evoked synthesis of IL-6 occurred via activation of ionotropic P2X receptors and CRAC channel–mediated calcineurin/NFAT signaling. In contrast to ATP, which elicited the production of both PGE2 and IL-6, the uridine nucleotide, UTP, stimulated PGE2 but not IL-6 production. These results reveal that human AECs employ unique receptor-specific signaling mechanisms with CRAC channels as a signaling nexus to regulate release of opposing immunomodulatory mediators. Collectively, our results identify P2Y2 receptors, CRAC channels, and P2X receptors as potential intervention targets for airway diseases.
Continuous Culture of Mouse Primary B Lymphocytes by Forced Expression of Bach2
Authors: Finney Joel , Kelsoe Garnett
Published: August 2021

Stable, long-term culture of primary B lymphocytes has many potential scientific and medical applications, but remains an elusive feat. A major obstacle to long-term culture is that in vitro mitogens quickly drive B cells to differentiate into short-lived plasma cells (PCs). PC differentiation is governed by opposing teams of transcription factors: Pax5, Bach2, and Bcl6 suppress PC commitment, whereas IFN regulatory factor 4 and Blimp1 promote it. To determine whether transcriptional programming could prolong B cell culture by blocking PC commitment, we generated mouse primary B cells harboring gain- or loss-of-function in the key transcription factors, continuously stimulated these cells with CD154 and IL-21, and determined growth potential and phenotypes in vitro. We found that transgenic expression of Bach2 prohibits PC commitment and endows B cells with extraordinary growth potential in response to external proliferation and survival cues. Long-term Bach2-transgenic B cell lines have genetically stable BCRs [i.e., do not acquire V(D)J mutations], express high levels of MHC class II and molecules for costimulation of T cells, and transduce intracellular signals when incubated with BCR ligands. Silencing the Bach2 transgene in an established transgenic cell line causes the cells to secrete large quantities of Ig. This system has potential applications in mAb production, BCR signaling studies, Ag presentation to T cells, and ex vivo clonal expansion for adoptive cell transfer. Additionally, our results provide insight into molecular control over activated B cell fate and suggest that forced Bach2 expression in vivo may augment germinal center B cell or memory B cell differentiation at the expense of PC commitment.
Prolonged non-invasive respiratory support in a COVID-19 patient with severe acute hypoxemic respiratory failure
Authors: Lanza Andrea , Sommariva Maurizio , Mariani Sara , Ferreyra Gabriela , Stagni Giuliana Enrica , Tombini Valeria , Oppizzi Angela , Pontiggia Catia , Bellone Andrea
Published: August 2021

A pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 was declared in 2020. Severe cases were characterized by the development of acute hypoxemic respiratory failure (AHRF) requiring advanced respiratory support. However, intensive care units (ICU) were saturated, and many patients had to be treated out of ICU. This case describes a 75-year-old man affected by AHRF due to Coronavirus Disease 2019 (COVID-19), hospitalized in a high-dependency unit, with PaO2/FiO2 <100 for 28 consecutive days. An experienced team with respiratory physiotherapists was in charge of the noninvasive ventilatory support (NIVS). The patient required permanent NIVS with continuous positive airway pressure, non-invasive ventilation, high flow nasal oxygen and body positioning. He was weaned from NIVS after 37 days and started exercise training afterwards. The patient was discharged at home with low-flow oxygen therapy. This case represents an example of a successful treatment of AHRF with the still controversial noninvasive respiratory support in one patient with COVID-19.
Blood Transfusion and Venous Cannulation — Medical Publication and Innovation Across 350 Years of History
Authors: Zundert Andre Van , Wiepking Floris S. S. , Roets Michelle , Zundert Tom Christophe R. V. Van , Gatt Stephen P.
Published: August 2021

This article reviews historical milestones during the last 350 years starting with early experiments in intravenous injections of drugs and blood transfusion conducted in a climate of scientific discovery rather than clinical application. Technical problems encountered during attempts of vascular cannulation and a lack of knowledge of physiology resulted in complications related to intravenous access, sometimes fatal, which resulted in a complete ban on blood transfusion in Europe for 150 years. Meticulous documentation of these first 17th century experiments was published in Britain, in the “Philosophical Transactions of the Royal Society of London,” the oldest continuously published scientific journal still in existence, and in France, in the “Journal des Sçavans.” These journals became the primary means of communication of scientific research and letters amongst the community of scientists. Intravenous therapy marked the start of the first primitive anesthetic and laid the foundations for anesthesia and blood transfusion, although their clinical application came centuries later. Successful intravenous anesthesia was established around the turn of the 19th century. Brave men in the 17th century endeavored to awaken the spirit of inquiry and research among their peers at the Royal Society of London. Thanks to these bold medical men acting at a time of accelerated change, there was a great impact on clinical practice in many medical fields. Anesthesia now bears the fruits of these initial experiments so that, ultimately, anesthetists can provide safe and effective anesthesia while delivering anesthetic drugs, intravenous fluids, and blood transfusions for the benefit of patients.
A 36-Year-Old Patient with Acute Urinary Retention Due to an Anterior Midline Prostatic Cyst
Authors: Deligiannis Dimitrios , Adamos Konstantinos , Tselos Angelos , Mavrikos Stamatios
Published: August 2021

During the years, there have been no more than a few reports (with ours being so far the sixth) of prostatic cysts prolapsing into the bladder and thus causing urinary obstruction. Most of those cystic formations are generally asymptomatic and are found during random controls. In our case, the cyst was located in the anterior midline of the prostate in a 36-years-old patient presenting at the E. R with severe suprapubic pain and urinary retention after 3 months of constantly deteriorating lower urinary tract symptoms. Transabdominal ultrasonography and magnetic resonance imaging revealed a projecting prostatic cyst that like a valve was blocking the bladder neck at 12 o'clock position. It was successfully removed by transurethral resection leaving the patient free of symptoms.
Indocyanine green enhanced near-infrared fluorescence imaging for perfusion assessment of colonic conduit for esophageal replacement
Authors: Gupta R , Madaan V , Kumar S , Govil D
Published: August 2021

Esophagectomy, followed by esophageal replacement using gastric/colonic conduits, is a complex surgical procedure with significant perioperative morbidity. The most significant and potentially life-threatening complication associated with esophageal replacement is conduit ischaemia, resulting in anastomotic leak and conduit necrosis. Ensuring adequate perfusion of the conduit remains the key to preventing conduit ischaemia. Indocyanine green (ICG) enhanced near-infrared fluorescence imaging is a novel technique which has been used for assessing bowel perfusion. While numerous studies have focused on ICG fluorescence imaging for assessment of gastric conduit perfusion after esophagectomy, data regarding its use for colonic conduits is limited to case reports. ICG fluorescence imaging can help in resolving intraoperative issues by predicting the adequacy of colonic conduit perfusion, thereby preventing postoperative morbidity. To the best of our knowledge, this is the first report in Indian literature describing the utility of ICG fluorescence imaging for assessment of perfusion of colonic interposition.
Association of headache, anxiety, and depression with the treatment of levetiracetam for epilepsy
Authors: Mantargi Mohammad Jaffar , Kondanath Saifudheen , Ikram Nadeem , Vigneshwaran Easwaran , Awais Muhammad , Thattarauthodiyil Usman
Published: August 2021

The current case report bears the details of the adverse drug reactions (ADRs) associated after the administration of the levetiracetam for the management of newly diagnosed epilepsy in a female patient aged 37 years. Datum related to the patient, medications and observed ADRs were noted after getting the consent from the patient during which she has explained her experiences after the beginning of the consumption of the said drug. The Naranjo's scale and World Health Organisation, Uppsala Monitoring Centre scales analysis for the assessment of the correctness of the ADR paved for the certainty of the side effect. Drug regimen modification was initiated by the neurologist after the complaints of uneasiness from the patient after which she was identified to be complying with the other medication. Therefore, it can be said that if any patient on antiepileptic medications experiences discomfort, must bring those issues in light as there is always other options available for the management of the epilepsy without delay.
Impact of pregnancy outcomes on postpartum depression among women attending primary health-care centers in Al-Madina Al-Munawarah, Saudi Arabia
Authors: Aljehani Yasmeen Talal , Alanzi Mariam Eid , Aljehani Suzan Talal , Saleem Alrehaily Sami , Alraddadi Salman Awadh Rasheed , Alblowi Rema Mahmoud , Aly Hanan Yousef , El Sayed Salah Mohamed
Published: August 2021

Background:

Postpartum depression (PPD) afflicts women and their families negatively. Unfortunately, PPD often goes undetected and untreated. We previously reported that PPD prevalence was 19.4% in Al-Madina region, Saudi Arabia.

Objectives:

The objective of the study was to identify significant risk factors of PPD among women in Al-Madina, Saudi Arabia.

Methodology:

A multistage random sampling technique recruited women visiting primary health-care centers in Al-Madina to immunize their babies. A cross-sectional descriptive study was done using Arabic translation of Edinburgh Postnatal Depression Scale for PPD screening using a cutoff score of ≥12. Our study also investigated demographic and other possible PPD risk factors.

Results:

This study enrolled 216 women out of 224 (response rate is 96.4%). PPD was not significantly associated with pregnancy planning, infant's gender, or infant's age. Primiparous women (n = 92, 42.7%) had a significant PPD risk (P < 0.05). More than half of mothers enrolled in our study (n = 124, 57.4%) were multiparous. Nearly 30.6% of participants (n = 66) used breastfeeding, while formula feeding was present in 40.7% (n = 88). PDD was reported more among women who breastfed their babies (27.3%) compared to those who artificially fed their babies (15.9%) and those using mixed feeding (16.1%). PPD was more significant among women who delivered by vaginal delivery (P < 0.05) compared to those delivered by cesarean section. Congenital abnormality of babies was reported by almost one-sixth of women (n = 36, 16.7%) but were not significantly associated with PPD.

Conclusion:

More than half of women having PPD (n = 124, 57.4%) were multiparous. PPD may negatively impair women's future pregnancy plans due to depression. PPD is significantly associated with primiparity and vaginal delivery and increases with breastfeeding. To the authors, PPD is a serious medical condition that should be taken into account with all deliveries. Primiparity is a risk factor, and PPD should be anticipated in primiparous women. Psychiatric evaluation and psychotherapy may be needed to help women and alleviate their fears in future pregnancies. Gynecologists should be aware of PPD and should receive a clinical experience in that. Psychiatric consultation is highly recommended whenever necessary.
Leiomyoma of ileum causing intestinal obstruction
Authors: Deshmukh Abhay Vilas , Vaidya Vihanka Devchand , Shivkumar Vitaladevuni Balasubramanyam , Gangane Nitin M.
Published: August 2021

Leiomyoma is a benign mesenchymal neoplasms arising from smooth muscles which accounts for 20%–30% of all benign gastrointestinal tumours. The occurrence of leiomyoma in ileum is rare. Very few cases of intestinal obstruction due to intestinal leiomyoma have been documented till date as per our knowledge. Here, we report a case of leiomyoma of ileum causing intestinal obstruction in a young woman who presented with pain in abdomen since 7 days. Intraoperative findings showed presence of 15 cm × 14 cm × 12 cm mesenteric tumour encircling the ileum. Microscopically, the benign spindled tumour cells were arranged in whorled pattern. Immunohistochemistry showed positivity for smooth muscle actin and negativity for CD117. One should always consider this rare entity in differential diagnosis of patients presenting with intestinal obstruction.
Significance of human leukocyte antigen-B27 expression in cases of reactive arthritis
Authors: Shougrakpam Jeshyca , Deshmukh Abhay Vilas , Gupta Anupama , Gangane Nitin M
Published: August 2021

Background:

Reactive arthritis (RA), apart from presenting as an immune reaction to certain microorganisms, had also shown to have a genetic predisposition. Human leukocyte antigen (HLA-B27) is an allele of the HLA Class I molecules and its positivity in a person is shown to be a strong predictor of RA. The present study was aimed to study the significance of HLA-B27 positivity in clinical presentation and progress of RA in rural central India.

Materials and Methods:

One hundred rheumatoid arthritis factor seronegative patients of symptomatic RA were enrolled in the study. HLA-B27 was detected by flow cytometry method and patients were divided into two groups, each of 50 depending on HLA-B27 positivity and negativity as case and control groups. The patients were contacted on their follow-up visits and the clinical information and progress of the disease was assessed and correlated with HLA-B27 status.

Results:

About 74% in study group and 62% in control groups were males in RA (P = 0.001 and 0.0007, respectively). Study cases with HLA-B27 positivity showed many significant differences in their clinical presentation and disease severity and progression over the control cases (HLA-B27 negative). The mean duration of symptoms in the study group was 22.7 ± 31.26 and 12.98 ± 6.94 in control group. Severity of arthritic pain was more in study group as compared to control group (P = 0.0007). Study cases showed more axial skeletal involvement (P = 0.0002), enthesitis (P = 0.0001), and sacroiliac joint involvement (P = 0.0005). Clinical evaluation of back pain with different clinical tests in study cases showed more morning spinal stiffness (P = 0.0001), low Schober index (P = 0.001), higher lateral flexion (P = 0.0001), and lower chest expansion (P = 0.0001). The severity of disease in follow-up period increased significantly in 92% of patients in the study group despite initiation of clinical management of arthritis, while decreased in 60% of patients in the control group (P = 0.0001).

Conclusion:

HLA-B27-associated RA presents with significantly more severe primary disease and a rapid course of disease. Thus, HLA-B27 association should be done in all patients of RS and positive patients must be followed more rigorously to prevent many possible complications. To the best of our knowledge, this is the first study in central India to report the importance of HLA-B27 in patients of RA with regard to its management and prognosis.
Positive correlation of serum angiopoietin-like protein 3 levels with metabolic syndrome in patients with coronary artery disease
Authors: Lian Sy-Harn , Hsu Bang-Gee , Wang Ji-Hung , Chen Ming-Chun
Published: August 2021

Objectives:

Angiopoietin-like protein 3 (ANGPTL3) regulates triglyceride metabolism by reversibly inhibiting the lipoprotein lipase activity. Metabolic syndrome (MetS) is an independent risk factor for further cardiovascular disease. This study evaluated the relationship between the fasting serum ANGPTL3 levels and MetS in patients with coronary artery disease (CAD).

Materials and Methods:

Fasting blood samples were obtained from 90 patients with CAD. Serum ANGPTL3 levels were measured using a commercial enzyme-linked immunosorbent assay kit. MetS and its components were defined using the diagnostic criteria of the International Diabetes Federation.

Results:

Fifty-three patients (58.9%) had MetS. The hypertension (P = 0.001), diabetes (P < 0.001), body weight (P = 0.027), body mass index (P = 0.001), waist circumference (P < 0.001), systolic blood pressure (P = 0.001), fasting glucose (P < 0.001), triglycerides (P < 0.001), blood urea nitrogen (P = 0.044), C-reactive protein (P = 0.010), insulin (P = 0.040), homeostasis model assessment of insulin resistance (P = 0.002), and ANGPTL3 level (P = 0.001) of CAD patients who had MetS were higher, and the high-density lipoprotein cholesterol (P = 0.001) and estimated glomerular filtration rate (P = 0.016) were lower. A binary logistic regression analysis of the significant variables also revealed that the ANGPTL3 level (odds ratio: 1.023, 95% confidence interval: 1.008–1.038, P = 0.002) was an independent predictor of MetS in patients with CAD.

Conclusion:

The results of our study indicated that the fasting ANGPTL3 level was positively associated with MetS among patients with CAD.
The potential of using itaconate as treatment for inflammation-related heart diseases
Authors: Ku Hui-Chen , Shen Ta-Chung , Cheng Ching-Feng
Published: August 2021

Intracellular metabolites can cause critical changes in biological functions. Itaconate is perhaps the most fascinating substance in macrophages. Lipopolysaccharide can activate aconitate decarboxylase 1 and induces the generation of itaconate from the tricarboxylic acid cycle by decarboxylation of cis-aconitate. It has been reported that itaconate has beneficial effects on inflammation and oxidation. The mechanisms involved in these effects include the suppression of succinate dehydrogenase, the activation of nuclear factor E2-related factor 2 by alkylation of Kelch-like ECH-associated protein 1, suppression of aerobic glycolysis through regulation of glyceraldehyde-3-phosphate dehydrogenase and fructose-bisphosphate aldolase A, and suppression of IκBζ translation through activating transcription factor 3 activation. All of these findings elucidated the possible therapeutic implications of itaconate in inflammation-related diseases. In this review, we highlight that itaconate is a crucial molecule of the immunomodulatory response in macrophages and can regulate between immune response and cardiovascular metabolism. Furthermore, these discoveries suggest that itaconate is a very novel therapeutic molecule for the treatment of inflammation-related heart diseases.
Metastatic leiomyosarcoma of the thyroid gland: cytologic findings and differential diagnosis
Authors: Lee Jiyeon , Cho Yunjoo , Choi Kyue Hee , Hwang Inwoo , Oh Young Lyun
Published: August 2021

Metastatic leiomyosarcoma to the thyroid is an extremely rare occurrence, and only 18 cases have been reported. Here, we report a case of a 37-year-old woman who presented with multiple masses on the scalp. Excisional biopsy was done and the mass revealed fascicles of smooth muscle fibers which showed positive staining for smooth muscle actin, thus confirming the diagnosis of leiomyosarcoma. The patient was also found to have a 0.9 cm mass within the left thyroid. Fine-needle aspiration was done and the cytological smear showed hypercellular spindle cell clusters with hyperchromatic and large nuclei. Normal thyroid follicular cells were found within or around tumor cells. In this report, we present the cytologic findings of metastatic leiomyosarcoma to the thyroid and offer differential diagnoses of the aspirated spindle cells.
Cancer incidence in the Tobruk area, eastern Libya: first results from Tobruk Medical Centre
Authors: Ismail Faisal , Elsayed Ahmed G. , El-Garawani Islam , Abdelsameea Eman
Published: August 2021

OBJECTIVES: Cancer is a major cause of morbidity and mortality worldwide, and it is an increasing problem in developing countries. Estimation of the incidence of cancer is important, especially in regions with limited epidemiological data on cancer. Therefore, the aim of this study was to provide an updated report on the incidence of cancers in the Tobruk region in eastern Libya.METHODS: Data on cancer patients from the records of the Department of Histopathology of Tobruk Medical Centre from January 2013 to June 2020 were included.RESULTS: In total, 402 cases were recorded. Men patients accounted for 30.3% (n=122) of cases, and women patients represented 69.6% (n=280). The overall mean age at the time of the first diagnosis was 49.0±17.1 years. The most common malignancies were breast and uterine cancer in women (18.4%, n=74; 15.9%, n=64, respectively), colorectal cancer (11.6%, n=47; 26 in women and 21 in men), bladder cancer (8.2%, n=33; 8 in women and 25 in men), and thyroid cancer (8.0%, n=32; 23 in women and 9 in men).CONCLUSIONS: Breast and uterine cancers were the most common cancers in women, and bladder and colorectal cancer were the most common cancers in men, followed by colorectal cancer in both genders. These data will help health authorities launch preventive plans for cancer in the region. Further studies to identify aetiological factors and cancer-related risk factors need to be conducted in the region.
Hydraulic Flange Clamps, Two-Screw Flange Connection to be Used with SAE J518-1 (Code 61) Connections Where Only Low Pressure is Required
Authors:   Hydraulic Hose and Hose Fittings Committee
Published: August 2021

This SAE Standard outlines general and dimensional specifications for flange clamps for use in low pressure applications with SAE J518-1 connections. For port dimensions, port design considerations, and flange head dimensions, please refer to SAE J518-1.

The rated working pressure of an assembly shall not exceed the least of all the component working pressure rated values.

The following general specifications supplement the dimensional data contained in the tables with respect to all unspecified detail. Parts manufactured to this standard are also compatible with ISO 6162-1 port connections and flange heads.
Validity Evidence for the Emergency Medicine Standardized Letter of Evaluation
Authors: Kukulski Paul , Ahn James
Published: August 2021

Background

The standardized letter of evaluation (SLOE) is the application component that program directors value most when evaluating candidates to interview and rank for emergency medicine (EM) residency. Given its successful implementation, other specialties, including otolaryngology, dermatology, and orthopedics, have adopted similar SLOEs of their own, and more specialties are considering creating one. Unfortunately, for such a significant assessment tool, no study to date has comprehensively examined the validity evidence for the EM SLOE.

Objective

We summarized the published evidence for validity for the EM SLOE using Messick's framework for validity evidence.

Methods

A scoping review of the validity evidence of the EM SLOE was performed in 2020. A scoping review was chosen to identify gaps and future directions, and because the heterogeneity of the literature makes a systematic review difficult. Included articles were assigned to an aspect of Messick's framework and determined to provide evidence for or against validity.

Results

There have been 22 articles published relating to validity evidence for the EM SLOE. There is evidence for content validity; however, there is a lack of evidence for internal structure, relation to other variables, and consequences. Additionally, the literature regarding response process demonstrates evidence against validity.

Conclusions

Overall, there is little published evidence in support of validity for the EM SLOE. Stakeholders need to consider changing the ranking system, improving standardization of clerkships, and further studying relation to other variables to improve validity. This will be important across GME as more specialties adopt a standardized letter.
Current State of the Medical Student Performance Evaluation: A Tool for Reflection for Residency Programs
Authors: Brenner Judith M. , Bird Jeffrey B. , Brenner Jason , Orner David , Friedman Karen
Published: August 2021

Background

The Medical Student Performance Evaluation (MSPE) provides important information to residency programs. Despite recent recommendations for standardization, it is not clear how much variation exists in MSPE content among schools.

Objectives

We describe the current section content of the MSPE in US allopathic medical schools, with a particular focus on variations in the presentation of student performance.

Methods

A representative MSPE was obtained from 95.3% (143 of 150) of allopathic US medical schools through residency applications to the Zucker School of Medicine at Hofstra/Northwell in select programs for the 2019–2020 academic year. A manual data abstraction tool was piloted in 2018–2019. After training, it was used to code all portions of the MSPE in this study. The results were analyzed, and descriptive statistics were reported.

Results

In preclinical years, 30.8% of MSPEs reported data regarding performance of students beyond achieving “passes” in a pass/fail curriculum. Only half referenced performance in the fourth year including electives, acting internships, or both. About two-thirds of schools included an overall descriptor of comparative performance in the final paragraph. Among these schools, a majority provided adjectives such as “outstanding/excellent/very good/good,” while one-quarter reported numerical data categories. Regarding clerkship grades, there were numerous nomenclature systems used.

Conclusions

This analysis demonstrates the existence of extreme variability in the content of MSPEs submitted by US allopathic medical schools in the 2019–2020 cycle, including the components and nomenclature of grades and descriptors of comparative performance, display of data, and inclusion of data across all years of the medical education program.
An Analysis of Gender Bias in Plastic Surgery Resident Assessment
Authors: Cooney Carisa M. , Aravind Pathik , Hultman C. Scott , Broderick Kristen P. , Weber Robert A. , Brooke Sebastian , Cooney Damon S. , Lifchez Scott D.
Published: August 2021

Background

Previous studies have shown men and women attending physicians rate or provide operating room (OR) autonomy differently to men and women residents, with men attendings providing higher ratings and more OR autonomy to men residents. Particularly with the advent of competency-based training in plastic surgery, differential advancement of trainees influenced by gender bias could have detrimental effects on resident advancement and time to graduation.

Objective

We determined if plastic surgery residents are assessed differently according to gender.

Methods

Three institutions' Operative Entrustability Assessment (OEA) data were abstracted from inception through November 2018 from MileMarker, a web-based program that stores trainee operative skill assessments of CPT-coded procedures. Ratings are based on a 5-point scale. Linear regression with postgraduate year adjustment was applied to all completed OEAs to compare men and women attendings' assessments of men and women residents.

Results

We included 8377 OEAs completed on 64 unique residents (25% women) by 51 unique attendings (29% women): men attendings completed 83% (n = 6972; 5859 assessments of men residents; 1113 of women residents) and women attendings completed 17% (n = 1405; 1025 assessments of men residents; 380 of women residents). Adjusted analysis showed men attendings rated women residents lower than men residents (P < .001); scores by women attendings demonstrated no significant difference (P = .067).

Conclusions

Our dataset including 4.5 years of data from 3 training programs showed men attendings scored women plastic surgery residents lower than their men counterparts.
Dark Clouds With Silver Linings: Resident Anxieties About COVID-19 Coupled With Program Innovations and Increased Resident Well-Being
Authors: Wietlisbach Larissa E. , Asch David A. , Eriksen Whitney , Barg Frances K. , Bellini Lisa M. , Desai Sanjay V. , Yakubu Abdul-Rakeem , Shea Judy A.
Published: August 2021

Background

The COVID-19 pandemic forced numerous unprecedented systemic changes within residency programs and hospital systems.

Objective

We explored how the COVID-19 pandemic, and associated changes in clinical and educational experiences, were related to internal medicine residents' well-being in the early months of the pandemic.

Methods

Across 4 internal medicine residency programs in the Northeast United States that have previously participated in the iCOMPARE study, all 394 residents were invited to participate in a study with open-ended survey prompts about well-being approximately every 2 weeks in academic year 2019–2020. In March and April 2020, survey prompts were refocused to COVID-19. Content analysis revealed themes in residents' open-ended responses to 4 prompts.

Results

One hundred and eighty-six residents expressed interest, and 88 were randomly selected (47%). There were 4 main themes: (1) in early days of the pandemic, internal medicine residents reported fear and anxiety about uncertainty and lack of personal protective equipment; (2) residents adapted and soon were able to reflect, rest, and pursue personal wellness; (3) communication from programs and health systems was inconsistent early in the pandemic but improved in clarity and frequency; (4) residents appreciated the changes programs had made, including shorter shifts, removal of pre-rounding, and telemedicine.

Conclusions

COVID-19 introduced many challenges to internal medicine residency programs and to resident well-being. Programs made structural changes to clinical schedules, educational/conference options, and communication that boosted resident well-being. Many residents hoped these changes would continue regardless of the pandemic's course.
Notes on Some Biological Aspects of Arctornis riguata Snellen (Lepidoptera: Lymantriidae)
Authors: SUTRISNO HARI , SUPUTA . , PURNOMO HARI , POLANDONO SISWO , WALUYO CIPTO , UBAIDILLAH ROSICHON , DARMAWAN . , ISMAIL . , HIDAYAT IMAN , WIDYASTUTI NUNUK
Published: August 2021

Arctornis riguata Snellen is one of lymantriids which attacked a vast range of mango trees in Probolinggo at the beginning of 2011. About 1.2% mango trees from nine sub-districts have been defoliated by the larvae of this species. The larvae of this genus have been reported to forage at Anacardiacea as well; however, they have never been reported to forage at cultivated mango trees in Indonesia. Since there is no biological information of this species, thus, a study on some biological aspects of this species is needed. This study was conducted in the field as well as in the laboratory during 4 months (March-July 2011). The diagnostic characters of this species are black scale at dorsal antenna on both male and female and slightly setae particularly at the costal angle of valve on the male genitalia. Life span of this species is in the range of 30-37 days. This study also found four natural enemies of A. riguata i.e.: Bleparipa sp. (Diptera: Tachinidae), Euagathis sp. (Hymenoptera: Brachonidae), Theronia sp. (Hymenoptera: Ichneumonidae), and Brachymeria lasus (Hymenoptera: Chalcididae). Moreover, a single fungal pathogen of this species also was identified, i.e. Isaria fumosorosea Wize. Having these results, we considered that to control A. riguata, one need to conserve the native natural enemies by manipulating their environment.
The Role of Green Finance in Community Renewable Energy Projects of main Region and Taiwan
Authors: Chiu Wen-Hsiang , Lin Wen Cheng , Liang Chiung-Ju
Published: August 2021

In order to achieve the goal of "non-nuclear homeland and realize the policy target that renewable energy accounts for 20% of power generation, the Taiwan government has actively promoted the integration of energy generation. Many small and medium-sized enterprises or start-up companies are faced with the challenge of financing their business expansion. This paper adopted document analysis method to seek more diversified financing channels compared with traditional ways of financing and lending from financial institutions, the combination of fintech and the power of the masses, such as crowdfunding, has become one of the emerging financial instruments for the development of green energy industry. Finally, the empirical result is compared main region about the community renewable energy projects and realized how to obtain renewable energy resources through new financing source. The study will be providing related reference to decision-making of country which plan to develop renewable energy projects.
Demiryolu Taşıtlarında Kullanılan Fren Disklerinin Isı ve Malzeme Yönünden Değerlendirilmesi
Authors: BAŞEĞMEZ Beytullah
Published: August 2021

Demiryolu taşıtı frenleme sistemleri, emniyetli şekilde durdurma, yavaşlatma ve uygun hızla hareketi sağlar. Yaygın olarak sürtünme etkisiyle mekanik frenleme gerçekleştirilir ve demiryolu taşıtları yüksek hıza uygun tasarlandığında fren disklerinin kullanımı, tek güvenli seçenektir. Fren diski boyutları ve ağırlığı, şasi altındaki alan, servis hızı gibi parametrelere göre çeşitlilik gösterir. Farklı malzemeler kullanıldığında ağırlık yarı yarıya varacak kadar azaltılabilmektedir. Frenleme esnasında mekanik enerji ısıya dönüşür. Çeşitli şekillerde ve boyutlarda tasarlanabilen soğutma kanatçıkları arasından akan hava, diskte konveksiyonla etkili soğutma sağlar. Diskte yerel olarak aşırı ısınan alanlar, fren diski malzemesinde yapısal değişikliğe, termal çatlak oluşumuna ve diğer hasarlara yol açar. Bu hasarlar, kontrol edilmediği ve ilerlediği, derin çatlaklar haline dönüştüğü takdirde zamanla disk kullanılamaz hale gelir. Demiryolu taşıtı fren diski imalinde yaygın ve geleneksel olarak dökme demir (lamelli, vermiküler, küresel grafitli) kullanılır; ayrıca yüksek alaşımlı dökme demirler, dökme ve dövme çelik. Fren diski çeliklerinin kırılma tokluğunu artırmak ve aşınma dirençlerini yükseltmek için bileşene çeşitli alaşım elementleri eklenebilir. Ayrıca özellikle alüminyum ve seramik matrisli kompozit malzemelerin kullanımı da söz konusudur, böylelikle istenilen özelliklerde ve oldukça hafif tren fren diski üretilebilir. Bu çalışmada fren disk yapısı ve soğutma kanatçıkları, frenlemede ısı oluşumu, transferi, sıcaklık gradyanları ve sıcak bölgelerde oluşan sorunlar, termik çatlaklar, fren disklerinde kullanılan ve kullanılabilecek malzemeler hakkında bilgi verilmiştir.
The Dynamics of Oil Prices, Exchange Rates, and the Stock Market Under COVID-19 Uncertainty: Evidence From India
Authors: Prabheesh K.P. , Kumar Sanjiv
Published: August 2021

This study empirically analyzes the dynamic relation between oil price returns, exchange rates, stock returns, and uncertainty shocks. Utilizing daily data, we employ a structural vector autoregression econometric technique to explore the impact of uncertainty in the Indian context. The study finds that COVID-19–induced uncertainty dampened the oil and stock markets. Further, findings suggest that COVID-19–induced uncertainty distorted the dynamics between oil and stock prices in the initial periods, due to the cautionary approach followed by investors.
The COVID-19 Outbreak and Oil Stock Price Fluctuations: Evidence From China
Authors: Zhang Yue
Published: August 2021

This study explores the relation between Chinese oil stock price volatility and the COVID-19 pandemic using an autoregressive conditional heteroskedasticity model and its generalization. We show that the COVID-19 outbreak has a positive and weakly persistent impact on oil stock volatility.
Uncertainty in the Pandemic and the Energy Stock Market: Evidence From China
Authors: Xiong Mengxu
Published: August 2021

This study probes the relation between uncertainty, the Chinese stock market, and the Chinese energy stock market during the COVID-19 pandemic period, using a structural vector autoregressive model. This paper shows that uncertainty negatively shocks both the energy and A-share markets. The impulse response results suggest that the adverse influence of uncertainty on the energy stock market lasts longer.
Segmenting Agri-Input Market in Odisha
Authors: Dash S. K. , Dash S. K. , Dash S. K. , Dash S. K.
Published: August 2021

There has been a significant transformation in social, physical and economic infrastructure. This has consequently changed the attitude and behavior of consumers/farmers. Farmers have shifted substantially toward consumerism, particularly over the past decade. This drastic and rapid change in the Indian agriculture sector has compelled agribusiness firms to continually adapt their marketing strategies to add & retain customers and increase the customer lifetime value. To maximize the efficiency and effectiveness of their market interventions, marketers have been segmenting their customers in numerous ways with its own set of advantages and disadvantages. Our study proposes and evaluates a new approach to agri-input market segmentation based on the farmer buying behavior - Brand loyalty, price sensitivity and response to market interventions. The study included farmers (marginal, small, medium and large) from different social, geographical and agro-climatic regions. The findings of the study would useful for the agri-input suppliers/marketers for developing better marketing mix strategies for different conditions of market and production orientations.
A EQUIPARAÇÃO DOS TRATADOS INTERNACIONAIS SOBRE MEIO AMBIENTE AOS TRATADOS DE DIREITOS HUMANOS
Authors: Alves Galdino Jonathan , Da Silva Miranda José Adelson , Fernandes Ferreira Adriano
Published: August 2021

Tradicionais ferramentas internacionais de defesa dos direitos humanos positivaram direitos civis, econômicos, sociais, políticos e culturais sem alusão específica e expressa a direitos sobre o meio ambiente sadio. Assim, esta pesquisa objetivou avaliar a existência de equiparação entre tratados internacionais sobre meio ambiente com tratados de direitos humanos no ordenamento jurídico do Brasil, examinando a forma de integralização dos tratados internacionais sobre meio ambiente no direito brasileiro, bem como apontando o nível hierárquico que esses tratados ocupam no ordenamento jurídico brasileiro, por intermédio de pesquisa exploratória, descritiva, explicativa, documental, bibliográfica e telematizada, utilizando-se o método dedutivo. Verificou-se que, no Brasil, conforme a Constituição Federal de 1988 e a jurisprudência do Supremo Tribunal Federal (STF), tratados internacionais sobre meio ambiente podem ser equiparados a tratados internacionais de direitos humanos, ocupando uma hierarquia supralegal e constitucional no arcabouço legislativo doméstico brasileiro.
Horner’s syndrome in dogs and cats – a review
Authors: Limeira Rodrigues Laís , Pereira Mesquita Leonardo , Alberto Zanatto Denis , Maiorka Paulo César
Published: August 2021

In dogs and cats, Horner's syndrome is characterized by a group of clinical signs arising from an ipsilateral dysfunction of sympathetic innervation of the eye and its appendages. These signs include ptosis, miosis, anisocoria, prolapse of the third eyelid, and enophtalmos. Lesions that may affect directly or indirectly the sympathetic innervation of the eye, such as trauma, neoplasms, iatrogenic lesions, otitis, encephalitis, among others, can induce HS. The aim of the present study was to review the anatomical and physiological characteristics of sympathetic innervation for the ocular globe, with emphasis on the description of the peculiarities of HS, including its etiology, clinical signs, diagnostic tools, as well as its possible treatments and prognosis.