Laparoscopic and bacteriologic evidence of bacterial vaginosis in unexplained infertility

Background: Aim of current study was to estimate the prevalence of Bacterial Vaginosis (BV) among women with Unexplained Infertility (UI) and to describe laparoscopic appearances in positive cases.Methods: Design: Prospective randomized comparative diagnostic trial. Setting: Tertiary care referral facility and University hospital. Patients: One hundred and fifty women divided into UI study group A (120 cases) and a control group B (30 cases). Intervention(s): Vaginal and endouterine swabs form two subgroups of the UI group (60 cases each) and vaginal swabs from control group (30 cases). All swabs were tested using Amsel's criteria then cultured. Thereafter, UI group (60 cases) was subjected to diagnostic laparoscopy. Main outcome measure(s):  the prevalence of BV among women with UI and laparoscopic findings among positive cases.Results: In the study group, the number of positive cases of BV confirmed by culture was 51 cases (42.5%) while it was diagnosed in three cases (10%) in group B (P = 0.0001). In group A, BV was diagnosed in 24 and 27 infertile cases with periods of infertility less than and more than 3 years respectively and in 39 patients (32.5%) with recurrent vaginitis without statistically significant difference. There was an insignificant difference in diagnosis of BV whether the site of sample was the posterior fornix of the vagina or the endometrial cavity. Positive laparoscopic findings were reported in 77 patients (64.2%). The most common laparoscopic abnormalities were hyperemic uterus and chronic salpingitis.   Conclusions: BV is frequently implicated in female infertility and it is probably an underestimated cause of UI. There is no extra benefit from using culture instead of Amsel’s criteria for the diagnosis of BV.  No difference in the site of sample taking in diagnosis of BV from posterior vaginal fornix or endometrial cavity.  Laparoscopy is very beneficial in explaining the effect of BV on the upper genital tract

Weight minimization of structural components for launch in space shuttle

Minimizing the weight of structural components of the space station launched into orbit in a space shuttle can save cost, reduce the number of space shuttle missions, and facilitate on-orbit fabrication. Traditional manual design of such components, although feasible, cannot represent a minimum weight condition. At NASA Lewis Research Center, a design capability called CometBoards (Comparative Evaluation Test Bed of Optimization and Analysis Routines for the Design of Structures) has been developed especially for the design optimization of such flight components. Two components of the space station - a spacer structure and a support system - illustrate the capability of CometBoards. These components are designed for loads and behavior constraints that arise from a variety of flight accelerations and maneuvers. The optimization process using CometBoards reduced the weights of the components by one third from those obtained with traditional manual design. This paper presents a brief overview of the design code CometBoards and a description of the space station components, their design environments, behavior limitations, and attributes of their optimum designs

Parallel Computational Environment for Substructure Optimization

Design optimization of large structural systems can be attempted through a substructure strategy when convergence difficulties are encountered. When this strategy is used, the large structure is divided into several smaller substructures and a subproblem is defined for each substructure. The solution of the large optimization problem can be obtained iteratively through repeated solutions of the modest subproblems. Substructure strategies, in sequential as well as in parallel computational modes on a Cray YMP multiprocessor computer, have been incorporated in the optimization test bed CometBoards. CometBoards is an acronym for Comparative Evaluation Test Bed of Optimization and Analysis Routines for Design of Structures. Three issues, intensive computation, convergence of the iterative process, and analytically superior optimum, were addressed in the implementation of substructure optimization into CometBoards. Coupling between subproblems as well as local and global constraint grouping are essential for convergence of the iterative process. The substructure strategy can produce an analytically superior optimum different from what can be obtained by regular optimization. For the problems solved, substructure optimization in a parallel computational mode made effective use of all assigned processors

Laparoscopic ovarian drilling-plus: a one-stop management approach for PCO-associated infertility

Background: The current study aims to estimate additional values of laparoscopic intervention for diagnosis and treatment of concomitant pelvic pathologies among infertile women with clomiphene-resistant polycystic ovarian syndrome (PCOS) subjected to laparoscopic ovarian drilling (LOD) in comparison to non-PCOS infertile women subjected to diagnostic/therapeutic laparoscopy.Methods: A prospective cross sectional observational study was carried out in the Endoscopic unit of a tertiary care university hospital.  The study included 232 infertile women planned for laparoscopy were divided into a study group A (116 cases) with clomiphene-resistant PCOS and a control group B (116 cases) without PCOS. Each group was further subdivided into two subgroups according to the presence and absence of risk factors (RF) for adhesion formation. Diagnostic/operative laparoscopy was done. The main study outcome was the prevalence of any pelvic abnormalities seen during laparoscopy.Results: Both groups showed insignificant difference regarding socio-demographic history and basic data. Laparoscopy detected pelvic pathologies in 44 cases (37.9%) and 86 cases (74.1%) in both groups respectively. In group A, we diagnosed pelvic pathologies in 29 (32.6%) and 15 (55.6%) cases with and without RF respectively while in group B they were diagnosed in 76 (84.4%) and 10 (38.5%) cases with and without RF respectively. If compared to women with unexplained infertility, PCO patients without risk factors have an insignificant but higher prevalence of pelvic abnormalities. All concomitant pelvic pathologies in both groups were treated on a one-stop (see and treat) basis.Conclusions: Detection and proper management of associated pelvic pathologies at laparoscopy is a valuable additional advantage of LOD particularly in women with positive risk factors. LOD plus see and treat associated pathologies is a time saving and prompt management approach for women with PCO–associated infertility

Hip Fracture and Disabilities among Elderly in Gaza Governorates, Palestine

Hip fracture is the most common fracture in the elderly people and causes many disabilities for people who don't receive appropriate rehabilitation after fracture or surgery. Objective: The general objective of this study is to recognize the disabilities arising as a result of hip fracture among the elderly in Gaza Strip. Methods: a descriptive correlation cross sectional design was used. Face to face structured questionnaire and international Barthel index tool were used to determine the disabilities among hip fracture population. One hundred one patients with old hip fracture were included. Sixty patients were from Khan Younis city and forty-one patients from Rafah city. Descriptive statistics, ANOVA test, t-test, correlation coefficient and Scheffe Multiple Comparisons test were used to analyze results in the study. Results: the results revealed that 82.2% of patients complaint from disability. 15.8% had total disability, 30.7% had severe disability, 19.8% had moderate disability, 9.9% had mild disability and 5.9% had minimal disability. Eighty-five percent of patients suffered from pain. 24.8% had mild pain, 36.6% had moderate pain, 17.8% had severe pain and 5.9% suffered from intolerable pain. The most common cause of hip fracture was falling down (81.2%). Also, the most common complications were failure of operation (32.3%), wound infection (29%) and bed sores (29%). The most common type of hip fracture operation was Plate & screw fixation which represented 63.1% from the operated patients. There were significant statistical differences between age and pain slope with development of disability. Conclusion: hip fractures among the elderly caused a high percent of disability, complications and pain which can be reduced by improving operation's techniques and good rehabilitation programs

Psychoanalytic explanation of key personality traits of instagram micro-celebrities: A qualitative study

Background: With the growing use of social networks, a large number of studies have investigated their psychological effects. Previous research has demonstrated that virtual networks, especially Instagram, negatively affect users' mental health and make them vulnerable to mental disorders. However, the studies have been descriptive and provide descriptive statements; hence, they do not contribute to in-depth understanding of such vulnerability. Accordingly, qualitative studies should be conducted to delve into this phenomenon. Objectives: This article aimed to understand the key personality traits of popular Iranian Instagram users, assuming that the networks make individuals psychoanalytically vulnerable to clinical outcomes. Methods: Regarding the research method, the deductive content analysis was adopted for the data extracted from semi-structured in-depth interviews with users having > 10,000 followers. Psychodynamic diagnostic manual, PDM-2 second edition, and the structured analysis matrix were considered to make sense of the collected data. Results: The results demonstrated that the dominant key personality traits in popular Instagram users were narcissism with three subcategories (namely narcissistic central tension, pathogenic belief about oneself, and pathogenic belief about others) and depression with two subcategories (namely depressive pathogenic belief about oneself and pathogenic belief about others). Conclusions: According to the findings, the structures and categories underpinning our experiences by Instagram are inherently narcissistic. Rather than changing individuals' dynamics, Instagram promotes this intellectual and communicative style inversely by normalizing it and reinforcing the narcissistic personality disorder established by the family and cultural structure of society. Copyright © 2021, Author(s)

Power laws in microrheology experiments on living cells: comparative analysis and modelling

We compare and synthesize the results of two microrheological experiments on the cytoskeleton of single cells. In the first one, the creep function J(t) of a cell stretched between two glass plates is measured after applying a constant force step. In the second one, a micrometric bead specifically bound to transmembrane receptors is driven by an oscillating optical trap, and the viscoelastic coefficient $G_e(\omega)$ is retrieved. Both $J(t)$ and $G_e(\omega)$ exhibit power law behavior: $J(t)= A(t/t_0)^\alpha$ and $\bar G_e(\omega)\bar = G_0 (\omega/\omega_0)^\alpha$, with the same exponent $\alpha\approx 0.2$. This power law behavior is very robust ; $\alpha$ is distributed over a narrow range, and shows almost no dependance on the cell type, on the nature of the protein complex which transmits the mechanical stress, nor on the typical length scale of the experiment. On the contrary, the prefactors $A_0$ and $G_0$appear very sensitive to these parameters. Whereas the exponents $\alpha$ are normally distributed over the cell population, the prefactors $A_0$ and $G_0$ follow a log-normal repartition. These results are compared with other data published in the litterature. We propose a global interpretation, based on a semi-phenomenological model, which involves a broad distribution of relaxation times in the system. The model predicts the power law behavior and the statistical repartition of the mechanical parameters, as experimentally observed for the cells. Moreover, it leads to an estimate of the largest response time in the cytoskeletal network: $\tau_m \approx 1000$ s.Comment: 47 pages, 14 figures // v2: PDF file is now Acrobat Reader 4 (and up) compatible // v3: Minor typos corrected - The presentation of the model have been substantially rewritten (p. 17-18), in order to give more details - Enhanced description of protocols // v4: Minor corrections in the text : the immersion angles are estimated and not measured // v5: Minor typos corrected. Two references were clarifie

Combined effect of steel fibres and steel rebars on impact resistance of high performance concrete

The investigation on the impact properties of normal concrete (NC)and reinforced concrete (RC) specimens, steel fibre reinforced concrete (SFRC) specimens and RC+SFRC specimens with different steel fibres dosages were carried out with the drop-weight impact test recommended by ACI Committee 544. The results indicate that the number of blows to final failure greatly increased by addition of steel fibres. Moreover, the combination of steel fibres and steel rebars demonstrates a significant positive composite effect on the impact resistance, which results on the improvement in impact toughness of concrete specimens. In view of the variation of impact test results, the two-parameter Weibull distribution was adopted to analyze the experimental data. It is proved that the probabilistic distribution of the blows to first crack and to final failure of six types of samples are approximately two-parameter Weibull distribution.Funded by the National Natural Science Foundation of China (NSFC) (Grant No.50578026)Financial support provided by the Research Center of Mathematics of the University of Minho through the FCT Pluriannual Funding Progra

Randomized, Noncomparative, Phase II Trial of Early Switch From Docetaxel to Cabazitaxel or Vice Versa, With Integrated Biomarker Analysis, in Men With Chemotherapy-Naïve, Metastatic, Castration-Resistant Prostate Cancer

Purpose The TAXYNERGY trial ( ClinicalTrials.gov identifier: NCT01718353) evaluated clinical benefit from early taxane switch and circulating tumor cell (CTC) biomarkers to interrogate mechanisms of sensitivity or resistance to taxanes in men with chemotherapy-naïve, metastatic, castration-resistant prostate cancer. Patients and Methods Patients were randomly assigned 2:1 to docetaxel or cabazitaxel. Men who did not achieve ≥ 30% prostate-specific antigen (PSA) decline by cycle 4 (C4) switched taxane. The primary clinical endpoint was confirmed ≥ 50% PSA decline versus historical control (TAX327). The primary biomarker endpoint was analysis of post-treatment CTCs to confirm the hypothesis that clinical response was associated with taxane drug-target engagement, evidenced by decreased percent androgen receptor nuclear localization (%ARNL) and increased microtubule bundling. Results Sixty-three patients were randomly assigned to docetaxel (n = 41) or cabazitaxel (n = 22); 44.4% received prior potent androgen receptor-targeted therapy. Overall, 35 patients (55.6%) had confirmed ≥ 50% PSA responses, exceeding the historical control rate of 45.4% (TAX327). Of 61 treated patients, 33 (54.1%) had ≥ 30% PSA declines by C4 and did not switch taxane, 15 patients (24.6%) who did not achieve ≥ 30% PSA declines by C4 switched taxane, and 13 patients (21.3%) discontinued therapy before or at C4. Of patients switching taxane, 46.7% subsequently achieved ≥ 50% PSA decrease. In 26 CTC-evaluable patients, taxane-induced decrease in %ARNL (cycle 1 day 1 v cycle 1 day 8) was associated with a higher rate of ≥ 50% PSA decrease at C4 ( P = .009). Median composite progression-free survival was 9.1 months (95% CI, 4.9 to 11.7 months); median overall survival was not reached at 14 months. Common grade 3 or 4 adverse events included fatigue (13.1%) and febrile neutropenia (11.5%). Conclusion The early taxane switch strategy was associated with improved PSA response rates versus TAX327. Taxane-induced shifts in %ARNL may serve as an early biomarker of clinical benefit in patients treated with taxanes