A Different Technique of Primary Indirect Inguinal Hernia Repair by Inserting a Synthetic Mesh into the Pre and Retroperitoneal Spaces to Wrap the Peritoneal Reflection: Preliminary Report

In most methods of indirect inguinal hernia repair, the region of the sac stump remains a potential site of recurrence. A different technique that covers the site of the indirect sac stump is presented. Anterior parietal peritoneum is reflected posteriorly in the inguinal canal. In cases with Gilbert type I-II inguinal hernia, after the indirect sac is removed, the pre and retroperitoneal spaces in this region are dissected. A synthetic mesh is placed into these spaces, lateral to the inferior epigastric vessels. The posterior wall of this type hernia is intact. In cases with Gilbert type III inguinal hernia, either posterior wall repair is accomplished by using one of the tissue approximation techniques after placing a mesh in the region of the sac stump, or the entire peritoneal reflection in the inguinal canal is wrapped with a mesh after dissecting the pre and retroperitoneal spaces. This technique was performed in five patients. Of five patients, mesh was inserted on the region of stump in three (Gilbert I and II) and along the entire peritoneal reflection in two (Gilbert III). There were no postoperative complications such as seroma and pain and no recurrence till follow-up. This technique effectively wraps the peritoneal reflection and may prevent recurrences in primary indirect inguinal hernia, but it needs to be performed in a large number of cases for further evaluation.KEY WORDS: Inguinal hernia; Indirect; Repair; Mes

Feasibility of Application of Modern Methods of Construction in Iran

Various plans and policies have been adopted by the Iranian Government to address the housing shortages in Iran. Some of these policies have been successful and some have failed dramatically deteriorating the housing conditions. Technology transfer from other countries, such as the UK, may facilitate industrialisation which has been recognised as an effective way to address housing deficiencies in Iran. The Iranian and UK construction industries, however, differ in various respects which may increase the risk of failure if transferred technologies are not adapted to Iranian needs and conditions. This paper compares the current conditions of the Iranian and UK construction industries to identify the risks and opportunities if Modern Methods of Construction (MMC) were to be transferred from the UK to Iran. Several issues such as demand and supply, regulations and standards, practicality, costs, design, sustainability, and governmental policies have been studied in detail. The results reveal that MMC could potentially improve the housing conditions in Iran by addressing major issues such as skilled labour shortages, energy and materials wastes, building quality and speed of construction. The major risks are also identified as volatile economy and housing market, transportation and industry capacity. The chance of successful adoption is considerably higher for those MMC that are suitable for small projects, do not require highly skilled labour and heavy machinery, and are compatible with prevailing methods of construction in Iran

Pilomatrix carcinoma of the lacrimal caruncle: a case report.

A 45-year-old man presented with a 3-month history of a mass located in the caruncle of his right eye. An incisional biopsy had been performed one month prior by another specialist, and the histopathology report showed basal cell carcinoma. The mass was completely excised with a 2 mm safety margin, and the large conjunctival defect was reconstructed with one sheet of amniotic membrane allograft. A histological diagnosis of pilomatrix carcinoma was established. To prevent recurrence after surgery, we added bevacizumab (25 mg/mL, 1.25 mg/mL per drop) eye drops four times per day for three months. At the one-year follow-up, the patient showed no evidence of local recurrence or distant metastasis after initial excision and remains under close follow-up. Pilomatrix carcinoma should be considered in the differential diagnosis of a caruncular mass

Workplace learning and organisational performance in the hospitality industry.

Purpose The hospitality industry creates a distinctive context in which learning takes place. The industry's international perspective and large globalisation play an important role in learning, as well as the operational and structural features that give meaning to learning and development in the hospitality industry. This explorative research therefore studies the relation between workplace learning and organisational performance in the Dutch hospitality industry. Design/methodology/approach The qualitative research is done through 15 in-depth interviews with general managers and HR managers of Dutch hotels with three or more stars and at least ten employees. Findings It can be concluded that there is a relation between workplace learning and organisational performance in the hospitality industry, as the participants in this research and the literature both mention workplace learning enhances organisational performance. Originality/value Little research has been done on learning and organisational performance specifically, in the (Western) hospitality industry. This research therefore focusses on HRD and studies the influence of workplace learning on organisational performance in the Dutch hospitality industry

The polymerisation of oligo(ethylene glycol methyl ether) methacrylate from a multifunctional poly(ethylene imine) derived amide: a stabiliser for the synthesis and dispersion of magnetite nanoparticles

A facile synthetic route to poly(ethylene imine)-graft-poly(oligo(ethylene glycol methyl ether)) (PEI-graft-POEGMA) functionalised superparamagnetic magnetite nanoparticles is described. The polymerisation of OEGMA from a model molecular amide demonstrated the feasibility of POEGMA synthesis under mild ATRP conditions (20 °C in ethanol) albeit with low initiator efficiencies. DFT studies suggest that the amide functionality is intrinsically of lower activity than ester functional monomers and initiators for atom transfer polymerisation (ATRP) as a consequence of higher bond dissociation energies and bond dissociation free energies (BDFE). However these studies further highlighted that use of an appropriate solvent could reduce the free energy of dissociation thereby reducing the relative difference in BDFE between the ester and amide groups. A commercial branched PEI sample was functionalised by reaction with 2-bromo-2-methylpropanoyl bromide giving an amide macroinitiator suitable for the atom transfer radical polymerisation (ATRP) of oligo(ethylene glycol methyl ether) methacrylate. The resulting PEI-graft-POEGMA copolymers were characterised by SEC, FT-IR and 1H and 13C NMR spectroscopy. PEI-graft-POEGMA coated magnetite nanoparticles were synthesised by a basic aqueous co-precipitation method and were characterised by transmission electron microscopy, thermogravimetric analysis and vibrating sample magnetometry and dynamic light scattering. These copolymer coated magnetite nanoparticles were demonstrated to be effectively stabilised in an aqueous medium. Overall the particle sizes and magnetic and physical properties of the coated samples were similar to those of uncoated samples

Tulathromycin disturbs blood oxidative and coagulation status

The aim of this study was to determine the effect of tulathromycin on serum oxidative status and coagulation factors in rabbits. Tulathromycin was administered to eight rabbits, and blood samples were obtained 0, 1, 5, 10 and 15 days after treatment. Indicators of serum oxidative status (malondialdehyde, nitric oxide, superoxide dismutase, retinol and -carotene) and coagulation values (antithrombin III, fibrinogen) were measured after tulathromycin treatment. In addition, routine serum biochemical values (creatine kinase-MB, lactate dehydrogenase, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, gamma glutamyl transferase, creatinine, blood urea nitrogen, cholesterol, triglyceride, high density lipoprotein, amylase, total protein, albumin, glucose and calcium), haemacell counts (white and red blood cells) and arterial blood gas parameters (packed cell volume, hemoglobin, pH, partial pressure of carbon dioxide, partial pressure of oxygen, actual bicarbonate, standard bicarbonate, total carbon dioxide, base excess in vivo, base excess in vitro, oxygen saturation, sodium and potassium) were also determined. Tulathromycin increased (P < 0.05) the levels of malondialdehyde, nitric oxide and superoxide dismutase activity, and decreased (P < 0.05) the level of antithrombin III. In conclusion, tulathromycin may cause oxidative damage and coagulation disorders during the treatment period.Key words: Tulathromycin, oxidative damage, coagulation disorder

Reservoir sedimentation in the Demirköprü Dam, Turkey

River morphodynamics and sediment transportSedimentation in reservoir

Activated Bone Marrow-Derived Macrophages Eradicate Alzheimer's-Related Aβ42 Oligomers and Protect Synapses.

Impaired synaptic integrity and function due to accumulation of amyloid β-protein (Aβ42) oligomers is thought to be a major contributor to cognitive decline in Alzheimer's disease (AD). However, the exact role of Aβ42 oligomers in synaptotoxicity and the ability of peripheral innate immune cells to rescue synapses remain poorly understood due to the metastable nature of oligomers. Here, we utilized photo-induced cross-linking to stabilize pure oligomers and study their effects vs. fibrils on synapses and protection by Aβ-phagocytic macrophages. We found that cortical neurons were more susceptible to Aβ42 oligomers than fibrils, triggering additional neuritic arborization retraction, functional alterations (hyperactivity and spike waveform), and loss of VGluT1- and PSD95-excitatory synapses. Co-culturing neurons with bone marrow-derived macrophages protected synapses against Aβ42 fibrils; moreover, immune activation with glatiramer acetate (GA) conferred further protection against oligomers. Mechanisms involved increased Aβ42 removal by macrophages, amplified by GA stimulation: fibrils were largely cleared through intracellular CD36/EEA1+-early endosomal proteolysis, while oligomers were primarily removed via extracellular/MMP-9 enzymatic degradation. In vivo studies in GA-immunized or CD115+-monocyte-grafted APPSWE/PS1ΔE9-transgenic mice followed by pre- and postsynaptic analyses of entorhinal cortex and hippocampal substructures corroborated our in vitro findings of macrophage-mediated synaptic preservation. Together, our data demonstrate that activated macrophages effectively clear Aβ42 oligomers and rescue VGluT1/PSD95 synapses, providing rationale for harnessing macrophages to treat AD

Nano-scale Flexible Interphase in a Glass Fiber/Epoxy Resin System Obtained by Admicellar Polymerization

Organosilane coupling agents are widely used in the composites industry to improve the wetting of inorganic reinforcements by low surface energy resins. An increased wettability is often a harbinger of better mechanical properties in a structural composite. Silane coatings effectively increase the spreading of liquid matrixes over glass reinforcement by altering the surface energetics of glass, not by extensive coverage, but by eradication of the high-energy sites present in the oxide surface. Commercial sizings often applied to glass fibers contain up to 10% of the active silane agent, while the remaining 90% is a mixture of lubricants, surfactants, anti-stats, and film formers. Recent investigations have demonstrated that non-reactive components tend to remain in high concentrations within the interphase, thus weakening the resin network crosslink density and increasing the potential for water ingress. Further, sizing formulations are proprietary and designed for specific resin system, which make them expensive, consequently limiting their widespread use. In this paper, admicellar polymerization, a versatile technique to prepare elastomeric thin films of styrene-isoprene copolymer and polystyrene on the surface of random glass-fiber mats is presented. This hydrophobic coating of monolayer thickness applied to the glass fibers is not expected to disrupt the matrix cross-linking reaction; and due to its higher elastic modulus, is believed to cause a change in the stress distribution along the fiber length. Admicellar-modified reinforcements were impregnated with an epoxy resin system: EPON 815C/EPICURE 3232, and molded by Resin Transfer Molding (RTM) into disk shaped parts. Tensile strength, stiffness and interlaminar shear strength (ILSS) were measured for the flexible interphase composites, and compared to parts containing commercially sized and bare fibers. Void fraction, void size and shape distributions, as well as water diffusivity were investigated for each system.YesPeer reviewed and presented at the 18th International Conference of the Polymer processing Society