Notes

Race along with Gender Bias in Internal Remedies System Representative Lertters of reference.
The optimal medical management of patients following endovascular deep venous interventions remains ill-defined. As such, the SIR Foundation (SIRF) convened a multidisciplinary group of experts in a virtual Research Consensus Panel (RCP) to develop a prioritized research agenda regarding anti-thrombotic therapy following deep venous interventions. Panelists presented gaps in knowledge followed by discussion and ranking of research priorities based on clinical relevance, overall impact, and technical feasibility. The following research topics were identified as high priority 1) characterization of biological processes leading to in-stent stenosis/re-thrombosis; 2) identification and validation of methods to assess venous flow dynamics and their effect on stent failure; 3) elucidation of the role of inflammation and anti-inflammatory therapies; and 4) clinical studies to compare anti-thrombotic strategies and improve venous outcome assessment. Collaborative, multicenter research is necessary to answer these questions and thereby enhance the care of patients with venous disease.Growth factor receptors (GFRs) and receptor tyrosine kinases (RTK) are groups of proteins mediating a plethora of physiological processes, including cell growth, proliferation, survival, differentiation and migration. Under certain circumstances, expression of GFRs and subsequently their downstream kinase signaling are deregulated by genetic, epigenetic, and somatic changes leading to uncontrolled cell division in many human diseases, most notably cancer. Cancer cells rely on growth factors to sustain the increasing need to cell division and metabolic reprogramming through cancer-associated activating mutations of their receptors (i.e., GFRs). In this review, we highlight the recent advances of selected GFRs and their ligands (growth factors) in cancer with emphasis on structural and functional differences. We also interrogate how overexpression and/or hyperactivation of GFRs contribute to cancer initiation, development, progression, and resistance to conventional chemo- and radiotherapies. Novel approaches are being developed as anticancer agents to target growth factor receptors and their signaling pathways in different cancers. Here, we illustrate how the current knowledge of GFRs biology, and their ligands lead to development of targeted therapies to inhibit and/or block the activity of growth factors, GFRs and downstream kinases to treat diseases such as cancer.
To study the validity of smartphone-based screening to detect moderate-to-severe levels of retinopathy of prematurity (ROP) in a low-resource setting.

In this observational validation study, all new patients at a single center who met screening criteria for ROP (birth weight of ≤1700 g and gestational age of ≤35 weeks) were examined by a pediatric ophthalmologist using indirect ophthalmoscopy. At the first ROP examination, a trained photographer captured fundus images using a smartphone fitted on an adapter, the Paxos Scope. The photographs were graded by two retina specialists masked to results of the gold standard examination.

A total of 100 children (200 eyes) were included. ROP was detected in 27.4% by indirect ophthalmoscopy, 16% of whom had moderate-to-severe ROP, defined as stage 3 in zone I or II, stage 2 in zone II, or pre-plus or plus disease. Sensitivity of fundus images reviewed by grader 1 against the gold standard in detecting moderate-to-severe ROP was 87.5%, and specificity was 82.1%. see more The positive predictive value was 48.3 %; the negative predictive value, 97.2%. The sensitivity of fundus images reviewed by grader 2 was 87.5%; the specificity, 81.6%. Positive predictive value was 47.5%; negative predictive value, 97.2%. The measured κ coefficient for intergrader agreement was 0.94.

Our study is one of the few studies on smartphone-based telescreening for ROP. The results suggest that smartphones may have potential as a screening tool for ROP in low-resource settings.
Our study is one of the few studies on smartphone-based telescreening for ROP. The results suggest that smartphones may have potential as a screening tool for ROP in low-resource settings.
To determine whether prophylactic caffeine and ibuprofen, which have been shown to have vascular endothelial growth factor-modulating properties in other contexts, have a detectable effect on the incidence of severe retinopathy of prematurity (ROP) when administered in extremely low birth weight infants during the first 48 hours of life.

In this retrospective cohort study, the incidence and severity of ROP with respect to total exposure to caffeine and ibuprofen were assessed. The effect of oxygen exposure at 28 days' postnatal age (PNA) and 36 weeks' corrected gestational age (GA) was also studied.

A total of 109 infants were included; of these, complete data were available for 93 infants (87%), of whom 18 (19%) had severe ROP (ETROP type 1, or stage 3), and 75 (81%) had mild-to-moderate ROP at final diagnosis. Infants with severe ROP had lower GA (P = 0.0006). Total caffeine and ibuprofen exposure did not vary with severity of ROP (P = 0.86 caffeine; P = 0.57 ibuprofen). Presence of oxygen at 28 days' PNA (P = 0.01) or 36 weeks' corrected GA varied significantly with ROP severity (P = 0.0005).

A relationship between prophylactic caffeine and ibuprofen exposure and severity of ROP could not be detected in our study cohort. Presence of oxygen at 28 days' PNA or 36 weeks' corrected GA was associated with ROP severity.
A relationship between prophylactic caffeine and ibuprofen exposure and severity of ROP could not be detected in our study cohort. Presence of oxygen at 28 days' PNA or 36 weeks' corrected GA was associated with ROP severity.
To assess the outcomes of superior rectus-weakening surgery in patients with thyroid-associated ophthalmopathy (TAO).

The medical records of patients with TAO who were treated with surgical weakening of the superior rectus muscle at the Zhongshan Ophthalmic Center from 2008 to 2018 were reviewed retrospectively. Data collected included sex, age at surgery, duration of deviation, ocular alignment, ocular motility, surgical procedures, and outcomes. Surgical success was defined as the absence of diplopia and a vertical deviation of ≤5
in primary and reading positions.

A total of 33 patients (mean age 45.7 years; 17 males) were included. Of the 33 patients, 28 received unilateral superior rectus recession, with a success rate for primary surgery of 79%. The mean preoperative hypertropia of 35.1
± 19.3
was significantly reduced to 3.9
± 9.7
. Ocular infraduction restriction significantly improved from a preoperative average of -5.3 ± 1.9 to -1.3 ± 1.3 postoperatively. Five patients underwent superior rectus tenotomy, with only 2 cases having a successful final outcome. For 27 of 33 cases, only a single surgery was required; 6 cases required a second surgery. The overall final success rate was 76%.

In our study cohort, superior rectus recession with or without traction suture for hypertropia in thyroid-associated ophthalmopathy resulted in a high rate of success.
In our study cohort, superior rectus recession with or without traction suture for hypertropia in thyroid-associated ophthalmopathy resulted in a high rate of success.The anaerobic bacterium Sutterella wadsworthensis has previously been isolated from the human intestine, both in healthy individuals and patients with gastrointestinal disorders, and the clinical significance of this bacterium is unknown. In this case report, we describe three cases of bacteremia with Sutterella wadsworthensis, from patients with recent intraabdominal surgery.Phytophagy has promoted species diversification in many insect groups, including Hymenoptera, one of the most diverse animal orders on Earth. In the predominantly parasitoid family Braconidae, an association with insect-induced, plant galls in angiosperms have been reported in three subfamilies, but in particular in the Doryctinae, where it has been recorded to occur in species of ten genera. Allorhogas Gahan is the most species-rich of these genera, with its species having different phytophagous strategies. Here we conducted a comprehensive phylogenomic study for the doryctine gall-associated genera, with an emphasis on Allorhogas, using ultraconserved elements (UCEs). Based on this estimate of phylogeny we (1) evaluated their taxonomic composition, (2) estimated the timing of origin of the gall-associated clade and divergence of its main subclades, and (3) performed ancestral state reconstruction analyses for life history traits related to their host-plant association. Our phylogenetic hypothesis confirmed Allorhogas as polyphyletic, with most of its members being nested in a main clade composed of various subclades, each comprising species with a particular host-plant family and herbivorous feeding habit. The origin of gall-association was estimated to have occurred during the late Oligocene to early Miocene, with a subsequent diversification of subclades during the middle to late Miocene and Pliocene. Overlap in divergence timing appears to occur between some taxa and their host-associated plant lineages. Evolution of the feeding strategies in the group shows "inquilinism-feeding" as the likely ancestral state, with gall-formation in different plant organs and seed predation having independently evolved on multiple occasions.
Clinical decision support systems (CDSSs) are used to help healthcare professionals in making decisions, offering them a tool for improved medical care practices based on monitoring and management procedures. Although CDSSs exhibit many advantages, challenges remain in terms of their adoption in the clinician community. One such issue is related to user satisfaction and the system reliability. Ensuring the quality of CDSSs is a way to improve their acceptance and adoption.

This study aims to propose a process model for evaluation of the quality in use characteristics of a CDSS to identify deficiencies that reduce its use by healthcare professionals.

We reviewed the existing literature on CDSS assessment and developed a process model based on the international standards ISO/IEC 25010 System and software quality models, and ISO/IEC 25022 Measurement of quality in use. To select measures for evaluating these characteristics, we adopted the Goal-Question-Metric (GQM) method. We evaluated the quality in use characteristics because they can represent system usability. Measurement of these characteristics helps us understand user needs, improve the user experience, and mitigate the low acceptance of CDSS, particularly by the primary users.

We developed a process model for measuring the quality in use (QiU) characteristics of CDSSs, explaining its applicability through an illustrative example focused on the characteristics of satisfaction and efficiency.

We consider that the proposed process model will benefit the CDSS adoption and contribute to the improvement of the quality of such systems by measuring its QiU.
We consider that the proposed process model will benefit the CDSS adoption and contribute to the improvement of the quality of such systems by measuring its QiU.
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