The Effects of the Roy’s Adaptation Model on Primigravida Women’s Self-Concept: A Randomized Controlled Trial

Most women do not have a positive self-concept and impression about themselves during pregnancy because they become less active and gain more weight. Self-concept significantly contributes to individuals’ mental health. This controlled trial was performed to assess the effect of an intervention based on the Roy’s adaptation model on self-concept among primigravida women. This study was conducted on a random sample of 83 Iranian primigravida women. Women in the experimental group received educational and counseling services in five sessions held in five consecutive weeks. Thereafter, they received a four-week follow-up care. Before the intervention, there were no significant differences between the two groups regarding adaptation knowledge and self-concept adaptation. However, after the intervention, these differences were statistically significant. The Roy’s adaptation model has positive effects on primigravida women’s physical and interpersonal self-concept adaptation. Given its simplicity and easy applicability, this model can be used for improving pregnancy-related outcomes

Impact of Mesh Use on Morbidity Following Ventral Hernia Repair With a Simultaneous Bowel Resection

Objective: To evaluate the impact of mesh use on outcomes following ventral hernia repairs and simultaneous bowel resection. Design: Retrospective review. Setting: Teaching academic hospital. Patients: We studied 177 patients who underwent a ventral hernia repair with a bowel resection between May 1, 1992, and May 30, 2007. A prosthesis was used in 51 repairs (mesh group), while 126 repairs were primary (mesh-free group). Main Outcome Measures: Demographic characteristics, comorbidities, mesh type, bowel resection type (colon vs small bowel), defect size, drain use, and length of hospital stay were compared between groups with Fisher exact test and multivariate analysis. Results: There were no statistically significant differences between patient characteristics and relevant comorbidities. The incidence of postoperative infection (superficial or deep) was 22% in the mesh group vs 5% in the mesh-free group (P = .001). Other complications (fistula, seroma, hematoma, bowel obstruction) occurred in 24% of patients in the mesh group vs 8% of patients in the mesh-free group (P = .009). Focusing on the patients who developed an infection, prosthetic mesh use was the only significant risk factor on multivariate regression analysis, irrespective of drain use, defect size, and type of bowel resection. Conclusions: We recommend caution in using mesh when performing a ventral hernia repair with a simultaneous bowel resection because of significantly increased postoperative infectious complications. Drain use, defect size, and bowel resection type did not influence outcomes

A mixed finite element formulation for Timoshenko fiber models based on the local stress field

This paper provides a program to adopt based on modeling the nonlinear behavior of arbitrary elements with combination of material nonlinearity and geometric nonlinearity for the purpose of structures assessment. In this study, total Lagrangian formulation is developed based on separate fibers with uniaxial behavior and interface elements with shear response of local stress field models, simultaneously. The accuracy of the suggested approach is verified through comparison of experimental results and existing analytical methods

Do partial glenohumeral degenerative changes in patients undergoing arthroscopic rotator cuff repair influence clinical outcomes?

Background The prognostic factors for patients with full-thickness rotator cuff tears (RCTs) include tear size, muscle atrophy and fatty infiltration. However, the influence of early coexisting degenerative changes on RCT outcomes is unappreciated. The purpose of this study was to calculate the impact that pre-existing partial glenohumeral cartilaginous changes have on patients undergoing arthroscopic RCT repair. Methods A study of 54 patients undergoing arthroscopic RCT repair was undertaken. The presence of co-existing patches of glenohumeral degenerative cartilaginous changes and RCT size was recorded at surgery. Pre- and postoperative outcomes were assessed using traditional (Oxford Shoulder Score [OSS], 5-level EuroQol-5D [EQ-5D-5L] questionnaire and EuroQol visual analog scale [EQ-VAS]) and patient-centric re-formatted prisms. Outcomes were assessed as an entire dataset, and sub-group analysis was performed according to the grade of co-existing arthritis and tear size. Results Significant improvements (p<0.05) in clinical outcomes were recognized when assessed using either the traditional or reformatted prisms (average % improvements in OSS, EQ-5D-5L and EQ-VAS were 47%, 33% and 43%, respectively; average improvements in pain, function, and psychological well-being were 48%, 33% and, 29%, respectively). Positive gain was noted in all sub-groups of arthritic grading and tear size. Conclusions Good clinical outcomes can be achieved following RCT repair even in the presence of local partial degenerative cartilage changes and advancing tear size. These benefits are patient-centered but require RCT repairability

Water degrading effects on the bond behavior in FRP-strengthened masonry

Fiber reinforced polymers are being extensively used for external strengthening of masonry structures. However, durability of this strengthening technique under environmental conditions is still under inves- tigation. Previous studies indicate that moisture plays an important role in the durability of bond between FRP and substrate. Moisture can cause degradation in the bond behavior and also in the mechan- ical properties of the constituent materials. This paper presents and discusses the results of an experi- mental investigation on the effects of moisture on the bond behavior in FRP-strengthened masonry bricks. The degradation in the bond performance has been investigated by performing pull-off and pull-out tests on the conditioned specimens. The change in the mechanical properties of the materials has also been investigated. Comparative analysis has been performed and the results are presented and critically discussed.This work was partly funded by project FP7-ENV-2009-1-244123-NIKER of the 7th Framework Program of the European Commission, which is gratefully acknowledged. The first author also acknowledges the financial support of the Portuguese Science Foundation (Fundacao de Ciencia e Tecnologia, FCT), through grant SFRH/BD/80697/2011

Suppressor of cytokine signaling-2: A growth hormone-inducible inhibitor of intestinal epithelial cell proliferation

AbstractBackground & Aims: Growth hormone (GH) and insulin-like growth factor-I (IGF-I) increase intestinal growth. GH is thought to act indirectly via IGF-I. In several models, including rats given total parenteral nutrition (TPN), IGF-I more potently stimulates mucosal growth than GH, even when GH induces similar circulating IGF-I levels. These studies test the hypothesis that GH induces a suppressor of cytokine signaling (SOCS), which inhibits intestinal epithelial cell (IEC) proliferation. Methods: Rats on TPN received vehicle, GH, or IGF-I. Jejunal SOCS (SOCS-1, -2, -3, and cytokine-inducible SH2-domain-containing protein [CIS]) and IGF-I messenger RNA (mRNA) were quantified. Caco-2, IEC-6 cells, and SOCS-2 null and wild-type (WT) mice were used to examine the expression and functional role of SOCS-2. Results: As reported previously, IGF-I, but not GH, prevented mucosal atrophy during TPN, although GH elevated plasma IGF-I and increased body weight. GH, but not IGF-I, induced jejunal SOCS-2 mRNA. SOCS-2 mRNA levels in GH and IGF-I-treated rats inversely correlated with mucosal weight. SOCS-2 is expressed in Caco-2 cells, and elevated SOCS-2 expression in postconfluent cells is associated with reduced proliferative rates. SOCS-2 overexpression in Caco-2 cells inhibited cell proliferation and promoted differentiation. In IEC-6 cells, GH induced SOCS-2 and reduced basal or IGF-I-induced proliferation. GH also reduced proliferative activity in isolated crypts from WT but not SOCS-2 null mice, and SOCS-2 null crypts showed enhanced proliferative responses to GH and IGF-I. SOCS-2 null mice have increased intestinal weight and length. Conclusions: SOCS-2 is a GH-inducible, novel inhibitor of intestinal epithelial cell proliferation and intestinal growth

Strengthening and repair of steel-concrete composite girders using CFRP laminates

The use of advanced composite materials for rehabilitation and repair of deteriorating infrastructure has been embraced worldwide. The conventional techniques for strengthening of substandard bridges are costly, time consuming and labor intensive. A total of 38 specimens made of steel and carbon fibers were prepared and tested to investigate the possibility of galvanic corrosion. Two simulated aggressive environments and three different amounts of epoxy coating were used. Potentiodynamic polarization and galvanic corrosion tests were conducted. The results of the experiments showed the existence of galvanic corrosion however the rate of such corrosion could be decreased significantly by epoxy coating. A total of 21 specimens made of S 5 x 10 A36 steel beams were prepared and tested to determine the effectiveness of CFRP patch on fatigue life of notched beam. The results showed that not only CFRP patch tends to extend the fatigue life of a detail more than three times, but also it decreases the crack growth rate significantly. To investigate the effectiveness of the epoxy bonded CFRP sheets in repair and retrofit of composite girders, a total of six large-scale steel-concrete composite girders made of W 14 x 30 A36 steel beam and 7.5 cm. thick by 91 cm wide concrete slab were prepared and tested. Three different numbers of CFRP layers and three different damage level in Range were considered. The retrofitting test results showed that epoxy bonded CFRP Sheet increased the ultimate load carrying capacity of composite girders and the behavior can be conservatively predicted by traditional methods. The repair test results showed that epoxy bonded CFRP sheet could restore the ultimate load carrying capacity and stiffness of damaged steel-concrete composite girders. The ultimate capacity of the repaired beam was predicted by traditional methods of analysis of steel-concrete composite beams, which was fairly conservative. Guidelines and procedures for design of Steel-Concrete-CFRP composite girders were developed to assist practicing engineers. The design considers the elastic and fully plastic behavior of the composite girders while is taking into account the different modes of failure. A design example is also given to illustrate the benefit of this retrofitting technique

Long-term results of a hydroxyapatite-coated femoral component in total hip replacement. A 15- to 21-year follow up study

Between 1986 and 1991 we implanted 331 consecutive Furlong hydroxyapatite-coated femoral components of a total hip replacement in 291 patients. A cemented acetabular prosthesis was used in 217 hips and a hydroxyapatite-coated component in 114. We describe the long-term clinical and radiological survival of the femoral component at a mean follow-up of 17.5 years (15 to 21). Only two patients (0.68\%) were lost to follow-up. With revision of the femoral component for any reason as the endpoint, the survival at a mean of 17 years was 97.4\% (95\% confidence interval 94.1 to 99.5), and with revision for aseptic loosening as the endpoint it was 100\%. The survival at a maximum of 21 years with revision of the femoral component for any reason as the endpoint was 97.4\% (95\% confidence interval 81.0 or 99.5). These results compare favourably with the best long-term results of cemented or uncemented femoral components used in total hip replacement