Horticultural performance of 'Fuji Suprema' and 'Maxi Gala' apple trees trained at Tall Spindle and Bi-Axis systems grafted on different rootstocks in Southern Brazil / Comportamento agronômico de macieiras 'Fuji Suprema' e 'Maxi Gala' conduzidas em Tall Spindle e Bi-Axis enxertadas em diferentes porta-enxertos no Sul do Brasil

The use of new rootstocks combined with different training systems have been studied to increase productivity, fruit quality, and reduce costs. Another important factor is the validation of studies under replanting conditions, due to the growing limitation of new areas for planting commercial apple orchards in Brazil. The present study aimed to evaluate the behavior of 'Fuji Suprema' and 'Maxi Gala' apple trees in two training systems grafted on two rootstocks. The study occurred during the seasons 2016/17, 2017/18 and 2018/19, in an orchard located in southern Brazil in an area previously cultivated with apple trees. A randomized block design consisting of a 2x2 factorial was used, with Tall Spindle and Bi-Axis as the training system and 'M.9' and 'G.213' as rootstocks of Fuji Suprema and Maxi Gala cultivars. Variables were evaluated to determine tree vigor, as well as yield and fruit quality characteristics. It was observed that 'G.213' promoted higher vigor for both cultivars as well as the Bi-Axis training system in the Maxi Gala cultivar. The highest yield was observed in Tall Spindle as well as the rootstock 'G.213' in both cultivars. The most significant changes on fruit quality occurred in the Bi-Axis training system, presenting higher intensity of red color as well as 'Maxi Gala' grafted on 'G.213' rootstock.

A utilização de novos porta-enxertos e diferentes sistemas de condução tem sido estudado para aumentar a produtividade, qualidade dos frutos e reduzir custos. Outro fator importante é a validação de estudos em condições de replantio, devido à crescente limitação de novas áreas para o plantio comercial de pomares de macieiras no Brasil. O presente estudo teve como objetivo avaliar o comportamento de macieiras 'Fuji Suprema' e 'Maxi Gala' em dois sistemas de condução enxertados sobre dois porta-enxertos. O estudo ocorreu durante as safras 2016/17, 2017/18 e 2018/19, em um pomar localizado no sul do Brasil, em área previamente cultivada com macieiras. Utilizou-se delineamento de blocos casualizados, consistindo em um fatorial 2x2, sendo Tall Spindle e Bi-Axis como sistemas de condução e 'M.9' e 'G.213' como porta-enxertos das cultivares Fuji Suprema e Maxi Gala. Foram avaliadas variáveis para determinar o comportamento vegetativo, bem como as características de produtividade e qualidade dos frutos. Observou-se que 'G.213' promoveu maior vigor para ambas cultivares, assim como o sistema de condução Bi-Axis na cultivar Maxi Gala. O maior rendimento foi observado nas macieiras conduzidas em Tall Spindle e enxertadas sobre 'G.213' em ambas cultivares. As mudanças mais significativas na qualidade dos frutos ocorreram nas macieiras conduzidas em Bi-Axis, apresentando maior intensidade de coloração vermelha, assim como na macieira 'Maxi Gala' enxertada sobre 'G.213'.

Korean Red Cross Hospital (1905–1907): Focused on its Establishment, Management and Abolition / 의사학

The Korean Empire, its state sovereignty threatened by the Empire of Japan, joined the Geneva Conventions in 1903 for the purpose of neutral diplomacy and established the imperial Korean Red Cross Hospital in 1905. This hospital was a result of the effort of the Korean Empire to seek a new medical system based on the Western medicine. However, after the Russo-Japanese War, Japan interfered straightforwardly in the domestic affairs of Korea and eventually abolished the Korean Red Cross Hospital in 1907 to create Daehan Hospital under Japanese colonial rule. With newly-found historical records, this study investigates the whole process of the Korean Red Cross Hospital, which has remained unknown so far, despite its importance. From the very beginning, the Korean Red Cross Hospital was under strong influence of the Empire of Japan. The site for the hospital was chosen by a Japanese army doctor, Junryō Yoshimoto, and the construction was supervised by Rokurō Katsumata, who also later on are involved in the construction of Daehan Hospital. Moreover, all the main positions for medical treatments were held by Japanese practitioners such as Gorō Tatami and Kaneko Yano. Nevertheless, the Korean government had to shoulder the all operating costs. The office of the Korean Red Cross was relocated away from the Korean Red Cross Hospital, and the government of the Korean Empire was not willing to burden the expenses of the Hospital. Moreover, the list of employees of the Korean Red Cross and that of the Korean Red Cross Hospital were drawn up separately: the former is left only in Korea and the latter in Japan. These facts suggest that those two institutes were managed dualistically unlike any other nation, implying that this may have been a means to support the Daehan Hospital project. According to the statistics, health care services in the Korean Red Cross Hospital seems to have been carried out successfully. There had been an increase in the number of patients, and the ratio of female patients was relatively high (26.4%). Only Western medications were prescribed and surgical operations with anesthesia were performed routinely. The approach to Western medicine in Korea was changing during that period. The rise and fall of the Korean Red Cross Hospital represent the urgent situation of the Korean Empire as well as the imperialistic methodology of the Empire of Japan to use medicine as a tool for colonization. Although the transition process of medical policy by the Japanese Resident-General of Korea still remains to be fully elucidated, this paper contributes to a better understanding of the history of modern medicine in Korea.

Comparative study of three clinical scoring systems in patients with acute pulmonary thromboembolism / 中华急诊医学杂志

Objective To compare the prognostic value of simplified revised Geneva Prognostic Score (sGPS), Pulmonary Embolism Severity Index (PESI) and simplified Pulmonary Embolism Severity Index (sPESI) in patients with acute pulmonary thromboembolism(PTE). Methods A retrospective cohort study was carried out on 276 consecutive patients with identified acute PTE admitted to our hospital from January 1997 to December 2016. We dichotomized patients as low vs. high risk in all three scoring systems. The 30-day mortality of the patients were used as prognostic factors. The prognostic value of each scoring system was evaluated by the area under the receiver operating characteristic curve(ROC). Results (1) The overall 30-day mortality of 276 patients with acute PTE was 22.5％. The 30-day mortality of patients in low vs. high risk groups according to sGPS, PESI and sPESI were 7.6％vs. 47.1％, 1.0％ vs. 34.3％, 2.4％ vs. 30.9％, respectively. The 30-day mortality of patients in high risk groups according to sGPS, PESI and sPESI were significantly higher than those of patients in low risk groups(P<0.01). The 30-day mortality of patients in low risk groups according to sGPS and PESI were significantly different(P=0.020). The 30-day mortality of patients in high risk groups according to sGPS were significantly different from those of patients in high risk groups according to PESI and sPESI, respectively (P=0.033, P=0.006). (2) The areas under the receiver operating characteristic (ROC) curves for evaluating the prognosis of patients with acute PTE according to sGPS, PESI and sPESI were 0.824, 0.891 and 0.846, respectively. The specificity (84.6％), the accuracy (84.4％) and the positive predictive value (61.2％) of PESI were the highest among the three prediction rules, the sensitivity (83.9％) and the negative predictive value (94.8％) of PESI were also relatively high. The negative predictive value of sPESI (98.6％) was the highest among the three prediction rules. Conclusions PESI can be more accurate for the overall risk stratification of patients with acute PTE, while sPESI is more helpful for identifying those patients with acute PTE who can be discharged early.

The Revision and Significance of 2017 Declaration of Geneva / 中国医学伦理学

Compared with the version of the Declaration of Geneva in 2006,the new revision in 2017 has great change and supplement,emphasizing the maintenance of the patient's autonomy.WMA (the World Medical Association) moved the all items of patients' rights to the beginning of the oath to highlight independent decision-making of patients in the medical ethics,and following the physician's professional responsibility.In terms of the structure,the declaration pay more attention of physicians themselves,and in content,it added and deleted some statements,and modified some words in detail.The revision of the Geneva declaration in 2017 improved the framework of the declaration and perfected the content of the declaration;raised the professional requirements for physicians and emphasized humanistic concern.Taking medical environment,economic and technological development into consideration,the further revision of the Declaration of Geneva should meet and adapt to the professional spirit of contemporary physicians.

Predictive value of revised Geneva score,ECG score and D-dimer in pulmonary embolism / 安徽医科大学学报

Objective To evaluate the value of revised Geneva score, Daniel ECG score and age-adjusted D-dimer for predicting pulmonary embolism(PE).Methods A total of 91 cases suspected as pulmonary embolism were collected, and 52 cases were diagnosed as pulmonary embolism by computed tomographic pulmonary angiography(CTPA) results.Receiver operating characteristic(ROC) curves and diagnostic test evaluation indexes were used to evaluate the probability of PE predicted by the revised Geneva score,Daniel ECG score, age-adjusted D-dimer and combination of these two clinical scores and age-adjusted D-dimer.Results The confirmed PE was 21.4% with a low probability(revised Geneva score 0~3 points),55.4% in intermediate probability(4~10 points),85.7% in high probability(score≥11 points).The prevalence of PE was 33.3% with a low clinical probability (Daniel ECG score<2 points)and 70.7% with a high clinical probability(Daniel ECG score≥2 points).The sensitivity and specificity of age-adjusted D-dimer in predicting pulmonary embolism were 92.3%,69.2%.The area under curve of the ROC curve(AUC)in the revised Geneva score and Daniel ECG score has no significant difference(Z=0.979).The negative predictive value of the revised Geneva score, Daniel ECG score combined with D-dimer in pulmonary embolism were 100.0% and 87.5%.Conclusion All of revised Geneva score, Daniel ECG score and age-adjusted D-dimer have certain predictive value on pulmonary embolism , and the revised Geneva score combined with age-adjusted D-dimer can be more safely exclude pulmonary embolism.

The Study on the Lives and Health Conditions of Internees in Santo Thomas Camp of Philippines: Based on McAnlis's The War in Manila (1941–1945) / 의사학

When Japan invaded the Philippines, two missionary dentists (Dr. McAnlis and Dr. Boots) who were forced to leave Korea were captured and interned in the Santo Thomas camp in Manila. Japan continued to bombard and plunder the Philippines in the wake of the Pacific War following the Great East Asia policy, leading to serious inflation and material deficiency. More than 4,000 Allied citizens held in Santo Thomas camp without basic food and shelter. Santo Thomas Camp was equipped with the systems of the Japanese military medical officers and Western doctors of captivity based on the Geneva Conventions(1929). However, it was an unsanitary environment in a dense space, so it could not prevent endemic diseases such as dysentery and dengue fever. With the expansion of the war in Japan, prisoners in the Shanghai and Philippine prisons were not provided with medicines, cures and food for healing diseases. In May 1944, the Japanese military ordered the prisoners to reduce their ration. The war starting in September 1944, internees received 1000 kcal of food per day, and since January 1945, they received less than 800 kcal of food. This was the lowest level of food rationing in Japan's civilian prison camps. They suffered beriberi from malnutrition, and other endemic diseases. An averaged 24 kg was lost by adult men due to food shortages, and 10 percent of the 390 deaths were directly attributable to starvation. The doctors demanded food increases. The Japanese Military forced the prisoner to worship the emperor and doctors not to record malnourishment as the cause of death. During the period, the prisoners suffered from psychosomatic symptoms such as headache, diarrhea, acute inflammation, excessive smoking, and alcoholism also occurred. Thus, the San Thomas camp had many difficulties in terms of nutrition, hygiene and medical care. The Japanese military had unethical and careless medical practices in the absence of medicines. Dr. McAnlis and missionary doctors handled a lot of patients focusing mainly on examination, emergency treatment and provided the medical services needed by Philippines and foreigners as well as prisoners. Through out the war in the Great East Asia, the prisoners of Santo Thomas camp died of disease and starvation due to inhumane Japanese Policy. Appropriate dietary prescriptions and nutritional supplements are areas of medical care that treat patients' malnutrition and disease. It is also necessary to continue research because it is a responsibility related to the professionalism and ethics of medical professionals to urge them to observe the Geneva Convention.

Predication of three kinds of scoring model for type 2 diabetes mellitus withacute pulmonary thromboembo-lism / 医学研究生学报

Objective There were few studies of prediction on type 2 diabetic patients with acute pulmonary thromboembo?lism.To evaluate the performance of the Padua score, revised Geneva score and Wells PE score in the prediction value of diagnosis of type 2 diabetes mellitus with acute pulmonary thromboembolism( APTE) . Methods 151cases with suspected APTE of type 2 diabe?tes were collected from January 2013 to December 2015 by a retrospective case analysis mode. Among 151 pations,80 cases had diag?nosed with pulmonary thromboembolism.The receiver operating characteristic (ROC) curve was used to evaluate the probability of type 2 diabetic patients with APTE predicted by the Padua, the revised Geneva and the Wells PE score. We calculated the Youden Index for the cut?off point. Results The area under curve( AUC) of the ROC curve in the Padua score, revised Geneva score and Wells PE score for APTE was 0.804±0.035、0.635±0.045 and 0.705±0.043. The area under the ROC curve of the Padua score was the highest and there was a significant difference compared with the revised Geneva( P0.016 7) . The comparison of revised Geneva score and Wells PE for the predication value was no statistically significant difference ( P>0.016 7) . The cut?off of Padua score was 3 points and Youden Index was 0.51. The cut?off of Revised Geneva was 3 points and Youden In?dex was 0.24. The cut?off of Wells PE score was 1 points and Youden Index was 0.39. Conclusion Padua score, revised Geneva score and Wells PE score in predicting diabetes patients have some ex?tent clinical value terms, which Padua score has higher predictive value than the Revised Geneva.The predictive value of Padua score and Wells PE score was equivalent.However, the predictive value of Padua score is limited.

Comparison of the screening effects between Wells and revised Geneva scores on suspected acute pulmonary thromboembolism / 中华急诊医学杂志

Objective To compare the screening effects between Wells and revised Geneva scores on suspected acute pulmonary thromboembolism (APTE),and to explore a optimum screening method for APTE in the emergency department of China.Methods The study was carried out by using random,crossed,prospective methods to compare the screening effects between Wells and revised Geneva scores for 167 suspected APTE patients in the emergency department of the First Affiliated Hospital of Xiamen University.Results The areas under the receiver operating characteristic curve of Wells and revised Geneva scores for screening APTE in the emergency department were (0.917 ± 0.022 ) and (0.927 ± 0.020),respectively ( P ＜ 0.05 ).The diagnostic concordance between the two score systems for predicting APTE was poor (Kappa value =0.276 ). In addition, the difference between their hierarchical discrimination for the possibility of APTE was statistically significant ( P ＜ 0.05 ).Compared with revised Geneva score,fewer patients were diagnosed with low clinical probability of APTE and more patients were diagnosed with intermediate or high clinical probability of APTE through Wells score.The patients with low chnical probability of APTE were excluded from pulmonary embolism in Wells or revised Geneva score.At intermediate clinical probability,the accuracy rate of Wells score for predicting APTE (9.64％) was lower than that (32.84％ ) of revised Geneva ( P ＜ 0.05 ).At high clinical probability,there was no significant difference between their accuracy rate [ (67.24％ vs.86.21％),P＞0.05]. Conclusions Revised Geneva score is more suitable than Wells score in screening suspected APTE patients in the emergency department in our country.

Ventana sin costo a la información biomédica; una perspectiva académica / Free window biomedical information to a academic perspective

Un acceso fácil y sin costo a revistas médicas en INTERNET a través de la Fundación Ginebra de Educación Médica e Investigación, la que facilita a médicos y otros profesionales de la Salud acceso a una biblioteca completa para investigar y revisar artículos, permitiéndoles crear sus propios programas de Educación Médica Contínua

An easy approach to free medical journals in INTERNET through the non profit contribution of the Geneva Foundation for Medical Education and Research, which facilitates doctors and other health related professionals access to a complete library of research and review articles, allowing them to create a self oriented program of Continued Medical Education.

Predication of Wells and Revised Geneva Scores for Pulmonary Embolism / 中山大学学报(医学科学版)

[Objective] To reduce misdiagnosis and underdiagnosis rate of pulmonary embolism,the prediction of the revised Geneva score and Wells score for pulmonary embolism were compared and analyzed by receiver operating characteristic curves.[Methods] Sixty-five cases with suspected pulmonary embolism (PE) were collected in the Third Affiliated Hospital of SUN Yat-sen University from January 1998 to October 2008.Of which 44 cases with PE were clinically confirmed.Relevant clinical data were recorded,summarized and the analysis variables were input to SPSS11.0 for statistical analysis.ROC curves was used to evaluate the probability of PE predicted by the Wells and the revised Geneva scores.[Results] Twenty-four patients had a low clinical probability of PE (Wells score ＜ 2 points ),of which 8 (33.3%) had proven PE.The prevalence of PE was 87.2% in the 39 patients with intermediate probability (2-6 points) and 100% in the 2 patients with high probability (＞ 6 points) (P ＝ 0.000).The confirmed PE was 22.2% in the 18 patients with a low probability (Geneva score 0-3 points),82.1% (32/39) in intermediate probability (4-10 points),100% (8/8) in high probability (score ≥11 points) (P ＝ 0.000).The area under curve (AUC) of the ROC curve in the Wells and Geneva scores was 0.785 ± 0.060 and 0.900 ± 0.038,respectively (P ＝ 0.000).The optimal cutoff value was 2 points in the Wells score and 6.5 points in the Geneva score.The Wells score more than 2 points predicted PE with a sensitivity of 81.8% and specificity of 76.2%.The Geneva score more than 6 points predicted PE with a sensitivity of 72.7% and specificity of 100%.The comparison of the area under curve between the Wells and the Geneva score had a significant difference statistically (P ＜ 0.05).[Conclusion] The Wells score and the revised Geneva score are beneficial to predict pulmonary embolism.The revised Geneva score is roughly superior to the Wells score both in sensitivity and specificity.