Solitary Crossed Renal Ectopia with Vesicoureteral Reflux

Solitary crossed renal ectopia is a rare anomaly of the urinary tract. This anomaly is often diagnosed incidentally when patients are being evaluated for other associated findings including genitourinary, cardiovascular, hematological or vertebral abnormalities. We report a boy with solitary crossed renal ectopia that was considered a solitary normal positioning kidney by ultrasonography and dimercaptosuccinic acid scan.  However, voiding cystourethrogram revealed vesicoureteral reflux and crossed ectopia. Therefore, in any normal appearing solitary kidney, crossed ectopia may be a possible finding. Keywords: EctopicKidney; Vesico-Ureteral Reflux; Ureter.

Coordination of recognition and disclosure decisions in uncertainties reporting: investigating the relationship between conditional conservatism and risk disclosu

Accounting Conservatism and risk disclosure are two information policies that managers can use to transfer business uncertainties to external users. Managers are expected to coordinate their reporting and disclosure choices by considering the cost and benefit of these two choices when making financial reporting decisions and coordinate or trade off the two options of conservatism and risk disclosure. This study investigated the relationship between conditional conservatism and risk disclosure. It also analyzed the effect of the factors of the level of debt financing needs and the manager's overconfidence by using a multiple regression model based on the sample of 87 companies listed on the Tehran stock exchange for the period of 2011 to 2020. The results indicate that managers use conditional conservatism and risk disclosure as two complementary information policies to reduce information asymmetry and agency costs. By applying more Conditional conservatism, managers improve the level of risk disclosure in proportion to the level of uncertainty perceived through risk disclosure by users to maintain consistency between quantitative and qualitative information. The debt financing needs has a negative and significant effect, and the overconfidence characteristic of managers has no significant effect on the relationship between the level of conditional conservatism and the level of risk disclosure of firms. Companies with a higher debt financing needs use more conditional conservatism than risk disclosure to reduce debt Costs. The results show that the relative costs and benefits of conservative reporting and risk disclosure affect financial reporting policies regarding risks and uncertainties. Introduction The relationship between accounting conservatism and risk disclosure is included under the relationship between recognition and disclosure decisions. The level of accounting conservatism is important in deciding the optimal level of disclosure, and Earnings Attributes are related to companies' voluntary disclosure decisions (Francis et al., 2008). Based on contractual and litigation incentives, conditional conservatism and risk disclosure are two alternative tools to reduce information asymmetry about uncertainties and reduce agency costs. As a result, managers may coordinate between these two options by considering the costs and limited benefits of each. The way managers make decisions in choosing the level of accounting conservatism and disclosure, such as earnings forecasting, has been investigated in previous studies, but no research has investigated the relationship between the level of accounting conservatism and risk disclosure as one of the types of qualitative disclosure. Hence, the question arises as to how managers coordinate the decisions of choosing the level of conservatism and risk disclosure. The purpose of this research is to explore how managers' decisions are coordinated in the two choices of conditional accounting conservatism and risk disclosure, under the influence of the debt financing needs and management characteristics in companies listed on the Tehran Stock Exchange. To cover the objectives of the research, three hypotheses including (1) the existence of a significant relationship between conditional conservatism and risk disclosure, (2) the effect of the company's debt financing needs, and (3) managers' overconfidence on the relationship between the level of conditional conservatism and the level of risk disclosure have been described and tested.MethodsResearch hypotheses have been examined by using a multivariable regression model and based on the sample of 87 companies listed on the Tehran stock exchange for the period of 2011 to 2020. The data needed for the research has been extracted from the financial statements, explanatory notes, the Management Discussion and Analysis, and the directors’ reports.The first research hypothesis is tested using equation (1).Equation (1) where RDit (the dependent variable) is the level of risk disclosure, which has been measured using the content analysis of the explanatory notes, the Management Discussion and Analysis, and the directors’ reports. Conservit (the independent variable) is conditional conservatism calculated using khan and Watts’ (2009) C-Score. Controlk,it are the control variables of the level of risk disclosure that have been selected and measured based on previous studies.The second hypothesis is tested using equation (2).Equation (2) where FIN_Needs is the variable of the need to finance through debt, which is calculated using the financing deficit criterion according to Deng et al. (2018).To test the third hypothesis, equation (3) is used to examine the effect of management overconfidence on the relationship between conservatism and risk disclosure:Equation (3) where OverConf is the manager's overconfidence variable, which is calculated based on investment-based overconfidence according to Ahmed and Duellman (2013). FindingsThere is a significant positive relationship between the level of conditional conservatism and the level of risk disclosure. The need to finance through debt has a negative and significant effect, and the overconfidence characteristic of managers has no significant effect on the relationship between the level of conditional conservatism and the level of risk disclosure of firms. Conclusion & Result The results show that managers use conditional conservatism and risk disclosure as two complementary information policies. The result conflicts with the results of Hui et al. (2009), Wang (2019), D'Augusta and DeAngelis (2020), Asadi and Bayat (2014), Nikbakht and Hajiazimi (2013) and AsadiMashizi et al. (2020). Based on the contractual and litigation demand, when companies face higher uncertainty and risk, they use more conservative accounting in their financial reporting (Dai & Ngo, 2021؛ Haque et al., 2019؛ Hsieh et al., 2019؛ Hejranijamil et al., 2020) and disclose higher risk to reduce agency costs, including the cost of debt and the possibility of lawsuits.This can be justified based on the argument of D'Augusta and DeAngelis (2020) about investors' understanding of the differences between quantitative and qualitative information. Conservatism conveys business uncertainties quantitatively and risk disclosure qualitatively conveys uncertainties to users. With a greater level of accounting conservatism, managers improve the level of risk disclosure in proportion to the level of uncertainty perceived through risk disclosure by users to maintain consistency between quantitative and qualitative information. The result is consistent with the results of Huang et al. (2014) and Nagar et al. (2019). Also, it can be explained with the assumption that the existence of reporting and risk disclosure requirements limits managers to trade-off risk disclosure and the level of conservatism, especially from the perspective of increased costs from the benefits of disclosure. Moreover, the results are consistent with the argument of Linsley and Shrives (2006) in support of mandatory risk disclosure and the research results of Dyer et al. (2017).Based on the contractual theory, companies with a higher need to finance through debt use a more conditional conservatism level than risk disclosure to reduce debt. The results show that the relative costs and benefits of conservative reporting and risk disclosure affect financial reporting policies regarding risks and uncertainties. This is consistent with the research results of Deng et al. (2018) and Michels (2017).Also, unlike previous studies (such as Ahmed and Duellman (2013) and Ramsheh and Molanzari (2014)), the results indicate that managers with overconfidence characteristics have higher risk tolerance and also provide higher levels of voluntary disclosure.Finally, the results of the research indicate that the users of financial statements should consider the financial reporting policies of a company in interpreting the information of financial reports about risks and uncertainties, because each of these policies and reporting choices in different conditions such as the need to finance through debt may affect how information is disclosed

Multimorbidity as an important issue among women: results of gender difference investigation in a large population-based cross-sectional study in West Asia

Objectives: To investigate the impact of gender on multimorbidity in northern Iran. Design: A cross-sectional analysis of the Golestan cohort data. Setting: Golestan Province, Iran. Study population: 49 946 residents (age 40–75 years) of Golestan Province, Iran. Main outcome measures: Researchers collected data related to multimorbidity, defined as co-existence of two or more chronic diseases in an individual, at the beginning of a representative cohort study which recruited its participants from 2004 to 2008. The researchers utilised simple and multiple Poisson regression models with robust variances to examine the simultaneous effects of multiple factors. Results: Women had a 25.0% prevalence of multimorbidity, whereas men had a 13.4% prevalence (p<0.001). Women of all age-groups had a higher prevalence of multimorbidity. Of note, multimorbidity began at a lower age (40–49 years) in women (17.3%) compared with men (8.6%) of the same age (p<0.001). This study identified significant interactions between gender as well as socioeconomic status, ethnicity, physical activity, marital status, education level and smoking (p<0.01). Conclusion: Prevention and control of multimorbidity requires health promotion programmes to increase public awareness about the modifiable risk factors, particularly among women

Multimorbidity as an important issue among women: results of gender difference investigation in a large population-based cross-sectional study in West Asia

Objectives: To investigate the impact of gender on multimorbidity in northern Iran. Design: A cross-sectional analysis of the Golestan cohort data. Setting: Golestan Province, Iran. Study population: 49 946 residents (age 40–75 years) of Golestan Province, Iran. Main outcome measures: Researchers collected data related to multimorbidity, defined as co-existence of two or more chronic diseases in an individual, at the beginning of a representative cohort study which recruited its participants from 2004 to 2008. The researchers utilised simple and multiple Poisson regression models with robust variances to examine the simultaneous effects of multiple factors. Results: Women had a 25.0% prevalence of multimorbidity, whereas men had a 13.4% prevalence (p<0.001). Women of all age-groups had a higher prevalence of multimorbidity. Of note, multimorbidity began at a lower age (40–49 years) in women (17.3%) compared with men (8.6%) of the same age (p<0.001). This study identified significant interactions between gender as well as socioeconomic status, ethnicity, physical activity, marital status, education level and smoking (p<0.01). Conclusion: Prevention and control of multimorbidity requires health promotion programmes to increase public awareness about the modifiable risk factors, particularly among women

Nanoparticles of Conjugated Methotrexate-Human Serum Albumin: Preparation and Cytotoxicity Evaluations

Methotrexate-human serum albumin conjugates were developed by a simple carbodiimide reaction. Methotrexate-human serum albumin conjugates were then crosslinked with 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide HCl (EDC) to form nanoparticles. The size of nanoparticles determined by laser light scattering and TEM was between 90–150 nm. Nanoparticles were very stable at physiologic conditions (PBS pH 7.4, 37∘C) and after incubation with serum. The effect of amount of EDC used for crosslinking on the particle size and free amino groups of nanoparticles was examined. The amount of crosslinker showed no significant effect on the size of nanoparticles but free amino groups of nanoparticles were decreased by increasing the crosslinker. The physicochemical interactions between methotrexate and human serum albumin were investigated by differential scanning calorimetry (DSC). Nanoparticles were more cytotoxic on T47D cells compared to free methotrexate. Moreover, methotrexate-human serum albumin nanoparticles decreased the IC50 value of methotrexate on T47D cells in comparison with free methotrexate

Recurrence of nephrotic syndrome following kidney transplantation in a child with congenital nephrotic syndrome

Recurrence of original disease is a common threat in the field of transplantation. Recurrence of nephrotic syndrome is not common in children with congenital nephrotic syndrome (CNS). We report a case of a female child with CNS who presented with nephrotic state at first month of age and became dialysis dependent at 17 months of age. After seven months of continuous ambulatory peritoneal dialysis, she received a kidney from a deceased donor. Eight months after transplantation, she presented with a full-blown feature of nephrotic syndrome. She responded well to rituximab

Gouty arthritis in a 15-year-old girl with Bartter′s syndrome

A 15-year-old girl, a known case of Bartter′s syndrome (BS) for 7 years, developed severe pain in her right knee and right and left ankle. Her older sister had BS and developed end-stage renal disease (ESRD) at the age of 14 years. Her serum uric acid was 12.6 mg/dL, 6 months ago, and 15.4 mg/dL in her recent lab data. Hyperuricemia and gouty arthritis are commonly seen in adults with BS, but to our knowledge there is no report of gouty arthritis in pediatric literature