Repair of low anorectal anomalies in female patients: risk factors for wound dehiscence

Background/purpose: Wound dehiscence after rectoperineal/vestibular fistulae repair may have adverse effects on the continence mechanism with delayed functional sequels. We report the incidence of wound complications following the sagittal anorectoplasty in a group of female patients, in addition to studying the effect of some possible risk factors.Patients and methods: This is a prospective cohort study conducted on female patients with rectoperineal or rectovestibular fistula operated during the period from January 2011 to December 2015. Patients were divided into three groups: group A (no dehiscence); group B (minor dehiscence); and group C (major dehiscence). Patients were compared regarding their age at the time of repair, the type of anorectal anomaly, the degree of dilation of the colon, and the prevalence of covering colostomy.Results: The study included 63 female patients. Group A included 34 patients (those with no dehiscence, 52.4%), group B included 17 patients (minor wound dehiscence, 26.98%), and group C included 13 patients (major wound dehiscence, 20.6%). There was no statistically significant difference between the three groups regarding the studied risk factors.Conclusion: With regard to the wound complications following the repair of rectoperineal/vestibular fistulae in the female patients, none of the studied risk factors appear to have a significant effect on the outcome.Keywords: anterior sagittal anorectoplasty, colostomy, posterior sagittal anorectoplasty, rectoperineal fistula, rectovestibular fistula, wound dehiscenc

Application of carbon nanotubes in chiral and achiral separations of pharmaceuticals, biologics and chemicals

Carbon nanotubes (CNTs) possess unique mechanical, physical, electrical and absorbability properties coupled with their nanometer dimensional scale that renders them extremely valuable for applications in many fields including nanotechnology and chromatographic separation. The aim of this review is to provide an updated overview about the applications of CNTs in chiral and achiral separations of pharmaceuticals, biologics and chemicals. Chiral single-walled carbon nanotubes (SWCNTs) and multi-walled carbon nanotubes (MWCNTs) have been directly applied for the enantioseparation of pharmaceuticals and biologicals by using them as stationary or pseudostationary phases in chromatographic separation techniques such as high-performance liquid chromatography (HPLC), capillary electrophoresis (CE) and gas chromatography (GC). Achiral MWCNTs have been used for achiral separations as efficient sorbent objects in solid-phase extraction techniques of biochemicals and drugs. Achiral SWCNTs have been applied in achiral separation of biological samples. Achiral SWCNTs and MWCNTs have been also successfully used to separate achiral mixtures of pharmaceuticals and chemicals. Collectively, functionalized CNTs have been indirectly applied in separation science by enhancing the enantioseparation of different chiral selectors whereas non-functionalized CNTs have shown efficient capabilities for chiral separations by using techniques such as encapsulation or immobilization in polymer monolithic columns

Seismic assessment and rehabilitation of a historical masonry mosque

In order to assess the structural behaviour and to evaluate the seismic vulnerability of old masonry structures located in Lebanon, a historical masonry mosque was analysed under earthquake loading. A numerical model developed by the finite element method using Abaqus software was elaborated on the basis of previously published experimental studies. It was concluded that the numerical model can predict maximum stresses with reasonable accuracy, allowing control of a full scale wall model. This analysis shows that the stresses generated in the joints between the blocks exceed the ultimate shear stress of the mortar, resulting in cracks in the joints. The choice of an adequate structural rehabilitation method was limited because the mosque is of archaeological importance and its original appearance should not be modified. Therefore, a seismic retrofit solution using internal or external post tensioned tendons was recommended

Thin layer concrete blockwork in compression: an experimental analysis

The compressive strength of concrete block masonry is dependent upon the unit compressive strength, the type of unit, the mortar and the form of masonry construction (Mirza et al. 1995). The design codes allow masonry compressive strength to be established (or better: estimated) by calculation, from tests, or from tabulated values. In this way the current European masonry standard EN 1996: Part 1-1 (LST EN 1996-1-1) tabulates the masonry strength for concrete blocks with thin layers of mortar. In France, doubts exist on the validity of these tabulated values for the blocks made with lightweight aggregates. To provide data for an extension of the use of the tabulated values for lightweight aggregates blocks and at the same time to provide input to the development of Eurocode 6, a major research program was set up. The research program aims to evaluate the mechanical strength of the thin joints hollow concrete masonry made with dense or lightweight aggregates. Tests have been carried out on a very large type of hollow blocks. Different geometries of blocks and different types of aggregates are tested. All these tests are based on CEN standards to meet Eurocode 6 requirements. This work proves that the formula proposed by Eurocode 6 to calculate the characteristic compressive strength of hollow concrete masonry are largely safe. It was also found that the strength of masonry depends only on the block resistance and is independent of the nature of aggregate

Repeatability and validation of Gait Deviation Index in children: Typically developing and cerebral palsy

The Gait Deviation Index (GDI) is a dimensionless parameter that evaluates the deviation of kinematic gait from a control database. The GDI can be used to stratify gait pathology in children with cerebral palsy (CP). In this paper the repeatability and uncertainty of the GDI were evaluated. The Correlation between the GDI and the Gross Motor Function Classification System (GMFCS) was studied for different groups of children with CP (hemiplegia, diplegia, triplegia and quadriplegia). Forty-nine, typically developing children (TD) formed our database. A retrospective study was conducted on our 3D gait data and clinical exams and 134 spastic children were included. Sixteen TD children completed the gait analysis twice to evaluate the repeatability of the GDI (test–retest evaluation). Monte Carlo simulations were applied for all groups (TD and children with CP) in order to evaluate the propagation of errors stemming from kinematics. The repeatability coefficient (2SD of test–retest differences), obtained on the GDI for the 16 TD children (32 lower limbs) was ±10. Monte Carlo simulations showed an uncertainty ranging between 0.8 and 1.3 for TD children and all groups with CP. The Spearman Rank correlation showed a moderate correlation between the GDI and the GMFCS (r = −0.44, p < 0.0001)

A new approach in the clinical decision-making for cerebral palsy using three-dimensional subject-specific musculoskeletal reconstructions.

Cerebral palsy (CP) is a neurological disorder which can cause muscular spasticity. Children with this condition suffer from a combination of gait deviations, skeletal deformities and muscular abnormalities. Precise evaluation of each of these three components is crucial for management planning in children with CP. The aim of this study is to review the latest innovative methods used for three-dimensional (3D) gait analysis and musculoskeletal modeling in children with cerebral palsy. 3D gait analysis is a quantitative objective method based on the use of infrared cameras. It allows the evaluation of dynamic joint angles, forces and moments applied on joints and is usually coupled with dynamic electromyography. Skeletal evaluation is usually based on two-dimensional X-rays and physical examination in clinical practice. However, a novel method based on stereoradiographic 3D reconstruction of biplanar low dose X-rays allows a more thorough evaluation of skeletal deformities, and in particular torsional anomalies. Muscular evaluation of children with CP is most commonly based on magnetic resonance imaging, whereby delimitation of lower limb muscles on axial slices allows 3D reconstruction of these muscles. Novel innovative techniques allow similar reconstructions by extrapolation, thus limiting the necessary quantity of axial slices that need to be manually delimitated.This study has been funded by the Research Council of Saint Joseph University (grant # FM 244) and the CEDRE project (grant N# 11 SCI F 44/L36)

Kinematic Evaluation of 4 Pediatric Collars and Distribution of Cervical Movement Between Primary and Coupled Angles

Background: Primary and coupled angle restrictions, when neck collars are used, have been investigated mainly in adults and not yet in children. Purpose: To evaluate the efficiency of 4 pediatric collars in reducing cervical range of motion (ROM) in primary and coupled planes. Methods: Thirty asymptomatic children (16 boys and 14 girls) aged 6 to 12 years participated in the study. A motion analysis system was used to evaluate the ROM of the cervical spine during flexion/extension, left and right lateral bending, and left and right axial rotation. Primary and coupled ROM were evaluated in unbraced and braced conditions. Four cervical collars were tested: Philadelphia, Miami Jr, Necloc, and the conventional Hard Collar. Thirteen subjects were tested 2 times to evaluate the repeatability of the parameters. The ROM in each plane was normalized to the sum of the ROM in the 3 planes, for each movement, to estimate the percentage of the movement in each plane (normalized ROM), in braced and unbraced conditions. The analysis of variance and post hoc Benferroni tests were applied on raw and normalized ROM. Results: ROM collected in collars showed a significant difference compared with the unbraced condition. ROM obtained in Necloc and Miami Jr showed a significant difference compared with Philadelphia and conventional Hard Collar. The primary plane is activated at 80% during flexion-extension and left-right axial rotation; however, 55% of the total movement was completed in the frontal plane during left-right lateral bending in unbraced condition. Statistical differences in the normalized ROM were found between the braced and unbraced conditions and among collars. Conclusions: Necloc and Miami Jr presented the highest limitation of movement in the primary and secondary planes. The distribution strategy of a movement, between primary and coupled angles, is different between the braced and unbraced conditions

Three dimensional kinematics of upper limb anatomical movements in asymptomatic adults: Dominant vs.non-dominant

The effect of dominance on upper limb (UL) kinematics has only been studied on scapular movements. Moreover, when an anatomical UL movement is performed in a specific plane, secondary movements in the remaining planes involuntarily occur. These secondary movements have not been previously evaluated. The aim of this study was to compare the kinematics of primary and secondary angles of dominant and non-dominant UL during anatomical movements in asymptomatic adults. 25 asymptomatic adults performed 6 anatomical movements bilaterally: shoulder flexion-extension, abduction-adduction, horizontal abduction-adduction, internal-external rotation, elbow flexion-extension and wrist pronation-supination. Kinematics of the dominant and non-dominant UL were compared by their ranges of motion (ROM) and their angular waveforms (Coefficient of Multiple Correlations, CMC). The comparison between dominant and non-dominant UL kinematics showed different strategies of movement, most notably during elbow flexion-extension (CMC = 0.29): the dominant UL exhibited more pronation at maximal elbow flexion. Significant secondary angles were found on most of the UL anatomical movements; e.g. a secondary ROM of shoulder (humero-thoracic) external-internal rotation (69° ± 16°) was found when the subject intended to perform maximal shoulder abduction-adduction (119° ± 21°). Bias of dominance should be considered when comparing pathological limb to the controlateral one. Normative values of primary and secondary angles during anatomical movements could be used as a reference for future studies on UL of subjects with neurological or orthopedic pathologies.This study was sponsored by the research council of the University of Saint-Joseph under the Grant number IPHY

An experimental study of algorithms for obtaining a singly connected subgraph

A directed graph G = (V,E) is singly connected if for any two vertices v, u of V, the directed graph G contains at most one simple path from v to u. In this paper, we study different algorithms to find a feasible but necessarily optimal solution to the following problem. Given a directed acyclic graph G = (V, E), find a subset H of E of minimum size such that the subgraph (V, E-H) is singly connected. Moreover, we prove that this problem can be solved in polynomial time for a special kind of directed graphs

Exploring the complexities of 1C metabolism: implications in aging and neurodegenerative diseases

The intricate interplay of one-carbon metabolism (OCM) with various cellular processes has garnered substantial attention due to its fundamental implications in several biological processes. OCM serves as a pivotal hub for methyl group donation in vital biochemical reactions, influencing DNA methylation, protein synthesis, and redox balance. In the context of aging, OCM dysregulation can contribute to epigenetic modifications and aberrant redox states, accentuating cellular senescence and age-associated pathologies. Furthermore, OCM\u27s intricate involvement in cancer progression is evident through its capacity to provide essential one-carbon units crucial for nucleotide synthesis and DNA methylation, thereby fueling uncontrolled cell proliferation and tumor development. In neurodegenerative disorders like Alzheimer\u27s and Parkinson\u27s, perturbations in OCM pathways are implicated in the dysregulation of neurotransmitter synthesis and mitochondrial dysfunction, contributing to disease pathophysiology. This review underscores the profound impact of OCM in diverse disease contexts, reinforcing the need for a comprehensive understanding of its molecular complexities to pave the way for targeted therapeutic interventions across inflammation, aging and neurodegenerative disorders