The FDA issued a “black box” warning regarding risks of fluoroquinolones in 2008 with updates in 2011, 2013, and 2016. To examine antimicrobial use in hospital-treated UTIs from 2000 to 2020. Cross-sectional study with interrupted time series analysis. Patient encounters with a diagnosis of UTI from January 2000 to March 2020, excluding diagnoses of renal abscess, chronic cystitis, and infection of the gastrointestinal tract, lungs, or prostate. Monthly use of fluoroquinolone and non-fluoroquinolone antibiotics were assessed. Fluoroquinolone resistance was assessed in available cultures. Interrupted time series analysis examined level and trend changes of antimicrobial use with each FDA label change. A total of 9,950,790 patient encounters were included. From July 2008 to March 2020, fluoroquinolone use declined from 61.7

Population-based studies to identify disease-associated risk alleles typically require samples from a large number of individuals. Here, we report a human-induced pluripotent stem cell (hiPSC)-based screening strategy to link human genetics with viral infectivity. A genome-wide association study (GWAS) identified a cluster of single-nucleotide polymorphisms (SNPs) in a cis-regulatory region of the NDUFA4 gene, which was associated with susceptibility to Zika virus (ZIKV) infection. Loss of NDUFA4 led to decreased sensitivity to ZIKV, dengue virus, and SARS-CoV-2 infection. Isogenic hiPSC lines carrying non-risk alleles of SNPs or deletion of the cis-regulatory region lower sensitivity to viral infection. Mechanistic studies indicated that loss/reduction of NDUFA4 causes mitochondrial stress, which leads to the leakage of mtDNA and thereby upregulation of type I interferon signaling. This study provides proof-of-principle for the application of iPSC arrays in GWAS and identifies NDUFA4 as a previously unknown susceptibility locus for viral infection.

Evaluate the effects of the ZIKV epidemic in the male reproductive function in a cohort of fertile men two years after a major outbreak in Brazil. Cross-sectional study. We enrolled 39 fertile men who attended the urology an outpatient clinic at Recife - Brazil for vasectomy. All subjects completed an epidemiological questionnaire, underwent standard semen analysis, sexual hormone levels measurement, and ZIKV serologic tests. Based on their serologic tests results, subjects were divided in two groups, a ZIKV negative (Z-) group and a ZIKV positive group (Z+). Epidemiological, clinical and laboratory variables were compared between both groups. There were 25 (64%) ZIKV positive subject based on positive serum IgG anti-ZIKV antibodies; no subject showed IgM anti-ZIKV antibodies or viral RNA by PCR in semen samples. There were no significant differences between the groups regarding demographic and clinical data, but a few variables deserve mention. Overall, only 7 subjects reported ZIKV infection symptoms in the last two years, a small number compared to the overall prevalence of ZIKV of positive serologic test. The proportion of participants that reported symptoms was higher in the Z+ group when compared to the Z- group (24% and 7% respectively). Fever, myalgia, headache and cutaneous rash were the symptoms described. There were no known neurologic sequelae in patients or first-degree family members. The Z+ group had a clinically significant higher incidence of mosquito bites than the Z- group, although without statistically significance. In addition, semen analysis parameters and hormone levels showed no differences between the groups. The prevalence of serum IgG anti-ZIKV antibodies was high in this cohort of fertile men, despite a low prevalence of ZIKV infection symptoms. There was no statistical difference in semen parameters or hormone between the groups. Screening of all male infertility patients should be considered in areas with high risk of exposure to Zika Virus.

OBJECTIVE To review current literature pertaining to the availability and implementation of urology-focused curricula, in an effort to highlight current approaches to urologic education at the medical school level. METHODS A medical librarian searched PubMed, EMBASE, the Cochrane Library, ERIC, and Scopus for articles focused on undergraduate urology education. Two reviewers adjudicated all retrieved titles. Only those describing interventions in undergraduate medical urology education were included in the review. Data extracted from each article included, but were not limited to: sample size, instructional aim, type of intervention, outcome measurement, significance of results, and strength of evidence. RESULTS After removal of 1478 duplicate search results, 2425 unique titles remained for adjudication. Title and abstract screening excluded 2311. The remaining 114 articles met inclusion criteria. The articles focused on knowledge-based education (43), urologic curricula (22), clinical skills education (19), surgical skills training (15), and survey of student experiences in urology (15). 73 had been published since January 1, 2010. CONCLUSION Analysis of the published literature reveals a paucity of articles investigating implementation and outcomes of formal urologic curricula. Most of the literature focuses on acquisition of knowledge concerning narrow urology-related topics. Physicians often receive minimal exposure to formal urologic curricula during their undergraduate years. Appropriate interventions aimed at increasing undergraduate student familiarity with common urologic scenarios are warranted. The results of this study can inform the efforts of urology programs seeking to expand their educational opportunities. (C) 2018 Elsevier Inc.

Introduction: Each year, varicella-zoster virus (VZV) affects nearly one million people in the United States, often in the form of herpes zoster, or shingles. The urologic system is a rare but often debilitating target. This paper reviews the epidemiology, symptomatology, diagnosis, and management of VZV as it relates to urologic practice. Materials and methods: We performed a PubMed search using the query "herpes zoster" and "varicella-zoster virus" combined with multiple urological terms. Results: Infection caused by VZV, specifically the resurgent clinical infection herpes zoster (HZ), is prevalent and increasing. It often affects older men and women and those in immunocompromised states and usually manifests as a painful cutaneous rash. However, urological conditions such as voiding dysfunction, erectile issues, and flank pain have also been noted in conjunction with an HZ infection. Additionally, urological procedures and treatments may incite an HZ outbreak. Awareness and prompt treatment can ameliorate the intensity and duration of this infection. Conclusions: An understanding of the atypical manifestations of HZ and disseminated VZV infection may aid urologic practitioners in avoiding misdiagnosis and delay of treatment.

Pyuria is defined as the presence of 10 or more white cells per cubic millimeter in a urine specimen, 3 or more white cells per high-power field of unspun urine, a positive result on Gram's staining of an unspun urine specimen, or a urinary dipstick test that is positive for leukocyte esterase.(1) Sterile pyuria is the persistent finding of white cells in the urine in the absence of bacteria, as determined by means of aerobic laboratory techniques (on a 5% sheep-blood agar plate and MacConkey agar plate).Sterile pyuria is a highly prevalent condition, and population-based studies show that 13.9% of women and 2.6% of men are affected.(2) Specific populations have a higher risk of this condition; for example, the frequency of detection of sterile pyuria was 23% among inpatients in one study (excluding those with urinary tract infection), and sterile pyuria is more common among women than among men because of pelvic infection.(3) Subsequent to initial detection, the costs of laboratory, radiographic, and invasive evaluation in such large populations can have a considerable effect on health care expenditures.(4)Although colony counts greater than 100,000 colony-forming units (CFU) per milliliter in voided urine have historically been used to distinguish bacterial urinary tract infection from colonization,(5) many U. S. laboratories currently report bacterial colony counts of more than 1000 CFU per milliliter in urine as being diagnostic of bacteriuria.(6) It is important to consider that lower bacterial counts can be associated with urinary tract infection. Contemporary studies indicate that a colony count of 100,000 CFU per milliliter would differentiate clinically significant from clinically nonsignificant infections and thus reduce the number of positive cultures by 38% relative to the number of cultures that would be considered positive with the 1000 CFU per milliliter cutoff point. Use of the higher cutoff point as the "level to treat" could also decrease the use of antibiotics.(6)In this article, we review causes of sterile pyuria and describe a clinical approach to its evaluation.

You have accessJournal of UrologyHistory of Urology I (Podium)1 Apr 2014FRI-10 REP. LARRY MCDONALD: THE ONLY UROLOGIST TO EVER SERVE IN CONGRESS Bobby Najari and Gilbert J. Wise Bobby NajariBobby Najari More articles by this author and Gilbert J. WiseGilbert J. Wise More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1728AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Lawrence “Larry” Patton McDonald, M.D. was born on April 1st, 1935 and raised in Atlanta, Georgia, where he practiced urology. He later became a member of the U.S. House of Representatives, prior to his death on September 1st, 1983, when a Soviet fighter plane shot down Korean Air Lines Flight 007 with Dr. McDonald on-board. Methods Biographical sources and primary documentation were reviewed to compile a summary of his life. Results Dr. McDonald came from a family of doctors; his grandfather, Dr. Paul McDonald, was a general practitioner, and his father, Dr. Harold P. McDonald was a urologist. As a youth, Larry McDonald was driven and studious; he was accepted into Emory University School of Medicine at the age of 17. After obtaining his M.D. in 1957, he served as flight surgeon in the Naval Reserve at Naval Air Station Keflavik in Reykjavik, Iceland. The intensifying Cold War had led to an American presence at this base as a deterrent for the Soviet Union. This experience had a lasting impact on Dr. McDonald, instilling an intense concern about the spread of Communism that would last into his political career. Returning to America in 1961, he spent two years training in general surgery at Grady Memorial Hospital in Atlanta and three years in urology training at University of Michigan in Ann Arbor. After completing his residency in 1966, he returned to Atlanta where he shared a urology practice, the McDonald Urology Clinic, with his father and his brother, Dr. Harold P. McDonald, Jr. Dr. McDonald’s political aspirations began in residency, when he ran for (but did not win) a city council position in Ann Arbor. However, in 1974 he was elected to represent Georgia’s 7th congressional district, where he served and was re-elected four times. Although a member of the Democratic Party, his politics were consistently conservative. As early as 1966, he was a member of the John Birch Society, a political advocacy group supporting less government and more personal freedoms. By 1983, he was president of this society. However, on September 1st, 1983 during a flight to South Korea to celebrate the 30th anniversary of the Mutual Defense Treaty, his passenger aircraft was attacked and destroyed by a Soviet fighter plane. Dr. McDonald was 48 years old when he died. Conclusions There are many physicians who have been elected to government office; however fewer urologists participate at this level of politics. As the only urologist to be elected to Congress, Dr. Larry McDonald had a memorable, however brief, life and political career. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e624 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Bobby Najari More articles by this author Gilbert J. Wise More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

You have accessJournal of UrologyHistory of Urology Forum1 Apr 20131112 JAMES BUCHANAN BRADY AND THE TWO BRADY DEPARTMENTS OF UROLOGY Bobby B. Najari and Gilbert J. Wise Bobby B. NajariBobby B. Najari New York, NY More articles by this author and Gilbert J. WiseGilbert J. Wise New York, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.704AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES James Buchanan Brady (1856-1914) was renowned for his wealth, flashy appearance, and appetite for food. While his life was characterized by the fulfillment of worldly desires, his legacy is carried on by two prestigious academic urologic departments: the James Buchanan Brady Urological Institute at Johns Hopkins University and the James Buchanan Brady Foundation Department of Urology at Weill Cornell Medical College. METHODS Biographical sources and primary documentation were reviewed to compile a summary his life and relationship with the two urologic departments named after him. RESULTS On August 12, 1856, Brady was born upstairs from Daniel Brady's Saloon in New York City. As a youth, he worked as a baggage handler at the New York Central Railroad; however, he quickly developed a fortune through his aptitude for the sale of railroad supplies. He used his wealth to acquire a large collection of diamond jewelry, hence his nickname “Diamond Jim” Brady. He also spent his fortune entertaining women and eating enormous quantities of food. Not surprisingly, Brady had numerous health problems, for which he often sought the care of Dr. Hugh Hampton Young at Johns Hopkins. Young wrote in his autobiography: “Brady's case did indeed present a formidable series of complications: diabetes, Bright's disease, generalized urinary infection, inflammation and obstruction of the prostate gland, difficulty and frequency of urination.” In appreciation of the care he had received, Brady gave $220,000 to Johns Hopkins Hospital in 1912 to establish the James Buchanan Brady Urologic Institute. Brady's urological problems often required urgent attention that precluded travelling to Baltimore from his home in New York City; thus, he turned to the care of Oswald Swinney Lowsley. After obtaining a medical degree at Johns Hopkins, Lowsley worked at Bellevue Hospital in New York as an intern and then in the Bellevue urology clinic. Brady found Lowsley always available to make house calls, and Lowsley never charged Brady for his services, although he did occasionally permit Brady to give him gifts. Brady appreciated Lowsley's care so much, that upon his death in 1917, it was revealed that Brady bequeathed over $1,000,000 of his estate to the formation of the James Buchanan Brady Foundation of Urology at New York Hospital (which was affiliated with Cornell Medical College), with Lowsley named as its first director. CONCLUSIONS Diamond Jim Brady led an extravagant and memorable life, and the care he received by Hugh Hampton Young in Baltimore and Oswald Swinney Lowsley in New York City led to two urologic departments being named after him. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e455 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Bobby B. Najari New York, NY More articles by this author Gilbert J. Wise New York, NY More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

You have accessJournal of UrologyProstate Cancer: Basic Research VI1 Apr 20101179 ROLE OF THE TRANSCRIPTION REPRESSOR, SLUG, IN THE PATHOGENESIS OF PROSTATE CANCER Gilbert Wise, Ruben M. Pinkhasov, David Silver, James Kashanian, Theresa Jacob, Sherman Chan, and Ridwan Shabsigh Gilbert WiseGilbert Wise New York, NY More articles by this author , Ruben M. PinkhasovRuben M. Pinkhasov Brooklyn, NY More articles by this author , David SilverDavid Silver Brooklyn, NY More articles by this author , James KashanianJames Kashanian Brooklyn, NY More articles by this author , Theresa JacobTheresa Jacob Brooklyn, NY More articles by this author , Sherman ChanSherman Chan Brooklyn, NY More articles by this author , and Ridwan ShabsighRidwan Shabsigh Brooklyn, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.680AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES During tumor progression, several key molecular players are involved that allow cells to leave their surroundings and migrate to a distant site. Loss of the cell adhesion factor, E-cadherin and up regulation of Slug, (a transcription repressor involved in epithelial to mesenchymal transition) has been shown to be associated with poor tumor prognosis. Our study investigated Slug and its relation to E-cadherin expression to elucidate its role in pathogenesis of prostate cancer (CaP). We hypothesize that over expression of Slug down regulates cell adhesion factor (E-cadherin) while resulting in cell de-differentiation and migration in CaP cells. METHODS Prostate tissue was obtained from a random selection of core biopsy specimens of men undergoing assessment for neoplasia or post radical prostatectomy specimens (n=65). Slug and E-cadherin mRNA transcripts were determined by real-time RT-PCR. Principal risk factors, PSA levels, Gleason scores, and tumor stage, were also compared. RESULTS All tissues with documented CaP (n=35; 54%) and prostate intraepithelial neoplasia (n=2; 3%) demonstrated increased expression of Slug with repression of E-cadherin. There was a significantly higher amount of Slug transcripts in CaP tissues as compared to that in benign tissues (6-fold vs 2-fold, respectively of internal control; p<0.05). A statistically significant association was found between Slug up regulation and E-cadherin down regulation (r=0.79). Transcripts of Slug were about 7 times that of E-cadherin in CaP samples, while they were less than 1.2 times that of E-cadherin in tumor negative tissues (p=0.01). The Slug/E-cadherin ratio is significantly higher in CaP tissues than that in benign samples. CONCLUSIONS Slug up regulation and associated E-cadherin down regulation were observed in CaP biopsy tissues. This is the first study that provides evidence of Slug/E-cadherin relationship in prostate cancer. Our results concur with the accumulating reports on the role of Slug in tumor invasion. Further elaboration of its expression in the genetic architecture of the prostate and the molecular repercussions therein, could possibly identify causative/susceptibility mechanisms and new therapeutic targets. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e457 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Gilbert Wise New York, NY More articles by this author Ruben M. Pinkhasov Brooklyn, NY More articles by this author David Silver Brooklyn, NY More articles by this author James Kashanian Brooklyn, NY More articles by this author Theresa Jacob Brooklyn, NY More articles by this author Sherman Chan Brooklyn, NY More articles by this author Ridwan Shabsigh Brooklyn, NY More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Tuberculosis remains an epidemic that affects one third of the world's population. The persistence of this disease is caused by a large pool of immune-compromised and lower socioeconomic populations. The advent of rapid transportation and migration has contributed to the persistence of this disease in developed and less developed nations. The emergence of drug-resistant strains has added an additional factor for the pervasiveness of tuberculosis. The genitourinary system is a primary target for hematogenous infections. This paper reviews the contemporary issues that affect the diagnosis and treatment of urinary tuberculosis.

This study investigated the expression of the epithelial-mesenchymal transition (EMT) regulator and zinc-finger transcription factor, Slug, and determined its relation to E-cadherin in human prostate tissues to elucidate its role in the pathogenesis of CaP. We hypothesized that over expression of Slug down regulates cell adhesion molecules while up regulating cell de-differentiation and migration.

Atypical infections of the prostate are infrequently recognized or cultured. However, clinical evidence points to their occult role in the pathogenesis of prostatitis. Atypical infections of the prostate can be caused by gram-positive and gram-negative bacteria, Mycoplasma, Chlamydia, fungi and Mycobacterium tuberculosis that are not classically associated with prostatitis. Increasing evidence suggests that viruses, protozoans, and various zoonoses also play an important role in prostatic infections. Bacterial 16S ribosomal DNA found in patients with chronic prostatitis suggests a bacterial inflammatory event that initiates an autoimmune process. Prostatitis may also cause elevated levels of prostate-specific antigen, a prostate cancer tumor marker. Hence, determination of an underlying infection becomes important in the evaluation of a patient with an abnormal prostate-specific antigen level. Awareness of atypical causes of infectious prostatitis improves understanding of challenges related to the diagnosis and treatment of patients with chronic prostatitis.

Tuberculosis of the genitourinary tract presents with atypical manifestations. Only 20% to 30% of patients with genitourinary tuberculosis have a history of pulmonary infection. Tuberculosis often affects the lower genitourinary system rather than the kidney. Tuberculosis of the lower genitourinary tract most commonly affects the epididymis and the testis, followed by bladder, ureter, prostate, and penis. Use of bacillus Calmette-Guérin therapy for bladder cancer can cause symptomatic tubercular infections of the lower genitourinary tract. Tuberculosis of the lower genitourinary tract can present with irritative voiding symptoms, hematuria, epididymo-orchitis, prostatitis, and fistulas. Tuberculosis of the seminal vesicles, vas, fallopian tubes, and the uterus can cause infertility. Urinalysis may demonstrate sterile pyuria, hematuria, or albuminuria. Identification of acid-fast bacilli in culture or tissue or by polymerase chain reaction studies is diagnostic. Medical treatment may not result in resolution of symptoms. Surgical intervention and reconstruction of the urinary tract are frequently indicated.

Primary genitourinary melanoma accounts for less than 1% of all cases of melanoma. Melanoma of prostatic origin is extremely rare. These patients are difficult to diagnose and carry a very poor prognosis. Aggressive surgical resection is the current treatment standard. We report a case of primary malignant melanoma of the prostate found during transurethral resection of the prostate.

OBJECTIVETo re‐evaluate the first‐ and second‐line therapies for treating uncomplicated urinary tract infection (UTI), as although fluoroquinolones are commonly used for this purpose, its level of use is thought to be inappropriately excessive and will eventually have a detrimental impact; thus we hypothesise that nitrofurantoin might be the best choice for this indication, due to its low frequency of use and its high susceptibility rate in common UTI pathogens.MATERIALS AND METHODSWe retrospectively analysed antimicrobial susceptibility patterns of urinary isolates from 2003 to 2007, taken from a community‐based institutional hospital in Brooklyn, NY, USA.RESULTSIn all, 10 417 cultures grewEscherichia colifrom 2003 to 2007. Overall, from 2003 to 2007, 95.6% ofE. coliurine isolates were susceptible to nitrofurantoin, with an average 2.3% resistance rate. By contrast,E. coliuropathogens had a mean 75.6% and 75.9% susceptibility and 24.2% and 24% resistance rate to both ciprofloxacin and levofloxacin, respectively. Co‐trimoxazole (trimethoprim/sulfamethoxazole; ‘TMP/SMX’) had a mean 29% resistance rate toE. coliover the same 5‐year period.CONCLUSIONSWe consider that nitrofurantoin is a good fluoroquinolone‐sparing alternative to co‐trimoxazole; this study shows that nitrofurantoin is bactericidal to a mean of 95% ofE. coliUTIs. Nitrofurantoin also has a resistance rate of 2.3%, by contrast to the quinolones (ciprofloxacin and levofloxacin), with resistant rates of ≈24%, and Co‐trimoxazole, with a resistant rate of 29%. Nitrofurantoin is an acceptable treatment for uncomplicated UTIs and should now be considered the first‐line treatment. A reconsideration of UTI treatment guidelines might now be appropriate.

You have accessJournal of Urology1 Apr 2008MOLECULAR PATHOGENESIS OF PROSTATE CANCER: ROLE OF THE TRANSCRIPTION REPRESSOR, SLUG Gilbert J Wise, Theresa Jacob, Getaw Hassan, and Kirugaval Hemavathy Gilbert J WiseGilbert J Wise More articles by this author , Theresa JacobTheresa Jacob More articles by this author , Getaw HassanGetaw Hassan More articles by this author , and Kirugaval HemavathyKirugaval Hemavathy More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(08)61228-8AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "MOLECULAR PATHOGENESIS OF PROSTATE CANCER: ROLE OF THE TRANSCRIPTION REPRESSOR, SLUG." The Journal of Urology, 179(4S), p. 419 © 2008 by American Urological AssociationFiguresReferencesRelatedDetails Volume 179Issue 4SApril 2008Page: 419 Advertisement Copyright & Permissions© 2008 by American Urological AssociationMetricsAuthor Information Gilbert J Wise More articles by this author Theresa Jacob More articles by this author Getaw Hassan More articles by this author Kirugaval Hemavathy More articles by this author Expand All Advertisement PDF downloadLoading ...

You have accessJournal of Urology1 Apr 2008NITROFURANTOIN AS A FIRST-LINE AGENT IN UNCOMPLICATED UTIs James Kashanian, Payam Hakimian, Michael L Blute, Jean Wong, Gilbert J Wise, and Ridwan Shabsigh James KashanianJames Kashanian More articles by this author , Payam HakimianPayam Hakimian More articles by this author , Michael L BluteMichael L Blute More articles by this author , Jean WongJean Wong More articles by this author , Gilbert J WiseGilbert J Wise More articles by this author , and Ridwan ShabsighRidwan Shabsigh More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(08)60245-1AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "NITROFURANTOIN AS A FIRST-LINE AGENT IN UNCOMPLICATED UTIs." The Journal of Urology, 179(4S), p. 84 © 2008 by American Urological AssociationFiguresReferencesRelatedDetails Volume 179Issue 4SApril 2008Page: 84 Advertisement Copyright & Permissions© 2008 by American Urological AssociationMetricsAuthor Information James Kashanian More articles by this author Payam Hakimian More articles by this author Michael L Blute More articles by this author Jean Wong More articles by this author Gilbert J Wise More articles by this author Ridwan Shabsigh More articles by this author Expand All Advertisement PDF downloadLoading ...