Résection trans urétrale de la prostate : première expérience à Bukavu, RD Congo: Transurethral resection of the prostate: pilot experience in Bukavu, DR Congo

Context and objective. Despite its large use as alternative to open surgical adenomectomy, transurethral resection of the prostate (TURP) is still poorly performed in many African countries. The purpose of this study was to describe a pilotTURP experience in Bukavu. Methods.This retrospective study included 159 patients (average age: 68 ± 8.5 years) with benign prostatic hypertrophy (BPH), treated at three medical centres in Bukavu between February 2014 andFebruary 2017. Socio-demographic, clinical, and ultrasound data were recorded, and comorbidities and complications reported. Each patient was questionned about treatment received before surgery. Results. The average prostatic volume was 53.2 ± 22 grams. All patients were severelysymptomatic (mean International Prostate Symptoms Score (IPSS) 26.8 ± 5.8) and severely bored (mean quality of life score (QOL) 6.2 ± 0.8).Hypertension (42%) and type 2 diabetes (41%) were the most common comorbidities. The most frequent complications of BPH were urinary tractinfection (44%) and urinary retention (40%). Prior to hospital admission, 60% of patients used traditional medicine. Conclusion.This study has revealed a late reference of patients to the hospital, when the illness is already in advanced stage with complications. There is a need of implementing educational measures targeting early detection and reference of patients with BPH in this area. Résumé Contexte et objectif. Bien que la résection trans urétrale de la prostate (RTUP) se soit imposée comme alternative à l’adénomectomie chirurgicale classique à ciel ouvert, sa pratique reste exceptionnelle dans quelques contrées africaines. L’objectif de la présente étude était de décrire la première expérience de la RTUP à Bukavu. Méthodes. La présente étude documentaire a porté sur 159 patients avec hypertrophie bénigne de la prostate (HBP), opérés dans 3 centres médicaux de Bukavu entre février 2014 et février 2017. Les paramètres d’intérêts comprenaient les données sociodémographiques, cliniques, échographiques les comorbidités, les complications et l’attitude thérapeutique avant l’intervention. Résultats. Leur âge moyen était de 68±8,5 ans. Le volume prostatique moyen était de 53,2 ± 22 grammes. Tous les patients étaient sévèrement symptomatiques (score international des symptômes prostatiques (IPSS) moyen de 26,8 ± 5,8) et fortement ennuyés (score de la qualité de vie (QOL) moyen de 6,2 ± 0,8). L’hypertension artérielle (42%) et le diabète sucré de type 2 (41 %) étaient les comorbidités les plus fréquentes. Les complications de l’HBP les plus fréquentes étaient l’infection urinaire (44 %) et la rétention urinaire (40%). Avant l’admission à l’hôpital, 60% des patients ont eu recours à la médecine traditionnelle. Conclusion. L’avènement de la RTUP à Bukavu a permis de déceler que la majorité des patients avec HBP consultent très tardivement au stade de sevérité symptomatique et des complications. Une campagne d’éducation, information et communication de la population sur le dépistage précoce de l’HBP est à envisager

Social Justice Through Access to Information at the University of Illinois at Chicago University Library

This paper outlines the efforts of the University Library of the University of Illinois at Chicago to provide free open access to information so that everyone has equal access to it. The library does this through advocacy for open access, providing resources to make information openly accessible, and providing training in information literacy to access and use open information

Exchange interaction effects in the thermodynamic properties of quantum dots

We study electron-electron interaction effects in the thermodynamic properties of quantum-dot systems. We obtain the direct and exchange contributions to the specific heat C_v in the self-consistent Hartree-Fock approximation at finite temperatures. An exchange-induced phase transition is observed and the transition temperature is shown to be inversely proportional to the size of the system. The exchange contribution to C_v dominates over the direct and kinetic contributions in the intermediate regime of interaction strength (r_s ~ 1). Furthermore, the electron-electron interaction modifies both the amplitude and the period of magnetic field induced oscillations in C_v.Comment: 4 pages, 4 figures; To appear in Phys. Rev.

Assisting walking balance using a bio-inspired exoskeleton controller

Background: Balance control is important for mobility, yet exoskeleton research has mainly focused on improving metabolic energy efficiency. Here we present a biomimetic exoskeleton controller that supports walking balance and reduces muscle activity. Methods: Humans restore balance after a perturbation by adjusting activity of the muscles actuating the ankle in proportion to deviations from steady-state center of mass kinematics. We designed a controller that mimics the neural control of steady-state walking and the balance recovery responses to perturbations. This controller uses both feedback from ankle kinematics in accordance with an existing model and feedback from the center of mass velocity. Control parameters were estimated by fitting the experimental relation between kinematics and ankle moments observed in humans that were walking while being perturbed by push and pull perturbations. This identified model was implemented on a bilateral ankle exoskeleton. Results: Across twelve subjects, exoskeleton support reduced calf muscle activity in steady-state walking by 19% with respect to a minimal impedance controller (p < 0.001). Proportional feedback of the center of mass velocity improved balance support after perturbation. Muscle activity is reduced in response to push and pull perturbations by 10% (p = 0.006) and 16% (p < 0.001) and center of mass deviations by 9% (p = 0.026) and 18% (p = 0.002) with respect to the same controller without center of mass feedback. Conclusion: Our control approach implemented on bilateral ankle exoskeletons can thus effectively support steady-state walking and balance control and therefore has the potential to improve mobility in balance-impaired individuals.Support Biomechanical Engineerin

The two electron artificial molecule

Exact results for the classical and quantum system of two vertically coupled two-dimensional single electron quantum dots are obtained as a function of the interatomic distance (d) and with perpendicular magnetic field. The classical system exhibits a second order structural transition as a function of d which is smeared out and shifted to lower d values in the quantum case. The spin-singlet - spin-triplet oscillations are shifted to larger magnetic fields with increasing d and are quenched for a sufficiently large interatomic distance.Comment: 4 pages, 4 ps figure

Development and Validation of the Metric-Based Assessment of a Robotic Vessel Dissection, Vessel Loop Positioning, Clip Applying and Bipolar Coagulation Task on an Avian Model

The evolution of robotic technology and its diffusion does not seem to have been adequately accompanied by the development and implementation of surgeon training programs that ensure skilled and safe device use at the start of the learning curve. The objective of the study is to develop and validate performance metrics for vessel dissection, vessel loop positioning, clip applying and bipolar coagulation using an avian model. Three robotic surgeons and a behavioral scientist characterized the performance metrics of the task according to the proficiency-based progression methodology. Fourteen experienced robotic surgeons from different European countries participated in a modified online Delphi consensus. Eight experienced surgeons and eight novices performed the robotic task twice. In the Delphi meeting, 100% consensus was reached on the performance metrics. Novice surgeons took 26 min to complete the entire task on trial 1 and 20 min on trial 2. Experts took 10.1 min and 9.5 min. On average the Expert Group completed the task 137% faster than the Novice Group. The amount of time to reach the vessel part of the task was also calculated. Novice surgeons took 26 min on trial 1 and 20 min on trial 2. Experts took 5.5 min and 4.8 min. On average the experts reached the vessel 200% faster than the novices. The Expert Group made 155% fewer performance errors than the Novice Group. The mean IRR of video-recorded performance assessments for all metrics was 0.96 (95% confidence intervals (CI) lower = 0.94-upper = 0.98). We report the development and validation for a standard and replicable basic robotic vessel dissection, vessel loop positioning, clip applying and bipolar coagulation task on an avian model. The development of objective performance metrics, based on a transparent and fair methodology (i.e., PBP), is the first fundamental step toward quality assured training. This task developed on the avian model proved to have good results in the validation study.info:eu-repo/semantics/publishedVersio