Complete diphallia associated with unusual multiple congenital anomalies: case report and review of literatures

Background Diphallus (duplication of phallus) is rarely encountered in surgical practice with only 100 cases reported in literature. Some cases may be isolated but mostly associated with other anomalies, without clear data about its etiology. Case presentation We reported a 1-day-old newborn baby who was presented with complete duplication of the phallus, one of them being hypospadic associated with a high type imperforate anus, omphalocele, congenital pouch colon, sacral meningocele, and other congenital anomalies not reported before in such combinations. Multiple stages surgical corrective procedures were performed over a period of 4 years with 4–6 months interval between each stage, starting with the management of omphalocele and colostomy, ended by excision of the abnormal phallus with abdominoplasty and closure of colostomy. The outcome was evaluated, and literatures were reviewed in relation to types, presentations, and options for surgical correction with optimal outcomes. Conclusion A combination of diphallia and other abnormalities in our patient are not reported previously in such manner and were very difficult to be corrected. Only expert pediatric surgeons should treat such conditions as every case is unique in nature. In all conditions, the abnormal phallus should be excised, and the final aim is to achieve a continent child with cosmetically acceptable genitalia.

Number of doses of Measles-Mumps-Rubella vaccine applied in Brazil before and during the COVID-19 pandemic

Background Due to the social isolation measures adopted in an attempt to mitigate the risk of transmission of SARS-CoV-2, there has been a reduction in vaccination coverage of children and adolescents in several countries and regions of the world. Objective Analyze the number of doses of vaccine against Measles-Mumps-Rubella (MMR) applied before and after the beginning of mitigation measures due to COVID-19 pandemic in Brazil. Methods The data collected refer to the number of doses of the MMR vaccine applied monthly to the target population residing in Brazil: cahildren, aged 12 months (first dose) and children, aged 9 years (second dose), from April 2019 to December 2020. Differences in MMR vaccine doses from April 2019 to March 2020 (before the start of mitigation measures) and April 2020 to September 2020 (after the start of the mitigation measures) were evaluated. Spatial analysis identified clusters with a high percentage of reduction in the median of applied doses no Brazil. Results There was a reduction in the median of doses applied in the Regions North (− 33.03%), Northeast (− 43.49%) and South (− 39.01%) e nos Estados Acre (− 48.46%), Amazonas (− 28.96%), Roraima (− 61.91%), Paraíba (− 41.58%), Sergipe (− 47.52%), Rio de Janeiro (-59.31%) and Santa Catarina (− 49.32) (p < 0.05). High-high type spatial clusters (reduction between 34.00 and 90.00%) were formed in the five regions of Brazil (Moran’s I = 0.055; p = 0.01). Conclusion A reduction in the number of MMR vaccine doses was evidenced as a possible effect by the restrictive actions of COVID-19 in Brazil.

Response of Spatio-Temporal Differentiation Characteristics of Habitat Quality to Land Surface Temperature in a Fast Urbanized City

The degradation and loss of global urban habitat and biodiversity have been extensively studied as a global issue. Urban heat islands caused by abnormal land surface temperature (LST) have been shown to be the main reason for this problem. With the accelerated urbanization process and the increasing possibility of abnormal temperatures in Zhengzhou, China, more and more creatures cannot adapt and survive in urban habitats, including humans; therefore, Zhengzhou was selected as the study area. The purpose of this study is to explore the response of urban habitat quality to LST, which provides a basis for the scientific protection of urban habitat and biodiversity in Zhengzhou from the perspective of alleviating heat island effect. We used the InVEST-Habitat Quality model to calculate the urban habitat quality, combined with GIS spatial statistics and bivariate spatial autocorrelation analysis, to explore the response of habitat quality to LST. The results show the following: (1) From 2000 to 2015, the mean value of urban habitat quality gradually decreased from 0.361 to 0.304, showing a downward trend as a whole. (2) There was an obvious gradient effect between habitat quality and LST. Habitat quality’s high values were distributed in the central and northern built-up area and low values were distributed in the high-altitude western forest habitat and northern water habitat. However, the distribution of LST gradient values were opposite to the habitat quality to a great extent. (3) There were four agglomeration types between LST and habitat quality at specific spatial locations: the high-high type was scattered mainly in the western part of the study area and in the northern region; the high-low type was mainly distributed in the densely populated and actively constructed central areas; the low-low type was mainly distributed in the urban-rural intersections and small and medium-sized rural settlements; and the low-high type was mainly distributed in the western mountainous hills and the northern waters.

A new species and a key to eleven species of the genus Conophyma Zubovsky, 1898 (Orthoptera, Acridoidea, Catantopidae, Conophyminae) from China

A new species and a key to eleven species of of the genus Conophyma Zobovsky, 1898 from China is described in this paper. The new species Conophyma lini sp. nov. is similar to C. xiai Zhang et al, 2015, but differs from latter by: vertex longer, apex narrower; minimum width of interspace 1.6 times length in mesosternum; posterior margin of epiproct waved, with angular projection in the middle, furculae small and width of Epiphallus 2.5 times high. Type specimens are deposited in the Northwest Plateau Institute of Biology, Chinese Academy of Sciences, Xining, Qinghai 810001, China.

Interval Type-2 Fuzzy Dynamic High Type Control of Permanent Magnet Synchronous Motor with Vector Decoupling Method

This paper presents an interval type-2 fuzzy dynamic high type (IT2FDHT) control based on vector decoupling method for permanent magnet synchronous motor (PMSM) to improve the dynamic characteristics of the system. Firstly, to address the shortcomings of the traditional PI regulator used in the current loop of PMSM, an improved PI regulator based on voltage feed-forward decoupling is used. Then, considering the characteristics that the higher the system type, the smaller the steady-state error and the shorter the regulation time, the high type control structure is added. However, a purely high type structure amplifies the oscillations of the system and is extremely sensitive to perturbations, which can easily lead to system divergence. Therefore, in order to solve the problems caused by high type structure, finally we designed dynamic high type control with the help of fuzzy logic systems (FLSs), which successfully achieved automatic switching of system type while improving response speed and steady-state accuracy. Meanwhile, quantum-behaved particle swarm optimization (QPSO) algorithm is employed to determine the parameters of FLSs. In summary, five methods including conventional PI, feed-forward decoupling PI (FDPI), FDPI high type (FDPI-HT), FDPI type-1 fuzzy dynamic high type (FDPI-T1FDHT), and FDPI-IT2FDHT, are compared to show the superiority of the proposed method. By means of simulations, the excellence of proposed FDPI-IT2FDHT is verified.

Sourcing from a Self-Reporting Supplier: Strategic Communication of Social Responsibility in a Supply Chain

Problem definition: To manage supplier social responsibility (SR), some firms have adopted a self-assessment strategy whereby they ask suppliers to self-report SR capabilities. Self-reported information is difficult to verify, and this leads to an important credibility question: can a buyer expect truthful reporting? We examine whether a supplier’s SR capability can be credibly communicated through free and unverifiable self-reporting. Academic/practical relevance: SR is a strategic focus for firms because consumers care about ethical production. Some firms rely on supplier self-assessment as part of their SR strategy. It is important to understand the value and challenges of this approach. Methodology: We develop a cheap talk model of a supplier and a buyer. The supplier is endowed with a given SR level (privately known to the supplier) that represents the probability of no violation. The buyer sells in a market that is sensitive to publicized SR violations. The supplier first communicates its SR level to the buyer, and then the buyer chooses between two audit stringency levels to conduct on the supplier and also chooses how much to order. Results: Influential truthful communication may emerge in equilibrium if (i) the buyer orders a larger quantity from the high-type supplier but imposes a more stringent audit than the buyer would for the low type and (ii) the high-type supplier opts for this larger order, whereas the low-type, fearing audit failure, does not. The buyer can benefit as the audit becomes more expensive. Managerial implications: Supplier SR self-assessments can be a valuable strategy for buyers but only if the buyer has access to auditing capabilities of different levels and does not precommit to a particular level. It is valuable for firms to engage in an up-front auditing step to ensure a minimum SR capability of approved suppliers because very low-performing suppliers never truthfully report. Implementing supplier self-assessments may or may not help reduce the social damage resulting from potential SR violations; we identify situations when it helps and when it does not.

Loose Thick Seton Suture Stimulates Rapid Healing and Lower Recurrence Rate in the Treatment of High Type Fistula in Ano

BACKGROUND: Fistula in ano is a chronic problem for the patients. It causes distressing because of foul odor and soiling with recurrent infection and discharge. Recurrence and anal sphincter injury were the most critical complications following surgery. Loose, thick seton placement was the most promising surgical operation. AIM: To reduce the time of seton placement, therefore, decreasing the suffering of patients from soiling and multiple dressing. PATIENTS AND METHODS: A retrospective study, one hundred patients with high type fistula in ano treated surgically in Al-Sader Medical city and Al-Najaf daily private clinic, Najaf city, Iraq, from February 2018 to March 2019. Fistulography and magnetic resonance imaging have taken from all patients. After that, fistulectomy with loose, thick seton suture placed for 3 months. Patients with the persistence of high fistula tract underwent a second surgery and third operation until complete healing. RESULTS: One hundred patients with high type fistula in ano with male 96 (96%) and female patients were 4 (4%). The rate of complete healing among male patients after the first operation was 90 (93%), while female patients showed a 4 (100%) rate of complete healing after the first operation. Three of the remaining male patients with persistently high fistula tract showed complete healing after the second operation, whereas 3 (3%) the rate of complete healing was 100% after the third operation. CONCLUSION: A loose, thick seton placed in high type fistula tract for 3 months provides excellent protection to the external anal sphincter with less recurrence rate and rapid healing.

Location Choice of a Partially–Private Monopoly Supplier

This paper analyzes the location choice of an upstream monopolist who supplies input to asymmetric duopoly firms in a downstream market. The monopolist is partially private, in that it cares not only about its profit maximization but also about the survival of the downstream firms. Based on the Hotelling model, we find that the monopolist is always attracted to locate closer to the efficient downstream firm. In particular, when the efficiency difference between the two downstream firms is not too high, such that no firm is driven out of the market, the monopolist locates at a distance of 1/6 from the efficient firm in the line segment of unit length. Finally, considering the downstream firms’ survival, we show that the upstream monopolist charges a higher input price on the efficient firm. This study may be relevant to the product differentiation framework, in which firms can benefit from producing goods that are close to the preference of high-type consumers; to the pharmaceutical industry, in which pharmacy companies must cover a broad market segment; or to the policymaking process, in which policymakers may have an incentive to make a policy preferred by a particular group of the society. JEL Classifications: D42, L12, L230

Modeling the effects of contact-tracing apps on the spread of the coronavirus disease: Mechanisms, conditions, and efficiency

This study simulates the spread of the coronavirus disease (COVID-19) using a detailed agent-based model and the census data of Japan to provide a comprehensive analysis of the effects of contact-tracing apps. The model assumes two types of response to the app notification: the notified individuals quarantine themselves (type-Q response) or they get tested (type-T response). The results reveal some crucial characteristics of the apps. First, type-Q response is successful in achieving containment; however, type-T response has a limited curve-flattening effect. Second, type-Q response performs better than type-T response because it involves quarantine of those who are infected but have not become infectious yet, and the current testing technology cannot detect the virus in these individuals. Third, if the download rate of the apps is extremely high, type-Q response can achieve virus containment with a small number of quarantined people and thereby high efficiency. Finally, given a fixed download rate, increasing the number of tests per day enhances the effectiveness of the apps, although the degree of improved effectiveness is not proportional to the change in the number of tests.