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Objective: The objective of this study was to analyze cases that had left the Pediatric Emergency Center Al Sadd, Doha (PEC) against medical advice, with the aim of developing policies to help reduce this occurrence. Methodology: All patients that were admitted to the main PEC observation room for treatment and/or investigation and subsequently left against medical advice from February 18, 2007 to June 18, 2007, were followed by a phone call, and a questionnaire, which was completed by the departmental patient representative. Results: 99,133 patients attended the facility during the study period. Of those, 106 left the facility against medical advice. Ninety-four guardians were successfully contacted. 90% of the cases were in children below 2 years of age. In 87% of the cases the mother was the main decision maker for leaving against medical advice. Domestic obligations were the leading cause of DAMA (discharge against medical advice), reported in 45% of the cases. Respondents reported that the consequences of DAMA were well explained by medical staff before they left the facility however, they had not met with the departmental patient representative during their stay. Conclusion:As the majority of DAMA cases occurred in infants, medical staff should address the concerns of this group early on in the course of treatment. Maintaining communication and providing support, in particular for mothers of higher risk groups may help to reduce the rate of DAMA cases.

In order to evaluate the quantitative and qualitative performance of spring bread wheat cultivars under different planting dates, an experiment was conducted in Gonbad Agricultural Research Station, Gonbad, Golestan province, Iran, during two cropping seasons (2020-2022) as split plot based on randomized complete block design (RCBD) with four replications. Seven planting dates (1 November, 11 November, 21 November, 1 December, 11 December, 21 December and 31 December) were placed in main plots and four bread wheat genotypes (Araz, Arman, Taktaz and N-93-9) were placed in subplots. The delayed planting led to a significant decrease in the length of the phenological stages and the grain filling period. The highest grain yield was obtained from the planting at 11 November (5813 kg ha-1), which was not significantly different from grain yield in 21 November (5788 kg ha-1) and 31 November (5641 kg ha-1) planting dates. In most of the agronomic traits, the delayed planting dates (21 December and 31 December) had significantly lower values than planting in 11 November, 21 November and 1 December. Mean comparison for interaction effect of planting date×cultivar showed that planting Arman cultivar in 11 November, Araz cultivar in 11 November, 21 November and 1 December, Arman cultivar in the 21 November and Taktaz cultivar in the 21 November led to the highest grain yield. In the three delayed planting dates (11 December, 21 December and 31 December), the grain yield of Taktaz and Araz cultivars was higher than other genotypes. Mean comparisons on the traits related to bread-making quality showed that the two delayed planting dates (21 December and 31 December) had higher values in terms of protein and wet gluten content, compared to the two early planting dates (1 November and 11 November). Taktaz cultivar had the highest bread-making quality, particularly because it indicated the highest protein and wet gluten content.

Focal liver lesions are routinely encountered by clinical radiologists and represent a wide spectrum of pathology. Majority of these lesions are likely to be benign in nature, especially in the absence of chronic liver disease or primary cancer. A radiologist must be aware of common and uncommon imaging features of benign lesions across the various imaging modalities. This review discusses pathognomonic imaging features of common benign focal liver lesions seen on ultrasound, computed tomography and magnetic resonance, and adds to existing knowledge with the recent updates to have emerged in this area., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Acute aortic syndrome (AAS) is a life-threatening condition which includes aortic dissection (AD), penetrating aortic ulcer (PAU) and intramural hematoma (IMH). Multi-detector computed tomography (MDCT) plays a crucial role in the diagnosis of this condition and for further clinical follow-up. It is important for radiologists to be aware of common pitfalls in cardiac-gated and non-gated CT in diagnosing AAS. They should also be wary of common mimics of AAS which may make a significant difference towards management of these patients. In this review, we present from our practice some of the common pitfalls and mimics of AAS on MDCT.

Aims/hypothesis: Defects in pancreatic beta cell turnover are implicated in the pathogenesis of type 2 diabetes by genetic markers for diabetes. Decreased beta cell neogenesis could contribute to diabetes. The longevity and turnover of human beta cells is unknown; in rodents <1 year old, a half-life of 30 days is estimated. Intracellular lipofuscin body (LB) accumulation is a hallmark of ageing in neurons. To estimate the lifespan of human beta cells, we measured beta cell LB accumulation in individuals aged 1-81 years., Methods: LB content was determined by electron microscopical morphometry in sections of beta cells from human (non-diabetic, n = 45; type 2 diabetic, n = 10) and non-human primates (n = 10; 5-30 years) and from 15 mice aged 10-99 weeks. Total cellular LB content was estimated by three-dimensional (3D) mathematical modelling., Results: LB area proportion was significantly correlated with age in human and non-human primates. The proportion of human LB-positive beta cells was significantly related to age, with no apparent differences in type 2 diabetes or obesity. LB content was low in human insulinomas (n = 5) and alpha cells and in mouse beta cells (LB content in mouse <10% human). Using 3D electron microscopy and 3D mathematical modelling, the LB-positive human beta cells (representing aged cells) increased from >or=90% (<10 years) to >or=97% (>20 years) and remained constant thereafter., Conclusions/interpretation: Human beta cells, unlike those of young rodents, are long-lived. LB proportions in type 2 diabetes and obesity suggest that little adaptive change occurs in the adult human beta cell population, which is largely established by age 20 years.