Surgically treated ovarian lesions in preadolescent girls

Introduction The purpose of this study was to investigate the epidemiology and characteristics of surgically treated ovarian lesions in preadolescent girls. Material and methods This was a retrospective cohort study including all 0- to 11-year-old girls operated at a single center from 1999 to 2016 for ovarian cysts, neoplasms or torsions. Patient charts were reviewed for symptoms, preoperative radiological imaging, operative details and histopathology. Results We identified 78 girls, resulting in a population-based incidence of 4.2/100 000. Infants (n = 44) presented with benign cysts (42/44, 95%, one bilateral), a benign neoplasm (1/44, 2%) and a torsion without other pathology (1/44, 2%). Torsion was found in 25/29 (86%) ovaries with complex cysts and in 3/15 (21%) ovaries with simple cysts in preoperative imaging (P <0.001). Most infants were symptomless. Lesions in 1- to 11-year-old girls (n = 34) included benign neoplasms (n = 21/34, 62%), malignant neoplasms (n = 5/34, 15%), a cyst with torsion (n = 1/34, 3%) and torsions without other pathology (n = 7/34, 21%). Torsion was more common in benign (17/21, 81%) than in malignant neoplasms (1/5, 20%) (P <0.020). Ovarian diameter did not differ between ovaries with or without torsion (P = 0.238) or between benign and malignant neoplasms (P = 0.293). The duration of symptoms in lesions with or without torsion was similar. Conclusions The majority of surgically treated ovarian lesions in preadolescent are benign lesions with torsion. Surgery should be ovary-preserving and performed without delay.Peer reviewe

Economic Degrowth and the Collapse of Institutional Order: Theory and Propositions

Integrating insights from new institutional&nbsp; economics and studies on the collapse of past empires, we sketch a process model that links economic degrowth to the collapse of institutional orders. Our thought experiment starts from emphasizing the importance of institutions and enforcement mechanisms in maintaining a sufficient level of economic activity to sustain public costs. We flip this established logic and elucidate the negative role of economic degrowth in the weakening of the public sector’s ability to enforce institutional rules. Internal and external shocks further shake the stability of the institutional order and, at some point, individuals’ belief in institutional rules and norms weakens, resulting in system-wide collapse of the institutional order. We use historical literature on the collapse of Roman Empire as an “experimental prototype” (Meyer, Gaba, &amp; Colwell, 2005: 471) to inspire and illustrate our thought experiment

Toeplitz operators with distributional symbols on Bergman spaces

We study the boundedness and compactness of Toeplitz operators Ta on Bergman spaces , 1 < p < ∞. The novelty is that we allow distributional symbols. It turns out that the belonging of the symbol to a weighted Sobolev space of negative order is sufficient for the boundedness of Ta. We show the natural relation of the hyperbolic geometry of the disc and the order of the distribution. A corresponding sufficient condition for the compactness is also derived

Spatial and Temporal Coherence in Strongly Coupled Plasmonic Bose-Einstein Condensates

We report first-order spatial and temporal correlations in strongly coupled plasmonic Bose-Einstein condensates. The condensate is large, more than twenty times the intrinsic spatial coherence length of the polaritons and hundred times the healing length, making plasmonic lattices an attractive platform for studying long-range spatial correlations in two dimensions. We find that both spatial and temporal coherence display non-exponential decay; the results suggest power-law or stretched exponential behaviour with different exponents for spatial and temporal correlation decays.Comment: 11 pages, 11 figure

Lower urinary tract symptoms and sexual functions after endorectal pull-through for Hirschsprung disease : controlled long-term outcomes

Background/purpose: To define the prevalence of lower urinary tract symptoms (LUTS) and outcomes for sexual function after endorectal pull-through (EPT) for Hirschsprung disease (HD) compared to controls. To date, similar controlled studies are lacking. Methods: Patients aged = 4 years (n= 123) operated on forHDat our center between 1987 and 2011were invited to answer questionnaires on LUTS and sexual function (aged = 16 years). Patients with an intellectual disability and patients with a definitive endostomy were excluded. Patients were matched to three controls and also invited to a clinical follow-up for urological investigations including urine flow measurement, renal tract ultrasound, and urinalysis. Results: Altogether, 59 responses concerning LUTS and 24 responses concerning sexual functions were analyzed. No significant differences were demonstrated in the overall prevalence of LUTS between patients (67%) and controls (80%), nor in the prevalence of frequent LUTS (14% vs. 16%; P = NS for both). One patient (2%) had a urethral stricture after laparotomy-assisted EPT. Male patients reported sexual satisfaction and erectile function similar to controls (P N 0.10). Female patients were currently less in stable relationships compared to controls (25% vs. 83%, P= 0.005). Conclusions: Our results support the safety of EPT in patientswith HDwith regard to preservation of the integrity and functioning of the genitourinary tract. (C) 2017 Elsevier Inc. All rights reserved.Peer reviewe

Participatory operations model for cost-efficient monitoring and modeling of river basins — A systematic approach

AbstractThe worldwide economic downturn and the climate change in the beginning of 21st century have stressed the need for cost efficient and systematic operations model for the monitoring and management of surface waters. However, these processes are still all too fragmented and incapable to respond these challenges. For example in Finland, the estimation of the costs and benefits of planned management measures is insufficient. On this account, we present a new operations model to streamline these processes and to ensure the lucid decision making and the coherent implementation which facilitate the participation of public and all the involved stakeholders. The model was demonstrated in the real world management of a lake. The benefits, pitfalls and development needs were identified. After the demonstration, the operations model was put into operation and has been actively used in several other management projects throughout Finland