Personalized e-Learning Implementation - The GIS Case

Personalized e-learning implementation is recognized as among one of the most interesting research areas in the distance learning Web-based education. In particular, the GIS e-learning initiatives that incorporate —by default— a number of sequencing spatial techniques (i.e. spatial objects selection and sequencing), will well benefit from a welldefined personalized e-learning implementation with embedded spatial functionality. This is the case addressed in this paper. The GIS e-learning implementation introduced in the current paper is based on a set of teaching (lecturing) rules according to the cognitive style of learning preferences of both the learners and the lecturers as well. It is important to note that, in spite of the fact that most of these teaching rules are generic (i.e. domain, view and user independent), there are no so far well-defined and commonly accepted rules on how the learning spatial GIS objects and techniques should be selected and how they should be sequenced to make “instructional sense" in a Web-based GIS course

Urodynamic and rationale evaluation of lower urinary tract symptoms in males

AIM Benign prostate hyperplasia is the most common benign disease in men. For many years the diagnosis and the cure of BPH was simple. Last years with the introduction of less invasive procedures and new drugs for treatment it is necessary to determine the cause, pathophysiology and natural history of the disease. METHOD The patients’ group with watchful waiting revealed that cystometry, pressure flow study and maximal frow rate can be used to predict the results of obstruction in the lower urinary tract. That’s why it is useful to enclose the urodynamic studies in the diagnosis of disease. The first group of patients had an urodynamic evaluation and then underwent an operation, the second group received oral medication - alfusozine 5 mg twice daily. RESULTS An important conclusion is that using urodynamic studies we can understand the reason of obstruction of lower urinary system. When pressure flow studies showed obstruction and IPSS score revealed obstructive or obstructive and urge symptoms possible operation leads to cure. When pressure flow studies showed urgency and IPSS score revealed urgency too, possible operation wouldn’t relief patient from disease. Furthermore, simple uroflowmetry, which is part of urodynamic studies, can be useful. Evaluation of average and maximal flow rates are enough. It is found the the delay of beginning of urination and low maximal flow rate are enlist patients in the obstructive group. It is clear then that patients with urgency wouldn’t undergo operations. Pressure flow studies helps urologists a lot to discriminate patients with obstruction of lower urinary system and utgency.ΣΚΟΠΟΣ Η καλοήθης υπερπλασία του προστάτη είναι η συχνότερη καλοήθης εξεργασία στους άνδρες. Για πολλά χρόνια η διάγνωση και η θεραπεία της ΚΥΠ ήταν μια απλή και ξεκάθαρη υπόθεση. Τα τελευταία χρόνια με την εισαγωγή λιγότερο επεμβατικών μεθόδων και με την ανάπτυξη των φαρμάκων για τη θεραπεία της ΚΥΠ, είναι απαραίτητο να ερευνήσουμε σε βάθος την αιτιολογία, την παθοφυσιολογία και τη φυσική εξέλιξή της. ΜΕΘΟΔΟΛΟΓΙΑ Από την ομάδα των ασθενών με απλή παρακολούθηση η κυστεομανομέτρηση, η σύγχρονη μέτρηση πίεσης ροής και η μέγιστη ταχύτητα ροής μπορούν να χρησιμοποιηθούν για να προβλέψουμε την πορεία της αποφρακτικής νόσου στο κατώτερο ουροποιητικό. Ενσωματώνοντας στον αρχικό έλεγχο των ανδρών με απόφραξη τις παραπάνω ουροδυναμικές παραμέτρους μπορούμε να προβλέψουμε την εξέλιξη της απόφραξης. Ο χωρισμός των ασθενών σε επιμέρους ομάδες έγινε προκειμένου να αξιολογηθούν οι ουροδυναμικές παράμετροι σε σχέση με την απόφραξη του κατώτερου ουροποιητικού καθώς και με το είδος της θεραπευτικής αντιμετώπισης. Η πρώτη περιλαμβάνει ασθενείς που αφού αξιολογήθηκαν ουροδυναμικά αντιμετωπίστηκαν χειρουργικά με διουρηθρική προστατεκτομή. Η δεύτερη περιλαμβάνει ασθενείς που έλαβαν φαρμακευτική θεραπεία με αλφουζοσίνη 5 mg δύο φορές ημερησίως. ΣΥΜΠΕΡΑΣΜΑΤΑ Ένα σημαντικό συμπέρασμα που προκύπτει από την αξιολόγηση των συμπτωμάτων και ουροδυναμικών παραμέτρων είναι ότι με βάση τον ουροδυναμικό έλεγχο μπορούμε να κατανοήσουμε το στοιχείο που κατά κανόνα προκαλεί τη συμπτωματολογία του ασθενή. Όταν ο ουροδυναμικός έλεγχος κατάτασσε τον ασθενή στην ομάδα της απόφραξης τότε και η συμπτωματολογία σύμφωνα με το IPSS κατεδείκνυε ότι ο ασθενής παρουσιάζει απόφραξη ή μικτού τύπου αποφρακτικά και ερεθιστικά συμπτώματα. Σε αυτούς η επέμβαση θα παρουσιάσει τα αναμενόμενα αποτελέσματα όπως αποδεικνύεται παρακάτω. Όταν ο ουροδυναμικός έλεγχος κατατάσσει τον ασθενή στη μη-αποφρακτική ομάδα η συμπτωματολογία κατά IPSS δείχνει ότι υπερισχύουν τα ερεθιστικά συμπτώματα και δεν υπάρχει απόφραξη. Με αυτό τον τρόπο ο ουροδυναμικός έλεγχος αποτελεί σίγουρο και ασφαλή τρόπο επιλογής ασθενών για επέμβαση και αποτρέπει περιττές προστατεκτομές. Αλλά και η απλή μόνο ουροροομετρία, κομμάτι του πλήρους ουροδυναμικού ελέγχου μπορεί να φανεί χρήσιμη. Η αξιολόγηση των μέσων όρων της μέγιστης ταχύτητας ροής των ούρων αρκεί αφού βρέθηκε ότι η δυσκολία στην έναρξη και η χαμηλή μέγιστη ταχύτητα ροής συνδέονται με την ομάδα των αποφρακτικών ασθενών. Πέρα λοιπόν από τις απόλυτες ενδείξεις προστατεκτομής που αναφέρονται στα συγγράμματα οι ουρολόγοι θα πρέπει να περιορίσουν τις προστατεκτομές που δε χρειάζονται, ιδιαίτερα σε ασθενείς με έντονη συμπτωματολογία ερεθιστικού τύπου. Η σύγχρονη μέτρηση πίεσης ροής προσφέρει πολύτιμη βοήθεια στην περίπτωση αυτή και κρίνεται απαραίτητη κυρίως στους ασθενείς με καλοήθη υπερπλασία προστάτη και ερεθιστικά συμπτώματα, γιατί η ομάδα των ασθενών αυτών υπάρχει πιθανότητα να μην παρουσιάζει απόφραξη. Εάν λάβουμε υπόψη ότι οι επιπτώσεις της απόφραξης στο κατώτερο ουροποιητικό είναι το μείζον πρόβλημα στην καλοήθη υπερπλασία προστάτη και ότι υπάρχει πτωχή συσχέτιση μεταξύ μεγέθους του αδένα, της απόφραξης και της συμπτωματολογίας ο ουροδυναμικός έλεγχος μπορεί να σταθεί πολύτιμος βοηθός

The effect of extended release tolterodine used for overactive bladder treatment on female sexual function

ABSTRACT Introduction Overactive bladder (OAB) is a common condition, especially in middle aged women, requiring long term therapy with anticholinergics to maintain symptoms relief. The aim of the study was to determine the effect of tolterodine extended release (ER) used for OAB treatment on the sexual function of women. Materials and Methods Between August 2010 and August 2014, 220 women with confirmed OAB, attended Urogynecology Outpatient Clinic and were prospectively enrolled in this study. 158 women were evaluated, with a comprehensive history, physical examination, urodynamic studies and Female Sexual Function Index (FSFI) questionnaire. 73 patients of group A (control group) received no treatment and 85 patients of group B received an anticholinergic regimen – tolterodine ER 4mg once daily. Data were evaluated again in accordance with FSFI after three months, using SPSS software. Results A statistically significant increase was noted in group B in domains of desire (pre-treatment 2.5±0.2 to 4.5±0.2 post-treatment), arousal (3.1±0.2 to 3.1±0.2 respectively), lubrication (3.4±0.3 to 4.3±0.3 respectively), orgasm (3.5±0.3 to 4.5±0.3 respectively), satisfaction (2.6±0.2 to 4.2±0.3 respectively) and pain (2.4±0.2 to 4.6±0.4 respectively) after three months treatment with tolterodine ER. In group A there were no statistically significant changes in pre and post treatment values (p>0.05). Total FSFI score for group B was significantly higher after tolterodine treatment (26.5±1.5) compared to pre-treatment values (17.4±1.4, p0,05) respectively. Conclusions This preliminary study demonstrates that treatment of OAB with tolterodine ER was found to have positive effect on sexual function of patients with OAB

The effect of extended release tolterodine used for overactive bladder treatment on female sexual function

<div><p>ABSTRACT Introduction Overactive bladder (OAB) is a common condition, especially in middle aged women, requiring long term therapy with anticholinergics to maintain symptoms relief. The aim of the study was to determine the effect of tolterodine extended release (ER) used for OAB treatment on the sexual function of women. Materials and Methods Between August 2010 and August 2014, 220 women with confirmed OAB, attended Urogynecology Outpatient Clinic and were prospectively enrolled in this study. 158 women were evaluated, with a comprehensive history, physical examination, urodynamic studies and Female Sexual Function Index (FSFI) questionnaire. 73 patients of group A (control group) received no treatment and 85 patients of group B received an anticholinergic regimen – tolterodine ER 4mg once daily. Data were evaluated again in accordance with FSFI after three months, using SPSS software. Results A statistically significant increase was noted in group B in domains of desire (pre-treatment 2.5±0.2 to 4.5±0.2 post-treatment), arousal (3.1±0.2 to 3.1±0.2 respectively), lubrication (3.4±0.3 to 4.3±0.3 respectively), orgasm (3.5±0.3 to 4.5±0.3 respectively), satisfaction (2.6±0.2 to 4.2±0.3 respectively) and pain (2.4±0.2 to 4.6±0.4 respectively) after three months treatment with tolterodine ER. In group A there were no statistically significant changes in pre and post treatment values (p>0.05). Total FSFI score for group B was significantly higher after tolterodine treatment (26.5±1.5) compared to pre-treatment values (17.4±1.4, p<0.01) and to control group A (17.7±1.2 and 17.9±1.5, p>0,05) respectively. Conclusions This preliminary study demonstrates that treatment of OAB with tolterodine ER was found to have positive effect on sexual function of patients with OAB.</p></div

Edward Hickling Bradford (1848-1926): The Founder of Pediatric Orthopedics in America

Edward Hickling Bradford (1848-1926) is considered as 1 of the most important figures in American and world orthopedics during 19th and early 20th century. His teaching ability, his gifted surgical skills and his innovations in orthopedics attracted the interest of the world orthopedic&apos;s community and gave him a long lasting reputation. But most of all he is considered as the founder of pediatric orthopedics in America

Association of Obesity with Telomere Length in Human Sperm

Background: Telomere attrition and mitochondrial dysfunction are two fundamental aspects of aging. Calorie restriction (CR) is the best strategy to postpone aging since it can enhance telomere attrition, boost antioxidant capacity, and lower the generation of reactive oxygen species (ROS). Since ROS is produced by mitochondria and can readily travel to cell nuclei, it is thought to be a crucial molecule for information transfer between mitochondria and cell nuclei. Important variables that affect the quality and functionality of sperm and may affect male reproductive health and fertility include telomere length, mitochondrial content, and the ratio of mitochondrial DNA (mtDNA) to nuclear DNA (nDNA). Telomere damage results from mitochondrial failure, whereas nuclear DNA remains unaffected. This research aims to investigate potential associations between these three variables and how they might relate to body mass index. Methods: Data were collected from 82 men who underwent IVF/ICSI at the University Hospital of Ioannina’s IVF Unit in the Obstetrics and Gynecology Department. Evaluations included sperm morphology, sperm count, sperm motility, and participant history. To address this, male participants who were categorized into three body mass index (ΒΜΙ) groups—normal, overweight, and obese—had their sperm samples tested. Results: For both the normal and overweight groups, our results show a negative connection between relative telomere length and ΒΜI. As an illustration of a potential connection between mitochondrial health and telomere maintenance, a positive correlation was found for the obese group. Only the obese group’s results were statistically significant (p Conclusions: Essentially, the goal of our work is to determine whether mitochondria and telomere length in human sperm interact. Understanding these connections may aid in the explanation of some male infertility causes and possibly contribute to the creation of new treatment modalities for problems pertaining to reproductive health. The functional implications of these connections and their applications in therapeutic settings require further investigation

The Silent Threat to Women’s Fertility: Uncovering the Devastating Effects of Oxidative Stress

Oxidative stress (OS), which arises through an imbalance between the formation of reactive oxygen species (ROS) and antioxidant defenses, plays a key role in the pathophysiology of female infertility, with the latter constituting just one of a number of diseases linked to OS as a potential cause. The aim of the present article is to review the literature regarding the association between OS and female infertility. Among the reproductive diseases considered are endometriosis and polycystic ovary syndrome (PCOS), while environmental pollutants, lifestyle variables, and underlying medical conditions possibly resulting in OS are additionally examined. Current evidence points to OS likely contributing to the pathophysiology of the above reproductive disorders, with the amount of damage done by OS being influenced by such variables as duration and severity of exposure and the individual’s age and genetic predisposition. Also discussed are the processes via which OS may affect female fertility, these including DNA damage and mitochondrial dysfunction. Finally, the last section of the manuscript contains an evaluation of treatment options, including antioxidants and lifestyle modification, capable of minimizing OS in infertile women. The prime message underlined by this review is the importance of considering OS in the diagnosis and treatment of female infertility. Further studies are, nevertheless required to identify the best treatment regimen and its ideal duration

Endometriosis in Transgender Men: Bridging Gaps in Research and Care—A Narrative Review

Endometriosis is a debilitating gynecological condition commonly seen in individuals designated female at birth; however, there has been limited research focused on its prevalence and impact among transgender men. This narrative review aims to fill a critical knowledge gap by exploring the epidemiology, clinical manifestations, management strategies, and quality-of-life implications of endometriosis among transgender individuals who identify as male. Specifically, this study seeks to estimate the prevalence rates and describe the symptoms experienced by transgender men undergoing testosterone therapy. Additionally, it addresses the diagnostic challenges posed by hormonal treatments and the lack of culturally competent healthcare services for this population. Recent molecular studies indicate that hormonal imbalances, such as increased estrogen synthesis and progesterone resistance, are significant factors in the persistence of endometriosis symptoms despite testosterone therapy. Moreover, evidence suggests that testosterone therapy may not always suppress endometrial activity completely, contributing to the persistence of symptoms in some individuals. Endometriosis in transgender men requires personalized approaches that consider both testosterone therapy and its interactions with endometriosis, as well as fertility preservation and the psychosocial aspects of treatment. This review emphasizes the necessity of taking an inclusive approach in both research and clinical practice to improve healthcare outcomes for this underserved population. The results demonstrate how continued research, education, and healthcare services tailored specifically to transgender men are necessary to better understand and treat endometriosis, thus improving both their overall health and quality of life

Sperm Mitochondrial Content and Mitochondrial DNA to Nuclear DNA Ratio Are Associated with Body Mass Index and Progressive Motility

Background: Mitochondrial dysfunction is a risk factor in the pathogenesis of metabolic disorders. According to the energy requirements, oxidative phosphorylation and the electron transport chain work together to produce ATP in sufficient quantities in the mitochondria of eukaryotic cells. Abnormal mitochondrial activity causes fat accumulation and insulin resistance as cells require a balance between the production of ATP by oxidative phosphorylation (OXPHOS) in the mitochondria and the dissipation of the proton gradient to reduce damage from reactive oxygen species (ROS). This study aims to explore the relationship between the mitochondrial content of sperm and the ratio of mitochondrial DNA to nuclear DNA in relation to body mass index (BMI) and how it may affect the progressive motility of sperm cell. Understanding the relationships between these important variables will help us better understand the possible mechanisms that could connect sperm motility and quality to BMI, as well as further our understanding of male fertility and reproductive health. Methods: Data were collected from 100 men who underwent IVF/ICSI at the University Hospital of Ioannina’s IVF Unit in the Obstetrics and Gynecology Department. The body mass index (BMI) of the males tested was used to classify them as normal weight; overweight; and obese. Evaluations included sperm morphology; sperm count; sperm motility; and participant history. Results: In the group of men with normal BMI, both BMI and progressive motility displayed a statistically significant association (p p p = 0.034) and not with BMI (p = 0.24). Conclusions: We found that in all three groups, BMI and progressive motility exhibited comparable relationships with mitochondrial DNA expression and the mtDNA/nDNA ratio. However, only in the normal group and in the obese group, the relative mitochondrial DNA copy number showed a positive association with BMI and progressive motility