1,152 research outputs found

    The Treatment of Complex Urethral Strictures Using Ventral Onlay Buccal Mucosa Graft or Ventral Onlay Penile Skin Island Flap Urethroplasty: A Prospective Case Series

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    Objectives: To compare the outcome of free onlay Buccal Mucosa Graft (BMG) with onlay penile Skin Island Flap (SIF) urethroplasty in the treatment of complex urethral strictures. Patients and Methods: A prospective comparative study was conducted at the Universitas Academic Hospital in Bloemfontein, South Africa. Patients presenting with complex urethral strictures were allocated to receive either ventral onlay penile SIF urethroplasty or ventral onlay BMG urethroplasty. A complex urethral stricture was defined as a stricture length of more than 2.5 cm or previous failed procedures, including urethral dilatation, internal Optical Urethrotomy (OU) and urethroplasty. Successful treatment outcome or cure was defined as no further treatment of the urethral stricture required after urethroplasty. Statistical analysis was performed with the t-test or chi-square test as appropriate. Results: BMG and SIF urethroplasty were performed on 18 and 17 patients, respectively. The mean age of the patients was 49.1 years (range 21–77) for the SIF group and 44.3 years (range 27–73) for the BMG group (p= 0.28). The mean urethral stricture length in the BMG group was 2.9 cm (range 2.4–4.0) and 4.5 cm (range 2.4–7.0) in the SIF group (p= 0.002). The urethral stricture site was bulbar in 67% in the BMG group and 59% in the SIF group. The cure rate was 11/17 (64.7%) for the SIF group and 13/18 (72.2%) for the BMG group (p= 0.63). Conclusions: No statistically significant difference in outcome between BMG and SIF urethroplasty was observed. However, given the longer operation time and more extensive surgical dissection of SIF reported in other studies, we recommend onlay BMG urethroplasty for the treatment of complex strictures.Key Words: Urethral stricture, Urethroplasty, Buccal mucosa graft, Skin island fla

    ac Losses in a Finite Z Stack Using an Anisotropic Homogeneous-Medium Approximation

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    A finite stack of thin superconducting tapes, all carrying a fixed current I, can be approximated by an anisotropic superconducting bar with critical current density Jc=Ic/2aD, where Ic is the critical current of each tape, 2a is the tape width, and D is the tape-to-tape periodicity. The current density J must obey the constraint \int J dx = I/D, where the tapes lie parallel to the x axis and are stacked along the z axis. We suppose that Jc is independent of field (Bean approximation) and look for a solution to the critical state for arbitrary height 2b of the stack. For c<|x|<a we have J=Jc, and for |x|<c the critical state requires that Bz=0. We show that this implies \partial J/\partial x=0 in the central region. Setting c as a constant (independent of z) results in field profiles remarkably close to the desired one (Bz=0 for |x|<c) as long as the aspect ratio b/a is not too small. We evaluate various criteria for choosing c, and we show that the calculated hysteretic losses depend only weakly on how c is chosen. We argue that for small D/a the anisotropic homogeneous-medium approximation gives a reasonably accurate estimate of the ac losses in a finite Z stack. The results for a Z stack can be used to calculate the transport losses in a pancake coil wound with superconducting tape.Comment: 21 pages, 17 figures, accepted by Supercond. Sci. Techno

    Inmate emotion coping and psychological and physical well-being: The use of crying over spilled milk

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    The study investigated the relation between coping strategies of inmates and their psychological and physical well-being. General affective states such as optimism were related to both psychological and physical well-being. Moreover, inmates who experienced specific negative emotions such as regret, anxiety, and sadness reported more psychological and physical complaints. The way in which inmates coped with these negative emotions was also important. Inmates who used an active emotion-focused coping strategy were in better health than inmates inclined to keep their negative feelings to themselves. Emotion-focused coping by sharing negative emotions with people in one's social network can help to increase both psychological and physical well-being. Engaging in emotion management in a more cognitive way, by emphasizing positive aspects of the situation, can help to reduce the intensity of negative emotions. Possible research and policy implications of these results are discussed. © 2007 American Association for Correctional and Forensic Psychology

    Probiotic and synbiotic safety in infants under two years of age

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    In this study, we systematically evaluated safety aspects in clinical trials with probiotics and synbiotics in young infants (0-2 years of age). This study is an update of earlier reports and covers the recent literature from 2008-2013. The safety evaluation is performed along the Common Terminology Clinical Adverse Events (CTCAE) version 4.0 scale, hereby also providing guidance for future studies. Safety aspects are represented and related to number of participants per probiotic strain/culture, study duration, dosage, clinical condition and selected afflictions. The results show a deficiency in the precise reporting and classification of adverse events in most studies. Analysis of 57 clinical trials with probiotics and synbiotics in combination with eight follow-up studies indicate that probiotic administration to infants between 0 and 24 months is safe with regard to the evaluated strains in infants with a particular health status or susceptibility. Most adverse events and serious adverse events were considered unrelated to the study product, and there were no major safety concerns. Almost all studies concluded that none of the adverse effects were related to the study product; the study products are generally well tolerated. Finally, inconsistent, imprecise and potentially incomplete reporting as well as the variation in probiotic strains, dosages, administration regimes, study populations and reported outcomes, greatly limit the generalizability of conclusions and argue convincingly for obligatory and standardised behaviour on adverse events (CTCAE) reporting in 'food' studies

    Rabies virus cross-reactive murine T cell clones: analysis of helper and delayed-type hypersensitivity function.

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    Three T cell clones derived from rabies virus-immunized BALB/c mice were analysed for specificity and function. The clones proved to be broadly cross-reactive by responding to different rabies virus isolates (PM, ERA, CVS, HEP) and other representatives of the genus Lyssavirus, like the Duvenhage-6 (DUV6) and Mokola (MOK) viruses. The clones detected three different epitopes: an epitope expressed on the matrix protein (M) shared by PM, HEP, MOK and DUV6 viruses (clone AA8), an epitope expressed on the M-protein shared by PM, ERA, CVS, HEP and MOK viruses (clone 35A) and finally an epitope expressed on the glycoprotein (G-protein) shared by PM, ERA, CVS, HEP and MOK viruses (clone BG2). Antigen recognition of all clones proved to be MHC-restricted and they all displayed the CD4+ CD8- phenotype. Intravenous inoculation of the T cells in syngeneic mice, which had been injected intracutaneously in the ear with HEP virus, resulted in a localized DTH reaction characteristic for TH1 cells. In vitro, the clones were able to provide help to rabies virus-primed B cells, resulting in the production of virus-specific antibodies directed against all the four structural proteins of rabies virus. Further analysis of this antibody response revealed that part of it was directed against antigenic determinants of the G-protein which induce virus neutralizing antibody

    Safety of probiotics and synbiotics in children under 18 years of age

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    This study aimed to systematically evaluate safety of probiotics and synbiotics in children ageing 0-18 years. This study is the third and final part in a safety trilogy and an update is provided using the most recent available clinical data (2008-2013) by means of the Common Terminology Clinical Adverse Events (CTCAE version 4.0) classification. Safety aspects are represented and related to number of participants per probiotic strain/culture, study duration, dosage, clinical condition and selected afflictions. Analysis of 74 clinical studies indicated that probiotic and/or synbiotic administration in children is safe with regard to the specific evaluated strains, dosages and duration. The population of children include healthy, immune compromised and obese subjects, as well as subjects with intestinal disorders, infections and inflammatory disorders. This study revealed no major safety concerns, as the adverse events (AEs) were unrelated, or not suspected to be related, to the probiotic or synbiotic product. In general the study products were well tolerated. Overall, AEs occurred more frequent in the control arm compared to children receiving probiotics and/or synbiotics. Furthermore, the results indicate inadequate reporting and classification of AEs in the majority of the studies. In addition, generalizability of conclusions are greatly limited by the inconsistent, imprecise and potentially incomplete reporting as well as the variation in probiotic strains, dosages, administration regimes, study populations and reported outcomes

    Teacher Voice in Global Conversations around Education Access, Equity, and Quality

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    Despite public commitments internationally and nationally to include the voices of all stakeholders, the voices of teachers have continued to be marginalized in the literature and in policy-making related to global educational development. The purpose of the current study is to examine the process of invoking teacher voice using a sample of international teachers participating in a US-based teacher exchange program. Toward this end, we conducted semi-structured interviews with 16 teachers from 14 countries and four continents (all participants in the Teaching Excellence and Achievement [TEA] program). Results demonstrate that teacher voice was more personal rather than systemic, narrative rather than propositional, and utilized colloquial vocabulary rather than technical jargon. Teacher voice is also not always positive, but can be biased, critical, or judgmental. Nonetheless, the interviews also illustrate the critical necessity of including teacher voice in educational planning and decision-making
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