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Background Thrombosis and pulmonary embolism appear to be major causes of mortality in hospitalized coronavirus disease 2019 (COVID-19) patients. However, few studies have focused on the incidence of venous thromboembolism (VTE) after hospitalization for COVID-19. Methods In this multi-center study, we followed 1529 COVID-19 patients for at least 45 days after hospital discharge, who underwent routine telephone follow-up. In case of signs or symptoms of pulmonary embolism (PE) or deep vein thrombosis (DVT), they were invited for an in-hospital visit with a pulmonologist. The primary outcome was symptomatic VTE within 45 days of hospital discharge. Results Of 1529 COVID-19 patients discharged from hospital, a total of 228 (14.9%) reported potential signs or symptoms of PE or DVT and were seen for an in-hospital visit. Of these, 13 and 12 received Doppler ultrasounds or pulmonary CT angiography, respectively, of whom only one patient was diagnosed with symptomatic PE. Of 51 (3.3%) patients who died after discharge, two deaths were attributed to VTE corresponding to a 45-day cumulative rate of symptomatic VTE of 0.2% (95%CI 0.1%–0.6%; n = 3). There was no evidence of acute respiratory distress syndrome (ARDS) in these patients. Other deaths after hospital discharge included myocardial infarction (n = 13), heart failure (n = 9), and stroke (n = 9). Conclusions We did not observe a high rate of symptomatic VTE in COVID-19 patients after hospital discharge. Routine extended thromboprophylaxis after hospitalization for COVID-19 may not have a net clinical benefit. Randomized trials may be warranted., Highlights • In a large multi-center study, the incidence of venous thromboembolism in COVID-19 patients followed for 45 days after hospitalization was relatively low. • Routine extended thromboprophylaxis in COVID-19 patients who have been discharged from the hospital may not have a net clinical benefit. • Older age, history of recent cancer, and history of recent diabetes were associated with higher risk of mortality after hospital discharge

Merkel cell carcinoma (MCC) is an aggressive skin cancer associated with a high risk of local recurrence and distant metastasis. Optimal care of this potentially life-threatening cancer is critical but challenging because: physicians are often unfamiliar with its management due to rarity, and MCC management remains controversial, in part because it is rapidly evolving across multiple specialties. While guidelines offer a broad overview of management, they are often not sufficient when making decisions for individual patients. Herein, we present a literature review as well as practical approaches adopted at our institutions for staging, surveillance and therapy of MCC. Each of these areas are discussed in light of how they can be appropriately customized for prevalent but challenging situations. We also provide representative examples of MCC patient scenarios and how they were managed by a multidisciplinary team to identify suitable evidence-based, individualized treatment plans., Lay abstract Merkel cell carcinoma (MCC) is a skin cancer with a high risk of recurrence and distant spread. Optimal care of this cancer is important. However, management is challenging because it is rare and its treatment is continuously evolving across multiple specialties. While treatment guidelines offer a broad overview of management, they are often not detailed enough to provide appropriate patient-specific assistance. Herein, we present a review of recent studies and our suggestions relevant to MCC staging, surveillance and treatment options. Each of these areas are discussed in light of how they can be appropriately customized for challenging situations often encountered by practitioners. We also provide representative examples of MCC patient scenarios and how they were managed by a multidisciplinary team to identify evidence-based, individualized treatment plans.

Background: Given the increasing use of waterpipe tobacco smoking in the world and its unknown effects on bone healing, this study investigated the repairing of femoral bone fractures in rats exposed to waterpipe tobacco smoking (WTS).Main Methods: This study involved 40 male Wistar rats that were divided into two groups, including the femoral fracture (Fx) and the Fx + WTS groups. Each group was divided into two subgroups that were evaluated for bone healing 28 and 42 days after femoral fracture. After fixing the fractured femur, the healing process was evaluated by radiography, pathological indicators, and a measurement of the blood levels of vascular endothelial growth factor (VEGF), parathyroid hormone (PTH), Ca ++, transforming growth factor-beta (TGF-β), and insulin-like growth factor 1 (IGF-1). Additionally, the density of VEGF and CD34 in fracture tissue was investigated by immunohistochemistry.Key Findings: Radiographic findings showed that factors related to the earlier stages of bone healing had higher scores in the Fx + WTS28 and 42 subgroups in comparison to the Fx groups. The density of VEGF and CD34 showed that the angiogenesis processes were different in the bone fracture area and callus tissue in the Fx +WTS subgroups. The serum levels of VEGF, TGF-β, and IGF-1 were significantly lower in the Fx +WTS42 group, and PTH in the Fx +WTS28 group was higher than that in the other groups.Significance: The findings showed the disturbance and delay in the femoral fracture union in rats exposed to hookah smoke. This is partly due to the reduction of molecular stimuli of bone synthesis and the attenuation of quantitative angiogenesis.

The aim of this study was to find out the raw of materials and supply chain management impact to company’s production progress. Population from this research are employee production division of PT. Niro Ceramic Nasional Indonesia as more as 250 persons and sample used are 130 respondents. Research method used is quantitative method, analysis technique multiple regression and simple regression. The results of this study indicate that simultaneously the raw of materials and supply chain management 45,9 % from the progress of production. 31,7 %. and from the Raw of materials to production process 16,0 % from the supply chain management to production process.

Purpose To describe dome-shaped macula and associated clinical findings in premature infants. Methods This prospective, observational cohort study included a consecutive sample of premature infants screened for retinopathy of prematurity (ROP) with 9-month follow-up. Handheld spectral domain optical coherence tomography (SD-OCT) was performed at the time of ROP screening. Images were assessed for dome-shaped macula, cystoid macular edema, epiretinal membrane, vitreous bands, and punctate hyperreflective vitreous opacities. Dome height measurements were performed in a subset of images. Teller visual acuity and cycloplegic refraction were performed at an adjusted age of 8-10 months. Results Of 37 infants (74 eyes; 49% male; mean gestational age 27.8 ± 3.2 weeks; mean birth weight 949 ± 284 g), 24/37 (65%) demonstrated dome-shaped macula in at least one eye (13 both eyes, 5 right eye only, and 6 left eye only). Of the 74 eyes, 26 (35%) could be reliably measured, with a mean dome height of 139.0 ± 72.3 μm (range, 54–369 μm). Presence of dome-shaped macula was associated with a diagnosis of ROP (P = 0.02; OR, 3.03; 95% CI, 1.18-7.82) and pre-plus or plus disease (P = 0.02; OR, 4.20; 95% CI, 1.05-16.78). Infants with dome-shaped macula had lower birth weight compared with those without (877 vs 1081 g; P = 0.04). No associations with other demographics, OCT findings, and 9-month refractive outcomes were found. Conclusions Dome-shaped macula was frequently identified by handheld SD-OCT in premature infants, especially those with lower birth weight and severe ROP. The long-term clinical significance of this finding is unknown.

Background Retinopathy of prematurity (ROP) can lead to retinal detachment and severe vision loss and is a common cause of childhood blindness. Optical coherence tomography angiography (OCTA) is a non-invasive imaging modality that can be used to detect potential abnormalities in the microvasculature in this population. The objective of this study is to assess the feasibility of a newly developed handheld swept source OCT (SS-OCT) device to successfully acquire structural vitreoretinal and retinal microvascular images in awake premature infants. Methods OCT and OCTA images were acquired at the time of routine ROP examinations from awake, unsedated preterm infants in the Neonatal Intensive Care Unit using a clinical research prototype handheld probe integrated with an SS-OCT system working at 1,060 nm wavelength and an imaging speed of 200,000 A-scans per second (200 kHz), enabling volume OCT and OCTA scans. Each volume was acquired with approximately 36˚ field of view (~6.3×6.3 mm in infants) in 4.8 s. Quality of acquired OCT and OCTA volume images, microvascular information, and vitreoretinal features were determined by 3-masked grader consensus. Results Twelve infants (5 females, mean gestational age 28.3 weeks, median birth weight 901 g, stages 0 to 3 ROP) underwent a total of 73 individual eye imaging sessions. High-quality OCT images of the fovea and the optic nerve were present in 69/73 (94.5%) and 56/73 (76.7%) scans, respectively. Vitreous bands were observed in 10/73 (13.7%); punctate hyperreflective vitreous opacities in 47/73 (64.4%); epiretinal membrane (ERM) in 6/73 (8.2%); and cystoid macular edema (CME) in 12/73 (16.4%) scans. Mild vessel elevation was noted in 3/73 (4.1%) images, and severe vessel elevation in 4/73 (5.5%) scans. OCTA images obtained in 8 awake infants revealed good quality images of the foveal microvasculature in 11/19 (58%) eye imaging sessions for 6/8 (75%) infants; and peripapillary microvasculature in 14/19 (74%) eye imaging sessions for 5/8 (63%) infants. Conclusions The SS-OCTA handheld device can capture important vitreoretinal characteristics such as peripapillary and foveal microvasculature, as well as hyperreflective punctate vitreous opacities and tractional vitreous bands, which may predict ROP severity. These images were captured in awake, premature infants without the use of direct ocular contact, an eyelid speculum, or sedation.

Various methods are available for the management of stage II thoracic parapneumonic empyema (TPE). The aim of this study was to determine the better method for the management of stage II TPE. We conducted a retrospective study on patients with diagnosis of TPE during 2005–2014. Demographic and clinical data of patients were recorded and analyzed. A total of 148 patients (112 males, 36 females) underwent therapeutic procedures for stage II TPE. The most common diagnostic tool for TPE was posteroanterior and lateral chest films. Tube thoracostomy with antibiotic therapy and therapeutic thoracocentesis were the primary treatment in 80 patients, of which 12 responded. One hundred twenty-eight patients underwent video-assisted thoracoscopic surgery (VATS) and 118 of them responded. Thirty patients underwent thoracotomy with breakdown of adhesions and decortications that was successful in 86 % of them. Average hospitalization in tube thoracostomy, thoracotomy, and thoracoscopy groups was 10, 8, and 6 days, respectively. Our study showed the high failure rate of simple drainage as the first procedure for the treatment of thoracic empyema. Moreover, our study showed the association of VATS with shorter duration of hospitalization, reduction in complications and mortality rate, and wound infection in the patients, so VATS may be considered as the first choice in the management of stage II TPE. In addition, decortication can be used in any patient with multiloculated empyema because of its high success rate.

The heart is an organ of human body which has a vital function, small abnormalities can have a big impact on the performance of the body. Heart disease is the number one cause of death in the world. Examination of the heart can be detected from blood flow in the fingertips, in order to obtain information about the number and rhythm of the heartbeat. This research aims to design and implement the FPGA board to monitor the heart rate with optical sensors.The results of this study are expected to facilitate the patient's medical team or independently in detecting heart health. The series is composed of blocks of sensors, signal conditioning block, the block pulse counter, block timer 10 seconds and blocks the viewer. Based on the test results of the 10 respondents with a variety of age and gender, has built a tool that the percentage error of 3.94%.

This study is assessing the ecological integrity of landscape condition to maintain freshwater biodiversity at highly urbanized catchment using geographic information system (GIS). GIS tools were used to calculate the percentage of land use types i.e. impervious cover, vegetation cover, and water body at 6 sub-catchments of Universitas Indonesia (UI) Depok campus. In order to evaluate freshwater biodiversity, 478 samples of macroinvertebrates were collected from the cascade-pond system. Each of pond was calculated using macroinvertebrate indices namely Singscore and The Shannon Diversity Index. Nine parameters of water physics-chemistry were also collected from each pond and calculated based on The National Sanitation Foundation - Water Quality Index. The highest percentage of impervious cover is located in the upper of catchment and simultaneously reduce the percentage downward. The impervious cover affects the pattern of freshwater biodiversity and water quality the of cascade-pond system. The most diverse and highest score of aquatic organism was found at Salam sub-catchment that located in the lower part of UI catchment. Integrated assessment of UI catchment area using GIS-based multiple criteria decision analysis shows that the term of “end-of-pipe” at cascade-pond system affecting the ecological status of each catchment.

Fingerprinting of ivory products is of considerable importance for both commercial and forensic reasons. An attempt at achieving nondestructive fingerprinting using a combination of optical methods is presented. It is based on Fourier transform imaging fluorescence (FTIF) and on micro‐Raman imaging. Although, fluorescence and Raman spectra of ivories have been studied, this is the first application of the imaging versions of these techniques. It is shown that the combination of the proposed spectral imaging methods may provide unique fingerprinting of the studied samples. The large range of the Raman spectra and the unique method that provides full fluorescence spectrum at each pixel, ensures proper fingerprinting of a variety of ivory samples.