A clinico-pathological evaluation of ovarian teratomas in Uyo, Nigeria during a 10 year period

Objective: To show the clinicopathologic pattern of ovarian teratomas (OT) in Uyo, Nigeria and how they compared to results from other parts of the world.Design: This was a quantitative observational, descriptive study of all OT specimens that were histologically diagnosed in the Histopathology Department of University of Uyo Teaching Hospital, Uyo, Nigeria.Results: Of the 149 ovarian specimens received, OT was seen in 54 cases accounting for 36.2% of all ovarian lesions. Most of the patients were between age groups 20-29 years (37%) and 30-39 years (29.6%). The youngest patient was aged 4.5 years, while the oldest was 68 years with a mean age of 33.7 years with a standard deviation of 13.8. The complaints at presentation were mainly abdominal pain (50%), abdominal swelling (42.6%), per vagina bleeding (7.4%). All the patients had laparotomy, which was a cystectomy (68.5%), oophorectomy (22.2%) or a hysterectomy (9.3%). In 46.3% of cases, the widest diameter of the mass was greater than 10cm, while in 37% of cases, the widest diameter was ≤ 10cm. The contents were cheesy material admixed with tuft of hair (70.4%), sebum (37%), serous / mucinous fluid (18.5%), bone (7.4%), teeth (5.6%), cartilage (5.6%). Histologically majority of the OT were mature teratomas (MT) (88.9%). Malignant transformation of a MT (MTMT), immature teratoma and struma ovarii were seen in 5.6%, 3.7% and 1.9% of cases respectively.Conclusion: The frequency and pattern (histologically) is same as known for OT globally. Very few asymptomatic patients presented, while no patient had laparoscopic surgery

The ethics of negotiation

I argue for the following: (1) Negotiation is a social construct whereby the parties seek to resolve differences and promote cooperation through a process rooted in mutual consent. (2) Negotiation is a feature of imperfect markets. Where there is a negotiated agreement, there is typically a significant cooperative surplus and, instead of a single market price, a range of possibilities as to how that cooperative surplus may be divided between the parties. The purpose of negotiation is to determine exactly where in that range agreement is reached. (3) The fairness of a negotiated agreement is wholly determined by the fairness of the process that leads to that agreement; and the fairness of the process is itself wholly determined by the adequacy of the constraints applied to that process. This makes negotiation an instance of pure procedural justice. In this regard, negotiation is to be clearly distinguished from judgment or binding arbitration. (4) Negotiated agreement itself implies some degree of consent. But beyond that there are pro tanto obligations on negotiators to (a) behave honestly and, in particular, not lie, (b) seek mutually beneficial outcomes, whereby their counterparties are left no worse off than they would be in the event of a failure to agree, and (c) avoid the abuse of extreme asymmetric negotiating leverage, that characterises a combination of monopoly, monopsony or cartel with essential goods and services, and discriminatory pricing. (5) These constraints are both necessary and sufficient to deliver a fair process and, therefore, a fair outcome. (6) Such constraints can be seen, in part, as attempts to counter market failure and compensate for shortfalls in consent. (7) A further constraint, related to the broader demands of distributive justice, is not called for. Such a requirement is the primary responsibility of society as a whole. To the extent that it does fall on any individual, it takes the form of a separate and narrower duty to aid that can, in cases of dire need, take precedence and require that negotiations cease. (8) The fact that these moral constraints leave the outcome of most negotiations less than fully determined is not a weakness, but a strength of this account. It properly captures the character of a negotiation as a cooperative but also partially adversarial process, during the course of which a fair outcome is constructed – importantly, an outcome that is not predetermined

Interpretation of small specimen creep test and recommendations on standardisation of impression creep test method

In-service monitoring of power plant components toward later stages of plant life requires several methods for evaluation. Strain monitoring, metallography and ultrasonic techniques are the most common for inspection. Sampling and mechanical testing are novel techniques that can be used alongside the tools mentioned above. Sampled material is mechanically tested using non-standard small specimens, generating creep data for components that operate in the creep range. Non-standard small specimen creep test methods include sub-size uniaxial, small punch, impression, small ring and two bar creep test techniques. The impression creep test is the focus of this thesis, consisting of a square specimen loaded by a flat-ended rectangular indenter, of which the recommended dimensions are 10x10x2.5mm. Conversions to equivalent uniaxial creep strain and stress are obtained through reference stress techniques. ‘Round Robin’ testing between several independent labs using different test rig set-ups has been used to provide feedback for the progression to standardization of the test technique. It is also shown how the test method can be used to determine the creep strength of high temperature components. Furthermore, the test method is used to characterise pre-strained materials at several strain levels to assess the impact on creep strength. Scoop sampling is integral to using the small samples for component risk management. Therefore, the impact of sampling on the component is assessed using creep continuum damage mechanics, a by product of which was the development of two new test specimens along with a novel validation method for the material model. Progress has been made on the standardisation of the impression creep test technique, with recommendations made based on the analysis in this thesis. A procedure for creep strength ranking of components is suggested and component-sampling tolerances are outlined too based on finite element analysis

Books

Human neurology The Human Central Nervous System: A Synopsis and Atlas. 3rd revised ed. Ed. by R. Nieuwenhuys, J. Voogd, C. H. R. van Huijzen. Pp. xii + 437. Illustrated. DM 85. Berlin: SpringerVerlag. 1988.Paediatric respiratory disorders Kendig's Disorders of the Respiratory Tract in Children. 5th ed. Ed. by Victor Chernick. Consulting ed. Edwin L. Kendig, jun. Pp. xxi + 1055. Philadelphia: WB Saunders. 1990.Maxillofacial imaging Maxillofacial Imaging. Ed. by A. M. Delbalso. pp. Vlll + 799. Illustrated. Kent: Harcourt Brace Jovanovich. 1990.Introduction to philosophy of medicine Philosophy of Medicine: An Introduction. Ed. by H. R. Wulff, S. A. Pedersen and R. Rosenberg. pp. xv + 222. £14,95. Oxford: Blackwell. 1990.Cataract management Management of Cataract in Primary Health Care Services. Pp. vi + 43. Illustrated. SFr. 15. Geneva: WHO. 1990.Family practice-management Family Practice Management. Ed. by G. J. and C. M. 1. Pistorius. Pp. 587. Illustrated. R99,50. Parow: Haurn/De Jager. J99O.Obstetrics and gynaecology Essential Obstetrics and Gynaecology. By E. Malcolm Symonds. pp. vi + 266. Illustrated. Edinburgh: Maskew Miller Longman.Surgical memoirs Surgical Roots and Branches. Ed. by R. Murley. Pp. x + 341. Illustrated. £18,50. Hamilton: Libriger Book Distribution. 1990.Survival in a hostile environment Staying Alive. Ed. by Ron Reid-Daly. Pp. ix + 259. Illustrated. R49,95. Rivonia: Ashami. 1990.Urolithiasis Urolithiasis: Medical and Surgical Reference. Ed. by M. 1. Resnick and C. Y. C. Pak. Pp. x + 375. Illustrated. R53,50. Kent: Harcoun Brace Jovanovich. 1990.Mental health in primary health care The Introduction of a Mental Health Component into Primary Health Care. pp. 1-59. SFr. 11,50. Geneva: WHO. 1990Tuberculosis in South Africa White Plague, Black Labor: Tuberculosis and the Political Economy of Health and Disease in South Africa. Ed. by Randall M. Packard. pp. xxii + 389. Illustrated. $40 (cloth) and$15,95 (paperback). California: University of California Press. 1989.Medical research Research in Medicine:"A Guide to Writing a Thesis in the Medical Sciences. Ed. by G. Murrell, C. Huang and H. Ellis. PP: xii + 105. Illustrated. £19,50 (hIb) £7,50 (Plb). Cambridge: Cambridge University Press. 1990

Hamiltonian dynamics and spectral theory for spin-oscillators

We study the Hamiltonian dynamics and spectral theory of spin-oscillators. Because of their rich structure, spin-oscillators display fairly general properties of integrable systems with two degrees of freedom. Spin-oscillators have infinitely many transversally elliptic singularities, exactly one elliptic-elliptic singularity and one focus-focus singularity. The most interesting dynamical features of integrable systems, and in particular of spin-oscillators, are encoded in their singularities. In the first part of the paper we study the symplectic dynamics around the focus-focus singularity. In the second part of the paper we quantize the coupled spin-oscillators systems and study their spectral theory. The paper combines techniques from semiclassical analysis with differential geometric methods.Comment: 32 page

Reduction of the Three Dimensional Schrodinger Equation for Multilayered Films

In this paper, we present a method for reducing the three dimensional Schrodinger equation to study confined metallic states, such as quantum well states, in a multilayer film geometry. While discussing some approximations that are employed when dealing with the three dimensionality of the problem, we derive a one dimensional equation suitable for studying such states using an envelope function approach. Some applications to the Cu/Co multilayer system with regard to spin tunneling/rotations and angle resolved photoemission are discussed.Comment: 14 pages, 1 figur

Effect of mineralocorticoid receptor antagonists on proteinuria and progression of chronic kidney disease: A systematic review and meta-analysis

Background: Hypertension and proteinuria are critically involved in the progression of chronic kidney disease. Despite treatment with renin angiotensin system inhibition, kidney function declines in many patients. Aldosterone excess is a risk factor for progression of kidney disease. Hyperkalaemia is a concern with the use of mineralocorticoid receptor antagonists. We aimed to determine whether the renal protective benefits of mineralocorticoid antagonists outweigh the risk of hyperkalaemia associated with this treatment in patients with chronic kidney disease. Methods: We conducted a meta-analysis investigating renoprotective effects and risk of hyperkalaemia in trials of mineralocorticoid receptor antagonists in chronic kidney disease. Trials were identified from MEDLINE (1966-2014), EMBASE (1947-2014) and the Cochrane Clinical Trials Database. Unpublished summary data were obtained from investigators. We included randomised controlled trials, and the first period of randomised cross over trials lasting ≥4 weeks in adults. Results: Nineteen trials (21 study groups, 1 646 patients) were included. In random effects meta-analysis, addition of mineralocorticoid receptor antagonists to renin angiotensin system inhibition resulted in a reduction from baseline in systolic blood pressure (-5.7 [-9.0, -2.3] mmHg), diastolic blood pressure (-1.7 [-3.4, -0.1] mmHg) and glomerular filtration rate (-3.2 [-5.4, -1.0] mL/min/1.73 m2). Mineralocorticoid receptor antagonism reduced weighted mean protein/albumin excretion by 38.7 % but with a threefold higher relative risk of withdrawing from the trial due to hyperkalaemia (3.21, [1.19, 8.71]). Death, cardiovascular events and hard renal end points were not reported in sufficient numbers to analyse. Conclusions: Mineralocorticoid receptor antagonism reduces blood pressure and urinary protein/albumin excretion with a quantifiable risk of hyperkalaemia above predefined study upper limit

Deriving the dietary approaches to stop hypertension (DASH) score in women from seven pregnancy cohorts from the European alphabet consortium

The ALPHABET consortium aims to examine the interplays between maternal diet quality, epigenetics and offspring health in seven pregnancy/birth cohorts from five European countries. We aimed to use the Dietary Approaches to Stop Hypertension (DASH) score to assess diet quality, but different versions have been published. To derive a single DASH score allowing cross-country, cross-cohort and cross-period comparison and limiting data heterogeneity within the ALPHABET consortium, we harmonised food frequency questionnaire (FFQ) data collected before and during pregnancy in ≥26,500 women. Although FFQs differed strongly in length and content, we derived a consortium DASH score composed of eight food components by combining the prescriptive original DASH and the DASH described by Fung et al. Statistical issues tied to the nature of the FFQs led us to re-classify two food groups (grains and dairy products). Most DASH food components exhibited pronounced between-cohort variability, including non-full-fat dairy products (median intake ranging from 0.1 to 2.2 servings/day), sugar-sweetened beverages/sweets/added sugars (0.3–1.7 servings/day), fruits (1.1–3.1 servings/day), and vegetables (1.5–3.6 servings/day). We successfully developed a harmonized DASH score adapted to all cohorts being part of the ALPHABET consortium. This methodological work may benefit other research teams in adapting the DASH to their study’s specificities

The state of the Martian climate

60°N was +2.0°C, relative to the 1981–2010 average value (Fig. 5.1). This marks a new high for the record. The average annual surface air temperature (SAT) anomaly for 2016 for land stations north of starting in 1900, and is a significant increase over the previous highest value of +1.2°C, which was observed in 2007, 2011, and 2015. Average global annual temperatures also showed record values in 2015 and 2016. Currently, the Arctic is warming at more than twice the rate of lower latitudes