Exact Criteria Research Articles

Generic criterion for explosive synchronization in heterogeneous phase oscillator populations

Ordered and disordered behavior in large ensembles of coupled oscillators map to different functional states in a wide range of applications, e.g., active and resting states in the brain and stable and unstable power grid configurations. For this reason, explosive synchronization transitions, which facilitate fast, abrupt changes between these functional states, has recently seen significant interest from researchers. While previous work has identified properties of complex systems that support explosive synchronization, these investigations have been conducted largely on an ad-hoc basis. Here we provide an exact criterion for explosive synchronization in coupled phase oscillator ensembles by investigating the necessary relationship between dynamical and structural disorder. This result provides a critical step towards untangling the intertwined properties of complex systems responsible for abrupt phase transitions and bistability in biological and engineered systems.

Comparison of Frequency of Body Dysmorphic Disorder in Applicants of Abdominoplasty with Applicants of Other Cosmetic Surgeries.

BACKGROUNDBody Dysmorphic Disorder (BDD) is a psychic disorder in which a person is dissatisfied with their normal appearance. Identifying these people among the applicants for cosmetic surgery leads to the proper decision about the cosmetic procedure of these patients and their postoperative consequences.METHODSThis cross-sectional study was performed on 250 women referred to a private Plastic Surgery Clinic in Mashhad, Iran from 2016 to 2017. Applicants were divided into two groups as abdominoplasty and other cosmetic surgeries. BDD was assessed using the modified form of the Bill Brown Questionnaire. Applicants’ information including age, marital status, number of children, education level, and history of cosmetic surgeries were recorded.RESULTSThe mean BDD score in the abdominoplasty group and another group was 93.6 ± 23.5 and 75.5 ± 25.8, respectively. There was a significant difference between the two groups in terms of the BDD score (P-value < 0.001). Although there was a notable relation between BDD score and marital status, no significant association between BDD score, age, and education level was found.CONCLUSIONConsidering the exact criteria of BDD, we noticed a significant increase in the frequency of BDD in abdominoplasty applicants. It was erroneous and could be explained by not applying the accurate diagnostic criteria of BDD.

P1350: THE EFFICACY OF UPFRONT HIGH-DOSE CHEMOTHERAPY WITH AUTOLOGOUS STEM CELL TRANSPLANTATION IN DECREASING RELAPSE RATE IN IV STAGE AND HIGH-INTERMEDIATE/HIGH IPI RISK GROUPS DLBCL

Background: Approximately 30% of patients(pts) with IPI≥2 diffuse large B-cell lymphoma(DLBCL) have relapsed after the frontline regimens. Upfront high-dose chemotherapy(HDCT) with autologous hematopoietic stem cell transplantation(auto-HSCT) can be an effective option to decrease the relapse rate and increase the response rate in these patients. Aims: To determine the significance of the upfront HDCT with auto-HSCT in decreasing relapse rate and increased response rate for IV stage DLBCL pts with unfavorable prognosis. Methods: Included 105 pts: DLBCL NOS, age 18-65, stage IV, IPI≥2, CR/PR after x6 CHOP/EPOCH+R from 2010 to 2019 at NMRC of Oncology named after N.N.Petrov of MoH of Russia were retrospectively analyzed. HSCT group (G1) includes pts with upfront HDCT followed by auto-HSCT (n=35). The control group (G2) includes pts with non-invasive follow-up after induction only (n=70). Groups had equal mean (53,4±21.2 mon in G1 vs 48,9±12.5 mon in G2, p=0.71) observation period and mean (48.0±11.7 yrs in G1 vs 48.9±12.5 yrs in G2, p=0.72) age. No difference was in sex (51% (18/35) men in G1 vs 45.7% (32/70) in G2, p = 0.67), IPI (71.4% (25/35) IPI≥3 pts in G1 vs 58.5% (41/70) IPI≥3 pts in G2, p=0.28) or extranodal (E) involvement (77.1% (27/35) pts with >1 E in G1 vs 71.4% (50/70) in G2, p=0.69). Extra with lung lesions (EL) was detected in 20% (7/35) pts in G1 vs 21,4% (15/70, p=0.86) in G2; with adrenal lesions (EA) in 20% (7/35) pts in G1 vs 6% (4/66, p=0.055) in G2. MYC and BCL-2 coexpression were analyzed in 100% (35/35) pts samples in G1 and in 74.2% (52/70) samples in G2 and were present in 37% (13/35) G1 pts and 31/52 G2 pts, p=0.0503. Between-group comparisons were conducted using a χ2, χ2 with Yates correction(Yates), Fisher’s exact test or McNemar criteria with Yates in paired samples for categorical variables and a two-sided independent t-test for continuous variables. A two-sided p-value of <0.05 significance level was considered to be statistically significant in all analyses. Results: Upfront HSCT significantly increased number of complete responses(CR) from 63% (22/35) after induction to 100% (35/35) after HSCT, p = 0.0009. Early relapse rate (RR) was significantly lower in G1 pts (2.8%(1/35) in HSCT vs 21.4%(15/70) in G2, p=0,027). Overall RR was borderline (8.5%(3/35) in G1 vs 27.1%(19/70) in G2, p=0,051). In combined group analysis, early RR was significanty lower in pts with double-expressor lymphomas (DEL) treated by upfront HSCT - 0%(0/13) in G1 vs 57.1%(12/21) in G2, p<0.001. Also, DEL was a worsening factor in overall RR(0% (0/13) in G1 vs 66.6%(14/21) in G2, p=0.013). Lung E significantly increased overall RR in control group (0%(0/7) in G1 vs 60%(9/15) in G2, p=0.021). In subgroup analysis no significant factors for overall and early RR were detected in HSCT group. In control group early RR was higher if pts had DEL (57.1%(12/21) DEL+ vs 16.1%(5/31) DEL-, p=0.003) or EA (75%(3/4) EA+ vs 24.2%(16/66) EA-, p=0.041). Overall RR was significantly increased in pts with DEL (66.6%(14/21) DEL+ vs 16.1%(5/31) DEL-, p<0,001) and with EL(60%(9/15) EL+ vs 18.1%(10/55) EL-, p=0.04). Summary/Conclusion: 1. Complete response rate significantly increased in 18-65 yrs, DLBCL NOS, IV stage, IPI≥2 pts treated by upfront HSCT. 2. Upfront HSCT significantly decreasing early RR and have tend to decrease overall RR in 18-65 yrs, DLBCL NOS, IV stage, IPI≥2 pts. 3. Double-expressor lymphoma increasing overall and early RR in 18-65 yrs, DLBCL NOS, IV stage, IPI≥2 pts. More than one site extranodal involvement with lung or adrenal lesions increasing overall and early RR correspondingly.

Epistemic Equality: Distributive Epistemic Justice in the Context of Justification.

Social inequality may obstruct the generation of knowledge, as the rich and powerful may bring about social acceptance of skewed views that suit their interests. Epistemic equality in the context of justification is a means of preventing such obstruction. Drawing on social epistemology and theories of equality and distributive justice, we provide an account of epistemic equality. We regard participation in, and influence over a knowledge-generating discourse in an epistemic community as a limited good that needs to be justly distributed among putative members of the community. We argue that rather than trying to operationally formulate an exact criterion for distributing this good, epistemic equality may be realized by insisting on active participation of members of three groups in addition to credited experts: relevant disempowered groups, relevant uncredited experts, and relevant stakeholders. Meeting these conditions fulfills the political, moral, and epistemic aims of epistemic equality.

Clue Cells and Pseudo Clue Cells in Different Morphotypes of Bacterial Vaginosis.

IntroductionClue cells (epithelial cells heavily covered with adherent bacteria) are an accepted clue to the diagnosis of bacterial vaginosis. However, the exact morphologic criteria of clue cells and bacterial adherence were never elaborated.Materials and MethodsWe investigated adhesive and cohesive patterns of main microbiota groups in vaginal discharge using fluorescence in situ hybridization (FISH). Samples from 500 women diagnosed with bacterial vaginosis and positive for clue cells with classic microscopy were collected from 42 gynecologic practices in Berlin and reexamined in our FISH laboratory for the spatial distribution of Bifidobacteriaceae, Gardnerella, Fannyhessea vaginae (Atopobium); low G+C (guanine+cytosine) bacteria, lactobacilli, Lactobacillus iners; Lactobacillus crispatus, Gamma-Proteobacteria; and Enterobacteriaceae, Prevotella–Bacteroides, Veillonella, and Coriobacterium groups.ResultsBacterial taxa present in vaginal smears were not accidentally assembled according to their relative abundance but were built in group-specific distribution patterns, which can be well described by two features: cohesiveness to each other and adherence to epithelial cells. Accordingly, four patterns can be distinguished: dispersed (non-adherent bacteria), dispersed adherent bacteria, cohesive (non-adherent) bacteria, and cohesive adherent bacteria. Direct cohesive adherence to the epithelial cells representing true clue cells was unique for Gardnerella species and observed only in 56% of the investigated samples. In the remaining vaginal samples, the epithelial cells were mechanically entrapped in bacterial masses, and the composition was unrelated to the epithelial cell surface, building non-adherent pseudo clue cells. The proportion of women with true clue cells in their samples from different gynecologic practices varied from 19% to 80%.DiscussionTaxon indifferent imaging is inadequate for the exact analysis of the microbial layer adjacent to the vaginal epithelial cells. Morphologically seen bacterial vaginosis is a mix of at least two different conditions: biofilm vaginosis and bacterial excess vaginosis.

Exact Criteria for the Existence of a Moving Singular Point in a Complex Domain for a Nonlinear Differential Third-Degree Equation with a Polynomial Seventh-Degree Right-Hand Side

Earlier, the authors formulated and proved interval and point criteria for the existence of moving singular points of a third-degree nonlinear differential equation with a polynomial seventh-degree right-hand side for a real domain. For the complex domain, these criteria are associated with specificity of transition to phase spaces. Necessary as well as necessary and sufficient conditions for the existence of moving singular points are obtained. The results of these studies are the basis of the algorithm for obtaining moving singular points of nonlinear differential equations in the complex domain. The results of this paper allow us to expand the classes of the studied nonlinear differential equations with moving peculiarities.

Ocular paraneoplastic pemphigoid

Paraneoplastic mucous membrane pemphigoid, a rare pemphigoid variant is associated with primary malignancy, and characterised by fulminant progression and frequent ineffectivity of classical systemic immunosuppression. In this paper, the clinical features, diagnostic and therapeutical challenges are presented through three cases. Detailed history and analysis of the immunofluorescent samples help the diagnosis. The therapeutic goal is to prevent the progression with systemic immunosuppressive treatment, which can be contraindicated during the ongoing oncological therapy. In absence of consent in the exact diagnostic criteria and management protocol of this rare condition, consultation with other specialists (ophthalmologist, dermatologist, dentist, ear-nose-throat specialist, immunologist) has high importance in early diagnosis and treatment.

On a conjecture of Kelly on (1, 3)-representation of Sylvester–Gallai designs

We give an exact criterion of a conjecture of L.M.Kelly to hold true which is stated as follows. If there is a finite family $\Sigma$ of mutually skew lines in $\mathbb{R}^l,l\geq 4$ such that the three dimensional affine span (hull) of every two lines in $\Sigma$, contains at least one more line of $\Sigma$, then we have that $\Sigma$ is entirely contained in a three dimensional space if and only if the arrangement of affine hulls is central. Finally, this article leads to an analogous question for higher dimensional skew affine spaces, that is, for $(2,5)$-representations of sylvester-gallai designs in $\mathbb{R}^6$, which is answered in the last section.

New insights on rocking of rigid blocks: Analytical solutions and exact energy‐based overturning criteria

AbstractIn this paper, the underlying energy flow in rocking dynamics of rigid blocks is utilized to elucidate their response details and overturning conditions. Based merely on the law of the conservation of energy, the exact criteria for a rigid block to overturn in the free vibration regime are established for the first time in the context of both nonlinear and linear theory. That is, if the initial conditions of the free oscillation fall within the prescribed stable libration region, then it is a priori determined that the block will not overturn and vice versa. The analytical solution to the nonlinear free rocking problem is also derived, utilizing integration techniques originating from the solution of the nonlinear pendulum. Regarding the forced rocking problem, an approximate analytical solution is presented based on a Taylor series expansion of the equation of motion. Moreover, employing the newly derived overturning criterion richer pulse‐type overturning spectra are constructed, revealing stability and instability regions that had never been shown before in the literature. The new characteristics of the overturning spectra are elucidated using color maps. Finally, some new results concerning the design of solid blocks against rectangular and half‐sine acceleration pulses are presented.

Diagnostic imaging in multiple sclerosis

Multiple sclerosis (MS) is an inflammatory autoimmune disease that leads to the development of demyelination foci in the central nervous system and can affect any neurological function. In the developed world, it represents the most common chronic neurological (nontraumatic) disease in young and middle-aged patients. Magnetic resonance imaging (MRI) is the first-line imaging modality for the diagnosis and follow-up of MS. The currently valid McDonald criteria, updated in 2017, define the exact morphological imaging criteria for diagnosing MS. In addition to the detection of typical MS plaques, the determination of spatial and temporal dissemination is essential for the initial diagnosis. Astandardized MRI protocol consisting of mandatory and optional sequences is recommended for reliable diagnosis and differentiation from a broad spectrum of differential diagnoses.

Which came first, allergic bronchopulmonary aspergillosis or asthma?

Aspergillosis includes a group of disorders caused by Aspergillus species that affect the respiratory system most commonly. The clinical spectrum of respiratory aspergillosis is divergent. Allergic bronchopulmonary aspergillosis is a result of hypersensitivity to Aspergillus antigens. Although it is known for many years, pathogenesis is not entirely clarified and there are no exact diagnostic criteria. The results are diagnostic delay, incompletely known management that can cause serious disability. Keywords: allergic; bronchopulmonary; aspergilosis; asthma.

Identification of ICU Patients with High Nutritional Risk after Abdominal Surgery Using Modified NUTRIC Score and the Association of Energy Adequacy with 90-Day Mortality.

For patients undergoing abdominal surgery, malnutrition further increases the susceptibility to infection, surgical complications, and mortality. However, there is no standard tool for identifying high-risk groups of malnutrition or exact criteria for the optimal target of nutrition supply. We aimed to identify the nutritional risk in critically ill patients using modified Nutrition Risk in the Critically Ill (mNUTRIC) scores and assessing the relationship with clinical outcomes. Furthermore, we identified the ideal target of energy intake during the acute postoperative period. A prospective observational study was conducted. mNUTRIC scores and the average calories prescribed and given were calculated. To identify the high-risk group of malnutrition, receiver operating characteristic curves were plotted. The ideal target of energy adequacy and predisposing factors of 90-day mortality were assessed using multiple logistic regression analyses. A total of 206 patients were analyzed. The cutoff value for mNUTRIC score predicting 90-day mortality was 5 (Area under the curve = 0.7, 95% confidence interval (Cl) 0.606–0.795, p < 0.001). A total of 75 patients (36.4%) were classified in the high mNUTRIC group (mNUTRIC ≥ 5) and had a significantly higher postoperative complication and longer length of surgical intensive care unit stay. High mNUTRIC scores (odds ratio = 2.548, 95% CI 1.177–5.514, p = 0.018) and energy adequacy less than 50% (odds ratio = 6.427, 95% CI 1.674–24.674, p = 0.007) were associated with 90-day mortality.

Peculiarities of personality adaption to psychological traumas in neurotic disorders.

It is known that anticipatory processes play a leading role in the regulation of behavior. These processes act as a leading mechanism of the link in the mental regulation of behavior and activity. Violation of processes anticipates to a mismatch in the work of the adaption system, and, as a result, to maladaptive behavior. However, many issues related to the detection of anticipation disorders in various manifestations of diseases have been insufficiently studied. The features of individual prognosis depending on diseases are studied here. As part of the work, 29 people were examined, of which 25 (86.2%) were women and 4 (13.8%) were men with a diagnosis of "adaptive reaction disorder" from the ICD-10 section "Neurotic and stress-related disorders" (F43.2) at the age of 20-65 years. Clinical-psychopathological and experimental-psychological research methods were applied (V.D. Mendelevich's test of anticipation, L.A. Regush's "Ability to predict" test, Lazarus' coping test, clinical questionnaire for the identification and evaluation of neurotic states). Statistical analysis was carried out using the program "IBM SPSS Statistics 25." The Shapiro-Wilk criterion, Pearson's chi-squared test, Fisher's exact criterion, Student's t-criterion, Mann-Whitney U criterion, Kruskal-Wallis H criterion, Pearson correlation, Spearman's correlation, and diagrams (columnar and span) were used. The presence of solvency in general anticipation reduced the severity of coping strategies «distancing» (P = 0.048, r = -0.371) and «escape - avoiding» (P = 0.048, r = -0.370), also personal-situational anticipatory consistency reduced severity of «escape - avoiding» (P = 0.017, r = -0.438). The anticipatory abilities and coping strategies in disorder of adaptive reactions were correlated. Patients with developed anticipation abilities are less likely to use no constructive coping strategies.

Инновационный подход к комплексной диагностике внутричерепной гипертензии при нейроинфекциях у детей

Objective. To develop an algorithm of structural and functional non-invasive diagnosis of different stages of intracranial hypertension (ICH) in children with acute meningitis and encephalitis. Patients and methods. We examined 115 patients aged 1 month to 17 years. We used neurosonography (NSG), transcranial duplex scanning (TCD), ultrasound examination of the optic nerve (ON), and fundus examination by an ophthalmologist. We have developed a comprehensive structural and functional diagnostic algorithm for different ICH stages in children with suspected neuroinfections. This algorithm should be applied within a day upon admission to the intensive care unit and includes NSG, TCD, ON ultrasound, and fundus examination by an ophthalmologist. The exact diagnostic criteria were developed for each method. NSG: clear contours of the brain stem; lateral ventricles between 12 and 16 mm in size; bone-brain diastasis between 1 and 4 mm. TCD: systolic flow rate in the middle cerebral artery between 60 and 180 cm/s; systolic flow rate in the veins of Rosenthal between 10 and 20 cm/s; arterial resistance index up to 0.8; venous resistance index up to 0.5. ON ultrasound: ON thickness up to 5.5 mm in children aged 1 month to 5 years and up to 5.8 mm in children aged 5–17 years. Fundus examination: dilated veins in the fundus. Decompensated ICH: deformed brain stem pattern; lateral ventricles up to 11 mm, bone-brain diastasis &lt;1 mm; systolic flow rate in the middle cerebral artery up to 60 mm/s; systolic flow rate in the veins of Rosenthal up to 10 mm/s; reverberation pattern; ON thickness 6.5 ± 0.43 mm with unclear ON contours; stagnant disk of the optic nerve. We provide clinical examples that illustrate the effectiveness of the new algorithm, as well as the effectiveness of comprehensive therapy with cytoflavin during acute disease. Cytoflavin has multiple effects on the organism, improves cerebral hemodynamics and metabolism. Key words: intracranial hypertension, children, duplex, optic nerve, meningitis, neurosonography, ultrasound, encephalitis, cytoflavin

Tomato maturity recognition using YOLOV 5 machine learning

The implementation of robotic systems and digitalization in agriculture are important tasks today. In this paper, the possibility of using pattern recognition and machine learning methods as a computer model of an agricultural robot for harvesting is considered. The grading of tomato fruits can be classified based on their ripeness according to their life cycles, which can be identified by their color: green in the growing stage, yellow in the pre-ripening stage, and red when ripe. Conventional skill-based methods cannot meet the exact selection criteria for modern production management in the agricultural sector as they are time-consuming and of low accuracy. Automatic feature extraction behavior using machine learning is most effective in image classification and recognition tasks. Thus, the article presents the results of a study on the recognition of ripe tomato fruits by a robotic system, carried out within the framework of the grant project of the Ministry of Education and Science of the Republic of Kazakhstan AP08857573 and implemented classical algorithms based on the HSV color model and color segmentation using the k-means algorithm as comparative algorithms and based on machine learning, a universal intelligent tomato classification system is proposed for practical use using Yolo 5. This study aims to provide an inexpensive solution with the best performance and accuracy for assessing tomato ripeness. The results are collected in terms of accuracy, loss curves and confusion matrix. The results showed that the proposed model outperforms other machine learning (ML) methods used by researchers for tomato classification problems, providing 99% accuracy.

Case C-848/19 P: Germany v Poland and its outcomes for EU energy sector: an extended case note on the European Court of Justice judgment in the OPAL case

Abstract The European Court of Justice (ECJ) judgment in the so-called Ostsee-Pipeline-Anbindungsleitung (OPAL) case on 15 July 2021 dismissed Germany’s appeal on the previous European Union (EU) General Court’s decision, which focused on the need for considering national interests of EU Member States and the interests of the Union itself in the decisions by the EU institutions in energy sector to acknowledge the solidarity principle provided in the Treaty on the Functioning of the European Union. This decision found a significant interest among academicians and legal practitioners and raised numerous discussions, since it is still not clear what are the exact criteria on application of this principle, especially in relation to such ambiguous energy notions as ‘security of supply’. The presence of the geopolitical context and direct impact of the decision on the volumes of Russian gas transported via the Nord Stream pipeline also makes this case extremely complex and raises some additional questions regarding the impact on external gas supply to the EU. Moreover, the statement of the Advocate General on the applicability of the solidarity principle to all the other objectives of EU energy policy (not limiting to the scope of security of gas supply), which was also supported by the Court, brings many additional aspects to be considered with regards to the impact of the OPAL case on EU energy sector. Therefore, this case note article undertakes a critical analysis of the recent ECJ judgment and Advocate General’s opinion to identify some gaps that are still not clarified and to estimate the possible outcomes of the judgment on the future of EU energy sector development.

The RareDis corpus: A corpus annotated with rare diseases, their signs and symptoms

Rare diseases affect a small number of people compared to the general population. However, more than 6,000 different rare diseases exist and, in total, they affect more than 300 million people worldwide. Rare diseases share as part of their main problem, the delay in diagnosis and the sparse information available for researchers, clinicians, and patients. Finding a diagnostic can be a very long and frustrating experience for patients and their families. The average diagnostic delay is between 6–8 years. Many of these diseases result in different manifestations among patients, which hampers even more their detection and the correct treatment choice. Therefore, there is an urgent need to increase the scientific and medical knowledge about rare diseases. Natural Language Processing (NLP) can help to extract relevant information about rare diseases to facilitate their diagnosis and treatments, but most NLP techniques require manually annotated corpora. Therefore, our goal is to create a gold standard corpus annotated with rare diseases and their clinical manifestations. It could be used to train and test NLP approaches and the information extracted through NLP could enrich the knowledge of rare diseases, and thereby, help to reduce the diagnostic delay and improve the treatment of rare diseases. The paper describes the selection of 1,041 texts to be included in the corpus, the annotation process and the annotation guidelines. The entities (disease, rare disease, symptom, sign and anaphor) and the relationships (produces, is a, is acron, is synon, increases risk of, anaphora) were annotated. The RareDis corpus contains more than 5,000 rare diseases and almost 6,000 clinical manifestations are annotated. Moreover, the Inter Annotator Agreement evaluation shows a relatively high agreement (F1-measure equal to 83.5% under exact match criteria for the entities and equal to 81.3% for the relations). Based on these results, this corpus is of high quality, supposing a significant step for the field since there is a scarcity of available corpus annotated with rare diseases. This could open the door to further NLP applications, which would facilitate the diagnosis and treatment of these rare diseases and, therefore, would improve dramatically the quality of life of these patients.

Double Crush Syndrome of the Upper Extremity.

The double crush hypothesis originally proposed that compression of a peripheral nerve at a proximal site increases its susceptibility to additional distal lesions. The etiology of double crush syndrome is likely multifactorial as mechanical, systemic, pharmacologic, or environmental factors may increase a patient's susceptibility to this syndrome. To date, there remains no standardized definition of double crush syndrome, and there is no consensus on its exact pathophysiology or diagnostic criteria. Patients with double crush syndrome should be counseled that surgical repair may produce inferior outcomes compared with those who are treated for isolated entrapment neuropathies.

Current practices in complex abdominal wall reconstruction in the Americas: need for national guidelines?

Component separation (CS) procedures have become an important part of surgeons' armamentarium. However, the exact criteria for training, procedure/mesh choice, as well as patient selection for CS remains undefined. Herein we aimed to identify trends in CS utilization between various cohorts of practicing surgeons. Members of the Americas Hernia Society were queried using an online survey. Responders were stratified according to their experience, practice profile (private vs academic, general vs hernia surgery), and volume (low (< 10/year) vs high) of CS procedures. We used Chi-squared tests to evaluate significant associations between surgeon characteristics and outcomes. 275 responses with overwhelming male preponderance (88%) were collected. The two most common self-identifiers were "general" (66%) and "hernia" (28%) surgeon. PCS was the most commonly (67%) used type of CS; endoscopic ACS was least common (3%). Low-volume surgeons were more likely to utilize the ACS (p < 0.05). Only 7% of respondents learned PCS during their residency, as compared to 36% that use ACS. 65% felt 0-10 cases was sufficient to become proficient in their preferred technique. 10cm-wide defect was the most common indication for CS; 23% used it for 5-8cm defects. Self-identified "hernia" and high-volume surgeons were more likely to use synthetic mesh in the setting of previous wound infections and/or contaminated field (p < 0.05). More general/low-volume surgeons use biologic mesh. Contraindications to elective CS varied widely in the cohort, and 9.5% would repair poorly optimized patients electively. Severe morbid obesity was the most feared comorbidity to preclude CS. The use of CS varies widely between surgeons. In this cohort, we discovered that PCS was the most commonly used technique, especially by hernia/high-volume surgeons. There are differences in mesh utilization between high-volume and low-volume surgeons, specifically in contaminated fields. Despite its prevalence, CS training, indications/contraindications, and patient selection must be better defined.

Comparison of Contractual Liability Patterns in the British Legal System and the Iranian Legal System

No part of society can elude legitimate occasions. Some of the time, eagerly or unwillingly, another is hurt, and the issue of hurtful obligation or how to compensate is raised by others. The rules and controls of each nation or other nations may be distinctive, and the way of demonstrating obligation and its components and the approach of the courts in deciding the sum of harms may moreover be diverse. Since the legitimate British framework is to some degree diverse from the legitimate Iranian framework, it appears valuable to know the sees of this framework. The think about of these likenesses and contrasts, counting the way of sanctioning laws, their modification, the way of the trial of courts and the limits of duties and the way of execution of judgments, raises numerous scores and gives other viewpoints for analysts to be utilized in tackling issues in society. The article presented attempts to clarify the perspective of the UK legal framework and compare it with the Iranian legal framework in terms of designing respectful risks within the contract to realize the over the result. All legitimate frameworks look for a full stipend. In this respect, due to the reality that the strategy of remuneration among other remuneration strategies within the UK, the legitimate framework of this nation has set exact criteria based on which the assurance of full emolument. It is more standard and precise. Iranian law is generally appropriate on the issue of damages. This can occur despite the fact that the refusal of the rule of the presence of a way of a stipend in infringement of legally binding commitments has not been considered with assurance.