Let
K
=
R
or
C
and
R
n
be the dihedral quandle of order
n
. In this article, we give decomposition of the quandle ring
K
R
n
into indecomposable right
K
R
n
-modules for all even
n
∈
N
. It ...follows that the decomposition of
K
R
n
given in
2
, Prop. 4.18(2) is valid only in the case when
n
is not divisible by 4.
Climate change is a reality, and the modern healthcare sector not just contributes towards this grave phenomenon but is itself being affected by it. The present review was thus conducted to ...understand the meaning of 'Green Hospital', to identify the many ways in which health sector is contributing towards climate change, to explore possibilities for countering this grave trend and last of all to look for institutions that are pioneering change. Data for the review was extracted from multiple online sources using the Google search engine. It was found that hospitals, being resource intensive establishments, consume vast amounts of electricity, water, food and construction materials to provide high quality care. It was also found that certain healthcare institutions, by employing simple, smart and sustainable measures can greatly reduce their environmental footprint. But constructing Green Hospitals can be a challenge considering the local conditions and growing customer expectations.
Abstract
Making precise measurements of pulsar dispersion measures (DMs) and applying suitable corrections for them is among the major challenges in high-precision timing programs such as pulsar ...timing arrays (PTAs). While the advent of wideband pulsar instrumentation can enable more precise DM measurements and thence improved timing precision, it also necessitates doing careful assessments of frequency-dependent (chromatic) DMs that were theorized by Cordes et al (2016). Here we report the detection of such an effect in broadband observations of the millisecond pulsar PSR J2241−5236, a high-priority target for current and future PTAs. The observations were made contemporaneously using the wideband receivers and capabilities now available at the Murchison Widefield Array, the upgraded Giant Metrewave Radio Telescope, and the Parkes telescopes, thus providing an unprecedentedly large frequency coverage from 80 MHz to 4 GHz. Our analysis shows the measurable changes in DM that scale with the observing frequency (
ν
) as
δ
DM ∝
ν
2.5±0.1
. We discuss the potential implications of such a frequency dependence in the measured DMs and the likely impact on the timing noise budget and comment on the usefulness of low-frequency observations in advancing PTA efforts.
Context: Atypia of undetermined significance/Follicular lesion of undetermined significance AUS/FLUS is a heterogeneous category with a wide range of risk of malignancy ROM reported in the ...literature. The Bethesda system for reporting thyroid cytopathology TBSRTC, 2017 has recommended subcategorization of AUS/FLUS. Aims: To evaluate the ROM in thyroid nodules categorized as AUS/FLUS, as well as separate ROM for each of the five subcategories. Settings and Design: Retrospective analytic study. Methods and Materials: A retrospective audit was conducted for all thyroid fine-needle aspiration cytology (FNAC) from January 2013 to December 2017. Slides for cases with follow-up histopathology were reviewed, classified into the five recommended subcategories, and differential ROM was calculated. Statistical Analysis Used: z test for comparison of proportions was done to evaluate the difference in ROM among different subcategories of AUS/FLUS. The P value of less than 0.05 was taken as statistically significant. Results: Total number of thyroid FNACs reported was 1,630, of which 122 were AUS/FLUS (7.5%). Histopathology was available in 49 cases, out of which 18 were malignant (ROM = 36.7%). The risk of malignancy (ROM) for nodules with architectural and cytologic atypia was higher (43.8%) than ROM for nodules with only architectural atypia (16.7%). Conclusions: The sub-classification of AUS/FLUS into subcategories as recommended by TBSRTC, 2017 may better stratify the malignancy risk and guide future management guidelines.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Introduction: Ovarian cancer is associated with high morbidity and mortality. This is due to the nonspecific symptoms and no effective screening methods. Currently, carbohydrate antigen-125 (CA125) ...is used as a tumor biomarker for the diagnosis of ovarian cancer, but it has its own limitations. Hence, there is a need for other tumor biomarkers for the diagnosis of ovarian cancer. Objective of the study was to evaluate the diagnostic test characteristics of plasma osteopontin (OPN) in detecting ovarian malignancy and comparing its performance with CA125. Materials and Methods: This is a prospective cross-sectional diagnostic test evaluation. Women with adnexal mass detected by clinical or radiological examination were enrolled as suspected cases. Women who presented with other gynecological conditions were enrolled as controls. OPN and CA125 levels were measured in all enrolled subjects. Results: Among 106 women enrolled, 26 were ovarian cancer, 31 had benign ovarian masses, and 49 were controls. Median plasma CA125 levels were higher in subjects with ovarian cancer (298 U/ml; interquartile range IQR: 84-1082 U/ml vs. 37.5U/ml; IQR: 17.6-82.9U/ml; P < 0.001). CA125 sensitivity, specificity, positive, and negative likelihood ratios were 88.5%, 61.3%, 2.10, and 0.19, respectively. Median plasma OPN levels were higher in subjects with ovarian cancer (63.1 ng/ml; IQR: 39.3-137 ng/ml vs. 27 ng/ml; IQR: 20-52 ng/ml; P = 0.001). Sensitivity, specificity, positive, and negative likelihood ratios of OPN were 50%, 87%, 2.58, and 0.62, respectively. Conclusion: OPN levels were higher in ovarian cancer than in the benign ovarian mass and had better specificity than CA125. OPN can better differentiate between benign and malignant ovarian mass as compared to CA125.
Of the most prevalent issues surrounding long-term spaceflight, the sustainability of human life and the maintenance of homeostasis in an extreme environment are of utmost concern. It has been ...observed that the human immune system is dysregulated in space as a result of gravitational unloading at the cellular level, leading to potential complications in astronaut health. A plethora of studies demonstrate intracellular changes that occur due to microgravity; however, these ultimately fall short of identifying the underlying mechanisms and dysfunctions that cause such changes. This comprehensive review covers the changes in human adaptive immunity due to microgravity. Specifically, there is a focus on uncovering the gravisensitive steps in T cell signaling pathways. Changes in gravitational force may lead to interrupted immune signaling cascades at specific junctions, particularly membrane and surface receptor-proximal molecules. Holistically studying the interplay of signaling with morphological changes in cytoskeleton and other cell components may yield answers to what in the T cell specifically experiences the consequences of microgravity. Fully understanding the nature of this problem is essential in order to develop proper countermeasures before long-term space flight is conducted.
Background: Pain and depression are associated, but it is uncertain if effective pain relief during labor by labor analgesia reduces the incidence of postpartum depression (PPD). This randomized, ...controlled study assessed whether combined spinal-epidural (CSE) labor analgesia is associated with a decreased risk of PPD. Other reported risk factors for PPD were also assessed.
Materials and Methods: Parturients were randomly assigned to either CSE labor analgesia or normal vaginal delivery (n = 65 each). CSE parturients received 0.5 ml of 0.5% hyperbaric bupivacaine intrathecally and PCEA with continuous infusion of 0.1% levobupivacaine and 2 μg/ml fentanyl @5 ml/h along with patient-controlled boluses with a lockout interval of 15 min. Parturients of both the groups were assessed using Edinburgh Postnatal Depression Scale (EPDS) for depressive symptoms at day 3 and PPD at 6 weeks (primary outcome; defined as EPDS score ≥10 at 6 weeks postpartum). Secondary outcomes included pain scores, maternal satisfaction, and Apgar scores at 1 and 5 min. Parturients were also screened for several risk factors for PPD.
Results: Incidence of PPD was 22.3%. The difference in incidence of PPD between the CSE group vs. control group was not significant (27.7% vs. 16.9%; Fisher's exact P = 0.103). Of all the risk factors analyzed in logistic regression model, perceived stress during pregnancy was the only significant predictor of the development of PPD (adjusted Odds Ratio 11.17, 95% Confidence interval 2.86-43.55; P = 0.001).
Conclusion: CSE analgesia in laboring parturients does not reduce PPD at 6 weeks. Instead, perceived high stress during pregnancy appears to be the most important factor.
Mayer-Rokitansky Kuster Hauser (MRKH) syndrome with lieomyoma is a rare disorder. Women with this syndrome have normal 46 XX karyotype, normal secondary sex characteristics and primary amenorrhea. ...There is a scarcity of cases in the literature where fibroid develops in women suffering from MRKH syndrome. Here, we present a case of an ectopic broad ligament fibroid found in a 41-year-old woman with MRKH syndrome type II. A 41-year-old married nulliparous female diagnosed with MRKH syndrome 20 years back, presented with an abdominal mass. Transabdominal ultrasound suggested a large mass on right side arising from paracolic area with heterogeneous echo texture. However, the ovarian vs leiomyoma origin of mass was of diagnostic dilemma. CEMRI confirmed the same findings and ruled out ovarian origin of the mass along with the presence of rudimentary uterus. Following this, the patient was taken for laparotomy followed by total abdominal hysterectomy with bilateral salpingoopherectomy, the fibroid was found to be arising from broad ligament and was removed along with the hypoplastic uterus and bilateral Fallopian tubes and ovaries. The case we presented exhibits the development of leiomyomas in patients with MRKH syndrome, although rare, is always a possibility and should be kept in mind as a differential diagnosis while evaluating an abdominopelvic mass. MRI is an accurate modality both for delineating the mass, confirming its origin as well as diagnosing MRKH syndrome. Keywords: Mayer-Rokitansky-Kuster-Hauser syndrome, MRKH, Leiomyoma, Mullerian duct anomalies
Aerobic exercise training is recommended to prevent and control obesity. The present study aimed to evaluate the effectiveness of a twelve-week step aerobics or floor aerobics exercise program in ...improving the physical and psychophysiological health of obese men. Sixty male adults of mean age 18.92 (SD 1.54 years) and Body Mass Index (BMI) ≥ 30 kg/m2 were randomly allocated into three equal (n = 20) groups: Step Aerobics Exercise Training (SAET), Floor Aerobic Exercise Training (FAET), and a control group (which did not perform any exercise). The SAET and FAET training protocols were performed three days per week for 12 weeks. Health-related physical fitness, biochemical, physiological, and psychological variables were used as outcome measures and measured at baseline and at 12 weeks. There were significant differences in terms of physical and psychophysiological health parameters in participants who underwent SAET and FAET training compared with the control group (p < 0.05). SAET and FAET proved to be helpful in managing the physical and psychological health of obese adults. Schools and colleges should administer aerobic exercise sessions to adults for better health perspectives.
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