Branchial cleft cyst arising within the parotid space is considered an extremely rare phenomenon. In contrast, cystic squamous cell carcinoma in the lateral neck is not an uncommon presentation of ...HPV-related head and neck cancer. Although they have singly been narrated in literature, simultaneous expression of these anomalies has yet to be reported. We describe a case of synchronous presentation of branchial cleft cyst of the right parotid gland and cystic metastatic squamous cell carcinoma of the left neck. These findings are discussed in light of the challenges in fine needle aspiration biopsy of cystic masses, and the risk of two distinct pathologic entities presenting as cysts in the head and neck.
Face coverings are a key component of preventive health measure strategies to mitigate the spread of respiratory illnesses. In this study five groups of masks were investigated that are of particular ...relevance to the SARS-CoV-2 pandemic: re-usable, fabric two-layer and multi-layer masks, disposable procedure/surgical masks, KN95 and N95 filtering facepiece respirators. Experimental work focussed on the particle penetration through mask materials as a function of particle diameter, and the total inward leakage protection performance of the mask system. Geometric mean fabric protection factors varied from 1.78 to 144.5 for the fabric two-layer and KN95 materials, corresponding to overall filtration efficiencies of 43.8% and 99.3% using a flow rate of 17 L/min, equivalent to a breathing expiration rate for a person in a sedentary or standing position conversing with another individual. Geometric mean total inward leakage protection factors for the 2-layer, multi-layer and procedure masks were <2.3, while 6.2 was achieved for the KN95 masks. The highest values were measured for the N95 group at 165.7. Mask performance is dominated by face seal leakage. Despite the additional filtering layers added to cloth masks, and the higher filtration efficiency of the materials used in disposable procedure and KN95 masks, the total inward leakage protection factor was only marginally improved. N95 FFRs were the only mask group investigated that provided not only high filtration efficiency but high total inward leakage protection, and remain the best option to protect individuals from exposure to aerosol in high risk settings. The Mask Quality Factor and total inward leakage performance are very useful to determine the best options for masking. However, it is highly recommended that testing is undertaken on prospective products, or guidance is sought from impartial authorities, to confirm they meet any implied standards.
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•Environmental effects of political stability and income inequality.•Second-generation panel data methods are utilized for four South Asian countries.•Political stability and ...renewable energy improve environmental quality.•Income inequality and urbanization worsen the ecological footprint.
South Asian economies have experienced considerable growth over the last two decades, which has brought with it a number of problems. Despite the rapid growth, income inequality has increased in South Asia and political instability continues mainly due to territorial disputes between Pakistan and India. In addition to these factors, the increase in population and energy consumption has also contributed to the environmental problems in South Asia. Therefore, there is a need to analyze the role of income inequality and political stability in environmental degradation and thus take measures to prevent irreversible environmental consequences. In this background, this study examines the role of income inequality and political stability on environmental degradation in four South Asian countries (Pakistan, India, Sri Lanka, and Bangladesh). For this purpose, the study employs second-generation panel data approaches on a Stochastic Impacts by Regression on Population, Affluence, and Technology model (STIRPAT). Based on annual data for the period 2002–2016, the empirical results show that economic growth, income inequality, urbanization, and financial development increase the ecological footprint, while political stability and renewable energy utilization help to reduce environmental degradation. The findings of the panel causality test also suggest unidirectional causality from urbanization, renewable energy, economic growth, and income inequality to ecological footprint. According to these findings, ensuring political stability, reducing income inequality, and promoting renewable energy are essential policy instruments for sustainable and green development in four South Asian countries.
Parathyroid cysts (PC) are infrequently encountered and characterize less than 1% of all head and neck masses. When present, PCs may present as a palpable neck mass and lead to hypercalcemia and ...rarely respiratory depression. Furthermore, the diagnostics of PCs is difficult as they can masquerade as a thyroid or mediastinal mass given their proximity. PCs are theorized to be a progression of parathyroid adenomas and often routine surgical excision is sufficient for cure. To our knowledge, there is no documented report of a patient with an infected parathyroid cyst that led to severe dyspnea. This case describes our experience of a patient with an infected parathyroid cyst presenting as hypercalcemia and airway obstruction.
Aortic stenosis: pathophysiology, diagnosis and therapy Joseph, Jessica, D.O, M.B.A; Naqvi, Syed Yaseen, MD, MSc; Giri, Jay, MD, MPH ...
The American journal of medicine,
03/2017, Letnik:
130, Številka:
3
Journal Article
Recenzirano
Abstract The incidence of aortic stenosis increases with age, affecting up to 10 percent of the population by the eighth decade. Once symptoms develop, aortic stenosis is rapidly fatal. Proper ...management requires an understanding of the physiology and criteria used to define disease severity. There is no effective pharmacologic treatment. Surgical aortic valve replacement has been the gold standard treatment for decades. However, over the last ten years transcatheter aortic valve replacement has emerged as an attractive less invasive option for appropriately selected patients. Refinements in valve design and delivery systems have led to widespread use of this breakthrough technology in selected patients. We review the pathophysiology, criteria for valve replacement and the results of the trials comparing transcatheter aortic valve replacement with surgical aortic valve replacement.
Automated retinal image analysis holds prime significance in the accurate diagnosis of various critical eye diseases that include diabetic retinopathy (DR), age-related macular degeneration (AMD), ...atherosclerosis, and glaucoma. Manual diagnosis of retinal diseases by ophthalmologists takes time, effort, and financial resources, and is prone to error, in comparison to computer-aided diagnosis systems. In this context, robust classification and segmentation of retinal images are primary operations that aid clinicians in the early screening of patients to ensure the prevention and/or treatment of these diseases. This paper conducts an extensive review of the state-of-the-art methods for the detection and segmentation of retinal image features. Existing notable techniques for the detection of retinal features are categorized into essential groups and compared in depth. Additionally, a summary of quantifiable performance measures for various important stages of retinal image analysis, such as image acquisition and preprocessing, is provided. Finally, the widely used in the literature datasets for analyzing retinal images are described and their significance is emphasized.
•An extensive review of the state-of-the-art methods for retinal image analysis.•Existing techniques are categorized into essential groups and compared in depth.•A summary of quantifiable performance measures is presented.•Widely used are described and their significance is emphasized.•A model system for ophthalmic healthcare and monitoring system is proposed.
Automatic optic disc (OD) localization and segmentation is not a simple process as the OD appearance and size may significantly vary from person to person. This paper presents a novel approach for OD ...localization and segmentation which is fast as well as robust. In the proposed method, the image is first enhanced by de-hazing and then cropped around the OD region. The cropped image is converted to HSV domain and then V channel is used for OD detection. The vessels are extracted from the Green channel in the cropped region by multi-scale line detector and then removed by the Laplace Transform. Local adaptive thresholding and region growing are applied for binarization. Furthermore, two region properties, eccentricity, and area are then used to detect the true OD region. Finally, ellipse fitting is used to fill the region. Several datasets are used for testing the proposed method. Test results show that the accuracy and sensitivity of the proposed method are much higher than the existing state-of-the-art methods.
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•Study examines wind and solar energy impact on environmental quality.•Wind and solar energy production has a negative effect on the ecological footprint.•Real GDP has a positive ...impact on ecological footprint.
The motivation of the present study is to evaluate the effect of wind and solar energy production and economic development on environmental quality in 43 countries covering the period of 1990–2017. The study uses annual data for real GDP, real trade, energy intensity, urbanization, foreign direct investment, ecological footprints, and wind and solar energy production. For econometric analysis, common correlated mean group (CCE-MG), cross-section-distributive lag (CS-DL), and cross-section autoregressive-distributive lag (CS-ARDL) approaches are employed. The outcomes show that real GDP has a significantly positive influence on ecological footprint. At the same time, wind and solar energy negatively and significantly influence ecological footprint. It is argued that a 1 % increase in wind and solar energy reduces ecological footprint by 3.1 % and 2.9 %, respectively. For policy recommendations, the study recommended that wind and solar energy resources may become more noticeable for electricity purposes despite rising investments in these energy resources. Indeed, the share of wind and solar energy production is limited and dominated by non-renewable energy resources, so low-carbon energy resources might be encouraged.
The adoption of sustainable residue management practices is considered as a cleaner production option for the agricultural sector. However, limited information is available from Pakistan on the ...current use and adoption of sustainable residue management practices and different socio-physiological factors are involved in the process of shaping farmers' intentions. Based on the protection motivation theory framework, this study analyzes the socio-physiological factors affecting the farmers' intentions on adopting sustainable crop residue management practices. The paper is based on cross-sectional data collected from 420 farmers across Punjab and employs a structural equation modeling to explore research objectives. The research findings show that farmers, who perceive high risk from crop residue burning or who are aware of its negative consequences, are more intended to adopt sustainable crop residue management practices. However, their adoption intentions do have significant relationship with the self-efficacy implying the lack of resources, time, knowledge, competency, and skills as constraints limiting the adoption of cleaner production strategies. Further, the research findings also confirm the positive and significant role of habits of farmers in shaping their intentions to use sustainable crop residue management practices. In addition to this, the paper found a positive and significant role in social interaction, sources of information and access to extension services in shaping farmers’ decision regarding sustainable residue management practices at the farm level. The research findings suggest enhancing awareness to highlight the negative impacts of crop residue burning and to train them regarding useful and sustainable crop residue management options that are not only cleaner production options but also generate economic benefits for farmers.
•Socio-psychological factors affecting farmers' SCRMPs intentions are assessed.•Perceived high risks of residue burning are more intended to adopt SCRMPs.•Socio-cognitive attributes significantly influence farmers' adoption intentions.•Farmers' intentions can improve by promoting ecological benefits of these practices.
This study uses ecological modernization and environmental transition theories to estimate the interaction among energy intensity, carbon emission and urbanization for the period of 1980–2017. We ...have systematically examined the empirical connections among emission, urbanization, income per capita, imports, exports, energy use, trade openness and energy intensity. The Johnson co-integration and Vector Error Correction Model (VECM) causality methods are employed for the sake of analysis. Overall findings confirm the dynamic and U-shaped relationship between emission and urbanization, and carbon emission and income per capita. The empirical results of urbanization, inflation and financial development illustrate positive association with the energy intensity, whereas trade openness, labour force participation and carbon emission show a negative association with the dependent variable. Moreover, outcomes of causality analysis provide evidence of varied causality link among the variables across the models. The study provides the implications for the decision makers in Pakistan to choose new urbanization patterns that are less reliant on energy consumption.
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