An unusual case of spontaneous bladder perforation with associated autodialysis of the ensuing urinary ascites

Spontaneous rupture of the urinary bladder is a rare occurrence, and when encountered it is a diagnostic challenge. We present an unusual case of urinary bladder rupture in a patient with severe cerebral palsy who initially presented with localized abdominal pain and during admission developed generalized peritonitis caused by bladder rupture. In this case, the patient had none of risk factors associated with urinary bladder

Implementation of a Matrix Crack Spacing Parameter in a Continuum Damage Mechanics Finite Element Model

Continuum Damage Mechanics (CDM) based progressive damage and failure analysis (PDFA) methods have demonstrated success in a variety of finite element analysis (FEA) implementations. However, the technical maturity of CDM codes has not yet been proven for the full design space of composite materials in aerospace applications. CDM-based approaches represent the presence of damage by changing the local material stiffness definitions and without updating the original mesh or element integration schemes. Without discretely representing cracks and their paths through the mesh, damage in models with CDM-based materials is often distributed in a region of partially damaged elements ahead of stress concentrations. Having a series of discrete matrix cracks represented by a softened region may affect predictions of damage propagation and, thus, structural failure. This issue can be mitigated by restricting matrix damage development to discrete, fiber-aligned rows of elements; hence CDM-based matrix cracks can be implemented to be more representative of discrete matrix cracks. This paper evaluates the effect of restricting CDM matrix crack development to discrete, fiber-aligned rows where the spacing of these rows is controlled by a user-defined crack spacing parameter. Initially, the effect of incrementally increasing matrix crack spacing in a unidirectional center notch coupon is evaluated. Then, the lessons learned from the center notch specimen are applied to open-hole compression finite element models. Results are compared to test data, and the limitations, successes, and potential of the matrix crack spacing approach are discussed

Patterns of injury and violence in Yaoundé Cameroon: an analysis of hospital data.

BackgroundInjuries are quickly becoming a leading cause of death globally, disproportionately affecting sub-Saharan Africa, where reports on the epidemiology of injuries are extremely limited. Reports on the patterns and frequency of injuries are available from Cameroon are also scarce. This study explores the patterns of trauma seen at the emergency ward of the busiest trauma center in Cameroon's capital city.Materials and methodsAdministrative records from January 1, 2007, through December 31, 2007, were retrospectively reviewed; information on age, gender, mechanism of injury, and outcome was abstracted for all trauma patients presenting to the emergency ward. Univariate analysis was performed to assess patterns of injuries in terms of mechanism, date, age, and gender. Bivariate analysis was used to explore potential relationships between demographic variables and mechanism of injury.ResultsA total of 6,234 injured people were seen at the Central Hospital of Yaoundé's emergency ward during the year 2007. Males comprised 71% of those injured, and the mean age of injured patients was 29 years (SD = 14.9). Nearly 60% of the injuries were due to road traffic accidents, 46% of which involved a pedestrian. Intentional injuries were the second most common mechanism of injury (22.5%), 55% of which involved unarmed assault. Patients injured in falls were more likely to be admitted to the hospital (p < 0.001), whereas patients suffering intentional injuries and bites were less likely to be hospitalized (p < 0.001). Males were significantly more likely to be admitted than females (p < 0.001)DiscussionPatterns in terms of age, gender, and mechanism of injury are similar to reports from other countries from the same geographic region, but the magnitude of cases reported is high for a single institution in an African city the size of Yaoundé. As the burden of disease is predicted to increase dramatically in sub-Saharan Africa, immediate efforts in prevention and treatment in Cameroon are strongly warranted

Modelling human factors in perceptual multimedia quality: On the role of personality and culture

Perception of multimedia quality is shaped by a rich interplay between system, context, and human factors. While system and context factors are widely researched, few studies in this area consider human factors as sources of systematic variance. This paper presents an analysis on the influence of personality (Five-Factor Model) and cultural traits (Hofstede Model) on the perception of multimedia quality. A set of 144 video sequences (from 12 short movie excerpts) were rated by 114 participants from a cross-cultural population, producing 1232 ratings. On this data, three models are compared: a baseline model that only considers system factors; an extended model that includes personality and culture as human factors; and an optimistic model in which each participant is modeled as a random effect. An analysis shows that personality and cultural traits represent 9.3% of the variance attributable to human factors while human factors overall predict an equal or higher proportion of variance compared to system factors. In addition, the quality-enjoyment correlation varied across the movie excerpts. This suggests that human factors play an important role in perceptual multimedia quality, but further research to explore moderation effects and a broader range of human factors is warranted

Observing and modelling phytoplankton community structure in the North Sea

© Author(s) 2017. CC Attribution 3.0 License. Phytoplankton form the base of the marine food chain, and knowledge of phytoplankton community structure is fundamental when assessing marine biodiversity. Policy makers and other users require information on marine biodiversity and other aspects of the marine environment for the North Sea, a highly productive European shelf sea. This information must come from a combination of observations and models, but currently the coastal ocean is greatly under-sampled for phytoplankton data, and outputs of phytoplankton community structure from models are therefore not yet frequently validated. This study presents a novel set of in situ observations of phytoplankton community structure for the North Sea using accessory pigment analysis. The observations allow a good understanding of the patterns of surface phytoplankton biomass and community structure in the North Sea for the observed months of August 2010 and 2011. Two physical-biogeochemical ocean models, the biogeochemical components of which are different variants of the widely used European Regional Seas Ecosystem Model (ERSEM), were then validated against these and other observations. Both models were a good match for sea surface temperature observations, and a reasonable match for remotely sensed ocean colour observations. However, the two models displayed very different phytoplankton community structures, with one better matching the in situ observations than the other. Nonetheless, both models shared some similarities with the observations in terms of spatial features and inter-annual variability. An initial comparison of the formulations and parameterizations of the two models suggests that diversity between the parameter settings of model phytoplankton functional types, along with formulations which promote a greater sensitivity to changes in light and nutrients, is key to capturing the observed phytoplankton community structure. These findings will help inform future model development, which should be coupled with detailed validation studies, in order to help facilitate the wider application of marine biogeochemical modelling to user and policy needs

Integrating ethics, health policy and health systems in low and middle income countries : case studies from Malaysia and Pakistan.

Scientific progress is a significant basis for change in public-health policy and practice, but the field also invests in value-laden concepts and responds daily to sociopolitical, cultural and evaluative concerns. The concepts that drive much of public-health practice are shaped by the collective and individual mores that define social systems. This paper seeks to describe the ethics processes in play when public-health mechanisms are established in low- and middle-income countries, by focusing on two cases where ethics played a crucial role in producing positive institutional change in public-health policy. First, we introduce an overview of the relationship between ethics and public health; second, we provide a conceptual framework for the ethical analysis of health system events, noting how this approach might enhance the power of existing frameworks; and third, we demonstrate the interplay of these frameworks through the analysis of a programme to enhance road safety in Malaysia and an initiative to establish a national ethics committee in Pakistan. We conclude that, while ethics are gradually being integrated into public-health policy decisions in many developing health systems, ethical analysis is often implicit and undervalued. This paper highlights the need to analyse public-health decision-making from an ethical perspective

Large amplitude oscillatory motion along a solar filament

Large amplitude oscillations of solar filaments is a phenomenon known for more than half a century. Recently, a new mode of oscillations, characterized by periodical plasma motions along the filament axis, was discovered. We analyze such an event, recorded on 23 January 2002 in Big Bear Solar Observatory H$\alpha$ filtergrams, in order to infer the triggering mechanism and the nature of the restoring force. Motion along the filament axis of a distinct buldge-like feature was traced, to quantify the kinematics of the oscillatory motion. The data were fitted by a damped sine function, to estimate the basic parameters of the oscillations. In order to identify the triggering mechanism, morphological changes in the vicinity of the filament were analyzed. The observed oscillations of the plasma along the filament was characterized by an initial displacement of 24 Mm, initial velocity amplitude of 51 km/s, period of 50 min, and damping time of 115 min. We interpret the trigger in terms of poloidal magnetic flux injection by magnetic reconnection at one of the filament legs. The restoring force is caused by the magnetic pressure gradient along the filament axis. The period of oscillations, derived from the linearized equation of motion (harmonic oscillator) can be expressed as $P=\pi\sqrt{2}L/v_{A\phi}\approx4.4L/v_{A\phi}$, where $v_{A\phi} =B_{\phi0}/\sqrt{\mu_0\rho}$ represents the Alfv\'en speed based on the equilibrium poloidal field $B_{\phi0}$. Combination of our measurements with some previous observations of the same kind of oscillations shows a good agreement with the proposed interpretation.Comment: Astron. Astrophys., 2007, in pres