Reliability of hypertrophy of the contralateral testis in prediction of the status of impalpable testis

Background: The hypertrophied testis can predict the status of the impalpable contralateral one. The aim of this study was to assess the accuracy of contralateral testicular hypertrophy for predicting the presence or absence of impalpable undescended testis (UDT) in Egyptian boys.Patients and methods: This study was carried out on 204 patients with unilateral impalpable UDT who presented to the Pediatric Surgery Department, Al-Azhar University Hospitals, from July 2014 to April 2016. Only 40 patients with unilateral impalpable UDT and hypertrophy of the contralateral testes were included in this study. They were subjected to routine laboratory investigations, ultrasonography measurement of the volume of the hypertrophied testis, and diagnostic laparoscopy for the impalpable intra-abdominal testis (IAT). Both ultrasonography and laparoscopic findings were reported.Results: Out of 204 patients with unilateral impalpable UDT, only 40 patients fulfilled the inclusion criteria. Their ages ranged from 1 to 5 years, with a mean of 2.3±1.18 years. Testicular volume ranged from 0.94 to 6.33 cm3, with amean of 3.12±1.41 cm3. Diagnostic laparoscopy indicated 30 patients with vanishing testis, four patients with low IAT, and three patients with high IAT and three patients with testicular vessels and vas passing internal inguinal ring, where inguinal exploration indicated atrophic testes.Conclusion: Hypertrophied testis can predict the absence of other contralateral impalpable testis when its volume is 1.85 cm3.Keywords: hypertrophy, impalpable undescended testis, laparoscopy, reliabilit

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p&lt;0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p&lt;0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Conjugated Conduction-Free Convection Heat Transfer in an Annulus Heated at Either Constant Wall Temperature or Constant Heat Flux

In this paper, we investigate numerically the effect of thermal boundary conditions on conjugated conduction-free convection heat transfer in an annulus between two concentric cylinders using Fourier Spectral method. The inner wall of the annulus is heated and maintained at either CWT (Constant Wall Temperature) or CHF (Constant Heat Flux), while the outer wall is maintained at constant temperature. CHF case is relatively more significant for high pressure industrial applications, but it has not received much attention. This study particularly focuses the latter case (CHF). The main influencing parameters on flow and thermal fields within the annulus are: Rayleigh number Ra; thickness of inner wall Rs; radius ratio Rr and inner wall-fluid thermal conductivity ratio Kr. The study has shown that the increase in Kr increases the heat transfer rate through the annulus for heating at CWT and decreases the inner wall dimensionless temperature for heating at CHF and vice versa. It has also been proved that as the Rs increases at fixed Ra and Rr, the heat transfer rate decreases for heating at CWT and the inner wall dimensionless temperature increases for heating at CHF at Kr 1 depends on Rr. It has been shown that for certain combinations of controlling parameters there will be a value of Rr at which heat transfer rate will be minimum in the annulus in case of heating at CWT, whil

Predictive value of body mass index to metabolic syndrome risk factors in Syrian adolescents

Abstract Background Obesity has become a serious epidemic health problem in both developing and developed countries. There is much evidence that obesity among adolescents contributed significantly to the development of type 2 diabetes and coronary heart disease in adulthood. Very limited information exists on the prevalence of overweight, obesity, and associated metabolic risk factors among Syrian adolescents. Therefore, the purpose of this study was to determine the relationship between obesity determined by body mass index and the major metabolic risk factors among Syrian adolescents. Methods A cross-sectional study of a randomly selected sample of 2064 apparently healthy Syrian adolescents aged 18 to 19 years from Damascus city, in Syria, was performed. Body mass index and blood pressure were measured. Serum concentrations of glucose, triglycerides, total cholesterol, high-density lipoprotein-cholesterol, and low-density lipoprotein-cholesterol were determined. Metabolic syndrome was defined using the national criteria for each determined metabolic risk factor. Individuals with a body mass index 25 to 29.9 were classified as overweight, whereas individuals with a body mass index ≥30 were classified as obese. A receiver operating characteristics curve was drawn to determine appropriate cut-off points of the body mass index for defining overweight and obesity, and to indicate the performance of body mass index as a predictor of risk factors. Results The obtained data showed that blood pressure and the overall mean concentrations of fasting blood sugar, triglycerides, cholesterol, low-density lipoprotein-cholesterol, and triglycerides/high-density lipoprotein-cholesterol were significantly higher in overweight and obese adolescent groups (p <0.0001) in comparison with the normal group. Based on receiver operating characteristics calculation for body mass index and some metabolic risks, the data suggest the best body mass index cut-offs ranged between 23.25 and 24.35 kg/m2. Conclusions A strong association between overweight and obesity as determined by body mass index and high concentrations of metabolic syndrome components has been demonstrated. Although body mass index values were lower than the international cut-offs, these values were good predictors of some metabolic abnormalities in Syrian adolescents; body mass index is a good predictor of these abnormalities in this population

The comparative effect of heating and irradiation on the physicochemical and sensory properties of licorice roots powders (Glycyrrhiza Glabra L.)

A study was conducted to investigate the changes in the physicochemical and sensory properties of the licorice root powders extracts as a function of heating, steaming, gamma irradiation and storage periods. Physical and chemical analyses of the extracts were performed after 0 and 12 months of storage, whereas, sensory evaluation was done only two days after irradiation. The results showed that the extraction yield of licorice root measured as organic dissolved solids was significantly increased by heating and decreased by steaming, but there was no significant difference between irradiated and non-irradiated samples. Reduced sugar, glycyrrhizin components, pH values, and color of the extracts were found to be decreased due to heating and steaming. Also the heating and steaming increased the total sugar and viscosity of the licorice root extracts. No differences were verified in the overall sensorial (color, flavor, texture, and taste), physical (color and viscosity), and chemical (total sugar, reduced sugar, glycyrrhizin components, and pH values) properties of licorice root extracts after irradiation with 10 kGy

Abnormal Event Detection Using Convolutional Neural Networks and 1-Class SVM classifier

International audienceIn this paper, we present a method based on deep learning for detection and localization of spatial and temporal abnormal events in surveillance videos using training samples containing only normal events. This work is divided into two stages, the first one is feature extraction for each patch of the input image using the first two convolution layers extracted from a pretrained CNN. In second stage, one-class SVM is trained with resultant features. The SVM classifier allows a fast and robust abnormal detection with respect to the presence of outliers in the training dataset. Experimental tests have conducted on UCSD Ped2 dataset, this dataset is considered as complex due to low resolution and presence of many occlusions. Our results showed high performance and were compared with state-of-the art methods

A Low-Power CMOS Piezoelectric Transducer Based Energy Harvesting Circuit for Wearable Sensors for Medical Applications

Piezoelectric vibration based energy harvesting systems have been widely utilized and researched as powering modules for various types of sensor systems due to their ease of integration and relatively high energy density compared to RF, thermal, and electrostatic based energy harvesting systems. In this paper, a low-power CMOS full-bridge rectifier is presented as a potential solution for an efficient energy harvesting system for piezoelectric transducers. The energy harvesting circuit consists of two n-channel MOSFETs (NMOS) and two p-channel MOSFETs (PMOS) devices implementing a full-bridge rectifier coupled with a switch control circuit based on a PMOS device driven by a comparator. With a load of 45 kΩ, the output rectifier voltage and the input piezoelectric transducer voltage are 694 mV and 703 mV, respectably, while the VOUT versus VIN conversion ratio is 98.7% with a PCE of 52.2%. The energy harvesting circuit has been designed using 130 nm standard CMOS process

Evaluation of limbal conjunctival autograft and low-dose mitomycin C in the treatment of recurrent pterygium

BACKGROUND AND OBJECTIVE: To assess the effectiveness of limbal conjunctival autograft and low-dose mitomycin C in the treatment of recurrent pterygium. PATIENTS AND METHODS: Thirty-four eyes with recurrent pterygium underwent surgical excision followed by the intraoperative application of low-dose (0.05%) mitomycin C and the use of limbal conjunctival autograft. All patients were observed for at least 18 months for any complications, including recurrences. RESULTS: Neither recurrences nor serious complications were recorded. Visual acuity improved significantly (P \u3c .05) in eyes with pterygium extending 3 mm or more beyond the limbus. CONCLUSION: Simple excision and low-dose mitomycin C followed by limbal conjunctival autograft is a safe and effective way of treating recurrent pterygium