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Renal cell carcinomas accounts for 2% of all the cancers globally. Most of the renal tumors are detected incidentally. Ultrasound remains the main screening modality to evaluate the renal masses. A multi -phase contrast enhanced computer tomography is must for characterizing the renal lesions. Imaging plays an important role in staging, treatment planning and follow up of renal cancers. In this review , we discuss the imaging guidelines for the management of renal tumors.

Since the innovative work of Terada and Akiyama, asymmetric reaction using chiral Brønsted acid has attracted great attention. Asymmetric aldol reactions are extensively studied in different organocatalysis. Brønsted acid-catalyzed aldol reaction may be carried out directly without modification of the substrates or Mukaiyama type aldol reaction using silyl enol ether as nucleophiles. The reaction may proceed through the formation of enol intermediate followed by the attack to the electrophile while Mukaiyama type aldol reactions may follow two mechanistic pathways- Brønsted acidic pathways where Brønsted acid directly activates the substrate or Lewis acid pathways where Brønsted acid acts as pre-catalyst. Here, the recent advancement of asymmetric aldol reactions using chiral Brønsted acid as a catalyst and the fate of the catalysts in the reaction has been discussed in this review. It is observed that some kinds of aldol reactions have rarely been studied and need more attention.

Morrison's pouch is the intraperitoneal space in the supramesocolic compartment located between the right liver lobe and right kidney. Pathological conditions that can involve this peritoneal space include fluid collections, infectious or inflammatory processes, and neoplasms. Frequent involvement by disease entities can be attributed to its dependent location, communication with the inframesocolic compartment, close proximity to the adjacent organs and peritoneal fluid dynamics. Knowledge of the appearance of pathological entities on various imaging modalities helps the radiologist in making the correct diagnosis.

Alice Walker was an American writer, the first African American woman to win the Pulitzer prize for Fiction in 1982 which she was awarded for her novel The Color Purple. This paper focuses on (FGM) Female Genital Mutilation in Possessing the Secret of Joy.Female Genital Mutilation (FGM) is a procedure performed on a girl or woman to modify her genitalia for non-scientific reasons. It most usually entails the partial or overall elimination of the outside genitalia. FGM is a contravention of women’s essential human rights.The reason behind the practice (FGM) varies in some African culture and it is seen as a religious belief. Tashi is a minor character in The Color Purple, the protagonist of the novel Possessing the Secret of Joy and undergoes the female genital mutilation (FGM) as a part of ritual practice.

Background Virtual recruitment is a new and more cost-effective alternative to traditional in-person recruitment in academic medicine. However, little is known about the perceived repercussions of the switch across a variety of training settings. Objective To describe the perceptions of graduate medical education program leaders about virtual matching and preferred format for future recruitment within an integrated health care delivery system sponsoring residency and fellowship programs at both university- and community-based primary teaching sites. Methods We surveyed program leadership of 136 Accreditation Council for Graduate Medical Education programs at a single sponsoring institution in April 2021, following residency match results but before matched applicants began programs. The 40-item survey pertained to various aspects of recruitment. Select questions were assessed using a 5-point Likert scale. Descriptive statistics, Student's t test, and ordinal linear regression models were used for analysis. Results Out of 136 programs, 129 (94.8%) responded. Overall, preferred format for recruitment was neutral, although there was wide heterogeneity of responses. Programs felt that virtual recruitment marginally decreased their ability to describe strengths but did not affect the strength or diversity of their matched class. Community sites preferred in-person recruitment. Conclusions Programs did not perceive that virtual recruitment affected the strength or diversity of their 2021 matched class, although community programs were more likely to prefer in-person formats.

Asylum seekers face significant and unique healthcare challenges, requiring healthcare practitioners, specifically in primary care, to be trained to care for this patient population. However, there is limited understanding of medical students' interest in and future ability to care for the population of asylum seekers in the United States.We aim to understand U.S. medical students' interest, experience, and knowledge in providing care for asylum seekers to assess the need for change in the ways in which medical schools introduce asylum seeker care to learners.A 23-question survey was administered to U.S. medical students at four institutions with asylum programmes affiliated with Physicians for Human Rights (PHR) from June 2020 to March 2021, querying various aspects of providing care to asylum seekers.Of the approximately 2846 students who received the survey, 436 students (15%) completed it in its entirety. Most respondents desired training about caring for asylum seekers (91%). Over half (52%) rated their knowledge of asylum issues overall as 'poor' or 'none', and 73% thought their medical school's curriculum on asylum seeker health needed improvement.Medical students at schools with affiliated asylum clinics desire to care for asylum seeker patients but feel unprepared to do so, highlighting an unmet need for formal asylum education in U.S. medical schools.

Purpose The COVID-19 pandemic may have exacerbated ethnic health inequalities, particularly in people with multiple long-term health conditions, the interplay with mental health is unclear. This study investigates the impact of the pandemic on the association of ethnicity and multimorbidity with mortality/service use among adults, in people living with severe mental illnesses (SMI). Methods This study will utilise secondary mental healthcare records via the Clinical Record Interactive Search (CRIS) and nationally representative primary care records through the Clinical Practice Interactive Research Database (CPRD). Quasi-experimental designs will be employed to quantify the impact of COVID-19 on mental health service use and excess mortality by ethnicity, in people living with severe mental health conditions. Up to 50 qualitative interviews will also be conducted, co-produced with peer researchers; findings will be synthesised with quantitative insights to provide in-depth understanding of observed associations. Results 81,483 people in CRIS with schizophrenia spectrum, bipolar or affective disorder diagnoses, were alive from 1st January 2019. Psychiatric multimorbidities in the CRIS sample were comorbid somatoform disorders (30%), substance use disorders (14%) and personality disorders (12%). In CPRD, of 678,842 individuals with a prior probable diagnosis of COVID-19, 1.1% (N = 7493) had an SMI diagnosis. People in the SMI group were more likely to die (9% versus 2% in the non-SMI sample) and were more likely to have mental and physical multimorbidities. Conclusion The effect of COVID-19 on people from minority ethnic backgrounds with SMI and multimorbidities remains under-studied. The present mixed methods study aims to address this gap.

The present study was conducted with an aim to assess the knowledge gained by trainees about various aspects of scientific dairy farming organised by Krishi Vigyan Kendra, Lakhimpur. A total of 172 numbers of trainees participated in trainings on scientific dairy farming over a period during 2019 and 2020. The data were collected pre and post completion of the training with the help of questionnaire which were distributed to the trainees before training. The questionnaire consisted of 15 different aspects of breed, management, breeding, feeding, marketing and diseases of cattle. A score of one and zero score was assigned for each correct and incorrect response and percentage calculation was carried out for analysis of knowledge level and knowledge gain. It was found that majority of the trainees were middle aged (47.67%), followed by young (29.65%) and Old age (22.67%).Majority of the trainees were from general category (34.30%) followed by OBC (31.39%), scheduled caste (22.09%) and scheduled tribe (12.20%). Among those who attended training 23.83% had education till middle school level followed by primary 22.67%, 21.51% were found completed secondary education, whereas ,15.69% completed higher secondary. 9.88% were illiterate lastly followed by graduates with 6.39%.The overall knowledge of trainees on pre training evaluation was found to be 25.54% which came up to 91.35% on post training evaluation. Evaluation of knowledge gain on various aspects of scientific dairy farming showed that maximum knowledge was gained on vaccination in cattle (85.46%, Rank I) and minimum gain was in knowledge on oestrus period of cow (47.67%, Rank XV).

Pomegranate crops are prone to wilt complex disease, which is known to severely hamper the crop yield. There have been limited studies that have explored bacteria–plant–host associations in wilt complex disease affecting pomegranate crops. In the present study, wilt infected rhizosphere soil samples (ISI, ASI) in pomegranate were studied in comparison to a healthy control (HSC). The 16S metagenomics sequencing approach using the MinION platform was employed for screening of bacterial communities and predictive functional pathways. Altered physicochemical properties in the soil samples were recorded showing a comparatively acidic pH in the ISI (6.35) and ASI (6.63) soil samples to the HSC soil (7.66), along with higher electrical conductivity in the ISI (139.5 µS/cm), ASI soil (180 µS/cm), HSC soil sample (123.33 µS/cm). While concentration of micronutrients such as Cl and B were significantly higher in the ISI and ASI soil as compared to the HSC, Cu and Zn were significantly higher in the ASI soil. The effectiveness and accuracy of 16S metagenomics studies in identifying beneficial and pathogenic bacterial communities in multi-pathogen–host systems depend on the completeness and consistency of the available 16S rRNA sequence repositories. Enhancing these repositories could significantly improve the exploratory potential of such studies. Thus, multiple 16S rRNA data repositories (RDP, GTDB, EzBioCloud, SILVA, and GreenGenes) were benchmarked, and the findings indicated that SILVA yields the most reliable matches. Consequently, SILVA was chosen for further analysis at the species level. Relative abundance estimates of bacterial species showed variations of growth promoting bacteria, namely, Staphylococcus epidermidis, Bacillus subtilis, Bacillus megatarium, Pseudomonas aeruginosa, Pseudomonas putida, Pseudomonas stutzeri and Micrococcus luteus. Functional profiling predictions employing PICRUSt2 revealed a number of enriched pathways such as transporter protein families involved in signalling and cellular processes, iron complex transport system substrate binding protein, peptidoglycan biosynthesis II (staphylococci) and TCA cycle VII (acetate-producers). In line with past reports, results suggest that an acidic pH along with the bioavailability of micronutrients such as Fe and Mn could be facilitating the prevalence and virulence of Fusarium oxysporum, a known causative pathogen, against the host and beneficial bacterial communities. This study identifies bacterial communities taking into account the physicochemical and other abiotic soil parameters in wilt-affected pomegranate crops. The insights obtained could be instrumental in developing effective management strategies to enhance crop yield and mitigate the impact of wilt complex disease on pomegranate crops.

Aim: To analyze the impact of postpartum antibiotic (Ab) prophylaxis on the infant gut microbiome. Materials & methods: Whole metagenomic analysis was performed on breast milk and infant fecal samples collected from mother–infant pairs who belonged to two groups: an Ab group comprising mothers who had received a single course of Abs in the immediate postpartum period and a non-Ab group comprising mothers who had not received Abs. Results: The characteristic presence of Citrobacter werkmanii, an emerging multidrug-resistant uropathogen, and a higher relative abundance of genes encoding resistance to specific Abs were noted in samples from the Ab group compared with those from the non-Ab group. Conclusion: Policies regarding prophylactic Ab prescription across government and private health sectors in the postpartum period need to be strengthened.

12 páginas.- 4 figuras.- referencias.- Additional supporting information can be found online in the Supporting Information section at the end of this article.- Full Access in https://onlinelibrary.wiley.com/doi/full/10.1111/geb.13652, Aim Our understanding of the mechanisms that maintain forest diversity under changing climate can benefit from knowledge about traits that are closely linked to fitness. We tested whether the link between traits and seed number and seed size is consistent with two hypotheses, termed the leaf economics spectrum and the plant size syndrome, or whether reproduction represents an independent dimension related to a seed size–seed number trade-off. Location Most of the data come from Europe, North and Central America and East Asia. A minority of the data come from South America, Africa and Australia. Time period 1960–2022. Major taxa studied Trees. Methods We gathered 12 million observations of the number of seeds produced in 784 tree species. We estimated the number of seeds produced by individual trees and scaled it up to the species level. Next, we used principal components analysis and generalized joint attribute modelling (GJAM) to map seed number and size on the tree traits spectrum. Results Incorporating seed size and number into trait analysis while controlling for environment and phylogeny with GJAM exposes relationships in trees that might otherwise remain hidden. Production of the large total biomass of seeds [product of seed number and seed size; hereafter, species seed productivity (SSP)] is associated with high leaf area, low foliar nitrogen, low specific leaf area (SLA) and dense wood. Production of high seed numbers is associated with small seeds produced by nutrient-demanding species with softwood, small leaves and high SLA. Trait covariation is consistent with opposing strategies: one fast-growing, early successional, with high dispersal, and the other slow-growing, stress-tolerant, that recruit in shaded conditions. Main conclusions Earth system models currently assume that reproductive allocation is indifferent among plant functional types. Easily measurable seed size is a strong predictor of the seed number and species seed productivity. The connection of SSP with the functional traits can form the first basis of improved fecundity prediction across global forests., The project has been funded by grants to J.S.C. from the National Science Foundation, most re-cently DEB-1754443, and by the Belmont Forum (1854976), NASA (AIST16-0052 and AIST18-0063) and the Programme d'Investissement d'Avenir under project FORBIC (18-MPGA-0004; Make Our Planet Great Again). Jerry Franklin's data remain acces-sible through NSF LTER DEB-1440409. Data from Hubbard Brook (New Hampshire) were funded through NSF-LTER. Puerto Rico data were funded by NSF grants, most recently DEB 0963447 and LTREB 11222325. Data from the Andes Biodiversity and Ecosystem Research Group were funded by the Gordon and Betty Moore Foundation and NSF 727 LTREB 1754647. M.B. was supported by grant no. 2019/35/D/NZ8/00050 from the (Polish) National Science Centre and by Polish National Agency for Academic Exchange Bekker programme PPN/BEK/2020/1/00009/U/00001. Research by the USDA Forest Service and the USGS was funded by these agencies. Any use of trade, firm or product names does not imply endorsement by the US Government. Any use of trade, firm, or product names is for descriptive purposes only and does not imply en -dorsement by the U.S. Government

A multi-institutional investigation for dosimetric evaluation of high-Z hip prosthetic device in photon beam.A bilateral hip prosthetic case was chosen. An in-house phantom was built to replicate the human pelvis with two different prostheses. Dosimetric parameters: dose to the target and organs at risk (OARs) were compared for the clinical case generated by various treatment planning system (TPS) with varied algorithms. Single beam plans with different TPS for phantom using 6 MV and 15 MV photon beams with and without density correction were compared with measurement.Wide variations in target and OAR dosimetry were recorded for different TPS. For clinical case ideal PTV coverage was noted for plans generated with Corvus and Prowess TPS only. However, none of the TPS were able to meet plan objective for the bladder. Good correlation was noticed for the measured and the Pinnacle TPS for corrected dose calculation at the interfaces as well as the dose ratio in elsewhere. On comparing measured and calculated dose, the difference across the TPS varied from -20% to 60% for 6 MV and 3% to 50% for the 15 MV, respectively.Most TPS do not provide accurate dosimetry with high-Z prosthesis. It is important to check the TPS under extreme conditions of beams passing through the high-Z region. Metal artifact reduction algorithms may reduce the difference between the measured and calculated dose but still significant differences exist. Further studies are required to validate the calculational accuracy.

Doom pig is unique indigenous germplasm of Assam which is adaptable to local climatic conditions and thrives with very low to negligible nutritional input and is capable of surviving in a migratory scavenging system, which makes it very popular among local communities of the state for rearing. Looking at the uniqueness and importance of the breed, it has been registered with the National Database of ICAR-National Bureau of Animal Genetic Resources (INDIA_PIG_0200_DOOM_09006). The present study was undertaken to study the breeding tract, rearing practice in the field, evaluate the performance in the organized farm as well as its conservation needs. Formation of breed society, recognition of farmers, educating the stakeholders to use improved packages of practices and provision of incentives to the farmers to rear the animals will be helpful for the improvement of this unique germplasm.

Electron beam from a linear accelerator is commonly used in total skin electron therapy (TSET) at extended distances. Since Das et al (Med Phys 21, p.1733, 1994) reported 5% bremsstrahlung dose for a 6 MeV electron beam at extended distance of 500 cm it has been accepted as common knowledge. However, measurements by Chen et al (Int J. Rad Onc Biol Phys 59 p.872, 2004) and Monte Carlo simulations by Ding et al (Phys. Med. Biol. 66, 075010, 2021) were unable to reproduce such high bremsstrahlung dose. As bremsstrahlung dose contributes to whole-body dose, which could produce bone marrow toxicity with serious complications for the outcome of the TSET, it is important to re-evaluate the magnitude of bremsstrahlung dose accurately.The EGSnrc Monte Carlo system is used to investigate bremsstrahlung doses from 6 MeV high dose rate total skin electron (HDTSe) beams from Varian TrueBeam and Clinac Accelerators. The measurements were carried out at a depth of dWe were able to reproduce previously reported high bremsstrahlung dose at extended distances by using a parallel plate ionization chamber. However, both the measurements made by using a cylindrical chamber and Monte Carlo simulations showed an insignificant bremsstrahlung dose (∼1%) even at SSD = 500 cm.The bremsstrahlung doses of a 6 MeV electron beam are 0.5% to 1% for SSD from 100 to 700 cm, although it increases with the increasing extended distance. The common belief of up to 5% bremsstrahlung dose at large extended distances is incorrect. Previously reported high bremsstrahlung doses might be due to poor signal-to-noise ratio of using a parallel plate chamber for measuring very low dose or particular setup.