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1
Yoder, David T. "Interpreting the 50-Year Rule." Advances in Archaeological Practice 2, no. 4 (2014): 324–37. http://dx.doi.org/10.7183/2326-3768.2.4.337.
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AbstractFor over 40 years, some archaeologists have labored under a distorted interpretation of the 50-year rule in which anything more than 50 years of age becomes “archaeological” and therefore must be recorded and evaluated for eligibility to the National Register of Historic Places. A reexamination of federal law shows that this is a mistaken interpretation. Data from the Intermountain Antiquities Computer System indicates that, if this practice continues, the number of featureless historical sites requiring documentation in the West will greatly increase at a large expense to the public and that most of these costs will be associated with sites not considered significant in American history, architecture, archaeology, engineering, or culture. Solutions are presented that will give archaeologists greater flexibility in recording material culture more than 50 years of age, allowing us to redirect our efforts to resources of greater interest while making the practice of archaeology more defensible to the public. These problems are symptomatic of a larger issue that relates to how cultural remains from the latter part of the twentieth century and beyond will be valued. The discipline of archaeology must begin candid conversations about the relative importance of such recent material culture and its management implications.
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Yang, Ji-Ann. "Analysis of Concentrations of Loans by Using Book Circulation Data in Korea University Library." Publications 8, no. 4 (2020): 53. http://dx.doi.org/10.3390/publications8040053.
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In this paper, data of almost 8 million loans of books recorded for 15 years by the Korea University Library are analyzed by using big data analytic techniques. During this period, book circulation decreased with an average annual rate of decline of 4.4%. The use factor of books in each Dewey decimal classification (DDC) class was evaluated to measure how efficiently books were used by library users. Loan frequencies of books were analyzed and meaningful results regarding loan concentrations and the half-lives of books were obtained. It was observed that 50% of the total loans in each year were for 20% of all borrowed books in that year. This phenomenon will be called the 20/50 loan rule, and the set of the top 20% most borrowed books, whose cumulative loan frequencies reach 50% of total loans, will be called a core collection. The 20/50 loan rule shows the loan concentration of library books. The extent of loan concentration gets stronger if loans for two or more consecutive years are concerned. It was found that with high probability, books in a core collection at a specific year are also categorized as a core collection in next years. Moreover, books categorized as a core collection in consecutive years have longer half-lives compared with all other circulating books.
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Johnson, Jeff, Phillip N. Johnson, Eduardo Segarra, and David Willis. "Water conservation policy alternatives for the Ogallala Aquifer in Texas." Water Policy 11, no. 5 (2009): 537–52. http://dx.doi.org/10.2166/wp.2009.202.
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Texas groundwater law is based on the rule of capture; however, recent legislation provides groundwater conservation districts with the authority to implement groundwater use rules to manage aquifers. The objective of this study was to develop optimization models to analyze effects of groundwater policies on the Ogallala Aquifer and evaluate economic impacts on the Southern High Plains of Texas. The results of this study indicate that a policy that restricts the quantity of groundwater pumped conserved more water over the 50-year time horizon than implementation of a water use fee, but at a higher cost to local economies.
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Soetopo, Widandi, Ussy Andawayanti, Rini Wahyu Sayekti, and Janu Ismoyo. "The comparison study for the models of reservoir release rule for irrigation. Case study: Sutami Reservoir." Journal of Water and Land Development 36, no. 1 (2018): 153–60. http://dx.doi.org/10.2478/jwld-2018-0015.
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AbstractThree models of release rule for operating a large reservoir for irrigation water supply are discussed in this paper. The models are a 50-grid storage continuous line restricted release rule, a single rule curve release rule, and a multi 4 rule curves release rule. These three models are to be optimized by stochastic simulation using 30 year inflow data with the maximization of the average monetary annual production in the irrigation area as the objective function. The purpose of this study is to look for the proper release rule for operating the Sutami Reservoir. The optimization is done first by the random search stochastic simulation model to generate a number of alternative solutions. Using these solutions as a generation of solutions, the genetic algorithm model is the applied to improve the solution. Afterward the best of solutions are checked by the Add-Ins Solver of MS-Excel 2010 to see if they can still be improved further. The results show that the 4 rule curves model gives the best solution with the average monetary annual production in the irrigation area of USD 72.248 million.
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Antonina Łuszczykiewicz. "Dealing with Colonial Past." Politeja 16, no. 2(59) (2019): 123–38. http://dx.doi.org/10.12797/politeja.16.2019.59.08.
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This paper is dedicated to reconstructing the image of the British colonial rule in India in modern Hindi cinema. The main stress in the analysis is laid upon the depiction of the political and cultural impact of the British rule on common Indian people, as well as the colonizers’ attitude towards the independence movement. Consequently, the author intends to enquire, how movies made after 2000 – among which Lagaan: Once Upon a Time in India (2001), Mangal Pandey: The Rising (2005), Water (2005) and Rang De Basanti (2006) are given special attention – deal with the difficult colonial past from an over 50-year-long perspective. Moreover, the author explains, how modern Hindi cinema shapes Indian viewers’ opinions on the British rule, intending to strengthen their patriotic feelings and national pride.
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Kangrang, Anongrit, Haris Prasanchum, and Rattana Hormwichian. "Development of Future Rule Curves for Multipurpose Reservoir Operation Using Conditional Genetic and Tabu Search Algorithms." Advances in Civil Engineering 2018 (2018): 1–10. http://dx.doi.org/10.1155/2018/6474870.
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Optimal rule curves are necessary guidelines in the reservoir operation that have been used to assess performance of any reservoir to satisfy water supply, irrigation, industrial, hydropower, and environmental conservation requirements. This study applied the conditional genetic algorithm (CGA) and the conditional tabu search algorithm (CTSA) technique to connect with the reservoir simulation model in order to search optimal reservoir rule curves. The Ubolrat Reservoir located in the northeast region of Thailand was an illustrative application including historic monthly inflow, future inflow generated by the SWAT hydrological model using 50-year future climate data from the PRECIS regional climate model in case of B2 emission scenario by IPCC SRES, water demand, hydrologic data, and physical reservoir data. The future and synthetic inflow data of reservoirs were used to simulate reservoir system for evaluating water situation. The situations of water shortage and excess water were shown in terms of frequency magnitude and duration. The results have shown that the optimal rule curves from CGA and CTSA connected with the simulation model can mitigate drought and flood situations than the existing rule curves. The optimal future rule curves were more suitable for future situations than the other rule curves.
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Yau, Rebecca K., Savannah G. Dennis, Barry P. Boden, Robert C. Cantu, James A. Lord, and Kristen L. Kucera. "Catastrophic High School and Collegiate Cheerleading Injuries in the United States: An Examination of the 2006-2007 Basket Toss Rule Change." Sports Health: A Multidisciplinary Approach 11, no. 1 (2018): 32–39. http://dx.doi.org/10.1177/1941738118807122.
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Background: Cheerleading is a specialized athletic activity that can lead to catastrophic injuries. Cheerleading rules are in place to maximize safety of participants. The purpose of this study was to describe catastrophic cheerleading injuries among high school and collegiate-level participants in the United States and to explore whether the 2006-2007 basket toss rule change was effective at reducing the number of catastrophic injuries. Hypothesis: The 2006-2007 basket toss rule change contributed to a reduction in the number of catastrophic injuries among high school and collegiate cheerleaders. Study Design: Case series. Level of Evidence: Level 4. Methods: Data on catastrophic cheerleading injuries were collected by the National Center for Catastrophic Sport Injury Research from July 2002 to June 2017. Information collected included cheerleader, event, and injury characteristics. The impact of the 2006-2007 rule change banning the basket toss on any hard surfaces was assessed by comparing injury rates and 95% CIs before and after the rule change. Results: There were 54 catastrophic cheerleading injuries, or 3.6 injuries per year. From July 2002 through June 2017, the injury rate was 2.12 per 1,000,000 cheerleaders (95% CI, 1.56-2.69). Most cheerleaders sustained serious injuries (n = 27; 50%) during practice (n = 37; 69%) to the head (n = 28; 52%) and cervical spine (n = 17; 32%). From July 2002 through June 2017, basket tosses were the stunt that accounted for the highest proportion of injuries (n = 19; 35%). The basket toss injury rate decreased from 1.55 to 0.40 per 1,000,000 cheerleaders among both high school and collegiate cheerleaders after the rule change. Conclusion: Catastrophic injury rates in cheerleading decreased dramatically after the 2006-2007 rule change banning basket tosses from being performed on any hard surfaces. In particular, there was a nearly 4-fold reduction in the rate of catastrophic basket toss injuries.
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Anand, Atul, Kuan Ken Lee, Andrew R. Chapman, et al. "High-Sensitivity Cardiac Troponin on Presentation to Rule Out Myocardial Infarction: A Stepped-Wedge Cluster Randomized Controlled Trial." Circulation 143, no. 23 (2021): 2214–24. http://dx.doi.org/10.1161/circulationaha.120.052380.
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Background: High-sensitivity cardiac troponin assays enable myocardial infarction to be ruled out earlier, but the safety and efficacy of this approach is uncertain. We investigated whether an early rule-out pathway is safe and effective for patients with suspected acute coronary syndrome. Methods: We performed a stepped-wedge cluster randomized controlled trial in the emergency departments of 7 acute care hospitals in Scotland. Consecutive patients presenting with suspected acute coronary syndrome between December 2014 and December 2016 were included. Sites were randomized to implement an early rule-out pathway where myocardial infarction was excluded if high-sensitivity cardiac troponin I concentrations were <5 ng/L at presentation. During a previous validation phase, myocardial infarction was ruled out when troponin concentrations were <99th percentile at 6 to 12 hours after symptom onset. The coprimary outcome was length of stay (efficacy) and myocardial infarction or cardiac death after discharge at 30 days (safety). Patients were followed for 1 year to evaluate safety and other secondary outcomes. Results: We enrolled 31 492 patients (59±17 years of age [mean±SD]; 45% women) with troponin concentrations <99th percentile at presentation. Length of stay was reduced from 10.1±4.1 to 6.8±3.9 hours (adjusted geometric mean ratio, 0.78 [95% CI, 0.73–0.83]; P <0.001) after implementation and the proportion of patients discharged increased from 50% to 71% (adjusted odds ratio, 1.59 [95% CI, 1.45–1.75]). Noninferiority was not demonstrated for the 30-day safety outcome (upper limit of 1-sided 95% CI for adjusted risk difference, 0.70% [noninferiority margin 0.50%]; P =0.068), but the observed differences favored the early rule-out pathway (0.4% [57/14 700] versus 0.3% [56/16 792]). At 1 year, the safety outcome occurred in 2.7% (396/14 700) and 1.8% (307/16 792) of patients before and after implementation (adjusted odds ratio, 1.02 [95% CI, 0.74–1.40]; P =0.894), and there were no differences in hospital reattendance or all-cause mortality. Conclusions: Implementation of an early rule-out pathway for myocardial infarction reduced length of stay and hospital admission. Although noninferiority for the safety outcome was not demonstrated at 30 days, there was no increase in cardiac events at 1 year. Adoption of this pathway would have major benefits for patients and health care providers. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03005158.
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Govender, Paulene, Michael J. Brooks, and Alan P. Matthews. "Cluster analysis for classification and forecasting of solar irradiance in Durban, South Africa." Journal of Energy in Southern Africa 29, no. 2 (2018): 63–76. http://dx.doi.org/10.17159/2413-3051/2018/v29i2a4338.
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Clustering of solar irradiance patterns was used in conjunction with cloud cover forecasts from Numerical Weather Predictions for day-ahead forecasting of irradiance. Beam irradiance as a function of time during daylight was recorded over a one-year period in Durban, to which k-means clustering was applied to produce four classes of day with diurnal patterns characterised as sunny all day, cloudy all day, sunny morning-cloudy afternoon, and cloudy morning-sunny afternoon. Two forecasting methods were investigated. The first used k-means clustering on predicted daily cloud cover profiles. The second used a rule whereby predicted cloud cover profiles were classified according to whether their average in the morning and afternoon were above or below 50%. In both methods, four classes were found, which had diurnal patterns associated with the irradiance classes that were used to forecast the irradiance class for the day ahead. The two methods had a comparable success rate of about 65%; the cloud cover clustering method was better for sunny and cloudy days; and the 50% rule was better for mixed cloud conditions.
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Santic, Danica, and Marija Martinovic. "The Luznica settlements: Geographic-historical and spatial-demographic transformation." Glasnik Srpskog geografskog drustva 87, no. 2 (2007): 115–24. http://dx.doi.org/10.2298/gsgd0702115s.
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Luznica is situated in southeaster Serbia and is consists of 52 settlements. In this paper are emphasized four main stages in evolution of Luznica: initial (from the old ages until the period of Turkish rule), early stage (period of Turkish rule), central stage (from the liberation to the end of The Second World war), and modern stage that lasts for more than 50 years. The specific demographic development from the year of 1879. until modern days is denoted with changes in natural increase and migration. That is caused by the influences of the environmental factors, and also social-historic, economic, socio-psychological and other factors. Since the 60-s this territory is the good example of the area with high altitude and negative appearances in demographic development (depopulation and intensive emigration).
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Shokohyar, Sajjad, Ehsan Taati, and Sara Zolfaghari. "The Effect of Drivers' Demographic Characteristics on Road Accidents in Different Seasons Using Data Mining." PROMET - Traffic&Transportation 29, no. 6 (2017): 555–67. http://dx.doi.org/10.7307/ptt.v29i6.2342.
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According to World Health Organization, each year, over 1.2 million people die on roads, and between 20 and 50 million suffer non-fatal injuries. Based on international reports, Iran has a high death rate caused by road accidents. The objective of this study was to extract implicit knowledge from road accident data sets on roads of Iran through data mining. In this regard, three useful data mining techniques were combined: clustering, classification and rule extraction. Following the preparation stage, data were segmented via three clustering algorithms; Kohonen, K-Means and Twostep. Two-step cluster analysis is a one-pass-through data approach which generates a fairly large number of pre-clusters. Next, the optimized algorithm and cluster were identified, after which, in the classification level and by adding the drivers' demographic features through C5.0, a classification algorithm was employed so as to make the decision tree. Ultimately, the effects of these demographic features were investigated on road accidents. The characteristics such as age, job, driving license duration and gender proved to be more important factors in accident analysis. Certain rules of accidents were then extracted in each season of the year.
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Layer, B. "COMMONWEALTH PERSPECTIVE ON PETROLEUM TAXATION." APPEA Journal 39, no. 2 (1999): 126. http://dx.doi.org/10.1071/aj98067.
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In 1997 the petroleum industry sought modifications to the petroleum resource rent tax (PRRT) regime which applies to all Commonwealth offshore areas except the North West Shelf Project area. Industry argued that the PRRT impeded deepwater exploration and development activity and the exploitation of large stranded gas deposits suitable for conversion to liquids such as LNG. Industry suggested that a more appropriate risk/reward balance in the tax structure could be achieved by providing a volume based PRRT exemption for projects located in water depth greater than 400 m and by increasing the uplift rates for unrealised losses. It was proposed that the risk premium for the general (development) expenditure carry forward rate be increased by five percentage points to the long term bond rate (LTRR) plus 10 percentage points. Another industry recommendation was that exploration expenditures incurred more than five years before the issue of a production license (PL), which currently attract the lower GDP factor rate (the five year rule), be uplifted at the long-term bond rate for the period prior to the five year mark and then rolled forward at LTBR plus 15 percentage points. In addition, industry asked that the reference date for the five year rule should be based on the application date for a PL and not the issue date. For integrated gas to liquid projects, industry requested clarification of the basis for valuing feedstock gas for determining gas liability.In response, the Commonwealth decided to adopt a gas transfer price (GTP) methodology based on a combination of established cost plus and net back formulas to be applied to the up and downstream stages of the project respectively. The difference in the price outcome of the two methods, the residual price, is split 50:50 to obtain the GTP. Details of how the residual price method will be applied are currently being finalised with a view to enacting legislation in 1999-2000. The Commonwealth also responded positively to the industry suggestion that the reference date of the five year rule be applied from the date of application for the PL on the proviso that the appropriate authority receives all information pertaining to a successful application. Recommended changes to the PRRT for deepwater areas and proposed increases to the carry forward rates of undeducted losses were rejected mainly on economic efficiency grounds.
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Ghisler, M. "Review of the Survey's activities in 1988." Rapport Grønlands Geologiske Undersøgelse 145 (December 31, 1989): 5–10. http://dx.doi.org/10.34194/rapggu.v145.8062.
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During 1988 GGU started two major field projects in Greenland, one in North-East Greenland, and another in West Greenland in the Disko Bugt area. In addition petroleum geological investigations in Jameson Land and glacio-hydrological studies in West Greenland continued. A total of 84 participants were engaged in the field work. The scientific and technical staff at GGU in Copenhagen continued research on material collected in Greenland; total staff including administrative personnel numbers at present 108. A 10 per cent reduction of the staff is forecast over the next four years, combined with an additional reduction of the budget by 14 per cent. Accordingly, decreasing activity in both field work in Greenland and laboratory work in Copenhagen is expected. This development, rather similar to the trend in other western European geological surveys, willlead to a relatively greater engagement in applied geological projects and to less basic geological research. The Act on Mineral Resources in Greenland was revised in 1988 by agreement between the Danish Parliament and the Greenland Home Rule Authority. In accordance with this, all revenues from mineral exploitation in Greenland up to 500 million kroner per year wiIl be distributed with 50% to the Danish State and 50% to the Greenland Home Rule Authority, independent of the annual capital transfers from Denmark to Greenland. In addition the Home Rule Authority's access to, insight into, and influence on the Danish administration of Greenland's mineral resources (including GGU) are increased in various respects. The agreement is valid until at least 1995.
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Mcginley, Hugh, and Richard A. Pasewark. "National Survey of the Frequency and Success of the Insanity Plea and Alternate Pleas." Journal of Psychiatry & Law 17, no. 2 (1989): 205–21. http://dx.doi.org/10.1177/009318538901700204.
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The 50 states and the District of Columbia were surveyed for the operative insanity rule and frequency and success of the insanity plea and related alternate pleas. These data were compared with data collected for the year 1983. As in the earlier report, there seems to be a dearth of information about the use and success of the pleas. The information that is available is quite varied. There is a discussion of why basic data may not be available and what information is needed in order to have a basic understanding of the use of the insanity plea and alternate pleas.
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Lapić, Ivana, Dunja Rogić, Mirjana Fuček, and Ružica Galović. "Effectiveness of minimum retesting intervals in managing repetitive laboratory testing: experience from a Croatian university hospital." Biochemia medica 29, no. 3 (2019): 531–58. http://dx.doi.org/10.11613/bm.2019.030705.
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Introduction: Inappropriate laboratory retesting can be addressed by implementing minimum retesting intervals (MRI). The aim of our study was to assess the effectiveness of the implemented MRI protocol for inpatients. Materials and methods: Minimum retesting intervals were applied for 53 laboratory tests. The overall reduction of test requests, reduction in charges and reagent cost savings, frequency of MRI alert appearance as well as the rate of MRI acceptance and ignorance were calculated for a one-year period. Reasons for violating the MRI rule, hospital departments that contributed mostly to MRI rule violation, and the frequency of MRI violations between routine and emergency laboratory were evaluated. Results: During the one-year period, 106,780 requests violated the MRI rule, which corresponds to 14.8% of all requests received. 13,843 requests were cancelled, yielding a 1.9% reduction of requested tests. High-volume tests, namely complete blood count, C-reactive protein, alanine aminotransferase, gamma-glutamyltransferase and total bilirubin, accounted for 65% of all generated alerts and had the highest alert ignorance (>85%). The highest cancellation rate was observed for tumor markers and autoimmunity tests, for most being at least 50%. Annual charge reduction was 62,641 EUR while reagent cost savings were 11,408 EUR. Tests performed in the emergency laboratory had a higher alert appearance than the same routine tests. The most common reason for MRI violation was clinical justification based on the patient’s condition. Most frequently ignored MRI alerts were in the intensive care unit. Conclusion: MRI implementation showed limited effectiveness in reducing testing repetition and achieving financial savings, yet provided the basis for future improvements.
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Krarup, Anne Lund, Asbjørn Mohr Drewes, Per Ejstrud, Peter Thaysen Laurberg, and Mogens Vyberg. "Implementation of a biopsy protocol to improve detection of esophageal eosinophilia: a Danish registry-based study." Endoscopy 53, no. 01 (2020): 15–24. http://dx.doi.org/10.1055/a-1206-0852.
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Abstract Background In the North Denmark Region (580 272 inhabitants), only 0–4 cases of possible eosinophilic esophagitis (EoE) were identified annually in 1999–2010, suggesting underdiagnosis. This study aimed to increase the diagnosis of EoE by introducing a regional biopsy protocol for patients with dysphagia. Methods In 2011, leaders of regional endoscopy units attended a consensus meeting where a biopsy protocol was proposed. The national pathology registry was used to identify patients with esophageal eosinophilic inflammation during 2007–2017. Results Discussion resulted in consensus on a protocol to take eight biopsy samples in dysphagia patients (four biopsies from 4 cm and 14 cm above the esophagogastric junction–“4–14–4 rule”) regardless of the macroscopic appearance, and to code eosinophilia systematically in the pathology registry. A pictogram showing the 4–14–4 rule was sent to all endoscopy units. The number of patients with esophageal eosinophilia detected per year increased 50-fold after the protocol was implemented in 2011 (median of 1 [interquartile range 0–3] vs. 52 [47–56]; P < 0.001), and the number of biopsy samples per patient doubled (median 4 [4–5] vs. 8 [6–9]; P < 0.04). Of 309 patients diagnosed with esophageal eosinophilia in 2007–2017, 24 % had erosive esophagitis or Barrett’s esophagus, and 74 % had EoE. Conclusions A consensus-based biopsy protocol and improved coding of eosinophilia in the pathology registry resulted in a 50-fold increase in patients diagnosed with esophageal eosinophilia/year. These patients can now receive treatment. The effort to establish the protocol and change the culture of endoscopists and pathologists was minimal.
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Al-Ani, Fatimah, Yimin Pearl Wang, and Alejandro Lazo-Langner. "Development of a Clinical Prediction Rule for Venous Thromboembolism in Patients with Acute Leukemia." Thrombosis and Haemostasis 120, no. 02 (2020): 322–28. http://dx.doi.org/10.1055/s-0039-3400303.
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AbstractRisk factors for venous thromboembolism in patients with solid tumors are well studied; however, studies in patients with acute leukemia are lacking. We conducted a retrospective cohort study of adult patients diagnosed with acute myeloid leukemia and acute lymphoblastic leukemia diagnosed between June 2006 and June 2017 at a tertiary care center in Canada. Potential predictors of venous thromboembolism were evaluated using logistic regression and a risk score was derived based on weighed variables and compared using survival analysis. Internal validation was conducted using nonparametric bootstrapping. A total of 501 leukemia patients (427 myeloid and 74 lymphoblastic) were included. Venous thromboembolism occurred in 77(15.3%) patients with 71 events occurring in the first year. A prediction score was derived and validated and it included: previous history of venous thromboembolism (3 points), lymphoblastic leukemia (2 points), and platelet count > 50 × 109/L at the time of diagnosis (1 point). The overall cumulative incidence of venous thromboembolism was 44% in the high-risk group (≥ 3 points) versus 10.5% in the low-risk group (0–2 points) and it was consistent at different follow-up periods (log-rank p < 0.001). We derived and internally validated a predictive score of venous thromboembolism risk in acute leukemia patients.
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Keng, Shao-Hsun. "The Effect of a Stricter Academic Dismissal Policy on Course Selection, Student Effort, and Grading Leniency." Education Finance and Policy 11, no. 2 (2016): 203–24. http://dx.doi.org/10.1162/edfp_a_00179.
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This paper uses data from a four-year college in Taiwan to examine the effect of adopting a stricter dismissal policy on course selection, student effort, and grading practices. Under the new rule, students are dismissed if they fail 50 percent or more credits in any two semesters as opposed to two consecutive semesters. The results show students who had failed 50 percent or more credit hours in a semester are more likely to strategically enroll in leniently graded courses after the policy change, especially in classes with a low failure rate. Study time and class attendance increase significantly after the policy change, suggesting the policy has achieved its goal of encouraging student effort. Instructors are found to grade more leniently after the policy change and the effect remains strong after student effort is controlled for. More importantly, instructors lower grading standards mainly through failing fewer students, as opposed to giving higher grades.
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Azman, Mawaddah, Balwant Singh Gendeh, and Siti Aishah Mat Ali. "Extramedullary Plasmacytoma of the Nasopharynx: A Rare Tumour with 7-Year Follow Up." Philippine Journal of Otolaryngology-Head and Neck Surgery 26, no. 1 (2011): 27–30. http://dx.doi.org/10.32412/pjohns.v26i1.599.
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Objective: To report a case of extramedullary plasmacytoma, a rare localized tumour involving
 the head and neck region in a 56-year -old gentleman.
 
 Methods:
 Design: Case Report
 Setting: Tertiary University Referral Center
 Patient: One
 
 Result: The patient presented with a 5-month history of right-sided nasal obstruction and intermittent epistaxis in 2003. Nasal endoscopy revealed a friable, dark red mass arising from the roof of the nasopharynx, occluding the right choana. No invasion of adjacent tissues or cervical lymphadenopathy was evident. A biopsy of the mass was diagnosed as plasmacytoma. Serum and urine electrophoresis failed to detect any monoclonal bands. All other screening tests to rule out multiple myeloma were negative. These findings confirmed the diagnosis of extramedullary plasmacytoma. He recieved radiotherapy to the nasopharynx of 50 Gy for a total of 23 fractions. No recurrence was noted at 7-year follow-up.
 
 Conclusion: Extramedullary plasmacytoma of the nasopharynx represents a tumour with good prognosis but requires long term follow up in anticipation of local recurrence and progression to Multiple Myeloma.
 
 Keywords: extramedullary, plasmacytoma, nasopharynx
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Graça, C. H., F. H. Passig, A. R. Kelniar, M. A. Piza, K. Q. Carvalho, and E. J. Arantes. "Multitemporal analysis of estimated soil loss for the river Mourão watershed, Paraná – Brazil." Brazilian Journal of Biology 75, no. 4 suppl 2 (2015): 120–30. http://dx.doi.org/10.1590/1519-6984.00613suppl.
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The multitemporal behavior of soil loss by surface water erosion in the hydrographic basin of the river Mourão in the center-western region of the Paraná state, Brazil, is analyzed. Forecast was based on the application of the Universal Soil Loss Equation (USLE) with the data integration and estimates within an Geography Information System (GIS) environment. Results had shown high mean annual rain erosivity (10,000 MJ.mm.ha–1.h–1.year–1), with great concentration in January and December. As a rule, soils have average erodibilities, exception of Dystroferric Red Latisol (low class) and Dystrophic Red Argisol (high class). Although the topographic factor was high (>20), rates lower than 1 were predominant. Main land uses comprise temporal crops and pasture throughout the years. The watershed showed a natural potential for low surface erosion. When related to usage types, yearly soil loss was also low (<50 ton.ha–1.year–1), with more critical scores that reach rates higher than 150 ton.ha–1.year–1. Soil loss over the years did not provide great distinctions in distribution standards, although it becames rather intensified in some sectors, especially in the center-eastern and southwestern sections of the watershed.
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Khatik, Neha, Arti Tiwari, and Kalpana Yadav. "Histopathological evaluation of endometrium and its clinical correlation in patients of abnormal uterine bleeding." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 10 (2020): 4169. http://dx.doi.org/10.18203/2320-1770.ijrcog20204308.
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Background: Abnormal uterine bleeding (AUB) is a very common, challenging gynaecological problem in all age group women. Neoplastic lesions are responsible for very less number of cases but they should be diagnosed early. Endometrial biopsy is necessary for histopathological diagnosis of endometrial lesions and to rule out any malignancy. In present study, we evaluated histopathological pattern of endometrium and different clinical parameters in AUB patients.Methods: A retrospective observational study done in Obstetrics and Gynecology department of SSMC Rewa, Madhya Pradesh in 2 year from 1st October 2017 to 30th September 2019. AUB patients who fulfilled inclusion criteria were included in study. All data were collected from department records in predesigned proforma and statistically analyzed by statistical package for the Social sciences (SPSS) version 20.Results: Total 366 AUB patients were included in study; most frequent clinical presentation was HMB (56%). Mostly patient’s age ranged from 24-84 years, belonged to 41-50 years age group (44%), multiparous (78%), and premenopausal (53%). On histopathological evaluation of endometrium most commonly nonneoplastic lesions (75%) were seen, out of which proliferative phase endometrium was most frequent. Neoplastic lesions were seen in 25% cases. Out of which benign lesions were noted in 7%, premalignant in 17.3% and malignant in 1% (all in >45 year patients).Conclusions: Endometrial biopsy should be done in all AUB patients >45 years and in selected premenopausal in order to get early diagnosis, to rule out malignancy and to help in management. Endometrial biopsy should be considered as first diagnostic modality.
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Singh, Jigyasa, Kalpana Kumari, and Vandana Verma. "Study of thrombocytopenia in pregnancy: clinical presentation and outcome at tertiary care rural institute." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 4 (2020): 1622. http://dx.doi.org/10.18203/2320-1770.ijrcog20201234.
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Background: Platelet count below 1.5 lakh/cumm is called as thrombocytopenia. After anaemia it is the second most common haematological disorder in pregnancy. It affects nearly 6 to 15%; on an average 10% of all pregnancies. Gestational thrombocytopenia is a clinically benign thrombocytopenic disorder usually occurring in late pregnancy. It resolves spontaneously after delivery.Methods: It is a hospital based prospective observational study over a period of 1 year. All pregnant women who attended OPD at the department of obstetrics and gynecology, UPUMS, Saifai for antenatal checkup were included for the study and blood sample was withdrawn.Results: Out of 263 cases enrolled for study, 90 women were found to have thrombocytopenia, and 173 had normal platelet count. Thus, incidence of thrombocytopenia was 34%. Gestational thrombocytopenia accounted for majority of cases of thrombocytopenia in pregnancy (50%) followed by hypertensive disorders (22.4%). It was further followed by ITP (11.11%) and dengue (5.5%).Conclusions: Gestational thrombocytopenia is the most common cause of thrombocytopenia during pregnancy (50%), but other underlying causes must be considered as well. A thorough history and physical examination will rule out most causes.
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Jones, Damon, David Molitor, and Julian Reif. "What do Workplace Wellness Programs do? Evidence from the Illinois Workplace Wellness Study*." Quarterly Journal of Economics 134, no. 4 (2019): 1747–91. http://dx.doi.org/10.1093/qje/qjz023.
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Abstract Workplace wellness programs cover over 50 million U.S. workers and are intended to reduce medical spending, increase productivity, and improve well-being. Yet limited evidence exists to support these claims. We designed and implemented a comprehensive workplace wellness program for a large employer and randomly assigned program eligibility and financial incentives at the individual level for nearly 5,000 employees. We find strong patterns of selection: during the year prior to the intervention, program participants had lower medical expenditures and healthier behaviors than nonparticipants. The program persistently increased health screening rates, but we do not find significant causal effects of treatment on total medical expenditures, other health behaviors, employee productivity, or self-reported health status after more than two years. Our 95% confidence intervals rule out 84% of previous estimates on medical spending and absenteeism.
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Malcolm, B., K. F. Smith, and J. L. Jacobs. "Perennial pasture persistence: the economic perspective." Crop and Pasture Science 65, no. 8 (2014): 713. http://dx.doi.org/10.1071/cp13419.
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Persistence of pasture in grazing systems has technical and economic dimensions. Profit from investment in pasture is maximised when the profit from the pasture is maximised over cycles of investments in pasture over the life of the farm business. The economic decision-rule is that an existing pasture should be replaced when the expected extra average addition to farm profit per year over the whole of the expected life of the next cycle of pasture investment exceeds the expected addition to farm profit from one more year of the existing pasture. This profit-maximising decision-rule means that the persistence of pasture is an economic phenomenon to be accounted for over several cycles of investment—a different concept to technical views that focus on the number of years of existence (i.e. persistence) of a pasture in one investment cycle. The number of years in which a pasture performs near peak potential annual dry matter (DM) production is a useful perspective on pasture persistence. The longer a pasture persists at peak level the more profitable. An empirical example was analysed of a pasture that had declined to carrying annually 6 dry sheep equivalents/ha (DSE/ha) and reinvestment occurred. The new pasture attained a peak of 11 000 kg/dry matter/ha in years 4–7, carrying an extra 15 DSE/ha.year, and declined to 50% of peak DM production by year 11, which was maintained until year 20. The modified internal rate of return for the base model of investing in pasture improvement was 12% real. The profit-maximising life of the pasture analysed was 8 years in repeated cycles over the life of the farm business. If this pasture produced at 65% of peak kg DM/ha for years 11–20, then the pasture was equally profitable whether the life of the pasture was any length from 8 to 20 years. If the pasture maintained production >65% of peak annual kg DM/ha, then longer pasture lives were more profitable than shorter lives.
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Nicolaides, Phedon. "‘The day after’." Maastricht Journal of European and Comparative Law 24, no. 2 (2017): 158–74. http://dx.doi.org/10.1177/1023263x17709749.
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The purpose of the two-year rule in Article 50 TEU is to prevent the remaining Member States from delaying the exit of the withdrawing Member State through stalling tactics. This article argues that the two-year period is a double-edge sword. It affords very little time to the withdrawing Member State to adjust its domestic legislation, regulatory system and administrative structure to be able to function effectively on the day after exit from the EU. The UK’s Great Repeal Bill proposes a ‘copy and paste’ approach. However, this approach is only a partial solution to the problem of the ‘exit-induced’ legal lacuna. With the use of two case studies, the article demonstrates that the UK will have to establish new regulatory procedures and redefine EU concepts inserted in national law. The UK will ‘regain control’ but will have to follow EU practice. At some point in the future it will also encounter the dilemma of diverging from EU practice and creating two sets of compliance standards for its companies.
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Sesay, Max Ahmadu. "Politics and Society in Post-War Liberia." Journal of Modern African Studies 34, no. 3 (1996): 395–420. http://dx.doi.org/10.1017/s0022278x0005552x.
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The brutal civil war that engulfed Liberia, following Charles Taylor's invasion in December 1989, has left an indelible mark in the history of this West African state. The six-year old struggle led to the collapse of what was already an embattled economy; to the almost complete destruction of physical infrastructure built over a century and half of enterprise and oligarchic rule; to the killing, maiming, and displacement of more than 50 per cent of the country's estimated pre-war population of 2·5 million; and to an unprecedented regional initiative to help resolve the crisis. Five years after the Economic Community of West African States (Ecowas) intervened with a Cease-fire Monitoring Group (Ecomog), an agreement that was quickly hailed as the best chance for peace in Liberia was signed in August 1995 in the Nigeriancapital, Abuja.
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Takkar, Aastha, Veenu Singla, Manish Modi, Vivek Gupta, Manoj K. Goyal, and Vivek Lal. "Rapidly progressive dementia: an unusual cause." Neuroradiology Journal 30, no. 4 (2017): 336–38. http://dx.doi.org/10.1177/1971400917706083.
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Brain metastases are known to be present with a history of increased intra-cranial pressure headache, seizures or altered sensorium. Corresponding to the clinical brain metastases are the most feared complication of a systemic cancer. Classically, brain metastases are associated with significant morbidity and are known to present with a history of increased intracranial pressure headache, seizures or altered sensorium. Neuroimaging is usually suggestive of massive peri-lesional edema and mass effect surrounding the space occupying lesions. This, however it is not a universal rule. We report a 50-year-old gentleman who presented with rapidly progressive forgetfulness. Interestingly, the patient’s neuroimaging discretely showed disproportionate involvement with regards to the clinical picture. The lesions were finally recognized as metastases underscoring the importance of an avid search for a primary systemic malignancy if similar findings are noted on radiology.
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Cardina, John, Catherine P. Herms, and Daniel A. Herms. "Phenological Indicators for Emergence of Large and Smooth Crabgrass (Digitaria sanguinalisandD. ischaemum)." Weed Technology 25, no. 1 (2011): 141–50. http://dx.doi.org/10.1614/wt-d-10-00034.1.
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We studied the emergence phenology of large and smooth crabgrass in lawn and bare soil environments and identified ornamental plants as phenological indicators that predict the progress of emergence. From 2002 to 2004, we monitored emergence of large and smooth crabgrass in field plots to estimate the dates of first emergence, and 25, 50 and 80% emergence. Each year, we monitored 74 taxa of ornamental plants to determine dates of first and full bloom. We compiled dates of weed emergence and ornamental blooming to create a biological calendar of phenological events for each year, ordered by average cumulative degree days (DD) (January 1 start date, 10 C base temperature). Ornamental plant flowering events that occurred in a regular sequence before crabgrass emergence events were identified as the phenological indicators. We also evaluated DD and rule-based models for predicting crabgrass emergence and optimum time of PRE herbicide application. In general, smooth crabgrass reached each emergence stage earlier than large crabgrass. Differences in emergence between environments were not consistent over years for the two species. There was no consistent pattern in parameters for DD models predicting emergence events for either crabgrass species or environment. For published DD models, the deviation between observed and predicted emergence events ranged from 0 to > 60 d. Published rule-based predictions, though accurate in some cases, were sometimes difficult to implement. The order of ornamental plant blooming and crabgrass emergence events was generally consistent over years (R2= 0.977). The biological calendar provided useful crabgrass emergence predictions using real-time field-based indicators of sequential biological events that can help managers plan and optimize management strategies.
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Jermendy, György, and Gábor Kovács. "A glargin és glulizin inzulinnal folytatott bázis-bolus kezelési rendszer egyéves eredményessége 2-es típusú cukorbetegségben. Elemzés a gyógyszerár-támogatás tükrében." Orvosi Hetilap 159, no. 50 (2018): 2122–28. http://dx.doi.org/10.1556/650.2018.31214.
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Abstract: Introduction: Being entitled for no patient co-payment, the Hungarian reimbursement condition of analogue insulins as part of basal-bolus treatment in type 2 diabetes mellitus (T2DM) requires that two HbA1c levels should achieve <8.0% target value within 12 months (measured two months apart) after switching from treatment with human insulins. Achieving this target, the treatment should be considered effective from drug reimbursement perspective. Aim: The aims of the study were to investigate the effectiveness of insulin glargine + insulin glulisine basal-bolus regimen from the payer’s perspective and to investigate the ability to maintain the achieved glycaemic control in previously uncontrolled T2DM patients (HbA1c >9.0%). Method: This one-year, non-interventional study included patients with T2DM inadequately controlled (HbA1c >9.0%) on previous human basal-bolus treatment. The main outcomes were the proportion of patients who achieved the adequate glycaemic control (defined by the reimbursement rules) and the proportion of patients who achieved reimbursement rules defined HbA1c <8.0% target value by the 6 months after switch and could maintain this glycaemic control for upcoming further 6 months. As safety outcome, the hypoglycaemic events were recorded. Results: Out of the 557 patients enrolled, 287 had available data to be included in the efficacy analysis. Out of the 287 efficacy analysis patients, 169 (58.9%) achieved the reimbursement rules defined glycaemic control. At 6 months, 167 patients had HbA1c value <8.0% and 152 (91.0%) remained in this target range until the end of the 12-month observational period. Overall, 1221 non-severe and 6 severe hypoglycaemic events were reported. Conclusions: More than half of the patients with T2DM who were newly switched to insulin glargine + glulisine basal-bolus treatment could achieve the reimbursement rule criteria requiring for prescription of the analogue insulins with no co-payment beyond 1 year of treatment in Hungary. However, the results revealed that glycaemic control assessment with HbA1c measurements had not met the reimbursement requirements in a significant part of patients. Orv Hetil. 2018; 159(50): 2122–2128.
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Marbacher, Serge, Alexander Spiessberger, Michael Diepers, Luca Remonda, and Javier Fandino. "Early Intracranial Aneurysm Recurrence after Microsurgical Clip Ligation: Case Report and Review of the Literature." Journal of Neurological Surgery Reports 79, no. 04 (2018): e93-e97. http://dx.doi.org/10.1055/s-0038-1676454.
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AbstractMicrosurgical clip ligation is considered a definitive treatment for intracranial aneurysms (IAs), resulting in low rates of local recurrence that range from 0.2 to 0.5% and a latency period that averages about a decade. Our case report describes an early asymptomatic recurrence (i.e., without sentinel headache or seizure) less than 1 year after this 20-year-old woman underwent clip ligation of a ruptured anterior communicating artery (AComA) aneurysm. At recurrence, the patient underwent coiling of the regrowth; follow-up imaging at 6 and 18 months demonstrated complete IA occlusion. To review the putative risk factors of this rare phenomenon, the authors searched the PubMed database using the keywords “intracranial aneurysm,” “recurrence,” and “clipping” in various combinations. In the seven cases identified, all occurred in initially ruptured IA, which was often at the AComA, and six of seven patients were younger than 50 years old. Although most IA remnants grow slowly, early recurrence may represent a more aggressive biological behavior that warrants special attention in younger patients, positive rupture status, and unintended remnant of any size. In such a constellation, early imaging follow-up within the first 6 months may be warranted to rule out early IA recurrence
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Camara-Lemarroy, Carlos R., Adrian Infante-Valenzuela, Hector J. Villareal-Montemayor, Carlos A. Soto-Rincon, Javier A. Davila-Olalde, and Hector J. Villareal-Velazquez. "Eosinophilic Granulomatosis with Polyangiitis Presenting as Acute Polyneuropathy Mimicking Guillain-Barre Syndrome." Case Reports in Neurological Medicine 2015 (2015): 1–3. http://dx.doi.org/10.1155/2015/981439.
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Eosinophilic granulomatosis with polyangiitis (EGPA) is a small-vessel vasculitis associated with antineutrophil cytoplasmic antibodies (ANCAs) which commonly affects the peripheral nervous system. A 38-year-old female with a history of asthma presented with a 2-week history of bilateral lower extremity paresthesias that progressed to symmetric ascending paralysis. Nerve conduction studies could not rule out Guillain-Barre syndrome (GBS) and plasmapheresis was considered. Her blood work revealed marked eosinophilia (>50%), she had purpuric lesions in her legs, and a head magnetic resonance image showed evidence of pansinusitis. Coupled with a history of asthma we suspected EGPA-associated neuropathy and started steroid treatment. The patient showed rapid and significant improvement. ANCAs were later reported positive. ANCA-associated vasculitides present most often as mononeuritis multiplex, but they can mimic GBS and should always be considered in the differential diagnosis, since the treatment strategies for these conditions are radically different.
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Lv, Li Qun, Ning Sheng Chen, Yang Lu, Qi Huang, Jun Li, and Yun Hua Zhu. "Characteristics and Mechanics Analysis of Debris Flow Disaster in Xinjiang Arid Area." Advanced Materials Research 594-597 (November 2012): 2318–22. http://dx.doi.org/10.4028/www.scientific.net/amr.594-597.2318.
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Xinjiang arid area is characterized by low rainfall, strong evaporation capacity, sparse vegetation, intensive tectonic movement, and fragile ecological environment ; the rainfall-type debris flow in the arid area are obviously different from the same type debris flow in humid and subhumid area of China with conditions of rainfall excitation, watershed morphology, motion and deposition processes, material composition, active period and disaster mechanism. Investigations and analyses of characteristics of rainfall-type debris flow in the arid area will reveal the rule of the occurrence and development and explore the evolution trends, to establish reasonable disaster reduction measures. Qiaoquli gully located in Kashgar is a typical arid area rainfall debris flow gully. The 50-year frequency outbreak of debris flow in 2005 destroyed chinapakistan highway . Further investigation to this debris flow gully will contribute to our understanding of this kind of debris flow disaster characteristics and mechanism.
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Cairns, A. J. G. "An Analysis of the Level of Security Provided by the Minimum Funding Requirement." British Actuarial Journal 5, no. 3 (1999): 585–610. http://dx.doi.org/10.1017/s1357321700000581.
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ABSTRACTIn this paper we investigate the effectiveness of the Minimum Funding Requirement (MFR) (pre-1999 version) under random future investment conditions. In particular, do the various liabilities calculated under the MFR deliver a suitable level of security to pension scheme members?The paper considers active (and deferred) members and current pensioners separately.For active members, Monte Carlo simulation is used to compare how the proceeds arising from investment of the pre-1999 MFR liability in an equity-backed personal pension would compare with the deferred pension promised by the scheme. It is found that, while there may be the intended 50% chance that the personal pension has a better outcome, there are very substantial downside risks for younger members. Investment strategies based upon index-linked gilts are shown to result, on average, in lower personal pensions, but they provide an extremely effective means of limiting the downside risks.For pensioners, Monte Carlo simulation is used to find the distribution of the initial amount of assets required to pay off precisely the pension liabilities as they arise. This investigation considers the effectiveness of the 12-year rule and different investment strategies. The 12-year rule in combination with an equivalent investment strategy is shown to provide reasonable security for a typical group of pensioners. However, if investments are restricted to an appropriate mixture of gilts then the level of security for pensioners is much increased. In particular, we investigate the use of value-at-risk reserves. It is found that 95% value-at-risk reserves are lower for a mixed conventional/index-linked gilts strategy than a mixed gilts/equity strategy.It is argued, because of the high degree of downside risk, that there is no place in MFR calculations for high, anticipated equity returns. Instead rates of interest should be based solely upon fixed-interest and index-linked gilt yields.
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Bidaki, Reza, Azam Ghanei, Seyed Mehdi Hosseinizade, and Mohammad Ebrahim Ghanei. "Von Hippel-Lindau Tumor; Radiographic Images." Internal Medicine and Medical Investigation Journal 2, no. 1 (2017): 30. http://dx.doi.org/10.24200/imminv.v2i1.52.
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The patient is a 34-year-old patient with abdominal pain, gross hematuria with anxiety and worries about it from 5 months ago. The physician requested renal computed tomography (CT) without and then with contrast for rule out of renal stone. However, he found multiple lesions in kidneys. The laboratory tests were normal except hematuria. He was a candidate for surgery. The pathologist reported clear red cell renal cell carcinoma. He was referred to a radiologist for staging. Von Hippel – Lindau (VHL) disease is an inherited and rare disease that is characterized by a variety of benign and malignant lesions (1). It preval ence is 1 in 31,000 -53,000 (2,3). Previous studies shown 59 – 63% of patients have renal cysts and 24 - 45 % renal cell carcinoma (4), and in 75 % of cases ,the lesions are bilateral (4, 5). Involvement of pancreas includes simple cysts (50 – 91%), serous m icrocystic adenomas (12%) and adenocarcinoma (7%) (2, 4).
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Kumar, Satish Chandra, Avinash Kumar Sinha, and Saurabh Singh. "Seborrahic keratitis: a benign pigmented skin lesion management." International Journal of Research in Medical Sciences 6, no. 11 (2018): 3776. http://dx.doi.org/10.18203/2320-6012.ijrms20184449.
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Seborrhoeic keratosis are formed from the basal layer of epidermal cells and contain melanocytes. Many terms such as senile wart, melanoacanthoma, basal cell papilloma, senile keratosis and seborrhoeic wart have been applied, but seborrhoeic keratosis is the most widely accepted term. In our case a 50-year-old female presented to the surgery OPD with a painless pigmented skin lesion 2.5cm lateral to the left lateral canthus and 1cm below the hairline of size of 4 *4cm. Pigmented lesion was from last 8 years and slowly progressive in nature and was not associated with any co morbid conditions. On clinical evaluation the clinical diagnosis of epidermal nevus was given and an excisional biopsy with rhomboid flap placement was performed and the tissue was sent for histopathological examination. Post operative period was uneventful and the histopathology report states the seborrhoeic keratosis. Hence, lesions for which the diagnosis is uncertain, based on the history and gross examination, should be biopsied for histopathologic examination to rule out malignancy.
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Singh, Chandra Veer, Shravan Shetty, R. K. Deshpande, and Priyank Patel. "Rare cervical nerve root C2-C3 schwannoma." International Journal of Otorhinolaryngology and Head and Neck Surgery 3, no. 4 (2017): 1123. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20174347.
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<p class="abstract"><span lang="EN-IN">10% of schwannomas that occur in the head and neck region mostly originate from the vagus or sympathetic nervous system whereas those arising from C2 nerve root are extremely rare. Extracranial schwannomas in the head and neck region are rare neoplasms. Diagnosis is established by imaging studies such as magnetic resonance imaging or computed tomography, while FNAC is used to rule out other condition. Histopathology gives definitive diagnosis. The accepted treatment for these tumors is surgical resection with preservation of the neural pathway. We present a rare case of cervical nerve (C2-C3) root schwannoma of 50 year old male who presented with right lateral neck swelling with pain radiating to right shoulder associated with right shoulder stiffness</span>. The swelling which also had an intervertebral part <span lang="EN-IN">was removed successfully through a posterior neck incision with no post-operative neurological symptoms.</span></p>
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Pires da Rosa, Gilberto, Francisca Costa, Joana Guimarães, and Fernando Friões. "Seronegative neuromyelitis optica spectrum disorder: severe polysymptomatic presentation with successful treatment response." BMJ Case Reports 12, no. 3 (2019): e228553. http://dx.doi.org/10.1136/bcr-2018-228553.
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We report the case of a 50-year-old caucasian man presenting with lumbar pain, bilateral ataxia, central facial palsy, ophthalmoparesis and urinary retention. Cerebral MRI hinted a hyperintensity of the medulla oblongata and cervical medulla suggestive of myelitis. Cerebrospinal fluid displayed lymphocytic pleocytosis and elevated protein concentration. Without the possibility to rule out an infectious or inflammatory aetiology, antibiotics and corticosteroids were started. Nevertheless, neurological status deteriorated with loss of muscle strength and left eye amaurosis. A neuroaxis MRI exhibited encephalomyelitis with signal abnormalities involving the pons, medulla oblongata, left optic nerve and cervicodorsal medulla. Although negative for aquaporin-4-IgG antibodies, the patient fulfilled criteria for seronegative neuromyelitis optica spectrum disorder with the presence of multiple core clinical characteristics. Through early institution of corticosteroids, plasma exchange and rituximab, good functional recovery was achieved (Expanded Disability Status Scale score of 2). However, left eye amaurosis persisted despite salvage therapy with intravenous immunoglobulin.
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Krithika, Muralidhara, and Dhareshwar Shashank. "Severe hypertriglycerdemia in pregnancy." Clinical Journal of Obstetrics and Gynecology 4, no. 1 (2021): 019. http://dx.doi.org/10.29328/journal.cjog.1001080.
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31 year old female presented with abdominal pain and respiratory distress in the third trimester of her second pregnancy. Her blood workup revealed a lipemic sample (Figure 1) due to markedly elevated serum triglycerides of 8178 mg/dl (Glycerol Phosphate Oxidase method). Total cholesterol and Low Density Lipoprotein were elevated at 1701 mg/dl and 788 mg/dl respectively. There was no family history of lipid disorders. Diagnosis was consistent with gestational hypertriglyceridemia with acute pancreatitis (Serum Amylase-50 U/L, Serum Lipase- 96 U/L), though genetic tests to rule out pre-existing primary hypertriglyceridemia was not feasible. In view of the life threatening condition, she was initiated on Insulin-Dextrose infusion and offered one session of Plasma Exchange. Figures 2,3 depict membrane plasma separation with the obtained effluent as lipemic plasma. Her serum triglycerides showed a declining trend and was discharged in good health (serum triglycerides at discharge-651 mg/dl).
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Fischer, Jean-Paul, and Christophe Luxembourger. "The Battle between the Correct and Mirror Writings of a Digit in Children’s Recognition Memory." Education Sciences 10, no. 7 (2020): 183. http://dx.doi.org/10.3390/educsci10070183.
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Recent research into character reversals in writings produced by occidental children has shown that they mainly reverse the left-oriented digits (1, 2, 3, 7, and 9) and therefore appear to apply a right-orienting rule. But do they produce similar reversal errors when asked to recognize the digits? In an experiment, based on eye-tracking observations of 50 children (Mage = 5.4 years), children had to point towards a target digit in a 2 × 2 matrix also containing three distractor digits, one of which was the mirror-reversed writing of the correctly written target digit. This recognition task led to a true “battle” in children’s memory between the two writings of the target digit. This battle is shown in the graphical abstract that represents a heat map from a sub-sample of children (on the left side) and the fixation points map from an individual child (on the right side). Rather than following the predicted right-orienting rule, the children’s responses appeared to be biased towards digits in the right-hand column of the 2 × 2 matrices (when the reversed target digit was not in the same column as the correctly written target digit). As a whole, these findings support the hypotheses that many 4- to 6-year-old’s representations of the digit writings are unoriented in their memory and that these children may adopt different solutions to overcome this lack of orientation depending on whether they write or read.
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Menon, Usha, Andy Ryan, Jatinderpal Kalsi, et al. "Risk Algorithm Using Serial Biomarker Measurements Doubles the Number of Screen-Detected Cancers Compared With a Single-Threshold Rule in the United Kingdom Collaborative Trial of Ovarian Cancer Screening." Journal of Clinical Oncology 33, no. 18 (2015): 2062–71. http://dx.doi.org/10.1200/jco.2014.59.4945.
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Purpose Cancer screening strategies have commonly adopted single-biomarker thresholds to identify abnormality. We investigated the impact of serial biomarker change interpreted through a risk algorithm on cancer detection rates. Patients and Methods In the United Kingdom Collaborative Trial of Ovarian Cancer Screening, 46,237 women, age 50 years or older underwent incidence screening by using the multimodal strategy (MMS) in which annual serum cancer antigen 125 (CA-125) was interpreted with the risk of ovarian cancer algorithm (ROCA). Women were triaged by the ROCA: normal risk, returned to annual screening; intermediate risk, repeat CA-125; and elevated risk, repeat CA-125 and transvaginal ultrasound. Women with persistently increased risk were clinically evaluated. All participants were followed through national cancer and/or death registries. Performance characteristics of a single-threshold rule and the ROCA were compared by using receiver operating characteristic curves. Results After 296,911 women-years of annual incidence screening, 640 women underwent surgery. Of those, 133 had primary invasive epithelial ovarian or tubal cancers (iEOCs). In all, 22 interval iEOCs occurred within 1 year of screening, of which one was detected by ROCA but was managed conservatively after clinical assessment. The sensitivity and specificity of MMS for detection of iEOCs were 85.8% (95% CI, 79.3% to 90.9%) and 99.8% (95% CI, 99.8% to 99.8%), respectively, with 4.8 surgeries per iEOC. ROCA alone detected 87.1% (135 of 155) of the iEOCs. Using fixed CA-125 cutoffs at the last annual screen of more than 35, more than 30, and more than 22 U/mL would have identified 41.3% (64 of 155), 48.4% (75 of 155), and 66.5% (103 of 155), respectively. The area under the curve for ROCA (0.915) was significantly (P = .0027) higher than that for a single-threshold rule (0.869). Conclusion Screening by using ROCA doubled the number of screen-detected iEOCs compared with a fixed cutoff. In the context of cancer screening, reliance on predefined single-threshold rules may result in biomarkers of value being discarded.
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Kovac, Mitja. "The Brexit Fiasco and the Failure of Article 50 of the Treaty on the Functioning of the European Union." Baltic Journal of Law & Politics 12, no. 1 (2019): 172–92. http://dx.doi.org/10.2478/bjlp-2019-0008.
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Abstract Modern game theory and the economic theory of federalism may offer an alternative view on the Brexit fiasco, in which the British government should not bear exclusive responsibility for current disaster. Moreover, the design of Article 50 of the Treaty on the Functioning of the European Union (TFEU) contains an intrinsic dysfunctional mechanism that generates irrational strategies. Article 50 is underdeveloped and should be redrafted. The two-year deadline provision should be replaced with a reasonable time period and should provide for a third-party dispute resolution mechanism in instances where free negotiations between the EU and the withdrawing Member State in the reasonable time period fail to achieve a winwin solution. This article also argues that the current sub-optimal institutional framework on the vertical and horizontal division of competences might be an additional generator of Euroscepticism. In order to prevent the decline of public support the EU should do less in current fields and should do much more in fields where it failed to exercise its authority and which cannot be addressed effectively at the local levels. The EU should redesign itself as an institution that mitigates broad potential sources of negative externalities, reinforcing the rule of law, protecting liberal democracy with all related civil liberties, reinforcing its political-global dimension, protecting its common cultural heritage, and combating destructive nationalisms, isolationisms and cultural introspections.
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Albenque, Grégoire, Yohann Bohbot, Quentin Delpierre, and Christophe Tribouilloy. "Basal Takotsubo syndrome with transient severe mitral regurgitation caused by drug use: a case report." European Heart Journal - Case Reports 4, no. 2 (2020): 1–6. http://dx.doi.org/10.1093/ehjcr/ytaa028.
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Abstract Background Takotsubo syndrome (TTS) is a reversible cardiomyopathy. Little is known regarding its basal form and possible complications. Case summary A 31-year-old woman with no medical history was hospitalized for attempted suicide by ingestion of cocaine, benzodiazepine, and methadone. Initially, the patient received intensive care for coma and bradypnoea. After naloxone administration, the neurological situation improved, but the patient developed acute pulmonary oedema. Transthoracic echocardiography (TTE) revealed left ventricular systolic dysfunction with the basal wall’s akinesia associated with moderate to severe restrictive mitral regurgitation. Global longitudinal strain (GLS) was impaired mainly in the basal segments. A coronary computed tomography ruled out coronary artery disease. Symptoms improved quickly under diuretic treatment. Transthoracic echocardiography at Day 6 showed improved basal wall contraction, with a left ventricular ejection fraction (LVEF) of 50% and moderate mitral regurgitation. TTE at Day 30 confirmed the diagnosis of myocardial infarction with non-obstructive coronary arteries related to a basal TTS after complete recovery of the LVEF, normalization of the wall motion and GLS, and the absence of residual mitral regurgitation. Discussion We report a case of acute pulmonary oedema due to basal TTS complicated by severe transient mitral regurgitation associated with moderate left ventricular dysfunction. Measuring strain by speckle-tracking can be useful to diagnose and monitor this entity. The use of coronary computed tomography is informative in young patients to rule-out coronary artery disease.
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Pothier, David. "Développement de sapinières éclaircies exposées à une épidémie de tordeuse des bourgeons de l'épinette." Forestry Chronicle 74, no. 1 (1998): 91–99. http://dx.doi.org/10.5558/tfc74091-1.
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In 1968, three intensities of low thinning were applied in 33-year-old balsam fir (Abies balsamea [L.] Mill.) stands of eastern Québec in order to remove 0, 20 and 30% of the total basal area. Sample plots were located in two distinct areas, one of which was annually sprayed with insecticides between 1978 and 1982 while the other was never protected against a spruce budworm (Choristoneura fumiferana [Clem.]) outbreak that occurred between 1976 and 1983. A total of 32 0.04-ha sample plots were periodically measured between 1968 and 1994. Low thinnings mostly removed non merchantable trees (DBH < 9.1 cm) and left 5 000 to 7 000 trees/ha while stand density of control plots reached 10 000 stems/ha. From 1968 to 1976, net annual increment in merchantable volume was around 8 m3/ha but no differences were detected between thinning levels. During the period of severe defoliation caused by spruce budworm (1976-1985), net annual increment in merchantable volume of sample plots sprayed with insecticides decreased by 50% but get back to its initial level after 1985. Net annual increment of sample plots that were never protected against spruce budworm was strongly negative during the outbreak period until the extinction of all trees was completed. While thinning level only slightly affected merchantable yield of sample plots during the 26-year period, mean annual increment in DBH was inversely proportional to stand density. This advantage of thinned plots could have been greater if stand density had been reduced further at the beginning of the study. Indeed, the analysis of the evolution of stand density as a function of mean volume of trees shows that mortality rate of all sample plots was similar to that given by the self-thinning rule. This suggests that even trees of most heavily thinned plots suffered from strong intra-specific competition. Key words: balsam fir, low thinning, spruce budworm, growth and yield, diameter increment, self-thinning rule
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Leerink, Jan M., Simone J. Verkleij, Elizabeth A. M. Feijen, et al. "Biomarkers to diagnose ventricular dysfunction in childhood cancer survivors: a systematic review." Heart 105, no. 3 (2018): 210–16. http://dx.doi.org/10.1136/heartjnl-2018-313634.
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ObjectiveTo systematically review the literature and assess the diagnostic value of biomarkers in detection of late-onset left ventricular (LV) dysfunction in childhood cancer survivors (CCS) treated with anthracyclines.MethodsWe systematically searched the literature for studies that evaluated the use of biomarkers for detection of LV dysfunction in CCS treated with anthracyclines more than 1 year since childhood cancer diagnosis. LV dysfunction definitions were accepted as an ejection fraction <50% or <55% and/or a fractional shortening <28%, <29% or <30%. Contingency tables were created to assess diagnostic accuracies of biomarkers for diagnosing LV dysfunction.ResultsOf 1362 original studies screened, eight heterogeneous studies evaluating four different biomarkers in mostly asymptomatic CCS were included. In four studies, an abnormal N-terminal pro-B-type natriuretic peptide (NT-proBNP, cut-off range 63–125 ng/L) had low sensitivity (maximally 22%) and a specificity of up to 97% for detection of LV dysfunction. For troponin levels, in five studies one patient had an abnormal troponin value as well as LV dysfunction, while in total 127 patients had LV dysfunction without troponin elevations above cut-off values (lowest 0.01 ng/mL). Two studies that evaluated brain natriuretic peptide and nitric oxide were underpowered to draw conclusions.ConclusionsIn individual studies, the diagnostic value of NT-proBNP for detection of LV dysfunction in CCS is limited. Troponins have no role in detecting late-onset LV dysfunction with cut-off values as low as 0.01 ng/mL. Further study on optimal NT-proBNP cut-off values for rule out or rule in of LV dysfunction is warranted.
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Bornmann, Lutz. "Which research institution performs better than average in a subject category or better than selected other institutions?" Online Information Review 42, no. 2 (2018): 222–37. http://dx.doi.org/10.1108/oir-08-2015-0276.
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Purpose Institutional bibliometric analyses compare as a rule the performance of different institutions. The purpose of this paper is to use a statistical approach which not only allows a comparison of the citation impact of papers from selected institutions, but also a comparison of the citation impact of the papers of these institutions with all other papers published in a particular time frame. Design/methodology/approach The study is based on a randomly selected cluster sample (n=4,327,013 articles and reviews from 2000 to 2004), which is drawn from a bibliometric in-house database including Web of Science data. Regression models are used to analyze citation impact scores. Subsequent to the models, average predictions at specific interesting values are calculated to analyze which factors could have an effect on the impact scores-the journal impact factor (JIF), of the journals which published the papers and the number of affiliations given in a paper. Findings Three anonymous German institutions are compared with one another and with the set of all other papers in the time frame. As an indicator of institutional performance, fractionally counted PPtop 50% on the level of individual papers are used. This indicator is a normalized impact score whereas each paper is fractionally assigned to the 50 percent most frequently cited papers within its subject category and publication year. The results show that the JIF and the number of affiliations have a statistically significant effect on the institutional performance. Originality/value Fractional regression models are introduced to analyze the fractionally counted PPtop 50% on the level of individual papers.
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Kriz, Peter, Gregory Lockhart, Steven Staffa, et al. "EFFECT OF PENALTY MINUTE RULE CHANGE ON INJURIES AND GAME DISQUALIFICATION PENALTIES IN HIGH SCHOOL ICE HOCKEY." Orthopaedic Journal of Sports Medicine 7, no. 3_suppl (2019): 2325967119S0002. http://dx.doi.org/10.1177/2325967119s00021.
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EFFECT OF PENALTY MINUTE RULE CHANGE ON INJURIES AND GAME DISQUALIFICATION PENALTIES IN HIGH SCHOOL ICE HOCKEY Background: Ice hockey has experienced a 44% increase in participation among 6 to 17-year-old players from 2009-2014 in the United States. Body checking remains legal among male youths at bantam through junior levels and in high school (HS) hockey. In the U.S., nearly 45,000 players (35,210 boys and 9,599 girls) participate in HS ice hockey, with ˜12,000 players 19 years and younger seeking care in emergency departments (ED) for ice hockey-related injuries annually. Recent efforts have focused on reducing dangerous hits and fighting at all levels of ice hockey. Rule changes such as Fair Play have proven successful in reducing injury risk, but have not been widely implemented at state, regional, or national levels. The purpose of our study was to determine the effect of a penalty minute (PIM) rule change in HS boys’ ice hockey on injuries and game disqualification penalties. Methods: Retrospective cohort study. Injury data were collected from 2 hospital systems in Rhode Island (RI), and game/penalty data were collected through the RI Hockey Coaches Association website. Participants included HS boys’ hockey varsity players ages 13-19 years presenting to 5 RI hospital emergency departments (ED) for hockey-related injuries during 6 seasons (December 2012 to April 2018). Rule change for 2015-16 season implemented varying suspensions for players accumulating = 50 PIM and = 70 PIM during regular season and playoffs. Injuries were classified as body checking-related or non-body checking related, and injury rates pre- vs. post-rule change were compared using the Cochran-Mantel-Haenszel Chi-square test. Multivariable logistic regression was used to derive odds ratios. A sample of 18,000 emergency department visits prior to the rule change and 18,000 emergency department visits after the rule change provides over 90% power to detect a 15% reduction in the odds of sustaining body checking injury requiring ED visit, assuming a body checking ED injury rate of 5% prior to the rule change, a correlation between study period ED visit rates of 0.5, and a two-sided alpha level of 0.05. Power analyses were performed in nQuery Advisor version 8.2.0 (Statistical Solutions Ltd., Cork, Ireland). Results: During the study period, a total of 1,762 boys’ HS varsity hockey games were played. Of 134 HS varsity game-related injuries presenting to the ED, 82 (61.2%) were attributable to body checking. Most (67.2%) injured players presented to Level I trauma centers, while 17.2% received transport by Emergency Medical Services. Regarding injury severity, 97.8% of injuries were non-catastrophic, while 2.2% were categorized as catastrophic serious (1 type 3 C2 dens fracture, non-displaced; 2 splenic lacerations, 1 requiring splenectomy). Three catastrophic serious injuries occurred, two of which occurred post-rule change (both splenic lacerations). The penalty minute rule change was associated with a significant reduction in all injuries (OR 0.55; 95% CI, 0.35-0.86; P = 0.008), concussion/closed head injury (OR 0.44; 95% CI, 0.23-0.85; P = 0.012), and concussion/closed head injury and upper body injury combined (OR 0.50; 95% CI, 0.31-0.80: P = 0.003). Game disqualification penalties per season were not significantly reduced following the rule change, occurring in 5.2% of games before and 4.4% of games after the rule change (OR 0.84; 95% CI, 0.54 – 1.31; P = 0.440). Conclusion/Significance: Implementation of a statewide PIM restriction rule change effectively reduced the mean number of game-related injuries per season in HS boys’ hockey varsity players. To our knowledge, this is the first study to demonstrate a statistically significant reduction in concussion/closed head injury following implementation of a Fair Play rule change at any level of ice hockey. Despite implementation of strategies to reduce intent-to-harm hits in recent years, the potential for serious head, neck, and spinal injury remains in high school boys’ ice hockey as body checking remains legal. Current opinion among sports medicine experts remains that rule changes designed to reduce injury risk are among the most effective ways to decrease traumatic injuries such as concussion. Rule changes in collision sports can effectively mitigate injury risk without fundamentally changing the sport. Implementation of PIM rule change in HS boys’ ice hockey in other states/provinces would allow assessment of significance of rule mandate as it relates to injury reduction. Future research utilizing prospective, longitudinal study designs and data collection by certified athletic trainers can provide state high school associations and other governing bodies of sport essential data to develop policy changes targeting injury reduction. Our study design could be extrapolated to other high school collision sports such as football, lacrosse, and rugby to determine the effects of rule change on collision sport injury rates. [Table: see text][Table: see text][Table: see text][Table: see text][Figure: see text]
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Chang, Kiki D. "Rapid Cycling in Children." CNS Spectrums 9, S2 (2004): 5–6. http://dx.doi.org/10.1017/s1092852900026390.
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Presence of rapid cycling appears to be the rule rather that the exception in children with bipolar disorder, although there is not much data to support this clinical notion. Geller and colleagues studied 93 pediatric patients with bipolar disorder, mean age 10.9 years. They found that 87% had rapid cycling defined as ≥4 episodes/year and 77% had ultradian cycling, defined as >365 episodes/year. In addition, Findling and colleagues studied 90 bipolar patients with a mean age of 10.8 years and found that 50% had rapid cycling by veteran CV criteria. (The study did not look at ultra-rapid or ultradian cycling.) Finally, using clinical interviews to study children with affective illness, Schraufnagel and colleagues found that 41% experienced >365 cycles/year (Slide 6).It is difficult to figure out the difference between a cycle and an episode when children are cycling so quickly. Tillman and Geller proposed that any kind of mood switching constitutes a cycle. An episode, they proposed, is defined as having ≥2 weeks of mood symptoms with either onset and offset of one mood state within that 2 weeks, or onset and offset of a period of ultra-rapid or ultradian cycling. It appears that with younger age comes more rapid cycling and more mixed states, which can be confused with ultra-rapid cycling. In turn, the older the child gets, the less rapid cycling occurs, and the more episodic the disorder becomes with more euphoria and less irritability. However, this tendency has not been well studied.
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Foxley-Marrable, Max, Thomas E. Collett, Chris Frohmaier, et al. "Observing the earliest moments of supernovae using strong gravitational lenses." Monthly Notices of the Royal Astronomical Society 495, no. 4 (2020): 4622–37. http://dx.doi.org/10.1093/mnras/staa1289.
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ABSTRACT We determine the viability of exploiting lensing time delays to observe strongly gravitationally lensed supernovae (gLSNe) from first light. Assuming a plausible discovery strategy, the Legacy Survey of Space and Time (LSST) and the Zwicky Transient Facility (ZTF) will discover ∼110 and ∼1 systems per year before the supernova (SN) explosion in the final image, respectively. Systems will be identified $11.7^{+29.8}_{-9.3}$ d before the final explosion. We then explore the possibility of performing early-time observations for Type IIP and Type Ia SNe in LSST-discovered systems. Using a simulated Type IIP explosion, we predict that the shock breakout in one trailing image per year will peak at ≲24.1 mag (≲23.3) in the B-band (F218W), however evolving over a time-scale of ∼30 min. Using an analytic model of Type Ia companion interaction, we find that in the B-band we should observe at least one shock cooling emission event per year that peaks at ≲26.3 mag (≲29.6) assuming all Type Ia gLSNe have a 1 M⊙ red giant (main sequence) companion. We perform Bayesian analysis to investigate how well deep observations with 1 h exposures on the European Extremely Large Telescope would discriminate between Type Ia progenitor populations. We find that if all Type Ia SNe evolved from the double-degenerate channel, then observations of the lack of early blue flux in 10 (50) trailing images would rule out more than 27 per cent (19 per cent) of the population having 1 M⊙ main sequence companions at 95 per cent confidence.
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Heikkinen, T., and P. Jalovaara. "Four or Twelve Months' Follow-Up in the Evaluation of Functional Outcome after Hip Fracture Surgery?" Scandinavian Journal of Surgery 94, no. 1 (2005): 59–66. http://dx.doi.org/10.1177/145749690509400115.
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Background and Aims: As a rule, follow-up for at least one year is recommended for fracture studies. This is considered the shortest reliable interval. Still, in the case of hip fractures of the elderly, shorter follow-up might be more practical, since the life expectancy of these patients is often short. The aim of this study was to see if a short four months follow-up period would be acceptable in hip fracture surveys. Material and Methods: Information on 196 consecutive non-pathological hip fracture patients aged 50 years or over (mean 79 years) was collected using a standardised hip fracture audit concentrating on functional measurements at admission and at four and twelve months' follow-ups. Results: 167 patients were alive at four months and 152 and at one year. The patients who died between four and twelve months had poorer functional capacity in the four-month evaluation than those who survived one year. The analysis of repeated measures, including only the patients alive at the last follow-up, showed that residential status, use of walking aids and 6 out of 10 and ADL variables (bathing, toileting, shopping, household activities, doing laundry, banking) did not change significantly. Walking ability and the rest 4 ADL variables (dressing, eating, food preparation, use of transportation) improved and pain decreased. Conclusions: Due to high mortality and age-related deterioration of functioning, no steady state i.e. “final result” is ever reached after hip fracture in the elderly. Four-month follow-up is justified as the shortest possible period, because the socioeconomically most important variable, i.e. place of living, and most of the ADL functions do not change significantly after that.
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Kondapalli, Chandra Sekhar, and Goutham Mandali. "Usefulness of fine needle aspiration cytology in diagnosis of causes of lymphadenopathy in children." International Journal of Contemporary Pediatrics 6, no. 2 (2019): 253. http://dx.doi.org/10.18203/2349-3291.ijcp20190035.
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Background: The present study was conducted to study the causes of lymphadenopathy, associated clinical findings, usefulness of FNAC in diagnosis of various causes of lymphadenopathy as lymph node biopsy is a difficult and invasive procedure in children attending pediatric department.Methods: A study was done at Katuri medical college and hospital. A total of 50 patients with lymphadenopathy including both local and generalized were studied for a period of 2 years by taking proper history, through physical examination both generalized and systemic and all the patients were subjected for relevant investigations for establishment of diagnosis which is essential for institution of proper treatment. A prospective study consisting 50 patients with lymphadenopathy (<12year) is undertaken to find the incidence of various causes of lymphadenopathy in the affected patients for 2 year.Results: It was observed that 10, 17 and 23 children were having lymphadenopathy in the age groups of 0-3-year, 4-8 year and 9-12 year respectively. Majority of patients were having lymphadenopathy only after 4 year of age, male 28 and female 22. The major symptoms in order of incidence were palpable swelling, fever, cough, weight loss, loss of appetite and sore throat. Duration of lymphadenopathy of less than 1 month was seen in 25 cases ,1-6 months 24 cases and more than 6 months in 1 case. Enlargement of lymph nodes in cervical region, was the major finding in these patients. 47 cases were having local lymphadenopathy mainly in the cervical region and 3 cases were having generalized lymphadenopathy. 80% of the patients were having firm lymph nodes, remaining 20% of the patients were having soft lymphadenopathy. 36 patients were having mobile lymph nodes while 14 patients were having matted lymph nodes. Tenderness was observed in 21 cases against absence of tenderness in 29 cases. Analysis of the FNAC results revealed positive for tuberculosis in 11 cases reactive hyperplasia in 26 cases, granulomatous changes seen in 4 cases and suppurative lymphadenitis in 6 cases.Conclusions: In developing countries like India whenever a patient attends the Department of Paediatrics with lymphadenopathy it is always be prudent to exclude tuberculosis, which is quite prevalent. FNAC is helpful in those with benign conditions like reactive hyperplasia to rule out underlying serious systemic diseases and reassuring the parents.