Nanoindentation on micro pillars for determination of intrinsic hardness and residual stress in coatings deposited on complex geometries

In this work a procedure to assess the local residual stress in coatings deposited on complex substrate geometries is described. A focused ion beam (FIB) is used to mill structures small enough to relax from residual stress. Nanoindentation is used to measure the change in mechanical properties, most importantly the hardness, in relaxed coating and in as-deposited coating. This change is then related to the residual stress in the coating. This relationship can then be used to calculate the residual stresses, at other positions or at other components, from changes in hardness as measured as before. The procedure is demonstrated on two different PVD coatings; one TiN coating and one nanocomposite TiNiC coating. On a large high speed steel substrate the TiN was measured to a hardness of 28 GPa using conventional techniques. Using this procedure, this could be divided into 23 GPa of intrinsic hardness and an extra 5 GPa induced by the known compressive residual stress of 3.9 GPa. When the same coating was deposited on a thin wire the full procedure allowed the residual stress to be determined to 3.5 GPa in compression

Surgery Versus Radiation for High-risk Prostate Cancer: The Fight Continues. But Is It Time To Call a Draw and Reach Consensus?

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Glycolytic potential and ultimate muscle pH values in red deer (Cervus elaphus) and fallow deer (Dama dama)

The ultimate pH value of meat (measured at approx. 24 hours post slaughter) gives information about the technological quality, i.e. shelf life, colour, water-holding properties and tenderness and is a direct consequence of muscle glycogen (energy) levels at slaughter. It may therefore also indicate whether or not the animal has been exposed to stressful energy depleting events prior to slaughter. In the present study, 141 animals (130 red deer (Cervus elaphus) and 11 fallow deer (Dama dama) were included to investigate the relationship between ultimate pH and residual glycogen concentration in red deer and fallow deer M. longissimus. In addition, the muscle glycogen content and ultimate pH values in three red deer muscles (Mm. triceps brachii, longissimus and biceps femoris) were studied. M. triceps brachii had higher ultimate pH and lower glycogen content compared with the other two studied muscles. The frequency of intermediate DFD (5.8≤ pH<6.2) was 5.4% in red deer M. longissimus, compared with 9.1% in fallow deer, while the frequency of DFD (pH≥ 6.2) was much lower in red deer (3.8%) than in fallow deer (54.5%). A curvilinear relationship between ultimate pH and total glucose concentration (glycogen and glucose) 30 min post slaughter in red deer and fallow deer M. longissimus was found. The relationship between muscle pH and lactic acid concentration however, was indicated to be linear. A significant variation in total glucose concentration at ultimate pH below 5.80 was observed, including values in the range from 18 to 123 mmol/kg wet tissue. It was concluded that further studies are needed to further explore the relationship between muscle glycogen content and technological and sensory quality attributes of meat from different deer species.Abstract in Swedish / Sammanfattning:Köttets pH-värde (mätt ca 24 timmar efter slakt) har stor betydelse för den teknologiska kvaliteten som t. ex. hållbarhet, färg, vattenhållande förmåga och mörhet. Glykogenförrådet (energinivån) i djurens muskulatur vid slakt är helt avgörande för köttets slutliga pH-värde. Därför kan pH-värdet också indikera om hanteringen av slaktdjur varit skonsam eller om stora mängder muskelenergi har förbrukats vid stress. I vår undersökning ingick 141 hjortar (130 kronhjortar (Cervus elaphus) och 11 dovhjortar (Dama dama) för att studera sambandet mellan köttets pH-värde och glykogeninnehållet i M. longissimus. Glykogeninnehåll och pH-värden i 3 muskler från kronhjort (Mm. triceps brachii, longissimus och biceps femoris) undersöktes också. M. triceps brachii hade högre pH-värde och lägre glykogeninnehåll jämfört med de två andra musklerna. Det var inte så stor skillnad i frekvensen av intermediär DFD (pH-värden mellan 5,8 og 6,2) mellan de två hjortarterna (5,4% för kronhjort och 9,1% för dovhjort), däremot var frekvensen av DFD (pH-värden över 6,2) mycket låg hos kronhjort (3,8%) jämfört med dovhjort (54,5%). Det fanns ett kurvlinjärt samband mellan slutligt pH-värde i köttet och total glukoskoncentration (glykogen + glukos) mätt i M. longissimus 30 min efter slakt för både kron- och dovhjort. Ett linjärt samband mellan pH-värde och koncentration av mjölksyra i M. longissimus kunde också visas. Vi fann en mycket stor varitation i glukoskoncentration (18−123 mmol/kg våtvikt) när köttets pH-värdet var 5,8 eller lägre. Det behövs fler undersökningar för att vidare klargöra sambanden mellan glykogeninnehåll i muskulaturen och teknologisk och sensorisk kvalitet i olika typer av hjortkött

Robotic intracorporeal urinary diversion: practical review of current surgical techniques

In this practical review, we discuss current surgical techniques reported in the literature to perform Intracorporeal Urinary Diversion (ICUD) after Robotic Radical Cystectomy (RARC), emphasizing criticisms of single approaches and making comparisons with Extracorporeal Urinary Diversion (ECUD). Although almost 97% of all RARCs use an ECUD, ICUD is gaining in popularity, in view of its potential benefits (i.e., decreased bowel exposure, etc.), although there are a few studies comparing ICUD and ECUD. Analysing single experiences and the data from recent metanalyses, we emphasize the current critiques to ICUD, stressing particular technical details which could reduce operative time, lowering the postoperative complications rate, and improving functional outcomes. Only analysis of long-term follow-up data from large-scale homogeneous series can ascertain whether robotic intracorporeal urinary diversion is superior to other approaches

Colour stability and water-holding capacity of M. longissimus and carcass characteristics in fallow deer (Dama dama) grazed on natural pasture or fed barley

The effects of feeding regimen on carcass characteristics, meat colour and water-holding capacity of M. longissimus were studied in 24 female fallow deer (Dama dama). All animals were farm raised; twelve were grazed on pasture and twelve were fed barley and a small amount of hay prior to slaughter. The animals were slaughtered at two occasions (during the Southern Hemisphere spring); after 19 weeks of feeding (n=12; 6 grazing and 6 barley fed animals; group 1) and after 24 weeks of feeding (n=12; 6 grazing and 6 barley fed animals; group 2). The barley/hay-fed deer had significantly higher body condition scores and carcass weights than the pasture raised group. No difference in meat ultimate pH values between the treatment groups was recorded. The meat from the pasture raised deer had significantly longer colour display life after 2 and 3 weeks of refrigerated storage (+ 2.0 ºC) in vacuum bags. There was no difference in drip loss between the two treatment groups. However, significantly lower drip losses were found in meat from the animals in group 2 compared with the ones in group 1 (P ≤ 0.001). It was concluded that the feeding regimen of the animals is an important factor that contributes to the variation in quality of fresh chilled deer meat (venison), mainly the colour stability and display life of vacuum packaged meat.Abstract in Swedish / Sammanfattning: I denna undersökning ingick 24 dovhjortshindar (Dama dama) för att studera effekterna av olika typer av foder (bete och korn) på slaktkroppskvalitet samt färg och vattenhållande förmåga i köttet (M. longissimus). Alla djur var uppfödda på en hjortfarm, 12 betade gräs och 12 utfodrades med korn och en liten mängd hö före slakt. Djuren slaktades vid två olika tillfällen (under våren på det södra halvklotet); efter 19 veckors utfodring (n=12; 6 betesdjur och 6 kornfodrade djur; grupp 1) och efter 24 veckors utfodring (n=12; 6 betesdjur och 6 kornfodrade djur; grupp 2). De dovhjortar som utfodrats med korn och hö var i bättre kondition och hade högre slaktvikter jämfört med de djur som betat gräs. Ingen skillnad i köttets pH-värde mellan de två utfodringsgrupperna kunde dock påvisas. Köttet från de betande dovhjortarna hade bättre färgstabilitet efter lagring i 2 och 3 veckor (+ 2.0 ºC) i vakuumförpackning. Det fanns ingen skillnad mellan kött från betande och korn/hö-utfodrade djur i vattenhållande förmåga. Däremot hade kött från djur i grupp 2 (slaktade efter 24 veckors utfodring) bättre vattenhållande förmåga jämfört med grupp 1 (P ≤ 0.001). Vi kunde konstatera att de olika fodertyperna påverkade kvaliteten hos färskt kyllagrat kött, framförallt färgstabiliteten hos vakuumförpackat kött

Impact of gastroesophageal reflux disease on work absenteeism, presenteeism and productivity in daily life: a European observational study

<p>Abstract</p> <p>Background</p> <p>The RANGE (<it>R</it>etrospective <it>AN</it>alysis of <it>G</it>astro<it>E</it>sophageal reflux disease [GERD]) study assessed differences among patients consulting a primary care physician due to GERD-related reasons in terms of: symptoms, diagnosis and management, response to treatment, and effects on productivity, costs and health-related quality of life. This subanalysis of RANGE determined the impact of GERD on productivity in work and daily life.</p> <p>Methods</p> <p>RANGE was conducted at 134 primary care sites across six European countries (Germany, Greece, Norway, Spain, Sweden and the UK). All subjects (aged ≥18 years) who consulted with their primary care physician over a 4-month identification period were screened retrospectively, and those consulting at least once for GERD-related reasons were identified (index visit). From this population, a random sample was selected to enter the study and attended a follow-up appointment, during which the impact of GERD on productivity while working (absenteeism and presenteeism) and in daily life was evaluated using the self-reported Work Productivity and Activity Impairment Questionnaire for patients with GERD (WPAI-GERD).</p> <p>Results</p> <p>Overall, 373,610 subjects consulted with their primary care physician over the 4-month identification period, 12,815 for GERD-related reasons (3.4%); 2678 randomly selected patients attended the follow-up appointment. Average absenteeism due to GERD was highest in Germany (3.2 hours/week) and lowest in the UK (0.4 hours/week), with an average of up to 6.7 additional hours/week lost due to presenteeism in Norway. The average monetary impact of GERD-related work absenteeism and presenteeism were substantial in all countries (from €55/week per employed patient in the UK to €273/patient in Sweden). Reductions in productivity in daily life of up to 26% were observed across the European countries.</p> <p>Conclusion</p> <p>GERD places a significant burden on primary care patients, in terms of work absenteeism and presenteeism and in daily life. The resulting costs to the local economy may be substantial. Improved management of GERD could be expected to lessen the impact of GERD on productivity and reduce costs.</p

Development and validation of the short version of the Psychological General Well-Being Index (PGWB-S)

BACKGROUND: The PGWBI is a 22-item health-related Quality of Life (HRQoL) questionnaire developed in US which produces a self-perceived evaluation of psychological well-being expressed by a summary score. The PGWBI has been validated and used in many countries on large samples of the general population and on specific patient groups. Recently a study was carried out in Italy to reduce the number of items of the original questionnaire, yielding the creation of a shorter validated version of the questionnaire (PGWB-S). The purpose of the present paper is to describe the methods adopted and to report and discuss the relevance of results. METHODS: Data for this study were collected from 4 different population samples: two general population samples a student and a patient sample. On the basis of the results of the first (development) sample population, six relevant items were identified statistically from the original questionnaire and grouped to assemble a new summary scale. Following the newly created 6-item questionnaire was administered in three independent population samples. Descriptive statistics, correlation coefficients, univariate and multivariate regression analyses were used to compare the performance of the long and short questionnaire, within and between population samples and across relevant subgroups. A further independent sample extracted by an ongoing cancer clinical trial served as final validation step. RESULTS: Overall, the questionnaires were administered to 1443 subjects. Six items were selected by a step-wise approach to explain 90% of the variance of the summary measure of the original questionnaire. Response rates reached 100%, while missing items were not observed. University students (n = 400) showed the highest mean value of the summary measure (75.3); while the patient sample (n = 28) had the lowest score (71.5). The correlation coefficients between the summary measures and the single items according to the different studies were satisfactory, reaching the highest estimates in the student sample. The internal consistency showed high values of the Cronbach's alpha coefficient (range 0.80 – 0.92) for all three study samples, coming close to the value of the coefficient established for the original questionnaire (0.94). A cross-validation in an independent sample of 755 cancer patients confirmed the item selection procedure and amount of variance explained by the new shorter questionnaire (ranging from 90. 2 to 95.1 %, across age and sex strata). CONCLUSION: The newly identified PGWB-S showed good acceptability and validity for the use in various settings in Italy. The translation of the PGWB-S into different languages, and its use in other linguistic settings will add evidence about its cross-cultural validity

Posterior reconstruction during robotic-assisted radical cystectomy with intracorporeal orthotopic ileal neobladder: description and outcomes of a simple step

A posterior reconstruction (PR) might improve the fluidity and delicacy of the maneuvers related to the neovesico-urethral anastomosis during robotic-assisted radical cystectomy (RARC). Our objective is to describe in detail the surgical steps of PR and to assess its feasibility and functional outcomes. The data regarding patients undergoing a totally intracorporeal RARC with neobladder and PR for high-grade and/or muscle-invasive urothelial cancer of the bladder at Karolinska University Hospital between October 2015 and November 2016 by a single surgeon (PW) were reviewed. Prior to the anastomosis, a modified posterior Rocco’s repair involving the Denonvillier’s fascia, the rhabdosphincter, and the posterior side of the ileal neobladder neck was performed. The steps are shown in a video at https://doi.org/10.1089/vid.2019.0029. The primary outcome was urinary continence; the secondary outcomes were urinary leakage, intermittent catheterization, and complications related to the reconstructive steps. Eleven male patients with a median age and BMI of 67&nbsp;years and 24, respectively, underwent RARC with PR associated to the neovesico-urethral anastomosis. Overall and posterior reconstruction time were 300′ (195–320) and 6′ (4–7), respectively. The daytime and nighttime continence rates were 100% and 44% at 12&nbsp;months, respectively; the median pad weight was 3.5&nbsp;g and 108&nbsp;g at daytime and nighttime, respectively. One urinary leakage from the urethrovesical anastomosis was treated conservatively. Two patients perform intermittent catheterization. The posterior reconstruction during RARC is safe and feasible, providing good continence rates. It supported a careful suturing of the anastomosis as well as an uncomplicated catheter placement