Plummer-Vinson Syndrome

A 37-year-old African American woman with no past medical history presented to the Emergency Department with a chief complaint of abdominal pain. She also reported associated fatigue and dysphagia. Over the past two months, she reported 40 Lbs. unintentional weight loss and decrease appetite. Her dysphagia primarily to solids, which also had been worsening over the past few weeks. She had no history of similar symptoms in the past. She was not on any medications. On admission, vital signs were stable. In the Emergency Department,. Hemoglobin on admission was 3.3 g/dL [11.9–15.1 g/dL] with a mean corpuscular volume of 61.1. Her serum iron on admission was 10 ug/dL [60–140 ug/dL], iron saturation was 2% [15–50%], and ferritin was 1.0 ng/mL [11.0–307 ng/mL]. Upon further questioning, the patient stated that she did not describe menorrhagia. She denied hematemesis, hematochezia, or melena. She was transfused with 3 units of packed red blood cells and was started on 1000 mg of IV iron dextran complex infusions. Gastroenterology was consulted, and the patient underwent esophagogastroduodenoscopy (EGD) and colonoscopy. Colonoscopy showed erythematous and edematous mucosa in the terminal ileum which was Biopsied. The EGD revealed a few intrinsic stenoses in the upper esophagus which were successfully dilated with savary. A pathology exam of the terminal ileum showed well differentiated neuroendocrine tumor. Given the clinical, laboratory, and endoscopic (as shown below) Esophageal web located in the upper esophagus. a diagnosis of Plummer-Vinson syndrome was made. Her dysphagia improved over the three days in the hospital after iron infusions and blood transfusions, and she was able to tolerate a regular diet. Approximately 2 months after her discharge, a follow-up phone call was made to the patient. She stated that she had been compliant with all her medications and her dysphagia had resolved. At the time of the phone call, she was tolerating a regular diet without any dietary restrictions.https://scholarlycommons.henryford.com/merf2020caserpt/1132/thumbnail.jp

Fermion Condensate and Vacuum Current Density Induced by Homogeneous and Inhomogeneous Magnetic Fields in (2+1)-Dimensions

We calculate the condensate and the vacuum current density induced by external static magnetic fields in (2+1)-dimensions. At the perturbative level, we consider an exponentially decaying magnetic field along one cartesian coordinate. Non-perturbatively, we obtain the fermion propagator in the presence of a uniform magnetic field by solving the Schwinger-Dyson equation in the rainbow-ladder approximation. In the large flux limit, we observe that both these quantities, either perturbative (inhomogeneous) and non-perturbative (homogeneous), are proportional to the external field, in agreement with early expectations.Comment: 8 pages, 2 figures. Accepted for publication in Phys. Rev.

Modern dance commodification strategy in tourism promotion (Study on the modern dance community in Kupang city)

Purpose: This study aimed to describe the modern dance commodification strategy in promoting cultural tourism in East Nusa Tenggara Province. Research methodology: The research method used in this research is a qualitative method. Respondents used in this study were 15 people. Data processing was performed using a SWOT analysis. Results: According to the analysis results, the most appropriate strategy for the modern dance community in developing cultural tourism in East Nusa Tenggara is to work together with various parties, create online competitions, innovate with culture, and organize independent events by the dancer community. Limitations: This study only discusses the strategy of the commodification of modern dance in tourism promotion in East Nusa Tenggara. Contribution: This research can become scientific information for students specifically studying tourism. Keywords: Modern dance commodification, Tourism promotio

Pengaruh Penggunaan Limbah Batu Onyx Sebagai Pengganti Agregat Kasar Pada Campuran Beton Terhadap Kuat Lentur Beton

Beton merupakan Bahan yang didapat dengan mencampurkan semen portland atau semen hidrolik yang lain, agregat halus, agregat kasar dan air, dengan atau tanpa bahan tambahan yang membentuk masa padat. Penggunaan beton yang masih mendominasi dewasa ini, membuat kebutuhan bahan material kerikil semakin meningkat. Di sisi lain terdapat beberapa lingkungan yang menghasilkan limbah padat. Sehingga menuntut adanya inovasi dalam pembuatan bahan material beton. Salah satunya dilakukan penelitianmemanfaatkan limbah batu onyx yang memiliki porositas kecil sehingga dapat mengurangi penyerapan air pada agregat yang diharapkan dapat digunakan sebagai bahan alternatif pengganti agregat kasar kerikil pada beton. Salah satu sifat mekanik beton yang perlu diperhatikan adalah kuat lentur beton, yaitu kuat tarik beton tak langsung dalam keadaan lentur akibat momen dari beton. Metode pengujian yang digunakan dengan balok uji sederhana yang dibebani terpusat di tengah bentang di atas dua perletakan. Tujuan penelitian ini adalah untuk mengetahui pengaruh penggantian kerikil dengan batu onyx terhadap kuat lentur beton dan mengetahui faktor air semen yang paling optimal. Balok uji yang dipakai yaitu berukuran 60 cm x 15 cm x 15 cm dengan mutu K 200 dan menggunakan macam variasi faktor air semen 0,4, 0,5, dan 0,6.Hasil Penelitian menunjukkan beton dengan menggunakan agregat kasar batu onyx FAS 0,4 memiliki kuat lentur rata-rata 5,351 Mpa dan 5,092 untuk agregat kerikil dengan selisih 4,840%. FAS 0,5agregat kasar batu onyx memiliki kuat lentur rata-rata 4,157 Mpa dan 4,551 untuk agregat kerikil dan 4,551 Mpa dengan selisih 8,657%. FAS 0,6 agregat kasar batu onyx memiliki kuat lentur rata-rata 3,128 Mpa dan 3,278 Mpa untuk agregat kerikil dengan selisih 4,795%. Dan FAS yang paling optimum pada penelitian ini adalah FAS 0,4 dan penggunaan limbah batu onyx dapat digunakan sebagai alternatif bahan pengganti agregat batu kerikil untuk beton struktural

Consumidor internacional

la presente ponencia intenta hacer un breve análisis de las disposiciones del Libro VI, Título IV del Código Civil y Comercial de la Nación en materia de contratos de consumo, efectuando un comparativo con las disposiciones sobre Contratos Internacionales en general. Se arriba a la conclusión parcial de que se elimina todo acuerdo de elección del foro (para evitar el aprovechamiento abusivo de la parte más débil de la relación) aunque el consumidor podrá elegir jurisdicción de un marco acotado de reglas. La autonomía de la voluntad está absolutamente vedada en materia de derecho aplicable, aunque se eligió el principio de mayor conexidad con el caso internacional, es decir, el domicilio del consumidor. Es notoria la ausencia de vigencia del Protocolo de Santa María sobre Jurisdicción Internacional en Materia de Relaciones de Consumo en el ámbito del Mercosur y de alguna otra Convención al respecto.Facultad de Ciencias Jurídicas y Sociale

Light-front wave functions of vector mesons in an algebraic model

Inspired by the recent development of an algebraic model which provides an adequate and unified description of the internal structure of the lowest-lying pseudoscalar mesons, belonging both to the light quarks sector and to the one of heavy quarks, we perform its first extension to the vector-meson case. The algebraic model describes the meson’s structure in terms of the spectral density function that appears in a Nakanishi integral representation of the covariant quark-antiquark bound-state amplitude, i.e., the Bethe- Salpeter amplitude. We compute the leading-twist light-front wave functions of the ρð770Þ, ϕð1020Þ, J=ψ, and ϒð1SÞ mesons through their connection with the parton distribution amplitudes. Among the results we present, the following are of particular interest: (i) transverse light-front wave functions can be obtained algebraically from the corresponding parton distribution amplitudes, whereas that is not the case for longitudinal light-front wave functions, which requires an intermediate step where a spectral density function must be derived from the particular parton distribution amplitude; (ii) the derived spectral density functions show marked differences between light and heavy vector mesons, the latter being narrower as compared to the former, and these are also nonpositive definite, although the integral over the entire curve is larger than zero as expected; and (iii) the longitudinal and transverse light-front wave functions of vector mesons with light quark content exhibit steep x and p2 ⊥ dependence, while those of the J=ψ and ϒð1SÞ mesons are characterized by narrow distributions in the x range but, comparatively, much more gradual falloffs with respect to the p2 ⊥ range depicted.B. Almeida Zamora acknowledges CONACyT (Grant No. CVU 935777) for the Phd fellowship. J. J. Cobos-Martínez acknowledges financial support from the University of Sonora under Grant No. USO315007861. A. Bashir acknowledges Coordinación de la Investigación Científica of the Universidad Michoacana de San Nicolás de Hidalgo Grant No. 4.10., the U.S. Department of Energy (DOE) under Contract No. DE-AC05-6OR23177, and the Fulbright-García Robles Scholarship. This work has also been partially funded by Ministerio Español de Ciencia e Innovación under Grant No. PID2019–107844 GB-C22 and Junta de Andalucía under Contracts No. Operativo FEDER Andalucía 2014-2020 UHU-1264517, No. P18- FR-5057, and also No. PAIDI FQM-370

Life-history traits of the giant squid Architeuthis dux revealed from stable isotope signatures recorded in beaks

Peer reviewedPreprin

Effects of a Six-Month Walking Intervention on the Physical Activity Measures Among Older Adults

Please refer to the pdf version of the abstract located adjacent to the title