Abuse of Dominant Position by Refusing to Issue Copyright Licenses

The aim of the paper is to analyze when firms abuse their dominant position, specifically with respect to refusing to issue copyright licenses. The objective is to understand what is meant by abuse by a dominant enterprise and view how different jurisdictions such as the United States (US) and European Union (EU) have dealt with the same, in order to examine the ability of the Indian legal framework to handle such cases. The scope of the paper is limited to providing a comparative analysis of the EU and US and attempts to apply the same to India. This paper seeks to explore whether competition law and intellectual property law intersect with each other and seeks to examine when dominant conduct can be regarded as abusive. The paper also scrutinizes how the US and EU courts have dealt with cases of denial of IPR license and whether the Indian scenario is well equipped to effectively handle cases of refusal to license

Provider Attitude towards Postpartum Sexual Health

Background: The prevalence of female sexual dysfunction (FSD) worldwide is estimated to be 41%. FSD is even more prevalent in postpartum patients. There are significant barriers to addressing FSD in a busy clinic, and the use of a standardized screening questionnaire could be used to improve outcomes during postpartum appointments. Methodology: Providers that care for postpartum patients at Regional One Health in Memphis, TN, were asked to complete an anonymous survey online. General knowledge and practices of providers were assessed. Results: 79% of respondents answered that they felt very comfortable assessing for postpartum sexual health, and 88% of respondents expressed a need for continued education on sexual medicine. The most common response for barriers to care was a lack of time. None of the respondents reported using questionnaires to assess for sexual health. Conclusion: The most significant barriers to assessing postpartum sexual health are a lack of time and provider knowledge. To overcome this, a standardized questionnaire should be created and improved continued education should be implemented

Renal abscess after the Fontan procedure: a case report

<p>Abstract</p> <p>Introduction</p> <p>The Fontan procedure is an intervention that helps to correct single ventricle physiology. There are many known long-term complications of 'Fontan physiology'. However, the occurrence of renal abscess in such patients has not yet been reported in the literature. The first generation of adults has now undergone the procedure and it is necessary to be aware of the long-term outcomes and complications associated with it.</p> <p>Case presentation</p> <p>We report the case of a 22-year-old South Indian man who had developed a staphylococcal renal abscess against a background of xanthogranulomatous pyelonephritis, nine years after Fontan surgery. He presented to our hospital with a high-grade fever of 25-days duration but with no other symptoms. Physical examination identified costovertebral angle tenderness and pedal edema. An ultrasound scan revealed a mass in his left kidney. The results of a computed tomography scan were consistent with a renal abscess. Despite treatment with the appropriate parenteral antibiotics, there was no change in the size of the abscess and a left nephrectomy was performed as a curative procedure.</p> <p>Conclusions</p> <p>The learning points here are manifold. It is important to be aware of the possibility of renal abscess in a post-procedural patient. The early diagnosis of a septic focus in the kidneymay help to prevent the rare outcome of nephrectomy.</p

Health and the built environment in United States cities: measuring associations using Google Street View-derived indicators of the built environment

The built environment is a structural determinant of health and has been shown to influence health expenditures, behaviors, and outcomes. Traditional methods of assessing built environment characteristics are time-consuming and difficult to combine or compare. Google Street View (GSV) images represent a large, publicly available data source that can be used to create indicators of characteristics of the physical environment with machine learning techniques. The aim of this study is to use GSV images to measure the association of built environment features with health-related behaviors and outcomes at the census tract level.https://doi.org/10.1186/s12889-020-8300-

Role of flexi-rigid thoracoscopy in undiagnosed pleural effusions and correlation of visual appearance of pleura on thoracoscopy with the final diagnosis

Background: Undiagnosed pleural effusions (UPE) account for roughly 25% of cases of all pleural effusions. Minimally invasive flexi-rigid thoracoscopy has high diagnostic yield. Some previous studies have looked into the correlation of the thoracoscopic findings and the final etiological diagnosis, however, data are scarce. This study is aimed to know the role of flexi-rigid thoracoscopy in establishing etiological diagnosis in undiagnosed, treatment naïve pleural effusion patients and the correlation of thoracoscopic findings with the final diagnosis. Materials and Methods: A retrospective descriptive observational study was conducted on 84 newly diagnosed patients in whom pleural effusion remained undiagnosed at the Department of Respiratory, Sleep, Allergy and Critical Care Medicine at the Metro Centre for Respiratory Diseases, Metro Hospital, Noida. Data from hospital records of patients, who were subjected to flexi-rigid thoracoscopy, was collected between January 2010 and December 2013 and analyzed. The diagnostic yield of pleural biopsy using flexi-rigid thoracoscope in UPEs was assessed and the visual appearance of pleura on thoracoscopy was correlated with the final diagnosis. Results: The diagnostic yield of flexi-rigid thoracoscopy in UPEs is 89.28%. When nonspecific pleuritis is considered as a diagnosis, the diagnostic yield increases to 97.6%. The pleural biopsy histopathological examination revealed Nonspecific pleuritis in 14.2% of patients, granuloma consistent with tuberculosis (TB) in54.8%, malignancy in 28.6% of patients confirmed on immunohistochemistry and in 2.3% the diagnosis remained inconclusive. Out of the 12 patients, two were diagnosed to have TB on the basis of pleural biopsy acid-fast bacilli culture showing mycobacterium TB. Post coronary artery bypass graft pleuropericardial effusion, chylothorax, and congestive heart failure were diagnosed in 1 case each, while the diagnosis remained uncertain in 7. The thoracoscopic finding of adhesions had negligible and no statistically significant correlation to the final diagnosis. The presence of pleural nodularity had a negative correlation with nonspecific pleuritis and a positive correlation with malignancy although statistically insignificant. It was seen that small and uniform nodules had a positive correlation with TB. The presence of large and variable-sized nodules had a strong positive correlation with malignancy. The presence of diaphragmatic nodules has a positive correlation with malignancy. Pleural infiltration has a strong positive correlation with malignancy and negative correlation with TB. Conclusion: Flexi-rigid pleuroscopy is an excellent modality to investigate UPE since it has a high diagnostic yield, is minimally invasive and safe procedure. The presence of a variable distribution of nodules, large nodules, diaphragmatic nodules, visceral pleural infiltration has a strong positive correlation with malignancy and increases the likelihood of malignancy as the final diagnosis. However, the visual appearance of the pleura is a subjective finding and possibly more informative when used by an experienced pulmonologists in combination with the pleural biopsy for the final diagnosis