Retraction: Abdominal Cocoon: A Rare Complication of Peritoneal Dialysis in Chronic Kidney Disease.

[This retracts the article DOI: 10.7759/cureus.20341.].

Anatomical Variations in the Pectoralis Minor Muscle Origin and Insertion: A Systematic Review.

The pathology of the shoulder is among the most widespread medical presentations and may be a result of existing anatomical variations. Therefore, the knowledge of the variations is vital for physicians and clinicians, tasked with treating patients presenting similar complaints to minimize misdiagnosis and prevent iatrogenic injuries. Therefore, the main objective of the present systematic review the variations in pectoralis minor muscle origin and insertion/attachment point. The study also seeks to better inform physicians and clinicians of the task of treating patients with various pathology problems and to ascertain that, upon identification, the pectoralis minor muscle variants are aptly appreciated. The search method used in this systematic review entails the use of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, and the searching of several online databases, for studies focusing on variations in pectoralis minor muscles. The author reviewer evaluated the studies for eligibility, and the selection criteria for the studies used are described below. This systematic review has disclosed that, in some individuals, the pectoralis minor muscles have their origins in the second, third, and fourth ribs, even as others have their origin in the third and fourth ribs. Still, the systematic review has disclosed that, in certain individuals, the insertion of the pectoralis minor muscle occurs at the supraspinatus tendon, even as there are anomalies in the pectoralis minor insertion points linked to subacromial impingement, possible compression of the brachial plexus anteromedial and the axillary artery, and the subcoracoid impingement.

Anatomical study of divergences in facial artery endings.

Despite several studies focusing on the facial arteries variable courses, the findings have significantly differed. The divergent findings have made it increasingly challenging to establish consistent correlations. Thus, as a vital artery, the facial artery is prone to numerous variations, which makes the identification of the variations vital to clinical practice, particularly for the orofacial and rhinoplastic surgery, and the increasingly selective chemotherapy procedures. The present research uses angiography images for analysis in studying the bilateral facial artery variations noted in patients undergoing carotid angiography for the evaluation of congenital anomalies, cerebral vascular malformations, and intra-arterial procedures. Conventional angiography was used, as it is a vital assessment tool that helps in the assessment of variations in the facial arteries and is suitable in evaluating smaller vascular anatomy, due to the perfect spatial resolution and portrayal of vascular anatomy. Thus, rather than normal ending of the facial artery as an angular artery, the study disclosed that in certain instances, the artery termination took the form of a superior labial artery with a small lateral nasal artery branch located closer to the midline compared to the normal cases. Also, the study has disclosed a conspicuous pre-masseteric branch with small branches originating from the infraorbital artery and providing potential compensation for the facial artery's shortness. Regardless of the infrequency of such variations, it is vital that they are considered during the performance of any facial surgical procedure.

Adaptive fuzzy-based stability control and series impedance correction for the grid-tied inverter.

The regenerative braking in the tram allows the energy to be returned to the power grid through a power inverter. Since the inverter location between the tram and the power grid is not fixed, resulting in a wide variety of impedance networks at grid coupling points, posing a severe threat to the stable operation of the grid-tied inverter (GTI). By independently changing the loop characteristics of the GTI, the adaptive fuzzy PI controller (AFPIC) can adjust according to different impedance network parameters. It is challenging to fulfill the stability margin requirements of GTI under high network impedance since the PI controller has phase lag characteristics. A correction method of series virtual impedance is proposed, which connects the inductive link in a series configuration with the inverter output impedance, correcting the inverter equivalent output impedance from resistance-capacitance to resistance-inductance and improving the system stability margin. Feedforward control is adopted to improve the system's gain in the low-frequency band. Finally, the specific series impedance parameters are obtained by determining the maximum network impedance and setting the minimum phase margin of 45°. The realization of virtual impedance is simulated by conversion to an equivalent control block diagram, and the effectiveness and feasibility of the proposed method are verified by simulation and a 1 kW experimental prototype.

Reciprocal Translocation T(Y;16) in a Male Patient With Non-obstructive Azoospermia: A Case Report and Literature Review.

Translocation of sex/autosome chromosomes is uncommon, but they have a stronger impact on fertility than autosome/autosome translocation. Y/autosome translocation is associated with azoospermia in 80% of cases. To our knowledge, there have been only eight cases reported of a balanced reciprocal (Y;16) translocation associated with male infertility.Here we report an infertile man with azoospermia who has a reciprocal translocation t(Y;16) (q12; p13.2).  A 38-year-old Saudi medically free male presented with primary infertility and azoospermia for six years. He has a positive family history of male infertility. Physical examination was unremarkable. Investigations showed normal hormonal panel and azoospermia. He has a male karyotype with a reciprocal chromosome Y,16 translocation. Histopathology report of bilateral testicular sperm extraction (TESE) revealed most tubules show early maturation arrest and few show either Sertoli-cell only syndrome or are completely hyalinized and atrophic.  This case illustrates a rare cause of non-obstructive azoospermia in a male with chromosome Y,16 translocation as a result of a meiotic arrest. Medical practitioners should be aware of the genetic abnormalities of male patients who present with primary infertility. Karyotyping has the capability to diagnose genetic abnormalities in this patient.

Defining the Components of the Deltoid Ligament (DL): A Cadaveric Study.

BACKGROUND: The deltoid ligament (DL) is a strong triangle-shaped ligament with a complex fascicular arrangement. Understanding the morphological and/or functional typing of the DL structure is hindered by a paucity of clear, quantitative, and reproducible data and is further complicated by inconsistent terminology use. The aim of this work was to describe different components of the DL using strict identification criteria. METHODS: Thirty embalmed cadaveric ankles of both sides were dissected on all sides and studied by using gross examination, micro-dissection, and light microscopy by tracing the fascicular pattern of each under 6X magnification. RESULTS: Six ligamentous bands were identified. The tibiotalocalcaneal ligament (TTC) and the superficial posterior tibiotalar ligament (sPTT) were two superficial variants and the anterior tibiotalar ligament (ATT), the anterior tibiotalonavicular ligament (ATTN), the intermediate tibiotalar ligament (ITT), and the deep posterior tibiotalar ligament (dPTT) were four deep variants. The TTC was identified in all 30 embalmed cadaveric specimens. Five additional ligamentous bands (ITT, sPTT, dPTT, ATT, and ATTN) were variable findings in the current cohort. CONCLUSION: This study presents six ligamentous bands as a regular finding and five additional ligamentous bands as variable findings in the dissected specimen. This data could assist in the radiological diagnosis of DL injuries and advanced procedures related to its surgical repair and reconstruction.

Hybrid Sharpening Transformation Approach for Multifocus Image Fusion Using Medical and Nonmedical Images.

In this study, we introduced a preprocessing novel transformation approach for multifocus image fusion. In the multifocus image, fusion has generated a high informative image by merging two source images with different areas or objects in focus. Acutely the preprocessing means sharpening performed on the images before applying fusion techniques. In this paper, along with the novel concept, a new sharpening technique, Laplacian filter + discrete Fourier transform (LF + DFT), is also proposed. The LF is used to recognize the meaningful discontinuities in an image. DFT recognizes that the rapid change in the image is like sudden changes in the frequencies, low-frequency to high-frequency in the images. The aim of image sharpening is to highlight the key features, identifying the minor details, and sharpen the edges while the previous methods are not so effective. To validate the effectiveness the proposed method, the fusion is performed by a couple of advanced techniques such as stationary wavelet transform (SWT) and discrete wavelet transform (DWT) with both types of images like grayscale and color image. The experiments are performed on nonmedical and medical (breast medical CT and MRI images) datasets. The experimental results demonstrate that the proposed method outperforms all evaluated qualitative and quantitative metrics. Quantitative assessment is performed by eight well-known metrics, and every metric described its own feature by which it is easily assumed that the proposed method is superior. The experimental results of the proposed technique SWT (LF + DFT) are summarized for evaluation matrices such as RMSE (5.6761), PFE (3.4378), MAE (0.4010), entropy (9.0121), SNR (26.8609), PSNR (40.1349), CC (0.9978), and ERGAS (2.2589) using clock dataset.

An Overview of the Perspective of Cellular Autophagy: Mechanism, Regulation, and the Role of Autophagy Dysregulation in the Pathogenesis of Diseases.

Autophagy is a cellular process that eliminates unnecessary cytoplasmic materials, such as long-age proteins, destroyed organelles, and foreign microorganisms. Macroautophagy (MaA), chaperone-mediated autophagy, and microautophagy are the three main types of autophagy. It is regulated by the integration of signaling from the AMPK and mTOR-ULK1 pathways. Autophagy plays a physiological role in health, and its dysregulation could be a pathophysiologic mechanism in different disease conditions. In the current study, we reviewed papers of Google Scholar database, PubMed, PubMed Central, Cochrane Database of Systematic Reviews, MEDLINE, and MedlinePlus with no time limitation and a recent World Health Organization report. In the current review, it could be concluded that autophagy plays many physiological functions, including immune system modulation, and regulates different cellular processes such as metabolism, protein synthesis, and cellular transportation. Dysregulation of autophagy is implicated in tumorigenesis, aging, age-related neurodegeneration, and endothelial dysfunctions. Autophagy dysregulation is also implicated in the newly discovered CoV-COVID-19 pathogenesis.

Molecular Precursor Route to Bournonite (CuPbSbS3) Thin Films and Powders.

Quaternary metal chalcogenides have attracted attention as candidates for absorber materials for inexpensive and sustainable solar energy generation. One of these materials, bournonite (orthorhombic CuPbSbS3), has attracted much interest of late for its properties commensurate with photovoltaic energy conversion. This paper outlines the synthesis of bournonite for the first time by a discrete molecular precursor strategy. The metal dithiocarbamate complexes bis(diethyldithiocarbamato)copper (II) (Cu(S2CNEt2)2, (1)), bis(diethyldithiocarbamato)lead (II) (Pb(S2CNEt2)2, (2)), and bis(diethyldithiocarbamato)antimony (III) (Sb(S2CNEt2)3, (3)) were prepared, characterized, and employed as molecular precursors for the synthesis of bournonite powders and the thin film by solvent-less pyrolysis and spray-coat-pyrolysis techniques, respectively. The polycrystalline powders and thin films were characterized by powder X-ray diffraction (p-XRD), which could be indexed to orthorhombic CuPbSbS3. The morphology of the powder at the microscale was studied using scanning electron microscopy (SEM). Energy-dispersive X-ray spectroscopy (EDX) was used to elucidate an approximately 1:1:1:3 Cu/Pb/Sb/S elemental ratio. An optical band gap energy of 1.55 eV was estimated from a Tauc plot, which is close to the theoretical value of 1.41 eV.

Direct synthesis of nanostructured silver antimony sulfide powders from metal xanthate precursors.

Silver(I) ethylxanthate [AgS2COEt] (1) and antimony(III) ethylxanthate [Sb(S2COEt)3] (2) have been synthesised, characterised and used as precursors for the preparation of AgSbS2 powders and thin films using a solvent-free melt method and spin coating technique, respectively. The as-synthesized AgSbS2 powders were characterized by powder X-ray diffraction (XRD), Raman spectroscopy, scanning electron microscopy (SEM) and energy dispersive X-ray (EDX) spectroscopy. The crystalline AgSbS2 powder was investigated using XRD, which shows that AgSbS2 has cuboargyrite as the dominant phase, which was also confirmed by Raman spectroscopy. SEM was also used to study the morphology of the resulting material which is potentially nanostructured. EDX spectra gives a clear indication of the presence of silver (Ag), antimony (Sb) and sulfur (S) in material, suggesting that decomposition is clean and produces high quality AgSbS2 crystalline powder, which is consistent with the XRD and Raman data. Electronic properties of AgSbS2 thin films deposited by spin coating show a p-type conductivity with measured carrier mobility of 81 cm2 V-1 s-1 and carrier concentration of 1.9 × 1015 cm-3. The findings of this study reveal a new bottom-up route to these compounds, which have potential application as absorber layers in solar cells.

Introducing free response short answer questions in anatomy spot tests: experiment study.

PURPOSE: A spot test is commonly used to assess practical knowledge through a series of specific questions related to the marked anatomical structures on cadavers. However, the continuous reviewing and developing of the medical curricula demands the need to improve the assessment method of the practical examination of anatomical knowledge. Therefore, the aim of the study was to examine the effectiveness of a free response short-answer questions (FRSAQs) test and traditional questions on medical students' performance. METHODS: This is an experimental study using a Randomized Posttest-Only Control Group Design to compare the mean of students' performance in addition to their perceptions about the two versions of the spot tests. Two hundred and ninety preclinical-year medical students were invited to participate in this study. RESULTS: Only 109 (38%) students participated in this study. The data analysis showed a significant improvement in students' performance in the FRSAQs test (5.3 ± 2.7) than the traditional spot test (4.7 ± 2.6), (P = 0.04). The majority of the students (70%) preferred the FRSAQs spot test, citing that it is good test to assess practical knowledge. The psychometric analysis revealed that the FRSAQs produced more ideal stations (60%) when compared to the traditional spot test (10%). CONCLUSION: The current study found that the FRSAQs spot test had a significant impact on students' performance, and it was considered an ideal, flexible, and stress-free assessment method when compared to the traditional spot test. Implementation of the strategy in teaching and in assessment is recommended.

Abdominal Cocoon: A Rare Complication of Peritoneal Dialysis in Chronic Kidney Disease.

The abdominal cocoon is a rare clinical entity characterized by a thick fibrocollagenous membrane encasing the intestinal loops. Despite its rarity, the abdominal cocoon is one of the most serious complications of peritoneal dialysis. We report the case of a 45-year-old man, with end-stage renal disease on peritoneal dialysis resulting from systemic lupus erythematosus, who presented to the emergency department with progressive abdominal pain for the last two weeks. The pain was associated with nausea, vomiting, abdominal distension, and decreased bowel motion. Upon examination, the vital signs were within the normal limits. Abdominal examination revealed a distended abdomen with generalized tenderness. There was evidence of ascites as indicated by the positive shifting dullness test. The bowel sounds were of increased frequency and intensity. The laboratory findings were non-contributory. The patient underwent an abdominal computed tomography scan that demonstrated a cluster of small intestinal loops in the middle of the abdomen with a surrounding thick and calcified membrane. This made the diagnosis of the abdominal cocoon. The patient underwent an operation to resect the fibrocollagenous membrane. The patient reported improvement after the operation. No recurrence was noted after three months of follow-up. Abdominal cocoon is a very rare complication of peritoneal dialysis. The diagnosis of abdominal cocoon should be kept in mind when the physician encounters a patient with peritoneal dialysis who presented with non-specific and unexplained gastrointestinal symptoms.

Three-dimensional Virtual Reality as an Innovative Teaching and Learning Tool for Human Anatomy Courses in Medical Education: A Mixed Methods Study.

Introduction Poor knowledge retention is one reason for medical student attrition in learning and has been a huge concern in medical education. Three-dimensional virtual reality (3D-VR)-based teaching and learning in medical education has been promoted to improve student learning outcomes. This study aimed to determine the effectiveness of 3D-VR in knowledge retention in human anatomy courses as compared to traditional teaching methods among medical students. Methods A convergent mixed methods design was utilized to evaluate learning outcomes in terms of short- and long-term knowledge retention scores among students using 3D-VR and those using traditional models and to describe students' experiences and views of the use of 3D-VR as a teaching and learning tool. Results Male students who used the 3D-VR tool had significantly higher short- and long-term knowledge scores than males who used the traditional methods. Meanwhile, females who used traditional methods showed significantly higher short-term knowledge scores than females who used 3D-VR. Conclusion Medical students described 3D-VR as a learning tool with a great deal to offer for learning human anatomy as compared to traditional methods. Therefore, we recommend adding the use of 3D-VR in the anatomy curriculum. However, several 3D-VR limitations were also identified, which may hinder its utilization for teaching and learning. These concerns must be addressed before 3D-VR tools are considered for implementation in medical education human anatomy courses.

Scalable and Universal Route for the Deposition of Binary, Ternary, and Quaternary Metal Sulfide Materials from Molecular Precursors.

A range of binary, ternary (CFS), and quaternary (CZTS) metal sulfide materials have been successfully deposited onto the glass substrates by air-spray deposition of metal diethyldithiocarbamate molecular precursors followed by pyrolysis (18 examples). The as-deposited materials were characterized by powder X-ray diffraction (p-XRD), Raman spectroscopy, secondary electron microscopy (SEM), and energy-dispersive X-ray (EDX) spectroscopy, which in all cases showed that the materials were polycrystalline with the expected elemental stoichiometry. In the case of the higher sulfides, EDX spectroscopy mapping demonstrated the spatial homogeneity of the elemental distributions at the microscale. By using this simple and inexpensive method, we could potentially fabricate thin films of any given main group or transition metal chalcogenide material over large areas, theoretically on substrates with complex topologies.