Prenatal radiographic evaluation of congenital transverse limb deficiencies:A scoping review

BACKGROUND Congenital transverse deficiencies are horizontal deficiencies of the long bones that occur with a reported incidence as high 0.38%.They can occur alone or represent a manifestation of a various clinical syndromes.Diagnosis has tradi-tionally comprised of conventional radiography and prenatal imaging studies.There has been much advancement regarding prenatal imaging modalities to allow for early diagnosis and appropriate treatment.AIM To summarize the current state of knowledge on congenital transverse limb deficiencies and to provide an update regarding the radiographic evaluation of congenital transverse limb deficiencies.METHODS This IRB-exempt scoping review followed the PRISMA-ScR checklist for scoping reviews strictly.Five search engines were searched for a total of 265 publications.Four authors reviewed these during the screening process.Of these,51 studies were included in our article.Prenatal magnetic resonance imaging(MRI),3D Ultrasound,and multidetector Computed tomography(CT)exist are emerging modalities that have the potential to improve diagnosis.RESULTS Use of the appropriate classification system,three-dimensional ultrasonography with a maximum intensity projection,and appropriate use of prenatal MRI and prenatal CT can improve diagnosis and inter-provider communication.CONCLUSION Further scholarly efforts are required to develop improve standardized guidelines regarding the pre-natal radiographic evaluation of congenital limb deficiencies.

Interactions among Micronutrient Deficiencies and Undernutrition in the Philippines

Data gathered from the 1987 National Nutrition Survey in the Philippines provided the opportunity to study the interactions among micronutrient deficiencies and undernutrition in different age groups as basis for program targeting. A randomly selected set of 50% of the households (3,200) covered by the national survey served as source of subjects. Results showed that there was a greater proportion of anemia among the undernourished (as judged by weight for age in children and weight for height in adults) (66.0%)than among the adequately nourished (54.6%) (P <0.01 ). However, the observed differencesin the proportion of serum vitamin A deficiency and of goiter among the undernourished compared to the adequately nourished were not significant. Also not significant were the observed higher prevalence of anemia among subjects with acceptable serum vitamin A levels for both adequately nourished and undernourished, and the higher prevalence of vitamin A deficiency among the non-anemics. Again there were no significant differences in the prevalence of anemia among goitrous and non-goitrous subjects, as well as the prevalence of goiter among anemic and non-anemic subjects. Neither were there significant differences in the prevalence of vitamin A deficiency among goitrous and non-goitrous subjects, but there were significant differences in the prevalence of goiter among vitamin A deficient and non-vitamin A defjcient subjects among the 7-14 years old and among pregnant and lactating women.The study concludes that at the national level, there is apparently an interaction between anemia and protein-energy undernutrition and possibly also between goiter and vitamin A deficiency in the high-risk age groups, but between anemia on the one hand and goiter and vitamin A deficiency in the other, perhaps because of clustering in the latter conditions not found in anemia and general undernutrition. These findings may be useful in targeting communities with high prevalence of micronutrient deficiencies by using prevalence of underweight and goiter as indicators for high prevalence of anemia and vitamin A deficiency, respectively

Selenium and Iodine Deficiencies and Selenoprotein Function

This paper reviews some recent findings on the interactions between selenium deficiency and iodine deficency. Both micronutrients can control the levels of selenoprotein mRNAs, particularly in the thyroid and brain. When selenium and iodine supplies are limiting the compensatory mechanisms work to minimise adverse effects on thyroid hormone metabolsm and thus neurological developtnent. The mechanisms for regulation of selenoproteins in selenium and iodine deficiency are however very tissue-specific. For example, unlike the brain and thyroid,brown adipose tissue is unable to retain selenoproteins in selenium and iodine deficiency and is therefore at greater risk from injurious effects of the deficiencies.

Nutritional deficiencies in the pediatric age group in a multicultural developed country,Israel

Nutrient deficiencies are prevalent worldwide.Diseases and morbid conditions have been described to result from nutritional deficiencies.It is essential to address nutrient deficiencies as these may lead to chronic longterm health problems such as rickets,iron deficiency anemia,goiter,obesity,coronary heart disease,type2 diabetes,stroke,cancer and osteoporosis.In the present review we surveyed the extent and severity of nutritional deficiencies in Israel through a selective and comprehensive Medline review of previous reports and studies performed during the last 40 years.Israel populations have multiple nutritional deficiencies,including iron,calcium,zinc,folic acid,and vitamins B12,C,D and E,spanning all age groups,several minorities,and specific regions.In Israel,some of the nutrients are mandatorily implemented and many of them are implemented voluntarily by local industries.We suggest ways to prevent and treat the nutritional deficiencies,as a step to promote food fortification in Israel.

Complications, Mineral and Vitamin Deficiencies: Comparison between Roux-en-Y Gastric Bypass and Sleeve Gastrectomy

Objective: Nutritional deficiencies are known side-effects of bariatric surgeries, specifically in those that bypass the proximal intestine. Therefore, in clinical practice, vitamin and mineral supplementations are often necessary after such operations. It was our intention to evaluate, whether alimentary deficiencies occur with the same frequency in patients following Sleeve-Gastrectomy (SG) compared to Roux-en-Y Gastric Bypass (RYGB) surgeries. Methods: We conducted a retrospective data analysis of 171 patients (121 RYGB, 50 SG). Vitamin levels were compared between SG and RYGB patients over the first post-operative year. Furthermore, regression analysis was performed with regard to vitamin and iron supplementations and their recommended dosages. Complications occurring within the first post-surgical year were documented as well. Results: Other than vitamin B6 deficiency, which was found to be more frequent in SG patients, there was no other significant difference regarding the type of operation and the number of patients who had these deficiencies. There was no significant difference in average vitamin and iron levels between RYGB and SG. A minimum dose of 1000 IU vitamin D per day was necessary to affect vitamin D levels. The intramuscular administration of vitamin B12 was the only route found to be effective. Complications within the first year were rare. Conclusions: Against common assumptions, vitamin and iron deficiencies in SG patients are not less frequent in the first post-surgical year?in comparison to RYGB patients. Standard supplementations should include iron in premenopausal women: Vitamin D at least 1000 IU per day and vitamin B12 i.m. administration in case of a deficiency.

The Effect of Audit Objectives on Audit Quality Why is There Little Disclosure of Significant Deficiencies in Japanese Internal Control Audits？

Many prior research findings indicate that audit quality differs between the Big 4 and non-Big 4 audit firms using an indicator variable. However, most previous research focuses on only outcome measures, such as audit fees, going concern reports, and non-audit services. This study investigates audit quality differentiation between the Big 4 and non-Big 4 audit firms hypothesis from an audit objective point of view. One of the material objectives of Japanese internal control audit institutions is to facilitate assessment and improvement of internal controls by corporations themselves. The findings of this study indicate that the Big 4 audit firms accomplish this objective better than non-Big 4 audit firms. Consequently, most Big 4 clients do not disclose significant deficiencies （SDs）, implying that they improve the quality of internal controls through internal controls auditing. This paper concludes that Big 4 firms produce a higher audit quality level than non-Big 4 firms, and this quality difference iS related to how an audit objective is interpreted and implemented.

Primary Immune Deficiencies (PID): Diagnosis Challenges

Background: Primary Immune Deficiencies (PID) are rare, under-determined diseases particularly in sub-Saharan Africa. The diagnosis is often suspected with uncommon clinical signs. Infections are the main diagnostic circumstances in infants. Confirmation is often difficult because some additional examinations are unavailable in many of our countries. Aim: Our aim was to share the challenge of diagnosis and treatment in PID. Case Presentation: It is about two infants, a boy and a girl, with early several infections. Both of them presented a hypo-gammaglobulinemia and to the boy, the immuno-phenotyping lymphocyte showed a decreased level of lymphocytes CD19. We are looking for genetic confirmation but it is not easy. The treatment of these infants requires a substitution for life of immunoglobulin which is unavailable in our countries. Conclusion: PID are suspected with atypical clinical signs. Confirmation genetic diagnosis is difficult in low income countries. To improve the follow up, we need to strengthen clinical-biological collaboration.

Micronutrient deficiencies in patients with chronic atrophic autoimmune gastritis: A review

Chronic atrophic autoimmune gastritis (CAAG) is an organ-specific autoimmune disease characterized by an immune response, which is directed towards the parietal cells and intrinsic factor of the gastric body and fundus and leads to hypochlorhydria, hypergastrinemia and inadequate production of the intrinsic factor. As a result, the stomach&#x02019;s secretion of essential substances, such as hydrochloric acid and intrinsic factor, is reduced, leading to digestive impairments. The most common is vitamin B12 deficiency, which results in a megaloblastic anemia and iron malabsorption, leading to iron deficiency anemia. However, in the last years the deficiency of several other vitamins and micronutrients, such as vitamin C, vitamin D, folic acid and calcium, has been increasingly described in patients with CAAG. In addition the occurrence of multiple vitamin deficiencies may lead to severe hematological, neurological and skeletal manifestations in CAAG patients and highlights the importance of an integrated evaluation of these patients. Nevertheless, the nutritional deficiencies in CAAG are largely understudied. We have investigated the frequency and associated features of nutritional deficiencies in CAAG in order to focus on any deficit that may be clinically significant, but relatively easy to correct. This descriptive review updates and summarizes the literature on different nutrient deficiencies in CAAG in order to optimize the treatment and the follow-up of patients affected with CAAG.

Fertilizer-Induced Advances in Corn Growth Stage and Quantitative Definitions of Nitrogen Deficiencies

Evidence that nitrogen (N) fertilization tends to accelerate maturation as well as increase rates of growth has received little attention when diagnosing N deficiencies in corn (Zea mays L.).Such a tendency could be a potential source of errors when the diagnosis is solely based on comparing plants with different rates of growth.Whether N fertilization could accelerate rates of growth and maturation was tested in a field study with 12 paired plots representing relatively large variability in soil properties and landscape positions.The plots were located under conditions where preplant N fertilization reduced or avoided temporary N shortages for some plants but did not reduce for other plants early in the season.We measured corn heights to the youngest leaf collar,stages of growth and chlorophyll meter readings (CMRs). The added N advanced growth stages as well as increased corn heights and CMRs at any given time.Fertilization effects on corn heights,growth stages and ear weights were statistically significant (P<0.05) despite substantial variability associated with landscape.Reductions in growth due to a temporary shortage of N within a growth stage might be partially offset by longer periods of growth within that stage to physiological maturity.Temporary shortages of N,therefore,may produce symptoms of N deficiency in situations where subsequent additions of N should not be expected to increase yields.Recognition of these two somewhat different effects (i.e.,increase growth rates and advance growth stages) on corn growth could help to define N deficiency more precisely and to improve the accuracy of diagnosing N status in production agriculture.

High-resolution computed tomography findings in humoral primary immunodeficiencies and correlation with pulmonary function tests

AIM To compare high-resolution computed tomography(HRCT) findings between humoral primary immunodeficiencies(hPIDs) subtypes; to correlate these findings to pulmonary function tests(PFTs).METHODS We retrospectively identified 52 consecutive adult patients with hPIDs who underwent 64-row HRCT and PFTs at the time of diagnosis. On a per-patient basis, an experienced radiologist recorded airway abnormalities(bronchiectasis,airway wall thickening, mucus plugging, tree-in-bud, and air-trapping) and parenchymal-interstitial abnormalities(consolidations, ground-glass opacities,linear and/or irregular opacities, nodules, and bullae/cysts) found on HRCT.The chi-square test was performed to compare the prevalence of each abnormality among patients with different subtypes of hPIDs. Overall logistic regression analysis was performed to assess whether HRCT findings predicted obstructive and/or restrictive PFTs results(absent-to-mild vs moderate-tosevere).RESULTS Thirty-eight of the 52 patients with hPIDs showed common variable immunodeficiency disorders(CVID), while the remaining 14 had CVID-like conditions(i.e., 11 had isolated IgG subclass deficiencies and 3 had selective IgA deficiencies). The prevalence of most HRCT abnormalities was not significantly different between CVID and CVID-like patients(P > 0.05), except for linear and/or irregular opacities(prevalence of 31.6% in the CVID group and 0 in the CVID-like group; P = 0.0427). Airway wall thickening was the most frequent HRCT abnormality found in both CVID and CVID-like patients(71% of cases in both groups). The presence of tree-in-bud abnormalities was an independent predictor of moderate-to-severe obstructive defects at PFTs(Odds Ratio, OR, of 18.75, P < 0.05), while the presence of linear and/or irregular opacities was an independent predictor of restrictive defects at PFTs(OR = 13.00; P < 0.05).CONCLUSION CVID and CVID-like patients showed similar HRCT findings. Tree-in-bud and linear and/or irregular opacities predicted higher risks of, respectively,obstructive and restrictive defects at PFTs.

A Review of the Causes of Sustainable Supply Deficiencies in Natural Gas Supply in Ghana

Although Ghana produces natural gas and has several gas reserves, the country still depends on supplies from neighbouring countries for power generation due to challenges like fuel supply inefficiencies and increasing cost of gas production. Gas supply is thus a limiting factor for power generation. This study explores strategies to improve gas supplies for sustainable power generation in Ghana. The study examined the underlying factors inhibiting gas supplies in Ghana, investigated the risks in the gas supply industry, and explored strategies for improving gas supplies in Ghana. The study adopted an inductive approach that utilises both qualitative and quantitative research methods. With the use of questionnaires, data were collected from 151 respondents who were selected by purposive and snowball sampling procedures. The collected data were descriptively and inferentially analysed with analytical tools in the SPSS. The study’s findings conclude that factors that inhibit gas supply in Ghana include the lack of growth and supply investment in the gas supply industry, power sector debt on the gas market, and the lack of an extensive distribution infrastructure/network. Also, the gas industry in Ghana lacks the requisite investment drive which culminates into inefficiency and ultimately undermines efforts to achieve sustainable power generation. Politics influence in issues relating to gas supplies in Ghana inhibits long-term supply relationships and permanent infrastructure in gas supply, both locally and on the world market.

Comparison of Congenital Tooth Deficiencies Seen in Permanent Teeth in Individuals with Unilateral Cleft Lip and Palate to Those without Cleft Lip and Palate

Objective: To compare the congenital tooth deficiencies seen in permanent dentition in individuals with unilateral cleft lip and palate (UCLP) to non-cleft individuals with Angle Class I malocclusion. Method: The study was performed on orthopantomograph films of 50 individuals with UCLP aged between 12 - 16 years and 50 individuals with Angle Class I malocclusion individuals aged between 13 - 15 years. Individuals with UCLP;32 clefts were on the left side and 18 clefts were on the right side. Permanent third molar teeth deficiency was excluded from the study. Results: In 50 individuals with UCLP;35 (70%) upper lateral incisors were congenitally deficient in the cleft area, while 15 (30%) missing lateral teeth were found in the non-cleft side. In control group, 12 (24%) of 50 patients had congenital lateral incisor deficiency. Congenital deficiency of upper lateral incisor in UCLP;the cleft area was higher than the non-cleft side (p < 0.01). The difference was statistically important when compared with the control group (p < 0.001). In 50 individuals with UCLP;while 27 (54%) of second premolar teeth were congenitally deficient in cleft side, 23 (46%) were missing in non-cleft side. In control group, 18 (36%) congenital second premolar deficiency was detected. However, second premolar congenital deficiency was higher in UCLP group when compared to control group (p < 0.01). Conclusion: The deficiency of the lateral incisors in the cleft side is more often congenitally deficient than upper second premolar teeth and this should be considered in the treatment planning from an early age.

An Analysis of the Causal Reasoning Deficiencies in English Majors' Argumentative Writing

The Syllabus for English Majors at Universities and Colleges(2000) makes it clear to further strengthen the English majors' critical thinking and logical reasoning ability.But how to effectively incorporate the cultivation of critical thinking skills into English majors' core courses,such as the writing courses,remains one of the most important tasks of teaching reform for English majors.The present study is aimed at having a systematic analysis on the causal reasoning deficiencies in English majors' argumentative writing.Furthermore,the reasons resulting in the causal reasoning deficiencies and the implications for the teaching of second language writing are explored.

Identification of suitable reference genes in leaves and roots of rapeseed (Brassica napus L.) under different nutrient deficiencies

Nutrient deficiency stresses often occur simultaneously in soil. Thus, it＇s necessary to investigate the mechanisms underlying plant responses to multiple stresses through identification of some key stress-responsive genes. Quantitative real-time PCR （qRT-PCR） is essential for detecting the expression of the interested genes, of which the selection of suitable reference genes is a crucial step before qRT-PCR. To date, reliable reference genes to normalize qRT-PCR data under different nutrient deficiencies have not been reported in plants. In this study, expression of ten candidate reference genes was detected in leaves and roots of rapeseed （Brassica napus L.） after implementing different nutrient deficiencies for 14 days. These candidate genes, included two traditionally used reference genes and eight genes selected from an RNA- Seq dataset. Two software packages （GeNorm, NormFinder） were employed to evaluate candidate gene stability. Results showed that VHA-E1 was the highest-ranked gene in leaves of nutrient-deficient rapeseed, while VHA-G1 and UBC21 were most stable in nutrient-deficient roots. When rapeseed leaves and roots were combined, UBC21, HTB1, VHA-G1 and A CT7 were most stable among all samples. To evaluate the stabilities of the highest-ranked genes, the relative expression of two target genes, BnTrxl;1 and BnPhtl;3 Were further determined. The results showed that the relative expression of BnTrxl;1 depended on reference gene selection, suggesting that it＇s necessary to evaluate the stability of reference gene prior to qRT-PCR. This study provides suitable reference genes for gene expression analysis of rapeseed responses to different nutrient deficiencies, which is essential for elucidation of mechanisms underlying rapeseed responses to multiple nutrient deficiency stresses

Differences in Physiological Age Affect Diagnosis of Nitrogen Deficiencies in Cornfields

Many studies have shown that chlorophyll meter readings （CMRs） can be used to diagnose deficiencies of nitrogen （N） during the growth of corn （Zea mays L.） in small-plot trials, but there is need to address additional problems encountered when diagnoses are made in fields of the size managed in production agriculture. A noteworthy difference between smallplot trials and production agriculture is the extent to which the effects of N are confounded with the effects of other factors such as tillage, landscape, soil organic matter and moisture content. We illustrate how some of these factors can cause differences in the physiological age of plants and introduce errors in the diagnoses of N deficiencies. We suggest methods （measuring the height to the youngest leaf collar and assigning leaf numbers by using the first leaf with pubescence and the ear leaf as references to identify growth stages） for minimizing these errors. The simplified method of growth stage identification can be used to select appropriate plants and leaves for making diagnoses in fields and to distinguish the effects of N from the effects of other factors that influence plant growth.

Performance evaluation of IoT-based service system for monitoring nutritional deficiencies in plants

This study aimed to develop and evaluate the performance of a service system platform based on the Internet of Things(IoT)for monitoring nutritional deficiencies in plants and providing fertilizer recommendations.There are two distinct differences between this work and previous ones;namely,this service system platform has been developed based on IoT using a system engineering approach and its performance has been evaluated using dependability.We have successfully developed and integrated a service system platform and chlorophyll meter that is based on IoT.We have also successfully tested the performance of the service system platform using the JMeter software.The dependability value measured from the five tested variables(reliability,availability,integrity,maintainability,and safety)showed a value of 0.97 which represents a very good level of system confidence in not failing to deliver services to users under normal operational conditions.From a future perspective,this platform can be used as an alternative service to monitor nutrient deficiencies in plants and provide fertilization recommendations to increase yields,reduce fertilizer costs,and prevent the use of excessive fertilizers,which can cause environmental pollution.

An objective method for color vision deficiencies measurement based on visual evoked potential

The equi-luminance of color stimulus in normal subjects is characterized by L-cone and M-cone activation in retina. For the protanopes and deuternopes, only the activations of one relevant remaining cone type should be considered. The equi-luminance turning curve was established for the recorded visual evoked potentials (VEPs) of the luminance changes of the red and green color stimulus, and the position of the equi-luminance was used to define the kind and degree of color vision deficiencies. In the test of 47 volunteers we got the VEP traces and the equi-luminance turning curves, which was in accordance with the judgment by the pseudoisochromatic plate used in clinic. The method fulfills the objective and quantitative requirements in color vision deficiencies test.

Deficiencies in Water Conservancy

Recent droughts and floods show the fragility of China’s water conservancy capabilities Be it extreme flooding or severe droughts,China has yet to find a stable middle ground concerning its water supply.These disasters,primarily in the

PRECISE FUNDAMENTAL INEQUALITIES AND SUM OF DEFICIENCIES

In the present paper, some precise fundamental inequalities are introduced. Applying them,we obtain the precise estimate for the sum of deficiencies. Let f(z) be transcendental mero-morphic in the finite plane and k be a positive integer. If ε is an arbitrary positive numberand a and b are two distinct finite complex numbers, then we have T(r,f)<(1+1/k)N (r,1/f)+(1+1/k)N (r,1/(f^(k)-1)) -N (r,1/(f(k+1))+εT(r,f)+S(r,f)and δ(a,f^(k))+δ(b,f^(k))≤1+1/(2k+1).

Complement genetics,deficiencies,and disease associations

The complement system is a key component of innate immunity.More than 45 genes encoding the proteins of complement components or their isotypes and subu-nits,receptors,and regulators have been discovered.These genes are distributed throughout different chro-mosomes,with 19 genes comprising three significant complement gene clusters in the human genome.Ge-netic deficiency of any early component of the classical pathway(C1q,C1r/s,C2,C4,and C3)is associated with autoimmune diseases due to the failure of clearance of immune complexes(IC)and apoptotic materials,and the impairment of normal humoral response.Deficien-cies of mannan-binding lectin(MBL)and the early components of the alternative(factor D,properdin)and terminal pathways(from C3 onward components:C5,C6,C7,C8,C9)increase susceptibility to infections and their recurrence.While the association of MBL defi-ciency with a number of autoimmune and infectious disorders has been well established,the effects of the deficiency of other lectin pathway components(ficolins,MASPs)have been less extensively investigated due to our incomplete knowledge of the genetic background of such deficiencies and the functional activity of those components.For complement regulators and receptors,the consequences of their genetic deficiency vary de-pending on their specific involvement in the regulatory or signalling steps within the complement cascade and beyond.This article reviews current knowledge and concepts about the genetic load of complement com-ponent deficiencies and their association with diseases.An integrative presentation of genetic data with the latest updates provides a background to further inves-tigations of the disease association investigations of the complement system from the perspective of sys-tems biology and systems genetics.