Obesity and high risk pathological features of papillary thyroid carcinoma: A retrospective analysis of a university hospital in Pakistan

BACKGROUND: Incidence of papillary thyroid carcinoma (PTC) and the frequency of obesity is increasing globally. In literature, relationship between excessive body weight and bad prognostic features of PTC is still debatable. In this study, we aimed to explore the association of obesity with high risk pathological features of PTC in a population treated by total thyroidectomy +/- neck dissection. MATERIALS AND METHODS: Retrospective analysis of patients at Aga Khan University Hospital from January 2013 to December 2014, who underwent total thyroidectomy +/- neck dissection due to PTC. Patients were grouped according to World Health Organization (WHO) classification of BMI. They were categorized into two groups, i.e. normal (BMI= 18.5 - 24.9 kg/m2) and obese (BMI = 30 kg/m2) as none of our patients lie in underweight and overweight category. Pathological features i.e. T-stage, multifocality, bilaterality, extrathyroidal extension, vascular invasion and N-stage were assessed. All tumors were staged according to TNM staging system proposed by 2010 American Joint Committee on Cancer (AJCC). Odds ratio (OR) with 95% confidence interval was used to examine the association between BMI ∧ pathological characteristics of PTC. RESULTS: A total of 53 patients were treated for PTC in two-years period. There were 38 female and 15 male patients. Twenty-eight patients had BMI in normal while twenty-five in obese category. Patients who were in obese category had a significantly greater risk of having a multifocal tumor (OR=5.55, p-value=0.02) and bilaterality (OR=6.54, p-value=0.01) compared to normal weight patients. No positive associations were identified between BMI and extrathyroidal extension, high T-stage, vascular invasion and N-stage. CONCLUSION: Obesity is not associated with high risk pathological features such as extrathyroidal extention, high T-stage, vascular invasion and N-stage in PTC. Although it has been correlated with multifocal and bilateral tumors in this retrospective study, the presence of these factors alone is not adequate to support the association conclusively

Analisis Distribusi Ayam Broiler di Propinsi Daerah Istimewa YOGYAKARTA

Production of broiler chicken at Yogyakarta Province exceeds its consumption so that Yogyakarta province becomes one of suppliers of chicken for other regions, especially Jakarta. The objective of this research is to formulate distribution channel of broiler chicken, to determine transmission price elasticity and to estimate margin among distribution chan¬nels. The results show that pattern of production system consists of non-cooperative sys¬tem and cooperative (nucleus-core) system. Distribution channel of the non-cooperative system is more various than of that nucleus-core system. The margin of former system is also more efficient but more risky. Finally, producers are less responsive to price changes than distributors

Vestibular schwannomas: Clinical presentation, management and outcome

Objective: To review the demographic trends clinical spectrum, diagnosis, management and outcome of patients with vestibular Schwannoma and to identify areas where improvements are needed.Methods: All patients with vestibular schwannoma admitted to the Aga Khan University Hospital over the past 11 years were reviewed retrospectively.Results: The age range of majority of 22 patients analyzed, was 41-50 years (23%). Hearing loss was the most common presenting symptom (96%). Other clinical features included cranial nerve palsies (59%) and headache (55%). Fifty percent had signs of raised intracranial pressure. Neuroimaging revealed Stage IV b (tumor distorting the brainstem and compressing the 4th ventricle) in 50% cases. Neurosurgical intervention was carried out in 86%; mainly using the retrosigmoid approach. Postoperative complications included facial nerve palsy in 13 (65%) and hydrocephalus in 5 (25%) patients. Hearing determined clinically was preserved in three patients (14%). One patient died during the inpatient stay.Conclusion: Presentation of these patients is late and the outcome is poor

Mindfulness and Creative Process Engagement: The Mediating Role of Workplace Relational Systems

Purpose Despite widespread recognition of the importance of mindfulness in organizational science literature, little is known about how mindfulness motivates individuals to configure information processing and team member exchange relationships to increase creative process engagement. Drawing on motivated information processing theory, this study conceptualizes and empirically examines whether and how mindfulness motivates individuals toward creative process engagement. Design/methodology/approach The authors collected data through an online survey from 311 respondents working in the Research and Development (R&D) departments of organizations in multiple industries in Pakistan. For analytical purposes, the authors have applied the structural equation modeling technique. Findings This study advances a different view of individual mindfulness on the creative process engagement in the following ways. First, mindfulness enables individuals to self-regulate in specific situations and become effective in fostering creative process engagement. Second, this study extends research on relational information processing by linking it to mindfulness and creative process engagement. Relational information processing partially mediates the relationship between mindfulness and creative process engagement. Third, this study highlights that mindfulness motivates individuals to focus more on developing quality working relationships, but they seem less willing to participate in idea generation and problem-solving solutions. Originality/value The study findings provide implications for research on mindfulness, creativity and motivated information processing to enhance individuals’ creative process engagements. The authors also discuss the implications for executives on the relational and creative benefits of mindfulness

Strongly lensed SNe Ia in the era of LSST: observing cadence for lens discoveries and time-delay measurements

The upcoming Large Synoptic Survey Telescope (LSST) will detect many strongly lensed Type Ia supernovae (LSNe Ia) for time-delay cosmography. This will provide an independent and direct way for measuring the Hubble constant $H_0$, which is necessary to address the current $4.4 \sigma$ tension in $H_0$ between the local distance ladder and the early Universe measurements. We present a detailed analysis of different observing strategies for the LSST, and quantify their impact on time-delay measurement between multiple images of LSNe Ia. For this, we produced microlensed mock-LSST light curves for which we estimated the time delay between different images. We find that using only LSST data for time-delay cosmography is not ideal. Instead, we advocate using LSST as a discovery machine for LSNe Ia, enabling time delay measurements from follow-up observations from other instruments in order to increase the number of systems by a factor of 2 to 16 depending on the observing strategy. Furthermore, we find that LSST observing strategies, which provide a good sampling frequency (the mean inter-night gap is around two days) and high cumulative season length (ten seasons with a season length of around 170 days per season), are favored. Rolling cadences subdivide the survey and focus on different parts in different years; these observing strategies trade the number of seasons for better sampling frequency. In our investigation, this leads to half the number of systems in comparison to the best observing strategy. Therefore rolling cadences are disfavored because the gain from the increased sampling frequency cannot compensate for the shortened cumulative season length. We anticipate that the sample of lensed SNe Ia from our preferred LSST cadence strategies with rapid follow-up observations would yield an independent percent-level constraint on $H_0$.Comment: 25 pages, 22 figures; accepted for publication in A&

Understanding Awareness of Cyber Security Threat Among IT Employees

yesCyber-attacks have been an increasing threat on people and organisations, which led to massive unpleasant impact. Therefore, there were many solutions to handle cyber-attacks, including Intrusion Detection Systems (IDS), Intrusion Prevention Systems (IPS). These solutions will provide a huge number of alarms that produce more are false positives. Therefore, the IDS tool result should be operated by a human intelligent be filtered effectively the huge amount of alerts to identify true positive attacks and perform accordingly to the incident response rule. This requires the IT employees to have enough knowledge and competency on operating IDS, IPS and incident handling. This paper aims to examine the awareness of cyber security threat among all IT employees, focusing on three domains: Knowledge, Monitoring and Prevention

Trehalose induced drought tolerance in plants: physiological and molecular responses

Drought stress is significant abiotic stress that limits crop growth and productivity across the globe. The intensity of drought stress continuously rises due to rapid climate change. Drought-induced alterations in physiological and bio-chemical processes by generating membrane dis-stability, oxidative stress, nutritional imbalance and leading to substantial reduction in growth and productivity. Plants accumulate various osmolytes that protect themselves from abiotic stresses' harmful effects. Trehalose (Tre) is a non-reducing sugar found in multiple microbes ranging from bacteria to yeast and in plants and it possesses an excellent ability to improve drought tolerance. Trehalose appreciably enhanced the plant growth, and counter the drought induced damages by maintaining cellular membranes, plant water relations, stomatal regulation, photosynthetic activities, nutrient uptake, osmolyte accumulation, activating stress proteins and detoxifying the reactive oxygen species (ROS) by strengthening the anti-oxidant system. Therefore, it is essential to understand the mechanism of exogenous and endogenous Tre in mitigating the drought-induced damages and to identify the potential research questions that must be answered in the future. Therefore, to better appraise the potential benefits of Tre in drought tolerance in this review, we discussed the diverse physiological and molecular mechanisms regulated by Tre under drought stress. We have a complete and updated picture on this topic to orientate future research directions on this topic

Realization of the farad from the dc quantum Hall effect with digitally-assisted impedance bridges

A new traceability chain for the derivation of the farad from dc quantum Hall effect has been implemented at INRIM. Main components of the chain are two new coaxial transformer bridges: a resistance ratio bridge, and a quadrature bridge, both operating at 1541 Hz. The bridges are energized and controlled with a polyphase direct-digital-synthesizer, which permits to achieve both main and auxiliary equilibria in an automated way; the bridges and do not include any variable inductive divider or variable impedance box. The relative uncertainty in the realization of the farad, at the level of 1000 pF, is estimated to be 64E-9. A first verification of the realization is given by a comparison with the maintained national capacitance standard, where an agreement between measurements within their relative combined uncertainty of 420E-9 is obtained.Comment: 15 pages, 11 figures, 3 table

Health promotion and screening for people with an intellectual disability

People with intellectual disability have significantly worse health than those without, and have a higher level of complex health needs. The life expectancy for men and women is 13 and 20 years shorter, respectively, than the general population. The increasing role of general practice in delivering and coordinating care across health and social care settings requires expert generalist skills to implement an integrated approach to care. This article explores how general practice can improve the health of people with intellectual disability, by making reasonable adjustments within health promotion, disease prevention, screening and detection