Dynamic Response of a Single Pile Embedded in Sand Including the Effect of Resonance

In this paper, responses of a single pile embedded in sand soil (loose and dense) under dynamic loading (sinusoidal dynamic vibrations of 0.1 g to 0.5 g) have been investigated by two-dimensional analysis using the finite element method (FEM). Viscous (dashpot) boundaries have been used for taking the boundary effects of far-field into account. The applicability and accuracy of site responses of two-dimensional analysis due to the FEM modelling have been well verified with one-dimensional site responses. The results indicate that the relative density of sand (loose, dense) becomes prominent for the displacements of the pile, specifically under the frequency effects of resonance. While the pile in loose sand causes the displacements of 0.1 m to 0.5 m, the pile in dense sand leads to the displacements of 0.05 m to 0.25 m, proportionally with the dynamic loads from 0.1 g to 0.5 g. Moreover, the displacements reach their peak value at the frequency ratio of the resonance case. Viscous boundaries are found sufficient for modelling excessive displacements due to dynamic loading. However, the displacements reveal that high vibrations (> 0.1 g for loose sand, > 0.2 g for dense sand) influencing the pile deformations are critical for the issues of settlements. This is more significant for the resonance case in order for ensuring sufficient design. Consequently, the findings from the study are promising good contributions for pile design under the dynamic effect

Skin Abrasion and Chafing Caused by Sauna Suit Clothing

Abstract Observation: Sauna suit clothing is used to help control and lose weight while exercising. A 35-yearold female admitted to our clinic with pain, and wound in the groin fold after she had been used sauna suit clothing 30 minutes a day for three day while aerobic exercising. She diagnosed with skin chafing and abrasion in the both side of groin. The wounds were treated conservatively for 3 weeks period without surgery. Best of our knowledge; this is the first report describing skin injury which was caused by sauna suit clothing

The prevalence of penile pearly papules among young men

The aim of this study was to determine the prevalence of pearly penile papules (PPP) among young men in Eskisehir, Turkey. This was a prospective, non-randomized, cross-sectional study. From December 2014 to September 2015, 2613 consecutive male patients who were referred to the dermatology outpatient clinic were included in the study. Patients were inspected for the presence of PPP, localization, and association with human papilloma virus (HPV). A total of 2613 patients were included in the study. The average age of the patients was 21.33±2.08 (mean ± Standard Deviation (SD); ranging from 18 to 24) years. All of the patients were white and circumcised men. Of the 2613 patients, 449 (17.18%) PPP were observed. PPP were localized on the corona of the glans penis (100%), coronal sulcus (18.9%), frenulum (15.1%), ventral shaft (5.3%), and dorsal shaft of the penis (2.4%). Of the 449 patients with PPP, 23 (5.3%) underwent treatment; 73 (16.2%) would consider removal, 7 (1.5%) had a previous treatment for HPV, and 5 (1.1%) had HPV. PPP are encountered very commonly in the pubertal age in boys and young men. All medical practitioners should be familiar with PPP. Their similarity to genital warts may generate a false apprehension of venereal disease and may lead to unwanted and hazardous treatments. Therefore, better health education is needed.  </p

Recipient Site Necrosis After Tumescent Infiltration with Adrenaline in Hair Transplantation

Letter to the editor No abstract available</p

Effects of evening primrose oil and 5-fluorouracil on the healing of colonic anastomoses in rats

Aim: This study was designed to evaluate the efficacy of evening primrose oil (EPO) on colonic anastomosis. Methods: Sixty rats with colonic anastomosis were randomly divided into six groups. EPO and 5-Fluorouracil (5-FU) were administered at doses of 5 g/kg/day and 20 mg/kg/day, respectively.&nbsp; Group 1 served as sham control. The rats in Group 2 (EPO) received EPO (14 days preoperatively), in Group 3 (Extended EPO) received EPO (14 days preoperatively and 7 days postoperatively), in Group 4 (5-FU) received intraperitoneally 5-FU (5 days preoperatively), in Group 5 (5-FU+EPO) received EPO (14 days preoperatively), and 5-FU (5 days preoperatively), in Group 6 (5-FU+ extended EPO) received EPO (14 days preoperatively and 7 days postoperatively)&nbsp; and 5-FU (5 days preoperatively). Histopathological examination, bursting pressure, and hydroxyproline content were used for evaluation. Results: Significant differences were found between the Groups 1, 2, and 3 and Groups 4, 5, and 6 in bursting pressures. Polymorphonuclear leukocyte (PMNL) and lymphocyte infiltration was significantly less in group 3, compared to the control and group 2. The least PMNL infiltration was in group 6 compared to groups 4 and 5.&nbsp; The hydroxyproline level was different in group 3 compared to the control and group 2. Furthermore, groups 5 and 6 were different compared to group 4. Conclusion: EPO had favorable effects on colonic anastomosis even in groups where 5-FU was used

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10&nbsp;years; 78.2% included were male with a median age of 37&nbsp;years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Global disparities in surgeons’ workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study

: The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity &gt; 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic