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Background: Echinococcosis (hydatid disease) is a parasitic infection that, in humans, mostly affects the liver and lungs. Pelvic and ovarian involvement with hydatid cysts is commonly secondary to...

Background Mature Cystic Teratoma (MCT) is a benign tumor that can lead to malignant transformation (MT) in 1–3% of cases. Management of MT is a big challenge for gynecologic oncologists due to the lack of specific diagnostic and treatment protocols. Case presentation We reported two Iranian cases of MT of MCT with two different stages and prognosis. Our both cases presented the same symptoms, including chronic abdominal pain and distention, loss of appetite, and weight loss. In case number 1, despite the large size of the tumor, the disease was at stage Ia and had a good prognosis; while, case number 2 was at stage IIIc of the disease with a poor prognosis. Conclusion The stage of the disease is the most important prognostic factor, and early diagnosis and treatment are very critical for better survival.

In clinical practice Cerebral Visual Impairment (CVI) is typically diagnosed by observation of abnormal visually guided behaviors which indicate higher visual function deficits (HVFDs) suggesting abnormal brain development or brain damage in a child with a suitable clinical history. HVFDs can occur even in the presence of good visual acuity and may remain undiagnosed because the good visual acuity does not prompt further investigation. This leads to a lack of understanding of the child’s visual perceptual difficulties. In a prospective study, we determined the spectrum of HVFDs in a group of children with history suggestive of brain damage or disruption of brain development and an independent diagnosis of CVI in comparison with typically developing children with a structured 51 question inventory, the Higher Visual Function Question Inventory (HVFQI-51) adapted from the Cerebral Vision Impairment Inventory, CVI-I. Here, we show that the HVFQI-51 can detect a range of HVFDs in children with CVI with good visual acuity and clearly distinguishes these children from typically developing children. HVFDs in our study group could mostly be attributed to dorsal stream visual processing dysfunction though the spectrum varied between children. We report on the inclusion of the “not applicable” response option in analysis providing a picture of HVFDs more in tune with the overall disability of each child. We also propose a subset of 11 questions (Top-11) which discriminate between children with CVI vs. behaviors seen in typical children: this provides both a potential screening tool for initial assessment of HVFDs and a measure of CVI-related impairment, and needs further validation in a secondary independent sample.

Purpose The PowerRef 3 is frequently used in studying the near triad of accommodation, vergence and pupil responses in normal and clinical populations. Within a range, the defocus measurement of the PowerRef 3 is linearly related to the eye's defocus. While the default factory‐calibrated slope of this relation (calibration factor) is 1, it has been shown that the slope can vary across individuals. Here, we addressed the impact of changes in viewing distance, age and defocus of the eye on the calibration factor. Methods We manipulated viewing distance (40 cm, 1 m and 6 m) and recruited participants with a range of accommodative capabilities: participants in their 20s, 40s and over 60 years old. To test whether any effect was larger than the range of measurement reliability of the instrument, we collected data for each condition four times: two in the same session, another on the same day, and one on a different day. Results The results demonstrated that viewing distance did not affect the calibration factor over the linear range, regardless of age or uncorrected refractive error. The largest proportion of the variance was explained by between‐subject differences. Conclusions Calibration data for the PowerRef 3 were not sensitive to changes in viewing distance. Nevertheless, our results re‐emphasise the relevance of calibration for studies of individual participants.

Cerebral Visual Impairment (CVI), vision loss due to brain injury in early childhood, is the leading cause --- approximately 40% --- of bilateral visual impairment in children from industrialized countries and is the most rapidly growing cause among children in developing countries. Typical causes of CVI include abnormal brain development or brain damage, often consequential to birth-related complications such as hypoxic ischemic encephalopathy, meningitis, hydrocephalus, and head injury. The current gold standard for clinical diagnosis require a trained clinician to administer visual-motor integration tests in conjunction with a thorough review of a patient's clinical history. This approach does not scale to meet the needs of undiagnosed children with CVI. Recently, non-invasive screening methods such as administering a higher visual function question inventory (HVFQI), have been shown to accurately capture the observations of teachers and guardians of children. Analysis of those observations has been shown to have very high correlation with visual-motor integration tests (p values The HVFQI web app is an online clinical diagnostic tool and database system designed to gather participant responses to over 50 questions and follow-up questions. No personally identifying information is stored in the database. The web app provides three critical functions: (1) scalable and accurate administration of the HVFQI; (2) global coordination of screening efforts; and (3) a consolidated database for efficacy analysis studies and rapid iteration of the HFVQI to maximize impact, accuracy, and accessibility. The HVFQI consists of a question inventory, a scoring rubric, and a conditional intervention strategy list. The question inventory is carefully curated and designed to capture observations from teachers and guardians that may indicate specific pediatric higher visual function deficits (HVFDs). In many instances HVFDs are accompanied by normal visual acuity, making diagnosis difficult, and requiring multiple questions to elicit HVFDs. These questions are presented at random to avoid leading the participant. The responses are scored according to the HVFQI scoring rubric, which indicates which HVFDs may be present, and relevant intervention strategies. The rubric responds to varying degrees of affirmative responses in a 5-category Likert scale, which includes 3 non-applicable responses with different causes. The rubric also responds to categorical responses for multiple-choice and multiple-answer questions. The web app prepares a report of relevant intervention strategies for the participant, along with the questions and responses as context. The web app is also designed to coordinate international clinical efforts. The web application administrators, led by a superadministrator, can create, manage, and remove centers and staff corresponding to physical (or virtual) locations as demand grows. Each center has a local administrator that can authorize staff to administer the HVFQI, interpret and discuss the results and relevant strategies with participants. The data is stored in a central secure database, accessible only to authorized researchers, and the site administrator. All data are anonymous and non-personally identifying. Authorized researchers can analyze the results for their local centers to estimate efficacy and submit suggestions to update the HVFQI to meet the needs of local participants. Researchers authorized by the super-administrator have full access to the entire database and can perform global analysis for rapid improvement. The HVFQI web app is the result of a collaboration between the SeeLab of the Smith-Kettlewell Eye Research Institute, and the Kulkarni Group of the Computer Science Department at San Francisco State University.

Background Diabetes mellitus (DM) is associated with poorer outcomes in some cancers. Its effect on ovarian cancer is less clear. We consider the effect of DM on overall survival (OS) and progression free survival (PFS) in patients with epithelial ovarian cancer (EOC). Methods A retrospective cohort study of 215 patients with EOC diagnosed between 2009 and 2016 was performed. Records were reviewed for standard demographic, pathologic and DM diagnosis data. Cox regression was used to evaluate the relationship between disease status and survival after adjustment for age, body mass index (BMI), parity, stage, grade, histology, debulking status, hypertension (HTN), menopause status and neoadjuant chemotherapy. Results Patients with DM (27.97, 95%CI: 23.63 to 32.30) had a significantly shorter OS rates compared to patients without DM (41.01, 95%CI: 38.84 to 43.17). The unadjusted hazard ratio (HR) for the association between OS time and DM was 4.76 (95%CI: 2.99 to 7.59, P

Objective Endometrial hyperplasia (EH) is a premalignant neoplasm. Most recently, metformin has been suggested as an adjuvant medication for treating of EH with better outcome. Recent evidence has suggested that metformin has anticancer activity by inhibiting cell proliferation and tumor growth. The aim of this study was to evaluate the effect of metformin plus megestrol acetate versus megestrol acetate alone on patient with EH without atypia. Study design This double blind placebo-controlled clinical trial was conducted among 60 women with EH without atypia. Participants were allocated to two equal groups. Treatment group (M + M) received 40 mg megestrol acetate for 14 days of one month and 1000 mg metformin daily for three months. In placebo group (M + P) each patient received the same dose of megestrol acetate plus two tablets of placebo. Endometrial biopsy was performed in all patients three weeks after the last day of medication Results Data were evaluated based on 29 and 27 women in the M + M group and M + P group, respectively. After 3 months of therapy 27 (93.1 %) women in M + M group had not EH and responded to treatment, which was statistically higher than the rate of response (19 women, 70.4 %) in M + P group. Conclusions This study showed that megestrol plus metformin was significantly better than megestrol alone for the treatment of endometrial hyperplasia without atypia.

Teratomas are the most common germ cell tumours that usually arise in the gonads. Extragonadal teratomas represent 2–5% of adult germ cell tumours which can be found in any midline structure includ...

Attention is important for selecting targets for action. Several studies have shown that attentional selection precedes eye movements to a target, and results in an enhanced sensitivity at the saccade goal. Typically these studies have used isolated targets on blank backgrounds, which are rare in real-world situations. Here, we examine the spatial profile of sensitivity around a saccade target on a textured background and how the influence of the surrounding context develops over time. We used two textured backgrounds: a uniform texture, and a concentric arrangement of an inner and an outer texture with orthogonal orientations. For comparison, we also measured sensitivity around the target on a blank background. The spatial profile of sensitivity was measured with a brief, dim, probe flashed around the saccade target. When the target was on a blank or a uniformly textured background, spatial sensitivity peaked near the target location around 350 ms after cue onset and declined with distance from the target. However, when the background was made up of an inner and outer texture, sensitivity to the inner texture was uniformly high, peaking at about 350 ms after cue onset, suggesting that the entire inner texture was selected along with the target. The enhancement of sensitivity on the inner texture was much smaller when observers attended the target covertly and performed the probe-detection task. Thus, our results suggest that the surface representation around the target is taken into account when an observer actively plans to interact with the target.

Ghrelin, a peptide hormone, synthesized in the stomach, has an effect on glucose metabolism and on blood pressure. The aim of this study is to investigate the effect of an exogenous ghrelin agonist in patients with type 2 diabetes. Three groups of rats were studied: control, sham and experimental (N = 6). After ascertaining that there were diabetic rats in both the control and experimental groups, a dose of 3nM of ghrelin agonist and normal saline was injected through a cannula into the right ventricle in the rats in the experimental and control groups. The results showed a decrease in serum glucose in the experimental group compared to the first day. This difference is comparable between the experimental (*P ≤ 0.05) and the sham group. It is concluded that the injection of a ghrelin agonist (3nM) probably reduces glucose-induced secretion by the pancreatic islets. Under physiological conditions, therefore, ghrelin agonist may modulate the secretion of insulin.

Background: Diaphragmatic injuries due to penetrating trauma remain a diagnostic challenge. Inspection is the best approach in diagnosis as palpation may miss some injuries. The following approaches have been used, either alone or together, to recognize penterating trauma injuries: physical examination, chest x-ray, computed tomography scan, focused assessment with sonography for trauma, and diagnostic peritoneal lavage (DPL). These modalities have been reported to miss 10 to 30 percent of injuries. These diagnostic tools have a low sensitivity and specificity to detect morbidities associated with these injuries. Finding a suitable diagnostic modality is essential for patient care. In this study, we assessed the diagnostic value of video-assisted thoracoscopy as an approach to diagnose diaphragmatic injuries in patients with negative DPL. Materials and Methods: This case series was conducted on 33 patients with penetrating thoracoabdominal trauma referred to the Loghman Hospital in Theran, Iran, from 2013 to 2014 (during an 18-month period). All negative DPL and hemodynamically stable hemopneumothorax patients with no indications for emergent surgical interventions were included in the study. All these patients underwent diagnostic thoracoscopy. Data were collected and analyzed by SPSS software version 20. Results: Thirty-three patients were eligible to participate in this study with a mean age of 23.79±6.42 years. The youngest participant was 17 years old and the oldest was 51. A penetrating wound was located in the right side in 11 patients (33.3%) and on the left side in 19 subjects (57.6%). Three patients (9.1%) had trauma on both sides of their thorax. During thoracoscopy, 6 subjects (18.2%) were found to have asymptomatic diaphragmatic injuries. Conclusions: Diaphragmatic injuries can be missed based on negative DPL. Application of video- assisted thoracoscopy is a minimally invasive procedure that is a practical approach for the evaluation, and management of trauma patients with diaphragmatic injuries

Context: Ovarian cancer is the most fatal gynecological malignancy with no effective screening strategy for early detection. As most cases are being detected in advance stages, conventional therapies are not beneficial for the majority of patients. Cancer-testis antigens (CTAs) are a group of tumor associated antigens with specific expression pattern in cancers which potentiate them for application as cancer biomarkers and targets for immunotherapy. Evidence Acquisition: We performed a computerized search of the MEDLINE/PUBMED databases with key words: ovarian cancer, cancer-testis antigen, biomarker and immunotherapy. Results: Thirty five CTAs have been shown to be expressed in ovarian cancer. At least 13 of them have been shown to elicit immune responses in different studies. The pattern of expression for some of them may facilitate molecular classification of different histologic classes of ovarian cancer. In addition, some CTAs such as NY-ESO-1 and MAGE have been used as targets for immunotherapeutic approaches with promising results. Conclusions: The expression pattern of CTAs in ovarian cancer and the preliminary results of clinical trials indicate that CTAs can be used as targets for immunotherapy of ovarian cancer patients.

Crowding increases with eccentricity and is most readily observed in the periphery. During natural, active vision, however, central vision plays an important role. Measures of critical distance to estimate crowding are difficult in central vision, as these distances are small. Any overlap of flankers with the target may create an overlay masking confound. The crowding factor method avoids this issue by simultaneously modulating target size and flanker distance and using a ratio to compare crowded to uncrowded conditions. This method was developed and applied in the periphery (Petrov & Meleshkevich, 2011b). In this work, we apply the method to characterize crowding in parafoveal vision (

We use eye movements constantly to gather information. Saccades are efficient when they maximize the information required for the task, however there is controversy regarding the efficiency of eye movement planning. For example, saccades are efficient when searching for a single target (Nature, 434 (2005) 387–391), but are inefficient when searching for an unknown number of targets in noise, particularly under time pressure (Vision Research 74 (2012), 61–71). In this study, we used a multiple-target search paradigm and explored whether altering the noise level or increasing saccadic latency improved efficiency. Experiments used stimuli with two levels of discriminability such that saccades to the less discriminable stimuli provided more information. When these two noise levels corresponded to low and moderate visibility, most observers did not preferentially select informative locations, but looked at uncertain and probable target locations equally often. We then examined whether eye movements could be made more efficient by increasing the discriminability of the two stimulus levels and by delaying the first saccade so that there was more time for decision processes to influence the saccade choices. Some observers did indeed increase the proportion of their saccades to informative locations under these conditions. Others, however, made as many saccades as they could during the limited time and were unselective about the saccade goal. A clear trend that emerges across all experiments is that conditions with a greater proportion of efficient saccades are associated with a longer latency to initiate saccades, suggesting that the choice of informative locations requires deliberate planning.

Ever increasing competition along with customer demands for receiving customised services persuade firms to collaborate with other firms to create and deliver more value. On the other hand, entrance of information technology into the supply chain (SC) processes offers new opportunities to do collaborative businesses and facilitates integration of appropriate competencies and capabilities through SC. These conditions put emphasis on the importance of effective and efficient resource management especially in supply chain management (SCM) to realise predefined objectives. In accordance with previous works, primary framework was organised by combining transaction cost economics and resource–based view. However, analysis in this case study displayed another important theory, social exchange theory, should be considered in sourcing decisions. Finally, a comprehensive framework to develop sourcing strategies was provided for an international logistics service provider (LSP), Persian Gulf Transportation Co. To present this framework, content analysis and focus group were used for data analysis and validation, respectively.

This paper aims to provide a methodology for strategy development based on previous works to exploit appropriate electronic supply chain management (e-SCM) strategies for a logistics service provider (LSP), PGT Co. Appropriate decision making frameworks in each step of this methodology were developed. To organise related frameworks in this methodology, deep interviews were done with four PGT’s experts. Analysis reliability and final validation were done by two coders and through focus group including four experts, respectively. Finally, appropriate strategies were exploited based on recommended methodology and benchmarking of top 3PLs in the worlds and evaluated via focus group. Despite the emphasis of current researches on opportunities for innovation, new collaborative businesses, PGT Co. experts preferred to develop opportunities for automation and especially process integration. This methodology provides other managers a road map to develop their own e-SCM strategies based on this work to create more value collaboratively. Previous works mainly concerned with some e-SCM strategies without a comprehensive methodology to cover all of them along with their critical dimensions. This paper has addressed this issue.