Nevoid basal cell carcinoma syndrome (Gorlin syndrome)

Nevoid basal cell carcinoma syndrome (NBCCS), also known as Gorlin syndrome, is a hereditary condition characterized by a wide range of developmental abnormalities and a predisposition to neoplasms

Diagnostic accuracy of a clinical diagnosis of idiopathic pulmonary fibrosis: An international case-cohort study

We conducted an international study of idiopathic pulmonary fibrosis (IPF) diagnosis among a large group of physicians and compared their diagnostic performance to a panel of IPF experts. A total of 1141 respiratory physicians and 34 IPF experts participated. Participants evaluated 60 cases of interstitial lung disease (ILD) without interdisciplinary consultation. Diagnostic agreement was measured using the weighted kappa coefficient (\u3baw). Prognostic discrimination between IPF and other ILDs was used to validate diagnostic accuracy for first-choice diagnoses of IPF and were compared using the Cindex. A total of 404 physicians completed the study. Agreement for IPF diagnosis was higher among expert physicians (\u3baw=0.65, IQR 0.53-0.72, p20 years of experience (C-index=0.72, IQR 0.0-0.73, p=0.229) and non-university hospital physicians with more than 20 years of experience, attending weekly MDT meetings (C-index=0.72, IQR 0.70-0.72, p=0.052), did not differ significantly (p=0.229 and p=0.052 respectively) from the expert panel (C-index=0.74 IQR 0.72-0.75). Experienced respiratory physicians at university-based institutions diagnose IPF with similar prognostic accuracy to IPF experts. Regular MDT meeting attendance improves the prognostic accuracy of experienced non-university practitioners to levels achieved by IPF experts

Numerical analysis of an H4A heavy containment level transition

It is fact that European highway safety personnel are not aware of the significance of transition barriers. As a result, most countries do not use transition designs on their highways. On the other hand, the ones that are currently in use lack adequate detailing and do not provide the required level of protection during a collision event. In this paper, the impact performance of a standard US flared-back guardrail-to-bridge rail transition is evaluated using a 30,000 kg heavy goods vehicle according to European EN1317 test TB71 requirements. A highly acceptable and versatile non-linear finite element code, LS-DYNA, is used for the analysis. Simulation results show that the transition fails to contain the vehicle. The vehicle overrides the transition due to insufficient rail height. To upgrade the impact performance of the transition to H4a, high containment level, an additional rail element was added to the current design to increase the rail height from 810 mm to 1050 mm. Subsequent simulation results show that the modified transition design meets the EN1317 test TB71 requirements. It is therefore recommended that the current US standard flared back guardrail-to-bridge rail transition design should have a minimum of 1050 mm rail height to satisfy European crash testing guidelines for H4a, heavy containment level transition

Prostate electromyography: A new concept

Knowledge of the pharmacological and electrophysiological properties of prostatic smooth and striated muscle myofibres are necessary in order to determine whether the dynamic component of benign prostatic hyperplasia (BPH). To our knowledge prostate electromyography have not previously been applied in any type of prostate disorder. The purpose of the present study is to evaluate the electrical activity of the prostatic muscle fibers. We were able to evaluate the features of prostatic muscle action potentials (PMAP) in 15 of the 16 patients from the area around the prostate capsule. Prostate was palpated in the knee-chest position then concentric needle electrode was inserted into the prostate tissue under digital guidance. Needle tip position in the prostate was confirmed with transabdominal ultrasonography. PMAPs were analysed with multi-motor unit action potential analysis (MMA) algorithm. Whenever the PMAPs were unsuitable for analysing with MMA software the amplitude trigger line method was used. Further studies with a large number of patients are needed to establish the correlation between the electrical activity of prostatic muscle fibers and dynamic component of patients with symptomatic BPH

Evaluation of 12 m Long Turned Down Guardrail End Terminal Using Full-Scale Crash Testing and Simulation

Abstract The beginnings and ends of guardrail designs have the function of providing adequate anchorage for the rest of the system. They should also demonstrate crashworthy performance and should not pose any hazard for errant vehicles. In Europe, the ends of guardrail systems traditionally have incorporated turned down end terminals. Due to its low cost, Turkey also adopted turned down guardrail end terminal, and the majority of these designs are 12 meters long. Accident statistics clearly demonstrate that this particular end terminal poses safety risks for impacting vehicles. However, crash tests performed on the system showed that it worked satisfactorily for cars impacting at 80 kph. In this study, a detailed finite element analysis was performed on a 12 m long turned down guardrail end treatment to fully evaluate its crashworthiness. Data obtained from previously performed TT 2.1.80 and TT 4.2.80 crash tests were used to verify the fidelity of finite element models used in the study. Further simulations performed in accordance with EN1317 part 7 at 100 kph demonstrated unacceptable performance for the end terminal. Results of the study are summarized and recommendations are presented

Evaluation of vertical wall-to-guardrail transition

Transition barriers are used to connect longitudinal barriers that have different stiffnesses. They are designed to provide a gradual increase in stiffness towards the stiffer barrier section. In this study, a W-beam rail and a W-beam rubrail transition connecting a rigid bridge rail to a semi-rigid guardrail was evaluated using numerical and experimental methods. First, a finite element model of the transition design was constructed and validated using a 2000 kg pickup truck impact. Then, a series of vehicle models, i.e., 900 kg compact automobile, 8000 kg single unit truck and finally 30,000 kg heavy truck was used to evaluate the impact performance of the same transition design numerically. Simulation results predict that the double W-beam transition barrier performs acceptably in containing and redirecting all vehicles except 30,000 kg heavy truck. Occupant injury criteria were also found to be acceptable for all the cases, except 30,000 kg truck impact. Performing further simulations with vehicle sizes heavier than 8,000 kg that exist in crash testing guidelines is recommended to evaluate the acceptability limit of existing W-beam rail and a W-beam rubrail transition