The surgical point of view of the geriatric patient — Urinary incontinence

Summary: Background: Urinary incontinence is one of the most frequent diseases in the ageing population. The aim of this manuscript is to present the current knowledge on urinary incontinence regarding (i) prevalence, (ii) pathogenesis, (iii) types, (iv) diagnostic assessment, and (v) treatment options. Methods: The current literature regarding urinary incontinence with special reference to the geriatric patient was reviewed. Results: According to a study performed recently in the Vienna area, 36.0% of women and 11.5% of men aged 70 years or older report urinary incontinence. Several factors, such as urodynamic changes, structural alterations of the lower urinary tract, increased sensory input, and impaired central control of the micturition reflex, contribute to the high prevalence of urinary incontinence with age. The four most common forms of urinary incontinence in the geriatric patient are combined stress/urge incontinence, pure urge incontinence, pure stress incontinence, and overflow incontinence. Diagnostic steps are classified into "mandatory”, "recommended”, and "indicated in selected cases only”. Particularly the "mandatory tests” are simple to perform and need no special equipment. Therapeutic options should be directed to the type of urinary incontinence as well as the physical and mental status of the patient. Conclusions: Urinary incontinence is highly prevalent with age. Conservative treatment is the therapy of choice for urge incontinence and mild to moderate forms of stress and overflow incontinence in the geriatric patien

An Analysis of Adding Land Cover as a Variable to the DRASTIC Ground Water Model

This study involved a geographic information systems (GIS) approach to modeling ground water pollution potential in the Southern Edwards Aquifer Region in Texas. The DRASTIC ground water model was analyzed using two methods. First, the effects of adding land cover data to the drastic model were evaluated. In the second approach, the effects of the removal of DRASTIC variables were evaluated. Six, five, and four variable models were generated and analyzed

Inappropriate Antidiuresis: Examples of an Hyponatremic Syndrome Resembling Exogenous Vasopressin Administration in Man

We have reviewed some of the features of hyponatremic syndromes, unassociated with sodium retention and edema, but associated with primary water retention. The syndromes were probably caused by excessive vasopressin activity, in the presence of normal circulatory, renal and adreno-cortical function. Underlying diseases, including bronchogenic carcinoma, head injury, and tuberculous meningitis, illustrated the diverse etiologic bases of this condition

IFKIS - a basis for managing avalanche risk in settlements and on roads in Switzerland

After the avalanche winter of 1999 in Switzerland, which caused 17&nbsp;deaths and damage of over CHF&nbsp;600&nbsp;mill. in buildings and on roads, the project IFKIS, aimed at improving the basics of organizational measures (closure of roads, evacuation etc.) in avalanche risk management, was initiated. <P style='line-height: 20px;'> The three main parts of the project were the development of a compulsory checklist for avalanche safety services, a modular education and training course program and an information system for safety services. The information system was developed in order to improve both the information flux between the national centre for avalanche forecasting, the Swiss Federal Institute for Snow and Avalanche Research SLF, and the local safety services on the one hand and the communication between avalanche safety services in the communities on the other hand. <P style='line-height: 20px;'> The results of this project make a valuable contribution to strengthening organizational measures in avalanche risk management and to closing the gaps, which became apparent during the avalanche winter of 1999. They are not restricted to snow avalanches but can also be adapted for dealing with other natural hazard processes and catastrophes

Gallot-Tanno Theorem for closed incomplete pseudo-Riemannian manifolds and applications

We extend the Gallot-Tanno Theorem to closed pseudo-Riemannian manifolds. It is done by showing that if the cone over a manifold admits a parallel symmetric $(0,2)-$tensor then it is Riemannian. Applications of this result to the existence of metrics with distinct Levi-Civita connections but having the same unparametrized geodesics and to the projective Obata conjecture are given. We also apply our result to show that the holonomy group of a closed $(O(p+1,q),S^{p,q})$-manifold does not preserve any nondegenerate splitting of $\R^{p+1,q}$.Comment: minor correction

Comparison of the endocranial- and brain volumes in brachycephalic dogs, mesaticephalic dogs and Cavalier King Charles spaniels in relation to their body weight

BACKGROUND: A number of studies have attempted to quantify the relative volumes of the endocranial volume and brain parenchyma in association with the pathogenesis of the Chiari-like malformation (CLM) in the Cavalier King Charles spaniel (CKCS). In our study we examine the influence of allometric scaling of the brain and cranial cavity volume on morphological parameters in different dog breeds. MRI scans of 110 dogs (35 mesaticephalic dogs, 35 brachycephalic dogs, 20 CKCSs with SM, and 20 CKCSs without SM) have been used to create 3-dimensional volumetric models of skull and brain parts. Volumes were related to body weight calculating the adjusted means for different breeds. RESULTS: There was a strong global dependency of all volumes to body weight (P<0.0001). The adjusted means of the absolute and relative volumes of brain parenchyma and cranial compartments are not significantly larger in CKCSs in comparison to brachycephalic and mesaticephalic dogs. A difference in absolute or relative volumes between CKCSs with and without SM after relating these values to body weight could not be identified. The relative volume of the hindbrain parenchyma (caudal fossa parenchyma percentage) was larger in brachycephalic dogs than in CKCSs, without causing herniation or SM. CONCLUSION: An influence of body weight exist in dogs, which can be sufficiently large to render conclusions on the difference in volumes of the brain and skull unsafe unless some account of the body weight is taken in the analysis. The results of this study challenge the role of overcrowding for the development of SM in dogs

Low-Dose Near-Infrared Light-Activated Mitochondria-Targeting Photosensitizers for PDT Cancer Therapy

Phthalocyanines (Pcs) are promising candidates for photodynamic therapy (PDT) due to their absorption in the phototherapeutic window. However, the highly aromatic Pc core leads to undesired aggregation and decreased reactive oxygen species (ROS) production. Therefore, short PEG chain functionalized A3B type asymmetric Pc photosensitizers (PSs) were designed in order to decrease aggregation and increase the aqueous solubility. Here we report the synthesis, characterization, optical properties, cellular localization, and cytotoxicity of three novel Pc-based agents (LC31, MLC31, and DMLC31Pt). The stepwise functionalization of the peripheral moieties has a strong effect on the distribution coefficient (logP), cellular uptake, and localization, as well as photocytotoxicity. Additional experiments have revealed that the presence of the malonic ester moiety in the reported agent series is indispensable in order to induce photocytotoxicity. The best-performing agent, MLC31, showed mitochondrial targeting and an impressive phototoxic index (p.i.) of 748 in the cisplatin-resistant A2780/CP70 cell line, after a low-dose irradiation of 6.95 J/cm2. This is the result of a high photocytotoxicity (IC50 = 157 nM) upon irradiation with near-infrared (NIR) light, and virtually no toxicity in the dark (IC50 = 117 μM). Photocytotoxicity was subsequently determined under hypoxic conditions. Additionally, a preliminarily pathway investigation of the mitochondrial membrane potential (MMP) disruption and induction of apoptosis by MLC31 was carried out. Our results underline how agent design involving both hydrophilic and lipophilic peripheral groups may serve as an effective way to improve the PDT efficiency of highly aromatic PSs for NIR light-mediated cancer therapy

V-Edge: Virtual Edge Computing as an Enabler for Novel Microservices and Cooperative Computing

As we move from 5G to 6G, edge computing is one of the concepts that needs revisiting. Its core idea is still intriguing: Instead of sending all data and tasks from an end user's device to the cloud, possibly covering thousands of kilometers and introducing delays lower-bounded by propagation speed, edge servers deployed in close proximity to the user (e.g., at some base station) serve as proxy for the cloud. This is particularly interesting for upcoming machine-learning-based intelligent services, which require substantial computational and networking performance for continuous model training. However, this promising idea is hampered by the limited number of such edge servers. In this article, we discuss a way forward, namely the V-Edge concept. V-Edge helps bridge the gap between cloud, edge, and fog by virtualizing all available resources including the end users' devices and making these resources widely available. Thus, V-Edge acts as an enabler for novel microservices as well as cooperative computing solutions in next-generation networks. We introduce the general V-Edge architecture, and we characterize some of the key research challenges to overcome in order to enable wide-spread and intelligent edge services

V-Edge: Virtual Edge Computing as an Enabler for Novel Microservices and Cooperative Computing

As we move from 5G to 6G, edge computing is one of the concepts that needs revisiting. Its core idea is still intriguing: instead of sending all data and tasks from an end user's device to the cloud, possibly covering thousands of kilometers and introducing delays that are just owed to limited propagation speed, edge servers deployed in close proximity to the user, e.g., at some 5G gNB, serve as proxy for the cloud. Yet this promising idea is hampered by the limited availability of such edge servers. In this paper, we discuss a way forward, namely the virtual edge computing (V-Edge) concept. V-Edge bridges the gap between cloud, edge, and fog by virtualizing all available resources including the end users' devices and making these resources widely available using well-defined interfaces. V-Edge also acts as an enabler for novel microservices as well as cooperative computing solutions. We introduce the general V-Edge architecture and we characterize some of the key research challenges to overcome, in order to enable wide-spread and even more powerful edge services

Ectrodactyly and lethal pulmonary acinar dysplasia associated with homozygous FGFR2 mutations identified by exome sequencing

First published: 11 July 2016Abstract not availableChristopher P. Barnett, Nathalie J. Nataren, Manuela Klingler-Hoffmann, Quenten Schwarz, Chan-Eng Chong, Young K. Lee, Damien L. Bruno, Jill Lipsett, Andrew J. McPhee, Andreas W. Schreiber, Jinghua Feng, Christopher N. Hahn, and Hamish S. Scot