Search results for: pelvic discontinuity

Authors: Hamad R. Jappor, Zeyad Adnan Saleh, Mudar A. Abdulsattar

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The ab initio restricted Hartree-Fock method is used to simulate the electronic structure of indium phosphide (InP) nanocrystals (NCs) (216-738 atoms) with sizes ranging up to about 2.5 nm in diameter. The calculations are divided into two parts, surface, and core. The oxygenated (001)-(1×1) facet that expands with larger sizes of nanocrystals is investigated to determine the rule of the surface in nanocrystals electronic structure. Results show that lattice constant and ionicity of the core part show decreasing order as nanocrystals grow up in size. The smallest investigated nanocrystal is 1.6% larger in lattice constant and 131.05% larger in ionicity than the converged value of largest investigated nanocrystal. Increasing nanocrystals size also resulted in an increase of core cohesive energy (absolute value), increase of core energy gap, and increase of core valence. The surface states are found mostly non-degenerated because of the effect of surface discontinuity and oxygen atoms. Valence bandwidth is wider on the surface due to splitting and oxygen atoms. The method also shows fluctuations in the converged energy gap, valence bandwidth and cohesive energy of core part of nanocrystals duo to shape variation. The present work suggests the addition of ionicity and lattice constant to the quantities that are affected by quantum confinement phenomenon. The method of the present model has threefold results; it can be used to approach the electronic structure of crystals bulk, surface, and nanocrystals.

Keywords: InP, nanocrystals core, ionicity, Hartree-Fock method, large unit cell

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Authors: Salahud Din, Saima Masood, Hafsa Zaneb, Habib –ur- Rehman, Imad Khan, Muqader Shah

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The objective of this study was to examine the osteomorphological differences between the long bones of adult Chinkara and an adult Beetal goat, using visual observation, which has still not studied. The osseous remains of these small-sized ungulates often encountered, but cannot distinguish, because of the lack of literature. Specimens of the adult Chinkara of known age and sex for osteomorphological studies are collected from the Manglot Wildlife Park and Ungulate Breeding Centre, Nizampur, Pakistan, while the bones of adult Beetal goats are obtained after slaughtering in a slaughterhouse. The research is carried out at the University of Veterinary and Animal Sciences, Lahore, Pakistan. In this research, the main morphological features recorded in the long bones of thoracic limb and pelvic limb of the adult Chinkara, by comparing them to those of the Beetal goat. The most important differences between the two species are noted in the scapula, the humerus, the radius and ulna, the metacarpal, femur, tibia metatarsal and phalanges. In conclusion, the present study suggests that the morphology of the long bones of adult Chinkara has different from the Beetal goat in various points of view. Based on these recorded points, long bones of these two species can easily be differentiated. The study is helpful in zooarcheological, comparative osteometric studies, for forensic specialists and veterinary anatomists.

Keywords: Beetal goat, Chinkara, comparative morphological features, long bones, osteology

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Authors: Bharti Arora, Michael Chen, Steven Lun

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Plasmacytoid urothelial carcinoma (PUC) of the bladder is a rare and aggressive subtype of urothelial carcinoma that usually presents at an advanced clinical stage, has a predilection for early metastatic potential and is associated with poor prognosis. The first reported case of PUC was in 1991 and approximately 100 cases were reported in the literature worldwide. We present a case of a 43 year old female presenting with a 3-month history of urgency and frequency. Failing medical management of her urinary symptoms with anticholinergic medication, she underwent a diagnostic cystoscopy which revealed an erythematous and indurated bladder. Bladder biopsies of these regions revealed plasmacytoid urothelial carcinoma. Pre-operative staging scans were clear of any metastatic disease and the patient subsequently underwent a radical cystectomy and pelvic clearance with the formation of ileal conduit for urinary diversion. Histology confirmed plasmacytoid urothelial carcinoma with involvement of right upper vagina and focally positive margins in soft tissue at right and left sides of bladder. She received adjuvant chemotherapy but passed away within a year from disease progression. PUC can present atypically and our case highlights the role of cystoscopy in patients with persistent urinary symptoms. By reviewing the literature on PUC, we aim to raise awareness and improve understanding of this rare bladder cancer subtype amongst urologists.

Keywords: urology, bladder cancer, plasmacytoid urothelial cancer, literature review

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Authors: Gheorghe Giurgiu, Manole Cojocaru, Mihnea Andrei Nicodin

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Background: Inflammation has the main role in the progression of endometriosis. The mechanisms by which endometriosis induces a chronic pain state remain poorly understood. Unfortunately, there is no known cure for endometriosis. But you can manage it with medication and at-home treatments. Some findings have highlighted the main role of inflammation in endometriosis by acting on proliferation, apoptosis, and angiogenesis. The introduction of new agents can be effective in improving the condition of patients; for example, plants are promising sources of bioactive natural components. Objectives: These natural compounds could be interesting strategies in therapy. While there is no absolute cure for this condition, some home remedies can relieve the pain and discomfort it brings. The purpose of this study is to summarize the potential action of Deniplant nutraceuticals in endometriosis by acting on inflammation. Materials and Methods: The primary symptoms of endometriosis are pelvic pain and infertility. The use of Deniplant nutraceuticals could be interesting in disease management for women. Results: Treating pain-related aspects of endometriosis would contribute to the improvement of mental health and daytime function. Because the microbiome can influence inflammation, new therapies can develop through its natural modulation. There are other options, including natural remedies, herbs like cinnamon twigs or licorice root, or supplements such as thiamine, magnesium, or omega-3 fatty acids. Conclusion: Deniplant nutraceuticals can downregulate inflammation in endometriosis. Nevertheless, the limited number of studies focusing on the different interactions of Deniplant nutraceuticals in endometriosis restricts its clear and immediate use in a therapeutic strategy.

Keywords: endometriosis, diet, Deniplant nutraceuticals, pain

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Authors: Qianyu Zhang

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The spread of digital technology in China has worsened the generation gap and intergenerational competition for cultural and aesthetic discourse. Meanwhile, the increased accessibility of cultural works has encouraged the sharing and inheritance of collective cultural memories between generations. However, not each cultural work can engage positively with efforts to bridge intergenerational aesthetic differences. This study argues that in contemporary China, where new media and the Internet are widely available, featured cultural works have more potential to help enhance the cultural aesthetic consensus among different generations, thus becoming an effective countermeasure to narrow the intergenerational aesthetic rift and cultural discontinuity. Specifically, the generational aesthetic gap is expected to be bridged or improved through the shared appreciation or consumption of cultural works that meet certain conditions by several generations. In-depth interviews of Gen X and Gen Z (N=15, respectively) in China uncovered their preferences and commonalities for cultural works and shared experiences in appreciating them. Results demonstrate that both generations’ shared appreciation of cultural work is a necessary but insufficient condition for its effective response to the generational aesthetic gap. Coding analysis rendered six dimensions that cultural works with the potential to bridge the intergenerational aesthetic divide should satisfy simultaneously: genre, theme, content, elements, quality, and accessibility. Cultural works that engage multiple senses/ compound realistic, domestic and contemporary cultural memories/ contain the narrative of family life and nationalism/ include more elements familiar to the previous generation/ are superb-produced and unaffected/ are more accessible better promote intergenerational aesthetic exchange and value recognition. Moreover, compared to the dilemma of the previous generation facing the aesthetic gap, the later generation plays a crucial role in bridging the generational aesthetic divide.

Keywords: cultural works, generation gap, generation X, generation Z, cultural memory

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Authors: Azusa Katsumata

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Several universities in Japan have introduced activities aimed at the mutual enlightenment of a diversity of people in career education. However, several programs emphasize on delivering results, and on practicing the prepared materials as planned. Few programs focus on unexpected failures and setbacks. This way of learning is important in career education so that classmates can help each other, overcome difficulties, draw out each other’s strengths, and learn from them. Seijo University in Tokyo offered excursion focusing Various Problems of Society, as second year career education course, Students will learn about contraception, infertility, homeless people, LGBT, and they will discuss based on the excursion. This paper aims to study the ‘learning platform’ created by a series of processes such as the excursion, the discussion, and the presentation. In this course, students looked back on their lives and imagined the future in concrete terms, performing tasks in groups. The students came across a range of values through lectures and conversations, thereby developing feelings of self-efficacy. We conducted a questionnaire to measure the development of career in class. From the results of the questionnaire, we can see, in the example of this class, that students respected diversity and understood the importance of uncertainty and discontinuity. Whereas the students developed career awareness, they actually did not come across that scene and would do so only in the future when it became necessary. In this class, students consciously considered social problems, but did not develop the practical skills necessary to deal with these. This is appropriate for one of project, but we need to consider how this can be incorporated into future courses. University constitutes only a single period in life-long career formation. Thus, further research may be indicated to determine whether the positive effects of career education at university continue to contribute to individual careers going forward.

Keywords: career education of university, excursion, learning platform, problems of society

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Authors: Tia Morosin, Marie Shella De Robles

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Rectocele may be associated with symptoms of both obstructed defecation and faecal incontinence. Currently, numerous operative techniques exist to treat patients with rectocele; however, no single technique has emerged as the optimal approach in patients with post-partum faecal incontinence. The purpose of this study was to evaluate the clinical outcome in a consecutive series of patients who underwent transperineal repair of rectocele for patients presenting with faecal incontinence as the predominant symptom. Twenty-three consecutive patients from April 2000 to July 2015 with symptomatic rectocele underwent transperineal repair by a single surgeon. All patients had a history of vaginal delivery, with or without evidence of associated anal sphincter injury at the time. The median age of the cohort was 53 years (range 21 to 90 years). The median operating time and length of hospital stay were 2 hours and 7 days, respectively. Two patients developed urinary retention post-operatively, which required temporary bladder catheterization. One patient had wound dehiscence, which was managed by absorbent dressing applied by the patient and her carer. There was no operative mortality. In all patients with rectocele, there was a concomitant anal sphincter disruption. All patients had satisfactory improvement with regard to faecal incontinence on follow-up. This study suggests this method provides excellent anatomic and physiologic results with minimal morbidity. However, because none of the patients gained full continence postoperatively, pelvic floor rehabilitation might be also needed to achieve better sphincter function in patients with incontinence.

Keywords: anal sphincter defect, faecal incontinence, rectocele, transperineal repair

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Authors: Hossein Askarinejad, Manicka Dhanasekar

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In railway tracks, two adjacent rails are either welded or connected using bolted jointbars. In recent years the number of bolted rail joints is reduced by introduction of longer rail sections and by welding the rails at location of some joints. However, significant number of bolted rail joints remains in railways around the world as they are required to allow for rail thermal expansion or to provide electrical insulation in some sections of track. Regardless of the quality and integrity of the jointbar and bolt connections, the bending stiffness of jointbars is much lower than the rail generating large deflections under the train wheels. In addition, the gap or surface discontinuity on the rail running surface leads to generation of high wheel-rail impact force at the joint gap. These fundamental weaknesses have caused high rate of failure in track components at location of rail joints resulting in significant economic and safety issues in railways. The mechanical behavior of railway track at location of joints has not been fully understood due to various structural and material complexities. Although there have been some improvements in the methods for analysis of track at jointed rails in recent years, there are still uncertainties concerning the accuracy and reliability of the current methods. In this paper the current methods in analysis of track with a rail joint are critically evaluated and the new advances and recent research outcomes in this area are discussed. This research is part of a large granted project on rail joints which was defined by Cooperative Research Centre (CRC) for Rail Innovation with supports from Australian Rail Track Corporation (ARTC) and Queensland Rail (QR).

Keywords: jointed rails, railway mechanics, track dynamics, wheel-rail interaction

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Authors: Francimar Alves, Marcos Castro, Marllus Lustosa

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In the context of the teaching of computer programming, the choice of tool to use is very important in the initiation and continuity of learning a programming language. The literature tools do not always provide usability and pedagogical dynamism clearly and accurately for effective learning. This hypothesis implies fall in productivity and difficulty of learning a particular programming language by students. The integrated development environments (IDEs) Dev-C ++ and Code :: Blocks are widely used in introductory courses for undergraduate courses in Computer Science for learning C and C ++ languages. However, after several years of discontinuity maintaining the source code of Dev-C ++ tool, the continued use of the same in the teaching and learning process of the students of these institutions has led to difficulties, mainly due to the lack of update by the official developers, which resulted in a sequence of problems in using it on educational settings. Much of the users, dissatisfied with the IDE Dev-C ++, migrated to Code :: Blocks platform targeting the more dynamic range in the learning process of the C and C ++ languages. Nevertheless, there is still the need to create a tool that can provide the resources of most IDE's software development literature, however, more interactive, simple, accurate and efficient. This motivation led to the creation of Falcon C ++ tool, IDE that brings with features that turn it into an educational platform, which focuses primarily on increasing student learning index in the early disciplines of programming and algorithms that use the languages ​​C and C ++ . As a working methodology, a field research to prove the truth of the proposed tool was used. The test results and interviews with entry-level students and intermediate in a postsecondary institution gave basis for the composition of this work, demonstrating a positive impact on the use of the tool in teaching programming, showing that the use of Falcon C ++ software is beneficial in the teaching process of the C and C ++ programming languages.

Keywords: ide, education, learning, development, language

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Authors: Jamie R. Chua, Christina Irene D. Mejia, Regina P. Berba

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Disseminated tuberculosis is an infectious disease caused by Mycobacterium tuberculosis involving two or more non-contiguous sites identified through bacteriologic confirmation or clinical diagnosis. Over the five year period included in the study, the UP-PGH TB DOTS clinic had total of 3,967 referrals, and the prevalence of disseminated tuberculosis is 1% (68/3967). The mean age was 33.9 years (range 19-64 years) with a male: female ratio of 1:1. 67% (52 patients) had no predisposing comorbid illness or immune disorder. The most common presenting symptoms were abdominal pain (19%), back pain (13%), abdominal enlargement (11%) and mass (10.2%). Anemia, leukocytosis, hypoalbuminemia, and high-normal serum calcium were common biochemical and hematologic findings. Around 36% (25) of patients were diagnosed clinically with disseminated tuberculosis despite lacking bacteriologic evidence of multi-organ involvement. The lungs (86%) is still the most commonly involved site, followed by intestinal (22%), vertebral/Pott’s (27%), and pelvic/genital (19%). The mean time from presentation to initiation of therapy was 22 days (SD 32.7). Only 18 patients (29.3%) were properly recorded to have been referred to local TB DOTs facilities. Of the 68 patients, only 16% (11 patients) continued follow-up at PGH, and all had documented treatment completion. Treatment outcomes of the remaining were unknown. Due to the variety of involved sites, a high index of suspicion is required. Knowledge on clinical features, common radiographic findings, and histopathologic characteristics of disseminated TB is important as bacteriologic evidence of infection is not always apparent.

Keywords: disseminated tuberculosis, Mycobacterium tuberculosis, miliary tuberculosis, tuberculosis

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Authors: Cecilia Estela Jiménez Pérez Campos

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Introduction: Amputation comes from a series of complications in diabetic persons; at that point, of the illness evolution they have a deplored aerobic capacity. Adding to that, cardiac rehabs programs are almost base in several activities in a standing position. The cardiac rehabilitation programs have to improve for them, based on scientific advice. Objective: Evaluation of aerobic capacity of diabetic amputee after an aerobic exercise program, with upper limb ergometer. Methodology: The design is longitudinal, prospective, comparative and no randomized. We include all diabetic pelvic limb amputees, who assist to the cardiac rehabilitation. We made 2 groups: an experimental and a control group. The patients did the exercise testing, with the author’s design protocol. The experimental group completed 24 exercise sessions (3 sessions/week), with an intensity determined with the training heart rate. At the end of 8 weeks period, the subjects did a second exercise test. Results: Both groups were a homogeneous sample in age (experimental n=15) 57.6+12.5 years old and (control n=8) 52.5+8.0 years old, sex, occupation, education and economic features. (square chi) (p=0.28). The initial aerobic capacity was similar in both groups. And the aerobic capacity accomplishes after the program was statistically greater in the experimental group than in the control one. The final media VO2peak (mlO2/kg/min) was experimental (17.1+3.8), control (10.5+3.8), p=0.001. (t student). Conclusions: The aerobic capacity improved after an arm ergometer exercise program and the quality of life improve too, in diabetic amputees. So this program is fundamental in diabetic amputee’s rehabilitation management.

Keywords: aerobic fitness, metabolic equivalent (MET), oxygen output, upper limb ergometer

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Authors: Matheesha Herath, Ned Kinnear, Bridget Heijkoop, Eliza Bramwell, Alannah Frazetto, Amy Noll, Prajay Patel, Derek Hennessey, Greg Otto, Christopher Dobbins, Tarik Sammour, James Moore

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Background: Important incidental pathology requiring further action is commonly found during appendicectomy, macro- and microscopically. It is unknown whether the acute surgical unit (ASU) model affects the management and disclosure of these findings. Methods: An ASU model was introduced at our institution on 01/08/2012. In this retrospective cohort study, all patients undergoing appendicectomy 2.5 years before (traditional group) or after (ASU group) this date were compared. The primary outcomes were rates of appropriate management of the incidental findings and communication of the findings to the patient and to their general practitioner (GP). Results: 1,214 patients underwent emergency appendicectomy; 465 in the traditional group and 749 in the ASU group. 80 (6.6%) patients (25 and 55 in each respective period) had important incidental findings. There were 24 patients with benign polyps, 15 with neuro-endocrine tumour, 11 with endometriosis, 8 with pelvic inflammatory disease, 8 Enterobius vermicularis infection, 7 with low grade mucinous cystadenoma, 3 with inflammatory bowel disease, 2 with diverticulitis, 2 with tubo-ovarian mass, 1 with secondary appendiceal malignancy and none with primary appendiceal adenocarcinoma. One patient had dual pathologies. There was no difference between the traditional and ASU group with regards to communication of the findings to the patient (p=0.44) and their GP (p=0.27), and there was no difference in the rates of appropriate management (p=0.21). Conclusions: The introduction of an ASU model did not change rates of surgeon-to-patient and surgeon-to-GP communication nor affect rates of appropriate management of important incidental pathology during an appendectomy.

Keywords: acute care surgery, appendicitis, appendicectomy, incidental

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Authors: Mohammed Tou, Adel Toumoh

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The availability of IT services within organizations has become increasingly important; however, in an interconnected world favoring the distribution and offshoring of organizational information system components, availability is directly based on the constancy and uninterrupted flow of the Internet. Internet attendance guarantees the continuity of IT services. In this communication, we introduce paradigms around the concept of service continuity, as well as the technical approaches and methodologies leading to its resolution. As the heart of the problem is indeed the non-continuity of service, we first start by framing the notion of continuity in the context of services offered by the information system and identify the failures resulting from the discontinuity; thus, we refer to related research to extract the tools and technological paradigms allowing the implementation of solutions that guarantee a minimum of service continuity. If the main element causing continuity is the availability of the Internet, it is obvious to look for an alternative path, which is a conventional PSTN telephone network. To complete the chain of solutions, we mainly used concepts such as voice and speech recognition, AI, NLP, and cloud computing. The research led us to introduce an important element between the user and the service: the request represented by a voice message. Thus, the broker guarantees the delivery of the message to the right recipient service, as well as the response to the user. All of these elements are orchestrated by a pipeline that guarantees the integrity of the request and response. The concepts related to speech recognition are used for the initiation of the process of the solution, along with the combination of NLP, with its two statistical approaches and neural networks, and cloud technology secures the solution in both directions. The targeted solution does not replace 100 \ 100 the availability, by default, of the service; however, our research aims for a minimum of continuity by preventing the organizational information system from being put into total shutdown mode.

Keywords: Cloud, PSTN, NPL, NLU, AI, MTTR, MTBF, RPO, RTO, SLA, SLO, LSR, SRS

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Authors: Adenike O. Olatunji-Akioye, Emmanual B Farayola

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In order to improve the animal protein recommended daily intake of Nigerians, there is an upsurge in breeding of hitherto shunned food animals one of which is the rabbit. Radiography and ultrasonography are tools for diagnosing disease and evaluating the anatomical architecture of parts of the body non-invasively. As the rabbit is becoming a more important food animal, to achieve improved breeding of these animals, the best of the species form a breeding stock and will usually depend on breeding soundness which may be evaluated by assessment of the male reproductive organs by these tools. Four male intact rabbits weighing between 1.2 to 1.5 kg were acquired and acclimatized for 2 weeks. Dorsoventral views of the testes were acquired using a digital radiographic machine and a 5 MHz portable ultrasound scanner was used to acquire images of the testes in longitudinal, sagittal and transverse planes. Radiographic images acquired revealed soft tissue images of the testes in all rabbits. The testes lie in individual scrotal sacs sides on both sides of the midline at the level of the caudal vertebrae and thus are superimposed by caudal vertebrae and the caudal limits of the pelvic girdle. The ultrasonographic images revealed mostly homogenously hypoechogenic testes and a hyperechogenic mediastinum testis. The dorsal and ventral poles of the testes were heterogeneously hypoechogenic and correspond to the epididymis and spermatic cord. The rabbit is unique in the ability to retract the testes particularly when stressed and so careful and stressless handling during the procedures is of paramount importance. The imaging of rabbit testes can be safely done using both imaging methods but ultrasonography is a better method of assessment and evaluation of soundness for breeding.

Keywords: breeding soundness, rabbit, radiography, ultrasonography

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Authors: Nilanchali Singh, Alka Kriplani, Reeta Mahey, Garima Kachhawa

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Objective: Resection of larger uterine septa does improve obstetric performance but whether smaller septa need resection and their impact on obstetric outcome is not clear. We wanted to evaluate the role of septal resection of septa of various sizes in obstetric performance. Methods: This retrospective cohort study comprised of 107 patients with uterine septum. The patients were categorized on the basis of extent of uterine septum into four groups: a) Subsepta (< 1/3rd), b) Septum > 1/3 to ½, c) Septum>1/2 to whole uterine cervix, d) Septum traversing whole of uterine cavity and cervix. Out of these 107 patients, 74 could be contacted telephonically and outcomes recorded. Sensitivity and specificity of investigative modalities were calculated. Results: Infertility was seen in maximum number of cases in complete septa (100%), whereas abortions were seen more commonly, in subsepta (18%). MRI had maximum sensitivity and positive predictive value, followed by hysteron-salpingography. Tubal block, fibroid, endometriosis, pelvic adhesions, ovarian pathologies were seen in some but no definite association of these pathologies was seen with any subgroup of septa. Almost five-year follow-up was recorded in all the subgroups. Significant reduction in infertility was seen in all septal subgroup (p=0.046, 0.032 & 0.05) patients except in subsepta (< 1/3rd uterine cavity) after septum resection. Abortions were significantly reduced (p=0.048) in third subgroup (i.e. septum > ½ to upto internal os) after hysteroscopic septum resection. Take home baby rate was 33% in subsepta and around 50% in the remaining subgroups of septa. Conclusions: Septal resection improves obstetric performance in patients with uterine septa of various sizes. Whether septal resection improves obstetric performance in patients with subsepta or very small septa, is controversial. Larger studies addressing this issue need to be planned.

Keywords: septal resection, obstetric outcome, infertility, septum size

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Authors: A. Ratika Thakur, B. A. K. Sinha , C. R. K. Pathak

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Reproductive Tract Infections are recognized as a serious global health problem with direct impact on women. In the developing countries, prevalence of RTI is much higher relative to other health problems. Women of the reproductive age group are socially, mentally and physically more vulnerable to infections. Also, it is a well established fact that RTI has prolonged complications in women rather than men. It causes ectopic pregnancy, pelvic inflammatory diseases, miscarriage and infertility in the long course. Women perspective about infections is less studied. In this view the study was carried out with an aim to determine knowledge, perception and belief of married women towards reproductive tract infection. The study was conducted in Junga village, District Shimla, Himachal Pradesh, India. 48 women were interviewed regarding awareness, beliefs and taboos related to reproductive tract infection. Other aspects like fertility history were also taken into account. The data were collected using interviews with the help of interview schedule and interview guide. Data were recorded in the form of narratives and case studies. The analysis was done using quantitative and qualitative analysis. It was found that a majority of women were not aware about the reasons of infection. Moreover cultural beliefs, perceptions and taboos made them more vulnerable and exposed to RTI. Economic dependency upon men, lack of control in barrier methods were some of the factors that contributed to delayed treatment of women. It was found that a majority of women suffering from RTIs were silently bearing the burden and underwent treatment when the case would not rest in their hands.

Keywords: belief, infection, perception, taboo, women

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Authors: S. M. Mahdi Niktabara, K. Seshagiri Raob, Amit Kumar Shrivastavac, Jiří Ščučkaa

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The presence of the discontinuity in the form of joints is one of the most significant factors causing instability in the rock mass. On the other hand, dynamic loads, including earthquake and blasting induce cyclic shear loads along the joints in rock masses; therefore, failure of rock mass exacerbates along the joints due to changing shear resistance. Joints are under constant normal load (CNL) and constant normal stiffness (CNS) conditions. Normal stiffness increases on the joints with increasing depth, and it can affect shear resistance. For correct assessment of joint shear resistance under varying normal stiffness and number of cycles, advanced laboratory shear machine is essential for the shear test. Conventional direct shear equipment has limitations such as boundary conditions, working under monotonic movements only, or cyclic shear loads with constant frequency and amplitude of shear loads. Hence, a large-scale servo-controlled direct shear testing machine was designed and fabricated to perform shear test under the both CNL and CNS conditions with varying normal stiffness at different frequencies and amplitudes of shear loads. In this study, laboratory cyclic shear tests were conducted on non-planar joints under varying normal stiffness. In addition, the effects of different frequencies and amplitudes of shear loads were investigated. The test results indicate that shear resistance increases with increasing normal stiffness at the first cycle, but the influence of normal stiffness significantly decreases with an increase in the number of shear cycles. The frequency of shear load influences on shear resistance, i.e. shear resistance increases with increasing frequency. However, at low shear amplitude the number of cycles does not affect shear resistance on the joints, but it decreases with higher amplitude.

Keywords: cyclic shear load, frequency of load, amplitude of displacement, normal stiffness

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Authors: Ge Sun, Monika Trzpis, Robbert J. de Haas, Paul M. A. Broens

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Introduction: Dynamic magnetic resonance defecography is frequently used to assess defecation disorders. We aimed to investigate the usefulness of dynamic magnetic resonance defecography for assessing the severity of defecation disorder. Methods: We included patients retrospectively from our tertiary referral hospital who had undergone dynamic magnetic resonance defecography, anorectal manometry, and anal electrical sensitivity tests to assess defecation disorders between 2014 and 2020. The primary outcome was the association between the dynamic magnetic resonance defecography variables and the severity of defecation disorders. We assessed the severity of fecal incontinence and constipation with the Wexner incontinence and Agachan constipation scores. Results: Out of the 32 patients included, 24 completed the defecation questionnaire. During defecation, the M line length at magnetic resonance correlated with the Agachan score (r = 0.45, p = 0.03) and was associated with anal sphincter pressure (r=0.39, p=0.03) just before defecation. During rest and squeezing, the H line length at imaging correlated with the Wexner incontinence score (r=0.49, p=0.01 and r=0.69, p< 0.001, respectively). H line length also correlated positively with the anal electrical sensation threshold during squeezing (r=0.50, p=0.004) and during rest (r= 0.42, p=0.02). Conclusions: The M and H line lengths at dynamic magnetic resonance defecography can be used to assess the severity of constipation and fecal incontinence respectively and reflect anatomic changes of the pelvic floor. However, as these anatomic changes are generally late-stage and irreversible, anal manometry seems a better diagnostic approach to assess early and potentially reversible changes in patients with defecation disorders.

Keywords: defecation disorders, dynamic magnetic resonance defecography, anorectal manometry, anal electrical sensitivity tests, H line, M line

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Authors: Jemini Vyas, Oluwatobi Adeyoe, Jenny Branagan, Chandran Tanabalan, Aakash Pai

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Introduction: Radical prostatectomy and radiotherapy are both viable options for the treatment of localised prostate cancer. Over the years medicine has evolved towards a patient-centred approach. Patient decision-making is not motivated by clinical outcomes alone. Geographical location and ease of access to treating clinician are contributory factors. With the development of robotic surgery, prostatectomy has been centralised into tertiary centres. This has impacted on the distances that patients and their families are expected to travel. Methods: A single centre retrospective study was undertaken over a five-year period. All patients with localised prostate cancer, undergoing radical radiotherapy or prostatectomy were collected pre-centralisation. This was compared to the total number undergoing these treatments post centralisation. Results: Pre-centralisation, both radiotherapy and prostatectomy groups had to travel a median of less than five miles for treatment. Post-centralisation of pelvic surgery, prostatectomy patients had to travel a median of more than 40 miles, whilst travel distance for the radiotherapy group was unchanged. In the post centralisation cohort, there was a 63% decline in the number of patients undergoing radical prostatectomy per month from a mean of 5.1 to 1.9. The radical radiotherapy group had a concurrent 41% increase in patient numbers with a mean increase from 13.3 to 18.8 patients per month. Conclusion: Choice of radical treatment in localised prostate cancer is based on multiple factors. This study infers that local availability can influence choice of radical treatment. It is imperative that efforts are made to maintain accessibility to all viable options for prostate cancer patients, so that patient choice is not compromised.

Keywords: prostate, prostatectomy, radiotherapy, centralisation

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Authors: Awais Naeem, Osama Shakeel, Aamir Ali Syed, Shahid Khattak

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Introduction: Laparoscopic right hemicolectomy is an advanced cancer surgery in today's era. The aim of this study was to evaluate the surgical and initial oncological outcomes after curative, laparoscopic resection of right sided colonic tumors. Also to compare our results with those of previous randomized trials. Methods And Procedures: We retrospectively analyzed the medical record files of all the patients who presented to our hospital with the diagnosis of right sided colon carcinoma from January 2012 to December 2017 and underwent laparoscopic right hemicolectomy. Demographics, operative findings and histopathological reports were all recorded on a preformed data sheet. All the analysis was performed on SPSS 20. Results: Total of 48 patients were included. There were 37 male and 11 female patients with mean age of 49.7 (range from 25 – 82). Mean hospital stay was 8.25 ± 3.17 days. Blood loss was 80mls and operative mean time was 240 minutes. Eighteen patients had extended right hemicolectomy. Median length of the specimen retrieved was 31cm (range, 14-59cm). Mean size of tumor was 6.44cm + 2.53. Total number of lymph nodes removed was 20.5 + 8.3. All had R0 resection. Post-operatively 2 patients had pelvic collection and there was no 30 day mortality. In 33 patients there was T3 disease, 5 had T2 and 10 had T4 disease. There was distant recurrence in 4 patients with peritoneal metastasis in 3 and liver metastasis in 1 patient. Forty-six patients are still alive and 44 are disease free. The mean follow-up period was 25.31 (12 to 60) months. Conclusion: Our early experience with Laparascopic Right hemicolectomy as a safe and oncologically feasible surgical option. We attained comparable surgical results with curative intent.

Keywords: right hemicolectomy, right sided colonic tumors, laparoscopic, curative intent

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Authors: I. Ramalho, S. Campos, M. Dias

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Introduction: Endometriosis may play a role in the pathogenesis of ovarian cancer (OC), however, the risk and prognosis have not been well established. The association between these two pathologies could have an important impact on prevention and early diagnosis of OC. Objective: To analyze the prevalence of endometriosis associated ovarian cancer and related clinical, epidemiological and histopathological issues. Design: We conducted a retrospective case series analysis of patients diagnosed with endometriosis and ovarian cancer in the Gynecology Department of Coimbra University Hospital Center since 2006 to 2015. Methods: We collected data from women diagnosed with ovarian cancer, with anatomopathology records reporting findings of endometriosis in ovarian cancer patients. Patients were retrieved from the pathological records and appropriate medical records were retrospectively reviewed. Statistical analysis was performed using SPSS 22.0. Results: Histological evidence of endometriosis was found in 17 out of 261 patients diagnosed with ovarian cancer (OC) (6.51%). The most usual symptoms were pelvic pain, abdominal distension, asthenia, ascites, weight loss and nausea. Mean age at diagnosis was 61.2 ± 15.1, 41-86 years old, 33.3% were pre-menopausal patients and cancer stage distribution was predominantly stage I (31.3%) and stage III (56.3%). OC occurred unilaterally in 14 patients and 2 patients were diagnosed with a synchronous ovarian and endometrial cancer. Regarding histological type, 10 OC were classified as clear cell carcinoma (CCC), 4 endometrioid carcinomas (EC) and 3 mixed type (clear cell and endometrioid). Four ovarian carcinomas presumably arose from endometriomas: 3 CCC and 1 EC. Conclusions: In accordance with previous studies, clear cell was the most common pathological type in endometriotic patients, followed by endometrioid carcinomas, and two rare synchronous ovarian and endometrial carcinomas were registered. Although endometriosis association to OC is uncommon, endometriosis should be managed with special care in order to early diagnosis.

Keywords: endometriosis, histology, observational study, ovarian cancer

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Authors: G. Judakova, M. Bause

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The ability to model and simulate numerically natural gas flow in pipelines has become of high importance for the design of pipeline systems. The understanding of the formation of hydrate particles and their dynamical behavior is of particular interest, since these processes govern the operation properties of the systems and are responsible for system failures by clogging of the pipelines under certain conditions. Mathematically, natural gas flow can be described by multiphase flow models. Using the two-fluid modeling approach, the gas phase is modeled by the compressible Euler equations and the particle phase is modeled by the pressureless Euler equations. The numerical simulation of compressible multiphase flows is an important research topic. It is well known that for nonlinear fluxes, even for smooth initial data, discontinuities in the solution are likely to occur in finite time. They are called shock waves or contact discontinuities. For hyperbolic and singularly perturbed parabolic equations the standard application of the Galerkin finite element method (FEM) leads to spurious oscillations (e.g. Gibb's phenomenon). In our approach, we use stabilized FEM, the streamline upwind Petrov-Galerkin (SUPG) method, where artificial diffusion acting only in the direction of the streamlines and using a special treatment of the boundary conditions in inviscid convective terms, is added. Numerical experiments show that the numerical solution obtained and stabilized by SUPG captures discontinuities or steep gradients of the exact solution in layers. However, within this layer the approximate solution may still exhibit overshoots or undershoots. To suitably reduce these artifacts we add a discontinuity capturing or shock capturing term. The performance properties of our numerical scheme are illustrated for two-phase flow problem.

Keywords: two-phase flow, gas-particle mixture, inviscid two-fluid model, euler equation, finite element method, streamline upwind petrov-galerkin, shock capturing

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Authors: Nayera E. Hassan, Salah Mostafa, Hamed Elkhayat, Kalled Hassan Sewidan, Sahar A. El-Masry, Manal Mouhamed Ali, Mones M. Abu Shady

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Pubertal growth is influenced by many factors including environmental and nutritional factors. Objective: To assess impact of nutritional status on pubertal staging, ovarian and uterine volumes among school girls. Method: Study was cross sectional and carried out on 1000 healthy school girls, aged 8-18 years selected randomly. They were categorized according to their ages into three groups: 8-12 years, 13-15 years and 16-18 years ±6 months, then according to their body mass index percentile to normal weight: (≥15-<85.), overweight (≥85-<95) and obese (≥95). All girls were subjected for physical, anthropometric (weight, height, body mass index), nutritional markers WAZ (weight/age Z score), HAZ (height/age Z score) and BMI-Z (body mass index Z score), pubertal assessment (Tanner stage) and pelvic transabdominal sonography (uterine and ovarian volumes). Results: Highly significant differences in ovarian and uterine volumes and nutritional markers (WAZ, HAZ and BMI-Z score) were detected among different grades of puberty in the two age groups (8-12 years, 13-15 years) coming in advance of obese girls (with increase of BMI); except HAZ in the second age group. Girls aged 16-18 years reached to final volume for the uterus and ovary with insignificant differences. Pubertal stage, ovarian and uterine sizes were highly significantly correlated with nutritional markers. Mean ages of onset: of puberty, menarche and complete puberty were, 11.65 + 1.84, 14.79 + 1.75 and 15.02 + 1.68 years respectively. Conclusion: Nutritional status has a crucial role in determining pubertal stage, ovarian and uterine volumes among Egyptian girls during the pubertal process.

Keywords: pubertal stage, nutritional markers, girls, ovarian and uterine volumes

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Authors: Margarida Matos, João Pereira dos Santos, José Tavares

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Anti-minority discrimination is a persistent phenomenon with long-run effects. While there is a vast literature in economics and psychology that shows that personality and beliefs are not fixed and can be altered by experience, particularly in the so-called impressionable years in early adulthood, less is known about the long-lasting impacts of major events occurring during this time on minority attitudes. In this paper, we study the impact of serving in the military on long-term attitudes towards minorities. For many, military conscription and serving in war are unique life-shaping events. In the context of military service, individuals from different socioeconomic backgrounds interact and learn with each other, potentially changing their views and attitudes in a persistent manner. A prominent theory about the change of attitudes is the contact theory. It suggests that prejudice can be decreased if members of the groups interact with one another. The present paper adds to the literature by providing evidence from a more complicated setting involving the exposure to combat. We study the attitudes of veterans of the Portuguese Colonial War between 1961 and 1974, what was the latest war between African independence movements and Europeans. More than 70 percent of military age Portuguese men were drafted every year and sent to fight in Africa in the widest draft in post-World War II Western Europe. The contact between Portuguese and African soldiers was both cooperative as well as adversarial. Portuguese fought against but also alongside locally recruited African men, who represented half of the Portuguese contingent for substantial periods. We use data from the European Social Survey to identify Portuguese citizens likely to have been drafted and were send to fight in the former Portuguese colonies in Africa. We show that men likely to have fought in African wars are more accepting of immigrants than women of their same cohort, as well as than males from younger and older cohorts. The use of corresponding cohorts from Spain as placebo tests confirms our results. Our findings also hold in a regression discontinuity design setting.

Keywords: attitudes, immigration, war in Africa, veterans, portugal

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Authors: M. Abuziarov

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The designed complex is intended for the numerical simulation of fast dynamic processes of interaction of heterogeneous environments susceptible to the significant formability. The main challenges in solving such problems are associated with the construction of the numerical meshes. Currently, there are two basic approaches to solve this problem. One is using of Lagrangian or Lagrangian Eulerian grid associated with the boundaries of media and the second is associated with the fixed Eulerian mesh, boundary cells of which cut boundaries of the environment medium and requires the calculation of these cut volumes. Both approaches require the complex grid generators and significant time for preparing the code’s data for simulation. In this codes these problems are solved using two grids, regular fixed and mobile local Euler Lagrange - Eulerian (ALE approach) accompanying the contact and free boundaries, the surfaces of shock waves and phase transitions, and other possible features of solutions, with mutual interpolation of integrated parameters. For modeling of both liquids and gases, and deformable solids the Godunov scheme of increased accuracy is used in Lagrangian - Eulerian variables, the same for the Euler equations and for the Euler- Cauchy, describing the deformation of the solid. The increased accuracy of the scheme is achieved by using 3D spatial time dependent solution of the discontinuity problem (3D space time dependent Riemann's Problem solver). The same solution is used to calculate the interaction at the liquid-solid surface (Fluid Structure Interaction problem). The codes does not require complex 3D mesh generators, only the surfaces of the calculating objects as the STL files created by means of engineering graphics are given by the user, which greatly simplifies the preparing the task and makes it convenient to use directly by the designer at the design stage. The results of the test solutions and applications related to the generation and extension of the detonation and shock waves, loading the constructions are presented.

Keywords: fluid structure interaction, Riemann's solver, Euler variables, 3D codes

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Authors: Moustafa Elwan, Sohier Shehata, Fatma Sedek, Manar Hussine

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One of the most risky factors that lead to a foot injury during physical activities are both high and low arched feet. Normally the medial longitudinal arch of the foot develops in the first 10 years of life, so flexible flat foot has an inversely relationship with age in the first decade, all over the world, the prevalence of flat foot is increasing. In approximately 15% of foot deformities cases, the deformity does not disappear and remains throughout adulthood, 90% of the clinical cases are complaining from foot problems are due to flatfoot. Flatfoot creates subtalar over pronation, which creates tibial and femoral medial rotation, and that is accompanied with increases of pelvic tilting anteriorly, which may influence the lumbar vertebrae alignment by increasing muscle tension and rotation. Objective: To study the impact of the flexible flatfoot on lumbosacral angle (angle of Ferguson). Methods: This experiment included 40 volunteers (14 females &26 males) gathered from the Faculty of Physical Therapy, Modern University of Technology and Information, Cairo, Egypt, for each participant, four angles were measured in the foot( talar first metatarsal angle, lateral talocalcaneal angle, , Calcaneal first metatarsal angle, calcaneal inclination angle) and one angle in the lumbar region (lumbosacral angle). Measurement of these angles was conducted by using Surgimap Spine software (version 2.2.9.6). Results: The results demonstrated that there was no significant correlation betweenFerguson angle and lateral talocalcaneal (r=0.164, p=0.313). Also, there was no significant correlation between Ferguson angle and talo first metatarsal “Meary’s angle" (r=0.007, p=0.968). Moreover, there was no significant correlation between Ferguson angle and calcaneal-first metatarsal angle (r=0.083, p=0.612). Also, there was no significant correlation between Ferguson angle and calcaneal inclination angle (r= 0.032, p= 0.846). Conclusion: It can be concluded that there is no significant correlation between the flexible flat foot and lumbosacral angle So, more study should be conducted in large sample and different ages and conditions of foot problems.

Keywords: calcaneal first metatarsal, calcaneal inclination, flatfoot, ferguson’s angle, lateral talocalcaneal angle, lumbosacral angle, and talar first metatarsal angle

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Authors: Raina J. Olsen, Andrew K. Gillespie, John W. Taylor, Cristian I. Contescu, Peter Pfeifer, James R. Morris

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While adsorbent surfaces such as graphite are known to increase the melting temperature of solid H2, this effect is normally rather small, increasing to 20 Kelvin (K) relative to 14 K in the bulk. An as-yet unidentified phase transition has been observed in a system of H2 adsorbed in a porous, locally graphitic, Saran carbon with sub-nanometer sized pores at temperatures (74-101 K) and pressures ( > 76 bar) well above the critical point of bulk H2 using hydrogen adsorption and neutron scattering experiments. Adsorption data shows a discontinuous pressure jump in the kinetics at 76 bar after nearly an hour of equilibration time, which is identified as an exothermic phase transition. This discontinuity is observed in the 87 K isotherm, but not the 77 K isotherm. At higher pressures, the measured isotherms show greater excess adsorption at 87 K than 77 K. Inelastic neutron scattering measurements also show a striking phase transition, with the amount of high angle scattering (corresponding to large momentum transfer/ large effective mass) increasing by up to a factor of 5 in the novel phase. During the course of the neutron scattering experiment, three of these reversible spectral phase transitions were observed to occur in response to only changes in sample temperature. The novel phase was observed by neutron scattering only at high H2 pressure (123 bar and 187 bar) and temperatures between 74-101 K in the sample of interest, but not at low pressure (30 bar), or in a control activated carbon at 186 bar of H2 pressure. Based on several of the more unusual observations, such as the slow equilibration and the presence of both an upper and lower temperature bound, a reasonable hypothesis is that this phase forms only in the presence of a high concentration of ortho-H2 (nuclear spin S=1). The increase in adsorption with temperature, temperatures which cross the lower temperature bound observed by neutron scattering, indicates that this novel phase is denser. Structural characterization data on the adsorbent shows that it may support a commensurate solid phase denser than those known to exist on graphite at much lower temperatures. Whatever this phase is eventually proven to be, these results show that surfaces can have a more striking effect on hydrogen phases than previously thought.

Keywords: adsorbed phases, hydrogen, neutron scattering, nuclear spin

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Authors: Fabiha Tanzeem

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BACKGROUND: Osteoporosis is a skeletal disease that is associated with a reduction in bone mass and microstructures of the bone and deterioration of bone tissue. Fragility fracture due to osteoporosis is the most significant complication of osteoporosis. The increasing prevalence of fragility fractures presents a growing burden on the global economy. There is a rapidly evolving need to improve awareness of the costs associated with these types of fractures and to review current policies and practices for the prevention and management of the disease. This systematic review will identify and describe the direct and indirect costs associated with osteoporotic fragility fractures from a global perspective from the included studies. The review will also find out whether the costs required for the treatment of fragility fractures due to osteoporosis impose an economic burden on the global healthcare system. METHODS: Four major databases were systematically searched for direct and indirect costs of osteoporotic fragility fracture studies in the English Language. PubMed, Cochrane Library, Embase and Google Scholar were searched for suitable articles published between 1990 and July 2020. RESULTS: The original search yielded 1166 papers; from these, 27 articles were selected for this review according to the inclusion and exclusion criteria. In the 27 studies, the highest direct costs were associated with the treatment of pelvic fractures, with the majority of the expenditure due to hospitalization and surgical treatments. It is also observed that most of the articles are from developed countries. CONCLUSION: This review indicates the significance of the economic burden of osteoporosis globally, although more research needs to be done in developing countries. In the treatment of fragility fractures, direct costs were the main reported expenditure in this review. The healthcare costs incurred globally can be significantly reduced by implementing measures to effectively prevent the disease. Raising awareness in children and adults by improving the quality of the information available and standardising policies and planning of services requires further research.

Keywords: systematic review, osteoporosis, cost of illness

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Authors: Amar Ranjan, Julieana Durai, Pranay Tanwar

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Background &Introduction: Ovarian cancer is one of the most common malignant tumor in the female. 70% of the cases of ovarian cancer are diagnosed at an advanced stage. The five-year survival rate associated with ovarian cancer is less than 30%. The early diagnosis of ovarian cancer becomes a key factor in improving the survival rate of patients. Presently, CAl25 (carbohydrate antigen125) is used for the diagnosis and therapeutic monitoring of ovarian cancer, but its sensitivity and specificity is not ideal. The introduction of HE4, human epididymis protein 4 has attracted much attention. HE4 has a sensitivity and specificity of 72.9% and 95% for differentiating between benign and malignant adnexal masses, which is better than CA125 detection.  Methods: Serum HE4 and CA -125 were estimated using the chemiluminescence method. Our cases were 40 epithelial ovarian cancer, 9 benign ovarian tumor, 29 benign gynaecological diseases and 13 healthy individuals. This group include healthy woman those who have undergoing family planning and menopause-related medical consultations and they are negative for ovarian mass. Optimal cut off values for HE4 and CA125 were 55.89pmol/L and 40.25U/L respectively (determined by statistical analysis). Results: The level of HE4 was raised in all ovarian cancer patients (n=40) whereas CA125 levels were normal in 6/40 ovarian cancer patients, which were the cases of OC confirmed by histopathology. There is a significant decrease in the level of HE4 with comparison to CA125 in benign ovarian tumor cases. Both the levels of HE4 and CA125 were raised in the nonovarian cancer group, which includes cancer of endometrium and cervix. In the healthy group, HE4 was normal in all patients except in one case of the rudimentary horn, and the reason for this raised HE4 level is due to the incomplete development of uterus whereas CA125 was raised in 3 cases. Conclusions: Findings showed that the serum level of HE4 is an important indicator in the diagnosis of ovarian cancer, and it also distinguishes between benign and malignant pelvic masses. However, a combination of HE4 and CA125 panel will be extremely valuable in improving the diagnostic efficiency of ovarian cancer. These findings of our study need to be validated in the larger cohort of patients.

Keywords: human epididymis protein 4, ovarian cancer, diagnosis, benign lesions

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Authors: Farzaneh Askari, Jila Ganji, Sedigheh Hasani Moghadam

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Background and Aim: Endometriosis has been reported as one of the most common chronic gynecological conditions characterized by physical and psychological complications. Given that the impact of this disease on marital relationships and quality of life is multidimensional, the present review study aimed to reflect on the effect of psychosomatic aspects of endometriosis on marital relationships and quality of life. Materials and Methods: A narrative review methodology using keywords determined by the Medical Subject Headings (MeSH) thesaurus was adopted in this study. For this purpose, the databases of ScienceDirect, Scientific Information Database (SID), Google Scholar, and PubMed were searched by means of key terms including endometriosis, marital relationships, physical complications, psychological complications, and quality of life in English and Persian from 2005 to 2020. At the end of the search, 38 articles were retrieved, and ultimately a total number of 16 studies were recruited for this review. Results: A review of the selected articles demonstrated that endometriosis could affect marital relationships and quality of life among couples featuring in three different categories, i.e. “category I: physical health dimension” (chronic pelvic pain, dysmenorrhea, cramps but not period, reduction and loss of fertility), “category II: sexual health dimension” (no sexual intercourse, dyspareunia, lack of sexual satisfaction), and “category III: psychosocial health dimension” (negative self-esteem, low energy, sense of loneliness, depression, social isolation, insufficient sleep, marital distress, divorce and marriage breakdown, inability to work and socialize). Conclusion: In general, it is suggested to pay particular attention to psychosomatic aspects of marital problems in patients affected with endometriosis. Accordingly, implementing educational and counseling strategies to minimize the complications of this disease can provide the grounds for improving marital relationships and maintaining the quality of life in these patients.

Keywords: Endometriosis, marital relationships, psychosomatic complications, quality of life

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