Amputation as a First Treatment is Highly Associated With Late Presentation: An Underestimated Modifiable Major Risk Factor for Diabetic Foot Ulcer

Purpose Several risk factors for lower extremity amputation in diabetic patients have been identified; however, late presentation has been poorly investigated. Very few studies looked at the impact of such risk factor. As none has investigated the link between admission to amputation and late presentation in this population, we investigated such association. Methods The study is a retrospective comparative cohort of continuous series of patients admitted for amputation related to diabetic foot ulcer (DFU) as a first treatment. A late presentation was defined as a period of 3 weeks or more from the onset of the ulcer. Results Forty-six patients admitted for amputation and all wounds were infected and located on the plantar forefoot in 32 cases (69.5%), on the toes in 10 cases (21.7%), and in the heel area in 4 cases (8.8%). The mean duration to admission was 5.2 ±1.8 weeks (range 4-10 weeks). Late presentation was recorded in 42 (91.3%) patients. Conclusion This study demonstrates that amputation due to DFU is highly associated with late presentation. Educational campaigns targeting patient and first-line health care providers and highlighting the urgency of diabetic ulcers are needed to impact this major modifiable risk factor. Levels of Evidence: Therapeutic, Level III: Retrospective Comparative

ALTERNATIF PENILAIAN EVALUASI PEMBELAJARAN PASCA PANDEMI COVID – 19 PADA JENJANG PENDIDIKAN SEKOLAH DASAR

Education is a conscious and planned effort to create a learning atmosphere and learning process that is actively able to make students develop their potential. Education is expected to be able to create students who have religious spiritual strength, self-control, personality, intelligence, and noble character. These skills are not only needed for themselves, but also useful for the people of the nation and state. Efforts that can be made to ascertain whether an educational goal has been achieved is by conducting an evaluation. This evaluation is carried out to determine whether a program is feasible. In addition, evaluation is intended to control, guarantee, and determine the quality of education related to the sharing of educational components. Evaluation is carried out at all levels and types of education in order to be accountable to students related to the implementation of education that has been carried out by an educational institution. Thus, between teaching and learning activities and evaluation is a continuous series and cannot be separated. This is because evaluation is used as a useful measuring tool to determine and determine the level of success of students in learning activities.

Obesity in Postmenopausal Breast Cancer Patients: It Is Time to Improve Actions for a Healthier Lifestyle. The Results of a Comparison Between Two Italian Regions With Different “Presumed” Lifestyles

BackgroundAdult body fatness is a convincing risk factor for postmenopausal breast cancer. With the aim to compare the different breast cancer (BC) features in Northern and Southern Italy, we investigated the relationship between BMI and BC characteristic in two groups of patients referred in the Modena and Lecce breast units.Materials and MethodsA retrospective analysis of a continuous series of BC patients referred to the Città di Lecce Hospital and the Modena Cancer Center, from January 2019 to December 2020 was performed. We identified four groups of BMI at BC diagnosis: underweight, BMI <18.5 kg/m2; normal weight, BMI ≥ 18.5–24.9 kg/m2; overweight, BMI ≥ 25.0–29.9 kg/m2; obese, BMI ≥30.0 kg/m2. BC characteristics and clinical outcomes were analyzed by the Kolmogorov-Smirnov test and Mann-Whitney U test; categorical data were compared using Pearson’s chi-square test, and dicotomic data were compared by odds ratio.ResultsNine hundred seventy-seven BC patients were included in the analysis. Overall, 470 were from Modena and 507 from Lecce. No differences were observed in the mean age of BC patients of Modena (61,42) and Lecce (62,08). No statistical differences between the two populations were shown in terms of tumor characteristics and pathological stage. Conversely, a statistical difference of BMI between the BC patients coming from Modena and Lecce (25.87 and 27.81, respectively; p = 0.000001) was found. BC patients diagnosed in Lecce at age ≥70 years had higher median BMI compared with the ones from Modena (p = 0.000002). The increased BMI in this aged population was also associated to larger tumor size (p = 0.040).ConclusionThe rate of overweight and obesity was higher in BC women living in Southern Italy, despite the presumed nutrition according to the so-called Mediterranean type dietary pattern. Unexpectedly, an increased BMI rate and a relationship with larger tumor size were found in Southern BC patients aged ≥70 years. Our findings strongly support the need for promoting a healthier lifestyle model in Italy, with the aim of reducing the rate of the obesity and, consequently, the increased risk of BC.

Continuous series of symmetric peak profile functions determined by standard deviation and kurtosis

A mathematical system for modeling the effects of symmetrized instrumental aberrations has been developed. The system is composed of the truncated Gaussian, sheared Gaussian, and Rosin-Rammler-type functions. The shape of the function can uniquely be determined by the standard deviation and kurtosis. A practical method to evaluate the convolution with the Lorentzian function and results of application to the analysis of experimental powder diffraction data are briefly described.

Modeling of Crisis Processes in the Financial Market

Global liquidity shortage as well as the availability on the market of overpriced assets and derivatives led to the situation where the global economy depends primarily on liquidity, becoming prone to chain-consistent world crises. Only for the last 15 years, the world has witnessed a continuous series of crises. Therefore, the study of the processes and phenomena of crisis is one of the most important scientific and practical tasks. The aim of this work consisted in the development of methods and models for the early detection of crises in the economy. The significance of the work is to develop an econometric model and tools for detection of crisis.

Diagnosis and Management of Uterine Fibromyomas in the Obstetric Gynecology Department of the Regional Hospital of Labe. Guinea

Objectives: To calculate the frequency of uterine fibromyomas, to describe the epidemiological profile, to describe the management and to establish the prognosis of women with uterine fibromyomas in the gynaecology-obstetrics department of the Regional Hospital of Labé. Methodology: This was a retrospective descriptive study lasting three (3) years from 1 January 2017 to 31 December 2019. All patients admitted and operated on in the department for uterine fibromyomas during the study period were included. Patients who were not operated for uterine fibromyomas in the department and incomplete records were not included. Our data were collected and analysed using Epi-Info software version 7.2.2.6. Word, Excel and Power point software from Pack office 2016 were used for data entry and presentation. The study involved a continuous series of 115 anaemic pregnant women. We proceeded with an exhaustive recruitment of pregnant women according to the criteria defined above. Results: The frequency of uterine fibromyomas among gynaecological pathologies was 44.75%. The epidemiological profile was that of a 30-39% (40.87%), housewife (53.91%) and nulliparous (40%) woman. Pelvic pain was the dominant reason for consultation (75.65%) and 46.08% of patients had no particular history. Intramural or interstitial uterine fibromyomas were the most common (49.57%) and ultrasound was performed in all patients. The surgical indications were dominated by large polymyomatous uterus 37.39%, followed by haemorrhagic fibroid 26.09%. Myomectomy was performed in 75.65% of cases, exclusively via the abdominal route (100%), while hysterectomy was performed via the abdominal route in 17.39% of cases and vaginal route in 6.96%. The postoperative course was simple in 75.65% of cases and complicated in 24.35%. Complications were dominated by anaemia (13.04). The average length of stay was 6.05 days with extremes of 3 and 13 days. Conclusion: The frequency of the uterine fibromyomas is raised in the region of Labé and the hold in charge is often surgical

A New Species of Cyrtodactylus Gray, 1827 (Squamata, Gekkonidae) from Southern Yunnan, China

A new species of Cyrtodactylus is described based on five specimens collected from the karst formations of Maguan County, Wenshan Prefecture, Yunnan Province, China. The new species is recognized by having a unique combination of morphological characters: medium body size, ventrolateral folds present without interspersed tubercles, 7 – 9 precloacal pores in a continuous series, enlarged femoral scales present and continuous with pore-bearing precloacal scales, femoral pores on each enlarged femoral scale in males, 1 – 4 postcloacal tubercles on each side, subcaudals enlarged, a black postocular streak extending from posterior corner of eye rearwards to above tympanum, nuchal loop discontinuous, 6 – 7 black irregular dorsal bands between limbs, most bands discontinuous. Genetically, uncorrected sequence divergences of the ND2 gene and its flanking tRNAs between the new species and investigated congeners ranged from 12.5% to 18.2%.

A new species of Hemiphyllodactylus Bleeker, 1860 (Squamata: Gekkonidae) from Da Lat Plateau, Vietnam

We describe a new species of the genus Hemiphyllodactylus on the basis of four specimens from Bidoup - Nui Ba National Park, Da Lat Plateau, Lam Dong Province, Vietnam. The new species, Hemiphyllodactylus dalatensis sp. nov., is distinguished from the remaining congeners by a combination of the following characters: a bisexual taxon; maximum SVL of 45.9 mm; dorsal scale rows 16; ventral scale rows 8 or 9; chin scales 7–10; postmental scales enlarged; femoral and precloacal pores in a continuous series, 23–25 in total in males, absent in the female; digital lamellae formula 4-5-5/6-5 (forefoot) and 5-6-6-6/5 (hind foot); cloacal spurs 2 or 3 on each side in both males and female; subcaudal scales not enlarged; dorsal trunk pattern with two paravertebral stripes, formed by two rows of dark spots; dark lateral head stripe distinct; postsacral mark cream or orange and bearing anteriorly projecting arms. In phylogenetic analyses, the new species is recovered as the sister taxon to a clade including all species from India although support values are low from all analyses.

A Numerical Study of the Flow and Sediment Interaction in the Middle Reach of the Huai River

In recent years, the incoming sediments from upstream of the Huai River have continuously decreased. The relationship between flow and sediment has significantly changed. Therefore, the erosion and deposition characteristics of the river could be affected. To investigate this interaction between flow and sediment, the present study was conducted using the Wanglin section in the middle reach of the Huai River as the study site. A 1D hydrodynamic model was developed and validated using field data. Data from 1985–2014 were used as a continuous series while data from 2004–2014 were used as a repetitive series. The sediment variation and distribution processes at different locations were discussed. It was found that the river channel displayed several notable characteristics. In the flow direction, the channel had frontal erosion and backward deposition. The variation rate was relatively slow. With reduced sediment, the overall deposition at the Wanglin section was significantly mitigated. Future recommendations are provided based on the present simulation for flood mitigation along the Huai River.